reviews and notices of books

2
673 pain had become very acute, and the urine was frequently turbid, and deposited a jelly-like substance. In addition to the above symptoms, the patient had now and then great diffi- culty in walking about, from the aching pain produced by such movement; the pain, however, ceasing immediately he sat down. Another severe symptom was great uneasiness felt at the neck of the bladder, when he had nearly emptied that viscus. A catheter was introduced by Mr. Curling, and a stone of moderate size was detected; the urine was found clear, and depositing a large quantity of transparent mucus: the pain in passing it was, however, trifling. Mr. Curling ordered the patient to be put on full diet, to have a suppository of ten grains of soap pill, and to take ten grains of carbonate of soda three times a day. A week after admission the patient was brought to the operating theatre, and placed under the in- fluence of chloroform, as Mr. Curling had resolved to remove the stone by crushing. The bladder was injected with tepid water, and the screw lithotrite introduced. We should here mention, that it was maintained a short time ago, by a French surgeon, that the bladder could not retain the injected fluid when the patient was narcotized. This is to a very small extent correct, as the warm water under such circumstances has been known to be squirted out; but we must say, that during a great many ope- rations which we have witnessed in the hospitals of London we did not perceive any such occurrence. Mr. Curling readily succeeded in grasping the calculus twice between the blades of the instrument, and crushing it with comparative ease, as it appeared to be composed of soft materials. When the instrument was withdrawn, some of the detritus, in the shape of a white powder, remained in the beak. The patient was sent to bed, and ordered beef-tea and a muci- laginous mixture; and in the evening he passed a large quan- tity of urine, containing some white powder, and irregularly- shaped fragments, which were composed of the triple phos- phate. Pieces of stone continued to pass for the five following days, some of them being the size of a pea, and giving but little pain in their transmission. On the sixth day, the boy was able to walk about the ward with comparative ease; the urine was becoming clear, but still deposited a transparent mucus. Fourteen days after the first operation, the patient was I again placed on the operating-table, and made to inhale chlo- roform. Mr. Curling introduced the lithotrite scoop, and re- I moved some masses of white calculous matter. The next day one large piece and several small ones were passed, the former looking very much like a portion of the original nucleus. The urine now became clear, the mucus almost disappeared, and the boy walked without pain. Seven days after the second operation the instrument was again introduced, but no calculus could be detected; no pain was complained of, and the boy began to run about, which he had not been able to do for the last six months; urine quite clear; no mucus whatever. The patient was discharged, being quite well, two months after admission; and he called at the hospital, ten days afterwards, to say that he never was in better health or freer from pain in his life. Such cases as the foregoing are well calculated to bring lithotrity into favour in the treatment of young calculous patients; the more so when it is noticed how little the urethra suffers from the passage of the fragments, and how incon- siderably the mucous membrane of the bladder is irritated either by the instrument or the detritus. It must certainly be an advantage in lithotrity to have pretty healthy organs to deal with, the contrast between a sound bladder and normal size of the prostate gland, in the young, being very striking with the very frequently diseased bladder and enlarged prostate of the old. It will be noticed, that in the earlier history of this patient, a calculus was voided through the meatus by repeated straining. This may be looked upon as a process not free from danger, as the urethra may suffer severely; and we are by this circumstance reminded of a case illustrating a different line of practice. We beg to adduce it nnder the following title :- SURREY DISPENSARY. Calculus in the Urethra. (Under the care of Mr. FORSTER.) A PALE, cachectic-looking boy, about six years old, with all that appearance of haggardness and anxiety incidental to suffering about the pelvic organs, was brought to the Dispen- sary in February, 1850. The abdomen was enlarged, and the I boy had had measles. His mother stated that she scarcely knew what was the matter with the boy, but that about twelve months ago, after he was first breeched, she found his small- clothes were constantly wet, and that his urine was continually flowing from him. From that time until the present he has been in the habit of getting up six or eight times in the night to pass his urine, for fear of wetting the bed. When she first noticed him, ho frequently pulled the prepuce, and his urine would sometimes stop suddenly; but these two symptoms had not been present for some time, most probably from the altered position of the stone; he has never passed any blood. The patient had continued getting worse, though he has had slight temporary relief from medicine, and from the constant irritation he appears almost worn out. Is extremely irritable and peevish; no apparent disease in any organ; chest healthy; urine pale and clear, occasionally a slight sediment. Mr. Forster immediately passed a sound down the urethra, and at the bulbous portion of the canal the passage of the instrument was arrested by contact with a stone. Not deem- ing it necessary or right to delay affording the child relief, he was placed, as in the operation for lithotomy, and the urethra opened in the perinseum, where the stone was readily felt; but some difficulty was experienced in extracting it, in conse- quence of its having become imbedded in a species of sac. The upper part of the stone, in which was a groove, forming the floor of the urethra, was so worn away by the urine and the forming of this canal as to give it the appearance of a common date kernel, but somewhat shorter. It so completely resembled such kernel that the mother did not believe it had been ex. tracted from the child. The caculus was of a brownish colour, slightly nodulated, and, upon chemical examination, found to be composed of pure lithic acid, with the same nucleus. The urine continued to flow from the wound in the peri- nsaum for one month, until it was considered necessary to pass a catheter by the urethra; and soon afterwards the whole of the urine came by the natural passage, and the opening healed. The child is now fat and well. This is one of those cases which, after the operation, might be considered in an exclusively medical point of view, and measures be taken, in respect to diet and habits, to forestall the formation of another stone, which event is, according to what happened in Mr. Curling’s case, (see above,) very likely to happen. Reviews and Notices of Books. Homceopathy Unveiled; or, Observations on Hahnemann, his Doctrines and Treatment of Disease. By WILLIAM PERRIN BRODRIBB, M.R.C.S.E., Member of the Court of Examiners of the Society of Apothecaries. London: S. Highley, Fleet- street. 1851. AT the present time, when the humbug which passes under the name of homoeopathy is so widely spread among the community, and, honestly or dishonestly, is practised by too many renegade members of the profession, it is refreshing to peruse a book, which, by dint of calm reasoning and con. vincing argument, lays bare the utter fallacy of this monstrous absurdity. For ourselves, we confess that we are so disgusted with puerilities and tricks of Hahnemann and his followers, that we think them hardly worthy of a serious notice, and would be willing to let them glide quietly into oblivion, as they soon must do from their inherent knavery; but experience has taught us that the multitude are ready to be deluded by the most flagrant nonsense, and that it is necessary occasionally for rational men to take up their pens for the purpose of stemming the torrent of wild and ridiculous theories, which are, from time to time, palmed upon the public mind as the emanations of elaborate thought and superior wisdom. In this spirit, the little work before us has been written, and Mr. Brodribb deserves credit, not only for the luminous and concise manner in which his arguments are arranged, but also for the temper and moderation with which he has treated a subject which might justly excuse the employment of ridicule and the expression of contempt. Mr. Brodribb has done what many other practitioners have

