Document YDew72n6B4XoxgZZ4n0jBR75E

L fit t +- J - . DiL ANDERSON ON THE EFFECTS OF LEAD UPON THE SYSTEM. 73 rit withfacility. Thisdoe*not occurnow. The curved fallen on the not very foolish thought, that patients enervated trite easily seizes fist calculi; and, unless they are very by stimulants and heating treatment might possibly find , the action of the screw or pinion crushes them with benefit in cold. His reward has scarcely reached his proto 1facility. type's--if we contrast the profits of a Wasser-Cur with the I`fca** thus described to you, gentlemen, the principal statue, the n D g , and the equestrian order of Augustus. $teelee which may render the manual part of the operation Preissnitz, however, may have been quite as fullysatisfied with 'Uthotrity more or less difficult in its execution. Let us his less dignified incomings; and we leave his memory and his frpmto the accidents. so-called system with more willingness in repose, since he has ( T p U am tbuud.) but lately fallen a sacrifice to perseverance in his own delu sions; whether a victim to faith in himself, or to the obstinate -n ! 1 -- i - at. Humletan Uectures, maintenance of a show of consistency,.is scarcely worth opr while to inquire. The prototype of homoeopathy is to be found, though more at fts. Soiled College of Physiciansfor the Session 1852, obscurelyf in the ancient doctrine of signatures. The old ab surdity of the red bed for scarlet fever is reproduced in the v Bt JAMES ALDERSQN, M.D., F.R.S. application of drugs calculated to excite the very symptoms which are to be removed, and the invention for modern ,,VN POE EFFECTS OF LEAD UPON THE SYSTEM. *- cj&3tytrht <m the stale of science. Hydropathy--Homoeopathy-- Mesmerism. Valuablefruits of science. Ozone. Epidemics. ..Quarantine. History <rf lead-disease. Citois; Sir George . fiaher; Hippocrates; Nicander; Dioscorides; Pliny; Paulus , fEgyseta; Avicenna and Rhazes. Use of lead among the , ^.{McienU. Vitruvius; Horace; Cdsus. Forms qf the disease. wonderment is added in the so many millioneth subdivision of the remedy, thus endeavouring to make the jargon of a system popular by an almost comic outrage on common sense. The subject claims hut an infmitesimaLapplication of sober criticism, and, like the last-named practice, reminds us too much of the vendors from the booths to require further notice. The monster delusion of the century, however, may detain us somewhat longer. It, too, has not sprung to life in our generation, though it has equally received tne stamp which . #r-HOFi it will not be thought out of place to preface the marks the time in which it flourishes, in having had its *>G%bjectwhich is to occupy us during the present and the two marvels multiplied by engrafting it upon another so-called \fAllowinglectures by a few passing allusions, embracing some science, resuscitated for the purpose from fast-approaching f the-prominent features of medical science as it exists in oblivion. ** tim es. I propose afterw ards to sketch th e history of th e The amalgamation has, as might he supposed, made huh a Wibject on which we are to treat, and to describe the syrap- motley figure of the two absurdities; the mesmerizing system fewasand the exciting causes of one formof the disease--viz. came with pretensions to a power actually superhuman, --reserving for the two following lectures the "JSistoir of Paralysis, the General Pathology of the Disease, Qndother topios connected with the subject. which, applied by instruments the most puerile, was sufficient to remodel the physical condition of man, and overturn his whole moral state. We have been told that a fewstarings or ',2t t* oo new remark, that ever since opinions have been grimaces, or holding of another human being's thumbs, was "ff&sorded,a generationhas scarcelypassedwithout a prevalent enough to cause the spirit " to shuffle off its mortal coil," and Mea.that times so portentous had never yet been known. endue a creature with a sort of omnipresence and omniscienoe. We start at all this pure essential spirituality, and are then presented with a strange contradiction in the assertion that r*~ _ AmwB OI nature, 1 0 some suaaeniy-to-De-aeveloped the recipient of these marvellous powers remains still pro of wealth, or to the immediately-approaching end of strated beneath the mesmerizer's will, and that the functions "jqjj *tme *nch belief has ever been upheld, and has both of mind and sense, which can be exercised without their 5ta9pt inquiring minds strung to the highest pitch of hopeful proper organs, may still be excited and directed by his touch ^oaeitoment. This propensity, often delusive, but powerfully upon certain imaginary organs in the brain, mapped out upon Keotiveboth to action and to laborious study, is natural to the skull. There is excuse enough in the face of these * 0bipg like man, whn feels that the range of intellectual absurdities to release us from the weary task of trying to *** n.