regeneration of the lens

4
613 Again, the hydriodic acid once formed, is midiv eliminated through the several excre- tory ehannets. In forty minutes we have found it in the urine, in which, in the dog just alluded. to, it was detected occasionally ;.r ;ire days; viz., on the first and second, and on the fourth and fifth, when he died. Strange to say, though the same process 1’35 pèrfofmed with every precaution on the third day, it gave no indications whatever of ::B compound of iodine. We found it, how- evtr, in the saliva, which was secreted in im- mense quantities on that day. After death not a trace existed in the contents of the ali- mentary canal. It is also worth recording, that in this instance and four others no trace of in- flammation existed in the intestines,with the exception of a few ulcerations of the glands of Pe)er and Brunner ; but the air-cells of both lungs were infiltrated with pus, and tueir substance was preternaturally soft. This case we consider of great practical importance, as we have strong reason to be- lieve that it affords an exact parallel to the chemical facts to be attended to in the hu- man subject. We believe that wherever death occurs later than sixty hours after poisoning by iodine, it will be sought in vain in the alimentary canal, while it may hre been readily detected during life in the urine. One of the first chemical duties of the practitioner called to a suspected case In Dr. Christison’s observations on the iodine poisons, these facts are entirely omit- ted as far as the analysis is concerned, and a mode of detecting the hydriodates is pro- poled, which would inevitably lead to total failure if applied to any complicated mineral fluid, such as the urinary excretion. We shall not, therefore, transfer it to our colomns, but proceed to detail the process which Dr. O’Shaughnessy has proposed, and which we have had repeated opportunities of examining since his paper was published in this Journal. He sets out in his chemical examination, on the supposition that some combination of has been taken. In order therefore t ,,;certain whether any free iodine is pre- sent, the contents of the alimentary canal :r: triturated with a little cold solution of starch, which would immediately cause the mixture to assume a blue colour. If the blue colour appear, the mixture is, if ne cessary, diluted with water, and exposed to’ a current of sulphuretted hydrogen, by which the iodide of starch is decolorised and con- verted into hydriodic acid. If no blue colour have been produced, the mixture is merely boiled with water and filtered. If the filter- ed fluid redden litmus paper, it should be neutralised with caustic potassa, and then. reacidulated with acetic acid. He next adds the solution of the chloride of platinum. which, with the most minute quantities oC hydriodic acid, either causes a dark-red pre- cipitate, or changes the fluid to a port-wine colour. It is then to be agitated with an ounce of ether, which dissolves the iodide of platinum, and separates it from the other fluids swimming on their surface, from, which it may be removed by a suction tube. The ethereal solution is, finally, to be eva- porated to dryness, and the iodide of plati- num heated by the spirit-lamp flame in a. small glass tube, when the iodine is disen- gaged in its characteristic violet vapour, and condenses on the sides of the tube in dark dendritic crystals. The above process we have found to be extremely delicate and easy of execution. It is especially applicable to the urine or saliva. Occasionally in the urine, the simple addi tion of cold solution of starch and sulphuric: acid will strike the peculiar blue colour, which may be considered sufficient evi- dence. This experiment, however, is by no means so delicate as that just detailed. and it is, moreover, exceedingly liable ta be interfered with by the animal matters which the urine contains. REGENERATION OF THE LENS. SOME years ago, MM. Cocteau and Leroy d’Etiolle published in Magendie’s Journal a , series of experiments, from which they wera led to suppose that the lens, after having been extracted, is reproduced. The follow- ing is a brief account of these experiments. The extraction of the lens was always made on both eyes by an incision at the up- per part of the cornea, and was generally attended by prolapsus of the iris, and fol- lowed by violent inflammation. First Experiment.—This was made on a rabbit three months old. The lens could

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613

Again, the hydriodic acid once formed, ismidiv eliminated through the several excre-tory ehannets. In forty minutes we havefound it in the urine, in which, in the dogjust alluded. to, it was detected occasionally;.r ;ire days; viz., on the first and second,and on the fourth and fifth, when he died.

