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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    ii | the connexion between the quantity of albumen and that of blood in the jj| urine, and to the simultaneous diminution in the two as the patient I approaches towards convalescence. The number of cases on which M. Legendre’s remarks are based was only 14; and he does not seem to have had the opportunity of watching- any patients who died after the disease HI had reached a chronic stage, so as to determine whether any tendency to !L granular degeneration of the kidney is induced by the previous scarlatinal dropsy. [The correctness of his views, however, is borne out by the observa- tions of cases where the dropsy has existed unconnected with albuminous urine, as in the epidemic at Berlin, in the spring of 1840,* as well as by the || results of recent microscopic investigations, such as those of Henle, |: lEichholtz, and Dr. G. Johnson.] The concluding part of his essay gives an account of that oedema of the 11 lung which comes on as a sequela of scarlatina, for the most part in cases I v where general anasarca is present or has previously existed. He describes | the sudden manner in which its symptoms often appear, while though the f| dyspnoea that attends it is extremely urgent, there are no auscultatory signs I of the affection of the lungs. The chief point in the paper, however, is the i anatomical description of this condition, which is an oedema of the iuter- 1’ lobular celluar tissue, compressing the air-cells in greater or less degree, and ; ■ thus differing from the oedema of Laennee, in which the fluid is supposed by that author to be contained within the pulmonary vesicles. Variola. An elaborate paper on the anatomy of the smallpox pustule has been written by Dr. Simon,]- of which only brief mention can be made here. He states that the pustule does not always owe its central depression to the presence of a hair-follicle pinning down the epidermis, but that in parts where no hair-follicle exists, the appearance is probably owing to the rapid desiccation of the exudation first poured out, while fresh matter is afterwards - effused around it. The white membraniform layer immediately below the surface of the pustule is not in reality a false membrane, but is chiefly made up of the lower desintegrated stratum of epidermis, and the cellular structure of the pustule is produced by this stratum remaining in connexion with the cutis at some points, while at others it is detached from it. The utility of the application of mercurial ointment or plaster, as a means of producing the abortion of the smallpox pustule, and thus preventing pitting, and diminishing the danger of the disease, is confirmed by the experience of MM. Goblin, Charcellay, and Briquet,]; and M. Thielinann and Dr. Panck§ state that they have obtained equally favorable results from the frequent use of a solution of the corrosive sublimate. M. Thielinann employed it of the strength of gr.j to 3’ij. Dr. Punch used it of about half that strength. M. Tardieu|| has related a case of the simultaneous existence of variola and vaccinia in a man aged 18, who was vaccinated on the day on which the eruption of smallpox had made its appearance. The variola ran its course with its characters modified, and after the desquamation of its pustules an irregular eruption of cowpox appeared. From this case he concludes that 1 we may vaccinate with the hope of doing good, not merely during the pre- : liininary fever of variola, but even after the outbreak of the eruption. The work of M. Steinbrenner,IT who, with M. Bousquet and M. Hard, has ' shared the prize of the French Academy for the best essay on vaccination and its influence on smallpox, will be found to contain a great amount of infor- mation on the subject, collected with the most laborious industry. In reply to the five questions proposed by the Institute, JM. Steinbrenner decides * Described by Dr. Philip, in Casper’* WochenBchr., Aug. 29, 1840. + MUHer’s Arcbiv, 1840, ii. t Revue Med., and Oesterr. Med. VVochensebr., September 20, 1845 ; Uull.de 1 Acai. oj.ie ' M^d., April 15, 1840; Gazette des Hdpitaux, September 10, 1840. $ Gazette des Hdpitaux, April 10, 1840 ; Oesterr. Med. Woehenschr., September 20, _ II Gaz. Med., November, 1845. f Traitc- sur la Vaccine. Ovo, Paris, 1840.