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
But it is also true, that in the very worst
sort of fevers in hot climates it is a favourable symptom where the
secretion of the liver is restored and increased, a bilious diarrhœa
being one of the most auspicious symptoms that can occur in a yellow
fever; and in those that are protracted and afford hopes of recovery,
there is generally a gush of bile from time to time.--We may therefore
lay down the following positions: 1. That in cases in which bile is
most freely and copiously secreted no fever exists, as in _cholera
morbus_. 2. That in the worst sort of fevers there is no preternatural
secretion of bile, but, on the contrary, a defect of it. 3. That
nevertheless there is an uncommon quantity of bile secreted in most
of the fevers of hot climates, and that part of the cure consists in
evacuating it.
I am extremely diffident, as I have said, in all matters depending
on our supposed knowledge of the animal œconomy; but the preceding
circumstances seem to countenance the following reasoning:--The bile,
according to Dr. Maclurg, who has given one of the best dissertations
on its nature and properties, is composed of two parts; the gross
part, which is coagulable by acids, and that part in which the
bitter principle resides. The first constitutes the principal part
in point of quantity, and seems to be that portion of the mass of
fluids which loses the property of sound healthy blood, by a tendency
to putrefaction, and is thrown out by this secretion. I will not
undertake to vouch for the truth of this, but shall assume it as true
in the following reasoning:--According to this theory, therefore, the
greater part of the bile is what may be called the effete part of
the circulating mass, or perhaps only of the red globules or gluten,
the watery and saline part, which passes off by urine being the
corrupted part of the serum. This part of the bile being very liable to
putrefaction, the bitter part is considered by Dr. Maclurg as intended
to correct this, and also to answer some good purpose in digestion.
One of the effects of the bile in this operation is to extinguish
acidity, whether proceeding from substances taken in, or generated in
the stomach. The blood in all climates, and in all situations of life,
is subject to have part of it thus corrupted, which, being separated
from the common mass by the liver, is mingled and discharged with
the common _feces_; but external heat continued for any length of
time tends to augment this corruption of the fluids, and therefore
to increase the secretion of bile; and it has been observed both by
myself and others, that the bile found in those bodies that have been
inspected after death, in consequence of fevers in hot climates, is
less bitter, and not so penetrating to the fingers, being therefore
deficient in the antiseptic principle. But since external heat makes
no alteration in the degree of temperature of the fluids themselves,
this effect must take place through the medium of the solids, in
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