AN ACCOUNT OF THE BILLIOUS FEVER 
 IN NEWBERN, N. C. IN THE FALL OF 1841 
 
 NEW YORK MEDICAL GAZETTE 1842 
 
HEALTH SCIENCES LIBRARY 
 OF THE 
 
 UNIVERSITY OF NORTH CAROLINA 
 AT CHAPEL HILL 
 
 From the Books of 
 
 WILLIAM P. Jacocks, M.D. 
 
 Class of 1904 
 Friend of the Library 
 

 
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 . OI^SIQKL QEJHEALTH AFFAIRS LIBRARY_ 
 
 No. 11. MARCH 23, 1842. Vol. 2. 
 
 ORIGINAL DEPARTMENT. 
 
 An Account of the Billions Fever , as it prevailed in Newbern, N. C. 
 in the Fall of 1841. By Geo. H. Taylor, M. D. 
 
 In giving an account of the fever as it prevailed in New¬ 
 bern during the late fall, it will be proper to premise a brief 
 description of the place, its location, etc. The town contains 
 about four thousand inhabitants, is situated on low ground at the 
 junction of two rivers, the Neuse and Trent, the former running 
 along the Eastern border of the town, and the latter running along 
 the Southern border. A little to the southwest of the town lies a 
 marsh several miles in length, and about half a mile in breadth. A 
 short distance from the northwest part of the town are a number of 
 large ponds, which contain a considerable quantity of water all the 
 year round, having no outlet to the river. There are also in one or 
 two parts of the town, a number of low places, in which water is 
 permitted to remain a good part of the year, the quantity being 
 more considerable after heavy rains. These points it is important 
 to bear in mind, when we come to consider the cause of the great 
 prevalence of disease with which the inhabitants are afflicted, to a 
 greater or less extent, almost every autumn, and which prevailed 
 during the fall just passed, to a much more alarming degree than for 
 many previous years. 
 
 During the summer months there were but few cases of fever; 
 early in September, however, the town having been previously visi¬ 
 ted by heavy rains, a number of cases occurred simultaneously in 
 various parts of the town. There was no part of the town that es¬ 
 caped entirely; but those parts most adjacent to the marsh and 
 ponds before referred to, were visited in a peculiar manner, scarcely 
 a family in such quarters escaping, and in many cases every member 
 of such families being down with the disease. There was a marked 
 difference, however, in the disease, as it appeared in the vicinity of 
 
 11 
 
 
162 
 
 Bilious Fever. 
 
 the marsh, and near the ponds, those cases in the neighborhood 
 of the former yielding promptly to remedies, scarcely a case 
 proving fatal, while those in the vicinity of the latter were much 
 more obstinate, successfully resisting all remedies, and many of the • 
 cases terminating fatally. 
 
 The general form of the disease was that of the bilious intermit¬ 
 tent and remittent fever, usually commencing with languor, uneasy 
 and painful sensations, followed with coldness of the nose, hands 
 and feet, sometimes with shivering and cold sensations running up 
 and down the spinal column. These symptoms would continue 
 from a half hour to three hours, and be followed by heated skin, 
 thirst, flushed countenance, and the usual symptoms of fever, which 
 would in many cases continue for about twenty-four hours, when 
 another chill would supervene. In the generality of cases, however, 
 on the day following the first ague, there would be only a slight 
 chilliness of the extremities, lasting but a short time, followed by 
 fever ; and the day succeeding the chill the patient would experi¬ 
 ence what is called a “ shaking ague.” And in this form the dis¬ 
 ease would continue till it terminated in death or convalescence.— 
 Some patients who were not visited with the “ shaking agues,” 
 would experience as many as half a dozen chills in the course of a 
 day. 
 
 Occasionally the disease assumed the purely tertian type, the ague 
 returning regularly every forty-eight hours, lasting from one to three 
 hours, followed by fever that would continue generally from five to 
 ten hours, sometimes abating after a copious sweat, and some¬ 
 times continuing during the whole period from one ague to another. 
 
 In some cases, in the commencement of an attack,the paroxysms 
 would assume a very mild form, so as for the first few days not to 
 confine the patient. But each succeeding paroxysm would become 
 more violent, and in a few instances the patient died in the cold 
 stage of the third or fourth paroxysms, no reaction taking place ; 
 although the patient appeared a short time before the ague to be in 
 a comfortahle condition, and to entertain no apprehension of death. 
 
 I was requested to prescribe for a patient, an adult female who had 
 been for several days suffering with the chill and fever, but who, at 
 the time I saw her, in the morning, appeared quite well and was at¬ 
 tending to her household affairs. I prescribed, as requested, and 
 at about two o’clock in the afternoon, was called in great haste to 
 see her, as she appeared to be in a dying condition. I found her 
 insensible, breathing heavily, with the eyes fixed and pupils some¬ 
 what dilated, the surface of the body generally being of a natural 
 temperature, excepting the extremities which were cool. The pulse 
 was frequent and feeble. Her ague had come on at the usual time, 
 and feeling more indisposed than on former occasions, she had retired 
 to bed, and in about twenty minutes from the commencement of the 
 paroxysm she became speechless, and had since remained in the 
 
Bilious Fever. 
 
 163 
 
 condition in which I found her. Directing a large sinapism to be 
 applied to the epigastrium, and others to the ancles, I waited for 
 half an hour in the expectation that they would rouse her ; but find¬ 
 ing she continued in the same state, notwithstanding the mustard 
 had sufficiently excited the skin, I commenced stimulating her with 
 ammonia, under the influence of which she was soon roused so as 
 to be able to converse. So soon, however, as the effects of the 
 ammonia were expended she would relapse into her former state.— 
 Finding the pulse at times to grow very feeble, 1 continued the 
 ammonia at intervals of a half hour, during the afternoon and eve¬ 
 ning, at which time I directed a sinapism to the back of the neck, 
 and left her. She continued in a state of stupor for several days, 
 after which it gradually wore off, and she had no return of the 
 chills. Quite a number of cases similar to the above occurred about 
 the same time. 
 
