A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Science
A system of practical medicine. By American authors. Vol. 2 : $b General diseases (continued) and diseases of the digestive system
Medicine -- Practice
The appetite is usually unimpaired in the early periods of the disease,
and even throughout its course the condition of the mouth alone
prevents the patient from indulging his desire for food, even, as is
occasionally noticed, to voracity. There may be a yearning for certain
articles of diet, principally those of an acid character; but, on the
other hand, some cases present exactly the reverse condition--a disgust
for food in general or for particular varieties; or the appetite may be
vacillating, at one time craving and at another repelling nourishment.
There is no noticeable change in the normal thirst, except on the
occurrence of febrile complications, when it is increased. The gums do
not, at this stage of the disease, present the livid, swollen
appearance of fully-developed scurvy, but, on the contrary, are
generally paler than usual, with a slight tumid or everted line on
their free margins, and are slightly tender on pressure. The breath is
commonly offensive, and the patient complains of a bad taste in the
mouth. The tongue is flabby and large, though clean and pale, and the
bowels are inclined to be sluggish.
This preliminary stage is followed, after varying intervals of time, by
certain local phenomena which are quite characteristic of the disease.
There is a marked tendency to extravasation of blood into the tissues,
either causelessly or upon the infliction of slight injuries or wounds.
Fibrinous exudations occur sooner or later into the gums, which become
darkened in color, inflamed, swollen, spongy, and bleed upon the
slightest touch or even spontaneously, and finally separate from the
teeth. These results are due, in part, to the considerable amount of
pressure to which these parts are subject in mastication, and it is a
conspicuous fact that the gums of edentulous jaws remain free from
these changes. In a few cases the gums are but slightly altered,
perhaps oedematous only or pitting upon pressure, or they become the
site of bloody extravasations. In severer examples, in later stages of
the disease, these various alterations progress to an extreme degree,
and the extravasation is so voluminous that the gums present great,
fungous, lacerable excrescences, which may finally break down into a
suppurating, brownish, and very fetid mass, communicating to the breath
an odor of a most offensive character. In certain epidemics of scurvy,
notably in that of Florence described by Cipriani, the lesions of the
gums were absent. The rest of the mucous membrane of the mouth remains
unaltered, or at most slightly ecchymotic. Samson and Charpentier[13]
in a large number of cases saw this but once, and in one of Leven's[14]
cases the fungous growth invaded the palatal mucous membrane, extending
to the anterior pillars of the fauces. The salivary glands are enlarged
and swollen; the tongue is imprinted with the form of the teeth, while
the latter become encrusted with tartar and more or less concealed by
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account