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a disagreeable odor. At times after eating she had attacks of vomiting and in the vomit food eaten days before was found. No hæmatemesis. Has lost greatly in weight and is markedly cachetcic. At the level of the navel a transverse, rough, hard, painful tumor is palpable 5-6 cm. long, freely movable and not affected by respiration. Marked splashing two fingers width below the navel. Repeated examinations of gastric contents showed acidity with presence of free hydrochloric acid, many sarcinæ and remnants of food. Gastro-enterostomy eleven days after first examination revealed a large tumor the size of the fist at the pylorus.
F. B., aet. 53, housewife. For ten years has had stomach trouble; one-half hour after eating pain and pressure. Vomits two to three times daily, often food eaten the previous day. Has lost in weight. Stomach reaches a hand's width beneath the navel. Four cm. above the navel and to the right is a transverse tumor about 5 cm. long which moves downward on inspiration. Repeated examination of stomach conterts shows them to be acid with the presence of free hydrochloric acid and sarcinæ. Gastrocnterostomy five days later reveals a tumor which extends from the lesser curvature and completely embraces the pylorus. Stomach movable in all directions. Small mesenteric glands enlarged.
F. T., aet. 74, widow. Always healthy until two months ago when sine began to lose greatly ir, weight. She vomits after two
. or three hours all liquids, while solids are better retained. The vomit has at times the appearance of coffee grounds. Suffers from pyrosis and heart-burn, but not pain. Tumor palpable.
Gastric contents show remnants of food eaten the previous day, free hydrochloric acid, lactic acid and many sarcinæ. Patient came to the clinic on two occasions only.
G. B., aet. 60, waiter. For over a year has had stomach trouble. Pressure after eating and loss of appetite. For the last three weeks has had daily attacks of vomiting, often of food from preceding days. Vomit is often of a greenish black color as is also the stool. In epigastrium a round, hard tumor. Total acidity in different examinations 32 to 56 and free hydrochloric acid 6 to 12. Many sarcinæ. Lactic acid absent. Patient has lost fifty-one pounds in last three months.
E. B., aet. 50, merchant. For five years has had pressure in the stomach and tendency to vomiting which has in the last three years increased. For the last four weeks frequent vomiting of food and sour belching. Patient has lost sixty pounds in weight, is anæmic, and the cervical and subclavicular glands are enlarged. Just above the umbilicus and extending from the middle line to the right is a distinctly movable tumor which is moderately sensitive. Gastric contents show the presence of free hydrochloric acid with carcina and the absence of lactic acid and yeast.
H. V. M., aet. 62, government official. For several years has been troubled with heart-burn, especially at night. About a year ago had after a rich dinner sudden vomiting. Appetite has been gradually failing with weakness and loss of flesh. Has recently had feeling of pressure and fullness after eating and on vomited food which was eaten three days previously, also belches foul smelling gases. A large round tumor palpable in epigastrium and movable to the right and left. Repeated examinations of gastric contents show markeri acidity with the presence of free hydrochloric acid and many sarcinæ, no lactic acid. Patient shows great loss of strength and marked cachexia.
1. Doutsches Archiv für klinische Medicin. 1879.
"HIT BY THE ECLIPSE."
WESTFIELD, N. J., June 5, 1900.
To the ANNALS:—Although “A Americanos para todo” (“To the Americans for everything !") implies something like disgust in Havana, and is an expression that is largely current, it is the more common thing for those who are very ill to seek the American medical men. I might say, in passing, that I think that the opportunity for our physicians is a good one; and in this Governor Wood (who is a physician) concurs. Of course, the disorders are much the same as in the southern states, but now and then the stranger discovers complaints that are apparently peculiar, at least in diagnosis and description. One very interesting incident is but recently on my note-book.
It has been generally read in the press as to the strange superstitions that were noted on the occasion of the eclipse. May I say they were not exaggerated ? I need not repeat any of them. Instead, there is another, quite original, and medically related. We had been warned in advance, for it should be known that these superstitions are current on the occasion of every eclipse, lunar as well as solar, partial or total. They had told me that when the eclipse occurred, one of the things that mothers and nurses of infants would do, would be to strip the little ones naked as soon as the eclipse began, and leave them nude, on the ground, out of doors, till all was over. This, understand, was “so as to keep from being hit," they commonly say, "by the eclipse," but in a whisper they add, "by the devil.” If the squalling young one
” takes a thorough-going attack of bronchitis or bronchorrhea as a result, then it is "hit;" if it escapes, it is blessed. The "hit" child is of course carried first to the priest, and then taken to the doctor.
