522 Howrah Hospital Report for 1846. 



I have found the best treatment to be large and repeated 

 doses of laudanum, employing at the same time free evacuants 

 and external counter-irritants. 



Insanity. — Three cases have been admitted ; ages under 20, one ; 

 between 30 and 40, two ; all three of them of many months previous 

 duration. One of the cases amounted to dementia (age 38). He had 

 been in hospital for a few days at the end of April, but, being quite in- 

 offensive, was discharged. He was re-admitted, May 30th, in a state 

 of apoplexy, or near akin to it — (the post morten is interesting,) 

 admitted at noon, died at 4£ p.m. He was at work, cleaning decks 

 in the morning, seemingly well 4 hours before admission. Symptoms 

 on admission, heat of skin ; heavy breathing ; does not reply to ques- 

 tions ; full, bounding, but compressible pulse ; pupils inactive, con- 

 tracted ; low muttering ; picking at bed clothes ; he had been exposed 

 to rain in the night ; he was bled, leeched, blistered, &c. Upon exami- 

 nation 20 hours after death, in May, the dura mater at the parietes of 

 the brain was found thickened and hard in texture ; serum effused 

 into the bag of the arachnoid and also beneath it ; the superficies 

 of the brain appeared ex-sanguine rather ; upon examining the base of 

 the brain, the cortical part of the whole base of the brain, and more 

 particularly on each side centrally, was found to be of a green colour, 

 and softened, and appeared much thinned, and separated readily into 

 loose shreds and flocculi upon handling ; the whole of the cerebral 

 substance at the base of the brain, as well as the optic thalami 

 and corpora striata, was softened ; upon dividing the tentorium cere- 

 belli, previously to removal of the brain, exit was given to a quantity 

 of clear fluid, three ounces, which must have been confined at the 

 base of the brain ; the lateral ventricles of the brain were found 

 distended by fluid to the extent of an ounce or two ; cerebellum sof- 

 tened also. 



Pulmonary Disease. — There have been admitted one case of 

 phthisis pulmonalis, aged 24 years, and eleven other more 

 or less acute cases of bronchitis, pneumonia, and pleuro- 

 pneumonia (omitting catarrh), ages of these cases between 

 20 and 30, seven ; between 30 and 40, four. It has been ne- 



