matter. It remains but to evaporate the alcohol, to obtain the ki nine of a superior purity. "The alkali of the cinchona thus prepared is sometimes impure by an admixture of oily matter-to separate which and purify it, we must dissolve it anew in an acid largely diluted with water, filter again the liquor, and treat it for the last time with magnesia and alcohol, as has been already mentioned." 264.* The sulphate of kinine has now been employed by a great number of French physicians in fevers of type, and with considerable uniformity of success. M. Double has administered the salt in doses of two grains, morning and evening, which have been sufficient to cause the fever to cease. To prevent a relapse, however, its use was continued some days longer. In other experiments made at the Hopital de la Charité, five grains have been given daily in simple quotidian fevers, and continued for eight days. From the very first dose the recurrence of the paroxysms was prevented. Dr. Bally has reported nine cases of fever to the Royal Academy of Medicine, cured radically by the sulphate of quinine. It appeared to M. Bally, that ten grains given in five doses during the apyrexia, were sufficient to check at once the fever. In autumnal intermittents, however, he conceives that larger doses will be necessary. Two great and obvious advantages of the salt of bark over the powder are, the smallness of the dose, whereby the stomach is saved from nausea or oppression, and the freedom from astringency, it being rather indeed of an aperient than an astringent nature. The dose may be carried to 28 or 30 grains in the 24 hours, which would be equal to about three ounces of the powder. In pernicious fevers where it is desirable, during a short remission, to introduce a large quantity of the cinchona, this new preparation will be of incalculable value! M. Duval, second naval physician at Brest, has sent up a memoir *The following process for extracting cinchonin from cinchona is given by M. Badolier, in the An. de Chemie, vol. xvii. p. 273. "A pound of yellow bark bruised, is to be boiled in three pints of a very dilute solution of caustic potash. After the ebullition has continued a quarter of an hour, the liquor is to be suffered to cool, and strained through a fine cloth with pressure; the residuum is to be repeatedly washed and pressed. The cinchona thus washed is to be slightly heated in a sufficient quantity of water, adding gradually muriatic acid until litmus paper is slightly reddened, and stirring the mixture. When the liquor is near the boiling point, it is to be strained, and the cinchona strongly pressed; then add to the strained liquor, while hot, an ounce of sulphate of magnesia. After this, precipitate the whole with caustic potash slightly in excess. When the liquor is cold, the precipitate is to be collected on a filter, washed and dried, then treated with alcohol, as directed by M. M. Pelletier and Caventon, in order to obtain the cinchonin. When sulphuric acid is added to the cinchonin immediately after the separation of the alcohol crystals of sulphate of cinchonin are obtained, which, when washed with a little water, are of a very fine white colour." of seventeen cases of intermittent fevers of different types, cured by the sulphate of kinine. The medicine was prepared by Messrs. Vasse and Colomb, of Brest, who employed a new process, which consisted in boiling the yellow bark in water acidulated with acetic acid, and precipitating the alcaline principle by ammonia. M. Renauldin, M. Hallé, and M. Robiquet have also furnished various notices of this interesting discovery. We trust that what we have here adduced will stimulate our chymists-particularly the Hall, to furnish the English practitioners with a medicine which promises to be a very valuable addition to the materia medica. 7. Epistaxis. Hæmorrhages are formidable occurrences at all times, and in all places. The application of cold in hæmorrhage from the nose and fauces especially, is no new principle, but it is generally done in a partial or local manner. Dr. Platt having a severe case of epistaxis, in which four pounds of blood were computed to be lost, and the bleeding persisting in spite of all the usual remedies, he directed, in consultation with another physician, Dr. Moorers, the patient to be immersed in a bath of well-water, till rigour was induced, This effect took place in about a minute after the immersion, and continued a few minutes after coming out of the water. The hæmorrhage abated before he left the bath, soon ceased entirely, and did not afterward return. Such is the general sympathy between the capillaries of the skin and those of all other parts of the system, that we believe cold might be more freely used to the whole external surface, in internal hæmorrhages, than it now is. Dr. Bond, of Philadelphia, was in the habit of using the cold bath with success, even in pulmonary hæmorrhage. 