gangrena senilis

1
27 fed, and of a corresponding age. The frequent occurrence of morbid admixtures with the gall, varying from thickened mucus to purulent deposits and calculous formations, render proper dis- crimination imperative ; otherwise, after carefully preparing a quantity of recent gall, disappointment will succeed the process, because negligence may have mixed up with the fluid the abnor- mal product of a diseased liver, which, on evaporation, converts the whole into a disagreeable, putrid mass, totally unfit for use, and quite different from the character of the somewhat aromatic animal mass which results from the evaporation of normal ox- gall. Healthy fresh ox-gall is a transparent fluid, of a bright, dark, grass-green colour ; of a viscid, tenacious, equal consistence, of a strongly animal with slightly aromatic odour, and bitter alkaline taste. Bile of this description, taken from about a dozen blad- ders, should be poured into a deep earthenware vessel, and allowed to rest for about twenty-four hours ; the supernatant fluid should be then poured into a shallow dish, such as an ordi- nary meat dish, and set into an oven, the temperature not exceed- ing 100 F., until the whole be reduced to the consistence of a pharmacopceial extract. Thus it is inspissated ox-gall, and easily made into pills. After employing it in this state for some time, experience showed the inconvenience which its highly deliques- cent property entailed. For, kept ever so carefully, it soon became too moist for use-a difficulty which evaporating it in mixture with magnesia did not satisfactorily remove, while it so aug- mented the bulk of the substance as to disqualify it for employ- ment in a pillular form. When rolled into pills, and buried in magnesia or powdered liquorice-root, or enveloped in silver or gold leaf, and put into well-corked phials, it still absorbed mois- ture, and they soon conglomerated into one mass. To obviate this troublesome difficulty and serious objection, as it proved, to the more extensive use of this invaluable remedial agent, I sug- gested that, instead of the gall being merely inspissated, it should be desiccated. For this purpose, it needs only to be allowed to remain at the same temperature, until there remains a dry, bright-green, friable, pulverulent, slightly aromatic mass; in which state the substance loses none of its medicinal virtues, its deliquescent character is nearly lost, it can be easily preserved in closely-stoppered bottles, and is with facility made into pills, par- ticularly with any spirituous fluid, or essential oil, and will mix well with various salts that are otherwise not readily made into pills, while it is, where desirable, with facility mixed with other materials into powders.-I remain, sir, yours obediently, J. HUNTER LANE, M.D. Maddox-street, Hanover-square, Junesist, 1845. GANGRENA SENILIS. DR. CORMACK’S REPLY TO CHIRURGUS. DR. RosE CORMACK, the talented editor of the London and Edinburgh Monthly Journal of Medical Science, has requested us to insert the following reply, published in his July number, to a letter signed 11 Chirurgus," which we received from an Edinburgh correspondent, and inserted in this journal. "We have great plasure in complying with Dr. Cormack’s request :- " In THE LANCET of June 21st, there is a laboured attempt to show that the claim which we felt called on to make in favour of Mr. Syme, to the introduction of the present mode of treating gangrena senilis, was founded upon imperfect acquaintance with the progress of surgical science. It is said that Sauvage, Mar- jolin, Avisard, Broussais, Dupuytren, Delpech, Dubreuil, Bouil- land, and Cruvelhier-whose books are of course beyond our reach-had adopted the practice in question. Now, all of these authorities maintain the grand remedy to be, depletion by local and general bleeding. They regard the disease as of an inflam- matory nature, requiring to be combated by the means ordinarily employed for subduing inflammatory action. The view taken by Mr. Syme is entirely different. He regards the limb affected as in a condition similar to that of one in which the principal artery has been tied. He would no more think of applying leeches than of using stimulating applications. In short, he treats the limb as if it had been subjected to operation for popliteal aneurism." J. HUNTER LANE, M.D. NEWS OF THE WEEK, REMARKS, AND CRITICISMS. LONDON HOSPITAL.—A Quarterly General Court of the Governors, held June 4th, having declared a vacancy in the office of physician, by the resignation of Dr. Billing, Dr. Little, the assistant physician, has been elected physician to that hospital. THE MARYLEBONE AND PADDINGTON HOSPITAL.