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Hospitals and Alms-houses in France. The present number of hospitals or alms-houses in France is 1338, having a revenue of 53,632,992 fr. There are 39 institutions for the education of the deaf, dumb and blind youth of the kingdom, in which at present 1675 pupils are receiving instruction. The number of deaf and dumb persons in France is computed at 20,000 10 25,000, and the number of blind at 12,000 to 15,000. As to the enfants trouvés, the number cannot be accurately made out, but 123,394 have been received at the Foundling hospitals, of which there are 144, in a single year. The number of indigent lunatics is 12,286, who are supported by the government at an annual expense of 4,326,138 francs, and by humane and judicious treatment a large number of these unhappy beings are every year restored to reason, and to their families and society:-Western Journal.
Analysis of Gun-Cotion.-In a late English paper I observed an analysis of gun-collon made by Professor Graham, of London. Exploded in a glass tube so as to collect the gaseous products, 53.33 grains of the cotton yielded 100 cubic inches of gas, of which the composition was as follows: Carbonic acid,
14.284, or 2 volumes; Cyanogen,
7.143, or 1 volume; Nitric oxide,
35.715, or 5 volumes; Carbonic oxide,
35.715, or 5 volumes; Nitrogen
7.134, or 1 volume. Besides these aërisorn bodies, a portion of oxalic acid is precipitated, and a considerable quantity of water results from the combustion.
Small-Pos.-M. Béhier, one of the physicians of La Charité, Paris, has had during the last few weeks several interesting cases of small
. pox in his service. A female, twenty-eight years of age, slept for some nights next to the bed of a patient labouring under variola: one morning, in making up a bed, she touched his person. Twenty days after she was seized with chilliness, followed by heat and a sensation of general lassitude, with pains in the loins, felt particularly in movements of the limbs. She complained of soreness of the throat, with tolerably intense oppression; the tongue was white, the eyes weeping, and the palate the seat of papulæ. The most remarkable phenomenon in this case, and it is on this account that I have reported it, was the form and volume of the pustules, which were small, pointed, resembling simple acne, and not presenting the appearance of pustules with wide bases which are observed in variola. This modification in the eruption alone gave rise to some fears of unpleasant complications. And this is a character which it is well to bear in mind, that whenever the pustules present themselves in this way, there is reason to anticipate an abnormal march, or some grave epiphenomenon in the disease. The third day a violent delirium declared itself; the patient jumped out of bed and ran across the ward. She complained greatly of her throat: her pulse was at first 74; then 84; then 90. Six leeches were applied behind each ear. Calomel was given inlernally ; two large blisters to the lower extremities, after having previously used sinapisms. The third day after the delirium the pustules became less distinct, and the symptoms improved. This is a remarkable fact--the patient had been vaccinated, and should have had varioloid ; but, on the contrary, her symptoms were exceedingly grave. It is generally the case, when a patient who has been vaccinated is attacked with variola, that the disease is more mild than if vaccination had not been performed. An opinion prevails very extensively among physicians, that in variola the pustule is umbilical, or pointed, and is not so in arioloid. This is proved to altogether erroneous. In variola, umbilical pustules are but rarely seen, and the only real difference between it and varioloid is in the time of desiccation. In the former, between the eruption and the desiccation, there is a distinct period, while in varioloid the pustules appear, become dry, and the scales are formed and fall off very rapidly.
There should be no importance attached to the umbilical shape of the pustules in these diseases, according to M. Béhier, who has made extensive and careful researches on the subject, both at l'Hospital Saint Louis and l'Hospital des Enfans, where he has had numerous opportunities of observing these diseases. As a general rule, variola does not offer umbilical pustules. The history of this patient, after her recovery from variola, shows the possibility of complications posterior to the principal affection. The parotid of the left side of her neck inflamed, and the abscess was opened. Erysipelas seized first this side, and afterwards the other, and was followed by anasarca, which commenced in the face, obstinate diarrhæa, and albuminous urine. The same remedy was employed in this condition, as in a similar case supervening upon an attack of scarlatina : vapour baths produced sensible amelioration of the symptoms.-Ibid.
Treatment of Hydrocele.-In the treatment of hydrocele, M. Blandin does not believe that the nature of the liquid injected into the vaginal tunic exercises any sensible influence upon the results of the operation. He employs, with equal confidence, the vinous decoction of roses de Provins, tincture of iodine, etc. It is only neces. sary that the liquid should possess irritating properties, in a sufficient degree to provoke an adhesive inflammation, in order that its use may be followed by success. . He prefers a simple mixture of three parts of water to one of rectified alcohol. This liquid possesses the advantage of being always at the hand of the surgeon, and not requiring, as the vinous decoction does, a manipulation more or less tedious; and what is of more importance, it possesses over the preparations of iodine the advantage of leaving no stain on the instruments or on the linen of the patients.-Ibid.
RECORD OF MEDICAL SCIENCE.
NEW SERIES.-No. XXIX.-MAY, 1847.
