1824.] 
pr sen] 
MEDICAL REPORT... 
Report of DiseasEs and Casuatties occurring in the public or private Practice of 
the Physician who has the care of the Western District of the City Dispensary. 
ET the individual who may be sceptical 
respecting the available nature of me- 
dical interference with the malignity of dis- 
ease, accompany the writer of these papers 
in one of his Dispensary rounds. It is truly 
distressing to witness the number of victims 
to “the medicable wounds”’ of disorder, 
that the streets and lanes of London daily 
present to the exploring eye. From neglect 
or mismanagement in its earliest stages, of 
one malady especially, namely, the measles, 
many infants among the poor are at this 
moment struggling against the suffocation 
of bronchial mucus, or lying prostrate under 
the pressure of pulmonary effusion. 
Than in eruptive affections, the measles 
more especially, there are none in which it 
is of more moment to guard against irrepa- 
rable mischief likely to be done to the lungs, 
by the rush of the distemper’s virulence 
upon these vulnerable organs; and even if 
death be not the consequence, immediately, 
of pulmonary inflammation from measles, a 
worse alternative often awaits the sufferers 
and their relatives. Consumption too often 
in after life claims as his own the subject of 
mismanaged measles, and substantiates his 
claim in despite of medical endeavours, now, 
‘alas! too feeble for the frightful conflict. 
The writer-believes, that he may before have 
quoted the quaint but impressive language 
of a modern author on this topic of melan- 
choly interest. ‘‘ If your convalescent 
from smallpox, hooping-cough, scarlet fever, 
or measles, bark but once, fear lest there be 
a murderer within; and, though dislodged, 
expect him again, he now knows the way.” 
Discharges of blood from the stomach 
and tungs have been exceedingly frequent 
during the few past weeks, and these oc- 
eurrences appear partly attributable to ex- 
traordinary variations in atmospherical tem- 
perature and aerial density. The offices of 
both barometer and thermometer baye of 
late been any thing but sinecures; indeed, 
the rapidity and stretch of transition from 
one state to another of the air has been such, 
as to affect persons who had hitherto 
scarcely known themselves obnoxious to at- 
mospheric influence ; and it is not only upon 
the nervous system that these ‘changes 
operate. We are rather reluctant, in the 
present day, to admit the somewhat lax 
phraseology of Hoffman, when he talks of 
“orgasm ebullition and turgescency of 
blood destroying the systaltic and elastic 
power of the vessel, and thereby inducing 
congestion, distension, and rupture ;”’ but 
it seems at least fair to infer, that what 
passes around us in the way of atmospheric 
alteration, influences in a measure, not only 
the tone and strength of organs circulating 
blood, but the aetual volume of the blood 
itself. Hemorrhage, both external and in- 
ternal, happens most frequently during 
spring and fall: in these intermediate sea- 
sons the effect now supposed is more likely 
to have place; and at these times the pre- 
disposed to disorder ought to be especially 
watchful with respect to their habits.  Pe- 
riodical blood-letting is not in the general 
way a desirable practice, but it is better oc- 
casionally to anticipate nature in her desire 
for discharge, than to permit that disorga- 
nising process to take’place, which hemorr- 
hage from the lungs, or on the brain, or 
from the stomach, implies. The best coun- 
teracting plans are, however, those of nega- 
tion and prevention. Let prudence, if not 
prudery, regulate the desire for repletion 
and the disposition to excess. The mischief 
of repeated debauches does not end with the 
morning head-ache ; nor can the organized 
system be cleared out and cleaned for fresh 
use, as plates and glasses are prepared for 
repeated repasts. 
It is in some measure owing to the pre- 
sent unseasonably warm weather that dys- 
peptic and stomach ailments are at this mo- 
ment also frequent. Warmth of air, when 
it is out of season, is much more debilitating 
than the same degree of atmospheric tem- 
perature at the periods of the year when 
cold is not regularly looked for; and we 
haye lately had humidity as well as heat 
to war with. The medicine which is now 
introduced into the pharmacopeia under 
the name of the subnitrate of bismuth, and to 
which allusion has more than once been 
made in these series of papers, is one of 
very considerable efficaey towards counter- 
acting that spasmodic affection of the sto- 
mach, and its accompanying pain, which is 
so common a manifestation of the debility 
now referred to. The writer has recently 
employed it pretty extensively in combina- 
tion with rhubarb and henbane; but it is not, 
he is convinced, to these latter ingredients 
that the virtues of the prescription, as some 
would suggest, are to be solely ascribed, for 
he has witnessed the powers of bismuth as 
an anodyne and antispasmodic, even when 
administered without the admixture of any 
other ingredients, beyond those which may 
haye been used merely as a vehicle for the 
main medicinal. 
D. Uwins, M.D. 
Bedford Row, Oct. 26th 1824. / 
METEO- 
