Part 20

"G.K..., a soldier aged 21 years, thin, tall, and who during his infancy had been subject to ascarides, has occasionally voided during more than 10 years past, portions of tænia. He had used several purgative medicines, by which several yards of this worm had been expelled; but annoyed with so many attempts at obtaining its total expulsion, he had ceased, three years before, the use of all sorts of anthelmintics. But the phenomena resulting from the presence of the animal being aggravated, the patient applied for advice to Dr. DE POMMER, who found him labouring under the following symptoms:--Frequent pain in the abdomen, and especially in the umbilical region, accompanied with a sense of burning heat, and alternate distension and depression of the abdomen. Appetite sometimes keener than in health; at others nearly lost. In the morning before breakfast, the patient was seized with extraordinary weakness, and general uneasiness, accompanied with trembling of the limbs, ineffectual attempts to vomit, a sense of constriction in the throat, and a profuse salivation. All these symptoms disappeared after K... had taken food; but reappeared two hours after. Milk and farinaceous aliments were the only articles of which he could make use without an aggravation of his disease. The pulse was febrile; sleep good, but attended with dreams. The pupils were in the natural state. From the symptoms, and from the history of the case, Dr. P. was induced to make use of the oil of turpentine in the following manner. The patient was ordered in the morning, before breakfast, three table spoonsfuls of the remedy, at half an hour's interval. The first doses produced only a few borborygma. Two more table spoonfuls occasioned a vomiting of mucous matter. Three more table spoonfuls were exhibited, and followed by a stool of solid fæces, mixed with which were five small pieces of tænia. The patient not finding himself incommoded, took in the space of an hour, three more table spoonfuls of the remedy, after which he experienced some pain in the head, and vomited about one pint of bilious liquid. An hour after, the same quantity of the medicine was taken, and followed again by vomiting, but after a repose of half an hour K... discharged, per anum, firm and greenish fæces, and with them five ells of tænia. The urine discharged had the smell of violets. He again took a few spoonfuls of the vermifuge, which were not followed, however, with any fæcal discharge, and only with some vomiting of mucus, and slight vertigo. In the afternoon the patient felt well, and experienced a great appetite, in which he indulged. From this moment he recovered, and has ever since enjoyed good health. The quantity of the remedy used was six ounces."

It appears, from the observations of Dr. P., that the gastric irritation occasioned by the spirits of turpentine, has never amounted to phlogosis, and has generally subsided after the remedy had been discontinued. Nevertheless, as the spirit of turpentine is a very powerful stimulant, we would not venture to recommend its use, when there exists an inflammation in the gastro-enteritic system. We are aware that it is resorted to in burns, and highly eulogized in puerperal and yellow fever. In the first, it is certainly very useful, but on what principle we know not, except perhaps that its stimulus is different from that existing in the diseased part. But in the second case, it acts, not on the diseased surface, but by revulsion, on the mucous membrane; and as regards its virtues in yellow fever, we are rather sceptical in respect to what has been said on the subject. In this opinion we are supported by the testimony of our friend Professor RHEES, whose situation of house surgeon to the fever hospital, during the epidemic of 1820, afforded him ample opportunities of testing the propriety of the practice.

In the number for March 1826, of the Revue Medicale, M. MAUDRU relates two cases in which large portions of tænia were expelled, and the patients cured, by means of a strong decoction of the bark of pomegranate. The first patient took, in one day, two pounds of the decoction made with four ounces of the remedy. The second patient took six ounces of the bark in decoction, in the course of forty-eight hours. In neither case did the medicine occasion unpleasant effects, with the exception, in the second patient, of slight colicky pains.

