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Pg. 349

Medical Times & Gazette page 15

1 Leave a comment on paragraph 1 0 PROGRESS OF MEDICAL SCIENCE.

2 Leave a comment on paragraph 2 0 349

3 Leave a comment on paragraph 3 0 should be employed at the same time. The liq. potassae is generally preferable.

4 Leave a comment on paragraph 4 1 ” Neuralgia, connected with Acidity of the Primae Vice, (a very common cause,) may often be removed by the administration of mild alkalies. In severe paroxysms of pain, Dr. Theophilus Thompson states, that he has known decided relief produced in a few minutes by the use of a few grains of sodae carb.

5 Leave a comment on paragraph 5 1 ” In Acute Rheumatism, Dr. Wright, of Birmingham, states that he has found no remedy so generally efficacious as the mild alkalies, particularly the carbonate of soda. He advises it externally in the form of bath, (3ij. to the bath,) and internally in the following form:—Rx Sodae carb. 3ij., Mist, camph. 3viij., M. sumat coch. amp. ij.,3tis horis. He relates several cases illustrative of the efficacy of this treatment, and considers that it acts by correcting the acidity which always exists in rheumatic attacks.

6 Leave a comment on paragraph 6 1  “In Purpura Haemorrhagica, the following formula, proposed originally by Dr. Stevens, has been found useful:—Rx Sodas carb. 3ss., sodii chlorid. )j., potas. chlorat. gr. vj. M. Ft. pulv. ter in die sumend. ex aqua.

7 Leave a comment on paragraph 7 1 “ In Diseases of the Skin, particularly in those of papular and scaly character, M. Devergie has extensively employed the alkalies, both internally and externally. The bicarbonate of soda is the one chiefly used, the corresponding salt of potash being found more caustic and irritant. Internally, the dose is gr. xv. daily, in some bitter infusion, or in syrup (3ss., syr. simp. 3viij.); and this quantity is augmented gr. viij. every third day, until 3j. is taken every twenty-four hours. This is the maximum quantity. Externally he employs lotions, baths, powders, and ointments. The baths are to contain each from 3viij. to 3xvj. of the carbonate, either of soda or potash. The lotions contain 3ij.—3iij. of the salt in Oj. of water, and are employed chiefly in eczema and impetigo of the scalp. The alkaline powder (one part of soda, ten of starch) is used principally as a depilatory, in tinea and sycosis menti. The ointments are of various strengths, according to the nature of the disease; thus, in Lichen and in its various forms, the strength is gr. viij.—xv., to 3j. of lard; in Lepra, Psoriasis, and Ichthyosis, gr. xv.—3ss. to 3j.; and in Porrigo Favosa, 3ss.—3j. to 3j., with a grain or two of quicklime. In Porrigo Larvalis, lotions containing this salt have been found highly serviceable.

8 Leave a comment on paragraph 8 2 “ In Albuminuria, Dr. Osborne advises the internal use of the alkalies. Alkalescence, he observes, is a necessary condition of he blood, and that the free alkali is soda, and that when the soda fails, either from a deficient supply or from want of power to decompose the muriate of soda in the stomach, the result will be coagulation of the blood in the capillary vessels, and phenomena of inflammation in those parts in which such coagulation takes place, and that potash or soda taken into the stomach, either uncombined, or as carbonates, have the power of rendering the urine alkaline, and of dissolving fibrin. On these grounds he reasons that, when in any disease the kidneys contain fibrinous deposits, alkalies should be given. He employs the following:—Rx Sodae carb., liq. potassae, aa. 3ij., decoct. chondri crisp. 3viij. Dose a tablespoonful every two hours in milk. When anaemia is very marked, he adds the tartrate of iron.”

9 Leave a comment on paragraph 9 0 The work is exceedingly well arranged for reference, and is calculated to prove very useful to practical men.

10 Leave a comment on paragraph 10 1 Notification of the Central Board of Health. Drawn up and Presented by the Members of the Standing Committee for Kingston. Approved of and Ordered by the Board to be Printed. Kingston. 1854. Reprinted by Direction of the Secretary of State for the Colonial Department. 8vo. Pp. 30.

11 Leave a comment on paragraph 11 2 This is an extremely useful pamphlet, highly creditable to the Jamaica Board of Health. In consequence of the cholera having appeared in the island in an epidemic form, the Board state, in the first paragraph of the notification, that they “ deem it to be their duty to offer such remarks upon the nature, origin, spread, and preventive treatment of the disease, as they consider may be of service in warding off or modifying the severity of the malady, and also briefly to state the curative treatment which experience has pointed out to be the most successful.” The Board support the opinion of the moderate contagionists. The treatment recommendeded is opium at the outset, that is to say, in the stage of diarrhoea. Salines at a later period. The saline powder the Board advise is composed as follows :—

12 Leave a comment on paragraph 12 0 Chlorate of potash, 7 grains.

13 Leave a comment on paragraph 13 0 Carbonate of soda, 20 grains. Chloride of sodium, 30 grains.

14 Leave a comment on paragraph 14 0  Such a powder is to be given when the patient is in a state of collapse, every quarter of an hour,—“as much cold or iced water being drunk between the doses as the patient will take.”

