In the course of the 2nd week, the cicatrization of the œsophagus occurred; the part was dressed with lint; and by the 20th day after the operation, the animal was quite restored.
This case would have been more useful, if more precision had been employed in describing the dressing and subsequent treatment of the wound. It would seem that the sutures were passed through the parietes of the œsophagus only, and that the external wound was kept open by being filled with tow. Certainly, union by the adhesive inflammation ought to have been attempted in all parts of the wound; but whether sutures in the œsophagus are advantageous, or whether the uniting bandage be preferable, is not so easily determined. In the two cases described in 3d vol. of the Mem. de l'Acad. de Chirur. the uniting bandage was alone employed, and with success.
50.Retention of Urine, caused by a Stricture of the Urethra, relieved by a forcible but gradual Injection.—The editor of Le Propagateur des Sci. Med. in the No. for Feb. 1826, introduces the following case, by observing, that it reflects great honour on M.Amussat, and that his discovery merits the greatest praise. M. D... aged 70 years, of a plethoric constitution, had suffered about 30 years before from three attacks of gonorrhœa; since which period he has had a difficulty in urinating, and can never discharge more than one or two ounces of urine at a time.
At eight o'clock, P. M. of the 1st of Feb. he tried to urinate, but could not succeed. He suffered great pain. Pulse agitated; face flushed; belly swelled, and globular at its inferior part; the subcutaneous abdominal veins distended, and the penis in a state of semi-erection. All attempts to urinate were painful and ineffectual. At ten o'clock, A. M., on the 2nd, M.Amussatvisited him, and passed a bougie. This was arrested by a contractionnear the bulb of the urethra, and caused the discharge of some blood. No urine had been passed for 14 hours, while ordinarily he urinated 12 or 16 times through the night. The obstruction was so great, that none of the usual means of relief remained, exceptthe forcible introduction of the catheter, or thepuncture of the bladder. M.Amussatresorted to the following plan which he had devised, and which completely succeeded. He injected warm water forcibly, but gradually, into the urethra, which, dilating the orifice of the stricture, forced backwards the thickened mucus which had obstructed it. As soon as the liquid injection met the urine, the patient cried out that he was saved, and immediately was able to urinate as formerly. At two trials, he discharged nearly two pints of thick urine. There was no return of the retention, the patient continuing well.
Should subsequent experience confirm this experiment of M.Amussat, this simple measure will be a most valuable substitute for those dangerous measures hitherto resorted to for retention of urine, in cases where the obstruction arises from thickened mucus, from small calculi closing the orifice of a stricture, from inflammation, or from what are termed, (justly or not,) spasmodic strictures.
51.Tracheotomy.—In the Amer. Med. Review for April, Dr.John Atlee, of Lancaster, mentions that on Wednesday, Aug. 11th, he was consulted by a child ten years old, who had that morning, while running, put a button-mould into his mouth, which during respiration was drawn into the trachea. He complained of uneasiness in respiration, with a slight rattling, and pointed towards the upper part of the sternum, as the situation of the button. On coughing, a rattling was heard, and immediately after, a sudden check to expiration, from the lodgment of the button near the rima glottidis, requiring a sudden and violent effort of inspiration to remove the sense of suffocation. An emetic was given with no advantage. During the night, he had two or three spells of coughing, threatening suffocation.
An operation was urged, to avoid immediate and subsequent dangers from the lodgment of this extraneous body, and was agreed to by the parents, and by Dr.Humes, who was called in consultation. It was performed on the 14th of Aug.; a cathartic, and afterwards an opiate, having been given.
An incision, one inch and a half long, was made through the integuments, extending downwards from above the cricoid cartilage, and exposing the sterno-hyoid and thyroid muscles, which were then separated. After exposing the trachea, a longitudinal incision, about three-quarters of an inch in length, was made through its parietes at the third ring. This was held open, and the patient requested to cough. This was ineffectual. The wound being closed, the button was, by coughing, thrown up against the rima glottidis. A probe passed into the trachea, produced a violent effort to cough, by which, as soon as the instrument was withdrawn, the button was thrown through the wound, to some distance from the patient.
The wound was dressed with two sutures and adhesive strips. Most of it united by the first intention: and in a few days the patient completely recovered.
52.Fistula Lachrymalis—At the session of the Royal Academy, on the 15th of December, M.J. Cloquetrelated the case of a female, who, three years previously, had submitted to the operation for fistul. lachrym. according to the method of M.Foubut. The canula which had been allowed to remain in the nasal canal, had ulcerated through the floor of the nose, and presented its inferior extremity on the inside of the mouth.
A practical commentary on this mode of operating, which is still recommended by able surgeons!
53.Aneurisma Herniosum.—This form of aneurism is supposed to consist of a dilatation of the internal and muscular coats of the artery; the external cellular having been destroyed. It is termed byArnaud, and by Dr.William Hunter,aneurisma herniam arteriæ sistens. Its existence in any case has, however, been denied by a large majority of surgeons; and perhaps the only cases reported are those ofDubois, in 1804, found in the thoracic and abdominal aorta of a dead subject.
