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you to stop short as soon as relief is obtained, and thus spare your patient any of the disagreeable effects of the drug.
4. By giving it only once in the twenty-four hours, you are able to give a larger dose than you would be able to do if oftener repeated.
5. By confining the dose to bedtime, the patient's days are, in spite of a large dose, passed in comfort; for, as the morning advances, the dullness of head, confusion of sight, and drought of mouth pass away.
6. You are thus enabled to find out what is the dose for the individual—a very important point. People differ very much in their tolerance of belladonna. Some of my patients have been unable to take more than twenty minims once in the twenty-four hours without very unpleasant symptoms ; while I have known others able to take a drachm three times in the same interval without any inconvenience. And as they differ in their tolerance of the drug, so do they differ in the dose at which their asthma will yield. The only way to ascertain what that dose is, is to make each case a separate experiment, and this can only be done in the way I describe.
7. By giving the remedy three or four hours before the attack is likely to come on, the treatment becomes prophylactic. If by taking a dose every night for thirty nights the attacks have been for that time prevented, the patient has ceased to be an asthmatic for a month. This is a very different thing from having had thirty attacks in the same time which have been cut short by the remedy. In all “habitual” diseases, in which the recurrence keeps up the tendency, prophylactic treatment has, in relation to final cure, a preeminence it does not possess in diseases in which habit has no place. For such diseases it is the treatment. It does more than spare your patient an attack of his malady; it breaks, pro tanto, that chain of sequences which is the very life of the morbid tendency.
Treatment of Typhoid Fever.
By E. SHEDD, Esq., Surgeon to the Ardwick and Ancoats Dispensary, Manchester.--Great success having this year attended my treatment of cases of typhoid fever, I have thought that possibly a few remarks on my mode of treatment may be not without interest.
My treatment is the following: As soon as there is any tenderness in the abdomen upon pressure, I prescribe drachm
doses of glycerine (in the case of an adult), to be repeated three times a day. Under this treatment, the temperature gradually subsides, becoming normal towards morning, and rising to 99° Fahr. towards evening. The secretions soon improve; a profuse perspiration frequently prevails ; diarrhea is quickly checked; and the patient becomes convalescent.
Of the numerous cases which have come before me in my practice, I have treated twenty-seven in the manner described, and with complete success, as not a single death from typhoid fever has occurred—a fact which, as it seems to me, is the more remarkable, as I have much reason to believe that the disease has been of a more virulent type than usual, because I find, from my own observation and the information of others, that fevers of the typhoid class have been this year more than usually prevalent, at least in Liverpool, Manchester, and Salford. -- British Medical Journal, and New Orleans Journal of Medicine.--Med. Gazette.
A Simple and Easy Method of Ascertaining Death.
Tue Marquis d'Orches having offered a premium of twenty thousand francs, for the discovery of a practical method of ascertaining death, available even in the poorest hamlet, Dr. Carrière, of St. Jean du Gard, presented the following which he states he has put in practice for the last forty years, namely, placing the hand with the fingers closely pressed one against the other, within an inch or more of a lamp or candle; if alive, we observe the hand to be transparent, of a rosy hue, and capillary circulation, or life in full play. If, on the contrary, we place the hand of a dead person in the same relation to light, we do not perceive any of the above phenomena; we see but a hand of marble, without circulation, without life.-- Journal de Medecine et de Chirurgie, and New Orleans Jour. of Medicine.
Recovery from Severe Cerebral Lesions.
In July, 1864, Mr. Chase was doing some work under a picket saw, which was running at great speed, when inadvertently raising his head against the saw he received a cut beginning at the frontal bone, one half-inch above the nose, and running back to the occipital bone, making an incision VOL. IV.NO, 12.
in length, measuring by the convexity of the skull. Dr. A. C. Folsom was called, but at first thought it useless to dress the wound, believing that the man would die in a few minutes; but Mr. Chase being perfectly conscious and free from pain, he concluded to attempt a careful dressing, encouraged somewhat, he says, by remembering the case of a man in Vermont who had a tamping iron blown through his head and recovered therefrom. The cut gaped open so that the skull bones were a full inch apart. Dr. F. estimated that the brain was cut nearly to its base, fully three inches deep. He inserted a pocket rule an inch and a half. lle carefully removed all fragments of the skull—taking out over thirty pieces-and washed out the saw dust that had got into the opening, using warm water to promote hemorrhage, which was slight for such an extensive wound. He also washed ont more than a tablespoonful of brain. How much more the saw carried away we can only conjecture. The doctor then shaved the scalp, applied a tourniquet to bring the bones together, and closed the aperture with six stitches, finishing with adhesive plaster, and leaving three openings. The only dressing ever used was cold water.