 The appearance of the tongue at the commencement of an attack 
 was usually natural, but it became covered with a whitish coat as 
 the disease progressed, which changed gradually to a yellowish and 
 brownish hue, and sometimes, when the disease continued for a 
 great length of time, the tongue became covered with an entirely 
 black coat, being also very dry, and cracked with a longitudinal and 
 numerous transverse fissures. In almost every case the patient 
 complained of pain in some part of the body, often in the head and 
 shoulders, back and legs, frequently of pain and a sense of weight 
 about the epigastrium, and right hypochondrium, and in many cases 
 of permanent pain in the region of the spleen. The fever following 
 the cold stage was frequently very high, attended with hot and dry 
 skin, quick and full pulse, and often delirium. There was generally 
 a manifest abatement or aggravation of the symptoms about the 
 seventh day—in some cases the patient would die at this period- 
 in others, there would be a remarkable transition from a state indi¬ 
 cating approaching death, to one of striking amendment, and in 
 others, again, the patient would sink into a stupor, with frequent 
 and feeble pulse, and a low muttering delirium, in which state he 
 would remain several days, and from which but few ever recovered, 
 death then terminating the scene. In the cases that proved fatal 
 this was the most common termination. Quite a number of cases 
 were complicated with a troublesome cough. The prirnae vise were 
 frequently found in a constipated state. In a few cases the surface 
 of the body was of a bright yellow hue. In a large proportion of 
 cases there was great irritability of the stomach, and violent vomit¬ 
 ing often formed a very unpleasant and obstinate symptom, the fluid 
 ejected being of a greenish or yellowish cast. 
 
 In the treatment of the cold stage of this disease, little was usually 
 done by the writer, except placing the patient in bed, covering him 
 with blankets, placing hot bricks or bottles of hot water to the ex¬ 
 tremities, and directing some warm mild tea ; although when the 
 
164 
 
 Bilious Fever. 
 
 cold stage was considerably protracted, he was in the habit of ex¬ 
 hibiting a full dose of the tincture of opium, and if necessary repeat¬ 
 ing it, with much benefit. In the hot stage, however, more active 
 remedies were required. Where it was not contra-indicated by 
 gastric irritability, I have in this stage exhibited the aqueous solution 
 of tartarized antimony, in small doses, frequently repeated, with 
 marked advantage, and in a number of instances have, with this 
 remedy and a mercurial cathartic, entirely cut short the disease.— 
 In many cases, however, the antimony could not be employed, and 
 I have directed in its stead the acetate of ammonia, with much relief 
 to the patient, the use of it being followed, after a few doses, with a 
 copious perspiration, and an abatement of all the symptoms. Where 
 the fever continued for a long time, as it frequently did, only slightly 
 subsiding on the recurrence of a chilliness of the extremities, I 
 have directed powders consisting of nitrate of potass, gr. viij., sub. 
 mur. hydrag. gr. ss., and tartarized antimony, gr. 1 -8th., repeated 
 every few hours, also with much benefit. 
 
 So soon as the fever sufficiently subsides, however, a remedy not 
 to be forgotten is the sub. mur. hydrarg., in a full dose alone, or in 
 combination with rhubarb, the latter of which I prefer and gener¬ 
 ally employ. Indeed my first aim on visiting a patient was to clear 
 the primse vise with rhubarb and calomel; for the catharsis indu¬ 
 ced by this combination is not attended with that debility, which re¬ 
 sults when the calomel is used in a dose sufficiently largo to affect 
 the first passages alone, or when it is followed by castor oil or the 
 sulphate of magnesia. 
 
 The next and most important part of the treatment is that which 
 is designed to prevent a recurrence of the paroxysm, for when this 
 is accomplished, the regular course of the disease is interrupted and 
 a speedy recovery may be expected. Recollecting the fact, that the 
 fever generally continued from one ague to another, it is manifest 
 that the sulphate of quinine could not be employed with advantage 
 in such cases, to fulfil the end under consideration. Even where a 
 total subsidence of the fever had taken place, I have been frequently 
 disappointed when depending on the free use of quinine to prevent 
 the recurrence of the ague. Keeping in mind the violence of the 
 cold stage, the great danger attending it, and the state of prostration 
 in which it uniformly left the patient, together with the fact that 
 the usual means had failed to prevent its return, it became necessary 
 for the physician to adopt some other means to accomplish an end 
 so desirable. Taking the hint from Good, after previous purgation, 
 I employed for this purpose a full dose of the compound powder of 
 ipecac, about two hours before the period for the return of the par¬ 
 oxysm, with entire success. The same remedy I repeated in some 
 twenty or thirty cases with the same beneficial result, in nearly every 
 case in which the paroxysms observed any uniformity in the time of 
 their approach. If this remedy failed on the first trial, as it did in 
 a few instances, I do not recollect that in any case it failed after the 
 
Bilious Fever. 
 
 165 
 
 second trial. One great advantage in the use of this remedy is, that 
 you need not abstain from its employment on account of the pre¬ 
 sence of fever. In about two hours after its exhibition a general 
 composure would pervade the system, the patient would be inclined 
 to sleep, and a gentle perspiration would break out upon the surface 
 of the body. In quite a number of cases, the Dover’s powder was 
 the only remedy used after purgation, to prevent the recurrence of 
 the agues; and I am not aware but those cases recovered as well 
 and as speedily as those in which the quinine was employed. I 
 would not however discard quinine, considering it a valuable aux¬ 
 iliary, to be used freely during the intermission, but not to be en¬ 
 tirely relied upon to prevent the return of the paroxysm, which, con¬ 
 sidering the great danger attending the cold stage, is a paramount 
 object with the physician. 
 
 In many cases during.the ague, and even after reaction has taken 
 place, the patient complained of a constant, painful and heavy sen¬ 
 sation about the region of the epigastrium, attended with shortness 
 of breath. These symptoms were greatly relieved by taking over 
 night about eight grains each of calomel and Dover’s powder. In 
 directing Dover’s powder in this disease, I think it good practice 
 generally to add to it a small quantity of calomel. In eight cases 
 out of about seventy-five that I attended during the fall, there was a 
 perceptible enlargement of the spleen. 
 
