Document xzJ9x96mM1VeMeb65vpEG5Q6Q

i , DiL ALDERSON ON THE EFFECTS OF LEAD UPON THE SYSTEM. 73 , geiiiijg it with faplity. This does not occur now. The curved fallen on the not very foolish thought, that patients enervated ' flitbotrite easily seizes flat .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 facility. type's--if we contrast the profits of a Wasser-Cur with the have thus described to you, gentlemen, the principal statue, tho ring, and the equestrian order of Augustus. ^sbstaoles which may render the manual part of the operation Prei8snitz, however, may have been auite as fully satisfied with vof lithotrity more or less difficult in, its execution. Let us his less dignified incomings; and we leave his memory and his next tprn to .the apeidents. so-called system with more willingness in repose, since he has f ' * _(To b continued^ but lately fallen a sacrifico to perseverance in his own delu sions; whether a victim to faith in himself, or to the obstinate maintenance of a show of consistency,.is scarcely worth our -'2Cfje UumUtari lectures, while to inquire. The prototype of homoeopathy is to he found, (hough more \flfUvtrc4 al the. Royal College of Physician.for the Session 1^52, obscurefyt in the ancient doctrine of signatures. The old ab surdity of the red bod for scarlet fever is reproduced in tho - By JAMES ALDERSON, M.D., F.R.S. application of drugs calculated to excite the very symptoms which are to be removed, abd the invention for modern ^ N TBE. EFFECTS OF LEAD UPON THE SYSTEM. wonderment is added in the so many millioneth subdivision of the remedy, thus endeavouring to make the jargon of a JUtmarht on the jlale of icience. Hydropathy--Homoeopathy-- Mesmerism. ' Valuablefruit* of science. Ozone. Epidemics. Quarantine. 1 History of' lead-disease. Ciiois; Sir George I.,;. (Baker;, Hippocrates; Nicander; Dioscorides; Pliny; Paulus *:J.. 'fEginela; Avicenna and Phazes. Use of lead among the x .^Undents. Vitruvius;. Horace; Celsus. Forms qfthe disease. system popular by an almost comic outrage on common sense. Tho subject claims but an infinitesimal application 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 dotain us somewhat longer. It, too, has not sprung to life in our generation, though it has equally received the stamp which 'T -e o p i i t w ill n o t be th o u g h t out of place to preface th e marks the time in which it flourishes, in having had its '-subject w hich is to occupy us duriDg th e presen t and th e two marvels multiplied by engrafting it upon another so-called ' following le c tu re s by a few passing allusions, em bracing some science, resuscitated for the purpose from fast-approaching \ @ the- p ro m in e n t fe a tu re s of m edical science as i t ex ists in oblivion. *our tiroes. I propose afterwards to sketch the history of the The amalgamation has, as might be supposed, made hub a *subject on which we are to treat, and to describe the syrap- motley figure of the two absurdities; the mesmorizing system 3toms and the exciting causes of one form of the disease--viz. came with pretensions to a power actually superhuman, 1^ad Colic--reserving for the two following lectures the which, applied by instruments the most puerile, was sufficient "History of Paralysis, the General Pathology of the Disease, to remodel the physical condition of man, and overturn his `$ad other topics connected with the subject. whole moral state. We have been told that a few starings or ;;:,,It is no new remark, that ever since opinions have been grimaces, or holding of another human being's thumbs, woa 6?oorded, a generation has scarcely passed without a prevalent enough to cause the spirit Mto shuffle off its mortal coil," and adea that times so portentous had never yet been known. endue a creature with a sort of omnipresence and omniscieuoe. Whether the expectation of something surpassing former ex We start at all this pure essential spirituality, and are then perience related to political .changes, to a discovery of the yet presented with a strange contradiction in tho assertion that (bidden, laws of nature, to some suddenly-to-be-developed 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 all things, some such belief has ever been upheld, and has both of mind and 60nse, which can bo exercised without their i^pt inquiring minds strung to the highest pitch of hopeful proper organs, may still be excited and directed by his touch sscitement. This propensity, often delusive, but powerfully upon certain imaginary organs in tho brain, mapped out upon aaceotive both to action and to laborious study, is natural to the skull. There is excuse enough in the faco of these ' beipg like man, who- feels that the range of intellectual absurdities to release us from the weary task of trying to ^.wer has not yet reached its utmost limit--who can retrace disengage the few grains of truth from the mountain of non successive bounds which have marked its continually sense which composes this so-called science, especially as one widening span--who feels'that from every point of pure truth, of the earlier features of its. history is repeated and brought ftttained, fresh vigour, as well as fresh aid, is gained for forward in a form most whimsical at tho present moment. Ssftber efforts---and who also at every