Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

201/440 (page 183)

scarcely ever wanting, and states it as occurring (p. 230) in 40 out of the 42 fatal cases recorded by him. In tlie still more precise observations of Louis, we find it wanting in only 3 of 128 cases, and in 58 of tbese it was contempo- raneous with tbe commencement of tbe affection. Spon- taneous diarrbcea was present in every one of tbe 9 cases observed by myself; in 3, it was one of tbe first symptoms, baving declared itself on tbe first day, along witb tbe general premonitory symptoms. In one, it began on tbe 4tb ; in anotber, on tbe 6tb; in two more, on tbe lotb; in an eigbtb, on tbe iitb; in tbe nintb, it was observed after a few days' illness, the precise day not being specified. Tbis symptom was present, in one case, from tbe ist till tbe 22nd day, recurred on tbe 36tb, and continued, during a second attack, till tbe 46tb day. Its shortest and longest durations were respectively ten and forty-three days; and its mean duration above twenty-two days. As to its characters, in two it was very violent, and opium bad little effect in checking it. In two, it occurred in severe attacks, which assumed a periodic character; and in the rest it was moderate but always or nearly always present. With- out insisting further on the comparative duration of tbe diarrhoea in tbe two diseases, though it would, if minutely investigated, bring out still more clearly tbe extraordinary contrast already presented,—I proceed to the consideration of the state of tbe abdomen in the two complaints. Tbis I propose to do under two beads, relating, Jirst, to tbe feelings of the patient, and second, to tbe sensations of tbe medical attendant. 2. In 30 out of the 60 cases observed by Dr. West there was pain in the abdomen, but in only g was it severe. Dr. Henderson remarked it in 46 out of 198, and never in tbe right ibac fossa. The following are tbe results of my own observation: Abdomen painful in 109 out of 139 patients. Males. rcmalea. Total. Pain intense, or at least severe, in . . I'j , 27 . 44 slight 24 . 41 . 65 41 68 109