convulsions, which were repeated frequently during the next twenty-four hours, when not under chloroform. At this time; active catharsis was produced, and the convulsions ceased. Five days after she was delivered of a still-born child. Recoverd. CASE IV. The same woman, on the 8th of April, 1862, after long suffering of headache and nausea, was taken with convulsions in the sixth month of her third pregnancy. They were controlled with chloroform until the operation of a cathartic, soon after which she became quiet, but was unconscious for nearly forty-eight hours, then gradually recovered. Her face and whole body was swollen, and her urine was loaded with albumen, and this continued long after her abortion, which occurred eight days after the convulsions. No motions were felt after the convulsions, and the mother recovered. CONCLUSION. 1st. Uremia is the cause of about ninety per cent. of all convulsions of pregnancy. 2d. Coma is more frequently produced by serous infiltrations and uremia, than by congestion of blood in the brain. 3d. Blood-letting is not admissible in a large per cent., from its tendency, in a remarkable degree, to aggravate the disease, and reduce the chances of recovery. It is often practiced with no appreciable good or bad results. It is not relied on alone in the best examples for its exhibition. 4th. Chloroform is admissible in all cases, and beneficial in nearly all. In those not benefitted by it, no injurious effects are observed. 5th. Hydragogue cathartics are followed by more uniform, permanent good results than any one remedy-a fact deduced from the detailed history of almost every case on record. 6th. Opium and its preparations are frequently attended by the happiest influence. 7th. In uremia, threatened with eclampsia, and not relieved by treatment, or when the fœtus is dead, artificial premature labor to be induced. The pregnant female, with albuminous urine, to be under the special care of the physician. CAMP DIARRHEA. BY DR. BROWER. The incidents of the expedition sent by our Governor, in January last, for the relief of the wounded and sick in the army and hospitals of Nashville, interesting and exciting as they were to its members, and fraught with agreeable reminiscences, are by no means devoid of points of professional interest, and as such, are worthy, perhaps, of record, and may furnish a basis for profitable discussion. The weary voyage to the seat of hostilities, was beguiled of its tediousness-not only by free and cordial interchange of views and sentiments on subjects of professional interest germain to the special objects of the mission, but by the free discussion of points of interest and questions of practical value, by a society extemporized for the occasion, much valuable and important information was elicited, and the occasion will furnish material for profitable and agrecable reminiscenses to all who enjoyed its privileges. The condition of the hospitals at Nashville, though exceedingly crowded after the sanguinary battle of Murfreesboro, was, in the main, excellent and satisfactory. The timely relief afforded by an ample relay of surgeons and nurses, gave to their exhausted and worn-out officers an opportunity for rest and recuperation, and added greatly to their efficiency. Having been detailed to the charge of a hospital steamer, with wounded men, for Cincinnati, my opportunity for inspection and observation of the special modes of treatment, and their results, in hospital and on the field, were less than those of other members of the commission who were detailed for duty in the several hospitals, and who, it is to be hoped, will favor the Society with the results of their observations. I left Nashville on the 13th of January with two hundred and twenty wounded men, crowded on a small boat, in most inclement weather, with most scanty and insufficient supplies; many of them not having had their bloody and soiled clothing changed, or their wounds dressed for eight or ten days previous, and destitute of comfortable clothing. The wounds were of every conceivable variety in character and locality-most of them inflicted by balls or fragments of shells, and involving every structure and tissue of the body. A noticeable fact, was the great disproportion of wounds of the lower extremities. Fully two-thirds were below the abdomen, and below the knees. As might have been expected, as the weather had been previously unusually warm, many of the wounds had assumed an unhealthy and erysipelatous character; over forty cases of severe erysipelas, with tendency to great prostration and pyemia, were noticed and treated. In most of these cases, by patient and careful dressing, the removal of foreign substances within their track, balls, fragments of shell, bones, pieces of clothing, and other irritating material, assisted by local and constitutional treatment, an improvement was soon established, with gratifying results. Great pains were taken to preserve the cleanliness of the parts, and the healthy condition of the atmosphere, by the liberal use of chloride of lime, burnt coffee, and other disinfectants. The local treatment was, the solution of acet. plumb, with tinct. opii, solution of creosote, 3i to a pint of spirits, and occasionally cataplasms of linseed meal, well saturated with tinct. opii and Labarraque's solution. As most of these cases were characterized by great prostration and fever of an asthenic type, the free use of stimulant and tonic remedies was indicated; quinine and whisky, with liberal doses of opium, (not morphia), were the sheet anchor. I never before realized, to such a degree, the truism of the great Scarpa, that "opium is a grand antiphlogistic remedy. Invariably, under its use in large doses, the pain, tumefaction and spread of the erysipelatous inflammation were arrested—the discharges from being scanty, ichorous and offensive, became bland, copious and odorless, and the febrile condition promptly removed. Of general disease, but little was observed, save some forty or fifty cases of diarrhoea, simple, and occasionally degen`erating into true dysentery. As there was nothing peculiar in their manifestations, arising, as they did, in most cases, from badly cooked and unhealthy food, they readily yielded to a more healthy regimen, with occasional laxatives, and, when necessary, mild astringents. The extract xanthoxylum, with tinct. op., camph. and sp. lavend. compound, formed a useful prescription; and occasionally acet. plumb., with ipec. and op., were resorted to with advantage. Opium suppositories were resorted to with prompt, and generally permanent relief. By unremitting care and attention, I had the satisfaction of returning all to Cincinnati, save one, accidentally frozen, in good condition and improving. While engaged in inspecting the sanitary condition of Indiana