Volume 2

A system of medicine / edited by J. Russell Reynolds.

Date:
1870-1872
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    1012/1058 (page 988)
    The chief of these have been Jaeger,1 Camerer,2 Cruveilhier,3 Louis,4 and Andral.5 The three first named of these authors, and also Billardj3 attributed to these supposed pathological conditions a definite set of symptoms, which are said to be met with in greatest frequency among children, but are stated to occur also occasionally among adults. Their leading characteristics are enumerated as violent fever, a semi-comatose condition, interrupted by restlessness, cries, and great irritability of temper, intense thirst, pain in the abdomen, frequent uncontrollable vomiting, diarrhoea, with grass-green stools, and early collapse, followed by death in a few hours, or in the course of a few days. It appears possible, however, from an observation of Ziemssen’s, that under conditions involving the unduly long retention of the contents of the stomach in its interior in an acid condition, this effect may even be produced during life.7 There has been, however, a wide diversity of opinion among these authors respecting the nature of these changes, and every shade of appearance has been described as presenting a distinct pathological character, while the significance of each of these has, in almost every instance, received a different interpretation from those who have opposed the views of Hunter and Carswell. Thus Jaeger and Camerer attributed them to disturbances in the nutrition of the stomach, induced by impaired innervation.8 Andral, while recognising as inflammatory the form of softening usually attri- buted to that process, described the appearances now under con- sideration as resulting from a vital change, non-inflammatory in its nature, and analogous to the softenings which occur in the cornea under conditions of impaired nutrition. Louis, on the other hand, regarded as inflammatory the softening which Carswell had ascribed to the action of the gastric juice; but described also a form of “simple softening,” which he attributed to cadaveric change. Cruveilhier again distinguished two forms : the “ Bamollissement pultace ” and the “ Bamollissement gfdatiniforme; ” the former being, according to him, of post-mortem origin, while the latter is caused by a vital change, “ specific ” in its nature, and due neither to inflammation nor to gan- 1 Ueber die Erweichung des Magens : Hufeland’s Journal fur prakt. Heilkunda, 1811, 1813. 2 Versueh liber die Natur der krankhaften Magen-Erweickung, 1828. 3 Med. Prat, eclairee par l’Anat. et Physiol. Path. 1821; Anat. Path. Liv. x. 4 Du RamollissementavecAmincissement de la Membrane Muqueuse Gastro-Intestinale, Rech. Anat. Path. 1826. De la Fievre Typhoide, 1841, 2d Edit. pp. 156, 157, 407. Phthisis, Dr. Walshe’s Trans. Syd. Soc. Ed. pp. 60, 189. 5 Prec. Anat. Path. ii. 88 ; Clin. Med. ii. 6 Maladies des Enfants, 182S. s' An opinion still maintained by Rokitanski, Path. Anat. m. 179. This distinguished pathologist states that precisely identical appearances may be produced in the stomach by changes ensuing before and after death. He says that the softenings of the stomach met with in cases of brain disease and in the acute febrile and inflammatory diseases, are effected during life in consequence of disturbed innervation. It would appear, however, to the author, for the reasons hereafter to be stated, that the post-mortem nature of these changes is the more tenable hypothesis, though the softening thus found may be due to and inny indicate perverted conditions of secretion existing during life.