Monday, April 26, 1841.

201 the " Edinburgh Medical and

Surgical

Upon inquiry

into the

previous history

of

Joarnal" (No. 134), with observations on this case, Mr. Hutchinson learnt from her many points of practical interest. Amongst mother, a pew-opener, that the patient had to the early at which stiffness after death took

others, attention is directed

period

place. " The rigidity of the muscles complete in this case one hour and a

was

half after death ; and the ’vital heat’ was evident to the senses after the commencement of the rigidity." It appears to be extremely probable, that cadaveric rigidity of the body occurred immediately after death, more frequently than might be generally believed, and that it might do so independently of any necessary connection with the vital heat. The case which he had submitted to the society appeared to strengthen the opinion, and those which he had adverted to corroborated it.

Monday, April 26, 1841. THE

Dr. CLUTTERBUCK, President. GRAVE-YARDS OF LONDON, AND

THEIR

EFFECTS.

Mr. HUTCHINSON related the following He was called on Monday morning, the 15th of March, to attend a girl, aged 14, who was suffering under the following symptoms :-Pulse 130, weak, and easily compressed ; tongue dry, and covered with a dark-brown fur ; skin burning hot; breathing much oppressed. She complained of great thirst, of pain in the head and back, and soreness over the extremities ; there was extreme restlessness and prostration of strength ; great anxiety of countenance ; and low, muttering delirium ; bowels coscase.

tive ; fered

urine high-coloured. In fact, she suffrom all the symptoms of typhus

gravior,

or

putrid fever, in a formidable de-

gree. Leeches were immediately applied to the temples; saline medicines were administered internally ; and vinegar and water applied to the head. The next morning, the 16th, she had passed a had night, but the pain in the head was much relieved. The other symptoms were nearly the same. A blister was applied to the nape of the neck. On the 17th she had passed a better night, but still complained of soreness over the body and extremities. A drachm ofvinum colchici was added to her saline mixture. In the evening her catamenia appeared for the first time. On the 18th she was much better, but complained of a troublesome cough, which left her in the course of a few days, and she then gradually recovered. On the 30th Mr. Hutchinson saw her again; a rash had a few days previously made its appearance, much resembling the nettlera3h, and attended with intense itching over the body and extremities. This was relieved in less than a week by warm bathing, and the use of some saline aperient; but it has continued more or less until the pre-

sent time.

recently returned from school ; and on the Friday previous to his seeing her had assisted, during three hours, and on Saturday during one hour, in shaking and cleansing the matting of the aisles and pews of a large city church ; that this work was generally done once in six weeks ; that the dust and effluvia which arose had a very foetid and offensive odour, very unlike the dust which collected in private houses, and had the effect of always making her (the mother) ill for, at least, a day afterwards ; and that it used to make the grandmother of his (Mr. H.’s) patient so unwell, that she was compelled to hire a person to perform her duties. His patient felt poorly on the Friday after her exertion, and complained of severe rigors, pains in the head, and other symptoms of fever. The church in question was situated in the centre of a small buryingground, which had been used for the interment of the dead for centuries ; the ground was raised much above its ordinary level, and was strongly saturated with the remains of humanity. There were vaults beneath the church, and persons buried in them had their coffins leaded. In this case Mr. Hutchinson had thought that the fever had arisen from an animal effluvia which had collected in the mats, and had come into contact with his patient during the time shewas assisting in shaking them. She had, however, previously been exposed to cold, and had used large quantities of water in washing out the church, but he could scarcely think it possible that so severe and so rapid a disease could have arisen from cold alone. He should be glad of the opinions of the members in reference to the influence which the effluvia had in the production of the fever. A lady he knew, who was in the habit of visiting the church in question, had always headach afterwards. Mr. PILCHER thought the facts detailed were of so much importance, that it was the duty of Mr. Hutchinson to communicate them to the Home Secretary, who was at present engaged with a Bill, having for its object the better drainage of the metropolis, the churchyards of which were also in such a defective state, that it would be of great service to the community if burials within the metropolis were altogether done away with. Mr. Hutchinson’s case was but a solitary one, but it corroborated other facts of a similar kind which had been brought before the public, all tending to show the danger of burials in crowded neighbourhoods. He thought that the effluvia from the mats had been sufficient to produce the fever. Dr. JOHNSON thought that in Mr. Hufch-

inp5on’s

case

there

was not

sufficient evi.

