British Medical Journals.
1
177 M. Dunos said that he had been led, from some experi- ments, to believe that the ether possessed a cataleptic power. On the 22nd of January, M. Velpeau, at the Hôpital du Charite, having used an apparatus constructed by M. Charrière, succeeded perfectly in removing a tumour without pain. The etherial vapour was inhaled by the patient about four minutes, after which time complete insensibility and relaxa- tion of the muscles were manifested. M. H. Larrey, who assisted at the operation, suggested the valuable assistance that the agent would render in the re- ducing of difficult luxations. At the Hôpital du Midi, a case occurred in which the sensi- bility seemed to have been exalted by the inhalation. The influence of the vapour has also been tested by M. Guersant, at the Hûpital des Enfants, on two children. One child, whose finger was amputated, declared that she felt pain, but was totally unable to cry out. The other, on reco- vering from the state of insensibility into which she had been thrown, declared that she had no recollection whatever of the operation. At the Hôpital du Midi, M. Ricord, in injecting in a double hydrocele, employed the inhalation with success, though he was obliged to renew its influence twice during the operation. A second patient, afflicted with single hydrocele, after respiring vapour for thirteen minutes, fell into a complete state of insen- sibility ; the limbs were relaxed; the pupils contracted; the conjunctiva was injected; and the pulse not affected. A third patient, who was apparently perfectly under the influence of the ether, suffered the usual amount of pain during an opera- tion for removing a tumour from the rectum. In the first two cases, a state of intense exhilaration pre- ceded that of insensibility. In the last, the use of the ether was followed by sickness and fainting. ’ At the meeting of the Societé de Chirurgie de Paris, Jan. 13,1847, M. Malgaigne mentioned a case in which the inhala- tion having been continued for too long a time, caused sinking of the pulse and coldness of the extremities to such an extent, that fears were entertained for the life of the patient. At the meeting of the Academie de Medécine, Jan. 26, 1847, M. Landouzy called attention to a case, where haemorrhage, after removal of a small tumour from the mastoid process, did not come on till half an hour after the performance of the operation; and suggested that surgeons should be on their guard lest accidents might happen from the arteries not being secured. M. Honore stated, that he had succeeded in relieving a patient afflicted with most obstinate neuralgia of the face, by the inhalation of ether vapour for about two minutes. Académie des Sciences, Meeting, Jan. 25.-M. Gerdy related several experiments with the vapour of ether, the results of which had been satisfactory in the highest degree. From the above it will be seen, that the success which our neighbours have met with has been varied; but we think that in most of the cases in which the ether failed to produce its stupifying effect, that fault was clearly in the instrument used for its administration. At first they attempted to use this agent by causing the patient to inspire by the nostrils, and respire by the mouth, and vice versâ; but afterwards they found it requisite to close the nostrils while respiration was carried on by the mouth alone. The fact announced by M. Malgaigne, that some of the patients retained their consciousness, but felt no pain while being operated on, is most interesting, and we leave it to be commented on by physiologists; but the statement requires confirmation by other observers. The influence, also, over the power of expression of pain, is also very curious, but seemed to be quite an uncommon result; for we only find that this was the case in two out of the nume- rous cases quoted. The continued lethargy, with failing of the pulse, and cold- ness of the extremities, is certainly a most awkward compli- cation to deal with in treating the shock of an operation, and one which should make us cautious in the employment of the vapour of ether. In this country, in more cases than one, this unpleasant effect followed its use. If the vapour of ether prove an efficient therapeutic agent in the treatment of neuralgic affections, then, indeed, will its introduction prove a boon to society. And we much regret that M. Honor6 did not give a more detailed account of those cases in which he employed this remedy. " It would be well worth while to collect together all that is positive in medicine, and of which not a jot is transitory. It would make but a small book:’-Pauli. British Medical