QUININE IN TRAUMATIC FEVER.
1
369 HAIRS UPON THE TONGUE. To the Editor of THE LANCET. SIR,-In your Journal of last week, p. 359, perceive a notice on the growth of hairs upon the tongue, quoted under the au- thority of the " Oesterreichische Medicinis- che Wochenschrift," and referred to by you as a statement unworthy of credit. On the continent the belief in the occa sional presence of hairs upon the tongue is by no means uncommon, and has for its sup- porters several distinguished names. Bichat in his "General Anatomy," enumerates, among the situations in which hairs are sometimes accidentally developed, the surfaces of mu- cous membranes, as of the stomach, the in- testines, the bladder, and the gall-bladder. On the mucous lining of the latter organ he found on one occasion about a dozen hairs, implanted by their roots into the tissue of the membrane. Villerm6, again, announces that hairs have been found on the tongue, and in the pharynx, the rectum, the uterus, and the vagina. If we turn our attention to the structure of c the mucous membrane we find that it is not t organised for the production of hairs, and in c this particular differs essentially from the t external investment of the body, which, in S every point of its surface, is endowed with hair-producing follicles. It would, perhaps, considering the close analogy subsisting be- tween the mucous membrane and skin, be presumptuous to declare that the production of hairs by the mucous membrane is impos- sible ; but we may safely affirm that such an d event is highly improbable. Admitting these 1 premises, we have no alternative but that of coming to the conclusion that Bichât and the other authorities on this subject have been deceived by the appearance of a something resembling hairs. And I think this the more likely to have been the case from the imperfect knowledge of the structure of the skin existing in the time of Bichât, and from the absence of the only satisfactory test in a case of this nature, the microscope. Indeed, there is sufficient reason to believe that at the period referred to, such a definition as the following would have been amply characte- ristic of a hair :-A filament, hair-like in form and dimensions, cylindrical, uniform. in diameter, adherent by one exti-e-ptity to the suiface of an organ; but your youngest reader must be aware that at the present day better proof is needed than such a defi- i, nition could embrace. With the kind of case described by the Austrian periodical, I am very familiar, having had my attention drawn to the sub- ject during some microscopic investigations, about seven years since, and having subse- quently seen many similar cases. In a work published in 1838, I have referred to these hair-like tufts growing on the tongue, and I have there remarked, in respect of them, that" the cuticular sheaths" of the papillae of the tongue " become enormously enlarged and lengthened in some fevers."* This is the real nature of these productions : they are epithelial sheaths of papillae, grown to a length of half or three-quarters of an inch, cylindrical in form, and hair-like in appear- ance and general characters ; indeed, with. out the aid of the microscope and recent knowledge on the mode of development of the epithelium, we might easily believe them to be hairs. About a year after my first ob- servation of these filamentary sheaths, I had the opportunity of conversing on the subject with Henlé, who quite agreed in the views which I had taken of them, and mentioned that he had seen a similar appearance in the epithelium of the alimentary canal. This explanation applies with equal force , to the other mucous surfaces indicated by Bichât and Villermé, and is peculiarly suited to the case narrated in the Austrian , hebdomadal, for as we there read the so , called hairs " disappeared under the influ- ence of an emetic," a phenomenon not at all f consistent with the kind of connection main. t tained between hairs and their papillae, but I quite in unison with the supposition of their being elongated epithelial sheaths. I am, 1 Sir, your obedient servant, ERASMUS WiLSON. , London, June 5,1843. ERASMUS WILSON. QUININE IN TRAUMATIC FEVER. A CASE has lately occurred in the Hôpital des Enfans at Paris, in which M. Guersant has employed, with entire success, the sul- phate of quinine in the treatment after am- putation of both lower extremities. The patient, a poor boy, whose limbs had been frozen by exposure during a winter’s night, and afterwards most injudiciously bathed in hot water, was brought to the hospital, the limb exhibiting a discoloured spotty ap- pearance, and other symptoms of inci- pient gangrene. This condition in six days, notwithstanding the application of bark-poultices and bottles of hot water to the extremities, so greatly increased as to render necessary an immediate amputation of both legs. The operation was success- fully performed, and with little suffering to the patient, who gradually recovered, though not without indications of considerable fever and erysipelatous inflammation, both of which were subdued by doses of sulphate of quinine, amounting to twelve grains in a day. M. Guersant cites other cases, also , in which he has employed the same medi cine with success, in all of which the lead- , ing feature was purulent reabsorption- Gazette des Hôpitaux, March 14. v * Practical and Surgical Anatomy, , page 307.
Transcript of QUININE IN TRAUMATIC FEVER.
369
HAIRS UPON THE TONGUE.