The patient was in full possession of all his faculties during the whole time, and said he experienced no pain then or afterward until he was entirely recovered. He visited the mill about four weeks after the accident, and soon after resumed his duties as filer and foreman, which position he still holds. He says he never lost sleep or appetite, or experienced any physical or mental pain or weakness from his wound.Med, and Surg. Reporter.
We think it necessary to put our readers on their guard against an incautious use of carbolic acid. It seems to be forgotten sometimes that this substance exercises a powerfully destructive action upon animal tissues, and that it is, in fact, a very strong caustic when concentrated. There is no doubt that many serious accidents have recently occurred from surgeons not being aware of the properties of the remedy they use so freely. It must also be remembered that the direct application of carbolic acid, even in a diluted form, to a granulating surface, will often delay cicatrization, and tend to promote suppuration, whereas, if it is employed at a distance from the wound, it will tend to diminish the formation of pus. There is, moreover, a good deal of evidence
to show that it tends to stimulate the circulation throngh the smaller vessels, and thus gives rise to hemorrhagic cozing from recently cut surfaces, preventing their primary adhesion. If, however, it be properly applied in a diluted form to the wound itselt, and in some permanent and non-volatile form to the external parts, it will be found to have a powerful influence in retarding and diminishing suppuration.-Med. Times and Gazette.
Defects in the present State of the Law with regard to
We have repeatedly pointed out how entirely inconsistent with our present knowledge of mental diseases are certain leading principles which are accepted and applied in the administration of justice. The metaphysical test of mental capacity, founded on a knowledge of right and wrong, or of good and evil, which is applied in criminal cases, las originated in opinions regarding mental diseases which are now obsolete, and is condemned with one voice by all those who, in this country and other countries, have practical knowledge of insanity and the modern method of its treatment. Indeed, the practicability and success of the modern humane treatment of the insane are based on the existence of a knowledge of right and wrong in the great majority of them; only those who are completely frenzical or fatuous can be truly pronounced destitute of such knowledge. And it is no exaggeration to say that if the unjust and inhuman legal dictum were stringently applied, as many as nine out of ten lunatics in asyluins would have to be hanged in the event of their committing murder. There is, in regard to this most vital point, a direct antagonism between advancing medical science and the law which has descended to us from the time of the witch-burning Sir M. IIale; and the antag. onism will never cease until the legal dictum has gone, as it must inevitably some time go, the way of the dicta under which poor old women were burnt as witches.-- Lancet.
The Dengue Fever in San Francisco.
SINCE the abatement of small-pox, some of our physicians have reported the prevalence of Dengue, or Break-bone fever, in San Francisco. This rather singular disorder, which has • run its course as an epidemic, or as an endemic, in several
parts of the world during the last fifty years, is marked by violent pains in the back and limbs, with an eruption resembling scarlatina, and bas been called scarlatina rheumatica by some writers. In respect to pain, it has a resemblance to the ante-eruptive staye of small pox. That it is now preralent, we are not disposed to admit. There is no doubt, however, that the variolous diathesis still lingers in the atmosphere or in the body, imparting to existing disorders certain modifications the chief of which are pain and eruption. In the majority of cases, the eruption has the appearance of measles or scarlatina, but the cough of the foriner and the red tongue of the latter are wanting. Other cutaneous affections of an anomalous character exist, and quite a number of cases of herpes zoster lave fallen under our notice. We hold that the opinion expressed by Dr. Logan in his account of the diseases of 1868, is highly plausible, viz: that some other epidemic may be expected to follow on the lieels of variola. Meantime the variolons clond, so to speak, still hangs over certain localities--Sacramento, for instance, and parts of Nevada and Oregon-showing how difficult it is, with all our protective agencies, to exterminate the disease when it has once made a home for itself and is fortified by the invisible and mysterious influences which we call epidemic.-- Pacific Med. and Surg. Journal.
A Most remarkable instance of blood-coagulation is recounted by Dr. Henry Gibbons, Jr., in the Pacific Medical and Surgical Journal. The case was that of an Irish butcher, aged 40, with cardiac disease, in St. Mary's Hospital. He had suffered from dropsy in 1864, but had subsequently partially regained health. A year ago a recurrence took place and he continued to grow worse. Examination revealed extensive dullness over the precordial region and loud systolic murmur especially at the base of the heart, whence it was propagated through the aorta ; sounds normal, except slight harshness of the first. There had been no pain in the chest
. Death occurred within twenty-four hours after the examination. The following interesting description of the post mortem appearance we give in Dr. Gibbon's own words:
Autopsy, assisted by Dr. Bates and Mr. Clarke of the Hospital. Lungs normal. Some effusion in the pleural and abdominal cavities. Five ounces of serum in the pericardium; heart enlarged to over three times its normal weight; and