Observations on the Diseases of SeamenBlane, Gilbert, Sir
History
Observations on the Diseases of Seamen
Blane, Gilbert, Sir
Medicine, Naval -- Early Works To 1800; Sailors -- Diseases
Upon the first attack the skin is extremely hot and dry, and the pulse
hard and frequent; but the external heat soon becomes very little
different from the usual standard of health, and the skin feels soft
and moist. There sometimes happens an eruption of small pustules, with
white heads, on the trunk of the body, which is a favourable sign; and
I have seen a head-ach disappear upon this breaking out. The pulse does
not serve as an index of danger; for, after the hurry of the first
attack, it becomes very moderate in point of frequency, varying from
eighty to a hundred pulsations in a minute, and is natural in point of
regularity and strength.
In these circumstances this fever differs from that which was last
described; and it also differs from it in being attended with little
delirium. I have seen cases in which the senses were not affected from
beginning to end; and I never observed that violent and incessant
delirium which attends other dangerous fevers.
The state of the _fauces_ is also different from that of most other
fevers, for there is no excessive thirst. The tongue is somewhat white
and foul; but I do not remember ever to have seen it black and dry.
A want of action in the bowels, and an insensibility to purgative
medicines, indicate great danger; and, next to the black slimy stools,
one of the most unfavourable symptoms is, when the _feces_ are like
white clay, as I have seen in some cases that ran out to the length of
a week before they proved fatal. When the black vomit and stools occur,
death commonly happens on the third or fourth day. A bilious diarrhœa
spontaneously coming on, is a very favourable symptom.
In more unpromising cases the urine is scanty, and in the last stage
of life it becomes of a very dark colour, as was mentioned before. A
plentiful secretion of urine is a very favourable circumstance, and
seems to be one of nature’s methods of curing the disease; for such
cases are observed to terminate well. I remember one case in particular
in which several quarts were made daily for several days together,
and it was of a very dark saffron colour, but looked green where
the surface was in contact with the side of the pot. I inspissated
a small quantity of it, and found a large residuum, which was very
deliquescent, and seemed to be all saline. In a hot climate the urine
does not shew that separation and deposition which denote the crisis
of fevers in cold climates, and this is perhaps owing to there being
less mucilage and more alkali in the former, on account of the more
putrescent state of the fluids. Upon adding a little vinegar to the
urine in the case above mentioned, it became turbid like the critical
urine of the fevers of Europe.
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