testimony goes for any thing, arsenic should be the most potent remedy in snake-bites; its reputed effects, after wounds inflicted by the serpent of St. Lucia, are well known to professional readers. In the stings of gnats, hornets, &c. Mr. James has seen great relief afforded by gently rubbing the part with ung. hyd. and applying extensively a lotion composed of liq. ammon. subcarb. 3ij. aquæ, 3vj. to the surrounding parts. Vegetable poisons are seldom very injurious, unless when introduced into the cellular tissue, or applied to parts deprived of cuticle. Even here they act for the most part as mere irritants. Thus port wine and water, injected into the cellular tissue of the scrotum, will kill it; but port wine and water is certainly not a poison under ordinary circumstances. The reason why it kills the cellular texture, is because this possesses a low degree of vitality, and it is destroyed by the injection, which scarcely produces inflammation enough in the tunica vaginalis. Mr. James remarks, that neither urine nor wine will always occasion sphacelus of the cellular membrane, if they do not continue long in contact with it, and, therefore, that the earlier incisions are made to evacuate the fluid the better. This is most true and most important; and we would repeat most emphatically, the earlier and bolder the better. Mineral poisons act variously, according to the chemical affinity of the agent with the living tissue. Nitric acid and the caustic alkali produce very different sloughs; the former destroys what it comes into contact with, the latter combines with it chemically, and is, consequently, a penetrating caustic. Thus, an issue made with the former is usually of determinate depth-with the latter, it may pass much more deeply than the inexperienced operator would imagine. The tartarized antimony appears to us to act on a particular texture, and it is well known to produce occasionally a sort of secondary eruption of pustules. The texture on which it more immediately acts seems to be the glandular system of the hairs. If a pustule, produced by tartar-emetic, be carefully examined, it will invariably be found to contain in its origin a hair in its centre; such, at least, has ever been the case when we have had the curiosity to inspect it. Arsenic exerts something like a specific operation, producing, when introduced into a wound, inflammation of the mucous membrane of the stomach. Our limited space compels us to close Mr. James's volume. We recommend it warmly to the attention of students, both in practice and out of it. There is much information to be derived from it. It is not without faults, but they are infinitely overbalanced by its merits; and again we repeat our hearty commendation, and recommendation to our junior brethren to peruse it. It is a pleasant thing to see our provincial surgeons exerting themselves, to prove that knowledge is every where diffused among the ranks of our intelligent profession. XI. DR. STEVENS ON THE BLOOD. Continued from page 336. "At the last meeting of the magistrates of the county of Middlesex, it was unanimously agreed, that a vote of thanks, and a piece of plate of the value of one hundred sovereigns, should be presented to Dr. Stevens, for his attention to the sick, and the great success which had attended the saline treatment, in the prison of Cold Bath Fields. Another piece of plate, of the value of fifty sovereigns, is also to be given to Mr. Wakefield, surgeon to the prison; and another of the value of twenty-five sovereigns, to Mr. Crooke, a young gentleman who lived for several years with Dr. Stevens in the West Indies, and is now a student of medicine in the London University. Small sums have also been awarded to several of the nurses; and some of the prisoners, who rendered themselves useful by their attendance on the sick, are to be recommended for pardon, through the magistrates, by the Secretary of State."-Med. Gaz. June 2, 1832. Orpheus, whose fiddle moved the trees and stones, was after all but a bungler when compared with Dr. Stevens. He has moved Sir Peter Laurie. Dr. Stevens proceeds to mention the success attending the saline treatment of Mr. Whitmore and Mr. Marsden. As, however, we consider the institution immediately under Dr. Stevens' own care, as affording the best means of testing his own practice, we shall leave those gentlemen without further notice. We have brought before our readers the whole of the Cold Bath Fields case as stated by Dr. Stevens himself, and we have shewn that, even reasoning on his own statements, the result is rather against his practice than for it. But this is the most favourable side of the question. The Board of Health being constantly dinned, no doubt, with the success of Dr. Stevens, determined, very properly, to investigate his statements. The result must have been distressing to the feelings of the saline party. In the Lancet for July 14th, 1832, there is a communication from Sir David Barry, stating the results of a visit which he made to the ColdbathFields Prison, on the 27th and 28th of June. "On the night of the 25th of June ult., in a casual conversation with Dr. William Stevens at the College of Physicians, I learned, with no small astonishment, that he had seen upwards of forty cases of cholera in Coldbath-Fields Prison within the preceding 24 hours. Struck with this formidable announcement, I requested permission to see these cases with the Doctor next morning, but could not obtain an appointment with him earlier than for the 27th. On that day I proceeded to the prison rather in a private than official capacity, accompanied by Dr. O'Shaughnessy, whose Report on the Chemical Pathology of Cholera' entitles him to such high consideration in everything connected with what has been lately denominated the saline treatment of that disease. Dr. Stevens conducted us round all the wards appropriate to cholera patients. On leaving the prison, at about half-past two o'clock, p. m., I observed to him, in presence of Dr. O'Shaughnessy, that I had seen no case of cholera in the prison that day-meaning, as Dr. Stevens appeared to allow at the time, that I had seen none actually labouring under the characteristic symptoms of the disease." 