THE

MEDICAL TIMES:

A JOURNAL

ov

MEDICAL AND CHEMICAL SCIENCE,

LITERATURE, CRITICISM, AND NEWS.

VOLUME THE TWENTY-FIRST.

JANUARY 5th, to JUNE 29th, 1850.

LONDON:

PUBLISHED BY JOHN CHURCHHX, 46, PRINCES-STREET, SOHO,

AND SOLD BY ALL BOOKSELLERS.

MDCCCI..
 INDEX TO VOL. XXI.

Anniversaiy meeting of the Institute,196 Baths and washhousea, 76, 170 '
Cafdne, 156
Abdomen, itraDguUted heinU within, 7 Ano, fistula in, 216 Battle,chloroform on the field of,57 Cdculus originating
in fhwture of the spine,
Aberdeen CoUegee, the, 140 Anomaly, renal,89, 289 Bear, extraordinarysurgicaloperationby a,
^...^... decreei. 107,144. 185, 187 Another case of murder by causing abor-
tion, 210 M..MM..M filling the whole bladder,216
...M..^... UnlTenlty and King's College,S09 829 Beaumont, Mr., en disarticulation of the Cdifomia. disease in, 70
AbeeeM in the hamerne, 868 Answer of the Coundl of the Royal College left condyle of the lower Jaw, 875 Campaign, the Egyptian, 169
....M...., mammerj, 104 of Surgeons to Sir Oeorge Grey, 856 BelfisstCollege, the, 8, 19 Campbell, Dr., 69
M"M...... perineal, banting into the Anthelmlntica Brayera,experiments with, BelgianPharmacopoeia, the, 150 Cauda, medullary of bone, anatomled de*
eefoton, S98 for the removal of taenia solium, 296 BeU, Dr., suicide of,at Cheltenham, 829 ments in the,20
......M... scrofalont,of the anterior me- Antidote to chloroform,886 Beneficence,329 Cancer of the breast. 195
dlaetlnnm. 804 Antrum, disease of the, 868 Benevolence, 289 epithdid, of the loww lip,5
M....M.,
"M...N..
of the fpleen,aappoeed, 211 Anus, rhinoplasticoperation in artificial, Bequests, munlfioent,894 M..M...
and hypcnrtrophy of the stamach,
M.M.....
in the thigh eonneoted with the 154 Benin, prostitution in,reportsupon, 199 difiterentiddiagnosisof,1 79
bowel and ilmalatlng obtttxator hernia, Apothecaries'HaU, licentiatesadmitted, 12, Bernard, Dr., on the panereatio Juice,257 of lip,154,277
M.M....

887,877 . 49, 70, 90, 149. 190. 209, 230, 249, 269, Bibliographical record, 871 .M.".M.M
the penis,195
Abaenee of the ntenu, hernia of the 289,810, 346, 862, 877, 894,410, 480,445, Biliarycalculi,diagnosisof,119 ....MM..MM.... skin,on seme cases of, 865
oTarlee,297 401,472 BiU, the Medical ChariUea, 818 Capillaryinjections, anatomled, 155
Abuae, Incult added to, 428 MM....,
memorial of the Societyof, MetropolitanInterments, 841
.M..., Capuron, M., death of;353
.M ......
of the ipeculnm, 45S 855,858 Superannuation Fund, 203 Carbonic add, sdU of, 462
Abnaee in privatelanatie aaylums, Ridgwa
j M.....M.M....M Society, 219, 879 Birmlngnam Lying-in Hospital,70 Carcinoma of the penla,866
Hooee,61 .......M....M of, what must be done
M.
Birth, premature, 129,208 Cariea,257
Academy of Medicine, 150 with the,242 Bladder, calculus fiUlngthe, 216 of the head of the femur, 104
.-...
the Royal Irish,178 Apparatus for employing the mechanical ...M. hsemorrhage into, death from, Carpenter,Dr.,the temperanceviews of,888
,
Aet, the Cofoners',and medical witnetiet, leeches,descriptionof the,86 246 Caadne in the blood, discoveryof, 288
10 for fkimf gating the scalp,128
M.M.. malignant disease of,S6 Cases,practical, by Mr. Amvot, 449
.M.MM..M,
Add, hippnrie,in the blood, 177 .M.M.M...M, new, for continued distillation, M..M,
obstinate irritabQitylof the, 156 simulating strangulated inguind
.MM., hvdrocTanic, in bomi, 88 158
".M, paralysisof,198 hemU. 295
Adda, Identityof malic and Mible, 817 Apparent and real death,816 .......M.M,.MM
cured by injection of Castor,157
Action of arsenical remedies,870 Application, practical,of the reduction in solution of strychnine,464 Cataract,soft,operationfor solution of,236
Acute necrosis, 257 sise,produced by debllluting infioenees .."punctureot from the rectuv, 417 Cat^rrhd pneumonia,458
......;. pericarditis,treatment of,88, 78,06 on the foBtus in ukero, 79 BlainvUle,M. do, death of;258 Cause of the atrophy of pardysed muscles,
"M..... synovitisof the wrist Joint,154 Appointments, 80, 49,70, 169,280,290, 878, Blister,sugar in the serum of a, 279 219
Addenda to the pharmacopoeia,206, 229 394.472 Blood, analysis of the,40 Causea of dyspepsia,289
Adipose tamonr, remoTal of,6 Appointment, militia, 878 changee "
In the quantity of albumen Caustic,new, 99
Administering chloroform, rule for,117 M..M..... miUtary,230,269, 289,829,
, in, 19 in stricture.188,206, 226
...M.....

Administration of chloroform and castor oil, 862,894,430,445 and chyle, analysis of,18 Cavitlee,serour, fUse membranes of,178
on the, f 28 naval, 80, 49, 70, 180, 149, .M.M..,,
M..,
diminution of the fibrioe oi;99, 256, Cemeteries and vaults, on the poisonous
Adnl'eratlon of milk, a new, 878 169, 190, 230, 249,269,289, 829, 378, 894, 296 gases of, 818
AUbctions,neuralgic,chloroform in, 294 480,445,461 discoveryof oaseine In, 238 Centenarians, 190
Ane, chloroform in, 278 Arm, tumour in the, 867 hippuric add In the, 177,
.M....... ^rfph*lbfpm*^^*i 867
Air, on the entrance of,by the open mouths Army appdatmenta, 49, 149 M..MM., quantityof,in animals,21 Cetd"fo-epind meningitis,240
of the uterine Tessds, considered as a M
medicd departmenL 210 M.M..Mveasela,on the unstriped muscular Cervix uteri.Inflammatory eruptionsof the,
eauae of danger and death after parturl- Amott, ICr.,retirement of,firom University fibrea in the,258 280
tion,286 Col]ege,856 Blow, a heavy, againetquackery, 210 Changes in the musoular ixritaUlity alltr
Albumen in the blood,changes in the quan-
tity Arseniona add and albumen, 408 Board of Guardians, the,860 death, 240
oi; 19 Artery,femoral,legatureof the, 417 .MM... M.MM....M.M..,
of the Chorlton .M.MM.M.M..MM.. quantity of dbumen in tho
Albnadnhneter,the, 7 Articular rheumatism and gonorrhceal Union bleed,19
Albumlnoua urine and dropsy, proximate arthritis,diagnosiatetween, 180 .M.MM..M.MM..M.MM.
of St. Luko, ChcIsca Chard, Mr., ease of congenitd mdpositloB
of;184
cose Artifleld mode of preparing quinine, priae and their medleal ofllcers, 150 of the viscera, by, 75
Albumitturin in pregnant woman, 177,840 Ibr the discoveryof an, 120 .MM.M..M Hedth, 88, 180 Charit6,la,869
AMcrson's, Baron, decision in a case of M.M..MM. pupUby separation,276 ....M.MM..MM..M.. the, and ita Inspectors, 21 Charities,Iridi Medicd, 88, 78
onaekery, 259 .MM.M.... ^rmpanum, the,189 Body, foreign,in the Intestine,104 Medled, 198,258,452
MM.,

AUmentaiT canal,on the phystolocyof,127 Artmery Company of London, 180 .MM..,

vident strain of,450 Charlnf-oroBSHoepitd, 480
Alimentatbo,gelatine, 77 Asdtes cured by iodine injections, 19 Bone in the longitudinalsinus, 86 Cheese, American, 408
AOeged case ofhydrophobU at Queenahead, Ashleyv. Wilson, 68 Bones, enlargement of;ood liver oil in,207 Cheltenham Oenerd Hospitd and Die-
in Yorkshire,41 Asiatfo chokra at Newport Pagnel in 1 838, Bonn, by Dr. Bushnan, 414 pensary, 290
Ahnonds, bitter, poisoningby, 70 aucclnct historyof,174 Bordeaux, chdera honours at, 315 M.M..M
suidde of Dr. Bdl, at, 829
,
'
Irish mediciaeno in,817
,
Aspect, the preeent, of homoeopathy,201 Bottomlcy, Mr., and medled reformt BS Chest punctured, 886
Amerlfan cheese,408 .M.M.MM.
medical
M.MM.ailUrs,21 Bouchardist, M., 829 tapping the, 238
,

M.M........ statisticsof cholera,21 Assimilation of iodine by plants,885 Bougies, gutta percha,418 Chilbldns,gutta perchasolce fbr,110
Ammonia, on the phosphate of, in gout Assistance,hospital,857 M M. ... M
and popliteal
M"., aneuriim, .M.MM..M.M,
useful remedy for,67
and rheumatism, 467 Assistant-surgeonson board the Apollo, ChiUren, animal heat of,219
Amphoric breathing and metallic tinkling, 829 Brdd, Mr., observations on trance or human .MM.M....,
nationd hospitalfor,241
Bkoda's views of, 118 .M.M...M..M.MM..M.,
tho uaval, 281, 308,309, hybernation by, 351, 401, 416 Chimner-sweeps' cancer, 367
AmpnUtlon (eirenbtf ) of the fore arm, 256 844 446 Queries regarding the Fakeer who Chloride of due for the purification of ships,
M.......M.....
of a finger,195 Assodation, the Britbh, 830 buried himself dive at Lahore in 1837, re-plies 129
M.M..MM........
the foreflnger, 216 .M
Dublin Sanitary,8 to, 852, 401 Chloiofbrm, antidote to, 386
"M.M*M...M".M".". leg,450 metropolitansanitary,meeting Brain,preservation of the, 157 in ague, 278
M

novel mode of,166 of, 106 Brayera anthelmlntica,experiment with,for and castor-oil, on the adminia-
................ M..^ M

"~..MM....". of the shoulder-Joint, 215 Assurance offices,life, and medical men, 248 the removd of taeniasolium, 296 tration of,828
"M.M.M.M thigh,5 Asylum, Female Orphan, 462 Breast,causer of, 195 .."M..M.M...
and ether, 20, 418
""... M.
for pulpy degener-
ation
.M..M....
Hanwell , Lunatic, 165, 189 sdrrhus
M,
of the, 366 external applicationof, in neu-
,
ralgia,
of the synovial membrane ol the for IdioU, 69, 243, 250, 346
M... Brighton Dispensary,New, 170 240
knee, 885 Middlesex County, 148
,
memorid firom, 405 .M
and Dr. Simpson, 353
M
,

Anastomosis, new, between the vena portse Asylums, District Lunatic,300 Brinton, Dr., on the physiology of the ali- mentary on the field of battle. 57
^...

and inferior cava, 450 private,90, 127, 147 cand, 127 impurities of, and mode of
",

Anassthetic agent, new, 99 Atelectasis of the lungs,439 British Association, the, 330 purification, 218
Anaesthetics in Edinburgh and London, 221 Athens, 130 Medled Fund, the, 261, 262
...M.M..M...,
insanityafter, 26
"-" ~.M midwifery, 219 M Atmosphere, epidemic condition of,179 Brodie,Sir B., and the Westminster Medled M
locd application
."...,
of, 45 i
Analysis of blood,40, 450 Atresia irldls, operationfor drillingthe lens, Society,164 In neuidgic aflbctlons,294
"M
the chyleand blood, 18 237 Bromide of Potassium, 451 mode of action of, 77
..."

Atrophy of paralysedmuscles, of the. Brompton Hospild for Consumption, 446 detecting, in the dead
" M."..M.M..cod-liveroll,21 cause ^.^

Anatomical cspnUry injections, 155 Bronchoeele, encysted, 338 body, 462

"MM. elements of the medallary canals Attendance,medical,in emigrationvessels, Bryson, Dr., on the respective vdue of on the use of,153
..,

of bone, 20 11 lime Juice, citric acid, and nitrate of in obstetricpractice, 297

Anatomy and School of Design, 58 Austria, homoeopathy in, 138 potash in the treatment of scurvy, 212, .M.M....M.M.M.
orchitis,119
Austrian in the, 169 435 puerperdconvulsions, 229
M..MM...., professorshipof, in Unlverdty army, surgeons ^. ......M.

Cdli^,888 Axilla, removal of enlarged glands firom, Burns, Dr., dedh of,459 M.,
removd of an ovum under the

Anderson, Dr., of Selkirk,830 255 Burns, hydrocyanic add in, 26 influence of, 144
sism by anastomosis, 215 Ayrcs, Dr., on the ftingoldand animalcular Burning the dead, 70 ^...,rulefor administering,117
MM.., popliteal,and gutta percha theoryof epidemic cholera,293 ,
po*t-morieai, 150 Chlorosis, manganese, in, 319
-*
Bursa the patella,suppuration in the, ..M.of pregnant women, 156
IS, 11 over
jular and fungoid theories of B. Cholera,the, 69, 88. 109, 130, 290, 330
epidemic chdete, 298 Baliia,129 patollse,iodide of potasdum in en- larged, ...... ...
American
.M.M.,
statistics of,21
Aneurism, treatment of,by electro-puncture, Bakerian Lecture, the, on the dillUsion of 148 .MM......
Asiatic, at Newport Pagnel in 1888,
156,814 liquids,10 Bush, Wm., Esq.,testimonid to, 190 suochit historyof, 174
"
Anfmalcttlar researchea,818 Bslioting-paper, the Lancet's," 444 Budinan, Dr., desultory sketches by, 214, causes of,418 .M.M...,

Animal heat of ohOdren. 219 Barker, Dr.,resignationof, 317 254,276,318,414 contsgiousnessof, 19, 99 .MM

Animals, diabeUs in, 240 Barron, Mr., on chloroform in neuralgic on mesmerism, 276,818 M..MM., cure for,480 ,.M.M ..,
. ^

M.M.M.M., hybernation of, 128 aflbctions,294 on the present state ofpracti- .MM.M., and the diatrlcts of the metro-
polis,
".,

.M...M...., organs of sense in invertebrated, Bath, order of, and naval and military cd medicine, 254 170
medical militaryofllcers,140 C. ...!M...,Dr.Hdlon, 11
", ^
dftct of poverty on themortdlty of,
^ ^

M.M.M.M., quantity of blood in,21 Baths, use of long continued, in madneu, Csesarean section,new mode of performing .M.M...,
An IntUglous malady, 155 57 the, 468 210
 u INDEX.

CkoLuB, epldemle,on fho ftufoidand anl- CoUodion,248 Detection of lead in minute qnaatitieein Enlargedglanda,removal of, fiEomtha sz-
nudeoUr thaorlM of,tBS Colon and Taa diUbnni, lUtnloos opening water or other fluids, 67 ilia,258
at Padua, poit-morUm
.M....... ntaaieliai between, 295 Devon and Exeter Hospital, 49 Enlargement,mammary, 114
made in the caMt of.886 Commissioners in Lunacy, 26, 878 Diabetes in animals, 140 Entropium, on, 888
""
in Penaanoe,28 "ftat"ethe Mata ......M*.., trsBimeat and oBse of,279 Epidemic cholera,ftingoid and animalonly
....M... ............
"M...M.... from a grare-yaid,466 ofSewevdeing't ^ Dh"Boeis hetweoB . ,
artfcBlar rhoumatiam theories of,298
pievention of,810 Committee, the Manchester, on medieal and gononhceal arthritis, 180 condition of the atmoipheva,179
"........, ........

M.^.... hononxs, 18 reform, 66, 208 ..............

of biliarycateuli, 110 ........ dvsenteiy, 157
"- at Boideanx, 815 CompostUon of coffee,156 diflbrential,of cancer and hy-
pertrophy
........
of Mumps, 79
M
loss of heat in, 819 Concussion followinga blow on the head, of the stomach, 179 Epidemics,proposedsociety Ibrinveatigatiiig
..........
in the Nethbrlands, 250 116 of hernia,218 the history "^, 428
obserfatioas on, 55I Conference ef delegaleo, seeonA, at the Diaphngm, rnptBreof,with DBBonlfaenila, Epithelial cancer of the lower lip,
5
"N...M. Bsvaid, m Hanorer.emtafe rooms, HI Epnlls,288
.M....M,
rewards at Exeter,12 of,and prawaedlagi
distoltttioii Diathesis, hsemonhagle, 449 Erysipelas of thelnngs,11
Mt..

......M.,
tallBe trsatmnit of,]" of the Collegeof Sufeons,201 DUbreBoe ef the rsflex flinetlon, 118 Eruptiena,inflaaanatacy, ef IIm e"9ls
.........
at sea, report of,bt the 9Hb ngi- "on(lBotionefrr, eolooreo, poteoningby, 899 Digitussemi-mortnus,the,418 nteil,109
meat, on boardTH. M. shipApollo,486 CongenitalalMence of the stOTnan, 401 DlmionlloB ef the flbrine ef the hlood,99, Eruptivefevers without empHon, 886
i"........ seyndary spssnu dimag eanr** ....MM. fungoid disease of eyeiidiasd 157,886, 299 Ether and chloroform, 19,419
......
hieeMe firaiB,117 laohrymalgland.866 Diploma,the CoUege. 148 Btherifloatlon, 480
"M.......
and small-poz, 858 medical,of th"
CoBstltntlon, year 1849 In a snigeoB's, obtained by firmd, Ethics, medieal,408,448,460
............
I
tiansmissioa of,819 Paris, 89 198 Bfher,mode of aetioB of, 77
.......... trsatHwnt of,in Penia, 99 Consumption" is it curable r 178 Diplomaa of London pbyalehHis, staHstiea of. Eclampsia nutans, the, of Mr. Nowaten,
wfll it return, S18 the salaam convulaioBa ef Sir Charias
.......... Contsgionsnessof cholera, 88 or
CJiwd. softeningef tt" pertolor eolBV"i of l^Nir-law medical ofltoeta^Directory, CoBTOBtion the *ed names in the,188 Clarke,187
105,128,161,444 medieal,148 Betropiom of the lower lidef the righteje^
Chordee,' a speeiilc in,10 Convict, Ann Merllt,who ia new nnder M.......
fbr 1880,121
..................

.M.M.M.M
from caries of the malar bone, 179
Cheilton Uiden, Board of Gaai"nt of ih", sentence of death in Hewnle, the, 227 Disappearanceof the panereaa, 240 Bflbct of pnevmo-thoiBX en the sooado of
150 In adhfld, 279 Disarticulation of the left condyle of the the
Convulsions, ivtatory. heart,on tlie,89
Chnhb, Mr., and Dr. Miller,Mr. MeClafe 8daam, or edampaia nutans, lower Jaw, 405
....M
....Ml
Efl^cts, 818
curious, erooflbe,
in replyto,47,68 287 Discovery,Dr. Graves's, 199
Oiyle and blood,aaaljats of,18 Cooper,AsUey, priae,the, 878 Disease of the antram, 868
Cleatrlz, dirislonof a,|^7 Cooperlanpriae for 1858 stniehire and in CaMfitmla, 70 "
.......... ,812
Circular nloer of the shmuA, SM function of the spleen, 879 of the knee-joint, 218, 487 Etiologyof typhoidfever,10
fff Cemrt of SeweM, 170,869 Cormack's,Dr.,hen,49 maUgaant, of the bladder,86 ...........
Eustachian tube, stiletue of the,148
CUmny, Dr.. death of,70 Cornea,new signof ulcerationof the,219 ovarlee, 126 ......M.M. BvBpeiatloBfkvmthe Thaaiea,99
gMsies at the OMlege of Sibbmbs, II Coroners' Ad, the^ and medieal wUueeses, EviU of SmoUng, 27,67
5}i*"rt"'"' "P""tton tor,Sf 10 Excavation In the Innga,fbrma ef,199
Cllft.^m., Esq., memoir of, 161 courts,139, 841 M. peculiar,
.........
of the nasal fbasa, 280 ....... ..,
Excision of the head of the fmaor,9r
Clinical illustrationsof diseasea of the of the penis, 210
expenses, 199 ............ warty, ........ ..............M... e#.ealcla,
ob, 498^
Borrow system, and of other aflbetlons simulation of, 878 shonwe^JoiBt, 1F7
inquests, 167 w.tM.MM.
........
..."".
...........
"imnlating them daiiag Hfli,
865 Coroner,medical,death of a, 190 .......of theteetlele, enee^olold,18 a tumour, 77
m.^^, tnatnoUoB, 280
singular oocorrenee befen a, 90 .,
the venereel,
"..., amongst horses,818 Bxeter,
461
"* Edlnboigh, 197 Correspondmits,
"

-at, 11
X"l"i "^"""..... 12,10,80. 70. 99,110, 190, Dlaeased heart,406
Clnb-foot, 154
150,170,190,210. 230. 280,279, 190. 810, DIsinfbotant, new, 452 ......
and DevoB 4
heeyHal,
S2*?.' """"'"1"in Edinburgh, 887 880,846, 862,878,894,410,480,449, 462, Dislocation of the hip Into the ohtBrstot ........ Dispenaary,189
Cod-Urer ofl, aoalysieof,21 472 fbramoB,lednctioB after obo Bnmth, 489 Bxpeneea,eoroaere', 199
""..MM.M"Mt.i., en 496 Cotton,gnu, 19 head of the humerus Bxpedltlea, the Polar,168
** *J""nl""g"Mntof Sir John FrankUn's,49. I8f
""jSr*" ""- bones, ConnoO, the, of the Cotlegeof guigeeua,88 dowBwaida, 188 ...........
of the CoUegeof Surgeons,pro- Dfspensaiy,Bxeter,199 Experimenta with the Bngretm AnnielHifB
""""""" phthisis. 8f specU of aiefonn bfflftom the, 190 FarringdonGeneral^189 tioafor the reawvalef tsMda
...M.M... pneunomia ftom, 78 ,
the, Kensington,89 External inflanmuttoBa,
........."......................."....^...,..^., ............
.- enbeHftntes fbr,106,198,297 and Mr. Pfleher, 471 the New 119
"
....."...,
...., Brighteii; 179
m.^"^^^..., why ohooM It be the only Kational Inatttnte to the Surrey,
.............M.......
879 ....H
Eztrsonnri iBtermeBt,tl9
remedy in consumption,108 ConnoU of the Collegeof Borgeona,162 Western City,69 ...........
ExtraordlnaiyeeenrrsBeo^ 119
5*y"" "l""ratleii^,489 reecrfntlonef fha, ngaidtag the Dispensaries,
M.M. Liverpool,108
....... ............. surgical(MMntion by a
alterations in charter, 841 eeirsopvertlmr, 11,111, 199, 119
(Mtof^ the Bettet,8, 19 Otrantiy, health of;In the ^qnartv eadbif Eyelidand lachrymalglaad,
" 805,816, 848,875
^... of ChemUtiyat Lirexpoei,
...... ISO Dec.. 167 DfsfointloB of the OoBftrenee and pnoeed- gold dlseaaeo"
868
"**""...... elassiee, 99 CoortoisTll., 190 ingsof the Collegeof flofieons,101
"......... diploma,the,148 Coxarius,morbus, ease of,18 DbtfilstloB, new apparatna for,155
......M.... election, 461 Cretins and idiots, 889 Distorted pelda,new praeUee in cases of.
-
fellowships, 2*6
-.. Crfaninalenes, temporsryfaieaBtly In,41 Farre,Dr. Arthur,471
a female medfeal,446 Curious eflbeteof eoAe, 815
"" "
DistrictLonatie Axioms In Irehnd, 890 FarringdonGeneral Dispeaaaiy,aBl LfftM^
.M^. the Oahray, 8,89 Cutaneous glands of the toad,ob the stne-
...... Division ef a ehstrix,137
"-" King's,862
"
tnreorthe,889 nrethralstrleture, 287,295 Fkttydiseasce of the heart,IM
"."..".." foctues, the,169,846, 878 Cure of hydrocele,iboIcbI, by aoTel me-thods, Daniell, Mr. Edward, snoclnet history of the ......tUBieur,% 199
the new, daim
"" ""-
of,to examine in 8 Asiatic cholera at Newport Pagnel In ................
removal of a, 899
188
snigeiy, D. 1883, 174 Fecundation,pveeiee seat of;489
Physicians, of
188,827,889
"-
Dead, burning of the,70 Doings in the provinces, 821 Feet,mortifleatien of the, f^om eoM, 98
-
inoorpoiattonof ,
the Deafhess,Mr. Yearsley on, (09 Drainage as it aflbcts the health,wealth, Fellows of the CoUege of Baifeeas,meettag
general piaetitioneisin the,806 new mode of treating,
176 and moralityof society, 48 of,241,
M...........
**" LlcenUates of, the, 169, 190,189. 810, 491
"""r":*'-r-" " ,
treatment of, 117 Drained,shall the metropolis be,22 Fellewahip,
281,287,817,884 Death of M. de Blainville, 853 Dublin,hospitals and medical chazitiea of, of the Collegeof Ssagwasb HU,
"-;"""" ,
the position
of the^ Capuron, 888 118 40,180
840 Dr. Claony,70 SanitaryAssociation, the,8 question, the,891
""" the Royal Tetertnary,310 fkom hsemorrliage
into the Fellowships, college, 108
# ".
bladder,
' TrinityCollege,12
.,
....~
...... studentships,
878, 446 246 Dysentery,epidemic.157 Female lAedical College, a, 446
of Surgeons,the,does it beloDgto of Dr. Healy, 394 Femoral
............

the Council or
......... Dysmenorrhoea,pathologyof,157 hernia,818
members, 182 .M.........
M. Gay-Lussae,871 Dyspepsia,causes of,239 in a very eorpolent
"^" '^ " ....
the fellowBhfp
of the, Mr. Malyn, 210 449
............ Professor Ms];Jolin,
196, 239 strangnhtted, 116
.,
members admitted, a medical Femur, caries of the head of, 104
.....^.... 250
coroner, Edinburgh, clinicalInstructionat, 197
1 169. 190,280,269,289, 8C0,829,846,862, presumed, Inutero,88 the Harveian exeision of the head of the^ 67
877
.......... Societyof,837 .".....,
of M. Preyost, 297 Infirmary,singularsuicide in Fevers,eruptive, without eruption, 899
the members of,188 of M. Fever,the French,at Rome, 815
"...""
M" Pros, 68 the, 58
"M"
M.......... meeting of the Fel-
lows supposed,from poison,170 and London, ansestheticsin,221 ........ puerperal,451
of,242 by takingoxalic acid, 115 Medical dubs in. 337 , typhoid,
256
Museum of,69 Deaths,registration
"
, at,80 medical news, 118 ^... etblogyof.19
and the practice of De Candolle, Professor,
""""'"
...~.... M... 190 Review, and the medical profes-
sion, typhus,70
pharmacy, 876 Decayed teeth,illlingup, 828 44 Dr. Jenneron, 107
,
"".
~..., Professor Paget*s Decorations, medical military, 440 Royal PhysicalSociety, 209 typhoid,and relapalag,
19,
..,
lectures on inflammation at, 389 to military 38, 113,135,:
."""."
surgeons, 220 , Royal Society of, 109 I,283, 433
"- and the proposednew Defective state of the law of lunacy,illus-
". trations Editor the, to his readers. 8 ....... yeUow 70,894, 410
measure, a54 of, with suggestions for its Election of M. MalgtiKne,256 In Pemambueo, 846
, regulationsof, 111 amendment. 121 Electro puncture, treatment of aneurism by, at Rio, 418
replyof the, 120 Degrees,Aberdeen,107,144,165, 187 156.814 Fevers,intermittent,on the ef,if oauae
the Royal, 209, 875, Delegates,second conference
""""".~ -
, of, at the Elements, anatomical,of the medullary ...".., quinine in, 458
445
Hanover-squareRooms, 141 canals of bone, 20 Forms of excavation in the lunga,290
"""""" Statements of,408 Delirium tremens, 225 Fibrins of the blood,diminutton of,196,
, Elephantiasis of the scrotum and penis,368
ultimatum of, 128 Dental pathology, 294
M..MM...., Emigrant surgeons' pay, 288 296
Tscancies in the De^utstion f^om the Proflncial Association Fibrous of the upper maxilla, 86T
Council of,455
Emigrstlon vessels, medieal attendance in. tumour
to Sir O. Orev, the,853 uterus, 104, 126
Trinity,
Dublin,12
~, to Sir GeorgeGrey, 183, 310 Empiricalsystems, the relation of true medi-cine FUling up decayedteeth, 328
Unirerslly,
268,289,862, 878 from the pub-
M..*. lic to,428 Filthyhabits of the poor, 210
""""""" Council of, and the f meeting at the Hanover- square Rooms, Empyema of four years' standing, consequent Finger,amputationof a. 105
students,801 360 on tapping, 438 Fingers,enehondrama of the,154
""""" Fellows of, and the Fire, alarming, at St. George's Hospital,
" -...: ,
......M M.........M. , report of, "Tapping the Chest,238
Lancet,"261 204 Encepbaloiddisease of the testicle, 18 410
"""""""
"the late inquestat, Description of the apparatus for employing Eochondromaofthe Angers, 154 Fistula in ano, 216
the mechanical leeches, 36 Encysted bronchocele, 838 ....... recto-vaginal,treatment of,816
the
: "; I professorship
of an apparatus for reducing tumour of the neck. 295
.....
Fistulous opening between the vaa f
'

anatomy in,389 fractures of the lower extremity, 844 tumour of the scalp, 237 and the colon, 2"5
CoUeges.198,298, 419 Despotism of the Poor-lsw Board, 202 Flemish
the Aberdeen, 140
England, the laws of,verttu the Council of twins,the, 371
"^
Desultory sketches by Dr. Bushnao, 214, the Collegeof Surgeons,328 Fluid,nervous, of,177
velocity
"""" proYineial,
78 254, 255, 813, 414 Engorgement, of the uterus, 117 ^ Foetal monstrosity,
147
.
 INPEX, m

Foitai,tlM of,a t""t of uterine ue, 14 7 Gngr,Sir Geoif", memorial of the mombars St. LOU'S,
Hoopital. 169 lastltut,aanivacaary meetingof the,196
"M..."
In ntoro, pnctiealappycatipnof tht of the medkal professioo at Eelgata
to,858 .............
St.Mary's.Fsddtngtoq,|82 .M
the French, 12 "
lednetion la die, produoedby debllltatiog of College.
Unlversitg 167. 190,410 Institute,the National,
.....M...* Society ...M*......, 299
infloencei on, 279 Apothecariesto, 356 Westminster,ISO,353 COUUCU
."., .M.M.M,M M.....MM..M, 0^ tO
Foot,olub,\H Cholera ftrom ", 466 Yarmouth, 21 the CeoncU of the Collegeof Surgeona,
Fonknn, clrtttlnr, eapntatloaof,SM Srareyard,
ay-Lussao,M., death of. 871
..,

HOSPITAL REPORTS:"
Vorednfer,ampntatlonof the,216 Gregory'sEdition of Relonenhach,451 St. Bartholomew's. 5, 18, 77, 116, 105, 214, ,M.., National, the General Meeting of,
Foroign body In the intestine,104 Guaidians, West Derby Board of,110 255, 276. 366, 884.437 260
Fonnatton of a new noie. 154 Ouggenbahl,Dr., 890 Centml London Ophthalmic Hoepital, 278 .M...MM.M MM., of Medicine,Burgoqr,
FonndUngt and orphans,42 Gun-shot woQpdf, 240 Charlng-eross Hospital, 417 and Midwifery,282
Fraeturt of neck of the scapul^two ctHt of, cotton, 20 Guy'n Hospital, 195. 215,136, 256, 814, 386 ^ the Nationai,.MemorIal of,891
,M..-
fhot wound, fztiMtlon of a ball ftom Klag'sCollegeHospital,116.154. 195,215, Instruction, clinical, 230
"M ... M..M .-
the ipine,ealenhit origieatlng
lo" tha bladder,265 237. 277, 296, 313. 868,385,416, 438,449 .M.M at Edinburgh, 197 M

M..M.M....M the upper partof the oa-femodif Qi^tta percha,19 Leeds General Infirmary, 37 .M...M , mUitary medical,385
205 bougies,418 London Hoeplta), 5, 56, 153, 336,439,450 Insult added to abuse, 428
Fnetaredrtb^-haBinatuxli^
439 aud poyliteal
anaur- North Staflbrd Infirmary, 6, 196 Insurance ofllces, 170
Fractures,SI 7 ,
ism, 11 Royal Frse Hosptul,4w Intermeuts Bill,MetropoUtaa,870
Fragmtna and mollitiesoetiuin, ease ef,8M solesforchilUaliis, 110 St. George'sHospital, 216, 237,336, 868 Interment,extramural,220
Fnnc^k 6, 18, 57, 77,99, 117,197,156, 177, duy's Hospital. 846 UniversityCollegeHospital,215,2S8,255, Interments,Government scheme for,310
196, 116, 256. 296, 314, 853, 418,490,468 biennial dinner,206
,
294, 867 metropolitan, 301 ,

^... medical sUtlstles of,217 Western Dispensary, 296 Internal use ofchlorofurm, 157
Fnii^ln, Sir John, 169 H. Hospitals, 76 Intestine,foreignbody In the,104
iianklfaiV 81r John,expedition, 48, 157 Habitations of the poor, 455 and medical ehariticaof Dublin, Introductory Lecture
.......M
at the St. Geoife^
Fiaoer,Dr., Report of cholera at sea, In thf Habits,filthy, of the poor, 210 118 Medical School,69
*'
59th Regiment, on hoard Ii.M.8. Apollo, Hasmaturla,489 ......w.....,., tha London, and the Timce," Intus-sutcepUon, case of,204
486 Hcmometers, 99 9 Invertebrated animala,organs of sease ia,
Fieiieheaf4, Indian hemp la,137 Hcmonhage into the bladdty,dsoth tfvn, of Paris.42,82,181,456 57
"^M.". Institute, the,12 316 Hot-blast furnace, 19 Involuntaryseminal discharges aad the die-
Freeh-water plants, iodine In,819 , from uterine polypus,279 Human hybernatioo, or trance,observations orders sttendlagthem, researches on, ]5S
r^
Function,new, of the spleen,458 Hs^moirhaglc diathesis, 449 on, 351 Iodide of potassium la enlarged bmaa
Functions of the pneumo-gastric nerrea , 80 Halifax Union. 49 Humerus, abscees In tha. 3"8 patellae. MS
Fund, the British MedicJ, 261, 262 HaU, Apotbecarlee', Hceatlatea admitted, dislocation of the head of, Iodides of mercury, 30
................

M..M, soperannuattoQ.and the ynioq |i"- 12.49, 70. 90, 148, 190,209,280, 949, 269, downwards, 238 Iodine,assimilation of,by plants,385
geons, 100 389,810.346,862, 877,884,410,480,445, Hungsry, surgery of the late war in,76, 115 In tttth water plants,319
...M....

Funds of 8t Thomas's Hospital,Of 461 Hunter, John, 150 inieetioas, aacitescured by,19
....M...

Fungoid and anfmalcnla theoiieiof epldemia HaU, Dr.,on cholera, 11 Hunterian Oration,ill, 139, 165,180 tincture of,138
cholera. 298 Hand, lacerationof the,158 Hybernationof anlnuls, 128 Ireland, 8, 19. 88, 58, 78, 90, 118, 178, 196,
.M." disease,eoogealtal,
...... of 47"V4a and Hanwell Lunatic Asylum. 165,189 Hydatid cj%tof the liver, suppuration
^
of a, : 218, 257, 29t, 317, 369, 419, 452, 468
Isohrjrmal glands,868 216 264 district lunatic asylums In,300
Ham-l(p. .M....M.,
Fungus eareu, 460 opemtlMi fbr,452 Hydrocele,radicalcure of,by novel siethods, Medical Charitlea BiU for.322, 890
M..
,

m,vtMM. hsematodcfi99 Hfxvelaa Societyof Sdinburgh,|ha, 837 Iridic atresia, operationfor drillingthe
fvni"Qe, M-blaal,19 Harvey, Mr., ou the treatment of perfora- tion unusually large,with soiotal
............... lens. 237
of the miunbnna tympaul to qnara- heinhi,867 Irish Academy, the Royal,178
a. Which contained sparmatoaoa, medical chariUes, 39,78
tion,135 .......;......., .M....

CWDUe iiMd In h"m"rrh"gehc9\ t)" hiad- Hasting,Dr.,a leltaiftma,9H 58 medicine in America, 317
M.M..

Head, a Uow on, concussionfoUawtiuL )lt HydioB^phalaa, tappli"in, 179 university new, 846
M.....

D.K8 of the fbmnr, excision af the,97 treatment

...""
of,156 Irritability, muscular, changca In after
- "

hearts molton anwUd

, hy. 805 Hesltb,Board of,58, ISO Hydmciinif acid in burn*. |8 8"0
influence of, la Mralysfd and iU laspacten,21 Hydrophobia,the allegedcase at of muscular flbm, the.836 .M
,
,....",i.M.
to f
of the couniifla tha ai^rtfrtuQlng
.........
head, in Yorkshire, 41
^".".^M.L mtdloal,llf SMcmber, 167 snioldaftom dmd of,17Q
.............M..O

Hygiene,public,11 Jackson, Mr., on the sploea, 307

QalvigCoWthe.8.9^ ^,M Landoa duiiaftha l||t 824
ljtmmlb% 310, 34S
Gangrene of the lung,119 Hyglane,BubUc.-"Oa drahtage. h Itafllkcts Jacksonlan priaee,
w"^t"*:i.. pulmonanr, "nd phthali,
171 "''ioi'Si'iVi'iMrii? iVi'iW, 139,'209! a29| the health,wealth, and morality of so- Jaw, tower,dIaartteuUtion of the lefttq"4^
vamian process, 157 249. 268, 889; 809, 328, 845, 361,377,398, dity. No. IV. Country ditches acting of,405
Gases, on a atw pronsst laralos" Old r" system of dminJng lands" tumour of the,369, 437
j of,by Frofbssor 409,429.444;461.471 M,

Gnilu|m,4 ..,"....."
Paris, "7 loot apptovad modem methods^Surthoe Jenner, Dr., on typhusfsver,107. 146 '

"wtviMuHqaafhetlon of,468 :. the soldier" highlanddresa, 69 drainage Af^ thorough drainage 00m- tvnhoidfceer. .".

"M.MM., on the poisonous, of Taultg and ......."^.

Towns Bill,170 pared" Coaitructloa of drains Villa relapsing fever,
" and febfflci^ |w." ^
eemeteitos, 818 Healy,Dr.. death of,894 had cottage gfoapda Importance of 113,135. 233, 433
^^

Gastio"ateme, opeisalloB o^ i% Heart, dlse8sed.400 proper dramage, 188 Dr.. on the umxhBate eaai9 "f
"..""".".

i^-lASsae, M.. 156, 440 Hypertrophy of prepuce aad imotuai, ivlth albuminous urine and dropsy,and oathe
...... on the eflbctsof pneumo-thoiax
^,
on
Gasette,the pulBng,441 thesoundsof the,88 phyamiu,216 pathologyof the renal Uood veasela la
aelaCfase,] 77 diseases of the,214 of tht tiuramsglaad,causing Brlght's disease,184
^^^t fatty ....M M

General Lyl"g-inHoepltal,
L: 150 .mechanism of the valves of the, SA laryngismus atridalaa and death, 98 Joint, knee, diseese of the, 215
"Mm*,., meenqg of the gnduatai of the narrowingef the rightside of;179 Hy"toiia" a naw form of,446 shoulder,excision of the, 277
.M.M.,

tmlTersIty of London, 168 Wardrop on the, 823 obseivatV"ai oa "Qma reoMikable

M,.MM.M., Journal, Provincial,last words of.404
,

^*^^.^^.^^^, the, of the National In- Heart's motion arrestedby galvanlsia, 885 cases of,047 JoDTnalism,medical, and Mr. Wakley,388
stltnte,26 403
Heat, loss of,in cholera.319
.MM.*... piactUlonfia, btoorporation of the. Hemp. Indian, in a Freoch caf5,187 Identityof malic and sorMe acids, 317 Jdoe, paaemotlc.Dr. Bernard oa, 257
In the Collegeof Physicians, 306 Hen, Dr. Cormaek's,49 Xdiotf, asylum for,69. 243, 250, 346
In medicine,surgery, Herbarium of the United Slates Ej(ploriag and cretins, 886 K.
.MM..M-.~..~...,^,..""
and midwifery,to the, 208 lUustratloBs of the defectivestateof law of Keal, Dr., oa hypertrophy of the thymns
Expedition,190
the. and Mt. they, 268 lunacy,with suggestions for its amead- gland,cauainglarjugtsmus stridulus(and
^^^^^ ^^, Hereditary insanity, 30 ^^

t........,.....^...........,
of the United King- dom, Hernia,diagnosis of,816 ment, 12^ death, 98
Impermeable stricture,419 KensingtonDispensary, 89
to the,223 ..,femoralt318
tamaaJioipital, 180 in a corpulent
......... woman, 449 Important ease. Hyett 9. the guardianaof Kidney,structure of the, 119
the Cheltenham union, S30 tumour in the, 178
M.M.M.... universities, 187 .........obturation, absceas in the th{gh
Gcfomay, 137 simulating, 287, 277 to the medical proftsslon,
.MM. 170 Khig's CollegeHospUal,70, 110, 150, lOA
of
OImpqIo. Frofbssor. 70 M.......
of the avarica abaeaca of thf Imparliios oX chloxoform and mode
"
80.862.894
Giimd thymus, hyj "phy of th""causing uterus, 3^7 purificatloa, the,218 KnMolnt,diaeaseor.437
laiyngismnsstridulus I a"d death,98 M..-."., atmngulatedfcmonl. 116 ImperialSocietyof Physlcianaof Viaaa% auUfuant diiease of t^ ,

Glanders,298 ,....;....inguinal, casca aimulat- 410 215

tn the human hefaig, 880 ing,295 Incision, subcnUaeous. 459 Knot, Gordian,cut,807
^"^^^ of (be generalpncUtloaars
Glands,enlarged, remoral af, ffom the .^..."....,.......M..."M, vitUn tha abdomen, Incorporation
in the CoUega ofPhysicians, .396 L.
MiUlWl55
M....^ of the teid,eutaneoui^oa the strue- ventral,with raptuia of the Ala- ladiaa hemp la a French caf6.137 Laceration of the hand-onlargemeat of Hk^
ture of,838 814 facta!neuralgia, 157 meUcarpalbones, 153
GlasgowInfirmary, 108 ehragm,
Its to medical lafermers, 280
2M
Inlhnt,synoTitlsla an, 224 Lachrymal gland snd eyelids,congeaital
Gleet and itstreatment,on, 440 Hip, dlsloeatiooof,into the obturator fora- men, traosmisaioa of syphilis
M.M..M,
flromtha,to fungoiddisease of,368
Gbick,Dr.,suntiy of the lau war In Hun- 439 its nurse. 385 "Laacet," the. and the Fellowa of Ualvee-
InfsntUe paralysis. 198 sityCollege, 261
Hippuricacid in the Uood, 177
Infidelity and studens, 147 the medical ethiee of the, 355
viyoerme, 17 HomoeopathicsUtUtics, 286,249, 267 ,

Golden flayUnt,210 Homoeopathy in Austria,138 tafirmary, Glasgow,103 tergiversation of,160 , ^ ^^_

Oonenhcea, can It produce syphilis t 818 atpeet of,201 ..: Torbay,46 and UniversityCollege, tha,221
, present
., ...M

and articular rheu* remarks on, 349 laflammatloo,new treatment of,816 Lancet's" balloting "
paper, 44^
M.M,"M"""., arthritis, M. .."....,
Professor Paget's Lectures last shift,242
matUm, diagnosisbetween, 180 Honours,cholera, 18 M..MM ..."""i
56
taorrhceal tubercular, 296 ...- ..fatBordeaux,815
MM.. ......
on, at the Collegeof Surgeons.389 Large hernial protrusion,
Gordlan knot cut,807 medical,177 Inflanuaatoxy eruptionsof the cervixuteri, nsevus, 255
Laryoglsmus stridulus, 279
Gorenunent scheme for interments, 810 M.
naval and military asedical, 139 280
Influenceof galvaaiamIn paralysed muae)es, Law of mortality inphthiais, 19
Graduates,London, meetingof,188 Horses, the veoefeal disease amongat, 318
of London Unirerslty, Hospital IQ Laws of England e. the Council of tbp Col-
"MM..""M"M,pxiYllages asslstaoce,257
Devon and Exeter, 49 pregnancy oa phthisis. 318

,
on ,
tha dlAislon of
.
.M..

.M
,

General Lying-la,150 lagulaal hernia,cases simulatiDg,

M.....M.

2 95 in LeafTdetecSSnof/
water or other fluldi*

Uoulda, 10 strangulated. 276 67

Guy's,346 ...M.M. M......

enuiyiagteatlmoabl,90 M....
biennial dinaar,206
M. "
lagiovlag of the toe-nail, on, 195 LEADERS:"
GzBvere, Dr.,discoverf 199 Irjuiyto the skuU,"trephining, 336 The Editor te his readers,8
M, King's College,19 . ,, , _

Times" and the London Hospital,

,
"

7, Sir Gaorge,aoawer of tha Council to, the London, 190 Iimervation of the lymphatics, the,49 The "
r
laquest,the late,at UniversityCollage, The uesent aspeotof medical afrsirs,21
,
London Fever, 150,180
M.,
443 The Board of health and lu inspectors, ti
............ Deputationto, 188, 840 ...,..."..,.
MIddleeex, 309
the OenutatlaB firoot the Inquests, coroners, 167 ShaU the metropolis be drained i 22
""".".^..."..,..", National, for Cblldioa, 241
The water qneetion, 23
Fravlaelsl Association to, 358 M,
naval, Plymoath, 109 Insane,urluarysecret loa of,439
Insaaityafter chloroform,26 The fbllovahlp ef the CoUigo of Suigaoaii
".M""M....MM...""M, Deputation to, from the ....MM...., Seaman's,250
mMIo aartlngat HiMove^squaro- rooms, Soothem and Toxteth,Liycrpool,"M.^,-.., hereditary, SO 40
M.M....M.,
150 M"M."".*I, ttniporaiy,
I ia eriniaole"ti, 14 Temporary lafaatty ig orimlaaloans, 41
 IV INDEX.

The tllMed eaat of hydrophobiaat Qooeac- The Collegeof Surgeons and the proposed of the gas" Its chemical characters Lung, gaonene of the,119
llMid.ToTkthlr",41 new measure, 854 Affinity fbr water" Action on litmus Lungs, atelectasis of,489

perties
"

HospitalsIn Paris. 4S, 8t The memorial of the Sooletyof Apothe-

caries, paper, ammonia, metals, and metallic .M...... erysipelasof,21
Sir John FranUln^s expedition,ii, 157 355 oxides" Liquid muriatic acid, composi-
tions mud in the. 119
What are the MetropolitanCommissioners The medical
ethics (7) of the Lancet," " of the several varieties of, as Davy's. Lymph, preservation of, 227,267,809
of Sewers doingt 44 355 Graham's, Dalton's" Physicalproperties M , vaodne, on
the preservation of the,
The "
Edinburgh aeTlew"and the medical The retirement of Mr. Amott from Univer-
sity of the liquidadd" Ure's table of density
proresslon, 44 College, 356 and per-centage composition Dalton's Lymphatics,the innervation of the, 40
"

Foundlingsand oiphans, 41 The Societyof Apothecaries,870 teble ofboUlng-points,132

What must the Collegedo 1 59 MetropolitanInterments Bill,
370 Lecture XV." Chemical properties of murl- M.
Mr. Sjme on medical reform, 60 The Flemish twins, 871 atie acid; iU affinityfor water; lu ac-
tion Madhouse, sin'gular inddent in a, 44
Abuses in priratelunatie asylums-RIdgwaj The medical staff of the new Colney"Hatch on the ammonia
vapour of
; on Madness, use of long continned baths In,57
Lunatic Asylum, 371 litmus
paper; earthy carbonstes ;
on Malady, an irreligious, 155
Water for London, 62 Death of M. Gay-Lussac, 371 on metals;on metallio oxides; on oxy- Malgaigne,M., election of, 256
Medioal reform,80 Medical Journalism and Mr. Wakley, 388 aclds ; on Ink ; on the metalloids" Malic and sorbic acids,identityof,317
Registntlonof deaths, 80 The professorship of anatomy in University action of the add on organiccompounds Malignantdisease of the bladder,
" 86
Classicsat the Collegeof Surgeons,81 CollegeHospital, 389 sugsr ; on woody matters
on ; on albumen; M............M .9. knee joiot, 215
Union Suriteons and the Superannaation College of Surgeons ProfessorFaget'sLec-
- tures on dead mucous membrane ; its ing
disinfect- M.M ovariea,126
Fund, 100 on inflammation, 889 and antiseptic properties" Tests for .M....M M..and rectum,
Mr. Sjme on medical reform,101 Mr. Wakley'sretirement from Parliament, the liquid add ; their reipeetive delicacies 86
The practice of pharmacy by generalprac- 390 and fallaciea"QuantiUtive determination tumour, removal of, 215
...... .........

tttfonen, 101 The University of St Andrews, 390 of the add in pure and mixed liquids- in the situation of tha
To oar readers, 120 Dr. Gaggenbubl, 390 Chemical effbcts of the acid on the body parotidgland,removal of,417
;
The replyof the College of Surgeons,120 Medical Charities'Bill for Ireland, 390 Malyn, Mr., death of,210
poet-mortem appearances Antldotee" "

Professionalnationality, 120 Medical Journalismand Mr. Wakley, 403 Modes of detectingthe acid in organic Mamma, sdrrhous dlsesse of,215
The coroner*s court, ISO The last words of the " Provincial Journal," liquids ; in the contents of the stomach, Mammary abscess, 104
Poor-law medical offloers, 139 40i urine,ftc Fallades to be encoantered"
" enlargement,154
The Hunterian oration,139 Royal Medlco-Chirurgical Society, 405 Detection of It In solid substanoes, 251 Manchester Committee on Medical Reform,
The Aberdeen Colleges,140 Memorial from Brighton,405 Lecture XVI." Detection ofchlorldes In the 66, 203
Order of the Bath and naral and military The Medlco-Chlrurgical Societyand the urine ; Orfilla's experiments thereon" Manganese In chlorosis,
purities
Im- 319
medical officers, 140 speculum uteri,422 contained in muriatic add, and Mania,puerperal"Ita nature and treatment.
The regulations of the Collegeof Surgeons, Statistics of medical reform, 422 modes of detecting them" Sulphurous
ProposedSocietyfor investigating the his-
tory add. Pelletier's test,GIrardln's, Heints's, Maple Durham water scheme, 29
-

The Royal Medical and Chlrurgical Society of epidemics, 428 Waokenroder's,Fordos', and Gells', Lem- Maijolln. M., death of,196, 239
and it^rejectedpapers. 159 Medical MiUUry Decorations, 440 bert's. Savory's"Sulphuricadd" Nitrous Mars, saffron of, 157
Tergiversstion of the " Lancet,"160 The Poor-law Medical Officers, 441 add, and other oxyoltrogenouscom- M'Cann ". Ferguson,
pounds"Free 410
Convention of Poor-law medical officers, 101 The PuffingGaxette, 441 chlorine Iodine and bro-
"
mine; Mcaure, Mr., In replyto Mr. Chubb and Dr.
The Hunterian Oration, 180 The Dr. Csntu's Miller. 47, 68
National Encouragement and Superin- tendence test for" Chloride of
The Medico-Chlrurglcal Society, 181 of Vaccination, 454 arsenio" Proportions detected by Wacken- MoDougsll, Mr., on in-growingof the toe- nail,
Parisian Hospitals"St. Louis, 181 The Vacancies In the Council of the College 195
roder, Dupasquier, Wittstein, Relnsch,
Does the Collegeof Surgeons belong to the of Surgeons,455 frc" Bichloride of Tin" Chloride of Lead researches on involuntary
....M

CouncO or the members r 182 Pablic Health. HabiUtions

" of the Poor, Chloride of iron
" Fixed salts" Organic
" seminal dischargeeand the disorders at- tending
The deputationto Sir George Orey, 188 455 matter" Modes of purifying the crude acid them, by, 152
Public meeting of the profession, 193 Parisian Hospitals, 456 "Lembert's process" Dufios', WiocUer's, Means of ascertaining the quantity and
The claim of the proposed new collegeto Disinterested Quackery, 469 Grwory's,Devergle's, 291 qnalltrof the mUk In women, 156
examine in surgery, 183 The Election to the Council of the College Letheby,Dr., on poisoningby coloured con- Mechanlcd
fectionary, leeches,description of the ap-
paratus
Sanitaryreform,200 of Surgeons,469 399 for employingthe, 86
The present aspect of homoeopathy,201 The abolition of the custom of intramural Levee, the,190 Mechanism of the valves of the heart, 20
Dissolution of tho Coniinrence,and the pro- ceedings sepulture, 469 ....^".
and the Profession, 249 Medisstinum, anterior, s crofulous abioeu
of the Collegeof Surgeons, 201 Model lodging-houses, 4T0 Liberality, Poor-htw, 129 of the, 304
The despotismof the Poor-law Board,202 Lean extreme, teetotallers, and the,288 Lioentiates admitted at Apothecaries' Hdl, Medical aiUrs,present aspect of,21
Apothecaries' Society, 219 Leberl on scrofula,376 12,49, 70, 90, 148, 190, 200, 280, 249, 269, .M...M.. Annuity and Rdisf Fund Sodety.
Xxtaanxal Interment, 220 M.. on tubercle and scrofula, 297 289, 810, 346, 861, 877,894, 410,430, 445, the National, 248
,
'Deoorations to military surgeons, 220 LECTURES :" MM
attendance In emigrationTeasels, 11
Aasssthetles In Edinburgh and London, 221 The Bakerian Lecture, on the dUTusIon of the,of the College of Physicians, .......... charltlea, 198, 258, 452
The "Lancet" and University College, 221 liquids, by Professor Graham, 10 281,287.323. Bill, the, 318
Publio meeting of the profession, 221 Lectures on the chemistryof poisons, ftc,by Life Assurance Offices and medioal men, M
for Ireland, 822, 890
Necessityfor sanitary reform,240 Dr. Letheby.31. 71,182, 251, 291 248 M....M.......M.......
of Dublin, and hospitals,
National Hospitalfor Children, 241 "M
clinical medicine, by Dr. Ligatureof femoral artery, 417 118
The "LaaeetVlast shift, 242 Parkes,2, 13,53, 94, 131, 151, 191, 271, Lightfoot, Dr. Thomas, on puerperalmania, Irish, 89, 78
'Xeetlng of the Fellows of the Collegeof Its nature and treatment, 273 .........
and ChimrgiealSodety, the Royal,
Sugeoni, 242 Hunterian Lectures,on the generation and ~. some practical servations
ob- 165,187
What must be done with! the Societyof development of the invertebrated animals, puerperalfever, 468
on by,
Apothecaries t 242 by Mr. Owen, 51, 91, 171, 231, 411 Lime juicein the treatment of scurvy, 212 and itandected
papers,159
The Asylum for Idiots, 243 The Hunterian oration by Mr. Skev, III dubs in Edinburgh,837
Lint,golden flax, 210 ...... M..
Medical charities, 258 LumleUn lectures for 1850, delivered Lip,cancer of the, 154, 277 constitution of the year 1849 In Paris,
Mr. Baron Alderson'i decision In a case of
.

at the College of Physiciansby Dr. Todd, ....,

lower, epithelial cancer of, 5 89
quackery,259 on the pathologyand treatment of de-
lirium nsBVus of the,255 M department,army. 210
The General Board of Health. 260 and coma, 311, 332, 847, 853,379, Liquids,on the dUTasion of, by Professor .M.M.... Directory, the, 148
The generalmeeting of the National Instl-
Graham, 10 fbr 1850. 128
tnte,260 On operative ophthalmlosurgery, by Mr. Listen testimonial,the. 189 M
,
the *ed names in the,188
The naval assistant-surgeons, 260 Wslton,1,272,331, 447 Lithotomy, 216, 255, 813 ethics.408, 443, 400
The prospects of a reform Bill ftom the Lectures,college, the, 169, 346, 878 Llthotrttv,the stone not found,384 (f)of the *' Lancet,"the, 855
Council of the Collegeof Surgeons,260 Lee, Dr. Robert, on the use of the speculum Liverpool, of
College Chemistryat,250 Fund, the British, 261, 262
The ** Lancet" and the FeUows of University in the diagnosis and treatment of uterine dispensaries, 103 galvanism,118
...........
CoHege, 261 diseases, 425 ." mortality in, in 1849,90 honours,177
Mesmerism and Dr. Bushnan, 261 Leeches,mechanical,description paratusLiver,presence of sugar In the. 99
of the ap- ...M Journalism and Mr. Wakley, 888,
The British Medical Fund, 261 for employingthe,86 ........ suppurationin a hydatid cyst of 408
Hints to medioal reformers, 280 L^, amputationof,450 the,264 men at inquests, 829
..........
M. Sedlllot's Plagiarism and Mr. Feignsson*s ulcer of,forty years'
...M., stsnding, 417 Livingbody,productionof sugar in the,319 .M.M......M...and life assurance offices, 248
operationfor staphyioraphy, 281 Lens,operationfor drilling, 237 Local application of chloroform, 454 ......... militarydecorations,440
The navsl assistant-surgeons, 281 Letheby,Dr.,Lecturee on the chemistryof London and Edinburgh,ansBstheties In,221 news, Edinburgh, 118
The lioentiatesof the Collegeof Physicians,
poisons,ftc. Lecture 8 ".".... Fever Hospltd, 130, 150 officers. Poor-law,139. 441
Lecture XII." Characters of the nitrates" graduates, meeting of, 188 .MM M.M.M.. ,
Convention of.
National Instituteof Medicine,Surgery,and Their solubility in water" Action upon al- kaline health of duringthe week, 11, 29, 105, 128,161
Midwifery, 282 carbonates, their taste,oryRtalUne 49,68, 89. 109, 129, 148, 168,159, 209, 229, of St. Luke's,Chelsea,180
Self-supporting dispensaries, 282 forms, tests,8rc." Delicacyand fallacies 249, 268, 289, 809,328,845,861, 377,393, profeesionand the " Edlnbunh
St. Mary'sHospitalPaddington,282 of these tests" QnantlUtive determlna- 409, 429, 4i4, 461 Review," 44
The National InsUtute, 299 of nitric acid; 1st, when In a ftee state; ^^.^. Hospital, the, 190. 425 importantto, 170
.M.............M.M......
Widows' and Orphans'Society, 301 2ndly. When combined" Pelouze's Pro- cess" Medical School. 878 .M
and the police, 190
M..M
BistiletLunatic Asylums in Ireland, 800 Nesblt's process" Rose's process- hospitab,the,and the " Thnes," 9 .M.*M.. refbrm, 12, 27. 48, 66, 80, 128, 223,
The water question, 300 Taylor'sorocess, 31 Medical Sodetiee of,80
....M.., 228, 245, 246, 268,288,808, 842, 859, 878
Metropolitaninterments, 801 Lecture XIII." Chemical eifecU of nitric ". prisons, 190
WiU the eholera return:? SOI acid on the fluids and tissueof the Living statistics of mortality
....-.., in,for 1849,2 ...M.M.M........M, Question, the,471
The studenU and Council of University body" Post-mortem appearances"Antf ......... University of,289, 346 M.....MM..........
and Mr. Bottomley.88
College, 301 dote to the poison" Metnods to be adopted , general meeting of ......M .M, Manchester,Committee on,
Cholera prevention, 320 for the detection of the acid. 1. In the graduatesof, 163 208
What must the CoUege do t 320 contents of the stomach. 2. In such or- of and the provincial
ganic M , privileges graduates, ,- medical
The doingsin the provincea, 321 liquidsas porter, vinegar,urine, 344 and surgical journal,344
Medioal CharitiesBUI for Ireland. 822 peritoneal fluid.8rc. 3. In the tissues of water lor,62. 110 M....M.. reformers, hint to,280
Establishment for genUewomenfduring Hl- the body. 4. Upon articles of clothing. Loes of heat in cholera,819 in Spain,177
"h o M.M.......
neM,322 5. In river and well waters which receive Lower lid of ^therighteye, eetropium of M.....M.......
Mr. Symeon, 60. 101
The UcentUtes of the CoUege of Phpieians, the surface drainageftom largetowns- the. 278 M.....M. School, London Hospital, 878
828 Importance of this of the in Lumleian lectures,the, 828
part inquiry a w. ....... Society,Westminster, 48
The Lumleian Lectures,823 Lunacy, Commissioners in,26, 878 Societies
sanitary pointof view, 71 .......M.
of London, SO
Wardropon the heart,823 Leeture 2CIV." Impuritiesin nitric add, defective state of the law of,with .M
staff of the New Colney-Hatch
The Collegeof Physicians, 339 their sourcee and modes of detection- suggestions for its amendment, 121 Lunatic Asylum, 371
Deputationto 8b George Grey,840 oxides of nitrogen ; muriatic add ; iodine .."....,
law of;208 stoUstles of Franoe,217
The positionof the Collegeof Physieiaai, and iodic add Lnnatio and
; sulphnrlo add ; Iron i Asylum, Hanwell, 165, 189 M..MM.. SurgicalSoolety,the Weetarn,
potash,soda, and other flxed substances; ,.-.
the medical staff of the 29
s' Courts,841 arsenic" The methods 871 " Medical
of purifyingthe new Coiney-Hatch, Times," new seriesof,420
*y 341 add, and of obtaininga pure monohy- Warwickshire,70 witnessee, 210
n'lnterments Bm, 341 diate" Hydrochlorleadd; its synon^
"........."........",
Asylums, abuses In,61
M........

and the Carontn* Ant, 10

.
_
...M.... M....M.M.M.....M...
The deputationftom the Ptovinelal Aiso- of the gaseous acid- In Ireland,
properties d" luac .........M.- district, 801 M.M..MM....M. at Inquests, refusal to az-
elationto Sir GMCfe Oiey,853 on plantsand "aimals" The physioal pro- i,Mw"t..*..M""M"M", pilvite^ 90, 127 BlBO,to avoid the pqrmnnt of te", 145
 INDEX.

Medical wItiMMet,nmiuiOTBtioii of,108 National Instituteof Medicine,

Suigery,and Operationof gastrostome, 40 and modiflcations of
spermatheoa vulva-
Iffedioln*.
Aoadcmyof, !M Midwiibry,282 for hare-Up.452
....
Female organs of seorplons : mental
develop-
"...". and politfet,
1S7 memorial of, 891 for ovarian tumours, Dr. Tilt's, pouchee of the vtvlparonsspe"rfet
....,
"-- pnetieal,pnaant t
state of,by Dr. Medical Annuity B"lief Fund ciety.
So- 207 "Coitus and ovipositionof spiders : their
Bushnao, 354 243 Tallacotlan, 195, 417 strong maternal instincts" silken and
Medieo-Chlrorgieal
Society,
the, 181, 208, Nationality,
professional,
120 Operativesurgery of Johann Friedrich Dlef- other nests -"
Developmentof germ and
405 Naval embryo earlymanifestation of the class-
appointments.SO, 49. 70, ISO, 149, fenbach, 222 :

"M """ "" (M

"""""" u" ","""" M* """ CM,
and ipeeii- 1^:9,190, 280, 249, 269, 289,829,878, 894, Ophthalmic Institution,the Royal,446 eharacter Repeated ecdysis during
lum Qteil,
4SI growth" Regenerationof partsof .spMeni
480, 445, 461 surgery, lectures on, by Mr.
Medico-legal
queetiont,
289 Naval assistant surgeons, the, 281,808,800, Walton, 1 "Orgons for secreting the material of the
MedoIIary canals of bone, anatomical Oiththalmiology, 58 nesto and webs, 2S1
elements In, 20 Naval Hospital. Plymouth, 109 Oration, the Hunterlan, 1)1, 189, 165,180 Lecture XIX." Generation of MoUuacn."
Meeting of the CtUows of the College of intelligence,100 Orchitis,chloroform in. 119 General characters of this great
group of
Soigeons,242 and military medical honours, 180 Order of the Bath and naval and military invertebrata, and of ite primary divisiona
- Oenenl.
of the graduatesof the ofllcers and the medical officers,140 and classes" Acephala tunlcata" R"l"-
Universityof London, 168 order of the Bath, 140 Organs of sense in Invertebrated animals,57 tlonsof the compound asoldlansto polypeo,
of London graduates. 188 touch, proofsthat theyonly In-form and their propagttion by gemmation aa
" .^^.
promotions,289
the MetropolitanSanitaryAssoci-
ation, of the sensation of warmth, cold, well as ova Supposed androgynous
surgeons, 169
"" ~
us "

106 of the,446 and presiinre, 78 spedes" Generative of diceelous

Navy, assistant-surgeons organa
public,of the profession,
188 atcldlse Development and
^.M...., Nasal fnsss.pecoliar disease of,280 Origlnof moles, 157 " phoses
metamor-
Members admitted at the College of Necessityfor sanitary reform, 240 Orphan Asylum, Female, 462 of asoldlans."" Alternate genen-
Surgeons,169,190, 280, 269,289, 810, 829, Neck, encystedtumour of the, 295 Orphans and foundlings. 43 tion " of viviparous^alpss" Braehlopoda
846, 877,894.410. 480, 445, 461 Neck of the scapula,two cases of fracture Osbom, Mr.,death) by takingoxalic acid,by, diceelous : their ramified teetes and ovaria
- the, of the Collegeof Surgeons,
f of the, S44 115 " LamelU branchiata" Alleged andro-
gynous
Ovarian dropsy, character of pecten" Dioecious
largetumour on the side of the, 18 potassafUsa In,229
Mombraaa tympani, treatment of perfora-
tion Ovaries, hernia of" absence of the uterus, condition the rule in lamelllbranchiate valves-Male
bi-
Necrosis, acute, 257
of,185 of the ulna,886 297 and female onans bulkybut
Membrane, false, of serous caTllles, 178 Netherlands, cholera in the,250 malignantdisease of the, 126 simple: short sperm-ductof males ; abort
Memoir of Wm. Clifl, Esq.,F.R.S.,161 Nerium oleander, 889 and rectum, malignant disease of, oviduct of females: no glandularappend-
ages
Memoslal from Brighton, 408 and no intromlttent Modifl
Nerves,pneumogastricftinctions of the,20 86 organ."
of Members of the Medical Profes-sion cations of gills to form marsupialpouchee,
""""""-
spinal, sensation of, exclusively OvarUn and uterine disease,connexion
, of,
residing at and in the neighbourhood confined to the posterior roots of,219 247 411
of RelgatetoSir George Grey, 858 119
Nervous fluid,velocity of,177 Ovariotomy,157 Oxone,
the National Institute, 891 Owen, Mr., on the generationand develop- P.
...
...^.^......
system, diseases of the. and other ment
to Sir Geo. Grey,480 aifections simulatingthem of the invertebrated animals,51 Packman, Dr.,murder of, 8S0
-
"...
during life,
" ftom the Societyof Apothecaries
-
clinical illastrations of, 265 Lecture XV." Generation of Insecto." Busi-
ness Page, Mr., on excision of the os calcis,405
to Sir George Grey, 885.858 Paget's, Professor,lecturee on infiammation
Neuralgicailectlons, chloroform In, 294 of generationIn hexapod or true" *'

Meningitis, cerebro-spinal,
Mercury, lodldee of,80
Mesmerism, Dr. Busbnan oh, 276
Metallic sponges, 6
tinklingand amphoric breathing,
.........
240 Neuralgia and rheumatism treated by cold inseete committed to four kinds of in- at the Collegeof Surgeons,S89
dividuals"males,
douches after sweating,77 females, neuters, or Palate, cleft,operationfor,87
external application of chloro-
form nurslng-femalss,and procreant virgin Pancreas, dhnppearance of,240
.............
Isrvse" Divi"ion of the dass accordingto Pancreatic Juice, Dr. Bernard on, 257
in,240
Indian hemp in filial, 157 generation characters Into
,
ametabola, Paralysedmuscles, cause of the atrophyof, -

Skoda'sriewsof.llO New anaatomoels between Aevenaportse hemlmetabola, and metabola" General 219
MeUU, therapeutic eilbct of some, 117 and the inferiorcava, 450 structure of the male organs" Chief influence of galvanism
Method of depriTing quinineof ito Utter- ....... ansesthetic agent, 90 modifications exemplified in speciesof on, 20
nesa, 440 apparatus for continued distillation,aptera, hemlptera,orthoptera,diptera, Paralysis
.....
of the bladder, 198

^"^n"polis, thediatrietsof, andthechdera, 155 lepidoptera, hymenoptera, strepelptera,

Analoiry of
cured
strychnine,
by
454
injection of solution of
....caustic, 99 neuroptera, and coleeptera"
shaU itbe drained, 22 dIsinreotant,452 the organs in their numerous and various infantile,198
";............, ,

Metropolitan Commissioners of Sewers,what form of hysteria, 446 forms and occasional bright colours to Paris,Dr., and Mr. Syme, 107
we they doing1 44 function of the spleen, 458 flowen".....Monogamy or polygamy In in- Paris,Dr., 446
Intermenu, 801, 841
................. Irish University, 846 oeeto govomed by the structure of the in-
....
Paria, health of. 57
*--..." BiU, 870 ... oflloe,
^ a. 289 tromittent
...... organ" Bxtemal outlete of hospitala.42, 82, 181,456
"....
...polloe,l70 mode of curing retrorerslon of the sperm-ducte remote fhmi that of the medical constitution of the year
Mieroseopicexamination of hnman urine, uterus, 177 veslcnisesemlnales and from the penisin 1849 in, 89
pereusslon, 57 the dragon-fly" General charaotffs of the Parkes', Dr., lectures on clinical medidne,
pathology, 298 deafness, 176 female orcans ; exceptional simplicity of lecture II.,18
...............
treating
Middletez County Asylum. 146 testingsugar, 286 those of the procreant larval strepelpteraLecture III." Hypertrophy and dilatation(tf
Hospital,110,800,446 and aphides" Chief modiflcations of the the left ventricle ; mitral regurgitation
:-r- -
nose, formation of a, 154 .....
;
MIdwiftoy, 80 Newport Pagnel, Asiatic cholera at,1888, female organs Uluitrated by parallel stances aorticobstruction ; slight
In- aorno regurgitar
M.M....M.M. anscsthotitsin,219 succinct history of,174 to those of the malea. Modifica-
tions tion ; dilatation or sacculationof aaoending
Militaryappointments,280, 269, 289,829, New practiceIn esses of distorted pelvis, of the vulva, and its appendages aorta, 53
862,894,480.445 418 the ovipositor and sting. Various usee and Lecture IV." Signs of aortic regurgitation ;
"....".... medical instruction, 885 preparation of potassa cum calee,86 applications
.....
of the colleterial secretion" posdble fallacies,exceptions,and occa- sional
and naval medical honours. 180 External sexual characters" Abnormal difficulties, 94
M.......M.
..... property of gases, on a, 4
surgeons, decorations to, 280 hermaphroditism, Lecture V. General summary of the signs
........... series of the ''Medical Times.'* 420 51 "

MDitla appointment,878 signof

ulceration of the cornea, 219 Lecture XVI." Generation velopment of valvular lesions ; case of aortitis and of
of I nsecto." De-
Milk, new adulteration of,878
a of the ova ; virgingeneration obstructive and regurgitant disease of tho
.....
treatmeut of external Infiammations,
Mineral vaters, 815 816 of tne aphides; ite true conditions and pulmonary valve ; alterations in the cavi- ties
Mode of action of ehlorofbrm, ether,8rc.,77 University, 488 analogies explained Supposed par- thenogenesis
" followingvalvular lesions; case of
Moles, originof, 157 Northern Dispensary,ISO of the Ptycheexplainedby general dilatation producing both ana- sarca
MolIItiesand fhigllitas osslnm,case of.804 Nose, worms in^suspeetedimposition, 265 the peculiaritiee of their impregnation" and hsemoptyds ; generalrule as to
Monstrosity, 247
festal, Novel methods, radical cure of hydrocele Various forms and appendages of the ova affection of individual cavities,131
Morbus coxaritts,
147 of insects Cocoons and other nidi- Lecture VI." Case of tubercular cachexia;
by,5 "

ofl 85 mode of 156 and

Oviparous,larviparous, of tubercle in the lungs,bron-
papiparous depodtion chial
. M....
*"..""...."".., case amputation,
Morris, Dr. Edwin, on a case of morbus Inseete" Striking
a chfld vomited
parturition" evidenne of designin the glands, peritonsenm,alimentary
coxarins of six years'standing,85 up, 177 instlncte of oviposition" Development of mucous membrane, ftc. ; consideration of
Mortality of cholera,effect of poverty on, Nutans,eclampsia, of Mr. Newnham. or the the embryo : various grades of this at other independentaifections, viz.,granular
salaam convulsions of Sir Charles Clarke, vhleh it quitethe ovum, 91 liver,and thickened pylorus,191
Lecture VII." Case of tubercular cachexia ;
...........flaw of,in phthisis, 19 287 Lecture XvII." The Metamorphoses of In-
seete."
In Liverpool in 1849,90 tubercles depositedto all appearancepri- marily
......... O. Entomologicaldefinitions of the
London, statistics of,for 1849, 2 coarctate. obtected. Incomplete,semi- in the mesenteric glands, and on
............. Obituary,18. 80. 49, 70, 90, 100, 149,169,
table,12. 29, 49,89, 180,148,209, the peritonssum, then in the lungs, tho
^.. 190, 210, 249. 269, 289, 829, 862,878,891, complete,and complete modlficatious"
180, 269, 289, 810, 889, 846, 861,877,698, The larva,vermllava, homomorphous and intestinal mucous membrane, the liver,
430, 445, 462, 479
409,450.445,461,471 Obsecvatlons on the recent opidemie cho- lera, heteromorphouslarvss- The pupa, mu- kidney.Sec, 8cc. ; laryngealand epiglottl-
Mortifleation ot the feet flram cold, 298 mise, chrjrsallsor aurella, The dean ulceration,271
by Mr. Ross, 55 nymph"
Moeeley v. Houghton. 70 some remarkable cases of imago" The true character of these de- fined Lecture VIII." Diagnosisof typhoidfever;
Mountain in labour, chemical and phydcal characters of the
the,140 hysteria, 407 stagesand varieties" Metamorphosis
Madin the lungs,119 trance or human tion,
hyberna- a course of development alike in ite es-sentials, stools considered as aids to diagnosis, 895
Mumps, epidemicof;79 851,401,416 with its stages varied as to tiuM Lecture IX." Idiopathicenlargementof the
Monlfleent bequests, 894 Obstetric practice, chloroform In,297 and place: all insects at firstvermiform : spleen; presence of an unusual number
Murder, another case of,by causingabortion. Obstinate irritability of the bladder, 166 larvsl types of entoxoa, earth-worms, of white corpuscles in the blood ; chemical
880 Obturator foramen, disloeation of the hip nerelds,myriapods,and crabs" metamor- and microscopic examination of the blood,
M...M..
of Dr. Packman, 880 into,439 phoeisand developmentof organs In lepi- doptera"chemical examination of the urine, ftc,
influence of galvanism
Muscles,paralysed, Economy of social hymenoptera. 481
hernia,abscess in the thigh,sim- ulating,
00,20 237 and of the iehneumones and
parasitic Parliament,Mr. Wakley's retirement txom,
MuseaUr fibre,the irritablUtv of,888 Occurrenceextraordinary, 829 strepelptera"Reproductionof parte : Mr. 890
fibres (unstriped)lnthe Parochial Uberality,480
......... coats of singular, before a coroner, 90 Newport's experiments"Comparison of
the blood-vessels,on the, 258 (Esophagus,stricture of the,142, 206 loseot-metamorphoseswith mammalian Partridge, Mr., on some cases of cancer of
after death,changes Office,a new, 289
liritabllity phasesof embryonicdevelopment,171 the skin, 865
.........

in.240 Offices,insurance, 170 LectureXVIII." 43eneratlon of Arachoida. Parturition, a novd mode of. 177
Mnseom of the Royal Collegeof Surgeons, lifeassurance, and medical men, "Characters of the dass, and of ito chief Patella,suppuration in the bursa over tho,
..........
09 248 divisions- Androgynous condition of the
N. Poor-law
Officers, medical,189, 441 lardigrada : conversion of moulted integu-
ment Patent portable suspensionstove, 149
Nsnma, 288 oonvention of, into an ovieapsnle" Testes and penis Paterson, Dr. George,70
255
laige,'"operation, of mitee" Male organs of spiders : termi-
nation Pathological elfecto fkom the use of iodide
."".., 105,444
...... on the Up,255 Oil,cod-Uver, analysisof.21 of sperm-ductsremotelyflrom the of potasdum, 157
of ttie right side of
'

100
preparations,
Narrowing _
the heart. .............. In the enhngoment of bones, veslcuIsB semlnales : transferof these saea
179 207 and the intromlttent organ to the end of society,
118
Nation^ Hospitalfor ChQdren, 241 In phthisis,87 ........ .%
the osphalic palpi"Tubular testes of scor-
pions Pathology,dental, 294
of 157
dysmenorrhcsa,
....... Institttte,the,299 substitute ftnr,
108, 198,207 .............
and their anaatomoses : short sperm-
Counea of,to the Council ............" duet and longcoecal sperm-sacs : paplUI- 298
microeoopic,
.................. why should it bo the only ,

of the Coilegoof Surgeons,162 remedy in consumption? 108 form penis: pectinate appendages"Ovarta Pelvia,distorted,new In
practioe eaioi of,
the Geneal Meeting of, Oleander,nerium, 889 and oviducts of mItee and phalaitflas" 418
.. ............

OptntionforeleftpaUta,87 Long oraria and short oviduoto of sputen : Ponis,eaaoer of,195

 VI INDEX.

PunlSf cardiMniiA of tlMt 866 Pregnant women, the chlorosisof,156 Registration of deaths,80 diseases of that bone, as a substitute for
and MMftui, dephutlMli of the, "61
.........
Premature birth,188,288 Renlatieai ef the Collegeof Simoom, 141 ampotatloa of the i"ot (with a case),by
......... wmrtf diMMo of fke, Sl" Ifresence of sugar In the liver,88 Rolchoobach,Gregory'sedition of,431 WIDIam Bousfleld Pago,Esq.,surgeon to
POBIMll,Mr., OMO of of
flllCtlUO thO XOOtlUB, Presentation of plate to Thos. 8. Fletcher, Refgate, memorial of members of the medl- the Cumberland InOrmary, 403
606 Esq.,Bromsffrove, 229 od profrssiop of, 338 A ease of atriotura of the reelum. wberelB .

PoBMnoo, ehoteio In, M Preservation of the brain, 137 Relation of true medicine to Empiricalsys- tems, an artificial anus was sueoesafrilly est"-
PcnoMiOB, now aodoof, 6T lymph, 827, 843,267,368 428 blishod in the left lumbar region, with re-
marks,
death in utero, 88 Remarka the health ef London during by Croker Pennell,Esq..licentiate
Poilbmtliigttlcor of tbo ttoniMh, eaao of, Presumed on
443 Prevention of eholora, 820 tho last alx months, ending the 30th of of tho ihonltyof modiolne of Rio do Ja- neiro;
March, 824 M.B. M.R.C.S.B.
Pwftntkm of tlM memtooM tymiMal by Prevost, M., death of. 297 LoDd., ; formei)y
opoxotioM, on tho treolmont of,ISi Prisons, the London, 190 Romarks on homosopalhy,349 lecturer on anatomy and physiology at the
of the "tomack,398 Warwickshire,70 Remedies, aisenlcal, 870 Weetmlnster HospitalSchool of Mediolno.
PeciottMtio, acnte, trootment of,33, 73,9$ Private asylums, 147 for psoriasis, 389 405
dmolotod, 19 lunatic asylums, 90, 127 Removal of adtpose tumour, 3 Ob the UM of the apcenlnm in tho diagnosis
...... .M

PoilBool alMCMi toafBting Into tho Mrotum, abuses in, 61

*- M
ef a fattytumour, 368 and treatment of uterine diseases,by
,
!"" Priie for the discover^of an artifleial mode of a malignanttumour, 215 Robert Lee, M.D., P.R.S.,to. 425
,

............ Indtkn, tMatment of ttiktiuo by, of preparingquinine,120 in thosltiia- Supplement to a paper on fibrocaloereoua
116 Priae,tho temperance, 267 tion of the parotidgland,417 tumours, aad polypi of the uterus, bf
....M...... ieetlon, tveolmont of "tiieturo of ,
an unlucky, 177 of an ovum under theinfluenoo of Robert Lee. M.B.,P.R.S., ftc., 426
thonwthraby.SSl, 834 Prices,Jacksonian,810,346 chlorofoim,144 On Fungus Cerebri. By G. Lowe,M. R.C.S.,
Ponmbneo, jrdlowIbTor in, 346 Process, Oannal's, 157 Remunecatlon of medleal wllnsesea, 103
Pinte, tieiOineBt of choloittin,99 Production of sugar In the livingbody, on Renal anomaly,88 Royal Soeiety, 10
PMMoB from tbo floSeral pnctitlonen of the, 819 M artory,anomaly of a, 239 Syio"BgyptlanBooletar,47
Eoi0Oto,S4t Prolbsaion the,and tho leveo. 240 Replies to Mr. Braid,queriesrsfardlag the Westminster Medical Sooiety, 86, 46, 47, 63,
FhonBOoopaio, addenda to, 866 medical,important
M to, 170 Pakeer who burled himself attvo at hore
La- 86, 104, 136,144,
' "" 204."
2M, 246, 263, '
286,
'^

Phfiiey, waetioe of, by ^mieral pmo" publicmooting o( 133 in 1337,852 805,406

r
tMovofo, 101 ProlbseloBal nationality, 120 Reply of the Collegeof Surgoons,120 Insanityafter nse of ehlerslMm. areua seiil"
Phoifhato of aauBonla,on the,In gout and Progressof typhus,187 Report of cholera at asa. in 59th Regiment, lis,hen's oggs united like the SiamoM
*oamatlan,4#7 Promotions,naval, 288 on board H.M.S. Apsllo.
436 twins, uterine searlflcatora,
contagionof
PhlhMe" ood-llvoroU in,87 Proeft that It Is only the organs of touch Srey,204
of the deputationto Sir O. choloaa, epilepsyand puerperal oonvul*
^ ^
...M.
tninence
.......
of nngnancy on, 813 which inform
the sensations of us of 417
of the Nadeoal Vaecine Sooiety. slons,26
.............
lav of mortaUty In, 19 warmth, cold, and proasure, 78 Hospital, 5, 18,37 Tuberaular diaease of the hmg' hernia,46
and pulmonary gangrene, 178 Propertyof gases, on a new, 4 upon in Berihh 133
prostitution Psriaeal abseess, 47
Phymotia, with hypertrophyof prepuee and Proposed society for investigating tho hla- REPORTS OP SOCIBTIRS :-- Cases and observattons upon the treatment
"orotum, 316 Medleal Saeletyof ionden : of some primary venereal uleers,not
toy of epidemlea,423
Phyiidana, CoUego of, 188, StS. 817,388 Prospeetsof a rsfbras bill from the Council ThsMoaaope 1 awaiui^ii ewedbyoiyalpeias, curable by asorcury, 63
(tnooffperaHonef th* of the Collogoof Surgeons, 260 47 New peepaiatlon of eQi|iealoe, 86
"
potassa
gepml fflMtitioBOVB tn tho, 318 Prostitution in BerUn, reports unon, 198 MioroseopkalSMieti, 847 Malignantdiaease ef the ovariee aad reetum^
Neentlalot of the, Provident,or setfeupportingmapensailes, Royal Institution. 87,186 86
331,237,307 386,343 Royal Medical and OhlniTgleal Soelaty, 64 Bone in the longitudinal stnna^86
, In^oilal ioelaty of,of Yknna, Prevlnoes,doingsIn the, 821 Twooases ef sompleteInteeiinalobstruction, Malignantdiaeaee ef the bladder, 86
410 Provincial ooUegee,the, 78 arising ttom disease of the sigmoidflexure Caries of the head of tho Ibmur, 104
...^.."....... the pealttaiof tho CoUige of, Journal,last wordo of,404 of the colon and the reetum. la which the Fibroua tomour of the ntorua, 104
340 Medioel and Surgleal
'

impending oeion was auocesafolUr opened Foreign body in the intmHae "fleealflatola,
Phyilriiiil of the allBMntaiy eanal, Dr. Hon. 'the,346, 454 in the loin, by Piederiek FleM and Josiah 134
Brinton on, 127 Prus,M., death of.tt Clarkson,Esqrs.,84 Maaamary abssses, 104
POeher, Mr., and the OoumU of the Onljifi PubUe health,463 Case af etrtetnw of oaeophagna,ihtal two Fibrous tumour of the uterus, 126
ef luiyeont. 471 and three months after accidentallyMaUgnant disease ef the ovaries, 126
hygiene,11 yean
Pineott,Ifr.Vease of cuppoted aheeeee ef the diainaga,as It swallowingsoap-lees, by W. R. Baaham, Treatment of stricture by the perinealMe-"
fpleen,by, 211 wealth, and moraUty of seolety, ^
M.D., Physicianto the Wmtmlaatar pital, tion,126
Hos-
Piorry,M., on the ewiae of tetaialtteBt 48,ltt 142 AndUor'a npeit. Iff
fovera,57 meellBg of the imlbwioa, 881 A case of stilsturaof the Boala^laa tube, Candidates for oflloo, 127
Plaeente Prvria,ease of,413, 461 fuerpoialooavulslons, ehloroMra Is^ 888 and the appsannees preaenledea a mortem The union af the medlsol eeeletles,
post- 187
PlegiarUm, M. lodlUQt-t and Mr. lorgua^ .......MM...., some piaotioalohaervatlona on, examination: to which am added Miacarriage, ^lemevai of the ovum \
Ml"i opvatlon Ibr ataphylonvhy,881 some observatiena en thi* use af the the infiuence of chlorolbrm, 144
Plan adoptedto prevent Uie spreadef of dlsoaaee of the Eketion ef e31een, 144
typhne, " fcver,462
..M... otoscope in tho disgnosts
.".......M...manis^ Ua ear, by Joeoph Toy oboe. P.R.8.. Senior Synovitis In an infant. 224
Plantt,aarimilation of iodine to, 88ft 873 Surgeon to the St. Oosoge'aand 8t.James' Delirium tremens, 833
..........tmA water, leidlnoIn. 819 Puling gaeetto,the, 441 Gtaeral Dlspoasaiy, 143 Death firom hmmeirhage late the biaddir"
Plyventh JUval Ro"ttal, 168 Puncture of the bladder from the rectwn, Chemical nsearehes on the naloM and eauae 246
Pneiiww geelHe nervea, fUnotlova of the, 88 417 ef eholora,by Robert Duodaa Theowea. Foetal monatroalty, 247
P"BOM"4horu, on the eAete of, on the Pnnotnied cheet,836 M.D.. Glasgow,85 Connexion of uterine a
sounds of tho heart, 39 PupU, artliclal,by aepanilleB, 878 On the proxkaatecause of albttmlaous urine 247
PneMsenla, 831 Psoriasis, remedks Ibr, 338 and|dropsy,and on the pathology of the renal Worms in the nose, suspeetedimpeeill"tr
"...~... eatanhal, 453
, OB the treatment
, of, 468 bleodveeeela In Biighrs diseaee,by George 265
"M from eod liver oO, 78 Johnson, M.D., assistant phyaioian to Fnolnre of the upper partof the es femeris,
..."."....."....., the etethoaoopo In, 370 King'sCoUege Hospital,184 265
Poison, snppeeed death ftoin, 170 Ouaekery, Baron Alderson'a deelslon In a Anniversary meeting,March 1, 1850, 186 Clinical illaatration of diseases of the ner- vous
Psisenbgl7 bitter al"onds, 79 oaae of,859 On fattydiseme sf the heart, by Riohard system, and ef other albotlons simu- lating
by ooloBfod oonlbetionery, with a heavy blow i"ataat,
,
210 Quain, M.D., assistant physicianto the them durina life, 265
Ea,byDr. Letheby,399 Queen ". Clndernr, 69 hospitalfor consumption,224 On the entranoo of al r by the open moutha of
with elno,418 Qosen's OoUsfe,Birmingham, 394 The late expulsionef a fellaw, 264
*
the uterine vessels considered aa a eauae el
" gases of vanlta and ewnereilsa,Quoenshoad. Yorkshire,the allegedease of A ease ef auppnntion in a hydatidcyst of danger and death after paituritien, 233
on the, 3i3 the ttvor,In which
hydrophobiaat, 41 the abacoss opened On the eclampsianutans of Mr. NowBhaa^
PolMroxpodltlen, the,166 "loeen*s Hospital, n"rmfa"iifc"iw^ 70 through the lungs,and one in which hy"l*- or the salaam convulsion ef Sir Chadea
PoMbs and the medleal nwibosien,188 doerles,repte to Mr. Braid's,regarding tids were B. Clarke, 287
oxpoelemtod, by ThonuM
..."...., "aetrupoMtan. lit the Pakeer who buried himself aUve at Peaeock,M.D., 264 The prmumod f^ueacy of uleeratioa of tiha
Pailtteeaisdmodlelno,lS7 Lahore, in 1837, 352 A ease of gunshot wound, and subsequent OS and eervix uteri, 806
Paiyteehjilo Institution, tho Royal, 88 Question,the fellowship. 381 extmctlon of a bullet from the Uadder, by Diseased heart, 406
Poor,iUthyhabNs of the,210 the water, 23, 300
,
R. M. Maophorson, Kaq.,265 Observations on some remarkable cases of
.....UhahUotloBSof;435 Queetions,medieo-legSLl, 239 Case of scrofulous abscess of tho anterior hysteria, 407
Poa"to" Board,deepotfam of the. 888 Quinine, artlfloialmode of piaparlag, piiae seminal disohargea
mediastinum, communicating with both Researches on involuntary
............rssdieal ofloers, 138, 441 for tho discoveryof, 120 aidesef the chest, the trachea, aad pericar- dium, aad the dlaorden attendingthem, 132
convention ef,101, in favors,433
.M^^.... , ^ .M
and forming a tumour above the poat-mortom,made In theoaeea
188,181,444 OMthod of doprivii", of Itsbitter-
ness, clavicle, simulatinganeurism of the inno- ef cholera at Padua, 836
440 Resignationof Dr. Barker, 817
'

arteiT or areb of the aorta,by IX

P^Uteel aneurism and gntta pershn ben- R.
Radkal ears of hydioeeleby novel methoda,
ilan,M.D., physiclatt
Maclachlan, to the Royal Reaolutions of the Council of the Royal Ool"
Heepltal Chelsea, 304 lego of Surgeons of England, respeotlnf
Poatarlor eelomas of tho ohord, solteningof certain alteratlona deemed
CaseormoUitiesand
'
fhigllltas osslum, aeeem- neeossaty la
Roadofs, to our, 120 with nrine stronglycharged with the charters and byo-lawaef the coUega t
boninff,110 li Real and apparentdeath,316 animal matter, by William Maeinlyre, and to which thoy roqueettho sanction or
rssearohoi Recto vaginalllatula, treatment of,316 M.D., 1 the of
secretary stale for the home depei^
i at Padua, 386 Reetns, division of, by means ef Lane's Circular ulcer of the stomaeh eardlao aad ment, 348
k frieaIn ovarian dfopqr.288 knife, 413 aertie valve dlsoeae,824 Respectivevalue,on the, of lime Juice, eltrio
earn
........... ealoe, new preparation of,86 Rectum, tho potatoflbvs peekingof the, 39 A ease of very large h"matooele of tho acid,and nitrate of potash,in the trea3"
Potassium,bromide of,451 .M..... pnneturs of the bladder from,417 apormatie eord, prevlag fatal after ton ment of scurvy, 483
ledldo of. In enlarged bursa stricture of, of, 405 William Bowman, Mr. Arnott firom Univeralty
"""rw- " pa-
'^ .M ,oaao years, by F.R.S., pro-fessor Retirement of
tells,148 Reoa, Dr., on atriotuie ef the cesophagua, of physiologyIn King's College, College, the, 336
PoUto fibre packing of tho rectum, 58 206 ef the utsnu, aa a cause of
assistant-surgeon to King'sCollegeHospi- tal, Retrovorsion
Poverty,eflbstof, en tho mortaUty of oho- Reflex Amotion, diflbrenee of the, 113 and to the Royal London Ophthalmte sterility. 14
lora,210 Reform Bill,proepeots of a, firom tho Coua- Hospital,to which is added,a case of very .........^ " ,
new mode of
PracUocrof phaxmaey and the CdUege of eil of the Collogo of Bttrffoooo, 260 largehmmatocele of the tunloa vaginalis curing,177
Medical,12, 27, 46. 68, 80, 128, 223, In an old man, terminatingfatally, treatment of"
Practical application
, by
of the reduction in siao 223, 245, 243, 268, 283, 808, 342, 859, 378, Thomas Bllzard Curling,Esq.,surgeon to 2S9.
produosd by dobilltattng influonees on the 454 the London Hospital, 874 REVIEWS :"
foetus In utero, 79 and Mr. Bottomley.88 Case of disartleulatlonof tho left condyleof Sketches of the Hedleel Topoflraphy aai
...M.................
""M".".. eaasa, by Mr. Amyot, 448 Manohsater oommlttee on, the lower law,with excision of nearlythe Native Diseases of the Gulf of Oulnea"
.......M.M.M.......
Practical medicine,present state of,by Zhr. 203 left half ot the bone on aooount of a very Western Africa. By Dr. Danloll,23
Bushnan, 254 In Bpein.177 growing from Tho Use of tho Blowpipe in Analysis.By
PnctiUoners, general,and Mr. Skoy,
the
.^...M"M..M...M., laife cartilaginous tumour
...M..MM..M
Mr. SyflM on, 181
"
.,
and occupying the site of all that part of Professor Plattnor, 24
....MM., "anitaay, 208 the bone, save the oondylo and neck, by Tho Physlolane*,Sorteons*, and Osaswl
IJnpie, typhne oxasrthematlens in.290 .....MM....M....M..., nsemsltyef,848 W. R. Boanmont, Bsq.,prafsosor of sur Practitioners' Vlsitiog List,fte. for 1850,8A
J^edseseat of feonndntlon, 468 Reibrmssi, Medleal,hints to, 280 gory In the Univenity of Toronto,Canada, On Tlo Douloureux, and md other Painful All^.
Pragnaa^,albomhiuria during,848 ReAieal to examine medical witneaaes at tionsof the Nerves, ",310. By Dr. Toogood
Pregnant women, albuminuria in,177 iaijnails, to avoid the pigment of free,146 pn excision of the os ealds, In iDoomble Downing, 24
 INDEX. vu

tjnopiift of DiMMet of Um Homaa Eac By Royal yetarinaiyCeHsfs*8iO Soeialy, the Westminster Modleal.894 inmaena, ooOeiaei;Mtabenadmitted, 188,
W. Banr^y, U Westminster M^ialmklnalitattMi,
.........
the Westminster Medkal, and 8it B
. 19M80, 868,889,818,829, 848,888,877,
MuatioB aodlta I"iaordaiB" fte.By T^jiion 446 Biodie, 164 884,418^488,448,481,478
Rule for admlDlstertng ehlonfocm, 117. .........
the Widows^ and Orphans', 8 00
............................
and the piofoaedmw
OnfltamnvlDif aadttatSMtaoBt. By! Rupture of tlte uteraa, 868 Societies, medical, of London, 80
Ved., tt Soft oatttact,operation for solution of,286 M.M.......M..M Counoil eL icoaueeti of
.""*..."*,
An AddreM dollTcnd on the Oponina of the 8. Softening of the posterior columns of the a nfacmrblU from the, 880
Now Sohool of Hedldno, Surgeon'e HaU, Saflhmofmars, 157 chord, 88 ............ Piofbosor Paget'a be-
......M....M.,

BdinbuYgb,Hot. 6, 1849. With an Ap- Salaam conTuIsIons, or eelaapaia nutans, Soldier, health of the-the highlanddress,68 tmes on InAammatlen at,888
Modix. By Alexander Wood, H.D., 857 founds of the heart, on the eflbcts of pnonmo' mgulatienaoi;141
.....................
F.B.C.P.B.,Leetuvn on the Pactioo of Saline treatment of cholera, 145 thorax on the, 89 ............................ raplyof the, ISO
Medloino, ftcfte.. M Sanitarium for gentlewomen,848 Spain,medical reform in, 177 ..................... ,
statemento of;408
QaStrfetnreoftbe Urethra,and Fletula in SanitaryAssoclatloa, the DobUn, 8 Specific, a. In ehordee, 20 vaoaneiee in theoonneil
M....M.,

Perlneo. By Jamoi 8yme, P.R.C.S. 68. Sanitaryreform, 800 Speculum, abuse of,452 of the,455
Allaa of Phyiicel Geography. Conitmeted Sanitaryreform, noeessity ti,840 on the use o^ in the diagnoeia ....M
deoonttons
........ to military, 880
by AngttitnaPotermann, P.K.a.S. ; with Sarcina ventriculi,the, 179 and treatment of uterine diseaaes, 485 diploma,a, obtahMd by Ikand. 198
..............

deeerlptlTo Lottorpreii, embracing a Oene* Scalp, apparatos for fumigatingthe,Incertain Spermatocele,58 feea under the Nuisances
....M.M..... Aet, 190
lal View of the PoyiicalPhenomena of the chronle diseases, 128 Spine,flracture of, calculus erigiaatlnff in, ...
the PeUewahlpef the CoUe"s df,
,
Gld"e. By the Rev. Thomaa Mllner,IC.A., Scalp, encystedtumour of,237 257 40,880
*e. lUnatntodlnr IMTignetteeIn wood, 88 ScaauU, neck of the,two eases of lirastars Spleen,Mr. JTsckson on the, 807 .."M....M.., naval,169
Cbatribntloiu to the PhveiolMnrof the A]i- o( 844 new flinction of,458 ...
naval assistant,881, 808, 808, 844
.,

nentary Canal. By Wnilam Brinton. M.D., Scheme, government, for interments, 810 supposedabaeeee of ths^111
.M....... pay (emigrant), 288
loDdoD, tieentlata of the Roral Collegeof School of designand anatomy,69 ...
.,
whatlstUuae?889 Royal Cidlofeof.70,208,888^ 874,
,

Physldana, Demonetrator or Anatomy In Schools (Paris), re-openingof,450 Sponges, metallic, 8 445

King'sCollefe, London, 8i Seixrhus of the breast, mmoTal at any early Sponglo pillne, 816 .M....M.M.M.M...M.M.M.M.M...M
UltlflHltSn OC
TheMedleal Directory for 18" ,
stage,366 Spontaneous separationof a large tumour 188
the Pint Medkal Report of the Hoepitalfor disease of mamma, 815 fh"m the thigh,after an unsueceesful tempt
at- Union, and the poor of Bngbuid,
......M.M..

Consnmptloa ; preeentedto tikeCommittee of the tongue, 294 at nmoval by operation, 18 488

of Management by the OOfceia of the In- Scotland, 7.87,58,118,188, IIB, 197, 217, Sprainedwrist,enlargementof the nlna and and the Superanmialion
.........................

etltntion. LondoOt 1849,lis 279, 316,337, 886,419, 451 fifth metacarpalbone, with absoassse over Pund,100
The Zoist : a Jonmal of Cerebral Phytiology Scrofula,Lebsrt oa, 376 them, 188 Surgery,the claim ef the pvopooedaav Col- lege
and Meemeriem, and their appUo^ione to Scrofbla and tubercle,M. Lsbert on, 897 SUphyloraphy, 196^856,875 to examine in,188
Human Natvro, 184 Scrofulous abscess of the aateiiof medias- tinum, Mr. Fergusaon'soperation
w M*.
of the late war in Hungary, 76, 116
............

Underwood's Medkal ApfUttment Book for 304 for,and M. Sedillofsplagiarism, 281 ......M..., operativeophtlmlmic, leeturea on, 1
1850, 148 Scrotal hernia,oomplicatedwith hydrocele,Statiatica, American, of cholera, 21 ... operative,
.........
of Johasm Friediiek Slef-
Pnetieal Oboeryatloni on the ProTontloa, of the diplemaa of London phy- fonbeeh,882
Cawee, and Treatment of Canratuiee of Sootum and penis, elephantiasis of,868 110 flurgleal and Medieal Society, the WesOan,
the Spfne. By Bamnel Hare, 141 Scrotum, phyroosls, with hypertro^yof,216 homoeepathie,8S8, 249. 867
....
Pkaetioal Remarks on Asiatic Cholera. By Scurvy on board temperance Tessels, 869 atatistiesof mortalityin London
.... operation, extmordinaiy,by * bear,
P. J. MnspoTe^M.R.C.8., Eng. Assistant- Ihne Juicein the treatment of,812 for the year 1849, br Mr. B. finlth, 2 818
Burgeon,Bembay Army, 148 .......
, on the respeotlTo ralue of liose Juice, Steatomatoua tumour, removal ot, 288 SurreyDispensary,878
MedJeo"ChlnuglealTransactions. Pnblbhed citric acid, and nitrateof potash.In the Sterility, retroversien of the uterua, a oanae Syme, Mr., on medieal rsdnm, 88, 181
1^ the Royal Medieal and Chinxrgleal treatment of, 485 of, 11 Synovitisin an Infont, 224
8odety of London. yol.ZXXII. 1849, 164 Sea, report of cholen at, in the 59th reg. Sternum, congenital abeenoe of,468 .............
of the wrkt-Joittt, aente, IM
imgical Anatomy of the Arteries. By the on board H.M.S. ApoUo, 488 Stethoscopein pneuBumia, 870 Syphilis, 818
kleTaleatlnePlood,M.D. New Edition. jamen's hoepital, 260 Stobo, Mr., on ruptureof the uterua, 868 can gonotrhceaprodnee,818
,........,

SjrJobaPower, ILD.
"""

Dublin. 1850.
185 184 Seamen's Hoepital Soeiety,169 Stokes, Mr., on dental pathology,294 transmission
...
,
olTfrmn the InfoBl to
Annalt of Anatomy and Pydologj. Con- Seeondaryspasms duringoonTaleaeeaee fkom Stomach, hypertrophyof, and cancer, dilTo- Uanuiae, 885
doeted by John Ooodtir,P.R.8.8. L.and
] cholera,117 rentialdiagnoeb ^, 179 Syatoma, empkical, the relation ef tne
E. Piefeaior of Anatomy in the University Seentloa, urinary, of the insaML 488 .. perforation of the^ 887 418,
,
nasdiflineto,tf8
of Edinburgh, Sec,184 Sedillot,M. 815 rheumatic alfoctienof the,187
,

Pathological and Praetioal ObaerraUons on Sedillofs, M., pbgUiism, mdMr. lai|U- W.M.M.M., uloer of the, 884 T.
Btrletnrea, some
and other Diseases of the son's for
operation ataphylamphy,281 Stove, patent portable suspension, 148 Tables of mortality,18,89^48,88, 188,148,
UrinaryOrgans. By PXands Rynd, Esq., Self-supporting dispensaiiea, 11,8a, 889,805, Strabismus, division of the rectus by means 809. 848, 889, 889, 818, 889, 848^ 881,877,
326, 343, 875 of Lane's knife, 418 888,409,430,448,481
IDnstrstions of the E/ftcts of DIssaiao and Seminal dlsehsigask InYolnntary, Strain,violent,of the body generally, 450 Taenia seUum, experimentswith the Bmy-
Uianr of the bones, Ml on, 168 Straagnlated fomoial hernia reduced on eraanthehnlntina, for the remeival eA 898
A Tieatlseon Dlseasee of the Bonea. By Sensation not exclaalvelyeanfned te the sixth day, 118 TaHacotian operation, 417
EdwaidStsnley, P.R.8.,S61. posterior roots of the spinal nerres, 819 .........M.......
hernia within the abdomen, 7 Tal^ee eouinna,195, 814
A Treatise on Diseases of the Bonee. nioo- Serous caHtlcs,filie awmbrane efc 178 inguinal hernia on the left Tapping Urn chest, 888
txadooa of the EiBMto of Disease and In- Sewers,cityCenrt of, 170,809 aide,operationwithout openinffthe sno, Tapping in hydraes^ialtta, 179
lofT of the Bonea. By Edwaid Stanley,Sewers, what are the MetropolitanCommle- 56 Teeth,SUing no decayed,888
PJLs. 802. sioners of^doing? 45 operation, 878 vegetablestoppingfor,808
...,

BfUiographleal Record,808 8heldon,Dr.,on a caae of intai Stricture, caustic in, 188, 206, 280 TsetotaUan and the baa extreme, 888
A Dissertotkm
npon Dialoeations and Prae" in which Ibnr anda half foot passed per of Eustachian tube,148 Teignmouth dispensary, 188
tnies of the ClaTicle and Shoolder-Jolnt anum, 894 impermeable,419
.............
Tempocary insanityin erlmlnal caaea, 41
heiogthe Jacksonlan Prise Essay for 1846. Shift, the Lancet's" last.848
*" of the oesophagus, 143, 806 Tempennce priae,the, 867
By Thomas Callaway, P.R.C.S. 328. Ships,purification of,byonlorideofahic,189 puncture
.............
of we bladder from the veseela, acurvy on boacd, 888
Rerelations of Egyptian Mysteries. By Shoulder Joint,amputationof the, 816 rectum, 417 views of Dr. Carpenter, tha^ 888
Robert HowazdTPnetltiflner of Medldne, M
excision of the,877 of the rectum, case of,408 Tergiveraatfam of the Lamett, 180
891 Silver in salt water, 6 Iieanmimf
.............
of by perineal incision,Teaticle, enoephaleiddiaeaae of, 18
Lsetwes on Eleetridty; comprising Gal- Simpson Dr., and chloraform, 858 126 ^atimonial,288
Tanism, Kagnetlsm, Elcctro-Msgnetlsm, Professor, letter fhmi, 408 urethral division of,237, 295 to Wm. Bush, Esq.,190
,

Megneto and Thermo Electricity, and Simpeon's,Dr., visit to the oontinent, 418 Structure of the cutaneoiu glands of the gratifying, 90 ,

Bleetro-pbyslology. By Henry M. Noad. Simulated pericarditis, 13 toad, on the, 888 the Liston,188
Lecturer on Chemistryat St. George'sHos- pital, Simulation of disease, 378 and faction of the spleen,Thames, evaporationfirom,90
fte., 484 Singularincident in a madhouse, 44 Cooperianpxiae for 1853, 376 Therapeutic eifocta of some metala, 117
On Diseases of Menstruation and OTarian Singularoccurrence before a coroner, 90 ..of the kidney, 119 Thigh,abscess in, connected witt the boweH,
Inflammation in connexion with Sterility, Singularsuicide in the Edinburgh inflrmary,St. George'sSehool of Medicine,Grosvenor- and simulating obturator hernia, 887,877
Pelvie Tumours, and AObctions of the place,394 amputation ^f, 5
...*...,

Womb. By Edward John TUt, M.D., 441 Sinus, longitudinal bone in the, 86 St. Thomas's Hospital,the fluids of,69 amputation of, for pulpy degeaem-
,

Tralt4 Thforlqae et Pratique de la M6- Studens and infidelity, 147 tion of the synovial membrane of the kneo,
Skey,Mr., and the generalpractitioners, 868
thode Anseetheoiqne,be. By M. Bonis- Hunterian oration by, HI Students, the, and coundl of University 885 '
,
son. Paria : BidlUeie. 1850, 458 Skin, cancer of the, 365 CoUege, 801
" Thomson, Dr., on vesicles and toralai in
The 8ea-elde Book. By W. H. Harrey,M.D., Skoda's Tlews of metallio tinklingand am- phoric Studentships, the college, 878, 446 urine. 194
U.JLSJL, 459 incision,452 Three warnings of the Council of the CeOege
breathhig,118 Subcutaneous
Howards,Cholera,at Exeter,13 Skull, injuryto the, 336 Substitute for cod-liver oil, 108, 198, 897 of Surgeons of England, the, 288
Rhenmatle afbetien of the stomach, 157. Thymus gland, hypertrophy of the, eaaring
Small-pox,829 Succinct historyof Asiatic cholera at New- port
Rheumatism, articnlar,and gonorrhcealSmall-poxand cholera,858 Psgnel in August, 1833, 174 laryngismusstridulus and death, 98
athritis, diagnosisbetween, 180. Time$, the, and the London Hospitala, 9
Smith,Mr. S.,on operatioo^for deft pafaite,37 Sugar,new mode of testing,256
Rhcumatlam and neuralgia,treatment of, Mr., on the treatment of strietufe of
"......,
in the serum of a blister,279 Tincture of iodine, 138
by cold water, 77 the urethra by the perinealseotion,834, presence of in the liver,99
,
TUt, Dr., letter tnm, 408
Rhine Wines, 179 the productionof in the Uving Toad, on the stmeture of the cutaneooi
881, 400 on ,

RhinoplastlG operationin artlfleial anus, 154 Smoking, evils of, 96, 67 body, 319 glandsof the, 338
Rib,fractured,hsematuria,489 219, 870 Suicide of Dr. Bell at Cheltenham, 889 Todd, Dr., Lumleian lectures at the GeUege
Soeietyof Apothecaries,
Ribs,resection of, 468 themeuMvialof the, fh"m dread of hydrophobia,170 of Physicians, on the pathology and tmat-
......M..........M...."

Rigl7iDr." on retroTorslon of the uterus as aneurism with ment of delirium and coma. Lecture I.
355 by perforatingan a
"

of sterility, 14 "The of fixed principles of

a eause
,
what must be done corkscrew, 279 importance
Rome, the French at, 815 with the, 242 of Mr. Rouse, 110 pathologyand practicein delirium and
Ross,Mr., obeerrations on cholera by, 55 Society, theMedlco-Chirurgleal, 165,181,187, Superannuation-ftind BIU, 208 coma." -Definition of delirium" of coma.
Ross,Mr., in replyto Dr. Turley,166 208,405 Supply of water, 341 "Existing views of their pathology un-

Rotatory
conmlsions in a ctiild,
879 and for domestic purposes, 49 setUed." CUnical historyof the different
lum
specu-
Bone, Mr., suicide of, 110 uterine, 422 Supposed death from poison,170 forms of delirium." EpiiepUcdelirium.^
RoyalCollegeof Surgeons,70, 110,280,875 77 Cases." Eflbcts upon the brain." Renal
National Vaccine,reportof,457
, Suppurationin the bursa over the patella,
Inflxmary, Edinburgh,69 SocietyPathological 118 a hydatid cyst of the liver, delirium." Choeric delirium."
-

"""."....Irish Academy, 178

proposed for investigating the history 264
, ,

"e." Hysterical delirium." Eflfects upon gUeptic

Medical and Chirurgical the brain." Cases." Delirium in men from
""""... Society,
the, of epidemics,428 Surgeons in the Austrian army, 169
185,187, 405 work." Puerperal delirium." EfltecU
for the relief of widows and orphans CoUege of,classics at, 81 over ,
Medical and Chiruigical Council of,88 the brain." Anemic delirium."
m,.^.^ Societyand of medical men in London and ita.vtanlty, .......a,
upon
reiJeeted papers, 159 289 does it belong to the Iraumatic delirium." Delirium of typhus
,

f 188 "of Rheumetlc delirium."

