Monthly retrospect of the medical sciences : January to December 1849 / edited by George E. Day, Alexander Fleming, W.T. Gairdner.

Date:
MDCCCXLIX [1849]
Catalogue details

Licence: Public Domain Mark

Credit: Monthly retrospect of the medical sciences : January to December 1849 / edited by George E. Day, Alexander Fleming, W.T. Gairdner. Source: Wellcome Collection.

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    Oxygen consumed - - - - 100 Oxygen in the carbonic acid - 74-191 Oxygen otherwise disposed of - 25-809 Nitrogen disengaged - - - - 0-0549 Average quantity of oxygen consumed in an hour - - - 7-44 These experiments rectify the errone- [J^VN. 0U3 results of Oulong and Hespretz, who found that the quantity of nitrogen disen¬ gaged during respiration, was sometimes as great as one-fourth the quantity of oxygen absorbed.—Comptes Rendns and Medical Gazette, Oct. 13, 1848. II.—PRACTICE OF PHYSIC. 4.— On Scarlatina. By J. W. Tripe, M.D.—Dr Tripe defines scarlatina to be “ a contagious eruptive fever, charac¬ terised by a uniform inflammatory action of the vessels of the skin, and of the mu¬ cous membranes of the alimentary canal, and of the urinary passages, which termi¬ nates in disquamation of their epithelium, it ordinarily attacks any one of these membranes but once during life.” After pointing out that this definition differs considerably from any other pre¬ viously given, he proceeds to show that the membranes above enumerated are or¬ dinarily attacked by the disease, and states his belief that such attack is necessary for the protection of the patient against a sub¬ sequent invasion of the malady. The phenomena presented by the dis¬ order during the epidemic of this year (1848), are next considered. The earliest symptoms consisted in diarrhoea or in vomiting, or in both; these were observ¬ ed in every case in which severe inflam¬ mation and ulceration of the throat oc¬ curred. The eruption was frequently of a purplish tint, and severe cynanche exist¬ ed in 44-4 per cent, of the whole number of cases. In all these latter cases a strong solution of the nitrate of silver (3 j to § j aquae) was freely employed, and with the greatest benefit. One case of very exten¬ sive inflammation of the parotids is men¬ tioned, in which the novel treatment of opening the external jugular vein was adopted, and with marked relief. Dr T. divides the cases in which coma and delirium occur, into two classes,—1st, in which they appear previously to the eruption; and, 2d, in which they super¬ vene after it has come out. This latter form is subdivided into the inflammatory and the non-inflammatory. Cases are given in support of this division. The alterations that occur in the urine during the progress of the disease are next considered. He observes that Dr Franz Simon, in his chemistry of man, was one of the first who investigated this point; and he gives several quotations from Dr Day’s translations to show this. From his own observations he states, that the urine in scarlatina simplex is at first re¬ duced in quantity, and subsequently con¬ tains albumen, a few mucus or pus and blood corpuscles, some other cells, and a smaller or larger quantity of disintegrated epithelium. In some cases the urine is but little altered. In scarlatina anginosa it contains a much larger quantity of albu¬ men, of blood and mucus corpuscles, and occasionally triple phosphate. If the al¬ bumen does not disappear from the urine before or at the same period that the erup¬ tion leaves the skin, he considers that the convoluted tubes of the kidneys are either impacted with epithelium, or inflamed, the latter condition being recognised by the fibrinous casts of the renal tubules which are described by Simon. Dr Tripe doubts that these cylinders have any true enve¬ lope, and states that the cells contained in the amorphous mass are often much larger than they seemed to be at first sight, as the nuclei appear like cells, and are frequently described as such. In scar¬ latina maligna the urine is much altered, usually containing a large quantity of al¬ bumen, of blood and mucus corpuscles, mixed with fibrinous cylinders, and a large quantity of disintegrated epithelium. The greater the quantity of blood and albu¬ men in the urine, the smaller is the chance of recovery. Under the head of secondary affections, are classed affections which are said to constitute an integral part of the malady, viz., the inflammation of the mucous mem¬ brane of the fauces, pharynx, and other, parts of the alimentary canal, and of the renal tubes. This inflammatory affection of these parts is considered to be neces¬ sary for the protection of the patient from a subsequent attack of scarlatina; and cases are related to show, that a person who is suffering from the cynanche without the eruption, may infect another with scarla¬ tina. Three cases are thus stated,—“ Mrs M. and her eldest daughter had scarlatina simplex of Bateman, some years since. Whilst the former was attending on her son, who died from scarlatina maligna, she felt very weak, languid, and feverish, with pains of her limbs and back. On the