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Page 1: Reviews and Notices of Books

673

pain had become very acute, and the urine was frequentlyturbid, and deposited a jelly-like substance. In addition tothe above symptoms, the patient had now and then great diffi-culty in walking about, from the aching pain produced by suchmovement; the pain, however, ceasing immediately he satdown. Another severe symptom was great uneasiness felt atthe neck of the bladder, when he had nearly emptied thatviscus.A catheter was introduced by Mr. Curling, and a stone of

moderate size was detected; the urine was found clear, anddepositing a large quantity of transparent mucus: the pain inpassing it was, however, trifling. Mr. Curling ordered thepatient to be put on full diet, to have a suppository of tengrains of soap pill, and to take ten grains of carbonate of sodathree times a day. A week after admission the patient wasbrought to the operating theatre, and placed under the in-fluence of chloroform, as Mr. Curling had resolved to removethe stone by crushing.The bladder was injected with tepid water, and the screw

lithotrite introduced. We should here mention, that it wasmaintained a short time ago, by a French surgeon, that thebladder could not retain the injected fluid when the patientwas narcotized. This is to a very small extent correct, as thewarm water under such circumstances has been known to besquirted out; but we must say, that during a great many ope-rations which we have witnessed in the hospitals of Londonwe did not perceive any such occurrence.Mr. Curling readily succeeded in grasping the calculus

