This article was prescribed with success in dropsy, by Dr. KNAPP, and by Dr. PARRISH of this city. It was likewise used in intermittent fever, in bilious affections, amaurosis, hernia humoralis, dysentery, chronic rheumatism, &c. Dr. KNAPP appears to have derived benefit from its use as an alterative in a case of fever in a child, attended with disordered bowels. "The powders (gr. ii. each at intervals of three hours,) were regularly persisted in for a week, and the child's health went on gradually improving. Neither vomiting nor purging was produced, but the morbid heat and thirst were allayed, the stools became natural, the skin soft and moist, and the functions of digestion and assimilation were gradually restored, and the child is at this time fat and healthy."—American Medical Review, &c. April 1826.
30. Remarkable effects from the external application of the Acetate of Morphia.—M. DUBOURG has recently published the result of an experiment made at the hospital de la Pitie, with the acetate of morphia, which we regard as sufficiently interesting to be noticed in this place. The patient had been affected twelve months before with puerperal peritoneal inflammation, complicated with cerebral symptoms, from which, notwithstanding a most energetic antiphlogistic treatment, she never entirely recovered. When she was admitted into the hospital, she presented the following symptoms:—"considerable emaciation; skin hot and pungent to the feel; pulse small and frequent; tongue of a pale rose colour, dry at the tip and edges, brown and smooth in the centre as far as the basis; severe pain on the least pressure on the epigastrium and over the whole abdomen; cardialgia, nausea, vomiting of all solid and liquid aliments, and during the empty state of the stomach, violent efforts to vomit occurring at irregular intervals; abdomen tense and tympanitic; violent intermittent pain along the course of the intestines; constipation; sensation of fatigue and lassitude in the lumbar region and in the extremities; dragging pains in the inter-scapular region; extinction of the voice; urine red and scanty; the face animated and bearing no marks of profound suffering; agitation, and total want of sleep."
The disease was regarded as a chronic gastro-entero-peritonitis, and treated accordingly, by the antiphlogistic regimen; but no benefit was derived from this plan. The patient continued to vomit almost every thing she took, with the exception of sugar and a paste made with the Iceland moss. A blister was applied to the epigastrium on the 15th of February, seven days after her admission. Called to her assistance on the 22nd of February, on account of an aggravation of the vomiting, M. LAMBERT, one of the house pupils of the hospital, endeavoured to calm the symptoms by means of the acetate of morphia in powder, applied to the raw surface of the blister. Half a grain was used in this way, and in a few minutes the vomiting disappeared, and the patient passed a better night than she had yet done. M. SERRES having authorized the continuance of this method, M. DUBOURG the next day applied half a grain in the same way; and the patient slept the whole night. The remedy was applied every day with the same effect, and was gradually increased to two grains and a half. From the first application of the remedy, the symptoms gradually subsided; aliments were retained and properly digested; the pain and swelling of the abdomen disappeared, and on the 14th of March the patient was regarded as in a fair way of recovery.—Archives Generales, March 1826.
In some remarks which accompany this interesting case, M. DUBOURG, seems to doubt the correctness of the first diagnosis, and to view the disease as a nervous, rather than as an inflammatory affection of the abdominal viscera.
31. Cure of Urinary Calculi by means of the internal use of the Bicarbonate of Soda.—At a late meeting of the Academy of Medicine, Mr. ROBIQUET read a memoir on the use of this salt in cases of urinary calculi. Having learnt from Mr. DARCET, that the use of the waters of Vichy changes the quality of the urine from acid to alkaline, Mr. R. conjectured, that this effect should be attributed to the bicarbonate of soda contained in them; and from this circumstance, he was led to administer this salt internally, in cases of calculi composed of uric acid. In July last, he made the experiment on a man 74 years of age, who had laboured under symptoms of the disease since the month of February, and in whom, by means of the sound, a small and soft calculus had been detected. Mr. R. ordered him 10 grains of the bicarbonate in the course of the day, dissolved in two pounds of water—prescribing at the same time, hip baths, injections, &c. At the end of fifteen days, much benefit had already resulted from this treatment; and in a month, the patient appeared to be cured. Nevertheless, the remedy was continued until November, when the patient passed through the urethra, a small calculus composed of uric acid, which appeared to have been the nucleus of a much larger one, the exterior strata of which had been worn off. From that period, the patient has not experienced any unpleasant symptom; but the sound was not resorted to, to ascertain whether the first calculus before felt, could be detected.—Archives Generales, February, 1826.
32. Attempt to cure Abdominal Dropsy, by exciting Peritoneal Inflammation.—In the number of the London Medical and Physical Journal for April, 1826, a case of ascites is related by H. R. OSWALD, Esq. in which the cure was attempted to be effected, by exciting peritoneal inflammation. The following symptoms were noticed at the time of application for advice: the abdomen measured nearly six feet in circumference, was exceedingly hard and tense; but not tender. The patient "could hardly walk across her cabin from dyspnoea and debility, and the weight and tension of the tumour; which caused her to bend the body much forward, leaning her hands on her knees. The emaciation was very considerable; the appetite good; thirst considerable; tongue clean; pulse 120, and small; skin dry, harsh, and rough; bowels habitually costive; urine scanty." "This affection commenced about twelve months ago, after an obstruction of the catamenia for nearly a year, arising, as was supposed, from exposure to cold. The swelling was preceded by lancinating pains in the abdominal and lower part of the thoracic cavities, but which, after a few months, ceased entirely; and the disease had, in a chronic manner, gradually arrived at its present oppressive form."
Paracentesis was performed several times; cathartics, diuretics, the lancet, blisters, and tonics were resorted to, with relief from some of the symptoms. The tumour, however, returned several times, so that M. OSWALD despairing of effecting a cure by following the same plan, and recollecting a case of ascites, which was cured apparently by an inflammation having supervened in the peritoneum, from the orifice made by tapping remaining open, attempted to produce the same effect in the present patient, by keeping the orifice of the wound open by means of a small tent. In this he partly succeeded, for in the course of a few months, all symptoms of the effusion had disappeared; health and strength had much improved, and the patient had experienced a return of the menstrual discharge, which had been suppressed for nearly three years.
About a year afterwards, however, the disease returned. Paracentesis was again performed several times, and a tumour was perceived to have formed in the lower part of the abdomen. The patient died in about five or six months from the re-appearance of the effusion. On dissection, much water was found in the abdominal cavity, which was lined by a dense, white, and rough looking membrane, of a fragile and diseased structure. The intestines behind this membrane, were unusually small, and of a dark leaden colour. The tumour above alluded to, was discovered to be situated in the region of the right ovarium; it was a tubercular, carcinomatous, and pale coloured fungus, possessing a structure not unlike that of the placenta, and was formed in the interior of the sac, which being traced further back, was found to be the cyst of a dropsy, originating in the right ovarium at the fundus of the sac, or "more properly speaking of its neck."
"The foregoing statement," Mr. O. remarks, "involves four facts and questions of considerable importance in pathology. 1st. The great quantity of fluids evacuated in so short a space of time: no less than ninety-six quarts in eight months, by four operations; and fifty-nine quarts from August to December, 1824, by three. 2nd. The variety in the nature, consistence and colour of these fluids. 3d. The possibility of curing ascites and dropsy of the ovaria, by exciting inflammation in the abdominal sac, either by the admission of air into it, or mechanical irritation; and 4th. The possibility of a thickening of the parietes of the abdomen by inflammation, or by an exudation of a carcinomatous sort, being mistaken for a tumour rising out of the pelvis."
33. Artificial Respiration.—Dr. J. WARE of Boston, relates in the New England Jour. for April last, that he was led by the experiments of the justly celebrated physiologist Mr. BRODIE, to employ artificial respiration in the case of an infant 9 weeks old, whose system was prostrated from an over dose of laudanum. "The action of the heart was reduced to an occasional throb; the pulse had entirely ceased, and the efforts at respiration, which for some time had consisted merely in an occasional gasp, became more and more unfrequent." The child had been afflicted for five or six weeks with hooping-cough, and had been very sick and feeble when the laudanum (about 15 drops) was administered.
By means of the stem of a tobacco-pipe, artificial respiration was excited, and continued for several minutes: the action of the heart was immediately renewed, and the pulse could be again felt. At the end of an hour, during which the artificial respiration was repeated at intervals; "the respiration became natural, the pulse distinct and tolerably strong, and the heat began to return." A fit of coughing, preceded by a livid appearance of the forehead and face, arrested the breathing, "which did not return till assisted by the artificial process." The child, assisted by these measures, and by attention to the more usual means of recovery, struggled through the night, but died during a paroxysm of coughing in the morning.
The conclusions of Mr. BRODIE are, that narcotics destroy life through the organs of respiration, and hence, if respiration can be artificially carried on until the effects of the narcotic subside, life may be preserved. Dr. WARE'S case would seem to confirm this idea; for it is probable his patient would have recovered from the effects of the narcotic, if the paroxysms of coughing had not interfered.
34. Secale Cornutum.—Mr. CHARLES WALLER has lately published (London Medical and Physical Journal, April 1826,) several cases illustrative of the action and efficacy of secale cornutum. We have not room for any of the cases, and content ourselves with transcribing Mr. W.'s inferences. These are: "That the secale cornutum is a remedy which is capable of increasing the force of the uterine contractions in a most remarkable manner, under certain circumstances; but that the effect is doubtful, unless there be some degree of action present. In other words, that, although it will increase the contractions when already present, it will not always renew them when they are suspended.
"That the effect is more certain if the infusion be of greater strength than is usually recommended; two drachms of the secale to six ounces of water being barely sufficient for the purpose.
"That it appears to be a stimulus peculiarly fitted for irritable, and what are generally termed nervous habits.
