240

larger to the smaller, causing each tocrack, so- as to be distinctly heard,which also succeeds from the processbeing extended to each connectingligament of the vertebrae of the backand loins. The sensation at the mo-ment is far from agreeable, but issucceeded bv effects not dissimilar towhat arises from brbk electrical

sparks taken from the joints in quicksuccession.

This operation upon the articulations of the limbs, is much less fre-quently repeated than the other partsof the process of shampooing, and inits effects on disease must be considered as generally unnecessary andoften mischievous ; but this shouldnot be said of friction, from which, byancient usage as well as modern ex-

perience, we are instructed how muchcan be derived when practised withjudgment and patient perseverance.,The Indians, who hold it in high esti-mation as a means of relief from theconsequences of excessive fatigue andfrom unusual bodily exertion, haveconstant recourse to it, and from itssoothing effects sleep is often

inducedwhere the usual means fail."-pp. 84,85 86.

The remainder of the work is occn.

pied by a detail of the various

practices of friction, (which we latelyadverted to in speaking of Mr. Gros-venor’s method of practice,) percus-sion, the pulsator of Dr. GOWER, &c.

&c., and concludes by some useful ob-servations on the applicability of va-

ponr in a variety of diseases,and with some admonitions and cau-

tions to be attended to in employingit. The work is both instructive

and amusing, and though obviouslywritten for the public, is not without

its value to the profession. There are

two plates deseriptive of the appa.ratus.

FOREIGN DEPARTMENT.

ANALYSIS OF FOREIGN MEDICAL JOUR-

NALS.

GERMAN JOURNALS.

History of a Patient from whom

THREE HUNDRED AND NINETY-FIVE

NEEDLES were extracted; commu-

nicated by Dr. OTTO, of Copen-hagen.

SOME notice has aiready been takenof this case by the journalists of thiscountry, but it was mentioned in such a.

superficial manner that its credibilitymight have been questioned with greatpropriety. We confess that, at fiist

sight we considered it a mere trick,played off upon some well-mean-

ing but weak individual for the

purpose of exciting the astonish-

ment of the public ; and had not thehistory of the case, as we now publisltit, emanated from such respectable

authority as Dr. OTTO, (the mention ofwhose name is sufficient to ensure foritattention and authenticity,) we shouldnot have given it a place in our pages.The case is as follows :-

Rachael Hertz had, np to her four-teenth year, lived in the enjoyment ofpretty good health; she was of a deli-cate constitution. active, and cheer-ful. On the 16th of August 1807, shecame under the care of ProfessorHERHOLDT for a violent cholic, whichsoon yielded to the employment ofantiphlogistic medicines. She con-tinned weil np to the 24th of Novem-ber of the same year, at which timeshe was seized with erysipelas of theface, accompanied with severe feter,which subsided in about the usnaltime, but returned again very fre-quently during the three followingmonths.

241

In March 1808, the patient foundherself very weak, and became gra-dually emaciated ; her countenance

was pale and haggard, and manysymptoms appeared which partook ofan hvsteric nature, but which wouldnot yield to the ordinary anti-hyste-rical medicines.From March 1808 to the end of

May 1809, a period offourteen month*!,she siiffeied from very distressingparoxysms of hysteria, sometimes accompanied by fainting, so severe thatmany persons thought she was dead.At other times she was seized withyiolent epileptic attacka, and some. ’’

times Btith high delirium, drowsiness,and hiccup. these symptoms con-

tinned from March to May 1808, andduring the fits of delirium she repeated long passages f1 om the writings ofGothe, Schiller, Shakspeare, and

Ochlenschlager ; she delivered themwith a loud voice and with as correctan emphasis as any one in health coulddo; and although at such times hereyes were closed, she accompaniedher declamations with suitable gesti-culations. The delirium went on in-creasing, and at last reached to a

fearful heighi; she gnashed with herteeth, bit the people about her, andkicked and fought with great violence,so as to disturb, not only her ownhousehold, but the whole neighbour-hood wiih her ravings ; sometimes she Ilay in a soporose state, deprived ofall sense and power of motion, appear - °ing scarcely to breathe, and wouldagain suddenly stai t up and utter wildand piercing shrieks.Ou the 20th of May, a violent vo-

miting of blood, continning for threedays and nights, more or less, wasadded to the list of her former com-plaints, followed by a congh, hiccup,and purging of a very datk colouredoffensive matter. All the other symp-toms remained for seven months, al-

