Imatges de pÓgina
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irritating, and we have seen substituted, with advantage, the poultice of linseed meal; or the unguentum elemi, much diluted, may be substituted. In obstinate sores that do not slough, a very weak nitrate of mercury ointment may be used. All applications of a more stimulant nature are hurtful.

It has been a common practice to resume the use of mercury when the bad symptoms are nearly removed; but the author observes, that his experience feads him to depart from this practice; and we had within these two vears a well marked case of its bad effects. It is more prudent to allow the sore to heal, and to be regulated by the subsequent appearanccs, bow far the mercury may be at all required. The author says that he has met with cases where the disease never returned.

The author now procceds to point out the application of the general principles he has so ably discussed, as applicable to the treatmentof buboin its aggravated form, and the ulceration of the fauces. But here it is unnecessary for us to follow him. We would rather reserve the details for the perusal of our readers in the origi'nal work. He concludes by some reniarks on the best mode of exhibiting mercury, so as to insure its effects in curing the dis

It is a cominon practice to throw in the 'mercury very rapidly at first, with the view of charging the system, and preventing the further progress of the disease; but this mode is apt to excite too much, and to develope diseases to which the habit is subject. The author, therefore, advises a smaller quantity, as a scruple of the ointment, to be used daily for a week, and increased by degrees according to its effects. He also disapproves of the practice of giving pills at the same time with the ointment, on account of the increased duse, and because it exhausts our resources too soon. The propriety of confinement, during the use of mercury, is generally acknowledged ; but practitioners are often necessitated to comply with the wishes of the patient, and his desire to conceal the disease.

The author concludes these commentaries with some useful practical remarks on the treatment of strictures, fistula in perineo, and the introduction of the catheter in retention of urine.

We have bestowed much attention on the numerous important practical points treated of in this small volume, and we think it a work that will reward its careful perusal. It is evidently written by a surgeon who has had many opportunities of witnessing the effects of the different modifications of cure, which he shews 10 be essential for the successful treatment of this direful malady:

PART III.

MEDICAL INTELLIGENCE.

REPORT of DISEASES treated at the PUBLIC DISPENSARY,

near Carey-Street, London, from February 29th to May 31st 1816.

ACUTE DISEASES.

No. of Casos.

3 1 9

No. of Cases. Febris

20 Enteritis infantum remittens 8 | Splenitis Cynanche tonsillaris

. 5 Dysenteria parotidæa

2 Scarlatina Pleuritis

6 Rubeola Peripneumonia

10 Variola Catarrhus

92 Urticaria febrilis Pertussis

6 Rheumatismus Phrenitis

1 Convulsio Peritonitis

21 Apoplexia

5 1 3

CHRONIC DISEASES.

No. of Cases.

No. of Cases. Vertigo

10

Ascarides Cephalæa

1 1 4 3 2 11 3

23 Tænia Catarrhus chronicus

22 Nephralgia Phthisis

18 Dysuria Hæmoptysis

11 Hæmaturia Dyspepsia

8 Menorrhagia Pyrosis

2 Amenorrhea Gastrodynia

12 Dysmenorrhea Vomitas

5 Leucorrhea Hæmatemesis

1 Hysteralgia Hepatalgia

5 Prolapsus uteri Icterus

1 Lumbago Diarrhea

13 Rheumat, chron. Enterodynia

10 Asthenia Constipatio

4 Hysteria

11 5 2 5 33

CHRONIC DISEASES continued.

No. of Cases. Epilepsia

4 Pernis Paralysis

6 Lichen Marasmus

6 Prurigo Hydrops

5 Psoriasis Anasarca

6 Impetigo Cachexia syphiloidea

2 Porrigo Struma

4 Scabies

No. of Cases.

1 5 2 2 2 8 5

A chilly and ungenial spring, which has retarded the progress of vegetation much beyond the usual period, has also prolonged the duration of catarrhal and rheumatic complaints, and rendered them obstinate and difficult of cure; so that those who happened to be attacked in the early part of the season, were often unable to conquer their disorders till towards the close of it. Other diseases do not seem to have been very rife; so that the character of the epidemic constitution has been principally catarrhal. The eruptive contagions never cease to shew themselves in this extensive metropolis, and even small-pox still continues to add some victims to swell the weekly bills of mortality; but we have had occasion to see but a few scattered cases of these exanthemata during the last three months. Typhus, or common contagious fever, has nearly disappeared from our district; for the cases, inserted in the list under the head of Febris, do not approach in any of their symptoms to that character; and it is long since we have witnessed any thing like the spreading of simple fever from one individual to another, in any of the courts and close habitations, which we are called upon to visit. The cases in the list are generally slight attacks of fever, of a gastric origin, with a white and somewhat loaded tongue, little or no affection of the sensorium, but with some manifest disturbance of the stomach or bowels, which yield speedily upon regulating the functions of these organs, with the use of the antiphlogistic regimen.

