LONDON MEDICAL SOCIETY. Monday, February 23, 1829.

715

ing aay benefit; and the latter uses it in all his manipulations, to rub, pummel, or thump

the ribs or vertebrae of young females, who are entrusted to his care ; but what success he may have in that whimsical practice, is not generally known ; at least no authentic and visible proofs of his success have yet

knowledge. For authentic proofs of other unsuccessful practices that have been used to cure come to

my

LONDON MEDICAL SOCIETY.

Monday, February 23, 1829. SUBSERVIENCY

OF

THE

COUNCIL.—POINT LEGED

FEVER

OF

BRAIN

SOCIETY

TO

THE AL’

ORDER.-THE

CASE.—UNUSUAL

FATALITY OF SCARLATINA.

these distortions I must refer to another patient, who is at present under my care. THE Council not having made their appearAbout six years ago, a lady of mature age ance at twenty minutes past eight o’clock, had an illness, of which I did not geta although several members and visitors were very satisfactory account. After her reco- waiting in the Society’s room,Mr. SHEARLY rose and stated, that by the very she felt a little lameness in one of her feet; this went on increasing, till her foot laws of the Society, the Council were diturned inwards, so that she stood upon the rected to meet between the hours of seven outer edge of her little toe, the ancle-joint and eight o’clock, and that the proceedings became quite rigid, as well as all the joints of the Society were regularly to begin at of her foot. When I first saw this lady, eight o’clock. A considerable portion of her foot bore a great resemblance to that of time had this evening been frittered away, Robinson, but was not so much deformed. and he eonceiced the Council were not jusDuring the progress of this distortion tifiable in thus acting ; and, as the law from bad to worse, the usual ineffectual stated that when seven members were preremedies were resorted to ; pumping upon sent they were competent to commence the the foot with cold water, steeping it in hot business of the Society, he should move, water, strengthening plasters, embroca- that some member, then present, should take tions, dry frictions with the hand and the the chair, there being neither President nor flesh-brusli, &c. ; as all these remedies Vice-President in the room. He moved, failed, a severe course of blisters was adopt- that Dr. Johnstone should take the chair. ed as a deraaier ressartafter bearing these Dr. JOHNSTONE would not take the chaix; for a month, without feeling any advantage, he could not think of such a thing ; it would she discontinued them, with a determina- be indecorous in him to do so. Mr. SHEARLY. I do not know how it tion to continue lame, rather than bear so much pain. The last summer she passed in could be considered indecorous for you to Brighton, and used the champooing bath do so ; it certainly is indecorous in the during her stay at that place, with no more Council to keep us waiting here, wasting advantage thari she had derived from the our time. other remedies, and,in October, placed her- Dr. JOHNSTONE. We do not know how self under my care. At that time, her foot they are engaged; let every man be judged so exactly resembled the foot of Robinson, of by his acts. which is represented in No. 27’4, that I did Mr. SHEARLY. Rut the Society is to meet npt think it necessary to take a cast of it. and proceed to business at eight o’clock. but reference to that of Robinson will exDr. JOHNSTONE. Well, but every one who plain all the appearances of the lady’s foot ; is acquainted with these Institutions knows the. distortion was equal in degree and in that such a circumstance as this will occa. rigidity in both cases ; the principal differ- sionally take place ; it is as great a disapence between them is in the age of the pointment to me as to any body, that the patients, Robinson being not yet fifteen, business has not begun precisely at eight and, as the lady has a son who is more than o’clock; but 1 think it is right we should twenty, we may, without formally asking first know what the cause is. tlle question, venture to put her down as Mr. SHEARLY. There is a rule stating, that when seven members are present, we being forty years of age. I have, on the present occasion, endea- shall go to business, and I do not know why voured to explain the general principles upon we should not proceed. which.the muscular action that I have used Dr. RYAN. No doubt the law is such; to perform these cures, operates to produce it is undoubtedly so. these effects; and, in my next, shall enMr. SnEARLY. I do not think the Coun. deavour to show, that the same principles cil have the power to keep us waiting; it of muscular action may be advantageously would be perfectly inconsistent if they had. employed to improve the health of invalids Dr. JOHNSTONE. I do hope and trust, and aild convalescents, in the forms of whose per- believe, it is not upon private concerns they sons there does not exist any defect, as well detaining us, but upon the concerns of as in some other eoinplaints, in which it are Society. _

-

-

may be used with

advantage.

the

’

.