* reac*ied .i^8utmost limit--who can retrace disengage the few grains of truth from the mountain of non Q&e successive bounds which have marked its continually sense which composes this so-called science, especially as one ndening span--who feels*that from every point of pure truth, of the earlier features of its history is repeated and brought ' a^ained, fresh vigour, as well as fresh aid, is gained for forward in a form most whimsical at the present moment. Jsss'ther efforts---and who also at every point obtains a view of Each professor in his turn has accused his predecessor of 'vasterobjects^to enepmpass. Whether it may owe its origin to imposture. Mesmer denounced Hell, and I^Ealon, Mesmer; *n the.moral constitution, inclining generations, and the electro-biologist now in bis nightly exhibition defies sak individuals, to delight in believing themselves dis- all the world to prove that his philosophy is connected in the ^'saguiahed,--or whether it may spring more rationally from the most remote degree with that of the mesmerists. After the fsafre*oe, that as intellectual progress, like mechanical power, often-repeated investigations, and as many confutations, by ;poceeds at a_oontinually increasing ratio, so, from accumulated really learned and impartial men, it is hard to be continually knowledge, some unimagined revelations may constantly be appealed to, as we are, to bestow time which might be far J&speotea,--still it has its use, and could wo repress it wholly, more usefully employed than in sifting the tricky evidence. Whould scarcely be inclined to do so. We have no wish, I conceive that the same test which was given us to distinguish fcroefore, to deny that this characteristic of former ages is as between true and false prophets may without impropriety be Prominently marked at the present period, if not more so applied to discriminate between true and false philosophers: it ever has been yet. " You may know them by their fruits." Tried by this rule, I t is not- now my province to trace the evidence of this we shall find that while our men of real science have bestowed fooyond the field of philosophy, but there we may observe it in on this generation two benefits which are actual blessings to xcees, bearing, also, many of the features which have been society,--that while the natural revulsion of the frame under prominent in times of greatest note: we have the same surgical assistance is altogether spared, and while most distant craving after marvels, and the same hasty acceptation of im friends have gained the consolation of immediate communi proved novelties: among the genuine seekers after truth, cation--we may search in vain for one^ single well-attested we have still the same feverish anxiety for new results, almost practical benefit from the inventors of this system, who claim Changing the calm demeanour of legitimate study into the a mysterious control over the most subtle and potent agencies. ^fness of an alchemist seeking for the philosopher's stone It is pleasant to pass from these " speciosa miracula" of ^ the elixir vitro; and amongst the deluded or wilfully de- empiricism to glance at the practical advantages which we {*53?. we have the same wild statements of discoveries are daily deriving from the advance of science in the legiti rp^r*n^ on the miraculous. mate path of sound induction. latter class--these false philosophers, however, though Even in this honoured course, a tendency to the same ney appear to stand forth as an unprecedented feature of the excited mode of study is observable, and may be traced in the texemplify this love of novelty only in the meretricious frequent and hurried announcements of new discoveries, in which their systems are re-dressed up for modern especially among the chemists, followed by as rapid abandon J v .J "J themselves, they are but reproduced fallacies, with ment of the new positions. In our own profession, the same nich the foreground of every picture of the state of science excitement is displayed in the eagerness to discard older ^ p ^ .000.