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AMERICAN MEDICAL INTELLIGENCER.
April 1, 1839.
ART. I.--CASES OF AMAUROSIS AND NERVOUS DEAFNESS.
BY JAMES BOLTON, A. M., M. D., OF RICHMOND, VIRGINIA.
Richmond, Va., Feb. &th, 1839. Dear Sir,- The following interesting cases having come under my care, I send the subjoined account of them to you, as perhaps they may, in your judgment, deserve a place in your valuable periodical, where I have before been honoured with a space. Very respectfully,
JAMES BOLTON, A. M., M. D. Robley Dunglison, M. D.
i. Amaurosis and amenorrhæa.--Mary J., a coloured woman, 22 years of age, unmarried, had suffered under amenorrhæa for two years, during which time her vision had become very much impaired, and she had been subjected to various modes of treatment, regular and irregular. I found both pupils nearly immovable; with one eye she could not distinguish light from darkness, and the sight of the other was so defective that she could scarcely attend to her ordinary occupation, that of chambermaid. Had severe headaches, and the other ordinary unpleasant symptoms of her principal malady, regularly every month.
Treatment.-As the bowels were somewhat costive, they were freely evacuated with pills of rhubarb and aloes. A week after the subsidence of her cephalalgia, &c. I put her upon the use of the following pills: R. Ext: Sabinæ, Sulph. Ferri. Kā gr. 4, G. Ammoniac gr. jiss. M. for one dose. One pill morning, noon, and night, increased daily by one.
On the sixth day from commencing the use of these pills, the menses returned, and with them a great improvement of vision. The discharge continued four days, during which time the pills were discontinued. "A fortnight afterwards she could distinguish a broom straw at the distance of six inches with the eye which before was so blind that she could not distinguish light from darkness. The vision of the other eye also was very much improved. At the next period of the usual return of the menses, they did not appear, and she had again headache, &c.—The use of two or three pills immediately reproduced the discharge, and a complete relief from all her unpleasant symptoms. I have since heard nothing further of the case.
3. Erethitic nervous deafness.-T. H., aged 17, son of a highly respectable gentleman of this place (Richmond), for about two years has been much annoyed by tinnitus in both ears, and a gradual diminution of hearing. The disease has been hereditary on his father's side of the family. January 26, 1839, much annoyed by a noise resembling the roaring of a waterfall, especially on going to bed-labouring under a severe catarrh witḥ enlargement of the tonsils. January 31st, catarrhal symptoms nearly removed. The day previously had suffered from severe headach, to which he is subject. Hearing distance of the right ear, as tried by my watch, 44 inches, left 3 inches.
of left ear.
Applied the vapour of acetous ether to the left ear, according to the directions of Kramer, and an issue to the arm for the cephalalgia.
Hearing distance Hearing distance
of right ear. Feb. 4th,
74 inches, 101 inches, Appl. æther ad aur. sinist. 5th, 11
do. 6th, 154
unmeasured, do. do. 7th, 17
do. do. do. 8th, 2ft. 84
do. do. dextr. Tinnitus very rarely heard, and then sounds like the buzzing of an insect.
This case is interesting as I have not seen any report of Kramer's treatment having been tried in this country, although his work has been re-published here several months since in the Library which you edit, and the treatment recommended in that admirable work has been astonishingly successful in the case above mentioned.
Remarks. The improvement of hearing in the left ear was undoubtedly due to the treatment, and that of the right ear was no doubt owing to the effect of the vapour of the ether, which escaped from the catheter while applying it to the other ear, finding its way into the eustachian tube of the righi side. I shall report to you at another time the further progress of this
Richmond, March 10th, 1839. Dear Sir,-Since my last communication in February, I have continued the treatment recommended by Kramer in this case, then reported to you, and it has been crowned with a success far exceeding my most sanguine expectations. The patient being attacked every five or seven days with severe cephalalgia, I applied a seton to the left arm, which so effectually warded off this unpleasant affection, that he suffered but one slight attack during the month he was under treatment.
Report of the case continued.
do. Patient remarked that now, for the first time, he was not aware that crickets do not chirp in winter, as he had been much appoyed by a similar sound. Roaring noise changed to a humming like that of an insect-very rarely heard-slightly on going to bed.
Left ear. Right ear.
15th, 20ft. 3in. 11ft. do. do. do. do.
do. sinist. catarrh 18th, do.
do. do. do. dext. do. increased. 19th, 16ft. 8ft. 9in. do. do. do. sinist. do. do. 20th, 13 11 5 do.
do. dext. do. do. 21st, 13 3 in. 11
do. do. do. sinist. do. severe. 23d, 16 6 11 5 do. do. do. dext. do. do. 24th, 13 4 9 2 do. do. do. sinist. do. do. 27th, 11 4 7
do. do. do. do. do. do. On the 28th, the patient left the city to go several miles into the country, and has not returned, nor have I been able to learn any thing respecting his hearing.
Remarks.—There are a few points worthy of notice in this case. The hearing distance of the right ear was rather greater than that of the left; but
after the first application of the ether, the reverse was the case. During the first week the left ear only was treated, and while the hearing of that side improved astonishingly, that of the other improved slightly and gradually, which, as I before remarked, was probably owing to an overflow of the acetous ether filling the esophagus and passing through the eustachian tube into the cavity of the tympanum of the opposite side. On applying the ether to the right ear for the first time, the hearing distance was nearly trebled. During the treatment, the hearing distance, although diminished by a severe catarrh, was about forty times that when diminished by the same cause before the treatment was commenced. The hearing was always worse in damp weather, and as it was very rainy the last few days, this no doubt increased the effects of the catarrh.