""....". OrthopeedicHospital,394 the Roya). 10,448 ,
Council or Members erysipelas."
....... PhysicalSocietyof Edinburgh,209 the Royal Medical and Chiruigical, England, the members Its complicationwith cardiac inflamma- tion,
,......, ,

""...... PolytechnicInstitution, 89 and its rfjected papers, 159 of, 188 311
Society,the, 440 of the Pellows Continued,338
, meeting
........ the Royal Medical
,......,
and CUmrgieal - ... "

M.-... Sodetj of Edinburgh, 109 165, 187 of,848 Lecture.II."(Continned ttaiarvH^ 884.)"
 VIU INDEX.

of scurvy, on the respective value Unwholesome meat, 69 Changes in the iris rendering it unfit to
Gouty delirliim.-"Delirla]nh potn or dell- Treatment
Tiam tremens." Deliriam from the habitual of lime-juice, dmc acid,and nitrate of Upper maxilla, fibrous tumour of the,367 operanon." Selection of a poeitionfor a
nae of optom." Toxic delirium from the potash in, 435 Ure, Mr., the operativesurgery of iohann fUse pu]^" Siae for pupil."Question
dlreot influence of potionsintroduced into Friedrich Dleffenbach, b v, 222 whether an artificial snonld be made
.M.M..M...M. strictures, 468
the
pupil
the system." Delirium in the exanthe- mata." syphilis, Ricord's formulss fbr Urethra, treatment of stricture of, by while the eve is sound, or nearly so.*
M..-.M

Clinical historyof coma." Bpileptie the, 468 perinealsection,334. 381, 400 Degree of hnperfectvision that renders
coma." Abercrombie's simple or conges- ,
value of lime-juice tn, Urethral stricture,division of,237, 295 the formation of artificial pupil Justifl-
tlye apoplexy." Cases." Renal epileptic 212 Urinary secretion of the insane, 439 able,272
eoma." Coma after scarlet fever, dropsy, stricture,by perinealincision,Urine,albuminous, and dropsy,proximate Lecture X." Artificial pupil(continuedfrom
and after acute dropsy."Slightattacks of 126 cause of,184 page 273)."Closure of the pupil,the lens
epileptic coma." Paralyticstrokes" their of the urethra, by , human, microscopic examination having been removed by extraction-
eonnexion with diseased Udney and blad- der." the perineal section on the, 334, 381, 400 of, 453 Manner in which it is closed" Changes the
Hystericalcoma." Mesmeric coma. TrinitycoUege,Dublin, 12 .......
torulse and vesicles In, 194 iris undergoes. Alterations
"
in the capa*
"Case of spontaneousmesmeric coma. Triplet,
"
2 50 Use of chloroform, on the, 153 city of the anterior chamber.
"
Operations
llr. Dunn's Case. Concussion
" of the brain Tubercular gonorrhoea, 296 ...... long-continued baths and irrigations of incision, and incision with extension.
or traumatic coma. "Coma tnm. com- Tubercle and scroftila, M. Lebert on, 297 in cases of madness, 57 Excision." Wenxel's central exciaion."
presrionof the brain. Apoplexy. Can Tumour, adipose,removal of, 5
" " UseAil remedy for chilblains and toothache, Closure of the pupil after the operationa
coma be caused by an increase of subarach- noid In the arm, difflculdes nosis 67
of diag- of displacement and solution,331
fluid? " Rheumatic coma. "
Gouty of,367 Uteri cervix, inflammatoryeruptions of the, Lecture XI." Closure of the pupU with the
coma. " Coma accompanying typhus and encysted of the neck, 295 280 existence of cataract." Closure of the
,

erysipelasand the exanthemata. Coma "

,
excision of a, 77 Uterine age, size of the foetus a test of,147 pupU with opacityof the cornea." Partial
tnm ansemia. Coma
" from poisons. Re- capitulation,
"
a fatty,195 diseases,on the use of the speculum opacityof the cornea sufficient to obstract
M7. maxilla, 367 in the diagnosis and treatment of, 425 the light,the free. Prolapsus of
,
fibrous, of the upper pupO "

Lecture 11." {Concluded from page 349.)" ,

of the uterus, 104, 126 and ovarian disease,connexion of, the iris,or adhesion of the iris to the
863. of the law. 437 247 cornea; the pupil destroyed or dimi- nished;
^^

Lecture III." What organ or parts are fected

af- lower Jaw, 369 polypus,haemorrhagefrom,279 and the cornea more or less
in delirium and coma r" The brain in the kidney,178 vessels,on the entrance of air by the opaque; the lens and its capsuletrana-
the organ of consciousness." Parts of the large,of the side of the neck, 18 open mouths of, considered as a cause of parent or opaque. " Conclusion of the
,
brain essential to consciousness." Delirium separarion f rom danger and death after parturition, 286 subject, 447
, spontaneous

an aflfection of the Intellect." Coma fectionthe thighof,after an unsuccessftil attempt Uterus, absence
an af- of," hernia of the ovaries,Walther, M.D., 137
of the consciousness "Seat of the at removal by operation, 18 297 Ward, Dr. T. O., on a case of perforatod
diseased action in delirium." Seat of the malignant^in the situation of the , engorgement
of the, 117 ulcer of the stomach, 448
,
diseased action In coma. Nature
" of the parotidgland,removal of,417 ,
flbrous tumour of the, 104, 126 Wardropon the heart,323
morbid processes which can cause delirium
,
removal of a malignant, 215 M,
retroversion of,a cause of sterility, Warty diseaseof the penis,216
and eoma. " Influence of certain narcotic of the scalp, encysted,237 14 Warwickshire lunatic asylum, 70
poisonsin producing delirium and coma. ,
steatomatous, removal of, 256 ,newmode of curing, prisons, 70
-Flourens*^doctrine of a specialelectiye Tumours, ovarian, Dr. Tilt's operationfor, 177 Washhouses and baths, 76
affinity between certain poisons and certain 207 M ,
treatment of,239 Water dressing, 410
parts of the encephalon." Immediate fect
ef- Turley,Dr., letter from, 207 , rupture of, 253 for London, 62
of one of these narcotic poisonson the Mr. Ross In replyto, 166 Waters,mineral, 315
brain." Congested state of the bndn in Tweed, Mr., a description of the apparatus Water question, the, 23,300
poisoning by opium." Is the congestion for employlngfthe mechanlcalleeches, by,36 Vacancies in the Council of the Collegeof ,
salt,sflver in, 6
the cause of the change in the brain's Twins, the Flemish, 371 Surgeons,455 scheme, the Durham, 29
mode of action r" A certain degreeof -ex-
Maple
haustion Tympanum, the artificial, 189 VaccinaUon, 289 , supplyof,
for domestic purpoeee, 49
necessanr to produce delirium,Typhoid fever,256 the national encouragement supplyfor London, 110, 341
in addition to a poisonousinfluence" trated
illus- and superintendence of, 454 Weber, ". H., nroofr that it Is only the
, etiology of,20
by delirium tremens." Case." Evi- Typhus exanthematlcus in Prague,299 Vaccine EsUblishment, the National,410 organs of touch which Inform us of the
drace of poisoningof the brain by alcohol. fever, 70 lymph, on the preservation of the, sensations of warmth, cold,and preaanro^
"Percy's obsenrations. Influence
" of hol
alco- ,
Dr. Jenneron, 107,146 248,267 by, 78
in altering the qualities of the blood. ver, Valves of the heart, mechanism of the, 20 West Derby, 210
, typhoidfever,relapsingfe-
State of the urine in eases of delirium. and by Dr. Jenner, 15, 38, Vas deferens and the colon, fistulous open- board of guardians,110
febricuia, ing M

"Humoral view of the pathologyof deli- rium 118, 185, 233, 433 between the, 295 Western CityDispensary,69
tremens. "Is there any inflammatory MQlett, 290 Medical and Surgical Society,SO
, planadopted spread Vaudrey e.
to prevent the
process In delirium tremens f- Analogous of, 217 Vaults and cemeteries,on the poisonous Westminster Hospital,130, 353
points in the pathologyof the renal epi- leptic of,187 gases of, 318 Medical Society, 48, 110, SOi
delirium." Poisoning of the blood Vegetablestoppingfor teeth, 208 Medical Society and Sir B.
by urea." Condition of the blood in chronic Velocityof the nervous fluid,177 Brodie,164
renal disease.- In simple rium
deli- Ulcer of the leg of fortyyears'
epileptic standing,417 Venereal disease amongst horses, the,818 What are the MetropolitanCommissloBen
the blood is probablypmsoned.- The Ulceration of the ccecum, 453 Ventral hernia, with rupture of diaphragm, of Sewers doing r 44
Tiews s^plicable to the explanation ...iM.M of the OS and cervix uteri,pre-
"ame ...... sumed 814 must the college dof 59, 320
of rheumatic and gouty' delirium" to that frequencyof, 306 Vesicles and torulsein urine"194 Widows' and orphans'sodety, 800
of eiysipelaB and of ^hus." Hystericde- lirium Ulcer of the stomach, 824, 448 Vessels,emigration, nodioal attendance in, Wild barleyswallowed, and evacuated by as
refoned to the same categoryae Ulna, necrosis Of the, 887 abscess in the groin,838
-
epileptic." Pathology of coma." Delirium Ultimatum of the Royal CoUege of Surgeons, ......M...., temperance,scurvy on board, 269 Wilks,Mr., remarks on homoeopathy by, U9
and eoma result firom dlibrent degreesof 123 Vessels, uterine, on the entrance of air by Wilson V. Ashley, 69
poisoning."Coma likewise due to paraly-Union, HaUfsz, 40 the open mouths of, considered as a cause Wines, Rhine, 179
alf from exhaustioB of nervous power." Surgeons and the Superannuation of danger and death after parturirion, 286 Witnesses,medical,210
Conditions similar to those which produce Fund, 100 VeterinaryCollege, the Royal, 310 and the Coronen'Act,
,
delirium exist in the different Ibnns of Union Surgeons and the Poor of England, Violent strain of the body generally, 450 10
coma." General principles of treatment in 460 Viscera,case of congenitalmalpositionof at inquests,reftisalto
,
delirium and coma." Objectionsto treat- ment Universityof St. Andrews, 390, 398 the,75 examine, to avoid the payment of fees,148
by bleedlng.^The use of opium not College,190, 209, 268, 289, 310, W. ,
remuneration of,106
anplieableto all forms." Conclusion,879, 862, 378,394 Wakley, Mr., and medical Journalism,388, Woman, a very corpulent, femoral hernia in,
,
Council of, and the stu- dents, 403 449
Tedd, Dr., his lectures, 408,428 301 Mr., his retirement ftom Parlia- ment, Women, pregnant,albuminuria in,177
Toe-nail, on Ingrowingof, 195
,
Fellows of, and the 390 Worms in the nose, "

suspectedimposition,
Tongue, scirrhus of, 894 "Lancet," 261 Waller,Dr., case of placentapraevia, 415 265
Toothache,usefrd remedy for,67 Hospital,169, 410 Walton, Mr. Haynes, on entroplum, 383 Wound, gunshot, extraction of a ball from
Torbay inflrmary, 46 and the " Lancet," 281 Walton's,Mr. H. Haynes, lectures on opera- tive the bladder, 265
Torulae and resicles In urine, 194 ,
the late inquestat,443 ophthalmicsurgery. ,240
Trance,obserrations on, or human tion,
hyberna- ,
the professorship of ana-
tomy Lecture VIII. "

Capsiuarcataract,the treat- ment Wrist Joint, acute synovitis of the, 154

351, 401, 416 in, 389 of,considered under heads of partial , sprained,
153
Transmission of cholera, 319 the retirement of Mr. capsular, the lens transparent, or opaque. Y.
,

syphilis from the infant to Amott ttom, 356 "

Oomplete capsular,enclosing a lens. Yarmouth Hospital,21
its nurse, 885 and King'sCollege, Aberdeen, 309 first,unbroken
"

Capsularonly "
; se Yearsley,Mr., on deaftaess,109
Treatment of acute pericarditis, by Dr. John of London, 289, 846 condiy,more or less torn or broken." In on a new mode of treating
,
Taylor,83, 73, 96 , general meeting of the vention of a new Instrument for the deaftaess when complicatedwith perfbrat-
aneurism, by ture,
electro-punc- graduatesof, 163 removal of capsule." Operation of drill- tion of the membrana tympani, 176
156, 314
, privilegesof gradu-
ates ling. Concluding remarks at the end of Yellow fever,the. 70,394, 410
"

cholera in Persia, 99 -

of, 344 the first course, 1 in Pemambuco, 346

deaftaess,117 ,
new Irish, 346 Lecture IX. " Arriflcial pupil. Definition."
"
at Rio, 413
and cure of diabetes,279 Universities, German, 137 Arrangement of the subject."Review of Yorkshire, Queen's Head, the allegedeaae
hydrocephalus,156 Unlucky prize, an, 177 certain conditions, local and general,with of hydrophobiaat, 41
perforationof the membrane Unstripea muscular fibres in the coats of reference to the selection of a proper time Z
tympani, by operation,by Mr. Herrey, blood-vessels, on the, 258 for operating." The state of the retina the Zinc, chloride of, for the purification of
Unusuallylargehydrocele, complicatedwith most valuable guide by which to deter- mine ships,129
"......"."..... Ml
retroversion of the uterus, 239 scrotal hernia,367 the admisnbllity of an operation.
"
poisoningwith,418
,

LONDON:

PRINTED BY WILLIAM TYLER,

BOLT-COURT.
 THE MEDICAL TIMES-

OBIOIHAL LBOTUBES. tion,and.' a mere scaleof lens,or littlesoft, white fule ; the onlyquestion involved is,the practicabi- lity
"
^ " matter, not unlike half-boiledrice, may be tJi that ; for it has alwa3r8 been considared a thingdiffi-
ii present Such cataracts have a shrivelled euit
pearance,
ap- tOi and
accomplish, duigeroasin the resolt
LECTUBES
OK
and the posterior chamber is large.The The vitreoua humour, havinglostits support, and
OPERATIVB OPHTHALMIC SURGERY. ordinary mode of operating is not applicable ; the itsstracture beingmostiybroken, is apt to escape
DSUYEBED AT THE CENTRAL LOinK)N object now is, to get rid of the oi^ule. When a under the necessary manipulation. I am happy to
OPHTHALinC HOSFITAL. cataract forms aftor childhood, and arrivesat such say, that these remarks applyto the jpast, and not
a state, there is much probability eye being
of the to the present time ; fat lir. Weiss has manufke-
By H. HAYKES WALTON, Eaq^ F.B.C.B., tared a little
Smgeon to tlie Hotpital,and to the St Panena Bojal otherwise unsound. instrament, a yery delicatekind of
Oenanl Diaponnry. In the adult,and,indeed,whenever the patient is foroejps, by which it may be removed with perfect
controllable, the best adapted operation iaextraction. security to the eye, as well as ease to the operator %
LECTURE VIIL It has been recommended to detach the capsule by and, had such means slwaysbeen within my readi,
Capaalar Gatanot, the Treatment of, coneidered under a posterior operation, placeand it in the anterior I should oftenhave extracted, insteadof having r
sorted
e-
head! of Partial Capeular,the Lena Transparent,or chamber as a means to the uncertainmethod of tearing
eoeloeinfa Lent.-~Cap-
of facilitating extraction. If throughthe
Opaque." Complete Capeular, such a preliminary be necessary, I think,that it capsule in some manner or other, in endeavouring to
anlar only" fint, unbroken ; teoondly, more or lest torn
Instmment for the would be far superior for the safety of the eye were a dear spsce, or entirely partislly detachmg
or broken." InTondon of a New
of Drilling."
p[6t or
Remoyal of Capeole."Operaftfen Coneliid- it efiected It,and tnuting to itsrolling
of the Pint Coune.
by a curved needle through the cornea. up," sn event fiv from
InffRenarka at the end
In allthe cases with which I have been personally oertsin.
Obntlemvn, " I proceedto-daywith the treat- ment
concerned the operation has been performed as if Here Is the instrument When closed, it is
of capaalar cataract, and I shallarrange it for extraction of a lens; in some the capstile has
to the daasiflcatioa diaeaae scarcely larger than an ordinary sewingneedle, and
conformably of capaalar
escaped with slight pressure on the globe ;m others,capable o f entering a small puntturein the cornea.
that I adopted in my second Lecture. ithas been necessary to introduce a hook,and with- After its
point is well introduced, t he blades are
Partial Capaular Caiaract,the Lent TrantparerUt draw it It is in congenital cataract that we see the
thrust out,the capsule isthen easily seised, secured,
or more or leu Opaqae, ^Very"
rarely, indeed,ia the most and best-marked examplesof these and withdrawn. The contrivance for
fluent opening and
capanlealone so extennyely opaque as to interfere adventitious changesin the capsule, and morbid
closing the blades is simple :
with viaion; but nearlyalwayswith the existence alterationsin the lens.
"

of capsular opacity, the lena ia inyolved to a coire- In childhood, and in earlylifb, the practice I Y? Certainly, I have not yet had mach
"ponding, or may be,to a greater amount.
have pursued is to use the needle as lor solution, in ^
with this "wee
experience pet," as a
Whenever the fhnctionaof the eye are interfered order to of whatever may re- friend calls it;but, in every mstance of
produceabsorption main
with by partial opacity, whether it be seated in the of the lens. I then wait to see ifthe capsule its employment it has fiilly realised my
capsuleor in the lena,or in both conjointly, the sufficientiv contracts to enable the patient to see. expectations. I shall briefly sketch the
pupilshould be dilated, and if, happily, useful sight
If that fiiiis, I endeavour to clear the pupilwith the firstcase in which I used it There had
be therebyacquired, no sorgical measure is ex"
needle. Sometimes itmay be advisable to attempt been soft cataract,and the operation was
pedient.But, should littleor no advantage accrue
to make a central aperture,after!the manner of that for the solution; the anteriorpartcf
from the enlarged pupil, the seat of the opacitySaunders. I
prefera largerneedle than he em- ployed, the capsule, alone opaque, had retracted
muat be remoTed. which was the same as he used for solution, eomewnat iWmi its droumferentisl at- tachment,
Some years ago I saw a housenuud with capsulo-and is known as Saunders's needle;" the anterior but still maintained oommuni-
lenticular cataract in each eye. I was induced to
operation is the better. Perhapsyou are not aware, cationl)y slight bands,which I suppose were
question her, because the pupilswere considerably that I am directing you to execute a difficult task, portions of capsular ligament I passed
dUated. She was then 18 years old ; since child- hood
and one that may require several attemptsbefore it abroad needle through the oomea, and
a dropof belladonna solution had been daily is perfected, or in which yon may altogether "il. the
separated greater number of the bands
appliedtoleach eye. With undilated pupilsshe In January,1846, I was consulted by a female of connexion, when the capsule contracted
was nearlyblind. Her employerswere totally who had been under Saunders with congenital at the
of her defect
to a mass
upperpart of the pupil,
unaware
cataracts, and in whom he carriedout this oper- ation. a portion of it bemg in each chamber.
An occasional patient at thisInstitution, a watch-
maker,
The capsules must have been very thick, The forceps then introduced,
were it was
aged 74, with partial capsulo-lenticular for,according to the testimony of the patient's seized,twisted to free it entirely, and
cataract in his right eye, has been using belladonna the one eye eleven times, withdrawn. I do not considerthe previous
mother, he operated on
for the last eight years, the period of tibecataract's and it only in of the needle
of the working
and on the other,nine; yet was one use actually necessary. An
duration. From long application that a sufficient aperturewas made. Her sight was entirecapsule slso may be removed with
glassto that eye, he cannot proceedwell with his imperfect much facility, and much betterthan with
work when he shiftsthe glass to the other, which he very
I have cautionedyou to be carefhl^ever to use the a hook; the opening in the cornea should
is forced to do with the pupil of "e righteye in a needle in the fbrsolutiontoo freely on any
operation alwaysbe in proportion to the size of the
natund 8tatf,but when dilated, he can adopthis old and the same be attended to in body to be extracted, but need never
one'occasion; must ceed
ex-
habit of applying the glissto it,and works with allneedle It is nevertheless essential, it It may be advantageoua to have
operations.
Shortlyafter I began practice I obtuned
; and this
ease.
alwaysto be as dibctual with it as possible a larger instrument,with a greaterspan,
great credit by thtis advantageously employing applies 'inan espedal manner to operations on opaque and with broader claws. I have given
belladonna in a littlegirl, whose eyes had been the Mr. Weiss an order for such a one. That
capsules.It is bad to create a necessi^for
condemned for operations. indecisive or in-
i| young persons, and in children,
repetition of any operation ftom an in the
Complete Captnlar Cataract entUeing a Lent. ef^ctuid '
"

measure. Before I pass to the next head, capsule may, in thismanner, be extracted,
I told you in a former Lecture that an opaque I will would be and boon conferred
justremark, that it improper to tempt
at- a great on them, I am
capsule never enclosesa transparent lens i therefore unless itis
the removal of opaque capsule, sure. How immeasurablysuperiorto
ifthe lens has not been removed, there must, of ne- cessity,
obvious thatitinterfereswith the exerciseof vision. a hole in itt
digging Heretofore, when a
be capsulo-lenticular cataract When the
Capsularcataract only^ or secondary cataract,as it capsule was to be removed, the imperfect
capsuleia but slightly opaque, there is so little is often called,is found in two states. In the one, forcepsthat we possessed, required, for
change in its physical properties, that you pro- ceed the
capsule is unbroken, the lens havingbeen ab- sorbed theirefficient use, a large openingin the
with wluitever operation you may have
by Nature's unaided effint. In the other,itis cornea, " ^a measure objectionable at all
selected,as if it were transparent If you ex- tract,
more or less torn,the conseqnence of some previous times, but insuperable, when a patient
it will in due time contract, and either for the removal of the lens,or the result does not possess self-control.There is a
clear
operation
leave a clear pupil, or one sufficiently of accident variety of other forceps, very ingenious,
for the purposes of vision. Exceptionswill The firstmuch retemhles the condition of capsuh^ and very expensive, yet most of them are
be alluded to as I pass on. The manner in which
lenticular cataract with thickened capsule, and re- duced absolutely worthless.
it haa been rent for the escape of the opaque lens
lens,but differsfrom it,since the latteris, The second state in tehieh capsular cata-
ract
involves a practical point; if ithave been across the so far as I have seen, alwaysopaque in its posterior is met with, more or less torn or broken,
centre,the retractionis easieraccomplished, and a which is by no means is the more
as well as its anteriorposition, common form, and the more
larger space obtained, in the most "TOurable situa- tion the case with the former. I think that,as a prin- ciple, difficultto treat. When its integrity is
for the exercise of sight, than if divided near
you should alwaysendeavour fint to make a destroyed, ithas lesstendency to contract
the margin. centralaperturein opaque capsule, when it com-pletely at its circumference, and to lose itsat- tachments.
When the operation forsolutionis performed there
retains its natural attachments,and, conse- quently, These cases differso widely
can be no doubt itwould be most desirablein allcases, fillsup the pupilbehind. The from one another, that itis difficult
entirely to lay
the firsttime the needle is used, to divide the cap- sule success of the attempt will depend as much, or down rulesof treatment foryour guidance. Their un-
completely across, because itis then lesstough, on the firmness with which those connexions manageableness often obliges the operator, during the
more,
would contract better,and is lesslikely to inflame
are maintained, than on itstexture ; for,even when operation, materially to alterhis original intentionof
and unite than at any subsequent period ; but I and
thin, itwill often yield u nder slight pressure, proceeding, adoptsome other course. Try first
have shown, that it is onlywhen the cataract is very
and affainreturn to itsplace. The formation of a to separate, with a sharpneedle,any bars or bands
fluidthat such an advantage can be embraced, and central when any that cross or obscure the pupil
opening is scarcely practicable : if theyyield to the
hence there is such frequent necessity for after- is detached. Undoubtedly,
portion of the capsule pressure employed, and mil not sever, use the for- ceps.
operations to clear the pupil.
extractionis the proper course, when an aperture It would be very improperto applythe
When the capsule becomes very much thickened,cannot be made. It is evident,that no treatment needle directiy to the circumference of the capsule
itscontents are sure to undergoconsiderablereduce can equalthat which can at once remove the cap- " I mean at itsciliary attachment "
and,as it were
Na 536, Vol. XXL
 THE MEDICAL TIMES.
to scrape or rake it away. When partially free lens was removed. I believe such frequentre- when one cannot be made with safety
petitions by means of
portions are obscuring the pupil, theymay be seized to be useless and dangerous ; in the young the needle,an artificial pupilmust completeyoar
with the forceps and torn off, or the forceps may be it can never be required, and is at variance with Mr. proceedings.
twisted tillthere is a separation somewhere. Tyrell's accustomed practice in operations on soft My own impression is that,exceptwhen the pnpil
To attempt to depress capsuleis nearlyalways cataract. In the middle-aged and in the old it is is of good size,and nearly or entirely cleared,there
to undertake an impossibility. It will not remain too often,and especially if what Mr. Tyrrellcon- jectured are few cases that would not be benefited by an ar- tificial

imbedded in the vitreous humour if it be healthy; be true, and which I fully admit,that the pupil. I believeitto be absolutely essential
if otherwise, it will ^oat about,and produce venience lens has not generally,
incon- even in elderly persons, the in all cases where the capsule is opaqueposteriorly.
; and then itsremoval would be dangerous ; hard character of the ordinary cataract ; but then Want of time prevents my illustratmg the subject
for an eye in that state cannot bear much injury. he does not attributethe want of hardness to the with cases from my own practice. I may, howerer^
Adhesions to the irisgreatly increasethe difficulty rightcause. If you refer to the passage to which refer you to one that I published in the Medical
of clearing the pupil.They are not easily over-
come I allude,you will see that he considers hard Timet,about eighteen months or two yean ago. I
unless theyare very slight ; the iriswill some-times cataract to be an increase of density of a lens,and am sorry that I cannot recollectthe date.
give way from its ciliary attachments rather not, as I have toldyou, merely opacity pervading the Drilling is certainly a valuable addition to oph- thalmic
than at the adherent spot Paralysis, that is,tremu- hard lens of an old person ; and he thinks that even surgery, although, if regarded comprehen-
sively,
lousness of the iris, not unfrequent after any opera-
tion should the lens be opaque in connexion with the it must be received principally as a means

on the capsule, is very liable to ensue when it capsular disease, it is not hard cataract ; whereas I of getting rid of an opaque lens,and, as such, a
is adherent, from the concussion that the irisneces- sarily say, itis in consequence of the diseasein the capsule, preparatory stepfortheformation of an artificial pnpil.
receives; wherefore the greatercare is manded.
de- whereby it is thickened, that the density o f the lens It is onlywhen the eye is free fti"m active or
It is certainly legitimate, to attempt to is not retained, and the lens degenerates and is more from low inflammation that you should operate. I
separateadhesions by force exerted throughthe or lessabsorbed. I prefer, therefore, to operateless have no hesitation in saying, that the four cases
medium of the capsule.But it is less applicable, often, and increase the lengthof the intervals; for if Mr. Terrell has published in illustration of drilling
and hence less practicable, than the ophthalmictime be allowed,three or four,or even fewer opera- tions are selected ones, chosen to display a superior result.
student would suppose, Considerable experience will suffice; and when I think that the lens is I would recommend you to read them, for theyare
in ophthalmic operations is needed to enable you to gone, I endeavour to effectwith a broader needle, instructive.
know when to attempt it, and how to do it with at one operation, allthat is possible to be efiectedin And this, gentlemen, ends what I had to say on
safety ; a Lecture cannot teach you how longto per- severe,the clearing of die pupil. One of the proofs of the the subject of capsular cataract The firstpart of
or when to desist. I have found a curveici removal of a lens,and the only one that can In my course also ends here. My lectures, it is true,
needle bettersuitedfor thepurpose than a straight one. observed or estimated when the pupilis closed "
might have been condensed, but then ideas and
Capsulethat has been divided may inflame and the concavity of the itisand the increased size of the facts, which I deem of importance, could not have
unite,and render nugatorywhat has been done. In anterior chamber " ^isnot always present;I may say, been developed so as to render them easy of com- prehension

a female who had undergoneextraction there was is rarely present Any knowledgeof the presence ; but,by amplifying a little, I have en- deavoured

prolapsus of the iris ; and the irregular pupil that of a soft or of a degenerated lens, or of the mentary
frag- to make them familiar, and I have, I
resulted was closed above by opaque and thickened remains of a hard one, can scarcely, if trust,thus succeeded in impressing them on your
the
capsule, remainiogaperture not being suffi- cientlyever, be ascertainedby the amount of resistance that memory. In conclusion, beg vou
I of to remember,
largeto admit of useful sight.The lefteye may be offeredto a sharp, fine needle. As far as I that when I have criticisedthe opmionsof authori- ties
was dark from lenticular cataract In this state know, it is onlyby the performance of a certain deemed standard,I have only exercised the
she appliedto me, requesting that my attention number of operations, sufficientto secure a proper rightof private judgment,and, as uiat was founded
should be directed to the righteye, and positively exposure of the lens to the action of the aqueous on my own experience, itwas my dutyto pointout
refusing to have the left touched. Had the capsulehumour, and the allowance of sufficienttime for these differences.
been unadherent,its removal mighthave been easilyabsorption,
___^_

that we can be certainof the empty state

effectedfrom its situation at the mar^n of the of the capsule.By reducingthe number of opera- ORIOINAIi OONTRIBUTIONS.
tions
cornea ; but, as things were, to draw it out would we reduce tha chances of failure,a very ma- "
terial
STATISTICS OP MORTALITY IN LO^-
have been to pull out the iris as welL Its ad-
hesion pointat any time, but most important here ;
DON, FOR THE YEAR 1849.
could not be destroyed. I divided it for an eye that is in a state to require drilling has
By Mr. BENJAMIN SMITH.
perpendicularly, in the hope that the edgesmight been much damagedby inflammation, and is there-
fore
in some manner separate. Three successive divi- less able to resistinjury. Remember what I told The past year, fruitfulalike in political and so- cial

sions were followed by adhesive inflammation. you in my lastLecture respecting a principal cause events,will be marked in future history, like
Then I tried to cut out a bit of it,but fruitlessly, of imperfection in solution cases ; and the observa- 1832, as the year of cholera ; one in which, bya
single disease not prevalent at other times,14,000
yet the attemptwas not without a result;for a new tiotls carry double force when an eye is unhealthy.
aperture, was made that did not close, and, althoughMr. Tyrell has overlooked the effectof frequently deaths were superadded to the general rate of mor-tality,

small, was well ^situated and fullysatisfiedthe repeated operations on an unsound eye. For his the particulars of which have been already
patient ; had the lasttrialbeen as unhappy as the argument is,that he believed the sensibility of the recorded in thisJournal (Nov.3rd,1849).
foregoing ones, I would have operated on the irissts retinahad been previously and permanently injured The total deaths in the year from all causes
for artificial pupil. in those cases in which he failed to restore sight,amount to 68,432,beingan increase over those of
The iris should alwaysbe fullyunder the in- fluencebecause he disposed of the cataract,and cleared the 1848 by 10,533. This resultwould show that,de- ducting
of belladonna, when capsular operations are pupilenoughto afford good vision,had the retina the mortality from cholera, the deaths from
undertaken. been healthy.Givinga fair allowance for previousother causes in 1849 were 54,327, or 3572 under
DRILLING. injury to the nervous apparatus,some portion of the those of the former year, althoughthat year num- bered

I have yet to say what is to be done when tensive illsuccess

ex- of which he speaks must, I am sure, be 468 deaths from cholera in the thirteen weeks
or entire adhesion of the iristo a capsulo-transferredto the account of the operations. from Oct. 7th to Dec. 30. The effect, as to popula-
tion,
lenticularcataract renders the usual operations applicable.
in- The superiority of any mode of operating must of the highrate of mortality, has been that the
rest entirely on the results, on the greatest
"
amount Births have been over Deaths by only 3626 (al- though
Before Mr. Tyrrell's time the practice was to of benefitconferred, with the longest continuance the totalfor the year is 1027 over that of its
divide the lens,its capsule, and the iris after the of it ; and to ascertain which, should constitute the whereas in 1848,an increase of popu-
manner of Maunoir; but its frequent failuresin- duced principal partof your studyof operative surgery.
firedecessor),
atiou accrued of 13,104.
Mr. Tyrrell to seek for other treatment He It is by no means certain that the needle alone The following shows the rate o" mortality in the dis-
tricts
ultimately adoptedthe operation for solution, but will clear the pupil ; it is,therefore, better that its of the Metropolis, comparedwith that of 1848.
with such modification as to serve the additional inability 1848. 1849.
be ascertained at once than after frequent
West 8,118 9,387
purpose of effecting an efficient aperturvin the cap- sule trials, putting out of consideration the disadvantage
North 10,309 11,053
; the term drilling was givento the process. of having to repeat punctures because previous Central 9,653 10,845
Accordingto the author's direction for its execu- tion, ones have healed.
East 13,009 14,847
a very fine and straight needle is inserted Whether the operation shall do more than remove
South 15,496 22,318
into the substance of the lens for about the sixteenth the lens,must depend,1st,on the density of the A comparison of ages at Death with the former
of an inch, and rotated to act .'like a drill. Each capsule,for,if it be very tWck and tough,it may year givesthe following
"

"
:
time that it is used,it should be introduced through not be to effecta patent aperture;2nd, on
possible 18(8. 1849.
a differentplacein the capsule, that a portionof the size of the closed pupil, because a very small Age from 0tol5 28,423 29,978
the capsule may be detached,or sufficiently ened,
weak- one may not be sufficiently large, even could we "
15 to 60 18,663 25,091
to admit of beingeasily displaced when the succeed in the removal of the entire capsule. 60 and upwards 10,385 12,979
lens has disappeared. Solution and This shows the following result: Tlie excess of
absorption Certainly, in the greater part of the cases that "

must be much Deaths in the first period is 1555 in the second*

advanced,by adniltting aqueous the I have seen, the pupilhas been partly clearedby the ;
fluid to !several portions of the lens,an advantagecapsule of its adhe- 6428 ; andin the third, 2594 ; thus showingthe weight
givingway from some portion
that renders drilling when the lenticular sion,and contracting of the Cholera epidemic upon the period from 15 to
applicable or floating aside. The idea just
cataract is hard. The 60 years of age.
capsulebeing unyielding, occurs to me, that the new forcepsmay be found
and the punctutesin it small,fragments of the lens useful in completing the detachment. It should be The other phenomena attending the year's tality
mor-

will be seen by the following Table, for the

cannot escape and do mischief. employedwith greatcare. I suspect that capsule
Mr. Tyrrell usually repeated the operation every will separate easier from an iristliat has lost its na-
latter half-year of 1849. (a)
three,four,or five weeks, and on an average from tural structure than from a healthier one. (a) The Table of the previoushalt-year
is given in
seven to eighttimes before he was satisfied
that the When the apcrtuieacquired is not sufficient,
or the Medical Times of August 4, 1819.
 THE MEDICAL TIMES.
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 THE MEDICAL TIMES.
in 1 106
pro- air,
of one atmospherein density, passes
The flvaDittrietiof London enoneimtod
in foncoing tho They appear to dependupon a peculiar perty
seconds, equalmeasure of airof two atmospheres,
IMttrkt comprlMt Ken- of gases, which I have,therefore, ventured to dis-
tinguish an
half
TU"Io an as follow :" Tho Wstr is found to pass in 553 seconds, or in exactly
; We"tmin" or Trans-
"Ington;Cheleee -"rfe, Heneraf^tqnaie by a new name, the Transpiration time. But this last measure is twice as
(Populedony is the character of gases in the first
~

St.
!^'l.""Mertln't-in-the Fields; ,

Marjrle-pirability of Gases. It that twice the weight is

diortiyheavy as *the first,so
MonTn"
_.
The
BM^nii area, ir'tiqnaremilcf.) which itis my object in
bone: St. Paneraa ; Islington; Hacknej ; Hampatead. respectof thisproperty, transmitted in half the time,or an equalweight
(Population, 875,971 ; aiea, 20*5 sqnaie mOes.) The Cbv-
to explain in the present communication, referring I may add, thatthe effusion
Oilet and 8t. George;Stnnd; Holborn;
Clerk- the subject to one-fourth of the time.
of for the details of my experiments
on
nu.xr-"t
onweD; St. Lokei Bast London;
West London; Citjr actions of air of all densities,
Trans- by an aperture,takes place
iMidon. (PopoUtion. 873,605; area, S-8 square milea.) a paper in the first partof the Philosophical the with equalvelocities, instead of velocitiescorre- sponding

The SAfv-Shonditeh; Bethnal Oieen; WUleehapel;

St. fi"r18i9"wnich is now passing through as in trans-
piration.
direcUy with their densities,
Georae-in-tbe East; St. Oeoige, Sontbwark; Newington;
: Ro- press.
Lambeth,Wandsworth, and Clapham ; CamberweZl502,548; As the capillary, or instrument of transpiration,
results in transpiration, ever,
how-
Onenwichf Lewishnn. (Popolation, The most curious
theriiltbe;
induding8,090 tile finest mermometer tube procurable may be
"ma, 961 square miles.) Total Population, in a length are the times of passageof differentgases,
Total 115-6 squan nOea. of either a round or nat bore, to depend
PdkeoBdut7,l,948"869. ana, employed, which are peculiar, and do not appear
of twenW^ or thirty inches ; or a short pieceof the of the respective gases.
flame,and upon the specific gravities
ON A NEW PBOPERTY OP GASES, same tube is softened at the blow-pipe and simpleof the results is,
length, The most general
drawn out to ten or twelve times itsoriginal of hydrogen gas is
BJ Profeaior T. GRAHAM, P.E.S., that the transpiration velocity
straw in size. A sheaf is
CoOMpondiag Member of the Institute of Fnaee, fre.x so as to form a rod like a
^

each exactiy double that of nitrogen gas. These gaaes,

UnlTanitjr College,Londaii. made up of thirty short pieces of thisthin tube, i elation in
have a less simple
itwillbe remembered,
four inches in length, which are laid side by side, of
The exutenoe of an atmotphereaiound the and bound thread. This is density, namely,1 to 14. The tzanspirability
up into a bundle by of that gas,
a
of air in carbonic oxide, likethe specific gravity
globe, and the nuceadng intervention an perfect instrument
the compound capillary, a more
be identicalwith that of nitrogen.
endless rariety of phenomena,both of the organic tube. appears also to in pointof
than the single The resultwhich may be placednext
And inorganic kingdoms, givean important bearing The be foroed throughthe capillary in
gas may and importance is,that the transpiration
and interest to everything that can be learned re- specting
1. By throwing the gas, by accuracy in
two differentways: "

of is related to tiiatof nitrogen

the gaseous constitution. Compared with of a condensing syringe, into a strongmetallic velocity oxygen these gases, that
means
the inverse ratio of the densitiesof
solidsand liquids, too,matter in the form of gas is box, where it is compressedto any desired extent, it is not equal
(rfsmall variationin physical is as 14 to 10. In equal times
susceptible properties, such as ^ or 2 atmospheres;and afterwards, the volumes but equalweights
of these two gases that
and ezhibiU onlya few grandfeatures. The di^r- when the experiment is to be inade, allowing
being more
which are preserved amidst the the air by passing are transpired ; the more heavy gas
condensed gas to escape into
of property,
enoes
in proportion to its greaterden- sity.
of gases may well, therefore, slowly transpired
the capUlaxy.The time is noted which
a
prevailing uniformity through Mixtures of and nitrogen have the
be supposed to be among the most deep-seated and inches of the gas take to oxygen
certain number of cubic and hence the
of tiiesetwo gases,
fundamental in their nature with whicn matter is mean veloci^
Or, 2. With gas under the atmospherictime of air is also found to be proportional to its
endowed ; they form the pillars of molecular escape. the admission
pressure only,by allowing
gas of
when comparedwith the time
"

oxygen.
^eory, while ihqralso pervadeand givesupport to to a
goodair-pifmp vacuum, by the channels of the density and oxygen is
the sciencesof eztemalnatuxe. and noting,as before, the time required The relation between nitrogen
capiuary, that between nitrogen and hy- drogen.
Tlie little Taxied proportions in which gases com-
for the passage of a constant volume.
The law of equallyprecise a s

of The densities, calculatedfrom the atomic

bine^by measure, so often that of actual equality quiteunexpected, but very beau-
temperature was
namely, 16 and 14,
"olume,tfe among tiieultimate factsof chemistry. other gas, weights oxygen of and nitrogen,
tifm. It is,that the colder air is,or any 0'9010 for air, and 0*8750 for
does a constant rolume of it,such being for oxygen,
also of gases exhibit constant 'rela- tions, 1
The densities the more quickly of
in which their atomic weightsor equivalent the capillary under nitroeen; the observed times of transpiration
as one cubic incn,pass through are for oxygen 1,
numbers are direoUyreflected Indeed,these any pressure. The increased velocity is simply in equalvolumes of the same Sgases
0*8708.
weightsmay themselves be based upon the densi proportion to the increased density which uie gas air 0*8970 to 0*9010,and for nitrogen
ties. at the low temperature. Of air,
for m- The result for carbonic acid,which is,perhaps,
acquires anomalous. It is,
The difiusive tendency gasesof does not imply a
stance, reduced to half of itsusual bulk by cold, one
next in interest, appean at first
diflarenoein density between two gases which,as cubic inch time ; and as one cubic that the transpiration time of this gas is inverselv
passes in half with
they touchyspontaneously intermingle under the is of double weight, it follows to its density, when compared
inch of the cold air proportional
influenoeof an irresistible impulse.But the com- in the same the time of oxygen being1.Their
oxygen, or 0*7272,
parative
that the weightof cold airwhich passes, ties.
theirdensi-
is well four times. be directly
process depends,
the isincreased of as
rapidity of as
time and by the same force, velocitieswill, course,
carbonic
Imown, entirely upon density, beingslowest with The law of the passage of air of diftrent tempera- tures It is to be remembered, however,that
which is six- teen an equal volume
the densest gases. Oxygen, however, through an aperturein a thin plateis very acid is a compound gas, containing
times heavier than hydrogen, is onlyfour times the air the more rapidlyof oxygen. The second constituent, carbon,which
dififerent The warmer ditional
ad-
less quickly diffusedthan the Utter gas ; the general while the ve- weightof the gas, appears
to give
does it pass for equalvolumes ; or,
locity increasesthe

to the oxygen, in tiie same

for equaldiffusion the manner
law being, that the time required of transpiration by a tube is directly as
velocity from
i" at the "guare-rootof the gas'sdensity.No me- chanical
the velocity of effiisionby an apertureis and to the same extent as increased density
density,
propertyof matter exhibits in a stronger inversely of the density, a nearly cold increases the transpiration
as the square root pressure or from
light itsinherentactivity. Allow two,three, or ten of itsel" A result of this kind
opposite result velocity pure oxygen of
^Mes to communicate togetherby the minutest
The law of density or elasticity is equally simple.shows at once the importantchemical bearing
chink or channel, theirmdecules are in instantmove- ment, the more and claims for it a place
The denser air is made by compression, gaseous transpirability, ing
combin-
have pervaded a tube of gaseous densities and
and restiesstilltiiey one an-
rapidly does one cubic inch of itpass through with the doctrines
the greatestpossible increases
ojner,and each attained of
intoa vacuum ; andhere,again, velocity
the volumes.
time of
dispersion ; and a inal uniformity composition in directproportion to the density.Air of doubled The cireumstance, that the transpiration
is thus produced. We at work a principle in half time. The indicates
see
passes into the vacuum is one-half of that of nitrogen,
of change, which ends in a fixed disposition density hydrogen
of a gas is therefore alwayspromoted that the relationsof transpirability are even more
transpiration
tnan the relationsof den-
and arrangement of the gaseous molecules " a
hy cold or by simplein their expression sity
by condensation, whether produced
structure in itsmost rudimentary aspect Analogy mechanical compression. It appears as if the mo- mentum
gases. In support of the same assertion
among
would lead us to conclude, that the molecules of a
from increased weightgave to the gas a the additionalfact, that binoxide of
isolatedgas, are not more at rest than mixing ance.
resist- may be adduced has the same
single correspondingly increased power to overcome nitrogen, although differing in density,
gases, but in constantmovement among themselves ; I may subjoin a Table of observationson
the time as nitroffen. Protoxide of ni- trogen
transpiration
the movement beingof that balanced kind,in which of air of different densitiesinto a vacuum, and carbonic acid have one transpiration
force is exhausted, like vibrations or circular passage illustrate and carbonic oxide,as each
no in confirmation of this law,and also to time,so have nitrogen
and which may, therefore, be perpetual.
gyrations, the degree of precision of which transpiration rimentspairhas a common
expe- density.
We have, in life, such active powers of matter con- trolled
are susceptible. The transpiration of twenty other gases and va- pours
and directed into certam channels.
TaAVsnmATiov ov Eaual Volwbb ov Aia. was experimentally determined,and found to
This diffhsionof gases in the atmosphere carries with tube sistances
re-
be uniform like the preceding gases,
to plantstheir food from the most distant sources. This
varyingin amount from to 1,000.
1
It is to plants the substitute for locomotion. time
listincludes the following substances : ^The "

Differentgases are forced by pressure tiiroueh a joined,

sub-
of transpiration of an equalvolume of each is
mmute aperturein a tiiinpUte, "e a pin-point in a of air
time of oxygen being1, and that
Aeet of platinum foQ,in different timesTwhich. the
of the
0*9. The shorter the time,the greater
course
times of
r^^"' y" " """" "" the relative velocity. Proto-carburetted hydn^n 0*5510,
fiant
de-
difliiSMm of tiiesame gases. The "effhsion"of a ammonia 0*5115, cyanogen
relation to density gas 0*5098,
gas IS thus ^emed by tiiie same
aeid 0*45"hydrosulphuxic acid
in tiiereceived 0*5060,hydrocyanic
as lU difianon, as was anticipated of carbon 0*61, sulphurous acid
of fluids. 0*62, bisulphide
theoryof the movements 1, clilorine 0 *67, bromine
The passage of ;asestiirough tubes, 0*65,sulphuric nearly acid
capillary acid 0*7363, ether 0*4408,
instead of apertures in
plates, presents results, ever,
how- nearly1, hydrochloric
ether 0*4826, chloride of ethyl0*4988,
which are entirely novel and whoUy unpro- It will be remarked, that the observed times methyllc coal gas 0*5716,and the
ynded fw in tiiereceived view of tiiegaseous conati- rarely differmore than two or three seconds firom chlonde of methyl0*5475,
both nearly the same
of vapouzB of water and alcohol,
tntioi, of whicV ndeeditiiey prove the incomplete- the calculatedtimes. While a certainmeasure
 THE MEDICAL TIMES.
as air,and coal tar naphtha nearly the same as that paratively so veiy few are affectedwith the disease out a idlure,as well as without
any untoward
of ooal gas. in question, that Mr. Lloyd was of opinion, that consequence whatever. It exdtea the necessary
The principal resultsrespecting the transpiration those gentlemen present who have a taste forit may degreeof inflammation, with as great, if not
of these rapours maj be sununed up as follows:" indulgein the use of theircigarwithout any fear of greater certain^ than the ixgection of wine, so- lutions
The Telocity of protocarbvuretted hydrogenis 0*8, epithelial cancer. of sulphateof zinc,iodine,"c" It is,
that of hydrogenbeing1. AHFUTATION AT THE UPPEB PABT OV a much more conveiiientmode of ment,
treat-
moreover,
The velocity of chlorine appears to be U times LOWEB THIBD OF THE THIGH. as well as savingmuch time. The mercury
that of oxygen J of bromine vapour and smphuric Leonard Minchin,aged 22, was admitted into is introduced, the patient is leftto himself, and the
add the same as that of oxygen. the Hospital on the 29th of Augustlast, under Mr. is
surgeon at once at liberty.
Bther vapour anpears to have the same Telocity Lloyd's care, on account of diseaseof his left knee, Mr. Lloyd has likewise latdycoced a case of
as hydrogen
gas; theirdensitiesare as 37 to 1. originating from an accident whilst plajring at
hydrocde, in a hospitd patient, by pressure" tightly
Olefiant gas, ammonia, and cyanogen to have cricketnearly three years ago. Su"red greatpain
strapping np the testicledirectly siterevacuating
eqnal or nearly equalvelocities, which approach at the time,but some ginbeinggivenhim, he was the fluid. The
pressure was
kept up forthree days,
cloaely to doublethe Telocity of oxvgen. able to finishthe game. From that time he has
by which time hernia humoraus was estabUshea ;
Hydrosulphuric acid gas and bisiUphide of car-
bon sufferedmore or less; but, duringthe last eight or
in the
since which the patient has gone on precisely
Tapour appear to have equal or nearly eqnal ten months, and particularly lately, his suSerings
same course aa is the case aftervinous ii^eotion*
velocities. have been very great The slightest motion of the
The compoundsof methyl appear to haTo a less limb occasioned the greatestpain. His rest at
Telocity than the corresponding compoundsof ethyl,nightwas much broken by pain; his pulsewas con- stantly
LONDON HOSPITAL.
but to be connected hv a cert"iconstant relation. quickerthan natural ; he had of late lost
It was no part of my plan to iuTestigate the flesh and strength considerably, and he altogether
On Thursday, the 18th of December, Mr. Cu"-
passage of gases throughtubes of great diameter, felt his limb such a burden to him, that he was lingperformedthe operation for strabismtts, on an
and to soIto pneumaticproblemscl actual occuz^ anxious for itsremoval. A consultationwas held
unmanied man, aged 40, who had been an in-"
leooe, such as those offeredin the distributionof on the case, and an unanimous opinion giventhat the patientunder Mr. C. sinee Oetober 22nd. The
"oal-MS by pipes. But I may sUte, thatthe results limb should be amputated. Mr. Lloyd, therefore, operation has sncoeeded,dthongh at the time the
must oe similaxwith truly elasticgases such as air on Saturday removed the limb, having recourse to to its natord position,
To restrainthe haemorr-
hage eye did not return exaetiy
and carburreted hydrogen, whether the tubes are the double flap operatioa. notwithstanding that every portion of the musde
capillary or scTeralinches in diameter, provided the it was necessary to apply ten ligatures. The
was perfbetiy divided.
lengthof the tube it not less than 4000 timet ita flapswere broughttogether by one suture. Wet who is of a somewhat robust,hot
This patient,
diameter, as in the long' fflasscapillaries of my ex- lint was appliedto the face m
periments; the stump, and a
in*
some of whjch tubes were l-40th of an calicobandagewas appliedallover, so as to make intemperate appesranoe,was admitted for an
flamed flngerand hand, which had followed a
uch in diameter. The small propulsive gentle pressure, and give support to the divided
pressure wound from a knife, a week prior to his application,
applied to ooal*gaa isalsofitvonrable to transpimtSon, muscles. The stump to be keptcool by the frequent
whilst he was aflectedwith syphilis ; the poison of
aa well as the great lengthof the mains ; and I application of co!d water.
which had inoculated the wound. His hand was
would theiefineexpectthe distribution "f coal-gas in There has been no secondary hsmotrhage,and swollen and inflamed, the inflammation
considerably
citieato exemplify approximatdytiielaws of gase- the case is going on favourably.
of the absorh-
oos transpiration. The vdocibr of coal-gas should BBMOYAL OF ADIFOSE TUHOUB
extending up the arm in the course
ents; the mrefinger fluctuated indistinctly, while
be 1'575,that of air being1 underthe same pressure. The next patient broughtinto the theatrewas a at its
And with a constant propulsive of Mr. Lawrence. The disease was a small apex is a small sore indicating the seat of the
pressure in the gas-ometer,patient The partwas fireely and
the flow of gas should inorease in volume tattytumour at the bend of the rightarm. It original acddent opened,
the hand enveloped in a poultice.
with a rise of the barometer or with a fallin tem- had existed more
perature, than twenty years. It waa very
connected with the adjoining The man, on his admisnon, was in a state of great
dixeothrin proportion to the increase of ita loosely tissues, and
removed by Mr. Lawrence. tremor and agitation; his articulation was paired;
im-
density "em eitherof these causes. waa expeditioosly
tongue furred, tremulous,and indentedat
BADIGAL CUBE OF HTDBOCSLE BT HOVEL
1CETHOD" its margin ; pulse f iill,
but very soft ; the man haa
and is evidentiy
BOSPZTAb RBPOBT8. A patient, Benjamin Green, aged38, admitted had no deen for sevenJ days, bouring
la-
with hydrocele of the tunica va- under an indpient attack of delirium mens.
tre-
into the hospital
ST. BARTHOLOMEW'S HOSPITAL. **
radical For the last nine years he has led an ex- tremely
was operated for the cure" by
rlis,Lloydalso on Saturday
on
last He pointed out irregular and intemperate life, seldom bein^
There were several operatums performed at this to the students that"e tumour projected more than free tnim the influenceof drink ; he has had deli"
Hospital on Saturday. common at its upper part,was contracted at its rium tremens, three years mnce, whilst at St
below,exhibiting somewhat the Helena,^ and a dight attack of the ** horrors" at
XPITHELIAL OAHGEB OF TBB LOWEB LIP. middle,and larger
A patientof the name of John Edmund, aged hour-glass shape. He statedthathe had seen many leasta doaentimes.
66t was operatedon by Mr. Lloyd,for epithelial largehydroceles of " similar figure.That the fluid About a month priorto his admisnon, he con-
tracted
caneer of the lower lip. The disease presented the in the two portions communicated was evident to two small dumeres,which still exist, one on,

ordinary character,and extended an meh or more the touch. But as a twelvemonth before Mr. and the other at the root of the penis;these have
across the centre of the lower lip. It had existed Lloyd had operated on the opposite side of this much increased the lastfow days,and now presen
about three months. There were no enlarged glands patient for strangulated inguinal hernia complicateda very unhedthy aspect
tD be discovered under the jaw, or in any partof the with hydrocele, it waa importantto examine the He waa sent to bed and ordered f^ Opiint xL
aeek. The morbid partwas removed by a horizontal present hydrocele with care. Mr. Stanleyhaving and allowed beef tea,gin $iv,porterOy. Towards
"ectioo. The operation onlyoccupied a "w seeonds. examined the case, and concurred in the opinion nightthe patient became more excited, so that two

The patient is goingon most fkvourably. that had been formed of the nature of the disease,more doses of $LOpiiwere given.
Aha the operation, Mr. Lloyd made some prac- tical Mr. Lloyd at once punctured the sac just below the Oct 23rd. Has passed very
a restiess nighty and
remarks. He stated, thatin thisdisease, when tiie contracted partand drew off about thirty ounces of had no ,^]eep. His cxdtement is in no way abated,
partsfre freely removed by the knife at an early pe- riod, greenish-yellow fluid. He then iigected the sac with and it is witiidiflieulty he can be keptin bed ; or*
thereisseldom any recurrence of the compuunt undiluted portwine, usinga pintfor the purpose. dered,|b Opii, 5ss stat : thiswas repeatedin the
He obeerved,that firaur patients in particular, on It waa allowed to remain in the sac for about four- teen evening, and 5i administered at night, with nxu.
whom he had operated under such circumstances, minutes, and occasioned very little pain. every hour if requisite.
had been long under his observation, without any Whilst waiting forthe abstractionof the wine, Mr. 24"th.Several doses of the mixture have been
"ymplom whatever of the disease recuiring.One Lloyd made some remarks on some other modes of given, but have failed to procurerest; on the con- trary,
of the patients lately died,who had been operatedtreating hydrocde. his symptoms have much increased, foncying
on nine years before. He was free from anything He mrst adverted to the treatment by forcibly jecting
in- innumerable objects about his bed, Are. His pulses
Hke earcinomatotts afiectionin every part of his the sac of the tunica vaginalis with air.
are quickened, but have lesspower, and the strength
bodyat the time of his decease. Another of the He employedthisplansome years ago in several of the patient is evidentiy beginning to fdl. Or- dered
patients, nearlysevenbr years of age, operated on cases among the out-patients of the hospital ; at flrst carb. gr.v. ; mist
liq.opiivid. 58S,ammon.
between thirteen and fourteen years ago, is quite he thought with success, but,with the exception ofone
camph.,4tis horis,and an extra pintof porter at
healthy, and free from every appearanoa of the case, the disease recurred in all;and what was the
night
diseoae. Adverting to the cause of the disease, Mr. permanent resultin that one, he had had no oppor- tunity 25th. Passed a betternight, has been less exdted,
lioyddoubted whether the habit of ** smoking"was of ascertaining. He had also givenacapuno-
and had about an hour's deep. This morninghe is
adequateIbr its production.Tobacco, as well as turation a fair trid, but found it a very unoertdn and seems much better. Bep. mis. ter. die.
the oommon
calmer,
pipe, mightbecome an irritantto the Up ; remedy. It is, however, oftener successful in The inflammation of tiiehand has subdded, and the
theymi|^t eadi producean actionof itsown; but isit children than in adults. But the planof treatment wound fredy. A solutionof nitr.silver
discharges
Ukely^t a spedflcdisease would be the resultt most reliedon by Mr. Lloyd,is one which he has and 5ijto be applied to the sores on the penis.
Most there not alwaysbe some cause previously adoptedalmost exclusively at the hospitdfor severd gr. v.,
As nightapproached the man became a little more
existing,apredisposfaig
*"
stete," as it is called, of years. It consistsof the introduction into the sac,
restiess, so that the mixture was ordered every two
the parts, or, in other words,the disease abeadypre- sent afterit has been emptiedof its contents,through
hours, and OL porterextra.
in an embryotie or latentcondition? Smoking the canula, of a smaJl portion of hydrarg. nitrico"
Isa habit ao mnoh indulged in by the greatbulk of oxydi,flneiy levigated. This plan has been em- ployed ^^^Il Mnoh impiovedt but ia yeiy weak ; haa
tta UbouiBg poor from a very early hiOertowith* ""^^^^^foKMvanahoiiii. Ho now begini to oava for
age^ aiideoni- in a large n umber of eases"and
 6 THE MEDICAL TIMES.

food. Orderedifull diet and wine Oy. From this labouring man, at irregular intervals. Since July, The airis a bad conductor of heat,and hence the
time he began Bteadily to improve, the wine was 1844,the pain and difilculty in voidinghis urine caloric of the human body does not vary much.
discontinued, and its placesupplied by porter Oiv. has increased, and he has not been able to do any But as water conducts heat much more rapidly,
and quinine and mineral adds were ordered. On work. When a boy he had been sounded at dif- ferent fishesare compelled to bimg their temperature into
Norember 4th the man complained a swelling
of times,but no stone was ever detected until an equilibrium with the surrounding fluid. As for
about the anus, which,on examination,was found Mr. Ball discovered one on the 8th of March. amphibiousanimals, air and water give them a
to be an abcess. Leeches were appliedand then a He 18 not a very healthy-looking subject, having temperature which varies accordingto the con-
poultice ; these were repeated until distinct tion
fluctua- a bloated and scrofulous appearance, but has always, ductibility of the media theymay happento be in.
was detected, when it was lanced,the patient's with the exception of the urinary afiection, enjoyed Man takes hisoxygen from a mixture of gases which
bowels been keptgently open. good health. Tongue rather furred ; pulse 90 ; he decomposes, setting free the nitrogen. Fiahes
During this period, the sores on the finger and urine neutral, coagulable by heat and nitricacid. take their oxygen from a liauidgas, which they also
peniswere rapidljr healing, under the application of 22nd. p" 01. ricini.ft.haust.
" st sum. ; enema decompose, setting free the hydrogen. Amphibious
the solutionof mtr. silver. calidae aquae. Tongue stillrather white; bowels animals,havingdouble organs, possess mixed pro- perties.
Towards the end of November, a pustular tion,
erup- openedtwice or three times duringthe day. Man perishes in the liquidgas, water; a
chiefly on the face, showed itself, which yielded This day Mr. Ball performed the lateraloperation carp perishes in a gaseous mixture ; an amphibious
to the decoct cinch, c. pot iodide,and pil. hydro- for lithotomy.The bladder being empty, some animal livesin both,and its temperature is a mean
chlor. CO. gr. t. omni nocte. By the 13th of De- cember, little difiiculty was experienced in seizing the stone. between the two classes. Hence the Author thinks
all traces of the original affectionwere re- moved, After it was removed, an elastic tube was intro- duced it demonstrated,that the medium in which the
and the man's health so fieur re-establishedas throughthe wound into the bladder,and se- cured animal lives alone determines the temperature of
that Mr. Curling considered him in a fit state to by tapes. The calculus was oval,the surface assimilation, which is absolute for all,and propor- tionate
mndeiig^o the operation for Btrabismus, which was in some partsuneven, particularly at one end,which to the quantity of ,oxygen absorbed, and this
accordingly done. was of a lighter colour than the rest of the stone. again sensibly proportionate to the mass of the
The foregoing case affi)rd8 a goodexampleof the It weighed 8 drachms. animal. From metallic sponges to animal heat the
^

violent and extensiveinflammation which often fol- lows 10 p. m. He expresses himself easier than be-
" fore distance, one would have thought, was great; but
a sUfl^ht wound, occurring to a person of in- temperatethe operation. M. Chenot shows the connexity by remarking,that
habits, complicated here, no doubt, TgoCalomel, is
sponge-iron amphibiouscombustible^the heat
by gr. iij. ; Opii, gr. j.h. s. s. an

the presence of a poison. 23. Has passeda quietnight;skin moist,a of combustion beingabsolute,proportionate
" to the
For three days,priorto his admission, the man little pain at the lower partof the abdomen, and quantity of gas absorbed,and the latteragainab- sorbed
havingexhui^d his means, was unable to obtain smarting of the wound. Bowels opened; pulse92. in proportion to the quantity of the metal.
his usual amount of stimulus,"thus explaining the 24. Going on favourably.Some of his water
" Jpropot of the same subject may be noticed an in- teresting
cause of the delirium tremens, with which he was passes throughthe penis. memoir, by M. Leon Dufour, on the aquatic
evidently afiected, and which yielded imder the ex- 25. No bad symptoms. Tongue rather loaded respiration
"
of insects. In this numerous class of
lubition of a largeamount of fermented and spi- rituous with a whitish fur. A weak solutionof aceticacid animated beings, respiration takes place, either in
liquors, combined with sedatives and applied about the perinseum. the air or in the water, according as Uie animal
nourishment. 26 Most of the water passes throughthe penis may
"
be a larva, nvmphe, or perfectinsect
It is curious, in this case, that the tincture of when he is lyingon his right side. He takes one- Whatever the mode of respiration may be, Ae air
opium failed to produce its desired effect,but third grainof morphiaevery night. circulatesin canals,which subdivide into an infi-
seemed rather to aggravatethe symptoms { the liq. 81. Stillimproving.Complainsof the wound "
finitenumber of smaller tubes,that transmit it to
opiisedativus, however, succeeded perfectly. smarting.Urine neutral. allthe viscera,and even to the minutest tissuesof
It will be seen, that,in the treatment of the P" Acid. nitr. muriat,m^j*; aqusa purte, 3J* the animal's body,where it apoears to serve fbr
"

primarysores, no mercury was administered. Mr. ft haust ter. die sum. nutrition. The air may be inhaled either through
Curling remarked, that,in this case, the mineral April2. Continues to improve.
"
external respiratory onfices or by special organs,
was contra-indicated, from the disordered state of 4.
" Has a good deal of pain in the penis when and the insect is thus enabled to live in air or
health under which this patient laboured, as fested passing
mani- his water, which is alkaline,and contains water, beingperfectly amphibious.After having
by the consequences of so slight a wound, by thick ropy mucus. P" Mist copaiba. givena minute anatomical description of the respi-
ratory
the delirium tremens,and by the subsequent ation
form- 8. ^Wound healing less thick ; much organs of these insects, M. Dufour enters
"

; water
of the abscess about the anus. less painin the penis caustic into curious detailsrelative to of them,the
; to the granulations. some one
For the reliefof the pustular eruption which suc- ceeded 14. "
Much better; wound nearly healed. Phytobiushydrupkiha.This insect lives on the
the healingof the sores, only the mildest May 20. Discharged " cured. branches of a submergedaquaticplant, Myrio- t he
remedies were employed,vix., Plummer's pill, in Dec. 21, 1849. pkyUum tpirahim: but although the author observed
alterative doses, and iodide of potassium in decoct it with the utmost attention, he never could detect it
chonae comingup to the surface of the water to breathe the
It will be interesting here to allude to a case air. From time to time,however, it shot off firom
PROG1UB88 OF KBDIOAL 80XSN0E.
which has lately occurred amongst the out-patients, the plant and executed the most rapid movements in
"
under Mr. Wara, showingthe care FRANOB. the fluid, intended,apparently, to disengage the air
necessaryeven
in the application of nitrate of silver, when the fixed in the watei', and thus render it more easily
system is out of order. A young female,who had (ParisCorreipondenee.) respirable.
had violentinflammation of the tiiecaof the SILYEB m SALT WATER.
thumb,
succeeding the prickof a pin,applied, when ithad UETALUC SPONGES. MM. Malagattiand Durocher had already
proopededso "r, that the phalanxhad become Of the various sciences connected with Medicine, pointedout the existence of silver in many mi- nerals,
necrosed. Chemistryhas alwa3r8 occupied the firstrank in with which ithad not been previously posed
sup-
Amputationat the firstphalanxwas performed,France,and been cultivated with the greatestsuc- cess. to have any relation. In a second and recent
and the flaps, in a short time, had imited,exceptat Hence the most important memoir to the Academy of Sciences, the same
Paperspresentied tlemen
gen-
the outer angle, where there were some prominent to the Instituteare generally more or lessdevoted to announce, that theyhave detected silver in
l^nulations,over which nitrate of silver was subjects of a chemical nature. A young pupilof sea-water, and even in many organic bodies. The
rubbed,it not havingbeen noticed, at the time,that the Mining School has bestowed an immensityof Anthers were led to the research on this precious
the patient was sufiering from considerable consti- time and labour on
tutional the production of metallic metal in salt water, by the fact,that the long ac- tion
disturbance, broughtabout from disorder sponges, some curious examplesof which he showed of the saline fiuid on the minerals called
of the digestive system,(aswas found to have been at the late exhibition. The experiments of M. pyrites, "c., which contain some silver, will con-
vert
the case on her next application.) Chenot on these sponges, led him to direct his the sulphuret into a chloride; and that the
The consequence of this was, that
very violent attentionto the subject of animal heat,and to pro- pose formations on which the sea now reposes, or has
inflammationsupervened, resulting separationof
in a new classification of animals,having for its reposedgenerally, contain some of the sulphureta
the line of union of the flaps, which became basis the absolute heat of each, which is propor-
very tionate just mentioned. This idea, at first p urely theoretical,
purple, appearing, in fact" allbut in a state of gan- grene. to the quantiwof
oxygen consumed. proved on experiment, to representa fact Our
"
Hitherto,"says M. Chenot, "animals have been Authors state, that the waters of the sea, taken at
After theexhibitionof a calomelandrhubarb classed into "warm and cold blooded. It isadmitted several leagues distance from the coast of St. Malo^
purge,
and a little alterative tonic medicine, the nitrate of that man consumes about six poundsof oxygen in contained a certain quantity of the precious metal.
"ilverwas again the twenty-four hours,and thathis heat is fixed. It The ashes likewise of severalsalt-waterplants,
freely applied, without the slightest as

ugunous eflbct, and the case did perfectly welL has also been admitted that fishes consume only the fueutterratut, and qf eeramoidet, contain more
1-6000 partof the quantity consumed by man, and than 1-100,000partof silver. It was also found in
that their heat is variable. They are called cold- blooded. common sea-salt, muriatic acid and aztificial soda"
NORTH STAFFORD INFIRMARY. As for amphibiousanimals,they have and in bullock's blood. Some
even persons, of
not been classedin any precise manner." warm imagination, hope that this discovery may be
GeorgeNicklin.aged 20, admitted under Mr. Now, it is certain that all animals consume turned to practical account, but the dose appears
Ball,March 11, 1849. Since two
haa had pain, years of age he oxygen, and that in proportion to their weight; too homoeopathic to presentmuch importance.
more or less severe, after his and M.
voiding Chenot concludes, that the variations In recounting,however,the labours of foreign
urine,which has frequently been so severe as to of animal heat depend on the peculiar medium discoverers, I must not forget our own countryman,
^ge him to layup for several weeks
together. in which the several animals live. The following the universal Brougham, who has been making
A" au, however, followeda light employment as a are the reasons on which he grounds his theory.some experiments, it is said,at hii ehateftu.
 8 THE MEDICAL TIMES.

fint conical,
then Bemi-spherical, and afterwards de- into some one particular
pressed line of study, is as much of a physician, (forsailor we would nut the
made Commissioners of Sanitary Reform); he would pre- fer

sions
sion
depres- as possible encouraged ; the student, in efiect,
at the apex, forms a corresponding would call com-
a disease by what he
mon
at its base as often as the suppuration takes to secure firsta general knowledgeof a nuo^ber of treating
laugh the idea of
; but he would
diately
imme- at
placecompletely throughout And when there is subjects, before he giveshis mind more sense

of thislineof study navigating a shipby common sense. An architect

confluence, the depressions and ridges oorres^nding to one. The good effects what
or musician will not trust to common sense" or
dwelt on, and some far off"epoch shadowed
to the aggregateof the pustules together give the were
aeamed and cicatrizedappearances, so disfiguring to when the Belfast and other Colleges should supply becomes of archivoltsand the laws of harmony. The
bosom. The first great secret is,that common sense is onlytrusted
the face after severe confluent small-pox. its own lecturers from its own
In aU the milder forms of small-pox, crete year,then.Classics,
as the dis- French,and Mathematics are the when we have nothingelse,and art and experience
and tiiemodified, the suppuration is less com-
plete, nuts the medical students have to crack " ^thevalue most sought after by those who understMidtheir
sense is of use in the appUcaOon
of
or does not extend down to the base and pits of each was of course dwelt on. In the second value. Common
;
and the different branches of art, but should never supersede it
therefore, do not follow. Whatever means, then, year. Chemistry,
can check the progress of the suppuration when it Natural History are required. In the third and sub- sequent The science of the mind" the lecturer hoped to
On the sub-ject be able to show in his course, was not that tangled
threatens to bec'omplete, or, in other words, makes years. Practice of Medicine.
the pustuleabort,will prevent pits. The term, of Medicine,the Lecturer seemed anxious to do web it was made out,but a true science;nay, as
Ectrotie, was introduced,we believe, by Serres,battlewith the old way of doingthingsin Ireland, Aristotie said,the basis of all the sciences. The
of the highest medical authori-
ties abuse of the word philosophy" term which the
pus- itbeingthe opinion
a
when he firstproposed to make the small-pox tules
abort,by means of Nitrate of Silverapplied to (?)in Ireland,that a knowledgeof French and ancienU limited to this very sciencewas next passed
given the Schools of Greece
each. The term beingtaken firom Esrirpwifroi, Classics was wantingin the preliminary courses, in review " a glance at
at Apothecaries' Hall both --at those of Rome, which the Lecturer ratiierhap- pily
abortum facio. And mercurials applications ap- not knowing that even
abortion also,this kind of treat- required. stigmatised of exotic growth,, under-and
pesring to produce ment are as

JSctrotic. fate of such. "

Cicero," aaid the Lecturer,
is not improperly termed The whole THB GALWAT COLLBOB goingthe
to have been too little attended to in Has experienced a greatloss hj the recent death "
wastiielastof thisschool" tiie lastof a race of great
subject seems
Christmas,too, has men, whom St Paul said: Having not a law,
*
this country. of the President, Dr. Kirwan.
come to divertthe attentionof the pupils. were a law unto themselves.'
"
The epochof Chns "

ofMental science, tions

observa- next dwelt on," the Middle Ages
and
imBIdkMD. In the department some tianity was

veiy worthy of the attention of the Medical their learning rather spiritedly defended,"Ireland
classes have been delivered by Professor Moffat. congratulated transmitting the lamp of science
[DablinCoiretpondenee.] on

Commencing his " by

Introductory" a general jection
ob- through the hands of Erigena,"Bacon dwelt on con
THB DUBLIN 8AMTABY AB800IATI0N to the iMresentcharacter of our studies,oswre" his philosophy happilyassimilatedto the
Held a meetingon Wednesday,the 28Lh ult,to re- ceive as too physical^the true science of mind
" and Tent the FairyParibanon gave Ahmed" folded up
the Reportof a deputation, appointed to wait on lifebeingpostponed to a mere matter of showy ex- perimentitbecame a toy to please the hand" spread out it
Sir William Somerville, relative to a Bill,now in The Lecturer entered into a laboured gave shelter to armies! The German school was
iramUu, on sanitary matters, and all important to this from B"le to
idealistic
analysis of our present knowledge on important shown to be very dangerous"
the inhabitants of Dublin. Some objections on the subject Galvanism and Electricity he guardedhis Konigsberg France, eclectic" Scotiand, com-
"
ing

score of taxation were urged; others as to the Board Medical friends against, as trying to supplant that back to tiie days of Reid" and Cambridge,of
of Health meddlingin the matter. The Deputationvitalprinciple, that England
of which the true physician should late lifting up itshead, and showing
was very politely received by Sir W. Somerville. never lose sight In France,Villemamsand Cousin was not behind in the race.
A very long discussion ensued, but as vet little have been swallowed
up in a cloud of mere physical
practical advance seems to have been made. The the same.
philosophers ; in England,itthreatened
Secretary would be happyto record suggestions TO 8UBSCBIBEBS.
The objections to the studyof the brain were next
firomthose who had applied themselves to the ques- their
tion reviewed ; the cui bono ? "c New SubscHbers wiU obligeby forwarding
of sanitary reform ; but otherwise things look Lecturer
The operations of the mind, the aptlv Names direct to the Office, 147, Strand, or to the
very like the way theywere before. illustrated by the circulation of the blood,of which Newt AgenU or Booktellere, AU Post-office
THB BELFAST OOLLBaB. we are of course quiteunaware, but which stillgoes
This branch of the " Queen's University in Ire-
land on every moment Orders should be madepagabUto the PubUsh^rs^
The act of standingwas not
"
Wm. B. ObB AMU Go.
was opened on the 20th ult,with all the dissimilar Ghostsof muscles were called almost in-
"
voluntarily
form and manner befitting so auspicious an event into action,the individual quite uncon-
scious

Among those present, we recognized the old fanuliar of any eBEbrt Even so may we conceive the the
According to our usual custom, we shall complete
faces of Dr. Corrigan,Professor Harrison, Dr. mind " and the question is often asked the Prac-
titioner
Index to the Volume in our next Numb er.
M'Donnell, Dr. Neligan,Dr. Duncan, Dr. Cimi- "
goes through acts of which it is itself
ing, (Armagh), Sir James Murray, Dr. Cooke often unconscious,without pain or efifort; but
and some others, anxious,of course, io stand pro tanto efforts,and to be looked on as such.
sponsors for the new undertaking. The Ad- dressEvery one must be cognisant of the matter. Who THE MEDICAL TIMES.
of the President, Dr. Henry, listened shall interferewith the merchant or banker adding
to with much attention, was, perhaps, of more than up his accounts mechanically?No mental effi"it,
average merit The Colleges, the Lecturer reminded he says ; yet there is mental wear and tear. In SATURDAY, JANUARY 5, I860.
his hearers, were due to the liberal feelings of Sir fever,in deUrimm tremena,what hosts of imagesare
James Oraham and Sir Robert Peel towuds Ire- land, bodied forth without mental effort; yet we allknow
the Act been passedin July of the with what mental wear and tear also. Thb commencement of a New Volume induces
having
Sir Isaac Newton's mind, the Lecturer intimated,the Editor of the Medical Twm to address
year IS46, The condition of Scotland and that of
Ireland,with respectto collegiate instruction,were was constantly at work in spiteof him. Those
briefly his readers on the endeavours which
compared. In 1840 Scotland had six colleges, five miraculous things done in sleep \ composing music,
willbe made duringthe ensuingyear to raise
universities, with apopulatbnof onlytwo a^ a half poetry,"c., belongedto the same order of pheno-
mena.
and not less than 3000 students. In Ire- the scientificcharacter of the Journal, to ex-
tend
millions, land, Many mental processes we are as uncon-
scious
onlyevery fiveparishes (whatever a parish of; as the organist of the several keys he its practical and to render itworthy
utility,
may
be)fiimished a college student Medicine in Eng-
land touches. of the Profession.
was spoken o^" Lord Clarendon very pro- perly The Lecturer enlarged on the uses of logic,which
The scientific character of a Medical Journal
lauded for his anxiety, for the spreadof edu-
cationhe well defined as the science " of the appreciation
bv theseinstitutions of
; greatthings, course, of evidence." others,the medical man
Amongst
can*be raised onlyby attracting to its columns
expected by the Lecturer from their happy re-
alization.
was one to whom itwas of never-failing use. To the contributions of eminent persons, whose
''Action is our principle," said Dr. draw inferences correctly, is about one of his best labours are enriching and advancingmedical
Henry,with more than usual emphasis, re-action guides ; and for this purpose, he would
'*
in practice
and by drafting into its pages the
our hope." Not such,we trust,as that of a learned do well not to neglectsome of the books on the knowledge,
additions that appear in
fimctionary in the west,who has tried to call the subject The ** Novum Organon" was mentioned, useful and important
In thisway a well
Collegesalready very ugly names. In the ** Bel-
fast Des Cartes on " Method," and others more recent contemporarypublications.
Institution," 175 studente have already entered The value of " experience" was dwelt on, and conducted Journal becomes not onlyin itself a
.^"more hopefulthan Galway. This,however,it Lord. Mansfield's advice (nmtaiis of
mutandis, use
constant source of advancement and improve-
ment,
must be remembered, is not the College. to the medical man) was dted.
*'
Give your opi-nions
An outlineof the course of education was entered said His Lordship,** the chances are but is, as it were, a mirror in which the
boldly," "

into, and as hereafter of use to the readers of the very elsewhere recorded are accurately
many that you are riffht but giiwno reasons" improvements
"

Medical Times, it may possibly be worthy of pre- ""The opinion

servation is the resultof your experience, and reflected.
;" the Colle|^ session has been extended obtained by a long mental process ; out do not go
to eight months from six, the old and venerable allow-
ance the groundagainor you will fail, and confuse The contributionsthat have appeared in the
over
of allour younger days. Six months' Lectures both and yourselfl Medical Times since the commencement of the
your patient
and dissections, and six months' idleness, the Lec-
turer ArchbishopWhately'sideas on what is called last Volume, abundantly testify to the rank
thought inharmonious" to mental training. Common Sense" in the world,as opposedto expe-
'* ""
rience,which the Journal has now taken as a medium
"
Residence " is insisted on in onlytwo out of were next dwelt on, very happily. ''A
icientifiooouununications. Tha
original
tiizee
BoiaioiM. Th" afterthe firstyear
diTergence^ ^ aailor/' "*
preten-for
says Hia Graoe, willdwpiwtiie
 THE MEDICAL TIMES. 9

nines of many of the most eminent of the improvements, all speculations, theories, with unflinching energy. Nor can it be

ples
Professionwill he found among those who debates,which take placein France or Ger- many, denied,that to make a Medical Journal what
ha?e enriched its pages ; and the Editor has are at once givenin the columns of the it oughtto be is a task demandingstrenuous
much pleasure in stating,that the promisesof MecReal limesjwith allthe accuracy to which labour, careful study,and cautious determina-
tion
continuedsupporthe has received from these, the inquirer ; but the Editor does not doubt that this
upon the spotcan attain. And it
and from numerous other gentlemen,enable may be safely said,thatifthe name of the Berlin,work,di"Bcultas it is,may be accomplished,
him to assert that the presentvolume of the Paris, or Vienna, and,to come
" nearer home, and the Medieal Times may be able honourably
Medieal Time$ willhe more copiously supplied Edinburgh or Dublin, Correspondents
" could to represent the EnglishMedical Professionin
with original papers than any former irolume be made known, they would be found to be the general literaryarena of the world.
has yetbeen. names of men of high rank in theirProfession, It appearedto the Editor, when, more than
Extreme pains will
alsohe taken to introduce whose words are entitledto the respect of every a year ago, the Medical Times passedinto the
intothe presentVolume short abstracts of all IVactitionerof Medicine. hands of itspresent Proprietors,tiiatthe greatest
important Paperswhich appear in any English, In the department of general Correspondence, services mightbe rendered by an independent
American,or Foreign Journals. In this way the rule of the Editor has hithertobeen,to give Journal. It did not seem imposublethat
it is intended that the Medieal Times shall ac- admission to letterswhich appear to be of the causes
complish, of dissensionmightbe removed by
on a largescale,what the half-yearly interest, and which do not involve matters careful examination ,ofdisputed questions,
Retrospects
attempt on a smaller. These of a personal ferred and by an
character. If individualsare re- unbiased expression of the judg-
ments
abstractswill be made by individualswhose to by name, the Editor deems itessential arrived at. It was known,also, thatthe
"ccmracycan be reliedon, and itis confidently
that the writer should not remain altogether same opinionwas entertained by some of the
hopedthat theymay be considered as giving anonymous ; but that the Editor should at least most eminent of the Profession, wearied by con-
tinual
soperfect
an acconnt document, have the opportunity
of each original of judgingfrom the known which producedno
discussions, tion,
convic-
thatreference may be made to them with as character of the writer as to the truth and and
by everlasting suggestions,which
mnch security as to the originaldocument honesty of his communication. nobody adopted. It was also felt,that there
itself. No rule has been,or will be more for M edicalJournal of scientific
strictly
was room a
In that departmentof the Journal which enforced, than that the Medieal Times must pretensions, and the Editor hoped to supply the
emanates more directly from the Editor, never
" be made the medium of slander and want BO generally expressed.
riz.,the LeadingArticles," various scientificscurrility. If the Editor deem it necessary It iswith great satisfaction t hat the Editor
questions have,during the lastyear,been taken to express an opinionadverse to any Indi- vidual againrecurs to the support and assutanoe he
up and discussed. In this way, hardlyany or to he
any Institution, will do it has received. It iswith no wish to paradehis
sabject has been started in medical circles, boldlyand unsparingly, but in a frank and success, that he states the circulationof the
which has not been thus explained and he is authorised to Journal to have rapidly and constantly increased,
and re- gentlemanly
viewed. manner,
The foundations of Medicine, Uie expect a similar tone on the partof his Cor- that offersof sympatiiy
respondents. and aid have reached
sspectof Medical Science,the influence of Nothing has been so injuriousto him from all classes, and that,if good wishes
Physiology and the cognateSciences upon our Medical literature, as the licensewhich certain could assista Journal, no periodical publication
Art,Sanitary Reform,the efiTectsof CivilizationEditors have taken, and have permitted mous
anony-
in allEnglandwould have a larger diffhsion
on Disease, "c.,have been debated, with those writers to take. It may possibly be the than the Medieal Times, The Editor and his
mora strictly technicalsubjects which are con- task of the Medical Times to unhood some of coadjutors accept this success as the natural

sttntly arising. those who damn with inuendoes the character rewa^ of honest and earnest labour, prompted
In addition to this,great painshave been of their professional by motives of no selfishand unworthykind.
brethren, and to pillory
tikento determine what is the realinterestof them as objects for the contempt and di^ust of They promisetheir readers that the present
thePjrofeseion in those complicated topicsof allhonourable and gentlemanly men. year shallwitnessincreasedexertions, and,with
MedicalReform, State Medicine,Poor-law The Review Departmenthas been carefully the experience gainedduringthe past year,
Medical Relief, "o. The Editor has not conducted duringtJielastyear, and will be stilltheydo not doubt that the Medical Times will
hesitated to express his opinions frankly on improvedin the presentVolume. Oentlemen become every way worthyof the noble and
thesepoints, and he believesthatthese opinionsof known authority Professionof which itaspiiesto be
on the special subjectof enlightened
have met with general approbation. the work willbe selectedfor Reviewers, and the the organ.
Daring the current year, these topics will be Reviews most conscientiously and carefully THE LONDON
TIMES AND THE
inow widelyand boldly discussed. The
rience written.
expe- HOSPITALS.
of the lasttwelve months has satisfiedthe
Reportsof Societies, and of allMeetings portantOur excellent Contemporary,
im- the Thnes, in
Sditoras to
many points connected with the best to the Profession,willbe regularly lished.
pub- itsvigilant anxiety for everything that tends to
mterests of the Profession. The
subject of A special Reporterhas been engaged the comfort of the poor and humbler classes,
MedicalReform will be entered into in allits for the London Societies and it is
; hopedthat speaksthisweek of the necessity of a more steady
bearings ; the dauns of Medicine on the State the Secretariesto Provincial
nish supportto the smaller but stillhighlyuseful
meetingswillfur-
win be vigorously enforced ; Mesmerism,Ho- short accounts of interesting debates, as it Metropolitan Hospitals, "Institutions among
mcEopathy, Hydropathy, and the like willbe has not been
possible at presentto make
any which,we need hardlysay, stands boldlyout
onsparingly tested, and every question which general arrangementin regardto thissubject. King'sCollege Hospital.There is something
can affectthe Profeseion in
any way will re-
ceive The chief Surgical and Medical occurrences at of satisfaction in a lay brother thus addressing
ample consideration. On allthese topicsthe London Hospitals will be reported, and in himself to the kindly officeof encouraging our
tteEditor willbe happyto receive
suggestions thisway a most valuable insight into the dailyHospitals and Schools of Medicine ; a feeling
from hisMedical brethren,
whoyet must pardon hospitol practice of the Metropolb willbe given which,we need hardlysay,we in a very eminent
bimif he should happensub'sequently to differ to the CountryPractitioner.
manner reciprocate. Our pages for the past
from them in opinion.One
thing the Editor Finally, the Editor has the satisfaction of
year bear very ample testimony
to the excel-
lence
MB promise, and that is, to speakhonestly; and believing, that the Medieal Timea will soon out by our
of the Institutionpointed
nother thinghe will
attempt, namely, to base realisethe expectations of itsProprietors, and Contemporary. And with the same opportuni*
hisspeaking on fo"ndations.
sure become, in every way, a worthyexpositor of ties of judging of the Institutionat Charing-
Another departmentof the Journal, with the progress of Medical Science. Indeed, the cross, and that in connexion with Uni- versity
whichgreatpainshave been
taken,is,the Foreignresultcan hardlybe otherwise, when it is re-
membered College,we have littiedoubt we
Correspondence. In Paris, Berlm,and Vienna, thatthe Journal is warmly supportedshould find these buildings as deserving of
Ksident medical men have been engaged to by a
large and influential portion of the Pro-
fession publicconfidence. More than a centurysince,
tnmsmit regularly to the Editor,an account of ; that itsProprietors are actuated onlyby seven of our largestHospitals were in existence,
""eiyoccurrence which can prove useful to the a desireto benefit the Profession
; and that its and at present we have, as remarked by Sir
Coglish Anctitioner. In thisway, allpractical Editor is determined to carry out theurprinci-Robert Pee!,bat added three otheni. The
 10 THE MEDICAL TIMES.
of our latertimes obtained by differentchemists in the analysis of th^
charity has evidently waxed solutionof the saltto be dif{used,which was entirely
cold,and these three Instilutions
even are not in
immersed in a largejarof pure water, so that the water of the Dead Sea,taken near the surface ; th^
solution in the phialcommunicated freely with the differentsalts diffusing up, with unequalvelocity*
that flourishing
condition, in the way of funds,
latter. Phials cast in a mould of the capacity of into the sheet of freshwater, with which the lake is
which every one would wish. covered duringthe wet season.
four ounces of water, or more nearly!2,000grains,periodically
We have taken some trouhle to exhihit the were generally employed,which were grounddown It was further shown that chemical decompo-
sitions
may be producedby liquiddiffusion. The
"
organisation"
of the Hospitals on the Conti- to an uniform heightof 3.8 inches. The neck was
0,5 inch in depth,and the apertureor mouth of the constituentsof a double salt of so much stability
nent. In l^aris,
they are all Government In-
stitutions;
1.25 inch in diameter. The
phial was filled as common alum
pliial ; and the sul-
being separated phate
many would like to see them so in of proportion.
in the largest
potashdiffusing
up with the solutionto be diffusedtillit reached the
London,but the thingis impossible. Stillwe pointof a pin,dippingexactly0.5 inch into the In fact,the diffusiveforce is one of great energy,
are gladto see the Government bestirringitselfmouth of the bottle. This beingthe solutioncellor and quiteas capable of breaking up compoundsas
bottle, and the external jarthe water jar," the pair the unequalvolatility
" of theirconstituents. Many
in matters of science, as evidenced in its do-
nation
together form a celL"
dififusion The diffusionwas
"
empirical operationsin the chemical arts, itwas
of a thousand poundsto the Royal So-ciety
stoppedgenerally after seven or eightdays,by said,have their foundation in such decompositions.
and we are sure it requires
" but to see its closing the mouth of the phial with a plate of glass, Again,one such
salt, as nitrateof potash,will
and then raisingit out of the water jar. The quan- diffuse into a solution of another salt,such as
way clearly, to do somethingfor our younger tity
of salt which had found itsway into the water nitrateof ammonia, as rapidly as into pure water;
Metropolitan Hospitals. diffusible, ^gases
it " called
jar the diffusionproductas the salts
was " was then as appealingmutually
determined by evaporating to dryness. are known to be.
REPORTS OF SOCIETIES. The characters of liquiddiffusionwere firstexa-
mined Lastly, of the salts into water,
the diffusibilities
^ in detailwith reference to common salt like those of the gases into air,appear to be con- nected

ROYAL SOCIETY, It was found,first, that with solutionscontaining by simple numerical relations. These rela-
tions
Dec. 21. 1,2, 3, and 4 per cent of salt, the quantities which are best observed when dilute solutionsof the
THE diffusedout of the phials, into the water of the jars, saltsare diffusedfirom the solutioncell, such as 4,2,
BAKEBIAN LECTURE,
""
ON THE and were obtained by evaporating the latter,in a or even 1 per cent of salt The quantities diffused
DIFFUSION OF LIQUIDS/'
constant period of eightdays,were as nearlyin pro- in th" same
portion periodof seven days from 4 per cent
By Profetsor GRAHAM. to these numbers, as 1,1.99,3.01,and 4.00; solutionsof the three salts, carbonate of potash, phate
sul-
The Lecturer commenced by observing, that a and that in repetitionsof the experiments, the results of potosh,and sulphate of ammonia, were 10.25
salt01 other soluble substance once than l-40th part The propor- grains, 10.67 and 10.51 grainsrespectively; and a
liquefiedand in did not vary more tion
a state of solution, is evidently spreador difilised of saltwhich diffused out in such experimentssimilar approach to equality was observed in the 2,
uniformly throughthe mass of the solvent, 4,and 6 per cent solutionsof the same salts.It also
by a amounted to about l-8th of the whole. of
spontaneous process. It has often been asked whe- Secondly, that the proportion of salt diffusedin- held at dififercuttemperatures. The
creases acetate
this process is of the nature of the difiusionof with the temperature;an elevation of 80" potash appearedto coincide in diffusibility with the
Gases,but no satisfactory answer to the questionFahr. doubling the quantity of chloride of sodium same group, and so did the ferrocyanide of potas-
sium.
appears to be obtamed,owing,he believed,to the diffusedin the same time. The nitrate of potash,chlorate of potash,
subject havingbeen snidied chiefly in the operations The diffusibility of a variety of substances was nitrate of ammonia, chloride of potassium,and
of endosmosis, wheie the action of diffusionis coin- stancechloride of ammonium formed another equi-difiii-
next compared,a solution of 20 partsof the sub-
plicated and obscured by the imbibing
power of the in 100 water being alwaysused. Some of sive gproup. The timet in which an equal amount
membrane, which appears to be peculiar for each the resultswere as follows, the quantities diffusedbe- of diffusiontook placein these two groups, appeared
soluble substance but not necessarily connected inffexpressed in grains : Chloride of sodium 58.68, to be as 1 for the second to 1.4142 for the first,
"
or as

with the difihsibility of the substance in water. of magnesia27.42,sulphate

sulphate of water 69.32, 1 to the square-root of 2. Now, in gases, the times of
the densities of the
Gay Lussac proceededupon the assumed analogy crystallized cane sugar 26.74,starch sugar 26.94, equaldiffusionare the squares qf
of gaseous and liquiddiffusionin the remarkable gum arable 13.24,albumen 3.08. The low diffusi- bility gases. The relationbetween the sulphate of potash

explanation which he suggested of the cold pro- duced of albumen is very lemarkable,and the value and nitrate of potashgroups would therefore fall,
in the be referred, the difllusionmolecule or diffusion
on diluting certain saline solutions, namely, of this property retaining serous fluidswithin to to
that the molecules of the saltexpandinto the water the blood vessels at once suggestsitself. It was vapour of the first group having a densityrepre- sented
like a compressedgas admitted into additional furtherobserved, that common salt, sugar, and urea, by 2, while that of the second group is
space. The phenomena of solubility were at the added to the albumen under diffusion, dififused away represented by 1.
same time considered by that acute philosopher as from the latter as readily as from their aqueous The corresponding saltsof soda appeared to fall
radically difierentfrom those of chemical affinity, solutions, leaving the albumen behind in the phial.into nitrate and sulphate group also,which have
and as the result of an attraction which is of a Urea itselfis as highlydiffusibleas chloride of the same relationto each other as the potashsalts.
phjrsical or mechanical kind. The characters in- deed sodium. The relation of the salts of potashto those of
of these two attractionsare strongly contrasted. In comparingthe dififusion of salts dissolved in soda, in times of equaldiffusibility, appearedto be
Chemical combination is uniformly attended with ten times theirweightof water, it was found that as the square-rootof 2 to the square-rootof 3 ;
the evolution of heat,while solutionis marked with isomorphouscompounds generally had an equal which givesthe relationin density of theirdiffusion
equal constancyby the production of cold. The diffusibility, chloride of potassiumcorresponding molecules,as 2 to 3. Hydrate of potashand sul- phate
substances which combine chenucally are the dis- with chloride of ammonium, nitrateof potashwith
similar, of magnesiawere less fully examined,but the
while the soluble substance and its solvent nitrate of ammonia, and sulphate of magnesiawith first presented double the diffusibility of
sensibly
are the like or analogous in composition and proper- sulphate of zinc. The most remarkable circum-
stance sulphate of poUsh, and four times the diffusibility
of the sulphate of magnesia. If these tinaes
perties. is,that these pairsare " equi-diffusive," not arc

It was further premised, that two views may be for chemically equivalent quantities, but for equal all squared,the following remarkable ratios are
taken of the physical agency by which gaseous dif- fusionweights simply. The acids differed greatlyin obtamed for the densities of the difl^ision-mole-
itselfis effected, which are equally tenable,diffusibili^, nitricacid beingnearly four times more cules of these differentsalts, each of which is the
beingboth entirely sufficientto explain mena. diffusivethan phosphoric
the pheno- acid;but these substances type of a class of salts," hydrateof potash1, nitrate
On one of of potash4, sulphate of mag-
dieory,that of Dr. Dalton,the also fellinto groups, nitricand hydrochloric acids potash2, sulphate nesia
diffusibility of a gas is referred immediately to its appearing to be equally diffusive; so also aceticand 16 ;]with nitrate of soda 3, and sulphatecf
elasticity. The same springor self repulsion of its sulphuric acids. Soluble subsalts and the ammo- soda 6.
particles, which sends a gas into a vacuum, posed niated saltsof the metals present
is sup- a surprisingly low In conclusion it was observed,that it is these
to propel it throughand among the particles diffusibility. The quantities diffusedin similar cir- difiusionmolecules of the saltswhich are concerned
cumstances
of a differentgas. In the other theory, the exist-
ence of the three salts, sulphate ammonia,
o f in solubility, and not the Daltonian atoms or

of an attraction of the particles of one gas sulphate of copper, and the blue ammonio-sulphate equivalents of chemical combination; and the
for the particles of allother g^ases assumed. This of copperbeingvery nearly indicated of the knowledge of the
is as 8,4, and 1. application was

attractiondoes not occasion any diminution of volume When two salts are mixed in the solution cell,diffusibility of differentsubstances, to the studyof
of gases on mixing, because itis an attrsctionresid they diffuseout into the water atmospheresepar-
-

ately endosmose, in which the effectdue to "iiffusibility

ingon the surfacesof the gaseous molecules. It is of and independently of each other, according to should be distinguished and separated from the
the same intensity for all gases ; hence itsefiectin their individul diffusibilities. This is quite gous
analo- proper action of the membrane employed.
brineing about intennixture is dependentupon the to what happenswhen mixed gases are diffused
weightof the molecules of the gases to be moved into air. An importantconsequence is,that in OORRESPONDSNCB.
by it,and the veloci^ of diffusion of a gas comes liquid diffusionwe have a new method of separation
to have the same relation to its density on this or analysis for many soluble bodies,quiteanalo- gous
hypothesis as upon the other. The suiface attrac-
tion in principle to the separation of unequally MEDICAL WITNESSES AND THE
of molecules assumed, will recallthe surface volatile substances in the process of distillation. CORONERS' ACT.
attraction of liquids which is found necessary to Thus, it was shown that chlorides difhiseout from
accountfor the elevationof liquidsin tubes, and other and carbonates, and salts of potashfrom [To the Editor of the Medical Tlmei.]
sulphates Sir," Can I expect to enlist your sympathies on
phenomena of capillary attraction. salts of soda ; and that from sea-water the salts of the side of the unfortunate victims of the
The apparatusused in studyingthe diffusioncf strange
soda diffuseout into pure water faster than the salts anomaly in the Coroners' Act, I
perpetrated, as
salts and other substances into water of magnesia. The lattercircumstance was applied reformer of
was very ^.
^ " " .^
^^, suppose, by the great pseudo-medical
"

simple. It consistedof an open phial, to contain the to explain the discordant resultswhich have been |the day?
 THE MEDICAL TIMES. 11

I allude to that unaccouotable provirion which the Prooindal MeSeal and Surgical Journal, forinser-
tion excitement was sufficiently subdued. In con- sequence
fcc,from receiving in that Periodical. of this error, it was necessary to discontinna

tional
ezcludeshou8e-8ur|peon8" any
remuneration for evidence given before the Coroner. I beg you will do me the favour to correct this the pressure fortwo whole dayssubsequently, during
Is it,Sir,that the houte-surgeonsof Englandare error in your next Number. which venesection and tartar emetic nad to be em- ployed.

so handsomely beneficed, as to put them fiirabove I have the honour to be.Sir, It is only an additional instance of the
for remuneration for extra work ? Is Your most obedient Servant, truth of the proverb,*"the more
any necessity haste the worse
itnot rather, Sir,an undeniable factthat,as a body, William Hall, M.D. speed." However, fortunatelv, no permanent W
tb^ receiveas small a pecuniaiy recompense aa any 12,Clifton-place, Exeter,Dec. 31,184^. effectwas produced.As to the use of electricity
bodyof professional men ? What were the reasons afterperfect consolidationhas taken place,I must
that induced the honourable M.P. to introduce such say I cannot conceive how itcould benefitthe case ;
a clauseis to roe a perfect mystery ; and very much MEDICAL ATTENDANCE IN EMIGRATION and, as a means of producing consolidation, 1 have a
"hoaldI like to hear on what groundshe can logically VESSELS. great otjeetion to it.as I think it calculatedto pro- duce
demonstrate the justiceor the proceeding. But a dead inst"aa of an organizabie coagulum,and
what, Mr. Editor, is to be done? Should the [To the Editor of the Medical Times.] consequent suppuration of the sac. This objection
aggrieved individuals petition Parliament directly Sir," As emigration has become absolutely cessary
ne- also appliesto the coagulation of the albumen of the
on the subject, or in petitioning for medical reform in the present state of society, it becomes serous fiuidin hydroceleby means of electricity.
generally, could a clause about thismatter be incor- porated the dutyof every one to make the system as perfect With respect to gutta-percha bougies,I take this
intothe Petition? as posnble. Within the last two years the Govern-
ment opportunity of mentioning that I have, for t."e last
Do, Sir,give a littlewholesome advice; and have paidmore attention to the subject, and twelve months, used no other. I makeihem myself,
believeme. Sir,your most obedient servant, have establisheda varietyof regulations, conducive by cuttinga gutta perchasole into slips, and rolling
Durham, Dec. 20, 1849. A House-Surgeon. to the healthand comfort of the emigrant; yetamong to the necessary size between two smooth mahogany
these improvements they have almost entirely over-
looked boards,havingfirstsoftened the material in boiling
the most importantcircumstance connected water. It is impossible for any accident to oceur
SELF-SUPPORTING DISPENSARIES. with the welfare of the emigrant,viz.,the ** medical with these,as they possess more tenacity than any
attendant." The Government agents certainly insist other flexiblebougies I know of, and their cheap- ness
[To the Editor of the Medical Timet.] upon the medical man possessing some diplomaor is an important consideration to hospitals and
Sir,"You are probably, as a Medical Journalist, qualification, but as to experience,skill,and cha- racter, the poorer classof patients.I also make stylesfor
aware of the many anxious attempts I have made to these are Isftto the discretionof the charterer the iaehrymal duct of the same material,which
introduce " Self-Sufmorting Di^mtsaries" to the or owners of the vessel. The consequence is,the answer admirably;and I may add, that forthe ap- plication
noticeof the AiedicalProfessionm London. These chartereror owners, whose objectis to economise in of water dressing, the gutta perchasheet
attempts have hitherto been met in the most dis-
gracefulevery possible way, endeavour to procure those who has completely superseded the oiled silk in mj
manner by the uneducated and unlicensed will take the smallest remuneration. Experience,practice.
dealersin drugs,counter-physicians, and blue-bottle skill, and character being,therefore, a secondary I am, Sir,your obedient servant,
surgeons. consideration, partiesare appointed who have no Omagh, Dec. 28,1849. H. Thompson, M.D.
The Councils of the Royal Colleges and of the character or ability, young
or men who have no perience,
ex-

Hall, althoughnot parties, have, by theircoldness and have justpassedtheir examinations i PUBLIC HYGYENE.
and indifferenceto my plans,which are calculated and very recentlya person was appointed who had
to improvethe characterof the Profession,as much falsediplomas, and who, upon beingprosecuted by pro the Editor of the Medical Times.]
as the physical condition of the poor, condemned the Government, was found to be insane. Sir," Your editorialremarks,both in the last
them, and that without a hearing, as if the honour I understand that,duringthe prevailing epidemic,number of the Medical Times,and in preceding ones,
and respectability of the Profession was nothingto the owners of these vesselswere compelledto be a on Public Hygiene, ought to be printed in lettersof
them. I am about to make another attempt. Dr. littlemore liberal; even their ships were actually gold; but,nlas ! I fear they are as ifwritten on sand
at the seashore.
Cormack,and, I believe, nearlyall the other medical detained while they were higgling with the surgeon We have seen tliatthe tide of dis- ease
men of Putney, have agreedupon the establishment about a few pounds. and death flowed, and allwas hurryand anxiety
of a ** Sdf'Supportmg Dispensary ;" and I have en- gaged It is unneoessary to pointout how.much depends to do what should have^ been done long before, and
to be there on the 9th of January, in order upon the character and abilityof a well-educated which could not then be done without addingto tba
to givethe public medical man in a vesselcontaining from two to three danger"the tide has ebbed, and the world has
an address, explanatory of my
viewson the subject. hundred individuals, pent up for four or five months ; breathed again. Warnings,admonitions, the sable
I think it very likely, Mr. Editor,that some of in fact,the medical man should be,in a great mea- sure, emblems of departedfriends, allare '* handwritings
those who fear their craft is in danger,may try to the superintendent, as itis well known that the on the wall ;" but the tide is once more flowing ;
pat me down. They have tried,backed by an un- captainand officers,
principled
however well skilledin their this time bearing on its bosom music, dancing,
Medical Press, and done such things ere profession, are too frequently men of littleor no masquerading, thoughtless pleasure,and the world
now. I,therefore, beg the favour of jG\xt attendance education,and, therefore, unqualified to poesess a forgetsits punishment and itspromises.
personally, or by your representatives, that you proper influenceover a large number of individuals; Littlethat I can aay or write is probablyworth
may givea report of the proceedings in such a way and besides these considerations, what misery and your perusal, but I send you my Lecture on Health
as you see fitand true. I ask no favour,and I court suffering are enuiled upon the emigrant, provided as*an acknowledgement for the valuable information
no patronage ; but I claim the aid of the impartial any malignant disorder should arise, when the sur-
geon your pages have affordedme on vitalstatistics.
Press. is deficientin experience, skill, and ability. I am. Sir,yours most respectfully,
All I require is a fair audience for my favourite It is rather an anomaly, that to the vessels chai^ Edward T. Roe, M.D.
plan of usefulness, and wherever,and whenever I tered by Government men of experience and ability Princess-square, Plymouth,Dec 24^1849.
have an opportunity, I shallcontinue to devote my are appointed, and liberally remunerated,and it is
humble talents to promote thisplan of disciplined surprising that, as theevilmigh t be so easily remed led, HEALTH OF LONDON DURING THE
charity. I do not intend to interfere, in any way, the Government have not compelled the owners of
WEEK ENDING DEC. 29.
with the social and political divisions, ever, those vessels chartered by private
which, how- partiesto be more In the last week, the deaths registered in the
I fear too much distract the attentionof my particular.There is no doubt,that if the remune- ration
1053 ; the weeklyaver-
liberalthere would be no difficulty in ob-taining metropolitan districtswere age
countrymen from comprehensive plans of utility, was
of this season, corrected for increase of popu-
which might be brought to bear upon, and operate a plenty of men of experience and character; lation,
is 11G2. The mortality o f last week is,
beneficial change in the prevailing sical and I would suggest a scale of remuneration
miserable phy- similar
condition of the poor. There is no other means to what the Government allows,with some tions
modifica- therefore, less than the estimated amount by 109
ader Heaven by which so much charitycan be as to distance. For example, if the distance deaths,and is the
nearly same as that of the ous
previ-
csttblishedbetween man and man, as by Self-Sitp- should be as far as India or Australia,then the me- dical week. Of the 1053 persons, whose deaths are
porting Dispensaries. attendant should reoeive 10s. per head upon included in this Return, 841 had medical attend- ants,
I remaia your humble servant,"c., every individuallanded/ man,woroan," orehitd ; ifthe and wntten statements of the diseases which
D. L. Smith. distance be about the Cape or America, then after
provedfatal, -distinguishing in many cases the pri- mary
Sootham,Warwickshire, Dec. 80,1849. the rate of 5s. per head. The captain, officers, and men
and secondary forms, are entered in the register-
beingattended gratuitously, in consideration of the
the books; 15 had no medical attendance ; in 15 cases
drugs,"c., being provided by owners. These
DR. HALL ON CHOLERA. drugs, "c., also requirelookingafter,as from the the cause of death was not certified, and in these it
same principleof economy, the cheapestare con- sidered does not appear whether or not the patients had
the best,and you may (suppose how the professional aid. 7 children are returned as having
[To the Editor of the Medical Times.]
surgeon must be disappointed in the effectsof his died of sufibcationin bed ; 5 deaths are ascribed to
SiR^"A very serious error has been committed in remedies. of which one was the case of a girl of
theMedical Times of the 29th inst., intemperance,
by attributing to I am, Sir,your obedient Servant, 14 years, who died after 38 hours' illness, of con-
gestion
me an honour to which I have no claim whatever. December 17,1849. Medicus. of the brain and other organs, from drink- ing
Among the OriginalContributions appears an essay
"
On Cholera,by William Hall,M.D., late Physician gin; a child died of want ; a man of 40 years,
to the EngliahEmbassy at the Court of Persia." POPLITEAL ANEURISM AND GUTTA in ^e sub-districtof St. Apdrew East, of '* ex- posure

This very excellent Paperwas addressed to me, in PERCHA BOUGIES. to cold and destitution," and a pork-butcher
a letter, by my eminent friend,Dr. C. W. Bell, of 27 years, on the third day after admission into
K.L.S., of Manchester ; and at the request of Dr. [To the Editor of the Medical Times.l the workhouse of St. Martin-in-the-Fields, from the
Massy, Secretaryto the Pathological Societyof Ex-eter," Sis, I should wish to observe,in reference to efiectsof starvationand neglect."A woman
"
*'
who
I having Dr. Bell'spermissionto make such your concluding remarks on my case of popliteal had no medical attendance died in Somers-town of
ate of his valuable communication as I should think aneurism,that tiie principle of varyingthe pointot ** inflammation of the
fitforthe benefit of the Profession,Dr. Massy was lungs;" she is statedto have
"
pressure was adoptedfrom the first; but thereteas a arrived at the advanced age of 100 years. Tables
allowed by me to read it to the Societyin question.fault in the treatment, which cannot be too promi- nently this Return, which show tlie deaths
NeitherDr. Bell nor I, however, gave leave for its brought before the Profession; and which accompany
from cholera in each of the 135 sub-districts of Lon-
don,
JDiertion, by Dr. Massy, in the Medical Times, and was tills,
hid some time ago transmitted it to the Editor of
that the treatment by compressionwas com- menced
in each week since October,1848.
too soon, beforethe great localand constitu-
 THE MEDICAL TIMES.
12
and falsehoodb]rwhich he was sufrounded ; and he
MEDICAL NEWS,
MOETALITY TABLE. that thej^edical
expressed an opinion, men oughtto
Dee. 29, 1849.
For the Week en^ng Sahtrday, of Gendemen
Apothbcaribs' be paidfor their extra
HALiN^Namea services. He rsmariced,
(Metiopolta.) who passedtheir Examination In the Science and however, strangely enough, that the undertaker, who
Practice of MediciDe, and reoeivedCertiflcatesto he caUed the more deserving man, had been over- looked.
Avenge of 18": "George He had had the disasreeable and gerous
dan-
Five
Pnedse, on Thursday,Dec. 27,
DCATS. Total.
GolledgePitt, London; task of burningthe clotnes, and ought to
CAUSSf or
Autumns. Clarke, Bath: Edward
Charles WiUiam, Whitby ; WUliam Vaughan Jones, be better paid therefore. He aniyreceived 4/"^SOr.
Wales. cf ufMeh M paid to a man to do the work for
1162
Festiniog,"N.
Obituary." At Antigu, on the 18th ult.,of nim, and 10s. for the fieldin which it was done ; so
1008 . ,

All Cauim
1048 1158
BpZCIFXKD CAUiBi ." ...
yellowferer,
"-

Charles Daw8en,M.D.,Surgeon to the that,according to this sapient, the

delegating burning
and
Zymotic (or Epidemic,Bnaemio, 176 807 54th R^ment On the 25th inst,John Lewis,Esq., the clothesof the cholerad^ad to another was a more
ConUgiooi)I"iseB0M ."
disagreeable and more dangerous task than constant
SvosADic Di""A"i ; Siugeon,formerlyof Mark-laneu
of iIlihittCollbob, Dublik." Dr. John Banks, professional attendance on the sick for weeks and
Dropcy,Cancer and other DiMaiai T he undertaker, however,had a
nncertatn or Tariable teat 58 ...
49
Physicianto the Whitworth Hospital, and to months together.
178
Tubercular I"lieasee -.
152 ".
the Lord-Lieutenant, has been eleeted King's fessorbetter knowledgeof bis services,
Pro- for,at the South
DlMaaes of the brain, SpinalMaixow, 185 of the Practice of Medicine at Dublin Uni- Ward meeting,he entirely disclaimed all rightto
185
Nerves, and Senses additionalremuneration. At the last-named meeting,
^'^ on the Foundation of Sir PatrickDun.
."
r,"
Diseases of the Heart and Blood' yersity.
,

40 40 At the annual electionof medical officers of the a person named Pope had the brutal insolenoeto
Aahton-under-Lyne Union on the 20th inst., the assert that the extra practice obtained by the me^Seal
Diseases of the Lungs, and of the other
185 S14 while tatetuUngcholera caaee, was a ti^MeiU com"
Organs of Respiration .. ...
salaryfor the workhouse and Fever^Hospital
... was duced men
re-

Diseases of the Stomach, Liver,and from lOOL to 90L The cases during past the pemaHon for their servicee, and this resolutionabso- lutely
48 65
other Organs of Digestion ."
600. Some of the district salaries had a seconder. Fortunately forthe reputation
"C. IS 11 year were nearly
Diseases of the Kidneys, ... ...
vaccination for honesty and good of the South Ward, it was
17 10 were reduced 20 or SO per cent, and sense
Childbirth,Diseases of the Uterus, fto.
Diseasea of the Bones, from Is. 6d. to Is. per case. Last year the work-house not carried,but resolutionssimilarto those of the
Rheumatism, Warn were ; it beingfurtherdetermined that
Joints ftc. salary was fixed at 100/.,and a gentkman West
be openedfor the ptn"pose of reward- ing
Diseases of the Skin, Cellular Tissue,
1 qferedto takeU ai 90L Now the Guardians jEa;the a subscription This was not carried without
ftc. -
90L, and candidate (M. R. C. L. and the medical men.
... ~
4 talary at one
Malformations ... .-

L. A. C. of 1827 or 1828) offers to attend the house

work- opposition. Should the cholera rerisit Exeter, we
88
Premature Birth and DebUlty
the Union will providetrust the medical men then will demand a written
...

