Imágenes de página


ptoms have followed after the dissection of a putrid body, Gen. VI. it has rather been from the action of the putrid matter

Spec. V. as a simple acuant on an irritable constitution, than from anatomicum.

Erythema any specific influence. Dr. Duncau's two cases of affection when the body was putrescent, affords a striking tion. confirmation of this opinion, instead of opposing it; for the first patient is described as being of a nervous irritable temperament, and the second, as being of scrophulous habit.

Under such and similar circumstances, even me- Hypothesis chanical and chemical irritants, and diseased secretions ;

irritants exof various kinds, though otherwise sufficiently innocuous, amined. are often found to excite not only local but diffuse inflammation, and a sympathetic fever that has sometimes ran so high as to prove dangerous and even fatal; the symptoms, indeed, being often a pretty close copy of those characterizing the disease before us. And hence many pathologists of the present day, chiefly from the difficulty of detecting a specific virus, have ascribed all the cases of anatomical erythema to the same cause of SIMPLE IRRITATION in a frame thus constituted.

But, in the first place, the disease before us has an es- Objected to sential difference from all the other sources of inflamma

cause of the tion in the manner of its onset, and in the state of the symptoms affected part. While all the rest open WITH LOCAL IN


LOCAL IN- with those of FLAMMATION, originating at the point of injury; the in- erythema flammation spreading thence visibly towards the shoulder a

And hence or axilla, and followed by fever and constitutional dis- a specific turbance as the result of the local mischief; the anatomic ėrythema COMMENCES WITH FEVER AND CONSTITUTIONAL DISTURBANCE, while the inflammation first shows itself about the shoulder or axilla; the local point of injury remaining little if at all affected by inflammatory action. There is often indeed, a severe and lancinating pain, which darts upwards from such point; but, except in a particular description of cases, which we shall notice presently, there is no inflammation worth noticing, even when the pain is altogether intolerable.


irus must be admitted.

the sai


Gen. VI. And, secondly, the plurality of individuals who have
Spec. V. frenantly he

frequently been affected at the same time, as well as with anatomicum. precisely the same train of symptoms, and who have Erythema from dissec. propagated the disease to their attendants, leads us, altion. most irresistibly, to the same conclusion of a specific Specific source of impression as in other cases of propagable convirus obvious from tagion. The same subject that gave rise to the complaint, the plurality which terminated fatally in Dr. Dease, originated it also, of persons affected at

though not to a fatal extent, in Mr. Egan*. The cases

of Mr. Blyth and Mr. Young, narrated by Dr. Duncan t, time, or from each

were in like manner derived from a common dissection, as were those of Mr. Hercey, Mr. Hennen, and Dr. Dumbreck, communicated from the same authority; in each of which, also, one of the anatomists fell a sacrifice,

while the others were fortunate enough to recover. Additional The following, forming another proof, from the pen illustration. of Dr. Duncan, is perhaps still more to the point. “Dr.

Cumming, a medical practitioner in this city, was pre-
sent Soth September, 1821, at the dissection of a young
woman who died from puerperal fever. Took no share
in the dissection, except introducing a fresh thread into
the needle which was employed in sewing the body, and
was not aware of an abrasion, or having punctured him-
self in the act of threading. About eight hours thereafter,
felt an uneasy sensation in the middle finger of the left
hand, at the inner side of the flexure of the first joint;
when, on examination, there was discovered an angry
pimple. Passed a restless night; towards the morning
had a severe rigor, to which supervened symptoms of
pyrexia.” The disease became established, and though,
its progress was less rapid and decisive than general,
the patient expired on the eleventh day from the attack.
The case, however, is here particularly selected, because
it appears that a female who was employed to wash, in
the evening after the above dissection, a towel that, in

• Dublin Hospital Reports, Vol. 11. ut suprà.
+ Trans. Medico-Chir. Soc. Edin. Vol. 1, ut suprà.



the course of it, had been used instead of a sponge, GEN. VI. scratched her finger with a pin which was left in it, and

nd Spec. V. received the same disorder, in a milder, indeed, though anatomicum. still a very alarming degree; but from which she ulti- Er

le from dissecmately recovered.

