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

1
| ministration OF ether, enough to get the cere-
| bral centres quieted, yet not enough to pro-
/ duce depression In them.
4. Respirations were stimulated bv ether
| and atropia hypodermicallY, using is NJ ether
/ and lao to 1-120 gr. atropia.
5. Pulse and heart Failure of the heart In
/ both "anaemic" and congestion" varieties
was most alarming symptom. Intermittent
action of the heart was controlled by dfgitalis
| or by digitaline. The force of the heart was
| sometimes increased by it. The other arenta
used in stimulating the heart were whisky
ether. atropia and aqua ammonia.
8. In the marked cases of the congestIve
variety hot water treatment was tried, baths
of temperature of 10, and patient immersed,
with his head surrounded by ice caps, and
with cold water poured on it, with the view of
increasing the capillary circulation of the body
and thereby decreasing the amount of blood
going to the head. In all cases where this was
tried it was unsuccessful
Modes of administration and ways Of reduc-
ing the temperatures:
Reducing Temperature. In all cases where
the temperature was 10s deg. or below, spong-
ing the naked body, first with tepid water and
afterward with successfully colder and colder
water, advancing by few degrees each time,
way.
Above i02 deg. baths cooled from s5 deg. to
80 deg, with careful watching, seemed the best,
although circumstances required us to resort
to ''cold packs" A sheet closely tucked over
the naked body, and using hydrant water at
first and in cases of persistent high tempera-
ture finally resortipg to colder aud colder
water until you reach ice water. In all cases
the heads were covered and surrounded bv ice
caps and bladders filled with ice.
AS regards Administration of Remedies
The order to which preference should be given
is about as follows, though We were guided by
the effects obtained: First, by mouth; second,
by rectum; third, by hypodermic; fourth, by
inhalation.
we're cases inconsistencies. commissions,
vomiting, or other difficulties, made
the administration by the mouth diff
cult and tedious, when rapidity was neces-
sary, and in other cases where the stomach was
overloaded with beer, etc, vomiting followed,
so that so much time aud medicine was lost.
Again, In greatly Frustrated cases, with very
weak and rapid pulse, absorption, or the effect
as noted from the medicine was slow in CON-
ing. Still, in certain cases where rapidity was
not desired, and when it could be used, it was
found to be easy and undoubtedly proper, and
in case the action is not sufficient, other means
can be resorted to.
Rectum-Many severe cases had relaxed
sphincter and others had diarrhoea and invol-
untary discharge of faces. In all cases of this
kind the methods of administration by rectum
had to be abandoned for others. Whisky, warm
beef-tea, tincture of digitalis and carbonate of
ammonia were used and the effect appeared to
be better and more rapid than when adminis-
tered by the mouth, and suitable to cases
where, for other reasons, the stomach could
not be reached.
yHypodermic. cases where rapid &C.
ton is necessary, and where other means
fail, this can be used by combining
a number OF different agents. You
can undoubtedly get larger amount of stimu-
lation than by any other agent, and with much
less danger OF producing bad effects from too
much of a single remedy.
Digitaline for the heart when intermittent
Ergotine for contraction of the capillaries.
Atropia for stimulating heart and respiratory
centres.
Whisky and aqua ammonia and ether for
stimulating effect on the heart
you choose the one best adapted to your symp-
toms. IL you do not get good and rapid
effect try the others; and when death seems
inevitable 'heroic treatment by hypodermic
injections of aqua ammonia, as in case No. 2,
Mike B., is justifiable and right. Experience
seems to show US that deep injections of aqua
ammonia, diluted one-fifth, do not often pro-
duce an abscess. You can use alcohol or water
for diluting it.
AMOUNT OR DOSES ADMINISTERED.
l. Ammonia carbonate. 20 gr., repeat hr.
2 Whisky, 11e OF and repeat p. +. n
3. Tinct digitalis. 1920 gifts. repeat p. r. n.
4 Digitaline ghypodermic), l-2O 100.
5. Ether, 10 20 NJ.
6. Aqua ammonia, 10-60M
z. Whisky (hypodermic), D. r. n.
We found you could not adhere to anv estah-
llshed doses, and in all cases were guided in
frequency of administration and amounts
given by the effects produced.
z. Ether administered by inhalatiops pro-
duced three effects not all noted in the same
case.
