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WOUND OF THE SCALP.
241 his brother, Mr. Henry, accorded me their valuable assistance. of the various alterations which characterize pneumonia, beI then cut down upon the anterior tibial, which we found sides those of ordinary catarrh. This affection is very dancompletely divided in the first part of its course, where it per- gerous, and medical men find themselves strangely mistaken forates the interosseous ligament, and applied a ligature to when, after a mild catarrh, which they pronounced trifling, both ends of the vessel. In removing the coagulum, a piece the mucous pneumonia attacks the little patient. The mucous of glass was found, about an inch in length, and half an inch secretion then becomes more and more abundant, it cannot in breadth, the point of which was sticking in the tibia. be got rid of, and the child dies. Dr. Duclos thinks that the January 22nd, 1850.-Five weeks have elapsed since the treatment ought to differ from the one usually adopted operation; during this time he has gone on most favourably. in common pneumonia, on account of the rapid progress No return of hmmorrhage; has been quite free from pain; of the disease when inflammation has set in, and the large health and strength rapidly improving, and wound almost amount of mucous secretion which takes place. He sums up healed. the means to be employed in the following manner:-Emeties Neweastle-on-Tyne, January, 1850. chiefly, antimonials simultaneously, cutaneous revulsion on the chest, and better on the legs.
WOUND OF THE SCALP.
Treatment of Typhoid Fe2cw by Calomel. Dr. ScnoENLEly, professor of clinical medicine We find that BY R. BELL, ESQ., M.R.C.S.E., Cockermouth. at the University of Berlin, treats typhoid fever with calomel I WAS summoned at mid-day, on the 27th of November last, In his " Lectures on Clinical Medicine," published by Dr. to attend a boy, aged fourteen, who had been struck by a Gueterbock, the professor condemns the practice of giving horse when incautiously taking hold of its tail. On my arrival, emetics in this disease, as formerly advocated by Hildebrand, he was apparently moribund from the shock and loss of blood, Stoll, and Richter. Emetics have had a fair trial at his hands, and on proceeding to examine the nature and extent of the and he found that they increased the intestinal erythema, and injury sustained, I discovered a semicircular wound of the did harm. The calomel treatment is preferable, and Authenscalp extending four inches over the upper part of the frontal rieth has the merit of having introduced this practice as far bone; corresponding with this there was a fracture without back as 1806 and 1807. Though Dr. Schoenlein condemns comminution, with a considerable depression on the low side, neutral salts, as well as emetics, he gives calomel, because where the greatest weight of the blow had fallen, diminishing this salt does not purge in the same manner as neutral salts towards the upper part of the head: this I ascertained by do; it produces what the ancients called atrabiliary stools, making an incision through the integuments in that direction. and these were long looked upon, by himself, as bilious; but A small portion of brain which had been forced through to recent investigations, they seem to be composed the fracture was seen adhering to his cap, and also to the according of altered haematosine. The evacuations, by the use of hair. calomel, become rarer and more consistent, and diarrhoea is Altogether, I formed an unfavourable prognosis of the case; not produced by it, as it is with neutral salts; and if the chlothe only symptom that gave me any hope was the rejection of ride of mercury does not prevent the erythema of the inteshis dinner, recently taken. By slow degrees he regained his it materially diminishes its intensity. The use of calomel tines, warmth, and in a few days his recollection; his pulse, for a in typhoid fever should be limited to the first week, or the fortnight, never exceeded forty-eight. I had no occasion to earlier days of the second; the sooner it is administered the bleed, or give purgative medicine beyond the first week. more efficacious it will be. When nervous symptoms arise, or Under these circumstances, I determined not to interfere intestinal complications occur,-when pressure on the abdomen in attempting to elevate the depressed portion of bone, so is painful, the tongue dry, and the pulse frequent,-the calomel long as no untoward symptoms presented themselves, more par- should be stopped, for it would then do harm. Professor ticularly as it was so much overlaid, and I have had no reason Schoenlein agrees with the practitioners of the Tubingen to regret my treatment, as up to the present time the wound and large doses of the salt-viz., fifteen grains, has been gradually filling up over that part, which is no longer school,other givesuntil the stools become more and more every day, visible, and I think in the course of a week or two, the wholei rare: to combat the aciditygreen generated, a few grains of carbowill be cicatrized. The boy, who is a servant, is even now nate of magnesia are added. Salivation ought to be looked performing all kinds of work, as before the accident, without’ upon as hurtful, but the practitioner cannot always avoid it; pain or inconvenience. My motive for relating this case, isI and to guard against it, the author advises the calomel to be to prove how much better it is, in a young and healthy subin such a manner as not to come in contact with the given ject, to wait patiently, carefully watching the symptoms, thanl mucous membrane of the mouth, as he believes (a creed in to perforate the cranium, as I must have done, according to the- which few in this will share) that salivation is rarer instructions of the older surgeons, who believed that every’ when the salt doescountry not come in direct contact with the buccal depressed fracture of the skull necessarily demanded the ap.’ mucous membrane. plication of the trephine. Cockermouth, 1850. ,
.
