this symptom is absent, or manifested in a most cases of this kind in the hospital, is very slight degree; still, as a general rule, very much that which was suggested, some the pain in peritonitis, augmented by pres- years ago, by Dr Wilson, of the Middlesex sure, is a most characteristic symptom. The Hospital. We commence by putting the , haggard expression and shrunken features patient in a warm bath, and, while he is constitute another mark of this terrible there, a warm water enema is administered; malady, and the feeble voice often assists us when the first enema is returned, a second to diagnose peritonitis. In peritoneal in- quantity of warm water is forced up, so as flammation, we almost always meet with a to distend the colon; this is done several small rapid pulse, and fever is invariably times in succession. Frequently, a cure is present; while in colic the pulse is but effected by these means without any farther slightly affected, and there is little or no treatment; but it is often necessary, in order fever. to empty the bowels fully, to give a purPerhaps the most important symptom of gative. And that which answers best in colic is the peculiar character of the pain-these cases is a combination of compound a twisting, writhing, griping pain, not a extract of colocynth and croton-oil. A burning or soreness, as in peritonitis, nor a drachm of the former, and from one to three sharp, shooting pain, fixed, and always re-drops of the latter, are divided into twelve ferred to one spot. This writhing character pills, and one pill is given every three hours of the pain should always be kept in view; until the bowels act. The stomach bears it will especially help you in the diagnosis these small and frequently repeated doses from ileus, from obstructed bowel, and from of the oil better than a full dose administered gout in the stomach. In the two former, at once, and the operation of the medicine the pain is often not at all a prominent symp. is more effectual. With respect to antitom; it may occur early, and disappear, and phlogistics, the abstraction of a little blood the subsequent symptoms arise chiefly from sometimes does good in colic; but, as a the obstruction-namely, vomiting, swelled general rule, you will find that bleeding and tympanitic belly, complete stoppage in only prolongs the convalescence of your pa the action of the bowels. The pain of gouttient. Leeches, also, are occasionally bene. in the stomach is exquisite; it is distinctly ficial, in cases where there is abdominal referred to the stomach-a fixed severe pain tenderness; but the majority will not require in that region, with more or less sense of them. You will find great benefit from the distension, due to the accumulation of air in careful use of opium, in the more obstinate the organ, which may be clearly determined and complicated cases. You may give it by percussion. The urgency of vomiting simply to relieve pain, when that is excessive; will, of course, excite suspicion of more se- or where there is great exhaustion, and the rious disease than colic; and the results of patient needs repose, you may give it freely treatment, the persistence of the symptoms, to produce sleep; and, in administering it notwithstanding the use of means calculated with this view, you will not find that your to act on the bowels, will indicate ileus, or ultimate object will be retarded. On the obstruction from some other cause. contrary, the exhibition of opium often gives Symptoms like those of colic often ac- tone and power to the muscular coat of the company renal irritation, either from cal-bowel, and promotes the favourable action culus or from acute inflammation. The of purgatives. Moreover, opium is a valuable diagnosis, under these circumstances, must preservative against abdominal inflammarest on the history of the case, the state of tions. Where you keep up a certain opiate the urine, and, in some degree, on the re-influence, your patient will be less liable to sults of treatment. peritonitis, or to enteritis. Opium also And now let me conclude with a few re-regulates and moderates the action of purmarks on the subject of treatment. Whether the case be one of simple colic, or gouty colic, or colic resulting from lead poisoning, you must endeavour to get the bowels to act freely. What you want is, to create a free channel through the intestine; and this you may effect by purging, and by the administration of enemata. The general plan of treatment which I commonly pursue with gatives; and this is worth your always keeping in mind, for in the use of purgatives in cases of intestinal obstruction it is often true that "the more haste, the worst speed." The value of opium as an adjunct to other parts of the treatment is well illustrated in the first case which I related to you. There was so much pain and sickness, that we at first relied wholly upon opiates and enemata, The following extract from an article in the New Orleans Bulletin, furnishes some interesting information relative to the prevalence of the yellow fever in former years : "The first advent of yellow fever in this city was in 1794, continuing with alternate increase and diminution to 1797. There are no records extant of the actual mortality from yellow fever alone during this period. The average population was less than ten thousand; the average mortality one in and it was not for some days that purgatives were given. Without opium in this case, the patient would have but little chance, such was the exhaustion under which he suffered. After the opium, we found that purgatives acted well; and you may sometimes even combine opium with them, as with calomel and colocynth, or croton oil and colocynth. For another reason, I would caution you not to proceed too fast with purgatives in colic, or to trust to them ex clusively, namely, because possibly the di-fifteen. For a number of years following, agnosis may not be quite certain, and you may find that your treatment is doing harm. and increasing the patient's distress. Ene.demics that have occurred have been obmata are perfectly safe, and may be given in tained, commencing with 1817. Previous all doubtful cases as a preliminary step, for to that period, the most patient investigation by this treatment you are not likely to do and research have not been able to collect harm, and you may often succeed in re any data that can be relied upon as fully aulieving the patient without having recourse thenticated. At the time, 1817 was conto any other mode of treatment -Med.sidered a bad year. The population was Times and Gaz. July 23, 1853. MEDICAL NEWS. DOMESTIC INTELLIGENCE. Yellow Fever at New Orleans.