HOSPITAL OF SICK CHILDREN, PARIS.

526 Under this treatment, aided by diet, the administration of a mineral water for drink, The following cases, reported by the au- &c., the anxiety, cough, and cold sweats, thor, supply additional testimony in favour gradually disappeared. The little patient recovered its strength, and became a fat, of this remedy :A healthy, well-formed child, though of healthy child. delicate constitution, somewhat more than nine months old, suddenly awaked from a HOSPITAL OF SICK CHILDREN, sound sleep with acute screams, and conPARIS. tinued agitated and sleepless. Symptoms of acute fever now set in ; the abdomen and IN proportion as our knowledge of pahead were very warm; and the child dozed with half-closed eyelids; the appetite was thological anatomy becomes more prolost ; severethirst; constant nauseau, but found and exact, a number of nosological no vomitting; the body was covered with in some cases a sweat; and exposure to light produced dis- denominations, representing and in others apure hypothesymptom, single were soon joined by symptoms tress. These of a different nature ; tha expresssion of the sis, disappear, and are replaced by others countenance became altered and anxious ; which have the merit of designating, if not the face pale; the forehead covered with the nature, at least the cause and seat of the cold sweat; the mouth distorted, and the disease. A great portion of the merit of limbs convulsed. No apparent cause could be discovered which might explain acci- this improvement belongs to M. Broussais, dents of so severe a nature. There was no and however regretting that, like most other trace of irritation of the gums ; no excess in inventors of a system, he may have been diet, &c., had been committed. However, carried too far by his active and original as the child lay with its head constantly on we cannot but reflect with pleasure the nurse’s breast, cried out whenever it mind, on the rapid march which the science of was moved, as the bowels were constipated, and the abdomen free from pain on pressure, medicine has made since medical men have fears of hydrocephalus were entertained. begun to trace up symptoms to the organic An antiphlogistic treatment (with the excep- derangements on which they depend, intion of bleeding) was employed,and calomel, stead of contenting themselves, as is still in conjunction with the flores zinci admitoo frequently the case, with combatting nistered internally. On the llth day of the disease, after seve- symptoms as they occur, heedless altogether ral natural stools had been passed, the child of the material lesion from which such symp evacuated a compact mass of foetid slimy toms arise. The foregoing observations are matter, about two inches long, and of the peculiarly applicable to the diseases of thickness of araven’s quill. The child, hitherto without appetite, and children.-Reflect, for an instant, on the careduced to a skeleton, now became vora- valier manner in which diseases of children cious, and although the lightest nutriment and of infants in particular are treated. was administered in very small portions, With some, worms form the primum mobile after each repast he became uneasy and of more than two-thirds of the affections of cried. A cold sweat covered the face, and the contents of the stomach were rejected children ; others find it more convenient to by vomitting. These symptoms, alternating lay every thing to the account of dentition; with a weak cough, continued for three a third class of practitioners, somewhat more weeks without receiving any modification advanced than the former, imagine they have under the treatmeat employed, which con- removed all difficulty by pronouncing the sisted in the administration of gentle stiword" fever! "-How many affections of mulating and strengthening remedies, warm the of the and of the chest, and to head, aromatic fomentations the abdomen, baths, ’ stomach and abdomen. are daily treated under the commodious deUnder these circumstances the author pre- nomination of " Infantile remittent fever ?’’’. scribed his favourite remedy. The childI Even our standard works on the diseases of enjoyed some sleep that night, and was much more tranquil than he had been for children, commented and revised by men some time back; the vomitting, also, gra- high in the profession, and possessing vast dually diminished. On the following day practical knowledge, are, for the most part, he took a tea-spoonful, every hour, of the disfigured, or rendered altogether unintellifollowing mixture:gible, by dissertations on 11 Inward fit," 1c Tincturcc ferrimuriat. " Fainting," Nightmare," 11 Tooth-ac;he," Extract. cortic. chinae, aa. 9!. " Worms," " Warts," and " Corns." (See Acq. flor. aurant. 3ij. Syrup. eO1’lnn, j. Underwood, 9th edit. pp. 405-G7.) The

and extract of tunate results.

-

bark,

and with

equally for-

&mid ot;

527 observations which we have just made, might be easily extended to a considerable length, perhaps we shall seize another opportunity of presenting them more methodically, in the mean time, we select one of the numerous cases which we possess, as presenting an example of an organic disease, which in certain countries where medical men still affect to despise the assistance of auscultation and percussion, would have been mistaken for fever with cerebral symptoms,"-to use the language (i-la-mode. Pneumonia occmTing in a child 4 years of age. Symptoms of cerebral congesti9n at the commencement. Cough slight,-no expectora-

tion.-Copious evacuation of 2nottei-,i,esembliiig the product of the intestine in cholera. Death.

