Gambar halaman
PDF
ePub

with weeping or other symptoms of distress. If taken with a view to produce merriment, its tendency, in a large proportion of cases, is to induce pleasurable sensations, as evinced by laughter, dancing, grotesque gestures, &c. When taken for the purpose of submitting to an operation, the mind of the patient, having dwelt much upon the ultimate object to be attained. is calmed and trained to that perfect state of inactivity, which allows the operation to proceed with but slight, if any, disposition to resist, on the part of the patient.

The cerebrum, while under its influence, acts from exciting causes, similar to those which occur frequently during natural sleep; that is, external circumstances will suggest the idea. Two cases will serve to illustrate : Miss F., a young lady about 18 years of

age, of nervous temperament, had two teeth removed after two minutes inhaling the vapour; she was at first perfectly quiet, opened the mouth at my request, and allowed the instrument (forceps) to be placed upon the tooth; but as it was necessary to force them well under the alveoli, she made considerable resistance, and appeared to suffer much; she screamed loudly, saying, "stop pulling.In less than two minutes after the teeth were removed, and when the effect bad entirely passed off, she assured her mother that she had not been in the least hurt. Upon being questioned as to why she manifested so much distress, she replied that her dreain was an unpleasant one; that she thought she was on board a vessel, and perceiving that they were going upon the rocks, she called to the man at the helm to stop pulling!! supposing that the vessel was propelled by this means. Now as the words made use of were a natural outcry, I prefer to attribute to them the suggestion of the dream, than to marvel at the coincidence. A

young man, æt. 20, was desirous of having a painful molar of the lower jaw extracted; his doubts were very great as to the possibility of destroying sensation; but still desired the experiment. For this operation I used the German Key; he manifested considerable pain ; carried his hand to the mouth; swayed the body forward and back, as in much agony. I asked if it hurt him much; he said, “ indeed it did.I then requested him to tell me if the tooth was out; he said, “ no.Here I made the remark that it was a humbug; he immediately replied that it was a humbug— that “ he did not believe it could be done"_“expected to be imposed upon when he came.” At this point he recovered consciousness; smiled when I showed him his tooth; assured ine that he suffered no pain whatever. Upon my asking him why he called it a humbug, he denied having said so; clearly illustrating that his ideas for the moment were dictated by my method of treating the matter.

From various experiments, I am satisfied that it is by no means necessary to produce entire unconsciousness, in order to act sufficiently upon the sensorium to allow of any operation being performed, of not more than two or three minutes duration. Several recent cases have been so treated by me that my patients were perfectly aware of their position; having a full knowledge of every process in the operation; and expressing themselves, invariably, as much delighted with the result; one stating that "it felt like extracting the tooth from a block of wood.

The medical properties and uses of sulphuric ether are well described in Wood and Bache's Dispensatory, page 810: "A powerful diffusible stimulant, though transient in its operation.” “ It is also esteemed anti-spasmodic and narcotic.” “Its vapour, when breathed, produces a transient intoxication, resembling that caused by respiring nitrous oxide, but dangerous if carried too far” “It is beneficial in some stages of low fevers; likewise good in nervous headache, unattended with vascular fulness—some stages of hysteria ; and generally in nervous and painful diseases, which are unaccompanied by inflammation.” “ In catarrhal dyspnea and spasmodic asthma, its vapour may be inhaled with advantage. In nausea it is given as a cordial; likewise in cramp in the stomach, &c.

From this abbreviated quotation from the above-mentioned work, it will be seen that the medicinal virtues of the article under consideration, have been well understood by the profession for a long time; and that it is esteemed an agent of so much potency, as to be used with much caution, even by the faculty; hence I am at a loss to comprehend the validity of a certificate, emanating from the hands of one quack authorising another of similar pretensions to administer it under any circumstances whatever. Ard should any accident occur in this view of the case, I trust that the medical and legal world will know how to discriminate.

I would not be understood as speaking lightly of all those gentlemen engaged in the dental art, who may not be provided with medical diplomas. There are many such, whose work show them to be bighly deserving of public confidence; and it is my belief that all who may be desirous of employing this agent, will be so led in their studies, physiological and pathological, that they will sooner or later demand and receive such testimonials as must serve to elevate our much abused and down-trodden profession.

It is much to be hoped that some attention may be bestowed upon this subject by our medical colleges: suffering humanity demands that the whole question be properly investigated and put upon such a footing as will secure to the community what Dr. Bigelow, in his article of the 18th Nov., Boston Med. and Surg. Journal, seems so desirous of accomplishing-A SUITABLE GUARANTEE AGAINST ITS ABUSE.

BIBLIOGRAPHICAL NOTICES.

Julii Vogel Icones Histologiæ Pathologicæ Tabulæ Histologiam

Pathologicam illustrantes viginti sex tabulæ, continentes ccxci figuras, quarum cclxx ad naturam delineatæ sunt. Lipsiæ, 1843.

Erlauterungstafeln zur Pathologischen Histologie mit vorzüg

licher Rucksicht auf sein Handbuch der pathologischen Anatomie herausgegeben von (Dr. Julius Vogel, ausserordentl. Professor der Medizin in Göttingen. Sechs und zwanzig Tafeln, mit 291 Figuren, wovon 270 nach der Natur gezeichnet sind. 4to. pp. 128. Leipzig, 1943.

