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suggested to bim by a friend who had invented it as a chemists to be those which contain the metal in the remedy for his own sufferings.
state of protoxido; but it has always been found The plan simply consists in returning the bowel, and difficult to preserve the metal in that form from its placing against it a piece of sponge four or five inches great affinity for oxygen. Even in the saccharine long, an inch wide and half an inch thick, rolled upon carbonate of the Edinburgh Pharmacopæia this change itself so as to form a pad. The buttocks are then takes place, and thus prevents the full advantage brought as nearly as possible into apposition, and which had been anticipated by the proposers of that retained in that situation by straps of plaster passed | formula. Dr. Clarke observes that the specimens lengthways from one to the other. By this means a examined by him rarely contained more than from very effectaal support is afforded to the relaxed bowel. fifty to sixty per cent. of real carbonate of the pro. If there is much irritation about the anus the part toxide, and he therefore has endeavoured to improve should be washed with vinegar and water.-Medical | upon the process, by uniting the precipitate as soon as Gazette, February, 1847.
it is formed, with as much sugar as it is capable [We regard this simple contrivance, the effects of of combining with. The details are as follows:which are stated by Dr. Hake to have been equally He first makes a solution of five ounces of carbonate satisfactory in other cases witnessed by himself, as one of soda in twenty-four ounces of water, and adds to of great value, and likely to supersede many more it four ounces of simple syrup; and having previously expensive inventions. The benefit derived from it obtained a pure sulphate of iron, by salphuric acid and might probably be increased by dipping the sponge water with iron wire, he then dissolves four ounces of previous to application in some astringent solution, it in two pints of cold water, and instantly adds the as a decoction of rhatany root, or a weak solution of solution of soda and sugar. The process being connitrate of silver.]
ducted, as in the Edinburgh formula, the whole is ON FISSURES AND EXCORIATIONS OF THE NIPPLE.
thrown on a filter, and the precipitate rapidly mixed
with two ounces of sugar, and dried by exposure to M. Donné (Conseils aux Meres sur l'Allaitement)
air. Dr. Clarke thus gets a preparation containing observes that fissures of the nipple, so frequently
from ninety to ninety-five per cent. pure carbonate of observed in nurses, are not to be deemed solely as an
| iron. inconvenience unconnected with the secretion and qualities of the milk; they have other inconveniences
TOXICOLOGY. beyond the mere pain which they produce. He does not
ON THE TREATMENT OF POISONING BY ACIDS, doubt that they are always related to a defective condition of the lacteal secretions, not less injurious to the
In poisoning by acids, the antidotal treatment alone infant than to the nurse, and in this point of view he
soffices, if applied early. All toxicological writers considers them worthy of every attention. He states
advise the employment of magnesia, the alcaline car. that he has constantly found that women who are
bonates, and soap, but these are not, according to subject to these fissures have a poor quality of milk,
M. Bouchardat, sufficient, and he thinks therefore, that and that it is commonly mixed with mucosities. So
he is entitled to some credit as having laid down a more constant is this connection, that he considers the
definite treatment. fissures the indication, if not the consequences, of
It is well to commence, he observes, with calcined poverty of the milk, of its being deficient in quantity,
| magnesia in excess, but as a portion of the acid and of its difficulty in flowing, which difficulty causes
is absorbed, and tends to destroy life by producing the infant to make violent and injurious efforts on
coagulation of the hlood, it is not enough to have suction. It happens too, that the infant becomes ill
neutralized the acid in tho stomach, but some soluble nourished, and this, according to Donné, causes the
antacid must be given, which may be absorbed, and secretion of an acid saliva, which adds to the mischief.
so neatralize the acid which has reached the blood. [In opposition to this theory of mechanical violence
The best substance to effect that purpose is the bicaras a cause of sore nipples, it may be observed, that
bonate of soda. The author remarks, that it is of Dr. Rossi has noticed that the painful excoriation
importance not to exbibit the soda in the first instance, never appears, even in retracted nipple, where the as the disengagement of the carbonic acid may cause greatest efforts on the part of the child are required. | rupture of the coats of the stomach. unless the infant's mouth presents aphthous ulcerations.