The reporter of the following case, quotes alsoMonro, as having cited examples of this kind of aneurism. But whatMonrotermed a "mixt aneurism," arose from the rupture of the coats of a "true aneurism," by which it was reduced to the state of a "false aneurism;" very different from that here contended for.SabatierandBoyer, also, deny the existence of this hernia of the artery, and a good summary of facts and arguments is given byBoyerin his Surgery, in support of this opinion, (vide article Aneurism, tome i.) which it would be difficult to invalidate, especially by cases analogous to the following. The reporter,M. Bonnet, of the late French army, considers this case as proving a hernia of the artery in a vessel of medium diameter; those ofDuboishaving been noticed in the largest arteries.
A Prussian soldier was wounded over the femoral artery by a musket ball. No hæmorrhage ensued, and the wound cicatrized. In this state, M.Bonnetvisited him for a mortification of the foot of the same limb, which had been frozen. Amputation of the leg was performed, the stump healed readily, and in 12 days the ligatures came away. On the 13th day, (being six weeks since wounded in the thigh,) the patient perceived a tumour at the original cicatrix on his thigh, which had appeared during the preceding night. On the 14th, it had enlarged to three times its former size: it was painful; fluctuation was evident; but there was no pulsation, not even the thrilling noise, which is evident in the last stage of aneurism. A consultation was called, to determine whether it was an abscess or an aneurism. The question could not be satisfactorily answered, and it was determined to open it, after having made the necessary arrangements to secure the artery, should the tumour prove aneurismal. As soon as the integumentswere punctured, the jet of blood evinced the nature of the complaint; and the artery was secured by ligatures above and below the tumour. The coagula were numerous, and the superficial ones, quite hard and cartilaginous. The patient did well, and there was every prospect of his recovery on the 1st day, when M.Bonnetwas forced by the movement of the armies to leave him at Meaux.
Such are the facts, from which the Reporter infers, that the aneurism consisted of a protrusion of the internal and middle coats of the artery. Thereasoning, founded on them, appears to us inconclusive; but we have not space to insert it, and must refer to the March No. of Le Propagateur des Sci. Med.
54.Extirpation of the Two Dental Arches, affected with Osteo-sarcoma.—Dr.Giorgi Regnoli, physician at Pesaro, performed this operation on a female 35 years of age, who had from infancy, been troubled with pain and diseases of the teeth and jaws. When Dr. R. visited her, both dental arches were enormously swelled; red and sanguineous tumours had formed over their whole surface, and covered the teeth. The alveolar processes were entirely softened. The diameters of the mouth were greatly lessened; but by the touch, it was evident, that the disease was confined to the alveolar processes of the two ossa maxillaria. A fœtid odour exhaled from the mouth. Lancinating pains continually tormented the patient; especially on attempting to masticate. The slightest touch was very painful, and was always followed by an effusion of blood. There was also an alteration of voice; a disgusting deformity of the mouth, with emaciation, fever, &c. The operation was performed on the 18th May, 1825.
The patient was seated opposite to a window; her head being supported against the breast of an assistant, who, at the same time, pressed upon the labial arteries. The inferior lip was divided perpendicularly, and detached laterally from the inferior jaw, so as to expose the whole extent of the carcinoma. Some strokes of the saw were made on the anterior and most prominent part of the bone, and into the groove thus formed, the blade of a very strong knife was inserted, by means of which, aided by some slight strokes with a mallet, all the diseased portion was removed. The soft parts had been previously detached from the internal surface of the jaw. The last left molar tooth, not being diseased, was alone left. The hæmorrhage from the dental artery was arrested by the actual cautery.
The dental arch of the upper jaw, was then completely removed in the same manner. The bleeding was here more profuse, but was arrested by a hot iron. The alveolar processes thus removed, were enlarged, and of a lardaceous colour, and the fungous growths had the appearance and consistence of indurated albumen.
In 25 days, the patient was discharged well. Her general health was good; the fœtor had quite gone; the cicatrix over the bone was regular, white, hard, and could be pressed upon without causing pain. The patient can triturate her food with facility; the lips are slightly drawn inwards,without any sensible inconvenience; and the voice is a little altered, but this even is daily improving.—Le Propagateur des Sci. Med.for Jan. 1826.
55.Traumatic Erysipelas.—In the Feb. No. of the Revue Medicale, is a clinical report of the celebrated BaronLarrey, surgeon in chief of the Hospital de la Garde Royale; in which he criticises severely the use of leeches in erysipelas, and recommends in that variety of the disease, arising from wounds, &c. the application of the actual cautery, as effectual in arresting immediately the progress of the disease. It causes, he says, but little pain; destroys the burning and tense pain of the disease, as also the redness and swelling of the part; is not followed by suppuration, and does not cause gangrene in the contiguous parts. The eschar separates, without leaving a cicatrix. Various other advantages are enumerated, all of which are confirmed by a list of cases, as treated at the hospital. We have no room for details, which would, if known universally, hardly render us Americans, whether surgeons or patients, as fond of the cautery, as our trans-atlantic brethren of the French school.
