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MEDICAL INTELLIGENCER.

47

of the unskilfulness of the operator. ly result from inflammation and swellSo widely did this impression obtain, ing of the parts underneath the lasthat the surgeon ceased to be em- cia. The tension and distress arising ployed, and was obliged to leave the from the swelling beneath the lascia place where his prospects, previous- has, sometimes, required the division ly to the occurrence of this fatal ac- of the tendinous expansion of the bio cident, had been unusually promis. ceps near its insertion into the fascia, ing.

and extensive suppuration, burrowPuncture of a nerve may happen ing under the fascia, has called for a in the hands of the most skilful, as more free division of both fascia and well as in those of the uninformed, integuments. for the branches of the cutaneous Wound of a lymphatic vessel I have perves sometimes pass over the known to happen, although of rare veio, wheo their usual course is to occurrence, In one case a capillarg. pass under the vessel, and unlike aperture remained for some weeks the artery, which may be felt by its from which there was a constant pulsation, aod thus any deviation oozing of limpid fluid, capable of befrom the regular course be observed, ing restrained by pressure below the these cutaneous branches of nerves orilice, but not affected by pressure cannot be distinguished. The branch- higher up the arm. No other ines of the interoal cutaneous nerve convenience was experienced, and generally pass under the median ba- the aperture healed spontaneously. silic vein, whilst those of the exter

(To be continued.) bal cutaneous more frequently pass

ORRIS Root; CAUTION AS TO ITS Use. over the cephalic aod median cepha-, -Orris root is frequently used by females lic veins. A gentleman, who was and others, in large quantities, as a scent house surgeon in one of the metro. and it has' lately happened, that very politan hospitals, suffered for sever serious consequences were produced by al weeks painful and uneasy sensa

this practice. Dr. Armont lately read io tions in his arm from the puncture a case in which two young girls became

the Royal Academy of Medicine of France of a nerve in bleeding. I have paralytic and insensible, from having put heard of tetapus being an occasional à considereble quantity of orris root into consequence of this accident, but po their hair on going to bed.

When they instance of so severe a resolt has awoke in the morning, they were seized

with violent head-ache and giddiness, with come under my observation, although pain and heat in the throat, similar to the possibility of such an occurrence what is produced by Cantharides, and the cannot be doubtéd, koowing what younger of the two was completely parslight injuries sometimes give rise to alytic on the right side for more than five

hours. that formidable disease.

Puncture of the fascia, and its supposed consequence, inflamination of M. Dupuytren communicated to the Aca

SUBLINGUAL PUSTULES IN RABIES.-the fascia, have been described by demy letiers from M. Marochetti, of St. authors as sometimes taking place. Petersburgh, and M. Lefon, resident in The puncture I do not question; but Turkey, in which those physicians mainthat the symptoms usually ascribed tain that the excision and cauterization to this accident are really produced of the pustules that come under the tongue by inflammation of the fascia, 1 be. and they request the Academy to supply

in rabies, prevent the hydrophobic disease, lieve there is sufficient reason to them with the means of continuing their doubt; for whilst it is known that researches. M. Dupuytren observed, the fascia is much less vascular and that as the method of cure proposed was sepsible than the textures immedi preventive, he should always prefer the

excision and cauterization of the wounds ately in contact with it, the symp- to that of the pustules, which were by no toms usually described would certain. means certain in their appearance. M.

Honoré mentioned two cases of rabies in ERRATUM.–Page 35, second columa, which he could not find these pustules ei- 32d line, for vaccinia read caccina. ther in the individuals, or in the animals which had bitten them. Messrs Girard

WEEKLY REPORT OF DEATHS IN BOSTON. and Barthelemy said, they had not been

Accidental, 1-Apoplexy, 1--Consumpmore successful ; the latter, in numerous tion, 6–Dropsy in the head, 1-Fits, 2– experiments that he has made, during the Infantile, 1-Lung Fever, 1-Unknown, last three years, on dogs, and the former 3-Stillborn, 2. Males, 7–Females, 9. in numerous cases of rabies which occur. red during the late summer in the establishment at Altfort. M. Orfila, on the

