Page images
PDF
EPUB

own house, the elder of them being taken with scarlatina. She did well for a few days, but then began to drag, and developed anomalous symptoms-an inveterate night-cough amongst others. The wall-paper had a great deal of green in it, and I examined it and found in it a large quantity of Arsenic. These two children had both slept in this room, which they had occupied since their parents entered the house some eight or nine months previously. Before that time the girl had never had the troubled sleep she complains of, the enlarged gland, or the styes, though she had had grinding of the teeth. The boy had been always delicate, but had not had the swollen body, and other abdominal troubles with which he came to me.

When his sister was taken with scarlatina, he, of course, was put into another room to sleep. There his cough persisted, most severe in the night, quite unamenable to treatment. He had also toothache, and several boils. A younger sister was put to sleep in the same room with him, and she began to suffer from night-cough just in the same way. This was equally intractable with the boy's; and she had never had a cough before, being remarkably healthy, and the strongest of the family.

I examined the paper of this room-a loose powdery grey-and found it also contained arsenic in large quantity. The paper in the room where the youngest child had been sleeping previously contained no arsenic.

The arsenical papers were at once removed. The elder girl recovered slowly from the scarlatina, and after going to the seaside became quite well. She lost the symptom of troubled sleep, and now sleeps quite naturally and well. The other two children soon lost their coughs, and became quite well on removal of the paper. Only the chronically enlarged glands in the necks of elder girl and boy remained of their former illnesses; and these never do disappear rapidly in my experience. In the case of the girl the gland enlarged greatly after the fever, and suppuration seemed imminent, but was happily averted.

I may add that I gave Bell. 3 through the house as a prophylactic, and no second case of the fever occurred.

CASE 19. Nervous debility from worry; headache.— November 30th, 1882. Mrs. K, æt. 40, mother of last two patients; thin, pale, dark, worn-looking, nervous and anxious, never strong, never had severe illness. Mother died of bronchitis aged seventy, father of bronchitis aged fifty-four. Has had children very fast, all but the last one have been very delicate, and she has never had proper rest at night. Has had five children and four miscarriages. Complains now of great depression; pressive headache at vertex causing burning in eyes. T. rather dirty; B. open, but not freely; app. very poor; sleep very bad, has worrying dreams; P. soft, reg.; cat. reg., dark, free at first, then an interval when there is nothing, and then flow again for seven or eight days. Great depression two or three days before the period comes on. Act. r. 1, p. j, 3 h.

December 18th.-Better generally; wakes tired; dreams. Rep.

January 9th, 1883.-Three weeks after last attendance. Has had headache very badly; it came on on 4th and 5th of the month, after the catamenia-it usually comes on before. She took Act. r. at the time but found no benefit then. The headache is better now. T. white; B. reg.; app. fair; sleep dreamful; dryness in throat; twitching in eyelids; pain in shoulder. Act. r. 1, p. j, 3 h.; Hyo. 1, p. ij, h. s. s.

CASE 20-December 5th, 1882. Mrs. G, æt. 38, dark, dark grey eyes, spare. In August last, and again a month ago, had terrible attacks of pain, which the doctor who attended her said were due to the passage of gall-stones. They left her prostrate for some time, and she is still suffering from the effects.

Family history.-Mother living and healthy. Father is dead; he was a healthy man but died mentally affected. Brothers and sisters healthy, with the exception of one who died of abscess of the brain.

Social history.-She has been married seven years, and has five children. She drinks stout.

Previous health.-Before marriage her health was good,

She first felt pain

and after marriage till two years ago. in the "chest," i.e. upper abdomen, whilst pregnant with first child. She was some time before getting about after it. She has had it more or less for five years, but it never became severe till last August, and again in November. She is not a bilious subject. The first thing she feels is a numb pain in the right hypochondrium and small of the back; this increases, she feels sick, and vomits. It lasts for two or three days. She can retain nothing but milk and soda-water. It goes away gradually, leaving soreness, and she is extremely weak.

She now complains of debility resulting from her last attack. T. coated at the sides; B. reg. ; they are reg. as a rule, and also in the attacks, but after the attacks the motions are difficult, she thinks from the medicine (allopathic) taken to relieve the pain. App. very bad; urine natural, not altered in an attack; cat. reg., every three weeks, too great quantity (Calc. c.). P. reg., soft. She never has headache. Has been much depressed lately.