18 and hospital |rraiw,if

Atrophy ."
-

SOL 1 This pledge for additionalremuneration ere they com- mence

57
drugtt which he guaranieee will not cost
Age :2 theirdisagreeable and dangerous duties.
Sudden ""
"". the Guardians declined, and elected a gentlemanat
Violence, Privation,Cold, and Intem- perance
86 901, the sum advertised. The Ashton Board has
with many TO CORRESPONDENTS.
Causes not Specified
4 hithertoevinced a liberalspirit compared
.m ...

Unions,yet,no doubt,willreduce the remuneration '"Mr. RamsbothsmV

...
oormpondenee with the Halifkx
is the number of Deaths occurring from some Guardians has been received. We to examine
The following of medical officers to the nUmmumt whilst theirprofit- less propose
of the more importantspecial causes :"
for. The the particulars of the ease referred to in those letters, if
44 Heart 86 Phthisis ...."115 appointmentsi are so eagerly s ought next week.
Apoplexy frequently to possible,
Bronchitis Hooping-cough 84 Pneumonia 69 members of the Profession are ...
more ** Mr. Brady" mar Mst assured, that the pages of the
25 blame than the Boards of Guardians, as this in-
".

Cholera m. Hydrocephalus84 Scarlatina 7

stance *' Medical
Times" will never be sallied bj migentlomaaly
Childbirth Influenaa 8 Small-pox ...... abuse. At the same time, the Editor will fearlessly cise
exer-
.....
proves.
10 Stomach 6 the righthe possesses, not only of criticiriog,
Convulsions.^ Liver ............
Medical Rbfobm. The foUowing Petition "
severely
Teething 1.......5
Diarrhosa Lungs if need be, partieolar easee and lystems ot medkloe, but
......
81 has been addressed to the BJghtHonourable Sir
Measles 42 Typhus also of expoetng individual Ignoranceor dishonesty, if
Dropsy
George Grey. Bart.,one of Her Muesty's prin- cipal sueh exposure
.........

21 Uterus 6 be neeessaiy for the good of the FxodiBSBlon

Erysipelas Paralysis .........

Secretaries of Stote?" ''As Chairman of

...

and the interests of the oommmilty.

BIRTHS AND DEATHS. of the Medical fession
Pro-
a Committee of members A notioe of Dr. Downlng's UtUe Work on Tlo Doloiuwux is
residingin Mancheater and its neighbour- hood,
Births. Deaths. Births over Deaths. at a publicmeeting to watoh the "'Dr. Rdd Clanny" is reminded,that those who live hi
appointed should not throw stones; and that When
I am di- rected glasshouses
progress of the Medical Reform question, "
go to ouft,"theymost expeet vile blows and
"

that a state-
ment players
Males 618 540 78 to respectfullyto represent you, boffets."
to the
Females ....
608 518 95 hasappearedin the publicjournals beg paitloQlaily
We to call the attention of oar readers to
effect, of Sur-
that the Council of the Royal College geons
a Mr. Smith,of Soatham, and to Inform them,
letter from
Total... 1826 1058 173 of England are about to Petition the Crown will deUver a Leeture on the eubilect
that that
gentleman
for the grant of a Charter which shall amend and
of Provident and other Dispensaries, on Wednesday, the
rectify the anomalies and deficienciesof that con-
ceded
in the Hall
9th January, at eight,p.m., of Putney
METEOROLOGY OF THE WEEK. in 1843. The Manchester Committee having
College ; when he will explain the working of the
maturelyconsidered this reported proceeding of the
""
- Provident Dispensaries whieh have been established in
Council of the|College,inbearings
its upon medical
would respectfully impress upon you Northampton, Coventry, Burton-on-Trent,and other
legislation, stron^y reeomraend our readers to attend
L i the justiceand expediencyof withholding all re-
commendation
we
Jlaoes.
fr. Smith's Lecture on the 9th. The sutMectis ono of
to Her Majesty, in conformity vital importance, and we are much inclined to think, if
with such Petition,until the Fellows and mem-bers Mr. Smith's views had been generally adopted,that two-
o r" B S o o ^ at large have had the outlines of the pro-
posed thirds of the evili of the Poor"1aw and its Boards of
Guardians, as affecting the best interest! of the Profes-
sion,
Charter submitted to them for examination would have been obviated. Were medical true
men
and discussion. The Committee beg Airther to to themselves, they might defy all the dnll-pated and
SS33'
represent to you that the Charter of 1848 was wooden-headed couneillorsthat ever presumed to ait In
granted without any such previous notification ; that, judgment on them.
when published, afteritsooncession,a condemnation Mr. Wardropp't
'" Work on the Heart."" As soon as the
of its provisions, all but unanimous, came from the Author will romish ue with the remainder of the copy, we
will completethe Work, and devise a means of supplying
Professionat large; and that this circumstance has
our Subscribers" we can do no more.
constituted the greatobstacleto all recent attempts Our Mend at Brusaels Is thanked. We shall use his in-
formation
at medical legislation. Finally, the Committee when occasion requires.
would express their convlation, that the grant of a A Constant B"ad"r.""We
" will endeavour to procure the
Charter to the College of Surgeons,which should alluded to, and giveit an earlyInsertion in our
Saper
oumal.
bringthe Institutioninto harmony with its mem- bers,
have received specimensof
of English Gutta Pereha Boagles."~-We
"

who constitute the great msgority

gutta perehabougiesfrom the Company in the City-road,
Practitioners, would remove all serious impediment and that the method the Company
are happy to perceive
to a satisfactory settlement of the question of medi-
cal now employ In their mannfacture totally precludesthe
reform. (Signed on behalf of the Committee) possibility of their untwuting.We beg particularly to
of the sut^ect, and we
W. Watson Beever, Chairman." Manchester, call the attention our readers to
recommend them to visit the establishment at Wharf-
Dec, 1849.
^ ^
Institute." One of the oldest "Scotus" road,City-road.
,^

The French writes:"" SupposingI were an M.D. EdIn., and

Members of the lostitut,M. Quatremere de M.R.C.S. Lond. : had served Ave years' apprenticeship to
the patriarchal of 96.
Quincey, latelydied at age the Protessor of Surgery of Edinbursh University ; had

He was PerpetualSecreury of the Academy of had six months' practical phannaey in the laboratoryof
Fine Arte,and had been Member of the firstLegis" the Edinburgh Infirmary ; vrith certificates of every elaso
requiredby the regulations of the Apothecaries' Hall ;
lativeAssemblies duringthe Revolution of 1798. should I be eligible for examination at tbat Board f
Cholera Rewards at Exeter." Two motes,
ward- of five years, to
[Not without a certificateof apprenticeship,
have been
as we presume we are to callthem, a legaUy-qualifled apothecary.The apprenticeship Is
held at Exeter, to decide respecting the gratuitiesabsolutely necessary.]
to be of H.M.S. Indefttbn.
recommended by the SanitaryCommittee, "Mr. McClure, Assistent-Surgeon
I have my answer
**
prepared both for Dr.
paid to the medical officers, "c., for services ren-
dered hie,"writes :"
Miller and Mr. Chubb. I would have sent it by this
duringthe late epidemic.At the meeting of day'spost,hut that I requireto refer to the hospital re-
ports
West Ward, it was unanimouslydecided,that the to confirm the accuracy of my statements. You
clerk and medical officers were sufficiently paidal-
ready,shall
positively have it by to-morrow's post ; so I hope
and the principle of gratuities to salaried you will giveme a column in Saturday's limes' '
for us
officersdiscountenanced. A Guardian who was Insertion.**
present seemed to have some slight glimmenng of [We promiseMr. MeClure the column he requests} hut wo
truth throughthe Cimmerian darkness of ignorance had not received his MS. when we went to press.]
 THE MEDICAL TIMES. 13

OBIOIHAL LECTUBES. impulsewas extremely feeble ; although the patient This is the case with our patient, M'Do-
leaningforward,I could not determine for a nald,now in the wards. Now, thishas been attributed

trium.
" "^^ " was

LECTUSES long time where the point of the heart was striking, but, by some entirely displacement
to of the heart sequent
con-
aftersome time,it was made out to be outside, and a on emphysema ; but, I think,in these
ON
little below the leftnipple ; therewas no pulsation where cases it willoften be found,that emphysema does not
else-
CLINICAL MEDICINE.
in the prsecordial region. The extent of dulness play the onlypart; the heart reaches lower than
DELiy"""D AT UNIVERSITY COLLEGE
HOSPITAL.
was definedwith greatdifficulty; in the centre of die usual,and itsupper partis more cove^ied by lung,
prsecordial space the percussion note was as nant
reso- but itis not alwaysabsolutely altogether lower,nor,
By ". A. PARKES, M.D.. Lond. :
Hembtr of the Royal College of Physicians, ProfeMor of almost as elsewhere ; but,after two or three if absolutely, is this owing only to emphysema.
Clinical Medicine in Unlvenity College^ and Phytielanto examinations, the upper limit of the dulness was fixed Emphysematous lungs
may, indeed,per se, some- times
the Hospital. between the third and fourth ribs ; the inner bound- ary lower the heart,by depressing the diaphragm,
was apparently a little inside the leftedgeof the but whenever we find the heart's dullnesslower than
LECTURE n.
sternum ; the outer was undefined, but was beyond normal, and close to the left of the sternum, we
Gentlemen, "
The case I bringbeforeyoa to"day the vertical
level of the nipple. At the base may, indeed,often anticipate the discovery of em-
physema,
differsconsiderably from the one we discussed at our theie was a very faint systolic murmur in the first but I think we shallgenerally findenlarge-
ment
lastLecture,but isof even greater importanec, as being
intercostalspace, close to sternum
right ; it was car" of the right heart also.
a more common and every-day affection.I shallalso ried
down from thispoint to midstemum, where itbe- came The loud systolic murmur at the apex was
be enabled,afterwe have briefly le viewed it, to allude
much increased in intensity, and it increased indicative of mitral regurgitation. This seemed
in this or in a subsequent Lecture, to some portant
im- stillas the apex was approached ; it was not heard at least probable from its loudness under the
practical points connected with the deranged at all
in the second left interspace. The second left nipple. We had no evidence that the
mechanism of the heart,especially to the changes
sound at the base was not changed. At the apex mitral orifice was contracted ; had it been so, with
in the capacities of its cavities, comparedwith the there was a loud systolic heard over a con-
murmur, siderable the amount of emphysema which existed, the pulmo-
nary
strength of its walls.
space ; it was at its maximum, not at the lesionswould have been stillmore marked ; we
On the 8th1 of April,a woman, Mary Saxton, pointwhere the apex was supposedto be,but inside should have had bloody and last
sputa, at nary
pulmo-
aged 57, was admitted into Hospital, (a) The first this, under the left nipple, and was
resembled that of Mary very loud also apoplexy.But also we had tricuspid gitation
regur-
aspectof the case strongly close to the sternum ; it was blowing, and had a cer-tain ; this was absolutely provedby the jugular
Gartland. When I first saw the patient she was
roughness about it,but no rasping ; the second pulsations, and the fillings of the veins from below.
sitting up in bed,breathing with the utmost diffi- sound
was sharpand well-defined; no pulsation in Again, Dr. Blakiston's observations, which prove
culty,with livid lips,daiklyflushed and dusky any of the arteries; the radial pulseregtdar,
very the importantpart which triouspid regurgitation
face,and an anxious painedexpression. There was
small, and weak. Both the external
extreme of the lower extremities, and of
jugular veins plays general
in dropsy, naturally would have sup-
ported
anasarca
pulsated, the left more than the right;theyalso the idea of tricuspid regurgitation in this
the abdominal Walls. Tliere was a small quantityfilledslowlyfrom below, when theywere emptied case, had the absence of more
of fluid in the peritoneum, buU none in the
positive signs dered
ren-
pleurae. and pressedupon at the upper partof the neck. it necessary for us to take this argument into
Every now and then a violent paroxysmalcough What now was the state of thisheart ? First, an account. The existence of emphysema also rendered
came, on, which was followed by copious, lather
of sputa,surrounded
extremelyfeeble impulseis chiefly producedby it likelythat there was hypertrophy of the right
viscid,greenish-yellow masses
three circumstances ; fluidin the pericardium,
fluid.
great heart,for this is the natural consequence of emphy-
sema,
by a frothy weakness of the heart itself, with or without dilata- tion, and is often ne antecedent of tricuspid gitation.
regur-
The history of the case was briefly this. She was
or interposition of lung between it and the
s married woman, a laundress,bom of healthyside of the chest. Which of these circumstances
But as we admitted tricuspid
lived and
regurgitation, may
parents, had temperately moderately w ell. existent here,was at once evident from these not the murmur at the apex have been attributable
was
She had been subject to shortness of breath for more
two positive signs " not to mention other considera- tions to it? This seems very likely, but as tricuspid
than thirtyyears. Had never had rheumatism. "
^first, that the sounds were by'no means regurgitation is very frequently unattended by
Thirtyyears before had had hsemoptysis. Except deficientin intensity and power ; on the contrary, any murmur, whenever we decide that a murmur
the shortness of breath,which she thought littleof,
they proceededevidently from a strong,vigorous is from the tricuspid orifice, it should be unequivo-
cally
she considered she had alwayshad goodhealth. A heart ; this would not have been the case either in the right it was in the case
over ventricle, as
year before admission she suflered from what she attenuation of the heart'swalls or weak action from of Mary Gartland.
called asthma and dropsy,"
" from which she soon other causes, or in hydro-pericardium of such amount In addition to the murmur at the apex, we had
**
recovered. Sometime after this she had an tack
at-
as to abolish impulse ; secondly, the percussion note a systolic murmur at the base, heard along the
at the heart," frofaiwhich she suffered
much
rang with grreatclearnessin tiie very centre of the aorta. This may have been an obstructive aortic
for three months, and then improvedsomewhat, still
prsecordialregion,provingthe overlapping of the murmur ; but I think,possibly,
from its exceeding
feeling very ill,tillfive weeks before admission. At
lung. But if we had had in this case low muffled faintness and gradualloss as we passedupwards,
this time she got worse, the legsbecame much and feeble from
sounds,appearing come
to a distance,that it may have been a transmitted murmur from
swollen,and the very distressing.
dyspnoea then
should have found it extremely
we difficultto the mitral orifice: in a case of this kind,to render
The state of the organs on admission was as
say what the condition of the pericardium, or of the a murmur unequivocally aortic, there should be a
follows; First,the lunj^s. muscular substance, in which
may have been. But, luckily, space between it and the mitral murmur,
"

I have alreadymentioned that the patient was such cases as these aie rare, as both hypertrophied the morbid sounds are less intense than at either of
snflTering from complete orthopncea, iu fact, she had hearts and distended aside of manifestation.
pericardia usually t hrust their seats o f
or points origin, or
not been able to lie down for many days. She was than in the present case The pulsewas
to a greater extent even very weak and compressible, as it
breathing, with greateffort, about thirty to thirty-two
emphysematouslungs, and can then be detected by usually is in mitral regurgitation, and as it may be
times minute. The ribs moved
per tively
compara- the amount and kind of dulness, and other symptoms in aortic obstruction.
little; the form of the thorax was moderately
proper to each particular state. In the present case, What was the state of the pericardium?We
rounded, without any partial bulgings;the per-cussionwe judged from the sounds that the heart was were certain, from the comparative want of dulness,
note was everywhere resonant; over both
actingwith considerable force. The importanceand the character of the heart's sounds,that there
bases abnormally so. Both anteriorly and poste-
riorly,of attendingto the heart's sounds, as in- dicative
was little,if any, fluidin the pericardium. But we
the lungsdescended lower than usual, and they of the vigour of the muscular had no certain evidence about adhesion. The pro-
tractions,
con- bability,
encroached on the praecordial region.Over the in indefinite of the from that the
and, an degree, negative evidence,was, cardium
peri-
whole of the lungsthere were coarse rauco-crepitant size of the heart,cannot be too strongly put before was non-adherent, and,therefore, ably
presum-
and mucous rhonchi,mixed, particularly in front,
you, as it is from these, and from the general healthy.
with rhonchi.
and cooing
whistling Expiration was
symptoms, that we are obligedoften to judgeof the The conditionof this heart then was as follows: its
somewhat increased there was no particular alteia- size of the heart,when
healthy its left ventri-
"

emphysematouslungspre- vent pericardiumwas probably cle ,

tion of voice. These, which were the onlypositive
from determining it more
us accurately by was probablydilated and hypertrophied to a
signs,indicated the existence of generally difiiised
percussion. certain extent, as it extended more to the left than
bronchitis, occurring in .lungswhich were matous
emphyse- We had,then,evidently, a heart acting strongly usual ; there was mitral regurgitation, judgingfrom
; at least, the exaggerated clearness of the beneath a thick stratum of lung which abolished the systolic murmur at the left apex. There was
percussion note at some points,and the manifest in-creased
impulse. Then, with some difficulty we made out dilatedhypertrophy of the right ventricle to some
size of the lungs, coupled with the historya kind of outline of the
heart,which showed us that it extent, tricuspid regurgitation, judging from the
of the case, which informed us of old standing and
was not higheror lower than usual, but rather more jugularpulsation and refilling from below,from
permanent dyspnoea, seemed to warrant this conclu-
sion, to the left than it should be, and, perhaps, more to the dropsy,and from the old emphysema; there
even in the absence of more definitesymptoms. the right, allowingfor the emphysematouslung. may have been very slight aortic obstruction. Tlie
The heart gave us the following signs.It was act character of the sounds seemed to indicate that the
Now, these were very significant
"
signs; theyseemed
ingregularly about 90 times per minute. Some- times, to show that the leftventriclewas
enlarged,the rightmuscular substance was tolerably healthy.
the patient told us, there was palpitation. The ventricle, in determining the
also,probably enlarged, but not to any There was some difficulty
very great extent, as, if it had been,it would have state of the liver,on account of the cedema of
(a) It should be mentioned,that the formal Clinical been more to* the right and downwards. Often, in the abdominal walls,but we deciflcd that the
Lectures given by the Physicians at University
great emphysema with its most frequent attendant, liver was not below the false ribs; its upper
College Hospital are summaries of the most portant
im-
featuresof the cases, given afterthe patienst'
dilated hypertrophy of the rightventricle, the car-
diac limit was quiteundefined, so thicklywas it covered
discbaige.In addition, duringthe patienta' dullness is found low down close to the left of by lung. But we had an indication that the liver
stay in
Hospital, the case is discussed, as faras can be done, the sternum, under the cartilages of the sixth and was not much in
affected, the small quantityof
at the bedside. seventh ribs, and extending even into the epigas-peritonaeal effusionas comparedwith .the^jxce^eive
No. M7, Vol. XXL
 14 THE MEDICAL TIMES.

anstai-ca. This seemed to show that the effiision8th the reportmentions that the coughwas much he appliedProfessor Simpson'suterine
into the followed the impedimentto the easier,the expectoration less viscid,the dyspnoea supporter, but it producedmuch irritation,

versio
peritODseum constant
portalcirculation, produced by the stagnation in much less,so that the patient had lain down two discharge, and profuse catamenia.
the lungs and heart. Had the liver itselfbeen hours the previous night; the lipsand face were of Examination per Faginam."Oa uteri turned for- wards
much diseased, the asciteswould have corresponded a nearly natural colour,and the legswere certainly "

large, soft,open, cervix hard ; uterus much

in intendty with the anasarca. rather smaller. From thistime she improvedslowly,swollen, retroverted" the fundus is very tender. I
We could Qot determine the sizeof the spleen, on and on the 16th of June was discharged free,or replaced the utenis with ease, and the swollen and
account of the state of the abdominal walls. almost free from anasarca, with a moderate cough, engorgedstate of the uterus instantly subsided. Let
The urine,on the admission of the patient, and and with the breathing nearlyas free as usual. her keep the prone position.
for some time afterwards,presentedcharacters In contrasting this case with the other,you will Extr. taraxaci |i.liq. ; calcis |viii. M. ft. mist ;
somewhat similar to its condition in Mary Gart- see some importantdifferences. Here evidentlycujus sumat cochl. magn. ij.ter die. P" extr. aloes
land. It was scanty,seldom reachingmore than the pointof departure of the disease was not in the aquosi 9ii.; ext. hyoscyamidiss. ; mastich. gr. xij.
from 12 to 20 oz. in twenty-four hours, high- heart,but in the lungs. Pulmonary emphysema, M. ft pil. XX. quarum sumat j ij." h. s.
coloured,of a specific gravityof 1020 to 1024, existent apparently duringthirty years, had neces-
sitated, P"Liq.plumbidiacetatis5ii. ; decoct papav. ^viij.
strongly acid,and depositing amorphous lithates. as usual,a gradually-augmented rightven-
tricle M. ft lotio.
But, in addition, it contained a certain amomnt of to force on the blood throughthe lungs. In July 3. Has carefully
" maintained the prone
albumen, when coagulated, formingabout one-fifth these cases, however, a nice balance is often pre- served, position ever since.
or one -sixth the bulk of the liquid.Now, what
of and, provided nothinguntoward happen,the Examination per Vaginam, The os uteri isturned
did this signify? Had we here renal disease in hypertrophied rightventricle is in emphysema a backwards,but it is swollen and very tender. Let
addition to cardiac and lung disease ? And if so, conservative change. Sometimes, however, as in her continue the Applic. hirud. yj,
prone position.
what share had the renal diseasein producingthe this case, some accidental circumstance,such as ori uteri" rep. mistura. p"pulv.guaiace. magpies,
dropsy? On examining the urine attentively, it the supervention of bronchitis, occurs, and then the carb. ac. gr. x. o. m. In a short time afterwards she
was evident that it did not present the charaoters of hypertrophied rightheart,unable to force on the returned to her residence in the country.
the urine in Bright' s disease ; it did not present blood through the longs, beginsto drive it through August 27. For the firsttwo or three weeks after
"

the peculiar brownish or opalinecolour; in the the tricuspid orifice, which may itselfhave become leavingLondon, she ** went on famously;" walked
sediment we had never any casts of tubes or of epi-
thelial
dilated coincidently with the ventricle; and, if its and rode about, but her old symptoms returned
nuclei from the urinary tubules ; its specific flaps have not proportionably increased, after a catamenial period;her medical man on
may oppose
gravity not low ; it was too acid. And althoughbut a feeble barrier to the forciblecurrent.
was Then visiting her,found the uterus retroverted, he recom-
mended
none of the characters here impliedare absolutely follows, as a matter of course, stagnation of the ge- her to continue on the prone conch, and
neral
essential to the urine in Bright's disease,still, circulation, and cedema of the feet passing into advised leeches to the os uteri, which was consider-
ably
when they aie all absent,the chances of the albu- men anasarca. If this proceeds to a certain extent,the swollen.
beingdependent on Bright's disease is minished.
di- left heart becomes engaged,inasmuch as it ex- periences Sept, 27. ^Went on very well for a short time,
"

Again, we had other conditions here an opposition in the general circulation; and feltso relievedthat she ventured to take a long
which are known sometimes to produce albu- minous hypertrophy and mitral regurgitation follow walk several times,which at lastbroughtback her
may
urine; we had tricuspid regurgitation and here, and would more often follow, were it not that old symptoms. Until this act of indiscretion the
seneral venous congestion.However, at first we the supply of blood to the leftside of the heart is uterus had been free from pain,and, to her feelings,
did not decide the case. While it was evident frequently much diminished in If in itsnatural but ever since she sufferedas
very amount. position,
that the pulmonary and heart diseases were the mitral
regurgitation occurred in these before, and her sensations distinctly showed that it
frequently
main causes of the dropsy,it did not seem probable
im- the lungs would suffer stillmore, from the had become
cases, displaced.
that there might be some superadded blood beingforcedback upon them throughthe patent Warned by this result she returned to the prone
renal disease. The progress of the case, however, mitral orifice. In thio instance it seemed that there
couch,determined to giveit a thoroughtrial. The
did not favour this opinion ; for subsequently, when mitral regurgitation,
was though,whether it ori symptoms of displacement soon ceased,and in the
the patient began to improve,and the anasarca to
ginatedin this way, or in an attack of endocarditis, couise of a few weeks the catamenial periodpassed
disappear, the albumen disappeared altogether from at the time the patient sufferedfrom the " asthma,' by without any appearance. She steadily continued
the urine ; and, for the last fiveweeks of the pa- cannot be determined.
tient's upon the couch for at leasttwo months, when the
stayin hospital, the urine became non-albu-
minous, The case we have discussed to
day givesus one of missing a second catamenial period, and the occur-
rence
more copious,
reaching
35 to 40, and sionally
occa- the most simpleforms
of cardiac disease consequent of other symptoms, gave her every reason for
50 oz., acid,and with occasional depositionon lungaffection. The case we discussed lastweek concluding that she was pregnant The uterus rose
of uric acid,or of amorphous lithates. It
might gave us a simplefonn of lung affectionconsequent out of the pelvisat the proper time, and now the
be inferred,then, that the lenal disease was form of heart disease. Either form may
on one retroversion being cured by the supervention of
trifling,
or that the albuminous impregnation de- naerge into the other,or
pended
may be accidentally bined
com- pregnancy, she was enabled to take her exercise with
solelyon the congestion followingthe with the other,or may be combined with safety and benefit She went her full time without
tricuspid regurgitation. Which was the actual other forms. Thence ensue numerous phases of any interruption, and was safely delivered,earlyin
case here,I cannot decide. But, let me remark, in heart and lungafiection, the relative of which the
bearing of following
fine July, a girl.
anticipation
of a subjectthat we shall have here-
after to each other may
be generally detected by acquir-
ing With the exception of one case, to which I
to take up, that the differenceswhich exist in an knowledgeof the simpleand ele-
accurate mentaryalluded some time ago, I have never seen a healthy
equallysevere cases of cardiac dropsy,in respectof conditions. OS and cervix uteri so completely m etamorphosed by
albumen in the urine,are not readily explicable, and swelling from obstruction to
severe congestion
unless we presume, that in the one case, the kidneys the returing circulationas in this case. The circu-
lation
are a littlealtered in texture, althoughnot ficiently
suf- ORIOINAZa CONTRIBUTIONS. in the os and cervix seems to have been nearly
so to cause albuminuria without superadded as much impededas if it had been encircled by a
congestion; while in the other case theyare alto- gether RETROVERSION OF THE UTERUS AS A moderatelytightligature.It was three times its
sound. But, observations are wanted upon CAUSE OF STERILITY. natural size, tense,throbbing, hot,and acutely pain-
ful.
this point.
Within two or three minutes after the re- placement
The history of thiscase, after the patient By EDWARD RIGBY, M.D., "c. ; Senior Phjtician to
entered the General Lylagln Hosptial;Examiner in Midwifery of the uterus, it had diminished con- siderably
the hospiul, need not detain us long. We com- In ttie Univeriity of London.
; it was soft,lax,and bore the pressure of
inenced at once with the treatment for these cases, the fingerwithout causingany severe pain. The
viz.,the administration of hydragoguecathartics, I willclose the subjectof retroversion, as a cause irritablehabit of the patient, the previous failureof
(inthis case we gave the bitartrateof potash,which of sterility, with the following case: "

the supporterin her case, the state of severe suAer-

producedcopiouswatery alkaline motions,) and of Mrs. J.,aged 34" ; a middle sized delicateblon-
ing and uterine congestion in which I found her
expectorants,such as squills and camphor,with dine married
"
11 years, has had 2 children and 9 forbade me to make another trialof this instrument,
small doses of digitalis. Subsequently, we added miscarriages. and leftme no choice but recourse to the prone
acetate of potash in half drachm doses, with scopa- June 80. Unable to rise from severe
"

pain of couch,to the confinement of which she was at first

rium. We were obligedto giveoccasionally sacrum and in the groin, greatly increased by stand-
monia
am-
very averse. A littleperseverance, however, soon
and wine,to sustain the under the in- iug,leucorrhsealdischarge
fluence with occasional loss of broughtsufi"cientrelief to
patient encourage her to make
of thepurging. These measures, with acupunc- blood bowels irritable and disposed to diarrhoea,a further trial. The
ture, "

irritablestate of the mucoui

and the regulated of the ward, else confined
temperature or are very tongue glazed pulse membrane
"
"

of the bowels disappeared ; her health

aftera short time relievedthe pulmonaryafiectiou ; feeble and quick.
improved,and encouragedher to venture upon an
the heart's action became quieter, the murmurs Her firstchild was bom nine or ten months after amount of exercise which,as the result proved, was
diminished in intensity, but did not disappear ; the her marriage,between which and her second child, not
justifiable. againShe returned to the prone
jugularpulsation ceased; the patient was enabled to she had seven abortions, each of which occurred couch,againtransgressed, and at last, h aving mined
deter-
liedown ; the peritonseal effusion disappeared first,during the first eightweeks of pregnancy ; since to devote herselfwhollyto the task of getting
and then the anasarca gradually diminished. The only the birth of her second child she has had two well,her utmost wishes and hopeswere crowned by
new feature in the case was the occurrence of a little moie abortions. Previous to marriage, the catame- the occurrence of pregnancy. I have heard indi- rectly
circumscribeddrypleurisy at the angleof the left nia were healthy but inclined to be profuse.Her of her since,and have
every reason to sup-
pose
scapula, which came on about the 21st of April; no first abortion was accompanied by a severe flooding. that the displacement has not returned.
efiusion followed, and afterbeing audible for some About half a year ago an eminent provincial titioner, I fear.
prac- Sir,that your readers will accuse me of
daysthe friction disappeared. On the 7 th of May the
suspecting presence of ulceration of the having over-illustrated this subject of retroversion
the albumen disappeared from the urine,and oti the OS, examined and ascertainedthe presence of retro- of the
uterus, whtthw as a cause of illhealth or of
 16 THE MEDICAL TIMES.
of the blood, and the smoothness of the mucous of the arachnoid. I shallnow detaila case in which arachnoid. On eitherside, extending from the greater
membrane of the stomach are both commonly pre- sent that lesion was detected after death,when there had wing of the spheroid bone to the tentorium cere-
after death from typhusfever. But softening been no symptoms to indicate its presence during belli,closely appliedto the arachnoid coveringthe
of the mucous membrane of the intestinalcanal is life. Case 11 ; and then I shall narrate a case. No. pia mater, and within the cavityof the arachnoid,
was a film of coagulatedblood of a bright red oolour,
very rarely seen to the same extent as in thisparti-13, in which convulsions occurred,but which
sentedwith
pre-
eular case. There had been no signs to indicate its spots of a dark venous hue scattered over It at
no lesion, excepting some congestion of the
intervals. The diffierence in colour dependedon the
existence during life; and it is probable that itwas brain and itsmembranes,to account for so serious a
difference in the thickness of the clot There was
in a greatmeasure cadaveric. Peyer's patches, and symptom ; and then Case 14, in which the cerebral
no trace of any clot in the longitudinal fissure, and
the mesenteric glands, it is to be observed, were in spmptoms were very prominentduring life, but in no coagulumat the base of the brain. In the meshes
all respects in theirnormal state. which, after death,not the slightest deviation from of the piamater was much colourlessserosity ; and a
Haemorrhagesometimes takes placeinto the sub- stancethe normal condition of the encephalon or its mem-
branes moderate amount of the same in the lateral ven- tricles.
of muscles where no external violence can could be discovered. The bloodv pointson the cut surface of the
have occurred. than natural.
The rectus abdominalis is a fre- quent Case 11. After exposure to the contagion
"
of cerebrum appearedmore numerous
seat of the efiiision of blood. The following There was increased vascularity of the plexuscho-
fever accompaniedwith mulberryrash.
case illustrates this complication. Ensued roides.The consistence of the cerebral substance was
^rigors
"

frequently repeatedpainin head natural.

"

Cmb 10." No history of early and limbs confined bowels

symptoms. "
rapidprostration There was no abnormal congestion
"
"
of the pttlsio-
Mary B., ased 70, a thin woman, with grey hair, hoarseness deafness disturbed vision mental of the bronchial
" "

wsry tittue. The liningmembrane

"

oame under observation on the sixth day of disease.

confusion drybrown tongue difficultdeglutition the tubes themselves
No particulars of the symptoms present before her
" "

tubes was finely injected ; tained

con-

admission into the London Fever Hospital, under

"-quickpulse"cool skin mulberryrash extreme
" "

much muco-purulent fluid. The pericardium

theoare of Dr.Tweedie, July 21st,1848,could be difficulty of breathingdeath on the 16th day.
"
and heart were healthy. The clotsin the heart were
obtained. She had resided forsome Eleven hours qfterdeathypersistence of spots firm.
yearsprecedingclot in the substance of
"

lier admission in Kensingtonworkhouse. left rectus abdominalis The mucous membrane of the pharynxwas of a
Several
and so soft that itcould be readily
gestion dirty
cases of fever,with mulberryrash,were admitted muscle " clot in the eavity of arachnoid slight"
con- yellow colour,
shortly before from the same removed by the slightest scraping from the subjacent
locality. of the posterior part of lung^ softening tissue.
" of
When first seen, on the sixth day of disease, her the mucous membrane of pharynx thickening
" of
mind was wandering.She fancied she had been in rima
glottidis Larynx, The rima glottidis
"
was narrow,the mucous
the hospital three days. There was no headache,
pus in larynx other organs normal. membrane
" "

of the whole larynxfinely injected, and

"he had slept a little.She was deaf. The tongue was
Mary G.,aged 49, a moderately stout woman, ject
sub- covered with a layerof purulentflnid.Orkand above
dry and brown ; the bowels slightly
to constant cough,was admitted into the London the chordie vocaJes was some solid opaque white
relaxed. There Fever
were, however, no
Hospital, May 9th,1848,under the care of matter,resembling lymphin physical character.
abdominalsigns ; the pulsewas Dr. Tweedie. Her danghterleft the hospital three the spleensmall,weighing
aniv 80. There was slight want of resonance, and very weeks before, The Uver wyis flabby;
and Mary G. washed her clothes. She onlv 4i soft and flabby.
feeble respiratory over the most oz., was
murmurs
aependingwas a native of London. The pancreaSf urinary bhdder, and uterus were
part of the lungs, the patientlying on her back \ the Present illnessbegan 13 days before her admission small
"kin was waim and dry. Mulberryrash was well healthy. The kidneyscontained numerous
with rigorsfrequently repeated" p ains in the head
marked. The prostration was so great,that the
tient and limbs,and confined bowels. She took to her bed
pa- cysts theircorticalsubstance.
in
was unable even to turn in bed unassisted.4oz. The oesophagus was normal in appearance.
the second day of disease,
ordered tci be givenduringthe twenty- entirely because she
on iS^omacA."The whole of the coats of the great cul
of gin were
feltgenerally illand extreme weakness. There had de sac were
four hours in divided doses. On the next day the been no She had taken before admission them with the greatest
so soft that the finger passedthrough
epistaxis. Bluish white bands,
pulse had risen to 120 ; it was very weak ; there was several doses of aperient medicine. Hoarseness first from which the muoons
facility.
"ome somnolence; in other respects there was little made its membrane had disappeared,
changej she died at 7. a.m., on the ninth day of appearance, her relationsstated, on the 9rh extend from the softened portion towards the pylo- rus.
disease,apparentlyfrom asthenia. day of disease. The whole mucous membrane of the stomach
The following notes of her case taken on the was exceedingly
The bodywas examined thirty one hours after death j thirteenth
were
soft, but very pale.
the weather beingcooli the cadaveric rigidity dayof disease:^No headaohe.slight ness
deaf- Large and small intestines, ^Toe thickness, colour,
had "

almost entirely disappeared} the spots observed

(notdeaf till present illness), no delirium,and consistence of the mucous membrane lining the
durinff lifecontinued; beneath and memory defective; complainsof seeingstrange otnects intestinalcanal,as well as the condition of Peyer's
extending among about the wards ; she is quite conscious that these
the fibresot the leftrectus abdominalis muscle was patches, were carefullynoted. They were healthy
objects have no real existence ; says she has a most all particulars. The mesenteric glandswere in
a loosely coagulateddark bloodyclot. 2 in.in length, m

and 1 in. in breadth. It was situated, disagreeable taste,and a constant sense of unpleasanttheirnormal eonditioa.
as above de- scribed,odours; there is flush of the face;she is unable
midway between the umbilicus and pubis. to leave her bed nowithout considerable In this case there was much more blood within
The heart was assistance.
fiabby ; the clots contained in it
The tongueis brown and dry ; she swallows either the cavity of the arachnoid than in Case 10, and yet
"oft and dark; the liningmembrane was stained solidsor there were convulsions. The softened condition
dusky red ; the lungswere deeplycongested liquids with considerable difficulty ; there
no
riorly is swelling
poste- a nd dusky redness of the tonsils, of the substance of the rectus abdominalis,and the
; the mucous membrane of the stomach uvula,
was and velum pendulum palati;
smooth and free from rugae ; the consistence, ness, stools
thick-
she has passed two presence of a clot of blood in it,are pointt worthyof
and colour of the whole gastro-intestinal during the Isst twentv-four hours; there is attention, as showing the relation between the dis-
eased
membrane
neither pain, tenderness, fulness,resonance, nor condition of the nolids and fluidsgenerally,
mucous normal; Peyer's
was
patchesin gurgling ot the abdomen ; no appetite, thirst.
all particulars healthy; larynx, pharynx,and oeso-
no and the presence of hsBmorrhage into the cavityof
phagus She can speak only in a faint, hoarse whisper ; no
healthy;there was no enlargementof the the arachnoid. Clots were found on both cerebral
mesenteric tenderness of the larynx; cough troublesome ; some
glands. A [few small cysts studded the The absence
both sides of the hemispheres.
of any trace of clot in
cortical substance of the kidneys; sonorous and mucous r"les over
the urinaryblad- fissurerendered it probable
der
chest;percussionnormal; pulse120, weak; heart the longitudinal
that the
and uterus were normal in allnarticulars; the sounds normal with mulberry haemorrhageoccurred primarily on the two sides,
pancreas healthy; the liver ; skin cool,covered
very flabby and sofki rash ; vin.alb.
the spleensomewhat enlarged. ^iv., jus.bov. On the fourteenth and i. e., that the blood did not pass before coagulation
ifearf." The piamater fifteenthdays there was littlechangein the local or from the one hemisphereto the other. As is com- mon
was congested;there was
a little subarachnoid effusionof generalsymptoms, exceptingthat the spots were in cases of hsmorrhageinto the arachnoidian,
serosity ; and the palersomewhat on the fourteenth day,and she was no trace of the vessels from which the blood escaped
pia mater and arachnoid separated from the oerebral
oonvolutions with abnormal facUitv. The substance quiteunable to protrudeher tonffue,she passedher could be detected.
of the encephalon stools in bed on the fifteenthday. The muscular
itselfappeared healthyin allre- spects.movements A small quantity of coagulated blood is, as I
at the same time were extremely trem-
ulous
have before remarked, by no means infrequently
This patient, i the pulse had risen at the latterdate to 128,
like all afiected with typhusfever found within the
was very weak, and the skin cool. She became very cavity o f the arachnoid after death
when theymake
any mistake as to the duration of restlessduring the afternoon of the fifteenthday. from typhusfever. Thus thislesion was discovered
time,supposeditlengthened ; thus she thought three Death occurred at 4 a.m., on the sixteenth day. For to existin one-seventh of the cases of typhusfever
dayshad elapsed between her entrance into the hos- pital some hours before the fataltermination the breathingwhich proved fktal during the progress of that
and my firstseeing her,whereas, laboured. There were no convul-
really, it was was exceedingly sions, disease analysedby myself in the Edinburgh
onlyone day. In addition to the presence of a clot and no coma.
Monthly Journal for October 1849, and my im- pression
in the substance of the rectus abdominalis A blisterwas applied to the throat on the fourteenth does not very far
muscle, is,that such proportion
of disease,
this case Ulustrates the early
periodat which death day increased to six ounces
and' at the same time the wine was exceed what the whole of the cases I have examined
from typhus fever,uncomplicated in the twenty-four hours. after
with local lesion, death would afford. The quantity of blood,
On the fifteenthday four ounces of gin were given.
may ensue. There was nothing found afterdeath to in however,I oughtto remark, is often very small. I
addition to the wine.
account for the fataltermination. Some have never the slightest trace of hemorrhage
congestion EUven hours trfter death the following appearances
seen
of the most depending of the
part lung" slight gestion were
con- observed :" The spots noted duringlifewere into the substance qf the brain after typhusfever.
of the piamater" trifling enlargement of the stillto be detected; there was of the membranes
no emaciation;at Now, intense congestion of the
spleen"and a small quantity of loosely coagulated least \\ inches of fatcovered the abdominal parietes.brain is frequently, almost constantiy, found after
blood in the substance of a muscle, all the Between the left rectus abdominalis muscle death from typhus fever. Congestion of the cere-
were bral
physical changesestablished duringlifewhich the and its sheath, anteriorly and posteriorly, and substance much more rarely ; and when it does
scalpel enabled us to laybare. The efiect on the also among the fibresof the musole,which were at
occur is infinitely lessintense.
solidsof the general that placesofterthan elsewhere,was a considerable
disease, which latteritselfour This case also illustrates one form of laryngitis,
of
scalpelcould not detect,was manifested by the quantity loosely coagulatedblood. The extent
flabby state of the heart and liver, the early
occupied by the clot was about six inches b^ two as found in typhusfever,i, e., that form which ad- vances
pearance
disap- inches. It commenced an inch above the pubis. insidiously, and is unattended with those
of the cadaveric rigidity, "c Htad* "
The bloodypointson the external surface violent symptoms which are consequenton sudden
In Case 9 an examplewas aflTordedof convulsions of the dura
mater were very numerous. A little swelling of the submucous tissueof the larynx.The
coincident with an effusionof blood into the
cavitybloodyserosity escapedon openingthe cavity of the physical obstruction to the entrance of the air was
 THE MEDICAL TIMES. 17
eompaatively trifling. It will be observed,that stomach was smooth; the mucous membrane was to affordthe slightest explanation of the morbid
from the history of the symptoms, as well as from posteriorly of reddish colour, anteriorly a darker red, vital

able
phenomena, by the demonstration of any
the more advanced stageof the disease of the pha- and along the greatercurvature of a vermillion hue ;
the
change of structure within the cranium. An irre-
gular
lyngeal than of the laryngeal mucous membrane, rednessSwas punctiformand capillary ; the deeper or intermitting
red parts were slightly thickened and firmer than the pulseis by no means rare in
that the affectioncommenced, as it usually does,in typhus fever, when no old disease of that organ is
the pharynx, and then spreaddown to the larynx. surrounding ; there was no softeniuff of
any part of
the lining membrane detected after death.
Deafnesswas noted in this case, as it was in Cases ; the largervesselsof the poste- rior
wall of the organ were moderately full of blood ; I do not givea case illushrative of the patholo-
gical
3,11,and 12. It is a common symptom in typhus none were visible on the anterior surface of the appearances observed within the cranium after
fever. The softening of the stomach was cadaveric,organ. death from typhusfever,complicated with inflam-
mation
a part of that tendency to softening of the tissuesso The mesenteric glands and intestines were healthy of the brain or its membrane, for this
reason,
eminently characteristicof the disease I am here in colour, thickness, and consistence. because / have never made an examination, afterdeath,
considering. The
^
sonorous rale,and the condition The pancreas, Uver,kidneys^ and vrinaryUaddery
of a case of typhusfever, in which such appearances
of the bronchial mucous membrane, were probablywere normal ; the gall bladder contained some dark werepresent. The assertion that the symptoms of
dependent on the chronic bronchitis, of which it green bile; the tpleen was dark and firm, and
this woman
peared
ap-
weighed 1\ oz. typhusfever are due to inflammation of the brain,
had longbeen the subject rests on as untenable grounds that of the same
as
Case 13. Slight Thus, with the exception of the congestion of
"
rigors, painsin back and abdo- men diseasein gastro-enteritis.
diarrhoeawithout medicine the brain, by no means greaterthan in many cases
"
sudden prostra-
tion"mental
"

confusion trifling when no convulsions occurred, theie was no lesion COMA VIGIL.
headache, vertigo
"

to account for that symptom. The patient died at Case 15." Maria W
"brown and dry tongue tenderness of abdomen "
"
aged 52, was firstseen on ,
an early period of the disease, i.e. on the 1 2th day, and the ninth day of disease; at that time the symptoms
mulbeny rash convulsions
"
coma death
"
per" "
"

nstence of spots meningeal "

and cerebral congestion no
lociu complication of importance was revealed by of typhus fever were present. She sleptmuch, and
the scalpel.The convulsions and death were on the tenth day almost constantly, nightand day.
"blood veryloosely coagulated"hypertrophy of the bably
pro-
the resultof the same Somnolence continued tillabout the middle of the
heart"other organs healthy. cause, the diseased con- dition
of the blood. I would wish particularly thirtt^enthday,gradually, however, becoming less
to
Thomas fi.,aged61, a printer, a thin man, whose constant. From the time of the visit, on the thir-
teenth
direct the reader's attention to the fact,that dia- rrhoea,
previous health had been very good, was received day, tillher death,at 1 a.m- on the fifteenth
into the London Fever Hospital, May 27th. 1848, painain the abdomen, and tenderness of the day, she never closed her eyes. On the fourteenth
on the 8th day of disease, under the care of Dr. belly, were among the earliestand most prominent day,the followingnote was made :" She lies con- stantly
Tweedie. He never had a fitof any kind before his symptoms, and yet there was no lesion of Peyer's on her back ; eyes open ; has not closed them
sdmissioninto the hospital. His illnesscommenced patches,The tenderness,probably,dependedon since the visityesterday ; cannot be made to open
with sllgbt rigorsand painin the back and abdomen. the condition of the gastric mucous membrane. I her mouth, or to attemptto protrude her tongue ; gives
His bowels were relaxed from the o\itsetand before shall have, hereafter, to detailcases, in which con- stipation no signof consciousness when spokento. The skin
he took medicine of any kind. He kept his bed is cool and sweatingprofusely the spots are darker
on the second day of illness.
was a prominentsymptom, and yet ex-tensive ;
than on admission ; there are no sudamina.
ulcerationof the agminatedglandswas de- tected
On the 9th day of disease the following notes of The body was examined twenty-two hours after
afterdeath. So that,by themselves, pain in death. There was some
hiscase were made :" colourless serosity in the
the abdomen and diarrhoea, even when presentin
He states,when asked, that he has slight ache
head- cavityof the arachnoid ; a little similar fluidin the
and some vertigo"he sleptbut fittle fever,are by no means diagnosticof lesion of meshes of the pia mater; a moderate quantityin the
last
piffht" his mind issomewhat confused. Tlie
tongue
Peyer's patches. ventricles. The pia mater, arachnoid,and cerebral
ifonr and brown Case 14. George C, aged 58, a stout,fair"com- substance,
the abdomen "
tender the bowels "
"
appearedhealthyin colour and consist- ence.
much relaxed. He has passed five stools since his plexioned man, was admitted into the London
admission yesterdaythere is no appetite and but Fever Hospital,
"
under the care of Dr. Tweedie,July
Thus, no condition of the encephalon was tected,
de-
hltlethirst. 4th,1848,labourinif under typhus fever, accompanied for the peculiar
to account symptom above
The pulse is only90. With the exception of rather with the diagnosticmulberry-rash. This man*s described.
extensive cardiac dulness.there are no wife and children were patientsin the hospital some
abnormal this
physical chest signs. weeks before ; they, too, laboured under typhus fever
I have seen one person onlyrecover from

The muscular powers are greatlyimpaired" with mulberryrash. From his admission tillabout state,and in that case the coma vigilwas not com- plete.
he is
the fourteenth day of disease, when the following n otes
qmte unable to leave his bed unassisted, even fo
reach the closestool. The skin is warm of his condition were taken, he was violently lirious Case 16. George P.,aged SO, a surgeon, was
de- ceived
re-
and dry.
"

" He
There is abundant mulberry rash. :" sleepsvery much when roused is
" into the London Fever Hospital, June 2nd,
Duringthe nighthe was seized with convulsions, very delirious; he cannot be made to take his medi- cine; 1849, on the eighthday of disease, under the care of
ttrowipg his arms about violently will not protrudehis tongue; is unable to Dr. Tweedie. He had well-marked and very severe
; he appeared at
the time unconscious of all goingon around him. leave his bed unassisted ; he has passedtwo stools typhusfever. At the time of his admission the mul- berry
This fitlasted for about ten minutes. He sleptfor duringthe last twenty-fourhours ; his pulse,which, rash was very abundant. On the sixteenth day
some time before and afterthe fit. up to this date,has not exceeded 96,is 108, and the following note was made : "

When I uw him asain on the following for the firsttime irregular; on the following day it " He has Been since last evening in his present
morning,
u e.,the 10th day of disease, he said he was fireefrom reached 120 in the minute; it continued iiTeguIar, condition. Is now lying on his back, his eyes open,
headache" his mind was rather more confused than on and, during the last twenty-four hours of life, was but he is apparently unconscious of all going on
the9th day the conjunctiva
"
was injected, pupils
the intermitting. On the fifteenthday, strabismus was around him. He cannot be made to protrude his
small--theurine was passed into the bed. On the observed for the firsttime; his eyes were both tongue, or even to make any effortto do so ; yet he
following drawn upwards and inwards ; his wife was struck by swallows a littlefluid when poured into his mouth.
day he had a second attack of convulsions,
which Issted, however,but a very few minutes. During his appearance, and remarked spontaneously,that His pupilacts very littleby the aid of a candle.
thisatuck his limbs became she had never seen him squintnefore his present Pulse 132, very weak. Urinary bladder distended ;
very rigid and he foamed
the spots grew darker as the disease ad- 1 urine passinginto the bed. The
at the mouth, and after it he
sleptforhalf an hour. illness; mulberry rash is
He was otherwise vanced ; coma preceded death for many hours ; he well marked. A blisterwas applied to his forehead,
very wakeful and occasionally de-
hnous. On the 11th day he continued watchrul and died on about the eighteenth day of disease." and on the following daythe pulsehid fallento 108.
delirious"there were frequent twitchinss of the mus- The following was the condition of the organs covered,
dis- He had some sleep ; assisted himself to drink ; pro- truded
cles
of the face the urine and the stools were on an examination of the body twenty-four his tongue fully when bidden ; and the spots
"
passed
into bed" the pulsewas hours afterdeath: were much paler. From this time he rapidly covered."
re-
scarcelyperceptible. He
"

diedat 11 a.nL, on the 12th day of disease. He There was no opacityof the arachnoid;a little
was
comatose for some hours before death. fluidonly in the cavity of that membrane ; a little It will be observed,that the condition described
The My was examined twefUff-seven colourless serosity in the meshes of the pia mater ; as
htntrsqfter death, havingexisted in the two last described cases was
"The spou marked during lifeoontinued visible. slightcongestionof the latter;the arachnoid and di^rent from somnolence or ordinary coma.
separatein one mass from the surface of very
congested.pia
Head." The dura mater was considerably mater
It was the opposite of that described as coma vigil
There was a littlefluidin the cavity of the arachnoid, the convolutions, without carryingaway any of the
Chomel and some other writers, t. e., a condition
and a small quantityinfiltrated the meshes of thepia cerebral substance ; a littletransparent serosity i n the by
mater. The arachnoid ventricles; there were a few more red pointsthan in which the patient sleeps a s much, or even more
was rather opaque. The pia
mater minutelyinjected over the whole surface of common
in the white substance of the brain ; the than in health,and yet declares that he has never
""e brain. Numerous but minute bloodypointsconsistence of that organ was perfectly normal. closed his eyes.
stnddedthe cut surface of the With the exception of some red serosity in the Pregnanct is by no means a necessarily fatal
grey and white matter
of the cerebrum. The consistence of the brain was pericardium, w hich microscopic examination proved complication of typhus fever ; nor do pregnant
nauiraL The lateral ventricles were to contain no blood corpuscles, a very flabbycon- dition the two following
moderately
"
women necessarily miscarry, as
distendedwith colourless fluid. The vessels of the of the heart, the lining membrane of which
17 and 18, prove.
plexus choroides were loaded with blood. was stained dusky red,"a nearlyfluid condition of cases,
Case 17." Mary Ann G., aged 23, a stout,well-
Ciei/."With the exception of a very small soft the blood throughout the body,"a limited amount married womgn, received into the London
of consolidation of the tissue of the left made, was
hUck clot in the rightauricle and ventricle,and a pulmonary 18, 1847,on the ninth day
"tillsmaller dot in the left auricle and ventricle, lungfrom central pneumonia, flabbyliver, dark of " "
Fever Hospital, A ugust
the disease, under the care of Dr. Tweedie. Her
bloodwas fluid throughout the body. thick bile, and
" smoothness of the lining membrane
brother also suffering from typhus fever, was admitted
Pvrieardhun healthy. of the stomach, common " after death from typhus
with her. This woman was between seven and eight
Heart somewhat enlarged and hypertrophied. fever,as I have before pointed out,the whole of the months
in a normal state. gone with child.She had well-marked severe
Larffiuf"bnmehial tubet" bronchial glandsand lungsorgans
were
fever. The mulberry rash was copiousand
I have narrated the above scanty particulars of typhus
healthy in appearance. characteristic. Her pulseon the tenth day of disease
Pwynzand oesapftagus normal. this case, in order that the reader may have another
was 140, and on the twelfth day 150; the tongue dry
Stomach. With the exceptionof a few rugae, along illustrationof the frequentpresence of what are
and brown, and the spots dark. On the fifteenth
"

the greater curvature, and trifling mammillation called head-symptoms, violentdelirium, "

squinting, day of disease the pulsehad fallento 100; the tonijue

near the pylorus,the mucous membrane of the and coma, and yet afterdeath-examination be un-
"
was moist,and the spots were fading.Vomiting
 16 THE MEDICAL TIMES.
of the blood, and the smoothness of the mucous of the arachnoid. I shallnow detaila case in which arachnoid. On eitherside, extending from the greater
the spheroid bone to the tentorium cere-
membrane of the stomach are both commonly pre- sent that lesion was detected after death,when there had win^ of
afterdeath from typhusfever. But softening been no symptoms to indicate its presence during belli, closely appliedto the arachnoid coveringthe
of the mucous membrane of the intestinalcanal is life. Case 11 ; and then I shall narrate a case. No. pia mater, and within the cavityof the arachnoid,
to the same was a film of cosgulated blood of a bright red colour,
very rarely seen extent as in this parti-
cular 13, in which convulsions occurred,but which pre- sented with
There had been no signs to indicate its of the spots of a dark venous hue scattered over it at
case. no lesion,excepting some congestion intervals. The differencein colour dependedon the
existence duringlife; and it is probable that itwas brain and itsmembranes, to account for so serious a
differencein the thickness of the clot There waa
in a greatmeasure cadaveric. Peyer's patches, and symptom ; and then Case 14, in which the cerebral no trace of and
any clot in the longitudinal fissure,
the mesenteric glands, it is to be observed, in spmptoms were but in no coagulumat the base of the brain. In the meshea
were
very prominentduring life,
all respects in theirnormal state. which, after death,not the slightest deviation from of the piamater was much colourlessserosity ; and a
Hsemorrhagesometimes takes placeinto the sub- stancethe normal condition of the encephalon or its mem-
branes moderate smount of the same in the lateral ven-
tricles.
of muscles where no external violence can could be discovered. The bloodv points on the cut surface of the
have occurred. The rectus abdominalis is a fre- quent Case 11. After exposure to the contagion
"
of cerebrum appearedmore numerous than natural.
seat of the effusion of blood. The following There was increased vascularity of the plexuscho-
fever accompaniedwith mulberryrash.
illustrates this complication. roldes.The consistenoeofthe cerebral substance was
case Ensued ^rigors
frequently repeatedpainin head natural.
"
"

C"se 10. No history of earlysymptoms. and limbs confined bowels

"
"

rapidprostration There was no abnormal congestion

" " "

of the pvlnio-
Mary B., a^ed 70, a thin woman, with grey hair, hoarseness deafness disturbed vision
"
mental "

The liningmembrane
"

of the bronchial
eame under observation on the sixth day of cfisease. nary tUsue.
confusion drybrown tongue difficultdeglutition tubes the tubes themselves
No particulars of the symptoms present before her
" "
was finely injected; tained
con-
-^uick pulse cool skin mulberryrash extreme
" " "

much muco-purulent fluid. The pericardium

admission into the London
"

Fever Hospital, under

the oare of Dr. Tweedie, July 21st,1848,could be difficulty of breathing death on the 16th day. " and heart were healthy. The clotsin the heart wero

obtained. 8he had resided for some Eleven hourt qfterdeath,persistence of spots firm.
yearspreceding clot in the substance of left rectus
"

lier admission in Kensineton workhouse. abdominalis The mucous membrane of the pharynx was of a
Several
dirtyyellowcolour, and so soft thst itcould be readily
cases of fever,with mulberryrash,were admitted muscle clotin the eavity
" of arachnoid slight gestion
con- "

removed by the slightest scraping from the subjacent

shortly before from the same locality. of the of posterior
of
part lungessoftening
"

When tissue.
firstseen, on the sixth day of disease, her the mucous membrane of pharynx thickening "
of
mind was wandering.She fancied she had been in rinia LarynK, Therima glottidis
"
was narrow,themucous
glottidis pus in larynx other organs normal. membrane
" "

of the whole larynx finely injected, and

the hospital three days. There was no headache,
"he had slept a little.She was deaf. The tongue was
Mary G.,aged49,a moderatelystout woman, sub- ject covered with a layerof purulent floid.On. and above
to constant cough,was admitted into the London the chordie vocales was solid opaque white
dry and brown ; the bowels slightly relaxed. There Fever some

were, however, no
Hospital, May 9th,1848,under the care of matter, resemblina lymphin phvsical character.
abdominalsigns ; the pulse was Dr. Tweedie. Her daughterleftthe hospital three
onlirSO.There was slight want of resonance, and very weeks The Uoer wps flabby;the "pleensmall,weighing
feeblerespiratory before, and Mary G. washed her cluthes. She
only oz.,
41 was soft and flabby.
murmurs over the most depending
was a native of London. The pancreas, urinarybladder, and uterus were
wt of the lungs, the patient lying on her back \ the Present illnessbegan13 days before her admission small
"km was warm and dry. Mulberryrash was well with healthy. The kidneyscontained numerous
marked. The prostration was so great,that the
rigors frequently repeated" pains in the head cysts in their corticalsubstance.
tient and limbs,and confined bowels. She took to her bed
pa- normal in appearance.
was unable even to turn in bed unassisted.4oz. The oesophagus was

of gin were ordered tii be given entirely on the second day of disease, because she jS^tomocA." The whole of the coau of the great cul
duringthe twenty- feltgenerally illand extreme weakness. There had de sao were
four hours in divided doses. On the next day the
been no epistaxis.She had taken before admission them with the
so soft that the finger passedthrough
pulsehad risen to 120 ; it was very weak ; there was several doses of aperient medicine. Hoarseness first from which the mucous
greatest facility. white bands,
Bluish
"ome somnolence; in other respects there was little made its membrane had disappeared,
appearance, her relationsstated, on the 9rh extend from the softened portion towards the pylo- rus.
change; she died at 7. a.m., on the ninth day of day of disease.
disease,apparentlyfrom asthenia. The whole mucous membrane of the stomach
The following notes of htr case were taken on the was soft, pale.
The bodywas examined thirty one hours after death ; thirteenthdayof disease:^No
exceedingly b ut very
the weather beingcool; the cadaveric rigidity headaohe,slight deaf-
ness Large and smaU intestines, ^Tliethickness,
" colour,
had
ilmost entirelydisappeared; the spots observed
(notdeaf till present illness), no delirium,and consistence of the mucous membrane lining the
memory defective; complains of seeingstranse objects intestinalcanal,as well as the condition of Peyer's
durinfflifecontinued;oeneathand extending
among about the wards ; she is quite conscious that these
the fibresot the leftrectus abdominalis muscle was patches, were carefully noted. They were healthy
a loosely
objectshave no real existence ; says she has a most in all particulars. The mesenteric glandswere in
coagulateddark bloodyclot, 2 in.in length,
and 1 in. in breadth. It was situated, disagreeable taste,and a constant sense of unpleasant theirnormal condition.
as above de- scribed,
odours there is no flush of the face; she is unable
midway between the umbilicus and pubis. to leave; her bed without considerable In this case there was much more blood within
The heart was assistance.
flabby ; the clote contained in it The tongue isbrown and dry ; she swallows either the cavity of the arachnoid than in Case 10, and yet
"oft and dark; the liningmembrane stained solidsor
was
liquids with considerable difficnlty there were no convulsions. The softened condition
dusky red the ; there
; lungswere deeply congestedposte-
riorly is swelling and duakyredness of the tonsils, of the substance of the rectus abdominalis, and the
; the mucous membrane or the stomach
uvula,
was and velum pendulum palati;she has passed two
"mooth and free firomruffss ; the consistence, presence of a clot of blood in it,are point* worthyof
ness, stools
thick- the last
and colour of the whole gastro-intestinal during twentv-four hours; there is attention, as showing the relation between the eased
dis-
neither pain, tenderness, fulness, resonance, nor condition of the solids and fluidsgenerally,
mucous membrane was normal; Foyer's patchesin guivling of the abdomen ; no appetite, thirst.
all particulars healthy; larynx, pharynx,and oeso- phagus
no and the presence of hsemorrhage into the cavityof
She can speak only in a faint, hoarse whisper ; no
healthy; there was no enlargementof the tenderness of the the arachnoid. Clots were found on both cerebral
mesenteric glands.A [few small cysts studded the larynx; coughtroublesome ; some The absence of of clot in
both sides of the hemispheres. any trace
""rtical substance of the kidneys the sonorous and mucous Htles over
; urinaryblad-
der the longitudinal fissurerendered it probable that the
and nteruswere normal
chest;percussionnormal; pulse120, weak; heart
in allnarticulars; the sounds normal; skin
pancreas healthy; the liver very flabby and sofk; cool,covered with mulberry haemorrhageoccurred primarily on the two sides,
the spleensomewhat enlarged.
rash ; vin.alb. Viv., jus.bov. On the fourteenth and t. e., that the blood did not pass before coagulation
fifteenthdays there was littlechange in the localor from the one hemisphereto the other. As is com- mon
Head." The pia mater was congested;there was
a little subarachnoid effusionof
generalsymptoms, exceptingthat the spots were in cases of haemorrhage into the arachnoidian,
serosity ; and the palersomewhat on the fourteenth day,and she was no trace of the vessels from which the blood escaped
pia mater and arachnoid separated from the cerebral
convolutions with abnormal iaoilitv.The substance quiteunable to protrudeher toneue, she passed her could be detected.
of the encephalon stools in bed on the fifteenthday. The muscular
itselfappeared healthyin all re- spects.movements
A small quantityof coagulated blood is,as I
at the same time were extremely trem-
ulous
have before remarked, by no means infrequently
This patient, ; the pulse had risen at the latterdate to 128,
like all affectedwith typhusfever found within the cavity o f the arachnoid after death
when theymake any mistake as to the duration of was very
weak, and the skin cool. She became very
restlessduring the afternoon of the fifteenthday. from typhusfever. Thus thislesion was discovered
time,supposeditlengthened ; thus she thought three Death occurred at 4 a.m., on the sixteenth day. For to exist in one-seventh of the cases of typhusfever
dayshad elapsed between her entrance into the hos- pital some hours before the fatalterminationthe breathing which proved fatal during the progress of that
and my firstseeing her,whereas, really, it was was exceedingly laboured. There were no convul- sions, disease analysedby myself in the Edinburgh
onlyone day. In addition to the presence of a clot and no coma. Monthly Journal for October 1849, and my im- pression
in the substance of the rectus abdominalis A blister was applied to the throaton the fourteenth does not very far
muscle, is,that such proportion
of disease, and' at the same
this case illustratesthe early
periodat which death day increased to six ounces
time the wine was
in the twenty-fourhours.
exceed what the whole of the cases I have examined
from typhusfever,uncomplicated with local lesion,
On the fifteenthday four ounces of gin were given,
after death would afford. The quantityof blood,
may ensue. There was nothing found afterdeath to however,I oughtto remark, is often very small. I
in addition to the wine.
account for the fataltermination. Some have the of hsemorrhage
congestion Eleven hourt "rfter death the following appearances
never seen slightest trsce
of the most depending of the
part lung-"slight con- were observed :" The spots noted duringlife were into the substance qf the brain after typhusfever.
gestion of the pianaater" trifling enlargement of the stillto be detected ; there was no emaciation ; at Now, intense congestion of the membranes of the
spleen"and a small quantity of loosely coagulatedleast 1^ inches of fatcovered the abdominal parietes.brain is frequently, almost constantly, found after
blood in the substance of a
muscle,were all the Between the left rectus abdominalis muscle death from typhus fever. Congestion of the cere*
physical changesestablished during lifewhich the and its sheath, anteriorly and posteriorly, and bral substance much more rarely ; and when it does
scalpel enabled us to laybare. The effecton the also among the fibres of the muscle,which were at occur is infinitely less intense.
solidsof the general that placesofterthan elsewhere, a considerable
disease, which latteritselfour was
This case also illustrates one form of laryngitis,
of
scalpelcould not detect, was manifested by the quantity loosely coagulatedblood. The extent found in t3rphus fever,t. e., that form which ad- vances
flabby stote of the heart and liver, the early
occupiedby the clot was about six inches b^ two as
pearance
disap- inches. It commenced an inch above the pubis. insidiously, and is unattended with those
of the cadaveric rigidity, "c. Head, "
The bloodypointson the external surface violent symptoms which are consequenton sudden
In Case 9 an examplewas affordedof convulsions of of the submucous tissueof the larynx.
the dura mater were very numerous. A little swelling The
coincident with an effusionof blood into the
cavitybloody serosity escapedon openingthe cavity of the physical obstruction to the entrance of the air was
 THE MEDICAL TIMES. 17
eoropaiatively It will
trifling. be obterved,that stomach was smooth { the mucous membrane was able to affordthe slightest explanation of the morbid
jfipomthe history of the symptoms, as well as from posteriorly of reddish colour, anteriorly a darker red, vital
phenomena, by the demonstration of any
the more advanced stageof the disease of the pha- ryngealand along the greater curvature of a vermillion hue ; of
the rednessSwas
change structure within the cranium. An irre- gular
than of the laryngeal mucous membrane, punctiformand capillary ; the deeper or intermitting pulseis by no means
red parts were rare in
that the afiectioncommenced, as it usually slightly thickened and firmer than the
does,in typhus fever,when no old disease of that organ is
the pharynx,and then spread down to the larynx. surrounding ; there was no of
softening any part of
the lining detected after death.
Deafness was noted in this case, as it was in Cases membrane; the largervesselsof the poste- rior
I do not givea case illushrative of the patholo-
wall of the organ were moderately full of blood ; gical
3, 11, and 12. It is a common sjrmptom in typhus none were visible on the anterior surface of the appearances observed within the cranium after
fever. The softening of the stomach was cadaveric, death from typhusfever,complicated with inflam-
organ. mation
a part of that tendency to softening of the tissuesso The mesenteric glandsand intestineswere of the brain or its membrane, for this
healthy reason,
eminentlycharacteristicof the disease I am here in colour, thickness,and consistence. because / have never made an examination, after death,
considering. The sonorous rale,and the condition The pancreas, Uver,kidneys, and vrinarybladder, of a case of
typhusfever, in which such appearances
of the bronchial mucous membrane, were probably were normal ; the gaiU bladder conUined some dark werepresent. The assertion that the symptoms of
dependenton the chronic bronchitis, of which it ap- green bile; the spleen was dark and firm, and
peared typhus fever are due to inflammation of the brain,
this woman had longbeen the subject weighed 7J oz. rests on as untenable grounds as that of the same
C"ue IS." Slight Thus, with the exceptionof the congestion of
rigors, painsin back and abdo- men diseasein gastro-enteritis.
diarrhcea without medicine the brain,by no means greaterthan in many cases
"
sudden prostra-
"

tion
mental confusion trifling when no convulsions occurred,there was no lesion COMA VIGIL.
"
"

headache, vertigo
to account for that symptom. The patient died at Case 15." Maria W , aged 52, was firstseen
"brown and dry tongue tenderness of abdomen
"
"
on
an early p eriod of the disease, "*.
e. on the 1 2th day, and the ninth day of disease; at that time the symptoms
malberry rash convulsions
"
coma" death"

per
" "

aistenceof spota" meningeal and cerebral congestion

no local complication of importance was revealed by of typhus fever were present. She sleptmuch, and
the scalpel.The convulsions and death were on the tenth day almost constantly, night and day.
" ^bloodvery loosely coagulated hypertrophy of the bably
pro-
"

the resultof the same Somnolence continued tillabout the middle of the
heart" other organs healthy. cause, the diseased con- dition
of the blood. I would wish particularly to
thirteenth day,gradually, however, becoming less
Thomas B., aged61, a printer, a thin man, whose constant From the time of the visit, on the thir-
teenth
direct the reader's attention to the fact,that dia- rrhoea,
previOQi health had been very good, was received day,tillher death,at 1 a.m. on the fifteenth
into the London Fever Hospital, May 27th, 1848, painain the abdomen, and tenderness of the day,she never closed her eyes. On the fourteenth
the 8th day of disease,under the care of Dr. belly, among the earliestand most prominent day,the following
on were note made :~She lies con-
stantly
was
Tweedie. He never had a fitof any kind beforehis symptoms, and yet there was no lesion of Peyer's on her back ;
eyes open ; has not closed them
admiasion into the hospital. His illnesscommenced patches,^ The tindemess, probably,depended on since the visit yesterclay; cannot be made to
open
with slight rigors and painin the back and abdomen. the condition of the gastric mucous membrane. I her mouth, or to attemptto protrude her tongne ; gives
His bowels were relaxed from the o'btsetand before shall have, hereafter, to detailcases, in which con- stipation no signof consciousness wnen spokento. The skin
he took medicine of any kind. He kept his bed is cool and sweatingprofusely ; the spots are darker
was A prominentsymptom, and yet ex- tensive
than on admission ; there are no sudamina.
on the second day of illness. ulcerationof the agmmated glandswas de- tected
On the 9th
dayof disease the following notes of afterdeath. So that,by themselves,
The body was examined twenty-two hours after
his case were made : "
pain in death. There was some colourless serosity in the
the abdomen and diarrhcea, even when presentin
He states,when asked, that he has slight ache
head- cavity of the arachnoid ; a little similar fluidin the
vertigo"he sleptbut fitilelast fever, by no means diagnosticof lesion of meshes of the pia mater; a moderate quantityin the
are
and some
night" his mind issomewhat confused. The tongue Peyer's patches. ventricles. The pia mater, arachnoid,and cerebral
is dry and brown the abdomen tender" the bowels
"
Case 14. George C, aged 58, a stout, fair-oom-
"
substance,appearedhealthyin colour and consist- ence.
much relaxed. He has passed five stools since his plexioned man, was admitted into the London
admission yesterday" there is no appetiteand but Fever Hospital, under the care of Dr. Tweedie,July
Thus, no condition of the encephalon was tected,
de-
littlethirst. 4th,1848,labourin^f under typhus fever, accompanied
with the diagnosticmulberry-rash. This man's
to account for the peculiar symptom above
The pulse is only90. With the exception of rather described.
extensive cardiac dulness,there are no abnormal wife and children were patients in the hospital some
weeks before ; they,
I have seen one person onlyrecover from this
physical chest signs. too, laboured under typhus fever
The muscular powers are greatly with mulberryrash. From his admission tillabout state,and in that case the coma vigilwas not com- plete.
impaired"ha is the fourteenth
quiteunable to leave his bed unassisted, even fo day of disease, when the following notes

reach the closestool. The skin is warm of his condition were taken,he was violently lirious Case 16." George P.,aged 80, a surgeon, was
de- ceived
re-
and dry. " He
There is abundant mulberry rash. : "

sleepsvery much when roused is

" into the London Fever Hospital,June 2nd,
During the nighthe was seized with convulsions,very delirious; he cannot be made to take his medi- cine; 1849, on the eighthday of diseaae, under the care of
throwinghis arms about violently will not protrudehis tongue; is unable to Dr. Tweedie. lie had well-marked and very severe
; he appeared at
the time unconscious of all goingon around him. leave his bed unassisted; he has passedtwo stools typhusfever. At the time of bis admission the mul- berry
This fitlasted for about ten minutes. He sleptfor duringthe lasttwenty-four hours ; his pulse, which, rash was very abundant. On the sixteenth day
aome time before and afterthe fit. up to this date,has not exceeded 96,is 108, and the fullowinffnote was made : "

When I saw for the first time irregular; on the following day it "
He has been since last evening in his present
him asain on the following morning,
i e., the 10th day of disease,he said he was free from reached 120 in the minute; it continued irregular, condition. Is now lying on his back,his
eyes^ open,
headache hismind was rather more confused than on
"
and, duringthe last twenty-fourhours of life, was but he is apparently unconscious of all going on
the 9th day the conjunctiva intermitting. On the fifteenth day, strabismus was around him. He cannot be made to protrudehis
"
was injected, the pupils
do so ; yet he
small-^the urine was passed into the bed. On the observed for the firsttime; his eyes were both tongue, or even to make any effort to
drawn upwards and inwards ; his wife was struck by swallows a little fluid when poured into his mouth.
following day he had a second attack of convulsions,
which lasted, however,but a very few minutes. During his appearance, and remarked spontaneously, that His pupilacts very littleby the aid of a candle.
this attack bislimbs became very rigid and he foamed
she had never seen him squintbefore his present Pulse 132,very weak. Urinary bladder distended ;
the spots grew darker as the disease ad-i urine passinginto the bed. The mulberry rash is
at the mouth, and after it he slept forhalf an hour. illness;
He was otherwise very wakeiul and occasionally vanced ; coma precededdeath for many hours ; he well marked. A blisterwas applied to his forehead,
lirious.
de-
On the 11th day he continued watchful and died on about the eighteenth day of disease." and on the followingdaythe pulsehad fallento 108.
delirious there were frequent
"
twitchinss of the mus- cles
The following was the condition of the organs dis- covered, He had some sleep; assisted himself to drink ; pro- truded
of the face" the urine and the stools on an examination of the body twenty-four his tongue fully when bidden ; and the spots
were passed hours this time he rapidly
into bed" the pulsewas scarcely
afterdeath: " were much paler. From covered."
re-
perceptible. He
died at 11 a.m., on the 12th day of disease. He was There was no opacityof the arachnoid;a little
comatose for some hours before death. fluid only in the cavity of that membrane ; a little It will be observed, that the condition described
The bodywat examined iwentu-sevenhours qfUrdeath. colourless serosity in the meshes of the pia mater ; as
havingexisted in the two lastdescribed cases was
"The spots marked duringlifeoontinued visible. slightcongestionof the latter;the arachnoid and different from somnolence or ordinary coma.
in the of very
congested.pia
IfeadL" The dura mater was considerably mater separate one mass from surface
It was the opposite of that described as coma vigil
There was a little fluidin the cavity the
of the arachnoid, convolutions, without carrying away any of the
by Chomel and some other writers, t. "., a condition
and a small quantityinfiltrated the meshes of the pia
cerebral substance ; a little transparent serosity i n the
ventricles; there were a few more red pointsthan in which the patient s leeps a s much, or even more
mater. The arachnoid was rather opaque. The pia
in the white subsunce of the brain ; the than in health, and yet declares that he has never
mater minutelyinjected over the whole surface of common
closed his eyes.
the brain. Numerous but minute bloodypointsconsistence of that organ was perfectly normal.
studded the cut surface of the grey and white matter With the exception of some red serosity in the Pregnancy is by no means a necessarily fatal
of the cerebrum. The consistence of the brain was pericardium, which microscopicexamination proved complication of typhus fever ; nor do pregnant
to contain no blood corpuscles,a very flabbycon- dition the two following
naturaL The lateralventricles were moderately
"

women necessarily miscarry, as

distended with colourlessfluid. The vessels of the of the heart, the liningmembrane of which
cases, 17 and 18,prove.
*

was stained dusky red,~a nearlyfluid condition of

plexuschoroides were loaded with blood. Case 17." Mary Ann G., aged 28, a stent,well-
CAej/.- With the exceptionof a very small soft the blood throughoutthe body,"a limited amount received into the London
of consolidation of the tissue of the left made, married womgn, was
black clot in the risht auricle and ventricle, and a pulmonary 18, 1847,on the ninth day
from central pneumonia," flabby liver, dark
Fever Hospital, A ugust
stillsmaller olot in the left auricleand ventricle, the lung
"

of disease, under the care of Dr. Tweedie. Her

blood was fluidthroughout the body.
thick bile, and
" smoothness of the lining membrane
brother also sufliering from typhus fever, was admitted
of the stomach, common after death from typhus
Perieardhtm healthy. "

with her. This woman was between seven and eight

Ueari somewhat enlarged and hypertrophied. fever,as I have before pointed out,the whole of the months
in a normal state. gone with child.She had well-marked severe
glandsand lungsorgans
were
Larynao-'hroHehial tube*--bronchial fever. The mulberryrash was copiousand
in I have narrated the above scanty particulars of typhus
healthy appearance. characteristic. Her pulseon the tenth day of disease
Phe^ynxand oesophagus normal. this case, in order that the reader may have another
was 140,and on the twelfth day 150 ; the tongue drr
Stomach. With the exceptionof a few rugae, along illustrationof the frequentpresence of what are
"

and brown, and the spots dark. On the fifteenth

the greater curvature, and trifling mammillation called head- symptoms, violentdelirium, squinting,
"

day of disease the pulsehad fallento 100; the toni^ue

near the pylorus,the mucous membrane of the and coma, and yet afterdeath-examination be un
"
was moist,and the spots were fading.Vomiting
 16 THE MEDICAL TIMES.
of the blood, and the smoothness of the mucous of the arachnoid. I shallnow detail a case in which arachnoid. On eitherside, extending from the greater
membrane of the stomach are both commonly pre- sent that lesion was detected after death,when there had wing of the spheroidbone to the tentorium cere-
after death from typhus fever. But softening been no symptoms to indicate its presence during belli, closely appliedto the arachnoid covering the
of the mucous membrane of the intestinalcanal is life, Case 11 ; and then I shall narrate a case, No. pia mater, and within the cavityof the arachnoid,
was a film of coagulatedblood of a bright red oolour,
very rarely seen to the same extent as in thisparti"13, in which convulsions occurred,but which pre- sented with
"ular case. There had been no signsto indicate its spots of a dark venous hue scattered over it at
no lesion, excepting some congestion of the
intervals. The differencein colour dependedon the
existence duringlife; and it is probable that it was brain and itsmembranes, to account for so serious a differencein the thickness of the clot There was
in a greatmeasure cadaveric. Peyer's patches, and symptom ; and then Case 14, in which the cerebral no trace of
any clotin the longitudinal fissure, and
the mesenteric fflands, it is to be observed, were in spmptoms were very prominentduring life, but in no coagulumat the base of the brain. In the meshes
all respects in theirnormal state. which, after death,not the slightest deviation from of the piamater was much colourlessserosity ; and a
Haemorrhagesometimes takes placeinto the sub- stance the normal condition of the encephalon or its mem-
branes moderate amount of the same in the lateral ven- tricles.
of muscles where no external violence can could be discovered. The bloodv pointson the cut surface of the
have occurred. The rectus abdominalis is a fre- quent Case 11. After exposure to the contagionof cerebrum
"
appearedmore numerous than natural.
seat of the effusion of blood. The following There was increased vascularity of the plexus cho-
fever accompaniedwith mulberryrash.
illustrates this complication. Ensued roides.The consistenoeofthe cerebral substance was
case
^rigors
"

frequently repeated painin head natural.

"

Cmb 10. No history of earlysymptoms. and limbs confined bowels

"
"
"

rapidprostration There was no abnormal congestion

"
"
of the pttlsio-
Mary B., aged 70, a thin woman, with grey hair, hoarseness deafiiess disturbed vision mental of the bronchial
wxry iittue. The liningmembrane
" " "

eame under ooserration on the sixth day of cUsease.

confusion drybrown tongue difficultdeglutition tubes finely the tubes themselves con-
No particulars of the symptoms present before her
" "
was injected ; tained

admission into the London Fever "quick pulse cool skin ^mulberry " " rash extreme "
much muco-purulent fluid. The pericardium
Hospital, under
of breathing death on the 16th day. and heart were healthy.The clotsin the heart were
the care of Dr.Tweedie, July 21st,1848,could be difficulty "

obtained. She had resided for some Eleven hours qfterdeath,persistence of spots firm.
years preceding
"

The mucous membrane of the pharynx was of a

lier admission in Kensingtonworkhouse. Several clot in the substance of left rectus abdominalis
and so soft that it could be readily
cases of fever,with mulberryrash,were admitted muscle " clotin the eavity of arachnoid slight gestion dirty
con-
" yellowcolour,
removed by the slightest scraping from the subjacent
shortly before from the same locality. of the posterior part of lung^ softening tissue.
"
of
When first seen, on the sixth day of disease, her the mucous membrane of pharynx thickening "
of
mind was wandering.She fancied she bad been in rima Larynx, The rima glottidis
"
was narrow,themucous
glottidis pus in larynx
"
other organs
" normal. membrane of the whole larynx finelyirgected, and
the hospital three days. There was no headache,
she had slept a little.She was deaf. The tongue was
Mary G.,aged49,a moderatelystout woman, sub* covered with a layerof purulent fluid.On. and above
jectto constant couffh, was admitted into the London the chorda vocales was some solid opaque white
dry and brown ; the bowels slirijtly relaxed. There Fever
were, however, no
Hospital. May 9th,1848,under the care of matter,resembling Ivmph in physical character.
abdominalsigns ; the pulse was Dr. Tweedie. Her daughter left the hospital three the spleensmall,weighing
only80. There was slight want of resonance, The liver vifiS flabby;
and very weeks before, and Mary G. washed her clothes. She onlv 4i oz., was soft and flabby.
feeblerespiratory murmurs over the most depending
was a native of London. The pancreas, urinarybladder, and uterus were
part of the lungs, the patient lyingon her back ; the Present illnessbegan 13 days before her admission small
"kin was waim and dry. Mulberryrash was well healthy. The kidneyscontained numerous
with rigorsfrequently repeated" p ains in the head in theircortical substance.
marked. The prostration was so great,that the pa- tient and limbs,and confined bowels. Sne took to her bed
cysts
was unable even to turn in bed unassisted.4 ox. The cesophapts was normal in appearance.
entirely on the second day of disease, because she StomadL"fhe whole of the coats of the great cul
of gin were ordered t"" be given
duringthe twenty- feltgenerally ill and extreme weakness. There had
fonr hours in divided doses. On the next day the
been no epistaxis.She had taken before admission them with the
de sao were so soft that the finger passedthrough
pulse had risen to 120 ; it was very weak ; there was greatestfacility. Bluish white bands,
several doses of aperient medicine. Hoarseness first from which the miiooos membrane had disappeared,
"ome somnolence: in other respects there was little
made itsappearance, her relationsstated, on the 9rh extend from the softened portion towards the pylo-
change; she died at 7. a.m., on the ninth day of day of disease. rus.
disease,apparentlyfrom asthenia. The whole mucous membrane of the stomach
The bodywas examined thirty
The following notes of her case were taken on the was exceedingly soft, but very pale.
one hourt qfter death ; thirteenth
the weather being cool; the cadaveric rigidity dayof disease:^No headache,slight ness
deaf- Large and small intestines, Tlie thickness,colour,
"

had
almost entirely (notdeaf till present illness), no delirium,and consistence of the mucous membrane lining the
disappeared;
durine lifecontinued;beneath and
the spots observed
memory defective; complainsofseeingstrangeotriects intestinalcanal,as well as the condition of Beyer's
extending among about the wards ; she is quiteconscious that tnese healthy
the fibresot the leftrectus abdominalis muscle was patches, were carefully n oted. They were
objects have no real existence; says she has a most all particulars. The mesenteric glandswere in
a loosely coagulateddark bloodyclot, 2 in.in length, m

and 1 in.in breadth. It was situated, disagreeable taste,and a constant sense of unplessant theirnormal condition.
as above de- scribed,
odours; there is no flush of the face;she is unable
midway between the umbilicus and pubis. to leave her bed without considerable assistance. In this case there was much more blood within
The heart was flabby;the clote contained in it
The tongueisbrown and dry ; she swallows either the cavity of the arachnoid than in Case 10, and yet
soft and dark; the liningmembrane stained solidsor
was
hquidswith considerable difficulty there were no convulsions. The softened condition
dusky red ; the lungs were deeplycongestedposte- is ; there
swelling and duskyredness of the tonsils, uvula, of the substance of the rectus abdominalis,and the
norly ; the mucous membrane of the stomach was
smooth and free fipom rugae ; the consistence,
and velum pendulum palati; she has passed two presence of a clot of blood in it,are points worthyof
ness, stools
thick-
and colour of the whole gastro-intesdnal duringtbe last twentv-four hours; there is attention, as showingthe relation between the dis- eased
neither pain, tenderness, fulness,
mucous membrane was normal; Beyer's patchesin guigling
resonance, nor condition of the solids and fluids generally,
of the abdomen ; no appetite, thirst.
all particulars healthy; larynx, no and the presence of haemorrhageinto the cavity of
pharynx, and phagus
oeso- She can speak only in a faint, hoarse whisper;
healthy;there was no enlargementof the tenderness of no the arachnoid. Clots were found on both cerebral
the larynx; cough troublesome ; some
mesenteric glands. A [few small cysts studded the The absence of any trace of clotin
corticalsubstance of the kidneys sonorous and mucous r"les over both sides of the hemispheres.
; the urinary der
blad- the longitudinal fissurerendered it probable that the
and nterus were chest;percussion normal; pulse120, weak; heart
normal in allnarticulars; the
sounds normal; skin cool,covered with mulberry haemorrhageoccurred primarily on the two sides,
pancreas healthy ; the liver very flabbyand sofk;
the spleensomewhat rash ; vin. alb.^iv., jus.bov. On the fourteenth and t. e.f that the blood did not pass before coagulation
enlarged. fifteenthdays there was littlechange in the local or from the one hemisphereto the other. As is com- mon
Bead," The pia mater was congested;there was generalsymptoms, exceptingthat the spotswere in cases of hemorrhageinto the arachnoidian,
a little subarachnoid effusionof
serosity ; and the paler somewhat on the fourteenth day, and she was no trace of the vessels from which the blood escaped
pia mater and arachnoid separated from the oerebral
convolutions with abnormal faoiUtv.The substance quiteunable to protrudeher tongue, she passed her could be detected.
of the encephalon stools in bed on the fifteenthday. The muscular
itselfappeared healthyin all re- spects. A small quantityof coagulated blood is, as I
movements at the same time were extremelytrem- ulous
; the pulse had risen at the latterdate to 128,
have before remarked, by no means infrequently
This patient, like all affectedwith
when theymake any mistake as to the cfuration
typhusfever was very weak, and the skin cool. She became very found within the cavityof the arachnoid after death
of restlessduring the afternoon of the fifteenthday. from typhusfever. Thus thislesion was discovered
time,supposed itlengthened ; thus she thought three Death occurred at 4 a.m., on the sixteenth day. For to exist in one-seventh of the cases of typhusfever
dajrs had elapsed between her entrance into the hos- pital some hours before the fatalterminationthe breathing which proved fatal during the progress of that
and my firstseeing her,whereas,really, it was was exceedingly laboured. There were no convul-
sions, disease analysedby myself in the Bdinbttrg^
only one day. In addition to the
presenceof a clot
and no coma. Monthly Journal for October 1849, and my
in the substance of the rectus abdominalis A blister was spplied to the throaton the fourteenth does not vr^
muscle, pressionis,that such proportion
periodat which death day of disease,
this case illustratesthe early and' at the same time tiiewine was exceed what the whole of the cases I hav
from typhusfever,uncomplicated increased to six ounces in the twenty-fourhours. after
with local lesion, death would afford. The quar'
On the fifteenthday four ounces of ginwere given,
may ensue. There was nothing found afterdeath to however,I oughtto remark, is often \
in addition to the wine.
account for the fataltermination. Some have never seen the slightest ^'
congestion Eleven hourt afierdeath the following appearances
trsc
of the most depending of the
part lung"slight con- were observed :" The spots noted duringlifewere into the substance rf the brain -

gestion of the piamater" trifling enlargement of the stillto be detected ; there was no emaciation ; at Now, intense congestion of t"
spleen and a small quantity
"

of loosely coagulatedleast1^ inches of fatcovered the abdominal parietes. brain is frequently, almost r
blood in the substance of a muscle, were all the Between tbe left rectus abdominalis muscle death from typhus fever,
physical changesestablished during lifewhich the and its sheath, anteriorly and posteriorly, and bral substance much more
scalpel enabled us to laybare. The effecton the also among the fibresof the muscle,which were at
occur is infinitely less in*
solidsof the generaldisease, which latteritselfour that placesofterthan elsewhere,was a considerable
This case also illust
quantity of loosely coagulated blood. The extent
icalpelcould not detect, was manifest*jd by the as found in typhusf
flabby sute of the heart and liver, occupied by the clot was about six inches b^ two
the early pearance
disap- inches. It commenced vances insidiously,
of the cadaveric rigidity,
an inch above the pubis.
"c. Head* "
Tbe bloodypointson the external surface violent symptom
In Case 9 an examplewas affordedof convulsions of the
of the dura mater were very numerous. A little swelling
coincident with an effusionof blood into the
cavitybloodyserosity escapedon openingthe cavity of the physical obstr
 THE MEDICAL TIMES. 17
compAmtively
trifling.
It will he nbtorved,that stomach was smooth; the mucous membrane wag able to affordthe slightest explanation of the morbid
from Ibe hialory
of the symptoms,
as well as fron^ posteriorly of reddiih colour, anteriorly a darker red, vital
phenomena, by the demnn^itrationof any
the more advanced stag-cof the diseaseof the pha- and alungthe i^reater curvature of a vermillionhue ;
change of structure within the cranium. An irre- gular
lyngealIhin of the liiiyngcal mucous iiicnibrsnc,the rednessjwas punciiform and njapillH-ir],''; the deeper or intermitting pulsei^ by no means rare in
thtC the afiectloncommenced^ as it red pans were shghtlyLblckenedand lirnierthim the
usually does,in typhus fever,when no old disease of that organ is
the pharj'nx, and then spread dowu to llielarynx. surrounding ; there wa.i no sofLenini; of any part of
detectedafter deaths
the lining metubrnne ; the larger vessels of the poste-
rior
Deafness was uoted m this case, as U v^"" in Cases I do not give a case illustrative of the patholo-
wall of the organ were moJeraieiyfullof blood ; gical
3, U, and 12- It is a common syTUptom in typhus nune were visibleon the anterior surface of the appearances observed within the cranium after
fever* The softening of the stomiirhwas cadavr rjc, death from tyf"hiis fever, complicatedwith inflam- mation
organ.
a part of that
tendency to softt-ning of the tmues so The tnex^iifrric ghttdJt and iffteitine$ were h^iilthy of thebrflin or its membrane^ for this reason,
eminentlycharactertstic of the disease I am here in colour, thickness,and consistence. because I ftftvenfver made an ^znminntionf after death,
consideritig* The sonorous rait?, and the condition The paucr^iiJ,Utxr, kidiictfs, aJid urtn^if hladderf of n cme of iijyhns f^ter,in which mch appearances
ofthe bronchial tnucou;} memhrane, were
probablywere normal ; the gaU bladder contained some dark icervprf^*nt.The assertion that the symptoms of
dependent on the chronic bronchitis, of whicliitap- green bile^ the ipleat was dark and firm" and
peared typhus fever are due to inllainmation of the brain,
this womun had longbeen the s object* weighed 7| oz. untenable grounds ah that of the same
rcFts on as
Cat" 13* Slight rigors, Thus, with ihe exceptionof the congE?stion of
"

pains jit back and nbdo- diseasein gastro- enteritis.

mea diarrhceawithout meditiine sudden prostra-
"
the hrain,by no meaDs greater than in many cases
tion "

meittftlconfu"ion trifling when no convul$ions occurred,there was no lesion COMA vir.iu

"

headache,vertigo "

-thrown and dry tongue" tendernessof abdomen^ to account for that symptom. The patient died at Crise 15." IVfaria W aged 52, wos firstseen
,
on
an
Ladyperiodof the disease, f.e, on the 1 2th day and the ninth day of disease; at that time the symptoms
mnlberryrash convulsions com a "
death ^p e r " "
^
,

She
iiai*'nce of spota" meningealand cerebral no locM complication o f importance was revealed by of typhus fever were present* slept much, and
congestion the The on the Senth day almost constantly, night and day.
"Mood very loosely scalpel. convubions and death were bably
pro-
coagulated"hypertrophy of the Somnolence continued till about the middle of the
heart other organs healthy. the resultof the same causc^ the diseased con- dition
thirtienth day, gradually, becoming lest
"

of the blood* J would wish particularly however,

to
Thomaa B.* Jtged61 a printer, a thin man, whose constant. Fn^m the time of the visit, on the thir-
teenth
"
direct the reader'^attention to the fact,that dia- rrhoea,
prevuMia health had been very good, was received day, tillher death, at 1 a.m. on the fifteenth
into the London Fever Hospitnl,May 27ih, ISiS, painain the abdomen, and tendertiCMof the day, she never closed her eyes. On the fourteenth
of Dr. helly,
"n ihf Sth day of disease, under the care were
among the earliest and most prominentday,the followingnote was made:" She lies con- stantly
Tweedie. Me never had a fitof any kind btforehis li^ymptoms, and yet there was no lesionof Peycr's on her back ; eyes open ; has not closed them
admiasion into the hospital.His illness commenced patches. The tenderness, probably,dE?pendedon since the visit yestertJay; cannot be made to open
^ith slight rigorsund painIn the back and abdomen, the conditionof the gastric mucous membranep ! hermouib,or toaUempt to protrudeher tongue; gives
Hii bowels were relaxed from the our set and before shallhave, hereafter,to detailcases, in which con^ no signof consciousnesswhen spokento. The skin
he took medicine of any kind. He kepthie bed stipation is cool and sweatingprofusely ; the spots are darker
was a, prominentsymptom, and yet ex- tensive
than on admission ; theresre no sudamina.
on (he fecond day of illness* tilceralion of the agminatedglandswas tected
de-
On the 9tU diiyof diseasethe following notes of TJ^e body was i^xatnined Ewcnty*lwo hours after
after death* So that,hy thfrnjielvrs, pain in death. There was
Illscase were made : " some colourlessserosity in the
the abdomen and diarrhcea, even when present In
He states,when asked*that he has altKhthea J- cavityof the arachnoids a littlesimilar fluidin the
iche and some fever, are by no means diagnostic of lesion of meshes of the piamaier; a moderate quantityin the
vertigo"he slept btii litile lusi
night"hia mind is somewhat confused. The tonffue Peyer'spatches. ventricles. The piamater, arachnoid, and cerebral
i" dryand brown" the abdomen lender" the bowels Case li. George C, aged o8, a stout,fair-com- substance, appeared healthyin colour and consist-
"
ence,
ranch relaxed* He has passedfive stools since his ple^cioned man, was admitted into the London
admission yestfirday" Fever Ho";pita], under the care of Dr. Tweedie,July de"
there k no appetite and but Tlius, no condition of the cncephalon was
HtElethirst. 4thfiStS,labouringunder typhusfever, accompanied tEcted,to account for the peculi;ir symptom above
The pulseis only 90* With the exception of rather with the dicif^nostic mulberry- rash. This man's
defcicribEd.
extensive cnrdi^icdulness, there are no abuDrinal wife and childrenwere patients in the hospital some
I have seen from this
weeks before;they, too, labouredunder typhus fever
one person only recover
physical chest signs*
The muscular powers are greatlyimpaired he is wjih mulberry rash. From his admission tillabodi state,and in that case the coma vigilwas not com- plete,
"

quiteunable to leave his bed unassisted, the fourteenth dny of disease, w hen ihe following n otes
even ro
reach the closesCool- The skin is warm of his condition were taken^}te was viokniiff de-
lirious; Caxe iri" George ?,,aged 30, a surgeon, was ceived
re-
and dry. June 2nd,
There isabuudunt mulberry rash. "He "
sleepsvery much" ^whcn roused is into the London, Fever Hospital,
During the nighthe was seized with convulsion^,very deliriouss he cannot be innde to take hia nicdi^ 184J",on the ciglitb dny of diaeaae,uuder the care of
throwing his arms about violently cine; will not protrude hi-^tongue in unable to Dr. Twee die. He hud well-marked and very severe
; he appeared at i

the time uacon"cions of ail going on around him. leave his bed unassisted; lie has passedtwo stools typhusfever. At the time of hU admission the mul- berry
This fitlasted for about ten minutes* He sleptfor duringibe lasttwenty-fourhours ; his pnlie. which, rash was very abundant. On the sixteenthday
some time before and afterthe fit. up to this date,has tiot exceeded Db, is IDS, and tb c fu ]Io w in g n 0 te vTa 8 m ad e : "

When I saw him againon the following furthe first time irregular; on the following day it He h!ts been since last evening in his present
*'

morning,
i*.,the 10th day of disease,he said he was free from reached 120 in the minute; it continued irregular, condition. Is now lyingon his back,his eyes open,
neidache" ^hismind was rather mo re confused than on and, during the last twenty-fuur hours of life,was but he is apparentlyunconscious of all going on
intermltdng* On the fifteenth day, f trabiiimu:^wns around him. Ho cMunot be made to protrudehis
lh*9tbday the conjunctiva "

was injected, the pup ds

both to m.'^ke any cflbrt to do so ; yet he
small" the urine was passed into the bed- On the observed for the first time; his eyes were toiigno, or even
mouth.
following day he had a second attack of convulsjoDSidrawn upwards and inwards ; his wife was struck by swallows a littlefinid when poured into his
which {asteJ.however^but a very few minuter During
hh appearance, and remarked spontaneously, that His ptipli Jict*^ verv littleby the aid of a candle,
thisattack his limbs became very rigid and he foamed
she li.id never seen him squint before his present pulse 132j very weat. Urinary bladder distended;
at thflmouth, and after it he sleptfor hslfan hour illness; the spots grew darker as the disease ad- urine passinginto the bed. The mulberry rash is
He was otherwise very wakclul and Vfinct^d; coma preceded death for many hours; be well marked. A blist".rwas appliedto his forehead,
lirioua.On the llth day he continued
occasionally dc-
died on about the i;ii;bteenih day of disease*" and on the following day the puUe h?idfallento 108.
watch Ttiland
delirious there were frequent
"
twitchings oF ":
'11,^ f.Tiirvwir,.;. ,4,,,= {)](,conditionof the organs dis- He bad grime sleep; assisted himself to drink; pro- truded
: ,

cleiof the fcice the urine and tbebtoolsi^'i

"
aion of the body twenty -four his tongue fully when bidden ; and the spots
into bed^^the pul^e was scGrcolv oerceptib- .i.
were much paler. From this time he rapidly re-
covered/'

diedat U fl.m, on the 12tt r the *irachnoid^ a little

: xi^ase. He wu
comatose for some hours L^ :". iluid cb;ti membrane; a little It will be observed, that the conditiondescribed
The bod^ u'Oi f:^umtnc4Ut*^* '
,.^h""sQfthe pia raater; as having existed in the two lastdcieribedcases was
and
"
Tt" ipots mark^ durit-
fftadi The dura mat
"
"iraclinoid
^
the surface of very
of the
It was
different from somnolence
the oppositeof that describedas coma
or ordinary coma.

vigji
There was a lilH i! other writers, "?., " condjljon
in the bv Chomel and some
r .
and'a im4ll ^jum '
"
i^ as muchp "/""
or
lints than which the patient sleeps ^
mater. The ai; ihst be nsa
rain the than in health,
; and yetdecJarflJ
mater minute?
the braiiK "* A. closedhis eyes. ^.^i^ssnrilr'*'*^
studded tlie Ihe Pju.n'a^cv Is by ^^ P^^"''
^^"'"'J^r ^

of ihe ccr cQirijIuaiion of tfpho*"r^* T^ ^^o foUowing

aecess*r/JymiB^MTTf, mm
nattjraL woniin
dintend'
plcxij.4 ^,^ ij^-^MMfT ^""^;JSi"''"^^ '^" London
^^li^sn,
rrriv^f^'^J*"' the ninth da^
"
on

^^'' ^^^
ttill ;.^tlrnng
fn"n^ w'^"* was admitted
,

fierweenB,.ve"
U ThiB ^om,n jii. and eight
"u, "ifhcbihl.Shoh^d Yt^M-irMrkedsevfri.
,, , ?n5
rh^ nm berry rash ^va, coniou,
""**
,., Uee Pii/se
on t be
t^nr h d^ v ofT
) .n the iweJfihdav h^O nf^K""^^"^i^^
^''"^"t*
.mt (he spots dark ;, "^^i f'*/
^^it pulse Imd l]],-
^/; ,
*''^ fifteenth
'^ ' were
imlm^. Vomiting
 16 THE MEDICAL TIMES.
of the blood, and the smoothness of the mucous of the arachnoid. I shallnow detaila case in which arachnoid. On eitherside, extending from the greater
membrane of the stomach are both commonly pre- sent that lesion was detected after death,when there had win^of the spheroid bone to the tentorium cere"
after death from typhusfever. But softening been no indicate its belli, closely applied to the arachnoid coveringthe
symptoms to presence during
of the mucous membrane of the intestinalcanal Is life.Case 11 ; and then I shall narrate a case. No. pia mater, and within the cavityof the arachnoid,
was a film of coagulatedblood of a bright red colour,
very rarely seen to the same extent as in this parti- cular 13, in which convulsions occurred,but which pre- sented with
There had been no signs to indicate its spots of a dark venous hue scattered over it at
case. no lesion, excepting some congestion of the
intervals. The differencein colour dependedon the
existence duringlife; and it is probable that wasit brain and itsmembranes,to account for so serious a
differencein the thickness of the clot There waa
in a greatmeasure cadaveric. Beyer's patches, and symptom ; and then Case 14, in which the cerebral no trace of any clotin the longitudinal and
fissure,
the mesenteric glands, it is to be observed, in spmptoms were but in no coagulumat the base of the brain. In the meshea
were very prominentduring life,
all respects in theirnormal state. which,after death,not the slightest deviation from of the piamacer was much colourlessserosity ; and a
Haemorrhagesometimes takes placeinto the sub- stancethe normal condition of the encephalon or its mem-
branes moderate amount of the same in the lateral ven- tricles.
of muscles where no external violence can could be discovered. The bloody pointson the cut surface of the
have occurred. The rectus abdominalis is a fn" Case 11. After to the contagion of cerebrum appearedmore numerous than natural.
exposure
"

There was increased vascularity of the plexuscho-

quent seat of the efiiisionof blood. The following fever accompaniedwith mulberryrash.
illustrates this complication. roides.The consistenoeof the cerebralsubstance was
case Ensued "

^rigors frequently repeatedpainin head natural.

"

Case 10. No history of earlysjrmptomi. and limbs confined bowels "

"
"
rapidprostration There was no abnormal congestion
" "

of the pulmo'
Mary B., a^ed 70, a thin woman, with grey hair, hoarseness deafiiess disturbed vision mental The lining of the bronchial
" "

under observation on the sixth day of disease.

