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dred feet for court yard. The principal front is on Fifty-fourth street, facing south, and extending east and west two hundred and eighty feet in length. The general plan of the edifice is an oblong parallelogram, with wings at each end, and a central chapel, flanked with towers. The elevations of the several fronts, even to the members of the cornices, are of square red brick.” The wards of the hospital are one hundred and nine feet long, twenty-six feet wide, and fourteen feet high. Each bed has one thousand and ninety-two cubic feet of atmosphere. The great distinctive feature of the institution is the central chapel. This has accommodations for about four hundred persons, is eighty-four feet long, thirty-four feet wide, and forty feet high. Here religious services are regularly held.
There are four attending and consulting physicians, three attending and four consulting surgeons, a resident surgeon and physician and his assistant, an examining physician, and a pathological cabinet. The board, for those who are able to pay, is seven dollars per week for adults, and four dollars for children, for whom a special ward is appropriated. No contagious diseases are admitted. Many patients are maintained on charity beds, to endow one of which, costs three thousand dollars, or three hundred dollars annually. There are fifty-five charity beds in all. Although this hospital is under Episcopal auspices, still patients are admitted without regard to religious creed. This is truly one of our noblest charities.
Yours, very truly,
JAMES B. BURNET, M. D.
LETTER FROM DR. CATLIN.
T. Parvin, M. D.-DEAR DOCTOR: My letter to you, published in the December number of your Journal, was so exclusively a statement of facts that I did not anticipate it could be disputed; I have just seen Dr. McElroy's letter, in your January number, attempting to ridicule and question my statements.
I did not attempt to give general instruction respecting the use of the hypodermic injection, or the doses of morphine to be used in different kinds of cases. I only stated a few cases and their happy results; though I remarked at the close of my letter, "It is perfectly safe when judiciously administered."
I have, as I wrote, used the hypodermic syringe, since 1860, in a great variety of cases, carrying my syringe with me as constantly as I do my lancet, and using it fifty times more frequently.
I do not remember more than one or two cases where the least unpleasant effect followed. My practice is to deal out a dose of morphine in powder, dissolve it in rain or distilled water. I often carry with me grain doses, carefully weighed, using the whole or such part as I find necessary. At other times, as in the case of vomiting in pregnancy, when I stated that about half a grain was used, I select the dose without weighing, but an experience of over forty years enables me to do it with great accuracy.
I purchase my morphine of Sisson & Butler, Hartford, Connecticut., some of the best druggists in the country, whose sales extend to the West as well as East. My patients were none of them opium eaters or drunkards.
In my letter of November 19, 1868, I write, page seven hundred and seventy-nine, in your Journal: “From that time I have treated every case in the same way, and they have been cured in ten or fifteen minutes.” In my manuscript I say every severe case.
The omission of this word I observed on first reading the printed copy, but did not think it necessary to request you to correct it in the next number. Indeed, I might have omitted the qualifying word in copying the article for the press.
The cases which I stated were all severe cases, where no judicious practitioner would have hesitated in giving, years ago, a grain of morphine, or two or three grains of opium, by the mouth. Whatever
be said or written, the facts remain the same. My patients are relieved in ten minutes, asleep in twenty, are well the next day; suffer no inconvenience from secondary effects of morphine(never having witnessed the slightest in cases of cholera morbus.)
Dr. McElroy's patient obtained partial relief in three miuntes, “but the lower extremities were still very painful. * * The sick stomach continued.” “Before eight o'clock she was asleep," something less than one and a half hours after the injection, though, from the record, she was visited three days after this.
No amount of ridicule will alter the facts. They speak for themselves. With much respect, yours truly,
B. H. CATLIN, M. D. MERIDEN, FEBRUARY 12, 1869.
EDITORIAL AND MEDICAL NEWS.
A DISTINGUISHED citizen of Indiana died at Indianapolis some two weeks since, a few hours after taking about one-half of a mixture containing eight ounces of brandy, twenty grains of quinine, and one ounce of tincture of gelseminum. The dose directed by the physician who prescribed this mixture was, a table-spoonful every two hours.
As to the condition of the party prescribed for, all our knowledge is derived—as are the statements above--from newspaper accounts of the event. According to one paper, he "had been suffering for several days from nervous prostration.” According to another, “he had been ill for some weeks, and latterly had been drinking quite hard. It is stated that for four or five days he had not tasted solid food, subsisting entirely on intoxicating liquors."
We apprehend it is not assuming too much to say that this patient was laboring under alcoholism. Letting this be assumed, two or three questions are suggested. Was this patient in a condition to be trusted with any medicine powerful in its effects? Was he fit to be trusted by himself even? And knowing that alcoholism when fatal, generally is so from coma, asphyxia, syncope, or exhaustion, was gelseminum a suitable medicine in such a case? Here are statements of different authorities as to the action of this agent:
" From the accounts given by various authors of the effects of yellowjasmine, it appears to be a nervous and arterial sedative, without nasueating or purgative properties, but sometimes causing diaphoresis, especially in febrile diseases. In moderate doses it produces agreeable sensations of languor, with muscular relaxation, so that the patient finds some difficulty in moving the eye-lids, and keeping the jaws closed. More largely taken, it occasions dizziness, dimpess of vision, dilated pupil, general muscular debility, and universal prostration; reducing the frequency and force of the pulse, and the frequency of respiration, and producing insensibility to pain; but without stupor or delirium. After a short time, these symptoms pass off, leaving no unpleasant effects. It usually begins to act in half an hour, and ceases to act after one or two hours. It is, no doubt, capable of producing death in over doses."— United States Dispensatory.
