페이지 이미지
PDF
ePub

within about half to three quarters of an hour after the meal, when it is about six or ten times larger than it had been just before the ingestion of food. Water has not the same effect: on the contrary, when taken simultaneously with solid food, it prevents the latter from causing so evident an increase. The concentration of the pancreatic juice appears frequently diminished in the same measure as the quantity is increased, but this phenomenon is not a constant one; and at all events, the absolute quantity of solid substances is greater after meals than before.

As regards the physical and chemical character of the secretion the author does in general, agree with Bidder and Schmidt; some differences, however, must he noticed. The specific gravity is, according to Kroeger, 1.01065, while Bidder and Schmidt had assumed 1.0306, and Frerichs 1.0082.1 Further differences become apparent by comparing the following figures relating to 1000 parts of fresh juice.

Kroeger.

Frerichs. Bidder & Schmidt. (Analysis by Č. Schmidt.) Water . . . . 981:52

986.40

900.76 Solid matter .. 18:48

13.60

99.24

[merged small][merged small][ocr errors]

Concerning the physiological action of the juice, its power of transforming starch into sugar is not doubted. According to the author's experiments, 1 gramme of the fresh juice transforms within half an hour, under the influence of a temperature of 35° C. 4:672 grammes of dry starch into sugar; as 1 gramme of fresh juice contains 0·014 grammes of pancreatic ferment, one gramme of this ferment would transform 333.7 grammes of dry starch. If we assume, with Frerichs, that an adult man requires daily about 490 grammes (=15 ounces nearly) of starch to compensate the daily loss of carbon, the quantity of pancreatic juice necessary for the transformation of this starch into sugar would be less than 105 grammes, while the quantity actually secreted amounts to more than 5000 grammes. Kroeger is therefore of the same opinion with Bidder and Schmidt-viz., that the pancreatic juice cannot have as its principal function the transformation of starch into sugar. As one of the functions, he considers the promotion of the constant interchange of fluids within the body, in the same manner as Bidder and Schmidt have made it so probable concerning the saliva, and with Grunewald and Schroeder concerning the gastric juice. It further appears to him that an intimate connection exists between the secretion of the stomach and that of the pancreas-namely, that the hydrochloric acid secreted by the former is, after having performed its part, neutralized by the soda of the latter, thus again forming the chloride of sodium previously disunited by the process of secretion. In favour of this theory Kroeger observes that the hydrochloric acid secreted by 1 kilogramme of dog through the gastric juice in twenty-four hours amounts to 0.305 grammes, while that of soda contained in the pancreatic juice of twenty-four hours is calculated at 0.237 grammes, i.e., very nearly the equivalent (0-259) corresponding to 0.305 grammes of hydrochloric acid.—Dissert. De Succo Pancreatico Dorpat, 1854; and Brit. and For. Med. Chir. Rev. ZSCHOKKE ON SUDDEN DEATH AND THE MEANS FOR ASCERTAINING ITS CAUSE.

This author believes that sudden death always depends upon disease or interrupted function either of the brain or the heart ; he regards death as commencing at the brain in cases of apoplexy, asphyxia, and congelation ; and at the heart in cases of paralysis of that organ, and in hemorrhages. In estimating the cause of death, the author places most reliance on the appearance and amount of the blood contained in the vessels. In examining the blood,

r i Wagner's Handwoerterbuch der Physiologie, iii. p. 844.

the extent of putrefaction must be taken into account, as it exercises a great influence on the condition of this fluid. When apoplexy has been the cause of death, the vessels of the head and lungs, as well as the right side of the heart, are distended with venous blood; and there is total or partial ramollissement of the brain, the same essential characters are present in death by asphyxia, and by excessive cold. The following is a resumé of the author's observations:

Signs of death commencing at the Brain. (a.) Constant signs.

