26th. Hand much less offensive. Took four doses of the rhubarb without effect. R. Sol. magnes. sulph. iv. Impon. manus in aquæ tepid. mane R. Infus. senn. comp. 3ij. quarta quaq. et vespere. hora. Omitt. catapl. lini et appl. catapl. panis. 20th. Mortification taking place. Wound so offensive as to render it necessary to remove him to a separate ward; and to use the fumigation of chlorine. Appl. vuln. pulv. carb. Catapl. cerivisiæ tertia quaq. hora. Cap. vespere opii, gr. iv. ad sextam et octavam horam. To be allowed a pint of porter in a day. 21st. Took two pills in the night. Poultice produced so great pain it was omitted, and a common poultice substituted. Bowels costive. R. Tr. rhei, Aq. pur. äā 3i. M. Repet. quart. quaq. hora, usq. ad alvi solutiom. Cap. pil. op. vespere, ut heri. Appl. pulv. carb. ut antea. Bene foveat.manus cum infus, tanacet. et absinth. ter in die. Cont. cetera. 22d. In the afternoon violent pain in the hand and much bleeding. After which he became more easy. Bene lavet, manus aq. et sapon. Teget. pars denud. cum linteolo, supra hoc, appl. catapl. cerivisiæ. 27th. Medicine operated well. Hand less painful. Night comfort able. Appl. cerat. simpl. quarta quaq. hora. Bene lavet. vuln. 28th. Sumat Tr. rhei, Aq. aa 3i. M. Statim. Omitt. catapl. 29th. Medicine operated well. Appears to be much easier than formerly. Hand not offensive. bis in die. Remov. empl. ter in die. Foment. cum tanacet. et absinth. 31st. A large piece of loose skin was removed from the hand on the 29th. Hand has a more healthy ap pearance. Sumat Tr. rhei, Aquæ, aa 3ij. M. After this the wound healed rapidly under a dressing of resinous cerate, and bathing twice a day with soap and water. The fingers are slightly movable. The forefinger, which at first it was thought impossible to save, is likely to prove useful to the patient in the absence of the thumb. By good management and the great advantages of the Hospital, this patient's hand was saved. With the common disadvantages of persons in his situation, he would have lost his hand. If he had been an intemperate man he would have lost his life. Fungus Hæmatodes of the Antrum. April. 1. An interesting case presented itself at the Hospital this day. The patient, a married woman of 34, living at Malden, applied to Dr. Buck, of that town, about ten days since; who, finding the case a bad one, recommended her to come to the Hospital for advice. Dr. Warren, on examining her, found an obstruction of the left nostril, which was produced by a tumor evidently of a red color, occupying the middle part of the middle meatus, or passage of the nostril. From this tumor blood issued sometimes, and also a constant discharge of very offensive matter. She has sometimes severe pains in the cheek bone, left ear and left eye. The vision of the left eye is slightly affected, and the function of the left ear very much impaired. Above the two incisor teeth of the left side are two apertures in the bone, through which matter is discharged. The teeth of the upper jaw on the left side are all of them in a decaying state, and the front teeth broken, from weakness. The patient suffers great distress at periods. About twenty years ago she had a lung fever, which injured her constitution; and the teeth of the upper jaw, on the left side especially, have been bad ever since. About a year ago she began to feel an uneasiness in that part of the face, and some months since the bone above the front teeth ulcerated. It is a few weeks only since her attention was distinctly called to the left nostril. The board of Consulting Physicians having a meeting at the Hospital, Dr. Warren took the opportunity of presenting to them this case for their examination and opinion. Present, Drs. Welsh, Spooner, Dixwell, Thompson and Walker; also the attending physician of the Hospital, Dr. Jackson; and Dr. Buck, who had been first consulted by the patient. The board united in opinion that the disease was a malignant fungus springing from the antrum maxilare, whence it had made its way into the left nostril; that it probably had its origin in the defective teeth, or some one of them; and that it would terminate fatally in a lingering and most painful death. In regard to the propriety of attempting any thing to save the patient, there was some difference of opinion. On the one side, it was said that all operations for the relief of this disease had been hitherto unsuccessful; that the patient would be exposed to the additional suffering of a severe operation, without any prospect of its succeeding; and that thus the result would be discreditable to the Hospital and to the operator. On the other hand, it was urged, that if no operations were attempted but those which had before succeeded, no improvements would be made in surgery; that the cases in which the operation had failed were, so far as the experience of the surgeons present extended, or so far as they had read, such as had been allowed to reach a more advanced stage than this; that the disease in this case being at present of an extent comparatively small, and having its probable origin in one of the roots of the molar teeth, might possibly be eradicated by removing the bone from which it sprung; that the antrum could be opened from the face, and then the maxillary bone under the antrum cut away to such extent as the seat of the disease might require; that the arteries involved in this operation were not large, and might be secured without difficulty, or if it was necessary to involve large arteries, the carotid MEDICAL INTELLIGENCER. JOHN G. COFFIN, M. D., EDITOR. THE BEST PART OF THE MEDICAL ART, IS THE ART OF AVOIDING PAIN. VOL. IV. TUESDAY, NOVEMBER 14, 1826. THE VAPOR BATH. Believing that many persons in Boston and the vicinity, are suffering from a variety of complaints, for which this bath would prove a pleasant and safe remedy, we are happy in being able to offer some evidence of the correctness of this opinion; and first in Erysipelas. E. R. had been exceedingly afflicted with Erysipelas for thirtyfive years. The disease generally made its appearance three or four times a year; always in the severest part of summer and of winter, and at these times very violently; so that he was confined to the house, and sometimes to the bed from a month to six weeks. It was generally confined to the face and hands, but not unfrequently