Billeder på siden

June 8.-Catharine McC- aged 22, married domestic. Did housework until a day before confinement; had a difficult labor, and on attempting to resume her duties too soon -one week after confinement, took a chill; which returned every other day until the time she presented herself (some three weeks), suffered from constant nausea and vomiting, with great nervous prostration and emaciation, tongue heavily coated, breath offensive. Although this patient was much reduced, we saw clearly it would be useless to attempt relief without thorough action of the liver; ordered

R Alc. Fluid Ext. Podophillum, mxl. ; Alc. Fluid Ext. Leptandra, 3 iss. ; Syr. Rhei et Potassa ad., 3ij. ; Misce. Capt. cochl. amplium nocte et mane.

By Quiniæ Sulphatis, grs. xxiv.; Ferri Ferrocyanidi, grs. xviij. ; Extracti Nucis Vom. Alc., grs. iij. ; Podophillini, gr. i.; Pulv. Capsici, grs. iv.; M. Ft. Pil. xxiv. ij. Ter. die sumend.

June 9.-Next day, on which she should have chills, patient returns, reports no chill, and in spite of the very thorough action of the medicine, reports herself feeling much better and stronger.

June 16.-Rapidly gaining, no chill, tongue clearingcontinue podophillum mixture in teaspoonful doses night and morning. In three days left for country, entirely well.

June 13.-Katy Daly, age 13, native of Mass. Phthisis pulmonalis, 3 years' standing, commenced with dizziness in the head ; severe cough for two years, with copious yellow expectoration, pain in infra scapular region, tenderness of left side, pectoral muscles and sternum.

During the last year severe diarrhea, amounting to from 4 to 7 actions daily without pain, consisting of mucns, pus and blood, with fecal matter, hectic fever, night sweats, loss of appetite; cough continues, but no expectoration ; eyes glassy, blue line around gums, nausea and aversion to food, tongue red and flabby ; percussion dull on upper lobe of both lungs and lower lobe of left lung, possibly due to pleural adhesions, with amphoric resonance under left nipple and in left lateral region.

A weak and feeble respiratory murmur on the left side, on the right harsh and rough. In this case I prescribed as follows: Cod Liver Extract (Dragees.) ij., 3 times daily.

R Syr. Rhei et Potass., 3x.; Alc. Fld. Ext. Geranium Mac., 3 iij.; Alc. Fld. Ext. Hydrast. Can., 3 ij.; Alc. Fld. Ext. Leptandr. Vir., 3 ij. M., 3 ss., 4 times daily.

June 24.-Character of discharges improved, but no diminution of frequency. Continue treatment.

July 1.–Patient reports the number of evacuations reduced to 4, and in color and consistence natural, night sweats and hectic fever gone, appetite improving, tongue less flabby and better color, continue treatment omitting leptandra, and recommend daily sponge-bath of water containing a little bicarbonate of soda; continue C. L. Dragees.

July 8:—Patient reports rapid progress in every particular, evacuations never exceed three, usually one or two, and natural; appetite good, tongue clean, no night sweats, a little color (constant) in cheek, better expression of eyes, can walk · a mile without inconvenience, before could scarcely walk a block without severe fatigue; very little cough, can take a longer inspiration, which is not painful.

I call attention to this treatment of the diarrhæa, inasmuch as she has been under the care of every physician of both schools in her native city for the past year, without the slightest relief. We continue the treatment, reducing the quantity of syr. rhei et pot. one half, replacing with glycerine and adding 3 ij. subcarb. bismuth.

June 23.—Bridget B., age 28. Married. Neuralgic headache. Took severe cold some three weeks since. Fever, with chill. Since then severe headache with fever, worse in afternoon ; sleepless nights with intense pain in frontal region and eyes; intolerance of light; throbbing in temporal region ; ringing noise in ears, with partial deafness; constricted feeling around head, says it feels as thongh it was tied with handkerchief; tongue coated; bad taste in mouth ; bowels regular; prescribe as follows: Alc. Fld. Ext. Gelseminum, (green) ml; Alc. Fld. Ext. Podophillum, mxi. ; Alc. Fld. Ext. Leptandra, 3 iss; Syr. Rhei et Potassa, 3j; 3i. Nocte et Mane.

This patient did not return until the 10th July, when she called with a child for treatment; on questioning her, she says she was entirely relieved of all symptoms before she had taken the whole of the medicine, and has had no return of same.

June 30.-William S., age 7. Scarlatina Anginosa ; attacked day before with vomiting; prostration, headache, and high fever, difficulty in deglutition; redness and enlargement of tonsils, fauces, &c.; swelling of the glands of the neck; great thirst, tongue heavily coated, with red edges, papillæ projecting; no eruption, no appetite, skin dry and hot.

