Vexation

“ The respectability of Mr. Vholes has even been cited with crushing effect before Parliamentary committees, as in the following blue minutes of a distinguished attorney’s evidence. “Question (number five hundred and seventeen thousand eight hundred and sixty-nine) : If I understand you, these forms of practice indisputably occasion delay? Answer: Yes, some delay. Question: And great expense? Answer: Most assuredly they cannot be gone through for nothing. Question: And unspeakable vexation? Answer: I am not prepared to say that. They have never given ME any vexation; quite the contrary. ”

“ VESICULAR EXANTHEMA OF HORSES. Definition: Vesicles usually on external genitals, with fever and infection. Causes: Contagion by coition, clothing or stable utensils; inoculated on man or cow, resembles cowpox, but a first attack does not always immunize a stallion; inoculable on sheep, goat and pig. Symptoms: Incubation one to six days; local redness, heat, swelling, tenderness, papule, vesicle, pustule, scab, desquamation, depigmentation on genitals or in sucklings on mouth, lips, nose; may extend to mammary and inguinal regions, with swelling, stiffness and constitutional disturbance. ”

“ Great exhaustion at times supervenes, and if the joint is an important one, the horse lies or falls and is unable to rise.
Treatment.—In small puncture wounds the immediate application of a vesicating ointment has given good results, but when infection has taken place to such extent that the animal manifests evidence of intense pain, and lameness is marked and local swelling and hyperesthesia are great, vesication is contraindicated. In such instances the exterior of the wound and its margins should be prepared as in similar affections of other joints. ”

“ How long time must the Vesicatory continue on the Part?
The Blisters are generally rais'd by 'em within the space of five or six Hours; yet this Operation depends more or less upon the fineness of the Skin; and when the Bladders or Blisters appear, it is requisite to deferr the openning of 'em for some time, to the end that Nature may have an Opportunity to introduce a new Scarf-Skin, by which means the Pain may be avoided that would be felt, if the Skin were too much expos'd to the Air. ”

“ One must press tightly or even bind fast the finger, the hand, the arm, above the wound, in order to prevent the passage of the venom into the blood. The wound must be made to bleed by the exercise of pressure all around it; it must be energetically sucked to draw out the venomous liquid. I have explained to you in speaking of the bee, and I now repeat it, that venom is not a poison. It will not act, however powerful it be, unless it mixes with the blood. ”

“ Lastly, it has been proved of nux-vomica, that if the extract be thrust into the paw of an animal after a ligature has been tightened round the leg so as to stop the venous, but not the arterial circulation of the limb, blood drawn from an orifice in a vein between the wound and the ligature, and transfused into the vein of another animal, will excite in the latter the usual effects of the poison, so as even to cause death ”

“ On the arms, it has the appearance of measles; on the hands, it is of a deep scarlet, with central vesicular elevations; on the legs is slight; tongue loaded and yellow, except at the borders, which are clean; pulse natural; complains much of pain in the back and sickness of stomach.
30th. Eruption covering the face, vesicular on a deep red ground with some tumefaction; rising vesicular on the limbs with scarlet bases. Tongue smooth and shining anteriorly, and with vesicles on it. Throat sore. Salivation. Pulse small and feeble. Has had menorrhagia since her admission into the hospital. ”

“ ALL venomous creatures act in the same way as the bee, wasp, and hornet. With a special weapon—needle, fang, sting, lancet—placed sometimes in one part of the body, sometimes in another, according to the species, they make a slight wound into which is instilled a drop of venom. The weapon has no other effect than that of opening a route for the venomous liquid, and this is what causes the injury. For the poison to act on us, it must come in contact with our blood by a wound which opens the way for it. ”

“ But if the defluxion be of a very acrid nature, we must abstain from venesection, and have recourse to the food and remedies formerly described when treating of Catarrh, and such as are now to be mentioned. When the spitting of blood proceeds from cold, the chest should be warmed, along with remedies which are of a desiccative nature; and we must give the medicine from two peppers, with the trochisk of amber. Those who bring up blood from the respiratory organs, owing to rupture or anastomosis of the [485] vessels, are to be bled from a vein, unless the discharge of blood be great. ”