TREATMENT OF ARSENICAL POISONING. He states that he has proved this to be the real cause, by applying children so affected to the bogom of
M. Bussy has demonstrated that magnesia forms an healthy women, when fissures of the nipple have been
insoluble compound with arsenious acid and may the result.Ranking's Abstract, vol. ii., p. 294.]
therefore be employed as an antidote to that poison.
The treatment recommended by Bouchardat is the MATERIA MEDICA.
following:ON THE PREPARATIONS OF IRON.
After having produced vomiting, give the hydrated Dr. Clarke (Dublin Medical Press, Jan. 27th,) has peroxide of iron in excess, in combination with magpublished a communication, in which he gives a | Desia. If there be prostration of the vital powers, the formula for producing a better preparation of carbonate surface is to be stimulated by sinapisms, frictions, of iron than has hitherto been adopted. The most warmıh, &c. Finally, the expulsion of the poison is active preparations of iron have been determined by I to be facilitated by purgatives and diuretics.
ANECDOTES OF THE MEDICAL PROFESSION.
TREATMENT OF POISOING BY LEAD.
ship. Hopeful, in gratitude for his efficient help in a There are three circumstances to be considered in case of great distress to the monarch. It seems that lead poisoning :
in the year 1636, (!)* (a very early period of our direct 1. The treatment of poisoning by the salts of lead intercourse with India, after the Portuguese had disin large doses.
covered the passage thither by the Cape of Good 2. The treatment of slow poisoning by the salts of Hope,) one of the princesses of the Great Mogul's lead.
family had been burnt dreadfully by accident, and 3. The prophylactic treatment.
that a messenger was sent to Surat, where foreign The antidote most relied upon by Bouchardat for traders resorted, to desire the assistance of one of the the falfilment of the first indication is the hydrated English surgeons there, for they had acquired a great persulphuret of iron given in excess, mixed with syrup. reputation amongst the natives for their skill in the Vomiting and purging may be solicited by large doses care of diseases. Gabriel Boughton proceeded forth. of croton oil. (The second and third indications are with to Delhi, and was successful in performing a care not touched upon.]
on which the Great Mogul's minister asked him what, TREATMENT OF POISONING 'BY OPIUM AND ITS
bis master could do for him to manifest bis gratitude
for so important a service? Gabriel answered with a PREPARATIONS.
disinterestedness,-a generosity,-a patriotism beyond 1. Empty the stomach by emetics or the stomach.
any praise, “Let my nation trade with yours.” “Be it pump.
so." A portion of the coast was marked out for the 2. Give a solution of the iodide of potassium.
future resort of English ships, and all duties were 3. Give strong coffee, without sugar. The proportions
compromised for a small sum of money.t A better recommended by Bouchardat are, an ounce and a half
station, it is true, was selected at the mouth of the of coffee to half a pint of water, to which is added
Hooghly riser some twenty years afterwards, and brandy, half an ounce.- Annuaire de Therapeutique
Calcutta was built; but here was the first establishment 1847.
of our power. Here did the civilization of that vast POISONING BY ARSENIC, DATING BACK TEN YEARS : continent begin; from hence the blessed light of the
DETECTION OF ARSENIC IN THE BONES OF THE Gospel may have been first promulgated amongst a SKELETON.
hundred millions of natire idolaters, since subjected A case of poisoning occurred in the village of to the control of British power, and made partakers Scamagne, without the fact having reached the ears of our enlightened comforts."— Sir Henry Halford of justice. Ten years after, certain circumstances “ On some results of successful practice of Physic.” arose which led to the apprehension of four suspected
2.-It has been before remarked how the English persons. A medical enquiry was instituted, and a
were indebted in 1655, to the skill of an English skeleton was discovered, which was recognized as
Doctor for permission to settle at Pipley; in 1713 belonging to the murdered individual, and who, upon
our country was again indebted to its medical skill for the confession of one of the parties implicated, had
further privileges. Mr. Hamilton, a surgeon in the died at the end of twenty-four hours, after having taken
East India Company's service, having accompanied an a large quanlity of arsenic. The skeleton and the
embassy to Delhi, soliciting certain privileges, a pow. remains of the funereal appurtenances were submitted
erful opposition was met in the Mogul's court, and the to chemical analysis, and arsenic was discovered to
embassy were on the point of returning unsuccessful, exist in repeated instances. The source of the poison
when it so happened that the Emperor Ferokshere was was rendered more certain by the fact, that none was
seized with a dangerous illness, which baffled the skill discovered in a skeleton which lay so close to the
of the native physicians. Mr. Hamilton's advice was above, that it was at first mistaken for it.-Cours
solicited, given, and successful. On being desired to d'Assize de la Haute-Vienne.-Gazelte Méd.Janv.,1847.
