Page images

and especially during the last spring, when exhausted by the labors of the winter, doubtless tended to hasten the event which we are now called upon to mourn.

In the summer of 1853, Dr. S. was chosen Professor of the Institutes and Practice of Medicine in the medical department of the University of this city, and lectured during the past season in that Institution with great acceptance. This appointment enabled him to realise the hopes in which he had long indulged, and rendered available for the benefit of others the valuable acquirements of long years of devoted study; and it is in this post that his loss will be severely felt.

Dr. S. was married in 1849, to Miss Margaret Dale, daughter of the late Dr. Dale, of Gloucester, Mass. He has left no children. His health had been precarious for some years. Signs of the disease which terminated his life were detected six or seven years ago, and in 1850, he visited Europe for the purpose of relaxation. By careful attention, however, he had been able to continue his active labors until the last spring, when more decided evidences of declining strength began to awaken the fears of his friends. He spent some time at Sharon Springs during the past summer, but without any benefit, and returned to the city in August, much reduced in strength and flesh, and with symptoms which showed too plainly that his earthly race was nearly run.

He still, however, entertained hopes of rallying, and after a short stay here, visited Gloucester, for the benefit of a change of air. All hope, however, proved fal. lacious, and he had hardly strength to get back to his own house, to breathe his last among his friends here. His end was calm and peaceful. He had not in his struggle for earthly lore, neglected that wisdom which cometh from above. He retained his consciousness to the last, dictating the arrangements for his funeral; and taking leave of those around him, quietly fell asleep in the arms of that Saviour in whom he reposed all his trust.

The post-mortem examination confirmed the diagnosis of his disease made during life. Both kidneys were found in an advanced stage of Bright's disease, and the liver in the second stage of cirrhosis. All the other organs were sound.

In the death of Dr. Swett, we feel that the profession has sustained no ordinary loss. An honorable man, and an accomplished physician, he had secured the confidence and commanded the respect of his brethren, to a degree rarely met with, and it is no disparagement to those whom he has left behind, to say that as a teacher and clinical lecturer, he had no superior among us.

A gentleman by nature and by education, Dr. Š. was always courteous in his manners, and ever secured the affection of his associates, and has left a circle of warm and devoted friends, by whom his removal will be most severely felt.

B. Died, at Hamilton, Canada West, Sept. 16th, Dr. Charles Enderlin, aged 41 years. Dr. E. was a native of Rastadt, and came to this country in 1850. At a meeting of the society of German physicians of this city, held recently, resolutions were passed on the occasion of his death, expressive of the high character of the deceased.

Died, in this city, Sept. 25, Edward Bullus, M. D., aged 50 years.

Died, on the 20th of September, in New-Orleans, of yellow fever, Valentine Mott, jun., M. D., son of Professor Mott of this city, in the 33d year of his age, on his way to New-York.

At Portici, near Naples, on the 11th August, of cholera, the Chevalier Macedonio Melloni, a most distinguished natural philosopher.' In London, Mr. G. B. Sowerby, a distinguished naturalist. In Paris, recently, the only child of Baron Louis, aged 19, of phthisis.

[blocks in formation]

Case of Acute Traumatic Tetanus successfully treated. By James M.

MINOR, Surgeon to Brooklyn City Hospital.

MARTIN KENNEDY, Irishman, mason, æt. 33, admitted December 19th, 1853, with traumatic tetanus, caused by lacerated wound over the anterior angle of tibia of right leg. Wound was received about ten days previous. Symptoms of tetanus began to show themselves about five or six days before admission. Had been under medical treatment, though of what kind, I could not exactly ascertain. Teeth firmly closed, resisting his own and our efforts to separate them. Cervical muscles and recti of abdomen constantly rigid. Deglutition difficult, with frequent spasm of glottis and of respiratory muscles generally. The wound had been brought together with sutures; upon the removal of which a small pledget of lint was found : a most singular surgical proceeding, and to be accounted for only, I suppose, upon the supposition, that having been previously introduced, the sutures were introduced without observing the pledget. Ordered poultice to wound; bowels being constipated, ordered an active cathartic and purgative enema, to be followed by opium and quinine, äā grs. ij. every three hours. Nutritious diet.

20th. No improvement; slept but little ; occasional spasms through the night. Wound dry, and covered with a buff-colored slough. Cauterize freely with nit. argent and renew poultice.

21st. A good many spasms through the night, but slept better than night previous.

22. No material change. Wound unchanged in appearance, and Vol. IV.-No. 2.


seems little disposed to action. Remove poultice and apply lint dipped in laudanum; medicine to be given every two hours.

23d. Violent and frequently repeated spasms through the night, with opisthotonos. Remove lint, and substitute a poultice containing powdered opium.

24th. Passed a rather better night; muscular spasms, however, frequent and severe.

25th. No material change. Slept but little. Continue treatment.

26th. Passed a bad night. Spasms violent and frequent, with opisthotonos; countenance anxious; eyes widely dilated and staring. To have a hot hop bath made by infusing two wash-basins of hops in boiling water, and put into the bath; the bath-tub to be covered (except a small space over the face) with a counterpane or blanket, causing him to breathe as much of the vapor as possible.