 The fever continued to prevail from early in September till the 
 latter part of October, after which but few new cases occurred. I 
 have no means of ascertaining the number of deaths that took place 
 during the fall but can only say that it was greater than had occur¬ 
 red, from the same disease, during any season within the recollection 
 of the oldest inhabitants. 
 
 The effluvium arising from the decomposition of vegetable mat¬ 
 ter, is undoubtedly the principal remote cause of the disease, as the 
 cases were invariably more numerous and fatal in the neighborhood 
 of those situations where the materials for the generation of this 
 effluvium were most abundant. Considering the unusual and vio¬ 
 lent form assumed by the disease during the late Fall, there is rea¬ 
 son to fear, that, unless the cause of disease be greatly diminished, 
 our town may be visited on the coming or some subsequent Autumn, 
 by that annual scourge of more Southern cities, the yellow fever , as 
 an epidemic. “ The occurrences,” says a medical writer, “ which 
 preceded the appearance of the epidemic of Barcelona, in 1821, cor¬ 
 respond with the old and recent observations on a similar subject in 
 other countries ; it almost invariably happening that the yellow fever 
 is preceded by unusual diseases of various form and force ; more 
 particularly by bilious remittents, which are not unfrequently so ag¬ 
 gravated and malignant, that physicians themselves do not venture 
 to define the lines of demarkation between them and the avowed 
 epidemic.” 
 
 Newbern , N. C., December , 1841. 
 
166 
 
 Notes of Clinical Lectures. 
 
 Reports of Clinical Lectures , delivered in the Anatomical Theatre of 
 
 the College of Physicians and Surgeons , Crosby Street. Willard 
 
 Parker, M. D., Professor of Surgery. 
 
 Case 1.—Gentlemen, the first case (child of four years of age) 
 is one of disease of the spine, affecting the vertebra?—the 7th, 8th, and 
 9th dorsal. It is a posterior curvature. Only another case of the 
 many we have already witnessed the past winter at this Clinique. 
 I have already made many observations on this class of affections, 
 and will now only add a few more. Not unfrequently, previous to 
 any suspicion of spinal disease, you will be called to children affec¬ 
 ted with pain in the abdomen. The mothers don’t know any par¬ 
 ticular cause for this—child seems pretty well, except at times, it 
 complains of pain about the scrobiculus cordis. Well, by and by, 
 irregularity of bowels comes on, and then spasms of the lower ex¬ 
 tremities, then tripping in the gait, and finally inability to walk.— 
 Whenever, therefore, you are called to children with these pains 
 about the scrobuculus cordis, recurring every now and then, I 
 would advise you to examine the spine at once ; and this more es¬ 
 pecially if there have been present, nausea and irregularity of the 
 bowels. The symptoms it is true may result from other causes.— 
 'This you will attend to of course. Should however, nothing seem 
 to be offending the canal by its presence—should this pain in the ab¬ 
 domen recur every now and then, without your being able to detect 
 any abdominal trouble, just pass your hand over the spine, and per¬ 
 haps you’ll find your little patient flinches at a particular spot. If 
 so, you’ll have the satisfaction of having detected the disease early 
 and thus be enabled to benefit your patient incalculably more than 
 if the disease, mistaken, is allowed to progress for months longer.— 
 This disease usually manifests itself between the ages of two and 
 six years. The dorsal vertebrae are far more frequently affected 
 than any other part of the column. Of more than twelve cases, I 
 have lately seen, all but one had the seat of the disease in the dorsal 
 vertebrae. One piece of advice let me give you, in these cases, never 
 promise too much, and never fix the time when you are to effect a 
 cure. They are the most tedious cases you can have, and require 
 time—months and years. Mow, after an issue has been set up for 
 some time, you may put on an apparatus that shall bring up the 
 body to the erect position, keep the patient from becoming more 
 curved in his figure, and hide the deformity. 
 
 Case 2. —This woman is affected with stammering—you know 
 that an operation for the relief of this defect has lately been very much 
 in vogue—but, gentlemen, I tell you it has had its run. Like other 
 surgeons, I operated upon all who called upon me for the relief of 
 this unpleasant defect, and was gratified to find, that they all uttered 
 so much more distinctly,just after the operation, than they could utter 
 
167 
 
 Notes of Clinical Lectures . 
 
 before the operation ; but in 10 to 14 days I found them coming 
 back again stammering as bad as ever. I have, therefore, abandoned 
 the operation. I pronounce it a failure and cannot conscientiously 
 recommend it. And if you will reflect, for a moment, you will see 
 how little cause there is for believing that we have hit upon the right 
 operation as yet. Dieflenbach, of Berlin, first cut into the tongue 
 itself. The hemorrhage that followed was, sometimes frightful, as 
 you might suppose. Well, he cured of course. Some of the Paris 
 surgeons thought that this was going a little too deep, so they took 
 to dividing the genio-hyo-glossus muscle; and they cured too—finally 
 a Mr. Yearsly, of England, conceived that cutting even any muscle 
 was cutting too deep, so he went to snipping off little pieces from 
 the soft parts of the fauces,—as, the end of the velum pendulum 
 palati, the folds of mucous membrane of the fauces and the tonsils ; 
 and he cured too—now, gentlemen, it is evident there is some de¬ 
 ception in all this. These cures I very much doubt. I divided the 
 genio-hyo-glossus muscle, the muscle divided now for this operation, 
 but I do not know that it ever was successful in a single instance. 
 
 Case 3.—This man, an Irishman, received a kick about 7 weeks 
 since on the left shoulder and arm from a horse, while shoeing him; 
 and you see he is not well yet. There is no fracture, no disloca¬ 
 tion ; simply a contusion—a severe contusion is often worse than a 
 fracture. You will have cases of this kind, and they will trouble 
 you exceedingly—of a simple fracture you can give some idea when 
 it will be sound again ; but when a contusion will get well you can’t 
 say. He is an alcoholic subject; and in such you will find that, du¬ 
 ring cold weather, bruises, contusions, do not get along at all, but 
 as soon as warm weather comes on they recover rapidly. Let this 
 man have the shower bath, some stimulating application to the part 
 and use of the arm and he will recover. 
 
