On the pathology of cholera collapse / by Horace Jeaffreson.

  • Jeaffreson, Horace.
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: On the pathology of cholera collapse / by Horace Jeaffreson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    having any further diarrhoea, at 2 P.M., 23d August, on the seventh day of his dlHOtlSCf Post-mortem.—Head, much sub-arachnoid fluid ; no opacity of membrane, considerable effusion of clear fluid in botli lateral ventricles; brain substances of somewhat too pink a tint; no deposit, lymph, or tubercle, anywhere, or any defined softening. Lungs, right, considerable lobular pneumonia at posterior base; portions, of size of nut, coalescing at various points, not softening at centre ; weight, 30^ oz.; left, lobular pneumonia, of less amount, present; smaller masses, and more scattered; weight, 25 oz. Heart, firm decolorized clots pass up from both sides of heart in pulmonary artery and aorta, and form casts of valves ; valves, etc., healthy. Liver, normal; weight, 60 oz. Gall-bladder, full of black bile. Kidneys, of pale colour,- cortex full; convex on section, and too opaque; capsule separates smoothly; no evidence of old. disease; weights, right, 6§ oz.; left, 6 oz. Stomach, patches of dull pink injection. Intestines, a few patches of congestion noticed on mucous surface, some foot or so above ccecal valve, but not strongly marked ; notable absence of the turgid, swollen condition of the coats of the small intestines; duodenum and upper part of jejunum found half-filled with firmish, pultaeeous, slimy, green matter; lower end of ileum empty. Large intestine, large patches of dark, purple con- gestion, with swollen condition of mucous membrane, and slight enlargement of solitary glands observed in ascending and transverse colon. Case 10.—Mary H., set. 45, a confirmed drunkard, after one day of moderate diarrhoea, was attacked at 9 P.M., 8tli August, with vomiting and more violent purging; severe cramps supervened; collapse set in the next day at about noon, and woman was admitted into hospital at 6 p.m. the same evening, with well-marked symptoms of cholera collapse. Woman rallied very favourably in the succeeding thirty-six hours. A note, taken on 11th August, 10 A.M., states :—“ Occasionally vomits a little green matter ; keeps down a fair amount of nom-islnnent; voice has returned; pulse, 76, distinct, and of fair power; temperature in axilla, 96°; feet warm; no blueness, or aspect of collapse; tongue moist, and furred ; is stated to pass a fair amount of urine, with several feecal motions ; dozes off and on ; the pupil of only eye small. Through the succeeding day and night patient got worse again, but there was no return of collapse; pulse remained at 80, feeble ; respirations became slow, and sighing; there was restless, active delirium, alternating with snatches of sleep; constant fsecal diarrhoea, and rapid failing of powers ; no urine was noticed to have passed. Death took place 8.30 A.M., 12th August. Post-mortem.—Lungs, old pleuritic adhesions, and some obsolete tubercle, with firm cicatrices at both apices; no collapse; right, lower lobe partly becoming solid from coalescence of points of lobular pneumonia; weight, 22£j oz.; left, less of scattered lobular pneumonia at posterior base ; tissue friable ;] weight, 16 oz. Heart, visceral and parietal pericardium very loosely glued | together over base of heart and large vessel; lymph very soft and aplastic,] shading off into a glutinous semi-purulent fluid, of which about 3'Th were) present; large, firm, and pale clots form casts of pulmonary and aortic valves,j and occupy cavities of heart. Liver, of normal appearance; weight. 46 oz.j Spleen, healthy. Kidneys, fairly full of blood, but not at all deeply congested d capsule tears tissue on being removed ; cortex too opaque at places, and bulges! on section; other points are firm, and contracted; a few minute cysts on sur-| face, weights, right, 4^ oz.; left, 5^ oz. Stomach, some injection, of pink I colour, at cardiac end,, but slightly marked; contains green, grumous fluid: Intestines, from^the outside, the small intestines do not appear to be congested; they are not thick, and fleshy to feel; nor on the mucous surface is the con-; gestion particularly marked, except at two or three points of the ileum ; som ot I eyci s patches are moderately injected, but most are normal; solitarj g anas too prominent; the most congested part of canal is the upper, 4 inclie below lleo-coecal valves ; parts below healthy ; the upper part of sma intestines contained much slimy bile-coloured mucoid matter; below, fece weie thin, and yellow. Gall-bladder contained dark bile; bladder half-full of clear urine. a
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