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Poisoning by Creosote.—Mr. Batho, surgeon to the 2Gth Regiment Native Infantry, records a case of poisoning from an over-dose of creasotc. A stout young man swallowed half an ounce of the drug. The symptoms presented ■were complete insensibility, small and rapid pulse, quick and laboured respiration, attended with puffing of the cheeks and violent working of the alte nasi, foaming from the mouth (exhaling a strong odour of creasote), a warm skin, flushing of the face, slight injection of the conjunctiva. There was neither vomiting, purging, nor convulsions. On the following day there was sympathetic fever, with pungent heat of the mouth, fauces, and oesophagus; no tenderness at the epigastrium, but little thirst, a foul tongue; and the mucous membrane of the mouth and fauces presented patches of erythematous redness. On the 3rd day there was a sense of burning in the chest, and difficulty of deglutition. These symptoms gradually subsided, and he was discharged on the filth day. The principal points in the treatment were the repeated injection and withdrawal by the stomach-pump of albumen in large quantity, until the odour of creasote was no longer perceptible, and the combating of the inflammatory symptoms by leeching the throat, general bleeding, and the administration of demulcents, castor-oil in the form of enema, and a turpentine epithem to the thorax. — Transactions of the Medical and Physical Society of Bombay, for the years 1855-56. Appendix, p. 19.
Notes on the Cape of Good Hope, Us Climate, Sec §-c.—Mr. Martin (Bengal Medical Service) comes to the conclusion that "with reference at any rate to the troops, the Cape of Good Hope is one of the most healthy of the British Colonies; and that, compared with even a European climate, it may be considered as favourable for British soldiers. The average mortality among the troops serving in the colony, during six successive periods, when they were not exposed to the risks and fatalities of active military service, only amounted to something less than 12 per 1000;" the rate of mortality of troops serving in Great Britain being about 15 per 1000. The Caffre war, with its attendant deprivation, exposure, aud excitement, has entailed very serious losses, apart from the direct casualties of combat, which however cannot be put to the account of climate. The author observes that the amount of moisture in the atmosphere is never very great, the rain which falls is in amount inconsiderable, so that the fevers of all types are rarely met with ; while the great and sudden transitions from heat to cold, and cold to heat, induce an unusual frequency of rheumatic affections, with their complications and consequences of heart disease. Accordingly, the diseases that predominate at the Cape are disease of the heart, rheumatic affections, and functional disorders of the stomach. Head affections are not common. Chest affections are more so; in children, mild forms of bronchitis are not unfrequeut; in adults, if pneumonia or any of the more acute affections of the lungs come on, they arise from neglect or extraordinary exposure. Diseases of the bowels are stated not to be common, but bilious cholera, diarrhoea, and dysentery prevail in the autumn. After some desultory observations about children's diseases, the author remarks that leprosy is not uncommon, in the form attended by loss of the joints, and intractable ulcerations ; and then says, "There is a complaint peculiar to the Cape climate, called Zinkins, which is most painful and prostrating for the time, but not dangerous. It seems to be a severe form of influenza, but I do not think it occurs as an epidemic; it is characterized by paiuful swellings about the jaws, face, head, and joints, great lassitude, and nervous derangement." For the children of European origin, the climate seems to act like a hothouse, causing a rapid and precocious development; to Indian invalids, who often resort to the Cape as a sanatorium, it is apt to prove too relaxing; while the sudden changes of heat and cold, dryness and moisture, render it peculiarly trying to those who are endowed with weak lungs. "The cases which seem to hare a chanee of doing well at the Cape, are those in which the nervous system has become debilitated bv residenee in a tropical climate, and has induced the various forms of indigestion, disorder of the funetions of the liver, bowels, &c."— Madras Annals of Medical Scienee, Oct. 1856.
