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SULPHATE OF COPPER IN CROUP.

AMONGST the papers in Kleinert’s Re-

pertorium, Vol. IX, No. 1, is one entitled" Observations on the great Efficacy ofthe Sulphate of Copper in Croup," ex-

tracted from the unpublished papers ofDr. SERLO, at Crossen...The great encomium bestowed ipon

this remedy in cases of croup, by Dr.Hoffmann in 1821, since repeated in va-rious German journals, has induced seve-ral physicians to give it a very extensive

trial. For the last seven years, Dr. Drosteof Osnabruck has employed no other

remedy, and according to his own ac-count (Heidelbertl. Klinis. Annalen, No. 2,1834), he has not since then lost a singlepatient. In the journal just cited, Dr.Droste gives an account of six cases of

croup treated with the sulphate of copper(one to ten grains), leeches, and purgativelavements; but if we analyze his observa-tions, we cannot see any reason for admit-ting them all to be cases of croup. In the

first only do we find any mention of afalse membrane, and the others appear tobelong to the disease which some Frenchwriters call false croup, or " laryngidestriduleuse," where the voice and coughresemble very closely the croupal form,but where no false membrane exists.

Dr. Serlo agrees completely with theauthor just cited, in his opinion on theefficacy of sulphate of copper; he remarksthat several inilammatory affections, suchas croup, infantile encephalitis, puerperalperitonitis, are incurable with antiphlo-gistic treatment alone. Experience hassufficiently shown the little trust we can

place- in blood-letting, leeches, &c., as a

means of curing croup; hence a numberof other remedies have been from time totime recommended, principally calomel

and emetics. The supposed action of theformer in checking the secretion of co-agulable lymph from inflamed membranes,led to its being given in large quantitiesin croup; but the action of calomel is

evidently too slow for the emergency ofthe case, while it produces the most un-fortunate consequences when adminis-tered in large doses to weakly children.As an emetic, the tartrite of potass and

antimony is too uncertain, on account of £the tolerance for the remedy which somestomachs rapidly acquire : it is difficult to

administer ipecacuanha to children, andit often produces violent straining; on thecontrary, a small dose of sulphate of cop-.er gives rise to severe vomiting, in a

rapid manner, and, if we agree with MM.erlo and Droste, is sufficient to completethe cure of croup without any other aid.

Since the year 1825 M. Serlo has em-

ployed the sulphate of copper, with leechesto the neck, in between forty and fiftycases, and assures us he has only lost fourpatients amongst that number. How-

ever, the same objection lies against theseas against the observations reported byM. Droste: many of them were certainlynot cases of true croup, under which head

the author seems to unite all inflamma-

tory affections of the larynx and trachea.Thus he says when the inflammation is

not primarily situate in the larynx andtrachea, the administration of sulphate ofcopper does not seem indicated, as was

proved by the autopsy of two children.

Six children of the same family wereaffected with measles and croupal symp-toms. In four the fever, hoarseness, andcough, continued ; they were ordered sul-phate of copper, but it was administeredto one only; all died, and two were exam-ined after death: in one the posteriornares were inflamed, and the larynx also;in the second the membrane and cartilagi-

*

nous portion of the septum were inflamed,and in a state of suppuration, but there wasno trace of disease in the larynx or trachea.M. Serlo reports nine cases in whilsh

the disease had lasted for some time whenthe remedy was employed. The followingwill give some notion of the idea he at-taches to the word croup, and of the ac-tion of vomitives in certain affections ofthe larynx.

Case 1.—On the 25th of February theauthor was called to a child one year anda quarter old. Since the’day before, it hadbeen hoarse, and to-day had a dry cough,with accesses of suffocation towards themiddle of the day. The child lay asleep,the breathing was irregular and short,and the pulse irregular and frequent.When the little patient was offered somedrink, he was seized with a hollow sifflantcough, and his voice was hoarse; on in-

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spiration a rale sifliant was heard ; sixleeches were applied to the neck, and threegrains of Cupr. Sulph., with six grainsof sugar, were given immediately after.When the action of the vomiting wasover, half a grain of Cupr. Sulph. was givenevery two hours.March 1. The leeches bled for several

hours. The vomit was given at eleveno’clock on the 28th, and brought on threelent fits of vomiting. The smaller dosesalso gave rise to vomiting, followed by aneasier state of the breathing; however,as the hoarseness became worse, and thecough more dry, the powder was con-

tinued. Up to one o’clock in the day thechild vomited after every dose, and wasmuch alleviated ; after one o’clock thisdiscontinued, and after eight in the even-ing the respiration was more difficult, thecough less violent, and the pulse veryquick. Powder repeated, and a blister tothe neck.

2. Morning. Vomiting was again pro-duced during the night by the powder,and towards morning a copious stool; thepatient now seemed a little better, but thehoarseness and dry cough continued; pow -der repeated. In the evening he tookfrom time to time a teaspoonful of Sulplt.Stil. Allr., Extract. Hyoscy., aa. gr. i, Aq.Flor., Tilia, Syr. Senegœ, aa. 3½. The coughnow became more soft, the general con-dition of the child gradually improved,and on the fourth day the patient wascured.

The other cases reported by the authorbear a general resemblance to the above;the children were between one and three

years old, and took twenty to thirty pow-ders, of a quarter of a grain each, beforethe cough gave way; a quarter of a grainwas administered every two hours as longas the cough continued dry and hoarse,and the remedy was only discontinuedwhen all symptoms had subsided. We

are far from thinking with the writer, thatthe cases thus treated were examples of

true croup ; however, the remedy seemsto have been administered with consider-

able advantage in cases closely resemblingthis formidable disease,-if not in its mor-

tality and nature, at least in external

symptoms.

CHANGES IN THE VACCINE BOARD.

To the Editor of THE LANCET.SIR,—YOU stated, in your last Number,

that in consequence of a hint from govern-ment, the National Vaccine Establishmenthad begun to reform, and that the head ofthe board had written to the working menthat their salaries would be reduced, whilehe continued to enjoy his own salary as be-fore. There can be no doubt but many ofthe vaccinators have been curtailed of partof their salaries, that some of the stationshave been discontinued, and that part ofthe Board have been obliged to fill two

occupations instead of one. It is nottherefore to be supposed, in the absenceof direct evidence, that Sir Henry Hal.ford in making this arrangement wouldconsent to so partial a distribution of thepublic memory as has been intimated.From your situation in the CommonsHouse of Parliament, no doubt you areacquainted with the particulars of thecase, and you will oblige the public at

large therefore, as well as the profession,by furnishing them with " the truth andnothing but the truth," so as to enablethem to judge correctly of Sir Henry.Can you state what is the exact sum al-lowed by Parliament, what the salarieswere at the beginning, and what they noware? I am, Sir, yours respectfully,

AN OLD SUBSCRIBER.July 6, 1835.’f.",’Ii Perhaps Mr. Carpue will enable us

to supply the information requested in theforegoing letter.-ED. L.

EXAMINATIONS IN CELSUS AT APOTHE-

CARIES’ HALL.

To the Editor of THE LANCET.

SIR,—It has been until now generallyunderstood, that the classical examinationof medical students by the Apothecaries’Company, would be made from the firstand third books of " Celsus de Medicina,"and the first ten chapters of " Gregory’sConspectus Medicinae Theoreticae." Withthis understanding I went up for exami-nation on Saturday last, when to my greatsurprise I had an extract given me fromthe second book of Celsus for translation,and I was informed by the examiner towhom I complained, that he had the liber-ty of examining from any part he mightthink fit. Now, Sir, I cannot blame theApothecaries’ Company for extending the