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British and Foreign Medico-chirurgical Review: Or, Quarterly ..., Bind 24
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of narcotico-acids, as they produce a paralysing action on the medulla oblongata, and an exciting action on the nerves. They cause death by producing paralysis of the respiratory muscular apparatus, by an action analogous to that of coneine and nicotine. They possess a therapeutical action in spasms and irritable conditions of the respiratory organs, in simple spasmodic couglı, hooping cough, and spasmodic asthma. Their therapeutical action in certain morbid conditions of the blood—as gout, rheumatism, constitutional syphilis, and perhaps in certain chronic diseases of the skin-may be due to their augmenting the excretion by the kidneys, of the constituent parts of the blood which have undergone combustion, and not to the excitement of cutaneous activity. Solanine and dulcamara may be given without danger in inflammatory conditions of the stomach and the intestinal tube, as they exercise no action on those organs. Inflammation of the respiratory organs presents no contra-indication to the employment of solanine and dulcamara ; but they are contra-indicated in inflammation of the kidneys. The medium dose of sulanine for an adult is from one to five centigrammes of acetate of solanine, a substance which M. Caylus prefers to the pure alkaloid, in consequence of its solubility. The most suitable form of administration is in pills, the solutions of the saits of solanine baving a very disagreeable taste. The extract obtained from alcohol, and then washed with water to remove the alcohol, is preferable to the watery extract generally employed.
cornea.
XIV. Some Formulo employed by the Medical Profession in Lyons. (Bulletin Général de
Thérapeutique, Jan. 30th, 1859.) 1. Antidyspeptic Powder.—Take of subnitrate of bismuth, twenty grammes; of hydrochlorate of morphia, five centigrammes. Mix, and divide into twenty powders; one to be taken immediately after each of two meals, in two tablespoonfuls of water.
2. Collyrium in Chronic Ophthalmiu.—Take of water, one hundred and twenty-five grammes; of tincture of aloes, ten drops; of ammonia, four drops; of sulphate of copper, five centigrammes. The eyes to be bathed twice a day for two ininutes. This wash is principally indicated in chronic scrofulous ophthalmia accompanied by obstinate ulceration of the
It should only be employed after the cessation of acute symptoms of inflammation. 3. Pommade for Ulcerated Chilblains.—Melt sixteen grammes of yellow wax in thirty grammes of linseed oil; add eight grammes of tincture of benzoin and fourteen grammes of glycerine, and flavour with essence of lavender.
4. Powder for Nocturnal Incontinence of Urine in Children.—Take of carbonate of iron, fifteen centigrammes; of extract of belladonna, three centigrammes; of powdered nux vomica, three centigrammes. This cose to be taken every day. The employment of this remedy is said by Dr. Faure to be generally followed by a complete cure at the end of eight or ten days.
5. Pommade for Acne.—Take of ları, fifty grammes; of sublimed sulphur, four grammes ; of tannin, four grammes; of cherry-Jaurel water, five grammes. Mix accurately. Dr. Rodet employs this pommade with success in all forms of acne, and has also found it serviceable in sycosis, when the inflammation has been subdued and the crusts have fallen.
6. Laudanized Wine of Squills. — Take of white wine a pint; of powdered squill, eight grammes; of laudanum, twenty-nine grammes. Dr. Teissier has obtained advantageous results from the employment of this wine in dropsies especially those which follow pulmonary emphysema.
XV. On the Vermifuge Properties of the Chinese Ailantus. (Journal de Pharmacie et de
Chimie, March, 1*59.)