1st, Veins of meninges full of blood. 2d, Bloody spots in the cerebral substance. 3d, Fulness of the large veins, and of the right side of the heart. The

blood is coagulated when death has been instantaneous ; the contrary

when death has occurred more slowly. 4th, Lungs engorged with blood ; which is dark, when the oxygen of the

air has been excluded from the organs ; and bright when air has been

breathed up to the moment of death. (6.) Inconstant signs. 1st, Tongue protruding between the teeth. (This indicates death with

symptoms of paralysis, and the external tissues of the head are engorged

with blood). 2d, Frothy mucus in air passages. (A sign of convulsions). 3d, Absence of two last signs. (This indicates paralysis, with diminution of

the quantity of blood, or a determination of the vital fluid towards the central organs or paralysis of the heart occurring simultaneously with

death commencing at the brain). 4th, Swelling and redness of the face and eyes ; lividity of the lips. (Signs of congestion).

Signs of Death commencing at the Heart. 1st, Blood uniformly distributed through all the veins of the body, with

out partial congestion of organs. 2d, Uniform emptiness, or fulness of both sides of the heart.

Signs" of Nervous Apoplexy-(if there be such a disease). 1st, Uniform distribution of the blood through both the veins and the

arteries. 2d, Partial fulness of the cavities of the heart.- Zeitschrift für die

Staatsartzneikunde. 1853. MOSLER ON THE QUANTITATIVE RELATIONS OF THE URINARY PHOSPHATES. Mosler made a series of observations partly on himself, partly on several other healthy persons. The average quantity of phosphoric acid secreted within twenty-four hours by a healthy man is calculated at 3.209 grammes; the acid contained in the alkaline phosphates to that in the earthy phosphates bears the proportion of 3:1. The quantity of colouring matter within twenty-four hours is about eight grammes. As regards the various periods of the day the secretion of phosphoric acid was greatest in the evening, when the author was, in general, mentally engaged ; after this follow in a descending series, noon, night, and morning. By intense mental occupation the quantity of phosphates excreted became regularly increased one-half, the increase relating more to the earthy than the alkaline phosphates ; the quantity of colouring matter became likewise greater. By an abundance of proteinaceous food the excretion of phosphates became in a similar proportion larger. The effect of both influences combined on the excretion of phosphoric acid, urea, and chlorine, is striking in the following table under A, while the figures found in normal circumstances are placed sub B.

Chlorine.

Phosphoric acid.
A. 43-050 grammes.

20.720 grammes.

5.104 grammes, B. 29•120

7.010

4.479

[ocr errors]

By fasting, the excretion of phosphoric acid was more diminished than that of urea, the quantity of chlorine in the urine remaining unaltered. The examination of a non-pregnant female, extending over five days, gave much lower figures for the phosphates, than of men under similar circumstances. Concerning the urine of pregnant females, the author found, as the mean figures of several examinations for women of 128 pounds' weight, after the sixth month of pregnancy : quantity of twenty four-hours — 1:488 C.C. (62 C.C. per hour); specific gravity —1:011; reaction more frequently neutral or alkaline than acid; colouring matter 14:592 grammes (0:608 per hour); urea -- 26193 grammes (1.090 per hour); chlorine – 7.930 grammes (0:330 per hour) ; phosphoric acid — 2:422 grammes (0:100 per hour); sulphuric acid —1:250 grammes (0-052 per hour).-Dissert. Giessen, 1853 ; and Brit. and For. Med. Chir. Rev.

HAFFTER ON THE ACTION OF THE GREATER SPLANCHNIC NERVE. Haffter, in connection with Professor Ludwig, divided, in five cats, the nervus splanchnicus externally to the peritoneum. Concerning the sensitive function, it appears to contain a large amount of sensitive fibres, as the signs of pain produced by the section of the nerve are as great as those by the section of an equally thick branch of the trigeminus. The perception of hunger was not destroyed after the operation; as the section of the vagus does likewise not annihilate it (Bidder and Schmidt), Haffter concludes that it depends on the combined action of the nervus vagus and nervus splanchnicus. As regards the motor function, the author is led to conclude from his experiments that the nervus splanchnicus neither excites the motion of the intestines, nor possesses the power of arresting it as the vagus that of the heart. The secreting function of the intestines became only slightly altered; the secretion of the stomach, however, and of the upper part of the small intestines, seemed to be rather increased. The nutrition, as well as the secretion of the kidneys unimpaired. The colour of the liver unusually dark.-Dissert. Zurich, 1853; and Brit. and For. Med. Chir. Rev.

