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Title: The intestinal antiseptic treatment of Ceylon sore mouth
Author: Drummond, John Russell
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1894
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As a medical practitioner in the Tea districts of Ceylon,I have found that Cases of Ceylon Sore Mouth show themselves from time to time among Europeans in the higher and cooler elevations,from 3,500 to 5,000 feet above sea level. Literature: The medical literature dealing with this disease is scanty, and difficult to get at. I have searched in "Diseases of Tropical Climates", Surgeon General MacLean, London, 1886, and found no record of it; also neither neither do Eagge's "System of Medicine" 2nd Edition '88, nor Parke's "Hygiene" 7th Edition '87,nor Q,uain's 'Dictionary of Medicine' '88, make any mention of it. But in a small popular treatise called,"Disease among Malabar Coolies and Europeans in Ceylon", Kandy, 1866, written by John Thwaites, M.D., there is a short paragraph, which says, "a prominent feature of low remittent fever is its almost invariable, tendency to end in the well-known 'Sore Mouth' of Ceylon. It is not, however, until after a long continuance of the fever that this result takes place. As the determined continuance of the fever arises from either already formed or commencing disease of the liver or spleen,so the first symptoms of 'Sore Mouth' should be a peremptory warning not to delay seeking professional advice." This succinct paragraph represents the literature on the subject,as far as I can ascertain from the means at my disposal, to gain farther information on the point. Definition: It is a clinical condition, which is invariably preceded by a long series of attacks of some gastro-intestinal irritation, such as stomachic dyspepsia, congestion and inflammation of liver,in all its forms, duodenal dyspepsia, enlargement and inflammation of spleen, dysentery, typhoid, tropical diarrhoea, inflamed haemorrhoids and anal fissure,and other intestinal lesions, in each case, in conjunction with low fever. Cause: It is caused by living in damp,moist atmospheres, in old bungalows (houses) where the wood is rotten or has dry-rot in it, and where the situation of the bungalow is unhealthy, from the proximity of swamps, or stagnant water. The fact, that many people have to live on bad or a poor quality of food, year in, year year out, no doubt causes the condition in those whose system has been undermined by previous sequence of gastro-intestinal illnesses. It is to be noted, that among Europeans in a tropical colony like Ceylon, by far the greatest proportion of diseases suffered from are, (1) those of the gastro-intestinal tract and its visceral appendages,and (2) those of the renal system. Clinical Features: One marked accompaniment of this disease is nostalgia, which is so strong in a patient, that if he is attacked by it, and wants to go home, he simply must go, or he dies in a short time, with strong melancholic tendencies present. After Ceylon sore mouth has been running its course for some time, in addition to the general ill-health induced,this nostalgia produces a mental peevishness and inaptitude for work. The patient becomes dull, apathetic, querulous and irritable. The incentive to work seems to have gone; the temper is uncertain, so that there is an alternating condition of complacent, listless apathy, and one of impulsive, spasmodic irritability, roused by trifles which previously would not have had that effect. There is a restless craving to escape from present surroundings,it may be to England or to Australia, or often the place wished for is. not specified, but but the desire is simply expressed by the wish to 'get away'. The patient is sleepless,or sleeps at short intervals throughout the night, wakes in the morning,dull heavy and unrefreshed, and during the day sleeps in snatches, to make up for the want of the night's rest. He cannot read even the lightest literature - the effort of concentrating the mind on the subject matter evidently being as tiring to the body as the effort to hold up the book or paper. The patient becomes a regular barometer of the weather: he can tell by his own feelings whether the rain is coming or not, for whenever damp, misty weather comes on, the raw, sore feeling is present in the whole outline of the large bowel,and the melancholic symptoms become intensified. The hypochondriacal tendencies increase day by day, and the patient is a victim to headaches, neuralgias, and other neurasthenic pains, which flit and chase one another about, from one part of his body to another. Aetiology:. As we look more minutely into the aetiology of this disease, we find that it occurs mainly in those those who have spent a long period of their lives in the Tropics. Most patients that I have seen, have lived at least 15 years in Ceylon, some of them longer than that, and seeing that the class of patients affected, are principally Europeans, who have come to the Island as adolescents, the age after which it may come on is from 35 onwards. Of course the disease may show itself before that age, if. the patient's environment as to climate, feverishness of district,and indulgence in alcoholic excess, has been too trying for the individual organism. The disease occurs more commonly in women, in the proportion of 3 to 2, and this is due mainly I think, to the fact that, in a tropical country like Ceylon, all the re-productive functions, such as menstruation and child-bearing,tell more upon the general health, and tend to wear out the system, as a whole, more than in England; it is also partly due to the fact that women in Ceylon lead solitary, uneventful lives, and do not take enough exercise; hence the tendency among them to congestion and sluggish liver, with its accompanying dyspepsia and constipation.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
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