reflex system? Various mineral substances used to be reputed also as oxytocic in their properties, as eagle-stone, &c. Borax has long enjoyed such a reputation. Homberg and La Motte long ago spoke of its oxytocic properties. In the first edition of the Edinburgh Pharmacopoeia, published in 1699, there is given a recipe for a "Pulvis ad Partum," containing borax as its first ingredient. The powder contains, besides, crocus and amber, substances to which oxytocic powers were ascribed in olden times; and two animal ingredients that were endowed with the same properties. Its exact composition consists of Venetian borax, British crocus, the livers of eels dried with their gall, white amber, of each two drachms, and of horses' testicles dried in an oven one ounce. Jecorum cum felle Anguillarum exiccatorum. Succini albissimi ana drachmas duas. Testiculorum Caballinorum in clibano siccatorum unciam unam. This last ingredient is almost a forestalling of the absurd modern therapeutic doctrine of isopathy. And the whole is perhaps not uninteresting as shewing one of the resources officially recommended in tedious labour in Edinburgh practice some hundred and fifty years ago. VITAL CONTRACTIONS IN THE UMBILICAL ARTERIES AND VEINS. It is well known that up to a late period, some physiologists doubted entirely whether the larger arteries of the human body, could be made to contract at individual points by stimulants applied to those points. Few or no satisfactory experiments have yet been published, showing that the veins possess the property of contracting locally under local stimuli. But in the umbilical cord, the medical practitioner may have daily an opportunity of repeating experiments, which prove both of these important physiological facts: viz. the contraction both of the tubes of arteries, and of the tubes of veins, under local stimuli applied to them. For some time past, Dr Simpson has pointed out to his pupils the following facts, regarding the contractility of the umbilical veins and arteries. First. After the child is born, the cord (whether tied or not), is generally seen to become contracted at different points, in consequence of the local contraction at those points of the vessels included within it. In fact, its vessels are thrown, by the irritation of the external atmosphere, and in consequence of their partially empty condition, into tubes consisting of a series of dilatations and contractions, like the peristaltic contractions of the intestine; but with this difference, that the contractions of the vessels are permanent. Secondly. By pinching a portion of the cord, immediately after the birth of the child, between the nails of the thumb and finger, contractions of the vessels of the cord will be seen to occur at the point irritated. And if this mechanical irritation is confined to individual vessels, as to one of the arteries or to the vein, the effect is equally marked. Thirdly. If the sheath of the cord be slit up by a pair of scissors or a knife, with any of its vessels or arteries exposed, the same experiment may be repeated upon the exposed individual vessels with similar effect: viz., that the mechanical pinching of them will be followed in the course of a short time, by a gradual but very marked contraction in the irritated part. Fourthly. Similar local contractions of these vessels occur, under the local application to them of irritating chemical substances, or of electricity. Fifthly. These contractions do not instantly follow the application of the stimulant, but a short time intervenes before the effect is seen, and the contraction is permanent. Sixthly. When the experiment is made upon the human umbilical cord, or upon that of the lower animals, when the circulation is still going on in the ves sels of the cord, the irritated vessel will sometimes almost entirely close its tube under such local irritation. Seventhly. These simple experiments, illustrative of the contractility and irritability of the coats of the veins and arteries, are the more remarkable as seen in the umbilical veins and arteries, in consequence of anatomists not being able to detect any nerves in the umbilical cord; although probably elementary nervous tissue may exist in some form in it. For if it did not exist, then we would have irritability in these vessels existing without nervous influence. And Dr S. proposed the investigation of the existence of nerve in any form in the umbilical cord and its vessels, as an interesting microscopical study, in reference to the physiological question of the dependence or independence of the contractility of vessels on the presence of nerves. VARIETIES. THE MEDICAL PROFESSION AND LIFE ASSURANCE COMPANIES.