tion. , It is unnecessary to accumulate examples. Whatever Other ex

amples unbe the difficulty of conceiving the existence of a specific

WC necessary virus generated shortly after death, and before putrefaction takes place; it is far more difficult to withhold our assent from such an explanation, or to account for such effects upon any other principle. It may perhaps, in a slight degree, assist the patholo- Physiologi

un cal illustragist in his future inquiries into this obscure subject, to tio observe that we have ground for believing that a new and active compound of some kind or other is constantly forming antecedently to the process of putrefaction, at the moment the living power, as well in plants as in animals, is ceasing to exist, and a play of affinities commences, which this power has hitherto restrained. In plants Saccharine

in principle this usually appears in the form of a saccharine princi- porn ple, perhaps a saccharine acid; among mankind in that of plants as the a phosphoric acid, and often, from its combination with he decays. other elements, of a phosphorescent light. This is par- Phosphoreticularly the case with those animals that have a peculiar in anima power of emitting, and, perhaps, of secreting light while recently, alive, as the glow-worm, the lantern-fly (fulgora), and the cancer fulgens, among insects; among shell-worms, the phola, medusa phosphorea, and various molluscæ; and amongst fishes, most that inhabit salt-water*. All these are found to pour forth a succession of light after their death, till putrefaction commences, but no longer. Yet something of the same kind seems also to take place in various other animals under certain circumstances;perhaps in all. M. Cuvier tells us that M. Percy, who, Issuing during twenty-five years of war, had under his care more from the

surface of than a million of wounded, and had often been obliged wounds.


* Hulme, Experiments, &c. on the Light which is spontaneously emitted from various bodies. Phil, Trans. 1800. VOL. II


Banatomicum, was at a rendering uid, as in


This illus

Gen. VI. to dress wounds in the dark, had frequently observed a Spec. V.

: phosphorescent light to issue from them, especially when anatomicum. extensive and dangerous, and where the living power Erythema froin dissec

was at a very low ebb. And he found, also, that the best way of rendering this emanation visible, is that of applying an aqueous fluid, as in the case of reviving the phosphorescent light of the recently dead animals we have just noticed. “In one instance”, says he, “a vivid light, a true ignis fatuus, existed for more than six days over the wound of an officer who had been dressed with compresses, wetted with pure water only."*

I pretend by no means to say that the new and active, tration how far applica

but virulent and contagious material, formed, perhaps ble. always in the human, and apparently in other animal bo

dies, on the cessation of the living principle, and when the laws of chemistry hitherto held in subjection by the operation of this principle, now begin to assert their sway is of either of the kinds I have thus adverted to; I have only endeavoured to draw the attention of the physiologist to the subject, by showing that some peculiar and extraordinary compounds of a very diffusive and active kind are assuredly formed on the immediate termination of life, and to urge him to a search after compounds that

have not hitherto been explored. The virus Be the contagious material, however, what it may, it pervades all the fluids of appears to pervade equally all the fluids of the decompos. the dissected ing body, whether natural or morbid : for the disease has body. Exemplified. followed where the punctured hand has been merely im

mersed in genuine pust that has flowed from an abscess of the stomach or some other viscus, as well as where it has merely come in contact with the lubricating lymph of serous or mucous membranes ; and, as already observed, where it has only touched a towel or a sponge employed in wiping up the fluids, or other materials that have required removal in the course of an examination,

• Analyse des Travaux de l'Academie des Sciences de Paris pour 1819.

+ Case of H. Callow, Esq. Surgeon of the 16th Regiment of Foot. Lond. &c. Phys. Journ. Aug. 1823. p. 123.



Erythema from dissec

or even a thread wetted with the same and pressed GÊN. VI.

Spec. V. through the eye of a needle.

Nor does the character of the contagious material ap- anatomicum. pear to depend in any degree upon the nature of the disease of which the subject submitted to dissection has tion. died. It has followed upon cases of dropsy, of pulmo- Does not

depend on nary affection, of enteritis, of puerperal fever, of aneu- the nature of rism, and of Cesarian section *. So that the nature of the previous

disease. the preceding disease has as little connexion with the

Exempli. virus as the process of putrefaction.

fied. The ordinary progress of the complaint cannot be Progress of

the disease. better described than by copying the sufferings of Professor Dease. His demonstration took place on a recent subject on February 13, 1819, at one o'clock. He awoke-early the ensuing morning with severe rigors, sickness, and acute pain in the left shoulder. On the next day a slight fulness was observed above the clavicle along the left side of the neck, which could not bear the slightest pressure. On the day suceeding a colourless swelling was noticed about the axilla, which first suggested the real nature of the complaint; and on examining the hand there was found by Dr. Colles the mark of a slight scratch with a superincumbent vesicle. He appeared to improve a little for a day or two, though full, florid, and crimsoning erythema occupied the side in the region of the pectoral muscle, extending downwards. On the morning of the nineteenth he showed delirium, and a vesicle appeared on his fore-arm, which remained stationary to the last. By the next day the erythematous swelling had extended over the entire side of the body from a little below the axilla to the hip; and the swollen part became studded pretty thickly with indurated papulæ; the delirium being more confirmed. On the twenty-first the inflammation completely involved the axilla, and on its posterior edge an abscess seemed to have formed though there was no fluctuation. At this

• Duncan's Cases in Trans. Medico-Chir. Soc. Edin. ut suprà; as also p. 566.

« AnteriorContinuar »