Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1845-6 / by C. West.

  • Charles West
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: Report on the progress of practical medicine, in ... midwifery and the diseases of women and children : during the years 1845-6 / by C. West. Source: Wellcome Collection.

    32/40 (page 30)
    which and his own expressions, published some months afterwards. Dr. Rees professes to discover so remarkable a coincidence.] DISEASES OF THE ORGANS OF DIGESTION, AND ASSIMILATION, AND THEIR APPENDAGES. Dr. Fanck* has described an epidemic of cynanche parotiden, that prevailed in the Alexandrine Orphan House at Moscow in the commencement of the year 1840, and affected 162 out of 300 inmates between the beginning' of January and the beginning of April. Both sexes appeared to be equally liable to the disease, but young persons about the age of puberty were most frequently attacked by it, while children under 7 years old had simple febrile seizures, without any swelling of the glands. It was quite evident that some epidemic influence was concerned in its production, and that it did not arise simply from cold ; neither did cold appear to be the principal cause of metastasis of the swelling from the parotids to other parts, though it did sometimes seem to cause a relapse in patients who had appeared convalescent. Dr. Duncanf relates several cases of ulcerous stomatitis, connected with diarrhea and entero-colitis, which he observed among the children of the South Dublin Workhouse. He gives a brief but good account of the disease, and dwells at some length on the evidence of its not being dependent on the administration of mercurials, though it would seem, from his remarks, that he regards it as identical with cancrum oris, an opinion to which the writer o f this Report cannot by any means subscribe. A very interesting account has been given by Dr. Daviot of an epidemic of diphtheritis, which prevailed in the department of the Saone and Loire from 1841 to 1844.J He states that the disease never occurred sporadically in this district, and that no case of it had been observed since 1809 ; though between 1782 and 1809, it had been four times epidemic. The pharynx was the part most frequently affected by it, and next to that the skin; then the mucous membrane of the trachea and larynx, and lastly, that of the mouth; but it frequently attacked many parts simultaneously. The affection of the skin often came on with intense redness, followed by ulceration ; or the skin appeared excoriated, and these excoriations then became covered with lymph. In other instances, an eruption resembling- scarlatina appeared over the whole surface, although not followed by any diphtheritic affection of the skin. The course of the disease was very rapid. It reached a high degree of severity in from 36 to 48 hours, and its fatal termination took place in from 7 to 10 days; the patients dying asphyxiated. Sometimes, after apparent recovery, bronchiopneumonia supervened, and led to a fatal result. Dr. Daviot bled both generally and locally at the onset of the disease. In the first stage he employed alum locally, but as the disease advanced, he had recourse to the nitrate of silver, believing it to be more energetic than hydro¬ chloric acid. Rubefacients were frequently applied to the throat with advan¬ tage, but blisters were avoided, on account of the tendency to diphtheritic affection of the skin. Diarrhea. The work of M. Legendre§ contains an essay on this subject, founded on the observation of 28 fatal cases. He ascertained that in some instances no alteration whatever of the intestinal mucous membrane could be found, while in the majority of cases enlargement of the intestinal follicles, or their more or less extensive ulceration, constituted all the morbid appear¬ ances. These changes of the follicles, too, appear always to precede any alteration of the mucous membrane itself. From these facts he concludes * Zeitschr. f. d. gesammte Medicin, Sept., 1845. t Dublin Journal., Sept., 1845. J The writer has been unable to obtain this pamphlet, which was published at Autun, in 1845 ; but an abstract of it is given in the J. f. Kinderkr., June, 1846. § Op. cit., pp. 363-418.