William Darrach MD.
Dear Dr.
below I give you more minutely the 
statement of the case I mentioned to you
the other day and beg you will excuse my
tardiness in answering your kind note.
Mr. R H. 21 years old called at my
office 2d. explaining of the most in
supportable pain arising as he thought from 
piles. On examining the anus I formed
no Haemorrhoids but the whole lower portion
of the rectum intensely injected and
protruded (prolapsed).- pulse 100
per minute conjuctiva of the eyelids infected 
also the fauces. some difficulty 
in deglutition etc.
By inquiring a little into the previous
history of the patient I learned that 
he had been attacked for the last 3 
summers in succession with heavy spells of

Dysentery and of a protracted
nature being at that time under the
care of a Homeopathic gentelman
After ascertaining these facts I considered
the young man to be under an attack of
Influence which had made its principal
marifestations on the weak spot of his 
system and put him therefore under
a general treatment. (Tyson's pulvis
antimonial) and had the pleasure to 
see him recover in a very short time
and without any local treatment what
so ever.
You may take the credit of the success
into yourself you having first drawn
my attention to that important fact that
difference will attack weak points.
Very truly
Your
obedient servant
Albert Frieke
Philad 1912 57

 

 

 

1
Asthma Anemia Nat. p. 111 A
Autumnal Powder hysop. 114 B
Abortin of 6 week Mr F K.O. 162 C
Aquarium Plantarun 213
Autopsy of T. P. Shawshank 218
Brain fever - Tubercular Meningitis? Cephalic inflame? 147
Cauli Vapour as Liqr.
Brumoc Polap. in children 211
Bark & thillandra Dee 228
Colch: Vin ʒi wth. Cal. Mag. ʒiij gout-112
Cancer catenatu wth Influare 214
Convulsion Pueperal 36 Eletuary p 102
Crepitancey Pulmonary-p. 125
Croup Ehrrine spasmodic & Membrane 142

 

5
D
D
E
F
Fever Epidemic Broncho-veni. air gesture form 95
" Remittent-3 steps & 3 in death W. Hamm 123
" Influenza gastric 142
" gastric sennac 143
Fungus Hæmatode & Neuters Mr McCannon 157. [cross out]
Eregeron Canadencis Ol: 3 cases of Leucorrhea page 75
Erysepelatus form of Epidemic Fever 98
Epidemic fever Bronchiae wh premunity neuralia
rheumet of the maul of Shoulder neck 160
Epidemic fever cephalic clear (Typhus 162
Epidemic fever argene 163
Epid. fever duretic 28 year 163
Epidemic of Nov 1858 229
Fungus Hamatodes of the gum 78
Fungus Hamatodes of the uterus 151
Fever-Epid. gastrocles capillary congestn.
bitter Enchatum-gastric pain-lax & flatulence 204
- Yellow. Bark Elizabeth J. Raa gr 206
- Hesmtal Dr Barker Darren 232.33

 

5 
Gon: Treatment p. 123
Glycerine wk leak in dry leak colic p. 161
Gala Bladder Death fr bursting of 225
G
H
I
Heart organic disease of weak cardae pain anasarca
urate ammonia in urine, thoracic paroxys & leak 76
Heart, adherence of Pericadica, depart a valve &
Hypetrophy. effect of capsular Rheumatis W. Hume 95
Heart enlarged & thinner as sequela to Rheumatismal 
influence & fatal for gastric bronchae Influence 146
Heart Functional dream of [illegible] Branches Pheum 153
Menth Bella
Hamorrhage of the Lung. S. Harrogh 234

 

7
J
Influence with gastro capilly congesti 163 K
" " congest of capily of tan of bra 163 S
J
K
S

 

9
Meteorism with Diseased Heart mistaken for Asate
+ Lapper p. 87 M
Miasm. Elev. 85 N
Meteorisn in gastri inflan 156 O
Neuro. Myls. pathy-223
Neuralgia new remedy in 229
Neuralgia Dr Lysseys 4 in 230

 

11 
Penitentiay E. State 210.
Paralysis 221 217
Pneumonic Typhus 219
Palsy embrocetic in. 228
Quinine & Opium in Epidemic p. 143 P
Dr Dr Pneumonic Influence 148 2

P Position elevated in papillary eruption of the leg. page 36 

13 
Rheumatism 110
Rheumatic fever 37
Remittant Bil. Fevr. 211
Scarlet Fever - Seasonal 115.
Scarlatina Intraverea p. 126
Scarlantia encreases stridence 220
R
S

 

15 
Fetter 124 7
Tussis Hyoidean Matriom 216
Taylor Mass Ann Sickness 226
Urate of Ammonia p. 161
J
U

 

17
Vertigo in childhood p.123 V
V
W 

 

19
Zinc Chloride of in Erypepela 229
Zinc Iodine " " Sunlite 230
X
Y
Z

 

21

 

23

 

25

 

27

 

29

 

31

 

33 
Epidemic Fever with congentn of the capillay
of the Menciphil & Medulla oblngata it induring 
palsy of the diastolic apte without loss of 
intellect: 
Infant daughter of Dr: C.J. Chamberlain 9th and Shippen
age two years and nine months had been sick
with brain disease for 2 weeks. At this time I was called
in consultation with Dr. Wiltanband her father
February 5th 1856.
I then found her lying on her side cheeks red capillary
circulation as rapid as in Scarlet Fever skin
heated, pulse frequent and contracted, urine as high
coloured as Madeira wine and transparent, breathing
peculiar consisting of passive respirations followed
at lengthy intervals with a deep protracted
inspiration and two short expirations. The 
face retained its expression except the eyes. These 
were without expression the eyelids would be retracted
quite a lengh of time, then the upper lid would slowly 
fall whilst at the same time the eyeballs would roll and
at times become strabismic. The inexpressive eyes were 
strangly in contrast with the other expressive features
of the face more especially with the mouth. This contrast
recalled the faces of the blind asylum and raised
the question if the child was not actually blind
of this sad fact we soon after became convinced.
The pupils became largely and permanently dilated 
after this we discovered that the child was also

2 
deaf. I then requested the carbonate of Ammnonia to be
applied to the nose or was it not the spirits of Hartshorne.
It remained at the nostrils without producing 
any effect for many moments, when there
was a watering of the eyes a contraction of the 
muscles of the nose and the child with aversion
to the effect rubbed its nostrils to and fro. This
satisfied us that the olfactories were impaired.
The child a month or two back had had a convulsion
from which it seemed to have entirely recovered
subsequently to this she was slightly indisposed
somewhat fretful and occasionally found
rubbing her nostrils. For this anthelmintics and
purgatives were administered, but without expulsion 
of worms: as
After a short space of time the cerebral complaint
set in.
Diagnosis. The red cheek appearing and reappearing
the rapid scarlet like flash of the cappillaries of the 
cheek, the wine coloured urine, the heated skin, the 
morning and evening exasperbations the pulse
in the first being 84 when that of the latter was 96.
And when the father was 96 the latter was 108 or 120.
These phenomina declare essential fever. 
The loss of vision, the abnormal actions of the eyelid, 
the fixed condition or the irregular motions of the eyeballs,
the fixed dilation of the iris, The impaired

35 
3
sensees of hearing and hearing and smelling indicate
a disturbance of the sensorium.
The diagnosis then essential fever with disturbed
sensorium.
The Acetate of Ammonia and blister to occiput and 
neck were administered.
6th On the following day the peculiar breathing was
a subject of special attention. The ribs were motionless
and so the sternum and clavical-there was
no rising and falling, contraction and expansion of 
the chest and as the abdomen was without expansion 
and contraction we may infer that the diaphragm 
was also at rest. The Thoracic cavity
did not dilate and contract with the contained 
lungs. The mechanical function of respiration
supplied with nervous power from the diastaltic
system-the respiratory nerves-was palsied. So that
respiration was reduced to the mere chemical function
as in animals like the tadpole and fish
deriving its nerve power wholy from ganglilar
system.
7th On the following day the right arm was frequently 
in motion obliquely up over the face
and then obliquely down over the face, chest
and bowels.
Eliterium had already been given since the 
last visit which after having expelled, some scybille
and lumps of mucus acted moderately as 

4 
hydragog. With this there was a partial return of 
hearing and smelling but not of sight. The 
child was far less insensible when the Ammonia
was applied to nose and intelligibly answered
yes or no to the parents, but yet the eye without
expression. The chest now again partially resumed
its natural motions.
8 The next day a remarkably [cross out] frequent pulse of
160 set in and continues. 9 The day after the same
frequency existed 1021. To this foreboding symptom follow
a venous congestin under the eyes. The face lost
all its expression and or the 21 day of its attack 
the patient here, calmly without convulsions of
any kind.
14
8
19
My diagnosis was an epidemic fever asks 
congestion of the capillars of the Sensorium 
and therefore ventures to predict that as
there was no delerium & no less of expression
of face except at the close, that the cerebelums
show no morbid appearances, but
that as the morbid phenomini was limited 
to the diastaltic septi vz. loss of venery heavy 
& swelling & to loss of much of chest & to convolutes 
much of the sym any not the lesser would 
he found open the sensori,
The Atrophy confined this diagnosis
Sugillation over two thirds of the back, the rest
of the body had an ordinary aspect. The scalp

37
5 
everted from the skull was bloodless. When the 
occipital portion of the skull was sawn through
a quantity of black venus blood issued. The seperated
portion of the skull being removed the 
longitudinal Sinus and the large veins of the 
Cerebri were engorged with black blood and the 
convolutions of the Cerebri were covered with vessels filled
with red blood (florid). Some there have been
and some, not withstanding the observations
of Yellorly who yet would regard this minute
injection as evidence of inflammation. But this
injection is not cappillary because it is not reticular.
It is aborescent and is therefore venus and
consequently the effect of the morobund condition.
Along side of one of the larger dark veins was
noticed one or two small deposits of dried fibrine
or of strumous matter which became
the topic of remark by the operator Dr. James
Darrach and by Dr. Wiltbank, Thicke and myself
whether it was a recent inflammatory
product of presend attack. I regarded it as irrevelant,
the surface of the brain was considered
as destiture of morbid phenomina.
The base of the brain and the upper part of the 
spinal cord were then exposed, here the eye
was quickly riveted upon the abnormal redness
upon the nates and Testes, the origin of the 
olfactory nerves the optics the 4th and the 7th the

6 
corpuscalosan the Medulla oblongata and the spinal
cord. This redness when examined under a
good glass was found to be reticular,it was therefor
neither venus nor arterial but cappillary
Its seat was neither in the arachnoid, nor piamatta
but in the binding cellular tissue between
them.
Here then on the censorium is seated and located
the cappillary congestion. NB. see drawing

39
7 
Local Small Pox on hands in contact with
small pox virus in Cloths
Jersey Shore Febuary 16th 1856
Dr. William Darrach Dear sir
An old lady who had been inoculated in
early life waited on her daughter who had the small
pox and among other things washed her clothing.
In a short time afterwards perhaps a day or two
she had genuine smallpox pustules covering her 
hands just as far as she had inserted them. They 
ran a regular course and she had not an other pustule
on any part of her person.
Yours truly J. Kenney
Icterous form of Influenza
Case 1st Jane Thompson aged 60 years Feb 24/56 at
Mrs Snodgrass's 5th and Green. On saturday 23rd inst:
she was attacked with severe pains in hupocondriac 
region of the abdomen. I saw her on Sabbath
Morning 24th inst: She was jaundiced her spirits extremly
depressed apprehensive of death, countenance expressive
of the extreme pain under which she
groaned, The slightest percussion upon the epigrastic
and right hupocondriac region was intolerable 
causing her to scream. The tongue was
large, hard, dry, coated with a white tipping of the Papillæ.
She has an insatiable thirst, felt very weak, urine

8
urine of a deep reddish brown, tranparent and having a
gamboge edge and small in quantity. The pulse was
tense and frequent. The skin was heated.
Diagnosis. Influenza with cappillary congestion of the 
duodenum and of the capillaries of the billiary ducts.
Indications 1st Special To relieve saind cappilliaries
Means v.s. and cups to hupocondriac and epigastric 
regions 2nd General indication to bring on a artifical
crisis of the essential fever. This is to be affected by the
salts of Antemony-Tartar Emetic-in combination with
Nitrate of Potash and Dover's Powders.

41 
9
Intestenal Form of Influenza
During the months of December and January Sensorial
forms of Influenza prevailed. And now in Febuary / '56
they have given place to intestenal form.
Case 1st Henry Leslie on the 26th also H. Dillingham
and myself. On the 25th Mrs ORiley, on the 23rd Mrs
Brown, [cross out] [cross out] were attacked with bowel complaint.
N.B. Small pox, Vareoloid and Catarrh still exist.
Broncho-Pneumonia benefited by blood letting
Case 1st George Habbard aged 30 at Mrs. Masons
contracted catarrhal influenza on the 1st of Jan
which resulted in a fixed affection of the chest
after two week inefficient treatment with lemon peice
Nux Vomica, hyosceamus, Muriate of Iron,
and Quinine I stumbled upon vs and found the 
blood to be cupped and sized. The urine has been
and continues to be extremly loaded with uriate of Ammoniæ.
The expectoration very abundant is mucopurulent,
the pulse a soft moderate calibal and 
120. Ascultation of the left lung anterioly with general
crepitance affords nevertheless respratory murmur
in both lobes. But the right lung in all its
lobes has but little respiratory murmur with
general crepitance and here and there an abundance
of mucous rale with tubular sounds.

10 
March 3rd 1 oclock PM. The pulse was an 120 soft 
and of moderate size, the urine abundant dark
Madiera wine color, heavly loaded with urate of Ammoniæ
expectoration very abundant muco purulent; emaciated 
and weak.
March 4th 1. PM His room to day as yesterday was
darkend. After opening the window shutter he remarked
you always catch me very sleepy at this 
time of the day. He had moustache shaved off
by a barber. This though he still retained his
goaty changed his aspect, But independently of 
this was fulled up and the lower eyelids
manifesly bloated as though he was he was under
the influence of Arsenic. Can it indeed be possible
that digitalis of which he is now taking 3
grains a day. The urine paler than that of yesterday
and containing less of urate of Ammoniæ.
The expectoration as yesterday, skin, softer
and less heated, expression of face as though in
health, pulse, softer, fuller, and less frequent.
Upon examinination of the limbs were not found
emaciated. He counted 20 before heaving. Oscullation,
no increase of disease. Prognosis favorable. 
Digitalis continued with some doubt lest it might
produce Edema of the lung. Treatment continued
March 5th 1. P.M. The bloat of his face has dispeared
notwithstanding the continued use of digitalis 
passed a sleepless and distressful night. Expectoration

43-7 
11
Expectoratio, urine and pulse the same continued treatment.
March 6th J.P.M. Urine paler less deposit, expectoration 
pale green, pulse 120 soft and full, good countenace,
clean tongue, stupid and dogy during the 
day wakeful at night.
March 7th 1. P.M. Continues to be soperose during
the day and wakeful at night. Urine, expectoration
the same Counts twenty upon second effort
is exhaused at 16, strong osculation discovers
in the left lung puerile respiration with
strong tubular breathing with crepitance
and in the right lung an absense of respiratory 
murmur for a strange mixture of
crepitant and mucous rales ronchus and
cavernous sounds. His strength is not lessing
he does not emaciate his deglatition is good
and his voice and countenance, natural
My diagnosis is still Bronchi pneumonia- not tuberculosis-
Prognosis, that he is consider cut in May. 
March 19th 1. PM. He is less taciturn, countenance expressive
of some hope of getting well, more sociable 
and extends his hand and welcomes you
with a warm grasp. Formally he could count
only to 17 and he can count to 50. The pectoriloquy 
has considerably diminished. The 
expectoration and urine as usual. Continue
the Cannabis Indicis.

12 
March 22. Pulse fuller, softer and less frequent
He lies on his side, sits up in his chair two and
three hours and his countenance is expressive
of hope; Expectoration and urine the same
He complains of the Cannabis making him
constantly sleepy I therefore have restricted
it again to an eving dose. Does not this medicine
remove chronic irratation.
March 25th He now sits up much of the day
and occasionally walks the room, which 
however quickly fatigues him. He says his
natural feelings are returning and that 
for the first time since his sickness he has
had natural sleep. His pulse is soft, full
96, his urine has lost its deep colour and the 
uriate of Ammonia is paler and of less quantity,
his craving of food is greater, and he desires
variety.
April 7th He now sits up most of the day
Expectoration has diminished. The urate 
of Am. soda and lime have diminished.
His pulse has become softer fuller
and less frequent.

13

14

15 
Tuberculosis in infancy congenital
Case 1st Sarah Montgomery conceived and born of a
mother whose system had gradually failed since a
previous birth at which she was attacked with intestenal 
influenza, which caused extreme meteorism
which then prevailed and rendered fatal in many
instances by purging. Even the half ounce of
Castor oil ordinarily given on the third day would
then commonly induce inordinate purging
followed with metorism. Mrs. Montgomery recovered
under the use of blister to the abdomen
and ten drops of spirits turpentine every 3 hours
and barley diet. Nevertheless she was ever after feeble
and contracted a dry cough, which continued
and became confirmed tesis. This was her 
condition before and after the birth of a small 
and feeble child. The mother died about 6 weeks
after its birth. Dr. James Darrach and myself
took the medical charge of the infant. It grew
but was always extremely emaciated and its
tongue became loaded with aptha and died
at age of seven months. Dr. James diagnosticated
Tuberculosus, which the autopsy verified.
Autopsy March 5 Right lung adherent to the 
chest a mass of tubercles aggrated. The messentary
as also diagnosticated by Dr. J. was also studded
with tubercles. The left lung though not adherent,
was nevertheless abundantly sprinkled

16
with congregated tubercles

17 
Scarlatina Simplex
Phila: Arch 4 & 12 h March 9th 56 Theodore Harrison
aged 6 yrs 2 m Cerebro-arterial temperament in full breath
& size.
9th 8 1/2 Sabbath Skin heated & off natural hue, pulse
contracted and 144 without quickness crayalanty to lightly
coated white. Edge abnormally red, soft palate entirely
searles & swollen uvuala & searles, & so lateral 1/2
circles and pharynx tinnts searles but not swollen 
I diagnosticated scarlatina simplex. NB Small pox
is passing away. With scarlatina now been prominent 
in accordance with a law that one species of the 
[cross out] genus exanthem is permanent at any one time
ꝶ Sulph Zinc & vi. Pulv Ipecac g viii. at 9 Am
It prompty vented
12pm Congestion of fauces & soft Palat lessen & deglutn
better. Face trunk arms and & thighs: Covered with erythene
but not the legs & feet ach the knees. [cross out]
ty now evald & dry. [cross out]
5 PM Skin mine healed erythene his extended on
the legs & feet. but put on the face is more 
intense. White lines from now to angle of mouth
& with the lower bit like a triangle. Extreme
flare of capillay circulation. pulse contracted 160. urine 
small in quantity turbid & salmn colour & deeply redder 
litmous paper.-evening exacerbate. 4 drank Water.
8. PM. symptn more moderate put 132. exacerbate say off

18 
Bowels moves, a yellow lax. Cent ꝶ ꝶ
Monday 10th 9 Am. thick dung the night. The erythem over the
whole body & sprinked abundantly with red points which end
the magnifing glass does not disturb or distanc or obliterate 
the fore bone mealy line of the skin but only more
deeply redder a few of the memb of skin
Why this local have maxm of capilly congest on the 
2nd dy of Eruption. pulse is less contracted & nervous to 96
skin less heated & evated with a thick white fur, which
under the mecurale is discover be detected epithelia
[illustration] not a parenytul vegetate as is aphæ.
[cross out] urine less [cross out] sev. bowel slight mmt. empty & Body wet
12m the white coat efty cast off in patches, by searle red 
& dry & slight congest for congested capillars
NB. The Dy Comb or Sabbath at 9 Am emptied the Stomach
of ingeste of salad, apple, potato, meat - the dime of the day 
person-Here is an arrest of digestion yet the child was
lively until the morng- an end is if centripetal dises
a very high centrifugal action- he was not observant to 
indisposed the day person-
7 Pm every exacerbation pulse 144 urin turbid & salmon coloured
130 8pm purge a slight mothly of the redness of the skin
Tues 11 9 Am mus fitula, pulse 136. yet more dilated 
sk=is more [cross out] mottled, [cross out] urine less red.
a more fibrin day
12m. 1/2 da
5 Pm pul 144. the day has be mu betr [cross out]
the urine be less [cross out] red & the more puls dilated 
by Billen & on then-

19 
Wednesday March 12 9 Pm Slepted, urine transparent & wthout deposit amber
colored, small in quantity and neutral - the blue litmus [cross out] 
way unchanged except very slightly so the red litmus was adhered tho Its remarkable that 
the wet litmus or dying became slightly red-Why so?
by [cross out] without coat was deeply red & so the gums-both were
swollen. the ty was coverd with minute translucent elevates
but not the back set horns projection of the papillæ.
The erythine of the ski has paper off. leaving confluent
arcolated cluster & skin of vernal color with
[cross out] minute conical elevates what may be, as
in cutis in sizing the [cross out] congested papulæ. This bring
into question & doubt, the muted guests of the 
venicular character of Scarlatina.
Pulv. 104 & dilated & soft. Furfara of Epidermis of
the skin of the face very evident today & began yesterday
afternoon. It does not get exat elv when
12 m the papilla elevated on the skin of the lip
& on a tm scent be lesser with venicle. but
of this there is dent or very much no moistures 
manifest pulse 104. Cont ꝶ
8 PM. Urine small in quantity transparent amber color wthout
deposit red slightly redder blue litmus paper. Dr. James D associated 
to the ear- remark that [cross out] small quantity with palor in
urea is remarkable more accounted for by walk. Why is it?
Puke 108 & soft & dilated-to clear deeply red & swollen & so 
gives. Skin a diffused redness without flash or capillary
coalition & when previous cut by the center hard, than
reappear the measlly [cross out] condition of Eruptieuclury

20 
circling that to the suspicion that the universal retin 
of Erythene is the effect of Belladonna. We the
distinguish the Bellad-Erythen for that of Scarla
by the form [cross out] being associate wth a moderate
& the latter wh a frequent flash [cross out] of circulate of
the capillar. Bowel pale yellow bulk up pearle 
ꝶ Toast water & Flax seed water & Barly water.
Ext Beler Qhei va.. 4 day of Eruption 7 day 
from [cross out] onset-[cross out] the
NB In the Furpura of the face & the red swolle ty 
aft carving off the white coat, coincident & if so 
is the red swolle ty the evide of the Retrocesse
- the seem Centripetal state. [illustration]
13n 9 am pulse 96 & more contracted & quick. the very next day, urine 
dent alter blue Citrus at the moment if testy but on during becomes
gradualy reddened. bowel slighy more with yellow feculence 
3Pm on pulse 108. epidermis of face cracks off- arate of cluster desate 
7 day. NB The exanthem of the face is in advance 
of the rest of the body.
7 1/2 PM restless scratchy [illegible] pain ꝶ Am and an only.
& omit medicine 
14" 9 Am Slept: Face red with erythem, Body without Erythem
& cover with the meanly cluster of eluate wth confluent entice
less without erythem & very few clusters but murmer red & 
elated papilla of the skin. or the hand Dr Jame exposed a 
watery fluid for some of the elevation what her as  
murmur. Bones sleeps more urine small in quantity

21 
14th 9 Am pulse-& contact a paler of the scale
Erythem less alt Nature redness of the check & the
[cross out] epidem still scurfy-The unarcolated chests has
paler aff but by rubby made me veribe
a the legs have pass off-In both the Erythem &
chest are last when & somet off the legs -
& redness DI D her remarks scale [cross out] spread
fr head downward & goes off fr feet when
6 1/2 mm. the [cross out] evening of the 7 day. the urine
has now become normally abundant after very 
durg the first week very small in quarts scarcely
a pt he dims. Urine now resume a normal reddy
of litmus fr the extra of abnormal redness-Red
of beg neutral. An Epithelm cell forms on
it at the arise the dise & 2 vary before 
the Eruption by is glow 2 enact of by: 1: where
coat 2: raw property powder 3. Chloro but have
15 9 AM to live surface but less congested & its musce 
last more ach, it makes & change of size returning.
urine has in it a perspired patch 
& it protudes & has no effect on the Citrus more 
or that reddening on previously. This state of
urine redness one under the suggests of DJD to 
omit the Br Cant too- what was prescribed yesterday  
& 1 ꝶ The chlor form Quinine NB. This case of Scarlat 
simplex has run for a full week and not a 2d week
alkali phosphate profuse state.  This alum, as hurt
phosphate state may be the condition for the dropsy

22 
as a sequlae of Scarlati simpl & and of abt the exanthm
the pulse 1 or 2 combined & quench. & that simple 
16 9 Am urine, remarkable & colorless & varies greatly of
urea & its inactive of blue or red litmus test paper
remedy. Fault of more return at his broth & ty has yet it scarlet 
red. but less raw & has more motion.
NB the less & distinct of the muscule act or the
ty her been overlooked. Pulse 96 Am & 108 Pm.
2d day of 3 death.
17: 11 day of Disease. 
pulse. 96 Epiderm pealing off in patch for
the back of neck & head. NB the desquamt
is not compar to the supher pimpl urine abounds & on ligament 
nearly it is a shiny Not in smalpox No 
epiderm is not after affected. cut Moquine
Nb Epidermis is Small pox is touched.
" Measle the likes of veneral primary this of 
desquamets
" Scarlet for the cutis epiderm skin off
Nb Scarlati course of a primary erythe which causes
desquante of the epiderm. & of a subsequent crop of cluster 
of pimple with aside like rubeola. then pimple hardy
been venata, yet have the beats flow for he expects
for this. In measle the primary pulse been venata but
the seconds easy do not & keep then & Now of 
scalet resemble each other.
18: urine slighty amber colour. translucent & fetid but although
it does not alter the deep blue litmus universally yet saw patch been
red it after by sticks sometimes with urine. pulse 99 Am 106 Pm. 9th day of dire
the cluster of erupt scaly be [cross out] seen.

23
Scarlatina Simplex
March 12. Ex Am
& thus Auld 12 Oyl Haneson aqv 8 qm at 3 Am sicken
& vomited, the ungentic was but of Lettin, meal & of the 
dem of 11 at strong an amevt of degestu for cerhaptic
cinclit of Scarlatina. An 9 Am 6 hours aft he was
cover to the knees with erythema & emplar of
hear & ea ach-She to sabyal to Ea ache. Soft Plata
& the rear of the faces is decty enjected, pulv
contact & 144. Skin heald to what which arch
infam & pressed part 
ꝶ Sulph Zinc & Sheer vol 11-
1 PM the Emetic pruely acid a a empty stomach
The engesti A Mruer Modied & the 
head ea ach remove. ꝶ Ext Bulue 8 1/8 e.b.h.
Face & [un??er] extementic in prespriation. papilla
on Arm & for Arm Marked.
8 PM. Aren-small in quantity pale amber what depress
& abunanaly Reddy litmis paper-NB. age in for pale
of head & pus. 
ure of & small to quantity NB? Skin moist deep erythema
one the enter body aches The leg effect-seph flash of the 
capuly curalati. ( no repose-Pulb 1 bo but not-exhaus
contacted [cross out] to it by moderty sup, 9 convice whe
powder & cured with suger what for studds with air papillie
a the [cath??] & edges [illustration] but where much [pr??]
No restleness
13 9 Am pulv 144. Erytha [p??] off & leans the clach of elect
week a flannel arcota. to cured what-[illegible]-where and
meant an [illegible] reha-bown [m??] cure
3 PM pulv 130 by what [illegible] urine emtic. What [illegible] 
7 1/2 PM & 144 by [sep??ed]

24 
Scarlatina Simplex
stomach. its digestive functions are arrested before even
the fauces are congested.
Proof 1st on the 9th of March at 9 1/2 AM. Theodore Harrison
at No Archer & 12 so of In Harrison before redness skin & during 
the full congestion of Sop palate & fauces, a dry vomit of Salt Zinc 8 vi
Pul Ipecac viii the which thereoff for the stomach, an ingest
consents of bits of salad, apple, wine & in quality about that of
the dinner meal of a child. This has remained [cross out] unchanged
in the stomach for 2 Pm of the 8th to 9 1/2 of the 9a. March 
19 hours.
2d or the 12th of March at 3 AM. Olga Hawsen aug 109
wakes & spontaneously vomited. a lite quantity of dinner ingest
but of salad meal &c-which had been eate or the 11 at 2 PM. 
Equal to 13 hours. the congested palate & fauces & Erupt appear
NB. These instances show that the mucus membra is six time aft vomits 
the stmach is congested before Nas of the throat or 
skin. Mosgagni states the measle erupt of the 
stmach - smallpox make its attacks persons in the 
stomach & in this beat out & headach. The stomach
the central ganglier the service is [cross out] primary attacked.
in Variety, Rubrola & Scarlata. Is it much of Erysepelas -
NB. Is not a mustard plate a black to Ehga to the
prop. finding applecat & [cross out] is not [illegible] & have &
not Tart Emet-applable.
NB. Unqualified indicates agt table Sut in Scaletfera 
18. 9 PM 8 day of the dise. -pulv 82 1/2 9 1/2 PM-urine pale desquants for almost
over. dents & paper while and a dart, no medic, were soak. 9 PM where
evacuant: ty her out be dehlter bit part of hendate a Nerve-

25 
Scarlatina Simplex
Tongue 1st light white coat. this consists of adherent Epithelia [cross out]
2 thicker white coat. accumulated adherent Epithelia.
3 thicker white coat with searles edge of to
4 Dith cast off in patches.
5 Dith entirely cast off displaying a raw & 
scarlet congested by with or without papilla projecting 
into cones seated backward
7 glased scarlet by & swollen without same papillæ.
8 the 2d lyn what was in place of the raw
red swoll to show this the cyst 
is not sunk below the part of the water.
9. The nuche of the ty are impartly the
disease. & restore by abatement of Vein.

26 
Scarletina Simplex
Skin
1. Erythene appearing on the face & spreads downd 
to the course of the day. 
2. new point dotted thus saw Erythene
3. Erythene palsy & the exposed in cluster
with camphor areol
4. Erythene passes off be any the cluster of
cannal red cluster or camphor areola
5. The cluster paler & which areola &
erythene.
6. Epidema on the [cross out] face scaly off on a 
surface & much itchy of the skin cause 
restlessness.
7. No venet detected

27
Scarletina Simplex
Urine
1. Turbed & Salman coloured for urete of Amminon-with increased
shape greuty 130 & redness litmus pack abnormally
2. Transparent & less pour to rede litums
3. The slighlest effect a litmus at the tem yet affectueny 
dry the litmus pack team ser.
4. Quatity less the a heatlh. Get speak graus him 105
5. Epitheic urine.
6. tents in ure
Do Ng exact dung Na 1s 7 Soup or the
remedy no prunes conget & if so
is the prunes congest universe or
the whole surface

28
Scarlideni Simplex
Pulv. cot
1. entered & frequent 144. 160
2 less contracted & less frequent
3 shell less so & so
4 Each day a marry parneya mild & short & every sever & long
5 Each week 1st run 2n a cm & decline
7 1cm 7
12.1 130 96.1 108 84 1-72
6 The dilatation of the capullan is assured wh
contraction of the arterial eystic & at the fomer
parson off the Medur also. 71
7 The venous system is not congested as in endermus
feve
8 The frequency of the puts is the [pa??s] of
[cross out. fever. [cross out] any to the pores
of the blow-The carthad cents only to
the epdem for if the feve & is owns to
not torn contactes but to abstraction of
blow awary for the week draw of blues the
molecular detact of the camphar-& has
what purges & [pe??] of fan. the
cahats nab of the ants [cross out] pathgam A
epidem fever.

29 
Scarlatina Simplex.
The peculiar Scarlet color-which owing to 
1 in the throat
2 or the tongue & gums
3 or the skin

30 
Scarlati Simplex
Pleura-
J Moore case
Sui Measles sudenlt cure
Sui Inflam in a O without cure

31 
continuation of Olga Harrison case of Scarlet fever
14: 9 AM Slept Erythema on face, Body without it & cover with
clusters of new elacte or [cross out] enfluent areola. legs without then
confluent archer & erythem & having only scatter pat
cluster of elate but may res projecting papilla - or
the hand Dr J Danar expressed watery fluid for the
res elerative if so is not Scarlatn Venacular-Bones
slips more. One Beladonna 2d day. The what pevat
of by has been cast off in patches-some of them remain. 
6 1/2 PM Urine redder litmus by is more a raw scarlet 
[cross out] swole by with a slight palor of white coat &
the papule elate but not papaly but cures
15: the pulse 84 ending [cross out] the chest he empty of
a white and has age from all by
16: Ear ache, ceases a white with sleep under cannabis 
but returned. by Connect & Pargn Elx bowel more
urine small is quantity pulse 96 Am. 108 PM.
17 9 AM Epiderm cracky off for the face. The areola
of the cluster pimple pass off & leaveing the smal
cluster M Manifest [illustration] & some appear of
remit at the lips. put 96 to her light coat &
quart much of it. bowels move, urine of [cross out] wn alu
[cross out] ex. out Beller & Ipecac-. [cross out] mild
case that the over. 6 day was a nip & oyntmt
ꝶ as the ski began to desquamat. the hardy 
is now necessary.
18: 6 - put 82 AM 96 PM desquat of fam but not yet of body.
pimple elected & elate a body - by has light white coat. 
19: put desquat of for cure but not those of the body.

32 
20 9 Am 10 day. desquament of face & neck has culled & yet
on the chest it has not yet begun. Has as seen
the chest of pimples wthout areola
or erythma-pulse 92 urine pale amber & redder litre 
cut warmer.
21 9 AM. desquanation resumed at the face but not yet
on the chest. pulse 84 ty to if almost normal character
a full & too new formatn & pealy face without pimples
urine has less its across & fetid like this:
22. 9 Am ty clea pul 84 face & Neck desquat but with chest
urine moderaty ear & pale
23 10 day 9 Am desquanate sore or on the face but 
more in the chest of a weaker body. 
24 11 day 9 Am idem & mutten chop. pulse 84.

