Note on Viburnum Prunifolium in Abortion


Campbell, W.M.

British Medical Journal 1(1313): 391-392

1886


Feb.
27,
1886.1
THE
BRITISH
MEDICAL
JOURNAL.
391
ptoms
were
only
developed
contemporaneously
with
the
cerebral
disturbances,
and
I
believe
they
are
but
the
mechanical
expression
of
increased
intracranial
pressure.
I
have,
on
more
than
one
occasion,
seen
patients
who
were
suffering
from
acute
symptoms
of
lead-poison-
ing,
whose
discs
I
had
examined
in
the
morning
and
found
normal,
the
same
evening
became
the
victims
of
the
most
acute
cerebral
sym-
ptoms.
Violent
epileptiform
convulsions,
dilated
pupils,
blindness,
exhibit
a
well
marked
Stauungs-papilla,"
or
choked
disc.
I
have
known
these
patients
pass
into
a
semi-comatose
condition,
and
remain
so
for
several
days,
and
then
gradually
recover,
with
impaired
mental
faculties
and
different
degrees
of
blindness.
The
pathology
of
these
cases,
as
far
as
vision
is
concerned,
I
be-
lieve
to
be
entirely
due
to
mechanical
causes;
and
the
amount
of
impairment
of
sight
is
exactly
in
proportion
to
the
duration
of
the
intra-
ocular
pressure,
and
the
amount
of
secondary
neuritis
which
the
stran-
gulation
of
the
disc
may
bring
about.
The
extremely
short
time
in
which,
in
these
cases,
a
normal
disc
may
be
observed
to
pass
into
a
condition
of
the
most
intense
congestive
oedema,
to
my
mind,
excludes
the
idea
of
a
specific
neuritis,
and
is
a
convincing
argument
in
favour
of
Mang's
theory
of
the
production
of
optic
neuritis
by
distension
of
the
intravaginal
sheath
space.
I
think,
then,
that
most
of
the
so-called
cases
of
lead-neuritis
may
be
accounted
for
upon
other
grounds
than
the
specific
action
of
lead
;
and
that,
at
all
events
before
this
cause
is
admitted,
other
more
com-
mon
causes
must
be
excluded.
In
the
notes
of
the
cases
detailed
by
Mr.
Hutchinson,
the
question
of
renal
disease
and
menstrual
suppres-
sion
is
not
touched
upon.
One,
the
case
of
Kate
M.,
was
known
and
seen
by
me
in
its
earliest
stage,
and
it
was
undoubtedly
one
in
which
the
eye-symptoms
were
due
to
rapid
intracranial
effusion.
I
regret
that
I
have
no
time
to
enter
more
fully
into
this
question
;
but
I
hope
this
note
may
lead
to
an
expression
of
opinion
from
others
who
have
had
special
opportunities
of
seeing
laige
numbers
of
cases.
EMBOLUS
OF
THE
BASILAR
ARTERY.
BY
CHARLES
M.
CHADWICK,
M.B.,
M.R.C.P.,
Phy,ician
to
the
Leeds
Public
Dispensary.
THE
following
case
appears
to
be
worthy
of
record,
as
one
which
is
rarely
seen
in
practice,
and
perhaps
of
still
further
interest
from
the
fact
that
the
post
mortem
examination
revealed
no
signs
which
would
lead
to
any
definite
conclusion
as
to
the
origin
of
the
lesion.
W.
E.,
aged
21,
a
collier,
was
first
seen
by
Mr.
Stericker,
Senior
Resident
Medical
Officer
at
the
Leeds
Public
Dispensary,
on
the
morning
of
December
Sth.
He
was
a
pale,
fairly
nourished
young
man.
At
one
time,
he
was
somewhat
intemperate
;
since
marriage,
nine
months
ago,
he
was
said
to
have
been
quite
steady.
There
was
a
history
of
marked
loss
of
hair
about
two
years
ago
;
otherwise,
no
history
pointing
to
specific
disease.
There
had
been
no
miscarriage,
and
no
child.
Two
brothers
and
two
sisters
were
alive
and
well.
