764

cause will be eradicated by comfortableclothing, wholesome food, and good lodg-ings, which comforts can only be obtainedthrough the medium of constant employ-ment given to the poor." I

ST. THOMAS’S HOSPITAL.

POISONING WITH OPIUM.

SALLY BLAKK, aged 40, a married woman,living in the Borough, was brought to the

hospital by her brother, accompanied by omedical man, on Tuesday, August 11, be-tween eleven and twelve at night, labouringunder the effects of a large dose of opium,which she had taken with intent to destroylife. Previous to her admission into the

hospital, sulphate of zinc had been adminis-tered by the medical attendant as an anti-dote, which had produced vomiting, and shewas still under the influence of its emeticproperties. It was thought advisable, how-ever, to employ the stomach-pump, and somewarm water was accordingly injected intothe stomach by Mr. Staple, (one of the

apothecary’s apprentices,) but it was quicklyvomited again. In consequence of the ten-

dency to a state of lethargy, which therewas great difficulty in overcoming, she wasliurried about the square of the hospital, andannoyed by irritating words, (the latterhaving been found the better method of

overcoming her stupor,) by which meansthe effects of the drug were, in a great mea-sure, prevented. After persisting in thesemeans for nearly four hours, the patient wastaken to her bed in Queen’s Ward, No.13, where she was attended by the nightnurse, and one of the female patients; seve.ral table-spoonsful of lemon juice were

given after the stomach had been thorough-ly cleansed, and repeated doses of housephysic taken during the morning.

12. The patient states, on her further re-covery, that the ill-treatment of her lus.band and son-in-law had caused her to at-

tempt self-destruction, for which purposeshe had swallowed twelve pennyworth ofliquid opium, which she obtained in smallquantities at different druggists. The symp-toms she now complains of, are sickness atthe stomach, with almost incessant vomit-ing ; the flaid ejected, of a brownish colour,and emitting a sour smell ; excessive pain inthe head, and a tremulous motion of thewhole body; pupils contracted, fixed; pulse82, full, and incompressible ; tongue thinlycoated with brown fur, and a bitter taste inthe mouth ; bowels open by medicine.Took a calomel pill about one o’clock, anda dose of eflervescing mixture in the after-noon. The bladder became distended in the

evening, but not having power to expel itscontents, a catheter was introduced, fromwhich she experienced great relief.

13. The pain in the head, and across theeyebrow, with vomiting, &c., continued thewhole day yesterday until towards the

evening, when it subsided, and has notsince returned. Gomplains of tendernesson pressure in the epigastric region, andsays she feels pain there on inspiration.Cannot lie on the left side, and experiencespain in it, even on attempting to turn inbed ; dimness of sight at times, which soonleaves her, and returns again after a shorttime. Still has a tremulous motion of ùle

body. Has not passed any urine since itwas drawn off by the dresser last night, butfeels easy in the region of the bladder;pulse 78, a little full, but more compressi-ble ; tongue slightly furred. To be cuppedon the nape of the neck to twelve ounces;

I milk diet; took a dose of effervescing mix.ture in the night.

14. Pain in the stomach still continues,with tenderness on pressure over the epi.gastric region, which appears distended;pain in the head much mitigated, but is

equally severe over the eyebrows. Haspassed her urine without the assistance of acatheter, but says she experiences greatpain and difficulty in expelling it, and alsopain in the bladder when it becomes dis.tended ; pulse 78 ; pupils as before ; stilloccasional dimness of sight, but tremulousmotion of body diminished; appetite bad.Took about half an ounce of castor oil in theafternoon of yesterday, which has producedone evacuation. Fifteen leeches to be ap-plied over the epigastrium.

15. Perspires a good deal during the

night, and towards the morning has coldchills ; has no pain in the head, but feels anacliing over the eyebrows ; dimness of sightless, as the paroxysms do not come on so

frequently. Complains of a swimming sen-sation in the head when she rises up in bed.Has continued to pass her urine without theassistance of a catheter, and only a smallquantity at a tirne, with difficulty and painin the attempt ; is less tremulous ; bowelsopen twice this morning. No pain in the

stomach, unless when she attempts to turnin bed, or takes any food, which, to use herown expression, " seems to lodge there,and when it goes off, the pain is increasedfor nearly half an hour." Pulse 73, less full;tongue rather white ; does not sleep at

night, and says she has not done so sinceadmission.

