« ZurückWeiter »
till I could obtain additional evi- these, it is not in my power to dence of the efficacy of the re- state ; the only one of which I medy. Having, in the mean time, have any knowledge, has been had many opportunities of pre- mentioned. scribing the remedy, I am now In a few cases, a single pint of prepared to make a more correct the medicated liquor is sufficient; estimate of its value.
sometimes a quart is necessary, With regard to the second and and occasionally several gallons third cases, the cure appears to are required to eradicate the habe complete; but I have not since bit of intemperance. met with an instance where so My usual practice is to add a small a quantity as was used in drachm of the acid to a pint of any the second case, had the desired description of liquor the patient effect. In the first there was a prefers : now and then I find it relapse several times; but a re- necessary to augment the quantity currence to the remedy invariably of acid to two drachmas to the excited the desired disgust. I pipt. The dose is a wineglassful have met with several other every one, two, or three hours ; cases, where a relapse ensued the interval between the doses at the expiration of three, four, being regulated by the quantity and six weeks ; but in the greater of liquor the patient has previousnumber of cases, the disinclination ly been in the habit of taking ; I to the use of ardent spirit has so always request that it may not be far continued. Some of the indi- taken to the extent of producing viduals have not indulged in their intoxication. An individual, about former favorite beverage, for three weeks ago, instead of atthree, four, six, eight, ten, and tending to the directions, took a twelve months. A single case of quart of liquor, containing two complete failure has come to my drachms of the acid, in less than knowledge ; in this instance, the two hours, and requested his wife use of the remedy was persisted to go for more, which she refused in for about a month, without oc- to do before the next day ; but on casioning the desired effect : the the ensuing day, he told her it dose, however, by this time, had was not necessary to get any become so extremely disagreea- more, as his desire for ardent ble to him, that he declared he spirit had ceased. No bad effect would rather have his hand cut was occasioned by so large a off than continue to take it : still quantity being taken in so short a no effect was produced on his ap- period. petite for liqnor which did not In one instance where the recontain the acid: I was surprised medy was directed without the to find, in this case, that the dose knotyledge of the individual, the was rendered comparatively pal- alteration in the taste of the liquor atable by the addition of a por- prevented its being taken : on tion of hop tea. Candor compels being informed of this circumme to say, that I have directed stance, I ordered a weak tincture the remedy in many cases, with- of ipecacuanha to be made, conout having been able to ascertain taining a drachm to the quart; the result. Whether or not there and as the taste of the liquor was dave boen failures among any of not perceptibly altered, it was
taken without suspicion by this effects, I am inclined to believe means, a considerable degree of that it contains, at least somenausea was kept up, and vomiting times, a portion of emetic tartar. was occasionally excited: he con We are pleased to find that a tinued to take it, however, till be society has just been established, finished two quarts; since which, in this city, for the purpose of he has felt no desire for ardent discouraging the nse of ardent spispirit; though it has repeatedly rit : from the conspicuous station been offered to him, he has uni- which many of its members hold formly refused it. I have suc. in society, joined to their well ceeded in four or five other cases known zeal in the promotion of with ipecacuanha ; indeed, I now objects of benevolence and public make it a rule to give the latter, utility, we anticipate much good where the patient refuses to take from their labors. It is quite the former, or where he is un- gratifying to observe so respectawilling to take any remedy; and I ble a number of medical gentleprefer it in these cases, because men in the list of managers. it can be given without the know The able report of a committee ledge of the individual, which is of the Board of Guardians of the often an important consideration ; Poor of the City and Districts of for I not unfrequently have appli- Philadelphia, recently published, cations from females, who are so contains the following important unfortunate as to have husbands remarks :addicted to intemperance, and yet “ Another indispensable instituso infatuated as to refuse to take tion remains to be established; we anything which they might sup- allude to an Asylum for the Inpose would deprive them of their temperate : this, if erected, and relish for spirituous potations. I properly conducted, would tend have succeeded in several cases to stop the progress of an increasof this description ; and to this ing and destructive evil. If full day, the individuals have not been powers were granted to its diable to account for their disgust rectors, to arrest and detain these to ardent spirit. I commence its brutalized beings, otherwise deuse by directing a drachm of pul- voted to shame and reproach, a verized ipecacuanha to be infused more effectual blow would be inin a quart of any kind of ardent Alicted on pauperism than could spirit, for ten or twelve hours ; be achieved by any other means ; after which the liquor is to be for drunkenness is the parent of decanted, and taken ad libitum : every crime, and disease and where a sufficient degree of nau- want its inseparable followers." sea is not excited, the proportion An asylum of this description, we of ipecacuanha is to be aug. are fully persuaded, would be mented.
