November 1834

/lr/ Novr. J'. 1834 Saturday I have intended for a long time to keep a journal-today, being the first of the month, determined to put my intention into effect. Went this morning to the Hopital La Charite'l-saw a case of fever (typhus)2 with complication in the chest, & suspected also, in abdomen-he has been admitted about ten days-lips & cheeks are livid, skin moderately warm-respn. very oppressed, 50 in a minute-considerable mucous rale3 in the smaller ramifications of the bronchi-pulse 120-skin is dry & very dirty, has had no bath or tepid ablutions &c-tongue is protruded with consid'. difficulty-on first coming in, he was bled4 from the arm & had leeches on the chest-has been taking lemonade alone since-no antimony5 or purgation. This morning, as his bowels have not been opened for six days, he was ordered an enema, & Iss of Magnes: Sulph.:-If this patt. die, of which indeed there was consid'. likelihood at one time, his physician ought to be prosecuted. Saw an excellent case of Herpes Zoster6 improving rapidly under simple baths & diet. Case of diseased heart-came in today-it is easy by means of the stethoscope7 to detect consid'. bruit de soufflet,8 in the 1 La Charite hospital in Rue des Saints Peres was considered the second most important of the non-specialist hospitals in Paris. Formerly directed by a sect of the monks of St. Jean de Dieu, at the beginning of the seventeenth century it had 100 beds, which by 1786 had increased to 206 and, by 1834, to 300: 100 for women and 200 for men. It had large airy wards and boasted only one patient to a bed. To this practice and to that of keeping wide distances between the beds, its low mortality rates could possibly be attributed. It was well provided with baths and fumigation equipment. (Ratier, Medical guide to Paris, pp. 45-56.) 2Typhus: a most infectious and contagious fever. Hooper stated that its "most common cause by far is contagion or a febrile miasm", which was common in dirty, overcrowded, damp, and generally unhealthy locations. 3Rale: rattle or abnormal sounds heard in auscultation within the respiratory tract that indicate dryness or that moisture is present. They are classified according to their location, for example, within the trachea, bronchial area or the vesicles in the lungs. (Larousse me'dical, p. 988.) 4Bloodletting: the artificial discharge of blood with the aim of preventing …