a case of hysteria following typhoid fever

1
923 cases ; and, concluding that erysipelas is antagonistic to diphtheria, he began to inoculate patients suffering from the latter with the bacteria of the former disease. The inoculation succeeded nearly always, and was performed by means of punctures in the submaxillary region. Of fourteen inoculated patients two died before the development of the erysipelas, but all others recovered. The patients took no medicine whatever, but the houses in which they lived were carefully disinfected. In every case in which erysipelas super- vened spontaneously on diphtheria, the latter disease was mild and the erysipelas was not of a dangerous character. LEAD IN DRINKING WATER. THE occurrence of lead in drinking water is not so rare a thing as is generally supposed. The symptoms of chronic lead poisoning are, however, so characteristic that a moment’s consideration will soon indicate the possible source of the evil, and in many cases the examination of the water used for drinking purposes will probably settle the question A simple method for the rapid and easy detection of lead in potable water, and within the reach of the medical officer of health and others generally, will be welcomed. Such a method is that which was introduced to the notice of the Society of Public Analysts, at their meeting last month, by Mr. Sidney Harvey. It depends upon the fact that the treatment of lead salts with bichromate of potassium results in the formation of the remarkably insoluble yellow chromate of lead. The following is the modus operandi directed. Two grains of crystallised bichromate of potassium are added to half a litre of the suspected water contained in a conical precipitating glass, and after stirring allowed to remain at rest for fifteen minutes or so. Side by !-ide with this, for the sake of comparison, is placed a similar vessel con- taining lead-free water, to which bichromate has also been added. If the water, so the author affirms, contains as little as one-fiftieth of a grain of lead per gallon, it will become sensibly turbid, and in about twelve hours the pre- cipitate will so subside that the water may be poured off nearly to the last drop. The blackening produced when sulphuretted hydrogen is added to water containing lead is, of course, well known as a test; but this might possibly be due to copper or tin, both of which give the same effect. No other metal likely to be present in water is said to give any reaction with bichromate of potassium. If the water is not clear, obviously filtration must be first resorted to. As a rule, lead is commonly found in very soft water as hydrated oxide, or in soft water containing much carbonic acid gas as carbonate, but scarcely ever, if at all, in water containing sulphate or silicate. - A CASE OF HYSTERIA FOLLOWING TYPHOID FEVER. PROFESSOR GRASSET of Montpellier has recently recorded a well-marked instance of this condition occurring in a girl twenty-three years of age, who until then had shown no signs of hysteria. She had passed through a mild attack of typhoid fever and was convalescent, and allowed to get up daily, when she was suddenly attacked with complete paraplegia. This was considered to be " hysterical " in character because of the coexistence of the following sym- ptoms : a number of persistent stigmata, incomplete left hemianassthesia, absence of the pharyngeal reflex, and con- traction of both fields of vision. A month -later complete aphonia was developed. The diagnosis of hysteria was verified a few days later by the patient suddenly recovering her voice and the power over her legs, so that in a few days she was able to leave the hospital in perfect health. A similar case is quoted from Trousseau. A patient of his, twelve years old, was attacked with paraplegia during convalescence from typhoid fever, and all treatment was without benefit, until one day she was accidentally locked in her bedroom. When the nurse returned she found the patient standing at the door, having walked without much difficulty from her bed to try to open it. In neither of these cases had there previously been any tendency to hysteria. ___ BENEVOLENCE OR BUSINESS IN THE PROMOTION OF HOSPITALS. AN evening contemporary comments with not undue severity on a proposal to publish abroad the virtues of Shanklin as a health resort, emanating from a public meeting of the inhabitants. The most brilliant idea of the evening was to the effect " that the best way to keep Shanklin going was to start a children’s hospital; the best way to increase the growth of Shanklin was to get in with the great physicians!" It was unanimously resolved to form a committee, having for its object the formation of a hospital. Many hospitals have had no better beginning than the proposed good of some person or place. Bat there is here a delightful openness of admission that the object of the promoters is the benefit of Shanklin, and that the benefit of children is a mere means to an end. TRACHEOTOMY IN BRUSSELS. La Clinique publishes an account of 101 tracheotomies which have been performed for croup in the St. Pierre H6pital during the four years ending Dec. 31st, 1889. The number of recoveries was twenty-eight. Of the 16 cases under the age of two years only one recovered. In most of the fatal cases the false membranes extended along the bronchi to the smaller branches, death usually occurring on the third or fourth day. The tube was generally removed about the fourth day for a few hours in the cases that were doing well, and after a few more days it was dispensed with altogether. Local antiseptics were always used-nasal injections, painting the throat, and spray. Generally chloroform was administered, so that the operation could be performed deliberately. Of course it very usually happened that the child was not brought to the hospital until it had reached the third or final stage of the disease, and the operation was usually performed within two hours after admission. THE CORPORAL PUNISHMENT BILL. THE new Bill relating to corporal punishment, which has ast passed a second reading in the House of Co mmons, wil be generally regarded as a needed and reasonable addition to the penal code. Briefly stated, it provides for the punishment of some youthful delinquents under sixteen years of age by means of a somewhat severe birching, and a similar but more vigorous chastisement of the same kind, to be repeated if advisable, for adult males convicted of certain specified offences. These are violent attempts to injure or alarm the Queen, various forms of robbery with assault, or where dangerous or offensive weapons are carried by the culprit, and a variety of indecent offences, for the most part suggesting or implying the use of violent com- pulsion. A surgeon is in all cases to attend in order to regulate the application of the penalty. There are some persons, doubtless, who could not be induced under any circumstances to see the justice or necessity of inflicting on adult offenders or even on boys an ordinary whipping. Their error, for such we consider it to be, must at least be allowed the merit of generosity ; but in this very merit lies , its unwisdom. It arises from a mistaken willingness to confer on any miscreant, however hardened, the credit of

