« ElőzőTovább »
are at full liberty to send it, together with any remarks of your own, to the Editors of the Medical and Physical Journal. I remain, dear Sir,
Your obedient humble Servant, Mortlake, May 2, 1813. RICHARD HENRY KING.
About three weeks or a month ago, a girl in the poorhouse of the parish of Mortlake, who was supposed to have had the small-pox in her infancy, but concerning which I regret my not having been able to obtain any satisfactory particulars, sickened with that disease, and had it in a very favorable manner. As all the other inmates of the house had had either the small-pox or the cow-pox, I did not think it necessary to use any particular precautions in keeping this patient separate from them. On the 2,°;d of April, however, Thomas Waite, aged about nine years, who had been vaccinated in Salisbury-square when six weeks old, •was seized with rigor and shivering, followed by head-ache, pain in his back, and nausea. When I saw him, his pulse was very quick, and the tongue was covered with a brown fur. 24th. The fever had increased; he had passed a restless night, had been slightly delirious, and still complained of sickness at his stomach. It may be necessary to state, that he had taken an emetic the preceding evening, and a purgative medicine this morning, both of which had operated sufficiently. 25th. He had been delirious during the whole night, and his fever continued very high. In the course of this day an eruption appeared all over bim, resembling measles. 26th. From the appearance of the eruption this morning, there was now little doubt of its being small-pox of the most unfavorable kind. He had again been delirious during the night, and the fever had not at all decreased, but the vomiting had now subsided. From this period till the 29th, the disease continued its progress, daily assuming a more unfavorable aspect. The eruption consisted of minute, but very numerous vesicles, which, on the face, already showed a disposition to run into each other. 30th. On this morning, being the sixth day of the eruption, the constitutional symptoms had undergone a most favorable change. The fever had abated, the boy had passed a quiet night, and he expressed some inclination for food, which he had not previously done. The appearance of the eruption, however, was still by no means flattering. The vesicles continued small and flat: in the interstices between them, the skin was pale and shrunk, and there was not the least tendency to swelling in the face and eyes. Still, however, the general
appearances were such as led me to hope that the previous vaccination would exert a favorable influence, so as to arrest the further progress of this apparently alarming disease; and this opinion I did not hesitate to express to the attendants. May-lst. On this day my hopes were confirmed. Almost all the vesicles had dried up and turned brown in the course of the night; the boy had slept well, was perfectly free from fever, and his appetite for food had returned. From this time he continued to mend rapidly, and he is now (May 5th) as nearly welt as possible. On his face there is now very little appearance of the eruption remaining. I have not thought it necessary to give a regular detail of the treatment of this case during the progress of the disease. At the commencement, his stomach and bowels were cleared, the antiphlogistic regimen was adhered to during the eruptive fever, and for the last three or four days he had taken bark and wine very freely. About the fourth day of the eruption he was attacked with diarrhoea, and voided several copious, dark-colored, and very offensive stools.
This boy has three or four brothers and sisters in the house, who were vaccinated at the same time with himself, and who, as well as all the other children, have hitherto escaped infection, unless, indeed, a slight indisposition of his elder .brother, William Waite, can be attributed to this cause. The mistress brought this boy to me on the 1st of May. He had been drooping for a day or two, complained of pain in his head and back, and had vomited once or twice. His whole body was now covered with an efflorescence exactly resembling the first appearance of the eruption in his brother Thomas; but this entirely disappeared on the following day, and he has continued perfectly well ever since. What is remarkable in this case is, that the boy complained of a severe pain on the spot where the vaccine matter had been inserted, and said he had felt it during the whole of the day preceding that on which I first saw him ; but this also ceased with the disappearance of the efflorescence.
From the girl who first had the small-pox, I was induced to inoculate a child whom I had previously vaccinated, but of whose security I had some doubts, owing to the vesicle being ruptured previous to the appearance of the areola. The arm inflamed and maturated, but there was no constitutional affection.
May (jth.—Since writing the inclosed, I have been informed by the mistress of the house that Elizabeth Waite was affected in a similar manner with her brother William, about the time that Thomas Waite first began to complain. She
F 2 complained complained for a couple of days of languor and loss of appetite. On the third day a rash appeared all over her, continued for two days, and then disappeared. As her indisposition was extremely slight, it was unfortunately not mentioned to me.
To the Editors of the Medical and Physical Journal,
I BEG leave to present for insertion in your Journal the following Case of Convulsions during Labor, which, by a prompt ana decisive mode of treatment, terminated very satisfactorily.
