Gambar halaman

that when he left my office he had some difficulty getting home, and felt as though he was intoxicated. He had a short sleep, from which he awoke with a great desire for something sour, and drank over a pint of cider vinegar. The paroxysm did not come on, and up to the present time has not returned. The cure seemed complete.

CASE II. W. B. presented himself with tertian intermittent. I requested him to go home, remain quiet, and return to my office a short time before the expected attack. He did as directed, and about half an hour before the usual time for the chill, I gave him chloral hydrate 30 grs., bromide potassium gr. xv, and placed him upon a lounge in my operating room. He soon fell into a profound slumber which lasted two hours, from which he awoke without any symptoms of a return of the disease. I repeated this treatment five times in succession, just before the expected attack, and each time with a like result. I then placed him upon cinchonia and iron to improve his general health, which had been failing for some time. The disease has not returned since.

CASE III. Mrs. H— called upon me in September and said she had heard that I could cure ague, that she had been afficted with the disease for three months, having the most violent shakes. I gave

her a solution of chloral hydrate, 40 grs. to the ounce, with directions to take one oz. just before the shake was expected to come on, and to repeat the same each day before the time for the shake. She followed my directions, and never had an attack while using the chloral hydrate; I subsequently placed her upon quinine and arsenic, fearing it might return.

In conclusion, I must say that in 20 or 25 instances where I could give the chloral just before the expected paroxysm, it never failed, but in quite a number of instances it did not act satisfactorily, but I had reason to believe my directions had not been lived up to. I bring this subject before the profession hoping that others who have opportunities will give chloral hydrate a trial in arresting the paroxysms in intermittent fever, and next fall report to this society the result of their experience. If it will prove to be effectual in arresting the cold, hot, and sweating stages, it will be a valuable adjuvant, if it does not attain even a higher place in the treatment and cure of intermittent fever.



The Mifflin County Medical Society holds its meetings every three months, and there is generally a good attendance. The county being one of the smallest in the State, our roll of members is necessarily small, but we work together harmoniously, and each and every member manifests a disposition to make the society the instrument to serve the purpose for which it was intended as declared in our constitution.

Milroy, May 8, 1876. Dr. SHEAFFER

Dear Sir: In writing my share of the County Society Report for the State Society, I am sorry to have so little to write. In fact, the past year has been so very healthy, and not anything new in the medical and surgical doings in our district. We have had no epidemics during the year. Very little pneumonia during the past winter. We have had some little acute rheumatism; treated sometimes with alkalies, at others with acids. We have had very good success in the treatment of chronic rheumatism with the phytolacca decandra. During last fall had one case of typhoid fever of very severe grade. We had about the usual number of obstetric cases, nothing abnormal transpiring; also had some dislocations and fractures. We are having, at present time, quite a number of cases of epidemic influenza; for aborting the attack we have had good success with Zj doses of tr. ferri chlo. every three hours. I believe I have written all I have.

Yours, respectfully,


In reviewing the health of McVeytown and vicinity for the past year, I find but little to report. We had no epidemic in our locality except scarlatina, which appeared during the month of August and September in rather a mild form. There were many cases, but so simple was the grade that there were but few deaths.

During the winter and spring months, rheumatism was the prevailing disease. In its ordinary acute form the symptoms readily yielded in a few days to an active mercurial purge, followed by

Epsom salts, alkaline drafts freely prescribed, and, as soon as the inflammatory symptoms began to subside, large doses of sulphate of quinia intermitted with the liberal use of iodide of potassium. Morphia hypodermically inserted added much to the comfort and recovery of the patient.

The neuroses for a time, during February and March, were more than ordinarily prevalent in the form of apoplexy and paralysis. Old persons, with feeble and broken constitutions, were the subjects, and for the most part died within a few days. Diseases of the respiratory organs were less common than usual. During the winter and spring seasons, when we expect to meet with pneumonias, I did not meet in my practice with a well marked, unmixed case. A few cases of pleurisy occurred, which yielded promptly to free venesection, saline purgatives, veratrum viride, and, if needs be, the application of sinapisms or epispastics over the affected part. We had some catarrh-fever among children, which readily yielded to ordinary treatment.

For many years past tubercular consumption has been very rare. For the last disease, within an area of twelve miles by six, I think I am safe in estimating that deaths from tuberculosis have not averaged two per year, which is in striking contrast with mortuary reports from other localities.

According to my observation, diseases are assuming more of the sthenic character than they did for many years past. I have found it necessary for the last year to resort to venesection more frequently than I did during the same period since 1847. I settled in this place in the year 1830, and have been actively engaged in the practice of medicine from that time, excepting two years and three months during the late war, when I held the unenviable position of surgeon of board of enrolment.