^ mes has been disfigured, theories, and seek for the elucidation of all diseases in the ireissnitz has only been a modern Musa, who has also state of some particular organs, thus referring to individual U1 DR. ALDERSON ON THE EFFECTS OF LEAD UFON T E E SYSTEM. parts the governing influence over the general system. The of pursuing the investigations which we have noticed as a rearing of this latter subject is worthy of deeper reflection characteristic of the age, has a salutary as well as an exciting than the present time permits me to bestow. I shall rather tendency. Intervals occur when there is a natural recoQ occupy a few moments in referring to some points in which from overstrained curiosity to a state when more sober mental I general philosophy and medical science are working unitedly exercise becomes at once enjoyment and relief. This is * I with the most flattering prospects. period favourable to the growth of true practical wisdom, J Inquiries have been extended, by which we already possess since it affords leisure for the dispassionate review of accuuiu. aew results scarcely exceeded in importance by those two lated facts, and for a calm inquiry into the alliance between discoveries just alluded to, although these latter appear to truth and nature. Though we may all be captivated by tht bear a striking pre-eminence from the practical uses to which brilliant realities of general science, I feel sure, that to leav# they have been so promptly adapted. The microscopists have this discursive introduction, and commence our immediate infused fresh vigour into our physiological as well as patholo subject, will not be unacceptable. And let me hope that gical researches, and have already disclosed many mysteries the observations which I have prepared, with the bat of nature, whilst the field of future discovery appears to be industry I could bestow, may not be devoid of that practical almost unlimited. Chemistry has not only displayed to us utility which it is the especial province of this learned corpo. some new properties of magnetic power, and, under Faradav's ration to seek and to promote. researches, shown that we are absolutely surrounded by tlie The subject of colic and paralysis the result of the absorp. influence, and that (I quote his words) " oxygen is in the air tion of lead, commends itself to the notice of this assembly by what iron is in the earth;" but it has also opened out a dis the same peculiarities which have deterred the great body covery which affords hope of elucidating one of the most diffi medical practitioners from bestowing much time and attv cult subjects of medical philosophy. Schoubein's experiments, tion upon it--it is, in one form at least, a disease almost ex, showing that a compensating substance exists in the atmo clusively confined to the labouring class, and therefore a fit > sphere, capable of destroying the oxidible miasmatic bodies subject for the benevolent consideration of those who are th$ i tnrown into it by putrefying organic matter, is a subject of true guardians of tho public health, and especially of the highest interest, of which we can hardly yet estimate the health of that part of the public who need the protection! full value, as bearing on the much-vexed question of the pro which they have not the power of obtaining for themselves. pagation of epidemic disease. Colica pictonum, considered as a disease depending on tho Having shown that electricity so changes the elements absorption of lead dissolved in cider, was first brought before which result from the decomposition of organic compounds, that the presence or very existence of these elements the medical profession in this country fn the year 1767. I* that year. Sir George Baker, a physician of great talent &n4 becomes no longer cognizable by the senses, he refers this celebrity, read an essay before the College of Physicians oq ascertained fact to a certain allotropic modification of the the causo of the endemic colic of Devonshire. The disease had * atmosphere--supposing, that, by the agency of electricity, the been previously noticed in the same locality byDrs. Musgrart $ same results are worked out on a larger scale which we arrive and Huxham, but without suspicion of its real origin--nay, j at when we disinfect small volumes of air containing miasmata even Citois, from whose accurate observation of the symp. with chlorine fumigations. This so-called allotropic change toms in the wine district of Poictou, the malady derived th* > was first supposed by Schbnbein to arise from the generation name whereby it is still known, deemed it only the effect rf'i of a peroxide of hydrogen, a substance which was discovered the unripe, austere wines of the province. ^ by Thenard as long ago os 1818, and was noticed by our Presi To Sir George Baker belongs not only the credit of dent in his a Medical Chemistry," in 1826. In this highly rate and persevering research in tracing the disease to fe1 philosophical work, we find the subject, in a passing manner, source, but the higher honour of having called in the foreerf J handled in a style which seems almost prophetic of the pre public opinion effectually to remedy