productive of results the most I may here remark, that ipe- beneficial. cacuanha
W. D. BRINCKLE, M. D. constituent, in the remedy of Dr. Philadelphia, August 1st, 1827. Chambers, of New York, disguised with cochineal, gum ammoniac, From the Gaz. of Health, Lond., Sept., 1827. and some other unimportant arti For the following valuable comcles; and from its occasional harshmunication, we are indebted to
the experienced and scientific Dr. symptoms. Instances have ocKinglake, of Taunton.
curred of the kidneys having been Morbid Fallacies.---Three cases vastly augmented in size, and on have "lately fallen under my no- the contrary, of having been ditice, in which the cavity of the minished and wasted almost to anpericardium was wholly oblite- nihilation. Of the former derated by adhesive inflammation, scription, an example was rewhich had the effect of embar- cently afforded in this place, in rassing the action of the heart, which one of the kidneys had been so as greatly to enfeeble its con- gradually enlarging for upwards of tractile energy. An aching sen- twenty years, and had finally atsation was also experienced about tained, as proved by examination the pericardial region. The res- after death, so enormous a bulk, piration was occasionally quick- as to weigh rather more than nine ened and somewhat oppressed, pounds. The strange anomaly on with a strong tendency to fainting this occasion was, that though the on sudden or unusual exertion. patient was an experienced me
Dyspeptic symptoms, of the dical practitioner, no ailment was worst descriptions, with intestinal ever either felt, or suspected to constipation and a vitiated state exist in the region of the kidneys, of the biliary and the various en- but was uniformly and exclusively teric secretions almost constantly referred to that of the liver, inprevailed. These ailments were ducing the patient to observe, to indeed so prominently afflicting use his own expression, that he as to have induced a suspicion had been oppressed for many that the disordered feeling of the years with a heavy liver,' which, heart sympathetically emanated from its long duration and magnifrom them, leading to the fallacy tude, was held to be irremediable. of substituting the effect for the The urinary secretion was ex
tinct in the diseased kidney, but Each of these cases was under the other had undergone no strucclose medical observation for up- tural change, and seemed to have wards of twelve months, and sufficiently executed the natural eventually proved mortal. After office of both kidneys. In the death they were severally exa- circumstances stated, it is almost mined, when a universal adhesion incredible that the deception of the pericardium to the heart so should have been so complete as as to consolidate the two struc- to have persuaded the patient tures, was found to be the organic that the liver and not the kidney disease that had been chiefly cha- was the seat of the enlargement racterized by disordered feelings that had prominently intruded itof the digestive organs. No ma- self into the anterior part of the nifestation of disease presented in cavity of the abdomen. the other viscera, excepting a In another case, a diseased liplethoric fulness of vessels result- ver was supposed to exist under ing from a retarded and impeded circumstances that had long circulation.
threatened to prove destructive. In renal disease, much uncer- At length, life was terminated, tainty and deception often arise in when on examination, the hepatic speculating on the concomitant organ was found to be in a healthy
state, and one of the kidneys was fallacies so often occurring in disdiscovered to have been broken eased appearances. Two cases down in its structure, and its whole have lately presented themselves substance nearly wasted away by of oppressed breathing, harassing suppurative inflammation. No in- cough without expectoration, and convenience had been experienc- frequent palpitation of the heart ed in the region of the kidneys, with occasional tendency to faintand neither the patient nor his ness. These symptoms were medical advisers ever imagined supposed to justify the inference any disease in this situation, but of a morbid affection of the heart, confidently ascribed every morbid but on examination after death, feeling to hepatic malady. this viscus in each case appeared
A similar case presented itself to be free from disease, and in in a person of about thirty years both instances, the liver was exof age, who had suffered from tensively disorganized, the one protracted typhous fever. Con- enlarged and tuberculated, the valescence, however, at length other somewhat diminished in took place, but advanced slowly, size, and so unnaturally soft and and was occasionally interrupted flaccid as scarcely to bear the by symptoms of hepatic derange- pressure of handling without its ment. After the lapse of some texture giving way to the touch. months, a palpable effusion was It was of a dusky livid hue, was discoversble in the cavity of the deluged with blood, and exhibited abdomen, for which the patient more the appearance and consistwas tapped. Not more than a ency of this fluid when coagulated quart of serous fluid was abstract- than of the natural hepatic struced. Death ensued in the course ture. of about a week, when on exami Dyspeptic ailment prevailed in nation, one of the kidneys exhibit- both these cases ; but the ostened the destructive ravages of sup- sible and leading affection seemed purative inflammation, being gorg- to be within the thoracic cavity, ed with pus, and its bulk reduced and more particnlarly about the to less than a fourth of its natural region of the heart. A plethoric size. The liver was not appa- and an oppressed state of the abrently diseased. As in the for- dominal viscera from faulty dimer instance, no pain or complaint gestion and an impeded transmishad ever been referred to the re- sion of blood through the liver, is nal organs.
