Lectures on the acute specific diseases : being the Gulstonian lectures, delivered at the Royal College of Physicians, March, 1853 / by William Jenner, M.D.

  • Jenner, William, Sir, 1815-1898.
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the acute specific diseases : being the Gulstonian lectures, delivered at the Royal College of Physicians, March, 1853 / by William Jenner, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    As to the mode in which this is determined, from the sud- den commencement and abrupt termination of relapsing fever, and the fact that it is usually uncomplicated, there is no difficulty in fixing its duration. The data for determining the duration of all the other diseases of this class are derived, first, from a consideration of the time that elapses between the first symptom of illness and the disappearance of the eruption; and, 2ndly, from a consideration of the appearances found after death. The eruption is one of the specific effects of tlie action of the exciting cause, i.e., of the poison, seed, or other principle of infection, or of the condition of blood directly produced by that exciting cause, (and its continuance is ordinarily equal in duration, after its first appearance, with that of the specific disease.) The length of the disease is then, at least, the period during which the specific eruption is present, plus the period occupied by the general symptoms anterior to the outbreak of the skin affection. The second class of data for determining the duration is derived from the examination of the bodies of those who die of these diseases: thus,—all the acute specific diseases are general diseases, and all may prove fatal without any lesion of structure of sufficient moment to account for death being found on the most careful examination. Death results, that is to say, in a certain number of cases of each of these dis- eases, from the direct action of the poison which induces them, ?. e.y from the change directly induced in the blood by that poison, or from the changes directly induced in all the tissues and organs of the body by that poison, or by the changes induced by the blood altered by that poison. Now, it is evident that death from this, or these causes, can occur only during the period that the disease itself lasts ; therefore, if there be a period in each of these affections, after whichj if death occur, changes of structure of sufficient moment or extent to account for death are alwaysfound, then the specific disease must be held to continue at least up to that time, whatever be the duration of the eruption. Now, experience proves, that in several of these diseases there is such a time,, and has shown, moreover, that it is never later in each of the diseases than the time when the eruption fades in typi- cal cases. Thus, the eruption of scarlet fever disappears in typical cases, by the ninth or tenth day of disease. If death occur in scarlet fever before the latter date, t^iea experience, shows that in a certain jjroportion of cases, no appearances are found of sufficient importance to account for death ; while, if death occur after that date, then death may invariably be explained by the lesions discovered. If, in typhus fever, death ensue within twenty-one days after the first symptoms of illness, then may no deviation from healthy structure, such as experience proves to be capable of producing death, be discovered; while, after twenty-one days, extensive alterations of structure are constantly found. if a pase of typhoid fever prove fatal before the twenty- eighth day of disease, then may slight ulceratiori of the