VOL. IV.

HEALTH OF OUR CITIES.

The season, generally speaking, has been unusually healthy through out the United States. Cases of malignant fever, it is true, have appeared at Mobile, Norfolk, and a few other places, but they subsided immediately. The New York Board of Health, with praiseworthy alacrity, have announced the existence of some deaths of yellow fever, at or near the Quarantine Establishment, on Staten Island, seven miles from the city. The infection was evidently of foreign origin, and prompt and successful measures were adopted to prevent its extension.

Smallpox. We hear of the existence of smallpox in various parts of the Union. Will it not hereafter be recorded to the disgrace of some of the existing authorities of this boasted, enlightened and provident age, that after the blessing of Vaccination had been discovered, and its sovereign efficacy as a preventive of Smallpox fully established, that they, by their gross negligence should have suffered the existence and prevalence of a most deadly and loathsome plague? It is known, however, that there are honorable exceptions to the pertinency of the above query; but it is to be regretted that there are not more. It will not, we trust, be considered adulatory, if we mention, that there have been two general Vaccinations in Boston-the last about two years since. The first made by direction of the old Board of Health, and the latter by the City Council; and both at a very trifling expense, compared with the benefits which have resulted from

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our almost entire exemption from any case of a disease, which, within the memory of many now living, has suspended, at times, the entire business of the town for weeks, and once occasioned the sittings of the Legislature to be removed to Concord. Summary laws for even the promotion of a blessing, are inconsistent. with the genius of our Constitutions, and the negligence of parents in having their children vaccinated, has. appeared to be without remedy, unless by coercion. A general Vaccination, therefore, appears to be the only remedy, and it ought to be repeated about every seventh year.' We cannot in justice omit to add, that the honor of having taken the lead in a general vaccination in our country,belongs to the town of Milton.

Columbian Centinel of Oct. 11.

No one can read the first part of this account without a grateful emotion which all should cherish, and on proper occasions acknowledge and express. But we have copied the article in order to notice what is said of the two general vaccinations of this city. The writer seems to think the friends of this measure to be entitled to much credit for bringing it about, and for the good influence it has had in securing the city against smallpox.

The

With regard to our last vaccination, we are compelled to differ entirely from the opinion of the Centinel editor. method of proceeding three years ago, was badly devised, miserably executed, and produced much more evil than good. After much unpleasant discussion in the city government, it was finally concluded to offer the cowpock gratuitously to every person in Boston who had not been pres

viously variolated or vaccinated, and such medical agents were engaged to perform this service as were willing to undertake it for an unknown, trifling, pecuniary compensation. The business of course, for the most part, fell into the hands of the younger, the least employed, and the most inexperienced part of the profession. Most of the rich, and those in competent circumstances, chose to employ their own physician, and to pay him for his services, as they were in the habit of doing, and therefore were not pleased to have a stranger enter their dwelling and almost insist, as was sometimes done, on vaccinating the family whether desired to do so or not. Some few again were pleased with the idea of cheapness, or gratuity, and were less solicitous about the ability or fidelity with which the services might be performed, than about the saving of expense. Many of the poor received rather coldly the proffered favor, from men they did not know, and whom they could have no cause to prefer. For these reasons, the undertakers soon found their task to be a disagreeable one, for they were not sustained by any adequate motive of charity for their labors and the rebuffs they met with; nor by the prospect of any suitable pecuniary reward. Their only resource then seemed to be, to execute speedily, what could not be done with any satisfaction. Accordingly groups of children were found, or collected, and vaccinated at once, Some of them never knew, nor ever saw again, the person who had vaccinated them. Some of these cases did not take, and were not revaccinated; and in many other instances nobody can now say whether the preventive process took place or not.

The objects intended to be secured by a good medical police, are the respecta bility, harmony, and usefulness of the medical faculty. Such a police a large majority of the physicians of this place have been endeavoring to establish for many years past. It would be difficult to imagine any measure more decidedly opposed to the wishes and efforts of the best

physicians in this city, than that last adopted to carry vaccination through this place. The rules and regulations which the physicians had adopted to regulate professional intercourse, and the relations and duties which exist between the phy sician and the patient, were violated and broken down by this arrangement. This was strictly a measure of confusion and disorganization, as it relates to the practitioners of medicine, and of disappointment and false security as it has, and will, affect the health of this city.

It is said that a general vaccination should take place once in seven years. But why defer for seven years what should be done, and can be more conveniently done, every year. Let a ward committee be chosen annually, whose duty it shall be, to ascertain and certify to a ward physician, to be selected for the purpose, the names of such persons as are unable to pay for vaccination. Physicians, both capable and disposed to undertake this service gratuitously, can always be readily found. If any of the poor should decline to avail themselves of this blessing and security, let a discrimination be made in favor of those who should apply for it. After this provision is made, let any proper methods be taken to stir up the whole population of all classes to take the cowpock, so that no one should live six months without it. If no milder method should prove sufficient to produce this effect, let it be enacted by the proper authority, after giving six months notice, that any inhabitant of Boston, falling sick of smallpox, not from his own negligence or fault, shall not be subjected to the inconvenience of being removed from his own dwelling.

In the last vaccination, the physicians were not consulted as to the proper mode of offecting the object, or as to the part they might be inclined to take in it ;had this been done, there can be no doubt that the result would have been very different. This is the more singular, and to be regretted, because the physicians of Boston now are, and for more

'than twenty years have been, from our personal knowledge, perfectly disposed, and even desirous, in any proper manner, to give their time and attention to a gratuitous vaccination of the poor. These gentlemen, as a body, have habitually recommended the practice,-explained, and even urged it on the poor, till he who now accepts of it, is ready to suppose that he confers, rather than receives a favor.

