his profession, in which, as teachers, we are wide as the poles asunder, it affords us satisfaction to award him any merit to which we may conceive him entitled. Trousseau and Belloc on Laryngeal Phthisis.-We conclude, in the present number of the "Library," Dr. Warder's translation of this valuable work, which the profession cannot but feel indebted to him for having put in an English dress. In the translation, by the way, we notice an innovation, in which, however, Dr. Warder has only followed the-in our opinion-objectionable example of others. The French word observation, when applied to the history of a disease has always been rendered by the English word case; but from ignorance of this fact, we have seen it translated by the English word observation, and of late, since the introduction of the system of "Observation" of Louis, we frequently see it thus rendered. Now, observation in this sense, although it may be good French, is undoubtedly bad English, and in the work before us there are some striking examples of this truth. In Case 59, (page 179 of the translation,) called "Observation 59," the authors observe, "Le Journal des Progrès des Sciences Médicales contient une observation de trachéotomie;" which the translator has rendered thus, "The Journal of the Progress of Medical Sciences contains an account of a tracheotomy." The true translation of observation here, as every where else, under like circumstances, is "case"-"the Journal of the Progress of Medical Sciences contains an account of a case of tracheotomy." We make this criticism on account of the solecism, both novel and inaccurate; observation in French, in the instances in question, has always meant " no new notions can justify its receiving any other interpretation. case;" and For the American Medical Intelligencer. Quarterly Report of the Obstetric Practice in the Philadelphia Dispensary. Joseph Warrington, Accoucheur. Fifteen women have been delivered at full term. Thirteen boys and two girls have been born. The average duration of labour in the 15 cases was 12 hours, the extremes being 3 and 25 hours. The average time required for the spontaneous delivery of the placenta in 13 cases was 20 minutes, the extremes being 5 and 60 minutes. In one case the placenta was retained within the os uteri one hour and a half, requiring finally the introduction of the hand to facilitate its delivery. In 11 cases in which the positions of the fœtus were ascertained, seven presented the vertex in the first position, two in the second, one in the fourth. One case presented the pelvis in the first position. The subject of the breech-presentation was still-born, appearing to have been dead several days previous to delivery. Another fœtus died during a protracted labour; probably from the severe compression exerted by the uterus upon the child, there not being apparently a drop of liquor amnii within the membranes. The rest of the children have done well. All the women recovered. case: June 19, 1839.-E. Carhart, æt. 22, subject of first pregnancy, was delivered of a female child, at 4 A. M. after a labour of six hours. Vertex presentation, first position; placenta extruded twenty minutes after the delivery of the child. 20th.-Great soreness and tenderness under slight pressure upon the uterine region; considerable febrile reaction; uterine contractions almost intolerant. In consultation with Dr. Warrington, agreed to take 3xij of blood from the arm, give 5 grs. calomel in 3ss castor oil, and apply fomentations of hops over the uterus. Evening. Increased fever; tenderness in uterine region not abated; medicine had not operated. Ordered enema of flax-seed tea; bled to Zviii; soda powders for drink. 21st. 1 A. M.-Was called from bed in consequence of great jactitation and increased fever; bled to about 3xvi, continued fomentations, and at Dr. W.'s suggestion of yesterday, directed flax-seed mucilage to be injected into the vagina. 10 A. M.-Symptoms all mitigated directly after the last bleeding, which nearly caused syncope; patient rapidly convalesced. Mr. Andrew Bruce, another member of the class, reports as follows:— Sept. 2d, 1839.-A. Agan, æt, 35, (one of the patients placed under my charge by Dr. Warrington,) subject of her thirteenth pregnancy, had enjoyed usual health up to this time, when she was surprised by a very sudden discharge of blood per vaginam. This continued three days, during which it is supposed she lost six pounds of blood. She became very feeble; her pulse reduced below its usual standard of frequency and strength. At 7 o'clock, P. M., 5th Sept., I found her in labour, with strong and frequent uterine contraction. Upon examination, the os uteri was considerably dilated, but presented a soft thick cushion, which gave the idea of an edge of the placenta. There was scarcely any sanguineous discharge at this time. The fœtus was detected with the vertex presenting in the second position. The pains were frequent and severe. Child was delivered at 9 P. M. The patient had complained of severe cramps in the lower