Savannah morning news. [volume] (Savannah) 1868-1887, 1881-12-01

pital was 1SO OF these IO7 recovered and 5.
died. this number being 1859 per cent OF
deaths, or one in six.
The greater mortality at the hospital NAV be
accounted for by the fact that many were
brought there in dying condition, and some
died on the way to the hospital.
l am indebted to DIR. Walter A. Dunn, interre
to the Cincinnati Hospital for the following
facts in reference to the symptoms and treat
ment or cases that occurred in that institu-
tion:
Table showing the number of cases admitted
into the Cincinnati Hospital, together with re-
suit OF treatment, condition, color, etc:
Number Of cases, 100; in six cases insanity
Followed; number recovered, 107; number died,
%; number unconscious, 35; number tempera-
ture range above los, 16; above 107, 9; col0red,
4; white, 1875; post mortems, 0; couldn't obtain
consent of friends in time number pulse above
l2O, AZ; opistholonos convulsions, 3; two recov-
ered; number dllated pupils, 81; number con-
trActed pupils, a.
The following is the clinical history of three
typical cases showing the difference in the
symptoms and course of the disease:
Case No. Julia H; June 10th, 1881; age As
born in Ireland; single; occupation laundress;
drinker.
Previous history-She is very poorly devel-
oped and nourished blue eyes; light gray
hair; contracted face and features; face Gov
cred with lines and wrinkles. She is much de-
bilitated by her bad habits and the discharge
from an ulcer on the right leg.
the anterior and lateral surfaces of the right
leg, about five inches above the ankle. Tho
ulcer is about four inches in diameter and Is
filed with poor bfueish granulations. This ulcer
began about ten years ago, and has continued
ever since, becoming better when she laid up
and had it treated in the hospital. Twice dur
ing this period of ten years the ulcer almost
healed and she never stayed long enough TO
have it completely healed. Ordered tiaxseed
poultice.
June 18th The discharge is greater and
consists of healthy pus. The granulations are
becoming redder and more active, and are
springing up from the floor of the ulcer.
July 7.-The granulations looked very
healthy. Skin grating was advised at
this time. She refusing that treatment, was
discharged from the house.
Diagnosis: Ulcer Of the leg. Condition i'm
proved.
July 13-She was admitted in the morning.
very profoundly unconscious; eyes were roll
ed up; pupils dilated head thrown back;
mouth widely opened
Respirations were short, very slow and gasp
ing, with apparently some obstruction about
mittent, 1-15; could not be felt at all at the
wrist Te nperature 106. Involuntary evacu-
ations of faces had occurred some time be-
fore; she had a black eye on right side; no
other bruises were noted.
Treatment mediately)-Hypodermic Digi-
taline, 100 gr. This stopped the intermittent
character of the pulse very soon, but did not
lessen the frequency nor appreciably increase
bath of hydrant water, and had ice cups ap-
piled to her head, and cold water poured on
her head from a height, while in the tub; she
was given hypodermic injections, 100 gr.
ammonia. aSnDp1nii a and 10 N. saiphuric ether, '
all without any effect upon either the pulse or
respiration. The temperature fell to SO and
she was removed and placed on a stretcher.
Pulse 168, respiration gasping, though possibly
a little deeper and more frequent. lnhalations
of ether were then given, endeavoring only to
get the stimulating effects. The reSpirations
almost Immediately became fuller, Ion GER,
stronger and slower, inhalations stopped, a
few minutes after she returned to her old con-
dition same as on entering, temperature alone
remaining down. InhaIations were again tried
with q result similar to before, consciousness
did not return. When respiration became
quiet again, was sent from the accident ward to
the medical ward. The same symptoms. that
of very difficult respiration, again manifested
ether. This symptom returned again and
again, and was controlled each time in the
same manner. The temperature remained at
the normal, but the heart began to fail and
would not respond to any Of the agents en-
ployed hypodermically. Death resulted about
eight hours after. No autopsy.
Case No. 2. Mike B., July 2, 1881, M; was
admitted about midnight July 12; he was
brought from Hammond Street Police Station;
had been there some time before the ambu-
lance could be got there. His condition was so
bad that the officers thought it was not worth
while to take him to the hospital, as he would
surely die on the way. On admission his Eulse
was us and very weak; temperature 105; pupils
he breathed with the greatest diff
dcultY: convulsions were coming on at inter
vals of a few minutes and we're marked by
Opisthotonos; lividity of face; frothing at
mouth and tonic contraction OF muscles involv-
ing more especially the upper extremity, and
especially dangerous affecting the muscles
Of respiration.
