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MEDICAL INTELLIGENCER.

JOHN G. COFFIN, M. D., EDITOR.

THE BEST PART OF THE MEDICAL ART, IS THE ART OF AVOIDING PAIN.

VOL. IV.

TUESDAY, OCTOBER 31, 1826.

NO. 24.

HEALTH OF OUR CITIES.

our almost entire exemption from The season, generally speaking, any case of a disease, which, within has been unusually healthy through- the memory of many now living, has out the United States. Cases of ma- suspended, at times, the entire busiligoant fever, it is true, have appear- ness of the town for weeks, and once ed at Mobile, Norfolk, and a few occasioned the sittings of the Legisother places, but they subsided im- lature to be removed to Concord. mediately. The New York Board Summary laws for even the promoof Health, with praiseworthy alacri- tion of a blessing, are inconsistent ty, have announced the existence of with the genius of our Constitutions, some deaths of yellow fever, at or and the negligence of parents in near the Quarantine Establishment, having their children vaccinated, bas, on Staten Island, seven miles from appeared to be without remedy, unthe city.--The infection was evi- less by coercion. A general Vaccidently of foreign origin, and prompt nation, therefore, appears to be the and successful measures were adopt. only remedy, and it ought to be reed to prevent its extension.

peated about every seventh year.' Smallpox.-We hear of the exist. We cannot in justice omit to add, ence of smallpox in various parts of that the honor of having taken the the Union. Will it not hereafter be lead in a general vaccination in our recorded to the disgrace of some of country,belongs to the town of Milton. the existing authorities of this boast Columbian Centinel of Oct. 11. ed, enlightened and provident age, No one can read the first part of this that after the blessing of Vaccination account without a grateful emotion which had been discovered, and its sove. all should cherish, and on proper occareign efficacy as a preventive of sions acknowledge and express. But we Smallpox fully established, that they, have copied the article in order to notice by their gross Degligence should what is said of the two general vaccinabare suffered the existence and pre- tions of this city. The writer seems to valence of a most deadly and loath- think the friends of this measure to be some plague ? It is known, bowev. entitled to much credit for bringing it er, that there are honorable exceptions to the pertinency of the above about, and for the good influence it has query; but it is to be regretted that had in securing the city against smallpox. there are not more. It will not, we

With regard to our last vaccination, trust, be considered adulatory, if we

we are compelled to differ entirely from

The mention, that there have been two the opinion of the Centinel editor. genétal Vaccinations in Boston--the method of proceeding three years ago, last about two years since.—The was badly devised, miserably executed, first made by direction of the old and produced much more evil than good. Board of Health, and the latter by After much unpleasant discussion in the the City Council; and both at a very city government, it was finally concluded tridling expense, compared with the to offer the cowpock gratuitously to every benefits which have resulted from person in Boston who had not been pre:

viously variolated or vaccinated, and such physicians in this city, than that last medical agents were engaged to perform adopted to carry vaccination through this this service as were willing to undertake place. The rules and regulations which it for an unknown, trifling, pecuniary the physicians had adopted to regulate compensation. The business of course, professional intercourse, and the relations for the most part, fell into the hands of and duties which exist between the phy. the younger, the least employed, and the sician and the patient, were violated and most inexperienced part of the profession. broken down by this arrangement. This Most of the rich, and those in competent was strictly a measure of confusion and circumstances, chose to employ their own disorganization, as it relates to the pracphysician, and to pay him for his services, titioners of medicine, and of disappointas they were in the habit of doing, and ment and false security as it has, and therefore were not pleased to have a will, affect the health of this city. stranger enter their dwelling and almost It is said that a general vaccination insist, as was sometimes done, on vacci- should take place once in seven years. nating the family whether desired to do But why defer for seven years what so or not.

Some few again were pleased should be done, and can be more convewith the idea of cheapness, or gratuity, niently done, every year. Let a ward and were less solicitous about the ability committee be chosen annually, whose or fidelity with which the services might duty it shall be, to ascertain and certify be performed, than about the saving of to a ward physician, to be selected for expense. Many of the poor received the purpose, the names of such persons rather coldly the proffered favor, from as are unable to pay for vaccination. men they did not know, and whom they Physicians, both capable and disposed to could have no cause to prefer. For these andertake this service gratuitously, can reasons, the undertakers soon found their always be readily found. If any of the task to be a disagreeable one, for they poor should decline to avail themselves were not sustained by any adequate mo of this blessing and security, let a discritive of charity for their labors and the re- mination be made in favor of those who buffs they met with ; nor by the prospect should apply for it. After this provision of any suitable pecuniary reward. Their is made, let any proper methods be taken only resource then seemed to be, to exe- to stir up the whole population of all cute speedily, what could not be done classes to take the cowpock, so that no with any satisfaction. Accordingly groups, one should live six months without it. of children were found, or collected, and If no milder method should prove suffivaccinated at once, Some of them never cient to produce this effect, let it be enknew, nor: ever saw again, the person acted by the proper authority, after giywho had vaccinated them. Some of these ing six months notice, that any inhabicases did not take, and were not revacci- tant of Boston, falling sick of smallpos, nated ; and in many other instances no not from his own negligence or fault, shall body can now say whether the preven. not be subjected to the inconvenience of tive process took place or not.