56.Obliteration of a portion of the Urethra, remedied by an operation.—M.Vanierof Cherbourgh, relates in the Jan. No. of "Le Propagateur des Sciences Medicales," the case of a man aged 27 years, who, on the 16th of June, 1815, was wounded in the penis by a musket ball, which completely divided the urethra at its middle portion, without injuring the corpora cavernosa. The wound healed up; but by degrees, the passage contracted, so that in May, 1819, the patient could pass his urine only guttatim, with pain and difficulty, and was threatened with inflammation, &c. of the perineum. Bougies afforded no relief. An incision was then made externally, in the direction of the urethra, so as to divide the cicatrix, and open the canal above and below the contracted part. The lips of the incision were drawn together over a sound, passed into the bladder; and by the 5th day, the wound was completely cicatrized. The sound was then removed, and a short bougie inserted, so as to pass beyond the cicatrix. This was worn occasionally, and the patient completely recovered. At the end of three years, he was able to "urinate with ease, and in a full stream."
57.Artificial Joint cured by Caustic.—Dr.J. Rhea Barton, has applied the caustic potash to the extremities of the fragments of a broken tibia, after an artificial joint had fully formed. Exfoliation was produced, followed by bony union. In three months, the patient recovered.
Dr. B. alludes to other cases, by Mr.Whiteof Manchester, and Mr.Henry Cline, thus treated with success; to two instances, in which the practice failed in the hands of Mr.Earle; and finally, to one case by Mr.A. Cooper, the result of which he has not learnt. He does not recommend the operation, as usually preferable to theseton, for which, the profession is indebted to Dr.Physick; but as an additional expedient, when other means fail.—Med. Record. April, 1826.
58.Epilepsy cured by Trephining.—In the 17th No. of the New-YorkMedical and Physical Journal, Dr.David L. Rogersrelates an interesting case of a man, aged 46, who had been subject to epileptic convulsions for 14 years, and who, of late years, had been unable to labour, and rapidly sinking into a state of idiocy, from their frequent recurrence.
These fits were preceded by a fracture of the os frontis, with depression, from which he readily recovered; but soon after he was attacked with convulsions. He now suffers pain on the injured side extending down the neck and left arm—the eye of the same side is diminished—the sight much impaired, and his memory almost entirely destroyed. A cicatrix covering a slight depression was easily found, above the left superciliary ridge of the frontal bone, and over the superior orbitar foramen. Under these circumstances, the operation of trephining was performed on the 7th of July, 1825, but with some difficulty, from the irregular thickness of the bone, and from the saw having to pass through the upper part of the frontal sinus. "The dura mater was unfortunately cut through for one-half the circumference of the circle." The parts were found more vascular than usual, and the under surface had a ridge corresponding to the internal depression, but too slight to have caused compression of the brain. "Having made a section of the frontal sinus, [with a trephine?] a part of theposterior tablewas removed with thecircularpiece. This portion of the internal table had been fractured, and separated to some distance from its inferior attachments to the frontal plate, and driven back upon the substance of the brain. Its sharp edge was worn round and smooth." This seemed to have been the cause of all the mischief.
After the operation, the patient suffered from pain in his head, with some moderate excitement, which was relieved by cathartics. He had no return of fits until the 25th day, when the wound was entirely healed. These had been brought on by overloading his stomach with food, and were followed by high arterial excitement and inflammation of the brain.
He was relieved in a few days by active depletion, and was discharged cured on the 20th of August.Nine monthsafterwards, this man continued free from fits, his memory had nearly recovered its usual strength, and he could attend to his business without any inconvenience.
59.Gastrotomy.—M.Bulk, in Germany, has successfully performed this operation on a female, aged 36 years, of good constitution, under the following circumstances. The patient, during her pregnancy, suffered from a severe pain at the left and inferior portion of the abdomen; her menses were not suppressed, and every six or eight days, a clot of blood and mucus came from the vagina. Her general health was very good.
About the middle of her 8th month, she was washing some linen, and suddenly felt as if something was tearing in her abdomen; at the sametime, a swelling of the size of two fists (poings) formed on the right side, below the umbilicus. She fainted, and for six weeks suffered dull pains in the abdomen. At this time, she hadtrue labour painsfor 48 hours, and was attended by a midwife. The os uteri dilated so as to admit one finger only. The tumour disappeared during these pains. The patient recovered, with the size of the abdomen undiminished.
In this state she continued for two years and three months, menstruating regularly. She became again pregnant, with little inconvenience until the 7th month, when her abdomen was painfully distended, and of a bluish colour, and fluctuation was induced on the least motion. At the full period, she was delivered of a large fœtus, which she suckled for 15 days. The infant then died of an aphthous affection.
Her milk ceasing, she rapidly declined with hectic symptoms. The tumour reappeared below the umbilicus about the size of an egg, and soon opened, discharging from small orifices a little pus. The opening was enlarged, and some skin and hairs were removed. The patient's constitution was fast yielding, and gastrotomy was immediately performed. An incision was made, with the requisite precautions, through the linea alba into the cavity of the abdomen, from two and a half inches above the umbilicus to within nine lines of the pubis, care being taken to prevent the escape of the intestines. A fœtus of full size, in which putrefaction had commenced, was found on the right side of the uterus. "I raised," says the operator, "the body with much care, and endeavoured to trace the umbilical cord. This was turned over the fundus of the uterus to the left side, and terminated in a vascular substance in a state of suppuration, (probably, the remains of the placenta,) which was situated below the great omentum. I pressed out, and dried up the pus, which covered these parts, by means of a sponge. The uterus was an inch and a half in length and an inch in breadth, of a pale rose colour, and could easily be distended (se laissait distendre aisément.) It was otherwise in a good condition."
