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nausea and other incipient symptoms of poisoning showing themselves.
Many curious remarks of authors on foxglove, which will repay perusal, are brought to light in their valuable summary of prior observations on the employment of the galenical preparations of the plant. Among these, none is more remarkable than the following statement of Professor Cruveilhier :-“ Alibert has formally denied the curative properties of foxglove in dropsies; and the judgment pronounced by this physician appears to have been generally adopted without appeal. This decision, however, is too absolute,” etc. How are we to account for this marvellous error, discreditable to medicine-discreditable above all to an author on materia medica ? The general sense of physicians in Britain has long since assigned to fosglove the first place among diuretics in the treatment of general dropsies; and for myself, I can confidently say that I have very seldom indeed obtained success in such dropsies from other diuretics, when foxglove failed. The probability is, that Alibert never found out how to use this singular remedy. It is plain that various authors and experimentalists quoted by MM. Ilomolle and Quevenne have also not known how to give it as a diuretic; for they have evidently aimed, in using both foxglove and digitaline, at exciting its action on the heart. But several others among them have gone very near to the enunciation of the proposition that diuresis is not produced in such circumstances. MM. Andral and Lemaistre, for example, have stated in their account of some trials with digitaline, that, “in every case, the diuretic action was invariably consecutive to the influence on the heart.” By this I understand that it did not take place until the influence on the heart passed off. At all events the prior establishment of the action on the heart is most assuredly not a condition for inducing diuresis, but on the contrary, in my own observation at least, positively interferes with it, must pass off before diuresis occurs, and may prevent it altogether. In 1832 I taught, in my first lectures on materia medica, that the two actions are probably incompatible; and I have repeated this opinion annually since then. I have seen no reason at any time to doubt the fact; which first occurred to me when a pupil at St Bartholomew's Hospital in London in 1821, on observing some remarkable cases treated by the late Dr Powell. The question is evidently a very important one to settle, both on account of its pure practical bearings, and likewise because, if settled as I anticipate it will be, it will explain the strange contrariety of opinion among reputable authors as to the merits of foxglove, and thus relieve medicine in this point from what may well be urged against it at present as a reproach.
2. On Preserved Meat-Juice. : About eighteen months ago, when consulted in the case of a relative of Mr Gillon, the extensive and skilful manufacturer of pre
refused, I Wasch, it was taken weggestion. Obsero
served meats at Leith, I found that the patient was entirely supported, in a severe illness, by the Preserved Juice of Meat, which had been given at Mr Gillon's suggestion. Observing the readiness with which it was taken when other food of every kind was refused, I was induced to try it in other instances, and eventually to employ it in various states of disease. The results led me to suggest the use of it to many professional friends, and to advise the druggists of Edinburgh to keep it; so that it is now much in request, and may be easily obtained.
This substance is the pure juice of beef, preserved in the way in which meats and vegetables are now so extensively preserved in the fresh state, for store provisions. The mode of preparation is as follows: Cylindrical cases of tinned iron are filled each with six pounds and a half of beef; and the lid is soldered on, but with a hole about half an inch in diameter in the middle of it. Two trays of such cases are shoved into iron retorts, analogous in form to retorts for gas-making, but double-cased, so that steam may be introduced into the interstice around. They are thus subjected to a heat of 220° under steam pressure, for about three hours; by which the beef is partially cooked, and, being thus also made to contract strongly on itself, squeezes out a portion of its juice, amounting to a few ounces from each tin. The tins are then drawn, the juice is poured out, and the meat, with certain additions, is subjected to the preservative process. The juice, after being cooled and entirely freed of fat, is put into small four-ounce tin cases. Each of these has a small aperture at one end, which is secured with solder, after the juice is poured in. The tins are then subjected, on trays, to a temperature of 220° in a muriate of lime bath. On being removed, the solderer rapidly touches with his iron the solder on the top, which giving way allows steam to rush out forcibly and carry with it the air in the upper part of the interior. By the time he has thus swiftly passed over sixteen or twenty tins, the first is ready for being re-soldered by a similar dexterous application of his iron, which then in succession as quickly secures the whole open and steaming apertures. The process of heating in the bath, tapping, and re-soldering, is then repeated a second time, to make sure of the thorough expulsion of every particle of air. The tins finally are painted to preserve them against rust.
