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ON THE OPERATION OF SELF-CASTRATION.
perplexing the case, and of making it appear that ing mixture every two hours :-Sulphate of quinine, eighteen ordinary sewage may contain the compound in question, and, grains; tincture of sesquichloride of iron, two drachms; water, therefore, that its existence in the so-called gas liquor is not re- to three ounces : mix. She was also ordered a mixture, consistmarkable ; but Dr. Taylor does not tell us what quantity of sul- ing of one drachm of the chlorate of potash in a pint of water, phocyanide is found in saliva, or how much of it is discharged of which small quantities were to be taken frequently; a gargle per day by each individual, although he would have us believe of the dilute hydrochloric nitric acid, and the external part of that the presence of it in gas liquor may be thus accounted for; the throat was painted with the compound tincture of iodine. in fact, we are called on to believe that gallons upon gallons She was to have brandy, wine, and beef-tea at intervals. On of this liquor may be furnished every minute by the inhabitants the 26th I saw her again with Dr. Jackson. She was much: of eight small houses !* worse; had frequent suffocative fits; swelling of the neck and, As to the similarity of the liquor to the bad sewage of the chest much inflamed. She had swallowed considerable quanriver Rom, it merely goes to show that the liquor was very bad, tities of beef-tea and stimulants since yesterday, yet she conand that the sullage of eight houses is identical with that fur- tinued to sink hour by hour. From three P.M. this afternoonnished by many thousand inhabitants, and by the trade refuse, she could not swallow. Stimulating enemata were now sugincluding gas liquor of a considerable town; for I have myself gested to the parents, but her state was so hopeless, that they
view of
x
examined the sewage of the river Rom, and know what matters were reluctant to use such means. She died in a few hours. are discharged into it along some miles of its course: or else afterwards. the similarity proves that something more than the sullage of In this case I was much struck by the rapid invasion of the throat by the false membrane; also by the speedy failure of the eight houses is drained into the sewer of the City Gas-works. I refrain from further comment on the case, and leave it to powers of life, notwithstanding the administration of powerful the judgment of your readers. stimulants. This sinking appeared to me to be quite indepenT rpmam- Sir- vnnr obedient serva/ntdent of the local disease. HENRY LETHEBY, M.B., PH. D., &c. I am, Sir, your obedient servant, London Hospital College, April, 1859. M.R.C.S. Gainford, near Darlington, April, 1859. RICHARD ELLIS, M.R.C.S, P.S.-Recollecting the good effects of turpentine in purpura, REPORT OF A FATAL CASE OF DIPHTHERIA, and other diseases of debility, I was induced to give it a trial in a case of diphtheria a few days since, and I am happy to, WITH REMARKS UPON THE ADMINISTRATION OF OIL OF say, with the best results. The patient was a strong child, TURPENTINE IN THAT DISEASE. aged three years, and had been ill two days before I was called To the Editor of THE LANCET. in. I found the tonsils invaded by the false membrane, and
SIR,-I send you an account of a fatal case of diphtheria which has occurred in my practice, as I believe it may possess some points of interest to the profession. I may mention that the district in which I practise is purely agricultural, and that it is considered to be particularly healthy. Throat affections have prevailed here a good deal for some weeks past, but they have been generally mild in their nature, and they have readily
yielded to appropriate treatment. The patient was a stout, healthy girl, aged ten years, residing in an isolated house, at a way-side railway station. She first complained of uneasiness in her throat, on the 19th of March. I saw her on the 21st, at ten o’clock in the morning.
On examination I perceived a white membranous exudation, about one inch in length, attached to the right tonsil. This membrane was triangular, and well defined, having its base parallel to the tongue, and its apex pointing to the roof of the mouth. There was very little disturbance of the system, and the power of deglutition scarcely impeded. I applied the nitrate I of silver freely to the throat; ordered an astringent gargle to be used frequently, and ten minims of the tincture of sesquichloride of iron to be taken every two hours; the bowels to be gently acted on by castor oil. I again saw the patient at six o’clock in the evening of the same day, and found that the disease had made alarming progress since the morning, the entire soft palate being covered by the membrane, and also part of the roof of the mouth. I again applied the nitrate of silver freely, and ordered wine, beef-tea, and the tincture of sesquichloride of iron to be continued. On the 22nd she appeared somewhat better; her strength was good; the membrane in the throat was loose and baggy, and the iron having had an emetic effect, some portion of the membrane was got rid of. This amendment continued next day, the 23rd, and with the exception of some slight delirium, she passed a good night. The tincture of sesquichloride of iron and the other treatment were continued. On the 24th she still continued to get rid of portions of the membrane; there was some swelling of the face and neck, and an annoying discharge from the nose. I did not think her worse, as her strength was such that she easily got out of bed, and walked to the window of the apartment, in order that I might have a good view of her throat. Her medicines &c. were continued, and a stimulating liniment ordered for her throat. On the 25th I saw her, with Dr. Jackson, of Darlington, who had a very unfavourable opinion of the case. The swelling of the neck and face had much increased since the day before, and it now extended down the chest; respiration and deglutition were much impeded; pulse 120, weak and thready, and the whole appearance of the patient was unfavourable. She was ordered to take two teaspoonfuls of the follow* The average amount of sulphocyanide contained in human saliva is rather less than one grain in a thousand; and as about 4460 grains, or nearly half a of saliva is secreted by one person in twenty-Jour hours, it would require pint, 46,OSO persons, supposing they did not swallow a single drop of the secretion, 0 furnish, only at the rate of two gallons a minute, a liquid much weaker in sulphocyanogen than that which flowed from the pipe at the City Gas-works.