202 dence to show that the fever was the resultt for typhus fever was rather mat-shaking. If the effluvia sup- increasing in London.

diminishing than

of the

to have collected in the matting were to be injurious, it was more probable that it would exert its influence on the

posed likely

Mr. LEESE had lately attended a lady, whom he was obliged to prohibitfrom going to a church in the north-west part of Lon. don, in consequence of the injury she had sustained repeatedly, from the effluvia pro. ceeding from the vaults beneath the build. iug. These vaults were nearly full of coffins, piled one above another, some of them hav. ing given way from the weight imposed on

who frequented the church, when there would be also present the effluvium from living bodies, and an increase in the temperature of the building ; the case of the lady referred to by Mr. Hutchinson was by no means an uncommon one; he (Dr. Johnson) had seen many such cases, both in the them. visitors to the church and the frequenters of the theatre, or other crowded assemblies. Mr. PILCHER related the following case of He could not think that the effluvia from OBSTRUCTION IN THE THROAT. dead animal matter alone produced fevers, if it did, why did not fevers originate in the The patient was a widow, aged 43, and without children. A little before last Christ. dissecting-room ? Mr. DENDY thought that every philan- mas she first experienced an uncomfortable thropist would be anxious to adduce evi- feeling about the throat; for this she apdence that might tend to do away with plied to a medical man, who examined the burials in cities and towns, and to the re- part affected, but could detect no tumour. moval of bodies to cemeteries on the out- Shortly afterwards she became affected with skirts. The case of Mr. Hutchinson was an considerable difficulty in deglutition and addition to the many given to the public by respiration, and a tumour was then observed Mr. Walker, in his work on Grave-yards. to be forming on the right side of the lower Although he (Mr. Dendy) did not admit part of the larynx, and apparently exerting that animal effluvia could produce fever by pressure on the larynx, trachea, and oeso. itself, in all cases of which he thought there phagus. This tumour was followed soon was a predisposing cause, such as depres- after by a similar growth on the opposite sion at work, yet he could not think that side of the larynx. These growths gradually there was any parallel to be drawn between increased in size ; the difficulty of respirathe effects of the effluvia of the dissecting- tion and deglutition also became gradually room and those of the grave-yard ; there augmented, and stiffocation was threatened. was abundant evidence to show that the Various remedies were tried, but without effect: Dr. Johnson saw her, and suggested latter were highly injurious. that tracheotomy might preserve her life a Dr. JOHNSON referred to the removal of the bodies from the sepulchre of the Inno- very short time, and he suggested the emcents at Paris, from which no ill effects fol- ployment of injections of beef-tea with lau. danum three times a-dav : this kept her alive lowed. for some time. He, Mr. Pitcher, saw her Mr. DENDY was not aware that no ill abouta week before her death. He found effects had followed the proceeding alluded to be situated beneath the to, but he was fully aware that precautions sterno-mastoid muscles, and apparently presstaken to were avoid evil consequences, on each side of the larynx, trachea, which would, moreover, be prevented by ing and oesophagus. She then breathed the absence of fear in the persons employed. pharynx, with great difficulty, but spoke in a voice When the plague raged at Malta, the cou- I louder than a whisper; but the exertion of rageous governor and a party of soldiers speaking, or any other excitement, threatremoved the dead bodies with impunity ; ened immediate suffocation. Tracheotomy whilst others, more fearful, took the was but not urged; she would suggested, disease. not accede to its performance. The tumour Mr. PILCHER said that a great quantity of was cut down upon, and shn expressed her. adipocere surrounded the bodies which self slightly relieved afterwards; the tumour were removed from the sepulchre of the In- was examined through the incision which nocents, and hence any effiuvium was pre- had been made, and was found to consist of vented. The dissecting-room did seem to a firm, hard, fibrous gland. Although this originate fevers, for towards the end of the patient had taken no food by the mouth for session fever was by no means uncommon a very long period, she had, daily, a good among the students ; it was true, however, faecal evacuation. She sunk. After death, that many of them were in a depressed con- the enlarged glands were found to have dition from over-work, a peculiar mode of exerted no pressure either on the trachea or living, and perhaps from the fear of the col- the other parts in the neighbourhood, neither lege before their eyes. did they press upon any nerves or vessels. Mr. PROCTER thought that metropolitan The difficulty of breathing, then, bad not churches were not so pesttferuus as Mr. depended on the tumours. On laying open Hutchinson’s case would lead us to infer, the pharynx, however, the cause of death