455. On the morning of the 28th a note was addressed by the Privy Council to the governor of the prison, requesting to be informed whether the statements in the newspapers respecting the frightful extent of cholera in the prison were correct. To this the governor replied that unfortunately much of the newspaper statement was correct, the number of persons then labouring under the disease in its various degrees being about seventy. In consequence of this deplorable insalubrity Sir David Barry was officially desired to visit the prison, which he did on the 28th inst. It will be recollected that his previous visit with Dr. O'Shaughnessy, on the 27th, was a nonofficial one, and it will also be remembered that at that non-official inspection of the 27th he declared to Dr. Stevens that he had not seen one case of cholera. There must indeed then have been grounds for serious alarm, when Sir David Barry finds no case of cholera on the 27th, and the governor of the prison, acting no doubt on information derived from the medical attendants, declares on the 28th that there are seventy. When pestilence rears its head with so appalling a front, it well becomes His Majesty's Government to institute an official investigation. The volcano, we suppose, alluded to by Dr. Stevens, had begun to discharge in the night of the 27th. The minutes of the official visit shall be given in Sir David Barry's words. "Coldbath-Fields Prison, June 28th, 1832. "Notes.-Visited the wards appropriated to cholera patients in this establishment at half-past four o'clock, accompanied by Deputy Inspector General of Hospitals Maling, and Staff-Surgeon Macann, conducted by the governor of the prison, and two visiting magistrates. Saw all the wards in which persons said to be labouring under cholera were treated, and examined individually all those said to be on the sick list, then present. 1st Ward visited.-Nine patients. One man who had been four days under the saline treatment for premonitory symptoms had been attacked this morning, after having been discharged from hospital. A genuine case. Attempts were making, by a young man of colour, to introduce the tube for saline injection into one of the veins at the bend of the arm, under the direction of Mr. Wakefield. Tube could not be introduced, as I learned afterwards. Fluttering pulse, livid and sunk countenance. This case will most probably prove fatal. Another man in this ward, looking thin, pale, depressed, hollow eyes, but good pulse, is under saline treatment. When I saw him about half an hour afterwards, his tongue was cold, with a weak slow pulse. Ward small for the number of beds; close, hot, and oppressive, with a very large fire. 2d Ward visited.-Eighteen persons said to be on the sick list in this ward. Two only present, boys, apparently well. This ward consists of two rooms; the inner a narrow slip. The sixteen not present were said to be out walking. 3d Ward called No. 5.'-Six patients on the Cholera Hospital Book. Five present. One man complains of constipation of the bowels. One boy has had pain in his side and head, now better; no vomiting or purging. No appearance of cholera in the others at present. 4th Ward visited.-Eleven patients. All present. One boy with slow pulse, and depression of look and spirits; may have an attack in the course of the night. All the others looking well, with no appearance of disease of any kind. Informed by Mr. Wakefield, the surgeon of the establishment, that the diet of the cholera patients consists of arrow-root, tapioca, beef-tea, coffee, and Seltzer-water for drink, ad libitum, a wine-glassful at a time. Convalescent Ward.-Fourteen patients. All looking well. Female Ward, No. 1.-Nine patients—all looking well. One young woman, apparently simulating cholera; warm skin, good pulse and tongue. very troublesome perverse character. Female Ward, No. 2.-Nine patients. One now in mild fever. been a severe case of cholera. One young woman with bad toothach. Said to be a Said to have The two men in No. 1, already mentioned, are the only cases which I saw with the appearance of cholera. Yet the governor assured me repeatedly, that he had shown me all the persons considered by the medical gentlemen as labouring under any stage of the disease, and referred to in his letter of this day to Mr Bathurst. The utmost cleanliness, regularity, and discipline, appear to prevail in every part of the prison, as far as I was able to judge; and the visiting magistrates, who went round the wards with us, seemed to be actuated by the most humane feelings, and to devote much time and attention to the health and comfort of the prisoners. No new case admitted this day. (Signed) D. BARRY. It is almost needless to observe, that no part of the preceding notes or statements is meant to refer to any time or circumstances connected with the patients, anterior or posterior to the moments at which they were seen by Dr. O'Shaughnessy, Mr. Maling, Dr. Macann, and myself. D. B." Now we appeal to the profession whether there was not indeed a necessity for instituting a full inquiry. On the 26th Sir David Barry is told by Dr. Stevens that he had seen forty cases of cholera in the previous 24 