Imagini ale paginilor
PDF
ePub
[merged small][merged small][merged small][merged small][ocr errors][merged small][merged small]

MEDICINAL EFFECTS OF WATER. AMONGST the various means resorted to by quackery to speculate upon the credulity of mankind, simple river or spring water, coloured and flavoured with inert substances, has not been the least productive; and many a time the Thames and Seine have been fertile sources of supposed invaluable medicines. Sangrado's doctrines on aqueous potations have long prevailed in the profession; and it has been stoutly maintained that a waterdiet can cure the gout and various other diseases. That relief, if not cures, have been obtained by this practice there cannot be the least doubt. Are we to attribute these favourable results to the effects of the imagination, the beneficial efforts of nature, or the salutary abstinence which this prescription imposed? Possibly they all combined to assist the physician's efforts, or rather aid his effete treatment. Cold water and warm water have in turn been praised to the very skies by their eulogists, and become the subjects of ridicule and persecution on the part of more spirited practitioners.

In surgery, water has ever been considered of great utility; it, no doubt, was instinctively used by man to cleanse and heal his wounds. Patroclus, having extracted the dart from his friend Eurypylus, washes the wound; and the prophet Elisha prescribes to Naaman the waters of Jordan. Rivers had various qualities, and were supposed to prove as different in their action on the economy as the mineral springs which from time immemorial have been resorted to. These effects may, in fact, not be altogether doubtful; for, although these salutary streams may not possess sufficient active ingredients to be recognised by chemical tests, yet we know that substances which appear perfectly inert may prove highly active and effectual when combined and diluted naturally or artificially. Moreover, in the effects of wateringplaces on the invalid or valetudinarian, we must not forget the powerful influence of change of air and habit, the invigorating -stimulus of hope, and the diversion from former occupations. To these auxiliaries many a remedy has owed its high reputation; and probably, when Wesley attributed his recovery to brimstone and supplication, he in a great measure might have considered rest from incessant labour the chief agent in his relief. The exhilarating effects of the picturesque site of many of these salutary places of resort is universally acknowledged. Montaigue, Voltaire, Alfieri, acknowledged their influence on the imagination. Petrarch's inspirations flowed with the waters of Vaucluse, some of Sevigne's most delightful letters were written at Vichy, and Genlis and Staël were particularly happy in their epistolary elegance at Spa and Baden.

We owe to accident many valuable discoveries in medicine. It is said that several Indians, having used the waters of a lake in which a cinchona tree was growing, experienced, the benefit which led to the use of the Peruvian bark; and the thermal

[ONE PENNY

properties of the baths of Carlsbad were first made known by the howling of one of Charles the Fourth's hounds, that had fallen in them in a hunt. It has been also observed, in various countries, that particular waters produced various morbid affections; and to this cause have been attributed goitres, cretinism, calculi, and other distressing diseases. The ancients dreaded the impurity of their rivers. The Romans boiled their water in extensive thermopolia, where not only potations were drunk hot, but occasionally refrigerated with ice and snow, and, when thus prepared, called decocta. Juvenal and Martial refer this custom to the Greeks. Herodotus informs us that the Persian monarchs were accompanied on their expeditions by chariots laden with silver vases filled with the water of the Choaspes that had been boiled, and which was solely destined for the king's use; Athenæus tells us that it was light and sweet. Many ancient coins and inscriptions have recorded these salutary properties of certain waters.

This real or supposed efficacy was scarcely discovered before it became the domain of priests, and common rain or river water became valuable and sanctified when blessed by them: hence the introduction of lustral water. The fluid extracted from the gown of Mahomet is the sacred property of the sultan. The moment the fast of the Ramazan is proclaimed, this holy vestment is drawn from a gold chest, and, after having been kissed with due devotion, plunged in a vase of happy water, which, when wrung from the garment, is carefully preserved in precious bottles, that are sent by the monarch as valuable presents, or sold at exorbitant prices as cures for any and every disease. Thus were the good effects of ablution, especially in wounds, attributed to some secret charm or quality conferred upon it by clerical benediction or the legitimacy of princes. When a quack of the name of Doublet cured the wounded at the siege of Metz in 1558, the water he used was considered to have been of a mystic nature. This Doublet, no doubt, was acquainted with an ingenious treatise on gun-shot wounds, written by Blondi in 1542, in which he strongly recommended the use of cold water; but as his recommendation was not founded on any miraculous quality, he was forgotten, while Doublet was considered a supernatural being. Water affords a beautiful illustration of that indestructibility with which the Creator invested matter for the preservation of the world He formed from elementary masses, and appears to have existed unchangeable from the commencement of the universe. Its constituent parts are not broken into by any atmospheric revolution; they continue the same, whether in the solid ice, the fluid state of a liquid, or the gaseous form of a vapour. Its powers are undiminished, whether in the wave or the steam; the most effective agent in the hands of man to promote that welfare and happiness which his own errors deprive him of, frequently bringing on those calamities that his perversity attributes to the will of the Omnipotent. Water is the same in the atmosphere as on the earth, and falls in the very same na