people

thetumours

203 in question hot-air and were found to be very much thickened by a vapour bath ; and also for the administration deposit of a scrofulous kind of matter. This of medicated baths. It appeared from a rehad so narrowed the passage, as to allow port of Dr. Emery, of St. Louis, that the apscarcely any space for the transmission of,. paratus had been much employed in that even, a few drops of fluid ; and in one part hospital in the administration of sulphurous had so thickened the anterior part of the and vapour baths with complete effect in a canal, that pressure was exerted upon the great number of cases of psora and prurigo air-tube, the caliber of which was found senilis. The apparatus may be seen at to be very much diminished. The posterior Weiss’s. Dr. BIRD remarked, that the bath had been and some portion of the anterior parts of use in Guy’s Hospital for several months: the larynx exhibited the same deposit, as did the arytenoid cartilages, and the chorda; Up to the present time, it had only been emvocales. The lungs were healthy, and faecal ployed for the administration of hot-air and matter was found in the intestines. The vapour baths. It completely answered the external tumours had been, evidently, merely purpose for which it was intended, and had been found of great service in cases of negsympathetic. Dr. JOHNSON had seen the patient twice ; lected rheumatism. Mr. ADAMS brought before the notice of although he did not decide that the tumours were the cause of the obstruction, he was the society, a new mode of treating defective convinced that this was dependent upon a vision-a kind of functional amaurosis, and mechanical cause, and that she must shortly depending possibly (?) on the morbid condie of one or both. He suggested tracheo- traction of the recti muscles, by which prestomy, as a means of possibly saving life for sure was exerted on the optic nerve. The a short period. operation consisted in the division of the recti, in the same manner as they were divided in strabismus. He had found the WESTMINSTER MEDICAL SOCIETY. proceeding to be of great service in several cases, the sight in some cases being instantly restored. There was no squinting present 1841. Saturday, April 17, in the cases in question. Mr. GREGORY SMITH, President. was made manifest; the sub-mucous, mus- ments, that the apparatus cular, and sub-muscular tissue of this canal answered all the purposes of

a

in

HUMBUG

OPERATIONS FOR STANIMERING.— NEW BATH.-DEFECTIVE VISION.

MR. Snwv directed the attention of the President to the dedication of a pamphlet on

stammering, published by Mr. Yearsley, and consisting of the paper on the subject, which lie read before the society. The dedication in question was, "To the members of the Westminster Medical Society, for the honour they did the author, in inviting him, though not a member, to read a paper to them on &c. the subject of his discovery," (!) &c. Now he, Mr. Suow, wished to inquire if Mr. Yearsley had been invited to read a paper, as stated in his dedication. He would therefore beg the secretary to refer to the minutes, to determine if such invitatioti had been given. Such a statement as that put forth by Mr. Yearsley was likely to injure the respectability of the society, as it might lead the profession and the public to imagine, that the members in general had countenanced the operations practised for stam mering. On referring to the minutes, it was found that Mr. Yearsley had not been invited, but, by an act of courtesy in the society, had been permitted, although merely a visitor, to read the paper in question. Several members deprecated the misstatement made by

Mr. Yearsley. Dr. SAYER made

some

observations

on

Saturday, April 24, 1841. The society held its last meeting for the session this evening; the proceedings, although interesting in themselves, were not available for a report. It was announced that the funds of the society were in a prosperous condition, and that during the past session seventeen new members had been enrolled. The society adjourned until the third Saturday in October. ANNIVERSARY OF THE

PARISIAN MEDICAL SOCIETY. THE members of the Parisian Medical

Society gave their annual dinner, on the 3rd instant, at the Cadran Bleu, Boulevard du Temple, at which Dr. Mott, of New York, the president of the society for the present year, took the chair. Amongst the invited guests were, Monsieur Orfila, the dean of the Faculty of Medicine, of Paris ; Monsieur Louis, and Monsieur Piorry, professor of the Faculty of Medicine. Amongst the members of the society, and other distinguished gentlemen who take a warm and lively interest in its scientific proceedings, I we noticed Sir Augustus West, M.D., Mon the sieur Ricord, Drs. Rutherford, D0ngJas,

After dinner, the Preof the hot-air bath, briefly al- Shrimpton, &c. &c. luded to in a report of a late meeting of the sident proposed, in succession, the healths of

employment

society.

It

appeared

from

published docu-

his

Majesty Louis Philippe, the King of the