The principles of surgery / by James Miller.

  • James Miller
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: The principles of surgery / by James Miller. Source: Wellcome Collection.

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

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    typhoid cases, where depression is great, and the nervous system much engaged, the tongue is dry, and of a brown colour in the centre. There is thirst, usually very troublesome, with nausea, loss of appe- tite, sometimes vomiting, and often tenderness of the epigastrium; the bowels are constipated.—5. The Secerning. The secretions and excretions in general are materially diminished. The bowels, we have seen, are constipated—mainly from want of mucous secretion from their lining membrane; the skin is hot and dry; the mouth is parched; the urine is scanty, high coloured, generally acid, spa- ringly aqueous, and holding much saline matter, with comparatively little urea, in solution.—6. Tlie Nutritive. Digestion is interrupted; so is assimilation; as the fever advances, so does emaciation ; and strength is more and more prostrate. Such are the ordinary symptoms of inflammatory fever. The more intense the action, and the more important the part involved, the more rapidly and formidably are they developed. They also vary according to the natural temperament of the patient. They may remit; nay, often do ; at one time increased, at another mitigated ; exacerbation usually vesperal, remission matutinal. But they never undergo an actual intermission ; therein resembling the local symptoms of the malady. Having reached a certain point of intensity, the symptoms may decline, like the local action Avhich caused them. The pulse becomes less hard, full, and frequent; the heat and thirst diminish ; strength and appetite begin to come again ; and the secretions re-appear. Not unfrequently, such amendment is ushered in, if not at least partly caused, by sudden and great exaltation of the secernent function—so marked, as usually to be termed critical. The patient is bathed in a profuse and sustained perspiration. Or diarrhoea occurs. Or the urine flows copiously ; more aqueous ; less saline ; at each evacuation less and less coloured ; and, on cooling, letting down a large quantity of sediment—resembling brick-dust, and hence termed lateritious— composed chiefly of urate of ammonia, more or less coloured by pur- puric acid. Hence, the state of the urine comes to be important to the practitioner; scantiness, concentration, and want of deposit denoting persistence of the symptoms; profuse flow and copious sediment, de- clension. Or a discharge of blood takes place ; by the rectum, the urethra, the mouth, or the nose—according to the pait affected. This is not unlikely to frighten the patient and his friends, and may alarm the practitioner. But the latter is highly culpable who, from such alarm, rashly interferes to stop the flow. His duty is to watch the event; withholding his hand, unless the bleeding should threaten to prove excessive. Such critical evacuations and discharges are usually
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