The process is most perfect. I have repeatedly opened tins eighteen months in my possession, and stated to have been many months in store when I got them, and in every instance the contents had the rich delicate aroma and taste of fresh beef-juice. Sometimes the taste is slightly resinous or soapy, in consequence of a little resin having obtained admission in the operation of soldering. But as this does not occur often, the impurity may be avoided with due care. The juice may be taken with relish in small quantity, either cold or warm, in its concentrated shape; but it is rather strong to be used without dilution. When diluted with three times its volume of boiling water, and duly seasoned with salt and pepper, it makes a more palatable beef-tea than any which can be made in the usual way. Sometimes, indeed, a patient will be found to prefer the ordinary sort, either because the preserved juice has unluckily been resinous, or on the principle that leads some people from the plains of England to prefer hard water to the pure mountain springs of the primitive districts of Scotland, viz., because they are not accustomed to the finer sort. But this is not the general fact; and there can be no doubt that the preserved meat-juice makes a most palatable beef-tea, and an equally eligible basis for many soups.
Until about ten years ago, in concurrence with general opinion, I used to regard beef-tea as a highly nutritive article, not to be rashly or freely given during disease. My sentiments in this respect were shaken, when I ascertained, in the course of some experiments for adjusting the dietaries of the General Prison and the Royal Infirmary, that a pint of the very finest beef-tea contained scarcely a quarter of an ounce of any thing but water. Since that time I have much more readily listened to the cravings of patients for beef-tea in even many acute diseases, and above all in protracted subacute diseases, and in chronic diseases with fever; and I have thought I saw that it maintains the strength almost like wine, lessens emaciation and weakness in tedious diseases, and does not occasion any increase of reaction. There is no disease in which these properties are more remarkably shown than in protracted cases of gastric fever, of which, by the way, I have seen an unusual number both in town and country during the last three years. These cases have often lasted for six weeks, or,—with a relapse, from too early indulgence or exposure,- for the long term of three months nearly ; during which little, or absolutely nothing else, was taken, except beef-tea or diluted meat-juice; and without the attenuation and debility which so protracted a fever and want of appetite ought to have induced. In some instances I could scarcely doubt that life was preserved by this nutriment. It is unnecessary to particularise the various states of disease in which the same practice has been followed. It is peculiarly applicable to all subacute protracted diseases, whether febrile or otherwise ; and in all such there is even no great reason to hesitate in resorting to it when local inflammation is present. Every one, I think, will be struck with the readiness with which such patients will often take diluted meat-juice or beef-tea repeatedly when they refuse all other kinds of food. It should be given in the quantity of a teacupful at a time, every four or six hours ; but it is well to alternate it with other simple nourishment, when the patient will consent to do so.
What is its mode of action ? Not simply nutrient. A quarter of an ounce of the most nutritive material cannot nearly replace the daily wear and tear of the tissues in any circumstances. Possibly it belongs to a new denomination of remedies, whose action never was even suspected to exist until recently- those which, by some peculiar influence, diminish the waste of the tissues under the exercise of their functions. Professor Lehmann has proved [Annalen der Chemie, 1853] that coffee possesses this singular property in so remarkable a degree, that in persons following an active occupation an infusion of an ounce of roasted coffee daily will reduce the daily waste by a fourth part; and the same property seems likewise to belong to tea, and other restorative beverages. It is not improbable that the sapid and saline principles of meat, united in what is called ozmazome, and constituting the ingredients of beef-tea and meatjuice, possess soine such property. It is difficult otherwise to account for the interesting results obtained by the late Dr Edwards in 1833, who, in bis researches on nutrition,-strangely overlooked by the celebrated Gelatin Commission of the French Institute, in their condemnatory report on gelatin in 1841, — found that dogs die slowly if fed on bread and gelatin alone, but, when thus greatly reduced, quickly regain flesh and strength by the addition of two ounces of meat-tea, which cannot appreciably increase their textures by its own insignificant amount of solids. Either it acts as a digestive ferment, so to speak-promoting the assimilation of other nutriment -or, like coffee, it must lessen the waste of the tissues in the exercise of their functions.