name his reward, he nobly cast aside private advan. tages, and implored a grant of the objects of the mission,
which were gratefully conceded. Hamilton's remains ANECDOTES OF THE MEDICAL PROFESSION. | rest without a stone to mark the spot in the burial.
[The following anecdotes of the Medical Profession ground at Calcutta, his patriotism and his services are the “ gleanings” of an esteemed member of the
alike unremembered; and although the patives of Provincial Association. They afford a tribute to the
India have been more linked to England in ties of
personal affection, by means of the skill of our surgeons skill, humanity, and disinterestedness which charac.
and physicians, than by any other class of the East terize the genuine medical practitioner, and are here
India Company's servants, they are the worst paid and recorded as an example and encouragement to others to go and do likewise.]
• In 1656 (?) owing to the skill of an English doctor,
(Boughton,) the East India Company received the Mogul's 1.-The anecdote most flattering to the medical
sanction to establish a factory on the right bank of the profession, which I would recall to your remembrance
river Hooghly.-Montgomery Martin's History of the British is, the occasion of the first establishment of the East Colonies, vol. i., p. 4,
“On the payment of three thousand rupees, a governIndia Company's power on the coast of Coromandel,
ment license for an unlimited trade, without payment of which was procured by the favour of the Great Mogul
red by the favour of the Great Mogul customs, in the richest province of lodia, was recorded," to one of our profession, Gabriel Boughton, of the | Mill's British India, vol. i., P. 7'.
most ill-requited officers in the East; their lives are | Mawthil Tearne, Stockton, Worcestershire; Horatio spent in doing good, and old age brings with it little Lillifant, Exeter; Charles Henry Holman, Crediton; to solace but the remembrance of the past. It is to Edward Hancock, Stoko, near Plymouth. be boped that a profession, combining in its exercise, Gentlemen admitted Licentiates, Thursday, March science, extensive knowledge, and christian cbarity, 18th :--Robert Finch, Greenwich; Robert Kemp will soon meet its deserts.--Montgomery Marlin's Buckell, Southampton; George Anstice Knott, Bristol; History of the British Colonies, vol. 1, p. 87.
John Edmund Currey, Essex. (Thero appears considerable discrepancy in the dates. Sir H. Halford says that Gabriel Boughton obtained his permission in 1636_i.e., four years after
OBITUARY. the Great Mogul granted permission to establish a Died, February 27th, at Tripoli, John Dickson, factory at Pipley; and Mr. Martin says, that in 1656, Esq., M.D., Surgeon, on the half-pay of the British owing to Boughton's skill, permission was given to Navy. Dr. Dickson had been resident at Tripoli establish one on the right bank of the Hooghly, and in upwards of thirty years, and such had been the extent allading to this he also says it was in 1655. The of his gratuitous attendance on the indigent, that his discrepancy, however, does not alter the merit of facts decease was looked upon as a great public calamity. 80 creditable to our profession.]