ture as it ascends; electricity has no other influence upon it than that of hastening its precipitation. Chemical agents, however powerful, can only decompose its elementary principles upon the most limited scale. The heterogeneous substances with which water may occasionally be alloyed must be considered as purely

accidental.

The homogeneous characters of this fluid admit of no alteration, and, like atmospheric air, are still obtained as pure most probably as when they first emerged from chaotic matter. The same principles are found in the clouds, the fogs, the dews, the rain, the hail, and the snow. For the preservation of the world it was indispensable that water should be endowed with the property of ever retaining its fluid form, and in this respect become subject to a law different from that of other bodies, which change from fluid to solid. This is a deviation from a general decree of Nature. Were it not for this wise provision of the Creator, the world would shortly have been converted into a frozen chaos. All bodies contract their dimensions, and acquire a greater specific gravity by cooling; but water is excepted from this law, and becomes of less specific gravity, whether it be heated, or cooled below 42° 5. Were it not for this exemption, it would have become specifically heavier by the loss of its caloric, and the waters that float on the surface of rivers would have sunk as it froze, until the beds of rivers would have been filled up with immense masses of ice. From the observations of Perron, there is reason to believe that the mountainous accumulations of ice that have hitherto arrested the progress of polar navigators have been detached from the depths of the ocean to float upon its surface,

The salutary medicinal effects of sea-bathing are generally acknowledged, although too frequently recommended in cases which do not warrant the practice; in such circumstances they often prove highly prejudicial. The ancients held sea-water baths in such estimation, that Lampridus and Suetonius inform us that Nero had it conveyed to his palace. As sea-bathing is not always within the reach of those who may require it, artificial sea-water has been considered a desirable substitute; and the following mode of preparing it, not being generally known, may prove of some utility. To fifty pounds of water add ten ounces muriate of soda, ten drachms of muriate of magnesia, two ounces of muriate of lime, six drachms of sulphate of soda, and the same quantity of sulphate of magnesia. This is Swediaur's receipt. Bouillon, Lagrange, and Vogel, recommend the suppression of the muriate of lime and sulphate of soda, to be replaced with carbonate of lime and magnesia; but this alteration does not appear necessary, or founded on sufficient chemical grounds for adoption.

Sea-water taken internally has been considered beneficial in several maladies; and, although not potable in civilized countries, it is freely drunk by various savage tribes. Cook informs us that it is used with impunity in Easter Island; and Schouten observed several fishermen in the South Sea drinking it, and giving it to their children, when their stock of fresh water was expended. Amongst the various and capricious experiments of Peter the Great, an edict is recorded ordering his sailors to give salt water to their male children, with a view of accustoming them to a beverage which might preclude the necessity of laying in large stocks of fresh water on board his ships! The result was obvious; this nursery of seamen perished in the experiment. Russel, Lind, Buchan, and various othet medical writers, have recommended the internal use of sea-water in scrofulous and cutaneous affections; but its use in the present day is pretty nearly exploded.

FIDGETS.

By fidgets we mean a general restlessness, or feeling of being ill-at-ease, accompanied with a perpetual desire to change the position of the body.

The English colloquial term fidgets, from fidgety, is most probably a corruption of fugitive, though the lexicographers have given us no origin of the term. Both import restlessness, unsteadiness, and perpetual change of place. The proper Latin term is titubatio; and, indeed, most languages have some peculiar term to express this troublesome and irritable sensation, though it has been rarely introduced as a disease into the nosological catalogue.