The Chinese ailantus (Ailantus glandulosa) has been hitherto known only as an ornamental tree of a very elegant appearance and rapid development. During the last few months it has acquired importance by yielding a valuable vermifuge agent, according to some remarks published by M. Hétet, Professor at the Naval School of Medicine at Toulon. In the experiments which he describes, he makes use of the following preparations, namely, the powdered burk, the powdered leaves, the watery extract of the bark, the alcoholic extract of the bark, the oleo-resin, and the resin. These experiments were made on dogs, and afterwards on man. M. Hétet describes three cases, in all of which the powdered bark of the ailantus caused the expulsion of tapeworms. The powder of the bark was given at first in the dose of half a gramme, and the watery extract in the dose of one-fourth of a gramme; the oleo-resin in the dose of one fifth of a gramme: the resin in the dose of two-fifths of a gramme rarely occasioned the expulsion of fragments of the tænia. M. Hétet thinks that it is to the volatile oil of ailantas that we ought chiefly to attribute the phenomena of weakness observed in man and in dogs, since the resin alone does not produce them. He also observes a fact deserving of recollection, namely, that the effect of this essential oil is so well-marked, that it is necessary for persons to take great care of preserving themselves from its vapours during its preparation. According to this author the ailantus, taken in a vermifuge dose, does not exert any injurious effect upon the health, and does not distress the patient like the root of the pomegranate and kousso. The local effects are confined to slight colic, and soinetimes a moderate degree of purging.
ease.
XVI. On the Treatment of Chorea by Arsenious Acid. By M. Aran. (Bulletin Général de
Thérapeutique, March 30th, 1859. In concluding the history of five cases of chorea treated and cured by the employment of arsenious acid, M. Aran remarks that he does not consider arsenic to be a specific in this dis
The arsenical treatment must inevitably fail in a certain number of cases; and M. Aran himself failed completely in four, where hysteria co-existed with choreiform movements. He considers that arsenic succeeds best in tho cases which, without losing their affinity the type of chorea, manifest themselves in a somewhat anomalous form; in other words, that the arsenious acid is an anchor of safety in anomalous forms of chorea, whatever may be the nature of the anomaly. Thus, one of his cases was complicated with hallucinations, a second was accompanied with incomplete hemiplegia, and a third with a very extraordinary agitation, occurring principally in the morning. But simple cases of chorea may also be advantageonsly treated by arsenic, and this medicine ought to have a fair trial in this disease, until it is proved to be inefficacious.
The question of the dose of arsenic to be administered in this disease is one demandiny much consideration. M. Aran considers that for children of seven years old, the close may commence at two or three milligrammes (a milligramme is about 0.0154 of a troy grain), and may be augmented to five milligrammes. In the adult the first dose may be five milligrammes, or one centigramme ('1543 of a troy grain), and he thinks it important to augment the dose with rapidity, so as to reach, in three or four days, to one centigramme, or one centi. gramme and a half in the child, and to two or three centigrammes in the adult. This rapid mode of administration is better than the long continuance of small doses, because the economy habituates itself to the latter, and the therapeutical effects may be lost; and this proceeding has the additional disadvantage of leading more easily to the saturation of the economy, and consequently to intolerance. If a cure does not take place in a short time, on the plan recommended by M. Aran, namely, by the rapid administration of increasing doses, or if there are not any favourable changes in the disease, then the arsenic does not agree with the patient, and it must be discontinued, and some totally different medicine substituted.
For reasons already given, M. Aran does not approve the practice of continuing the use of arsenic for a long time in sınall doses. It may have been harmless in a certain number of cases, but this does not prove its utility. In conclusion, he observes that the arsenical treatment is undoubtedly efficacious in a certain number of cases of chorea; that it appears especially applicable to obstinate and anomalous cases of that disease; that nothing proves that it may not be employed with advantage in the treatment of simple and recent cases; that, employed prudently and cautiously, it does not produce any serious symptoms; and that the cure, when it takes place, is generally obtained in a very short time. "Such," says M.
are the considerations which, as it appears to me, ought to recommend this treatment to the attention of the medical profession; I do not hope that the prejudices of physicians will completely disappear before so small a number of cases as I have just related; but let them try the remedy, and if they meet with results similar to those I have recorded, they will arrive, like myself, at the conclusion that this medicine is one of the most remarkable therapeutical weapons we possess against a very serious and obstinate disease."