"

nary tiuue. membrane

eame
confusion drybrown tongue difficultdeglutition the themselves
No particoiars of the symptoms present before her
" "
tubes was finely injected ; tubes tained
con-

admission into the London Fever "-quickpulse cool skin mulberryrash extreme
" " "
much muco-purulent fluid. The pericardium
Hospital, under
difficulty of death clotsin
the care of Dr.Tweedie, July 2l8t,1846,could be breathing "
on the 16th day. and heart were healthy. The the heart were
obtained. She bad resided for some Eleven hourt qfterdeath,persistence of spots firm.
yean preceding clot in the substance of left
"

lier admission in Kensington workhouse. rectus abdominalis The mucous membrane of the pharynxwas of a
Several
gestion dirty yellowcolour, and so softthat it could be readily
cases of fever,with mulberryrash,were admitted muscle " clot in the eavity of arachnoid slight con-
"

shortly before from the same the removed by the slightest scraping from the subjacent
locality. of posterior part of lungs softening tissue.
"
of
When jSrstseen, on the sixth day of disease, her the mucous membrane of pharynx thickening" of
mind was wandering.She fancied she had been in rima
glottidis Larynx. The rima glottidis
"
was narrow,themucous
the hospital pus in larynx other organs normal. membrane
"
"
of the whole larynx finely injected, and
three days. There was no headache,
ahehsd slept a little.She was deaf. The tongue was
Mary G.,aged 49, a moderatelystout woman, ject covered with a layer
sub- of purulentfloid.On"and above
dry and brown ; the bowels slightly
to constant couah,was admitted into the London the chorda vocales was some solid opaque white
relaxed. There
were, however, no
Fever Hospital, M"j 9ih,1848,under the care of matter,resemblina lymphin physical character.
abdominalsigns ; the pulsewas Dr. Tweedie. Her daughter left the hospital three
aniir80. There was slight want of resonance, and very The liver was flabby; the spleensmall,weighing
weeks before, and Mary G. washed her clothes. She soft and flabby.
feeble respiratory murmurs over the most depending only a oz., was
was a native of London. The pancreas, urinary bladder, and uterus were
part of the lungs, the patientlying on her back t the Present illnessbegan13 days before her admission
akin was wann and dry. Mulberryrash was well with healthy. The kidneys contained numerous small
marked. The prostration was so great, that the
rigors frequently repeated"pains in the head cystsin their cortical substance.
tient and limbs,and confined bowels. She took to her bed
pa-
was unable even to turn in bed unassisted.4oz. The auophapts was normal in appearance.
of gin were ordered t"" be givenduringthe entirelyon the second day of disease, because she Stomach." The whole of the coats of the great cul
twenty- feltgenerally illand extreme weakness. There had
four hours in divided doses. On the next
day the been no epistaxis.
de sac were
She had taken before admission them with the greatest
so soft that the finger passedthrough
pulse had risen to 120 ; itwas very weak ; there was facility. Bluishwhite bands,
several doses of aperient medicine. Hoarseness first firom which the mucous membrane had disappeared,
aome somnolence: in other respects there was little
made itsappearance, her relationsstated, on the 9rh extend from the softened portion towards the pylo-
change; she died at 7. a.m., on the ninth day of day of disease. rus.
disease,apparentlyfrom asthenia. The whole mucous membrane of the stomach
The following notes of her case were taken on the was exceedingly soft, but very pale.
The bodywas examined thirty -one howt after death ; thirteenth
the weather being cool; the cadaveric rigidity dayof disease:" -No headache,sliahtdeaf- ness Large and small intestines, ^Tlie thickness,
" colour,
had
almost entirelydisappeared (notdeaf till present illness), no delirium, and consistence of the mucous membrane lining the
i the spots observed
durine lifecontinued;beneath and memory defective; complainsof seeingstranae otnects intestinalcanal,as well as the condition of Peyer's
extending among about the wards ; she is quiteconscious that tnese healthy
the fibresot the leftrectus abdominalis muscle was patches, were carefully noted. They were
objects have no real existence ; says she has a most all particulars. The mesenteric glandswere in
a loosely coagulateddark bloodyclot, 2 in. in length, m

and 1 in.in breadth. It was situated, disagreeable taste,and a constant sense of unpleasanttheir normal eondition.
as above de- scribed,odours there is flush of the face ; she is unable
midway between the umbilicus and pubis. to leave; her bed nowithout considerable In this case there was much more blood within
The heart was assistance.
flabby ; the clote contained in it The tongueis brown and dry ; she swallows either the cavity of the arachnoid than in Case 10,and yet
soft and dark; the liningmembrane was stained solidsor there were convulsions. The softened condition
dusky red; the lungswere deeplycongestedposte- liquids with considerable difficulty ; there
no
riorly is swelling and duskyredness of the tonsils, of the substance of the rectus abdominalis, and the
; the mucous membrane of the stomach was
uvula,
and velum pendulum palati; she has passed two presence of a clot of blood in it,are point* worthyof
smooth and free from rugs ; the consistence, ness,
thick- stools duringthe last twenty-four hours; there is attention, the relation between the eased
dis-
and colour of the whole gastro-intestinal as showing
neither pain, tenderness, fulness,resonance, nor
mucous membrane normal; Peyer's condition of the solids and fluidsgenerally,
was
patchesin guivling of the abdomen ; no appetite, no thirst.
all particulars healthy; larynx, and the of haemorrhage into the cavityof
pharynx,and oeso- phagus She can speak only in a faint, hoarse whisper; no
presence
healthy;there was no enlargementof the tenderness of the arachnoid. Clots were found on both cerebral
mesenteric the larynx; cough troublesome ; some
glands. A [few small cysts studded the The absence of of clot in
both sides of the hemispheres. any trace
cortical substance of the kidneys; sonorous and mucous Hlles over
the urinaryblad-
and uterus were normal
der chest;percussionnormal; pulse120, weak; heart the longitudinal fissurerendered it probable that the
in allparticulars; the sounds normal skin
pancreas healthy; the liver very f"bbyand soft; ; cool,covered with mulberry haemorrhageoccurred primarily on the two sides,
the spleensomewhat enlarged. rash ; vin.alb. tiv., jus.bov. On the fourteenth and t. e., that the blood did not pass before coagulation
Ifearf." The pia mater fifteenthdays therewas littlechangein the local or from the one hemisphereto the other. As is com- mon
was congested;there was generalsymptoms, exceptingthat the spots were in cases of haemorrhage into the arachnoidian,
a little subarachnoid effusionof serosity and the
; palersomewhat on the fourteenth day,and she was no trace of the vessels from which the blood escaped
pia mater and arachnoid separated from the oerebral
convolutions with abnormal faciUty. quiteunable to protrudeher tongue, she passedher could be detected.
The substance stools in bed on the fifteenth
of the encephalon itselfappeared healthyin allre- day. The muscular A small quantityof coagulated blood is, as I
spects.
movements at the same time were extremelytrem- ulous
; the pulse had risen at the latterdate to 128,
have before remarked, by no means infrequently
This patient, like all affectedwith typhusfever found within the cavity o f the arachnoid afterdeath
when theymake any mistake as to the duration of was very weak,
and the skin cool. She became very
restlessduring the afternoon of the fifteenthday. from typhusfever. Thus this lesion was discovered
time, supposed itlengthened ; thus she thought three Death occurred at 4 a.m., on the sixteenth day. For to exist in one-seventh of the cases of typhusfever
dayshad elapsed between her entrance into the hos- pital some hours before the fataltermination the breathingwhich proved fatal during the progress of that
and my firstseeing her,whereas, really, it was was exceedingly laboured. There were no convul- sions, disease analysedby myself in the Edinburgh
onlyone day. In addition to the presence of a clot and no coma. Monthly Journal for October 1849, and ray im- pression
in the substance of the rectus abdominalis A blister was spplied to the throaton the fourteenth
muscle, is,that such proportion does not very far
this case Ulustrates the early
periodat which death day of disease, and' at the same time the wine was exceed what the whole of the cases I have examined
from typhus fever,uncomplicated increased to six ounces in the twenty-fourhours.
with local lesion, after death would afford. The quantity of blood,
On the fifteenthday four ounces of gin were given,
may ensue. There was nothing found afterdeath to in however,I oughtto remark, is often very email. I
addition to the wine.
account for the fataltermination. Some have never seen the slightest
congestion Eleven hourt rfter tleath the following trsce of haemorrhage
of the most depending of the appearances
part lung" slight gestion were
con- observed :" The spots noted duringlife were into the substance qf the brain after typhusfever.
of the pianuiter" trifling enlargement of the stillto be detected; there was of the membranes of the
no emaciation; at Now, intense congestion
spleen---and a small quantity of loosely coagulatedleast 1^ inches of fatcovered the abdominal parietes.brain is frequently, almost constantly, found after
blood in the substance of a muscle, were all the Between the left rectus abdominalis muscle death from typhusfever. Congestion of the cere-
bral
physical changesestablished duringlifewhich the and its sheath, anteriorly and posteriorly, and substance much more rarely ; and when it does
"calpel enabled us to laybare. The e^ct on the also among the fibresof the muscle,which were at occur is infinitely lessintense.
solidsof the general disease, which latteritselfour that placesofterthan elsewhere,was a considerable
of
This case also illustrates one form of laryngitis,
manifested by the quantity loosely
scalpelcould not detect, coagulated blood. The extent
was
flabby state of the heart and liver, the early
occupied by the clot was about six inches b^ two as found in typhusfever,i. e., that form which ad- vances
pearance
disap- inches. It commenced an inch above the pubis. insidiously, and is unattended with those
of the cadaveric rigidity, "c. Head. "
The bloodypointson the external surface violent symptoms which are consequenton sudden
In Case 9 an examplewas affordedof convulsions
of the dura mater were very numerous. A little swelling of the submucous tissue of the larynx.The
coincident with an effusionof blood into the
cavitybloodyserosity escapedon openingthe cavity of the physical obstruction to the entrance of the air was
 18 THE MEDICAL TIMES.
became Tcry troublesome during convalescence. She that itbled profusely at the leasttouch of the knife. in slices, and thiswas continued until the increas-
ing
kft the hospital in the earlypart of Sei)tember. After a littlefurther dissection, it was soon haemorrhage from the cut surfSiceof the tumour
ap**
Case 18." Margaret G., aged 36, night-nursein parent, that the deep-seated connexions of the forbad any further proceeding.
tbe London Fever Hospital, came under observation timiour
were such as to render its removal next to The operation waa followed by very littlecon^
on the 6th day of disease, March 2nd, 1849. She was
impossible. On the one side it was porated stitutionaldisturbance.
firmlyincor- The tumour began to
then about seven months gone with child ; she had with the rectus and vastus entertained that the remain-
severe typhus fever ; thus, on the 12th of
day disease,the
intemus ; on slough,
a nd.a hope was ing
140 ; her mind was confused ; the other,with the adductor muscles ; and a portion of it i n
portion mightperish, consequence of the
her pulsewas
mulbery rash was dark and characteristic;from this of it seemed to be prolonged upwards towards the disturbance of its connexions. But a changeof the
time slowly recovered. Like case 17"she suf-
she fered pelvis.Thus, scarcely any part of its circum- kind ensued.
ference opposite About the third week after
from vomitingduring
much convalescence. could be detached. Moreover,in attempt- the operation, the tumour began to increase so ra-
pidly,

This leftthe hospital

woman at the beginning of iiig to do this,a very largeartlrywas divided,and that,at*theend of the followingweek, it had
April; went her full time, and was then delivered bled profusely b efore it could be secured. The attained
nearly the size of the head.
patient's No
of a child.
living I saw her about two months operation was then given up, but not before so serious amount of constitutionalmischief came on

after her confinement; she said that she had much blood had been lost,that fears were tained
enter- till the fifth week after the operation, when the
good time. The child, I it lestthe patient should die on the table. patient gradually s ank, and died at the end of the
a very saw; was

small, and did not look very healthy;but the Notwithstanding the profusehaemorrhage, the sixth.
mother informed me it was strong,and it appeared patient sufferedlessthan mighthave been expected Poat-mortem examinatioji, The deeperportion " of
to her to be thriving. This woman had been con- fined from the operation.He soon rallied,and the the tumour extended to the transverse processes of
to her bed for a fortnight in the precedingwound began to granulate.On the sixth day it the cervicalvertebrae, with which it was intimately
November, t. e., when two months advanced in the was discovered, that the tumour was beginningto connected. The carotid artery and the nervua
same piegnancy, with modified small-pox.I saw slough. The sloughingincreased with such ra- pidity, vagus were closely united to its inner border. The
her dailyduringthat attack,and for a few daysshe that, by the eighteenth day,the entire tumour hypoglossal nerve was buried in itssubstance. The
was exceedingly ill; she was, moreover, the subjecthad perished, and become detached from its con- nexions phrenic nerve was displaced by, but not implicated
of rather extensive valvular disease of the heart. ; so that Mr. Lawrence drew out the dis- ease in the tumour.
en maste from its bed in the thigh. On careful The tumour itselfwas of the consistenceof firm
examination of the disease thus removed, the femo- ral jelly, of a yellowish colour,and semi-transparent,
BOSPITAli RJSFORTS. vesselswere found runningthroughthe centre of and permeated throughout by vessels. Examined
" it This circumstance accounts for a symptom microscopically, it was found to consist of a fibious
ST. BARTHOLOMEWS HOSPITAL. which we have not hitherto mentioned, namely,the stroma, of oil globules in g^eatquantity, and of irre^
considerable swelling of the whole limb after the gularshapedcells, some of which were caudate.
flPONTAlOSOUS SEPARATION OF A LARGE operation. ENCEPHALOID DISEASE OP THE TESTICLE,
TUMOUR FROM THE THIGH. AFTER AN The large excavation in the thighleft after the WITHOUT ANT LOCAL PAIN, OR DISTURB*
UNSUCCESSFUL ATTEMPT AT REMOVAL
separation of the slough,has been filled up by ANCE OF THE GENERAL HEALTH.
BY OPERATION.
healthygranulations, and the patient has left the Mr. Lawrence broughtto the Musetmi an en- larged
The following very remarkable case has recentlr Hospital with the perfectuse of the limb,and with testicle, which he had recently removed from
been discharged from the hospital, a perfect cure. "We every prospectthat there will he no return of the a private patient.It was about the size of the
are, therefore, enabled to give a completereportof disease. closed fist, and even on the surface. When cut into,
the many interesting pointsbelongingto it,from The chief practical pointdeducible from this it presented, in the most marked form, all the cha- racters
tbe commencement to the close. case is the caution with which we oughtto estimate of encephaloid, or pulpydegeneration. The
Evan Davies, a thoroughly robust and healthy the connexions and extent of a tumour by itsloose- ness disease had onlybeen five months in progress, and
lookingman, about 46 years of age, was admitted and mobility.In this instance,there was no had not been attended with pain, or even the
into "Henry" Ward, under the care of Mr. to suppose that the tumour disturbance of the generalhealth. The
reason had such deep slightest
Lawrence, on the 4th of October,1849. He had a connexions as would prevent its completeremoval ; patient from whom it was taken was said to be of
largetumour on the front of the rightthigh, just but it proved otherwise. The subsequentspon- taneous remarkably healthyappearance at the presenttime.
above the middle. It was of a nearlyspherical detachment of the growthby sloughing is a
shape,between four and five inches in diameter, most rare occurrence.
uniibtm on the surface,compact and elasticto the As a contrast to the preceding PR0ORB88 or MEDICAL 8CIENCB.
case we relatethe
feel. It was, evidently, deeplyimbedded in the following, in some respectsparallel to it,which
thigh.As one might expect of a tumour so situated,occurred some time ago in the Hospital. FRANCB.
it could be moved very littleindependently of its
LARGE TUMOUB ON THE SIDE OF THE NECK
surrounding connexions; at the same time, there "OPERATION"
(ParisComspondence.)
for believing ^SUBSEQUENT VERT RAPID
was no reason that it was in any way GROWTH OF THE DISEASE" DEATH" SECTION
DIS-
fixed to the bone. The superincumbent skin was CHOLERA HONOURS.
OF THE PARTS CONCERNED.
quitehealthy, and so was all the rest of the limb. A stout, healthy-looking sixteen
girl, of
The " Cholera Rewards" of the Republichave
We years
gatheredfrom him the following history. age, came under the care of Mr. Stanley, on account
been completed this week by an extensive distribu- tion
About nine months ago, while engagedin the exe- cution of a tumour about the size of a largeorange, of an of crosses of the Legion of Honour amongst the
of his dutyas a constable, he was kicked on provincial physicians who distinguished themselves
oblongform, with the longaxis vertical, situated on
that partof the thighwhere the disease
subsequently the right side of the neck. It had existed upwards duringthe epidemic. Medals have also been
appeared.The kick was so severe that he was of ten months, and was firstnoticed as a small
awarded to the Sisters of Charity in the provinces,
compelled to remain at rest fora few days, and apply moveable lump, beneath the skin. Its whose eeal and devotedness in the cause fksufiering
leeches to the affectedpart. Not tilltwo months, subsequentand all
growth had been slow. It had never occasioned humanity are above praise. To our own Go- vernment
or thereabouts, afterthis injury, did he perceiveany pain,or interfered with the we might say, Go thou and do likewise ;"
"

trace of the tumour.

generalhealth. The but
Various means were then tumour, when graspedand compressed, any suggestion of the kind were speaking thet o
was firm to
tried with a view to disperse it; and, amongst the feel, and so loose and moveable on the subjacentdeaf. Until the Medical Profession in "ngiand be
others, a thorough salivation; but the lump steadily the belief that its base had no raised by wise reform to the rank which it has a
parts,as to justify
progressed in size,and became gradu^ly more deep connexiocs. The skin covering it was fectly
per-
rightto occupy, itwill be vain to demand due con- sideration

painful, especially after unusnal exeroise. Under

healthy, and there was no enlargement of the
for its members, however honourable or
these circumstances, he determined to eome worthy of honour theymay be.
London for the benefitof the best
up to neighbouring glands.
surgieti advice, As there waa no groundfor supposing The German papers bring us the news of the
the tumour
and had the goodfortune to fallunder the of to be malignant, death of Walther of Munich, one of the oldestand
care as it was increasing in size,and
Mr. Lawrence. the patient was anxious to have it removed, the most distinguished of tbe German professors. He
Mr.^ Lawrence,after maturelyconsidering all operation was undertaken by Mr. Stanley. When
was the author of the " Anatomical Museum," and
the circumstances of this many other works of standard metit,though ancient
case, recommended the the skin was turned aside, the mastoid muscle was
man to submit to an operationfor the removal of seen expandedover date.
the tumour. The muscle was
the tumour, and on these
grounds:" 1. The dis- divided transversely, and then it was discovered ANALYSIS OF THE CHTLE AND BLOOD.
""^go^ld be got rid of in no other way, and was that the inner border of the tumour At the last meetingof the Academy of Sciences,
extended so
progressing in size ; 2. Its nature,
thongh uncer-tain, deeplyand so far towards the middle of the neck, M. Milot presented a memoir on this subject.The
was in all probability innocent;8. Its mo- that its surface was
bility in close connexion with the author analyzed simultanetmsly the chyleand blood
and connexions were such as to justify the sheath of the greatvessels.
By careful dissection, of two dogs,which had been submitted to different
hope that it might be entirely removed ; 4. The the detachment of the tumour from the sheath of kinds of alimentation. One had taken
in the best possible nothingfor
patient was health. Accord-
ingly, the vessels was efi!ected ; but, when the laststageof two days except milk; the other had been fed
on the 28rd of October, with the approbation the operation, the removal of the tumour from the duringthe same
"

time with a quantityof fat,

ofallhis^colleagues, Mr. Lawrence undertook the subjacent
parts,was attempted, insuperable cultiesmixed with bread and meat.
diffi- The blood of the
operation,the patient beingunder the influence of Ite base was found to extend to the firstcontained carbon and nitrogen
arose. in the same portions
pro-
chloroform. A free crucial incision was made transverse processes of the cervical vertebrae, and it as albumen, but it also contained a great
through the integument. The sartorius muscle, was clear that the cervical
which crossed over the tumour, was plexus of nerves was plicated
im- excess of oxygen. The chylepresented a sponding
corre-
then divided, in its substance. change,and resembled albumen, with an
and thus the entirefront of the disease laid bare.
was Under these circumstances, so much of the excess of oxygen.
It was firm in texture, and so exceedingly vascular,tumour as could with safety be removed,was cut off In the blood of the second dog were found carbon
 THE MEDICAL TIMES, 19
and nitrogenin the proportions which constitute to four ounces of water, was thrown into the cavity allowed ; hence, in a wJtole country, he says, Eng- land
albumen ; but it was hydrogen, not oxygen, which it of the abdomen. No accident whatever supervened, or Ireland, for instance, the preponderance is
contained in excess ; and the same changewas ob-servedand the cure was permanent. at the side of the weaker sex. Mr. Farr long since
in the chyle, which latterfluidwas extremely stated the fact, and ascribed it to tight-lacing, very
ri'-h in hydrogen. properly remarking, " Girls have no more need of
IREIsAND.
The practical remarks which M. Milot deduces artificial bones than boys." Dr. Duncan, however,
from his experiments are important They prove [DublinCorrespondence.] thinks this has little to do with the matter. Ex-^
that the arterial blood of an animal is essentially posure of the chest, confinement to the house, de- privation
modified, by the diet to which the mal
ani- While the three new Irish Colleges are mined
deter- of the light and heat of the sun, also
may have been submitted. The analysis to push their way, through** evil report and alluded to by the Registrar-General, Dr. Duncan
of the firstblood shows that, in addition to the albu-
men, good report," commencing the year with the full considers of lessmoment
" than the moral emotions.
fibrin, and globules, it contains a consider-
able tide of Government favour, the members of the
"
SIMULATED PERICARDITIS.
proportion of oxygenated matter, which, in all differentSocieties in Dublin appear not less busy, A rather singular case of thisdiseasehas been met
probability, furnishes the products of secretionsthat and the openingof the Royal Irish Academy, the by Dr. Hudson, of Navan, and may be worthy
abound in this principle. In the second blood,the Surgical Society, the Obstetrical Society, tend of recollection to the practitioner.
"c.,por- All the usual
same elements for oxydation probablyexist also ; well for the season justset in. At each of signsof pericarditis present, with this membrane,
but theyare combined with a considerable quantitythese Societieshighlyinteresting papers from time on necroscopic examination, quiteand entirely
of fiitty matter, introduced by assimilation. to time occur, in every way worthyof the highcha-
racter healthy.The friction sound,duringlife, was mor^
At the of the Dublin School. Among these than usually distinct. Even when the respiratory
Academy of Medicine, littleworthyof a very
note occurred lastweek. demy, practical
The librarianof the Aca- one, lately, by Arthur Jacob, the* emi-nent movements were stopped, the man had oppression of
who had been sent with the Expedition to anatomist, may be mentioned,on the subject of the chest, and many of the symptoms Uiat ordina-
Rome, wrote to announce that he had made rinarily attend pericarditis, so much
"
so as to be
some GUTTA PERCHA.
"ery interesting discoveries in the manuscripts This substance, which has been turned into every- treated for this disease. The affectionhe was
thing,
of the library at the Vatican. One of the last from has reliefs to candlesticks, Dr. Jacob labouring under being emphysema of the anterior
works of an ancient writer has, I believe, been considers nearly invaluable for the construction of mediastinum, of which no history could be ob- tained
recovered. This announcement came very catheters. The
apro- ordinarygum-elasticinstruments ; the pericardium quitesound.
pos to restore the good humour of the acade-
mician?,are now, according to Dr. Stapleton, fabricated in CHLOROFORM IN OBSTETRIC PRACTICE
disturbed by a terriblereportfrom MM. the most singular way. Without a bit of gum elastic Has recently gainedmany adherents in Ireland.
Bousquet and Bouillaud againstpoor Piorry,in their composition, of a woven tissuein the same A Reportwas read at the Obstetric Society some
bis pleasiraeter, and other like fantasies. A cer- by Dr. Denham, of a highlysatisfactory
tain manner as ordinary cutting whips ; this structure,time smce
Dr. Durand had ventured to support,in a long steeped in dryingoil, is dried, polished with pumice, character ; the pains are diminished in force, fre-
quency,
memoir, the hazardous theory,that intermittent and varnished ! Left in the bladder,the layers and duiation ; the muscles of animal life
fever and engorgement of the spleen and little are those firstafiected; the pupils remain natural
are one stripoff one after another,and it requires
the same thing. Carried away by his zeal,he pro- nouncedstretch of imagination to conceive, may often form duringthe firststageof its effects; but, when full
the word "
splenomacrosie," whereon the the nucleus of dangerousdeposits. Gutta percha,asthenia is produced, theybecome dilated; the va- gina

worthy reportersobserve,that none save

"
a de-
votedon the contrary, is far more cheap; immersed in and OS externum also become sensibly re-
laxed.

and grateful pupilof Piorry"could descend urine,as Dr. Jacob found, it suffersno change, "
It has never influenced the infant.
to such barbarisms. As for the corrier-stone even after a fomight, and is every other way
"
BELFAST COLLEGE.
of the doctrine, nothingwere easier than to root it adaptedto the formation of flexibleinstruments. The Professors of Medical Jurisprudence fessors
(Pro-
up, M. Dnrand estimates the diameter of the Gutta perchacatheters are used in the Paris ho- spitals. Hodges and Molyneaux) have openedtheir
spleenat 7 to 7J centimetres, and regards every The brittleness of the new substance seems class at this College, b y an interesting "
tory,"
Introduc-
organ as engorgedwhich exceeds this dimension. its chief fault, but this is remedied by leaving it as placing this science higherthan the ordinary
But other writers show, that the spleen may have a homogeneous as possible, excluding colouring matter one of healing. The Lecturer descanted at con*
diameter of 12 centimetres, without beingdisor- dered; and not exposing it to too much heat. siderablelength on the value of medioo-legal studies.
and M.Cruveilhier estimatesitsnormal weight Dr. Benson exhibited to the Surgical of cited,especially that
Society Some very apposite cases were

as varyingfrom 2 to 8 ounces. These facts of Dublin,a

gutiaperchastethoscopet which he said was of a man named Shally,chargedwith attempt to
themselves show how impossible it is to draw
any more pleasant to the patient and the physician's poison.An adequatemducement to the act was
correct conelosion from slightvariations of the ear, and quite as good a conductor of sound as the first proved. The prosecutrix swore the prisoner
spleenduringthe course of intermittent fever; but ordinary wooden one. had given her tarts with arsenic. The Medical
the weakness of the pupil's theoryhardlyjustified THE CONTAGIOUSNESS man, however, was struck with the fact, that the
OF CHOLEBA
the sarcasms of the reporters against the master and discussion in Ireland, taste she described was not that of arsenic. The
Has latelycreated some
his hobby. facts been adduced action of the tarts was not as quick as it ought to
many very striking having
Dr. Donovan, of Skibbereen,one of the ablest have been ; her appearance did not correspond. The
ASCITES CUBED BY IODINE
by
INJECTIONS. corroborated, and the man
physicians in the south,as to the certainty of the evidence,however, was
The following
two oases, though not of very disease beingcontagious closerexamination of on the point of beinghanged. By a proper ledge
know-
; on
recent date,mayhave the effectof directing atten- the cases, however, many of them must be mere of chemical analysis, it was now found, by
tion to a mode
of practice, once much in vogue, but coincidences ; others,it is not difl"cultto account comparingthe residue of the pie,that she should
now undeservedlyneglected. for by the ordinary defects of sanitaryarrange- have taken ten grains; the vomited matters contained
ments,
A fifteen. The prisoner at once dismissed ; the
young girl, 17 years of age, of feebleconsti-
tution, in a placelike Skibbereen,too,where such was

had laboured under ascitesfor 14 months. destitution existing, the number of per prosecutrix after confessing the whole story. Some
frightful
The disease appeared to be consequent on a slightsons likely to be attacked must be very great,which other cases as striking were noticed,and the im- mense
affection. value of this department of the Physician's
pulmonary Diuretics and drastic tives
purga- will still t he
complicate question.Cholera, van
Dono-
had been employed by several medical men thinks not likely to occur a second time in the education fully entered into.
without success, when M. Lericheundertook the same individual. The fact of Medical men, nurses,
case. Havingpunctured the ^domen, he drew off "c.,not beingattacked, he ascribes to the prelimi-
nary SBIiECTIONS FROM FORBIGN
eleven quartsof fluid, and then injected a solution dlarrhcea beingalwaysin them watched and JOUBNAXiS.
of 1 drachm of iodine and an ounce of the tincture,checked. In the north, at Belfast, the question,
in 8 ounces of water. Only one-half of the injec- tion too,has been entertained, with almost similarresults.
CHANGES IN THE QUANTITY OF ALBUMEN
could be removed from the cavity of the abdo-
men IN THE BLOOD.
HOT-BLAST FURNACE.
on pressure, varied in
every direction. On the At Belfast, Dr. Stevelly has read an instructive The following conclusions regardingthe varia-tions
following m'ght,the patientcomplainedof some paper on the hot-blast furnace,and, among other of the albumen are givenby M. A. Becquerel,
in the abdomen, which was somewhat tympan-
pain itic things, stated the appalling fact, t hat of the men em* the son of the well-known physician, a memoir in
; she passedurine in abundance ; there was no
ployedat thistryingwork, especially the " puddling lately read at the Academic des Sciences. In the
fever,but duringthe next fortnightthe patientfurnace,"not one ever lived beyond twenty-eight of albumen is 80 partsper
seemed feeble, and sleptbadly. She continued to
blood,the mean quantity
years of age. 1000 ; the variationsfrom 75 to 85. The quantity minishes
di-
improve,and was perfectly cured on the twenty-
LAW OF MORTALITY IN PHTHISIS. in persons insufiiciently fed ; in many cases
second day after the operation. in who have been much
In this disease,in which the mortality is almost of chronic disease; persons
The second case was that of a boy,aged18,affected equally formidable.Dr. Duncan has of late shown, bled, or in whom there have been losses of other
with abdominal dropsy formanyyears,broughton by that some singularfacts obtain; males are more liquids, as in dropsies, "c In ^ simplecontinued
frequentattacks of intermittent fever. A great liableto phthisis m cities;females m the country. It fever," the tdbumen remains at its usual figure;
variety of remedies" tonics, iron,bark,sulphate of is known, that those attacked at Sheffield of in plethora,sometimes normal,sometimes decreased ;
quinine,diuretics, purgatives, "c., had been em- ployed "grinder'srot," or "grinder's asthma," are all in erysipelas of the face with fever,decreased ; in
without the slightest success. The child's men, and die before they reach thirty-two years of pneumonia,much decreased after the second day ;
health became so broken down that he was unable age. Stone-masons, miners, coal-heavers,flax^ in acute pleurisyand bronchitis, decreased to a
to leave his room. Everyfortnight it was necessary dressers,and many other male occupations, also, less degree;in pulmonaryemphysema decieased
to puncture the abdomen, and draw off from eight come into the same and duringthe access of dyspncea; in disease of the
category. The passions
to ten quartsof fluid. On the 27th of
April,an in- the mind Dr. Duncan representsas havingmore heart unchanged,unless there is dropsy, when
iection, composedof one ounce of tinctureof iodine to do with the originof phthisis than is usuallyit diminiahei ; in Bright* s disease diminished, ap-
 20 THE MEDICAL TIMES.

puentiyby the abundant dropsy, and not by the morbillis, so also can there be typhoid fever without or six dorsal branches, which fibres traverse the
actual lossthroughthe kidneys. M. A. Becquerelrose spots. In typhoidfever,as in other conta- gious sympathetic before reaching it.
describes also a polariscope founded on the extent diseases, the intensity of the disease bears no 4. The means of innervation are multiplied on count
ac-

to which the albuminous liquid rotates to the left necessary relationto the anatomical signs ; persons of the physiological importance of the nerve.
the ray of light." (Z'Un, Med. Nov. 29). may die from the extreme intensity of diseasebe- fore 5. The blanch of Uie accessory presides o ver the
ETIOLOGY OF TYPHOID FEVER. the intestinallesions appear. Only the ma- lady vocal movements of the larynx, and is to the vagus
M. Chomel has latelybeen delivering some itself, and not its local manifestations, can what its lesserportion is to the trigeminus.Jrch. "

clinical lectures on the disease which he has al- readyexplainthe march and termination of the symp- toms. Gin. for Nov.
so admirably described. We abstract from an This is the case with all contagious diseases, CHLOBOFOBV.
ETHER AND
account of these lectures in L* Union Medicate,the and marks a great difference between them and Steam has broughtus within a few days of New
opinions tli"Lecturer on the cause of typhoid
of fever. those affections, as pneumonia or other inflamma--
York, and among the sea of communications with
He (M. Chomel)believesthat physicians have in ge-neral tions, which do not arise from specific viri. {L*Un,
which we are deluged, we find sundrylucubrations
made a veritableromsnce of the causes of dis-
eases,Med., Dec. 18.)
of our medical brethren in the New World. The
more often basing them on a pre-conceived ANATOMICAL ELEMENTS IN THE MEDUL- American schools,if not remarkable as yet for
opinion, than on the simpleobservation of nature. LAKY CANALS OF BONE. but that of ether in surgical
With regard to many diseases,the causes are
any great discovery
M. Robin describes, in the medullarycanals of operations, are not wanting in zeal and anxiety for the
hardlyyet recognised. With regardto others,the
short,flat, and longbones,besidesadipose tissue, ves- advancement of General Medical Science., We have
cause is perfectly known by itseffects, its
although sels,and a fine
granular m atter, a special kind of cell room but for one or two excerpts.
principle and intimate nature are unknown. Such
whiefi he calls" medullarycells," because theyare We are sorry to see the old dispute between ton
Mor-
effectsare the diseasesknown as small-pox, measles, to the medullary tissue. They are spherical, and Jackson still occupying the minds of theirvery
scarlatina, syphilis, glanders, and marsh fevers, proper
or slightly polyhedral, have a diameter of from *015 good natured friends, when all the world has settled
which all arise from specific causes. Is typhoid
to *018 of a millimetre,are transparent,with de- finedthe honour of the ether discovery on the former. A
fever to be approximatedto those diseases is "

borders,and enclose a transparentspherical discussionhas been also goingon between Professors

there,in fact, a virus? This seems almost cer- tain.
nucleus, which has a diameter of fh)m *006 to *007 Mejgs,of Philadelphia, and Simpson, as to the use of
Connected with this question, the question
millimetre. Between the nucleus and the cellwall anaestheticsin midwifery. The EdinburghProfessor
of the contagionof typhoid fever may be
are molecular gpranules in variable quantity.These defending their trialas totally without danger, Pro*
examined. Two species of contagions viri may be
cellsare more abundant in young than old persons. fessorMeigrs, says, he should sit
*'
on the contrary,
admitted, the one indigenous, the other exotic. The
Another anatomical element not before described is in ashes" all his life, if one of his patients sunk
exotic poisons are those which cannot arise sponta-
neously of more
imp"ytance, as sometimes forming tumours under the experiment an attempt, as he styles it,
in a country; thus the variolous and mor-
of bone. Some tumours considered as cancerous by to ** abrogate one of the general conditionsof man,"
billous poisonsdo not spontaneously a rise in
pathologists, possess no cancer cells, but a special "

query, woman. At which Dr. Simpson inviteshim

Europe,but have been broughtto us from without. elament characterized that if his
Typhoid fever is on the contraryan Europeanma "
by largepatchesor flattened to the Baltimore Railwayand intimates,
lamellae, sometimes polygonal, sometimes
spherical, doctrine be true, every man, woman, and child
lady; it is indigenous; it can arisespontaneously, a diameter of from*05 to *08 of a millimetre.there should walk and not ride,it beingclearly
bat also it can, perhaps, be having a
propagati^d by conta-
gion.
In these patchesare from six to ten nuclei, "c.,"c., to go by steam. In
The contarion can be judgedonlyby facts
tained
con- planto "abrogate,"
in the thickness of the patch. These bodies 1840, one humdred persons were poisoned b y opiom
negativeor positive. Among the negative facts
are also normal elements,and can be found in the in England; if so, and Dr. Meig'sline of argument
may be mentioned,the small number of those visit- ing
the sick who are attacked ; the rarity with which
medullarytissuesof healthy bone,but are much less be adopted, we should be deprived of one of our moat
numerous than the cells above described ; theyare valued medicines. Dr. Simpsonlooks upon his Ame- rican
patients are able to state that theyhave been in the
also more abundant in the bones of young persons brethren as rather "
slow," and tellsa story
vicinity of diseasedindividuals. Also there is little
than in those of adults or the aged. {Gazette
doubt, that few persons entering into an hospital
"
Med., of Lord Campbell once beingthree nightsand two
Dec. 22.) daysgoingfrom Edinburgh to London, now done "

for another disease, take typhoidfeverfrom such

in twelve hours. Nay, His Lordship was adnsed
cases as happen to be there at the time. During INFLUENCE OF GALYANISIC ON PABALYSED
from the fright-
nineteen years that M. Chomel has been physician MUSCLES. to stophalf way for fearof apoplexy, ful
rapidity of the mail post of those days !
to the Hotel Dieu, there have been admitted In a paper lately sent by M. Duchenne to the
yearlyinto his clinique from 600 to 800 sons,
per- Academic des Sciences are some important tions
observa- GUN COTTON.
and yet there have been only four cases of this point. Paralysis of the upper ex-
on tremity
Among some new discoveriesat the other side of
persons who have contracted typhoidfever in the is divided into two kinds; one in which the AUautic, is that of a substance analogousto
wards. On the other hand, exceptions msy be taken contractility and electro-muscular sensibility (a)are gun cotton,which promisesto play an important
to the negative facts, while there are certain positive diminished or abolished as in saturnine palsy, palsy partin the treatment of nervous diseases. Glycerine
factswhich speakstrongly for contanon. Thus the from diseased spinalcord or derivative nerves, and (we are glad some use has been found for it)is
immunity of visiters may be partly explainedby one in which the is
contractilityalways intact,pouredon the acidsin placeof cotton. An oilyre- siduum
the fact,that many have previously suffered from while the electro-muscular sensation may be aug- mented, is the result, which seems to act very power- fully
the disease, for tjrphoid fever is a very common ease
dis- may be normal, or inay be diminished. on the brain producingintente headache.
"

from which few persons escape. Then, in many This occurs in cerebral,rheumatic,and
hysterical A SPECIFIC IN CHOBDEE
cases, typhoid feverdoes seem to transmit itself from Daisies. With regard, especially, to cerebralpalsies,
M. Chomel has often seen Has been found, according to American journals,
person to person. one, M. Duchenne states,that when contraction is ex- cited

two, or three persons of the same familyfallsick with the most feeble current,the contractility in Lupulin, which may be worthy of trial in that
afternursingone of their relations; the lather and of the paralysed muscles appears sometimes greater affection. Dr. Page, of the Philadelphia Hospital,
has found it of great value. He gives itin ^oses of
the mother, on account of their age, are rarely at-
tacked than that of the non-paralysed. But this di"rence
from fiveto ten grains.
; the brother and sisterare often so ; and is so trifling as to be without value,and to be,indeed,
what is remarkable,the disease in them often pre- sents not greaterthan occurs often in a state of health be- tween MECHANISBC OF THE YALYES OF THE
a sreat similarity. Again,nurses are much different muscles. To be able to say, that the ex- citability HEABT.
more liame than other persons. " Les tceurs paientU isaugmented, the difference should be much Some views of Hamemik, of Prague, on the
tribut," is theircommon rule is, greaterthan itreally is. The resultsobtained by Dr. mechanism
expression. The
by wtfichthe valves of the heart are
that nurses are atUcked ; to escape,isthe exception. Marshall Hall are not confirmed by these experi- ments."closed, and by which the sounds are produced, have
Students of medicine are also very liable. The (C7ax. Mid., Dec. 8.) in
been corroboratedin America, agreeing generally
transmission of typhoidfever can hardlybe traced Dr. Hamemik's
FUNCTIONS OF THE PNEUHOGASTBIC the views of Baumgarten. new
in a great citylike Paris, but neither can that of ideas may He believes it
NEBVES. be thus summed up:
"

small-pox ;^indeed,there are in Paris physicians, M. Longet,in an able Paper in the Archives Gi- possible that one or more systoles of the ventricleSy
who, for this reason believe, that small pox can arise nirales, arrivesat the following conclusions : " unpreceded by any auricularaction, may take place.
apontaneously. In the
country, however, the trans-
mission 1. From its originto its superior g anglion the In chionic asthma and pneumonia, the blood,
of t}rphoid fever can be often followed, as
vagus is a purelysensitive nerve. powerfully propelled, may distend the auriclesthat
has been perfectly done by M. Bretonneau, who has 2. The exciUtion of the terminal fibres of the they become unable to contract fullv on theircon- tents,
seen the diseasecarried from one village to another,
vagus produces reflex movements, which assistin in which circumstances he thinks two or more
and propagated gradually
among those about the accomplishing digestion, circulation, and respira-
tion. systoles are not uncommon. The division by the
tick person.
These actions can, however,go on without it older anatomists of the ventriclesinto two portions,
From all these facta it results, that if the con- tagion 3. Below its superior ganglionthe vagus is a one auricular, the other arterious, he considers true.
of typhoidfever is not
demonstrated, it is mixed nerve ; a voluntary motor influence can be In the former, a current of blood existsuntil the
yet very nrobable. Yet this contagionis feeble,excited the medium of the flbresit gains closing of the valves ; in the latter, a current estab-lished
and, therefore, in order that thereshallbe transmis-
through
sion, from the spinal by the ventricular systole, continuous with
certain special and particular accessory,the facial, the hypoglossal,
conditions are and the first and second cervical. The vagus ac- quires that of the artery ; simpleroughness of the mitral
demanded.
an involuntary motor power from the branches valve will not giverise to murmur. The firstsound
M. Chomel remarks, that typhoidfever, like it receives from the anterior
cervical, and firstfive he considers as occasioned by the vibration of the
smallpoxor measles, attacks only once duringlife; tense auriculo-ventricular; the second by the
it resembles these diseases also,by
presenting an
(a) By the term "electro-muscular sensibility,' impulseon the semi-lunar valves alreadyshut, not "

eruption as one of itsmost constant

symptoms ; but Duchenne the sensation experieuced the their closure. A double, or even treblesound is
as there can be variola sine variolis,
means by
morbilla sine patientwhen muscles are galvanised. sometimes heard over th? yentricles, but this, he
 THE MEDICAL TIMES. 21

says, dependson a double vibration; as a sailof a TO SUBSCRIBERS. could prevent it; and the only true battle-
ground
shipstruck by wind emits several sounds. Kew Subscribers will obligeby forwardingtheir is,therefore, against the principle o^
As the small specific of the valves facili-
gravity tates Names 147,Sirand^ or to the the Fellowshipitself. The
direct to the Office, condescending
their closure,anything which can render them
heavier,as fibrinous deposits,
News Agents or Booksellers. All Post-officespiritin which Mr. Bottomley proposes to grant
specifically will in-
Orders sJwuld be made payableto the Publisl^erSfto the Members in the election of the
teriterewith this. On a similar principle Hamer- a vote
nik is inclined to explainthe bruit in chloxotic Wm. S. Obb AMD Co. Fellows will not be sufficiently appreciated.
patients.We feel, however, we can scarcely This part of the scheme is a mere puerility,
go alongwith him. Here he would seem to think,
mainderand
the
planaltogether is much too complicated
of course, that the blood getslighter,unable to buoy Our Subscribers will Jind in this Number tlie re-
qf the Index to Vol. XX., which should for theregulation of so homogeneousa body
up the valves.
EBTSIPELAS OF THE LUNGS. be cut out and inserted in itsproper place. as the Members
of the College of Surgeons.
This
In the practiceof surgery, fiveremarkable cases in exercise of an undoubted rightwould
partial
one month of erysipelas attacking the "mucous
be a positive and strongly- marked badge of
membrane of the lungs,"in the practice of Dr.
Steiner,of Texas, are given the chink of the
"
THE MEDICAL TIMES. abasement which the Members would diately
imme-

glottis c losed up by effusion. In some cases tended

at- resent. They demand a direct vote
even with erosion "
more or less inflamma-
tion in the election of the Council ; and to attempt
of a somewhat unusual character of the bron- chial SATURDAY, JANUARY 12, 1850.
to defraud them of this rightby givingthem
tubes,were the chief distinctivemarks, inde- pendent
the
privilege of electing an intermediate elective
of the usual ones of erysipelas. All the
The Council of the Collegeof Surgeonsara
cases were fatal; and had come into the hospital for body,as numerous probablyas themselves, is
other complaints. greatly agitatedupon the subject of a reform of those chimerical notions invented by the
one
ANALYSIS OF COD LIVEE OIL. of the Corporation. It is probable
that, on the of some
crazy imagination closet-politician,
Analysesof three kinds of cod-liver oil have been 10th inst., Mr. Guthrie may endeavour to in-
troduce
made in America, which seem to corroborate the
who, infatuatedwith the beauty of a system,
more important q uestions for discussion
opinioQ that light
"
brown" is best,containing more
loses all sight of individual rights.Far better
than are included in the Resolution recentlywould it
iodine,and which we are inclined to look on as not be, that every Member acquired at
less of value in this excellentmedicine" phosphorus.passed by the Council. We have alreadyex- hibited
the end of ten years an absolute rightto the
Dr. Williams's experience, which has been the the extent and bearing of Mr. Guthrie's
Fellowship, than that he should be elected to
chief cause of itsimmense use in America, has been and we do not consider that,even
projects, it at that time by the body of Members. The
very remarkable. He prescribedit at the time of should be the Council, there
publishing his resultsin over 400 cases of tubercles they adoptedby scheme proposedby Mr. Bottomleywould be
of the lungs;in 100 cases of incipient would be much chance of carrying them into
softening, its absurd,if not impracticable in operation ; and,
effectswere decided and lasting ; and in 206 out of effect.
The principal designwhich theybetrayif it had its tendency
234 marked any real force at all,
and unequivocal improvementalmost is to yieldthe appearance of reform,but to
would be, to bringthe Fellowship within very
immediatelyfollowed its exhibition. Nay, among withhold the reality, in fact,to deceive the
"

the appalling limits. Such a proposition is hostile to

ravages of the third stageof the dis- ease, narrow
just expectations of the Profession.
in over 60 cases he found it of very great a just and liberal reform of the College, and
value. Its mode of action is,of couise, open to Mr. Guthrie^s planwould giveincreased pa" will not is
gain many supporters.Simplicity
much speculation. In an analysis of the blood in an Council them with desirablein all
tronage to the by endowing projects intended for practical
individual takingthe oil,the animal matters were
the privilege of oppointing numerous miners,
exa-
found nearlydoubled ; the fibrin, usually high in operation.
was]reduced. There seems but would not confer a single privilege
phthisis, some reason,
then, for,supposing that,in addition to this healthyupon the members. It would aggrandise the THE BOARD OF HEALTH AND ITS
nutritivematter, (asort of magazine to the system,) but would leave INSPECTORS.
governing body of the College,
that the oil supplies certain fat molecules,which
the members as homeless,unfranchised,and The peopleof England are reportedto be a
appear essential to forming the nucleoli of the
primarycells of ordinary tissues fat,according
" to unprotected as they now are. Theoretically, generous and a grateful people ; and measured
Ascherson,havingthe physiological lating the scheme
power of coagu-
is bad, as it tends to degradethe by the lofty standard of their voluntary volence,
bene-
albumen around ic. science of medicine a result that mightbe ex-
"
pected, no nation has ever compassedtheir
QUANTITY OF BLOOD IN ANIMALS. since the Council of the College have
wide-reaching munificence,or rivaled their alted
ex-
An ingeniousmethod of testingIke quantitycf
made it their barbarous boast that they "
sentiments of fraternity and good-will.
blood in animals has been tried in America by Dr. ever
of St. Louis. knew nothing of physic;" practically, the teration
al- This is boast call the Black
Blake, Injecting a certain weighed our we "
man,
quantityof a salt into the veins,and a littleafter would be a matter of indifferenceto brother,and pour our riches into his lap. We
testing the blood when the salt had got thoroughlythe
Members, who could reap no advantagecontrive numberless schemes for the amelio- ration
mixed in the circulation, the quantity of blood in a
from the change. We can see nothingto ad- mire of his savage condition ^we fill
"
up sub-
scription
dog, he says, does not amount to more than one-
ninth or one-eighth the weightof the animal, an in the proposition of Mr. Guthrie,except listswith our guineas, that we
"
may
estimate much lower than that generally received. the adroitness with which it is attemptedto carry to him the alphabet and the Gospel, the
AMERICAN STATISTICS OF CHOLERA. draw off the Members, and the Profession at beginning and the end of wisdom ; and
On the subject of Cholera we have, of course, large,from the pursuitof their inalienable
although, sometimes, when we cannot civilise
innumerable suggestions. We are not aware, how-
ever,
from what we have rights. exterminate, this onlyproves the excess of
that they "Ser materially we

been taughtin the Old World. Mr. Bottomley's propositions will also come our zeal,and the irreclaimable stupidity of the
In America, as well as in this country, the rate under the considerationof the Council on the ungrateful subjects of our experimental benevo"
of mortality is about once and a half wha it was in 10th inst. ; their fate it is not difficult
" to fore-
see. lence. Yes, the Englishare prodigal of their
1832 ; the same cl"sses of peopleattacked ; the These propositions go so far as to confirm wealth in the cause of humanity; theyhave a
disease infectionsrather than contagious; haunting the two
gradesof Fellows and Members that lively sense of theirresponsibilities as a people ;
low and badly-drained localities; evidently origi-
nating
with they are just,too, in their generaldealings,
in some epidemicinfluence,and spreadingnow exist in the College ; a temporizing
"

according to the nature of the locality; the circu-

lating wrong, which, whilst it humbles the injuredand theyhave a profound horror of ingratitude.
current thoroughlydisorganized; the best
Members, vindicates no justprinciple.If it They have,withal,a high admiration of suc- cessful
tzeatment that directed to the cUsease in its early
mean anything, it is simplythis : that the con- test enterprise, whether in commerce or
stages,and to the support of the normal functions
of the capillary is not for honest principles, but for privatewar. A Hudson can scarcelyfathom the
system; the signson dissection,
everything considered, actuallynegative. In interests, and especially the immediate interests depthsof their generosity, and a great mili-
" tary
America, chloroform and naphthahave been
found of a few. Either the institutionof the order of Fel-
lows name has been liftedto the steps of the
of great use in the treatment, actingon the capil-
laries was wrong in principle, or itwas not. Mr. throne by the successive waves of national
and keepingoff collapse
even under the most
nnfavonrable circumstances. Bottomleyadmits the wisdom of the principle, gratitude. The English have,indeed, a reve-
rence

with
but is dissatisfied its It
application. is for great exertion;and towards those,
Yarmouth Hospital." The funds of this perfectly clear,that the attemptto carry out from sacrifices they have received
whose
hospital have been increased by a donation, amount-
ing of this kind at any time
an exclusive principle their hearts overflow with
honour or blessings,
to nearly 36/.,the profitsof a hymn-book, the
upon existing
would act injuriously Members, thankfulness,and their purses with rewards.
coi"yright pf wbio^has been preseDted to that Insti-
tution,
and excite disaffection. No human foresightIs thistruth or 7 an historicalpor-
flattery
 16 THE MEDICAL TIMES.
of the blood,and the smoothness of the mucous of the arachnoid. I shallnow detaila case in which arachnoid. On eitherside, extendingfrom the greater
membrane of the stomach are both commonly pre- sent that lesion was detected after death,when there had wing of the spheroid bone to the tentorium cere-
afterdeath from typhusfever. But softening been no symptoms to indicate its presence during belh, closely appliedto the arachnoid coveringthe
of the mucous membrane of the intestinalcanal is life, Case 11 ; and then I shall narrate a case. No. pia mater, and within the cavityof the arachnoid,
was a film of coagulatedblood of a brightred colour,
very rarely seen to the same extent as in thisparti- cular 13, in which convulsions occurred,but which pre- sented with
There had been no signs to indicate its spots of a dark venous hue scattered over it at
case. no lesion, excepting some congestion of the
intervals. The differencein colour dependedon the
existence duringlife; and it is probablethat it was brain and itsmembranes,to account for so serious a
differencein the thickness of the doL Then was
in a greatmeasure cadaveric. Feyer'spatches, and symptom ; and then Case 14, in which the cerebral no trace of and
any clot in the longitudinal fissure,
the mesenteric glands, it is to be observed, were in spmptoms were very prominentduring life, but in no coagulumat the base of the brain. In the meshes
all respects in theirnormal state. which, afterdeath,not the slightest deviation from of the piamater was much colourlessserosity ; and a
Haemorrhagesometimes takes placeinto the sub- stancethe normal condition of the encephalon or its mem-
branes moderate amount of the same in the lateral ven- tricles.
of muscles where no external violence can could be discovered. The bloodv points on the cut surface of the
appearedmore than natural.
have occurred. The rectus abdominalis is a fre- quent Case 11. After exposure to the contagion
"
of cerebrum numerous
seat of the efiiision of blood. The following There was increased vascularity of the plexuscho-
fever accompaniedwiui mulberryrash.
illustrates this complication. roides.The consistence of the cerebralsubstance was
case Ensued rigors
"

frequently repeated painin head natural.

"

Case 10. No history of early83rmptom8. and limbs confined bowels

"
"

"
rapidprostration There was no abnormal congestion
" "

of the puhno-
Mary B., afed 70, a thin woman, with grey hair, hoarseness deafness disturbed vision mental of the bronchial
nary tissue. The liningmembrane
" " "

oune under observation on the sixth day of diisease.

confusion drybrown tongue difficultdeglutition the tubes themselves
No particulars of the symptoms present before her
" "
tubes was finely injected ; tained
con-

admission into the London Fever Hospital, under

"
quickpulse"cool skin mulberryrash extreme " "
much muco-purulent fluid. The pericardium
the care of Dr. Tweedie, July 21st,1848,could be difficulty of breathing death
"
on the 16th day. and heart were healthy. The clotsin the heart were

obtained. She had resided for some Eleven hourt qfterdeath,persistence of spots flrm.
yearsprecedingclot in the substance of left rectus
"

lier admission in Kensingtonworkhouse. abdominalis The mucous membrane of the pharynxwas of a

Several
of fever,with mulberryrash,were admitted muscle clotin the eavity of arachnoid gestion dirty yellowcolour, and so soft that it could be readily
cases "
slight" con-
from the subjacent
shortly before from the same removed by the slightest scraping
locality. of the posterior part of lungs softening tissue.
"
of
When jSrstseen, on the sixth day of disease, her the mucous membrane of pharynx thickening
"
of
mind was wandering.She fancied she had been in rima
glottidis in larynx other organs normal. Larynm, Tberima glottidis
"
was narrow,themucous
the hospital pus "
"
membrane of the whole larynx finelyinjected, and
three days. There was no headache,
she had slept a little.She was deaf. The tongue was
Mary G.,aged 49, a moderatelystout woman, ject
sub- covered with a layerof purulentfluid.On"and above
to constant couffh, was admitted into the London the chordie vocal solid white
dry and brown ; the bowels slightly relaxed. There es was some opaque
were, however, no
Fever H("spiul, May 9th,1848,under the care of matter, resemblinglymphin physical character.
abdominalsigns { the pulse was Dr. Tweedie. Her daughterleft the hospital three the spleen
anIvSO. There was slight want of resonance, and very The liver w^ flabby; small,weighing
weeks before, a nd Mary G. washed her clothes. She soft and flabby.
feeble respiratory murmurs over the most depending
a native of London.
a
only oz., was

part of the lungs, the patient

was The ptxncreas, urinary bladder, and uterus were
lyingon her back j the Present illnessbegan 13 days before her admission small
"kin was wann and dry. Mulberryrash was well healthy. The kidneyscontained numerous
with rigorefrequently repeated" pains in the head in theircorticalsubstance.
marked. The prostration was so great,that the pa- tient and limbs,
cysts
and confined bowels. She took to her bed The oesophagus was normal in appearance.
was unable even to turn in bed unassisted. 4oz.
of gin were ordered tii be givenduringthe twenty-
entirelyon the second day of disease, because she iSltomacA." The whole of the coaU of the great cul
feltgenerally illand extreme weakness. There had de sac were
lonr hours in divided doses. On the next day the
been no epistaxis.
so soft that the finger passedthrough
She had taken before admission them with the greatestfacility. B luish white bands,
pulsehad risen to 120 ; it was very weak ; there was several doses of aperient medicine. Hoarseness first from which the mucous
some somnolence: in other respects there was little membrane bad disappeared,
made itsappearance, her relationsstated, o n the 9rh extend from the softened portion t owards the pylo-
rus.
change; she died at 7. a.m., on the ninth day of
disease,apparently from asthenia. day of disease. The whole mucous membrane of the stomach
The bodywas exBtnintdthirtyottehourt
The following notes of her case were taken on the was exceedingly soft, but very pale.
after death; thirteenthday of disease:" No headache, ness
deaf-
the weather being cool; the cadaveric rigidity had slight Large and small intestines, The thickness,
" colour,
ilmost entirely (notdeaf till present illness), no delirium,and consistence of the mucous membrane lining the
disappeared i the spots observed
durine lifecontinued;beneath and memory defective;complains ofseeingstrangeobjecU intestinalcanal,as well as the condition of Peyer's
extending among about the wards ; she is quiteconscious that these healthy
the fibresot the left rectus abdominalis muscle was patches, were carefully noted. They were
a loosely
objectshave no real existence ; says she has a most all particulars. The mesenteric glandswere in
coagulateddark bloodyclot, 2 in.in length, in

and 1 in.in breadth. It was situated, disagreeable taste,and a constant sense of unpleasanttheirnormal condition.
as above de- odoura there is flush of the face ; she is unable
scnbed,midway between the umbilicus and pubis. to leave; her bed nowithout considerable In this case there was much more blood within
The heart was assistance.
flabby;the clots contained in it The tongue is brown and dry ; she swallows either the cavity of the arachnoid than in Case 10, and yet
"oft and dark; the liningmembrane was stained solidsor there were convulsions. The softened condition
duskyred; the lungswere deeplycongestedposte- is liquids with considerable difficulty ; there no

norly; the mucous membrane of the stomach

swelling and duskyredness of the tonsils, uvula, of the substance of the rectus abdominalis,and the
was and velum pendulum palati;
"mooth and free from rugse ; the consistence, she has passed two presence of a clot of blood in it,are point* worthyof
ness,
thick- stools duringthe last twenty-four
and colour of the whole gastro-intesdnal houn; there is attention, as showingthe relation between the dis- eased
neither pain, tenderness, fulness,resonance, nor condition of the solids and fluidsgenerally,
mucous membrane was normal; Peyer's patches in
all particulars healthy; larynx, guraling of the abdomen ; no appetite, no thirst. and the presence of haemorrhage into the cavityof
pharynx,and oeso- phagus She can speak only in a faint, hoaree whisper; no
healthy; there was no enlargementof the tenderness of the the arachnoid. Clots were found on both cerebral
mesenteric glands. A [few small cysts studded the larynx ; cough troublesome ; some
The absence of of clot in
cortical substance of the kidneys the sonorous and mucous r"les over both sides of the hemispheres. any trace
; urinaryblad- der the longitudinal fissurerendered it probable that the
and uterus were chest;percussionnormal: pulse120, weak; heart
normal in allnarticulars; the sounds normal; skin
cool, covered with mulberry haemorrhageoccurred primarily on the two sides,
pancreas healthy $ the liver very flabby and soft;
the spleensomewhat enlarged. rash ; vin. alb. Xiv., jus.bov. On the fourteenth and t. e., that the blood did not pass before coagulation
Head.--The fifteenthdays therewas littlechange in the local or from the one hemisphereto the other. As is com- mon
pia mater was congested; there was
a littlesubarachnoid efiusionof
generalsymptoms, exceptingthat the spots were in cases of hsmorrhageinto the arachnoidian,
serosity ; and the palersomewhat on the fourteenth day,and she was no trace of the vessels from which the blood escaped
pia mater and arachnoid separated from the cerebral
convoluuons with abnormal fadlitv. The substance quite unable to protrudeher tonsue, she passed her could be detected.
of the encephalon stools in bed on the fifteenthday. The muscular
itselfappeared healthyin all re- A small quantitvof coagulated blood is, as I
spects.
movements at the same time were extremely trem-
ulous
have before remarked, by no means infrequently
This patient, like all affected ; the pulse had risen at the latterdate to 128,
with typhusfever found within the cavity the arachnoid afterdeath
of
when theymake any mistake as to the duration of
was very weak, and the skin cool. She became very
restlessduring the afternoon of the fifteenthday. from typhusfeyer. Thus thislesion was discovered
time,supposed itlengthened ; thus she thought three Death occurred at 4 a.m., on the sixteenth day. For to exist in one-seventh of the cases of typhusfever
dayshad elapsed between her entrance into the hos- pital somehoura before the fataltermination the breathingwhich proved fatal during the progress of that
and my firstseeing her,whereas, exceedingly laboured. There were no convul- sions,
really, it was was disease analysedby myself in the Edinburgh
onlyone day. In addition to the presence of a clot and no coma. Monthly Journal for October 1849, and my im- pression
in the substance of the rectus abdominalis A blister was applied to the throat on the fourteenth does not very far
muscle, is,that such proportion
this case illustratesthe early periodat which death day of disease,and' at the same time the wine was exceed what the whole of the cases I have examined
from typhusfever,uncomplicated increased to six ounces in the twenty-fourhoun.
with local lesion, after death would afibrd. The quantityof blood,
On the fifteenthda^four ounces of gin were given,
may ensue. There was nothing found afterdeath to however, I oughtto remark, is often very small. I
in addition to the wine.
account for the fatU termination. Some have never trace of haemorrhage
congestion Eleven hours qfterde"Uh the following appearances
seen the slightest
of the most depending of the
part lung" slight con- were observed :~The spots noted duringlife were into the substance qf the brain after typhusfever.
gestion of the piamater"
trifling enlargement of the stillto be detected ; there was no emaciation ; at Now, intense congestion of the membranes of the
WDleen" and a small
quantity of loosely coagulatedleast 1^ inches of fatcovered the abdominal parietes.brain is frequently, almost constantly, found after
blood in the substance of a Between the left
muscle, were all the rectus abdominalis muscle death from typhus fever. Congestion of the bral
cere-
physical changesestablished duringlifewhich the and its sheath, anteriorly and posteriorly, and substance much more rarely ; and when it does
scalpel enabled us to laybare. The eflfect on the also among the fibresof the muscle,which were at occur is infinitely less intense.
solidsof the general that placesofter than elsewhere,was a considerable
disease, which latteritselfour This case also illustrates one form of laryngitis,
scalpelcould not detect,was manifested by the
quantity of loosely coagulated blood. The extent
flabby state of the heart and liver, the early
occupiedby the clot was about six inches by two as found in typhusfever,t. e., that form which ad- vances
disap.inches. It commenced an inch above the pubis. insidiously, and is unattended with those
pearance of the cadaveric rigidity, "c. Head, The bloodypointson the external surface violent symptoms which are consequenton sudden
"

In Case 9 an examplewas afforded of convulsions of the dura of the submucous tissueof the larynx.
mater were very numerous. A little swelling The
coincident with an effusionof blood into the
cavitybloodyserosity escapedon openingthe cavity of the physical obstruction to the entrance of the air was
 THE MEDICAL TIMES. 17
oomparatiyely trifling.It will be obierved,that stomach was smooth; the mucous membrane was to affordthe
slightest
explanation of the morbid
from the history of the symptoms, as well as from posteriorly of reddish colour, anteriorly a darker red, vital

able
and along the greatercurvature
phenomena, by the demonstration of any
the more advanced stageof the disease of the pha- of a vermillion hue ;
ryngeal changeof structure within the cranium. An irre- gular
than of the laryngeal the rednesajwas punctiformand capillary ; the deeper
mucous membrane, or intermitting pulseis by no means rare in
that the affectioncommenced, as it usually red parts were slightly thickened and firmer than the
does,in typhusfever,when no old disease of that organ is
the pharynx,and then spreaddown to the larynx. surrounding ; there was no softeninffof any part of
the lining detected after death.
Deafness noted in this case, membrane; the in Case*
vesselsof the larger rior
poste-
was as it was I do not givea case illustrative of the patholo-
wall of the organ were full of blood ;
moderately gical
3, 11, and 12. It is a common
symptom in typhus
none were visible on the anterior surface of the appearances observed within the cranium after
fever. The softening of the stomach was cadaveric, death from typhusfever,complicated
orean. with inflam-
mation
a part of that tendency to softening of the tissuesso The mesenteric glands and intestines were healthy of the brain or its membrane, for this reason,
eminentlycharacteristicof the disease I am here in colour, thickness, and consistence. because / have never made an examination,after death,
considering. The sonorous rale,and the condition The pancreas, Uver, kidneys, and urinarybladder,
of a case of typhusfever, in which such appearances
of the bronchial mucous membrane, were probably were normal ; the gaU bladder contained some dark werepresent. The assertion that the symptoms of
dependenton the chronic bronchitis, of which it ap- green bile; the spleen was dark and firm, and
peared
weighed 7J oz. typhus fever are due to inflammation of the brain,
this woman had longbeen the subject rests on as untenable groundsas that of the same
Case 13. Slightrigors, Thus, with the exceptionof the congestion of
"
painsin back and abdo- men
the brain,by no means
disease in gastro- enteritis.
diarrhoea without medicine
"
sudden prostra- greater than in many cases
tion
"

when no convulsions occurred,thexe was no lesion

mental confusion trifling COMA VIGIL.
"
headache, vertigo
"

"brown and dry tongue tenderness of abdomen "

to account for that symptom. The patient died at Case 15." Maria W , aged 52, was firstseen on
"

an early period o f the disease,*, on the 1 2th day, and the ninth day of disease at that time the symptoms
mulberry rash convulsions "
coma death
"
per " "
"
e, ;

siatenceof spots meningealand cerebral no local complication of importance was revealed by of tvphus fever were present. She sleptmuch, and
"

congestionthe tne tenth day almost constantly, night and day.

"blood very loosely coagulated" hypertrophy of the scalpel.The convulsions and death were bably
pro-
on

the resultof the same Somnolence continued till about the middle of the
heart other organs healthy.
"
cause, the diseased con- dition
of the blood. I would wish particularly thirteenth day, gradually, however, becoming less
to
Thomaa B.. aged 61, a printer, a thin man, whose constant From the time of the visit, on the thir-
teenth
direct the reader's attention to the fact,that dia- rrhoea,
previoushealth bad been very good, was received ain the abdomen, and tenderness of the
day, tillher death,at 1 a.m. on the fifteenth
into the London Fever Hospital, May 27th. 1848,
pain day, she never closed her eyes. On the fourteenth
of Dr. belly,
the 8th day of disease, were among the earliestand most prominent
on under the care day,the followingnote was made;" She lies con- stantly
Tweedie. He never had a fitof any kind beforehis symptoms, and yet there was no lesion of Peyer's on her back;
eyes open ; has not closed them
admission into the hospitaJ. His illnesscommenced patches, The tindemess, probably,dependedon since the visityesterday ; oannot be made to open
with slight rigors and painin the back and abdomen. the condition of the gastric mucous membrane. I her mouth, or to attempt to protrude her tongue ; gives
His bowels were relaxed from the o'btsetand before shall have, hereafter, to detailcases, in which con- stipation no signof consciousness wlien spokento. The skin
he took medicine of any kind. He kept bis bed is cool and sweatingprofusely ; the spots are darker
was A prominent svmptom, and yet ex- tensive
on the second day of illness. than on admission ; tliereare no sudamina.
ulceration of the agmmated glandswas de- tected
On the 9th day of disease the following notes of The body was examined twenty- two hours after
afterdeath. So that,by themselves, pain in death. There was some
his case were made :" colourless serosity in the
the abdomen and diarrhcaa, even when presentin
He states,when asked, that he has sHffhthead- ache cavity of the arachnoid ; a little similar fluidin the
and some vertigo"he sleptbut nttle last fever,are by no means diagnosticof lesion of meshes of the pia mater; a moderate quantityin the
night" his mind is somewhat confused. The tongue Peyer's patches. ventricles. The pia mater, arachnoid,and cerebral
IS dry and brown" the abdomen Case 14. George C, aged 58, a stout, fair-oom- substance,appearedhealthyin colour and consist- ence.
tender" the bowels "

much relaxed. He has passed five stools since his plexioned man, was admitted into the London
admission yesterday" there is no appetiteand but Fever Hospital, under the care of Dr. Tweedie,July Thus, no condition of the encephalonwas tected,
de-
httlethirst. 4th,1848,labourinff under typhus fever, accompanied for the peculiar
to account symptom above
The pulse is only90. With the exception of rather with the diagnosticmulberry-rash. This man*s described.
extensive cardiac dulness,there are no abnormal wife and children were patients in the hospital some
I have seen one person onlyrecover from this
physicalchest signs. weeks before ; they, too, laboured under typhusfever
The muscular powers are greatly with mulberryrash. From his admission tillabout state,and in that case the coma vigilwas not com- plete.
impaired he is the fourteenth "

quite unable to leave his bed unassisted, even to day of disease, when the following notes
reach the closestool. The of his condition were taken,he was violently lirious Ctue 16. George P.,aged SO, a surgeon, was
de- ceived
re-
skin is warm and dry. **
"

There is abundant mulberry rash. : He "

sleepsvery much when roused is
" into the London Fever Hospital,June 2nd,
During the night he seized with very delirious ; he cannot be made to take his medi- cine; 1849, on the eighthday of diseaae, u nder the care of
was convulsions,
will not protrudehis tongue; is unable to Dr. Tweedie. He had well-marked and very severe
throwinghis arms about violently ; he appeared at
the time unconscious of all goingon around him. leave his bed unassisted ; he has passedtwo stools typhusfever. At the time of his admission the mul-
This fitlasted for about ten minutes. He sleptfor duringthe lasttwenty-fourhours ; his pulse,which, berrv rash was very abundant. On the sixteenth day
some time before and afterthe fit. up to this date,has not exceeded 96,is 108, and the following note was made : "

When I saw him asain on the following for the firsttime irregular; on the following d ay it ** He has been since last evening in his present
morning,
t. "., the 10th day of disease, be said he was free from reached 120 in the minute ; it continued irregular, condition. Is now lying on his back, his eyes open,
headache ^liis
mind was rather more
"
confused than on and, duringthe last twenty-fourhours of life, was but he is apparently unconscious of all going on
the 9th day the conjunctiva the pupils intermitting.
On the fifteenth day, strabismus was around him. He cannot be made to protrudehis
"
was injected,
passed into the bed. On the observed for the firsttime; his eyes were any effortto do so ; yet he
small" the urine was both tongue, or even to make

following drawn upwards and inwards his wife struck by swallows little fluid when poured into his mouth.
day he had a second attack of convulsions, ; was a

which lasted, however,but a very few minutes. During his appearance, and remarked spontaneously,that His pupilacts very littleby the aid of a candle.
thisattack hislimbs became very rigid and he foamed she had never seen him squintbefore his present Pulse 132, very weak. Urinary bladder distended ;
at the mouth, and after it he slept forhalf an hour. illness;the spots grew darker as the disease ad-i urine passinginto the bed. The mulberry rash is
He was otherwise very wakeful and occasionally vanced; coma
lirious.
de- precededdeath for many hours; he well marked. A blisterwas applied to his forehead,

On the 11th day he continued watchful and died on about the eighteenth day of disease.*' and on the following day the pulse had fallento 108.
delirious"there were frequent twitchinss of the mus- The following was the condition of the organs dis- covered, He had some sleep; assisted himself to drink ; pro- truded
cles
of the face" the urine and the stools were on an examination of the body twenty-four his tongue fully when bidden ; and the spots
passed hours afterdeath this time he rapidlyre-
into bed" the pulsewas scarcely : "
were much paler. From covered."
perceptible. He
There was no opacityof the arachnoid;a little
died at 11 a.m.. on the 12th day of disease. He was
comatose for some hours before death. fluidonly in the cavity of that membrane ; a little It will be observed,that the condition described
The bodywoe examined iwentyteven hours ^fUrdeath, colourless serosity in the meshes of the pia mater ;
as having existed in the two lastdescribed cases was
"The spou marked duringlifecontinued visible. slightcongestionof the latter;the arachnoid and diflerentfrom somnolence or ordinary coma.
separatein one mass from the surface of very
congested.pia
Head, The dura mater was considerably mater
"
It was the opposite o f that described as coma vigil
There was a little the convolutions, without carryingaway any of the
fluidin the cavity of the arachnoid, other i. e., a condition
cerebral substance ; a little the by Chomel and some writers,
and a small quandty infiltrated the meshes of the pia transparent serosity i n
sleeps as much, or even
mater. The arachnoid was rather opaque. The pia
ventricles; there were a few more red pointsthan in which the patient more

in the white substance of the brain ; the than in health, and yet declares that he has never
mater minutelyinjected over the whole surface of common
the brain. Numerous but minute consistence of that organ was perfectly normal. closed his eyes.
bloodypoints With the the fatal
studded the cut surface of the grey and white matter exception of some red serosity in Pregnancy is by no means a necessarily

of the cerebrum. The consistence of the brain was pericardium, which microscopicexamination proved complication of typhus fever ; nor do pregnant
to contain no blood corpuscles, a very flabbycon-
naturaL The lateralventricles were moderately
" dition
women necessarily miscarry, as the two following
-distended with colourlessfluid. The vessels of the of the heart, the liningmembrane of which
17 and 18,prove.
stained dusky red,"a nearlyfluid condition of cases,
plexuschoroides were loaded with blood. was
Case 17." Mary Ann G., aged 28, a stout,well-
CAef/." With the exception of a very small soft the blood throughout the body," a limited amount
received into the London
of consolidation of the pulmonary tissue of the left made, married womgn, was
black clot in the risht auricle and ventricle, and a Fever Hospital, August 18, 1847,on the ninth day
still smaller clot in the left auricleand ventricle, the lungfrom central pneumonia," flabbyliver, dark of disease, under the care of Dr. Tweedie.
"

Her
blood was fluidthroughout the body. thick bile, and " smoothness of the liningmembrane
of the stomach, common brother also suffering from typhus fever,was admitted
PerieardMum healthy. " after death from typhus
with her. This woman was between seven and eight
Heart somewhat enlarged and hypertrophied. fever, as I have before pointedout, the whole of the
in a normal state.
months gone with child.She had well-marked severe
glandsand kings organs
were
Larynso"bremehkU tubes" bronchial fever. The mulberry rash was copiousand
I have narrated the above scanty particulars of typhus
healthy in appearance. characteristic. Her pulseon the tenth day of disease
Pharynxand oesophagus normal. this case, in order that the reader may have another
was 140, and on the twelfth day 150 ; the tongue dry
Stomach, With the exceptionof a few rugse, along illustrationof the frequentpresence of what are
"

and brown, and the spots dark. On the nTteenth

the greater curvature, and trifling mammillation called head-symptoms, violent delirium, squinting,
"

day of disease the pulsehad fallento 100; the tongue

the pylorus,the mucous membrane of the and coma,
near and yet " after death-examination be un- was moist,and the spots were fading.Vomiting
 24 THE MEDICAL TIMES.
Baniell states,tliatPlearitisiPneumonia, Phthisis invariablythe case. Inquiriesamong the different examination of the work before us. Itseminently
tribes have amplysatisfiedme, that in many in- stances

ened
Palmoualis,and other pulmonary diseases, as well practical character, and indisputable usefulness,
the parturientwoman has perished from the
as Dysentery, Diarrhoea,and numerous abdominal must placeit in the hands of every real student of
want of a littletimelyassistance in those complex
affections,are common during the cold, rainy and preternatural labours which have been liereto- chemistry. The thanks of the community are due
months. Of the above. Phthisis and Dysentery fore supposed to be of less frequencyamong them, to Dr. Musprattfor the strenuous effi"rts
he made to
than in the females of more civilisedcommunities.
fatal complaints in establisha College of Chemistry For a
appear to be by far the most Puberty in these regionscommences about the ige of
at Liverpool.

low marshy localities. Teniae and ascarides are eleven or twelve,and sometimes much earlier." knowledgeof practical chemistry cannot be dissemi-
nated
the intestinalworms most frequently
seen. The We in the woik Mr. Daniell promises among our agriculturists, merchants, and
hope, that
frequency of hepatitis, induration, and other organic ns on the " Endemic Diseases of the Coast of manufacturers,without the country at largepar- taking
diseases of the liver is attributedby our Author to Guinea," he will be a littlemore in his scription
de- of the benefit We rejoice that success has
specific
the immoderate use of stimulants. Serious cere- bral, than the majority of writers, and favour us crowned his exertions. Ere, however, we conclude
as well as maniacal afiections, are rarely seen. with a few well-toldcases, rather than loose generalthisbriefnotice of the labours of Dr. Muspratt, we

Calculous diseases are unknown. Elephantiasis sketches. must advert to one fact. The Apothecaries' pany
Com-
to be limited to slaves importedfrom Sou- dan. refuse to receive Dr. Muspratt's certificates.
appears
The Use ofthe Blowpipe in the Qualitative and Quan-
titative
j
He is recognised by the London University, but
Charms and medicine-bags, fabricatedby the e ho Examination of MineralSfOres, Furnace repudiikted by the Hall ; and that,while the latter
dihia or doctors,^] and held in the hand, or attached Products, and other Metallic Combinations, By receives certificates from men, who, as chemists,and
Professor Plattner, Assay Master at the Royal with reference to their means of givinginstruction
to the neck by copper wires,arc the means relied on
Freyberg Smelting Works. Edited with Emen- dations in'the would
as preventives against both sickness and danger. science, a re so inferiorthat comparison
by Dr. Sheridan Muspratt, Professor be simply ridiculous. We
Capping appears to be the favourite remedy for all reallytrust, that the
of the Liverpool o f
College Chemistry, "c. Second
deep-seated pains.Three incisions, eightlinesapart, good sense of the Hall authoritieswill pointout to
and about one inch in length, are made by a sharp Edition,revised and enlarged., 8vo. Pp. 401. them the absurdity of their position.
knife. A small calabash is then Taylor, W alton, and Maberly.
razor or applied,
the air beingexhausted by burningpaper or cotton. The Preface of this Work, written by Liebig The Physicians*, Surgeons^and General Practitioners*
The wounds are dressed with a kind of soot The concise as it is,sufficiently attests the value of the Visiting List,and Register of Engagementsfor
green pods of capsicumfructescena, pounded into a original, and the fidelity and ability of the translation. 1850. London : John Smith.
pulp,are used as powerful counter-irritants.
*'
The blowpipe," writes that illustrious "
man, is of To such of our readers as have used the '' Visiting
Both males and females are ordinarily cised.
circum- the highest advantageto the chemist,geologist, and List" for the past
year, our recommendation of the
of ascertaining, with the Number
It is generally performedon the males in mineralogist, as a means for 1850 will be
unnecessary. The few
earlyinfancy ; but in Dahomey the time of sub-
mitting greatestaccuracy, in a few minutes,all the consti^ who have never seen the "VisitingList," we
to the operation is left to the boys them- selves.tuents of a mineral. Professor Plattner's work is strongly recommend to obtain it. That its judi-
ciously-arr
the simplest and best adapted for this pnrpose. will save them much
contents
When applied Professor Plattner himself states, *"
Dr. Sheridan trouble, affirm from
to women the expicssion c
cision
ircum- we can personalexperience.
signifies "
the excision of the clitoris, and Muspratthas publishedin English,my *Probir- It contains,in addition to the ruled papers, an
other organic structures connected with it." kunst nuit dem Lothrohre,'and, really, with such almanack; a Table of the various Medical and
It appears that the parts actually excised,how- ever, circumspection and profound knowledgeof the sub- ject, other ScientificSocietiesof London, theirdays and
varies in different countries. that I deem it my bounden dutyto tender him hours of meeting;a List of the Physicians and
The operation Mr. Daniel,con- my heart-felt acknowledgments." A second English Surgeonsto the London Hospitals, their days and
may, according to sist

of either 1. Simpleexcisionof the clitoris edition of so elaborate and highlypractical a work, hours of
visiting, "c. ; and a variety of matters of
"

; 2.
Excision of the nymphse ; 3. Excision of both is a hightribute to its intrinsicvalue, and to the serviceto the Practitionerof Medicine.
nymphse and clitoris; or 4. Excision of a portionability judgment Dr. Muspratt. and of

of the labia pudendi, with either or all of the pre- The work consistsof a description of the blowpipe,On Tic
Doloureux,and Other Painful 4ffections qfthe
ceding
of the combustible material of the flame, oxidating Nerves; with for their Treatment
structures. Suggestions
It appears to be a renmant and reducing, with the mode of usingthe instru- ment. the
of some mysterious by Aneuralgicon. By C. Toogood Downing,
Then follow excellent practical accounts of M.D., M.R.C.S., "c.
religious orgies. Pp. 73. London: J.
The firstof these operations the various pieces of apparatusrequiredin the ope-
appears to be simply ration. Churchill.
custom of these countries, The whole of this portion of the book is
a performedwithout re- ference Dr. Downing'spamphletis published for the pur-
pose
to any special end. It is effectedbefore illustratedby well-executed woodcuts, which Dr. of introducing to the notice of the Profession

puberty,and is unattended by dangeroussymp- Muspratt has judiciously i ncorporated with the an instrument he has devised for **
warmth
toms. applying
An old female is the operator. work itself, instead of, as in the original, puttingand sedativevapour" along the course of the trunk
Our Author thus describes this very curious rite,them togetherat the end. The three principal any givennerve. This instrument he hastermed to
in
as performedin his own presence, while in the re-agentsindispensable examination with the the Aneuralgicon.It consistsof a cylinder to hold
Calabar river ; "
blowpipe, are, carbonate of soda, biborate of soda, some sedativedrug,thesmoke and vapour from which
"
The jjlrl havingbeen placed on the knees of a or borax,and phosphateof soda and ammonia, or is to be applied to the painful spot; a pairof bel- lows,
woman, with the legsapart,the clitoris was diligently microcosmic salt. The mode of testingthe purity the nozzle of which enters the lower part of
sought out, (forin this, as in other subjects of tender of these salts,as well as various other re -agents, the
cylinder, and forces a current of air throughthe
a^e, from imperfect development,it was sometimes
useful in facilitating fusion,"c., is givenwith all ignited
difficultof detection,) and, upon discovery, was body; and finally, a caoutchouc tube, at- tached
seized forceps-like by two piecesof bamboo or palm the precision and conciseness necessary in a practi- cal to the upper part of the cylinder, by which
sticks, gentlydrawn forth,and severed by means of
treatise.The above constitutethe firstsection of the hot air and vapour can be directed on to any
a sharprazor. The hsemorrha^e was rather copious,
the work. part of the patient.Cones of various sizesare made
but it was sufferedto exhaust itself."
In the second section,qualitative analysis with to fit the free extremity of the tube,so that the cur- rent
The second operation is resorted to only in cases
the blow-pipeis considered. Each alkali,earth, of air may be largeor small,at the pleasure of
of hypertrophy of the nymphae.
and metal beingseparately described ; and a listof its the operator. It is evident,that, by the use of
The third is frequently adoptedby woman as a
compounds and their composition subjoined. This the bellows, the temperature of the current be
means of " ingratiating herself into the favour of may
list is followed by an account of the mode to be varied at will. The drugs used for the purpose of
her liege master."
in detecting
The fouith appears to be intended to " produce adopted
the body by the aid of the assuaging the painin tic, by Dr. Downing,are stra- monium,
blow-pipe in each of those compounds. belladonna,"c., the combustion being
an artificial impedimentin the vagina,to prevent
The method of determining t he quantity of silver, supported by a little finely-bruised cascarilla bark.
sexual intercourse, in order not to impairthe value
of slaves." gold,copper, lead,and tin in ores, minerals,"c. The odour of the lattermay also enhance the confi- dence
occnpy the third section. of the patient in the virtuesof the aneural-gicon,
With the following extract,interesting gically,
physiolo-
While in an appendix isa chapter on the behaviour and so tend in certain cases to assistin the
we must closeour'noticeof this work, assur-
of urinary calculibefore the blow-pipe. cure. From the cases detailedby Dr. Downing, it
ring our readers, t hat they will find it abound in in-
formation
We regardthe factof this excellentwork having appears, that,in some instances, his ingenious mode
respecting these stilllittleknown regions
evidently the result of personal observation :
"
passedthroughtwo Englisheditionsas a convincingof applyingheated air (forit is to that alone we
proof of the great ardour with which chemical re- should attributethe good effects obtained,and not
searches
'*
Parturition in the negro female has been ge- nerally
representedto be an easy process, and not arc at the present moment carriedon. Itwould to the drugs)has been attended with the most bene- ficial
fttteodedwith much danger;such,however, is ntt ^be obviously out of placefor us to givea more length- efi^cts.
 26 THE MEDICAL TIMES.
REPORTS OF SOCIETIB8. are allconcerned to maintain to itslull
women. They may not be epileptic, but theyof asj^lums,
est rigour,for their own each trivial

peral
sometimes are of this description. Dr. Cormack justification,
WESTMINSTER MEDICAL SOCIETY. had seen in common, he ventured to with word or action which appears, however remotely,
"
say,
most of those who had heaid him "
fitsof strictly indicative of the captive's insanity.
Dr. Conolly has the reputation of beingthe friend
F. HiRD, Esq.,President, in the Chair. epileptic character " the coma, the clenched teeth,
of the oppressed, and to him, in a great degree,is
and bitten tongue arising "
from toxoemis,depend- ent
functional disease of the kidney
the milder system oi treatment adoptedin our asy- lums,
INSANITY AFTER USB OF CHLOROFORM "
ARCUS on organic or
owing. His Remarks on Asylums in general
hen's EOOS UNITED or of the liver; from irritationof the peripheral tremities
ex-
SENILIS "
LIKE THE SIAMESE are just and fair, and if asylums were (seepage
of the intracranial nerves by osteophytic
TWINS "
UTERINE SCARIFICATORS "
CONTAGION* 12) places of protection abounding in the **

OF CHOLERA "
EPILEPSY AND PUERPERAL VULSIONS. specula,
CON- by the presence of effused fluids, or by cere-
bral means of diverting the thoughts, of calming mor- bid

hypertrophy or tubercular deposit ; sometimes excitement, of soothing the depressed, of

Dr. Webster mentioned a case from irritation o f the fifth pair of nerves in dentition ; rousing the apathetic,of restraining the lower
of midwiferyin
of the stomach,bladder, propensities o f the insane, and the
which a drachm of chloroform had been employed,from irritation restonng
of the nerves trol
con-

and ovaries; and, if epilepsy be more of reason,** every man of sense would ap- prove
the^ effectof which was sudden and violent, the uterus, mon
com-
of them ; but we allknow what human nature
in females,the two lattercauses must be those
patient becomingquiteinsensible. Aftei a painful IS, and that each, in his own pursuit, is essentially
and protracted which cause this preponderance. T he greater quency
fre-
labour, she was leftin a very nervous the same man, coloured like the chamelion,as it
of epilepsy in woman is not, however,
condition, and ultimately became maniacal,requiring were, by the actual circumstances of his position,
"

ooerdon. This condition lastedfor many months. established;for there is reason to believe,that and that man's chief desire is to accumulate; and,
the^ severer forms of certain other convulsions to while some few nobler persons are actuated by
Mr. Canton described the microscopic anatomy of which the sex are liable, have been indiscriminately benevolence and a sense of duty in the attention
the arcus senilis, as consisting of that state of
placed with it; and perhaps a rigid d iagnosis might and care they devote to those under theirch/irge, the
disease described by Paget as atrophywith iatty but so much
nearly, if not entirely, equalize the number of epi- leptic greater number behold in theirpatients
degeneration. It is alwaysfound in connexion with
seizuresin the sexes. From these considera-
tions. income, justas the expectant conductewroi an omni- bus
a corresponding of the crystalline lens and
opacity Dr. Cormack maintained that ovarian irrita- tion sees in the hurrying and panting pedestrian other
an-

capsule, and is sometimes so extensive that a very sixpence.

was not so frequent a cause of epilepsy as some
small portiononly of the cornea remains clear. One faultamong others, in the present syslem, is
supposed; and that it was onlywhen the fits de- pended
the incompetencyof the parties to judge
Mr. Canton believed, fromthe resultsof the examin- ation appointed
he had upon that cause, that the ovarian repose of of lunacy,in particular cases. Persons have been
instituted, under the microscope,
that it was caused by a deposit pregnancy could be meliorative. Ovarian repose, denominated insane, have undergone years of cruel
of adventitiousfat in
however, was by no means a constant condition in imprisonment in asylums, merelybecause theydif- fered
the cells.
gravidwomen. If a young unmarried woman had in principle and practice from some other men,
Dr. Cormack exhibited two hen's
eggs, united at epileptic fits at her catamenial periods, marriage including, o f course, their near friends, the medical
one end by a narrow neck. They were somewhat who signthe certificate, the proprietors of asy-
mightbe allowed,because pregnancy would proba- bly men lums,
missbspeuby havingbeen pressed on each other. be curative ; but it was onlywhen thus strin- gently and the Commissioners in Lunacy; all of
"
He (Dr. Cormack) believed the specimento be whom might, upon closer inquiry, be found to be
limited, that the sanitary infiuence of mar-
unique. Eggs with double yelkswere not'uncomo much more eccentric than theyfrom the onlytrue
riagein epileptics could be admitted. And if Dr.
centre of rightconduct,vis. : moral truth and
mon, and he had once seen a tripleyelk,but Smith's proposition
"

was intended to be a general

here were two eggs, in distinctand perfect shells,one, he (Dr.Cormack)must dissent from it. The equity.
No one can question the necessity forlunatic asy-lums
joinedby a neck, also thinlv covered with shell. ovarian repose of onlybe curative
It was pregnancy can ; the great difficulty is,to insure their proper
surprising thatthe hen had been able to pass when the seizures
depend on ovarian excitement. management. Two plans here present themselves;
the united eggs, from their breadth and parallel After some
sition,
po- further interesting observations, which the one, that privateasylums be altogether lished,
abo-
for hens often die when the egg is in a trans- verse our limits preclude from detailing. and the whole lunacy of the countrybe under
us
position.The hen in questionwas of the Dr. Cormack said,that the three points
the care of a Government Board,deputies, house-
keepers,
to which
Dorkingbreed,and belongedto Dr. Cormack. "c.; the houses to be subjected to inspec-
tion
he wished to directattention were "

who shimld
Dr. Routh exhibitedseveral instruments for scan "
by the magistrates of the counties,
Ist. That the term epilepsy o ught to be used no longer, now, make their report to the Board of
fying the neck of the uterus. as

onlyto designate a particular form of convulsion. Lunacy,but,through the regular channels,report at

Mr. Chreenhalgh bore testimony to the utility of which would thus become
2. That pregnancy can once to the Home Office,
the scarificator.He had seen it employed in two only meliorate the con- dition
both a check and a spur on the otherwise arbitrary,
of epileptics, when the epilepsy is dependent or, perhaps,
cases, and the amount of blood drawn was able,
consider- dilatory and inefiicientproceedings of
and sometimes continued for two or three days. on ovarian excitement the chief Board.
The patients, however,experienced but little incon-
venience 3. That the abnormal development of the intra-
cranial The other plan (alsoto be guaranteed by the
from it; and one he had seen that day osteoph3rte of pregnancy may be an occasional Home Office inspection) should be. that the Board
walked home afterwards. cause of puerperal convulsions. of Commissioners (fewer in number than now)
should sit in London, and have attached to them a
Mr. Barlow narrated several cases to prove the After some further discussion, in which Mr.
of sub-commissioners, whose duty it should be
contagion of cholera. Streeter, Dr. James Bird,Mr. Wing, Dr. Snow, Dr. corps
to visitall the asylums in the country at alltimes,
Dr. Cormack then resumed an adjourned discus "
Routh, Dr. Webster, and Dr. Alison took part, (notannouncing theirapproachby the rumbling of
^

lion on epilepsy and puerperal convulsions;and Dr. TylerSmith, in reply, stated that the case he the old green coach,) and,where requisite, frequently,
"aid,the renal puerperal convulsions were not ne- had broughtforward had not been selected to illus-
cessarily, trate so as to become intimately aware uf all that takes
nor, indeed,were they generally con-
nected any particular opinion.The two most im- portant placein them, which must so closely affectthe wel-fare
with organicdisease of the kidney; the of the parties confined.
points, namely,that in the migority of cases
pressure of the uterine tumour attacks were The Commissioners should be instructedto cause
upon the emul- epileptic more rare duringgestation close investigation into the moral as well as mental
gent veins being sufficientto cause congestion than at other times, and that epileptics were rarely
of the organ, functional disturbance, deficient affected with puerperalconvulsions, had not been
qualifications (alludedto p. 35) of persons applying
for licences. They, the Commissionere, have not
blood-moulting, and consequent toxaemia. The questioned ; but, on the contrary, had received ad- ditional
been misled by great improvement
lochial puerperal convulsions, confirmation. The cases
unfrequently
dependedupon sup* he had related
being visible in the physical health of patients, to
pression o f the lochial discharge.Toxcemic con- vulsions would, probably, be published hereafter in detail,conclude that they were recovering from their in- sanity,
(renal and lochial) were produced by direct with others of great interest, which he had since overlooking the fact, that while theiranimal
imj^ressious upon the spinal centre ; but the cases b ut
received, which, at that late hour, he would not powers had been greatly developed and improved,
which had been so instructively broughtbefoie the read to the Society, though he should have felt they had actually become degraded in the scale of
Society by Dr. TylerSmith, were of reflexor eccen- tric bound to do so, had they been at variance with moral beings.
origin ; though,of course, it must be remem-
bered, those he had already cited in his paper. Dr. C. asserts,that the whole time qfthe ComntU'
Uiat cases of mixed origin is spent in endeaoouring to protectthe insane and
occurred. Adjourned. turners

The main propositions helpless^ and to preventthe improper detention cfpersons

which Dr. TylerSmith
had soughtto establishwere able to take care rfthemselves and theirproperty. What
these, " Utat epilep-
"
tics
CORRBSPONDENCB. a pity it is that the public have no means of
were not more liablethan others to puerperal
forming a judgmenton such noble and philanthn"pic
convulsions ; and that pregnancy has a
tendencyto conduct,except from the Reportsof the Commis- sioners
meliorate epilepsy." But what is epilepsy 1 and the noticeswhich find their
THE COMMISSIONERS IN LUNACY. themselves,
What are puerperal convulsions 7 Epilepsy of the surprising
cannot way into the papers periodically,
be considered as the name of a disease; and if [To the Editor of the Medical Times.] efforts of the individual Commissioners,who have
ithave any definite all, i t is each visited, in incredibly short time,thousands
meaning at when limited Sir, " I regret very much that so palpable a case
an

in itsuse to describe apaiticuhrform of convulsion. of

insanity as that of Nottidge v. Ripley, should have of insane patients.
Its causes are very various; and ovarian irriutionis become the field of attack between the supporters We would gladlysee justicedone to all,and
convulsions do and opponentsof privateasylums,because it has honour bestowed where due ;
onlyone of them. Again,puerperal and to this end would
not by means alwaysdependon the same patho- given the former the opportunity of laying ^eater suggest the followingalterationsin the practice of
any
loftioal btress on arguments than, under ordinary circum-
stances, asylums, whereby their inmates would be protected
causes ; and each case must stand by itself,
they could well have borne, and'of exag- from injustice, and the Commissioners in Lunacy,
tillinvestigated and placedin its own gerating
group. The instances of unsoundness of mind, which proprietors of Asylums, and Medical men connected
twrm is mischievous, if employedwith reference to it would
be no easy matter to prove untrue, where with them, from obloquy and suspicion.
causes or treatment,and oughtto be restrictedto friends, medical men, (who signedthe certificate,) To remove the anomaly of an irresponsible thority
au-
itsstrictmeaning convulsions "
occurring in puer- the CommiaaionerB in Lunacy, and the proprietors existing in our free country, independently
 THE MEDICAL TIMES. 27

of the Civil Power, the followingpractice is whose utility consists not only in diminishing perature
tem- For superficial bums, scalds,or excoriations:
soggested:" by evaporation, but in softening and relaxing intertiigo, chapsof the lips, herpes labiorum,"c.,
1. Erery license to keep an Asylum, issued by the heated and inflamed skin. The tendencyto dry P" Gu. Tragac. pur. 5^. ad. ^ss.; liq. Calcis,^iv. ;
and adhere to the is well known, often Glycerine purif. ; Aq.
^. Rosse dest. ^iij.
; to form
the Commissioners,shall have no force until ap" up, part, as

in Session, such oonfirma- frustratesthe beneficialefiecisof these applications, a soft jelly, to be used by way of ointment or em- brocation.
jirovedby the magistrates
tion to be notified to the Secretaryof State for the and various counteractive expedients have, conse-
quently,

Home Department. been adopted ; as the addition of fatty For prurigo, lichen, strophulus,lepra, psoriasis,
matters, covering the poultice, lotion, "c., with oiled pruritus, "c.:" J^ Acid. Nitric, del. Jss.ad. Xj.;
2. A Registerof allAsylums, and theirinmates,to
be keptat the Home
silk. Now, thisisrendered entirely unnecessary by Bismuth. Trisnitr. 5ss.; Tine. Digitalis, 5j.;Gly-
cerine
Office, to every one who
open the addition of the substance I hand round for your purif. 5ss.; Aq. Rosn, ^viiss.M.for a lotion
shall present a Petition to inspect it,containing
You will perceiveit is like oil,and to be used by dabbing the part.
puch reasons for the inquiry as shall be deemed by inspection. For chapped or hands,fissures of the lips,
the Officesufficient.
when rubbed upon the skin it furnishes a watery nipples
coatingor varnish,which even the microscopefails irriution ot the skin of any kind,as after shavlnc,
3. Every medical certificate of unsound mind shall to distinguishas different from the ordinary se- cretionsexposure to the sun, for Pityriasis, "c. : {^ Sodss "

be sanctioned by the signatureof a Magistrateor of the part. Half an ounce of this liquid, Biboracis,5ss.ad. 5J,;Glycerinepur. ^ss.: Aq.
Justice of the Peace,before it can be put in force ; a added to half a pintof lotion, will prevent the skin Ross, ^viiss. M. for a lotion, to be used by dabbing
notiRcation of the warrant being executed,to be ever becoming dry. In baths the result is also the part affected.
made within forty-eight hour?,to such Magistrateor equally but here the cost is an obstacle, For alopecia following fevers,"c.,or forthe falling
apparent ;
Justice of the Peace, who shall communicate the thotigh the liquidis by no means dear, as, at the ofi^of the hair, dryness,or want of action of the scalp,
same to the Home Office. resent time,tons of it are thrown away ; but if, as thinness of the hair,"c.:" '$" Sp. Ammon. co. ^.;
4. Every warrant of transfer of an inmate to fanticipate, its application prove general, its priceGlycerine pur. ^ss.;Tinct Cantharid. 3j. ad. 5]].;
another Asylum, or release,to be certifiedby the will be shortly augmented.This fluidbody,to which Aq. Rosmarin. ^vij.M. for a lotion, to be used with
of glycerine, is hair brush or twice a day.
likecivilauthority, and itsexecution likewisenotified the chemists have given the name a a wet once

and communicated. peculiar uncrystallizable saccharine matter, found For " hot" rheumatism, or arthriticgout, neoralgic
in animal fats or oils,or producedduring their pains, sprains, bruises, stiffness, "c. :-^Lin. Saponis
5. The Reports of Visiting Justices, to be made
through the ordinary channels,to the Secretaryof admixture and
oombination with alkaliesandoxides. comp. ^iss.;Glycerinepar. ^ss.;"xt. Belladon.
it is abundant in the refuse of the soap 3j. ad. vel.Veratrise, "c. M. for an embrocation,
the Home Department,and not, as heretofore, to the Thus, most
and stearine matter. That which you are now in- to be used twice a day in the ordinarymanner.
specting
Commissioners in Lunacy.
from Apothecaries* Hall, and I am. Sir,your obedient servant,
6. On such information being conveyed to the is formed
was procured
during the manufacture of lead plaster on
3,Saville-row, St James's. Jambs Btartin.
Home Secretaryas shall satisfy him of any person I should mention, that it requiresto
a largescale.
beingunjustly detained in an Asylam, he shallcause be diluted with water for use. otherwise it makes
a searchinginvestigation (atthe public expense)to the skin feelstifiT, and sticky; but,as MEDICAL REFORM.
uncomfortable,
be made into the case ; and, if thisinquiry confirms I am
shallimmediately
now about concludingsome experiments, long
the fact of unjustdetention, issue since of this [To the Editor of the Medical Timei.]
commenced the on application liquid
as
his warrant for the liberationof the party so detained. Sir." A letter appearedlast Saturdajr, in the
a therapeutic agent, to several forms of cutaneous
Much stress has been laid on the proprietyof of your Contemporary,the LasiceL which seems
disease, I will defer any further observations upon pages
saving pain
the and distresswhich would be sioned
occa- t shall designed, and, so far as it has any influence, oolcti-
it until a future occasion. In the meantime
to families, its becoming known that one dissension between the friendsof me-
on
be obligedif any Professional brother will giveit a kUed to sow dical
of their members has been subjected to restraint trial
in his practice, and communicate to me the reform in the two leading cities of Scotland ;
Althoughwe think*these feelingsare morbid, we result. and which bears strong internal marks of being the
should be disposed to respect tnem scrupulously^, To redeem the pledgethus given two years after- wards, production not merelyof an enemy, but of one un-
connected

were thc^not liable to be made use of as a veil with either city.It ischaracterised by
the pages of the same journal{Med. Times, and the sig-
to screen ii^ustice and persecution. They must be Vol. XVI., 469)contained a renewal of the subject vulgarity and spitefulness throughout; nature
p. ;
altogether put aside if found to support or tenance
coun-
when, after having described the mode of preparing
assumed by the writer,** A Member of the
practices subversive of liberty.
and itschemical composition, I gave the RoyalCollege of Sur^onsof Edinburgh," sumps it
glycerine, there is no
I am, "c, "c., of its therapeutic **
In as a spurious production ; inasmuch as
subjoined summary uses ":
X. Y.
the use of glycerine I nave had but little such titleconnected with the RoyalCollege ; a foct
internally well known to everybody here.
experience; but it is a mild stimulant, antiseptic
I have only to conciude. byassuring all able
respect-
ON THE THERAPEUTIC USES OF and demulcent,and might be employedto sweeten
members of our Profession in London and In
GLYCERINE, many articlesof food or drinks for those invalids
which this person
THE SWEET PRINCIPLE OF OILS. whose disordered digestive 'organsforbid the use of Glasgow, that the sentiments to
has given utterance,would be universally scouted by
sugar. Pills made with the addition of a few drops
and and the medical reformers of Edinburgh, and especially
of glycerine never become dry, syrups tracts,
ex-
such of them entitled subscribe selves,
them-
by Its means, are kept moist, as also from by
[To the Editor of the Medical Times.] as are to

the favour,on several fermentation ; and the formation of cryptogamoiis like your present Correspondent,
Sir, You have done me
"

occasions, to publish remarks upon the re- other such like A Fellow
previooc medial vegetationor mouldiness; many
Of the Roval College of Surgeonsof Edinbui^gh.
agent heading thiscommunication ; and I am uses forthis agent will not failto suggest themselves,
iodaced again to trespasson your liberality, by re- for the recapitulation
questing of which,however,your pages Edinburgh,3rd January, 1850.
of the ob-
you to reprint, or refer to, some servations
can scarcely be deemed the appropriate place. [Thewriter of the above has favoured us with his
I made upon Glycerinein your pages up- wards I shall,therefore,briefly enumerate some of
name." Ed. MtdietU TtmesJ]
of four years ago, as they would appear to be the diseases of the skin in which I have
overlooked or forgottenby several of your Cor- respondents;
employedglycerine with most benefit and Buccess|;
although my name (printed Starlm)these are pit3rriasis or dandreff*, particularly that ON CERTAIN EFFECTS OF AN
appears connected with the subject in your last Num-
ber, form of the disease which 1 have termed (P. conge- INVETERATE HABIT OF SMOKING." THE
in a letter from Mr. Amyot of Diss. Now, nilch) l epra, psoriasis, lichen,(in its dry advanced DENUDATION OF THE
althoughGlycerineisnot a panacea for allills,"
"
and stage.) impetigo inveterate, and prurigo.I have
OF THE FANGS OF
for deafness, for which I unsuccessfullyfound glycerine also a useful addition to lotions in
PERIOSTEUM
particuJarly
before its nndryingpropertiesthe encrusted forms of THE TEETH.
employed it, (even lupus or herpes exedens,and
suggested its uses in afTectionsof the skin,) havingto various syphilitic or strumous eruptions,having a
three members of my own familyincurablydeaf; tendency to producefetid discharges and hard [To the Editor of the Medical Times.]
yet my further experience has proved it to be de- serving crusts ; for which reason also,it has provedof ser- vice Sir," Permit me to callyour attention to the fact,
of all I have adduced in itsfavour on previ- ous in the scabbingstage of small-pox. As a wash that extreme smokers often suffer greatly afterthe
occasions,which will be found to comprehend also for the hair,and forcktgtped^ndt, factt ornipplet,habit has been intemperately indulged,partica-
nearly,if not every suggestion, for which it has lat-
terlycombined with a littlerose-water and a few grainslarlvwith their teeth, which are found to ba denuded
been recommended.|Lest,therefore,the Virgi-of borax to the ounce, the glycerine beingin the pro- portionof the periosteum of the fangs. In order to render
lian adage, Sic vo$ non vobis" Sfc^
"
find a verifica-
tion of one-sixteenth, this remedy furnishes, the suDsequent statements and inferences appre-
ciated,
in myinstance,I subjoin the quotations referred perhaps, one of the most elegantand efficacious pre- we majr remark, that tobaoco is ranked,by
to: "Another very efficaciousmeans yet remains which has been introduced. It may also writers on toxicology, the nareotio poisons,
"

to us in glffceriTtey which,as a palliative in squamous Earations

e combined with soaps, which it renders penculiarly that it isinjurious
among
to the digestive organs, "c You
affections of the skin,has not, to my knowledge,softening and detergent, particularly for individuals will, therefore, not be surprised that the teeth should
been hitherto made known or adopted; In fact,it is who have a dry or hard skin." sufferfrom the use of this narcotic, because theyare
peculiarto myself,and,althoughI have not yet ad- dressedTo this somewhat lengthycommunication I will sympathetically affected under every form of dys- pepsia,
the Profession or any learned bodyupon the only add, for the guidance of those amongst your whenever,in consequence of such disturbed
subject, i n accordance with my intention, when my readers who may desire to make trial o f this remedy, functions,there is an excess of acidity.
observations are matured, I will,nevertheless, here a few of the more common and usefulformulae em- ployed It is my intention, therefore, to attempt to explain
announce it for your consideration. It consists in at the London Cutaneous Infirmary, where why tobaoco induces a double injury when used for
the employment of this liquidlately discovered,glycerineis extensivelyused ; notwithstandingits smoking,eitherin pipesor cigars.
whieh has the property of remaining fluid,and high considerable obstacle, The phenomena attending the of combus-
tion,
present price, proves a process
resisting evaporation, under any temperature the funds of this Institution being quiteinadequate may be observed as follows: that during the
to which the body can be exposed; indeed, to meet the increasing demands upon them. I would time of itsburning,there is givenoffa white smoke,
I have wetted a dinner plate with that glycerine should never be used vndUuied which contains some small portionsof the essential
common
this fluid,and kept it in an oven !)reniise,
whilst a jointof or cutaneous maladies ; and that when prescribed in oil of the tobacco, which, as being a coiioentrated
meat was eooked by its side,and the liquid has ex- the annexed
perienced recipes, the porified M odorous and hydrous
an- portion of the narcotic agent, affectsthe teeth ; and
no evident change or diminution. The quality is alone indicated, which is of a pale some of it,mixing^ with the saliva which,if carried
tacility with which this bodymingles with water or sherry colour,and of the consistence of treacle. into the stomach, induces derangement of that im- portant
other fluids, even oils,renders itan Invaluable adjunct N.B. Beware of a spurious articlelately found in the organ. Consequently, smokingtobacco is
to lotioDs, poultices, embrocations, and applications, shops,composed chiefly of honey, or sugar and water. ; likely to anect the health of the teeth in a direct
 28 THE MEDICAL TIMES,
maoDer, and, indirectly,as a cause of morbid condi-
tions in which diseasethe saliva is more or less acidified, in about half an hoar, he had purgings,vomitings,
of tliestomach and the auxiliary agents of the and the condition of smoker's teeth are acted on so and spasms both of the bowels and legs.He became
functions.
veg"tati?e much more potently. For, when the teeth are cold and pale,and shrunk very considerably. He
As evidence of my first statement it may be re- marked, healthy, they,like all organicsubstances, can resist,recovered, however,and the house wasoleaned,white- washed,
that smokers arc subjected, occasionally, to to a certain degree,the action of corrodine agents ; and well-aired, and no other case oecurred.
agonizingpainin theirteetli,even when there does not but, when they no longerretain a normal vitality, I had several cases of diarrhoea after, but all of a
appear any symptoms of dvspepsia. In these cases, their decomposition follows. very mild form. My own districtforms but a repe- tition
the crowns are often sound, but the enamel, instead The case must be thus briefly stated, that the in-jury of what was found in allthe others.
^

of being a beautiful polished, white, opaque stance,

sub- of the teeth in inveteratetobacco-smokers is in- duced A case of cholera occurred in the districtof Mr.
as in its normal condition, presents a trans- by a two-foldoperation. 1st. The fangsbeing Moyle,which terminated fatally in a few hours. In
^

lacent and vitreous appearance, whilst the edges of denuded of their periosteum, must be regarded as thiscase all the inmates were removed to the hospital
the incisorsare often transparent. That we may at- tribute extraneous bodies,and are then acted upon most prepared for them, and the dead was removed to its
these changes to the cause previously stated,energetically by the absorbents;and 2ndly.When f ast resting-place, and the house thoroughly cleaned.
arisesfrom the fact thatthisis the ordinary aspectof such is the case,the teeth are liableto be acted on Several of the partiesthus removed bad diarrhoea,
the enamel in great smokers. The colour and ap- pearanceby acids in an inverse ratio to the loss of vital ac- tion; but,under the care of Drs. Montgomery and Millan,
cannot be confounded v^th the dark shades Finally, these two causes enable us to ac- count soon recovered. Shortly afterthis case, another oc- curred

g[iven to this substance whenever the subjacent tine

den- for the translucent appearance of the enamel in the district of Mr. Berriman, which also
is carious. We have seen numerous well-marked in the teeth of smokers : as thisappearance is a sim- ple terminated fatally.The living were againremoved,
instances in persons who have smoked claypipes, or resultof the rapidloss of the earthymatter. We and thoughthere was slightdiarrhoea, yet all re-covered.

meerschaums, or cigars, the effectbeingthe result of may add^ that there appears to be a well-defineddif- ference About this time many cases of deranged
the heat givenoffwhilst the tobacco is ouming ? It in the diseases of the teeth,resultingfrom bowels occurred ; but, by constant vigilance, all covered,
re-
should be rememl"ered that the average temperature stomach "diseases per se and the smoker's disease." and we have had no return up to tlie present
of the mouth variesfrom 88 to 95 degreesof Fahren- heit's In the firstspecies the gums are spongy and full, time.
thermometer. It might have heen d priori in- or else they recede from
ferred, the necks of the teeth, and From the cholera beingto near, and the constant
that hot streams of smoke, at such an elevated by exposing the alveolar processes, subject them to intercoursegoing on between Penzanee and infected
temperature, could not be harmless. Besides which, absorption. Then the denudoHon of the periosteum districts, there was every probability of an invaaion,
the stimulating influence of the heated smoke ex- commences at the necks of the teeth,and cariee is and yet there may be said to have been none. But
oitesthe action of tiiesalivary glands,producingan the consequence. But,in the " smoker's disease,"diarrhoea became so prevaleut, that I think but for
excess of the fluid, which aftera time ceases, and a these processes are reversed, the hot smoke affects the timely and judicious arrangements of the autho- rities
lessthan a sufficient quantity of salivais produced ; the fangsin the first instance, without, in any seri- ous we must have had the cholera*
and, when such is the case, the smoker desires way, affecting the crowns ; so that the homd pain Each medical visiterhad his own district, hut ifhe
something "
to wet his mouth," and hence the habit does not arisefrom exposure of the
pulp cavity(as was out of the way, another was to be called ; bnt
of drinkingstimulating beverages is the ultimate in ordinarycaries,) but from the rougnened state of this was not to interferewith private arrangements.
consequence. the denuded fang or fangskeepingup constant local I make these remarks in allusionto Mr. McClure's
Id a vast number of cases of extreme smoking, irritation. paper, at page 472, and in confirmation of your own
when those who have indulged in such excess have I am. Sir,yours,"c. views.
had what has been called tooth-ache,their suffer- ings J. L. Levison. I enclose you a copy 'of one of our publicnotice!
have been great,yet in most of the instances I 14, Devonshire-place, Brighton, Dec 4, 184". for your inspection.
have observed,that the erownt of the affectedteeth I am. Sir,yours truly,
seemed perfect, excepting that the enamel appeared R. Q. Couch.
to be alteredin structure and colour (asalready men-
tioned), CHOLERA IN PENZANCE.
and thereforeI directed mv especialatten-
tion "
CAUTION.
to the state of the fangs,and found them,in all To the Editor of the Medical Timea. **
The Board of Sanitary think it right
Inapection
such instances, denuded of their periosieum, being Sir, Having,in a former number of the Medical to advise the public,
"
that,at the present moment, it
rough at the extremities, as if rasped;whilst the Times, givenan account of the epidemic that visited is of the utmost importanceto everyindividual to
colour of the fangsthemselves resembled horn,being Penzance in the autumn of 1848,1 will,with your adoptmeasures for securing the public health ; and
of a darker hue than healthy dentine, and of a porous permission, brie6j state the nature of the health of to this end :"
appearance, differing matenally from the UEual dense the town since that visitation up to the present time. "
Let allpay strictattentionto cleanlinessin their
substance which envelopes them,and which substance The diarrhoeaand dysenteryentirely disappearedin persons and dwellings ; and to effectthis, remove
is designated eruttapetrota.In consequence, there- fore, February, and the town continued free till May, and every
speedily depositsof ashes,offal, garbage,
ot the active absorptiongoingon, the affected when a raw cases of diarrhoeaagainoccurred, in a kind of filth.
b ut
teeth act as extraneous bodies,and produce much very mild form. About thistime the cholerahad made "
Inspect and cleanse gutters,drains, pools, and
localirritation.Hence, from data of thiskind I am itsappearance in differentparts of the Kingdom,and
cess-pits.
led to the inference, that tobacco affectsthe teeth in Cornwall visited Mevagissey with friahtfulse- verity. to change the air of
"
Open windows frequently
themselves, and that the affectionmust not be con-
founded It visited Plymouth, Falmouth,Tmro, and staircases.
rooms
with their ii^jury, induced by the acidityand Haylevery severely; and the last town is but *"
Let whitewash of quicklime be used plentifully.
often eaused by stomach derangement, resulting from eight miles from Penzance,with omnibus and other
an inveterate habit of smoking tobacco. There is communications every hour in the day. This being
**
The Board have appointedsub-committees to
the state of
nothingspeculative in thesestatements. Their truth the case, every one expectedthat we should be visitthe differentdistrictsto report to on
the laws now
has been verified visited. In this state the Mayor called a the same, in order to secure attention
by years of experience. The meeting
svmptoms are well-marked in the ** smokers' disease." of the Council,and means were advised to ward off in force for sanitaryprotection.
They are as follows:" More or lessuneasy sensations the attack. The Town Council,with the Medical "
The Board of Highways will remove ashea,or
about the crown of the tooth, which gradually extends men ol the town, were formed into a Board of Health. other refuse,from every house, twice,at leaat,in
to the fangs.At this stage of the disorder, if the The Medical portion of the Board were reouested to each week, or oftener if requested. Notice ahould
teeth are touched,there is a tenderness experienced; divide the town into districtsso as to suit tneir con- veniences.immediately be givento the surveyor, Mr. Charles
and if bittenon in thiscondition, a sudden and most This theydid,and one was appointedto Reynolds, in the event of this duty having been in
painful sensation is experienced.As the disease each district, and a member of the Town Council, any case neglected.
the
proceeds, patient seems cognizant of the imme-
diate with another eentleman of the town, assistedhim in "
In addition to the above, the Board recommend
seat of the disease; the agonizing painbeing his duties of the district It was agreed,that every strictattentionto health ; and in case of indisposi- tion,
confined to the bottom of the alveolarprocess of the house in every districtshould be visited officially and especially *
bowel complaint,' the poor
affectedtooth or teeth, which is attended with a pal- pableonce every week, and as often as one or other of the should make Immediate application to the diatrict
throbbing; or, as an unscientificsuffererex- pressed visiters could beside. This was done, drains were surgeon, "
viz., Mr. Richard Q. Couch, residence.
it," a jumping pain." The most distressingcleared, cess-pits filledup, and everything offensive Chapel-street, who willattend gratuitously. Assistant
sensations are feltunder vicissitudesof climate" in removed. The town had not been k" clean for years Visiters: J. Batten,Esq.; Bfr.James Flamank.
great and sudden changes from heat to cold, or vice as it was then, and is now. It was feared that an "
The Board will meet at the Council Chamber
after drinkingspirits-and-water, wine, alarm would be created, which would do more harm
vertas or
every Monday evenine,at seven o'clock, where com-
munications
beer, or any other alcoholic stimulants. In other than the effortcould do good. To prevent this, the may be addressed,or personalapplica- tion
words, the teeth,under this affection, suffer from object was clearly explained to thepieople : and when made, referring to any existing cause of com-
plaint.
everything that acceleratesthe circulation. Among they saw thatthere was no differencemade between
many of my most intelligent patients, when there the rich and poor" all assisted us in our efforts. I **
John N. R. Millett,
happenedto be a simce (from previous extraction)believe there were but two who resisted, and these Chairman of the Board.
between the affecteoteeth,theynave described their were brought beforethe Mayor and fined. **
Council Chamber, Pensance,
sensation as ifa seriesof galvanic or electrical shocks I had the districtof the quay and shipping signed
as-
August 28th, 1849."
continually passedfrom tooth to tooth ; and, tiredat to my share a district
"
generally supposed to
last by this continued disturbance, they have had be amongst the worst part of the town. Diarrhoea
ACID IN
the offenders removed. not of unfirequent but it no sooner THE USE OF HYDROCYANIC
forcibly was occurrence;
It is,therefore, evident, that when much made its than the patient was visitedand CASES OF BURN"
very so appearance
sufferingresultsfrom teeth that are not eortoiw, we the disease checked. In some casi*s the diarrhoea
may safely attributethe pain to the fact,that with was severe, and would have been much worse but for [To the Editor of the lltdicalTimet.]
the loss of the periosteum,the fangsloose their the earlyapplication formedicine. In one case, that Sir," Will you oblige me, by inserting in the Jfe-
normal vitality, and that the local irritationarises of a pilot, it was very severe. He went offin a boat dioal Times the following treatment of buma : Place
"

from the fangs acting foreign

a s a body. to board a ship fti"m Swansea" a place in which the in a mortar two ounces of sissple cerate or lard,and
We are further prepare to explain, when teethare cholera was raging very severely^but the crew on rub into it, gradually adding, as much hydrocyanic
thus injured by the action of hot fumes of a powerfulboard were healthy,and had been so all the time acid,of Scheele's strength,as it will take up, then
narcotic poison, that they are rendered, in conse- quence, theywere in Wales. While passingunder the stem spreadon lint or linen,and applyit to the burned
more susceptible to any other kind ot de- of the ship,
structive holding by a rope, this man felta sudden parts. This treatment will be found to allay allpain
agency. Among the causes which tend to and desperate painin the stomach and bowels,which and vascular excitement If the burned surfaceis
expedite rapidchtnges, must b" mentioned dytpeptia, ended in rapid fiuideracuations. When I saw him very extensive, the patient should not be leftwhile
 THE MEDICAL TIMES. 29
this a]"p]ication is applied "
and opium should not be THE PUBLIC HEALTH IN THE The deaths in the several hospitals of London oc- curred
administered in any form with the aoplication. A METROPOLIS. follow :
as "

littlechild of four years old was treatedwith this ap- plication, Warburton's
The deaths in Kensington Houm lum
Asy- Lunatic
whose chest was severelyburned,which registered the metropolitan tricts,
dis-
1 Asylum M

nad caused the child to be in fits before tlie applica- in the week endinglast Saturday, amounted
tion Lock 0 London
was applied; but very soon after its use the fits to 1133. In the first week of ten previousyears CooKumption, Brompton S PortugueseJews' Hos-
ceased,and the littlepatient recovered without a re- (1840-9)they rangedfrom 869 to 1510 ; and the St. George 6 pital
Grenidier Guards' pital
Hos- Lunatic Asylum, Bow
torn of them. I have been thus led to trouble you average of the ten corresponding weeks, raised ac- cording
...

with this,
1 Guy's
seeingin the papers the death of a ladyat to increase of population, which is esti-
mated Westminster 5 St. Thomas ... ""

Cheltenham very recentlyfrom burning. at 1-55 per cent is 1252. CharingOf OSS 3 Bethlem
annually, As com-
pared .m ... ^

I am, Sir,yours much obliged, with deaths registeredweeklyin lastDecem-

Middlesex 4 New County Lunatie
ber,
ASURQEON. UniversityCollege 8 Abylum ... ...

the present Return exhibits an increase of Small Pox 0 Pcckham House Lunatic
January3,1850.
nearly100. The mortality from bronchitis has in- creasedFever Hospital 0 Asylum
Invalid Asylum, Stoke Camberwell House natic
Lu-
in two weeks from 78 deaths to 103, while
Western Medical and Surgical Society. Newington 1 Asylum
... ...
"
that from pneumonia has increased from 69 to 95 ;
At the lastmeeting of the members of this Society, King's College S Dreadnought Ship
the averages of the two diseases in the same week St Luke, 0 Devonshire Ship ~

Mr. G. E. Blenkins narrated a case of congenital

often previous years are 57 and 104 From phthisisCity
of London Lying-in
obliterationof the ductus communis choledochus in Hospital 1 Royal Hospital,Chelsea
there were 129 deaths,which is slightly under the
an infant, w ho survived its birth thirty-three days. St. Bartholomew 7 (South)
corrected average. From small-pox there were
No bile had ever passedinto the intestines, either Miles' Lunatic Asjflum... 0 Royal Hospital,Green- wich

during its foetalcondition or subsequent to birth. only8; in the ten corresponding weeks of 1840-9, (East)
The angle of union of the hepatic and cystic ducts this epidemic ranged from 5 to 86. Hooping-cough, In the Registrar- General's Return for the Week,
was found distended to the size of a walnut,and con- tained which was fatal to 23 children,is also under the (full of the most important particulars,) the follow-
ing
inspissatedbile. Large deposits of blood usual number. Measles, scarlatina, and typhus, Table is given,showing the Mortality from
were found in the brain, side,leg,and arm, and also in producenearlythe ordinaryamount of mortality ; Cholera,1848-9, and the Annual Mortality from all
other parts of the body. The author attributedthese but all the five the with the Elevation of the ings
Dwell-
epidemics, with of
exception Causes, 1838-44 ;
to the fact of the want of due nutritionof the tissues,measles, are now much less fatalthan in the same
from the chylenot bein^ from the chyme, week of
Above High Water-mark, the AverageAnnual
separated lastyear. From diarrhoea there were only Value of Houses, and the AverageCost of House-
from the absence of bilein the intestines, and thought
8 deaths ; but 6, which is rather more than usual, room, in the Districts of London Supplied by Nine
this determined the question as to the true and pri-
mary
occurred from dysentery. Water Companies:
use of the bile in the small intestine. "

The Maple-Durham Water Scheme. "

We
are glad to find that public attentioncontinues to be 5 Densityof Average
Population. Value of
directed to the subiect of an alterationof the present it House-room
objectionable supply of water to the Metropolis.The to
points for reform are quality,quantity,and cost to WATER COMPANIES
5 s each Person.
the consumer. The exposition put forth by the sug- which supplythe Sources of Water Supply.
gesters of the planfor procuring water from the several groups of Districts.
Thames at Maple-Durham, contains a very clear
and comprehensive review of these three points,and ^ o
is well worthyof the attention of those who are in- terested
in the subject. That the existingfluids
dispensed(and that sparingly) by the Metropolitan
Water for the wants of d.
Companies, are quite unfit s.