When I commenced the practice, bilious remittent and intermittent fever was the prevailing disease in our Juniata Valley. The fevers then were of a highly synochus grade, according to Cullen's definition. The treatment was clearly defined and established by the teachings of the late distinguished Professor Chapman and others, which consisted of free venesection in the early stage, a large dose of calomel followed by Epsom salts, then nitrous powders, which were composed of nitrate of potass., tartar emetic, and calomel, and given every three hours until an intermission of the fever appeared, which was the signal for the administration of large doses of cinchona (about this time sulph. quinia was discovered and introduced). This course generally broke the fever, and only required careful administration of restorative measures to

complete the cure. Occasionally an emetic of tartarized antimony was administered after venesection, followed by calomel, etc., as above detailed. The fever, under this treatment, was generally broken in from three to five days.

The sthenic type prevailed until about the year 1844, when diseases of all classes became less inflammatory, and in 1847 typhoid fever suddenly set in, and raged with fearful violence, which required a stimulating and supporting treatment, directly the reverse of that pursued for many years previous. So clear was the typhoid form at this time, that every class and variety of disease assumed the livery. Now (1847), instead of the lancet and other depletions, so long our main reliance, every disease required a plan of support and stimulus, which has continued more or less until the present.

Within the last four or five years now my observation leads me to the conclusion that diseases of every denomination are becoming more inflammatory in their character, and the present year more decidedly so than those preceding, requiring sometimes the use of the lancet, veratrum viride, and other depletions, to a greater extent than at any time since the invasion of typhoid in our locality.

At the time I commenced the practice of medicine, the experience of our physicians was, that if we omitted venesection in a case that clearly indicated its employment, the fever, instead of running a limited course of short duration, or an unlimited course of long duration, assumed a typhoid form of bilious fever, and if recovery did take place, it was protracted, subject to relapse, and often run into dropsy and other cachexias, clearly proving the necessity of bleeding.

I do not myself endorse the idea that bleeding is to be classed among the lost arts, notwithstanding the high authority from which it emanates. I admit that fashion, to a limited extent, rules the practice of medicine; but I am slow to believe that when our fathers in medicine, of high culture and medical and scientific attainments, came in contact with disease so highly inflammatory as they were half a century ago, under the observation of such men as Chapman, Eberle, and other celebrities, they should be so far misled by the symptoms they encountered as to practise and teach a system so fatal to human life as venesection would have been if practised in the adynamic type we have witnessed for many years past.

I assume that the diseases of the present day are essentially different in character from what they were fifty years ago, and to presume that our teachers in medicine blindly taught and practised a system which, though it proved successful, was unscientific, or was adopted as the fashion of the times dictated, is paying a false tribute

to their memories. Judging from the past, we may be safe in predicting that what is now considered as scientific practice, and based on sound physiological principles, will in the future be superseded, or so modified as to vary from what we now deem correct, to as great extent, as the present system differs from that of half a century ago.

In proof of the every-varying character of disease, I will add that in 1830, when I located in this place, bilious fevers were so common that the inhabitants of the Juniata Valley looked for a return of “fever and ague," as it was familiarly called, during the months of August, September, and October, as they anticipated the return of the season itself, and this continued until 1847, when bilious was superseded by typhoid fever, the latter continuing the whole year through for three consecutive years.

In 1850 typhoid fever appeared to have exhausted itself, and gradually subsided.

From that time to the present we have enjoyed almost perfect immunity from bilious or typhoid fever as an epidemic, and we now congratulate ourselves in the enjoyment of one of the most healthy localities in Pennsylvania.

The question is often raised, will bilious fever ever return as in former times? The reply to this interrogatory is veiled in the obscurity of the future; but what has transpired may again be looked for. The annals of our valley furnish us with the fact that since the earliest settlement there have been three distinct visitations of bilious fever, and as many distinct intervals such as we now enjoy.

The Pennsylvania Railroad was laid about contemporaneously with the subsidence of fevers here. The question is raised again, has the railroad, with the burning of the coal and the rapid motion of the cars, any influence in producing the healthfulness of our valley? Popular opinion favors this idea. For my part, I can see no philosophical reason why the health should be promoted in

but may not the continuous track of iron rails that lie along the whole length of our valley have some influence in this direction, by their being a medium of communication by the conducting power of the iron and steel, and thus neutralize the positive and negative states of electricity abounding in the atmosphere? I merely offer this hypothesis as a suggestion. I am led to the inquiry by the fact that during the prevalence of bilious fever, when the atmosphere became oppressive to our organs of respiration on a sultry day, before a thunderstorm, we found we had many new cases of fever ; but after a good storm with much lightning and

this way;

« SebelumnyaLanjutkan »