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flammation of the lungs, life may be lost bythe very delay caused by having many milesto send ; but even in ordinary cases ofillness, that the poor creatures should haveto send or attend personally at so great adistance, seems a monstrous cruelty. I amtold that the guardians think it best to havebut one responsible medical officer, whomthey require to be a legally-qualified prac-titioner, leaving to him the supply of neces-sary aid. But do they require also, and see,that the aid so furnished, is that of " quali-fied persons? Can they expect the medicalofficer to expend so much of his paltrysalary as a qualified person would have aright to expect ? I think, Sir, that these arematters for the serious consideration of the" guardians," ere a coroner’s jury remindthem of their duty.

In the furnishing of medical aid to theUnions in general, and to this Union inparticular, one would almost be led to con-sider that the very lives of paupers were putin competition with a few paltry poundssterling. Many other observations suggestthemselves to me on this occasion, but thecommunication of Mr. Rumsev coming beforeme, and having reason to expect that hisquestions will be generally considered andreplied to by the medical men in this neigh-bourhood, I shall for the present suppressfurther remarks on the ma,tter, and am, Sir(authenticating my communication in a

private note), yours truly- HUMANITAS.

Rochester, Nov. 9th, 1835.


Hufeland and Ossan’s Journal. - June and- July, 1835.

The two last Numbers of the above jour-nal, which we have received, contain :-

1. Practical Observations by ProfessorFLEISCHMANN, of Erlangen. 2. On an

Epidemy of Angina Parotidea, at Ohrdruff,in 1830, by Dr. KRUGELSTEI. 3. A FewRemarks on the Diagnosis of Intestinal Ci-catrices, by Dr. ALBERS, of Bonn. 4. Prac-tical Remarks by Dr. LOWENHARD. 5. On

Thymic Asthma, by Dr. Hzn.scH, of Konis-berg. 6. Two cases of Religious Madness,with remarks, by Dr. WEIGEL. 7. On theefficacy of 11 Ai-gilla depurata" in the Diar-rhœa of Children, accompanied with vomit-ing, by Dr. G. E. DURR.

We shall notice only the most remarkableof the above communications. The first is

contained in the "practical observations" ofDr. FLEISCHMANN.



Some experiments with this medicinewere made on fifty-two children during anepidemy of scarlatina, and though not on asufficiently extensive scale to have much

weight, deserve to be added to the numberof those instituted for a similar purpose.The extract of belladonna (2 grs. to an

ounce of distilled water) was administeredto fifty-two children, of from six months tofourteen years of age. Each patient took,morning and evening, as many drops of the

solution as he counted years, and this dosewas in some instances increased. The re-

mcdy was thus administered for the mostpart during five weeks,-the duration of theepidemic.Of the fifty-two individuals forty-eight

remained free from any attack, and four

were affected with the disease. In two fa-

milies, where the children commenced tak-ing the remedy immediately on the diseaseattacking one of the family, all the childrenremained free from contagion, although theywere in constant communication with theaffected individual during the whole courseof the disease.

In several cases (23) the author remarkedsymptoms of the action of the belladonna afew days after its use; such as disturbed

nights, slight inflammation about the throat,salivation, thirst, torpor, dilated pupil, painin the head, vomiting; and one girl, six yearsof age, was seized, on the 10th day after thefirst dose, with fever, pain in the throat,restlessness, and delirium. On the follow-

ing day the whole of the body, except theface, became red, and was covered with

miliary vesicles : this continued a coupleof days, and then disappeared.A boy, four years of age, who had taken

the belladonna for three weeks, became veryuneasy and disturbed on the 5th of March;on the 6th this had passed off. On the 9th,the child, enjoying perfect health, was co-vered in all parts of the body, except theface, with a red eruption, which remainedtill the llth. On the 12th it diminished,and had completely disappeared on the 13th.A child, eighteen months of age, who had

taken the belladonna six days, was seizedwith difficult deglutition, slight tumour ofthe cervical glands, salivation, fever withexcessive thirst, and general redness of theskin. The eruptiun was much diminished



on the second day, and the child was well onthe fifth.