The actual cause seems to consist in an undue accumulation of sensorial power, which seeks an outlet, so to speak, at every pore, for want of a proper channel of expenditure. Thus every one becomes fidgety who is obliged to sit motionless beneath a long-drawn and tedious story of common-place facts totally destitute of interest; and still more so when he is eagerly waiting, and fully bottled up, as it were, to reply to an argument loaded with sophisms, absurdities, or untruths, and over which he feels to have a complete mastery. So the high-mettled horse is fidgety that, called out, in full caparison, and still restrained in his career, is panting for the race or the battle. "So the squirrel, when confined in a cage, feels," as Dr. Darwin has ingeniously observed on this disease, which he calls jactitatio, "a restless uneasiness from the accumulation of irritative power in his muscles, which were before in continual and violent exertion from his habit of life; and, in this situation, finds relief by perpetually jumping about his cage to expend a part of his redundant energy. For the same reason, children that are constrained to sit in the same place at school for hours together are liable to acquire a habit of playing with some of the muscles of their face, or hands, or feet, in irregular movements which are called tricks, to exhaust a part of the accumulated irritability by which they are goaded."

In the two last instances, this irritability is simply accumulated for want of a proper outlet, and not from inordinate secretion. In the two preceding cases, of the restrained horse and the restrained orator, there is added to this simple accumulation, for want of disbursement, an accumulation also from inor

dinate excitement.

It is this last source alone that can give the present affection any thing of a morbid character; and in irritable temperaments this is often the case; for there is a diseased excess of sensorial power produced constitutionally, which is apt, on various occasions, to show itself by a perpetual restlessness or jactitation, as troublesome to those who are of the company, as to those who are afflicted with it.

Paulini observes that worms, and Lentin that atony, (loss of muscular power,) alone is a cause; and hundreds of other sources of irksome irritation may be added to these; one of the most common of which is an obstinate and unconquerable itching, like that of prurigo senilis, and especially in a part of the body that we cannot conveniently get at to scratch; and hence ascarides in the rectum or pudendum, into which last organ they have been sometimes found to creep, is a most distressing, and, in some cases, a maddening cause.

A course of cooling purgatives, warm bathing, or increased exercise, will probably be found most serviceable in this harassing complaint; with an attention to the primary disease, where it is sympathetic.

DISEASES OF THE CHEST.

No. VII.

BY THE EDitor.

(Continued from page 154.)

EMPYEMA.-LODGMENT OF MATTER IN THE CHEST.

THE term Empyema is applied to a collection of pus in the cavity of the pleura, the result of previous inflammation of that membrane. An empyema was formerly said to exist when a large vomica of the lungs (already described in the papers on Tubercular Consumption, page 2, Vol. II., No. 27,) burst into the cavity of the chest. Since Laennec inculcated more correct principles, empyema is now considered as denoting a collection of purulent fluid, caused by pleuritis. The great authority just named says, "I apprehend no one now considers empyema as the product of a vomica, which has burst into the cavity of the pleura. A softened tubercle may, indeed, discharge its contents in this manner, and may thus become the cause of a considerable effusion, by exciting a chronic pleurisy; but, in such a case, the tuberculous matter must be only considered in the light of an extraneous body, determining inflammation, and consequent effusion, by its mechanical or chemical qualities. It is also to this species of pleurisy that we must refer those histories of lungs entirely destroyed by suppuration, which we find recorded in the older writers."

The symptoms of empyema are common to it and to other diseases of the thorax as well; in fact, we may say that the diagnostic signs are equivocal. Knowing this, it is scarcely to be wondered at if the disease was, and we may add, is, constantly mistaken, or its very existence overlooked; of which so many examples are recorded in medical literature, that the only difficulty in citing them lies in the selection. The following symptoms and physical signs are those most characteristic of empyema, and when they are all combined, may be considered as diagnostic of the disease.

