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very intolerant of sudden pressure, although they may bear or accommodate themselves (as we know they do) to the gradual pressure
It is not easy to account satisfactorily for this rapid enlargement; the perfect integrity of the sac shows it was not from extravasation of blood by rupture; moreover, no traces of blood could be discovered. We know that during the galvanic action a quantity of hydrogen is evolved from the negative pole; it would, however, have been scarcely equal to the actual amount of the increase; the sensation, also, was of something more solid than if the contents were gaseous fluid. It now appears to me more likely to have been caused by the galvanic influence extending beyond the sac, and coagulating the fluids in the cellular tissue around it, the coagulated matter having been afterwards absorbed. The size of the aneurism at the time of death was certainly not larger than it would have been in the usual progress of the disease, and if the galvanism had never been applied.
M. Petrequin insists on the necessity of the needles crossing, to produce a proper coagulum. The needles, in this case, though they could be made to touch, certainly did not cross, and yet coagulation was complete. But I have further reasons for believing this is not necessary: I thought that, in performing the operation for the future, it would be as well to avoid, if possible, the entrance of the hydrogen gas evolved from the negative pole directly into the circulation. I therefore suggested to Mr. Fagan to make the experiment of putting an albuminous fluid into a small bladder, and to insert the positive needle into the fluid; but merely to apply the negative wire to the outside of the bladder. He accordingly filled a small portion of sheep's intestine with one part of white of egg and two parts water, quite full, and without any air. He inserted the positive needle its whole length through the gut into the fluid, and applied the negative wire merely to the outside of the sac, and succeeded in producing a large tea-spoonful of mucous-looking coagulum, without a bubble of hydrogen in the fluid inside, but many adhering to the outside, and to a silver plate on which the sac was placed. We have no grounds to say the entrance of hydrogen into the blood is injurious; but the fact that coagulation can be produced without its necessarily being present is interesting. The condition in which the par vagum was discovered may, perhaps, explain the incessant vomiting. It is scarcely possible to suppose that a nerve so closely connected with the functions of the stomach could be so much deranged in structure without considerable gastric disturbance.-Dub. Quarterly Journal of Medical Science.
Observations on the Oxalic Diathesis, and the Influence of the Rhubarb Plant in its Production. By JOHN S. BARTRUM, Esq., Surgeon, Bath.-Having for some years been in the habit of paying attention to the general and chemical conditions of the urine, it was with much pleasure that I perused the paper of Mr. Wilson, inserted
in No. 35 of the Provincial Journal, (September 2, 1846,) especially from having, on several occasions within these two or three last years, noted in my own person, the effects on the urine of the rhubarb stalk and other articles of diet. The portion of urine passed after rising in the morning was always examined by the miscroscope without heat, as the shortest and not fallacious mode.
Being apparently in the most perfect health, excepting rather overworked, and as far as unlike a patient suffering from oxaluria as possible, at first I could scarcely believe myself to have passed oxalate crystals, till confirmed in my supposition by Dr. William Budd, who immediately remarked that I must have been eating rhubarb, which, however, had not been recently the case. This induced further and oft repeated examinations, the general results of which I can only now give, having not long since destroyed the daily records, considering them as not worth keeping.
While passing the smaller oxalates, and then partaking freely of rhubarb, the first effect was generally to increase the size and quantity of oxalates thrown down, with the occasional addition of some of the reniform bodies; the diet being continued, the crystals of all shapes increased in size, especially the latter, till on two occasions they almost solely were passed. However, after a day or two, the oxalates diminished and then disappeared, although rhubarb was still partaken of; this may probably be explained by having regarded the appearance of the oxalates, as sure warning that I must give myself more relaxation. The results have been similar on two or three occasions, when from continuous exertions I have expected their presence and found them; but I have never been able to induce their appearance by the freest use of rhubarb, except in the very fine cuboid forms, for a day or so, unless they were previously present.
If Mr. Wilson continue his inquiries, I think he will find, that any article of diet, adding to the irritability of the kidneys and bladder, will induce an additional secretion of the oxalates; for I always found, that partaking freely of water-cresses added materially to the quantity of oxalates, provided I were already passing them, from the irritation of the bladder, caused by the abundant secretion of free lithic acid. Whether the elimination of oxalates, as well as of lithic acid, was due to the water-cresses, or the common salt accompanying them, I cannot say. That must be left for future investigation.