The Pathological Anatomy of the Human Body. By JULIUS

VOGEL, M. D. Professor of Clinical Medicine at the University of Giessen. Translated from the German, with additions By George E. DAY, M. A. and L. M. Cantab. Member of the Royal College of Physicians: Physician to the Western General Dispensary; Lecturer on Histology and Animal Chemistry at the Middlesex Hospital Medical School; Member of the Pathological Society of London, and formerly Senior President of the Royal Medical Society of Edinburgh. Illustrated by upwards of one hundred plain and coloured Engravings. 8vo. pp. 597. London, 1847.

In the last volume of the Examiner, (p. 239,) we heralded the advent of the “ Icones” of Vogel—the first work on histological pathology that had been issued. The “Pathological Anatomy of the Human Body” by the same author, of which we have before us the translation by Dr. Day, is illustrated by plates taken from the “ Icones;” and is, as the translator remarks—or rather implies--the only work in the language that embraces the recent discoveries effected by chemistry and the microscope. It is a treatise on general pathological anatomy; and, we are told, will very shortly be followed by another, devoted to the consideration of pathological changes affecting special organs.

The work consists of an Introduction treating of the relations of pathological anatomy to the other departments of medical science; and of ten chapters, which consider-I. The abnormal development of gaseous matters—Pneumatoses. II. Abnormal collections of aqueous fluids-Dropsies. III. Pathological relations of the blood. IV. The general relations of pathological epigeneses, [new formations.] V. Special relations of pathological epigeneses. VI. Pathological changes in the physical properties of the tissues and organs of the body. VII. CombiGations of morbid elementary changes. VIII. Independent organisms in the human body-Parasites. IX. Congenital modifications of the human body-Malformations. And X. Changes occurring in the body after death - Post-mortem changes.

It is obviously impossible for us, in the space we can assign to this notice, to examine into the views of the author on all these important subjects; but we may refer to a few. Under Pneumatoses he properly remarks, that gas may be developed in the human body partly from food in the act of decomposition in the intestinal canal, and partly from the decomposition of the constituents of the body itself. He has no doubt, too,-nor have we,—that it may be actually secreted by different parts of the frame.

“ Thus, Magendie and Girardin assert, that on confining a portion of the intestine of a live dog between two ligatures, in the course of some hours the included portion was found full of air, which escaped with a hissing sound on making an incision.* In the intestinal canal of swine we sometimes meet with considerable accumulations of gas between the layers forming the walls of the bowels. Sir Francis Smitht has described an interesting case of the development of gas in man, which deserves a full notice. He states—“On the 12th of May, 1840, I was consulted by a gentleman, who told me that he often suffered from an enormous development of gas in the stomach, which he discharged by eructation: that he likewise, occasionally, experienced a development of gas from the bladder, and that his skin acted in a similar manner, as he had observed in the bath. On the morning of the 15th, I found my patient in a bath at 79° F.

• Magendie et Girardin; Recherches physiolog. sur les gaz intestin. Paris, 1824. p. 24; Lobstein, Path. Anat. Vol. 1, p. 138.

Dublin Med. Journal, January, 1841. p. 454.

His breast, shoulders, abdomen, and hands, were literally covered with minute bubbles of gas. On being questioned, the attendant at the bath stated that he had never previously witnessed anything of the kind. On removing the hands and arms from the water, the air bubbles disappeared, but gradually returned on again immersing those organs. The bubbles were of the size of a pin's head. On wiping them off, they disappeared, but gradually formed again.

“In opposition to the above observations of Magendie and Girardin, it may be urged that the gas which was developed might probably have arisen from the decomposition of remnants of food in the inclosed portion of intestine, or that the portion of gut becoming distended by peristaltic motion had imbibed air from the peritoneal cavity, or from the adjacent portions of the intestinal canal; and similarly the escape of air from the stomach and urinary bladder, in Smith's case, admits of the same mechanical explanation as has been given in a previous page. Not so, however, the escape of air from the skin: the fact that all bodies, when immersed in water, give off a little entangled air, affords no explanation of the continuous evolution of gas from the skin: neither does the accumulation of air occasionally noticed in the intestinal canal of swine seem to admit either of a mechanical or chemical solution. If we are asked for the particular causes of these developments of gas, I confess I can give no satisfactory reply. No secretion of gases occurs in the human body in a normal condition; for the development of gas in respiration is a purely physico-chemical proceeding, and is in exact accordance with the laws of displacement and diffusion of gases, as has been recently proved by Valentin and Brunner;* and, probably, the same law holds good for the development of gas through the skin. We can only refer to the analogical proceeding in fishes, where we find an actual secretion of gas in the swimming-bladder, and must, for the present, defer all further questions respecting their causes or pathological indications." p. 32.

The most important deviations in the condition of the blood, are described to be as follows:

“1. Its physical and chemical characters may undergo alteration. It may be either thinner or thicker than usual, and its colour may be affected. The blood-corpuscles may appear changed. The proportion of its constituents to each other may be altered, and it may contain matter not normally existing in it, as sugar, free lactic acid, &c.

* Valentin, Lehrb. d. Physiol. d. Menschen, vol. 1, p. 559.

« SebelumnyaLanjutkan »