THE NEW ZEALAND GAZETTE. 251

Schedule above referred to.

All that piece of land situate at Kaiapoi
(Canterbury), bounded as hereinafter described,
that is to say, Twenty (20) acres of land, the
commencing eighteen chains, five links, south
of a point at which the intersections of a line
drawn from Trig. Pole No. 14, with one drawn
from the Maori boundary post, marked H.,
forms an angle of one hundred and fifty-five
degrees, fifteen minutes; thence running
Easterly a distance of one thousand, three
hundred, and thirty-five links; thence South-
erly, and at right angle with the last line, a
distance of fifteen chains; thence Westerly,
1335 links; and from thence returning to the
first point.

Report adopted with the advice and consent
of the Executive Council of the Colony this
sixth day of September, 1861.

T. GORE BROWNE,
Governor.

F. G. STEWARD,
Clerk of Executive Council.

Office of Minister for Native Affairs,
Auckland, 13th September, 1861.

HIS Excellency the Governor has been
pleased to direct that the following
Report on Diphtheria by the Colonial Surgeon
of the Province of Taranaki be published for
general information.

W. B. D. MANTELL.

REPORT ON DIPHTHERIA, WITH
POST MORTEM AUTOPSIES.

Colonial Hospital,
New Plymouth, 3rd August, 1861.

Diphtheria has been more than sporadic in
this town, for several months past, and the
fatality therefrom in the proportion to the
number attacked has been very considerable.
Until to-day, when two cases, in a wharre near
the Henui, were brought under my notice, no
cases among the Maories have occurred, con-
sequently I have hitherto taken few cases under
my own care, and indeed felt, until very
recently, so bewildered, as to the nature of the
disease, consequently so undecided as to the
methodus medendi, that I rather willingly held
back from having farther to do with it than to
be merely an onlooker. Yet I was early led
to believe that the pharynx was not the
primary seat of the disease, and that the morbid
action on that was not the cause of the fatality.
Therefore I endeavoured, lately, to overcome
that silly prejudice against post mortem
autopsy, and within the last fortnight succeeded
in examining the bodies of three patients who
had succumbed to the disease, the particulars
of which I append to this Report. On inquiry
I learned almost invariably—the exceptions
being very young children—that the gastric
symptoms preceded the pharyngeal, hence
infer that these were resultants of the former,
and nothing more. The coatings of the
pharynx, which has given the nonsensical
names, "Diphtheria" and "Angina Membra-
nacea," to the disease, should be regarded rather
as a deposition intended by nature to protect
the tender parts they cover from the acrimony
of the eructations, or risings of noxious gas
from the stomach. But be this speculation
right or wrong, still the stomach, as is verified
by dissection, is the organ which suffers most
from the disease. My theory, therefore, is
that, from some hitherto occult cause, a
morbific ferment takes place in the stomach,
which excites, first a functional disturbance of
that viscus, but eventually an inflammation of
the inner membrane thereof, which, as in the
instance of the milder, yet often fatal grades
of yellow fever, runs on, very generally, but in so
far as my experience goes, somewhat insidiously,
till towards the final stage, to the utter dis-
organizing of the inucous tissue, or villous
coat. The similarity of effect on this, to that
which I have a hundred times witnessed in
autopsies of fatal cases of yellow fever, was
very remarkable in the appended cases Nos. 1
and 2, even to the deposition of dark patches
of matter on the said coat, resembling the
notorious Black Vomit. And, moreover, in the
first of these, the vomiting in the last stage
had distinctly the coffee ground expression of

Treatment, of course, is various. Hitherto
I have failed in no cases treated as follows, but
these have only been four in number, and to
these I was called so early that the pharyngeal
membrane was in patches, or just beginning
to form. I commence my treatment by the
exhibition of a brisk emetic of the sulphate of
copper-say sixteen grains to an adult, in an
ounce of rain or distilled water. After the
action of this I mop over the entire pharynx
with a strong solution of nitrate of silver (3 i.
to 3 vi. of distilled or rain water). Next I
give liberal doses of levigated charcoal, not
simply as a deodorizer, but more as a corrector
of gastric fermentation. I pay no regard to
the high nourishing, quinine-and-wine-giving
plans; but confine my patients to the least
fermenting species of food, such as rice, soaked
sea biscuit; and for drink, rice water and
linseed tea. I take care to have, in the first
instance, the bowels well cleared out by a large
dose of calomel, followed by a draught of
castor oil; and during the whole of the disease,
I am careful also that the constipating tendency
of the charcoal is obviated by laxative doses of
the same medicines. The emetic requires,
generally, three repetitions, and on two occa-
sions I exhibited it twice a day. Generally it
has the effect of forcing off the adventitious
pharyngeal membrane much more effectually
than the caustic appliance. But my opinion
is that the benefit derived from these is some
peculiar subduing action on the no less peculiar
inflammation-probably in some such way as
cayenne pepper acts on the stomach in yellow
fever, or on the pharynx in angina. I have
hitherto found that where the charcoal is given
in frequent and sufficiently large doses, the bad
odour of the breath is completely obviated;