1827.] [ 445 ] 



MONTHLY MEDICAL REPORT. 



IN many of the preceding Reports attempts have been made to connect the occurrence 

 of diseases in the human body with certain conditions of the atmosphere ; and it is but rea- 

 sonable to presume, that when any particular disorder manifests itself very abundantly, it has 

 for its cause some agent, not less extensively diffused. It will not, however, be supposed, 

 that, while supporting this doctrine, the Reporter has been insensible to the operation of a 

 variety of other causes in the production of human maladies. He would enumerate, amongst 

 the most important of these, our food, drink, exercise, and clothing ; the influence of time 

 in impairing the structure of our frame, which is, in one word, age ; a mind overstretched, 

 or over-anxious ; a constitution originally feeble and delicate, which is, translated into 

 pathological language, scrofula ; and, lastly, the condition of the soil upon which we tread. 

 But, besides these obvious and cognizable causes of disease, there are a variety of changes 

 which take place in the functions of the body, which the physician would in vain attempt to 

 explain on these or any other of the more acknowledged principles of diseased action. There 

 is, indeed, something about the origin of disease which is exceedingly puzzling ; and the 

 Reporter is strongly inclined to think that the blame isoften laid, both by the world generally, 

 and by physicians themselves, to causes which are, in truth, perfectly innocent of the 

 imputed mischief. These reflections have been called forth by the circumstance of the last 

 month having been remarkably free from severe atmospheric and epidemic malady, and having 

 exhibited, in the Reporter's practice, a rather unusual share of those complaints which, 

 whether justly or unjustly, medical men are in the habit of imputing to some one or other 

 of the causes above enumerated. 



The reign of coughs arid colds is not, indeed, yet at an end. The mild and soft weather, 

 however, which has chiefly prevailed during the last month, has greatly broken their force ; 

 and, though late in shewing themselves, they may perhaps, in strictness, be all laid to the 

 charge of the preceding frost. Several cases of erysipelas have lately occurred a 

 disease which has given occasion to much controversy. Many of the disputed doctrines in 

 our science have descended to us from the fathers of physic ; but the discussions concerning 

 the nature, seat, and treatment of erysipelas are altogether of modern origin, and have evi- 

 dently sprung out of our improved notions concerning the primary structures of which the 

 human body is composed. It is certainly a curious circumstance that the same disease should 

 at one time occur idiopathically, and exhibit all the symptoms of a genuine exanthema ; 

 and, at another, present itself under the form of a common inflammation the obvious con- 

 sequence of some external injury. Such is the fact : but the Reporter cannot agree with a 

 late writer (Mr. Arnott), that the circumstance is sufficient to constitute any real distinction 

 between the two affections. A remark of the same author is deserving of more considera- 

 tion ; viz. the connexion of erysipelas of the face with inflammation of the fauces. In fact, 

 he believes the one to be only a continuation of the other. The observation is certainly borne 

 out by the phoenomena of a case now under the Reporter's care. This case is, perhaps, more 

 curious on another account, as illustrating the hereditary tendency to erysipelas. The father 

 had the disease very severely six years ago ; the daughter, now only ten years of age, has 

 it in a degree hardly less violent. The sort of dogged determination of some practitioners 

 to treat all cases of erysipelas upon the same plan viz. bark and tonics would have caused 

 great astonishment in former times ; nor can the Reporter consider it justified by any prin- 

 ciple in pathology. In his own practice he finds the necessity of accommodating the plan 

 of treatment to the character of the accompanying symptoms. Clearing the bowels, by castor 

 oil and rhubarb, is of undisputed value ; and, when a check has once been given to the spread 

 of heat and swelling, the decoction of bark is eminently serviceable. The violence of con- 

 stitutional excitement (or, in the less pretending language of the old school, the ebullition 

 of the blood and humours) is seldom so high as to call for the evacuation of blood : but the 

 Reporter would no more fear it in erysipelas than he would in small-pox or measles. Cool- 

 ing spirituous lotions to the affected part are infinitely preferable to the use of dry pow- 

 ders, so much in vogue in Scotland, but which increase the heat of the surface ; and thus 

 aggravate one of the greatest sources of uneasiness to the unfortunate sufferer. 



During the last twelvemonth it has fallen to the Reporter's lot to witness a variety of 

 cases of ulcerated tongue. The ulcers are usually situate upon the tip and sides of the 

 tongue : they are seldom deep, and the inconvenience they occasion is scarcely sufficient to 

 induce the patient to swallow nauseous medicine ; but they give evidence of considerable 

 constitutional disturbance. In one case they proved very obstinate, but ultimately yielded 

 during the cure of a severe fit of jaundice, by which the patient was attacked. In another 

 case, they accompanied a generally cachectic state of body, which terminated in a fatal con- 

 sumption. A case of the kind, now in progress of cure, has been much benefitted by the 

 Abernethian system, which, as we need hardly tell our readers, consists in the exhibition of 

 blue-pill at night, with a bitter aperient, carrying with it some carbonate of soda, the follow- 

 ing morning. 



An interesting case of aneurism of the aorta, in an elderly person shewing the effects of 

 time in deranging the structure of the body has terminated during the last month. Exa- 

 mination of the body after death shewed the beautiful provision of Nature for preventing the 



