Acquired haemophilia is rare and potentially fatal, with a mortality of 20% if left untreated. There is a strong association with other autoimmune diseases. This report describes a patient with rheumatoid arthritis, vitiligo, and bullous pemphigoid where the diagnosis of acquired haemophilia was made after an extensive bleed into a bullous lesion in the buccal mucosa. This case highlights some of the potential complications of acquired haemophilia and its treatment.
and such as I have adopted. I have used chloroform in one case of delirium tremens, which was quite as extreme as this, and with success. I applied a larger quantity than that said by Mr. Teale to have been used. I have known it given with very great success in other cases. I consider, after other remedies have failed, it is giving the patient the last chance. It is a curious fact, that in delirium tremens the virulence continues while the pulse fails. In the case I treated, the patient was extremely violent, and we held him down and gave him the chloroform. The spasmodic convulsions were very violent, and he had an epileptic fit at the time, but if he had died under the application, we should have applied it, for he had no other chance of life. After a while he slept about twenty-four hours, and to revive him we gave him some brandy, and he quite recovered. Opium treatment had been carried as far as it could safely be done, the patient having been five days under the attack. Mr. Teale saw this case for me in the first instance, in consequence of my being out of the way at the time ; it was a very striking case.I consider it was justifiable to use chloroform in such a case, though the man might have died, as it was giving him the last chance.The Coroner, in commenting upon the evidence, said the only question for the jury to decide was, whjat was the cause of this man's death ; and in deciding that, they would have to be guided by the evidence of the medical gentlemen. As regarded Mr. Teale, all he did was with the best intention. He had bestowed as much pains as he possibly could, applying first the usual remedies without any good effect, and then, without any want of ordinary skill and care, he applied chloroform to the patient, who died shortly afterwards. According lo all the evidence'given, death resulted from delirium tremens combined with the application of chloroform ; but the leading cause was the former. With respect to the use of chloroform, as on every other point, there would be differences of opinion, but it was in evidence that the use of it was approved of, and it had been successfully adopted by Mr. Hey in a specific case. True, Mr. Price said he would not adopt it without consultation, and, therefore, if he erred at all, it was on the side of caution ; but he did not say he would not apply it in such a case. Under all the circumstances it did appear to him that no blame was attached to Mr. Teale or to any body else, and the only safe and proper conclusion the jury could come to was, that the man had died of delirium tremens.The jury conferred together for a short time, and then the foreman stated that they were unanimously of opinion that the deceased bad died from delirium tremens ; and they thought it due to Mr.
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