Reviews.
Foreign Department. Pneumonia, or Suffocating Catarrh of Infants. Dr. DUCLOS, in the Buhetin de Thérapeutique, has given the Mucous
Practical Observations on the Preventiw, Causes, and T1’eatrnenJ.£
of mucous pneumonia to an inflammation of the parenpp. 245. chyma of the lungs in very young children, which differs from THE author of the present work has devoted considerable the usual type of pneumonia by its mode of production, attention to diseases of the spine for a number of years, and anatomical characters, and symptoms. Instead of occurring his views regarding their pathology and the mode of treat= at once, as pneumonia often does with young children, it follows upon, and seems to be an extension of, a catarrhal ment to be adopted in these affections have for some time phlegmasia. It has likewise been observed to attack children been before the profession in former editions of this book; during dentition. In ordinary pneumonia, there is generally and in this, which is the third, are contained the results of a sub-crepitant rale when the inflammation is lobular, or further experience, which have " tended to confirm the views sonorous râles when a whole lobe is involved. In the mucous he then took relative to the several forms of the disease, and pneumonia, however, as the inflammation does not extend to still further, to convince him of the value of the plans of the whole lobe, there is no sonorous rale, and as the bronchial secretion is extremely abundant, mucous rhonchi entirely treatment which he advocated." inask the sub-crepitating rates. But both varieties present a It too often happens that the treatment of some particular certain amount of oppression, violent movements of the forms of disease, as those of the urinary organs, ears, and al2e nasi, and a peculiar furrow at the base of the chest, along falls into the hands of some ignorant and rascally prethe insertions of the diaphragm, which is so characteristic, spine, to scientific knowledge, who too readily delude the tenders that Dr. Trousseau has given it the name of " peri-pneumonic do an immensity of mischief. When, however, a and fever. public, Post-mortem after and examinations, furrow," lastly, fatal cases of mucous pneumonia, have disclosed the existence regularly educated member of the profession devotes himself name
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WOUND OF THE SCALP.
Treatment of Typhoid Fe2cw by Calomel. Dr. ScnoENLEly, professor of clinical medicine We find that BY R. BELL, ESQ., M.R.C.S.E., Cockermouth. at the University of Berlin, treats typhoid fever with calomel I WAS summoned at mid-day, on the 27th of November last, In his " Lectures on Clinical Medicine," published by Dr. to attend a boy, aged fourteen, who had been struck by a Gueterbock, the professor condemns the practice of giving horse when incautiously taking hold of its tail. On my arrival, emetics in this disease, as formerly advocated by Hildebrand, he was apparently moribund from the shock and loss of blood, Stoll, and Richter. Emetics have had a fair trial at his hands, and on proceeding to examine the nature and extent of the and he found that they increased the intestinal erythema, and injury sustained, I discovered a semicircular wound of the did harm. The calomel treatment is preferable, and Authenscalp extending four inches over the upper part of the frontal rieth has the merit of having introduced this practice as far bone; corresponding with this there was a fracture without back as 1806 and 1807. Though Dr. Schoenlein condemns comminution, with a considerable depression on the low side, neutral salts, as well as emetics, he gives calomel, because where the greatest weight of the blow had fallen, diminishing this salt does not purge in the same manner as neutral salts towards the upper part of the head: this I ascertained by do; it produces what the ancients called atrabiliary stools, making an incision through the integuments in that direction. and these were long looked upon, by himself, as bilious; but A small portion of brain which had been forced through to recent investigations, they seem to be composed the fracture was seen adhering to his cap, and also to the according of altered haematosine. The evacuations, by the use of hair. calomel, become rarer and more consistent, and diarrhoea is Altogether, I formed an unfavourable prognosis of the case; not produced by it, as it is with neutral salts; and if the chlothe only symptom that gave me any hope was the rejection of ride of mercury does not prevent the erythema of the inteshis dinner, recently taken. By slow degrees he regained