the constitutional atmosphere of our neighborhood was more favorable to its production.

"Symptoms.-The disease was ushered in with a cold stage, lasting from a few hours to several days. In the former reaction ran high; in the latter the patient was a little unwell, with chilly sensations, loss of appetite, languor, irritable stomach, foul tongue, pain in the head, back, and limbs; enlargement of the glands of the throat, neck, etc.; soreness of the skin, or sensitiveness of the cutaneous nerves. The pulse varied from one hundred to one hundred and thirty: in the former full and resistent; in the latter small and more compressible. With these symptoms before us, without any inflammation of the skin, we were led to suspect scarlitina as our antagonist; and our late distinguished and lamented friend, Dr. A. M. DeBow, so noted them in his case-book. But we were long groping in the dark as to what we had to contend with. Erysipalatous inflammation, with its well-marked line of invasion, showed itself on the skin. This led us to look again into the throat: the inflammation was there, with its scarlet redness, invading the tonsils, uvula, palatal arches, and palate, but without the swelling and ash-colored ulceration common to scarlatina.

"Epidemic erysipelas has great partiality for the throat, and often spends its force there. At other times it follows the mucous membranes of the ears and nose, showing itself on the external skin of these organs, often covering the entire face and scalp, or, following the nerves, attacks the membranes of the brain, producing coma and death oftener than terminating in health. At other times it extends into the bronchial tubes, and even the substance of the lungs, from which very few if any recover; and anon it takes a fancy to the alimentary canal, assuming a chronic form, as in the case of Dr. DeBow, from which very few recover. This is the more malignant form, while others of the same family have the disease so mildly as to require little remedial treatment. In a few cases the tongue was inflamed, swollen, and black or dark brown.

"Treatment.-My practice, and that which proved most successful, was active depletion; as soon as reaction set up, copious bloodletting, followed by active cathartics, first with calomel, aloes, and ipecac; subsequently with seidlitz powders or epsom salts. If the bowels were hard to move, we gave comp. extract colocynth, with ipecac or tartar emetic. Drastic purging seemed to control the disease and procure rest better than any other constitutional treatment.

"The profession is much indebted to Dr. A. McCall for his able treatise on the subject, published in the Nashville Medical Journal for May, 1854. As to local remedies, a strong solution of nitras argenti, forty

gr. to the 3, applied with a camel's hair pencil to the inflamed mucous membrane of the throat, or, what is still better, the pulverized substance applied with a wet pencil in the same way. It often arrested the disease before it had had time to invade any other organ. We adopted the fashionable treatment of encircling the inflamed skin with caustic pencillings. It is of doubtful propriety: but few cases were arrested in their progress, and those few not benefited. It seemed to expend its pent-up wrath with more fury on the part enclosed, or retire from its present fortress to attack a more important citadel, especially the brain. In some cases of delicate constitutions we used mur. tinct. iron throughout the disease, regardless of fever, in connection with the above remedies. It did not increase the circulation, though given in from twelve to twenty drops. Supposing the disease to depend partly on a vitiated state of the blood, we determined to try it, and in all cases where the stomach bore it well, we thought it of benefit in sustaining the system.

"The appearance of the blood was more healthy after being drawn than in any other inflammatory disease, seldom buffed at all; and but little when it did occur. In one case of erysipelas anomalous, in which my patient could not bear the lancet, I used the tinct. veratrum viride with the happiest effects, reducing the pulse at will from one hundred and thirty to sixty, or any standard we choose. The points attacked were the face, foot, and hand, externally, all of which suppurated, and the pleura internally, which left him with a cough, from which he slowly recovered. The sputa had the appearance of pus, after the discharge of which he rapidly recovered."

I have done the best I could towards correctly recording all that was possible of the epidemics of this region, having devoted all the time to this purpose which could be spared from the exigencies of a laborious profession. To make my history as complete as possible, however, I enclose a paper on Milk-sickness, by Dr. D. W. Mentlow, a gentleman of intelligence and high reputation. You will find it in every way worthy of your attention.

AN ACCOUNT OF MILK-SICKNESS, AS IT OCCURRED IN THE NEIGHBORHOOD OF HARTSVILLE, ON GOOSE CREEK, TENN. BY D. W. MENTLOW, M. D.

Milk-sickness has prevailed in the neighborhood of Hartsville, on the different branches of Goose Creek, from the time old Dr. Yandell, the father of Professor L. P. Yandell, now of the Louisville School of Medicine, practiced physic in that section of country, which was as far back as the 1812 or 1814. He called it, when it first made its appearance,

year

"the puking fever," a very appropriate name indeed. Goose Creek is divided into three prongs, called east, middle, and west branches. The country lying between the west and middle forks of said creek is quite rich and broken, except what lies on the creeks, and contains what is called the "Millstone Knob." This knob is celebrated for the production of the best millstone quarry in the State. In the immediate vicinity of this knob it is supposed the milk-sick poison abounds in great abundance. One reason, as I suppose, why this spot is regarded as much more dangerous to stock than many other portions in the same neighborhood, is that the hill or knob is constantly covered by a very dense growth of cane, which circumstance attracts the stock from the surrounding country to this point. One of my neighbors concluded to winter his mules on this point, as the green cane was very abundant, believing at the same time that "nothing would kill a mule;" but, to his utter astonishment, two or three out of the five died. Captain William Thompson drove his cattle to this knob some years ago for the purpose of wintering them on the cane. They remained during the winter, and seemed to do well; but in the spring of the year, when he attempted to drive them home, thirteen out of the twenty died. I will just remark here, that exercise, either in man or beast, develops the latent poison in a few hours. Hence the necessity of exercising all animals before they are slaughtered, particularly if they have ranged in the milk-sick region. It is proper to remark that on the east fork of Goose Creek no case of milk-sickness has as yet appeared; it seems to be confined to the territory embraced by the waters of the middle and west forks of the creek, extending as far as the ridge which divides the waters of the Cumberland from the waters of Barren River. On the north side of the ridge the people are exempt from this formidable disease.