Aran, "
XVII. On the Influence of Mercurial Preparations upon the Secretion of Bile. By Dr.
GEORGE Scott. (Beale's Archives of Medicine, No. 3.) Dr. Scott relates the details of some experiments made on dogs, with the view of ascertaining whether the preparations of mercury really increase the flow of bile, as bas hitherto been generally believed. In these experiments the ductus commnnis choledochus was tied, so as to prevent any bile from reaching the intestine, and the gall-bladder was opened in order to allow all the bile secreted to escape externally. It was then collected in an apparatus constructed for the purpose, and calomel being given at different periods, the quantity of the bile secreted was carefully noticed. In the first place, however, Dr. Scott ascertained the normal amount of bile secreted by a dog's liver in the twenty-four hours. The quantity amounted on an average of three days to 2752-562 grains of fluid bile each day, the average weight of the dog being seventeen pounds, and the average amount of food being 7000 grains, and of drink nineteen ounces, or 8312.5 grains of milk.
In determining the effects of calomel on the secretion of bile, Dr: Scott calculated the average amount of bile secreteil in twenty-four hours two days previously to the administration of the drug, and ihen the average amount secreted in twenty-four hours two days after the calomel was given. The calomel was given each time after the morning's bile was collected, and therefore the effect of the medicine was upon the bile of the day following that on which it was given. The four experiments performed by Dr. Scott all gave the same rather paradoxical result--namely, that there was a diminution in the amount of fluid bile and bilesolids secreted after the administration of large doses of calomel.
Although Dr. Scott considers that it would be rush to venture any decided opinion from the results of four experiments, yet these all point so much to one conclusion that if they should be confirmed by future and more varied trials, they will throw considerable doubt upon the generally-received opinion that calomel in large and purgative doses increases the flow of bile. It may be urged, he adds, that although calomel does not increase the secretion of bile in the doy, there is no reason why it may not do so in man, and that even if mercury does not excite the liver to increased secretion in a healthy state of the organ, it may yet do so in some of its diseased conditions. But if the first objection were true, the same could be urged against the results of experiments on the lower animals to ascertain the action of poisons or any articles of the materia medica. With regard to the second objection, nothing analogous occurs in the action of drugs upon other organs, and it seems difficult to suppose that anything which diminishes the flow of bile in a healthy condition of the liver, should iucrease it in a disea -ed state of that organ. Whether it be the mere purgative effect of calomel which causes the dinination in the secretion of bile, or some specific action, must be decided by further experiments. It is also a matter for further inquiry, whether small and frequent coses of calomel continueil for a length of time, so as to produce the specific action of mercury upon the system, may not really augment the biliary secretion.
XVIII. On the Use of Raw Meat in the Colliquative Diarrhæa of Children at the Breast.
By Dr. J. F. WEISSE Director of the Children's Hospital at St. Petersburg. (L'Union Médicale, April 7ıb, 1859.)
Seventeen years have passed since Dr. Weisse drew the attention of the profession to the beneficial effects attending the use of raw meat in the treatment of the colliquative diarrhea of children at the breast, and since that time numerous writers have confirmed the views originally advanced. Dr. Weisse now declares, after an experience of twenty years, that raw meat, reduced into a pulp by scraping, to the exclusion of all other treatment, is the true specific for this destructive form of diarrlica. He cannot agree with the remarks of Mr. Charles Hogg, who recommends beef-tea in preference, for he finds in raw meat not only an aliment for the children, but also a remedy for the kind of diarrhea in question; besides, he has never spoken of the juice of the meat, but has recommended the muscular substance itself
, minced or scraped, so as to be swallowed and digested without difficulty. The object proposed is to introduce into the digestive tube the muscular substance of the meat, and ihe leeftea has no controlling power over the diarrhæa, for by its mere fluidity it traverses too rap dly the intestinal canal. By giving the meat in a pulp, the solid parts remain longer in the intestine; they act by contact, and may, by exciting the intestinal mucous membrane, stimulate absorption; and it is probabile also that this plan may contribute to neutralize the acidity of the gastric juice. The treatment of children's diarrlica by raw meat has become general at St. Petersburg, and has been adopted rather by the establishment of the good effects which have resulted from it than by the publication of special memoirs. Dr. Weisse has employed the treatment in nearly 200 cases, and the result has been always satisfactory when the case has been taken in time. When the disease is too far advanced, ind has assumed the character of gastromalacia, a cure is seldom obtained; but even in such circumstances it is possible to mitigate some of the symptoms felt by the patient, such as the inextinguishable thirst and the vomiting.