the evil which he had sent discovery; and Gregory, in his recent work on Chemistry, exposed. We, too, may be encouraged in a kindred researsb) of 1817, treating on this subject, has adopted the very words by remembering how many forms of the same disease are of Dr. Paris. The supposition that the change was referable rife amongst us, the prevention of which, by well-arrangi^H to the presence of the per- or bin-oxide of hydrogen, (a sub sanitary measures, may be found as certainly practicable | | k stance which is wholly without odour,) has been abandoned, their cure is difficult and precarious. Considering the variu t and Schonbein, as well as others, hold that the phenomenon forms in.which lead is a deleterious agent, we could have is; consists in chemically excited oxygen; but, whether the final doubt, &priori, that some of its effects would have been noticed cause be yet sufficiently brought tolight or not, the ascertained by the ancients, and we find, accordingly, allusions to the existence of the change is enough for our present purpose. poisonous action of lead in various classical and semi-classical ` The old and popular impression, that thunderstorms have writers. Yet, after inspecting all, or nearly all, the passagt^ a purifying effect on the atmosphere, obtains now a scientific of ancient authors which can be brought to bear on the suh-. a confirmation; and we are, at the same time, in a position to ject, I have found but few deserving of particular notice. hope that the subject, further developed, may lead to the dis Hippocrates has but some cursory remarks, which rather j closure of the connexion between animal and physical include than specify the particular effects of lead. Nicander^ * agencies. Experience in the use of the telegraph has taught however, who wrote nearly a hundred years before the, as the value oi water as a connecting link to complete the Christian era, in a didactic poem on poisons and tbt / circuit in the galvanic battery; and this fact appears to me to antidotes, notes several peculiar symptoms produced by tfcr. suggest the hypothesis, that a state of atmosphero may exist action of litharge--constipation,flatulence, suppressed secre along the course of rivers, and even in tracts across the ocean tions, griping pains, burning heat in tho limbs, and, finally,. 15 itself, favourable to the development of epidemic disease, livid paleness of complexion, which he fancifully comparesJej that development being the consequence of a deficiency in the dull hue of leaa. Again, in describing the action. pL the peculiar modification which is necessary to render it ceruse, he alludes to these further symptoms--adhesion `tft harmless. Should this suggestion be found tenable, and be opaque white mucus to the gums and cheeks, and inability U; hereafter supported by statistical observation, the result move the limbs. Dioscorides,+who flourished about the mid$|vj would afford us better data than we have ever yet possessed, of the first century (p. c.), writes nearly to the same purpose;* on which to form a conclusion as to the value or expediency but the terseness of his prose deserves a literal translation > of quarantine regulations. The quarantine system has hitherto MThe drinking of litharge causes oppression to the stonuuj, > been supported in the face of conflicting evidence, because, belly, and intestines, with intense wringing plains; sometimpl} in the obscurity of our knowledge of the relations between it even wounds the intestines by its severe pressure; it sup* physical and animal agencies, men have not dared to relax a presses the urine, while the body swells and acquires an.: caution, the advantages of which could not be disproved, but unsightly leaden hue." Pliny}: adds nothing to the above hot ^ which has been manifestly inadequate to the purpose for some remarks on the noxious quality of the fumes of lead. / which it was contrived. Could the acknowledged evils, both Paulus 2Egineta exactly follows Dioscorides. Vitruviwl : personal and commercial, be conscientiously remitted, in con dwells at some length on the disadvantage of receiving water' sequence of clearer views as to the propagation of disease, through lead, arguing thus, that lead must be unwholesome,: the assistance^ thus rendered by chemical science would count since it produces ceruse, the noxious effects of which were^ among the brightest triumphs of true philosophy. generally recognised; and alsodrawing the same inference more j While hastily recurring to subjects such as these, we feel logically from the pallid complexion of the workers in lead. it is impossible not to perceive that our times abound, if not in greater intellectual fruition, yet at least in prospects such * Nicander, AAefi^xip/ituca, L 6oo (circa.) as have no earlier parallel; and feeling so, we cease to wonder at the anxious eagerness with which inquiry is pursued. There is a point of view, however, in which the eager mode t Dioscorides, AXefi^ap/iaxa, cap. 27* X Pliny, N at. H ist., lib. 34, cap. 18. } Paulus ALglneta, lib. 6, cap. 59. 