-Yellow fever has prevailed for some weeks in New Orleans to a fearful extent, and is still continuing its ravages. The following table exhibits the mortality in that city during the fourteen weeks since the outbreak of the disease. When it is considered that the entire population of the city is only about 150,000, and that at present it does not, it is said, exceed 50,000, so many having fled, an idea may be formed of the fearful ravages of the disease: the average mortality was over five per cent. Full and accurate details of the several epi about 38,000, and the per cent. of deaths by yellow fever to the total mortality of the year was 33.86. The year 1822 was a very fatal year, and so was 1841." In a report made by the Board of Health in 1841. the following statement is made: "Of the season just past, to the 1st of November, 1325 have been reported to the Board, as victims to the acclimating process, out of a probable number of near 15,000 subject to it, at the commencement of the epidemic. Of this number, 561 have died at the Charity Hospital; probably near 500 have died at the other hospitals, and under the care of our charitable and benevolent associations; and the balance must be left to private practice. In saying, then, that from 10 to 12 per cent. in private, and from 30 to 40 in public and private hospitals, and Total. under the charge of our benevolent asso140 ciations, have died, probably we arrive at a 142 fair average of the mortality, making allow. 154 ance for the many that have escaped the 147 fever in any form, with the comfortable 167 assurance of being acclimated without risk; 177 and it is gratifying to state, that no instance 188 has come to the knowledge of the Board, 344 where a second acclimation was necessary 617 (accompanied by fever or not), unless in 880 the interval the individual spent some win1186 ters in a more northern climate.' 1532 The Bulletin gives the following addi1575 tional statistics: 6699 2178 8877 "The first cases of yellow fever reported The average population in 1847, in New Orleans, was 90,000. were for the week ending on the 10th of July, and the number was 5. It continued to increase slowly until the 31st of the same month, when the weekly return was 47. The total of yellow fever for the month of July in that year was 74; of other diseases, 647. form. Eleven persons died of the disease in the 60 hours ending at noon 22d Aug. The sexton reports twelve deaths for the week ending on the 19th, seven from yellow fever, and five from other diseases, which he specifies in his report. Several of the yellow fever cases, says the Courier, were "The disease was pronounced epidemic from abroad, while those said to have orion the 5th of August. The deaths on thatginated there, we believe, without excepday of yellow fever were 17, and from that tion, had no treatment until beyond the time daily returns were published until the control of the physician. 22d October, when the epidemic ceased. In the month of August, the yellow fever deaths amounted to 1057; of other diseases, to 570. In September, the deaths by yellow fever were 986; by other diseases, 468. In Oc-city, and to report any organization they tober, up to the 22d, inclusive, the yellow fever interments were 135, and of other diseases 244; making a total for the season, from the 5th July to the 22d October, 1847, inclusive of 2,252 yellow fever interments, and 1,924 of other diseases; making a total of 4,176. "During 1832, the highest number any one day of yellow fever was 60, and of all cases 80. On the 23d, a meeting of the citizens was held at the City Hall, and a committee of ten was appointed to take into consideration the condition of the sick and the poor in the might deem necessary for the furtherance of this object, to raise the necessary funds for that purpose, and report to an adjourned meeting the next day. The Courier of the 23d apologizes for being compelled to curtail its matter in consequence of the illness of the editor and one of the workmen. On Saturday (August 21) there were six interments; on Sunday, 5; on Monday, 3; and on Tuesday, 3; equal in proportion to "During 1833. the largest mortality any one day was 53-no specification as to dis-present population to one hundred a day in ease. "During 1841, the highest number from yellow fever was 33, and the greatest mortality 60. New Orleans. The disease, however, seems to prove fatal almost entirely among foreigners and others unacclimated, but chiefly among the former, though several "In 1847, the highest number from yellow of our oldest citizens have been seized with fever was, on the 2d September, 77, and of it. Everybody has left town that could, and all diseases 95. but very few are left. Business is at a "In Lafayette, up to the 10th of Septem-dead stand. But two dry goods stores were ber, the yellow fever deaths in 1847 were open on Main street yesterday; most of the 316, and of all other diseases 255. "Up to the present date, the official returns give for the present epidemic season 3,039 deaths from yellow fever, and 1,747 from other diseases; making a total of 4,786 from the 28th day of May to the 10th of August. The daily reporting commenced on the 27th of July. The most fatal day we have yet had was on the 5th instant, when the total deaths were 238, of which 208 were of yellow fever." -- Yellow Fever at Pensacola.-It is stated in a telegraphic dispatch, dated Aug. 31, that yellow fever of a most malignant type is prevailing at Pensacola. Yellow Fever at Natchez.