BMJ

Academy of Sciences, ParisSource: Provincial Medical and Surgical Journal (1844-1852), Vol. 8, No. 16 (Jul. 17, 1844), pp.237-239Published by: BMJStable URL: http://www.jstor.org/stable/25497995 .

Accessed: 15/06/2014 02:04

Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at .http://www.jstor.org/page/info/about/policies/terms.jsp

.JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range ofcontent in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new formsof scholarship. For more information about JSTOR, please contact support@jstor.org.

.

BMJ is collaborating with JSTOR to digitize, preserve and extend access to Provincial Medical and SurgicalJournal (1844-1852).

http://www.jstor.org

This content downloaded from 62.122.76.45 on Sun, 15 Jun 2014 02:04:34 AMAll use subject to JSTOR Terms and Conditions

ACADEMY OF SCIENCES. 237

cotton wool, and intended to pass under the chin and

occiput, is attached to a cord, which passes over the

centre pulley, to which a weight is suspended; shoulder

straps, composed of the same materials, and attached

in a similar manner, pass under the axilla of each

arn and over the outer pulleys, having weights also

adjusted to them: similar means of extension are also

applied round the ankles, and occasionally in the Imale sex above the pelvis; these are passed over the pulleys at the lower end of the plane."

" The patient, being laid upon the plane and the appa ratus adjusted, will be operated upon by a double

extension, the head and shoulders will be extended

upwards, whilst the trunk will be drawn gently in the

opposite direction, the weights being so equipoised that the body is kept upon the plane, having no ten

dency to move either upwards or downwards, at the

same time, almost imperceptibly drawing the distorted

parts towards their natural position: hence, is com

pletely obviated the objection of some practitioners, who think that an inclined plane is not desirable on

account of the weight of the upper part of the body

pressing on the lumbar vertebra, because here, the

pressure downwards is counteracted by the extension

upwards." Regulated pressure and friction are made over pro

jecting parts of the spine or ribs, and judicious direc

tions given for the employment of such other means

as the nature of the case renders necessary. The

author is opposed to any kind of violence, and recom

mends extreme caution in the application of the

weights, regulating them so as to prevent the patient

experiencing any inconvenience from them.

In the chapter which is devoted to the consideration

of the causes of the disease, much stress is laid upon the injurious effects produced by the pressure and con

finement of stays, and other parts of the dress, and upon the neglectof proper exercise inthe system of management

pursued with young females. There is little novelty in

these observations, but they add the testimony of another

writer to the experience on this point before accumu

lated, and as the work is evidently intended, in part at

least, for general circulation, may possibly have some

effect in quarters where treatises addressed solely to

medical practitioners rarely gain access.

First Lines for Chemists and Druggists preparing for Examination before the Board of the Pharmaceu

tical Society. By J. STEGGALL, M.D., Licentiate

of the Royal College of Physicians, M.R.C.S., &c. London. 1844. 12mo., pp. 169.

This is one of those manuals, intended to assist

students in acquiring such an amount of knowledge of

subjects, on which they are about to undergo an examli

nation, as ImLy enable them to give correct answers to

the questions likely to be proposed to them. The

weighty objections to such a mode of preparing for

examination do not apply to the work itself, which

contains a good deal of information on pharmaceutical

preparations, and we have no doubt will be found well

adapted for the attainment of its object, and useful to

those for whose convenience it has been compiled.

The Retrospect of Practical Medicine and Surgery,

being a Half-yearly Journal, containing a Retrospec tive view of every Discovery and Practical Improve

ment in the MIedical Sciences. Edited by W.

BRAITHWAITE, Surgeon to the Leeds General Eye and Ear Infirmary, and Lecturer on Midwifery and

the Diseases of Women and Children, in the Leeds

School of Medicine. Vol. ix., January-June, 1844.

London. 12 nmo, pp. 339.

Mr. Braithwaite's Retrospect is too well known and

estimated to require any notice or commendation from

us. WVe shall content ourselves with stating therefore

that, together with the usual amount of valuable prac tical information, collected from various sources, this

volume possesses the additional advantage of a general index to the contents of its predecessors. We could

wish to see the example followed by some other of our

contemporaries. The practice was adopted many years back by the then editor of the Edinburgh Medical and

Surgical Jonrnal, who published an index to the first

twenty volumes of that work. A similar opportunity will shortly be afforded to the editor of the British and

Foreign Medical Review, on the completion of his

second decade, which we trust he will not allow to

pass over.

