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No. 73.]

Medical Obituary.

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it may have been the effect of bleeding. The liver, to the great disappointment of some practitioners, who attributed his indisposition to a morbid condition of that organ, was found perfectly healthy. We think that the state in which the heart and blood-vessels were found, by no means proved his indisposition to have arisen from plethora, either general or local. He applied his hand over his heart, as much as to say, here is the seat of my malady; and in this organ Ossifications were found, but not to such an extent as to account for his death. Dr. Baillie, and his other medical attendants, will excuse our asking them, if the loss of blood by " cupping and bleeding," (as stated in Mr. Bell's Report) might not, in a case of irregular action, or spasmodic affection of the heart, arising from "ossifications of the valves," prove fatal to an elderly man, and one who had been for some time an invalid?

The late MR. CHEVALIER.-This gentleman was much esteemed by the leading members of the profession, for his scientific attainments, and his fund of practical knowledge. He was one of the Court of Examiners of the College of Surgeons of London, and had held the appointment of Surgeon to a public Dispensary, the duties of which he discharged with great ability and humanity. Notwithstanding his practice was extensive in the circles which can afford, and generally do, remunerate surgeons very handsomely for their advice and assistance, he regularly devoted three or four hours of three days in every week, to the poor, or those who could not afford to pay for advice. As a surgeon, he was second to no one in this or any other country. He was a very acute observer of facts, and never disgraced himself by broaching a flight of fancy, or a new theory, for the sake of giving publicity to his name, or by any of the artifices generally practised by men, whose only study is to accumulate wealth.

The late Mr. JOHN RING practised many years, in Swallowstreet, as a surgeon-apothecary. Soon after Dr. Jenner promulgated the power of cow-pox, as a security against small-pox, Mr. Ring published a voluminous work on the subject, the object of which was, to confirm the reports of Dr. Jenner, and to advertise himself as a vaccinator. The publications of some failures by the late Drs. Moseley and Rowley, gave such offence to Mr. Ring, that he assailed them, and all who dared to doubt the powers which he had ascribed to cow-pox, with the most virulent abuse. The disgraceful invectives, and personal abuse, in which both parties indulged, at length so disgusted the liberal members of the profession, that their works were soon condemned as waste paper. Vaccination, for a few years, proved an advantageous concern to Mr. Ring, partly in consequence of Dr. Jenner having recommended him to many families of noblemen, to communicate the disease to their children. The practice having greatly fallen off, Mr. Ring has scarcely been known for the last six years as a practitioner. About eight years ago, he compiled a Treatise on Gout, in which he attempted to make an imposing display of his knowledge of the Latin language, and the works of some ancient writers. The work, however, experienced a very limited sale, and consequently failed to answer the object.

Here our praise of him must end; he was an apothecary of the old school, and a surgeon, we suspect, of no school. As to his writings in defence of cow-pox, and his attacks on the characters of those who opposed it, they speak for themselves. All we are disposed to say is, peace to his manes.

POISONING BY ARSENIC.-On the case of the young married woman, who attempted to terminate her existence by taking arsenic, which we have noticed in our last Number, Mr. Humes has communicated to the profession the following remarks:-" Conformably to the promise in my last letter, I now communicate some further circumstances concerning the case of recovery from the poison of arsenic; which cure I still believe to have been accomplished, mainly, by a frequent exhibition of carbonate of magnesia and opium, especially during the commencement of the patient's sufferings.

"There are several cases of recovery from this deleterious drug already before the public, in which great skill, and a judicious variation of treatment with that of the symptoms, are very conspicuous. In some of these instances, it must be observed, after the primary and specific effects on the constitution had been overcome, and began to decline, that a very different class of indications presented themselves to the practitioner's notice, requiring a total change in the management of the patient, and the employment of opposite remedies. Among other examples of this versatility of appearances, and the consequent deviation in the practice, I shall refer your readers to Dr. Roget's paper, published in the MedicoChirurgical Transactions, Vol. II. and to Mr. Marshall's Remarks on Arsenic, quoted in my last communication, both of which I consider to be excellent authorities for the best instructions on similar occasions.

