ADVERTISEMENTS. SOM THE MEDICAL RECORDER. Nullius addictus jurare in verba magistri.-Hor. NOME time ago, a premium was offered by the conductors of the Medical Recorder, for the best Essay on Typhous Fever, agreeably to which several essays have been received. It was intended to have published the successful one in number 40, now in the press; but owing to the quantity of matter now on hand, besides Reviews, Analysis of late foreign publications, the time of receiving essays is extended till the 10th day of October next; this will not only give a longer time to candidates, but will afford those who have handed in their essays, an opportunity to make corrections or additions. The successful essay will be published in number 41, for January, 1828; and in all probability, one or two other prize essays will be published at the same time, several having been received agreeably to an offer made in January, 1825, namely, that gentlemen might have an opportunity of writing on any subject best suited to their views; that is, the choice of the subject was left entirely to candidates themselves. Essays offered under this arrangement, that might be considered papers of merit, and calculated to promote the science of medicine by their publication, are entitled to fifty dollars, to be paid in books. names to make the journal appear more national, at least one hundred of the most respectable medical gentlemen in the United States, might be given as collaborateurs; but the fact of its having been published ten years, during which time many attempts have been made by medical schools and particular sets of men, to get the work under their control,—one party after another have commenced other journals, nearly all of which have died. From these circumstances, it is not deemed necessary to call in a reinforcement of names. The Medical Recorder will continue to be devoted to the interests of science and the cause of humanity; on these, and its merits only, will a continuance of patronage be asked. It is "not under the thraldom of any scholastic dogame, wor pledged to support any particular institution to the prejudice of another. In fine, it is exempt from circumstances which too often attend works of this description, the promulgation of error under the imposing influence of names, &c." At the same time, it is expressly stated, that, to show perfect impartiality, and throw open a fair field to honorable competition, the only legitimate course to arrive at correct principles, its pages are open to all honorable and respectable institutions. Candidates for the prize essay on the articles of the "Indigenous Materia Medica of the United States, embracing their practical application," &c. will please to reThe above being a standing rule, the collect that their dissertations must be deattention of the profession is particularly livered on or before the first day of Januacalled to it, as being, perhaps, one of the ry, 1828. The premium Hospital Report best modes of "enlisting the medical ge- will be received at any time most suitable' nius and learning of our country," and of to the authors. For more particulars conmaking the journal truly National. A cerning the prize essays, see Recorder, number of papers have been published number 39, page 197. under this arrangement, by gentlemen of the first literary talent in our country; many are also now engaged in writing expressly for this department of the journal. By this, it will be perceived, that premiums are not only offered for essays on particular subjects, but that all contributions of merit have been, and will continue to be liberally paid for. The journal will continue to be conducted in its usual independent manner, giving an analysis of the American Medical Journals, also, those of Great Britain, France, Germany, &c., embracing all the important practical information they con tain; for which purpose the journals of these countries are regularly received, as may be seen by an examination of the numbers of the Recorder. The Medical Recorder contains upwards of 250 pages, each number. Terms, Five Dollars per annum. ADDITIONAL ARRANGEMENT. N. B. Should any Medical or Surgical information, either in this or any other country, be promulgated between the regular times of publication of the numbers of the Recorder, and it is deemed necessary to lay the same before the profession immediately, it shall be given in an extra form. This arrangement will no doubt be satisfactory to subscribers, particularly to those who may be desirous to have monthly Journals, so as to have early information, &c. RICHARDSON & LORD receive subscriptions and are agents for the above Sept 1 Was it considered necessary to procure work in Boston. Published weekly, by John Cotton, at 184, Washington St. corner of Franklin St. MEDICAL INTELLIGENCER. JOHN G. COFFIN, EDITOR. DEVOTED TO THE CAUSE OF PHYSICAL EDUCATION, AND TO THE MEANS OF PREVENTING AND OF CURING DISEASES. VOL. 5. TUESDAY, OCTOBER 16, 1827. NO. 22. DISEASES PRODUCED BY LEAD. By MM. LERMINIER and G. ANDRAL, fils. Paris, 1827; as taken from the Medico Chir. Review, for July, 1827. THE divers preparations of this metal, our authors observe, which are introduced into the animal economy, in a state of extreme division, produce, both in the digestive organs and other parts of the body, a host of anomalous and strange affections, the cause of which has been too confidently attributed to chronic inflammation of the intestines. To this pathology of the diseases produced by lead, the attention of physicians has been almost exclusively directed; but our authors think that the facts which they are enabled to bring forward, on this occasion, may perhaps shake the foundation of this exclusive pathology. COLICA PICTONUM. What is the best mode of treatMent? Are the means which remove the colica pictonum adapted also to remove the consecutive or primitive affection of the nervous system? Is the colic produced by copper, in which disease there is diarrhoea, instead of constipation, to be healed by the same remedies as colica pictonum? Finally, do not the symptoms and the treatment of the class of diseases under consideration, and the state of the intestines after death, throw some light on the nature of those various abdominal pains which cannot be accounted for as the results of either peritonitis or enteritis? 