66 5-595 2 2
the inhabiUnts,is a face that few men are now bold All LoxnoM

enough to deny. We must have pure soft water dis-

tributed
Rsst London River Lea f9 6-7 3-407 1 4
abondantlyand continuouslythroughout New Rivrr and East London Rivers Arowell
...

and Lea 29 IS 5 9 4-3y7 1 8

every partof town. It must not he confined,as now
New River Rivers
Rivers Amwell and Lea 48 100 81 6-C38 2 7
to particular streets, houses, or floors of houses ; it fRiv"vers Amwell and Lea, by\
must be generally and universally so that
distributed, New River, Hampstead, and iprings on the hill at Hamp- I 8-8 4-871 1 10
60
the poor, as well as the rich,may enjoythe luxury of West Middlesex ^ lead, and by the Thames at [

elemnlinessat moderate cost

a The quality of the I Hi
Hanimt-rsmith )
Junction 10 58 116 5 1
Grand Thames at Kewbridfte
water, however, is the firstpointto be considered ;
... ...
^..

and it would appear that ^oodwater is to be obtained

in one of two methods; either by procuringit from
Grand

tlie present supply.West

Junction, West
and Chelsea
dlesex,
Mid-
\
(Thames at
Hammersmith,
I tersea
Kew-bridge,
and at Bat-4) 38

17
10

46 9-5
33

68
6 070

7-471
fresh sources, or by purifying Middlesex Thames at Hammersmith
We that the Thames at Dattersea 56 66 80 41 5 309
are perfectlyaware existingCom-
panies Chelsea
Southwark Thames at Battemea 156 9 6-5 26 4- 133
are unable to furnish suflicieiit for the re-
quirements
/Thames at Battersea and at\ 26 4-229 1 7
of the entire metropolis, but, since Southwark and Lamheth ...
131 37
\ Waterloo-bridge J
eost of production is of importance in the ques-
tion, at Batterseaand Rlver^ 268
to
we cannot help thinkins that itwould be cheaper Southwark
purify the existing siphonic
supply (possibly fil-
tration
and East Kent ...
(Thames
Ravensbourne
ford Common
near Dept-"
)
277 5-8 23 4-238 1 8

through charcoal would bestaccomplishthis) East Kent I( River Ravensbourne near"

71 I 218 6-5 3-704 I 5
and to |"rocure the remaining quantityfrom some
"
\ Deptford Common /
near available source, than to seek an entire fresh
supply.If,however,the latterplan be indispensable,This Table affordsthe means of investigating the
Deaths in the Week ending Saturday, J^n, 5, 1850.
the waier must be obtained either from Artesian effectsof elevationof soil(whichis a good index to
wella or from the Thames* Each of these planshas the natural of densityof population,
drainage), Average of
its disadvantages. The object is to obtain pure soft Causes D^ath. ;Total. Ten
and of poverty which is expressed "

by the lowness op
iPoUr. That from the Artesian wells is exceedingly WeeU.
of the rating of the houses" or still more closely
soft, b ut then it is highlyalkaline, which renders it
tlfe head of house and
objectionablefor some culinarypurposes. On the by average cost per shop-rent. 1)33 11 SO
All Causes ...j
otner hand, the Thames water is very hard,and more Arrangingthe districts in the order of mortality, that
SPEcirico Causes 112G 1142
or less impregnated with organicmatter. vious,from Cholera was lowest in districts
It is ob- which have their Zymotic (or Epidemic, Endemic, and|
therefore, that wherever the water for London water chiefly from the Thames so highas Hammer-
smith Contagious)Diseases \ 179
and its suburbs be obtained,it will have to undergo in the districts which Sforadic Diseases:
and Kew, and highest j
some preparatory processbefore it will be fitfor use, are supplied from the Thames low as Battersea Dropsy,Cancer and other Diseases of
so
uncertain or variable seat 54 62
and it only remains to be determined which plan and the Hungeiford-bridge. The serves
ob- 174
Registrar Tubercular DUs"sci 18? ^ ^ ""
will supplythe purest constant supply of water at :
"
For those unacquainted
"
with the Thames, Diseases of the brain, SpinalMarrow,
the leat cost. The Thames seems to be the most Nerves, and Senses H0
it is necessary to state,that the contents of the
natural and available several Heart and vessels
Blood-
source, and, hence, of the
Diseases of the
schemes have been laid before the publicforobtain-
ing greater part drains, sinks, sewers, and ... M
SO

the requisite supplyfrom one or another part of water-closets

of 2,200,000 people, after sUg- Diseases of the Lungs, and of the other
228
the river ; and, as far as we have been able to judge, nating in the sewers, are poureddaily into itswaters, Organs of Respiration
Diseases of the Stomach, Liver, and
from the pamphletsissued by the various proposers, which bpread over more than 2000 acres in the 64
other Or"{ans of Dgestion
the planof the " MetropolitanWater SupplvCom- midst of the inhabited parts, and are incessantlyDiseases of the Kidneys, "c. 8
for taking from the stream at Maple-Dur-
it agitatedby the tides, which ascend to Teddington, Childbirth, Diseases of the Uterus, "c. IJ
Koy,"
m, between Panbourne and Reading, has many and carry the matters in the thickestwaters below
Rheumatism. Disease, of the Bones.
Joints 8ce.
advantages over the other. London-bridge, and a mile and a half above Bat- Diseases of the Slcln, Cellular Tissue,
The Koyal Polytechnic Institution." We twice a day. The largeChelsea "c 1
the endeavours of the
tersea-bridge,
notice,with much satisfaction, above the pointat Malformations
2

of this Institutionat to in-

timestruct
sewers open into the fThames 23
Managed the
same Premature Birth and Debility
and amuse. The lecturesof Dr. Bachoffher, which the water is taken up from the Thames by Atrophy 13
the Southwaik and Chelsea Water 72
" On
the Philosophyof ScientificRecreation,"are Companies; but Age 2:
the suction-pipe of the Chelsea Company extends Sudden
worthy of the most honourable mention,as an at- tempt
Vi "leuce. Privation. Cold, and Intem
to redeem pure science out of the hands of the into the centre of the stream. The water, it is said, 43
peraoce
"conjurer." is filtered
by all the Thames Water Companies." Causes not Specified 7
 30 THE MEDICAL TIMES.
The foUovlnf !" the number of Deaths occurringfrom i were they,in addition to the weekly papers and TO CORRBSPONDBNT8.
of the more imporUmt ipecialeauses :" discussions,to eombine some of the advantagesof a
Apoplexy 37 Heart 40 club,the attractionwould be almost irresistible.A CItIi."" We "
stronglyluipeet our correspondentlabofin
Bronchitis 108 Hooplug-cough 23
"
reading-room, with the newspapers, journals, the under tome mistake. We doubt if he is,aa he imagines
Cholera......^ 1 Hydrocephalus 40
Childbirth t Tnfluenxa 5 best magazinesand reviews*and the possibility of "himself to be,doubly bleiied. Four of the organs spoken
31 Liver 9 refreshments at moderate charges,would of fall to the lot of no one man. We should advise him
Convulsions...
9
obtaining to
Diarrhoea 8 Lungs constituteadvantages such as would be greatlyap- take the opinion a luq^eon on whose Judgment he can
of
Dropsy 20 Measles ^
38 preciated.
Erysipelas ...
12 Paralysis 46 While the beads of these societies are rely, ^bove all,let him not be led by any false modesty
of their union, it would to seek the aid of quaeks,or he may bitterlyroe his foUy
preparingthe preliminaries .

Avoid a man who advertises as a plague. Depend on it,

be as well if they were to take intoconsideration the
no medical adviser thinks a question whleh eases the
possibility and proprietyof combining these addi- tional
mind of his patientunworthy of an answer.
alterations and improvements.
*' Mr. Ramsbotham."" Press of matter has compelled us to
Appointment. W. O. Markham, Esq.,M.D.,
"

has been elected Physicianto the Western General postpone the consideration of the allegedcase of hydro-
phobia
Dispensary, in the placeof Dr. Day, resigned. tillnext week. Mr. R. must be aware that ifhe
The Iodides of MERcuRY."Of all the mercu-
rial has not vaunted the case, his homceopathiofriends have
and
preparations, of all the remedies of what-
soever
for him, and that in no modest terms. The oase either was
kind, which have been recommended in the or was not one of hydrophobia"if the former the ssaii
treatment of the syphilides, none can approach, in would have died had not Mr. R. Uken chargeof the ease
METEOROLOGY OF THE WEEK. therapeuticvalue, the iodides of mercury. We
would have reeoveied If
-"if the latter, the man assuredly
are indebted to Biett for the introduction of these
he had been left to himself. Either Mr. R. baa covered
valuable remedies in the treatment of the venereal
I I eruptions. This Practitioner at first preferredthe himself with glory, or there has been somewhere a mighty

biniodide, and administered it in pillsof the follow-

ing fuss about nothing.
form: Biniodide of mercury, ten grains; We have not received Dr. Fleetwood ChuiehiU's book on
* 5 I
"

liquorice powder, one drachm ; make sixty pills. the Diseases of Children. We never accept volunteer re-
2

"
^
^ S
S
11 Dose, from two to three per diem. But he soon re-
this preparation for the more
linquished

manageable
received two
; and we of the
have

which,when it comes
in
views

Work tion,
ques-
to hand, will be noticed lo due
S and more efficient proto-iodide of mercury. This is,
s s undoubtedly,one of the most valuable remedies we course.

possess ; ana it is certainly that under the influence We have much pleasurein announcing we shall next week
of which we can almost invariablymodify, if we publish,with an engraving,a case of morbus eozarius
Rain in Inches. the
o e cannot cure eruptions. This agent
syphilitic of six years'standing,in whleh Professor Fergusson's
seems to acquire a aou))le value from the combina-
tion
Amount of Hori-
zontal
^ 2 operationof excision of the head of the femur was sueeesa-
Movement of iodine with mercury. In the great majority
fullyperformed by Dr. Edwin Morris, of Spalding,Lfai-
of the Air. of cases it is borne easilybv the patients, and may
colnshire. It is a matter of great eongratolation to ob-
serve
be continued for a considerable period without
the extension of sound surgicalknowledge In the
^"- causing any inconvenience. Dr* Burgesson Eruplions
"

."
"
^ ^ o/iheFacetHead, and Hands. provinces, and it must be highlygratifying to the London
'80
Hereditary Insanity. Some time a^o the daily
"
College of Surgeons that their country Fellows reflect so
of two homicides com- much credit upon that Institution. In Leeds, aleo, Mr.
papers contained an account mitted

by two young French gentlemen,the brothers Smith, the Senior Surgeon to the Inflrmary, baa lately
*.." fr CO
^ ^ Montesquieu,nt St. Louis, U.S., where they had operatedfor cleft palate, the detailsof whleh ease we alto
justarrived. Two young men were killed by them, trust next week to lay before our readers.
and others severelywounded before they could be
"
Mr. ScatterKOod's" request will be complied with. We
Dilference between secured. Such was the popularexcitement in con- sequence,
the Mean Tempera-
ture that the prisonerswere removed to the
trust frequentlyto hear from him.
9
of the day and
militarybarracks for protection.Their manner at
The commission of a Paris Correspondent has been ex*
the snme day on "
ecuted.
the time showed evident indicationsof insanity, but
an average of I I +
it appears that their condnct during theirprevious "Mr. Chard's" (Wye, near Ashford), ease of congeniUl
7 years.
travels in the United Sutes was perfectlycorrect malpositionof the viscera will be puUbhed as soon aa the
Ditto.
Dew Point. si and proper. Letters have since been received in illustrative engravingcan be piepared.

Mean of
America,addressed to Senators Benton,Winthropp, Our sense of Justicewill induce us most assuredlyto com.
Thermometer.
and Cass, stating that their late father (Count with the request
ply,and that at the earliest opportunity,
Dry.
"
CO
"^
eo
"

"" H Montesquiou) laboured under insanity, and com-

mitted of " a Magittrateof QlouesHershire.**
suicide two years aince,and that theirelder
Mean of e" "" " "
An Unitiated" is entreated, if he values either his health
" "" r brother is now insane in Paris. Evidence such as
Barometer. his purse, to avoid the person to whom he alludes ~a
ass s s this,we presume, must eventuate in the acquittalof or

person we believe to be a member of the Apothecariea'

the unfortunate brothers.
Company, but still a most unmitigatedquack" of whose
f i About Midwifery.
five months ago consider-
able
"

failures we do not hear, and the secret of whose success Is

created in Sheffieldby the pub-
sensation was licitythat " fools rush on where wise men fear to tread."
the extraordinaryconduct or an
given
i f to
**
lago" alludes
of the nameelderlywoman
of Hannah Cu.shforth, We fancy the proposedregulation to which
ot the midwivesof the Sheffield Public Dispen- will affect candidates for the fellowship, and not for the
one sary,
displayedduring the exercise of her vocadon diploma.
In the case of Harriet, the wife of Francis Mappin, We are requested, by a valued correspondent, to inquireof
MEDICAL NEWS.
a fileforger. On the 27th of June, Mrs. Cushforth, our readerR where any information can be obtained re- lative

some time in the afternoon, commenced the critical to the transmission of gases through perforated '

ObitIjary." On the 2nd ult.,Sir David James operationwhich she had undertaken. So unsuccessful plates. Our correspondent has some reason to conclude,

IL Dickson,late Inspector of Hospitals and Fleets. were her efforts, that she separatedthe body of the from experiment!!, that the molecules of different gases
infant from the head, and afterwards made a barbar- ous are of different sizes,and that bearing some relation to
On the 14ili November, at Meerul, E. I.,Dr. Thoi.
use of a common meat-hook as an instrument to the specificgravity of the gas. Perhaps some of our
C. Elliott, 6th Bengal Light Cavalry,aged 5^. On aid her in the completion of the operation.The chemical readers will favour us with a few words on the
the dth inst., at llfracombei Jesse Foot,surgeon, lat" agonisedmother began to sink under the
treatment, subject.
of Jamaica,aged 70. when Mr. Moore, surgeon and druggist, who had
We have ones for all to request, that books for review may
Naval Appointments." John Gil)son,surgeon been fetched by a neighbour,arrived,and speedily be SENT to us through our publishers.
at about six in the evening, that which
superintendent, to the Scindian ; John Cnmpbfll, completed,
the midwife had so unskilfully attempted. Mrs. "Quseso" writes:"'* Do me the favour, at your earlycon- venience,
Surgeon to the Gladiator steam frigate; John llorio, to answer the following query In yourooluma
Mappin afterwards revived, and ultimately recovered. me
(181-9,) Assistant- Surgeon to the Gladiator. John An investigation took place,and the result was that
'
to Correspondents.'A benefit club of 100 members,
Maclcod, M.D. (1847),Surgeon, and Thomas Sfc- the jury found Mrs. Cusliforth guiltyof manslaugliter young and middle-sged,in a healthy district,wishes to
combe in respect of the infant. She was committed to York have a medical man altflched. He is to be paidby a eon-
(1845),Assistant-Surgeon, to the Hermes
fur trial. Before the bill of indictment had been tribution from each member, "ick or well. What do you
steam-sloop. which
presentedto the Grand Jury,[however, the learned think is the minimum sum per head, yearly, a spectable
re-
The Medical Societies of London. There "

Judge, who had looked over the depositions, mated

inti- praetitioner of ^ood standing,(say thirtyyeara
is a rumour abroad of an approaching coalition be-
tween with due re-
to the conductors of the prosecution that he M.R.C.S.,) would be Justifled in accepting, gard
the Westminster Medical Society and the did not think it possible that the evidence would bear to his status and that of his Profession V*
Societyof London, the latterbeingthe oldest Medical out the chargeof manslaughter, inasmuch as it could [This Is a difficult questionto replyto satisfactorily. The
Society In the metropolis, and in possessionof a not be proved that the infant was alive when the matter is almost one of caste,and depending on a variety
valuable library of old medical woiks,some of which midwife undertook the case. His there- of circumstances. Lordship,
We refer it to our readers.] .
that the prosecution should oe aban- doned. "
are not to be found in the library even of the Collegeof lore,advised Mr. McCl ore's" replyto Mr. Chubb and Dr. Miller waa
The hint was at once adopted,and the con- sequence
Surgeons. It is not impossiblethat another Society received too late for Insertion in this week's Journal.
was, that on Thursday Mrs. Cushforth was
may be amalgamated with these two. The junctiondischargedfrom custodyafter wi incarcerition of " A Constant Reader."" Next week. Communication ceived
re-

of these societies will be a decided advantage, and nearlyfivemonths. BedfordTimes. "

too late for replyin the present Number.
 THE MEDICAL TIMES. 31
LEOTVKES. of a littlebrucia,
slass-rod, of itsstrength ; for by takingIfaespecific
OBieiHAL means a strychnia,
or
morphia. If no discolorationtake place, of the liquid, and then referring

minati
cautiously gravity to the table
heat the mixture,and you will then get the rose or alreadyat vour disposal, yon may read oflfthe
LECTVBSS blood-red colour which is so eharacteiistic of nitric amount of diy nitric acid contained in it Or,
ON acid. Lastly, to the third portion add a grainof secondly, the strength of the solution may be esti-
mated
THE CHEMISTRY OF THE POISONS i copper filings, and j^ceover the month of the test- by takinga givenquantl^ of it,diluting it
tube a pieceof paper moistened with a solutionof until it has a density of 1020, or thereabouts, and
OK, OH
starch and iodide of potassium.On applying i t
heat pouring upon a weighedportion of roughIy-pow"
PRACTICAL TOXICOLOGY.
to the liquid, so as to make it boil prettyactively, dered and welUdried marble or carbonate of baryta.
SHOWIirO THE APPLICATIONS OF CHEMISTRY TO nitrous acid and binoxide of nitrogen will ba set By allowing the acid to aot for twenty-four
TUB DISCOVERY OF CRIME. free. These gases will instantly decomposethe hours,occamooally agitatmgit,a portionof the
ByH. LBTHEBT, M.B., Lond: iodideupon the paper, and stain it of a violet brown earthy carbonate will be dissolved.The mixture U
LMtoif r on ChemUtry in the M"dieal College of the London colour. In performing thiiexperiment you are par- now
ticularly to be evaporated to about half its bulk* On
HospitaL to notice that the liquid does not evolve filtering dj^ng
It, the residueof undissolved car- bonate,
any violet-colouredfumes. It is,I hope,hardly and weighingit, you can estimate,by
LECTURE XII. of the diminished weight,
necessary for me to caution you against the em means the amount of freo
Chancten of the Nitrates." Their Solubility in Water."
Actionnpon Alkaline Carbonatei, their Taste. Crystalline
ploymentof impuresulphuric acid; or againto tell acid present; for every 50 grs.of carbonate of lime,
Forms, Teete, fto." 'Delicacyand Fallacies of these you, that the oilof vitriol isto be carefully examined, or 99 ofcarbonate of baryta,so acted on and dissolved,
Tetts.-QuaDtitatWe Determination of Nitric Acid; 1st. by submitting it to the action of every one of these are the representatives of 54 grs. of drynitricacid,
When in a Free State; 2ndly. When Combined." Pe-
tests,before you think of resortingit as a decom-
to posing or of 90 grs. of the ordinary tetrahydrate.
lonxe's Process." Nesblt's Process." Rose's Process."
Tsylor's Proeeta. agent for the nitre. And should it,when it Thirdly, the amount of freenitricacid in a sola*
is thus treated, exhibitthe presence of even a trace tion may be ascertained by saturating itwith re- cently
of nitric acid,it is to be purified by introduciog a ignited carbonate of soda,every 53 grs. oC
At the close of the last Lecture, gentlemen, we
fiuidounce of itinto a fiaskwith ten dropsof liquorwhich wiU exactly neutralise54 of dryaeid.
were occupied in considering the tests for free nitric
ammoniae,and then boiling the mixture fora period of It too often happens, however,that the solutionto
acid. I have now to direct your attention to the ten or fifteen minutes,by which means the sulphuricbe testedcontains other adds besides nitiio; itmay
properties and re-actions of this acid when itexists acid will in most cases be deprived of every trace of even contain thisacid in combination with a base,
is a stateof combination* the impurity in question. and be mixed with various saline and organicsub- stances
Again, it is my duty to remind you, that the ; in which case, itis not possible to estimate
CHARACTERS OP THE NITRATEa re-actions which you have justwitnessed are not the amount of nitric acid presentby any direct
All the neutral salts of nitric acid are freely to the nitrates, mode of analysis, and you willbe compelled
altogether peculiar but that theyare to re-
sort
solublein water ; hence itis that we have not any common to the saltsof allthose acidswhich contain to one or other of the following processes: "

test or re-agent
excepting albumen, which possesses a largeproportion of oxygen. Hence it is that the 1st Pelouze^t Proceu, " ^This process is founded
the property of furnishing a precipitate with a solu-
tion chlorates, the bromates,and]the iodates will, when on a propertywhich nitric acid possesses of con- verting
of aqua fortis. of iron into a persalt;
theyare treated like a nitrate, deflagrate upon red a protosalt and, by
Boiledwith carbonate of potash, allthe nitrates, hot charcoal ; that theywill decomposeand redden usinga ferruginous of a givenstrength, and
liquor
excepting those of soda and ammonia, are easily composed,
de-
brucia,strychnia, and morphia; and that they will then testing it with a standard solutionof perrnan-
and converted into nitre and an insoluble decolorise solution of indigo.It has ganateof potash, itis easy to determine how much
a of sulphate
carbonateof the complementarybase. The two been remarked,moreover, that these salts, whei^they of the protosalt has been thus acted upon, and hence
nitrates, with which you oughtto be very familiar,are re-acted acid and copper, will to deduce the amount of nitric acid present. In
upon by sulphuric
tie thoseof potashand soda. They are known by evolve gases which have the power of decomposingperforming the analysis, to proceed thns i
you are
their cooling saline taste,and by their formingvery and
discolouring a mixture of starch and iodide of take a known weight, say 10 grs., of pure iron,
cluracteristic crystals when their solutionsare eva- porated
wire,) and introduce itinto a flaskwith
potassium ; and, lastly, it has been noticed that the (harpsichord
on a slip of glass; forsaltpetre crystallizes in like the nitrates, have the faculty fluid ounce of concentrated muriatic acidt
iodates, of com- one
long- flutedor six-sidedneedles, which do not undergo municating an olive-brown tint to a solution of closing the mouth of the vesselwith a cork,pierced
any change on being exposed to a damp atmosphere, green vitrioL How, therefore, you will say, are with a small hole for the escape of hydrogengae.
whilethe correroonding salt of soda assumes the such important sources of fallacy to be avoided t Apply a moderate heat to the flask, and, at the m"^
form ofminute rhombs,or of rhombic prisms, which will answer this question by showingyou how tb^ ment when the iron is dissolved, introduce 5 grs. of
are very deliquescent Both of these salts displayare to be detected. the siupected nitrate. Immediately cloeethe vessel
thephenomenonof deflagration when theyare thrown In the firstplace, the chloratesand the bromates with the perforated oork,and quickly raisethe tem^
OQ red-hot carbonaceous matter; and if they are of the the
of the alkaliesare instantly rendered of a blood-red perature liquid to boilmgpoint The solution
acidulatedwith sulphuric acid, and tested in the colour,when they are broughtinto contact with thus treatedaoquires 4 deeip brown colour, and dense
manner referred to in the last Lecture,theyexhibit acid. Moreover, they effisrveseevapours of hydrochloric acid,mixed with binoxide
strong sulphuric
allthe re -actions which characterisethe presence of when
they are thus treated,and evolve gases by of nitrogen, gushforthfrom the orificein the eoik.
freenitricacid which they are easilyknown. The chlorates, ample, The liquor
for ex- soon losesits olive-brown eokmr, and,
Such is the extreme delicacy of these tests,that evolve the fumes of chlorineand hypochlo-afterboiling for fiveor six minutes,itbecomes yel- low,
a quarterof a grainof saltpetre, containing onlythe rous acid two gases which are to be recognised and somewhat transparent. When thisappear-
"

by ance
13-lOOths of a grainof dry nitric acid,is amply theirgreenish-yellow has taken place, the liquor, with the
colour,by theirodour of chlo^ together
raflicient for the manifestation of all the re-actions ride of lime, and litmus washings of the flask, to be pouredout into a
by their faculty of bleaching are
to which I have just alluded. We will,in fact, paper ; while the bromates,when thus acted on, set vessel containing half a pintof cold,recently boiled,
proceed to demonstrate the truth of this. free the deepred vapour of bromine,an elementary distilled and the mixture is to be immediately
water,
Here are 2d-100ths of a grainof powdered body,which has a most tested with a measured quantity of a standard solit*
acrid,unpleasant, and suf-
focating
nitre, of which you are to take about a fourth part; odour. tion of permanganate of potash, the test liqnor
and by carefully droppingit on a pieceof ignited
Secondly, an iodste is known by its evolving the beingadded until the mixture assumes a very pale
coal, you will perceive that it deflagrates, without tint This having been accomplished,
rich violetcoloured funtes of iodine, both when it is rose we
evolving any violet-colouredvapours. have now to calculate from the results, in order to
The remainingthree-fourthsof the saltare to be deflagrated
on red-hot charcoal, and when it is
healed in a tube with copper and sulphuric acid. ascertain the amount of nitricacid present. But,
introduced into a test-tube with 20 dropsof strong before we do this,it is proper that you should be
All these characters will be sure to
pure oil of vitriol, and you will notice that the salt presentthem-
selves
acquainted with the ratioHole of the changeswbieli
quicklydissolves without acquiring a red colour, duringyour inquiries into the nature of the
you have just witnessed.
without exhibiting any sign of effervescence, and suspectednitrate, and, as theyare so very evident On introducing the iron wire into the flask with
without liberating any fumes of chlorine or of bro- mine. and distinctive, you can 'hardlyfail to recognisemuriatic acid,the metal the liquid,
them. decomposes drogen
hy-
To this acid liquor you are to applythe fol- lowing is and an acid solutionof protiv"
gas evolved,
tests :"
Before I leave this part of the subject, I ought,^chlorideof iron is formed. This solutionhas a
greai
Put 10 minims of dilutesulphuric acid into a test- perliaps, to inform you that Professor Penny has for oxygen, so much so that it reacts npon the
affinity
tube,and tint the liquidof a paleblue colour by proposedthe use of nitric acid as a means of distin-
guishingnitricacid of the nitrateand then upon the perman*
means of a little sulphate of indigo, then add a these fallacious salts ; for,according to ganicacid of the test liquor. Now Pelouxe has shown,
couple of dropsof the acid solutionof nitre, and ap-ply this authority, while strong aqua fortisis entirely that one equivalent of nitric acid will react on six
heaL In a few minutes, generally longbefore without action upon the nitrates, yet it decom-
poses acid protochloride of iron, and
equivalents of an
the liquid boils, the blue colour of the indigo will be the chlorates, bromates,and iodates, and causes convert them intothree equivalents of a persalt of
discharged. the liberation of those characteristicvapours of this metal, the change which takes place being
Dilute the remainder of the acid liquor with its chlorine, bromine,and iodine. He states,however,thus represented J 6, FeCl, -I-NOs + 8, HCL -*
own bulk of water, and divide the mixture intothree that the aqua fortis must, in some cases, be boiled 3 Fes Cls + NO2 + 3H0, consequently every 168
equalportions.To one portioncarefully add a drop upon these salts, in order to producethe
necessary parts of metallic iron used and so acted on, re- present
or two of a solutionof protosulphate of iron,and, if changes. 54 partsof dry nitricacid,quantities which
necessary, applyheat,when you will obtain the pe- culiarQUANTITATIVE DETERMINATION OF NITRIC are very nearlyin the proportion of 3 to 1. Jf,
olive brown colour to which I have already ACID. therdbre,a nitratebe added to a solutionwhich con- tains
referred. When a pure solutionof free nitric acid is
sented
pre- a known weightof thismetal in the state of aa
Into a second portionof the liq'oid, introduce^ by to you, nothing is more easy than the deter- acid protochloride, a certain amount of rc^a^on
No. .538,Vol. XXL
 32 THE MEDICAL TIMES.
takes place, and it is onlyneceaary to have some hundred grainsof clean granulated zinc,cover the ORZaZNAIi OONTRIBUnOMB.
the quantity of zinc with water, and treat the mixture from time to "
sure and easy method of ascertaining
iron unacted on in order to know what proportion of time with a few drops of hydrochloric acid, until ON THE

the metal has been sur-oxydized by the nitratein nearly the whole of tiie zinc is dissolved, then set TREATMENT OF ACUTE PERICARDITIS j

question, and thence to deduce the proportion of dry the liquor aside so that it may brighten and become ESPECIALLY ON THE
acid. Iliis problem has been happily settledby clear. In perfoflbing this part^of the experiment, EFFECTS OF BLOOD-LETTING AND
the researches of Margarite, who discorered that yon are to take care that the temperatureof the IN THAT DISEASE.
MERCURY
permanganate of potash, the test liquor employed,liquid does not rise, and that the efl!ervescence sioned
occa-
By JOHN TATLOR, M.D.,
18 decolorised so longas any protosalt of iron exists by the acid goes on slowly and continuously,
Fellow of the Royal College Physidans In London, and
of
in the solutionto which it is added ; and if the test for if the re-action is permitted to be too violent,
Phjiieianto the Hoddersfield Inflrmary. Fonnerly Pro- fessor

liquor is made of a standard strength, so that, for some of the nitrogen will escape either as binoxide, of CltnicalMedicine In the UniversityCollege,
London.
"sample,50 parts of it,as measured by a cruet, or as nitrous acid.
representone of iron,it is easy to calculate, from The liquid havingbecome transparent, is to be
the quantity ofthe test liquor used in the experiment, pouredoff from the undissolved zinc,and distilled In tiieyear 1845,1 submitted to the RoyalMedical
how much of the protosalt of this metal remains with about half an ounce of powderedquicklime ; and Cbirurgical Society of London, a paper upon the
unacted allthe anmionia g^enerated by the Causes of Pericarditis, which was published in the
upon after the operation of the suspectedby which means
xutrate. To illustrate this, we willgo back to our ex- perimentaction of the nascent hydrogenon the nitric acid 28tiiVolume of theirTransactions. That paper was
We have here used lOgrs. of iron and 5 grs. will be set free, and willpass over into the receiver,the resultof an analysis of allthe cases of pericar-ditis
of a suspected nitrate, and it took 200 measures of which is to be keptvery cold duringthe process of which had fiiUenunder my own observatioii up
the test liquor to communicate a pinkishhue to the distillation. to the time when it was written. In the present
diluted solution, that is to superoxydize the residual The ammoniacal liquor thus obtained is now to communication I propose to make some obaerva-
protosalt. Now as the 200 measures of the test be submitted to a careful examination, in order to tions upon the treatment of the same disease,de- duced
uqnor represent 4 grainsof unchanged iron,it is discover the amount of free ammonia contained in fh)m an analysis of the same cases, together
elear that the other 6 grains of thismetal must have it,and hence to calculate the proportion of nitric witiione or two others which have since oceurred to
been acted on by the questionable salt; and, there- acid originally acted on. For this purpose Mr. me.
Ibre,to judge from our equation, these 6 grains of Nesbit makes use of a iolution of litmus, and a neu-
tralising The cases analysedare fortyin number. They
iron,as protochloride of iron, are the representatives acid of known strength.He employs were published in the Volumes of the Inmeet for the
cf 2 grams of diy nitric acid or of 3*4 gr. of the dilute sulphuric acid of specific gravity1032*7, years 1845 and 1846. In order to facilitatethe
commercial tetrahydrate. 1000 grains of which contain 40 of sulphuric acid, verificationof any statement made in the coarse of
In performing the experiment which you have and are, therefore,capable of neutralising 17 the following investigation, I have very frequentiy
justwitnessed, i t is necessary that the re-action be- grains ammonia, a quantity
o f which represents 54 given referencesto the individual cases, and, when- ever
tweuo the acid protochloride of iron and the suspected grainsof dry nitricacid,or 90 grainsof the ordi- nary I have done so the Number of the case will be
nitrate should take place in the absence of atmo- spheric tetrahydrate. found to correspond with the Number attached to it
air i in fact, ifthe airgains access to the flask, Ag^n, the proportion of ammonia contained in 1in the publication referredto.
it will act rapidly on the binoxide of azote, and, by the liquid, may also be estimated prettyaccurately, Two cases (33and 34) I exclude from all consi- deration,
formingnitrous acid,render the liquid capableof by precipitating itwith a cold saturated solution qf because I never saw the patients during
peroxydizing a new quantityof iron. Hence the bichlorideof mercury. The white precipitate thus theirlife-time, and have no accurate history of their
of nitricacid present would be exaggerated
proportion ; formed is a compound of mercury, chlorine,and illness.
Dttt it is easy to guard against this inconvenience,ammonia, and, when it is dried in a water bath, Mortality, ^Of the 38 remainingpatients, 17
for,when the iron has disappeared the acid,the every 136 grainsof it are the equivalent
in of 17 of recovered and 21 died.
globe is filledwith hydrc^n and the vapour of ammonia, and, consequently, of the before-named In 9 at least of the fatal cases, the pericarditis
hydrochloric acid. By takingadvantageof this quantities of dry and liquid nitric acid. had little or nothingto do with the deatn ; the dis- ease
circumstance, the cork may be removed, and the Mr. Nesbit's process appears to be applicable beingin several very insignificant (Nos.7, 28,
nitrate introduced without admittingany serious to the analysis of the alkaline and alkalino-earthy 39),and in otiiersit was cured (27,30, 86). All
proportion of atmospheric air; and, by rapidly ing
bring- nitrates, and it does not appear that the results of these 9 patients died of other seriousdiseases. One
the liquid to a state of ebullition, the flask be- comesthe process are at allinterferedwith by the presence of haemorrhage into the brain (27),several of ooma
filledwith the
vapours of muriatic acid and of the conunon kinds of salinematter ; but, for all (26,31, 36),two of great organicdisease of the
binoxide of nitrogen, which are evolved in such this, I am bound to tellyou that the process is not heart;"c. (24,39),and the rest of other diseases.
quantity that theyrush out throughthe openingin altogether freefrom objection, inasmuch as a portion Upon further careful examination,I have found
the cork,and so preventthe access of atmospheric of the nitratewill sometimes escape decomposition, several important features, in which the two classes
oxygen. or be evolved as binoxide of nitrogen ; so againit is of patients, those recovering and those dying,difier
**
1 may add," says Pelouze,"that the influenceof almost impossible to preventa portion of the ammo-
nia from each other.
the air may not be really dreaded until at the mo- ment from beinglost duringthe distillation, both of 1. Form qftheDisease," AM the patients who re-
when the nitrate beginsto re-act ; for I am which circumstances tend to lower the value of the covered had pericarditis in connexion with acute
certain," continues this author," of the exactness of nitric acid in the saltmade use o" On the other rheumatism, and none of them were ascertamed to
Margarite's assertion, namely,that in the centre of hand, it is justpossible that a salt of ammonia may have disease of the kidnevs.
a strongly acid liquid, the iron,even when free,is existin the questionable matters, and if so, itslibe- ration Ofthe patients who died,two-thirds'were known
peroxydized in the air,so slowlyand with so much willlead you to over-estimate the proportion to have disease of the kidneys, and of the rest there
difliculty, as not to interferein a sensiblemanner of nitricacid. is no sufiicientinformation respecting the state of
with the analysis." Other processes have been proposed titativethe kidneys.On the other hand, three onlyhad
for the quan-
The nitratesmay be employedeitherin a state of determination of this acid in saline sub- stances; acute rheumatism,and one the rheumatic diauesis.
solution in water, or in the solid form ; but it ap- pears, thus,Rose recommends that the alkaline All those cases which were complicated with renal
that thismode of estimating the amount of nitratesshould be distilledto dryness with dilute disease were fatal, whereas four onlyof the rheuma- tic
nitric acid in any questionable matter, is most ap- plicablesulphuric acid,and the distilledproductsaturated cases were fatal.
when that matter is presented to
you in the with hydrate of baryta,in order to estimate the My cases, however, would not warrant the infer- ence
latter condition; and I may state,that the process quantity of free acid present;but it is needless to that all cases of renal pericarditis are fatal.
suggestedby Pelouze takes precedence of every state that the presence of muriates,acetates,and Some of the patients did not die of the pericarditis,
other mode of analysis as a correct means of esti-
matingsome other salts, will entirely vitiatethe results. but of other serious affectionsoften found in con- nexion

the value of the several alkaline nitrates, Again,Mr. Taylor tells us to convert the nitric with disease of the kidneys.Neither did
whether those nitratesbe required for chemical,for acid,contained in a measured quantity of the liquid, the four patients who had rheumatism die of the
pyrotechnic, or for agricultural purposes. to nitre, and then to convert this nitre into sulphatepericarditis alone. In one (No.7) the pericarditis
2. Netbifs Proeest. This process dependson a of potash,
" from the weightof which, after ignition, was trifiing, and had nothing to do with the result
iacultywhich nascent hydrc^n possesses, of de- composing
the amount of nitricacid is to be calculated. But, In a second,(No.2,)there was also severe ditis
endocar-
nitric acid,and converting its nitrogenin proposing this process, no regardwhatever has and pleuritis, and the inflammation of the pe- ricardium
into ammonia ; for it appears, that when aqua fortis been paid to the circumstance that nitric acid may appeared t o have been cured. In a third,

or a nitrateis introduced into a liquid, from which exist in the liquid in conjunction with many other (No.1,)there was also pleuro-pneumonia, and the
hydrogen gas is beingslowly evolved,8 equivalents saltsor salt-forming substances, and hence the pro- cess kidneysand urine were not examined, and may,
of thisgas will re-act on 1 equivalent of nitricacid, is totally inapplicable to the ordinarysub- jects therefore,have been diseased. In the fourth,
and will form 5 equivdents water of and 1 of am- monia"thus of inquiry. Altogether, it reads very like Mrs. (No.19,)there was also severe endocarditis, ritis,
pleu-
NOs + 8 H " NHs + 5 HO. Now, Glass's receipt about catching the hare and then and pneumonia. The kidneys, likewise,were
althoughthe facts connected with these changes cookingit. found to be larger than natural. These facts have
have been longsince known, and carefully studied With this I finish the chemistry of nitric acid, suggested to my mind the following question, which
by Kuhlman, Dumas, Playfair, and others, yet they and, in my next lecture, I shallproceed to applythe I submit to be answered by any persons possessed
have onlylately been made availableto the purposes facts which we have elicited to the discovery of of the required facts, vis.
" : Is rheumatic ditis
pericar-
in question. This has been effected by Mr. Nesbit, nitric acid in the tissuesand fiuids of the animal ever fatal,when occurring in a subject viously
pre-
whose I shall, with some little modification,body. free from renal disease,and otherwise
process
exhibit to you. Take a givenquantity, In Lecture XI., at page 501, col. 1, healthy, and when it is not complicated in itscourse
now say five Erratum. "

grains of the suspected nitrate, dissolveit in a little line 39, for " with a few grainsqf sulphur,'* read,a with any other important affection? All my observ- ations
wat"r,and introduce itinto a flask with about one few grainsqf sulphate of ammonia. support a negativeanswer to this inqmry;
 34 THE MEDICAL TIMES.
pmr,hy comparingthe cases in which it was em- cases bled within the firstfour days,with that of before the pericarditis began. This did not prevent
with those in which itsuse
early,
plojred was longer those bled afterthis period. the accession of the disease, but perhapsshortened
deferred. Those bled within the firstfour dayshad an aver- age its course, for the duration was 13 days ohly,al- though
The duration of pezioarditia can be detenninedt in duration of about 13 1- 5th days;or, including the next bleeding was not copious, and not
i"ost insttfncesi with more certainty than that of the two cases bled immediately before the disease before the 5th day of the disease.
most diseases,by means of the physical signs.appeared,13f days. The average duration of Casell was bled also before the pericarditis came,
When soughtfor,either a Motion sound, or the those bled later ^ 21 2-3rd days. The duration but with a longerinterval (11 days) between.
signs liquideffiudon,
of will be found, except in a of the cases in which bleeding was employedafterthe Leeches onlywere employedafter.Hence, perhaps,
very small number of oases. The eommenetment of firstfour days, was greater,by one-ha^, than that of the longer duration 16 days.
"

the disease, in my cases, has sereral times been those bled before tJ^s period. Case 23 was bled to 12oz.,three daysbefore the
dated earlierthan die occurrence of a frictionsound, This difierenceof duration cannot fairly be as-cribed pericarditis appeared, and lost lOoz. more blood on
when the generaland local83rmptomswere present, to any important difierencein the other cir- the 1st and on the 4th day of the disease.The duration
and there had been no oppoitnnity of examining eumstances of the eases. The mean age of the was at least 20 days. It may have been longer, in
the heart In two cases a slight Motion sound con- tinued patients bled early, was somewhat lessthan that ^ consequence of the previously impairedheuth of
for some time, after all pyrexia, and every those bled later;the former being19^ years; the thispatient, who was the subject of phthisis.
other symptom of the inflammation had disappeared. latter23 years. The age of both classesis favour- able, Tne infiammation was not stopped at once
b^
In respectto the efieetsof treatment, these cases and the difierence is, probably, not importantbleeding in any case, however earlyor copiously it
have been regarded as cured,from the time when all at this periodof life, and would be at least com- pensated might be employed. In several cases, however,it
the other symptoms oeaaed, and notwithstanding the by the greaterseverity of the disease,and appeared t o be suspended f or some days; and it is
continuance of the trifling morbid sound justre- ferred of the complicating afiections, in the cases bled early.remarkable that,in each of these cases, local bleed- ing
to. All the patients bled late were salivated, and the onlyhad been employed,and that not to a great
In the following Table, the oases are classed ac- cording treatment of the two classes, in other respects, was amount.
to the day of the disease on which the not materially difierent. In Case 10, the disease was suspended for three
patients were bled. The fatal cases are not in- cluded.The cases bled early, copiously, and repeatedly, daysimmediately afterthe lossof 10 oz. of blood by
The columns of figures in each day'scom- partment other things beingalike,ran a shorter course than cuppmg, on the second day of the disease, and be-
fore
proceeding from leftto right, indicate: " those in the opposite circumstanoes.(a) the gums were tender.
1. The number of the case. 2. The duration of Gate 8 occurred in a young* subject, very robust ; In Case 15, the patient was cuppedto 8 oz. the
the disease in da^ 8. The number of bleedings the disease was intense and uncomplicated. Bleed- daybefore the pericarditis
ing appeared.On the first
employed. This includes venesection and cupping. was employedthe firstday ; 48oz. of blood were day the disease was suspended for three days. The
4. The number of ounces of blood abstracted. 6:ihe drawn at 4 bleedings, besides the application 60 suspension
of occurred before the gums were tender.
number of leeches applied. leeches. Salivation waa produced early.The dura- tion In Case 12, the disease was suspendedfor about
was only10 days. nine days, beginningon the firstday, after the ap-
plication
Bled on 1st Day. Bled on 4th Day.
Case 8 was supposedto be pericarditis, ring
occur- of 16 leeches,and before the gums were
t 10 4 46 50 6 17(8)4 62 -

4 1 24 aNo.
in a patient whose pericardium was previously sore.
18 20 18 20
12 adherent. The diagnosis, therefore, from the ab- sence In Case 21 (belonging to class 2),the disease was
5(1) 28
14 16 2 16 - Bled on 5th Day. of physical signs,is more uncertain. The perhapssuspendedfor 23 days. The suspension
"17 16 18 " "9 24 346- duration was 4 days only. Thirty-six ounces of occurred on the first or second day aftersix leeches
8(2) 4 8 36-- blood were drawn, at 3 bleedings, on the first8 were applied.When the frictionsound returned it
"16 11 8 28 " Bled on 8th Day. successive days. continued for 18 days.
5 24(4)5 74 "
CUue 16. The duration was
"
about 11 days,but The cases do not furnish the means of a satisfac-
tory
Bled on 2Dd Day. the duration of Mction sound only7 or 8 days. of the infiuence upon the duration
comparison
10 10 8 26 " Bled on 10th Day.
Twenty-eight ounces of blood were taken by 3 early of the disease, exercised on the one hand by vene-
Ij 20 S4 "18 17 1 4 -

bleedings. sectibn or cupping,and on the other hand by

The following were bled h"/bn the pericarditisCaae 10. Duration 10 days.Bleeding"
on second leeches. Several cases were treated chiefly by
day to lOos.,and on 7th day to 8oz. On the 11th leeches. In Case 12, the disease, we have seen, was
No. 15d" Duration 18 days,c c. to 8oi.,daybe- fore; after the of
day(t. e., the day after the pericarditis ceased) a
other
n- suspended for nine days application
V. s. to 10 oz. 5 daysafter, 20 leeches.
V. s. to 8oz. leeches. On its return, 10 more leeches were plied,
ap-
No. 2L" Duration 20 days; v. s. 3 daysbeforeto
Ctue 9 may be usefully c ontrasted with Coie 3. and the disease continued onlyfive daysmore.
U OS. ; c. c. 1st day, 4ch day,each to 10 os.
No. 11." Durauon 16 days, v.s. 11 daysbefore to
Both were bled fr"e1y, almost equally so ; both cases In Case 13, the patient was young
"

aged15 the
"

16 OS., 8 leeches 6 daysbefore,and 8 leeches in 2 were fireefrom complications ; but in this one the disease not much complicated. Blood was taken
daysafter. bleeding beganon the 1st day, in the other on the by leeches only; but, althoughthe treatment was

(1.)The pericarditis was suspendedin thisease 5th. The duration of the former was 10,and of the begun on the second day, the disease continued 20
during9 or lO days. Its duration was 5 days from latter24 days. days, whereas the duration of Case 10, in which
itsreturn,or 17 daysfrom itsfirstappearance. Case 5 may likewise be contrasted with Case 3. cuppingand venesection were used, beginning also
(2) This case maif have been one of intercostal The bleeding was more copious, 74os. of blood having on the second day,was onlyten days. In the two
rheumatism merely. been abstractedin the firsttwo daysof treatment The cases in which the treatment was begun on the 4th
(3.) The patientappeared to be convalescent on
firstbleeding, the 8th day. The day (6,20),one was bled copiously and generally,
the l/th day; but a slight Mction sound continued
however,was on

until the 82ud day. duration was at least 24 days,and, probably, 32, the other by leeches only. The duration was nearly
exclusive of a slight f riction sound for month the same in each. The patient b led with leeches,
(4) The patient appeared to be convalescent on a

the 24th day ; but a littleMction sound continued longer. however, was ansemic,and would prpbablybe as
til]abouth the60th day. Case 18 probably ran the same course as if no much prostrated by the local as the other patient
" These
cases were less severe than the rest. bleedinghad been employed,seeingthat 4oz. of was by the general bleeding.
The medbm duraUon of the cases bled on the blood onlywere taken,and that on the 10th day. The Class 2. The cases in thisclasshavingall proved
"

duration of the disease was 17 days. The disease was fatal, do not furnish us with the means of ascertain-
ing
lat daywas 11, Z4^ days, i f
(or, Case 8 be excluded mild.
on account of its un-
certain
the effectof bleeding upon their duration. Nor
diagnosis 18 "
Case 15." The patient lost 8oz. of blood the day do theyenable us to compare the relativeduration
days.IfCases 15aDd28 of the cases in the two classes.
be added, because of the (a)M. Louis infersthat,in his cases, the influence In Case 21, treated by leeches only, the friction
bleedine justb^fitre the of bleeding was not more marked in the circum- stances sound continued for 18 days after admission,and
pericarditis "
14 days.) described than in the apposite ones.* ceased before the patient's death.
|2ndday 15 "
.. (If Case 11 from those Of the two seriesof cases of pneumonia analysed In Case 27, 20 oz. of blood were drawn on the 1st
bled before the peri- carditis by him, however, it appears that,in the firstseries,or 2nd
day,44 oz. within the 1st three days,and
be added to the average duration of those bled within the first 68 continued 28
oz. in the whole. The pericarditis
these,the average re- mains four days, was 17 days,the average age being 33 years.
it appeared then to be cured, but the patient
about the same) The average duration of those bled laterwas 20 days, days;
4th day- 17* and the average age 36 years. died of disease of the brain. The duration of this
..

5thday 24 "
..
-^ In the second series of cases, the average duration case was much longer than that of any case in
8thday-24 of the cases in corresponding circumstances, was
Class 1 treated equallyearly.This case, together
..

lOthday-17 .. (Here was 1 case only. I5h and 18} days, and the average ages 3^ and 47 with the two following,
" the onlyones in which the
Four 02. of blood were 2-8 Tears. disease assumed a very chronic form," may justify
taken bycupping. This, The duration of the disease was lessin the second the suspicion, that cases accompaniedby renal dis- ease
on the lOth dav,is,pro- bably^ seriesof cases than in the first, although, from the have a disposition to continue longerthan the
equivalent to no more advanced age of the patients, we should have rheumatic cases. This is only what mightbe ex- pected
bleedingr) expectedit to be sreater. The only explanation from the greaterage, and worse health,of the
that occurs to me, of this more favourable result, is
It appears, therefore, from this Table,that the havingrenal pericarditis. It is possible,
Airnished by the fact, that in the cases of the second patients
durationof pericarditis increases, as the number of that the absence of treatment in one, and
between
series, the early bleedingswere more copiousthan in however,
daysincreases, the commencement of the those of the first the late treatment in the other,of the two following
series.
disease and the firstbleeding.The efiectof bleed- ing cases, may have contributed to producetheir chro-
in shortening the disease, will be stillmore evi- I " Becherches sur les Efiets de la ftc nicity.
Saign6e,
dent, by comparingthe medium duxation of the Paris. 1885. P. 31. | Ceus 22." Admitted with pericarditis, of what
 THE MEDICAL TIMES. 35

had been ill3 CASE OF MORBUS COXARIUS OF SIX months; the convulsive movements of his limbs
duration uncertun, but the patient
YEARS' STANDING. very violent He was admitted into the
weeks. Bled to 28 02. in firsttwo daysafteradmis- were

SpaldingDispensary, and underwent a course of

Boo. Died in 11 weeks afteradmission. Bloody EXaSION OF THE HEAD OF THE FEMUB,
in pericardium. treatment for the recovered,
and quite
complaint,
lemm 8UCCESSFULLT PERFORMED-
and afterwardshad several severe epileptic seizures,
Case 38. " Under treatment for bad emphysema. By EDWIN MORRIS, M.D., F.R.C.8,frc.
which, however,ultimately left him ; he is now in
Pericarditis supervened at least11 or 12 weeks be- fore Surgeon to the SpaldingUnion Inflimary,fro.
a deplorable condition, being very much crippled,
death. No treatment Very thick and rough
also and considerably reduced by a constant drain upon
frlsemembranes in pericardium, which was
distendedwith bloodyserum.
his systemthrough fistulous openings communicating
The with the diseasedbone.
8. J^g^t rfBleeding upon the Potn." pain
was relieved by venesection, at once, in 3 cases, (5,
Present State ff the "tm6." The rightthighia
but not by the first, three inches shorterthan the other,and the knee is
8,16;)by a 2nd venesection, and the sole of
inclinedinwards over the left thigh,
inone case (6).
The painwas relieved by cuppingover the heart the foot is turned outwards,the greattoe pointing
to the ground midway between the heel and
infitf cases, (1,8, 10, 14, 23.) No cases are
toes of the sound foot, againstwhich it rests;
mentionedin which this mode of drawingblood did
the heel hangs opposite Uie lower third of the
not relieve the pain. The abstraction of a very
left tibia,and is exactlyseven inches from
smallquantityof blood was sufficientto giverelief.
the ground; the great trochanter projects back-
wards,
In Case 1, four ounces onlywere drawn.
The pain was relieved by the application of and presses firmly againstthe integuments,
as if it would burst through; the distance from the
leeches, in six cases, (1,2, 8, 12, IS, 20.) In
two cases, the pain ceased for a time, at once, on
trochanter to the anteriorinferiorspurious process
of the ilium is five inches ; immediately below and
two soccessive occasions, when leeches were applied.
Inone case (19)leechesfailedto relievethe pain.In behind the trochanter are three fistulousopenings,
whateverway blood was drawn, the reliefof painwas throughwhich carious bone may be felt Consi"
sometimes temporary and sometimes permanent deringthis a favourable case for excisionof the
There sterns no reason head of the femur, I called a oonmltation of my
to believethat any one mode
colleagues at the Dispensary, when itwas decided
ofabstracting blood was more efficaciousthan an- other
that the head of the bome was Itixatedbackwards,
for the reliefof pain. It ought to be re- marked,
and that the carious bone felt through the fistulous
likewise, that the cessation of pain did
openingswas a portion of the head of the femur.
not implythe cessation, nor even the abatement,of
Excision of the head of Uie bone was approvedof.
theinternalinflammation, (Cases},20, 21.)
4. ^feet ofBleeding An examina- Operation^ Nov. 1^, 1849." Having placedthe
upon the Pulse, "

tionof all the cases will justify the general state- boy on bis leftside upon a table,I conunenced by
making an elliptical incision over the greattto-
ment,that no amount or form of bleedingreduced
chanter about six inches in length, and dissected
thefrequency of the pulseuntilthere was other evi-
dence
that the inflammation had decidedly abated. the integuments well back from each side of it I
soon found that the head of the bone was still
THien,as in several cases, the lossof blood was
of within the acetabulum and diseased ; nevertheless,
10 considerableas to produce decided prostration
having thorou^y laid bare the bone, I sawed
thepowers of the system,the pulse rose in frequency,
throughit below the great trochanter, with a stndght
sod againsubsided in proportion as the strength
was restored.
metacarpalsaw, and then tumed the head of the
bone completely out of the socket The ligamentum
6. Necessity of Caution in Venesection, In some "

in very teres was destroyed. Althoughthe capsular ligament

esses of pericarditis, even when occurring
also I
destroyed,experienced some difficulty in
strong and robust men, thece is a great "sposition was
head of the bone from the aoetabulum,
removing the
Id
syncope. In these cases the rapidabstractionof overiap-
owing to]the edges the cotyloid
of cavity
a large quantityof blood might,perhaps, prove sud- the neck of the
denly fatal. This disposition is illustratedby cases pingthe head ; and firmly grasping
3,10, 18, 32. In the last case the pulsewas very femur, I next made an incisionof three inches in
immediately low
be-
imaU,a mere thread,and there was copiousserous lengthover the fistulous openings
tSusioninto the pericardium.There is no neces- and behind the acetabulum, and removed a
of
portion dead bone, which proved to be a piece
isiy connexion,however,between the smallness of
from the head of the thighbone. Having made cer- tain
pulse, tendencyto syncope, and efiltsionof serum.
The two firstof these circumstances may be present that no more necrosed bone remained,that the
acetabulum was in a sound state, and no arteries
without the last,and the last may exist without
either of the first requiredligature, I brought the edges of the
wound together by means of strips of adhesive
The sudden suspension of the heart's action,
plaister, and afterwards placedmy patient in bed
which,when temporary,producessyncope only,is, This drawn by Dr, Westmacott, rfKing's
Engraving, upon his back, and extended both legs,tyingthem
inodier cases, permanent, and is, of course, fatal. shows the condition qf the limb be/ore the
In eithercase, it seems
CoUege, together by means of handkerchief at the knees
especially prone to occur at
operation, and ancles. This position was the most comfort-able
thetime when some sudden movement or changeof
GeorgeHughes,agedeighteen years, of strumous for him. The boy underwMit the operation markably
re-
position is made. In case 19, the patient was turn-
the Union Infirmary, well and with greatfortitude. No anas-
mg upon her back,and immediately expired.These habit, was admitted into of the
9th, 1849. About seven he thetie agent was used. To take half a grain
frctipoint out to us the dangerof sudden changes November years ago
attack of typhusfever,from which he hydrochlorate of morphiA in a salinedraughtim- mediately;
"f posturein pericarditis, and the importance of had a severe
slowly recovered. Six months afterthe attack lefthim very comfortable.
avoiding any position, which (as in case 19) has very
he firstobserved swelling about the right 10 Found that he had lost a considerahle
disturbance of fever, a p.m. "

"Iready been found to producemuch of a

of thecirculationor respiration. hip,which was very painful and inflismed: poultices quantityof blood, but by pressure by means
the abscess gave linen pad and bandage, I completely suppressed it
The following facts, relating to other inflamma-
tions, were applied, and, aftera few days,
^

occurring in the course of pericarditis, deserve, way, and discharged a quantityof matter ; the hip To have fever diet
that he was unable to 18th. Has passeda comfortable night; no further
to be recorded here, in order to show that and thighwere so painful, "

jeihaps, stand upon his leg, or walk with it;ofiensivematter hasmorrhi^ firom the wound; pulse120; feverish
nee venesectiondoes not alwaysprevent the subse- quent four
of invarious continued to drain through a fistulous o pening fortwo and thirs^; to take a saline draughtevery
supervention inflaihmation organs.
a grain of opium at bed- time
Plenro- pneumonia came on after pericarditis had years, duringwhich time the legbecame graduallyhours,ana a pill containing
oessed,after venesection to 24 oz., leeches, and shortened, and the knee projected somewhat over the ; an aperient draughtto be givenearlyin the
nlivation.(Case4.) leftthigh; small portions of bone occasionally came morning.
Pleuro-pneumonia came on the 9th day of the away ; the discharge began to lessen in quantity ; 14th.^ " Had a goodnight; the bowels have been
and con- discharge firom
pericarditis, the second day of the treatment,and the painabated,and the abscesshealed up, tinued well relieved; there is a sanguineous
"ftertwo venesections. (Case5.) well for two years, leaving permanent the wound; the limb feelseasy.
a

shortening of the leg he unable to bear his bowels

Pleuritis came on the 8th day of the pericarditis, ; was
15th. Sleptwell during
"
the night; lieved;
re-

weightupon it,and was obliged to walk about upon

afterthree venesections, and whilst the patient was to continue the saline draughtsand the
nhvated. (Case23. See also Case 2.) crutches. In December, 1847, he began to have
opiate pillat bed-time.
Acute Endocarditisappeared on the 1 1th day, after painabout the hipagain,accompaniedwith swell- ing,
16th. Passed another good night; removed the
and, after about a fortnight's suffering, it "

two bleedings and salivation. (Case 10. See also from the wound, a greatportion of which
Csacs2, 14, 20.) broke,and discharged about half a pintof matter ; dressings
the adhesive inflammation.
at the end of the the discharge has continued more or lessever since ; is united by
Erysipelas of the face supervened
the febrilesymptoms
pericarditis, and afterthe lossof 88 oz. of blood, and his generalhealth began to fail; he became ema- [ 17th and 18th.^Domgwell,
; he had an much less;wound discharges a thick,clear pus,
two salivations. (Case27.) ciated,and had profuseperspirations
Iattack of chorea, which continued during several {and is rapidly f illing with healthy granulations ; a
[To be eontlnued*]
 36 THE MEDICAL TIMES.
linseed poultice to be applied; and to take two thinks it commences firstin the cartilages ; Sir A. described, a pitiable
**
object,harassed by pain
glasses of portwine daily. Caoper in the synovial membrane ; but this is of and worn down by slow and wastinghectic ;" in*
December Ist "
Up to thisdate the boy has gressed
pro- little importance as to where the disease begins,deed, from the description givenof the girl,none
most favourably, having had no drawback ; inasmuch as the treatment would be precisely the but such an enterprising surgeon as Mr Cotton
the wound is nearly filledup with gpranulations, and same. The progress of the disease is as follows: would have had the courage to have removed the
the discharge is much lessin quantity, so as onlyto we have firstinflammation about the joint:an head of the thighbone from its unnatural position,
requiretwo poultices duringthe day ; to continue abscess forms,which aftera time gives way ; ulcera-
tion in so apparently hopeless a case. The case is unique
the wine, and to have four ounces of meat daily "
of the cartilages takes place ; the capsular ment in its way ; and from the severity
liga- of the symptoms,
with milk nightand morning. The hip is quite is destroyed, together with the ligamentum caused by the irritationof the carious head of the
free from pain; the boy is in excellentspirits, and teres ; and lastly, the globular head of the femur femur in itsabnormal position, makes it a fidr test
his appetite is very good; he is very desirous of becomes diseased ; the action of the muscles produce as regardsthe propriety of the operation in these
sitting up. luxation of the bone,and the displacement rally diseases. I am
is gene- fullyacquainted with Professor
7tiL Continu'esimproving
"
; very little discharge ; upon the dorsum ilii; sinuses communicate Syme's objections to this operation. With due defer-ence,
to discontinue the poultices, and dress with simple with the diseased bone,throughwhich an ofiensive however,to the learned Professor, I think that
cerate ; he sat up to-day half an hour for the first dischargeescapes, with occasionally piecesof his conclusions are rather premature. The case
time. carious bone; hectic fever sets in; there is above narrated, together with those of Professor Fer- gusson,
20th. Going on remarkablywell; sits up all great constitutional disturbance; the
"
system will go far to convince the Profession of the
day,and is able to walk about the infirmary with gradually givesway, imtil death terminates the safetyof the operation, as well as to set aside the
crutches;the wound is healed over, excepta portionpainfulscene, and the surgeon has to regret erroneous views propagated by Professor Syxne,in
about the size of half-a-crown ; very little dis- charge, that the resources of his art did not enable him reference to a proceeding with which he hai himself
and only requires dressingonce a-day; to effecta cure. I am happy to bear testimonyhad no practical acquaintance.
anpetite continues good; he now takes half a pintof to the fact, that we are now in a position to hold out Since the last report, I have been "ivoured with a
ale daOy,instead of the wine; has discontinued the to the unfortunate sufierers a chance of their com- plete visitfrom Mr. Henry Smith, from London,who has
opiate some time since ; there is not the leastpain recovery from this truly formidable disease, by carefully inspectedthe case, and it is his opinion,
about the hip,and can bear to press his foot
upon an operation which may be effectedwith expedition
takinginto consideration the shortness of the time
the ground. and perfectsafety.It is advisable, that the disease since which the and the
operation was performed,
Jmntary2, 1850." Progressing most favourably, should be so far advanced,that dislocationof the condition which the patient
deplorable waa viously
pre-
wound nearlywell,the cicatrix is firm,and free head of the femur should have taken placebefore the most satiafitetoxj
in,that it is altogether
fnm pain; tiiereis great fiicHity of motion at the any attemptis made to remove it; indeed,it is the and of those hithertorecorded.
interesting
hiD-joint, as he can move the thighmost freely in excessive irritationcaused by the presence of the
all directions; when standing upright, the heel is ex- actly head of the bone in its abnormal position, coupled
four inches and three quartersfrom the with the weakened state of the patient by the ex- haustingA DESCRIPTION OF THE APPARATUS
ground; he is much stouter than he was, and as he discharge, that renders surgical interference FOR EMPLOYING THE MECHANICAL
has expressed a wish to return home, he will be dis- charged justiflable ; nevertheless, it does not follow that the LEECHES.
from the infirmary in a few days. In con- trasting operation would not be proper or advisable even By J. J. TWEED, Esq.,Snrgson,
his present condition with that prior to the when the bone is stillwithin the acetabulum. The
operation, the advantages gainedare the following, case I have justdetailedbears me out in this asser- tion, Every medical man, in the course of practici^
"IS., a perfect freedom from exhausting as well as one must have experienced the disadvantages, as well as
discharge, operated upon by Professor Fer- gusson.
hectic lever, and excruciating pain; and, instead of (a) In both cases, an error in diagnosis was the advantages, of applyingthe living leech. Not
a fixedand crippled state of the limb,a straight leg committed, but in neither instance had we to regret to mention, in the first place, t he trouble and diffi-
culty
and perfect pliability at the hip. the operation, as the cariousbone was effectually moved,
re- sometimes experienced in making them ad- here
Ducripiion and Paihologieal Condition of the Head and the acetabulum and pelvis free from dis- ease. to the surface, the uncertainty attending the
efiheThighBone removed. The pieceof bone ex-
" cised I do not, however,advise the operation, im- quantity of blood which may fioi^from the oriflceis
measures exactlytwo inches and a quarter, less we are tolerably certain the bone is dislocated, also a greatobjection ; in one case, perhaps, being
from the upper extremity of the greattrochanter to or that it is still in situ with the greattrochanter and exceedmglydeficient, amountingto a mere nothing;
the edgeof sectionbelow the neck of the bone which, neck in a carious state only. Then, under such cir- in another,as is frequently
cumstances, the case in children, being
;
instead of formingan obtuse angle with its body, we should be justifled in cutting down very profuse and indefinite, so much so, as to turn
runs in a straight linefrom the trochanter to itshead. upon and removingthe great trochanter and neck the scale unfavourably for our littlepatient.We
The head of the bone has lost itsglobular shape;is of the femur. The shortening of the limb, where cannot possibly measure the quantity of blood lost,
much flattened and spreadout ; the whole of the the head of the bone is stillwithin the socket,is nor order a definite quantityto be drawn, as by
cartilage is gone from the articulating surface, upon accounted for by the neck of the femur becoming bleeding
and cupping,but prescribeso many
which are four carious cavities; there is also a softened from disease, the greattrochanter is forced leeches to be applied, and ten chances to one, we are
carious cavity upon the upper and anteriorsurface upwards,and the neck, instead of formingan ob- tuse not^ disappointed in the result. Instances must
cf the trochanter; the neck of the bone is firm and angle, is in a straight line with the greattrochan-
ter. occur to every one's mind, in which important time
in a healthy condiition. This willcause a shortening of the limb of several has been lost,in the early stages of bronchitis or
Remarks. "Excision of the head of the thighbone inches,the knee will project over the thighof the pneumonia children, in through the leeches ordered
has been performedbut few times in this wardsnot having taken,'or the flow of blood beingmnch
" '

country; sound limb,and the greattrochanter be carried up-

in fiict, it is only within the last few years, that the and outwards firmly aeainst the integuments, lessthan anticipated ; on the other hand, in the more
operation has been revived by Professor Fergusson,as in the case justgiven. My case is both interest- ing advanced stages, when the loss of blood is illborne,
of King's College, London. The attention of and instructive. The boy,afteryears of suffer- ing a much largeramount has escapedthan was tended,
in-
anrgeons, however, has been recentlyforcibly in a crippled pitiable
and condition, i s now in great prostration induced, and in conse- quence,
directed to this subjectby Mr. Henry Smith, perfect healdi, and his deformity nearlyremoved ; a fatal termination to the case. Even in
of London, who has displayedconsiderable ta- lent and allthis was effectedin the short space of six adults, the haemorrhage from a leech biteis often
in an article upon it publishedin the weeks, the large cavity filledup by healthy granula.exceedingly troublesome,and, althoughin them,
Lancet, 1848. The Profession are certainly tions, and nearly skinned over. Surelythis is evi- dence cuppingis generally prescribed, yet,there are some
under greatobligations to Mr. Smith,for the lucid enough ^if,"
indeed, any were wanting to parts of the body upon which it is impossible
" to
and phUosophical manner in which he has recalled show us what Nature is capable of efifecting apply a glassof that site,especially in emaciated
their attentionto this interesting surgical procedure, where the cause of irritation is removed. Years subjeetsmoreover,
: the services of an experienced
which,as he justly observes, is calculated to elevate had been lost in excruciating pain, accompa-
nied cupper are not alwaysat hand,and, if theywere, the
the "
science of surgery,"The result of several by exhaustingdischarge,in endeavours poorer class of patients cannot affi"rdto pay the
cases recorded held out g^eat to throw offthe obnoxious substance, w hen, thanks to fee. In the country,the surgeons are compelledto
encouragement to tempt
at-
the removal of the diseasedbone by operationMr. Henry Smith for his practical suggestions, I take that department of surgical practice into their
;
and, indeed, as Mr. Smith remarks,and very truly,put in force the operation, and, after a few minutes, own hinds, and yet how few performit with any
"
one of the chiefrules of surgery isthis, that where- cleared away the carious bone,when Nature, as if thinglike dexterity or success. To these gen- tlemen,
ever any foreign substance is lodgedor produced in grateful for my assistance, immediatelysets about I cannot conceive but that the mechamcal
any partof the body,causing irritationand disease,repairing the mutilated part and completes the cure. leeches will prove a great desideratum. A village
the sune should be removed by the art of the sur- Since operating practitioner is frequently obligedto send three or
geon upon Uie boy,the detailsof a most
if it can be got at." Acting four miles or more, to the nearest countrytown, in
upon this prin- ciple,interesting case of resectionof the head of the femur
I was induced to operatein the case I have has been publishedby my friend Mr. Cotton,of order to obtain a supplyof the living leeches,and
detailed, ;the result of which is most satisfactory, Lynn,(b) Great creditis due to that talented sur- geon that,perhaps, a case of great emergency.
and willprove very encouraging for the clear and precise
to future operators, way in which he has I propose now, to explain the manner of employing
as well as a powerful
argument in favour of Mr. giventhe particulars of his case to the Medical Pro- fession, these mechanical leeches, and hope,with the assist- ance
Smith's views, as regardsthe propriety of removing and the candour with which he has described of the accompanyingwoodcuts,to render it
the head of the thigh bone when in a canons condition, the progress of it. The patient, a girl, was in a quiteintelligible. In me firstplace, particular care
indeed, itis the onlychance the patient has,save most pitiable state when admitted into the hospital, should be taken that the tubes and scarificatorare
and excepting the remote one of anchylosis, when and was, as Mr. Henry Smith has so graphically in good order, act easily, and the pistonwell
the bone remains within the socket. Considerable
greasedwith the lard contained in me box for
discussionhas taken placeas to what part isfirst " Lancet, April,1849. ISiat purpose.
Attackedin diseaseof the hip-joint.
Six B. Brodie [h)ProvincialMedicalJoitnal,
F."93 im. 1 The box contaixu twelve glaM tubee
ordinary
 THE MEDICAL TIMES. 37

or leeches,
a scarificator,
style,
and other minor leather covers the whole of the tube of the scarifi- cator, of the uvula was observed to be discoloured, as
the piston in itshould be pusheddown rather thoughlikely to slough.
apparatiu.
Each tube or leech is about two inches and a more than two-thirds. If the parts to which the 25th. " One of the sutures was removed on the
hilflong,with a diameter about that of a six- pence,tubes are to be appliedare soft and flabby, the 24th,and the other thisday. The edgesof the cleft
two-thirds,or nearly so, of which are skin should be put upon the stretchwith the Uiumb were found to be united,as far down as nearly to the
ooreredwith leather; one extremity of the tube and finger of the left hand, as the tube then adheres second suture ; a portion of the apex of the uvula on
is open, the other closed,by a circular plateof much better ; if the parts are covered with hairs the right side was sloughing.
boDe or wood, which is pierced by a small aperture these must be cut with scissors. Dec. 4th. The case had proceeded
"
quitefavour-
ably
in the centre ; within the tube,and attached to the Cletuuingthe Tubes, To do this,it is necessary
"

; the union of the upper three-fourthsof the

under surfitceof this plate, by means of Indian* to withdaaw the circular disc and piston, wash the cleft was now quite firm, and at the lower partof the
rubber, is a piston, closely adaptedto the tube. tube in water with the little brush provided for that uvula there were two clean granulating surfaces. A
purpose, and afterwards dry it. The pistonmust suture was intxoduced in the same manner as
pre-
not be wetted,but greasedeveiy time it is used ; it viously, to keep these surfaces iu apposition.

is also necessary, before usingit,to work the piston 9th. On remoring the suture,the parts were"

twice or three times,so that it may act easily upon found to be quite adherent
the interiorof the tube. 14th. "
There was no fissure remaining. The
uvula was rather shortened and thickened at its
The Scar^ieator, (Fig.1.)consistsof a glasstube
threeinches in length, with a diameter rather smal- ler apex, but its movements were quiteperfect Ever
HOSPITAIa REPORTS.
than that of the other tubes ; itis entirely since the operation, the patient had been able to
covered
withleather,
" swallow liquids without any portion of them regur- gitating,
open at one extremity, and closedwith
the piston and circular plateat the other ; to its LEEDS GENERAL INFIRMARY. as theypreviously did,throughthe nose.
upperpartisaffixeda stem, (a,) two-thirdsof an hich His speechwas somewhat improved,and the im- provement

high,upon which moves a steel arm or key,(6.), OPERATION FOR CLEFT PALATE. very apparent, indeed when he was
one end of which is free, and terminates in a rounded By SAMUEL SMITH, Esq., S"nior Surgeon. induced to make the attemptto speakdistinctlv. It
knot,(o;)the other having attached to it a piece [Reportedby Mr. THOMAS 8CATTERG00P, Assistant was evident that the muscles required tutonng in
of caoutchouc, (d,)which constitutesa spring, and Apothecary.] order to articulation being rendered completely
beneathwhich is concealed a three-edged lancet, or
Henry Wilkinson, aged 18, a delicate-looking distinct
scarificator, ("). Besides this,there is a small hook, lad,with face deeplypittedby the small-pox, was The principal peculiarity in this operation was the
the dosed end of which, when the extremity admitted Nov. 21st, 1849. He was the subject of employment of a pairof dressing forceps, to the
near (o) of inside of the blades of which (asabove described)
isdepressed, receivesit Fide Fig.2.
"
cleft-palate, the fissure extending from the apex
the uvula to about half an inch from the marginof portions of cork had been fastened, for the purpose
The stylemerely consists of a rounded pieceof
the hard palate, the latterbeingquiteperfect The of holding the needles. This instrument was found
steel, three inches long,fixed in a handle, for the
inconveniences he experienced from the malfi"rma- to have a great advantage over the potfe-aiguilk,
convenienceof usingpressure.
tion were, that he spokewith a strongnasal tone and inasmuch as the lattercan only hold the needle in
Directions for Using. Any number of tubes in a very indistinctmanner
"

; and that whenever he one direction; whereas,by the armed forceps, the
nay be applied at the same time, according to the
attempted to swallow liquids, a portion of the liquidneedle may be securely held at any angle,and
quantity of blood we wish drawn.
regurgitated throughthe nostrils. pointed an^ in direction whatever. The cork tached
at-
The part to be operated on must first be wetted Nov. 22, 1 p.m. Mr. Smith operated.The first
"
to a handle,which was held in the lefthand
with tepidwater ; we then take the scarificator, in the divide the levator palati of which he enabled
step operation was to of the operator,by means was
snd having^ removed the case, which protectsthe muscle on each side,as advised by Mr. Fergusson.to make, as it and to leceive
were, counter-pressure,
lancet, we depress the freeextremity of ;thekey,till This was done with great ease. When the velum the points of the needles, was alsofound very useful ;
itreachesthe hook, underneath which 'it is carried,was touched, the muscle was thrown into strong the cork held the pointof one needle so firmly, that
and thereheld ; this of couise elevates the oppositeaction, and could be felt by the fingeras a tense the latterwas withdrawn,by itsmeans, fairly out of
extremity, and it is then said to be charged. CSee cord. The edges of the cleftwere then pared, by the mouth.
Fig. 2.) transfixing each fiap near the upper extremityof The firmness of the patient, in steadily abstaining
the cleft, and carrying the knife down to the apex of from any but liquidfood (boiled milk and arrow- root)

the uvula so as to separatea narrow strip of mucous for numy days after the operation, no doubt
membrane on each side ; then removing both these contributed greatly to itssuccess.

portions, hithertoleft connected together and to the

velum, by dividing their common attachment,the PROGRBSS OF MEDICAL 8CXBMOB.
patient was now sent away to wash his mouth out "
well with cold water, while another operation was
SCOTLAND.
beingperformed, Mr. Smith not wishing to attempt
the union of the cut surfaces until the bleeding, [Edinbugh Correspondencs.]
We then introduce the styleinto the small aper- which was not great,should have ceased. After a
ture
few minutes the patient r eturned, and all oozing COD LTVBB OIL IN PHTHISIS.
of the circular pieceof wood, and usingfirm
but steady having ceased, two sutures were introduced,one The curability of Phthisis, and the nature of the
pressure, we push down the piston about
cod-liver oil over that and
three-fourthsof the tube,and in thisway applythe about a quarter an of inch from the apex of the beneficialinfiuence of
the first and other forms of tubercular diseases, are subjects of
open end to the ^tatto be operated on ; holding it uvula,and the other midway between
in this position the upper extremity of the cleft. Small curved surpassing interest, which cannot obtain too much
firmly, with the index finger and
Profession. A paper on these
thumb of the lefthand we remove the style needles, threaded with a long silk ligature, were attention from the
; the
of the employed, and they were introduced by means of a points, read by Dr. Bennett at the first January
pistonis drawn back by the elasticity has
caoutchouc spring, and a nodule of flesh is thus pairof dressing forceps, havinga small fiatpieceof meeting of our Medico- Chirurgical Socie^,
drawn into the tube ; the key is then to be released cork, one-eighth of an inch thick,tied upon the been the topicof much discourse in our Medical
sujface each
of blade. The circles. Dr. Bennett has before called attention
from the lock, or unsprung, the lancet descends inner roughened operator,
without repeatedly to the curability of phthisis, and he was
simultaneonaly, and, without the slightest pain, standingin front,passedthe needles from
makes the puncture. to within on the leftside,and from within to with- out the firstto placebeforethe Professionin thiscountry
on the rightside. Holding in his lefthand a evidence of the great utility of cod-liver oil in
tremity tubercular diseases. The evidence he bringsfor- ward
slipof cane about fiveinches long,armed at its ex-
of the curability of phthisis deserves to be
with a small cork ; by gentle pressure with
this instrument he prevented draggingof the fiaps,well-considered, and the theory which he supports
while the needles were being introduced, and re- ceived as to the operation of cod-liver oil, thoughstill in-
complete,
cork the of each needle after is of so probable a character as to
upon the point
promiseto lead ultimately to the truth.
ithad passed through the soft parts. The sutures
and the The term curability, as applied to a disease, plies
im-
were then tied with the ordinaryreef-knot,
patient was sent to bed, with strict injunctions to that the cure takes placein consequence of
the of definitecurative agents, or that the cure
take nothing to eat or drink untilthe next morning, use

and not to speakto any one exceptthe house surgeon may be ef^ted, or at least promoted, by the exer- cise
The scarificator is then removed by depressing the or nurse. During the whole of the operation the of the art of medicine. Here, then,there is a
piston and one of the tubes applied in the same behaved with firmnessand self-control difierence of opinion. It is well-known to the
patient great ;
manner. In thisway we can applyas nuiny as we but considerable embarrassment was caused by the Medical Profession, that Laennec taught thatphthisis,
wish,and the same tube several times over the same occurrence of vomiting, which took placefour times though not curable by art, is sometimes cured by
puncture, ifnecessary to draw more blood. duringthe operation. Nature-" or that it sometimes happensthat tuber- cular
Particolar care should be taken " 28rd." The patient had strictly obeyedthe di- rections cavitiesbecame closed by a calcareoiu deposit,
1st To have the piston well greased. which had been givenhim as to abstinence and that,if there bfe enoughof healthy lung left to
carry on the function of respiration,patient
2nd. Not to apply the tubes upon the skin from food and from conversation. He was now
the re*

before having first pushed down (as is shown allowed (about take little b oiledmilk turns to health. Accordingly, Aere are some
ten,a.m.), t o a

above)the piston, until it may be seen below with arrow-root, and it was found that none of it here who regard the evidence of the curability
the leather which covers the tube ; as the passedintothe nose. The apex of the right portionof phthisis, broughtforward by Pr, Bennett, and
 88 THE MEDICAL TIMES.

the pathologists who agree with him in opinion, as starch eontained in the aliment, it can be under-
stood thisdifficulty, probably, dependson the oilsand fats
Tather confirming what Laennec taught,namely, why the direct ingestion of an animal oil taken into the stomach as food,beingso very differ- ent
that there is at times a spontaneouscure of phthisis, should be useful towards counteracting thesis. from the normal oilymatter of the human
that dia- chyle,
than as proving that it ever can be cured by means The pointsto be inquired into then, are that the conversion of the one kind of oilinto the
in
put in force by art. Bot, answer to this view,we how far there is probable evidence, in the firstplace,other is less easy than that of transforming starch
are reminded by others,that it is hardlyless true that the tendency to the deposit of tubercle is con-
nected and sugar into the same fatty or oily substance. On
in medicine proper than in surgery that Nature with the failure of the digestive organs to this subject, Mulder says : " When fats in the ani- mal
wMle remedies but serve to disembarrass the manufacture fat out of the usual aliments, which body are produced from those that exist in the
cures,
healingtendencies of whatever may at the time giveorigin to it,namely,starch and sugar; and, se- condly,food,there must happen,in every case, a converrion
interfere with their otherwise spontaneous efibrts. how far the ingestion of cod liveroil or of of neutral fats into fatty acids,and, again,of the
That thus,theiefore, it may be there is as much any other animal oil can supplythe place of the fat latterinto neutral fats. But there must take place,
natural tendency to the cure of tubercles as to the or oilwhich normally should be producedin the besides,a change in the relative proportions of mar-

healingof wounds, but that this tendencyis too course of the process of digestion. The fiistplainlygarinand elain; in the human body, for instance,
often overpowered by the derangementof health, involves the question, whether the wasting of the Uie fats of which contain margarinand elain in a
perpetuated by the unchecked successive deposition body be, in its commencement, antecedent to, or definite proportion, if the requisite proportion of
of new tubercular matter. Now, it can hardlybe consequenton, the deposition of tubercle. There is these is not supplied to itin the food. It is evident,
doubted that the infliction of a number of wounds in no want of probability on the side of the former for example, that olive oil, which contains much
a long-continued succession,each in itself of no alternative; but,if we would be sure of seizing tlie elain, and but little margann, cannot be converted
dangerous character,would so interfere with the truth,no definitiveopinion should be pronouncedinto human fat,without previously undergoinga
heaUng process, that death would generally be the without further inquiry and observation. Next, as change. Further,there must take placea conver- sion
result. Let it be supposed, that the same drcum- to the necesatyfor oily matter towards the form- ation of one fattysubstance into another, for in- " stance,
stances which firstgave riseto the depositionof one of chyle. The most exact recent accounts of of margarininto stearin, or vice versH" On
"r two tubercles continue to operateunchecked for the chylesffbrd such a representation as the follow-
ing: the other hand, thoughthe whole subject requires
a lengthenedperiod, and the usual fatality of " The chyle the
in dififerent lacteals contains an exact inquiry, t here is no difficulty in admitting
phthisis is at once accounted for,even on the sup- position fat in minimum quantity, albumen in minimum the probability of certain fish oils bearinga close
that there is an inherent power in the system quantity, and is almost destituteof fibrine. In the analogy, in composition, to the liquidfat of the
under
to arrest or cure a moderate deposition of tubercle. dififerent lacteals it contains fkt in medium quan- tity, human chyle, and thus,that these may be,
"

Dr. Bennett rests much of his argument on the albumen in maximum quantity, fibrine in certain circumstances, not merelyconvertible, like
largeproportion of cicatrised tubercular cavities medium quantity ; in the thoracic duct it tains
con- other kinds of non-azotised aliment, but much
found in those who, at a subsequent period, die of fat in minimum quantity, albumen in me- dium more easily" that is,with lesseffiirt of the digestive
other diseases. He affirms that one-fourth of all quantity;fibrine in maximum quantity. apparatus than ordinaryfats into the necessary
"

While, then,the subject is one

the bodies examined after forty years of age in the Whence, then, is this fat derived, and what kind of oily matter.
pathological theatre of EdinburghInfirmary during becomes of it as it disappears f The firstquestionof the highest interest, every one here, who takes
it
a period of severalyears, where death had occurred will sufficefor the present. The onlyconceivable up, feelshow much stillremains to be done before
firom other diseases, showed unequivocal marks of sources of this fat are, " secretion from the a complete theorycau be obtained. As Dr. Ben- nett,
previously cicatrisedtuberclesin Uie lungs. Thus, blood either into the small intestines, or into the doubtless, will soon publish his Paper,no at- tempt

if this be true, or be even a distant approach to the afferentlacteals; 2, its direct supplyfrom the ali- ment has been made to state its peculiarities.
truth, it is certain that the system, after the tion
forma- taken in ; or the conversion of certain aliments Neither have we entered on what he considers a

of tubercles, often comes spontaneously into into "t by an assimilationalready completed by the most importantpart of the subject, namely,the
this ject,
sub-
that state which prevents the further deposit of time theyreach the firstportion of the lactealsys- tem. deductions which he draws,as bearingon^
tuberculous matter, and which permitsthe natural Of these suppositions the lastisthe most cer- tain, from Ascherson's experiment, in which, when
healing tendencies to close already existing cavities. there beingundoubted chemical evidence that oiland albumen are brought in contact,a membrane
There is,therefore, at least an encouragement held the starch and sugar of the food are changed forms, enclosing particle a of oil. Dr. Bennett's
out to consider attentively whether there be not any to oil,and, as it would seem, bv an assimilation Paperon this subjectis already published, as read
means within the power of art by which, in cases of which is completedbefore the lacteal absorption before the RoyalSociety of Edinburghin 1847.
partial tuberculous deposit, the system may be commences. Of the other two suppositions, that
broughtinto the state,the spontaneousoccurrence which points to the blood as the source of the fatty
XRBIiAND.
of which, as it appears, so often puts an end to this globules of the chyleseems untenable,while the
malady. other,or that which regardsthe "t of the chyleas
[DublinCorrespondence]
Under thisview of the subjeot, those who feelun- derived
convinced directly fixim the aliment,requires some
of the truth of the main features of Dr. consideration. In the mean time, then, the case
TYPHUS, TYPHOID, AND BELAPSIKQ FEVER.
Bennett's theory, as to the operation of cod-liveroil, stands thus : " It is not an assumption^at the
after the partial deposit of tubercle, as well as those starch and sug^ of the food are converted into oil; The views lately put forward by Dr. Jenner, in
London, have created no little sensation among the
who reject the evidence of itsutility in phthisis, must but itis an assumption that this source of oil fails
thinking portion of the Profession in Ireland, a key
feel themselves called on to investigate the whole in those cases in which cod-liveroil acts beneficially,
been length furnished the plied
multi-
fectionhaving
at to many
subject, with the expectation of discovering how the " itis perhaps undeniable,that there is an imper-
shapesin which this peculiarly "
indigenous'"
system is to be broughtinto the state which repels of nutrition in such cases, but it is an as-
"
sumption
the further invasion of tubercular disease. In all that that imperfection disease to use Chomel's phrase has hitherto ap-
"
"
peared.
consistsin the in- ability
A lengthened and elabonite Reporton the
fairness, Dr. Bennett's views deserve a fulldiscus- sion of the digestive system to convert starch
before any other channel of investigation be re-
sorted and sugar into oil. This,then,is one of the pointslate epidemicfever, got together by the unwearied
assiduity of Mr. Wilde, furnishes a wide field for
to. In 1841,he, on his return from a pro- longedmost deserving of investigation, or further evidence
the subject, and corroborates, in a very
residence abroad, published a monograph must be soughtto connect the tubercular diathesis studying the very novel and interesting^
on cod-liver oil, drawingattention to the beneficial with the defectin the system to convert starch and singularmanner,
effectshe had witnessed from it in Germany,an 1 sugar into oil. positions so ablyadvocated by Jenner. The fact"
been furnished by the chief men iu all the
detailing cases in which it had been successful in But, if this pointbe taken for granted, in the have
his own nands. He was twitted by our highest cri- mean
tical differentcounties,and coming to us without any
time,can itbe admitted further as a probabi- lity, doctrine to uphold,are peculiarly able.
valu-
authoritiesat that time,with making much ado that the ingestion of an animal oil can supply particular
about nothing, and told that what he might have to the placeof an oil usually In some few placesa littleobscurityexists,
producedby the trans- mutation
the tens of thousands of cases
have but] considering on
say might more appropriately the
graced pages of starch and sugar ; and, if so, that cod
which the Reportis founded,the regularity with
of one of our medical periodicals, and that the re- medy, liveroilshould be particularly adaptedto that pur- pose. which the three forms of fever of Jenner are found
the merits of which he advocated,would,like Here a whole phalanxof questions diately
imme-
remarkable.
so many of its predecessors, "
fret its brief hour starts up. Can oil, received into the stomach, is quite
of Munster.
upon the stage."The Profession, however,has since act the part of the normal oilyfinidsof the living The Reportbeginswith the province
this their Here have the chief disease ^relapsing fever
almost universally with body? Judging generalgrounds, we "

stamped remedy drawn from

"

on

and m truth itseffectsare really chemical physiology, should here answer in the going into typhoid, and among the higherclasses
approbation, sur- we

prisinff. The diseases in which its effects are so negative.In the human body there are various typhus.
relapsefever,"no eruption ; doubts
"
In Cork,
remarkably may be described as diseases oily
beneficial, bodies more or less differentfrom the oilsor fats
marked by defective nutrition, such as so signally found in the bodies of other animals. True, it can- of contagion expressed ; in -43 only,out of 747,
not
characterisestubercular maladies. be said that we know what is the precise mical spots; the re-lapsecases
che- going into typhoid "

Dr. Bennett is not inclined to insist on constitutionof the fatty matter of the human typhus, upper classes.
any
special influence of cod Uver oil. He thinks the chyle, but, consistently with the known general In Tipperarytwo epidemicsseem a littlefounded con-

good effectproducedby it to be due to itsbeingan pnnciplesof organicchemistry, it is hardlycon-

ceivable ; one, in 184^, with mulberryeruption
animal oil,so as thereby to supply the placeof the that cod liver oil, or any other fish (typhus?) the other the peculiarepidemic of 1847
normal fatty matter which is nrovided from other oil, without a distinct process of assimilation, we are speakingof,and which seems all through
sources in the healthy state, for the formation of should at once supply the place of that oil this largeprovince, simple relapsefever." The "

perfect chyle. Thus, if the tubercular diathesisbe which is usuallyderived by assimilation from cases rose from the usual average in hospital, 75, to
keptup by such a defect in the assimilativepower starch and sugar. Here, unquestionably, a dif- 518, and were marked by this peculiar] tendency
as prevents a sufficiency of fattymatter from being culty arises. The assimilation of oils,under to relapse ; at firstnot contagious and without erup-
tion,
formed in the normal manner, from the sugar and ordinSury circumstances, is confessedly difficult
; and
the disease went off after a few days ; this
 THE MEDICAL TIMES. 39
fatalrelapse ensuing, andtypboid,with ulceiation In some cases, theywere covered from head to foot ; anginaspassedoften into bad diphtheritia

piece,of a dark or gangrene; scarlatina,

if accompanyingsuch an-

toms
of the bowels,the result. with spotsas largeas a fourpenny
In Clare,among hundreds of cases, the same mulberry colour,while in others they were of a ginaai, followed an irregular
course ; ooeaaionalljr"
tale " relapse
" fever,"spotsnot observed ; relapse" brightVermillionhue." No mistakingthese,one the exanthemata seemed to terminate in a kind
the higher should think. In of the islands off the coast, of remittent itYn, A singular qpeoieeof fever
frequent,with ulceration. Among one

classes, on the contrary,typhus,with mulberry the fever was of the simplest kind; in 86 cases, was also observed at Paris, very dififerenl fnim
eruption ; no relapse. Among the poor, Dr. Culli- however, there were 79 relapses. In Down, the b ut
ordinarytyphoid, presenting, especially at ifta
the former was known as the "
short evidence of contagion, positive among the poor, not close, the appearance of one of the forms of epi- demic
nan says,
not very fatal; while,among the latter,80 clear in the upper ranks of the community; the cholera. There was in this fever littleor no
sickness,"
25 per cent, died, and was universally dreaded. disease marked typhoidamong the former, with diarrhcda, but alternations of heat and cold ; a small,
Limerick." True "
relapse fever ;" doubts ex- pressed,diarrhoeaand dysentery. In all this province, lapse soft,
re- and irregular pulse;no meteorism, so defi-
both here and in Clare,about contagion, was present,but not so common, perhaps, as rium; an extreme feebleness. After sene days,
thoughthe popularprejudice ran the other way. in Munster. Spotsrarelyoccurred, except they when nothingindicated danger, the pnleesnddesly
" Petechiaein the
relapse cases, where theydid not made their appearance in die primaryattack. The became threadlike;the eyes became malkem ami
occur in the primaryfever;" upper olaaaes, typhus mortality was far greater among Uie respectable surrounded with a dark circle;and Ae patient died
without I elapse. classesin Cavan, amountingto 66 per cent. ; while, without agony, (a) In October, 1846, ffsatro-inlet-
Kerry. Relapsefever,"
"
"
goinginto typhoid with in the Fever Hospital, out of 1236 cases, but 48 tinal auctions became more commoB, aaA were
"
aphthous"ulceration of the bowels ; the disease died, 4J per cent. In Donegal,the average mor-
" tality, accompaniedby symptoms whose eonnexion wkk
itselfnot particularly dangerous, but made so by 8 J ; in Tyrone,11 ; in the Belfast HospiUl^ cholera could not be doubted ; such as abdoniaal
various causes. The frightful account, indeed, 12i. In Derry, the cases seemed a little puzzling; pains,bilious vomitings,meteorism, small and
givenby Dr. Crurope,is like a leaf taken out of Dr. Jenner's distinctionnot at that time known. slow pulse, lowering of temperature, aehi^ in the
Ainsworth's " History of the Plague." No one can **
The cases following relapse," says Dr. Rogan, thighsand legs. At the end of November, 1948;
read it,and think such an epidemic againpossible ;
**
were of a peculiar character,differing from true a case of cholera occoned at Calais. In Jaafuary,
and the Government higglingabout Medical Cha-J^ typhus." Of course theywere, "
the relapse fever, 1849, the usual aflfeetioiis stilleontiinBedto present
rities,without feeling a shudder. Waterford. "
The and itasucceeding typhoid, differing as haps, an unusual character. At the onset of fevers Aere
much, per-
threevarieties distinctly marked. Typhoidjwith rosc- as scarlatinaand measles. was often an extreme adynamia, which diesfpeeied
colonredpatches ; 490 together in hospital, (summer, Province of Connaught In thispartof the king-
"
dom, in a few days. Many symptoms seemed to foretell
1847;)distinctly have the same evidences of the conta^^ous the advent of cholera. Tlie first ease of cMen
contagious;then, in autumn,
"
we

dysentery set in with " relapse fever" and typhus.chaiacter of the disease, afterit passed the ordinaryoccurred on the 10th or 11th of Mardi at St Deaie.
In 1832 the first case ooenrred in Paris on tiiea5th
In a largeamount of cases relapse beingthe most relapse fever. At Sligo, purplespotswere frequent,
prominent feature. No eruption tillthe second at- tack, (typhoid). In Leitrim,the same. In Galway,great of Msroh. During the prevalence of cholera at
when it was mulbeiry. (Typhus?) tendencyto relapse ; purplespota in
"
ten out of Paris,then wera ohmved a number of intereuneBt
In Schull and Skibbereen the poor had **
famine every twelve cases." All throughthis province, as abdominal afibetions, mora or lees impwssed,so to
fever." TTie persons better off" i elapse fever" and in the others, diarrhcea and dysentery attended the speak,with the seal of diolera. These diseases
tlie upper classes typhus and "gastro-relapse cases, pointing to ulceration, (typhoid ?) were especially non-febrile serous diarrheeas,
typhoid; non-

biliousfever." The " famine fever" was very pecu- GALWAT OOLLEGB. febrile and febrile dysentery, gastro-enteritis, with
liar,
characterised by great prostration, thirst;a Matters here are beginning to wear a more little diarrhoea, neuralgic colics, "e. llieee affec-
tions
mising
pro-
dry chaffyhot feelof the skin ; weak, feeble pulse; have not disappeared. (GaseMe
aspect The Matriculation Elxamination even now "

intellectclear. No period, or crisis terminat-

stage, ; ing terminated on Thursday week, when 39 candidates Mid., Dec 29.)
in death from inanitionalone. The person ex- haled were admitted,which,with those alreadyadmitted, SOFTBNIKG OF THE FOSTBBIOR OOLUUKS OF
peculiar
a septic odour, and when in contact make 69. The Scholarship Examination,a few THB CHORD; OONSEBVATIOW OF 8EI78I-
widi better fed individuals, impartedfeversof dif- ferent daysafter, was not lessencouraging. BILITT AND HBFLBZ MOYBBISirrS" ABOLI.
types. Forty-eight medical men died in the nOH OF VOLUNTABT MOTION.
IRISH HEDIGAL GHABITIE"
province. In Cork, a move has been made to get the Medi- cal A remarkable case in a child has latelybeen raad
Province of Ulster. The contrast between this
"

Charitiesunder the Poor-law. A meetingwas by M. Brown-Seguard,befora the Socilt^de Bio-

province and the preceding one is not a little re-
markable.
called, but no one attended. There were no knight- hoods logie.In this case lifewas ultimately destroyed by
In the preceding, contagion was doubted ; to be distributed.In Dublin, the same nearly the supervention of acute tubercular cerebral me- ningitis
in thisprowince, on the contrary, at Antrim,Derry, has occurred, a Remonstrance on very old spinal meningitis, with soften-
ing
"
havingbeen issued
Donegal, Tyrone,Cavan, Armagh, and Down, the by the Board of Guardians againstthrowingthese of the posterior columns of the cord in the
wealtfipr parts of Ireland,the marks of con- tagion institutions on them. The intentionof Government, cervical region.There had been perfect paralysis
and of altogether a differenttj'pe of fevei
it was rumoured, was to withdraw the grants,at the
of the muscles of allthe extremities; but,ft-omthe
were unequivocal.At Belfast, as one should ex-
pect, rate
of 10 per cent, per annum. Rather shabby, by retentionof the reflexmovements, the muscles wera
the three varietiesalready spokenof were re- marked: the in excellentcondition.Tbe sensibility of the skin was
way, of the Government, if true.
1st. "Relapsingsynocha," so described
"
preserved in toto. The patient had attained, in spite
In Kilkenny,celebrated for its feline achieve- ments,
by Dr. Malcolm. 2nd. Simple continued,with of the disease, a stature nearly as greatas in healthy
the Guardians have been discussing the pro-
prietyindividuals of the
typhoid symptoms ; and 8rd. T^'phuscases spotted of building a Cholera Hospital, wMch looks, same age.
"
(Gaxette M id., 29th
generally. be confessed,very like the old piece of Dec.)
In a population of 110,000,one-seventh,
it must
or 16,000 got fever! At Omagh, 814; in Cavan,
gmtcherie, shutting
" the stable when the horse is ON THE EFFECT OF PNBUHO-THOBAZ ON
915. Dr. Black describesthe chief peculiarity the stolen. TBE SOUNDS OF THE HEABT.
tendencyto relapse.In Deiry,among the upper The variations in the extent to which the sounds
classes, the brain was chiefly affected.In the lower, of the heart are transmitted are well known. The
the fever differed from previous epidemics in its flBIiEOTIONa FROM FORBION
transmission is impeded by emphyftma,increased
tendencyto relapse.In Donegalnearlythe same JOURNAIta
by consolidationof the lung,and occasionally, as
tale contagioneverywhere;
" the disease differing stated lately by M" Racle,by pleuralexudation.
from other epidemics.In the early
"
appearance of THE MEDICAL CONSTITUTION OF THE YBAB
M. Barth has lately published a curious instance of
typhoidsymptoms the frequencyof purplespots 1849 IN PARIS.
and relapses
some rare auscultatoxy phenomena observed in a
; in some cases three and four times." The Gazette Midicale,of the 29th of December, case of perforation of the pleura.The patient, a
In Tyrone and Cavan the same. In Armagh, evi- dencesattempts a retrospective of the medical man
summary agedtwenty-two,when firstseen, was labour*
of conta^on, as elsewhere. In the better constitutionof the year 1849. This retrospect is
ing under pleurisy, w ith efi^sion, as evidenced
classestyphus,without ulceration.Among the poor, liableto the objection made to allsimilar attempts,
by generalsymptoms, by dulness on percussion
typhoid, with diarrhoeaand relapse ; purple spotsnot viz.,that one man's experience, however accurate at the left base, absence of
respiration and sego*
common. The rate of mortality higheramong the we may admit it to be, can never representfairlyphony at the angleof the scapuia. Subsequently
upper elasaesthan among the poor ; 40 per cent among the actual occurrences. A true account of the me-
dical
there were signsof softening, no doubt tuberculous,
the former, 4 among the latter. In Roscommon, history of a year can onlybe safely founded on
of the leftlung,and,finally, perforation of the pleura
thecases with well-marked crisis,"
"
on the fifthor a basis of accurate observations, sufficiently ous
numer- and nneumo-thoraz. This announced itself by the
seventh day, toithout a single exception, relapsed; as to representin some measure the totalamount usual symptoms of metallictinkling, of tympanitic
they were generally non-petechial at first. In of sickness. Even the historiesof Sydenhamhave, note
on percussion, and ringinff voice and cough.
Castlebar,a repetition of the dreadful scenes of on this account, met with few imitators, as most men
But,in addition, the sounds of the heart had,on the
Kerryoccurred ; the most firightful typhus, from the have been consciousthat theycould not fairly ralise left side,a distinctiy
gene- metalliccharacter,which,
huddling together of the sick; the mortality 40 per from theiroomparativdy limited fieldof view.
although not uncommon in some cardiac affections,
cent. ; while outside,in the country,the fever was The statement made in the GazetteMidkak is,how* has not, M. Barth believes, been noted in pneumo*
the mild relapse kind, relapse from the typhus ever, possessed of considerable interest,and we, thorax. M. Barth entertainsno doubt that the air
"

scarcely occurred at all,(never, perhaps.)In the therefore, with the reservationabove made, g^ve an in the pleura,maintained at a certain tension,
Ballinrobe workhouse, the ravages of typhuswere abstractof it duced
pro-
thismetallic note,and suggests the possibility
also terrific. In addition to a mass of wretched In July,August, and September,1848, the
of^in some cases, the same note beinggivenby the
paupers,huddled together in the disease,the Phy-
sician,
observation was made, that many diseasesseemed a stomach distended
apex of the heart strikingnear
Master,Matron, Chaplain, and Clerk, were to be acquiringunusual features;more hoea
diarr-
alllying, at the same time,in bad typhus.Among than ususd occurred, and, especially in (s)No account is givenof the post-mortemap-
pearances,
the better classes, six or seven out of every ten died. children, is any mentioned.
eruption
was complicatedwith cerebral symp- nor
 40 THE MEDICAL TIMES.
"withgaa.In thia case, alao,there waa a friction was found below the standard,as also testified by and which would desireto abolishallem-blems
.aound in the cardiac regionsynchronoua with the Andral and Gavarret,and allother observers.

ters,
of scientificor literary
eminence in the
heart'amoYementa, which M. Barth believes to have OPERATION OP GASTR0-8T0ME.
Profession, down the prouddestinies
and to bring
been entirely pleural, and producedsimplyby the In a case of malignant disease of the cesophagus,
of geniusto the monotonous level of medio-
crity's
pericardium mbbing i^inst the inflamed pleura.in which the patient was dying of starvation,M.
A similar case is recorded by Dr. Stilly of Phila-
delphia.S^Uot recentlyperformedthe bold operation of crowded highway. This is contraryto
{L'UmonMid.,Jux,l.) making an openingdirectly
into the stomach for all we have ever written, for it is in no cold
the purpose of food.
introducing A crucial in- cision
THE INNEBVATIOir OF THE LTUFHATICa and niggardspirit that we have attemptedto
about 1^ inches in diameter, and 2 inches
the scientific tendencies of the sur-
made in front of the develope
The dependence of the movements of the frog's geons
below the cusiform cartilage was
lymphatic hearts on the spinal cord was discovered of this country.
right rectus. The flaps were reflected, the fasciaand
by Valentin; but, from the experimentsof the some muscular fibrescut through,and the More contingencies, however,are dependent
author,it would appear that his conclusion is sus-
neum
perito-
of amplification and extension.
cautiously opened. The greatomentum was
upon this questionthan our Correspondent
iceptihle then seen spread out over the abdominal viscera.
The fibreswhich pass from the spinal' cord to the seems to have considered. Grantingthat it ia
The omentum beinggentlypulledupon, the trans- verse
Anterior lymph-heait liein the second spinal and honourable to a scientific sion
profes-
wards, becoming
nerve ;
colon came into view, and was drawn out-
on a branch which passes backwards from this nerve
the anterior edge of the transverse pro-
with the hope of bringing the stomach to the distinguish
to its ablestmembers by titles
"opposite opening. This beingaccomplished w ith littledif-
ficulty,
of the third vertebra. of merit, so that theymight stand before the
"cess
the great curvature of the stomach was
Destruction of the cord, or section of the second world with the legalstamp upon their brow
reached,and soon afterwardsthe anteriorwall. An
nerve previous to thia branch, or section of this
openingwas now made into the anterior wall, that givesan unchallengable currency to their
blanch itself, alike result in an instantaneous still- ness
as near the lesser curvature as possible, and worth,what becomes of the claims of unscien-
of the anterior lymph-heart In from fifteen
a tube, consisting of two parts, with prominent |ific members? Can the same titleof honour,
to ninetyseconds the pause is interrupted by the borders to hold the stomach
of movement in a few muscularfasciculi. up to the abdominal without absurdity, be employed to distinguish
resumption walls,and to support the tube internally, was troduced.
in-
These movements extend to other fasciculi until, both ? The College now admits Members to
The stomach then beingreduced, con- tracted
ftully,a complete contraction is reproduced. somewhat strongly, and drew the whole the Fellowship by examination,and if the Fel- lowship
Hereafter this regular contractionismixed with in- complete
lengthof the canula,which was rather more than were merelya titleof honour,it might
ones, and the heart often pulsates iiregu-2 inches,into the abdomen. Some efibrtswere made
laily" but Btnmgly, for a quarterof an hour. do so also by nomination throughthe exercise
to raisethe stomach again ; but,these beingunsuc- cessful,
Hbe application of magneto-electric irritation duces
pro- of a similar power now enjoyedby the Pro-
the instrument was simplysecured,without
the aame instantaneoua stillness : thislasts as sident of the Collegeof Physicians;hut if
renewingthe attempts. The operation lasted an
longas the cause; and, on its removal,the contract hour chloroform beingadministered. A littleeau
" Members be admitted also by seniority, or even
tiona are quickly resumed. When appliedto the tacrie and chicken broth were gradually introduced
cut surface of this partof the spinal cord itself, the by the electionof the Members,the Fellowship,
into the stomach, and, for some time, the patient
same phenomena result as a tideof honour,isextinct. No matter what
The fibres corresponding to the hinder lymph-
appearedto be doingwell,but eventually ssiUe, and
died twenty-one hours after the operation. After ingenious expedients might be used to distin-
guish
heart lie in the tenth spinal nerve, ^rarely in the
all the orders would be
"

death the tumour of the oesophagus was found to be class from class,
ninth. Experimentssimilar to those above gave "
epithelial cancer;" there was some sero-sangui- embraced in the Fellowship, and the scientific
aimilar results, exceptthat the stillnessproduced nolent effusion In the lefthypochondrium.The
'
by section, or galvamsm,was less complete.This honour would merge into a corporateprivilege.
death was, by various persons, attributed to the
difierenceis explained by the author as probablyweakness of the to the effectsof chloroform,
Itis simply as a corporate privilege that the re-
calcitrant
due to the greatdifficulty of isolating the particular
patient,
to lesion of the vagus, or by M. Sedillot, to a kind Members of the College have hitherto
fibres. Rwely they seemed to come off from the
of indigestion caused by the too rapid introduction regardedit. They desire the Fellowship for
nerve so close to its emergence as to elude section
of food into the weakened stomach. "
(La Presse the sake of the vote. There may be something
altogether.
Mid, BruxeUes,Dec. 2,and Arehiv. Gin. Dec)
Tlie author concludes that,in the frog, the second in the name, too, that has its attractions ; but
and tenth spinal nerves fulfilthe officeof the vagus the onlycorporaterightthat would be gained
to these as those of the cerebralvagus
lymph-heavta, TO SUBSCRIBEBS. by it would be that of votingfor the electionof
do to the olood-heart
He adds, that a completecontrolwould best be New 8ubtcriber" wiU obligeby forwarding their Council. If one-half of the Members of the

provedby irritationof the corresponding nerves, 147,Strand, or to the Collegewere

Namet directto the Office, admitted to the Fellowship, it
simultaneously with local impressionson Sieheart, Newt Agents or BookseUert. All Post-office would be abrogated as an order of merit,whieh
producing pulsation. But its small size and little Orders should be made payableto the Publishers,
was one of itschief originalintentions; and if,
render this impracticable.
irritability Wm. S. Obb aid Co. under the pretextof givinga vote, a still
Nevertheless, the appearances above, to wit, the "

almost immediate resumptionof movement after greaternumber of Members, or all of thena

aection or irritationof die nerve, are altogether
"
included in this order,itwould be, as a
analogousto the phenomena of the vagus and THE MEDICAL TIMES. were distinctInstitution, utterlydestroyed ; and the
blood-heart,and in no way referribleto a tetanus
of "e nerves.
irritation Fellows would be merelyMembers with a vote.
producedby an (C Eckhardt
"

qfMarburg,in the Zeitschrift

**
JfUrRatUmette Medi- SATURDAY, JANUARY 19, 1850. To open the Fellowship very widelyis to anni-
hilate
"l"." 1849. "Bandviii. Heft 1 and 2. Pp.211 ; and thisresultwould
it as an Institution
"
215). A CoKREspoNDCNT, who signs his letterwith equally happen, even though many aspiring
ANALYSIS OF BLOOD.
the initials" C. J. B.," has erroneously buted young men
attri- should continue to become Fellows
In the Bitme Midicale,for September,is a paper
to ui the of abolishingthe order by examination.
by M. Abeille, on the composition of the blood in purpose
various diseases. The writerhas limited himself to of Fellowahip in the Collegeof Surgeons, What, then,should be done? We are of
the sole task of following exactlythe ground througha misapprehension of some remarks opinion, thatitwould be a prudentstepto give
occupiedby the researches of M.M. Andral and made
by us in a recent Article. Those remarks corporaterights, t.0.,a vote in the election of
Oavarret He has analysed the blood according to
merelyset forth the position which,for consist-
ency's Coundl to allthe Members, but to reserve the
tiie method recommended by these pathologists,
and as fkr as possible selected the same diseases sake, and in vindicationof a principle, titieof honour for Practitionersonly of emi-
nent
aa were chosen by them. In infiammations he oughtto be taken
up by those gentlemenwho knowledgeor celebrity. The two snhjects
finds, as Andral and Gavarret and many others honours"-
have since found,the fibrineaugmented; in t3rphoid
participate in Mr. Bottomley's peculiar yiews. corporaterightsand collegiate
"

It is an open question, whether,in principle, the are distinctin themselves,and ought not to
fever and in dimini^ed,
variola, the diminution
beingmost marked in the adynamicforms of both Fellowship be a justand useful institution, or have been united. Their union is the cause of
these maladies ; in intermittentfevers,the propor-
tion not We have not sought,and do not now all the embarrassments that now exist;their
of fibrine was normal ; any augmentation, would tend to simplify and to re-
M. Abeille believes to be dependenton a latent
seek,to force our own opinions upon the Pro-
fession's
separation move

inflammation. attention; we desire chieflyto laybe-

fore The Council say, that
the difficulties.
In nine cases of " cerebro-spinal
views and argumentswhich theycannot open the Fellowship to the Mem-
bers
meninffitis " the fibrine was found invariably creased itthe leading
in-
from 4*8 even to 10*1 parts per 1000. bear schemes that attract the by the rightof seniority, it would be
upon the political as
These observations agree with three analyses of M. or the better judgment of the hour. breakingfaith with those Fellows who
curiosity have
Levy,who found the fibrineto range fhnn 4*3 to 5*6 of the become so by examination : and the Members,
We do not assume, that the members
per 1000, and implya great distinctionbetween
typhusand typhoidfever and " cerebro-spinal Collegehave that extreme
ningitis."
me- republican spiriton the other hand,are resolved upon havinga
In of let-
the albumen of the blood which issaid to characterisethe society
albnminuriai vote in the of the CouncU,and
election can, at
 42 THE MEDICAL TIMES.

of the case, so far as we can gatherfrom the gara a Tery different, and mach mora minute the totalis now 17,702.The number of patients
conflicting testimonyof the man and his account of the so-calledconvulsions to Dr. In- glis treated in the generaland special hospitals,
friends. and Mr. Holroyd. To these gentlemen he duringthe year 1848, was 83,647, thus dis-tributed
At four p.m., Aagust6th,he was firstseen denied having had convulsions,properlyso "

hy Mr. Ramshotham, who informs us, that at called, but said that his legshad ached,and Remainingin from 1847 5.772
Received duringthe year 1848 77,875
that time his face was flushed, the countenance that,on awakeningin a fright, he thought he ....

expressing greatanxiety, and a peculiar hright-felthis legsjump, and then he sent off*for Mr. 83,647
ness of the eyes ; there was intense thirst, a Ramsbotham. Of the patients, 37,743 were men ; 33,555
parchedfeeling in the mouth, no deficiency of Mr. Fawthrop 's evidence shows clearly what were women, 6401 boys,and 5,948 girls. Of
saliva;the tongue was covered with a white the case reallywas; Mr. Ramsbotham 's own the whole number, were discharged cured or
fur ; there was achingpain in the arm, which unequivocally demonstrates what it was not, convalescent,31,443 men, 28,369 women,
followed the course of the nerves, and was very I. e., a case of hydrophobia ; for we regardthe 5253 boys,and 4883 girls.The deaths were
severe in the neck. He said he felt sure he allegedcombination,if true, of convulsions 3627 males,2761 females,777 boys,692 girls ;
should he choked "
unless he mended." He with difficulty of swallowing, unaccompaniedgivinga totalof 7857 deaths. The Revolution
in
complained a difiicultyswallowing, by any dread
of not of the attempt to drink,as lutely
abso- of Februaryfurnished 670 wounded ; the surrection
in-

from,sore throat,hut "

as if somethingmet proving, that,whatever the diseaseunder of June, 1857. During the same
the water in histhroat." which the man laboured, it was not phobia.year, viz.,1848,
hydro- the number of persons ad- mitted
The evidence of Mr. Fawthrop,a surgeon into the infirmaries (hospices) was

living at Queenshead^ who saw the man Hop- For our part, we can affirm,that we have 29,145, of whom 1530 died ; or 687 men, 832
kinson lessthan one hour af^er Mr. Ramsbotham repeatedly seen all the symptoms Messrs. Rams- botham women, 9 boys,and 2 girls.
had lefl him, and about four hours after Mr. and Fawthrop noted as presentwhen The mean mortality and duration of treat- ment

Ramsbotham had first seenhim,show8that there theyrespectively saw the man, in patients who in the differentEstablishments are, of
was then "
elongation of the uvula,inflamma-
tion have recovered with rest and restricteddiet ; course, greatly influenced by a variety of cir-
cumstances.
of the fauces givingrise to slight sore and we should as soon have thoughtof signing
throat and some difiiculty in swallowing." a certificate that such persons were suffering In the medical wards of the general hospitals
Now, did Hopkinson manifest at any periodfrom insanity, as that they were affectedwith the mortality varied between one in 6 4-5 and
the slightest symptom of hydrophobia ? We hydrophobia. one in 12-25. At the HdtelDieu and la Charity,
think our readers will agree with us that he We pass by, as too contemptible for notice,where the most severe cases are received, it
did not. He sufferedsimply from an attack of the illiterate epistie of the person named Moore, held the former proportion ; at the hospital of
anginafaucium,which Mr. Ramsbotham failed which we were rather surprised any respectable St Antoine,the latter.
to detect. The cause of the anginawas evidently JToumal,intended for general circulation, should In the medical wards of the special hospitals
excess, fatigue, and cold. The disease itself have admitted into its columns ; and we pity we find a stillgreaterdifference.At the Enfans
was trifling. Mr. Ramsbotham heartily for the pain he must Malades, or Children's for
Hospital, example,
Accordingly, on examiningthe patient, Mr. have experienced on readingthe puffdirect the mortality was one in 87-100; at the
Fawthropat once declared,that there were no givenhim by his layfriend Mr. Pope. Such ClinicalHospital, one in 35 4-5 ; at the Fe- male
symptoms of hydrophobiapresent, that the testimonialscan scarcely aid him in procuring Venereal Hospital, one in 534.
illnesswas trifling, and would soon disappear. "dupable" patients. Why, the veriestquacks In the surgical wards of the differenthospi- tals
About four hours after Mr. Fawthrop *s visit,in existence could offer evidence as good in nearlythe same proportions are observed.