point obtains a view of Each professor in his turn has accused his predecessor of 'taster-objects to enepmpass. Whether it piay owe its origin to imposture. Mesmer denounced Hell, and I^Ealon, Mesmer; *n the.moral constitution, inclining generations, and the electro-biologist now in his nightly exhibition defies lake individuals, to delight in believing themselves dis all the world to prove that his philosophy is connected in tho tinguished,---or whether it may spring more rationally from the most remote degree with that of the mesmerists. After tho | iferenoe, that as intellectual progress, like mechanical power, often-repeated investigations, and as many confutations, by jpoceedsatooontinually increasing ratio,so,from accumulated really learned and impartial men, it is hard to bo continually knowledge, some uuimagined revelations may constantly be appealed to, as we are, to bestow time which might be far 'Bspeoted,--still it has its use, and could wo repress it wholly, more usefully employed than iu sifting the tricky evidonce. should scarcely be inclined to do so. We have no wish, I conceivo that the same test which was piven us to distinguish, therefore, to deny that this characteristic of former ages is as between true and false prophets may without impropriety bo Pj^ninently marked at the present period, if not more so applied to discriminate between true and falso philosophers: than it ever has been yet. u You may know them by their fruits." Tried by this rule, ^ It-is not- now my province to trace the evidenco of this we shall find that while ourmen of real science havo bestowed byond the field of philosophy, but there we may obsorvo it in' on this generation two benefits which aro actual blessings to oxcess, bearing, plso, many of the foaturcs which have been socioty,--that while tho natural revulsion of the framo under prominent in times of greatest note: wo have tho samo surgical assistance is altogether sparod, nnd whiio most distant craving after marvels, ana tho samo hasty acceptation of im frionde havo gained tho consolation of immediato communi proved novelties: among tho gonuino seekers after truth, cation--wo may search in vain for ono singlo well-attested wo have still the same feverish anxiety for now results, almost practical benefit from tho inventors of this system, who claim changing the calm demeanour of legitimate study into tho a mysterious control over the most subtle and potent agencies. ukeness of an alchemist seeking for the philosopher's stone It is pleasant to pass from theso " speciosa miracnla of )r the elixir vitce; and amongst the deluded or wilfully de empiricism to glance at tho practical advantages which wo prived^wo have the same wild statements of discoveries are daily deriving from the advauco of science in the legiti ordering on the miraculous. mate path of sound induction. This latter class--these false philosophers, however, though Even in this honoured course, a tendency to the samo key appear to stand forth as an unprecedented feature of tho excited mode of study is observable, and may bo traced in tho ge, exemplify this love of novelty only in the meretricious frequent and hurried announcements of new discoveries, tjle ip which their systems are re-dressed up for modern especially among tho chemists, followed by as rapid abandon in themselves, they are but reproduced fallacies, with ment of tho new positions. In our own profession, the Bamo rhich tho foreground of every picture of tho state of science excitement is displayed in tho eagerness to discard older p^.ono. has been disfigured. theories, and seek for tho elucidation of all diseases in tho creiesnitz boa only been a modorn Musa, who has also Btato of somo particular organs, thus referring to individual bft. aldersok ok t e e effects oe lead uton t e e system. parts the governing influence over the general system. The of pursuing tho investigations which wo have noticed as bearing 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 rccofl occupy a few moments in referring to some points in which from overstrained curiosity to a state when more sober mental general philosophy and medical science are working unitedly exercise becomes at once enjoyment and relief. This is & with the most flattering prospects. period favourable to the growth of true practical wisdom Inquiries have been extended, by which we already possess since it affords leisure for the dispassionate review of accumu. aew results scarcely exceeded in importance by those two lated facts, and for a calm inquiry into the allianco between discoveries just alluded to, although these latter appear to truth and nature. Though wo may all bo captivated by bear a striking pre-eminence from the practical uses to which brilliaut realities of general science, I feel sure, that to leave they have been so promptly adapted. The microscopists have this discursive introduction, and commence our immediate infused fresh vigour into our physiological ns well ns 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 beat of nature, whilst the field of future discovery appears to bo 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 corpQ. some new properties of magnetic power, and, under Faraday's ration to seek and to promote. researches, shown that we are absolutely