1. POSTMORTEM APPEARANCES. We are told that, in those who die of colica pictonum, the intes tines are found contracted in their calibre. Traces of inflammation, The history of the disease has indeed, have been found in some. been traced with care by many cases, but not in others, hence writers; but still the following we may conclude that the phloquestions may be asked:-What gosis is only an accidental comis the nature of the disease? plication, and not necessarily conWhat is the exact condition of the nected with the disease. Of digestive tube, in those who fall more than 500 individuals who victims the malady? What have been affected with colica sort of lesions are those which are pictonum, during the last eight consecutive, and especially of the years in LA CHARITE, five only nervous system? Are these dis- have died, while under treatment orders of the nervous system al--and two of these did not die of ways consecutive of the disease the colica pictonum, but of comin the digestive organs? Are plaints quite independent of this they not sometimes primitive? disease. Case 1.-A painter, aged 33 years, had been already twice at LA CHARITE for the treatment of colica pictonum. He came in for the third time, in the year 1820, presenting all the usual symptoms of the disease, as violent abdominal pains, not augmented by pressure,--shrunk state of the abdomen,-vomitings,-obstinate constipation,-tongue natural,--pains in the limbs,--apyrexia. He had no motion during the last fortnight, and the abdominal pains were of five days' standing. He had taken castor oil, without effect. Immediately after his entrance, he was put on the usual treatment of LA CHARITE. On the third day, he com. plained of sudden and unusual pain in the region of the heart, and in a few minutes afterwards he expired. Dissection.-It was found that the root of the aorta, within the pericardium, had given way, and this bag had been filled with blood. A most careful examination was then made of the parts concerned in the original malady, as this was the first time they had had an opportunity of examining a patient who had died during the treatment of colica pictonum. They were rather astonished to find a total absence of all contraction or straightening of the intestinal canal. The knuckles of the great and small intestines were, on the contrary, more dilated than usual. The peritoneum was healthy. The internal surface of the stomach was pale, and of natural consistence and thickness. It was covered with ropy mucus. The duodenum was sound in all respects. In a few points of the small intestines, there were faint and very trifling arborisations of the vessels under the mucous membrane. The large intestines contained but a small portion of hard fecal matters. Now this patient died when the colica pictonum existed in a very intense degree, and there could scarcely be said to be a blush of redness on the mucous membrane of the intestines, and that too, after the patient had been taking drastic purgatives. It cannot be said, in this case, that the mucous membrane, had been blanched by the hemorrhage of which the pa tient died; for there were not eight ounces of blood in the pericardium. Case 2.-A man, of middle age, who worked in a white lead manufactory, had experienced, for some days, acute abdominal pains, and all the symptoms of colica pictonum. The disease was so well marked that the house pupil noted it on the man's ticket the day he came into the hospital. The very next day this patient was seized with apoplexy, and died in fortyeight hours afterwards. Purgatives and glysters, in this interval, had procured no stools. Dissection.-A large extravasation of blood was found in one of the hemispheres of the brain. The internal surface of the stomach presented a slight degree of injection, towards the great CUL DE SAC. In other respects this membrane was in its natural condition throughout. The mucous membrane of the small-intestines presented some slight traces of injection, particularly in the venous system. The membrane was otherwise pale throughout. The same was the case with the large intestines. There was no contraction of calibre in any part of the intestinal canal. As far as these two cases go, they certainly afford no ground for considering colica pictonum as dependent on enteritis. Case 3.