 Here, gentlemen, is a case of syphilis. This man has a chancre 
 behind the corona glandis, it is well worth your while to observe this 
 case. Surgeons have written much about the venereal ; but there 
 is much yet to be learned. I believe there is a wide difference be¬ 
 tween syphilis and gonorrhoea—in fact they are two distinct disea¬ 
 ses. Now as to chancre there are the Pustular, Phagedenic, and 
 the Hunterian. The Hunterian is rare—the Pustular the most com¬ 
 mon—this man’s is pustular. You see an enlargement of the gland 
 in the groin. It is a bubo. Now in scrofula several glands are en¬ 
 larged, in syphilis only one. You may have one on each side, and 
 then you have what sailors call “ a watch on both sides.” Observe, 
 too, in gonorrhoea you have a bubo; but its tendency is not to sup¬ 
 purate, while syphilitic buboes always do tend to suppuration, and 
 sometimes rapidly. Bubo sometimes comes on in ten to twelve 
 days after the sore on the penis, but sometimes not for six months. 
 This is the longest period I ever knew before it made its appear- 
 
\68 
 
 Notes of Clinical Lectures. 
 
 ance. This man looks quite stout and hearty, V. S. may, therefore, 
 not improperly be practised on him. A dose of calomel at night, 
 and salts with antim. tart, in the morning—gruel diet. Local treat¬ 
 ment should be—keep the parts clean, and pledgets of lint, dipped in 
 lime water, or black wash laid on. A very useful work was pub¬ 
 lished in England some time ago, and reprinted in this country by 
 Langston Parker. The first part of the work is devoted to the con¬ 
 sideration of affections of the digestive Organs. And the second to 
 gonorrhoea and syphilis. The views of Dr. Parker are those of Ri- 
 card condensed. Ricord is decidedly the best living authority on 
 this subject, and hence the work of Parker is of decided value. 
 
 By Dr. Bulkley. Cutaneous Diseases. Case 5.—This, gen¬ 
 tlemen, is a case of papular disease. Of this order, Willan makes 
 three genera—Strophulus, Lichen and Prurigo. While Biett whose 
 classification I follow makes only two, Lichen and Prurigo—consid¬ 
 ering Strophulous a species of Lichen, by which the matter is sim¬ 
 plified, as it is merely a form of papular disease running in infants. 
 Now, all these are distinguished by the shot-like feel when you pass 
 your hand over them—they are slight elevations, and are at once 
 recognized by the sensation conveyed. You will find it frequently 
 at the joints, and sometimes on the groins as well as on other parts 
 of the body, occurring often in patches of the size of a two shilling 
 piece ; and soon attaining a larger size. It affects all ages—and results 
 from alimentary disturbances and frequently from exposure to heat; 
 hence workmen in foundries, cooks, and glass-blowers, are liable 
 to it. Cleanliness and attention to diet, and regulating the digestive 
 organs are curative means. 
 
 This next case, in this little boy, is one of Impetigo. It is a pus¬ 
 tular disease. Eczema, you have seen here and observed how it 
 was disposed to spread, whereas this, you see, confines itself to 
 patches. You usually find Impetigo in children from six to ten 
 years of age. The secretion is not unlike honey. One of the di¬ 
 visions of Impetigo, derived from its appearance, is that called figu- 
 rata and this is a case of that division now before you. Impetigo, as I 
 stated, occurs in patches and has a run of from 12 to 14 days. The 
 disease may be kept up for a longer time, if nothing be done for it 
 and the sources of irritation are not removed, but about 14 days is its 
 usual run. It is in itself a trivia! disease ; but from its frequently 
 occurring on the scalp, you will find parents often alarmed lest it 
 should be “the scald head.” Now Impetigo is not the disease 
 known under that name ; neither have we the consequences to fear 
 which we have in that disease for in scald head which is Porrigo, 
 the bulbs of the hair not unfrequently become affected, so that the 
 hairs fall out and permanent baldness is induced—but if you make 
 a true diagnosis, if your case is one of Impetigo, you need have 
 no apprehension on this point; for if the hairs do fall out, the bulbs 
 
Local News. 
 
 169 
 
 are not affected and consequently the hair will again appear. The 
 treatment in this case would consist in keeping the hair close shaved 
 about the parts affected, and clean with warm water and regulating 
 the digestive organs. 
 
 Prof. Parker. Case 6.— This, gentlemen, is a case of paralysis 
 of the left lower limb occurring in a little girl of three years old.— 
 you see the limb is smaller than the right, of a lower temperature, 
 and she drags it when she walks. Now, here you can detect no 
 spinal curvature and no disease of the spine. It is very seldom you 
 will find any thing written on this kind of disease. You'll find it, 
 however, mentioned by Underwood in his treatise on diseases of 
 children. And by the way, among all the treatises and compilations 
 on these diseases, this one of Underwood’s is, I think the best. 
 
 To the Editor of the Medical Gazette : 
 
 In the last number of the Philadelphia Journal of Pharmacy, the new 
 mass of copaiva is described as of latent discovery, and as being recom¬ 
 mended by a Physician at Paris, and it is therein proposed to be incorpo¬ 
 rated in the forthcoming U. S. Pharmacopoeia ; having however, prepared 
 the same according to the Codex Medicamentaries Hamburgensis, of 1835, 
 6 years ago, and recommended the same to my medical friends long be¬ 
 fore the gelatine capsules came into use, I beg leave to lay before you the 
 recipe extracted from the above work. 
 
 R. 
 
 Cera Alb. 
 
 3ii- 
 
 
 Balsam Copaiv. 
 
 ? x - 
 
 
 Pulv. Cubeb. 
 
 3 1 - 
 
 
 Nif. pilal. 
 
 gr. ii. 
 