The wound in the abdomen was closed with sutures. The patient was in great danger from inflammatory symptoms for 8 days, but eventually recovered. She left her bed on the 55th day.
60.Cæsarian operation, performed with safety to the Mother and Fœtus.—We condense fromJohnson'sReview for April last, the following summary of a case of Cæsarian section performed byGraefe, on the 20th of September, 1825.
Carolina Bechang, was admitted intoGraefe'sClinicum, in an advanced stage of pregnancy; being 30 years of age, much deformed by rickets, and only four feet (Rhenish) in height. On the 20th of Sept. after having been five days in labour at the full period, pains severe, and os uteri dilated, she consented to the Cæsarian section.
A little after 2 o'clock,Graefeplaced the fore finger of his left hand, immediately below the umbilicus, and with a large scalpel, made an incision downwards in the linea alba, to within one inch of the pubis; dividing theentire parietes, and even penetrating the substance of the uterus. A second incision penetrated the uterus and exposed the placenta; which, as had been anticipated, was found on the fore part of the fundus. The assistants now compressed firmly the edges of the divided abdominal parietes upon the uterus, to prevent the protrusion of the intestines, in which they succeeded; andGraefecarried his hand in a moment into the uterus, separated the placenta with his finger and thumb, and then withdrew it and the child almost together. The child was very active, and cried lustily. The uterus immediately and suddenly contracted, and the bleeding was inconsiderable. Not more than twelve ounces of blood were lost, and no ligature was required. The whole operation was completed in four minutes and a half. The wound was secured by three broad sutures, and adhesive plasters, assisted by a bandage round the abdomen. The child weighed six pounds and was well formed. During the operation, the patient was sick, and once vomited slightly. In two hours had pain and fever: V.S. ℥xij. Draught with ten drops of the aqua laurocerasi was given, and repeated in a few hours. The patient passed a quiet night. The symptoms of pain, inflammation, and fever, were threatening for some days, and were promptly resisted by the lancet, by enamata, by narcotics, especially the laurocerasus and hyosciamus, by fomentations, &c. By the 9th day, the wound had cicatrized, excepting near the symphisis; symptoms all favourable. The lochia were discharged regularly; and in three weeks, she was able to sit up, and in three more, quite well. Early in November, she returned home with her child, both in perfect health.
InFerussac'sBulletin Universel; for February, another case, in which the Cæsarian operation was performed with safety to the mother and infant, is copied fromRust'sMagazine.
61.Extirpation of the Uterus.—Dr.Rheineck, of Memmingen, was consulted by a female, who in December, 1824, was attacked by fever, from which she slowly recovered. A prolapsus of the uterus, which gradually became inverted, followed, attended with frequent hæmorrhage and discharge, by which she was almost worn to the grave. The whole of the uterus was inverted, and without the labia externa; its surface loose, fungous, and in several places easily broken down upon pressure; but there was no hardening nor ulceration. The irritation was so great, as to threaten the patient's life, and after a consultation, in which it was agreed, that the swelling was really formed by the uterus, the tumour was laid hold of and drawn forwards, and a broad ligature, secured with a double surgeon's knot, was applied round its base. In about three weeks, the whole had separated, and the part above the ligature was cicatrized. During this period, the patient was dangerously ill, and was only rescued by great care and attention.
The operator had before performed a similar operation, in which case, the patient died suddenly from hæmorrhage, on the separation of the ligature.Osiander,Struve,Longenback,Sauter,Siebold, andZaug,have in late years performed the same operation, with various degrees of success.—Johnson's Review for April, 1826, who quotes fromSiebold's Journal fur Geburtshulfe, 1826.
62.Uterine Hæmorrhage.—In the Bulletin Universel for Jan. 1826, the following case is detailed from the Gazette de Santé, for Dec. 1825.
A female aged 32 years, was taken with labour with her first child, on the 12th Feb. 1825. The pains soon ceased, and on the 15th of Feb. M.Bedel, physician at Schirmack, was consulted, who speedily delivered her, by means of the forceps, of a dead child. The hæmorrhage was so considerable, as to render the immediate removal of the placenta necessary; but the uterus did not contract, and the bleeding continued, with tremblings, syncope, cold sweats, &c. Irritation on the internal surface of the uterus, the use of cold water to the abdomen, injections into the uterus of cold water and vinegar, were unavailing.
Plugging the vagina, and also theuterus, was now resorted to, as the only means of safety remaining. The uterus was filled with pieces of rags, for fear the patient could not sustain the loss of blood necessary to fill that cavity; while a methodic compression was at the same time made to the abdomen. The hæmorrhage was immediately arrested, and soon after reaction ensued.
On the 16th, M.Bedelextracted the plugs from the uterus, cautiously and in succession; and had the pleasure of finding the uterus regularly contracting after each removal. The lochial discharge continued, and there was no secretion of milk. The patient recovered slowly.