There is fixed pain in the side, of a heavy, though, occasionally, darting and acute character; the breathing is laborious, and generally proportionate to the degree of pressure which the lung sustains, or, in other words, to the quantity of the effusion. Experience has shown that the difficulty of breathing is extremely urgent when the empyema is formed rapidly, but that in more chronic cases the dyspnoea is generally proportionate to the violence of the fever, and the quantity of the pus thrown out. Some individuals, however, have their breathing much more easily affected than others, and accordingly, under apparently similar circumstances, the dyspnoea continues extremely urgent in some from the commencement of the disease to its termination; in others, the respiration is at first gently affected, but the dyspnoea gradually diminishes, and recurs only at intervals when the circulation is excited; whilst, in a third set, the respiration continues apparently unimpeded from the beginning to the end of the disThe difficulty which patients affected with empyema experience from lying on the sound side has been noticed by all writers since the time of Hippocrates; and this in all probability arises from the load which is thereby thrown on the mediastinum (that fold of the pleura which divides the cavity of the chest into two parts), as well as from the obstruction which the muscles of respiration experience when the side which they have to dilate is placed under the weight of the body. To avoid this inconvenience, patients labouring under effusion into the chest generally lie on the diseased side, or else on the back, with a slight inclination of the body towards the diseased side. This latter position is the more general of the two, and is so very characteristic as to lead,

ease.

in some cases, to a suspicion of the disease, even before any further examination has been made. In all cases, the erect position, so long as the strength of the patient will permit him to maintain it, affords the greatest relief. When the empyema is double-that is, when both sides of the chest contain pus--he can seldom lie in the horizontal position, but remains constantly seated with his body inclined forwards. If we remove the dress from a person affected with empyema, and then examine his chest, we generally perceive a marked difference in the size and shape of the two sides; that into which the effusion has taken place being considerably larger; and this difference, which is most evident at the back, is rendered still more remarkable by the altered position of the ribs, which remain immovably in the position they naturally occupy during full inspiration, and contrast strongly with the increased motion of the ribs of the opposite side. We may frequently detect fluctuation of the purulent fluid through the intercostal muscles-that is, in the fleshy spaces between the ribs; this is one of the least fallible signs of empyema, but yet should not be trusted to exclusively, as abscesses occasionally form in the parietes of the chest, which yield a similar sensation to the fingers; cedema, or a dropsical swelling of the integuments of the diseased side, extending sometimes to the arm and side of the face, is an occasional, but by no means a constant symptom of empyema; it sometimes occurs at an early stage of pleurisy, accompanied with pain and tenderness in consequence of the inflammation extending to the adjacent parts, and in some instances does not make its appearance before the last stages of the disease. The cough in empyema is generally short, dry, and tickling; sometimes it is altogether absent; if there be any expectoration, it is of mucus or phlegm, unless a communication is established between the effused fluid in the pleura and the bronchial tubes; in such cases, which are rare, the expectorated matters have a peculiar fetid smell, the odour of which has been compared by some to garlic, assafoetida, or phosphoretted hydrogen. There is a greater or less degree of fever invariably present; the pulse is rapid; the skin burning hot; the urine scanty and high coloured, with all the symptoms which usually attend hectic. As the disease progresses, the breathing becomes extremely difficult, with repeated fainting-fits, and the dew of a cold. sweat constantly covers the throat and forehead; the cheeks and lips are of an ominous red, while the nails are livid, the pupils dilated, and the sight dim.

By the stethoscope we discover that peculiar modification of the voice, termed ægophony, but it is not nearly so distinct as in hydrothorax; the respiratory murmur is absent over that portion of the lung which is surrounded by the purulent fluid, and we frequently discover in the healthy side that the respiration has become puerile. Percussion yields a dull sound, like that when the thigh is struck by a stick; by succussion, or shaking the patient's body, we may occasionally hear the roll, rattle, or rumble, of the contained fluid, in the same manner that we may detect the presence of fluid in an overloaded stomach whilst descending a staircase or riding on horseback.

The first object in the treatment of this disease must be to moderate any febrile excitement which may arise, and to effect this we must adopt the antiphlogistic means usually resorted to in inflammation. General bloodletting is seldom, if ever, required, unless in cases of internal hæmorrhage; whenever there is great increase of pain, and the other symptoms indicate a renewed attack of inflammation in the diseased surface of the pleura, cupping or leeches may be required over the part. With regard to the general treatment of the patient, we cannot do better than quote the words of M. Broussais, who says,- The physician cannot be too strongly impressed with the idea that, so long as any fever continues, the more his patient eats, the shorter time

