1826.] Monthly Medical Report. 225 
The reporter finds it difficult to characterize, with any accuracy, the prevalent disorders 
of the last month. Slight rheumatie affections have been met with, yielding, for the 
most part, with great readiness, to saline draughts, colchicum, and Dover's powder. 
Scarlet fever also has been general ; and the reporter has heard of a few very severe, and 
of one or two fatal cases, He is, at the present time, in attendance upon a young 
man, who passed through the early stages of the disease without any symptoms ‘of 
particular severity, but whose convalescence has required a more than ordinary share of 
superintendance and of active practice. The process of desquamation of the cuticle 
has been attended with a high degree of constitutional excitement. The pulse has 
been uniformly too quick. The tongue has been very tender, from the formation of 
small yesicles; and muscular power has been throughout greatly enfeebled. Evacuant 
and relaxant medicines have in this case been perseveringly administered, with great 
and well marked advantage. It can hardly be doubted that to the neglect of such 
timely resources is to be “ascribed, in a great measure, the subsequent occurrence of 
that formidable symptom, dropsy. 
Measles and small-pox are also to be met with in different parts of the town; but it 
does not appear that either of these diseases, as at present occurring, offer any features 
of peculiar interest. It may perhaps be worth remarking, that the reporter has 
occasionally (and especially during the last twelvemonth) observed several instances of an 
eruption, resembling measles in some of its characters, which appears to originate in 
the contagion of small-pox. He has been in the habit of designating these cases by the 
name of variolous lichen ; and he has reason to believe that the same thing has occurred 
to the notice of other practitioners, and given rise occasionally to considerable embarrass- 
ment. In some instances the first formed papule have subsided, leaving the rash to 
follow its regular course. In other cases, papule have shewn themselves on the second 
or third day of the efflorescence, advancing to a rapid, but very imperfect and super- 
ficial suppuration. The precise nature of these affections it is by no means easy to 
ascertain. 
Among the medical occurrences of the past month, none has given more surprise to 
the reporter than finding consumptive cases so very abundant. This may possibly be 
owing, not so much to any positive increase in this particular class of maladies, ‘as 
to the paucity of other disorders of well-marked character. Making every allowance, 
however, for this, he is still inclined to say that they have been unusually prevalent 
for this season. It is not unreasonable to suppose that the extreme heat of the 
weather, by increasing the perspiration, may have so far weakened the powers of life 
as to kindle into activity those tubercles which are the latent causes of consumption. 
Certain, at least, it is, that delicate persons are always found to complain more than 
others of what is called relaxing weather ; and though breathing with freedom with the 
thermometer at 60°, are languid, oppressed, and exhausted when the thermometer 
approaches 80°. 
Of chronic disorders the past month has afforded the usual number and variety. 
Several cases of dropsy have occurred in the reporter’s practice, of which one was 
sufficiently interesting to merit particular notice. A young man, fifteen years of age, 
of yery irregular habits, having enjoyed his ordinary state of health during the winter, 
first observed dropsical swellings of his legs about the beginning of June ; which in- 
creased so rapidly, that by the 20th of the same month, he was scarcely able to walk. 
Tt was a dropsy of that kind called plethoric, or inflammatory, or more properly active. 
His pulse was full and strong, and his appetite unimpaired. He was bled, but without 
experiencing any relief of the symptoms. On Monday June 26th, soon after break- 
fast, he was seized with apoplexy, but medical assistance being close at hand, he was 
almost instantly bled, and to a considerable extent, and in a short time recovered the 
use of his senses. Very little impression, however, ws made upon the dropsy. On 
Wednesday the 28th the comatose symptoms increased, and he was again bled, with 
seareely temporary relief. Late on Friday night he died; and his body was examined 
the next day by the reporter, in the presence of several of his professional brethren. 
The encephalon was perfectly healthy. There was not more than the ordinary quantity 
of serum within the ventricles of the brain. The heart and lungs were equally free 
from disease. Inthe cavity of each pleura was contained about a pint of a bloody serous 
effusion. The abdominal cavity presented no unusual appearances. This case affords 
one of the most striking instances that could be adduced of general functional dropsy, 
and may be received as a sufficient answer to those who would make dropsical effusion, 
in all cases, the result of some mechanical impediment to the free motions of the blood. 
It is easier, however, to say what dropsy is not, than to determine exactly what it is. 
Weare, and shall in all probability continue to be, too little acquainted with vital actions, 
and the mutual influences of the brain and heart, ever to define, in clear and explicit’ 
_ terms, the real nature or essence of ag GEORGE GREGORY, M.D. * 
3. palleger: John-street, Golden-square, July"22, 1826. 
MM. New Series.—Vot. Il. No. 8. ~ 2G 