It is in such cases as the above, that the physicians of the United States have employed the Secale Cornutum (Ergot,) the judicious use of which would have probably superseded the necessity of instruments, and prevented or arrested the hæmorrhagic discharge.
63.State in which Morphia exists in Opium.—In the 80th article of our Quarterly Summary for January, we stated thatMr. Robinethad announced the discovery of a new acid in opium, with which the morphia was combined; while the meconic acid was alleged to be united with soda. To the former salt, he gave the name ofcodeate of morphia.Mr. Robiquet, however, has shown, that the pretendedcodeate, is amuriateof morphia, formed by double decomposition between the muriate of soda, employed byMr. Robinetin his analysis, and meconate of morphia. The same decomposition shows the source of the meconate of soda. We observe thatMr. Robinetadmits his mistake.—Archives Générales de Medicine.
64.Peculiar principles of Narcotic Plants.—"Dr.Brandesof Sabzerflen, having been prevented by extreme illness, induced by investigating the peculiarprinciples of narcotic plants, from completing his inquiries, has announced the results of his labours in general terms. He states, that he has found a peculiar narcotic principle in all the narcotic plants; as belladonna, hyosciamus, conium, stramonium, chelidonium, digitalis, &c. The narcotic principles are readily soluble in alcohol, ether, acids, and water, and of a highly offensive odour. This odour is so great in the principle of conium, that it is almost impossible for an individual of an irritable habit, to remain in the room, where there is an etherial solution, containing only a few grains of it. The smell of such a solution is equal to the smell, arising from twenty or thirty pounds of the plants. It is also remarkable, that as this principle is neutralized by acid, the disagreeable odour disappears, or is greatly diminished; which so far agrees with the circumstance, that the plants themselves give little of their peculiar smell, because the narcotic principle is not in a free state. Dr.Brandeshas promised to communicate the manner of obtaining the principles."—Lond. Med. Repository, Feb. 1826.
65.Relative quantities of Cinchonia and Quinia in the most esteemed Varieties of Peruvian Bark.—Mr.Ballyasserts, that practitioners, from observation, have classed the Peruvian barks in the following order;—first, the gray loxa bark, (Cinchona Officinalis;) then the red bark (Cinchona MagnifoliaofRuizandPavon, orOblongifoliaofMutis;) and lastly the yellow bark, or calisaya, (Cinchona CordifoliaofMutis, orpubescensofValli.) TheCinchona Officinalisfurnishes much cinchonia, and little quinia; theCinchona Magnifoliaaffords about equal quantities of the two salifiable principles, while theCordifoliacontain much quinia.
Mr.Bally, assuming it as proved, that cinchonia is the more powerful salifiable base of the two in a medical point of view, considers, therefore, that, in regard to the above barks, chemical analysis justifies the order of their relative value, which had been previously deduced from their medical employment.—Archives Generales de Medecine.
66.Sulphate of Quinia, extracted from the Cinchona Bark, exhausted by Decoction.—Mr.Julia-Fontenelle, from the sparing solubility of quinia and cinchonia, suspected that decoctions and aqueous extracts of Peruvian bark contained but little of those vegetable alkalies; whence it would follow, that the residuum, generally rejected as having no febrifuge power, would still contain the greater part of them. This suspicion has been in a great measure verified. The aqueous extract was found to contain but little cinchonia and quinia; while the residuum of decoctions, giving the mean results, furnished two-thirds of the sulphate of quinia, yielded by the same weight of cinchona not acted on by water.
As decoctions and aqueous extracts of bark are febrifuge, though containing inconsiderable quantities of quinia, and cinchonia, Mr.Julia-Fontenelleis led to believe, that these salifiable bases are not the only febrifuge principles in Peruvian bark, but that the extractive matter also possesses that property.
His results present a striking difference between alcoholic and aqueous extracts of bark; for while the former contain nearly the whole of the salifiable principles, the latter contain very little.—Revue Medicale.
67.Analysis of Rhubarb.—It is some time since Mr.Nani, an Italian chemist, announced the discovery of a crystallizable vegetable alkali in rhubarb. Mr.Caventouhas repeated the experiments of Mr. N. and finds them, in many respects, inaccurate. Upon analysing the alcoholic extract of rhubarb, by the aid of alcohol and ether, employed separately and combined, Mr. C. obtained a fatty matter, containing a little odoriferous volatile oil, and a yellow colouring principle, capable of crystallization, and of being sublimed without decomposition, which may be calledrhubarbin. He also detected in the alcoholic extract, a brown substance, insoluble in water when pure, but rendered soluble by combination with rhubarbin; when it forms a compound, constituting theeaphopicriteof some chemists, and therhubarbinof Psaff.—Archives Generales.