"In this woman's case, the abatement of the specific signs, such as the excessive retchings; sensation of a burning heat in the fauces and other parts subservient to deglutition; fixed and severe pain about the præcordia and upper portion of the abdomen; together with frequent, but not effectual, evacuations from the bowels; were succeeded by a train of very contrary symptoms. The principle of these were chilliness, with cold extremities; nausea, and slight efforts to vomit; a trifling head-ache, a peculiar feeling of smarting and pain at the termination of the rectum; an inclination to evacuate, but not at all of the nature of tenesmus s; and some oppression in the chest, with difficulty of breathing.

The most urgent of these sequelæ were the two last, especially the difficulty of breathing, and this was presently relieved by tincture of henbane, given every three hours, with the common saline mixtures. Each dose of the tincture did not exceed twelve drops, and this was continued for nearly two days, the breathing having by that time been perfectly restored. For the irritation in the rectum, I gave the patient two doses of castor oil; and this medi, cine, with those already described, constitute the whole that were required in the present case. To ascertain the quantity of arsenic which had been taken, Iweighed the remaining portion in the paper,

No. 73.]

Poison by Arsenic.

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believing that a certain weight by avoirdupois had been purchased, and that the deficiency would indicate the dose. I also questioned the woman herself, as well as her mother, respecting every particular, so as to elicit the truth, and I found that the powder had been conveyed into the glass on the point of a common table knife; that cold water was added, and the whole stirred well with a teaspoon: this dose was then instantly swallowed, and as the patient said, it had no other taste than a gritty or sandy sensation among her teeth.'

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"Taking every circumstance into consideration," says Mr. Humes, "I am confident that more than eighty grains were mixed in the water. However, from the very ponderous and insoluble nature of the white oxide of arsenic, especially in cold water, it is proper to make a fair allowance for that portion which must subside or adhere to the surface of the glass. I regret that I could not proceed in this part of enquiry, for the mother of the patient was too officious to allow the glass to remain a moment for my inspection: it was well washed out even before she called for my assistance..

"Whether the mode of mixing the arsenic, and the state of the stomach on receiving it, can have any influence on the subsequent action of the poison, seem to be questions of some import, and deserving at all times to be taken into account. In the five cases related by Mr. Marshall, the powder was mixed in that species of food known by the name of yeast-dumplings, in which, to my knowledge, a considerable quantity of the arsenic was introduced; for I received the mere scraping of the dish in which the paste had been kneaded, and of this every atom was loaded with the poison, and too palpable in quantity to require much trouble or nicety in the analysis. The viscid nature of this paste would tend greatly to sheath and envelop the arsenic; and, consequently, when the stomach, in such a case, is excited, and vomiting ensues, there is a probability of much of the powder ejected on every effort made by that organ to release itself.

"I have already described the supper which my patient had eaten just before she took the poison; that this meal was more of solid than liquid or porous nature; and have also mentioned that she was at the time in a high state of intoxication. Hence the stomach may, in some measure, be considered as defended from the deleterious action of the fatal dose; and this with her having once or twice vomited copiously, may have materially assisted in saving this woman from a premature death.

"The dose of arsenic which Dr. Roget's patient took, was, I believe, mixed with bread and butter. But whether the powder was strewed over the surface, or previously mixed with the butter, I cannot at this moment recollect. In either case the whole of the powder must have been effectually swallowed.

"It seems to be a growing evil, the employment of arsenic for effecting suicide and murder; and frequent instances have lately occurred of horses and other animals, having also been destroyed by it. I very lately had occasion to analyze the contents of the stomach of a most valuable horse, which had been poisoned by arsenic; and, with some others of minor consequence, I may add the late murder

perpetrated in the County of Essex, for which the culprit very deservedly suffered death. He had effected his horrid plan by administering the powder in form of pills, some of which were sent to me for analysis. Besides the proof of the quality of the pills which were very palpable, the clumsy form in which they were finished, shewed that no professional gentleman had prepared them, a circumstance that still added to the veracity of the evidence. Í was not subpoenaed upon that trial, there being sufficient proofs to convict the man (James Emery), without my aid. The opinion and report I wrote, and sent into my employers, was almost verbatim the same as delivered by one or two of the witnesses; I presume, therefore, that they also had analyzed another portion of the pills, and met with the same result!" On the tests which Mr. Humes has recommended for detecting the presence of arsenic, he observes :

"Having in all my experiments, relied on the tests which I have so often recommended for the detection of arsenic, particularly the two triple salts of silver; I shall now enter again upon that subject. All the thoughtless assertions respecting difficulties, and of the similarity of arsenite of silver, with the phosphate of the same metal, are fully refuted.

