Εικόνες σελίδας
PDF
Ηλεκτρ. έκδοση

The attack commenced at night, without any premonitory symptoms whatever, with the sensation of suffocation, as though a cord was tightly constringing the throat; there was much distress experienced in attempting to swallow even the smallest quantity of saliva. There was most intense pain in the region of the stomach, passing backwards from the scrobiculus cordis towards the spine, then taking the direction of the lumbar portion of that column, it terminated in the lower part of the sacrum.

This pain was most intense in the situation of the diaphragm, and became less so as it progressed towards the sacrum. It was described by the patients themselves as though the part affected was torn with hot pincers. There was considerable pain experienced on making pressure over the lumbar vertebræ. The breathing was much laboured, requiring the patients to remain in the sitting posture, the distressing sense of suffocation rendering it impossible for them to remain in the recumbent position. The respirations were upwards of sixty in the minute; the expirations were much longer, and accompanied with less pain than the inspirations; during the latter, the ribs and clavicles were elevated to an extraordinary degree. A most distressing hiccough recurring in fits at short intervals, left the patients at times almost breathless. There was slight fulness of the abdomen, with tympanitis, but no pain on pressure, excepting when it was made upwards towards the diaphragm, and then the other symptoms became, if possible, slightly aggravated. The skin was quite natural, but the extremities were very cold. Urine was voided in larger quantity, and paler in colour than usual. Bowels always regular. Pulse not altered in any way from the healthy condition.

The administration of anodynes in combination with some of the volatile spirits (as ether, ammonia, ammoniated tincture of valerian), together with warm applications to the feet and abdomen, afforded temporary relief, but the attack recurred again in a few hours without any abatement of the symptoms. The same plan of treatment had a like effect, till at length, on the approach of morning, a deep sleep came on which lasted for several hours, and the patients awoke, free from all cause of complaint.

When the patient did not submit to a continuous treatment for several days, the attack again returned, and the same remedies had to be resumed, and with a like success. However, a permanent cure was effected by the administration of the fætid gums, combined with the volatile spirits; anodynes on the slightest threatening of a recurrence of the attack; sinapisms to the sternum and spine; and plasters of belladonna to the loins. These measures, when steadily adhered to for seven or eight days, permanently cured the attack.

No class or condition of persons, nor habit of body, seemed exempt from its attack. Of those Dr. Ringland attended, one was a lately married female; another, a lady who was nursing her second child; another was at that period of life when the catamenia are about to present themselves; and, in the last, the menstrual function had been fully established.

Again, one of the four was in the higher rank of life; one had been reduced to considerable poverty, but was, at the period of the attack, in comfortable circumstances; while the other two belonged to the better portion of the lower rank of society. Besides this, three of the patients were extremely fat, and of middle size, whilst the fourth was tall and slight. Five cases are related at full length.

LIQUID MEDICINES. (Medical Examiner).

It has been found that fifteen grains of sulphate of quinine exhibited in infusion of senna, are more efficacious, as a tonic, notwithstanding the aperient quality of

the vehicle, than twenty-four grains of quinine taken in pills. M. Panezza accounts for this difference by supposing that the senna, by augmenting the peristaltic action of the alimentary tube, and increasing the secretions of the bowels, excites the production of a fluid well adapted for perfectly dissolving the quinine, and in that state to be applied to a much greater surface of absorption than if it passed along the canal in the form of pills. There may be something in this reasoning. Indeed we never had much confidence in quinine pills, or even steel or other tonics in that shape.

PROPHYLAXIS PTYALISMI.

All attempts at curing mercurial ptyalism by medicine, being now given up by universal consent, the idea of prophylaxis has struck Professor Schoeph, of PERTH. We suppose the worthy Doctor is Professor of " DENTISTRY," for the preventive check is a tooth-powder composed of alum and cinchona! We can inform Dr. S. that a far more certain Prophylaxis Ptyalismi is, the non-administration of mercury.

OBSERVATIONS ON THE TREATMENT OF ACUTE RHEUMATISM BY CINCHONA BARK. By JOHN POPHAM, M.B. (Dublin Medical Journal, September).

Though far from agreeing with Haygarth and his followers in their excessive approbation of this remedy, Dr. Popham considers it as one of too great value to be overlooked by the profession. At the commencement of the complaint, and while the symptoms were severe, the administration of the bark was attended with no good effect, but the results were different when it came in at the turn of the disease. In twelve cases of acute rheumatism in which it was given at a period varying from the fifth to the tenth day after the attack, nine were perfectly cured in less than three weeks, without relapse or loss of strength, and without those unruly pains and aches that so often survive the original attack.

The cases in which it was most successfully employed were those of fibrous rheumatism or rheumatic fever properly so called. When it appeared at all probable that either the pericardium or heart was affected, the bark was not exhibited, at least until the inflammatory symptoms were checked. In capsular rheumatism the bark seemed to disagree with the acute stages, aggravating the symptoms, but in very chronic cases it seemed of service.