It will be found almost universally, that cases characterised chiefly by deposits of oxalates are combined with an asthenic condition of the assimilating organs; some of them corresponding closely with those caused by the excretion of an abnormal amount of urea, the urine then being dense and loaded with lithates, while others, from the excessive excretion give rise to a suspicion of diabetes mellitus, so much so, that of the many specimens sent me for examination, where a large quantity of urine is voided, the greater proportion are of low specific gravity, with some few small oxalates, and often swarms of vibriones. These latter cases, however, are essentially cases of want of nervous power without any specific ailment, sometimes passing
phosphates, sometimes oxalates, according to the varying condition of the system, which always displays a very reduced vitality.
In this, as in all other diseases of the urinary organs, where chemistry is called into our aid, there is great danger of their being treated as though the body were a mere laboratory, wherein we could modify these secretions at our will, overlooking the essential cause of the ailment; but, however useful and necessary such examinations may be, it behoves the practitioner carefully to eschew being implicitly guided by them; as some cases of this disease are treated successfully by alkalies, others by acids; some by restricted, others by a generous diet; for though medicinal remedies are most useful, and in the majority of cases requisite, they will be of little avail, if not well supported by carefully-applied general and dietetic measures.
I think that the size of the crystals of oxalates passed will often afford a good indication of the extent of the oxalic diathesis. If the crystals, especially the reniform, be large, distinct, much inclined to become clustered, crystalize on the hairs, &c., much oxalate of lime is passing. As the case improves, the crystals lessen in size and numbers till at length they become undistinguishable, except to the educated eye. Though it is unusual, the reniform bodies may continue to the last, when, in some positions, they may become in appearance almost like a blood-corpuscle; in the majority of cases these crystals are not to be found.
It has been suggested (by whom originally I cannot learn,) that these reniform bodies are not oxalate of lime, but lithic acid, modified in shape by the presence of oxalic acid. This can scarcely be, for I have, with several different specimens, macerated the whole deposit in liquor potassæ, to get rid of any free lithic acid; then, in diluted acetic or muriatic acid, whereby the phosphates and lithates are separated; yet both the cuboid and reniform crystals have remained quite unaltered. I have not succeeded in throwing down crystals of oxalate of lime, when a deposit of free lithic acid and oxalates was dissolved in sulphuric acid, and the former separated by the addition of water, perhaps from sufficient care not having been taken in the
Should it be desired to separate any deposit of these salts for examination, it is most easily effected by decanting the upper layers of fluid, adding distilled water to the remainder, with or without potass, or acetic acid. The oxalates soon fall to the bottom, and may be readily collected on a watch-glass, without heat or any other process that could modify its composition after leaving the body. By careful manipulation you may obtain and weigh all the crystallized salt in a given specimen. To those not conversant with the salt naturally deposited, yet desirous to examine it, one of the best modes of learning all its usual shapes and sizes is to add a dilute solution of oxalic acid to fresh healthy urine, when after some hours the characteristic crystals will be found in abundance.
I do not know whether this city more abounds with cases of this disease than most others, but among its labouring population, of the
class next above the poor, such as policemen, schoolmasters, carpenters, &c., (some hundreds of whom come wholly under my observation,) dyspepsia, of an atonic character, and marked by the pallid, depressed, emaciated countenance, with more or less hypochondriasis, pain of the side, (often of great intensity,) or of the back, and the passage of oxalate crystals is most rife, though in most cases readily amenable to judicious treatment. From my own observation this form of dyspepsia does not seem so common among the women of this class as among the men, even in those, wherein from their appearance and symptoms I had fully expected to find it. Of the presence of the oxalates in the more acute or in cutaneous diseases, I can say nothing, not having examined them for that purpose.-Provincial Med. and Sur. Journal.
TRANSACTIONS OF THE PHARMACEUTICAL SOCIETY.
