Page images
PDF
EPUB

throat this was removed, and the wet compress was sprinkled over with Crotalus, 3rd trituration; this was renewed after an hour, and then every three hours.

There was no retching after the first application of the Crotalus to the denuded cutis; not even when beef-juice was administered, but the respiration and pulse remained much the same. In the evening as I sat by her bedside (for she was my daughter), expecting every moment to be her last, I noticed she gradually became less distressed; and during the night she dosed at intervals. Towards morning she really slept, and the breathing gradually became less laboured and less hurried and irregular; and on being roused for a dose of medicine she opened her eyes, and seeing me, she exclaimed : " Oh ! Pa/' as though surprised at my presence. By 8 a.m., October 8th, the pulse had fallen to 120, and could be distinctly felt; the respiration was becoming easy; the head was less thrown up; and the struggle appeared to be turning in her favour. The rash was now freely out on the body and legs, it was, however, of a purple colour. At his visit about 11.30 a.m., Dr. Drysdale was surprised at the alteration, and he gave a favourable prognosis. The same medicine was continued, now every two hours, and a simple water compress was kept to the throat. During the day of October 8th the rash gradually brightened in colour, and all the distressing symptoms receded rapidly, so that by evening she was able to drink with but little difficulty or pain; the respiration was almost normal, and the pulse was 100, and had gained some force and fulness. She slept well during the night, and the next day, that is, October 9th, her appetite began to return, and she looked wonderfully better; the change was really marvellous. From this date her recovery went on rapidly and steadily, the cuticle exfoliated rapidly, so that by the aid of vinegar baths and lard inunctions the skin was about natural on October 14th. She was attacked on the 5th, and nearly dead on the 7th under the treatment with Bel. Rhus, and Merc. bin.; Crotalus was administered in the morning of the 7th, it rallied her almost immediately, and she recovered so rapidly that a confident prognosis was given on the morning of the 8th.

Case 2.—J. D. H—, set. 13, brother of the above, began to complain on the fifth day after his sister, that is, October 10th. His attack began in the morning, and was marked by much the same symptoms as in his sister's case. He had Rhus every hour and a wet compress outside over the tonsils. There was at once great weakness, much dizziness, trembling, and staggering to falling before evening, and there were headache and nausea. The fauces and tonsils' were dark red, and during the day they became tumid, and swallowing became painful and difficult. Pulse 130, small and soft. He had a restless, feverish night, with increase of all the symptoms, especially those of the throat; the prostration was extreme, and on blowing the nose it bled freely. The next morning, October 11th, that is, the morning of the second day of the illness, there was some brown miliary rash on the chest, and all the other symptoms were worse. Crotalus was now exhibited internally every hour, and Canth. $ was poured on the wet compress round the throat. There was much haemorrhage from the nose during the day, and reddish mucus hawked up from the fauces. In the evening he appeared much the same. The cuticle raised by the Canth. (j> was removed, and Crotalus 3rd trit. sprinkled on the compress as in the former case, and Crotalus 4 was continued internally. The epistaxis returned twice during the night. The next morning, October 12th, the rash was out well and the throat symptoms were diminished. He improved during the day, and had some sleep during the night. Next morning it was evident he was to recover. He made a like rapid progress with his sister, and was soon in fair health again. In this case, as in the former, Crotalus arrested the blood-poisoning almost immediately, and turned the scales in favour of the patient within a few hours.

I am satisfied that the application of Crotalus to the denuded cutis had a considerable share in bringing about the recovery, and in such cases I am persuaded that it would be advisable, as suggested by Dr. Drysdale, to introduce the Crotalus subcutaneously in the second or first attenuation (vide Hahnemann Materia Medica, Article "Crotalus: Mode of Administration."

250

REVIEWS.

Nitro-glycerine as a Remedy for Angina Pectoris. By William Murrell, M.D. London: Lewis, 1882.