"That the fears entertained by some practitioners of its proving detrimental to the child, are groundless.
"But, although it is in general necessary, not only that there should be a disposition for labour, but that this process should have actually commenced, before we can expect the secale cornutum to have any effect upon the uterus, still one solitary case has indirectly come to my knowledge (and I will vouch for the authenticity of it,) where this remedy was given for the purpose of producing abortion in a female, about the second month of utero-gestation; and this effect was accomplished in a few hours after its exhibition."
35. Animal Magnetism.—This strange doctrine begins to acquire considerable vogue in France, and other European countries, from which it seemed to have been expelled, by the contempt and ridicule which it met with, from most of the learned of the latter part of the last century. ANTHONY MESMER, the great choroegus of the magnetic mummers, was born in 1733, and excited a vast deal of attention, by the enormous pretensions which he set forth on the subject of magnetism. MESMER came from Austria to Paris in 1778. He addressed the Academy of Sciences, and that of Medicine, but no attention was paid to him, till a commission was appointed to examine carefully into the merits of the question. This commission in 1784, so fully exposed the fallacy of MESMER'S theories and practice, that he soon afterwards quitted Paris, and retired to England under a feigned name. He subsequently went to Germany, and died in obscurity, in the year 1815.
In December last, M. HUSSON (for himself, and MM. ADELON, BURDIN, MARC, and PARISET,) read a report to the Royal Academy of Medicine, on the question, whether it was fitting for the section to undertake new researches on animal magnetism, as it had been thought to be definitively settled by the decisions of 1784. The report concluded affirmatively, for several reasons; among which the principal seems to be, that magnetism has at present fallen into the hands of the learned, whereas it was formerly under the domain only of quacks and the vulgar.
M. HUSSON'S report was discussed at subsequent sittings of the Academy, for the purpose of ascertaining whether a new commission should be appointed; and as this topic is certainly one of the greatest novelties of the day, we shall give some account of the discussions, making free use of the report of them, contained in the Revue Medicale, Mars. 1826.
M. DESGENETTES, declared against the appointment of a commission, because he considered the magnetism of the present day, quite as much a matter of jugglery as that of 1784; and he informs us, that the publicity given to the report, had already increased the audacity of the magnetisers, who look on it as an approbation of their art.
M. VIREY, regretted that the report had not spoken in strong terms, against the ridiculous practices, and shameful jugglery, which disgrace the cause of magnetism; he wished the committee had announced an intention, to make only physiological, or psychological researches, on the influence, which magnetism really appears to exercise on the nervous system; and gave his voice for the formation of a commission of experiments.
M. BALLY, voted against it for several reasons, and among others, because of the fact announced by all the magnetisers, that the person who magnetises, acquires a sovereign power over the magnetisee; and he inferred from this, all the inconvenient and even dangerous consequences which may result to public morals!—Finally, he voted against it, because magnetism is ridiculed every where, because it is all darkness and confusion, and especially, because it being an inexhaustible mine of empiricism, the section ought not to lay open such a fertile field for those gentry who live by quackery.
M. ORFILA, (eheu!) defended the propositions of the reporters. It is opposed, said he, on the three grounds following: 1st. Because the section has not been invited to the examination now recommended. 2nd. Because magnetism is nothing but juggling. 3d. Because commissions will not commonly do any work. The first ground is not correct: M. FOISSAC, a physician of Paris, has invited our attention to it, and offered to subject a magnetic somnambulist to its exploration; and very reputable physicians, members of the Academy, MM. ROSTAN, (the ramollissement man, is his head soft too?) and GEORGET, have in their recent publications called the attention of the learned to this subject. Secondly, if there be any jugglery, in the magnetic phenomena we are told of; it is nevertheless certain, that the whole of them are not simulated. The testimony of well taught physicians, ought to be received on this head. That the phenomena are extraordinary, is no argument; for those of electricity must have been quite as marvellous, at the period of their discovery, &c. &c.
M. DOUBLE, blamed the report as being nothing more than an apology for magnetism, which is tarred with the same stick as that of 1784, and only modified a little, by the esprit de notre temps, &c. &c. He said he had made magnetism a special subject of study, and never saw a phenomenon produced by it.——He thinks the commission could only do injury to science, and compromit the Academy, &c. &c. He would vote against the appointment, and advised the section to wait until some scientific memoirs should be sent to it.
M. LAENNEC, agreed with M. DOUBLE, because after studying the subject for twenty years, he is satisfied, that it is almost nothing but deception and juggling; although, when he commenced the study, he was prejudiced in its favour. According to M. LAENNEC, among the magnetic influences, there are several, attributable to the impressions, which one individual naturally makes on another in correlation with him; and he cited a mistake, which he saw committed by a somnambulist woman. She was magnetised by two persons, one of whom was handsome, but anaphrodisiac, the other ugly, yet possessing in integrity, the genital faculties. She received no impression, except from the first individual; so that the impression which this female had received by the organs of vision, before the experiment, superseded that, which the pretended magnetic sense ought to have made on her. He thinks, the academy ought to observe the magnetisers, but what he has seen, has convinced him, that nine-tenths of the facts in magnetism are supposititious. The phenomena effected by magnetism, and the oracles uttered by the somnambulist, vary with every magnetiser. MESMER excited convulsions; DESLIN effected crises, such as are seen in diseases. The somnambulists of Mr. DELEUZE, a learned man, are much better taught than those of PUYSEGUR, who is ignorant of the sciences, and finally, Mr. LAENNEC has seen a somnambulist under the direction of a pharmacien, who was quite distinguished, by the art with which she compounded the medicines, she recommended. The discussion was now adjourned to the next sitting.
On the 24th of January, it was resumed.
M. CHARDEL, bears witness to a reality of the magnetic phenomena, as he has witnessed them himself, in a case of what is called somnambulism. He dares not pronounce on the question of magnetism, as a therapeutical agent; but is disposed to think it ought, if ever, to be used with great reserve. Whether it consist of nervous phenomena of a particular order, or whether it be a product of the imagination, in either case, it deserves to be studied, &c. &c.
M. RONCHOUX, thought the proposed examination would be impossible; for the magnetisers assert, that if one of the parties have a will opposed to that of the magnetiser, no phenomena can be produced. Their confessed inability to surmount any opposite will, seems to Mr. RONCHOUX, an invincible obstacle to any exploration to be attempted by a commission.
M. MARC, gave some explanation of the labours undertaken in Germany. According to the opposition, nothing conclusive can be derived from these labours; because Germany is the native soil of sects and of thaumaturgae but, Mr. M. proved by citations, that they are not to be attributed to excited imaginations, as has been urged, but to the most celebrated Savans of that country, as for example, OERSTDT, KLAPROTH, and HUFELAND, to learned bodies, and to governments. The Royal Academy of Berlin, offered in 1818, a prize of 3300 francs, for an essay on this topic.
The governments of Prussia, Russia, and Denmark, have founded medical commissions for the examination of it, and subjected its therapeutical application to certain regulations. He thought, therefore, that the Academy could follow without compromising its dignity, such good examples. He added, that the examination was absolutely necessary, unless they desired that every French practitioner should hereafter reject the whole subject, and for ever abandon its employment to jugglers and credulous fools.
M. NACQUART thought, that as magnetic somnambulism is something wholly independent of organical, physical, or physiological laws; that as the senses here have no need of organs; as time, space, and intermediate bodies, wholly disappear; we can avail ourselves of no method of appreciating magnetical facts, and consequently, the Academy ought not to trouble their heads about it—a very good joke truly: but M. ITARD said, that jokes had nothing to do with the question, because they are meant only for the abuses and extravagancies of magnetism; but we want to get at the truth, and to eschew the folly. Magnetism, says he, is either a real or imaginary agent; it ought to be examined. To refuse this, is to despise the path of experiment, which can alone lead to truth, &c. &c.
M. RECAMIER, could add nothing to the observations of MM. DESGENETTES, BALLY, and DOUBLE; but he wished the section to know, that he been a witness to the magnetic phenomena—he had been present at the oracles of the marichale of M. DE PUYSEGUR, who was represented as the most lucid of all possible somnambulists. He had reason to suspect a cheat in this case, as he was denied the means of dissipating his doubts; and heard this woman repeat what he had before said to the patient himself. How ridiculous, moreover, is it, to hear one drachm of glauber's salt prescribed as a transcendental remedy for phthisis pulmonalis! He also attended at the Hotel Dieu, at experiments made on one woman and two men. He saw the woman go to sleep (as was asserted,) at the simple will of the magnetiser, who for that purpose was concealed in a closet of the apartment. The only mode adopted, to prove that she was really asleep, consisted in some slight pinching of her ears, and some noises; yet, in the recital, these slight impressions have been transformed into most painful tortures. In the experiments made on the men, he employed a more powerful proof, which was the application of moxa; and that he did, because it was indicated by a coxalgia, with which the patient was affected: it is a fact, says he, that the man did not awake, or show the slightest sensibility. Mr. R. believes, therefore, in magnetical action; but does not think it can ever be available in the practice of physic. In Germany, said he, where magnetism is so much employed, do they cure better than elsewhere? And has magnetism been the occasion of any therapeutical discovery any where? In somnambulism there is only a disordered sensibility, and not an increase of it; and the pretended clairvoyance of the somnambulists, has no real existence, &c. &c.
M. GEORGET, cited in proof of the existence of magnetic power, the names of many physicians, members of the Academy, as MM. ROSTAN and FOUQUIER—he cited the experiments made at the Hotel Dieu, by Dr. DUPORTET, in the presence of many members, who had signed the results, as MM. HUSSON, GEOFFROY, RECAMIER, DELENS, PATISSIER, MARTIN, SOLON, BRICHETEAU and KERGARADEC. If there be any analogy between magnetic and natural somnambulism, ought we to be astonished at the production of the former by certain practices? The magnetisers conceal nothing, but publish all their proceedings, and do you call these the tactics of jugglers and charlatans?