On Extract of Indian Hemp. BY ANDREW ROBERTSON, Esq., Professor of Chemistry to the Medical College, Calcutta.-A number of pounds of the extract of hemp were prepared by meI think upwards of thirty in all-for the purpose of having its medical properties fully tested by European medical men. A quantity went to Paris, another to Berlin, another to London, sent by different parties, and for my share of the matter I sent four pounds of it to Scotland, part of which went to you. I do not care about making more of it, as its preparation is most tedious and troublesome, in which I was tormented by the excise regulations of the country, for both the plant and the spirits used are the subject of heavy duties and stringent precautions, and the cost price of the extract to me, counting nothing for trouble, was fully fifteen shillings per lb. Dr. O'Shaughnessy made his extract with alcohol, in a Papin's digester, at a heat above the boiling point of alcohol-the extract so obtained is brown; mine is of a deep green, and gives a grass-green tincture to alcohol, and has six times the activity of the brown, as ascertained by trial on hospi tal patients. If a speedy effect is desired it is given as a tincture; if a deferred and protracted, as a pill.
As the process by which it was prepared is an idea of my own, since copied by others, and which probably may be claimed by them afterwards, I may mention it to you. It is a variation of the process of percolation, alcohol in vapour being the agent. A still was charged with strong spirits, and its nose introduced into the side of a cask in which the plant was pushed.
The vapour of the alcohol, and alcohol at a boiling heat thus acted on the plant, instead of cold alcohol in the usual mode of percolation. First issued a thin tarry matter containing much resin latterly, a brown liquor containing little resin but much extractive. At this point water was substituted for the spirit in the still, and as much as possible of the spirit retained by the plant thus expelled from it. From the bottom of the cask a pipe led to a common condensing worm. Part of the alcohol was recovered from the fluid by distillation, the rest dissipated by evaporation in Wedgewood ware on a 6
sand-bath, not exceeding the temperature of 150 deg. Fahr. One hundred weight of the plant was used at one operation, and about eight pounds of extract obtained. The operation was conducted so slowly as in all its stages to last a fortnight.
The extract of hemp has been long known in the East, in a most widely extended range of countries, under the names of Gunjah, Churrus, Hashish, Beng or Bang, the emerald cup of Haider, &c., and under every name renowned for its exciting and narcotic qualities. It is used by the natives here in the same way as opium is by the Chinese, and on that account is the object of fiscal regulations and duties. It is known throughout all India, Arabia, Syria, and Eygpt. You will find it in the Arabian Nights, translated by Lane, under the name of Beng, as the narcotic used by Haroun Alraschid, and others. There cannot, therefore, be a doubt that it is a drug nearly as active as opium.
The inactivity of the drug, therefore, prepared in Britain, I can attribute only to faulty preparation and overheating, or to its being made from old and decayed plants. The good plant is of a greenish brown, the heads loaded with a sticky resin; the bad is palish-brown and does not adhere to the fingers. The good extract gives a grass-green tincture, the bad a brownish. My extract was made from dried plants of good quality, as it cannot be readily obtained fresh in Calcutta.
Mr. Fordred stated, that it had recently come to his knowledge that some of the extract, sold in London as extract of Indian hemp, was made from the plant grown in the neighborhood of London, and he believed possessed but little, if any, of the narcotic properties of the Indian plant. The extract made from the hemp (Cannabis sativa) grown at Mitcham, was of a green colour, and being apparently an aqueous extract contained but little resin, while that prepared from the plant grown in India contained a large proportion of resin. He thought it important, as many medical practitioners in different parts of the country were trying the efficacy of this remedy, that they should be cautioned to be particular in obtaining the extract of the Indian hemp.
Mr. Redwood said, that much of the extract made from the hemp plant imported from India, as well as the extract which had been imported ready made, was found to possess but little narcotic power when tried in this country; certainly they had not realized the expectations which were formed from the accounts of its action given by medical men in India. Dr. O'Shaughnessy, when last in this country, had admitted that the extract, even some that he had brought from India himself, had failed to produce the effects he anticipated, when tried in our hospitals; and he had undertaken, on his return to India, to have some extract very carefully prepared, and sent over to this country. Mr. Squire had received a quantity of this extract, and he presumed it was that alluded to in the paper just read, as having been made by Mr. Robertson.
Mr. Bartlett had witnessed the effect of a very small dose of extract of Indian hemp, obtained from Mr. Squire, on one of his assistants,