Billeder på siden


Case of Strangulated Inguinal Hernia.Mortification of the Toes.

the omentum excited particular atten- branes, when the examination was tion. It was seen stretching from made, was a subject of surprise to all its attachment to the stomach, and present. Upon the calvarium being the transverse arch of the colon down- removed, the vessels on the surface of wards to the abdominal ring, where, the dura mater seemed numerous and as we have said, it was again firmly dilated, and the blood flowed in some secured by old adhesions. The in- quantity when it was cut. The testines lying in this interval appeared arachnoid membrane was remarkably to suffer a considerable compression, thick and opaque, and gave a dilute for the omentum made an indentation milky appearance to the convex surupon them in its course. Mr. Law. face of the brain. A copious serous rence at once observed that this rela- infiltration into the pia mater had also tion of the intestines and omentum taken place; so that when the dura could not possibly have subsisted mater was removed, the two hemifrom the commencement of the adhe- spheres appeared as if they had been sion of the latter to the back of the sac, covered with a layer of thick jelly, or and that the tense state of the omen- (with reference to the colour and contum, which was so conspicuous, must be sistency) of blanc-mange. Yet during of recent production, and could only be the time that the man was in the ascribed to the sudden distention of the Hospital, he exhibited no symptom bowels. The result of the pressure was whatever of confusion of intellect to curious: the colon, at the point of its lead to the suspicion that such preterattachment to the omentum, was con- natural changes existed in his brain. stricted, and so reduced in its dia- It was mentioned in the dead-house meter as to oppose an impediment to by one of the gentlemen present, who the passage of the fæcal matter. The minutely inquired into the history of convolution of intestine which had the patient, that he had had a parabeen protruded into the hernial sac lytic attack in the left arm. The right was somewhat inflamed; it presented side of the brain was accordingly mispots of vascularity and of ecchymosis, nutely examined, when upwards of and was agglutinated to another por- three ounces of a very pellucid fluid tion of intestine, not, however, so as were found in the right lateral vento offer the slightest obstacle to the tricle. The right corpus striatum had continuation of the ordinary functions lost its colour ; it was light brown, of the bowel. The wounded part was and in a flaccid state, and on concompletely concealed from sight, as tinuing the examination, the adjacent was every portion of the ligature, by structure was found to have expea copious effusion of lymph.

rienced a similar change. Mr. Law. a beautiful specimen of the initiatory rence had no doubt that this alteration process of nature to repair injury, and was produced by the effect of an there could have been no doubt that effusion of blood into the corpus. The the ligature would ultimately have blood was absorbed, and the same been passed off through the alimentary result followed as takes place from the canal, if life had not been extin- same causes in other parts of the body. guished from other causes. The brain was examined, but no anticipation of Mortification of the Toes from Cold. a morbid condition had been pre- Richard Wilson, a boy about 16 years viously entertained by any person. of age, was admitted into the HosMr. Lawrence, indeed, stated that he pital on the 26th ult. on account of wished to see the contents of the mortification of the toes of the right cranium only to have an opportunity foot, under the care of Mr. Earle. of contemplating the appearance whieh The poor boy appears to be half

nnealthy brain would present. The idiotic; and therefore the account actual state of the brain and its mem- which he gave of the cause of his

It was

complaint could not be relied on, But the persons who brought him to the Hospital stated that he was found in a most distressing condition, and that the disease under which he laboured was produced by continued exposure to the inclemency of the weather. On a close examination of the boy, after he had been placed in bed, there were found black patches over merous parts of the body, which could not readily be referred to any other cause than great violence. Inquiries were instituted, and there is reason to believe that the marks about the boy were the results of the sort of chastisement which was inflicted upon him in a workhouse, of which it appears he had been an inmate for some time, but from which he had at last made his escape.