extremities; and at the moment the head was passing through the vulva she was seized with an hysterical convulsion. The rest of the delivery took place without her consciousness. Placenta came away in five minutes, spontaneously, followed by a very free discharge of blood. Dr. W., who had been previously sent for, now met me. We used free frictions over the uterine region; applied a graduated compress of several diapers over the hypogastrium, and pinned the bandage firmly over all; the uterus, however, becoming very flaccid, we determined upon administering five grains of powdered ergot, suspended in fluid, every half hour. I watched the patient closely during the night, and had the satisfaction to find that after the administration of one dram of ergot in this manner the uterus contracted firmly, and the hemorrhage ceased. The pulse, which during the evening was scarcely perceptible, and beat only 60, had reacted finely next morning; when the patient, who had been in a continual state of insensibility for eight hours after the convulsion, recognised surrounding objects. She promptly recovered upon the use of laxative farinaceous diet. The members of Dr. W.'s obstetric class are permitted to attend upon the cases which occur under his charge in the Philadelphia Dispensary. BOOKS RECEIVED. From the Author.-Narrative of the Discoveries of Sir Charles Bell in the Nervous System. By Alexander Shaw, Assistant Surgeon to the Middlesex Hospital. Svo, pp. 232. London, 1839. From Mr. Adlard, the publisher.-A Treatise on the Diseases of Infants, founded on recent Clinical Observations and Investigations in Pathological Anatomy, made at the Hospice des Enfans trouvès: with a dissertation on the viability of the child. By C. M. Billard, Docteur en Médecine de la Faculté de Paris, &c. &c., with notes by Dr. Ollivier, of Angers (motto.) Translated from the third French edition, with an appendix, by James Stewart, M. D. 8vo, pp. 620. New York, 1839. THE AMERICAN MEDICAL INTELLIGENCER. Vol. III. November 15, 1839. No. 16. For the American Medical Intelligencer. ART. I.-CASE OF POISONING BY STRAMONIUM. BY ERASMUS D. JONES, M. D., OF LEAKSVILLE, N. c. Oct. 23, 1839. Sir, I was called to see a child, (daughter of John Hamlin, a resident of Rockingham, N. C.,) age 3 years, whom I supposed to be labouring under colic, but discovered it to be a case of poisoning by stramonium, on the exhibition of a dose of ol. ricini, which caused her to throw up a teaspoonful of the seed. The symptoms were very violent; the pupils of her eyes were dilated to the size of a 124 cent piece; the muscles of the face rigid, and the stomach contracted to the size of a man's fist. She was rolling from side to side with convulsions, which had continued six or seven hours previous to my seeing her. I gave an emetic of sulphas zinci, with copious draughts of warm water, which did not produce vomiting. I repeated it without effect; after which I administered a teaspoonful of ipecacuanha in a cup of water, repeated every fifteen minutes without better success. I now determined to try the effect of titillating the throat with a feather, continuing the draughts of water, all of which proved insufficient. Finding the child was sinking rapidly, I resolved, as a last resort, to try the use of a leaf of moistened tobacco applied to the stomach, which acted like a charm. It relaxed the spasm, and the child lapsed into a tranquil sleep. As soon as the effect of the tobacco wore off the spasms returned, to be removed only by the reapplication of it. I continued this application during an entire night, ordering an enema of epsom salts to be given next morning, which brought away about three hundred of the seed; and in forty-eight hours she was restored to her anxious parents, entirely free from danger, although the pupils of her eyes were dilated for several days longer. If you consider the above case worthy of an insertion in your journal, you will oblige me and many of my medical friends, who joined in requesting me to forward it. To Prof. Dunglison. Yours, respectfully, ERASMUS D. JONES, For the American Medical Intelligencer. ART. II.-PHILADELPHIA HOSPITAL. Report of Cases occurring in the Service of Dr. Dunglison, Attending Physician, between July 15th and September 1st, 1839. Reported by JOSEPH B. COTTMAN, M. D., and WILLIAM B. PAGE, M. D., Resident Physicians. (Continued from page 240.) 1. Hypochondriasis.-This woman we found in the ward at the time we took charge; she had been in since the 1st of July; very little was done for her except to regulate her bowels, which had been in a constipated state for some time previous. She was discharged from the ward, August 2d, somewhat improved. 2. Phthisis Pulmonalis.-Elizabeth Dutill, æt. 40. This patient came in June 15th, labouring under confirmed phthisis. The treatment adopted in her case was merely palliative, consisting merely of a pectoral mixture for the cough; and intermittent counter-irritation by means of the ointment of tartarised antimony. A week or ten days before her death, gangrene of the lungs took place, for which four-grain pills of the chloride of lime were prescribed. She died August 16th, but no examination of the body would be permitted. 