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kilogramme of slaked quick lime; a tube must be conducted to within a few inches of the bottom of this liquid, which must be stirred with a wooden spatula, to conduct the chlorine disengaged from a mixture which may be one half less considerable than that which has been indicated to obtain the chloruret of oxide of sodium the discoloring property of this liquid chloruret must be tested; it will be too strong for the disinfection of the wards and of putrid animal substances; it must be diluted with a sufficient quantity of water, and may be used for sprinklings."

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Having thus presented to our readers, at some length, an account of the nature and mode of applying these preparations for the purpose of destroying putrid effluvia, it remains that we should notice them as therapeutic agents. This, however, may be done very briefly; for the principle must be the same, or nearly the same, in every case.

The diseases enumerated by Mr. Alcock, as those in which the chlorurets have been beneficial, are such as are either liable in their progress to be attended by putrefaction, or by some peculiarly offensive odor, which perhaps reacts by aggravating the disease from which itself originated. Accordingly, in compound fractures, and all accidents to which an offensive, and sometimes even putrid, discharge may succeed, these preparations may be applicable. It is scarcely necessary, however, we apprehend, to inform our readers, as Mr. Alcock has done, that sprinkling a broken leg with solution of chloruret of soda will not set the limb.

The object at all times is in

the first instance to destroy an offensive odor; but in some cases it seems to have been used as a simple stimulant.

As usual with every new discovery, the French appear completely to have exhausted the subject. Almost every disease in which there is any odor, has been submitted to the influence of the chlorurets, and unquestionably in very many instances beneficial results have ensued. We shall do little more in the present paper than enumerate the affections in which it has been tried. These are hospital gangrene, phagedenic, syphilitic, and other ulcers, in compound fracture when unhealthy suppuration and offensive effluvia are present; diseases of the bladder and urinary organs; diseases of the uterus, burns, scalds, cancer, ozona, herpes, ulcerations with caries, ptyalism, and ulcers of the mouth, putrid sore throat, &c. &c.

The mode of employing the chloruret of oxide of sodium must be much governed by the nature of the parts. In general, it may be safely used when diluted with eight or ten times its weight of water; but this may readily be ascertained after the first trial. If it is unattended, by pain, the solution may be much stronger; and in some rare instances it may even be employed pure.

When injected into the vagina, it should be much diluted; sometimes even with thirty times its weight of water, and the solution may be rendered stronger, according as the patient becomes able to bear it. Mr. Alcock has quoted several instances of its utility in diseased uterus, but appears to us somewhat too sanguine in his opinion respecting it. That

by destroying the offensive effluvia of the discharge, however, it very greatly contributes to the comfort of the patient in diseased uterus, we are fully convinced by experience; nor, after the effects we have seen, do we think medical men will be justified in neglecting its use in these cases.

To those who wish for more ample details, we refer to the volume before us, which appears to contain everything that has been written on the disinfecting chlorurets.-London Med. Repository aud Review.

For the Medical Intelligencer. THE PAINS AND PLEASURES OF THE PRACTICE OF MEDICINE.

Pains. In every company you go into, to be reproached with the shortness of human life as the fault of your profession, especially just after you have been so unfortunate as not to be able to rescue a patient who has indulged every passion of which he was capable, and at last brought his system, like an old worn out kettle, to you to repair, but like this, too full of holes to place a patch on. -To be saluted every where, here comes the doctor, well how many has he killed to day?

Pleasures.-To be sent for a few days after by some one of these disturbers writhing under the torture of colic, putting himself completely in your hands as submissive as a spaniel; then to give him complete relief in the shortest time possible, and restore him to the happiness of indulging in a 4th of July dinner.

Pains. To wear out considerable shoeleather in assiduous attention on a patient whom you have felt quite anxious to save, and after doing it and handing in a

moderate bill, to have it disputed, or be put off from day to day, or hear that it is impossible to pay it, or that the family have moved nobody knows where, not even leaving their thanks as remuneration for the medicine.

Pleasures.--To be called on by a poor patient, perhaps a colored one, from whom you expected no return for your services, and be overwhelmed with grateful thanks and have your bill paid in full.

Pains. In your attendance on a patient who requires frequent visits, to be told by a friend that it is supposed that you attend oftener than is necessary to increase your bill.-On the strength of this by slackening your visits in another case, not very urgent, to be told that you are not thought to be sufficiently attentive, and that a consultation is desired by some of the friends.

In a case in which you have been consulted and have attended, on calling again, to find by the odd faces and broken sentences of the family, that another physician has been called in unknown to you, keeping him in the dark also, with regard to your attendance.*

-After unremitting and anxious attention on a lovely child whom you cannot save, to know that you have forfeited the good will of the parents, and perhaps too when the want of attention to your prescriptions may have been the cause of death, and where from regard to the feelings of the

*Two physicians meet at a chamber door." Sir, how d'ye do?"-" How not know that a consultation was called." d'ye do, am happy to see you,—but I did -"Nor did I,-I did not think my patient required it."-"Your patient, sir! attended for a week,"-" And I for eight the patient is mine."-" Yours, sir, I have days, sir."

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lessen this sum of evil, is, in the first place, to know that these instances of trying misconduct do and will sometimes happen to the best men,— and in the second, to preserve a consciousness that they are never deserved. The impropriety of this conduct on the part of the sick and their friends is not greater or more obvious than its folly. It indicates no greater injustice to the good phy. sician than it does blindness to one's own interest and safety. Who suffers most by these deceptive and disingenuous acts? The suffering of

the medical attendant is a moral suffering; he is indeed hurt and grieved to find that his best efforts to relieve his patient are thwarted and counteracted by those who should be as much bound by an enlightened regard to their own happiness, as by candor and courtesy to him, to cooperate with him.