“ When a clot of blood obstructs the vein he directs us to squeeze it out, or to dissolve it with oil or vinegar. When coldness of the body, occasioned whether by the temperature of the air, or the nature of the disease, prevents the flow of blood, he recommends fomentations and frictions. When a piece of fat or flesh blocks up the opening of the vein, he says there is no remedy for it but to cut it out or push it aside. When the object is to produce a sudden depletion he directs us to make a large incision in the vein, but a small one when it is intended to procure revulsion. ”

“ When one pricks oneself [347] with a very fine needle the pain is of no consequence and passes almost immediately. Well, the prick of a needle, insignificant in itself, can be made very painful indeed if the little wound is poisoned with venom from a bee or a wasp. ”

“ Symptoms. The attack is sudden, the skin around the pastern becoming red, warm, swollen and tender, with the formation of vesicles, isolated or confluent, which rupture and discharge a serous exudate that dries up into crusts and scabs. Lameness is a marked symptom and in bad cases the swelling and pain are such that the foot may be habitually raised from the ground and rested only on the toe. ”

“ From this source proceed two large veins, which branch into the fore-part and the back of the body, and which, spreading out in a series of branches, convey the vital blood by other smaller veins over all parts of the body. This is the only one271 among the viscera that is not affected by maladies, nor is it subject to the ordinary penalties of human life; but when injured, it produces instant death. While all the other viscera are injured, vitality may still remain in the heart. ”

“ Normal Clinical Course.—After primary vaccination in man there is a stage of incubation lasting for from forty-eight to seventy-two hours; a papule then develops, and by the end of the third or fourth day this has begun to show umbilication and a vesicular structure. When fully developed, about the sixth day after vaccination, the vesicle is distended and pearly in color. On the seventh or eighth day the areola develops,—i.e., the skin about the vesicle becomes hard, sensitive, and red, the redness extending a variable distance, not usually more than two inches from the edge of the vesicle. ”

“ The Venom that falls upon the Skin, is not so mischievous as that which enters into the Stomach, or is communicated by a Wound. “Yea, the Venom of a Viper, in itself, is not mortal to a robust and strong Body; and tho’ very unhappy and mischievous Accidents attend it, as Convulsions, Vomitings, &c.” ”

“ In the sea-scurvy there exists an inactivity of venous absorption, whence vibices and petechiæ, and sometimes ulcers. As the column of blood pressing on the of origins of the veins of the lower extremities, when the body is erect, opposes the ascent of the blood in them, they are more frequently liable to become enlarged, and to produce varixes, or vibices, or, lastly, ulcers about the legs, than on the upper parts of the body. ”

“ The animal regained its appetite, eat and drank freely, and went to sleep. The day following, it appeared nearly well. On the third day, three drachms of the same pus were injected into the opposite vein; after the lapse of a certain time, there occurred, as in the first instance, faintness, vomiting, and frequent desire to pass urine; twelve hours after the injection, frequent liquid, white, and very fetid motions were passed, and the animal died at the expiration of twenty-four hours. On opening the body, no alteration was found either in the intestines or other organs. ”

“ Sharp and pointed bodies are especially liable to be entangled in the cells of the reticulum; so that this viscus is the most common seat of the resulting trauma. Around this there occur hyperæmia, exudation, thickening and centrally ulceration, which may lead into a fistula or abscess, confined it may be to the wall of the viscus, or continued into the surrounding organs. In this way may be implicated, the liver, the spleen, the diaphragm, the abdominal or thoracic walls, the lung, the pericardium or the heart. The pus is always fœtid and usually mixed with alimentary matter. ”

“ By which (he saith) it is manifest, that solid bodies sufficiently great, have penetrated the Stomach, the Bowels, the Womb, the Caul, the lower Belly, the skin upon the inside of the Ribs, the Bladder, Membranes (he saith) impatient of so great a wound. That is to say, that Knives have been transmitted through these Membranes without wound, which is equivalent to the penetration of dimensions made in nature without the help of the Devil. And that an human body may be drawn through a small hole, through which a Cat might only pass, but not through a Wall. ”