ACADEMY OF SCIENCES, PARIS.

May 6, 1844.

A L B U M I N U R I A.

Doctor Fourcault read a paper on the causes of

albuminous urine, in which he proposed to explain the

influence of impermeable coverings applied to the

surface of the skin in the production of the disease known by the name of Albuminuria, or Bright's kidney, and to deduce therefrom the office and functions of

the skin. The following are the author's conclu.

sions:

1. The skin is an excretory organ, and the products of transpiration are not formed in its tissue.

2. An animal preserves its proper temperature when its skin is taken off. Albuminous urine is not the

result of this operation. 3. Complete suppression of the cutaneous transpira.

tion gives rise to five series of phenomena--st, a

material alteration of the blood; 2nd, a considerable diminution of temperature; 3rd, extra secretions and effusions of various nature; 4th, local lesions; 5th, an alteration in the composition of, and ultimately albumen in the urine.

4. The saume Ilphnonmna, and especially the last, are

prodiiced when after having taken off the skin of an

animal, either partially or entirely, impermeable cover

ings are applied to its surface.

This content downloaded from 62.122.76.45 on Sun, 15 Jun 2014 02:04:34 AMAll use subject to JSTOR Terms and Conditions

238 ACADEMY OF SCIENCES.

5. Cutaneous asphyxia is the result of complete

suspension of transpiration, and death may in this way be caused both in man and in the superior animals.

The effect of this suppression is, that the blood acquires at a maximum the cooling and stupifying properties of

venous blood.

6. When this suppression is partial or incomplete, it produces the general phenomena observed in fevers

and inflammations.

ORIGIN OF THE PLAGUE.

M. Serres stated the opinions of Professor Sturmer, of St. Petersburgh, on the propagation of the plague

during the war in Turkey, of 1828-9-30.

His principle propositions are as follows:

The plague is endemic in the east (Asia Minor,

Epypt, and Constantinople) where it appears some.

times sporadically,sometimes as an epidemic; the ende mic cause is still unknown, but there are certain atmo

spheric and meteorological conditions, which give rise

to the sporadic cases, and contribute to develope an

epidemic. The physicians engaged in the war of the east are

divided into two parties. Those who reject absolute con.

tagion,and are of opinion that the plague is derived from some internal causes, from thestate of the atmosphere,

miasmata, &c.; and those who admit a specific con

tagion existing from an indeterminate period, and pro

pagating itself by means of individuals, goods, &c.

The plague of the Russian war, observes Dr.

Sturmer, like typhus and cholera, had no similitude to

the diseases which are propagated by an immediate or virulent contagion, such as variola, the itch, syphilis, and, in particular, it presented no characteristic

eruption; inoculation did not give rise to any breaking out of the same nature, as commonly happens in

syphilitic cases; neither are we in possession of any palpable facts which demonstrate that contact, inde

pendent of every other circumstance, has ever com municated the disease. The plague which prevailed in certain countries, appeared simultaneously in many places, and attacked the same individual many times; but Dr. Sturmer is of opinion that mediate or miasm. atic contagion gave rise to it in some cases.

CANCER.

M. Tanchou laid down the following propositions on the cause of cancer :

The number of cancers annually increases. In

England, M. Faur, (Mr. Farr we presume,) has stated it to be 2,448 in the year 1838, and 2,691 in 1839.

The same remark had been previously made at

Berlin, in 1826.

From the registers of the department of the Seine, we find that in 1830,668 persons fell victims to cancer, or 1.96 in 100 deaths, and in 1840, the number rose to 889, oi 2.40 in 100 deaths.

Civilization appears to be the cause of this disease. Thus it is nearly unknown in Africa and America. In Egypt we find it occurring among the Turkish

-vomen, and not among the Fellahs. It is not uncom mon also in domestic animals, and in those of our

menageries, whilst no example is known of its

development in animals in the wild state. In Paris, in the town, the mortality from cancer has'

been 2.54 per cent. of the deaths; in the environs, only 1.63 per cent,

Of 9,118 deaths caused by cancer, 6,967 were in

women, and 2,161 in men.