The conclusions at which Dr. Popham appears inclined to arrive, with regard to the administration of this medicine, are these:

"That it is important to procure due evacuations previous to the exhibition of the bark, except the patient be greatly deteriorated by constitutional debility, or the protraction of the disease.

"That it is more quickly successful when the disease is early combated by depleting measures, than when inefficiently managed at the onset, and allowed to take root in the system.

"Hence that is more likely to extinguish the disease and prevent chronic infirmity in the sequel of first attacks being uncomplicated, than when a habit has been formed by reason of repeated relapses.

"That the periodicity of the symptoms either peculiar to the attack, or produced by treatment, and the duration and apyrexia of the intervals, afford strong presumptive arguments for the use of bark.

"That bark is especially called for in cases where there is complete atony of the cutaneous vessels, so that the skin is unceasingly pouring out acid colliquative sweats, giving it a dull and parboiled appearance, at the same time that the pains are abated, and the pulse small and indicating debility.

"That to produce its effects, quantity is not by any means so essential as in intermittent, and that large quantities, especially of the sulphate of quinine, derange the stomach in many cases, and bring back the fever.

"That it is judicious to administer it at the periods of remission, and stop it at the return of the exacerbations.

"That it is injurious when important visceral disease co-exists, and is espe cially contra-indicated in cerebral or the acute stage of cardiac complications.

Lastly, that in the synovial variety, it is inferior to other modes of treatment, but in persons of a rheumatic diathesis, when, from the long continuance of the disease the strength has suffered, and disfiguration of the joints has occurred without serious destruction, a course of bark, combined with sulphur, &c., often prevents the recurrence of subacute attacks, and promotes the absorption of the effused synovia."

DR. HAMILTON ON THE JAMAICA DOGWOOD. (Pharmaceutical
Journal, Aug. 1, 1844.)

Dr. Hamilton, during a visit to the Antilles, was struck by the powerful narcotic effects on fish produced by the bark of the roots of the Piscidia erythrina, or Jamaica dogwood. Thinking that this might be of utility as a medicine, he found that the tincture, prepared by macerating the bark of the roots gathered during the period of inflorescence, and before the appearance of the leaves (the piscidia being one of the few deciduous trees indigenous within the tropics), in four times its weight by measure of rectified spirit for twenty-four hours, and filtering, was the only eligible mode of preparation. The following was his experiment, and its result.

"Having been for some time a martyr to the tooth-ache, which had deprived me of my natural rest, I determined to make the first trial of my new medicine upon myself; and accordingly on going to bed, mixed a drachm-measure of the tincture with a rummer of cold water, and drank it off-waiting to observe its effects. Soon after receiving it into the stomach, I experienced a violent sensa tion of heat, which gradually increased in intensity, awakening in my mind a suspicion that the predictions of my friends, who assured me I should poison myself, were on the eve of fulfilment. However, the deed was done, and I resolved to abide the issue without flinching. The sensation of burning gradually extended itself to the surface, and while I was considering what antidote I ought to employ, a profuse diaphoresis burst out from every pore, and a sleep the most profound I ever experienced arrested me so abruptly, that I remained motionless for the whole night, with the uncorked phial in one hand and the glass out of which I had taken the dose in the other, till after the sun was high above the horizon on the following morning, a space of twelve good hours, when I first returned to consciousness, free from every pain or ache, and without any of those unpleasant sensations which invariably succeed to an overdose of opium. "I had certainly taken a larger dose than was, perhaps, necessary; but the result was most triumphant. I afterwards employed it with equal success, as a topical application, in a number of cases of carious teeth, introducing it on a dossil of cotton into the diseased cavity; and after a single application, I never heard of a return of pain in that tooth. Wishing to compare its powers with those of opium, I took equal measures of water, containing the animalculæ of the mosquito, and having dropped into one glass as much of the tincture of opium as was necessary to make them fall motionless to the bottom, I added an equal number of drops of the dogwood tincture to the other, with a corresponding effect. I then decanted the supernatant liquor, and washed the mass of animalculæ in each glass with fresh filtered water from the dripstone; after a

few ablutions, those which had been stupified by the tincture of opium recovered, and swam about with their wonted vivacity, while all my efforts to revive those acted upon by the dogwood proved ineffectual."

[ocr errors]

Dr. Hamilton subjoins certain cautions as absolutely necessary to be kept in view. First, the bark of the roots should be collected about the period of the full moon, in April, at which time the tree is in full flower, or coming into flower, and the leaves have not yet unfolded. Next, that the best rectified spirit alone should be used in making the tincture-the active principle of the bark being only soluble in spirit, and precipitating on the addition of water, with which it makes a milky compound. It is possible that a longer maceration than I employed might be successful in extracting more completely the active principle; but it might be desirable to divide the tincture so obtained, keeping that made during the first twenty-four hours distinct from the second, or making a portion with twenty-four hours' maceration, and another portion with fortyeight hours' or more; and comparing, by some common test, the relative qualities of each. The following is the formula for the tincture I used :

B Pulveris crassi Corticis Radicis Piscidiæ Erythrinæ, 3j.

