Imágenes de páginas
PDF
EPUB

HYPODERMIC INJECTIONS, BY DR. THORNTON.

In the last number of Braithwaite's Retrospect, Dr. Anslie has published a very interesting article on "The Hypodermic Injection of Remedies." His assertions are worthy of the name of aphorisms, and need but a practical test to prove that they are also axiomatic.

He says: "The subcutaneous mode of administering medicines is still very much unappreciated, not however by those who have given it a fair trial."

"That the physical activity of nearly every substance which can be thus used is three if not four times greater when it is given by the skin than when it is swallowed."

"Economy of the drug."

"Entire abolition of the depressing or irritant effects which are locally produced in the alimentary canal during the digestion of various remedies."

"Far greater permanence of effect, in many cases, than can be produced by a medicine swallowed."

"Much greater rapidity of action-a quality which makes injected remedies of priceless value in certain emergencies.” "A country doctor should never start on his rounds without a syringe and a bottle of morphia solution."

He has thus administered hypnotics, antiperiodics, purgatives, antispasmodics, febrifuges, emetics, &c.

Among the hundreds of hypodermic injections he has made he has met with serious inconvenience but once, and this was, he writes, "the formation of a small abscess in the cellular tissue of a gentleman in whom I injected chloroform, an agent entirely unfit to be used in this way, as I am now aware."

Case 1. Miss Brock, aged, twenty-five years-disease, severe facial Neuralgia. During the last three weeks was in

Philadelphia, and under Dr. Hartshorne's treatment for this disease. I suspect his treatment was constitutional. She returned home to-day, Feb. 1, 1869; is suffering much, and states she has been unable to sleep for many hours. I injected hypodermically one half grain of sulphate of morphia below the left malar bone, and over the malar nerve. The operation was quickly and easily done, and caused no complaint.

Feb. 2. The pain left in half an hour after the operation; she slept well all night, and feels well.

Feb. 11. The disease has not returned.

Case 2. Henry Skein's wife has been during several days and nights suffering from "a dreadful pain in the right side." In a former attack I gave her one half grain of sulphate of morphia in solution, every two hours, and several doses were taken before decided relief was procured. Whilst she was convalescing from this former attack, I left an equally strong solution of morphia that she might take should the pain return. All of this she has taken, four grains of sulphate, without relief. Of this I was notified at 2 A. M., Feb. 2, and sent a solution gr. f. 3j., of which one teaspoonful was to be taken every hour until she dozed or slept. At 10 A. M. I visited her. The solution had been taken as directed, and not ejected; the pain had not been alleviated. The teaspoon was a very small one from which she had taken the medicine. I attempted the insertion of morphia hypodermically, but did not succeed on account of the pain, soreness, general irritability, and dread of the instrument. Consequently she was thoroughly anæsthised by chloroform, and while in this state one half a grain of morphia was hypodermically inserted in the right hypochondrium.

Feb. 3. Was informed she was drowsy during the remainder of the twenty-four hours, and was free from pain, and has had no pain to-day.

Case 3. Morris Haines-disease, fever. To allay great irritability, jactitation, &c., I attempted an injection of half a grain of morphia in the arm. The syringe was out of order, and I did not succeed in producing sound sleep.

Case 4. An old lady, with irritable ulcer of the leg, accompanied with varicose veins of the limb. I injected half a grain of morphia hypodermically in the limb just above the internal malleolus. This produced nausea, ease but not sleep, and she was also virtigenous-common effects of morphia.

Case 5. John Brown, of Bridgeboro, about thirty years of age-disease, Bilions Colic. March 11, 3 P. M., visited him ; found him groaning, rolling on the bed, and vomiting bilious matter, &c. I was informed he had been in this condition several hours. Gave him two grains of opium and six of calomel. The dose was soon ejected, and so was everything he had swallowed during the day. I injected half a grain of sulp. morp. in the right fore arm. In half an hour he was free from pain.

March 12. Has had no pain, nor sick stomach, and is convalescent. I am satisfied without this injection this man would have been in much pain several hours longer, and that no better test case need be wished.

ANOMALOUS CASE, BY DR. THORNTON.

1869, August 26. P. H. Slim's daughter Ann-aged 40 years, of medium height, and weight ten stone, I visited today. When her father requested me to visit her, he stated she had not felt well for several days, and suspected she had the ague. She was lying on a lounge in the dining room when I saw her; sometimes walked across the room, &c. ; lay down when too much fatigued to walk. Complained of feeling tired and debilitated. I found nothing unusual the mat

ter, in fact I could find nothing wrong. But for prudential motives, I followed the advice of Celsus in the treatment of of an early case: "that what is in itself small, may not, by his negligence (the physician's) become more considerable," and certainly the family would have put no favorable construction upon my omission or negligence to leave something. Tinc. valerian was the most convenient, and was accordingly prescribed; also requested the family to inform me if she did not in a day or two recover her health, which they did on the 31st. This morning she concluded to remain in bed. Last evening she took tea with the family. She felt no worse, but got no better, therefore sent for me again. And this time I could detect nothing wrong, neither could she define any particular symptom. Small doses of quinine and pil. hyd. were given, as expectants rather than anticipants.

Sept. 1, 9 A. M., I saw her again. I was told she was more restless all night, otherwise they perceived no difference. Having left her room, I informed her family she was rapidly sinking, and would not live twenty-four hours. I also stated I suspected the trouble was owing to intestinal hemorrhage, and although she was well nursed by her sisters, with all the advantages that the families of first-class farmers possess, yet so insidiously and unsuspectingly had death been approaching, that this proximity was astounding. She died in fifteen hours afterwards. On the 3d, I opened the abdomen. The right ovarian vein was found in varicose state, and possessing in the middle, half way between the uterus and ovarium, a solution of continuity that admitted the extremity of my little finger. Below this orifice, in the cul de sac of peritoneum that lies back of the os pubis, was less than an ounce of coagulated blood. The uterus supported on its exterior, five fibrous humors, the smallest of which was nine lines in diameter, the largest eighteen in length, and was acuminated. I

was not more surprised at the solution of continuity than at the small quantity of blood found.

The absence of a competent assistant, the lateness of the hour, and the frozen state of the cadaver, are the reasons why the thorax was not opened, and search made for an embolus or some other more probable cause of death, than the pathological state described.

METEOROLOGY, BY DR. THORNTON.

[merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small]

CASE OF SPONTANEOUS EVOLUTION, BY D. B. VAN SLYKE, M. D.

On the 29th of June, 1868, I was called to see Mrs. L. S., in her first labor. On arriving, at 11 o'clock, A. M., I found the patient had been having what she called severe and regular labor pains since the evening before. The os uteri, however, had scarcely begun to dilate, was very high up, and no presenting part could be felt. An external examination disclosed the anomalous fact that the fœtus was lying horizon

« AnteriorContinuar »