M. CHATIN ON IODINE IN ATMOSPHERIC AIR. This chemist read a paper at the meeting of the Academie des Sciences, on the 4th December 1854, on the experiments by which he had satisfied himself of the existence of iodine in the atmosphere. He detected it by agitating distilled water with air; and he demonstrated its presence both in rain water and in hoar-frost. He particularly directed his attention to the dew, gathered from vessels which had been exposed to nocturnal irradiation. He found such dew to contain six times as much iodine as was absorbed by the same weight of water. M. Chatin's researches beautifully supplement the investigations of Regnault on the variations in the proportion of azote, and those of Boussingault on the presence of ammonia in the atmosphere. -L'Union Médicale, 16th Dec. 1854.

PATHOLOGY AND PRACTICE OF PHYSIC.

DR LINDSAY ON THE HISTOLOGY OF THE BLOOD IN THE INSANE. Tue following remarks are founded on the results of a microscopical examination of the blood in 236 insane patients, and in thirty-six officers and attendants in the Crichton Royal Institution and Southern Counties Asylum at Dumfries. The blood exainined was, in almost all cases, that drawn from the point of some of the fingers by the prick of a needle. As a general rule, the insane are extremely bad subjects for such experiments. This applies, of course, in different degrees, to patients labouring under different forms of insanity. They are extremely sensitive, restless, and suspicious of operative interference, even, of so slight a nature. Many obstinately refused to allow their fingers to be pricked. Some did so from a firm conviction that a deep

NEW SERIES.-NO. II. FEBRUARY 1855.

laid conspiracy against their lives or welfare lurked under the cloak of apparently simple experiment ; others simply objected to become tools of experiment or amusement ; some declined on the plea that in their greatly debilitated condition they could ill afford to spare even a single drop of blood; others lacked courage to submit to the operation ; some demanded full explanations of the motives which led to my making the singular request of allowing their finger to be pricked by a needle; in others this formed the key-note of their delusions, delirium, or vituperation, for days or weeks after the experiment was attempted in them. On the other hand, many, who could not appreciate the objects of experiment, submitted cheerfully, merely from a wish to please their medical attendant; others—chiefly cases of confirmed dementia or of deep lethargy–were perfectly passive, freely permitting any kind or amount of experimentation ; some presented their fingers, under the impression that, from the single drop of blood, the state of the constitution, the chances of cure, and the period of their removal, could infallibly be predicted; others from curiosity to see the appearance which their own blood, or that of their companions, presented under a microscope ; many, especially of the educated classes, comprehending at once the objects of the experiment, cheerfully submitted, and evinced the liveliest interest in the microscopical appearances, which, in all cases where the patient was in a condition to appreciate them, were demonstrated and explained ; some carried this laudable curiosity to a great extent, begging most earnestly not only to see their own blood at different periods of the day, but that of fellow-patients and attendants, evidently strongly impressed with the belief that between their own blood and that of companions who exhibited most different traits of character or conduct, or between that of insane patients and sane attendants, there should exist a perceptible difference. On various occasions, I was obliged to demonstrate the condition of my own blood under the microscope, to satisfy the curiosity thus awakened. There was a marked difference between the two asylums in the readiness with which both patients and attendants submitted to experiment. In the Crichton Institution, a much larger proportion submitted, and with greater cheerfulness and readiness than in the Southern Counties Asylum, where a great amount of persuasion and explanation was frequently necessary. It may, at first sight, appear surprising that the experiment should have been more successful among the rich than the poor insane,-among persons of refined habits, and many of them of delicate constitutions, than among rough, hardy artizans and field labourers. This I attribute entirely to the difference in the education of the respective classes ; to which, also, I attribute the fact that the patients in the Crichton Institution submitted more readily and cheerfully than the attendants. It is noteworthy, moreover, that, among the higher class patients, a much larger proportion of ladies than gentlemen offered themselves as the subjects of experiment. The cause of this difference appeared to be that curiosity strongly predominated in the former. They evinced great anxiety to know the difference in the condition of the blood between the sane and insane, the diseased and healthy. The classes of cases most readily experimented on were amentia, confirnied dementia, melancholia, and general paralysis ; those least readily mania and monomania. In consequence of the difficulty to which I have already adverted—of prosecuting such researches among the insane-I was unable, in the inajority of cases, to examine the blood of the same individual more frequently than once ; and as I was obliged to do so when favourable circumstances in each individual case presented themselves, my examinations were made at irregular periods of the day. I was thus prevented from making other than a qualitative and rough examination, from ascertaining the variations in the condition of the blood according to the period of the day (in connection with the digestion of food, etc.), sex, age, and type of disease, mental and bodily, and from accumulating similar data on which to found general deductions, which I should, under more favourable circumstances, have endeavoured to do.

