« AnteriorContinua »
inhale the vapour for twenty minutes or half an hour, a blanket or some other covering being previously thrown over the head and shoulders to prevent its escape. It will be advisable to go to bed immediately afterwards, as it often induces profuse perspiration." p. 77.
The cases of ulceration of the pharynx, larynx, and trachea, are interesting. They were all chronic, and terminated fatally; but we must refer our readers to the volume itself for the details. The following proposition, however, we quote, not with a view of recommending its adoption, but on account of its originality.
"Query? Would it be advisable to make an opening into the trachea or larynx, and apply such substances to the ulcer as would have the effect of exciting a healthy action upon its surface? I have seen several ulcers upon the surface of the body, bearing a very strong resemblance to ulcers of the larynx, cured by one or two applications of nitrated silver.
"That this is a hazardous operation, I am ready to admit, but perhaps the fatality of the disease fully justifies its being resorted to. Ample experience has shewn, that, if the disease be left to itself, or combated only by internal remedies, it will uniformly prove, sooner or later, fatal." p. 92, 93.
When treating of hæmoptysis, our author states his objections to the use of digitalis strongly, and quotes two cases in which he considers it as the cause of death. The form in which it was exhibited was the infusion, which, as well as the decoction, we have always found very uncertain in point of strength, and therefore dangerous. In the case of empyema related, the operation was unsuccessfully performed.
Diseases of the heart are treated of in the third section, What would some of the practitioners of the old school think of the following practice?
"A case of carditis has fallen under my observation, in which the whole arterial system seemed to participate. A violent and rapid pulsation could be seen, as well as felt, in its minute ramifications. It was peculiarly distinguishable in the labial and digital arteries. This man lost, in twelve days, two hundred and sixty ounces of blood, For eleven days in succession, twenty ounces were abstracted, and on the twelfth, forty at one operation. From this last bleeding he derived more advantage than from all those which preceded it. Syncope was induced by it, and a permanent diminution in the force of the heart and arteries was effected. He recovered more speedily than could reasonably have been expected, and is at this time in perfect health.
"This man sometimes perspired so profusely, that it became necessary to place vessels under the bed to catch the fluid as it trickled through the bedclothes and sacking." p. 133.
From the fourth section, which is appropriated to the diseases of the stomach, intestines, and abdominal viscera, we shall only quote the following account of the effect of ardent spirit upon the stomach, as it is the result of frequent observation.
"Upon the first arrival of the fleets from the West Indies, men are frequently brought into this hospital in a state of total insensibi. lity produced by drinking rum. The precise quantity swallowed can seldom be ascertained, as it is procured by boring holes into the casks, and sucking the liquor through straws or small reeds.
"The degree of danger arising from intoxication may be best estimated by the irritability of the iris. If the iris retain its contractile power, the patient will generally recover, however overpowered his senses may be; if, on the contrary, it remain in a state of extreme dilatation when a strong light is directed upon it, but a feeble hope of recovery must be entertained.
"The paralysis, or immovable dilatation of the iris, is, for the most part, attended with apoplectic stertor, laboured and imperfect respiration, and a slow oppressed pulse. The power of the stomach is also lost, the strongest emetics being insufficient to excite it into action. Next to the insensibility of the iris, want of energy in the stomach indicates the greatest danger.
"Treatment. We must use all our efforts to excite vomiting. Ipecacuanha and sulphate of zinc or copper, in large doses, should be given, and the patient compelled to swallow as much warm water as possible. The expulsive force of the stomach should likewise be solicited by irritating the fauces with a feather
If we can make the stomach eject its contents, the patient may be considered out of danger,
"As soon as re-action in the system takes place, he should be put under a copious shower-bath. The application of cold water will of ten restore him instantaneously. On the following day, if any preternatural fulness of the vascular system be present, blood should be abstracted from the arm, and an active purgative administered. "Vencsection, in the early stages the affection, seems to be especially indicated, as there is always a considerable determination of blood to the brain; I have, however, seen it employed to a great extent without any manifest advantage; more frequently it has proved injurious. From all that I have observed, I am arrived at the following conclusions: If we can excite full vomiting, we shall save our pa tient; if we cannot, he will have a better chance of recovery if we leave him to the operations of nature, than if we bleed him, agitate him, endeavour to make him walk, or in any other way disturb him. I have had several opportunities afforded me of examining the brains and stomachs of persons who died intoxicated. The appear ances I have met with have been uniformly the same. The vessels of the brain were gorged with blood, and a quantity of serum deposited in the lateral ventricles. In the stomach I have never been able to
discover any deviations from a healthy state, but a quantity of the pernicious spirit is generally to be detected.