 I am very Respectfully, Yours, 
 
 Dr. LOUIS FEUCHTWANGER. 
 
 N. B. The mass need not to be kept ready, as it is very easy to pre¬ 
 pare it when ordered. 
 
 NEW 
 
 YORK 
 
 MEDICAL 
 
 GAZETTE. 
 
 
 NEW 
 
 YORK, MARCH 23, 
 
 1842. 
 
 Local News. — We notice among a series of scraps in the last number 
 of our Boston cotemporary the following: 
 
 “ Multitudes of items have crowded in upon us relating to the two Med¬ 
 ical Schools of New York, the surgical Cliniques, their rivalry, their hos¬ 
 pitals, and lastly their quarrels, about which we don’t care a straw.”—We 
 have reason to believe that many such “ items'' as our good natured friend 
 
170 
 
 Editorial Notice . 
 
 speaks of are afloat, not only in Boston but elsewhere. It is therefore 
 worth while that a word or two, or “ an item ” or two, should occasionally 
 emanate from the scene of action that the facts may be known where they 
 are of any interest. Now the first and most important fact is, that between 
 the two schools there is not, and never has been, any quarreling , of this 
 our friends far and near may be well assured. 
 
 As to the Cliniques the facts are that a Clinique was established by the 
 Professors of Anatomy and Surgery at the University, before the Lecture 
 term began, that it was continued till about New-Year, and then for rea¬ 
 sons that have never been made public, abandoned. As to the Clinique 
 at the other school, it had its origin not in any “rivalry” but in the fact 
 that the Professors of Surgery and of Obstetrics, having been last season 
 connected with one of the Dispensaries, and having through the session 
 given clinical instruction there, found it more convenient to themselves 
 and their pupils, to have the patients come to the college and be there 
 prescribed for; this plan was adopted, the co-operation of the gentlemen 
 connected with the other Dispensaries was afterwards secured, and now 
 all the most interesting cases, from the three Dispensaries, are by the lib¬ 
 erality and zeal of the medical officers of those Institutions, made availa¬ 
 ble for Clinical instruction at the College of Physicians and Surgeons.— 
 An ample supply of interesting and instructive cases is thus secured; of 
 the manner in which they are improved our readers have an opportunity 
 of judging, from the reports of the Clinical Lectures which have appeared 
 in our columns. This Clinique will be continued during the Spring and 
 Summer, it will form an important and valuable part of the instruction 
 communicated to the students who attend the Spring Course. These our 
 Boston cotemporary, and our other friends at a distance, may be assured 
 are all the facts in which stories of rivalship and quarrels between the 
 schools have had their origin. There has been, we repeat it, no quarrel¬ 
 ing, and the two Cliniques so far from having any thing of rivalship about 
 them, were conducted upon totally different principles. The one at the 
 new school was publicly advertised and patients in need of relief invited 
 to come and receive gratuitous aid. The Clinique at the old school had 
 as we have explained, its origin in the connexion of Professors Parker 
 and Gilman with the Dispensary, and the essential feature of it was, and 
 is, that patients were not invited to come, but that physicians were invited 
 to bring them—the patient therefore always comes by request and direction 
 of his physician , in this way the evil that was complained of in the Clinique 
 of the new school, viz., that it interfered with the practice and injured 
 the business of the profession, especially of the Junior portion of it, is 
 avoided, no patient will find his way to the Crosby Street Clinique unless 
 his physician send him. 
 
 We received some weeks since a small pamphlet entitled “ Quarterly 
 Summary of the Transactions of the College of Physicians of Phila¬ 
 delphia. 
 
 This Society was instituted in 1786, and is believed to be the oldest 
 College of Physicians in the United States. They have never as we be¬ 
 lieve published any thing, but at the stated meeting in June, 1841, they 
 
Medical Law. 
 
 171 
 
 resolved “ to publish a bulletin of their transactions”—of that resolution 
 the pamphlet before us is the fruit. The first thing that attracted our at¬ 
 tention was a list of the officers, past and present of the College—in it we 
 find many of the great names of Philadelphia — Redman, Shippen, Rush, 
 Weston, James, Parrish, &c. We have next a paper by Dr. Parrish, the 
 worthy son of that most skillful physician and excellent man, Joseph Par¬ 
 rish—it is entitled Annual Report on Surgery, and presents a good view 
 of the progress of that branch of Science. He condemns as every sensi¬ 
 ble and honest man has, or soon will, the rage for tendon cutting and the 
 operation for stammering, of Dieffenbach. The rest of the pamphlet is 
 occupied by a summary of papers read before the college, and remarks 
 upon them made by the members; both are creditable to the association. 
 We hope the college will continue to publish these transactions. 
 
 We re-publish the subjoined statement of the Law, in relation to Grad¬ 
 uates and Licentiates from other States practicing in New York, from the 
 Circular of the Albany Medical College. The action of the State Medi¬ 
 cal Society in the premises is important, as if the directions which are 
 there given to the County Medical Societies, are rigidly followed, and we 
 believe that a compliance with them is unavoidable, Graduates from schools 
 out of this State will hereafter find it very difficult, if not impossible, to 
 obtain the right to practice in the State of New York. For our readers 
 will remark that the County Societies are directed not only to examine 
 every candidate, but to require the same credentials as to time , and terms of 
 study as are required by the laws of this State before proceeding to an ex¬ 
 amination. 
 
 Our Albany friends have displayed not a little of the wisdom of the 
 serpent, in obtaining this law and clinching it by the action of the State 
 Society. That it should be published as part and parcel of their circular, 
 is natural enough. 
 
 Quere— Will it make part of any of the circulars from down East ? We 
 shall see—Brother Jonathan must rouse himself and trump over this new 
 card, or the New York Student will not cross the State line in search of 
 good and cheap medical education.—By the way ; had our friends in Ge¬ 
 neva any thing to do in this matter ? Those who know the Prof, of Prac¬ 
 tice there, will think they see “ the hand of Saul." 
 
 Law relative to Licences from other States. 
 
