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Chapman, M.D., 25 Somerset-street, Portman-square (of which I had taken a note), in which the writer advocated the use of a bag of ice down the spine. Feeling that if I did no good, I could, under the circumstances of the case, do no harm, I made up my mind to try whether ice would do any good. I now proceed to give you an account of what I did, and as to what the results were. 10:30 a.m.: The man, a Mussulman, a hackery-wallah, arrived with his own and other hackeries from Calcutta. He had been for two or more hours' purging and vomiting violently; voice scarcely audible; pulse imperceptible; hands, arms, legs, and feet quite cold. He was throwing his legs about and twisting his body in great agony; he complained much of thirst. I gave him water with a little carbonate of soda in it. He appeared to be sinking fast. 11.0: I procured some ice from a neighbour. Having no gutta-percha bag, I took the leg of a pair of flannel trousers and made a long bag to reach from between the shoulder-blade to the bottom of the spine, of a width of three inches ; into this I put broken ice, and applied it to the spine. After I had applied the ice the purging and vomiting ceased, and by 11.20 the spasms were much diminished. 11.30: The patient was much easier. On questioning him he said in a very low voice that he felt easier. A little before twelve I found that his pulse was perceptibly stronger, and that his arms and legs, which were previously as cold as stones, began to be slightly warm. The flannel in which the ice was put was now saturated with water, and as Dr. Chapman said the cold was to be a dry not a wet cold, one of my natives suggested the use of a bottle, on which I got a preserved-fruit bottle into which I put the ice, and had the bottle held against the spine. 12.30 p.m.: No more vomiting, &c., the arms
, and legs getting warmer; no pain, very great thirst; I let the man drink as much as he liked. From this time till 1.30 I kept the bottle of ice on his back, when, finding that his hands, arms, legs, and body were becoming hot as if he had fever, I removed the bottle of ice; and as I was about to leave my house for tiffin with a neighbour, I told my khansamah if fever came on to put in the place of the ice-bottle a bottle of hot water. 4:30; I returned to the man, He was fast asleep, and a more deadly object I never saw. At 5:30 he awoke and asked for food. I gave
him some thick conjee with sugar and brandy. 7.30 a.m., Monday, 26th : The man is sitting up; convalescent, but weak. He wants to take his bullocks and hackery away. The above are the facts of the case."Medical Times and Gazette, April 28, 1866, quoted from tho Homeward Mail.
A CASE OF ATAXIC LOCOMOTIVE PROGRESSIVE PARALYSIS. By R. MURNEY, M.D., fellow and licentiate of the College of Surgeons, Ireland.
The case which I am about to describe will serve to illustrate a disease (if my diagnosis be correct) which is well known in Dublin, but not so well throughout the country: it is for the latter reason that I venture to bring forward this case so as to ventilate the subject as much as possible. I confess that I cannot throw any new light on the pathology of the disease, inasmuch as I had no post-mortem in the case. The disease ran its course in four months, terminating in perfect recovery, which was contrary to my prognosis, as I looked on the symptoms indicating a disease which experience has hitherto, at least, found to be incurable. The disease I allude to is the ataxic locomotive progressive, described by M. Duchenne. The subject of this paper is a young gentleman of about 20 years of age, tall and well proportioned, fair complexion ; he consulted me on the evening of the 7th of last February; said he suffered great pain since four o'clock in consequence of not being able to pass any urine; made some about eight o'clock in the morning, but none since, though having made many efforts; said this incessantly came on without any cause that he was aware of; was in his usual health and spirits the previous day, and slept well the night before. I passed a catheter without the least trouble, urine natural in quantity and quality, and acid reaction, sp. gr. 1020, it was microscopically examined by Dr. Barker, who pronounced it healthy. I passed the catheter twice each day for fifteen days. At this date the bladder recovered itself for a short time. On the third day of my attendance on him his gait became unsteady, and when turning round staggered. In the course of a month, as those symptoms increased and became aggravated, could not walk with his eyes shut, had great difficulty in maintaining his balance, when once in motion he could get on pretty well by moving quick with his head down and eyes fixed on the ground. About a week after the bladder recovered itself, another and distressing condition of it set in, incontinence of urine; his face presented a peculiar sardonic grin, apparently drawn to right side; no anæsthesia on the left; right eye amaurotic; pupil dilated; appetite bad ; lived on wine and brandy occasionally. His friends were greatly afflicted at the appearance of his face, being so much changed; did not perceive it himself; his memory was not as perfect as usual; he became careless and filthy in his habits; complained of pains in his thigs and legs. The history he gave of himself was:–Had always enjoyed good health; both his parents and all his family were living; a few days before last Christmas got for the first time in his life pain in his head and back, with sick stomach ; went to bed ; lay for three weeks
with a feverish cold, as he was told by the medical man who attended
a him when convalescent; went to Kingstown; there became strong in a short time; a few days before his return to town got a pain in the lower part of his back corresponding to the fourth lumbar vertebræ; it was very severe for some days; the intensity of it gradually lessened and finally disappeared. When first consulted the treatment consisted of citrate of quinine and iron, a blister over the region of the bladder, beeftea, wine, &., subsequently tinc of ergot, strychnia, nitrate of silver; the latter medicine he continued to take for four weeks without ever making any change in the colour of his skin. The patient himself imagined he was very much improved, though I could not perceive it. Went to Galway on the 2nd of April to see some friends there; returned on the 4th of May to Dublin, to my great astonishment strong and fat, and to all appearance quite recovered. How long he will continue so remains to be seen.
