« ZurückWeiter »
There are three standing committees, viz., Committee of Examination; Committee to nominate a Physician to the Medical Institution; Committee to nominate a Physician of the Retreat for the Insane.
A list of persons recommended by the several county societies to attend a gratuitous course of lectures at the Medical Institution of Yale College, is published in these proceedings. We are at a loss to see any good reason for such publicity. Delicacy to the feelings of the parties benefited should forbid it.
There must be great competition for the office of Treasurer, as we find that this officer was allowed no less a sum than—" ten dollars for his services."
The number of Ordinary Members of the Society is 333 "taxable" and 29 “ not taxable.” The honorary members are 32 in number, of whom eight are deceased.
AN AMERICAN PHRENOLOGICAL JOURNAL AND MISCELLANY, is about to be published in this city, as we learn from a Prospectus recently issued by Adam Waldie, 46 Carpenter Street, Philadelphia. Mr. Waldie will be the publisher of the Journal. The name of the editor is not announced, nor is it known to us, hence we are unable to speak of the auspices under which the work will be conducted, or of the probabilities of its success on this score. The subject is one of vast importance; the materials are very ample and allow of being exhibited under various aspects, and with multiplied applications. Intellectual and ethical philosophy, education, criticism, national and individual character, and jurisprudence, and political economy may be specified, among the subjects on which phrenology is calculated to throw great light, if it do not prove a sure guide. To say that it has already done more in these respects than the commonly received metaphysical systems of the schools, would be small praise, except by comparison.
Touching the security for the continuance of the Phrenological Journal for at least one year, we read in the prospectus" As funds are already deposited for sustaining the work one year, subscribers will incur no risk of loss by paying in advance; and for the same reason, subscriptions will be invariably required in ADVANCE,"
Each number to appear monthly, and to consist of 32 octavo pages, inaking a volume of not less than 384 pages ; corresponding in point of mechanical execution with the best periodicals of the day. The Journal will be furnished to subscribers at $2, per annum. To CLERGYMEN AND THEOLOGICAL STUDENTS, single copies will be furnished at $1,50 per annum. First number in October.
On the cover of the “ Journal and Library” will be found an advertisement of a proposed work on Phrenology, by Alexander A. Young. The author is painstaking and conscientious, and will do his best to show that phrenology is not only sound philosophy, but that it is the best philosophy with which we are yet acquainted, and that it is not only in accordance with, but strikingly sustains the lessons of Scripture, and revelation. We have seen sundry testimonials by gentlemen-professors and others in different colleges-expressive of the pleasure and instruction which they derived from hearing Mr. Young lecture.
BALSAM OF COPAIBA IN DISEASES OF THE MUCOUS MEMBRANE
OF THE INTESTINAL CANAL.
The next subject to which I shall call the attention of the reader, is the effects of the copaiba in the treatment of diarrhæa.
When and by whom the practice of resorting to this remedy originated I shall not attempt here to determine. It will be sufficient for my present purpose to show, by a brief reference to a few writers within my reach, that for more than a century it has been countenanced by practitioners of deserved reputation, and by some of them warmly recommended.
In his work on copaiba, which was published as early as the year 1710, Hoppe speaks of its use in diarrhea, in a way to indicate that the practice was common at the time he wrote. Nor was it neglected at a later period. It has been already stated, that Dr. Pemberton recommends it in those cases of dysentery in which the disease, having continued for some time, has assumed the form of chronic diarrhea and is attended with exudation of mucus and blood, occasional griping pain and tenesmus, The same writer also used it, both by the mouth and in the form of injection, in cases in which he was led, by the offensive smell and curdled appearance of the discharges, to suspect that there existed ulcerations in the large intestines. Hallé in his notes on Tissot, and also Nysten, speak in favourable terms of the copaiba in atonic diarrhea. Richard regards it as an advantageous agent in the chronic form of the disease when the mucous membrane is the seat of slight inflammation; and Barbier of Amiens also speaks favourably of its effects in some varieties of the same disease. Dr. Good recommends it, in a particular manner, in that form of diarrhea in which the discharges consist more or less of membrane-like tubes, whitish, viscous and inodorous. He remarks, that the copaiba has proved still more serviceable in such cases than the milder preparations of mercury, which he thinks are very useful. “When in this disease I have not been able to induce the patient to take it by the mouth, I have recommended it in the form of injections. In one case, in which I prescribed it in this form, three drachms intermixed with three ounces of mucilage of linseed being thrown up three times a day, it proved eminently use
ful.” Dr. Copeland also advocates its use in the chronic form of simple mucous diarrhæa, and in cases complicated with, or depending on, ulceration of the intestines.