surrounded by the The subject of colic and paralysis the result of tho absorp. influence, aud that (I quote his words) " oxygen is in the air tion of lead, commends itself to tho 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 of covery which affords hope of elucidating one of the most diffi medical practitioners from bestowing much time and atteo. cult subjects of medical philosophy. Schonbein's experiments, tion upon it--it is, in one form at least, a disease almost e*. showing that a compensating substance exists in the atmo cltisively confined to tho labouring class, and therefore a fit sphere, capable of destroying the oxidible miasmatic bodies subject for tho benevolent consideration of those who are tho thrown into it by putrefying organic matter, is a subject of true guardians of tho public health, and especially of tho the highest interest, of which we can hardly yet estimate tho health of that part of tho public who need tho 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 pictonuin, considered as a disease depending on the 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, the medical profession in this country in the year 1767. In that the presence or very existence of these elements that year, Sir George Baker, a physician of great talent aod 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 allotropio modification of the the causo of tho endemic colic of Devonshire. Tho disease ha<j (atmosphere--supposing, that, by tho agency of electricity, the been previously noticed in the same locality byDrs. Mufigmro same results are worked out on a larger scale which we arrive and Iluxham, but without suspicion of its real origin--nay, at when we disinfect small volumes of air containing miasmata even Citois, from whose accurato observation of tho symp with chlorine fumigations. This so-called allotropic change toms in the wine district of Poictou, tho malady derived the was first supposed by Scbbnbein to arise from the generation name whereby it is still known, deemed it only the effect if of a peroxide of hydrogen, a substance which was discovered the unripe, austere wines of tho province. by Thenard as long ago as 1818, and was noticed by our Presi To Sir George Baker belongs not only tho credit of accu dent in his " Medical Chemistry," in 1826. In this highly rate and persevering research in tracing tho discaso to Lti philosophical work, we find the subject, in a passing manner, source, but the higher honour of having called in tho forco of Joandled in a style which seems almost prophetic of tho pre public opinion effectually to remedy the evil which ho bwj sent discovery; and Gregory, in his recent work on Chemistry, exposed. We, too, may be encouraged in a kindred research of 18*7, treating on this subject, has adopted the very words by remembering how many forms of the same discaso are yet of Dr. Paris. The supposition that the change was referable rife amongst us, tho prevention of which, by well-arranged to the prescnco of tho per- or bin-oxide of hydrogen, (a sub sanitary measures, may be found ns certainly practicable u stance which is wholly without odour,) has been abandoned, their cure is difficult and precarious. Considering tho various and Schonbein, as well as others, hold that the phenomenon forms in,which lead is a deleterious agent, we could have so 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 tho ancients, and wo find, accordingly, allusions to tho existence of the change is enough for our present purpose. poisonous action of lead in various classical and sorni-clasaical Tho old and popular impression, that thunderstorms havo writers. Yet, after inspecting all, or nearly all, tho passages a purifying effect on tho atmosphere, obtains now a scientific of ancient authors which can bo brought to bear on the sub confirmation; and we are, at tho 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 _ 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 beforo tho us the value of water os a connecting link to complete the circuit in the galvanic battery; and this fact appears to me to Christian era, in a didactic poem on poisons and their antidotes, notes several peculiar symptoms produced by tho \ suggest the hypothesis, that a 6tate of atmosphere may exist action of litharge--constipation, flatulence, suppressed secre aloDg the course of rivers, and even in tracts across the ocean tions, griping pains, burning heat in the limbs, and, finally, i itself, favourable to the development of epidemic disease, livid paleness of complexion, which he fancifully compares to that development beiDg the consequence of a deficiency in tho dull hue of lead. Again, in describing the action of the peculiar modification which is necessary to render it ceruse, ho alludes to these further symptoms--adhesion of harmless. Should this suggestion bo found tenable, and be opaquo white mucus to the gums and chocks, and inability to hereafter supported by statistical observation, the result move the limbs. Dioscorides,+who flourished about the middle would afford us better data than we have ever yet possessed, of the first century (p. a), 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 " The drinking of litharge causes oppression to the stomach, been supported in the face of conflicting