Report on the progress of practical medicine, in the departments of midwifery and the diseases of women and children in the years 1845-6 / by Charles West.

  • Charles West
Date:
1847
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Licence: Public Domain Mark

Credit: Report on the progress of practical medicine, in the departments of midwifery and the diseases of women and children in the years 1845-6 / by Charles West. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    that the diarrhea of early childhood is at first merely an excessive secretion, and not the result of any appreciable morbid change, and that the anatomical alterations of the digestive canal are the consequences of the diarrhea, not its cause, whence it happens that their extent is usually proportionate to the severity and continuance of the flux. The grand object of this essay is to combat the opinions of the disciples of Broussais, anti by disproving the in- flammatory origin of diarrhea, to explain the frequent failure of antiphlogistic treatment, and to justify a return to the practice of the old physicians, and the use of evacuants and absorbents. Dr. G. Bird* has made an analysis of the green evacuations of children. He finds that they give no indication of containing an excess of bile, as has generally been supposed, but conceives that their colour is due to the presence of altered blood, and that the state in which they are produced is analogous to that which exists in inelsena, the portal system generally being in a congested state. In support of his views, he mentions that stools originally of a yellow or orange colour, often turn green under exposure to air, an oc- currence very unlike what takes place with matters containing bile, though it is an ascertained fact that blood under the influence of some oxidating agents acquires a green colour. Two cases of fatal intussusception of the intestines are related; the one by 1 Dr. Boyer, the other by Mr. Murkwick,f in each of which the characteristic symptoms were present. Dr. Duclosj relates two cases of fissure of the anus in infants, treated by M. Trousseau. The symptoms seem to be the same as in the adult, namely, pain and spasmodic contraction of the sphincter, betokened by a cry when tbe bowels act, and the escape of a drop or two of blood. M. Trousseau treats these cases successfully with enemata of one part of extract of krameria to 100 of water. M. Morand§ recommends the extract of belladonna as a valuable remedy tor nocturnal incontinence of urine, in those cases of it which seem to be as- sociated with a state of general debility. For children from 4 to 6 years old, he begins with a pill containing gr. \ of the extract twice a day, increasing the dose to gr. j in the course of id days. He suspends the medicine if syinp- .toms of narcotization emne on, but otherwise continues it for 2 or 3 months so as to effect a perfect cure. fevers. Ague. Dr Petzold,[] who inhabits a malarious district, describes the pe- culiarities which this disease presents in early childhood. Its characters are on the whole less marked, so that there is some danger of mistaking the nature of the affection. The shivering fit is less severe, and neither the hot nor the sweating stage is so well marked as in the adult. The intermissions, likewise, are less complete, the child being manifestly out of health between the paroxysms, while there is often a very great tendency in the attack to antici- pate, so that the periodicity of its return may easily be lost sight of. When it occurs in children of only a few months old, the cold stage usually sets in very suddenly, attended with great depression, or sometimes it comes on with convulsions, and manifest cerebral disturbance, so that when the hot stage has succeeded, the case may be taken tor one of inflammation of the brain. The tranquil sleep, however, into which the child falls as the hot stage passes off, will serve to guard from this error. It is of importance to recognize the disease early in the infant, as well as in the aged, si nee the attacks of ague exhaust the strength very rapidly, while quinine, which is of the most marked benefit while the disease retains the intermittent type, seems to lose much ot its efficacy so soon as the fever has assumed the continued form. * Med. Gaz., Sept. 5, 1845. + J-f. Kinderkr. June, 184G. f Casper’s Wochenschr., March 10, 1840 $ Ibid., Sept. 1845. 11 ; Lancet, July 18, 1846. Ibid., Sept. 1845.