Monthly retrospect of the medical sciences : January to December 1849 / edited by George E. Day, Alexander Fleming, W.T. Gairdner.

Date:
MDCCCXLIX [1849]
Catalogue details

Licence: Public Domain Mark

Credit: Monthly retrospect of the medical sciences : January to December 1849 / edited by George E. Day, Alexander Fleming, W.T. Gairdner. Source: Wellcome Collection.

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    several cases of rheumatic fever lately in St Vincent’s Hospital, Dublin. In com¬ menting on those in the wards, Dr O’Ferrall stated that he was induced to believe that this disease had a tendency, in its latter stages, to produce phenomena connected with a diminution of the glo¬ bules of the blood. Some modifications in the constitution of the blood during rheu¬ matic fever had been already observed. It had been ascertained that, at an early period of the disease, the fibrine is in¬ creased ; but it would appear that, subse¬ quently, there is, in many instances, a diminution of the colouring matter. The attention of Dr O’Ferrall was first called to the subject by observing that, in cases with endocardiac complications, after the employment of depletion and mercury, a cardiac bruit, of a different character from that which originally presented itself, continued to persist, notwithstanding the steady employment of the usual means for subduing inflammatory action. By- and-bye cases terminating fatally came under his observation, in which, although this bruit was present to the last, no mor¬ bid appearances could be detected in the heart, upon post-mortem examination. Afterwards he found that a rale musicale in the cervical vessels very constantly accom¬ panied this peculiar cardiac bruit; and he was led to suspect that, after the subjec¬ tion of the inflammation by bleeding and mercury, an anemic condition followed the use of these remedies, which would require a very different treatment for its subdual. He accordingly ordered chaly- beates, as in an ordinary case of chlorosis, and found the cervical and cardiac bruits to disappear under the use of this remedy. As yet he imagined the anemia to be due to the effects of the antiphlogistie treat¬ ment employed in combating inflamma¬ tion ; but during the last few years he has had repeated opportunities of observ¬ ing, that a rale musicale in the neck, and a bruit accompanying the first sound over the aortic valves, very frequently coin¬ cide with the decline of rheumatic fever, in cases where no active and weakening remedies have been employed; and he has been thus led to the conclusion that the natural tendency of the disease in its advanced stages is to produce a diminu¬ tion of the haematosin of the blood, evinc¬ ing itself by its ordinary physical pheno¬ mena. This observation is one of very great practical importance, teaching us the necessity of discriminating between those cardiac sounds produced by the participation of the heart in the general rheumatic disease, and those arising from deterioration of the blood. The treat¬ ment in the two cases must obviously be of a totally different nature.—Med. Times, September 15. 307.— Curability of Phthisis. By M. Le CoDPPEY.—According to the author, we have in our hands a pharmaceutical preparation, which possesses the power of causing tuberculisation to retrograde, and of reducing it to zero. This is the mercurial ointment {Codex, No. 659) given in the dose of one to eight grains in the form of pill—one-half in the morning, the other in the evening. Under the influence of this modifying agent, employed during the first stage, the morbid phenomena soon de¬ crease, and ultimately disappear, and some of them in a constant and invariable order. Thus haemoptysis, when it exists, disap¬ pears immediately, even after having re¬ sisted other remedies. Sweating disap¬ pears next; then comes the cessation of the cough ; and, lastly, that of the symp¬ toms revealed by percussion and ausculta¬ tion. In short, the cure is perfect, and is effected in the course of a few months. The author concludes by saying, that we can thus invariably combat pulmonary tuberculisation successfully, provided it has not reached the last stage. The cura¬ bility of phthisis is thus, by M. Couppey, determined in the affirmative-Gazette Medicate, No. 32,1849. [M. Couppey says nothing as to whether the constitutional effects of mercury were observed in any case. Neither does he give any cases or statistics. And he says nothing as to diet and other circumstances, which must exert considerable influence in a disease several months under treatment. We give the above more from the con¬ fidence with which it is related by the author, than from any great faith in the probable success of the treatment recom¬ mended. A trial, however, could do little harm, if no good.] III.—PRACTICE OF SURGERY. ZaS.—History of a Case of Ligature of 1842. The patient was discharged from the Common Iliac Artery. By Dr Peace, the hospital, cured, six weeks afterwards, Pennsylvania.—This case was published and five months after the operation, the in 1843. The artery had been tied in tumour, which had been very large, was