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It may be proper to observe, that there is no occasion to seek new means of disguising the bitterness of sulphate, or as it is more properly named, disulphate of quinina, at least for the use of those who can swallow a pill. For patients who cannot take it in the state of solution, which is undoubtedly the best, the form of pill is convenient. It is true there is an objection to this form, on account of the insolubility of the salt, but it is easily removed by the employment of the neutral sulphate of quinina, a crystallizable salt, which easily dissolves in water without any addition of acid. The neutral sulphate is in fact the preparation that should have been originally introduced into medicine, instead of the insoluble disulphate, which sometimes causes much inconvenience. The dose of both salts is much about the same; the neutral sulphate may be given with propriety in a somewhat larger quantity if the prescriber wishes to be critical.
A convenient formula would be the following: the sulphate of quinina, for the sake of clear distinction, should be marked neutral. R. Sulphatis quinine neutralis grana duodecim.
Pulveris glycyrrhizæ subtilissimi grana octodecim.
Theriaca q. s. M. fiat massa quam divide in pilulas duo
As many of these pills may be directed to be taken as the prescriber wishes: they will remain soft, and hence will have no chance of passing through the intestinal canal undissolved. No astringent substance should be contained in the pill: hence the mass must not be formed with conserve of roses. The pills may be silvered to disguise the little bitterness which otherwise they would have had.
According to M Pierquin, thirty-two grains of carbonate of mag. nesia conceal the taste of six grains of disulphate of quinina, without interfering with its virtues. It is also affirmed that anise or fennel perfectly masks the bitterness of this powerful febrifuge.-Dublin Medical Press.
Observations on the coexistence of Variola and Scarlatina, with remarks on the coexistence of other eruptive fevers. By J. F. MARSON, Surgeon to the Small-Pox and Vaccination Hospital, London.-During the last eleven years, the author of this paper has seen, at the SmallPox and Vaccination Hospital, seven persons who had variola and scarlatina simultaneously. These patients were apparently suffering from small-pox only on their admission, but in the course of a few days scarlet fever also developed itself. In each case, all the leading symptoms of scarlatina were well marked, and the eruption was evidently different from the roseola which frequently precedes the eruption of small-pox, and also different from the erythema, (somewhat resembling it,) arising from the miasm of hospitals; in fact, it was the florid red eruption peculiar to scarlatina, which no other eruption
exactly resembles. Three of the patients were unprotected, and four of them had been vaccinated. All recovered but one, the particulars of whose case were given in full. Three other patients with variola and scarlatina existing at the same time, have been seen, within the last few years, at the London Fever Hospital. Reference was made to the opinion so strongly expressed by Mr. Hunter, that no two fevers could be coexistent. Several cases were then alluded to, that have been published by different observers, in France and England, of the coexistence of variola and scarlatina, variola and rubeola, variola and pertussis, variola and vaccinia; rubeola and scarlatina, rubeola and vaccinia, rubeola and pertussis; varicella and vaccinia, pertussis and vaccinia. The individuality of erysipelas, as a special eruptive fever, was commented on, this disease being shown to arise, almost invariably in hospitals, from the impure air produced by morbid animal effluvia. The French were acquainted with the fact, fifty years ago, of smallpox and scarlatina existing together occasionally, some cases being referred to by the author, published by M. G. Vieusseux, at that period, but the subject has nearly escaped attention, or at least remark, by writers of this country.-Dub. Med. Press.
Sir Astley Cooper was kind enough to make us acquainted with his researches on the structure and functions of the thymus gland, with which he was then occupied; and I am the more pleased to recall this circumstance, because it enables me to record a reply of Sir Astley's, which proves delightfully the perfect truth and honesty with which he conducts his researches and experiments. While he was pointing out to us, on a most delicate preparation, the two membranes which he has found in what he calls the reservoirs of the thymus, I said to him, “You said, and it is." "No," he replied, "It is, and I said." The scientific character of the great English surgeon breathes in this response.-Prov. Med. and Surg. Journ. from Six mois de Sejour en Angleterre par S. Pironde, D. M.-British and Foreign Medical Review, vol. 8, p. 534.
When Dr. Dimsdale inoculated Catherine the Second for the smallpox, that Princess (who, whatever might have been the vices of her moral character, possessed a very large and magnanimous mind,) took precautions for securing her personal safety in case of her death. Finding herself much indisposed on a particular day, she sent for Dimsdale, whom she had already remunerated in a manner becoming so great a sovereign. "I experience," said she, "certain sensations which render me apprehensive for my life. My subjects would, I fear, hold you accountable for any accident that might befall me. I have therefore stationed a yacht in the Gulf of Finland, on board of which you will embark, as soon as I am no more, and whose commander, in consequence of my orders, will convey you out of all danger." This anecdote, so honourable to the Empress, I heard from one of Dimsdale's sons, above forty years ago.-Ibid, from Sir N. W. Wraxall's Posthumous Memoirs of his own Times, vol. 3, p. 199.
RECORD OF MEDICAL SCIENCE.
NEW SERIES.-No. XXXIV.-OCTOBER, 1847.
A Case of Retention of a Dead Ovum in Utero for six months, without Putrefaction. By GEORGE L. UPSHUR, M. D.
