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TREATMENT OF MARSH FEVER BY SUBCUTANEOUS INJECTIONS OF CARBOLIC ACID.
THE DEATH OF MR. FAWCETT.--ISOLATION AT BRISTOL,
883
of the part being directly due to a want of blood, and not scarlet fever, and now it would appear that typhus is to be dependent in any degree upon inflammation. The treat- relegated to private houses. Unfortunately, the people ment adopted was undoubtedly the wisest possible, and amongst whom this disease of dirt and overcrowding almost Such a mummi- exclusively prevails have not such houses as Mr. Davies was brilliantly justified by the result. fied member was not a source of danger to the patient possesse. Then again, although the Public Health Actconfrom blood-poisoning, and there was at no time any tendency tains a clause as to compulsory removal, experience everywhere for the gangrene to spread, so that there was no justification shows that the powers given as to this are rarely resorted to, for amputation, which would have been attended with grave and that thousands of cases of such diseases as scarlet fever are risk to a man of this advanced age, suffering as he was from isolated without any reference to it; and this with nothing chronic pulmonary disease. Dr. Hare, who had several but benefit to the surrounding community. And further, times seen the patient previous to the occurrence of the though the same Act enables sanitary authorities to recover gangrene, laid stress upon the little evidence of atheroma in the cost of the maintenance of patients in isolation hospitals, the large vessels. This, however, is quite consistent with yet it was certainly never anticipated that such authorities would make an undertaking as to payment an absolute advanced calcareous disease of the smaller arteries. condition of admission. The prime object of infectious is to the hospitals prevent spread of infection, and not to THE DEATH OF MR. FAWCETT. make such prevention dependent on recovering a small THE death of Mr. Fawcett, humanly speaking, is one of payment on behalf of the individual who assents to be the saddest events which could have occurred, and deprives isolated in the interests of the community. We wish that the State of one of its most faithful and promising servants, i Bristol could see its way to follow in the path of many and society of one of its most remarkable men. The existence other sanitary districts which, having provided themselves of such a man-blind, yet " leading the blind," and showing with proper isolation hospitals, so use them as to protect to them the possibilities of life under conditions of blindness, the utmost possible extent the public by whom and for and full of light and hope for humanity, as well as of whom they have been constructed. political wisdom and strength-was a national blessing and credit, of which the country might have hoped for a continuance for years to come. Many men with sight might TREATMENT OF MARSH FEVER BY SUBCUTANEOUS INJECTIONS OF CARBOLIC ACID. have been better spared. Wehave little to add to what has his It been already made public of the nature of illness. DR. DIEULAFOY communicated to the Société Médicale was of a pneumonic and pleuritic character, and accomplished des Hopitaux of Paris, on the 10th ult., the history of a its deadly work with much quickness and, we regret to say, patient who since 1877 had had tertian fever three times, with much pain, the pleura covering the diaphragm being which had always been successfully treated by the adminismuch affected. It is easy to speculate on the probable causes tration of sulphate of quinine. The fever having returned of such a disaster to a man of fifty-one, whose father and mother, last Jtine, the patient Came under the care of Dr. Dieulafoy, by the way, are yet alive. The season has been favourable to who on the first day injected subcutaneoualy two centisuch attacks. His previousillness did not lessen his liability to grammes and a half of carbolic acid dissolved in a hundred them, and we should probably not be far wrong in supposing parts of water. The quantity was increased on the following that the worrying autumn session, added to his departmental days to five centigrammes, and to seven centigrammes on labours, produced that fatigue which makes the system more the days of apyrexia. Recovery was complete at the end of vulnerable to the causes of catarrhal disease. seventeen days. The patient had then absorbed eighty-four centigrammes of carbolic acid, without showing any signs of poisoning. In the subsequent discussion, Dr. Laveran reISOLATION AT BRISTOL. verted to the fact that carbolic acid injections had been IT is not often that we find ourselves at variance with the employed against marsh fever so far back as 1869, with veteran medical officer of health for the city of Bristol, but success. He doubted the propriety of attemptquestionable in the matter of the isolation of infectious diseases we are to supplant so certain a remedy as sulphate of quinine. ing quite unable to understand the advice