and skin there was no tendency to stupor. In one case where there was extreme restlessness and a dry, hot skin, I used the bromide potash with the chloral hydrate with very satisfactory results. If the theory held by some be true, that chloral produces its anodyne effects by diminishing the caliber of the smaller cerebral blood vessels, thus detracting from the amount of blood circulating in the brain, it would certainly prove a potent agent in the treatment of cerebral diseases. I am not prepared, however, to embrace the theory until experience is more extended and satisfactory.

The month of October presented but one case of interest--a case of hæmorrhagic fever. The subject was a young man about eighteen, whom I saw in twelve hours after the first discharge of bloody urine. I found him quiet with nothing remarkable in his condition or appearance, save an occasional discharging of urine, each becoming less and less sanguinious. Anticipating a chill within twelve to fifteen hours, I gave five grains quinine, to be repeated at intervals of two hours, also at same intervals, gave ten drops spirits turpentine. During the night gave calomel, podophylin and extract hyoscyamus one full dose. The following morning there was no paroxysm as expected, bowels were moved during the night two or three times, pulse 85, compressible and small, extremities cool, restless with frequent sighing, nausea and occasional vomiting, eyes yellow and skin of a bronze color, urine still unchanged in color. Continued turpentine with a little toddy, also one or two grains of quinine every fourth hour, applied frictions of turpentine to the spine and ordered mustard bath to the extremities. Afternoon--patient no better, pulse very feeble, 112, surface cold, vomiting a fluid of an indigo color with smaller flakes of darker color, urine very dark with sediment resembling broken clots of blood, increased sighing and much delirium, bowels quiet. Since morning ordered brandy with aromatic spirits ammonia, at usual intervals, a dose of oil at night, frictions and rubefacients.

Third day.-Pulse weaker, otherwise without change; continued treatment.

Fourth day. Urine scanty and thick, delirious, quite restless. Gave chloroform 20 drops, laudanum 8, to be repeated every two hours. After the fourth dose was taken evidences of reaction were visible, and on the morning of the fifth day his condition was much improved, although the kidneys had not resumed their wonted functions; a few doses of fluid extract buchu were given with the desired effect, and the case progressed favorably for nearly a week; he then became extremely irritable and, although forbidding examination, I had reason to believe he suffered under tonsilitis, an eruption similar to scarlatina covered the body, and some small sores about the hands and mouth, noticeable but insignificent during his entire sickness, now assumed an angry appearance. I was unable to get him to take food or medicines, and after lingering several days he died.

66

Some few cases of pleurisy, pneumonia and bronchitis constituted our stock in trade" during November.

In December, meningitis made it appearance, confined, however, to one or two farms. With but one exception the disease was confined to negroes, and generally to children, none, however, under eight years of age. The manner of living doubtless had much to do with the disease, as it was noticeable that in every house where the disease occurred, one farm, there was near it a pen of hogs confined to fatten. Full doses of calomel and strong counter irritation had more effect than other agents in alleviating symptoms, yet they did not cure. With one exception every case died. Some, six or eight in all, within forty-eight hours after the first attack, one case within six hours. One case was relieved of the disease but died from supervention of pneumonia, while the only case that fully recovered did so after a like attack.

Since December several other cases have fallen under my care, and I have treated them successfully with blisters, calomel and morphine. I have also used chloral, but nothing very encouraging has resulted from its use.

REPORT ON THE DISEASES OF COLBERT COUNTY.

BY R. T. ABERNETHY, M. D., of TuSCUMBIA.

Owing to continued bad health, I have not been able to practice medicine, and consequently have nothing to report, except my own case. The symptoms heretofore given have continued with varying severity-indigestion, constipation, pain, bloody urine, &c. The urine at present has less blood in it, but is very red with the urates, sometimes cherry, sometimes dark. The redness is brightest when the pain in the right parietal region is most severe. I have suffered with several attacks of pain in both kidneys, and more or less paralysis, increased during these spells. Albumen and tube casts, variable in quantity, always present in urine. Spent a part of the spring and summer at Bailey's Springs. The water acted freely on bowels and kidneys, and I grew excessively nervous under the drain, so much so that I had a sort of convulsion, which came on while asleep. This was followed by a feeling of shuddering, which came on often but irregularly, beginning at the base of the brain. My body was cold all over and bathed in cold sweat, and my back and legs were mottled with reddish purple spots. Quinine, large drinks of gin, cupping over spine, and mustard plasters, induced a reaction and the ice bag over the base of the brain and spine brought about sleep and removed echymosed patches from back and legs. During convalescence from this spell I had a return of ascites. The effusion was partially expelled by cream of tartar, jalap, and podophyllin, with a large blister over abdomen, sufficiently so to enable me to ride to Ligon's Springs, which hurried off all the symptoms of dropsy and renewed both appetite and strength in the course of a month's use of the water.

