Medical diagnosis : with special reference to practical medicine. A guide to the knowledge and discrimination of diseases / By J. M. Da Costa ... Illustrated with engravings on wood.

  • Jacob Mendes Da Costa
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Medical diagnosis : with special reference to practical medicine. A guide to the knowledge and discrimination of diseases / By J. M. Da Costa ... Illustrated with engravings on wood. 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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    typhus fever, in which disease, however, the muscular pains are wanting.* The osdema marks the beginning of the second stage of the aifection. It manifests itself first in the eyelids, about the seventh day of the disease, and is attended with a catarrhal state of the conjunctiva, with dilated pupils, great susceptibility to light, diminished power of acconmiodation, and pam in moving the eye. The swelling may extend over the whole face, and is some- times associated with flushing. It is uninfluenced either by the sweats or by the diarrhoea, but lessens generally very much, or even disappears, after lasting eight or nine days, though it may vanish in a few days; at the same time, too, the diarrhoea is apt to diminish, or even gradually to cease. But instead of the oedema subsiding, it may extend to the chin, to the arms and legs, and to the back ; or it may show itself in the extremities subse- quently to the disappearance from the face, and shortly afterward become perceptible over the trunk. In some cases an anasarcous condition, beginning at the ankles and extending upward, occurs during convalescence, and is of long duration. It is then prob- ably connected with the state of the blood; whereas the oedema happening earlier in the malady is thought to be due to the ])ress- ure upon the arteries, exerted by the parasites and the exudation of plastic material they produce, or, in accordance with the ob- servations of Thudichum, to their presence within the lymphatic spaces, vessels and glands, and blood-currents.^ The dropsical swelling of trichiniasis is not associated with albumen in the urine, for, except an increased quantity of uric acid, the urinary secretion contains no abnormal ingredient. The quantity of urine is much diminished. The trichinae may at times be detected in the passages from the bowels. Boils, acne, and ecthyma are often noticed after the cedema has passed away.| The muscular symptoms begin in the second stage, at about the tenth day, with pain and stiffness in the limbs. Soon at all parts of the body the muscles give the impression of being swollen ; they are extremely painful when touched or moved ; and the patient * See Clinical Lecture on Acute Trichiniasis, reported in Medical News and Abstract, March 1881. t Thudichum, loc. cit, pp. 362 and 386. I Meissner, Schmidt's Jahrbiicher, No. 4, 1868.