ACCOUNT OF A CASE IN WHICH THE ENTIRE LOWER JAW WAS REMOVED ON ACCOUNT OF DISEASE

J PERRY
1838 The Lancet  
94 in which the same remedy was equally successful. Arsenic was most efficient in cases of atonic menorrhagia, but he had employed it with much benefit in cases of the acute form of the affection, after depletion had been resorted to. Respecting the use of arsenic in cases of cancer of the uterus, he had had a case some years since in which the pain was so excruciating as almost to set the influence of narcotics at deflince. As much as 24 grains of the acetate of morphia, in 24 hours, gave
more » ... 24 hours, gave little relief. In a consultation with Sir B. Brodie, the use of arsenic was suggested, Sir A. Cooper having found it remarkably efficacious in a case of cancer of the womb. Small doses of the liquor arsenicalis, given repeatedly in the day, but never -collectively, amounting to more than ten drops in the 24 hours, afforded the patient more relief than the dose of acetate of morphia, just mentioned. Dr. MERRiMAN could have wished that the cases of menorrhagia, related by Mr. Hunt, had been given more in detail. In only two instances had the author made an examination per vaginam, in consequence of which we were left in ignorance of the state of the uterus in the other cases. Menorrhagia might be the result of causes in no way implicating disease of the uterus itself; and he (Dr. 1B'1.) thought the author had not clearly made out, in all his cases, the proposition he wished to establish, that arsenic had a specific and local effect on the uterus. Regarding ca.nce? of the uterus, we found, occasionally, that a remedy which was remarkably beneficial in one or two cases of the disease, failed when resorted to in other instances. About the time Mr. Carmichael published some observations on the effects of the preparations of steel in cancerous affections, he (Dr. M.) had iinder his care a severe case of cancer of the uterus. He gave the carbonate of iron internally, with the effect of considerably increasing the sufferings of the patient. An injection of a solution of sulphate of iron had, however, a remarkably soothing and beneficial effect. He had not found such benefit from the remedy in other cases of the disease, though occasionally it had affnfrteri KfMne 1'Alipf. . Dr. LEONARD STIWART believed that the curative effect of the arsenic in Mr. Hunt's cases depended on its specific and local action on the uterus. Many cases were on record which proved that arsenic acted on the genital organs specifically. Dr. LococK considered that in many cases the arsenic acted merely as a tonic, but he' believed mere as a local than a general one. He was quite aware that many cases of menorrhagia depended on causes which did not in any way implicate the uterus. He had seen many cases of menorrhagia. from local debility, as after frequent miscarriages, or frequent parturitions. In this kind of cases the use of the arsenic was generally most successful The c:;tses of menorrhagia related by Mr. Hunt were of the atonic kind. In the other cases related by that gentleman the arsenic was employed to relieve the pain which followed inflam. mation of the uterus. It was not generally necessary in cases of menorrhagia in young; women to examine the uterus. He (Dr. L.) did not understand the nature of Dr. Merri. man's objections to Mr. Hunt's cases. Mr, Hunt was a sound practitioner, and would not employ a remedy like arsenic without a full inquiry into the history of the case. He (Dr. L.) had employed arsenic in small doses, in a case of dysmenorrhoea occurring in a hysterical patient. Both the hysteria and painful menstruation were materially relieved. In that case he believed the arse. nic acted on the uterus itself. Dr.MERRiMAN did not deny that the arse, nic in Mr. Hunt's cases had produced great benefit; but he thought no evidence had been adduced to show that the uterus itself in these cases was affected, to support Mr. Hunt's proposition, that arsenic acted locally and specifically on the womb in the process of cure. Dr. BURNE said, that disordered function of the uterus was often the result of disorder of the functions in general ; let these functions be restored, and the uterus generally would be set right. All the viscera of the pelvis were affected by sympathy with one another; thus we had dysuria in stricture of the rectum, &c. There were cases, however, in which the function of the uterus was not properly performed, when the other functions of the body were set right; and he thought these were cases in which medicines having a special and direct action on the uterus were most successful. He had employed ergot of rye in very many cases of menoi-rhagia with success, and also in those cases of constant discharge of blood from the uterus after abortion. The ergot of rye, either in decoction, infusion, or powder, he had found of great benefit, In cases of
doi:10.1016/s0140-6736(02)95695-3 fatcat:kg7ine65wbbzvovqcq6foza2lm