Abbildungen der Seite





VOL. 5.


NO. 26.


From the Medico Chirurgical Review. out loudly. During these accesPERIODICAL APYRECTIC DISEASES. sions, the muscles of the member

PROFESSOR FUlci, of Catania, contracted violently and involunin Sicily, has published five cases tarily, and the sufferings were of novel apyrectic affections, of a mitigated by pressure, especially periodical nature, of which we by lying on the affected side. shall here give some particulars. The countenance was anxious, They are very curious and inter- and there was great uneasiness in esting.

the epigastrium, --no sleep, Cervicobrachial Neuralgia.-A pulse quick. The integuments gentleman of Cantorbi, aged 40 of the arm affected were tivo deyears, of pervous temperament grees colder than the rest of the and very studious habits, had been body. The paroxysms of pain subject, for some years, to came on twice in the 24 hours, chronic bronchitis, for the relief the first about 11 o'clock, lasting of wbich he got into the habit of three hours,-the other at 10 taking opium to rather an excess. o'clock in the evening, ceasing Being subject to considerable towards morning, and giving the perspirations, and having caught patient an interval of repose till some cold, he became suddenly 11 o'clock. Vapor baths were affected with severe pain in the employed, under the idea that the cervicodorsal region of the spine, neuralgic irritation was occasioned extending afterwards along the by oppressed transpiration,-and left side of the body, and then the author was afraid of the sulfixing itself in the shoulder, shoot- phate of quinine, as there were ing occasionally along the arm, symptoms of gastric irritation and even to the hand of that side. present. Diluents were tħereAfter an accurate examination of fore prescribed, with nitre and the seat of this pain, it appeared mucilaginous drinks. These means evident to our author, that it mitigated, in some degree, the sometimes followed the divisions symptoms; but did not remove of the internal cutaneous brachial them. On the seventh day of the perve,-sometimes the course of disease a number of leeches were the external. The sensations ex- applied to the upper part of the perienced by the patient were spine.

The immediate consevery various at different times, quence was, a reduction of the but almost always of a very dis- morning paroxysm entirely, and a tressing kiad, causing him to cry mitigation of the evening one.



The leechings were several times exhaustion and depression, but repeated. In twenty days the with complete restoration of reapatient returned home cured.

The author now saw that Mental Alienation, periodical.-- he had to treat an intermittent A female, aged 40, of highly san- encephalitis, in the form of perigaineous temperament, and very odical mania, but determined to fond of strong liquors and other let the third paroxysm pass beexcesses, started from her bed, fore he attempted to stop its one morning, in a state of mental course.

This attack came on at derangement. The phenomenon the expected period, but with was attributed by her friends to still a new form of mental halluexcesses in drink, and little at- cination. The ideas of the patention was given to the subject. tient, this time, were all of a deOn the following day she was votional and penitential characquite well. On the third day, ter,—and she actually forced her the same hallucination recurred. husband to repair with her to the Our author was called to the pa. church, in order to confess her tient, and after an attentive exa- manifold sins and transgressions. mination of the symptoms, he de- Our author saw her on her return, terinined that the disease was an and, on examination of the other encephalic irritation, accompa- functions of the body, nothing parnied by active sanguineous con- ticular could be detected. Her gestion in the braiù, caused by face was rather flushed, and she addiction to wine. He therefore complained of pain at the summit ordered ten leeches to the tem- of the head. À consultation was ples,-cold lotions to the head, - called, and it was agreed to prewarm bath to the lower extremi- scribe the quinine, with cold apties. Rigorous diet was pre- plications to the head. Twentyscribed, and diluent drinks. Re- four grains of quinine were given turning next day, our author found within the 24 hours. The next the patient quite well in mind, paroxysm was on the usual day, and occupied with her domestic but greatly mitigated in severity. concerns. The most positive in- When over, the quinine was again junetions as to regimen were given administered, and the malady now and observed ; but, notwithstand- was entirely checked, and did not ing hese, the malady returned return. the next day, though the pheno Mental alienation has been obmena of the hallucination were served to take on periodical acvery different from those previ- cessions in all ages; but it is rare ously presented. The bizarre- to see it assume a regular tertian ries of the patient we shall not form. The brain, however, beenumerate, as they may be as ing an organ through which both various as the shapes of the clouds, physical and intellectual fvactions without any real difference in are manifested, we canet wonder their nature. In this case, the that its derangements should dismaniacal paroxysm was so violent turb the latter as well as the forthat no sanguineous depletion, lo- mer class of functions. In such cal or general, could be effected. cases it is by physical, not moral In 22 hours the agitation subsided, , remedies, that we can expect to and was succoeded by a state of cure the disease.