From the above-mentioned experimentsthe author concludes :-

t. That the belladonna seems to have aninfluence in counteracting the contagious-ness of scarlatina.

2. That in some cases it diminishes thesusceptibility for the contraction of the dis-ease, though it does not altogether removeit.

3. That when the disease does occur dur-

ing the use of belladonna, its character ismuch more mild than in ordinary cases. ’,


In many cases (says Dr. LowENHARD,the author) of obstinate sciatica, the causeof the disease is unknown, and all the reme-dies which are applied fail to relieve the

patient from the dreadful and constant suf-fering to which he is exposed. The effectof division of the branches of the third pairof nerves, has induced some surgeons to

recommend a somewhat similar operation forthose of the extremities; and M. J obert a fewyears ago divided and removed a portion ofthe sciatic nerve for obstinate sciatica, butwe do not at this moment remember whatthe result of that bold operation was. The

following case, though not exactly of the, same nature, deserves to be recorded.

Case.—Mr. B , 38 years of age, of goodconstitution and sanguineous temperament,was seized with pain in the region of theleft hip-joint, in consequence of some vio-lent exertion. The pain continued fixed forabout two months, and then extended down-wards in the direction of the sciatic nerve.After the expiration of six months, the painbecame so severe that the patient was una-ble to place his foot on the ground. He

now demanded medical aid for the first

time ; various remedies were tried in vain,and he came under the author’s care in sixmonths afterwards. The patient was nowmuch emaciated; the injured limb particu-larly reduced in size, and the heel so pain-ful that the patient could not stretch out hisfoot without aid, and had the most acutesuffering. A cord about the thickness of a

finger could be felt under the skin, in the

course of the ischiatic nerve, which wasthrown up into a kind of tumour; this partwas excessively tender to the touch; thebowels were costive ; the urine deep red,

and throwing down a dirty sediment.After some reflection the author conceivedthat perhaps the swollen nerve contained awatery fluid, as in the case mentioned hyRichter (Speciel. Thera. part 2, p. 79), buthow to give issue to this fluid was the ques-tion of most importance. A simple incisionwould easily have produced the desired

effect, but it was necessary at the sametime to impress a stimulus on the muscularsystem ; the author therefore determined onemploying the actual cautery, which wasapplied immediately to the nerve, where itpasses between the trochanter major andthe tuberosity of the ischium : on the ironbeing pressed with some force into the bot-tom of the wound, two to three ounces of ayellowish-gray fluid came away. The woundwas then dressed with some mild salve, andas the patient was nearly in a fainting con-dition, he took a restorative.The day after the operation, the patient

was more oppressed and weak, uneasy, andwith a very small pulse. Some stimulantsand cordials were given. On the 21st same

state ; the wound still discharges a little

fluid, and was dressed with ung. canthar.The pain of the foot has now changed intoa dull sensation, the patient slept a littlethis night for the first time since manymonths.

22. Passed a good night; he can nowstretch out his foot without aid ; the woundsuppurates abundantly. In the course ofeight days the patient recovered a good dealof strength; a considerable quantity of agrayish fluid, different from pus, was dis-charged from the wound. The injured limbincreased rapidly in size, and after a lapseof some months, during a part of which thesame discharge continued, the patient wasperfectly cured.There can be no doubt, from several cases

which have been published, that water mayaccumulate in the tissue uniting the medul-lary filaments which compose a nerve,

nearly in the same way as in hydrocephalus.The author is inclined to attribute both phe-nomena to a similar cause, namely, chronicinflammation. In the present instance itseems probable that the capsular ligamentof the hip-joint was also involved in the

disease, and that the quantity of fluid sub-sequently discharged was in part furnishedfrom the joint itself.