33 
continuation of the case of Theo: Harrison.
On the 9th day of his disease, I prescribed orange & milk chop
water milk & sage & spong cake. Why the fetid urine? The clart
erupte has vanished. NB Is there recession aft the 8 day
What is the stat of things in the 2 week in Scacelus. Ep Nitre an
in the uri at the easy part of the 1st week. Causg No
Joining intend congest of the 2 day before cutan erupt 
the 2d internal congest must be in the 2d week. & then 
but cast of urine follow.
19 n 12 days 9 Am. pulse 100 skin heated, no perspiration desquamt over No
body exact to swel now spore as tho' related when eleatr where
has now disappeared leany tho the faded cluster of capilly
congestion the desquamt at the face is colored as thick was 
success as that of a skin ulcer-succesive causes epithel
until the permanent epiderm is established-Nb there is the 
2n week is a feeble & abnormal state of skin, the face is pale
as tho there was feeble ach of [cross out] liver before bile-NB Belly liver 
powder smell greatly ℥i if bile little kidney powders a qt of urine
urea is translucent full quantity, pale amber & redder normaly 
blunt litmus by is [cross out] scarlet. center pline was granulated
apporatey health. ꝶ milk chop cray &-
20: 9 Am. pube 84. there is yet a nuth of the sk
fr the part clust to the skin. Muscle catah of
by increased but he is weakness & redness at night
are fitful. urine is translucent & deep amber & 
peculiar fetid yet redder litmus.
21. pulse 80. urine has one amber color & less fibre & redder
sleepy stubborn. From disg or far & some red clust
22 pulse 84 Urine with indirect pulsant & very

34
the face still desquamty to her a styp case-
the chest yet in the skin
237 Some then of desquamat of the face
an then fetor - bit were consequent 84 yr
24. L. Restless at night

35

36 
Elevated position with blood letting in a chronic
obstinate papillary eruption of the leg.
Philadelphia March 8th/ 56. George W. Maclellan Esq
aged 70 at 202 Arch St. had been some time confined
to his house with an eruption of his
right leg and which also had extended half
way up the thigh. He had been using for it various
remedies and at the time when I saw him
the entire limb was enveloped with thick slippery
elm poultice. This was evidently aggravating 
the disease. But the chief cause of aggravation
was the pendulous position of walking, standing
and sitting. Thereby the limb weakend by disease
became congested with blood and edematus
The indications were elevation of the limb cold
water cloths vs and finally dry rye meal application.
Under this treatment the successive
crops of irruption dimished and ultimately ceased
and the swollen limb was reduced in size.
The limb became covered with dry caducaus
epidermis, a bangdage was applied and he
resumed his ordinary occupation. Here in
two weeks was cured an obstinate papillary
irrpuption recurring in successive crops which
had lasted some months.

37
Ergthematous reumathional Influenza.
Tsza Sandland aged 16 Race above 9th After exposure
to damp and cold was attacked on the 22
of March 1856 with pains over first the right and
then the left instep. The skin over these painful
spots was tumid and erythematous. Pressure
here was intolerable even that of a finger
to discover as it did the extreme rapidity of
the circulation. The parts were much heated.
She was unable to walk nor could She suffer
a pendulous position of the limb. Her
pulse was contracted and frequent, the tongue
covered with white caducous epithelia,
which is the pathognomic of fever with
cappillary congestion indicating the 
case to be a form of epidemic fever. I prescribed
arne, Ant ʒi, Tinct: dig ʒiss, Tinct: A con:
ʒiss, Simple Syr: ℥ss, Aq: Month: ʒ, Aq: Font: ℥ss
M ʒiq b h:
March 23rd Past a restless night erythematous
patches about the ancle and also yet upon the 
painful insteps. Tongue more thickly coated,
pulse more corded and frequent. N.B. Nothing
I believe but bloodletting can reduce the
system to the point of secretions and to susceptibilities
of medicine 8 ounces of blood were
taken. The blood was extremely bluffed and
cupped and the pulse became fuller and softer

resumed the mixture, diet toast water
24th 9 A.M Head comfortable sleep, pain and redness
have entirely left the feet, but not both
wrists are painful and intolerant to touch. The
serum of the blood was turbid and bilious and
deeply redded blue Litmas. The urine was
thickly turbid and redend blue Litmas paper
and only a pint in 24 hours. A piece of blue 
Litmas paper was moistened in the mouth
and thereby redended. Blue Litmas was put
in contact with the profuse, sweat of the palm
of the hand and thereby redened. N.B. Here
is evidently an acid condition in rheumatismal
fever. At the suggestion of Dr. J. Darrach
and give half an ounce of pure lemon juice 
every three hours. She prefers toast and 
water as her food.
25th Passed a comfortable night pain has left the
wrists, but the skin over all joints of both
hands-knuckles and finger joints present
erythematous patches, the joints are slightly
tender continued Lemon juice.
26th 9 A.M. Slept comfortably during the night
but now evidently more febrile than yesterday
skin heated and dry, pulse an 108
tongue yet coated white, urine without urate
of Ammonia, turbid urine color
or rather like beer and water with

39
somewhat of a light gamboge edge indicative
perhaps of some inaction of liver, blue Litmas
paper was changed only to reddish purple
indicating perhaps the antacid effect of
Lemon juice in rheumatismal fever. The 
insteps, and wrists are no longer affected.
The erythema on the knucles has lessend
pressure on them with the finger discovers
more moderate cappillary circulation, The Erythema
on the middle joints which are yet
painful and stiff is more intense and the 
circulation more rapid. The extreme joints
have begun to reden and to be somewhat
stiff and painful. The under part of the right
knee joint has now become stiff but without 
pain or redness.
[cross out] ꝶ continued

40
Epidemic Pneumonic Fever
Case 1st James McCharen aged 70 stones
short, large chested. On the twenthiet
of March was attacked with a pain
and stitch in the right side, skin
heated, pulse hard frequent and intermittent.
N.B. This by an ordinary practicioner of
antiphlogistic school would have been 
considered a case of Thoracic phlegmasia-
A pleurisy or pneumonia, and
would have been treated by bloodletting
blisters, Antimi and Calomel such a
pulse could not be reduced according
their motion without V.S. This notion was
corrected in me by the following event.
Whilst in Paris Dr. Holbrook invited me
to feel the pulse of Miss Valancien, it was half
full, bounding she was in bed suffering
with severe pain in her side which caused
a stitch at each inspiration and consequently 
short frequent breathings with
abnormal dilutations of the Ali Nasi:
At his request I expressed my opinion 
that bold and prompt v.s. was indispensable
and urgently demanded. He
replied that Brusseis had just viscited
her and had ordered leeches over

41
the seat of pain. I can yet recall my presumptuous
and conceited contempt at this
inefficient practice. At Dr. Holbrook's request
I visited the lady subsequent to the application
of leaches and to my asstonishment I
found that the pain was removed, the breaking
relieved and the pulse softened. This case
knocked my American medical conceit
out of me.
Since I have distinngished between
occasional cases of Pneumonica and the
frequent cases of Pneumonic form of
epidemic I have learned not only
to dispense with general but even local
blood letting and to rely on antimonic
and Aconite in connection
with bella donna and Bicarbonate
of Soda. [cross out]
In the present case I gave the following
R. ꝶ Bis Carbon Soda ʒss
Vin. Ant ʒi
Tinct: Aconite ʒiss
Ext: Bellad grii
Vin: Ipcac ʒii
Simp: Syrup [cross out] ℥ss
Aqu: Menth ʒss
Aqu: Flont ʒss
♏︎
ʒi of this every two hours removed all the symptoms

42 
Epidemic Pneumonic Fever
Case 2nd George Benson April 2nd After exposure
to damp and cold at duck shooting
during an entire day of rain storm was attacked
with pain in the left side of the
chest and short breathing in consequence
of a stitch and aggravation of the fixed
on the inspiration and a cough quick,
spasmodic, frequent and dry at the expiration.
His countenance expressed thoracic
disease, his skin was heated, pulse was
synochus-hard, full, bounding-demanding
anteflugistically v.s. prompt and copious
followed with antimoni &c as though
it were a case of thoracic phlegmasia.
But it was a pneumonic form of epidemic
fever. Oscullation did not indicate a local
crepitant rale with purile respiration
elsewhere nor was there a bloody sputa but
on the contrary both lungs afforded tubular
sounds crepitant and mucus rale. There
for the case was treated as fever by triturini 
and Aconite.
Under this treatment the urgent thoracic
symptons disapeared but on the eight
day severe abdominal pains, frequent 
and contracted pulse gastric and distressed
countenance which under ordinary

43
ordinary treatment subsided.

44

45 
Scarlatina Simplex
Alice Harrison ages 10 yrs Arch 12th Ap: 8/56
complained of sore throat at 3 pm upon examination at
5 PM I observed a moderate congestion of the uvala & 
lateral 1/2 arches & not much else. Being anxiously asked
by the Mother if it be scarlet fever, I replied that I hoped
that it was only a slight color as the pulse was not frequent
nor contracted one the to water nor eye lids injected
9th next 8 Am: [cross out] Her uncle the Gen
Paul here call upon for me to say that Alice was covered with
a scarlet & has vomited. Immediately visited her & found
a small clusty redness without erythema over fan chest but not much
on Arms & between the knees only a very pale cluster 
The veins were without congest as a yellow taken by damp weak
But the throat extremely congested Top pale & ancles
hand each we think & faces by her a white heat. pulse pique
but not be contracted. Much put out & each down out of temples
& Salt Tea Ipec gvii M
12 M pulv 144 & contracted, the eruption is blotchy Ruberlow 
cluster with red points consisting of congested arthritis eryth. pastulea, circutate
of capilea moderaty rapid not much of the eruption
below the knee to be what was, light which exposed 
eye lids ducts infected. urine is clear & another where
still congested & tumid but the pain & different 
depends remind by the dry vomit - Bi Carb nate
gv. Cal gii-& treat water she has no urine
for hour.
7 PM. Pulse 144 even heated urine pale peculiar fetor, abnormal
& instantly redder deep blue litmus-quarts normal -

46 
to has a slight increase of the white coat & some red 
points studded over it. not permanently so. [cross out] throat 
[cross out] congested & very tumid - uvala is congested to 
double its normal size & so the parches but not fibrin 
white has water no impair deglutn - & pain 
or in scalet or pira. She says that it does 
not pain her more is it different to swallow it we
bef the emeti was given. The face is cover with 
layer patch of erythm & the white line are 
arm - the more mouth. This saw Olga Theodr & is 
a fatid mark is the same case of Scarlatina 
on the chest then a arm fr intense Erythem. 
& so on the arm but with any much color in 
brown palate over elbow & on the hair - has 
the palm has such palate. The erythem is  
slow palate exact on the thigh. but bets the 
knee then are any the tubulen cluster with 
papillu cluster: NB. Has the erythe of a pelet 
charat appear. sutre greaty to the ruberten 
cluster & papille where in There Olga [cross out] the 
unifr erythen preceded the cluster
The calyn & the cast swap & has not yet operated. no 
other means is [cross out] given. Rx mineral & treat water 
The comple any of a heel of the skin. 
10th inst. 2nd day of dermal eruption. 9 Am. [cross out] a restless 
night. pulse 132 & contracted. to has detached patch 
of white coat. slimy frequenty color not deeply scarlet 
& motion much impaired. Paryem fr to favorite 

47 
but palate & faces deeply scarlet & tumur - the 
uvula is scarlet & even aches but without pain & 
deglutn not [cross out] much disturbed. the erupt as
now without [cross out] much erythen & caused chiely if
cluster with murmur projects papila under
perfectly to apulla are more shaky then each the
cluster or erythema. [cross out] the erupt [cross out] is now at over
the legs & feet but moderately however the bowel have
be now 3 times day the day by the cal & sore
the dense any tumeric water, toast water & Barley 
water salted with sugar.
9 Pm pale 144 & idem
11th inst: 3 day of Erupt ext. pulse 108. urine clear & pale
moldy and. & small in quantity - to her cast off is even & 
new pressure is broad relaxed, deeply congestd frequety
papilla- The Erupt is papily - & or the back
of her & want the papilla cente a broken fluid
like pus. throat get neck congestd-
12 int he lay of Erupt ext pulse 84 & enlarging and
clue & is great about & slighty ache when
to her a glop in the centre, congested throat 
less, papilla of the skin into min birth mark
Rx Barley dose & no medic yet
13: 5 day to pulse 84 Am 109 Pm to urine pale
amber & stripy redder litums, to min glops
& very mint congested, & min gland for the
meduium line areole of chest gone the papule
min lightly [illustration] & lymph tender.

48 
14 week: 6 day. to more globe less congested fauces
must lesser - uvula reduce to natural size &
color. but arches are red - pulse 86. slight fitful
a fever. papilla in back of head reduced - Erupt 
bleeds In gestures. Can bark tea & spring cake
15 week 8 day pulse 84 stay general recipe. The elevated papila
of skin are platted & prevent dilate crust or dried seats -
the glass of it to give plea to more granular papila 
& the nature most of it & must be retire, the 
fauces somewhat more congested- arm & very part
absorbed & translucent & her the peculiar fetor
of neck of this. Desquenat exist in face & 
on the papille of the neck of the body.
This fetor indure now to give much tea & the
[cross out] gentia. But at 8 PM. I found her
with [cross out] blotches of erythem on the face 
pulse freq & cubeb & then restless - omit the
breakfast & return to Barley diet- She is m 
restless or numb It is the 2 week 
16 c. 9 1/9 pulse 84 fetid & pale healthiest urine desquat
in face & in circles is the benefit here [illustration] wh
meal cake [illustration] like a dip of congested lymph.
17 10 day pul 84 idem. to her loss it scales wh 
but less yet scaled fauces get 1 layer congested
18 11 day pulse 84 urine more abuden wh fetor 
& of a light arm be color & less hardened is
more transparent
19 12 day pulse 84. She peels off the epidem for back of head; desquamatn
or fauces

49 
20 13d pulse 84
20.14 pulse 84 desquant cut: emaciated cut. Mother tea

50 
Epidemic Fever with primary congestion of intestine & becomes of 
spinal cord with congesta cure
Lydia Cope aged-Arch St. Philadelphia
April 18th /156. Called upon to visit her on account
of a sudden attack of diarrœha. Perceiving
that besides this the skin was
heated and dry, the pulse frequent and
contracted and the tongue somewhat which
I remarked that she had fever which
required her to be in bed. Restricted in
food to barley enter and toast water
with ice, and to take pills of Calomel, She
cac: and Opium, and under moist clothes
covered with oil silk constantly applied to the 
abdomen, the occasional interposing of a
thin mustard plaster between jaconet
muslin to sustain a moist and reddened
surface without pain.
19th The diarrœhea was arrested but she passed 
a restless night and now is extremly
restless. The pulse is an 108, urine scanty and
high colored, complains of gastric distress.
Prescribed Saline mixture V: Antimonii
Exp: Cannabis Indicis. She threw off
the first dose. The medicine therefore admitted.
A 5 [cross out] pulse an 120 contracted
restlessness increased.
20th A yet more restless night skin healed,
pulse 96 contracted. She complains

51 
extremely of a fixed pain under the Sternum
along the outside of the thighs the urine
scanty and of a translucent beer
colour. She had occasional reachings.
6. P.M. Pulse an 108. 
21st The fifth day of the fever passed a restless
night and now her patience is exhausted
by universal distress of body, fidgets.
Being asked where is your pain she replied
Oh it is everywhere how can I endure it
and grasping my hand in agony she cried
Oh! let me die. With this she had a 
fixed aching at the Sternum, Sacruna
and thighs. Her pulse was 120 hard and
bounding demanding release, the urine, more 
of the beer colour with gamboge edge.
The ball of the eye at the external canthus
tinged greenish yellow. N.B. The
day previous under an impression that
the condition of the stomach was of
nervous irratability. I percussed the
spine and found the two spinal 
processes opposite was painfully intolerant
to percussion. I therefore applied
cups to dorsal spine and from four
of the 8 nearest the painful vertebra
drew blood. It produced only a momentary
abatement of the gastric distress. In

52 
some of the reachings there was thrown
up some of the dark particles-venus
blood.
22nd Finding that the stomach continued
to be intolerant of food and medicines
and that the liver was evidently
disordered and that the pulse had now
become full and tense even to hardness
I took ten ounces of blood from the 
arm. The blood was abnormaly dark
and shot out with abnormal force.
When about ten ounces had been drawn
and its color more normal, and the 
pulse had lost its hardness and increased
in frequency the vein was closed
After this there was a discharge of
malinea. The stomach having now
become more tolerant of food barley 
gruel was given and I ventured to give
ten grains of Calomel, and subsequently
on the following day 8 grains of
Calomes in the drachms of Castor
Oil. The bowels now discharged more
abundantly the same melinoid
substance evidently from the portal
system through the villi to be mix
and modified by intestinal contents

53 
24th The seventh day of the disease I administered
a drachm of glauber salts
and a grain of Calomel every three hours
in order to relieve what seemed now
to be evidently a congestion of the portal
system.
25th The eight day of the disease the pulse
which during the previous week had been
at an 108 in the morning and an 120 in
the evening became 106 in the morning
and an 108 in the evening, [cross out]
The discharge from the bowels ceased to 
be melinoid some sybilous feculence was
discharged. The urine was less bilous
26th The ninth day of the disease the pulse
84 in the morning 96 in the evening
Urine has entirely lost the beer tint
stomach is now tolerant of rich chicken
tea and her sufferings very much
abated. The Calomel pills were now omitted
to avoid unecessary action of Mercury.
N.B. In review I considered that as
the primary irritation of bowels and
stomach had passed off and the congestion of
the portal system had 
been relieved and that the frequency
of the pulse had strikingly lessened
on the eight day. I prognosticated

54 
prognosticated a favorable issue that on the 14
day there would be the important crisis
when the system being released from
the strength of fever the hepatic system
be much less embarrassed, the urine
become more normal in quantity
and quality.
27th The tenth day pulse 84 in the morning
96 in the evening menstruation
came on all medicines having been
now omitted her sufferings greatly
abated. Every prospect was pleasant, a
beautiful bougueau of flowers was presented
to her, which she reached out
her hand for and with a bright
countenance enjoyed.
28th The eleventh day of the disease pulse
26 in the morning and 84 in the evening 
more febrile.
29th the twelfth day less febrile the menstruation
did not last beyond a day
30th The thirteenth day suppression of urine 
now occurred which not yielding to fomentations
to the hupograstrium and
spirits of Nitre with watermelon tea
The Cathiter was used and a full pint 
of urine drawn off this new and 
unexpected system was at the 

55 
the time unaccountable.
May 1st fourteenth pulse an 120 in the morning
and an 128 in the evening tremor in
the fingers, abnormal action of the Aloenasi.
Slight flush of the countenance, she
accidentaly puts some spirits of Hartshorne
which produced a slufing ulcer
on the tongue and roof of the mouth
behind the left incisor. No urine was
passed during the day and at her own
request owing to pain it was again
drawn off and that abundantly the
quantity and quality was such as
might be suspected at the second crisis
of fever except that it was a brandy
tint.
2nd fifteenth day pulse an 120 in the evening
an 132 Ther complaint was restricted
to extreme prostration she lay on her 
back without disposition to move even
her limbs tremor of her fingers continued
incapacity to urinate, Catheter again
used at night and a full quantity
of urine drawn off. Wine whey was 
now administered an account of her
prostation
3rd sixteenth day pulse obstinately continues
an 120. Distressing ulceration of tongue

56
tongue and gumb continued. Delirious
during the night, she has lost her
expression of face her uncommonly
brilliant and expressive eye has become
a tremulous staring eye, her lips
are swollen and affected with a tremulous
pouting, the tremor of the fingers
and wrists are more manifest her intellect
and will are unaffected [cross out] uninfested
by promptly and correctly answering 
questions relative to time place
and numbers.
4th Seventeenth day. Mild delirium during
the night, pulse smaller, weaker, and 
from an 120 to an 130 her will and intellect
are yet retained but her natural 
expression of face is changed into an 
inexpressive stare with tremor as of
one under fear. She has incontinence
of urine and increased tremor of hand 
and wrist, the entire hand of each 
arm was in constant tremor, I asked
her to move her arm, she looked 
at me in an anxious tremulous manner
and an impulsive manner
dried out I cannot. I then for the 
first time perceived the present
state namly palsy of the diastaltic

57
diastaltic system from epidemic cappillary
congestion of the membranes of the upper
part of the spinal chord. I called
Dr: Pepper in consultation.
5th Eighteenth day All the symptoms
of said palsy increased yet will, intellect,
and speech continued melenoid
discharges returned. We considered 
the case hopeless.
6th Nineteenth day. The cerebral functioncs
of will, intellect and speech
continues, The entire loss of voluntary
muscular action and of power
over the bladder, and in their place
muscular tremor, prone position 
of the entire body, the head sunk
down upon the shoulder, and incontinence
of urine and loss of expression 
of face indicative of palsy
of the diastaltic system in connection,
[cross out] and the melenoid alvine
discharge, constitute the three
categores of symptoms of this dubly intents
case of Epidemic fever. in which, with
chronic congestion of frontal system there
was congestion of the capilea of the
intestines as shown in the primary diarrhea
& the recessive to the capillary congest of spine
end. & chronic palsy or diastole urea

58

59
Secondary Venus congestion of the brain mistaken
for apoplexy.
Case No 1. Mrs Peter Hay aged 58 years Dilevyn
street and green. On saturday May 16th she became
unconscious and continued in comatose 
state with laboured breathing, pupil of the 
eye fixed and dilated. The nearest physian
called in haste regarding it apoplexy applied 
cups to the temples and the back of
the neck. After a few hours the family physian
arrived and prescribed a grain of Carbonate
of Ammonia every two hours. I was
called in consultation on them 18th at 10 M
The doctor stated that he regarded it as
apoplexy from the softening of the brain and with
a fatal prognosis has given this opinion
to the family. It was owing to the alarm
thus produced that I was called in. I 
found her with a feeble and frequent
pulse, relaxed, resembling the pulse in
the convalescence of epidemic fever. The
skin was slightly heated. The Coma was
not extreme she could be roused and
induced to slightly protrude her tongue 
her almost insensible breathing 
was occasionally interrupted by deep
heavings. After this visit I obtained from 
the doctor in consultation the following

60
history. Three weeks ago she had had remittent
fever, but during said three weeks
he had ceased visiting her because he
regarded her convalescent. The attack
of supposed apoplexy came on suddenly.
Upon inquiry it appears that the 
so called remittent fever lasted 4 weeks
had no augmenting exasperbations, and
no black alvine discharges or other evidence
of portal system, no gastroentericic
symptons. The doctor therefore
was willing to accede to the suggestion
that the fever was not endemic but
epidemic, that there was no venohepatic 
congestion but a cappillary congestion.
I then ventured the opinion
that his patient during the hazards
state of convalescence had owing to an 
indulgence in table diet and to an unusual
damp and cold of may had
become subject to a capillary of bronchi,
which induced a primary venus 
congestion of the lungs, and a secondary
venus congestion of the brain, and
that the cephalic system were not 
apoplectic from softened brain but
comatose symptoms from venus congestion.

61
I therefore suggested Carb: of Ammoniæ and
the oil of turpentine, the latter to remove capillary
congestion, the former to increase
the vital force of the lungs. Under this treatment
she gradualy improved.
On the 20th our attention was called more
especially to oscullic signals of the lungs. Anteriorally
the morbid sounds were confined
to the upper lobe of the left lung
consisting of crepitancy and various
abnormal tubular sounds. Posteriorly
there was crepitance down the entire line
of both lungs 

62

63

64

65

66

67 
Fracture at the Back of the Skull &c
John Currier aged 38 yrs [cross out] cerebral nervous
temperament, energetic but Aclicate - bones small -
sharp right. Allen Sr. E Kensington.
May 13/56 Tuesday 10 Am he fell from a sharp scaffold 11
feet & struck the right side of his back upon a large
block whilst working in Maxwel ship yard near the
Navy yard. He was carried home completely insensible 
& so remained from the moment of the blow
[cross out] until Wednesday 10 PM. = 36 hours
Insensibility from Concussion of Brain from
momentum = weight by 130 lb in velous of 10 ft fall 
lasted 36 hours
Wednesday night relief from febrile reaction
& so on for several days.
I was called in consult by Dr Senderling on the 20th 
of May several days after the accident at 12 pm.
Understanding that the patient was a ship right 
I was expecting to see a stout muscular drunken man
[cross out] but was surprised to see him on his back
in a semispurn state or span about intellectual 
looking person. Dr Sendering, speaking
loudly to Mr. Saul, Here is Dr Darrack who is corny 
to see give. He lifts his eye lids, looks at me &
reaches his hand to web in one. Here was no
distortion of the muscles of his face but 

68

69

70 
right eye lids was ecchymn. He sank back
onto his soporm state My attention was directed to
a hard side or the [cross out] right parietal bone as an 
endema of part of the skull. It reaches the
case of Gen Edlene who was stunned by a pale
or the head what left the hand irregular rides under 
the scalp &c. sembly fracture. I relieve the
mur of the & that there was no fracture but
that the injury was upon the base of the brain
from the contd curve He then stated that there 
has been a copious bleedy for the eyes ear.
Then I regarded as additn ender of my
portion but has no notn of fractr of the 
back of the skull.
I then directed my attention to as cater of the 
injury we or the cerebra the seat of intellect
or as the decartath system & theref put
the folthy questions. What month is this. Am February
I directed his attack to the condit of a base at the
wander. Oh it must be may for the glorum leaves
He is an elder the Baptist  chh. & very diuretic. How much
is 2 & 2. Am 4. 12 time 12 146. adds 43 & 32 Am 75.
How may child Am 3. He had 2 but a new way
allay him- & one of the fauces which he heads his own 
All the sulpr was that the lenin was not or
the cerebium. I then applied by ear with chest &
may surphus to find a total absen of same
no abunance some & no restricts murmur.

71 
the ribs were muhales but the pulse was full & regular
but only [84] 60. There seems to be a palsy of the 
respect function.
I regard the conjoing wh the sertum & not when
the cerebra & hard recals to mor the care
of fire of Lynne whe Dr Chamberly chief 
but I had no idea of part of the back of 
the skull not the input of the bleedg for
the Ear & the ecohym ear
I mention the case to D J. Danan & instant
he recognize one of Hilton case of fract wh 
the been 2 aches of these were not also a
dischs of seru for the Ear. All this was new 
to me & open up a new intent of parts
of the skull. The very incredulus I has near 
of parts at the base of the sku but one 
and it requires wh the part at the 
tempure [cross out] base from color or the occahet
ꝶ Barley diet & salimi mixt & rest & quiet the
bones have been newer.
21 Pass a restless night. semisopmore, Early 
rower into an exa of man or name, number
& recognition but not of recollect. I asked her
what was [cross out] matter with him & what the
occurs but he has no knowledge of such 
matter. he could be waked not an excess
of mur but has no cntind action of mur 
He prefer wh an uncnscious sleepy state 
ꝶ continued ꝶ

72 
22d 23d the symptom contin the same
24 the pulse always behind 72 never been harder &
the night more restless. Under the idea that 
more have inflam bones [cross out] temple
blow was taken for the arm, back of the hand
speck blister, & Cal Nit Potass & T Emet to 
salivate was administer.
25. 26. 27 28 29. the previously been more
encrease, she left it suddenly & the
bladder but it suddenly so that the accumulated
watch her when drawn off wh a cathet.
the urine was paler with saturni.
29. 30. 31. sympt greedily became worse & 
4 In 1:1 11: whe the calm expire either
convulsion 29 days aft accident
Autopsy was never by Dr J. Danark in the prese 
of Dr Sanderly & Mr Danark [cross out] Dr Tucker
on the 12 of Lime at 4 P.M.
The scalp very dissected & evicted from the 
aponium muscle, the peak of the blow was
curved or the right temporal bone.
The skull cap being sound & renewed. there
was found a clot of adherent granules blow
or the dura mater covig the right temporal bone
the sz of 2 1/2 inches diameter. & here was with
a vertical clean fracture of the square postn
of the temporal bone a parglobe bone ! No diploe 
& much liebe to postn. here ends the diploe. [illustration]

73 
the upper surface of the cerebra when the duranet was remove 
exhibited no nuche appearance
The under surface of the brain was sifted for the bare of
the cranum by an moderate quarts of serum, and adherent 
to the pons varoli & the nares last then was a
low mass of yellow jelly looking fibre & under it 
then was a new emulent & adherent fibre wh 
the congestd (inflamn, capilly of the pre nare
the ventrile of the Bra was enlare to Ureater
the natural temples with serum. The sulph
luciden wh dissolves to a softer placates 
the cupen strict & Release use of pia comte

74. 
Dr A Fuche Case of Ovarian Dropsy
with Pregnancy
Jany 16/56 Dr Fucke tapper Mr Master Sr 
and drew off 2 1/2 gallons of olive colour whey albuminous
fluid.
The ovarian dropsy began Ap. '53 the uterus before tapes
was laterally displaced so that the os facis the less
acelatalum. The swelling of the abdomen was uniform
pulse is full & healthy. patient is fluid & healthy.
This is not dropsy for fever, inflament a disease
but perhaps mutation for sharp a Manner
Aug 18/56 num 4 1/2 mn pregnant Dr Fuche sapps
her in the hennitue part are new below the 
unbelieve safely. The fluid was clear & whithish
[cross out] & moderates ripy. It flowes with dispartes & dram 
of 22 pints = 1 gal 3 qrt
She was not in the least exhausted but
the next day D J found her wth Materin
cast pain in the right has lumbar & ehichnenac
region. With a pulse of 120 & lower 
He took below & gave Calomel & meraic oil
or the 3 day a serous quarter of prectorents
or nervous irritates for shock of operate
& steretous of distentn. ꝶ Salt Merth &
of camph & each cal &c.
or the 4 day symptoms aggerated & now
the pulse ever more lower & the delerium 
or V.S. by see cutis pile. & then xxx. Ounce

75 
when later & about appear & calomel crust
The next day the blood was found buffey & cupp'd
crimped in all the cuts. & patient must take
month & relive skin, put sevar to 108 & the 
urine less red & no pain in the red.
NB vs boldy as in Nu Lilac cures has saved the
patient. see Homeopathy declar the vs should
never be performed.
Olium Erigerum Canidensis
in Leucorhœa
June 1856. Mrs: H Parrish st: had been for
a length of time subject to L-which induced
pelvic pains and distress with loss of appetite,
palpitation, headache and general weakness.
After taking the full dose for some weeks
the L-ceased and with cessation the constitutional,
symptoms disappeared she now enjoys
health.
Case 2nd
Mrs Newel aged 38 years has for sometime 
been subject to L-and after taking full
dose four times a day for four days the L-
has much abated and she enjoys better
health.
Case 3rd
Miss M. R. has taken during the whole
month full dose without benefit.

76 
For sore nipples the following recipe
ꝶ strong infusion of green tea an ℥i
honey....ʒii
Alum...ʒi
Armenian bole..ʒi
Organic disease of the heart inducing cordal
pain, anasarca, urate of Ammonia deposit
S. Jamison aged 81 Norristown August 31/56
called in consulation with Drs Carson and
Baker. Mr: J is one of the most extensive and
enterprising manufacturers of Norristown
Scotch Irish, nervous temperament, six foot
in height, brawn, strong featured and has
experienced as a manufacturer all the shocks 
of all the tariffs from that of 1816 until 
now. He has been seven weeks under medical
treatment. His face is not indicative
of disease. The Cappilaries are full,
countenance natural and so the featurs.
He is care taking, kind, but unsocial and
inclined to look upon the dark side of
things. A week past he has a copious spontaneous
vomiting of dark offensive matter,
and his bowels are easily disordered. The 
symptoms though which are at present subverted 
are paroxisms of pain in the left side of 
chest short, convulsive breathings, tremors of 

77 
the arm which frequently occur based upon a regular
action of the heart and an irregular intermitting
pulse without venus congestion and
associated with anasarca and cerate of Am: 
in the urine.
N.B. Is this a primary organic disease of the 
heart or are these cordial symptoms sympathetic 
from a primary disease of prima via,
and if so is this abdominal disease so affecting 
the chest a congestion of the muscous
membranes or schirrous of the stomach or
is it nephritic disease.
Unable to make a satisfactory diagnosis
we ventured to proscribe ext: Cannabis 
Indicis and sulphate of Morphia for paroxisms
Am: Sulphate of Copper, Oil of Turpent
and for the calomel half a grain
every three hours with Ipecac: fourth of
a grain. 
Sep 3rd The Thoracic paroxisms have ceased,
diarhæra has occured the swelling of
leg worse continued treatment and recommended
nutritous diet.
Sep 5th he suddenly died in one the thoracic
paroxisms.

78 
Fungus Hematodes in the abdomen & thigh.
The tumor at the time of the operation, was, on
the thigh, spherical and without the least irregulants
of surface, tense, smooth & even, as tho' uniformely
distended with air or water but when manipulated
its surface very irregularly yielded to pressure
as tho the contents of the tumor was heterogeneous.
This, with the rapid softening & growth of the tumour &
the explicating with tweas & cannula expose any
blow induces me to diagnosticate the tumor
a case of Hey's Fungus Hematodes. our recalls
the Shomberg St. Case under Dr. Physic & During dress
by Dunbar & myself.
The origin of this tumour is as follows
Five years ago the strained himself in
the right groin by kicking with all his
might a dog which attacked him this
lamed him for awhile and swelled for a time the
glands of the groin of this however he entirely 
recovered. Two years ago he was in 
the habit of frequenting Craigs riding
school, and took a pride in athelectic

79 
exercise of leaking into the saddle from the rump
of the horse and even also on to the neck of the horse
from the rump and indeed such was his uncommon
muscular power that he could leap from 
the rump beyond the head of the horse when it
the head was secured in a proper position.
Thirteen months ago he experienced a slight pain
limping and lump in the right groin at the 
place of the former lump. Since which the lump
has grown into a hard tumour on the crural
side of Gimbernats ligament, With its very gradual
increase there has as gradually taken
place a hard tumor within said ligament
evidently a projection of crural tumor; Constituting
an irregular dumb bell tumour, the 
narrow middle part of which occupying 
the crural canal the outer portion being
the crural and the inner the abdominal
portions.
In this form and hardness and in these localities
it continued to grow for several months,
during which time he continued to walk
daily in the practice of the profession.
The last six weeks its growth became remarkably
and alarming so that on the thigh it
assumed a projecting spherical body of two
and more inches diametre, and within the 
abdomen an oblong body of equal bulk

80 
The last two weeks have yet much more rapid
by increased the abdominal portion more
than three inches in length and the crural
having become a spheroidal body of at
least three inches in diameter, Besides this
rapid increase the tumors more especialy
the crurals have become manifestly semifluid
and painful.
Dr: Murray determined with the concurrence
of Drs: Altee, Darrach to have the tumor
removed. Therunto the tumor was subjected
to the following examination
First the crural tumor being placed between
agas light and the eye of the observer was
found to be opaque.
Second. Being manipulated over the surface
it was found to be of different degrees of
density fluid, semifluid and solid.
Third: A very delicate groveed trocar encanulæ
were passed three inches into the 
substance of the crural tumor and thereby
was abstracted blook of a dark color,
which under the microscope was found to
be nothing but blood.
These observations induced me to diagnosticate
the cases Fungus Hamatodes
A medical council was held to meet it possible
the desire of Dr: Murrary for treatment by ablation

81 
ablation. Dr: Altee at his own request was present to
give his opinion after that of the council. Dr: Drisdell
the youngest gave his judgement in favor of
an operation. Dr: J Darrach expressed serious
doubts of its propriety. Dr: Frickee favored the operation
without hesitation. Dr: Gumminger
urged the operation. Dr. Roberts felt that he
could not oppose the operation and also Dr:
Wiltbanks. The chairman being then called
upon to express his views at large stated, that
he considered the tumor Fungus Hamatodes
a local disease resulting from accident, but
which reccurred after an operation on the excise
part, but did not return [cross out] if a limb
on which it was situated was amputated.
This occured in the case of Dr: Physick patient
in 1819 and in some of Mr: Heys cases. But
that in Dr: Murray case the affection implicated
the pelvis and was therefore beyond the 
amputation if it recurred and the original
operation of ablation might require
the excission of the peritineum. He could 
not therefor see how an operation could
cure the case nor how it could lengthen
life, on the contrary he beleived that the
disease would recur and by being beyond
the reach of amputation would shorten life.
Dr: [cross out] [cross out] A second opinion of the 

82 
council was then called for, when Dr: Fricke and
Gumminger reiterated their judgement in
favor of an operation, Whilst J. Darrach, Robert
Wiltbank and [cross out] opposed the operation.
Dr: Altee then gave the following opinion 
He could not agree with those who regarded
it of a malignant nature though not prepared
to call it Fungus Amatodes that name
been given it by the chairman and not by 
him. He feared that it originated and was
attached to the bone and so connected to peritineum
would be feared be removed in an operation
of oblation and therefore could not reccomend
the operation.
The following questions were then put to him
by the chairman.
Is not the tumor malignant?
Will it not most likely recur?
If so will it not be beyond the reach of amputation?
Will not the primary occupation greatly
hazard speedy death by peritineal inflamation 
and in all respects will not an operation
an acute fatal issue instead of an
chronic fatal issue? This was replied to in 
the affirmative.