While in Galway discontinued the nitrate of silver pills and all other medicine. On my first interview with him after his return, the first thing he did was to walk with his eyes shut and dance a polka. I confess that on this occasion I was not a little shaken in the correctness of my diagnosis, but when I grouped all the symptoms--the staggering gait, the peculiarity of raising and putting down the foot, the heel first, the head bent, with eyes looking down on the ground, the amaurotic eye, and the inability to walk with eyes shut, which M. Trousseau says is pathognomonic of the disease ataxic—all these symptoms confirmed me in my former diagnosis. The only other disease that this could be confounded with is reflex paralysis. On this subject I published two papers, in one of them the disease was ushered in by loss of power of the bladder, succeeded by incontinence of urine. In those two somewhat similar, but totally different diseases, you have in both the staggering gait, the peculiar motion. In the ataxic the heel is first put down, in the other (reflex) the toes. In the latter the patient can walk with his eyes shut and his head erect, never any affection of the eyes or face, which we know is not the case in the ataxic.
In those cases of reflex paralysis alluded to, both recovered, they were read and discussed at the meetings of the Surgical Society of Ireland.
CHRONIC DYSENTERY.-H. Hartshorn, M.D., has treated chronic dysentery of three months standing, where the patient was relieved entirely in a few days by the use, twice daily, of an injection of four ounces of water, containing eight grains of zinci sulphas, with forty drops of laudanum.--New York Journal of Medicine, vol. 3, p. 271.
MONTREAL, JUNE, 1866.
We owe an apology to our readers for the delay in the issuing of the June number. During the greater part of the month, both editors were on the frontier, in medical charge of volunteers, and this is our excuse. We trust to have the July number ready very shortly, and will use our best efforts to have the future numbers out in good season. May we again solicit the aid of our subscribers for original communications? We must say we find a sad want of energy among the practitioners of this Province, in giving the result of their observations.
THE HEALTH OF THE CITY.
“ It is an ill wind that blows nobody good,” is an old saying, and we think it has been proved a true one, in relation to the anticipated visit of cholera. From all appearances, and judging from the past, we had good reason to apprehend the appearance of this terrible disease in our midst this season, and we in this Journal, more than once raised our voice against the criminality of neglecting to take all the precautions which sanitary science has taught us, were likely to mitigate or prevent the appearance of the scourge. It was hard to rouse our people to a realizing sense of the duty they owed, not only to themselves and their families--but also to their fellow-citizens; but once fairly roused into action, Montrealers are proverbial for the earnestness and enthusiasm which they throw into all their works. It was late in April before our citizens were aroused to the danger which seemed to be overhanging them -in the threatened appearance of cholera; but then two health officers were appointed, and a sanitary association formed, and the result of their combined labour, is that on the 1st of July, we find our city in a state of cleanliness, such as we b.lieve it has never before in its history been. Of course we do not for a moment mean to assert that this cleanliness has prevented the appearance of the disease—but we do assert, that had we been visited by cholera, the condition in which the city is now in, would have exerted a very modifying influence over its spread and fatality, as it has been exerted, even over the ordinary mortality of the season. Seldom, if ever, after such intensely hot weather as we have had for a month past, has the weekly bills of mortality raged so low, we might say remarkably low, and we think the result of our labours to prevent or arrest cholera, should it appear, has taught us a most valuable lesson, which we trust our citizens will never forget. If by such simple means as have been made use of—we can bring about such grand results—how grave a responsibility would rest upon us—if in the future, we should neglect to employ them. Montreal has ever been remarkable for its very high mortality, and one of the reasons—what others there may be we do not enter upon now-we at all events have ascertained to be the filthy yards, foul emanations arising from putrefying animal and vegetable matter so long usually allowed to remain, and which this season have been compelled to be constantly removed. This should be ever remembered-should be earnestly impressed upon all who have the good of our city at heart; and we feel that much credit is due to the Sanitary association in placing before the people facts, which sbow them how simply yet effectively preventible diseases may be kept from their doors. We anticipate much permanent good will result from their labours, and whether cholera come this season or not, (for it is yet too early to say whether we will yet altogether escape it, although appearances seem to indicate we will,) we have certainly realized great benefits from its anticipated appearance. In closing we would simply add, events have taught us there is ample work for a Sanitary association in Montreal, and we hope that the association will become a permanent one—the fruits of whose labours will become yearly more visible.
OUR VOLUNTEERS. Since we last issued the Journal, our country has been roused from Sarnia to Gaspé, by the infamous invasion of the Fenian brotherhood, and never before has Canada been so united, or so nobly responded to the call for volunteers. We hope perhaps ere a great while, to be able to publish something regarding the medical history of the brief-but hard campaign-in the meantime we invite attention to the communication of Dr. Caniff, on some of the wounded at the battle of Ridgeway. Among the Montreal volunteers sent to the frontier, considering they were under canvas all the time, and that the weather was remarkable rainy– that there were many badly clothed and shod, ill supplied at first with overcoats and blankets-that they performed hard and long marches over most abominable roads, that they were hard worked on guard and picket duty-they were most remarkably free from serious disease. Among the Field Battery, Cavalry, Prince of Wales, Victorias, and Royals, very few cases presented themselves for admission into hosiptal. The majority that