Mr.George W. Carpenter, of this city, prepares the medicinal principle of rhubarb in combination with sulphuric acid, under the name of sulphate of rhubarb, by the following process:
"Boil, for half an hour, six pounds of coarsely powdered Chinese rhubarb in six gallons of water, acidulated with two and a half fluid ounces of sulphuric acid; strain the decoction, and submit the residue to a second ebullition in a like quantity of acidulated water; strain as before, and submit it again to a third ebullition. Unite the three decoctions, and add, by small portions, recently powdered pure lime, constantly stirring it to facilitate its action on the acid decoction. When the decoction becomes slightly alkaline, it deposites a red flocculent precipitate, and the fluid is changed from a yellow to a crimson colour. The precipitate is then to be separated by passing it through a linen cloth, and dried; after which, reduce it to powder, and digest in three gallons of alcohol, at thirty-six degrees, in a water bath, for several hours, at a moderate heat. Separate this solution from the calcareous precipitate, and distil off three-fourths of the alcohol. There then remains a strong solution of rhubarbine, to which add as much sulphuric acid as will exactly neutralize it. Evaporate this slowly to dryness, without having access to atmospheric air. The residuum will be of a brownish-red colour, intermingled with brilliant specks, possessing a slightly pungent styptic taste, soluble in water, and its odour that of the native rhubarb." This residuum is the sulphate of rhubarb. (Sulphate ofrhubarbin.?)
Mr.Carpenterassures us, that this preparation contains the medicinal principle of the rhubarb, apart from its inert portion; and considers it as bearing the same relation to rhubarb, as the sulphate of quinia to the Peruvian bark. The Chinese rhubarb, at half the price, furnished twice as much rhubarbin as the reputed Russian, which Mr. C. considers to be spurious in the Philadelphia market, being the English prepared in imitationof the Russian.—Philadelphia Journal of the Medical & Physical Sciences. May, 1826.
68.Alkaline Lozenges of Bicarbonate of Soda.—Mr.D'Arcetproposes the following formula for these lozenges:—Take of
Bicarbonate of Soda, pure and dry, and in fine powder,5 parts.Very white Sugar, in fine powder,95Mucilage of Gum Tragacanth,q.s.Essential oil of Mint, pure and fresh,2 or 3 dropsfor about every 3 ounces of mixture of bicarbonate and sugar.
Shake the bicarbonate and sugar in a well dried bottle, with the view of mixing them intimately. Withdraw the mixture from the bottle, and add the mucilage and oil of mint, blending the whole together on a marble. The mass obtained, is then to be divided into lozenges, which should weigh, when dried, about 15 grains each. As they slightly attract moisture, they ought to be kept in a dry place, or in well stopped bottles.
Mr.D'Arcetpraises very highly the effects of these lozenges in disordered digestion, and in preventing its occurrence, as well from experiments made on his own person, as from observations on others. He believes their operation to be purely chemical, consisting in the saturation of the morbid acid of the stomach, and, therefore, not likely to be lessened by habit. Their effects are much more prompt than magnesia, either pure or in the state of carbonate.
In the phosphatic diathesis, where the urine is disposed to be alkaline, it would seem that these lozenges would do harm. But, perhaps, we have this security against their use in these cases, that the stomach would not at the same time be troubled with acidity.Annales de Chimie et de Physique, Jan.1826.
69.Presence of Mercury in Samples of medicinal Prussic Acid.—Mr.Regimbeau, apothecary at Montpellier, has detected this impurity in some prussic acid, prepared in Paris. Its presence was first suspected, from a portion of the acid, accidentally dropped, leaving a white stain on the copper dish of a balance. It is probable, that the impure acid, spoken of, had been made by passing sulphuretted hydrogen through a solution of cyanide of mercury, according toVanquelin'sprocess; and that an insufficiency of the decomposing gas had been employed.
May not this accidental impurity explain the occasional salivating effects of prussic acid.
70.Proposed Method for preparing Protoxide of Mercury by precipitation, for Medical Employment.—Mr.Thomas Evanshas published some observations on this subject, and justly remarks, that the blue pill, mercurial ointment, and other mercurial preparations, are not uniform compounds, but contain variable proportions of the real protoxide, and uncombined mercury. Some blue pill, which had been carefully prepared by Mr. E. by the usual process of trituration, was found to contain on analysis 20 percent. of unoxidized mercury; and the blue mass from Apothecaries' Hall, London, furnished about the same proportion.
As it is obviously a desideratum to procure preparations of protoxide of mercury of uniform strength, Mr.Evanshas been led to seek a process, by which to obtain this oxide in a pure state. After repeated experiments, he has pitched upon the following formula: Dissolve four ounces of caustic hydrate of potassa in a pound of water, and to the clear solution, decanted from any impurities, add four ounces of calomel, and shake the mixture frequently. Pour off the liquid, and wash the precipitate formed with water, and then dry it at a gentle heat.
In regard to the medical efficacy of the protoxide obtained in this way, Mr.Evansreports the following to be the results obtained by Dr.Coates, at whose suggestion the article was prepared. As a substitute for calomel, it is more apt to vomit and purge, two grain doses operating several times. As an alterative, it was found incomparably more efficacious than the blue pill, being more certain and regular in its operation. Dr. C. thinks, that one-fourth of a grain of the precipitated protoxide, as prepared by Mr.Evans, is equal to three or four grains of the blue mass.—Journ. of the Philad. Col. of Pharm. May, 1826.
