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MONTHLY REPORT OF DISEASES in N. W. LONDON; 



From Nuvcinb(r2l, to December 24, 1816. 



INFLAMMATORY complaints take the lead. Acute rheumatism is very gcneralw 

 Catarrhal and pulmonary complaints are numerous, but much less so than 

 during the winter months of Inst year : where catarrh is unaccompanied with 

 manifest inilammation, cither of the substance or membranes of the hmgs, 

 it generally disappears spontaneously ; but, in many instances, the congh proves 

 cbstinate, and not unfreijuently terminates in consumption, in constitutions pre- 

 dii-posed to it. It becomes therefore a matter of importance to watch and to check the 

 j)rogress of this symptom— I find it generally yield to laudanum, in the dose of from five 

 to ten drops, with a tea-spoonful or two of oxyniel of squills. When it is accompanied 

 with fever, the addition of nitie may be useful, and sometimes it is uccessaty to have 

 recourse to the lancet. This last is indispciisal)ly necessary where, upon taking a deep 

 inspiration, either pain is felt, or an increase of cough is produced, by it. 



It is a lamentable mistake in some practitiouers,who expect to find inflammation in these 

 organs characterized by acute paiu alone; in the substance of the lungs and bronchial 

 membrane this is rarely felt, even while the most rapid disorganization is taking place, 

 1 have just quitted the'abode of a female who, for want of early advice, w ill shortly be- 

 come the victim to her disease. This poor woman, to whom I was led by chance, was 

 said to be in what is generally called a galloping consumption, a term expressive of the 

 awful rapidity of its course : when I first saw her she had been ill six weeks— the coim- 

 tenance was anxious, the eyes sunk, the tongue furred and dry, the skin hot, the pulse 

 quick andstroug;licr respiration was hurried; she expectorated a large quantity of mucus, 

 and conshed incessantly, especially when made to take a larger inspiration than com- 

 mon. There was no pain, and, till within a few days, nothing to alarm her unsuspecting 

 friends, or herselt ; but the presence of inflammation of a fatal nature was indisputable, 

 and the plan of treatment obvious. Though there was little prospect of nitiniatc suc- 

 cess, I had blood taken from the arm, which appeared in a highly inflamed state : I di- 

 rected a decoction of seneka-root with nitre, which purged her well, and she was con- 

 siderably relieved in every respect. The next evening, the same indication existing, 

 the bleeding was repeated, with the same happy result ; the cough was scarcely to be 

 heard, and the expectoration was much duninished : three days had not, however, 

 elapsed before the svmptoms returned with irresistible force, and tlie expectoration ex- 

 hibited an appearance «hich left ns without a glimpse of hope. 



My experience of the fatality of pulmonary consinnption this month has been woeful—, 

 six cases, in their last stages, have occurred to nie in immediate succession. One case how- 

 ever, brought 10 me during the last month, was actually cured about a fortnight since, and 

 I promised myself no small pleasure in pronuilgating a fact not geneially known, that one 

 species of this disease arises from diseased liver, and is emable by mercury. Jly pa. 

 tient was completely recovered, to the astonishment of all who knew her, but, straniie 

 to relate, she died, very unexpectedly, two days since, in the midst of seen)iiigly perfect 

 health; she ccmplained, for about half an hour, of pain in the region of tlic heart, and 

 then suddenly expired. I obtained permission to open the body, and, although ^ pint 

 of mucus had been cxpeciorated daily for three months previous to her recovery, no 

 appearance of disease in the lungs existed: the liver was greatly enlarged, indurated, 

 and of a wl:itish appearance. Not the slightest cause of the sudden death was discov 

 vered, if wc except the disease of the liver, which sometimes occasions it. 



Hoofing- cfeiijh has been, in many instances, fatal among the children of the poiir, 

 ^^l!0 have liot ihc nifans of obiahung ^arly-and proper medical ailvice ; several 



cases 