-We have always regarded the replying to questions respecting the health and constitutions of patients for the information of Insurance Companies, as a troublesome and responsible duty, which ought not to be discharged gratuitously. We have also been of opinion, that the remuneration for this service, whencesoever derived, should proceed directly from the office to the medical man employed. But, while entertaining these sentiments, we have not the less regretted and deprecated the unseemly conflict which has been carried on through the refusal of individual practitioners, to give the information required without a fee. Nothing, in our opinion, could be more calculated to lower the character of the profession than such a course of proceeding; and while sympathising with the feeling of injustice which led to it, so far as to withhold any blame from our brethren who have waged this warfare, we have long deplored the occasion of its origin and continuance. It consequently gives us great pleasure to learn that the Colleges of Physicians and Surgeons of Edinburgh have taken up the matter, and brought their influence to bear on the refractory Insurance Companies. There can be no more legitimate and praiseworthy exercise of the power which such bodies possess on the public mind, than their interference under the present existing circumstances, and we entertain not the slightest doubt that before twelve months have expired, every office in Scotland will have complied with the reasonable remonstrances of our profession. The Standard Insurance Company, which now transacts about the largest business in Scotland, and is second in this respect to only one in England, has lately made the concession, which we trust will soon be general. The Scottish Equitable had previously led the way. In connection with this subject, a Life Assurance Company, under the title of the "New Equitable," which has lately been instituted in London, appears to require notice, since, under the insidious pretext of recognising the claims of medical men, it appears singularly calculated to lower the tone of feeling which should exist in our profession. A circular issued by the directors and addressed to all legally qualified medical practitioners, which now lies before us, holds out a series of pecuniary temptations for connecting themselves, directly or through the medium of their patients, with the office. In the first place, they are to have two guineas instead of the one, hitherto considered sufficient for a medical report; then they are to have 10 per cent. down, and 5 per cent. annually, on the amount of policies obtained through their recommendation; and lastly, they have it in their power to take shares in the concern, so as to derive a further profit from their exertions in its support. It is well-known that medical practitioners are apt to acquire, in a remarkable degree, the confidence of their patients, in regard to other matters than those strictly belonging to the field of practice, and it is much to the credit of our brethren, that the opportunities so acquired have so seldom been used for their own advantage. But it seems to us that the various baits held out by the so-called "New Equitable" Company are cunningly devised to excite the feeling of cupidity, which has happily been dormant, and may have the effect of suggesting counsel not directed solely with a view to the patients' advantage. Under these impressions, we shall watch the proceedings of this Company with extreme suspicion, and in the meantime beg to raise a warning voice against too ready confidence in its plausible schemes. STATISTICS OF INFLAMMATION. HINTS FOR VISITORS TO THE GREAT EXHIBITION. During seventeen years, ending with 1849, there have occurred in London 11,305 fires, great and small; 451 houses have been totally destroyed, 3,335 have been considerably damaged, and 342 lives have been lost. Of the total number of fires, 3,584 have happened in private houses, 967 in lodging-houses, 579 in victualling-houses, 83 in hotels and club-houses, 74 in eating-houses, and 34 in churches. A stranger is certain to be burnt out once every three years who may be quartered with a lucifer match-maker, and once every six years if he inhabits a lodging-house. Even an unoccupied tenement is not so snug as it might seem, 4 or 5 being burnt annually. Nay, a man is not quite secure at the water-works, one fire having happened there, "which did serious damage." He is as safe indeed at a milliner's or dressmaker's, among whom there has been only one fire in seventeen years. But the safest berth of all is a china-shop,—no such establishment appearing in Mr Braidwood's list. Among the causes of fires in private houses, the most prolific are candles, curtains, bad flues, and tobacco smoking; the cat accounts for 9, the dog for 1, children for 61, old age for 1, drunkards for 19, smokers for 18, carelessness for only 10; 2 fires are traced to "airing beds," 5 to "reading in bed," 2 to "bug-hunting." Whence it follows, that in London, at a time when people should be sleeping, for every five persons who read in bed, there are two hunting bugs.-Abstract of Statistics of London Fires in the Assurance Magazine, No. 2. PUBLICATIONS RECEIVED. Pharmacopoeia Collegii Regalis Medicorum On the Medicinal Springs of Harrowgate. 1851. Practical Treatise on the Diseases of the The Prescriber's Pharmacopoeia, containing By On Syphilitic Eruptions, with Especial Re- Giornale Oftalmologico Egiziano del Dr On the Cure of Popliteal Aneurism by Pres- Practical Analysis of Seventy Cases of Inflammatory, Functional, and Structural Disease of the Heart, with Observations on the Treatment and Prevention. By S. Scott Alison, M.D. (Reprinted from London Journal of Medicine.) London: Churchill. 1851. We beg to inform our readers, that the paper by Mr Syme at p. 401 of our present No. was printed before we received the statement by Mr Miller, which will be found at p. 456. Part First. ORIGINAL COMMUNICATIONS, ARTICLE I.