He
had
always
had
good
health.
The
patient
was
quite
well,
and
at
work,
till
two
days
before
the
attack,
when
he
was
said
to
have
complained
of
pain
at
the
back
of
the
head.
It
being
Saturday
night,
the
patient
took
a
strong
purge
of
senna,
salts,
and
liquorice.
On
the
following
day,
he
got
up
;
he
appeared
much
better,
and
his
appetite
was
good.
Towards
evening,
his
wife
went
out
for
a
few
minutes,
and,
when
she
came
back,
he
was
"all
of
a
heap"
in
the
arm-chair,
and
could
neither
speak
nor
walk.
He
signed
to
her
that
he
wanted
to
go
to
bed.
He
was
carried
upstairs,
and
never
moved
his
position,
spoke,
or
showed
any
further
signs
of
consciousness,
till
his
death,
which
occurred
fifty-six
hours
later.
It
was
said
that
he
once
drew
up
his
legs
and
slightly
moved
his
right
arm.
When
seen,
the
patient
was
lying
on
his
back
in
bed.
The
skin
was
covered
with
a
copious
sour-smelling
perspiration
'
the
eyes
were
semi-closed,
and
the
pupils
(partially
dilated)
reacted
well
to
light.
The
deep
reflexes
were
increased,
the
superficial
well
marked.
There
was
well-marked
ankle-clonus.
The
right
arm
was
semi-flexed
over
the
chest
;
the
legs
and
left
arm
were
extended.
The
temperature
was
100.2
;
pulse,
98
;
respiration,
20.
The
patient
was
continually
uttering
a
wailing
sound,
tears
running
down
his
cheeks
;
and
the
facial
muscles
were
contorted
as
in
ordinary
crying.
Any
irritation,
such
as
pricking,
or
twisting
the
hair
about
the
temple,
would
produce
this
at
once;
and,
in
the
latter
case,
the
head
was
turned
towards
the
side
where
this
was
done;
the
facial
muscles
of
the
same
side
were
con-
torted.
The
mouth
could
not
be
opened
;
the
tongue
was
motionless
;
the
lips
and
mouth
were
covered
with
sordes.
Any
attempt
to
allow
fluids
to
run
down
was
followed
by
coughing
and
choking.
The
patient
remained
in
the
same
state
;
the
breathing
became
more
laboured,
the
pulse
more
rapid
and
feeble,
and
he
died
"
quite
quietly"
fifty-six
hours
after
the
attack.
Post
Morton,
Examination,
conducted
eight
hours
aftar
death.
—All
the
organs
were
found
to
be
healthy.
The
heart
was
not
enlarged
;
the
valves
were
entirely
free
from
vegetations
;
the
left
ventricle
was
contracted.
The
veins
in
the
meninges
were
congested,
and
at
the
anterior
extremity
of
the
basilar
artery
was
a
small
rounded
clot,
in-
creasing
its
calibre
at
this
point
to
the
size
of
a
small
pea,
and.
plainly
visible
before
opening
the
vessel.
On
opening
the
vessel
a
round
clot,
black
internally
and
colourless
externally,
was
seen.
REMARKS.
—The
post
mortem
appearance,
the
age
of
the
patient,
and
the
sudden
onset,
would
lead
to
the
determination
that
this
was
a
case
of
embolism
;
while
the
reported
pain
in
the
back
of
the
head,
and
the
absence
of
signs
in
the
heart
indicating
embolus,
would
lead
to
the
supposition
that
thrombus
was
the
cause
of
the
occlu-
sion.
Had
the
occlusion
occurred
at
the
proximal
instead
of
the
distal
extremity
of
the
vessel,
death
would
have
been
either
immediate,
or
much
more
rapid,
from
asphyxia.
NOTE
ON
VIBURNUM
PRUNIFOLIUM
IN
ABORTION.
BY
W.
MACFIE
CAMPBELL,
M.D.,
Liverpool.
SINCE
the
publication
of
Dr.