QUARTERLY REPORT ON PATHOLOGY AND MEDICINE.
By EDWARD H. SEIVEKING, M.D. Fellow of the Royal College of Physicians, Physician to, and Lecturer on Materia Medica at, St. Mary's Hospital.
I. On Cerebral Deficiency and Hydrocephalus. By Professor R. HESCHL, in Cracow. (Pra
ger Vierteljahrssclirift, xvi. Jahrg. 1859, Erster Band, p. 69.)
PROFESSOR HESCHL has observed four cases of deficiency of the central gyri of the brain and of the adjoining parts. The first case occurred in an idiotic beggar, who died at the age of twenty-six, who had only had an imperfect power of executing the ordinary movements, and whose range of speech had been very limited. His left side was more powerless than the right. The right parietal bone bulged out, the most prominert parts being reduced to form one-balf a line to one line in thickness, while the remainder of the cranial vault was from two to two and a half lines thick. The left cerebral hemisphere and its membranes were essentially norinal, nor was any malformation perceptible in the cerebellum, medulla oblongata, and spinal cord. In the right cerebral hemisphere the whole middle portion of the centrum ovale, together with the convolutions appertaining thereto, both on the surface and at the Sylvian fissure, were absent, so that on removing the dura mater one at once looked into the patulous lateral ventricle. The space was occupied by a large bladder with very thin parietes, containing about a pint of clear serum. This bladder evidently consisted of the distended internal cerebral meninges of the defective portion; it was in close proximity externally with the dura mater, and was intimately united to the arachnoid and pia mater of the remainder of the hemisphere. The right corpus striatum and tha'amus opticus was smaller than those of the left side; the septum was perforated at two points. The tissue of the brain was otherwise healthy, and nowhere showed any extravasation or traces of inflammation.
It is unnecessary to give the further details of this case, or to specify those of the remaining cases, which in their essentials are identical with the first. The author sums up the conclusions to which he is led by the analysis of these cases as follows:
1. Idiots affected with hemiplegia exhibit a congenital defect in the brain, which gives rise to a communication between the lateral ventricles and the sac of the arachnoid. He terms this defect porencephalia.
2. This porencephalia is always associated with other defects in the formation of the hemispheres.
3. Porencephalia is probably not an arrest of development, but a true disease occurring during the growth of the brain.
4. It is sometimes associated with hydrocephalus, but as little as other cerebral defects explicable as the effect of intra uterine hydrocephalus.
5. Intra-uterine hydrocephalus is probably the consequence and not the cause of numerous malformations of the brain.
II. On Partial Hypertrophy of the brain. By GIACOMO SANGALLI. (Gazz. Lomb. 30, 1858,
Schmidt's Jalırb., Jahrg. 1859, No. 4.)
Some doubt existing as to the reality of partial hypertrophy of the brain, and such cases at all events being very rare, the following deserve attention. It is right to add that we have not seen Dr. Sangalli's own account nor his illustrations; we therefore give the cases without further comment:
1. A youth, aged nineteen, well formed, with unimpaired mental powers, had been out of health for some months; this became worse, and after a fortnight's serious illness he died comatose and icteric. The autopsy revealed acute yellow atrophy of the liver. The dura mater was yellowish, the pia mater normal. Convolutions of usual size; no change in the vascularity, consistency, or colour of the brain. On exposing the centrum ovale, the surface of the corpus callosum was found abnormally curved, with its convexity upwards. In the lateral ventricles there was a drachm of clear serum, and the left thalamus opticus was manifestly much larger than the right one, which was of normal size. The left thalamus retained the usual form; its long diameter was 47 millimetres (1•83 inch), its transverse diameter at the thickest part was 27 millimetres (1.05 inch), while the corresponding dimensions of its fellow were 37 (1:44 inch), and 18 millimetres (0:70 inch). No material change was observed in the tissue of the part. The author is of opinion that the condition must have been congenital, or have been developed soon after birth, because there was another congenital defectviz., material contraction of the entire aorta.
