3S0 



Medic ul Report. 



I April 1, 



did oratorios at Drury Lane on Wednes- 

 days, in whicli lie has captivated larp;e 

 audiences by the sinn;ing of Mrs. Sal- 

 mon, Madame Camporose, INIiss Good- 

 all, and Mrs. Bellchainbers, supported 

 by Mr. Braliam and others. At Covent 



Garden Mr. Bishop has prepared a si- 

 milar treat on Friday Evenings; but 

 the effect at Drury Lane is increased 

 by the capacity of (ho stage and the 

 Iiouse. Both these Oratorios have been 

 well supported. 



MEDIC AL RE PORT. 



Report of Diseases and Casualties occurrinq in public and private Practice 

 of the Physician who has the care of the ]Vestern District of the City Dispensary. 



THE thyroid gland is one of the very 

 few parts in the auimal frame of 

 which the use has not hitherto been satis- 

 factorily detected. That, however, it has 

 some immediate connection with the ner- 

 vous system, would seem more than proba- 

 ble, from several particulars connected 

 with its ecouomj'. 



A^'e all know that the cretenism ia some 

 of the alpine vallies is accompanied by an 

 enlarg-ed neck, caused by a thyroideal 

 swelling;, and Mr Astley Cooper relates, 

 that he has occasionally dissected out this 

 substance from living- animals, and has 

 thereby destroyed the degree of under- 

 standing before possessed, by the re- 

 spective animals who were the subjects of 

 the operation. A patient is at present under 

 treatment in the Dispensary, whose dis- 

 order evinces likewise the alleged connex- 

 ion. She has hysterico-epileptic fits, and, 

 prior to the paroxysm, an enlargement of 

 the thyroid gland is perceptible, which de- 

 clines with the declension of the fit. Seve- 

 ral instances have lately occurred of a more 

 permanent enlargement of this part, and 

 in most of these cases there is a sort of he- 

 betude of the nervous power — a fact which 

 would appear in accordance with the as- 

 sumption now adverted to. Tlie Empla.s- 

 trum Ammoniaci cum Hydrarg-yro of the- 

 London Pharmacopoeia, is a most useful ad- 

 dition in these cases, to infernal medicinals, 

 of which burnt sponge claims an unequivo- 

 cal efficacy •, but it is fair to question whe- 

 ther this last substance possesses any vir- 

 tue beyond the alkaline principle which it 

 contains. 



One of the most curious circumstances 

 which mark the peculiarities of diseased 

 action, is the tendency often conspicuous 

 to regular periods in a disorder's recurrence, 

 and this habit is again conquered by means 

 which a priori would appear inadequate to 

 the end. A patient, some time since, ac- 

 quainted the writer of this article, that his 

 complaint (a species ofas'hma) had assumed 

 such a regular character as to return on 

 each succeeding Friday. It was agreed 

 that he should be seen on that day, but the 

 appointed hour of attendance occurred 

 without the recurrence of the paroxysm, 



the first time for many weeks, and although 

 the malady still exists, it has now lost its 

 wonted regularity. The reporter may just 

 take occasion to say, that the Peruvian 

 bark often appears conspicuously service- 

 able in those affectious, which are decidedly 

 intermittent, although nothing like fever 

 may characterise the disordered state. 

 Even the derangements of infancy are occa- 

 sionally stamped with the peculiarity ad- 

 verted to ; and the writer has just had a 

 little girl under treatment, whose sickness 

 consisted in strong contractions of the 

 hands and feet, which, prior to the medici- 

 nal treatment, happened on each Sunday 

 morning. The derangement, in this case, 

 owned a source which, it might have been 

 expected, would have produced rather a 

 permanent than a periodical effect, and it 

 has yielded to vermifuge medicines, of a 

 purgative and tonic quality. 



Some iustances have occurred within the 

 month of typhoid fever. The more that is 

 seen of this complaint, the more evident will 

 it appear to the observant practitioner, who 

 is untrammelled by preconceptions respect- 

 ing its actual essence, that no condition of 

 the system can be marked down as the ab- 

 solute something from which every symp- 

 tom springs, as from a solitary source. At 

 one time the brain appears to be peculiarly 

 implicated — at another the cerebral func- 

 tions are comparatively little disordered. 

 In a first case the w hole force of the malady 

 shall appear to be concentrated upon the 

 pulmonary organization — in a second the 

 membrane spread over the bowels shall be 

 the particular part for the display of the 

 distemper's virulence — and in a third, ge- 

 neral disorder shall be present without any 

 cognizable locality. 



In the required treatment there is also a 

 corresponding variety, which must be left 

 to the prescriber's individual and unsi/ste- 

 matic discretion. Topical and even gene- 

 ral bleeding will sometimes preserve the 

 vital principle from being overwhelmed by 

 the sudden rush of the disorder's force; 

 but, alas '. for the patient in the hands of 

 a practitioner who should either refuse to 

 bleed at all in fever, or should indiscrimi- 

 nately unsheath his lancet because some 

 writem 