27th. Obtained great relief from bath ; slept none; spasms neither so violent nor frequent. Brandy to be taken freely.

28th. No change. Continue opium and quinine; anodyne poultice.

29th. Passed a bad night; symptoms aggravated. Repeat hop bath.

30th. Much relieved by bath ; slept three or four hours; action of muscles less violent. R. Quinine, grs. xx., three times a day, in conjunction with other medicines.

31st. Not so well. Chloroform liniment to cervical spine. Discontinue the large doses of quinine. R. Pulv. opii, grs. iv.; sulph. quinine, grs. iv.,-every two hours in place of pills heretofore given. Long and narrow blisters on each side of dorsal vertebræ.

Jan. 1st. Decidedly better, slept well. Teeth can be opened a little, spasms less frequent and severe. Continue pills and brandy. To take also chloroform, gtt. viij. in emulsion, three times a day.

2d. Not so well. Discontinue chloroform, continue liniment. Substitute morphine for opium, in equivalent doses.

3d. No material change. Chloroform inhalation ; to be resorted to only when spasms are very


4th. Inhalation of chloroform seemed to aggravate the violence of the spasms. Discontinue it. R. chloroform, 3 ss., tinct. aconite, 3 ij., liniment saponis, 3 iss., to be used as a liniment to spine.

6th. Rested tolerably last night. During my visit on this day, he was thrown into the most violent spasms ; opisthotonos of the severest form, foaming at the mouth ; face purple, resembling in many respects an epileptic convulsion. To be placed immediately in a hot bath, with very strong infusion of hops.

7th. Much relieved by the bath. Continue treatment as before.

8th. A little more comfortable. Slept better. Had him removed to a private ward, to avoid as much as possible all noise, which causes a frequent recurrence of the spasms.

9th. Improving decidedly. Teeth can be separated a little more. Spasms less frequent, and altogether more comfortable. Reduce quantity of morphine gradually,

14th. Improvement progressive.

19th. Brandy to be reduced to 3 ij. daily. From this time he steadily but slowly improved, until the 10th of February, when he was discharged, cured.

Remarks. The bare details of a case can never convey to the mind of a reader the same full appreciation of its striking points as they do to one who witnesses them in their progress at the bed-side.

With this view, I venture to add, very briefly, what appeared to me the most prominent features, both in the case itself and the treatment.

1st. We have a most violent case of acute tetanus, from a very aggravated cause, in a large and powerful man, and one of intemperate habits.

2d. The disease in its seventh day, scarcely any thing having been done to check its progress.

3d. The treatment, as in almost all cases of extreme severity, underwent a variety of changes, though in the main was steady and persistent, and based upon a correct appreciation of its strict pathological condition, so far as that is known. The sequence between the relief and the remedies is not as direct and immediate as we could desire ; and yet I think it may be said that, the disease being one of nervous irritation, or even inflammation (as some have supposed), the treatment would be generally appropriate, the use of nitrate of silver to the wound destroying the sentient extremities of the irritated nervous trunks, and the anodyne applications producing local anæsthesia.

The blisters along the spinal column, and the chloroform liniment, are but adjuncts to the more prominent remedies, and tending towards the same end. The hot hop bath I consider to have been more immediate and striking in its remedial operation, thon any other of the remedies used. I should be most happy if this paper may induce others to resort to it in similar cases, in order that its efficiency may be tested more fully. My experience of its effects in this case, and also in several cases of mania a potu, has caused me to place a very high value upon it in all cases of nervous irritation. Upon opium in the large and frequently repeated doses, as above detailed, I place great reliance, and cannot but look

upon it as the most potent and valuable of all the drugs used in this disease.

Brandy, and the most nutritious diet, doubtless played an important part, and materially aided in the final result.

33 Pierrepont street, Brooklyn.

Case of Recovery after Rupture of the Vagina, at its junction with the

Uterus, and escape of the child into the peritoneal cavity ; by John T. Metcalfe, M. D., Professor of Institutes and Practice of Medicine, University Medical College.

Mrs. H. æt. 35, a stout, well made woman, was taken in labor with her fifth child, on Sunday, April 27, 1851, at 2, P. M.

In her first confinement, from what cause, it was impossible to ascertain, there had been necessity for instrumental delivery, after a long and difficult labor. Neither the patient nor her friends, were able to say what kind of instruments had been employed.

Her next two children were born, at term, after short and easy labors. Her fourth child presented the arm; and, after trusting to nature for twenty-four hours, delivery was effected by turning.

During pregnancy, she had always suffered from nausea and couh, which latter lasted for several weeks after parturition. Convalescence, in every case, had been rapid and uninterrupted. Her general health was excellent.

From the commencement of her present labor, she had been constantly troubled with pain in the right side, vomiting, and heartburn. Dr. Wiggins saw her at 64, P. M. on the 27th, and found her suffering from regular, strong, dilating pains, recurring every fifteen minutes. At this time, by vaginal examination, he recognized a presentation of the vertex, and dilatation of the os uteri to the size of a quarter dollar. The membranes were very tense during the pains. In the course of the afternoon, there had been a “show.”

« PreviousContinue »