[ 662 J [JUNE, 



TCiiflflf If'CTo arfJ at ylno Wsi? 

 MONTHLY MEDICAL REPORT. ^ & n7 ^J 



THOSB derangements of the biliary system which were described in the last commuirf- 

 cation have continued to shew themselves during the month now elapsed, and in most 

 instances they have been accompanied by fever. To so great an extent indeed have com- 

 plaints of this nature prevailed, that the reporter, if called upon to name the most generally 

 diffused disorder of this period, would designate it by the title of gastric fever. This term 

 is of French origin, and of recent introduction into medical phraseology, but it will probably 

 become soon naturalized in our language, from its being so admirably fitted to convey 

 an idea of the essential features of a very common and very distressing malady. A sense 

 of weight, tightness, uneasiness, or of actual pain at the pit of the stomach, accompanied 

 with headache and giddiness, and the usual evidences of febrile excitement, viz. languor, 

 lassitude, alternate flushesand chills, and weakness of the back and limbs, are the charac- 

 teristic symptoms of the disease. With these are generally associated an uneasiness in 

 breathing, commonly described under the name of a catch in the breath. The practitioner 

 of experience will readily distinguish this from the painful respiration which attends inflam- 

 mation of the serous lining of the ribs and lungs, and the difficult or laborious breathing 

 which results from the deposition of extraneous matter, whether solid or fluid, within the 

 thoracic cavity. The pathologist will at once refer it to some cause extraneous to the 

 chest; and he will easily perceive how a weakened, and consequently a distended 

 stomach opposes the free and naturally insensible descent of the diaphragm, and occasion* 

 the act of breathing to be attended with a constant, and therefore unpleasant, consciousness^ 

 To these pat ho gno manic characters of gastric fever various others are superadded, depend- 

 ing principally upon the constitutional tendencies of the individual suffering under the 

 attack. Thus in young women they will be found associated with the globus hystericus, 

 a disposition to syncope, and a weak tremulous pulse. In persons more advanced in life, 

 who take their daily allowance of wine, and use exercise but sparingly, the decided 

 evidences of flow of blood to the head will probably manifest themselves. 



This may serve as a sketch of the prevailing malady of the present month. No particular 

 difficulties have been experienced in the management of it. Where the strength of the 

 patient's habit was such as to admit of the operation of active remedies, the union of 

 calomel and antimony has proved singularly . serviceable. The heightening of the effect of 

 particular drugs by combination is a principle well known to physicians, arid admirably 

 exemplified in the instances of Dover's Powder, and Cathartic Extract. The principle is 

 equally well illustrated in the case of calomel and antimony. This union of two powerful 

 drugs supplies us with an evacuant remedy of very extensive operation, influencing indeed 

 the whole series of the natural functions ; and it will be found highly efficacious in all 

 those cases of fever which are of fortuitous origin. Within four or five hours after being 

 received into the circulation, its influence will become apparent. The liver is perhaps the 

 first to feel it, and the biliary ducts are emulged. If the stomach be at all irritable, 

 vomiting now takes place. In a short time afterwards the bowels are relieved. A second 

 dose, administered the following day, will in many cases complete the cure, by further 

 relaxing the skin and the kidneys. By assuming this as the basis of treatment in gastric 

 fever, it is not meant to infer that other remedies will not afford effectual aid. In many 

 cases indeed they are indispensable. Leeches to the pit of the stomach are often a valuable 

 preparative, and the stimulus of aether and of camphor is frequently required to support the 

 system under the exhausting effects of so powerful a medicine. 



Disorders of the respiratory organs have been very generally met with during the pre* 

 ceding mouth, but not more perhaps than the season would warrant us in expecting. An 

 English spring is proverbially variable, and the Meteorological Register for the last month, 

 so faithfully kept by Mr. Harris, will satisfy the reader that hitherto our climate has no 

 disposition to improve in this respect. Coughs, and asthmas, and spittings of blood are 

 abundant. There has been perhaps less of the acute pleurisy than is usual at this season, 

 and the lancet, therefore, has been less in requisition ; but to compensate this, leeches and 

 cupping glasses have been largely resorted to, and the benefits which they confer will bear 

 out the pathologist in all his speculations concerning local congestion, and irregular distri- 

 butions of blood. Few practitioners perhaps have sufficiently turned their attention to 

 that curious doctrine in physic, the limitation of diseased action in internal organs, a 

 doctrine than which we know none admitting of a wider or more practical application. 



Among contagious and epidemic diseases, hooping-cough has been the most generally 

 diffused. The reporter has himself met with many instances of it in children; and he has 

 heard from others of grown up persons who have lately passed through it with no incon- 

 siderable degree of severity. One of those cases, which fell under his own care; was 

 extremely violent, and affords a fine illustration of the varied dangers to which the little 

 sufferer in this disease is too often exposed. Permanent difficulty of breathing was the first 

 untoward symptom, and the engorgement of the lungs was with difficulty restrained. The 

 brain suffered next, and an attack of convulsions was sufficient to create alarm. This 

 danger was scarcely obviated, when hectic fever developed itself, under the daily attacks of 

 which the child is now suffering and wasting. The cough still continues, and will probably 



