Meneghelli U G
Clínica Médica da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo.
Arq Gastroenterol. 1996 Jul-Sep;33(3):115-21.
In the present study an attempt was made to analyse from a clinical viewpoint the descriptions in the book "Noticias do que he o achaque do bicho" by Miguel Dias Pimenta (1661-1715), which are considered by some authors to be the first reference to the chagasic megaesophagus and megacolon that appeared in history. In descriptions considered to refer megaesophagus, although dysphagia, the major symptom of this disease, is not recognized, typical manifestations of a irritating, inflammatory or ulcerative condition are identified, not affecting the esophagus but the stomach. In the description considered to refer to megacolon, the signs and symptoms suggest the diagnostic possibility of hemorrhoids and of the "achaque do bicho" itself, and do not recall the clinical picture of the chagasic megacolon in an absolute manner. On this basis, there is no reason to maintain the book "Noticias do que he o achaque do bicho" within the history of the digestive form of Chagas' disease.
在本研究中,我们试图从临床角度分析米格尔·迪亚斯·皮门塔(1661 - 1715)所著的《Noticias do que he o achaque do bicho》一书中的描述,一些作者认为这些描述是历史上首次提及的恰加斯病所致巨食管和巨结肠。在被认为是指巨食管的描述中,虽然未认识到这种疾病的主要症状吞咽困难,但识别出了刺激性、炎症性或溃疡性疾病的典型表现,不过这些表现并非影响食管,而是影响胃。在被认为是指巨结肠的描述中,体征和症状提示了痔疮以及“achaque do bicho”本身的诊断可能性,并未绝对地让人联想到恰加斯病所致巨结肠的临床表现。基于此,没有理由将《Noticias do que he o achaque do bicho》一书保留在恰加斯病消化形式的历史中。