Wilson's
paper
in
the
Liverpool
Medico-Chirurgical
Journal
of
January,
1885,
I
have
had
the
oppor-
tunity
of
testing
the
use
of
viburnum
prunifolium,
so
much
vaunted
in
America,
in
several
cases
of
threatened
miscarriage,
and
I
can
entirely
endorse
the
good
opinion
he
has
formed
of
it.
Nothing,
pro-
bably,
in
midwifery
is
more
disappointing
than
the
ordinary
routine-
treatment
of
miscarriage
by
opium
or
Indian
hemp
on
the
one
hand,
or
ergot
on
the
other.
For
these
drugs
as
often
act
in
the
way
con-
trary
to
the
prescriber's
intention
as
in
accordance
with
it.
How
often
has
a
dose
of
Battley's
solution,
administered
to
arrest
uterine
action,
and
give
rest
and
ease
from
pain,
been
followed
by
immediate
and
severe
expulsive
pains,
while
the
attempt
to
empty
the
uterus
by
a
dose
of
ergot
has
resulted
in
a
perfect
calm,
and
a
disappearance
of
symptoms.
It
is
a
comfort
thus
to
have
some
hope
of
success
in
dealing
with
such
a
condition
as
miscarriage
;
and
although
I
have
so
far
only
the
notes
of
six
cases,
of
which
five
were
successful,
yet,
these
five
being
consecutive,
and
the
effect
exactly
following
the
administration
of
the
remedy,
I
have
no
hesitation
in
my
own
mind
in
giving
the
credit
to
the
viburnum.
The
case
of
failure
was
my
first.
CASE
I.—Mrs.
B.,
two
months
pregnant,
had
discharge
of
blood,
with
uterine
action.
She
was
treated
in
the
usual
manner,
with
opium
and
rest
for
two
days,
when
extract
of
viburnum,
in
two-grain
doses,
three
times
a
day,
was
ordered.
There
seemed
no
effect
upon
the
pains,
the
os
continued
to
dilate,
and
the
uterus
was
soon
empty.
Perhaps
the
dose
was
too
small'
;
at
any
rate,
I
had
lost
two
days,
which
I
take
to
be
the
reason
of
the
failure.
CASE
H.—Mrs.
a,
pregnant
for
the
seventh
time,
two
months
and.
a
half,
was
awakened
by
a
gush
of
water
early
one
morning,
followed
by
a
bloody
discharge.
On
examination,
the
os
was
soft
and
dilatable.
She
was
kept
in
bed,
and
given
at
once
three
grains
of
extract
of
viburnum
every
four
hours.
There
was
no
return
of
bright
blood,
and
the
discharge
gradually
ceased.
The
relief
to
the
pain
after
the
first
dose
was
in
this
case
very
marked.
CASE
III.
—Mrs.
B.,
in
her
sixth
pregnancy,
one
night
during
the
fifth
month
was
wakened
by
the
"
breaking
of
the
waters,"
the
escape
being
sufficient
to
saturate
her
night-dress
and
bedclothes.
This
was
followed
by
pains.
I
saw
her
in
the
early
forenoon,
and
gave
three
grains
of
the
extract
three
times
a
day,
and
there
were
no
further
symptoms.
CASE
IV.
—Mrs.
G.,
in
the
fifth
month
of
her
second
pregnancy,
had
a
bloody
discharge,
with
uterine
pains.
The
same
dose
was
used,
and
with
the
same
good
result.
CASE
V.—Mrs.
W.,
in
the
second
month
of
her
sixth
pregnancy,
had
already
had
two
miscarriages.
Two
grains
of
'extract
of
viburnum,
three
times
a
day,
gave
relief,
as
also
a
month
afterwards,
when
the
same
threatening
symptoms
appeared.
CASE
VI.
Mrs.
S.,
first
pregnancy,
fourth
month.
This
case
was
particularly
interesting
from
the
fact
that
miscarriage
had
been
imminent
in
her
case
at
each
monthly
period.
The
first
and
second
attacks
occurred
in
America,
when
she.
was
given
viburnum,
and
her
medical
man
provided
her
with
a
large
store
of
the
liquid
extract,
which
he
told
her
was
unknown
in
England.
