sarcoma of thigh: banerji. 177€¦ · sarcoma of thigh: banerji. 177 rnent with chlorodyne and...

2

Upload: others

Post on 21-Apr-2020

11 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: SARCOMA OF THIGH: BANERJI. 177€¦ · SARCOMA OF THIGH: BANERJI. 177 rnent with chlorodyne and stimulants, and she was soon well enough to assist in nursing her mother. This young

A CASE SHEWING THE APPARENT GREAT value of cholera inoculation.

By Sukgn.-Capt. A. H Nott, m.b,,

Civil Surgeon, Hazaribagh.

In July last an extremely virulent type of cholera became epidemic in the town of Hazari- bagh and the surrounding villages, the general mortality being from first to last well over 80

per cent., and at first almost 100 per cent. Cholera inoculation, according to Professor Haff- kine's method, was carried out by Assistant- Surgeon Gopal Chunder Mookerjee under the directions of Surgeon-Capt. J. 0. Vaughan, in chai'ge of cholera inoculation work at Purulia. On the whole, little was to be gathered in an

affirmative sense as to the value of the work by a statistical consideration, as considerable delay took place owing to difficulties of communica- tion and delay of the passage tubes in the post, it being the rainy season, before any consider- able amount of work could be performed. How- ever, it has been ascertained with certainty that no deaths from cholera took place out of the nearly 500 individuals inoculated.

Reference however has been made in the

Englishman by a correspondent to an inci- dent which occurred under my close immediate notice in a European family, which has been considered, and I think with reasonable grounds, as striking evidence in favour of its value. I have thought it, therefore, desirable to place on record the facts in connection with it, so that those interested in the matter may form a judg- ment as to its value as evidence.

On Sunday morning, July 25th, at about 10 A.M., in the family of Mrs. D., which consisted of the mother and five daughters, two of the latter were inoculated. At about 4 a.m. the next morning the youngest daughter, aged nine years, who had not been inoculated, developed the initial symptoms of cholera, the case turn- ing out to be of the most virulent type, death occurring the same afternoon. About 7 a.m., whilst I was in attendance on this patient, the mother and one of the older daughters also com- plained of identical symptoms. In the case of the mother, who had not been inoculated, in the course of two or three hours well-marked symp- toms of cholera developed and death occurred the next day, the case being hopeless after the initial period. But with regard to the daughter, who was attacked at the same time as the mother, the result was very different as, although for two to three hours the symptoms were exactly the same as those of the other two patients, yet rapid recovery after that period took place under treat-

Page 2: SARCOMA OF THIGH: BANERJI. 177€¦ · SARCOMA OF THIGH: BANERJI. 177 rnent with chlorodyne and stimulants, and she was soon well enough to assist in nursing her mother. This young

May 1898.] SARCOMA OF THIGH: BANERJI. 177

rnent with chlorodyne and stimulants, and she was soon well enough to assist in nursing her

mother. This young lady was one of the two

who had been inoculated the previous day, the other escaping altogether, as it is right to say did two others who had not been inoculated. The symptoms actually displayed were profuse watery diarrhoea and well-marked nausea, al-

though there was no actual vomiting. It is of course possible, in the absence of

proof of the presence of the cholera bacillus in the evacuations, which under the circum-

stances was impracticable to obtain, to urge that the attack was only one of simple intestinal derangement, but it seems unreasonable to be- lieve that, in an individual who had been re-

markably free from diarrhoea at a time when most of the European residents were more or less affected with slight bowel disorders, such a remarkable incidence should happen as this would be. It might also be said that it was

only the result of the inoculation, but this can hardly be accepted since all the symptoms, such as fever and lassitude caused by the inoculation, had passed off before she went to bed the night before and hardly any of the other Europeans who had been inoculated shewed any symptoms at all of this character, and none of any thing like the same severity.

It must, hovvever, be admitted that such an

extremely favourable result is more than the warmest advocates of inoculation would claim for it, as it seems quite certain that the latest

period at which the infection could have been received was at breakfast time on the Sunday, ?-e., almost immediately after the inoculation had taken place. No doubt, however, the imme- diate efficacy has been much hastened since the practice of using two inoculations has been re-

placed by a single operation. The result in this family was therefore as

follows :?Of four individuals uninoculated, two contracted the disease and both died, whilst of two who were inoculated one escaped entirely and the other was attacked as above recorded and recovered.