Monthly retrospect of the medical sciences : February to December 1848 / edited by Alexander Fleming and W.T. Gairdner.

Date:
MDCCCXLVIII [1848]
Catalogue details

Licence: Public Domain Mark

Credit: Monthly retrospect of the medical sciences : February to December 1848 / edited by Alexander Fleming and W.T. Gairdner. Source: Wellcome Collection.

    27/286 page 21
    air, and then smelling it, when tlie strength is readily ascertained. In M. Kayer’s experience, extending to over a hundred cases, a single application rarely failed to afford relief, and in many instances pre¬ vented a return of the attack for three or four months. This mode of treatment is alone applicable to simple or idiopathic asthma, that form which is so often de¬ pendent on emphysema, and is attended with catarrh; it has, nevertheless, afford¬ ed relief in some cases of symptomatic asthma.—Annales de Thirapeutique de Royneita, November 1845. [We had an opportunity in Paris of see¬ ing several cases of asthma relieved by Kayer’s mode of applying the caustic am¬ monia. It is our opinion, however, that the practice is not unattended by dan¬ ger.] 39.—Ricord’s Treatment of Gonorrhoea— Action of Copaiba. If the patient be seen within the first twenty-four hours, M. Ricord recommends the immediate injec¬ tion of a strong solution of nitrate of silver, (15 grs. of the nitrate to an ounce of dis¬ tilled water). In many cases, one injection suffices for this abortive treatment, in others a second may be necessary after an interval of two days. At the same time copaiba and cubebs are administered internally in large doses. M. Ricord observes, “ The injections mo¬ dify, and create a new action in the mu¬ cous membrane, and copaiba and cubebs, by yielding their principles to the urine, contribute powerfully in rendering that modification more effective.” He considers copaiba the most important of the internal remedies against gonorrhoea, and treats of its action under three heads :— 1. Revulsive action.—When copaiba acts on the bowels, it may bring about a revulsion on the intestinal canal, and thus possibly establish a cure ; it then acts like any other purgative, as colocynth, &c. But you must not trust to cures thus obtained, for it often occurs, that when the revulsion ceases, the blennorrhagia returns ; so that I would lay it down as a general rule, that the purgative action of copaiba is not to be sought for, when we administer this sub¬ stance against blennorrhagia. 2. General action on the system.— blood being modified by the principles of the copaiba, may, in its passage through the textures of the mucous membrane, act upon it in a peculiar manner; but it is plain that this mode of action is very feeble, since those varieties of blcnnorrha- gia, which have not their seat within the ui’ethra, are in nowise benefited by its ad¬ ministration, 3. Direct anti-hlennorrhagic action.— Copaiba, after being taken up by the tor¬ rent of the circulation, is elaborated in the kidneys so as to acquire new properties. Thus it is that the urine of persons who are using copaiba has a peculiar smell, very easy of recognition for those who have had practice in these matters. This principle, the result of the renal elaboration, is con¬ tained in the urine, and it is by means of this peculiar element that the affected sur¬ faces become modified. M. Ricord has seen several qases of gonorrhoea in individuals who had a urethral fistula, and in whom the internal use of copaiba succeeded in controlling the discharge which issued from that por¬ tion of the canal which was situated pos¬ teriorly to the fistula, namelj', that portion placed under the influence of the urine— Lancet, December 1847, p. 617. 40.—Action of Nitrate of Silver on the Liquids and Solids of the Body: By Kellek.—The use of this salt as an ex¬ ternal application in affections of the mu¬ cous membranes of the eye and of the generative organs is generally allowed. These effects, says our author, are easily explained by the property which the salt possesses of destroying the vitality of the parts with which it comes in contact. Further, it decomposes the chloride of so¬ dium and the soluble phosphates, so that there are formed two insoluble salts, the chloride and phosphate of silver. The fre¬ quent application of this salt to the epithe¬ lial cells of the mucous membranes, not only causes their rapid separation, but also their rapid and abundant reproduc¬ tion. The mode of action of the salt, when taken internally, is not by any means so clear. From seven experiments, in which the blood, urine, and faices of patients who had taken large doses (3 to 12 grains daily) for some months were examined, he was led to the conclusion that the whole was removed, in the form of chloride of silver, with the faeces. From a direct ex¬ amination of its action on the gastric juice, he concludes that the whole is at once converted into chloride of silver, and con¬ sequently that no portion enters the circu lation ; he even goes so far as to regard the well-known change of colour as merely fortuitous. We need hardly state that the coloration in these instances is too certain to be doubted ; we have far better evidence of Us truth than that of Keller’s
    digitised image 1
    digitised image 2
    digitised image 3