North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826

by Various

The Revue Medicale for February 1826, contains the details of a case lately cured at La Pitié, by Mr. Lisfranc. The patient, a woman, aged 36 years, of a strong and good constitution, had suffered the removal of a cancerous breast, 18 months previous to her admission into the Hospital, on the 10th October, 1825. The following symptoms were observed. On the whole surface of the cicatrix were felt a number of engorged ganglia, and an induration situated on the large and small pectoral muscles, and spreading from the clavicle to all the external and superior part of the thorax, and as far as the axilla, where other swollen ganglia were felt. The enlarged surface was elevated about half an inch above the level of the chest. Severe lancinating pains were at short intervals felt by the patient—which came on without any evident cause, and were particularly severe on the least pressure of the swollen part.

This patient was treated by means of frequent and copious bleeding from the arm—the very frequent application of leeches to the inflamed part, and to the upper and interior part of the thighs, to bring on the menstrual discharge—digitalis to remedy the frequent palpitations—emollient applications, and low diet. On the 10th of January, she was considered well;—the swellings and pain having disappeared—the menstrual discharge being well established, and the movement of the arm (which during the progress of the disease had been impeded from the swelling in the axilla) perfectly free.

We are happy to learn that this practice is pursued with success by the Spanish physicians, as may be readily found by a reference to a late number of the Periodico de la Sociedad Medico Quirurgica de Cadiz, which contains cases of scirrhous mamma cured by the repeated application of leeches.

25. Essential oil of Male Fern, as, a remedy in Cases of Tænia.—The male fern has long been regarded as a valuable anthelmintic medicine; but, as every powder administered in large doses, its exhibition is difficult and disagreeable; so much so, indeed, that many patients refuse to make a sufficiently constant use of it to ensure its beneficial effects. Struck with this inconvenience, M. Perchier, a pharmaceutist of Geneva, has lately made some experiments with a view of discovering its active principle, and to see whether this latter may be administered with equal success with the powder or infusion of the plant. We are happy to learn that the result of his experiments are very satisfactory. We translate the following observations from a memoir on the subject, read on the 7th of October last, by Mr. Gendrin, before the medical society of the department of the Seine. "This medicine, which is a fatty oil extracted by distillation from the æther, in which the powder of the root of the male fern has been macerated, has caused in many cases, the expulsion of the tænia, without occasioning nausea, colics, or any other morbid phenomena." "It is exhibited at bed time, either in an oily potion, in pills, or incorporated in an electuary, in doses of 18 or 20 drops. On the following morning, a similar dose is given, and two hours after, two ounces of castor oil are administered. In most cases, the tænia is expelled in the course of the day, but if this does not occur, the same doses of the oil are given in the same way, and followed by a similar quantity of the castor oil. The fatty oil of fern, has an æthereal and empyreumatic smell; its colour is brown, and its consistence rather greater than that of castor oil; it is, however, easier to separate in drops. Its taste is acrid, pungent, empyreumatic, and very disagreeable."—Propagateur des Sciences Medicales, Janvier 1826.

26. Tincture of Bastard Saffron[33] for the expulsion of Tænia.—Dr. Chisholm, of Canterbury, has lately used with success, in a case of tænia of many years standing, the vinous tincture of bastard saffron. The patient had already undergone various plans of treatment, and had especially used the oil of turpentine in very large doses. Dr. C. was induced to try the above remedy, from having noticed, that in a case in which it had been prescribed for the cure of rheumatism, a large portion of tænia had been expelled. He consequently administered two ounces of the tincture; advising the patient to take a table spoonful more of it mixed in a little water, two or three times a day. On the third or fourth day after commencing the use of this remedy, the patient voided a large portion of the worm, and has since been free from the usual symptoms of the disease.