Among the physicians of our own country we find, so far as my memory extends, but a few by whom the copaiba is spoken of as an useful agent in the disease in question. Indeed, I believe, that of the writers of note, Dr. Eberle, again, forms an exception on the subject. In his work already quoted (ii. 305), he remarks that in obstinate cases the internal use of that remedy will sometimes do much good. Differing, however, from some of the writers already mentioned, he does not think it probable that it can procure any permanent relief in cases attended with ulceration of the intestinal mucous tissue. Yet, in cases of this kind, he has known considerable temporary benefit derived from this article. In a case of chronic diarrhæa, of upwards of six months' continuance, and depending, as Dr. E. thinks, on simple chronic inflammation without ulceration of the mucous tissue, he succeeded in effecting a perfect cure by means of copaiba, given to the extent of from thirty to forty drops three times daily, and fifteen drops of laudanum with each dose.
Such being the views entertained by high professional authorities abroad, relative to the remedial agency of copaiba in diarrhea, and such the neglect it has met with at home, I shall offer no apology for devoting a few pages to the consideration of the subject, by laying before the reader the details of several cases, and a few remarks suggested by the phenomena presented.
Case 1.-A case answering to the description given by Dr. Good of the tubalated form of diarrhea, and bearing some resemblance to those, of which an account was published by Dr. Powell in the sixth volume of the Transactions of the London College of Physicians, came under my immediate notice a few years ago. The patient, a female, aged about forty years, had been subject, occasionally, for sometime back to a slight derangement of the bowels. The attack in question had come on suddenly, and had rapidly assumed a serions character. When I first saw the patient she had not left the house for several weeks ; during which time she had taken a great variety of family medicines. She complained of pain along the arch of the colon, and about the umbilicus. The pain was occasionally very severe and griping, but was not excited or increased by pressure. The stomach was irritable; there was some fever, and the tongue was pasty. The alvine evacuations were not very frequent, but consisted, in great measure, of thin unhealthy feculent matter, mixed up with a large portion of a substance which was at first supposed by the friends, and attendants to be worms, and subsequently by some persons the internal lining of the intestines; but which evidently consisted of flakes of coagulable lymph. Leeches were applied around the anus and over the epigastric region—the diet was restricted to small quantities of farinaceous articles; and tepid baths, opiates, alterative doses of blue mass, with rhubarb and ipecacuanha, were successively prescribed. But, although by these means, the pain and irritation were allayed, yet little impression was made on the diarrhætic symptoms—the discharges continuing as frequent as before, and containing the same albuminous flakes. It was in consequence thought advisable, with a view if possible of expediting the care, to resort to additional means ; and selection was made, at my suggestion, of the copaiba. It was administered both by the mouth and in the form of injections, as recommended by Dr. Good. Under the use of this medicine the disease gradually gave way, and in a few weeks the patient was restored to health.
I am disposed to attribute the largest share, if not the whole, of the benefit obtained in this case to the copaiba, because during the time it was used no other article likely to exercise an agency in the cure was resorted to, and before it was prescribed the amendment obtained was not such as to justify a belief that the disease, if left to itself, would terminate favourably in so short a time.
While on this subject it may be proper to remark, that Dr. Powell is of opinion, there was no evidence, in the cases of which he has given an account, of an inflammatory process going on, as the pain was rather of a spasmodic nature, and the skin and pulse were natural. With due deference, however, to the pathological knowledge of Dr. Powell, others may be allowed to suspect that in the present instance he has not adopted a correet view of the subject. To this opinion we are led by the circumstance, that when exudations of coagulable lymph occur in other portions of the mucous tissue, they are found to be the product of inflammation. They occur in dysentery, in croup, &c., which are undoubtedly inflammatory diseases; and experience has fully shown that inflammation, even of vital organs, is not necessarily accompanied with fever and hot skin. But, however it may be in regard to the cases which fell under the notice of Dr. Powell, there can scarcely be any doubt that in the instance just described the complaint depended on inflammation. The state of the skin, the febrile excitement, the abdominal pain, the furred and pasty tongue, and the effect of the treatment to say nothing of the character of the matter discharged -indicate that such was the nature of the disease. Nor can this view be invali. dated by our knowledge of the stimulating property of the copaiba : the facts already detailed in this communication, as well as others to which I shall advert presently—to say nothing of its use in gonorrhæa and other diseasesdemonstrate that the same remedy is used with unequivocal success in cases depending on inflammation. Dr. Powell relies principally on purgatives—senna tea, combined with infusion of gentian and liquor of potassæ. From such remedies, however, it is not probable we can obtain any other effect than the evacuation of the coagulable matter ;-snpposing, indeed, that purgatives will not be sometimes apt to aggravate the disease. By those who entertain views different from those of Dr. P. relative to the pathology of the disease, and who are sensible of the mode of operation of purgatives, it will be readily admitted that it would be more rational to resort to such means as are calculated to remove the cause of the exudation, by changing the action of the secerning vessels, than to trust to those that act principally as evacuants of the bowels.