twice between the blades of the instrument, and crushing itwith comparative ease, as it appeared to be composed of softmaterials. When the instrument was withdrawn, some of thedetritus, in the shape of a white powder, remained in the beak.The patient was sent to bed, and ordered beef-tea and a muci-laginous mixture; and in the evening he passed a large quan-tity of urine, containing some white powder, and irregularly-shaped fragments, which were composed of the triple phos-phate. Pieces of stone continued to pass for the five followingdays, some of them being the size of a pea, and giving butlittle pain in their transmission. On the sixth day, the boywas able to walk about the ward with comparative ease; theurine was becoming clear, but still deposited a transparentmucus.Fourteen days after the first operation, the patient was Iagain placed on the operating-table, and made to inhale chlo-

roform. Mr. Curling introduced the lithotrite scoop, and re- Imoved some masses of white calculous matter. The next dayone large piece and several small ones were passed, the formerlooking very much like a portion of the original nucleus. Theurine now became clear, the mucus almost disappeared, andthe boy walked without pain. Seven days after the secondoperation the instrument was again introduced, but no calculuscould be detected; no pain was complained of, and the boybegan to run about, which he had not been able to do for thelast six months; urine quite clear; no mucus whatever. Thepatient was discharged, being quite well, two months afteradmission; and he called at the hospital, ten days afterwards,to say that he never was in better health or freer from painin his life.Such cases as the foregoing are well calculated to bring

lithotrity into favour in the treatment of young calculouspatients; the more so when it is noticed how little the urethrasuffers from the passage of the fragments, and how incon-siderably the mucous membrane of the bladder is irritatedeither by the instrument or the detritus. It must certainlybe an advantage in lithotrity to have pretty healthy organs todeal with, the contrast between a sound bladder and normalsize of the prostate gland, in the young, being very strikingwith the very frequently diseased bladder and enlargedprostate of the old. It will be noticed, that in the earlierhistory of this patient, a calculus was voided through themeatus by repeated straining. This may be looked upon asa process not free from danger, as the urethra may sufferseverely; and we are by this circumstance reminded of a caseillustrating a different line of practice. We beg to adduce itnnder the following title :-

SURREY DISPENSARY.Calculus in the Urethra.

(Under the care of Mr. FORSTER.)A PALE, cachectic-looking boy, about six years old, with

all that appearance of haggardness and anxiety incidental tosuffering about the pelvic organs, was brought to the Dispen-sary in February, 1850. The abdomen was enlarged, and the I

boy had had measles. His mother stated that she scarcelyknew what was the matter with the boy, but that about twelvemonths ago, after he was first breeched, she found his small-clothes were constantly wet, and that his urine was continuallyflowing from him. From that time until the present he hasbeen in the habit of getting up six or eight times in the nightto pass his urine, for fear of wetting the bed. When she firstnoticed him, ho frequently pulled the prepuce, and his urinewould sometimes stop suddenly; but these two symptoms hadnot been present for some time, most probably from the alteredposition of the stone; he has never passed any blood.The patient had continued getting worse, though he has had

slight temporary relief from medicine, and from the constantirritation he appears almost worn out. Is extremely irritableand peevish; no apparent disease in any organ; chest healthy;urine pale and clear, occasionally a slight sediment.Mr. Forster immediately passed a sound down the urethra,

and at the bulbous portion of the canal the passage of theinstrument was arrested by contact with a stone. Not deem-ing it necessary or right to delay affording the child relief, hewas placed, as in the operation for lithotomy, and the urethraopened in the perinseum, where the stone was readily felt; butsome difficulty was experienced in extracting it, in conse-quence of its having become imbedded in a species of sac. Theupper part of the stone, in which was a groove, forming thefloor of the urethra, was so worn away by the urine and theforming of this canal as to give it the appearance of a commondate kernel, but somewhat shorter. It so completely resembledsuch kernel that the mother did not believe it had been ex.tracted from the child.The caculus was of a brownish colour, slightly nodulated,

and, upon chemical examination, found to be composed of purelithic acid, with the same nucleus.The urine continued to flow from the wound in the peri-

nsaum for one month, until it was considered necessary to passa catheter by the urethra; and soon afterwards the whole ofthe urine came by the natural passage, and the opening healed.The child is now fat and well.

