- Email: [email protected]
PATHOLOGY OF PHLEGMASIA DOLENS.
564 case was
ease
to four or five inches ; the skin around red, of a deeper colour towards the dis; when the finger was pressed upon this
from
one to four drops in water two or three times a-day ; one to two drachms to a pint of water, as an injection or lotion. I have
a white mark was left for the honour to be, Sir, your obedient servant, E. E. W.W.Tuso:’<. TUSON. As the redness round the disease , veins became Russell-place, Fitzroy-square, visible,passing increased, large in a radiated and tortuous direction from the , July 10, 1843. disease to the surrounding healthy parts ; the It will give me pleasure to hear the %’’ slough next took place, when all this ap- result of the exhibition of this new remedy pearance gradually diminished, and the from any of the profession that may be surrounding parts became again in a healthy inclined to employ it. state, the skin assuming its natural colour. The same application was employed during PATHOLOGY OF PHLEGMASIA these changes. DOLENS. One curious and interesting fact may be DIFFERENCES OF OPINION. noticed, which, I think, can be proved, -that this chemical preparation has some peculiar efieet in cancerous patients, and in A DEBATE on this subject recently took some sunering from other diseases, acting as place in the French Academy of Medicine, a powerful sedative, but when it has been in the course of which MM. Brescliet, employed in some other cases it had no such Blandin, and Velpeau, announced their sedative effect. It is not my intention here opinion that the disease was not invariably to enter into a lengthened detail on this sub. dependent on inflammation of the veins, but, ject, as I intend to do so on some future in a great number of cases, on that of the occasion; but I wish to point out in what lymphatics. M. Velpeau said, " According cases this remedy may be employed advan- to my observation phlebitis is far from being tageously, and where its use has proved the common cause of phlegmasia dolens; most frequently the disease commences by beneficial. In gangrena seniiis its local application an inflammation of the deep lymphatics of will be of the greatest service ; its antiseptic!, the hmb in which the oedema takes place." property is here remarkable, for where it was Both M. Blandin and M. Cloquet admitted used by a patient, the fetor being so great that the disease was by no means confined that we could hardly approach the bed, we to recently delivered women, but often apcan now examine the foot without incon- peared in men; and the latter gentleman, venience. Opium failed here to give relief, with MM. Moreau, Berard, and Gerardm, either in removing the pain or procuring considered it to have its seat essentially in sleep. This remedy, employed locally, had the cellular tissue of the limb affected. M. Andral attributed the more frequent occurimmediate effects in producing both. In sloughing ulcers, also, its local applica- rence of the disease in women solely to the tion will present the slough extending, and greater liability of their sex, to pelvic dis11 In certain cases of phlegmasia (he greatly assist in its removal, rendering the ease. I parts beneath of a healthy character, and, said) have verified the cause to be inflaiiiin cases accompanied with much pain, will mation of the lymphatics, but the oedema, when from such a cause, has been slight. give immediate relief. In uterine affections, carcinoma, scirrhus, When phlebitis is present, on the contrary, ulcerated surfaces, with profuse discharge, the oedema is considerable, and the pam its use as an injection has produced the acute. In the great majority of cases the greatest benefit : where all other medicines painful engorgement is due to the obliterahave failed this has frequently proved a tion of veins previously inflamed." These views have been made public in the valuable remedy. In neuralgic affections its local and inter- " Experience" and the" Gazette des Hôpi. nal exhibition will be of the utmost service. taux." We believe that as long back as In some cases of severe sickness, dependent 1817 or 1818 the late Dr. D. Davis enterupon nervous irritability, after the usual tained the idea that the true pathology of remedies have failed, this has been success- phlegmasia dolens was inflammation and ful to a pre-eminent degree. It allays nervous obliteration of the external iliac and femoral irritability, removes anxiety of mind, invigo- vein ; we do not, however, find his claim to rates and raises the spirits, and where patients discovery alluded to, or even his name menhave one day been in a state of complete tioned, in the reports of the above discussion. misery, they have on the following one become happy and joyful from its eflects. UREA IN THE BLOOD.-Simon took the The ter-chloride of carbon* is a clear coagulum of the blood, in several instances, transparent fluid, smelling strongly of chlo- and procured from it an alcoholic extract of rine, as its name implies; it consists of three hasmatogtobutiue. By the addition of mtnc parts of chlorine and one of carbon ; the dose acid to this, followed by drying under the air-pump, a crop of crystals was obtained, * Prepared by Mr. Garden, Oxford-street. which turned out to-be nitrate of urea.
