146 had more than the usual amount of diarrhoea at this season of a drachm; oil of peppermint, drachm; compound tincture of the year, and not, as yet, one case of Asiatic cholera. " My usual treatment in these cases of diarrhcea, where camphor, and compound spirits of lavender, of each three drachms; distilled water, eight ounces; of this three table- there havebeen frequent dejections, with violent griping pains and sometimes sickness, has been to administer one or two spoonfuls are given every four hours. When the cases are more severe, and the motions watery, grains of solid opium, followed up by chalk mixture, five the following is administered:-Dilute sulphuric acid, three ounces and a half; tincture of opium, a drachm; tincture of drachms; syrup of ginger, half an ounce; peppermint water, catechu, half an ounce; aromatic confection, a drachm and a
drachm ; sesquicarbonate
six drops; white sugar,
of
soda,
one
Three tablespoonfuls after each liquid motion. ounces. half. Two tablespoonfuls to be taken every hour. This has In addition to this, a one-grain opium pill is given at bed- generally acted like a charm. In this stage the disease is time, and strong mustard plasters applied over the entire completely under control. " In 1849, I had a district of the parish assigned to me as abdomen, and kept on as long as the patient can bear them. well as the workhouse, and, from March to October, I attended 1669 cases, the principal part being in August, September, WESTERN GENERAL DISPENSARY, and Octoher; out of these I had twenty-seven deaths. LISSON-GROVE. "Where the deaths occurred, with one exception, the THE ordinary treatment adopted here, for diarrhœa, in patients, when I first saw them, were labouring under children under seven or eight years of age, consists of a vomiting, rice-water purging, the peculiar sepulchral hoarsemixture of the following composition: Prepared chalk, ness, suppression of urine, cold tongue, breath and surface, powdered gum acacia, aromatic confection, of each an ounce; cramps, blue skin, and were sometimes nearly pulseless, caraway water to eight ounces; of which two drachms are indeed, in complete collapse. " To several of these I gave large quantities of ammonia and given every four hours. For adults the same mixture is ordered, with the addition brandy. In some I tried dilute sulphuric acid; in others, Dr. of half a drachm of tincture of opium to the eight ounces. Ayre’s plan of scruple doses of calomel every ten minutes, Dilute sulphuric acid, two Or else: compound mustard poultices, frictions, &c., but no remedies appeared to tincture of cardamoms, half an ounce; water, seven ounces have the slightest effect, as there was no absorption. ’’ The conclusion to which I have come from actual observaand a half. Mix. An ounce to be taken every four hours. About 1000 cases of diarrhcea have been treated during the tion of this disease is, that the remedies I have mentioned are last month. We have no returns of cases of genuine Asiatic almost specific in ninetv-nine cases out of one hundred, if given Where the patients are nearly pulseless, cholera under the care of the medical officers of this establish- sufficiently early. with rice-water motions and general collapse, I believe all ment. remedies are unavailing." INFIRMARY OF ST. GILES AND ST. GEORGE.
eight
-
drachms;
-
-
MR. BENNETT, the senior surgeon, states, that in mild cases COLDBATH-FIELDS PRISON.—HOUSE OF of diarrhoea., the ordinary prescription has been a mixture of DETENTION. aromatic confection, compound spirit of ammonia, (or of sulTHERE have been no cases of cholera under the care of Mr. phuric ether,) chalk mixture, peppermint water, and. tincture of opium; the doses graduated according to age. When there Wakefield; but from the 24th of July up to this time there has been great irritability of the stomach, and vomiting, a pill have been 133 cases of diarrhœa, most of them attended with of calomel and opium has been given, and no drink suffered sickness. The stools have generally been of a bilious character, but in some instances there was a deficiency of bile; in until an hour after taking the pill. Dilute sulphuric acid has not been used, as the preceding re- none was there any appearance of rice-water evacuations. At first, in most of the cases, there was a feeble pulse, with coldmedies have been found successful. When cramps have occurred, frictions, mustard plasters, and ness of the tongue and extremities, and violent pain in the hot wet cloths, sprinkled with turpentine, have been employed; abdomen. All of the cases soon recovered. The treatment in the latter applied, according to circumstances, over the limbs every instance was as follows :-A scruple of the sesquicaror the abdomen. In severe cases, two grains of calomel, with bonate of soda in a wineglassful of strong mint tea, repeated every half-hour, if necessary; sinapisms to the abdomen. The a quarter of a grain of opium, are given every two hours, and diet consisted of beef-tea for dinner, and cocoa night and brandy freely. Two cases of Asiatic cholera have been attended out of the morning. At the House of Detention, also under the care of Mr. house by the medical officer. They were a husband and wife, there has been no cholera, and only one or twoWakefield, in one of the worst localities in the Church-lane, living very cases of ordinary diarrhoea, which soon recovered. of The treatment St. Giles. recommended for the parish former was not carried out, and, indeed, when first visited