 A very general opinion prevails among students in this and one or two 
 of the adjoining states, that the law of this state requiring that persons re¬ 
 ceiving Diplomas in other states or countries, should undergo an examina¬ 
 tion before they could legally practice physic and surgery in this state, has 
 been repealed. This is an error. The law has been modified but not re¬ 
 pealed. For the information of all parties interested, the law of the 
 state, as it now stands in relation to such persons, is here inserted, together 
 with the proceedings of the State Medical Society at its last session, rela¬ 
 tive thereto. 
 
17*2 
 
 Medical Law. 
 
 An Act in relation to Foreign Practitioners of Medicine , passed March 
 
 29, 1841. 
 
 The People of the State of New York, represented in Senate and As¬ 
 sembly, do enact as follows : 
 
 Sec. 1. The second section of the act entitled “ An act to amend title 
 seven, chapter fourteen, part first of the Revised Statutes and for other 
 purposes,” passed May 26, 1836, is hereby amended so that it shall read 
 as follows: 
 
 No person coming from another country shall practice physic or surgery 
 in this state, until he shall have been examined and licensed by the cen¬ 
 sors of the state medical society, and no person coming from another state 
 shall practice physic or surgery in this state until he shall file a copy of his 
 diploma in the office of the clerk of the county where he resides, and un¬ 
 til he shall have exhibited to the medical society of that county, satisfac¬ 
 tory testimonials of his qualifications, or shall have been examined and ap¬ 
 proved by its censors. 
 
 PREAMBLE AND RESOLUTIONS 
 
 Of the State Medical Society , relative to Foreign Practitioners , passed 
 
 February 2, 1842. 
 
 Whereas the Legislature of the State of New York, by an act passed 
 March 20th, 1841, did enact as follows: 
 
 “ And no person coming from another state shall practice physic or sur¬ 
 gery in this state, until he shall have filed a copy of his diploma in the 
 office of the clerk of the county where he resides, and until he shall have 
 exhibited to the medical society of that county, satisfactory testimonials 
 of his qualifications, or shall have been examined and approved by its 
 censors.” 
 
 And whereas, in some of the states, the requirements for license are less 
 than in this state, and the facilities for procuring Diplomas greater, induce¬ 
 ments are held out to students to desert our own schools for those of other 
 states : 
 
 And whereas, while Diplomas so procured are received as licences to 
 practice physic and surgery in this state, it will be impossible to elevate 
 the character of the profession, or to ensure any uniformity in the education 
 or qualification of its members : Therefore 
 
 Resolved , That the several county societies be, and they are hereby di¬ 
 rected, to instruct their respective censors to require the examination of 
 all persons bringing Diplomas from other states, as affording the only sat¬ 
 isfactory evidence of their possessing the requisite qualifications ; and that 
 the same credentials, as to time and terms of study, shall be required be¬ 
 fore proceeding to such examination, as are required by the laws of this 
 state in licensing physicians and surgeons. 
 
 Resolved , That the secretary of this society send a copy of the foregoing 
 preamble and resolution to the presidents of the several county medical 
 societies of this state, with a request to lay the same before their respective 
 societies, at their first regular meeting. 
 
 A true copy from the minutes of the State Medical Society. 
 
 P. VAN OLINDA, Secretary. 
 
Poisoning by Lead. 
 
 173 
 
 ANALYTICAL DEPARTMENT, 
 
 Poisoning by Lead. —The last No. of the Western and Southern Medi¬ 
 cal Recorder contains a valuable practical article on the above subject, 
 from Professor Mitchell of Transylvania University, occupying 14 pages 
 of that Journal, we can only give our readers the principal results. 
 
 Dr. M. commences by observing, that much of the dyspepsia and bowel 
 complaints prevalent through the country, is attributable to the slow oper¬ 
 ation of lead, connected with the various processes of cookery, using lead 
 pipes for water, &c. It is well known he observes, that printers, plumb¬ 
 ers, &c., are often attacked with colic merely from handling the simple 
 metal. 
 
 The first important principle laid down and which the writer assures 
 us is well established by experiment in this country and Europe, is, that 
 water, free of the salts usually found in spring water, is soon contaminated 
 by coming in contact with lead, while the presence of such salts destroys 
 the capacity of the water to corrode the lead. Distilled water charged 
 with sulphate of lead failed to display any action on the lead pipes. This 
 fact accounts for the impunity with which lead pipes are used for convey¬ 
 ing water. Most water used for domestic purposes being from springs 
 charged with saline principles. Lead we are also informed < has been de¬ 
 tected in rain water falling from roofs covered with lead. 
 
 Among numerous other cases Dr. M. gives one of Lord Ashburnhams 
 family in England, who suffered with frequent colic. On analyzing the 
 water used for domestic purposes, which was conveyed in lead pipes a 
 considerable distance, it was found to contain an unusual amount of car¬ 
 bonic acid — after substituting wooden pipes, the family suffered no more 
 from colic or bowel complaints. 
 
 The presence of lead may be detected in water by means of sulphurated 
 hydrogen gas, which strikes a brownish color and a precipitate finally 
 settles at the bottom. But as Dr. M. justly observes, an able analyst is 
 not always at hand, hence, the safest course is to avoid the hazard by ma¬ 
 king use of agents not capable of doing harm. 
 
 Acids of all kinds particularly cider are extremely liable to become 
 poisoned by lead. A gentleman boiled cider in a brew vessel wiih a 
 lead rim. All who drank of it were sick — one died immediately—and the 
 master died miserably after lingering three years. Milk and cream may 
 be poisoned by being kept in lead pans, and hence probably the old reme¬ 
 dy for diarrhoea, of milk, in which shot had been boiled—(forming acetate 
 of lead,) a remedy now used in the same disease. 
 
 Numerous examples are given where sugar has been poisoned by the 
 oxide of Lead. 
 
 In one instance a whole family were violently attacked which finally 
 proved to have been caused by using sugar from a barrel in which white 
 lead had been left. Others who used of the same lot taken from the cen¬ 
 tre of the Barrel were not affected. 
 