15 Leave a comment on paragraph 15 0 PROGRESS OF MEDICAL SCIENCE.

16 Leave a comment on paragraph 16 0 SELECTIONS FROM FOREIGN JOURNALS.

17 Leave a comment on paragraph 17 0 UPON THE EFFICACY OF ICE COMBINED WITH COMPRESSION IN THE REDUCTION OF HERNIA.

18 Leave a comment on paragraph 18 1 In sixteen cases of strangulated hernia, in which all the ordinary means of reduction had been unsuccessfully employed, M. Bau- dens has effected the return of the bowel by the application of ice associated with permanent local pressure. The degree of refrigeration is to be regulated in proportion to the amount of inflammation in the hernial tumour, and the sensations of the patient. M. Baudens commences by the application of a simple compress, which is soaked from time to time in water, whose coldness is gradually increased. Fragments of ice are afterwards placed on the compress, and the cold thus produced may be augmented, if necessary, to a very considerable intensity by the addition of increasing quantities of common salt. Sometimes the refrigeration alone is sufficient to effect the reduction, as M. Baudens has witnessed on three occasions; but when this does not take place, an elastic bandage is applied over the ice, by means of which a continual steady pressure is exercised on the tumour. Whenever the rupture is so painful that no pressure can be tolerated, ice alone must be employed at the outset, and the elastic bandage may be added as soon as the sensibility of the swelling is sufficiently diminished. In order to facilitate the action of these measures, the pelvis should be kept in an elevated position.

19 Leave a comment on paragraph 19 2 M. Baudens ascribes the efficacy of this treatment to the powerful influence of cold in diminishing the size of the hernial tumour, by overcoming the capillary congestion, and extinguishing the inflammation in the strangulated bowel. Hitherto, says he, the treatment by cold has been condemned, because its therapeutical effects have been neglected or misappreciated. He regards the idea that the application of cold to a strangulated rupture is likely to produce mortification in the bowel as a groundless apprehension, believing that so large an amount of heat is developed in a part during the continuance of inflamma- tion, as to enable it to resist with facility long and powerful refrigeration, without at all endangering its vitality. He admits, however, that it is quite possible to continue the application of cold too long, but maintains that the feelings of the patient furnish the best index as to the advantageous or prejudicial operation of the remedy. As long as the patient feels that the action of the refrigerant is grateful, and productive of comfort, its application should be continued; but, as soon as he begins to experience a disagreeable sensation of coldness and moisture, it should be immediately removed.—Gaz. des Hopitaux, June 3, 1854.

20 Leave a comment on paragraph 20 0 UPON THE PATHOLOGICAL ANATOMY OF RANULA.

21 Leave a comment on paragraph 21 0 By Dr. C. O. WEBER.

22 Leave a comment on paragraph 22 0 The author relates the particulars of two cases of ranula, treated in the Surgical Clinique at Bonn, and adds thereto remarks to illustrate the pathology of the disease, which, in spite of the researches and writings of many authors, seems to be yet involved in some obscurity.

23 Leave a comment on paragraph 23 1 A smith, aged 33, applied, in the winter of 1851-2, at the Surgical Clinique, in consequence of a plastic membranous exudation on various parts of the mucous membrane of the mouth, following an attack of chronic diphtheritis. The use of the knife and scissors, and the application of hot iron, ultimately got rid of the affection; but, in May, 1852, there formed, close to the fraenum linguae, on the right side, a ranula, which required many operations for its complete obliteration. The patient, who was also suffering from hydrocele, left the Institution in July, but returned in October, to have the radical operation performed on the tunica vaginalis. The tumour under the tongue had re-appeared, and required the re-application of the knife and cautery. In January, 1853, the ranula had formed again, having acquired the size of a hazel-nut. The contents were squeezed out, and collected for examination. The greater part of the cyst was excised, the operator having seized it with hooked forceps; the small piece which remained was rubbed with caustic. This proceeding seems to have been successful, for there was no return of the disease in January, 1854, when the patient was again seen on account of the hydrocele. The extirpated piece of the cyst was examined. It was covered by the mucous membrane of the mouth, and was composed of firm areolar tissue, containing many bloodvessels. The fluid was thick, greenish, and transparent, and contained epithelium and mucous corpuscles. Acetic acid caused immediate coagulation.

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