455 was no
contraction of the
womb; would the removal of the
placenta produce this contraction, and stop the bleeding? We were generally called to these cases when there was hoemorrhage only, and no contraction. He related a case of this description, in which a woman was reduced so low by the haemorrhage, and in which there was no pain, that he performed transfusion, to the extent of twelve ounces; she rallied somewhat, but still there was no pain; six hours after, transfusion was again performed, and she slept for six hours: labour-pains then came on, and she did well. With respect to the removal of the placenta, it was just as difficult to effect this as to remove the child;-why then, if there was no pain, should we not bring down the child after the placenta, had
Mr HEADLAND thought, that to consider purpura to be the result merely of disorder of the chrylopoietic viscera, was taking much too narrow a view of its origin. He thought that the treatment which usually succeeded in the cure of this disease, indicated an impoverished state of the blood, arising from want of fibrine, or some other of its elements, in which respect the complaint resembled scurvy. His usual treatment, after improving the secretions, was the administration of lemon-juice, the recommendation of good air, and treatment which might be called, generally, anti-scorbutic. It would yield also to bark and steel, or chlorate of potash. In one severe case of purpura occurring in a child from whom there was excessive haemorrhage, consequent upon the removal of one of -the milk teeth, the purple spots became pale, and the patient nearly sunk; turpentine administered internally appeared here to have a marked good effect. Dr. TUEOPHILUS TH031PSON observed, that purpura developed itself in different conditions of the system. In one, attended with congestion of liver, calomel, by putting the secretions right, would be of much service. In other cases, the disease appeared to have its origin simply in irritation of the mucous membrane, and then demulcentswere indicated. Other cases, again, did best under the use of acids. Dr. WtLLSHiRE said, that purpura appeared to occur under two circumstances: in one there was a preponderance of the watery portions of the blood; in the other, the blood might be normal, but the walls of the smaller vessels allowed the fluid to permeate. In the first, saline purgatives might be useful
been removed? Mr. DENDY had found no difficulty, in cases of placenta prasvia, in passing the hand through, or by the side of, the placenta. He suggested that, in cases where the placenta was over the os uteri, and a portion of it was so adherent that it prevented the os uteri from dilating, it would be good practice to entirely detach the placenta. Mr. CRisr had been informed, by two practitioners, of cases similar to the one detailed by Mr. Stedman. In these instances haemorrhage had continued for some time; the placenta- was expelled, and there was no after-haemorrhage. Mr. HEADLAND referred to eight cases of placenta prasvia, recorded very lately in the Meclical Gazette, by Dr. R. Lee, in which the old practice was, in every instance, successfully employed. If so successful, why should we depart from it? He related a case of placenta proevia, in which haemorrhage con- by lessening the quantity of watery fluid. tinued after the placenta had been expelled into the vagina. Dr. WALLER had seen a case lately dependent on hepatic ME. CRisP mentioned, that in previously recorded cases, Dr. congestion, which was cured by brisk purgatives, followed by Lee had lost fourteen cases out of thirty-eight. Dr. Simpson’s tonics. He inquired the condition of the blood corpuscles in loss was one in fifteen-by the old method, it was one in three. this disease. He related the case of a woman who, during the last month of Dr. G. 0. REES remarked, that we knew little of the conpregnancy, suffered from frequent attacks of hoemorrhage, dition of the blood in purpura. When viewed under the microconsequent upon the situation of the placenta over the os uteri. ’, scope, in advanced cases, the blood appeared to be entirely The child was at last turned, and delivery effected; but the. broken up; in other cases, and these too of a severe character, mother perished. If the placenta had been detached in this the blood appeared normal. In some cases, the blood was case, the bleeding would have ceased, and the woman’s life buffed and cupped; in others, there was deficiency of fibrine. been saved. He thought that these facts indicated the presence of two Mn. HEADLAND said, that the eight last cases, recorded by stages in purpura, such as for instance were known to exist in Dr. Lee, had occurred in his private practice, and aid was Bright’s disease, in the first stage of which there was, in the afforded sufficiently early; whilst the other cases, which were blood, a deficiency of albumen and a superabundance of blood usually those of charity patients, had been under the care of corpuscles, in the second stage, the opposite state presented midwives, or incompetent persons, and were not attended to itself. It should be recollected, that when we gave lemonsufficiently early. Most of the cases, recorded by Dr. Rigby, ofjuice in this disease we were really giving soda, for lemonNorwich, had also occurred among the neglected poor. After juice was a super-citrate of soda, rendering the urine alkaline. an experience of twenty-five years, he, Mr. Headland, had He had seen cases do well under the employment of carbonate of soda. only seen one fatal case of placenta prsevia. Dr. OHOWNE considered that any debilitating cause might DR. WALLER had found in his own practice no such morinduce purpura. It did not, however, depend wholly on tality as that referred to by Mr. Crisp. Some discussion followed, in reference to the connection be- poverty of the blood, as it appeared sometimes to be a local disease, the constitution being robust, and the patient pletween the foetus and mother. With respect to the question at issue, it was contended by thoric. The treatment must depend on the condition preMr. Fisher, that it was desirable to take as facts those cases sented by each case. Dr. A. B. GABROD had found various conditions of the blood that were recorded, and then to explain, if possible, the phenoin purpura; in some cases there was a deficiency of filxrine, in mena presented to us. DR. BENNETT made some general remarks on certain ano- others, excess of it, but we were ignorant entirely of the essential condition of the blood in purpura. malies in the discussion, after which the Society adjourned. At the next meeting a successful case of laryngotomy will MONDAY, OCTOBER 20. be detailed. °
PURPUR-K AND ITS TREATMENT.