R. Pulv. Jalape Co. grs. xx. at bedtime; R. Alc. Ald. Ext. Gelseminum, MXV.; Alc. fid. Ext. Aconiti, mvi.; Alc. fid. Ext. Asclepius, 3 ss; Aqua Camphoræ, 3jss; M. one teaspoonful every hour until diaphoresis takes place, to be aided by the alkaline sponge bath.

July 1.—Has perspired freely since night, body covered with eruptions; bowels act freely, no vomiting since first dose medicine, tongue still coated and throat very soreorder comp. soap, and comp. camphor liniment to throat. Keep up sponge bath, and internally the following. Saturated Sol. of Chlorate Potassa at 60° 3j.; Alc. Fld. Ext. Belladonna, mxv. M., 1 teaspoonful every hour for 4 hours, then every two hours.

July 2.—Improving in every respect; tongne still coated and throat much swollen. Alternate, 10 drops Compd. Acetous Tinct. Sanguin. with the last medicine. July 3 to 6, rapidly improved and discharged.

July 6.--Nora Mc-age 34. Widow. Erysipelas. Eruption on both ankles, neck, and in axillary region, the ankles presenting symptoms of phlegmonous ulceration; intense redness; tumefaction and itching; commenced 3 days since, and is spreading rapidly. Treatment-painted the whole surface with a solution of equal parts of Alc. Fld. Ext. Veratrum Vir. and water, gave lotion composed of 2 drms. of the fld. ext. in 4 oz. water, to be applied constantly to the parts; ordered 15 drops tincture sesquichloride iron in water every three hours.

July 7.-Itching, pain, and swelling gone; slight blush left to mark the point of attack; patient much astonished, having been treated before, some two years since, allopathically for same trouble, and sick three inonths; showed large cicatrices on arm result of sloughing. Gave a little mild zinc ointment to apply to broken surface, and continue other treatment.

July 8.--All sign of disease gone.

July 8.--Eliza P—, age 22. Married. Erysipelas 3 days standing, face, neck, and ears ; symptoms about same as the above, and ordered same treatment; patient took only 5 drops iron, and returned next day only slightly improved. Painted parts with strong Fld. Ext. Veratrum, and told her to take 15 drops iron every 3 hours.

July 10.-Rapidly improving.

Insolation, or Sunstroke.

BY J. M. F. BROWNE, M. D.,

Professor of Physiology and Pathology in the Eclectic Medical College of the City of

New York.

This morbid condition is caused by exposure, either to the direct rays of the sun or to an intensely heated atmosphere. It has long been known to the inhabitants of intertropical countries, and cases of it are related in some of the earliest records. In one of the apocryphal books of the Bible, for example,—the book of Judith to wit,—there is a brief but unmistakable description of it. In the eighth chapter, we are told that Manasses, the husband of Judith, became suddenly ill while overseeing the reapers and binding sheaves in the harvest-field. '“ The heat,” says the record, “came on his head, and he fell on his bed and died,” etc.

Insolation, however mild the attack may be, is never unattended with danger; and the mortality, as shown by the cases that have recently occurred in New York, ranges from forty to fifty per cent. The premonitory symptoms, if any occur, are slight: dulness, or listlessness, with headache, and

a general feeling of uneasiness may sometimes come to warn the patient of his danger ; but even these are not unfrequently wanting, and he suddenly falls down insensible, and in a few moments expires.

Post-mortem examinations reveal to us that there are at least three ways in which death by insolation is produced.

1st. There may be intense cerebral congestion, and the result is death, as in a true apoplectic attack..

2d. The pia mater and arachnoid may be inflamed, and the result is death, as in cases of genuine meningitis.

3d. The brain and its membranes may be perfectly healthy, and the heart alone, of all the organs of the body, show signs of disease. When such is the case, that organ, instead of being firm and florid like the other muscles, is soft and flaccid, and pale.

Another condition which morbid anatomy reveals is congestion of the lungs, with distension of the right side of the heart. It may be remarked that this congestion is more complete in this than any other disease.

In cases in which the heart alone is affected, the morbid condition is undoubtedly one of nervous exhaustion. The heart is stimulated to unusual activity by the excessive heat, and perhaps by severe muscular exertion. Its unwonted exercise soon results in fatigue, and, overpowered 'and exhausted, it ceases to act, and “suffers syncope and a solemn


In insolation, the skin is hot and dry—the pulse quick and full—the face pale—the tongue red or brown-the pupils contracted—the conjunctivæ congested—the breathing difficult—the vision dim—and the evacuations involuntary. Treatment.--As soon as a patient is attacked, let a stim

a ulant be promptly adıninistered.

B Vini Cremati, 3 ij; Tr. Capsici, 3 ij. Take two teaspoonfuls every fifteen or twenty minutes, until reaction takes place. At the same time let ammonia be applied to the nostrils, and ice to the spine. If the patient cannot swallow, let the following be administered by enema.

B Aque Amyli, šv.; Tr. Xanthoxyli, 3 ss.; Capsici,

gr. x.

« ForrigeFortsæt »