Strange to say, though the same process1’35 pèrfofmed with every precaution on thethird day, it gave no indications whatever of::B compound of iodine. We found it, how-evtr, in the saliva, which was secreted in im-mense quantities on that day. After deathnot a trace existed in the contents of the ali-

mentary canal. It is also worth recording, thatin this instance and four others no trace of in-flammation existed in the intestines,with the

exception of a few ulcerations of the glandsof Pe)er and Brunner ; but the air-cells ofboth lungs were infiltrated with pus, andtueir substance was preternaturally soft.This case we consider of great practical

importance, as we have strong reason to be-lieve that it affords an exact parallel to thechemical facts to be attended to in the hu-man subject. We believe that whereverdeath occurs later than sixty hours after

poisoning by iodine, it will be sought invain in the alimentary canal, while it mayhre been readily detected during life inthe urine. One of the first chemical dutiesof the practitioner called to a suspected case

In Dr. Christison’s observations on theiodine poisons, these facts are entirely omit-ted as far as the analysis is concerned, and a

mode of detecting the hydriodates is pro-poled, which would inevitably lead to totalfailure if applied to any complicated mineralfluid, such as the urinary excretion. Weshall not, therefore, transfer it to our

colomns, but proceed to detail the processwhich Dr. O’Shaughnessy has proposed, andwhich we have had repeated opportunitiesof examining since his paper was publishedin this Journal.He sets out in his chemical examination,

on the supposition that some combination ofhas been taken. In order therefore

t ,,;certain whether any free iodine is pre-sent, the contents of the alimentary canal:r: triturated with a little cold solution ofstarch, which would immediately cause the

mixture to assume a blue colour. If the

blue colour appear, the mixture is, if ne

cessary, diluted with water, and exposed to’a current of sulphuretted hydrogen, by whichthe iodide of starch is decolorised and con-verted into hydriodic acid. If no blue colourhave been produced, the mixture is merelyboiled with water and filtered. If the filter-ed fluid redden litmus paper, it should beneutralised with caustic potassa, and then.reacidulated with acetic acid. He next addsthe solution of the chloride of platinum.which, with the most minute quantities oChydriodic acid, either causes a dark-red pre-cipitate, or changes the fluid to a port-winecolour. It is then to be agitated with anounce of ether, which dissolves the iodideof platinum, and separates it from the otherfluids swimming on their surface, from,which it may be removed by a suction tube.The ethereal solution is, finally, to be eva-porated to dryness, and the iodide of plati-num heated by the spirit-lamp flame in a.small glass tube, when the iodine is disen-gaged in its characteristic violet vapour,and condenses on the sides of the tube indark dendritic crystals.The above process we have found to be

extremely delicate and easy of execution. Itis especially applicable to the urine or saliva.Occasionally in the urine, the simple addition of cold solution of starch and sulphuric:acid will strike the peculiar blue colour,which may be considered sufficient evi-dence. This experiment, however, is byno means so delicate as that just detailed.and it is, moreover, exceedingly liable ta beinterfered with by the animal matters whichthe urine contains.

REGENERATION OF THE LENS.

SOME years ago, MM. Cocteau and Leroyd’Etiolle published in Magendie’s Journal a ,

series of experiments, from which they weraled to suppose that the lens, after havingbeen extracted, is reproduced. The follow-

ing is a brief account of these experiments.The extraction of the lens was alwaysmade on both eyes by an incision at the up-per part of the cornea, and was generallyattended by prolapsus of the iris, and fol-lowed by violent inflammation.

