DR. STRONG reported a case of rubeola with hæmatemesis preceding the eruption. The hæmorrhage was arrested with per sulph. ferri, and the case resulted favorably.

Miscellaneous business being in order,

DR. ROCHESTER read a communication from the Council of Hygiene and Public Health, of New York city, asking the profession of this city to take such action as may seem most judicious for the prevention of epidemic cholera if it shall prevail here at any time in the future.

After considerable discussion upon this subject and the means to be adopted for carrying forward preventive measures, Dr. Rochester offered the following, which was unanimously adopted:

Resolved, That every member of the regular profession, resident in Buffalo and vicinity, is earnestly invited to be present at the rooms of the Buffalo Medical Association on Tuesday, February 13, 1866, at 7 o'clock P. M. to take action respecting the sanitary measures proper to be instituted for the welfare and protection of our citizens during the ensuing summer.

DR. BOARDMAN made the following report of the soldiers received into and treated either medically or surgically at the Buffalo Hospital of the Sisters of Charity, compiled by M. Picket, remarking that he believed that the results of treatment in that institution had been very favorable:

Whole number received from June 30th, 1864 to August 31st, 1865-14 months. Whole number of surgical cases 186; whole number of medical cases 177; total 363; 74 had chronic diarrhœa; deaths from surgical cases 4; chronic diarrhoea 3; small pox 1; other medical diseases 3; total 11; whole number returned to duty 125; discharged or mustered out of service 123; transferred to other hospitals 51; reported deserted, but of whom many returned and were afterwards honorably mustered out 53; not accounted for 11. About twenty of these were sent to the front, and were a second time sent to this hospital on account of some medical or surgical disease contracted since their first discharge from this institution.

DR. STRONG remarked that he believed that the cases mentioned above were, with but few exceptions, mild-not severely sick-and that the good results reported were to be expected.

DR. BOARDMAN said that many of the cases were very severe, and regards the results as very flattering.

DR. GAY concurs in Dr. Boardman's statements.

Report on prevailing diseases being called for variola and variolid were reported as prevailing.

Adjourned.

THOS. M. JOHNSON, Sec'y.

ART. III-Eclampsia-Poisoning by Opium. BY M. W. TOWNSEND.

At 9 P. M., November 30th, 1865, I saw Mrs. M. S., aged 20, in her first pregnancy, at the sixth month. Dr. J. O. Loomis, a stranger to me, was in attendance. The patient was a very anæmic lady, who had had for the preceding few days oedema of the extremities, face and eyelids, a scanty renal secretion, and a distressing headache. I learned that at about 5 P. M. she had been convulsed, and that three or four convulsions occurred previous to my visit, for which she had been treated with saline enema. The urine, drawn by catheter, yielded under tests an extraordinary amount of albumen. No signs of uterine action.

Induction of labor and the exhibition of chloroform were advised on the grounds that the case was one of uræmic poisoning, dependent on passive congestion of the kidneys, which was the result of the pressure of a gravid uterus; that although there might be great hope for fœtus and mother, in a case of hysterical or epileptical convulsions, or in convulsions of reflex origin, there could be none for a fœtus of six months in uræmic poisoning, and little for the mother, unless promptly delivered; in which event, according to M. Blot, Herr Braun and others, we might expect the kidney to recover its elimination of urea-that chloroform meantime would control the convulsions and nullify the reflex disturbance attending delivery.

The attendant physician objected to the advice, and proposed to "leave her to the 'vis medicatrix naturæ' of Cullen!" Other advice was sought of Drs. Horace Clark and J. W. Craig, and under the advice of the former the membranes were punctured and a large amount of amniotic liquor was discharged. One hour after, patient being under the influence of chloroform, no evidence of uterine action. At midnight, Dr. Craig arriving, another examination was made, revealing evidence of labor-pains; os uteri patu

lous, and readily admitting the index and easily yielding to a second finger; it was determined that an effort at delivery should be made. Fortunately the left foot of the foetus was within the grasp of the two fingers used as forcep blades, and was readily brought down, followed by the right foot and pelvis. The patient was delivered without violence or undue effort, of both child and placenta. Chloroform was used occasionally during this procedure, and afterward, immediately upon indications of an impending paroxysm, and kept up only so far as to cause the premonitory symptoms of the paroxysm to disappear.

After delivery an enema was given and the bowels moved freely; a small quantity of stimulus was given and ordered to be repeated according to the discretion of the attending physician. Acetate of potassa grs. xx, in spts. nire. 3j, once in four hours, and fluid food a teaspoonful once in two hours, completed the prescriptions.