Mr. DENDY related a case of purpura, ocurring in a little boy, four years of age, of very debilitated constitution, and who, when two years of age, had suffered from an attack of " congestion of liver," attended with opisthotonos and other formidable symptoms. Five months since, the little patient became affected with a pain in the side, and immediately after purpura developed itself ; for fifteen weeks the child was under treatment, and took tonics without any relief; five weeks since, he was brought to Mr. Dendy, he was then not constitutionally ill, and was able to walk. It appeared, that he had lived, almost entirely, on bread and water, and the stomach was unable to retain any sweet or oily matter. Whatever might be the predisposing cause of the disease, he felt convinced that the exciting cause existed in the alimentary canal and portal system. With the view of improving the secretions, he ordered three grains of calomel to be taken every night at bed-time for fourteen nights; and during the day he prescribed -five drops of Fowler’s solution of arsenic to be taken three times a-day; the dose to be gradually increased until it leached twelve minims. Under this apparently opposite treatment, of extreme purgation and extreme stimulation, the patient recovered without any bad effects having developed themselves from either of the powerful medicines prescribed.
ANTICIPATIONS OF ORGANIC CHEMISTRY.
following remarks, by Drs. Hofmann and J. S. Muspratt, prefixed to a paper recently published in the Transactions of the Chemical Society, seem to us to possess a high degree of interest for chemists and physiologists. They are followed by the account of a new organic base, termed toluidine, discovered in an investigation made to test these general views:"The artificial formation of different compounds hitherto considered as exclusively the products of the vital process has been during the last ten years among the most interesting results furnished by the study of the metamorphoses of organic bodies. We have found in cyanic acid and ammonia the compounds by the union of which urea is produced; by the
oxidation of uric acid with peroxide of lead allantoin is formed, the crystallizable matter existing in the allantoic fluid of the cow; and salicine and fousel oil, when properly treated with substances rich in oxygen, furnish us the acids produced
vegetation of Spiraea ulmaria and Valeriana ammonium upon nitrogenous compounds, which latter were the composition and properties of the procured by treating various carbo-hydrogens with nitric acid. volatile oil of Gaultheria procunebens were only necessary to be Zinin investigated in this point of view Laurent’s nitronaphthaknown for its artificial production to succeed immediately in lase obtained by the action of nitric acid upon naphthaline, the hands of the chemist. and nitrobenzide, discovered by Mitscherlich, and he arrived at 44 still the greater part of the researches made during the the remarkable result that these bodies lose their whole oxygen last ten years in organic chemistry have been of a purely under the influence of sulphuretted hydrogen, and in assuming analytical nature. Although the metamorphoses of a consi- hydrogen pass into combinations, presenting in every respect derable number of organic bodies have been studied, still this the characters of true organic bases; the two bases formed by has not been with the view of obtaining certain compounds Zinin in the manner described, are the naphthalidam, for which which suggested themselves to the theoretical inquirer, but Berzelius * has lately proposed the more appropriate name of rather with the intention of drawing conclusions as to the naphtalidine, and benzidam, afterwards recognised as identical composition and properties of the body which was the starting- with aniline. The following comparison of formula* shows how point of the investigation from the properties and nature of nearly the original compounds are connected with the respective the products of its decomposition. products: "From such inquiries we have reaped a rich harvest of experience, they have made us somewhat better acquainted with the transformations which an organic substance suffers under in the process of the
officinalis; and, lastly,
the influence of the most different agents, and have thus qualified us for attempting the formation of a given compound in But few such synthetical experiments one or the other way. have as yet been performed; it is likely that a great number will be made without success, which may be probably owing to suppositions contrary to nature; but it cannot be doubted "By this comparison the transformation by means that we shall proceed in this direction with greater certainty of sulphuret of ammonium may be considered as ultimately a when a number of even unsuccessful trials of this kind has substitution of the elements of amidogen for those of peroxide of nitrogen, independently of these combinations existing or been undertaken. "The artificial production of bodies occurring in nature not in the compounds. Zinin’s discovery is very remarkable presents at first a purely theoretical interest, but all will agree in its consequences, and will, without doubt, become of vast that such endeavours may become of the highest practical importance for the group of alkaloids. If we