2. A peasant, ayed twenty-seven, died of pleuro-pneumonia. On raising the anterior half of the brain a protuberance was discovered, connected with a convolution of the posterior part of the left middle lobe. It was of the size of a small hazel-nut, shaped like a wart, rather softer than the cerebral tissue, not covered by pia mater, which ceased abruptly at the coinmencement of the projection. The grey investment (of the protuberance) was 1 millimetre (0039 inch) thick, and passed into the adjoining grej cortical substance; the subjacent medullary matter was normal. The microscopic examination showed few nerve fibres with double outline, many fine fibres of cortical tissue, and between them molecular granulations, nuclei with nucleoli, and some transparent nerve cells without remarkable prolongations. The other portions of the brain were perfectly norinal, and neither the dura mater covering the protuberance, nor the bone above, were in the least altered. The man had never exhibited any cerebral disturbance.
3. A man, aged sixty, had died of severe diarrhea, accompanied by severe abdominal pain, without manifesting marked cerebral disturbance. There was extensive suppurative enteritis, besides other abdominal lesions. In the brain was found an oval white-grey transparent body, of the size of a small bean, and with a smooth surface, situated on the middle of the right corpus striatum, external to the tænia semicircularis. Its longest diameter corres; onded with that of the part from which it was developed. It was invested by a thin membrane traversed by delicate vessels. The tissue of which it was composed resembled the brain of a child; exhibited nothing to distinguish it materially from the remaining cerebral tissue, and like it, was traversed by capillaries. No other abnormity could be discovered in the brain, but the larger arteries exhibited a medium degree of fatty degeneration,
III. On the State of the Mental Powers in Chorea. By M. Marok. (Archives Générales de
Médicine, May, 1859.)
In a memoir, read before the Academy of Medicine, on the above subject, the author advances the following conclusions :
1. The moral and intellectual functions are very commonly affected in choreic patients, at least two-thirds show some affection of the kind; the immunity enjoyed by the remaining third cannot be explained either by the age or the sex of the subjects, by the acuteness or chronicity of the disorder, nor by the extent or intensity of the convulsions.
2. Four morbid elements, which are sometimes isolated, but most frequently associated, should be studied together in the mental condition of ch rea patients.
a Derangements of the moral sensibility, consisting in a notable change of character, which becomes irritable and capricious, and may be unusually animated, but is more frequently depressed.
b. Derangements of intellect, characterized by a loss of memory, by too great a flow of ideas and by the impossibility of fixing the attention.
c. Hallucinations which occur in the staie intermediate between sleeping and waking, rarely in the morning and on waking; these hallucinations are commonly limited to the sense ot sighi, and rarely extend to hearing or general sensibility; they occur most frequently in hysterical subjects.
d. Chorea may from its commencement be complicated with maniacal delirium; this frequently terminates in death, or, if recovery takes place, intellectual disturbance remains.
IV. Cases illustrating the Pathology of Mental Dise.78€ arising from Syphilitic Infection.
by Joux B. Ünapix, M.D." (The American Journal of Insanity, Jan., 1859.) The author argues that the defective nutrition of the brain resulting from the syphilitic diathesis perverts its healthy nutrition in such a way as to induce insanity. The perverted nutrition induced by the long-continued aetion of the morbific cause, the loss of sleep, the pain and other circumstances accompanying constitutional syphilis, canse, first, a cliange in the temper, artections and morals of an individual, which gradually pass into the graver forms of mental disease. The mental disease may not alone arise from the effects upon the brain of this general cacheria, but from a direct srplisitie affection of some of the intracranial structuris "The fibrous structure of the dura mater, the fibro-servus tissue of the arachnoid; the periosteum and the cranial tones, are severally and collectively liable to
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