Hopkinsonwas seen by Dr. Inglis, of Halifax, favour of their vile and trashycompounds! In the generalhospitals the mortality varied
and two surgeons, all of whom, unequivocally, Sure we are, such testimonialsmust lower him between one in 9 4-5 to one in 21 3-5. In the
and at once, affirmed that the man was not in the eyes of the more intelligent partof the special hospitals, it was one in 10} for the
labouring under a single symptom of hydro-phobia.community,as well as in the esteem of all pro- Clinical Hospital
fessional ; one in 39| for the Female
These gentlemen, like Mr. Fawthrop, men. Venereal ; and one in 186 for the Male Ve- nereal
were qualified to givean opinion from having We shall enter on the subject of Homoeo-
pathy Hospital.Again, if we take alto- gether,
attended the firsttwo cases. Mr. Ramsbotham at some future time. In thus speaking general and specialhospitals, with
has never witnessed the fearful disease,of the on thisparticular are in nowise medical and surgical wards, we find the fol- lowing
freely case, we
incipient symptoms of which he speaks the value of the dogma, SimiUa '^
rates of mortality in 10} for the
so fidently.
con-
considering :
"
one

It may be objected to our account, eimifibus curantur,** or the intrinsic value of men; one in 12 1-7 for the women; one in 8^
that we have omitted all reference to the con- vulsions decillionths of a grain of charcoal. The for boys; one in 10 1-12 for girls.
and spasms which the man stated to merits or demerits of the The duration of treatment likewise
system,we acknow-
ledge, mean

Mr. Ramsbotham he had suffered, beforehe, cannot be affeeted by the result of an varies in the general and special hospitals; or,
Mr. Ramsbotham, saw him ; for Mr. Rams-
botham into one the narrator of according the cases may have appertained
investigation case, as

never asserts,that he witnessed any-

thing which has either displayed ignoranceof the to medicine or surgery. In the medical wards
of the kind. We can onlysay we have rudiments of his profession, by confoundinga of the general hospitals it varies from 16 to 33
done so after due deliberation; 1st. Because ailment
trifling with one of the days for adults,and from 4 to 23 days for
most fearful
we know, from prettyextensive practical that
quaintance
ac- can affectthe human frame, or has being,on a generalaverage, 24 days
children;
tempted
at-
with illiteratesick people,how to supplythe credulous with food for all. In the special hospitals, on the other

likely theyare to confound severe rigors with seasoned for their morbid appetites. We have hand, the mean is naturally longer, being29 1
spasms or convulsions. This very day,we were givenMr. Ramsbotham the benefitof the former days.
told by a nurse in a largehospital, that a man but bad or imperfect observers For surgical cases, in the special hospitals,
explanation;
had experienced an attack of convulsions early must not feelhurt if,when theyset themselves we have a duration of treatment which varies
in the morning. On closeinquiry, it appeared they get credit for being from 21 to 81 days for the and 21 to 49
up for discoverers, men,
that he had really suffered from muscular tre- mors, deceivers. for the women.
from extreme nervous agitation. We should be gladto hear,if thiswas a case In the infirmaries the mortality is of course
2ndly. Because,from the colouringMr. of hydrophobia, why the Colne drink was ex-cluded stillhigher.For the insane it is 1 in 5 32-100 ;
Ramsbotham has lent to the throat symptoms, from allshare in workingthe cure ? for the aged and infirm,1 in 6f ; and in the
which unequivocallydepended on angina almshouses 1 in 7, 85-100.
fattctunif we cannot have the slightest dence
confi- HOSPITALS OF PARIS. FOUin"IJKGS AND OBPHAN"
in his powers as an observer, or as an [continued.] The number of foundlings and orphansad- mitted
acute investigator into the past history of a In 1837 the number of beds in the Parisian duringthe year 1848 was 4597, of whom
disease. Hospitals amounted to 16,224. Since then 2555 were boys and 2060 girls, with 161 male
3rdly.Because the man Hopkinsonhimself there has been an increase of 1478 beds,and and 121 female orphans.1299 of the above
 THE MEDICAL TIMES. 43
were furnished from
the Lying-tn Hospital, feet thick,as happens in the winter. It the more polarregionsof the North American
610 from the other hospitals, and 2286 from was stated, that Sir John Franklin, ing, Continent to afford food to the crews
before sail- of the
Paris. In addition, 322 were admitted fr^m had made himself acquaintedwith the Erebus and Terror, our readers can now judge,
the environs, and only80 without a registry of situation and resources of the Hudson's Bay supposingthey had got to these regions, to
birih. Of the whole number 522 were
posed Company's posts,and that,in the event of any some of which
sup- ^the more advantageous " ! we "

to be legitimate, and 4075 to be illegiti-

mate. accident occurring, would,if he thoughtit ex- are positive
pedient, theyhave not ; and, with regardto
Besides the abore,we have to take into push on to some of these posts,or seek the others, we are in the same respectpretty
account 1132 infantsin the hospital on the Ist the whalers in Barrow's Straits. The Great well certain. Is it then upon the deer,bears,
January,1848, together with 1667 deposited Slave Lake, the last port to the eastward of the white foxes, and fowl, or on the whales and seals
by their parents,the police, "c., which gives Mackenzie River, has not been reached by of Melville Island,Banks' Land, Victoria or
a sum total of 7396 infants treated in the Franklin,nor has news there been heard of his Wollaston Lands, that these unfortunate men

hospital, where theypassed193,823days. The party ; the whalers in Barrow's Straits have not have been nourished for the whole
year, if not
mortality amongst these 7396 infants was, 458 been appealedto, and the Advice whaler,from June, 1848? Is it upon the produceof
for the male foundlings ; 346 for the female, we have latelybeen informed, penetratedsome favoured island, likethe one of the Wol- laston
(1 in 5 or 6,) 21 for the male orphans,(1 in as far as Navy Board Inlet,and its group visited by CaptainPenny, who
28,) and 12 for the female,(1 in 50.) This captain went on shore at one of the says : "
We disturbed, on our landing,about
enormous diiference arises from the circum- stance, Wollastou Islands. Further, the exploringhalfa dozen pairs of the eider duck, (somateria
th^ the foundlings are diately party in the Welcome, alluded to by Mr. mollimma,)two brent geese, (aiuerbimida,)
received imme-
after birth, while the orphansare older,Weld, got to the isthmus connecting North and a singlepairof Arctic terns,{tlema are*
and thus better able to resistdisease or Somerset with the Continent of America, and tiea.)These were the onlybirds,with the ex-
vation.
pri- ception

neithersaw nor heard of the missing Expedition. of a solitary raven, (eorfmaeorax,)"

The children broughtup in the country, Sir James Ross has now returned from North " Times, Or is it upon the ptarmiganand
under the direction of this establishment, are Somerset,and tellsa liketale. It is not, then, musk oxen of the western coast of North Somer- set,
17,202in number, and the expense for the year upon the dried meat and pemmican of the Bay more southerly than Ross has proceeded,
1848 amounted to the large sum of 66,000^., of settlements, the fish of the North American that theyhave been provisioned ? It is statedto
which 9,000/.were defrayed from the hospital riversand its coast,the stores of the whalers,be the opinion of Sir John Ross,that Franklin
funds, and the rest by the departmentof the or the white foxes,hares,bears,or fowls of had pushed on so far beyond Melville-Island
Seine. Out of the 57,000/. thus furnished, the the northern parts of North Somerset, that, so (110'' W. long.)that he had preferred making
Medical Professionreceived 2,000/. for attend-
ance far as we can believe, the crews of the Erebus for the Continent of America to returning in an
on the infants, at the rate of 2s. 6d. and Terror have subsisted. But, in truth, let easterly direction and seeking assistance from
per
head per annum, and la. 8d. for each vaccin- ation. any one read King's,Franklin's, ardson'sthe Bafiin's Bay whalers,
and Rich- {Times,)But,accord-
ing
journeys,and then say on what to Sir John Barrow, the attention of Frank-

theycould expect 126 (138?) men to live for lin was particularly drawn to the propriety of
SIR JOHN FRANKLIN'S EXPEDITION. two years much eastward of the Mackenzie and avoiding that desolateand miserable island,"
"

(Continued from Vol. XX., p. 487.) north of the Bear Lake. The very party in (Melville "
;) (Barrow'sArcticVoyages, p. 114;)
It has been stated, on
"
the highest official search of Sir John Ross saved themselves from -"so that,according
thority,"
au- to his orders or advices,
before remarked,that Sir John starvation by consumingthe food intended for we may
presume he had no business there.
aa we

FrankKn was provisioned for the summer of that officer long before they had reached the Let us stillsuppose, for the sake of argumenti
1848, and we suppose, of course, for no longer.half-way house to him (King). In 1847,thus that thereabonts he has become besiegedby
We will assume, however, that at that time, the writes Dr. Rae, "
Leavingtwo men in a snow ice and snow. At this spot, during a
shipsbeing safe,though firozen in, and their hut in lat.68" 48^ N., long. 85"" 4' W. to en- deavourstay of nearly twelve months, the following
crews living, Sir John Franklin, foreseeing the to fish and shoot,"":c. "
The men we amount of provisions was procuredby Parry
probability of beingice-bound another winter, had lefthere were well, but very thin, they
a s when detained there in his first voyage ; "

"that of 1848-49,"had managed,by dint of had neither caughtnor shot anythingexcept 3 musk oxen, 24 deer, 68 hares, 53 geese,
the greatesteconomy and care, not to say de- privation, Had been absent twelve 59 ducks, 144 ptarmigan
two marmots. we ; these, amounting,
to make his stores extend through hours more theywere to have cooked a piece in weight,to 3,766 poundsof meat, affording
the greater portionof such a dismal period.of parchmentskin for supper." "Only three to each of 94 men 3^ poundsper month ; and
But on what,may itbe asked,|httve the crews years ago,"writes Mr. Isbister,one-half of thisquantity is the produceof an island stated
"

of the Erebus and Terror subsisted since then ? the Hare tribe of Indians perishedaround to exceed 5,000 square miles in surface ('" row,"
Bar-
In the Mackenzie River and Great Bear Lake, Fort Good Hope, after havingkilled and eaten
op. cit. p. 116). Now, of the creatures
and, for aught we know, in the Coppermine two of the Hudson's Bay Company's people above enumerated, not one, in allprobability,
and Great Fish streams, exists the coregoniu who imprudently ventured beyond the gates,"except rein -deer,could be procured after the
albut or whUefsh,calledby Dr. King the "
bread "
"
a partynumberingnot more than ten indi-
viduals, middle of September;so that,in this spot,this
of life,"to the inhabitantsof North America, stationedon the borders of the largest desolate region,"
'* all provisions for the winter
in gratitude for its having been the provision and most productive lake in this part of the would have to be hunted for and preserved in
which mainlysaved his party from starvation world,and, aided by all the resources of the the summer season. The rein-deer, too,migrate
when in search of Sir John Ross. This fishis Hudson's Bay Company, barelycontrived to from the island before the end of October,
said by Dr. Ring not only to be a food upon subsist on half-rationsthrough the winter ; leaving onlywolves and foxes there duringthe
which men can livefor several months together, while of the unfortunate natives attracted longwinter months. Not even the Polar hare,
but actually fatten,and to that resource must round Fort Reliance by the presence of the or seals, gulls, or ducks,'* condescended to visit
the crews of the Erebus and Terror trust their whites,it is recorded,that at one time from Melville Island ; but two or three specimens of
livesif theycould reach it. But theyhave not, forty to fifty human beingslay dead around a caterpillar were obtained,one of which was
or had not reached it,for the coast line has the place, and so scattered that it was impos- sible broughtto England." (Parry's " FirstVoyage.)
been explored by Richardson, from the mouth to walk in any directionwithin twenty Even the procuring or huntingany animals,
of the Mackenzie River to Coronation Gulf, "
mjiles without stumbling over a frozen body." when and where that can be effectedin these
nothingseen of the lost party,and not any ac- count In 1846 dried meat and pemmican failedin regions of the Ice King,
heard of them from the Esquimaux,to the Hudson Bay Company'ssettlements, so that "*
Where frost
lead one to suppose that the ships or theircrew the Company could not undertake to provide Reignseverlastingly, and ice and snow
had ever got so far down, and so wintered on Thaw not, bat gather,"
for any parties travelling throughthe interior,
the coast But itmust be difficult to fish when and were obliged to freight an additionalshipto is constantly attended with great risk from
the streams are frozen to the bottom,and when carry out supplies of food from Europe to their snow-drifts, frost-bites, and " snow-blindness ;"
the sea, near the coast,isturned into ice,even own ports,(Weld.) Of the capacities, then,of the former peril endangering the personal safety
 44 THE MEDICAL TIMES.
of the whole partywho may happento wander crowded dwellings of the poor, and the reek-
ing of Arches,and that funniestof allabstractions,
any distancefrom the ship. However, it is yet soil is turned up dailyand nightly ; while,the Court of Delegates ? Yes, of course, every
in some of the most densely
open for us to imaginethatFranklin has avoided populatedneigh-
bourhoods,
profession and every calling,where opinion* are

the ''island*' and pushed beyondit. But how the curious may see how the inge-
nuity to be formed,have their minor differences; but
far he has proceeded who can tell? Thit we, of parochial officerscan packthe bodies that such should be gravely in bar of the
put,
unfortunately, are aware of, that his progres-
sion
" of twenty or thirty paupers in one hole. We proper carrying is simply
oat of such profession,
has not been so far as to enable him to not onlyallow a noble riverto be contaminated absurd. We may differ from Mr. Guthrie
come home again. "What detains him, then ? by all the filthwhich our metropolitan lation about College
popu- arrangements;but is there a
Is it" how fearfulthe conception !" that the can generate,but we pay, for the privi-
lege man in the Professionthat does not respecthis
command of his ships has been taken out of his of introducing the noxious fluidinto our views as a Surgeon? The opinionis hazarded
hands, their screw-propellers rendered useless,houses,three times as much money as ought by the Review, that Nelson would never
and that theylie motionlessand powerless "in to buy us a twofold supplyof have obtained high command from a board
pure water.
the centre of a fieldof ice more than fiftymiles Still, as we have alreadyintimated, we are of old Admirals; "nor is it uninstructive to
in circumference ?" " an imbeddingwhich capableof excitement Our farmers clamour remember,"it adds, "that the idea of sanitary
curred
oc-

this year to Ross,but from which dread-

ful for protection, and our little boys cry for the reform did not originate within the Medical
encasement his vesselwas quite unexpectedlymoon. Let but the King of the Cannibal Profession." Accordingto the Review,the con"
released as if by a "
miracle," as if by some
"
Islands come upon 'Change as a borrower, a nd stant direction of the Facultiesto the cure of
unseen power." (Ross'sNarrative.)If such straightway
" a public meetingwill be held to disease, dees not leave much time to devote
should have happened,on what kind of sus- tenance frighten Englishmerchants from doingwhat to the studyof its external cause. To prove
have the crews subsisted? Are even they like with their own money. Five thou- sand this very questionable position, we are carried
bears and snow-buntiogs to be found? What gentlecreatures in sober-coloured gar- ments back to the times of Greece and Rome, and to
resources forfeeding his men SirJohn Franklin will weep over the immoralitiesof the the pipes for sewers and aqueducts plannedby
mightdiscover on the western coast of North Chickabiddy Indians^and club their half- the great men of those times at the sugges-
"
tion
Somerset or Boothia, more southerly than Ross crowns for the devoted orator who has made of physicians we would say;" but we shall
could take his exploringparty, supposingExeter-hallring with his eloquence, and then not discuss thatpoint, resting satisfied with the
Franklin has got there, no one can positively say, go home in happy unconsciousness, that within facts, that all that is known on sanitary matters
since no one has been there; or of what he might a few yards of their pretty villas there are isdue to the Profession, and that, without the
find on Victoria or Wollaston Lands, we are many houses, in which,from ten to thirty sons knowledgepossessed
per- by the physicianof the
equally in ignorance ; but what he might pro-
of all ages, and both sexes, are nightly relation of the human to air, and
organization
hably meet with, few, after readingour re- marks, huddled in
together one small room. light, and water, and the many other agents
we believe, can hold much doubt If we could but collect a titheof the siastic
enthu- that surround us, the subjectwould have no
about the matter. With regard, however, to zeal and earnest feeling which is now existenceat all.
these latter stations, Sir John Richardson, in wasted and thrown away, and set it to work in The great eatholicon of the Review seems
his late narrative, thus promisingly speaks: "
the rightdirection, we should not despair of centralization, with some noble Lord at the
''
Deer migrate over the ice in the spring from shortly finding out even what the Metropolitan head, responsible to Parliament Why not a
the main shore to Victoria and Wollaston Commissioners of Sewers are about. Medical man responsible, we would ask ? The
Lands in large herds,and return in the autumn. noble Lord,of course, is not to tread on the toes
The lands are also the]breeding- places of vast THE EDINBURGH REVIEW AND THE of the Chancellor of the Exchequerby talking
flocks of snow-geese; so that, with ordinary MEDICAL PROFESSION. of abolishing the window-tax : he is,of course,
skillin hunting, a largesupplyof food might In an otherwise interesting article on the to be on a perfect understanding in that way.
be procured on their shores in the months of genera]Sanitary question, the EdMurgh Rt- Our Medical friend might,on the contrary,be
June, July,and August. Seals,also,are view of the presentquarteralludes, with some-
what very troublesome, talking of air and ligh^ and
in those seas, and are easily shot, of regret,to the jealousyfelt by the Mrs. Somerville'sexperiments. None
numerous repeating
theircuriosity rendering them an easy prey to Medical Professionas to the constitutionof the regret the littlejealousies of the Profession
a boat party. In these ways, and by fishing, presentLondon Board,stating, however,in no more than we ourselves, yet we feel itwould
the stock of provisions might be mented.very equivocal
greatlyaug- terms, that they cannot regret be an insultto the common-sense of our readers
And we have the recent exampleof the circumstance, that its chiefleader is not a to say that anything of the sort could bias the
Mr. Rae, who passeda severe winter on the Physician. It is very necessary,"
"
says our of
opinion any one man in the Profession on
very barren shores of RepulseBay, with no blue-and-yellow friend, ''that such a depart-
ment the all-important subject of Sanitary Reform.
other fuel than the withered turf of a herba- ceous should have the best scientificcouncil We trust our Northern Contemporary will give
Andromeda,and maintained a numerous the country can afford;but," yes, but is us credit at leastfor this,
" if he venture again
party on the spoils of the chase alone for a alwaysnear when it is necessary to prove some- thing on the subject.Without the generalintelli- gence
whole year." We have not yet closed thissub- ject, very out of the way " but,on the other
"
of the Profession, and the eminent
but shallconclude itin our next. hand, it seems indispensable that an admini-
strative services of Mr. Farr, the Registrar-General's
body comingin contact with constitu- tional Reportswould be a tabula rata; and without a
"
WHAT ARE THE rights"^rathersay, forthe goodthings
" of more generalrecognition of this intelligence
METROPOLITAN COMMISSIONERS Downing-street should have another kind of by the State,Sanitary
"
"
Reform will ever he m
OF SEWERS DOING?" leadership." The Medical body, too, have nubibus,
''

So asks the TimeZf and we wish that we could defects,"continues our wise cotemporary,"in
SiNGULAH InCIDBNT 19 A MADHOUSEU"The
answer it.The mysterious personages in questiontheir jealousies and prejudices, which un- fit BoiUm Herald, U.S.,mentions that some time since a
have already evinced so obstinatea determination them for such a position." Now, without at singular and romantic incident occurred in the City
to keepthe public ings, all granting that these littledifferences of Lunatic both
in the dark as to theirproceed- Hospital.A mother and daughter(emi-
became inmates at differantdates,
grants)
and
that we suspect theyare not doingmuch opinion would unfit any of the Profession in were
placed in the same storey of the building, where
good.Verily, we are a patient people ! That is, the way alluded to, we would ask^ have the they had access to the same baU. Thej met and
each other,thoughone bad left the other
we are patient in allmatters which come under other Plrofessions no littlebattlesand dices?recognisedin
preju- Ireland. They had each crossed the
years ago
very eyes and We have abundance of the Guards and the Line
are as amiable
our noses. ocean, become residents in New York, and lost all
"

indignationreadyat a moment's if
notice, any towards oneanother as could be wished ? are knowledgeof the other'shistorr or fate; both became
"

bereft of and in a madhouse,surrounded by

barbarityis committed two or three thousand tionsthose whoreason,
naval officers contented in their relativeposi-
were hopelessly insane,the child and
miles off;hut thingsat which barbarous ? ^isthe Qorham case likely to remind us dethroned, and
our "
parent met ; though reason was
brethren would blush,are submitted to without of the true qualityof Charity ? Then the law "
they were there with minds diseased,yet nature
shall Charles Dickens not be made minced- moment triumphed over the clouded intellect,
and for a brief
a murmur. Our burial groundsare bordered
they conversed on the land of their birth,
by the spacious mansions of the rich,or the meat of for letting out the secrets of the Court and of their separation.
 THE MEDICAL TIMES. 45

PUBLIC HYGIEHE. clayor stone-ware tubes,itwill be obvious that the with the dimensions of the main or larger drain,so
DSAIKAGE : AS IT AFFECTS THE HEALTH, suggestedis that of a circle. But althoughthat there should never be any need for enlarging
form
WEALTH. AND MOBALITY OF SOCIETY. thisis gpreatly to any of the other forms the latterin order to receive the branch current.
preferable
which have been usually chosen,we do not see why Traps. The numerous
" inventions and patentsfor
No. III. the last impnyrementin the shape of the sewers, thisimportant littlepieceof mechanics,which is so
DiJieuUyoflayingdown a regular SystemofHouse- put forth by the Sanitary Commissioners in their necessary to the attainment and preservation of a
draimng,-^AnApproximationthereto. Materials firstReport,as the result of innumerable experi-
"

ments " sweet house,"may allbe reduced to two, viz.,the

and Stmeture, Form,
" Dimensions.
" tion,
Construc-
"

by the most experienced surveyors and en- gineers,water-trapand the flap-valve. All the others,at
"
Puwtps. Protection qf Inlets. Cesspools.
" " "

should not be equallyavailable for house presentknown, are modifications of these. The
United Back-drainage. Water supply.
"

drains. all
Admitting necessary exceptions pe- in culiar flap-valve is excellent, so long as itsaction can be
To display the shocldng condition of our metro-
cases, we think that an egg-shaped tubular keptin perfect condition ; but this is very liable to
politan sewers and drains, and the yarious dangers
drain would be preferable to allother forms. The be disturbed, and itseffectdefeated by the leastsub- stance
attendingthat condition botii as to health,and
"

falland
alao with lefeienoe to the chances of injury by the broader end of the egg-shaped tube should be up- permost adhering, so as to preventthe perfect

Not to dilateupon experiments and tech-

nicalities,
closingof the flap.The water-tnp is,therefore,
imminent dangerthere existsof some of the sewers
in was oni anzions task in the first Number which would occupy more space than we preferable for allhouse-drains ; and the best of this
fidling "

of these papers. To pointout the principal defectsin can afibrd, it may here be sufficient to
say briefiy, class is ascertained to be the syphon. It is the

our house-drains,not merely as to condition, but that the egg-shape presentsfewer facilities nant most effectual in its action ; it is lessliableto de-
for stag- posits;
accumulations ; ithas the best form for a re- gular it can most readily be cleared;itisleast
with regardto their original construction, which in
flow of sewage, the deepest space below for an liableto displacement ; and it is the most mical.
econo-
aeneral respectsrenders their foul {and inefficient "

in the ordinarystream, with the largest space above for For all house purposes drains,closets,
"

state within almost inevitable, was our object

accidental storm-water or other fioodings ; and is, sinks, areas, yards, "c., itisthe best of allthe ous
numer-
second paper of this series. To propose more
and to explainmoreover, the best form for beingcleansed by flush- ing tribe of traps hitherto invented. Double and
correct principles of construction,
their main features, is our presentfar more difficult or any other process. In all cases, however, triple syphons may also be used, at times,with
the rationalchoice rests between circular and egg- greatadvantage, by which means several pipesmay
biuiness.
shapedtubular drains. oftenbe trapped by one syphon.Finally, care should
Tlie attempt would, no doubt, be sufficiently
arduous in ^my case ; but, inasnmch as the regular I"MMiuioiM." One of the most important r esults be taken Uiat the syphon should alwaysbe of the
missionof experience
which the Com- and experiment is in the reduced di- mensions
same sizeas the drain or pipeintowhich itleads.
"yitem of metropolitan drainage
of sewen and drains. Instead of a drain Protection rf Inlets." It is importantthat the
of Sewers has promisedto laydown, has not
yet been determined ^with all the engineers
" and of a foot square, which was commonly given to a greatestcare be taken to preventthe entrance of
in house of the smallest class that had any under- ground impropersubstances into the drains and pipes.The
"nnreyors at their conmiand, long experienced
drainageat all, it is now known that,with openings, therefore, of allkinds,should have protec- tions
this special department, not to mention the privi-
leges
a three-inch tubular drain will at least moveable onlyby a proper
and powers of the Commission in other respectsa proper inclination, fixed, or

" ^itwould be the greatestpresumption in any indi- not onlybe largeenough,but that thissame three- tool, and not by hand; while,with respectto those
"idual to step forward witii a positive inch tube, properly inclined, willbe sufficientfor openingswhich are necessarily left unguarded,
system as-
sumed

and detail.Under eight houses of the same kind. It of

will, course, strong ii\junctions should be laid on everybodyin
to be complete in principle
be undentood, that the area to be drained should the house against throwing down rubbish or any im-proper
these circumstances,we would have it understood
that what we propose must be considered as subjectnot be unnecessarily large,that is,not exceeding substances.
to the oorrectionof further experiments ; but at the
2,500 square feet Larger houses will obviously Cesspools. Concerning
" these odious old monsters,
time we readers that the require larger drains,viz.,tubes of four inches, five the long-continued curse of our houses,the polluter
same may promiseour
main principles about to be laid down will at least inches,
and six inches diameter at the largest As of our air and of our water, the generatorof
be greatly in advance of any of the ordinary a generalprinciple, it may be stated,that the bad odours,of bad health,of sicknesses and fevers
systems
smaller the tube and the
greater inclination,
the in alltheir
forms, "
the rich man's
enemy , secret
and practices at presentadopted.
(according to the previous proportions,) the more the open destroyer of the poor, the friend of long "

We cannot do better than givea statement of the

efficientand certain will be the drainage.The doctor's bills, and of the undertaker, the protege "

conect method of drainageunder the same heads

same principle should be kept in view in all the of the lowest degreeof poverty,of filthiness, and
and in the same order as we adoptedin our second
smaller drains of the house closet-drains never
" of ignorance,^thegreatestand most insidious re-
"
proach
paper, when speakingof the evils of the ordinary
in practice.
exceedingthree inches in diameter ; while those of to science, civilization, and the parishau- thorities,
systems of house drainage now
sinks,yards,areas, and rain-water pipes,should there is onlyone thingto be said, abo-
" lish "

Materials and Structure. Instead of bricks for

"

seldom be larger than two inches in diameter. them allfor ever. Put decent closets in their
the building of drains,even if theywere of the best
Construction, A proper flow of sewage can never
"
place, draining d own into the main sewer, and in the
quality, and cemented together in the best manner,
be obtained without sufficientinclination of the ledgeof the nearest window a row of garden-pots,
we would stillrecommend the use of clayor stone
drain. A child might understand that ; and yet it where mignionette and his favouriteLondon-pride
ware tubes as preferable in the great msjority of
is really necessary to state thisin the broadest man- ner, mighthelpthe denizen of a crowded street to lose
cases. They should be smooth inside and imper- meable. from the simplefiu;tof this obvious principle all memory of his pestilent foe.
The joints of each of the lengthsof tube
havingbeen so frequently disregarded. And here United Back-drainage. A very greatadvantage, "

ahould be so contrived as to fitperfectly, yet with a another advantageof the reduced dimensions of
both in efficiency economy, may be expected
and
facility of displacement for examination ; and they
drains will be apparent ''Where, for instance,"from the adoptionof a
ahonld not be liable, at the same
system of united back-
time,to get acd-
says Mr. Donaldson, nine inch barrel drains" (on drainage
"
of a street, or number of houses,(wherever
dentally displaced. For these combined advantages,
the old brick-work construction) "of ninetyfeet practicable,)
aU thingsconsidered, the half-socket jointis the
as recommendad by Mr. Donaldson
length, c ould only be laid on a dead level,a four- and other Surveyonof the Commission of Sewers.
best.
inch pipe-drain would be laid with a fall of 1 in Instead of carryingall the drainagethroughthe
The following Table is taken from the fint Re- port 120.
Sixtyfeetof length, which would be levelin house into the street, (most of the inletsto the drains
of the Metropolitan Sanitary Commissioners.
brickwork, would, with the pipe-drain, be laid at and pipesbeingat the back of the house,)itmay
1
Table ifComparative Time of Run rf Water through in 80 ; and thirty feet of lengthwould be laid at easily be undentood, that all the drains beingcar- ried
1 in 40 ; a savingof nine inches being^effected, and
Brick Drains and Glaxed Pipes. from every house in the street into one main
the differenceof the dimensions of the drains,and line at the back,would be a of
greatsaving expense
the thickness of the material." in the lengthof the drains,and it would also pre- vent
In the junctions of branch-drains allright angles the chances of effluvium in cases of accident
or other abruptentrances should be most carefully and repair.
avoided. The branch-drains should be led into the Water Supply. A proper supply " of water is es-
sential

main or larger drain byagradual curve, sweeping down to gooddrainage.In the presentuncertain

at itspoint of entrance to a level with the bottom of and transitionalcondition of affiun with respectto
the larger drain. No junction should ever be made the grandsystem of drainage which we expectto be
at the top of a drain. Junctions made in vertical laid down and carried out by the Metropolitan mission
Com-
pipes of any kind should be made by a curve of Sewen, itis difficult to say what should
Jbrst." Having stated that,in placeof the old sloping down into one side. The size of the junc- tion be done in the matter of the water-supply. This,
teiek*bailtdraina it would bo advisableto adopt pipoat itspoint of entrance shouldalways vaf y howevcTiappears clear,^there must stillbe in-
 46 THE MEDICAL TIMES.
REPORTS OF 800IETIB8.
but,in the plentiful
enrred the expense of tanks or cisterns; harvest,thoughhe cannot bid the sun shine
the nippingfrostor
streets,it mightsurelybe managed or the dew descend,or prevent
building
of new
disastroushail,
so the pnysieian willseek to treat his WESTMINSTER MEDICAL SOCIETY.
by the landlord that one* largetank should sup-
ply to those laws which Nature herself
agreeably
half-a-dozen houses. Eventually,
however, we Ktient
knowing that contingencies
aUught him and ;
F. HiRD, Esq.,President,in the Chair.
oonfidently
anticipate,that the expense, inconve-
nience, may arisewhich may frustratethe best-laid plans
and bafflethe most judicious management, he will
occupationof space, and trouble of cisterns,seek TUB"BCULAB DISEASE OF THE LUNG^
to labour in subordination toHim in whose bands
will be totallydone alone are the issues of lifeand death." HERNIA.
duringa hard frost,)
("specially
At the meetingof this Society, "

away with,and the water be laid on to every house Dr. Wood, in the outset of his Lecture,quotes a Mr. Haynes Walton presented a well-marked ex- ample
in sufficientabundance for all domestic purposes, from in far it is
passage Herschell, o n which" as as of the conversion of tubercleintoearthy matter.
and for the promotion of good and unfailing drain-
age to medicine,much instructive comment It was taken from the lung of a patient who had been
applicable
of the premises. under Dr. Taylor, of Guildford. She was aged 40,
mightbe made.
and had been subject to palpitations for six or seven
''
Medicine,"be says, " is at once a science and Dr. Taylor had attended her frequently
RBVIBWS. years.
an art. But as a livinsphilosopher observes, art is the
during the last six or seven months for chronic
" " application of knowledgeto a practical end. If the
mercurials
An Addrut delivered on the Opening9^ the New knowled^be verily accumulated experience, the art bronchitis. She had improved under
is empincal; but if itbe experience reasoned upon, and counter-irritation over the larynx. Mr. Walton
School ofMedieinet Surgeon* sHaUf Riinlmrgh, Nov.
and broughttuder generalprinciples, it assumes a had been called in to applynitrate of silver to the
6, 1849. With an Appendix. By Alexander
M.D., F.R.C.P.E. Lecturer on the higher
character and becomes a scientific art." larynx. She died suddenlyon the I8th of this
Wood, There must have been originally
art ! month. very
a
Practice of Medicine, "c. "c. To what extent,then,isMedicine a scientific
largetubercle, forthere is a larg^ cartilaginous trix,
cica-
firstof all, what examplescan be found of un-
The IntroductoryLecture delivered by Br. And, equivocally
and much puckering of the surrounding pul-
monary
scientific arts t The art of constructing
Alexander Wood at the openingof the new building substance. The earthydepositis bigger
and repairing steam engines, as also the art of con than and of hardness. The cavity that
forthe Edinburgh Extra Academical Medical School, a pea, stony
and repairing docks, watches, or time- keepers, contains it is lined by a smooth membrane. Except
has been published.Dr. Wood is stillyoung, but strncting
are scientific arts ; for in both cases, every some lobular emphysema, the rest of the lung was
iswell known in Edinburghas a clever speaker and
of the mechanism dependson known principles healthy.The rightlininghad miliaryand crude
popularLecturer,the author of *' Homosopathy part tubercles in each of its lobes. There was able
consider-
of science. Medicine, that is the art of curing,
Unmasked," and of "A Sequel to Homceopathy disease of the heart The consolidated aortic
Unmasked.*' The Lecture contains a great deal of palliating, and preventing disease,is not a morbid
valves were exhibited. The most interesting
instructive observation, addressed to the student, scientificart to the like extent ; for we cannot
part, the larynx, which was oedematous,was left
accompaniedwith much ingeniousand eloquentso certainly explainthe relation between the oper- ation behind by accident
of the medicines used and the effect on Mr. Erichsen then related four cases of hernia
illustrationof the topics introduced. It is impos- sible, that had, amongst others,occurred to him during
within a small compass, to state the substance health which follows their use, as to devise plans
the last few months, and that presented some tures
fea-
of such a Lecture. One or two specimensmust of treatment at once on this understanding. Every of unusual interest The firstwas a case of
suffice. planof treatment must be judgedof by itsimme- congenital hernia in a 3roa]]g
strangulated inguinal
dlste effects, and changedor continued according to the of which rendered scure
ob-
** I
am he
aware," says. "
that the student too often man, diagnosis was very
prefers that teachingwhich stores his memory out
with- the indicationssupplied by these. Again,medicine by the presence of a very largequantityof
exercising his Judgment This arisesfrom the is not merelyan empirical art ; because,even when fluidin the tunica vaginalis, and by the fact of the
Utilitariantendency of the present age, of which a
of science to the descrip- tumour, though containing strangulated bowel,
the numerous applications tion
chiefcharacteristic is that, in knowledge, as in soft and fluctuating throughout,and
thing
every- and diagnosis of diseases, and to the discoverybeingpeifectly
else, an immediate advantage is demanded."
partly reducible with an emphysematouscrackling.
"
Give us that information which will and preparation of medicines,are leftout of view as
On cutting down upon it,the stricture was fbund at
serve us in the real and practical business of life, is belonging to the preliminaries of the art rather than
the almost universal err. And will not dispute,
the internal ring,where the coil of intestinewas
we
to the art itself, there is stillno small share of sci- ence confined by very firm adhesions, and separated by a
that in this age of bustling and jostling contention"
when the ingenuity of roan issharpened left, in the shapeof generalprinciples, cable distance of more
appli- than two inches from the testis,
by necessity,
and when everything is brought to bear on the to the choice of remedies for the treatment of which layin its normal situation. The patient had
business and ordinary transactionsof life, such con- various groups of diseases, as fevers, a smart attack of peritonitis afterthe operation, but
siderations "
periodic, tinued,
con-
are imperatively demanded. But let us eventually did well. The second case was peculiarly
and eruptive, acute inflanunations, active
well weigh,and maturely considerwhat is the really, from its bearingupon Petit*s operatioA.
convulsive mala-
interesting,
the practically usefnl. If,as we have attemptedto haemorrhages, comatose diseases, dies,
The patient was a young man, who had su"red from
show you, every fact involves a theory, and ifboth dropsical efi!usions, dyspeptic complaints. Yet, reducible rightinguin^ hernia from birth. At the
are inseparably connected in the building up of a how far the art of curingdiseases is,and longmust time of the operation, it had been strangulated
seience, and iftheory is onlyto be rightly formed and
hours. There was feculent vomiting
constructed be, from beinga scientific a rt, in the same sense in about fifty
"acurcly by the reasoning powers of man,
is it not by cultivating these powers and by directingwhich the repairing of steam-engines and that of and much peritoneal inflammation. The stricture
them into this new and somewhat appeared to be at the external abdominal ring.This
peculiarchannel, time-keepers are scientific arts,must be manifest at
that your minds willbe bestformed to think on such was freely t he
divided, sac having been opened; but
a single glance. The question, how far medicine,
of constriction
aul^ects, and to think correctly." still it was evident that the cause
on the one hand, is a scientific art,and how far,on
Such sentiments cannot but meet with the general had not been removed. The contents of the hernial
the other,an empirical art, is a proper subjectfor sac, which were composedof omenttmi and a knuckle
approbation of the thinkingpart of the Medical
arithmetical computation, and such a statement,of dull intestine, well drawn down, when it
were
Profession; for undoubtedly one of the firstthings
drawn up in a trustworthy manner, would be highly was found that a very firm, narrow band of pale
that should be impressedon the mind of every side of the coilof gut. This
instructive. But, whatever might be the result, it fibres tied down one
Medical Student at the very outset of his studiesis, had no connexion with the sac, but stretched across
is certain that no one is competent to practice cine,
medi-
that the course prescribed forhim is designed forthe from the mesentery to the omentum. It was care-
fully
even within those limits in which it is an em- pirical
twofold purpose of supplyinghim with a sufficient dissected off the bowel, which, together with
art,whose conceptions of what is required of the omentum, was then returned. The patient died
amount of practical knowledgefor dailyuse in his him are not framed in the
after-life
spirit of physiological of the peritonitis, which was very intense before the
in the treatment of disease, and to train his
science ; because, without the impress of that kind operation. Mr. Erichsen remarked, that had the
mental facultiesto a correct method of thinkingin
of knowledgeon his mind, he is not capable, for the sac not been openedin this case, the stricture at the
regardto the phenomenaof the animal economy "

external obliquemerelyhaving been relieved,the

that is,in obedience to the spirit
most part,of perceiving exactlythe occasions to
of the laws which intestinewould have been returned still strangulated
which his empirical remedies are applicable. Thus,
govern these phenomena in health and disease. by the narrow band of fibres, the case beingone of
science in medicine does not so much aid the art internal in an incvceratedhernial sac.
Such views as the following cannot be too strongly strangulation
itself, by making it scientific, as it renders men The third case was one of femoral hernia,operated
nxgedon the attentionof the student,as well illus- trating
competent to put in practice with success the empi- The stricture here was
rical on without openingthe sac.
the extent to which superior skillmay con "
rules which time has accumulated. It adds to occasioned by a firm band of fibres lyingupon the
duce to success, notwithstanding that the art of neck of the sac, and constricting it in an hour-glass
the senses new powers of observation ; to the judg- ment,
medicine is not one in which failurecan be positively of discrimination; and daily shape. This was carefully dissected off the sac,
new means
averted :" when the contents went back with difficulty. This
afibrdsto experience fresh opportunities for exercise.
** case was interesting from its bearing upon the ope- ration
All the agenoiet of nature are not at your dis- posal,
that had been proposed, of dividingthe
nor are allthe powers of lifeobedient to your
call. But justas the skilfulpilot directshis vessel, ToRBAT Infirmary.~A
stricture by a limitedextemiU incision. This could not
sum of 300/.is about to
and trims and changes its course asreeably to tlie be expendedin changing the styleof architecture of have been done here,as the stricture layvery deepat
laws of his art, as the winds or tides, wnich he cannot the front of this building, from the Italian to the the neck of the sac, and full
required exposure of this.
may aiffect
control, it ; Justas the judicious man
husband- Tudor. True charitywould dictatea bettermode of The fourth case was of a very largehydrocele of the
uses allthe means whioh ordinarily seeure a
^

employingthe money. hernial sac The patient, about forty years of age.
 THE MEDICAL TIMES. 47

to Mr. Erichsen,with
appiied a tumour as largeas MEDICAL SOCIETY OF LONDON. a small building, forminga cube of about thirty
He feet, with a smaU pyramidat itssummit The en-
trance
8 child's head on the right side of the scrotum.
badhad herniathere for twentyyears. Of lateyears H. Hancock, Esq.,President, i n the Chair. is on the north side,near which the Doctor
copiedthe fragmentary inscription T'ENTEHL-
ithftdonlyheen redncihle to a partial extent, and THE OTOBOOPB'AICAUROSIB CUBED BT
hidrecently increased very rapidly. The upper part ERTSIPBLA8. eOAON. In the interior are small compartmento,
J
the probably sepulchral chambers. Near to the ruins
ofthe tumour was found, on exammation, to be com- posed After some observations by Dr. Cogswell on

of reducible hernia ; the middle portionof propagation of cholera throughoutthe United is a natural bridge, about 180 feet highand 100 in

sdherent omentum; and the lower part of fluid; Kingdom in 1848-49, to prove that the facto length.
belowwhich laythe testis, quitehealthy.The fluid connected therewith were in no way opposedto Hence the Doctor proceeded by the beautiful vale
tumour was uniform below ; irregularly circum- the doctrine of contagion, Mr. Harvey exhibited of Kadisha to Hosrun, Kanobin, Aden, and Beshcwe,
icribedabove ; was reducible on pressure, and soft an instrument,called the Otoscope, the object of and thence back to Tripolito obtain horses for
Slidfluctuating. From the history of the case, and which is to ascertain the permeability of the Hosn Sphyre,(commonly called Kalaat el Hosn.)
esreful manipulations, diagnosis
the from encysted Eustachian tube, by placing the bell over the Hence he visitedAkkar, the Area of the Romans,
when with the who placeditin the northern part of Phoenicia, and
hydrocele was made, and the tumour tapped, patient's ear, and directing him to expire,
stronghold, in after times,of the so-called
about three pintsof yery dark chocolate-coloured mouth and nose closed, so as to drive the air into the a leading
"
Assassins." Dr. Zimpel'snotices of these ferent
dif-
fluidwere drawn off. cavity of the tympanum, its impulseagainstthe
membrane being transmitted throughthe tube to mountain siteswere very detailed and satis-
PERIITEAL ABSCESS. the ear of the surgeon. Mr. Harvey was of opinionfiictory.
The following case was narrated by Mr. Hancock, that the use of this insttument would enable the After a visit to Safitta and the Island of Ruad"
from Tortisa,bjr the coast,to
iQigeonto the Charing-cross Hospital : "He was surgeon to dispense, in a greatdegree, with the use the Doctor proceeded
calledduringlast July to a gentleman suffering of me catheter for the Eustachian tube ; as, ifit were Latakiyah, one day's ride from which he visited
from extravasationof urine. He had sufferedfrom could be discovered the Castle of Sahium, or Sayum, which he believes
not obstructed, itspermeability
stricture for nineteen years, and had had the stricture without it He belieyed that Eustachian catheter- not to have been previously described. This extent
is,in most parts,as perfect in
(lirided throughthe perineum, and also the bladder ism was practised fiirtoo f^quently, and alluded to sive fortification as

olden times,excepting the buildings in the interior,

punctured throughthe rectum, but without any re- lief, cases in which that operation had been performed,
which mostly in ruinous condition, is situated
as in the firstinstance the wound in perineowhile the tube and adjoining a
partewere in a state of are
feel
had been allowed to heal up without any attention active inflammation. He was further of opinionat the extreme pointof a well several hundred
in height,between two valleys with mountain
being paidto the uiethra. Mr. Hancock treatedthe that "tonsil snipping"had been practised to an
extrsTusationin the usual way, and, in the course streams, so that it forms the fork between them.
enormous extent, with the professed view of relieving
of a few days,with the patient's consent, again or curing with which it was in no way con- nected. The base
of the triangle thus formed is separated
deafness,
diridedthe stricture through the He from the continuous land by an artificial cutting in
perineum.
the wound
kept in the perineumopen by passing a Mr. Hancock mentioned the case of a plethoric the solid rock, about sixtyfeet in breadth,by a
than a hundred feet A pillar is left
No. 10 gum catheter into the bladder,until he man about 38, who had been under his care in the depthof more
eonldeasily introduce a No. 11 silvercatheter along Charing-cross Hospital f br amaurosis of two years' standingin the cut for the support of a bridge.
building in the interior that
theurethra into the bladder, when he allowed the standing, which Mr. Hancock supposedto depend The most perfect was

perineal wound to heal, and the patient is now covered.on

re- cerebral congestion. He could not distinguish which contained the well. It has a largehall,with
lightfrom darkness. He was cupped and bled, vaulted roof about sixty
feet in length by twenty-five
for six weeks,but feet in breadth,a stone staircase leadingdown
to
He considers the case of interest, as bearing upon and had small doses of blue pill
The buildings and
thequestions mooted duringlast sessionvrith refer- ence without benefit. He then had an attack of rheumatic the water, which was excellent
works of defence showed evidence of changes and of
to the treatment of abscess in the perineum iritisin one
. eye, which, after the lapseof three
connectedwith obstinatestrictureof the urethra, and weeks,was succeeded by a severe attack of erysipelas differentepochsin history.
alsowith reference to the operation for openingthe of the head,on the subsidence of which the man From LaUkiyah,Dr. Zimpel proceeded to Suedia,
urethrafiromthe perineimi, and itsafter tre^^ent, could distinguish f rom darkness. After this, (Seleucea Piena,) whence he made excursions into
light
in relation to the employmentof the ca- restored the Jibal,Kaisenick and adjacent country. He next
especially theter yision gradually improved, and is now fully
I that when the abscess is unconnected with in one eye, and nearly so in the other, the one
"
that travelled,byway of Daphne, Antioch,Jisr Hadid,
opening into the urethra, it is better to abstain from had been affected with iritis; the impurment of (Pontisfer of the Crusaders,) Herem, and Dana to
returning to Edlip,Reiha, Kefr el Bara,
the employment of the catheter, notwithstanding sight in that eye Mr. Hancock referred to the Aleppo,
the patient experience diflSculty in passing his effecto of the iritis, and not of the amaurosis. He Kalah el Medek, (Ahamca,) Hamah, Homo, the
may
water: but that, where such complication exists,(Mr.Hancock)remembered the case of a preventive source^ of the Orontes,and Baalbek to Damascus.
vhieh he believes is most frequency the case, the service man, stationed at Margate,who was a It is impossible to follow Dr. Zimpelin his descrip- tion
of the many objects which presented themselves
employment of the catheter should be carefully at- tended patient under Mr. Guthrie at the OphthalmicHos- pital,
to him in comprehensive journey but he dwelt
to, particularly when it has been found ne- cessary about twenty years ago, for amaurosis. The so a ;

to open the urethra through the perineum,longissue in the scalp made in this case, and particularly on the extensive ruins of towns, monas- teries,
was
and churches of the early Christians to be
in which case he thought the instrument oughtnever caused a yiolent attack of erysipelas, which, as in
Mount
to be entirely discontinued. To this cause he attri-
buted the preceding instance, was followed by recovery of met with in the mountains around Dana, (
the failure of the first operation in the case vision. Mr. Hancock thoughtthat these two cases St Simon, "c.,)and near Edlip,Reiha, and Kefr
el Bara, and which it is to be regretted have not, as
just related, as well as in others to which he Erected the
taught lesson, t hat in the treatment of amaurosis
artists. Dr. Zimpel
the attention of the Society ; the catheter had been we do not push the practiceof counteraction yet,been visitedby competent
neglected, the parts allowed to heal and contract, vigorously issues, and also states,that at Apamca, at the west end of the
enough. Cupping,bleeding,
and so the patients became as bad as ever. setons were useful agents,but not sufficiently city, he found a colonnade of from 18,000 to 12,000
ful
power-
In conclusion,he of"red some feetin length, consisting of four rows of pillars with
remarks on the in many cases to cure thisformidable disease.
Qsoal perineal a space of about thirty between each double row.
operation. H e considered that the Mr. Dendy observed, that the very interesting
difficulties of its performance were greatly enhanced cases narrated by Mr. Hancock were supported by The pillars were thirty feet in height, some standing,
order. There
hjthe situation at which the urethra was usuallyanalogous instances occurring dailyin the practicemany tumbled down, of the Corinthian
intervals on
opened, the openingbeingmade towards the anterior of infantilediseases. In cases of morbid conditions appear to have been -small edificesat
of the membranous portion of theurethra, which of the brain,as indicated by the state of the
pupil, each side of the colonnade, a nd at the extremity large
part
ISsometimes completely cut across, so thatwhen the "c.,where there mightbe amaurosis, but the patiento and extensive buildings.
catheteris introduced and passedalongthe anterior were too young to recognise it,the occurrence of a
partof the urethra,it comes out through the wound, papular or other eruption on the scalp was sufficient
OORRSSPONDENOB.
out the posterior part having nothing to supportit, to remove all the threatening cerebral symptoms.
thesides of the canal fall together, close up, and The connexion between the two was well-marked ;
MR. McCLURE IN REPLY TO MR. CHUBB
greatdifficulty is experienced in hitting itwith the for,in those cases in which the eruption was repelled, AND DR. MILLAR.
point of the catheter. This difficulty may be obvi-
ated the symptoms of brain aflfection recurred.
by making' the openingin the urethra further
[To tht Bditor of the Medical Tlmsi .]
hack, close to "e front of the prostategland. In id your
the surireon wilfbegreatly SYRO^EGYPTIAN SOCIETY. Sir," Mr. Cbubb's letter, which appeared
performing the operation
Paper of the 22nd insunt, demands some notice
tssistedby recollecting that tne urethra passing from me. I dislikedealing in personalities, but, at
January 8 , 1850. characterand professional
throughCouper' ligament,
8 corresponds exactly t o
present, justice my
to own
thepoint in the raph6of the perineum, midway be-
tween David W. Nash, Esq., iu the Chair. reputaaon callsupon me to refutethe statemenU put
the posterior roots of the scrotum and the forth by him.
I may premise, that the Report which he so unge-
nerously
anterior margin of the anus, so that a knife plunged Dr. Charles F. Zimpel read an account of his
ttraightin at this point willreach the membranous recent trayelsin Syria* Starting from Beyrout, the attacks was originally preparedat the re- quest

of Dr. Gavin Milroy,one of the Inspectors

portion. After describing the various stepsof the Doctor followed the coast to the Dog River,whence
acting under the General Board of Health ; it was
operation, he concluded his paper by observing that he took a north-easterly course to the ruins of Fokra.
dated from TorpointDevonport 25th September
thecatheter employedshould be sufficiently largeto These ruins are situated in a valley surrounded by communication.
1 849" and sent to him aa a private
fill
the canal of the urethra, otherwise the portion of lofty mountains, and part of them occupy an ele- vatedThe facts contained In itso strongly corroborated the
theurethra behind the stricture, when divided, will position at the margin of a deep and wild adoption of preventive measures in successfully
"i)ltogether, and the pointof the instrument catch, precipice. The ruins are very extensive, but in a treatingthe epidemicwith which this country was
and thus be pTeventedentering the bladder. Ivery dilapidated state. The most perfect of all is then visited, that he thought worthyof publication.
it
 48 THE MEDICAL TIMES.
The manuscript was sent to you, accompanied, lieve, medical aid,would not coincide with that given memoranda which I made during
I be- the prevalenceof "he
by a note from Dr. Milroy, explanatory of the by Mr. Chubb. I am well assured that they did not epidemic,|by which it appears,that of thel9Marinei

ing
written ; but,it say that the cholera had nearly spent itselfat that who died in the hospital
circumstances under which it was from cholera, 8 died on
having been broughtout in the Medkal Times in the time ; on the contrary,theymade a most lamentable the day of admisaion 8 on the day following, 1 on
ibrm of a paper, (andnot as a letter,) without mak- ing representation of the health of the town, and which, the second,and 1 on the fifthday after adnussion,
the necessary verbalalterations required in such a when I went to the place, I found to be too true ; and only one case was admitted for diarrhoea, which
out of the 87 cases ofcholera which occurred terminated I think,
in cholera;this, issurely
case, the construction of the sentences was, in some besides, jgrtsii
instances, leftopen to criticism; to the truth of the at Torpoint,I was mys"lfconcerned in the treat- ment facieevidence that I was correct ; but, I am quite
statements, however,contained in that article, rently
appa- of 39; and when I furtheradd, that during my willing to be judgedby, and solicita referenceto
so unpleasant to Mr. Chubb, I still adhere. residence there I had 253 patienUsuffering firom the publicrecords of the hospital, as to whether I

Mr. Chubb commences by saying." that the pic- ture diarrhcea under my care, I think you will be fully was rightin stating, that the men were brought into
is overdrawn,and more particularly with regard satisfiedthat the disease had not nearly spentiUelf that establishment on the firstoutbreak of the dis- ease
to the supply and Quality of the water, on which so on arrival. in a state of collapse.
my
much stress is laid'^ by me. He then goes on to lead Another statement put forth by Mr. Chubb is, that I must apologise fortrespassing so far on your vs-

his readers to believe, that the inhabitantsof Tor- " on the 2nd of Septemberthe deaths had diminished luable space. I am enabled to bringforthpublic do-
cumenta to confirm the truth of my statements,and
pointhave never been at a lossforplentyof goodand down to about one a day,having been previously
wholesome water since he came among them. How five times that number." This, he says. ** can be defy any person to show that they are incorrect.
willMr. Chubb reconcilethiswith the fact,that,for proved by reference to the Registrar's book." Now, I have the honour to be.Sir,your obedient servant,
the space of a month from the 2nd of September, if by the convenient expression "
about one," he A. McClure, A.M., Assistant-Surgeon R. N.
between thirty and forty tons of water were sent, means turn,he is quitecorrect,as there were exactly H.M.S. Indefatigable, Hamoaze, Devonport,
three times a week^by Nicolas, in of the but I afraid 27th December, 1849.
Captain one two deaths on the in
day question ; am

Victualling-yard lighters,' for the use of his town. the Registrar's book willnot bear him out in asserting
Why did not Mr. Cfhubbprevent so much unneces- sary thatfivedeaths oecurred in one dayduring any pe- riod WESTMINSTER MEDICAL SOCIETY.
trouble and expense, if as he insinuates, itwas of the epidemic I have now oefore me a list
not required7 But that it was required,and that of those who died from cholera in his town, prepared [To the Editor of the Medical Timet.]
the peoplewere grateful forthe boon,is provedby a and attestedby the Incumbent of theparish, by which
letterwhich was sent from the inhabitantsto the it appears that the number of deaths never at any
SiR,~In a reportof the Westminster Medical
gallant the ISth of October,in which time exceeded three a day.So much for Mr. Chubb's
Society, givenin your journalof lastweek^a little
Captain, on
error has inadvertently crept in,which you willoblige
the foUowmg sentence occurs :
"
"
And especially statistical accuracy. me by oorreeting. I am stated to have said, in
theyreturn him their most grateful thanks for the Mr. Chubb asserts,that he never relinauished his ^
reference to the arcus senilis,'* that " itis always
most salutary and bountiful supply of water by him duties during the whole period of the epidemic, and
found in connexion with a corresponding opacity of
so frequently sent to them,which,under God's pro- vidence, seems highly indignant 1 should have hinted that he
the crystalline lens and capsule." The remainder of
they believe materially astitted to cheek the was ever indisposed. Now, when I said so, I did the is faultless, but in respectto the quotstion
report
raxHigee tfthe epidemic.This letterwas signedby not for one moment imaginethathe could be offended above made, the error may be thus corrected^" I
about 200 persons, who evidently seem to have laid with one for so doing,as I mentioned, in the same mentioned,that I had not as yet been able to dis- cover,
considerable ** stress**on the benefit conferred;and sentence, that his attention to those suffering from in numerous dissectionsol the eyes of sged
that Mr. Chubb must have been of the same opinion the disease had been most praice worthy; but I am (inwhom thissenile existed, the
told people
zone
at that time is evident from his name being fifthon certain he will not deny that he has frequently appear"
ance wnich Von Ammon has described ana de- lineated,
the list. Surely,Sir,this document of itselffully me he was quitedone up, and could not possibly of the anterioror posterior
viz., an opacity
bears me oat in my statements with regard to the have held out any longer had he not obtained the
capsule of the lens,in the situation (whether above
water. timelyassistance affordedhim by Captain Nicolas ;
or oelow) which is occupied by the senileare in the
Mr. Chubb asserts,that ** all the precautions culcated
in- many of his friends, also,were of the same opinion,cornea. Since pointing out the structure of the
in my paper were in activeoperation long and,ifI mistake not, he was obliged, some time be-fore
arcus, at the Society, I have, fronn severaladditionsl
before he had the benefit of my assisunce." Now, Ijoinedhim, to leave the town in consequence dissections, found that when that appearance is
aithoughI do not wish to cast the slightest tion
reflec- of inability to attend to his duties, and J am pretty it is almost invariably la connexion with a
on Mr. Chubb's treatment,yet I deny thissUte-
He must
certainthat the Board of Guardians were
that on the very evening necessityof employinga medical gentleman from
under the {)resent,
iatty degenerationof some other part or organ ofthe
roent. recollect, body.^ Thus, in one subject the recti muscles ofthe
I firstwent to Torpoint, I suggested the house-to- Devonportto look afterthe cholera patients during
eye were similarly affected, and the liverwas fktty;
house visitation" 4 measure then almost in itsin- fancyhisabsence.
in another, the heart was to a great extent in the like
" and which, I well know, had not been pre- viously Mr. Chubb thinks it ungenerous for one medical
condition ; and in a third example,the same de-
in operation. Does Mr. Chubb forget, also, man to expose the deficienciesof another, if
even
by eeneraey had afiectedthe kidneys.These are onlya
that the chlorideof zinc was not used in Torpoint such means he could in any way advance himself;few instances of the concurrence of this condition.
until I went there,to the efficacy of which, as a in replyto this J can onlysay, that my report is not Contrasted
with the above, I may mention,thatip
sanitary agent, he has borne publictestimony in the calculated to cast the slightest discredit on Mr.
the eyes of a female afed 67 yean, in which the "tc
following words: "During the prevalence of the Chubb or any of tliegentlemen who assistedhim. I
absent,there could not be found the leastfatty
"

was
lateoutbreak of cholera in this district, I have had have no doubt but that theybrought alltheirprofes- sional degeneration of those structures which, in the cases
ample and frequent opportunities of judgingof the knowledge to bear upon the cases that came
value of this method of lettemngor checkingUu under theirnotice,and did all in their just given,were observed to be so affected. With
powerto re- lieve
apologies tor intruding upon your columns,
amount of an epidemic disease, and I am very glad the sufferers; but,as I did not professto relate I am, Sir,yours obediently,
to be able to say of the flnidinquestion, (thechloride what was done before I went to Torpoint, I could not
8lA,Saville-row. Edwin Cantoh.
of zinc,) that it is most cerUinly the best of disin- fectants be expected to enter into* details of treatment and
of which T have had any experience, and, in sUtisticswith which I had no opportunity of becom-
ing
numerous its
instances, application has been highly acquainted. M r. Chubb also knows, that I had MEDICAL REFORM.
usefuli" and whatever good results may have fol- lowednothingto gainby my services, which were both
from the supply of water ahready alluded to. voluntary and gratuitous.I think,therefore, the in- ITo the Editor of the Medical Timet.]
Mr. Chubb must acKoowIedge, that it was introduced sinuaUon contained in the latter part of the quotation Sir," AlthoughI was an opponent of the exclusive
after my arrival. I could remind him of many other is out of place and uncalled for. of the Council of the College of Surgeons, in
policy
sanitary measures suggested by me; but,as I do not Since writing the above, I have read a letterin instituting the Order of Fellows,yet I cannot, at the
wish to trespass too much that
on your space, I shall your Journal from Dr. Millsr,the surgeon of the present time, see the advantage of destroying
refrainfrom doingso justnow. Plymouth Marines, in which he chargesme with grade, as you appear to intimate would be desirable,
Mr. Chubb states,that "* Mr. Bowden (thegentle- man imputing''neglectof due precaution on the partof in your remarks upon Mr. Bottomley'spropositions
who accompaniedme from the hospital) was the meoiea] omoers, and of the officersin'command in the lastnumber of the Medieal Times. With due
recalledaftera few days, as the epidemic had abated of the division," during the lateoutbreak of the epi- demicrespect for your jud^ent,I must differfrom you on
in virulence;"now Mr. Chabb must be aware that in the corps. Tne followingis the passage in thispoint. By exacting a higheramount of scientific
Mr. Bowden was recalledby an order from Captain my Report, to which he refers:" ** I was often asto- nished knowledge as a qualification forthe Fellowshipthan
Nicolas, because his servicescould no longer be dis-
pensed at the numbers (ofmarines) brousht into the is required fora member's diploma, there willneces*
with in the hospital, and not for the reason Naval HotpiUl in a sUte of collapse on the first out-
break sarily be a lar^r number of well-educated surgeons
given in his letter.Was|it,I would ask,alsoin conse- quence of the epidemic ; the patienU were sometimes in the Profession than at present,and the cause of
of the virulence of the epidemichaving so much exhausted,"c., ficc. Upon inquiry, ever, scientificsivgery will be greatly
how- promoted. This
abated,that subsequent to Mr. Bowden's removal, it invariably turned out, that they had been Institutionis now a fiict, and to oestroy it would
and when I had been m Torpoint for seven days,to suffering from diarrhoeafor severaldaysbrfore they be merely to overthrow an anraiwement which,
my own knowledge,he applied to the Board of thoughtit neeeuary to acquaintthe surgeon with the with all itafaulta. promises to be of great eventual
Guardians for,and obtainedthe assistance of a dis- penser, state of theirhealth. What reflection this casts upon utility. It woula be better to endeavour to
who remained with us for a fortnight wards? eitherthe medical or commanding officers,
after- I am at a reform it,so as to do away with the injustice infiicted
But Mr. Chubb further states that the loss to discover;but, if Dr. Millar still Csnciessuch upon the members at its original institution. I
"
cholera had nearly spent itselfon my arrival." If to be the case, all I can say is,that it was tentional
unin- quiteagree with you in your subsequent remarks,
such had been the case, how could he have had, as on my part, and i resret that I should, and particularly that the electionof the Fellows by
he states, ** ample and frequentopportunities of without being aware of the fact, nave givenhim any the members would be a superfiuity and an em- barrassment

judging of the value of chlorideof zinc in checkingcause for onence. In another part of his letter, in a practical measure, as it could have
the disease," and by w^at means did he discover however, he atucks the accuracy of my statement; no effectin selecting for honour a highlydistin-
that,"in numerous instances its application had he says, " As rewards the men beingbroughtinto the ^shed member, who would, by this plan,merely
been highly useful7" or what grounds had the inha- Naval Hospitalin a sute of collapse ning torm one of a group, or, in branding an unworthy
at the begin-
biunu of f or
Torpoint sayine. they that believed the of the epidemic, I have to state that such one, who could only he known in the minority of in-
stances
water sent them by Captain Nicolas
**
materially sisted was
as- not generally the case, fcc." Again,he sutes, to a few individuals. Why not give full
to check the ravages of the epidemic ?" I am ''that some who ultimately died of cholera, actuallypowers to the Council to exclude from the Fellow^
afraid, also,that the account of the state of Torpoint did walk there, beingat the time merelyaffected ship every individual who, upon sufficientcause
which the deputation gave who waited on the Super- intendent with diarrhoea, which,however, merged into cholera shown, may be considered to have dishonouredhis
of the RoyalNavalHospital, when solicit-alterAdmistion.", Now, Sir, I bav" beforeme some profeaiioiuu chwacter? Thii would m"et excep-
 60 THE MEDICAL TIMES.
respect. It iswell to wrge the necessityof '' being JVom a Lecture by Mr, Orahiger a" the Edm' It has bsen rsrely seen oat oltScaadiiBavla. It
seens aot
washed and made dean ;" bat such counsels are burgh Society of Arts, to differ maeh, however, flrom the ElephaatiaBlft

plied."
knova
whollyunavailing,unless copioussapplies of pure Influence of Wabm Climates on the Skin. at one time In Egypt.
and wholesome water be provided at moderate
The action of intense heat,exposure to the rays of
"
Ja W6hl, Belfast,**
"
is thanked. We shall be ali^ays
charffes. The methods by which water is at ("re8ent the happy
sun, are strong exciting causes, as I have fre- quentlyto hear of the progress of the Collegesin the
suppliedto towns mav 'be comprehendedin two observed in Ital^. A gentleman who accom-
panied of the *" Irish Athens,**" we
west,thia
t"elievethat is the proper
classes:" 1st. Where the source of the supplyis
me through Switzerland, in the autumn of For
phrase,"more particularly. oertaia opponents of the
sufficiently elevated to admit of its beingdischarged attacked by eczema of the hands
1847,was suddenly Colleges, we woald recommend some of the painsand
into the cisternsof the consumers by itsown gravity.in a severe form, while descending from the Great
This is known as the *' Gravitation System."' 2nd. St penaltiesoar Correspondentdoabtless recollectsin the
Bernard to the villageof Aosta, in Italy. We Universities along the Rhine. Our
Where the water is obtained from streams or springs, contemporary, the
slept at the convent, where we were anythingbut "
Dablin EveningPost,"might suggest something"mote
situatedbelow the level of the pointof discharge, so
comfortable, owingto the intense cold ; and the fol- lowing Irish," ftc.
that it becomes necessary to employ maohineryto
raise it to the required altitude. The firstof these beneath
morningwe set out for the warmer climate
us, in company with three other gentlemen '*N.i Boulogne.'*-"The "hemisphericalganglia" are not
is unquestionably that which should be adopted,whom we met at the what stated, but the true cerebral part of the nervous
wherever itis practicable at a moderate cost. On
Hospice. In descending,we
made sensible of the changeof tempera- system they do not, of coarse, inelude the oorpors
this principle, thatportion of Glasgow situatedsouth
were soon ture; ;
and the scorching rays of the southern sun, striata,thalami,or corpora quadrlgomlna,but are cos*
of the riverClyde is supplied with water, and there afterso nected with them.
great a transition, were not longof produc-
ing
is the prospectof its being extended to the other their effect. Four of the
party were attacked by "Assistant-Surgeon, Chatham." "Sambul is the name of
parts or that city. Greenock, Dundee, Dunfermline. smart diarrhoea, and the gentleman who escaped this one of the innumerable things pat forward as a speelfle
Stirling, Kilmarnock, Paisley, Portsmouth, ana unpleasant" compagnon du voyage,"had for his for Cholera. It Is well known on the continent. It Is s
Newcastle,are all supplied in the same way. But
share a severe attack of eczema of the faceand hands,
the gravitationprinciple has been carried out In the heat and root not unlike Colombo, with a muak-llke odour. It has
smarting of which fully employed him
in all its details, in Edinburgh. Of been tried lately at King's CollegeHospital, we bellevs,
greatperfection during the remainder of the journey. This was the
the SIX Companieswhich supply London, fiveob- tain eczema for epilepsy.
solare of Willan. Eczema of the hands is fre- quently
water from the river Thames, and some of its
the result of constant metallic
handling M., Bath.**" Of coarse, anL tart, and tra. aurantU are In-
or
"
compatible.
tributarystreams on the same level, an
"
ment
arrange- other pulverulentsubstances. Thus it is often ob-
served
which requiresthe water pumped to the
to be
on the hands of sugar refiners; hence has Diseases
"
Dr. F. Churehiirs WoTk on the of Children.""
required altitude. The water supplied bv the New arisenthe popular "
term, itch,"by which it
grocer's We beg to Dr. F. Churchill, that our remarks oa
River Companjr is brought into London by itsown is commonly known.
assure
Dr, Burgesson Eruptionsqf
"
volunteer had no referenee
gravity.This is one ot the oldest of the London the FaosyHoadt and Hands, reviews, In our last Number,

Water Companies. At Perth and Aberdeen, and to him. It is true, we received, not Dr. Churchill's book,
but two reviews of It, from talented and much-ra-
by one of the Gla^ow Companies, steam-engines one a

are employedfor raising the water. In some cases, spectedCorrespondentin Dublin, the other from a man
gentle-
too, as at Philadelphia,and other placesin America, TO CORRESPONDENTS. in London. We never for a moment supposedDr.
the power required for workingthe forcing-pumps is Churehill to have forwarded either. We are quiteaware

derived from the river from which the supplv of that there are authors who do not hesiUte to review their

water is obtained. Where this can be acoomplished, *'

A Reader of Joornals" Is laformed, that the impertiaent own publications ; and also editors who pmstimtetheir
itis generally found whether considered with refer-
" ence psragraphto which he slludet did not escape oar notice. columns to such meretricious doings. It is a subject

to the first cost or the current expenditure to " It served as straws to show the vrlnd, and marked how upoo which we are peculiarlyjealous; but we againuian
be the most economical plan.Some towns, as Liver- pool much the galledjade winced. Oar eorrespoDdent may Dr. Churchill that our notice to CoriespondeaU did
and New York, obtain part of their supplies moreover find,that forbearanee has Its limits. not bear the reference
slightest to blm.
fromwells. At New York, the gravitation principleWe this week commence a short series of very valuable "
A Constant Reader, Hungerford." Boiled bacon consists "

has recentlybeen adopted on a scale of magnitude papers on Pericarditis, by Dr. John Taylor,of Hudden- of about seven eighthsof fkt,the remaining eighthslba-
hithertounknown, and has,in a greatmeasure, super- seded field. We trust that nothing will oceor to prevent our and beef the above
men and fibrin ordinarymatton
.
For
the use of wells. This new supplyof water for continuingthe publication every week until completed. proportionsmight be reversed" one-eighth fat, seveS'
the cityof New York is brought from Che River
of the Hudson, and passes along
Dr. GlUck," vrho filled a high medical appointmentduring
"
eighthsalbumen and flbrhi. It is probablethat, thongk
Croton,a tributary the late Hungarian war, has favoured us with lome all these axe nutritloua agenta In tlae strictest sense, yrt
the leftbank of that river. Itis conveyed nearly the
its surgery. We propose to pabllsh the flnt that the two latter principlesare more universally so, sad
whole distance of 40^ miles by an open aqueduct, papers on
part as soon as possible, being assarsd theymust be most are, therefore, more Important and laatritioas.
which is lined throughoutwith maaonry ; itis about
seven feet broad,and the water, in itsosual state, is acceptable to our readers. " The Son of an Old Sabeeriber."" It Is well ondersteed
about two feetin depth.The fallon the whole course
"
Hospital8tatisties."'"We beg to Inform a Correspondent that there Is % in
prestige favour of a diplosu
physician's
of thisaqu" uct is47 feet, and the reeeivin^ reservoir who addresses as en tillssubject, that when oar lo the services referred to; bot thci predse naturs sr
papers
York, from which the distributing pipes on the Parisian Hoepltaluare oompleted,wepropoeeto amoantof inflaence which its possession
exerts upon motion
pro-
at New .

isauout 115. feet above the levelof the sea. of the London Hospitals.The flrit is unknown. For the pay, ftc.,we referhim te
diverge, oommenee an aeeoaot
There are several very interesting works connected of the series, oa the Origin of Hospitals,is alreadyIn the regulstlons.
with thisundertaking, the chiefof which seems to be type. V M.D. London, M.R.C.S.,"speaking In referenceto Pro-
fessor
the aqueduct over the Haarlem River,consisting of We shall
next week completeoar series of papers on "
Our Jamleson's proposalthat a year at King'sCollege
15 arches, seven of these being50,and eightof them madictu at Kdinbargb,
SanitaryLaws." In the meantime, we will consider the should be recognisedas an anniu
80 feet span ! The height, from the foundation in the at Aberdeen go to Edinburgh
proposalof our Correspondent, to reprint them in a sepa-
rate says:" "Do the StudenU
river to the top of the works,is about 150 feet The form. to graduate?"and if so, for what reason, when they have
expense of the whole works has been about of doing so It must be for one
Mr. Renton's" letter has been received.
"
Should occasion an opportunity at home f
2,400,0002., an enormous sum certainly, with re- bs
of New require, we shall be willing to investigate ibe subject to of two reasons : either degree Aberdeen must
the at
lation to the present population York;
which it refers. held in low estimation by them, and to further theirpro-
spects
but it is considered that the supply thereby tion
Examina-
in life they must go to Edinburgh ; or the
secured is sufficient for one million of inhabitants. If .R.C.S."" We are sorry to differ in opinion. We will,
"
at
that they find It easier to graduate
is so difficult,
An exceedingly vimple apparatus for raisingwater, however, consider the matter. Perhaps our Correspond-
ent
siderable,
incon- will further favour us on the subject. Edinburgh,as Irish Students find It less troubleto pass
where the required quantity is comparatively the EuglishCollege of Surgeons than their own. U they
is the Hydraulio Ram. It is selfacting, The
Societyfor the Protection of Young Females has our doprefergraduatingat Edinburghfor the firstreason,
then
and its firstcost istrifling. It will raisewater nearly best wishes; and weare happy to find the Directors have do
they hold the degree at Aberdeen less in value than we
300 feet ; but it is essentialthat there be 10 or 12 feet issued a monthly Paper on their behalf. other
of water in the stream here, for we preferit to Edinburgh ; If,on the
of fall, and that the quantity heard, the
from which the supplyis taken should be about ten
"
Juvenis, of Wednesbury."" The best Manual of Materia hand, (which I consider, from what I lave
Medica and Pharmacy is that of Dr. Royle,publishedby roost probable,)it is for the last reason-then,I
times that to be raised. This might be applied for
of
whose Churchill. say, should
go, let them and let them bear the shame
raisingwater for small towns and villages,
trom which us if we say, that
the act."
elevations, with reference to the sources Out Islington Correspondentmustexeuse
the supplymay be obtained, are such as to prevent we have no great faith in the sunteons of special plaints. [Our Correspondent
com- says, it is the man that makes the "

reaching the cistern by gravitation, and He should apply to any surgeon of repute ; University, and not the University the man." We advise
the water
where the use of engine-power would be too ex-
pensive. perhaps preferablyto a Juniorin a case requiringgreat him to applythis test to the Universityof Edinburgh,
The cheapness and simplicity of the Hy-
drauliccare and attention. and compare her roll of graduates, fh"m the middle of the
Ram are recommendations for its applica-
tion shall be most last cemury, with the list of distinguished medical men
Dr. Nellgan" is Informed
"
we happy to re-
ciprocate
in cases where the suppliesare incon-
required siderable,
his kindness. We unwillingto poach on
are throughout the empire, not excepting the most eminent
in comparison the extent of the re-
with spective
his manor, but our Irish correspondence is really
so volu-
minous men of the present day, and he will perhaps discover
sources. It would be very Important if the from all parts of the Island, that a Upsaa such as why It Is stillheld a distinction to postess the Edinburgh
same principle c ould be carriedout, by taking tage
advan- Degree.]
be speaksof Is not impossible.We will Uke an earlyop- portunity
of the rise and fallof tides as the moving power. to remedy it. An Uninitiated."" We desire we may not be troubled
" with
By this means, an abundant supplyof sea-water
in this and B.,Cirencester."" "Spedalskhed" is the name of a dis-
" J. ease such nonsense. Let our Correspondent applyto the near*
might in many placesbe made available, Member of the CoUege of and he wiU obtain
latelyn oticed for the firsttime, occurring Denmark,
I n est Surgeons,
many other coast towns, for sanitarypurposes, and
Sweden, and especially in Norway : a specific skin aflee- all he desires.
at littlemore than the cost of layingdown the pipes.
of the tlon,consisting of a thickening of the corium, which, In
This would be a most important application Our French correspondence arrived too late for insertion.
For instance, the rise ana fallof the tide the ulceraiive stages, gives out an ichorous discharge
principle. Our Engraverhas,unfortunately, been unable to finish
to
at Leith would be sufficient to raise sea- water,
with formingcrusts not unlike rupia; In Its more formidable
hard and time the sketch illustrating Mr. Chard's case of Congeni-
tal
below that of the base of the shape,extending, we believe, to the mouth,
to any level
ease,
Where the riseand fall of soft palates, to the cares, destroyingthe septum, and Malpositionof the Viscera. The Article, therefore,
General Register-house. Is postponedtillnext week.
the tide is much greater,as at Bristol and Liverpool, even larynx, and showing itselfIn a peculiar manner

readily a nd totally the latter

this principle of
could, course, be more ap- in the eye-lash eye, destroying organ. ^*' Fearon's" communication is In type.
Dr.
 THE MEDICAL TIMES. 51
OKieiHAL LBOTirSES. tion: "
^males,nubile females,
iteiilefemalea,and glandsaxe bent upon themselves,Uke a oomteoii
procreantvirgins. magnet; one end of each opens into the dMCtut "fa-
Certain modifications of the func-
tions eulaioniu.
HDHTEBUV LECTUBES generative
have served as a basis for the classification In the order Dipierathe testee ahrajspresent
ON THE themselves as two simpleglands, the outer capsule
of the hexapod insects,some of which, as e. g"
GENERATION AND DEVELOPMENT OF of which is of a brown or yellowcolomr;in the
THE INVERTEBRATED ANIMALS. apterotare said to undergo no metamorphosis, Jtilut, when this outer coat is removed, the surface
and have been called *' ametabola." Others, as of the testisis nodtilatedby the prominent ends o|
By RICHARD OWEN, F.R.8.,
Hnnteriaa Professor and Curator of Museum of Royal e, g., the hemipUra
and orthcptera, are described in the component ccsca : two slender sperm-ducts minate
ter-
CoUego of Snigoons,Conesponding Member of the In- entomological treatisesas undergoing onlya partial in a small sperm receptaoie, which also
ititvte of France,"c.
and are called, '' hemimetabola." receives two longfilamentary prostatic glapds;a
metamorphosis,
[fieported exprtsaljfor the '* Medical Tfaaes,"and xoTiMd is then continued to the base
beingmore patentand conspi"long
ductus commmiis
The metamorphosis
by the Lecturer.] of a trifidpenis.
cuous in the rest of the class, is admitted, said to be
In many of the Lepidoptera, the testisis clothed
LECTURE XV. (a) perfect or complete, and made the characteristicof
with bright pigment,crimson in the common white
GxiBVATioir or Ihsscts. " Business of generation In the " metaboia." The divisions so founded and de- fined
and green in the Sphinx.
Hexapod or *'
True" Insects committed to four kinds butterfly (Pontia Brassier),
are insufficient, however, for the generalisa-
tions In
of individuals, Males, Females, Neuters
"
or nurs- most of the species the two glandsapproximate)
injt-females,and procreant virgin larvae. Divinion of the comparative anatomist,and, by that and become confluent in the progress of the meta- morphosis
of the dasa according to generation- characters into
Ametabola, Hemimetabola, and Metaboia. " General very defect, are evidently less naturalthan the orders ; but in certain moths, as, e^., the Tinea,
itructure of the male organs. Chief modifications exem* in the Linnsean system, from the characters of the the originally distinct condition of the testes is re-
tained
plified in species of Aptera, Hemiptera, Orthopiera, in the imago state ; the testes also remain
Diptera,Lepidoptera,Hymenoptera, Strepsiptera, Neu- wings,which I have here adopted. distinctin the Yponomeuta. In most Lepidoptera
rapters,and Coieoptera.Analogy of the organs in their I proceednow to demonstrate the structure and
aud various forms and occasional
the vasa deferentia, or sperm-ducts, alter a short
numerous bright modifications of the or instruments servient
sub-
coloars to flovrers. Monogamy or Polygamy in Insects
organs course, receive two capillary prostates, and then a
i!ovemed by the strnctare of the intromittent organ. to the retention, nourishment,and trans- mission longand convoluted ductus ejaculatorius^ What is
External outlets of ipermdacts remote Arom that of the
vesicula: seminaWs
of the sperm -cells and germ-cells, and remarkable in some butterflies (Pontia, e. g,),is not
and from the penisin the Dragon-
fly."
General characters of tliefemale organs : exceptionaltheir products or developments ; and,first, of the only the greatlength of the prostatic gland, but also
simplicityof those of the procreant larval Strepsiptera " the extreme length aud winoing convolutions of the
snd Aphides. Chief modiflcstions of the female organs parts called the male organs." In entering
the
common terminal duct. The structure of mittent
intro-
iUustratrd by parallel instances to those of the males.
upon a review of the structure of the male or- gans
in the Lepidoptera is such as to
Modifications of the vuWa, and its appendages the ovi- positor organ
of insectsgenerally, we found their simplest
and sting. Various uses and applications of the precludethe repetition of the act, and they con- sequently
colleterial seeretlon. External sexual characters. normal type in the lowest organised
Ab- members of the class, livein a state of compulsory monogamy.
Hemoapbroditlam. The testes The bifid hooks on the terminal segment of the
viz., the chylognathic myriapoda.
Mr. President and Gentlemen," In the ge- nerative
and their ducts, with short and mittentdorsal valve of the penis,whilst they serve
simple intro-
organs of insects, as in those of plants, Na-
ture to retain the female,preventthe extricationof the
organs, alone existed; there were no sory
acces-
seems to have been prodigal in her power of virileorgan in a state fitfor repetition of the act.
glands, no mechanical a^uncts in relationto the
producing endless varietiesof forms out of one With respectto the order Hymenoptera,Hunter
coitus. The sexual apertures, on the seventh primary
common type of organ, and subservient all the segment, thoughnear the anal end of the bodyin the has leftsome gooddissectionsof the male organs in
vhile to one common the bee. W^e observe here, (showing the prepara-
tion,)
end or office; ansithe ana- logy nine-jointed larva,become advanced much nearer
to the reproductive
that the testes are of a simpleoblongform "
flower is the more striking, the head in the fully developed iulus,by reason of "
but, when we dissect away the capsule or tunioii
fitomthe brilliant colours which the essential the vast snperadditionjoints,through
of the cessive
suc-

of segments between albuginea,"

we expose many long ccecal tubes,
parts of generation assume in some speciesof the sextuple g emmation
which, as theyuncoil and floatin the liquid, givea
penultimate and antepenultimate primaryseg- ments
insect. But all insects are dioecious;the indi- viduals character to the gland. The sperm-ducfc
of the larva. In the chilopoda, the ordinarybushy
are of distinctsex. And there are not only risesfrom near the middle of each testes,and soon
insect-type of the generative apparatuswas more
"males" and " females ;" but, in certain families swells into a largecellularreservoircommon to it"
nearlyapproached, by not only the more definite
of true or hexapod insccU, there arc other kinds boundarybetween testis and vas deferens, but by
with the openings of two pyrilormprostatic glands,
whence a common ductus ejaculatorius iscontinued
of individuals, which are essentialto the successful the termination of the sperm- ducts at the anal ment,
seg-
to the base of the intromittent oigaa. Mr. New- port
propagation of the species. In the social families and, likewise, by the presence of accessory has givena good description and figures of the
of Bees and Ants, for example,there is a third glandular organs.
male organs in a wild bee (MkaUa oenttfoiia,) in
Testes,with distinct sperm-ducts, and super-
added
Ibnn or condition of the individual,commonly which we have the same characteristics ; the testes an
glands are present in all hexapod insects;
called" neuter," and sometimes labourer or nurse. two in number, but lobulated ; the sperm-duets am
and in all, with a few exceptions, the sperm-ducts
but are convoluted into a kind of epi-
But,these are essentially female; havingthe female open at the base of an intromittent organ, developedexpanded,
didyn"%answering to the reservoirin the hive-bee :
wgMw but imperfectlydeveloped and fVom the anal segment.
sive.
pas- from this part the duct extends to the neck of tho
The The testes are remarkable for the endless di- versity
working bee, at least,exercises the prostatic 'sac,which repeatsthe bent form. Th#
function of only one of their forms, and often for the bright or
part of those organs, an brilliant-coloured short ductus ejaculatorius terminates at the base of
pigment which besets the tunica a virile plates, besel
accessory part, which is metamorphosedinto a
vaginalis f in both characters remindingus of the organ, covered by two pointed
special poison organ, but which is the homo- flowers of plants.They appear to form a singlewith soft hairs. Above these are two other irregular,
logueof the ovipositor double* jointed plates, folded somewhat fanwise, and
in fertile female insects. organ in most Lepidoptera, but are actually two
furnished with horny hooks. Between these are
This workingbee, or "non-breeder,"as Hunter confluent testes,and were originally distinct in the
two muscular parts, which immediately enclose the
calledher,relievesthe parturient larva of all that beautifulorder.
queen of her ova, intromittentorgan.
In most insects the testes form a distinct pairof
places them in the appropriate nest-cell, and feedsthe As an illustrationof the male apparatus in the
their ccpcal and the
larva when it is hatched : it thus acts the part of glands ; but structure, gra-
the aphides. Thi
dational development of the secerning folliclesat order Hemiptera,I shall select
midwife as well as nurse, and is an indispensable is winged,and is commonly smallei
length producesa seemingmultiplication of testes, male insect
adjunct to the multiplication of the species. There and itis difficult than the winged female. The internal organs of
to avoid giving this definition to the
the male consistof six oval testes,two larger and
is,again, in insects, a fourth modificationof the in- six clustersof
dividual, spermatic
coeca, ^-iththeir six ducts,
on

in relationto the sexual function. I allude each side in the dung-beetle, Scaraboriis^or to the
four smaller, so closely impacted together as to re-
semble

with as many a singlesexlocular organ. The two gently con-

voluted
tothat remarkable state of the jlphis,
twelve flattened circularglands, ducts,
which, like sperm-ducts proceed close together fh)m the
which represent the testis on each side in the rose-
the workingbee,is an arrested
stage of the female, testes and open externally, in common with the
beetle,Cvtouia.
constitutingthe larviparousindividual,which propa-
gates In all these cases, however, the ducts from the ducts of two long,colourless ccecal appendages,
by a kind of internal gemmation, witliout divisions distinct lobes of the testis
or unite upon
rapidly a soft,nnanncd penis.These appendages
; theyare a simple
Ibrm
sexual concourse in her own person. She possesses, to Ibrni the hepnning of a single vas dvfercvson never contain s]"ennatozoa
found
however, the female organs ; but,contrariwise to the eaeh side ; and the cs"-entially parialcharacter of the of accessory prostate.The spermatozoaare
in various degrees of development in the testes;
working bee, it is the external and accessory parts testes is manifested by the pair of vasa defvreniia,
of the whether the character be masked in the gland it-self when fullydeveloped, they form oval bundles of
apparatusthat are wanting, whilst the more fine filaments,which separatein water, at one
by confluence, ae in the butterflies,or by mul- very
essential organs are of fiowers. The intro-
mittent
exficmely active. Thus, at the
as in the beetles.
tifid division, end expanding like a bunch
outset of our
survey of the generativesystem and In the Jptrra, Treviranus has organ is not broken away m coitu,and the
given a good
fanction in hexapodinsects, we encoimter four ferentdescription
dif- and fio;urcof the male organs of the
male aphismay, enjoya frequentrepeti-
therefore, tion
kinds of individuals in relation of the act.
to that func- Lephma. The testes are by four or five
represented
elliptical
glands,the slender ducts of which soon In the order Orthoptera, we find the locustswith
^*)The Ikh lecture,
in our Number of Novem-
communicate with a common vas deferens^
which, composed of numerous
testes blind tubes,in most
iTk U- ^^' ^^ ^y mistake,printedas beingthe
longfold,descends and dilates into enclosed in capsule.The pro-
Ix!?"
^""ch appeared in the Number for November
after a a sperm- species a common static
reservoir OH each side. The glandsalsoconsistof fasciculi of tubes,and re-
lUth. accessory prostatic
No. 539, Vol. XXI.
 62 THE MEDICAL TIMES.

mind us of the condition of the prostatein some and rapidly undergone;the ordinary every -daylife The sperm-reservoir is pyriform, and ge-
nerally
ductus seminalis,

scrib
Todentia. of the insect, spent in acquiringand consuming providedwith a longspiral
The order Cokoptera offers the greatest diversity daily
its food, forms a far largerproportion of its in whose basis a sometimes simple, sometimes furcate
bi-
in the form and structure of the male organs. In existence, and is passedunder a very different and glandular ccecum opens. The colleteriaare

the dytiscus, each testisis a filiformtube, much a very inferior form ; which, if, in comparison to situated below, and consist of a pair of convoluted
longerthan tlie abdomen, but convoluted into a the last stage, we should regardas the more coeca, swelling out into pyriform receptacles at the

round ball. In the hydrophUtu,the glandis repre- sented typical form of the animal,we shall not probablyvagina, where theyopen by a common duct
short blind off The cock-chafier three terranean
sub- In butterflies, two small branched ular
gland-
by a series of processes given err. passes years as a some

from one side of a common sperm-duct In the worm, but lives hardlyas many months organs are superadded, called the " scent-
a fasciculusof longer coecal tubes radiate in its wingedstate. An ordinary observer sees and glands;"they secrete the peculiar odorous particles
buprestit
from the end of the sperm-duct Sometimes the knows the May-flyonlyin that lastjoyousstage of that attract the males ; and of which propertythe
extremities of similar radiating tubes are dilated its existence, and deems its lifeconcentrated in one entomologist sometimes avails himself in catching
into sacculated flattened (glands, as in the rose- wingednuptialjioliday ; but,thisso- called -Ep7M?"M?ra the finest specimens of that sex.
beetle,(cetonia,) and numerous more compositehas previously passedthree hundred and more The bursa copulatrix finally presentsa remark-
able
forms have been detected ; all,however,are reftr- workingdays as an aquatic larva. development, being a capacious pyriform, times
some-

lible to modifications of the primitive blind secern-

ing In no class of animals are the partsof generation hour-glass-shaped, reservoir, which isfurnished
sac. Their analogy to the sexual parts plantsso complex as
of in insects. The female sexual with a peculiar intussusceptive canal opening wardly
out-
beneath the vulva. This latter canal gives
has already been alluded to,and entomologists have organs consist of the ovaries,the oviducts,the
found itrequisite or advantageous to borrow the neat uterus, the spermatheca, the bursa copulatrix, offf the by the way, a narrow convoluted lateral canal,
and descriptive terms, with which Linnaeus has en- riched mucous glands, or colleteria, the scent-glands, and which opens into the vaginanear the orificeof the
botanical science,in order to indicate the vagina ; but,these are not all present in all insects. spermatheca,
and thus effects the communication
diversifiedforms of the male apparatusid the sub- jects The external organs are the vulva, the sting, the between the copulative sac and that reservoir.
of theirfavouriteclass.The intromittentorgan holders,and ovipositor, some of which are likewise Experiment has provedthe ofl"ce of the sper- matheca
is a longhomy tube ; usually retracted within the peculiar particular
to species. to be that which its name implies.By the
abdomen, but not capableof retraction after com- plete The most constant and essentialpartsof gener-ation application of the fluidcontained in it to the eggs of
intromission, which usually terminates by rup- ture of the female insect, viz.,the ovaria,are sub- ject an unimpiegnated female.Hunter made them fruit- ful
of the organ. Hence the coleoptera^ like the to ahnost as many varieties as the testes in the : he also found that the intromittent organ pene- trated
lepidoptera, are monogamous. The terminal portionmale ; their forms may be arranged into almost as its canal, an observation which has since
"

of the ejaculatory duct is continued into the penis,many genera and species, which are very often been confirmed by Audouin, and other observers.
and, in the earabus clathrattUf opens upon the centre analogousto those of the essentialglandsin the op- posite In the hymenoptera the ovaria present greatdi- versity
of a softglandiform termination of the intromittent sex. The ovaria in the Lepidoptera do not, as to the number of the egg-tubes, which
in the
organ. however,coalesce into a single mass, like the testes varies from 3 or 4 in the humble-bee, to 6
Much unityof planmay be traced throughoutin the male ; theyare either digitate or verticillate ; wasp, to 10 in Pimpla,up to more than 100 in the
the varied modifications of this organ in insects. that is to say, they consist of a few egg-tubes sus-
pended queen-bee.To the short canal of the sperm-re- servoir
In general terms, the intromittentorgan may be de- fined to the end of the oviduct, becoming atte-
nuated there are always attached tubular and
as a modification of the last, or two last, ments
seg- as they recede from it ; or they consist of glandular appendages, which usually bifurcate, and
of the abdomen. It consists of a larg^ exterior numerous very longegg-tubes, proceecUng from a open into the duct of the reservoir. There is no
sheath and a delicatemembranous tube ; the sheath short oviduct, and terminating in filiform extre-
mities bursa copulatrix in the hymenoptera. The colle-
commonly consists of two lateral valves. It is ; they are usuallydisposed in spiral coils terium is metamorphosedinto the poison- bag and
usually retracted out of sight Accessoryprehensile bendingat the two sides in opposite directions, as in glands, unless,indeed,we may view the appendages
organs are developed in some of which the the Noctua
insects, Braasica, In the forest-fly each ovarium to the sperm-reservoir as homologues,and not
most remarkable are those which are attached to the consists of two egg-tubes ; in the flesh-fly it con-
sists merelyas analogues, of the colleteria in other insects.
base of the abdomen in the male Libellula. In this of a single tube, which is of greatlength, and With regard to the hemipterous modifications of
remarkable insect, the sperm-ducts terminate,as twisted spirally. In the mantis a single series of the female organs, I shall refer, as in the case of the

usual, on the anal segment; but the vesicula short egg-tubes are attached to one side of a com-mon male organs, to the Aphis.
seminalis is situated at the base of the abdomen. The duct. In the gnats, crickets, and locusts, the The two kinds of fertile females of this remarkable
"emen is transferred thitherby a strong inflection of numerous egg-tubes, which are somewhat com- pressed, genus presenttwo modifications of the female organs.
the caudal end of the abdomen, prior to the coitas, lieupon one another like scales, or the tiles The viviparous females have two ovaria,from
and passes firomthe sperm reservoirinto the vulva upon a roof. In the Ephemera and Stratiomys, the each of these,four multilocular oviducts are con- tinued.

of the female,which is retained in contact with the ovaries have the primitive form of simpleelongated The vaginais devoid of all appendages.
basal joint by the claspers attached to that part. bags,in which the eggs are contained linked toge- ther The eightoviducts are similar in size,and the em- bryo

The spermatozoain allhexapod insects are fili- form, by delicatefilaments. is contained in the lowest or hindmost chamber.
and oftenremarkable for their extreme length ; Swammerdam has givenan accurate description,The oviparous females have,also,two ovaria with
the anterior extremity is usuallythickened for a vrith excellent figuresof the female organs of the eightoviducts,divided into two chambers each.
considerable extent louse,the discovery of which helpedhim to an ex- cellent The oviducts are seen in the most differentstages
The sperm-cells usuallycontain many "
sperma* argument against the spontaneousgeneration of development, so that usually not one of the eight
toa," or vesicles of development ; these spermatoa of that parasite from the filthof the abject members resembles another. In the fullest developed tube,
are at firsttransparent, then granular, sind lastly, of our species, which it commonly infests. Five the last chamber is capacious,- large, and oval ; the
the spermatozoon is developed, one in each. This egg-tubes converge and coalesce into a single short upper one small and conical. In the undeveloped
makes the spermatoon change its form. It is oviduct on each side ; the two unite into a common state the whole tube forms only a simplepyriform
stretched by the uncoiling of the spermatozoon,and tube,with which a pairof branched accessory fol- licles swelling of the oviduct, from which the upper coni- cal
at last bursts and allows the spermatozoon to communicate. The vulva is surrounded by compartment is by degreesestablished. The
escape. Thus letfree in the common sperm-cell, four mammillaryeminences; the spermatheca and lower chamber contains a finelygranularmass,
theygronpe themselves into regular bundles. Some-
times bursa copulatrix are wanting. which is gradually transformed into an oval egg ;
these fasciculiresolve themselves,and the In most Diptera the ovaria consist of numerous the upper chamber is fullof cells, containingsmaller
spermatozoadisperse as soon as the sperm-cell gives short egg-tubes, each divided into three or four nucleated cells. If we regard these nucleated cells
way ; but usually a part of sperm-cell remains as a compartments or egg-cells : the egg-tubes are riously ars
va- germ cells,we may conclude that more than
partial sheath to the bundle,and when the sperma- tozoa disposed, combined, and associated in the eighteggs are laid. Near the outlet of the vagina
remain in this way closely packed togetherdifterent species.The sperm reservoiris present; are two short cocca with thick walls,which contain
the whole bundle might be taken for a giganticit is generally trifid, rarely bifid, as e. g. in tliis a colourless, oil-likemass. A little before these the
spermatozoon. The handle is very long,and ap- pears Stomoxis (showingthe dissection) stillmore rarely spermatheca opens ; it is a colourless pyriform np-
convoluted in a knot m staphyliuus, but is simple, as in Pulex. pendixto the vagina, and is of so delicate a structure
resolvableinto its constituent spermatozoa, which beneath the but it
There is no bursa copulatrix; b ut as to be readily overlooked when it is empty,
become separated as theyadvance alongthe
sperm sperm-reservoir, in the common fly, the vagina is filledwith the spermatozoaafter the coitus. The
duct swells out into a cordiforra cavity, which receives spermatheca is not so crowded,as in many other sects,
in-
But here frequently, by the addition of the the impregnated ova, and in which they are deve-loped with the spermatozoa,and hence their mar- vellous

prostatic secretion, they are again collected into in the larviparous genera, e, g., Mmca^ An- vibratory and undulatory movements may
fresh bundles,and packedup into " spermatophora.' thomyiafSarcophaga,Sachina, and Dexia, be witnessed.
These secondary aggregatespresentan elegantar- In the greatforest-fly{Hippobosca)^ the ovaria are The ova are fertilizedduringtheirpassage along
rangent in the Xocim^iimp,' beingdelicately barbed each a small simpleccecum, opening into a short the vagina by the spermatozoa,and are smeared
like a feather,and the spermatophora, with their common oviduct,which swells out a littleabove the with the viscous secretion of the "colleteria," called
fertilizing contents are finally conveyedin coitu to communication. A pairof small sperm-reservoiis glandess6b%fiques by L6on Dufour. From the dif- ferent
the proper " vesiculaseminalis," or
"
spermatheca," next open into the oviduct, and afterwards the ducts organization of the internal generative organs
which, as a geneial rule in hexapodinsects, female Aphides^ it
belongsof two ramified colleteria; the part answering to of tlieoviparous and viviparous
to the female. vagina,swells out below this into a uterus,in which follows that the first cannot ever bringforthliving
As a general rule, the lifeof an insect soon ends the ova ace developed, and the larva metamorphosed,young ; and that when once this oviparous generation
after the great act of impregnation has been ful-
filled.m this pupiparous insect is produced, no external circumstances, e.^.,
warmth,
The changeof form priorto the acquisi- the individuals of such generation into
tion In the Lepidoptera^the ovaria consist of four can convert
of the procreating power is usually extreme, pairs of egg-tubes, disposed as I have already de- viviparous females.
 THE MEDICAL TIM^IS. 53
The maled frequently
are seen in coitu with the LECTUEES cartilages of first,second,and perhapsthir^
the
onparousfemale^and the eitibraceis so close, that of second and third le^

der
ON rightribs,under cartilages
when seizedby his wingsthe female israised along ribs, in post-sternal hollow, in subclavian arteries, i*^
CLINICAL MEDICINE.
withhim. The males seem to be much fewer in carotids, but not perceptibly under the firstbone o^
DELIVERED AT UNIVERSITY COLLEGE
number than the oviparous females; yet Siebold HOSPITAL. sternum ; there was also distensionof both externa^
detectedin allthat he examined
spermatozoain the By E. A. FARKES, M.D., Lond. jugularveins,without pulsation
:
; the leftjugular
gpermatheca, and thence concludes that the Aphides Member
of the Royal CoUege of Physlciana, Profeiior of and the other large veins were especially distended
are polygamous ; to which the structure of the male to and tortuous,so as to fill
Clinical Medicine la University College,and Pliyaiclan the triangular space. The
organsofiersno physical impediment,as in Lepi- the Hospital. heart'simpulsewas strongand heaving, and a littls
iopteraand Coleoptera, LECTURE III. irregular. The radialpulBe120,justvisible, rather
In the Orthoptera, the ovarian tubes are com- Hypertrophy and Dilatation of the Lift Ventricle-^ or tenth beat.
monly thrilling, intermitting every eighth
numerous and multilocular. The sperm Mitral Regurgitation Aortic Obstruction "