In this little monograph Dr. Murrell gives an account of the introduction of Nitro-glycerine into medicine which is singularly incorrect. He attributes its first notice and employment to Mr. Field, of Brighton, twenty-five years ago, whereas all who are familiar with homoeopathic literature are aware that the first to introduce it into medical practice was Dr. Hering, of Philadelphia, whose experiments were published in this journal thirty-four years ago, viz. in 1849, and that in 1853 some further observations were given also in this journal by Dr. Dudgeon. Since that time it has been extensively used in homoeopathic practice. So that it was not until nine years after it had become one of our common remedies that it was noticed by the old school. Dr. Murrell, who betrays on many occasions a considerable familiarity with the writings and remedies of our school, must have known perfectly well that the credit of its introduction into medical practice is due to us and not to Mr. Field, and it says little for his candour and sense of fairness that when giving a history of its medical use he omits all mention of the real source whence those of his own school derived their knowledge of it. In this, however, he acts only as is usual with the writers of his school.

It was not until four or five years ago that Dr. Murrell determined to investigate the powers of Nitro-glycerine for himself. He prepared a one per-cent. alcoholic solution of it, and he found it to produce on himself the remarkable symptoms so well known to all who have tested its effects on their own persons. We may give in his own words the result of his first trial of this one per-cent. solution.

"Wishing to taste it, I applied the moistened cork to my tongue, and, a moment after, a patient coming in, I had forgotten all about it. Not for long, however, for I had not asked my patient half a dozen questions before I experienced a violent pulsation in my head. The pulsation rapidly increased, and soon became so severe that each beat of the heart seemed to shake my whole body. I was quite unable to continue my questions, and it was as much as I could do to tell the patient to go behind the screen and undress so that his chest might be examined. Being temporarily free from observation, I took my pulse and found that it was much feebler than natural, and considerably over 100. The pulsation was tremendous and I could feel the beats to the very tips of my fingers. The pen I was holding was violently jerked with every beat of the heart. There was a most distressing sensation of fulness all over the body, and I felt as if I had been running violently. I remained quite quiet for four or five minutes, and the most distressing symptoms gradually subsided. I then rose to examine the patient, but the exertion of walking across the room intensified the pulsation. I hardly felt steady enough to perform percussion, and determined to confine my attention to auscultation. The act of bending down to listen caused such an intense beating in my head that it was almost unbearable, and each beat of the heart seemed to me to shake not only my head but the patient's body too. On resuming my seat, I felt better, and was soon able to go on with my work, though a splitting headache remained for the whole afternoon."

Exactly similar symptoms are recorded by many of Hering's and Dudgeon's provers, and Murrell has found similar symptoms caused by the drug in thirty-five people to whom he administered it, and of whose symptoms he has the notes.

Dr. Murrell had his pulse tracings taken by the sphygmograph when under the influence of Nitro-glycerine, and he gives for the purposes of comparison sphygmographic tracings of his pulse when under the influence of Nitrite of Amyl. He says that these tracings show that the effects of these two drugs on the pulse are similar, and that they both produced a marked state of dicrotism, but this dicrotistn is certainly not shown in the tracings he gives, on the contrary, all the normal curves of the sphygmograph are seen in all the tracings. We have taken sphygmographic tracings of the pulse of healthy persons under the influence of Nitro-glycerine (or glonoine as we term it), and find that the only alterations seen are an increase in the force and frequency of the pulsations and occasional irregularity of the rhythm. Murrell's tracings show nothing but increased force in the pulsations, and we may add that the tracings made by the pulse under the influence of Amyl nitrite differ completely in character from those caused by Nitro-glycerine, as any one can see at a glance. All the tracings he gives betray the mechanical imperfection of the instrument he used, which was evidently Marey's, or some modification of it. It is this mechanical imperfection that causes one of the tracings (No. 4) to seem dicrotic, but a close inspection of it shows that it has all the normal curves, and had the instrument been capable of representing the systolic up-stroke perpendicularly, the curve commonly but improperly called "tidal wave" would have been more plainly delineated.

So also the tracing given of the pulse under the influence of Nitrite of Amyl is not dicrotic, but only shows increased vivacity of the systolic up-stroke, and increased rapidity of the pulsations, precisely similar to what is observed after taking an alcoholic stimulant. Our own experiments with Nitrite of Amyl show that these are the only effects of this substance on the pulse-tracings.

Several cases are given where Nitro-glycerine exerted a marked beneficial action in angina pectoris, and other cases are related where it failed to cure, or even to prevent a fatal termination to the disease.

Some of the cases show a great susceptibility to the action of the drug, which, even in the small dose of jigth

« PreviousContinue »