part it pitted, and a
second.
il
ease
to four or five inches ; the skin around red, of a deeper colour towards the dis; when the finger was pressed upon this
from
one to four drops in water two or three times a-day ; one to two drachms to a pint of water, as an injection or lotion. I have
a white mark was left for the honour to be, Sir, your obedient servant, E. E. W.W.Tuso:’<. TUSON. As the redness round the disease , veins became Russell-place, Fitzroy-square, visible,passing increased, large in a radiated and tortuous direction from the , July 10, 1843. disease to the surrounding healthy parts ; the It will give me pleasure to hear the %’’ slough next took place, when all this ap- result of the exhibition of this new remedy pearance gradually diminished, and the from any of the profession that may be surrounding parts became again in a healthy inclined to employ it. state, the skin assuming its natural colour. The same application was employed during PATHOLOGY OF PHLEGMASIA these changes. DOLENS. One curious and interesting fact may be DIFFERENCES OF OPINION. noticed, which, I think, can be proved, -that this chemical preparation has some peculiar efieet in cancerous patients, and in A DEBATE on this subject recently took some sunering from other diseases, acting as place in the French Academy of Medicine, a powerful sedative, but when it has been in the course of which MM. Brescliet, employed in some other cases it had no such Blandin, and Velpeau, announced their sedative effect. It is not my intention here opinion that the disease was not invariably to enter into a lengthened detail on this sub. dependent on inflammation of the veins, but, ject, as I intend to do so on some future in a great number of cases, on that of the occasion; but I wish to point out in what lymphatics. M. Velpeau said, " According cases this remedy may be employed advan- to my observation phlebitis is far from being tageously, and where its use has proved the common cause of phlegmasia dolens; most frequently the disease commences by beneficial. In gangrena seniiis its local application an inflammation of the deep lymphatics of will be of the greatest service ; its antiseptic!, the hmb in which the oedema takes place." property is here remarkable, for where it was Both M. Blandin and M. Cloquet admitted used by a patient, the fetor being so great that the disease was by no means confined that we could hardly approach the bed, we to recently delivered women, but often apcan now examine the foot without incon- peared in men; and the latter gentleman, venience. Opium failed here to give relief, with MM. Moreau, Berard, and Gerardm, either in removing the pain or procuring considered it to have its seat essentially in sleep. This remedy, employed locally, had the cellular tissue of the limb affected. M. Andral attributed the more frequent occurimmediate effects in producing both. In sloughing ulcers, also, its local applica- rence of the disease in women solely to the tion will present the slough extending, and greater liability of their sex, to pelvic dis11 In certain cases of phlegmasia (he greatly assist in its removal, rendering the ease. I parts beneath of a healthy character, and, said) have verified the cause to be inflaiiiin cases accompanied with much pain, will mation of the lymphatics, but the oedema, when from such a cause, has been slight. give immediate relief. In uterine affections, carcinoma, scirrhus, When phlebitis is present, on the contrary, ulcerated surfaces, with profuse discharge, the oedema is considerable, and the pam its use as an injection has produced the acute. In the great majority of cases the greatest benefit : where all other medicines painful engorgement is due to the obliterahave failed this has frequently proved a tion of veins previously inflamed." These views have been made public in the valuable remedy. In neuralgic affections its local and inter- " Experience" and the" Gazette des Hôpi. nal exhibition will be of the utmost service. taux." We believe that as long back as In some cases of severe sickness, dependent 1817 or 1818 the late Dr. D. Davis enterupon nervous irritability, after the usual tained the idea that the true pathology of remedies have failed, this has been success- phlegmasia dolens was inflammation and ful to a pre-eminent degree. It allays nervous obliteration of the external iliac and femoral irritability, removes anxiety of mind, invigo- vein ; we do not, however, find his claim to rates and raises the spirits, and where patients discovery alluded to, or even his name menhave one day been in a state of complete tioned, in the reports of the above discussion. misery, they have on the following one become happy and joyful from its eflects. UREA IN THE BLOOD.-Simon took the The ter-chloride of carbon* is a clear coagulum of the blood, in several instances, transparent fluid, smelling strongly of chlo- and procured from it an alcoholic extract of rine, as its name implies; it consists of three hasmatogtobutiue. By the addition of mtnc parts of chlorine and one of carbon ; the dose acid to this, followed by drying under the air-pump, a crop of crystals was obtained, * Prepared by Mr. Garden, Oxford-street. which turned out to-be nitrate of urea.
part it pitted, and a
second.
il