28. _Action of the Oil of the Euphorbia Lathyris._--At a meeting of the Academy of Medicine, (section of pharmacy) M. BALLY read the results of some clinical experiments made by him at the hospital of La Pitié, on the action of the oil of the euphorbia lathyris. The preparation used by him, had been made by means of alcohol and expression. It appears to be a little more active than the other preparations. Administered to fifteen individuals of different ages, it did not produce very various results, nor prove very active in its purgative effects. As a purgative, indeed, it is far less active than the croton oil, and requires to be given in much larger doses; as much as six or ten drops. It has also the bad property of exciting emesis, by which it is rejected from the stomach. On the other hand, however, it does not, like the croton oil, produce salivation, and is, on the whole, regarded by M. BALLY, especially when fresh, as a useful purgative in diseases of children.--_Archives Generales, Decembre, 1825._

29. _Medicinal properties of the Apocynum Cannabinum, or Indian Hemp._--In an essay on this plant, submitted to the medical faculty of Jefferson College, by Dr. M. L. KNAPP, we are informed, that in doses of 15 or 30 grains it possesses emetic properties. It was besides, on trial, found to be cathartic, expectorant, diuretic and diaphoretic. It appears to have been generally administered in powder, and Dr. K. remarks, that "in decoction, it seems to lose some of its emetic properties, and to act more upon the bowels as a hydragogue cathartic." "The root possesses all the medicinal properties of the plant, and is active throughout, both in its cortical and ligneous portions. Water or proof spirit is its proper menstruum."

This article was prescribed with success in dropsy, by Dr. KNAPP, and by Dr. PARRISH of this city. It was likewise used in intermittent fever, in bilious affections, amaurosis, hernia humoralis, dysentery, chronic rheumatism, &c. Dr. KNAPP appears to have derived benefit from its use as an alterative in a case of fever in a child, attended with disordered bowels. "The powders (gr. ii. each at intervals of three hours,) were regularly persisted in for a week, and the child's health went on gradually improving. Neither vomiting nor purging was produced, but the morbid heat and thirst were allayed, the stools became natural, the skin soft and moist, and the functions of digestion and assimilation were gradually restored, and the child is at this time fat and healthy."--_American Medical Review, &c. April_ 1826.

30. _Remarkable effects from the external application of the Acetate of Morphia._--M. DUBOURG has recently published the result of an experiment made at the hospital de la Pitié, with the acetate of morphia, which we regard as sufficiently interesting to be noticed in this place. The patient had been affected twelve months before with puerperal peritoneal inflammation, complicated with cerebral symptoms, from which, notwithstanding a most energetic antiphlogistic treatment, she never entirely recovered. When she was admitted into the hospital, she presented the following symptoms:--"considerable emaciation; skin hot and pungent to the feel; pulse small and frequent; tongue of a pale rose colour, dry at the tip and edges, brown and smooth in the centre as far as the basis; severe pain on the least pressure on the epigastrium and over the whole abdomen; cardialgia, nausea, vomiting of all solid and liquid aliments, and during the empty state of the stomach, violent efforts to vomit occurring at irregular intervals; abdomen tense and tympanitic; violent intermittent pain along the course of the intestines; constipation; sensation of fatigue and lassitude in the lumbar region and in the extremities; dragging pains in the inter-scapular region; extinction of the voice; urine red and scanty; the face animated and bearing no marks of profound suffering; agitation, and total want of sleep."

The disease was regarded as a chronic gastro-entero-peritonitis, and treated accordingly, by the antiphlogistic regimen; but no benefit was derived from this plan. The patient continued to vomit almost every thing she took, with the exception of sugar and a paste made with the Iceland moss. A blister was applied to the epigastrium on the 15th of February, seven days after her admission. Called to her assistance on the 22nd of February, on account of an aggravation of the vomiting, M. LAMBERT, one of the house pupils of the hospital, endeavoured to calm the symptoms by means of the acetate of morphia in powder, applied to the raw surface of the blister. Half a grain was used in this way, and in a few minutes the vomiting disappeared, and the patient passed a better night than she had yet done. M. SERRES having authorized the continuance of this method, M. DUBOURG the next day applied half a grain in the same way; and the patient slept the whole night. The remedy was applied every day with the same effect, and was gradually increased to two grains and a half. From the first application of the remedy, the symptoms gradually subsided; aliments were retained and properly digested; the pain and swelling of the abdomen disappeared, and on the 14th of March the patient was regarded as in a fair way of recovery.--_Archives Generales, March_ 1826.