Materia Medica. other hand, cited a case communicated by M. Marcq, in which pustules under the THE following are the general outlines tongue had been seen, and a cure effected by their cauterization. The Academy States, which has been written by Wilappointed a permanent Committee to in LIAM ZOLLICKOFFER, M. D. &c. &c. and quire into this subject.

which will, without any farther delay,

be published in the month of September. GALVANISM has lately been used, and The cause of its not having emanated with great success, in the treatment of from the press last fall, may be attriouted paralysis. A case is described in the to the intention that the author had in Revue Medicale, for May, 1825, in which view, of enlarging it, in order, if posssithe lower extremities were completely ble, to render it more useful and acceptaparalyzed. Nux vomica, digitalis arrina, ble. The work alluded to will contain and other remedies were employed in 240 pages, octavo, instead of 180, as was vain. Galvanism was then employed, formerly contemplated. It will, thereand after seven applications, the disease fore, be perceived, that the matter conwas completely removed.

tained therein has been increased in con

sequence of the delay. A letter from Huntington, S. C. dated CHAPTER 1. Treats of the improveMay 21, 1826, says, “ It is quite unheal- ments of the Materia Medica.-2. Modus thy in this section of country-Epidemic Operandi of Medicines.-3. Classification Influenza has been very prevalent since of Medicines. Christmas, of which a number have died Division 1- Chapter 4. Treats of Nar. --the disease is still prevailing- the wea- cotics.-5. Antispasmodics.-6. Tonics. ther extremely dry and warm, and the at- _7. Astringents. The four last chapters mosphere appears to be loaded with im- are included in the first division of genepurities."

ral stimulants.

Division 2–Chapter 8. Treats of EmeSTRENGTH OF Mes.-The strength of tics.---9. Cathartics.--10. Emmenasavages has frequently been represented gogues.-11. Diuretics.–12. Diaphoreas far superior to that of men in a state of tics.--13. Expectorants.--14. Sialacivilization : towards the end of the last gogues.-15. Errhines.-16. Epispastics. century an ingenious instrument, to which -17. Escharotics. The chapters includhe gave the name of dyna meter, was ed in the second division are such as treat invented by M. Regnier of Semur, for de- of local stimulants. terming with precision both human pow DIVISION 3–-Chapter 18. Treats of er and that of machinery. This was em- Refrigerents. The articles that are inployed by Peron in his voyage to New troduced in this division belong to the Holland, and this able navigator has chemical remedies, shown that the strength of savages is uni Division 4–Chapter1 9. Treats of Deformly less than that of civilized men. mulcents.-20. Anthelmintics. These

two last belong to the mechanical remeNew EMETIC.It is said that soap suds, dies. The classes of Antacids, Lithondrunk in large quantities, is a speedy and triptics, Diluents, and Emollients, have effectual emetic, well suited to cases of been omitted, from the circumstance of poison, and whenever else an immediate their not being materials that properly rejection of the contents of the stomach belong to these classes. is desirable.

The price of the work will be two dollars.

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MEDICAL INTELLIGENCER.

“ NON EST VIVERE, SED VALERE VITA.

VOL. IV.

TUESDAY, JUNE 27, 1826.

NO. 6.

ON THE OCCASIONAL ILL CONSEQUENCES the too early use of the arm; a foul
OF VENESECTION.

