Southern Medical and Surgical Journal - Georgia Regents University

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Dft. O. C. Gibbs. Summary. [November,K. Mitchell, M. D., who referred them to a crjptogamous origin.That certain diseases occur only when there is a conjunction ofcertain atmospheric and terrene conditions ris almost universallyadmitted; that the terrene conditions exercise a controllinginfluence, is a fact too well established to admit of doubt ; andthat that terrene condition or element is effluvial, is more thanproblematical. But why dissimilar diseases from similar causes ?That the plague and yellow fever occur only under similar, ifnot absolutely identical conditions, is well known. High temperature,humid atmosphere, lowness of site, density of population,and animal and vegetable putrescence, with a preponderanceof the former, are necessary conditions to the productionof a miasm that will develop either of the above-mentioned diseases.If the causes are the same, why not the results ? If theseconditions develop the plague in Constantinople, why not inNew Orleans ; and the reverse, in regard to yellow fever ? Weanswer by putting another question. If sugar, starch, and gumarabicare composed of precisely the same ingredients, in twoof the instances, in precisely the same proportions, why are notthe physical properties of the resulting compounds identical ?If dissimilar substances are isomeric, may not the causes of dissimilardiseases be also isomeric ?Intermittent, remittent, and bilious remittent fevers have alsoterrene causative relations and dependencies, and those causativesare apparently identical, and always present where thesefevers are endemic. The miasm of intermittent differs from themiasm of yellow fever and cholera, but we are not prepared tobelieve the difference to be what Dr. Harvey suggests. Themiasm of an intermittent has a more vegetable origin than thatof yellow fever, and its conditions of development are not thesame. If intermittent fever has always terrene causative relations,why is not that disease always present whenever thosecausative relations exist ? True to our Yankee instincts, weanswer by asking, Why carbon and hydrogen, in the relativeproportion of five parts of the former to four of the latter, incombination, are not always oil of turpentine, and not sometimesoil of lemons, as is well known to be the case ? Why isnot C, 2H, 0, not always starch, when in combination, andnot sometimes gum-arabic and gum tragacanth respectively ?This is not the time or place to enter upon controversial ground,the above thoughts are thrown out simply as suggestives.Laryngismus Stridulus.—In the same nnmber of the Lancetand Observer, Dr. K. E. McMeens, of Sandusky, Ohio, reports acase of the above disease, with a few remarks upon its pathology.Dr.. Hord, in the British and Foreign Medico- ChirurgicalReview^ declares the exciting and sustaining cause of the disease to
1859.] Dr. 0. C. GrBBS. Summary, 783depend upon an enlarged state and disordered function of theliver—a condition of that organ vulgarly termed and treated bynurses as " livergrown," and the laryngeal difficulty, dyspnoeaand spasm of the glottis, are sympathetically excited and secondarilyinvolved; and offers, in support of the allegation, therevelations of twelve autopsies of fatal cases, all confirmatory ofthe fact. " To the truth of this proposition," Dr. McMeenssays, " I am disposed to differ, from the ostensible efficacy ofremedies adapted to such pathological inductions. Catharticdoses of calomel, followed by free discharges of vitiated bilioussecretions, were invariably succeeded by a marked amendment,while the absence or deficiency of such secretion was precursorto a decided aggravation of the disease. As an alternative, theproto-iodide of mercury had a most happy influence over thesecretions. Dover's powder usually sufficed to allay any disturbanceor pain in the bowels. Frictions along the spinal columnwere premised for the contractions and insensibility of the extremities,and the inhalation of ether, hyoscyamus, and anise, tosoothe the irritability of the larynx and allay cough. Underthis treatment, at least, the disease was manifestly modified, andthe patient steadfastly improved.The pathology of this affection has been anything but definitelysettled, and anything concerning it we regard with interest.Some, with Drs. Ryland and North, have supposed the diseasedependent upon cerebral derangement, while others consider itdependent upon gastric irritation. Dr. Marsh thinks it ma^proceed from irritation of the pneumo-gastric nerve ;while Dr.hey supposes it dependent upon paralysis of the muscles whichopen the glottis, in consequence of pressure of enlarged glandsupon the recurrent nerves. It is probable that the laryngealaffection is due to a reflex nervous action, the seat of irritationbeing variously located : sometimes in the gums ; at others, inthe medulla oblongata ;and still at others, in the liver, or anypart of the digestive apparatus.Erysipelas.—In the Medical and Surgical Reporter for August13th, J. R. McClurg, M. D., of Philadelphia, has an able articleupon the above subject. In regard to treatment, after the actionof an emetic and a saline cathartic, combined with a mercurial,if there be symptoms of billious derangement, he says :" Ialways use some tonic medicine, and my favorite prescription,and the one I uniformly use in all cases of erysipelas, of whateverform or character, as soon as the system is prepared forit, is,#.—Spiritus aetheris nitrici, f. Sij.Tinctura ferri sesqui chloridi, f. 3ij.Quinae sulphatis,gr. xvj.
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