Pg. 347

¶ 1 Leave a comment on paragraph 1 0 CHOLERA CORRESPONDENCE.

¶ 2 Leave a comment on paragraph 2 0 347

¶ 3 Leave a comment on paragraph 3 0 The two preceding cases serve well to illustrate the results which may occasionally follow injuries of the head. In some respects they are similar in their nature, in others totally different. In both cases concussion of the brain occurred; in the first, the immediate effects passing off rapidly; in the other, lasting for a longer period. In the first, the re-action probably having something to do with the inflammation of the brain, which subsequently manifested itself; in the latter, the reaction giving rise to scarcely any symptom at all. tn both cases the bone was denuded of its pericranium at the time of the receipt of the injury, varying only in extent of surface; in both cases treatment of an unirritating kind was employed. Thus far the similarity holds; but, when we consider the results, we trace no resemblance. In ope instance, where the injury to the scalp was but slight, and the extent of bone exposed small, we find inflammation of the brain of an insidious kind taking place and terminating fatally; while, in the other, where there was severe injury to the scalp, and a large extent of bone denuded, and where the nutrition which is carried by means of the dura mater was so interfered with, that a large portion of the bone exfoliated, and at one spot throughout its whole thickness, so as to expose that membrane itself, and yet no symptoms of head affection occurred.

¶ 4 Leave a comment on paragraph 4 0 How are we to account for the discrepancy in the results in the two cases? That, in the latter case, the unirritating and simple nature of the treatment adopted had much to do with its favourable termination, was strongly impressed on the minds of all who watched its progress; but yet the treatment in the other case was equally unirritating and simple ; and I think we must rather look to the antecedents of each individual than to the injuries sustained or the treatment adopted, for an explanation of the results that followed. In one instance the patient was in the middle of life, the accident happened while he was in a fit of intoxication, previous habits of drunkenness had undermined his constitution, and the result was fatal. In the other, case, the patient was young, of temperate habits, and the powers  of nature were sufficient to repair the complicated injuries he had sustained.

¶ 5 Leave a comment on paragraph 5 0 SATURDAY, SEPTEMBER 30.

¶ 6 Leave a comment on paragraph 6 0 CHOLERA CORRESPONDENCE.

¶ 7 Leave a comment on paragraph 7 0 As, on board a blazing ship, one can excuse little hurry and confusion, so, in the midst of a raging pestilence, it is not to be wondered at if the laws of logic are somewhat neglected. Were it otherwise, we should be compelled to cry shame upon more than one of those who, during the last few weeks, have spilt ink on the various questions connected with cholera. The zeal of several has far outrun their prudence, and the laudable anxiety to be the first with good news has induced many to make broad statements regarding the, treatment of this fell disease which further examination soon showed to be utterly unsupported by facts. Men love to exert power, and take pleasure in recognising their own influence in the events which surround them. Hence arise innumerable fallacies. We assume hastily that the part we have played has been the all-important one. Our deed turned the scale. It was bur hand which won the victory. We did our best, and it is hard to be told, that, after all, that best was but dust in the balance, and had the least possible influence on the result which ensued.

¶ 8 Leave a comment on paragraph 8 0 There is something in the excitement and alarm which the outbreak of a violent epidemic causes which peculiarly unfits those closely concerned with it for cool reasoning. The effect is a constant one. It has been observed by all the chroniclers of former visitations, and is apparent in no less a degree in the present day. No sooner does the cholera show itself , among us, than the Medical and General Press is at once inundated by letters which agree only in manifesting a spirit of daring defiance of all that Locke and Whateley have taught.

¶ 9 Leave a comment on paragraph 9 0 Reasonings on insufficient data, and reasonings upon no data at all, at once become the order of the day. There is, perhaps, not much to wonder at in this haste. It is, indeed, to a certain extent, excused by circumstances. The public are clamorous to be cured by drugs in which they place implicit faith, and the Profession is naturally anxious to cure by drugs, and to attribute to them whatever benefit may follow their employment. Hence arises ah habitual forgetfulness of the spontaneous tendencies to cure, and bold statements are made as to the anti-  choleraic virtues of remedies at which any tyro might smile. It is often observed that the first Cases in which any therapeutic experiment is tried do well, and that only after some little con- tinuance of the plan failures begin to occur. We are acquainted with an instance, during the former epidemic of cholera, which occurred under the observation of a Physician to one of our largest Hospitals, and which well illustrates the deceptiveness of first conclusions.  A new plan of treatment, in which the exhibition, of nitro-muriatic acid was a chief feature, had been adopted, and no fewer than sixteen consecutive cases of severe cholera recovered under it. The experienced Medical logician declined rushing to print with this cheering piece of experience, and went on with the plan. Of the next sixteen, with one or two exceptions, all died, and further trials made it evident that the first result had been a mere coincidence, and that the plan possessed no superiority whatever over others. Another instance  of remarkable coincidence happened a few years ago at St. Bartholomew’s. Of six consecutive hernia cases, it chanced that in three the bowel was found gangrenous, and had to be cut open, while in the three others reduction was effected in the usual manner. The former, three all recovered, the latter three all died. What, then, might be the conclusion ? Plainly, that in hernia operations the safest practice is to slit up the bowel ! Such are the absurdities which hasty reasonings lead to.

¶ 10 Leave a comment on paragraph 10 0 So long as the Communications to which we have referred are restricted to Medical circles, there is not much fear of their doing evil. They are brought before those who are well able to judge of their merits, and, counting only as isolated facts, are supported or rendered doubtful by further experience. If false, the antidote is soon provided by some one else. By free discussion, even if both sides a little pass the bounds of cautious reasoning, there is much hope of ultimate arrival at truth. With the General Press, however, the case is totally different. The appeal is then made to those who are altogether unfit to judge. The evil which one-sided writing on Medical subjects in the general newspapers may do, is incalculable. We need not extend any caution to our readers, for we trust there are none among the respectable part of the Profession who would think of addressing themselves to the public upon purely Medical matters through the newspapers. To newspaper Editors, however, we may say, that in extracting, either from ourselves or from other Medical Journals, letters of the character alluded to, they incur a responsibility which they cannot estimate. We may make use of a recent instance to enforce the caution we would advise. In our edition of September 3, there appeared an able letter from Dr. George Johnson, of King’s College, giving the results of his experience in the treatment of cholera by castor oil. The letter was written in the spirit of warm laudation of the remedy. It, at the same time, however, stated the facts on which the conclusions were founded. That letter was, as every one knows, reprinted by the Times, and preceded by some unwarrantable reflections upon the conduct of the Profession in rejecting novel modes of treatment. The very page of our Journal which contained that letter, had also one on “ Purgatives and Cholera,” professing to prove the induction of the disease by purgation. Two pages further on, in the same number of the Journal, was the following, from the pen of our own reporter “The circum-