This is one of those cases which, after the operation, mightbe considered in an exclusively medical point of view, andmeasures be taken, in respect to diet and habits, to forestallthe formation of another stone, which event is, according towhat happened in Mr. Curling’s case, (see above,) very likelyto happen.

Reviews and Notices of Books.

Homceopathy Unveiled; or, Observations on Hahnemann, hisDoctrines and Treatment of Disease. By WILLIAM PERRINBRODRIBB, M.R.C.S.E., Member of the Court of Examinersof the Society of Apothecaries. London: S. Highley, Fleet-street. 1851.

AT the present time, when the humbug which passes underthe name of homoeopathy is so widely spread among thecommunity, and, honestly or dishonestly, is practised by toomany renegade members of the profession, it is refreshingto peruse a book, which, by dint of calm reasoning and con.vincing argument, lays bare the utter fallacy of this monstrousabsurdity. For ourselves, we confess that we are so disgustedwith puerilities and tricks of Hahnemann and his followers,that we think them hardly worthy of a serious notice,and would be willing to let them glide quietly intooblivion, as they soon must do from their inherent knavery;but experience has taught us that the multitude are

ready to be deluded by the most flagrant nonsense, and thatit is necessary occasionally for rational men to take up theirpens for the purpose of stemming the torrent of wild andridiculous theories, which are, from time to time, palmed uponthe public mind as the emanations of elaborate thought andsuperior wisdom.In this spirit, the little work before us has been written,

and Mr. Brodribb deserves credit, not only for the luminousand concise manner in which his arguments are arranged,but also for the temper and moderation with which he hastreated a subject which might justly excuse the employmentof ridicule and the expression of contempt.Mr. Brodribb has done what many other practitioners have

Page 2: Reviews and Notices of Books

674

done before him-namely, he has taken the globules himself,and of course without perceiving any symptoms whatever:

"I have taken" says he," daily,for a fortnight some globules ofrhus toxicodendron, varying in number from four to thirty. Ihave taken also for the sume period, globules of nux vomica,of aconite, of pulsat,illa, of mercurius, and of arsenic, and oneach occasion without feeling the slightest effect whatever.Desirous of testing them as fairly as possible, I have re-

quested homoeopathic practitioners to give me any of theirmedicines, offering to take them in any dose, and for anylength of time they pleased, but these ofers have always been- declined."

We cannot, perhaps, wonder that Mr. Brodribb’s veryreasonable expe1’imentum crucis should be declined by a cliqueof pseudo-philosophers, to whom the ordinary rules of reason-ing appear to be wholly unknown, and to whom the novumorganon of Bacon is a sealed book!

On Diseases of the Mucous -4-fe7nbrane of the Throat, and their IITreatment by Topical Medication. By W. R. WAGSTAFF, IM.D. 8vo, pp. 183. London. ,

SoME few months since, we reviewed somewhat fully a workon the treatment of diseases of the air-passages, by local appli-cations to the mucous membrane of the affected parts. At thattime we went fully into the mode employed by the author, Dr.Horace Green, and spoke of it in terms of approbation. Dr.

Wagstaff’s little work contains nothing very original or striking,and we think it was scarcely necessary for him to have takenthe trouble to manufacture a work expressly to inform usthat he is a disciple of Dr. Green. A short anecdote heremay not be out of place. Mr. Burke and a merchantwere candidates to represent the old city of the West. Mr.Burke addressed his constituents with his usual eloquence andpower; his colleague with as much good taste as-good sense,merely remarked, " I say ditto to Mr. Burke, gentlemen-Isay ditto to Mr. Burke !"We have no wish, however, to disparage Dr. Wagstaff’s

unpretending volume, which conveys in a simple and concisemanner the principles on which Dr. Green’s plan is founded,and the practice to be pursued.

