페이지 이미지

treated, were all cured in periods varying from 3 to 22 days, and on an average, by, from 2 to 7 applications.

4th. Concentrated Solution of Tannin.-A strong solution of tannin, in distilled water (100 grammes of each), applied directly to the inflamed vaginal mucus membrane, was found to be the best of all the modes of treatment. The solution thus obtained was a viscous liquid, and its application caused no pain or uneasiness. Twenty-eight patients treated by means of it were cured in an average period of 26 days, and after 6 or 7 applications.

Messrs Becquerel and Rodier recommend this latter mode of treatment as the best for the affection, being as speedy, and less painful than that by means of solid nitras argenti.-L'Union Médicale, 18th January

TWINS BORN AT AN INTERVAL OF FORTY DAYS. A healthy primiparous woman, æt. 24, who had always menstruated regularly, gave birth, after a short and natural labour, to a completely developed, but rather puny child, which died of catarrh when it was eight days old. The placenta came away naturally, an hour after the birth of the child. Some hours afterwards she attended to household duties. The abdomen was only partially diminished in size ; active fætal movements were felt by the patient; and there was no lochial discharge, no lacteal secretion, and no milk feyer.

Nothing particular occurred until the fortieth day after the birth of the child, when another infant was born, which, though feeble like the first, had evidently reached the full period of its development. The lochial discharge, and secretion of milk then became established.-Gaz. de Hôpitaux, 5th Dec. 1854.


THE REMEDIES RECENTLY PROPOSED FOR ITS CURE. In Henke's Zeitschrift für die Staatsarznei Kunde, (Hft. I. 1854), Dr Bierbaum, has recently published a lengthy paper on this subject, which contains much valuable information on the relative prevalence of this affection among certain kinds of artizans. There are two great classes of men very liable to the lead disease, viz., · 1st. Those who are engaged in obtaining the metal, and in manufacturing its preparations.

2d. Those who use lead and its compounds for industrial and artistic purposes.

Among the first class are, a, the miners who dig the ore, and the foundrymen who fuse it thereafter; both are very often martyrs to the affection. b, Also those engaged in the fabrication of leaden articles. Tanquerel des Planches, found that 406 out of 1213 cases of lead poisoning occurred in individuals thus employed. c, Those who work among salts of lead, as cinnabar, litharge, etc.

In the second class are found, a, Artists. They used to be affected more in former times than they are now, as they were then obliged to grind their own colours in a dry state, and thus they unavoidably inhaled the dust. b, Heraldic and decorative painters, are not very subject to the disease. Among 1213 cases, 33 were decorative painters. (Tanquerel des Planches), C, Varnishers of carriages and metal are very often thus affected. d, Manufacturers of pottery and earthenware, and porcelain, are also liable on account of the salts of lead used for the process of enamelling. e, Artizans in glass works are not very liable to the disease, although the oxide of lead is used to facilitate the vitrefying process. f, Manufacturers of cards and fancy paper are also not much affected, al

1 Tannin and gallic acid are peculiarly soluble in glycerine. A solution of either in this fluid would form an admirable and elegant preparation for use in such cases.- Translator.

though they use the preparations of lead very extensively. 9, Typefounders, compositors, and printers, as also, h, tinsmiths, etc. are very little subject to it. i, Lapidaries are not very much affected by lead colic, for although the stona are subjected to the friction of a leaden wheel, the particles of the metal liber ated thereby are not inhaled, as the stones are covered with water and ener; powder during the process. Tanquerel des Planches found 35 cases anos 1213 of lead disease occurring among lapidaries. j, Copper and bronze founders are occasionally affected on account of the lead which is mixed with these metak k, Workmen in shot manufactories contract lead disease occasionally. De Planches found 11 cases out of 1213 among those employed in such works. CIILOROFORM AND IODIDE OF POTASSIUM FOR THE TREATMENT OF LEAD