The sphincter ani-muscles were relaxed and
involuntary excavations Of faces had oc-
CURED; was given hypodermic injections of
jigitaline, atropia, ether and alcohol in rapid
succession. without any material effect: his
increased and the pulse rose
Cold was applied and this seemed to induce
the commissions more frequently; the pulse be-
came very rapid, could just be felt at femoral
artery, and rose to 230 per minute.
Thinking the mans condition could not be
made worse, go minimS of aqua ammonia
were given hypodermically. Immediate effect
was noted. The heart responded, and in FIVE
minutes beat 140, with fair strength. Ether
was next required, viz to quiet the convul-
sions and was repeated as often as the convul
sions returned.
About a. m. he was sent to the ward, ard
5he ether was continued whenever the convul-
sions returned.
He became better gradually and was rational
10 the morning..
July 15th.-Abscesses developed where the
had been injected. They were
opened, and large quantity of pas escaped.
He became stupid and lost all reason about
this time, and appeared 'idiotic." The alb
scesses were dressed daily, but he grew weaker
and worse and died in two weeks afterward
On August 4th, of septicemia
July 13, 1SS1.-CaSe No. 3, DOC" NJ, aged g.
When admitted was unconscious; pupils 0i-
lated: pulse u and weak; temperature SO.
Had been treated before his admission
BE was sent to the medical ward from the
accident ward. On his arrival there, it was
found that his temperature had risen to 106;
pulse quite rapid and weak; sterterous breath
ing; contracted pupils; profound unconscious
ness. His temperature was reduced by cold,
StimulantS were administered podermically.
He remained unconscious for day or two
This was followed by delrium, which In turn
for few days, and then he ap-
peared to be rational, though he was highiy
at times. day or two later he sat up and
was much better. A week after he was walk
ing about the ward In the meantime it was
that he took outside about an ounce
of morphia every week, and was a hard
drinker. A day or two later no had nervous
attacks, a general tremulous' condition of all
the muscles OF the body, with sleeplessness,
and easy fatigue and unstea0ineSs OF speech.
Thinking this was in a measure due TO
the sudden withdrawal of the whisky and
morphine, to which he had been accustomed,
At this time he was quite rational, but refused
to take the morphia absolutely, saying he
wanted to break off the habit.
July 24.-He was about the ward apparently
rational, and gave material and intelligent as
sistance to the interne in treating cases In
cined to refuse all medicine offered, he dis
played great deal of ingenuity in getting him
to take it. His condition was about the same
from day to day.
August 6-Nearly four weeks after adnis-
sion, while talking to him, the inferno dis
covered that he had just begun to recollect
things. He had never heard of the man with
whom he had displayed so much ingenuity in
getting to take medicine; did not know he
had been sick himself; in short, this whole
period of some three weeks and more was a
He recovered fully and was discharged
well.
sunstrokes can very appropriately be
arranged into three varieties:
l. Class Marked congestion of brain, de-
noted by contracted pupils, Inconsistencies,
full, rapid, bounding. incompressible pulse;
high temperature and congestion of surface,
well marked in the upper extremi
ties and head and neck; great difficulty of
respiration and at times commissions. In these
cases the heats action was reduced when the
was reduced.
II. Glass. Partaze of the nature OF the
frst with the symptom added OF great en-
feeblement or depression OF the hearts action,
instead of increased action Of the heart-in
other words. the hearts action is changed,
possibly by involvement of the cardioinhibi-
tory centre.
Ill Glass. Cases of profound depression,
where the patients lie unconscious, dilated
pupllS, pal6 face ana Ups, puISeleSS at the
wrist, very feeble and rapid action of the
heart, shallow and insufficient respiration, and
often after return of consciousness still retain
a weak and rapid pulse and general en-
feebled condition of vital force, IS shown by
effort, weak stomach, etc.
Condition Of case considered in reference to
treatment;
1t VIII be noticed that the three classes Of
cases are marked by a great difference of the
and that the treatment varies with
the symptoms. In other words, no set line Of
treatment for sunstroke can be laid down"
4raa fo a1xyO orfra md