tbough the hematemesis ceased inabout five days, and continued to varyin severity throughout the whole otthat period, althologh the greatest at-tention was paid and aU sorts of me-dicine were administered to her.On the 5th of July 1809, she was

seized with a peculiar pain in thelower belly ; she complained of nau-sea, a sense of writhing, and greatuneasiness in the region of the left

flexure of the colon, with great anx-iety of countenance and depression ofspirits ; to this succeeded a severeand obstinate ischuria, which wastreated in the usual manner withoutmuch benefit ; a careful examinationof the rectum showed that there wasa stricture of that gut, and that thedistension about the strictured pointpressed upon the urethra and bladder.The rectum was so firmly contractedthat the pipe of an injecting syringe:was with difficulty passed; the dailyemployment of the catheter was ne-cessary in order to procure the eva-cuation of the urine, till at length, bythe use of various diuretic medicines,the hip bath, aromatic fomentations,and copious injections, the spasmodiccontraction of the rectum was over-come, and with it the globus hysteri-cus was also removed ; the ischury ’continued, however, just as bad as

before, notwithstanding the further

employment of the same remedies fora great length of time.In the beginning of March 1809,

the general state of the patient wa&somewhat improved, and she was able.at last to take some rest, which afford-ed a hope that a favourable changehad taken place; she soon verged intothe opposite extremes, and became socomatose that-it was necessary to giveI stimulating medicines in large doses.Abollt the middle of the day this un-fortunate woman lay as if dead, de-prived of sense and motion, and therespiration so slow that it appeared,

at times, altogether suspended, andthe pulse was so small and sott thatit could scarcely be felt. Medicinecouid accomplish nothing for her re-lief, and during the space of a weekshe took nothing to eat or dnnk ; herbowels were opened only once in

eight days, and then without her

knowledge.On the 13th of May 1809, she was

seen by the celebrated CALLISON, whorecommended that snuff should be in-troduced into the nose, in order torouse her from that comntose statein which she was at times plunged,

* This should have been calleddysury, which is the tetm employed toexpiess a difficult excretion of’ theurine, whilst ischury means a difficult

. or suppressed secretion.

242

and the first essay was attended withgreat success; it did not producesneezing, but restored her to hersenses, and during the rest of the daythe power of motion also returned.During the eight following days thesnuff produced less effect, and thepatient gradually reverted to herformer state of torpor, drowsiness, anddelirium, which coutinned, with theischury, more or less severe, from the18th May 1804 to 8th Dec. 1810.At the end of November 1810, she

was seized with extreme weakness;her extremities were cold, the coun-tenance had a cadaverous appearance,the deglutition was difficult, the respi-ration slow and laborious, and inter-rupted frequently by sighs ; the bow-els much constipated, and the secre-tion of urine almost entirely suppress-ed. From this she again graduallyrecovered-, but remained incapable ofmoving the right side. During thetwo following years she enjoyed tole-rably good health.

In April 1813 she had the measles,qnd in July of the same year she wasattacked by intermittent fever, stic-

ceeded by cough and some vomitingof blood. Cooling vegetable acidswere administered, with sedatives,and by the end of November thesecomplaints were removed, and up to13th June 1814 she remained prettywell. A large carbuncle then maderoveli. A large caa-’bttncle then madeits appearance on the left thigh, whichWas removed by the ordinary means.In May 18i6, the patient was seized

with violent pains ’in the abdomen,particularly about the regi@n of theleft hypochondrium, succeeded by vo-miting of blood, from which she againrecovered, and remained without anyrelapse for about three years.In January 1819, violent cholic pains

seized the patient, attended withconsiderable fever and purging ofblood, and so low was she reduced,that no one who saw her thought thatshe could recover.On the 2d of February, a tumonr,

which had appeared just beneath theumbilicus was examined, and was

found to consist of three principaldivisions, or lobes ; sedative and emol-lient cataplasms were applied to this,but the pain was not assuaged ; thepatient appeared to be gradually sink-ing. She remained very low until the