This suffering however is greatly mitigated by the conviction that it is wholly unmerited. Time and events constantly tend to justify him who has done right, and to lighten the pain he first feels from ill treatment. Not so the pain of him who finds on a moment's reflection that he has both injured himself and another. This pain may increase with time, not only from conscious error, but from an internal and ceaseless struggle with a false and unprincipled pride, which prevents his making that acknowledgment of injury inflicted, and that explanation and reconciliation which can alone set his heart at ease with himself or with another.

Consistency in our own conduct

and candor towards others, are all that is requisite to avoid all this injustice and pain to both parties. If the patient has -reason to change his physician, let this be done in a proper manner; if he wishes a consultation, let this also be effected in like manner. What this manner is, a little common sense and good intention will generally be sufficient to decide. or if doubts remain, such an acquaintance with the rules of professional intercourse, as any one can obtain, will readily suggest a right mode of proceeding. A proper understand ing among all regular physicians with the observance of reciprocal courtesy and candor, would go far to check and disappoint that disposition, which too many are willing to gratify, to treat a worthy physician with treachery and baseness.-This disposition too is sometimes encouraged and strengthened by a want of selfrespect, and independence in a correct course of conduct, which is occasionally seen among physicians. This we deem to be equally injurious to the profession and the public. It favors insolence on the one hand, and lowers professional reputation and its power to be useful, on the

other.

ON BURNS.

The following judicions remarks on this subject are taken from Dr. Dewees' Treatise on the Physical and Medical Treatment of Children. Accidents from fire, or hot water, are so frequent and so sudden in their occurrence, and so dangerous oftentimes in their consequences, that it becomes important that almost every body should

have a knowledge of the modes of treating them.

The extent of such accidents must necessarily be various; connot be treated precisely in the sequently all cases of burns need same manner. A burn may con sist simply of inflammation; or it may be accompanied by vesications; or the mischief may be still greater, and the part may be killed.

The great anxiety when this should first be applied. Authors accident happens, is to know what differ widely in their opinions on this point; and opposite remedies in their turn are proposed, or tried. We shall not enter into the disputes on these points; but shall simply relate what we ourselves have found to answer best; and only name some of the other remedies, of which we have no experience.

When a part is merely inflamed, we have found the steady application of cold whiskey, brandy, alcohol, and even water, not only to remove the immediate pain, the inflammation, especially if it but sometimes quickly to remove be not extensive. If the inflamed portion of skin be considerable, the same plan may be pursued; but the relief will not be so sudden, though it may eventually be as certain. Wrapping the part in cotton, is highly recommended, but we cannot speak of it from experience.

most always apply the spirit of If vesications attend, we alturpentine a little warmed, to the part, and protect it from the air as quickly as possible, if the wound be considerable, and also, that the turpentine should not be applied to the sound skin. Should much pain attend, we give a suit

able dose of laudanum. We al-
most always allow the first dress-
ings to remain for twelve hours;
and when we open the sore, we
take care that it shall not be ex-
posed to a current of air, or a
cold atmosphere. Our
Our second
dressing consists of the basilicon
ointment, according to the recom-
mendation of Dr. Physick.

We are in the constant habit of opening the vesications by the point of a needle, before we apply the ointment. This kind of dressing is continued so long as the peculiar inflammation of a burn continues; or as the common people express it, till the fire is out. Should the discharge now become too abundant, a very common occurrence, especially if the surface be large, we use the cerate of Turner, or the simple cerate, in which a quantity of prepared chalk is incorporated.

Should the burn be deep, and of course the part killed, the basilicon is the best application till the parts begin to show signs of separation. But should the parts immediately round the injured part be much inflamed, we are in the constant habit of using the bread and milk poultice, till it subsides. When the inflammation is reduced to a healthy degree, we return to the basilicon, or to the cerate, till the part sloughs out. After this has taken place, we either use Turner's cerate, or the basilicon, or simple cerate, as the wound may seem to require. We use the first where the discharge is too abundant; the second, where it is deficient; and the third, where the suppurating process is going on kindly.

In extensive burns, the patient almost always complains of a sen

sation of cold. When this is the case, a free dose of laudanum should be given, and he should be placed in an atmosphere of a moderate temperature. The wound should be opened only when necessary. Should much reaction take place, all stimulating substances, animal food, or broths, should be withheld; and in some few instances, even bleeding and purging are necessary.

The consequences to be apprehended, or in other words, the prognosis of burns, are sometimes extremely difficult to pronounce

for they do not always endanger in proportion to their extent, yet they do so as a general rule. We once saw death in a very few hours, follow a scald over the region of the stomach. The wound was not more than four inches square; the whole of the cuticle was removed in taking off the clothes. The child made no complaint; on the contrary, it soon fell into a sleep, from which it did not properly awake before it died. A remarkable circumstance attended this wound; it appeared to heal over its whole extent, an hour or two before death.

Nor is the pain in proportion to the injured surface; on the contrary, small burns sometimes give more pain than large ones, owing doubtless, to the more or less destruction of the vital principle in the parts affected. My friend Dr. Physick and myself, witnessed a remarkable case of this kind, in a young lad, who had fallen into a soapboiler's cauldron up to his chin. He was quickly taken out, but complained of no pain whatever. He died in a few hours after the accident.

When burns become extremely

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