1st. Sometimes stimulated pulse, and it be-
came stronger and less frequent. ID Made
respiration easier and deeper, and Sd, quieted
convulsions.
Tie next paper announced in order was
by Dr. j. f. Adams, of Massachusetts,, but
In the absence of that gentleman It was read
by the Secretary, Dr.. Azel Ames. It was as
follows, on the subject Of
MALARIA IN NEW ENGLAND.
year ago, at the request of the State Roar
of Health IUnacV and Cha ritxy Of AToeo, -,
setts, the writer of this paper made an invests
CATION of the recent appearance of intermit-
tent fever in that State, the results Of which
have just been published in the supplementary
report of the board. The Investigation involv-
ed, OF necessity, an extension of the inquiry
into the other New England States, especially
Connecticut; In the present paper the results
Will be briefly summarized, and the bearings
of the observed phenomena upon the nlalarial
problem, stated as succinctly as possible.
The following points will be considered in or
der:
1st. The periods when malaria has been pres
ent in New England.
I'd. The nature Of the localities visited.
3D. The rate of progress of the malarial
4th. The subsistence Of typhoid fever coincf-
dent with the appearance of malaria.
9Th. The bearings of the facts observed upon
the etiology of malaria,
FIRsT-THE PERIODS OF PREVALENCE.
To the present generation of New Tngla nd
ers, malarial fevers of home origin have
been, until quite recently wholly nm
known. The whole literature of the sub
ject prior to the present epidemic is Comprised
in monograph by DR. Oliver Wendell Holmes
published in 1896. The malarial fevers have
never been truly endemic in New England. but
have been occasional visitants, taking the form
OF epidemics Of few years duration. When
that portion of the country was first settled
fever and ague was one of the common dis
eases, being apparently incident to the clear
ing of of the forest. The accounts Of it. which
are very incomplete, and chiefly from nom
medical sources, make no mention of it subse-
quent to the latter part of the seventeenth CEN
tury, and from this time onward for a hum
dred years, namely: until the latter
land enjoyed complete immunity from this
disease. In 1898, however, intermittent fever
reappeared, and, together with remittent
Iever and epidemic dysentery, prevailed in
necticut and Massachusetts, until 1893, when it
vanished, and did not again appear until 1928
except in single locality, namely, Sheffield,
Mass, where it seemed to have obtained q foot
hold, for outbreaks occurred three times durine.
this interval in the years 1906, 1910 and 1900
From 1928 to 1886 was the next Period of gene.
RAJ prevalence, the same portions of
the country being affected as in the
previous visitation. From 1886 to 1850
no cases occurred, so far as can be
learned in any portion Of New England But
in the latter year, 1850 few cases began to
appear in a swampy locality near New Haven
From this time to 1854 cases continued to ap-
pear there and at several other points on the
shore or Long Island Sound between New Ha-
ven and the boundary of New York Having
established itself upon this base malaria he
gan, in 1854, a northward invasion, following
the rivers in the western half OF Connecticut,
reaching the Massachusetts line in 1877, and, In
the next three years, penetrating almost to the
northern border of that State Since the be-
ginning or this invasion malaria has
not disappeared from any locality where
1t has once obtained footing
so that it has now prevailed continuously on
the Southern shore of Connecticut for thirty
one years. In the centre of that State for ten
years, and in Massachusetts for four years In
the localities where it first appeared in Con-
necticuty however, it is said that its influence
appears to be on the wane.
No other New England State has vet lheeu
visited except Rhode Island, the first cases
Ia that State having occusred near
east Of the towns bordering the
Connecticut river, remaired up to last winter
free from the malarial fevers, the cases being
limited to the western half Of the State, the
great bulk OF them being in the counties of
and hampshire. and most of the re-
malnder IA few scattered localities in Berk-
shire. OF the cases reported in 1880, 1874 oc-
CURED IN Hampton county. $50 in Hampshire
and 257 in Berkshire, Only five cases were re-
ported in Franklin county, so that the north
ern boundary of Hampshire county, thirty
miles north OF the boundary Of Connecticut,
may be stated as practically the northern limit
CT malaria In the Connecticut valley. Ia Berk-
shire county no considerable number of cases
has occurred ia any one locality north of New
Lenox, which is twenty-five miles from the
Connecticut line. The places report
are in Hampden county, Spriuefield-
West Springfield. Chiconaa opd IJosS,a1-o'