Thesis on the Signs of Pregnancy. Presented to the Faculty of Influence of Sex on the Diseases of Children, Remarks on the mode of administering Calomel, Bi-Tartrate of Potassa in the Treatment of Menorrhagia, Action of different Medicines on the Mental Faculties, The Evils arising from Tight-Lacing, Instantaneous Cure of Sciatic Neuralgia by Cauterizing the Lobe Treatment of Prolapsus of the Funis, Iodohydrate of Ammonia in Constitutional Syphilis. Holopathy, 233 St. Joseph Medical and Surgical Journal, College Announcements Received, GEORGIA Medical and Surgical Encyclopedia. VOL. I.] SEPTEMBER, 1860. [NO. 5. ORIGINAL COMMUNICATIONS. "Errors in Diagnosis." BY E. SHACKELFORD, M. D., CAVE CITY, KENTUCKY. GENTLEMEN:-In the Encyclopedia for July, I noticed a communication from Dr. E. B. Hook, upon "Errors in Diagnosis-with cases," &c. It brought to my mind cases in my own practice so forcibly and vividly that I cannot. refrain from offering you a communication, hoping and be lieving, as I do, it will be an advantage to the profession and community at large. How important is it in all our dealings with the sick man, that we should know his disease. It is the lever that elevates and dignifies the profession; it is the fulcrum upon which turns our success; it is the harbinger of contentment to the conscientious and upright physician; and last, and above all other considerations, it is the sick man's shield and protection. In 1854, the flux dysentery, or coletis, as it was termed, prevailed as an epidemic in southern Kentucky. The old, the middle-aged and the young, fell alike victims to its ravages. I encountered it in my practice, and resorted to the regular routine of remedies then in use: sulphate magnesia, hydrargyrum, oleum terebinthi, oleum ricini, rhei, &c., &c.; in fact, the catalogue of remedies was exhausted, and to no purpose. I consulted the oldest physicians with a like ill I concluded that there must be something behind the throne greater than the throne itself. I simply reflected success. it over in my mind, Is the disease really coletis, dysentery, or what, in fact, is it? I had charge of the case of Mr. David Seatts, of Madisonville. I was called to him the fifth day of his illness. He had got but little rest or sleep, so intense were his sufferings. The tenesmus and formina were so urgent that they called him up upon an average of every fifteen minutes, with a discharge of blood and mucus from his bowels. I visited him again, determined to spend six or eight hours with him, to see if I could discover anything in his case that I had not already noticed. Knowing how nice and delicate the shades are between inflammation and congestion, I set about a new analysis of his case, and from a consideration of the effects of all the agents that I had used, and their entire failure as you may say, I was forced to the conclusion that the disease in question was not inflammation, but congestion of the abdominal viscera generally. In accordance with this conviction, I immediately. prescribed x. grs. sulphate quinia, (for which the patient had a great aversion), and drew near his bed to watch the effect. So perfectly satisfactory was its action, that in two hours I repeated the dose; and I say to you, in all candor, that this patient, after having suffered intense agony for five days, was convalescent in twenty-four hours, after having used about forty grains sulph. quinia in that time. With an occasional suppository pill of opium, one ounce sweet spirits of nitre every two hours to regulate the venal secretion-which was very scanty and highly colored--and now and then a dose of ten grains of blue mass, I effected a cure in his case. If this were an isolated case, I would not feel justified in asking it a place in your journal; but I treated a number of cases of it in a large practice of the epidemic— which lasted about four months-with the most perfect success. My usual mode was, and is yet, when called to an adult case, to prescribe fifteen grains quinia immediately, with ten grains blue mass, and sweet spirits nitre every two hours in dram doses, with a suppository pill of opium containing two grains, to be used until retained. You may use two of these, and, if necessary, three. The sulphate quinia I repeat in eight hours, so as to use forty-five grains in twenty-four hours. Under this treatment be assured the disease vanishes like a mist before the morning sun. I do not pretend to contend that this congestive stage, if let alone, would not pass into inflammation; but I am satisfied if it does it is after the physician has let the proper time to give it the right treatment pass, and hence, the all-important thing, in the language of Dr. Hook, is a correct diagnosis of your patient's disease. Otherwise, you are like a ship upon the ocean without a helm. It is the foundation, it is the basis, the lasting guardian of the exalted science. Do not be afraid of the dose of quinia; there is no danger in it; small doses do not answer. I treat children upon the same principle, governed, of course, by the age, constitution, &c., &c. This is a hasty sketch of my experience, views and treatment of this formidable disease. I present it to you with the best of motives, with the belief that it will be an advantage to the profession and suffering humanity, whenever this dreadful malady may take them. This is the only successful mode of treating this disease that I have known of in this portion of Kentucky. I am satisfied in my own judgment that whoever adopts it will concur with us that it is the treatment. Cave City, Ky., August 6, 1860. Indigestion. BY TOM W. NEWSOME, M. D., SANDERSVILLE, GA Indigestion, a term synonymous with dyspepsia, and though a disease proper in itself, embraces a greater variety of forms than any other one known disease, many of which baffle the skill of our most scientific physicians Digestion, performed in its natural way, is more complex than the steam locomotive that flies along the iron rail annihilating time and space at the rate of forty miles per hour. Indeed, its functions might with some propriety be compared to such a machine, dependent upon harmonious |