83 
Dr: Murrary was then called in to hear the result
of the council, he determined upon the 
operation It was therefore determined to have
the operation on the following Thursday.
Accordingly at this time Dr Altee performed
it assisted by Drs: Drisdell and J
Darrach in the presence of about twenty
physians or more, A semilunar incision
was made through the integument
over the crural tumor, a flap of the
integuments having been made and
everted upon the groin exposed or cyst, 
which either by a touch of the knife
or from its delicate texture burst open
and discharged an enormous quantity 
of black blood clots fluid blood
and lumps of medulary carsinometus
matter. The quantity thus discharge
more than filled the largest size
wash basin. Dr: Atlee then freely introduced
his hand from the crural
sack of the tumor through a large
opening of Pouparts ligament into 
the cavity of the abdominal saculated
portion of the tumor and emptied
them of the above mentioned matter,
he discected off as much of the sack
as possible, which belonged to the crural

84 
part of tumor. There was no hæmorrhage
in this operation beyond the bloody contents
of the tumor. The form of the sack seem 
to have been thus [illustration] crural abdominal portu 
The wound was then closed with a few ligatures
and treated with cold dressings.
During the first fortnight there was a copious,
fetid, saneous discharge from the
wound. The face of the patient assumed
a cachectic characture, the pulse became
weak, frequent and quick, muscles affected
with nervous ragors, tempting us to make
an unfavorable prognosis, Nevertheless
the ages of the wound closed by the first
incension, and now on the fifthteenth
day after the operation he is sitting up
in good spirits, good appetite, pulse reduced
from 100 to 84 tongue clean, no 
pain, in the seat of the tumor and but
very little discharge from the draining 
orifice.

85 
Elio-Miasm
June and July 1856 was without pain. I therefore
predicted that August would be very rainy and
as there would be the ordinary August heat
and ordinary maximum quantity of de composible
vegetation I inferred that there would
be formed a heavy amount of Elio-Miasm,
and consequently a heavy amount of remittent
and intermittent fever. Accordingly I cautioned
against remaining in the country after
July.
But although the predicted August rains
did occur there was unexpectedly a remarkable
absence, of the ordinary heat of this month
consequently the triple agency heat, moisture,
and dead vegetable matter in [cross out] creating
Miasm, was absent. The Fall has therefore
been every where, without, endemic fever. The
Apothecaries of the city report that their sale
of sulphate of Quinine has been unusually
N.B. If endemic fever be not caused
by Miasm, Why has it not existed this 
Fall?

86 
Epidemic pulmonary congestive fever.
Case 1st Samuel H Porter aged 35.
Strumous habit and for many years a victim
to it even to the destruction of the bowels
of the nose, a soft palate, one third of the 
derm of the back, the integuments of the 
foreheads and a large portion of the outer 
table of the Os frontis.
The last three years were without this active
Scrophorilous disease. He married and enterted
into buisness. October 3rd /56 he was attacked 
with, a bronchial congestion, which
continued with fever with increased destructiveness 
until it ended at 3 P.M. 4th end 
N.B. The case resembled that of Dr: Grant's

87 
Disease of the heart and gaseous distension of
Abdomen, which last, was mistaken for Ascites
and tapped.
Case 1st Thomas Brown, aged 40 sanguineas,
muscular, large frame and very corpulent
had for many years been a grocer on the 
Schuykill and accustomed and able drink
ardent spirits excessively without intoxication.
Fifthteen years ago he was attacked 
with disease of the heart for which his
physcian Dr: Hartshorne frequently bled
him which always relieved the distressing
circumstance. Nevertheless he has been
more or less embarrased eversince with 
cordal symptoms. So
Last July he visited Saratoga to obtain
alleviation of his suffering by drinking
the Congress spring water. During to fatigue
from travelling he drank the water of
the spring in his bed room which was
somewhat stale and drank of it very abundantly.
He then very soon after became permanently
distended in the abdomen which continued
till his death. Naturally corpulent and
having a large corporation, nevertheless there
was a distension which alarmed him and
which was accociated with embarrasment

88 
of his beast and endema of the legs. I 
I was called to see him on the 12th of September
He told me that he was so enormously swelled
with the dropsy that unless it were removed
he could not live. From his enormous sized
prejudged the case Ascities and was surprised
to find no impulse of water upon my hand
Dr: I Darrach also percussed the abdomen
without satisfactory evidence of the existence
of water. Dr: Fricke who I knew cordal
detect it also very kindly made percussion
with but very slight evidence to him of 
its existence. 
Dr: Naudyne and myself now under
our care And after three bleedings by which
the blood was cupped and sized and firm 
The urine of 137 specific gravity dependant
upon extractive matter, which was reducable
to sugar. The pulse large and bounding
We determined upon tapping believing in 
spite of want of evidence of the existence of
water. We were compelled to this by the urgent
solicitation of the patient. Dr: Fricke was invited
to the operation and were all inferentialy 
satisfied that the abdomen was enormously 
distended by Ascities. Accordingly
I plunged the trocar but not a particle of
water came forth. Through a gum elastic

89 
cathetar but not a particles of water issued.
This astounded us the next day we more carefully
percussed the abdomen by tapping over 
the hand and found the abdomen everywhere 
resonant. This fact satisfied us of Meteorism.
And as it recalls a case succesfully treated
by me with the stomach tube introduced into
the large bowels. I obtained the consent of
Drs: Fricke and Naudyne to introduce it 
which I did but without deriving any benefit.
Not a particle of gas passed out through the 
tube.
Remarks. 1st There was no water in the abdominal
cavity. This is evident from the 
facts that there was no perceptible fluctuation, 
the distension came on suddenly at Saratoga
after an extravagant drinking of state
congress spring water and the use of the trocar
and canula and gum elastic cathetar
failed to draw off a drop water.
2nd The extreme distension was owing to 
gas in the small bowels because the abdomen
was resinent when one hand being laid upon
it and strickened by the other. And because the 
distension was greatest laterally and above,
whereas in dropsy the shape is more ovoid
with butt end below.

90 
3rd In Ascities the patient shuns the horizontal
position that the water may gravitate in
to the lower regions of the abdomen and give
greater freedom to respiratory action of the 
diaphram.
4th In Meteorism the elevated position affords
no relieft and therefore seeks not to 
change for it the more easy recumbent
position.
5th In this the lower limbs and genitals
are not distended, whereas in Ascities which
has become so extreme as to demand tapping,
the lower limbs and genitals are distended 
with dropsy.
Practical Rule. Ascertain in proof of Ascities
that fluctuation is perceived That the horizontal 
position is more embarrasing to respiration
than the elevated, that lower limbs
and genitals are distended with dropsy, and 
that the quantity of urine is diminished.
2nd Ascertain in Meteorism that the resinents [cross out] of
the abdomen exist [cross out] the application of one hand
upon the abdomen and the striking of it by
the other; that the horizontal position is
generally preferred, that there is an absence of
distension of the lower limbs and genitals
and that a normal quantity of urine is
passed.

91 
Meteorism.
The decomposition of vegetable and animal matter
is attended with the illimination of gases hence the
flatulence of the bowels and stomach. It is true that
digestion counteracts putrefaction, nevertheless
gaseous elimination in the bowels and from injesture
and there are some kinds of food which cause
it more than others such as cabbage, turnips, chesnuts
&c. The Mother's milk in the stomachs of 
the infants within six weeks of age is a prolific
sort of flatulence, and is the cause of the extreme
colic of tender infancy.
There is however a formation of gas in the stomach
and bowels independent of injesture. My
attention was first called to this fact in the
case of my friend Dr: H We had neither of us 
eaten supper and before day began our journey
from the valley to ascend and cross Mount
Senis. After we had ascended he was affected
with gastric flatulence and rifted off gas from 
his stomach in great abundance. We were both
satisfied that as our stomachs were empty
that this gas did not proceed from injesture
Whence then did it proceed?
After excessive purgation the alvine discharge
becomes very frothy which to the experienced
practioner indicates hypercatharsis. Here also
there is gas without injesture whence did 

92 
it proceed? In the extreme stages of cholera
infantum the bowels become extremely enflated
with gas, and so also in the final stage of mortal
remittance. In neither of these cases do injesture
exist. Whence then the origin of the gas.
A few years ago I gave on the third day of 
confinement the ordinary dose of Castor Oil
in a case of obstetrics, it inordinately purged
and then the empty bowels became enormously
distended with gas. This occurred so frequently
in this city at that time in similar
cases and for a while very fataly that 
it was called the the swelled belly and much
dreaded. Some obstreticians owing to the unusual
mortality dreaded to practice, When 
this gaseous illimination? Pe
Persons of weak bowels are subject to extreme flatulence,
whence it is?
I have known the cavity of the uterus subject
to gaseous illimination when is this?
I have seen bubbles of gas in the veins of the
misentary of a frog. (in the field of a magnyfying
glass) Whence is this?
I once tied the neck of a green summer snake
from six to eight inches long, and suspended
it in water, In a short time the entire skin 
was studded with countless minute air bubbles.
Whence these air bubbles?

93
We must not forget that is not only the mucous
surface of the stomach and bowels and of the 
dermal surface, but that all the bronchial
tubes terminate in air cells which eliminate
gas.

 

95 
Broncho Veno Congestive form of Epidemic Fever
associated with Chronic thickening of the 
valves of the left side of the heart.
Case I. William D. Hannum aged 15 and half
year Trancisville Oct: 1856 After an unusual
exposure which localized itself on the bronchia.
After a primary chill he had a moving
and exascerbation with a contracted pulse
varying from an 120 to 130. His local symptom
were extreme oppression of the chest, fixed pain
in the left side, and extreme shortness of breath
with short arrested inspiration a constant
and most distressing sensation in the chest
was that the chest was to small its contents
O: Mother said he, I could cut my chest open
to make room.
These symptoms increased daily and to them
was added bloody expectorations. He died with
in three weeks of the attack. The autopsy was 
made on the afternoon of the subsequent day
of his disease. The left lung was found adherent 
to the sides of the chest but the adhesions
were tendered and easily ruptured
the lower lobe of both lungs were distended
one half beyond the normal size of dark venus
color and when cut into the parenchema
of charcoal blackness, detached portions sank
in water, but [cross out] not softened there was not

to be found, the bronchiæ were then were then 
exposed and found to present a reddend surface
through their extire extent on both sides. 
Here then we have the bronchial cappillary
attraction of Epidemic fever which by constricting
the bronchial tubes diminishes inspiration,
and thereby causes an accumulation
of venus blood in the lung and accummulates
carbon.
This is often may commonly mistaken for
Neumonia
The pericardeon was found closely adherent
to the heart so that there was no pericardial
cavity. The heart was enlarged in it cavities
and thickened in its parieties two thirds
beyond its normal condition and the 
valves of the arotæ under the left oracles
were thickened with fibrinous deposit
The Adhesion of the pericardeon and these
thickening of the valves are consequences of
his previous attacks of articular rheumatism
It recalls the case of the late Henry S. Patterson.

97 
Snyderian form of Scarlet Fever
Case Ist aged 3 years at the Southern
Children's Home Nov: 1st 1856
The child lay on its left side its head bent
down upon the chest its left hand covering
the eyes which were constantly closed, the cavity
of the nose filled with mucous which
constantly and abundantly were discharged
from the nostrils pulse an 100 and
30 contracted skin heated.
This case at a first and superficial examination
might be mistaken for cephalic
form of Scarlet Fever and on which
therefore a bad prognosis might have been
made but it is to be distinguished from 
so fatal form by the patient's position on 
the side in the place of being upon the 
back upon its vouluntary assuming the 
sitting position and its hearing not
being impaired under the administration
of sulphate of Zinc and Ipecac folowed
by Aconite the child recovered. 
N.B. This case is ascociated with Catarrhal
forms of the Epidemic which now appears
in the community associated with spasms
and convulsions.

Erysipelas as a Form of Epidemic Fever 
an Exanthem-Dr Tompson. Jany 1857. 16th St
On the 8 Jany '57. I was called upon to visit Dr. Thompson
16th St above Arch at J. Paxson
Dr J. aged 35 yr graduate of P.M.C- nervous temperament
complained on the 8th inch of Southern head ach
and fever. Regarding it as the unmodified 
Epidemic fever- Influenza- I presented 
Tysus Ant Pine.
9th. The two pounds & IV 8 Each q to be removed 
the symptms & medicine we [cross out] omited
on the 9th Friday I found him in the parlor
and expressing my surprise. Saw to him
that he must be careful. that although
the symptom were arrested by Antimony by
an artificial cure, that the person was
yet in his blood and might manifest 
itself in some new form by exposure 
& improper diet. He but withstanding 
every at the dinner table & eat solid
food, potasss &c- Never as we be demonstrated 
that scarlet, measl & small pox has a
primary gastic congest so we prese that
inflam has By the eveng fever & appresion
set in & on the
10th I was sent for ages to see him again in 
bed. His skin was again healed & dry by coated 

99 
pulse contracted & frequent & he again complained 
his throat & urine of a dark wine color.
Here was evidently a revive of symptom
or the 11 Sabbeth I neither a red spark or the eye
lids at the urine cauther of the right eye. He saw
that it was a contraction of the mouth stomach 
of the nose & throat & requested me to look
at his Urine. He felt that the spit was 
connected with the stomach affection. It was
all a capilly congestn.
or the 12 Monday the red spit has spread on the 
upper eye lid & one 1/2 the nose. showing without 
dark that the form was near erysipelas. Not
a local phyman but a for of Epidemic fe 
a exanthe & the hairy the primary sympt
then of influence. 2 days of centripetal congestion
like scarlatina. His stomach was very
irritable & therefore I only give 2 grs Calomel
for the line & camphor him to being wet.
or the 13 Friday-4 day of week. 2 of centrifuge stage
the center more & eye lid red & swollen pulse 108. 120.
to dry & coated urine deep restless & stubby 
on the 14 vicous 5 day of week 3 or centrifuge this
[cross out] redness & swellg spreads on [cross out] the lower
1/2 of less cheek. Now arm swoll & tend 
as I regard the case a essential fever. I
appear anyway because wth fever.
or the 15 6 day of arrest 4 of centrifuges too- more

less tender but more swoll eye more swoll 
& the erysipelas has spread on the whole
cheek. urine red pul 96-108.
on the 16: Today 7 day of arret 5 day of centrifuge
[cross out] more & eye less sarte & the erysipelas
is spreading on the right cheek-& both 
cheek much swoll to white pulse
9 11 & 108
on the 11th day 8 day if cured 5 day at centrifuge 
[cross out] more & eye less swoll & red & without 
pa but the cheek swoll red & pasture
& more spread & extendg on the farther 
right & less for between eyebrow- pul 94-108
are red to what [cross out] less restless- stomach
better 
or the 17 Saturday 9 day of arret 6 day of 
centifuge- more general swells of face
but less redness & pa pul 96 96 are
now a bit wh & less red.
or the 18 sabat 10 day of arret 7 day of
centifuge- copious deprest of urat of arm 
more in urine pul soft pil & 84 swoll
less no redness in face & he has a  
swell in his face. feels better & want his 
food. 
Remarks
1 Erysipela in an Epiderm fever. 
2 " deports  of eval of amma or 7 day

101ed
3 has an intense capily congest in three 
of 2 fewer days as in scarlet fev 
4 Its arise is like influence
5 its exact a 108 & 120-96 & 108. 84 & 96
& puts less & less contacts on the face adver

 

102 
A Case of 36 Puerperal Convulsions, of which
24 were with two successive days, with the spirtual
exercises of a dying itch and get recovery.
Mrs Margaretta Abbey aged 20 yrs. 16 George
Dec 22d gave birth to her first born a son. 1st presented
ordinary labour.
On the stormy rain of the 20th she walked to chesnut
and 16th st to obtain medicine. The 21s was a severly
cold day N.W. pavements wet & cold. She went to 
chh 16 d spruce & on her way lost one of the gum shoes
May we not find her sufficient cause [cross out] for [cross out]
influza.
The circumstances of the birth were
ordinary and lactation was duly
established, but on the 7th day 
when the milk fever, ordinarily
subsides and a nourishing animal
diet is to be given. I formed
a pulse to my surprise contracted
and frequent, Hoping however
that this was a mere accidental
excitement I banished my fore-
boding of evil.
29th December. The ninth day I found
her too weak and febrile to have her
first sitting up out of bed, which produced
a general disappointment
I was disconcerted and perplexed

103 
but as the locise continued and
lactation was yet well sustained
I suppressed a dawn of anxiety
that the present state of things was 
not serious.
30th She passed a restless night. This unaccountable
febrile state continued. My desire to give
a sustaining and tonic diet, and to have
her up out of bed was kept at bay by the 
strange and provoking pulse contracted
and frequent. For want of a better notion
I fell into that of influenza. I percussed
the abdomen but detected no meteroism
There was no diarrhœa, I therefore was relieved of
the apprehension of meterorismic epidemic
puerperal fever. I treated the case expectantly
as influenza contracted before labor
and suspended by it and lactation
and now resumed to take its course of
twenty eight days. In order to settle the 
minds of all I expressed the above diagnosis
31st I was now satisfied that she was a patient
laboring under essential fever and was
perplexed and anxious least it might assume
some serious puerperal form.
Jan: 1st 12th day. Continuation of symtoms
Jan: 2nd 13th day. At 8 A.M Mr: Abbey relieved
the nurse who had gone to breakfast.

104 
his wife called for a basin saying that
she felt sick at the stomach and soon
after vomited. After this there was twitching
of the muscles of the face which
soon after passed off. The nurse subsequenly
stated that there had been a similar
attack of vomiting and twitching five
days after the birth.
Jan 3rd 14th day. At 1 Oclock A.M. She was attacked
with a severe convulsion. Dr: J. Darrach 
and myself were sent for, before daybreak
she had a second. Do J. D gave a
℥ss of Milk of Assafedita by injection, after
which she had no more convulsions until
Jan 5th
4th 15th day, she was without convulsions 
5th 16th At 2 Ol AM. A very severe convulsion
At 1 PM a second convulsion
6th 17th day No convulsion.
7th 18th At 5 AM four convulsions within an 
hour very severe. From 2 1/2 PM until
bed time 13 Convulsions, varying in 
severity
8th 19th day 15 min before 8 Ol. AM A severe convulsion
10 m after 9. A second severe 
convulsion, 28 m bore 10 Ol, A convulsion
on the left side only. 10 m before 
10 Ol. severe convulsion 5 m before 11 OC

105 
severe convulsion. 5 m before 10 C severe. 20 m
before 3 severe, 12 m before 8 PM. severe
No more until 20 m before 1 Ol. AM of the 9th
9th 20 day. 11m after 10 C A severe convulsion
At 6 Am a convulsion at 3 1/2 PM one-
On the at she was attacked with the
severest form of convulsion which paused
into a state, apparently moribund, the 
pulse was small, and too frequent to be
counted, respiration extremely disturbed
and the rattles constant and protracted
All about her regarded her in a dying 
state, I was urged to express my opinion
in accordance with their impression
but there was no venous congestion
The lips retained their florid hue, the
circulation was not imbalanced
And therefore notwithstanding the
rattles and thready countless pulse
I withheld my opinion. To the surprise
of all this extreme condition, terminated
in full consciousness and tranquility
Her father brother and sisters and husband
relatives were sent for [cross out]
[cross out] 
When restored from this extreme condition

106 
Ms Abbey anxious about her future state
urged her to express a hope and belief
in christ, her reply was, O! no, it is 
too late now. Can't you trust in him?
No. After this he prayed with her
She then said; O! help me to trust
in him; pardon my sins. Thus passed
the night; The following day 8th [cross out] passed
with 11 convulsions, the last of which 
was at 8 PM, Then began a state
of spiritual exercises of joy in Christ
if a dying Christian, Her expression
of face was Angelic, Her expressions
were, O! it is bright meet me in heaven
Father you will meet me in heaven
dear Ma You will meet me in
heaven, O! its brightens High up O! how
bright, Henry do what your Ma wants
you to do, promise me that you will
promise me that you will meet me
in heaven, William meet me in heaven
O your faces are so white, you are
all so white, O it as so bright, brighter
Lilly kiss me, obey Ma Mary take
my place, be to Mother what I have
been I am going to leave you; Dear 
Charles you have been A good husband

107 
but we must part, meet me in heaven
O! so bright. Aunt Marjie meet me
in heaven. O! its bright, brighter, brighter
brighter And so she continued repeating
this word, with a fixed Angeleic expression
of joy, As of one passing from lasth to heaven
joy seemed to brake open upon her And
to shine into eternal day.
In like manner she gave the same expectations 
to the Parent, brother & sisters of
her husband. In all
In all this, there was no venous Congestion
And there was to me, lacking the evidence 
of death, and I felt it may duty to take
the first opportunity without obtrusion
of feeling her pulse. I found it not
that of a dying person. My thoughts were
these. This is epidemic fever with capillary
congestion of the meso cephal and all
the phenomena of extreme convulsive
action of the muscles of the eye of the 
face, of the accesory muscles of the 
chest, of the trapezius especially of the 
limbs is a category. Constituting disturbance
of the diastaltic system. The Cerebrum
is not involved. Then there is disturbed
condition of the lungs and all preceeded

108 
by gastric debility. Is it not influenza
modified by the puerpural condition in 
which the uterus influences the stomach
This as the esodic surface, (central) of the
great caliac centre of the ganglian system
by reflexion action is settled upon the
sensorial system.
If so thereputical indication is to 
divert from said sensorial system to
the nutritive and reproductive system
The back of the head had already been
shared and blistered. I now directed
a blister to the epigastrium, to attack
to the nutritive organism and sinapism
over the mamma to attract to the reproduction
organism, and administered, what
seems to be good musk, a gr every hour
It was not long before the diastaltic
convulsions gave place to histerical 
grimaces with peculiar projecting of the 
tongues since this she has been gaining
and on the 28th day she eating solid
animal food, some return of milk,
strong enough to sit up in her bed for 
a short time, Urine of healthy colour
flatulence of bowels And disposition to
have them Mond, Pulse 84.

109
The Bowels were, without medicine, open on
the 25th in at 6 PM & copious & healthy
discharge

110
Rheumatism in Tendo Acchilles
and small joints of the feet with pain
extending up the limb and locating
and aching in the hip joints morning
and exascerbations, pulse contracted
quick. 96 A.M. 108 P.M. skin heated face
flushed, tongue without slightest coat
urine red but less so than in the rheumatic 
case of Mrs: Sandling turned
blue Litmas abnormaly red, but less
so than in that of Miss S. S.G. abnormally
high as 1032-12 above normal
abnormal quantity of urea epithelial
in pavements abnormally abundant
The above is the 2nd day of Rheumatism
of Miss L.G. Darrach in her 19th year.
3 years previous she had a similar
attack aged 17th year and previous
to that in her 14th year her first attack

111 Astheric Anemic state with impervious less
a sequelæ of Bronchial Epidem fever
John Leonard aged 17 yrs Queen St: I visited him
on the 25' Feb 57 in consultation with Dr Senderling.
He was asthenic & anemic with impervious state of the
lower lobe of left lung. This chronic cachectu condition
is the effect of a bronchial from of Epidemic
Fever.
He was emaciated weak, pale, night sweats
pulse small, weak & frequent, expiration short
& can count in a break any to 17. Urine pale
small in quantity tuber fetid & cheap gravis 
only 1015 & containing vibrinous.
I regarded the indication when the restriction of the 
health of the blood & then retention of the diminished
cerebral heat. [cross out]
& restoration of the impervious lung
The 1st was attempted by nitrogen fever &c
The 2nd by convul over cotton clothg & the
3 by Potass acct: ʒi in pt 1/2 of wet q.t h.
By the 24 March = one month = He under
the abmn treatment because therein & sanguinous
with healthy urine, & restrate of
strength & shins: & with sepitas of lung
in place of absence of sound

112
An attack of Articular Gout arrested by an Heroic dose
of Vin Colchi: ʒi with 311 of Husbands Cali Magnes
& ʒi of Potass Acct in pt 1/2 of water of 3 hours
care.
R. McCunney 19th Gene Sts aged 45. cerebr neuro
sanguineous: intellectual- agent & bark herbs if in 
long cuts exats. Has had a severe attack of gout
& more aft some vexation of mind & expose to a
cold damp. March day at an Auctn Sale. has
become transpiration, sleepless with sickness of stomach
& pulse hard & frequent. Urine acutely 
red, with a point of pain on the node of the 
left throat.
I gave 1/8 Nuc Vomica Ext g 3 h which removed
the sickness of stomach but the other gouty
simptoms increased. He then took ʒi Vin Colch
with ʒii Husband Calc Magne & drank pt 1/2
water with ʒi Potass Acet q th. and all the
gouty symptom, red serum, pain knee hard frequent
pulse & sick stomach, sleeplessness & lower pulse
was greatly abated.
NB This case is in contrast with that of the Jaw
70 gtt of the same prep Vin Colch repeated throu 
excited fever & vomitg This is a cause
Asthenic Neuralgia gout-from indirect debility
of over stimation in the spring of the year.
[cross out] urine pale turbid & ag 1012 She gouty pale mild
and wh depressn of wound & going she Neter- more the
norml quantity or else generaly

113
Asthenic Neuralgia Gout pm empowered
blow in which the cold & Potass acet
were injurious.
Case.
W. Goud aged 35. active nervous temperament
very easy excited 1/2 cochar person. His public 
life her lead him wth tho deny use of spices &-
After a painful. constrictn of the urethra &
suppress of urin (vey painful) the tendn achils
& the muscle of it were attacked with neuralgia 
gout. Then the liver- with weak pulse & not 
very of stomach. I gave him colch & Potass were 
but the sympt we agrevated. I then
her the urin exact & Dr J. Danare who 
had use the bollus 
Dear Father
I examined the specimen
Sp gr 1012-pale-mildy acid-
with deposit of spotted oil round
& young-More desquamation 
than normal-indicating either
a weak mucous membrane
of the urinary passages or the 
existence of morbic matter in the
blood which the epithelial of
the kidney are endeavoring
to remove- Blood must be
impoverished-
Indication Non &c &c
Yours affectionatly
James-
OP Am & night-

116
114
Tyson Ant Powd No 1 gr IV with only sulph Morph 8 1/16!!
will remove the restlessness & sleeplessness of
the evening exacerbation of epidemic fever.
Case.
Dr Fricke on Thursday evening, mentions
the case of a Lady who complained sadly of 
wakefulness from fever. He gave the above & 
induced a comfortable sleep.
Tyson Ant Powder is according to my experience,
more a febrifuge than any other form of 
Antimony. - After having for several years
noticed said powder in my lecture, I hav the 
prepared for my practice by Mr Hodysn in 1856.
some which I ve advantaging substitute it
for the Tart Emet. Dr. Frick, Wiltbenh. I Danner
Lippincott Robert are now makg heal of it 
- Truman, act 22, single, a brick
maker by trade. When about 16 years of 
age had Intermittent for one year, and
about a year subsequent to this, he
was attacked with convulsions (apparently
epileptic) during which
he is unconscious falls & foams; has also
rigid spasms, but during these is perfectly
conscious, of what is going on
These appear to be unconnected with
the convulsions. Was supposed to have
been produced by Coup de Soleil. He
presents the picture of perfect health,
has a florid countenance, appetite
good, bowels pretty regular but a 
full and resistant pulse pupils dilated-96; the
Diagnosis-Epileptic Convulsions &c
Sulting from the Intermittent.
Treatm bleeding, purging & Donovan's
Solution. Aconite or Dig

115
Sensorial Form of Scarlet Fever
Case 2d
Edith Seymore Lyons. aged 2 yrs. Went Haverford 
School.
April 5th My first visit-At rest on her right side
in her crib apparently in a sweet infantile
sleep. But this, the parents informed me was her
alarming by constant state and had been becoming [cross out]
increasingly so for some day, and on account of which
I had been called in. On further examination, I found
the skin pale but heated, the pulse contracted & 120 or 130 
the tongue coated with a coat of what caducous epithelia
and hyper normally red at the edges & lips. The 
throat congested & toung swollen as in scarlet fever.
The child had been sick already sever days. Its 
sickness was ushed in with a chill, seven which
she had had daily morning & evening exacerbations.
The case had thus far been treated with daily calomel
& oil pungery to relieve the lives from a supposed
congested state. Every symptom was made referable
to this.
I regarded the case that of scarlet feve with capillay 
congestion of the sensorium-
The purgative treatment was therefore discontinued
and a mustard plaster under an abundant
poultice covered with oil wch was applied to 

116 
the abdomen & nape of the neck
Ap: 6th/57 5. PM The soprose state continues: but she can
be roused to speak, and take food and at the request
of grandmother puts out the tongue for the 
Doctor. I found it without the loaded white coat
except here & there a few patched. The discolored
surface of the ty was scarlet-red, raw & with
projecting papilla as in scalatina or the 8th day. The
pulse was contracted & 120, skin dry & heated, every inch
was of the eye lids congested & of scarlet colour.
Ap: 7/57 5 PM. 9th day. More soporose, pulse 120 & contracted
more soporose, pupils permanently dilated & without
doubt, she has become blind & likely deaf. I gently
liked the soles of the feet and thereby induced her
to quickly draw upon her limb.
Ap 8/57 5 PM. 10 day. soporose state increased. She has
cleared to respond to the request of the mother
to protude the ty. a soles of the feet are moveable
to tickling movement of the fingers. a feather
twirled about and in the nostrils and ears does
not disturb her : but she winces upon the application
of a cold wet towel upon the feet and
quickly draws them up. The left eye ball tends
to the strabismus portion and the limbs of
the left side are occasionally in diastaltic 
motion the arm quickly draws up & the leg
mine quickly draw down after being slowly drawn
up. The urine, which is pale, stiffen without

117 
colouring the diaper. There is occasionally gritting
of the teeth. Pulse 120 & contracted
Ap 9/57 5 PM 11th day. soporose state increased
pulse 96. pupils dilated arm & leg of left side more 
frequently jactating: yet she takes food, breathing is
normal & animal heat normal & circulation
equalized.
Ap 10/57 5 PM 12 day. mere soprose, yet no indic 
that the cerebrum is the seat of the brain disease
This as a localizing of the capillary congestion is
at the brain in the membra of the meso cephal
or sensorium and implictes, not the
mind but the diastaltic system. The case
is like that of Dr Chamberlain child
The jactation are more frequent & violent, the 
pupil are more perminantly dilated, pulse
small & more frequent. I fear an effusia of 
serum at the base of the brain.
ꝶ Head shaved: Blister to the occiput & neck
& the body raphed in camphor mercurial 
clothes & [cross out] whey & mutton tea as diet
Ap 11/57 PM 13th day. all the symptoms increased
& especially the increased frequency of the 
pulse. ꝶ the blade drew well-The mercurial
ointment removed. NB The grand mother, Mrs Dayde
on removg The mecural ointment by washing
the limb with the hand caused, thereby the 
patient to cry Nana! Nana! This was the

118 
Nana the way in health accustomed to give her
grandmother. Here then is the most of the now
[cross out] mentioned soporose state- the condition of the 
sensorium-[cross out] with blindness & doubtless deafness
& loss of smell, the cerebru becomes active &
the voice induced by the perception of the 
grandmothers hand & moor in the act of washing
the body.
Ap 12/57 5 PM. 14th day. The jactation with gritting of
teeth increase and death occur at 11 Am.
NB. This sensoriae form of scarlet fever is not
to be confounded with the cervical form in
which with pus formati in the subcutanus cellular
tissue & cervical gland then exist, without capilly 
congest of the brain membrane there are mainfested
a predominen of brain symptom. So much so that
the case is considered brain disease. as in the muscle
of J S child in chery abn 7th st. Dr Willbuth can
in Brandy wine at spry gentle. Kot Keg Dr. Sanderly
child can-&c &c-& Dr. Trick can in 1857 Am. 13

119 
Samuel Snodgrass aged 21 5th green St
Tall, slender pale-taller faces. stramon-his
father soft slanted tender eyed deeply & thready
pitted with small pox-atomic-
At 5 yr of age he has a severe attack of
scarlet fever-which left cold abscess of the 
cervical glands. And continued delicate
thro' the 1st characterate. From 8m to 15 yr
be moderately thrown. But the development
of the reproductive organ in the thru
climate with smoky &c- & spring 
established a dilation of the left venticle
of the heart which dulness have a precedant
deprest of fibre on the valve 
for the scarlet fever of the 15 year.
At the close of the throat climatterate- June
15th/57
He was attacked with a epidemic
gastro cephalic-rheumatic fever.
It began with spontaneous nasea & reaching
upon a [cross out] empty stomach [cross out] inducing
heart ach & answered with chill & extra
depress of shape with coolish & clamy wrists
& hands- & general paleness

120 
I administered ℥ss lemon juice fresh q. 3 h. &
warrant him 4 changes or ℥ii of Lemon whey
q 3 h.
This arrested the recharge- but the headach
continued & the constant syngaltis with
great weakness & pulse frequent & pithy 
for the heart disease.
[cross out] To divert for the return to the heart
oganic & preserve fr metastas fr throat 
to heart. I applied blut to the urine 
This removed syngaltis & headach & the 
care advanced regulary as a scarlet 
fever

121

122

123 
Treatment of Gon:
ꝶ Tinct: Kalinde ʒii
ag: Curo Ceran ʒ IV
M LX drops in ℥ss of sweetened water every
3 hours on an empty stomach.
then adminster
ꝶ Cubebs ʒ i to ʒiss
opii pur: 8 1/16 ft ful-every 3 hours
& use also injection of
ꝶ oxyd Zinc 811
oj Rosæ ℥i M
Habitual vertigo & swonings in W.M. Kiney
aged 4 yr removed by changing adult
table diet to chilos four of Bread & Milk
& milk & potatoes. Sept 10/57. 
The 3 indication in Remittant Fever
1st Remove gastro-diodeno hepatic irritat &
by calomel & blissbitty
2d Arrest the augmenting exacerbation
by Sulpher Quini.
3d Remove congestion of portal up to
by blueful 8 1/16 Ipeca 81 pils-to produce
tar like discharge alvne
as Flus had by care of W, Odenheimer 
Sept 1/57 lasts 4 weeks.