His funeral was escorted by a military guard of
honour, sent by the Pacha, and attended by the 3.-" I was very apxious to procure, if possible, some
Foreiga Consuls, by all the European residents of medical advice for Mysseri, whose illness prevented
every class, and by several thousands of Jews and my departure. Every one of the European practising
Mahomedans. doctors, of whom there had been many, had either! March 16th. at Southampton, aged 28, Julius died or ied; it was said, however, that there was an
Veronge, Esq., M.D., Surgeon of one of the Royal Eoglishman in the medical service of the Pasha, who
West India Mail Packets. quietly remained at his post, but that he never engaged
March 20th, aged 71, Charles Rochement Aikin, in private practice. I determined to try if I could
Esq., of Bloomsbury Square, a Member of the Royal obtain assistance in this quarter. I did not venture
College of Surgeons, and well known for bis scientific at first, and at such a time as this, to ask him to visit a
and practical knowledge of chemistry, servant who was prostrate on the bed of sickness, but March 26th, in Bedford Square, T. Wilkinson King, thinking I might thus gain an opportunity of persuading | Esq., Surgeon, Lecturer on Pathological Anatomy, him to attend Mysseri, I wrote a note mentioning my 1 &c., at Guy's Hospital. own affair of the sore throat, and asking for the benefit of his medical advice. He instantly followed back my messenger, and was at once shown up into my room.
BOOKS RECEIVED. I entreated bim to stand off, telling him fairly how
The Microscopic Anatomy of the Human Body in deeply I was “compromised," and especially by my | Health and Disease. By Arthur Hill Hassall, F.L.S. contact with a person actually ill, and since dead of &c. Part VII. London: Highley. 1847. plague. The generous fellow with a good humoured
" with a good humoured Lecture, introductory to a Course of Clinical laugh at the terrors of the contagionists, marched | Medicine, delivered in the Theatre of Queen's College, straight up to me and forcibly seized my hand, and
Birmingham. By Samuel Wright, M.D., Edin., shook it with manly violence. I felt grateful indeed,
F.R.S.S.A., Physician to the Queen's Hospital, and and swelled with fresh pride of race, because that my | Professor of Clinical Medicine in Queen's College, countryman could carry himself so pobly. He soon
n Birmingham, &c. &c. London: Churchill. 1847. cured Mysseri as well as mo, and all this he did from no
| 8vo., pp. 23. other motives than the pleasure of doing a kindness,
? An Essay on the Nature and Properties of the
An and the delight of braving a danger,''- Cairo and the
Tenbury Mineral Waters. By A. W. Davis, M.D., Plague. Eöthen, p. 314.
London: Whitaker. 1847. pp. 40. (To be continued.)
Mr. W. White Cooper would feel greatly obliged to HEALTH OF TOWNS.
any gentleman who would, from observation, favour Lord Morpeth obtained leave on Tuesday, March | him with the particulars of cases of conical cornea, 30th, porsuant to notice, to bring into the House of together with an abstract of the treatment employed, Commons a Bill for improving the Health of Towns. and the result.
2, Tenterden Street, Hanover Street. SOCIETY OF APOTHECARIES. Gentlemen admitted Licentiates, Thursday, March
TO CORRESPONDENTS. 17th :-John Shepherd Fletcher, Manchester ; Thomas Communications have been received from Mr. F. Oldacres, Market Bosworth ; Thomas Binford Eyre, l Buckill; the Sheffield Medical Society: Dr. J. Yeovil; Nathaniel Best Gill, E. I. Comp. Service ; 1
Campbell; the Birmingham Pathological Society ; George Booker, Dronfield, Derbyshire; Edward |
Booker, Dronfield, Derbyshire; Edward | Mr. Bartrum; Mr. J. E. Wood,
PROVINCIAL MEDICAL & SURGICAL JOURNAL.
A COURSE OF LECTURES ON CLINICAL the touch, and the course of which is marked by a MEDICINE.
dusky red line. It is evidently the saphena major By W. R. BASHAM, M.D., Physician to the Westminster vein in a state of inflammation. The cord-like hardHospital.
ness extends the whole length of the vein, and is lost LECTURE IX.
only as the vessel disappears under the fascia to join Clinical remarks on idiopathic Phlebitis : Record of the the crural. The same condition exists in the saphena
case ; treatment and convalescence ; probable cause of veins of both legs. There is no swelling of the glands the disease ; reasons for thinking it connected with of the groin ; no wound or any abrasion of surface on the rheumatic diathesis.- Pathological conditions of the foot, or any part of the lower extremities. Has the vein in phlebitis : exudation of plastic lymph ; not felt any rigors. The pulse is 84, soft ; the tongue tendency of venous inflammation to centripetal pro- is white and moist; there is no deficiency of appetite; gress.-Changes occurring in the plastic deposit :- no thirst; no febrile heat of skin ; but the urine is 1. Solution and removal.-II. Semi-organization dark coloured, and deposits a copious precipitate of and persistent thickening.--III. Purulent transform- | the pink urates. He has been at work in the cofferation and its serious consequences. Observations on dam at the Houses of Parliament, working often for the treatment.-Cold and rheumatism considered as hours up to his ankles and knees in water. predisposing causes of phlebitis.