[ocr errors]

he lives, and that by lowering his diet he will take a more prompt and effectual method of removing the febrile symptoms than by repeated bleedings, or by covering his chest by blisters." Purgatives, according to Laennec, to be useful ought to be frequently repeated; diuretics are of little efficacy in promoting the absorption of the fluid; when employed, they require to be given in large doses, as from six to eight drachms of the acetate of pot-paration; and even in Dr. Guy's edition of Hooper's Vade Meash, or thirty or forty grains of nitre daily; Quarin used to give doses of two grains of the extract of squills every three hours. Diaphoretics and expectorants have been found serviceable in some cases, where the efforts of nature manifest a tendency to produce a critical evacuation by perspiration or expectoration; in which case, the propriety of promoting the discharge established by nature is manifestly indicated. So long as any fever remains, we should resort to counter-irritants with the greatest caution; when all the febrile symptoms have ceased, a large blister may be applied with advantage over the affected side, and kept open for several days, provided it does not produce much constitutional irritation.

We now have to speak of the surgical treatment of empyema, to which we must have recourse when there exists no reasonable prospect of the effusion being removed by absorption, or evacuated by the efforts of nature; and that is Paracentesis thoracis, or the operation of tapping, as it is vulgarly called. This operation we have witnessed in several cases at the London Hospital; it is performed by inserting a trocar and canula into the parietes of the chest, and thus drawing off the accumulated matters; the place selected for the insertion of the instrument should be ruled by the seat of pain, or of fluctuation, when it can be felt; David advises near the sternum; and Mr. Sharp between the sixth and seventh ribs. The fluid should not be evacuated suddenly, but a small quantity allowed to escape daily. Borelli relates a case in which the patient seems to have sunk under a sudden

evacuation.

Numerous cases are recorded in which the fluid has disappeared spontaneously. It has passed off by the intestinal canal, by the bladder, and by the vagina, in the form of pus. It has also been frequently carried off by an opening formed by nature, and the patient has recovered his usual health. This opening has commonly been between the ribs; most usually between the third and fourth; but in one instance, attended by M. Hurten, the abscess pointed and burst under the scapula.

In our next we shall describe ASTHMA.

SCURVY.

SCURVY is now luckily a very rare disease, both on board our vessels and in the London hospitals. That the affection no longer makes such ravages among seafaring men, we owe, as every one knows, to the unfailing effects of lemon-juice; and that the malady reigns less among the people at large is probably the result of the abundance and low price of fresh vegetables, and the better hygienic regulations in our prisons, poorhouses,

&c.

The miserable state of some Lascars who lately died at an English port victims to aggravated scurvy, shows, however, that neglect in providing crews with fresh vegetables, or at least with lemon-juice, if such vegetables cannot be had, will still give rise to a very severe form of the disease.

From the Registrar-General's quarterly return of deaths in London, ending September 30, 1850, we find, under the head "Purpura and Scurvy," that nine persons only died of those diseases during the quarter. In the same period, however, of 1849 there had been thirteen; the like number in 1848; and twenty-two in 1847. In the quarter above mentioned (viz., 1850) the whole number of deaths with specified causes was 11,520,

