103

In other instances, a sore or excoriation will have healedentirely, when the patient or surgeon may be surprised at thecicatrix becoming gradually indurated until a cartilaginousmass is formed, but confined to the situation of the sore whichhad previously existed.

In whatever manner indurated chancres may have com-menced, their progress is usually characterized by little, ifany, pain or discharge. The consistence of the indurationseems to increase, as well as its extent, until it becomes likea piece of cartilage of a clear pearly colour; no vessels canbe seen permeating it, and in this respect it differs from thesurrounding surface. In some of these cases the ulcerationwill heal gradually; in others, it will increase to a considerableextent, or it may remain stationary, in spite of all our localmeans to assist cicatrization. If no mercury be given, andthe case allowed to run its course, secondary symptoms willappear in a few weeks, and after an indefinite time, the indu-ration may abate, and ultimately disappear. If, however, notreatment is pursued, or if friction of this indurated massaccidentally follows, ulceration will occur, depending, as Ibelieve, on stimulating applications, or excessive inflammatoryaction, or unusual rapidity in the induration, incarcerating, asit were, the distended cellular tissue within the areolae ofthe infiltrated dermis, and causing mortification of the part.(See Plate 2, Part II., of author’s work on " Venereal Dis-eases.")When mercury is given in the manner hereafter to be

recommended, we witness a very peculiar effect on the indu-ration ; the circumference of the indurated mass becomesredder than usual; there seems to be increased action of thevessels; the transparency becomes less and less, and absorptionof this interstitial deposit takes place rapidly, particularly if ithas existed only a short time. But it does not take place sorapidly as it was deposited.

COMPLICATIONS.

Indurated chancre is attended with fewer complicationsthan most other forms of primary syphilis. As above ob-served, inflammation is rarely met with interfering withthe course of induration. Bubo is an uncommon occurrenceand when present, is, like the attendant sore, a very chronicaffair. One gland may slightly enlarge and continue irthat state, but we seldom find it suppurating, unless by th(negligence of the patient. One of the most common anc

sound parts in the vicinity. In fact, it marks the part most recently con-taminated, which has not yet passed into ulceration. In the progress ofthe case, the induration spreads first, so that no parts are involved in theulcer until they have previously passed through this chance of texture. A

primary venereal sore is scarcely ever stationary. The ulcer itself may bestationary, but careful observation will detect a gradual increase of thethickened base. which proves, no less certainly than the enlargement of theulceration itself, that the virus is steadily extending." It is not very un-common that a primary venereal sore should assume the following charac-ter :—A portion of the prepuce, of about the size of a silver penny, shallbecome slightly thickened, so as to lose its natural flexibility, and perhapsthe surface shall be slightly excoriated. In the course of a few days, if thepart is kept very elean, the excoriation shall in many cases disappear;but the hardness shall progressively increase, assuming; a more defined cha-racter, and at last forming; a large fla’ mass, of the size of half-a crown, soinflexible and rigid, that the prepu^e cannot be everted without difficulty.There shall be no trndrrness, no inflamrnation, som times no ulceration atall; at other times only a slight dark excoriation of the surface. Yet thecase shall be venereal. In this case the aspect ot the part bears no obviousresemblance to that of a common chancre, yet the difference is more appa-rent than real. The venereal virus produces the usual induration, but fromthe slowness of its progress, and the absence of inflammation, the induratedportion does not pass into ulceration. With this single exception, thecourse of the disease is the same as that of an ordinary chancre."—Babing-ton’s Notes to Palmer’s Editinn of Hunter’s Works, vol. ii. p. 321.

