North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826Various
History
North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826
Various
Medicine -- Periodicals
M. BRETONNEAU has prepared a set of specimens, taken from the bodies of
those who have died in various stages of this complaint. He traces the
malady day by day, with a precision which we will not copy here. The
seat of this affection is the glands of PEYER and BRUNNER. The former
are found in groups, throughout the lower half of the jejunum and the
whole of the ileum, gradually increasing in the size and number of their
clusters, till they reach the valve of the colon, where they cease. They
have been mistaken by some dissectors of the modern school for the
effects of inflammation. They are found in honey-combed patches; which
are agglomerations of mucous glands. The glands of BRUNNER are thinly
dispersed mucous follicles which are scattered singly throughout the
whole length of the small intestines, with nearly equal frequency. These
organs are well described by HALLER in the great Physiology. They are
not seen well, unless in a young subject, and by cutting into the
intestine very close to the mesentery.
When inflamed, they swell and thicken, and, after some days, the
membrane around them assumes a reddish tint. The mesenteric glands are
enlarged. M. BRETONNEAU has seen one as large as a hen's egg: they
generally equal in size that of a pigeon. The disease spreads and
affects an additional number of glands. It reaches its acme generally on
the 9th day; after which sometimes all, and always a part of the
affected glands return to their natural condition, by resolution of the
inflammation. Those which are to run the full course of the disease
continue to augment in size and projection into the intestine. On the
13th and 14th days they are discovered tinged with bile, which
penetrates their substance, and thus proves the occurrence of
disorganization. On the 15th and 16th, the sloughs separate, and leave
from one to six ulcers. These penetrate the gland, and with it the
mucous membrane, of which it forms a part, and next, the cellular tissue
of the intestine. In numerous instances they perforate the muscular
coat, leaving nothing but peritoneum at the bottom; and frequently,
passing this, they induce inflammation of the cavity of the belly, and
death.
The cases of simple resolution terminate in three weeks: those in which
sloughs are formed, in from 30 to 40 days, if not fatal. If death be
from peritonitis, it is of course soon after the 15th and 16th days; if
from exhaustion, at periods varying according to the strength of the
sufferer. Dothinenteria occurs in many of the cases commonly called
typhus fever, gastro enteritis, &c. It is proper to remark that both the
author and the journal are in opposition to Dr. BROUSSAIS.--_Archives._
Public-domain text, read in full here on John Shaqi.
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