She
had
an
attack
at
sea,
and
in
due
time
in
Liverpool,
and
was
pleased
to
discover
that
1
In
repeated
large
doses
it
is
apt
to
give
rise
to
headache.
t92
THE
BRITISH
MEDICAL
JOURNAL.
[Feb.
27,
1886.
the
drug
could
be
taken
in
pill,
and
was
equally
efficacious,
as
the
liquid
extract
is
very
nauseous.
While
I
was
from
home
she
had
another
attack,
in
which
she
was
attended
by
Dr.
Westby,
who
con-
siders
she
was
only
saved
from
miscarriage
by
the
viburnum.
During
this
last
attack,
she
took
her
pills
five
and
six
times
a
day
;
in
fact,
her
faith
was
such,
that
she
would
hav'
taken
too
many.
Bromide
of
potassium
was
also
given
to
allay
her
nervous
excitement.
Two
other
cases
turned
up
during
my
absence,
both
of
which
com-
pleted
their
miscarriage
;
and
I
cannot
help
feeling
that,
if
tney
had
been
treated
with
viburnum,
the
result
would
have
been
different.
One
sent
for
Dr.
Westby
on
the
third
day
;
the
other
was
treated
by
another
doctor
with
opium
and
morphia
hypodermically.
It
does
not
do
to
build
too
much
upon
the
result
of
these
few
cases
;
but
I
have
been
so
constantly
foiled
in
my
endeavours
heretofore
to
prevent
miscarriage,
that
I
hope
to
have
found
in
viburnum
the
sure
arrester
of
uterine
action,
which
we
certainly
at
present
do
not
possess.
As
recommended
by
Dr.
Wilson,
I
prescribe
the
solid
extract
pre-
pared
by
Messrs.
Clay
and
Abraham,
of
Liverpool,
from
the
liquid
extract.
THE
TREATMENT
OF
PAINFUL
FISSURE
OF
THE
ANUS,
WITHOUT
OPERATION.
BY
A.
D.
'MACGREGOR,
M.
B.
,
C.
M.
,
Kirkcaldy,
N.
B.
IN
the
interesting
and
instructive
lecture
on
the
male
perinceum,
by
Mr.
C.
0.
Wheelhouse,
the
operation
of
"
stretching"
the
sphincter
ani
is
advocated,
in
preference
to
"
cutting
"
the
muscle.
This
treat-
ment
Mr.
Wheelhouse
recommends
in
fissure
of
the
anus,
because
"
we
can
attain
our
end
without
causing
an
external
wound,
and
thereby
rendering
our
patient
liable
to
septic
poisoning."
I
have
hitherto
treated
these
fissures
without
any
operative
interference
at
all,
and
with
such
success
as
to
warrant
a
continuance
of
the
method.
The
following
case
will
illustrate
it.
J.
T.,
a
coachman,
aged
56,
had,
for
eighteen
months,
suffered
such
agonising
pain
during
defalcation,
that
an
enforced
habit
of
constipa-
tion
was
established.
From
time
to
time,
he
relieved
his
bowels
by
enemata,
first
taking
a
large
dose
of
laudanum
to
alleviate
his
sufferings.
On
examination
with
a
speculum,
I
found
a
fissure,
nearly
an
inch
in
length,
with
irregular
edges
and
an
indurated
base.
The
sphincter
was
much
hypertrophied,
and
contracted
powerfully
and
spasmodi-
cally
during
the
examination.
I
ordered
a
full
dose
of
castor-oil,
with
some
rhubarb
for
its
secondary
astringent
action,
forbidding
the
customary
laudanum.
When
this
had
operated,
I
had
the
bowel
well
washed
out
with
an
enema
containing
Condy's
fluid.
This
done,
I
passed
the
speculum,
and
painted
the
fissure
with
a
solution
of
chloride
of
zinc
(twenty
grains
to
one
ounce)
;
then
introduced
a
piece
of
lint,
smeared
with
boric
ointment,
the
contraction
of
the
sphincter
keeping
it
in
contact
with
the
sore.
The
bowels
were
kept
in
check
by
pilula
plumbi
et
opii.
Liquid
food
only
was
allowed.