Mrs., æt. 38, the mother of six children, menstruated the first week in November, 1846. She supposes herself to have conceived immediately afterwards. About the middle of the following January, while walking in the street, she felt suddenly, without pain or other premonition, a fluid discharge from the vagina, which, upon hastening home, she discovered was blood. Fourteen days after this, the breasts became flaccid, and the morning sickness, which had been gradually lessening, entirely ceased.
On the 30th of July, about 10 o'clock at night, she was seized with pains like those of labour, which steadily increased in force and frequency until early next morning, when there was expelled a dead foetus, three inches long, with the membranes and placenta attached by a cord six inches in length. During the whole time, from the first hemorrhage to the expulsion of the ovum, a period of six and a half months, there was more or less sanguineous discharge from the vagina. This discharge was as free from unpleasant odour as the catamenial fluid usually is, except during three days in the month of April, when it was slightly putrid in its character. She consulted no physician about the matter, as the flow was unaccompanied by pain, and never
so profuse as to affect her health seriously, or to prevent her from attending to the ordinary duties of the household.
The correctness of this statement may be implicitly relied on. The lady in question is sensible and intelligent, and noted for the particularity with which she marks the various events connected with her pregnancies. After the morning sickness ceased, and the breasts became flaccid, she believed she had aborted and so she expressed herself to her friends, pointing to those symptoms as evidences of the fact.
I had an opportunity of carefully examining the ovum two hours after its expulsion. There was not the slightest sign of putridity about it, the odour resembling very closely that of fresh beef. The placenta was hypertrophied, three and a half inches in diameter and an inch and a half thick, lobulated, very firm under pressure, and nearly exsanguine.
The cord was not uniform in size, nor invested by the membranes, of which a small proportion only were attached to the placenta. The vessels of the cord seem to have coalesced into one, and were impervious. The foetus was of a variegated mahogany colour, preternaturally firm to the touch, with features just distinguishable. The fingers and toes were scarcely sufficiently developed to be counted, and there was no ossific deposit in any portion of the body. I have the entire ovum as it was expelled, preserved in alcohol.
It is a universally admitted law in obstetrics, that as soon as the ovum dies, it is thrown off from the uterus as a foreign body; or, if it remain any length of time in that organ, it begins to decompose, and is eliminated in a putrid discharge from the vagina. And it seems, indeed, difficult to imagine, how a dead body can be long exposed to the combined action of heat, air, and moisture, without undergoing the putrefactive process.
In the September number of the Medico Chir. Rev. for 1823, p. 308, there is an article entitled "Cas Rares," extracted from the Dict. des Sci. Med., by M. Fournier, in which three cases are given of retention of the fœtus for a very long time after its death. The first is cited from Albosius, where the foetus was retained twenty-eight years, and was petrified. In the second, it was retained in utero thirty-one years. The woman died of peripneumonia, and, upon examination of the body, the fœtus was found enveloped in chorion and amnion, which were ossified, as well as the placenta. There was no sign of putrefaction about it, nor did it exhale any unpleasant smell. It was about the size of a nine months' child. In the third case, a fœtus was found in the uterus of a woman who had been pregnant twenty-three years. It had neither umbilical cord, placenta, nor membranes, and was almost entirely petrified.
These cases seem to be well authenticated, being recommended as both curious and useful, by Dr. Johnson, the then editor of the Med. Chir. Rev. I leave these anomalies to be accounted for by older and more experienced heads than mine.
Norfolk, Va., September 7th, 1847.
On the Inhalation of Ether in Labour. By JONATHAN CLARK, M. D., of Lower Merion, near Philadelphia.
To the Editor of the Medical Examiner.
DEAR SIR,-I send you an account of some obstetric cases, in which the inhalation of Ether was used with not unpleasant results.
CASE 1.-July 19th, at 10 o'clock, P. M., I saw Mrs.
aged 18, in labour with her first child. An examination shewed the head to be presenting, with the vertex to the left sacro-iliac junction, membranes entire, and the os uteri dilated to the extent of two inches.
She had been in labour since 5 o'clock; the pains had not been very severe, but were increasing in force and frequency, occuring at intervals of three minutes, the os uteri being moderately rigid, and external parts quite so.
The progress of labour was scarcely perceptible, and there appeared to be an unusual want of fortitude and power of control over her feelings, on the part of my patient. As there appeared to be nothing to contraindicate it, I resolved to use the ether. In two minutes from the commencement of the inhalation, she pushed away the sponge and exclaimed, I am losing my senses. On being assured that it would relieve her pain and do her no injury, she renewed the inhalation, and was fully under its influence in five minutes. From the time I first saw her, her pulse had been 80, but upon the application of the ether it fell to 75, and continued at that rate during the labour.
She appeared to be almost unconscious of pain, judging from her actions, but the expulsive efforts of the uterus were not quite so frequent as at first, but more efficient. She said but little except to ask for more, when the ether had evaporated from the sponge. On one occasion she exclaimed, "more, more, I am suffering dreadfully." This was during a pain. She would hold the sponge wet with the ether, to her mouth and nostrils, and inhale with eagerness, till her power of supporting it was lost, when her hand would fall, and with it the sponge, in this way guarding effectually against an over-dose. After remaining quiet a few minutes, she would upon the recurrence of the pain, apply the sponge and inhale again as eagerly as before.