126 
Tetter on the back of the hands
cures in Mrs Overton's case Wood & 8 yr 1857
ꝶ Nit Argent gr v
Lugols Iod: oint ʒss
Glycerine ℥ss
Sulph Murph gr x M applied daily
Ol: Terebeth gtt v q 3 h changes the dry loaded
by or May-S. Home to a sope moist to &
with it the sympt of the case became better
Crepitation of the lung
This I have noticed to exist at the expiration
and not at the inspiration.
Case 1st I Mc Innis aged fifty, lime burner
had since the death of his wife a dyspepsia
from inervation. A visit of two weeks
at Atlantic City in mid winter, at my
advice, restored his spirits and digestive
powers. During the subsequent
spring he was attacked with the bronchial
form of influenza which was
removed by Tyson antimonial powder
followed with sulphate of quinine
and morphia. He is now in Oct
of the same year 1857 attacked with
an asmathic form of influenza
Upon ascultating the dorsal regions

125
of the chest and discovered in the 
inspiration tubular sounds consumed
with respiratory murmur without
crepitance. But the expiration was
crepitant-crepitancy, in this case, was
exclusively confined to the expiration
whilst the inspiration was destitute
N.B. I have noticed that in other cases 
the crepitancy was, on the contrary,
confined to the inspiration. And
again in still other cases I discovered
crepitancy in both inspiration and
expiration. These circumstances
of crepitancy have not I believe
been hitherto observed. The question 
arises on what do they depend

126
Scarlatina Intraversa.
Case 1st A German child of two years
of age a patient of Dr Fricke Oct: 19th 1857
has now on the 8th day of its attack
profuse papilae slightly desquamating
with some remains of passing off eryphemia, 
This erythema to papilus eruption
is of three days standing
previous to which it had for four
days been most alarming by attacked
with obstinate vomiting and
profuse bowel complaint and daily
attack of convulsions being doubtless
agravations of the rigor of children
N.B. An older brother had but recently
died of a similar form of disease,
Doctor Fricke gave in second
case quinine and thereby overcame
the danger of the case.

27 
Cornelia Skinner aged 25 Cerebro Arterial
temprament brilliant black eye in infancy
afflicted with severe attack of 
Scarlatina in which her father Dr
Skinner administered the nitrate of
silver to the extent of discoloring her
skin. For the last two years she had
been dyspeptic, her life has been
that of independent mental efforts
for self support. For last years has
been spent as a governess in the 
south. Last Time (1857) she was called
to take charge of a select school
in Mississippi, On arrival after a fatiguing
journey she was vexed and
disappointed at the undesirebleness
and unjust tasks to be imposed upon
her, and declined the contract. These
depressing matters and fatiguing journey 
was followed on the 16th with
what she calls a bilious diarrhea which
lasted, at its onset she took successively 
during the night four teaspoonfull
of paregoric but without relief.
In the morning she sent for Dr
Fergurson who by means of calomel

128 
Ipecac and opium brought on bilious discharges.
This attack which lasted ten days was
followed by constipation, for which without
advice she took in the course of two
weeks fifty grains of blue mass. This
was followed with an attack of dyepepsia
so that her food passed undigested. On the
On the 27th of August she was attacked
for 3 hours with a profuse and alarming
uterine hæmorrhage attended
with a peculiar and extreme tonic
contraction of the peubo perineal muscles
accompanied also with similar
contractions of the muscles of the
forearms and legs attended with
general cold and numbness.
This condition was relieved by half
ounce of the tincture of illy rium. She
had two such attacks of 4 days interval
between 27th and 31st of said 
August.
On the 2nd of September at 8 P.M
she was attacked with peubo perineal
contraction in connection
with exalted perception of hearing 
halucination and double individality 

129 
individality which lasted six hours The passing
off of this was immediately followed
with extreme prostration in connection
with the above mentioned a 
contractions of muscles.
It has resulted in a want of will 
over the pelvic muscles giving her the 
strange sensation of having no lower 
limbs, yet she has power of will
over the hip knee and anckle joint
and those of the toes. In addition
to these symptoms we may add
the right arm has no dermal sensation
and may be pinched with 
impunity the firmest grasp but
if the finger be drawn gently over 
it provokes horror and contraction
of the muscles. There exists also the
most exalted spinal irritation
of the neck and back and cocygie
N.B. The case recalls those of Miss
Seckel, Sarah Haverstick, William
Newbold. Mr Mynch & I Snodgrass from 
Miss M. Calle- Miss S for limbs once Practice
Dr Weltherth case 8th & change of total scapula 
through [cross out] alternatly. Dr. Frick can
Elizbeth Ray 20 gr exter of spine strong 
menstral today. double perioneal, talks of person 
hallucinate persons.

130 
ꝶ applat of cicute of are uters ergot
& full of cicuta & leg ceruse
case of summer heat
ꝶ Ext Cicute ℥v dui 8 11
aq: Cause Ceruse ℥iss Lanta ℥i
M [cross out] M
[cross out] ℥i g-t h.
Dr Muller can cure Ammona Fever
in to rem Lavender
Maryland to Mamma
She arrived in Philadelphia Oct 18th
1857 to be under my medical care, I 
visited her for the first time at 2 PM.
and found her with the ordinary
appearance of a person in health
full of spirits, good appetite, respiration
and degutition perfectly
normal, but was informed that
she could not stand erect nor 
walk except for a very short and
distance, Towards evening I again
visited her and found that the 
servicle and dorsal vertebra could
not be pressed upon without pain
and that moderate percussion was 
intolerable

131 
Oct 19th She had some sleep during
the night. I found this morning in 
a peculiar state, consisting of an abnormal
exaltation and acuteness
of hearing ordinary sounds produced
exaggerated and painful 
impressions upon the ear. On taking
out my watch to count her 
pulse she started off, raised her
hands stairing with a brilliant
and wild eye, and exclaimed
A take that watch away I cant 
stand it, it sounded painfully
loud, A carriage rode by and again
started and exclaimed
O that thunder does it rain!
I Clapped my hands, she started,
looked wildy, O don't ! I cant
bear that, your have shot me
The same exaggeration of sight
occasionally exists, when a spark 
has the magnitude of sun.
She also is under constant hallucinations
and has also double 
individualities, I pinched the
skin of the right arm with impunity
and so also grasped it
severely, but the slightest move

132 
over the skin of the hand caused
painful contraction of the muscles
of the arm, enclosure of the hand, as
under galvanism. This morbid condition
of the censorium continued
throughout that day and the subsequent
night during which she had
not a particle of sleep but constantly
talking very witty and intellectual
and pert, demandatory and
commanding.
Oct 20th 9 1/2 A.M. She has now returned
to her natural state of
mind without the contraction
of the muscles, and so she has continued
through the day. She 
called my attention to an abdominal
pain, which has existed for
a length of time, which I found 
to be in the locality of the right 
ovary.
N.B. This pain the leucor [cross out] and 
the spinal irritation inclines
me to regard the whole case as originating
in the reproductive system
and to be regarded as one
of proteus forms of Histeria. I 
have therefore determined to 

133 
begin the treatment with Squire
fluid extract Ergot in order to
remove a chronic glucochæi, this
symptom and tenderness of the 
spin she has suffered under for 
several years.
21st 9 A.M She has passed a comfortable
night, both category of
symptoms that from disturbed
sensorium and that from spinal 
chord are absent her muscles
are in a normal state and there
is no exaltation of the senses
of sight of hearing. Her pulse
is normal but she has neither
disposition nor capability to 
stand or walk the spinal chord
is intolerant of the mose moderate
percussion of the spine. I 
made a careful percussion of the
six abdominal regions and found
that the three lowest were peculiarly 
sensitive, especially the hit  
progastric and leptileic, and of
these the acutely sensitive spot 
and extremly intolerant to any
percussion was over the left ovary.
Collodion was prescribed

134 
for the spine, and a mustard plaster
for the left illic region the urine
of the morning was only of a 1000. 111
s. p. and of a light indicating an
hysterical condition.
N.B. Hysteria like influenza is
multiform comprehending mild
simple, harmless, cases and
those of different degrees of complication
and danger and protracted duration.
22nd 9 P.M. She has passed a 
pleasant night but this morning 
feels excited. averse to conversation
and company and anxious
for her. The mustard plaster relieved
somewhat the pain of the 
left Ilic region. She continues the
use of Squire Fluid Ex: of Ergot
6 P.M. The after part of the day
has been comfortable.
Oct 23rd I am disposed to regard
the cause to be psycological, rather
than uterine, have reccommended
Collodion broadly down the 
spine a mustard plaster over 
the left Iliac region.
Oct: 24th Passed a comfortable

135 
night.
Oct: 25th Passed a comfortable
night, a new symptom of micturition.
The Collodion enables
her to turn and rest upon her 
spine and renders it evidently 
less irritable. the mustard has
also somewhat relieved the 
spot of toothache pain presented
by me in accordance with 
Tills notion to be owing to an
irritation and congestion of 
the left ovary which however 
may be merely notional. She 
is doing
Oct: 26th Monday. She is doing somewhat
better, She passed a comfortable
night unaffected by a prevailing
cold. North East storm. The 
micturition which continues may likely 
be owing to the use of the Fluid
Ex: of Ergot
N.B. Upon careful examination
I am satisfied that there is not
as feared by Dr Skinner a retroversii
nor is there ulceration
nor any other lesion the Os tinsi On the 
contrary the Os tinsi is [cross out] firm 

136 
and contracted, the neck is long
narrow and firm, and the fundus
uteri is in bulk under size,
pressure frequently and in various
ways upon it gave not the 
slightest uneasiness, its position
was high up upon the sacral
region, the only pain which I 
could produce was by vaginal
pressure upon about the middle 
of the sacrum I made pressure
also externally upon the 
same portion of the sacrum
and it also equally painful 
above the sacrum was not painful
nor below, nor was there pain 
on the bones the oxygis, I pressed
also the limber of the vertebra
without producing pain and
so also some of the lower dorsal 
vertebra, but the slightest
pressure upon the upper sever 
of the vertebræ was intolerabile
and so also the lower cervical
vertebræ
N.B. I am disposed to regard
the disease of a neuralgic character.

137 
Oct 27 Tuesday edem
Oct 28 Wednesday edem urine 2 grs: pale
Oct 29 Thursday extreme mental acuteness
& extreme excitement of the Emetics
Full of wit funny & sarcasm & ridicule 
and desires neck and self will. Puttg the
ends of the ferifuges together she demanded 
partly [cross out] is of one her uncles Physician 
What is that? Dont you know? Matter metaly 
What is that. I answer a triangle-what Its an
angle Dont you know better? thats a triangle 
extendg a thumb has nerly. But what
Rev say say quickly Dont be so stubborn - I am
answer an inosolic heap. Then you are term
something? Uncle all the Deveport will go 
to Deaver. Work the J is a hard drinker but
he has Deveport blow. Say Sam ale the
Deveport get to heaven! Want this I answer
that men be a difference of opinion. Ah! a
difference of opinion- premier- one duck 
with two [cross out] premier & one [illegible] only one
person- Its only a difference of pinions
NB I indistinctly premium the war & opinion 
say person & she [cross out] then premier parts in 
the war person & so tossing about the bed
with a sharp blk eye she pains &c- the
enter deny, commandg & demandg

138
Oct 30 Tuesday after a day of on feet & mother
she has some rest during the night & today
is exhausted & lactas & avoid 
very extreme in person. I found her
lying on her left side head turned back
eye 1/2 clear & no dis pint to sheath to 
me. & in the paper the day.
Oct 31 Saturday- Day the morng she has
tea quiet & intellect & like herself
but I [cross out] found that she owing to some
more for company to the room below
her has much exald & at the church
the day again with [cross out] disturb emote
crying & disrupts & has taken an avate
to sent matter and work to have another 
plan to boards.
I fear that she, leaning uncontrolable 
that she needs the cold drink. & the
Has mild treatment.
Ive determind when the ext of Cicuta
Oct 31 Saturday Menst: dark small close & granules
much mentic excitement
Nov 1st Sabbath. state mental excitement
Nov 2d Many Exhaustd very excitable. solved!
with me to soon here the least norm excite
her.
Nov 5 to 7. She has been better. after a sever rebuke 
from me.

139
Dec 1/57 She has now been about 7 weeks under
treatment and is now with out cramps - double powdered
extra spine irritate, toothach pain less diaregen-
& spate of sleeplessness & talking-&
has been under the care of their ext Erym: Arm Vinti
Erysi & Ext cicuta to 38 gr does & more for
it likes the face a peculiar tightness where &
peculiar feel in the throat - 
I regard the cause chiefly Psycological-
extra emotion, distress & perplexity added to 
a spine if less self reliant

140

142

143

141

142
Epidemic Croup.
There are two kinds of Epidemic Croup
first, capillary congestion of the lining
of the larynx with spasm of the muscles
of the larynx, and transudation
Serim into the binding cellurar
tissue The closure of the rymoglotidis
is owing to both muscular spasm
and tumefaction of the mucous
membrane from ceres transduation
Case No 1. John Odenheime Majr 16 Months was attacked
suddenly on the 24 of october 8 P.M. with suffocation, thiness
deep house inspects & a dog barking expects. Dr Keating 
adon alone & molass. I found his return of the suffoction
the next morng but with the other curbs symptom &
a contracted pequant pulse morng & eveng exacabation &
an evald ty.
Second capillay congestion with serv fibrines hard into
causes membrane cramp but the care amount 
with enertic fever.
Case 1: Mary Feruly age 3 yrs. a hoarse inspirat 
& beating expirate with sufficient embarass 
breathing & aft 2 days coughing up portion of
membrane

143 
Quinne & Mryhh in Epidemic Fever
After meeting the special indicate of capillary
congestion by Sulp Zinc Ipecac & Tyson Ant Powder
and the contracted pulse is thereby one cause. The 
essential fever is best heated by sulph Quin &
morphia. Does it not anew & break up the 28 day fever
Case 1: Stockton Bates has the ardent Epidermis 
catarrh which has healed wth Suphr Zinc Ipecac
& Lyse Ant Powe The Ipecac sympt was removed
when the eneteric fev cutur I adn Salt
Quin ℈i Sulph Morph 8 1/6 tbspful pil x. one evry hr 
for 2 hrs. I saw him at 16 M & to my delight
I found the puls slow & pale & he expuls
his subfuet it by stronger.
Case 2. Infant ser if C. Pulse by sickly 5 weeks old was
attacked with catarrh fever what I have give on the 
7 Nov/7 Sulph Zinc 81 Pul Ipecac iii m at it 8 PM where
vomit & ulcer the crusty symptic. At 6 Am I adminstered
Tyson Act 8 1/2 [cross out] At 8 Am he was attacked
with an extreme depression blueness of eyelids & hard & colorless
& convulsive vigor. This passes off & gave plea to a
fever with a contracted pulse of 144 & corp & sharpness
of breath & watery Diarrhea. Under the impression
that this essential fever might be arrested or at least
that its depress prevented I had a omen at the
next morng at 2 oclk 8 1/2 of Sulp Zinc every hour

144 
for 8 hours-I saw the patient at 9 AM with a [cross out] tryd
face pul pile & only 108. & satupor that no depression
black pale eye. The day passed on without
heat of skin & wth any main of pulse 120.
The 8th much better 9 center better-There is cough
but only slight aft nor exatent.
Case 3d [cross out] Leple-colt age 2 yrs has have
seve catarrh fever longer more several night
with tyh fever. ꝶ 1/2 gr given 8 h for 2 Am to 10 Am
& the chill can be only a modest cough
& pulse pale & 84. ꝶ Tyrus for the afternoon
& return to the quarter. 2 Am
Case 4 Ani J as 3 gr with S. Hon a crusty
calcul wth frequent & constant pulse & had the 
4 1/2 quin at 2 Am & 10 Am. The next day & 
aft by moderate corp & pulse reder & 
th cool.
Case 5 D I. Danan has the asset of
influence ꝶ 2 Am gr 1 Qui 1 10 ch & 
pulse worst 72. & then cool-

 

146 
146
Gastro-Bronchial Influenza aggravating a 
chronic enlagement of the heart from articular
Rheumatis & resultg in Deep 
Case 1s Mrs G M. Watson Pine St-South Camden 
aged 37 yrs Nov 12 1857 visit at 5 Pm
Constant nausea & vomiting without ingestion, extreme
tumultuous palpitation of the heart even to liftng 
the sternum, cordal dyspnea, slight blackness of
lips pulse extremly irregular auscult of chest discover
no abnormal sound but great rush 
of blood with a dilated ventricle.
History of the case. In her 18th year, she took cold fever
and rheumatism in the joints which produced palpation 
of Heart. [cross out]
This was caused by sleeping in March in new house before
the plastering of the rooms was dry.
A few years after she may again attack with the 
same followers with papitations from exposure
in Naut at first distubation on the warf. The
March of a subsequent year she, from the 
same kind of exposure to cold & damp hard in  
their attack.
After this she married and gave birth to
3 children and have three additional attacks
And now it has established an enlargment
of heart which under an attack of gastric
bronchial influenza induced [cross out] blue dark hands
& death of 25 day.

147
History of my visits. On the 12 Nov 57. I found he
under recourse & vomitg which aggravated the
palpitations. This was moderated by Lemon juice
& mustard plants or the 13. I found that she had
a very restless night from febrile exacerbation.
On the 14 The gastric distress moderated, the urine
hearg evades with the urate of ammonia and
the febrile exacerbatns more manifest
On the 15 symptom moderated
On the 16 the stomach without weakness. some app
into but her sleep disturbed by frequent congest 
on the 17: cough increased or auscultation I found
crepitating externus & deep down the dural parts
of both lungs. 
On the 18, 19 & 20 the hands become cool, & capilly
torpor & finally on the 21 they were of a reasn people
& damp & cool & with very slow circulate in the the capilly 
[cross out] which comes in death at 11 Am. 

142
148
Gastric Influenza
Case 1 Grace U Berate In Harrison's Nov. 21s/57
She complain of constant nausea, bitter taste & vomiting
Her pulse is contracted & frequent skin heated. At first
careless regardng it dyspepsia I adv: cream & lime water
& Brain Bread. or the 23d she called at my office &
complains of much distress from the cream & lime water
& pulse or Ext Nuc Vomica 8 1/8 after meal.
I am perceived that it was a case of gastric
Influen & adv: Mustard plast & Barley diet
I saw her on the 24 & found her better. I then prescribed
qr of 1/2 pul of Quin gh for 12 m - on the 27 I found
her skin bett .I requested a repetition of the Quin
& the solu next.
Gastr Influe
Case 2 J.J Mason Nov 12/57 After an attack of his
haemorrds with Influen. he had now for some
days a constant substances & been least & scarlet 
of when eyes- Ale the ordany remedy are unless
Gastr Influen 
Case 3 Mr D. has constant sickness of stomach
without the ordinary fenal care.

143
Gastro sensonal Influence or Tubercular Meningits!??
Case 1: Caroline Vanhorn age aft 4ys was attacks with
vomitg and pulse frequent & contracted & as much
with tetan canula & much the req at the 
sympt have moderate
NB The gastric Influeza which appear in July &
Aug in G W McCellar & some snodgrass has we
reappear in the case of Caroln Vanhorn, J.J Marn
Greer O'Bat Mr Dr Treatment is Lemn june ℥ss
q 3h Lemn. whey-& given in the apyrexial
per for 12 m to 9 Am 12m 9Am
Autopsy of Caroline Vanhorn Dec 1757
The scalp was detached from Crania with great
Ear & almost bloodless. The crania also easy
seperated without much blood. The Dura Mata easily
seperated.
The surface of the cerebrun was perfectly normal
with a liberal congestion of the veins. But
without a vestor of capilly congestion and therefore
in this, a perfect contract to the autopsy
of J. Kennedy child in 8 & Arch Dr. Patten case) in 
which without pus or fibrin then with universaly 
over both hemispheres a fine capillary congestion 
& also in cathart with & Welbank can in 10d & diet 
in which the center safe under the arachnid 
was heavy cover with pus

144 
150
The base of the brain was the detached & removed
with the root of the spinal cord. ℥i ss of serum
was left in the base of the skull. This is the 1st abnormal
symptom.
The pia mater over the anteral & march like &
over the cerebelle & over the Pan. Valolei- Medula
obliged & the quadgenniu [cross out] was coverd
with congested orb [cross out] and vessels from where the
blow was easily removed by the nerve & back
of the scalpel handle: But be such this removable
arbsent congestn- there was numerous & scathed
patches of unifor injection what was not so easy
by entirely removed. The ordinary glass cover any
detect red papsillys of veins-with a Anest nor
yet satisfactory by reticular. Nevertheless were they 
not capillary congestion for disease- be this
fever or Phlegmon.
Bends then phenomina there were patch
of opate straw colour matte- where we presume
to call transversal fibrin. Be this as it
may it be especially abundant over the 
quadra genius& from varolic & medall
obligat-B
Bend this depene. There was haere & these
on their part of the season repeat granules
& yet more of the in the fissu of sylarias
When a cales tubercles & on the presence of
the the disease is called Tube calus Meningitis

145 
These seperate minute granul under the Muscle
[cross out] appear as black & translucent molecules encld in a
circle line. thus [illustration]. This is a nucleus contang molecules 
This is the so called tubercle
But the opake patches were also subject the
microscope. A parlet of one of them was then discusd
when the same as the seperat minut granully 
blk & harden muscles enclosed in a circular line
the [illustration] This also is a tubecle.
Now this opake patch is allowed by also to be
naurate of fibrin - then this is the cytoblast of
the nucleus-[cross out] an [cross out] imperfect cell -
But the hands fibre is for capilly congest
& therefor the nucles is an effect & not a
cause of Disease.
These supposed tubecles are then the 
irritant to cause the fatal disease & if 
then sympt Mar. 17 days-the variety
& exacerbate & tetanus convulsions & 
loss of the serum.
Tubecle did not excite a inflammation
what causes transdate of pulse & serm
but was the child of the fibrin as its matrix.
NB When we also several transrate
in the vebrates.
I reveal therefor to the bulby ducts

146
152
NB. Caulm- Van-horn was attacked with a gastri
[cross out] sensorial Influenza.
At first the child [cross out] for some weeks back complain
of her heart- & has a peculia snuffy
& of rubbg the nostrils.
For these symptm the mother brough the child rig 
to my office under the idea that she hard 
women or the IV. Nov. 57. I disregard the mother of
women & prescribed patients. She visited me on the 12 &
as being better. No more visits to office. But on the 17
I was sent for to visit her. [cross out] She was suddenly attacked
with vomiting & pain in the function & a the cream of
the snuffy & rubbg of the nose.
I regarded the case or on of chronic catarrh of the frontal 
sinuses with [cross out] attack of gastric influenza
& regards the aggravetion of the nose & have a [cross out] owing
to the Epidemic attack. I prescribed lemn whey which 
remove the vomitg but the morng & eveng exacerbate  
excited. I therfr prescribe guin for 12 mon & found
this puts the render less frequent. But some aft
[cross out] spasm at the attack of palsy water.
So much so that one attack was directed to 
the bladder. I examd the attack but found 
no redness now swelling as in Maria Odenheine 
Then spasm became more frequent & attack
became tetans & opak throtanu - & so day after
day. notwithstanding blister to occiput & hitherto
&c & consult with Dr Wiltbert & Dr J. Danart

147
the case became fatal Nov. 30/57-19 day after 1am
vert & 30 17 / 13 & 13. after the vomiting & fever 11/19
the case is associated with
Infant of & Chamberlin page 1 of the book 
cinn 268 
Blue B.
" Dr Lyons page 118 " Hays 59 the Book  
" J. Buckalow. Cumm 87 "
" G. W. Blight. Abbey 103
" J. Runele 8 & Mar D Palber pol
" - 10 Solat D. Willardpen
" 8 & Filbart- Dr. Beerly case
" Eli. D
" W. Heul-& Jan Ludlow recur-
NB. The so called tubercles are nuclei-imperfect cells
aborting-[cross out] from the fibrine transuded from congested
capillaris of epidemic fever. They are effects & not cause
of the existing disease. this is not a primary liver Phlymas
for the irritatn of tubecles but the as fever with capilly
congestion.
But yet if so how do I account for the precendent
pain in the forehead & the snuffings & rubbing of the 
nose: Blight. Elge D cases were not form of
Epidemic fever. Buchanan, was likely a repeted
Eruption. Lyons was a soporose case throughout
Bligre was fixed regards of less leg & chron hydroceple
Buchahn in a sporose case-
Remedy was violent epilept convulsive 
& calmol & vetre to neck &c
ꝶ Tysons & vs. & cube & blunt for special in daily
& quin & make for general indirect 

148
154
Benefit of gumm & mirhh to the apyrexial penor for 12 mon
in Pneumon form of Influene- in combinatn with
Tyson-
Mrs Culbert aged 40 yrs strumous for some years
liable to chronic bronchiae attacks- was doing
well under the use of guiac & urea. When suddenly
on the 28 Nov 57 she was attacked with chill &
pain in the chest & legs shoulder & side of the 
neck which was followed with a continued fever
of a synochus degree of fever- & dry painful
cough & short inspirate & quick exp as in
pneumon. skin dry & heated urine dark &
in small quantity.
years back I should have regarded the case as Pneumon 
& timed has copiously bled & has recourse to Tart Emet
but none I regard the case as Benchece Rheumatic
Influenza of a synochus degree of fever & to
be regained under thro in defects by
special by Tysons Aut Powd to reden the
local capily congest of the bronchia & generally
Quin & Opi to arrest or moderate the
exacerbate. I therefore come Tysons Aut Pard
or the 28 8'11 q 3 h or the 29. I found the patient
not much changed. I therefore repeated the Tysons &
orders quin 811 Sulp Murph 10 of 1/2 q h for 12 pm to
10 Am 30. I saw on the 20 at 11 Am & found the 
pulse of 120 reduced to 84. & without the junk & the skin normal

149
& the chest symptom all relieved
Im more than ever pleased with the use of
quin- much at the abysmal period in
the influence-especaly of the lungs
Dec. 3rd. 11 Am. the alterate lesser febril day-Pulse 96
& larger countenance improved less depression of spirits &
body urine pt 1 & 1/4 & has no more urate of amm but of a 
slightly turbid beerish look. he seldom must & again
at 12 m the Quen ℈i (qr 11 g h)

150
156

151
Fengas Hamatodes of the uterus with
cachexia & Dyspeptic symptom of qm duratn
mistaken for cancer of the stomach.
Mrs Cath. McCammar upon DC McCammar
aged 44 yrs. Pine believe 6 Sr One of the fullest size women
cerebro-spinal system nobly develops - but she & mother
& sisters disposed to fat-formation - none of the family
have color- rather of the tallow face tribe-
She enjoys good health apparently until last
march. It was there she was afflicted with
dyspeptic symptoms. Dr Wallance her physician
[cross out] advised her to visit the mountains
but she was induced to spend the heat of summer
at the Atlantic City.
I there saw her and was called to attend her.
She was pale, conjuncture of eyelids exsanguineous
and all her symptoms were dyspeptic.
On the 22d Nov. I was called in Consult with Dr Wallace
I noticed a sadly rapid change- Emaciated and
to the pale face & exsanguineous eyelids there 
was a shock of ceterous yellowness and vertal & 
numerous wrinkles of the lips and exactetions & belchg
and extream weakness. To this meterur
What was the cause The face indicated the
cachexia of Cancer & the cartart dyspepia
unclear is to say, Cancer of the stomach

158
But there was no postive amaretia, emity, par
hemarrage no tumor, yet why the cancerous
cachera.
She died on the 30. Nov: after sickness of month
Autopy. 2/3 inch of yellow fit of the integament. The 
overturn load with fal.
Seve 1.3 large the [??el], of a pale yellow dewey
and fatty.
The stomach was flably, the carda pouch was 
trans heat. The plgum was tick but no cancer
exists.
The bowels kidney & spleen all healthy
But the pelvis carty was full with an enlarged
uterus-4 inches in diameter. On the right
side of the enlarged fundus. there was discovered
a molbes & bloody lump of an inch diameter
or touching it I found it soft & easily removed
as a soft mass from the rupture surface
of the fundus. They poved to be a protruded
portion of a fungus Acenctodies. I then borrown
my finger with the orific of the 
rupture fundus of the uterus & discover the 
enter sabite of the usteru curved into
a mass of fingers hands.
NB Here there is an instant in which diseaes
may be in one part of the body & yet
all the [??tus] are else where

153
Functural Disease of Heart with Bronchal
& Pneumum chronic disease.
Merritt Ballance of Lancaster Co. aged 21 yrs
6 for 4 inch. pale & mottlen lips. cood red purple &
thin capillars of the hands-a deep raspery
broke voice as tho there was ulceration of the 
larynx. a dry raching cough & ease pancres
provides a white fully expechetion. Puts very frequent 
& irregular.
I at first regarded it a hopeless case of
Tubeculus consumption. But on examation
I discover the metale link of the hear &
the unique pulat & nere began the [illegible].
I detects all [ca??tas] in the [pa??ta]
portion of all the loha of the legs-& I say
[illegible] a menu rata in the whole look of
the lepslary & so in a less day of the right.
Three ideas occur me for the above
examanation.
1st Tincture degree of heart for
development of the [rep??] says to
2: [cross out] Chronic Bronchial derm of [cross out]
both legs.
3. Pural [illegible] of chin. [Br??] [Pa??]
if the whole both of the left lung occurs
of the right

160
I regard the cause a sequele of Measles
Influence & inflam of reproductive system.
[cross out]
The Prognosis is an aggravate of the dose
for attack of influence-To this indicate 
The protect of the skin by cotten & wool clothes
& a genial climat say Thomas Willoby 
near Magnolia at for 51 & 10 what can be
rear to a few days by that and to Seamen &
the by rear steam. Then to rene the last
of watr & the cong spring.
2d Iron. 3. cooln ol 4.Nitrogen fever.-
After a faithful examatn at 8 Am & 3 PM. daily
for two weeks of your patient at M.B.-almost
daily auscultation, miasmta & chemical analye of
his urine, and exposing are of several medicine
I may return to say that there is no
Tubercules in the lungs.
But that the diagnosis is a disease of three
elements.
1. Functinl disease of the heart for the effects
of the reproduct system & measles
2d. Chronic Bronchial disease from influen 
3. The Purulent state of lung cont ulcer of
Broch Pnemu is the upper left of the left
lung.
Prognosis [cross out] a fatal aggravate of this complete 

155
degree of dung the coming colds & damp of Wint
& Spring he has attack of influenza or if 
to prevent this he been dyspetic by being
compare to as heated room. If, on the contrary,
he enjoy out done exa with bones &
moving food in a genile climate so that 
he has a rich blood to heal their weak
lungs & restore the reprod system, the
we my parts have to pad his with is
next Quin with the restorg barks of 
the claret of Fluids.

156
162
Meteorum in Gastric Influenze from imprudent vomitg 
& hungry successfuly [cross out] healed with. amot enema sulph
Quine & rebuh & epigat.
William Harrison aged 15 years. Nov 7
1857 was attacked with gastric influenza, 
for which he was incautiously
vomited and purged. The
treatment ought to have been a
mustard plaster and absorbent
to the epigastrian, and abdomen
and quinine during the apyrexial 
period from 12 midnight
to 10 A.M., with entire abstinence
from food, in order that the 
cappillaries of the mucous membrane
of the stomach might be
relieved of their congestion and
that the diurnal exascerbations
of the essential fever might
be reduced and thereby sensation
augmented and strength
measurebly restored.
The aggravating treatment produced
meteorism, and its associated
symptoms, nevertheless
the child recovered, sufficiently
to be about.
A few, weeks, after he was exposed

157 
exposed to damp and cold, and
was indulged in improper food
and consequently suffered a meteorism
with extreme pain with
a contracted pulse of 160. The pain
was so extreme and constant
day and night, and the meteorism
became so intense that serious
apprehensions, were entertained
of the issue of the case.
Being called in consultation
I prescribed the mustard plaster
and absorbent poultice and
an injection of the solution of
Morphia 1/4 of a grain to the repeated
if necessary to remove the 
prominent and aggravating
symptom of pain. The
The next day he found the pain
removed and that he had some 
sleep, which owing to the pain
he had been deprived the three
previous nights. The next indication
was to arrest the febrile
tendency, this was affected by
administering quinine morphia
after the aperexial period 
after 12 midnight.

168 
164
Under this revulsive and frebrifuge
and anodyne treatment the pain
was entirely removed the pulse
from reduced from 108 to 95
and the meteorism gradually
subsided. He had had with
the above symptoms severe and
frequent vomitings which
resulted in anarexia. But
now these also ceased and gave
place to return of appetite, cheerfulness
and good nature.
N.B. During the extreme meteorism
the respiratory murmur 
could be distinctly heard by applying
the ear to the abdomen
whilst at the same time there
were no gurgling intestenal
sounds, but with the reduction
of the meterorism the respiratory
cease to be heard and
the true intestenal sounds
restored

159

160
166
Bronchial form of Epidemic fever-usher in
week neuralgia rheumat of the must of the
shoals & such.
Mrs Culbert aged 40 yrs strumus-chronic bronchial
diseases which for years has been annual regard
by influence dry the water & arrested annualy in
its progress by 2 & 3 weeks went to the sea shore.
On the 29th Nov. 1857, 8 green gs, she was suddenly attack
with a chill & the weak fever, several neuralgia pain
about the left should & along the neck & back
ending in the breath of the trapezius muscle
of the left node (respiratory muscle!) and a
severe purple shift in the lips neck with
cough which caused an arrest of expection-like 
the color pleurisy or pneumonia.
The pulse was contracted & 120. skin hot & dry. She
passes weakfulness night morng for the 
pain in the shoulder neck hip - shake [cross out]
aggravatg
This case became a bronchial form of Epidemic 
fever in whose the 16: 21 & 28 days prevented a
depent of urate of ammonia to the urine.

161.
Glycerine adulterated with lead &
causing dry colic
Case 1
Alex: Dougherty aged 30. subject to
various hæmorrhage of the lungs under any
direction took the glycerin for some days
and thereby benefited. But a subsequent
portion of the medicine he obtained at another
shop which after taking a few doses
powderd lead colic. The fact was mark known
to Mr Ellis who states that some of the Glycen
then careless has lead in it.
Urate of Ammonia
This is found in the urine under the following
circumstances
1st In certain form of Dyspepsia
2nd " the critical days of Epidemic fevers
3  " is diseases of the head.
4 " " amenorhrea
NB In Miss Allebrough Case Callubrate below 9
the urate of Ammonia was assured with a
urine what quietlyo beca of a ruby color
& regulation son found on the surface
This is owing to lactic acid -being formed & the 
urea deeply redder litmus

162
Abortion of 6 weeks from chill of Influenza &
fatigue
Mrs J.B.O aged 26 yr a birth, abortion, baths and now
a second abortion
She terminated her last menstruation on the 10' Nov. '57
and after protracted walk and a chillness & adding of
an influence she aborted on Nov 18 of Jany 1858. 69m days
= 9 weeks & 6 days. The abortion is of the size of a
chesnut & presumable theref of 6 weeks-
Cephalic & ciliac form of Influenza
Mary Stranagha aged 3 yr large head liable to trachelism
spasmo-So the Influenza began & the spasm of the
arms the flurr of the face & the moments uncommonly 
recurred frequently. Then she became stupor with
a contracted pulse of 120. Or the seventh day a diarrhea
set in & continued for five days. The pulse became
108 the morng exacerbatn. on the 12. 13 & 14 days
the bowels became closer and the pulse reduced to
96 & large, skin soft & cool & the express 
of face more intelligent- she has become cross
& never be chill. Here a typhoid fever-
Anginosa Form of Influenza
John Davis aged 19 yr express himself as the funereal
parade- a lent Sabbath Day 17/58. This chilled him 
and son his tonsil swelled to about the close of
the throat and the skin became heated & dry & the pulse
contracted & frequent

163 
The Dogma that Epidemic Fever
has a continued duration of 
28 days
Proof 
Sally Gabel again 4 yrs sicked
with a cephalic form of Epidemic
fever on the 21 of Dec '57. After
the brain symptoms abated the
urine became colorless and so continued
until the class of the 28 days
of the attack-when it became of
normal character. Day/58

164
168
Influenza in a strumous constitution
does not allow the employment of means
which relate to the special conditions. The
sole reliance is upon means which relate to
the general indications.
Case Dr. J. Darracy owing to fatique exposure and mental
excitement became despresed and was attached
with a chill. His throat became congested & swollen
hear ached came on, became to weak to sustain
the erect positon, skin dry & heated and pulse
weak & refluent asthenic state.
Antimony calomel potass was soda was
admissable.
The treatment adopted was exclusively
sulph Quin 81 q h from 2 Am
Under this the exacabations were greatly
subdued & the pulse became stronger and
in due [cross out] time the symptoms taper off
Influenza with capillary congestion at the 
base of the brain in which the means actative
to the general indications were inadmissible
and blood letting indispensable.
Dr. Fricke case of- female child [cross out] 26 
The eyeballs when in convulsions motions & so the 
muscle of the mouth & of the arm & occasionaly the
muscle of the lower limb. [cross out] with these diastaltic cn

165
Doubtless mal-practice is not regardg
Erysipelas as an Epidemifere
BISHOP WAUGH, whose death, in Baltimore, has
been announced by telegraph, was, at the time of
his demise, the senior bishop of the Methodist Episcopal
church, and was in the 69th year of his age.
His death was a very sudden one for although he
had been some time suffering from erysipelas, his
physician considered him to be improving, when,
at one o'clock, on Monday night, a change took
place, and in half an hour he was dead. He was
born in Fairfax county, Virginia, in 1789, joined 
the church at the age of fifteen, and five years
afterward entered the ministry. In 1836, he was 
elected and ordained bishop, at Cincinnati, and, in
1852, on the decrease of Bishop Hedding, he became 
senior bishop. In the first year of his episcopacy,
he organized the Texas conference. Ad
superintendent of the church he had traversed
nearly every state in the Union.