716 such publicity has been given, by call asubject report, that I think it right what is the misDr.

But the Council have Mr. SHEARLY. from seven to eiaht o’clock to deliberate, and surely the Society is not to be kept waiting for them. After they arrive, the Minutes of the last Meeting will have to be read, which will occupy from this time till nearly a quarter to nine, and then the Society will break up at half-past nine ; now, what use is there in gentlemen leaving their business and coming a great distance to attend a Society of this kind ? In a few minutes afterwards the Council entered the room.

to

Ramadge

on

to state,

statement" I made respecting the case I then communicated to the Society; and who is the relative of the deceased on whose authority lie has accused me of a misstatement.

Dr. RAMADGE. Sir, I beg leave to say, that 1 have seen THE LANCET, and that the statement I made in the Society has been correctly reported in that work. I never said that I had had an opportunity of seeing the relative of the deceased. I merely men. Dr. WiLLiAMS took the Chair. tioned that I had seen several persons at Mr. SHEARLY then said, Sir, I beg to rise the West End of the Town, and that it was to a point of order. The Society has now reported there that the patient had fever: been kept waiting for twenty-five minutes. There is a gentleman in the room who heard The business of the Society is to commence Mr. Jewell state, that the patient had fever at eight o’clock. It has not been this even- for at least five days before his death ; that ing only that the proceedings have been he had been in the country ; had taken thus delayed, the practice has now become cold, an.l was seized with delirium. The generally speaking, the same every night; gentleman who told me that he had fever and I, for one, think it excessively indeco- was Mr. Howell, and I am sure he will bear rous that our time, so exceedingly short as me out in the statement. I did -not state it is, an hour and an half, should be thus any- thing intentionally offensive to Dr. frittered away before the business can Johnstone. My object was further inquiry into the case. I should be glad to know, begin. this person had any Dr. WiniAMs. Really, I must confess, from this evening, the Society has been kept the nostrils or not? The REGISTRAR. I did not insert Dr. waiting beyond it3 usual hour, but a question of very material interest to the Society Ramadge’s observation in the Minutes, hewas referred to the Council, about a fort- cause, after the meeting separated, I thought night ago, and it has been under discussion Dr. Ramadge would have another opportu. this evening. That is the reason why the nity of disposing of it, which I considered to be the better way. If any thing particu. Society has been kept waiting. Mr. SHEARLY. The Council are to meet lar turns on what passed I can now make a from seven to eight, and I do not think it note of it. Dr. RAMADGE. I took the only opporcompetent for them to keep the other members waiting here for twenty minutes, or half tunity I had of making my observations. If an hour, under any pretext. I had suffered the Minutes to pass over then Mr. PROCTOR. Perhaps Mr. Shearly will as they stood, I do not think I should have be satisfied when he is informed, that this done right. Dr. JOHNSTONE. There are two things question, of very great importance to the Society, is to be referred to him and the to be considered - the statement and the deduction. I have no objection to any gengeneral body of the Members. Mr. SHEARLY. No, I am not at all sadifferingfrom me in deductions; but tisfied with that. 1 think, if a man differs from me in facts, he The Minutes of the last Meeting were is bound to produce the evidence that war. read. rants that opinion. I stated the symptoms, Mr. SHEARLY stated, that Dr. Blundell and I said there was no fever ; I stated the had considered that the specimen of mon- condition of the skin, of the secretions, of strosity he (Mr. Shearly) exhibited to the the respiration, and so on, and 1 said, those Society on the last night, would be more did not exhibit symptoms of fever. Now useful to the public preserved as a speci. Dr. Ramadge told the Society, for I came in men, than if it were dissected, and he had, late that night, and did not hear it, that hetherefore, presented it to tli,it gentleman. had it from a relative of the deceased’s. This rendered it impossible for him to deDr. RAMADGE. The statement never was tail any morbid appearances. The twin w&6 made by me. alive and likely to do well. Dr. JOHNSTONE. Then the only relative Dr. JOHNTSTONE. I believe this is the of the deceased was Mr. Jewell himself who proper time to take notice of the Minutes, called on me on Saturday morning, saying, and tbough it does not appear by them that that he had read the statement in THE any notice was taken of a subject that was LANCET, and lie expressed his utmost sur. mentioned on the last evening, yet to that prise that it should have been made. lie