He was admitted on the 20th January, and ordered Gentlemen,-Cases of idiopathic phlebitis-inflam- Hydrarg. cum Creta et Puir, Ipecac. Co., utrg., gr. v., mation of the veins occurring spontaneously—are of quartis horis. Beef tea diet, and the lower limbs to be sufficiently rare occurrence to be of some interest to enveloped in hot moist flannels, to be repeatedly you in a course of clinical instruction. On this renewed. On the next day the cord-like tension of the occasion I propose to point out to you the pathological veins liad materially diminished, and much less pain conditions of this disease, the most frequent predis- was felt on pressure. The dusky-red colour now marks posing causes, the general principles of treatment, the course of the veins, from the inner ankle to the together with the ulterior consequences or effects of groin, indicating that some smaller branches, emptying this affection, when existing independently of local into the main trunk, are here and there likewise injury. The case of inflammation of the saphena veins affected. On the 23rd slight ptyalism was noticed, of both legs in a man in Burdett ward will afford me and in the course of the afternoon a brisk diarrhæa this opportunity. The case during its progress, may commenced, which was directed not to be checked have appeared trilling to you, the symptoms being for unless it became urgent. The remedies were to be the most part unaccompanied by pain, or much con- repeated. On the 24th the report states, that after stitutional disturbance, yet, is this condition of the many watery dejections the looseness spontaneously reins, fraught with much possible danger," the chances ceased, and this day no pain was experienced in any of purulent termination being by no means remote, part of the indurated vein, and the dusky-red colour and wbich once established excites conditions of was now confined to the inferior part of the rein. On fearful jeopardy, and rarely exempted fatality
the 25th the cord-like tension was gradually disapThe ward-book reports the case of J. H., a labouring pearing, his general appearance had much improved, man, aged 27, admitted suffering from idiopathic the appetite, wbich bad not been deficient from the phlebitis. The appearance of the patient on admission first, had now become craving, and he was placed on an was that of a man throughly out of health, of some improved diet. On February 1st he was reported conwbat anxious aspect, but not suffering any amount of valescent, and discharged on the 2nd. pain. He states that he has felt a tense cord-like It may be mentioned as remarkable, that a man, sufswelling in both bis legs for the last seven days. There fering from chronic rheumatism, and in Dr. Kingston's is no want of mobility in the lower extremities. He ward, is suffering from a similar condition of the walks and moves about without pain ; but commencing saphena in both limbs. I have no hesitation in referat the internal malleola of both legs, and extendering the origin of this state of the veins to the effect of iog up on the inner edge of the tibia, and between cold. We did not see this patient during the first the edge of the belly of the gastrocnemius, a cord- period of the attack ; we cannot, therefore, determine like swelling is felt, which is slightly painful to the amount or nature of the constitutional disturbance
No. 8, April 21, 1847.
existing at the commencement; at any rate, we are capal, and considerably diminished its capacity-not assured of certain circumstances capable of predis- totally closed it. It is now, irrespective of complete, posing the system to such disturbance. The exposure or only partial, obliteration, that the ressel has of the lower extremities for hours at this season of the acquired that cord or quill-like character to the sense year, to the influence of cold and wet, is not an unlikely of touch, which you felt in this case. The plastic disturbing cause. Had symptoms of rheumatisin co- lymph lining the vein is for the most part colourless; existed with the inflammation of the saphena veins, as it has been derived from the blood, and consequent is the case in the patient in Bouverie ward, there could upon its isolation and deposition there occurs a have been so difficulty in associating this state of the serous infiltration into the outer tunic of the vein, veins with the phlebitis accompanying the rheumatic and not unfrequently extending into the cellalar diathesis, and which has been noticed by more than tissuc investing the vein. This serous fluid holds in one author. Yet, notwithstanding the absence of all solution the hæmapbæin, or colouring matter of the erratic pains, I am still inclined to refer this condition blood; and it is its presence in the serous infiltrated of the veins to a rheumatic origin, the state of the Ruid which causes the dusky-brown red hue that urine presenting all the features of rheumatism, and externally marks the course, extent, and ramifications the exciting causes being in every respect capable of of the inflamed veins. developing most of the conditions and elements of that It may happen that the inflammatory action does disease.