166
170
Category of Cephalic Symptoms
in the following cases
Case No 1. Mary Chamberlane aged 2 ys 6 mt
Feb. 1856
1st Lying on her side nor on her back as in unconsciousness
2d cheeks red with capillary circulations as rapid
as in scarlatina during morning & evening exacerbated
3d skin heated.
4 Pulse contracted & frequent
5. Urine transparent and of madiera wine redness
6. Breathing peculiar being a spell of passive
respiration followed with spell of a deep
protracted inspiration & two short expectorations
& then a return to saw spell of passive respiration.
7 expressive countenance retained on the 
face except that the eye is without expression
upper eye lids deeply retracts into the orbit
and then slowly & passively following down over 
the ball when the eye ball would roll & become sleepy shapes more
there is no evidence of sight: yet
nevertheless bearing is retained. the impaired
8 Carb: Ammon: was applied to the nostrils [cross out]
with out for some time producing any effect, but tears flow
from both eyes, the member of the more contracted and
the child with manifest aversion to the sensatn
or the stryder member rather its nostrils for right 
to left. This was an impressn up the ganglia right 
& not when the olfactories of the stupor. 

167 
valerian the child was not unconscious. It would
take drink & swallow but tho the hearing excited
yet the sight did not the pulse was 130.
It was judge to be influence was congestn of the 
capillary of the sensorium & medule oblong No 
vs to ℥vi, producing bloodless state of likes & equals
was performed This lessend the convulsions--Salt
Murph 8 1/16 was adm as an enema. blister to wrist 
rebutn poultice effect & Tyson Powder-The
symptom are diminished & the child is
more safely pasing this the essential fever

168
172
On the 5th of Feb: 1856. I visited the daughter of DC
aged 2 1/2 yrs in consult with the father and Dr Wiltbank
She after that she had fourteen days been already sick, and
after that she had had, two months previous, a
convulsion from which she seemed to have entirely
recovered. occasionally however she was fretful & had
spells of rubbing her nostrils which induced her father
to administer the spigelia but without effecting the
expulsion of a worm.
I found the child in the cradle quietly & naturally on its side as
though it were in health and not upon its supine
rubbing its head to & fro upon its occiput and its
eyes and mouth & limbs in convulsive motions.
The cheeks wre abnormally red and their capillary
circulations as rapid as in scarlatina. The breathing
was peculiar being spells of passive respiration
alternative with spells of a deep protracted inspiration
follows by two shore expirations. The face was
also peculiar The eyes [cross out] were with out expression
with the eye lids retracted with the socket & the
the upper lids slowly falling down whenever the eye ball
was irregulary rubbing and at moments belong strabismus

169
The rest of the feature, especially the mouths retained
their ordinary intelligent expression
The inexpressive eyes was so in contrast with the 
intelligence of the rest of the face that is recalled
the countenance which characterises the 
inmate of a blew any lime and rain unclear the
question of existing blindness. Upon close examation
the pupils was discovered to be largely and
permanently dilated.
The hearing was always evidently [cross out] impaired but
not entirely lost.
Spirits of Harshorn was applied to the noslets
with out any effect for several moments and
than only to produce a flood of tears and inducing
the child to rub its hand to & for upon the nostrils
[cross out] with enclosed aversion a mean slugish effect
upon the ganglia nerve of the snyders mabus
& not upon the olfactive & sensorium 
The powder the mouth & freely drank fluid
food. [cross out]
The sense of touch then carelessly
was unnoticed.
The urine was transparent [cross out] of the redness
of ordinary madeira wine- but was not subjected 
to chemical & mesential examination.
There was a disease morning & evening exacerbations & work
then the redness of the cheek rare its degree of
inlarge & at the inner disappear & the put which
was always contracted round in frequency with saw
exacerbatn by 84 & 96.

170 
174
ꝶ Acet: Ammonia ꝶ blister to nape of the neck
Feb: 6 th 16 day of sickness. 10 Am.
The peculiar breathing became a subject of special
after time & interest. The ribs sterneum & clarreles were
motionless-none of the access muscles of respiration
was in action. As as the abdominal parietes were 
without distention & contraction, it may be inferred
that the diaphram was also at rest.
The Moranic cavity did not dilate & contract with
the expansion & dimnatn of its contained organs
The spinal respiratory nerves which govern the 
Moranic muscles & sustains their constant
actions is in some way diseased; and respiration
is reduced to a mean organic function of
the lung-a slow inherant dilatn of the 
broncho admits the atmospher are two sucessive
in heart contraction of the bronchi. Such 
is the mode of respiration of the tadpole & 
such in the hour follows his fanciful expiration.
after each jet of expirat then follows a pass 
pouring out of air. It is to the last organic
respect that the little patient was reduced
when depress of the inflamation of the spinal neves
The only new power less saw lungs was that further 
frenic fray of the ganglia system. which it
enjoined an common with the heart. ꝶ Eleteria
Feb 7th 17 day of sickness 10 AM
The right are was more frequently in motion obliquely

171
up over the face & the rebeng obliquely down
ove the face, chest & abdomen. This form of 
convulsion contend with entares of rest.
The Eleterium proves a hydrogay effect: & with
this revulsion action on the bowels there was happens
a partial [cross out] of improvement is heavy & 
smelly but not in [the] venia. She was now
particular to the applicat of an mines to the
move [cross out] the chest particly resume motions
& she intelligently answer yes & no to the
parents.
Feb 8 18 day of sickness w Am. A remarkable frequent
pulse of 160 has now set in & is constantly so.
Feb 9 19 day of Sickness. She same inordinatey
frequent pulse contins Feb 10-21-day of diet 
& now in connexion with us 
there exists a permant serious congestion
in the lower eye lids & the face has loss
all expression-
Feb 11 21 day of sickness She died without convulsion
such it the short History of the case.
The diagnosis which I [cross out] gave was 
a form of Epidemic fever with capilly congestion
[cross out] of the [cross out] medulla oblongata & a sore 
& not of the cerebrum or in other words - that
the capilly congestion was at the base & not
up the whole cortext of the brain

172
176
The autopsy was made on the 12 Feb by Dr James
Darrach to the person of the talk of the chair & Dr Frick
Wiltbut & myself -
Remarks upon the case
The vital phenomina observed during 
my five days after done and thrice obtained
by naration of the Talk & Dr W of the previous
time admit of being classed under
the heads. viz
1st the convulsion at the close of November or
Early part of December with some subsequent
frettfulness & itching of the nose suggesting
the ineffectual administration of anthelmintic.
but otherwise a quick return to [cross out] ordinary
[health] goood health & vigorous; may be
[This may be] regarded a reflex convulsion
from intestinal disorder. Both parents are
of cerebral nervous temperament and the 
father is pale tallow like - nerve prevail over
blow, or is it taken that the nerve power being weak the 
blow is weak- asthenic & anemic: and therefore
suggesting the possibility that the child may have
been strumous. And of struma & tubercle be the same
vicia, which I doubt, that it may be that the case 
is one of tuberculosis menigitis as it is called.
2nd The morning & evening exacerbations, [continued for]
with a contracted & frequent pulse & rapid circulation in
the capillaries & high colored urine with that & dry heals skin.
all indication of an essential contains [cross out] fever

173
3d the loss of sight, impaired hearing & smile,
palsy of the thoracic functions reducing
respiration to a urea organic action of the lungs
as the heart & [cross out] live & kindess with the funal convulsion is the 
weak rather pale & venous congestion in contract
with the expression feice and [cross out] intelligent
taken of four & fretfulness indicates a cause
seated not or the cereb but upon the
sensoria & medulla oblongata. Thus I regard as
a capilly congest which associated with
essential fever constitute Epidem fever
I therefore diagnosticated the case of as a 
form of Epidemic fever in when the essential
associated of capilly congestn we located
at the base of the brain who the sensori
& medulla oblongata involng the new of
same & respirate & diatalic much &
not when the cerebr to involves directs [illegible]
& intellect although disturbg them by reflex
influence.
The entity, which was made by Dr James Darrach
in the prev of the Fall & Dr Fricke William & 
myself presented the follng phenomena 
sugillation one 2/3 of the [cross out] back. The rest of
the body had an ordinary aspect.
The evated scalp was bloodless. The removal of the
calvaria we accompand with a copius fluid
venous blood. The exposed cerebra preserved an enjoined

174
178
longitunal server & cerebral vein. The blood is there
large vessel was black & in contract with the flow
blow of the small arborent veins or the convultions. These
will not now as formerly be regards as end 
of inflament but only as a part of the venous
system which in the pruel stage of the dise
became congested. Being arborrent & not reticular
it was not a capilly congestn.
Along side of one of the largest dark veins we
notice a fever small had opake bodies like dry
fibri on strumous malt which for a manner beca
a topic of internal but as soon disregards unless up at 
We all considerd the upper & cerebral sense if
the brain as destitute of morbid pneumonia. This
as week be these process & in shaking cerebral with
the entity of another fatal case of fran dise.
The base of the brain & upper part of the spinal
cord were the exposure. Here the eye was immediately
rippled upon the abnormal redness upon the quadra
gemin, the corpus of the olfactory & optic nerves the 4 &
7 nerve the corpus calorer, medulla oblongata & 
& what part of the spinal cord. The redness when 
examined and [cross out] a magneta glass was
discovered to be entirely reticular. The congest was
that much venous in cerebral but capillary &
when more attending noted, was found to be scaled
neither in the arachnoid imprenate but in the 
in latent & bindg cellular tissue. In this tissue
there was a depend of fibre in the rige of the cortal

175 

180
Cases of Bronchial Influenza
Thite April 1858 Edwin Taggart Alvin Farr Child
of Dr Frick practice
Case 1st Edwin Taggart aged 6 yrs: 8th Crate Ap 11/58
Chill Fever & Cough & stick intense & oppression of chest. 
urine lesser in quantity & red morng & eveng exacerbation
pulse contracted frequent with sharpness. 
ꝶ Tyson ant Powder 
12d Restless night increased dispnea & pain in 
sink & catch at inspiration cont Tysons
13d Sympns increased, urine less & redder.
Pulse more jerky & stik contracted & frequent
NB the ender, oppress pulse of Dr Rush &
indicatng vs: to relieve system of 
imitate inflamation congest, suffering
of time & to all anternus to act on the 
system & the circulation to be balanced 
& seactary functions of organ to be resumed.
ꝶ VS ℥ viii.
Pm 5. The blood cappil. size pain removed
from side. dispnea much relieved pulse
with such & pulse less frequent. urine urea 
& less red. Felt much better
cont Tyson's Auth
14: Cont better 15. 16. 17 cont 1 or well and
Tysen with sulp morph.
18 The 8th day. Deposit of urate of Ammonia of
1 1st Crisis. a proof of essential feve

178 
10n Epidemic much with sulp morph
20 centa & drug will. pulv redder 1-96
& pilla
21 11d day. depress of urate of Ammonia cont
22 12. day depondent
23. 13 day. PM. cough increasg with
expectant & pul became age frequent
& contacted-a secondary fever ser in of
contact- irritatn hectic
Auscultatn discovered at the dural
site of chest large. Mucus rata & 
gugling & splashing. such as the 
Læannec school might mistake for
abscess or vomica: When of the sclia-its
pathinologae parerchera school would
call pneumonia & yellow softness but
what the membrane & capilly congest
febri school call bronchial dilate
& fibrin mutation.
2d 14 Ditto
25. 15. Pale. but strong & subrart organs
return to mind & muscularity but 
the urine 1/4 quantity & loaded [cross out] with
water & congest & rale gargle & a blast
26 16d idem: 27: 28: idem Dr Fricke suggested
the Bark dilat sulph clear & Fennell infam

178 
182

179
Case 2. Alvin Farr. aged 15 yrs. Race & 8 gr
Born in New England he has had Urine what
has been always there earlier Lung Fever &
what is here commonly called Pneumonia
but what Id called Bronchial Epidemic Fever
Ap 20/ 58 I paired my first visit. I found my patient
a pale emaciated boy. One might regard him as
under that as musc- perhaps Tabes Erotica. This
may & may not be. In dependents of it have he
has been subject to ser gumous expectoration
since the said surg fever. His present attack
is evidently Bronchial Influenza several the 
old sanguinous expectorant.
The expectorant is new albuminum subates
pulse cerbal & frequent. The heated auscultatn
large mucus rale. gurgling spleen as tho
the parechem has excareted & according
to the La'annex school prognosticating a 
fatal case. ꝶ Tyson & Murpher M
2i 2 dg. Many & Lung exacerbate 
urine quite above & not very red.
strong that the pulmony functn was
not impared by the emplast or the
I took curry & prognosticate functn
Cut Tyson
22 3d Index
26, 25. 121 The ral gargle & splat center
but she; better 27, 25, 29. The symptom has disappear 
& near an day will aft Quin & Morph and Ant

180 
184

181 
Case 3 Dr Fricke patient of 4 yrs of age
He was attacked with epidemic cough for
which Tyson & Sulp morph & Sulph Quinn
& morph were given & under which the 
child improved but afterwards a secondary
fever set in & induced death.
The Bronchial system at the vernal sys
discovered to auscultat the large mucus
rale the gaggling & the splash as this
the parenchem was reddened to absorp
The disease in fact was congestion of the
entire bronchial system & of the larynx
which or the recipe establish a seeming 
congest with fibrin transudate & pus foment
& plug-

182
186
Secondary Feve of Measles
Case 1 James Blai aged 3 yrs 2nd Poplar Called in consult with
Dr Gemagen.
April 29/58 The fever had passed the 14th day & more 
there exertd hair panes of abden, resonant percussion
indirectly meterun, dark severe abr discharged
pala 108 & contend-ski heated & dry-
ꝶ Mustard & abundent poult to aboney ꝶ Br Carb Feve
Ipecac & Suph Muph m & Barly Chet
30 15 day abv,. sup & what mecury pull soft
& pull the 12 on any likely to the more fibrin
day. No mn-abr discharged-(& is more pale)
NB envaribly impared-omit morph coat.

183
Cases of Fatal & Rapid Pneumonia, Congestion of Lung
Apoplexy of lung, Gout of lungs, always as I 
understand.
Bronchial Epidemic Fever with &
with out urea, (gout &c [cross out] convulsion & venery
congestn of age & nervous & sanguinous
temperment:
Case 1: Judith Rane died in Feb of Pneumonia
congestion on the 5th day
Case 2 Dr. J. K Mitchel previously
afflicted with Palsy was suddenly attacked
with Pneumonia congest & died on 5 day
Case 3 Con Davenport because suddenly induress
after much party going & drinking drunkless
& was suddenly attacked with pulmony oppress
& dur in a blue hue. Pulm: Congestion
NB.
The debility of the bronchia [cross out] of previous
to capilly congestion of the Mucus Membrane
of the bronchi resulted in Muscular contracted
of the tube & in congestion the air being
no longer a stimulus with more excitable
errors surface of the tube- an asphyxia
occur & remains congest & dev
ꝶ Carb: Ammonia & urine they
& vs:
1 to restore vital fever  
2 to relieve venous congestn } 
stimulate  
stomach

184
188
Apply a stmuln to erode surface of stomach
the great mart of the ganglia system
which [cross out] This stimulus is Carb. Ammon
Its action is reflected wh the Pnem fevers
The restn excitability when error
sup of the bronch & make of age
susceptic that stimulant of atmosphere
The venous congestion is mechanical &
to be much relieved by vs. Rech
ꝶ Vs. to remove Venous Congestion
ꝶ Carb. Ammona to restore
normal excitability to the
error bronchal surface &
thereby restn the virtue relation of
[cross out] air tubes & air
It so
My Lorrie, Kane. Mitchelle & leave put
might have been saved-&
many others. (1
Medical Error-
The manifest temper of Carb: Ammon has
been tested in Dr Wiltbark Case-of this form
of Epide fev to bronchial-(calc tyhupus)
in Dr Fich care & urine in my care of
Alvin Fricke. Muad Sade guggle & splan
all quickly disapperd under its use-

185
The chest is geared by the spinal nerves
The lungs by the gangler
The pasive organ respiration is the 
affection of the base of the Brain is
owing to the palsy of the respiratory
nerves-demand for the spinal cord
The sterbone breaks of apoplexy is
only to the palsy of the phren fever
of the gargle system
The Breathing in Typhus fever is only
to the same.
The Mucus rale, gaggling & splash in
Bronchial inflamn is only with
same as Tan cu &c
The sudden asphyxia in the arm is
Just Kane. Davenport is owing to
the same &
the ꝶ -
Carb: Ammonia & V.S. & sulp Quine

186 
190
Tuberculous Mennigitis
Case 1: Clara patient of Dr Fuchei
April 55 Clara aged 4 yrs
The symptoms were cephalic and specially
none of a soporose diastacted charact &
not usually the intellect 
The autopsy showed the membrane in the fissure
of sylvien & shudder with the granular
which under the microscope even nuclei
artery granule-[illustration]

187
Phila: May 5/58
My Dear Friend
Your very welcome favor of
[cross out] Feb: 22/58 [cross out] has just been received. It is therefore,
owing to the length of time since the date of
your letter, necessary to [cross out] offer you my medical
advice conditionals.
1st if the blotches have not entirely disappeared, 
use the following.
ꝶ Iodide of Potass. ℈IV
Vin: Ipecac ʒIV
Ext: Bellad gr II
aq: Menth: ℥ss
aq: font: ℥iss
m a teaspoonful an hour before meals.
2nd If the blotches have disappeared use the following
ꝶ Infusion of yellow Back ℥viii
an ounce at 10 Am & at bed time
for two week & after omiting it for two weeks
resume it to the above time.
It will not [cross out] be necessary to take medicine for
the complaint in question [cross out] unless new
symptoms make their appearance.
It is very important you around all
hazard of a second infection; as this
in your strumous constitution may undo 
mercuy under you liable to be an ulcerated

188 
192
and debilitated condition. Around also, to the same
end, an night assemble-& all temptat
to smokg & case of sputa drink-
So soon as you are done with the inf on Back create the follg
ꝶ Brmid Potass-gr v a hour before
near & at bed for two weeks. Then
omit it and for the same length of
time. take the follow
ꝶ Fluid ext-secule cirnuti
℥vii
a teaspoonful every 3 hours. that is
an hour before meal & at bed time

189
Epidemic Fever: Influenza in April & May 58
1st Relaxed Elongated Uvala, with capillary congestion
& Edema of it with capilly congestion of throat &
contracted frequent pulse &c with congest
Case. Miss Horn aged 35 yrs full habit & good
constitution.
She called upon me on the 3 of April '58 on account
of an obstinate cough. She stated that a physician
advised her to have a portion of the 
uvala removed by an operation. I found upon
examination of the fauces that the Uvala was
relaxed elongated & edematous. This last
noticed condition induced me to feel the pul
which I found frequent & contrasted: There
were other Evidence of febrile condition.
I prescribed an Emetic of Sulph Lime & Ipecac
& Tyson & quine & sulp cupri.
Under this the uvula recoved a healthy date
and the cough disappeared.
NB This was palsy of the muscle of the uvula
for Epidemic fever-Capillary congestion, branded often
of serum, loss of muscular contractile &
cough from tickling or an Elongated uvala.
2d Congestion of Laryn producing loss of voice.
Cases Mrs Carser, Ann Harrison, Thos S. Clayton
Mrs Walt, Mary Bates. Pressure of the larynx give 
pain.

190
194
3d Congestion of the mucous membrane of the 
trachea immediately below the cry cord
cartilage producing a difficult hacking cough
with a muc purulent but of sputa and a sore
& painful spirit below said cartilage.
Case 1: We attacked with general indisposition
& freq & contracted puls & redder urine in connexi
with a hackg difficult cough to express, apparently
a firey body, a portion of mucus purulent define
& a sore & painful spot at the ten upper way 
of the trachea.
4 Congestions of the mucous membrane of the 
larynx & upper part of perophages.
Case 1: Thomas H S. Clayton aged 18 yr was attacked
last hours May 8/59 with chill & depression of
strength. This general condition was followed with
a distress at the Larynx. and a sour after with a
loss of voice & extreme difficulty of swelling
May 9/58 9 Am. I found him with this local congestn
& a heated skin freq: contracted pul & red urine in 
diminished quantity.
ꝶ Tyson Aut P & 111 at 5 Am. Sulph Zinc gviii
Pulv Ipeca gx at 10 Pm. & the next day Tyson at
9 Am & 12 M.
May 10: 5 PM. general sympt abated, difficult 
of swallg removed & the voice less aphonic
ꝶ Epidem M contary Bellard under bell
that better relics in mucous congestin

191
Fever
Epidemic.
Thorasic.
Capillary Congestion of the membrane
of [cross out] S
1st Larynx.
Pathos. apherria & Barking Cough
1 Cases Mrs J Harrison, Mrs b. Bates
Mrs Walt. J.S. Clayton Ap 58
2 Trachea immediately below Cry cord
Pathos difficult hawking & aching
& pain at the 2 upper rings
Cases W. Darrach, J.J Mason
3d Bronchi
Pathos. Dyspnea. Stitch inside
mucous & crepitant Rale 
guggling & splashing at 
dural region.
Case. Low. Taggart. Alvin Farr
ap. 58
4d Bronchi Larynx &.
Palting: Croup symptom. dyspn
short inspirate, quick expiration
Case Dr Fricke patient. Ap 58
5a Extreme bronchi & cells & venous Congest
Pathing Ext. Dysphia-oppulse
stary eye dilated all man
action of access muscles
venom congestn asphyxic
Death.
Case of 5 Juda Kane
Dr J.K Mitchel
Dr Johnson
Col Devenport.

192 
196
Remarks of
No 5 Capillary congestion of extreme Bronchi & cells
Cases Zorru-Karen, Mitchele, Johson Devenport
Dr Reals case anter Mr Egna Newler case-
Willkus Reale Dr Grant: Mrs Room-Dr0 Fuch Hawke
These cases are called Pneumonia, Congestion of the
Lungs, Apoplexy of the Lung. Gout of the Lung
What is its nature?
Ans. An essential epidemic Fever with capillary
congestion of Bronchi & cells.
This congestion is owing to loss
6th Tho-Broncho-cell puerperal-3d slow Parencheme, 
Pathing: Meteorun-donel crepitant rale -
short in & quick ex-spuatmus & convulsive
action of acceny muscles-pulse 144.
Case Ann Forbes. 7 & Fig water. May 14/58.

193 
Epidemic Fever-Puerperal-Meteorun-Bronchial
capillary congestion treated as Puerperal Perlimbs
with Cal & opii full, leech & cups &c
Amedical error. Aleopathy. Physiologial ductre
Ilio-Bronchial Puerperal Tonic of Epidemic Fever?
Case 1st Mrs Forbes aged 28 yr 7th bel. Fitz water: She is
[cross out] thin-dyspeptic. flatulent stomach & bowel before
[illegible] manager. During this her 1st pregnancy had
sickness sometimes riffing of gas until the time of quickness
He labor was arrested at the passage with face presentation
& delivered with forceps-child gas her & expired.
The birth occured on the 30 Ap.
On the 28 she took a full den of castor oil for what
she called costiveness: which dose being ineffectual
She took a second full dose. whats operated
On the 1 & 2 &3 May she was doing ordinary well
Adine of ʒvi Castor oil was administed. This
produced a copious purging.
Then on the 4 Dec in the feve & abdominal
distress and soon follow with abdominal enlargement
which [cross out] daily increased.
The case was diagnosed & heated as puerperal
peretonates. with cal. opi dover powder. Leeches &
cups. This was the practice until the 12=8 days.
I was then called in Consult at 1. PM. I found the
patient on her back, eye lids retracted alæ men
abnormally dilating, mouth disposed to be opened
short inspirations & quick expirations & with there

198 
therein & pulmonary symptoms, the abdoman was distended
as before delivery-a conical enlargement
on percussion it was tense & extremely resonant
evidently meteorun of the ilium: The pulse was weak 
& 144 & jerking.
Her voice strong & natural, intellect perfect.
She has no cough, counts only 9 at a breath but
this without exciting coughing.
What is the diagnosis.
The distended above is not as was immagined
from gasous elimation for an inflam pereton 
of peretomts. It is, on the contrary, from the mucous
membrane of the small bowels: There here is the 
capillary congestion & not of Phlegmon. but of Fevers
The care is nt Mr Puerpue perelents, but 
Epidemic fever-after child back with capillary
congest & consequent meterun punches by purging
of the ileum.
ꝶ omit fault treatment for Phylgm: & substitute
ꝶ Mustard plant & absent: Click & are treat to abom
as a revulsion to the intestine congest
to next a special in dication.
ꝶ Tyson Ant Pendi gill Sulph Morph 8 1/16 g 3 h
to allay irritate & relax as a febr fever
ꝶ Sulph Qui 8 1 Sulph Murph 8 1/21 qh for 1 M
to cocta as an amet of the exacerbate
to next the general indication.
May 13d Thurs 9 Am The above plan of treatment was

195 
adopted. She passed a comfortable night, the exten
pain of the back was removed, abdomen smaller
less tense and or percussia giving a dulle remains 
but the pulse is till 144 and the Urinare & 
pulse symptoms are can changed.
ꝶ cert. treatment
May 14 58 9 1/2 Am Thursday. The countenance is improved
she says that shes better & stronger & can nor means 
to turn & repose on her sis. [cross out]
The abdome less, softer & of dull resonance
She has passed a qt of urine of urine redder & with
urate of ammonia. This is no the 14 of Delivery
& 11 of Manifest disease. P
But the pulse is 144 & the chest symptom is alter
she can count aug 10:
Being now by her own efforts with differently, slowly
was upon her right hour. I ausculted the
dural region of the lung for the first time &
discord entire crepitant & remain set with
the short in [cross out] & quick exipiration. This indirect
copully congest of the extra bronch scela &
sufficient explain the parasite of thoran system
& assumes the diagnosis of
[cross out] [cross out] Ilio-Bronchial [cross out] puerperal from 
of Epidemic Fever & new evidently [cross out] peritoneal
I suggested the substitute of Carb-Am as the 
vitalyze of the phlem from of the gargle system for
the Tyson. Morph & Quin & to apply the 

196 
200
martar & absorb-penlt to the dense riger of the 
chest & emt that on abd & to subtle Wintry
for the base gust or alterent
ꝶ Carb Ami gv e 2 h. ℥ii in when by 2h
calmly reden or divine & abdome skin.
NB. The local irritant from distured abdome & Nunx
by capilly congest of alum & branches & all have so 
superinduced a symp alth constitution excitement, the 
the sympt of the primary essential [cross out] [ep??]
fences & clyper. The removed of said excitant 
being removed, the constitutional effort will disappear
yet still will never an emetic for what not
ran it come of 28 days-and take the the
patient is not convalescent & exten to damp & cold 
& like due with herein inflamatory sequla of 
inpaten organ-
Sabbath May 16.58 9 1/2 Am. Passed a good night
feels better excite a very passage & swole knew
a mercury star of bronchial disease inwards set
in. pulse less frequent cont 15. cont &c &c &
adv syr. & Sench with cont ones urine whats
repint & of wine hue. bowels frequent mind
before discharge one healthy yellow.
Sabath May 17/58 Passed a good night. abv. less swollen
large mucousal abdomen-chest coats 20 pulse 130.
but fuller. Rue shl several but less painful. cont

197 
Monday May 18/58 9 1/2 Am cont better Cont treatment
Thursday ,, 20 .. 9 1/2 Am. Metiorim increased, Breathing
more through than pulmonary. [cross out] less expectorate
pulse now frequent & relaxed. cont common & which
Saturday 22d 9 1/2 Am. 22 day of success.
Uteran still on the encrease-accing much
of Uteran respiration abnormaly active employed 
a loss of action of organ respiration
pulse weak & more frequent & joking & relaxed
Monday Manfestily weaken-meteorun increased
Uteran breaking more Cabarer-expectoration
has ceased pulse weaken.
Evidently the disease has pasd into
the parenchan for the bronchi-Ten more 
capily congest of bronch to fibrous capilly
congest of the budg cellul line of the 
parenchem.
NB. This occurs with the law of principe
of [cross out] children fever & a second certipetal
congestn what is always fibrious & caused
absorpen-( Atthem Inflamentn)
Thurs May 25 9 1/2 Am 31 day of fern 25 of sickness for
delivery of child S. furch-Diev-
Diagnosis Ilio-Broncho-pneumonic form it
Influence-pueperal-Epidemic feve

202 
Remarks on the above case of the Ferbes
1 Bronchial form of Influenza
3 stages 
1st Meteorism-abdominal-capillary congestion
of ilium. conical tumur. [illustration]
2nd Cough, dyspnœa, crepitant & mucous rale
on the dorsum
3 Return of meterorun & aggravation of the
pneumon syste-encroachment of capilly
congest fibrious in drug has in the paraches.
Deak a 21 a 38 day
NB This case recall
abdominal therein care of Typhus fever
under Dr Fricke & a Dr Wellbank benefits
carb: ammonia
2. The difference of respiration in sensorial &
Bronchial Influenza.
1. Sensorial Influenza.
Palsy of the Muscle of Chest & consequent
reduction of respiration to organic resperation:
as in the tall pole.
2. Bronchial Influenza
Defect of organic respiration & augmented
action of the muscle of the thoraic respiration.

