Volume 2

The internal secretions and the principles of medicine / by Charles E. de M. Sajous.

  • Sajous, Charles E. de M. (Charles Eucharist de Medicis), 1852-1929.
Date:
1911
Catalogue details

Licence: Public Domain Mark

Credit: The internal secretions and the principles of medicine / by Charles E. de M. Sajous. Source: Wellcome Collection.

    1027/1124 (page 1785)
    articles as chalk, slate pencils, soil, etc. Enteroptosis, gastrop- tosis, hyperchlorhydria, gastrodynia (due in some cases to gas¬ tric ulcer), and movable kidneys are commonly observed. Constipation is almost the rule. Dyspnoea, palpitations, some¬ times accompanied with some irregularity in the heart’s action, though the pulse be large and soft, are frequently noted, along with purely functional cardiac murmurs, usually located at the base, and sometimes at the apex, when the heart is markedly dilated. The murmurs may often be traced up along the vessels of the neck. Along the course of the jugular vein, especially on the right side, a peculiar venous hum, the “bruit du diable,” is also discernible in over one-half of the cases. Neuralgia, vertigo, fainting, moroseness, and hysterical phenomena are not uncom¬ mon, especially in young girls, who constitute the great major¬ ity of cases. The eyes are unusually brilliant, as in some febrile disorders, and the sclerotic appears bluish. In fact, fever is not infrequently observed in these cases. The menstrual flow is usually scanty and sometimes suppressed, but in a large pro¬ portion of cases, there is metrorrhagia or dysmenorrhoea. The urine is of low specific gravity and deficient in urea, and is gen¬ erally very pale. (Edema of the face and ankles occurs in ad¬ vanced cases. In a small proportion of cases there is a tendency to thrombosis, especially of the veins of the legs, which exposes the patient to a dangerous complication: pulmonary throm¬ bosis. The cerebral sinuses may also be affected. Birch-Hirschfeld29 and Kockel,30 according to Lazarus,31 “beliere that chlorotic blood has a greater tendency to coagulate, and they asso¬ ciate this with the increased number of blood-platelets.” Indeed, we have seen that adrenoxidase is the fibrin ferment, and that the platelets are but droplets of the former. Stengel32 refers to Leichtenstern’s33 study of 1658 cases of chlorosis in which thrombosis positively occurred only 11 times, and “pr°l)ably jn a mi]d form in a few other instances.” Thrombosis is evidently a rare complication. In typical cases of chlorosis, the red corpuscles are not diminished to any material degree, the salient feature being a reduction of the haemoglobin. So decided is this in most cases, that the blood and the corpuscles themselves appear quite pale. 23 Birch-Hirschfeld: Congr. f. innere Med., Bd. xi, S. 2S. 1S92. 30 Kockel: Deut. Archiv f. klin. Med., Bd. lii, S. 557, 1S94. 31 Lazarus: Nothnagel’s “Encyclo. of Pract. Med.,” vol. on Dis. of the Blood, p. 402, 1905. 32 Stengel: Ibid. 33 Leichtenstern: Miinch. mcd. Woch., Bd. xlvi, S. 1603, 1S99.