Imatges de pÓgina
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as possible, when the old name is equally simple and good, that it should be retained, or made the officinal name. This might be done out of respect for our ancestors, but, in my opinion, for a much more powerful reason ; viz. that we ourselves may the more easily understand their works; and, as my good friend H. E. Dr Rogerson lately said to me, for the advantage of our successors. To appreciate the advantages of a fixed nomenclature for our posterity, we need only recal to mind how much more easily, and with how much more pleasure, we would read the works of our ancient writers within only a century, in Britain (not to speak of continental writers), had the terminology been the same as at the present day, or as it was only twenty years ago. Indeed, if I mistake not, we have already made considerable progress, and are rapidly advancing into the same state of obscurity, by the multiplicity and confusion of names in pharmaceutical nomenclature, that was so objectionable in botany, for want of a general plan, previous to the time of the ingenious, indefatigable, and immortal Linnæus. I wish some individual, of a mind equally clear and capacious, would devote his time to a science still more important than botany, and issue a Pharmaceutical Nomenclature into light worthy of its author, by which he would do himself much honour,contribute greatly to the advancement of pharmaceutical knowledge,-and, I am of opinion, call forth the gratitude of his medical brethren, but still more so, that of future generations. I shall only add, that I should be happy to see you crowned with the laurels.--I have the honour to be, &c.

St Petersburgh, May 15, 0. S. 1816.

P.S.- In the above letter I have alluded chiefly to a Universal Officinal Nomenclature, the first and most important requisite for a general Pharmacopæia for the empire,--of course an universality of the formulæ for chemical preparations and compound medicines would necessarily follow; a circumstance also of the greatest importance. Would that it were the case throughout Europe.

IV.

Contributions to Diagnosis. By MARSHALL Hall, M. D., &c.

Contribution First : containing, 1. The Effects of the Habit of giving Opiates on the Infantine Constitution. 2. Inflammatory Affection of the Chest in Infants. 3. Inflammation of the large Intestines in Adults. 4. Notice on the Beneficial Effect of a Warm and Regulated Temperature in conducting the

Mercurial Course, and in the Cure of Syphilis. UNDER the title of Contributions to Diagnosis, it is the

author's wish to furnish such practical observations, relative principally to the history, description, and discrimination of diseases, as his professional evocations may, from time to time, suggest to his mind. Such, at least, is the general object of these papers. But, as they may sometimes prove rather desul. tory, and of a mixed nature, it is thought better to omit any further explanation, and rather offer an example or two to the readers of the Medical and Surgical Journal, as specimens of the rest, than

occupy its pages by any further preliminary remark. 1. The effects of the habit of administering opiates or anodynes on the infantine constitution.

Feb. 10, 1816.- A boy aged six months. This infant had the breast during the first month after its birth, at which period, being deprived of it, its mother began the pernicious practice of giving it an anodyne every night; a practice which has been continued to the present day, and which has indueed the following effects.

The countenance has a shocking disfigured appearance; the colour is sallow; the eye-lids, especially the under ones, are swollen and red, secrete a glutinous matter, and are without lashes ; the lips, especially the upper one, are also bloated and swollen ; the integuments of the face, in general, are puffy and flabby, and are marked with deep furrows or wrinkles, especially below the under eye-lid, and from the nostrils obliquely downwards, and outwards. When the infant cries or laughs, the countenance assumes an aspect still more shocking, the preceding appearances being increased; the action of the muscles is deeply marked, the integuments being partly stretched, and partly puffed úp; the whole face is at once aged, haggard, and painful to see. There is an entire want of that appearance of intelligence observed in infants in general even of this age. It is constantly employed in sucking its thumb; a circumstance which may contribute to aggravate the appearances described.

'The infant is thin, emaciated, sickly, and puny, and is said to be less in bulk than on the day of its birth.

The integuments of the body are flabby, like those of the face. The skin is shrivelled.

The infant is apt to be very restless and cross, frequently cries for a long time together unappeased, and sometimes appears to be affected with griping. It was at first stopt by the anodyne ; at present it does not sleep, but becomes composed and tranquil, and ceases to cry.

Its appetite is constantly urgent, and it eats so voraciously sometimes, as to be overcome by the load of food. It vomits occasionally only, perhaps not more than is usual with infants at this age. Its bowels are alternately without evacuation for a day or two, and then affected with looseness, and much griping. The stools are dark-coloured, and fetid. Occasionally there is a copious sweat over the body.

This infant was, at this period, made to abstain from its anodyne, and to take small doses of calomel and of magnesia daily, with a nutritious diet. It gradually, during two months, recovered a healthy appearance, and its appetite, bowels, and other functions, became natural; nor did the morbid state of the integuments, countenance, and the general decrepitude, continue after this period.

March 15, 1816.–Subsequently to the last report, three infants, affected in a similar manner from anodyne compositions, have been made to forego their use, and adopt the plan of treatment just noticed. They have all improved remarkably in health, strength, and general appearance.