which he tenders, and Dr. Huchard related the case of an Arab in whom quotidian it is evident from the comments in the local press that we are attacks of fever, which had resisted all other remedies, not alone in this matter. The whole system, as indicated and Dr. Libbe alluded to yielded to bromide of by a letter which he, in his official capacity, has addressed the good effects, tao potassium; much overlooked, of arsenical medito the Bristol Mercury, is evidently regarded by the cation in malarial poisoning. sanitary authority from a point of view which we think to be faulty. Although from recent reports it apALLEGED DEATH FROM VACCINATION. pears that two hospitals exist, and although their value in enabling the city to crush out an outAN inquest was held on Friday, Oct. 31st, at the Clapton break "in the bud"is prominently brought forward, yet Park Tavern touching the death of aa infant aged four now, when the closure of the fever hospital is in question, months. From the evidence it appears that the deceased Mr. Davies, instead of advocating the maintenance of a was found dead in bed by its mother’s side. Dr. Aveling of building to which first attacks could be removed, points out Clapton was called in, and at the inquest he deposed that all the hindrances to isolation, explaining that he can only he had not the slightest doubt that the child had been compel removal on a justice’s order, that no one would be suffocated through overlaying, but a majority of the admitted unless payment is guaranteed in advance; and then jury, ignoring the expressed belief of Dr. Aveling, rehe goes on to say that typhus can be safely isolated in a fused to return a verdict in accordance with it, though private house, he having done so in his own house success- advised to do so by the coroner, Mr. Collier. Very fully, With all due deference to Mr. Davies’s high merits wisely, as we think, the inquiry was adjourned for a as a sanitary official, we would urge that the tendency of his post-mortem examination to be made. The jury, however, letter is retrograde in the extreme. In the first place, declined the assistance of the doctor nominated by the Bristol, whilst keeping open a hospital for the only infectious coroner, and demanded that the autopsy should be disease the spread of which can be prevented by other mears supervised by a gentleman of their own selection. After than by isolation-namely, small-pox-never makes any much bickering, it was eventually settled to ask Dr. Collins attempt to nip in the bod " the far more fatal scourge of to officiate. This he did in the presence of Dr. Bristowe, "
883
of the part being directly due to a want of blood, and not scarlet fever, and now it would appear that typhus is to be dependent in any degree upon inflammation. The treat- relegated to private houses. Unfortunately, the people ment adopted was undoubtedly the wisest possible, and amongst whom this disease of dirt and overcrowding almost Such a mummi- exclusively prevails have not such houses as Mr. Davies was brilliantly justified by the result. fied member was not a source of danger to the patient possesse. Then again, although the Public Health Actconfrom blood-poisoning, and there was at no time any tendency tains a clause as to compulsory removal, experience everywhere for the gangrene to spread, so that there was no justification shows that the powers given as to this are rarely resorted to, for amputation, which would have been attended with grave and that thousands of cases of such diseases as scarlet fever are risk to a man of this advanced age, suffering as he was from isolated without any reference to it; and this with nothing chronic pulmonary disease. Dr. Hare, who had several but benefit to the surrounding community. And further, times seen the patient previous to the occurrence of the though the same Act enables sanitary authorities to recover gangrene, laid stress upon the little evidence of atheroma in the cost of the maintenance of patients in isolation hospitals, the large vessels. This, however, is quite consistent with yet it was certainly never anticipated that such authorities would make an undertaking as to payment an absolute advanced calcareous disease of the smaller arteries. condition of admission. The prime object of infectious is to the hospitals prevent spread of infection, and not to THE DEATH OF MR. FAWCETT. make such prevention dependent on recovering a small THE death of Mr. Fawcett, humanly speaking, is one of payment on behalf of the individual who assents to be the saddest events which could have occurred, and deprives isolated in the interests of the community. We wish that the State of one of its most faithful and promising servants, i Bristol could see its way to follow in the path of many and society of one of its most remarkable men. The existence other sanitary districts which, having provided themselves of such a man-blind, yet " leading the blind," and showing with proper isolation hospitals, so use them as to protect to them the possibilities of life under