being removed from his own dwelling. The objects intended to be secured by In the last vaccination, the physicians a good medical police, are the respecta- were not consulted as to the proper mode bility, harmony, and usefulness of the of offecting the object, or as to the part medical faculty. Such a police a large they might be inclined to take in it ;majority of the physicians of this place had this been done, there can be no bave been endeavoring to establish for doubt that the result would have been many years past. It would be difficult to very different. This is the more singular, imagine any measure more decidedly op- and to be regretted, because the physiposed to the wishes and efforts of the best cians of Boston now are, and for more

SURGERY

a way

'than twenty years have been, from our those exposed to casual smallpox is daily personal knowledge, perfectly disposed, increasing. and even desirous, in any proper manner, The subject is far from being exhaust. to give their time and attention to a gra- ed, but we are as unwilling to pursue it tuitous vaccination of the poor. These to any useless extent, as any of our readgentlemen, as a body, havo habitaally re ers can be to follow us. It is said, in facommended the practice,-explained, and vor of the procedure, that it cost but liteven urged it on the poor, till he who tle money : this is true, but all it did cost, now accepts of it, is ready to suppose is so much, at least, more than it is worth. that he confers, rather than receives a If this, however, were the only item of favor.

loss and injury, the example would not We have entered on this subject not have merited or received any notice or because it is a pleasant one, but because animadversion from us. it ought to be one of admonition. It is besides part of an obligation we have assumed-to warn the public of any exist

Fracture of the Thigh bone. Plan of

Treatment recommended by Sir A. ing danger, or source of fallacious secu

Cooper. rity, on the score of their physical well.

In going round the Hospital a few being; and as far as may be, to point out days since, Sir Astley Cooper was

of

escape. One of the effects of led to make some observations on the deprecated measure, is a belief in the the treatment of 'fractures of the minds of many parents, that their chil- thigh, and to recommend a plan dren have been placed beyond the power which we consider as altogether novof smallpox, while they remain suscepti- el. The reasons adduced by Sir Astble of taking it. Another effect is an im- ley Cooper in its favor are certainly pression, in the minds of many, that from ingenious. In all cases of fracture the recent general vaccination, they of the os femoris, except when bro. cannot again be in danger for a long time ken immediately above its condyles, to come: this leads to indifference and Sir Astley Cooper observed that he delay, till the preventive is again offered considered the best plan of treatment to them without expense, thought or ef was to place BOTH limbs on a double fort on their own part.

The past mis- inclined plane. By thus keeping up management, too, has rendered many is not brought lower

on one side than

extension from each limb, the pelvis persons indisposed to pay for an exemp- another, which effect invariably tion which they now imagine will come to them every few years without expense. with one thigh only on the double

takes place if the extension be made We allude now to a portion of the com- inclined plane.- London Lancet. munity, perfectly well able to pay for this benefit, as they willingly do in other

Successful Case of Acupuncturation. cases, and would do in this, had they

J. T. aged 40, a carpenter, compot, by indiscreet and deceptive treat plained of extreme pain in the gas

trocnemii muscles of the right leg, ment, been led to form on this topic, notions equally injurious to themselves, and extending from the knee to the foot?

The pain was increased towards unequal and unjust towards others, evening, and on taking exercise, freWhile the physicians, thinking they have quently accompanied by slight iovolfully done their part, become tired of re- untary contractions of the muscles, commending a practice, to the merits of The integuments were of their patwhich too many seem indifferent, and are ural appearance, with the exception waiting to be called on before they move of a small scar, on the back part again. Thus both parties are kept at of the calf. Felt much inconvenience rest and inactive, while the number of in walking ; general health good.

Stated, that about two years ago, above its middle. A couptry surgeon while cleaning a window, he fell treated him in the usual way, but as down and hit his leg against a board, his parents were necessitated to at. a splinter of which penetrated the tend their work in the field, and to calf of his leg to the depth of half an leave the youth alone in the house, inch. The piece of wood was taken he rose in the fourth week. In the out, and most acute pain followed, 8th, a complete false joint had been which, however, went off in a few formed, which compelled bim to days. Eighteen months after the ac- make use of a stick in walking, at cident, the pain in the leg returned, the age of 18. In order to gain and continued for several months, better livelihood, he changed his ocnotwithstanding the frequent appli- cupation of herding cattle, but as his cation of leeches, and severe and re- work was much severer, the false peated blistering. The acupunctura- joint inflamed, and caries of the bone, tion needle was introduced into the with two fistular openings, soon folsubstance of the gastrocnemii mus- lowed. On examining the two fistucles, to the extent of an inch and a læ, they were found to open in the half at two different places, and al- false joint itself. Boh of them were lowed to remain for a few minutes ; laid into one, and in the chinks of the immediately after the application he soft substance, the needle trephine felt relief, and he remained nearly was applied, boring a hole through free from pain for eight days, wben, the thigh; into this the wedge shap after a long walk, the pain returned ; ed seton was afterwards introduced. the acupuncturation was again per. Cold applications were then applied ; formed with complete and perma- a reaction commenced in the fourth dent relief. Ib.

