A practical treatise on the diseases of children / by Alfred Vogel ; translated and edited by H. Raphael.

Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on the diseases of children / by Alfred Vogel ; translated and edited by H. Raphael. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    resemblance to coxitis). Purulent collections take place in the pelvis and may escape through the obturator foramen or into the rectum; they seldom make their appearance in the inguinal region. Paralysis of the sphincters and bladder is rare, as the affection is located deep- ly, and the nerves which control these organs are found above the site of the.disease. Life is jeopardized by the suppuration w'ith its effects; fatal meningitis or myelitis has also often been seen to ensue. Therapeutics.—The treatment, besides being directed to the sul> jugation of the cachexia, should be conducted with the view of j^re- venting the spreading of the disease upon delicate structures, the brain, meninges, and spinal cord. Every mechanical violence and all in- juries to the spinal column in particular, when the disease is confined to the upper section—for the reasons mentioned—are to be prevented with the utmost care. To accomplish this indication, a horizontal posture on the back, or, if this be impossible, the lateral decubitus upon a good upholstered mattress, should be prescribed for the patient so long as the morbid process is active, and he should be retained in that position, by mechanical appliances, under all circumstances. In order not to deprive the patients of the enjoyment of fresh air, they should be taken out upon the couch as often as possible. [The best appliance for this purpose is the plaster-of-Paris jack- et, or a corset with steel braces, made to fit the body properly, and sufiiciently firm to support the head and shoulders, thereby taking off the weight and pressure from the diseased vertebrse.] Besides the internal use and local application of narcotics in the form of opium and ointments containing morphine, derivatives will have to be employed against the violent pains. Small blisters (upon which morphine is subsequently strewn) are very advantageous. The seton, however, will not infrequently be found to be more potent and none the less advantageous against the intense painfulness. Depending abscesses, that are not voluminous, should be left un- opened as long as possible, since the disease, in most instances, makes more rapid progress after they are opened: if they have attained to great dimensions, are attended by excessive pains, and redness and in- flammation of the integument, indicating their approach to a speedy bursting, they may be opened and the pus allowed to escape. (e.) Joints.—Inflammations of the joints occur very frequently in scrofulous individuals as local manifestations of the general disease, without it being possible to demonstrate any other external cause, and are, as a rule, attended by other phenomena of scrofula in some remote part of the body. Pathologically, these inflammations differ in no essen- tial respect from others that have originated through injuries, rlieu- rnatic influence, etc., but their phenomena derive a sufficiently peculiar