The method here proposed for obtaining the black oxide of mercury by Mr.Evans, was first suggested and put in practice by Mr.Phillips. See his "Experimental Examination of the last edition of the Pharmacopœia Londinensis, London, 1811," page 114. His words are, "When solution of potash is employed, the several inconveniences attendant upon the use of lime-water are avoided, and a blackish coloured protoxide is obtained without heating the solution. As potash is much more soluble than lime, it is scarcely necessary to employ one-tenth part of the quantity of water; this not only renders the process more convenient, but the quantity of air contained in the water being less, very little of the oxide, perhaps none of it, is converted into peroxide." See also the experiments, and observations of Mr.Donovan, on Mercurial Ointment, &c. published in the Medical Journals, several years ago.
71.Goulard's Extract of Lead.Mr.Daniel B. Smithproposes the following formula for obtaining Goulard's extract of uniform strength:
Acetate of lead, crystallized,15 ounces, troy.Protoxide of lead,9 ounces, troy.Distilled water,4 pints.
"Boil them together for fifteen minutes and filter. The filtered liquid will weigh about five and a quarter pounds, is transparent, colourless, and of the specific gravity of 1.267. (30° Baumé.)"
We conceive that Mr.Smithhas erroneously denominated the sugar of lead, a binacetate. The best usage is to deem that the primary saline compound, which contains a single proportional of acid and base. Accordinglywe call the saturated carbonate of potassa, abicarbonate; and Dr.Thomsoncalls borax, a biborate of soda, on account of its containing two proportionals of acid to one of base, notwithstanding the alkaline qualities of this salt. Goulard's extract is, therefore, a sub-binacetate of lead, or according to Dr.Thomson'srecently suggested nomenclature, adiacetate.—Ibid.
FOOTNOTES:[29]Series of Engravings to the morbid anatomy; fasc. 1. pl. 6. fig. 1, 2.[30]Lond. Med. Review; vol. 4.[31]Pathological Researches; Essay 1.[32]Medical Researches on the Effects of Iodine in Bronchocele, Paralysis, Chorea Scrofula, Fistula Lachrymalis, Deafness, Dysphagia, White Swelling, and Distortions of the Spine. By Alexander Manson, M. D., &c. London, 1825.[33]Carthamus Tinctorius.
[29]Series of Engravings to the morbid anatomy; fasc. 1. pl. 6. fig. 1, 2.
[29]Series of Engravings to the morbid anatomy; fasc. 1. pl. 6. fig. 1, 2.
[30]Lond. Med. Review; vol. 4.
[30]Lond. Med. Review; vol. 4.
[31]Pathological Researches; Essay 1.
[31]Pathological Researches; Essay 1.
[32]Medical Researches on the Effects of Iodine in Bronchocele, Paralysis, Chorea Scrofula, Fistula Lachrymalis, Deafness, Dysphagia, White Swelling, and Distortions of the Spine. By Alexander Manson, M. D., &c. London, 1825.
[32]Medical Researches on the Effects of Iodine in Bronchocele, Paralysis, Chorea Scrofula, Fistula Lachrymalis, Deafness, Dysphagia, White Swelling, and Distortions of the Spine. By Alexander Manson, M. D., &c. London, 1825.
[33]Carthamus Tinctorius.
[33]Carthamus Tinctorius.
Observations on the Autumnal Fevers of Savannah. By W. C. Daniell, M. D. 8vo. pp. 152.—W. T. Williams, and Collins & Hanway. Savannah, 1826.
An Analysis of Fever. By Charles Caldwell, M. D., Professor of the Institutes of Medicine, and Clinical Practice in Transylvania University. 8vo. pp. 97.—Lexington, K. 1825.
Medical and Physical Memoirs. By Charles Caldwell, M. D., Professor, &c. Containing, 1. An Introductory Address, intended as a Defence of the Medical Profession against the charge of Irreligion and Infidelity; with Thoughts on the Truth and Importance of Natural Religion. 2. A Dissertation in answer to certain Prize Questions, proposed by his Grace, the Duke of Holstein Oldenburg, respecting the "Origin, Contagion and general Philosophy of Yellow Fever, and the Practicability of that Disease prevailing in high Northern Latitudes;" with Thoughts on its Prevention and Treatment. 3. Thoughts on the Analogies of Disease. 8vo. pp. 224.—Lexington, K. 1826.
Florula Cestrica: an Essay towards a Catalogue of the Phœnogamous Plants, native and naturalized, growing in the vicinity of the borough of West-Chester, in Chester County, Pennsylvania; with brief notices of their Properties and Uses, in Medicine, rural Economy and the Arts. To which is subjoined an Appendix of the useful cultivated Plants of the same District. By William Darlington, M. D. 8vo.—West-Chester, 1826.