- The first stone of the new hospital of St. Mary was laid on Satur- day by Prince Albert, who arrived on the site at three o’clock, accompanied by Colonel Bowater and Mr. G. Anson, and was received by a deputation of the parochial authorities, a deputation of the hospital committee, the Bishop of London, the vice-presi- dents, and trustees, &c. There were also present, the Dean of Chichester, and a large gathering of the clergy, Lords Beverley and Manvers, Mr. B. Bond Cabbell, &c., and having first in- spected the plans of the building, presented and explained to him by Mr. Hopper, the architect, proceeded with his attendants to the platform, which was erected beneath a marquee capable of containing several thousand persons, and which prevented those assembled from being incommoded and annoyed by the showers and the continual gusts of wind. On the arrival of Prince Albert at the platform, the Bishop of London opened the proceedings by a short address on the subject of the meeting. The inscrip- tion on the stone, " This stene was laid by his Royal Highness Prince Albert, consort of her Majesty Queen Victoria, on the 28th of June, 1845," was then read by the honorary secretary, who presented his Royal Highness with a bottle containing another inscription, coins, &c., to be deposited in the cavity of the stone. The Prince then laid the stone, with the usual cere- monials used on these occasions. One of the wards of the new building is to be called the Albert Ward. MIDDLESEX HOSPITAL.—We learn that the lately vacant appointments in the Middlesex Hospital Medical School have been filled as follows:.-.The chair of medicine, by Dr. Mervyn Crawford; anatomy, Mr. De Morgan; midwifery, Dr. West; materia medica, Dr. Day; medical jurisprudence, Dr. Latham ; and that two new lectureships have been formed-namely, in pathological and morbid anatomy, to which Dr. Seth Thompson has been appointed ; and on the diseases and operations on the teeth, by Mr. Tomes. LONDON COLLEGE OF PHYSICIANS.—The following gentlemen were elected Fellows on the 25th of June:-Dr. Jenks, Dr. Seth Thomson, Dr. Golding Bird, Dr. Patrick Black, Dr. R, G. Latham, Dr. Pitman, Dr. Bence Jones, and Dr. Pereira. CHESTERFIELD. DINNER TO R. C. BOTHAM, Esq.- On Wednesday, the 25th of June last, a dinner was given by the medical practitioners of Chesterfield and the neighbouring towns, to R. C. BOTHAM, Esq., as a testimony that, in the opi- nion of his professional colleagues, he had successfully vindicated his skill and character in his defence to the recent action - Osborne v. Botham-which was tried at the last Derby assizes. The dinner was held at the Commercial Hotel, Chesterfield, when Dr. FAVELL, of Sheffield, was chairman, JOHN WALKER, Esq., of Chesterfield, was vice-chairman, and Messrs. H. E. Walker and W. E. Boddington were stewards. Among the pro- fessional gentlemen present were - Dr. Favell, Messrs. J. Walker and D. Evans, Belper; John Wright, senior surgeon to the Infirmary, Derby; S. Evans and J. Johnson, Derby ; H. E. Walker, W. E. Boddington, T. Jones, J. Holland, - Marshall, and R. T. Wylde, Chesterfield; E Brown, Clay-Cross ; Thorpe and France, Staveley; M’Karsie, Crich; - Cooper, Mansfield; Woolham, Mexbro’; - Evans, Winster ; - Clarke, Dronfield ; and Alsop, Bolsover. The dinner passed off with considerable 6clat. HOUSE OF COMMONS. Wednesday, July 2nd. THE Bill of Lord AsHLEY, to provide for the " Maintenance and Care of Pauper Lunatics," was considered in Committee of the whole House this evening. In one of the clauses it was pro- posed to empower the Committee of Justices to appoint a "visit- ing physician" to every pauper lunatic asylum, and Mr. WAKLEY moved as an amendment, that the words " or surgeon" be intro- duced ; and he enforced the propriety of adopting such an amendment by insisting that the scientific education and the nature of the practice of surgeons rendered them not less eligible for such offices than physicians. The amendment was adopted, but immediately before it was put from the chair, Sir JAMES GRAHAM, laughing somewhat heartily, exclaimed, " Suppose we add the words or general practitioners !’ " Considerable mer- riment was manifested at this remark, and it was not diminished by one of the honourable members asking, in rather a hurried manner, " What are they ? who are they ?" The honourable member was afterwards, in private, referred for information on the subject to Blackfriars, and 296, Regent-street.

