Contributions to the pathology and treatment of the scorbutus, which is at present prevalent in various parts of Scotland / by Charles Ritchie.

  • Ritchie, Charles, 1798-1878.
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to the pathology and treatment of the scorbutus, which is at present prevalent in various parts of Scotland / by Charles Ritchie. 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.

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    Instances It Avas flabby and bloodless —sometimes It was tender, and In others again It was chopped and disposed to bleed. There was in general some ptyalism, and then the tongue was Indented on its sides, and the sweUing of the parotids and of the gums, gave the patient the look precisely of a mercurialized person. The saliva was usually acescent. Thei-e was often extreme thirst, the appe- tite was almost uniformly good, and it was not uncommon to see it voracious. The belly was at times enlarged, and either meteoric or obscurely fluctuant. The bowels in a large proportion were slow, but in some individuals, who were exposed to cold and wet before admission, there was diarrhoea; in others this symptom arose after they had been put on a full stimulating diet, and in both of these the abdomen Avas not rarely found shrunk and flaccid. Some- times the dejections were pale, or nearly white ; but In others they were of a bright orange colour, and attended by bilious vomiting. In the diarrha3as brought on by treatment, the stools passed rapidly into fermentation, and had in this respect, and In their general aspect, a strong resemblance to those of well fed diabetic patients. In some the evacuations were incorporated with blood; many complained of piles, and then the blood lay more on the surface of the excretions. The urine varied in specific gravity from lO'lO to 10-28. In a few instances it was reported to have been bloody; in one it was alkaline immediately on being voided, but in no one of the many specimens tested was it found to be albuminous or abnoi-mal in other respects. There was retention in one case. Amenorrhoea took place simul- taneously in one woman, with the first symptoms of the disease. Necroscopical Appearances.—It gives me pleasure to state that there has not yet been a death among my patients by this disease. One old man, who was admitted to another part of the house with scorbutic cachexia and diarrhoea, I saw incidentally both before and after his death, and for the facts of his case I am indebted to Mr Steven. Patrick Crombie, aged about 70.—Admittea jMarcli 5th, 1847, in a state of great destitution and exhaustion ; the face stamped with famine, the clothes reduced to a few rags ; the skin harsh and filthy; breath fetid.—P. 90. Heart sounds short and sharp ; tongue brown, dry, furred and choppetl. Much dysenteric purging. Died on seventh day from admission. Inspection.—InteaWnel canal healthy to about three feet from the ctecum, where the bowel began to assume a dark red colour, which was continued down to upper part of rectum. The large intestmes contained about froua three to four i)ounds of fluid blood. Many of the solitary glands in lower part of ileum were enlarged, and of a brownish or blackish colour. The mucous lining of the great bowels—of the intestinum ca?cum in particular—was soft, friable, and delicately roughened ; further down, as in the rectum, this stjite was better marked, and was obviously produced by the abrasion of the internal surface by superficial and minute ulcerations. The colour of tlie whole was a delicate bluish red. In this individual the mucous membrane of the large intestines and its connections were in a similar condition to that of the mouth n