troops in the Army of the South-west, in March last, my attention was drawn to the great number and fatality of cases of (so called) camp or chronic diarhœa. The peculiar character of the weather and climate, excessive heat, alternating with frequent heavy rains; the submergement of vast extents of country by inundation; the consequent crowding of large numbers of men in a small space; the vast accumulation upon the surface of decomposing animal and vegetable remains, acted upon by an almost tropical sun, may well be imagined as forming a nucleus for the development of all forms of zymotic disease, and generating a miasmatic influence, such as would seriously affect the health of our troops. Add to these the want of sufficient supplies of fresh vegetables and fruits, and the habitual neglect of the healthy condition of the skin, so common in soldiers, and it will not be wondered at that enteric diseases, pneumonia and rheumatism should largely prevail. From conversation with several gentlemen of the medical staff, who have been directing their attention and interest to the subject of diarrhoea, (among whom I would make honorable mention of Drs. Comingore and Casselberry), and whose views coincide with my own personal experience and observations, there seems to be some peculiarities attending the progress and results, both immediate and remote, which are worthy of attention. Unlike the ordinary forms of diarrhea, it does not seem to depend upon errors in diet as a proximate cause, but to have for its origin a morbific atmospheric condition, generated by solar influences, upon large accumulations of animal and human decomposing material, aided, no doubt, in many instances, by unhealthy diet, and want of proper attention to the functions of the skin. In closely packed camps, generally on low or alluvial soils, the enormous amount of animal and vegetable offal, the debris of the cuisine, and the human excreta, must furnish the pabulum, which, acted upon by solar heat and moisture, must evolve an atmospheric condition highly morbific, and well calculated to induce diseases, characterized by great irritation of the surface of the intestinal tube. Hence, the prevalence of fever of a low asthenic type, while rheumatic and pneumonic inflamations, generally of a sub-acute character, owe their origin to the same vitiated atmospheric condition. In a majority of cases of camp diarrhea, so called, the salient point of irritation seems to be confined almost entirely to the lining membrane of the lower portion of the colon and the rectum. In most cases, the healthy condition of the stomach and large intestines are comparatively unimpaired, for weeks, while the frequent, sudden and copious evacuations of semi-fluid galls, attended with deep obtuse pain across the loins, unusual sense of prostration, and a partial paralysis or loss of control over the muscular power of the lower limbs, indicate a high degree of morbid irritability of the lower bowels, in connection with a peculiar want of innervation of the nerves, arising from the sacro-ischiatic, or sciatic plexus, and distributed to the extremities. In many cases, this deficiency of motor-nervous power is felt by the circulatory system, the sacral region, nates and limbs becoming cold and torpid, by reason of want of healthful accelarative power; in the capillary circulation, during the early or irritative stage, usually little or no frebrile movement is observed, until structural lesion of the epithelial coat is developed; then symptoms of typhoid condition manifest themselves; a dry, cracked and brown tongue, great depression, a distinct circumscribed tenderness in the left hypochondriac region, pressure upon which induces nausea and a sense of faintness. At this stage, duodenal irritation supervening, either by sympathetic action with the lower intestine, or hepatic congestion, develops true dysenteric symptoms, with frequent, scanty and sanguine purulent discharges, and ultimately terminates either by exhaustion, or perforation of the bowel by ulcerative action, with obscure peritonitis, dropsical effusion into the extremities, and death. If this view of the etiology and pathology of the disease be correct, it is evident that the use of astringents, opiates or laxatives, useful in their proper place in ordinary forms of diarrhea, would be here out of place, and perhaps injurious. Mercurial alteratives are equally contra-indicated, and there is reason to fear that much of the terrible mortality from this malady is connected with the injudicious habit of confounding it with the common forms of intestinal fluxes. Words are things, and to many, the assumed name or common designation of a disease, indicates the common routine line of treatment, without special inquiry or investigation. The postmortem examinations and morbid specimens made by Drs. Comingore, Casselberry and Taylor, fully substantiate the fact that the gravamen of the disease has its location in the membranous and epethelial structures of the lower intestine, and, therefore, to that point should our remedial efforts be directed. The use of sedative enemata, or suppositories, by their local and general influence, seems well adapted to meet the requirements of the case; and from the report of those who have had a large experience in the disease, as well as my own personal observation, they may be made to exercise a most salutary effect. During the expedition from Nashville, having no injecting apparatus, I used a pill containing 1 gr. opium, with gr. nitr. argent, with immediate and permanent relief. Administered at night, the frequent and inordinate movements were promptly suspended for twenty or twenty-four hours. An enema of 4 oz. cold water, to 1 gr. argent. nitr. and 25 drops tinct opii., repeated once or twice in twenty-four hours, seldom failed to give instant relief, and by due perseverance, to overcome the graver symptoms. Of internal medicines, the nitric acid, with tr. opii. and aq. camphore, or the well-known Hope's mixture, was followed by decided and prompt benefit. Under its use, the evacuation became more consistent and less frequent, the appetite improved, the tongue moist and clean, and the abdominal tenderness relieved. I am indebted to my esteemed friend, Dr. Winton, of Wabash, for the sugguestion of this valuable prescription, and can bear personal testimony to its great value. In the chronic stage of the disease, especially where partial paralysis of the lower extremities has supervened, the preparation of strychnia has had an admirable effect, and when carefully used, is a safe and reliable prescription. The preparation used was of the solution, made by adding 12 grs. strychnia to 12 oz. diluted alcohol and 60 drops acetic acid. From 10 to 20 or 30 drops were given three times a day, in a mixture of equal |