« AnteriorContinua »
REPORT of DISEASES treated at the PUBLIC Dispensary, near Carey-Street, London, from November 30th 1815, to February 29th 1816.
No. of Cases.
The winter, though it can scarcely be said to have been a severe season, has been productive, however, of much illness by the perpetual fluctuations, and the occasional intensity of the cold. On two nights, indeed, in February, the thermometer was lower by many degrees than it has been for a great number of years, and much lower than it ever was during the severe frost of 1814.* In fact, although there has been no longcontinued frost, and therefore it has not been felt as severe, if the number of frosty days, from the early part of November when they commenced, were to be counted, it would be found that, on the whole, the cold of this winter has been considerable. The fluctuations, however, have been frequent and unusually great, a change of above 20 degrees of the thermometer having sometimes occurred in the course of twenty four hours.
The result of this has been very unfavourable to the public health; for a more general prevalence of catarrhal and pulmonary diseases has not been observed since the year 1803, than has occurred since Christmas. The number under the heads of all the other diseases in the preceding list is small, and seems to have given place to the multiplication of catarrh. Indeed for a few weeks it was scarcely necessary to inquire respecting the nature of the complaint, so uniformly catarrh followed catarrh, among the successive applicants at the Dispensary. On
* The common registers in the magazines are not to be depended upon, as their great difference demonstrates. From the accurate observations of Mr Howard, it appears, that on the 9th of February, at night, the thermometer near the snow at Tottenham stood as low as minus 5, or 5a below zero. I understand it was observed at -2 at Kew, and -4 at Northampton on the same night; a degree of cold not observed above once in 20 or 30 years.
the whole, the disease, too, has assumed an unusually inflammatory type: it was not the influenza, however general its attacks; for it was not accompanied by the usual depression of the vital powers, which mark that modification of catarrh; nor was it prone to assume the low and bastard form of peripneumony, or that of the moist and expectorating chronic cough and dyspnea: but was in most cases a hard and active catarrhal cough, or a more active pneumonia, requiring and bearing well the lancet, and free blistering, with evacuants of calomel and antimony. We had an opportunity of witnessing the benefit of a second and even a third bleeding, in some cases, where neither the apparent constitutional vigour nor the age would have led us to anticipate an inflammation so active as to require so much depletion; but which the consequent relief and success amply proved to be necessary. Whatever may be the cause, there seems to be a manifest difference in the character of the same diseases at different periods, as Sydenham remarked; and the epidemic catarrh of this season appears to have been more inflammatory than those which have sometimes obtained the ap pellation of influenza.
In each of two families among whom the cases of measles occurred, there appeared to be tolerably clear evidence of one individual, who now had the disease, having previously undergone the eruption and catarrhal affection in a regular way; in fact, that one child in each family now had the measles for the second time. The boy first attacked in one family, and who infected the rest, was eight years old, and the mother, an intelligent woman, would not believe that the eruption could be rubeolous, in consequence of a distinct recollection of his having gone through that disorder when he was a year old, through the course of which he was attended by a medical practitioner, who pronounced it to be measles. We have the high authority of Dr Baillie, recently published in testimony of the same fact; and the measles would indeed constitute an anomaly among these contagions, if the general rule of its occurrence only once during life were not liable to the same exceptions with the smallpox and scarlatina.
London, Feb. 29, 1816.
REPORT of DISEASES treated at the New Town Dispensary, Edinburgh, from its institution September 1st 1815 to March 1st 1816.
No. of Cases.
No. of Cases.
costa cum emphys.
Contusio et subluxatio
The winter has been chiefly remarkable for the frequent and sudden alternations of hard frost (accompanied with snow, and cold piercing winds), and moist mild weather; of which changes there have been five between the middle of November and the middle of February.
The number of inflammatory affections, particularly of the chest, has, in consequence, been very considerable. In infants and young children, since the beginning of December, catarrh has been unusually prevalent, and attended with much fever, and hurried laborious breathing, and occasionally, as far as could be judged, with acute pain of breast. The pulse was generally very quick and sharp, the countenance pale and anxious. Forty-seven of the cases of catarrh in the foregoing enumeration were of this description. In one case, of a child of seven months, which proved fatal, decisive marks of inflammation of the pleura and lungs were found on dissection, particularly recent adhesions of the pleura costalis and pulmonalis, and effusion into small portions of the substance of the lungs, increasing the density of these portions to such a degree as to cause them to sink in water. In another fatal case, of a child of eighteen months, in which the cough had continued for several weeks, with irregular fever, and progressive emaciation; the left lung was found adhering to the pleura costalis; numerous tubercles were dispersed through its substance, and a collection of pus was found in its upper and back part, inclosed in a sort of cyst, of caseous consistence, and considerable thickness.
The early and sometimes repeated application of leeches to the breast, followed by blisters, appeared to be the most successful practice in this formidable disease among infants. In the slighter cases, purgatives and warm bathing, with or even without blistering, gave effectual relief.