The attention of the profession, says Dr.Hirseh, of Konigsberg, was first drawn tothis peculiar affection of children, in the

year 1830, by Dr. Kopp, who gave it the

name of " Asthma Thymicum ;" since thenseveral interesting observations have been



made by the German physicians, of whichthe author of the memoir now before us

gives an ample resume.Asthma 1’hym’icum, or, as it is more gene-

rally called in Germany, "Kopp’s asthma,"attacks children between three weeks and

eighteen months, but prevails most betweenthe fourth and tenth month. It is charac-

terized by accesses of spasm in the air-pas-sages, and general irritation ; the respirationbecomes suddenly suspended, and we ob Ifserve only a whizzing, very fine, small, and I,imperfect inspiration, an embarrassed pas-sage of the air through the rima glottidis,whieh is spasmodically contracted in thehighest degree. The tone has a certain

analogy with the crowing inspiration ofhooping-cough, but it is much finer, higher,and less deep; the closest analogy we canfind for it, is in the spasm which frequentlyattacks certain hysterical women. In cer-tain cases we remark from five to six

whistling, deep, and difficult inspirations,alternating with scarcely observable expira-tions, and which resemble the tone in a verysevere degree of croup : in the most danger-ous cases the breathing is completely sus-pended ; the fine inspiratory scream is thenperceived only at the commencement of theparoxysm, being immediately suspended, to-gether with the breathing; or on the cessa-tion of the attack it gives the first indica-tion of returning life; it is quite charac-

teristic of the disease, and pathognomic.The remaining symptoms of the paroxysmsare the natural result of the spasm of the

respiratory organs; the child is violentlycontorted in the bed, or under a more severeattack seems quite overwhelmed ; the face

is distorted by the expression of painfulanxiety, is of a blue-red, or pale colour ; ithe nostrils are expanded, the eyes fixed,the hands cold, the thumbs contracted; theexcretions pass involuntarily. Within a half,or one, two, or three minutes, the parox-ysm goes off: the child utters a painful andiineasy cry, and soon becomes gay and play-fnl. It is only when the constitution is weak,or when the attack has been very violent,that the child remains for some time pale,flaccid, and with a tendency to sleep. In theintervals of the paroxysms the child is gay,the respiration quite unembarrassed, andthe patient seems to enjoy perfect health.

Kopp gives as peculiar symptoms the twofollowing’, viz., the tongue during the inter-

mission remains projected a little beyondthe teeth, and the pulsation of the heartcan scarcely be felt ; but in several genuinecases of this disease the first symptom has snot been observed, and even in healthychildren the pulsation of the heart is not

readily felt. The paroxysms are generaltysingle, with an interval of eight or moredays, but by degrees they occur more fre-quently, and even reach ten to twenty inone day; in this period the child frequentlygoes off suddenly; however, in several othercases a second period sets in, which is cha-racterized by general convulsions of an epi-leptic nature. The cerebral and respiratoryparoxysms never occur together, but alter-nate ; and now, even when the child is freefrom the attack, the lumbricales and the ad-ductors of the thumbs become spasmodi-caIly contracted, and give the hand an ap-pearance of deformity. The child now com-monly dies in a paroxysm between suffoca-tion and apoplexy; or, in many cases, whenthe accesses have been severe from the out-

set, he is carried off suddenly, as if by nerv-ous apoplexy, without asthma, rale, or any

agony ; in this way the child of ProfessorEck died, (Rust’s Magazine, xx.) and severalother children.

On examination of the body after death,we find a blue colour of the skin ; conges-tion of the brain and lungs; softness of theright ventricle; the foramen ovale some-

times open, and in all cases the thymusgland is remarkahly enlarged. The longand broad diameters of the gland are re-markably enlarged, but chiefly its thick-

ness; in the latter case the lungs were fre-quently pushed down by it into the lower

part of the cavity of the thorax ; in other; cases the thymus was found closely con-

. nected with the great arterial and venous’ trunks of the chest or neck. The tissue ofthe gland appeared normal, or (what wasmore common) was more fleshy, red, andt dense than natural, but never showed anytrace of hardening, suppuration, tubercles,, &c. When divided, it frequently gave out a> peculiar"chlous-looking" fluid. In the cases

