Monthly retrospect of the medical sciences : January to December 1849 / edited by George E. Day, Alexander Fleming, W.T. Gairdner.

Date:
MDCCCXLIX [1849]
Catalogue details

Licence: Public Domain Mark

Credit: Monthly retrospect of the medical sciences : January to December 1849 / edited by George E. Day, Alexander Fleming, W.T. Gairdner. Source: Wellcome Collection.

    29/262 (page 27)
    lungs. All these, however, and various other anomalous affections, at length gave place to cholera in its ordinary form, with vomiting, purging, and spasms, as little marked by intermission as it ever is, and differing in no respect from that I had witnessed in Edinburgh and London. Its temporary disappearance was then fol¬ lowed by the return of intermittent fever.” The author thinks that cases very simi¬ lar to these have been occurring in Man¬ chester since the middle of September last. The treatment suggested by Dr Bell for cholera, as well as the whole of the affections to which he believes it to be allied, is the combination of quinine and iron, which he has found remarkably use¬ ful, not only as an anti-periodic, but in obviating congestion of the internal or¬ gans. He thinks bloodletting to be only useful when the disorder has not fairly commenced, and injurious when per¬ formed at a later period.—Prov. Med. Journ., Nov. 29, and Dec. 13, 1848. [The details of Dr Bell’s experience of individual cases in the original papers are most curious and interesting ; and we strongly recommend their perusal to those interested in this subject as the fruit of a large experience in cholera, in a region little known, in a medical point of view, to most Europeans. W e think, however, that the author has decidedly overstepped the limits of sound induction in connecting together in one class diseases differing so much from each other as those he de¬ scribes. The number of disorders which are admitted as manifestations of the pre¬ cursory epidemic fevers is so great, and their kind so various, that we scarcely think it possible that cholera could at any time have invaded Persia without being heralded by some of them ; and we can¬ not help thinking that the author has been betrayed into the recognition of analogies far too vague and indefinite when he asso¬ ciates apoplectic, paralytic, neuralgic, and dropsical attacks with ague, and all of these with cholera. Suspending our judgment, however, as to the Persian epidemics, we must say, with more confidence, that we are con¬ vinced of the fallacy of Dr Bell’s ideas as to the relapsing fever of this country. The epidemic of Edinburgh in 1843 pre¬ sented no resemblance whatever to a fever of “ remittent or quotidian intermittent D'P®)” such as the author seems to have seen in I’ersia; nor did it resemble a ma¬ larious fever at all, except in the single circumstance of periodical relapse; and even here there was a marked difference, seeing that the relapse was not in the slightest degree influenced by the admi¬ nistration of quinine, as ascertained by numerous trials in Edinburgh—(see Dr Bobertson’s paper, in Monthly Journal for November 1848). The origin of this fever by contagion was, we think, placed beyond all doubt by the researches of Dr Henderson and others—{Edin. Med. and Sury. Journal, 1844) ; and its con¬ nexion with endemic causes or with ma¬ laria cannot be said to be established, or even rendered probable. Neither can we admit that the relapsing fever has at any period of its history shown the slightest tendency to pass into thefoim of cholera. We think it satisfactorily proved that it has existed in Ireland during the last half century at least—(see Dr Robert Paterson’s article inEdin. Med. and Siirg. Journal, Oct. or Monthly Eetrospect, Nov. 1848); and during this period it has made several visits to this country, not one of which has been immediately fol¬ lowed by cholera. The epidemic of 1843 presented a remarkably fixed and definite character : it subsided without a trace of choleroid affection. It reappeared in Edinburgh, with nearly the same charac¬ ters, in 1846-7, reached its acme without variation, and again subsided, without having ever suggested to any one, so far as we are aware, the idea of its being either cholera or quotidian intermittent. Finally, when cholera broke out in October 1848, the relapsing fever could not be said to exist in an epidemic form, and such cases of it as did occur in no way varied from the ordinary type. We think, therefore, that any supposed analogy of this fever, with intermittent on the one hand, or cholera on the other, is, so far as this country is concerned, entirely unwar¬ ranted by observation.—W. T. G.] 40.— On the Contagion of Cholera, by M. SwAAGMAN, and Dr M'Cobmac. In an account of the epidemic cholera of Groninguen, M. Swaagman cites the fol¬ lowing facts, favourable to the contagion- ist1. The hospital required only two nurses, both had cholera. 2. It happened that in two large families where the mothers were the subjects of the disease, one child only of each was attacked, and in both cases it was the child that lay with the mother. 3. The disease was observed to attack a great number of members of certain families, although they lived in very different quarters of the town. 4. In a neighbouring hospital, no