Remarks relative to Dr. Paine's commentaries upon the writings of M. Louis / by H. I. B.

  • Bowditch, Henry I. (Henry Ingersoll), 1808-1892.
Date:
1840
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Licence: Public Domain Mark

Credit: Remarks relative to Dr. Paine's commentaries upon the writings of M. Louis / by H. I. B. Source: Wellcome Collection.

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

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    that Chomel ever said so, or meant to be understood so to say; and we assert that he declares exactly the contrary, and that it is Dr. Paine’s garbled quotation that has led the reader into error. That he has made exactly the same inferences that Louis has, we do not wish to state. What two men are there that will agree wholly, when there is any room for difference of opinion ? But the differences in the present case do not affect the point under consideration. Chomel divides the anatomical lesions into those that are constant and those that are accidental. In the first class are reckoned, as is done by Mons. Louis, the lesion of the fol- licles of the small intestine (with this difference, that under this expression Chomel includes both Peyer’s and Brunner’s glands), and he continues thus: “ We conclude from these researches, depending upon numerous observations, agreeing in the most important particulars with those made by Mons. Louis in Paris, and Dr. Bright in England, that the alteration of the intestinal follicles is a condition wholly peculiar (tout a fait par- ticular) to the typhoid affection, the different periods of which we can follow as we can those of an abscess or a cutaneous exanthema— (Lecons, page 222). Truly this looks very much as if Chomel thought the follicular affection, in the typhoid disease, was “a comparatively un- important lesion of structure.” But our author says, Chomel has seen the same alterations in other diseases. We deny even this. On the contrary, in the three diseases mentioned by him as having something similar, viz., cholera, phthisis and scarlatina, he makes two very evident distinctions—for instance in cholera : 1st, “There is less prominence of the follicles than in typhoid. 2d, The lesion is the same at every epoch of the disease—whereas there is a regular change in them in fever.” In reference to scarlatina, Chomel says that the disease of the follicles resembles that in cholera, and therefore is not like that of the typhoid disease. More- over, let any one peruse the cases collected by Jackson* while the cholera was raging in Paris, and he will find nothing to confirm him in the idea that in the two diseases is the same anatomical change. In cholera the congregated glands, or Peyer’s patches, were not diseased in comparison with Brunner’s or the isolated follicles. With regard to phthisis, Chomel makes similar statements. We have our- selves had some opportunities of comparing the intestinal lesions of phthisis and typhus—and we must say that the idea of confounding the two when we examine the whole track of the canal, never could have been entertained by us. The anatomical differences aie much more * Cases of Cholera collected at Paris, &c., by James Jackson, Jr., 1832.