12th of February, when ProfessorHERHOLDT considered it necessary tomake a deep incision into the swell.ing, in order to let out any pus thatmight have been contained in it. Nomatter came out, and but very littleblood; he then examined the woundwith a sound, and felt it strike againstsomething, which communicated thesensation to the hand of its being ametallic body ; with a forceps he laidhold of it, and, to his great surprise,drew out a needle. All the symptomsgradually subsided, but soon afterreturned again with a fresli vomitingof blood. The abdomen was againexamined, and another tumonr wasdiscovered in the left lumbar region,the slightest touch of which occasion.ed great pain.On the 15th of February, an inci-

sion was made into it, and a blackoxydised needle extracted from itscentre. From this time, that is to

say, from the 12th of Febrnary 1819to the 10th of August 1820, a periodof eighteen months, the patient ex-perienced pains in different parts ofthe body, supposed to be occasionedby needles deeply seated, and duringthat time two hundred and ninety-fiveneedles were at different intervalsextracted; namely,-From the left breast........ 22- between the breasts.... 14- the epigastric region .. 41- - the left hypochoudriac 19

region ............ j- right hypochondriac reg. 20- the navel ............ 31- the left lumbar region.. 39- the right ditto........ 17- the hypogastric region 14- right iliac region...... 23- left iliac region..... 27- -- the left tliigh.... ..... 3- the right thigh........ 23- between the shoulders 1- --- beneath the left shoulder 1

Total...... 295

Many of them were broken, or cor-

roded, some being without points,others without eyes; some were largeand black, like the pins used for dress-ing the hair, and others were small.The brass needles retained their pro-per polish, but all the others were

black and oxydised. They made their

243

appearance at different intervals ;sometimes days, weeks, and monthsintervening between the times of theextraction. The patient, during thegreatest part of this time, was so lowand weak that she was obliged to

keep to her bed, and although she didnot experience much pain when theneedles were deep, yet as soon as theyapproached the surface her sufferingswereverygreat. Professor HERHOLDTwas often urged to cut into the skinto seek for the needles, and thus toafford some relief to the patient, butsuch attempts were without success ;itwas in vain that he sought for them ;he was obliged to wait several days,until the needles appeared in thewound, or could be distinguished bythe touch. Only once did he attemptto draw out a needle with his fingersfrom the breast without making anincision, but the needle broke and hewas ohliged to make two openings toget it out. On four occasions onlydid any bleeding follow the extraction,but no suppuration attended a singlecase. The patient bore her sufferingswith wonderful fortitude until Jann-ary 1822, when her mother was seizedwith an apoplectic fit, which had such Ian effect upon her mind that she be-came paralytic, first in her right arm,then in her left, and afterwards in herlower extremities also ; she lost theoseof speech, so that neither by wordsnor by signs could she direct the at-tention of the bystanders to the placesat which the needles gave her pain.In about five days the voice returned,and up to the 10th of August 1820, nomore needles were discharged; the

pain in the bowels, and other symp-toms, had also ceased. By the em.ployment of antispasmodic medicines,cold bath, blisters, and so on, the pa-tient gradually became better, andon the 8th of March 1821, she appear-ed to be quite relieved, so much im-proved was she, that Professor Her-holdt considered her quite well. Thusthe remained up to this time, when anew series of sufferings commenced ;a painful tumour showed itself in theright armpit, which increased to a

great size, and was so very painfulthat her life was considered in greatdanger. This swelling also containedneedles, and so great was the num-ber, that from the 26th of May to the

10th of July 1822, one hundred wereextracted, making, with the two hun-dred and ninety-five before mention-ed, the enormous number of threehundredand ninety-five!!! !The patient is marked with scars in

various parts of the body, and is at

present in Frederick’s Hospital, at

Copenhagen, where she has been vi-sited by Dr. OTTO, and thirty otherpersons, at different times, who arewilling to verify the assertions hereillcontained respecting her. The pa-tient’s ischnry, in the year 1822, lefther, and she was, instead of it, attack-ed by diabetes insipidns, which pro-ceeded to a very great length ; herbowets remained obstinately costive,with great emaciation and delrility,but hopes are still entertained of herrecovery. During this long illness, or-rather toward the latter part of it,,the patient amused herself by learn-ing Latin, and wrote an account ofthe principal changes that hadoccurred in the history of her case.

Such is the detail of this very asto-

nishing case ; the principal defects ofit are the want of a more minute spe-cification of dates, and the too fre-quent occurrence of long intervals inthe notices of the state of the patient.Another difficulty, which has not beengot over, is to account for the intro-duction of the needles into the body ;as they could Mot have grown there.It is supposed, by Professor Her-holdt and Dr. Otto, that she musthave swallowed the needles duringher delirious fits.