In some remarks which accompany this interesting case, M. DUBOURG, seems to doubt the correctness of the first diagnosis, and to view the disease as a nervous, rather than as an inflammatory affection of the abdominal viscera.

31. _Cure of Urinary Calculi by means of the internal use of the Bicarbonate of Soda._--At a late meeting of the Academy of Medicine, Mr. ROBIQUET read a memoir on the use of this salt in cases of urinary calculi. Having learnt from Mr. DARCET, that the use of the waters of Vichy changes the quality of the urine from acid to alkaline, Mr. R. conjectured, that this effect should be attributed to the bicarbonate of soda contained in them; and from this circumstance, he was led to administer this salt internally, in cases of calculi composed of uric acid. In July last, he made the experiment on a man 74 years of age, who had laboured under symptoms of the disease since the month of February, and in whom, by means of the sound, a small and soft calculus had been detected. Mr. R. ordered him 10 grains of the bicarbonate in the course of the day, dissolved in two pounds of water--prescribing at the same time, hip baths, injections, &c. At the end of fifteen days, much benefit had already resulted from this treatment; and in a month, the patient appeared to be cured. Nevertheless, the remedy was continued until November, when the patient passed through the urethra, a small calculus composed of uric acid, which appeared to have been the nucleus of a much larger one, the exterior strata of which had been worn off. From that period, the patient has not experienced any unpleasant symptom; but the sound was not resorted to, to ascertain whether the first calculus before felt, could be detected.--_Archives Generales, February, 1826._

32. _Attempt to cure Abdominal Dropsy, by exciting Peritoneal Inflammation._--In the number of the London Medical and Physical Journal for April, 1826, a case of ascites is related by H. R. OSWALD, Esq. in which the cure was attempted to be effected, by exciting peritoneal inflammation. The following symptoms were noticed at the time of application for advice: the abdomen measured nearly six feet in circumference, was exceedingly hard and tense; but not tender. The patient "could hardly walk across her cabin from dyspnoea and debility, and the weight and tension of the tumour; which caused her to bend the body much forward, leaning her hands on her knees. The emaciation was very considerable; the appetite good; thirst considerable; tongue clean; pulse 120, and small; skin dry, harsh, and rough; bowels habitually costive; urine scanty." "This affection commenced about twelve months ago, after an obstruction of the catamenia for nearly a year, arising, as was supposed, from exposure to cold. The swelling was preceded by lancinating pains in the abdominal and lower part of the thoracic cavities, but which, after a few months, ceased entirely; and the disease had, in a chronic manner, gradually arrived at its present oppressive form."

Paracentesis was performed several times; cathartics, diuretics, the lancet, blisters, and tonics were resorted to, with relief from some of the symptoms. The tumour, however, returned several times, so that M. OSWALD despairing of effecting a cure by following the same plan, and recollecting a case of ascites, which was cured apparently by an inflammation having supervened in the peritoneum, from the orifice made by tapping remaining open, attempted to produce the same effect in the present patient, by keeping the orifice of the wound open by means of a small tent. In this he partly succeeded, for in the course of a few months, all symptoms of the effusion had disappeared; health and strength had much improved, and the patient had experienced a return of the menstrual discharge, which had been suppressed for nearly three years.