We are much gratified with the appearance of this little flora. It is really an uncommonly neat, useful, and convenient performance; and, we have no doubt, is by far the most elegant and creditable botanical work, if not the only one, published in any small town in America. To a country town, we would not think of looking for such a production; but in fact, the county of Chester has, of late years, made very considerable advances in science and literature. It has produced a public library, and perhapsothers with the existence of which we are not acquainted, several botanical and mineralogical collections, a very respectable series of essays on its history, similar to Mr. Jefferson's notes on Virginia, schools, teaching the higher branches of the English mathematics, and one of those partly literary newspapers which have recently sprung up among us.The above title considerably explains the nature and extent of the work. Of its scientific accuracy, sufficient time has not yet elapsed to form an adequate judgment; but we observe that the author has had the frequent assistance of Baldwin, Collins, Steinhauer, Torrey, and Schweinitz: so that, if the maxim "noscitur a socio" be at all applicable in the present case, it is evident that he has been in the very best botanical company which our land affords.The work is executed with very great neatness, such as would do credit to the press of a metropolis, and is really wonderful for a moderate sized village, and for the disturbed life of a country physician, its author. There is also a great deal of that kind of popular explanation, which so agreeably relieves the repulsiveness of dry works on natural history: such as the familiar names of the plants; the derivations of the names of the genera, designed to assist the student in remembering them, by enabling him to associate some idea with them; occasional comments on their uses and injurious effects, &c.We may add, that from the close proximity of Chester County to Philadelphia, extending to a large part of the line of the Schuylkill, this little work will answer extremely well for common use around this city, with the single exception of the sands of New-Jersey.
We are much gratified with the appearance of this little flora. It is really an uncommonly neat, useful, and convenient performance; and, we have no doubt, is by far the most elegant and creditable botanical work, if not the only one, published in any small town in America. To a country town, we would not think of looking for such a production; but in fact, the county of Chester has, of late years, made very considerable advances in science and literature. It has produced a public library, and perhapsothers with the existence of which we are not acquainted, several botanical and mineralogical collections, a very respectable series of essays on its history, similar to Mr. Jefferson's notes on Virginia, schools, teaching the higher branches of the English mathematics, and one of those partly literary newspapers which have recently sprung up among us.
The above title considerably explains the nature and extent of the work. Of its scientific accuracy, sufficient time has not yet elapsed to form an adequate judgment; but we observe that the author has had the frequent assistance of Baldwin, Collins, Steinhauer, Torrey, and Schweinitz: so that, if the maxim "noscitur a socio" be at all applicable in the present case, it is evident that he has been in the very best botanical company which our land affords.
The work is executed with very great neatness, such as would do credit to the press of a metropolis, and is really wonderful for a moderate sized village, and for the disturbed life of a country physician, its author. There is also a great deal of that kind of popular explanation, which so agreeably relieves the repulsiveness of dry works on natural history: such as the familiar names of the plants; the derivations of the names of the genera, designed to assist the student in remembering them, by enabling him to associate some idea with them; occasional comments on their uses and injurious effects, &c.
We may add, that from the close proximity of Chester County to Philadelphia, extending to a large part of the line of the Schuylkill, this little work will answer extremely well for common use around this city, with the single exception of the sands of New-Jersey.
Memoir on the Topography, Weather, and Diseases of the Bahama Islands. By P. S. Townsend, M. D.—New-York, 1826.
The New-England Journal of Medicine and Surgery, and Collateral Branches of Science. Conducted by Walter Channing, Jr. M. D., and John Ware, M. D. No. 2. Vol. XV.—Boston, April, 1826.
The American Medical Review, and Journal of Original and Selected Papers in Medicine and Surgery. Conducted by John Eberle, M. D., Nathan Smith, M. D., George M'Clellan, M. D., and Nathan R. Smith, M. D. No. 1, Vol. III.—Philadelphia, April, 1826.
The Medical Recorder of Original Papers and Intelligence in Medicine and Surgery. Conducted by Samuel Colhoun, M. D. No. 2, Vol. IX.—Philadelphia, April, 1826.
The Philadelphia Journal of the Medical and Physical Sciences. Edited by N. Chapman, M. D., W. P. Dewees, M. D., andJohn D. Godman, M. D. No. V. New Series.—Philadelphia, May, 1826.
The New-York Medical and Physical Journal. No. 17. Edited by John B. Beck, M. D., Daniel L. M. Peixotto, M. D., and John Bell, M. D.—New-York, April, 1826.
Journal of the Philadelphia College of Pharmacy. No. 2, Vol. 1.—Philadelphia, May, 1826.
Manual of Surgical Operations; containing the New Method of operating, devised by Lisfranc; followed by two Synoptic Tables of Natural and Instrumental Labours. By J. Coster, M. D. and Professor of the University of Turin. The Translation and Notes by John D. Godman, M. D. 12mo. pp. 265.—Carey & Lea. Philadelphia, 1825.
A Treatise on Derangements of the Liver, Internal Organs, and Nervous System. By James Johnson, M. D. 12mo. pp. 223.—Carey & Lea. Philadelphia, 1826.
An Inquiry into the Nature and Treatment of Diabetes, Calculus, and other Affections of the Urinary Organs. By William Prout, M.D. F.R.S. From the second London Edition, with Notes and Additions, by S. Colhoun, M. D. 8vo. pp. 308.—Towar & Hogan. Philadelphia, 1826.
We are sensible that the foregoing does not present a full list of medical publications for the last quarter; but it is as complete as our opportunities have enabled us to make it. It is obviously for the interest of authors and publishers, to send us the titles of their medical publications as soon as they appear, and we invite them to do so.