199 
Lesser Exanthem
They have come in a cluster in March April & May
with epidemic dyspepsy Diarrhee Potasses &
The Broncho Pneum inflam venious congest
of lung for constition Bronchi fatal-&
observe of the greate exanthus
1. Rosides W Kem 7 Ken May Strangle
W. Kneedle
2. Erythem
3. Erticare Dr Paul
4  Heavy Cough & Taggart
Pathological Remarks
Congestion of Brain
Convulsion is Inflamy relates to the 
sensorium. This is developed the cerebral
is not.
Delerium of adults, relates to the
developed cerebrum
Brain over loaded with blood produces
1 pain
2 Heaviness of Heart
3 Convulsion
4 Delelium
5 Coma
6 Death

200 
204
Otis B Merril agd 19 yr Went While May 13 58
in consult: with Dr Buhncle.
Extremly emaciated, less bursting & red from 
extreme anasarca. for which the lung was
punctured by Dr B. Cordae dyspnœa mouths
opened constantly & [cross out] at almost emmant internal
by intalsii in depressia of the lower jaw. cndee pultrate
over the enter cheek & extension & principal [cross out]
beats but what [uneg??] or abunnel sounds-
Respiratory Murmur was when mixed up with
the predominent & ovebearg canal beats &
transmitted pulsatn on the chest. The urine of a
pecular modes appear what on examents by D
J Danachs indeed extre debril of tissue [cross out] or
of the blood stress: distribute of the album of the blood
After a useless of untie Tener 6: he dead
Autopsy by Dr. I Danmark
The abdominal organ were remarkable bulky 
especialy the liver & kidney-One of the kidnies of
a remarkable & abnormal paleness. The liver had small
abnormal whiten & hair bodes to the mustach for tobacco
a case shots or convulsions but when clear examples
and the Masah by DJ Danac discovered to be more

201 
What the? Ans: Depends of uncommented fibrin: The sense
we detected in the apex of both lungs. Then much
has been [cross out] mistake for tubercle or cancer but
not so. uncemented fibri.
The heart was found of double its normal size
but paused not thicker-It was lax [cross out]
diagnosed by me as dilated heart. And then was
therefor also no contract of aert as the orifce of
the less valuble-In strumous flesh no alike if
val for deferent of fibres yes the edge of the
relc were rounder & thicker. [illustration] Each not
lessened more pushed & by no means embaress the
facts so as to contract the capi & prevent
the free exit of blood-Then was not retentn of
blood to cause therby of parts & regulated
of venus blood & congest venus become for
venal & bronch and hylahuge of [illegible]
The pericadia was enlarge adhered with heart
by harded fibr, to there the pressure early 
was obliterated.
On the fact I make the follng remarks. When my
thine light upon the enlarged of the heart.
Dr Senda lime, care demonstrated that a sequelæ
of measles are [double] transudatn of fibri of
both pleura & of the perecardien.
This of Merril; is a transudatn of fibri of the
pericardia with obliteratn of pericardiae &
enlargment of the cavity of the left ventricle as
a sequelae of scarlet fever

202 
206
But the care of Dr Grant Patterson shows the endocarder
is the seat of symptom of Rheumatism Influnze-
& of pleurisy. Hence the deposit of fibre or the valves
& consequent alum & pucking of the valve & want
of vital dilation of the urate & conseqent bequestng
of the heart & very hepatic congestion & melan &
venus sputa
W Hamm case as a contract of scarlet fever & 
subsquent Rhematisml Influenza sequela- by
endocarditis & pericardia & pleurisy-& congest
enlargement & hypetry of heart.
NB.
3 Forms of Heart disease
1d Dilatation of left ventricles with obliterations
of Pericardial carts from adhesive 
inflammation.
2d Hypertrophy of ventricles [cross out] with atrophy &
pinckey of valves & contraction of aortae orifrece
for deposit of fibrin- endocarditis
3d

202

204 
208
Epidemic Fever August 11/58
Gastro-ileo capillary Congestion.
Better Evaulations, gastro pains, meterum Lax & flatultory
W. Watson aged 50m yrs. Aug: 11/58
He complains of a turnip of stomach at times,
a bitter taste from stomach followed with a
coming up of a frothy fluid of a tough nature
with some of his fever & with this throwing off here
is some relief. This is an half hour more 
after meals & more so after dinner. Some litter
head ache an unusual swelling of the bowels
with downward passing off of wind. There are
attacks of violent pain in the stomach. No desire 
for fur. Bowels move turn daily & windy lax
& tar smell.
Tongue is without fur pulse small weak & 72.
skin cool & clamy disturbes sleep. Urine diminsh.
These symptoms have exsited two weeks.
Diagnosis
Gastro-clio. capillary congestion. with general
disease epidemic. He says he had a child & every
exacabatn inducing indigestion of stomach & flatul
& lax in the bowels.
ꝶ Homeretic position
ꝶ Mustard plant & abnormal clots to abdom
ꝶ Barley clith
Thursday Aug 12 '15 apples mustard & absorbent clothes 
rested hours entales & diet wineglass of Bark with a phen 

205 
result. better sleep pulse 72 & fuller & bowels not
moved. no better eructative & no melanin flatulancy
& lax & only weak for want of food.
Saturday Aug 14/58. The bowel complaint has ceased
but he is weak. ꝶ Sulph Quine

206
210
Yellow-Fever. Bark Elizabeth J. Rau fr
warf. Aug. 1858.
W.M Cambell aged 23 yrs. Wilmington N. Carolina
at Arcarte Hotel. Chemut bel: 7th: August 8/58
visited in Consult: with Dr Wiltbank & DJ. Darrach
He lay on his right side, legs right by bent
the less extended, arms down head sunk down
upon his chest. He in a stupid state. Nevertheless
when roused by Dr W and introduced to me
he returned my salutations with full intelligence:
but reverted to his careless condition
with an eye without expression & upper eye lid fallen.
I exposed his chest & abdomen, and under
a good light, a pale green or yellow hue
was observable. Pressure of the finger less whitish
mark, over which the saw hue very slowly returned
The same slow return of the amber color occur upon 
similar spots near by pressure on the forehead
cheeks & a red part of the neck. Percussion at
epigastrium & not else when upon abdomen, caused
pain. The soft palate, arch & tonsils not congested
as in Epidemic fever but below in the lower part
of pharynx. the mucous surface was in an state
of macelated capally congestion. He has
pushing up of blood & phlegm. Pulse was 72 but
refluant & small. Extreme prostrate & mental
mactn &

without emetic & passion. yet with intellect
The category of symptoms are peculiar
1st Pale greenish yellow hue of skin
2d very slow capillary circulation of the skin
3: Absence of Epidemic congestion of fauces but
4: Extreme Maculated capillary congestion of Pharynx
5: Hawking up of bloody phlegm
7 Pulse refluent small & 72. 
8 Skin without [cross out] febrile heat
9. Mental faculties perception, memory & Judgment
inactive but not disordered.
10. Emotions & passion inactive-he is careless
& without complaint and concure
11. Extreme prostration but when requested he
can extend & elevate his arm without tremour
yet the pulse becomes very feeble indicating
a loss of strengh of the nutritive rather than 
the sentient organism.
12 The capillary owing of blow contained & increased
until dress presentng a bloody mucous greenish yellow
skin, stupor animal eye & expiring without
consciousness-
Diagnosis. Poisoned blood with necro remain &
consequent palsy of capillar - maculated congestn
& destructn of live cell.
He died on the 4d day without violent action
of any one or move of the organs

208
212
on the 9th Aug: '58 at the Arcade Hotel in the presence
of Dr Wiltband & J. Darraity the following statement
was made to me by Dr Edw: E Wescoat.
The infected Bark. Elizabeth J: at race for warf sailed
from Haramuh on the 3d July 58. W L Wescoat the 
brother of Dr W belonging to the Bark her mate Thurs 28 after being sickened at Hararmuh 14 day
and after [cross out] 3 days illness, died July 1 at sea & the body 14 days buried
in the ocean. A sailor sicked 5 days before arrival & dead after 11 days sickness at Quaratn
The Bark after 15 days quarantine & fumes alone
was allowed entreme to the Part of Thib or
the 23d inst: At or near Race in she under the 
day watch of the Custom pour. I Shesline and
the night watch W. Dunn discharged her can go
of Sugary Molass: & Hodis & sojan
Shesline was under Epidemic Dysentery, eat
pure apple, drank to intoxication & indulges in
pickle'd clams. He sickened at his home at
Rockborugh, and died after 4 days illness.
The case was regard Bilious, fever, Typhus fever &
finaly Yellow Fever.
3d Dunn, the night watch subsequently sickened and
died after [cross out] 2 days illness
4d Capt. of the Bark Blodjet of Welnough to N. Carlin
on side the Elizabeth J. less for Boston & there
sickend and died after 2 days illness- He had
had Manna a polu.
5 Then Mr Campbell was attacked after drunkness

Remarks.
A The above case have, each of them,
sickned by exposure to an infected locality
1. irrate Wescoat by being at the infected
Part of Havannah
2 The sailor of the Elizabeth I by being in
the sand Bank which exported the
infection from Havannah.
3 & 4 The 2 Custom Hour waletes by exposure
to the discharges the cangors of sugar
molass & Sugar tho' possible these subtens
may not have contained the poison
yet the bowels & trogrthe and may have been the 
vegetable modus.
5 & 6 The Capt & super cargo of the contagious Bark
took the disease from the objective infected
locality
B. There is no case of contagion. The
diseased person has never imparted
the disease to another.
C. There is an objective infection 
but no subjective contagen.

210
214
Statistics of Eastern State Penitentiary
Jany 1st 1838 Prisoners 387 of which are colored 158.
" " '39 " 417 " " 165
" " 40 " 434 " " 183
" " 41 " 376 " " 160
" " 42 " 335 " " 134
" " 43 " 331 " " 118
" " 44 " 359 " " 121
" " 45 " 340 " " 106
" " 46 " 344 " " 99
" " 47 " 308 " " 88
" " 48 " 294 " " 83
" " 49 " 292 " " 83
" " 50 " 299 " " 76
" " 51 " 299 " " 81
" " 52 " 310 " " 75
" " 53 " 288 " " 52
" " 54 " 267 " " 43
" " 55 " 270 " " 48
" " 56 " 285 " " 48
" " 57 " 297 " " 51
" " 58 " 376 " " 67
Remarks. The part 21 yrs skew a reduction of prisoner
in the ratio of 4. 3. 2. & a reduction of the colored
prisoners in the ratio of 160 to 50. Why these two reduction. 

211. 
Bromide Potass in Chlorine
Finding it beneficial in the 2nd & metastic
stage of Erotism in males. I gave it
in the case of feeble menstruation, headache
edema of low eyelids and general bloat
& exsanguneous skin-(chlorate) After various
ineffectual ꝶ the Bromide Potass g v. as
of curran ℥i q.3.h removed all her
[mort??] & depression of spirit & rested
a healthy menstration. Aug 22/ 88 Miss Allibouge
Bilious Tertian Remittant nux with Gastric Epidemic then
treated with Calomel. Tyson-Cebral Myer & Sulph Quin-
Mr Church Buck aged 35 yr of Brownwrle. Tenass
at Merchant Notice recommended to me by S. Alden Er
Wednesday Aug: 18.
He had bath recently arrived and sickened with
a chill followed with a synochus reaction.
Bilious sangunious-gentel spirit.
His stomach was so ittitable & intolerant of
percussion at the Epigastriodic region. that
he rejected the saline next. This was not only 
quickly rejected but it excited a proheated
violent reaching & thing off only a phlegm
puss.
Aug. 17th Thursday. After midnight be rested-Aug Am
I found him with less gastric irritate & a pulse of 108.

212 
216
I regarded the case a compound of Endemic
Bilious tertian Remittant. & Epiderma gastric fever
ꝶ Tysons ant: Powder & Calomel g v 2 8 V
The day passed off moderates. ꝶ Sulph Soda ʒi
q s h. Urine only moderately red.
Friday Sept 18 A severe chill pillow with a sever fever
He & friends 2 Al dry. all alarmed. The squalle Soreness
of Western merchants fixed attach on Dr J. McCellan for
a consultation. Without much ceremy he was called
upon & was activating at the Medical House.
I decided agt the Hotel as the place for my patient &
agt all consultantn for pains of their gouts. & by
5 PM. My patient was at 1121 Wallace St at the Harrugh
& cont Tyson & ador ꝶ [illegible]: This moved
his bowels.
Saturday Sept 19: After midnight had sleep. Urine is
of beer color with bile as the bottom of the vessel. Eye balls
yellow, face flushed-slow circulation. pulse 120.
The indirection was my that the stomach is less crutch 
to prevent the expected chle of sabbath. 2.
Sabbath. Sep 2d: From 1 Am to 7 Am. He took 12g Sulp Quin &
1/8 gr of Supl Morph:- Aug 9. Am I found him without
chill or habits to chill. But in the afternoon The
exacerbate of the pain was very seve & whelts of hives over the cor 5 day. Strong the
cause to be Remittent & not an intermittent. The
urine extends beerish & bilous- & eye ball more
bilous ꝶ Bis Carbonate Va Art Vu Ipec Vh
sore & cal g111, g111 g111 g111 C. 3 h-

213 
Monday Aug 22. The whelts of hives have pains off
nthe pulse reduce to 96 & less hard. Urine is content
beerish & bilous-eye balls yellowish. face red with
sloughy capilla feel better. [cross out]
he [cross out] omit cal & Epid Mur &
resume the citrart of Meyer-
Wch he have a chill tumours? Barley wch.
Plants used by Somerville for an Aquarium
* 1. Cerala filum [illustration]
* 2 Eudora.- [illustration]
3 Ludurigia- [illustration]
* 5 Callitreche [illustration]
* 6 Valieneria- [illustration]
7 Ranuenculu- [illustration]
* 8 Ulricularia- [illustration]
NB Thru with * use to be 
preferred.

214 
218
Case of Influenza Calenated with Cancer.
Sept 10/58. I visited Mr Gerv bel: 16
in consult with Dr Fricke. She has been several
week [cross out] sick. The chief complaint was in
the abdoman. Constant distress. a face expressive
of gastric disease. The abdomen presented a 
convidal swelling like that at the 5 & 6 M of Pregancy:
being chiefly at the umbilical region.
-This and not the diffused swelly of Arat
or Metenem. This indicated a localized of the
disease in the snale rather than in the large
intestines. This abdomanal distress for a 
whole yulved to an extreme & rather painful
palpitation of heart, which hang yulved
to thus ext Valenic wch he Valera. The abdom
distress returned. But now the distres
seems much to the region of the large bowels
& the motion was extant of a having
excrement congestion epidemic. The follow constant
vomiting & passages & finally death
Authors. Cancer & thickeng of Omartea. Cancer
of the pylumus-cancerous body a the ulerum
reddness of the mucous cavity illum.
With
1 Serum abv cavity 2. fibrous adhesive
of the neck intestine.- alher of the
less less leg. ove

215 
Abs:
1st Schirrus of the omentum. (entire)
2. chronic form adhension of transverse colon
to the under surface of omentum
3d Schirrus of the pylirus. cells [illustration]
4 small schirrus bodies studding the cinchea
surface of the peritoneal coat of the ilium
So much for cacer.
5. Mucous surface of the ilum presents a congestn
of a modenous red color extensively in broad 
patchs.
6. Thickning of the parriets of the ilum but without
evide of cancer cells. Was it not only depend
of fibrum.
7. Febrinous depent from the serum surface
of the ilum & jejune & color adhering them
together: but not as in peretint to
the abdominal peritonea.
8. Transparent another color serum in the 
cases of abv:
Then are the remule of Inflamation.
9. Case Cancer produce Inflamation

216 
220
Tussis Hyoidine Matrionii
A day convulsive cough excited by any [cross out] [cross out]
emotional excitement. Pressure upon trachea or upon
larynx give no pain but pressure upon the ends
of the os hyoides is intolerable & excretes coughing.
It resists are the ordinary remedy.
Miss-broke an engagemant of Marrage-she
became attached with a dry convulsion cought
[cross out] which baffeled all ordinary appliances.
Miss on the apparent of the muphal became
attacked with a dry convulsion cough
Miss-exposed her head & neck at the window of a
car or an inclemant night. A dry cough with fever 
was therby caused. They both continues for 4 weeks
The cough was without pain or expectorate and
on the forth week dubious & now on the we
of manage it has almost disappeared.
Nervous disease can work in the 
morning.
Blood disease are worst to the 
evening.

217 
Paralysis
John Constable. age 74 yrs
On Sabbath Oct 17/58. He suddenly fell in
his chamber & was unable to move.
He was lifted into bed. I visited him at 10 Am
& found him with loss of voluntary motion of
right arm & right leg with loss of sensation
of both limbs yet with papel soundness
of manner in all its faculties common to 
his time of loss-
On Monday Oct 18/58 I found that the loss
of Sensatn & Motion of arms & leg very 
removed & atn the rigor in - of 
face draws & caused an oblique of the 
mouth: but his manner in pulse strength & 
I never regarded it any diet to
myself the impulse of setting to
workng appears as the dise must
gradually become also his mind.
Next morn he has pile soundness its
never to prefer diet or fuly.

218 
222
The Autopsy of J.P. Spawhawk
by Dr J. Darrach & Dr Darrach Nov: 5th/58 11 PM
at Chestnut Hill
Habitual. Extremely Emaciated. The integument
one the abscess in the less iliac region was flattened
as though the pus has in some way [cross out]
been removed, and was spotted over with dark
petechoid spots. The other pubat region of the 
abdomen was greenish & distended.
The abdominal cavity being opened, the diagnosed
portion of the abscess was demonstrated to be in
the parieties & not in the abdominal cavity but
on removing the abdominal wall [cross out] its peretone
was found adherent to the omenten & so sphacalated
that it ruptured & [cross out] caused a discharge
of pus from the abscess cavity- The intestine 
have over of a dark & leaden hue the rest of
the intestine was distended with gas-evidently
postmortal-The stomach was without disease
But the Pancreas was disorganise & of Double
its ordinary size. He was & has been for a laugh
of time dessacreated: Which accords with he
dislike to fat & gravies.
Thorax. left lung collapsed-& without tubercles
& exsanguinous-the right was adherent &
has some blood, but without the ordinary venous
congestion. the apex contains a face hair bodies.
The Heart was empty & one 1/2 the adult size

219 
Dr Fricke Case of what called Typhoid Pneumonia 
Popler gr & 3d Nov: 4th/58 Gerna Gul
1 Cubritus on the Back
2 Short quick inspirations & lung passive expiration
3 Scarlet trocar patches on both cheeks.
4. Eye lids (upper) retracted
5 All mari quickly dilated
6 Pulse small, feeble & 108
7 Torque entirely clear & healthy. 
[cross out]
Auscultation. Fine crepitant rale in every parts
of both lungs.
NB. If this be Pneumonia. This so of both lungs
& of every look. & with tends to softening & ensure quiety 
will be fatal: But not so. Its nature is a capilly
cngest of all the bronchi & transudate of fever &
[cross out] thus making serv-mucus fluid in said as
[cross out] limbs. There is also transudate of serous outcomes
the tubes & consequent cnstrictn of pulse impactment
of fluid & exclusive of air-asphyxia-
& in consequent of the condition of bronchi-the
blood for the pulmonary acts cannot be arrested
& is therefore- retan-this cause verve congestion
of lung.
Indicate-
1 Support the men for of lung by Carb Ani mon
2 removed cepillary congestion by Temperture
3 watch Tyson the coarse & cure of the Epide fev

220 
224
Dr Fricke case of 
Endemice Epidem Scalateus form of Fever
The want if regard to external objects seem to 
favour the idea of sensorial form of Scarlet
fever But the state was associated with a state
of constant fretfulness-disturbed emetics-
gangliar & not sensorial nor cerebral & nb
to the confounder with soper of seasorial cases
commonly tuberculos meningitis
The sordes on teeth, the Epistaxs, the moderate
pulse of all 120 & 108 & 96 and the [cross out] also blue
above discharge was indicate an endemic 
element. & indicate the ꝶ of Calomel
NB This is confirmed by the case of atribitus
abv deck in the [cross out] du Bastin-Mary Harington
& the bronchi of quin in a case of Dr Wiltbrook
& so this idea we would not forget the atril
sour of micar is the great insudate of
the sorts & long week & the privacy of Wounds
for the S week in Septic be.
NB.
Soper must not be confounded in Torpor of
Hepatic origin.

221 
Nov: 7/58
Palsy. Case of John Constable Em age 75yr
He has had for some years a weakness in the 
bladder. Ive visited him medically for three years
& have regarded his condition [cross out] debility of
blow. his urine way less than 1020.
He has now been palmed since 17 Oct: 21 days.
The urine is more improving but has been slowly
better alkalascent with different of sope purulent mats
as that of yard & clayton. in which Nitre had so
manifest bereft, annointed with state &
gleet: thus this evidently such.
Mr. C is of New York state-a country fellow man
found & expert at hunting 2. but without
intellectual tendency. good nature - well 
developed dilation syste but not cerebal
& weak neutral organism.
Now what is the mater of his palsy.
1 He suddenly felt after ring from his head
in the morning-without previous vestige or
unconscious as one that is suddenly tuppe 
or has both the crumbled terror of the thigh bones.
I saw him with a few hours and at first both
the mildest [cross out] [cross out] more favorable with
of the case-as only a [cross out] concussion
of the muscles for an accordance fall
He had to be lifted not far & had no urine of
right upper & lower limb-The next day
The right end of face was pale & the mouth

222 
226
oblique yet the to was not obliquly projected
The thursday-he was ordinary better & the
[cross out] much of the shoulder-here & [cross out] lone joints
return-but not there of elbow wrist, fingers
ankle & toes.
Sensation what has be much impared
was new also return-
But the urine was putrid, alkaline & 
contains much ruby purulent malt at the 
both of venice-
For condition of urine but not of feces-
Bad Symptoms
1d Loss of motion of movement of elbow wrist
finger ankle & toes
2 Incention of urine
3. Urine 1013 Alkalin & ruby purent malts
4. thickness of speech. 5. thickness of speech
What is the cause. Diastalic
Is it: Neuropathy-(cerebral, seasorial, spine,-)
excenti cecxcetion
or perephial-cystic-Emetic Febra-Sequla
cope- matter-starburst because very case
[cross out] end [cross out]
capil - spidem
capuls-epidemics
Is it Mylopathy. shock or delutn
in the Flu Ne.-
Debility in fever.
Emaciatn fr fever.
Loss of err for bandg-Treat
any degree & fibes

223 
Neuropathy
Coxcentric
cerebral care Boyd, Ritter, Blight-& [cross out]
Deposits children-
softening
Sensorial. Blight child. Erotic case
spinal. Starburst-S Haverheh
excenbrus
Perephial, Isral case-Middle, Hunts
cystic. Ich Matthew
Erotic, Starburst
Febris &c guilac
Endemic
secondary vene congest
Epidem
capillary congest & hemocele
reflex for mucus surface.
Mylopathy.
Centurion.
oily degenerate
Febrile Depose of strength
Absorptn of muscles
[cross out]

Cases 
G.W. Blight-His infant-Honed Drea care of tumor
or first of cerch. Early case of spinal symptom
hue copper care-that Ruth care. Sub Matter
save child-Sof. Paper-Starbust-Bronchi
Boyd. skull. Mittchel Houster. Sal Harash
-Castabh Rawle Sichel J. Harris, Jack
Dr Boyd Case. loss of Sensation & Motion in 2d & 3d fingers of right hand
recurring after weeks & the rapid & continues
loss of Sensat & much of hand, work force
elmk. humerus, unconscious state & death 
with 12 hours. Aaboth [cross out] discoverd softened
less corpus strictu with clot of dark blood
& cocyle a venus- Evidenly becomes hamerus
upon softened state.
Partial Paralyis, unconsciousness, stated
cause. Sequela cardae & hapatic dispetic
melancholy [illustration] more stauty New Boyd
38 yrs or age-
NB Neuropathy. Cerebral. Softing concetun.
Partial paralytic apoplexy. Right arm
less shade lung smooth nerve power
Sadness anxious sedentary ship less-Dyspepe
Hepatic descid -Cordea Sisard-softed
sep strichter.

225 
Death & Bueshing of Gale Bladder for
Fright

You may meet him there. 
The relations and friends of the family are respectfully
invited to attend the funeral, from the residence
of his parents, Montgomery street, one door below
Front, on Thursday afternoon, at 2 o'clock. 703** 
On the 23d inst., JAMES J.KANE, aged 25 years.
The relatives and friends of the family are respectfully
invited to the funeral, from the residence 
of his father, James Kane, No. 726 Carpenter
Street, above Seventh, on Thursday morning, at 8 1/2
o'clock. Funeral service at St. Paul's Church. Interment
at St. Joseph's Cemetery. 39*
On the 23d inst., HUGH QUINN, aged 45 years.
The relatives and friends of the family are respectfully
invited to attend the funeral, from his late residence,
No. 1016 Federal street, above Tenth, on Friday
morning, at 8 1/2 o'clock, without further notice.
to proceed to Cathedral Cemetery. 40**
On Monday, Nov. 22d, Mrs. SARAH SIDDONS,
aged 74 years.
The relatives and friends are respectfully invited to 
attend the funeral, from her late residence, No. 924
Chesnut street, on Thursday morning next, at 9
o'clock. 31**
On the 23d inst., SAM'L SATTERTHWAITE,
of Falls Township, Bucks county.
His friends are invited to attend the funeral, on
fifth-day, 25th instant, at 10 o'clock, without further
notice. 864*
On the 22d inst., MR. EDWARD IRVIN, aged 60
years.
The relatives and friends of the family are respectfully
invited to attend the funeral, from the residence
of his son-in-law, Mr. Robert Irvin, corner of West
and Marlborough streets, this afternoon, at 2 o'clok,
without further notice.
On the 22d inst., LAWRENCE RILEY, aged 37
years.
His relatives and friends are respectfully invited
to attend the funeral, from his late residence, 1521
Germantown Road above Jefferson street, this afternoon,
at 2 o'clock. *
On Sunday, 21st inst., Mrs. SARAH HECK, in the 
[??th] year of her age.
The relatives and friends are respectfully invited
to attend the funeral, from the residence of her son-in-law,
Wm. S. Hart, No. 1223 North Tenth street,
above Girard Avenue, this afternoon, at 1 o'clock,
without further notice. *
From Mexico.
Conspiracy of the Zuloaga Government to
Funds Discovered.
WASHINGTON, Nov. 23.-The New Orlean 
pers of Thursday state that a conspiracy was
covered in Campeachy on the 22d ult., which
to have been followed by an outbreak on the
suing Sunday, when the city was to be sacked
raise resources for the Zuloaga Government.
North Carolina Politics-Democratic No

[From the Manchester (English) Guardian.] 
A Girl Frightened to Death.
An inquest was held on Monday evening, at Mr.
W. Sutton's Much Hoole, near Preston, touching
the death of Marth Spencer, a girl 13 years of age,
who came to her death through a most shameful
joke perpetrated on the preceding Friday evening.
The following evidence was adduced:-Bridget
Riley, a factory worker, said the deceased also
worked in the factory. On Friday night last they
left work together, a little after 6 o'clock, and in
company with five other girls, went along the turnpike
road leading to Liverpool. They had about a
mile and a half to go. When they got near the 
Primitive Methodist Chapel in Hoole, they saw a
coffin lying across the footpath. When they got 
within four yards of the coffin, it moved, and a
hollow sound came from it. The girls all ran back
and screamed.
Martha Spencer and witness were the only two
who got near to the coffin. They ran back about
fifty yards, and came up with Joseph Gill and Jane
Hinde. Witness and the deceased turned back
with them, and when they had got within five or
ten yards of the place where they had before seen
the coffin, they saw Richard Forshaw and Robert
Mawdsley (two apprentices to Mr. Howard, wheelwright,
of Hoole) with the coffin on their shoulders.
It was not quite dark but dusk. The deceased
said she was rather frightened. They did
not speak to the two young men. The deceased
turned off home when she and witness had gone
about a half a mile further.
On Saturday morning the deceased was work
as usual, and asked witness if she had forgotten
last night, but she did not say much about it. She 
then fell ill and died in a few hours. Henry Hunt
stated that on Saturday night witness saw Richard
Forshawe in the club-room at the Rose and Crown
Inn, at Much Hoole, and said to him, " You are a
bonny fellow to go and frighten children so."
Forshawe said, " We put in the coffin down, and tied
a string to one of the handles, and Mawdsley went
at the back of the hedge into the field with the 
string, and I went into the ditch on the other side
of the road." Forshawe also said that Mawdsley
pulled the string when the children came up, and
moved the coffin, and that they were doing it for a
lark to frighten the children.
Mr. W. Howitt, surgeon, Preston, said he had
made a post mortem examination of the decreased,
and found the cause of death to be rupture of the 
gall bladder and extravasation of bile over the internal
surface of the intestines. The external surface
of the stomach was also covered with bile; the
interior contained a quantity of mucus and coagulated
blood, and the whole of the lining membrane
was very much congested with blood. He had no
doubt that was the cause of death. The probable
cause of the rupture might have been the fright she
received on Friday. The jury returned a verdict
of "Manslaughter" against Richard Forshawe and
Robert Mawdsley, and they were committed for 
trial at Lancaster on the coroner's warrant. Forshawe 
is about nineteen years of age, and Mawdsley 
seventeen.

226 
Miss Ann Taylus Sickness
After some weeks medical care of Ill
Taylor, I regarded it a duty to inform
the Brother & the Brother in law Mr F King, that
I believed she would not recover from her
sickness: & what a symptom [cross out] of constant
dosing have come when he which I believed
under gradually increase so that eventually
[cross out] she would not have mental actions
[cross out] muscles are very to transact inhale
worldly makes [cross out] she might have
to do. I therefore so confirmed Ms Foley
her brother in law, her brother & Ann King he
sister the [cross out] afternoon of Nov 26 1858.
and at about 5 PM of Next day. I felt of
my duty to state to my patient that
the drowing of which may existed would
likely increase & remet in a few
days in lack feebleness of mind &
body as to prevent her has acting
very important worldly matters which
she might desire to transact.
This waried her: she has I understand
interven with her Brother & Sister & made
her well. At my second interview. I asked her

the time of day, Its about 4 oil-This was correct 
what is the number of qui have 1118-he was
correct-How long have you limber 11 yrs
about-this was correct- When are you
formely have in Race by What [cross out] is the
Number of that home. 30 - the old number 
wh answer was correct.
I regard her on the day & previously of
sound mind & manner-
Her disease is of a Dyspeptic nature
causing impeverted blow what 
attack inducing disorder of mind which
gradually so weaken her that there
until a gradual indispute &
necessary to thick, feel or act.
The following day she was also
in sound mind & [cross out] memory.
[illegible] 28 until she was more feeble
but less dining. The drowness was a
characteristic symptom through the 
day.

228 
230
Dr Fricke Decoc of Red Bark with Phillandria
℥ss q 3 h
ꝶ Red Peruvian Bark Pulv: ℥i
Diluted Sulph acid ʒi
Decoc with aqua ℥xii
down to ℥viii
When nearly dose add
Phillandria aquatice ʒii
add to fever
syr orange  ℥ss
M  ℥ss e 3 ii
Tar Palsy
ꝶ. [cross out]
olei Phos fr ℥ss
unguent: resinum
Pine Burgund ℥ss
olei Hyorc. ʒii
M to rub the palms burnt
Dr Jolt cured a case of partial 
Palsy with it
ꝶ Phospt g IV
Solutn olei: Passav ℥vi
Less ammon fat ʒii
olei Terebeth ℥ss
M To be with a limb Hemphlega
with it Dr Horn of Germany cured a card

 

232

228 
Chloride of Lime & Erysipsela
Dr J K Kane, Dec/58 in Consult with
Dr J Daniel myself in J Constable can
mentioned the promp arrest of
erysipelas by means of a Lihitin of 
chloride of Lime
NB This accord with the action of
Sulph Zinc in congestion the
mucous capillary.
It is [cross out] tumor to the capilla & restore
vital contracting
The Epidemic of Oct Nov 4 1858
has been of the tracheal & bronchial
mast & not of the Fauces &
durg the previous year.
There is no Scarlatine, 
The Case in Cerarture & Breast 
A new ꝶ for Neuralgia
ꝶ Etherial Tr Guiac ℥i
Vini Colchi: ʒvi
Canabis Indicas ʒii
M gtt X at a sore-
at Wegand Drug this.

230 
234
ꝶ
Elix: Valer: Ammon
2 1/2 grt ℥i ℥i
ꝶ Iodide Zinc for Tonsilitis
ꝶ For condilometa
Powder Burt Alum
Verdegris
Powd Savin aaa ꝶi
♏
Dr Lindsays ꝶ for Neuralgia
ꝶ Ext Aconite grx
Sulph Quini gxx
Acid. Arrinin gi
mppil xx
one every 3 & 4 hours

231 
Neuropathy
concentuent
cerebral
Seasonal
spinal
excentrio
Periphial
cystic
erotic
Febris
Hæmmorrhage
Funlare
Mylopathy
cinturia W. Fluther case
[cross out] only degenerative
Febute Depressia Fred: Haverfort
Abs [cross out] of Muscle. the cause Muscles

232 
236
Hospital Fever in Dr Barton Darrach
While Dec 17/58 Dr Baron Darrach arrived at
my hour 1120 Act: from New York on his way
to Quinsey Illinois. But felt so indisposed that
he determined to remain with in a day or more 
The two previous weeks have been spent in ventral
relations about Ny & up the Hudson at Newbery
& First Kite. The weather was cold & damp & as
the period the travells on the Hudson is hazardous
He has been also much examined in mind 
about leaving home permanently for the week
and find he has just been longed for
manager.
Previous to the sand 14 days he had been
engaged as pendent Thynacea in the NY
Hospital in the fever ward
His indispostion assumed a fever forms
of morning & eveng exacebation pulse contracted
& frequent 120 & 130. urine deep brownish red with 
grand of edge to evated while with yellow starts
down its reds. skin heated-night restless & 
watchful & loss of appetite.
On the eight day a spirit of urate of ammonia
appeared in the urine & petechal form osf
eruption on the whole body-& when the
skin of abdomen way streches with the function
in very persistent red lime was marked

233 
The second week was delerious the delena
increased during the night. pulse refluent &
frequent. urine of brown red color. skin heated
empty continued.
The 14 days prevented copious defent of urate
of ammonia & a full & less frequent pulse
& a papps of of the alean & less pruslent
& some appetite.
The 21 day has no depont but the urine
lost its brown red color & around a orange
color-men abundent & clear
& so the symptom contained until the 
28 day when the urine became of normal quantity
of an apparent to lemon hue-& a
paole return of emetic wheter & 
derive for animal food & for society 
& for his Ly L!
NB Here is evidence of the 28 days
duratn of the essential  fever
& but also the fun of Epidem & pustulus
fev &c &c is only a poison in the
water of the blood which diminishes 
surate, depression strength & disturbs
facult-emetic pain & funct 
& in 28 days & in less it proves 
& the system return to its annual
state.

234 
238
Twelve Hæmorrhages from the Lungs within 
Three weeks in the Case of
Geroge Harrington by age 25 yrs calcuated
with Catarrhal Influenza on [cross out] & Jay 59
Wallace abv 11..
Tommorrow Jany 23 will be the 21 day of the attack of
sickness and I ve predicted that the liability
to Hæmmorage has paper because then is an
the 4 week of Epidemic fever no depression
of system & no venous congestion of lung-the
cancer in this case of the bleeding-the Hæmorrage
was dark & disposed to the clothes &
without froth.
PS Pulmony Hæmorrhage
1st Frequent recurrence & answer Bark Tabinel 
can Increase Ishuria in Blkbery Alloys
2: occurance recurrance & accorded with
lock lobules congest
case Rev. J Phelbs
3s Copious Frothy Hæmorragh & around
with shine & sanguios temperant
1 N of Bangor & more in Tennant 
4. occasional Hæmorrhage any to yank 
& indg at 3 yrs
case the I Wartburn.
5:

235
Phila Feb: 12 '59.
I was called to visit the daughter of Mr Janvier
No 3. Plymouth & 20 yrs in consult with Dr Wellbank
The symptoms were soper, pulse extremely frequent
and contracted [cross out] [cross out] and paroxysm of
diastaltic convulsion.
The patient has then reached the day of the 
disease. The symptoms of the previous period of
the sickness where abdominal among wich 
were prominently diarrhea and metorisms.
We regarded the case as a sensorial form
of Scalatant: and a [cross out] from the extreme
contraction & frequency of the pulse at so late
a stage as the day prognosticated death.
The child died on the 13 at 7 Am.
An autopsy was made on the 14 by Dr James
Darracy & his student Mr Willen Whisler in the 
presence of Dr Willbank Fucke and myself.
The skull, cerebral membranes and brain
were fully displayed and not a symptom of
[cross out] disease could be discovered. I have
predicted at least capillary congestion of
the membrane of the sensorium and upper
pard of the cord with transaction of serum
disallowing the [cross out] popular notion of Tuberculosis
meningitis.

