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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    there was maniacal excitement, and in another dementia and para- lysis. Tinnitus aurium, musca3 volitantes, and vertigo and deafness were occasionally complained of. In some patients it was frontal headache, in others acute hemicrania, and in others again it was cither dental or facial pain,—sometimes of an intense kind, which were the most prominent disordered sensations. In a few, again, the most urgent pain was in the neck, from which it shot upwards into the articulation of the lower jaw, or downwards into the arm ; while often it was found in the lumbar spine, from whence it ex- tended, in some instances, along the ischlatic nerves ; and in cer- tain patients of the latter description, the sensation complained of was less of the nature of pain than of an overpowering feeling of weakness and loss of voluntary motion, and in others, again, an extreme coldness in the same localities. In regard to the circulatory system, the heart's sounds were usually short and snapping ; sometimes they had a ringing, metal- loid character; often there was an obvious prolongation of the second sound, and on some occasions, the first sound was either much or quite extinguished. Sometimes there was a soft systolic nmriniir over the aortic valves, and just as often the diastole was marked by a harsh, rough, and grating noise, which in some in- stances was heard also in the larger arteries. In many cases there w-as a loud, humming bruit in the external jugular; sometimes even when the cardiac sounds were good, there was violent throb- bing, and a loud whirring noise in both the carotid and subclavian arteries, while in others there was only a short blowing sound, annihilated often on the gentlest pressure of the stethoscope, to be heard in the vessels of the neck. The pulse varied from 60 to 144. It was always easily accelerated, and sometimes it was so weak, that it could not be numbered either at the wrist or inner ankle, and in such cases the systole of an artery even so near to the centre of the circulation as the femoral, was found to be appreciably behind the diastole of the heart. The larger arteries had in some individuals much of the visible impulsive throbbing, which appears to indicate in other cir- cumstances, as in regurgitation through the aortic valves, a want of the due distention of their walls. The peripheral capillaries, also, everywhere unless in the congested portions of the surface, were empty at least of red blood, and both this and the unusual action of the arteries might be seen at the same time with a com- paratively shrunk, flattened state of the cutaneous veins. There was often in such, and in the exhausted patients generally, a dispo- sition to syncope on their getting out of bed. The tract of the larger vessels of the limbs, and situations which were most de- pendent, or which were much exposed to pressure were the most frequent seats of ecchymosis, and the nostrils and gums were the most constant sources of hemorrhages, which sometimes were both frequent and profuse. In one young man the quantity of blood