Phthisis; its morbid anatomy, etiology, symptomatic events and complications, fatality and prognosis, treatment and physical diagnosis : in a series of clinical studies.

  • Flint, Austin, 1812-1886.
Date:
1875
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Licence: Public Domain Mark

Credit: Phthisis; its morbid anatomy, etiology, symptomatic events and complications, fatality and prognosis, treatment and physical diagnosis : in a series of clinical studies. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    tensive, ulcers were found everywhere throughout the small in- testine which in some situations was encircled by bands of ulceration from one to two inches in width. Perforation took place in this case. In another case the ulcers were few in num- ber and of small size. In two cases there were ulcers in the large, as well as in the small, intestine, and in one of these cases the ulcers in the large intestine were more numerous and larger than in the small intestine. In the single case in which ulcera- tion was not found after death, the appearances in the small intestine were described as follows: At the lower part of the ileum in spaces occupied by the Peyerian and solitary glands, numerous round bodies of the size of small peas projected into the canal. Some of these contained a liquid like softened tubercle; others were white and cheesy. There was no thick- ening nor any appearance of inflammation around these bodies. They were most abundant near the caecum. The mesenteric glands were enlarged, some of the size of a small bean, and were of a cheesy consistence. In one case in which there were numerous small ulcers in the ileum, there was a solitary small round ulcer in the stomach. In this case there were no symp- toms noted which pointed to the existence of gastric ulcer. In most of the ten cases the diarrhoea was a prominent symp- tom, and persisted up to the time of death. There were two exceptions to this rule. In one of these exceptional cases the diarrhoea ceased some weeks (the number not noted) before death. In the other case it was noted that the diarrhoea was readily controlled, and continued for only a short time. The diarrhoea was prominent and persistent in the case in which there was only a single patch of ulceration in the ileum. It is certain that the amount of ulceration cannot be accurately estimated by the prominence of the diarrhoea. The mesenteric glands were, without an exception, more or less enlarged. In several cases it was noted that the en- largement was great or considerable, and in one case some of the glands were as large as hickory-nuts. It was generally noted that the glands contained material of a cheesy consist- ence. That the affection of these glands is not always depend- ent on a prior intestinal affection, is a fair inference from the fact that the latter does not invariably coexist. In one of my cases the mesenteric glands were enlarged without any affection