the glands of the neck much inflamed; respiration croupy; pulse very weak and frequent. I gave him five minims of oil of’ turpentine every hour, rubbed up with yelk of egg and water, There was an apparent amendment when he had taken about six doses, and the treatment was persevered in until he was out of danger. Further experience is necessary to determinethe real value of this remedy; meantime I am well satisfied that my patient owes his life to its adoption.
ON THE OPERATION OF SELF-CASTRATION.
[NOTE
FROM
CHARLES
MR.
HAWKINS.]
To the Editor of THE LANCET. case of " self-castration" related by Mr. Litchfield, SIR,-The in your last number is the one, I think, that was admitted into St. George’s Hospital when I was house-surgeon there, but it was in the year 1836, not 1839. I mentioned the case to Mr. Blizard Curling when he was writing his work on " Diseases of the Testis," and he has related the case at page 70 of the edition published in 1856. If Mr. Litchfield will refer to the work, I think that he will recognise his case. I did not, at the time I related the case to Mr. Curling, recollect the name of the practitioner who first saw the patient, or I should have mentioned it. I am, Sir, your obedient servant, F. R. C. S. CHARLES HAWKINS, Savile-row, April 18th, 1859. HAWKINS, F.R.C.S.
THE COMING ELECTION.—THE MEDICAL INTERESTS IN PARLIAMENT. To the Editor
of THE LANCET. is
game kings would seldom wise we should have better laws. Is it not the bounden duty of every medical man to. ascertain from candidates for seats in Parliament their opinions on homoeopathy, hydropathy, table-turning, and such like conceits ; and also their feeling towards the profession as regards its position in the army, navy, under the Poor-law Commission, and, in fact, in every capacity ? A few minutes’ conversation with the candidate would not only prevent a mistake in polling, but might secure a useful vote when questions of science or the interests of the profession are before the House. I am, Sir, yours truly, A FINSBURY ELECTOR. Gower-street, April, 1859.
SIR,-If people wise, play at, they say. If electors were
war
a
were
THE INDIAN MEDICAL SERVICE.- In the debate
on
the vote of thanks to the Indian civil and military servants, H.R.H. the Commander-in-Chief took occasion to speak in high terms of the services which the surgeons of the army had rendered in the late rebellion. It was a graceful tribute to a body of men whose claims were ignored in the speech of the of State for India.
Secretary
427
view of
x
examined the sewage of the river Rom, and know what matters were reluctant to use such means. She died in a few hours. are discharged into it along some miles of its course: or else afterwards. the similarity proves that something more than the sullage of In this case I was much struck by the rapid invasion of the throat by the false membrane; also by the speedy failure of the eight houses is drained into the sewer of the City Gas-works. I refrain from further comment on the case, and leave it to powers of life, notwithstanding the administration of powerful the judgment of your readers. stimulants. This sinking appeared to me to be quite indepenT rpmam- Sir- vnnr obedient serva/ntdent of the local disease. HENRY LETHEBY, M.B., PH. D., &c. I am, Sir, your obedient servant, London Hospital College, April, 1859. M.R.C.S. Gainford, near Darlington, April, 1859. RICHARD ELLIS, M.R.C.S, P.S.-Recollecting the good effects of turpentine in purpura, REPORT OF A FATAL CASE OF DIPHTHERIA, and other diseases of debility, I was induced to give it a trial in a case of diphtheria a few days since, and I am happy to, WITH REMARKS UPON THE ADMINISTRATION OF OIL OF say, with the best results. The patient was a strong child, TURPENTINE IN THAT DISEASE. aged three years, and had been ill two days before I was called To the Editor of THE LANCET. in. I found the tonsils invaded by the false membrane, and
SIR,-I send you an account of a fatal case of diphtheria which has occurred in my practice, as I believe it may possess some points of interest to the profession. I may mention that the district in which I practise is purely agricultural, and that it is considered to be particularly healthy. Throat affections have prevailed here a good deal for some weeks past, but they have been generally mild in their nature, and they have readily
yielded to appropriate treatment. The patient was a stout, healthy girl, aged ten years, residing in an isolated house, at a way-side railway station. She first complained of uneasiness in her throat, on the 19th of March. I saw her on the 21st, at ten o’clock in the morning.