his it materially diminishes its intensity. The use of calomel tines, warmth, and in a few days his recollection; his pulse, for a in typhoid fever should be limited to the first week, or the fortnight, never exceeded forty-eight. I had no occasion to earlier days of the second; the sooner it is administered the bleed, or give purgative medicine beyond the first week. more efficacious it will be. When nervous symptoms arise, or Under these circumstances, I determined not to interfere intestinal complications occur,-when pressure on the abdomen in attempting to elevate the depressed portion of bone, so is painful, the tongue dry, and the pulse frequent,-the calomel long as no untoward symptoms presented themselves, more par- should be stopped, for it would then do harm. Professor ticularly as it was so much overlaid, and I have had no reason Schoenlein agrees with the practitioners of the Tubingen to regret my treatment, as up to the present time the wound and large doses of the salt-viz., fifteen grains, has been gradually filling up over that part, which is no longer school,other givesuntil the stools become more and more every day, visible, and I think in the course of a week or two, the wholei rare: to combat the aciditygreen generated, a few grains of carbowill be cicatrized. The boy, who is a servant, is even now nate of magnesia are added. Salivation ought to be looked performing all kinds of work, as before the accident, without’ upon as hurtful, but the practitioner cannot always avoid it; pain or inconvenience. My motive for relating this case, isI and to guard against it, the author advises the calomel to be to prove how much better it is, in a young and healthy subin such a manner as not to come in contact with the given ject, to wait patiently, carefully watching the symptoms, thanl mucous membrane of the mouth, as he believes (a creed in to perforate the cranium, as I must have done, according to the- which few in this will share) that salivation is rarer instructions of the older surgeons, who believed that every’ when the salt doescountry not come in direct contact with the buccal depressed fracture of the skull necessarily demanded the ap.’ mucous membrane. plication of the trephine. Cockermouth, 1850. ,
.
Reviews.
Foreign Department. Pneumonia, or Suffocating Catarrh of Infants. Dr. DUCLOS, in the Buhetin de Thérapeutique, has given the Mucous
Practical Observations on the Preventiw, Causes, and T1’eatrnenJ.£
of mucous pneumonia to an inflammation of the parenpp. 245. chyma of the lungs in very young children, which differs from THE author of the present work has devoted considerable the usual type of pneumonia by its mode of production, attention to diseases of the spine for a number of years, and anatomical characters, and symptoms. Instead of occurring his views regarding their pathology and the mode of treat= at once, as pneumonia often does with young children, it follows upon, and seems to be an extension of, a catarrhal ment to be adopted in these affections have for some time phlegmasia. It has likewise been observed to attack children been before the profession in former editions of this book; during dentition. In ordinary pneumonia, there is generally and in this, which is the third, are contained the results of a sub-crepitant rale when the inflammation is lobular, or further experience, which have " tended to confirm the views sonorous râles when a whole lobe is involved. In the mucous he then took relative to the several forms of the disease, and pneumonia, however, as the inflammation does not extend to still further, to convince him of the value of the plans of the whole lobe, there is no sonorous rale, and as the bronchial secretion is extremely abundant, mucous rhonchi entirely treatment which he advocated." inask the sub-crepitating rates. But both varieties present a It too often happens that the treatment of some particular certain amount of oppression, violent movements of the forms of disease, as those of the urinary organs, ears, and al2e nasi, and a peculiar furrow at the base of the chest, along falls into the hands of some ignorant and rascally prethe insertions of the diaphragm, which is so characteristic, spine, to scientific knowledge, who too readily delude the tenders that Dr. Trousseau has given it the name of " peri-pneumonic do an immensity of mischief. When, however, a and fever. public, Post-mortem after and examinations, furrow," lastly, fatal cases of mucous pneumonia, have disclosed the existence regularly educated member of the profession devotes himself name
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