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undiscovered information, and a duty of punctilious observance to every conscientious physician to see to it that its promulgation reaches him.
Graceful style and plausible speculation are alike absent from this matter-of-fact treatise; but its conciseness is rarely indefinite, and its terseness is often relieved by the in the main excellent drawings.
Those parts relative to the diseases of the nerves, cord, and medulla are indicative of great research and familiarity in these matters.
The introduction to the section devoted to the consideration of brain diseases is alone worth the cost of the volume.
Very befitting, but a little unusual as compared with what we often see, is the candidly short and imperfect treatment of the diseases of the muscular system.
His presentation of the diseases of the skin will compare favorably with that of any general work on practice.
THE DISEASES OF THE LIVER WITH AND WITHOT JAUNDICE, WITH
THE SPECIAL APPLICATION OF PHYSIOLOGICAL CHEMISTRY TO THEIR DIAGNOSIS AND TREATMENT. By GEORGE HARLEY, M.D., F.R.S., F.R.C.P., Physician to University College Hospital, and Professor in University College, London. Illustrated by two chromo-lithographs and thirty-six wood cuts. Cloth, 8vo, pp. 751. Price, $3. P. Blakiston, Son & Co. 1883.
To the students of medicine who may here apply, be he the novitiate or the high-priest of Apollo's modern representative, there is available a feast both pleasantly and unpleasantly varied. To avoid the heretical stain, he must accept specific medication ; admit that a case of jaundice presenting a stricture of the hepatic duct was conclusively one of suppression; assent that salicylic acid is formed from salicine in the system; receive the germ theory in its entirety, and, after additions to it, long for more to believe; abandon our dread familiar yellow fever as contagious jaundice; and everywhere subserve an “I” that is neither adorable nor yet despicable.
The many pleasant episodes are most of them of a good, broad
ening influence; but somehow or other they make you feel your obligation too strongly.
The promise conveyed in the latter part of its title we consider to have been fully and ably redeemed. Diagnosis is patiently attended to, and treatment of judicious and scientific stamp is always the lesson taught.
We could wish that the book were as pleasant as it is instructive, or that its contents as pleasing as its appearance.
REPORT OF THE SURGEON TO THE TENNESSEE STATE PENITENTIARY, FOR THE TWO YEARS
ENDING DECEMBER 1, 1886.
TENNESSEE STATE PENITENTIARY,
NASHVILLE, TENN., DEC. I, 1886. Col. T. C. Cain, Superintendent of Prisons :
My DEAR SIR :—This report embraces the two years ending December 1, 1886.
The health of the main prison has been better during this period than any two years in the last decade. In fact, considering the construction of the cells, the character and condition of the inmates when received, I feel justified in stating that it has been fully as good as could possibly be expected. The deaths, as you will see by Appendix A, during the two years ending December 1, 1886, amounted to 33.
From reference to former reports, I find that the deaths in the two years ending December 1, 1874, were 63 :
43 46 54 51 13 33
During the term there were fully the usual number confined within the walls, on repeated occasions going above the number limited by law of 550, and rarely falling below it. The effort has been assiduously made by the officers in charge to keep the number down to the limit; but this being, as it were, the main or receiving prison, especially for all of West and Middle Tennessee, and the requirement by statute of the confinement of certain classes of criminals from all parts of the State in the main prison, on repeated occasions the number has unavoidably gone above the limit. I feel confident in the assurance that the prison during the past term has been quite as full, if not more 10, than during any preceding term.
Of the thirty-three deaths, only three were white, although the proportion of whites to blacks has been about as three to four. The blacks have at all times during the term been slightly in the majority.
Of these three deaths, one, Henry Bell, together with Ben Mays, colored, also deceased, were brought from the Maury County jail February 12, 1885. Both were in bad health when received, but were assigned to light duty in the wood-shops. At the time of their recep
tion, erysipelas was prevailing to some extent, in Columbia and vicinity. Within about a week after their arrival they both developed erysipelas, and died-Bell on the ist, and Mays on the 4th of May following. They evidently had the germs of the disease in their systems on arrival. I may further mention, that from these, the disease was communicated to every wounded man in the hospital, and to some who were not wounded, who were in the work-shops. All of the cases were quite severe, but all recovered with the exception of the two above named.
Another of the white deaths was F. D. Hale, who was brought to the prison December 19, 1885, in an advanced stage of consumption. He was placed in bed in hospital on arrival, and remained there until his death, October 1, 1886.
