Clinical Studies
- Author:
Sir John Eose Cormack, K.D.,
F.R.S.E., M.D., F.R.C.P.,”Chevalier of the Legion of Honour, Physician to the Hertford British Hospital of Paris. London : J. Churchill, New Burlington Street. Paris : Gralignani, 224 Pue de Pivoli.
Sir John Rose Cormackhas produced two volumes on clinical medicine, the result of his private and hospital practice in Paris, Edinburgh, and elsewhere.
In the first volume much valuable information is given on the various epidemic fevers, and more than two hundred pages are devoted to the consideration of “The Epidemic lever” which prevailed in Edinburgh and other towns in 1843?1846. In 1843 the same author published a treatise on this epi- demic form of fever, now known by the name of ” relapsing fever.” A good deal of this is reproduced by him, but with considerable additions, and he now places before us all that is yet known of this peculiar epidemic. I he account is very care- fully put together ; and a reproduction of what has been out of print for some time, and consequently so difficult to obtain, especially when it bears directly on an important question, is a subject for congratulation, especially when the matter has been collected together by much labour and hard clinical study by the bedside and in the post-mortem room.
A number of cases illustrative of the symptoms and treat- ment of relapsing fever are carefully compiled, and the patholo- gical changes in cases which have proved fatal are given, and the description concludes with statistical details and practical inferences. It is the most complete history of relapsing fever that has yet been published, and we heartily recommend it in all its details to those who are interested in the subject. The remainder of this volume is taken up with the conside- ration of cholera, nephritis from scarlatina, puerperal convul- sions, granular degeneration of the kidney, infantile remittent fever, and other matters of special interest.
An account is given of the epidemics of cholera, entering into the minutest description of the various forms of treatment, with a careful analysis of each.
With regard to the arrest of the serous diarrhoea which precedes the state of collapse as well as of the cramps, the follow- ing drugs are specially mentioned : creosote, turpentine, sul- phuric acid, nitric acid, nitro-sulphuric acid, nitrate of silver, quinine, gallic acid, alum, and acetate of lead. The combination of quinine with a mineral acid, or with iron, appears to have had great success, as also creosote in doses of two or three drops in mucilage every hour. This latter remedy is the one especially mentioned by the author. The other diseases in this volume are ably treated by Sir J. R. Cormack.
The second volume of these clinical studies commences with the Gold Medal thesis on ” The Presence of Air in the Organs of Circulation.” This thesis is divided into four chapters, each being more or less a complete essay. The causes and conse- quences of the entry of air into the various veins are fully dis- cussed, and cases are given in illustration of this interesting subject.
The fatal results of the entrance of air by the uterine veins is carefully placed before us, and appear to favour the formation of emboli and fibrinous formations in the organs of circulation. We are told that ” the causes of most of the unexpected sudden deaths which occur some days after delivery, when all seems to be going on well, are embolism and fibrinous tormations in the organs of circulation. In the puerperal state?as also in some diseases?the blood has a tendency during life to coagulate the heart and large vessels. This tendency does not depend upon Jin excess of fibrin in the blood, but upon a condition, induced by different causes, which determines an abnormal clumping or aggregation of the red corpuscles.”
Some instructive and interesting chapters are given on reflex convulsions of infancy, diphtheria, and the paralytic affections so often associated with it, congenital syphilis, concussion o e brain, general paralysis with insanity, and sharp attac s o in sanity in women. Cases are here cited of general paralysis in which cures have taken place. We must con ess a in our experience the diseases known in England as genera paralysis of the insane, or general paresis, is quite incura e, and when once the symptoms have become developed, it s ow y but insidiously progresses. It is due to organic disease o e brain, probably softening. Another peculiarity of is com plaint is that it is rarely, if ever, met with in females. ^ e have, however, read the case of Miss A. B., described as^su ermg from symptoms of ” general paralysis with insanity, at page 495, in which recovery took place.
This is indeed a most remarkable case. The patient appears to have had all the symptoms of a typical case of general paiesis, the extravagant delusions, ideas of grandeur, and thickness in articulating and in speech. Her attack appears to have lasted for seven months, and the symptoms, progress, and result of t us case have led the author to the conclusion that there exis e congestion of the left corpus striatum and optic thalamus prior to and at the time of her illness, and when first put u”~er .” ment. Had our space permitted it, we should have publis e 11s case in extenso, the interest in a psychological pom o view being so great. In our next issue we hope to pu is 1 ur ei particulars concerning it. Other cases of geneia para ysis given, all being of interest. The volume conclu es W1 account of some short attacks of insanity occumng in w , chiefly due to uterine or ovarian excitement, associa e hereditary predisposition _ s of clinical We cannot speak too highly of tnese ywu ,, i studies. They are most complete in their debciip 10 ,, guage is elegant in the extreme, the statemen sare , by facts, the result of practical experience, an we * clinical careful perusal of them to all who are eager to study clinical medicine.
Disclaimer
The historical material in this project falls into one of three categories for clearances and permissions:
Material currently under copyright, made available with a Creative Commons license chosen by the publisher.
Material that is in the public domain
Material identified by the Welcome Trust as an Orphan Work, made available with a Creative Commons Attribution-NonCommercial 4.0 International License.
While we are in the process of adding metadata to the articles, please check the article at its original source for specific copyrights.