It is

We have entered on this subject not because it is a pleasant one, but because it ought to be one of admonition. besides part of an obligation we have assumed-to warn the public of any existing danger, or source of fallacious security, on the score of their physical wellbeing; and as far as may be, to point out a way of escape. One of the effects of the deprecated measure, is a belief in the minds of many parents, that their children have been placed beyond the power of smallpox, while they remain suscepti ble of taking it. Another effect is an impression, in the minds of many, that from the recent general vaccination, they cannot again be in danger for a long time to come: this leads to indifference and delay, till the preventive is again offered to them without expense, thought or ef fort on their own part. The past mismanagement, too, has rendered many persons indisposed to pay for an exemption which they now imagine will come to them every few years without expense. We allude now to a portion of the community, perfectly well able to pay for this benefit, as they willingly do in other cases, and would do in this, had they not, by indiscreet and deceptive treatment, been led to form on this topic, notions equally injurious to themselves, and unequal and unjust towards others. While the physicians, thinking they have fully done their part, become tired of recommending a practice, to the merits of which too many seem indifferent, and are waiting to be called on before they move again. Thus both parties are kept at rest and inactive, while the number of

those exposed to casual smallpox is daily increasing.

The subject is far from being exhausted, but we are as unwilling to pursue it to any useless extent, as any of our readers can be to follow us. It is said, in favor of the procedure, that it cost but little money: this is true, but all it did cost, is so much, at least, more than it is worth. If this, however, were the only item of loss and injury, the example would not have merited or received any notice or animadversion from us.

SURGERY.

Fracture of the Thigh bone. Plan of Treatment recommended by Sir A. Cooper.

In going round the Hospital a few days since, Sir Astley Cooper was led to make some observations on the treatment of fractures of the thigh, and to recommend a plan which we consider as altogether novel. The reasons adduced by Sir Astley Cooper in its favor are certainly ingenious. In all cases of fracture of the os femoris, except when broken immediately above its condyles, Sir Astley Cooper observed that he considered the best plan of treatment was to place воTH limbs on a double inclined plane. By thus keeping up extension from each limb, the pelvis is not brought lower on one side than another, which effect invariably takes place if the extension be made with one thigh only on the double inclined plane.-London Lancet.

Successful Case of Acupuncturation. J. T. aged 40, a carpenter, complained of extreme pain in the gastrocnemii muscles of the right leg, extending from the knee to the foot. The pain was increased towards evening, and on taking exercise, frequently accompanied by slight involuntary contractions of the muscles, The integuments were of their natural appearance, with the exception of a small scar, on the back part of the calf. Felt much inconvenience in walking; general health good.,

intense every time it recurred. She was bled both locally and generally, bad baths, mustard sinapisms, injections, &c., but without any effect.

After being convinced, from the symptoms, that the disease was rheumatism, we resolved, from the harmlessness of the remedy, to try what effect acupuncturation would have on the patient.

The patient being placed on her back, and a little on her right side, a needle 13 lines in length was introduced between the fifth and sixth ribs, near the middle of the cartilage of the latter. It was then directed with a rotatory motion towards the heart, going from below upwards, and from right to left, without reach ing the organ. The patient felt no pain during the introduction. No sooner was this done, however, than she began to stretch out her limbs, then to contract them, and at last to fall into a kind of delirium. This 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 needle, 15 lines in length, was then introduced into the same intercostal space, at a point corresponding to the sixth rib, an inch before its union with the cartilage. The acupuncturation was repeated a third time, with a needle 18 lines in length; and, according to M. Pegros, who details the case, it no doubt entered the pericardium, and reached the point of the heart. From this time the patient got better, and though the weather was for some time afterwards damp, the rheumatic pains never returned.-Revue Medicale.

ACADEMY OF MEDICINE.

A committee of the Parisian Academy of Medicine has made a report on M. Lesueur's paper relative to his new mode of administering medicines. Cutaneous absorption is considered by M. Lesueur as, in many cases, the best method of introducing medicinal substances into the animal

system; but he thinks that instead of simple friction on the unbroken skin, the epidermis ought to be first removed by a blister; a precaution which renders the absorption certain. Fourteen detailed experiments made before the committee, induce themto consider M. Lesueur's process capable of becoming eminently useful. Among other effects, they saw the acetate of morphine produce, in cases of chronic catarrh, cures, which the introduction of the same substance by the mouth never would have effected. One evident cause of the difference which results from M. Lesueur's mode of administering medicines is, that, by adopting it, they escape the changes to which certain substances are exposed by remaining in the stomach. A new committee, composed of five members, has been appointed by the Academy, for the purpose of repeating these interesting and important experiments.

HEMOPTYSIS.

The great heat in the month of June, brought into the hospital several cases of hemoptysis. On the 18th, three cases came in together, and Mr Recamier determined to show his pupils the effect of large doses of nitre, in this complaint, as employed by the Italian physicians. To each of the patients, therefore, he gave half an ounce of nitre, dissolved in a mucilaginous mixture, to be taken in the course of the day. In one patient who had been bringing up blood freely for four days previously, and who had taken no other medicine, the hemoptysis was completely ar rested during the first day in the hospital. The day after, it returned, and was again stopped by the same medicine, and did not afterwards recur. This patient took the half ounce of nitre in the course of four hours, by which the urine was very much increased, and some disagreeable sensations were produced in the stomach and mouth, but no other ef