« AnteriorContinuar »
the anæsthesia remains absolute, and the animal might be considered dead, if auscultation did not still reveal the weakened sounds of the heart, and some rare inspiratory efforts. The ordinary life soon recommences, respiration is re-established, and the heart progressively resumes its normal rate, and sometimes slightly exceeds it. But occasionally the passage from stupor or apparent death to real death is sudden, unexpected, and similar in this respect to sudden death by chloroform : the heart and respiration, already very slow in their actions, cease at once and for ever.
In case of poisoning by carbonic oxide, the antidote most likely to prove serviceable is ammonia; and Dr. Ozanam details two cases of rabbits poisoned by carbonic oxide, which were restored by the application of the vapour of ammonia.
VIII. On the Use of Amylene as an Anæsthetic Agent. By M. Luton.
(Archives Générales de Médecine, February, 1857. After describing the properties of amylene, as recorded by Dr. Snow in some papers recently published in this country, M. Luton details the results of two experiments made in Paris upon young children with this anæsthetic. In both cases there was sudden and remarkable lachrymation, as in breathing the vapours of ammonia; and there was evident repugnance at first to the inhalation; but this soon passed away, and anæsthesia was induced. Both children rapidly recovered after the amylene was withdrawn. Admitting that the results observed in two cases only are insufficient to justify the expression of any decided opinion upon the qualities of amylene as an anæsthetic, M. Luton thinks that he may draw the following conclusions: The advantages resulting from its employment are, that its action is rapidly manifested and rapidly dissipated, owing to its great volatility; that the insensibility is sufficient, although the sleep is less deep than that induced by chloroform; and that there is less uneasiness to the patient during the course of the operation. The inconveniences of amylene are to be found in the necessity of employing a great quantity of it during the operation, and its disagreeable odour, which is so strong as to be offensive to the persons engaged in the operation, and, of course, is still more so to the patient.
IX. On the Employment of Electricity in the Suppression of the Lacteal Secretion.
(L'Union Médicale, January 3rd, 1857.) M. Becquerel, in a late communication to the Société Médicale des Hôpitaux de Paris, has made some remarks upon the influence of electricity in restoring the secretion of milk. His attention was called to the subject by a case related to him by M. Aubert, who had employed electricity in the case of a young woman whose milk had been suppressed in consequence of a double pneumonia. The electricity was applied to the breasts by means of moist excitors, and after four applications, each lasting twenty minutes, the lacteal secretion was completely restored. M. Becquerel was at first incredulous as to the reality of the result; but the following case, which fell under his observation, removed his doubts :
A young woman, aged twenty-seven, well formed, although of a nervous temperament, had suckled a young infant for six months, but, on the occasion of some intense and often-repeated mental emotions, the lacteal secretion diminished considerably; the right breast retained a little milk, but the left was almost completely dried up. M. Becquerel applied the electrical current at first to the left breast, placing the moist excitors, made of sponge, successively
in the different points of the circumference of the breast, so that the currents might traverse the organ in all directions. Three applications were made, each lasting a quarter of an hour. The patient suffered very little, and indeed experienced little more than a feeling of inconvenience. From the time of the first application, the rush of milk supervened almost immediately after the application of the electrical currents. After the third application, the secretion was full and entire; the child had taken the breast, and the milk was abundant in the left breast, and sufficient in the right to obviate the necessity of applying the electricity on that side.
X. On a Case of Diabetes treated by the Use of Rennet. By Dr. IVERSEN.
(Archiv des Vereins für Gemeinschaftliche Arbeiten, 1856.) Dr. Iversen relates the case of a patient, in the lower class of life, who had well-marked diabetes, who was treated with rennet, and the details of whose case were carefully recorded day by day. As all the usual plans of treatment had been unsuccessful before the patient's admission into the hospital under Dr. Iversen's care, he made an experiment of the rennet treatment. In order to obtain as accurate a result as possible, it was determined, in the beginning of the treatment, not to alter the diet of the patient, except to recommend the greatest possible abstinence from drinking. By the table prepared by Dr. Iversen, the treatment seems to have been successful in diminishing the quantity of sugar in the urine; but from some circumstances which are not explained, the patient was seized suddenly during the progress of the case with fainting, followed by spasms, ending in death. No post-mortem examination was permitted, and the case is therefore imperfect. Notwithstanding the unfortunate result, Dr. Iversen considers that the constant diminution of the urine, both in its actual quantity and in its saccharine ingredient, was very remarkable. He shows that in the first four days, during which the patient took no medicine, the average quantity of urine voided amounted to 10:108 cubic centimètres. In the following period of seven days, during which she took the rennet, the quantity of urine reached only 7.927 cubic centimètres, with a quantity of sugar amounting to 324 grammes. In the next five days, during which she took the rennet in combination with phosphate of soda, the average daily quantity of urine sank to 6.988 centimètres, with 250-317 grammes of sugar. The patient herself attributed to the rennet the power of allaying in some measure the burning thirst which she experienced.