In England, of 5,139 deaths, 3,859 were among

women, and 1,228 men.

This disease is most frequent between the ages of 40 and 70.

In women the breast, and in men the stomach, are most often affected.

There is no cure at present known for this disease.

Surgeons operate, but all are agreed that the operation is not a cure, and, as M. Leroy d'Etiolles lately proved to the academy, it does not even prolong life. From this consideration M. Tanchou thinks it is incumbent on physicians:

1st. Carefully to study cancerous affections. 2nd. To treat patients medicinally, before sub

mitting them to an operation. 3rd. Only to have recourse to operation in obstinate

cases, and when the therapeutic measures have failed.

May 21st.

DISCUSSION ON OPHTHALMIA.

M. Velpeau alluded to a memoir of M. Morant, entitled "An Account of an Epidemic Ophthalmia

which broke out in a Colony of Young Persons con. fined at Mettray." M. Morant had remarked, that in nearly all the young subjects seized with the epidemic the disease commenced with coryza; in a very great number he had found the Schneiderian membrane inflamed. Having had occasion since then to repeat this observation, he does not hesitate to pronounce that inflammation of the pituitary membrane is fre

quently the cause of ophthalmia, especially in young subjects. In consequence of this, he had been induced to try a new therapeutic agent. He attempted to

apply to the treatment of ophthalmia, with pituitary inflammation, the means which are ordinarily em

ployed when the latter only exists; he had recourse to the cauterisation of the nasal mucous membrane by the nitrate of silver, in the form of a pencil, or that of a very strong solution, or an ointment. He applied it twice a day at first, during the acute stage of the disease; afterwards only once. This method had been fre

quently successful, whilst every remedy which he had

previously tried proved of no avail. M. Velpean, since the time when he first received

this information from M. Morant, had carefully examined the pituitary membrane in all ophthalmic cases which had been presented to his observation; and he was compelled to acknowledge that only in a

very few had he seen this membrane inflamed. He then made some remarks on the term scrofulous ophthalmia, which M. Morant had assigned to this epidemic, and took this opportunity of raising his voice against the classification of ophthalmic diseases according to their

presumed causes. As to the proceeding proposed by M. Morant, consisting in the application of topical remedies to the nasal fosse, he thought it one which

ought to be continued.

M. Roux: I think that I heard, in the course of this report, an expression which does not appear to me

quite orthodox. M. Velpeau has said, if I am not

mistaken, we should establish a distinction between different kinds of ophthalmia according to their mme diate seat, and not according to their causes. I am not of this opinion. There is much truth in what has

This content downloaded from 62.122.76.45 on Sun, 15 Jun 2014 02:04:34 AMAll use subject to JSTOR Terms and Conditions

BATH AND BRISTOL BRANCH OF THE ASSOCIATION. 239

been said on the specific causes of ophthalmia; it is

indisputable, for example, that in scrofulous ophthal mia there are, independently of other general characters

of scrofula, which can at once decide its origin, par ticular local characters which it is not possible to

mistake. Does M. Velpeau think that we ought thus

to neglect the consideration of special ophthalmic

causes, only to take into account the difference in their

ophthalmic seat ?

M. Rochoux: The opinion put forth by M. Roux is of such great importance that it ought to be sufficient

merely to mention it, that it may be acknowledged by the profession at large. It is of the greatest importance to consider the specific nature of diseases. Does not

syphilis, for instance, wherever may be its seat, always require the same treatment We know that syphilitic ophthalmia specially affects the free margin of the eye

lids; is not that in any way to modify the treatment i

M. Velpeau: I maintain that a scrofulous ophthalmia without any other designation, means nothing at all. I insist upon the necessity of giving to the different

species of ophthalmia their anatomical qualifications. As to distinguishing them according to their causes, itis a different thing. The study of anatomy has com

pletely reformed the science on this point. We have seen that what has hitherto been considered symp tomatic of a special ophthalmia, frequently merely resulted from the difference in the tissues affected. M.