To the Editor of THE LANCET.
SIR,-In your Journal of last week,p. 359, perceive a notice on the growth ofhairs upon the tongue, quoted under the au-thority of the " Oesterreichische Medicinis-che Wochenschrift," and referred to by youas a statement unworthy of credit.On the continent the belief in the occa
sional presence of hairs upon the tongue isby no means uncommon, and has for its sup-porters several distinguished names. Bichatin his "General Anatomy," enumerates, amongthe situations in which hairs are sometimesaccidentally developed, the surfaces of mu-cous membranes, as of the stomach, the in-testines, the bladder, and the gall-bladder.On the mucous lining of the latter organ hefound on one occasion about a dozen hairs,implanted by their roots into the tissue ofthe membrane. Villerm6, again, announcesthat hairs have been found on the tongue,and in the pharynx, the rectum, the uterus,and the vagina.
If we turn our attention to the structure of c
the mucous membrane we find that it is not t
organised for the production of hairs, and in c
this particular differs essentially from the texternal investment of the body, which, in S
every point of its surface, is endowed withhair-producing follicles. It would, perhaps,considering the close analogy subsisting be-tween the mucous membrane and skin, be presumptuous to declare that the productionof hairs by the mucous membrane is impos-sible ; but we may safely affirm that such an devent is highly improbable. Admitting these 1premises, we have no alternative but that ofcoming to the conclusion that Bichât and theother authorities on this subject have beendeceived by the appearance of a somethingresembling hairs. And I think this themore likely to have been the case from theimperfect knowledge of the structure of theskin existing in the time of Bichât, and fromthe absence of the only satisfactory test in acase of this nature, the microscope. Indeed,there is sufficient reason to believe that at theperiod referred to, such a definition as thefollowing would have been amply characte-ristic of a hair :-A filament, hair-like inform and dimensions, cylindrical, uniform. indiameter, adherent by one exti-e-ptity to thesuiface of an organ; but your youngest reader must be aware that at the presentday better proof is needed than such a defi- i,nition could embrace.With the kind of case described by the
Austrian periodical, I am very familiar,having had my attention drawn to the sub-ject during some microscopic investigations,about seven years since, and having subse-quently seen many similar cases. In a
work published in 1838, I have referred tothese hair-like tufts growing on the tongue,
and I have there remarked, in respect of them,that" the cuticular sheaths" of the papillaeof the tongue " become enormously enlargedand lengthened in some fevers."* This isthe real nature of these productions : theyare epithelial sheaths of papillae, grown to alength of half or three-quarters of an inch,cylindrical in form, and hair-like in appear-ance and general characters ; indeed, with.out the aid of the microscope and recentknowledge on the mode of development ofthe epithelium, we might easily believe themto be hairs. About a year after my first ob-servation of these filamentary sheaths, I hadthe opportunity of conversing on the subjectwith Henlé, who quite agreed in the viewswhich I had taken of them, and mentionedthat he had seen a similar appearance inthe epithelium of the alimentary canal.
This explanation applies with equal force, to the other mucous surfaces indicated by Bichât and Villermé, and is peculiarlysuited to the case narrated in the Austrian, hebdomadal, for as we there read the so, called hairs " disappeared under the influ-ence of an emetic," a phenomenon not at all
f consistent with the kind of connection main.t tained between hairs and their papillae, butI quite in unison with the supposition of theirbeing elongated epithelial sheaths. I am,1 Sir, your obedient servant,
ERASMUS WiLSON., London, June 5,1843.
ERASMUS WILSON.
QUININE IN TRAUMATIC FEVER.
A CASE has lately occurred in the Hôpitaldes Enfans at Paris, in which M. Guersanthas employed, with entire success, the sul-phate of quinine in the treatment after am-putation of both lower extremities. Thepatient, a poor boy, whose limbs had beenfrozen by exposure during a winter’s night,and afterwards most injudiciously bathed inhot water, was brought to the hospital, thelimb exhibiting a discoloured spotty ap-pearance, and other symptoms of inci-
pient gangrene. This condition in six
days, notwithstanding the application ofbark-poultices and bottles of hot water tothe extremities, so greatly increased as torender necessary an immediate amputationof both legs. The operation was success-fully performed, and with little suffering tothe patient, who gradually recovered, thoughnot without indications of considerable feverand erysipelatous inflammation, both ofwhich were subdued by doses of sulphateof quinine, amounting to twelve grains in a
day. M. Guersant cites other cases, also, in which he has employed the same medi
cine with success, in all of which the lead-, ing feature was purulent reabsorption-Gazette des Hôpitaux, March 14.v
* Practical and Surgical Anatomy,, page 307.