240 
Happily the operation determined to continue the 
autopsy by opening the abdome and to our common
surprise was discovered a universal adherence of
the intestinal to the parietic peretonea with capillary
congestion, transudate of fibre & lenic & meteorun
in the small bowels.
NB The case evidently was [cross out] epidemic fever
with primary capilly congest of the mucus memb
of the ilum & jejune with a want of centrifuge
secondary congestion of the skin & a tertiary fibrus
congestion of the peretoneum or as Lydah may he
know as febris inherence & such as occur with
- a patient of Dr Fricke & resemblg that subsequently
of Rebecca Herr ago leg-as
Rebecca Hood age 4yr. 17 so Arches she had had
scarletfin senay 2 yrs ago-& subsequently or
severe bowels and plant-
Feb: 24/89 Thursudy many she, after each headach wat
attacked with protracted vomiting. I saw her at 11 AM
she state cnted to vomit: The congestion of the eye
lid was abnormaly congested, the to & bips acts abormaly
read, scarlet. the pulse contracted & rales
I requested a mild murtern plant to Epigastric &
ꝶ Ext. Bellew & Br Cant tinc [cross out] 8 PM. Vomiting had
ceased but pulse contracted & 144. Cent ꝶ
Thurday 9 PM. too much vomiting. cent ꝶ ꝶ PM 3 Lde

Saturday 9 PM pulse less frequent & contracted. urine of 
a light amber color. abda newment & pulse
but not tense. ꝶ Obstruct point own number
plate to slippy redder & moist abdomen.
3 PM Less scarlet stage with much  or cover cheek patient 
abs scarlet & congestion of eyelid also congested & scarlet
pulse reduced to 120. No urine her pulse in
movement of bowel. ꝶ Gen treat water ie - ꝶ ꝶ
I regard the case ententic influenze with liabily
to peretoneum sequelae.
Sabath 9 PM. Pulse reduced to 120 less to & eye lids extenally
less scarlet. the number plate of ʒi to ℥iss of 
fever not reducing the quantity of number was
increased in greatly so that the surface of abdom
became too much redder & thereof omitted fr 
the night & are under applicate made with
the abundent purulen center. no urine in also
ducts: then is a slight congestion Cont. ꝶ
5 PM. Pulse 120. more contracted beter & to more
scarlet: there is more congest & a [cross out] lower
phlgm
NB This is a case of Scalatinna-febri
interverse of a primary congestion a the
mucus membrane of the ilium & a tertiary
fibrus congest of the bridg celerl time
of the legs or of the bronchial tubes. If the 
cone more congest & a red cheek the I shall
understand the bronchial or premium state
of the congest-

242 
Monday 28/59. Pulse reduced to 108 AM & 120 PM. Cough
& bronchial respirate abdomen not without distention
& without remain lesser to & eye lids less scarlet
ꝶ cont Br. Carb form & Ga Ipecac
Tuesday. March 1/99 9 AM pulse 9 1/2 large incle 
in urine & quantity increased less & to have lost
entirg the scalet him. congest of eyelids see inject 
& somewhat feeble. Bronchial case continues &
cough.
NB Capillary congestion with fibres hardest & pus fomet 
1 for Bae & upper surface of Brain
2. Pleura & Pericardia
3 [cross out] Fauces
4 Trachea & Bronches
5 Jejune 
6 Illium
7 Large Q tests.
8 tubala soreness
9 tubala biliaria
10. Pneumen- lung cont abscess
11 abundan glands
12 sebceous aortic & cilerl tine. 
13 Dutseed cellul ter new bone 
Wednesday March 2/ Ex 9 PM Bowels move at 8 AM 7th day
of attack-healthy faces-1/2 inch diameter brown, 8 inch long
NB. This is another instance of harmless abscess of alv-evacuate
for 7 days & to the uselessness of purging in Epidem fever & 
the likelyhood of urgency of purging. scarlet when has disappeared
pure 96-& full urine much

Hydraphobia Pete Brady America fr - 
Feb: 26/39 aged 40 yr- a Hirrile 
He had been bit two months [cross out] by a fox in the 
nose-No morbid symptom was manifested
until two age-Then he was exposed to water
He either was employed in through bunches of water
upon a hour & witness it when a sudden painful
sensat came over him. Subsequently the disease
drink & get have him of drinking. the idea 
of drinking gave him a shudder than had
her face & appetite of hydrophobia for
the bit of the fox two month prenia & such
for Dr-I was called in consultation.
He has a stary look as of on in tenn has
perfectly servant & servicable & seem to rely up 
one in curing him. He gave me a pull
& satisfactory & detant all of the whole month
I then asked him to drink-or yes he saw
Ill-a lincut cut of wat was handed tea-
He with extreme violent revisted him home 
& arrested & quenches a spasmodic effect 
garreles it down & then the tea for
him is aging-says these! Never!
Down I drink-yes. Yes I can,
ꝶ [cross out] I examined her fauces &
funct is with a dark red congestion
ꝶ Dry vomit-& the ather urate-& sweatg

244
I saw her the next day- He is very violent 
stay far- & capilla of the face of the jaw 
dark red as was the fauces [cross out] the
dsyprenia- His pulse we very rapid-
Here seem to a developed pour raging in
his blood where must pulse be
He dev the even of the day E.S. and-
This was rapid-
Constant vomiting of cold water whenever 
he found himself to drink it 

Another case of Entent Epidema fever in
[cross out] Feb & March of 1859
Same Hoffman aged 40 yrs 12 gree
He has been disturbed in the bowels since the 25 of Feb.
On the 1st of March he sent for me. I found him
under fever & freq: lax. For this I prescribed rest
and Cal g i Pulv Ipecac gii Opii gi mphie IV
one every 3 hours at 5 Pm.
March 2 Am 9: I found him without relief for 
the ꝶ. This induced me to regard the case more
seriously: The pulse was contracted & frequent. Skin heated
she 9th depressed, urine of high wine color, and
the also descb a feculent diarrhea as in typhoid
fever. I percussed the abd: but found no special
tenderness nor gurglings in the case iliac region
but on the cn has the pain from percuss
we cmpnd to the umbilical region.
I diagramtated the case- enteritic form of Epidem 
fever. the fear of the congest of capillar being 
in the back of the ilium.
The Therapeutical indicatns were 
1st Genial to abate & contrast the 
essential fever in its cour of 4 weeks
by Tyson Ant Pow & Sulp Morph
2. Special Indicat to remove capillary
agent of more morp by subsate
cutaneous capily congestn of above
& makes pla & abn ie & more bread 
no food 

NB. The month of Feb & March seems to be marked 
by enteritic form of scarlatin and Epidemic fever.
by Lorri Janne entero peritoneal and Dr Wiltbank case
Reb: Hour. Gastro entero-bronchial they case
Sam Hoffman. Diarrheal- umbilical region.
- Mer Quarlet
Weekly medical meeting of Medical Club
at Dr. Frick. March 14/59 Monday evening
Dr. Frick stated a case of Erysipelas volitions
attacked the lips thighs with edema & redness without
phlyslteace sprinkled with variolous or variolea
the with the same spinking of erupt or swelling
redness of the right foot & leg & the the right
thigh -&-with epidemic pulse.
I stated a case of scarlet like diffuse redness 
& then a positive small pox in an unvaccinated
infant. 1st 1825 small pox epidemic.
I stated a case of vaccination which had advanced
to the six day when measles to appear & the
vaccine ceased to augment in size & so remained
stating until the measles had disappear, whe
age the vacci resumed its progress to
a powerl & [cross out] normal innic 
Dr Frick stated a case of chancre which
ceased to progress [cross out] when the appear
of a small pox erupt on the same person
& when it dessicate the chancre it resumes
its active condition.

Sensorial form 
There was now a fixed condition of fever. I advised the
patient to cease being up & being rear to by &-
and to be in bed in a dark room. Sensorial congest
Wed 30 [cross out] 3 visit The pulse 108 Am sensorial 12 Pm. heated sking pain 
in the head & dry cough. Pulse
ꝶ Typons Ant P: Citrate Potass fomulate to
feet & dark room.
Thursday 31. [cross out] 3 vals p 108. 120. head relieved by fomenture
cnst Tyson. Bowel cnst relieve Colic feces
Friday Apr 1. [cross out] Friday p 108. 120. Bowel & cont ꝶ
Mustard & abs pulse & milk at c. to abdom
Saturday 2d The abdo limb surture or a constant redness
& more-& the bowel congest less
freq & [cross out] the seq holows more burnt 
& solar-the melanin removed
ꝶ Salt Quin 8i LL for 2 Monday
the abysmal power 
Sunday 3s 16 day Bone conges [cross out] & most all has
ceased-abs-[cross out] pulse cont
numbed amber pulse red
for 2h + 100 to 86 g 1- af
Monday 4. 15 vs- 
Tuesday
[cross out] 5 
Cough [cross out] dry & spent & distend
& extends- & demands attack
& relief ꝶ Carb: are [cross out]
a copious uter discharge of fluid 
blows-alks then had had the mean
but a week pnuem-
The congest became worser & from
no distress but a quart
durin brochial respiratn it 
took longer-indicate on give 
bronchial congest but no 
by husbands. [illegible]
Wednesday
[cross out] 6. cough better. bowel relived
[cross out] are above & short by 10 10.

248 
pulse long & in const 
Thursday [cross out] 7: 84. 9h.- [cross out] prevent sequelae an
have if urea - lesser auto-82 g 1000-1000. 1004
1004 at subsequent-for 7-[cross out] exactg &
[cross out] worry spells of dry death [ha??l] cough-as the
the when bronchial syst was dilute-a constant
fever of means & avenue & disfrequent to sopor &
when rousd she was up due let me sleep &
want to sleep - yet when roused [cross out] she has a
painful & quiet manner-& let all she spontaneous
paper with a sopor- skin is heated-sardamiac-
[cross out] She is deaf- soon this gives but yet
Friday [cross out] continues so-ꝶ Rigor the blood as
[cross out] s- impure- but near the back
assert & pulse-congest at has
of he or is the sop the effe
Saturday of bronchial [c??]
[cross out] 9 96. 84 wine whey-whey carb amon
Sunday
[cross out] 10 84 84 Mur at tr in. Wine whey- Beef tea.
Monday 11 Consultant Dr Pepper. He tell that is Typhoid
Jany 12. Consult Dr Pepper. He says its Typhoid yet abodem in
[cross out] treatment but syrup Quin & a dropnut
ꝶ 50 of Murrid Tr of in 2.2 hours-Beef tea ʒi g 2h
Pulse full-by weak, jukng- 84 he say exand 96. 18 &-
sopor-yet perfectly in [cross out]-deaf-very [cross out] excitable
& early irritated & ammen- urin other 2 gr 10v4 pale and
vs [cross out]

[cross out] 
[cross out]
1 Faintness stomach
2. Bowel complaint Large bowels
3. Cough Bronchial
4. Headache Bane of Brea
5. Bowel compl Large Bowels
6 Cough Bronch
7 Sopor  B of Man
Wednesday Ap. 13 59 day of sickness 10 Am
From 10 Pm of 127 to 2 Am of 13 she was restless &
coughs a great deal-( the dry bronchial warm cough)
constantly in a freq & sayg or I want you to let
me sleep. At 2 Pm she ceased to be restless &
fretty & have, apparently, a sleep until 7 Am
during what hastens awoke her bowels to
take quine pills. At 6 1/2 Am bowels made
small soft scybillæ for free to Senna bea syr
& this with blood-again at 6 3/4 7 1/2 8 1/2 & 9 1/2
also said scybillæ & with blood. There was a 
sprinklg of blood on the side of the venal & as as
so often [cross out] in hæmorrage owing to the congestion of
the rectal vein for the freqency of the feces.
& the subject stanning. I theref judge [cross out]
the existed a congest of rectal vein [cross out] in
consequence of a relieve of peristalt action of the 
large bowels after the debilty of thin capillary
congest dysenti of the same large bowels.
prognosis favorite but Dr Pepper

saw blood!! a! blood! gave Jalpha. Typhoid 
fever as a bad symptom!!! Ba!
The blood is one of 3 conditi - for the uri & the
a fatal hæmature-[cross out] 
[cross out] [cross out] lentray congest
of large bowels & very dangerous [cross out] as
accordance bleeding of congested rectal vein
ꝶ Dose powder for cough-
She drank 1 pt of whey durg the night
pulse 80-The cough is more like the
habitual chronic cough - in morn takng 
She passed the day with betterment of
symptoms & I am ful less anterior
its the 2 day urea 1004 (I dnt give Sapatin)
[cross out] The sopor is less- the causes 30-
is much related by external things.
Thursday Ap 14 26 day
Disturbed during all the night by incessant
coughing. dry. The quantity of urine passed
from 9 Am 2 Pm 13th- 9 Am of 14 is 2 1/2 qts.
pale amber sp. qrants 1004 & does not in
the slightest effect blue litmus paper &
quickly beca of a peculiar offeni odour
all indicate, with the paleness & emaciated 
num temperment of expressive
blood. The sopor, & deafness on lessend skin
less heated pulse less jumping-She better Ive hope
[cross out] Bowels will- Never no crude of Typhor

Lectures of Annie Odenheimer's sickness
before the D [cross out] presented by Mrs C
On the evening of Linday March 20 she told
me that her bowels were disturbed several times
I asked if she had pain & of the discharges
were copious. She replied that they were
slight but frequent & with straing-that
she had no pain except at the time of the
movement. I gave her at the time 10 drops of
Laud:
On Monday 21 the bowel complete: gradually
subsided: but it left he weak. Throughout Tuesday
there was no disturbance of the bowels but her
strength seemed prostrated yet, the longest
she kept up & spent the evening in the parlor
On Wednesday I sent her to Ambery that she 
might be refreshed & strengthened by change of
air. [cross out] she from Ambery also [cross out] made a plea.
saw trip to N.Y. On Tuesday she returned and
saw that she had not been well all the time
she was away & had also taken cold. I sent
for Dr. Darrady who took her under his care
Ap: 14 cont 1 1/2 Consult with Dr Pepper.
He suggested Acet Ammon ʒi Sulph March 8 1/8 q. 3 h
for the constant dry cough I suggested Decor of Bark
with Sulp acid diluted with [cross out] sol. of fennel seed-
This was yesterday [cross out] 1 light swelling of the left 
side of neck which is now more manifest

250 
This I name jade a sequela of the epidemic fever
by an Epidemi flue the shock of skin for the 
storm of Friday 19 March-the tertiary congest with
hardness of fibrins-in the subcutaneous cellul ten 
of the neck. This may be followed with headach in
The cerval glands.
Friday 15th 26 day.
9 1/2 Am. she [cross out] slept 
during the night under the influence of
Acct: Ammon: ʒii Sulp Morph 8 1/8 q 3
hour. so as to have take two dose. This
[cross out] gave sleep & arrested the dry
bronchial coughing. The [cross out] integument swellg
under the left jaw has increased & [cross out] under
the angle of the jaw it a very tender & hard
the restless the swellg is without hardness [cross out]
tenderness. The cervical glands are
not yet affected She is in a steely
matter. pulse quick & 108 ending sympathet 
constitional excitment from the sequelæ
of fibrous trasudation. skin of face is which
& wax as one that has last blow extremes or
who is chmaly anemia. [cross out]
owing to an obst case diuret meet Dr P at
1 1/2 PM. vent at 6 PM. she frequently unrest 
the consum in bed- [cross out] frequently it quick for
her in congest. she fals into sopor & mouth are
a palat of dreaming. & the [cross out] hand & are
one at jokg & & shaky or w pulse 

sensorial disturbance & likely any to 
the [cross out] fibrous depend on the neck-
ꝶ avoid morph -
ꝶ Acet Amm Hoffman dry & Alk 
in its place & in the Frick Decor of Bark -
& sulph air - & beef tea
the anise [cross out] been the better to a 
black pupil-& is any 9t iss with that 
look in bin-& is of a dark amber
she has more mind when amber
Mant more act. & more a caustic in [m??]
Saturday Ap: 17: 27: day 9 1/2 Am
From 10 Pm to 2 Am of 17 doing & dreaming and constantly
asking for water cough very much moderated.
From 2 Am until 9 Am adv: discharge 6 times [cross out]
& moved unconsciously. It is a granulous feces
in small quantit. Cough moderated. At 10 Am
has mother discovered dark spots or the 
mater. I examined this & judge this to be pale was 
rather the stronger-for there was no areola.
The tooth ʒii of the Bark & tulp aim M. q.h. fr 
2 Am to 9 Am. The pulse thereby stronger.
But at 1 Pm. She has a rigor after but slight
exposure, she complain of cold. the pule was reduced to
extreme smallness-I gave Milk powder.
Dr Pepper saw her during the rigor & saw one of
the alv: disch: He express a extending unfavorable
prognosis-regard the adv dent or exhaustg her
& that the swelling at the jaw was a very severe &

252 
unfavorable complat-& saw that he had
sometime seen some complation
appear of the Bark, Beef tea & milk powder
& laud. ingesta
The Milk powder & Lavages we give & 
the regard depression passes off I vigor
the depression as in adat to the passes off
of the conautal fever more by the 27 day
& owing to the natural debris & the
empowdered blow & the irritats sequlee
My prognosis is recovery
2 1/2 PM the depression paper off-& she resumed
her natural condition
From 3 PM to 7 PM she has slept away likely & 
the ʒi of Laud given by Enema. pulse 108 & not
weak. when waked to give preventative- She was
incoherent-same gene no gas give the 1220 by
not hard & dry-check flushed. swelly under ja
had & increased. the is movement or part oif hte 
bowl-Bones not mur-& he passed less urine.
But has she at the hour of the 29 day
Secondly the fibrous depent & a regular had
exated watchful-& cause sopor-& may
termnate less. ꝶ remlinfact [cross out]
[cross out] 9 Pm Sopor has alarming encreased
The sensorial disorder is becoming more settled
and [cross out] the deafness
is greater, & I sight, it seems to me, is begining to be

compound, certainly there is a lessing of its expression
I [cross out] fear that serious transudate at the base of the
brain is poundg & if so then in the ventricle &
that weak must then be.
In view of all this for the sequelous transudate
in the cellular tissue of the upper part of the next &
[cross out] aching pembe in place of the upper 
cervical abundant glands- secondary & that [cross out] upon 
[cross out] closing up of the [cross out] 28 day course of
the essential epidemic fever-what has assured
them form of capilly congestn of the large
intestine; agravation (not of the ilium) of the bronchi
of both lungs & [cross out] subjectively of the ser-
serious- there is more established or sym pallet
constitutional exatent- imitate fev-wh long 
& quick pulse wch returned frequen; & thusday that
she has impevented blur- indurate to the want
of actn in the litmus & low sh qu 10v4. I 
applied a blist from Ear to Ear & dwn the 
cervical spine to counteract the cephalus 
servg [cross out] transudate by a more exterem
& abundant accepted dermal headach of ser -
&c. The blist was ajourned at 11 PM.
When I commonly allevates give durg the
night & for 2 hr & 7 AM. The Acid Bark decoctn
q.h. [cross out] bowels now are at 6 1/2 seql or
scybalous fecal & urine.

254
[cross out] Sabbath Ap. 18: 28 day. 9 1/2 Am. The blister has or the 
neck acted profusely & has drips for the abundan of
the serum: then containing there comes not have
be a serous effusn going on with the craves 
when so much was Lady Jola without. Whether-for opposte
surface as skin & [cross out] cephate-skin & [cross out]-
Miner Skin & abdomal surface cannot
on the same time be having serum.
[cross out] The sopor is greatly lessend-the
[cross out] eye full of [cross out] expression- & the
mental faculty ache & without the slightest 
obstruction for abhor influence if She serious.
The pulse is redder to She with less quickness & without
junk & less atomic. she by is clean & then
crack & healthy.
As morn the is the last day of the essential fever which 
[cross out] for a combin subjective & objective cause, has successuly
assumed [cross out] dysenteric
sennae & bronchial forms & established
a [cross out] sequela of cervical seem fibrin tranadate
[cross out] inducing sopor & harady bolus & external
& 4 internal drips of the brain & as replenish
of blow is of prin impulse. therefore in addit 
to the flux anual nervousness with [cross out]
milk punch..It bores bit of has shown be
given to probab the action of the powder sal many
& sulpher goes & they reexat gast &
intest & hepat for it &c &c

Tuesday- and vent 
Wednesday May 4: cure her less the pil 

256

  

258

Monday. Ap: 18/59 29 day. 9 1/2 Am
She passed a restless night from protracted spels
of coughing. There has been much wanderg
of mild [cross out] movement of between- no additional
petechie. She objected to the Bark after
[cross out] on the 3d dise or sickness- omited
the pulse in 108 but large & with tone
not the pulse of fever-She had about 9pm
of Sabbeth a very general prostrat
amountg to a sweat: This bag at the close 
of the calculated end of a 28 day fever
favours the idea of a tenent of the 
essential fever. The swellg is still hard &
I therefore regard the patient within extern with schema 
The general disease of an essential fever
& that therefr the circulatn ago
equalizes the functn of the body restores
to convalescent circut & that the
Indicatn is nourished by solid amount
food & lact flour sack, a milk, a coagulate 
in the stomach. [cross out] & masticate to exat
the salivy glans & prevent stiffness of the 
jaw for the transudate of fibrin with hands
ꝶ [cross out] bit of burns to alvin- milk with wm 
sweet almonds- ant [cross out] formal at a slower. 
1 1/2 M connect with Dr Pepper. Mn 6 mader 
strong in prep about the coughg-This 
been the [cross out] sole topic of anxiety if Do

260
the emmago the [cross out] rest lung of more free action the
the less- & not the aloe dilated difrently-& 
proper havng an auscultatn tomorrow-[cross out] especialy
as her hue has not here for a week
In the cmmt: her open it by saying she's a very sick
patient, those lungs ! Ive had a case severe pulsing
symptom case or a deak & the lungs were found
[cross out] filed with tubercles. These lungs may be
seriously affected bett be after diet - I repld 
that its more the 29 day of the sickness. that the
same cough were always hard cong &
going to sleep & paroxysm or thr for
irritat of bronchi are as nervous & another here 
& not influte the parachima - that she
has alway been more or less taken with
a congested cough & that she, are unqualifd
nervous temperament & that I was happy to say
that- I did not think it more the rest or
doubly & contact of the bronch- He quickly &
panting repear. I dont think so & with
her unil point dictn. He has in every consent 
bark bee the slab pragmaticae dictatn
to be listened to & to be opened. He cautions 
me agt geny so much brandy-this is in accoundence
& an with the notion of serious disease of the 
lungs. (What is the name of the present disease) He
saw it-big typoid. 9 PM She has a continuatn
of the intolerable trachea cough. which heal her 
ꝶ. Paneyma & Blk  MXII

Tuesday Ap 19 30 day. The second day of Convalesce
embarassed by sequelæ of transudation of fibrin
under the lip cough of the lung on & with spasmodic
tran reachg exhausting coughing.
The paragoric Elix ʒi Blk dwh M xii arrested
the cough, induced a good sleep & thus more
she [cross out] is without sopor, cough, bowel compl. 
& the Edema of the neck is submoge but
the solid fibrin remains. This must be cmmuted
into pus. Still she, disposed to soporose
sleeping. pulse 96 7 Am. Prognosis still good -
1 1/2 M Consult: DP He made no mention of discutients 
& no nothe! suggested Bark less of Bark -
Bar- Bark for Convuln its under authentic
I say beef-milk-oyst Bread into & 
He has no just cure of the cause- He does
compliment the cure. 9 PM The coughing 
spill relieves dung the eveng & the milk
gave 1/8 gr of Sulph morph. I found her
sweetly sleeping under its influence & her puls 
as 84.  ꝶ Meth Sloughy brades.
Wednesday Ap 20 31st 3d of Convalescence
9 1/2 Am have a night spell of coughing of 1/8 gr Morph
by Emer & then a good night. She occaniously
both milk & with but bitter brands. Reject 
[cross out] all sick then from work for [cross out] color hue
1 1/2 She is silly up & prefer it to her -
taken-Else Bates one but visible it.

262 
consult with Dr. Pepper He makes free to express 
his opin [cross out] in the chambe & to remove 
this & disappeared of that as that the cure
was his-Im silent in comp part of his ignine
of the center cure & of his presept &
dictative wn in the compote room. I hope
the I fear that - Belt or this & take care of
that- great - very pleasant to or who 
given or & in express Bat
Miss Ballut says that Dr P says that she cannot
seem
10 Pm She has pains Monday the day st silly wh 
for 9 Am to 5 PM without [cross out] fatigue &
with alight. This fact aln is suffer
convert that depress if slight was or
the 4 five off-theif the conduct is that
of conval- What are Necs Bark-
But DP is very amex for the end Bark
as onto pernium & for the infreqln
fever- but the case is convales 
embarass with synth the course exact
for sequl fibrous he & may
be only a irritant. Bark is to be omitted 
Dr P but what Here is the 5 error of Do
1. Tyhous when the ilica was not implicated
2. ꝶ Turpentine when the fever has passed began the 16 day & the sear &
concert was the trochar 
3. Serious preven of retu of colic first by seldom descrip wh hæmorr
4. One night of the sequlae be to fibrin congest haras out of here 
5. Sem. frequent of a mem pulse become sequlae when recess 
in expen of [illegible]
6. Bark is convuls 7. urate

As this Normal!
1. He contact possible comm unless it was a 
cause of less & Death & then centr cause when Dr C
importance him at 6 PM
2. Receive the history of the case on hour of the 
attending Scurvy phlegm. has sense & expressed -
3. Takes the leave - by same will the death cause
without [cross out] internally herself to the [cross out] hearts 
of the case.
4: 1M consult: is only as his declat to the attendg Phys 
that the case is Typhus fe & when no arrested 
he says I [cross out] rete I ve very may
consultation.
5. 2 & subsequent consult he express opium fals
out the bed room &c- as then he was the 
attendg Phys & the cause was a cyst 
of declat & at consult with the atten
Physn
6. Decl the case typhus-to outward at the 
onset & put my diagn as a arm 
& its curing
Thursday Ap. 21/59 32 days. 4 days of Convalance
went at 1 1/2 Pm in consult: He asked with there was any advance 
through the swelling less, engain about the cough-pale and
again about the Elx Bark- went & use of - gav her sm
acted as the attend physc In the consult-[cross out]
[cross out] Regards the case favourably four time
says that he can vent the case at the early 
hour 9pm if I want I replied that the previous 

264
hour or 1 PM urine some more & more disturbed unfound the
Mar I regard the case convelance in since Monday
[cross out] under the Bark. I cannot piece that he
has yet completed the case-
9 PM She has been in the fright all day
without appetite-& having a pecul 
hallucinatn & exaggerate of mind-[cross out]
[cross out] want to rear-The percep to faculty
[cross out]-weak-& the formal faculty
presenty objects-a weak subject mind
constanly the extreme perceptn faculty
[Roma??] [cross out] urine action-the 
perceptn weak.
Pulse is small & very frequent &
she is restless in body & mind &
is constantly picky her mouth hard as
she wind to the as [illegible]
ꝶ 1/2 grd Morphing enema & warm when
to remain fridays
Friday Ap 22/59 33 day. 5 day of Convalance can with
embarassment of fibrious transudate at the lower jaw
thick substance & it may be in the cervical gland
with irritate fever preventng respiration
9 1/2 Am She has notwithstanding the inject of gr 1/8 morphine
& gtt v of Blk dress, passes a very restless night
with hallucinatn & she, sitting up dosing
& with hallucinatn & put small & repair &
the fibrin is suppinatg- Im alarmed at
the small unstable pulse

Im again deeply anxious the small weak frequent
irregular pulse, the halluacents, the return of [cross out]
white patch or to, the extreme tempatures now formentation
(suppuatica) the fetid alkali urine and
indisfenct to form anorexia all declare that
the state of convalence is serious & extremely
emtarass by componant blow and [cross out]
emaciaty general imitation fr sequelous
fibrinous tumour at the neck effecting the brain.
The danger is not [cross out] disturbed full of cephale thorax
abnormal organs for capilly congestion for less
lenia of the but [cross out] marasmus & dripy 
for [cross out] natural endurance & want of replenish at
most of blow by fever & [cross out] reduction of 
man power by wanting of sleep-she I below the
part of sleep & has fallen and fidgets.
6 PM. She is not reposing, the hallucinatn 
have passed off & give place to retur of spells
of dry hoarse coughs. the urine is age too abudate
with turbrous-pale amber & feb alkaline
It is albaneous & with water. she been benefit by
the milk poweder & the mustard fometat to 
feet.
ꝶ Elix wt gtt iii 3. 3 h. Elix Bark Milk powder
cream & milk & when obtaind buttermilk
Indicatn. Sustain the blood & wait the time 
of irritatn for the deposit of fibre at the same
The petechea case & that on the same as
a blood blister & may be s bed sore

266
After the irritation of the sequela is over the system until
it resumes its desposit & capilly of nourishing-around
ammone -& [cross out] what ever unti [cross out] degenerat
the blood-What of Mineral acids-What of Cream
Saturday Ap: 23rd 34 days. Under the 15 drop of blk drop
she passes a quiet night. the fidgets & hollow contracts
have passed off but she passing 3 pt of urine in 12 h.= 3 grs in
24 h. pale, tender, alkalerant sq gravels-at 12 1/2 PM
she sittg up, energy stationary has taken the
Elix: Vit: Elix: Cinchona cont
1 PM Consult: He for the first notion that the lump is supper
sationay makes ex guinen about the bowel-expressed open
& gives direction as thro he was the physician & not
the consulting physician not too a the quarter deck &
one & I supportated with me he convinces the new fact
for my informat that the [cross out] swellg in supperatn 
& adds I'm sorry first it must irritate the system.
I ve hoped that it wont have been abated. I replied that
the transuded serum which chiefly made the temperment
was absorbed & but that the solid hands fibre which
constitute the hardness can only be removed by mutation
into pus & for several day the convulsion was
entained by a symp other constite excitment fr
said fibrinous transudate & that lends this the [cross out]
the urine was 3 qts to 24. alkaline, low sp. gr
with vitreous So this he gave arrest by directed 
may attest to hide to bed down & the [illegible] 
of & I replied that the much has fully ammn of Nat
& was an experience man- It is fussy & smal
& not compound the cure & is Pt has flesh

9 1/2 PM She has been doing well enjoying the sharpen 
& nibblg at squat & take coffee & cream & milk
Her hearing most copious - pul less gently &
quiet & large She has more muscle stronger
But then a purple spot on the [cross out] skin over
the suppuratg limp-Dr P has served a 
splendid bend of flower very patient He
Sabbath Ap: 24 35 day 9 Am. Wakeful restless night
owing to pain in the absess of the neck which has since opened
at the spot of purple - yet she look for sleep ℥s
in Hops & M xv Blk Dress-since 8 PM to 5 Am=9 h
she has passed 5 pts of urine- Clear & colorless-
the last 24 h she has taken 3 pts of milk. 1 pt cream
a grt of Brandy-1/2 pt of shaken-with 3 small
cube of coffee but of cream wart & a mite of bowels
squal-she, sittg up-glancing on book aft book
& again the same without readg with a tremblg
hard & am found wh external object without
regard to person diet even return has taken
salulatn-a sort of animal intent Egote
what exact repillary what entirely selfish
or regard for human & very demanding
like a spoilt child -Bowels move & feces
banal & normal & pale bilous
he cont diet- Bark & Element
Monday Ap 25 36 day 9 Am. She took ʒi q. 3 h for 3 hrs
Syr Larbucarm yet without sleep. But its
the low blood & prevent sleep The remedy
is not anodyne but found - better blood -
she is noting & make a bad out at it hands
hard tremble - much weak as old age is
relieves to children

268
4 pt of urine in 12 hour-=4 qts in 24 h & this clear-
without vitrious-but contrary Sulphate &
chloride. The abscess in the neck discharged
without for kidneys-pulse 96-Evidently the intact
of the dependant fibre to [pa??] & the
case is not [mu??] for 
want of blood-
Acute Marasmus is the present conditn
9 1/2 PM still sitting up & morbidly wakeful very
achey vomitting [cross out] with a tremblg hand- &
a tremblg plantern [illegible] with determent will. saving
want again give something to make me sleep
Dark strong lung  Imn not going to stay limp. Less urine
passes the 24 h than the day previous.
She falls asks me my opin of the case now. I stated that 
it was convalasance embarassed by asthenic condition
for empoverished blood & for irritatn of the syst
for the leting capily congested [cross out] that this irritat
has her color secondary fever-this previous [cross out]
depressed & anointed & that consequent the
body Emaciate. But that this irritat was at its
decrinent & that the digest function are then poor 
acting. [cross out] more & then the blood warm
been innate & annoit gave & [cross out] that
the present want of sleep was owing to the low conditn
of blood-I also state that subjective condition was
the chief difficulty of the case & [cross out] the
face. Ceph has her thinkg of by part fr I of subject
He has not comprehend those days.

The case has not been Typhoid fever [cross out] but
an [cross out] Epidemic asthenic fever with a primary
congestion in the mucus membrane of the large bowels
& an accadulat & subsequent capilly congest of
the tracheal & large bronchi owing to consequent weakness
[cross out] of the air tubes & by exposure to [cross out] mixed 
sea & land air & to fatg during the exist of sand 
colic form of epidemic fever
1s Primary disease-Colic (Dysentic) Epidemic fever
in cure now with other the the city or marsh
2 Superinduced tracheal & large bronchial capily
congestion [cross out] owing to congestion liabilly
& to express to a [cross out] more sea & land much at
night at Aubry & NG -
3 indirect debility- absolute loss of nerve power
& consequent imparment of the blood & dements vitaly -
owing to fatique &c in a female of them of a weak 
blood cyst for [cross out] heredity to present
& external sequela of scarlet fever
Cor: Have the case, thro a handful case, objectively
of a mild epidemic fever, was an exting harand
on for [cross out] subject conditions & Frick cu
of scarlet fever is in print
The case objects subsequent corrode been a [cross out]
colic-trachea bronchial for of asthen [cross out] epidemic fever
harandy death for [cross out] cephalic effusion & marasmus 

270
Dr Powers was that of the Phymlgal duet what 
regard local Sem of ilem & pare it of lung
& therefr its mind is few in Typhoid diarrhea &
pheinah French Soldiers & disregard of
emetic for & the condit of the blood -
Tim Frick & Pepper & I consider especially
it his the jane tea detat & in consultion
Tuesday Ap. 26 37 2 PM [cross out] sittg up urine 3 pr in the 
last 17 hours more color. 
She knows better, quicker & more. this [cross out] useful emplast
not has like the ple of the unless & shudders being
on books what recedg-there is more steadily
of the arm. pulse below to 9 h the discharge
fr the abscess continues abundant pus healthy
thinks yellow- strikes mon morng & passing &
[cross out] eats more & delops in prayer - un 1005 bilious 
3 le.17
Wednesday Apr 27 38 [cross out] 1 PM consult: He in the room,
examined, enumerated & seem madded to us Mrs O Mrs O gen
& myrels-!! inqury above bed sore- her food & in the very time
& manner of Dr Reys enquire into details, How much normalities
she take..Mr O say that she had has eaten 5 orange - a
mite of her any, [cross out] harden her, & smoke [cross out] oh but that
cont just as her - she enjoy [cross out] ear Mutton, & beef &
chicken. How much been slow down the take = Nov 6
saw a bit a day. He express that, quiet congest
But you dog will give a pulve is full Im say
both I not gn some flame the morng-Oh me Meth
fr the country man. He saw the case as dry well
Ill see you on Saturday-Meys above
slough
is coarse
of about 
the size of
[illustration]
then in cheer
serenity
urine
3 pt in
15 hour.
teeters &
pale

Thursday Ap 28 39 day 11 Am Took gttx Bld drop at
10 Pm & had a comfortable night. a long thick slough
of cellular tissue was discharged from the abscess of 
the neck. The swelling of the cheek is much redened
by mutatin abruption. Urines is 164 4 pr
8 tender pale slow color 8 pr gra 1004 slightly and
she has more appetite eate more solid from
less of orange-dark Brown stout abundate with
delyrr. small bones up the shoulder start
ulcer [cross out] not large. heavy much tell
she not any knelts better but she has deep
a dole & to day for the first smiled & has been
volut Emetic loss of self - now of others. bowels
mind & more bilious. Eats liver, chicken collar char
Friday Ap 29 40 day [cross out] 11 Am. The depression of yellow
at 11 Am was following fever the night was restless 
She complained of the pain in the soles of the feet
& general muscular distress-all this is the known
of convalance - but the bowels have been more - been
more bilous & fumat, am recovered to 3 hr in
15 hr with timbers removing another color-tho pale
spt g 1008. Eats meat & more desires the
meal at the require time & when of the ding
table diet-she been herself quick & better.
a fine grasp heavy also impious-cont Bran Sprout
resan oranges & beef rath the oth kind of meat
Saturday Ap 30 41 day 13 day of Course been
1 Pnm sleep under 17 days of blk Dress-more concrete
manner quick pulse strong & 84. heavy restored almost perfectly

272
she fussing about a new bonnet-the urine is of yet shine
amber-she grew-the swelling of the check
has almost disappeared & the orfice of the neck discharge
urine in 2 1/2 for in 12 h-she shrew & rest more
[cross out] & full of discharge bowels & condle of the [illegible]
yet in the humour of convls-
convals the same or less-look less of the case
Sabbath May 1 42 day. 14 day of Convales
Pasen a comfortable night what blk drop. Pulse 4 mm
95 & full & strong-she has no warmness of neve &
empty & has stev teas-bowel yest of mind 
& headful bilious hue- & consiste-urine 1009
slighty turbid hue of dark amber-the nat of
[cross out]. the previous day eat more meat
& disregard the orange but [del??] yell
the Bromstrant. She has stood up with help
& wiggle herself [cross out] from chair to bed-she
smile & gave a sharp grin-2 pr of water in 12 hrs
[cross out]-The gradual restoratn of the funch
of the bowels & feculent the more & the emote & pain
is deeply intents Hence is a reflex ende
of essential fever & are agreeable aft
than [illegible] doctrine.
Monday [cross out] May 43 day 15 day of Convalance
Pass a good night under 15 SN blk O. there seems
to be a day deprest of cyst & exatant not
much apparently, is suffering from the sore -
urine esp is general, decide amber color-1012
more emit & regard the other