"The brain of a person who was destroyed by a large dose of laudanum exhibited the same marks of increased vascularity; some se. rum was effused within the ventricles, and some of the narcotic was likewise found in the stomach.
"The practice which has been here recommended, and successfully adopted, for the relief of persons under the influence of ardent spirit, 1 conceive to be equally applicable to those who have taken opium, but my actual experience in this respect has been very limited." p. 187-190.
We have prolonged this quotation to include the last sentence, in order to caution our readers against being misled by it, to neglect the agitation necessary to prevent persons under the deleterious effects of laudanum from falling asleep.
The remaining sections treat of the diseases of the pelvic viscera, of affections of the spine, of febrile diseases, and of general affections; but we have already extended our quotations to a sufficient length.
An Analysis of the Mineral Water of Tunbridge Wells, with some Account of its Medicinal Properties. By CHARLES SCUDAMORE, M. D. Member of the Royal College of Physicians, of the Medical and Chirurgical Society of London, &c. &c. London, 1816. 8vo. pp. 58.
E have perused this little pamphlet with great interest. It contains some good and original observations. Dr Scudamore found the Tunbridge water to contain in the gallon, carbonic acid, 8.05 cubic inches; oxygen, 0.5; and azote, 4.75; in all 13.3; and of solid contents, muriate of soda, 1.25; sulphate of soda, 1.47; muriate of lime, 1.54; muriate of magnesia, .29; carbonate of lime, .27; oxide of iron, 2.29; traces of manganese, insoluble matter, .44; loss, &c. .19; in all, 7.68 grains. The temperature of the water is uniformly 50°. The supply of water is more plentiful, but it contains a smaller proportion of iron in spring than in autumn. We pass over the observations on the medicinal properties of the water, which are very judicious, because we are anxions to retain room for the
following quotation from Dr T. Thomson's appendix, which is perfectly conclusive as to the refutation of Dr Lambe's opinion concerning the supposed evils arising from the presence of very minute quantities of lead in our common drink.
"These examples I consider as quite sufficient to establish the fact, that minute quantities of lead may be detected in all waters which pass through leaden pipes. I only know one exception to this general law; and it is an exception by no means favourable to. the purity of the water which constitutes it. I allude to the water of the river Thames, in which I have never been able to detect any lead, though it had been allowed to flow in teaden pipes. Whoever will consider the situation of this river, and the immense population along its banks for so many miles, must at once perceive the prodigious accumulation of animal matters of all kinds, which must be constantly making their way into it. These matters are, no doubt, the cause of the putrefaction, which it is well known to undergo at sea; and of the carburetted and sulphuretted hydrogen gases which are evolved from it. These animal matters prevent it from dissolv. ing lead, or from holding the carbonate or oxide of that metal in mechanical suspension; because they have the property of combin ing with it, and forming with it a bulky insoluble precipitate. If you add nitrate of lead to Thames water, you will find, that it becomes milky, and that a white powder falls to the bottom, which dissolves without effervescence in nitric acid. It is therefore a combination of oxide of lead with some animal matter. Thus it is the impurity of Thames water that prevents it from containing lead. Probably hard waters, containing sulphate of lime in solution, may also be free from lead. But with these exceptions, we may lay it down as a general fact, that all waters which pass through leaden pipes, or which are kept in leaden cisterns, contain small particles of carbonate of lead. But it is evident from Edinburgh water, Hampstead water, Bury St Edmond's water, &c., that these particles are present in too small quantities to be in the least injurious to the human constitution."
REPORT of DISEASES treated at the PUBLic DispensarY, near Carey-Street, London, from May 31st to August 31st
No. of Cases.