another on the same subject, published by Dr. J. A. PUEL, in a late
number of the Archives Generales de Medecine. Dr. P. details many
cases, which were treated by his father, by means of leeches,
emollients, purgatives, &c. so early as 1807. In most of these cases,
the practice appears to have been very successful. As it is our wish to
impress our readers with the propriety of making a fair trial of this
method, in cases of scirrhus and cancer, we shall select and translate a
few cases from the latter essay. It is proper to premise, however, that
the practice must not be viewed as completely successful in _every_
case, and that the older the complaint, the less confident we ought to
be, in respect to the happy results of the case. Nor is it to be
expected, that _boldness_ in the employment of the lancet and leeches,
will answer as well as a perseverant, constant, but moderate use of
these means. Chronic inflammations are not to be removed by storm, but
by a _chronic_ use of remedies, and particularly by attention to diet.
We cannot at present determine precisely the proportion of cures
effected, by this method, of scirrhus or cancer, in a given number of
cases, and how far it will surpass, in point of success, the common
method of treatment by _specific_ narcotics and escharotics; but, even
supposing that it is not more successful, (which we are disposed to
deny,) it has at least the vast advantage of being more _comfortable_,
and much less painful to the patient.
Mrs. D. enjoying good health, and mother of three children, was brought
to bed in 1823, of a healthy child, which, however, she did not suckle.
With a view of suppressing the secretion of milk, irritating
applications to the breast were resorted to, which brought on an
inflammation of that organ. Emollient poultices were now applied; these,
however, did not prevent the formation of an abscess, which was opened
by means of caustic potash. The suppuration, for a few days, was
abundant and the matter discharged healthy. Purgatives were prescribed,
with the view of suppressing the discharge, and mercurial ointment was
rubbed on the tumour, to produce its absorption. These remedies were not
successful, because no means were employed to arrest the inflammation,
which gave rise to the suppuration.
When the patient applied for advice, she had been sick already four
months, and presented the following symptoms. She was very much
emaciated, and laboured under fever, resulting from a gastro-enteritic
inflammation, kept up by purgatives and deostruents, (_fondans_,) which,
from the commencement of the attack, were prescribed for her. The
ulceration of the mamma was of the size of a five frank piece, unequal
and gray, and gave issue to an ichorous and foetid purulent matter.
The edges were thick and everted, and surrounded with an erysipelatous
inflammation. The whole mamma was large and hard, and the seat of
lancinating pain. Thirty-five leeches were applied around the tumour,
and gave rise to a profuse haemorrhage, which continued many hours. From
this, the patient experienced so much relief from pain, as to be able to
take some repose, of which she had been deprived for some weeks.
Emollient poultices and drinks were prescribed, and a low diet enjoined.
By all these means, the pain was lessened, and the swelling much
diminished. Leeches were again applied, and the other remedies
continued. The wound gradually improved, and in forty five days, was
completely healed.
Mr. P. was called on the 25th of September, 1817, to attend a lady, who
had been affected for two days with uterine haemorrhage, which he
succeeded in arresting. The following history of her complaint was given
to him: she had aborted about 18 months before, and since that time, had
experienced every fortnight an uterine haemorrhage, which generally
lasted five or six days. During the intervals, she complained of deep
seated pain, numbness and cramps, in the lower part of the abdomen, in
the thighs and groins. The pain was much aggravated when she had a
stool--walking, especially when long continued, was painful, and
attended with a sense of dragging, which was only relieved by repose.
From the same period, her disposition had changed from gay and lively,
to melancholy and morose--her digestive functions were slow and
painful--she was affected with leucorrhea, and during coition, felt much
pain, and often lost some blood. On examination per vaginam, it was
found, that the neck of the uterus was elongated--the anterior lip of
the same organ was soft to the feel--the orifice somewhat enlarged, and
painful when the finger was introduced into it. On the inferior lip
there was a small unequal and painful spot, which was regarded as a
superficial ulceration; the uterus was a little prolapsed, and somewhat
enlarged; the pulse small and frequent; febrile exacerbations every
evening; sleep not refreshing, and interrupted by short lancinating pain
in the uterus.
The disease was judged by Mr. P. to be a chronic metrites, with
ulceration, and all the symptoms usually attending incipient cancer.
Guided by this belief, and notwithstanding the already long duration of
the disease, and the debility of the patient, the following treatment
was adopted--complete repose in the horizontal posture--leeches to the
vulva, repeated several times--vaginal injections, with emollient
decoctions--hip baths--very low diet. After persevering in this plan
twenty days, the patient appeared much better, and was allowed to sit
up. General baths were substituted for the partial ones. The same
treatment was continued, with the exception of the leeches, and at the
end of thirty days more, all the symptoms of the disease had completely
disappeared. Mrs. P. was allowed to spend the following spring in the
country, from whence she returned in very excellent health. She has
since continued to enjoy it, and has borne several children.
Cases nearly similar, are detailed by Mr. MARESCHAL, as having occurred
in the practice of professor LALLEMAND. The same gentleman, also gives
the history of two cases of external cancerous sores, in which the same
treatment was adopted. The patients having died during the progress of
the cure, of other diseases, an opportunity was offered, of examining by
dissection, the changes that had occurred in the parts. We cannot
enlarge on the subject in this place, and can only remark, that these
changes were such, as to lead us to hope, that less difficulty will be
experienced in the treatment of sores reputed cancerous, by the local
antiphlogistic plan, than is commonly supposed. At any rate, recommended
by such high authorities, the practice deserves a trial.
