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MARYLAND MEDICAL JOURNAL. 273 
conclusions. If it be admitted, as we 
think it must be, that polluted drinking 
water may be a source of grave danger 
in the case of epidemics, especially of 
cholera, yellow fever, and perhaps diph- 
theria, and when it is remembered that 
it is not the quantity, but the kind of 
organic matter that makes water danger- 
ous, it becomes at once a matter of pro- 
found importance to correct the defect in 
the water supply above pointed out. 
We speak of “ preventable pollution,” 
because, in our opinion, the defect is re- 
movable; Sanitarians are at one as to 
the importance of the proper disposal of 
sewage, and of the utter perniciousness 
ol the privy system, with which Balti- 
more, in common with other large cities, 
is cursed. But, although we may raise 
our voice in condemnation of this abom- 
ination, it stays with us. It is suggested 
however, that the dangers from this 
source may be considerably lessened by 
the general substitution of an in-door 
hydrant in place of the out-door filth ac- 
cumulator now in use. This would not 
only be cheaper, but while removing the 
danger pointed out in this paper, would 
add materially to the comfort of the 
family using the water. 
SOCIETY REPORTS. 
BALTIMORE MEDICAL 
ASSOCIATION. 
MEETING HELD MAY 24TH, 1880. 
John F. Monmonier, M. D., Presi- 
dent, in the Chair. 
The Association met at 8.30, P. M. 
After the ordinary formalities were dis- 
patched, Dr, Arnold read a paper upon 
Puerperal Insanity, which was pub- 
lished in this Journal, June 15th, 
Dr, Jones inquired whether much of 
the trouble in these cases was not due to 
hysteria. 
Dr, Arnold replied that there was no 
evidence of this in his cases. The in- 
sanity was unmistakable. Delirium is 
not a common symptom of hysteria 
Dr, Morris regarded it as true insanity, 
but not a peculiar form. He related a 
case similar to that of Lady Mordaunt, in 
which a married lady four or five days 
after confinement openly declared that 
she had been guilty of adultery. It may 
be that this is one peculiar feature of 
puerperal insanity. 
He did not regard the transient insan- 
ity which occurs just as the head is being 
expelled, and of which he had seen at 
least a dozen cases, as puerperal insanitv. 
He referred to a case due to lactation 
in which a woman murdered her children; 
he thought the anaemia produced by 
prolonged lactation might favor its oc- 
currence. 
Dr. Erich had seen nothing peculiar 
about puerperal insanity. Only one of 
his cases terminated fatally ; none in per- 
manent insanity. Death was due m the 
fatal case apparently to meningitis 
Opium he regarded as injurious. Chlo- 
ral-hydrate was a remedy of great value. 
He referred to the case of a patient who 
had been subject to attacks of insanity, 
for which it had been deemed necessary 
to send her to an asylum. Being called 
to see her in an attack. Dr. Erich ordered 
3 ss of the chloral every half hour until 
she slept ; he ordered her to be fed every 
time she awoke, and to be kept asleep for 
twenty-four hours, after which bromide 
of potassium was prescribed in 3ss 
doses three times a day. Recovery was 
complete in three weeks. A relapse and 
several subsequent attacks (she has been 
under care three or four years) have been 
treated in the same manner and with 
similar results, without the necessity of 
sending her to an asylum. To feed the 
patient, and to secure sleep (thereby giv- 
ing rest to the brain), he deemed the two 
principal indications. 
Opium is sometimes useful in melan- 
cholia, by its stimulating effect On the 
brain ; it should not be used in such 
quantity as to disturb alimentation. 
Quinine is a good substitute, causing 
slight hypersemia ; but if it produces 
sleeplessness, which it is apt to do, it is 
hurtful. In cerebral anaemia these are 
the remedies. In cerebral hyperaemia 
bromide of potassium and chloral are 
appropriate. 
Dr. Cordell had seen but one case of 
puerperal insanity, which occurred in a 
mulatto woman, aged 40, some weeks 
after childbirth. The diagnosis was for 
some time obscure, the symptoms point- 
ing strongly to typho -malarial fever. 
Aversion to her husband was a marked 
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