Ricord, after describing indurated chancre much in the same way asBabington, goes on to say-,’ Cette induration est parfaitement ciretilaire,quand elle siège dans du tissu cellulaire lache et qui cède egalement danstous les points de sa circonférence; mais pour peu qu’elle rencontre destissns plus denses on qu’elle eprouve des compressions, elle varie de forme,peut devenir elliptique, ou ressembler a une crête, comme on en voit de fré,quents exemples :a rainure de la base du gland. Dans tous les cas, elle estplus étendue que 1’utcerarion qu’elle supporte, et quand elle soulève celle-ci,il en resulte une variete de l’ulcus elévatum. Quoi qu’il en soit, cette in-duration specifique du chancre donne au toucher une sensation élastiquepartictiliere et caracteristique qu’on reconnait bien quand ou 1’a une foiséprouvé. et qu’on ne confond que rarement avec l’œdème dur et le tissu in-odulaie, qui s’en rapprochent le plus. Jamais, dans aucun cas un chancren’est precede de eette induration comme 1’avance M. Babington ; bien pluselle ne survient guère qu’apres Ie cinquième jour de 1’infectinn, et le plusordinairement plus tard. Ce qui a pu tromper quelques observateors, cesont les ca" dans lesquels la maladie avait débuté dans nn follicule dontl’orifice avait pu d’abord s’ohliterer ou êlre le siege d’une tres petite utcera-tion ; ceux ou el’e avait pris naissance dans le tissue cellulaire dans unvaisseau lymphatique oa dans un ganglion, circonstances dans lesquelles,comme je fai dit ailleurs, il se forme autour du point infecte. une surface dechancre et un coque induree ou espèce de kyste calleux : et enfin ceux ouil survient des ulcerations consecutives sur les indurations qui peuventrester apres la cicatrisation des premiers chancres."-Hunter, with Notesby Bicord, p. 423.

tiresome complications is a general or partial thickening ofthe prepuce, preventing the patient from retracting the fore-skin, thus allowing the secretion to accumulate, particularlyif the indurated masses are at the orifice. I have abovealluded to the ulceration of the surface of the sore, and neednot here, therefore, speak of it.Queen Anne-street, Cavendish-square, July, 1845.

REVIEWS.

Abstract of Researches on Magnetism, and on certain allied Sub-jects, including a supposed new Imponderable. By BARONVON REICHENBACH. Translated and abridged from the Ger-man by Dr. GREGORY, F.R.S.E. London : Taylor and Wal-ton, 1846.

IT has been our misfortune, during the last few years, to havewitnessed in many instances the errant fancies, the eccentricwanderings from the paths of science, of many men who hadpreviously illumined and made easy much that was obscureand difficult therein. It has been likewise our duty to tracethe strange proceedings of some of those fallen philosophers-to have discovered in them the workings of some latent am-bition, or of a cursed thirst for praise, leading them to torturesome chimera of their own or of another’s brain into the formand shape of a scientific reality-and, duped or duping, to bedeservedly despised. It is painful to add another to the list oflost ones. Baron von Reichenbach-a name once favourablyknown to the scientific chemist-announces the discovery of anew imponderable agent. This greatest even of Germanwonders proves, however, but an old acquaintance-it is mes-merism, in a disguise, skilfully arranged as an elaboratescientific inquiry to cover the fallacies and the follies of thissilly subject, which seeks now to dazzle and to blind underthe prestige of a new magnetic light. Indeed, to reduce thevolume to its level, it is little more than a history of mes-meric experiments, being the effects produced on a number ofhighly-sensitive and nervous females subjected to certainmental processes. It is but the old story of the woman hood-’winking the philosopher. We find those young ladies, whobore the appropriate and suggestive names of No-wot-ny,Maix, and Sturman, conscious of the existence of this newimponderable, which they observe in magnets, in crystals, inthe sun, in the human hand, and, as might have been ex-pected, in the moon. We have over again the usefulness ofmetallic tractors, urged with sufficient force of argument todraw the very shade of Haygarth from its tomb. Let us,however, before going further, grant for a moment the truth ofall this; and let us ask what are the tests, and where is the

proof, of the existence of this new imponderable ? Has this

power been insulated ?-what is its influence on the molecular

arrangement of matter? It must have some, as it must form a

necessary constituent of matter. We find these importantquestions answered only by the effects produced on a numberof hysterical young women-styled by the Baron (not Du-potet, but Reichenbach) " nervous," " cataleptic," " subject tohysterical spasms," to " hysterical paralysis," " lunatic," " som-nambulistic," and altogether most suitable subjects for thedevelopment of shams-in fact, the very class of persons whohave deceived in England such numbers of weak-headed indi-viduals. If anything can be considered decided in medicine, itis, that the statement of a nervous patient as to a peculiar sen-sation, or its absence, cannot be considered as worth anythingin evidence of the existence of an abnormal state; and yet, ofsuch statements do M. Reichenbach’s discoveries consist.