M. MAGENDIE thought the examination expedient, and wished commissioners to be appointed to examine the somnambulist, offered by Dr. FOISSAC.
M. GUERSENT was in the affirmative: he himself had magnetised, and witnessed several phenomena, &c.
The discussion was then adjourned to the next setting, and on the 14th February, after hearing M. GASC against, and M. LHERMINER for the report, M. HUSSON the reporter was heard. The section then closed the discussion, and it was decided by a majority of ten, (35 to 25,) that a commission should be appointed to examine animal magnetism.
We are indebted for the above account to the Revue Medicale for March—the No. for February, also contains a review of M. DUPAU'S Lettres Physiologiques et Morales sur le Magnetisme Animal, 8vo. Paris, 1826. In order to show our readers how they manage these matters, we shall translate the following from p. 269.
"Here, says M. ROSTAN, is an experiment that I have often repeated, but which I was finally obliged to interrupt, because it fatigued my somnambulist prodigiously, who assured me, that if I continued, it would make her go mad. This experiment was made in presence of my colleague and friend, M. FERRUS. I took my watch, which I placed three or four inches from her occiput. I asked my somnambulist, if she saw any thing: "certainly, I see something that shines; it hurts me." Her countenance was expressive of pain, and ours expressed astonishment. We looked at each other, and M. FERRUS breaking silence, said, if she sees something shine, she can doubtless tell what it is. "What do you see that shines?—Oh! I don't know, I can't tell. Look at it well—Stop, it fatigues me, wait—(and after a moment of great attention) It's a watch." More astonishment. But, if she sees the watch, said M. FERRUS, she will doubtless see what o'clock it is. "Could you tell me what o'clock it is?—Oh! no, it is too difficult." "Look at it, try." "Wait then, I'll try; may be I can tell the hour, but I never shall be able to see the minutes;" and after the greatest attention—"It wants ten minutes of eight o'clock:" which was exact. M. FERRUS now desired to make the experiment himself, and repeated it with the same success. He made me turn the hands of his watch several times, and when presented to her (occiput we suppose,) without her having seen it, she never made any mistake."
These statements we have thought fit to lay before our readers, who will observe the respectable names which are connected with them. We shall seize the first opportunity to give the report of the new commission, and if they confirm the miracles, we can still say, credat Judaeus apella. If it will make no cure, it will probably make much pay; since MESMER got upwards of 340,000 francs for his mumming exhibitions, to the spectacle loving quidnuncs of Paris. The commission consists of 11 members, viz. LEROUX, BOURDOIS, DOUBLE, MAGENDIE, GUERSENT, LAENNEC, THILLAYE, MARC, ITARD, FOUQUIER and GUENEAU DE MUSSY.
36. Sketch of the Medical Literature of Denmark, Sweden, and Norway—by Dr. C. OTTO, of Copenhagen, apud Bulletin des Sci. Med. Feb. and March.—"Denmark is richer in medical literature, than the other countries which in conjunction with it, composed the ancient Scandinavia. Although it does not in this respect, bear a comparison with France, Germany, England, and Italy, nevertheless, medicine, of all the sciences, seems to be that which is most successfully cultivated, and Copenhagen contains a great number of learned, and able physicians." In proof of what Denmark has done, Dr. O. refers us to the great names of the two BARTHOLINS, of STENO, of WINSLOW, of CALLISEN, &c.
"In the 16th century, Denmark possessed the anatomical works of the two BARTHOLINS: (Instit. Anatomicae de vasis lymphaticis, &c.) and other works of the same kind, which have been translated into all the languages of Europe. STENO, the disciple of THOMAS BARTHOLIN, followed the career of his master, with an equal success. HALLER never spoke of this anatomist, without the highest admiration. RODE enriched the literature of Germany and Denmark, with works which have made his name illustrious, wherever science is cultivated. Among these, we may chiefly distinguish his Bibliotheca, and Materia Medica." The Danes are indebted to him for several popular works on medicine, which are in the judgment of Dr. OTTO, chef d'oeuvres of this sort of writing. He published more than 13 volumes on these topics. "To the celebrated CALLISEN, who is recently deceased, we are indebted for 1st, a Systema Chirurgiae Hodiernae, a work of the highest merit, and which has reached a fourth edition. 2nd, a Medical Topography of Copenhagen, published in Danish. (2 vols. 8vo. Copen. 1807.) 3d, the Director of the Academy of Surgery. He is also the author of several important memoirs, inserted in those of the Roy. Soc. of Sciences, of Denmark, and in some other collections. The late professor MATH. SAXTORPH, composed an excellent manual of labours, for the use of midwives. A second edition with plates, appeared in 1804. T. L. BANG, has given a Praxis Medica, an excellent guide to young physicians in their first outset in practice. HERHOLDT has shed some lustre on Danish Physiology: his dissertations on the life of the foetus, and on the question, whether vision is performed with both eyes, or with one only, bear testimony to his genius and penetration: he is also author of a memoir on penetrating wounds of the Chest, inserted, as well as the former dissertation, and many other pieces, in various medical journals.
"TYSCHEN published in 1804, a Treatise on Pharmacy, in Danish; and professor MYNSTER, gave a work on Pharmacology, of which two volumes only had appeared, when death interrupted his useful labours. In 1794, he commenced the publication of a journal, the Bibliothek for Physik Oeconomic og Medicin, which was continued in 1799, by BAHN, and afterwards under several names, till 1807. We now come to the existing state of Danish medical literature.
"The Royal Medical Society of Copenhagen, which, without contradiction, holds the first rank among those of Scandinavia, celebrated its 50th anniversary in 1822. It publishes at irregular periods, its memoirs, under the title of Nova Acta Societatis Medicae Havniensis. The last volume appeared in 1821. Professor JACOBSEN, is ardently devoted to the study of Comparative Anatomy, and has published several works on the subject, inserted in the Mem. of the Roy. Soc. of Sciences, extracts from which have appeared also in several foreign journals. The collection we have just now cited, (for 1824, V. I.) contains a memoir of Dr. GARTNER, which confirms the opinion entertained by the ancients, as to the presence of a glandular body in the uterus of some animals. The author has added a plate to this interesting dissertation. Dr. OTTO has enriched the physiological sciences with his Phrenology, and is zealously occupied with all that relates to this subject. Professor WENDT, physician to the General Hospital of Copenhagen, has recently published several small medical works. We may cite his Historical and Chemical Supplements, to the knowledge of some therapeutical agents, of the class Euphorbiae; some notices on small pox, vaccina, and modified small pox.
"Denmark possesses three periodical journals of medicine, without counting those of the Royal Societies of Sciences and of Medicine of Copenhagen. The first and best of these journals, is the Bibliothek for Laeger, published by a society instituted for the advancement of medical studies. CLASSEN, the founder of this association, bequeathed to it a sum of money, to purchase annually, some foreign medical works. This collection is composed of original memoirs, extracts, and announcements of other works, and a review of the course of the faculty of medicine. It is specially consecrated to the practical department of the art—(three numbers per ann. of 70, to 100 pages each.) The 2nd collection, is the Nye Hygaea, the editor of which, (M. OTTO,) embraces in his plan, all the medical sciences. This journal, although specially devoted to physicians, is in reach of all those persons of education, who can be interested in a variety of important medical questions. It contains original memoirs, and extracts from foreign works, (five leaves per month.) The 3d collection, Archives for the History of Medicine in Denmark, (Archiv. for laegevidens kabens historie in Danmark,) does not appear periodically, but at indefinite times. Professor HERHOLDT, the editor, has only published one number, in 1823.
"As to inaugural dissertations for the doctorate, the number amounts only to three or four in the space of ten years; because the title of M. D. is not requisite to the practitioner in Denmark."
The above is taken from the Bulletin for February, the ensuing portion of the sketch is contained in the March number of the same journal.
"The medical literature of Sweden, must have been very insignificant in past ages, if we may form an opinion, from the total want of documents in relation to it. There existed no scientific lien between the physicians of that country, or even among those of the capital. A medical society might in vain have been sought for there, at a period, when they were common in all other countries. The Royal Academy of Sciences, published some essays relating to medicine, from time to time, but until 1807, a work on this topic was regarded as a sort of rarity. However, in the course of that year, seven physicians of Stockholm, united in order to found a society, which received the royal sanction, and took the title of Svenska Loekare Soellskapet, (Society of Swedish Physicians.) This institution, seemed to communicate to the practitioners of Sweden a new existence, and then really commenced the aera of medical literature in that country. The number of works published since that period, has scarcely amounted to more than one or two per annum. Dr. RABEN is the author of three works, which, though not large, give evidence of considerable knowledge and penetration: Their titles are: 1st. De praecipuis causis mali Scrophul. ejusque remediis Commentation. Lund. 1807. 2nd. A second volume on the same subject, written in the Swedish language, Lund. 1819. 3d. Observationes in Syphilidem, ejusque curationem, ubi novae quoque proponuntur curandi rationes. Lund. Goth. 1821.
"We shall also mention among the works recently published in Sweden, 1st. A biographical and literary gallery of the physicians of that country, from the reign of Gustavus I. down to our own times, by Dr. J. F. SAKLEN. 2nd. FLORMANN'S Manual of Anatomy. Finally, a collection of the laws of the kingdom, which relate to medicine. The Medical Society of Stockholm, regularly publishes its transactions, Svenska Loekare Soellskapets Handlingar, the 10th vol. of which has just appeared. In it, are some remarkable cases, a table of the constitution of the atmosphere, and of the diseases which have prevailed at Stockholm, and in its environs; reports on the hospitals and baths of the whole kingdom; extracts from Medico-legal Examinations, recent discoveries, &c. M. ECKSTROM promises to publish a complete description of the variolous epidemic, which prevailed last year at Stockholm, and in the provinces. Besides these transactions, the secretary makes an annual report, on what passes at the sittings. To this he adds, short notices of the most interesting recent discoveries and observations, which he derives from foreign medical literature. He publishes this collection once a year, and adds some nosological articles. In closing this review, we ought not to forget to mention the collection of theses, defended at the university of Upsal, which is published yearly by Dr. ZETTERSTROM."