Mr Gillon's meat-juice contains only 6 per cent. of solids. As a mere nutrient, therefore, it is much in the same category with beef-tea. Sixteen ounces of beef-tea, made with the contents of one tin, yield only 114 grains of solid extract. It contains no fibrin, no albumen, no gelatin. It does not even gelatinise, on exposure to the air for days : it is ozmazome, with the salts and sapid and odorous principles of meat, and materially different from all boiled extracts.
I should add, that no good beef-tea can be made so cheap as with this preserved meat-juice. A tin of four ounces makes sixteen of strong beef-tea. This much requires, in the ordinary way, a pound of the finest beef, which at present costs ninepence, and is scarcely ever so cheap as sixpence. The reason for the cheapness of Mr Gillon's meat-juice is, that the residual meat is economised, while that of the ordinary cooking process is good for nothing.
It is a much more convenient article for use than any of the extracts made from meat by extemporary processes in the kitchen, or by certain very dubious chemical methods lately come into vogue. It differs materially from all meat-extracts prepared by boiling
i Comptes Rendues, etc. 1841. xiii. 243. 2 Archives Gén. de Med., N. S, i. 313.
NEW SERIES.-.NO. 1. JANUARY 1855.
ARTICLE II. - Contributions to Obstetric Pathology and Practice.
By J. Y. SIMPSON, M.D., F.R.S.E., Professor of Midwifery in the University of Edinburgh, etc., etc.
NO. XIV.-ON THE EXCISION OF LARGE PEDUNCULATED UTERINE
POLYPI; AND ITS ADVANTAGES OVER DELIGATION.
A VARIETY of operative means have been proposed and practised for the removal of uterine polypi, after they have once passed the os uteri and come within the reach of surgical interference. The means usually followed differ according to the size and consistence of the polypus.
In the removal of small and soft uterine polypi of the mucous or cellular type, practitioners employ-l, simple avulsion with proper forceps, or with the fingers; or 2, avulsion by torsion; or 3, compression or crushing of the neck or body of the polypoid growth; or 4, scooping out its attachment with the nail, if the cervix is opened, or with the scraping or gouging instruments invented by Recamier and Dr Locock; and 5, the introduction and application of a stick of potassa fusa inside the os, followed by the free application of vinegar, is sometimes most advantageously had recourse to where, as is often seen in practice, several small, sessile or pediculated polypiformed by dilatation of the Nabothian follicles—are attached to the lips of the os and along the interior of the cavity of the cervix uteri. · In the present communication, however, I wish only to speak of the larger and firmer forms of pediculated uterine polypi. These are usually fibroid or cellulo-fibroid in their structure, and vary from from the size of a small walnut to that of a newborn child's head. In the removal of them one or other of the following operations is generally had recourse to; viz., either,
I. The slow and gradual division of the pedicle of the polypus by
Deligation, or by the constriction of ligatures of silk, catgut,
silver wire, etc., applied by means of various forms of canulæ; or II. The instantaneous division of the pedicle by Excision by the
scissors, scalpel, or bistoury, and the consequent immediate re
moval of the amputated polypus. Some practitioners combine together these two methods-applying deligation first, and then--either immediately or some days subsequently-using excision or resection in addition.
In this country the operation by deligation alone has been the plan usually adopted. “In England (as Dr Ashwell states), the ligature has always had a decided preference.” “British practi
1 Diseases Peculiar to Women, p. 485.