Journals. " TWO CASES OF ANEURISM TREATED BY LIGATURE, WITHOUT CON- FINEMENT TO BED; THEIR FORTUNATE TERMINATION. By J. KIRBY, Esq. " Since the period in which it was satisfactorily ascertained that ligatures should induce a certain amount of division in the tunics of an artery to secure their successful application, all operators have experienced much anxiety about the degree of force they employ when an artery is being tied, especially in cases of aneurism; but more is esteemed neces- sary than the due adaptation of force for the purpose of ensuring a fortunate result. Itepose is strictly enjoined as an essential to union, and commanded with such authority, that it appears as if the slightest infringement of the rule might defeat all previously well-executed proceedings. " The following cases are calculated to abate the great solicitude, which many, in contmon with myself, have felt upon the latter subject. How far the cautious precept may be neglected or opposed with surprising impunity, the prac- tical reader may judge. " CASE 1.—Some years since, assisted by my former pupils, Drs. Mathews and others, I tied the femoral artery at the groin in a man residing in Wexford-street. He was young, intemperate, and there was obscure evidence of morbus cordis, of which he died in a few years. He was a thin person. The artery was easily exposed, readily secured, and matters being finished in the usual way, I felt quite satisfied that the case was one of comfortable promise. " The day was Sunday. Monday, and every succeeding day, I saw him morning and evening. The thirteenth day the ligature came away with the dressing, &c., and the wound was healed. " I was now informed that all my rules, as to rest and quiet- ness, were from the first neglected. Being summoned to a. police-office a few days before the operation, he left his house the day after it was performed, and walked about a mile to the court, repeating the journey every day for a week, during which his attendance was required. My visits being always at the same hours, he easily carried on the deception, of which one could not hold the least suspicion, as he was always found most comfortably and quietly settled in his bed. " CASE 2.-I assisted Mr. Mitchell in an operation for popliteal aneurism, performed in the groin. The patient was thirty years old, very plethoric, and very intemperate. Im- patient of hospital restraint, he left on the third day, and nothing was heard of him until the fourteenth, when he pre- sented himself in a state of intoxication, with the ligature dangling on his finger, and wishing his joy to whoever might next require to wear it.’ "-Dublin Medical Press. The cases do not require a word of comment. It is enough to remember, that it was an Irishman who did not die after having a red-hot poker run through his chest. ’ "A CRITICAL DELIRIUM FEROX. " The following is an amusing example of the effect pro- duced by an unfavourable notice upon the proverbially irritable race which is so ambitious of the honours of author- ship. These gentlemen enter the lists mounted on their hobby-horses, with lance in rest, challenging all comers, and , vaunting their prowess; but the moment a pettifogging scribbler, with as much brains as a beetle,’ makes his appear- ance, then their courage cools, and the tongue is substituted for the arm. If medical reviewers err at present, it is most . assuredly not on the side of severity. On the contrary, the ’. great, and perhaps the just, reproach against them is the lenity of their decisions, or perhaps their partial leaning to . the author and disregard of the interests of the reader."— - Idem. 1 Here follows the specimen of " philosophic temper" ad- dressed to the Editor of THE LANCET by the bellicose indi- vidual who puffs off his sorry trash by a trumped-up quota- t. tion. APHORISMS. "In stomatitis, peppermint drops allowed to melt in the mouth produce a feeling of coolness, and are a good palliative. " Cold foot-baths at bedtime are a valuable remedy in that sleeplessness caused by loss of blood. "Brandy-drinkers can generally bear very hot baths; the peripheral nervous system being dulled in them."—Pauli, in British and Foreign Review.
Transcript of British Medical Journals.
177
M. Dunos said that he had been led, from some experi-ments, to believe that the ether possessed a cataleptic power.On the 22nd of January, M. Velpeau, at the Hôpital du
Charite, having used an apparatus constructed by M. Charrière,succeeded perfectly in removing a tumour without pain.The etherial vapour was inhaled by the patient about fourminutes, after which time complete insensibility and relaxa-tion of the muscles were manifested.