hours. On the 27th he visits the warehouse, and finds not one. On the 28th the Government is informed that there are seventy cases in the same establishment; on that very day Sir David Barry goes and finds just two. Out of 18 cholera patients in one ward (18 of those who, Dr. Stevens has formerly said, could not be cured by ordinary remedies, and one half of whom should, according to Mr. Wakefield, die) 16, proh nefas! are taking a walk. Out of six in another ward one man is constipated, one boy has pain in his head, three have no appearance of cholera, and the other is not to be seen! Out of 11 in another ward, 10 look well and have no disease of any description. In a female ward, we have nine patients, all looking well, plump, and hearty, no doubt fattening on the pestilence. Out of nine in another ward one has mild fever, and one has, risum teneatis? a toothache. Can we wonder that Dr. Stevens, Mr. Wakefield, and Mr. Crooke obtained from the magistrates that better reward than empty praise, the solid pudding of three pieces of plate. Must not every humane and philanthropic mind rejoice that a pestilence so fearful, a visitation so awful, should have been, under Dr. Stevens and the magistrates, the means of liberating from durance vile a few deserving persons, whom the hardship of the laws and the vicious injustice of society had immured? Out of evil indeed cometh good. Perhaps it may be said that, at the time of Sir David Barry's official visit the disease was on the decline; that the persons who were walking, talking, suffering from tooth-ache, constipation, or nothing, were, in point of fact, triumphant living witnesses to the might and majesty of the saline treatment. But this will not do; for, on the very morning of that visit the governor of the prison writes to the Privy Council to state that " unfortunately much of the statement from the Globe newspaper is correct," and that "the number of persons now labouring under the disease, in its various degrees, is about seventy." From this it is evident-that the Governor, acting of course on information derived, in one way or other, from the medical attendants, considered the pestilence as then prevailing, and the epithet "unfortunately" must unfortunately convince every rational person that it was by him considered in a serious light, probably as serious as at any preceding period. But this is not the whole of this extraordinary farce. The magistrates who had plated Stevens, Wakefield, and Crooke, finding that Sir David Barry's statement made them cut a figure bordering on the ridiculous, determined to put down by the weight of their wigs the saucy impertinence of a few doctors. Accordingly these magistrates held a meeting on the 7th of July, for a report of the absurdities at which we must refer to the newspapers of the day. Sir Peter Lawrie, "a name to science ever dear," especially patronized Dr. Stevens, and dubbed him a second Jenner, an exterminator of pestilence, a missionary from Heaven for the protection of man. To all this we have no objection, as Dr. Stevens possesses as good a right to the receipt of these various orders, as Sir Peter Lawrie has to the conferring of them. Another of the magistrates, Mr. Rotch, made a more specific statement, which can therefore be met by a specific answer. In alluding to the official visit on the 28th June, he asserted that it was superficially conducted, and much incredulity was manifested by Sir David Barry. Now our readers will remember that the visit of the 28th was Sir David's second, his first having been on the 27th in company with Dr. O'Shaughnessy. Fortunately, notes of this visit were preserved, and were published immediately on the notification of the magisterial charge. In the Lancet of July 21st, there is the following letter from Sir David Barry; it is the minute of the before-mentioned visit on the 27th inst. and serves to complete the annihilation of the saline humbug. "June 27th, 1832, visited the Coldbath-fields prison this day, at two o'clock, accompanied by Dr. O'Shaughnessy. Learned from the Governor in his office, that the population of the prison at this moment is about eleven hundred of both sexes, including twenty-one children, that the daily discharges and admissions are about thirty-five on the average; the whole composed of malefactors, vagrants, and paupers; that the daily allowance of food to an adult is (since the introduction of cholera) 14lbs. of bread, 1 pint of gruel, 1 pint of ox-head soup, 6 ounces of boiled meat, four times a week, free of bone, and weighed after having been boiled. No soup on meat days. That the deaths during the spring, summer, and autumn months last year, were only two; during the whole of last year, fifteen. That since the 3d June, there had been twelve deaths, all from cholera. That the present state of cholera cases in the prison is as reported to him, the Governor, Men, 55 cases. Women, 15 cases. That he had not lately seen them; he could be of no service, and was recommended not to go into the cholera wards.* Walked with the Governor, Dr. Stevens, and Dr. O'Shaughnessy, round the gardens and other open spaces within the walls, and recommended the prisoners' rooms to be thinned by encamping a part of the inmates in the gardens. Dr. Stevens, with his two assistants, then conducted Dr. O'Shaughnessy and myself round his cholera wards, in which there might have been thirty or forty patients, but not one in the collapsed stage, though thirteen cholera cases are stated to have been admitted this morning. There certainly was not a single case which from any symptoms witnessed by "The Governor accompanied me round the sick wards on the 28th, but not on the 27th June." |