37. Erysipelatous Mumps or Angina Parotidiana.—Dr. BEHR of Bernberg, has published in the Journ. der Pract. Heilkund for July, 1825, an account of this disease, which we find in the Bulletin for Feb. 1826. Dr. BEHR'S "memoir is intended to pourtray the principal features of an epidemic prevalence of parotitis at Bernberg, in the months of December, 1822, and January and February, 1823. Dr. B. attributes it to the frequent and sudden variations of the atmosphere at that period." He says, "the disease is so rare in this country, that physicians of 30 years standing had never met with it before." Bernberg contains 6000 souls; it is divided into two parts by the Saale, and it is situated on the great road from Leipsic to Magdeburg, in a narrow valley, which runs from N. W. to S. E.
The precursory symptoms were rigors followed by heat, heaviness of the limbs, pains in the joints, especially in the evening, sense of tension in the region of the lower jaw, and sometimes a difficulty in mastication. The appetite was usually natural, with gastric symptoms only in the most severe cases. On the evening of the 3d day, there was an increase of uneasiness with chills and heat, after which the patient commonly enjoyed sweet sleep. The next day, on awaking, he felt tolerably well, and had no more sense of heaviness in his limbs, but his face was swelled on one or both sides. Speech and mastication were effected with difficulty; the lower jaw was comme engourdie, and a dull pain was felt in the ligaments of the joints; the tumefaction increased and soon extended from the ear to the cheek. On a careful examination, it was found to affect the parotid gland, and the surrounding cellular tissue. The tumour was hard, diffused, and not very painful, except on pressure. The colour and temperature of the swollen part were natural. In the evening, the pulse became hard and accelerated, the tongue white, the stools more consistent than common, and the urine pale. The following night he was agitated, frequently awakened by lancinating pains in the affected part, and sometimes by a sense of tension in the head. The following day, the tumour reached its maximum of elevation, and sometimes comprised the submaxillary glands of the same side. From this time, the pains did not increase, and the skin became slightly red only in a very few examples.
The disease having thus reached its acme, a gentle sweat commenced behind the ears, then extended over the whole tumour, and remained as long as the swelling lasted. This evening there was no fever, but a gentle perspiration continued throughout the night. The day following, being the 6th of the disease, the tumour was evidently diminished, and continued decreasing until its final disappearance, which occurred on the 9th, and sometimes on the 7th day. Until this period, abundant local perspirations in the day-time, less abundant, but more general ones in the night, were observable. When the disease was critical by urine with sediment, the diminution of the swelling was dated from this appearance; but the resolution was not perfected in some cases till the 14th day, and in such cases, the integuments of the part were covered with a mealy desquamation. Dr. BEHR did not observe any metastasis to the genitals, but he saw cases, in which the disappearance of the swelling, was followed by considerable fever with augoisse, and then an oedema, commonly situated on the head.
He often saw the termination by induration, but this soon yielded to a proper treatment. As to the contagion of mumps, the author thinks, it can only occur where there is desquamation of the integuments; and remarks on the analogy of this circumstance, with what occurs in scarlatina. Dr. BEHR thinks, that antiphlogistics are rarely indicated in the treatment of parotitis.
38. Taenia.—In several cases in which gum. gutt., salts of tin, and other medicines, were unsuccessfully used for the expulsion of tape worm, Dr. BOUGARD succeeded in expelling them with pills compounded as follows: Merc. dulc. Extr. aloes, aa. gr. iij. divided into three pills. This dose was given every evening for eight days, and gradually increased or diminished, so as to procure three stools per diem. A rigorous diet was observed during this treatment.—Rust's Magazin fur die gesamte Heilkunde apud Bulletin des Sci. Med. March, 1826.
39. Scrophula.—Dr. WETZ recommends the employment of caustic potassa in scrophula. He dissolves x grs. of caustic potassa in one ounce of orange-peel water, and gives from xij to xx gtt. four times a day, in a cup of broth. A solution of caustic potassa in six ounces of distilled water, is applied as a wash to the ulcers.—Ibid.
40. Digitalis.—We find in the Propagateur des Sciences Medicales for Feb. 1826, an account of the directions of Dr. NEUMANN of Berlin, for the employment of digitalis in pulmonic diseases: they are said to be the result of long experience. Digitalis is useless, says the writer, in all cases of suppuration of the lung, consequent to tubercles of that organ. It is of no avail in those suppurations, which succeed inflammatory haemoptysis. It is employed without success in local phlegmorrhagies of the lungs; but it almost invariably cures those chronic catarrhs, which depend on a state of erethism of the mucous lining of the bronchiae. This disease is sometimes called chronic bronchitis, sometimes mucous consumption, pulmonic catarrh, and galloping consumption. If the diagnosis in this case be well made out, hopes may be entertained of a cure, one of the two following conditions being present:
A. The patient must be susceptible of the stimulant action of the remedy: this is often not the case. We may be sure the digitalis will not produce its effect, where the pulse of the patient remains uniform and frequent after he has taken it for several days. It does not suit such persons.
B. The medicine ought to be administered in a proper manner. To be good, the leaves, even in the dried state, should be perfectly green and free from any brown spots. Two ounces of the leaves, should be infused in six ounces of boiling water; and the patient may take a table spoonful every hour, until he feels nausea, or a sense of constriction in his throat, or flashing of the eyes, or irregular pulse. The use of the foxglove should then be interrupted for seven or eight days, in which interval, the full action of the medicine is developed, the pulse remaining irregular, and the mucous secretion diminishing gradually. If the first trial does not remove it entirely, a second course may be commenced after a few days.
 Series of Engravings to the morbid anatomy; fasc. 1. pl. 6. fig. 1, 2.
 Lond. Med. Review; vol. 4.
 Pathological Researches; Essay 1.
 Medical Researches on the Effects of Iodine in Bronchocele, Paralysis, Chorea Scrofula, Fistula Lachrymalis, Deafness, Dysphagia, White Swelling, and Distortions of the Spine. By Alexander Manson, M. D., &c. London, 1825.
 Carthamus Tinctorius.
41. Dr. Physick's operation for artificial anus, denied to have been performed!—We have often had occasion to remark the claiming, and, we fully hope, the actual re-invention of American operations and practices among physicians on the other side of the Atlantic. As we are not a publishing people, it is, perhaps, not very strange that the French and English should be generally unacquainted with the discoveries and inventions which have been made among us; but here comes an actual denial of the invention having ever taken place!
Every American who has any pretensions to the character of a surgeon, is most probably familiar with the proposal and performance, by Dr. PHYSICK, of a peculiar operation for those cases of artificial anus, where the two ends of the divided or opened intestine adhere laterally to each other, in the manner of a double-barrelled gun. We are now told that M. RICHERAND, in his new work "On the recent progress of Surgery," "avoids giving this the least confidence." (Archives Generales, Janvier, 1826.) The reviewer in the Archives, in a paroxysm of angry jealousy for the honour of French surgery, deeply wounded, as he conceives, in the admissions by M. RICHERAND of discoveries and inventions among the English and others, adds no small amount of ill-nature to this unworthy intimation, and makes the observations which we have translated below.
It is certainly an easy method of erecting reputations, to deny, directly, the priority of others in operations which a favourite has repeated. No matter though the knowledge of this priority be widely diffused; if readers can, by means of national predilections, be induced to place confidence in your denial, the effect, as far as relates to them, is completely obtained. Yet one would think it an ungenerous act, to call in question, and before partial judges, the veracity of such men as are here named. Where a physician reports cases which agree too well with his preconceived theories, we doubt the correctness of his observations; and with justice: for we know that an already formed belief will greatly tinge the most honest seeings and hearings of very sensible and honourable heads. But this is a far different thing from impeaching, in a manner entirely gratuitous, the moral honesty of the record of a historical fact, made by men at the head of their profession.
The reviewer, Mr. and probably Dr. L. C. ROCHE, comments as follows:
"1. Dr. PHYSICK never published any thing on this subject.
"2. Dr. DORSEY, who makes the claim for him, never published the work in which he does so, [the Elements of Surgery,] till 1813.
"3. In the English journal (?) and in that work, he contents himself with a simple assertion, without giving either the date of the operation, the name, age, or sex of the patient, the names of his assistants, or the details of the operation; all points which men never forget to make known, when treating of the first attempt in a new operation of this importance."
To the first of these comments we reply, that Dr. PHYSICK, to the great regret of his countrymen, has never been in the habit of publishing; but still possesses many useful improvements in medicine and surgery, which he has not committed to the press. On the other hand, however, he has taught this operation annually, to from three to four hundred pupils, in his lectures, during about twelve successive years; and this is no mean substitute for a publication in types. M. ROCHE'S memory will supply him with an instance of an eminent French surgeon, whom we shall not attempt to defraud of his laurels, who also made it his practice to leave the publication of his observations and improvements to his pupils.
To the second remark, the above is also a sufficient reply; but we will add that it was recorded in the case book of the Pennsylvania Hospital in 1809.
Our comment on the third observation of Mr. ROCHE may be brief. It is that we promise an account of the case for the next number of this Journal. In the mean time, the patient was well known to us and to many persons now living. The operation was performed in 1809.