conditions of blindness, the utmost possible extent the public by whom and for and full of light and hope for humanity, as well as of whom they have been constructed. political wisdom and strength-was a national blessing and credit, of which the country might have hoped for a continuance for years to come. Many men with sight might TREATMENT OF MARSH FEVER BY SUBCUTANEOUS INJECTIONS OF CARBOLIC ACID. have been better spared. Wehave little to add to what has his It been already made public of the nature of illness. DR. DIEULAFOY communicated to the Société Médicale was of a pneumonic and pleuritic character, and accomplished des Hopitaux of Paris, on the 10th ult., the history of a its deadly work with much quickness and, we regret to say, patient who since 1877 had had tertian fever three times, with much pain, the pleura covering the diaphragm being which had always been successfully treated by the adminismuch affected. It is easy to speculate on the probable causes tration of sulphate of quinine. The fever having returned of such a disaster to a man of fifty-one, whose father and mother, last Jtine, the patient Came under the care of Dr. Dieulafoy, by the way, are yet alive. The season has been favourable to who on the first day injected subcutaneoualy two centisuch attacks. His previousillness did not lessen his liability to grammes and a half of carbolic acid dissolved in a hundred them, and we should probably not be far wrong in supposing parts of water. The quantity was increased on the following that the worrying autumn session, added to his departmental days to five centigrammes, and to seven centigrammes on labours, produced that fatigue which makes the system more the days of apyrexia. Recovery was complete at the end of vulnerable to the causes of catarrhal disease. seventeen days. The patient had then absorbed eighty-four centigrammes of carbolic acid, without showing any signs of poisoning. In the subsequent discussion, Dr. Laveran reISOLATION AT BRISTOL. verted to the fact that carbolic acid injections had been IT is not often that we find ourselves at variance with the employed against marsh fever so far back as 1869, with veteran medical officer of health for the city of Bristol, but success. He doubted the propriety of attemptquestionable in the matter of the isolation of infectious diseases we are to supplant so certain a remedy as sulphate of quinine. ing quite unable to understand the advice which he tenders, and Dr. Huchard related the case of an Arab in whom quotidian it is evident from the comments in the local press that we are attacks of fever, which had resisted all other remedies, not alone in this matter. The whole system, as indicated and Dr. Libbe alluded to yielded to bromide of by a letter which he, in his official capacity, has addressed the good effects, tao potassium; much overlooked, of arsenical medito the Bristol Mercury, is evidently regarded by the cation in malarial poisoning. sanitary authority from a point of view which we think to be faulty. Although from recent reports it apALLEGED DEATH FROM VACCINATION. pears that two hospitals exist, and although their value in enabling the city to crush out an outAN inquest was held on Friday, Oct. 31st, at the Clapton break "in the bud"is prominently brought forward, yet Park Tavern touching the death of aa infant aged four now, when the closure of the fever hospital is in question, months. From the evidence it appears that the deceased Mr. Davies, instead of advocating the maintenance of a was found dead in bed by its mother’s side. Dr. Aveling of building to which first attacks could be removed, points out Clapton was called in, and at the inquest he deposed that all the hindrances to isolation, explaining that he can only he had not the slightest doubt that the child had been compel removal on a justice’s order, that no one would be suffocated through overlaying, but a majority of the admitted unless payment is guaranteed in advance; and then jury, ignoring the expressed belief of Dr. Aveling, rehe goes on to say that typhus can be safely isolated in a fused to return a verdict in accordance with it, though private house, he having done so in his own house success- advised to do so by the coroner, Mr. Collier. Very fully, With all due deference to Mr. Davies’s high merits wisely, as we think, the inquiry was adjourned for a as a sanitary official, we would urge that the tendency of his post-mortem examination to be made. The jury, however, letter is retrograde in the extreme. In the first place, declined the assistance of the doctor nominated by the Bristol, whilst keeping open a hospital for the only infectious coroner, and demanded that the autopsy should be disease the spread of which can be prevented by other mears supervised by a gentleman of their own selection. After than by isolation-namely, small-pox-never makes any much bickering, it was eventually settled to ask Dr. Collins attempt to nip in the bod " the far more fatal scourge of to officiate. This he did in the presence of Dr. Bristowe, "