Cold Plague, or Malignant Bilious Pneumonia. By JAMES
D. Rivers, M. D., of Hall County, Ga. The February number of the Examiner contains an article extracted from the Southern Medical and Surgical Journal, in which the writer makes some remarks in reference to a disease which has prevailed more extensively in Georgia and South Carolina (and perhaps in other Southern states) during the last year or two than formerly, and which has been attended with an extraordinary degree of mortality.” The disease to which the writer alludes, under the name of “ Pneumonia,” or “Pleuro Pneumonia,” is well known to the people of North Carolina, South Carolina and Georgia, as the “ Cold Plague;" and from the little ex. perience that I have had in some fifteen or twenty cases, I am induced to believe that this latter appellation, or the more scientific one of Malignant Bilious Pneumonia, is preferable to the one which the writer has given, and is more descriptive of the malady than any other name that has come to niy notice. The disease called the “Black Tongue,” which prevailed to such an alarming extent in the north-western section of this State last year, is, I suspect, another form of the Cold Plague. With these remarks by way of prelude, I propose to make a few observations in reference to the general characters of the disease as developed in the cases that have fallen under my charge, and the method of treatment adopled, and then to give a detailed account of a VOL. X.
few of the most important cases which I have had; merely remarking beforehand, that all my patients affected with this disorder, to the number of about twenty, recovered under the prescribed treatment.
The diagnostic symptoms of the Malignant Bilious Pneumonia of this section of country, are rigors, but never a shaking chill; coldness of the body and extremities, pain in the forehead, generally an inch or two above the orbits of one of the eyes, most commonly over the left eye, severe pain in the chest, usually on the right side, pain in the region of the liver and pain in the abdomen. As the malady advances in its inflammatory course, the tongue thickens and expands laterally. In the outset of the disorder the pain is metastatic, sometimes inoving from the head to either lung, usually the right one, frequently to the superior lobe of the lung, then to the lower part of the lung adjacent to the diaphragm, then to the liver, and finally to the abdomen in the region of the large intestines; frequently returning over the same track. It is not uncommon for this moving, jumping pain to lessen in intensity in one organ or part of the body, and to in. crease in a corresponding ratio in another organ at a considerable distance. I have seen the left eye of a patient contracted or shrunken and turned in toward its inner canthus, and vision so impaired that objects appeared double, the pain being much more acute in the region of the lungs and liver than in the head. In two instances I have seen numbness of the extremities; in all there was venous congestion and generally a corresponding increase of action in the arteries. In one of the ten cases hereafter spoken of, there was both venous and arterial congestion, and the pulse never rose to the healthy standard, either in volume or stroke, until the patient, a negro woman, became convalescent; and even after she began to expectorate freely, the oscillation of the artery at the wrist was not perceptible. The Cold Plague assumes many different garbs in which to make its appearance, one of which, as already remarked, is no doubt the Black Tongue; I have known abscesses to form in the early stages, in two instances in the soft parts of the lower jaw; in another case the lips were excoriated and much swollen. I consider that the lungs are primarily affected, the liver secondarily; the liver is engorged, though the engorgement may only produce a suspension of the secretory process, sometimes perhaps causing irritation or inflammation to supervene.
The Malignant Billious Pneumonia in its metastatic state yields to stimulants and diaphoretic ptisans. Brandy and water I consider an excellent remedy in the incipient stages, during the metastasis of the pain, and I gave it in several instances with desirable effect. A tea made of the Eupatorium perfoliatum,
sufficiently strong to act as an emetic or purgative for a short time, then diluted and given as a diaphoretic, is also a valuable remedy in the first stages of the affection. But whenever the disease becomes seated or any organ of the body, the antiphlogistic treatment seems generally to have the best effect; and in no case where expectoration had not taken place, did I dare to give stimulants, opiates, or animal diet in any form. I have found farinaceous diet to be the most suitable, especially before expectoration takes place. Before expectoration has become free, the principal articles of diet I use are rice water, corn gruel, rice, grits, and the crust of corn bread browned by the fire.
I had ten cases of the Cold Plague on a single plantation in Forsyth county, situated on the Chattahoochee river, a rapid mountain stream. The place had been settled about fifteen years, during which time, according to the positive declarations of the occupants, no endemic epidemic, or disease of any kind, had affected those that lived upon it. The appearance of so many cases upon one farm cannot therefore be attributed to any local causes. Most of the persons that visited the plantation during the prevalence of sickness upon it were more or less affected; while none of the neighbors that did not visit the sick were molested by the malady. While in attendance, I was myself twice attacked with it, the first time lightly, the second more severely.
Case 1. Miss E. B. aged 16. This is the case mentioned in which an eye was affected. Symptoms presented themselves in the following order: rigors, general coldness of the body and extremities, sore throat, slight pain in the side, and in the diaphrag. matic region of the right lung and liver. The arterial action was considerably increased, with evident venous congestion. A vein was opened in the arm and but little blood taken, which indicated congestion in the superficial veins at least; she began to
; prostrate, and the artery at the wrist to thread, the bleeding was stopped, and I have not used the lancet in any case since. The tongue thickened and enlarged laterally, as the irritation or inflammation of the lungs and liver increased; it also became coated with a brown fur, and was red at the tip and edges; the skin was dry, the face flushed, with slightly impeded respiration, and considerable nervois excitement, but not so as to affect the mind. The stomach was in an abnormal state, nauseants in the form of tartar emetic water and ipecac. producing no more effect upon it than so much cold water. I gave her a combination of calomel, nitrate potass, and tartar emetic, in the proportion of calomel 2 gr., tartar emetic & gr., nitrate potass 2 gr., every two hours, and put her in a warm saline bath whenever she would bear it; the skin continued dry, and the medicine produced no effect. I now gave her, in connection with the use of the bath, strong tea of