CASE 2.-Mucous Diarrhæa.-A gentleman applied to me a few years ago for advice. He had recently returned from India, and had laboured, during nearly the whole passage, under bowel derangement. At first the disease was attended with pain, and, as far as I could ascertain, with considerable fever. But whatever might have been the case at first, these symptoms had in great measure subsided at the time the patient came under my observation; for the skin, though dry and harsh to the feel, was rarely preternaturally hot, the pulse was but moderately excited, and the pain was seldom if ever troublesome. The stools were very frequent, and consisted of a mucous-like substance, with very little bile, and a small portion of feculent matter, and occasionally contained a fluid having the appearance of pus tinged with blood. The patient was emaciated, and laboured under depressed spirits--the abdomen was tense and hot, the stomach was not much implicated, and the urine was passed in small quantity, and of a red colour, The disease had come on after exposure to wet and cold, and was probably ago gravated and kept up by improper treatment and diet.
Believing from a review of the symptoms enumerated that the disease depended on chronic inflammation of the living membrane of the intestines, and fearing the existence of ulceration, I had recourse to antiphlogistic means, leeches around the anus, and cups over the abdomen; followed by ipecacuanha and opium, alterative doses of blue mass, tepid baths, diluent drinks, and emollient injections. Under this plan, the evacuations gradually lessened in frequency, and the skin lost, in a great measure, its harshness and dryness. But though some amendment was thus obtained, the disease was not arrested; the evacuations continuing to present the same unhealthy appearance both as regards the colour and the consistence of the matter voided. Under these circumstances, and expecting little further benefit from the remedies already used, it was thought advisable to make trial of others of a different character. With this view the balsam of copaiba was prescribed in doses of twenty-five drops three times a day, with from five to ten of laudanum in each dose according to circumstances, in a wine glassful of cold camomile tea. Finding that the remedy did not disagree with the stomach, and that the effects on the bowels appeared from the first beneficial, it was persevered in-the dose being gradually increased, and light nourishment at the same time enjoined. At the end of about a month the patient was restored to health.
Whether in this case the diseased membrane was the seat of ulceration is a point upon which I am not prepared to express a decided opinion ; although the appearance of the dejections, as also the long duration of the disease, may probably be thought to justify an opinion that such was the case. This leads me to remark, that I am not disposed to join Dr. Eberle in the opinion that the copaiba though capable of relieving, cannot cure diarrhæa attendant upon ulceration of the bowels. It is well known that these ulcerations are curable, and cases in which they are thought to occur are cured, by the same means which succeed in those in which they do not exist; hence it is very difficult, if not impossible, to decide positively during the continuance of the disease, whether or not they are present. When we bear these circumstances in view, and remember besides, that it is admitted the copaiba may afford relief in such cases, it is difficult to discover what are the grounds for believing that in none of the cases that had got well under the use of that remedy the membrane was the seat of ulceration. Nor is this all. Dr. Eberle admits that the copaiba is excellent in chronic enteritis, and in describing the post mortem appearances in that disease, he states that ulceration is the ordinary condition of the mucous tissue of the intestines. By this he seems to involve himself in contradiction, for it is not probable that ulcers exist only in cases that terminate fatally. As they are not necessarily fatal they may be presumed to have existed also in individuals who recovered ; and if the copaiba has contributed to their cure, there can be no reason to deny that it is adequate to the same task in chronic diarrhea, which dissection shows is generally accompanied by ulceration, and between which and chronic enteritis there appears to be a distinction without a difference.