Autopsy. Adolphi Bossclue, 4 years of age, was received into St. John’s ward, No. 2, on the 3rd of May, 1837. The father and mother

6th. Face a little flushed ; the child is agitated : delirium with somnolence during the night. The abdomen continues painful. Three liquid evacuations. The dulness of sound under the clavicle and the soufle persist. We hear only a few bullae of the sub. crepitant râle. P. 123.—Two blisters, one in front over the affected point of the chest,

the other behind at the same level. Oxide of arttimony, grs. xviij.-Decoction of mallozv. Diet. 7th. Same somnolence; face slightlyflushed. The child cries when disturbed : respiratory organs in the same state as yesterterday : the soufle somewhat less dry ; eyelids are closed; the lips dry and split ; the tongue somewhat dry and foul; abdomen painful on pressure over the epigastrium ; several liquid stools. P. 126. Feeble, irregular respiration, 33.—Gum-water. Oxide of antimony, 2 scruples. 8th. Decubitus dorsal ; face pale ; èxcessively anxious; nostrils dry, dilating at each inspiration: lips dry and incrusted ; tongue foul ; abdomen more painful ; the eye-balls seem to deviate a little, but no convulsions ; no paralysis of the limbs, or change in the sensibility. Respiration exaggerated ; sighing: pulse excessively feeble, 150 ; respir. 48 to 50. Emollient lavement. Decoction of mallou’. Blisters to the

of this child enjoy habitually good health ; the child himself was always strong and healthy until about eight days back, when he was seized with epistaxis, headach, vomitting, tendency to sleep, and fever. On the evening of his reception into the hospital, legs. we remarked that the child slept constantly Towards 12 o’clock the child was seized with the eyes half-closed, the pulse was with vomittings, which continued, at interslow and regular, 66 ; the respiration some" vals, until 3 o’clock : during this time the what irregular ; bowels constipated; face face became bluish and cold ; the eyes sometimes pale, sometimes fiushed; no sunken, and surrounded with a dark circle; grinding of the teeth, or convulsive move- extremities blue, and covered with cold ments of the face; on auscultating the chest sweat; the evacuations were very abunbehind, we discover no abnormal sound.- dant, and composed of a whitish fluid, very Six leeches, three behind each ear. Laxalive i similar to that passed by patients affected with cholera. The pulse was imperceptible elysta. 4th. The leech bites have Oied a goodi three hours before death, which took place deal, and the child is pale; he passed an ’, at 6 o’clock, P. M. agitated night, and coughed frequently;-no Bodyexamined thirth-two hours after death. Head.—No effusion into the great cavity vomitting ; tongue red; about the edges moist, and somewhat foul at the base; thirst; of the arachnoid ; no trace of inflammation the abdomen is painful on pressure; two at the surface of the brain. The vessels of yellow foetid stools, skin warm; p. 120,— the pia mater are gorged with blood, and respiration accelerated ; dulness of sound here and there are several patches of santo the extent of about I inch beneath the guineous infiltration, without adhesion of right clavicle in front; crepitating rate the membranes. The cerebral substance is with some soune in this point.—JFtfe leeches i of normal consistency, and but little injelj1tto the right side of the chest-solution of gum- ed : the lateral ventricles contain about a arabic.-Diet. tea-spoonful of clear serum. No softening 5th. The dulness of sound is more marked’; of their parietes. to-day : the soufle is stronger, the rale cre- Chest. Lungs.-Red hepatization in front pitant is now more sub-crepitant in its ’, and above, limited to the right lung ; the nature; the dyspnea is less, much less, lower lobe of this lung contains several cough ; no expectoration, tongue white and points of lobular hepatization ; the rest of foul; abdomen sensible, especially in the the tissue is healthy. The whole of the epigastric region; slept little; p. small, left lung of a rosy appearance, is perfectly contracted 130. Respiration 45 ; the leech healthy. Larynx, trachea, and bronchi, bites bled copiously, and the bleeding was normal. The right ventricle of the heart arrested with some difficulty. Decoction of contains some brownish fibrinous coagula; mallow for drink.-Potion with xvii.. j grs. of the left ventricle is distended with fluid oxide of antimony.—Diet. dark blood. Pericardium normal.