296

1.
Abortion Phila
Mrs Hoff aged menstruated Aug. 1st 1835, abortion with subsequent flooding
Sep 30th 1835 size of a chesnut. the ovum 60 days old.
Ditto Menstruated Feb 30th 1836 abortion without much hammorage but much
pain in the back & hip April 9th 1836 ovum 39 days old size of a large cherry stone.
NB the ovum of 60 days is four times the bulk of that of 39 days. The daily growth
of the human ovum is therefore more rapid. in 30 days = [illustration] in 60 = [illustration]
These abortions are the 3d and 4th large sized, small bones, active mind, calm temperture.
Abortion threatened
Mrs Keen aged 24 ys 16 castle st 32 month gestation, violent pain in the back
and hupogastic region. Aug 2d 1835.-On 16th Feb 1836 1st birth, male
Abortion.
Mrs Horna aged 25 short alley Dec 7th 1835 she had a slow when walking 3 days after
splitting wood and lifting &c after washing, flooding followed the show & fainting. Elix vit
gtt vi iii q.h. at 5 pm some show cont elix vit Laud gtt xxv 8th inst cont Elix vit gtt vi & the iii
9 time q.h hamorrage anestid 9th uterine pain & hamorrage resume elix vit abortion at
10 Pm on 10th without pain cont Elix vit: 12th inst some show 13th yet in bed but doing well.
NB 7th fainting & flooding no pain sleepless-abortion on 10th or 10 Pm. 4th day
after flooding
Mrs Clark, Prospect Alley: floodings: abortions threatened on 1836
birth.
Twins female at 9 PM male at 11 PM double placenta
Jany 1st '36 No 75 George Sr. Phila: Elizabeth Norman lbk:
2nd birth male 8 AM Jany 11th 1836. secondine removed at 8 30 [cross out] AM:
Labour from 2 AM 10th to 8 AM 11th = 30 hours. large male child
mother small- father large. 1st birth still born small
Mrs W.G. Heye N. Str St. She has fainting after delivery.

on the 12th severe uterine pains causing faintings, Camph & opii 8 PM & 10PM
the severe uterine pains aggravated by pressure with rapid
pulse, cast oil, inject, Laud poult 13th pains removed but pulse
rapid, 14th Am pains. PM some small clots removed pains ceased
omit Blister & dovers powder. 15 small rapid pulse cont 19th carbuncle 
& Barks. 29th deep sloughing ulcers about left nipple. absorbent poultice
& exercise. 30th ulcers better Feb 1st ulcers healing. 4th ditto. 15th ditto
16th chill, fever lump in left breast 17th vs ℥vi spots of size a crass. cal qs 1/2
Nitre qx barley water absorb poult. 19th redness ova the lumps, pulse quick
& frequent Leeches nitric powders 20th fear an abscess 22nd ulcers or nipple
better lumps & soreness confined to two reddened spots, one seems to have
fluid 25th ditto. 26th ulcers healed abscess less, a painful tumefaction
about the nipple. March 10 abscess discharges by a small opening cont Bark
sore & painful 20th doing well.
Remark This is the case of tedious labour and exhaustion of
vital powders from too large a child causing 30 hours labour
faintings after delivery, very severe & long continued after pains
ulcers or nipple & lumps & abscess of mamma & much Emaciated
& irritable pulse. 2 ought the forceps to have been used?
3rd Birth male 3 PM after birth removed before pain at 3 1/2 PM Jany 14 1/36
Labour from 1 PM until 3 PM = 14 hours. At 2 AM os uteri then an paper
cease. 1st position pains now almost constant 3d exam heard covered
with the unbroken membranes in the vulva Birth & braking of the 
membranes at 3 PM umbilical circulation stopped by rubbing
the cord. Mrs HA Adams
Remarks this is a case of easy labour
no after pains
294

7th Birth male 4 1/2 AM after b removed after two pains Feb 3d/36
rapid long pains. much after pains camph opii philii 4th
rapid pulse 5th ditto Mrs Ray N 13th
4th Birth male Mrs Clark Buttersworth Sr Feb 6th/36
1st Birth female 1 1/2 AM after b after 2 pains removed 2 AM
Labour from 2 AM Feb 9th to 1 1/2 AM 10th inst=23 1/2 hours
no after pains. Mrs Alex Young S.12th
1st Birth male 11 PM after b 11 1/2 PM. cord stopped by rubbing Labour
began at 5 PM duration only 6 hours remarkable easy as well
as rapid for a 1st birth. Mrs Kean carllet Feb. 16th 36
4th Birth male large child 8 1/2 AM after b 9 AM. Pains began at 6 AM
by passive evacuations of water so gently until the last 20 minutes
that no alarm was given. She quickened Oct 20/35 ended mensturation
June 12th birth March 2d making utero gestation 8 m 19d so it
was with her 3 former children. Her mensturation are of 3 days
and always ends within the 4th week after conception. Some
after pains. sop full pulse. no campher was taken, lochi, less dark
no milk yet was sure of milk. Mrs Cappe 12th March 2d 1836.
4th Birth male large 4 1/2 AM after after pains, removed at 1/4 by 5 AM
something of the hourglass contration on the hand. She has much after
pains. 7th conception: the two pills only moderated the pains
Laud qtt xxx 5th oil gave pain much after pain yet abl di of inf gave
Mrs Stephens March 3d 1836

1st Birth male 10 PM after b after a few pains, removed from the vagina
the membranes yet in the uterus [illustration]. Labour began 8 AM duration 12 hours
NB The placenta is sometimes attached to the cavity of the uterus
sometimes, retained in it, sometimes thrown off into the vagina
having the membranes yet in the uterus. No after pains 2g
are there after pains when the placenta is thrown off
by a strong contractions. It may be good practice
to give Tinct Ergot ʒi after delivery to secure the complete contraction
of the uterus & thus prevent clots & pains. If pains
occur the camph & opii is the best remedy. I seen 2 cases of
tumefaction of the placental portion. Milk on the 4th day. April
5th: no lumps in mamma but little milk infants bowels have now between
yellow: (1st black, then green, nor yellow) Mrs Orr Macbeth. March 29th/36
4th Birth. I visited 4 PM at the return of pain something was
felt suddenly to descend: on examination I found in the vagina
a doubling of the cord out of the vulva & a hand out at the 
os uteri-or retaining this hand back during a pain I found the
other descending torward it-retained them both during the pains
which were rapid-no pulsation in the cord-rapid pains head
delivered at 6 PM still born. Warm & so continued for some
time when marble cold-removed after b after some severe pains
Labour lasted only 2 hours-violent & frequent after pains
with faintings. Camp & opuu & warm Laud & spia application.
Mrs Hassinger May 31/74 on June 1st more than 12 clots came
a way. Milk abundant or 4 day & to this moment Oct 11/36 Eurine
Sack Na.
292

2nd Birth male 4 1/2 AM after b after 2 slight pains removed from the 
vagina. male child soon, became cool, cord permitted to pulsate 20 min
then stopped rubbing with thumb & finger near have. Labour from 3 AM
duration one & half hour Mrs Dulty June 21/26-on 22d, no fever
nor afterpains, bowels moved no milk yet. 23 milk has come, some external
24 h bowels frequently minor, chicken water almonds
2nd Birth female 4 1/2 PM after b removed after some pains which soon
came on rapid labour large child. Labour began 10 AM rapid after
2 PM duration 6 1/2 horus. Mrs Kennedy 307 S. 5th St. July 13d 1896.
July 15th Mrs Canary and St
1st Birth female 4 AM lingering pains for 2 days-long 1st stage
rapid last. 18th abdomen tumor & enlarged. ꝶ copious inject of
salt & water: instanding 2 grs of urine were discharged and the 
alaming symptom removed-( a bad nurse). Any 1st flooding from 
fatigue no milk infant pouring, sore mouth, dark green dry feces
Elix vit in rose water. Borax & sugar
5th Birth 6 1/2 Am afterb after 3 pains male Labour began at 6 1/2 AM
or 12th, water gradually oozed all day, occasional pains
until 6 PM then every 1/2 hour until 12 M Then every 1/4 hour until
5 PM rapid until birth. fine child. Mrs Dirk Marketh Sept 13/36
3rd Birth 7 PM female, afterb removed. Labour [cross out] rapid. Mrs Banarity Aug 8/36
7th Birth male large child labour began at 5 AM. slow & 
but slight pain birth at 10 AM afterb removed after 3 pains at 1/2 10 AM
Labour from 5 AM duration 5 hours. Mrs Throckmorton. Sept 20th/36

4th Birth Male 9 AM after b removed at 10 AM after 2 pains. Night
before last slight pains in front, occasional pains yesterday
more regular at 6 PM every 15 M from 10 1/2 PM till 1 AM-at 4 AM
pains every 3 & 5 Mo powerful & exhausting & inefficient, as times
thick hard neck of uterus so also-pulse tense 8 AM ℥xx for 
buffed-rigidity of uterus, os uterus & neck softened, birth hastens
an hour after, very large make child 10 1/2 lb. Mrs H Darrach Sep 23d/36
1st Birth female 25 minutes after 8 PM, Tuesday Sept 30 '56 afterb removed 10 m bef 9 PM
after 3 pains, 3rd presentation, labour began Wednesday 12 M continues
Thursday & Friday. 56 hours. Mrs Williams
1st Birth, Male delivery by forceps at 10 m before 2 PM Oct 4th 3h 
with Dr Hodge, head more that six hours in passage, pains ineffectual
perineum timid & rigided had 3 convulsions vx ℥xx: Enormous size
of abdomen, pain small [illustration] apprehension of twins-duration of
operation from 15 to 20 ns. cord pulsated feebly a while-pulse
above after inflation of lungs. Infant 26 inches long 7 inches a cross shoulder
15 inches from occiput to os points. weight 9 3/8 lb-Mother small
infant large. Mrs E. Janney 21 ys (see 1st care book)
NB There was danger of [cross out] abortion at 2 1/2 mo.
5th Birth female at 1/2 part 11 AM Oct 24th. circulation of cord stopped
by compression near navel at 1/4 bef 12 m. aftb removed bef pains
came or at 1/4 after 12 m. found in passage with membrane & clots in
uterus. Castor oil to inf: This case like Mr Capps mild & quick.
Mrs I. G. Runell 32 yrs about

3rd Birth male: flooding. Labor began at 6 AM. birth at 1/2 2 Nov. 3h
9th Birth blk: delivered by forceps with Dr Hodge. Dec. 25th at 11 AM
slite form 
See com. case book-Mary Pleta blk: as 45 yr
1837
3rd Birth female, began at 4 AM. birth at 12 m bef 1. PM. after removed
from vagina at 1 1/2 PM. exhausted. Mother small. infant large
12 lb had been twice bled in 8th m owing to inf & tumid vulva. Jany 7 37
Mrs M. Lelor 28 yr.
4th Birth male 8 PM 11th Jany. Labor began 2 PM = 4 h. Premary pains
from Saturday. pains at intervals of 15m until 6 PM then rapid
strong forcing; water broke away at 3 m before last pain. no recession
of head, cord stopped pulsating 8 m aft the birth, afte b removed by a
pain excited by rubbing abdom. Subject to severe after pain.
Mrs Ann Dermott aged 30 yr
10th Birth: Male: still born: breech presentation 11 PM Jany 11th
aftb rem at 11 1/2 PM see care book. Mrs Poulter aged 46 yr
7th Birth: female 8th m child, still born, 10 m bef 6 AM June 12th 37 aftb 15 aft birth
Mrs Peddifield ages 33 yr. NB the forma birth similar: see care book. June 37
4th Birth male sh m. child: living 11AM Sep 12th 37. almost with
one sudden pain arrived aftr the birth: small feeble infant: sustained
by warmth, bowel move by oil & spt Tupentine. Mother & infant doing well
Mrs Capp.

2nd Birth female small, feeble, bluish likely premature: 3 weeks before
he calculation, delecat mothe: at 2 1/4 PM Oct 4 1/2 '37 second 
removed before any pain at 1/4 of 3 PM: circulation of cord stoped by
friction & pinching of the end. Mrs W.J. Car aged 32. Oct 37
5th Birth 1st mensatration male, fine child, born 10 m bef 1 AM Dec 4th 37 afte b 5 m aft
1 AM removed aft a pain from uterine cavity. Labour began at 8 PM. 4 1/2
duration-Previous birth shoulder & ever present: inf died in four hours.
Mr John Hassinger. Vini Tr about 11 -
1st Birth male, large fine child. born 20 m before 11 Pm Dev. 22d 37
labor began 2 PM 23d aft removed 20m of 12 m after a pain from again
Mrs Harrison aged 20 yrs 127 Rach Schuylkill:
5th Birth Male fat like the father, born 11m aft 1 PM Dec 26th 37 Labor began
2 AM pain every 15 m until 9 AM the SM until 12 Pm Na q 5pm & rapid
without recession until birth. aftb removed from uterine cavity After
a pain at 1/4 bef 2 PM.-1st birth still born twins-2d Margerette, like father: 3d
Heavy like mother, 4 h Louise died of convulsion. Mr Mary Lelar.
1838
2d Birth male, thin, large head like father, small body. Birth 28 m before
12m Jany 10th 38 last menstration began April 6th & ended April 11th makes
uteri gestation from conception to delivery=274 days 39 weeks 21 day. 9. m & 4 d. cab
aft birth removed from vagina 10m bef 12 aft a few pains: copen clots
than with left pain after wise: prevent steel campher opii canth:
Mr Janng: and 2.5 yr: the forme birth was by freely: infant died.
parent lacceatd. Labor began 7 PM ended 28m bef 12m = 4 1/2 hours.
288

5th Birth male Labor began 2 AM ended 7 AM: second with dra
after 3 pain from fundus against contraction of neck Mrs Sleplan
Jany 25th 7 Am:1838
2nd Birth, male, labor began Feb 11th 38 9 AM ended 2 PM duration 5 hours: aft removed
aft 3 pains at 2 1/2 Pm from uterus parts: It was 2 weeks after he calculated
she has no use of her lower extremities for carries &c of the dorsal vertebrae
has milk & child put in medicly to heat: Mr J. Foxhill: second 13th
2nd Birth: female: large child: Labor began Feb 11 '38 1 PM with sadde bursting
of the waters ended 27m after 5 AM: 4h 27,: aft birth 6 AM: aft some pain.
for require Mrs J. Osv Quarly gr:
2d Birth: (1st Stillborn) female, labor began Feb. 17th 12m ended 8 PM:
attended by Dr Brinckly in my place: Mrs D. Bates 5th
2 Birth female 7 PM. Less by 12m aft removd at 1 1/2. Feb 24th 38
Mrs W Jackson: Nea Maddeth Sr.
4th Birth female. 3 AM Feb 25th 38 Labor began 5 PM aft b 3 1/2 AM after
3 pain: panted. Mrs Robert Clark 10 p.
1st Birth male. from child 26m bef 11 AM aftb 10 AM 3 days premature
pains. Labor began at 2 AM duration 9 h: Mrs Farley March 20th 38.
1st Birth female 3 PM March 21 38 lomg prem pain from 
accidental rupture membrane. Mrs Graham
1 Birth male 12 1/2 m Labor began at 4 PM 8h small, short mus.
March 25th 38 Mrs Harris

5th Birth. female 12m: March 29th 38. Mrs Jaye
May 38
3d Birth female, Labor began at 1 PM. ended 15 m bef 5 AM second at 1/4 of 6 AM
removed from uterus after a short span: Mrs Hayl: 8th May 15 35
Nb The 1st birth is sht for fer at: 2d a fine for 3 an easy
short birth female: The 2 previous was difficult labor. she a
male born to a short ma.
2nd Birth make Labour began at 1 AM ended next day as 1 AM secondence as 1/4 of birth
the labour in the process difficult: large child Mrs Young Adams
June
3d Birth female Labor began at 11 PM birth at 1 AM after removed without p from pangs
at 1 1/2 AM small child: Mrs Snodgrass: Temperance st. [cross out] June 5th 38
[cross out] August
1st Birth female Labor began 5 PM 16th ended 24m after 7 AM. 17th
14 hours duration 1st presentation. Mrs John Dale aged 20 yrs. Aug 17 58
3d Birth female; labor after several false alarms for 2 weeks
began at 2 PM and briskly continued until 26 m before 4 PM
1 h & 36 m during which the stages were completed-after which secondary
after a pain removed from uteurine cavity at 1/4 after 4 PM:
Mrs W. Dalty 9 Ag:
September
1st Birth: male, 20 m before 5 AM. labour began at 5 PM. 12 h labor
aft birth removed from vagina after a pain. Mrs Boon 22 yr Arch & schy pus.
286

1st Birth, female. 26 1/2 hour labor began 10 PM 15th ended 12 1/2 17th
still born large head like the father. small pelvis abt b removed
soon after. mother small women. Mrs Lourna Tarna of Miss
Oct 38
1st Birth male labor of 24 h from 8 PM of 18th to 8 PM of 13th. slow regular
1m position male child large head mother delicate 28 yr of age.
aft b removed soon. Mrs Hammen Oct 13th 38
November 38
1st Birth male, labor of only 12 h 33 m began at 6 AM & ended 12 33m rapid pains
from the begining of the end of labor without recession of the head at the
last stage-shore violent-muscular foment. Mr C.J. Jack Nov 24th 38
7th W N.
6th Birth, Male, fat child white mucus abudant pain begain deciding
aft a week under position, 10 days & stop pain. & more contend in a very passion
way without any outward manifestation of pain by the patient or
recession at the close bulk at 2 PM Nov 28 aft 2 hours actual labor
Mrs J.D. Runill Madin h
7th Birth Male labor began at 10 PM Dec 20 & stopped 11 AM = 13 hours aft birth
ejected. Mrs J.E.W Spees
8th Birth Male, labor after premonitory pain of 2 days began at 9 PM & ended
at 3 AM 6 hours labor-second-removed from uterus aft a pain
no recession at the last stage. Mrs C. Clayton Schylk. 25 & Va

Cases of Obstetrics in 1839.
1st Birth Female 43 hours labor mother 36 yrs of age. 29 m aft V Am Monday
7th Jany 39 Mrs Barthan Raigs.
2d Birth. Male. Feb 7th 1/2 before 9 AM: aft birth removed from uterus 1/6 aft
9 Am afte some pain Labor began at 1 AM: at 5 AM rapidy & so
contained the birth with recession at the last step of labor.
Mrs W M Havestate: 10th Sr. g Van
1st Birth Male, Feb. 15th Labor began at 10 Am & ended 4 PM
Mrs Ranager Rach above 8th Schyll
June 1839
1st Birth Male. June 3d 39. Mrs Andrews: visit at 8 Am Saturday Jan 1st end
of 9 m. Some pain water, ruptured at 2 PM or exa os uteri this but
not dilated at 3 PM pain freq & short & so began strong os uteri
gradually dilated Birth at 10 m before 11 AM. Sabbath 2d aft b
removed after a pain at 1/6 aft 11 Am.
6th Birth. female. June 12 39 [cross out] Labor began early in the morning
5 Am abdominal pains q 15m until 10 AM then 10 m the 5 min & than
abdomnal & reply pain at 2 1/2 PM pain in the back q 3 m birth
10 m aft 4 PM. 1st position now recession aft b after a few pains
at 1/4 before 5 PM. Mrs J Hassinger.
8th Birth female. Mrs Throckmorton. June 13/5 39. Labor began at 3 AM
& ended 3 PM: steady pain & no recession aft birth removed from
uteri aft 4 pains at 1/2 4 PM.
284

August 39
1st Birth: twins. Mrs Odenheimer: Pem gr Aug 9th: Male. large. femal.
similar: both under this: but healty: mother has abundent of 
milk: On accident 2 weeks before of rupture of the water for
ready on to infants a chamber window. The fln was arrested
by rest is but & Elix vit: yet essentialy labor can or a
month left calculation. The labor pain aft a whole being
ineffectual: fullness used & the sufficent was four very
to month before: The boy was born 1st: the plump but small
& with leg arm: but the girl was smaller & shriveled
& without leg arm. The rupture was liking for the whole
part of the girl. No [illustration]
rupture.
7th Birth: Male: with large child: Dr W. Mrs Darran at 12 MM 25 m. Friday
morning. aft 6 after a few minutes pa removed at 1/2 of 1 AM
[illegible] at dinner. this without pain cracking he said with laught.
with his friends some pain at 3 Pm to the back & so until tea at 
the tea table & yet up till 11 Pm with increase of pain in the
birth Mrs Lockand sat for put to bed at 11 PM & at 12
M 25 M birth of a fine boy: ripe & safe: Aug 23rd 39.
September 39
3rd Birth: female. about: Beth Rhodes at 9 PM: Labor less
at 6 PM some pain ingest day the day: aft b removed
at 9 1/2 for regan aft slight pain
A slight round tumour one of a bricky nut attached by
pedum 2 No 1st bone of little finger or right hand. The [illustration] which
a close examation I found to be a small pregency. Which with
a nail [illustration] a whi opak hard elat tumor: Sept 6th 39

2d Birth Female. Mrs Bates at 25 m before 1 PM. Sept 14th 39 Water broke 12/2. no pain
until 12 h 6 PM. Shipy & slept the night with the occasional pains examd
at 4 AM. Os uteri dilating & so with moderate pain without exalted
the cries of the mother until the birth. apt removal 1/2 10 PM within
previous pains & for the vagina.
3d Birth female I Mrs J Darries at 8 & 1/4m Am. Labor begin at 5 Am.
& no recess: aft b aft open removed from vagina: Moderate sharp pains. 
5th Birth: Male. Mrs H Lelavat 8 PM. lays fat child and genchy
[illegible] pulsate or pain with the finger she contratct pain without recess
[cross out] vent at 5 Am. [cross out] be Sep 30 hrs: when she has some grindg pain
os tusi top & this but not dilats. Dilatable vent during the fore part of 
the day during what general supposed pain on abdomen: Inch short & 
head ache: she set up-than diffused pain contract & with the dilate
parts at 4 Pm which until with 8 PM. abv is larger nights [illustration] her
I approached at hours: but it was a very low fast sore at 8 PM
Novembe 1829
9h Birth: female: Mrs N. J Van Auringr: at 5 1/2 Am. male: left hand
presented, returned 2 the head prevented with & the Colon [c??d]
from 7 Pm Nov 12th 35th 5 AM. 4 1/2 hour they which the last she & forceful
continous expulsive this. the pain gr without recess to the birth. aft a 
day & 1/2 of premitory pain. the water ruptured at 1 PM.
Dec. 1839
4 Birth. Male of the Ms Hagl: se aft-
2d Birth femal of Ms W Hamer: see afte
282

Feb. 1840
Mrs Mrs Mc Cownell. 12th h above vini fr. Obst 5th Birth female 12 M. Feb. 18th
repair bult second in removed after a pain:
Mania: blh domestic of c J.J.: Feb 7th: Malt Shlebon
Mrs J.C. Capp: 13th moth Obst: 5th Birth Male: very repair: 8 Pm. after 2 weeks
persons premuture aft b: removed for uterus aft 2 pain.
March 1840
Ellen Dowling agd 26 1st Birth: March 12th 1 1/2 PM Male after 86 hours
taken owing to small pelvis & elongated head [illustration] effected by
small repeated down of ergot
May 1840
Elizabeth Boon: age 28 yrs 2d birth female: 2 AM May 2 afte b
removed after a pain from uterus:
MRs C. Cavender: aged 22 yr 1st Birth. female. May 25th from 8 PM to 12 Am
4 hour labor. 1st presation easy labor: small [cross out] child
after bith after 2 pain an over for uterus at 12 1/2 AM.
August '40
Mrs Young, 12th 3d Birth female large Child bith aft 1/2 pain 5 AM Aug 26th
secondine after slight pain removed from uterus 1/6 of 6 AM: Labor began
at 3 AM Aug 25 a slow labor into the doing pain. the forceful 
& without recession birth at

Mrs C.J Jack 2d obsr: male. Labor began at 5 PM under 10 m of 8 PM
Aug 30th/407
Mrs WM Haverstick: 3d birth: male Labor began at 5 AM ended 102 of 10 AM
Second at 10 1/2 from uterus after a pain removed Aug 31th 40
September 1840
Mrs J. Hasseinge 6th Birth: female Labor began & ended.-
Sept 10th 40
Rev W N Oderheine: 2d birth Male. Labour began at 3 PM 7 PM
Sept 13d 40
October 1840
Hon Knees Mrs 1d birth Oct 40 male
Mrs R Newbor: 1st birth: male: Labor began 11 PM Oct 30 ended 12 PM 31 24h
lenghty labor: infant fn sn to breech less.-
November 1840.
Mrs Dults 4th birth Male: Nov 1st Labor began 10 Am & and 3 1/2 AM & her
aft Necessary of water & rapid afterwards
Mrs Brown with of Rev Cl Brown. 5th for alone calenhlest:
4th birth: Male [cross out] Pemorny's pain during the 
day vented at 5 PM: 14 [cross out] Nov/40 rapid forceful pains aft a while
& birth at 4 M aft 7 PM: second removed from vagina at 7 1/2
Mr Synex Chalbeth n. 23 yrs 1st birth: 9 m: female: guply pain at 2 AM Nov 16t
membrane lay ruptured birth 11 Am . 8 hour Labour: seconds in pancreas & 
removed 1/2 aft 11 AM
280

Dec 1840 
Dr Bates: 4th Birth Male-died in 3 hours
1841
Febrary
Mrs Marshell Lloyd: age 25: 1st birth, female, like father-Labor by a
6 PM: Feb 11 & ended 7 PM Feb 12 25 hours with extensive Eruption of
perinaum- aft birth removed easy after a pain.
March
Mrs J.G. Runill: 7th Birth: Male: labour began at 10 PM 17th ended 12 M after b removed
with pain
May 
Mrs Croby 1st birth. Still born: Male: 24 inst.
May
Mrs Hurlburt: 2 birth: female
July
Mrs N Kneass 1st birth female.
June 
Mrs H Lelar 5th birth female 10 AM June 17 Natural.
July
Mrs Berry Bradford. still born. Male. 7 Month. July 8
Aug
Mrs Rob Porter. 1st birth female. Labour began at 4 AM & ended at [illegible]

Sept 1841
Mrs John: 1st birth female:
Oct 41
Mrs Bon: 2d birth. Male at 1/2 PM.
Oct 41
J. M Felford. 1st birth. female. breech presatn. instrumetat
to remove the head
Nov 41
Mr. Van dern: pm bulk: male - instrumentat Rator Nov 45
Dec. 41
Mrs G.S. Blurn: 1st birth Male. 8lb: Labor began at 1 AM 4th & [illegible]
1 PM 4th: aft birth removed at 1 1/2 PM. without previous pain.
Dec 41
Mrs Thorne Waddle: 1st birth female at [cross out] 7 m of 3 AM
after labor of 5 hours:
Dec 41
Mrs Curtis Clagton: 8th birth. female 10 lb afte: 7 days
Dec 2 2d from [cross out] to 8 PM-4 hours labor
1842.
Jany 2d Mrs Bingham aged 40: chery St: 5th birth. 8th conception
still born full time. Forceps delivery at 5 1/2 PM after 32 hours of very
ineffectual pains constact vomiting. asthamatic chime-delibrated 
by the previous epidemic-She died at 7 PM of debrility exhausted
weight of child 14 lb. head very large had conversly her acord before labor pain
3 caused of death of Mother. debrility, dead child largeness of child & ineffecutual
pain & lingerg cabon.
Jany 22. Mrs J.C Capt: 7th birth. Maple. William. labor begain at 1 AM birth
at 27 minutes of 9 AM seconds a head. Moderate removed head-for
hence-after on pain-
282

Jans 23d 42
Mrs Wilson Jones Ally. 1st birth-23d 30 hours labor at 1 1/2 AM. removed
after after a pain for passage-male.
March 4. 42
Mrs Horn R Kneess 6th fr below Prune h. at 1/4 of 3 AM after 3 hours labor
seem dis dislodge 3 pains & by without of Mamm expelled from the 
passage - 2nd Birth Male. Moderate size.
Mrs Hasting: 5th above rea. 1st birth female. labor begain 12 m &
ended 3 AM. 16 hours: after birth removed passage after a pain.
Mrs N.W Stoker. 8th below Walnut. 5 & 6 Birth twins both Male
labor began (premature by one Month) at 4 PM & ended 6 1/2 & 7 PM
after birth at 7 PM.
Mrs W. Mullin. McDuffer jr. 1st birth Male 8 1/2 AM. March 30. Labor
begin at 4 PM 29s=9 hours. Large head: small body. aft birth
removed from passage after a slight pain.
May 1842.
Mrs James Smith. Soak Gr: 2 & 3d Schuylkill. 1st Birth female.
Labor 12 1/2 h. began at 7 PM 3d & ended 7 1/2 AM 4: AM but after slight
pain expelled by uterine contacted excited by introductn of head at 8 Am.
Mrs Welb square taver, rea gr 8th birth Male, a repired birth of 4 hours
after 3 days of lingering premonitory pains. after birth removed from
uterus by uterine contraction excited by introductn of head.

June 1842 
Mrs W. McConell: 6th Birth. female still born of 6 ms-after
protracted suffering of several days-pain relieving in
the affected part of the day. Monfary St-Jan 7th 62
Sept 9th
MRs J. Hassinger 8th B. 10th conception: Male: 12 1/4 Am of 10th Labor
pain began at 10 PM of 9th. Violent cramps of the [cross out] right leg.
12th
Mrs A Young 4th B. female Labor began at 8 AM under it 11 1/8 Am
3 1/4 hours. second is removed at 11 1/2 Am.
13th
Mrs W.S. Hege: 4 B. Male Lingering labor 17 hours: efficient from 
Tr Egot ʒi ʒss removed pains
Oct 29th
Mrs Montgomery Fraguea Co: 2d birth femal: 12 1/2 Am or 29th
after 24 prematurely pain Labor began at 5 PM lasts 7 1/2 h. 
aft birth removed with previous pain:-
Nov 7th 42
Mrs Wm Dulty: 5th birth: still born: Male at 2 PM Sudden
premature birth of 7 AM: only likely to a jump
2 weeks ago from a bed since which she; not
felt Mother of child-
276

Nov 24th 42 
Mrs JH Cavender: 2nd birth Male at 25 m of 4 AM
Labor began at 12 m duration 3h 35m after pain &
the removal the placate-
Dec 16th 42
Mrs Edwin Lilar 1th birth male. began at 12 am & labor at
9 1/4 Am: 10 1/4 hour Labor. Natural. 1th position.
Mrs WM Haveshah: 5 birth Male
1843.
January.
2nd Birth. Male Labor began 9 Am ended 8 PM=11 hours. second in
removal at 8 1/4 PM: 16th week: Mrs Margaret Benson. 4th fr above Spruce.
4th Birth Male. labour rapid secondine taken from Vagina
3 weeks one calculation very lain child. 11 1/2 lb or 26 pint
of Mrs John Davies Butterwood Sr.
February
5th Birth Male 9 1/2 lb 19 hours labor at 5 1/4 Pm 24th mnt: second 
removal from Vagina. Mr D Bates 7th from above Nove fr
9th Birth Female: afternoon recurrence of pain for some 
days then rapid at 10 PM delivery. after fev pain removed
the placenta from the uterine cavity. Mrs J. Throckmorton.

6th Birth. Male. 3 1/2 Am rapid delivery. second in removal
from uterus. The AM C. Brown W 36 yrs: Vin fr 7th Schyl
1st Birth. Male. Feb. 20th: premonitory pains at 8 PM of 19th birth at
8 PM 20 24 hours labor secordinis removed from uterus after
a pain Mrs T. Poultre Jr. 12th hr & Willen at Jn. Harrison
4th Birth. Male, labor repaired 3 PM Feb 22 '43 Mrs Earthan
Marketh above 11 h.
Feb 
8th Birth Male labour began at 5 AM to Mrs
J.G. Russell. Feb 24th 1843
April
1st Birth Male April 14th 1843 24 hours labour. second 
removed 8 AM Mrs J. English.
3rd Birth female April 23rd 1843 began at 5 AM ended
at 29 M after 2 PM 9 1/2 hours labour Mrs Troutnine
July
3rd Birth female began at 7 AM ended 1/4 of 12 M labour
4 1/5 hours. July 4th 1843 rs W. Hurlburly
1st female Labour 24 hours birth at 58. Mrs H Kelly July 4.
3rd Birth Male. Began at 8 am Ended at 1/2 12 Labour 4 1/2 hours
Secondaries removed from Uterus at 1/2 1 PM July 9 1843
Mrs Hammon
274

Aug 
7th Birth female Labour began at 12 M Ended at 9PM
Aug 6th 1843 Mrs H Lelar.
1st Birth Male Labour 6h began at 4 PM. August 14th 1843
Jus Lemon No 29 new st.-
2nd Birth Male 6 hours labour. 6 1.4 AM Secondaries removed
from uterus after 3 pa-W Ray Aug 24
8th Birth female Commenced at 2 1/2 PM Labour began 
at 7 PM Secondaries removed after pains at 8 PM
August 27th 43 Mrs Wells-
2nd Birth female water broke on 27th lingering pain until 5 PM of
29: the forceps pain until 7 1/6 Pm birth: Secondin removed
from uterus 7 3/4 after 2 pain: Mrs J. Wandele 10th & Va
Aug 29 43
Oct. [cross out] 1843
1st Birth. Male. Oct 6th 20 m after 2 Am Labor from 5 PM 5th to Oct 6 2 AM
after 2 pain Secondin removed from uterus by excitg contraction of
uterus by inverted hands as 1/4 of 3 Am. Sydy Armstrong tbl. 7th Tr - persist

296

L.G. Darrach page 110 
C
D

298

 

300 

Abortion  Page 1 
A
B

302

Dewiess 
ꝶ 
Magnes Carb ℥ss
Sacch alb ʒi
Tinct. asafœt 8tt I.X
Tinct. Opii gtt. xx
Aquæ ℥i
♏︎
Dalby's
ꝶ
Aque ℥i 1/3
Sacch alb ʒij
Potass Carb gr viij
Magnes Carb gr. XL viij
Tinct Opii m xxiv
Ol. Menth pip 8tt i
" Carni 8tt i
" Fæniculi 8tt i
♏︎

32 
8
20 356
2
480 
120 960 8

304

 

Watson. Amal of Phila. pge 573. 
There were in older times two men or able-hot summers
so called & referred to in many years afterwards. the
years 1727 & 1734 I describe the latter from the gerelte
of the time, to wit. July 1734 The weather has been so 
hot for a week part, as has not been known in
the memory of man in the country. excepting the
hot summer about 7 years since-Many of the 
harvest people fainted of Jale with convulsions
in the field, and 'tis said in some places a
multitude of birds was found dead. The name
of 5 what taut dying of heat are give. Subsequent
papers confirm the extreme heat in the
country & the death Ready.
I ought to have mentioned too, that as early as
the year 1699 Isaac Norris Sen. Vide Logan S.S.
speak then of the hot heat harvest season he
had eve before experienced. Several persons died
in the field with the violence of the heat.
1789. page 593. In July, very hot weather-by 11 O'clock
Am the meat in the market putrefy, and the 
city Mayor orders them cast with the even, merchants
shut up the stores, them at 96 for
[cross out] several days.
The greatest heat Dr Rush has known 95
1805. page 596 No rain from the Middle of June to
end of July heat 90 to 96 dg. partem burn up &
summer vegetable fail'd.
1811. 31.9 of July hot weather continued from 94 to 97,
1825 Severe heat at 2 O clock then at 96 in the 
shade.
1699.