Strange idea, to introduce from Germany such stuff to anEnglish public !-strange indeed, as if we had not a sufficientnumber already of subjects of our own-young ladies and oldladies-ladies with blue stockings, and ladies without,—ay,ladies, in themselves a very infirmary of sensations, and allsusceptible, usque ad unguem, of a moulder’s influence !We must instance a few of the author’s results. He finds,

104

that a young lady, sufficiently sensitive, may be considered asa modified piece of soft iron wire;--happy ductility for happierwould-be Benedicks ,·-that, contrary to experience, gold andsilver coins appear amongst the list of inert articles; that it ispossible to light even a cigarwitha magnet; thatMahomedans,in sleepingwith the head towards the east,are using a most un-comfortable position; that the sun’s rays are erroneously con-sidered warm; and that several sensitive persons, like first-class London exquisites, experience great difficulty and annoy-ance in walking towards the east. Our readers, after all this,will not be astonished at hearing " that positive bodies causewarmth," but they could not have anticipated from this that"the same thing is true,m1ltatis Tnutai?disof the negative bodiesand those which cause cold," (p. 95.)

It is poor comfort to know now,that from the time of Adamto the present,we have been labouring under a delusion, or thatthe seasons are altering, as now " the sun is strikingly cold,the moon as strikingly warm." On this point, however, thereseems to be a difference of feeling in the regions of the space,as we are told that " the fixed stars agree with the sun, the

planets with the moon," (p. 95.)A comet, hereafter, may be considered--unlike, we fear, our

author—" a reflecting body." All fire "affects the sensitive ata certain distance with a sensation of cold," (p. 100,) and Mdlle.Reichel, one of the sensitive patients, is almost frozen whenshe goes near a heated stove. At times M. Reichenbach seemsto entertain some doubts of the truth of his statements, as weread in the next page,that, according to Mdlle Atzmaunsdorfer,"the author’s whole right side was cool and negative, the left,warm and positive,"-this being perhaps a philosophic explana-tion of the expression, " I have half a mind to do so and so."It is truly interesting, amidst such a mass of results, to learnthat the ideal flames of the poets are dim hints of the real deve-lopment of caloric, which takes place from the sensitive lips ofardent swains and loving lassee. Sleep is " a dislocation ofvital activity," a reduction of which must, no doubt, takeplace every morning. But enough of this; the reader canjudge of the nature of this new imponderable, of its influenceand the mode of its development. We feel performing a dutyin tearing off the electrotype of science which is thrown overthis worthless mass ;-of again lmmasking disguised quackery,and placing in its fall the discoverer of creosote beside thesprawling advocate of the same, the Mesmeric Harveian orator.

CHEMISTRY, PHARMACY, ANDMATERIA MEDICA.

AMORPHOUS QUININE.COPY OF A LETTER FROM DR. NATORSS, OF BERLIN, PRIVY COUNCILLOR,AND MEMBER OF THE BERLIN BOARD OF HEALTH, ON THE MEDI-CINAL PROPERTIES OF AMORPHOUS QUININE.

"You tell me that you are desirous to know whether I con-tinue to employ the uncrystalline alkaloid of the cinchonabark, and what are the results of my experience respectingthe therapeutic effects of this remedy. In answer to yourinquiries, I am happy to communicate the following facts :-

" The late Mr. Reidel, pharmaceutical chemist, was largelyengaged in the manufacture of the various preparations ofcinchona bark, and he obtained an uncrystallizable residue,incapable of further purification. Thinking that this sub-stance might be employed as a remedy, he furnished me witha considerable quantity, for the purpose of making experi-ments in my practice amongst the poor peasantry. It hap-pened that just at that time an epidemic intermittent feverwas raging in Berlin and the neighbourhood, which gave mea most favourable opportunity of testing its anti-intermittentpower; and I was quite astonished at the extraordinaryeffects of this new substance. Another physician, Dr. Skil-ling, physician to the forces, made at the same time similarexperiments with it, and obtained the same results. As thefever was excessively prevalent in the villages around Berlin,many of the proprietors to whom I am physician applied tome to furnish them with a remedy against the disease. I

prescribed the new substance in question, in solution, as I

will presently explain ; and the result was, the rapid dis-appearance of the malady from their estates. The reputationof these cures at that time extended so far, that the peasantscame from forty-five to fifty miles’ distance to fetch thefever-drops.’ One proprietor of a large estate near Warsawhearing that an epidemic fever had broken out amongst hispeasantry, forwarded large quantities of the fever-drops; andhe was soon gratified with the intelligence that the use of thisremarkable remedy had been attended with immediate success.