 The oxides of lead when used in plasters, or as glazing for domestic 
 
174 
 
 Poisoning by Lead. 
 
 utensils, often produce the most deleterious consequences, and the greatest 
 caution should be observed in their use. 
 
 A fact of great practical consequence is mentioned by Dr. M., which 
 we think is not generally known, viz. : that the poison of lead when ap¬ 
 plied in a dilute state, often produces its effects so slowly that they are 
 not observed in months, or even years, and until too late for precautionary 
 measures. 
 
 The evil effects of lead when used for sweetening wines, refining syr¬ 
 ups, is well known — a gentleman had suffered from colic two days in 
 succession after drinking part of the same bottle of wine each day—by ac¬ 
 cident the bottle was broken and found to contain a quantity of shot 
 wedged in the sharp angle of the bottom. 
 
 Habit often enables patients to escape with impunity, while palsies have 
 been induced by sleeping a single night in a newly painted room 
 
 Treatment . — Dr. M., besides stomach pump, vomiting, and other usual 
 remedies, places great reliance on sulph. magnesia, compound infus. of 
 roses, with a view to form an insolublue sulphate of lead in the stomach. 
 Castor and olive oils are to be used freely. 
 
 We have known some lead manufacturers who required their workmen 
 to take weekly, a dose of from four to eight ounces of these oils as a pre¬ 
 ventive, and it was said with the best effects. 
 
 We extract the following very judicious and truly philosophical obser¬ 
 vations from a paper by M. E. Bowyer, in a late number of the Parisian 
 Medical Gazette, to which we are so frequently indebted for valuable 
 matter. 
 
 Intermittence whenever it manifests itself in a disease, constitutes the 
 essential phenomenon of that disease, and this, whatever may be the se¬ 
 ries of symptoms which appear during the paroxysm. The therapeutics 
 of all intermittent affections is based upon this fundamental fact. The 
 symptoms which appear during the paroxysm are only of secondary im¬ 
 portance whatever may be their severity ; and medication directed against 
 them is entirely unimportant unless we have also a special treatment for the 
 periodicity of these symptoms. There is scarcely a disease in the whole 
 circle of internal pathology, which has not presented itself in the inter¬ 
 mittent type, indeed many external affections have been noticed in this 
 form. 
 
 It is in vain to oppose to an intermittent disease the most rational treat¬ 
 ment, in vain we employ against it the medication which ordinarily tri¬ 
 umphs over it when in the continued form, we shall not thus cure a single 
 patient unless we attack the fundamental phenomenon — the intermittence 
 which alone is of more importance than all the other phenomena which 
 constitute the disease during its paroxysm. M. Braid, speaking of the 
 neuralgia of the face which so frequently appears in the paroxismal type, 
 says, “ the consideration of the type of the disease predominates over all 
 others, for it is nearly useless to seek for the cause of tic douloureux when 
 the attacks of the disease are distinctly periodic.” 
 
 This may be applied to all periodic diseases, and in my opinion it leads 
 us to the only rational treatment which can be successfully employed 
 against them. 
 
Gleanings. 
 
 175 
 
 G LEANINGS, 
 
 Louisville Medical Institute .—The fifth annual commencement of this 
 school was celebrated on the 3d instant. The degree of M. D. was con¬ 
 ferred on fifty-three young gentlemen alumni of the school, two graduates 
 of from other colleges were admitted ad eundem, and the honorary degree 
 M. D., was conferred on four practitioners, from Kentucky, Tennessee and 
 Alabama. The valedictory address was delivered by Professor Caldwell. 
 
 The number of bona fide students was 263, of whom Kentucky furnished 
 85— Tennessee 81—Alabama and Mississippi, each 30 —the remainder 
 were from States South and West. According to the Louisville Journal 
 this is the second school in the United States, standing next to Philadelphia, 
 which the editor thinks it may soon equal, yet says they are willing to 
 rank second to the oldest school in the country. If quackery is invading 
 the country, our medical schools bid fair to send forth an army fully com¬ 
 petent at least in numbers, to cope with it.-Dr. C. Knapp has been 
 
 removed from the superintendence of the Insane Hospital, of Maine, and 
 Dr. Isaac Ray has been appointed his successor the whole number of pa¬ 
 tients during 1841, was 133 ; deaths six. 
 
 Obituary. — Died in South Berwick, Maine, Albert Bartlett, M. D., 
 aged 27. 
 
 INSTITUTION FOR THE TREATMENT OF CALCULOUS AFFECTIONS, 
 
 AND OTHER DISEASES OF THE URINARY ORGANS. 
 
 The undersigned, formerly Professor of Surgery in the College of Physicians and Surgeons of the 
 University of the State of New York, and in the Medical College of Ohio, begs leave to inform the 
 Medical Profession that he has established an Institution for the accommodation of patients laboring 
 under Calculous Affections, Fistulse, Diseases of the Bladder, Kidneys, &c. 
 
 As the Members of the Profession are generally aware that the undersigned has practised Lithotrity 
 for many years, and devoted much of his time to diseases of the urinary organs, he hopes that this 
 Institution will meet with the approbation of his friends in the profession and the public. 
 
 Any person desiring further information, may apply, personally or by letter, to him, at No. 9 Park 
 Place , New York. 
 
 October, \2th, 1841. ALBAN GOLDSMITH, M. D. 
 
 DR. ALBAN GOLDSMITH will deliver a course of lectures on diseases of the genito-urinary 
 organs, including Lithotritus, &c., every Saturday at 2 p. m., at the Eastern Dispensary. At the 
 same time operations will be performed with clinical remarks. Students and Physicians are invited 
 to attend. 
 
 DR. CHAPIN’S UTERO-ABDOMINAL SUPPORTERS. 
 
 Trusses, Suspensory Bandages, fyc. 
 
 The subscriber having appointed Dr. Uriah Turner, General Agent for the above, a constant sup¬ 
 ply will be kept at the Office of the Medical Gazette, No. 121 Fulton htreet— Liberal discount 
 to wholesale purchasers. 
 