First Experiment.—This was made on arabbit three months old. The lens could

614

not be made to prolapse, except by means ofthe curette; the eyes became violently in-flamed, and when the animal was killed, afortnight after the operation, the right eyewas found almost.destroyed by inflamma-tion, and without any trace of the lens ; butin the left, where the inflammation had beenless intense, the capsule is stated to havecontained a small lentiform transparentbody, of less consistence than the healthylens, and in that respect almost similar toits external portion. Of the size of the re-generated lens nothing is mentioned.In the Second Experiment, which was also

performed on a young rabbit, the same re-sults were obtained, viz. in the right eye, notrace of a reproduced lens was discovered onthe 33rd day after the experiment, but inthe left eye the capsule was found to con-tain a transparent lentiform body, of lessconsistence than the lens in its natural state.In the Third Experiment, the animal was

killed on the 38th day after the operation ;2?o lens had formed on either eye, and the

capsule contained only some grumous matterof rather more density than the vitreous

body, but in no respects resembling a lens.Fourth Experiment.-During the opera-

tion, which was performed on a cat, consi-derable haemorrhage took place, in conse-quence of a wound of the iris, which alsoprolapsed. Violent inflammation ensued,and when, on the 30th day after the experi-ment, the eyes were examined, the mem-branes were found firmly adherent to oneanother, so that their contents hardly ad-

mitted of any distinct examination. Nothingis said about the lens in the right eye, butin the transparent centre of the left eye, theexperimenters found a small body of almostlenticular form and amber colour, whichfirmly adhered to the surrounding parts,and was of great consistence, so as almost toresemble a dried portion of the lens, or apiece of thick menbrane. (Analogue dureste à une membrane epaisse ou a une por..tion du cristallin desséché.)The Fifth Experinzent was performed on

a dog of middle size ; considerable inflam-mation ensued, and when the animal waskilled, about six weeks afterwards, no traceof any lens could be discovered in the lefteye, but in the right the capsule was foundto contain a transparent lentiform body, ofless size and consistence than the lens in its

healthy state.The Sixth Experiment was performed on a

rabbit, and it is stated that when the animalwas killed, six months after the operation,the capsule of both eyes was found to con-tain a transparent lens of the same size andconsistence as those which had been ex-

tracted. In order to obtain stiil greatercertainty about the result, the reproduced

lenses were put into boiling water, by whichthey became opaque, hard, and friable, those which had been extracted, except thatthe lamellous structure of the new lenseswas evident in their external portions only,It is to be regretted that the last expe.riment is related in a few words onlv,while in the five former a detailed deserip.tion is given of the operation and its imme-diate consequences up to the death of theanimal.

From these experiments, MM. Cocteauand Leroy conclude, that no doubt can beentertained with regard to the reproductionof the lens, an inference which might appearextraordinary, if the experimental physiolo.gists of the Magendie school had not theexclusive right of forming hasty conclusionsfrom imperfect experiments. Fortunately,the above experiments have been lately re.peated by M. Backhausen at Berlin, underthe superintendence of M. Rudolphi, andwe must state, that the manner in which his

experiments are conducted and described,entitles them to much more confidence tbanthose of MM. Cocteau and Leroy. The titleof the work in which M. Backhansen has

published his experiments, is, De Rege.neratione Lentis Crystallinœ Script. Opli.thalfn. Min. ed Radius, vol. iii.M. BACKHAUSEN begins his treatise with

a few comments on tae experiments of hispredecessors. " It will be remarked," he

says, " that, on the whole, twelve eyes were

examined, in which the lenses had been ex.tracted ; of these, six did not exhibit anytrace of a reproduced lens; in two (fourthand fifth experiments), after very iutenseinflammation, so as to produce a completeconcretion of the tunics, lentiform bodieswere found, of which the one ’ resembleda dried portion of lens, or a thick membrane,’and the other was ’ less in size and consist-ence than the lens in its healthy condition.’With regard to the first and second experi.ments, in which rudiments of the new lenswere found after slight inflammation, I

must observe, that the lenses of rabbits are sovery large, as to render it extremely difficultto extract them entirely, and without leavingsome portion of them, and if the removal oithe lens requires the assistance of the cu.

rette, I am convinced . that some divi-sion of it cannot be avoided. The pieces ctlens which were fouud in the two expeti.