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Page 1: A CASE OF HYSTERIA FOLLOWING TYPHOID FEVER

923

cases ; and, concluding that erysipelas is antagonistic todiphtheria, he began to inoculate patients suffering fromthe latter with the bacteria of the former disease. Theinoculation succeeded nearly always, and was performed bymeans of punctures in the submaxillary region. Of fourteeninoculated patients two died before the development of theerysipelas, but all others recovered. The patients took nomedicine whatever, but the houses in which they lived werecarefully disinfected. In every case in which erysipelas super-vened spontaneously on diphtheria, the latter disease wasmild and the erysipelas was not of a dangerous character.

LEAD IN DRINKING WATER.

THE occurrence of lead in drinking water is not so rare athing as is generally supposed. The symptoms of chroniclead poisoning are, however, so characteristic that a

moment’s consideration will soon indicate the possible sourceof the evil, and in many cases the examination of the waterused for drinking purposes will probably settle the questionA simple method for the rapid and easy detection of leadin potable water, and within the reach of the medical officerof health and others generally, will be welcomed. Such amethod is that which was introduced to the notice of the

Society of Public Analysts, at their meeting last month, byMr. Sidney Harvey. It depends upon the fact that thetreatment of lead salts with bichromate of potassium resultsin the formation of the remarkably insoluble yellow chromateof lead. The following is the modus operandi directed. Twograins of crystallised bichromate of potassium are added tohalf a litre of the suspected water contained in a conicalprecipitating glass, and after stirring allowed to remainat rest for fifteen minutes or so. Side by !-ide with this,for the sake of comparison, is placed a similar vessel con-taining lead-free water, to which bichromate has alsobeen added. If the water, so the author affirms, containsas little as one-fiftieth of a grain of lead per gallon, it willbecome sensibly turbid, and in about twelve hours the pre-cipitate will so subside that the water may be poured offnearly to the last drop. The blackening produced whensulphuretted hydrogen is added to water containing lead is,of course, well known as a test; but this might possibly bedue to copper or tin, both of which give the same effect.No other metal likely to be present in water is said to giveany reaction with bichromate of potassium. If the water isnot clear, obviously filtration must be first resorted to. Asa rule, lead is commonly found in very soft water as hydratedoxide, or in soft water containing much carbonic acid gas ascarbonate, but scarcely ever, if at all, in water containingsulphate or silicate. -

A CASE OF HYSTERIA FOLLOWING TYPHOIDFEVER.