“ The initial precautions, binding to prevent the diffusion of the venom, pressure to make the poisoned blood flow, hard suction to extract the venomous liquid, concern us personally, and all that must be done instantly. The longer it is put off, the more aggravated the evil. When these precautions are taken soon enough, it is seldom that the viper’s bite has injurious consequences. ”

“ The expansion of the abdominal viscera, or the bowels, is also prevented by the same cause.
In some instances, when the body is that of a stout, fleshy person, or especially when some length of time has elapsed from the time of death until the undertaker has been called in, and particularly if the body has been reclining in a horizontal position, the face, neck and shoulders, will be found highly congested [Pg 40] with blood; the face, in fact, may be swelled and of a purple appearance, owing to the extravasation of blood into the capillary vessels under the skin. ”

“ In poisoning by the venoms of Viperidæ, the hæmorrhagic phenomena appear at the outset, and are more intense. Death is always preceded by a period of asphyxia, indicating that the bulbar nuclei of the pneumogastric nerve have become affected. At the autopsy, however, the blood, instead of remaining fluid, is always 172 found to be coagulated into a mass in all the vessels; it afterwards gradually becomes redissolved in six or eight hours, and then appears laccate, as after poisoning by Cobra-venom, but darker.
All mammals exhibit the same symptoms after inoculation with lethal doses of venom. ”

“ The fluid continues to increase in amount until the papule is converted into a little blister or vesicle. As the change is going on, the height of the papule grows less and less, and when vesiculation is complete we have a broad, flat, umbilicated vesicle with a firm, dense base. ”

“ The first symptoms indicative of the approaching efflux of blood occur on the Thursday, generally about noon. On each of the pink surfaces already described on the hands and feet, a vesicle is seen to commence, and to rise little by little. When completely developed, it is a rounded hemispherical prominence on the surface of the skin; its base is the same size as the pink surface on which it rests—that is, nearly an inch long, by a little more than half an inch broad. This vesicle is formed by the epidermis detached from the dermis, and elevated as a half sphere by serous liquid within. ”

“ Although the mode of performing venesection be known to everybody, yet, in order that no part of surgery may be omitted, and for the sake of its technical distinctions, it must not be overlooked by us. The first object then in venesection is the evacuation of a fulness of blood. It has been shown that fulness of blood is of a twofold nature: first, with regard to the strength, although the veins do not appear full, in which case those affected soon become weak and enervated, nature not being able to support, as it were, the load ”

“ When incised the tissues are found to be gorged with blood, and of a black or dark red color; they break down under pressure into a bloody pulp, and from the wound flows a bloody fluid which may be red in the early stages, black in the advanced, and frothy in the latest. Where the connective tissue is very loose and abundant, the bloody extravasation is surrounded by an extensive straw colored œdematous infiltration. The swelling is sometimes single, but more frequently several appear and become confluent. The lymph glands in the vicinity become greatly enlarged. ”

“ The epithelium may separate from the stratum basale, leaving a red lesion with shreds of torn epithelium. Vesicular fluid may leak through the stratum corneum without the formation of a true vesicle (Seibold and Sharp 1960) . Since vesicles are most often seen at the site of mechanical stress, they usually rupture quickly, leaving a red erosion. Often, lesions are contaminated with dirt and debris (Fig. 25.2) , resulting in infection with opportunistic bacteria. ”

“ Bruises of the abdomen are apt to be followed by inflammation of the contained parts, particularly of the serous membrane. Occasion439ally lacerations of the viscera, both solid and floating, but more frequently of the former, are produced by bruising or squeezing of the abdomen, as by a blow, or by a heavy body passing over; they may also follow a violent concussion of the parts by falling from a height. The liver is the organ most frequently torn, and death is commonly the result, rapid, and principally from hemorrhage. The laceration is generally on the convex surface ”