evidence, because, belly, and intestines, with intense wringing paios; sometimes in tho obscurity of our knowledge of the relations betwreen it even wounds tho intestines by its severe pressure; it sup physical and animal agencies, men havo not dared to relax a presses the urine, while tho body swells ami acquires an caution, the advantages of which could not be disproved, but unsightly leaden hue." Flinyt adds nothing to the above bnl which has been manifestly inadequate to the purpose for some remarks on tho noxious quality of the fumes of lead. which it was contrived. Could the acknowledged evils, both Paulii8 -ZEginota exactly follows Dioscoridcs. Vitruviusl personal and commercial, be conscientiously remitted, in con dwells at some length on tho disadvantage of receiving water sequence of clearer views os to tho propagation of disease, through lead, arguing thus, that lead must be unwholesome, the assistance^ thus rendered by chemical science would count Bince it produces ceruse, the noxious effects of which were/ among the brightest triumphs of true philosophy. generally recognised; and also drawing the same inference more While hastily recurring to subjects such as these, wo 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 * N lcandcr, AXrf <<Mp/ia*a, 1. Ooo (circa.) as have no earlier parallel; and feeling so, wo 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 Dioscoridcs, AXrfitpitpyiaKa, Cap. 27. J r iin r , N at. H ist., lib. 31, cap. 1R. S Paulus jtg ln e ta , lib. 5, cap. 5Q. Cl. | V itruvius de Arch. V et., lib. 6, cap. C (vulg. 7-) DR. TANNER ON OVARIAN ABSCESS. 75 rgm: the writers of the Arabian school, Avicenna and ON J shall not quote, as the substance of their remarks been anticipated in the passages which I have cited TWO CASES OF OVARIAN ABSCESS. WITH REMARKS. hese, though interesting, and, as far as they go, not inreet, do not evince any great extent or accuracy of ob- Bt T. H. TANNER, M.D, L.R.C.P. ation: they seem to imply that the attention of the I n July, 1819, a poor woman, forty-four years of age, tho .en had been awakened by the singularity of the pheno- mother of three children, the yonngest eighteen months old, ia rather than rivetted by their frequency, came under my care at the Farringdon General Dispensary, bs truth is, that lead was in very little use amongst the suffering from the symptoms to be presently mentioned. Her eat*. Their reservoirs of water were of marble and history was, that seven weeks previously she was kicked by ent; their domestic utensils, when not of their own in- her husband over the lower part of the abdomen, which gavo abls pottery, were of copper, with its various compounds, rise to so much sickness and Buffering, that she was obliged to ich they early learnt to line with tin,) or of metals yet remain in bed for two days. The pain then diminished, but : precious. In decorative painting, their pure atmosphere returned with increased severity, accompanied with rigors, ouraged the use of fresco, in which the oxides of lead, so at the end of a fortnight, when her catamenia appeared, ntialin oil-painting, might bo readily dispensed with. The though more Bcantily than usual. She had some medicine entire use of lead-piping alluded to by Horace,+ as well as from the parish surgeon, which gave her relief, and she waa Vitruvius (ui rupra), would doubtless bring into more enabled to continue doing her household work, until tho fol oe a certain class of morbid effects, and the entire Bilence lowing monthly period, when she became much worse, com Uus as to these is probably owing to his having followed plaining especially of acute pain at the bottom of her abdo ek authorities. Still, had the medical profession of the men and towards the left side, of lancinating pains down tho oat day no stronger motive for the close investigation of thigh of the same side, and of inability to keep any food, iic. subject than their predecessors under the Cassars, it would upon her stomach. The menstrual flow was vory Bcanty, and s little of practical utility to recommend it to an assembly ceased five days ago. the present. Bat, unhappily, the victims of that poisonous On examining the abdomen, I found it swollen, tympanitic, acy which in days of yore was but suspocted or casually and tender on pressure, especially in the left iliac region, on. anted, are now to be numbered by hundreds--nay, pressing into which, a tumour, about the size of an orange, isands--in all classes, and especially among the artisans could be felt. On examining per vagiuam, this swelling oreral trades hereafter to be particularized. could be more distinctly felt on the left side of the uterus; 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 when lead, whether in fumes or in powder, is diffused in upwards, and on pressure an indistinct sensation of fluctua atmosphere, it may be absorbed into the system. After a tion was communicated to the finger. The cervix uteri waa able period of exposure to its influence, an impairment of healthy. Her bowels were costive, and she experienced e of the functions of the body becomes manifest by much pain on going to stool, and was never free from " bear aia signs and symptoms. The effects of the imbibed ing-down pains." on are by no means constant: different