POISONING. I. Chloroform.- This remedy is recommended by M. Aran, Physician to the Hópital St Antoine, in Paris. He has just published a somewhat lengthy paper on its use, in which he gives some very interesting illustrative cases. One ar these occurred in a house painter, æt. 31, who was affected with lead colic for the second time, after having followed his trade for twenty years. There was obstinate constipation, bilious vomiting, pain in the epigastrium, tormina, scanty urine, and a very slow pulse-only 48. A compress, on which nearly a drachm of chloroform had been poured, was placed on the umbilical region, and 18 tained there for several minutes. In spite of the sensation of heat and burning occasioned, immediate relief was experienced by the patient. In addition to this a sulphureous bath was ordered; a mixture containing 30 drops of chlors, form was administered ; and a domestic enema was prescribed, to be followed by a small clyster, with 20 drops of the anæsthetic in it. This treatment as continued for a week with great benefit, the chloroform being given morning and evening; and 16 days after admission the patient was discharged cured. Rather an interesting incident occurred in this man's case—he swallowed one day, by mistake, nearly an ounce (30 grammes) of chloroform. Symptoms narcotic poisoning appeared, but the patient recovered satisfactorily. Severa other cases are given in which the same treatment proved very efficacious....

M. Aran says that the compress saturated with the chloroform should be covered with dry compresses, and that it should be allowed to remain in contacs with the skin from 2 to 5 minutes. After the preliminary large doses the following mixture should be used, R chloroformi gtt. 20-50; gum, tragacap 3j ; syr. simplic. Zj; aguce züj:-misce. Dose:-a tea-spoonful frequently. ? gives the following formula for the chloroform enema:-R chloroformi glise 20-50; gum. tragacanth zij; ov, vitelli. j ; aquce ziv. misce.

The patient should be desired to endeavour to retain this enema as long as possible.-L'Union Méd., 4th, 6th, and 13th Jan. 1855.

II. lodide of Potassium.-It has been asserted by MM. Natalis Guillot an Melsens that the administration of the iodide of potassium is the best means for ridding the system of lead and mercury, inasmuch as the insoluble cow pounds which the salts of these metals form with organic substances, are soluble in the iodide of potassium, which is a salt very easily and rapion eliminated from the animal economy. Mialhe denied these assertions, which were foundled on experiments made on dogs. M. Malherbe, chief physician the Hôtel-Dieu at Nantes, has recently tried the drug in some cases of lea poisoning, with great benefit. He never gave more than 15 grains daily, bu often much less. His experience of the remedy has not been sufficiently tensive to enable him to arrive at definite conclusions; but he thinks, from te trials he has made of it, that the following deductions are warrantable :..1st, In lead poisoning elimination of the metal takes place naturally by.me, of the urinary organs, which is probably due to the influence of the alka! chlorides contained in the animal Auids, as has been thought by M. Mial But this eliminatire process is not sufficiently rapid to produce a spontane cure of lead poisoning.


2d, This elimination of lead by the urine is rendered much more active by the use of the iodide of potassium; the excretion of the phosphates by this channel is also considerably increased; and these salts yield an insoluble residue which contains the greater part of the eliminated lead.

3d, Although lead is not naturally eliminated by the saliva, the iodide of potassium seems capable of occasioning its discharge through this medium

Malherbe gives the following rules for the rational treatment of lead poisoning, in which he has arranged the remedies according to their relative importance, and not in the order in which they should be administered, which must necessarily vary in different cases. The indications are :

1st, To eliminate the lead contained in the economy by means of iodide of potassium, which should be administered methodically, and should be given as long as the urine and the saliva give the reactions of the metal.

2d, To cleanse the cutaneous surface by means of sulphureous and soap and water baths; and to purify the mucous surfaces by the internal use of the preparations of sulphur and by purgatives. The latter medicines, by inducing abundant bilious evacuations, doubtless eliminate a part of the lead contained in the liver, but they cannot reach those portions of the metal which are combined with the tissues of other organs.

3d, To calm hyperästhesia and nervous symptoms in general (as epilepsy, delirium, convulsions, coma), by narcotics, and especially by belladonna, which, in addition to its sedative properties, is possessed of a cathartic action which often renders the employment of purgatives unnecessary.