or rough laocet may be an occasion(Concluded from page 47.) al cause; it has happened that a lanInflammation of the integuments and cet armed with vaccine virus has subjacent cellular membrane, com- been used through mistake; constimrnly called festering, is the most tutional causes may, perhaps, prefrequent of the accidents resulting vent union, but when the requisite from bleeding. It may extend from pretautions have been used, I am a mere spot surrounding the orifice, well convinced the want of union sometimes to a considerable distance, will be of rare occurrence. I have and in degree may be slight or se- entered thus fully into the causes of vere. There is stiffness of the arm, festering, as, though mere festering attended with pain and swelling. is the least of the occasional ill conSometimes the lymphatic vessels sequences of bleeding, it is, as it and glands partake in the inflamma- were, the parent of greater evils. tion, and hence swellings in the ax The treatment consists in rest and illa, &c. occasionally supervene. I such means as will subdue the in- zbt bave not known an instance of this flammation of the part; if the inflam. affection of the lymphatics, from mation be not subdued, it not un 29 bleeding, where the oritice had beal- frequertly terminales in abscess. ed without sestering. If the sides of Abscess in some instances has pro

69 the orifice be accurately placed in ceeded to a dangerous and alarming 69 contact and be thus retained, without extent; I have seen the deeper parts being disturbed, for a sufficient time, at the bend of the arm laid bare to the want of union will be extremely an extent of several inches, by the rare ; but when it is coosidered how loss of substance occasioned by abapparently slight the causes are scess of the cellular membrane, and which may prevent union, the fre- sloughing of the integuments. In quency of that occurrence cannot one instance, the patient, who had excite surprise. If the sides of the beep bled as an ho ,ital out-patient, orifice be not in contact, they cannot was one of those unfortunate beings, ooite by adhesion, or, as it is tech- an Irish labourer, forming one of pically termed, by the first intention; the inmates of a crowded apartment, hence the wound scab3 or suppu. where everything was unfavourarates, and inflammation may recom- ble to health, and so great was the pany to a greater or less extent. coostitutional irritation, that for ma. Sometimes a small particle of fat ny days his life was in danger. He protrudes at the orifice, and if this recovered; but for seyeral weeks be not removed or replaced, union was unable to use the arm. is prevented ; any extraneous mat Erysipelas may arise from bleed. ter, such as particles from a dirty ing when the orifice does not heal sponge, blood coagulated in the ori- kindly. It bears the same charac. fice, or the compress 80 placed as to ters as when taking place on other separate the edges, may prevent parts of the body, and is generally union ; this may also be effected by connected with coostitutional de.

Fangement, on which must in a great was, perhaps, some difficulty in stopdegree depend the mode of treat- ping the blood. The arm was tied ment; but I have not kpown it to up, and directions gived not to untie occur when festering of the orifice it. In the afternoon he complained has not preceded. You are aware of stiffness in the arm, and in the that erysipelas sometimes termioates evening that it was painful. The in mortification and death.

paio increased so as to prevent him Inflamination of the brain is anoth- from sleeping, and his wife stated er of those dangerous consequences “ bis groans were dreadful.” Early of venesection, which bas in many in the morning he awoke his wife, instances terminated fatally. This, stating to her that the pain had been like the former accidents, has its ori- so great that he had not been able gin in the irritation and suppuration to close his eyes. She removed the of the orifice, which proceeds“ up- baodage from his arm, and he bewards in the course of the vein. Un- came somewbat easier. Sbe observless the inflammation be subdued by ed the arm was swelled. He passearly and judicious treatment, it ex- ed another restless nigbt. His wife tends along the course of the vein was obliged to leave him during the towards the heart, and dissection has day, and when she returned be said shown the vessel filled with pus as “he had suffered a martyrdom.” far as its termination in the subcla- She observed that the arm was a vian vein. Whether the pus thus darkish kind of purple for a hand's found be formed within the vein, or breadth above the arm, and red behas passed into it by the opeo ori. low it and very much swelled. His fice from whence the inflammation night was again restless, and next had proceeded, does not appear to morning (the fourth from the bleedhave been ascertained; but of the ing) the arm was black about a dangerous and fatal results of pusband's breadth on each side of the carried into the circulation we can- wound, and the upper part of the not doubt; and the experiments of limb was swollen very much. In M. Gaspard, related in an early vol- the course of his illness bis head beume of Magendie's Journal of Phys- came much affected. The further iology, afford demonstrative evidence details were such as mark the proop that interesting subject.