I instructed her to avoid alcohol in any form, to use butter and fat foods sparingly, and also sweets. I gave her Calc. c. 30, pil. j, t. d., for three weeks. She did not return, but I heard of her up till the 31st of January, and then she had had no return of the pain.

Remarks.—I saw no reason to doubt the diagnosis of the medical man who saw this patient in the attacks, and I prescribed accordingly. The Calc. c. was indicated by the state of the catamenia, apart from the gall-stone habit. gave the thirtieth attenuation, as that has been found most serviceable in the latter condition.

I

As

This patient was the wife of S. G-, Case No. 7. there was constitutional history in his case, though of long previous date, this may have had an effect on Mrs. G—. There were, however, no definite signs of it about her.

TWO CASES OF

SCARLATINA

MALIGNA

(HÆMORRHAGIC) CURED BY CROTALUS.

Reported by JOHN W. HAYWARD, M.D.

CASE 1.-Miss H-, æt. 9, was apparently quite well on the 5th of October, 1870, but in the evening she complained of sorethroat, with headache and dizziness. On examination the fauces and tonsils, especially the left one, were found dark red and swollen-cedematous.

ordered every two hours.

Bel. was

The only exposure to infection that could be traced was that the cook was laid up with diphtheria; and the only traceable cause for that was that scarlatina was in the house of her family, and she had been there on Sunday, September 25th.

During the night the patient was very restless and feverish, and retched a good deal, getting up some dirtylooking slimy mucus. At eight o'clock next morning she was found to be extremely weak and very tremulous; her pulse was 160; the skin was dry and burning hot, and there was some brownish miliary rash on the chest; the tongue was furred, the mouth dry; great thirst, but drinking only a little at a time, apparently because swallowing was painful; the fauces and tonsils were mottled with rather bright redness, and considerably swollen, as if with serous effusion into their structures, and there was a dark, dirty, sloughy appearance on the left one. Bel. and Rhus were now ordered every hour alternately, and a wet compress applied outside over the tonsils.

In consultation, at 11.30 a.m., Dr. Drysdale diagnosed scarlatina maligna, and suggested Acon. instead of Rhus, to be alternated with the Bel.; these were given alternately every hour until evening. During the day she steadily grew worse; the pulse increased in frequency and feebleness. There were extreme prostration and torpor, so that she lay apparently unconscious, except when roused by the retching of the brown, slimy mucus. The tonsils enlarged

rapidly, making considerable fulness at the angles of the jaw, and causing the head to be thrown up and backwards. Swallowing was very painful and difficult. In the evening of October 6th, that is, twenty-four hours after the beginning of the illness, as she was rapidly growing worse, Rhus and Merc. biniod. were substituted for the Acon. and Bel., and alternated every hour. During the night she continued to grow worse in every way; was extremely restless and uneasy, moaning constantly and attempting to turn about, but was apparently too prostrate to do so, and dirty mucus trickled from her mouth. In the morning of October 7th all the symptoms were worse; the throat was nearly closed, and she breathed with difficulty, with an occasional interruption as though from the swollen condition of the fauces; the fauces and tonsils appeared softened, jelly-like, and as if gangrenous, and the head was thrown upwards and backwards as far as possible. There was retching when anything was given by the mouth, even a teaspoonful of cold water would provoke it, and the matter brought up consisted of mucus reddened with the blood apparently oozing from the mucous membrane or resulting from the gangrenous state of the fauces, with some blood in streaks as if forced out by the retching. After retching she always fell back on to the pillow moaning, in a very weak and low voice, as though dying; she also sank down in the bed in a state of stupid lethargy like a dying typhus patient. The breathing was sighing, jerky, and intermittent, and there was loose, tickling, almost incessant cough, as though from trickling of the mucus into the larynx; the pulse could scarcely be felt; the rash was only faintly visible, and was brown and rough. Appreciating now the hæmorrhagic character of the attack Crotalus was (in the morning of October 7th) given internally, in the 4th attenuation, a drop in a teaspoonful of water dropped slowly into the mouth every half hour. Canth. p was also poured on the compress which was applied over the tonsils, in order to raise the cuticle, with the object of applying Crotalus to the denuded cutis. In the afternoon she appeared to be dying. The Canth. p having raised the cuticle round the

« PreviousContinue »