and the deaths from purpura and scurvy, nine, which gives about
0.77 per cent. This per centage includes, however, both pur-
pura and scurvy; though the two diseases are now recognised as
distinct, thanks to Dr. Budd's investigations on the subject.
Cazenave and Schedel, in the second edition of their work, con-
sider the two diseases not sufficiently distinct to authorise a se
cum, we find the following somewhat obscure classification:--
"Purpura-Land Scurvy, and Purpura-Nautica-Scorbutus or
Sea Scurvy." That purpura should no longer be reckoned
among skin diseases is now generally acknowledged; but that
purpura should be clearly distinguished from scurvy, both as it
appears on land and at sea, is likewise desirable, for the follow-
ing reasons, derived from Dr. Budd's researches: Scurvy occurs.
mostly from privation from succulent vegetables; purpura may
arise when vegetables are being used. The gums are swelled
and bleed in scurvy, but not necessarily in purpura. Scurvy is
rendered worse by blood-letting and mercury, not so with pur-
pura. Scurvy is cured by lemon juice, but purpura is not
generally benefited by vegetable juices, and often yields to blood-
letting and cathartics. It would therefore be interesting if we
were told in the returns of the registrar-general what number
of deaths have taken place from scurvy and purpura respectively.
We were led to trouble our readers with the foregoing remarks
as a genuine case of scorbutus has just been discharged from St.
Thomas's Hospital. The patient is a married woman, aged
thirty-seven years, who was admitted July 16, 1850, into Ann's
ward, at that Hospital, under the care of Dr. Bennett. She
was rather delicate-looking, and stated, that about fourteen
months ago she had a very severe attack of diarrhoea, which she
attributed to the use of vegetables and fruit. Imbued with this
idea, she left off vegetables entirely for three months, and re-
sumed the use of them after that period. But, as she soon
had another attack of diarrhoea, she entirely gave up the habit of
eating green vegetables or fruit of any kind. The patient lived
very scantily all the winter, eating nothing but gruel and farina-
ceous food, and partaking of meat only two or three times in a
fortnight. Her health was nevertheless pretty good during this
period, except at the time when the catamenia should have ap-
peared, at which periods she sometimes lost a large quantity of
blood; this menorrhagic attack being occasionally accompanied
by bleeding at the nose. She continued in about the same state
until three months before admission, when she began to ex-
perience pain about her arms and legs; the attacks of epistaxis-
bleeding from the nose-became more frequent and abundant, so
much so, that she sometimes bled to fainting. Hæmorrhage
tender and spongy. About this time the bowels became relaxed,
now likewise came from the gums, and the latter became very
and the patient subject to griping pains in the abdomen; the
stools varying in colour, being sometimes almost black, and at
other times of a light straw colour.

were

relieve the pain and tenderness of the gums by gargles of salt-
The poor woman did not seek medical advice, but tried to
and-water; these gave her some relief at first, but soon lost their
efficacy. When these symptoms had continued for about two
months, streaks of a yellowish-green colour appeared on the
legs; their direction was in the long axis of the limb, and these
now gradually becoming more and more swollen and soft; they
ecchymosed lines were very tender to the touch.
The gums
bled profusely, and the epistaxis also persisted. At the catamenial
period the hæmorrhage was likewise very considerable. The
patient made, meanwhile, no alteration in her diet, did not take
any medicine, and had gradually grown worse up to the time of
her admission, at which period she had daily an attack of epistaxis.

On careful examination the gums were found very vascular,

considerably swelled, so as even to conceal some of the teeth from view, and they bled very frequently. The bowels had been rather constipated; the patient had a sallow anæmic appearance, and complained of great weakness. The menorrhagia had not occurred for the last five weeks, but there were pains in the loins. The legs were so painful and tender that the patient could with difficulty stand or walk, and a few greenish streaks were observed down the anterior parts of the legs, these lines being extremely painful, and the ankles rather oedematous. Patient evinced a desire for animal food; her tongue was pale and flabby, and marked with the indentations of the teeth; the pulse small and feeble, and the sleep much disturbed.

Here there were almost all the symptoms of sea-scurvy, except that the hæmorrhage was not profuse, and the ecchymosis not very considerable. From the patient's statements the cause of the morbid manifestations could be clearly made out; the absence of succulent vegetables had been mainly concerned in the development of the disease, and the causes sometimes, but rather erroneously, supposed to be connected with scurvy, were absent; such as contagion, cold and damp, impure atmosphere, and the continued use of salt provisions. The likelihood of the latter cause used to be supported by actual experiment; thus we read, in the first volume of the "Library of Medicine," p. 48, "that an excess of the saline ingredients diminishes the coagulability of the blood has been proved by experiments; hence we may derive an explanation of the state of the blood observed in that form of scorbutus which is caused by the long continuance of salted provisions."

Dr. Bennett ordered a drachm of compound powder of jalap to be given immediately, and prescribed the following tonic medicines; fifteen minims of the tincture of the sesquichloride of iron, and twenty of dilute hydrochloric acid, to be taken three times a day, in infusion of cascarilla. The patient had full diet, with a pint of porter daily. The purgative acted freely, and removed all griping. The food was on the second day taken without inconvenience, but the legs were very painful, particularly in the depending position, and the gums swollen and spongy. The patient was now ordered green vegetables with her dinner. On the fourth day the gums were less swelled, but still very vascular; they had bled very little since the patient's admission, and there had been no epistaxis; the legs were not so painful, save when in the erect posture; and the bowels being confined, (in spite of the green vegetables,) a purgative draught was ordered. On the eleventh day the bowels became rather relaxed, but the patient was improving in every respect; there was no epistaxis, and the bleeding from the gums was trifling. The appetite was good; but as the bowels were loose, Dr. Bennett desired the green vegetables to be omitted for a day or two.

