CHOLERA IN THE METROPOLITAN HOSPITALS.

93 to record, but at the time of our last visit of undoubted cholera had recovered. Some circumstances of interest have occurred which bear upon the question of contagion. On the 19th instant a young woman employed as a nurse became affected with the disease, and died on the 24th. We saw her on the 21st, when she seemed likely to do well. She did, in fact, recover from collapse, but sank with symptoms of lung congestion. At first sight this case would appear a discouraging one as regards the disputed question of contagion; but we learnt that although employed by day in the hospital, she slept at night in Chapelstreet, a quarter whence a number of cases had emanated, and where she probably acquired the disorder. A child who had been sent into the attic ward with measles previous to the arrival of the first cholera patients was seized a few days afterwards with symptoms, and died in a few hoursNo case of cholera was actually placed in the same ward with her, but the room she occupied was close adjoining the cholera ward, and she was tended by the same nurse who was employed about the cholera patients. At Guy’s l1o8pital we heard. of a few cases which had been admitted. On the 20th a man who was a patient of Dr. Moxoo. died after eighteen hours’ illness. About the same time a mother and child were admitted under Dr. Rees. The child died shortly after admission. The mother we saw on Monday: she seemed in a fair way to recovery. Her husband had died out of doors. On post-mortem examination, nothing remarkable was found as regards the child’s lungs. The man’s lungs, Dr. Moxon told us, weighed 12g oz. and 15 oz. respectively; and they were considerably engorged with dark blood. All the heart-cavities contained white gelatinous clots. Besides these, we heard of a man and a woman admitted from the Borough Market, who were doing well. At the We8tminster Hospital, a dock-labourer was admitted on the 19th inst., under the care of Dr. Fincham, with symptoms of cholera. Dr. Maclure, registrar, has been kind enough to give us notes of the case. from which we gather that the man’s bowels had been slightly relaxed on the 17th and 18th; but, as there was nothing urgent in the diarrhoea, he had paid no attention to it. He slept in Lambeth Workhouse on the night of the 18th, and was seized with choleraic symptoms at four A.M. of the 19th. At three r.i. he was admitted, and treated with mustard sinapisms to legs and belly, ten-minim doses of sulphuric acid and five of tincture of opium, and a little brandy and water occasionally. At the time of admission there was no lividity of countenance; but six hours afterwards (nine :P.lNi.) his face, hands, and arms were blue and cold. At that time the vomiting had ceased, but the ricewater purging still continued. It subsided, however, during the night, reaction ensued, urine was passed next day, and on the 22nd the man was going on well. The Belleisle, the hulk of a 74-gun frigate which served in the Baltic during the last war, has been lent by the Admiralty as an hospital for cholera patients. She is about a hundred yards from the Dreadnought up the river. Six cases of cholera have been received on board. The first patient was a Russian Fin, aged thirty, belonging to the ship Ukka, which arrived in the river on the 4th inst. Since then he has lived on board the vessel now lying in docks. He is said to have drunk some of the dock water. He was admitted at noon on July 18th in a state of collapse, with a blue tinge of skin. He had no vomiting, either on or after admission. He was purged eight times, and died two hours and a half after admission. A mixture of opium and sulphuric acid was given to him, of which he took two doses. He had besides a quart of beef-tea, and fiveounces of brandy. All that he swallowed remained on nis stomach. A post-mortem examination was made by Mr. Gannon, clinical resident. Great fluidity of the blood was found; tthe lungs were congested ; the bladder was empty, and quite contracted. Fivecases havesince been received, one of which died. The last two cases came from vessels lying in the river near the Commercial and West India Docks. At most of the other hospitals there has been a great amount of diarrhoea, but no cases of cholera, so far as we have heard, been admitted.

is

A Mirror OF THE PRACTICE

OF

MEDICINE AND SURGERY IN THE

HOSPITALS OF LONDON. Nulla autem est alia pro certo noscendi via, nisi quamplurimas et morborum 4t dissectionum historias, tum ajiorum, tum proprias collectas habere, et inter ee eomparare.—MoBGA&ifl -De Sed. et Calls. Morb., lib. iv. Proaemium.

CHOLERA IN THE METROPOLITAN HOSPITALS.

a

melancholy fact

no case

past week cholera has spread in a most malig- Jiant form over the east end of London. The scattered cases ’which wehavealready reported have proved the precursors of an outbreak which has probably not been exceeded in severity in any previous epidemic. As regards the hospitals, the brunt of this attack has at present fallen upon the London Hospital. In this institution, up to the time at which we write, no less than 150 cases of cholera and diarrhoea have -been admitted, and of these 63 have already proved fatal. Al-together, in the week ending Tuesday, July 24th, 2083 persons had received medical treatment for bowel complaints. The first cases of cholera came from St. George’s-in-the-East; but, :as time passed on, the area of diffusion has been extended, and Stepney, Stratford, Hackney, and Old Ford have contributed patients. All the resources of this splendid institution have teen brought into requisition for the reception and treatment of the sufferers. Already eighty-two beds are set apart for - cholera cases; and the committee resolved, at a meeting on Tuesday, that an additional number, amounting to forty-two, should be placed at the disposal of the staff for these cases, if they should be required. The London Hospital deserves well of the public for this prompt and liberal conduct in a time of ,great need. We visited the cholera wards on Saturday and Tuesday last. ’There was no mistaking the severity of type displayed by the - cases. They have been marked by all that intensity which is characteristic of the first cases in an epidemic, and, we regret to say, by the usual amount of fatality. Some have died within nine hours of the attack, others have lingered on in a .state of collapse for several days. Some have rallied from - collapse and succumbed afterwards with symptoms of local congestion in various organs. It is scarcely necessary to say that no effort has been spared by the physicians, Drs. Fraser, Davies, Andrew Clark, and Hughlings Jackson, under whose care the patients have been admitted. No words of praise are too great either for the unremitting care and attention bestowed by the resident medical officers. The sudden influx of -the numerous and severe cases threw an amount of labour upon these gentlemen which only those who have gone through similar experience can rightly estimate. Nothing can exceed the devotion displayed by Dr. James Jackson, the resident medical officer, and Mr. Frederick Mackenzie, assistant medical officer. To help them in their arduous task three additional officers have been appointed,-Mr. George Mackenzie, Mr. Bat1.urst Dove, and Mr. M’Carthy. All these gentlemen Lave worked with an energy and goodwill which entitle them to the gratitude of the public which receives the benefit of their services, and of the profession of which they show themselves such worthy members. Would that we could record an amount of success in the treatment of the cases corresponding to the energy displayed. But here, as is but too often the case at the commencement of an epidemic, the efforts of medicine seem unavailing to check the ravages of this terrible disorder. As regards the treatment adopted, this has WESTMINSTER HOSPITAL. been of various kinds. Calomel in oft-repeated doses of twenty and hot baths have A CASE OF EMBOLISM. grains, astringents, stimulants, vapour been severally tried. Iced water ad liúitU1n has been given in (Under the care of Dr. RADCLIFFE.) every case. In two cases injections of salines were thrown WE are indebted to Dr. Maclure, registrar to the hospital, into the circulation, with the effect of producing immediate, -but unfortunately not lasting, benefit. Transfusion of blood for notes of the followingcase. has been employed also in two cases with a similar result. It F. J-, a pale, cachectic-looking man, aged twenty-seven, DuEiy&

the

have