SUght Auscultation gave us the following

"
signs: At "

leservoircommunicates with the vaginaby a short Aortic Regurgitation Dilatation or Sacculation of the top of the sternum the heart'ssounds were
"
pletely
com-
neck in Locusta, and by a longer canal in Acheta. AscendingAorta. obscured by the respiration, which took place
There is no "
bursa copulatrix ;" and the coUeteria Gentlemen," I have another case of heart dis- ease in the following there was a short,harsh,me- tallic
way :
aie likewisewantingin Parficula, Phatma, and the to bring before you to-day,which contrasts inspiration, followed by a long,metallic,
Aeridida, but they exist in the and with the two exampleswe have previously in four or five distinct
genus Locusta, sidered. almost croupy
con- expiration
are complex and ramified in the cockroach,where did not average
puffi.Although the respirations
theyhave to providethe materials for the complex Benjamin Pooley,aged 30; a policemanfor more than twenty per minute,the man was unable
egg-case. three years, before that a labourer. A temperate to hold his breath for a moment, but when he did
The ovarium presents two types of structure in the man, who had alwayslived well ; bom of healthy hold it for a second or two, we heard the he"f 8
the
ColeopUra, flagelliform and the sacciform ; in the parents; had been alwaysexposed to weather. When sounds very rapid and irr^ular, but apparently widi-
formertype,there may be either three or six egg- sixteenyears old had a very bad attack of rheumatic out bruit. At the second rightcartilage, there'was
tubes in each ovarium, according to the species. fever,which confined him to bed for eleven weeks ; a distinctsystolic, and a more indistinctdiastolic
The sacdfotm type is presentedin the darklinghe sufiTeredat the same time fiom palpitation. bruit; at the second left cartilage the same ; the
beedes(Meioe), and the ovarium is remarkable for After this he got well,and had no rheumatism sub- sequently lessmarked here. At mid-
croupy expiration was
the imbricated of its countless occasional of both systolic diastolicmur"
and
arrangement egg- except an twinge pain in sternum there were
capsules. The sperm reservoir is claviform in the shoulders and hips. Till four months before murs ; the lastindistinct. At the apex outside the
Searttbcaa, or is bent upon itself, with a longneck, admission he considered his health good; he had nipple there was a loud,rasping, ^stolic bruit, the
"

commonicating with thevagina, or with the copulative never losta day'swork from illness; "eu an abscess second sound often inaudible ; inside nipple a much

pouch.Usuallya simple, sometimes a bifid(rarelyformed,without obvious cause, in the right axilla,softer systolic murmur; at times a littledoubtful
a ramified) gland opens into the and it
opened; discharged and elsewhere in cardiac
accessory mucous was a great deal, friction quite apex;
at none
base the sperm-reservoir.
of^ There are no true made him feel weak. At this time he had a littleregion ; decided impulseand systolic murmur were

colleteria; may remark that these organs are palpitation,

and I but no dyspnoea, no dysphagia ; a slightperceptible in the leftinterscapular region.
likewiseabsent in the NeuropterousMay-fliescough,which he almost disregarded ; no rheumatic The sUte of the lungswas as follows:" All over
(Ephemera) and Dragon-flies (Libellula). symptoms of any kind duringfour weeks previousthe chest,more or less, was leng^enedand divided
The vulva is a complexaperturein most insects,to admission. Four days before admission he had harsh expiration ; at both basee fine muco-crepitant
and is defended by an his ancles became pufly,and he rhonchi, without dulness, more marked left
upper and two lateralvalves some shivering; on

or plates ; it is usually accompaniedby other modi- ficationshad an attack of haemoptysis, or rather coughedup side ; on right also sibilantrhonchi,mixed with lest
or appendages of the terminal segments for a greatquantity of expectoration, which was deeply muco-crepitant, and a distant and feeble respiratory
grasping the penisand for oviposition. tingedwith blood. He had had no nausea or murmur. The heart'ssounds were heard over the
Certainsocial Hymenoptera, which,as John Hun vomiting,and, tillwithin the last three or four whole of the back. Every now and then the man said
"

terquaintly observes, "have propertyto defend,"pos- sess weeks, had kepthis appetite. He had never had that '* wheezing came on," and then he coughed.
a peculiar poisonapparatus, which is essentially headache,vertigo, or tinnitusaurium. He had no painin the chest
a modification of these accessory partsof the female Such were the chief pointsabout the previous The hepaticdulness extended firam the upper
organs,which are the onlypartsthat acquire tional history
a func- of thiscase, which by no means prepared me edgeof the sixthrib to three finger-breadths below
activity in the neuters of the bee and wasp. The for the enormous cardiac disease discovered on the false ribs.
poiaon is secreted by two longand slender ducts "
examination.^ The feet were not at allswollen ; the superficial
the homologues of the " colleteria," which unite I examined the patient on the day he was mitted.
ad- veins were not enlarged.
together and empty their secretion into an oblong I found a strong stout man, 5(L Sin. in After four days'rest,with digitalis and opium,
bag,which discharges itselfby a narrow tween height,
duct be- with a rather brilliantfloridcomplexion, a the following w^ his condition: "

the valves of the sting.This is a long, circumscribed flushon the cheeks,a bright sparkling The extreme dyspnoea had disappeared ; the pro-
longed
slender, and sharpprocess, with a serrated edge, eye, and red lips.The countenance did not in the harsh expiration had almost gone ; the great
which generally prevents its retraction when thust least betray, what was, however, immediately dent,
evi- veins of the neck were hardly at all distended ; the
intothe skin ; it is the homologueof the " ovipo* that the patient was labouringunder great face was lessflushed ; the pulsehad fallento 92 ; the
sitor:"the protecting valves are modifications of dyspnoea ; in fact, he could not lie down, but rested heart'saction was less forcible ; there was a systolic
thelastabdominal segment. in a semi-inclined position. He could,however,lie bruit under the firstbone of sternum, and to the right
The corresponding partsare variously modified in on either side, or on his back,provided the head and and leftof it;hardly, ifany diastolic bruit ; the "a-
otherinsects to insure a proper deposition of.the shoulders were raised. Although there was this stolicbruitwas hardly perceptible at second right car-
tilage,

eggs. In some insects,as the Locusta viridissima, inability to lie down, he was not breathing absO' audible at midstemum ; loud rasping systolic
the bivalveovipositor is longerthan the body,and, lutely quicker than usual; the bruit both loudness and
respirations were at apex, maximum, as to

bymeans of it,the ova are conveyedto the proper slightly irregular and deep, but on an average not roughness outsidenipple, where there was alsoa littie
depth the soil,the act of oviposition
i n cisely above twenty per minute; expiration
beingpre- was longer thrill;the heart's action was a litUe irregular. The
analogous to that of setting seeds in the earth. than inspiration. The chest was broad and well- urine,which we had now examined, was scanty
In the saw-flies, the main part of the ovipositor is formed ; the right claviclewas more prominentthan (|xx.), slightly acid,sp. gr. 1024, without sediment,
long, slender, and serrated, likethe stingin the bees. the left; the right post-clavicular space deeperthan and without albumen, ^ere was a littleextremely
With this instrument the female saw-fly (Tenthredo) the left; the tendon of 'the rightstemo-cleido mas- toid, finemuco-crepitation, or even crepitation, at the base
saws intothe substance of leaves, and there insinuates manifestly more prominent than the left There of the leftlung, but less. coarse rhonchus than before.
hereggs. The Ichneumons have a similarapparatus,was decided, but very slight prominenceof the car- There was more pulsation at the upper right edge
but extremely elongatedand slender, by means of tilages of the firstand second rightribs, and of the of the sternum,unclerthe bone,and in the neck. In
which theyintroduce theirova beneath the skin of rightupper edge of the sternum. There was cided,the arteriesof the neck there was
de- a systolic murmur.

otherinsects. but slight generalbulgingto the left of the A few days later he had still further improved,
Insects, like crustaceans, are occasionally ject
sub- sternum, from the second interspacedownwards. and said he breathed as well as ever. The only
to one -aided or dimidiate hermaphroditism. The heart's apex was beating at the seventh rib, material differencein the reportwas, that there cer- tainly

Numerous instances of this kind are given by exactly 4 inches below the verticallevelof the nipple, appearedto be somethinglike a diastolic
Ochsenheimer. In fourteen of the instances which find 1 inch outside a line prolongedvertically from murmur at the extreme apex outside nipple, lostim"-
be cites, the rightside was male and the leftfemale ; nipple.The superior limit was at the upper edge mediately above apex ; urine same characters.
innine instances it was the reverse. Occasionally of diethird rib; the inner limit | of an inch to the A few dayslaterhe had stillmore improved, but
hermaphrodites are found, where the characters of rigJtt of the sternum ; the outer edge2^ inches out- side a cholera patient beingbroughtmto the next ward,
one^ sex, instead of extendingover one-half,are left nipple. Vertico-diagonally the dulness he got alarmed,and quitted tiieHospital, sayinghe
limited to particular parts of the body,which agrees measured 8 inches,laterally 7i; vertically, 5. should return to his work.
inthemain with the other sex. Thus an individual Over the whole of thisspace there was pulsation, Three questions presentthemselves here for con^
of the GattrophagaQuercus has been observed, in which was most marked at the apex, where,indeed, sideration. What was the state of thisman's heart
which the body,the antennae, and the leftwingswere it was very etrone, and under the thirdleft rib,and and other organs on admission ? By what stepshad
thoseofthe famale, the right wingsthose of the male. second and third leftinterspaces. There was alsodul- ness tiieheart attained to that state ? What were the
The external sexual charactersare striking and under the firsibone of the sternum, and nearlypoints in which thiscase contrastedwith the previous
very
"Mious in the classof insects, and readily lead to equally on both sides of it ; this dulness measured two cases ?
thedetectionof the hermaphroditical conditionof the 3 inches laterally, and assumed a circularshape, 1. As to the size of the heart There was no
internal organs. contractedabove and|below. There was pulsation un- doubt about the existenceof enozmous enlargement
 54 THE MEDICAL TIMES.

of the heart,and chiefly of the leftTentricle. As is there was some hypertrophy, as there must to break down, an amount of disease is disco-
vered
thoughnot inyariahlein these cases, the heart have been for some time an impedimentin the pul- which must have been gradually augmenting

bably
gins
vfiutl; monary
had extended downwards and to the left,very little circulation, but the extent of such hypertro for many years. Now, here is a feature about this
upwards.Now in the onlyother disease, or, at least,phy,although indeterminate, was, probably, not con-
siderable.case which I wish you to note ; a man labours for many
usual disease,which causes marked increase of prae- years under a seriousdiseaseofthe heart which causes
coxdial dullness,tIe.,pericardial effusion, the in- 3. As to the pericardium, there was certainly him no discomfort,
" of which,in fitct, he is unconscious.
oreased dulhiess is upwardsmore than downwards. no fluid. Were there any adhesions? Here, again,This, again,throws light on the course of events.
But tiieheart had extended more to the right than is we had no evidence. There was a littleintermis-
sion But let me continue the hypothetical account of the
usual in hypertrophy of the leftventricle. Was every now and then,but no great irregularity, case. I presume that this man suffered, fourteen
of
there,then,enlaigement the rightTentride,or and no inequality in the heart's action ; the diag- years ago, from endocarditis of the leftside,and
was itmerelydisplaced hy an immense leftventriclef nosis of adhesion,alwaysdifficult when the case has probably of the aortic orifice chiefly. Thence en- sued,

This is a difficultquestion, and we will defer its not been traced up, was, in this case, unsupported after his recovery from the rheumatism,
considerationfor a few moments. We had no direct by any positive evidence,and was, therefore, left slow thickening of the aorticvalvules,and coarcta- tion
evidence about the aurides, hut there was little undetermined. I fancied I heard a littlecircum- scribed of the aortic orifice; as slowlyensued upon
doubt that the leftauricle must be hypertrophied, friction about the apex, and, at the last re- port, this,its conservative and compensating condition,
on account of the existence of certain lesions of the a curious diastolicsound was noted at the ex- treme hypertrophy of the left ventricle. As the man
orifices, and this conjecture was somewhat strength-
ened apex, which may have been pericardial. If was young and otherwise healthy, the muscular
by the pulsation in the ^third leftinterspace, so, it mightbe owingto a patchof old roughl3rmph substance was firm,and there was no disposition to
which was, no doubt, auricular. It was also pro- bable,at the apex, a condition which will girerise to a dilatation. Now, had the man been in an easy and
from the strong, heaving stroke of the heart, sound of this kind. This would imply freedom of non-laborious trade, he might have lived a number
that the muscular substance was in good condition,the rest of the membrane, as the apex is seldom of years with this lesion without inconvenience ; in
i.e., was not fittty. free if the other parts are adherent. But the patient fact,he did livefor many years without any notable
3. As to the orifices. That the mitral orificewas leftthe hospital before we had time fully to investi-
gate discomfort Engaged,however,as he was, in athletic
patentwas evident from the extremely loud,rasping this point. occupations, the hypertrophy went on increasing.
systolic murmur which had itsmaximum at the left 4. As to the aorta. The dulness, on percussion, At lengththe mitral valve,either ftom some ease
dis-
apex, and from the state of the lungs,which were under the firstbone of sternum and to the sides, the which ithad sufikred duringthe endocarditis,
evidently i n that condition which, when secutive
con- pulsation, and the slight b ut decided prominence, or from the force of the strong ventricle breaking
to cardiac disease, seems to result only were evidence of dilatation at any rate. But was down its valves,or from its orifice increasing in
from two conditions, via.,from contraction of the there more than this;was there sacculated aneu- rism circumference faster than the valvules in length
mitral orifice with hypertrophied left auricle, t This is a most difficultquestion, as the and width,began to permitregurgitation. Then
or from patencyof the mitral orifice with presence of hypertrophyand of valvular disease ensued the inevitable effects of regurgiution ; the
hypertrophied ventricle. In either of these eases the complicated the case to an extreme degree.The blood,thrown back on the auricle and the lungs,
bloDd is dirown back throughthe pulmonaryveins pulsation was nearly,though not quite, equalat caused pulmonarycongestion.But, this being
upon the lungs; then ensue congestion, pulmonary either side of the sternum ; the systolic bruit was slowlyaccomplished, was unperceived by the pa- tient,
apoplexy, or capillary hnmorrhageintothe bronchial not louder,nor even more hollow,here than over the one of a class who pay but littie attention to
tubes; and, as a consequence, more or less bron-"- aortic valves ; the diastolic,heard,was not nearly personal
if sensations of any kind. Another evil waa,
chitis. This state,in which the lung disease is so loud aa over the valves ; there was no heaving,however, gradually developing itself, viz.,dilata-
tion,
aeoondaiyto the heart affection, is in most cases and no thrill. There did not appearto me to be or possibly sacculation of the aorta,and slight
easilydistinguished by many circumstances from unequivocal evidence of anything beyond dilatation, pres9ure on the trachea and large veins. Then the
tiielung diseases, such as emphysema,which are unless the signsof pressure were to be considered general health began to fail; the man began to get
primary to the heart afifection. In addition to the so. After four days'rest, and when the heart's tion
ac-
"
nervous,"as he told us ; an abscess in the axillMy
Initral disease, we had evidently aorticobstructive, had quieted, and the pulsehad descended to probablyfrom a strain,but, nevertheless, to be
and very slight aortic regurgitant disease. I say 92, the pressure excited by the dilatation on the considered as a sign of impairedhealth,formed.
very slight aortic regurgitation, because the murmur jugular veins ceased,and these emptiedthemselves. Finally, hsemoptysis came on ; the man became too
feeble, yet not like the feeble, At the same time,the slight pressure on the trachea ill to do his duty, and entered the hospital. The
was
peculiar murmur
of aortic valves, completely broken down , and because also ceased,and the short abruptinspiration, the onlypointwhich is not clear,is the cause of
the beats of the arteries did not possess the thrilling croupy, prolonged expiration disappeared. Let us the disease of the aorta itself. But, aortic dilata- tion
moving character they exhibit in great aortic leave,however,
gurgitation.
re- the consideration of the condition of and sacciilation are, as far as etiology is cerned,
con-
On the rightside we had no positive the aorta tillanother occasion, as this is not one of more obscure even than the cardiac afifec-
evidence about the pulmonary valve,and therefore the special points about the case to which I desire to tions. It is not of much use to inquire, with this
we concluded, according to the usual rule,that this direct
your attention. singlecase before us, whether there had been any
orifice, the leastliableto disease of any, was healthy. 6. As to the lungs. There was bronchitis, and, lossor elasticity of the aorta, any tmusual yielding^
But now as to the tricuspid opening. Was there re- probably, some amount of hsemorrhage.After en- trance to the current of blood,forced on by this strong
gurgiution throughitf The systolic murmur at into hospital, the patient had no hemoptysis ventricle, after the aortic valves had been a littie
the apex was evidently chieflyor altogether owing and scarcely any expectoration, but that there was broken down, or, whether any other causes may
to mitral regurgiution. That itwas not attributable some hflsmorrhage appearedto be probable from the have been in operation ?
to tricuspid disease was probable, not onlyfrom the fact, that when tiiecongestion had lessened, and the Let us now contrast briefiy this case with the
comparative rarity of tricuspid murmur8,but alsofrom muco-crepitant rhonchus had nearlydisappeared, two former.
the fact that it was louder at the apex of the there was left an extremely
not fine, pufiycrepitation,1. In all three cases there was dyspnoea, or even

rightventricle than it would have been,had it pro- ceededwhich was eitherpneumonicor from hasmorrhage ; orthopncea, t. e., the patients said they could not
entirely fh)m the mitral oriflce. It was
every other symptom pointed to the latter. breathe,and could not lie down. But,how different
heard here, it is true, but then it was heard 6. As to the liver. Its extreme heightwas four from the lastcase were the two first In them we had
all over the chest; that it was heard here and a halfinches, it was not at all tender, and though, lividlips, and darkly-flushed faces ; a sense of suf-
focation,
provednothingfor tricuspid regurgitation. Then, as already said, itwas below the falseribs, itwas very which the deepestinspiration did not
Again,the Jugular veins were distended. Was littieenlarged. thoroughly relieve; a respiration frequently re-
peated,
not this 9 sign of tricuspidregurgitation?7. The spleen, kidneys, other abdominal organs IS if the patients responded constanUyto
Not in this case, fbr this reason, the veins were and cerebralorgans, presentecl no positive that ever-recurring necessity f or air. In the last
"
symptoms. case

distended, but theydid not pulsate, and theydid not The urine was testedfive or six times and was always we had a respiration not quickened;when once the
fillfrom below. They appeared to be distended in non-albuminous, and without deposit of lithates. air had passed the obstacle, all sense of suffocation
a diffbrent than is usual in tricuspid and watery-staring
manner gitation, Such was the conditionof thisman
regur- ; an enormous vanished ; we had no livid lips
as if from pressing leftventricle, scarlet flush of the cheeks, de- pendent
some cause upon the enlarged and hypertrophied a probablyeyes, but a bright
vens innominatse, or even the superior cava. When hypertrophied left auricle, a patentmitral,an structed
ob- on other causes than the dyspnoea. We
the patient leaned forward the jugulars emptied, and slightly patent aortic orifice, a dilated had, in fact,a good instance of the difference be- tween
evidently from the removal of pressure ; in tricuspidor aneurismal aorta,slightiy pressing on the trachea two of the three greatvarietiesof breathlesa-
regurgitation theywould stiU have filled, though and largeveins ; a probablyenlargedrightventri- cle ness, viz., 1st. That in which from affection of the
not so well as in the recumbent position. And ; the condition of the pericardium doubtful ; th! lungs,the blood cannot be properly aerated,even
there did appear to be a compressing cause, as we lungs suffering moderatelyfrom the regurgitant when airis freely admitted ; and 2nd. That in which
shall presently notice, a state of thingsimpeding mitral disease;the liver comparatively
" or gether the blood at once can undergoitsproperchanges,if
alto-
the free flow of blood into the rightauricle. As unafiected; the other organs, also, so far as the obstaclewhich opposes the entrance of ur can be
these signsprovednothing for tricuspid tion,
regurgita- we could make out,sound. momentarily relieved. In our presentcase the dys- pnoea
so there was strongnegative e vidence against What, now, was the of events in this was evidently owing more to the pressure on
sequence
it ; there was no general dropsy. Once there had case ? How came this heart into the state I have the trachea than to the mitral regurgitation ; for it
been a littleoedema of the feet, but this had passed described ? Fourteen years previously the patienthad much lessened in a few days, and it was evi- dent
off;there was not a signof any impedimentto the had had rheumatic fever and cardiac palpitation. that the dilated aorta exerted less pressure,
generalcirculation; therefore, most probably, the We may, therefore, assume, takingthe progress of since the jugularveins emptiedthemselves easily,
tricuspid valve was competent. But now, the com- petence the case into consideration, that he had endocarditis, while,at this time, the force of the ventricle,
of the tricuspid, coupledwith the history I or pericarditis, or both. He recovered,and con- ,
though lessened,could not have been so much so
of the case, lessened the probability of there being aidered himself in penect health for nearly fourteen as to cause this greatdifference, had the dyspnoea
"ay greathypertrophy of the right ventricle. Pro- Iyears, although at the end of this time,when he be- been owing chiefly to mitral regurgitation. The
 THE MEDICAL TIMES. 55
in the kind of
difference dyspnoea
to which I have but generally aided by other remedies. I rarely astringent
ministered
ad- remedies,aa I have heretofore stated in
now viz.,thatf
alluded, in which the blood can be other agentsuntil I feared that the saline this Journal,I have found none to equalthe nitrate
or only
perfectly imperfectly is
aerated, well worthy planwas incompetent to the cure. I was unable to of silver in its power of arresting the evacuations
of consideration ; of^en, at once, observing it,we may administer the saline remedies in the form recom- mended in cholera. It will rarelyfail; and sometimes a
nupectaneurism or tumour commencing to press by Dr. Stevens, in consequence of the dominance
pre- single pill h as the efiTect of stayinghe purging,
t re-
lieving
on the trachea. I have seen one case of either of common salt,which was ofiensiveto the cramps, and restoring warmth to the
aortic or innominate aneurism, in which the respir- the and caused the remedyfrequently If
to be patient.givenduringthe stageof convalescence,
ations patients,
were only four per minute ; the inspiration set aside. I thereforedevised the following formula, itis apt to induce fever,which is generally, how*
occupied four or five seconds ; the man was quite which may pleasethe chemico-physiological titioners,
prac- ever, transient
reliered; that quantity of air sufficed for perfect as it bears a close relation to the more In consequence of this result,I refrainedfrom
aCration for the moment ; then came recent views of the combination of the saline con- it in some
on expiration, stituents administering cases of cholera induced
lasting fourteen to seventeen seconds,and then the of the blood. upon gastio-enteritis and the remittent fever of
Bhorter inspiration followed. It is,of course, un- ^ Sod. chlorid.; potas.nitr. ; sod. phosph., aa. children. In one remarkable case of a child,the
deistood, that this dyspnoea, with slow breathing, is ^iss. ; potas. chlor.,^bs, ; aq. purse, ad Oiv. Mist evacuations by vomiting and purgingwerf most
not constant in aneurism or tumour pressure on cyath. vin.; pro re nata sum. profuseand constant ; but I dared not staythem by
the trachea, particularly in the advanced stages. This formula was constantly used throughout the the nitrateof silver, as high fever was certain to
2, Another point of difierence between these whole periodof the epidemic, when it was thoughtissue. I thereforerefrainedfrom interfering directly
cases was, that in the two former there was dropsy ; necessary to administer salines. with the evacuations, but placedleeches over the
in the last none, or merelya little transientoedema. The greaterttumber of my early cases died in the abdomen, and gave febrifuge remedies, in short,
"

And the cause of the difierenceis consecutive and I inclined treated in accordance with the
very evident;for, stage, was to think that my patient ordinary
in the firsteases, we had impedimentto the generalit was owingto the salts, which helpedthe patients rules of art,and she recovered. Many other patients,
circuJationoccurringfrom disease, of the over the collapse, I mightalmost say the majority,
especially but were unequalto accomplish "

a duringthe last
light sideof the tricuspid orifice, and the ventricle finalcure. At this period, both duringcollapse and month, who suf"reid
"
from cholera, with thismodi-
fication,
itself, and from primitive or superaddedlung the re-action,the salines were employed abun- dantly were treated according to the same plan,
disease. But, in the last the with and I desire this the
case, general cir- ; but, the exception of the apparent vantage
ad- to impress upon reader, as I
culationremained free ; the blood found its
way above stated, I could perceive no probablewish to show that differentmodes of treatment must
into the right; side,with}only tT be for this under
trifling pediment,
im- benefitfrom their use. It mighthave been expected adopted disease, Taiyingcomplica-
tions,
which was and that he must bring his science to bear
sooft relieved;was pro" that theywould have excited the action of the kid- neys,
polled throughthe lungs,and then returning, out
with- and removed the soppression of urine,-r-U|at upon every case that comes beAOre him. It matters
much difficulty, to the left side, was hurled most imperative indicationduringthe latter stages; little whether these cases are genuinecholera or not
hy that immense ventricle forcibly through the but theyevinced no such power. Subsequently, I They are so called and reported, as I know ; and it,
system. But, if the patientdoes not die of pres- sure was induced to employ more active remedies,with therefore, behoves us to be on our guard,and to
on the trachea,or from some other cause the view of arresting the disease in itsearly stages,discriminate between such cases and simple cholera;
connected with the aorta, as most wUl be and, as I believed, with far more for by so doingonly can estimate tiievalue of
probably benefit. It ap- peared we
Ae case, he will die with dropsy for, different of P atients will die of
; gradually, to me, that granting that the salines might systems practice.
the longs will be more and more in such cases, as in uncomplicated
congested by the carry the patientover the collapse, theycertainly collapse cholera.
mitralregurgitation" haemoptysis relieve this could
will in the of and it With these' reservations, then, let be stood
under-
not cure stage re-action, was, me
from time to time,until,at to say, that I know of nothingthat exercises
length, the rightheart therefore, necessary to employremedies that, if pos-
sible,
willbeginto dilate and thicken,in order to over- had a more the col-lapse,such remarkable curative power over Asiaticcholera
come restraining power over
the obstacle in the under the saline as the nitrate of silver. If another epidemic
lungs; then will ensue as the subsequent re- action, should
stagnation of the general venous system,from dilata- tion plan,most frequently terminated in death. Other unhappily visitus, I trust that it will be largely ployed.
em-
of the right side,or from tricuspid have declared diflerent
tion,
regurgita- gentlemen to ^ experience ;
and dropsy willfollow. Thus, we should have but that I cannot help,and desire not to account As an adjuvant, I recommended my patients to
(mc of those
complicated cases to which I referredat for. My object is merelyto givethe jresults of my take tolid ice; and certainly nothingis so grateful to
my lastlecture. own observation. them, or accomplishesso successfully the end in-
3. Another difference between these cases that perhapsthe employ- tended that of assuaging the intense thirst,
was It has been suggested, ment "
and of
alsovery well marked, though so well of other remedies interfered with the action of calmingthe vomiting that is so very trying and con-
not, perhaps, stant
IS it is sometimes that it is in tricuspid I gave effervetcent salinesvery largely,
; viz., ease the salines ; but I do not think that any practical
dis- At first,
that the liver suffers especially ; for itscapil-man will admit thisplea. A moderate experienceand they quieted the stomach in some cases, but m
Isiy circulationis affectedno less directly by tricus-
pid will enable a well-educated practitioner to distin-
guish others theycaused urgentvomiting ; cold water, also,
regurgitation than that of the lungsis by mitral the various effects of diilerentremedies,and used liberally, producedthe same undesirableresult
regurgitation with ventricular hypertrophy, or by no one presumes to doubt,that, in most cases, the In my Lectures on the Asiatic cholera, I suggested,
mitral contraction with auricular efiectsof calomel,digitalis, or iodine can be that the vomiting not probablya dangerous
hypertrophy. specific was

Many other remarks might be made on these obtained and determined,thoughgivenin combina- tion symptom ; and even now I consider it far lessdan-
gerous
cases ; but I am afraid of wearying with other remedies. Of course I do not mean than purging, for reasons that will readily
you, and we
shallhave frequent of goingover simi- that if large quantities of brandyshoul"^ to the reader ; but I am fully persuaded, that
opportunity lar to assume, occur

ground. be giventhat the efifect to be expected from salines ifthe case can be carried throughwithout vomitmg,
would not be frustratedj but when adjuvant dies
reme- it is better to adoptthe plan, as it removes a most
are administered in moderation, and with specialunpleasant symptom. Ice assuages the thirstmore
ORXaiNAIi CONTRIBUTIONS.
indications, it cannot be admitted that theyinterfere readily than anything else; and if taken immedi- ately
with the ordinaryphysiological action of saline me sensationof vomiting is felt, ithas a singular
OBSERVATIONS ON THE RECENT
remedies. The converse argument is usually ployed
em- power in arresting it; on the contrary, cold water, or
EPIDEMIC CHOLERA.
to cover a failure. Although,therefore, I effervescing medicine,by distending the s"mach in
By GEORGE ROSS, Esq.,
Late Medical Officer of the West London did not continue to placeconfidence the power of nearlyallcases, onlyprecipitatesvomidng.
in the
Union, Author of
Lecturoion the Asiatic Cholera, "
"c., Medical Times." saline"^ to arrest this terribledisease, I regularly Ice rubbed alongthe limbs will also abate the
employedthe formula cited,until the latterweeks yiolence of the cramps ; but I have employeditonly
TREATMENT. of the epidemic, when I doubted its efiUcacy. My in those cases where a liniment composedof equal
Many curious phenomena in relation to the object in administering salineswas to convey saltsto partsof turpentine, oil, and laudanum did not avail.
nervons observed the process of I have generally found this liniment,when rubbed
system were
among my patients the blood; but I do not believe that
labouring under cholera. One lady, who died in the absorption can supplythe blood with its lostprinci- ples, in in largequantities, answer the purpose ; but the
consecutive stage,showed symptoms of catalepsy on and bringit to its normal state,under the pe- ice is preferable.
culiar
thefourth day after her attack. On the following conditionsof cholera,in a few hours or even Another remedial measure that I have generally
%, the cataleptic state of the muscles of the upper days,and conceive that something is wanted of more employed, is,I consider, of the highest importance
extremitieswas complete ; but towards eveningit rapidand decided action. in the treatment of this disease: it is the admini- stration
^sappeared. Obscuration of mind commenced with My generalplanof treatment, therefore, was, to of an injection, |)er amtmf of strongbeef tea,
thecaUlepsy ; torpor succeeded ; but the ladydid administer six grains of calomel and two of opium, with fi"rty minims of laudanum, twice or oftenei a
not die until five daysafterwards. In another under day. This injection calms the irritability of the
case, on the firstapplication of a patient labouring
on the fourth day from the attack,at about six sickness and in the consecutiye stages, and
diarrhoea,before the rice-water stage bowels, especially
tfclockin the xSkea.
morning, the patientr" a man" lost was confirmed. These remedies were followed up nourishes the patient when food cannotbe into
fl"e sense of vision, of hearing, and taste for the periodwith chalk, kino,and laudanum, of which last, ten the stomach "
a most important object to attain, as I
of halfan hour. I was and him at minims were givenaftereach loose motion. have died of mere
sent for, saw Tlius, have no doubt that many patients
seven o'clock, when, however,these facultieswere it occasionally happenedthat five or six grainsof starvation. The advantagethat patients gainfrom
i^e"tored. He now complainedof a sensation of opium were given within the firsthour. If these this injection cannot be over-estimated.
warmth,which had succeeded to extreme cold,but remedies failed in arresting the diarrhoea, and the Calomel I have employedin some cases, both in
therewas no coma mental dulness. He died at true rice-water purging,with prostration, set in, I one or in repeated small doses,but I cannot
or large,
thieep.m. on the same day. was accustomed to administer one, two, or three say that I have observed any beneficialeffects from
Beingdesirous of tryingthe saline planrecom- mended grains of nitrateof silver, combined with a quarter its use ; at the same time I do not think that it has
by my excellentfriend Dr. Stevens,I em- or half a grain of opium every hour, according to done any harm, and certainly would not dissuade
pbyedit in allmy firstcases "

not, however, alone, circumstances. Al"ough I have tried ntimeious any practitioner employingit,onlylet him
from
 56 THE MEDICAL TIMES.
a smaller number of cases, and theyhad been boundaries mergingtogether, in this instance, at the
have prudenceto administer other remedies of
the
cable collectedunder one roof,I mighthave been able to outer ring.

tended
a more positive character, and more directly appli-
the urgent of the disease at the gfive more precise r esults, but situated as I was, CONGENITAL INGUINAL (LABIAL) HERNIA.
to
symptoms and a largenumber of patients, Case
same time. The practiceof pinningfaith on a with a wide district 1. A child,aged 7 weeks, was" brought as

singleremedy,and that remedy,too, employedin I was unable to note separate symptoms, in every an out-patient under Mr. Ward, with an elastic
subordination to theoreticalnotions, cannot be too casej with sufficient minuteness to form the basis of
tumour in the region of the right labium,and which,
strongly condemned, as it cannot fail, in the end, to a tabular statement ; and tables constructed from from the account of the mother, had existed ever
make our Profession the scoff of the reflecting public.loose data,after-thoughts, and shrewd guesses,as I since its birth. The
rightlabium had a peculiar
The stage of re-action is that which most fear they commonly are,
too could lead only to error.
cially
espe- appearance, beingoval in form, broader above than
demands the exertion of all the skill and below,the integument being tense and shining.It
knowledgethe Medical attendant possessesto effect projected about half-an-inch beyond the levelof the
The waste of the system must be supplied, HOSPITAL REPORTS. and on a superficial examination gave the idea
a cure. left,
and the kidneysinduced to action;but these ore of beingin a state of hypertrophy. .

problepis not easily solved. Salines in moderation LONDON HOSPITAL. On placing the hand on it,however, a distinct
shouldbe persisted in, or if there be great irrita-
bility
impulsewas detected on the cryingor coughingof
of the stomach ten grains of carbonate of soda, STRANGULATED INGUINAL HERNIA the child, and the swelling could easily be passed
and one-twelfth of a grainof a salt of morphiaevery ON TEE LEFT SIDE" OPERATION WITHOUT and the tipof the
back into the abdominal cavity,
three or four hours will prove a very agreeable and OPENING THE SAC.
middle fingerintroduced into the outer ring; the
useful formula. The beef-tea injections are pensable. John Merritt,a waterman, aged 64, who had swelling
indis- being,in fact,an oblique inguinal hemii,
been subject to rupturefor some years ; but,forthe which had descended anteriorly and internally to
To remove the suppression of the urine is a relief of which he had not alwaysworn a truss,came
Poupart's ligament.A truss was ordered,and the
matter of greaterdifliculty. In all cases it would into the London Hospital, under the care of Mr. thus retained within the abdomen.
rupture easily
be well to pass a catheter to ascertain whether the Nathaniel Ward, with a large conical protrusion, Case 2." This patient, also a female, aged 20
bladder may not be over distended and paralyzed, which had come down eightor nine hours before months, was broughtto Mr. Critchett,havinga
for sometimes, on usingthis instrument,I have his admission. tumour in the left inguinal region, which on exami-
nation
drawn offa large quantityof urine,although after-
wards It had descended into the scrotum, was equalin presented much the same characters as the
secretion was not continued. On one sion,
occa- size to the two and, from the greatdistension last,
fists, exceptthat its circumference was more distinct
I injected the bladder in the hopeof stimulating of the integumentover it,the peniswas entirely The period of existence of thishernia was somewhat
the kidneys, but without effect. I can recommend c^cealed, a puckeringof the skin onlyindicating doubtful,for, according to the statement of the
nothing with confidence that be said its position.
can to establish
re- mother,she had onlynoticed it a few days prior to
the renal function. Leeches and repeated The tumour excessively tense and tender to her when she thoughtit had originated
was
application,
blistering ever the loins, d iuretics of every kind, dry the touch, and no on t he
yielded impulse coughing, in a fallwhich the child had from a chair. No
cupping,the vapour bath (bymeans of Moss's in- latterbeingevident only in the course
geniously of the in-guinal
particular attention, however,was at the time drawn
contrived portable apparatus), calomel, canal. On graspingits base, and gentlyto the situationof the rupture.
and the voltaicpile, have been employedand failed. compressing it from below upwards,the upward that ithad existed from birth,
It is more probable
The onlyremedial means that ever distinctly coveredimpulse
re- was found to cease exactly in the situation but had
escapedobservation, for it only appears
this secretion, was wrappingup a patient, of the outer ring. when the child cries or coughs,speedily returning
who had sufferedunder suppression for four days The usual constitutionalsymptoms of tion
strangula- to its natural position. A truss was also ordered
in a wet sheet,and covering him over with five or existed. Attempts at reduction havingbeen for this case, in the hope,that,in the process of
six blankets. This process was gone throughabout carefully made by a medical man priorto the pa- be restored to their normal con-
tient'stime,the parts'may dition.
4 or 5 p.m., and about 10 o'clock the patient passed admission,and the symptoms being very
half-a-pint of urine, and the function was continued urgent, it was deemed expedient to operateat once. LARGE HERNIAL PROTRUSION,
in a healthymanner from that time. I should The patienthaving been placedunder the influ- ence COVSIfflTNO OP PAKT OP 6TOMACB AlID THB LABOE
advise the adoption of this planin similar about an DEPICIEMCY OP
strongly of chloroform, a longitudinal incision, AND BMAXL IITTESTIIVES." "PABTaAL
cases. The wet sheet alsoproves usefulin the early inch in length, was made over the situation of the ABDOMINAIi WA1.L"" "MALFOEMA.TIOlf OP BLADDBJI.
of the disease and but blunt- On December the 28th, a child, aged fourteen
stages commencingcollapse, I outer ring,which, havingbeen exposed, a
should doubt if itwere of any service in deepcollapse, pointed bistoury was passed under its upper pillarhours, was broughtto Mr. Ward, havingalarijp
as I know of nothing that really is. and the latterincised. and oval tumour protruding from the abdomen, in
I have also givenchloroform,and have found it Uniform pressure being then made with both the mesial line between the umbilical opening and
a defi-
ciency
suppress vomiting and purgingin the onset, but as hands,on the body of the tumour, and its neck pressed
com- the pubis, there being,within these limits,
the same result can be effectedby opium, I saw no with the fingers, the gut went back without of the abdominal parietes. Its upper snr"ce
sufficientreason to givea new remedy the prefer- ence. any difficulty. The bowels acted in twenty"four was of a" deep red colour,smooth and firm to the
It will also allay the troublesome hiccough hours after the operation ; a common enema having fingers, and entering it immediately below the cord,
that supervenes duringthe re-action ; but it can been exhibited two hours previously. which was to the left of the tumour, was a knuckle
onlybe regarded as a subordinate remedy. The wound had healed in fourteen days ; the pa- of intestine, about the size of a small orange, which,
With rebpectto the employmentof opium, I may tientexpressed himself as never better in his life,when the child cried,became distended with
observe,that full doses givenat the commencement, and leftthe hospital shortly after. flatus, and had a distinctimpulsecommunicated to
in what is commonly calledthe
premonitory stageof Itemarks. " The advantageof relieving ture, it. The largetumour
the stric- did not undergo any altera- tion
the disease,are highlybeneficial, but small doses without openingthe sac, was in this case well in size, nor was there any similar impulse.
of no value. When, however, the purgingis of shown. it on the rightside,was a finger-
are Had it been opened, the difficulty of re-
ducing Overlapping
the rice-water character, and profuse, and collapse the gut would, no doubt, have been con like mass, solid to the feel, and of a deepercolour.
is settingin, opium,according to my experience, siderable, in consequence, mainly,of the large tity
quan- On lifting up the tumour, its under surface was
wholly fails, and, if given m larg^quantities, is of intestine protruded, and the impossibility very irregular, having several small projections
highlyinjurious. Nothingwill answer the end but of employinguniform pressure for its reduction ; from it,which presented no definite character.
nitrateof silver. It would have been necessary, on the contrary, to Immediately above the pubis, and attached by a
My plan in future would be opium, the wet have passedthe gut back, fold by fold,which pro- of a dark red
"
ceedingsmall pedicle, was a triangular mass

sheet,and vegetable astringents, in the first or pre-

monitory might have caused, as occasionally occurs, colour, moist on iU surface, and having no covering
stage. a further descent of one or more folds; and thus a of skin,which,from its shapeand appearance, mucfc
Nitrate of silver in the rice-water stage and in considerable time (to say nothingof the probableresembled an enlargedglanspenis. On eitherside
^
that of collapse, with the steady exhibitionof salines injurious eflectsfrom manipulation, and the exposure of this,about an inch down, and situated on the
" solidice and beef-tea injections. of the serous membrane) would have been taken up upper part of the thighs, were two small conical
In the stage of re-action, the continuance of the before the final return of the bowel to its natural projections of skin.
injections and the ice, the use of the wet sheet and position. No external organs of generation could be recog-
nised,
.
the employment of the catheter, with such other In t^cprocess of reduction,however, the sac not but,from the appearance of the two small
local remedies as the case may seem to require. having been opened, these difficulties were entirely folds mentioned, Mr. Ward inclined to the opinion
If I am asked why I have not tabulated my cases, obviated, and the intestine was the that the child was a female, as the projections had
easily replaced,
my answer is,that my faithis shaken in that system, facility of so doingbeingmainlyattributableto the some resemblance to the two labia.
because I have found it utterly impossible to draw The anus imperforate, and no impulse when
equable pressure exerted on it,throughthe medium was
the
the linebetween diarrhoea and cholera. I the child cried could be detected by pressing
apprehendof the strong elastic bag of peritoneum.
that nearly one-half of allcases of confirmed collapse The exact seat of stricture was here also well t^hown finger in the perineum. There was also spina bifida
will die under any treatment ; but these cases are a by the method of diagnosis particularly alluded to opposite t o about the third lumbar vertebra.
very small minorityof the cases that exhibit the by Mr. Luke, (a)who observes : "
"
The pointof ces The child was small,its surface of a blueish
veritablecharacteristicsignsof cholera,and these sation of impulseon coughing, indicates the upper aspect, and extremities wann. Intra-uterine
againrun so insensibly into the ordinary forms of boundaryof the stricture, and the point of cessation existence about seven months. Since its birththe
the disease, that I conceive there is an amplerange of impulseon of the hernia,indicates napkin had been wetted with reddish dischaiffe,
compression a

for error in arriving which constantly oozed from tlie under side of the
at a diagnosis ; and thus only the lower boundary of the stricture, and consequently
can I account for the prodigious incongruities in the the boundaries are the limits of its extent ;" the tumour.
statements that have already appeared. I shall not The child had not been sick,but w^as slightly
increase these embarrassments ; perhaps ifI had at- (a)Medical GazeiU,Vol. II.,1841,p. 863. convulsed, and refused to take the bre-astj but in
 58 THE MEDICAL TIMES.
in the next bed,fluid was heard falling
certain quantityof airbetween itand the end of the which the evacuated fluid contained spermatozoa, the patient
Is this then the sense into from his bed,which the nurse discovered to be blood
finger.This does not alter in the fslightestdegree cases of spermatocele.
Before the
the nature of the sounds, but renders them much which this word should at lastsettle down ? It has issuing from the seat of the disease.
dear and intense. It has also the advantagebeen floating about apparently in search of a mean-
ing Medical Officeragain arrived,he was in a dying
more
It found that he had perforated the
sound under a much slighter
of eliciting shock than for some hundreds of yeais. We do not indeed member
re- state. was

in the ordinaryway, and thus saves the patientfrom that itis used by any very ancient surgical aneurism with a pocketcork-screw belongingto
but Morgagnitellsus that it was a mistake, himself, which he had concealed in his bed. No
many disagreeable manipulations. writer,
before Ws time,to think that it was a new other conjecture be formed of the cause of the
a little can

BCOTLAlifD. word. He the sense

argues againstattached to it sudden alienation mind, of than that it dependedon
by Barbette,of Amsterdam, who ranked it among delirium tremens.
incipient
[EdiobuxghCorrespondeDce.] the true hernias as signifying
a peculiar
corrugation
of the vas difierensand the descent of that vessel,
like a hernia,into the scrotum ; and he refers to IRELAND.
HTDBOGELE WHICH CONTAINED ,

SPERMATOZOA. the " BibliothecaAnatomica," that of Mangctus,

"

In a portion of a Clinical Lecture lately pub- as we think, in which itis described as a turge-
lished "
[DablinCorretpondence.]
by Mr. Syme, there are two pointswhich scence of the testes by an accumulation of their
BOARD OF HEALTH.
have attracted particular notice here ; first, the making them swell up to a great
proper secretion, The Board at Ely-place has been l^ly exhibit-
ing
evidence of the utility of the undiluted tincture of bulk,and sometimes
givingriseto abscess adjacent
iodine in small quantity as an injection for the to the epidydimis, with the contents of which semi-
nal
of
signs activity, throughtheir very efficient
officer, Mr. Hopper,"the statisticsof the several
radical cure of common hydrocele ; and, secondly, fluidmay finally issue. Most modem ties
authori-
the unexpected of the same injection for the Dispensaries being at present,for the hundredth
success
representspermatocele as a turgescence of time, in previous,it is to be
radical cure in cases where the evacuated fluidcon- tains the testes by the retention of the secretion, but process of collection,
spermatozoa. Mr. Syme states that he had theyhardlyafibrd us the means of determining hoped, some permanent arrangement of these In-
to stitutions
the coming Parliament. One of the
longsince givenup the port-wine injection in hydro-
cele, whether theythink this name by
belongsto the mere local papers is angry that any notice should be
on account of its uncertainty; thathe had after-
wards simpleswelling, or to thiskind of swelling, because
of the sick poor by the Committees of the
employedthe tinctureof iodine,one part to it sometimes ends in an effusionof seminal fiuid,taken
tihreeof water ; but that, Houses, suggesting that the Poor-law should be tirely
en-
duringthe last five years, he by a breach of continuity in some part of the sur-
face
had alwaysinjected the tincture alone," without a abolished,or the rates, as ingeniously gested
sug-
of the gland. The firstMonro describessper-
matocele
failure by Mr. Butt, paid out of the Consolidated
single case of or unpleasant either
eflect, in
among the spurious hernias,representing Fund ; tillthisepocharrives, however, the suffering
publicor private practice.** The quantity Mr. Syme it as a swelling of the testicle, from a stricture, or
employsis about a teaspoonful, or as much as fills a other obstruction, at the caput Gallinaginis,
poor must be attended. The harrowingtale of fever
apt to and famine,summed in the last Medical TVmes,
common sixpennypewter svringe, "which is the degenerate into sarcocele. Brechet, in our own
up
exhibitswith what fidelity the medical men in Ire-
land
most convenient instrument for the operation, as the
times, describes tpermatoceleas a swelling of the
have done theirduty; and that, in addition to
substance composing it allows the nozzle to be spermaticcord,and especially of the epidydimis pending
de-
the trials there witnessed, they should suffer from
readily adaptedto die canula of the trocar.** He on retentionof the seminal fiuid,among
regardsthe undiluted tincture as givingless pain the consequences of which are bursting
the generaldistress of those who formerlysub-scribed
of the swells
to the different Medical Charities,would be
duringthe time it is retained than any other fluid ing and actual fistula, characterised by escape of
that has been employedin thisoperation. In further the seminal fiuid. South deeplyto be deplored.
says, that spermatocele is
evidence of the efficacy of this mode of treatment, a troublesome of the testes from retention OPHTHALMOLOGY.
swelling
he gives the history of a case, as statedby the patientof the A Treatise on " Inflammations of the Eye-ball"
secretion; but, tliat he has seen no such
himself,from which it appears that,fifteenyears consequences those mentioned by Brechet It has justmade itsappearance,from the pen of Dr.
as
ago, when ten years of age, he had received a bruise does not appear, however,that the presence of sper- Jacob,including all the varied shapesof this dis- ease,
matozoa
on the testicle on horseback,which ended in hydro- cele. in the fiuidof any form of hydrocele had Idiopathic,
"
Scrofulous,Rheumatic, Gouty,
Febrile," and what
Mr. Syphilitic, Gonorrhceal, Post
"
Nothing was done for ten
years, when he been observed tillwithin the last ten years.
appliedto the late Dr. Hannay,of Glasgow,who Listen,in 184S,was the firstto draw attention, at
Dr. Jacob calls ** Neuralgic" Inflammation, with "

evacuated the fiuid,but declined to attempt the least in this the existenceof some forms of Inflammation of the Cornea, Mem- brane
country,to tozoa
sperma-
injection,
on account of the enlargement of the in the fiuidof an encysted hydrocele ; and im-mediately of the Aqueous Humour, Choroid, Chrystal-
Lens. Few, in Ireland,have had the op
testicle. He was then treated in 1847 by Diefien-
after,Mr. Lloyd found the like organ Hne, and
"

bach, at Berlin, bv the method of incision, but after ism in the fluidof what he conceived to be several portunities of studyingthis class of diseases both
great suflering, the disease,though reduced, re- mained cases of common hydrocele.Velpeausays, these
in privateand at the " Baggott-street" Hospital,
uncured. Dr. Angelstein next recommended that Dr. Jacob has had ; the work, therefore,espe "

organismswere observed by Letellierin 1840, in

the Englishmethod, or the cure by port-wine jection,
in- tliefluid of hydrocele at the Hospital La Charity, cially among his own pupils, (withwhom the worthy
but, as he had heard Dieflenbach declaim and that he himself observed them immediatelyDoctor is sometimes a littlehrusquey) has been
against this operation, he declined to submit. Dr. after. dence regardedwith much interest. Though not much
Velpeau,however, insists that furtherevi- tinental
Con-
Buhringthen attempted the cure by electricity, after is requiredof these organisms beingreallygivento the transcendentalisms of the newer
the introduction of two rows of needles into the
spermatozoa. Of this,indeed, there cannot main
re-
Schools,the work at once stamps Dr.
scrotum ; and this failing, he proposed to perform Jacob as a deep observer and sound practitioner.
any doubt; and yet the precise conditions
excision but hearingfi-om home of Mr. Syme's under which
theyappear in the fluidof hydrocele,
"

CONTAGIOUSNESS OF CHOLEBA.
success, the patient came to Edinburgh, and, as he seems to be stillunknown. Mr. Lloyd's ations
observ- This subject seems as unsettled, at least in Dublin,
says, is now completely cured by the injection of show at once that theymay occur in the as ever. The observations of Dr. Donovan, men- tioned
undiluted tincture of iodine,the operation being fiuidof what seems to be common hydrocele, and lastweek, would lead, to the belief of there
almost painless, and the confinement for three weeks
yet that they are much more frequently absent; beingno second opinion in the matter, while some
beingbut partial. since out of thirty cases in which the fiuidwas nutely
mi- remarks of Dr. Sunter,communicated to the Medical
It appears that Mr. Syme has treated two cases than Press this week, are quiteas conclusive on the op-
examined, he found them in no more posite
of hydrocele, with spermatozoa in the evacuated If the presence of these organisms found view of the question. thinks a
two. were Dr. Sunter
fluid,by the same injection, with complete success. to be connected with some form of en- cysted deal of unnecessary discussionhas arisen about con-
particular tagion
In the firstcase the man fifty
was
years of age, a hydrocele, then there could be no objection ; thatlike typhus, scarlatina, measles,small-
pox,
gamekeeper,who appliedon account of a large to the term spermatocele
beingrestrictedto denote or erysipelas, cholera, under particular stances,
circum-
scrotaltumour of eleven years*standing. The swell-
ing the form of hydrocele it is ful
doubt- crowd
; but, so longas becomes contagious ; that,if yon
gether
to-
had the ordinarycharacters of a hydrocele. on what condition their it is
presence depends, cholera patients, the disease becomes con- tagious.
After the operation was completed, in the manner advisable from
plainly to abstain addingone more He does not believe cholera a whit worse
alreadydescribed, the fiuid was examined scopically,
micro- to the numerous uncertain significations in which than scarlatina, "
or what he calls epidemicmucous
and found to contain myriadsof sperma- tozoa. the unlucky word ployed. catarrh ;" that," like a comet," *" it is a thingto
spermatocele has been em-
Mr. Syme says, had this been discovered wonder at" The views of Dr. Sunter are not with- out
before,the ix^ection would not have been practised, interest. It is quiteclear he has not had the
SIN6ULAB SUICIDE IN THE EDINBUBGH
as such cases have not done well under the ordinary kind of patients
INFIRMABT. same as the poor of Skibbereen or
radical treatment. He determined, however, to A man of intemperate habits was broughtre- cently Dublin ; that in his hospital, where he has had " all
tiythe same treatment if another case of the same into the Infirmary, with an aneurism of the appliances and means," hispatients otherwisehealthy
kind should occur. Soon after a gentlemanpre-
himself who had been tappedfor hydrocele
sentedfemoral artery. The cure by operation was poned soldiers,
post- that the diseasehasbeen more manageable ;
for a few days,that his general health might that if we could but raise the socialconditionof our
twenty years before, by Sir AstleyCooper,and had be improved. He spoke quiterationally, and pressed city populations, be possibly as successful
subsequently been treated with the port-wine
ex- we might
tion,
injec- a desirefor the operation, as he feared the in grappling with this fearful scourge. Sunter
by another surgeon, but remained uncured. aneurism mightburst. One night, soon after he was speaksof " contagious clouds of cholera in the air,"
The fiuid evacuated presentedthe same opalescent stand
under-
admitted, the ward was disturbedby the noiseofblows, a highlyexpressive phrase ; and could he but
appearance, as in the former case, and the micro- scope and it was found that he had struck himself several how these nebular masses settleddown in all
discovered abundance of spermatozoa. The
times severely on the temples with a metal jug.One the low parts of DubUn, in the dingylanes,for in- stance,
cure in thiscase also was satisfactory. of the resident Medical Officers was about "St. Patrick's" Cathedral,or at the
summoned,
SPEBUATOCELE. and the wounds were dressed. He appeared to have opposite side of the river, near *"
the Bichmond," a
Mr. Syme terms these cases of hydrocele, in become quiet;when,as he was in conversationwith locality not entirely unknown to him, his opinion
 THE MEDICAL TIMES. 59
Bught undergo aome modification. The queetion, Clarendon veir correcdyrated higher than that the usual publicity.A contemporarycer-tainly
in all its bearings,is no doubt one of the most in-
tenseof the English;he seemed to think there was obtained a copy of the precious
doctt-
interest,one on which some of the firstmen far more certainly
genius, more imagination among but
in the Profession Dr. Grayes,for instance,
ment ; this exceptionalfact only proves
"
known the former than the latter. Facts, too, he said,
^rough "orope ^havc entertained rery peculiarboiehimottt; for already,
"
in the Dublin school, our statement, for the ignorance of the suIh
"iews. The experience of the lastyear has thrown there were 4fO0 students, whUe,even in London, it jectof Medical Reform, and the pettysyco-
^
phantic
much light on thequestion. The it
disease, is clear,bad only very recently amounted so high. The policyevinced in that print,haw
in the ordinary' of the term, is not con- of Taste" was alluded to in the earlier
acceptation "
Physiology
tagionsyno more than ordinary "'
longdeprived it of allauthority
upon the ques"
fever,"for partof the evening,the entire addiess leavingan
relapse and reduced it to the
two or three at least There is
days not time, per-
that His
haps, impression, had studied tion,
Excellency deeply humble office very
for
the formation of malaria. On the contrary, the subject himself,and deeplyfeltitsvalue. The of playingShadow to the Moonshine of little
among the poor of Skibhereen or Dublin,where the Address of Dr. King,and one some time since on demagogues. It has become,in fact, the re-
ceptacle
whole physiological sfructiue of the systemis falling the kindred subjectof " Botany in relationto De- sign," of defunct prejudices. It would be
in pieces,malaria is quicklyformed, the disease Dr. the b otanist of Ireland,
by Harvey, first "

act of to let these extinct

spreading more quicklyand fatally, and in many invitedsince to America to lecture, ^are very worthy
"
an mercy dogmas
drcnmstances simulating contagion.* of the studyof the Profession. sleepthere in peace; but we are sometimes
And speakingof this wretchedlydisorganised called upon to break burglariously into such
state of the system in the poor of Ireland,during
dead-houses,and to abstract the putrifying
the late famine,the cases, not
very different, of want TO SUBSCRIBERS.
contents for the purposes of dissection, and to
of action in the lower bowel, mentioned
by Dr. New Subscribers will obligeby
Banks in one of the Numbers of the Quarterly, and forwardingtheir benefitliving sufferers.
Names direct to the Office, 147,Strand, or to the
brought againinto notice by Dr. Popham, in the The two Associations named, together with
Lancet, hare been the subjectof some discourse. News Agents or Booksellers. All Post-office that of the Associated Surgeons, presided over
The disease is one of the most frightful that can be Orders should be made payableto the Publishers,
by Mr. Bottomley, have constitutedthe chevmuf
imagined; and, as peculiar to Ireland, deserves a Wh. 8. Obb ahd Co.
passingnotice. The d4 hataiUe of the journalin question for these
description of Dr.Popham is
highly graphic; indeed,any one who has seen the last threeor four years, and the Profession
disease,as I have myself,can never forget it. The be surprised
willnot,therefore, that theyshould
agony of the patient,in some of the worst cases, is THE MEDICAL TIMES. be againcalled into activity at this crisis.
dreadful ; the smell beyondanythingthat can be
imagined by one who has not met*wi"the disease; Their views, however, are discrepant, and
a month's washingwill not get itoff the fingersthat SATURDAY, JANUARY 26, 1850. although theyare united in hostility,
they ap-
pear
have once examined the rectum. Every other day, to be jealous of opinion.This may be,
in spiteof a sea of eau de Cologne, it haunts the
The diseasemay be, perhaps, termed
Mbrb in relation to Medical
particanship notwithstanding, a mere appearance, adopted
memory.
Reform cannot faU
prolongagitation,
to by the more skilfully to conceal the source from
THE POTATO FIBRE PACKII70 OP THE
EECTUX. givinga temporaryimportance to fiJse opinions, whence in common the inspiration of eacb was
The originof the potato disease, in the plant and
complicating the difficulties that alreadyderived. We cannot kelpfeeling a sense of
itself, is not very clear; it appears certain, however, exist. It is attendedalsowith
that at the return of the "
much that is dis- pain and humHiatioo whilst readingthese
creditable,
cambium," the proper
formation of starch was interferedwith,and that,in as it dokes itselfin secresy, avoids spiritless documents.
addition to a few store-cells, the bulb was merely freeand honeit discuisioni indulges in a clan-
destine The Shropshire gentlemenadopt the resolu*
made up of itsusual fibres, and cell-wallsdepressed of sectionalviews and per-
exposition sonal tionof the Council of the College, upon which
and weakened to a degreethat can scarcely be
interests, and tries, by the indirectarts we have lately commented, with the modifica-
tion,
imagined. The poor of the South and West strove
to lessen the of cajolery, menace, or compromise, to accom-
plish however,of a twblvb years' instead of a
pangs of hungerby masses of these
black potatoes, ^mere indigestible
"
fibre. Examined its own ends, rather for die purpose of twenty years' franchise. Nothingcan be more
with a microscope, would expect,a total ab- sencedefeating than of establishing than this submission to the vote of the
as one
opposition just paltry
of starch was found. Passingthroughthe
principles. We have made ita dutyto examine CouncU. It is mean-spirited, at the same time
upper portionof the intestinalcanal, the small
amount of digestible the propositions of all parties as theymay have that it tends to set the seal upon the unjust
matter was, of course, re-moved

; but getting into the colon,and lower down, incidentally or directly come under our notice,exclusion from the Fellowship of largenum-bers
the aggregation of huge masses of a thing like for whatever be considered to possess of provincial surgeons, livingin retired
may
choppedhay took ^in
place, some fatalmoment the matter of interest or
possessed of small means, who
consequence to the Pro- fessionsituations,
"

or
lectum refused to act. Medicine seemed but to
aggravateallthe sufferings, tillmechanical means, generally, or to any section of it,must cannot, from these causes, meet the require- ments
in women, had unloaded the cells of the be also of importance to our readers. They stand of the resolution, but who are, in other
especially
rectum. The miserable creatures, the subjects of beforeus for the whole Profession; and indeed, respects, far more eminentlyqualified for the
the disease, tossed about in the wildest agony ; the in than the two or three bustling
a wider sense, it may be literally affirmed Fellowship tors
agita-
hands pressing the lower part of the abdomen. Days
and nights
thatthere are few intelligent practitioners who who ])ave gotup thisMemorial, but have been
passedin this way without relief.Every-
thing
but aggravated the sufferings. do not now read the Medical Timet. Our afraidto publishto it the Ptofessionfrom a just ap-
prehension
Stuping, "c.,
was tried, all in vain. The rectum pressing on the pages, therefore, are a field for candid of the criticism itwould evoke. These
bladder, new tortures were added. A horrid sanious discussion. We have no party views; and gentlemen, besides, do not desire a wider enfiran-
matter escaped,andgave out the most horriblestench ;
we are resolved that, wherever the cloven chisement than would be infficient to admit the
tenesmus and bearingdown filledup the list of
horrors. The diseaseis quitea new one ; and, as it foot of sinisterself-in^rest shallobtrude itself,members of the College who obtained their
is not impossibleit may arise from other causes be- guise Diplomaspriorto the year 1S43 ; forgetting,
sidesfrom beneath the foldsof its meretricious dis-
the one specified, may be worthy of recol-lection. the spear-point of open that since that time between three and fowr
investigation
shall iix it to the spot of its opprobrium,and fAoiMai}(^new members have been received,who
ANATOMY AJTD SCHOOL OP DESIGN.
At a meetingof the Dublin Society,on the 21 st we will strip it of the drapery ^at would hide have as stronga daim on the Grovemment for
inst.Dr. Croker King delivered a highlyvaluable its deformity from the public's eye. A good admission to the exercise of their corporate
disconrw on Physiology and Anatomy,in connexion cause ever shows a bold front A true knight,rights as the Memorialists themselves ; foigel-
with the studyof Design.Lord Clarendon, whose
**tafupeur et Mons reproche"would scorn to ting,too, all fiiture members, who, the Me- morialists
popularity in Ireland seems ever on the increase,
from his excellentgood sense in everything sneak into a battle-field, or to steala victory. may be assored, will never cease to
relating
to the country, seconded the proposal ofthe Lecturer, Within the lastweek or two the members of agitate until theyhave been invested with all
in one of his quiet, but usuallyapposite addresses. the Manchester Committee of Surgeons, and the theircorporateprivileges. It is true that the
Not unaware, perhaps, that Delia Torre and Da for admiarion to the Fel-lowship
Vinci changedthe easel occasionally
Shropshire Association, wishingto act simulta-
neously, Memorialistsprovide
for the forceps
if not in unison with Mr. Bottomley, by examination ; but if this mode of
and dissecting knife,and schooled themselves in the
fine models of the Spanish Lord Clarendon have presented M emorials to the President of obtaining Fellowship
the b e the only one that
galleries.
addressed himself to the subject with much fervour ; the RoyalCollege of Surgeons, prayingfor an these worthies consider justin principle, let
as well observed by him, " Nature is the of alterationof the Charter of the College.The them
grammar noblyforegotheir personsl grievaaoes,
the designer ;" and if our students would trust more
Memorial from the Manchester Committee is and present themselvesforexamination. There
to her guidance, we should not be shocked by those
anatomical shapes that so often outrage her forms. published in another column,but the Shrop- shire is no necessity for an alterationof the Charter
The "artistic aptitoda" of the Irish student Lord gentlemenhave not giventheirdocument in order that "Asymay be admitted. It is said,
 eo THE MEDICAL TIMES.
however,and bygoodauthority, that the mem- the
Bottomley, Chairman of the Committee of certificates
of attendance on Lectures can be
ben of this particular will never
Society consent the Associated Surgeons,
are the members of a received at the Uall ; and in England,as in
to any rt-arrangement of the Profession until united Committee,and are supposedto enter- tain Scotland, the Medical Schools have to regulate
theyhave been admitted to ^theFellowship of identicalopinions. It is not easy to divine the order and lengthof their courses to meet

the College of Surgeons.The immitigated fishness

sel- how these gentlemen can understand each the requirements of the Licensing Bodies. The
of this policy requires no comment to other ; but there are many mysteries in medical duration and succession of the various lectures

expose it to the contempt of the Profession. politics, and perhaps thisis one of them. must ever be determined by that Body which
The Manchester men are wiser in their The Council of the College, however,can- not grantsthe license to practise ; and surely Mr.

generation. They demand the Fellowship for escape their duty because of the multipli- city Syme would not publicly advocate the propriety
all exMng members who now have or may of schemes propounded to them by volun-
teer of permitting the teachers in any school to
hereafter arrive at a fifteen years'standing. counsellors. The franchise must be ex-tended.licensethe men theyhave themselves educated.
Future members, however, shall be admitted to Independently of all scientificclaims, Having thus set out with a fallacy, Mr. Syme
the Fellowshiponly by examination. The the members must have a home, a rightof proceeds
"
to magnifythe imaginary hardship by
Manchester men, in getting off one horn of expressing their opinions upon all public ques^ a comparison between the Scotch and English
the dilemma, faU heavily upon the other. They tions at General Meetings, " and a vote in the schools of medicine. We shalllimit ourselves,
have a prudentregardfor the 3,000men who electionof their governing officers. These are in the presentArticle, to a considerationof thia
have become members einee 1843, and would essential corporaterights, boughtby the bers
mem- comparison. And we enter on the subject, 1st.
introduce them to the Fellowship upon the when theypaidfor their Diploma; and, Because the statements of Mr. Syme may be
same terms as those who were members priorunless the exercise of them be grantedto the credited by the learned and influential gentle-
man
to the year 1843. Now, what right to the Fel-
lowship members, and the Collegehe thus constituted he addresses, ignorant as allLord Advo- cates
have these 3,000 members, who have the home of the members, there will be no must be practically on the subject ; and
become such since the great iniquity of 1843, peace for the College of Surgeons. 2ndly.Because some of the reasons urged for
that future members have not? If these gen-
tlemen givinga higherplaceto the Scotch than to the
have a right to it, the members prior to MR. SYME ON MEDICAL REFORM. English schools,involve such fundamental
1843 can have no more, and future members When the President of a College breaks silence errors in the policyof Medical Government,
no less. Either the Manchester Committee on such a subject as Medical Reform, the Pro- fessionthat it appears to us absolutely necessary to
propose to admit these gentlemen in defiance of is bound to listenwith respectful tion
atten- enter our protest against them.
their convictionsof justice, for the sake of con- ciliating ; but when, as in Mr. Syme's case, to the Mr. Syme states,"that to the medical schools

support for their schemes of self- accident of position is added the possession of of Scotland must be conceded a higherplace

aggrandisement, or otherwise theyare yielding undoubted abilities of a certain order,that than to those of England; " that the system of
to a sense of right, and think that every member which the office claims the man commands. teaching in Scotland is much more complete
is entitled to a vote in the electionof the body Still, in a matter which must exert so greatan and ample than that of England." We shall
that spendshismoneyand governs his interests. influenceover the welfare of everyj member of examine the grounds assigned as the foundation
The Manchester men are notoriously **cute,** our Profession, the dicta of no one, however high for the above statements eeriatim,
and can comprehend the essentials of an argu- ment his station, however greathis abilities, however "
1st. Many of the Scotch Professors hold
as quickly as most people ; and we, there-
fore, warm his zeal,ought to be received
tioned.
unques- theirappoinments direct from the Crown."
givethem credit for the latter supposi- tion. We own we are at a loss to conceive how thia

But,in such case, all future members There are two idols which lead most men very objectionable mode of appointing school
are equally entitledto a vote ; and, we inform astraywhen theytouch on Medical Reform, "
teachers can be regarded as addingto their effi- ciency.
the Manchester Committee, that,whether they Interestand Prejudice.Both appear to us to When the Crown has a Professorship to

Bay yea or nay, the members will have it. have exercised a powerfulinfluence over the bestow,the question of who willobtain the vacant
Beyond these matters, there are some RegiusProfessor. Prejudice, educated as we chair is not to be answered, by determining
shadowy suggestions about a joint Board of were in Auld Reekie,and honoured with the which of the candidates is the best man, but
Examiners in Medicine,Surgery,and Mid- wifery; Fellowship of one of its most venerable Institu- tions, what are their political opinions, and what the
but this subject is so indistnctly dealt mightperchancelead us, as theyhave interestthat each possesses. We have heard
with,that it would seem that the Memorialists Mr. Syme, into partizanship, if our sense even of him who, when the happy moment
had no clear understanding in the ascendant, duced
in-
upon the matter, of duty,as holdingthe balance of the publiccame that his star was
and cared not much, so that "somehow or Censor,did not prevent. Peeuniaryinterest, the holder of a certain chairto vacate at
other" a compromiseof some kind v another fortunately, cannot even be imagined to that particular moment for a peculiar consider-
-was made up, and theywere admitted to the sway us. ation"-of more than one Professorwho would
tranquil beatitude of an aristocraticsiesta The object of Mr. Syme*sLetter is,nomi- nally, never have held his presentchairs if his wealth
upon the privileged benches of the RoyalCol- lege to impresson the Lord Advocate of had not been more potentthan his merit.
of Surgeons.May their slumbers be light, Scotland, the cryinginjustice
**
of that law by A Secretary of State for the Home ment
Depart-
and their dreams golden. The Fellowship in the action of which it is rendered impossible, isnecessarily ignorant of the respective qua
-

possession, is an Examinersbip in prospect; and by any extent of education or examination in lificationsof the rivals. Magniloquent nials
testimo-
it is but reasonable that the honours of the Col- lege Scotland, to obtain the right to medical practice are to be had by any one, " ^therefore, where
should be followedby itsrewards. Sir James or Sir Georgenatur-
in England." Now, is the implied
meaningof all are first-rate, ally
We are gladthat these Societies have spoken this statement correct? It is not. The Medical chooses him who has the greatestinte- rest.
out In conmion with the rest of the world, we Schools in Scotland are on the same level, with It appears to us that RegiusProfessors,
have a great dread of dumb oracles. Frowns reference to tlfepower to educate, as those in
like Divine Doctors, derive a very questionable
and shakes of the head are portentsof terror London. Certificates of attendance on Lectures honour from the source of their elevation.
to our hearts,and we would rather, at any time, are received by the Apothecaries'
Company, 2ndly. The University
"
of Edinburghhas
be the subjects of hard words than black looks. the College of Surgeons, and the London Uni- had upwards of 100,000/.
versity, from Government,
The Council of the College a-year for
can now choose be-
tween with equalfavour,whether granted by and still receives more than 1,000/.
theserivalschemes. From the concoction the Professor of Medicine in the University of the payment of expenses connected with the
of the Shropshire Society,justpalatably ulated Edinburgh,
acid- or King's Medical Faculty of the University."
College, London.
by the smallest possible infusion of '* The
objectof our desire," says Mr. Syme, One"can scarcely keepcountenance when this
lacticacid,up to the corrosive vitrioliccom-
pound "is not licence,but to teach."
to This object, is urgedas agroundof superiority. The London
of Mr. Bottomley,there is ample room we repeat,is in no way interfered with by the schools mightwith reason complainof the in-
justice
for selection. The most amusing part of the existing regulations of either of the Licensing of such grants; but how a teacher, with-
out
matter u, that Mr. PeploeCartwright, the Se-
cretary
Bodies in England. The pupils of the English blushing, can put forth a claim for superi-
ority
of the Shropihire
Association,and Mr* Schools have to pass an apprenticeship ere their over his brethren,because he ispermitted
 THE MEDICAL TIMES. 61
to dip his liandinto the public purse,we are at a when by so doinghe can detract from their entrance of the King'sPaltee here,onlj that the
Ion to conceive. It has always, value ; while,on the other hand, he speaks of west port
is of stonern work, and mair decorated
moreoTer, ap-
peared with architectureand the policy of bigging."
to us, that such a mode of payingcertain each singly as the London School, when that I suppose you will tell me next, you have at
"

Professors, was not onlyvnjust to their equals, serves his object. Edinburgh as fine a navigable riveras the Thames
wiih ail its shipping."
hot,what is of far more consequence, likely to 5thly. In London, the lectures on such im-
" portant
The Thames." exclaimed Ritchie,with ineffable
"

to be injurious to the interestsof their students. subjectsas surgery arc givenonlythree God bless your honour's judgment,
"
contempt, we
The man whose income dependson the excel- lence times a week." and "the system of clinical have at Edinburgh the water of Leith and the Nor
Loch." On finding his interrogator was a Scotch-
man.
of his teaching, will be more on the alert instructionis so imperfect that the University
Ritchie added, I took yoar honour for an "

to benefit those who resort to him for instruc-

tion of Edinburghare unable to recognize cates
certifi- Knglislier ! But I hope there was naething wrang
than he who receives his salary from Go- grantedat the Metropolitan School." in standing up for nne's ain country's credit."
call it for "
Do you credit show your country's to
"emment, without reference to the number of When we remember that the ^bove is written
that she has a*' "

his class. For our by the Professor of ClinicalSurgeryin a scliool

part,we think the sooner We forbear the remainder of Master George's
such grants are stoppedthe better. If the whose "objectof desire" is to get students if we finished the sentence,
"

reply,fearing lest,
Eoglish schools can supportthemselves unaided that it is the teacher par excellence of Clinical we mightappear personal.
by Government, we cannot conceive why the Surgerythat speaksin proprid pertond that it
"

Having thus disposedof some of the ex-traneous

Scotch schools should be allowed to draw on is Mr. Syme who vaunts his own superiority matter contained in the Letter to the
the publicincome. over the distinguished Metropolitan surgeons Lord Advocate,we shall, in our next, consider
3rdly. We are informed that "
all the Medi-
cal whose names confer honour on their respective Mr. Syme'sscheme of Medical Reform.
teachers in the University of Edinburghnot Schools, one feels, to say the least, that modesty
appointedby the Crown,are chosen by the Lord is not the Regius Professor's characteristic
ABUSES IN PRIVATE LUNATIC ASYLUMS
IVoFost,Magistrates, and Town Council, ^not trait. The fact is, that surgical
"
lectures are RIDGWAY
" HOUSE.
as in London,merelyfrom the narrow circle of givenin London four times a week for teven We sincerelyhope, that during the ensuing
aspirants, who, by filling in succession the months,instead of,as in Edinburgh, six times a Session of Parliament,the Legislature will in-
troduce
positionof dressers, assistants, demonstrators, week for between Jive and six months ; and some measure for the amendment of
or other subordinate places, are regardedas clinical lectures are givenfive times in a fort- night the Law of Lunacy,and the better regulation
haTinga claim for preference ; but with perfect (in one, at least,of the Metropolitan of private Lunatic Asylums. These establish- ments
freedom of selection, and without any admission Schools), the regulations of the Edinburgh are very justly viewed with suspicion and
of respectbeingdue to local connexion. "
This University onlyrequiringtwo a week. The distrust; the public has no confidence in them,
sentence caused us no littleastonishment. We Lectures on Clinical Surgeryof the Metropo- litan because,ever and anon, as the curtain is inci- dentally
could scarcely believethatthe man who penned School (atleast usingthe word in one of drawn aside, and we have an opportu- nity
it,was the same who, a few months since,had Mr. Symc'ssenses)are, then,recognized by the of observing the manner in which theyare
himself held officein one of those very London Edinburgh University. conducted,abuses are discovered which make
schools which,he declares, elect none but their 6thly. So far from thinking with Mr. Syme, humanity shudder. Not many months ago an
own pupils.Mr. Syme cannot be ignorantthatattendance on a six months',instead of a three inquirywas instituted by the county magis- trates
that his predecessor and his successor, as well months' course of Materia Medica is desirable, into the management of the Fish -Ponds'
as himself, received their education in schools we would strongly recommend the Edinburgh Lunatic Asylum in Gloucestershire, and from
totally unconnected with University College. University to follow in the footsteps of the the testimonyof numerous witnesses, it was
Nor can we suppose Mr. Syme ignorant of the Apothecaries Society, who have deliberately, clearlyprovedthat the patients therein con-
fined

name of the school in which the presentdistin- guished and by the advice of a largenumber of the were subjectedto the most horrible
Professorof Surgeryin King'sCollegeLondon Lecturers, altered their regulations. neglectand maltreatment. The old inquisi-
torial
educated. The last Medical appointment We strongly of mechanical restraint chains
was
suspectthat the worthyPresident means " " "

save one in this Metropolis, was that of Dr. never heard a six months' course of Materia iron rings shackles hand-cuffs ^leg-locks-^
" " "

Peacock,an Edinburgh not the Pro- hobbles muffles indiscriminately had

man, and not long be- fore Medica. If so, let him consult, were
"
"

the Assistant"Surgeonship of Middlesex fessor, who ever magnifies the importance of the recourse to; and, when these instruments of
Hospitalwas givento a St. Bartholomew stu- dent. subject he teaches,but one who has recently torture were ordered to be removed into the
But, is the mode of electing the Profes-
sors graduated,and he will tell him that at store-room, the quantity of them amounted to
of the University of Edinburghby a limited least half of the six months' course he so greatlynot less than a quarter^ of a hundred weight I
number of tradesmen "
fleshers, bakers,print-admires,is taken up in repetitions of what has (Report, p. 171.) It was furthermore shown,
stripped and
sellers, and paper-makers, disguised under the been alreadymore fullytaughtin the classes that patients who were dirty, were

appellations of Lord Provost and Bailies ^pre- of chemistry and botany,and a varyingpro- taken naked into the yard,where,in the open
"
ferable portion
to that adopted in the London schools ? of the remainder of the course with air, theywere mopped down with a common mop
We opinenot. The before-mentioned honour- able learned,but certainly not very edifying, sitionsdippedin cold water.
disqui- The cruelties, in fact,

disposers of wares have an appointment of on tobacco, snuff, and wine. described in this Report, are so revolting, that
whether
so much a year to give away ; to obtain it is,and In conclusion, we would assure Mr. Syme, we might well ask with astonishment,
must be, a matter of personal interest," that while the Edinburghschool ranks amongst we are really living a in Christian land ?
one, we
of an equally painful
should say, purely of local connexion." Bennett,Miller, An investigation nature,
*'
itsteachers Alison,Christison,
and of somewhat similar description, has also,
4thly."In England,"says Mr. Syme, "a and Simpson,it need not groundits claims for a

largepart of medical education is derived from a high position at the instance of the Gloucestershire magis-
on the somewhat questionable
self-constituted teachers, who have taries trates,lately been institutedinto the management
young men honour of havingitsteachers appointed by Secre-
made no serious preparation for teaching."In of State for the Home of Ridgway House, a private Lunatic Asylum
Department, or by
Bristol, then under the superintendence
Edinburgh tee remember well certain not aged the
worthybody of Bailies, nor on the still more
near

Mr. Ogilvie.In the Mescal Tmee of the

extramural lectureers, or small would have been questionable honour of drawing a yearlyof
our own knowledge of some subjects connected from the public 24th of November, 1849,we called attentionto
stipend Exchequer.
closely with our Profession. But here,as in every between the Third Report of the GloucestershireMa- gistrates,
We pass by the absurd comparison
detailing the irregularities and abuses
partof his pamphlet, Mr. Syme,when itsuitshis the
EdinburghInfirmary and the Metropolitan
which theythere noticed ; and, as we would
purpose, speaksof the EdinburghUniversity as
Hospitals, convinced that those who read it
the Edinburgh School of Medicine without will have the firstinterview between Master feignhold the scales of justice with an im- partial

referenceto these extra-mural lecturers; while and even hand, so as to weighcarefully

George Herriot and Ritchie Monipliesof the
on other occasions he classes all together as the the evidence -^ro and con ^between the accuser
"

honourable house of Castle Collop, as forcibly

Edinburgh School. So with reference to the recalled to their memory as itwas to ours. and the accused,we inserted also,on the 29th
London School,Mr. Syme applies the term to of December following, a long letterfrom Mr.
The West Port,"says Ritchie, is a gate of our
" "

the whole of the Schools of Medicine in London, city, of Whitehall forms the Ogilvie, defending himself from the charges and
as yonder brick arch ,
 62 THE MEDICAL TIMES.
iinputationa
brought him.
against The Fourth Re-
port such time powerfulmedicine. Not allowing him miles ; and three reserToirafor the water are
of the Mr. Fumell access to a water-closetclose to his room, he could t^ London.
County*Chairman "
" to
only have recourse to a convenience within it,on
proposed, of ita course
in the tntjet
the GloucestershireMichaelmas Court of Quarter So far well.
many occasions not dailyemptied. The stench that so
Sessions is now before us, and the evidence it he lived in is described by the witnesaes aa intoler- able."" At Hampstead it is prc^waedto raise the
Fourth Report,p. 14.
contains proves to our mind, more conclusively Furthermore, water by steam to an elevation of not lessthan
it is stated, on the authority of
than ever, the absolute necessity of the Legisla-
ture 250 feet above high waUr, for the aupplyof
Mr. Hasell and Gregory "

interposing itsauthority to revise altogether " London ;" and how is this to be done? It is
That, by the 5th June, he had become much
the existing system of private Lunatic Asylums. altered, reduced in flesh, pale and haggard in coun-
tenance, proposedto force the water into the mains of
What are theyat presentmore than individual and his strengith so prostrated, that,from the old Companies, whose worka are to merge
ridingthirtymiles a day, as at the time of his arrest, Commiasion"
pecuniary speculationSjCon ducted under the arbi-
trary the management of the new
he could not then at times walk without assistance; into
will and caprice of their proprietors ? Is the that he talked quickand ramblingly, and evinced in the old Shareholders, of course, being indem-
nified.
his manner mudi excitement, a nd that his
poor lunatic doomed
nervous
to be cut off from all sym-
pathy condition
produced theirremark, that it was evidently
in
by medicine and confinement, Three hundred million gallons
with his fellow-men, oris he really a State Mr. Ogilvie's twenty-
intention,
care to the Legislature, which professes to throw to prevent bis discharge." Ibid,p. 16 " four hours will be thus supplied, a supply "

around him the protection of a Commission in After this, it is added, that far above that at doled out to our
"

very present
" Mr. Ogilvie again confined him closelyto his immense population.
Lunacy? Let facts speakfor themselves ! And
bed-room, as before,for a month, for begging a
of London,
first,
we may ask,does Ridgway House possess visiting justice's servant to ask his master to visit
The proposal to flush the aewera
*

the capacity and appurtenanceswhich ranted

war- him ; and again for a fortnight, for sendingthe same by means of the largeaqueductat Drayton,is
itsbeinglicensed at allfor the reception magistrate a brace of birds,
being dosed on each occa
highlydeserving of attention. Aa far as tlie
sion." Ibid,p. 15."

and treatment of the insane? We apprehend health of the Metropolis is concerned, nothing
We confess that we should hesitate before
not. The entries of the Visiters state, that can be more desirable. Without aome auch
we could believe in these statements, did they
many of the rooms are so small and confined arrangement, indeed, we almoat despairof the
not come before us formally and ofRcially
as to be wholly unfit for patients ; besides which, authenticated health of the vast microcosm about us ever being
the out -door accommodation
by the Chairman of the Court of of the upper
althoughthe Quarter Sessions and when we look
" what it oughtto be. The waters
; carefully
lurrounding scenery Is exceedingly picturesque Mr. Ogilvie's letter of defence,
Thames could not be better employed.
over we regret
and beautiful would
"
appear to be equallyto find The second proposal ia that of the *' Metro-
politan"
no counter -evidence but, on the con-
" trary,
restricted. Upon these points we make, from admissions which to be Company, by which the aupplyis
many appear
the Fourth Report, the following extracts from to be attained seventeen miles higherup the
collateral evidence in support of the charges
entries made in the " Patient's Book," and river than the Henley,and to be purified on Dr.
against him. Thus, he tellsus that '' several of
*' Visiters Journal" of this Asylum : "
There
" Clark's patent process ; and distributed to the
his patients," after "more or less perfectly covering,"
re-
does not appear to be any outlet whatever for three levels into which London ia divided
" the
have been permitted to *" remain in
the male or female patients, exceptone largehis house for northern or western district, 120 feet ; the centre
years," and others have '*
placed
ground,to which theycan have access onlywith themselves under his care without certificates."district, comprehending, of course, the City, 70
a keeper, and at stated times." '"Mr. H.'s and the south and east district, 10 feet
Before the passing of the late Act this was not feet;
room is onlysix feet eleven inches high, and above highwater. The highest of the reservoirs
illegal, and Mr. Ogilvie questions whether the
only four to the slopeof the roof;and the Commissioners,in to these practices,
is to be 233| feet above highwater. One at St.
objecting
adjoining room throughwhich it is approachedhave not Giles's, 114. This Company ia to be a joint-
a fatalblow to the greatest
"
given provements
im-
is onlyadapted for a closet, lighted by a window stock one.
of which Asylums are capable?"
to the stairs, and whollyunfit for a keeper'sWe know not what notions The difference in the money-making way, "

may be entertained
room, to which it has been appropriated." On
the improvements which
between the two Companies,consists in this,
the 31st July,1849, the Visitorsfound "this
respecting private ^that of the
Lunatic Asylumamay be capable of ; but from
"
one proposes to take possession
attic bed-room occupiedby a patient taking the evidence before us we are of that present Companies'
works, while the other
opinion
bis meals there and then,wholly confined there,
Mr. Ogilvie has done quite merelyproposes to bringfresh water to the
rightin withdrawing
and the outer closet was stillused as a keeper's
from the management of this Establishment, present Companies and sellingit to them.
bed-room." The entry givesthe dimensions and that Mr. Purnell, the County Chairman,
The present supplyof water to London is some- thing

of several other attic-rooms unfit for patients ; and his brother under fifty million gallonaper diem.
magistrates, have performed,
**
and adds, There is an outer room used for a
albeit a painful,
The supplies offered by the two Companies
a very imperative publicduty. under discussion
dirtylady patient, only five feet ten inches are very considerably over

wide, and eleven feet long. This room is ceedingly

ex- this, a nd as such very worthy our notice.
of
offensive in smell. The patient is WATER FOR LONDON. The Henleyplanhas been objected to, from
to her bed every night." In another purities,
im-
"trapped Wb are glad te
find that a Reporthas been the liability of an open canal to receive
entry,signedby six Visitors, it is stated, We "
furnished projected
on the
plansfor the supply and its progress impededby ice. The
consider this room to be whollyunfit for this of London with water by the Henleyand Lon- don other arrangement, on the contrary, would seem
or any other patient." It is also reported,that Commission, and the Metropolitan or Ma-
ple to be preferable, as the water of seventeen other
** there
are no fixed baths in thisestablishment, Durham Company ; and that notices and miles are added at Henley,Reading,Wargrave,
There is a moveable bath,in which we found a applications to Parliament have been lodged."c., besides the fresh springs of the Loddon
hen's nest with eggs in it ; the hen leaving it,and These Companies propose to give a more and Kennet.
a warm egg, on our approach." Six months ample supply of better water to the whole of At t he
Staines, reporters state, four hundred
afUrwards another entry states, Again saw "
London, than that afforded by the seven Com- panies million gallons may be safely taken out of the
this bath in an outhouse filled with different at present in existence ; and as much Thames. At Teddington, eighteen miles lower,
articles, and were informed that it was rarelyof our prospective sanitary improvementde- pendsfive hundred ; but higher up, as at the points
used,not even for a dirty patient, who required on the workingof one or other of these we speakof,the aupplyia neoesaarily limited.
it daily."A much graver charge, however,is plans, theymay be worth examining. Some little difficulties, of a no insurmount-
able

broughtagainstMr. Ogilvie in the Reportbe- fore The Henleyplanis the oldest : it proposes a kind,seem to offer themselves in the way

us, which is that of keepingin confine-

ment, commencement by an aqueduct from the of navigating the river, if the supply were taken
and protesting againstthe discharge of Thames, four miles below Henley,comingfirst from the sources we have spoken of. The traffic,
a patient whose recovery had been reported to by an open canal as far as Drayton; hence to by a littleordinary precaution, however,is not
the Court the river Brent,and thence,by brick culverts,likely to be interfered with ; and we trust the

Strong in body and sound in mind," observes to Hampstead and London.

** The lock above health of this vast Metropolis will far outweigh
the Report, Mr. Offilvie kepthim closelvconfined Henley is 88 feet above high water
"
in the all such minor points.
and locked-upin his oed-room for nearly nve weeks, Thames
him but little ; the whole length, througha multipli-
city We are quiteaware many other Companies
granting and that only with
exercise,
a keeper in the garden, administeringto him during of windings, not less than about thirtywill be starting up, now that we are on the
 THE MEDICAL TIMES. 63
threshold of Parliament. We are glad,Low- and well illustrates
the benefitof this
proceeding, the writings of Professor Syme. We are no

terise
aptitude forcontractionthe urethra possesses,as greatadmirers of the planof usingcaustic in stric-
the ture,
; the
ever, to find a stir makiog on the auhject
as instruments have been omitted ; and which
soon (because, probably, we have not had sufficient
facts stated ahove cannot failto interest our
forms the main feature of difficulty in these oases of experience of it,)but we truly believe that it is a
readers; and ve are almost inclined to hope mode of treatment well adapted
stricture. to certain forms of
somethingpermanent will he done. The reader is aware that there is no noveltyin thisaffection, and that it does not deserve the con-
demnation
If we have a word of counsel to offer in the
dividinga stricture by external incision through passedupon it by the Author. Mr. Syme
matter, it is this : ^that the health
" of the
the perinaeum.It is an operation which has been must know well,that the advocates of caustic have
Metropolis should outweighall other con- siderations.
practised for centuries; but, there is thisdifierence gis'envery favourable results in their published
Private and publicinterests will between the here recommended, and that works. Why, then, should he throw out such an
operation
clash,perhaps, to the end of time but no one
; usually performed.Mr. Syme puts his proceedingaccusation againstthose who have used it,as is con- tained

wUl say the latter are not to be preferred to the in force onlyin cases where an instrument can be in the following passage : "

former. If there is thingmore than an-

one passed through the stricture. Whereas, it is
other first
" Onthe whole,it seems more reasonable to con-
clude,
that in the cases of allegedcure by caustic,
we want, as palpablydemonstrated among only in cases where no instrument of any kind could
there was no real stricture in existence, than to sup-
pose
the poor it is a supply be introduced,that surgeons have generally
duringthe late visitation,
been in that so improbable or rather impossible, an
the habit of section.
to pcrinaeal
resorting It has achievement had been accomplished," P. 53.
of pure water ; if we can have it,then,at any "

of hitherto
been the impressionamongst
the sound practical This is rather too bad, to accuse the excellent
reasonable cost, far away from
that a stricturewhich would allow even surgeons who have used this remedy,not only of im- proper
liow-bells,and the sliadow of St. Paul's,so surgeons,
the smallest instrument to pass, might be cured by practice and of a completeignoranceof tlieir
much the better : the higher up the river the
patience, and would not requiretlieknife ; but Pro-
fessor subject,but even of dishonest motives. We are per-
suaded
better, the larger
"
in amount the
the quantity
Syme has attemptedto overthrow this some-
what that the Author knows littleabout the
proper
more welcome. wholesome doctrine, and to n)b the catheterof use of caustic,and we would advise him, for the
a greatdeal of itsvirtue,
by substituting a planof future,to make himself acquainted with his subject
B.EVISW8. treatment, which must be considered as somewhat beforehe attemptsto pass upon it such a sweeping nunciation.
de-
^ heroic. We would advise him, also, to be a little
Om Stricture rf the Urethra and Futula in Perineo. We have doubt that the recommended charitabletowards his brother surgeons, and
no means more to
By James Syme, F.R.S.E. Edinburgh:Suther-
land
by Professor Syme may be of use in certain cases ; have a littlemore regard to the opinions of others who
and Knox. London: Simpkin,Marshall, but we must confess, on readingthe latterpart of may be as honest and as good men as he is himself!
and Co. 8vo. Pp. 72. his work, which contains some observations on the Internal section of the stricture finds no favour in
Some few years ago Professor Syme published, in of other plansof treatment, we were quite the sight of the Author; and he mentions two cases
efficacy
the EdhUntrghMonthly Journal,an account of a new surprised at the manner in which he under-rates all in which it had been triedwith no benefit ; but the
method of treating certain forms of stricture of the other kinds of treatment Treatment by dilatation, occurrence of failurein one or two instance^hould
urethia. His recommendation, however, of this the use of caustic, of in-
cision
and the ordinary operation not warrant a
surgeo^ in givingsuch an unfavour- able
particidar plandid not, according to the Professor's by perinaeum, a re each of them considered opinion,as is expressed in the following tence
sen-

showing,have the effectof inducingany members as unsatiaUictory, or terribly abused by the author. : "

of the Profession to adoptit ; consequently, he has He states, that the use of the bougieis totally equal
un- But, while unnecessary and useless in those
"

determined to trythe most effectualmode of bringing cases which admit of dilatationby the bougie, such
in many cases to bring about a lasting cure.

collected
an operationis not sufficientfor counteracting the
surgeons to carry out his practice. He has We certainly are not surprised to find thisinstru-
ment Gontracriletendency,when it existsin a more getic
ener-
together the cases of a more extended experience, so useless in the hands of Mr. Syme, when form." P. 55.
and by these means, and with the help of some we find him advise,that it should not be allowed "
We admit with the Author, that sectionof a
generaJobservations on the subjectof stricture, to remain in the urethra more than one or two stricture, whether internally or externally, is quite
has furnished us with a thin octavo volume ; and seconds." Mr. Sjnne is a greatauthority, but we and useless,in cases which be
unnecessary can
we dare say that Mr. S3rme will not be so much must beg to difiler entirely from him on this portant
im- cured by dilatation ; but, the experience of other
disappointed he has been prior occasion. point. How it be expected that
as on a can a
surgeons, which Professor Syme would only be
His object is to show the good effectsof dividingthickened and indurated stricturecan be absorbed, doinga professional duty to respect, has shown,that
a strictureof the urethra, by free external incision,if the b9ugieis not allowed to remain in the urethra in numerous instances of the worst forms of stricture
to certain instances where the more common for a much greaterlength of time ? internal section has cured the patients.Some
methods of treatment have been found unavailing. The following is the Author's estimate of the credit
surelyshould be attached to Stafford, lips,
Phil-
Every Surgeon who has had much to do with value of the treatment by dilatation: and Civiale,
"
the first and last of whom have
stricturemust every now and then have met with one "When carefully conducted, with due attention probably seen more of stricture than Mr. Syme has ;
of those very obstinateand troublesome cases, in which to all the precautions which have been mentioned,
and we would advise him to read the little work of
the process of dilatationfrequently affi"rds the most
of the
very littlegood has been effectedby means satisfactory results; but,except in cases which yield M. Civiale, on
"
Urethrotomy," published this year,
catheter, where dilatationcould onlybe carried to a readily, itis stillexposed to thefollowingserious tions and reviewed by us a few months
objec- ago. He will
certain extent, and no further, the patientbeingleft, :" In the firstp i
lace, tisattended with the risk of
there find the subjectwell considered,and will
after many many untoward occurrences, which not onlyimpede
weeks' treatment, much in the same find evidence enough to prove that internal
recovery, but complicate the patient's suffenngs, and
condition as when it was firstcommenced. Either it be section will cure
pended
de- the most inveterate forms
his even endangercannot life;secondly, even

from some peculiar of the part,or from

irritability upon as a source of lasting relief;and thirdly. of stricture ; and Civiale distinctly states, that
other the stricture resists dilatation, It is altogetherinadequate to remedy that obstinate "
some cause,
form of the disease in which the stricture has a re-
a cuttinginstrument should not be used until
and as soon as instruments have been omitted, other means have been found useless ;" and the
silent disposition to contract, accompaniedwith a
speedilyand obstinately acraiucontracts. authority
great degreeof irritability." P. 47. same "
givesthe reason'whyinternal sec-tion
The Author has accurately pourtrayed the cha-
racteristics
This certainly is dispiriting for those of in fails.
enough some cases He says, " it is in conse-
quence
of these cases, and he particularly insists us who are, and have been always inclined to trust of not dividing the whole of the indurated

upon the aptitude of the strictureto contract, as to the bougieto a for the
formingthe stricture,
greatextent of stric-
tures. tissues
that he has observed
cure

the main feature of difficulty. We have and had considerable success

incomplete
seen cures.
"

In order to bringabout a satisfactory cure in with the use of thisinstrimientin the most
We do not by this mean some
trouble-
to speak of internal

such instances, Mr. Syme dividesthe stricture witk cases ; but we have never been contented with section as the best mode of dividing a stricture; on
the knife by means of an external incisionthrough leaving the instrument in a stricture for one or two the contrary,we are not fond of the practice ; but
the perinaeum.In order to facilitate the operationseconds only, and it is likely enoughthat Professor there can be littledoubt that there are certainforms
he firstpasses a small grooveddirectorthroughthe, Syme would not be obliged to resort to the knife so of stricture of a very obstinatenature,which
may be
obstructed portionof the canal, and divides the often, if he were not to remain contented with keep-
ing cured by a skilfuluse of Stafford'sinstruments, and
strictureupon it,from behind forwards. Eleven the instrument in for so short a time. that internal section should not be condemned so

cases are narrated in the presentwork, where this regard to the application
With of caustic to a summarilyas it has been done by our Author.
planhas been pursuedwith a greatamount of tem- the Author heaps a load of abuse upon
porary stricture, Going on throughthe book,we come to his re-
marks

success at least; and, it appears, that the in-

dividuals planof treatment
this particular And in these ob-
servations on the usiul operation
of perinseal
incision,
upon whom the operations have been per-
formed, we are sorry to say we can too clearly see and here again Mr. Syme deals out a heavy blow,
have suffered nothing from them. that unfortunate spirit
or little
of depreciating other modes and in his accustomed way. He somewhat boldly
The firstcase narrated is a remarkable instance of of treatment differing from his own, which charac- insinuates that those who use this operation are an
 64 THE MEDICAL TIMES.
awkward Ki of fellows, who do not know how to use not noticed any diminution in theirdiameter. Four which takes
placein the larynxin acute laryngitis*
a catheter properly.Alas! for AstleyCooper, days before the author'sTisit, the bowels had ceased The artificial openingwas funnel-shaped, with itsapex
to act, and all the symptoms became greatly vated.
aggra-
Liston,and Fergusson, were and externally; the outer orificewas contracted to the
yon are mere
When seen, the abdomen was greatly tendedsize of a small
dis-
goose"quiIl; it appeared to be lined
bunglers, and should all of you have gone to learn and tympanitic ; there were pain,tenderness,by mucous membrane. The lower portionof the
catheterism from Professor Syme, Surgedn to the and some bulging over the transverse colon ; the intestinewas much contracted.
Royal Infirmary at Edinburgh. Hear what he says pain was paroxjrsmal, and accompanied by strong Mr, Clarkson's Case. B. F., oged twenty-one, a "

tenesmus; vomiting was almost incessant Five robust and

of this operation,and admire his consistency: healthy-looking woman, appliedto the
grains of calomel and two grainsof opium were
"

author,in'July, 1846,with symptoms of dyspepsia,

"
The operation by external incision, hitherto ordered ; to be followed by a black draught every the bowels not
having been relievedduring the pre-
ceding
""mployed,has been resorted to as the refuge of four hours. On the following day, (May 4th,} five days. She was ordered an aperientpill
awkwardness or failurein the introductionof instru-
ments, the symptoms continued unabated; the urine and
there draught. Two days afterwards she returned,
being
no truly impermcahle stricture, was scanty and high-coloured. Pruasic acid and the symptoms beingstillunrelieved, and bowels stilt
while the one now advocated can be acoomplished castor oil were administered at distinct intervals,constipated.A
only by steps requiring
the nicest manipulations." and the calomel and opium continued. Some relief but
strongeraperient was administered,
stillwithout relief. On the 22nd, (thebowels
Yet a little further on, after havingthus broadly to the pain and vomitingwas thus procured.In the not
havingacted since the 14th,)j she complained of
bath were
have evening a purgative enema
insinuated that those who use this operation and warm pain in the umbilicaland leflb hypochondriac regions ;
ordered;the injection was immediately returned, the abdomen was slightly d istended and tym-panitic,
done so onlybecause theyare too awkward with the and than a pintcould be thrown up. On
not more and pressure increased
upon its parietes
catheter, he recommends it to a certain extent; but, the 5th of May, the colon-tube was passedup, but the pain. Constant nausea, but no vomiting; pulse,
mark, it is not to " be undertaken by any one who could not be introduced more than eight inches.
110; urine copious.To take croton oil,half a drop,
Twelve ounces of blood were taken from the arm;
is not able to overcome the ordinary difficulties which every second hour. On passing the colon tube,itoould
largerdoses of calomel and opium,croton oil,the not be introdaeed further than six inches. Two pinu
are presented in the surgical treatment of the cold douche, were
successively tried,but without of fluid were injected, and returned untinged by fcecal
urethra !" Why, the fact is,if the surgeon were any relieffiroro the bowels,or other than a tempo- rary matter. The abdomen became more distended and
able to overcome the ordinarydifficultiesin a
*
reliefto the more urgent symptoms ; galvanism tender ; flatusmoved about the bowels,and appeared
was equally ineffective; stillthe patient's strengthto be arrested in the leftiliacfossa. Leeches were
stricture, it would not be
necessary to resort to and spirits sustained untilthe 15th,when they twice
were of Battley'ssolution of
section in any case, internal, external,or that re-
applied, and some
beganto fail,
commended and his countenance, tongue, and pulse opium given; vomitinghad commenced. quently,
Subse-
by the author; so that,accordingto betrayed a marked change for the worse ; the mat- ter the following expedientswere tried, but in
this view of the matter, Professor Syme himself is ejectedby vomitinghad assumed a fcBculent vain,to induce the bowels to act: largedoses of
colour and smell. It wss then determined that an
unable to overcome the ordinarydifficulties of a opium, the cold douche,free injection of water into
operationwas the only resource left,and this was the rectum, and its retentionby pressure, galvanism ;
strictureof the urethra;otherwise, would he recom-
mend accordingly performed.As the patientlay on his and on the 26th,the symptoms becoming more gent,
ur-
a cutting operationat all? back or belly) no indication was observable of the an operation was undertaken,Mr. Hodgson
seat of obstruction, for the abdomen was equally
A few observationson Pcrinseal Fistula, in which concurring in the propriety the step,and urging
of
swollen on both sides, and no bulging was perceptible its immediate performance. The patient laid on
was
nothingbeyond what we all know before will be in eitherlumbar region,thoughpercussion eliciteda her
belly, a pillowbeingplaced under the abdomen,
found, completethe work before us. We have dullersound on the leftthan on the right side. The pa- tient so as to raise it. An incision, fiveinches in length,
giventhis lengthened notice of it,because we think was extended on a bed with his face downwards, was carried outwards from the edge of the erector
and a transverse incisionwas made in the leftloin, spinse
that the subject on which it ireats is of very great muscle,about two fingers' breadth above the
eonimencing about two inches from the spine,and crest of the ilium; the and
importance. Mr. Syme has added another to his carried directly outwards for five inches and a half, fasciawere
quadratuslumborum
exposed and divided,and after some loose
very many useful contributions to surgery, in this about one finger's breadth above the orest of the fat was removed the intestinewas reached four liga-
; tures
endeavour to improvethe treatment of stricture; and
ilium. The skin,fat,latissimusdorsi muscle, and
were passed throughit,and fastened,two to
quadratuslumborum were successively divided,and the
we givehim fullcreditfor it. Still, we cannot shut a shining membrane upper and two to the lower edge of the wound,
exposed. This last,which and tne bowel then divided longitudinally between
our eyes to the manner in which some parts of this was mistaken for intestine, proved to be fascia,them. A large quantityof fluidfceces at once escaped.
treatise are written,and that somewhat peculiar and, when divided,a largequantityof fat was The patient, who expressed herself relieved,was
spirit in which he discusses and undervalues the brought into view, which was carefully cleared placea
on her leftside,in bed. The discharse con- tinued
away, and the intestine at length exposed,
doctrines and practice of others. Our criticism on very profuse, and a poultice was shortly after
at a considerable depth. Sutures were passea
these pointsmay be severe, and some applied. On the following d ay, the symptoms were
may think throughit, to retain it in itsposition, and subse- further
relieved, and the distension of the belly had
unjust; but the careful reader will too plainly see
(juentlyto affixit to the edgesor the wound, and an subsided, the escape of foeculentmatter being abund- ant*
incisionwas then made into it,to the extent of half From this and
that Professor Syme has exposed himself to censure, time she steadily improved, was
an inch,which immediately ^ve exit to an immense able,after a time,to return to her usual household
in endeavouring to raise in estimation his own
quantityof light-coloured fluidfseces. Vomiting en- tirely duties.Whenever
the bowels became confined,
relievedof all his
a
ent
peri-
practice by depreciating that of others. We
say, ceased,and the patient was
medicine,and an injection relievedher,but a ten- dency
however. Read Mr. Syme'sbook, acquaintyourself urgent symptoms. Tne openingin the bowel being to contraction of the bowel gradually exhi-
bited
fixed by sutures to the skin, a large bread poultice
with his mode of treatment ; but stillstick to the which
itself,^ was, for a time, relievedby the
was placedover the wound, and the patientwas en- joined
use of bougies.This annoyance increased,*ana her
bougieand catheter as much as possible in your to lieon his leftside. Throughout the following health began to suffer seriously.After the expir- ation
treatment of stricture. niffht the evacuations continued abundant; the of ten months, the patient's di-
gestion
appetite failed,
belly b ecame soft and free flrom tenderness, and the was impaired,and she sufferedfrom more
stillfurther relieved. On
RBPORTS OF 80CIETIB8.
Seneralsymptoms
lay 17th,the
were
sutures had ulcerated from the in-
constant
testine,
and severe pain. The artificial
furtherdilated with sponge tents,and subsequently
anus was

which was adherent all around to the cir- cumference

with the scalpel; but the constipation and other
of the wound. On the 18th,the wound
and she vomited nearly
ROYAL MEDICAL AND CHIRURGICAL svmptoms were not relieved,
was rather inactive; it was syringed with yeast mixed allshe took into the stomach. She died in Septem-
SOCIETY. ber,
with warm water, and dressed with lintdippedin the operation nearly
1847, having survived
Tuesday,January8, 1850- oil, the surrounding skin being smeared with cerate. fourteen months. On examination of the body, the
Granulations subsequently sprans up, and with occa-
sional
parietal peritoneum was found mottled,tubercular,
Dr. Addison, President. variations and triflinedrawbacks, he pro- ceeded and thickened ; the opposedsurfacesof the intestine
favourably, his health became ultimately were glued together,and to the liver, spleen, and
re-established, and he was able to follow his former stomach
TWO CASES OF COMPLETE INTESTINAL ; these adhesions were very firm,and suf- ficient
calling, which required great physical exertion. The to have greatly interferedwith the peristaltic
OBSTRUCTION. health
only interruption to perfect resulted from oc-
casional
action of the bowels. The small intestineswere tended
dis-
ARTSINO FROM DISEASE OF TBE SIGMOID FLEXURE OF
constipation, caused,apparently, in a mea-
sure,
with foeces,but the transverse and descend-
ing
THE OOLON Ain" TBF. RECTUM, IN WHICH THE of the artificial
by tendencyto contraction colon were empty. The mucous membrane was
DESCEKDIKO COLON WAS SUCCESSFULLY OPENED IN
anus, which was remedied by the introduction of ulcerated at several
points;the obstruction was
THE LOIN. bone glyster-pipe,
a and the iniection of warm found to be about six inches from the anus, and on a
By FREDERICK FIELD and JOSIAH CLARKSON, water; tnus the passa^ was ailated,and the levelwith the fundus of the uterus. It consistedof
Efqrs., feces were, at the same time, softened. 'Thisstate of dense,cartilaginous
Hembera of the Royal College of Sargeont of England. substance, surroundingthe in- testine
thingscontinued until the latterpart oi 1847* when and completely the canal ; it ap-
(Communicated by JOSEPH HODGSON, Esq.,F.R.8.) the patientwas attacked with symptoms of hepatic obliterating
to have originated externally, and pushed
Mr. Fieltts Case." On Monday 3rd,1846,tlieauthor disease; he lost his appetite, and became emaciated f"eared
brward the fundus of the uterus, to which it adhered
was requestedto see J. R ,
a coach -axle forcer,and ascitic, and ultimatelydied in Febmarv, 1848, firmlv. On
section,the canal was found to be com- pletely
aged38,corpulentand muscular,and accustomed to one year and nine months from the time of tne ope- ration. obliteratedto the extent of halfan inch. The
drink largelyof beer. He had alwaysenjoyedgood On examination of the body,the peritoneum
edges of the artificialopeningwere rounded and
health until a year back, when he began to suffer was found covered with lymph, the liver granularsmooth, and the
from painin the bowels,constipation, and tenesmus, and thickened,and the kidneys congested. The neighbouring mucous membrane
was healthy.
his stools becoming scanty, and roided with difficulty. strictureof the intestine was found to be in the
also some Mr. Hilton observed,that in allthe cases in wliich
There was derangement of the functions sigmoid flexure of the colon, and was about four
of the stomach. Three months since all these inches ih length; this portionbeingfilledby a plug this operation has been performed, all the usual
symptoms became aggravated,and were relieved of coagulatedlymph. This plug became broken up remedies were employedin the firstinstance, but he
only temporarilyby purgatives.He often vomited and detached by maceration in spirit,leaving the was of opinion, that the earlier the operation was
afterhis food ; his stools were voided with more culty, intestinaltube continuous,thoughcontracted and had recourse
diffi- to, the greaterthe patient's chance of
beingof a more fluidconsistence, thoughhe had slightly thickened. The plugresembled the depositsafety.In cases of obstruction in the large intcs-
 66 THE MEDICAL TIMEa
mercurial action, by givinff the pillat nightoften or let it be whollyomitted. It is not without sus- picion course of studies,and one title, that of Doctor of
enough to keep the gums tender, put cold water upon one hears of such terms as the stimulant or Medicine and Surgery,leaving each man to adopt
the ujcers, and gave one dropoF the nitricacid, two alterativeaction of mercury, as applied to the use of that branch of the Profession for which his tastes
of the muriatic acid,with some liquorice and poppy this remedy for the cure of syphilis. The multifa-
rious and talentsqualify him ; thus rendering the medical
Byrup in water twice a day. Stillthe resultwas un- and hybriddisorders so engendered would bodya more consolidated one than it is likelyto be
latisfactory. There was an appearance of skinningseem to bear out the non-mercnrialistin allhis ob- while there are three grades. Thirdly.
jections, Are unedu-
cated
upon one margin of the ulcer,but then it was less if it does not render his triumph complete ; and unlicensed persons to have full liberty to
clean and wider in an opposite direction. Under these but I submit,that nobody who has ever watched the attempt, /or gaint the cure of diseases;or should
circumstances, the mercury was wholly withdrawn. effect of the only remedy capableof summarily some checks be imposed upon them, and of what na- ture
Ten drops or the tra. ferrlmuriatis were ordered stopping the course ulcern of the should those cnecks be. These and other ques-
of some phagedsenic tions
twice a
aa^, with directions to persist in the cold genitals, can ever afterwards doubt its efficacy, or willbe more likelyto receive a thoroughana- lysis
water dressing. The ulcer now for the first time hesitateas to itsemploymentfor the cure of primary in the pages of a journal similar to that here
assumed a healthy aspect, the healing process was sores, the history and activity o f which justify sent
pre- proposed, t han they could possibly have du-ough the
slow,but uninterrupted, and the patient,latterly apprehension,to say nothing of a reasonable examination of witnesses oefore a Committee of the
much dejected, became heartwhole and well. He has fear,that the party to visited will,after the usual House of Commons.
now been convalescent for some weeks,and as yet no interval, suffer from secondary symptoms, unless The adoption of the course recommended in this
secondary symptoms have shown themselves. Nor theyare averted by a mercarial course. letterwill, doubtless,delay foranother sessionor two
do I anticipate their approach.On two occasions the passing of a law regulating the practice of
after the mercury had been withdrawn the sore was
medicine ; but there is every reason to expect that we
touched with the nitrateof silver, and with the best CORRBSPONDBNOB.
effect.Some years ago a younggentleman of delicate
shallthen be rewarded for our patience by having a
" creditableBill, based upon broad and enduring
habit showed me prin-
ciples
some ragged,spreading, preputial MEDICAL REFORM. ; and considering the importanceof the object
sores, contracted in the ordinary manner, which, as to be attained, we may well,after havingwaited so
in the foregoing case, were made nf ither better nor
[To the Editor of the Medical Times.] many years, consent to wait yet one more, or, if ne-cessary,
worse by mercury. 1 never succeeded in salivating
even two. As Members of Parliament have
him, but on that occasion I resorted at last to full Sir, " As the time approaches when another spasm-
been sufficiently plagued during several years with
doses of the sulphate of quinine,alongwith a cold- modic attempt will probably be made to obtain the
of
aboitive attempts at Medical Reform Bills,I would
water dressing; these,with a trip to the sea coast, passing a Medical Reform and Registration Bill,
recommend that between the present period, and the
cured him completely in three weeKs. He has never perhapsyou will allow the following suggestions upon
sufferedfrom secondarysymptoms. In another case, the subject to appear in your pages. drawingup of such a Hillas tnat now advocated,all
mention of medical matters in the House of Com- mons
where the primarysore was healed under precisely Hitherto the members of the Profession have made
should be discouraged, in order that,when the
similar circumstances, systematicand combined effortto elucidate the
mercury having previously no
proper time arrives, itsmembers should come to the
proved not otherwise prejudicial than as beingalto- gether principles upon which medical reform should be discussion of the BUI with minds not wearied of the
unavailing, the party remained well for some based. The history of the question has for the most
subject
years ; but I hear that he has recently been com-
pelled part presented a succession of paltry sqaabbles and
to quitbusiness, in consequence of impaired manoeuvres arising from the attempts of certain bodies
In conclusion, letme againdraw attention to the
differencebetween the method already tried for con-
cocting
health, and that he has been the subjectof penetrat- ing to obtain or keep for themselves a monopoly of
local ulcersand glandular a Medical Reform Bill,and that now
swellings. In this case specialprivileges; and in the discussions which
In the firstcase, we have only the evi- dence
mercury was givenfor a short time only,in the form have,from time to time, taken place upon the sub- ject suggested.
of calomel and opium at nighu The party, aged the great mass of the Profession have had no
of men connected with the existingMedical
Corporations, and of a few others called " eminent,"
twenty or thereabouts, at the periodof his firstill- ness,good opportunityof recording the ideas and sug- gestions
was stout and fi-eshcoloured, but his circulation which theirexperience mayhaveglven rise to. both standing
and apart from the rest of the Profession,
of which partiesare likely to be biassed by
was feeble, and there was some reason to suspect the When the Anti-SlaverySocietyundertook its agita- tion thHr
presence of struma in the habit. In the practiceof in favour of negro freedom,one of its most im- portant peculiar positions, while the jury empanelled to
receive and weighthe evidence tnus given,is com- posed
the hospital, I remember formerlyto have dealt with acto was to establish a Paper devoted exclu- sively
the disease on precisely entirely of men perfectly unversed in medical
similar terms, in its primary to that subject, in order to concentrate all
and not in a situationto be conversant with
form, and with the like results, after mercury had available information regardingit; the Anti-Corn- matters,
failedin its effect. In the face of these statements, law League likewise had its Paper for the promo- the wants and interests of the Profession. By the
tion
I must stillprofess of the
second method any man, no matter what his position
myself an advocate for the use of one object, t hat of free- trade, and the
in the great bodyof the Profession, would have it In
mercury as the generalrule ; but I know,from ex- authors of the Freehold Land Societies'Agitation
perience,
his power to make any suggestions which seemed to
that,in certain cases, its exhibition is. to are about,it seems, taking a similar step. Now, it would
him good, and the who would test them
say the least of it, only so much time lost What, appears to me, that the medical reformers would act be jury
then,are the circumstances which justify hesitation, wiselyin imiutingtheir example, and establishing a
composedof medical men of all^ades, who would
act as checks upon each other in sifting the different
or rather warn us to abstain from "
this panacea,"on small Paper to be devoted exclusively to their ques-
tion.
certain occasions ? The sores contracted by impure It may be published at firstmonthly, and suggestions.
intercourse are typical of one and the same afterwards bi-montnly, or from the commencement I am, Sir,your obedient servant,
poison,but people now-a-days are certainlynot bi-monthly; and be continued for a year, and medical George Feabon, M.D.
all alike as regards the remedy. For myself, men throughout the country should be invited to Birmingham, January,1850.
'
I believe, that in these anomalous cases the ex- contribute to itscolumns any suggestions that may
P.S. Should sucb an organ of Medical Reform be
"