Quarantine.—The minutes of the proceedings of the Quarantine Convention held at Philadelphia by invitation of the Philadelphia Board of Health, in May, 1857, is an interesting document. The Convention agreed, That the system of quarantine regulation should be revised. That the diseases smallpox, typhus, vcllow-fevcr, and cholera may be introduced into a community by foul vessels and cargo and diseased crews, but that such diseases cannot become epidemic unless there exist in the community circumstanees favourable for their development, independent of importation. That all parts of a vessel should be ventilated during a voyage, and that no vessel arriving between the 1st of May and the 1 st of November should be admitted into port until her hold is ventilated and her bilge-water removed. That all portions of the cargo of a vessel capable of communicating a disease should be removed and purified. That all persons labouring under a disease should be removed immediately, and comfortably accommodated. That these provisions should be intrusted to a single officer, who should be a qualified medical man, and one competent and firm in the discharge of his duties. That a thorough examination should be made of all emigrants on their arrival, and that if they are not protected against the small-pox, thev should be vaccinated. Lastly, the Convention recommends that there should be attached to quarantine establishments stations for meteorological observations and vaccination, and that records of these should be published for the public benefit.
Transmission of the Virus of Grease from the Horse to Man.—Drs. Maunoury and Pichot have published an interestiug series of experiments tending to prove the identity of grease and cowpox. This doctrine, which was always maintained by Jenner, has received confirmation from the observations of Loy, Godine, and others.
The following is a summary of the facts related by Drs. Maunoury and Pichot.
'Francois Barthelemy B , aged twenty-eight, of lymphatic temperament, a
farrier, presented himself to Dr. Pichot on the 5th of March, 1856. JHe had not been vaccinated. On the hacks of his hands, which were red and swollen, were several confluent opaline pustules, depressed in their centre, having all the appearanee of vaccine pustules of the eighth or ninth day. The inflammation with which the pustules were surrounded had appeared on the second, the pustules themselves preceded the inflammation some days. This man had not been iu contaot. with any cow, but on the 11th of February he had shod a horse suffering from grease. There existed at the time numerous cracks about his hands. The disease from which the horse was suffering was certified by a qualified veterinarian. On the 11th of April, circular depressed cicatrices occupied the situation of the pustules. Various inoculations were practised with
the liquid taken from the pustules presented by B , with the effect of
reproducing the same disease. The most perfect set of experiments were made by M. Maunoury, who transmitted the virus through four sets of cases. The following are the results of his observations:—
1. That virus obtained from the hands of the farrier B , and inoculated on the arm of an infant, produced a full pustule, having all the characters of a vaccine pustule—form, evolution, termination.
2. That lymph taken from this pustule and inoculated on the arm of three persons, has produced identical pustules, which are truly vaccine.
3. That the transmission of the virus by successive generations, has not diminished the intensity of the force of the poison. One of the set of cases presented large pustules, depressed in the centre, and filled with matter; each pustule served for several moculations, and the charging of several sets of glasses.
4. That from these facts it is evident that the virus taken from the pustules of the farrier was identical with the vaccine.—Archives Generate de Medecine, April, 1857, pp. 365-398.
Death by Hanging.—Dr. E. Leudet publishes a case of asphyxia by hanging, in which death was the result. Examination revealed fracture of the two great cornua of the thyroid cartilage, tearing of the thyro-hyoidean membrane, and incomplete rupture of the epiglottis.
An English sailor was occupied in the rigging of a ship, when a spar broke under his weight, and in falling he was arrested by a rope, which held him suspended by the neck. When he was taken down he had not lost consciousness. He was carried, about an hour after the accident, to the Hotel Dien, at Rouen. The face was cyanosed, the conjunetivae much injected, there was considerable dyspnoea, a full, strong, and frequent pulse. The rope had left a large bluish-red furrow round the neck, there was tenderness on pressure over the anterior part of the larynx, the voice was feeble but very distinet, respiratory murmur feeble, expectoration sanguinolent. He died at one o'clock the next morning. On exammation thirty-two hours after death, the integuments of the whole body, but prineipally of the face, were found cyanosed. There was considerable ecchymosis and swelling about the neck, the two stcrno-cleido-mastoid muscles were ruptured transversely, the right almost completely, the left through half its thickness. The great vessels and nerves had escaped. In front of the thyroid cartilage was a small cavity bounded by cellular tissue and the ruptured muscles, which communicated with the cavity of the larynx through a rent in the thyro-hyoid membrane. The body of the os hyoides was sound, its right greater cornu loosened. The two great coruna of the thyroid cartilage were fractured near their base, one was almost de tached. There was an oblique crack on the front of the thyroid cartilage, also a transverse fissure on the posterior surface of the fibro-cartilage of the epiglottis.—Archives Generates de Medecine, April, 1857, pp. 479-481.