615

ments in question, must consequently ra-’

ul her be considered as remains of the parti-any extracted lens, than as rudiments of

reproduced ones. Lastly ; the sixth expe-riment is entitled to no confidence at all, forthe description of it merely states the fact ofits having been performed, and attendedwith complete success."We now give an abridged account of M.

Packhausen’s experiments. The incision of

the cornea was always made at the uppersegment with Beer’s knife, or in very youngrabbits with a smaller one.

Exp. I.—In a rabbit of four months bothlenges were extracted ; a small portion ofthe corpus vitreum of the right eye pro-truded, but the iris was not wounded ,ineither eye, nor did it prolapse. Slight in-flammation followed, but was speedily sub-dued by cold lotions ; and after twenty-twodays, when the animal was killed, both eyes,tith the exception of the cicatrix of thecornea, were found healthy, without anyeffect of inflammation, but also without any ,

trace of lells in the capsule, the posteriorportion of which was healthy and trans-

parent.

Exp. II: A rabbit of two vears was sub-mitted to the operation, which, however, onaccount of the violent contractions of theinfundibuliform muscle, proved unsuccess-ful. In the left eye almost half of the lenscould be made to protrude, and was ex-tracted; in the right the extraction couldnot be performed at all. On the death ofthe animal, twenty days after the operation,the left eye was found in a healthy con-dition, without any signs or effects of in-flammation; the capsule was perfectlyclosed, and contained a portion of the lensin a semi-transparent state; the right eyewas entirely destroyed by inflammation.

EXPS. III. and IV.-In a full grown rab-bit, the lens of the right eye was extracted ;during the operation, a small portion of thei’is prolapsed, but within a few days spon-tzceously went back, merely by ,keepingthe animal in a dark place. After a weekthe lens of the left eye was extracted ; nei-ther of the operations was followed by anyinflammation; and when the animal waskilled on the 25th day after the extractiono the lens, the cornea of the right eye wasfound to be rather opaque, but the othertan,es, as well as the humours of the eye,were in a healthy state ; of the capsule andlens no trace could be discovered. Theame was the result of the examination ofthe left eye, except that in it the posteriorLjtina of the capsule was found.

Exps.V. and VI.—On a young rabbit theleft lens was extracted without difficulty;slight inflammation followed, but havingalmost subsided on the seventh day, theoperation was performed on the right eye ;the section of the cornea was, however, un·

fortunately, not large enough, so that onlypart of it could be removed; the iris alsoprolapsed, and could not be reduced.Twenty-five days after the first operationthe animal was killed ; the left eye, withthe exception of a slight opacity of thecornea, was perfectly healthy, but withoutany trace of lers ; in the right the effectsof iritis were visible, and the capsule con"tained a small portion of lens.

Exrs. VII. and VIII.-The extraction of £the left lens offered nothing of interest ;that of the right was performed after an in-terval of a week, though not with completesuccess, for the lens did not prolapse en-tire, but was removed in several pieces.However, on the examination of the eyeeighteen days after the second operation,nothing of the lens was found in it, so thatit was either removed entirely by the ope-ration, or what remained had been absorbedafterwards. In the left eye no trace of thelens could be found.

EXPS. IX. and X.-In a rabbit of fourteendays, both lenses were extracted, the onesix days after the other ; hardly any in.flammation took place ; and when, aftertwenty-three days, the eyes were dissected,they were found perfectly healthy, butwithout any trace of lens.

, The extraction of the lens was then per-:formed on two other rabbits of the same age,with exactly the same result.

,

All the eyes on which the experimentshad been made, were placed in spirit of

wine, but even by this method no tracesof lens could be discovered in any, exceptthose which had been the subjects of thesecond and sixth experiments.The researches of M. Backhansen appear

to us to be almost conclusive against MM.Cocteau and Leroy ; we should, however,wish to see them again repeated by as ac-curate experimenters as M. Backhausen,with the precaution of letting the animalslive in some cases for six months after the

operation, as was done by MAI. Cocteauand Leroy in one case.

616

PUNCTURE OF THE SKULL INHYDROCEPHALUS.