8. Prussic Acid.t Dr. M'Leod, Physician to the Westminster General Dispensary, has given an extensive trial to the prussic acid in pectoral complaints, but has discontinued its exhibition, "because he was unable to discover any certain indication which it was capable of fulfilling." He did not find any deleterious effects from the remedy, except once, and that was not productive of serious inconvenience. In complaints of a spasmodic nature, such as hoopingcough, Dr. M'Leod believes this acid may be of use" but the only class of cases in which he feels any real confidence in its exhibition, is dyspepsia, attended with much pain in the stomach, or anomalous feelings about the chest and heart. Indeed he has known it afford relief in structural affections of this organ." A new property, however, of the prussic acid is here developed-namely, the power of ulcerating the gums and producing ptyalism. Dr. Granville appends some remarks to this communication of Dr. M'Leod, and quotes three cases, related by Dr. Nancrede of Philadelphia, in which the said acid appeared to produce considerable benefit in pectoral complaints. We need only add, that Dr. M'Leod's experience confirms the observation of Dr. Elliotson, and also of the reviewer of Dr. Elliotson's work in our 4th number for March last. 9. Partial Retinal Paralysis.* 1. Læcour, a soldier in the Royal Guard, received, 19th November, 1820, a thrust of a sharp foil between the globe of the right eye, (which was not touched) and the internal parietes of the orbit, the weapon penetrating, by all accounts, three inches or thereabouts. The wound healed, but Læcour, when looking with the right eye alone, could only see the perpendicular half of objects placed in the antero-posterior axis of that eye. As it was with that half of the eye next to the nose, which Lacour saw objects, so when these objects were carried towards the left of the patient, he could see them entire; while, if carried in a contrary direction, he lost sight of them, in toto, at a time when they could be distinctly seen with the left eye, if open. Thus it appeared, that the inner or nasal half of the retina was paralytic. In this state he was seen by the members of the Faculté de Medecine, three months after the accident occurred. A few weeks subsequently, Læcour committed some excesses, was seized with phrenitis and enteritis at the same time, and died on the fourth day of the disease. Necrologic Examination. Invaginations of the small intestines and peritoneal inflammation were observed in the abdomen, but the head was the greatest object of research, on account of the retinal paralysis before described. It was found that the point of the foil had pierced the orbital plate, and grooved the under surface of the anterior lobe of the right hemisphere, passing obliquely behind the point of the falx, and above the decussation of the optic nerves, stopping under the inferior paries of the left lateral ventricle. This tract was marked by a kind of reddish clot of fibrinous substance, but without any appearance of suppuration. Immediately surrounding this clot, the cerebral substance was yellow, and manifestly altered in consistence to about half a line in depth. Some slight serosity was effused under the left hemisphere. Another, somewhat similar case, is transcribed from Demours. Madame de Pompadour took cold in December, 1762, in the Park of Versailles, and awoke the succeeding morning capable of seeing only the half of objects with the left eye. If a person stood right before and close to her, she could not see his right cheek or corresponding side of the nose. The iris preserved only half its mo Two cases of paralysis of half of the retina (amaurosis dimidiata) par le BARON LARREY. Revue Medicale, August, 1821. tions of dilatation and contraction. This affection disappeared in about two months by means of stimulants to the skin in the neighbourhood of the eye. 10. Inverted toe-nail.