About a year afterwards, however, the disease returned. Paracentesis was again performed several times, and a tumour was perceived to have formed in the lower part of the abdomen. The patient died in about five or six months from the re-appearance of the effusion. On dissection, much water was found in the abdominal cavity, which was lined by a dense, white, and rough looking membrane, of a fragile and diseased structure. The intestines behind this membrane, were unusually small, and of a dark leaden colour. The tumour above alluded to, was discovered to be situated in the region of the right ovarium; it was a tubercular, carcinomatous, and pale coloured fungus, possessing a structure not unlike that of the placenta, and was formed in the interior of the sac, which being traced further back, was found to be the cyst of a dropsy, originating in the right ovarium at the fundus of the sac, or "more properly speaking of its neck."

"The foregoing statement," Mr. O. remarks, "involves four facts and questions of considerable importance in pathology. 1st. The great quantity of fluids evacuated in so short a space of time: no less than ninety-six quarts in eight months, by four operations; and fifty-nine quarts from August to December, 1824, by three. 2nd. The variety in the nature, consistence and colour of these fluids. 3d. The possibility of curing ascites and dropsy of the ovaria, by exciting inflammation in the abdominal sac, either by the admission of air into it, or mechanical irritation; and 4th. The possibility of a thickening of the parietes of the abdomen by inflammation, or by an exudation of a carcinomatous sort, being mistaken for a tumour rising out of the pelvis."

33. _Artificial Respiration._--Dr. J. WARE of Boston, relates in the New England Jour. for April last, that he was led by the experiments of the justly celebrated physiologist Mr. BRODIE, to employ artificial respiration in the case of an infant 9 weeks old, whose system was prostrated from an over dose of laudanum. "The action of the heart was reduced to an occasional throb; the pulse had entirely ceased, and the efforts at respiration, which for some time had consisted merely in an occasional gasp, became more and more unfrequent." The child had been afflicted for five or six weeks with hooping-cough, and had been very sick and feeble when the laudanum (about 15 drops) was administered.

By means of the stem of a tobacco-pipe, artificial respiration was excited, and continued for several minutes: the action of the heart was immediately renewed, and the pulse could be again felt. At the end of an hour, during which the artificial respiration was repeated at intervals; "the respiration became natural, the pulse distinct and tolerably strong, and the heat began to return." A fit of coughing, preceded by a livid appearance of the forehead and face, arrested the breathing, "which did not return till assisted by the artificial process." The child, assisted by these measures, and by attention to the more usual means of recovery, struggled through the night, but died during a paroxysm of coughing in the morning.

The conclusions of Mr. BRODIE are, that narcotics destroy life through the organs of respiration, and hence, if respiration can be artificially carried on until the effects of the narcotic subside, life may be preserved. Dr. WARE'S case would seem to confirm this idea; for it is _probable_ his patient would have recovered from the effects of the narcotic, if the paroxysms of coughing had not interfered.

34. _Secale Cornutum._--Mr. CHARLES WALLER has lately published (London Medical and Physical Journal, April 1826,) several cases illustrative of the action and efficacy of secale cornutum. We have not room for any of the cases, and content ourselves with transcribing Mr. W.'s inferences. These are: "That the secale cornutum is a remedy which is capable of increasing the force of the uterine contractions in a most remarkable manner, under certain circumstances; but that the effect is doubtful, unless there be some degree of action present. In other words, that, although it will increase the contractions when already present, it will not always renew them when they are suspended.

"That the effect is more certain if the infusion be of greater strength than is usually recommended; two drachms of the secale to six ounces of water being barely sufficient for the purpose.

"That it appears to be a stimulus peculiarly fitted for irritable, and what are generally termed _nervous_ habits.

"That the fears entertained by some practitioners of its proving detrimental to the child, are groundless.

"But, although it is in general necessary, not only that there should be a disposition for labour, but that this process should have actually commenced, before we can expect the secale cornutum to have any effect upon the uterus, still one solitary case has indirectly come to my knowledge (and I will vouch for the authenticity of it,) where this remedy was given for the purpose of producing abortion in a female, about the second month of utero-gestation; and this effect was accomplished in a few hours after its exhibition."