During the day-December 1st-patient recovered consciousness, swallowed readily, talked of her sickness, and when not disturbed slept quietly. In the evening Dr. Craig used catheter and left patient sleeping. No appearance of coma.

December 2d, 7 A. M. Dr. Craig saw patient; remarked more restlessness, and left a small anodyne powder which was administered. At 10 A. M. I saw her, and there being considerable restlessness gave the attending physician three powders of one-sixth grain each of morphia, and advised him to administer one every four hours, as long as indications for use of morphia lasted, and no longer. At this visit the patient's appearance was favorable, as evidenced by the regular respiration, the good character of the circulation, and the voiding of eight or ten ounces of urine by catheter, which, when tested, yielded a much diminished quantity of albumen according to volume.

At 10 P. M. I found Mrs. S. comatose, would open the eyes when called, and when roused thoroughly answered a few questions and recognized her friends; pupils were contracted to the last possible degree; pulse small, not very much diminished in frequency; respirations infrequent, and when allowed to rest a moment would almost cease, but when shaken or spoken to in a loud tone more frequent for three or four moments; skin moist, cold and pale; catheter used and a full pint of urine voided.

In

a few minutes voluntary respiration ceased. Resort was had to Marshal Hall's method, and by it respiration was sustained for five hours. At times she respired voluntarily, and a marked improvement was noticed a half hour after the alternate, prone and supine positions of the body were commenced.

The character of the coma, the fact that she could be roused to consciousness when I first saw her, the condition of her pupils, the fact that she was kept alive for five hours by artificial respiration, her condition at the exhibition of the last powder, show the case to be one of poisoning by morphia.

That the uræmic intoxication made her more susceptible to the power of opium might not be denied, but that it was not the cause of death is evidenced by the free secretion of urine, her recovery from uræmic coma more than twenty-four hours before, the absence of the convulsions, the sudden invasion of the coma, and the almost entire absence of the general indications of uræmia. To attribute to chloroform any share of the result would be gratuitous, as the article had not been used for about thirty hours.

It is proper in this connection to say, that an emetic course at 10 o'clock P. M. was entirely out of question, impossible; there was scarcely any excito-motor power when I first saw her at my last visit. The morphia had been given rather more than two hours before, in solution.

I wish to mention also, that during the past year I saw a case of poisoning by opium-a half ounce of laudanum having been given per anum, which was saved by Hall's method. Respiration had ceased, the pulse was barely perceptible, but a resort to artificial respiration commenced seven hours after the enema, and after all else bad been tried resulted in recovery from the effects of the poison, although it was six hours before the patient could be trusted to voluntary breathing.

At the Students' Medical Society at Edinburgh much discussion has occurred of the results of acupressure. It is stated that Prof. Syme will try the method of temporary ligature, described by Mr. Churchill in a recent number of the London Lancet.

Whether Cholera is Contagious.

[Communicatel for the Boston Medical and Surgical Journal.]

BY JACOB BIGELOW, M. D.

Within the present century, cholera, a disease indigenous in hot climates of the East, has, at various intervals, made its appearance in the temperate latitudes of Europe and America. It is now again exciting interest fro n its possible and perhaps probable approach to this country.

The experience of the last thirty or forty years has led a majority of medical men who have observed the disease to believe that, as a general law, it is not contagious. In this belief I must individually remain, until evidence more satisfactory than any which has yet appeared shall justify an opposite conviction.

The great epidemics of 1830 and 1847 had a remarkable coincidence in the path wfiich they pursued, and in the order and dates of their arrival in different cities. They seem to have followed certain great routes of travel, and to have avoided others equally frequented. According to Leségue, they both visited consecutively, and in corresponding months, Tiflis, Astrachan, Moscow, Petersburg and Berlin. In 1831, cholera did not take the most frequented route from Berlin to Paris, but passed along the shores of the Baltic, crossed over to Sunderland, went down to London, and again crossed the channel and arrived in Paris about six months after its appearance at Berlin. A disease propagated by contagion of any kind would hardly have avoided the most frequented thoroughfares from Berlin to Paris, while it occupied half a year in going round by England.

The epidemic now or lately prevailing in Europe appears to date back at least nine months, at which time it existed among the caravans of pilgrims visiting or returning from the city of Mecca. In the middle of May last it was at Alexandria and Cairo, in June at Constantinople, Ancona and Marseilles, and in November at Paris, Havre and other European cities.

Thus it appears that cholera has now existed in Europe from three to eight months, among cities having constant commercial intercourse with seaports of the United States, during which time thousands of passengers and tens of thousands of bales and packages have been landed in our maritime cities. If cholera were as

VOL. 5, NOS. 8 & 9-42.