The
subsequent
treatment
consisted
in
the
use
of
a
powder
(powdered
boric
acid,
half-a-drachm
;
violet
powder,
one
ounce),
which
was
sprinkled
freely
on
lint,
and
introduced
into
the
anus
to
dry
up
any
discharge,
and
the
continued
use
of
the
boric
ointment.
By
these
means
the
fissure
was
entirely
healed
in
six
days,
and
there
has
been
no
return
of
the
symptoms.
I
have
always
found
one
application
of
chloride
of
zinc
enough
;
it
usually
causes
some
smarting
and
uneasiness,
but
nothing
more
effec-
tively
purifies
the
ulcer,
or
stimulates
the
reparative
process.
The
introduction
of
cucaine
robs
the
operative
procedure
of
one
drawback—
the
necessity
of
taking
an
anaesthetic
;
yet,
I
may
recommend
a
trial
of
this
treatment,
at
least
in
the
case
of
those
who
have
an
innate
horror
of
anything
approaching
"
cutting."
BEQUESTS
AND
DONATIONS.
—Mr.
A.
F.
Millns,
the
late
Borough
Treasurer,
has
bequeathed
£1,000,
and
a
moiety
of
the
"
residue
"
of
his
estate,
to
the
Windsor
Royal
Infirmary.—Mr.
William
Tattersall
has
given
£250
to
the
Recreation
Hall
Fund
of
the
Royal
Albert
Asy-
lum
for
Idiots
and
Imbeciles
of
the
Northern
Counties.—The
Charing
Cross
Hospital
has
received
£200
under
the
will
of
Mr.
John
Purssord.
—"
Z.
0.
T."
has,
in
addition
to
many
previous
donations,
given
£100
to
the
Royal
Free
Hospital.
—Mr.
Joseph
Sturge
has
given
£200,
fur-
ther,
on
account
of
£2,000,
to
University
College
Hospital.—"
Liver-
pool
Jack
"
has
given
£60
to
the
_London
Hospital.—"
A
Friend"
(per
Mr.
J.
Tindall
Harris)
has
given
50
guineas
to
the
North-Eastern
Hos-
pital
for
Children.—"
M.
A."
has
given
£50
to
the
Metropolitan
Con-
valescent
Institution.
THERAPEUTIC
MEMORANDA,
PURE
TEREBENE
AND
TERPENE.
I
HAVE
received
so
many
letters
from
medical
men
in
different
parts
of
the
country
giving
the
results
of
their
experience
with
pure
tere-
bene
in
the
treatment
of
winter-cough,
that
practically
there
has
been
an
informal
collective
investigation.
I
have
before
me
brief
notes
of
94
additional
cases,
and
in
81
of
these
a
distinct
success
is
recorded.
In
six
of
the
cases
of
failure,
a
further
investigation
showed
that
there
had
been
an
incomplete
diagnosis,
the
patient
suffering
from
some
complication,
such
as
aneurysm
or
aortic
disease,
the
existence
of
which
had
not
previously
been
suspected.
In
ten
cases,
the
patients
complained
of
nausea
after
taking
the
medicine
;
and
in
several
in-
stances,
when
inhaled
from
lint,
it
excited
the
cough,
and
apparently
acted
as
an
irritant.
The
explanation
is,
that
much
of
the
pure
tere-
bene
now
sold
is
of
very
inferior
quality,
and
would
be
more
accu-
rately
described
as
"
impure
"
terebene.
Medicines,
as
a
rule,
do
not
improve
by
keeping,
but
pure
terebene
is
certainly
an
exception,
for
as
it
gets
older,
it
becomes
bland
and
oily.
It
is
to
be
feared
that
most
of
the
old
stock,
which,
in
consequence
of
the
small
demand,
must
have
been
in
druggists'
shops
for
years,
has
now
disappeared,
so
that
greater
care
has
to
be
taken
in
the
selection
of
good
specimens.
Much
of
the
pure
terebene
now
sold
is
crude
and
irritating,
and
quite
unfitted
for
medicinal
use.
My
attention
has
been
called
to
the
fact
that
there
is
a
terebene
which
is
labelled
"
patent."