A late Number of the Lancette Fran-

çaise mentions a case of hydrocephalus in achild of fourteen months, on whom a Dr.Bedor, of Troyes, performed the punctureof the skull with complete success. The first

puncture, which was performed on the 12thof December 1827, gave issue to about a pintof limpid serum, and was followed by thecessation of the effects of pressure on the

brain, as coma, squinting, hemiplegia of theleft side, and contraction of the left thigh.’These symptoms having however returned,it was found necessary to repeat the opera-tion, by which a smaller quantity of serumwas evacuated with considerable relief. In

this manner the operation was performednine times within four months, after which

period the child seemed to be perfectly well,and remained so for a year, when it died ofpneumonia. On examination the right ven-tricle was found larger than usual, with at-tenuation of its parietes. At its upper part

an infundibuliform impression was found, atthe bottom of which were three fistulous

points, probably the consequence of the

punctures.’

A CASE OF

SCIRRHUS UTERI,WITH MALIGNANT ULCERATION OF THE UTE-

RUS, AND EXTIRPATION OF THAT ORGAN.

By D. EVANS, Esq., Surgeon, Belper,Derbyshire.

[Communicated by DR. BLUNDELLand DR. CALVERT.]

JOSEPH HASLAM’s wife, aetat. 47, of lightcomplexion, stout, and not of unhealthy ap-pearance, the mother of thirteen children,applied for relief in the beginning of Aprilunder the following circumstances :-She states, that in Feb. last, during the

- severe frost and snow, she exposed herselfto the cold at the time she was menstruat..ing ; the discharge disappeared suddenly,and ever since she has felt great uneasiness,and occasionally very severe pains in the

region of the uterus, sometimes extendingto the loins and down the thighs. She has

a very offensive discharge from the vagina,On examining with the finger by the vagina,the os uteri felt of a scirrhous hardness.With the assistance of a speculum, an un.healthy-looking ulcer, somewhatlarger thana sliilling, was discovered on the posterioredge, and rather within the os uteri withthe finger by the rectum the uterus feltharder than natural, and apparently some.what enlarged. Her general health was

pretty good : she had menstruated regularlysince she left off suckling her last child.She was directed to use a lotion, consist.

ing of one part of the solution of cbloruretofsoda, and sixteen of water; to have the ulcertouched daily with a strong solution of ar-genti uitras, by means of a camel-bair

pencil ; to take the extracts of byosciamusand cicuta three times a day, an opiatewhen the pain was violent, and to have thebowels regulated by means of castor oil.This plan of treatment was continued until

the time she uaderwent the operation, with.out any material alteration. She was seen

by Drs. Calvert and Bent, who consideredher case to be hopeless. The latter recom.mended the muriated tincture of iron to beused in the same manner as the nitrate ofsilver, which was to be discontinued.

In the beginning of July she took to herbed. Not deriving any material benefit fromthe treatment above mentioned, and beingaware of the malignant nature of the diseasefrom which she was suffering, she inquiredif it were not practicable to have the dis.eased parts removed by an operation, andstated her willingness to submit to any mea.sures, however painful, that would afford hera chance of recovery. She was told that no

operation short of removing the entire wombcould possibly benefit her, that this was auoperation attended with extreme danger,that every possible means should be taken topalliate her sufferings, and with this assur.ance she had better be resigned to her fate.This, however, was far from satisfying her;she continued to urge an operation at everysucceeding visit. Her solicitations were par.ried for some time, but at length consentedto. With the assistance of Mr.Bennett,I per-formed the operation at one o’clock on Sa.

turday, October 16th, in the following 13 man-ner. :-Before proceeding with the details ofthe operation, it may be proper to state thealteration that had taken place in the pa-tient since her first application. Her gene.ral health was impaired, but not more thanmight have been expected from the longconfinement and the suffering she had under-gone : she was not much emaciated, but

very pale. For the last seven or eight ii-eeksshe had had a considerable discharge ofblood, which she called being unwell. Theulceration had extended considerably; theos uteri had quite a ragged appfardace. lu