admire. If parturient women are less able to bear depletion-so, we should imagine, are they less able to bear the inflammatory disease for which it is used. When inflammation therefore exists in such cases, the sooner it is reduced the better. We strongly suspect that it is with blood-letting in inflammation, as with mercury in syphilis many remedies will be proposed as substitutes before one is found to stand the competition. Dr. Payne states that oil of turpentine has cured every case of puerperal fever that has occurred to him during the last seven years! If Dr. Payne's experience has been considerable, the remedy, we may safely aver, is here overrated-if trifling, the success of the remedy should not have been stated in such positive terms. We are friendly to the medicine in question; but such sanguine friends as Dr. Payne would ruin any remedy, whatever was its merit. 23. Purpura Hæmorrhagica. Here we have oil of turpentine again. We thought, some time since, that colchicum would have banished the lancet and broke up Apothecaries' Hall:-oil of turpentine now threatens to do the same. What will be the next Herculean remedy to grapple with all kinds of diseases? Dr. Nicholl has exhibited the oil of turpentine in three cases of purpura hæmorrhagica. Two of these cases were published in the Medical Repository for July 1821, and "in each of these cases there was an absence of every appearance which could call for the employment of venesection; in neither of them was there any visceral congestion; but the cause of the affection seemed to be referable to general want of tone in the extreme vessels." This view led our author to the ol. terebinth. and the result was most satisfactory. The recent or new case was a child two years and a half old, who was brought to Dr. Nicholl, her skin, mouth, gums, tongue, &c. being sprinkled with small black spots, like flea bites. The child was pallid and languid. Half a drachm of the oil with some syrup of senna and water was ordered thrice a day from the first till the 11th of December. The spots gradually died away; but the child being weak, some decoction of bark and acid was prescribed. There was a return of the complaint in March. The terebinthinate and cinchonic medicines were ordered to be taken alternately, and they were persevered in till June, when the child appeared free from the disease. Our readers will readily grant that there is nothing very decided or satisfactory in this case, when we consider that other remedies were conjoined with the turpentine, and that the time occupied with the relapse afforded Nature an ample scope for the cure of the disease. At the same time we are disposed to think that the oil may be a serviceable medicine in certain conditions of purpura that do not indicate the use of the lancet. * Dr. Whitlock Nicholl. 24. Turtrite of Antimony in Pulmonic Inflammations.* Our professional brethren in this country have very generally been sceptical as to the large doses of certain powerful medicines, especially emetic tartar, exhibited by the Italian physicians. We have lately seen several English medical men, who were eye-witnesses to these administrations, and they confidently assert, first, that the medicines were of the usual strength, and secondly, that these large doses did not produce those effects which we would be led to expect from their comparative magnitude. We all remember that when the East India practitioners first prescribed scruple or half-drachm doses of calomel, the facts were denied by some in this country, because the effects were not what they hypothetically considered they should be. They are now less incredulous on this subject, and therefore we should not be entirely sceptical as to the practice of our Italian brethren, who have eyes, ears, and brains, as well as ourselves. The writer of the paper before us resides in the Canton de Vaud, where inflammatory affections of the chest are very frequent and severe. For several years past he has given up all sanguineous depletion and counter-irritation in the treatment of this class of complaints, and trusted entirely to large doses of emetic tartar. He exhibits, for instance, from six to twelve or fifteen grains in the 24 hours, dissolved in a six-ounce mixture, of which he gives a table-spoonful every two hours in abundance of a common laxative ptisan. If there occurred much tendency to perspiration, he added two drachms of the spir. ætheris nitrici-and where there was much uneasiness and insomnium, a drachm of tincture of opium was added to the mixture. In general the quantity of emetic tartar was increased three grains daily till the patient took twelve or fifteen grains per diem-a quantum which he has rarely had occasion to exceed. The following were the usual effects of the medicine. The patients generally vomited after the second or third dose of the first mixture, and afterwards it either acted