In reply to that portion of the last observation, which we have marked with italics, we can assure the reviewer that he is mistaken; at least with regard to this side of the ocean. We Americans are a very peculiar people, and but little affected, as yet, with the cacoethes scribendi; a malady which the present work, in its humble sphere, is designed to disseminate. We are not in the habit of frequently publishing, and above all, of publishing volumes. Books are dear, private libraries small, public ones few, and encouragement for even the best original publications but limited. Of this we have known some melancholy instances. It is impossible for either a Frenchman or an Englishman to judge correctly of a country, which, in many important respects, is in such a different situation from his own.
It is a thing of by no means uncommon occurrence here, to make a valuable discovery or improvement in the healing art, and not to make it public. A striking instance of this fact, at least with the exception of the insertion of an imperfect account in the Eclectic Repertory, which very probably never reached England, is mentioned in our last number. We allude to the extirpations of diseased ovaria, by Dr. M'DOWALL, of Kentucky. Here a unique and brilliantly successful operation was performed, successful as yet beyond European imitations, and still the inventor and achiever of it did not possess vanity or industry sufficient to treat the public with a full account of it. M. ROCHE may find it hard to explain modesty of this species; but we can promise him, should these sheets ever reach his eye, and he still continue skeptical, abundance of proofs, and some more instances of the same kind.
42. Gangrenous Sore Mouth of Children.—Dr. COATES begs permission to add the following quotation from FABRICIUS HILDANUS to the authorities quoted in his paper on gangrenous ulcer of the mouth, at the commencement of the present number.
"Gingivarum inflammatio maxime in infantibus in gangraenam interdum degenerat. Morbus enim magnus, vehemens et peracutus; magna quoque requirit remedia: sed quis illa in ore adhibere ausus?"—De Gangraena et Sphacelo, Cap. IV. p. 773. col. 2. Edit. Beyeri. Francofurt ad Maen. 1646.
"Gangraena in partibus humidis, gingivis, palato, naribus, &c. raro sanabilis; in sphacelum autem degenerans, insanabilis."—Cap. XI. p. 781. col. 2.
This is all I find in that author, relative to the subject.
43. Operation for Phymosis.—M. J. CLOQUET, has so improved this operation that no deformity results. He recommends the incision to be made at the inferior surface, near, and parallel to, the fraenum praeputii. The longitudinal wound thus made, becomes transverse, as soon as the prepuce is drawn behind the glans penis, and cicatrizes in a line scarcely visible; so that the prepuce acquires in breadth what it loses in length. M. CLOQUET has, in this way, perfectly cured many patients; the prepuce appearing to possess its natural conformation.—La Propagateur des Sci. Med. for March.
44. Lunar Caustic on Wounds and Ulcers.—The practice of healing wounds and ulcers by natural or artificial scabs, to which the attention of the profession was first directed by Mr. J. HUNTER, has been too much neglected, and the circumstances under which it is useful, have not been accurately stated. In a small work published by Mr. HIGGINBOTTOM, in January last, at London, the practice of forming an eschar by the lunar caustic over small ulcers and recent wounds, has been strongly recommended as saving the patient much pain, trouble, and danger. The whole surface is to be pencilled with the solid caustic so as to form an eschar, and where this remains adherent, the wound or ulcer invariably heals with comparatively little inconvenience. When effusion occurs under the eschar, whether of serum or of pus, there is more difficulty; but if this fluid be evacuated by a puncture, and the caustic applied to the orifice, the eschar will often remain adherent. Sometimes the fluid must be frequently evacuated. If the eschar does not separate favourably, a cold poultice may be applied, which not only removes the eschar, but lessens the irritation and inflammation. Should the sore not be healed, Mr. H. recommends the reapplication of the caustic. To prevent effusion under the eschar, and to preserve it adhering, he advises the whole to be covered with a piece of gold-beater's skin; but we may add, that as this effusion arises from too much inflammation, more powerful means may occasionally be employed, especially a solution of acetate of lead. LARREY recommends with the same view, after the application of moxa, the use of the aq. ammoniae. Indeed any evaporating, cold, astringent lotion will be advantageous.
The application of the caustic, of course, produces some pain, but this soon subsides, and the patient experiences more ease than under any other mode of treatment.
Particular cases in which the Caustic is useful.—In punctured wounds, it should be applied to the orifice and surrounding skin, and the eschar allowed to dry. The terrible effects of punctured wounds, are thus completely prevented, whether caused by needles, hooks, bayonets, &c. So also of wounds from saws; of bites from leeches and animals; of the stings of insects; and especially of those small scratches, and punctures, received in anatomical dissections. The danger of these last mentioned accidents may, according to Mr. H., be completely arrested by the prompt and free application of the lunar caustic. Even in neglected cases, when a small tumour has formed under the skin, attended with a smart stinging pain, he advises the tumour to be removed, and an adherent eschar to be formed by the caustic; and in still more neglected and advanced cases, where inflammation of the absorbents has supervened, "a free crucial incision is to be made, the caustic to be freely applied, and afterwards, the cold poultice and lotion; the usual constitutional remedies being actively enforced."
In bruises, especially of the shin, the adherent eschar from lunar caustic, has, with Mr. H., always effected a cure; and even when a slough has been produced, the application of the caustic will moderate the inflammation.
In ulcers, which are small, not exposed to friction or motion, and discharging little, the cure by eschar will be preferable; especially in those little irritable and painful ulcers often seen about the ancle and tendo Achillis. Apply first a cold poultice, and then form the eschar, which may be freely exposed to the air. Should the matter, nevertheless, collect, it should be evacuated by puncture as often as necessary, until the eschar remains adherent.
This practice is recommended by Mr. H., in various other affections; as in inflammation of the fingers; in the fungous ulcer of the navel in infants; in tinea capitis, &c. In this last case, we have ourselves used it with marked advantage. In all cases, the lunar caustic has a decided effect in diminishing the irritability of the parts to which it is applied; and hence should usually be preferred for the purpose of forming a "scab," for such the eschar really is, in a practical view; and we think that our author has hardly done justice to nature's methodus medendi by "scabbing;" while he so ably and strenuously recommends his own imitation of her process. Scabs may be formed by the coagulation of blood; by the drying of mucus or pus; and by the formation of an eschar, by the actual or potential cautery. The surgeon may frequently reduce parts to the same situation, by the use of gold-beater's skin, court-plaster, or other unirritating applications, which prevent exposure and evaporation. In all cases, care must be taken to prevent the surrounding inflammation from transcending the adhesive stage.
45. Haemorrhage from Lithotomy.—In the London Med. and Phys. Jour. for Jan. Mr. JOHN SHAW has published an account of a patient, who unfortunately perished from haemorrhage, in consequence of being cut for the stone. The parts being injected after death, it was found, that the bleeding proceeded from the unusual distribution of a branch of the pudic artery, which traversed the neck of the bladder, and lay directly in the way of the incision. The pudic artery was uninjured.
46. Extirpation of the Parotid Gland.—The best surgical writers have condemned this operation, if not as absolutely impracticable, nevertheless, as too dangerous to be ever attempted. Successful cases have however been reported, and Mr. A. COOPER, in a letter to the operator in the following case, avers, that he twice removed the parotid gland in one year. Mr. KIRBY, late president of the Royal College of Surgeons in Ireland, in a work published in 1825 at Dublin, on haemorrhoidal excrescences, has given the details of a diseased parotid, and of the operation for its removal. We condense from Johnson's Review for April, 1826.
The patient was a poor female, aged 40, who had a tumour extending from above the zygoma downwards on the neck, two inches below the angle of the jaw, stretching as far forwards as the anterior edge of the masseter muscle, forcing the ear backwards, and raising it outwards from its natural position. Above the surface, it was about the size of a goose-egg; immoveable; painful when handled; irregular on the surface, and of a deep livid colour over the prominent points. Pains of a lancinating character, extended over the head and neck, producing sickness and want of sleep.
The operation was performed chiefly by the fingers and the handle of the knife, after dividing the integuments by a crucial incision. The branches of the portio dura were of course divided, and great embarrassment arose from a copious haemorrhage, caused by the bursting of the tumour, while Mr. K. was rooting it out from between the pterygoid muscles. The bleeding was restrained by the finger of an assistant, and the complete extirpation of the diseased gland was effected. Mr. KIRBY says, "the space between the pterygoid muscles was void—the auditory tube was fully exposed—the articular capsule of the jaw was brought into view—the finger could trace the length of the styloid process, and on sponging the wound of its blood, it could be seen by those who surrounded the chair." The haemorrhage was restrained by a sponge firmly lodged at the bottom of the wound, covered by compresses of lint, and the whole secured by a double-headed roller.
The patient was much exhausted, slept tolerably well the next night, complaining of thirst and inability to swallow. On the 2nd day, inflammation, swelling, and fever followed—erysipelas appeared on the neck—patient lethargic—pulse small and frequent. Fourth day, suppuration—symptoms improving—no relapse. The patient completely recovered, without any regeneration of the tumour.
In FERUSSAC'S Bulletin Universel for Jan. 1826, we observe the following notice, from a German Medical Magazine, conducted by M. D. Schmidt.
A female, aged 33 years, had suffered for 9 years from a diseased parotid gland, which had gradually attained a large size. It was extirpated by Dr. PRIEGER, and the patient soon returned home in good health, and little disfigured. The tumour measured 8 inches in circumference, and weighed three and a half pounds. (Livres.)
Dr. PRIEGER had previously extirpated a scirrhous parotid successfully. M. WIENHOLD affirms, that he has extirpated three parotids; the details of these operations are published. M. SCHMIDT, however, suggests some doubts, as to the nature and seat of the tumours removed.