gress

of mortification. This poor unThe application of a compress fortunate patient was bled on Saturabove the punctured part bas been day, and expired on the following recommended, and a total division of Thursday, leaving a widow and three the vein has been suggested by Mr. children without any means of supAbernethy, as a mode of treatment port. which may be proper; but I should The treatment, I fear, will not rather trust to those means which bear scrutiny. From Saturday till might subdue the inflammation. Tuesday the time was unfortunately

Strangulation of the limb by undue lost, nothing having been done ; and or excessive tightness of the bandage the widow, in deploring her loss, exafter bleeding, bas not, so far as I pressed her grief that her husband, know, been noticed by authors; a fac although anable to leave his bed and tal instance occurred in an out-pa. notwithstanding her repeated solici. tient of one of the metropolitan hos- tation, had not been visited by any pitals, in the summer of 1822. The of the principal surgeons of the Hospatient was so slightly indisposed as pital where he had been bled, till to have continued his employment within an hour of bis death. up to the time he was bled; he was In viewing this melancholy case it bled by one of the pupils, and there may serve to impress upon our

minds the necessity of attention even ged in public as well as private practo the smallest details, upon which tice, my pupils have not had the opthe welfare of a fellow-creature may portunity, nor, I believe, the inclidepend.

nation to be idle. One of them, It is probable that the difficulty in who, during the period of more than stopping the blood might arise from nine years, has been my pupil and the orifice being made larger than my assistant, and whose habitual atnecessary; this circumstance, and a tention to bis professional duties has laudable anxiety to prevent after. wop my esteem, has, during that pebleeding from the wound, might lead riod, had occasion to perform veneto the undue tightness of the band- section in thoạsands of instances, and age; this, and the caution given not without one single untoward accito untie the bandage, allowed the dent; his junior, one of your fellow

mischief to go on increasing, whilst students, now present, has kept an · the patient bore the pain for many account of more than eight hundred

hours with great fortitude, till he no . instances in which he has performed longer could support the suffering. blood-letting, and he assures me that * Even here all might bave been re- only four of these have festered, to trieved, had he been fortunate enough which may be added one in which, to receive judicious surgical aid, but inflammation of the parts under the much valuable time was lost, and fascia required rest of the arm for when competent assistance was ob- two or three weeks. No serious tained, it was too late.

accident has occurred. The case of The gradual increase of pain and wounded lymphatic occurred in my swelling whilst the bạpdage was con- practice, but whether in my own tinued, marks the progress towards hands, or those of my pupils, I do strangulation, and whether the ban- not recollect, for l profess to have dage be used after bleeding, or as no superiority in what they have part of the dressing of an accidertal been instructed in, for I have no sewound, or of a fractured limb, and crets to withhold. whether it be too light at first, or Jo expressing my belief that the become so by the gradual swelling ill consequences occasionally sucof the limb, still the injury may be ceeding renesection may, by proper lo that extent to endanger the limb, care, be almost wholly avoided, i or even the life of the upfortunate speak from no limited experience; sufferer.

but far from thinking there is any From what bas been shown, it is merit in having possessed ample opobvious that simple as the opera- portunities, I am the more convinced tion of bleeding may be considered it is the imperious duty of every when perfectly performed, yet dan- one who enjoys such advantages, to gerous and even fatal consequences render them subservient to the welhave resulted from errors apparent- fare of others. Since all are liable ly very trivial in the outset." "I have to err, there is no need, in alluding Endeavoured to trace the causes of to errors of practice, to hurt the these errors that you may avoid feelings of individuals, the object bethem. The principle I have habit ing to prevent the recurrence of siually acted upon has been, where milar evils, but the surgeon who the responsibility rested upon my conceals the errors he may have self, to let instruction, careful and as- fallen into, or which he may have aiduous instruction, precede practice, observed, is as blameable as the piby which I have avoided many anxi- lot who should conceal his knoweties which must otherwise have ledge of rocks and shoals wbich had fallen to my lot. Many years enga. caused shipwreck and destroction.

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