 Many eminent physicians in the city give these Instruments the preference, and those practitioners 
 unacquainted with them, can scarce be aware of the relief they afford in one of the most distress¬ 
 ing class of diseases with which the female sex are afflicted. J. R. Chapin. 
 
 New York , Oct. 22, 1841. 
 
 Dr. Turner is also Agent for Dr. Haynes’ 
 
 UTERO-ABDOMINAL SUPPORTERS. 
 
 An entirely new article, highly spoken of in the Boston and Philadelphia Medical Jouinals, and ex¬ 
 tensively used in the former city. Physicians are respectfully invited to call and examine them; 
 
176 
 
 Medical Advertisements 
 
 SPRING COURSE OF LECTURES AT THE COLLEGE OF PHYSICIANS 
 
 AND SURGEONS, 
 
 No. 67 Crosby Street, New York . 
 
 The Association by whom the spring course of Lectures was last year delivered, have the plea¬ 
 sure to inform the Medical Profession and Students of Medicine, that the course will be re-com¬ 
 menced next spring, with an additional number of lecturers, and as they hope, with added facilities 
 for Medical Instruction. The course will commence on Monday, the 21st of March, 1842, and con¬ 
 tinue till the 1st of June. Three Lectures will be delivered daily, except Saturday—hours from 
 nine to twelve, A. M. 
 
 The following Lectures will constitute the course : 
 
 On the Diseases of the Eye, by Geo. Wilkes, M. D., Surgeon to the New York Eye Infirmary 
 Clinical instruction at the Infirmary. 
 
 On Surgical Anatomy, by G. Buck, M. D., Surgeon to the New York Hospital. 
 
 On the Diseases of the Skin, by H. D. Bulkley, M. D.—Clinical Instruction at the New York 
 Dispensary. 
 
 On the Pathology of the Female Organs of Generation, by C. R. Gilman, M. D-, Professor of Ob¬ 
 stetrics and the Diseases of Women and Children in the College of Physicians and Surgeons. 
 
 On Materia Medica, (new articles), by B. McCready, M. D. 
 
 On the Diseases of the Mind, by J. Macdonald. M. D., late Superintendant of the Bloomingdale 
 Asylum, now of the Retreat at Murray Hill. 
 
 On Operative Surgery, by W. Parker, M. D., Professor of Surgery in the College of Physicians 
 and Surgeons. 
 
 On the Anatomy of the Nervous System, by J. Quackenboss, M. D., Demonstrator of Anatomy, 
 in the College of Physicians and Surgeons. 
 
 On the Diseases of the Abdominal Viscera, by W. C. Roberts, M. D. 
 
 On the Diseases of the Chest, Percussion and Auscultation, by J. A. Swett, M. D. Clinical In¬ 
 struction at the New York Dispensary. 
 
 On Clinical Surgery and Surgical Pathology, by J. Watson, M. D., Surgeon to the New York Hos¬ 
 pital. This course will be delivered at the Hospital. 
 
 On Fractures and Dislocations, by R. Watts, Jr., M. D., Professor of Anatomy in the College of 
 Physicians and Surgeons. 
 
 As this course was originally undertaken and is now prosecuted with the single aim of doing 
 something for the cause of sound and thorough Medical Education, and particularly to develope the 
 great advantages which New York, by her superior size, and by the consequent abundance and va¬ 
 riety of Diseases which are met with in her Hospitals, Alms-house and Dispensaries, offers to the 
 Student of Practical Medicine and Surgery, the Association have determined to continue the fee 
 for the Coarse at a price merely nominal—intending thereby to place the instruction offered, within 
 the reach of all who are anxious for Professional improvement. 
 
 Fee for all the Lectures, $10. 
 
 New York, October, 28th, 1841. 
 
 Observations on Strabismus, with engravings, &c., by Alfred C. Post, M. D., one of the Surgeons 
 of the N. Y, Hospital, formerly one of the Surgeons of the N. Y. Eye Infirmary, &c. &c. Published 
 and sold by Charles S. Francis, 252, Broadway. 
 
 WM. R. GOULDING, 35 1-2 CPIATHAM STREET.—SURGICAL INSTRUMENT MAKER IN 
 GENERAL.—Has on hand, and makes to order, all kinds of Surgical Instruments, of the most im¬ 
 proved patterns, and of the best workmanship. From a long experience in manufacturing, he feels 
 confident in recommending his instruments to the faculty in general, to whom he returns his thanks 
 for past favors, and solicits a continuation of their patronage. 
 
 He begs leave to call the attention of the profession to an instrument recently invented for intro¬ 
 ducing suppositories into the rectum, &c. in cases of irritation or inflammation of that tube, or of the 
 neighboring parts. 
 
 New York , September 1, 1841. ly. 
 
 GEO. TIEMAN, 63 CHATHAM ST.—SURGICAL INSTRUMENT MAKER.—Has on hand all 
 kinds of Surgeons’ Instruments, warranted of the best workmanship. Every variety of Instruments 
 made to order at short notice. From a long experience in Europe and America, G. T. feels confi¬ 
 dent in recommending his Instruments to his old customers, and Surgeons generally, and solicits a 
 continuance of their patronage. 
 
 New York, July 21, 1841. 
 
 THE NEW YORK MEDICAL GAZETTE is published every Wednesday, by Uriah Turner, M. 
 D., No. 121 Fulton St., entrance through Dean & Trevett’s Bookstore, to whom all communications 
 should be addressed, post. paid. Price $3 per annum, payable in advance—after three months $4. 
 No subscriptions received for less than one year. 
 
 By the regulations of the Post Office Department, Post-Masters are allowed to forward, under their 
 frank, letters written by themselves, containing money to pay the subscription of third parties to 
 any periodical. To render the performance of this act of courtesy less burthensome, the letter should 
 be prepared for the Post-Master’s signature, by the person washing to avail himself of the privilege. 
 If this is done, the favor will rarely be denied by any Post-Master. Advertisements inserted on fa¬ 
 vorable terms. 
 
 DEAN, PRINTER, 2 ANN STREET. 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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