The term Cachexia syphiloidea has been appropriated by Mr Pearson to a class of symptoms, with which he is undoubtedly better acquainted than any other practitioner, but which have not yet, perhaps, been sufficiently investigated to be finally subjected to generalization. It expresses the leading characteristics of this polymorphous disease with brevity, and is less equivocal than pseudo-syphilis, and some other appellations that have been proposed, as it implies merely a malus habitus, resembling, in its external signs, the morbid state which the poison of syphilis induces. The symptoms of syphilis were soon detailed with great minuteness and accuracy, and mercury early ascertained to be its specific remedy; but it seems to bave first occurred to the sagacity of John Hunter, that such symptoms were not invariably the result of the syphilitic virus, nor invariably required the specific treatment. Observation has subsequently confirmed that opinion, and greatly extended it; insomuch that the soundest observers begin to admit, that there are, in fact, no symptoms which unequivocally characterize a disease of syphilitic origin, or unequivocally indicate the necessity of administering mercury; and that it is only by combining an examination of the appearances, with a history of their origin and progress, and of the treatment to which they have already been subjected, that a satisfactory conclusion can be deduced. Neither the nodes of the periosteum, the ulcerations of the fauces, nor any of the modifications of cutaneous eruption, upon which so much stress has been laid, can be relied upon as unequivocal indications of a syphilitic or non-syphilitic disease. An ingenious attempt has indeed lately been made with great confidence, in the sister island, to settle the characteristic eruptions connected with particular modifications of the cachexia, resulting from specific primary ulcerations, as well syphilitic as non-syphilitic; but, anxious as every zealous practitioner must be for solid instruction upon this subject, and ready as every friend of independent inquiry to admire the acuteness of the suggestion, it is but too manifest that this attempt is premature. If the point, indeed, could be thus expeditiously settled, it would have been determined long ago. The practical inference, from this state of uncertainty in the diagnosis, however, is, that we should be extremely cautious in pronouncing diseases to be syphilitic, without a careful examination of their history and treatment, and of subjecting a cachectic patient to the severity of a mercurial course, when he may be restored to health by more safe and certain means. London, May 31.

T. B.

REPORT of DISEASES treated at the New Town Dispensary,

Edinburgh, from February 29, to May 31, 1816.

No. of Cases.

No. of Cases, Febris continua 19 Mania

1 ephemera 14 Epilepsia

3 intermittens 3 Convulsio

6 dentitionis Cborea

2 infantum remittens 35 Ophthalmia acuta

25 Hydrocephalus

2
chronica

. 26 Cephalæa 30 | Cataracta

3

13

15

No. of Cases,

No. of Cases. Amaurosis

1 Scirrhus uteri Fistula lacrymalis 2 Amenorrhea

8 Otalgia 5 Dysmenorrhæa

5 Surditas 5 Rheumatismus

46 Odontalgia 12 Paralysis

9 Ulcera faucium

5 Morbus spinalis
Cynanche tonsillaris
16 Caries

1
trachealis
1 Rachitis

5
Catarrhus
87 Scrofula articulorum

12 Pneumonia

26
glandularum

14
Pleurodyne
20 Syphilis

1 Phthisis 37 Phlegmasia dolens

1 Asthma

10 Venæ varicosæ Hydrothorax

5 | Tumores Pertussis 24 Phlegmon

32 Palpitatio 7 Ulcus

11 Aneurisma aortæ 1 Mastodynia

7
Hepatitis acuta
1 Erysipelas

3
chronica
5 Erythema

2
Icterus
5 Variola

4 Gastritis

1 Varicella
erythematica
1 Scarlatina

1 Fungus hæmatodes ventriculi Miliaria

1 et hepatis 1 Urticaria

1 Dyspepsia 72 Strophulus

3 Hypochondriasis 3 | Lichen

2 Hysteria 10 Prurigo

1 Enteritis 1 Lepra

7 Obstipatio et colica

27 Psoriasis Vermes 35 Purpura

1 Diarrhea 19 Ecthyma

S Dysenteria

11 Inperigo Tabes mesenterica 6 Porrigo

24 Hæmorrhois

decalvåns Fistula ani

i Psora Heroia 7 Herpes

6 Ascites 2 Acne

1 Hydrops ovarii 1 Eruptiones variæ

5 Dysuria 5 Fractura

1 Hæmaturia

1 Vulnus Gonorrhæa 3 Ustio

9 Hæmorrhagia uteri

8 Contusio et subluxatio 31 Leucorrhea

6

13

49

1

* The list above given, though referring to the practice of only three. months, comprises, in consequence of the increase of applications, almost exactly the same number of cases with that given in the last Report of six months, and may therefore be fairly compared with it.

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