61. 0 Vitruvius de Arch. V et., lib. 8, cap. 6 (vulg;. 7.) DR. TANNER ON OVARIAN ABSCESS. 75 --rite rs f Ike Arabian school, Avicenna and g^**e,* I shall not quote, as the substance of their remarks iaa been anticipated in the passages which I have cited ON TWO CASES OF OVARIAN ABSCESS. W ITH REMARKS. , These, though interesting, and, as far as they go, not inytrrect, do not evince any great extent or accuracy of ob- By T. H. TANNER, M.D., L.R.C.P. -ration: they seem to imply that the attention of the I n July, 1849, a poor woman, forty-four years of age, tha t .fnter* had been awakened by the singnlarity of the pheno- mother of three children, the youngest eighteen months old, ^ assna rather than rivetted by their frequency. came under my care at the Farringdon General Dispensary* f . The truth is, that lead was in very little use amongst the suffering from the symptoms to be presently mentioned. Her. CSfiients. Their reservoirs of water were of marble and history was, that seven weeks previously she was kicked b j at; their domestic utensils, when not of their own in- her husband over the lower part of the abdomen, which gava -/ Jpitabls pottery, were of copper, with its various compounds, rise to so mnch sickness and suffering, that she was obliged to * (which they early learnt to lline with tin,) or of metals yet remain in bed for two days. The pain then diminished, but a--c-r-e---p-r-e-c-i!o--us. In decorative painting, their pnre atmosphere returned with increased severity, accompanied with rigors* esoonraged the use of fresco, in which the oxides of lead, bo at the end of a fortnight, when her catamenia appeared, essential in oil-painting, might bo readily dispensed with. The though more scantily than usual. She had some medicine . extensive use of lead-piping alluded to by Ilorace,+ as well as from the parish surgeon, which gave her relief, and she waa by Vitruvius (ul rupra), would doubtless bring into more enabled to continue doing her household work, until the fol aotioe a certain class of morbid effects, and the entire silence lowing monthly period, when she became much worse, com <&Celsns as to these is probably owing to his having followed plaining especially of acute pain at the bottom of her abdo I reek authorities. Still, had the medical profession of the men and towards the left side, of lancinating pains down the present day no stronger motive for the close investigation of thigh of the same side, and of inability to keep any food, this subject than their predecessors under the Caesars, it would upon her stomach. The menstrual flow was very scanty, and ; Save little of practical utility to recommend it to an assembly ceased five days ago. like the present. But, unhappily, the victims of that poisonous On examining the abdomen, I fonnd it swollen, tympanitic, ajencv which in days of yore was but suspected or casually aDd tender on pressure, especially in the left iliac region, on suoarlced, are now to be numbered by hundreds--nay, pressing into which, a tumour, about the size of an orange, fimosanda--in all classes, and especially among the artisans could be felt. On examining per vagiuam, this swelling several trades hereafter to be particularized. could be more distinctly felt on the left side of the uterus; it . It is a fact now so clearly understood as to become familiar, appeared rather moveable, that is to say, as if it could be pushed that when lead, whether in fumes or in powder, is diffused in upwards, and on pressure an indistinct sensation of fluctua i!haatmosphere, it may be absorbed into the system. After a tion was communicated to the finger. The cervix uteri waa variable period of exposure to its influence, an impairment of healthy. Her bowels were costive, and she experienced sane of the functions of the body becomes manifest by much pain on going to stool, and was never free from u bear certain signs and symptoms. The effects of the imbibed ing-down pains." ?ieon are by no means constant: different individuals are ejected in dissimilar ways. In one colic will be the result, te. another paralysis; in a third the effect may be merely ioomalous pains in the limbs or in the body, which without the history of the case might seem obscure in their origin and My diagnosis was, that the left ovary was enlarged, and that suppuration had probably taken place. As there were no indications for immediate local treatment, and as the woman was exceedingly weak, I ordered her tonics and nourishment, and directed her to keep as quiet as possible. JWture; in a fourth, the morbid influence may be manifest in This treatment was continued until the morning of the 12th &$aform of epilepsy or convulsions, and a modification of the of August, when I was suddenly called to visit her, as shq iroulytia is sometimes fonnd in the forms of amaurosis and was said to be dying. Mafcess.