Clinical and pathological observations in India / by J. Fayrer.

  • Fayrer, Sir Joseph, 1824-1907.
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: Clinical and pathological observations in India / by J. Fayrer. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    urine, and excretions from the lungs and skin. But there is sometimes a pecuKar appearance of hebetude or fatuity in the countenance, accompanied by incoherence, and even delirium, vnth great restlessness, A feeble and irregular pulse, excited though feeble action of the heart, dyspnoea and hurried respira- tion, all tell of the struggle nature is making against an enemy that is rapidly sapping and taking possession of the very citadel of life itself. After death, the post-mortem appearances reveal the coagula j&rmly impacted in the auricle, ventricle, and pul- monary vessels, like the branches of a tree, entangled in the cords or moulded on the valves, leaving it a mystery how the circu- lation had been carried on thus far. That such changes should take place in cases of blood-disease, where from hyperinosis, lowered vitality, or other causes, a preternatural tendency to clot exists, and where the natural nutritive relation between the tissues, the blood, and the innervation must be disturbed, does not, though it may be unexplained, seem strange; and the fibrinous coagula which intervene and carry off the patient, are regarded as one of the events to be expected in the course of the disease. But when, as I have before said, a person previously healthy so suffers after a surgical operation or severe injury, we cannot avoid the conclusion that the shock of the operation, the relative or absolute loss of blood, and other changes which con- sequently occur in the tissues, must have much to do in bringing about this dangerous disease. It is also highly suggestive of the necessity for ascertaining the state of our patients' health, and their freedom from the complications of visceral disease, before we submit them to the chances of this danger. I am now alluding to that form of obstruction in which the right side of the heart is affected. With that of the left, and the arterial system, I am not at present concerned, though it is a subject equally worthy of attention. Obstruction, as it happens in the right Bide of the heart, may occur ]3artially, to a slight extent, and be recovered from. It may be more extensive, and slowly but surely destroy life. It may be sudden and complete, and prove suddenly fatal, by withdrawal of blood from the pulmonic circu- H
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