ache, thirst, heat, foulness of tongue, griping, nor constipation followed, or were increased if previously present. But the question occurs, is there any advantage from these large doses over smaller ones? This question our author is unable to an"A drachm dose may perhaps be as useful as one of swer. half an ounce.' "Reasoning analogically, one would conceive that large quantities must be more serviceable. Cinchona, for instance, will cure an ague in doses of a drachm, given every two hours, when two or three tablespoonfuls of the decoction three times a-day, or even a drachm of the substance given not more frequently, altogether fails. We are accustomed to increase the doses of all medicines for the purpose of increasing the effect. In the very example of subcarbonate of iron, practitioners prescribe sometimes what they consider a small dose, sometimes what they consider a large one, according to the force which they judge necessary to bring up against the disease; and they increase the quantity as the disease proves obstinate. Now since it appears that the dose of this medicine has a much wider range than has been thonght, and that the terms large and small must relate to quantities different from those to which they have been hitherto applied, the same habit of practice would incline one to these large doses in obstinate cases, unless such comparative observations, as have been just alluded to, prove them to be no wise superior to what have hitherto been considered large." 238. Cullen seems to have been of opinion that the good effects of preparations of iron have often been missed by the medicine being given in too small doses. And Sydenham was in the habit of giving the simple rust of iron freely. It is curious that Cullen mentions the rust to have been given in the quantity of six drachms in one day; but observes that he had found hardly any stomach capable of bearing more than a third of that dose. Before concluding these preliminary observations, Dr. E. begs to say that a scruple of the sulphate of iron, made into pills, with the extract of gentian, is borne just as well as half an ounce of the subcarbonate-and that every observation which he has made respecting this dose of the latter applies nearly to that of the former. Eight cases are related by Dr. Elliotson in illustration, of which we shall give the particulars of two. Case 1. This was one of paralysis agitans, in which Dr. E. tried the subcarbonate, after first having brought out a crop of pustules on the limbs by the tartar-emetic ointment, and purged him freely with oil of turpentine. He also went through a course of the sulphate of zinc, and was blistered on the occiput. Dr. E. then prescribed the iron in half drachm doses every eight hours, with leeches to the temples, and a perpetual blister to the forehead. The dose was gradually increased until the patient took three drachms for a dose, when the shaking was greatly abated, and the man finally left the hospital perfectly well. Case 2. The first case induced our author to try the same medicine in chorea, in the person of an emaciated pale girl of 14 years, who had universal chorea. It was one of the most frightful cases our author ever saw, she being unable to walk or stand, and could scarcely be kept in bed without the assistance of two or three persons. She was continually screaming -never slept and had suffered some epileptic fits. She was first purged with the submuriate of mercury, and then the subcarbonate of iron was commenced in half-drachm doses every six hours. It was gradually increased to a drachm, and in six weeks she was discharged cured. All the remaining cases are those of chorea, and in all our author was successful. Yet Dr. E. does not attempt to extol the medicine as a specific. He is confident the iron may be often given safely when there are head-aches, foul-tongue, and torpid bowels; it being prudent, however, in such cases, to draw blood, and open the bowels. Dr. E. has failed with the largest quantities of iron in epilepsy, cancer, and lupus; but found it very beneficial in chronic neuralgia, and various chronic ulcerations and pustular diseases, as well as those diseases of debility in which it is so justly celebrated. Dr. E. gives a case where the sulphate was used in chorea, instead of the carbonate, and with beneficial effects. Dr. Elliotson deserves the thanks of the profession for his zeal and ability in trying the remedial efficacy of certain medicaments in unusual doses. As far, however, as regards the carbonate of iron, we are disposed to think that, when very large doses are given, a great proportion of the medicine passes the stomach and bowels unchanged, and without doing more than much smaller quantities. ART. V. Notes of a Case of Hydrophobia, with some Remarks on the Puthology of that Disease. By GEO. GREGORY, M.D. The phenomena of this case, during the miserable life of the patient, present nothing very particular. On dissection, the spinal marrow was found free from disease throughout its whole extent. There was some slight effusion on the surface and in the ventricles of the brain. The stomach and bowels were in a healthy state-lungs gorged with blood. The internal surface of the pharynx, epiglottis, larynx, œsophagus, and trachea, appeared of a coffee-ground colour, or almost black, which colour remained after the parts were sponged. There was no breach of structure in any of these parts. The inner coat of the aorta, and large arteries proceeding from it, was of a bright scarlet colour. Heart and pericardium healthy. Dr. Gregory observes that, although the appearances on dissection, in hydrophobia, vary exceedingly, yet in this case, at least, it is impossible not to connect the symptoms with the appearances about the throat, on dissection. "These phenomena tend to the conclusion, that the symptom which gives name to the disease is directly dependent upon some form of inflammatory action in the larynx and pharynx, and that the true nosological situation of