35. _Animal Magnetism._--This strange doctrine begins to acquire considerable vogue in France, and other European countries, from which it seemed to have been expelled, by the contempt and ridicule which it met with, from most of the learned of the latter part of the last century. ANTHONY MESMER, the great choroegus of the magnetic mummers, was born in 1733, and excited a vast deal of attention, by the enormous pretensions which he set forth on the subject of magnetism. MESMER came from Austria to Paris in 1778. He addressed the Academy of Sciences, and that of Medicine, but no attention was paid to him, till a commission was appointed to examine carefully into the merits of the question. This commission in 1784, so fully exposed the fallacy of MESMER'S theories and practice, that he soon afterwards quitted Paris, and retired to England under a feigned name. He subsequently went to Germany, and died in obscurity, in the year 1815.

In December last, M. HUSSON (for himself, and MM. ADELON, BURDIN, MARC, and PARISET,) read a report to the Royal Academy of Medicine, on the question, whether it was fitting for the section to undertake new researches on animal magnetism, as it had been thought to be definitively settled by the decisions of 1784. The report concluded affirmatively, for several reasons; among which the principal seems to be, that magnetism has at present fallen into the hands of the learned, whereas it was formerly under the domain only of quacks and the vulgar.

M. HUSSON'S report was discussed at subsequent sittings of the Academy, for the purpose of ascertaining whether a new commission should be appointed; and as this topic is certainly one of the greatest novelties of the day, we shall give some account of the discussions, making free use of the report of them, contained in the Revue Medicale, Mars. 1826.

M. DESGENETTES, declared against the appointment of a commission, because he considered the magnetism of the present day, quite as much a matter of jugglery as that of 1784; and he informs us, that the publicity given to the report, had already increased the audacity of the magnetisers, who look on it as an approbation of their art.

M. VIREY, regretted that the report had not spoken in strong terms, against the ridiculous practices, and shameful jugglery, which disgrace the cause of magnetism; he wished the committee had announced an intention, to make only physiological, or psychological researches, on the influence, which magnetism really appears to exercise on the nervous system; and gave his voice for the formation of a commission of experiments.

M. BALLY, voted against it for several reasons, and among others, because of the fact announced by all the magnetisers, that the person who magnetises, acquires a sovereign power over the magnetisee; and he inferred from this, all the inconvenient and even dangerous consequences which may result to public morals!--Finally, he voted against it, because magnetism is ridiculed every where, because it is all darkness and confusion, and especially, because it being an inexhaustible mine of empiricism, the section ought not to lay open such a fertile field for those gentry who live by quackery.

M. ORFILA, (eheu!) defended the propositions of the reporters. It is opposed, said he, on the three grounds following: 1st. Because the section has not been invited to the examination now recommended. 2nd. Because magnetism is nothing but juggling. 3d. Because commissions will not commonly do any work. The first ground is not correct: M. FOISSAC, a physician of Paris, has invited our attention to it, and offered to subject a magnetic somnambulist to its exploration; and very reputable physicians, members of the Academy, MM. ROSTAN, (the ramollissement man, is his head soft too?) and GEORGET, have in their recent publications called the attention of the learned to this subject. Secondly, if there be any jugglery, in the magnetic phenomena we are told of; it is nevertheless certain, that the whole of them are not simulated. The testimony of well taught physicians, ought to be received on this head. That the phenomena are extraordinary, is no argument; for those of electricity must have been quite as marvellous, at the period of their discovery, &c. &c.

M. DOUBLE, blamed the report as being nothing more than an apology for magnetism, which is tarred with the same stick as that of 1784, and only modified a little, by the esprit de notre temps, &c. &c. He said he had made magnetism a special subject of study, and _never saw a phenomenon produced by it_.----He thinks the commission could only do injury to science, and compromit the Academy, &c. &c. He would vote against the appointment, and advised the section to wait until some scientific memoirs should be sent to it.