When it was announced that there was to be an eclipse, mothers went about among their friends crying "Guarte de el como diablo!” (“Beware, as of the devil!") The eclipse came, the children were exposed, and, as might have been expected, there were plenty of the babies who were "hit.” Our medical men had their hands full, caring for the outraged specimens of humanity. That was in Cuba and Puerto Rica. But superstition has difficulty in shaking off its coil, and at least one Cuban mother, here in our enlightened United States, clung to it.
They are people of some education, a man and wife, with two little ones, aged three months and fourteen months. On Tuesday evening he came to the office very much excited, exclaiming "Dos hijas con su madre son tres diablos para el padre!” (“Two daughters with their mother are three devils for their father !") During his absence, for nearly three hours, on the sand in her back yard, the woman had exposed the children to the chill east wind. The father blamed her, but at the same time was inclined to fear the "devils.” The woman was frank in her statement and averred that the little ones were "hit by the eclipse." Acute bronchitis, and the worst cases that I ever saw. Already there were atelectasis and apneumatosis, the bronchial tubes filled with mucus, respirations frequent, faces livid, high fever, and relative dullness. The prognosis was serious. The woman volunteered the information that in Havana “her doctor" (Spanish) would give tartar emetic, "to dislodge the devils," and, incidentally, the
This was out of the question. A remedy to maintain nausea would depress. It was plain that the chief object of treatment would be to supply the wants of voluntary efforts of expectoration, and by sustaining measures to maintain the force of the respiratory acts. The priest had arrived a moment after we did, and he was a jolly, good-natured Irishman. He recognized the gravity of the situation at once, and I think horrified the woman by not mumbling prayers, but instead, offering to go with my prescription. We had had the best of success with eucalyptol in the treatment of grip; and it seemed to fill the indications. The priest went for it, and I gave it in ten minim doses every two hours, remaining to watch the effect. In four or five hours, I was gratified to find that the older child began to show better symptoms. The other did not show relief, but, apparently was suffocating. It was necessary to give eau sedatif to quicken the vitality. The effect was all that could be desired, and before midnight the child was perspiring even more freely than the other. The eucalyptol odor appeared in the breath, and as soon as the diaphoresis was in evidence, the dose was changed to once in four hours. Both children recovered.
Last evening the priest called to see me, and with a hearty laugh informed me that the Spanish woman gave him the credit, declaring that he had obtained "such a pleasant holy water" for me, which, "used as directed," had saved her children, "driven out the devils.” And this is in commentary on the Australian doctors' opinion that "our eucalyptol is devilish good.” Omit the adjective, and every physician who has used it for bronchial and broncho-pulmonary affections, will say “Verily."
W. H. MORSE, M. D.
Shall the Patho- It is unfortunate that any dispute should have
logical Institute arisen between the State Commission in Lunacy of the New York and the Director of the Pathological Institute of State Hospitals
the New York State Hospitals, still more unStudy the Patho
logical Material fortunate that this dispute should find expression of the State Hos- in medical journals, and most unfortunate that
pitals ? the real point at issue should be obscured by personalities and that a letter should have been published resurrecting old antagonisms and animosities which were supposed to have been buried nearly a quarter of a century ago.
Up to the present time advance in our knowledge of disease has been acquired by a clinical study of the patient, by an investigation of the excretions and secretions during life, and by an examination of the diseased organs after death. This is a very laborious process and it is perhaps conceivable that better methods of studying disease may be found, but the old method has led and is daily leading to very substantial results, and where it has been replaced by theorizing and generalization, usually error has ensued.
The need of utilizing the pathological material afforded by an institution for the insane was publicly recognized in New York by legislative enactment in 1872, creating the position of special pathologist and providing for the equipment of a laboratory at the Utica State Hospital. This was further emphasized in the organic laws of later hospitals, and finally by the State Commission in Lunacy, which urged in 1893 the appointment of “an experienced and competent pathologist who should act for all the hospitals of the State," and in 1895 announced the creation of the “Pathological Institute of the State Hospitals.” The authority for this action by the Commission is contained in the appropriation bill of 1895, providing “for pathological research and for necessary expenses in establishing and maintaining a pathological laboratory for the benefit of the State hospitals," and again in the "Insanity Law" of 1896, providing for the appointment of a "Director of the Pathological Institute who shall perform, under the direction of the Commission, such duties relating to pathological research as may be required for all the State hospitals for the insane."