-Yellow fever is now prevailing at Natchez in an epidemic merchants have sought temporary locations in the country and neighbouring villages. A greater panic never occurred before, from a similar cause, among any people. Our streets look desolate, indeed. You may walk for an hour sometimes, and not meet a dozen persons. Weather and Mortality in Philadelphia the city. Our rule is to tarry on the lookin July, 1853.-Several plentiful showers out till the highlands which border the westearly in the month, relieved, in this vicinity, ern bank of the Schuylkill are shut out; the drought which prevailed extensively at till the river (about a mile distant) and Fairthe time of our last report. Later in the mount itself are hid, and then hasten down month, rains were so abundant as to endan- to give warning to close doors, windows, ger disease, it was thought, in the growing and shutters. With this precaution, so crop of potatoes. The whole fall of rain dense is the gale with almost impalpable for the month, as recorded at the Pennsyl- limestone dust, that not a naked polished vania Hospital, was 6.29 inches. surface in our dwellings but exhibits a greater or less deposit when the gale is passed; and, from the same cause, the breathings of those exposed to the blast is impeded. Everyone seeks a retreat; even the pigs, when they tenanted our streets, would run squealing to their sties, and pigeons fly wildly to their cots. The severity of the gale las's, ordinarily, not more than ten to twenty minutes, and the dustcloud has passed over in five to ten minutes. The mean temperature of the month was 77.14 degrees, which is about 2 degrees above the average mean of many years, and very nearly corresponds with the mean temperature of the same month for the two preceding years. The morning of the first was calm, with the mercury at 77, which rose to 93 at 2 P. M., with a light air from the south east. At Wilmington, Delaware, The afternoon was nearly clear, and the heat very oppressive, till near six o'clock, The gust of the first instant was attended when one of those gusts or wind-squalls so with thunder, but was without rain or hail, common in this vicinity after a very warm and was not unusual in severity or duration day, sprang up from the north-west. These in this city; yet in New York city the hailsqualls come over us very suddenly, are storm and tempest were violent and degenerally attended with thunder and light-structive. ning, and frequently with a shower of rain, buildings were injured and trees uprooted. often light, sometimes copious. These tornadoes are characterized, in the vicinity of the city, by one phenomenon which is believed to be somewhat peculiar to this locality, viz., a dark cloud of dust from the limestone covering of the turnpikes and other well-travelled roads that converge towards the city from the north and west. From this material a very light dust is formed, which rests upon the road. in dry and still weather, to the depth of one and sometimes two inches, and will hover over the shoe of a pedestrian like the lightest snow in winter. The approach of one of these tornadoes is known by a dense, murky cloud, seen to rise hurriedly from the north-west, and often, when formerly this meteor possessed more of novelty to the writer than now, he has hastened on these occasions to the house-top, to witness its progress. The remote hills and woodlands west of the Schuylkill River would, one by one, be shut from view, as perfectly as by the most dense fog, as the tempest advanced. Often have we seen many miles of country thus veiled in a surprisingly short space of time, as the storm seemed to skip from hill to hill, and from ridge to ridge, in its progress towards So in the neighbouring counties of Bucks, Montgomery, and Berks, the storm raged with great violence, injuring chiefly standing crops and orchards. Hailstones, near Shoemakerstown, completely perforated the canvass top of a carriage, and the driver of a mail-coach says the hail drew blood from his horses. In Doylestown, Bucks County, the hail is said to have been three inches in circumference. But what gives more especial interest to the tornado of the first, is the fact that its severity has caused time and place to be published in so many instances to enable us to mark its course and the rate of progress; thus, it passed over Northumberland County about 3 P. M., and over Doylestown, which is 160 miles distant in a south-east direction, at 5 P. M., travelling from the north-west 80 miles an hour, or nearly at a hurricane speed, which is 90 miles an hour. The range of the thermometer was between 65, on the morning of the 28th, and 95, on the afternoon of the 9th, or 30 degrees. The weekly mortality for the five weeks embraced in the month was rather high, ranging from 205 for the first week, to 265 for the last, and showing an aggregate mor * This observation was at 1 P. M., or the maximum; at 2 P. M. it had fallen 10 degrees. Medical Department of Yale College. Dr. ELI IVES has resigned the chair of Materia Medica, and Prof. SILLIMAN that of Chemistry, in this institution. Dr. HENRY BRONSON has been appointed the successor of Dr. Ives, and Dr. B. SILLIMAN, Jr., has been elected to the chair so long and ably filled by his father. the purpose, makes the following record of its sentiments on the occasion of the death of Dr. Nathaniel Chapman, Senior Fellow of the College: The fulness of years and failing health of Dr. Chapman, and his consequent withdrawal from the active discharge of his professional and social duties, gave, like the twilight that precedes the gloom of night, unmistakable notice of his approaching departure. The melancholy event thus anticipated has occurred; and this College now mourns the loss of its venerated and oldest memberStated Meeting, August 3, 1853. of him, in whom was blended the skilful The College of Physicians of Philadelphysician with the kind friend, the instruc phia, through its Committee, Drs. Bell, tive writer, and the lucid and emphatic Ruschenberger, and West, appointed for teacher, with the paternal adviser. Proceedings of the College of Physicians, of Philadelphia, in reference to the Death of Dr. Chapman. Chamber of the College of Physicians, |