, where the gland was weighed, a good dealof difference was observed. Kornmaul found

the largest to weigh 14 drachms ; FelixI Plater, 1 oz.; the author has observed one. of 9 drachrns; Kopp, one ounce; the others

varied between six and nine drachms.The duration of the asthma thymicum is



very various ; -the quicker and more severethe paroxysms, the shorter, of course, is thedisease. It commonly lasts several months.Dr. Eck’s child died on the third week;Rullman’s (Kopp, p. 64), after a sufferingof twenty months. When a cure takes

place, the symptoms gradually decline, andthe disease goes off in one to three weeks;but in other cases the spasms are not com-

pletely removed before one or two years.Children of a scrofulous habit are parti-

cularly exposed to this disease; in manycases the mothers were of a weakly phthi-sical constitution, and several writers haveremarked a family predisposition. Boysare nnro frequently attacked than girls.It holds good also with respect to adults,for from Frank’s observations (Prax. Med.Pr.Teel3t. 11, p. 760), men are more exposed ito asthmatic affections than women, in theproportion of six to one.

The diagnosis of this disease is not verydifficult, and it bears but a slight analogy toa few of those mentioned by authors. Mil-

lar’s Asthma is a disease so loosely describedby English writers, who have confoundedvarious and different affections under thesame name, that it is difficult to say what

particular malady is meant; however, it

evidently differs from the disease which nowoccupies our attention, by the nature andlength of the paroxysms, and by the acutemarch of the disease.

GoIII; has described, as a symptom ofchronic hydrocephalus, a peculiar cough,which affects the child when awakened from

sleep ; the infant becomes stiff, the wholebody blue, and he remains for a minute

without breathing, until the respiration re-commences with a loud cry. This symp-tom is constant in the latter period, andthough it bears muchresemblance to " Kopp’sasthma," may be distinguished from it bythe other symptoms of hydrocephalus.From an examination of the symptoms

and morbid anatomy of this disease, the

author concludes that it consists,-1st. In a periodic tonic spasm of the re-

spiratory organs, and perhaps the heart,which, as the disease advances, extends tothe brain and spinal marrow, giving rise toepileptic convulsions and death. 2nd. In anbypertrophy of the thymus gland, whichthus presses upon the lungs, heart, andgreat vessels, and- more or less disturbstheir functions. -

The healthy thymus of a new-born child

varies very considerably in size and weight;in small feeble children it weighs (accord-ing to Haugsted’s experiments) scarcely adrachm; the average weight may be esti-mated at from two to three drachms ; it

increases up to the second year after birth ;remains stationary to the eighth or tenthyear, and then gradually becomes absorbedto the sixteenth or seventeenth, when no-

thing but a rudiment remains. Its specificgravity also varies; in the fcetus of eightmonths it is 1.099; in new-born children1.071 ; in a child fourteen years of age 1.020,and at a later period is lighter than water.In the asthma thymicum, however, theweight of the gland is very considerablyincreased, and varies from six to fourteendrachms, while its thick fleshy structure

contrasts strongly with the soft spongy ap-pearance of the normal gland. -

Having established the coincidence of

enlarged thymus gland with the disease inquestion, the author proceeds to answer

several objections which may be opposed tothe idea of the asthmatic symptoms beingreally dependent on the abnormal state ofthe thymus. Our limits will not permit usto follow him through these; we shall there-,fore pass at once to the treatment.

The proyraosis of the disease, though a’

very dangerous one, is not hopeless, elpe-cially when the child is strong, and not aub-ject to catarrhal affections, when the caae

has been seen early, the paroxysms are notvery frequent, and before the appearance ofgeneral convulsions.

In the treatrnent, we must not lose time

by the employment of any temporizing re-medies. The first and most pressing indi-cation is evidently to moderate the spas-modic attack; this is best done by the ad-ministration of small doses of the " aqualaurocerasi," which are to be gradually in-creased. When given with precaution, theremedy is not dangerous, and has the mostbeneficial effects. When the spasms are

very violent, a small dose of musk may beadded; in addition to these, asafoetida, zinc,and particularly the sulphate of zinc, havebeen given with very great benefit. Thesecond object we have in view is to diminishthe state of congestion towards the heartand lungs, by proper diet, by frequently-re-peated (every four to eight days) local bleed-ings, blisters on the chest, and other similar



means, regulated of course by the strengthand constitution of the child.