Dave Turner, colored, was brought to the prison from Memphis, March 13, 1885, suffering with pneumonia, from which he died April 13th following:
Dyard Algee, colored, from Carroll County, received at prison March 15, 1885, died suddenly of heart disease, May 16th following.
Wesley Cloyd, colored, from Davidson County, sick soon after reception on January 13, 1885, dying of remittent fever May 17th following
Thomas Fitzgerald, from Weakley County, received June 21, 1885, dying of consumption July 8th following.
Reuben Cole, colored, from Davidson County, received January 8, 1885; dying of consumption August 8th following.
James Webster, colored, from Maury County, received February 12, 1885, dying of organic disease of the heart September 8th following
Julia Johnson, who suicided October 12, 1885, evidently by poisoning (I think strychnine), had made repeated threats that she would destroy herself. After a rigid investigation, I failed to ascertain as to how she procured the poison, but was told by her companions that she had repeatedly said that she had the means, and presume she kept it secreted about her person from the time of her reception, April 21, 1885.
An epidemic of cerebro - spinal meningitis developed in the women's quarters early in December, 1884. Eight cases in all occurred, with three deaths. Upon its appearance the women were immediately removed to other quarters, and their former quarters were thoroughly disinfected by means of high heat and sulphur fumes, before they were permitted to return to them, since which time no other cases have occurred.
The other female, Eliza Peppers, colored, was brought from Bedford County January 6, 1885, at that time suffering from an aggravated, severe, and neglected case of syphilis. Under appropriate treatment she seemed to improve for a while, but her system was so thoroughly impressed with the disease, that the improvement was only temporary, and she succumbed November 21, 1886.
These detailed facts will all be found tabulated in Appendix A, but I thought proper to call special attention to them; not that I claim that the Penitentiary is a “Hygeia," but of the 33 deaths, all are not justly to be charged to it.
As to the great difference in the death-rate between the whites and colored, it is needless to suggest that a great disproportion has existed between them in all localities, especially during the past twenty years, where they are exposed to the same causes of disease. And of the mortality and sickness among the blacks, I have ever found it greater in the most ignorant. As a race, they are careless and thriftless, and from ignorance neglect the proper precautions or instructions to prevent or arrest disease. Many come to the prison badly broken down in health, by reason of want of proper food, proper air, and cleanliness. Of the 33 deaths, we find 8 to have died of tuberculosis, 4 of organic
4 disease of the heart, i of cancer, 2 of marasmus, i of syphilis, and i by suicide - a total of 17, or a little over one-half that cannot be chargeable to any local cause that is preventable with the present prison building.
It is needless that I follow in the footsteps of my predecessors for the past decade, and call the attention of the General Assembly to the
urgent, nay, the imperative, necessity of a new, improved, and mod-
my former report I called attention to the number of cubic feet of air space in the cells; the smallest, or those built in 1828, only affording 160.04 cubic feet; those of later construction, 168.43 cubic feet, and those last built, 314.43 cubic feet. Many of these to be occupied by two men ; there being only 360 cells in all, to accommodate 550 or more prisoners.
In the last report of the Kansas State Penitentiary, the physician in calling attention to the cells in that prison, with a capacity of two hundred cubic feet, says, that when you place in this space two men, with their beds, bedding, and other paraphernalia, it leaves the occupant a little less air space than a common grave.
This building (the Tennessee State Penitentiary), whose construction was commenced in 1828, and added to subsequently by the addition of wings Nos. 2 and 3, was at that time located outside the city--yes, at a distance from it. Since that day our beautiful capital city, in its progressive growth and development, has completely surrounded it with a dense urban population. The sewage of your convicts is discharged into a tributary of Lick Branch, and by that stream into the Cumberland River, at a point now in the corporate limits of Nashville, after an open-air transit of nearly one and a half miles through a quite populous part of the city. The epidemic of cholera that last devasted our capital (1873) was charged to the retention of the Penitentiary within the corporate limits. I am satisfied that it would be far better both for the city and the inmates of the Penitentiary that the latter be at once removed to a more suitable locality. This Penitentiary was built at a time when little was known of, and but little cared for, hygienic architecture. Since then it has been demonstrated that men can be held in durance without killing them.
In Appendix B, I give a full tabulated report of every man treated in the hospital during the two years, containing the name, age, color, county from where sent, date of reception at prison, date of admission to hospital, date of death, discharge from hospital or discharge from prison, diagnosis, and character of employment while in prison. From it, I think, more important facts can be elicited than from a mere statement that there were so many cases of each particular dis
A careful study of it, I think, will be of interest to the medical or prison statistician.