ABSTRACT
The Spanish famous writer Leopoldo Alas, also known by the pseudonymous of "Clarín" suffered from two main kind of illnesses: nervous and digestives. Both began early, when he was only thirty two. At that moment, and during all his thirties, nervous ailments were conspicuous, but digestive problems were growing up slow but steadily and became the most serious and even menacing during his forties. Nervous pathology was double: on the one hand, some attacks of migraine with visual disturbances (scotoma), dysphasia and other "indescribable nervous oddities", which happened about 4-5 times per year; on the other, several emotional and vague symptoms, such as melancholia, dejected mood, anxiety, nervousness, etc. Digestive symptomatology, consisting of atonic constipation, intestinal dyspepsia, febricula, and a feeling of being "as a blocked drain", is due--no doubt--to tuberculous peritonitis diagnosed by his young nephew Dr. Martínez. This serious illness was the cause of his death on the 13th June 1901, when he was only 49.
Subject(s)
Famous Persons , Literature, Modern/history , Aphasia/history , Asthenia/history , Constipation/history , Dyspepsia/history , Fever/history , History, 19th Century , History, 20th Century , History, 21st Century , Humans , Intestinal Diseases/history , Male , Migraine Disorders/history , Nervous System Diseases/history , Peritonitis, Tuberculous/diagnosis , Peritonitis, Tuberculous/history , Scotoma/history , SpainABSTRACT
Abdominal tuberculosis was common in the United Kingdom in the 18th and 19th centuries and in the first half of the 20th century. During the 1950's the recognition of Crohn's disease, the use of streptomycin and other drugs, and the pasteurisation of milk led to the virtual disappearance of abdominal tuberculosis in the western world. During the last two decades a new type, mycobacterium tuberculosis hominis, has appeared mainly in the immigrant population, especially in those from the Indian subcontinent. A retrospective review of 68 patients with abdominal tuberculosis is presented. The pathology, diagnosis and management of these cases is discussed, together with the differential diagnosis of Crohn's disease. It is suggested that the immigrant brings the disease into the United Kingdom in his mesenteric glands and that the disease is reactivated or 'revived' at some later date due to some modification of the immune process.
