Medical and Surgical Monographs Classic Reprint

Excerpt from Medical and Surgical Monographs

We have long observed, that when under the influence Of wine the pulse became less and less frequent, the termination of the case was generally favourable, and as might be expected, the contrary result led to a bad prognosis. This practical Observation I do not put forward as original, but I wish to express my great confidence in its truth} Let us suppose a case of typhus on the tenth day of fever, and presenting severe symptoms of prostration, the pulse varying from 115 to 120. Wine is exhibited, and on the first day the pulse rises to 125, and on the second to 130, and if on the third day there is no diminution, we may make a bad prognosis; and thus the fol lowing rule may be laid down, that when, in a case where the symptoms seem to indicate wine, the pulse either does not come down, or increases in frequency under its influence, we may expect a bad result.

These facts naturally lead to the examination of the state Of the heart in typhus fever, and the cases in this report are so arranged as to exhibit together the condition of the heart, and the amount Of wine employed. In this investigation we have sought for an additional rule, drawn from the state of the heart itself, to guide the inexperienced man in the exhibition of wine, and I am not without hopes, that in the careful study Of the cardiac phenomena, an indication hitherto unobserved will be obtained.

In typhous fever two Opposite conditions of the heart may be observed; in the one the impulse becomes extremely feeble, or altogether wanting, while the sounds are greatly diminished in intensity; while in the other, the heart's action and sounds con tinne vigorous throughout the whole course of the disease.

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