the man was in collapse and speechless, and the case rapidly ST. GEORGE’S, SOUTHWARK, proved fatal. The wife was treated with brandy; the mixture first above-mentioned; calomel and opium; mustard plasters MR. J. W. WAKEM writes :-"I beg to inform you that I and turpentine externally. The treatment was so far success- have treated 400 cases of diarrhoea, and 28 of cholera, since ful, that her life was prolonged through a state of collapse the 26th of July, in the London-road district of St. George’s, lasting sixty hours, but she subsequently sank from the conse- Southwark ; 6 cases of diarrhœa, proved fatal, of which 3 cutive fever, dying on the eighth day of the choleraic attack. were previously debilitated, and 3 passed into cholera; the remainder recovered, most of them speedily. Of the 28 cases of cholera, 12 died in from twelve to forty-eight hours; 3 PUBLIC DISPENSARY, fresh cases are now under treatment; of the remainder most LINCOLN’S-INN-FIELDS. CAREY-STREET, are convalescent. In one case paralysis of the left arm FROM fifty to sixty new cases of diarrhoea have been occurred, and the patient (a muscular young man, about twentyattended here during the present month. One plan of treat- five years of age) has now, twelve days after attack, but ment adopted has been, at the outset, the administration partial use of it, but is daily improving. In this case the of two grains of calomel with eight of rhubarb, followed by a patient was in a state of collapse in half an hour; he also mixture, of which ammonia and tincture of opium are the suffered extremely from cramp in his stomach, legs, and arms, chief ingredients. At other times, the two following formulae for two hours. have been made use of :-Chalk mixture, decoction of logwood, "Symptoms (Di(,zri-7icea).-Puroing in most cases has been equal parts, with five minims of tincture of opium, every four very frequent, attended with severe tormina, and in many cases hours; or, chalk mixture, with five minims of tincture of cramps in the stomach, bowels, &c.; motions, from pale yellow opium, four grains of carbonate of ammonia, and a drachm of to rice-water; in about a third vomiting has been very severe. In diarrhcea I have found the following pills more effectual than tincture of catechu, for a dose. In certain cases two grains of calomel, witha third of a grain any other medicine :-Powdered opium, capsicum, camphor, of opium, were followed by an ounce of castor-oil. No cases and calomel, of each half a grain; commence with two pills, of confirmed cholera are reported. afterwards one to be given after every liquid evacuation. " I have not found the dilute sulphuric acid generally succeed ; but in some few cases I haveused it, combined with opium and MARTIN’S-IN-THE-FIELD’S WORKHOUSE. ST. decoction of logwood, when the disease has assumed a someIN a communication received from Dr. Bainbridge, medical what chronic form. I find very large mustard sinapisms of the officer of !"it. Martin’s-in-the-Fielcls, he says:greatest service in all forms of diarrhcea and vomitings, whether "I have to state, that up to the present time we have or not attended with pain or cramps. They should be applied
not
147 bably due to the susceptibility to impression, and the power of passive endurance, which characterize the organization of
the skin, and sufficiently large to cover the whole of the abdomen. "In the treatment of cholera, I have never found any medicine that I could positively say has been of any use. In the I am in the habit of giving plenty of saline stage of collapse diluents."
directly to
females. 4. In reference to tenaperature.-The degrees of temperature, and the number of deaths, are in the inverse ratio to each other. The greatest mortality is observed in the first quarter, and also in the winter half of the year; and the least mortality in the third quarter, and the summer half-year. The maximum BLOOMSBURY DISPENSARY. mark is about April, and the minimum about August, and the Cases of dirrhœa. -From July lst to July 15th, 1854, 7; mortality passes from the latter to the former in uniform waves. from July 16th to July 31st, 23; from August 1st to August The highest temperature precedes the lowest mortality by about a month. The line of temperature separating high from low 15th, 103. Cases of cholera.-From August 1st to August 15th, 1854, 3. mortality is 48°. The waves of the greatest intensity of occur every second year, being then 76 and 74 cases Treatment: Diarrhœa. -Thin broth; calomel, half a grain; mortality in contrast to 47 and 52 cases per week observed in per week, of in a followed three drachms three rhubarb, by pill; grains; the highest mortality in the alternate years, or those of recastor-oil. Afterwards,-Chalk julep, one ounce; nitrate of cession. After a severe outbreak of the disease, there is potash, five grains; Dover’s powder, three grains; three times diminished intensity, and lessened temperature does not then without a has a day. case, yielded produce its ordinary effects. As the year of recession leads Every single exception, readily to this plan of treatment; and, in several instances, it has into that of intensity, the intensity becomes so great as to effected a speedy and permanent cure where the astringent move in advance of, and not in the rear of, the lines of tempemethod had failed to afford more than temporary relief, either contrary to the established rule. The deductions in the diarrhoea having returned, or headache, coated tongue, rature, reference to hooping-cough do not correspond to the general pain in the epigastrium, and other symptoms of biliary mortality; they are directly opposed to the zymotic class, and derangement having supervened. have little relation to the nervous class, but exhibit a remarkCholera.