Case of Chronic Farcy. Reported by John H. Weir, M. D.,
Philadelphia.
(-----) Novi, aged 36 ; was never sick in his youth—of delicate
constitution, without bad health; never has had any eruptions on
his body, or inflammation of eyes or nose. His parents died of
diseases having no relation to the one in question. He has
heretofore been a stable boy, and the stable to which he was
attached contained 26 horses, eight of which were glandered. He
was specially charged with the care of these glandered beasts,
and was often obliged to wash their noses and lips, that the dis-
ease might not be remarked when out of the stable.
Novi slept in the stable, which was damp and unhealthy ; he
had done so for three years. He has noticed for some time past
that the horses were frequently sick, and from his description, it
appears that most of them were affected with chronic farcy. He
does not remember at what time exactly he became unwell, nor
what was the exact cause of his disease. He ascribes it, however,
to a kick on the axilla, which pained him so much as to confine
him to bed for a short time. The pain w7as relieved by bleeding
and leeches. He was soon much better, and able to attend to his
work.
On the day after commencing his usual work he became sud-
denly so faint as to be unable to walk, and was soon obliged to
seek his bed. This faintness was accompanied with nausea,
slight vomiting, but no perceptible fever. Two or three days
after he perceived a slight running from the nose. He had at
the same time considerable pain in the pharynx, with slight diffi-
culty in deglutition. No headach. His treatment at home was
confined to simple ptisans and foot baths. A short time after
having taken a foot bath he felt a violent pain, both in his arms
and legs. The next day his legs were covered with tumors,
which increased rapidly.
From the commencement of the attack the patient has been
confined to bed.
On the 19th August, patient entered Hotel Dieu, service of
M. Guenau de Mussy.
At the first examination he presented the following appearance.
General emaciation; great prostration; pulse 70, easily com-
pressed ; slight heat of skin; appetite pretty good ; tongue red ;
but little headach. Patient sleeps soundly; perfectly free from
any starting in sleep.
On both anterior and posterior pillars of the throat there is
much redness. The uvula is of a deep red, swollen, and clotted
with whitish plaques; the patient is continually sniffling, spits
rarely, and always pure saliva. Nothing remarkable in the ante-
rior portion of the nasal fossae, which are entirely dry. The
excretions are normal and regular. There exists on different
parts of the body a large number of fluctuating tumors; one on
the lower part of the left thigh, of the size of a hen’s egg ; one
on the inner side of the right thigh; one smaller, on the calf of
right leg; one on same leg above the last mentioned, and more
deeply situated; another below and around the tendo Achillis ;
one at the inner and inferior portion of the right thigh. The
right calf is extremely painful, somewhat reddened, tense and
fluctuating, apparently filled with pus. Under the right pectoral is
major, precisely at the point where the leeches had been applied,
is another and large abscess.
These tumors are painful to the touch, and some of them slightly
reddened. There is no appearance of pustules on the body.
Patient has never had any severe wounds or cuts; never has
taken snuff, and has stopped smoking for several months. There
is no pain in the abdomen ; no cough. The chest is perfectly
healthy, with nothing abnormal about the heart. No abscesses or
pustules are to be found in the hair; and no engorgement of the
lymphatics can be found in any part of the body. Both feet, the
right one particularly, are the seat of a very tense and painful
oedema. Motion in the feet and ankles almost destroyed.
JI. Friction of Mercurial Ointment over tumors, with Dover’s
Powder, grs. xii.
In the evening no change.
20th. Patient slept quietly all night, sweating profusely this
morning. The symptoms are generally the same. Pulse 76;
tongue dry and red ; no expectoration ; the tumors are all painful,
with the exception of the one over the pectoralis major ; the urine
is of a dark color, not muddy; there is no deposit on standing,
and the odor is natural; there is a perceptible diminution of
quantity, and when treated by nitric acid, there is a slight whitish
precipitate, which, when heated, leaves no residue.
From the 20th to the 31st the symptoms continued the same ;
the abscesses, as they formed, were opened, and discharged freely
a grayish pus, with the consistence of cream and colored with
blood. New abscesses continued to form, and, in consequence,
the strength of the patient diminished rapidly. The appetite was
gradually lost, and the urine decreasing daily in quantity, becom-
ing, on the 31st, somewhat purulent.
3d September. The urine is yellow, slightly tinged with red,
alkaline; no precipitate from nitric acid, and contains a sensible
quantity of albumen and salts of lime—but little uric acid.
7th. Patient died this morning without pain, and with mind
perfectly clear to the last.
At the autopsy all the internal organs were found healthy,
with the exception of the bladder, which showed traces of inflam-
mation, and in some places slight erosion of the mucous coat.