Lectures on the acute specific diseases : being the Gulstonian lectures, delivered at the Royal College of Physicians, March, 1853 / by William Jenner, M.D.

  • Sir William Jenner, 1st Baronet
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the acute specific diseases : being the Gulstonian lectures, delivered at the Royal College of Physicians, March, 1853 / by William Jenner, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    the deviation from its natural size and consistence of tlie spleen in so large a proportion of cases, and the disseminated character of the structural changes;—the simultaneous occur- rence of so many functional derangements, and subsequently of so many organic lesions. Leaving, however, this point as beyond the purpose I have in view I propose now to consider the peculiarities manifested by each of the species which I have enumerated asbelonging to the group of proper stationary fevers, with reference to the several points which constitute, considered generally, the grounds for their combination into one class or genus, taking typical cases of each for the terms of comparison, and 1st. Of the general symptoms which precede the local lesions of structure, and, during the whole course of the disease, are out of proportion to them in severity—Rigors; abnormally high temperature ; pain in the back and limbs ; headache; mental disturbance; increased frequency of pulse ; loss of muscular power, andgeneral sense of illness; these, it may be said, are common to all, but still they pre- sent marked differences and peculiarities in regard of each of the species in question. A severe rigor often ushers in an attack of small-pox, of erysipelas, and of relapsing fever. Rigors are very com- mon, but rarely severe at the outset of typhus fever; they are of infrequent occurrence in measles and scarlet fever. In typhoid fever rigors are replaced by a frequently repeated sense of chilliness. A rigor occurring so long after the outset of the disease as that which ushers in the relapse in relapsing fever, would, in typhoid fever, as has been proved by Louis, indicate the establishment of some serious local complication. The temperature of the skin, which from the very first is much higher than in health in scarlet and relapsing fevers, is in typhus fever peculiar in kind—pungent, biting, but not particularly high. In small-pox it often, and in typhoid fever occasionally, falls considerably after the appearance of the eruption.(a) The severity of the pain in the hack in small-pox is, as is well known, singularly great ; in erysipelas it is often com- plained of a good deal. In typhus fever the pain is usually more severe in the limbs than in the back, while in rela])sing fever it is commonly present and often severe in both situa- tions. In typhoid fever, scarlet fever, and measles, the pains in these parts are generally from first to last trifling. Present in all these diseases, headache varies in severity and duration in each. Thus in small-pox it is severe at the moment of invasion, but quickly disappears; in relapsing fever it continues through the whole of the primary attack and of the relapse ; in typhus and typhoid fevers it is one of the more constant symptoms at the outset, and in both dis- (a) I speak only of the temperature as determined roughly by the hand. The results obtained by Traube and Zimmerman by the daily use of the thermometer, leads one to anticipate large advances in our knowledge from the more extensive employment of that instrument.
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