A manual of medical diagnosis / by A.W. Barclay.

  • Andrew Whyte Barclay
Date:
1857
Catalogue details

Licence: Public Domain Mark

Credit: A manual of medical diagnosis / by A.W. Barclay. 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.

    89/642 (page 65)
    may not occui- in real cholei-a, and may be present jbben the case is unequivocally not cholera. There is no Lomplaint of nausea, though the constant and urgent tomiting can scarcely be supposed to exist without it; mere is also no complaint of pain with the purging: the ?cnsations no doubt are blunted; but this painlessness .; an important feature in the case, and it may even sicite surprise on the part of the ]>atient himself, that liiach enormous discharges take jdace from the stomach liid bowels, when he has so little feeling of internal eerangement. In the beginning of an attack, the Xiistence of diarrhoea without pain or griping, will cause i'le medical attendant to be on the alei-t; but, nnfortu- aately, it has just the opposite effect with the ^latient, Iho cannot fancy that anything is seriously wrong ■I' hen he has so little feeling of diseomfort. Another Remarkable feature is the sensation of burning heat and Ijpppression so often complained of, while the skin is cold nnd coiqise-like; the patient obstinately resists every ittempt to raise the temperature by artificial means, I iiad, in the restlessness of the disease, throws off the ■?arm blankets in which he is wrapped. Among particidar symptoms are ranked the change •jff the natural sound of the voice into a hoarse wlihsper, if- he vox choleraica; and the circumstance of the tongue :'nd the breath being sensibly cold to the hand of the i bservei-. These facts may be interesting in any pai-- flcular case, but, as they belong to the accidents of the (i-.isease, they must not be elevated into diagnostic ^ ymptoms. The mental faculties are not obscured till an ad- ‘ 'anced pei’iod, when the pupils become contracted, the train oppressed, and the patient comatose. Prior to i his, there is only a condition of restlessness of body ,nd inactivity of mind. During tlie existence of an cpiileinic of cholera tliere can be no ifficulty in classifying the cases whidi jtresent well-developed eaturi'S of the disease; but its marcb is attended by coincident iarrham, and there is in reality no detinite boundary between the F