I
distinctly
stated
in
my
paper
that
the
substance
I
employ
is
not
a
"
patent
"
preparation.
In
almost
every
case,
I
find
the
pure
terebene
has
been
given
on
sugar,
and
has
not
been
used
in
the
form
of
spray,
probably
from
the
difficulty
experienced
in
obtaining
the
atomising
apparatus.
The
combination
of
oil
of
cubebs,
oil
of
sandal-wood,
and
pure
tere-
bene,
which
I
used
with
success,
has
given
good
results
in
other
hands.
I
have
had
no
returns
of
cases
of
phthisis
treated
in
this
way,
but
most
of
my
correspondents
speak
of
having
found
pure
terebene
of
benefit
in
acidity,
flatulence,
and
other
forms
of
dyspepsia.
The
smell
of
violets
which
the
terebene
imparts
to
the
urine
is
often
re-
ferred
to, and
in
one
instance
it
gave
rise
to
complications.
A
lady
called
on
her
lover,
who
was
ill
in
bed
with
bronchitis,
and
was
very
angry
because
he
would
not
show
her
his
violets.
She
searched
for
them,
but
did
not
find
what
she
had
expected.
I
am
surprised
that
pure
terebene
has
not
been
recommended
for
diseases
of
the
bladder
and
urethra.
My
experience
of
its
employment
in
these
cases
is
limited,
but
I
have
certainly
found
it
useful
in
cystitis
and
gleet.
Delicate
and
fastidious
women
sometimes
object
to
the
smell
and
taste
of
pure
terebene,
and
I
then
use
terpene
in
the
form
of
tabloids
with
good
results,
although
I
do
not
think
it
is
equal
to
pure
tere-
bene.
WILLIAM
MuRRELL,
M.D.,
Weymouth
Street,
W.
TEREBENE.
IN
the
article
on
Terebene
in
the
JOURNAL
of
February
6th,
one
of
its
characteristics,
and
that
which
is
the
test
of
its
purity
(optical
neu-
trality)
is
omitted.
English
oil
of
turpentine
is
strongly
dextrigyrate,
a
column
of
200
millimetres
giving
a
rotation
of
—59°,
whilst
tere-
bene
is
absolutely
without
action
on
polarised
light.
For
several
years,
I
have
used
oil
of
turpentine
with
excellent
re-
sults
in
the
treatment
of
acute
as
well
as
chronic
bronchitis,
being
led
thereto
by
a
fortunate
mistake
about
a
decade
ago.
I
had
sent
an
illiterate
old
fellow
a
mixture
of
senega
with
carbonate
of
ammonia,
and
a
compound
of
olive-oil,
turpentine,
and
caustic
ammonia
to
apply
to
the
chest.
A
day
or
two
afterwards
I
found
him
wonderfully
bet-
ter,
and
he
told
me,
literally
with
tears
in
his
eyes
from
a
recent
dose,
that
the
last
medicine
was
the
best
he
had
ever
had,
but
that
it
had
taken
the
skin
off
his
tongue
and
throat.
He
had
been
taking
the
liniment
(through
no
fault
of
mine),
and
applying
the
mixture
as
an
epithem.
An
objection
to
the
remedy
is,
however,
its
very
offensive
taste,
and
especially
so
with
children,
and
this
terebene
happily
removes
;
but,
while
much
more
agreeable,
it
has
certainly
proved
less
efficacious
in
my
hands
than
its
base.
And
again,
in
justice
to
Dr.
Bond,
who,
I
think,
has
been
rather
hardly
treated,
it
should
be
stated
that
his
commercial
terebene
is
undistinguishable
in
taste
and
smell
from
the
hydrocarbon
in
its
pure
form,
and,
although
somewhat
viscid
(from
contained
colophene
?),
it
acts
with
me
quite
as
well
therapeutically
as
the
much
more
expensive
purified
form,
and
I
find
it
yields
by
frac-
tional
distillation
in
a
current
of
steam
about
30
per
cent.
of
optically
inert
terebene.
There
is
another
body
having
the
same
formula