4th, To combat paralysis by means of strychnia and electricity.--Gaz. des Hopitaux, 21st Dec. 1854. DR FRAZER ON THE RECOGNITION OF VEGETABLE POISONS BY THE AID OF THE

MICROSCOPE. Considerable practical difficulties exist in the medical investigation of fatal instances of poisoning, and the detection of the deleterious substance which has been employed, even when it chances to be one of our well-known ordinary chemical agents which are most easily recognized, is a problem that requires considerable skill in the details of analytic chemistry, and often slow and tiresome operative manipulation ; still, thanks to the present state of chemical knowledge, it is a question which may be solved by any one who exercises adequate care and enjoys an average extent of practical dexterity, and at the same time, with so much certainty, that its accomplishment removes the possibility of error, leaving not the shadow of a doubt on the mind as to the exact nature of the poison itself.

It is, however, a very different matter when vegetable poisons have been the source of mischief ; owing their activity to varied proximate principles, many of which are as yet obscurely known and difficult to recognize, even when isolated, by the aid of chemical agents, they are almost completely beyond the reach of our recognition if absorbed into the system, and we are, under such circumstances, usually obliged to rest satisfied with whatever accidental information can be obtained from circumstantial evidence, or to confess that whilst Degative results demonstrate the absence of chemical substances, our positive information extends no farther than of stating that some vegetable possessing dangerous properties has been the cause of death.

Now we meet, although not very frequently, with instances of the latter form of poisoning, in which, usually as the result of accident, some of our ordinary indigenous plants have caused deleterious, and perhaps, fatal effects; such for instance, as the ænanthe crocata (which seeins pre-eminently to deserve the rank of the most dangerous of our native flora), or the other poisonous umbelliferæ ; or of the solanaceæ, as belladonna, which appears to cause more frequent accidents in England than with us, probably from its greater abundance; or the ranunculaceæ, as aconite, etc.; and in all these, and similar poisons, our test tubes and reagents appear to be as yet almost powerless in

detecting their presence. In such cases I would propose, that, aided by t2, history and symptoms, an aid of which we always avail ourselves in other forms of poisoning, the microscope be employed in their investigation; the most certain way, I believe, to accomplish this result, especially for the not very intimately acyuainted with the peculiar differential characters of the plants, is to compare whatever vegetable fragments may be ejected by Tom during life, or found in the body after death, with some recent specimens e those vegetables which are most suspected to have been the cause of the accide I have satisfied myself in this manner that the leaves, especially of aconte henbane, foxglove, belladonna, and several other of our indigenous poisondes plants, can be easily recognized, and that they present distinctive characten adequate to establish ample ground for their discrimination.

The point in such an investigation, which we require to determine in the first instance, is identically similar to the first step in deciding on the nature of a botanical specimen ; if the specimen consists altogether of cellular tissue, it is to be classed as one of the " cellulares," and possibly may prove to be some of the poisonous fungi; should it, however, yield us distinct evidence of *** cular tissue, thus demonstrating its more exalted place in the botanist's start matic arrangements, in that case we will have as our next duty, supposing," is a fragment of leaf which we are examining, to decide on the nature of the venation, which at once points out whether it constituted & portion di exogenous or of an endogenous plant, the latter having the well-known pardie venation, and the former presenting an equalled distinctive reticulated arno, ment. Having advanced so far, we then have four other points, at least, i aiding our further identification of its source.

1st. The presence or absence of hairs, their relative abundance on the uppe. or under surface of the leaf, and their shape, composition, and arrangemen

2d. The appearance of the epiderm on the upper surface of the form of the cells of which it is composed, the existence or non-existed stomata, and if they are present, their shape, size, and disposition in the epi

3d. Similar observations on the epiderm upon the under surface of th

4th. The disposition of the parenchyma of the leaf, the development various crystalline matter (raphides) in this tissue, and their form when they exist.

An agreement in these four points, with corresponding appearances recent specimen, would, I conceive, afford more than an equivalent to degree of moral certainty which is now derived from a chemical analysis mineral poison, and I can readily understand, with the scientific aids now our disposal, that just as the chemist is able to place securely in a seal and exhibit before the court sublimates of arsenic and mercury as un evidences of his analytic skill, so the microscopic observer might prod corroborate his testimony, accurate drawings of the fragments of a po! plant, printed by solar light, as photographs, or more slowly obtained with aid of a pencil and camera. I have myself made, during my investige on this subject, a number of rough sketches in the latter manner, oft pearances presented by several of our ordinary vegetable poisons, but the so easily identified by the method I have attempted to describe that I neet dwell further upon them.-Dublin Hospital Gazette.