Fatal Results from the Sling of a Bee.—Dr. N. Nivison records a case in which death was apparently produced by the sting of a bee. A farmer in good health, aged about fifty, was stung by a bee at the side of the neck, on the 8th ot August, 1850. He had been used to such accidents, which wer« always followed by considerable swelling and local inflammation. On this occasion, though severe pain was momentarily felt, no swelling or discoloration followed. lie removed the stiug with his fingers. Two hours after he began to experienee unpleasant sensations, and a degree of nausea, which was followed by free vomiting. Four hours after the accident, when Dr. Nivison saw him, he complained of nausea, was vomiting occasionally, and his breathing was somewhat oppressed, and sighing. There was no trace of local irritation in the part stung. Dr. Nivison supposed that the poison had been speedily absorbed, or had entered directly the circulation. The next day the vomiting had continued, and diarrhoea was added. The countenanee was shrunken, wan, and anxious. The pulse had lost much of its force and volume, but was natural in frequeucy. The tongue was covered with a dirty white fur, pale, soft, and flabby. These symptoms continued with but little relief from remedies; sleeplessness, and great restlessness and jactitation were present during the whole of the attack. The patient sunk, and died six days from the date of the sting. The remedies prescribed were sinapisms to the epigastrium, the free use of brandy and opiates, mercury in the form of calomel and hjdr. cum cretfi, and quinine. The attack differed from any of the gastro-mtestinal diseases peculiar to the season of the year, and Dr. Nivison's impressions were ftrongly in favour of the belief that it resulted from the cause specified. He thinks that had the danger been anticipated, by the free and early exhibition of powerful stimulants and anodynes, the result might have been averted.—Nev York Journal of Medicine, May, 1857, pp. 339-341.
QUARTERLY REPORT ON PATHOLOGY AND MEDICINE.
Fellow of the Royal College of Physicians, Lecturer on Materia Medica,
I. Embolic Apopleryfrom Detachment of Fibrinous Coagula in an Aneurim of the Carotid. By Dr. Fr. Esmarch, Director of the Surgical Cliniquc at Kiel. (Archiv fur Pathol. Aunt. und Physiologie, Band xi. Heft 5.)
Captain C. H., from Sweden, consulted a medical friend of Professor Esmarch, coneerning an attack of angina tonsillaris, and at the same time drew his attention to a tumour of the left side of his neck which had formed suddenly three years previously, without appreciable causes, and had now attained the size of a hen's egg. It occupied the upper triangle of the neck, was slightly diminished by pressure, and communicated a distinet thrill to the touch. It was at onee diagnosed as an aneurism of the common carotid. On repeating the examination a few days later, and exerting pressure upon the tumour for the purpose of reducing it, the patient suddenly fell back with symptoms of apoplexv. He was at onee bled and conveyed to the hospital, where he was placed under the care of Dr. Esmarch, on the 8th of May, 1855.
The patient was well built and robust; in a state of coma, from which he could only be roused momentarily; the pulse was moderately full, heart normal. The whole right side of the face was paralysed, the right check was distended in expiration; there were spasmodic movements in the facial muscles of the left side. The pupils reacted to the stimulus of light. The tongue, which was much furred, pointed to the left. Respiration was stertorous. The thoracic muscles and diaphragm acted well, but only the left abdominal muscles moved in respiration. Both right extremities were completely paralysed. Deglutition, defalcation, and micturition were normal. The tumour pulsated isochronously with the carotids, Tiut presented no murmurs.