17. Has not any pain in the head, ororerthe eyebrows ; is still giddy when she risesin bed, and feels the pain in her stomachwhen she attempts to turn in bed, whichshe cannot do without pressing with herhand over the part. Sleeps little, is trouMrd

765

with frightful dreams, and, on awaking,feels a pain in the epigastric region, whichcontinues for some minutes, with tremor ofbody; swelling of epigastrium less, butfeels pain there on pressure, which, she

Mys, shoots through to her back. Pulse 74,natural ; bowels not relieved since yester-day morning; has a sensation of bearingdown, and pain in passing her urine, andalso a cutting pain in the genitals; tonguewhitish. Ordered sulph. of magnesia, adrachm, in infusion of roses, three times a Iday. Continue milk diet.20. Micturition still painful, and accom-

panied with sensation of bearing down;frequent desire to void her urine, which is

passed in small quantities. Vertigo dimi-Dished, and dimness of sight less frequent;tongue whitish, and slightly furred ; bowelsopen; pulse 73. Unpleasant dreams at night,with sensations of falhng from heights ;stomach better; can lie with ease on eitherside. The pupils have gradually becomedilated, and are still fixed.24. Is now able to walk about in the ward ;

continues better in every respect, with theexception of the pain and difficulty in void-ing her urine, which she says is increased,and, from straining in the attempt, hasforced her womb down, which gives hermuch additional pain ; is obliged to sit forsome minutes with her hand under her,after making water, before it recedes. Statesthat she received a kick in the hypogastricregion some time ago, and experienced adifficulty in passing her urine the same day,and occasionally at different times since.Bowels kept open by castor oil. Catheter!Wt introduced since the day after admis-Mn.26. The patient is now attacked with

diarrhoea, but is in other respects muchbetter; she passes her urine with greatertise, and says that the womb has not de-Kended since yesterday, and then butslightly. Has been taking camphor mix-ture since the 24th, but it does not appearby whose directions, not having been en.tered in the physician’s book.Sept. 7. The diarrhoea subsided sponta.

seously in about two days from its occur-rence, and all the other unfavourable symp-toms have smce gradually disappeared. Thef4mpljor mixture was omitted on the 31st,and sulph. of maanesia, with infusion ofses, three times a day substituted. From ,the 20th to the 26th, the pupils were dilated Iand cxed, but have since regained a more !natural size, and become more susceptiblethe intiuence of light; they act still’a’:er sluggishly; in other respects she is The patient was under the care of Dr.Williams.

GUY’S HOSPITAL.

CARCINOMATOUS TUMOUR OF THE BREAST.

Sept. 1. 1’o-dav a woman, about 45 yearsof age, was brought into the operating the-atre for the removal of a carcinomatous tu-mour of the right breast. The tumour tirstmade its appearance about two years ago.The junior surgeon (who was the operator,)commenced by making semilunar incisionsabove and below the diseased mass, begin-ning at the superior, and outer part of thetumour, and continuing them in a directiondownwards and forwards, including thewhole of it, and dissecting it from its attach-ments : no artery required to be secured.The arm was at the same time held by Mr.Morgan, to put the pectoralis major muscleand integument on the stretch. The edgesof the wound were then brought together,and a pad of lint was placed over, and keptin this position by strips of adhesive plaster.

On ’I’uesday, Sept. 8th, Mr. Morgan re-moved a scirrhous tumour from the rightbr east of a middle-aged woman. The opera-tion was performed in the usual manner;about half a pint of blood was lost, and thepatient having become faint, some wine andwater was administered to her; three ves-sels were required to be secured ; the edgesof the wound were brought together by foursutures, a pad of lint was placed over it, andsecured by strips of adhesive plaster.

SEVERE INJURY OF THE FACE.

Catherine Flemming, a middle-aged wo-man, was brought to this hospital, Aug. 26th,in consequence of having received a severeinjury on her face from a horse ; the animalhad run away, and some men in attemptingto impede iti progress, caused it to hick thewoman. The whole of the left cheek wassevered, the superior maxillary, nasal, andmalar bones, were fractured, and the poorcreature presented a most frightful appear-ance ; the oibit appears not to be injured.She was put to bed, and the wound approxi-inated by a tape passed across it, and stripsof adhesive plaster applied to the edges.

24. Cold applications have been used withconsiderable benetit, and she is ordered a

pint of porter daily.2.’). The assistant surgeon (in the absence

of the junior) viaited her, and ordered thenitric acid wash to be used. There is a

fetid discharge from the wound, and a por-tion of bone has come awav.

26. Complains of pain in the head ; bow-els not open ; ordered three grains of calo-mel.

29. Wound looks healthy ; general health