OHIO STATEWIDE FILES - Lindsay Journal #1, PART 7 *************************************************************************** OHGENWEB NOTICE: All distribution rights to this electronic data are reserved by the submitter. Reproduction or re-presentation of copyrighted material will require the permission of the copyright owner. *************************************************************************** File contributed for use in USGenWeb Archives by Helen Silvey Helen_Silvey@macnexus.org http://jpaul.gwdi.com/silvey/ January 8, 1999 *************************************************************************** Continued Mr. Clemmer's Son case which had strong symptoms of Lock Jaw or Tetanus. In Month of Mr. 1829. was called to see this young man who from Being engaged in making spickets or spiles out the Elder, by runing out the pith with a heated spindle of a big spinning wheal. unfortunately ran the spindle through the hand between the Thumb & forefinger in the thick part of the hand, the Iron spindle lodging against the skin on the back of the hand. What inproprieties he was guilty of, or how he had been treated the first few days have forgotten this part of the history of his case, it was about 2 or 3 weeks after the injury I was called in. when I found him with strong symptoms of Tetanus or Lock Jaw. The hand had been in a high degree of inflamation. was much swolen & the ha(n)d had put on the appearence of gangrene. The nervous system highly affected, severe pain extended up the arm, exreme pain in the head--& back some stiffness of the Jaws, occasional spasms, a general listlessness. Twitching of the mussles of the face, attended by a difficulty in speaking, & articulation. The hand had become benumbed, the puncture in the hand discharging a thin bloody, & very offensive matter, The wrist was highly inflamed & it seemed as if nature was about to effect a seperation in the carpus between the arm & the hand. On my first visit I made a puncture quite through the hand which as before stated had extended in the first injury, nearly through the hand, the skin only remaining unabraded over the punture on the back of the hand. I ordered a poultice of Elm Peruvian Barks, Charcoal & East prepared in a decoction of Dogwood, Slipery Elm, & Oak Bark which was afterward changed for the light bread & milk. In this decoction made as hot as could well be borne, had the arm from the elbow down & hand immmersed from 15 to 30 minutes frequently repeated. This seemed to give great relief to the pain & appeared also much to relieve the spasms before described. for a day or two, the hand still continued of the leaden & gangrenous appearance, & on my 2d. visit took my instruments, & remained all night with my patient, expecting that an amputation of the hand would be necessary. The next morning symptoms appeared rather more favorable, having put my patient on the free use of wine & decoction of the barks in as large portions as the stomach would bear, about thd 3d. day from my first attentions. The inflamation of the wrist had come to superation, & was lanced. this being a healthy discharge, seemed much to releive the whole arm. by this time the unhealthy discharge from the puncture or place of injury in the hand had nearly ceased discharging the puffy swelling had much subsided, and the dead gangrenous appearance began to change for that of a more healthy one. In the course of a few days more the inflamation at the carpus had pretty much subsided. & the suppuration soon was now very trifling which in a few days more subsided altogether. By this time the young man had began to improve in every respect, the nervous & feverish excitement had given way to a more healthy action of the general functions. & in something like 2 weeks he was able to sit up & walk a little about the room. I would again remark that the bath as described heated as hot as could be borne, in which the hand & arm was frequently immersed for a considerable time, seemed to have an excellent effect and in my practice since have frequently resorted to the hot bath, in cases of a high degree of inflamation and severe pain, either of the arm hand or foot. The particular preperation, or composition of the bath think is a matter of less importance than the Temperature. myself am much troubled with corns on my Toes, which occasionaly on becoming irritated inflame & produce the most acute pain & sufering. In these cases the hot foot bath gives more relief than the best emolient & soothing Poultises. In Felons or Whitlows of the fingers & hand have seem much benefit from it. And were I called to treat a case of inflamed nerve or Tendon, threateing Tetanus, should have great confidence in this as a very important means of releiving my suffering patient. The bath should be used as hot as to counteract the pain of the injured part. so hot as scarcely to be endured at first. I had forgotton to notice that so soon as the wrist had superated & was lanced, in a short time omited the poultices. & the hot both was not longer necessary. for the poultice I now substituted as an embrocation & linament, a saturated preperation of Sweet oil with camphor. This is an excellent embrocaton, being soothing and anodyne. and I generally use it in cases where poultises have been necessary, after suppuration has been brot about. As well as a linament in many cases of inflamtion & pain, where no superation is induced or anticipated. Richmond Jany. 10. 