extended itself over the whole surface of the skin. It usually assumed the form of pustular erysipelas, was accompanied with an almost insupportable itching, and much pain. Perhaps no human being ever was a greater martyr to this disease. During three and four months of every year he was in constant suffering, and sometimes sick, more or less, all the year. Every re No. 26. medy had been employed, under the direction of our most skilful physicians, in vain,and at last he concluded to submit to it as an unavoidable, incurable evil, with as much patience as possible. About six years since, while laboring under a violent attack of inflammation, he, at the request of a friend, applied Goulard's extract to the face, which in about half an hour occasioned a complete translation of the disease from the skin to the internal organs. He instantaneously became deadly pale, had a very violent and universal rigor, which continued half an hour; at the expiration of this time the pulse was scarcely perceptible, and we thought he was dying;-he, however, recovered under the remedies employed, but never afterward enjoyed his usual health. He was costive, dyspeptic and languid. The erysipelatous affection never made its appearance perfectly as before; but at the seasons in which it formerly did, he was a very sick man. I have seen him at such times for a month and six weeks, suffering from acute, severe pains in the stomach der all medical treatment, and and bowels, shooting to the as the vapor bath appeared to back, and this suffering with- be an appropriate remedy, I out the slightest intermission, recommended it. At the time night or day; the power of he used it, he had a violent the stomach entirely suspend- erysipelas about the face, of ed during the whole time, so the pustular kind, and was that a teacupful of beeftea, suffering exceedingly with itchduring the day, occasioned vio- ing pain of the face, and the lent distress-the erysipela- internal disorder. The effects tous inflammation sometimes of the bath were singularly appeared partially about the beneficial. A few hours after face, but more frequently there he came out, the scabs on the was no appearance of it at all. face dropped off, the itching The duration of these severe was entirely relieved, the insufferings was about as long ternal pains subsided, and in as the attacks of erysipelas the course of the night, a usually had been-from four mild erysipelatous inflammato six weeks, when they grad- tion came out over the surface ually left him in pretty good of the body, unaccompanied health, during an interval of with the itching usually attentwo or three months;-his ap- dant on the disease. He used petite and digestion tolerable, the bath twice more in the bowels regular, and strength week, and no more. He bas moderately good, but never never been troubled with the quite so well as he formerly internal symptoms since, and was, when not laboring under has grown fat and healthy. It his constitutional disease. may be well to add, that after the third application of the bath a great number of large painful biles broke out on his body. way Things went on in this six years, each attack seeming more and more violent. I considered it erythematous or erysipelatous inflammation of the mucous membrane of the bowels and stomach, accompanied with diseased liver, all being the consequence of retrocession of the disease of the skin; and as it seemed to be daily growing worse and worse un Pains as violent as are occasioned by the passage of a gallstone through the gallducts. Another fact of importance in this case is, that he has since been very little troubled with his St. Anthony. It has appeared very mildly twice only, I believe, and lasted but a few days. The vapor bath on one of these occasions relieved it entirely. The other attacks have been so mild, that he has not thought it worth his while to use the bath. I have since been in the habit of recommending all my patients, laboring under erysipelas, to use the vapor bath, and so far as I know, it has been uniformly successful. Boston, Nov. 1826. As we shall have occasion to avail ourselves of the work of Dr. Gibney, in order to diffuse a knowledge of steambathing, we shall now introduce the author and his book to the At the period of their publication, want of experience prevented me from entering on the present part of the subject with so much satisfactory information as has been since afforded me by a residence at Brighton, during many years, and at the time when the use of the Vapor Bath has considerably increased in general estimation. A daily inspection of its powpublic, by giving the title, preface, ers and its influence on the vaand introduction of his treatise, that riety of diseases that present his principles and conclusions, which themselves in so populous a are of great value in the use of this seabathing place, has confirmremedy, may thus be the better un- ed me in the conviction of the derstood, and more justly estimated. advantages arising from it; A Treatise on the Properties and, in most instances, of its and Medical Application of superiority over the usual the Vapor Bath, in its differ- mode of bathing. From this ent Varieties, and their Ef experience, I am of opinion, fects, in various Species of that it should be considered, diseased Action. By J. GIB in most circumstances, as a NEY, M. D. of the University much more more powerful agent of Edin.; resident Physician than the common fluid bath, at Brighton, and senior Phy- under any degree of heat; and sician to the Sussex co. Hosp., hence, to obviate the abuses and General Seabathing In- which but too commonly arise firmary. from temerity or inexperience, more prudence and circumspection will be required in its administration; and, like all other means of an active character, used for the removal of disease, respecting which there may be a doubt or difficulty, whatever facts we possess should be made as generally known as possible. Preface. An inquiry respecting the use and influence of different baths, in disease, having occupied my attention for some years past, I am induced to publish the result of my experience on the nature and effects of the VAPOR BATH, as a continuation of my Observations on Baths in general, which have been for some time before the public. With this design principally in view, the following compi |