One of the toes nearly dropped off on the morning of the 28th ult., and there is some danger of the remaining ones.

which he detailed several cases of deafness, caused by an impervious state of the eustachian tube, in which a perfect cure was effected by iodine, given in the form of tincture, according to the formula of Dr. Manson, of Nottingham. The medicine was given in water, and not as draughts, which accords with the recommendation of M. Lugol, who states the tincture will be decomposed in a short time, if mixed with water. We can bear our testimony in attestation of Mr. D.'s success in treating diseases of the ear, and of his high attainments as a surgeon.)


Guy's HOSPITAL. Hydriodate of Potass in Scirrhus

Uteri. MR. ASHWELL has tried and is still trying the hydriodate of potass, in the form of suppository in scirrhus uteri, in the obstetrical wards of Guy's Hospital. His formula is composed of 2 or 3 grains of the hydriodate, and 6 of extract of hyosciamus, introduced into the rectum every night. The most decided improvement has been effected in six well marked cases, by this remedy. The general health was of course attended to by mild aperients and tonics. The facts proved by this report are in direct opposition to the experience of Dr. Elliotson, who proclaims to the world that hydriodate of potass may be given in drachm doses, and is merely a diuretic.

(Mr. M. D. Darwin, of Bedford Street, has lately read a paper on the causes of deafness, and on diseases of the ear, at the Medico-Chirurgical Society of the Medical School, at the Westminster Dispensary; in

Rheumatitis. Richard Daniell, æt. 28, a waiter, admitted under Dr. Cholmeley, Dec, 14, 1831.

Is of a pale complexion, delicate constitution, and of an irritable nervous habit.

States that he is married, and has lived regularly, but from his occupation has been much exposed to changes of temperature. His present illness commenced seven days ago, with pains in the knees, hips, and elbows, accompanied by great difficulty of breathing. He was bled and blistered, and had some medicine, which relieved his respiration. He says that he had typhus when nine years old, since which period he has been subject to palpitation of the heart. The right wrist is inflamed and swollen, tongue coated with a yellowish fur, bowels not opened; since yesterday, skin moderately warm ; pulse 105, sharp and hard ; urine light coloured; has had a slight attack of rheumatism about four years ago.

V.S. ad žxij. Submur. hyd. gr. iv. Pil. antim. opiat. fort. h. s. Jalap. Ammon, acet. c. vini antim. m. xxx. 4tis horis.

15th.-Feels somewhat better, bleeding produced great faintness, no sleep during the night, owing to severe pains in the stomach (suppos. ed to be caused by the mixture).


The pain is less this morning, but is 22d.-Feels rather better, but sufincreased when the medicine is taken. fered more pains in the night in his Tongue moist and nearly clean. No left hand and wrist; tongue coated, thirst, bowels opened twice, dejec- with a yellow fur; troubled during the tions loose, and yellow, and afford night with flatulence; pulse 108, relief. The most painful joint is the sharp. Hirudines parti dolenti, Deleft wrist, which has become affected coct. Cinchon. c. Iod. Syrup. Aurant. since his admission; pains of the et Tinct. Ejusdem aa; 3js, 4tis horis. other joints much diminished; pulse –Pergat. 105, full, hard, and bounding; urine 23d.-Improving.Pergat. high-coloured, and turbid; blood 24th.-Better; pulse 90, and soft; drawn yesterday considerably cupped, bowels opened, not freely; appetite and buffed. Jalap and magnesia were good. To take milk and arrowroot. administered, and the pills continued. -Pergat.

16th.—Much better, slept well, 25th.—Great pain in the right slight dejection. Ordered this morn- hand and knee, in other respects beting a dose of house physic; tongue bowels

open, dejections unnatural moist and nearly clean; no sickness; and offensive; tongue nearly clean ; pulse 108, rather soft ; skin moist, pulse 72.-Pergat, but hot; complains of very little pain 26th.—Troubled with great pains in the joints. Pil. ant. opiat. fort. c. last night in both arms and hands, but cal. gr. ij. omni nocte.—Pergat. is better this morning ; tongue as yes

17th.—He is much better, the terday; pulse 92; bowels not opened; most painful joints are the fingers and ordered a dose of castor-oil.—Pergat. toes; bowels once copiously opened; 27th.—Much better, less pains in pulse 108, full ; skin rather hot; no the arms and wrists; bowels twice thirst ; urine high-coloured, and tur- opened; slept well ; pulse 96, small; bid.—Pergat.

