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¶ 1 Leave a comment on paragraph 1 0 ARMY MEDICAL REPORTS.
¶ 2 Leave a comment on paragraph 2 0 339
¶ 3 Leave a comment on paragraph 3 0 ORIGINAL COMMUNICATIONS.
¶ 4 Leave a comment on paragraph 4 0 ARMY MEDICAL REPORTS
¶ 5 Leave a comment on paragraph 5 0 No. XIX.
¶ 6 Leave a comment on paragraph 6 0 (SELECTED WITH PERMISSION OF THE DIRECTOR-GENERAL, FROM DOCUMENTS IN THE OFFICE OF THE ARMY MEDICAL DEPARTMENT.)
¶ 7 Leave a comment on paragraph 7 0 extracts from a report
¶ 8 Leave a comment on paragraph 8 1 ON THE TOPOGRAPHY AND DISEASES OF THE TURCO-DANUBIAN PROVINCES.
¶ 9 Leave a comment on paragraph 9 1 By DAVID DUMBRECK, M.D.
¶ 10 Leave a comment on paragraph 10 0 Deputy Inspector-General of Hospitals.
¶ 11 Leave a comment on paragraph 11 0 Diseases of the Provinces.—I found, on minute and incessant inquiry everywhere, that intermittent fever, with its sequelae, and dysentery, are the most prominent maladies of the countries visited. The information, however, to be derived from local sources is extremely meagre and unsatisfactory. There are literally no Medical men in Bulgaria except those employed in the Turkish Army. In Servia there are District Surgeons appointed; but, from Widdin, throughout Bulgaria, on to the Southern Slope of the Balkan, there is only one resident Medical man—the Prussian Consul at Rustchuck; and his information was entirely at variance with what I derived from better sources. Information is, therefore, extracted with difficulty. The Chiefmen, the local Governors of (towns, are rather disposed to laud the salubrity of their places of residence. Of intelligent inhabitants the number is extremely limited; therefore, the aspect of the country, the appearance of the people, the account they themselves give of their ailments, are often the only means by which the actual sanitary state of the countryman be arrived at, at least by a mere passing traveller through these provinces. From these circumstances, therefore, without a prolonged residence and an opportunity of seeing the diseases as they present themselves, any account of them must be meagre, and less satisfactory than if detailed from the. observer’s own actual experience.
¶ 12 Leave a comment on paragraph 12 0 FEBRIS INTERMITTENS.
¶ 13 Leave a comment on paragraph 13 0 I have said that this disease is that which reigns dominant in the Danubian Provinces in the spring and autumn. I could hear of no form of fever which I could identify with the remittent. I hear of its existence in some parts of Roumelia, but not in the route traversed by me, though I think it highly probable that it may be found in such a country and climate.
¶ 14 Leave a comment on paragraph 14 1 In April, when evaporation commences, we have the spring fevers, generally of the tertian type; these yield readily to the employment of quinine pushed to cinchonism ; and, unless ne- glected, they are rarely obstinate, or lay the foundation of organic complaints; this is a general rule; but there are exceptional years, and instances when the tertians are of great severity, running into double tertians, etc. In Belgrade, in 1853, this form of disease prevailed much among all classes, particularly affecting those living low down near the Save. Among the troops of the Turkish garrison, in the early summer, as many as 80 cases out of a strength of 2000 were sufferers at one time from this ailment. I have said it was Of the tertian and double tertian form, that is, the paroxysm of the interposed day was obviously milder, and with a different hour of Digression from that recurring at intervals of forty-eight hours; occasionally double paroxysms occurring on the same day were observed, and the disease, when successfully treated, as far as checking the paroxysmal attacks went, was in about a fifth of the cases followed by general anasarca. This complication did not prove obstinate; yielding to the use of hydragogues, cathartics, and diuretics ; and when the oedema of the lower limbs lingered, the use of baths of hot sand proved of the greatest value, and always removed the affection.
