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lytic affections, bruises, and other injuries of the mascles, &c. In all these cases, our author thinks, it will be found, upon careful examination, that the muscles of the limb are wasted and flaccid, baving almost entirely lost the power of moving the limb from long-continued inaction. The limb is usually bent on the side on which the largest and most powerful muscles are situated. Mr. Ward selects the knee joint for the subject of his observations. It is not easy some times to distinguish between complete anchylosis, and a stiffening short of that process, where art may be productive of some benefit. Where inflammation bas been so severe and protracted as to produce erosion of the cartilage and a union of the articulating extremities of the bones, it will generally be found, on enquiry, that the pain has been of a very severe and insupportable kind, attended with much watchfulness, the seat of the pain being referred to that part which is immediately under the patella-that the disorder has continued without any diminution of swelling or remission of pain, accompanied with a grating sensation on the slightest motion of the limb-and lastly, that the pain bad for some time preceded any appearance of external swelling, the growth of which had been gradual and uninterrupted.
“ In those cases where there has been considerable inflammation of the parts, depositions of coagulable lymph, fluid, or gouty concretions in the joint, I think it better to trust their absorption to the influence of gentle exercise of the limb, rather than by the employment of friction, manipulation, or percussion on the joint itself, 10 incur the risk of the injurious consequences likely to result from the application of local stimulus to parts which, from previous disease, are more liable to the recurrence of inflammatory action. As this use of friction also to the joint itself is commonly attended with some degree of soreness and stiffness of the part on its first application, a circumstance which might mislead the practitioner, and induce him to ascribe it to the effect of disease, I think it better in the first instance to direct friction, manipulation, or percussion to be applied over the extensor muscles of the thigh only. If the angle at which the tibia is fixed on the femur be acute, the patient being placed sitting on a high chair, a line passing over a pulley is altixed to the heel with a small weight attached to it, and he is desired to pull it sleadily forwards, and continue to repeat the efforts till fatigue is induced. The first attempts should be continued only for a short time, and in proportion to the increased strength of the extensor muscles ; the weight, as well as the length of time occupied in the exercise of the limb, should be gradually augmented. When by a steady perseverance in these means considerable motion bas been gained, and sufficient strength acquired to allow the patient to bear his whole weight on the affected limb, a further plan may be adopted of extending the flexor muscles by placing the foot on an inclined plane (which may be made by attaching two pieces of Bat board, à bout one foot and a half in length, and a foot in breadth, to each other, so that when placed on the floor a triangle will be formed, the base of which is the ground, the point of attachment the apex,) the heel resting on the ground, and the toe towards the upper part. In this position the patient should stand on the affected leg only, holding by the back of a chair, so that by advancing the body forwards, or receding, the flexor muscles of the leg may be proportionally extended. This exercise should be persevered in as long as it can be borne without excessive fatigue, and repeated at intervals during the day.” 104.
For the cases in illustratiou we must refer to the work itself.
The 5th chapter is on Paralysis, of which our author presents a pathological and etiological sketch. With the treatment of recent paralytic and apoplectic attacks we need not meddle here, as we have more than once entered pretty deeply into that subject. It is with the chronic effects of the paralysis, the loss or diminution of muscular power, that our business now is. Muscular exertion is recommended by our author as the surest means of restoring muscular power. It is on this principle he explains the reason why hemiplegiac patients generally recover the use of the lower before that of the upper extremities, in consequence of making earlier and more persevering efforts to walk than to work. Friction with the hand, and percussion, appear to have a local effect on the nerves distributed upon the muscles, by increasing their energy, as well as inducing a greater sanguiferous circulation and corresponding increase of strength. 66 These stimuli I consider inferior in their effect to that excitement produced by the act of volition."
“ I have usually advised that the patient should observe a rerumbent position, and in that posture make use of muscular exertion till a considerable degree of strength was acquired.
“ It has been remarked by patients who have suffered much from the spasmodic twitchings and pains in the night, described by Pott, * that on using considerable muscular exertion, or frequently attempting it, and repeating it at intervals during the day-time, the pains and cramps
either did not occur or were lessened. To effect this object it appeared to be necessary to induce complete fatigue.” 135.
Chap. VI. Chorea Saneti Viti, our author is induced to consider was a modification of hemiplegia occurring in a young subject."
In this we cannot bring ourselves to agree with Mr. Ward. The two principal modes of treatment that bave been found most successful, viz. purgatives and tonics, do not seem in accordance with Mr. Ward's theory. That it is an affection of the nervous system we have no doubt; but the nature of its cause we cannot but think to be different from that of hemiplegia, which is pressure on the brain or spinal marrow. TO Mr. Ward's favourite remedy, muscular exercise, we have not the smallest objection in chorea. He has detailed some cases in which this measure appeared to be serviceable.
* “ Farther remarks on the useless state of the lower limbs, &c."
The 7th and last chapter contains miscellaneous observations on several subjects. In this chapter our author leads our attention to the good effects of muscular exercise in obstinate cases of chronic rheumatism, combined with the use of mercury. The cure of this disease, in general, he thinks, “ may be ascribed exclusively to the administration of that medicine," but several cases have fallen under his care where mercury failed till the aid of muscular exercise was called in.