These, with nume- apt to disturb the action of the rous other analogous facts, are in heart and that of the pulmonary proof of the equivocal and incon- organ so as to induce the aspect clusive evidence afforded by mor- of original and severe disease in bid feeling. Original disease, and these viscera. the sympathetic disturbance ema A married female of the age of nating from it, are often so com- about twentyfive, had a long series plicated and blended as not to ad- of miscarriages continuing for a mit of being accurately distin- period of nearly three years.
guished from each other. To These accidents usually occurred • feel assured of the positive seat about the third month of pregnan
and nature of an internal ailment cy, attended and followed by a can hardly be warranted by the most painful state of uterine ex
citement. On these occasions, a In the other two, a similar expulsense of acute suffering was re- sion did not occur, but from the ferred to the lumbar vertebræ, exact resemblance of the circumwhich induced a suspicion that it stances under which the several arose from vertebral disease. patients unexpectedly sunk out of Caustics were under this impres- life, it may be reasonably infersion inserted in the back near the red, that the same kind of accualleged seat of pain ; the erect mulation had also distended the posture, and all locomotion were uterus, and equally occasioned a rigorously interdicted. At length, destructive effusion of blood into the customary miscarriage did not its cavity. happen, but the pregnant state Seasonable removal of this dipassed on to ultimate maturity, lating mischief by the hand, and and finally issued in the birth of a firm compression of the abdomen fullsized healthy child. From by suitable bandaging would prothis period, no disease in the back bably have insured the uterine or in any other situation was ima- contraction which would have obgined. Several future pregnan- viated the internal mortal hemorcies ensued, which proceeded to rhage, which unhappily supera favorable termination without vened the parturition. any intervening obstacle or alarm. Vaccination seems to be too in
The fallacy in this case was cautiously conducted to insure its occasioned by not correctly ad- permanent antivariolous efficacy. verting to the accidental miscar. The quality of the vaccine matriages and the painful effects re- ter is not sufficiently regarded. sulting from them, but hypotheti- It is commonly used as it can be cally and erroneously seeking an casually obtained, without
preexplanation of the obscurity that viously examining the person from had arisen, by speculating on whom it is taken, with a view to views and forms of disease which ascertain whether the state of the had no real existence. Undenia- skin is free from eruptive ailment ble and tangible facts can alone of any description, and the indiviconduct to truth and certainty, dual is free from any known diswhilst the mere semblance and ease. imagination of them, however The genuine preventive virus specious, may prove a baneful is generated in those conditions in source of delusion and mischief. which no countervailing influence
The lives of three females in from either latent or evident disthe upper rank of society in this ease exists. If the precise conneighborhood, were lately termi- stituent arrangement be impeded nated within an hour after partu- by any circumstance that is inrition and the removal of the pla- compatible with the real vaccine centa. No external flooding was product, its lasting agency in obapparent; but in each case, arte- viating the accession of variolous rial action rapidly sunk and alto- disease will be too doubtful to be gether ceased. In one of these entitled to confident reliance. instances, a coagulum of blood of Vaccine matter deteriorates by nearly the size of the child's head being repeatedly subjected to the that had been born, was expelled vital actions of the human animal from the uterus soon after death. economy. Its original strength