M. H. Larrey, who assisted at the operation, suggested thevaluable assistance that the agent would render in the re-ducing of difficult luxations.At the Hôpital du Midi, a case occurred in which the sensi-
bility seemed to have been exalted by the inhalation.The influence of the vapour has also been tested by M.
Guersant, at the Hûpital des Enfants, on two children. Onechild, whose finger was amputated, declared that she feltpain, but was totally unable to cry out. The other, on reco-vering from the state of insensibility into which she had beenthrown, declared that she had no recollection whatever ofthe operation.At the Hôpital du Midi, M. Ricord, in injecting in a double
hydrocele, employed the inhalation with success, though hewas obliged to renew its influence twice during the operation.A second patient, afflicted with single hydrocele, after respiringvapour for thirteen minutes, fell into a complete state of insen-sibility ; the limbs were relaxed; the pupils contracted; theconjunctiva was injected; and the pulse not affected. A thirdpatient, who was apparently perfectly under the influence ofthe ether, suffered the usual amount of pain during an opera-tion for removing a tumour from the rectum.In the first two cases, a state of intense exhilaration pre-
ceded that of insensibility. In the last, the use of the etherwas followed by sickness and fainting.
’
At the meeting of the Societé de Chirurgie de Paris, Jan.13,1847, M. Malgaigne mentioned a case in which the inhala-tion having been continued for too long a time, caused sinkingof the pulse and coldness of the extremities to such an extent,that fears were entertained for the life of the patient.At the meeting of the Academie de Medécine, Jan. 26, 1847,
M. Landouzy called attention to a case, where haemorrhage,after removal of a small tumour from the mastoid process, didnot come on till half an hour after the performance of theoperation; and suggested that surgeons should be on theirguard lest accidents might happen from the arteries not beingsecured. ,M. Honore stated, that he had succeeded in relieving a
patient afflicted with most obstinate neuralgia of the face, bythe inhalation of ether vapour for about two minutes.
Académie des Sciences, Meeting, Jan. 25.-M. Gerdy relatedseveral experiments with the vapour of ether, the results ofwhich had been satisfactory in the highest degree.From the above it will be seen, that the success which our
neighbours have met with has been varied; but we think thatin most of the cases in which the ether failed to produce itsstupifying effect, that fault was clearly in the instrument usedfor its administration. At first they attempted to use thisagent by causing the patient to inspire by the nostrils, andrespire by the mouth, and vice versâ; but afterwards theyfound it requisite to close the nostrils while respiration wascarried on by the mouth alone.The fact announced by M. Malgaigne, that some of the
patients retained their consciousness, but felt no pain whilebeing operated on, is most interesting, and we leave it to becommented on by physiologists; but the statement requiresconfirmation by other observers.The influence, also, over the power of expression of pain, is
also very curious, but seemed to be quite an uncommon result;for we only find that this was the case in two out of the nume-rous cases quoted.The continued lethargy, with failing of the pulse, and cold-ness of the extremities, is certainly a most awkward compli-
cation to deal with in treating the shock of an operation, andone which should make us cautious in the employment of thevapour of ether. In this country, in more cases than one, thisunpleasant effect followed its use.
If the vapour of ether prove an efficient therapeutic agentin the treatment of neuralgic affections, then, indeed, will itsintroduction prove a boon to society. And we much regretthat M. Honor6 did not give a more detailed account of thosecases in which he employed this remedy.
" It would be well worth while to collect together all thatis positive in medicine, and of which not a jot is transitory. Itwould make but a small book:’-Pauli.
