Medical Inquiries and Observations, Vol. 3: The Second Edition, Revised and Enlarged by the Author — John Shaqi
Medical Inquiries and Observations, Vol. 3: The Second Edition, Revised and Enlarged by the AuthorRush, Benjamin
Science
Medical Inquiries and Observations, Vol. 3: The Second Edition, Revised and Enlarged by the Author
Rush, Benjamin
Medicine; Yellow fever -- Pennsylvania -- Philadelphia
The _bowels_ were generally costive, and in some patients as obstinately
so as in the dry gripes. In some cases there was all the pain and
distress of a bilious colic, and in others, the tenesmus, and mucous and
bloody discharges of a true dysentery. A diarrh[oe]a introduced the
disease in a few persons, but it was chiefly in those who had been
previously indisposed with weak bowels. A painful tension of the abdomen
took place in many, accompanied in some instances by a dull, and in
others by an acute pain in the lower part of the belly.
IV. I come now to describe the state of the _secretions_ and _excretions_
as they appeared in different stages of this fever.
In some cases there was a constipation of the liver, if I may be allowed
that expression, or a total obstruction of secretion and excretion of
bile, but more frequently a preternatural secretion and excretion of it
took place. It was discharged, in most cases, from the stomach and bowels
in large quantities, and of very different qualities and colours.
1. On the first and second days of the disease many patients puked from
half a pint to nearly a quart of green or yellow bile. Four cases came
under my notice in which black bile was discharged on the _first_ day.
Three of these patients recovered.
2. There was frequently, on the 4th or 5th day, a discharge of matter
from the stomach, resembling coffee impregnated with its grounds. This
was always an alarming symptom. I believed it at first to be a
modification of vitiated bile, but subsequent dissections by Dr. Physick
have taught me that it was the result of the first stage of those morbid
actions in the stomach, which afterwards produce the black vomit. Many
recovered who discharged this coffee-coloured matter.
3. Towards the close of this disease, there was a discharge of matter of
a deep or pale black colour, from the stomach. Flakey substances
frequently floated in the bason or chamber-pot upon the surface of this
matter. It was what is called the _black vomit_. It was formerly supposed
to be vitiated bile, but it has been proved by Dr. Stewart, and
afterwards by Dr. Physick, to be the effect of disease in the stomach.
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