XI. On the Use of Sulphate of Atropia in Diseases of the Eye. By Dr.
FRIEDRICH MOSLER. (Archiv des Vereins für Gemeinschaftliche Ar
beiten, 1856.) As the result of practical investigations upon the use of sulphate of atropia in ophthalmic medicine, Dr. Mosler arrives at the following conclusions : -1. That the sulphate of atropia is preferable to the pure alkaloid for therapeutic purposes. In a state of purity the sulphate, employed with the necessary precautions, even in large doses (such as five grammes to an ounce of distilled water), produced ng unfavourable effects upon the eye. In using it, care must be taken of the absorption of the tears running from the eye and mixing with the solution, and the absorption of the solution itself is to be guarded against. 2. In ophthalmoscopic investigations, atropia has rendered especial services in many cases ; in order to diminish as much as possible the inconvenience felt by the patient in its use, attention must be paid to the investi. gations of Donders, upon the more or less enduring operation of the different
strong solutions. The employment of atropia is not a priori to be recommended in every ophthalmoscopic investigation. 3. In inflammatory states of the eye, especially those characterized by violent pain, intolerance of light, and abundant lachrymation, as particularly in injuries of the eye, with or without affection of the iris, we have been acquainted with atropia as an essentially soothing agent, as by its operation on the sensitive nerves of the eye it possesses the power of removing rapidly the state of excessive irritation. As a decided remedial agent, it appears moreover to act by its operation upon the motor nerves in the eye, inasmuch as, according to the explanations of Dr. Von Gräfe, it paralyses the muscles which are found in and about the eye, and which in such cases exercise an excessive pressure upon the internal structures of the eye, and in consequence of the return of the blood being impeded, give rise to accumulation of blood in those structures. It is thus explained why abscesses of the cornea under its use are less perforating and more easily healed, and why hypopyon is more rapidly absorbed. 4. Astringent eye-waters, especially the stronger cauterizing fluids, are better borne, and are attended with more rapid success, when the excessively heightened sensibility of the eve, which exists in the cases where this remedy is applicable, has been pre. viously deadened by atropia. 5. Cauterization of the eye, employed only once daily with all necessary precautions, is better borne in many cases than the more frequent instillation of eye-waters, which every time appear to induce a new and well-marked irritation.
XII. On the Employment of Iodide of Calomel (Chlorure Mercureur) as a Local
Application in Uterine Engorgement. By Dr. F. RoCHARD.' (L'Union
Médicale, January 6th, 1857.) Dr. Rochard having applied the iodide of calomel in certain hypertrophic and sub-inflammatory affections of the neck of the uterus, has arrived at the following conclusions in favour of this kind of medication.
When a pledget of charpie, covered with a pommade of iodide of calomel, is applied to the neck of the engorged uterus, ulceration being absent, the women in general experience no particular sensation, but sometimes they feel towards the conclusion of the application a slight sensation of heat in the hyypogastric region; when ulceration exists the sensation of heat is manifested very early, and is habitually followed by pains which may be rather severe. As soon as the dressing is removed, the sensation or even the pains are immediately re. lieved, and the neck of the uterus when examined appears more voluminous than before. If it is not ulcerated, there is formed upon all the surface of the mucous membrane touched by the pommade a thin exudation of a greyishwhite colour, and of a consistence rather less than that of boiled albumen, which, when examined by the microscope, exhibits neither pus, nor epithelium, nor fibres, but only a granular, transparent, and apparently amorphous mass. When the neck is ulcerated, the same exudation is formed, but it does not remain adherent to the mucous membrane, and is removed with the dressing; in this case it contains some remnants of deformed epithelium. Besides this exudation, the charpie which has served for the dressing is always moistened with a serous liquid, sometimes sufficiently abundant to flow outwards and to form greyish spots upon the patient's linen. In the days succeeding the dressing, the exuded coagulum is detached by degrees, the volume of the os uteri diminishes, and becomes less than it was before the topical application; if there was any induration, which is generally the case, this induration is much less from the day succeeding the dressing. At the end of eight, ten, or twelve days, if the amelioration has made no progress, the dressing is renewed, and gives rise to the same phenomena, although in a less marked degree; and
after two, three, four, or five applications made at the same intervals, the os is usually restored to its normal volume, and the ulcerations are cicatrized. The patients, who feel themselves less heavy on the first application, are relieved from all painful sensation, particularly those who had no ulceration. The latter recover only after a longer period; the others can generally walk with ease after the second application, even when walking was previously impossible. The mode of applying the pommade is by preparing a pledget of charpie of suitable thickness, and of rather larger dimensions than the volume of the os uteri. The centre alone is covered with a light layer of the pommade, so that the edges which remain dry defend the vaginal mucous membrane from the contact of the application, which might cause inflammation.