not continue with sufficient intensity completely to Phlebitis from rheumatic causes may be considered plug up the canal of the vein; and I think the case as the lightest form of this most serious malady; it before us presents us with an example. When this differs only from the phlebitis produced by wounds, or happens, the circulation is still imperfectly carried by the absorption of animal septic poisons, in that forward through the centre of the plastic layers; for tliere is less tendency to terminate in purulent forma- | as these layers are invariably thrown out from the tion, a condition that renders these two latter affections lining membrane of the vein, and are added to the of such inomentous importance. The plastic contents circumference of the plug, it follows, that for a time, of the vein in this rheumatic form of phlebitis, either at least, the circulation goes on, the calibre of the dissolve or liquefy; and being thus remored, are car- vein diminishing as each succeeding layer is added to ried away into the general circulating mass, or at most the circumference of the deposit. As a consequence remain as a plug in the vein, becoming seini-organized, of the complete obliteration of the vein, the circulation and either completely or partially obstructing the cir- | is then maintained by the anastomosing veins. culation through the affected vessel, the numerous One of the most important characteristics of venous venous anastomoses subsequently carrying on the cur- inflammation is its tendency to centripetal progress : rent through their enlarged and dilated canals. | it less frequently extends from trunks to branches
When a disease presents distinct external manifesta- than from branches to trunks; and thence progresses tions, it is convenient to consider it-first, in reference towards the heart, the centre of the circulation. This to the local symptoms; and, secondly, as to the is one of the conditions that causes phlebitis to be extent of constitutional disturbance, accompanying or of such vital moment. produced by the local disease. I wish therefore to The subsequent changes that take place in the detail to you-first, the pathological conditions of plastic mass, plugging the channel of the rein, are the infamed vessels, the cord-like tension of which strictly analogous to those observed in inflammatory first arrests our attention; and, secondly, the con- products in other parts of the body. One of three stitutional conditions, if any, produced by the state conditions must happen :of the veins.
1. The fibrinous mass disappears slowly, and It would appear from the pathological researches gradually becoming dissolved, it is carried away by of the most recent observers, that the inner membrane the restored current of the circulation. of the veins in the earliest stage of the inflammatory 2. The lymph becomes semi-organized, and forms process becomes discoloured, of a purplish hue, a permanent addition to the inner parietes of the vein : occasionally of a light scarlet, and that this discolour- this more frequently happens when the plastic layers ation is not uniformly spread over the inflamed portion, have not completely obliterated the channel, but but irregularly-in patches, sonetimes presenting a merely lessened its calibre. When this occurs, tense, striated appearance. Accompanying this alteration in quill-like hardness persists, and a subsequent examinacolour, and as the result of the hyperæmia of the lining tion of the vein would present its walls much thickened, membrane of the vein, is the exudation or deposit of its capacity diminished, and when cut across, the vein plastic lymph, which, forms in layers, each succeeding would remain uncollapsed, and as an open cylinder. layer being deposited external to the last, the whole 3. The third and most serious change to which the being concentrically arranged, till the tube of the inflammatory exudation is exposed, is the special vein becomes completely clogged, and impervious to tendency that it has to pass into suppuration. It is the current of the circulation. It does not, however, this tendency which makes phlebitis at all times so necessarily follow that the vein becomes totally hazardous in its consequences; the blood becomes impervious; for the fibrinous deposits do not always contaminated by the purulent degeneration of the continue till the canal of the vessel has become plastic layers, abscesses in different organs of the body, obliterated. The inflammatory process being arrested, the liver, lungs, and other glands, are the formidable the layers of lymph bave, perhaps, only lined the effects, and death the inevitable termination.