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Page 1: GANGRENA SENILIS

27

fed, and of a corresponding age. The frequent occurrence ofmorbid admixtures with the gall, varying from thickened mucusto purulent deposits and calculous formations, render proper dis-crimination imperative ; otherwise, after carefully preparing aquantity of recent gall, disappointment will succeed the process,because negligence may have mixed up with the fluid the abnor-mal product of a diseased liver, which, on evaporation, convertsthe whole into a disagreeable, putrid mass, totally unfit for use,and quite different from the character of the somewhat aromaticanimal mass which results from the evaporation of normal ox-gall.

Healthy fresh ox-gall is a transparent fluid, of a bright, dark,grass-green colour ; of a viscid, tenacious, equal consistence, of astrongly animal with slightly aromatic odour, and bitter alkalinetaste. Bile of this description, taken from about a dozen blad-ders, should be poured into a deep earthenware vessel, andallowed to rest for about twenty-four hours ; the supernatantfluid should be then poured into a shallow dish, such as an ordi-nary meat dish, and set into an oven, the temperature not exceed-ing 100 F., until the whole be reduced to the consistence of apharmacopceial extract. Thus it is inspissated ox-gall, and easilymade into pills. After employing it in this state for some time,experience showed the inconvenience which its highly deliques-cent property entailed. For, kept ever so carefully, it soon becametoo moist for use-a difficulty which evaporating it in mixturewith magnesia did not satisfactorily remove, while it so aug-mented the bulk of the substance as to disqualify it for employ-ment in a pillular form. When rolled into pills, and buried inmagnesia or powdered liquorice-root, or enveloped in silver orgold leaf, and put into well-corked phials, it still absorbed mois-ture, and they soon conglomerated into one mass. To obviatethis troublesome difficulty and serious objection, as it proved, tothe more extensive use of this invaluable remedial agent, I sug-gested that, instead of the gall being merely inspissated, it shouldbe desiccated. For this purpose, it needs only to be allowed toremain at the same temperature, until there remains a dry,bright-green, friable, pulverulent, slightly aromatic mass; inwhich state the substance loses none of its medicinal virtues, itsdeliquescent character is nearly lost, it can be easily preserved inclosely-stoppered bottles, and is with facility made into pills, par-ticularly with any spirituous fluid, or essential oil, and will mix wellwith various salts that are otherwise not readily made into pills,while it is, where desirable, with facility mixed with othermaterials into powders.-I remain, sir, yours obediently,

,

J. HUNTER LANE, M.D.Maddox-street, Hanover-square, Junesist, 1845.

GANGRENA SENILIS.

DR. CORMACK’S REPLY TO CHIRURGUS.

DR. RosE CORMACK, the talented editor of the London andEdinburgh Monthly Journal of Medical Science, has requested usto insert the following reply, published in his July number, to aletter signed 11 Chirurgus," which we received from an Edinburghcorrespondent, and inserted in this journal. "We have greatplasure in complying with Dr. Cormack’s request :-

" In THE LANCET of June 21st, there is a laboured attempt toshow that the claim which we felt called on to make in favour ofMr. Syme, to the introduction of the present mode of treatinggangrena senilis, was founded upon imperfect acquaintance withthe progress of surgical science. It is said that Sauvage, Mar-jolin, Avisard, Broussais, Dupuytren, Delpech, Dubreuil, Bouil-land, and Cruvelhier-whose books are of course beyond ourreach-had adopted the practice in question. Now, all of theseauthorities maintain the grand remedy to be, depletion by localand general bleeding. They regard the disease as of an inflam-matory nature, requiring to be combated by the means ordinarilyemployed for subduing inflammatory action. The view taken byMr. Syme is entirely different. He regards the limb affected asin a condition similar to that of one in which the principal arteryhas been tied. He would no more think of applying leeches thanof using stimulating applications. In short, he treats the limb asif it had been subjected to operation for popliteal aneurism."

J. HUNTER LANE, M.D.

NEWS OF THE WEEK, REMARKS, ANDCRITICISMS.

LONDON HOSPITAL.—A Quarterly General Court ofthe Governors, held June 4th, having declared a vacancy in theoffice of physician, by the resignation of Dr. Billing, Dr. Little,the assistant physician, has been elected physician to thathospital.

