32 Dr. Osborne's Account of a Ilcemorrhagic Diathesis, 8;c.

ART. IV.--Account era tla~norrha~c Diathesis existing in a Family, also of a peculiar Appearance of the lris belong- ing to a ~Yamily. By JONATHAN OSBOaNE, President of the College of Physicians, &c.

JOHN GAMI3L~ aged 13, was admitted into Sir Patrick Dun's" Hospital, with inflammation of the capsule of the left shoulder joint. Two leeches were ordered to be applied. The appli- cation took place on the same evening, and considerable diffi- culty was experienced in stopping the bleeding. On the follow- ing morning it appeared that the bleeding had recommenced during the night, and was still going on. Recourse was had to the nitrate of silver, but although this was frequently applied, and all the other usual means for suppressing haemorrhage were successively adopted, yet the blood repeatedly broke out during the three following days. I was now first made acquainted with the facts which I am about to relate. This lad had ,been lately affected with epistaxis to an alarming degree, and had lost two brothers in the following manner.

The eldest, when about nine years ofage, laboured under some affection ofthe knee-joint, for which he was cupped at one of the surgical hospitals of thiscity. Aftersome blood hadbeen obtained, the knee was bound up and he returned home. He was not long at home when the bleeding recommenced, and the haemorrha~ at length became so formidable, that a messenger was sent to the hospital to request immediate assistance ; an answer was re- turned that it might be allowed to continue, as tile only danger was that it would not bleed sufficiently. It thus continued till a rapid sinking excited an increased alarm. Assistance was now procured, but all efforts proved unavailing, and he died on the following day.

A younger brother of my patient, aged about six years, while running, fell down and struck one of his temples a~inst

the corner of a table ; a haemorrhage ensued, which, notwith-

Dr. Osborne's Account of a Itr Diathesis, 8;c. 33

standing the efforts of the most distinguished members of the faculty in Drogheda, where the accident occurred, could not be appeased, and lie rapidly sank and died on the next day.

My patient was of thir and ruddy complexion : the blood effused from the leech bites was observed not to coagulate; but whether the h~emorrhagic diathesis was attributable to this cir- cumstance, or to the capillaries and small veins opened by the leech bites continuing open like arteries, and their coats not re- laxing into contact with each other, as is usually file case in veins, we have not had any opportunity of determining.

A sister of those children is married, and has had a child without experiencing any dangerous h~emorrhage.

Much light may be thrown on the difficult subject of hereditary diseases, by accurate investigations into hereditary diatheses, idi- osyncracies, or even hereditary likeness. Such are connected with peculiar temperaments, and these latter with peculiar diseases.

As a physiological question ; the descent of peculiar fcatures in famillcs, has never been examined so as to afford the pathologist proper data for ascertaining the laws of hereditary diseases, and yet there are the most abundant materials for this purpose, in the observations familiar to persons engaged in breeding cattle ; nor are facts relating to our species wanted, but these lie scat- tered, and are often difficult of access. ], therefore, have file less hesitation in subjoining to the above case of hereditary dis- position to heemorrhage, a singular case, illustrative of heredi- tary likeness which fell under my observation.

John Murphy, aged fifty-two, was a patient in Sir Patrick Dun's hospital, for chronic inflammation of the capsules of the right hip-joint. At my first interview with him, I was struck with the remarkable appearance of his eyes, which is partially represented by the figure subjoined.

VOL. VII. NO. 19. F

34 Dr. Osborne's Account of a I-lawnorrhagic Diathesis, Sic.

The iris in both had a dusky light yellowish ground, and a number of round dark reddish brown spots were sprinkled on them in an irregular manner, but in greatest number towards the internal angle of each eye. The spots on the back of a tortoise shell cat afford the best resemblance. My curiosity was excited, and having learned from him that he never had any affection of the eyes, he intbrmed me of the following par- ticulars, which were confirmed by the testimony of another per- son, who came from the same part of the country. He had fifteen brothers and five sisters, (by the same father and mother), who all possessed the same peculiarity, which was derived from his mother, whose name was Murray. Her three sisters and one brother had the same, which was derived from her mother, whose maiden name was F -, (I do not publish tile name in full, lest possibly it might be disagreeable to the feelings of some individual). It]is to this latter family that the peculiarity belongs, insomuch, that in the part of the country where they resided, (county Wexford), they have been commonly recog- nized by this distinction, ~nd celebrated for communicating it to their posterity. He mentioned the name of a titled indivi- dual, not a resident of this city, and whom I have never seen, but who has obtained the same peculiarity, in consequence of an intermarriage between one of his ancestors, and a daughter of the F--s.

The above case is not to be explained on the principle of imitation, which has been resorted to as a means of accounting for similarity of countenance, of tone of voice, or of character. This is a structural peculiarity, and in a number of the Edin- burgh Medical and Surgical Journal, I have mentioned a pecu- liarity of the stomach existing in a family, ineapaeltating them from vomiting, which, as will appear fi'om a consideration of the circumstances attending it, must have been structural. Those structural differences handed down in families, and of which family likeness is only a part, may be conceived as furnishing the strongest predispositions for certain diseases, and thus here-

Dr. Little's Practical Observations on Fever. 35

ditary diseases will appear to arise from hereditary similarity of structure, rather than from the semina morbi lying in a latent form in the patient's frame, as is commonly supposed.

The subject is one of great interest, and in order to be pro- perly investigated, requires a great number of observations. The above are offered merely to induce others, who may be in possession of similar facts, to record them, and thus to aid in filrnishing the materials for enabling us to arrive at a definite conclusion on the subject.

ART. V.--Preactival Observations on Fever, particularly with reference to the Plan of Treatmc'nt which has been generally pl~rsued in the Belfast Fever Hospital for several years. By ROaEnT LITTLE, M. D., Physician to that Institution, Physician Accoucheur to the Belfast Lying-in Charity, Phy- . sician to the Ulster Female Penitentiary, Lecturer on Mid- wifery, and the Diseases of Women and Children, &e.

FaoM file very frequent occurrence of contagious fever in this country, and from the great annual mortality which it produces, especially amongst the lower classes of tile people, I consider it entitled to more attention on the part of the student of me- dicine and that of tile practical physician, than almost any other disease with which I am acquainted. Most othe r epide- mic and contagious diseases occur only at intervals of one, two or more years, and then only prevail for a short time and after- wards disappear. This, however, is not by any means the case with the disease in question, for it is to be met with, particu- larly in large towns, at every season of the year, and although it has its periods of increase and decline, yet it cannot be said to be extinct at any one time. One would naturally suppose, from the great prevalence of this disease, that its nature would be much better understood by physicians than almost any other. This, however, is not the case, and I am certain, there is scarcely