tongue clean.—Pergat. 18th. - Improving; tongue cleaner; 28th.-Better.- Pergat. little pain in any of the joints ; pulse Jan. 1st, 1832.-Continues im108, full, and rather incompressi- proving; middle diet.Pergat. ble; he felt a slight spasmodic pain 3d.-Sleeps well; bowels opened in the right hypochondrium this once; tongue clean; pulse 96, rather morning, which was relieved by tak- sharp.—Pergat. ing warm water ; bowels freely open. 17th.—Dismissed, perfectly cured. ed, and offensive. - Pergat-haustus statim sumendus.

St. George's HOSPITAL. 19th.-Says he is better; bowels

Iodine in Ovarian Diseases. regular ; urine high-coloured, and

Dr. SEYMOUR is now employing turbid ; slept pretty well, no perspira

iodine in diseases of the ovaries, tion; tongue dry, the centre coated with a yellow fur; pulse 144, sharp.

with manifest advantage. The di

minution of ovarian tumours is most Calomel gr. 3, c. Pulv. Doveri gr. iiij. hora somni.—Pergat.

remarkable. 20th.-Continues to improve; great

MIDDLESEX HOSPITAL. pain in the left knee and hands ; tongue improved; bowels opened once Iodine in Cancer of the Face. yesterday, pulse 96; no thirst, appe- SEVERAL cases of cancer of the face tite much better.— Pergat.

are being treated with iodine, by Pro21st.—Still considerable pain in fessor Mayo, at the recommendation the shoulders, arms, and hands; slept of M. Magendie, which was given well during the night; bowels once when that distinguished physiologist opened; pulse 90, full.— Pergat. was on his way to Sunderland. The

most decided improvement has been frame. Some latent influence seems derived from this mode of treatment. to produce derangement in the natuThe following is the formula of this ral combination of the ultimate eleHospital :

ments of our bodies, and to dispose By Iodinæ


them to combine in new and untoPotas. Hydriod. Dijss.

ward proportionals, incompatable with Aquæ destil. Zviij.

the laws of life, or a state of health. m sit mistura, cujus capiat m, x. As mentioned in myTreatise on Health ad xxx ter de die.

it seems that the deleterious cause We hope to detail the results of has the power to break up the healthy these cases.

principles composing our blood and tissues, and to make them join in the

altered and disordered atomic proporCholeranew Mode of Treatment. tions constituting the basis of poisonDr. Murray, of Dublin, whose work

ous prussiates. “On Heat and Humidity" has proved

When therefore some of the proxihim to be a physician of no ordinary

mate principles of our constitution are acquirements, has favoured us with a

decomposed, the alternate elements copy of a letter, addressed to Dr. Fer

which had formed them may produce gusson, who was lately appointed by

new results when acted upon by some

occult the Irish government to investigate

agency. Thus the carbon and the nature of cholera at Sunderland,

nitrogen may be disposed to combine Newcastle, &c. which contains some

in proportions calculated to form pruscurious original views, well worthy of

sic acid or its basis ; and the oxygen consideration. It will be seen by the

and hydrogen then set free would date of the letter, that the administra

constitute water, which fluid (as tion of ammonia by the lungs, and pointed out in my treatise) would skin, and especially over the spine and

account for the blackness of the

blood. epigastrium, is an original proposition. Ammonia has been given by the

I have already mentioned to you, mouth, since the following letter was

that if nascent prussic acid pervade written. Dr. Murray has termed it a

the human system or cavities of the new and cheap atmospheric blister, in

body during this Asiatic epidemic, an his work already referred to, and

atmosphere of ammonia diffused which was published in 1829.

through the air of the apartment so as to be easily respirable, might be a

manageable, economical, and benefi[Copy of a letter to Dr. Fergusson.]

cial antidote.