British Medical Journals." TWO CASES OF ANEURISM TREATED BY LIGATURE, WITHOUT CON-
FINEMENT TO BED; THEIR FORTUNATE TERMINATION. By J.KIRBY, Esq." Since the period in which it was satisfactorily ascertained
that ligatures should induce a certain amount of division inthe tunics of an artery to secure their successful application,all operators have experienced much anxiety about thedegree of force they employ when an artery is being tied,especially in cases of aneurism; but more is esteemed neces-sary than the due adaptation of force for the purpose ofensuring a fortunate result. Itepose is strictly enjoined as anessential to union, and commanded with such authority, thatit appears as if the slightest infringement of the rule mightdefeat all previously well-executed proceedings.
" The following cases are calculated to abate the greatsolicitude, which many, in contmon with myself, have feltupon the latter subject. How far the cautious precept maybe neglected or opposed with surprising impunity, the prac-tical reader may judge.
" CASE 1.—Some years since, assisted by my former pupils,Drs. Mathews and others, I tied the femoral artery at thegroin in a man residing in Wexford-street. He was young,intemperate, and there was obscure evidence of morbuscordis, of which he died in a few years. He was a thin
person. The artery was easily exposed, readily secured, andmatters being finished in the usual way, I felt quite satisfiedthat the case was one of comfortable promise.
" The day was Sunday. Monday, and every succeedingday, I saw him morning and evening. The thirteenth daythe ligature came away with the dressing, &c., and the woundwas healed.
" I was now informed that all my rules, as to rest and quiet-ness, were from the first neglected. Being summoned to a.police-office a few days before the operation, he left his housethe day after it was performed, and walked about a mile tothe court, repeating the journey every day for a week, duringwhich his attendance was required. My visits being alwaysat the same hours, he easily carried on the deception, ofwhich one could not hold the least suspicion, as he was alwaysfound most comfortably and quietly settled in his bed.
" CASE 2.-I assisted Mr. Mitchell in an operation forpopliteal aneurism, performed in the groin. The patient wasthirty years old, very plethoric, and very intemperate. Im-
patient of hospital restraint, he left on the third day, andnothing was heard of him until the fourteenth, when he pre-
sented himself in a state of intoxication, with the ligaturedangling on his finger, and wishing his joy to whoever mightnext require to wear it.’ "-Dublin Medical Press.The cases do not require a word of comment. It is enough
to remember, that it was an Irishman who did not die afterhaving a red-hot poker run through his chest.
’ "A CRITICAL DELIRIUM FEROX.
" The following is an amusing example of the effect pro-duced by an unfavourable notice upon the proverbiallyirritable race which is so ambitious of the honours of author-ship. These gentlemen enter the lists mounted on theirhobby-horses, with lance in rest, challenging all comers, and
, vaunting their prowess; but the moment a pettifoggingscribbler, with as much brains as a beetle,’ makes his appear-ance, then their courage cools, and the tongue is substitutedfor the arm. If medical reviewers err at present, it is most
. assuredly not on the side of severity. On the contrary, the’. great, and perhaps the just, reproach against them is the
lenity of their decisions, or perhaps their partial leaning to. the author and disregard of the interests of the reader."—- Idem.1 Here follows the specimen of " philosophic temper" ad-
dressed to the Editor of THE LANCET by the bellicose indi-vidual who puffs off his sorry trash by a trumped-up quota-
t. tion.APHORISMS.
"In stomatitis, peppermint drops allowed to melt in themouth produce a feeling of coolness, and are a good palliative.
" Cold foot-baths at bedtime are a valuable remedy in thatsleeplessness caused by loss of blood."Brandy-drinkers can generally bear very hot baths; the
peripheral nervous system being dulled in them."—Pauli, inBritish and Foreign Review.
![LIST Medical BRITISH MEDICAL ASSOCIATION.Sept. 12, 1863.] LIST OF MEMBERS. [British MedicalJournal. BRITISH MEDICAL ASSOCIATION. OFFICERS AND COUNCIL FOR 1863-64. President. JOHNADDINGTON](https://static.fdocuments.net/doc/165x107/5eb967eea36b8d04b84916e8/list-medical-british-medical-sept-12-1863-list-of-members-british-medicaljournal.jpg)