on the bowels, or produced no other sensible effect than that of mitigating quickly the symptoms of the disease. The patients generally expressed themselves as very much soothed about the chest, and when the usual doses were de layed, they complained of not being so well. "I have to remark," says our author, "that large doses of the tartrite produced much less vomiting than small doses which always gave rise to great distress without beneficial results." In the greater number of cases this mode of treatment did not require more than eight days—it was rarely prolonged to a fortnight. In a few cases a blister was applied to the painful part, but neither local nor general bleeding was ever used. No case of pulmonic inflammation terminated fatally in our author's hands since he commenced this method of treatment. * M. Peschier. Revue Med. Aug. 1822. 25. Cystitis. The unfortunate subject of this paper fell a victim to his curiosity. Having ascended an unfinished scaffold to get a view of the pageantry attending the regalia in its removal from the Castle to Holyrood, (12th August, 1822,) he and several others were wounded by the erection giving way. He had some ribs broken, and a bruise on the loins, which deprived him partially of the power of the lower extremities. Being carried to the Royal Infirmary, he was there cupped and scarified, but, according to his own account, without effect. There being retention of urine, the catheter was introduced in the evening without difficulty, but during the two succeeding days and nights, the patient reported that the efforts of the surgeons were ineffectual in drawing off the water. On the third morning his friends removed him from the infirmary, and on the fourth day Mr. Liston was sent for, who found the bladder reaching to the umbilicus. A full sized catheter was introduced without any difficulty, and two pints of putrid fluid, more resembling blood than urine, were discharged. The fluid was drawn off every day once or twice, for some days, and hopes were entertained of his recovery. But these hopes were fallacious. On the 2d of September, the catheter was passed, but failed to draw off any fluid, and in the evening the symptoms were so threatening that Mr. Liston was obliged to take some more active steps. The bladder could be felt as a circumscribed doughy tumour rising into the abdomen, the superincumbent integuments being oedematous. The catheter was again passed with ease, but only a small quantity of offensive pus came away. The bladder was therefore opened freely by striking a sharp-pointed bistoury into the anterior part above the pubes, and thus making an opening sufficient to admit the finger. A great quantity of putrid purulent matter came away, but was stopped by the protrusion of a flocculent membrane. This was withdrawn by the fingers, and the bladder completely emptied. The lining of the bladder was found to be rough, and had lost the disposition to contract. The patient, from being apparently moribund, was greatly relieved; but at his age success could hardly be expected. He lived till the 20th of the same month. The separated membrane was apparently the product of recent inflaminatory action; but whether from over-distention of the organ or other cause we feel incapable of saying. We think Mr. Liston was perfectly justifiable in performing the operation above-mentioned under the desperate circumstances in which the poor man was placed, and we wish that able and zealous surgeon all possible success in his professional career. 26. Elongated Uvulat. Dr. Physic and the editors of the Philadelphia Journal of Medical Sciences desire to draw the attention of their professional brethren to a species of consumption, in many instances of a very formidable character, produced by the irritation Mr. Liston. Med. Repos. No. 107. Nov. 1822. Vol. III. No. 11. of an elongated uvula, and which is relieved by simply cutting off a portion of it. Whether such a circumstance might give rise to disease of the larynx we cannot say, but we have seen three instances, within the last twelve months, where the relaxed uvula, by keeping up a constant tickling cough, rendered the patients very uncomfortable-indeed very unwell. In two of the cases, the complaint was subdued, though tediously, by stiptic and stimulating gargles-in the other case the tip of the uvula was snipped off by a pair of scissars, and the patient was quickly cured. In the same journal we are informed that the superacetite of lead combined with opium is pretty freely exhibited in America for several affections of the bowels-especially the cholera infantum and dysentery. To an adult they give from half a grain to a grain of the lead with five drops of tincture of opium every hour or two, according to the urgency of the symptoms. In some instances, where it was desirable to act upon the skin, small doses of ipecacuan were added. Occasionally the medicine was omitted, and purgatives exhibited. 