-Salt emetic, (two ounces of salt to half a pint of able with the pectoral class, (excluding phthisis.) water;) calomel, one grain; rhubarb, three grains; every This correspondence latter fact indicates a close analogy between fatal cases of hour. Chloride of sodium, one scruple; chlorate of potash, and chest affection. five grains; bicarbonate of soda, ten grains, every two hours. hooping-cough cold drinks. Warmth to the extremities. Of the three cases thus treated, two, both occurring in A PATHOLOGICAL INQUIRY INTO THE EFFECTS OF SYPHILIS children of the same family, proved fatal. The treatment was UPON THE UTERINE ORGANS, AND THE RELATION AND PRACfollowed, in one, by copious bilious evacuations, return of TICAL IMPORTANCE OF VARIOUS UTERINE ABNORMITIES. pulse to the wrist, and of warmth to the surface, perfect relief PART II. from cramps and spasms, and restoration of the renal secretion; BY F. W. MACKENZIE, M.D. LOND. but the patient died a week afterwards from exhaustion. The other child did not rally from the stage of collapse. The THis was a continuation of Dr. Mackenzie’s communication family were living in a wretched kitchen, surrounded by fæcal read to the Society at the last meeting on June 13th. The emanations, and nearly in a state of starvation. The third former paper consisted of a detailed history of the several uterine case was that of a woman, who has recovered under the calomel lesions following syphilitic infection; the present comprised an and rhubarb, and saline treatment. account of their several pathological relations, and their practical importance. -
____
ON SOME POINTS OF PATHOLOGY AND PHYSIOLOGY.
Medical Societies.
BY S. F.
STATHAM, ESQ.,
Assistant-Surgeon to University College Hospital.
ROYAL MEDICAL & JAMES
Supplementary Observations on Low Inflamanatioaz. - The author commenced by alluding to the rarity of experiments performed by the inoculation of putrid fluid into animals, and he gave the results of his own observations in some carefully drawn-up tables. The latter part of the paper consisted in remarks upon low inflammation, action of chloroform, development of cancer, &c., in which the author’s views were ably stated.
CHIRURGICAL SOCIETY.
TUESDAY, JUNE 27TH, 1854. COPLAND, M.D., F.R.S., PRESIDENT.
ENGLISH
STATISTICS BY EDWARD
OF
HOOPING-COUGH.
SMITH,
M.D.
(Communicated by Dr. B. JONES.)
statistical inquiry into the frequency, age, sex, and mortality of hooping-cough, as deduced from the Registrar-General’s returns. The following are the author’s conclusions :1. In reference to its frequency.-In the London district, the diseases which are more fatal are phthisis, pneumonia, bronchitis, typhus, convulsions, and scarlatina, in their order. In all England, in 1847, diarrhoea was added to this list, and their order varied. There was greater diversity in the great registration divisions, both as to the precedent diseases, and their order of mortality. The proportion to the total mortality in London is 1:29-6, in all England, in 1847, 1:45-7; and varying, in the great divisions, from 1:28-1, in the eastern, to 1:94-8 in the south-western: it is as 1:1814 of the total population. The most fatal years from 1844 to 1853, in London, were 1849 (45 per week) and 1853 (50 per week); and although both these years had high general mortality, the mean mortality from hooping-cough was not due to that circumstance. The lowest mortality was observed in 1844 (25 per week), and that did not correspond with the general THIS
was a
temperature,
Reviews and Notices of Books. of Practical Therapeutics, considered chiefly with, reference to articles of the ltTateria Medica. By EDWARD JOHN WARING, M. R.C. S. E., H. E. I. C. S. Fcap.8vo.pp.755. London: Smith, Elder, and Co. Bombay: Smith, Taylor,
A Manual
and Co. THE author, or rather as he styles himself, the compiler, of this book informs us in his preface, that it is not his intention to compete with any of the established works upon Materia Medica, but rather to develop one of the most important aspects . of that science, and in fact the only part of it bearing directly upon the employment of drugs in the treatment of diseases-viz., the medicinal qualities of the materials employed. Whilst not omitting the botanical and chemical characters of the agents of which he treats, he dwells most fully upon their ascertained effects upon the human frame in various states of mortality. 2. In reference to age.-It is a disease essentially of dentition health and disease. This important view of the subject has of the first series, and, under one year, is the most fatal of all certainly been barely treated in some of the most popular diseases. It thus differs from all other members of the zymotic works upon Materia Medica with the consideration which it class. and there is therefore (we would incline to think) 3. In reference to sex. ---The mortality is more prevalent in demands, females at every period of life, and this prevalence increases as ’, just ground for the idea that there was room for such a work life advances. It does not thence follow that the disease as the one before us, without in any degree exposing the autho itself is more prevalent in that sex; but if it be so, it is pro- to the charge of book-making.
li