* This troublesome little complaint is not beneath the notice of the surgeon. Dr. Meigs thinks it probable that the disease is generally produced by the practice of cutting at the lateral edge of the nail, with a sharp-pointed penknife. In this process, if the skin be once abraided, a sore is formed, which is perpetually irritated by the pressure of the nail above, till fungous granulations shoot out. As the nail does not yield its position, it ap pears, by the swelling of the soft parts on one or both sides, to have grown down into the flesh, while, in reality, the edge is no deeper than is natural. After reducing inflammation by the usual means, our author has cured the complaint by the following simple pro cess: "Let a small pledget of lint, just large enough to cover all the granulations, and of sufficient thickness to act as a compress, be neatly adjusted, over which a roller of linen three quarters of an inch wide, and eight or ten inches long, is to be applied, having one end previously spread with adhesive plaster. By this method we are enabled, with great ease, to make it act not only on the compress, which will destroy the granulations very rapidly, but, by confining the toe and nail, to prevent even the small degree of sliding motion or friction formerly mentioned, thus doing away one principal cause of the disease. By pursuing this treatment, the patient will generally recover, even while walking about-and the pain certainly is removed very quickly, for he can now wear a shoe, who before found a tight stocking incommodious." Philadelphia Journal, p. 266. 11. Extract of Opium,† Majendie thinks that the variable effects of opium on the human frame are owing, in all likelihood, to the opposite principles of which the opium is composed. It is considered therefore, that as those who take morphium do not experience the exciting properties resulting from the aqueous extract of the shops, the process proposed by M. Robiquet should be adopted by apothecaries and chymists, since it well accomplishes the object in viewthe separation of narcotine. M. Robiquet macerates opium, cut into small slices, in cold water, and evaporates the filtered solution to the consistence of thick syrup. This extract is to be repeatedly agitated with ether in a proper vessel. * Dr. Meigs. Chapman's Philadelphia Journal, No. 4. The ethereal tincture is then decanted, and submitted to distillation, in order to separate the ether. This operation is repeated as long as crystals of narcotine are obtained. When the ether no longer acts, the solution of opium is evaporated, and the extract prepared. As the same ether may be employed again in the preparation of extract, the process is not so expensive as might be imagined at first sight. It is said that excellent effects have already resulted from the exhibition of this preparation. 12. Nitrate of Silver.* The Giornale di Fisica, tom. xi, contains,at p. 355, a paper by Il C. Sementini, on the use of nitrate of silver in eases of epilepsy. After remarking on the difficulty which occurs in treating such cases, and the good effects which have been observed in using the nitrate of silver, and its superiority in this respect over all other remedies, both as to the effect it produces, and the little inconvenience it causes; the Cavalier states, that to secure the good effects belonging to it, the nitrate of silver should be well triturated with the vegetable extract, in combination with which it is given; that the first doses should be small, and the quantity gradually increased to six or eight grains, or even more, in a day: that the use should not be continued very long together; and that the patient should keep out of the action of light. The latter precaution is necessary, to prevent the discolouration of the skin, which sometimes happens after a long and copious use of this remedy. The precaution, however, only regards avoiding the meridian sun-light. "It frequently happens, in the use of this medicine, that a species of cutaneous eruption, consisting of small pustules, occurs. This may be regarded as a certain proof of the good effects of the medicine. "In the early part of this paper, II C. Sementini, in endeavouring to remove the impression existing against nitrate of silver, because of its poisonous qualities, remarks, that being mixed with vegetable extract, it is not really the salt, but the oxide, that is given; and, therefore, the observations of M. Orfila, on the nitrate as a poison, have nothing to do with the power of the remedy. At the same time, as an argument for using the nitrate in place of the oxide, it is remarked, that at the moment of decomposition a combination is, probably, effected between the extract and the oxide; and that actually the salt is found most efficacious. ་་ Being assured of the use of nitrate of silver in epileptic affections, and reasoning upon its tonic effect, Il C. Sementini was induced to try its powers as a remedy in cases of paralysis. The first instance quoted is of a gilder, who, probably from the fumes of mercury, had become very paralytic. An eighth of a grain of nitrate of silver was prescribed at first, but the dose was increased every * Gior di Fisica. See also Med. Repos. No. 95. |