During the winter, caused by exposure to a cold east wind, I had an attack of congestion of the kidneys, attended with paralysis of the lower extremities, which was relieved by cupping, liniments, and the use of valerianate of quinine, six pills (three grains) a day for three days. For the last two months have worn a seton. During the past year have worn setons in different localities along the spine,

and found much relief from the paralytic symptoms by their use. Finally, I have to say that the disease of my kidneys progresses steadily in spite of all the remedies used, though I have gained strength and flesh lately from drinking porter and gin freely, and guarding well against changes of temperature.

Appended hereto, I give the report of the diseases of Tuscumbia by Dr. Wm. Desprez, F. R. C. S., London.

DR. ABERNETHY:

The past season has been remarkably healthy, in fact the healthiest that I remember since 1843, except 1858, in which year one practitioner could have done all the practice it ordinarily took four of us to do. I think the reason last year was so very healthy is, that we had so little northeasterly or easterly winds, which winds, from the location of this place, invariably come to us loaded with miasm. For the topography I would refer to the report for 1871. By reference to the table you will see there were only thirty-seven days during the year on which the wind blew from the northeast and east, and to that cause I attribute the health of this neighborhood.

Since the first of February we have had several cases of pneumonia, which were fatal, among old and debilitated persons. Such children as had it recovered without difficulty. I met with three or four cases of typhoid fever; in these I tried sulphuric acid in twenty drop doses every fourth hour, alternating it with turpentine, carbolic acid and glycerine, given every fourth hour during the intervening period. Within the last few weeks mumps have made their appearance, but attended with no casualties except in two cases-in one it attacked the testes, in the other the mammæs.

60 Snow 30°

42 Snow 25° 39

REPORT ON THE DISEASES OF CONECUH COUNTY.

BY S. S. FORBES, M. D., OF BELLEVILLE.

When solicited to report upon the diseases of our county, my reply was, that the practice of medicine was at such a low ebb in this section, that I should have to rely upon my own resources. My reports show that my prognosis was correct; but such as I have I give.

The following article is intended for inexperienced obstetricians, and I trust they may read and profit by it:

Case 1st.-Mrs. A had been in labor forty-eight hours, when I was called. The attending physician told me he had been giving tincture ergot for twenty-four hours, and could get no effects from it; did not think it was good. Upon examining the patient, I found the os opened about the size of a half dollar. I said to him, the reason you get no effect from your tincture is, your patient has not arrived at the stage of labor when stimulants are admissible. I would advise a dose of morphia to quiet her, and at the same time as a relaxing agent to dilate the womb. He said he had thought of it, but was afraid to give it. I have resorted to it for the past twelve years, in similar cases, and generally with the happiest results. The morphia was given, the patient slept four hours. When she awoke, examination showed the mouth of the womb dilated, when labor commenced in earnest, and she was soon delivered.

Case 2d.-Mrs. J- first child, had been having pains for three days. The attending M. D. had been giving uterine stimulants for thirty-six hours, as he expressed himself "to make her have it," nolens volens. At this stage I was called. Examination showed the os open, only the size of a twenty-five-cent piece. The patient was bled, put into a hot bath, and a dose of morphia administered. She slept eight hours, when examination showed the os opened the size of a tea-cup. In three hours more she was in full labor, the child's head distending the perineum so that its hair could be seen. At this time all pain ceased, and no stimulant could arouse the womb to action, it had become exhausted before labor commenced. The forceps were applied, when she was delivered of a dead child, weighing twelve pounds. The question is, had the case been left to nature, would not her efforts have proved successful, and instead of a dead child, might it not have been living?