3. Neuralgia and Hyperesthesia.-Elizabeth Gillues at. 39. This woman came in June 24th, labouring under what Dr. Dunglison considered neuralgia, with supersensitiveness of the lower extremities. She could not bear the least touch of the finger, it would often throw her into the most violent nervous agitation; but, what was singular, at other times she could hear us to press her limbs as hard as we pleased, without its causing pain. This condition came on about a week before her entrance; she had been confined to her bed for some months with an attack of fever, went out and exposed herself too soon, caught cold, and attributes her present affection altogether to that circumstance. It commenced at first in her ankles, and gradually proceeded up until the whole lower extremities were in the state described; she has great tenderness on pressure down the whole tract of the spinal column; is very restless at night; sleeps very little; general health very much impaired; emaciated and anæmic; action of heart much excited; bowels constipated. The following was the plan of treatment adopted : . Pulv. rhei, grs. x. Mag. ust. 3i. Fiat pulvis statim sumendus et pro re nata repetendus. B. Acid. hydrocyanic. gtt. i. ter in die, in mucilag. acaciæ, q. s. Occasionally all the symptoms become very much aggravated; the action of the heart very much excited, and the fear of being touched almost intolerable; cups applied to the spine and region of the heart, or a blister, with perfect quietude in bed, and the use of the tincture of digitalis in the dose of ten drops three times a day, ameliorated the symptoms so much, that on the 1st of July the digitalis and hydrocyanic acid were discontinued; and she commenced with ten drops of the liq. ferri hydriodatis, three times a day. On the 31st of July, small blisters were applied to the inuer side of the ankles, and the exposed surfaces were dressed with the acetas morphina; this remedy at first appeared to promise greater success than any other, but as soon as the blistered surface healed, there was a return of all the symptoms; the blisters were again opened on the external part of the ankles by means of the lotio ammoniata fortior of Granville, and dressed with morphine; but as soon as the surfaces healed, the symptoms returned: Granville's lotion was now applied to the sacral region, and the surfaces dressed with morphine; this gave more relief than any thing else, and, on the 14th of August she was able to walk about the ward with less sensitiveness in her limbs; a scruple of the precipitated carbonate of iron three times «a day was now substituted for the liq. ferri hydriodatis. On the 39th of August her general health was very much improved; she was able to walk much better, and the sensitiveness had diminished. She is still in the ward. [N. B. Under strong revellents applied to the spine, with galvanic shocks, and time-which was probably an element-she became so much better, tbat she was discharged to a situation in which she was able to take appropriate exercise.-Ed.] Dysentery-Jane Wallace, æt. 26. July 17th. Symptoms: bloody evacuations; pain on pressure over the abdomen; great tenesmus; restlessness at night, constantly tossing about in the bed. B. Ol. ricini, zii. Tr. opii, gtt. x. Fiat haustus statim sumendus. . Sol. morph. sulph. zi. nocte sumendam. Injections of starch and laudanum, and a cataplasm of equal parts of muse' tard and flaxseed meal to be applied over the abdomen. 18th.-Slept four hours; bowels open frequently during the night; continue the treatment. 19th. The tenderness over abdomen, and the number of evacuations have increased. Applicentur cucurbitulæ cruentæ abdomini. . Hydrargyri chlorid. mit. gr. §. Pulv. opii, gr. 4. Fiat pilula ter in die sumenda. Continuentur enemata. 22d.-Dysentery still continues; mouth not yet affected. Continuentur remedia. 30th.-Mouth now affected; number of evacuations less, and they contain no blood. Omittatur hydrargyri chloridum mite, sed continuetur opium. August 4th.-Number of stools somewhat increased; no blood; no tenderness over abdomen. Omittatur opium.. . Tr. opii, gtt. xl. Mist. cret. comp. 3iv. M. Capiat semiunciam omnibus secundis horis. 9th Diarrhoea has ceased altogether for the last three days; discharged cured. Dysentery and Pleurisy. Mary Simpson, æt. 26. Came in July 20th labouring under pleurisy of left side; had had a slight attack of dysentery for several days; number of evacuations at present about ten in the twentyfour hours, bloody; a small dose of castor oil was given to clear out the intestinal canal, and afterwards she commenced with the following . Hydrargyri chlorid. mit gr. §. Pulv, ipecac, comp, grs. ii.. Fiat pulvis quartis horis sumendus. Applicetur empl. epispast. 6X4 lateri sinistro. 29th-Mouth affected; dysentery has stopped.. Omittatur calomelas. Continuentur pulv. ipecae comp. gr. iv. nocte maneque. |