1837 W. Lindsay A Case of Phlebitis P.S. While practicing at West Alexandria O. some years ago was called to see the wife of a Mr. Philip Hewit, who during Parturition a few weeks previous had been bled in the arm. which by the time I was called the vein had taken on a high degree of inflamation. The whole arm had become pretty swolen, & highly inflamed. The place in which the vein had been opened, had began to discharge a thin watry like fluid, along the course of the vein a distinct red streak seemed to mark the state of the inflamation. The whole system was now much affected by the state of affairs. A high degree of Fever which was marked by irregular exacerbations. accompanied by great nervous irritability. how far her fever was complicated with Puerpural am unable to say, but am of the opinion that Phlebitis or the inflamation induced by the venissection was the great & proximate cause of the fever, consequent on the peculiar inflamation of the arm & vein. The whole system was peculiarly affected. the legs for instance seemed to be affected by a Rheumatic excitement, but might say more properly nervous or neuralgic. The pain of one particular limb or part of the body was so great and accuto that she could scarcely bear the weight of the bed clothes. & her position of recumbency could only be altereed by the assistence of a nurse, & with all the care posible, in aaltering her positions, she would cry out indicating the most actue suffering. So very cautiously & tenderly was the assistence obliged to be given in helping her to change her situation from one position to another however trifling, several minutes was generally occupyed in effecting it. but when I commenced this case my principal object was to further instance the beneficial effects of the hot bath. In conjunction with emoluent poultises, a strong decoction of the Hop (Humulus Lupulous) prepared quite hot in a bread Trey so as to admit the arm from a little above the elbow to be completely immersed, a period sometime of 15 or 20 minutes & frequently repeated had a decided excellent effect in releiving the arm of its high toned pain & inflamtion. before the inflamation could be repelled or had run its course. Superation took place at Two or three points on the arm below the point of the bleading in the hollow of the elbow. These points of superation were small rising up a little like a Phlegmon. which when the matter was first discharged, did not conutinue to discharge longer at this point. As evidence that the arm was the cause of the feverish action, & Neuralgic distress before described when the arm began to amend, all these symptoms began to subside. & so soon as the arm was well all other bad symptoms had become exhausted, having worn themselves out & run their course. Having commenced this case under the head of a Post(s)cript. merely intending it as an instance of additon evidence of the good effects of the hot levigation, or emersion of a painful limb or part from severe swelling & inflamation, would say, induced from whatever cause it was not my design to have given any thing like a detail of the case or of the treatment. would here remark that the Metastasis of the disease was followed up as it appeared in various parts of the body & treated per indication with particular reference to the first cause of her disesae, As before observed the whole system suffered much. the general character neuralgic & a circumstance worthy of a passing notice was set on a highly nervous temperament. In general terms I would remark that various soothing & Anodyne Medicines were resorted to in the treatment. The various secretions required attention & were treated as above stated on the plan of indication. The liver & stomach suffered considerably. And required their usual appropriate Medicines. when the knee, ancle, or foot took on the Metastasis of the nervous irritation, The hot bath, soothing linaments, & applicatons all members of the same class or family were all given a trial in turn, on the plan or principal of giving relief On the plan of counter irritation. vesication was to some extent made use of. & for the time being generally promised a benifit to the patient. but the hydra character of the affection was such that it was no sooner repelled in one point