hydrophobia is in the genus cynanche." The practical inference which our author would draw from these data is, "that when a man has been bitten by a rabid animal, he should be closely watched about the end of the fourth week, and on the first appearance of any marks of nervous irritation or uneasiness about the throat, those remedies should be adopted, of whatever kind, which the practitioner would have employed, had the real nature of the disease been unequivocally ascertained." We fear that it is upon the prophylactic treatment we are solely to rely in the present state of our knowledge of hydrophobia. That prophylaxis, we imagine, will hinge on cupping the wound well-then excising it, and establishing a suppuration by means of caustic. It is proper to state, however, that, in a paper by Mr. Hewitt, of the Bombay Medical Establishment, on the bites of a mad jackall, one patient was apparently saved, after the hydrophobic symptoms had commenced, by rapidly inducing ptyalism. This corresponds with the experience of Mr. Daniel Johnson, as published some years ago in this Journal. We have now finished the present volume of the MedicoChirurgical Transactions, and presented our readers with almost every fact contained in it. We shall look with impatience for another production from the same source, and hope it will not prove inferior to its predecessors. III. I. On the Use of the Chlorate of Soda, and the Chlorate of Lime. By A. G. LABARRAQUE. Translated by JAMES SCOTT, Surgeon. Octavo, pp. 36. Highly, Fleet Street, 1826. II. An Essay on the Use of Chlorurets of Oxide of Sodium and of Lime, as powerful Disinfecting Agents, and of the Chloruret of Oxide of Sodium more especially, as a Remedy of considerable Efficacy, in the Treatment of Hospital Gangrene; Phagedenic, Syphilitic, and ill conditioned Ulcers; Mortification; and various other Diseases. Dedicated by Permission to the Right Honourable ROBERT PEEL. By THOMAS ALCOCK, Member of the Royal College of Surgeons in London; Member of the Medical and Chirurgical Society, &c. &c. Octavo, pp. 152, with a Plate. Burgess and Hill, 1827. Ir is now some thirty or forty years since the fumes of nitre and salt, as disinfecting agents, were sold to the good people of England by Dr. Carmichael Smith, at a very handsome sum of money-the price being fixed by the same "collective wisdom," that gave a magnificent reward of 5000 pounds to Mother Steevens for some calcined egg-shells. At the time we mention, it was usual to see the wards of hospitals, the decks of ships, the floors of prisons—nay, the private chambers of the sick, ornamented with rows of pipkins exhaling the magic fumes that were supposed to annihilate those invisible beings called contagious or infectious miasms. True it is, that these acid fumes did render the air of the wards of hospitals and other domiciles of the sick, much less repugnant to the olfactories; and we had reason to believe that the confidence inspired by the new disinfectant among nurses and attendants, did, in some degree, check the spread of contagious diseases. But it was found, in the end, that, to correct a fetid smell, and to destroy a febrific or contagious miasm, were two different processes, not equally performed by the fumes of nitro-muriatic acid. The new disinfectant was soon exchanged for pure atmospheric air; but not before Dr. Smith had realized the motto on his crest-" FUMUM VENDERE." The world is now grown older, if not wiser than it was, and specifics are put forth with more modest pretensions, and more in their true character than formerly. But the history of mankind, and especially of medicine, warns us to distrust the first accounts of extraordinary powers or virtues in medicinal substances not because the experimenters wish to deceive; but because they are, themselves, liable to be deceived. perientia fallax." "Ex It appears that M. Labarraque was led to the discovery of the powers of the substances under consideration, while endeavouring to destroy the infectious odour, and prevent putrefaction in the materials used for the manufacture of catgut and other strings made from the intestines of animals. The CHLORURET of LIME is only a new name for the old oxymuriate of lime; and the dry preparation is a sub-chloruret of hydrated lime, and is well known in the arts of this country by the term BLEACHING POWDER. Of the preparation of this we shall say nothing, as few will take the trouble of preparing it, when it can be procured so cheap from the great manufactures. The formula for the chloruret of soda-or, as Mr. Alcock terms it, the "chloruret of oxide of sodium," we shall give from Mr. Scott's pamphlet, as the shortest. "CHLORATE OF SODA. Pure Carbonate of Soda, 24 Kilogrammes. "Mix in a Bottle that will be about one quarter empty--then into a Glass Balloon Bottle (of about Two Quarts) with a long neck and a large mouth, put the following mixture. Hydro-Chlorate of Soda, 576+ Grammes, Peroxide of Manganese, powdered, 448 Grammes. "In the mouth of the Balloon Bottle, lute a large curved tube, and one also in the shape of an S; the first tube is inserted into a bottle containing a small quantity of water, a similar tube passing from this into the Bottle containing the saline solution. The lutes being dry, a mixture of 576 Grammes Sulphuric Acid, and 448 Grammes water, is to be poured into the Balloon through the curved tube S, heat is next applied and gradually regulated until the disengagement of Chlorine gas ceases. "TEST. Powdered Bengal Indigo, one part. "Mix and add Nine Hundred and Ninety-three parts of distilled water-one part of the Chlorate of Soda, mixed with Eighteen parts of this liquid, should deprive it of colour. "The saline solution should be of the specific gravity of 120 by Baume's hydrometer-if the liquid be too concentrated, add the requisite quantity of water; if, on the contrary, the solution is too weak, * A Kilogramme is 2lb. 3oz. 5dr. Avoirdupois. + A Gramme is about 15 Grains. 1,089 of common standard, temperature 55, Fah. |