Professor Esmarch diagnosed the detachment of fibrin from the aneurismal sac, and a consequent obliteration of the left cerebral carotid. Ice was applied to the head, sinapisms to the legs, and an enema with vinegar was administered. Some improvement ensued; the paralytic symptoms diminished, and the patient was able to converse with a countryman; a relapse, however, followed, and on the 11th of May profound coma ensued; the pulse was very quick, the skin cool, the complexion livid, the right pupil was somewhat drawn out transversely, but both pupils continued to react to the light; both lips were distended by expiration; urine was passed involuntarily. The livor increased, the pulse became too quick to be counted, respiration slow, and accompanied by screams in inspiration; and death ensued at midnight.
The cadaveric examination was made the day after by Professor "Weber.
The aneurism had a spindle-shaped form, and commenced about four centimetres above its issue from the aorta; the external and internal carotids quitted the upper end of the aneurism, preserving their normal size. The internal jugular vein was pushed outwards, the vagus lay between the vein and the aneurism and was unaltered, but the descending branch of the hypoglossus was adherent to the tumour, and much altered in appearance. The whole internal surface of the carotid from its origin was in a state of atheromatous degeneration, and contained enormous chalky formations; both below and above, a portion of the inner coat of the artery formed a projecting ridge in the aneurismal sac. The sac was partly lined with a smooth red membrane, partly with more or less firmly-attached, ragged, fibrinous coagula; much loose fibrin, irregularly interwoven, was also in the sac; a firm coagulum was drawn out of the internal carotid, which tore off from its continuation within the carotic foramen. There was no coagulum in the external carotid. Within the cranium there was found considerable hyperemia of the vessels of the pia mater, a moderate effusion of serum under the arachnoid; the whole middle portion of the left hemisphere, including a part of the corpus callosum, was converted into a )ulp of a greyish-yellow colour. Beneath the aquseductus Sylvii, in the mesial iue of the pons Varolii, was a perfectly recent extravasation of blood of the size of a bean; a smaller one, a centimetre in front of the former, and in the vicinity several small capillary extravasations. Normal cerebral tissue could not be discovered in the softened portion; it consisted of granular matter and short fragments of broken-up fibres, with capillaries containing shrivelled corpuscles. In the extravasations at the pons, the blood corpuscles were unaltered. The cerebral carotid, the arteria fossa Sylvii, and the arteria ophthalmica, were completely blocked up with coagula of a dark-brown colour, inclosing numerous red and greyish-white plugs, which evidently were derived from the aneurism. Their identity was proved by the microscope. The thoracic viscera
Eresented no marked disorganization, except that the ascending aorta exibited extensive atheroma; the same was tlie case with most of the large arteries.
Professor Esmarch, in his concluding observations, dwells upon the danger of much manipulation of aneurismal tumours, as being liable to give rise to such consequences as those above described. He particularly discusses Mr. Fergusson's mode of treating aueurism of the subclavia, recently brought before the Medico-Chirurgical Society, which consists in forcing the coagula contained in the tumour into the axillary and brachial arteries.
II. On (Edema Glottidis. By Professor Pitha. (Prager Vierteljahrsschrift, Jahrgang xiv., 1857. Band liv.)
In an interesting article of considerable extent, on the whole subject of tumefaction of the glottis (which applies rather to the epiglottis and the aryepiglottic folds than the true glottis), we find the following instance of acute oedema, assumed to have been Drought on in a healthy person by an article of diet.
Madame Grabinger, a robust ruddy woman, aged thirty, on a hot summer's day felt poorly and faint immediately after her dinner, which she had enjoyed in perfect health. She lay down on the sofa and went to sleep quietly. After about half an hour the children observed that their mother breathed laboriously and noisily, so that they roused her. She awoke with difficulty; her face was distorted, pale, and swollen; the voice hoarse; the respiration became more laborious; the patient complained in broken words of constriction of the throat, and a sense of suffocation. A few minutes later, Professor Pitha found the