The patient, however, soon resumed the use of the vegetables, and one month after admission she was evidently gaining strength; the gums were very much reduced in size, and less tender, though still vascular; the ecchymosed streaks of the legs had disappeared, and the patient could walk comfortably about the ward. After about seven weeks' stay in the hospital the patient was quite convalescent. She had regularly continued to take the steel and mineral acid in bitter infusion, and succulent vegetables, besides a generous diet. She was quite free from pain, and could masticate without feeling any uneasiness in the gums. No uterine hæmorrhage had taken place for the last three months; nor had the catamenia appeared during the same period. The patient was discharged in very good condition, the gums being slightly more vascular than in the normal state.

The efficacy, both of the lemon-juice and of fresh succulent vegetables, especially of the potato, seem now to be firmly

established; whether these act in restoring to the blood the potash in which, according to Dr. Garrod, it is deficient in the scorbutic affection, time and further experiments will show. It is, in the meanwhile, worth noting how simple was the treatment adopted in the foregoing case. The patient had voluntarily proscribed green vegetables from her diet; these were ordered to be resumed; tonics and a generous diet were given, and the symptoms yielded in a very satisfactory manner. If we are often obliged to confess that some diseases are still imperfectly understood or treated, we certainly may congratulate ourselves upon the ready manner in which scurvy yields to the means employed; and though the actual change which takes place in the blood is not positively ascertained, we can at least cure the disease with lemon-juice or fresh vegetables, as we do syphilis with mercury, and ague with quinine.-The Lancet.

ANIMAL HEAT.

THE animal heat has been accounted for in different ways, by several ingenious physiologists. From the aggregate of their opinions and experiments, I deduce that heat is extricated all over the frame, in the capillaries by the action of the nerves during the change of the blood from scarlet arterial to purple venous, and also whilst it is changing in the lungs from purple to scarlet. There is a perpetual deposition, by the capillary system, of new matter, and decomposition of the old all over the frame, influenced by the nerves; in other words, the galvanoid or electroid influence of the nerves, which occasions these depositions and decompositions, keeps up a slow combustion. In this decomposition there is a continual disengagement of carbon, which mixes with the blood returning to the heart at the time it changes from scarlet to purple, this decomposition, being effected by the agency of the nerves, produces constant extrication of caloric; again, in the lungs that carbon is thrown off and united with oxygen, during which caloric is again set free; so that we have in the lungs a charcoal fire constantly burning, and in the other parts a wood fire, the one producing carbonic acid gas, the other carbon; the food supplying through the circulation the vegetable or animal fuel from which the charcoal is prepared that is burned in the lungs. It is thus that the animal heat is kept up; on the other hand, the evaporation of perspiration keeps the surface cool; but in inflammatory fevers, when this is deficient, the body gets too hot; and, in low fevers, when the nervous influence is not sufficient to keep up the full fire, the surface gets cooler than the natural standard. This is peculiarly evident in the beginning of eruptive fevers, as scarlatina, where there is strong heat, with the arterial colour of the skin; but if the same becomes malignant and low, with deficient arterialisation, the temperature sinks, and the diminution of the charcoal combustion in the lungs is evinced by the dusky colour of the skin shewing that the carbon is not thrown off, as it ought to be; and the same phenomena takes place in typhus cases.-Dr. Billing.

66

THE POTATO FIBRE PACKING OF THE RECTUM.

THE origin of the potato disease, in the plant itself, is not very clear; it appears certain, however, that at the return of the cambium,' ," the proper formation of starch was interfered with, and that, in addition to a few store-cells, the bulb was merely made up of its usual fibres, and cell-walls depressed and weakened to a degree that can scarcely be imagined. The poor of the South and West strove to lessen the pangs of hunger by masses of these black potatoes,-mere indigestible fibre. Examined with a microscope, as one would expect, a total absence of starch was found. Passing through the upper portion of the

« ÎnapoiContinuă »