47. Aneurism from a Wound, cured by Valsalva's method.—This interesting and valuable case, is condensed from Le Propagateur des Sci. Med. for March, 1826. M. Antouard, a healthy female, aet. 18, was wounded on the 18th of June, 1825, by a poniard, in the left carotid artery, below the superior extremity of the sternum; the instrument passing obliquely inwards and downwards. The anterior and lateral portions of the neck, were enormously distended with blood, and syncope supervened. Four days after the injury was received, an aneurismal tumour was observed at the edge of the sternum, the surrounding effusion being greatly diminished by absorption; and at the expiration of a month, when she was first seen by Dr. SOUCHIER, it was of the size of the two fists of the young female. The pulsations at this time, were nearly equal over the whole surface of the tumour; but rather more distinct over the orifice in the vessel. The surrounding blood was entirely absorbed. No pain was experienced, unless from the pressure of the swelling; from which cause also, resulted a troublesome and continued headach. Dr. SOUCHIER, not believing an operation adviseable, during the warm season of the year, and on a tumour, situated so much under the sternum, determined to fulfil the following indications: 1st. To lessen the quantity of blood; and thus, to diminish the stimulus to the heart, the projectile force it exercises, and consequently, the rapidity with which the blood escaped from the ruptured vessel, and the impulse hence imparted to the sides of the tumour, preventing, in some degree, the coagulation of the blood. 2nd. To increase the effect of general and local bleeding by the use of cold, of pressure, and especially, of the digitalis purpurea: that thus the force of the circulation may be lessened, the blood allowed to coagulate, and a radical cure be accomplished.
Mademoiselle Antouard, determined to yield herself to this plan, and was directed: 1st. Rice-water, acidulated with lemon-juice, and an infusion of mallows, for food and drink. 2nd. To employ frictions on the abdomen, and on the insides of the thighs, morning and evening, with eight grains of the pulverized leaves of digitalis, previously macerated for 24 hours in a sufficient quantity of saliva. 3d. To apply every day 12 leeches, near the aneurismal tumour, and after favouring the flow of blood by emollient fomentations, to cover the part with compresses, wet with a saturated solution of the acetate of lead, to be frequently renewed, so as to be kept below the temperature of the skin. 4th. The effect of these means to be augmented by pressure, made by means of the base of a glass tumbler, fixed by the hands of assistants; and 5th. To be kept at rest, and in perfect silence.
Fourth day of treatment, being 2nd of Aug. 1825. Pulsations more central; tumour very sensibly diminished; pulse less strong and reduced from 86 to 74 in the minute; the menses, which had been suppressed for two months, appeared on the 31st ulto. and still flow. Prescription, V. S. [Symbol: ounce]xviij. next day, twelve leeches, on the lateral parts of the tumour; gr. xxiv. of digitalis in three applications through the day. Continue ut supra.
Aug. 8th. Patient tranquil; pulse 60, full, not active; face not flushed, but preserving a delicate tinge of red; headach now slight; no nausea; menses continued until the 6th inst. Prescription, V. S. [Symbol: ounce]xij.—fifteen leeches to-morrow; increase digitalis to gr. xxviij. daily; the rest, ut supra. The tumour has diminished at least one-fourth.
Aug. 12th. Tumour reduced to 3-5ths of its former volume; pulse at 56; her nights are comfortable; has some headach, and lately, cardialgia; complains of hunger and weakness, and from the fatigue of her assistants, the pressure was made with a bandage less effectually than before. This was allowed, as the pulsations are weakened, and more and more central, while the elevation of the tumour is trifling. For fear her health might be injured, she was permitted to rise a little from bed, and to add to her rice water, some light jellies, (cremes) made from the same grain. V. S. [Symbol: ounce]x. and every 2nd day, eight leeches around the tumour; digitalis increased to 32 grains daily; warm pediluvium for one hour, morning and evening; silence as complete as possible.
Aug. 18th. No tumour visible; pulsations can yet be felt; the skin is thickened; pulse at the wrist is at 50. V. S. [Symbol: ounce]viij.—six leeches every 4th day until menstrual period; digitalis reduced to gr. xx. and still to the same parts; continue the pressure; allow some rice jelly, vermicelli soup, gentle exercise; silence to be preserved, continue pediluvium, and relieve constipation by simple enemata.
In 15 days, Dr. SOUCHIER again visited his patient. It required an experienced hand to distinguish, at the spot where the artery was cicatrized, an elevation rather more evident, than over the rest of the artery. Pulse 48 per minute; hunger great, and the remedies now unpleasant. Most of them were suspended, and fruit and the white flesh of poultry added to her diet list. The digitalis reduced to 12 grains a day. Compression, silence, and moderate exercise, to be continued as before. The menses appeared at the expiration of twenty-five days, and were more abundant than at the last period.
At the end of a month, no trace of the tumour was discoverable. The young lady had carefully increased her nutriment and exercise without inconvenience, and all remedial measures were now omitted.
During the months of December and January last, she remained free from any inconvenience from the tumour, and the union of the parietes of the artery was therefore regarded as complete.
In the above account, we have only to regret that the state of the artery above the tumour, before and after the treatment, had not been noticed. Perhaps this may be supplied by Dr. SOUCHIER, in the commentary, which he proposes publishing on the above case.
48. Protrusion and Wound of the Stomach.—Mr. TRAVERS, in the Edin. Journ. of the Med. Sciences, for Jan. 1826, relates, that a female, aged 53, and the mother of nineteen children, inflicted on herself a wound in the abdomen, three inches in length, and in a transverse direction. When admitted into St. Thomas' Hospital, at the expiration of six hours, the greater part of the large curvature of the stomach, the arch of the colon, and the entire large omentum, were protruded and strangulated in the wound. The omentum was partially detached from the stomach, which organ was wounded in two places; one, half an inch long through the peritoneal coat; the other, a perforation of all the coats, admitting the head of a large probe, and giving issue to a considerable quantity of mucus. Patient faint; pain slight; pulse 102, and irregular; some hiccup. A silk ligature was placed round the small puncture in the stomach, and the displaced viscera returned, after enlarging the external wound. This last was closed by the quill suture. Warm fomentations and abstinence from food and drink enjoined. 2nd day, some re-action; had been sick in the night from some drink given; is free from pain; pulse 120; pain on pressure; an enema ordered. Evening, a dose of castor oil, and twenty leeches to the abdomen. 3d, much fever; V.S. [Symbol: ounce]xviij. and 20 leeches to the abdomen; bowels not opened. 4th day, two stools; pulse 98; tension of the abdomen; three more stools during the day. 5th, sutures removed; wound united, except at its right extremity, where a serous fluid is discharged in considerable quantities. On the 6th day, was allowed food, and on the 23d of Dec., about two months after the accident, was discharged cured.
49. Oesophagotomy.—This operation has been objected to, not only on account of the dangers attending its performance, but from the alleged difficulty of promoting the union of the wound in the oesophagus; as it is seldom at rest, the lips of the incision being often separated, and the mucous coat adhering with difficulty under any circumstances. Hence we are induced to notice the following case, in which the operation was successfully executed on an inferior animal, by M. FELIX, a veterinary surgeon of Bergelac. The account is published in the Feb. No. of Le Propagateur des Sci. Med.
A Cow was threatened with immediate suffocation from the lodgment of a potato in the oesophagus. It had shortness of respiration, an incapacity of swallowing even its saliva, which flowed from the mouth, was in great distress, and covered with a cold sweat. Being properly secured in a horizontal posture, an external incision was made on the inside of the sterno-mastoid muscle, and a cautious dissection practised until the tumour was completely exposed. The oesophagus was divided by "an incision extending the whole length of the foreign body, which was extracted without any force, which is almost always fatal. I immediately made two close sutures; and also two others in the skin, on each side, adapting to them two pieces of packthread, more easily to fix the dressings. I dressed the wound with brandy, filling the opening with hemp soaked with brandy." The animal was kept on very little food or drink. On the third day the wound was dressed for the first time, and a digestive ointment applied.
In the course of the 2nd week, the cicatrization of the oesophagus occurred; the part was dressed with lint; and by the 20th day after the operation, the animal was quite restored.
This case would have been more useful, if more precision had been employed in describing the dressing and subsequent treatment of the wound. It would seem that the sutures were passed through the parietes of the oesophagus only, and that the external wound was kept open by being filled with tow. Certainly, union by the adhesive inflammation ought to have been attempted in all parts of the wound; but whether sutures in the oesophagus are advantageous, or whether the uniting bandage be preferable, is not so easily determined. In the two cases described in 3d vol. of the Mem. de l'Acad. de Chirur. the uniting bandage was alone employed, and with success.
50. Retention of Urine, caused by a Stricture of the Urethra, relieved by a forcible but gradual Injection.—The editor of Le Propagateur des Sci. Med. in the No. for Feb. 1826, introduces the following case, by observing, that it reflects great honour on M. AMUSSAT, and that his discovery merits the greatest praise. M. D... aged 70 years, of a plethoric constitution, had suffered about 30 years before from three attacks of gonorrhoea; since which period he has had a difficulty in urinating, and can never discharge more than one or two ounces of urine at a time.
At eight o'clock, P. M. of the 1st of Feb. he tried to urinate, but could not succeed. He suffered great pain. Pulse agitated; face flushed; belly swelled, and globular at its inferior part; the subcutaneous abdominal veins distended, and the penis in a state of semi-erection. All attempts to urinate were painful and ineffectual. At ten o'clock, A. M., on the 2nd, M. AMUSSAT visited him, and passed a bougie. This was arrested by a contraction near the bulb of the urethra, and caused the discharge of some blood. No urine had been passed for 14 hours, while ordinarily he urinated 12 or 16 times through the night. The obstruction was so great, that none of the usual means of relief remained, except the forcible introduction of the catheter, or the puncture of the bladder. M. AMUSSAT resorted to the following plan which he had devised, and which completely succeeded. He injected warm water forcibly, but gradually, into the urethra, which, dilating the orifice of the stricture, forced backwards the thickened mucus which had obstructed it. As soon as the liquid injection met the urine, the patient cried out that he was saved, and immediately was able to urinate as formerly. At two trials, he discharged nearly two pints of thick urine. There was no return of the retention, the patient continuing well.