On examination I perceived a white membranous exudation, about one inch in length, attached to the right tonsil. This membrane was triangular, and well defined, having its base parallel to the tongue, and its apex pointing to the roof of the mouth. There was very little disturbance of the system, and the power of deglutition scarcely impeded. I applied the nitrate I of silver freely to the throat; ordered an astringent gargle to be used frequently, and ten minims of the tincture of sesquichloride of iron to be taken every two hours; the bowels to be gently acted on by castor oil. I again saw the patient at six o’clock in the evening of the same day, and found that the disease had made alarming progress since the morning, the entire soft palate being covered by the membrane, and also part of the roof of the mouth. I again applied the nitrate of silver freely, and ordered wine, beef-tea, and the tincture of sesquichloride of iron to be continued. On the 22nd she appeared somewhat better; her strength was good; the membrane in the throat was loose and baggy, and the iron having had an emetic effect, some portion of the membrane was got rid of. This amendment continued next day, the 23rd, and with the exception of some slight delirium, she passed a good night. The tincture of sesquichloride of iron and the other treatment were continued. On the 24th she still continued to get rid of portions of the membrane; there was some swelling of the face and neck, and an annoying discharge from the nose. I did not think her worse, as her strength was such that she easily got out of bed, and walked to the window of the apartment, in order that I might have a good view of her throat. Her medicines &c. were continued, and a stimulating liniment ordered for her throat. On the 25th I saw her, with Dr. Jackson, of Darlington, who had a very unfavourable opinion of the case. The swelling of the neck and face had much increased since the day before, and it now extended down the chest; respiration and deglutition were much impeded; pulse 120, weak and thready, and the whole appearance of the patient was unfavourable. She was ordered to take two teaspoonfuls of the follow* The average amount of sulphocyanide contained in human saliva is rather less than one grain in a thousand; and as about 4460 grains, or nearly half a of saliva is secreted by one person in twenty-Jour hours, it would require pint, 46,OSO persons, supposing they did not swallow a single drop of the secretion, 0 furnish, only at the rate of two gallons a minute, a liquid much weaker in sulphocyanogen than that which flowed from the pipe at the City Gas-works.
the glands of the neck much inflamed; respiration croupy; pulse very weak and frequent. I gave him five minims of oil of’ turpentine every hour, rubbed up with yelk of egg and water, There was an apparent amendment when he had taken about six doses, and the treatment was persevered in until he was out of danger. Further experience is necessary to determinethe real value of this remedy; meantime I am well satisfied that my patient owes his life to its adoption.
ON THE OPERATION OF SELF-CASTRATION.
[NOTE
FROM
CHARLES
MR.
HAWKINS.]
To the Editor of THE LANCET. case of " self-castration" related by Mr. Litchfield, SIR,-The in your last number is the one, I think, that was admitted into St. George’s Hospital when I was house-surgeon there, but it was in the year 1836, not 1839. I mentioned the case to Mr. Blizard Curling when he was writing his work on " Diseases of the Testis," and he has related the case at page 70 of the edition published in 1856. If Mr. Litchfield will refer to the work, I think that he will recognise his case. I did not, at the time I related the case to Mr. Curling, recollect the name of the practitioner who first saw the patient, or I should have mentioned it. I am, Sir, your obedient servant, F. R. C. S. CHARLES HAWKINS, Savile-row, April 18th, 1859. HAWKINS, F.R.C.S.
THE COMING ELECTION.—THE MEDICAL INTERESTS IN PARLIAMENT. To the Editor
of THE LANCET. is
game kings would seldom wise we should have better laws. Is it not the bounden duty of every medical man to. ascertain from candidates for seats in Parliament their opinions on homoeopathy, hydropathy, table-turning, and such like conceits ; and also their feeling towards the profession as regards its position in the army, navy, under the Poor-law Commission, and, in fact, in every capacity ? A few minutes’ conversation with the candidate would not only prevent a mistake in polling, but might secure a useful vote when questions of science or the interests of the profession are before the House. I am, Sir, yours truly, A FINSBURY ELECTOR. Gower-street, April, 1859.
SIR,-If people wise, play at, they say. If electors were
war
a
were
THE INDIAN MEDICAL SERVICE.- In the debate
on
the vote of thanks to the Indian civil and military servants, H.R.H. the Commander-in-Chief took occasion to speak in high terms of the services which the surgeons of the army had rendered in the late rebellion. It was a graceful tribute to a body of men whose claims were ignored in the speech of the of State for India.
Secretary
427