The Revue Medicale for February 1826, contains the details of a case
lately cured at La Pitie, by Mr. LISFRANC. The patient, a woman, aged 36
years, of a strong and good constitution, had suffered the removal of a
cancerous breast, 18 months previous to her admission into the Hospital,
on the 10th October, 1825. The following symptoms were observed. On the
whole surface of the cicatrix were felt a number of engorged ganglia,
and an induration situated on the large and small pectoral muscles, and
spreading from the clavicle to all the external and superior part of the
thorax, and as far as the axilla, where other swollen ganglia were felt.
The enlarged surface was elevated about half an inch above the level of
the chest. Severe lancinating pains were at short intervals felt by the
patient--which came on without any evident cause, and were particularly
severe on the least pressure of the swollen part.
This patient was treated by means of frequent and copious bleeding from
the arm--the very frequent application of leeches to the inflamed part,
and to the upper and interior part of the thighs, to bring on
the menstrual discharge--digitalis to remedy the frequent
palpitations--emollient applications, and low diet. On the 10th of
January, she was considered well;--the swellings and pain having
disappeared--the menstrual discharge being well established, and the
movement of the arm (which during the progress of the disease had been
impeded from the swelling in the axilla) perfectly free.
We are happy to learn that this practice is pursued with success by the
Spanish physicians, as may be readily found by a reference to a late
number of the Periodico de la Sociedad Medico Quirurgica de Cadiz, which
contains cases of scirrhous mamma cured by the repeated application of
leeches.
25. _Essential oil of Male Fern, as, a remedy in Cases of Taenia._--The
male fern has long been regarded as a valuable anthelmintic medicine;
but, as every powder administered in large doses, its exhibition is
difficult and disagreeable; so much so, indeed, that many patients
refuse to make a sufficiently constant use of it to ensure its
beneficial effects. Struck with this inconvenience, M. PERCHIER, a
pharmaceutist of Geneva, has lately made some experiments with a view of
discovering its active principle, and to see whether this latter may be
administered with equal success with the powder or infusion of the
plant. We are happy to learn that the result of his experiments are very
satisfactory. We translate the following observations from a memoir on
the subject, read on the 7th of October last, by Mr. GENDRIN, before the
medical society of the department of the Seine. "This medicine, which
is a fatty oil extracted by distillation from the aether, in which the
powder of the root of the male fern has been macerated, has caused in
many cases, the expulsion of the taenia, without occasioning nausea,
colics, or any other morbid phenomena." "It is exhibited at bed time,
either in an oily potion, in pills, or incorporated in an electuary, in
doses of 18 or 20 drops. On the following morning, a similar dose is
given, and two hours after, two ounces of castor oil are administered.
In most cases, the taenia is expelled in the course of the day, but if
this does not occur, the same doses of the oil are given in the same
way, and followed by a similar quantity of the castor oil. The fatty oil
of fern, has an aethereal and empyreumatic smell; its colour is brown,
and its consistence rather greater than that of castor oil; it is,
however, easier to separate in drops. Its taste is acrid, pungent,
empyreumatic, and very disagreeable."--_Propagateur des Sciences
Medicales, Janvier 1826._
26. _Tincture of Bastard Saffron[33] for the expulsion of Taenia._--Dr.
CHISHOLM, of Canterbury, has lately used with success, in a case of
taenia of many years standing, the vinous tincture of bastard saffron.
The patient had already undergone various plans of treatment, and had
especially used the oil of turpentine in very large doses. Dr. C. was
induced to try the above remedy, from having noticed, that in a case in
which it had been prescribed for the cure of rheumatism, a large portion
of taenia had been expelled. He consequently administered two ounces of
the tincture; advising the patient to take a table spoonful more of it
mixed in a little water, two or three times a day. On the third or
fourth day after commencing the use of this remedy, the patient voided a
large portion of the worm, and has since been free from the usual
symptoms of the disease.
27. _Oil of Turpentine in Taenia._--Although the oil of turpentine is
used in many parts of this country, in cases of taenia, we have good
reasons for believing, that some physicians continue, notwithstanding
the testimony in its favour, to hesitate exhibiting it in doses
sufficiently large to destroy and promote the expulsion of the worm.
Such being our opinion, we are induced to offer here a few remarks on
the subject, and to notice a memoir published by Dr. DE POMMER, in a
late number of Hufeland's Journal. The employment of this remedy in such
cases, is not of recent origin, having been resorted to many years ago
by the Swedish practitioners, and subsequently revived by the English.
In Germany it has recently been used by Professor OSAN, and we believe
particularly by Dr. DE POMMER, who appears to have prescribed it boldly
in very many instances, and in some, after the ineffectual employment of
all other anthelmintics. Dr. P. adds, that he never saw any bad effects
resulting from its use, and that patients are very little liable to
relapses when treated by it.
Among the cases detailed by Dr. DE POMMER, we select the following, as
calculated to show the manner in which the Dr. uses the remedy.
"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 taenia. 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 faeces, mixed with which were five small
pieces of taenia. 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 faeces, and with them
five ells of taenia. The urine discharged had the smell of violets. He
again took a few spoonfuls of the vermifuge, which were not followed,
however, with any faecal 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 taenia 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 Pitie, 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 Pitie, 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._