consider how importance when they consider those compounds which now large is the number of carbo-hydrogens already known, all of take a high place in medicine, the arts and commerce. The which change their composition when acted upon by nitric valerianic acid is already so often employed in medicine, that acid, giving compounds corresponding to nitronaphthalase and its production upon a large scale from fousel oil cannot long nitrobenzide; then, supposing these products to suffer also an be postponed, and this becomes the more feasible, as we can analogous decomposition with sulphuret of ammonium, there obtain the latter in such large quantities as a secondary pro- will be no limit to the production of new bases, and we may duct in rectifying distilleries. Of what influence would be naturally infer that even those occurring in nature might be the invention of a process for procuring the medicinal ve- produced if we only succeed in obtaining the appropriate getable alkaloids in a simple artificial way? If a chemist carbo-hydrogen. "A greater correspondence as to properties and chemical should succeed in transforming in an easy manner naphtlialine into quinine, we would justly revere him as one of the noblest character cannot be imagined than that subsisting between aniline and the two following bases: nicotine contained in the benefactors of our race. " Such a transformation has not as yet succeeded, but this fresh leaves of the tobacco plant, and coniine found by Geiger does in nowise show its impossibility. We have become ac- in all parts of the hemlock (Conium maculatum). " quainted in the last ten years with a remarkable series of According to the analysis of Ortigosa and Belard, lately artificial organic bases, but, with the exception of urea, which corrected by Melsens,nicotine is represented by the formula in many respects differs from the other organic bases, there ClO H7 N, is none which has been met with in nature, although there are and coniine, by Ortigosa’s formula, which has yet to be many among them bearing the greatest similarity with the confirmed, by natural ones in properties and composition. CI6 H16 N (?). " The artificial bases which we now possess have been ’, Now, if we could succeed in obtaining the carbo-hydrogens obtained in very different ways. The first bases procured by Cio H6 Cis Hi:, Liebig,* melamine, ammeline and ammelide, were produced by the decomposition of sulphocyanide of ammonium by heat; there would be no difficulty in procuring, in an artificial way, and others, such as anilinet and chinoline, were formed by nicotine and coniine, i. e. by treating the product of the acfusing alkalies with organic matters, or by distillation only, tion of fuming nitric acid upon the above hydro-carbons with as the first mentioned and lophine, recently discovered by sulphuret of ammonium. We should haveLaurent§. Basic bodies have further been produced by the action of ammonia upon organic compounds. To these belong the Thiosinnamine of Will,and anzarine obtained by Laurent T from the hydruret of benzoyl, and another highly remarkable base prepared by Fownes** from the so-called artificial oil of ants. Lastly, chemists have succeeded in replacing the sulphur in sulphuretted compounds by oxygen, and thus obtaining new bodies possessing basic properties. We see examples of this kind in sinnamine formed by Varrentrapp and Will from the thiosinnamine; and Simon’s sinapoline, obtained by"the desulphuration of oil of mustard. "These hypothetical hydro-carbons have not, indeed, been These methods, however, for the formation of organic bases are only applicable in a very few cases, as the bodies from yet obtained, but when we consider how many decompositions which they were derived were themselves more or less insu- are already known to produce such bodies, and, further, that lated and peculiar, and therefore till chemists succeed in dis- the destructive distillation of organic matters promises to covering more compounds of the same classes, the formation furnish an inexhaustible supply, and more especially as we of basic bodies in this manner must be limited. clearly see in these processes of transformation new bodies " It is quite different with another method, by which che- produced perfectly analogous to those we seek, we need not mists have also succeeded of late in procuring basic bodies. despair of obtaining them. The destruction of organic comZinin wasttthe first who conceived the happy idea of investi- pounds, therefore, has opened a source for the production of gating the products produced by the action of sulphuret of substances inwhich nature presents us with, and which are the organisms of plants. Thus the products of generated * Annal. der Chem. und Pharm., Bd. x. S. 1. the living principle, subjected to destructive chemical pro&dag er; Fritzsche, Annal. der Chem. und Pharm., Bd. xxxvi. S. 84. cesses, will givt us the identical compounds, formed by the &Dag er; Gerhardt, Annal. der Chem. und Pharm., Bd. xlii. S. 310. vital processes of other things." § Compt. Rend. t. xviii. p. 1016.
# Annal. der Chem. und Pharm., Bd. lii. p. 8.
¶ Compt. Rend., t. xix. p. 353. Phil. Trans., 1845. &dag er;&dag er; Annal. der Chem. und Pharm., Bd. xliv. p. 283. **
Jahresbericht, xxii. p.
&dag er; Ann. der Chem. und Pharm., Bd. xlix. p. 353. ‡ Ibid. Bd. xlii. p. 313.