week, and before the eleventh, the Coxalgia cured by Moxa.

falso joint was cleared of its small M. Larry presented a young me- bones,

and the separation, previously chanic who had been cured of this unhealthy, became much better. In disease by repeated applications of the twelfth week the callos began There was anchylosis and

to harden. The limb bent no more. shortening of the limb, about four The seton was reduced in size daily, centimètres . M. Larry is of opinion thirteenth week, the patient rose,

and only one string was felt.. lo the that the shortening is not caused by the displacement of the head of the and in the sixteenth was 80 com. femur out of its cavity, but by the pletely cured, as to be able to follow destruction of the head of the bone

his usual occupations. and cotyloid cavity. At the same Case of Rheumatism of the Heart, time the Baron presented cured, a treated by Acupuncturation. young man who had lost by an explosion, twotbirds of the left branch

A girl, 18 years of age, after bay. of the lower jaw, a similar piece of matism in the upper and lower ex

ing suffered from an attack of rheuthe upper, of the palate, and edge of tremities, was seized with a violent the orbit. Several sutures had been used, and the eye extirpated.

pain in the heart, immediately after

being relieved of her complaint in Case of a False Joint of ten years the joints. This pain resembled

standing, with Caries and Fistule, what she had felt in the extremities, in the right Femur, cured by means was aggravated by emotions of the of the wedge shaped Seton, in less mind, during rainy weather, south than three months.

and easterly winds, and in damp J. C. H., 20 years old, a young places. Sometimes it continued for

from the country, broke, several days, with violent palpita, at the age of ten, the right femur tions, which - became more and more

moxa.

man

intense every time it recurred. She system'; but he thioks that instead of was bled both locally and generally, simple friction on the unbroken skin, had baths, mustard sinapisins, injec- the epidermis ought to be first retions, &c., but without any effect. moved by a blister; a precaution

After being convinced, from the which renders the absorption certain. symptoms, that the disease was rbeu. Fourteen detailed experiments made matism, we resolved, from the harm. before the committee, induce them lessness of the remedy, to try what to consider M. Lesueur's process caeffect acupuncturation would have pable of becoming eminently useful. on the patient.

Among other effects, they saw the The patient being placed on her acetate of morphine produce, in cases back, and a little on her right side,a of chronic catarrh, cures, which the needle 13 lines in length was intro. introduction of the same substance duced between the fifth and sixth by the mouth never would have efribs, near the middle of the cartilage fected. One evident cause of the of the latter. It was then directed difference which results from M. Lewith a rotatory motion towards the sueur's mode of admioistering meheart, going from below upwards, dicines is, that, by adopting it, they and from right to left, without reach• escape the changes to which certain ing ihe organ. The patient felt no substances are exposed by remaining pain during the introduction. No in the stomach. A dew committee, sooner was this done, however, than composed of five members, has been she began to stretch out her limbs, appointed by the Academy, for the then to contract them, and at last to purpose of repeating these interestfall into a kind of delirium. This ing and important experiments. last symptom lasted only ten minutes, and on recovering she seemed as if she was awaking out of a sleep: the pain was still very violent. A second The great heat in the month of needle, 15 lines in length, was then June, brought into the hospital seveintroduced into the same intercostal ral cases of hemoptysis. On the 18th, space, at a point corresponding to three cases came in together, and the sixth rib, an inch before its union Mr Recamier determined to show bis with the cartilage. The acupunctu. pupils the effect of large doses of niration was repeated a third time, tre, in this complaint, as employed with a needle 18 lines in length; by the Italian physicians. To each and, according to M. Pegros, who of the patients, therefore, he gave details the case, it no doubt entered half an ounce of nitre, dissolved in a the pericardium, and reached the mucilaginous mixture, to be taken point of the heart. From this time in the course of the day. In one pathe patient got better, and though tient who had been bringing up blood the weather was for some time af- freely for four days previously, and terwards damp, the rheumatic pains who had taken no other medicine, never returned.-Revue Medicale. the hemoptysis was completely ar,

rested during the first day in the hos

pital. The day after, it returned, A committee of the Parisian Aca- and was again stopped by the same demy of Medicine bas made a report medicine, and did not afterwards reon M. Lesueur's paper relative to cur. This patient took the balf his new mode of administering medi- ounce of nitre in the course of four cines. Cutaneous absorption is con- 'hours, by which the uripe was very sidered by M. Lesueur as, in many much increased, and some disagreea. cases, the best method of introducing ble sensations were produced in the medicinal substances into the animal stomach and mouth, but no other ef

HEMOPTYSIS.

ACADEMY OF MEDICINE.

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