Rochoux has cited syphilitic ophthalmia; but syphilis is a material thing,it is an inocculated virus. It is not the same in scrofula ; there it is the effect of a special constitution. The same as regards rheumatism, which is now considered nothing but an inflammation of the

fibro-synovial tissues.

PROVINCIAL MEDICAL AND SURGICAL ASSOCIATION.

BATH AND .BRISTOL DISTRICT BRANCH.

The third anniversary since the union of these

Branches was held at the Literary Institution, Bath, on Thursday, the 27th of June. Mr. George, Presi

dent, in the chair.

The Report of the Council was read by Dr. Morgan, Secretary for Bath; the concluding part of which it

may not be out of place to submit to the consideration of our readers.

"Your Council would commend to your fostering care that most useful appendage-the Benevolent

Fund. Our unions as a body, is not exclusively selfish; and while aiming at the future welfare of the whole

family, our pleasing anticipations are often interrupted by pressing appeals for present pecuniary relief on behalf of some unfortunate but deserving brother. There are many reasons why such relief should not be left to individual charity; and many, also, why the

peculiar circumstances of the object himself, should not be subjected to the needless publicity of a tribunal of the whole profession. To meet these two difficult

and delicate points, the committee of the Benevolent

Fund exists, to hear, determine, and relieve, according to the best of their judgment, and the extent of their

means;r*nd it is only that which is due to their

efficiency to acknowledge, that all who have had

occasion to apply to them on behalf of some indigent

but well-deserving brother, can bear their testimony to the kindness, the willingness, and the promptness,

with which they administer their trust.

"Your Council regret that the claims of the Bene volent Fund are not better known and appreciated; but they are aware that from the rank, the education, and the feelings of the individuals for the relief of whom it exists, more publicity cannot be given to its worth-the very perfection of its administration

requiring that it should court the shade. Not one, perhaps, without the walls of the Council-chamber in which the committee hear the particulars of the case, and the gladdened heart of the recipient himself, being conscious of the amount of benefit which your bounty has so silently conferred."

After the election of Mr. Estlin, of Bristol, as

president elect, and the conclusion of the ordinary business, Dr. Morgan, in compliance with the wish of the members present at the last quarterly conversazione, introduced a female, aged 24, married, without

children, in whom, two years since, the subcutaneous tissue of the hands and feet became dense, resisting, cold, contracted, and in appearance like wax; the

fingers flexed, without the possibility of being extended; the integuments of the whole body being tense, cold, and discoloured; the muscles and tendons much con

tracted; the disease remaining nearly stationary after four months of active treatment in the Bath Hospital, under the late Dr. Barlow, where she had been seen by Inany other eminent physicians. The disease was

cotemporary with distress of mind, and she is occa

sionally subject to hysteria.

Mr. Norman related the particulars of a case of tic

douloureux, recently treated by him at the United

Hospital. The patient, a female, aged 59, leuco

phlegmatic, much emaciated, had suffered from it fourteen years, with few intermissions. Severe

paroxysms, distorting the features, recurred every five or seven minutes, day and night, during the last four

months, confining her to bed, and by which her health was much impaired. Belladonna was administered internally in doses of one sixth of a grain every six hours, during two days, apparently without

any particular effect on the disease, but acting as a purgative, which croton oil, administered freely, as advised by Sir Charles Bell, had failed to do. It was then combined with quinine. (Extract of

belladonna one quarter of a grain, disulphate of

quinine half a grain, every four hours.) After the sixth dose she became delirious in the night; the pupil partially dilated, but the paroxysms were reduced to

sixteen, and on the following day to three, since which she gradually omitted the medicine, was able to leave her bed, to take full diet, having previously sub sisted on fluids; and, having wholly omitted her

medicine for one week, and having had no return of

her distressing malady during ten days, she was dis missed the hospital.

Mr. Mortimer stated that in a case of tic-douloureux well known to him, two grains of extract of belladonna had been given at once by mistake. The patient was

alarriugly ill for ;a week, but never suffered from the

diseaSe again, though twenty years have since elapsed.

Mr. Smith, visitor, house-surgeon to the United

Hospital, read the following case of diverticulum,

This content downloaded from 62.122.76.45 on Sun, 15 Jun 2014 02:04:34 AMAll use subject to JSTOR Terms and Conditions