-The Treatment of Erysipelas by the Muriated Tincture of Iron. By G. HAMILTON BELL, Surgeon, F.R.C.S.E. With Additional Remarks and Cases, by CHARLES BELL, M.D., F.R.C.P.E. (Read before the Medico-Chirurgical Society of Edinburgh, April 16th 1851.) Ir will be generally admitted that practical observations on the treatment of diseases of daily occurrence are more valuable to the medical practitioner than the most interesting descriptions of anomalous cases, however extraordinary in their character, or successful in their treatment. I am convinced, indeed, that the publication of the journals of well employed medical men, giving in detail the treatment of every case occurring in their private practice, would prove most useful to the young practitioner, and be a valuable contribution to our medical literature. In furtherance of such views, I am anxious to bring to the knowledge of my professional brethren a mode of treating erysipelas, differing from that usually resorted to, but which I have found invariably successful. I have no intention, however, of writing a treatise on a disease so well known, and on which so much has been recently published, because I think my object will be fully attained by reporting a few cases from my own journals, illustrative of my experience, to which will be added some cases of my brother's, Dr Charles Bell, who has adopted the same treatment in this disease. My purpose then being purely practical, it would be out of place to premise with a disquisition on the nature and causes of inflammation; but in order to explain in some measure the principle by which I have been actuated in employing a powerful tonic in a disease generally occasioning so much fever and cerebral excitement as erysipelas, I consider it necessary to repeat the opinion I have elsewhere expressed, viz., that "in inflammation, the capillary vessels having apparently lost the power of separating or electing the component parts of the blood which are necessary for functional purposes, and become to a certain extent inert tubes, a stream of blood is admitted, NEW SERIES.-NO. XVIII. JUNE 1851. 3 s for the circulation of which they are not calculated." In other words, I consider that in erysipelas the capillary vessels are in an atonic state. This hypothesis appears to me to be supported by the effect of the treatment I have adopted in erysipelas,-the cases demonstrating that when an extensive portion of the surface of the body is violently inflamed, producing a high degree of fever and cerebral excitement; on the system being rapidly surcharged with, or brought under the influence of, the muriated tincture of iron, while the cerebral affection and other symptoms of fever subside, the local pain is relieved, and the redness and swelling gradually disappear; and, so far as the tonic medicine appears to be concerned, all this is effected without any appreciable evacuation from the emunctories of the system. But refraining from theory or speculation, and in the hope that I shall lead to the general adoption of the practice I have suggested, and which I shall illustrate by a few cases, I shall proceed at once to state shortly the mode of treatment I have resorted to, in every case of erysipelas I have attended for upwards of a quarter of a century, without having in a single instance failed of success. I have found that my remedy is not only effectual in removing erysipelas, but that it generally renders the patient more healthy and robust than before the attack of the disease; and in no instance in which I have had the charge from the commencement of the disease has suppuration taken place. I have for a series of years pressed privately on the attention of the senior members of the profession the value of this remedy in the treatment of this always troublesome and often fatal disease; and I have taught many of my junior brethren successfully to combat it. But my prolonged experience of the invariable success of my practice justifies me, I think, in thus bringing it to the notice of the profession generally, trusting that, in the hands of others, it may prove as great a blessing as it has in mine. Mode of administering the remedy. Of course the first object is to have the bowels freely acted on. If the erysipelas be mild, fifteen drops of the muriated tincture of iron are administered in water every two hours until the disease is completely removed. When the attack threatens to be more severe, the dose of the tincture is increased to twenty-five drops every two hours, and persevered in night and day, however high the fever and delirium. The only local applications I ever find necessary, are hair powder and cotton wadding. While I depend for the removal of the disease on the chalybeate, it is necessary that the bowels should be attended to throughout the treatment. Cases. I. 25th December 1832.-Mrs Naughton, a poor woman, about 60 years of age, of broken constitution, and having what is vulgarly called "shaking palsy"-a state of continuous chorea had been suffering from erysipelas some days, and I was called to see her late at night. I found her head entirely covered with erysipelas; she was 1 Treatise on Diseases of the Liver, p. 5. |