Two cases of Viper-bites, one of whichproved fatal,

In the month of August, 1824, ahealthy old woman, the wife of a vil-lager at Knnppe, went into the neigh-bouring wood to gather fuel, andwhilst going through a part of a mo-ra,s, she left something which, as shethought, pricked her foot. When shereturned to the village her foot hadswollen very much, at which she wasmuch alarmed, and in a short timeshe was -seized with great anxietyand restlessness, and bleeding fromthe nose. Her husband sent for Dr.WUSTAND, and having done this,thought he had done all that was ne-cessary and went about his work,seeing his wife only from time to time.

244

Before, however, the doctor arrived,the poor woman died, and it was re-marked, that even in a few hours thecorpse was rapidly going into a stateof putrefaction. The singularity of’this case is, the very short time inwhich the bite proved fatal, beingonly a few honrs.The second case is that of a man

named Scholbart, of the village ofMalitzclien, who was, in the dischargeof his duty as a forest-ranker, walk-ing through a thick part of a wood,when he felt a pain in his foot as if a- sharp instrument had pierced his shoe,and looking at the place, he saw a ,,

large speckled viper darting into thecover. He was much alarmed at thecircumstance, and repaired, as speed-ily as possible, to a neighbouring- ditch, where he washed the foot forseveral minutes, and applied a liga-ture tightly round the ancle. Beforehe could reach home the foot had"Swollen very considerably, and in a

Ishort time it spread with great rapi-dity up the ler and assumed a blueappearance. The bandage was now- taken off, and the whole limb foment-ed with warm milk and mithridate ;he took some cordials also internally,and adopted a nourishing and warmdiet. During the next night the swell-ing diminished a little, but the suffer-ing of the patiett was very great; hecontinued to use ihe fomentations andmithridate with advantage. In aweekthe degree of fever which had attend-ed the progress of the complaint hadconsiderably abated, and in a fort-night the patient was quite well.-Litterarischee Annalen der GesannutenHeilkunde.

From the history of this and other- cases which we have published informer numbers of THE LAKCET, itwould appear a moderately stimulat-ing plan of treatment internally, withmild and tepid fomentations to thebitten part, is the most successfulmode of managing cases of the bites ofvipers.

CURE OF HYDROPHOBIA.

Cure of a Person who had exhibitedsymptoms of Hydrophobia, communi-cated by Dr. CASTAGNO.

Signer Francisco Ferroglio, an apo-thecary, residing at Rivara, 32 year

of age, of a sanguine temperamentand cheerful disposition, and who,dming the who!e course of his lite,had never been the subject of anydisease, while he was shutting a cellardoor, on the evening of the 22d ofOctober 1824, was suddenly attackedby a cat which belonged to one of hisneighbours. The animal fastened itsteeth on his left hand, and it was withsome difficulty that he disengaged it,and not without receiving severalscratches on the other hand. Therewere three wounds inflicted by thebite of the cat on the left wrist, twocorresponding to the dentes incisore.sof the animal on one side, and pene.trating beyond the cnticle, fromwhich a considerable quantity orbloodflowed, and the corresponding teethon the opposite side had inflicted atransverse wound, from which also agood deal of blood flowed; no otherprecaution was taken at the momrnt

except washing the part with coldwater. It had been observed, for thelast two or three days, that the catattempted to bite every one whooffered it food, and the day after theabove wounds were inflited the ani.mal was kil:ed, with ali the symptomsof madness.

Twenty-four hours after the patientapplied to a surgeon, who canteri’.ed,superficially, two of the wounds, omit.ting, I know not for what reasou, tocauterise the third, which was themost extensive.A few days after, Ferroglio came

to consult me at Lanzo, and as I hadread, some time before, in the Pied-montese Gazette, that an interestingwork on hydrophobia had just beenpublished by the celebrated Profes.sor ROSSI, I determined to send thepatient, with aletter, to that eminentsurgeon. The Professor, with the ut-most courtesy, immediately comnitt-

nicated to me the method of cure

which he advised in such circum-stances, the indications which he haddeduced from his own pathologicalobservations, and some practical re-marks on hydrophobia, which he badread before the Academy of Sciencesat Turin, in March 1824:The following is a copy of the letter

which I i eceivcd from Professor Rosa:‘ I have attentiveiv examined the

scars occasioned by the bite of a cat,