I do not deem it necessary to enter into a minute topographical description of the country, as nothing would be elicited that would lead to a satisfactory solution of the cause or causes of this malignant disease, milk-sickness. There have been many theories as to the etiology of milksickness. Some contend that it has its origin in vegetatble matter growing in the immediate vicinity of the Millstone Knob. Others contend that the atmosphere surrounding this knob becomes contaminated by some means, they know not how, and that animals breathing this poisoned air during the night become affected. Some ascribe it to animalcula floating in the atmosphere: these are inhaled by the lungs of the animal, and by this means the poison enters the system. And, lastly, some contend that it is a mineral poison, rising from the earth during the day in the form of halitus or gas, and settles on vegetable matter during the night.

In this way cattle that are permitted to run out during the night contract the poison by feeding on the bedewed vegetation. This seems to me to be the most plausible theory; for it is well known by all who live in the vicinity of the poison, that the most dangerous time is when the dew is on vegetative matter; consequently many keep up their milk cows until the sun has evaporated the dew in the morning, and drive them up before it begins to settle in the evening: these escape with impunity, notwithstanding they graze on the Millstone Knob during the day. As further evidence that it cannot be a vegetable poison, Dr. M. D. L. F. Sharp and myself were requested by some of the professors in the Pennsylvania School of Medicine, in 1826, to collect every species of vegetable growth on and around the Millstone Knob, dry them in the shade, and send them to Philadelphia, that they might be submitted to the most rigid analysis; and we did so. In a few months we heard from these same professors, who reported that they had tested every vegetable, and found them entirely innoxious. We also pulled a mushroom from the earth, near the Millstone Knob, and tried this on dogs and cats, without producing any deleterious effect. From these indisputable facts, and from all that I know respecting the cause of milk-sickness, the conviction forces itself upon my mind that the cause resides in the earth, near its surface, and that it is exhaled by the sun during the day, and settles on vegetable matter during the night.

This poison, whatever it may be, differs from all the known poisons in the world, in the following particulars :

1st. It may lie quietly in the system for a long time without exhibiting any of its toxical powers, until the person or beast is forced to take

exercise.

2d. It is more ethereal and diffusive than any known poison to me. Most of the poisons with which I am acquainted affect the stomach and bowels, the brain and nervous system: this pays no court to either, but extends through every muscle, bone, and tendon, affecting the whole system; yes, even the skin and cellular substance under the skin. It will be remembered that I stated that Captain Thompson lost thirteen of his cattle, as he was driving them from the Millstone Knob. He had them skinned, and the hides were hung on poles between his cribs; the rats being quite numerous, they gnawed the cellular substance from the hides, which was so poisonous as to kill every rat about his cribs. This circumstance alone proves the great diffusibility of the poison, finding its way even to the skin and cellular substance. It is known by all the old settlers in the neighborhood of Hartsville that if a cow should die with this poison, and a hog should eat of the cow, the hog will die; and

if a dog should eat of the hog, the dog will die; and if a buzzard should eat of the dog, the buzzard will die. A respectable old citizen now living on Goose Creek, has seen as many as seventy dead buzzards around one carcase, and some so sick they could scarcely fly. Again, a gentleman on Goose Creek had put up his hogs to fatten; he had a cow that was complaining; he turned her in with the fattening hogs; she died in a short time; the hogs ate part of her flesh, which killed every one, some thirty in number. A Mr. Hall and his wife were poisoned and died by eating a chicken that had been poisoned by picking some of the flesh from a cow that had died with the milk poison.

The above cases go to show that the poison of milk-sickness is entirely sui generis, not like any poison known in medical books.

I am happy to announce to the reader that this poison in the milk-sick region is on the decline. Very few persons die with it now, and fewer cattle than in former years.

I shall close this communication, already too long, by giving some of the most prominent symptoms of the disease, also the treatment which seemed to be most successful in my practice.

The earliest symptom which manifested itself, according to my observation, was weakness in the calves of the legs, and general lassitude, after taking the least exercise. The patient would yawn and stretch as one in the initial stage of a regular chill: this in a short time would be followed by some slight pain in the head and back, and a disagreeable sensation about the stomach, with more or less thirst. This state of things always ushers in more or less fever. Just in proportion to the febrile excitement, so would the thirst increase, until it was intolerable, the patient calling for large and repeated draughts of water, and the stomach rejecting it as soon as swallowed. The tongue exhibited nothing more peculiar than what we see in all gastric derangements; the bowels invariably obstinately costive, resisting the best-directed efforts to open them; the pulse increased in frequency, with what I call a hollow artery; the skin in a few days becomes rather cool and corrugated, with a collapsed condition of the veins of the hands and feet. When this state of things supervenes, the patient is restless, tossing from one side of the bed to the other; straining to vomit every few minutes; calling incessantly for water, with an expression of countenance indicating extreme distress. There is an indescribable odor on the breath, almost characteristic of the disease. Any one who has waited on patients laboring under this disease can tell as soon as they enter the room whether it be milk-sickness or not, from this very peculiar odor on the breath.

In the treatment of this herculean disease, of course we must resort