’ " I now employ this substance only, to the exclusion of allother preparations from bark, quinine, &c., in all cases of in-termittent fever; and I can boldly assert, that in the expe-rience of many years it has never disappointed me. It hasthis great and inestimable advantage, that one can determinewith absolute certainty, by administering it, that the recur-rence of the attack shall be prevented. No other preparationof bark, and no other remedy that I know of, will enable usto say with positive certainty that the next expected accessionshall not take place. Moreover, it prevents the occurrence ofrelapses, more than any other febrifuge ; and in many thou.sands of cases in which I have had occasion to employ it, Ihave never seen the cessation of the fever followed by un-pleasant sequelae. My way of prescribing this remedy is in aspirituous solution, of which I mix one ounce, with acid ofHaller, a drachm; peppermint-water, three ounces. Ofthese drops, I give in quotidian fever a teaspoonful every hourfrom the commencement of the perspiratirnz; in tertian, oneevery two hours; in quartan, one every three hours." When the attacks have ceased, which I feel almost inclined

to assert is uniformly the result of the administration of thisremedy, I always give a teaspoonful of the above mixture everynight and morning, until there is no longer any fear of a relapse."I have also experienced the efficacy of this remedy in

fevers of a sporadic origin ; and I and many physicians ofBerlin employ it as a tonic in all cases where we used to fre-scribe any of the other forms of bark.

" I will not presume to pronounce on the chemical nature ofthis uncrystalline body. I suspect that’ chinoroth’ plays animportant part in it.

" Should you deem any further or more minute informationrespecting this matter desirable, I shall be happy to supplyyou with all I know. You are at liberty to publish or makewhat use you think proper of this communication."I may add, that this substance will be introduced into the

next edition of the Prussian Pharmacopeia."

THE USE OF CHARCOAL IN THE TREATMENT OF CONSUMPTION

is recommended by a writer in the Boston Medical and S’2ar-gical Journal, with such modesty and apparent truthfulness asregards its value as a therapeutical agent, that we are inducedto extract the passage in which his view is expressed. The

remedy may deserve a trial midst the thousand and one otherswhich claim attention:-" Within the last two years, the writer has prescribed char-

coal as a tonic, and with such well-marked good results,especially in cases of consumption, that he is induced to invitemedical practitioners to test its remedial powers, and reporttheir experience, even should they not find it so well deserving

’ of attention, as he has been forced, from a close observation ofits effects, to consider it.

" In six cases of tubercular consumption in which it hasbeen used, and in which the writer had frequent opportunities

, of witnessing the results that followed its administration, he is, satisfied that it possesses the power of lessening profuse sweats,and of resisting emaciation. He will not claim for it the

virtue of entirely arresting the former, or completely prevent-’ ing the latter symptom of phthisis; although, in one of the cases. in which it was given, the symptoms alluded to were arrested, from the commencement of its exhibition; and increase of. flesh was plainly manifest, after a few weeks of its continuance.i " In two of the cases the tubercular irritation is suspended.- The patients believe themselves to be entirely free from dis-- ease, after having been so much reduced as to be obliged to’ confine themselves, almost constantly, for a number of weeks,. to their beds, and having suffered for months from all thet characteristic symptoms of tubercular phthisis-a disease which had proved peculiarly fatal in each of the families of- which the individuals referred to were members.r " The charcoal has usually been directed to be taken finely, powdered, in drachm doses, three times a day; and whenever, it appeared to occasion the least irritation to the bowels, a few) drops of paregoric have been administered with each dose.[ On the other hand, costiveness has been obviated by combining[ with it, occasionally, a few grains of rhubarb."