Natural history, pathology, and treatment of the epidemic fever : at present prevailing in Edinburgh and other towns, illustrated by cases and dissections / by John Rose Cormack.

Date:
1843
Catalogue details

Licence: Public Domain Mark

Credit: Natural history, pathology, and treatment of the epidemic fever : at present prevailing in Edinburgh and other towns, illustrated by cases and dissections / by John Rose Cormack. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    A remission on the third day is very common. It occurred in all the cases, which I have had an opportunity of attentively observing from the invasion onwards. On, or about the fifth day, there is an evident manifestation of the violence of the disorder being expended; and this change for the better is often very sudden and complete. One day, we hear the patient moaning and groaning in pain; and on the next, he is at ease and cheerful, his only complaints being of hunger and weakness. This state is generally ushered in by a copious sweat; or by epistaxis or diarrhoea. The sweating was by far the most common critical evacuation till the beginning of October, when diarrhoea and dysentery, formerly rare occurrences, became com- mon; and at the present time (October 30) they are as usual as sweating. After this change, the pulse, tongue, and skin are quite natural; and the facial bronzing often becomes much less striking. For several days, or till about the fourteenth or fif- teenth day of the disease, there is a period of intermission, dur- ing which a great deal of lost strength is regained, and a steady improvement goes on in all respects. On, or about the fourteenth or fifteenth day from the beginning of the disease, the patient relapses; or, in other words, has a paroxysm of fever, similar to that which began his first attack. The relapse takes place late or early, just according to the date of the first convalescence, as will be clearly seen from all the cases to be detailed. It sometimes happens, that the onset and progi'ess of the second attack is attended by severer, and at other times, by milder symptoms than those of the first. In the relapse, the abortions most commonly take place.* In it also, the muscular and articular pains are very often most severe. Cases, which in the first attack were strictly mild and ordinary, have in the second, become signalized by jaundice, delirium, diarrhoea, dysentery, and other grave symptoms. Such occur- rences are, however, not common. A large number of patients have a second and generally mild relapse, on or about the 21st day. As these relapses take place ’ In one or otlier of the attacks, pregnant women almost invariably miscarry. My assistant Mr J. W. Reid attended a Dispensary patient who did not miscarry, till a tecond relapse about the 21st day.