!i

’

whether

discharge

’

tleman

717 not only authorised me to repeat, that what any of the viscera, to account for death; I had stated was true, but offered to come he therefore concluded, the nervous strucforward to prove every thing 1 have said. ture only was affected ; and that death must This gentleman had an opportunity of see- have arisen from that. He lamented to find, ing the patient every day, indeed I may that scarlatina was very prevalent at presay every hour, and every week during the sent, and extremely fatal, in spite of the he lived. The young gentleman was most judicious treatment. period for Dr. RAMADGE had found scarlatina also three or four weeks; for seven ailing He was inhe was out in the extremely destructive of life. his before death, days carriage, and from that time he was con. clined to apply leeches to the throat in the fined to bed, and then, I say, he had no first instance, followed by large poultices, symptoms of fever. I think it was really to keep the bowels open, to sponge the very unhandsome, to say the least of it, that body with vinegar and water, to make use Dr. Ramadge should have brought forward of mercurial medicine and stimulants. He this subject behind my back ; it was not did not think gargles, in the inflamed state only irregular, as I was not here, but I of the throat, of use ; warm water was the think, really, that knowing well that every simplest and best gargle. He likewise rething against me is so exaggerated in THE commended a tea-spoonful of the infusion LANCET, (cries of hear, hear, order, and of roses, with a little syrup, frequently. chair,) he ought not, then, to have ad- Mr. PROCTOR had generally carried his dressed the Society on the subject. patients through ; and he thought scarlatina Mr. GossET was surprised at the time, ought to be treated according to the strength that Dr. Ramadge should make the state- of the patient, and very much upon the ment, and was more surprised at his not principle that would be adopted by a judibeing called to order by the Chair. He re- cious practitioner in any other case of fever, commended that the subject should be where the nervous system was considerably dropped, as he did not believe Dr. Ramadge affected. In some cases blood might, and made this statement with any intention to in some it might not, be abstracted. The annoy, or to offend Dr. Johnstone, but from last season produced more fatality than usual his not exactly understanding the regula- in the neibhbourhood where he resided. One very strong man, who had a sudden tions of the Society, he proceeded with it. Dr. JOHNSTONE. I am perfectly satis- attack of jaundice, was bled, and soon afterwards became partly delirious ; in less than fied, and content that it should now drop. 36 hours from the appearance of the disDr. RAMADGE rose, but Dr. WILLIAMS observed, I think it would ease, he expired. Dr. Chomelly had in. be better that this matter should drop ; formed him, that five cases of the same kind however, I beg to bear testimony to the re- had fallen to his lot, three of which he had peated expressions of respect on the part carried through with stimuli. Dr. RYAN had had considerable opportuof Dr. Ramadge towards Dr. Johnstone, and though it may appear, that at that pe- nity of witnessing scarlatina. In one house, riod he may have been irregular, I am sure two children died suddenly, the one five, that Dr. Ramadge did not intend any per- and the other seven years old. Leeches to the throat, and treatment very similar to sonal offence. Dr. RAMADGE. I appeal to the gentle- that recommended by Dr. Ramadge had A third child in the men who are here, and who were here at been had recourse to. the time, whether I said that I myself had same house became affected, which the pahad it from a relative of the deceased ? I rents refused to be allowed to be treated in mentioned that I had heard from a gentle- the same manner, but gave wine, and apman who heard from a relative of the de. plied sinapisms to the feet : he got well. ceased, that fever was not present ; andThere were cases in which it was impossi. what is stated in THE LANCET is perfectlyble to save the patients. Stimulating treat-

.

,

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-

seemed to have been the favourite in ancient times ; and he was inclined to resort to the decoction of bark, wine, and sinaMr. WRAY brought forward the subjectpisms to the feet. of scarlatina, to ascertain, if possible, the; Mr. GossET had found great benefit from opinion of the Society on what producedIusing the subcarbonate of ammonia. death in some of the recent cases of searla. Mr. SALMON regarded the chloride of tina, where patients had sunk so speedily . lime in the shape of a gargle as a very exHe enumerated particularly two cases cellent remedy ; halfa drachm of the chlowhere both the patients, two of the fines tride of lime to a pint of water, injected children he had ever seen in one family into the stomach. In some of the severe died within about five days. In the cases, the ulceration went down throughout mortem examination that he made, he haci the mucous membrane, not only of the stoment

correct.