PROFESSOR GRASSET of Montpellier has recently recordeda well-marked instance of this condition occurring in a girltwenty-three years of age, who until then had shown nosigns of hysteria. She had passed through a mild attackof typhoid fever and was convalescent, and allowed to getup daily, when she was suddenly attacked with completeparaplegia. This was considered to be " hysterical " incharacter because of the coexistence of the following sym-ptoms : a number of persistent stigmata, incomplete lefthemianassthesia, absence of the pharyngeal reflex, and con-traction of both fields of vision. A month -later completeaphonia was developed. The diagnosis of hysteria wasverified a few days later by the patient suddenly recoveringher voice and the power over her legs, so that in a few daysshe was able to leave the hospital in perfect health. Asimilar case is quoted from Trousseau. A patient of his,twelve years old, was attacked with paraplegia during

convalescence from typhoid fever, and all treatment waswithout benefit, until one day she was accidentally lockedin her bedroom. When the nurse returned she found the

patient standing at the door, having walked without muchdifficulty from her bed to try to open it. In neither ofthese cases had there previously been any tendency tohysteria.

___

BENEVOLENCE OR BUSINESS IN THEPROMOTION OF HOSPITALS.

AN evening contemporary comments with not undue

severity on a proposal to publish abroad the virtues ofShanklin as a health resort, emanating from a publicmeeting of the inhabitants. The most brilliant idea of the

evening was to the effect " that the best way to keepShanklin going was to start a children’s hospital; the bestway to increase the growth of Shanklin was to get in withthe great physicians!" It was unanimously resolved to

form a committee, having for its object the formation of ahospital. Many hospitals have had no better beginningthan the proposed good of some person or place. Bat thereis here a delightful openness of admission that the objectof the promoters is the benefit of Shanklin, and that thebenefit of children is a mere means to an end.

TRACHEOTOMY IN BRUSSELS.

La Clinique publishes an account of 101 tracheotomieswhich have been performed for croup in the St. Pierre

H6pital during the four years ending Dec. 31st, 1889. Thenumber of recoveries was twenty-eight. Of the 16 casesunder the age of two years only one recovered. In mostof the fatal cases the false membranes extended alongthe bronchi to the smaller branches, death usuallyoccurring on the third or fourth day. The tube was

generally removed about the fourth day for a few hours inthe cases that were doing well, and after a few more daysit was dispensed with altogether. Local antiseptics werealways used-nasal injections, painting the throat, andspray. Generally chloroform was administered, so that theoperation could be performed deliberately. Of course it

very usually happened that the child was not brought tothe hospital until it had reached the third or final stage ofthe disease, and the operation was usually performedwithin two hours after admission.

THE CORPORAL PUNISHMENT BILL.

THE new Bill relating to corporal punishment, which hasast passed a second reading in the House of Co mmons, wilbe generally regarded as a needed and reasonable additionto the penal code. Briefly stated, it provides for the

punishment of some youthful delinquents under sixteenyears of age by means of a somewhat severe birching, and asimilar but more vigorous chastisement of the same kind,to be repeated if advisable, for adult males convicted ofcertain specified offences. These are violent attempts toinjure or alarm the Queen, various forms of robbery withassault, or where dangerous or offensive weapons are carriedby the culprit, and a variety of indecent offences, for themost part suggesting or implying the use of violent com-pulsion. A surgeon is in all cases to attend in order to

regulate the application of the penalty. There are some

persons, doubtless, who could not be induced under anycircumstances to see the justice or necessity of inflictingon adult offenders or even on boys an ordinary whipping.Their error, for such we consider it to be, must at least beallowed the merit of generosity ; but in this very merit lies, its unwisdom. It arises from a mistaken willingness toconfer on any miscreant, however hardened, the credit of