A manual of the practice of medicine / by Frederick Taylor.

  • Taylor, Frederick, Sir.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: A manual of the practice of medicine / by Frederick Taylor. Source: Wellcome Collection.

    99/966 page 79
    hours, the tertian especially at noon; sneceeding attacks are, however, not always at the same hour, but in some cases may get earlier and earlier—in others, later and later. The former are said to anticipate, the latter to 2)ostpo7ieand the character of the fever may he thus changed, the tertian becoming quotidian, or the quartan tertian. Some other symptoms that occur in association with ague are regarded by wTiters as manifestations of malarial jjoisoning, and the cases have been called masked i)itermitte7it. Such are especially different forms of neuralgia, of which attacks may occur on alternate days, or themselves alternate with definite paroxysms of ague. The supraorbital division of the trigeminal nerve is the one most often affected, the second and third divi- sions less frequently. Sciatica, thoracic neuralgia, and cardialgia also occur. It is said that attacks of the following, among others, may rej^resent masked agues:—sneezing, coughing, hiccough, tremors, convulsions, temporary paralysis, aphasia, delirium, hallucinations, maniacal attacks, and sleeplessness ; or bronchial catarrh, skin eruptions, and haemorrhage from the mucous mem- branes. But some writers throw doubt on the nature of the association between them. Ordinary attacks of tertian ague are not generally fatal, though death may happen in very young or in old peoi^le, or in those debilitated by previous illnesses. Occasionally, enormous dis- tension of the sx)leen may lead to its rupture (the rupture may follow injury), with the escape of blood into the peritoneujn ; and a case is recorded of hjemorrhage, followed by suppuration, and rupture of the abscess into the peritoneum. But, ai^art from tliis, fatal forms occur, and these are generally distinguished by the special implication of certain organs, such as the nervous system, the bowels, or the respiratory organs. In these so-called ^><->- nicious forms, the more serious symptoms are not generally developed at the beginning of an illness, but only after the lapse of some days. Among forms involving the nervous system may be mentioned a comatose form : there are marked headache, dizzi- ness, apathy, or even drowsiness in the cold stage: and these pass into complete unconsciousness in the liot stage, with rapid, stertorous breathing, wide immovable i)ui)ils, and limbs com- pletely relaxed. The patient may lie thus for ten or twelve hours, or more, and then gradually recover consciousness in the sweating stage. In other cases there is delirium or violent maniacal attacks with screaming, and liallucinations. The patient may sink into coma and die, or gradually fall into sleep, from which he recovers. Cases are described in which the patient's condition simulates death, with arrested respiration, and imperceptible pulse or heart-l)eat. Different forms of con- vulsions also occur sometimes. In other forms all the con- ditions of cholera are produced—vomiting of yellowish inatter, with diarrhoea, cramps, coldness, and lividity; or a condition of
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