Cataract in the Horse. Some months since I performed the operation of couching on a filley of about five years old with entire success. The disease had affected both eyes, so as to render her entirely blind. The animal may now be seen in the vicinity of Fredericksburg, and is in the possession of a Mr. Perkins.
JAMES BOLTON, A. M., M.D.
ART. II.--ANOMALOUS DISTRIBUTION OF THE VERTEBRAL
BY RICHARD P. CATLEY, M. D., OF OHIO. [Although the anomaly in the subjoined case may differ somewhat from those recorded, there are many examples of a similar irregularity of origin and distribution referred to by Meckel' and other anatomists.-Ed.].
Philadelphia, March 15th, 1839. Dr. Dunglison.
Sir,-On the 8th of February last, whilst attempting the ligature of the innominata on the dead subject, at my residence in the state of Ohio, having exposed the vessel in the manner directed by Mr. Liston, of London, I tried to pass my finger from the division into the right subclavian and carotid along the innominata to the arch of the aorta; but, in so doing, I met with an anomalous arrangement, which, the touch, seemed like a bifurcation of the arteria io nominata. I immediately commenced a careful dissection of the parts, and found that both the common carotids, as well as the right subclavian, were given off by the innominata ; and that, on the left side, there were two vertebral arteries, one arising from the arch of the aorta and entering the transverse process of the fourth cervical vertebra, the other arising from the subclavian and entering the transverse process of the sixth cervical vertebra as usual. I have preserved the parts in a preparation, which I have shown to Dr. Pattison, Professor of Anatomy in the Jefferson Medical College, to Dr. Horner, Professor of Anatomy in the University of Pennsylvania, and to Dr. Pancoast, Lecturer on Anatomy in this city-all of whom concur in stating that they have never seen or read of precisely such an anomaly:
Should you tħink this notice worthy a place in your journal you are at liberty to use it. Believe me to be, sir, yours respectfully,
RICHARD P. CATLEY, M. D. 1 Handbuch der pathologischen Anatomie. B. ii. Abth. 1. s. 108.
ART. III.-CASE OF HYDROPHOBIA.
BY WASHINGTON L. ATLEE, M. D. OF LANCASTER, PA. [The following statement, contained in a letter to a non-professional friend, which has been sent to us-we presume, by the author-contains a full description of the sufferings of one labouring under this horrible disease.Ed.]
Lancaster, Feb. 20, 1839. Dear Sir,--At your particular request I send you a detailed account of the symptoms and treatment of the case of hydrophobia which recently occurred in this city. In doing this I do not wish to be understood as approving of this method of publishing or recording cases of disease. Medical men have their medical journals, through which their communications can be offered to the members of the profession, 10 whom they properly belong. Nor would I have consented had I not known the exciting interest that is created in all classes of the community by the occurrence of this frightful disease, and, in consequence of this excitement, the tendency there is to magnify and falsify the circumstances attending the progress of the case. The strongest inducement, however, for consenting to adopt this method in making the case public, is to bring it more particularly before the medical practitioners of our own county, who, as the guardians of the health of our community, can have the benefit of the history of this case, should such a misfortune occur again in any part of our couniy. I shall avoid, as much as I can, with propriety, the use of those terms not capable of being understood by the common reader.
On Saturday, the 9th inst., I was called upon to visit Mrs. Elizabeth Keely. I found my patient to be an intelligent looking woman, of spare habits, of ordinary stature, and about 34 years old. She told me that she had an attack of rheumatism in her arm, and complained of pain the whole extent of the left arm, particularly in the shoulder. She informed me that she had selt unwell for three or four weeks before, and that on Wednesday previous she had perceived some soreness on the back of the hand, which continuing to increase, had traveled up to her elbow on Thursday, and becoming more and more severe, bad on Friday reached the shoulder. During the progress of the pain, having received a phial of British oil from a neighbour, she rubbed it on her arm without receiving any relief. She then, of her own accord, applied a blister on the outside of her arm just below the shoulder with no better success. On Saturday, the pain becoming worse, and advancing into the left side of the neck, and through the arm-pit into the left breast, she thought it advisable to consult a physician, and I was sent for. I found the symptoms as above described, with the pain more acute in the joints than in any other part of the arm, taking on the character of the local symptoms of acute rheumatism. Her countenance was somewhat anxious, and her manner a little hurried. The tongue was lightly coated with a yellowish fur; the pulse, skin, and other perceptible functions being natural. I prescribed a blister to be placed over the spine, between the shoulders, and four cathartic pills composed of submur. hydrar., aloes socotor., convol. jalap., stalagm. cambog. and sapo castil., to be taken immediately. Upon taking leave of her, I directed her to send me word in the morning if she was not better, or sooner if she became worse.
On Sunday morning, the 10th inst., word came tha was no better. At half past 9 o'clock A. M. I visited her, and was informed by her husband that she had passed a bad night. Shortly after she had retired to bed, she was aroused by a sense of suffocation and tightness of the chest with pain in the præcordia or at the lower part of the breast bone. After this she could not sleep. Every few minutes throughout the night she would suddenly start np with a wild and anxious countenance, a sensation of smothering,