The Laws of Health in Relation to ll2ind and Body. A Seriesof Letters from an Old Practitioner to a Patient. By LIONELJoiix BEALE, M.R.C.S. 8vo, pp. 308. London.

WE gladly welcome Mr. Beale’s work. At the present time,when quackery is rampant, and when, as Goldsmith well re-marked, "every man professes to be able to mend the consti-tution and to cure his neighbour," such works as the one be-fore us are calculated to confer great benefits on the com.munity. It is from the spread of knowledge such as thework of Mr. Beale will communicate, that we must expectto stem the torrent of empiricism; for the quack-deluded areever as ignorant as they are conceited. An analysis of the11 Laws of Health" would exceed the limits which our crowdedcolumns at present allow for notices; it will suffice, then, tosay that it contains a most elaborate but familiar account ofthe laws which regulate the economy from the cradle to thegrave. The observations are those of a most experienced andintelligent practitioner, and they do equal credit to his headand heart. It is not only to the lay reader that Mr. Beale’swork will be acceptable, and we augur for it an extensivepopularity.

____________

A Compendium of Materia Medica and Pharmacy, adapted tothe London Pharmacopaeia, embodying the New French,American, and Indian Medicines, and also comprising a Sum-mary of Practical Toxicology. By J. HUNTER LANE, M.D.Fcp., 8vo, pp. 310. London. Second Edition.

THE issue of the New Pharmacopoeia has rendered it neces- ’,sary for Dr. Hunter Lane to bring out a new edition of his I," Compendium." Of the first edition we spoke favourably ’,

as a careful and useful compilation. The present editionembraces all the new medicines, and will be found useful inthe dispensary of the practitioner and the shop of the

druggist. ,

The Wisdom and Beneficence Qf the Alm1’ghty as Displayerl inthe Sense of Visioia. (The Actonian Prize T°eatise for l8al).By T. WHARTOAT JONES, F.R.S. Fcp., 8vo, pp. 135. London.

Tnis may be called a Bridgewater Treatise in miniature, andis really a most interesting little work. The whole matters

relating to the organization and functions of the eye aretreated in a masterly manner, but in a most familiar andpleasing style. To the young in particular Mr. WhartonJones’s Actonian Prize Treatise will be most acceptable, andwe think that neither family nor school should be without it.

Elements of Materia Illediect, comprising the Chemistry andNatural Ilisto2-y of Drugs, t7icir Effects, Doses, and Adtilterct-tions, with the Preparations of the British Plaarmocopceia.By WILLIAlI1 FRAZER, M.D. Fcp., pp. 466. London: H.Bailliere. Dublin: Fannin & Co.

Tms will prove a useful work to students, dispensers ofmedicines, and the practitioners of medicine. The title suf-

ficiently explains the nature of the work, and the manner inwhich it is executed entitles it to be regarded as a usefuladdition to our works of reference.

New InventionsIN AID OF THE

PRACTICE OF MEDICINE AND SURGERY,

Abdominal Belt. HUXLEY, Vere-street, Cavendish-square.AN efficacious belt for the abdomen in certain disorders ofthis cavity, and relaxations of the abdominal walls, whichshould be at the same time effective, easy to wear, andmoderate in cost, has long been a desideratum. The beltmade by Mr. Huxley, on a principle suggested by Mr.Walter Bryant, answers these indications more perfectlythan any other which we have used in practice. Inthe construction of this belt, the abdominal protrusion or reolaxation becomes the fulcrum, from which the necessarypressure is exerted. It is light, preserves its shape after longwearing, and does not wriggle out of its proper place, as toooften happens with bandages and common belts. The follow-ing diagrams show the shape and mechanism of the belt veryclearly.

Mr. Bryant’s belt is highly useful in affording support inthe latter part of pregnancy, for compression after delivery,and in cases threatening haemorrhage, for which compressesare adjusted; it also affords valuable abdominal support inuterine prolapse, irreducible hernia, excessive corpulency,deficiency of tone in the abdominal walls, and in every case