-A man, 50 years of age, a plumber by trade, entered LA CHARITE, for violent colicy pains, under which he had labored for some days. The common treatment of the hospital was commenced. On the third day he was relieved a little, but still suffering severely. In this state he was taken suddenly with nervous symptoms of a grave character, which carried him off in two hours. On dissection, the mucous membrane of the stomach presented nothing particular. In the intestines, a few insulated points were injected red, but not to such an extent as to show the color through the peritoneal coat. The rest of the tube was transparent. In the transverse arch of the colon, there were a few inches of the inner membranes red. No other appreciable alteration could be found in any of the three cavities. In this case it will hardly be contended that the post mortem appearances could at all account for the symptoms of colica pietonum during life. Case 4.-A ship painter, aged 38 years, entered LA CHARITE, for the treatment of colica pictonum, the symptoms of which were very well marked. On the succeeding day he had an attack of epilepsy. For some days afterwards the abdominal pains continued their course, but were not very severe. The usual hospital means were employed. Ten days after he entered the hospital, the colica pictonum still in existence, the man fell down suddenly and died. On dissection, the mucous membrane of the stomach, near the pylorus, was of a slate color, in a space double the size of a crown piece. The small intestines were pale, with the exception of a few spots of injection, and a few of the valves of Peyer, with minute black spots in their centre, near the valve of the colon. The internal surface of the transverse colon presented a small patch of red, and there the mucous membrane was softened. It is needless to observe, that more strongly marked appearances of inflammation than the above are often seen, where no colica pictonum, or any symptom of enteritis existed during life. Case 5.-A plumber, aged 50 years, had had attacks of colica pictonum several times, and was now in the third week of an attack, when he entered LA CHARITE. The pains were not severe, but they were constant, and exasperated from time to time, so as to cause the patient to cry out. The constipation was obstinate, and the upper extremities were paralyzed, as to muscular power. The ordinary treatment of the hospital was commenced. On the 4th day, he was seized with symptoms of asphyxia, and died suddenly. The stomach was found distended with fluids. Toward the great cul de sac, there was a portion of the mucous membrane softened, though white, except two small round spots. All the rest of the gastric mucous membrane was of natural appearance.. The intestines, small and large, were dilated rather than con tracted. In the mucous mem- stances, in the locomotive as well brane of the small intestines, there were some injected patches. The rest of the membrane, throughout the whole canal, was unaltered. Thus, in the whole of these five cases, there were evidently no post mortem changes to account for the symptoms of colica pictonum. To these five, our authors add one, observed by M. Louis. The patient was in the eighth day of an attack of colica pictonum, when he died suddenly. No disease was found in the intestinal canal. SYMPTOMS. Our authors do not enter into an analysis of the common symptoms of this disease, which are so well known; but confine themselves to remarks on some particular phenomena. They observe that it is not correct to say that the abdominal pain, in colica pictonum, is always diminished by pressure,-in some, pressure increased the pain. Yet, in all these cases, the other phenomena of the disease were similar. Neither is it true that the abdomen is always shrunk in the malady under review. In many cases, the abdomen is unaltered in volume in some, it is distended beyond the natural size. The most constant and unvarying symptom was the constipation. It precedes the abdominal pains, and these last diminish in proportion as the constipation is overcome. But the digestive tube is not the only organ which suffers in colica pictonum. The nervous system is often affected in a remarkable manner; and thus a great variety of phenomena are produced, according to the idiosyncrasy of the individual and and other circum as in the nutritive system. The most common of these nervous disorders is the pain in the limbs, and especially in the arms. These pains often precede the colic : sometimes they constitute the whole of the apparent morbid phenomena, the digestive organs being unaffected. Hence our authors rationally conclude that the disorders of the nervous system are not purely sympathetic of the disorder in the digestive tube. These pains are often accompanied by a remarkable debility of the muscles in the vicinity of which they are situated,-which debility gradually changes into veritable paralysis. Thus we find the sensibility of certain members exalted, while their muscular powers are diminished or annihilated. What takes place in the limbs bears no small analogy to what obtains in the bowels, where we find great pain, accompanied by want of contractile power in the muscular coats of the intestines,-at the same time that the mucous membrane is much less sensible to the presence of even drastic purgatives. The most ordinary site of paralysis, in those who handle lead, is in the extensor muscles of the hand, hence results, from loss of balance of power, an habitual contraction of the flexor muscles, the hand being clenched, and the wrist bent on the forearm. This paralysis does not generally occur till after the individual has bee a long time subjected to the manations and contact of lead, and till he has had repeated attacks of the colica. Nevertheless, our authors have seen some exceptions to this statement. The paralysis is generally very slow of |