Periodical Ascites.--A young The above is certainly one of woman, 25 years of age,

of pre- the most curious instances of pevious good health, good constitu- riodical ascites which we have tion, and affected with no heredi- ever heard of. Stork asserts tary disposition to disease, expe- that he has seen an intermittent rienced a fright and violent men- ascites, and there a few others on tal agitation, soon after which she record; but none, we think, so perceived her abdomen swell, well authenticated and unequivoand her urine to become very cal as this one. scanty. A physician was called Anomalous Intermittent Neuroin, and after attentive examina- sis.-An ecclesiastic of Catania, tion, he pronounced the disease to aged 55 years, of good constitube ascites. Before any medicines tion, but of a family disposed to could be administered, however, hypochondriasis, had led a very the swelling quickly disappeared regular life. Twenty years ago after an eruption of the menses. he became affected with epilepThe belly again swelled, and sy, which lasted four years, and again the urine became deficient. then disappeared. Two months Medicines of the diuretic and ago, the patient, without any evacuant kind were prescribed, known cause, except some bodily but without the least effect. The fatigue, was suddenly seized with catamenial discharge, as before, dyspnea, which obliged him to was immediately succeeded by a stop short and sit down quietly, copious flow of urine, and a sub- when it ceased. This was considence of the ascites. This re- sidered a thing of no importance, curred a third time, in spite of and was not attended to; but the various medicines. Our author attacks became frequent and sewas now called in, and discovered vere, and then our author was some signs of gastroenteric irrita- consulted. On examining the retion, if not inflammation, with an gion of the heart, the pulsations unusual exhalation from the peri- were found deep and obscure, toneal surface. The remedies the sternocardiac region sounded were, of course, leeches to the dull,—the pulse was irregular,abdomen, low diet, and demulcent there was inability to lie on the drinks. External applications of left side,-the cheeks were flushcolchicum, antimony, and squills, ed. Prof. Fulci concluded that were also employed over the ab- the disease was angina pectoris, domen. These means failed, and and prescribed accordingly. The then various physicians, both of attacks of dyspnea, however, Sicily and Italy, were consulted, continued two or three times a and exhausted the Pharmacopeia, day, for six days, and then they without the slightest advantage. disappeared. In these attacks The ascites commenced imme- the pulse sometimes fell to 45 ia diately after each menstruation, the minute, with a strange sense and continued to increase till the of dragging along the spine, and next period, when it entirely sub- weakness of the upper extremisided. The complaint has now ties. continued for six years, with the The attacks of dyspnea had most obstinate regularity, and no not 'ceased more than 24 hours, remedy has ever interrupted its when a new train of phenomena course.

was developed. In these now

paroxysms, the pain darted from es were employed, with baths and the left side of the chest all round blisters. These also failed,--and the thorax, to the spot whence it the disease ultimately gave way first emanated, accompanied by to oil of turpentine exhibited night rapid action of the heart and pal- and morning. This last form of pitation. The spinal column was the disease harassed the patient also the seat of violent lancinating for 28 days, but he has since conpain, and the features becanie tinued well.--Bibliotheque Médidecomposed. There was no dysp- cale, March, 1827. nea, and the attack generally Diseases of an intermittent lasted about six minutes, returning type are, we apprehend, becomthree times in the 24 hours. ing more prevalent in the present Looking on the complaint, in its day than formerly ; probably from present form, as neuritis, leeches the nervous system being more were applied along the vertebral susceptible in modern times than column, and counterirritation to in the days of our ancestors. The the lower extremities, with rigid more accurately we observe phevegetable diet. In eight days the nomena in sickness, the more frecomplaint vanished; but in three quently will we find a regular or days afterwards, he was seized irregular periodicity in the march with a burning heat along the of maladies, especially those of lumbar region of the spine, ac- the nervous kind. companied by convulsive movements of the lower extremities, BROUSSAIS ON ASTHMA. keeping the whole body in a state M. Bonnez, assistant surgeon