The following is a resumé of the chief general conclusions or results drawn by Dr Lindsay from his observations :

'1. That the blood of the insane varies considerably in-a. colour, granularity, and dulness; b. density or consistencc ; c. coagulability; d. relative proportion of serum, fibrin, and globules; e. the tendency of the red discs to agglomerate; f. rapidity, readiness, and amount of the flow.

2. That the red discs vary in a. size, b. form, c. colour, d. number, e. tendency to agglomerate.

3. That the white globules vary in a. size, b. form, c. granularity, d. number, e. reaction of acetic acid.

4. That, in the blood of the insane, a leucocythemic condition frequently exists.

5. That, in many cases, this condition may be more apparent than real, and due to a deficiency in the amount of red discs.

6. That there is no fixed relation between the kind or intensity of the above conditions, and the various forms or phases of mental alienation.

7. That there is, however, a certain relation between these conditions and the physical complications of mental alienation.

8. That these conditions are not peculiar to the insane, but occur in the sane, under similar circumstances of physical disease.

9. That the blood is more altered in the insane than the sane, chiefly in proportion as anæmia, struma, and other physical states, are more common in them.

10. That, contrasting the condition of the blood in the rich insane, with that in the poor insane, it is deteriorated more frequently and to a much greater extent than the former.

11. That this is due, in great measure, to the essential difference in the education and habits in the respective classes ; to the predominance of mental over physical culture in the higher classes ; and to the predominance of physical over mental exercise in the labouring classes.

12. That, contrasting the condition of the blood in various forms of mental alienation, no alterations can be considered peculiar to, or frequent in, any one of these forms.

13. That, contrasting the blood of the insane with that of the sane, any structural alteration in either class is usually due to physical disease.

14. That the physical conditions or diseases, both in sane and insane, in which the above structural alterations most frequently occur, are debilitated states of the system and general vitiation of the blood, resulting from longcontinued and exhausting diseases, e.g., anæmia resulting from phthisis, menorrhagia, or intestinal diseases.-Psychological Journal.

DR PEACOCK ON PLASTIC BRONCHITIS. William Chambers, aged 11, was admitted an out-patient of St Thomas' Hospital, on March 17, 1854. His mother stated that he had always been delicate, and that, when about six years of age, he had an attack of influenza, and had since that time been subject to cough and expectoration. After the attack of influenza, his mother observed that he occasionally spat up pieces of skin, which spread out when put into water. He continued to expectorate this kind of matter for five or six months. In May 1853, he had another similar illness, in which he expectorated solid matter, and continued to do so till the June following:

He has now had the peculiar expectoration since Christmas. He took cold at the end of the year, and had profuse epistaxis. The masses are generally brought up after a hard ringing cough, which comes on in paroxysms and threatens suffocation; but sometimes they are expelled with very little effort. Usually only one portion is spat up at a time, but the expectoration is sometimes repeated every hour or two hours. The paroxysms of coughing are caused by any exertion or excitement, and are relieved by the expulsion of the membranes.

« 이전계속 »