¶ 15 Leave a comment on paragraph 15 1 After the febrile attacks are checked, the use of quinine in diminished doses is judiciously continued for seven or eight days after the seeming cure. During this period of convalescence, the spine is to be carefully examined, and if any tendernesses found to exist there, or if even uneasiness in the course of the dorsal vertebrae is complained of, there is risk of relapse. This tenderness, arising from hyperaemia of the spinal column, from about the third to the ninth vertebrae, is nearly an invariable concomitant of periodic fever here, and it must be watched and treated. The application of leeches—plenty in the Danubian provinces—dry cupping, scarifications, sinapisms, and blisters, are all used to relieve this state, while the use of quinine is coincident with the local remedies.
¶ 16 Leave a comment on paragraph 16 1 Enlarged spleen and induration of the liver are very frequent in neglected or mistreated cases; the former of these affections is of constant occurrence, and the organ attains an enormous bulk. One of these cases I saw. This complication does not prove obstinate in treatment; half-a-drachm of strong mercurial ointment rubbed over the region of the spleen once or twice a-day, and the internal administration of quinine, are the means most successfully employed.
¶ 17 Leave a comment on paragraph 17 1 The quotidian variety, of intermittent, for the most part of autumnal occurrence, is of a more, intractable nature; and its consequences are, that, it occasionally becomes continued, running into a nervo-typhoid form, and terminating fatally. Dysentery is a frequent follower of this type of
¶ 18 Leave a comment on paragraph 18 0 The quartans are apt to be prolonged and obstinate, and these resist the action of quinine in many instances. The following combination is Well spoken of in some of the obstinate forms of this type: –
¶ 19 Leave a comment on paragraph 19 0 R Sulph. quininae gr. xx., prussiat. ferri gr. vi., acet. morphiae gr. 1/4, sacchar. alb. 3j.
¶ 20 Leave a comment on paragraph 20 0 M. Divide in ten doses; one every hour.
¶ 21 Leave a comment on paragraph 21 0 Fowler’s solution of arsenic is the remedy most trusted when quinine fails; and occasionally the white oxide of arsenic, the fourth of a grain divided into twelve doses, one of these to be taken every hour, is said to have proved efficacious When other means have failed.
¶ 22 Leave a comment on paragraph 22 0 In a very obstinate form of intermittent, which had its origin in these countries, and which baffled every remedy; which had, as a distressing concomitant, periodic <neuralgic pains of the severest character, the patient, after everything had foiled, (including change of air from Bosnia to Roumelia,) was effectually cured by the nauseating influence of tartar emetic kept up for a week, as much as the stomach would bear, without vomiting being induced; and the cure was complete.
¶ 23 Leave a comment on paragraph 23 0 DYSENTERY
¶ 24 Leave a comment on paragraph 24 0 is frequent as an uncomplicated affection, and is a sequence of fever. The phenomena of the disease, or its treatment, have nothing novel in them. Leeches applied to the arms are much relied on. The injection of iced water, in acute forms of the disease, and the use of the solution of nitrate of silver in the same manner in its chronic state, are practised. Salicine, twelve grains in twenty-four hours, is said to have been highly useful in the chronic forms of the disease.
¶ 25 Leave a comment on paragraph 25 1 Among diseases occurring frequently near the Danube, I may note the presence of the tenia solium, which is extremely common, and, when undetected, is the cause of much obscure ill-health. The following strong decoction of the well-known remedy, the pomegranate, is found rarely to foil in inducing the speedy expulsion of the parasite.
¶ 26 Leave a comment on paragraph 26 0 Rad. pun. granatae 3iis.; water a pint, boiled down to half a pint.
¶ 27 Leave a comment on paragraph 27 0 This at one dose. After three hours, an ounce of castor oil is taken, and the effect is as I have said above.
¶ 28 Leave a comment on paragraph 28 0 [To be continued.]
¶ 29 Leave a comment on paragraph 29 0 CASES OF CHOLERA, WITH OBSERVATIONS.
¶ 30 Leave a comment on paragraph 30 0 By F. A. BULLEY, Esq., F.R.C.S.
¶ 31 Leave a comment on paragraph 31 0 Surgeon to the Royal Berkshire Hospital, Reading.
¶ 32 Leave a comment on paragraph 32 0 Case 1.—Intense choleraic spasm of the extremities and abdomen following the cessation of a pre-existing diarrhoea; great reduction of the temperature of the body; treated by hot-water applications; recovery.
Tucro-Danubian Provinces: Located by the Danube river. The Danube is the second largest river of Europe and the most important one in Central-East Europe.