Spiritus Vini Rectificati, fiziv.

Macera simul per horas viginti et quatuor in vasi aperto et cola. Dosis Al3j. et infra ex haustu aquæ puræ."

SIMPLE METHOD OF PREPARING THE PILULA FERRI IODIDI. (Pharmaceutical Journal, August, 1841.)

Take of iodine 127 grains, iron wire, about the thickness of a thin quill, halfan-ounce, distilled water 75 minims. Agitate them briskly together in a strong ounce-phial, provided with a well-fitted glass stopper, until the froth which forms becomes white, which will happen in less than ten minutes. Pour the liquid upon two drachms of finely-powdered loaf-sugar in a little mortar, and triturate immediately and briskly for a few minutes; add gradually a mixture of the following powders, viz,, liquorice powder half-an ounce, powder of gum Arabic a drachm and a half, and flour one drachm. Divide the mass into 144 pills. Each pill contains about a grain of iodide of iron.

In operations on the large scale, the bottle ought to be wrapped in a strong towel, in case of an explosion being caused by the evolution of steam from the heat produced; and even on the small scale, the stopper must be held firmly, otherwise it will probably be blown out and the materials lost.

THE RESPECTIVE RIGHTS OF CHEMISTS AND APOTHECARIES.

Every-body knows the jealousy felt by chemists and apothecaries, on the subject of their respective rights, privileges, and encroachments. The apothecary accuses the chemist of prescribing-the chemist replies that the apothecary retails medicines. There are some observations in the Pharmaceutical Journal, of a very moderate character, which, perhaps, may be read with advantage by both parties. We must say, however, in anticipation, that the apothecary has a better right to retail medicines, than the chemist has to prescribe them.

"It is probable that some of our brethren, who are desirous of invading the province of medical practitioners, may cordially approve of a measure which leaves them at liberty to use their own discretion, and even to visit patients, without becoming liable to any kind of interference. But those who take this view of the subject will do well to consider, whether this unlimited licence might

not be attended with some disadvantage. If the members of our body are to be allowed to encroach, ad libitum, on the medical department, is it likely that we can obtain any protection against the grocers, oilmen, and bucksters, who may, in their turn, feel disposed to embark in a ruinous competition in the sale of medicines? May we not also expect, that if all restraint upon quackery is to be at an end, 'doctors' shops' will rise up like mushrooms against us; and that what we lose on one side will much more than counterbalance what we gain on the other?

"While we claim a certain amount of liberty, as vendors of medicines, in giving our customers the requisite information respecting the properties and doses of the remedies, it may reasonably be questioned, whether we should be gainers by overstepping the boundary, and professing to act in every respect as medical men."

"But while the Apothecary sells medicine not only to his patients, but to any retail customers who present themselves, the Druggist in self-defence is obliged to overstep the bounds of his office, knowing that if he were in every trivial case to refer his customers to the Apothecary for advice, he would by so doing lose the sale of the medicine altogether. But if it were the custom for each party to perform the duty for which he is by his position and education best qualified, the patient would be better served, the prescriber and dispenser would be more adequately remunerated, and the jealousy between them would cease."

We fear that such cordial agreement is improbable. The tendency of things appears to be, that the general practitioner should grow more of a chemist-the chemist more of a general practitioner. Most young apothecaries now commence with an open shop, and as much retail custom as they can procure. As they get on, the open shop is replaced by a private one. Whichever party began the war it is now waged actively, and is not likely to come to an end in a hurry. Should Sir James Graham's Bill pass, matters, we fancy, will grow

worse.

PREPARATION OF CARBONATE OF LITHIA. (Pharmaceutical Jour. Sept. 1844.)

This salt has been recommended by Mr. Ure, as a solvent for stone in the bladder. Whether it will really prove so we may be allowed to doubt. The following is the mode of preparing it.

"Lithia, from which the carbonate is made, was discovered by M. Arfwedson, a Swedish chemist, in the petalite found at Uton, in Sweden; it also exists in the triphane found in the same locality. To prepare the salt, the mineral containing the lithia is first to be porphyrized, and then calcined in a platinum crucible, with five times its weight of pure nitrate of barytes. The product of the calcination is to be immersed in from fifteen to twenty times its weight of water, and hydrochloric acid added in excess, which entirely dissolves it. Evaporate the solution to dryness; treat the residue with water acidulated with hydrochloric acid, and filter to separate the silica. Into the filtered solution pour sulphuric acid in excess, to throw down the barytes; saturate the liquor, from which the sulphate of barytes has been separated, with ammonia, which throws down the alumina; and the liquor containing sulphate of lithia with some ammoniacal salts, is to be evaporated to dryness, and calcined so as to drive off the ammoniacal salts.

"The residue, which consists of sulphate of lithia, is to be treated with water, the solution filtered, concentrated, and precipitated with carbonate of soda. The precipitate should be washed with a very small quantity of water. “Carbonate of lithia is found in solution in some mineral waters, and more especially in those of Bohemia; it is also found in some of the mineral waters

« ΠροηγούμενηΣυνέχεια »