1839 The Lancet  
admitted on 10th May, eleventh day of his fever, complaining of intense headach ; general eruption of petechiae ; the sounds of the heart were feeble, but proportionate; impulse imperceptible ; pulse 98, full, but easily compressed. -Ordered wine, eight ounces ; camphormixture, with carbonate of ammonia. May 11. Pupils contracted ; countenance flushed; decided bronchitic rales ; impulse of heart just perceptible; the sounds are acquiring the foetal character: between the fourth and fifth
more » ... stal spaces scarcely anything is heard but the second sound; pulse 92. -Continue wine and mixture cupping, and blister to the chest. 12. The bronchitis more severe, but the countenance has a better expression. The first sound is more distinct; at the mamma both sounds can be heard, although feebly; pulse 84.-Wine, twelve ounces; decoct. of senega, and carb. of ammon.; dry cupping between the shoulders. 13. Bronchitis continues. Both sounds are now distinctly audible under the mamma and below the sternum.-Wine, eight ounces; repeat the rest. 14. Slept well; some aphonia, with tenderness of the trachea on pressure ; countenance flushed. The impulse of heart just perceptible; sounds distinct, still feeble; pulse 92.-Wine, eight ounces; blister to throat. 15. Bronchitis less ; passed a good night. Both sounds of the heart are proportionate; pulse 82.-Wine, six ounces. 16. Bronchitis subsiding in the right lung, but engaging the minute tubes of the left to a considerable extent. Both sounds proportionate and distinct; pulse 88.-Wine, six ounces. 21. Impulse of the heart perceptible; the sounds natural; pulse 60.-Dry cupping; senega mixture, with antimony. 24. On this day he was pronounced convalescent. PETECHIAL FEVER.-DIMINUTION AND TEMPO-RARY ALTERATION OF THE FIRST SOUND OF THE HEART.-RECOVERY. Thomas Devereux, admitted into hospital on the 23rd of May, the eighth day of fever. Petechiae plentiful, but of healthy colour; respirations hurried; complains of cough, which is accompanied with a frothy mucous expectoration; bronchitic rales are only heard in the upper portion of the right lung, —is very low; pressure on the abdomen gives pain ; great thirst ; the impulse of the heart is scarcely perceptible ; the sounds are proportionate, but feeble ; pulse 112.-Ordered six leeches to the epigastrium; castor oil, three ounces, in emulsion, with tinct. opii, three minims. May. 24. Complained of intense headach yesterday evening, which was relieved by epistaxis ; bronchitic rales very intense ; ; breathing laboured ; respirations 40. Sounds of the heart are feebler than yesterday ; pulse 116, fuller and stronger.-Wine, six ounces ; cupping to eight ounces ; blister over the heart. 25. Bronchitic rales not so intense; respirations 48; countenance more animated; ; abdominal tenderness completely gone; had slight epistaxis yesterday evening; some headach; pulse 10S; sounds of the heart somewhat louder over the apex ; impulse perceptible.-Omit wine; leeches to the temples. 26. Three leeches were applied, and gave great relief; respirations 48 ; slept well. The Dulse taken earlv in the morning, was 108; later in the day, 116 the sounds of & p o u n d ; the left cavities of the heart are exceedingly feeble, at the apex the first sound can be distinbuished, but at the mamma only the second is heard; the superiority of the second over the first is also perceived over the right cavities ; impulse just perceptible.-Effervescent mixture. 27. Slept well; bronchitis better; complains of stuffing in his head ; countenance to-day is more flushed ; had slight epistaxis yesterday evening ; respirations 44 ; pulse 100, soft and compressible ; the impulse of the heart is perceptible ; the sounds are feeble, the second still predominates over the first.-Omit mixture; porter, a pint; arrowroot diet. 28. Had slight epistaxis yesterday evening ; slept well. The sounds of the heart are yet feeble, the second predominating over the first; pulse 96, good strength.-Senega mixture. 29. Respirations 28, easy; no headach ; slept well. Sounds to the left of mamma very weak, distinct however; much stronger to the right.-Continue. 30. Respirations 28 ; tongue clean and moist; skin cool; slept well; countenance improved ; still has slight bronchitis ; pulse 76, soft; phenomena of the heart as before. -Continue ; porter, one pint. 31. Much improved. Impulse of heart perceptible; the sounds over the left cavities are stronger, the two sounds being now proportionate.-Porter, one pint. June 1. Pulse 60, natural ; the sounds of the heart are stronger; impulse perceptible. , -Porter and beef-tea. 8. Convalescent.
doi:10.1016/s0140-6736(02)80011-3 fatcat:f2uhu6bshvgytlg6oqixfxk4we