Several physicians have endeavoured toact immediately on the enlarged gland, bythe administration of anti-scrofulous resol--vent medicines (and apparently with muchsuccess), as mercury, digitalis, iodine, &c.

Twenty years ago, A. Burns proposed to ex-tirpate the gland by making an incision inthe anterior part of the neck, between thesterno-hyoid muscles; the finger was thento be worked down into the chest, betweenthe sternum and gland, and the latter re-moved with the aid of a polypus hook ; butthis operation has never, as one may wellconceive, been attempted on the living body. z,The following case, selected from amongst I

those published at the end of the memoir,will serve to give an idea of the progress ofthe disease. ’

CASE.-Victor V. M., twelve months old,suffered at an early period of birth fromdiarrhoea; this however soon ceased, andthe child became healthy; when, at the ageof five months, he was seized with chronicbronchitis ; from this time the mother re-marked a symptom which she had not pre-viously noticed, viz., that the infant onawaking from sleep, or immediately after,had the respiration suddenly suspended ; theattack however soon went off, and was

generally mild in the commencement, butafter the lapse of some time the paroxysmsbecame more severe. The breathing wasnow completely suspended, the face expres-sive of great anxiety, pale, or at times pur-plish, and the body convulsively bent back-wards. After one or two minutes the childrecovered from the attack, drew a few finedeep inspirations, and then uttered some

sharp cries, after which he became gay andapparently well. The nature of the diseasewas evident; leeches were applied to thebreast, followed by a blister, and small dosesof calomel with rhubarb were administered.

This treatment at first seemed to be at-tended with benefit; the paroxysms weresuspended for a week, but soon returnedwith increased violence, even every one ortwo hours ; musk was now given withoutany amelioration, and after a lapse of eightdays the child was carried off in a fit of suf-focation, without any general convulsion.

The body was examined thirty hours afterdeath.-The thymus gland was remarkablyenlarged, and filled the whole of the anteriormediastinum; from the middle of the glanda process was sent off, which closely em-braced the common jugular vein; the sub-stance was very dense, and it weighed 9drachms, or 570 grains. The right lung wasremarkably compressed, but sound in struc-

ture. The appearance of the heart wasnormal; the right ventricle was very soft;the left was firm ; the foramen ovale wasclosed. The head was not examined.

On Dropsies, connected with Suppressed Per-spiration and Coagulable tl)-i2ze. By JON A-THAN OsBORNE, M. D. London : Sher-wood, 1835, pp. 64.

THE condition of the urine has received lessattention from the Scotch school of medical

writers, and from all the theoretical schoolsof the continent, since the time of Hoffman,than its importance in pathology and in

practice would warrant; partly owing to the ehorror of hiano: alisn prevailing, and partlyin consequence of the want of good chemicaltests of its constituents, or to the exagge-rated views with which certain ignorant em-pirics and mountebanks choose to misleadthe community. The orthodox practitionercould not but treat the glass with disdain inwhich the quack had pretended to see thedisease; and, "to cast " the fortune of hispatient; and to avoid giving occasion to

odious comparisons, he could unreluctantlyabandon signs which he knew scarcely howto ecognise, much less to interpret,-over-looking those very critical points on whichHippocrates, Galen, and the ancients, madethe whole course of diseases to hinge; for,unfortunately, the authority of the ancientGreeks, and the light of their genius, werehidden from the commonalty amongst us,by their works not being translated, as wasthe Bible, into English. Cullenists, Brown-ists, and theorists of every class, found it

easy, in the last century, to divert the pro-fession for a time from those extensive and

easily-discerned changes in the secretionswhich the ancients had signalized, and todirect their attention only to the beatings ofthe pulse, to the tongue, and to the extremevessels.The investigations of chemistry, applied

to the urine by Berzelius, Prout, Marcet,and others, have already become of practi-cal importance; the presence and the pro-portion of urea, the phosphates, bile, andsugar, deserve in many cases more atten-tion than any other symptoms, and whenpathology is more strictly studied, will pro-bably be found always worthy of consider-ation.

Albumen, so constantly occurring in