27. Experiments upon the Roots of the Spinal Nerves. M. Magendie had been, for some time, anxious to make an experiment for the purpose of observing the effects of the section of the posterior roots of the nerves which have their origin in the spinal marrow. He had attempted it several times, but without being able to succeed, in consequence of the difficulty of opening the vertebral canal, without injuring the spinal marrow, and producing death, or, "at the least, severely wounding the animal." During the last month, however, a litter of puppies having been brought into his laboratory, he considered them proper subjects for a repetition of his experiment in opening the vertebral canal. With a single stroke of a very sharp scalpel he laid bare the posterior half of the spinal marrow, covered with its envelopes. He then divided, with ease, the dura mater surrounding it, and exposed the posterior roots of the lumbar and sacral pairs, and, by raising them with the blades of a pair of small scissars, he was enabled to cut them on one side, without injuring the spinal marrow: the wound was reunited by suture, and the animal watched. M. Magendie at first believed that the limb corresponding to the divided nerves was entirely paralyzed: it was insensible to punctures and the strongest pressure, and seemed likewise immoveable; but, to his great surprize, the animal began to move it, in a very apparent manner, although the sensibility was still quite extinct. A second and third experiment gave an exactly similar result. M. Magendie then began "to consider it probable that the posterior roots of the spinal nerves might have different functions from the anterior, and that they were more particularly destined for sensibility." He then thought of dividing the anterior roots, leaving the posterior untouched; but he found this easier to conceive than to exe * Magendie's Physiological Journal. cute. After some consideration, he decided upon attempting to pass before the posterior roots a species of cataract knife, the blade of which being very narrow, might permit him to cut the roots by pressing them with the edge of the instrument, upon the posterior part of the bodies of the vertebræ; but this plan he was obliged to quit, in consequence of the great veins which the canal on that side contained, and which were opened at each movement in advance. In making these attempts, he perceived that towards the vertebral dura mater the anterior roots might be seen united into fasciæ, immediately before piercing that membrane, M. Magendie immediately divided all the pairs which he was desirous of doing, but, as in the preceding experiments, only cut those of one side, for the purpose of comparison: the limb became immediately lax and immoveable, whilst it unequivocally preserved its sensibility. He finally cut, at once, both the anterior and posterior branches, when there was an absolute loss of both sensibility and motion. "I have repeated and varied," says M. Magendie," these experiments in several species of animals: the results which I have just mentioned have been confirmed in the most complete manner, both as regards the anterior and posterior roots. I am following up these researches, and shall give a more detailed account of them in the next number; it is enough for me, at present, to be enabled to assert positively, that the anterior and posterior roots of the nerves which spring from the spinal marrow have different functions; that the posterior appear more particularly destined for sensibility, whilst the anterior seem more especially connected with motion.' 28. Apparatus for Removing Poisons from the Stomach, invented by Mr. Jukes and Mr. Bush.* It (Mr. Jukes's) consists of an elastic gum tube, a quarter of an inch in diameter, and two feet and a half in length, terminating at one extremity in a small globe of ivory, with several perforations; the other extremity is adapted, either by screw or by plug (the latter is preferable) to an elastic bottle of sufficient size to contain at least a quart of liquid, and having a stopcock fitted to it, in a similar manner as in the hydrocele bottle. Instead of the bottle, a pewter syringe, of an equal capacity, may be adapted, in the same manner, to the flexible tube. The operation by the syringe is performed more quickly, and may therefore, perhaps, be preferred by some. In cases where surgeons have neither bottle nor syringe, the tube alone might be made to answer the purpose, if the operator apply his mouth to its extremity, and thereby institute the office of a siphon. Application. The patient ought to be placed on the left side, and the globulated end of the tube be then carefully passed to the greater curvature of the stomach, either through the mouth or nostril, as Med. Repos. for October, 1822; London Med. and Phys. Journal, September, 1822. |