XIII. On the Treatment of Scrofulous Affections by the Todide of Potassium.
(L'Union Médicale, February 17th, 1857.) Dr. Vincent Duval adopts the following plan in the administration of iodide of potassium in infantile scrofula. In children from one to three years of age, he prescribes the iodide of potassium in solution in distilled water, in the dose of ten to fifteen centigrammes a day during the first week, and of twenty to thirty in the three succeeding weeks. At the end of this time he discontinues the use of the drug for a week, and during this interval he purges the patients with castor oil, or preferably with calomel. Then he recommences the use of the iodide as before. At the end of two months, if the digestive passages are in an unfavourable condition, he orders one or two grammes a-day of bicarbonate of soda, dissolved in sugared water or the infusion of hop. After a fortnight or a month of the use of the bicarbonate, he returns, if necessary, to the employment of iodide or bromide of potassium for one or two months. In children of more advanced years, the dose must be augmented in proportion; but even in adults, Dr. Duval seldom gives more than one gramme in a day. He often adds to the iodide of potassium the sulphate or the citrate of iron, more frequently the latter. When the patients are thin and weak, cod-liver oil agrees very well, not only as an iodized medicine, but also as a fatty body; it renders the blood more plastic and more fibrinous, the respiration more active, and the absorption of oxygen more abundant. Given at the same time with the iodide of potassium, this latter medicine does not cause emaciation in the patients. If citrate of iron is added, independently of the iodide of potassium, its action is still further augmented. [Combinations, ready prepared, of cod-liver oil with iodine, iron, and other alteratives and tonics, have been long employed in British practice.—REPORTER.]
XIV. On a Nero Principle of the Colchicum autumnale. (L'Union
Médicale, January, 10th 1857.) M. Oberlin has just communicated to the Académie des Sciences at Paris some observations on the Colchicum autumnale, from which he has extracted a neutral crystalline principle which he calls colchicéine, and which differs from colchicine, a complex and uncrystallizable product. The properties of colchicéine are to crystallize very easily in pearly laminæ, and to be almost completely insoluble in water, but to communicate to this fluid a slight bitterness, which increases sensibly when it is boiled. At this temperature a notable part of the product is dissolved, but is deposited immediately after cooling. The solvents of colchicéine are alcohol, ether, methylated spirit, and chloroform, which contract, when mixed with it, a very intense and persistent bitterness. The alcoholic solution of colchicéine is coloured by the addition of bichloride of platinum, but no precipitate is formed. Pure concentrated nitric acid dissolves colchicéine, and becomes coloured of a very intense yellow tint, passing into a violet colour, then to a deep red and a clear red, and finally returning to its primitive yellow colour. Concentrated sulphuric acid forms with it a solution of a very intense yellow colour, which is preserved even when it is diluted with water, and brownish flocculi are formed in it. Hydrochloric acid dissolves it with a clear yellow colour. The acetic acid also dissolves it, but without change of colour. Colchicéine is soluble in ammonia, and crystallizes by evaporation in the air; and it dissolves in caustic potash. It is unalterable in the air; it has no effect upon turmeric paper or litmus paper; exposed to heat, it first softens and afterwards fuses at 155° (Cent.?). The elementary composition of colchicéine is C 62, 83+H 6, 60+N4, 19+026, 38=100, 00.
XV. On the Treatment of Strangulated Hernia by the Internal Use of
Belladonna. (L'Union Médicale, January 27th, 1857.) Dr. de Larne, of Bergerac, relates the following case, in which the emplovment of belladonna combined with the taxis succeeded in effecting the reduction of a strangulated hernia. An old woman, aged seventy, had suffered for about seven years from a crural hernia of the right side, which however did not generally give rise to inconvenience or pain. On rising from bed on the 17th of September, 1856, she experienced the symptoms of strangulation of the hernia; the belly was stretched, tympanitic, and painful to the touch; there was repeated vomiting, most frequently stercoraceous; total absence of evacuation by the anus; small, weak pulse, without marked frequency; skin dry, moderately hot; respiration anxious; slight thirst; dislike of food: the tumour was resistent, of a violet hue, as large as a turkey's egg. All attempts at manual reduction having failed, the patient was ordered rest, low diet, a suitable position, cold water for drink, and a belladonna mixture. The latter preparation was composed of the watery extract of belladonna, 20 centigrammes; of syrup of orange flowers, 30 grammes ; and of distilled water, 60 grammes. It was given in the dose of a teaspoonful every quarter of an hour, and was continued for nearly four days, when the obstacle having been sufficiently removed by the use of the belladonna, the hernia yielded readily to the taxis. The author of the communication observes, that during the administration of this drug a notable and real amelioration of the tumour was observed, although the strangulation continued; and that, notwithstanding the dose (which amounted altogether to one gramme and a half of the extract of belladonna), only a few alternations of delirium or sleep were induced, without any other toxical symptoms of importance.
XVI. On the Therapeutical Applications of Glycerine. Supplemental Notes. By
Dr. W. LAUDER LINDSAY. (Edinburgh Medical Journal, April, 1857.) In continuation of the remarks previously made by Dr. Lindsay on the therapeutical applications of glycerine, he has collected together a large amount of evidence in favour of this substance as a remedial agent in various affections, employed both internally and externally. As an internal medicine, it would appear to possess properties very similar to those of cod-liver oil, but it has the recommendation of being more pleasant to take ; and in certain cases where the cod-liver oil was not tolerated, glycerine has been used as a substitute with the best results. It should be mentioned that the effects of glycerine vary considerably in proportion to the kind of article supplied, and that the specimens obtained from various sources are by no means of equal purity and value. As an external application, glycerine may be considered as