April 21st, I was requested to attend the wife of W. B.
of C > near this place, who had been in labor several
hours. On examination, I found the os uteri very little dilated and rigid, the membranes not ruptured, and the presentation natural. The woman appeared nearly desponding, on account of the circumstances attending a former labor, she having been delivered with the forceps. I represented the state of the labor to her, and left her, promising to see her again in a few hours. On my return, I found that she had been attacked with convulsions, about an hour before my arrival: her extremities were contracted and stiff, pulse nearly gone, breathing scarcely perceptible, and a peculiar wild appearance in her countenance. I immediately procured a strong mixture of brandy and water, and, withsome difficulty, succeeded in getting her to swallow two tea cupfuls: this gave her the most decided relief; she became rational, strong pains followed, and the child was expelled in less than an hour afterwards, in a natural manner. My patient has recovered very well.
I am. Gentlemen,
Your obedient Servant, Earl's Heaton, near Leeds, H.HEMINGWAY.
May 21, 1813.
To the Editors of the Medical and Physical Journal.
I INTRODUCE the following case to you for insertion in your Journal, if you think it worthy such insertion. It appears to me especially instructive in one point of view, although a perfect restoration to health has not taken place, that of the advantages to be derived from the re-introductioh
of of mercury intp the system when the most distressing symptoms had occurred during the original use of that mineral, and had continued in the most painful way for about fourteen months. Isolated cases do not in general contribute to. our experience, except they come in confirmation of the observations of others. For this, among other reasons, the case deserves attention, as strengthening the remarks and practical information of Sylvester*, Dobsonf, and Bardsleyj, on resuscitated Salivation.
I am, Gentlemen,
June j, 1813. G. D. YEATS, M. D.
On the good Effects of resuscitated Salivation. March 2, 1812.—E. P. a=t. 22, a female, complains of a tremulous sensation at the pit of the stomach about once or twice in twenty-four hours, attended by a fainting disposition, and cold perspiration in considerable quantity. Sometimes passes a day without such sensations. On these attacks she takes a little cold water, which, though immediately rejected, relieves the uneasy feel at the stomach. Is frequently troubled with a giddiness, heaviness, and pain in the head—complains also that nothing stays on her stomach; whatever is taken of any description causes a weight and tightness at the stomach, until thrown up again; and the rejected matter is always in a very acid state, and in much greater quantity than what is taken. Is never sick except something is taken into the stomach. Has no appetite but when she sees food that she fancies, such as breadpudding, nauseating the idea of meat. She feels a disposition to eat, but in indulging the disposition, the above sensations of weight and tightness, with consequent vomiting, are instantly produced. When the ingesta are first thrown up, it is with scarcely any effort, but afterwards a good deal of struggle takes place with the retching, and much clear liquid, extremely acid, is vomited, with a little phlegm. Has very considerable thirst, with a sensation of heat at the scrobiculus cordis, which is allayed by half a pint of cold, water, although it is immediately rejected. Once she took a little warm rum and water, which caused instantly great pain with a violent burning heat, aggravating all the uneasy sensations at the stomach, followed by profuse perspiration and vomiting as usual. Her agony was such that she appeared to her friends to be dying. Bowels costive; urine
* Med. Observ. and Inquiries, vol. in'- pp. 241-56.
high-colored. She states her stools to be dark-colored. Pulse 7G, feeble.
E. P. has been in this state of symptoms for about fourteen months, and they commenced under the following circumstances. She complained at that time (December 1810) of, a great tightness all rouikd the waist, with a swelling on the region ot the stomach towards evening, to such an extent as to oblige her to unlace her clothes; dyspnoea; occasional pain about the stomach; appetite indifferent; no thirst; no vomiting, nor sickness of stomach; and no particular uneasiness after taking food. Previous to the accession of these symptoms, she had been gradually failing: her ankles had swelled about the preceding May, and she had felt languid. She says these complaints were brought on by living on a watery vegetable diet, to get rid of some pimples in her face, but, notwithstanding, she grew lusty. The swelled ankles and languid feel went otf on a return to a more generous diet, and she remained well till about the period when the train of symptoms just described commenced. She began to be regular in her nineteenth year, and had always enjoyed perfect health, never having been ill except having had the small-pox in the fourth year of her age. She continued perfectly regular in her menstrual discharge till September 1810, when it ceased, and returned in the following January, and appeared twice till May, since which time it has never made its appearance.
In September, 1810, a physician was consulted. He ordered various remedies, which the nature of the symptoms indicated; but these not succeeding, she was put upon a course of mercury in the beginning of December following, both by friction and pills, which, in about three weeks, brought on a very considerable salivation, which lasted three weeks. On the commencement of the salivation, she felt a constant inclination to make water, with a bearing down pain and straining at stool, which continued in a greater or less degree for a month, but the tightness, &c. across the waist, abated. Two days after the commencement of the salivation, on taking some broth, she felt a squeamishness at the stomach, and ..the broth was immediately thrown up; and from that day to this, Monday, March 2d, 1812, she has invariably vomited instantly whatever solid or liquid food has been taken.*
* As some opening pills remained on her stomach, it occurred to Mr. Goodwin, her surgeon, to make trial of meat made into pills: they were given, but were speedily rejected. She was not informed of what the pills were composed.