than it would (a)ppear at some other point. As a change of Medicine, as an anodyne & tranquiliser of the nervous irritation, after giving the opiates, & camphor a trial, the cicuta Ext. was in the form of Pill made trial of which were attended with apparently for the time being with some good effect. the opium & camphor combined generally gave rest & tranquility for a night. & until the combination had spent itself. & perhaps until the bowels from becoming torpid required, moving off. It was 3 or 4 weeks before this nervous irritability had exhausted itself. and it was not until about this time that, Tonics in their effects promised any advantage. The system had very much run down, the prostration of the powers of life was such that recovery was for a considerable time a matter of much doubt. her friends generally considered the case a hopeless one, & myself was unable to hold out much encouragement. and if Phlebitis be admited was her disease. I had little to encourage me among my community of authors. & as regards my then experience, nothing. being the first of the kind opertunity of see had presented. & I might add it is fortunate for humanity such cases are of rare occurrence. The foregoing case occured late in the fall of 1828. Richmond, Jany. 11. 1837 W. L. Mr. Badon Case of Phlebitis In Summer of 1830. Treated this case in conjunction with my friend Dr. J. T. Plummer. It is my intention to give quite a brief notice of the above case. And should not notice it all, only for its similarity to the foregoing case of Mrs. Huit. She like Mrs. Huit had been bled during her accouchment, which was quite protracted & difficult. The accouchment was managed by Dr. J. T. P. but owing to the difficulty of the case council was considered necessary, when I was called in. The bleeding was in the arm appeared to be called for, & no doubt was well enough performed. the geting up during the first week or 10 days appeared fine, had been out in the garden, & had commenced spining at the little wheal, being a hard working indutrious woman no doubt left her room too early. The orifice from the bleeding, had got quite well. but the soreness was so trifling no attention had been paid to it, until after she had been in the garden & took her seat at the spinning wheal. Soon after the arm began to be a little painful & the orifice to show a slight appearence of inflamation. a day or two afterwards the arm had been considerably swolen and the orifice began to emit a thn discharge. At the termination of about 2 weeks from her parturition I was called in, & found her in great distress & agony from the state of the arm. Fever had supervened, great nervous irritation pervaded the general system. In this as the foregoing case the arm ran into a high degree of inflamation & the pain was of the most acute character. The the general & local treatment in the course of a week after Dr. Plummer & myself were called in the arm began to show some symptoms of amendment. Our treatment had been the warm bath to the arm, frequently repeated, & Emoluent and soothing Linaments. Soon after the arm had began to shew symptoms of amendment one of her legs began to take on swelling, inflamation, & severe pain of the neuralgic or Rheumatic character. The usual treatment for Rheumatic & Neuralgic affections were resorted to, & after a few days continuence this leg having become much better. the other leg was taken in turn & ran about the same round of swelling & suffering as the first. & in like manner yielded to the treatment now strong hopes were entertained that our patient was about to get well but delusive hope the arm a 2d. time took on inflamation & ran about the same round as before, & as before appeared to yield to the same or similar treatment as before. Again we flatered ourselves that the disease had worn itself out. and that our patient was in a hopeful way of recovery. but again vain delusive hope. When it was thought our servises could in a few days be dispensed with about this time, by a metastasis the lungs & breast was the next pint of attack by this potent hydra. The Pleura & lungs seemed now the seat of the disease and such was the severity of the attack, in the now great debilitated state of the system, in a very few days our patient terminated her severe & protracted sufferings in death. What the Puerperal irritation had to do, in this and the foregoing case, am at a loss to determine. and in what manner, or what was the bearing of the Parturient period on the venissection at another time, & under other circumstances, would have run into a development of Phlebitis. is with me a matter mantleed (sic) in doubt & uncertainty. So far as I have read have no recollection of a parallel case. Richmond Jany 11. 1837 W. Lindsay To be continued Helen, Sacramento ***********************************************************************