“ The influence of exercise in diminishing the frequency of the pulse is not undeserving of notice in this place. In the case of a young gentleman, whom I directed to use considerable muscular exertion, the first effect was to produce a considerable increased quickness of the pulse; at the expiration of a quarter or half an hour, however, when the immediate acceleration from exercise had abated, the number of beats had been reduced twenty and thirty in a minute. The same effect I have also frequently witnessed in adult age. In a gentleman of forty years of age, whose pulse had regularly, during two years, beat ninety strokes in a minute, it fell to eighty, and subsequently seventy-five, on using daily strong muscular exercise.
“ In gouty concretions of the joints, excitement of the muscles, whether by voluntary exercise or other modes, as those of friction, shampooing, or percussion, or a combination of all of them, may be employed with success, observing the caution before given to bring into action the muscles which move the affected joints, and to limit the friction, &c. to those parts only, rather than apply it to the seat of disease.” 165.
We have now given a very full account of the little volume before us, and our readers will probably perceive that we are inclined to think favourably of the work. It is written with great modesty and good sense; and it invites our attention to a remedial agent which is much wanted in these days of effeminate manners and sedentary babits.
V. 1. Saggio Clinico sull'Iodio, e sulle differenti sue Combi
nazioni e Preparazioni Farmaceutiche, 8c. i.e. Clinical Essay on Iodine, and its different Combinations and Pharmaceutical Preparations; from Results obtained in the Clinical School of Padua, in 1820-1821. By
PROFESSOR BRERA. Octavo, pp. 106. Padua, 1822. 2. Observations on the remarkable Effects of Iodine in
Bronchocele and Scrophula : being a Translation of three Memoirs published by J. R. COINDET, M.D. of Geneva, Octavo, pp. 32. London, 1821. Translated
by J. R. Johnson, M.D. Being thoroughly convinced that it is not to the discovery of new remedies, but to the improved application of those already known, through the increase of pathological knowledge, that we are to look for any important advancement of therapeutics, we are accustomed to lear the frequent announcement of fresh accessions to the materia medica, with perfect tranquillity, and if we occasionally avail ourselves of such in our practice, it is rather in compliance with fashion than from a conviction of their superiority, much less of their exclusive power to fulfil any important indication in the treatment of discases. Indeed, we are well convinced, that modern medicine has derived infinitely more precious bene
fits from many physiological and pathological discoveries, of little notoriety and less pretensions-contained probably in some few unostentatious paragraphs, than from all the multifarious additions, rejections, and revivals, which have characterized our pharmacology during the last fifty years. Still it is neither liberal nor pbilosophical to reject unheard the claims of these new candidates for a place in the storehouse of health ; nor is it just to declare that all those which have been heard and tried are either useless or unnecessary. The great majority of such novelties unquestionably are so ; yet it is but fair to admit that some few of these (for example, colchicum, croton, cubebs, prussic acid,) are at least deserva ing a place among the list of substances possessed of analogous powers. Each and all of these, it is true, we expect to live long enough to see consigned, like the other articles of present fashion, to a temporary oblivion, until resuscitated to gratify the unquenchable appetite of novelty, with the bag-wigs, red heels, hoops, or trunk-hose of our ancestors; still we feel that it is our duty, as ministers of health, and still more as medical annalysts, to make ourselves, and also our readers, acquainted with them as they respectively present themVol. III. No. 12.
selves before us; and to hear and judge their claims and pretensions to our regard, be they great or small. It is on this principle that we have, in former numbers of our Journal, deyoted some portion of our pages to the medicines abovementioned ; and in the present article we intend to introduce to our readers another new agent, that comes before us with as high pretensions, and probably with powers as great, as any of its recent precursors. This new medicine is IODINE, which has now been somewhat more than two years known to the profession, but which has hitherto obtained from us only a very brief and imperfect notice.-(Vol. II. p. 322.)
The simple substance, lodine, was discovered in the soda derived from the incineration of certain marine vegetables, by Mons. Courtois, in the year 1813. Several of its properties were first investigated by M. Clement; but it is principally to Sir H. Davy and Gay-Lussac that we are indebted for our knowledge of the chemical habitudes of lodine. For the history of this discovery, and the subsequent development of the various relations of this substance we must refer to the 88th, 89th, 92d, and 93d vols. of the Annales de Chimie, and to the various scientific journals published in this country since the period of its discovery.
The first experiments on the living body with this new agent, were made by Majendie, who was led to conclude that it was not poisonous; but subsequent experiments of Orfila on animals completely establish its great virulence, in certain doses, and justified its classification among the corrosive poisons. It is to Dr. Coindet of Geneva, however, that we are entirely indebted for the introduction of iodine into medicine. This gentleman reflecting on the benefits derived from .burnt sponge, from time immemorial, in the cure of broncho
cele, * and on the more recent discovery of similar virtues in the preparations of the common sea-weed (fucus vesiculosus;) and on the fact that iodine is common to these and other marine productions; was led by analogy to suspect that it was to it that the influence of these substances in curing bron.chocele was to be attributed. As he lived in the midst of a
* We are informed by Professor Brera that there is preserved in the library of St. Mark, in Venice, a copy of the works of Van Helmont, full of marginal annotations in the hand writing of our famous countryman Locke, among
which is the following formula recommended for the cure of goitre: R. Spungiæ marinæ in carbonem combustæ uncias tres ossium sæpiæ
ustorum, piperis longi, zinziberis, pyretri, gallarum, salis gemmæ, calcis testorum avorum-ana unciam unam. Terantur omnia simul in pulverem An. cujus uncia semis. liquat. deglutitur paulatime deorescente luna."