might produce, to

dant disease of the

THERAPEUTICAL NOTES. X. I. GALLIC ACID IN Pyrosis.--Dr Bayes says that in pyrosis, where this decimo

is unaccompanied by extensive ulceration, or organic malignant diseas stomach, or by disease of the liver, the most marked benefit will follow of the remedy. Gallic acid, here, not only checks the secretion with tainty and rapidity he has never seen follow the administration of any. remedy, but it gives general tone to the stomach, increases the apperitoniski(what I very little expected when I first used it) in many cases removes

tion with a cer. fon of any other

removes consti

pation. This I can only account for on the supposition that the relaxed atonic state of the stomach which favours pyrosis is continued throughout the alimentary canal, the constipation in these cases arising from want of power in the muscular coats of the intestines to expel the fæces. This want of tonicity is remedied by gallic acid.--Association Med. Journ.

II. Cod-LIVER OIL WITH QUINA.-Mr Bastick gives the following account of his mode of preparing this medicine:—The oleum morrhuc cum quinâ is simply a perfect solution of quinine in cod-liver oil. The quantity of quinine may be varied according to the wish of the prescriber, although it is generally employed in the proportion of two grains to each ounce of the oil. This preparation is best made in the following manner : The requisite quantity of disulphate of quinine is dissolved in distilled water, with the aid of a little dilute sulphuric acid. The quinine is precipitated from its solution by means of an alkaline carbonate ; the precipitate is treated with boiling alcohol; the resulting alcoholic solution, after being filtered, is evaporated to dryness. The residue, which is pure quinine, is then added to the cod-liver oil, and the mix, ture is heated in a water-bath until solution is completely effected, which is known by the oil becoming perfectly transparent. -Lancet.

III. LIEBIG'S ALBUMINOUS Soup. This soup may justly be considered a valuable therapeutic agent; it is prepared in the following manner :- Take half & pound of fresh meat, beef or fowl; wash it; then place it in a pint of distilled water, containing four drops of hydrochloric acid and about thirty grains of common salt, and leave it to macerate during one hour. After this, turn out the whole mass and strain through a linen cloth, repeating the process for the first portions of the soup, which are never clear; when the liquid has all passed through, wash the meat with distilled water to obtain a pint of soup. A cupful of this will be a nourishing dose for an invalid; it should be kept in a cool place.Bulletin Therapeutique.

VI. COLLODION IN HYDROCELE. --Dr Malik has published a case, in which a child was born with hydrocele of the left tunica vaginalis. Diuretics and local firictions were tried without success. Compression, by means of adhesive plaster, was resorted to, but irritation of the skin was produced without any diminution of the tumour. It was resolved to try collodion. The repeated application of this substance appeared to cause considerable pain ; the child cried a deal, and slept ill ; but there was no fever, or functional disturbance induced. In a few days notable diminution of the tumour was observed, so the application of the collodion was continued. The child gradually became habituated to the constriction occasioned by the collodion, and was not much annoyed by it. At the end of a month, the little patient was completely cured, no trace of a hydrocele remaining.–Prag. Vierteljahrsch. Bd. 38.

V. APPLICATION OF THE NITRATE OF SILVER FOR THE CURE OF PROLAPSUS Ani, under the care of Mr Lloyd in St Bartholomew's hospital. The plan is to smear the whole surface of the protruded bowel with solid caustic, and then return it. The application is repeated once in a week or fortnight, as may be requisite. Mr Lloyd states that he rarely found it necessary to employ it more than three or four times ; and further, that although the plan had been one invariable resort with him, for a long series of years, that he had never known any untoward consequences to result. In cases in which the protruded bowel has become swollen, and is difficult of reduction, the effect of the caustic is surprising. In one such case, the mass could be easily seen to diminish in size under its influence. Mr Lloyd does not limit the use of this remedy solely to prolapsus, but adopts it also in cases of hæmorrhoidal congestion, and thickening of the mucous membrane about the verge of the anus.-Med. Times.

VI. PHOSPHATE OF LIME.-Dr Kuchenmeister recommends the following for. NEW SERIES.-NO. IV. APRIL 1855.

2 x

« 이전계속 »