Should subsequent experience confirm this experiment of M. AMUSSAT, this simple measure will be a most valuable substitute for those dangerous measures hitherto resorted to for retention of urine, in cases where the obstruction arises from thickened mucus, from small calculi closing the orifice of a stricture, from inflammation, or from what are termed, (justly or not,) spasmodic strictures.
51. Tracheotomy.—In the Amer. Med. Review for April, Dr. JOHN ATLEE, of Lancaster, mentions that on Wednesday, Aug. 11th, he was consulted by a child ten years old, who had that morning, while running, put a button-mould into his mouth, which during respiration was drawn into the trachea. He complained of uneasiness in respiration, with a slight rattling, and pointed towards the upper part of the sternum, as the situation of the button. On coughing, a rattling was heard, and immediately after, a sudden check to expiration, from the lodgment of the button near the rima glottidis, requiring a sudden and violent effort of inspiration to remove the sense of suffocation. An emetic was given with no advantage. During the night, he had two or three spells of coughing, threatening suffocation.
An operation was urged, to avoid immediate and subsequent dangers from the lodgment of this extraneous body, and was agreed to by the parents, and by Dr. HUMES, who was called in consultation. It was performed on the 14th of Aug.; a cathartic, and afterwards an opiate, having been given.
An incision, one inch and a half long, was made through the integuments, extending downwards from above the cricoid cartilage, and exposing the sterno-hyoid and thyroid muscles, which were then separated. After exposing the trachea, a longitudinal incision, about three-quarters of an inch in length, was made through its parietes at the third ring. This was held open, and the patient requested to cough. This was ineffectual. The wound being closed, the button was, by coughing, thrown up against the rima glottidis. A probe passed into the trachea, produced a violent effort to cough, by which, as soon as the instrument was withdrawn, the button was thrown through the wound, to some distance from the patient.
The wound was dressed with two sutures and adhesive strips. Most of it united by the first intention: and in a few days the patient completely recovered.
52. Fistula Lachrymalis—At the session of the Royal Academy, on the 15th of December, M. J. CLOQUET related the case of a female, who, three years previously, had submitted to the operation for fistul. lachrym. according to the method of M. FOUBUT. The canula which had been allowed to remain in the nasal canal, had ulcerated through the floor of the nose, and presented its inferior extremity on the inside of the mouth.
A practical commentary on this mode of operating, which is still recommended by able surgeons!
53. Aneurisma Herniosum.—This form of aneurism is supposed to consist of a dilatation of the internal and muscular coats of the artery; the external cellular having been destroyed. It is termed by ARNAUD, and by Dr. WILLIAM HUNTER, aneurisma herniam arteriae sistens. Its existence in any case has, however, been denied by a large majority of surgeons; and perhaps the only cases reported are those of DUBOIS, in 1804, found in the thoracic and abdominal aorta of a dead subject.
The reporter of the following case, quotes also MONRO, as having cited examples of this kind of aneurism. But what MONRO termed a "mixt aneurism," arose from the rupture of the coats of a "true aneurism," by which it was reduced to the state of a "false aneurism;" very different from that here contended for. SABATIER and BOYER, also, deny the existence of this hernia of the artery, and a good summary of facts and arguments is given by BOYER in his Surgery, in support of this opinion, (vide article Aneurism, tome i.) which it would be difficult to invalidate, especially by cases analogous to the following. The reporter, M. BONNET, of the late French army, considers this case as proving a hernia of the artery in a vessel of medium diameter; those of DUBOIS having been noticed in the largest arteries.
A Prussian soldier was wounded over the femoral artery by a musket ball. No haemorrhage ensued, and the wound cicatrized. In this state, M. BONNET visited him for a mortification of the foot of the same limb, which had been frozen. Amputation of the leg was performed, the stump healed readily, and in 12 days the ligatures came away. On the 13th day, (being six weeks since wounded in the thigh,) the patient perceived a tumour at the original cicatrix on his thigh, which had appeared during the preceding night. On the 14th, it had enlarged to three times its former size: it was painful; fluctuation was evident; but there was no pulsation, not even the thrilling noise, which is evident in the last stage of aneurism. A consultation was called, to determine whether it was an abscess or an aneurism. The question could not be satisfactorily answered, and it was determined to open it, after having made the necessary arrangements to secure the artery, should the tumour prove aneurismal. As soon as the integuments were punctured, the jet of blood evinced the nature of the complaint; and the artery was secured by ligatures above and below the tumour. The coagula were numerous, and the superficial ones, quite hard and cartilaginous. The patient did well, and there was every prospect of his recovery on the 1st day, when M. BONNET was forced by the movement of the armies to leave him at Meaux.
Such are the facts, from which the Reporter infers, that the aneurism consisted of a protrusion of the internal and middle coats of the artery. The reasoning, founded on them, appears to us inconclusive; but we have not space to insert it, and must refer to the March No. of Le Propagateur des Sci. Med.
54. Extirpation of the Two Dental Arches, affected with Osteo-sarcoma.—Dr. GIORGI REGNOLI, physician at Pesaro, performed this operation on a female 35 years of age, who had from infancy, been troubled with pain and diseases of the teeth and jaws. When Dr. R. visited her, both dental arches were enormously swelled; red and sanguineous tumours had formed over their whole surface, and covered the teeth. The alveolar processes were entirely softened. The diameters of the mouth were greatly lessened; but by the touch, it was evident, that the disease was confined to the alveolar processes of the two ossa maxillaria. A foetid odour exhaled from the mouth. Lancinating pains continually tormented the patient; especially on attempting to masticate. The slightest touch was very painful, and was always followed by an effusion of blood. There was also an alteration of voice; a disgusting deformity of the mouth, with emaciation, fever, &c. The operation was performed on the 18th May, 1825.
The patient was seated opposite to a window; her head being supported against the breast of an assistant, who, at the same time, pressed upon the labial arteries. The inferior lip was divided perpendicularly, and detached laterally from the inferior jaw, so as to expose the whole extent of the carcinoma. Some strokes of the saw were made on the anterior and most prominent part of the bone, and into the groove thus formed, the blade of a very strong knife was inserted, by means of which, aided by some slight strokes with a mallet, all the diseased portion was removed. The soft parts had been previously detached from the internal surface of the jaw. The last left molar tooth, not being diseased, was alone left. The haemorrhage from the dental artery was arrested by the actual cautery.
The dental arch of the upper jaw, was then completely removed in the same manner. The bleeding was here more profuse, but was arrested by a hot iron. The alveolar processes thus removed, were enlarged, and of a lardaceous colour, and the fungous growths had the appearance and consistence of indurated albumen.
In 25 days, the patient was discharged well. Her general health was good; the foetor had quite gone; the cicatrix over the bone was regular, white, hard, and could be pressed upon without causing pain. The patient can triturate her food with facility; the lips are slightly drawn inwards, without any sensible inconvenience; and the voice is a little altered, but this even is daily improving.—Le Propagateur des Sci. Med. for Jan. 1826.
55. Traumatic Erysipelas.—In the Feb. No. of the Revue Medicale, is a clinical report of the celebrated Baron LARREY, surgeon in chief of the Hospital de la Garde Royale; in which he criticises severely the use of leeches in erysipelas, and recommends in that variety of the disease, arising from wounds, &c. the application of the actual cautery, as effectual in arresting immediately the progress of the disease. It causes, he says, but little pain; destroys the burning and tense pain of the disease, as also the redness and swelling of the part; is not followed by suppuration, and does not cause gangrene in the contiguous parts. The eschar separates, without leaving a cicatrix. Various other advantages are enumerated, all of which are confirmed by a list of cases, as treated at the hospital. We have no room for details, which would, if known universally, hardly render us Americans, whether surgeons or patients, as fond of the cautery, as our trans-atlantic brethren of the French school.
56. Obliteration of a portion of the Urethra, remedied by an operation.—M. VANIER of Cherbourgh, relates in the Jan. No. of "Le Propagateur des Sciences Medicales," the case of a man aged 27 years, who, on the 16th of June, 1815, was wounded in the penis by a musket ball, which completely divided the urethra at its middle portion, without injuring the corpora cavernosa. The wound healed up; but by degrees, the passage contracted, so that in May, 1819, the patient could pass his urine only guttatim, with pain and difficulty, and was threatened with inflammation, &c. of the perineum. Bougies afforded no relief. An incision was then made externally, in the direction of the urethra, so as to divide the cicatrix, and open the canal above and below the contracted part. The lips of the incision were drawn together over a sound, passed into the bladder; and by the 5th day, the wound was completely cicatrized. The sound was then removed, and a short bougie inserted, so as to pass beyond the cicatrix. This was worn occasionally, and the patient completely recovered. At the end of three years, he was able to "urinate with ease, and in a full stream."
57. Artificial Joint cured by Caustic.—Dr. J. RHEA BARTON, has applied the caustic potash to the extremities of the fragments of a broken tibia, after an artificial joint had fully formed. Exfoliation was produced, followed by bony union. In three months, the patient recovered.
Dr. B. alludes to other cases, by Mr. WHITE of Manchester, and Mr. HENRY CLINE, thus treated with success; to two instances, in which the practice failed in the hands of Mr. EARLE; and finally, to one case by Mr. A. COOPER, the result of which he has not learnt. He does not recommend the operation, as usually preferable to the seton, for which, the profession is indebted to Dr. PHYSICK; but as an additional expedient, when other means fail.—Med. Record. April, 1826.