*“Death has followed the employment of what was supposed the tincture of gelseminum, in a few instances, and further investigations are required to determine its probable cause, and whether this agent will produce any fatal
# Dr. John King, the author of the Dispensatory we quote, is not remarkable, as this ex. tract shows, for the accuracy of his composition-his words indulge in a sort of promiscuous intercourse which must be annoying to any one trained up in the virtuous use of language. Ob. serve the second sentence and tell us to what word the relative which refers; so, too, in the third sentence-the which is in trouble as to ownership—80 far as grammar can guido 18 it refers to eyes, “and which gradually pass off in a few hours;" “ fatal results in largo medicinal dosos" is so obviously an absurd expression that it needs no comment.
results in large medicinal doses.
Gelseminum is, undoubtedly, an unrivaled rebrifuge, and which appears to be dependent upon its relaxing and antispasmodic properties. Whether it is a narcotic is not yet satisfactorily explained.
Its effects are clouded vision, double-sightedness, or even complete prostration, and inability to open the eyes, and which gradually pass off in a few hours, leaving the patient refreshed and completely restored.
If carried to such an extent that the patient can not open his eyes, the relaxation may be too great for the system to recover from, hence its use should cease as soon as the symptoms above named have been produced.
"The tincture is the form in which it is employed. The dose is from ten to fifty drops in a wine glass half full of water, to be repeated every two hours."— American Dispensatory.
“ Possessed of narcotic properties to a very considerable degree,” many employ the tincture of the root in fevers. It acts in a similar manner to digitalis and V. viride, with the addition of some narcotic property. It has to be used with caution on these accounts, and because it induces delirium in overdose."— Resources of the Southern Fields and Forests, by Dr. Francis Peyre Porcher.
However, without discussing these interrogatories, because there are details in reference to the death-how soon it occurred, what symptoms marked its approach, et cetera-and facts which a post-mortem examination that ought to have been made in the interests of medicine at least, would have discovered, which are wanting to us, we wish to make this positive and general assertion, that the administration of alcohol to a patient suffering with alcoholism, is wrong, both on scientific and moral grounds; and this position is taken without special reference to the case above mentioned. We imagine that hemlock is not often given for paraplegia, strychnia for tetanus, or ergot for excessive uterine contraction; and if alcoholic stimulants have been resorted to frequently in the treatment of the disease in question, it has been from erroneous views of its pathology, and probably the practice has been as successful in furnishing victims for the undertaker as has that which administered opium larga manu in the same disorder-each plan is fraught with incalculable mischief. We often think of the anecdote told by Dr. Theophilus Thomson, we believe, of an old lady upwards of eighty, who was suffering with fatal disease, and for the prolongation of whose life the doctor was urging the free administration of alcoholic stimulants, when she uttered the urgent request, "Doctor, let me go home sober.” And should we not permit our patients, when they must die, to go home sober—not drugged to utter stupor with opium, nor drunk with alcohol?
As to the pathology of alcoholism, some of us who are not very old can remember when we were taught that the disease arose from the withdrawal of an accustomed stimulant; but this teaching, with the
pernicious practice which was its natural sequence, has been exploded by the advance of modern science. Here is what we are taught by some of the best and most recent authorities:
* The essential nature of delirium tremens is associated with the loss of cerebral power, evinced especially in the want of control over thoughts, emotions, and muscular action, consequent on the direct influence of the alcoholic poison."-Aitken, vol. 1, p. 776.
* The pathology of alcoholism naturally divides itself into three portions. The morbid influence wbich the poison exerts is of three kinds. In the first place, it acts as a local irritant (when highly concentrated) upon the mucous membrane of the stomach, and of the alimentary canal generally; and in the second place, after absorption, it affects the rate of movement and the vitality of the blood, and as a consequence of this impairs the nutrition of every organ in the body. And, thirdly, it is clear that the nervous centres, independently of the ill effects on their nutrition of the blood-changes, have a certain chemical attraction for alc which accordingly is found to ac. cumulate in their tissues.
The successful treatment of delirium tremens, in pine cases out of ten, depends on the regular and continuous supply of suitable nutriinent, whereby the functions of the nervous system are supported during the struggle towards recovery."-Reynolds' System of Medicine, vol. ij
" Delirium tremens is but the acute form of chronic alcoholism."
"Science has determined that the administration of stimulants and alcoholic drinks in this disease, is at once irrational and experimentally dan. gerous.”—Nouveau Dictionnaire de Medecine et de Chirurgie Pratiques, Tome premier. Alcoolisme.
“The view of its pathology now prevalent is, that alcohol, a poison dan. gerous to life in large doses, is also cumulative taken habitually in small quantities.
Formerly the treatment used to consist of supply. ing the usual stimulus; but, theoretically, it is clear that this is tantamount to adding coals to fire, and, practically, it has been shown that patients more rapidly recover under the use of nutriment.”—The Principles and Practice of Medicine, Prof. J. Hughes Bennett, M. D.
We think the authorities adduced are ample to establish the general principle that alchehol is not a suitable agent to administer in alcoholism.
There are certain moral considerations which should enter into the discussion of this question, but which we have not space now to consider. If the poor wretches who have been narcotized with opium, alcoholized or chloroformed, because they had delirium tremens, were faithfully enumerated, we believe it could be shown that vastly more were killed than cured by such irrational treatment.
THE COMMENCEMENT exercises of the Medical College of Ohio will be held in the lower lecture room of the college building on Monday, the 1st of March, at eleven A. M., the valedictory to be delivered by Prof. James Graham, M. D., the degrees being conferred and an address delivered on behalf of the Board of Trustees, by Judge Dick