"To those who have not been habituated to such experiments, I would inculcate the propriety and advantage to be derived from observation, by a few examples, and applying the tests to a solution of arsenic made expressly for that purpose. I might say that this is incumbent on all professional men: for if we refer to the numerous trials that have occurred, and where the cause of death was from this poison, (especially one which took place in Cornwall,) we shall find that physicians, surgeons, and apothecaries, alone were taken as witnesses. Amongst other cautions which are requisite and should always be observed, let the suspected solution be quite cold, when either of the ammoniacal preparations is applied, and let the experiments be always made by day-light.

"I regret that this woman's case had not fallen into other hands, and that more attention on my part could not be bestowed to render it more complete. I visited not more than three times, and these were not daily, so that the progressive state of the pulse, and many other particulars, are evidently wanting. Should magnesia prove a needful antidote, I certainly would always prefer its carbonate. Indeed, on many accounts, calcined magnesia is not so good a medicine; for in the usual progress of preparing it, by submitting the carbonate to a red heat, the magnesia becomes, I may say, too pure: it loses all its water as well as the carbonic acid, and becomes a kind of anhydrate, a dry and harsh substance, divested of all moisture whatever."

We expected to have found in this second communication, some reason assigned by Mr. H. for having employed so simple an article as common magnesia, to counteract the effects of so powerful a poison as that of arsenic. If it does not possess the power of decomposing arsenic so as to render it inert or less virulent, on what principle was it exhibited? The recovery of the patient, if she really took arsenic, is, in our opinion, to be attributed more to the vomiting it

No. 73.]

Acupuncturation.

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As to

excited, than to the carbonate of magnesia and laudanum. the tincture of henbane, in the small dose of ten drops, having succeeded in relieving the difficulty of breathing, appears to us not a little extraordinary; for so weak an anodyne is this tincture, that we have given it to the extent of a quarter of an ounce, without producing any effect whatever.

When a practitioner, who ranks so high in the chemical world as Mr. Humes very deservedly does, publishes a chemical case, as that of treating poison taken into the stomach, we naturally look for something like a rationale of the intended operation of the antidote he administered; and this, we hope, Mr. Humes will condescend to give to the profession.

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ACUPUNCTURATION. — Mr. Morss Churchill, Member of the Royal College of Surgeons of London, has lately published a description of this operation, which originated with the Japonese and Chinese, and by them termed Zin-king. Mr. Churchill expresses his surprise, that a mode of treating painful and formidable diseases, which has been so long held in the highest estimation among Asiatics, and so simple in its application, should have been so long neglected in Europe. He supposes that the hyperbole, in which its efficacy has been related, has induced the sober minds of our Northern soil to treat the representations as the fictions of Eastern imagination, and to reject them without examination, as fables calculated only for amusement. There have not been wanting sensible minds, and men of talent and reputation, to recommend the operation; and the names of Ten-Rhyne, Bidloo, Kampfer, and Vicq-d'Azyer, stand conspicuous on the list of those who speak in its favour; but still it appears, that neither of them had given it a trial. Of late years, several practitioners in France have adopted the practice, and their reports confirm the favourable accounts which others have given of it. It was first employed in this country by Mr. Scott, of Westminster, a surgeon of experience and observation, and the successful results in his practice, which Mr. Churchill witnessed, induced the latter gentleman to adopt it; and the uniform success of the operation in his own practice, he observes, "warrants a recommendation of it in almost any terms I could give it."

The method of performing the operation of Zin-king, or Acupuncturation, is both easy and simple, requiring neither practice to become dexterous, nor adroitness to produce its proper effects. A knowledge of the anatomy of the human body, particularly the courses of large blood-vessels and nerves, is however necessary. Of the operation of Zin-king, Mr. Churchill gives the following description:

"The first step necessary to the performance of this operation is, the selection of a proper apparatus. It is not requisite, however, that our needles be either of gold or silver, as those of the Japanese are, although it is true that the flexibility of these metals prevents the risk of their breaking; but I have not heard of, or seen, any instance of such an accident with the steel needle, which is the material employed in European practice. It may however be left to the discretion of the surgeon, whether he uses the former or not;

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