Notes on fetid bronchitis and other lung-diseases with fetid breath / by Thomas Laycock.
- Thomas Laycock
- Date:
- 1865
Licence: Public Domain Mark
Credit: Notes on fetid bronchitis and other lung-diseases with fetid breath / by Thomas Laycock. Source: Wellcome Collection.
Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.
19/32 page 17
![course, and occurring in rheumatic subjects, to wliicli I liave already referred. A case of this kind is now under my care in the Infir- mary, in which the seat of lesion is (as is most common) in the left lung, with persistent pain there, and tingling in the palm of the left hand. The patient (a man) has had profuse strongly- smelling sweats, like those of the. rheumatic, and rheumatic corpuscles in his urine. Fetor of the breath closely resembling that under consideration is observed in pregnancy, scorbutus, and cachectic states of a rheu- matic character; in all these the blood is highly fibrinous and embolism not uncommon. Since the pulmonary artery has been found plugged in cases of pulmonary gangrene and rodent pul- monary ulcer simulating it, tlie plugging has been usually con- sidered as the cause of the morbid change. There seems to be, however, just as solid ground for the opposite theory, namely, that the plugging is caused by the pulmonary disease. But, however caused, the excess of fibrin is probably a predisposing or exciting cause of the fetor. These remarks refer chiefly to cases of pulmonary fetor in which changes of structure have been observed. But in one class of these affections there is no cognisable disease, and yet a very characteristic odour (the faical) is exhaled. But these cases, when examined, only serve to show more clearly its rheumatic origin. In offensive perspiration of the feet a peculiar cabbage-like stench is given off. It has been roundly asserted that this is due simply to want of cleanliness, just as the stench of fetid bronchitis has been attributed to gangrene; but the theory is certainly not sound. Cases occur in which the most scrupulous cleanliness fails to prevent the smell. Indeed, I know no more intractable malady, for even when the stockings and shoes are changed two or three times a-day and powerful scents used, the morbid stench is still diffused. It seems ])robable that the perspiration contains an element which undergoes decomposition at a low temperature or on exposure to the air. I have been informed that a surgeon in extensive practice in the north of England committed suicide a few years ago because of this offensive malady. A patient soon infects the air of a large room. In the cases that have come under my observation I could trace distinctly a rheumatic habit, and sometimes rheumatism was a complication. Allied to this is the offensive odour in some forms of rheumatic fever and in cases of acute recuiTcnt attacks of leprous inflammation of the skin, in which the paroxysm termi- nates by a copious plastic exudation into the cutaneous cellular tissue. The urine sometimes becomes fetid in like manner. Dr Low, of King's Lynn, had communicated to me the particulars of a case of this kind in a pregnant female, and which ceased with delivery. Speculations have naturally arisen as to the immediate origin and composition of the volatile matter which causes the stench; and as the blood is easily impregnated with volatile stuff, it is readily concluded that it comes from the blood. Perhaps it may](https://iiif.wellcomecollection.org/image/b21481246_0019.jp2/full/800%2C/0/default.jpg)