May 18, 1816.-Since the foregoing remarks were penned, numerous instances of the effects of opiates on the infantine system have fallen under the author's observation. The appear. ance has, indeed, become quite familiar. One female infant, of five months old, died of the effects of this baneful practice. Before death it presented the most remarkable living miniature of old age, in the female countenance, that can be imagined. To this appearance the absence of the teeth would, no doubt, contribute materially.

The effects of opiates on infants require to be accurately distinguished from those of chronic disease, -of defective nutrition, of syphilis, and from that state of feebleness in which some infants, especially one or both of twins, or those which are born prematurely, or of sickly or aged parents, are brought into the world.

2. Of inflammatory pectoral affections in children. During the months of December, January, February, and March, inflammatory affections of the chest, in children, were particularly frequent. These affections assumed, in general, one of the four following forms, or appeared as catarrh and hoopingcough.

In the first form, there are acuteness of the features in general, and contraction and whiteness about the nostrils and upper lips. The countenance is pale, except a little flush on the cheeks. The nostrils move quick with the alternate motions of respiration. The child lies still, and appears to suffer when moved. The skin is gently warm, and sometimes moist. The respiration is quick, but short ; and if the infant begins to cry, this soon ceases, the motions of the chest, which crying implies, being evidently checked by the little sufferer. There is much motion of the abdomen, and little of the chest, during respiration. The cough is dry and checked ; the pulse frequent and sharp; the stomach irritable ; the bowels regular ; the tongue whitish.

In the second form of these affections, there are general fulness and deep colour of the countenance; tumidity and enlargement of the veins of the upper eye-lids and of the cheeks ; appearance of great general oppression; whiteness of the tongue ; much oppression and rattling in respiration ; a severe, repeated, and unsuppressed cough, inducing additional tumidity, injection, and lividity of the countenance; frequency and softness of the pulse; a little heat of surface, with occasional moisture.

A similar state of countenance, of general appearance, and of the functions, is also observed in the latter and aggravated stage of the hooping-cough.

A third form of infantine pectoral affection is characterized by tumidity, redness and heat of the cheeks, with acuteness and whiteness of the nostrils. There are much heat, tumidity, and dryness of the surface, with subsequent roughness and exfoliation of the cuticle. A rapid, hurried respiration, and a hard dry cough; whiteness and load of the tongue; great frequency of the pulse; constipation. Pain of the head, aggravated by coughing

In their latter stage, the first and second forms of infantine pectoral complaint just described, are occasionally attended or succeeded by a state of general ædematous paleness and tumidity. The face is pale and swelled, particularly on one side, according to the previous position of the body. A soft flabby tumidity is observed about the hands and feet. The urine is scanty. There is a hard cough ; irritability of the stomach ; pain; looseness or irregularity of the bowels.

3. Of inflammation of the large intestines.

On Friday evening, Mr W. H. aged 50, and previously subject to dyspepsia, became seized with acute pain in the hypogastric region, attended with desire and difficulty of voiding urine. He seemed to experience relief by taking a little Sp. æth. nitros. The next morning his complaints were renewed, and they increased through the day. In the evening there was violent pain of the hypogastric region, inducing writhing of the body, and still attended with urgent desire to void urine, with ineffectual efforts. This violent attack of pain seemed to have been immediately induced by the operation of a dose of Oleum ricini. The pulse and tongue remained natural. Urine was voided, and ease obtained, on coming out of the warm bath.

On the Sunday, the pain was felt extending generally over the abdomen. The desire to void urine continued, but the bladder was found empty on passing the catheter. No further alvine evacuation. Pulse nearly natural

On Monday, there had been copious evacuations by stool, and some high-coloured urine had been passed. The pulse was 90, soft and regular ; the tongue white.

On Tuesday, the pain seemed to have been again induced by the scanty operation of a saline opening medicine. A particular pain was now distinctly referred to a spot in the left iliac region, increased by pressure, and attended with a more general pain of the abdomen. No writhing of the body, but a degree of restlessness, manifested by throwing about the hands and arms; much flatus on the stomach; a little vomiting, for the first time, on taking any thing; no continued nausea or retching. Pulse 96, in the evening 84, soft and regular ; the pain of abdomen continuing ; tongue white and loaded.

About 4 A. M. on Wednesday, the 6th day of the disease, the hands were observed to be livid and cold, and the body to be covered with a profuse cold sweat. At 7 A. M. the pulse was 124 and small. A fixed pain, similar to that formerly described as felt in the left iliac region, was now distinctly described as affecting this region on the right side, the former pain having now nearly ceased. The patient was affected with a fallen countenance, a general coldness, and profuse perspiration, clamminess of the mouth, and change of voice. The pulse became gradually smaller and indistinct, and the patient expired at 4 P. M.

On examination of the abdomen, there appeared much exudation and tender adhesions over the surface of the bowels.

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