THE MARYLEBONE AND PADDINGTON HOSPITAL.-The first stone of the new hospital of St. Mary was laid on Satur-day by Prince Albert, who arrived on the site at three o’clock,accompanied by Colonel Bowater and Mr. G. Anson, and wasreceived by a deputation of the parochial authorities, a deputationof the hospital committee, the Bishop of London, the vice-presi-dents, and trustees, &c. There were also present, the Dean ofChichester, and a large gathering of the clergy, Lords Beverleyand Manvers, Mr. B. Bond Cabbell, &c., and having first in-spected the plans of the building, presented and explained to himby Mr. Hopper, the architect, proceeded with his attendants tothe platform, which was erected beneath a marquee capable ofcontaining several thousand persons, and which prevented thoseassembled from being incommoded and annoyed by the showersand the continual gusts of wind. On the arrival of Prince Albertat the platform, the Bishop of London opened the proceedingsby a short address on the subject of the meeting. The inscrip-tion on the stone, " This stene was laid by his Royal HighnessPrince Albert, consort of her Majesty Queen Victoria, on the28th of June, 1845," was then read by the honorary secretary,who presented his Royal Highness with a bottle containinganother inscription, coins, &c., to be deposited in the cavity of thestone. The Prince then laid the stone, with the usual cere-monials used on these occasions. One of the wards of the newbuilding is to be called the Albert Ward.MIDDLESEX HOSPITAL.—We learn that the lately

vacant appointments in the Middlesex Hospital Medical School havebeen filled as follows:.-.The chair of medicine, by Dr. MervynCrawford; anatomy, Mr. De Morgan; midwifery, Dr. West;materia medica, Dr. Day; medical jurisprudence, Dr. Latham ;and that two new lectureships have been formed-namely, inpathological and morbid anatomy, to which Dr. Seth Thompsonhas been appointed ; and on the diseases and operations on theteeth, by Mr. Tomes.LONDON COLLEGE OF PHYSICIANS.—The following

gentlemen were elected Fellows on the 25th of June:-Dr. Jenks,Dr. Seth Thomson, Dr. Golding Bird, Dr. Patrick Black, Dr. R,G. Latham, Dr. Pitman, Dr. Bence Jones, and Dr. Pereira.

CHESTERFIELD. DINNER TO R. C. BOTHAM, Esq.-On Wednesday, the 25th of June last, a dinner was given bythe medical practitioners of Chesterfield and the neighbouringtowns, to R. C. BOTHAM, Esq., as a testimony that, in the opi-nion of his professional colleagues, he had successfully vindicatedhis skill and character in his defence to the recent action -Osborne v. Botham-which was tried at the last Derby assizes.The dinner was held at the Commercial Hotel, Chesterfield,when Dr. FAVELL, of Sheffield, was chairman, JOHN WALKER,Esq., of Chesterfield, was vice-chairman, and Messrs. H. E.Walker and W. E. Boddington were stewards. Among the pro-fessional gentlemen present were - Dr. Favell, Messrs. J.Walker and D. Evans, Belper; John Wright, senior surgeon tothe Infirmary, Derby; S. Evans and J. Johnson, Derby ; H. E.Walker, W. E. Boddington, T. Jones, J. Holland, - Marshall,and R. T. Wylde, Chesterfield; E Brown, Clay-Cross ; Thorpeand France, Staveley; M’Karsie, Crich; - Cooper, Mansfield;Woolham, Mexbro’; - Evans, Winster ; - Clarke, Dronfield ;and Alsop, Bolsover. The dinner passed off with considerable6clat.

HOUSE OF COMMONS.Wednesday, July 2nd.

THE Bill of Lord AsHLEY, to provide for the " Maintenanceand Care of Pauper Lunatics," was considered in Committee ofthe whole House this evening. In one of the clauses it was pro-

posed to empower the Committee of Justices to appoint a "visit-ing physician" to every pauper lunatic asylum, and Mr. WAKLEYmoved as an amendment, that the words " or surgeon" be intro-

duced ; and he enforced the propriety of adopting such anamendment by insisting that the scientific education and thenature of the practice of surgeons rendered them not less eligiblefor such offices than physicians. The amendment was adopted,but immediately before it was put from the chair, Sir JAMESGRAHAM, laughing somewhat heartily, exclaimed, " Suppose weadd the words or general practitioners !’

" Considerable mer-riment was manifested at this remark, and it was not diminishedby one of the honourable members asking, in rather a hurriedmanner, " What are they ? who are they ?" The honourablemember was afterwards, in private, referred for information onthe subject to Blackfriars, and 296, Regent-street.