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
4. There was frequently discharged from the stomach in the close of the
disease, a large quantity of grumous blood, which exhibited a dark colour
on its outside, resembling that of some of the matters which have been
described, and which I believe was frequently mistaken for what is
commonly known by the name of the _black vomit_. Several of my patients
did me the honour to say, I had cured them after that symptom of
approaching dissolution had made its appearance; but I am inclined to
believe, dark-coloured blood only, or the coffee-coloured matter, was
mistaken for the matters which constitute the fatal black vomiting. I
except here the black discharge before-mentioned, which took place in
three cases on the first day of the disease. This I have no doubt was
bile, but it had not acquired its greatest acrimony, and it was
discharged before mortification, or even inflammation could have taken
place in the stomach. Several persons died without a black vomiting of
any kind.
Along with all the discharges from the stomach which have been described,
there was occasionally a large worm, and frequently large quantities of
mucus and tough phlegm.
The colour, quality, and quantity of the _fæces_ depended very much upon
the treatment of the disease. Where active purges had been given, the
stools were copious, f[oe]tid, and of a black or dark colour. Where they
were spontaneous, or excited by weak purges, they had a more natural
appearance. In both cases they were sometimes of a green, and sometimes
of an olive colour. Their smell was more or less f[oe]tid, according to
the time in which they had been detained in the bowels. I visited a lady
who had passed several days without a stool, and who had been treated
with tonic remedies. I gave her a purge, which in a few hours procured a
discharge of fæces so extremely f[oe]tid, that they produced fainting in
an old woman who attended her. The acrimony of the fæces was such as to
excoriate the rectum, and sometimes to produce an extensive inflammation
all around its external termination. The quantity of the stools produced
by a single purge was in many cases very great. They could be accounted
for only by calling in the constant and rapid formation of them, by
preternatural effusions of bile into the bowels.
I attended one person, and heard of two others, in whom the stools were
as white as in the jaundice. I suspected, in these cases, the liver to be
so constipated or paralyzed by the disease, as to be unable to secrete or
excrete bile to colour the fæces. Large round worms were frequently
discharged with the stools.
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