58. Epilepsy cured by Trephining.—In the 17th No. of the New-York Medical and Physical Journal, Dr. DAVID L. ROGERS relates an interesting case of a man, aged 46, who had been subject to epileptic convulsions for 14 years, and who, of late years, had been unable to labour, and rapidly sinking into a state of idiocy, from their frequent recurrence.
These fits were preceded by a fracture of the os frontis, with depression, from which he readily recovered; but soon after he was attacked with convulsions. He now suffers pain on the injured side extending down the neck and left arm—the eye of the same side is diminished—the sight much impaired, and his memory almost entirely destroyed. A cicatrix covering a slight depression was easily found, above the left superciliary ridge of the frontal bone, and over the superior orbitar foramen. Under these circumstances, the operation of trephining was performed on the 7th of July, 1825, but with some difficulty, from the irregular thickness of the bone, and from the saw having to pass through the upper part of the frontal sinus. "The dura mater was unfortunately cut through for one-half the circumference of the circle." The parts were found more vascular than usual, and the under surface had a ridge corresponding to the internal depression, but too slight to have caused compression of the brain. "Having made a section of the frontal sinus, [with a trephine?] a part of the posterior table was removed with the circular piece. This portion of the internal table had been fractured, and separated to some distance from its inferior attachments to the frontal plate, and driven back upon the substance of the brain. Its sharp edge was worn round and smooth." This seemed to have been the cause of all the mischief.
After the operation, the patient suffered from pain in his head, with some moderate excitement, which was relieved by cathartics. He had no return of fits until the 25th day, when the wound was entirely healed. These had been brought on by overloading his stomach with food, and were followed by high arterial excitement and inflammation of the brain.
He was relieved in a few days by active depletion, and was discharged cured on the 20th of August. Nine months afterwards, this man continued free from fits, his memory had nearly recovered its usual strength, and he could attend to his business without any inconvenience.
59. Gastrotomy.—M. BULK, in Germany, has successfully performed this operation on a female, aged 36 years, of good constitution, under the following circumstances. The patient, during her pregnancy, suffered from a severe pain at the left and inferior portion of the abdomen; her menses were not suppressed, and every six or eight days, a clot of blood and mucus came from the vagina. Her general health was very good.
About the middle of her 8th month, she was washing some linen, and suddenly felt as if something was tearing in her abdomen; at the same time, a swelling of the size of two fists (poings) formed on the right side, below the umbilicus. She fainted, and for six weeks suffered dull pains in the abdomen. At this time, she had true labour pains for 48 hours, and was attended by a midwife. The os uteri dilated so as to admit one finger only. The tumour disappeared during these pains. The patient recovered, with the size of the abdomen undiminished.
In this state she continued for two years and three months, menstruating regularly. She became again pregnant, with little inconvenience until the 7th month, when her abdomen was painfully distended, and of a bluish colour, and fluctuation was induced on the least motion. At the full period, she was delivered of a large foetus, which she suckled for 15 days. The infant then died of an aphthous affection.
Her milk ceasing, she rapidly declined with hectic symptoms. The tumour reappeared below the umbilicus about the size of an egg, and soon opened, discharging from small orifices a little pus. The opening was enlarged, and some skin and hairs were removed. The patient's constitution was fast yielding, and gastrotomy was immediately performed. An incision was made, with the requisite precautions, through the linea alba into the cavity of the abdomen, from two and a half inches above the umbilicus to within nine lines of the pubis, care being taken to prevent the escape of the intestines. A foetus of full size, in which putrefaction had commenced, was found on the right side of the uterus. "I raised," says the operator, "the body with much care, and endeavoured to trace the umbilical cord. This was turned over the fundus of the uterus to the left side, and terminated in a vascular substance in a state of suppuration, (probably, the remains of the placenta,) which was situated below the great omentum. I pressed out, and dried up the pus, which covered these parts, by means of a sponge. The uterus was an inch and a half in length and an inch in breadth, of a pale rose colour, and could easily be distended (se laissait distendre aisement.) It was otherwise in a good condition."
The wound in the abdomen was closed with sutures. The patient was in great danger from inflammatory symptoms for 8 days, but eventually recovered. She left her bed on the 55th day.
60. Caesarian operation, performed with safety to the Mother and Foetus.—We condense from JOHNSON'S Review for April last, the following summary of a case of Caesarian section performed by GRAEFE, on the 20th of September, 1825.
Carolina Bechang, was admitted into GRAEFE'S Clinicum, in an advanced stage of pregnancy; being 30 years of age, much deformed by rickets, and only four feet (Rhenish) in height. On the 20th of Sept. after having been five days in labour at the full period, pains severe, and os uteri dilated, she consented to the Caesarian section.
A little after 2 o'clock, GRAEFE placed the fore finger of his left hand, immediately below the umbilicus, and with a large scalpel, made an incision downwards in the linea alba, to within one inch of the pubis; dividing the entire parietes, and even penetrating the substance of the uterus. A second incision penetrated the uterus and exposed the placenta; which, as had been anticipated, was found on the fore part of the fundus. The assistants now compressed firmly the edges of the divided abdominal parietes upon the uterus, to prevent the protrusion of the intestines, in which they succeeded; and GRAEFE carried his hand in a moment into the uterus, separated the placenta with his finger and thumb, and then withdrew it and the child almost together. The child was very active, and cried lustily. The uterus immediately and suddenly contracted, and the bleeding was inconsiderable. Not more than twelve ounces of blood were lost, and no ligature was required. The whole operation was completed in four minutes and a half. The wound was secured by three broad sutures, and adhesive plasters, assisted by a bandage round the abdomen. The child weighed six pounds and was well formed. During the operation, the patient was sick, and once vomited slightly. In two hours had pain and fever: V.S. [Symbol: ounce]xij. Draught with ten drops of the aqua laurocerasi was given, and repeated in a few hours. The patient passed a quiet night. The symptoms of pain, inflammation, and fever, were threatening for some days, and were promptly resisted by the lancet, by enamata, by narcotics, especially the laurocerasus and hyosciamus, by fomentations, &c. By the 9th day, the wound had cicatrized, excepting near the symphisis; symptoms all favourable. The lochia were discharged regularly; and in three weeks, she was able to sit up, and in three more, quite well. Early in November, she returned home with her child, both in perfect health.
In FERUSSAC'S Bulletin Universel; for February, another case, in which the Caesarian operation was performed with safety to the mother and infant, is copied from RUST'S Magazine.
61. Extirpation of the Uterus.—Dr. RHEINECK, of Memmingen, was consulted by a female, who in December, 1824, was attacked by fever, from which she slowly recovered. A prolapsus of the uterus, which gradually became inverted, followed, attended with frequent haemorrhage and discharge, by which she was almost worn to the grave. The whole of the uterus was inverted, and without the labia externa; its surface loose, fungous, and in several places easily broken down upon pressure; but there was no hardening nor ulceration. The irritation was so great, as to threaten the patient's life, and after a consultation, in which it was agreed, that the swelling was really formed by the uterus, the tumour was laid hold of and drawn forwards, and a broad ligature, secured with a double surgeon's knot, was applied round its base. In about three weeks, the whole had separated, and the part above the ligature was cicatrized. During this period, the patient was dangerously ill, and was only rescued by great care and attention.
The operator had before performed a similar operation, in which case, the patient died suddenly from haemorrhage, on the separation of the ligature. OSIANDER, STRUVE, LONGENBACK, SAUTER, SIEBOLD, and ZAUG, have in late years performed the same operation, with various degrees of success.—Johnson's Review for April, 1826, who quotes from Siebold's Journal fur Geburtshulfe, 1826.
62. Uterine Haemorrhage.—In the Bulletin Universel for Jan. 1826, the following case is detailed from the Gazette de Sante, for Dec. 1825.
A female aged 32 years, was taken with labour with her first child, on the 12th Feb. 1825. The pains soon ceased, and on the 15th of Feb. M. BEDEL, physician at Schirmack, was consulted, who speedily delivered her, by means of the forceps, of a dead child. The haemorrhage was so considerable, as to render the immediate removal of the placenta necessary; but the uterus did not contract, and the bleeding continued, with tremblings, syncope, cold sweats, &c. Irritation on the internal surface of the uterus, the use of cold water to the abdomen, injections into the uterus of cold water and vinegar, were unavailing.
Plugging the vagina, and also the uterus, was now resorted to, as the only means of safety remaining. The uterus was filled with pieces of rags, for fear the patient could not sustain the loss of blood necessary to fill that cavity; while a methodic compression was at the same time made to the abdomen. The haemorrhage was immediately arrested, and soon after reaction ensued.
On the 16th, M. BEDEL extracted the plugs from the uterus, cautiously and in succession; and had the pleasure of finding the uterus regularly contracting after each removal. The lochial discharge continued, and there was no secretion of milk. The patient recovered slowly.
It is in such cases as the above, that the physicians of the United States have employed the Secale Cornutum (Ergot,) the judicious use of which would have probably superseded the necessity of instruments, and prevented or arrested the haemorrhagic discharge.
VII. CHEMISTRY AND PHARMACY.
63. State in which Morphia exists in Opium.—In the 80th article of our Quarterly Summary for January, we stated that MR. ROBINET had announced the discovery of a new acid in opium, with which the morphia was combined; while the meconic acid was alleged to be united with soda. To the former salt, he gave the name of codeate of morphia. MR. ROBIQUET, however, has shown, that the pretended codeate, is a muriate of morphia, formed by double decomposition between the muriate of soda, employed by MR. ROBINET in his analysis, and meconate of morphia. The same decomposition shows the source of the meconate of soda. We observe that MR. ROBINET admits his mistake.—Archives Generales de Medicine.