The Cholera Gazette, Vol. I. No. 5. Wednesday, August 8th, 1832.Various
History
The Cholera Gazette, Vol. I. No. 5. Wednesday, August 8th, 1832.
Various
Cholera -- Periodicals
The appearances after death, were almost constantly the same. The
external parts were very much diminished in size; the extremities, the
nose, lips, eyelids, cheeks, &c. were of a bluish or livid colour,
and the skin was wrinkled upon the hands and feet. The vessels of the
brain in some subjects contained black blood, but generally there was
nothing peculiar in the contents of the cranium. There was more blood
in the spine, probably arising from position. The heart, lungs and
large vessels were filled with a fluid resembling tar in colour and
consistency. Two hours after death it was liquid and appeared like
venous blood; but at twenty-four hours it seemed deprived of serosity
and of the property of coagulation, and albuminous concretions were
found in the heart. The stomach and intestines were either empty or
contained matter similar to the vomitings and purgings; their coats
were contracted and paler than in a natural state, or as was most
frequently the case, presented all the varieties from congestion to
sub-inflammation. The liver and vena portæ were distended with black
blood, and the gall-bladder with tenacious, dark yellow, or green bile.
In almost every case the bladder was found empty and contracted.
From the above symptoms and results of post mortem examinations, it
would seem that the pathology of the cholera morbus may be explained
by a want of oxegenation of the blood, which becoming surcharged with
carbon is unfit to stimulate the heart to contraction, and hence the
congestion upon the internal and vital organs at the expense of the
surface and extremities. With this pathological view of the disease,
and from the positive fact of there being a centripetal action of the
blood, is easily deduced the principle of conducting its treatment--the
equilibrium of the circulation must be restored or death will ensue.
Now, mechanically speaking, there are two ways of affecting this
object, either by introducing a power which will give the blood a
centrifugal direction, or calling it back to the surface, by direct
external applications. But the animal economy is governed by other
as well as mechanical laws; the vital properties of the heart are
oppressed, its energy is diminished, and its power of reäction impaired
by an accumulation of blood, and this is peculiarly the case when the
blood is black or not oxegenated; the stimuli or powers introduced
to rouse its action would therefore be worse than useless; besides,
we usually address the heart through the stomach, which is in such
an irritable state as to reject even the mildest article. Upon the
surface, on the contrary, there is a want of action, and stimuli are
called for to excite the skin; to restore its lost or increase its
feeble circulation, and thus draw the blood and heat from the internal
parts of the extremities.
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