Clinical lectures on the principles and practice of medicine / by John Hughes Bennett.

  • Bennett, John Hughes, 1812-1875.
Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on the principles and practice of medicine / by John Hughes Bennett. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    cold from sitting up for several nights in succession in a large room, heated by a fire, and ventilated by keeping the windows open. Having no adequate protection from the cold draught thus caused, she became affected with sore throat, and had pain in the chest. This occurred in t'.ie latter part of October last, and from that time up to November 20th she suflered from slight shivering and uneasiness ; transient paui in dilferent parts of the body; nausea and vomiting. About a fortuiglit before admission, she had a distinct rigor, followed by heat of skin and other febrile symptoms, with very severe pain in the johits especially, much increased by any attempt at motion. The vomiting also continued ; and last week she suffered from pain and palpitation in the cardiac region, and at the same time a;i aggravation of her former symptoms. At present she cannot move without suffering excruciating Jigony, having severe pain apparently in every joint of the body. Heart's sounds, impulse, rhythm, and position normal; pulse about 100, weak. IrreguUir fits of copious clammy perspiration, of acid smell; no osdema of the joints. Urine scanty, dark-colored, deposits crystals of the triple phosphates, with some mucus. Tongue loaded; anorexia; thirst ; occasional vomiting; no tenderness on pressing the epigastrium; bowels confined ; pulmonary functions normal. ]J 'Muriatis Morphice semigranum ; Pulverls Aroinatici grana quinque. M. Fl. pidv. Mittantur tales sex. One to be taken every half hour. December 4th.—She tooli three of the powders last night, after which she fell asleep; and this morning feels somewhat better; she has also had the bowels emptied by an enema, and is now using a diuretic mix- ture. December 5th.—Pains in limbs much the same ; gets no sleep; perspiration still copious ; urine not increased in quantity ; vomiting continues ; has been taking diuretics and Dover's powder. December 6th.—Had an exacerbation last night, the pain in the joints and limbs being excruciating. J} Potassm Nitratis semimiciam ; Aquce uncias sex. Misce et signetur—a table-spoonfal every four hours. December Wi.—Has taken three doses of the medicine; she perspired a good deal during the night; urine not inci'cased in quantity; pain is less severe. December 8fh.—Still sweats a good deal; pains much the same as yesterday. Adde inisturce JVitratis Potass. 3j. December 9th.—Pains better; copious perspiration; urine increased in quantity; increase of the nausea and vomiting and of the thirst. December lOth.— Pains nearly gone ; sickness continues ; refuses to use her medicine ; pulse 80, weak; much general debility. After this date the pain ceased entirely, and she was shortly afterwards discharged cured. Commentary.—This was a severe ease of both general muscular and articular rheumatism, of a fortnight's standing whea she entered the house. There was still, however, great pain on the slightest movement, which, during two days, in no way yielded to morphia, diaphoretics, and diuretics. On the exhibition of the nitrate of potash, profuse diaphoresis came on, which was apparently kept up by the medicine, with marked amendment to the rheumatic pains, followed by rapid recovery. The improvement could not be attributed to the occurrence of any critical day in this case; and the night previous to the exhibition of the remedy there had been a marked exacerbation. Every one who saw this case felt persuaded that the good effects were attributable to the nitrate of potash. Case CCLXXIII.*—Jane Irvine, set. IT, servant, admitted 19th December 1851. States that seven days ago, whilst engaged at her usual occupation, she was suddenly seized with severe febrile symptoms, and constant pain in the left ankle, whicli was increased by pressure and motion; it was red and tumefied. On the following day the right ankle became similarly affected, and then in succession the knees, shoulders, wrists, and fingers; tlie pain still continuing, but modified in severity in the parts first attacked. She had been undergoing treatment by diaphoretics, without, however, having experienced any relief from them. On admission the pulse is 100, fall and soft. A soft bellows murmur, synchronous with the radial pulse, accompanies the first sound, heard loudest at the base, and is propa-