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nearly transparent and colourless. It was found, on examination, to contain numerous spermatazoa, some of which continued to move actively for some considerable time after the fluid was drawn from the cyst.

This was made manifest to some practitioners who were present, and to many of the pupils of the hospital.

SOME ACCOUNT

OF

AN EPIDEMIC

WHICH PREVAILED AT TEHERAN, IN THE MONTHS OF JANUARY AND FEBRUARY 1842.

IN A LETTER TO GEO. JOS. BELL, M.D.,

TRAVELLING FELLOW OF OXFORD.

By C. W. BELL, M.D.,

ATTACHED TO H. B. M.'S MISSION AT THE COURT OF PERSIA.

COMMUNICATED BY ALEXANDER SHAW, Esq.

READ MAY 23RD, 1843.

Teheran, 22nd Feb. 1842.

I HAVE had much trouble and anxiety of late, with a very curious new disease, which made its appearance in our neighbourhood, and thence spread to different parts of Teheran.

It occurred nearly simultaneously with an anomalous complaint in Baghdad, and was, probably, analogous. This, I understand, has been described by Dr. Ross, of Baghdad, in a report (which I have not seen) under the title of epidemic angina pectoris. I give you, however, an extract from his letter to me on the subject, dated Baghdad, Dec. 30, 1841 :—

"We have got a most curious disease raging here, just now, more like angina pectoris than any thing else. But it proves fatal in an hour or two. In fact, though eight or ten of my personal friends have died from it, I have not yet been in time to see a case while life remained. You knew several of them while here. Old Mahomed Aghaiba, Chederakee, Ismael Beg, &c."

The only thing that I have to remark of that disease, before proceeding to a detail of cases, is, that in the one I am about to describe, the fits appeared to be always accompanied by a nervous excited action of the heart and arteries, periodical, but neither preceded by chill nor succeeded by perspiration. Those who suffered from numbness and sleeping of the hands and feet alone, had always more or less palpitation of the heart, at the same time, sometimes amounting to pain.

The first patient I saw, which was a short time before the receipt of Dr. Ross's letter, was Syad Khan, who happened to be my neighbour. Having stomach-ache, to which he was subject, he took ten drops of the oil of peppermint, instead of the spirit which he was in the habit of taking, and it produced inflammation of the stomach. I applied 30 leeches to the epigastrium, by which, and other means, the inflammation was subdued. He was convalescent and in good spirits, only considerably reduced in strength, when he was suddenly attacked, about ten at night of the 20th of January, with a fit resembling epilepsy; became insensible, and died in half

an hour. I saw him in this state, convulsed, the mouth drawn to one side, moaning and insensible, pulse quick, but rapidly sinking. I was wholly at a loss to account for his death, and imagined fifty things; but a post-mortem examination was out of the question.

At this time anomalous local pains, some like tic douloureux, were becoming remarkably prevalent.

On the 23rd January, Mr. R., æt. 40, accountant to the mission, of gouty diathesis, who had been formerly subject to ague, and latterly every six or eight months to plethora, complained that he had suffered much from headache for some days, and that last night, on putting his feet into warm water, the left foot was seized with numbness, as if asleep. At present, however, the pulse is good and soft, and he has no particular symptoms: ordered 2 pills of calomel and colocynth at bedtime, and compound jalap powder in the morning.

23rd. Last night, at midnight, was seized with excruciating headache, and spasms, and numbness of the left leg and arm; the pain continued severe till 8 a. m., when it gradually abated. The medicine operated only once. To repeat the dose at night, and take salts and senna in the morning.

24th.-Has had similar attacks of pain and numbness of the whole of the left side, last night exactly at 12, and at 10 in the morning. Although somewhat relieved since 8 o'clock, has still much headache and some numbness of the hands. The medicine has operated little. Pulse full and bounding,

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v. s. ad 3xx. Five grs. of calomel immediately, and castor oil two hours afterwards. This produced two full evacuations.

25th. The pain returned at midnight, but was less severe, though continuing more constant in the morning. The spasms and sleeping of the left side the same as in the preceding night. To take ext. colocynth comp. gr. v and ol. croton m 12, immediately and at noon; after which, every two hours, to take a grain of quinine, and two at 11 p. m.

26th.-Nightly accession of headache much less, but the numbness of the leg and arm came on at the same hour. To take rhubarb and magnesia zj immediately; and from 2 in the afternoon, to take one grain of quinine every hour, and three at 11.

27th.-Has still headache, the pain shifting a little to the cheek; had no accession at midnight, but still has sleeping of the leg and arm at the same hour. He went to office for an hour or two, but felt giddy, and had several spasms in the hands.

At four and a-half p. m. was suddenly seized with a fit like epilepsy; convulsions; face and breast became mottled purple ; pulse good, without much power; hands and feet cold. He recovered his consciousness in a few minutes, but above an hour elapsed before the memory was completely restored. The pulse getting low, he had some spir. ammoniæ aromat. in water, and hot fomentations to the stomach. The headache continues severe, but the senses perfectly restored.

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