individuals are My diagnosis was, that the left ovary was enlarged, and :ted in dissimilar ways. In one colic will be the result, that suppuration had probably taken place. As there werq jaother paralysis; in a third the effect may be merely no indications for immediate local treatment, and as tho nelous pains in the limbs or in the body, which without woman was exceedingly weak, I ordered her tonics and history of the case might seem obscure in their origin and nourishment, and directed her to keep ub quiet as possible. re; in a fourth, the morbid influence may be manifest.in This treatment was continued until the morning of the 12th form of epilepsy or convulsions, and a modification of the of August, when I was suddenly called to visit her, as she lysis is sometimes found in the forms of amaurosis and was Baid to be dying. ness. These several varieties have been separated by the On m y a rriv al I found th a t 6lie had rallied, and le a rn t from ich into distinct forms of disease, for each of which h e r th a t tho catam enia had appeared on th e p r o v i c s evening, have olauorated a high-sounding designation, such as th a t th e flow was ra th e r m ore a b u n d an t th an it h ad been on hralgia," " encephalopatic," k c. th e previous occasion, and attended with less pain u n til this Uthese various results of the action of lead may, however, m orning, w hen, on g ettin g out of bed, she fe lt som ething give t up in different individuals under the name identical way in h e r stom ach, and becam e very faint. FeeliDg a stro n g instances, labouring in the same workshop, and exposed desire to go to stool shortly afterw ard s, she did so, end passed he same deloterious influences. I t is more reasonable, about h a lf a p in t of unhealthy-looking pns m ixed w ith a little oquently, to regard them as a series of symptoms blood. She had felt easier since tak in g some hot gin-and- loped differently, according to the peculiarity of indi w ater. On exam ining th e abdom en, th e tu m o u r could not be al constitution or of the especial mode of absorption of fe lt in its usual situation; b u t as pressure gave h e r pain, an d poison. The classification will be more convenient, as caused a sensation of sickness, it was only em ployed w ith as more efficient for the purposes of treatment, if we gentleness. le tlio subject into the two leading forms of Colio and T he fu rth e r progress of th is enso wns vory satisfactory; lysis. Colio has usually boon called the acute, and although m uch depressed by a troublesom e a tta c k o f diarrliooa, lysis the chronic form; but I havo considerable doubt of yet, as she was fortunately able to obtain nourishing food, a n d accuracy of this distinction. There are well-recorded had a good ap p etite, she g radually gained stre n g th , an d a t th a ncea of paralysis being set np after a very short period of end of th re e m onths was q u ite well. I sh o u ld m ention th a t sure to the noxious influence, without any intervention she continued to pass sm all qu an tities of pus w ith h e r stools "he, while, on the other hand, long-continued and for Borne tim e a fte r tho first discharge, and th a t she alw ays lently-repeated attacks of colic occur without paralysis felt m uch re lie f on doing so. On exam ining th e abdom en a t evening. Colic is undoubtedly the form of most frequent th e end of th e th ree m onths, no sw elling n o r en la rg e m e n t fraoce, and that with which practitioners are most w h atever could be fe lt; b u t on m aking a vaginal ex am ination, bar, especially in this country. Happily, also, it is the a slight hardness could he felt a t th e left side o f tho uterus, which is the most amenable to treatment--indeed, so p ressure on w hich gave a little pain. 'geable that it is rarely fatal. Before m aking any rem arks on tho peculiar features of th is [To be continued.) case, it will be b etter to relate the second exam ple of the saina disease which has come under my notice, but which unfor Vricenna, vol. 5, Fen. 6, Q u art!; T ra ct. 1, onp. 4, 5. Rhazcs, lib. 8, tu n a te ly h as te rm in a te d in a v ery differen t m an n er. On th e evening of the 28th Jan u ary , 1852, 1 was hastily sum m oned to Purior in vlcls aqna tendit ram p ere plum bum , ^u am qocc per pronum trepidat cum m urm urc rlvum ?* F rau d ,- L. 1., E p lit. 10. a lady who had been under my care for about two m onths, suffering from incom plete hem iplegia of tho left side of tho body, attended with great debility. I was unable to attend " *1 w ater p u rer from th e b u r,lin g lead, in a n g-entlj- murm uring- dow n its native b ed?" for about an hour, and on my arrival found h er propped up in bed, excessively prostrated, body and extrem ities cold, and covered with a clammy sweat, and with a pulse scarcely per ssay on HvDitopnoniA.-- It will be seen, by nn cep tib le; Bhe was gasping an d crying o ut w ith agony, an d appeared to have h er sufferings increased on touching hor tisement in this day's I.ancet, that the sum of 50 is abdom en, to w hich she pointed as tho sc at of h e r pains; whilo for the best essay on Hydrophobia, its Nature and Treat- h e r countenance was distorted, and bore a peculiar expression strongly indicative of approaching death, She appeared, in