27. Oil of Turpentine in Tænia.—Although the oil of turpentine is used in many parts of this country, in cases of tænia, we have good reasons for believing, that some physicians continue, notwithstanding the testimony in its favour, to hesitate exhibiting it in doses sufficiently large to destroy and promote the expulsion of the worm. Such being our opinion, we are induced to offer here a few remarks on the subject, and to notice a memoir published by Dr. De Pommer, in a late number of Hufeland's Journal. The employment of this remedy in such cases, is not of recent origin, having been resorted to many years ago by the Swedish practitioners, and subsequently revived by the English. In Germany it has recently been used by Professor Osan, and we believe particularly by Dr. De Pommer, who appears to have prescribed it boldly in very many instances, and in some, after the ineffectual employment of all other anthelmintics. Dr. P. adds, that he never saw any bad effects resulting from its use, and that patients are very little liable to relapses when treated by it.

Among the cases detailed by Dr. De Pommer, we select the following, as calculated to show the manner in which the Dr. uses the remedy.

"G.K..., a soldier aged 21 years, thin, tall, and who during his infancy had been subject to ascarides, has occasionally voided during more than 10 years past, portions of tænia. He had used several purgative medicines, by which several yards of this worm had been expelled; but annoyed with so many attempts at obtaining its total expulsion, he had ceased, three years before, the use of all sorts of anthelmintics. But the phenomena resulting from the presence of the animal being aggravated, the patient applied for advice to Dr. De Pommer, who found him labouring under the following symptoms:—Frequent pain in the abdomen, and especially in the umbilical region, accompanied with a sense of burning heat, and alternate distension and depression of the abdomen. Appetite sometimes keener than in health; at others nearly lost. In the morning before breakfast, the patient was seized with extraordinary weakness, and general uneasiness, accompanied with trembling of the limbs, ineffectual attempts to vomit, a sense of constriction in the throat, and a profuse salivation. All these symptoms disappeared after K... had taken food; but reappeared two hours after. Milk and farinaceous aliments were the only articles of which he could make use without an aggravation of his disease. The pulse was febrile; sleep good, but attended with dreams. The pupils were in the natural state. From the symptoms, and from the history of the case, Dr. P. was induced to make use of the oil of turpentine in the following manner. The patient was ordered in the morning, before breakfast, three table spoonsfuls of the remedy, at half an hour's interval. The first doses produced only a few borborygma. Two more table spoonfuls occasioned a vomiting of mucous matter. Three more table spoonfuls were exhibited, and followed by a stool of solid fæces, mixed with which were five small pieces of tænia. The patient not finding himself incommoded, took in the space of an hour, three more table spoonfuls of the remedy, after which he experienced some pain in the head, and vomited about one pint of bilious liquid. An hour after, the same quantity of the medicine was taken, and followed again by vomiting, but after a repose of half an hour K... discharged, per anum, firm and greenish fæces, and with them five ells of tænia. The urine discharged had the smell of violets. He again took a few spoonfuls of the vermifuge, which were not followed, however, with any fæcal discharge, and only with some vomiting of mucus, and slight vertigo. In the afternoon the patient felt well, and experienced a great appetite, in which he indulged. From this moment he recovered, and has ever since enjoyed good health. The quantity of the remedy used was six ounces."

It appears, from the observations of Dr. P., that the gastric irritation occasioned by the spirits of turpentine, has never amounted to phlogosis, and has generally subsided after the remedy had been discontinued. Nevertheless, as the spirit of turpentine is a very powerful stimulant, we would not venture to recommend its use, when there exists an inflammation in the gastro-enteritic system. We are aware that it is resorted to in burns, and highly eulogized in puerperal and yellow fever. In the first, it is certainly very useful, but on what principle we know not, except perhaps that its stimulus is different from that existing in the diseased part. But in the second case, it acts, not on the diseased surface, but by revulsion, on the mucous membrane; and as regards its virtues in yellow fever, we are rather sceptical in respect to what has been said on the subject. In this opinion we are supported by the testimony of our friend Professor Rhees, whose situation of house surgeon to the fever hospital, during the epidemic of 1820, afforded him ample opportunities of testing the propriety of the practice.