^ These several varieties have been separated by the On my arrival I found that 6he had rallied, and learnt from French into distinct forms of disease, for each of which her that the catamenia had appeared on the previous evening, aey have elauorated a high-sounding designation, such as that the flow was rather more abundant than it had been on arthralgia," " encephalopatic," &c. the previous occasion, and attended with less pain until this All these various results of the action of lead may, however, morning, when, on getting out of bed, she felt something give !^et up in different individuals under the same identical way in her stomach, and became very faint. Feeling a strong G&3umst*ncea, labouring in the same workshop, and exposed desire to go to stool shortly afterwards, she did so, and passed the tame deleterious influences. It is more reasonable, about half a pint of unhealthy-looking pus mixed with a little ^8quentlv, to regard them as a series of symptoms blood. She nad felt easier since taking some hot gin-and- weloped differently, according to the peculiarity of indi- water. On examining the abdomen, the tumour could not be *l*al constitution or of the especial mode of absorption of felt in its usual situation; but as pressure gave her pain, and ^poison. The classification will be more convenient, os caused a sensation of sickness, it was only employed with, a* more efficient for the purposes of treatment, if we gentleness. the subject into the two leading forms of Colic and The further progress of this case was very satisfactory; Colic has usually been called the acute, and although much depressed by a troublesome attack of diarrhoea, the chronic form; but I have considerable doubt of yet, as she was fortunately able to obtain nourishing food, and accuracy of this distinction. There are well-recorded had a good appetite, she gradually gained strength, and at the ^***068 of paralysis being set up after a very short period of end of three months was quite well. I should mention that to the noxious influence, without any intervention she continued to pass small quantities of pus with her stools |colic, while, on the other hand, long-continued and for some time after the first discharge, and that she always f^aquentl^-repeated attacks of colic occur without paralysis felt mnch relief on doing so. On examining the abdomen at Supervening. Colic is undoubtedly the form of most frequent the end of the three months, no swelling nor enlargement J^currence, and that with which practitioners are most whatever could be felt; but on making a vaginal examination, ^fcdiar, especially in this country. Happily, also, it is the a slight hardness could be felt at the left side of the uterus, onn which is the most amenable to treatment--indeed, so pressure on which gave a little pain. manageable that it is rarely fatal. Before making any remarks on the peculiar features of this (To be continued.) Avicenna, Th 5 F en. 6, Q a a rti; Tract. 1, oap. 4, 5. Rhazes, lib. 8, Punor in vicis aqua tendit rampere plumbum, Wuam quae per pronum trepidat cum murmure rivum ?* <*(-STnmcU-. L. I., Epist. 10. Wu*er purer from the bursting lead. Than gently m urm uring down its native bed?" E s s a y o n *H*yiydnruorpnhuowb iAa ..---It will be seen, by an Qofireejjrlv' ^f6o1r116th?e1 b1Desttbesissaydaojn'sHIyjAdrNoCpEhTo*bitat,aittsthNeatuorme aonfd T5re0ati-s cose, it will be better to relate the second example of the same disease which has come under my notice, but which unfor tunately has terminated in a very different manner. On the evening of the 28th January, 1852, 1 was hastily summoned to a lady who had been under my care for about two months, suffering from incomplete hemiplegia of the left side of tha body, attended with great debility. I was unable to attend for about an hour, and on my arrival found her propped up in. bed, excessively prostrated, body and extremities cold, and covered with a clammy sweat, and with a pulse scarcely per ceptible; she was gasping and crying out with agony, and appeared to have her sufferings increased on touching her abdomen, to which she pointed as the seat of her pains; while her countenance was distorted, and bore a peculiar expression strongly indicative of approaching death, She appeared, in