-

-

-

post.

been able

to

detect

nothing

whatever irmach, but of the

intestines;and he had

718 any kind of work, and especially to convey meat or drink to the mouth, was Mr-. ASHWEI,L had witnessed surprising attended with constant mistakes, which sel. benefit from using the subcarbonate of am- dom failed to excite the laughter of bymonia. He first attended to the state of the standers, and in which she generally took bowels, put the child into the warm bath, her part. She could not direct her steps in with some mustard, and immediately gave going from one place to another, so as to the subcarbonate, not confining himself to directly to the spot. One of the any particular form ofit. He had frequently feet dragged, and made a sort of semicirgiven 10 or 15 minims of the spiritus ammo- cular turn in walking. She continued in .nia aromatici, in a little peppermint or sirup. this state, with scarcely any alteration, till He recommended light poultices, consisting the following June, when she expired rather of three parts of linseed meal and one of suddenly. The next morning, my friend Dr. Veitch, mustard, to be applied to the neck, by which he had seen children relieved from a state of Horncastle, and I, were suffered to of almost certain suffocation. In more se- examine the head. On removing the skuli, vere attacks, more active remedies were we found the dura mater looking flabby and necessary ; but he had not, for the last three very pule, as did the tunica arachnoidea und or four years, employed leeches. pia mater. There was an unusual quantity Mr. BnowN had never employed the la-a- of moisture lying between these several cet to infants ; he might have availed him- membranes. The brain, when cut into, self of the use of leeches. He objected to appeared extremely pale, but was of the blisters remaining on infants, so long as to usual consistence. On laying open the vena occasion much stimulating irritation, by tricles, we found them distended with a which sloughing might be induced. Hefluid, which was nearly pellucid. A large considered an ounce of the sirup of rho;do?,, quantity of the same kindof liquid flowed with 12 dropsof muriatic acid, an excel- freely, and, in great abundance, ont of lent linctus for children. He had never given the theca-spinalis. The chord and its mem. ammonia. He preferred the tepid to thebranes, as far as we could trace them warm bath. If he wished to give sti:uu- through the foramen magnum, presented a similar hue to that of the ceiebrum, and its lants, he should prefer wine to ammonia. Mr. WRAY regretted that the object for. involucra. No other morbid appearances which he had introduced the discussion,, were discovered, though we carefully exhad not been attended to. lie wished to amined the different parts of the brain and have had the morbid symptoms, if any had membranes. As we were not prepared been explained, by which death had been to meet with any preternatural quantity of caused, and these had entirely been passed fluid in the skull, or spinal tube, we incauover. For his own part, he esteemed bleed-tiously suffered some of it to escape upon the fioor. We could not, therefore, meaing a very valuable remedy. A MEMBER, whose name we did notsure the quantity lodged in the brain and but-we were of opinion that it did ascertain, expressed his opinion, that there must be something peculiar in the season, not amount to less than six ounces, and prowhich alone could account for the great bably considerably more. She retained her mortality that hadprevailed of late in cases faculties almost to the very last ; indeed, of scarlatina and other fevers. He had lost the day previous to her death, she was cases without being able to account for death thought better ; and it was, upon some in any otherway. On dissection, he had sudden motion, either in rising from her discovered nothing. bed, or from the night-chair, that she ex. pired. She had always been considered (what is called) a nervous person ; but from regular Mabits, of every description, she was unusually healthy, and remained free fiom CASE OF ST. VITUS’ DANCE FROM AN complaiut at her advanced yeais, till the EXTRAORDINARY CAUSE. period above alluded to ; and she had not been in the habit of taking any medicine, EDWARD M.D. HAERISON, By found

iitjectiorie of the chloride exceedingly serviceable.

into the

perform

rectum

proceed

-

its

theca,

MRS. BmABiNs, ætat. ahout 90, of a tlii-I spare habit, was the mother of several clnidreu. She had thron;,;h lire enjoyed excellent health, the consequence of her teriperate and methodical habits. April 20, 1812, she was seized with irregular motions of the superior extremities ; they kept increasing for several days. when the inferior became similarly nr’2ected. Her attempt to

excepting, occasionally, electuaty.

a

little aperient

REMARKS.

The accession of idiopathic chorea after puberty is, as far as I hnow, of very are It is a disease of early youth, occurrence. and generally vanishes on the full developmeat of the constitution. uosologists class it among the neuroses, supposing it to emannte from the nervous system. I have