of of agitation. A sense of coldness the 10th regiment of Chasseurs

, spread along the thighs and legs,- in garrison at Libourne, aged 36 the pulse was contracted and fre- years, had the imprudence to quent, ,- and there was some ten- bathe in a river, after a hearty dency to delirium. These pa- dinner, on the 18th of July. In roxysms lasted six hours, and then the middle of the night he was went off, leaving the patient ex- seized with general malaise, suchausted and depressed. The next ceeded next day by fever, headday, and nearly at the same hour, ache, coryza, and cough. During the paroxysm returned, preceded the night of the 19th he had no by a sense of tightness in the epi- rest. On the 20th the phenomegastrium. The periodicity of the na changed into a complete attack complaint being now ascertained, of convulsive asthma, the second thirty grains of the sulphate of paroxysm which he had expequinine were given in the suc- rienced, the first being three ceeding interval. The next at- years before, and he then 'sent tack was less violent, and the for his medical colleague. Ten complaint did not return,-at least ounces of blood were taken froin in that form. In two or three the arm, and pediluvia applied 70 days it made its reappearance in the feet. By these means the the shape of a violent sciatica, symptoms were relieved, and the the pain running from the hip to night of the 20th was 'spent less the foot. These attacks were miserably. 21st, the paroxysm also periodical, returning diurnal- returned, and continued till near 1y. Narcotics failed -- then leech. the evening. The anhelation this


day was very distressing, and an August, however, when M. Bonantispasmodic julep was ordered, nez thought himself in complete which augmented the dyspnea, security, he was suddenly seized and brought on another paroxysm with pain in one side of the chest, of asthma. The night was spent with fever, cough, headache, &c. in a state of agitation. 23d, Ipe- Cuppingglasses were applied to cacuan had been taken in small the side, and afterwards a large doses, and also castor; but the blister. But these means were paroxysm returned this day, with of no avail. The symptoms beas much violence as before. 24th, came exasperated, and the sputa The asthmatic paroxysm came on sanguinolent. When Dr. B. was at the usual hour, six in the even. again called to the patient, he ing. "On the 25th, Dr. Bagard found him with violent headache, was called in, and found the pa- acute pain in the right side of the tient with the following phenome- thorax, intense fever, full pulse, na :

--Dejected countenancc, burning skin, and countenance ineyes şunk, breathing short,-- dicative of despair. It was now pulse small and quick,--tongue evident to Dr. B. that the inflamcoated, great tenderness at the mation had spread from the muepigastrium-oppression under cous membrane to the pulmonary the sternum, -abdomen rather parenchyma, and even to the tense, --urive scanty and high- pleura. Dr. B. advised the apcolored. Sixteen leeches were plication of 25 leeches to the applied to the sternum and epi- chest; but the regimental surgeon gastrium, the bites to be encou- protested against any more leechraged by cataplasms,--very low es, and our author took his leave. diet,--diluents,--lavements. The Two other physicians were called șucceeding paroxysm, 26th, was in, and ventured on the abstracvery much milder, being only a tion of six ounces of blood from simple dyspnea. 27th. When the arm. This made no impresDr. B. visited his patient, the sion on the complaint, and Dr. latter observed that he was quite Bagard was called." He applied well, and had a strong desire for 25 leeches to the chest, which, food. But it was evident that the with a blister, completely repatient was not well. At the moved the disease. usual hour, the dyspnea returned, M. Broussais' Remarks.- Most accompanied by some cough cases of Asthma depend on some 28th, Felt very well all day, till obstacle to the course of the six o'clock, when the dyspnea re- blood"; and this obstacle is most turned as usual. Dr. B. now be commonly a disease of the heart. ing struck with the periodicity of This, however, is not always the the complaint, and seeing nothing case. A determination, however wyrong with the digestive organs, induced, of blood to the mucous prescribed the sulphate of qui- membrane of the lungs, in a sannine, in doses of three grains eve- guineous subject, will often give ry three hours. The next pa- rise to a paroxysm of asthma, as roxysm was prevented.

was the case in the above inmedy was continued for three stance. M. Broussais has known days, and the patient was free inflammation and irritation in the from complaint. On the 6th of mucous membrane of the stomach

The re

« ZurückWeiter »