The generation of ammonia in sick Dublin, January 3d, 1832. rooms would maintain and convey Sir,–At this moment of dismay, I uniform heat to the patient, and think it my duty to explain more being imbibed in hot vapour of water fully the opinion I have already men- by the skin and lungs, might countertioned to you, that whatever the re- act the further evolution of disordered mote cause of cholera may be, the

animal products. proximate one seems very similar to As a mode of prevention, the air those which would arise from the of suspected or infected chambers evolution of cyanogen in the solids might be deprived of malignant miasand fluids of our system.

mata by a proper impregnation of The cold, black, and clotted blood,

ammonia. the progress of the malady, and the The mode of procedure detailed motion of the muscles after death, all in my dissertation, page 272, would appear like the effect of prussic acid, convey a continued warm vapour of formed and circulated through the ammonia and water around the patient


in bed, and also diffuse a sufficient bear, in a conspicuous place, respecquantity of volatile alkali through tively, an inscription, signifying that the air of the apartments.

each was given to Edward Stanley, After proper attention to the use Esq. F.R.S. by the Governors, as a of mustard and other emetics, then, testimony of the sense which they ammoniated spirits DULY DILUTED,

entertained of his ability and industry might be administered internally, and in directing and arranging their even per enemata, as useful adjuvants Museum. of treatment. I am the more anxious to draw attention to these sugges

A Demonstration of the Nerves of tions, from the result of experiments similar to those mentioned in my

the Human Body ; founded on the work, page 160, showing the great

Subjects of the Collegial Prizes for changes effected on the blood by an

1825 and 1828, adjudged by the atmosphere in which aminonia is

Royal College of Surgeons. By Joseph diffused; I refer to the work alluded

Swan. This Part completes the Anato, as containing observations on the

tomy of the Sympathetic Nerve. Part influence of æriform remedies, the

III., containing the Cerebral Nerves, detail of which would now be te

will be published in the ensuing dious.

spring. Price of Part I. 21. 2s.

A Treatise on the Diseases of the Having mentioned the substance of this letter to some of those con-

Heart and Great Vessels. Comprising nected with Government, I am ad

a new view of the Physiology of the

Heart's Action. By J. Hope, M.D. vised to submit it to the consideration of the Board of Health at New

Senior Physician to the St. Mary-le

bone Infirmary, of London, formerly castle. I also request you will give these

House Physician and House Surgeon

to the Royal Infirmary of Edinburgh, suggestions the benefit of your in

&c. &c. vestigation, during the series of

A Treatise on Physiology applied experiments you are about to institute on the subject of morbid

to Pathology. By F. J. V. Brous

sais, M.D. From the French, by John poisons.

Bell, M.D. and R. La Roche, M.D.
I am, dear Sir,
Your's truly,

History of Chronic Phlegmasiæ, or

Inflammations, founded on Clinical J. MURRAY.

Experience and Pathological AnaMr. Stanley.-We have by acci.

tomy; exhibiting a view of the vacident been enabled to inspect a mag

rieties of these Diseases, with their

Treatment. nificent present which has been given

By F. J. V. Broussais.

From the French, by Isaac Hays, M.D., to this distinguished professor of

and R. Eglesfeld Griffith, M.D. anatomy, at St. Bartholomew's Hospital, by the Governors of that splendid institution.

The present

Communications have been receivconsists of a tray composed of massive silver, which is chased in the very

ed from Dr. Murray, of Dublin, Dr. richest style of luxurious ornament;

Hays, of Philadelphia, Dr. Copland, and of two smaller waiters of the same

Dr. Gordon Smith, Dr. Crane, Dr. metal, and decorated upon a similar

Bourne, of Coventry, Dr. Hacket, of

Trinidad, Mr. Rolls, Mr. Myers, Mr. scale. The tray presents in the middle of its surface, in beautifully-wrought Boyle, and Mr. Henry, which are engraving, the arms of the Hospital,

under consideration. internsingled with those of Mr. Stan

The Reports of the Medical So

cieties in our next. ley. On the waiters also his arms are engraved. The three pieces of plate



« ForrigeFortsæt »