jplanation turns largely upon a latent peculiarityoccur to them as likely to be of service in drawing
I shallbe happyto contribute, if needftd,
of constitution, established,
a distinctionwhich for the present up a fair, practical, and comprehensiveMedical a small donation towards its expenses, and to aid it
we must be content to arrive at chiefly throughthe Reform Bill. As many of the suggestionswobld,of in any other way that I can.
teachingof the medicinal agent; bat,as I have be- fore course, meet with objectors, we should have the ad- vantage
said,I look for another and an earlier, if not a of having them critically discussed, and thus [The sul^ectof our Correspondent's letterhas ftt*
better guide. Some indication to be drawn,at the be betterable to estimate their relative value,while, quentlycome under the consideration of medical
firstglance,from the aspect of the Ipcaldisorders,at the same time, we should get at the sense of the politicians, but has not been persevered with,as,
and an estimate of the Profession upon the questionin a more effectual from the limited number of readers in the Profes-
powers of the patient," a re-
sult sion,
which implies lengthened and carefulinvestiga-
tion. manner than seems likely to be done by any other
and especially of those who take sufficient terest
in-
It is reasonable to suppose that the action of means. In order that this Paper should have a free
so powerfulan evacuant it would be better for it to be in Medical Reform to patronise a Journal ex- clusively
as mercury," to say nothing and wide circulation,
of the incidental aids of an advanced and mature conducted by parties who have no directinterestin devoted to the question, it has been found,
civilisation," have insensibly modified and very ma- terially any of the existingweeklymedical Journals. It that the sale would never cover the expenses. So
weakened the force of the venereal virus; should contain in one or more of its numbers a full far as the discussion of all vital questions is con-
cerned,
but to my mind, it is not enoughto of alllaws and regulations affecting the Pro-
fession
say that struma account
and we invite Cor- respondents
IS present in these cases, for many in other countries, and at the end of the half
our pages are open to it,
scrofulous subjects
to communicate to us theirideas upon
bear the moderate action of mercury very well, and so year or of each quarter a Supplementmightbe pub- lished,
we may say of scurvy or gout I am not aware that these containing in opposite columns,and in a con- cise the criticalpoints that bear upon sectionalor general
offerany immunity from lues,or hinder the action of manner, a summary of the differentsuggestionsinterests. It would be as easy to draw up a plan
medicines directed for its cure. Bnt, be this as it that had been oflered, and the objections with which based upon abstract principles, as to frame a new
may, when parties do present themselves who, being each had been met. Constitution for a new French Republic ; but what
poxed, are found to be inaccessible to the action ot If this planbe fairly carriedout,the resultwill, most ling
hand-
the Profession desiresis, a thorough practical
mercury, the sooner the discovery is made the better ; probably, be a Medical Reform Bill, which will serve
the Profession in relation
and it is satisfactory of all the interests of
to know that they
may be cured as a model to other countries ; while,on the other to institutions, and this object
upon other terms,and that, as a general rule,theydo hand, any measure passed in the irasatisfac- existing we are pared
pre-
present
not sufferfrom secondary to aid and to carry out to the uttermost. Free
symptoms. I cannot bring tory state of the questiouj will,in all likelihood,
this little summary of my observations in this matter prove to be a bungled, i ll-considered one, itself discussion is the life of truth, a nd just principles can
to a conclusion without referring to the case of in-
adequate
needingto be reformed and amended in less than only be discovered and exhibited by and in itslight.
mercurialization, wherein the system be- comes half-a-dozen years. There are several questions ED.Afcrf.
impaired and eventually
"
rime*.]
succumbs, under the which will requirefull discussion and careful consi- deration
wastingeffectsof the medicine on the one hand, before legislating upon them. Three we
added to the anoontrolled progress of the disease on may specify. First.Whether it is to the advantageTHE
the other. Even in our own MANCHESTER MEDICAL REFORM
dayone sees cases oc- of the Profession, that there should be so large, and
COMMITTEE.
sionally (and a most melancholyone has recently apparentlyincreasing, a number of diplomafactories
come under my notice), of
which prove the necessity scatteredabout the United Kingdom ; or whether it
and steadiness of
a constant singleness purpose in would not be preferable to have one central Examin-
ing^ [To the Editor of the Medical Timet.]
the exhibition of mercury for the eradication of Board for the whole Kingdom, or one for Great Sir, I am directed by the Committee to forward
"

lues. Let it be administered to salivation with Britain, and another for Ireland. Secondly. Whe-
ther you the enclosed copy of a Memorial sent by them
the fixed intention of extinguishing the disease, itwould not be better to have, in future, but one to the President of the RoyalCollegeof Surgeons of
 THE MEDICAL TIMES. 67
England, and to request you to insertitin the next DETECTION OF LEAD,have read with much pleasurethe account of the iuc-
Nomber of your periodical. IN IN cessful operationof excision of the head of the
MINUTE QUANTITIES, WATER, OR
I remain.Sir,your obedient Servant, OTHER FLUIDS. femur,by Mr. Morris,of Spalding, to whom great
Gboroe Bowmey, Hon. Sec. creditis due for having turned out of the old beaten
[To the Editor of the Medical Times.] path,and who, by acting upon the principles laid
"to the
gen,) down bv Professor Fergusson,cured his patient
president op the royal college op of
Sir, Hydrosulphuric
"
acid,(sulphuretted hydro-
of a formidable disease and restoredhim to health and
surgeons op england.
preferably,
or, a solution of hydrosulphurec
"
Sir," In conformitywith a resolutionpassedby potassa, is considered the best and most sensitive comfort.
the Manchester Medical Reform Committee, I bejr test of the As Mr. Morris has so kindlymentioned my name
presence of lead in water ; but there is
re^"ectfullT to convey through
you, to the Council great difficulty in estimatingthe amount actuallyin connexion with this case, I think it my duty to
of the College, the high satisfactionthey feel at corroborate what he has said regardingthe patient's
present, unless it be in sufficientouantityas to be
the announcement of an intention, the part of its capable condition. Through that gentleman's courtesy
of being collected and weigned.The follow- ing
Council, to applyto the Crown for an amended
on

method was adoptedby me last week in testing a

fresent
had the opportunity of seeingthe case, and I un- hesitatingly
Cluurter. and provedto do so ; affirm, that the result which has taken
'"
water supposed tocontain lead,
j^ In reflecting upon the probable details of such and,although not, strictly speaking, correct, is,theless,
never-
1"lace is far beyond that which wc could be possibly
Charter, it has appearedto the Manchester Com- mittee, to truth and ac-
ed to expect.
after much
as great an approximation curacy
and anxious deliberation, that a as can well be conceived, and sufficiently near My object, however, in addressing you, is to refer
measure which shall embrace the following provi- for all practical
sions take a half- to a pointof very great importance in connexion
would be generally
purposes. Suppose we
with this operation, which has strongly attracted
acceptable to the Profes-
sion: tumblerful of the suspectca water, and add from one
" fint
to 3 or 4 dropsof a soludon of hydrosulphuret of my attention. I am speaking in reference to^the
*^1. That upon the grant of a new Charter,allex- isting
potassa ; if lead be presentin largequantity,it will
mode of proceeding adoptedby Mr. Morris.
Members of the Collegewho have attained, It
oe immediately precipitated in black flocculi; but, appears,that on cuttingclown upon the joint he
or may hereafterattaina standingof fifteenyears, if small,there will be no but the liquid found the head of the femur still within the aceta- bulum,
shall,upon the recommendation of six Fellows,be will be more or less discoloured precipitate, and that he firstsawed through below the
of a dirty brown.
elected to the Fellowship and the of the
without the payment of any
Having,in the above experiment,sought for and great trochanter, then dislocated it head
fee,provided that the candidate do not openlytrade discovered lead of the hydrosulphuret, bone,not, however, without finding a difficult
in medicines.
by means we
in consequence of the edgesof the cotyloid
now, as a comparativeand confirmatory experiment, matter,
"
2.iThat Fellowsof the College
Aall be eligible
practising midwiferyreverse the order of testing, by using a solution of easily overlapping it.
to the Council, bnt.ihat Fellows en- gaged acetate of lead of known strength.For instance, I would stronglyrecommend any one who per- forms
in the practice of pharmacy be therebydis- qualified.
make a test liquor in this operation to disengage the head of the
by dissolving 12| ounces, or
100 drachms fluid, bone as far as possiblefrom its surroundingcon- nexions
ofdistilled water, 1 grainof acetate
,.".?\'r**"* Fellows residing in the provinces be of lead ; take another tumblerful of dis- tilled first, before making the section ; for,if the
eligibleto the Council,but that two-thirds, at the
half-pint bone be not sawn throughthe operator has the ad- vantage
water, and add from 1 to^3 or 4 dropsof the
least, of that body shallbe resident in London.
of of the thigh as a powerful lever in the hands
*'
4. That in the election of the Council the Fel-
hydrosulphuret potassasolution, and placeboth
of a goodassistant ; the nead of the femur may be
lows vesselsin strongllgnt, with a pieceof while paper at
shall have the privilege of votingby proxy. their backs;then,with a graduated thrust well out of the wound, and the remaining
steps
syringemeasure, of
"
5. That afterthe grant of the Charter the admls- the operation will be easily, accomplished. But if
or a nicelystoppered drachm vial filledwith the test
sion to the Fellowship shall be by examination, and the section be firstmade, and the head of the femur
liquor made with lead,dropin so much as will bring
every candidate shall have previously been admitted up the colour to the be either in its socket,or strongly connected to the
a Member of the College.
required depthof shade as that be great,
of the original water under examination, every drop for the
neighbouring tissues, the difficulties may
"6. That the Council of the leverage of the thighis lost,and the surgeon
Collegeshall be em- powered of this test
liquor answering to l-6000th of a grain has
by the Charter to appointExaminers in all of lead salt. This method of testing, it will be per- little use for his left hand. In certain instances
ceived,
departmentsof Medical and SurgicalScience,and applies to other substances besides lead.
similar to that of Mr. Morris,where the head of the
that the Board so constituted shall be formed inde- pendently bone is still in the socket, flattened, cut, and over- lapped
John Horslet.
of, or comointly with the Examiners of
Ryde, Isle of Wight,Jan. 9. by the edges of the cotyloid cavity, it might
the Royal College of Physicians or the University of almost be impossibleto get it away. Whereas, the
London. limb beingwell carriedinwards by a strong assistant,
**
I have the honour to be, A USEFUL REMEDY FOR CHILBLAINS (the neck of the bone not bein^ sawn through,) the
"* AND TOOTH-ACHE. whole proceeding is much facilitated ; and an^rone
Your obedient Servant,
who willtake the trouble to operate on each side of
"
W. Watson Beevbr, Chairman, the dead body, in these two ways, will subscribe to
[To the Editor of the Medical TImM.]
"
Manchester, Jan. 11,1850."
Sir,-;" At this season few diseasesare so generalas the justice of this remark. I am sure Mr. Morris
chilblains, and the plansthat are generally employed willexcuse my referring to this point, which I am
for their removal are seldom attended with more than persuaded is one of very great importance,and
ON THE INJURIES WHICH THE HABIT very slight advantage to the sufferers. worthy of the attentiot; of those who have not had
OF SMOKING TOBACCO IS SUPPOSED It is a disease that attacks most generally females the opportunity of performing this operation.
TO CAUSE TO THE TEETH. and delicate children, and those of a languid circu-
lation. This interesting case teaches us much. Mr. Mor*
ris has the satisfaction of showing to the Profession,
ITo the Editor of tho Medical Timet.] The very numerous and various medicines which /or the first Umef that the head of the thigh-bonemay
Sir, I have seen in your last Number a commu- have been from time to time employed,prove be disarticulated from its socket, in cases of the hip-
"

nication very
from Mr. Levison, in which he detailsthe clearlythat no very effectiveor successfulplan of joint, and be recovered with perfect success. Hitherto
injuries he supposes to arise to the teeth and digest- treatment has hitherto been found. Such is the Professor Fergusson has only recommended the
ive
organs from the smokingof tobacco. He believes present state of treatment, both of chilblainsand adoptionof this proceeding, when the head of the
that the fan^ of the teeth, after a time,become de- nuded tooth-ache. " bone was dislocated ; and it has appeared to me
of their periosteum by the conjoined actions of My planof treatment is simplyto saturate a piece that,were the operation put in force when the head
the heat of the smoke and excessive acidity of the of sponge or flannelwith the concentrated tinctureoff of the femur was stilllyingin a carious condition
saliva secreted when the dijjestive organs are de- ranged capsicum, and to rub well over blainswithin the acetabulum,the resultwould be anything
the seat of the chil-
by the habit of smoking. It is easy to per- until such time as a strong tingling but satisfactory ; still here is practical proof to the
ceive, and elec-
trical
by the tenor^ofthe communication,that Mr. Le- vison feelingproduced.
is contrary, which must cause me at least to change
is not addicted to the ase of the "
charming This medicine possessesan extraordinary power in my
opinionon this matter. StillI am glad to see
weed," Now, Sir,as I have been in the habit of removing congestion, by iu action upon the nerves that Mr. Morris would not advise the operation,
smokinff some little time, I am personally terested
in- and circulation. unless one was tolerably certain that dislocation
in the subject; as yet, no evil whatever This application ought to be continued dailyuntil exists.
has resulted to my teeth, and I have made inquiries the diseaseis removed ; reliefwill be experiencedon It must be admitted, I think,that this case speaks
amom; my smokingfriends, with a view of ascertain-
ing the very firstapplication, and frequently there will volumes in favour of thisproceeding ; for, if a suc-
cessful
if they had experienced the generalsensation of be a totalremoval of the disease afterthe second or result can be obtained under such difficult

aehii^ and throbbing to which Mr. Levison refers. third; this, of course, depends
upon the severityof circumstances as were here present,how much more
All of them assure me that theysuffer no inconveni-
ence the case. likely is it that a favourable issue will be brought
about when the
producesand this latter head
of the sort,although of them This embrocation, when rubbed, never of the bone is out of the socket;
some
carryit to has had the opportunity of recovering
such an extent as to make a pointof smokinghefore excoriationif the skin is not broken.
breakfast, and allhave been addicted to its use for The manner of it
using lor tooth-acheis by putting itself f tom the morbid action it has probably gone.
under-
years. a drop or two of the tinctureon cotton,and
applying Mr.
Under these circumstances, I cannot but be sur- prised it to the part affected ; the relief will be immediate. Morris might well have dwelt upon some of
the
that none of them should have been troubled The following is the formula :" Tinctura
oapsici circumstances of this case, as showingthe fal-
of Professor Symes' views respecting
lacy
by the ill effectsreferred to ; and think it possible concentrati, p,Capsici Baccarum,5iv.; Spiritus Vini that dis-ease,
that some other reason miphtbe found which would Rect., 5xij. Macera per dies septem et cola. (It and the operation of excision of the head of the
have caused the inconveniences recorded ; such, tor may also be made with advantageby displacement.) femur. How clearly does it overthrow that Pro- fessor's
instance, as the use or abuse of mercury. I have I remain.Sir,your obetfientservant, doctrine,that the acetabulum is always
seen the symptoms in persons who have never smoked A. TURNBULL, M.D.
diseased with the head of the bone! And how
at all; and a friend informs me that he has seen the ,^ ,, ,

16, Manchester-square, Jan. 17, 1850. signally does it aid in utterlyconfounding his as-sumption

edgesof the teeth worn of the improprietyand uselessnessof this

away by the frictionof the
day pipe, in the lower classes, without theirbeing operation !!
otherwise injured. EXCISION OF THE HEAD OF THE It is pleasing to see that the
surgeons of England
I^therefore,think,that tobacco can plead" Not FEMUR. are not deterred by this authority from a laudable
Gailty"of the charges broughtagainst it. attempt to relieve human misery, and add to the
[To the Editor of the Medical Timet.] triumphsof their art ; and it must be gratifying to
I am, Sir,your obedient Servant,
SiR,--Iam sure that allthose who are interested my old teacher to find his doctrinesso well and suc- cessfully
Walter Raleiqh.
^

iQ the advance of sound surgical knowledge, must carried out; and it ii no less pleasing to
 68 THE MEDICAL TIMES.
myselfto find that my humble effortsto disseminate fiut the best proof,perhaps,'I can give you, is HEALTH OF LONDON DURING THE
and defend those doctrines, which I am more and the very document from which Mr. McClurc made WEEK ENDING JAN. 19.
more convinced are correct,have not been entirelya quotation in his last letter; but,I conclude, he
unavailing, notwithstandingthe strong opposition did not give you the whole of it, as it would not suit
In the week endinglast Saturday, 1156 deaths
theyhave encountered. his purpose. I allude to our worthy incumbent's
; the
I am, yours obediently, report of the mortality during whole periodof were registered
the in the Metropolitan districts
Henry Smith. the prevalence of cholera in this place: average for ten corresponding
" weeks of previous
13,Caroline-street,Bedford-square. is 1125, which, correction be
Deaths. Deaths. years (1840-9) if a

made for increase of becomes

population, 1 227- The
HEALTH OF THE SOLDIER.-HIGHLAND lowest number in the ten weeks was 916 in 1840 ;
DRESS. the highest
was 1401 in 1848. , Though the rate of

mortalityhas much increased since December, and

[To the Editor of the Medical Times.]
tliepresentreturn shows an increase of nearly lOO
Sir," In the SiirUng Observer, of January 17,
the following occurs, which, as it lias in view the on the previous week, the deaths are stillless than
comfort and health of a gallant part of Her the average by 71. To the coldness of the weather
Msyesty's army may not unsuitably occupy a small may be ascribed the increase of mortality
chiefly
portionof the Medical Times. The remarks of the last
which recent returns have exhibited. In the
Editor,we conceWe, are in the best spirit, and,it is
hoped, will meet, in the proper quarter,with the at- tention three weeks the deaths from phthisis, or tion,
consump-
Now, Sir,from this Report,it is quite clear that
they deserve,backed, as they alreadyare, the disease had have been respectively 129, 140, and 157 (the
begun to decline some days be-
fore
or appear to be, by the present Assistant Adjutant-
his arrival in Torpoint; that it continued to corrected average for last week being146);from
General for Scotland :--" We are gladto learn,that, decrease
steadilyand slowly, but decidedly; and
bronchitis, 103, 120, and 131 (theaverage being
on Monday last.Colonel Eden, Assistant Adjutant- that I was
General for Scotland,
quite right in using the expression from asthma,19,35,and 27 (theaverage being
I did,that at the time of Mr. McClure's arrival 73);
arrived in our town with the which
intention of instituting certain inquiries concerning the number 52); and from pneumonia,95, 83, and 85, whilst
of deaths had diminished down to
the uncomfortable nature of the Highland dress worn
abtmt one daily. There is one point in bis last the average is 117. Of the 85 (persons tively
(compara-
by the 93rd reg[iment now garrisoningour castle, letter at which I am rathersurprised,
andjit is,that.he few) who died,last week, from pneumonia,
and the conclusion is, that henceforth,in winter
says, itwas not intended by him thathis paper should 60 were children;but of the 131 who died finom
weather,when the men mount guard,they are to be make its worded as it is; but this is bronchitis, which much exceeds the average, by far
appearance
dressed in the trews, and not in the kilt as hereto-
fore.
scarcely reconcilable with the fact of his having the larger
This is so far an improvement, and perhaps proportion were persons of advanced a|i^.
written to you for a proof sheet before itwas lished,
pub-
is as much as mightbe expectedin a system so com- plicated
in your
Epidemic diseases continue to be less fatal than
which, notices to Correspondents, which is rather more than
as the military system, and when no one, usual, except measles,
was stated to be the case. Mr. M'Clure is an
without the consent, and even the directorders of the average. This disease ranged, in the correspond-
ing
assistant-sureeonin Her Majesty'snavy of only
the highest Powers at the Horse Guards would
twelve months' standing; and itis to be hoped,that
weeks of ten previous years, from 8 to 51.
undertake the responsibility of introducing a change
by-and-by he will be a more accurate reporter, for The deaths in the several hospitals of London oc- curred
in dress, even though the ordinary dictates of nature
had his statements on this occasion been truthful, it
as follow :
tellevery man that the Highland dress,in weather "

would have saved a great amount of trouble and !"

like the present^ (the thermometer ranging from KensingtonHoiueAsylum 0 St. Bartholomew... ...

annoyance ; or, had he shown me his Report before Lock 0 Miles' Lunatic Asylum... 0
7 deg.to 31 deg.of Fahrenheit,) cannot but be pro-
ductiveits publication, it would,I think, have been wiser and Consumption, Brompton % Warburton's Lunatic
of the utmost discomfort in the strongest
more courteous, seeingthat he was writinga medical Brandenburgh-house natic
Lu- Asylum 0
...

men, and the precursor of disease, less or more veterate,

in-
statement about a placeof which I am the only me- Asylum 1 London 2
dical
in others. "
In the natural world, Royal MilitaryAsylum 1 Portuguese Jews' Hos-
. . .
man. A man ought to be very careful as to the
those ^nimals which are formed to live in cold Blacklands-houseLunatio piUl 0
accuracy of bis facts before he appears in print. 1 Lunatic Bow S
climates have
always provided for them a different Asylum Asylum, ...

I remain. Sir,yours truly, St. George IS Guy's ..IS

and much warmer clothing during winter than that ...

Grenadier Guards' pital

Hos- St. Thomas 3
which they are found to possess in the heat of sum- mer." Charles W. Chubb. ... ""

Bethlem m. ...
0
...

The present distinguished and veteran chief Torpoint, January23, 1850. Westminster
"

... ^
St. Peter's Hospital 1
...

of the Army Medical Department is himself a Celt, Charing- c ross Retreat Lunatic Asylum 0
and no one can be better qualified, from long expe-
rience Middlesex New County Lunatic 4
and scientific aided as these must Death M. Prus." This distin^iished Queen Charlotte'sLying- Peckham House Lunatic
knowledge, of ber
Mem-
0
be by the statisticsof the health of the Hishland of the French Acsdemy of Medicine died last in Hospital Asylum ."

UniversityCollege Camberwell House natic

Lu-
Re^jriments, to pronounce an opinion,and ^iveweek from a pulmonaryaffection, brought on by exces-
sive Small Pox.^ Asylum ...
2
.M

advice on this important subject, to the autliorities fatiffueindischargeofhis official duties in Egypt. Fever Hospital Dreadnought Ship 0
...

under whose chargethese matters are. Although M. Prus's connexion with Medicine was Northumberland- house Devonshire Ship 0
An Old in some accidental,for he was originallyLunatic Asylum Unlt6 Hospital Ship 0
Peninsular. measure "
...

destinedforthe law,~he devoted himself with ardour Invalid Asylum, Stolee Royal Ordnance S
Banks of Lochleven, Jan. 19,1850. m. m.

to his profession, of which he soon became a bright

Newlngton
German Hospital... Royal Hospital,Chelsea
ornament. Havingbeen present at many ofthe^rand King'sCollege (South) t
MR. CHUBB IN REPLY TO MR. McCLURE. battlesof the Empire, he attracted the attention of St. Luke Royal Hospital,Greei|-
Larrey. He settled in Paris about the year 1827, City of London Lylng"m wlch(East) ...
6
...

[To the Kdftor of the Medical Times.] and was soon elected Member of the Academy of
SiR,--On Mr. McClure's letter, which appeared Medicine. M. Prus was the author of several excel- lent MORTALITY TABLE.
in your paper of Saturday last,I desire to make a wurks,amongst which we may distinguish his Deailis in the Week endingSaturday, Jan. 19, 1850.
few observations, which,I trust,will be the means treatises " On Cancer of the Stomach,"and "
On the
of settingat rest the matter at issue between us. Diseases of Old People," but his chief titleto our (Metropolis.)
With regard to that part of his letterwhich has respect is derived from his labours on the subjectof
allusionto the supplyof water at Torpoint, he says, the plague. He was one of the chief means of effect-
ing
that I save you to understand,by my writing, that importantreforms in the quarantinelaws; and
we had an abundant supply of water. How Mr. when the French Government, yielding to the sug"
McClure, or any other person can infer that from gestions of the Academy of Medicine,institutedthe
it is beyond
my letters, my power to discover ; for Oriental Commission, M. Pras was naturally placed
the very words I used are calculatedto the posite
op- at the head of that body, and took up his residence
convey
impression. All I said was, that Mr. McClure's in Egypt* There his whole attention was directed
picturewas overdrawn ; and so I stillconsider it,for to the ciiflicult task of eradicating the causes of plague.
he called the water deleterioos and unwholesome; His last illnesswas broughtonby excessive fatigue in
and such|duringmy residence here,I never ber
remem- Upper Egypt. In his fastwords he lamented that
it to have been. But,as I consider this part of providence had not been pleased to grant him one or
the letter quitesecondary,I wish to say a few words two more years to complete the reforms which he
about the epidemic outbreak of cholera in this place, had begun so well. Sit tibi," may the eartii lie lightly
which I consider the primary and importantmatter ; over him.
and, as Mr. McClure does not appear inclined to Mr. Aburrow, the manager of the Liverpool
take my word forit, I will now giveyou a proofthat he Apothecaries' Company, has had a handsome piece
is not a very faithfulreporter ; and that he is usurp-
ing of platepresentedto him by the persons in the
to himself (by his writing so much in the firstper-
son) employ of the company.
credit which is not his due. It may all be Steel-ribbed Umbrellas. A Correspondentof
"

summed up in a short space. The whole gistof the the Liverpool Mercury,states, that while walking with
matter lies in this. Wns epidemiccholera in Tor- a friend,and protectingthemselves from the rain with
the decline or not at the time of Mr. a steel-ribbed umbrella,he suddenly felt a shock
Soint on
IcClure*sarrival among us ? That gentleman ap- pears like that of electricity, and became enveloped in a
to imagine,from his letter, that,because we blue flame. He was bewildered for a second or two,
had many cases of cholera and diarrhoea after he and,then heard a thunder-clap. He had been struck
came here, the disease could not possibly be de- by lightning, attracted, doubtlessly, by the steel in
olining.At the time he arrivea, and for some his umbrella. His friend did not feel anything,but
days before that period,the cases of cholera saw the flame. When begothome he examined his
were fewer in numner, less severe, and less fatal. watch,and found it had changedto a copper colour.
 THE MEDICAL TIMES. 69
The followingia the number of Deatha occurring f^om fome models of the brain of the torpedo; 3 diameters." of the abdominal viscera, the complete or partial
of the more importantipecial causes :"
Case 9."" Torpedo : magnified models of the struc-
ture peritoneal coveringthey received, the peculiar racter
cha-
Apoplexy ...."
23 Heart Phthisis 157
of the galvaniccolumns of the electrical of serous
Branchttia ^ 191 Pneumonia orj^an; membranes, contrasting their struc-
tural
Hooping-eough ...
85
Gholenu.....M. Scarlatina 12 diameters." Case 10."" Torpedo: magnified and functional peculiarities with those of
Hydroeephalua ... 17
Childbinh 5 Influenza . Small-poz ......
7 model of the ultimate distribution of the vessels and mucous membranes, and enteringfullyinto the
OaaTolaiona... 45 Liver Stomach ............ 8 nerves of one of the plates of an electrical column ; morbid appearances of peritoneal inflammation, with
Oianhoea 10 Lungs Teething 8 400 diameters."
......
Case 11. " Torpedo: magnifiedthe treatment
" to be pursued in those important
]"ropa7 17 Measles Typhus 3S
~.....^ .........
models of the mucous tubes and savian corpuscles : varieties of structural disease. The Lecture was
Eiyaipelaa 8 Panlysis
...
Uterus 4
15 diameters. Distribution of nerves on the bulb of listenedto with marked attentiom
BIRTHS AND DEATHS.
a mucous tube ; 120 diameters." Case 12. Torpedo;
" Cholera Rewards." The Middlesex magistrates
venous system, base of brain, ovum, embryo, and have emulated the conduct of the several country
Births. Deaths. Births over Deaths.
magni6edmodels of the blood discs ; 500 diameters." parochialboards, and refused to grant a gratuity of
These are by far the most beautiful examplesof the 30/. to Mr. Lavles, Surgeon to the Tothill-street
683 546 137 Florentine art which we have hitherto seen. We are House of Correction, for his extra-servicesduringthe
Fema}08 ..
700 610 90 informed that they were ordered by the Grand Duke cholera. Mr. Hope, the gentleman who proposed
to be expressly preparedfor Professor Owen, after the donation,resolutelv and very properly refused
Total.. 1383 1156 S27 an interview with which the Professor was honoured to withdraw it; Itwas lost by a majorityof 4i. Sir
during his visit to Florence in 1846. Professor Peter Laurie was one of the majority. If the public
Calamai,the Superintendentof the Wax-model De- be desirous to have the services of the profession,
partment in
in the Museum of Natural History at case the epidemic should return, they should scout
Florence, has prosecuted with much ability and suc-
cess such disgraceful conduct.
the anatomy of the torpedo, and has published Western City Dispensary. " The Court of
the results of his dissections, which arc so beautifully Common Council have presented 521. lOs. to the
perpetuatedin the models now in the Hunterian above Dispensary,and 200/. towards the building of
Museum, in a Work entitled "
SuIl*Anatomia the King'sCollege Hospital.
Delia Torpedine,"8vo.,Firenze,1845. Wilson v. Ashley.
" The defendant in this
Introductory Lecture at the St. Geobge's action,a surgeon residing at Hightown, near ford,
Brad-
Medical School. Dr. Daniell (late
" of Bath) Fel-
low Yorkshire,beingin illhealth, sold his practice
of the Collegeof Physicians,and Lecturer on to the plaintiff for 400/.,for which he was to give
the Principles and Practice of Medicine at St. him a year's introduction,and then to retire, binding
George'sSchool of Anatomy, Medicine, and Sur- gery, himself not to practicewithin seven miles of High-
lately to be paid by instalments,
his course "
commenced Gentlemen," town.
.
"
The money was
said the learned Professor, "permitme to thank you and, at the time of the trial, there were 50/,still
un-
paid.
Amount of Hori- I "
o a" for the
of support which hasevidence
gratifying The action was brought for liquidated
amtal Movement I s :!; -

of the Air. S
S marked your approbationof my appointmentas damages,on the ground that the defendant bad failed
5*

your teacher in the importantsubject of the Prin-

ciples to introduce the |)laintiff to his best patients, and
and Practice of our noble Profession. Believe had resumed practice at Hightown. Defendant paid

^ ^ me, I assented with reluctance to the kind proposal 50/. into Court in satisfaction of the damages. Evi- dence
CO
^ of one of your most eminent and valued Lecturers, was adduced in favour of the plaintiflTs claim,
Dr. Pettigrew, to appear before you in the respon-
sible and a verdict for 300/. returned. *

character of one of the Professors of this far- The Queen ". Cluderay." This was an appeal
sC wo famed and highlyappreciatedSchool. I repeat, case against a capitalconviction for administering
that my to the proposal was tardily yielded; poisonto an infant, to wit, the berriesof the cocculus
^55 izi S5 S5 " assent
not that the subjectin which I shall be engaged is indicud. At the trialof the prisoner, although it
irksome,tedious, or uninteresting; but knowing the was proved that the child was seriously illafterthe
Difference between
difficulties of conveyingto a class of students, in ingestion of the berries, it was contended, from medi-
cal
the Mean ture
Tempera-
of the day and appropriate terms, preoisediction, and well adapted evidence,that although the berries when broken
theanme day on language,those observations on the treatment of up are dangerous, in the husk there is no danger that
from them, and it appearedthat the berries
an average of I I I I I I \" disease which expsdence and abundant tunities can accrue
oppor-
7 years. of practical remarks have furnished rac, were giwento ilie infant in that state. The point was
^Ditto. aware, also, of the talent, matured advan-
" tages, reserved by Mr. Justice Williams,who triea the case
"5 r; *"
Dew Point. and valued professional reputationof my at York. The conviction was confirmed by the
Mean of coiieagues, I felt myself overpowered by the contrast Court, the Judgment being,that when a man stered
admini-
Thermometer. between their brilliant, useful,and efficientquali- ties, a thingthat was ))oisoii, with intent to mur- der,
00 m ^
,
D^. and my inexperienced efforts as a teacher; but in such a way that it did not act. he W48
Mean of
and here allow mc to remark that one of your Pro-
fessorsguilty. It was said at the trial, that the prisoner gave
s s
Barometer. in this school stands pre-eminent as an ana* the berries for the child to play with,and that he ac- cidentally
9" Ok O
"i #4 m
tomical teacher. In a great measure, the high repu-
tation put them into his mouth. The child wai
of this well-appointed school is supportedillegitimate, and the prisoner his father.
by the long-tried, able,and popular professional The Funds os St. Thomas's Hospital have
" 1
I character of the disgtinguished
allude
gentleman to whom been recentlyincreased by the compulsory sale of
freehold and Maiden-
" 2 2 I your Anatomical Teacher, "Mr. Lane, some property in Queen-street
a H ^ second to none as a publiclecturer ; he com- bines lane for the Cityimprovements.The amount claimed,
with his well-earned professional reputation 2,700/., beingdisputed, legal proceedingswere had in
MEDICAL
an unimpeached and unimpeachable character. the Lord Mayor'sCourt, and the jury awarded 2,300/.
NEWS. With each and all of my I hopeto The City authorities offered 2,000/.
colleagues,
be associated in feelingsof kindly fellowship as Dr. Campbell, the superintendent of the Sanita-
rium
Museum of the Royal College Sur- labourers in the extensive fieldof science and litera- ture; and Dr. Hooker, the naturalist,
of at Darjeeling,
GEOV8." We observe that a valuable and beautiful 1 trust our friendshipmay be matured and the son of Sir William Hooker, while on a scientific
addition has recentl^r been made to the Museum of cemented by reciprocal to the last
the Royal Collegeoi Surgeons,
respect and regardfor those tour in the Himalayas, were, according
consisting of a series attainments which add dignityto our useful profes- sion, received news from India,arrested and imprisoned
of highly-finished, and, apparently, most accurate, and that thus gradually we may unite our efibrts by the Rajah of Sikkim. The reasons for this
ceeding
pro-
models, in wax, of the entire anatomy of the elec- trical to raise the sttmdard of our
generous and noble Pro- fession are not known. There seem to be no tears
ray, and showingthe minute structure of the above the consideration which it obtains in entertained that tlieirlives are in danger,and it is
electrical apparatus in that remarkable fish.A tablet
any other country "
probablethat,ere this statement appears in print,
attached to thpspecimens informs
us, that they are "
Friendship theyhave been set at liberty.Dr. Campbell,it is
"*
Models of the Anatomy of the Torpedo,{Torpedo Gal- Is not a plantof hastygrowth. said,has been treated with the greatest severity.
eomt,) preparedby Professor Calamai. of Florence ; Though nurtured in esteem's best soil ; Sikkim is within the territory of Thibet.
presentedby His Imperial and Royal Highness the The slow and gradualcultureof kind intercourse The Cholera." The latest cholera rerurn for
Grand Duke of to Professor Owen, and by
Tuscany
him to the Royal College of Surgeons. January, Of one
Must bringit to perfection." England givesfour deaths from cholera,and five from
point I am certain that of receiving
"

at your diarrhoea ; for Scotlanil,

"
four from cholera,and none
1850." The models are twelve in number, of the hands a patientand attentive in the
hearing;and permit from diarrhoea. The di"ease evidently lingers
natural size or of parts highlymagnified, each pre-
in a handsome glazed case.
served me to hope,that your candour will overlook all im- country as an endemic,and may soon, if exciting
perfections
The following prevail, become a fearful epidemic.Let
the
: "
causes again
are which have been attached to
descriptions "
That you will giveme heart and give me time, the publiclook to it;theyhave treatedthe Profession
them : Case I. " Male torpedo ; digestive, lating,
circu- Till every string's
"
accordant glee,
"

infamously.
branchial, and electrical organs, in situ." Case Is blended into harmony." Asylum for Idiots." The late Sir Charles
2."" Digestive, renal, and genital organs of the male Advanced onlyin the knowledgeof my Profession by Forbes has left 500/. to this most excellentInstitu-
tion.
torpedo,removed from the body and displayed." the advantages derived from practical experience,
Case 3. **
Male torpedo, subcutaneous muscles, and attentive observation in the treatment of disease, Unwholesome Thirty-eight sheep have
"

Meat. "

mucous tubes, and electricalorgans." Case 4." I am with yourselves a student in the varied incere"t recently been seized in Smiihfield Market,and since
*"
Inner surface of the int^ument,showingthe dis- tribution
connected with professional research. Thus we form
of the mucous
killed. They were suffering at the time from the
tubes." Case 5."" Female one common bond of union in the ambitious pursuits scab or smaiI-pox,and Mr. Nice, veterinarysurgeon,
torpedo, showing the ovaria and impregnated uteri." of our useful calling, remembering the languageof stated that their flesh would be unwholesome as an
Case 6."** Digestive, renal,and genitalorgans, the Cicero : ' Omnes artes, qus ad humanitatem
"
tinent,article of food. The person who sent them to market
per-
habent quasi vinculum commune.' (Much was fined 5/. "

applause.") Dr. Daniell then commenced his lecture Royal Infirmary, Edinburgh." Tjie Annual
"
un Peritonitis," demonstrating the various positions Report of the Infirmary, recentlypresented, shows
 70 THE MEDICAL TIMES.

admitted duringthe past of this Institutionhave been increased by donations if the healthiest and nicest in Paxlt. The hour of vlsittng
that 4006 patientswere
St. Louis and the Hdtel Dieu,eighto'clock.
year; of whom 2466 were cured^391 relieved, ceived to the amount
84 re- of upwardsof 802.
"
tional A Student" asks :"
Two addi- Where in London is there a clxonlat- "

and 518 died in the Hospital.

benefit,
no 282 Queen's College, Birmingham."
Ing medical library, or a reading-room, not attached to aa
patientswere remaining in the Hospital at the date lecture-halls,a library, m odel-room,and two
hospiuir"
of the Report There were 726 cases of fever,and engineering workshops, have been added to the above
B., Minories.""-The idea is borrowed from ValhallB, the
"

132 of cholera; 88 of each complaint terminating College. happinessof which consisted in the inhabitants quaffing
fatally. The income exceeded the expenditure by Burning the Deap. A Society has been draughtsfrom the skulls of their enemies slain in battle.
"

14/. The managers of the Hospital state, that they formed for the purpose of substituting burningthe 2. The cheapest, perhaps,Giessen.
have purchasednear]3r allthe remaining propertiesdead, instead of interments. Such a proceeding*'T. C.**" Some experimentson dia-magnetismlast week in
ofthe house would have the great inconvenience of preventingall
the phenomena very well. London, show
There is no
inSur^ns-square,with the exception of doubt of the connexion l"etween shadow
light and
to the Medical Society
; and tbey purpose of discovering poisoning, if suspicions
belonging possibility electricity, as explained by Faraday. In solutions of the
enlargingthe Surgical which theyconsider
Hospital, should arise at any future time. Under the present
silleates, the experiments, we believe,are best shown.
they will be able to effectwithout encroachingon system, poisonineby arsenic has been detected four- teen *'
H., Navan."" Goal-tar naphtha is the best solvent of gntta
any ]"artof the existingcapital,
as they have received years after death. If incremation be generally percha.
legaciesand other becjuests which, with the surplus adopted, such a discoveryof crime would be utterly Our Leith Correspondentshould pay postage.
oUhe present year,itissupposed will be sufficientto prevented. Graduate,Cambridge." We have not the originalGenilan
*' "

meet the whole of the contemplated expenditure. The Yellow Fever is committinggreat ravages by us. If in town, we are quitesure our obligingfrSiuid,
of Edinburgh, at Antigua in the 54rth Hegiment. The navy has Mr. Stone, at the Collegeof Surgeons, would make out
The lateJames Chalmers, a plumber,
the work; the subject is a very difficult one. Hassal tells
lefl 30,0002. for the sick and hurt
to found a hospital ; hithertoescaped. This diseasehas
nearly ceased at
Schwann, Valentin,and Remak, consider the
us, that both
and it wasproposed,at a meetingof the Town cil,
Coun- Barbadoes. Small-pox has broken out at Granada, corpusclesas ealls; the last-mentioned states,that he
by the Lord Provost,that some portionof this supposed to have been imported from Trinidad. has witnessed their development even within the cells
fund be appropriated to the enlargement of the In-
firmary.
Fever is said to be very prevalentat Port Royal, which line the walls of the blood-vessels. Dr. Barry goes
Jamaica. The Apollo,troop-ship, recentlyarrived further; and the chrystalline lens,the spermatozoon, and
in at the Cape with cholera on board. The bad cases the ovum, he looks on as but modified globules, "oai""
is said to be fearfully
"

Typhus Fever severe

ex ovo."
Vienna. Thirty-two medical men have been attacked were landed at a small island called Rio Grande, " Mr. E. W. *'
Howey, of Bromyard," asks : Can the Editor "

by it where several deaths occurred. At the date of the or any of the readers of the
*
Medical Times' refer me to
Royal College of Surqeons. The follow-
ing "

report the was said to be healthy.There

ship should a Union under the New Poor-law where the medical
gentlemen having undergone the necessary be an a^ to the cause of the attack. I'he
inquiry officers are paid for attendance only,and the medicine
for the admitted from Englaud. supplied from a voluntarily-supported dispensary, by pay-
ing
examinations diploma,
were Apollo came
for each Union
the of the A large party of the patient at the same rate as private
members of the College
at meeting Dr. George Paterson. "

subscribers pay for their tickets ? Or what valid objec- tions

Court of Examiners on the 18th inst.: Messrs. professional "
and personalfriends of this gentleman could be made againstsuch a planV
Samuel Taylor, Bolton,Lancashire ; Peter Am- brose recently gave him a dinner at Archer's Hall,on the " M.K.C.S " shall receive our anxious consideration.
Cotterell,Birmingham : John Langford, occasion of his Edinburgh,to settleat Tiver-
ton,
leaving We^ have received a copy of a letter addressed by P. H.
St Leonards at Sea, Sussex ; James Keiran,Dub- lin; in Devonshire. Dr. Sellers, President of the Holland,Esq.,of 74, Upper Stamford-street,Blackfriars,
in the chair; to the General Board of Health, on street cleantinets.
John Moore Swain, Long Clawson, Lei-
cestershire
Northern Collegeof Pliysicians, was
We quiteagree in the views taken by Mr. Holl tnd as to
; Izaak Dobree De Beauvoir, and Professor Syme, President ofthe
Chipmell, lege
Col- Edinburgh
its importanceas regardsthe publicwelfare and the real
Guernsey; Watson Armorer, Newcastle-upon-
of Surgeons,was the croupier. Dr. Paterson
economy of incurring the expense necessary for its main-
tenance.
Tyne ; James Cleife Lane, Grosmont, Monmouth-
shire; was the to the Collegeof Physicians.
Secretary Mr. Holland has well shown the advantagesand
Charles O'Callaghan, Killarney,
r Kerry
Obituary. After a few days' illness,John
" B. convenience of sweeping by machines, and the necessity
Leonard William Sedgwick,Boroughbridge,York- shire; Abercromby, Esa., Surgeon."On the 24th ult., of of occasionally using water for proper cleansing.
pitals. Dr. Barker, of Dumfries."" Many thanks.
"
and John Lee Jardine, Brixton Hill,Surrey. bronchitis. Dr. ICidd,Inspectorof MilitaryHos-
'"
Dr. SpencerThomson," on Vesicles of Torulaj In Urine,
At the same meetjng of the Court, Mr. George Lately,aged 34, H. G. Harbord, Esq.,sur-
"
geon,
will have earlyinsertion.
Clarke passedhis examination for Naval Surgeon. of Liverpool, one of the members of the
We fear a union medical officer has no redress. He must
Apothecaries' Hall. Names of gentlemen
" who Town-council. bear or resign.
passed theirexamination in the science and practice Professor Giagominx- The Italian journals We quite.agree with "Nimrod*'; at present, however, it
"

of Medicine, and received certificates to practise, announce the death of Professor Giagomini, of would not be desirable lurlher to agitatethe subject. We
collectingevidence.
on Thursday,17th January, 1850 :" Andrew Ha- milton,
Padua, the reformer of Italianmedicine. are
Truth" is advised to tell the truth to any respectahle
*'
dical
me-
Scarborough; John HoUingsworthj Stave- Death of Dr. Clanny. At bis residence, "

doctor.
man, and to avoid a speciality j
ley,Derbyshire; Leonard William Sedgwick, Bo- Bishopwearmouth, on the 10th inst., Wm. Rcid
"An Ass'stant, Portarlington."" Bell's Anatomy, Cooper's
roughbridgejThoniaii Warburton, Benfield,Lei- cester.Clanny,Esq.,M.D., F.R.S.E., M.R.LA., K.C.S.Ll., FirHt Lines, Boyle's Materia Medica, and Reid's Che- mistry.
Physician Extraordinaryto H.R.H. the late Duke
Kino's College Hospital." At the last meet-
ing of Sussex,and upwards of forty-five years Physician "'T. li."" We consider Mr. ChurchiU's Manuals the best
of the Common Council of the City of London, to the Bishopwearmouth Infirmary,inventor of the "' published.
A Chfcuiist and Druggistand a Subscriber."" Certainlynot.
the sum of 200^ was voted towards the fund firstsafetylamp, and an eminent contributor, in
The corrected proof of the second number of Dr. John
now raising for increasing thisvaluable Institution, various branches of to most of the leading
philosophy, Ta} tor's admirable paper on Pericarditis reached us. we
and. at the same meeting,the civic authoritiesgranted publications of the day. regret to say, tob late for insertion in the present Num- ber.
fifty guineasto the Western CityDispensary. Mosblky v. Houghton." This was an action by
Appointments." Dr. John Manley has just been an advertising dentistagainst a widow lady at Leam-ington,
'*
Dr. Joseph Dickson, of St. Heller's,Jersey," has favoured

unanimously elected Physicianto the City Dis- pensary, for 52/. 10s. for two sets of teeth. Credit was us with an interrstingcase of Monstrosity,which we pro- pose
in the vacancy occasioned by the resignation given for sundry payments, reducingthe amount speedilyto lay before our readers.
The engraving illustrative of Mr. Chard's case is not yet
of Dr. Bentley. claimed to 4U 10s. It appearedthat the plaintiff
prepared.
Naval Appointments. Charles D. Steel,
"
(1841),had representatives at Exeter,Tenby, Monmouth, "Mr. Barrow" reports a severe case of nlgidecholera,oe-
Surgeon ; Eustace J. Walsh (1839) and John Cotton, Leamington, Stratford, Coventry,and Warwick, who curlngso late as the Tth of the current month, at South-
Assistant-Surgeons, to the Arethusa,50 gun took casts of the patients' jaws In wax, afterwards port. The report reached us too l:itofor this week's Num- ber.
(1847,)
triffare." Assistanc-Sur^eon H. D. Speer,from the made models of these in plasterof Paris, which were "
Scrutator."" Next week.
Alligator to the Columbine. then sent to London, in order that the sets of teeth " Un We will endeavour obtain the formation.
in-
At the might be prepared. The deliveryof the teeth was
Chirurgien." "
to
Birmingham Lying-in Hospital. "

meeting of the Quarterly Board of this Hospital, proved,and also the reasonableness of the charges. " A Constant Reader." "
We will consider the proposal.
Mr. Haslack sent a chequefor 251.,and the Mayor For the defence,Mr. Rogers,dentist, of Cork-street,We are unable to afford Mr. Loveder the information he n-
10/. 10s.,as Christmas donations to the funds of the stated, that the first set was perfectly useless, because quires. We do not believe in a specific for Cholera.

Institution. when in the mouth, there were intersticesbetween "M.R.C.S."say8, "I always give my opinionopenly and
freely, whether paid or not, and now I will just state my
Disease in California.-" A settlerin San Fran- cisco, the gums and teeth,so that a whistle was produced
opinion regarding the vexatious question, ofthe offices re-munerating
writinghome, says, that the emigrantsare when the defendant attempted to speak ; and, as to the medica] men. I always answer whether
dying at the rate of from seven to ten daily;so cer-
tainly the second set, they projected so much as to produce paid or not, but I think that a line should be drawn.
is thin looked for,that tJtegraves are got ready a hideous appearance. Mr. Hockley, another dentist, When the medical man is employed by the Assurance

beforehand. The peopledie like dogs of dyaeiiiery and stated the mechanical arrangement of the artificial Office as their Medical Examiner, I think it is their duty
to pay him. But when a patient referlthe office to his
fever. The water is thick, white, and very bad; it is teeth was defective. In fact,they were proved to be
medical man as his friend and referee,then I think the
also very dear ; the regular priceis half a dollar per utterlv useless. The plaintiff's own witnesses showed patient or party about to insure is the party to pay ; at the
gallon. The " chills" (thepremonitory symptoms that the second set was made because the firstwas same time, I should never ask it of a friend and patient,
of fever, we presume.) are often fatal in twelve hours. utterly valueless to the unfortunate defendant. The but consider it as a friendly act, which every liberal-
minded would and should do for his friend,because
Warwickshire Prisons." A sweepingmeasure jury,notwithstandingthis evidence,gave a verdict man
I look upon the familymedical man generally to be as good
of reform is contemplatedwith respect to these pri- sons,for the amount claimed.
a friend as any man has."
in the reduction of salaries. Among others,it
A Correspondentat Wednesbnry, writes, " In reference to
is proposedto reduce the salaryot the Surgeon of TO CORRESPONDENTS. Quoso'sCiub question, in a late NumbtT, the ])racticein
tlieHouse of Correction from 1 10/. to 100/. a year. "Enquirer.""!. Books left at our publishers'will be re- viewed. this part of the counlry is 48. per head per annum, if
We do not know the extent of this gentleman's du- ties, 2. Either Hodges and Smith's or Fanoia's; at within a mile of tlie club-house, and 5s. if more ; beyond
but, if we conipare his salarywith those given the latter,be believe, there is an excellent library.3. thrpc miles, Is, per mile oxtra."
have Write to Edinburgh. lu of a misdirection of his letter the part
to parish-surgeons, and the hard work they to consequence on
"
B., Woolwich." Some of the Rhine wines are nearly of the Author, the followingerrata occurred in Mr.
be a doubt but that he is
"

perform, there cannot specific in curing gout. If our invalid Correspondentis Tweed's, jun., paper on Artindal leeches:" The first
greatlyoverpaid, and the others infamouslyunder- paid.
in eatinga piece of a horse or dog, he sentence of the 4 th paragraph should thus: "Each
not over particular run
Need we say, that the latter is our opinion? "ill find the table d' holes, too, all very agreeable. tube or leech is about two Inches and a half long,two-
The salaryof the Surgeon to the Coventry Gaol is The note with the " Maidstone " post-mark is totally thirBs,or nearly so, of which, are covered with leather,
illegible. with a diameter about that of a sixpence." In the 9th
to be reduced from e50/.to 40/. a year,
Warwickshire Lunatic Asylum. Mr. Green,
"
"'
M.D." The catalogue is,perhaps,not without its faults.
"
line,delete the words, " in the first place." lu line 36.
A figureIn one of the galleries ot the British Museum, for "site" read "siae;"in the 2nd column, line 20, lor
of Newhall-street, has been appointed the
surgeon, described as a high militaryofficer, "
bearing the shrine '*
rounded knot" read '" round knob ;" same column, iine
Medical Superintendent of this Asylum. His duties of Osiris,"the eye of an anatomist made 40, road *' Wc introduce;" and in line 45, read.
lately out to be now

commence on the Ist of March. a uegresH.

"
holding it in this positionfirmlywith the iud"x linger
Queen's Hospital, Birmingham." The fundg "
H. G.,Guy's."" The new school just fiaJstaed at Clamor t and thumb of the left hand, we remove," "c.
 THE MEDICAL TIMES. 71

OSISIVAI IBOTirSI" to a pulpystate,and in many instanoeathe walls of examinations in these eases, it has been remarked,
itare so rotten that they easDygiveway before the that the calibreof the oesophagus has been reduce^
finger-naiL and that the mucous membrane of the stomach hai
X."CT(IBS8 Like otheroonosive acids, aqua fortisacts strongly beoome thick and puckered.
ON the blood contained in the vesselsof the digestive With regardto the sutffect
on rf m"ido$eStmd tt#
THS CHEMISTBY OF TH" POISONS; organs, and converts itinto a black pitchy-looking trealtmsiniwhich wm aretoadoptin otues rfpoisoning
compound. Hence itis that you will usually find hjf aquafortis, I have merelyto reiteratethat whiu
OS, ON
numerous dark yasoalar nuaifications upon the I said on a foimer oocasion, whan I was ipeakiii^
PKACTICAL TOXICOLOGY. outer snrfitoe of the stomaeh; and should the mu- of the antidoles to tulphurio add. Your reviediet
cous
SHOVIMO THB 4FFI*IGATI0Nft OF CBBMUTaT VO membrane of this organ have been dissolvedor hehig chalk aad water, magnesia, white of egg,
TKS "I9C0y"RT Of OKIMB. destroyed duringthe lifetimeof the sufiferer, some of flour, or even soap and water,ifnothing betterbe el
BylLLBTHKBY, lf."., Lond: this dark grumoua-looking matter will escape into hand, for the best practice isthe promptest ; ai^ddo
U0"ww "tt Chttiitatiy 1" the lfadl"a GoUef" of tiw iMidoa the cavity of the stomach,and be eithervomited up not, I implore you, ever be rash enoughto incieaae
HotpiUl. or else passed, at a laterperiod, by stooL A portionthe mischief which is already effectedby resorting
of the acid may also escape into the cavity of the to the use of the stomach -pomp. Moreover^a ledge
know-
LECTURE XIIL
abdomen. This may occur eitherby perforation, or of the serious ix^'ury which must necessarilr
ChMdeal eflboti of Nitric Acid on tbo Fluida and TImuos transudation. In the former case the surround- have been done by the chemical effects W the acia
of ihe LlTlng Body" Post-mortem
by ing
appearinco"~Anti- stained of a yellowcolour,upon the coats of the stomach, will suggi st to you
dot.
to the PoiaoD" Methods to be adoptedfor the deteo- parts are generally
tioa of the Add. 1. In the contenta of the stomach. and firmlyagglutinated by means of coagulated the propriety of usingdemulcents to sheathe the
1. In aueh oisanio llqaidias Porter,Yincffar, Urine, to calm the system,and active leech- ing,
lymph; while,in the latter, the acid may merely parts, opiates
Peritoneal fluid,fto. a. In the Tissues of the hody. be necessary, to combat the
4. Udoo articles of clotUng. S. In river and well waters give a slight i rritating character to the peritoneal ifit very firstsigOA
which receive the surfsce drainagefrom largetowna" fluid, and so det up a milder,but, perhaps, more of inflammatory action.
ImporUneo of tUa part of tho inquiryinasanltaiypoint extensive inflammatory action. Lastly, I oughtto
ol^iov.
METHODS TO IIS ADOPTED FOE TH"
state,that ifthe transuded or effusedacid come into DETECTION OE NITSIG ACID IN TBM
Having made oivaelvM acquaintedwith the contact with the bile contained in the gallbladder, TISSUES AND FLUIDS OF THE ANIHAIi
"hemiatryof nitric acid, we will now proceedto itwillooDuuunicate to thisfluida deepgreenish or BODY. ,

applyour knowlec^ to medioo-legal purposes ; and purplish oolour. 1st In^ contents qf fAe Stomaat,-^Hem I mus
the first ^ pointto which I shall direct youratten-
your at Now, althoughthese are the post-mortem ap- tell you, before I proceed
pearances with our experiment^
tkm is: "
commonly presented in a case of rapid that it is not at any time an easy thing to determine
Tbe Chtmical I^ecttqf the Add
upon the Tissues
poisoning by nitric acid,yet theymay, under cer- tain the presence of nitricadd in the matters removed
amd FkUds of the livingAnimal Body, You "
circumstances, assume a differentaspect;in from the alimentary canal ; for not onlymightthe
of which I willquote a case from Mr. Taylor poisonbe neutralized by the antidotes auninis*
have alreadyseen that an acid, whose density is proof :

above 1 100,acts readily on the albuminous tissues, "

"
A man swallowed about two ounces of fortis,tered,
aqua- but it might even be rendered soluble,or
for it instantly and died speedily i^m its effects. On nearlyso, by a combination with albumen, or, what
coagulates, and then more or less
quicklydiscolours 3ie suidEacesof the dead mucous examiningthe body,the lipswere found partlyisworse still, itmightbe decomposedin the course
membranes. Now I hardly need tellyou that itwill yellow and partly of a brownish red colour, dried up of our operation^, hythe saccharine or amylaceous
exert a precisely similaraction if it be permitted to
like parchment Several yellow or parchment-matters with which it is in all such cases associated
flow over the living animal structures. H^je,for coloured spots were observed on the chin as also on These difficulties have been feltby every toxicolo-
the cravat. The' mucous membrane of the mouth gistwho has devoted his attention to tne subject,
instance,are the tongues,gullets, and stomachs of
two individualswho were was white, and easily detached, " that of the tongue and many suggestions have been offeredin the hope
poisonedby strongnitric
acid ; and you that the entire mucous was dry and hard, that of the pharynxand oeso-
"
phagus of overcomingthem ; but, as Professor Christisoa
may perceive
surfaces of these several parts are deeply yellowish green in colour, and of a leathery
says, a pure and delicate pocess"
^ for the detee-
stainedof
a bright citron yellow colour. In one of these cases consistence. The stomach contained a dark-coloured tionof thisadd in organic mixtures,"is stilla de- sideratum
the sufierer, a girl liquid, highly acid. It was externally mottled, of in medico-legal chemistry.*' Guided
aged two years and a half, drank
only about two teaspoonfuls of an acid havinga a greenish- blue and black colour. The mucous however, by certain rules which I have laid dowQ
membrane throughout was softened, and in a gan- grenousforthe examination of matters supposed to contain
densityof 1267 j but, notwithstanding that the
condition. The same appearances were poison, I have determined upon a planof operation
^ecific gravity of the aqua fbrtis was thus low, that
met with, although i n a less degree, in the duo- denum which is founded the processes reconunended
:he child drank freely of diluentsdirectly after it upon
bad swallowed the poison, and that itsurvived the
and upper part of the ilium. On analysis, by Christisonand Orfila.
accident for severaldays, the contents of the stomach yielded nitricacid." The following is an ouUine of it Treat the con- tents
yetthe discolorationof the In this e"ct observed in the
membrane is particularly case the whitening of the stomach,if necessary,with a littie dis-
tilled
mucous well marked. In
pointof fact,it is not an easy thingto get rid of the mouth was doubtless due to the action of a weak water; then neutralise them, or, what i
acid, and the dried,parchment-like appefirance of better still, make them slightly alkaline, with a soi"
yellow stain producedby nitricacid,for it persists
as longas the cuticular surface remains intact
the lips and chin were, in all probability, the result lution of bicarbonate of potash ; a^ply heat to the
; it
even continues to be evident for some time after the
of a drying or desiccationof the corroded surfaces. mixture, so as to raiseit "to the boiling point; then
Lookingat the facts generally, it may be said,that filterit throughfine muslin or coarse paper, and
decompoKition of the part In these'preparations
eflfect of nitricacid is by fhr the most it to drynesain a water-bath. Dremdl
the oolour ha" been preserved for a considerable the yellowing evaporate
periodof time, simply by ixTrimpri^ipg the partsin common, certain,and valuable signof itsaction; the residue with strong alcohol,so as to diei"
weak spirit. and, should you be called on to investigate a case solve out chlorides, sugar, "c. That which f^
of poisoning by aqua fortis, it is your duty to seek mains is to be dissolved in water, filtered, ey"i"
As regards the distance to which tke disoolora-
for this efiisct, not onlyupon the cuticleof the lips, porated, and tested for nitric add in the manner
tion caused by the acid may e:(tend alongthe aH-
mouth,tongue,pharynx,oesophagus, and stomach, aready shown you.
iKcntaryoanal,you may notice,from these cases, but also suiiace of the body,and the grosser im^
that the orange-yeUow tint becomes much upon the general In the course of these operations
paler upon the woollen and silk clothing worn by th^ purities are removed by the firstfiltration, and by
soon after you pass the pyloric end of the stomach,
victim, or by any other partywho may be impli- cated the addition of bicarbonate of potash, saltpetre Is
aiid that it ceases to be evident
beyond the second in the inquiry. formed at the expense of free nitricadd, of the
turn of the duodenum, at which
pointit is very I have already informed you, that this yellowingnitrates of lime, magnesia,albumen,."c.; and*
likely that the alkalinesecretionsfrom the liverand
of the tissue results from the formation of an in- from the circumstance of thissaltbeingalmost ia"
soluble
intestineshad quiteneutralized the corrosive
power compound of nitrous acid with albumen, soluble in pure alcohol, itis separated from suoh
of the acid.
called xanthoproteic acidt and notwithstanding impurities as sugar, chlorides, lactates, "c. ; but,, as
Other eflects, whi"h occasionally resultfrom the that two other substances, that you may employa weaker
viz.,iodine and bromine it is very possible
action of thispoison, are the solutionand
perforationwill producestains which have a somewhat similar spirit in your analysis, a portion of the nitratewill,
of the walls of the stomach. Some aailinritiesstate, and
appearance ; yet, in the two latter cases, the dis- in all probability, be dissolvedby the liquid
that the lattereiiect is not by confidence
any means a cominon colorations are instantly discharged by means of a lost This is the great drawback to our
one ; but, if you examine the smaller of these little it to thM
caustic alkali,(potash or ammonia,) a re-agent in the process ; but, for allthis,I prefer
stfonachs, you will observe that the acid has quite which onlyserves to heighten the colour produced which has been proposedby Professor Christison,
eaten throughthe posterior and inferiorboundary of aoaiysis
by aqua -fortis. who advises us to " macerate the subject
of the organ, making a round hole therein of about The powerfully corrosive nature of this acid ren- ders for a few hours in distilled water,ifit be not akead^^
the siae of a halfpenny.I am quitesure that this ^^ i^ for
it such a destructive agent,that death com- monly liquidenough; and then to a few mi*
perfbratioa took placelongbefore death,inasmuch takes placein a few hours after the poisonnutes, and to filter. Adcertain now, whether the
IS the edgesof the
openingare perfectly smooth ; has gainedaccess to the stomach. There are, how- ever, fluid be acid to Utoius ; and, if itbe so, neutralise
they are, moreover, tinted of a yellowcolour,and several instanceson record in which individuals it with ci"hitionof potash, or, as Orfila suggests^
the fuixounding parte are firmlybound together by have survived for months afterhavingdrank a con- siderable with a solutionof the puier salt, the bicarbonate of
eflhaed and partially organized lymph. Again: in quantity of the acid ; but,in thpi" cases soda. Evaporate gently, to obtain crystals, ifpon"
allcases of rapiddeath from nitricacid, willbe the sufierers have lingeredon, only to die at last sible; and, if these do not tend to the cubical fonn^
you
sure to find abundant evidence of the solutiveaction
from extreme exhaustion,the stomach havingbeen distilthem with snlphuiic acid,and proceed as dJr
of the poison in the softened conditionof the tissues
so deranged by the corrosive action of the liquid, rected for nitricacid simplydiluted. If crystals do
ol the stomach generally; for in such cases the as to be quite unfitted for the proper performance not appear, or theur form tend to the ouhe-^in
muoous surfaoe of this organ is commonly reduced of the functions. On making post-mortem which case chloride of sodium is present, ^redis-
digestive "

No. 540, Vol. XXI.

 72 THE MEDICAL TIMES.
solve the whole reaidue of the evaporation in dis-
tillednever relyon the purityof this substance, so on the upon it,notwithstanding that the sleeve 4ndbody
watei ; add a slight excess of a warm solution other,if the liquid examined contain other poisons, of the coat were found to be covered with ifumerous
of acetate of silver, to throw down organic matter as, for example, lead,silver, mercury, the vegetablespotsof a yellowish brown colour. '

There was no

and the chlorine of chlorides that may be present; alkaloids, prussic acid,oxalic acid,or oilof vitriol^ doubt, says Mr. Taylor,that nitric acid had been
filterand evaporateto dryness, and distilthe resi- duum they will be either absorbed or neutralized by the used,but,failing to discover it,this gentleman con- cluded

with sulphuric acid ; applyas usual to the agentreferredto, and thus placed beyondthe reach that its (Usappearance was due, partlyto its
decomposition in the stu^ and partlyto its vola- tility.
vapour the tests of litmus paper and morphia; also, of further inquiry.
as Orfila proposes the solution of narcotine in phuric
sul- 2. In other organicftuidsy such as Porter,Vinegar ,
Now, as these statements are likely to mis"
acid and protosulphate of iron in water ; Urine,Peritoneal Fluid,S^c, These liquids " are to lead you, I am bound to direct your attention to a
and, ifthe quantity of vapour be greatenough,the be tested with litmus paper, then neutralized with few factswhich have an opposite import.
sense of smell and the action of copper with the con- densed potash,and treated with alcohol and water, in the Here are several pieces of linen and woollen cloth
vapour." manner alreadydescribed. While speaking on this upon which I have spilt acids of various strengths.
The objections which may be raised to the point, I am anxious to remind you of a fact which Tbis was done more than five months ago, and the
preceding are : "
Firstly. That a considerable quan- tity has been announced by Orfila and confirmed by fabricshave been exposed ever since to a free current
of nitric acid must be present in the liquidothers,viz.,that when nitric acid or a nitratehas of air. Some of the woollen stufib are, as you per- ceive,
examined in order to get any evidence of crys- tallizationbeen administered internally, a salt of this acid soon more or less deeplystained of a citron yellow
in the mass of orji^anic matter duced makes its appearance in the urine. It is your duty, colour. These spots are stillvery
pro- acid to Utmos
by the firstevaporation. Secondly, that when therefore, carefully to examine this secretion, and to paper, and exhibit ample proofsof the presence of
nitrate of soda is formed in the liquid, it is very bear in mind that the nitrates do not naturally exist free nitricacid. In the experimentswhich I am
difficult to distinguish the rhombic crystals of this therein. In a case of poisoning by saltpetre, which about to conduct, I shall not make choice of the
substance from the cubes of a soluble chloride. came under my notice a few years since, so much of tissues which are so stained, but I shall placebefore
Thirdly, that ifsuch a chlorideexistin the matters the nitre was eliminated by the kidneys, that the you some small piecesof fiannel and linen cloth
which are subjected to distillation, chlorine,not urine, when dried and heated on filtering paper, which have been touched with a solution consisting
nitric acid,will be the productof the operation. defiagrated. of 10 drops of commercial nitric acid in 1000 of
Fourthly. That saccharine and amylaceouscom- pounds 3. In the Tissues ofthe Stomach,S^c.When "

strong water, a liquid which contains much less than one

will also decomposethe nitricacid,and lead nitricacid has been brought into contact with animal per cent of pure nitricacid. Now, althoughthese
to the formation of oxalic, mucic,carbonic, a nd other it
tissues,forms compounds which are not very soluble fabrics have been exposedto the air for the time
acids. Fifthly. That the addition of a saltof silver in water, cousequentiy you will, in most cases, have mentioned, and are quite dry,being neither stained
to
anj such questionable matter is very objection-
able but littledifficulty in recognising the presence of nor corroded by the poison, yet they still exhibit
in a medico-legal pointof view, inasmuch as the acid in the mucous membrane of the stomach, a faint acid re-action when they are pressedon
it mightinterferewith the discovery of other metallic even when this organ has been emptiedof its con- tents moistened litmus paper. And by taking small
poisons.Sixthly. That the process does not provide and exposed to the action of water or other pieces from these stuffs, a nd testing them in the
for such sources of fallicy as the chlorates, bromates, diluents. Heie, for instance,are portions of sto-
mach, same way as you did the tissuesof the stomach, you
iodates, "c. And, Seventhly.That as the modus intestine, cuticle, w hite of egg, and blood, will have no difficulty whatever in demonstrating the
operemdiis groundedupon the supposition that nitric all of which have been acted on by strong nitric presence of free nitricacid. Here, for instance, is
acid is the onlypoison present, it mightmislead the acid,then washed and dried. The pieces of stomach an acid solution of brucia,and on heatingit with
operator, not onlyby directing him upon a wrong and intestinehave,moreover, been exposed to the air a portion of the fabric, every fibre of the cloth stantly
in-
route,but also by preventing the discovery of other for a period of twenty-three weeks. On examining acquires a deep blood-red colour. Here it
pernicious substances. them you vrill notice tbat theyhave a yellowish brown dischcrges the blue colour of an acid solution of
Mr, Taylor's process is barbarous in the extreme. colour, and that theyare stillslightly acid to moist-
ened indigo, and here againit evolves vapours which act
He advises us to filterthe liquid, and then to litmus paper. To prove that this acid is nitric upon iodized paper. All these experimentsclearly
neutralize it,if necessary, with liquor potassae, after you are to make a mixture of equalparts of pure show you that there must have been some monstrous
which it is to be boiled for two hours,wi^h a large oil of vitriol and water. Put twenty dropsof this source of failurein the case of the coat justreferred
quantityof well-washed animal charcoal. TMs mixture into each of four test tubes. To the first,to ; in fact,if we may judgefrom the following servations,
ob-
being accomplished, it is to be againfiltered, centrated,add a littlebrucia,strychnia,
con- or morphia, and then we may conclude that there was a great
and tested for nitricacid. " The crystals a small pieceof the acid tissue; ifnecessary, apply want of dexterity in the operator. " I have been
obtained,"says Mr. Taylor, "
may be coloured and heat,and you will instantly obtain the characteristic able,"says Mr. Taylor, "
to procure certain evidence
impure; but,"continues our author," thiscircum- stance blood red colour to which I have before alluded. of tliepresence of nitric acid in stains on black cloth,
does not at all inter/ere with the action of the Colour the liquid in the second testtube with a small a fortnight after the liquid had been spilled. The
most importanttest for nitric acid,viz.,that by quantityof sulphateof indigo, then introduce a quantity of acid presentwas, however, so small,that,
copper filings and sulphuric acid." Now, it is fragmentof the tissue, and if the blue colour is not on adding to the filtered liquid gold-leaf and muriatic
veally worth while to take " portion of some common instantly dischargedapply heat Into the third acid,and boiling, there was no apparent solutionof
alimentary liquid, such as broth or beef-tea, and, portion of dilute acid,drop a grainor so of copper the metal, nor, on tryinganodier portionwith
having mixed it witlia little sugar and common salt,filings, and then a pieceof the tissue. On making sulphate of indigo, was the colour discharged. A
so as to simulate the contents of a stomach,to neutralizedby
charge the liquidboil,you will find that the evolved va- pour third portion of the acid liquid was
it with fifteen or twenty drops of fortis, and has the of giving blue colour to carbonate of potash, and evaporated, when crystals
aqua power a a
then to treat it in the manner recommended by Mr. pieceof paper moistened with starch and iodide of of nitre (amounting to about a grain) vrerc obtained.
Taylor, in order to judseof the utter insufficiency potassium. These rapidly gave, with copper filiugs and sulphuric
of his process. You wiU doubtless find that much The liquid contained in the fourth tube is to be acid,the character of a nitrate. There was but a
colouring matter is removed during the prolonged treated in the same way as the last, and by using thin slip of cloth used in the experiment."In all,
ebullitionof the fluid, but you will also find that the a larger poTtion of the acid tissue you will have no therefore, Mr. Taylormust have procuredabout
animal charcoal has not the power of absorbing in producinga deep olive brown colour three grainsof nitre from this "thin slip of cloth,"
any difficulty
of the more objectionable constituentsof the liquid, with a solution of protosulphate of iron,and thus to and yet he failedin getting more than one test for
as, for example, the sugar, Ae proteine, the common to demonstrate the presence of freenitricacid. the nitric acid to act With such a fact as thisbe- fore
salt,"c. ; and, consequently, when you proceed to It may happen,however, that the tissuehas quite you, I trust that you will never think of resorN
filterthe dirty-looking mixture,the impurities will lost its power of reddening litmus,the excess of ingto the gold-leaf test,and that you will be espe- cially
clogthe pores of the paper, and defyall your eflbrts acid havingbeen entirely removed by the antidotes careful not to performthe indigoexperiment
to eflfect a hasty percolation. Wait, however, for a administered. In such a case, you are to search for in a bunglingor slovenly manner.

day or two, and you may be fortunate enoughto that portionof the poisonwhich is more firmly To go stillfurther with this inquiry,I now
obtain a few drachms of the filteredliquid.This fixedin the tissue. Heat the substance,therefore,placebefore
you portions of gun-cotton and of
you are to concentrate by evaporation, when, much with itsown bulk of liquor potasss,by which means woollen cloth which had been stainedby nitricacid.
to your astonishment, the residue will look as brown the organic compound will be broken up and dis- solved. Both these substances have been well washed, and
as ifithad never been clarified ; in fact, to use Mr. If nitricacid be present, the liquor acquirestheydo not at juv^oentexhibit the leastsignof acidity,
Taylor's expression, "'the crystals will be coloured a deep brown colour ; and, on acidifying it with for the/ neither redden litmus,nor do theystain the
and impure;" and on treatmgthem with vitriolic solution of brucia. The acid, however, is
copper strongoil of vitriol, and then testing it in the way
filings them
and sulphuric acid,you will discover that, justmentioned,you will obtain the desired proofsstillresident in these tissues ; for by dissolving
instead of obtaining the red vapours of nitrous acid, respecting the presence of the poison. in a littleliquorpotasss,you will observe the dis- colouration
the test-tub" will be filledwith the yellowish-green4. In detecting the Acid on Clothing, you are to of the fiuid, a nd on testing itin the ner
man-
fumes of chlorine, showing that "
this circumstance," rely, f irst,on the appearance of the fabric ; for, as I already described, you will get indisputable proofs
the presence of an iwipurity (common salt)does have already shown you, aqua fortishas the power of of the presence of the poison.So that,on review- ing
tHterferef and that very maiovially, with the action reddening and then discharging most vegetable co-
lours, the facta which I have justplaced before you,
of Mr. Taylor's most importanv
"
to"t" In fine, and of givihga yellowor brownish tint to you will, I think,hesitatein admitting, thatthiscor- rosive
the process is not worthy of a more prolon)(oa mination. most
exa- animal tissues. It is commonly stated that acid is rapidly evolved from or decomposed
It is enoughfor you to know, that it is "ihic acid,from its beinga volatile liquid, pidly by the tissue upon which it has fallen,
is ra- and you will
defective in principle, and tiiatits results are fal- lacious evolved fipom those partsof the dress on which scarcely venture to conclude,with Mr. Taylor,
and uncertain. Besides which, I ought to It has fallen. One medico-legal author tellsus that either that the deeply-stained portions of the mucous
tellyou that the emplo3rment of animal charcoal in he was unable to recognise the presence of nitric membrane of the stomach commonly yield but very
acid on a blue stuff* sent to him for fainttraces of the acid,or that,should the watwr
in
any chemico-legal research is exceedingly jectionable;
ob- coat, which was
for,while on the one hand you can examination fiveweeks afterthe acid had been BpUt which the yellow , spotshare been steeped^ acquire no
 74 THE MEDICAL TIMES.
CLASS II. and rheumatism, unchecked
This classcomprises 17 cases^ allfataL
by ptyalism,and liverand spleen; anemia. It is possible that the
pleuritis
of one side,and pneumoniaof both lungs pericarditis have existed 8 weeks without treat-
may ment
Of these, salivationwas produceddnrii^ supervenedwhilst the mouth was sore. before admission.
theperiearditisiii(27"
21, 22) 2 Case 6." Treatment beganfourth day.
Salivatioiiwas producedand maintained Mereury, Case 20." Treatment beganfinilthday.Friction-
eleventh day. Gums sore seventeenth
lbr" mokith,bnt had been omitted for a day.Copious sound ceased on eighteenth day. Cidomel giv"B
non" before the pericarditis
blood-letting.
Friction-sound continued 32 days. during 19 days; but without affhctitig the guma.
appeared Disease, however, appeared to abate about seven-
in(No.24.) ..r.VT.,. teenth Complications: Pneumonia fhim the commence-
ment
1 day,atad an increase of serous efiusioninto ; endocarditisftom the fourteenth day.
Mere"7 was ^v"n, but no salivation pre* periciatdium 8 or 9 days after this. No compli- cation. Case 28. Treatment beganfourth day after tod-
duoed in i;25"
"

26, 28,29,82) 6
We meivaxywas given, misfion. Gums sore on eighthday after. Pbri-
or other treatment Case 7." Pericarditis very slight and partial. terditistniiyhav^ been presentftmn the first; bat
Mliiptedua(S0,ll,d5,"6,df,88""8, 40) " Patient died on second day of another disease. frietion-sound
appearedonly the day before the
Mercurygiven every nightfor ten daysbefore gLims were sore, and continued for 19 daysafter.
pericarditis came " then (miitted. Two days after Complications : Phthisis ; double pleurisy sipelas
ery-
Thns, ikrie onfyof tiiepatients faeim% daw were the omission pericarditis
;
salitated duringthe appeared^No mercury of the fkce ; pleurisv supervened8 days,
progress irfthe disease^ imd givenafter. Gums not afifected. and erysipelas 80 daysafter the gums became sore.
"tghtonlytook mercury. It deserves to be remaiked, Cam 8." Treatment first
that allIhe patients in thisclass died^
day. Gums sore second
and that only day.Earlyand firee Duration of disease CLASS It.
one half of them took bleeding.
mercnxy$ whereaa,amontp four days,lliiswas believed to be a case of Case 21. Pericarditissuspendedfrom second or
the patiMitB in "e firstclass, the mortality
carditis
peri- "

wm ; but,as the physical signs were absent, the third day, (and before mercury was giv^i,) to twenty-
"maH and theyall took mewmiy. We have had diagnosis is uncertain. It may have been only in- sixth or twenty-seventh
occasi^ to make the same obwrvation inspecting
tercostal day,or 10 days aftertlie
rheumatism. Ko complication. gums had become sore. The peHcuditis then con-
tinued
the eanptoynent of bloodletting in th" two classes Case 0. ^Treatmenton
"
admission. Mouth sore 15 days longer, calomel beinggivenduring
(l^85)"and the remark already made fespectinirfhe on fifteenth day. Free bleeding. Friction-sound ^e last 12 or IS of these dHys. Complicationa:
^"^^L^ eqmdly^plicableto the oAerTvi*., SiminUked in 6 days, and ceased in 9 days- after Fneumonia appeared 12 daysaftermonth sore, and
that the differencein the
moitality is not due to the ptyalism,Ko
inflammatory complications. contmued for several weeks; pleuritis came on 20
3ise"* omission of any remedy,but to the diierence Case 10." Treatment begansecond
in Ae iRMm of the disease. day. Disease days aftermouth sore, and whilst calomel was being
almost suspended during8 daysimmediatelyafter givenagain.
^^^n i?". ""? "** *^*^ ** *11"
two ("",gf ) m which there is the
*^"e are only dupping on the second day. Salivation
began On Case 22, " Peribaiditu on admission) Mercury
smallest btnbi- seventh and continued until givensame day. Gums sore on fifthday. Morbid
bih^ tlMitany treatment eeuld have led to a more twenty-first day. Fric-
tion-sound
continued 4 days after salivation sound (probably firietioh-souttd) continued, and was
fMnsnraWe result: and among the cases in which peared,
ap-
and 11 days in all. Endecavditis present28 days after, it is not mentioned later
vened
super-
memry WM givenbnt no salivationpreduced,there on eleventh day, the mouth bdng very sore at Ptotientdied62 days after this,(t."., 75 daysafter
is "nly one (88)in which m
can'snppese that the the time. mouth sore).Bloodyaenun in pericardium. Heart
earlier and freer administration of this remedv
^ Cms ll.-^alitated fforacute rheumatism. Three soft.Complications: Bronchitis{ convulsions;dis- eased
could ha^ tod to a fhvoui"ble issue. days after salivation, the mouth beingstillvery kidneys.
^. ^ci qfllfercury(he Dttraium of sore, pericarditis appeared, and continued for 18 Case 24." Mouth kept sore fbr a month, " from
t^s"n
PerieartUHt. days. Venesection toll daysbefore the perica^tis. September27, to October 25. Mercurytiienomitted.
We have not the meani Complication: Some endocarditis. Koyeml"er 28, (t. e., a month after,) pericarditis and
of comparing the
duation of cases tteatedwith and without Case 12." Treatment first day. Giims tender t)leuritis of leftside appeared.Death followed after
mereurv ; third day. Friction-sound
afteraj^Iica- days.6 No bleedings mercury, mr special treatment
tiM onl^ wuv, therefore^ bywluoh we can attemptto tion of leeches on the firstsuspended
determine the influence of this
remedy,is by com- day; returned "ine days for these affections. Hie patient died of other and
After gums sore, and continued 5 days afterits more urgent diseases^
as in the ease of
l^fmg"
of the oases in which the
bloodletting, the duration
return. An attack of pneumonia, and an increase C"tse.85. Admitted with pericarditis
"
and double
remedy was employed of the rheumatism Died on thirddayafter. Mereutygiv"n.
early, with that of Uioie in whidi its appearedsimultaneously witli pleuritis.
use was de- the return of Gums
feired unto a latorperiodof the disease. pericarditis, and whilst the gums w"re not afiected.
The questionof the stillaffected. Case 26. Admitted witii pericarditia,
"
Died on
utility of mercuiy in inflam-
Case 18." T^atment second dayafter ftom coma.
mataon of the pericatdinm, and other serous mem-
on second day. Gums sore Mercury given.Guma
branes, sixteenth day. Friction-sound diminished the hot afifected.
n OM of mek impertanee^
on
Complications: Emphysema, leftside ;
and upon which
such decided TOiiniotts day aftergums became sore, but did not cease till hsematemesis; ulceration of colon f gangrene of
are entertained by the most
re^eetoblephysicians, Aat itseems to me desirable
five days after. Complications:
Anaemia,bron- chitis lungs ; Bright^s disease.
to give a bnef outline ef the facU of each acuta, pneumonia^ Case 27. PericarditisprebaUy existed on
" ad*
case, so CtMtf 14. Treatment first mission. If it continued 80 days,and was then
to as
th^ bear upon tiieuse of this remedy, in tenth
"
on day* Salivated on so,
order to furnish every one with the
means of testinffafter
day. Friction-sound graduallydiminished cured,although the patient died of other diseases.
tte ftctioncyof the conclusions to be salivation, and ceased 6 days after,having Mercurygivenon admission. Moutii sore in 4 daya.
drawn from continued
them. The preparation used,in almost everv case, ditis
for 16 days. ComplicationsEndocar- : Mercurygivenagainon !K2nd,and mouth sore on
wte cidonMl. supervened 4 days after the moutii became 25th day. Friction-Mund less in 21, aad ceased in
sore; pneumonia; ansemia. 26 daysafterfirstptyalism ; or it became less on the
CLASS I.
Case 15. Treatment beganfirst
"

day. Salivation same day,and ceased on 5th day after tiiesecond

.^ JrrTreatment
wmj in 24 hours.
begah the fint day. Ikfonthon second day. Friction-sound
suspendedduring ptyalism.Complications c Erysipelas of face and
Bleeding also femployed.Death 3 daysfrom the firstday. It returned with more laryngitis, or oBdema of the glottis, appearedafter
m f8 houfs. Pericardium
everywhereadherent intensity 3 daysafterthe mouth had become sore. two salivations,vis., days
"
8 after the second,and
exceptat apex. Pleuro-pneumonia of leftside. Friction-soundcontinued 8 days after its second, 18 daysafter the first; pneumonia; pleuritis ; soft^
flAuT^^J^.'^"^^
fifthday. Pnction-sound
^^ admission.Mouth
sore on and 18 days after its firstappearance. Complica- tions eningof the brain with heemorrhage ; Bright's ease.
dis-
ceased 2 daysbefbre, and Endocarditis
death dccuired 2 days s ; pneumonia ; rheumatism.
and earlybleedingi
after, ptyalisi. Very ftee The two laAtdiseases both increased afterthe gums Case 88. " Admitted with pericarditis, of uncertain
Universal adhesSoils of peri-
cardium. not afiected.
were afiected, and the rheumatism continued 40 duration. Mercury given. Gums
Comj"lications.
the first Pleuntis
Sevete endocarditisfrom
daysafter. Died on 4th day*Complications : Double pleuritis ;
appeared2 daysbefore ptyaUsm, C""16. pharyngitis V. S. cokUs ; necrosis of
and w^s fbnnd r j *
"

Mereurygiven8 daysbefore, and gums ; hypertrophy

toearly cured. became sore 11 days after pericarditis tibia ; abscess in antrum maxillare.
Oste8.--2"eatmentfirstday. Gums appeared.
sore in 24 Friction-sound ceased about the time the gums be- came Case 29." Admitted vrithpwicarditis and double
hours. Very free
bleeding. Friction-soundrfi- tender ; but it had been gradually decliningpleuritis, of uncertain duration," perhaps2 weeks.
mmsfud an the eveningof the fourth
day, and for several days before. Total duration, 11 or 12 Died on thirdday. Mereury given. Month never
ceased on
tendtoh
the tenth, i, e., nine
No complication*
days after^^s days. The case was a mild one. sore.

Case 17. Treatment beganfirstday. Salivation

" Case 82." Admitted on 5th day of illness, with
wl!?*litrP*f**"i*.*^*'*^^ Oums sore early. on third day.Six daysafter salivationfriction-sound acute pericarditis and severe double pleuro-pneu-
monia.
l^iittT}^' , P^**P" convalescent L louder than at any other time,and signsof serous
^^^"* Died fifth day after admission. Calomel
S^?l!?J*^ **^ ^^^ *" 70 or 80 ; but effusion stillin
pericardium.Friction-sound and givenevery few hours. Gums never afiected.Peri- cardium
ffli^toott-sonnd cmibmted to hrenty^second
fourth day sAat is, about 8
or twenty, rheumatism both continued 18 daysaftergums were filledwith serum. Soft pulsemembranes.
weeks afterptyallsm tender. Cases 83 and 34. No history.
appeared.No eOmpUcations. 8ev"Y* pleure-pneu- Case 18. ^Treatment
Complications : Roseola ; endocarditis.
"

"
began ninth day. Gums In the following cases, no treatment whatever waa
moni^ however, supervened, as the pericarditis for the pericarditis, the disease not having
ceased,
sore on nineteenth day. Friction-sound ceased 2 adopted
^ted by l)leeding, mercury, end tartar daysbefore gums sore. Case mild. Four ounces been discovered duringlife: "

emetic. On fifth day nearly

gone. No second of blood onlytaken. Cases 80, 31, 35,36,37,38, 39, 40." In none of
ptyalism. Case 19. Treatment beganon admission. Gums
" these cases, unless it be in case 35,and perhaps 37,
Cate 5." Treatment on eighth
2 daysafter. Very
day. Gums sore sorem 11 days. Death 2 dayslater. Pericarditis is it probable that any treatment would have afiected
copious blood-letting. Priction-intense. Copiouseffusion of bloody and the result.
sound contmued 22 days, serum,
and in a trifling degree60 thick false membranes. ComplicationsEndocar-
: ditis Case 38. " Patient admitted for empyema, which
days,after gums tender. CompUcations: Pleuritis ac Pleuritis; lobular pneumonia; enlargedcontinued until his death, 9 months after. Peri-
 THE MEDICAL TIMES. /;"

1. Salivation was not followed by any speedy and reading is, probably, " not very different in
carditissupervened perhaps12 weeks before death. France and in this country, althoughthe active
Was treated in commencement of illnessfor pleu- abatement of pericarditis, in 16 cases: "

15, treatment of the French consists of bloodletting

ritis, by bleeding and salivation. Copious effusion Class I." Cases 1,2, 3, 4, 5, 6, 9, 10, 11, 12,
and does not include the use of mercury ;
of bloody serum, and very thick,rough,falsemem-branes 17,23. chiefly,
whereas in England we almost always use both
found in pericardium. "
II." Cases 21, 22, 27.
2. Salivationw"sfolhwed bypericarditis in 5 cases these remedies.
The following tabular analysis of the above cases that the friction-
Ist Clas8.^Cases 11, 12, 23. It may be objected by some,
shows the duration of the cases of pericarditis responding
cor-
sound is not a goodtest of the duration of the dis- ease^
2nd Class." Cases 24, 27.
to the day of the disease on which mer-cury
that the lymph thrown out may continue to
3. Salivation was followed by an increase in the "

was firstgiven: "

the sound, long after the inflammation ducing

pro-
extent and intensity of the in 3
pericarditis cases. generate
Day on which Averaffe du- Class I. Cases 15, 17. Class II. Case 21. it has ceased. To this t would reply: "

Mercury ration No.o! before the 1. That the commencement of the disease has not
4. Friction-sound ceased two days
was given. of the cases. but by the occur-
mouth became sore, in 2 cases : Case 18, which, been fixed by this sound alone,
case. rence
Days.
l8t I5k 9 (case 8 is excluded) perhaps, ran the same course as ifnot treated at all;
of pain and other symptoms, and physical
2nd 15 Case 2, the patient died two daysafter the mouth signsas well. 2. 1 believe that no better general
4th 18 1 and four after the cessation of of the termination of the inflammation, than
sign
became sore, days
5th 24 (or 60) 1 friction-sound,from adhesions. the cessation of the riibbing sound,can, probably,
10th 17 1 be found. In a great proportion of the cases, end-
ing
5. Salivation was followed by a speedydiminution
11th 17 (or32) 1 13 and 14. It favourably, this sound will be found to cease,
of the friction-soundin two cases "

Again. The cases in which

mercury was given did not cease, however, in less than fiveand six days from the formation of adhesions,quiteas soon as

within the first four days (12 in number,) had an more, nor until it had run its ftiU ordinarycourse, the inflammation ceases, and sometimes, probably,
average duration of about 15 J days.Those in which twenty-oneand
viz., sixteen days. sooner. (SeeCase 2.) In a few exceptional cases,

this remedy givenlater,

was (4 in number,) had an 6. The pericarditisceased soon after salivation, the sound is,probably, prolongedbeyond the term
the disease of existence of the inflammation ; but these casea
average duration of 20^ days. in 2 cases (16,8). In one of these (16),
The followingTable willshow the duration of the was mild,the friction-sound had been declining for have begn allowed for,and considered as terminat- ing
several dajrsbefore the gums were affected, and its when the pain, fever,and disturbed action of the
cases, coriesponding to the day on which salivation
the inflamma-
tion
occurred. duration was not less than eleven or twelve days.In heart have subsided. 3. The sooner
is arrested,the less will be the amount of lymph
the other (8),it is not certain whether the disease
rheumatism. thrown out, the sooner will it be re-absorbed, or
was or onlyintercostal
pericarditis,
adhesions, and,therefore, the sooner will the
7. Mercury was given^ but no salivatioii
was duced, lead to
pro-
sound cease. Whether, therefore, the cessation of
in 7 cases
: "

1. It was otnittedtwo daysbefore the pericAr- the morbid sound be a sure test of the actual cessa-
tion

of the inflammation, in any individual case or

carditisappeared, (Casie
7).
2. Salivation could not be produced, and yet not, it will, at least,be a fair test of the relative
of duration of the inflammation, among the
the case went on favourably.Merfcuryperiod
days,(Case20).
for nineteen individuals, in a series of cases.
given
fatal before salivation (To be continued.)
pericarditis was 3. The
occurred. (2nd Class." Cases 25, 26,28,
29, 82.) Of CONGENITAL MALPOSITION
CASE
Or, those salivated within the firstfour days,(7 in 8. No mercury was given,nor bther treatment OF THE VISCERA.
number,) had an average duration of l5 5-7th days. adopted, in 8 cases. (ClassII. Cases 30, 31, 35, fe.I".CHaRD, E"|.
By OCTAVIUS
Those salivated later,(8 in number,)had an average 86, 37, 38, 39, 40.)
The following cases exhibit the occurrence of
duration of 17 j days.
various internal inflammations,in the course of
If we estimate the ef"cts of mercury in the same
pericarditis, and (^erthe production of salivation;
way as those of bloodletting, the remedy will ap
and theydeserve to be recorded as materials to aid
pear, at firstsight,to have been very beneficial, asmuch
in-
us in determiningthe effects of mercury: "

as the duration of the disease was lessby

Endocarditis supervenedafter the occurrence of
five dayswhen mercury was given within the first
salivation. Case 5, 21 days after ; Case 10, 4 days
four days,than when it was givenat a later period.
the
after, mouthbeing still sore; Case 14, 4 days
But there is
one source and
of fallacy of dimculty after, mouth
the beingstillsore.
to be keptin mind, namely,that all the patients
Pleuro-pneumoniasupervened after salivation.
who took inercury were likewise bled,and, m every clined
de-
Case 4, 8 Weeks after,and as the pericarditis
instance but two, (Cases6 and 15,)the two dies
reme-
; Case 5, whilst the mouth was sore ; Case
were first employedon the same day. It is,
12, 9 daysafter, the gums beingstillsore ; Case 21,
very difficultto
therefore, determine to which medy
re-
12 days after, and continued for several weeks.
the benefitobserved was due, or whether
to
Pneumonia increased after salivation. Case 15,
both,and in what proportion to each. Without
tempting
at-
on 13th day after.
to decide the question, one or two argu-
ments Pleuritis followed after salivation. Case 23,
may be mentioned, which would seem rather
double pleuritis came on 8 daysafter mouth sore ;
to favour the view,that the benefit was more due to
Case 24, one month after;Case 21, 3 weeks after
bloodletting than to mercury.
salivation, and duringa second course of mercury.
1. If the benefitwere due to the mercury chiefly, Pleuritis continued unabated after salivation.
and if aaitvoHon be essential to the full efiectof Cases 5 and 38.
mercury, then the duration of the cases should be
Erysipelas followed salivation. Case 23, 30 days
shorter in proportion salivatum occurred earlier. after Case 18 days after
as
; 27, after two salivations,
Now this is not the fact ; for those salivatedwithin the first, and 8 days after the second.
the firstfour days had an average duration onlytwo
Rheumatism continued long after salivation.
daysless than that of those salivatedlater; whereas Case 5, continued 4 daysafter; Case 15,continued
those to whom mercury was simplygivenwithin the 40 daysafter; Case 16, continued at least 11 days
first four days,(without regarding the periodof
after;Case 17,continued 13 daysafter.
salivation,) had an average duration lesshy fivedays Rheumatism ceased about the time the gums came
be-
than those who took it later. The bloodletting sore. Cases 11,12, 14.
coincided with the first administration of mercury, Rheumatism was increased after salivation. Case
but not with the firstappearance of salivation; and
12, whilst the gums were afffected;Case 15.
the result juststatedis justwhat mightbe expected, In the mass of these cases, the pericarditis seems
on the supposition that the benefitwas chiefly due to
to have run its course justas we may suppose it
the bleeding.This,imperfect it may be, seems
as
would have done if no mercury had been given.In- flammation
1. Bladder. 4. Heart.
to be the onlymethod we possess of separating the of the pericardium, endocardium,pleura,2. Descending Colon and 5. Thymus Giand.
eftcts of the one remedy from those of the other. when the Rectum. 6. Bight Lung.
and lungs often supervened system was
2. If the production of salivationhad anythingunder the fullinfluence of mercury, and then lan 8. Liver. 7. Intestines.
like the marked influencein arresting inflammation, their ordinary course. When the friction-sound On recently examiningthe body of a new-bom
and in promoting the removal of its products, which diminished or ceased soon after salivation, it was female child, I was surprised to find that the
it is currently believed to possess, the duration of onlywhen, from the previous duration of the dis- ease, abdominal cavity contained onlya small portion of
the cases of pericarditis after salivation ought to it must have been approaching its usual term the intestinalcanal. The liver occupied its usual
have been much less than it really was. This state-
ment of existence. Pericarditis has been proved,by position, as well as the stomach and duodenum,
can onlybe appreciated aftera carefulperusalLouis and others,to terminate favourably, in many but at the point where the latter terminates in the
of the details of the cases. The generalresults cases, without any treatment; and the course of the jejunum,the intestinaltube passeddirectly into the

may be classifiedas follows: "

disease if I may judgefrom my own observation kleftside of the thorax,by an apertureat the posterior
"
 76 THE MEDICAL TIMES.
partof the diaphragm,there formed the largeand the wounded alike of Gorgey's army and those of jeopardy, or maiming or killing those in attendance
small intestines,and,emergingby the same opening,the Austrians and Russians were diately on the wounded
received imme- ; or perhapsthe chosen house was

descended to the rectum. On exposing the cavity after the battles,I had the opportunity of burned with rockets while the wounds were being
of the thorax,the pericardium and its contents were seeing and attending a greatnumber of cases, which dressed,as in the engagements of Czoma, Thar, "c.
observed to be more to the rightthan interest to warrant
usual,the appear to me to possess sufficient At Morr one of our surgeons was killed,and another
displaced bowels being situated on its left side. their publication. received five deep wounds on the scalp.Not un- frequently

The leftlung was about the size of a walnut,and The frequentbattles at Schwechat, Presburg, the surgeons were killed in the decuste
lay in contact with the intestines, the latterhaving Altenburg, Raab, Comorn, Morr, Czoma, Thaz, of the battle,wearingthe same uniform as the
no special sac inclosing them. The right lung was Teth, Szolnok, Tisrafiired, Koresd, Kapolna, officersof the regiment in which theyserved.
small, and, of course, much compressedby the Pesth, Waitzen, and many other places, gave us The wounded were carried away immediately
encroachment of the heart and mediastinum. opportunities for observation and for obtaining aftera battle to the placechosen for their reception
perience,
ex-

The child was well formed externally. It gave a which merely civil life does not supply.on sheets, paillases, or on wagons filled with
peculiar shrillcry at its birth, breathed with a slightIt was frequently the case, that in one and the same straw, their wounds dressed,theywere afterwards
noise, and survived twenty hours. battle, all kinds of wounds were received. On the conveyel on the wagons to the hospital of the
The above sketch will convey some idea of the 3rd of August, 1849,^at Snzomy, near Komorn, nearest town or village. Their number so frequently

appearance of the displaced parts. General Klapka made a sortie from the fortress. A exceeded our worst anticipations, that we had not
The species of congenital malformation, of which simultaneous attack of 5,000 men of the centre sufficientcarriages at our disposal, and hence we had
an exampleis here given, is,I believe, not common; took place, led on by Klapka,while the wings, 2000 to leave several suffererson the field. It sometimes
still,there are various detached cases to be found re- corded strong,advanced at Georgey's command against the happened, as after the battle at Thauy,that some of
in periodical and other medical works. I Austrians and Russians. Besides those killed of our hussars would come in on horseback without a
have had an opportunity of perusing the descriptions the Russian and Austrian troops,which amounted hand, a shoulder,or a leg; and not unfrequently the
of three such cases viz.,one by Dr. Montgomery, to 2500, we had 735 wounded, and among these wounded
" would have to walk several miles,many of
in his article on the Abnormal Conditions of the were to be seen incised, punctured, lacerated, con-
tused, them havinghad operations performedupon them.
Foetus,in the "
Cyclopaedia of Anatomy and common pistol, and gun-shot wounds, as well At the above-mentioned place, for instance, we had
Physiology," and two of earlierdate by Dr. George as luxations and fractures. Before making fur- ther 65 men wounded, out of which number 1 1 under- went
Macaulay, in the firstvolume of the "Medical mention of these and their treatment as amputation, and immediately afterit performed
Observations and Inquiries." well as the various amputations, dislocations, and an eighthour journey.
The instance givenby Dr. Montgomery agrees trepannings, and the diseaseswhich occurred in the At the hospital of Passa,we had, in all,273 in- mates;
in most pointswith the one I have related. The Hungarian army, I would sketch some of those of these,183 were wounded, and 54 weie
abnormal opening of the diaphragmwas on the left circumstances in which the surgeon and the wounded interns, besides 36 Austrians,whom I leftthere.
aide,the displaced bowels lay in the left cavityof were placed, from the openinguntil the end of the Of this number of public-houses, as weU as empty
the pleura, and the leftlungwas smaller than half war.
"
buildings, were occupied for this purpose. It occa-
sionally
the kernel of an almond," and solid in texture. Politicalcircumstances, with which the reader is happened, that in consequence of military
The stomach,liver, and spleen, were in theirnatural familiar, havingrendered necessary the raising and disposition, tiiosewho were but slightly wounded,
situation. The preparation, which belongedto Dr. calling out of an Hungarianarmy, twelve battalions would be first attended to with care ; while others,
E. W. Murphy,is now in the Museum of University were fbrmed, each numbering12,000 men. These whose cases were of more importance, could scarcely
College, London. (called Honveds) were obtained by enlisting all secure any assistance.
In one of the cases described by Dr. Macaulay, able-bodied men from 19 to 25 years of age. Each In October, 1848, I attended our wounded
the displaced viscerawere alsolodgedin the leftaide battalionhad two surgeons. The regular regimentsmen in an empty house, where not even straw
of the thorax. They consisted of the stomach and and Hxe Austrian battalions which were then in could be obtained;while,at the same time,of those
the greater part of the intestinalcanal, with the Hungary,as well as those ordered there from Aus- tria, who were sufiering from trivial injuries, 11 un-
derwent

spleenand part of the pancreas; the duodenum were providedwith skilful and experienced amputation;114 had received gun-shot
dippedback into the abdomen to receive the biliary surgeons. wounds; 15 contusions;and 43 incised wounds
duct,but the intestine speedily returned into the The war may be said to have commenced in the and lacerated. I had here greatdifficulty in ob-
taining
thorax, with one end ofthe pancreas. The jejunum, month of May, 1848. From the largenumber of a sufficient number of weapons. Those who
ilium,caecum, and greaterpartof the colon,lay in wounded continually requiring attention, we were could,therefore, walked, and others crawled a dis- tance
the pleura ; the rest of the greatintestinepassing, obliged to avail ourselves of the services of surgeons of four miles to the nearest village, where
with two or three turns, down to the anus. in civillifein the hospitals. In October,1848, the carriages could be procured.When opportunity
In the second case, related by the same observer,Hungarian army received considerable reinforce- ments, prevented, the wounded were transported on ers
steam-
the openingin the diaphragm was on the right and whilethe continual skirmishes and or by railway.In the month of October,1848,
side,and ^e small intestine, with a considerable pitched battlesserved to fill our hospitalswith the many hundreds were sent from Pesth,and in July
portion of the liver, layin the rightpleura.The wounded and dying,the cholera now broke out, and of the next year, thousands were conveyedfrom
rightlung was, of course, here the smaller, and the placed us in a still more harassing position. Until Pesth to Szeged-Arad by steamers ; others to
mediastinum and heart were pushed to the left. January,1849, however, the army and hospitals Szolnok,by railway.
This is the less common condition, for,in by far the were tolerably well providedwith surgeons; but HOSPITALS.
greater number of instances, the abnormal opening duringthe winter,very many of them died while in
of the diaphragmand the misplaced
Besides the regular hospitals in towns and villages,
viscera are on the performanceof their duty in the hospitals,
were fitted up temporary ones near to the scene of
the leftside. crowded,as theynow were, with cholera and typhus action. All
diligently tended in the neighbouring
In the first of Dr. Macaulay's cases the infant patients, as well as wounded. Others of them were
^
villages.The cholera which, as I said,broke out
lived an hour and a half; in the second only three- killed on the immediate theatre of the war. In May, in
quartersof an hour j and indeed,with such a serious 1849,the Austrians retreated from Pesth, leavingthe
January,1848, committed great ravages during
of the war, and helpedto fill
period our hospitals,
Encroachment of the abdominal viscera on the space on the fieldabout 6000 wounded and sick men, who
for other destined The purposes, with sick. more
allottedto the thoracic organs, the maintenance of were attended to by surgeons in civillife. Having
we retreated, the more we had to contend with. The
lifeis scarcely to be looked for. Examples,how- ever, taken Buda, we were compelledto minister to the various
hospitals in towns and villages contained at
are not wanting of individuals wifli a minor these,besides those we found in the crowded hospi-
tals one time, some 1400 ; others 1000,
as many as
degreeof the same malformation attaining to adult of the countrylyingbetween Pesth and Raab,
and so on, while beingoften in but a
i^" Such an instance is givenby Sir Astley while the advance of the Russians on differentposts 4000, 6000,
small village, more than 2000 patients were to be
Cooper in the Medical Records and Researches. rendered it necessary to transportthe sick from found. At
The patient, Komorn, when Klapka left it,all the
a woman twenty-eight years of age, those places in Hungary which had come into our
hospitalswere crowded with cholera cases and
died with symptoms of strangulated hernia. The possession.
wounded men, while the fortresscontained no less
transverse colon,with part of the omentum, was In Julywe retreatedfrom Pesth,pursuedby the
than 4916 sick and wounded. The mortality from
found projecting into the left cavityof the chest, Russians and Austrians, takingour wounded with cholera there rangedfrom 30 to fortya day. The
througha circular openingin the fleshy part of the us, their devotion to the Hungariancause, mingled fortresses of Arad, Katz, and Peterwardein were in
diaphragm,two inches in diameter. From the with exasperated feelings towards their enemy, dering
ren-
had 2000 sick in
the same state, and at Buda we
appearances after death,as well as the previous them comparatively forgetful of sufiering.
the time it was beingbombarded.
hospital during
history of the case, it was inferred that the mal- The wounded
formation were now beingbroughtin from all To the patriotism of the ladies we wete indebted
was congenital. A case of a similarkind parts to At ad, Szegedin, Maks, Kalvesa, "c., in for liberal
supplies for dressings.In February,
occurred to Petit,in which the patient was a man such vast numbers, that surgeons could barelybe
1849, the sister of Kossuth inspected a hospital taining
con-
fortyyears old. found to attend them.
800 sick; and her unwearied attention to
Wye, near Ashford,December, 1849. In anticipation of an engagement, we usuallythe suffererswas such that she was soon appointed
selected a placefor carrying on our surgicsl tions. to inspect
opera- allthe hospitals of Hungary.
SURGERY OF THE LATE WAR IN Whenever it was practicable, we chose the
(To be continued.)
HUNGARY. vicinity of a river,a grove, a single house, or the
lasthouse of the next village or town, or a railway
By Dr. GLUCK, Surgeon-ln-Chicf to the Baths and Washhouses. ^The Directors of the
"

Hungarian Husssrt. station;but accordingas the army advanced or

Exeter Water Company have agreedto supplythe
retreated, we were compelled to do the same, and baths and washhouses in that town with water
Havingbeen called ou to take partin the recent changeour position. Not unfrequently the cannon
gratuitously. This is greatly to be commended.
Hungarianwar, first as RegimentalSurgeon,and balls would faroutstretchtheirmark, and fallamong The managers of similar establishments at St.
latterly as Surgeon-in-Chief to Hospitals into which the wounded men, takijig a lifealready placedin Martin*8-in-the-Fieldspay 160/.a-year for water.
 THE MEDICAL TIMES. 77

HO8PITAI1 REPORTS. unconsciousness, from which I never recovered (general and local), sometimes preceded by the use
" {"Iete
instant until I awoke
or an in bed, an hour_ and a of the hot-airbath. The duration of the treatment
ST. BARTHOLOMEW'S HOSPITAL. half from the commencement of the operation. I varied from one to six months, and its
average was
sufferedfor some hours from vomiting, for three days three months. Three patients who for five tc^fifteen
from nausea, head-ache,aching of the knees, and in the most marked degree,
EXCISION OP A TUMOUR years had presented,
SITUATSD IH THE IHTERIOR 07 THE PABOTID OLAHD, generalmal-aite, and from a distressing sensibility that ensemble] of symptoms known under the titleof
and want of command over the expression of my
BEHXATH THE BRAHCESS OF THE FACIAL VERVE. "

all ceased instantly the

"
nervous accidents,"and who had been reduced by
PERFECT RXCOVERT. feelings. These feelings on
them to the lowest state,in spiteof medical art,
free action of my bowels. Tlie wound healed in its
The following operation,one of singular interest,
upper half by the first intention. There was slight were cured in the same manner. Here, however,
and highlycreditableto within
surgery, fairly comes
venous hscmorrhageon the second night,which Mr. the treatment was continued from seven to eighteen
the scope of these reports, since it was performedPagetarrested by the removal of the sutures and months, and the average duration was more than a
within the walls,though not publicly in the wards coagula, and by applying cold-water dressing.On year.
of St. Barthomolew's Hospital.The subject of it is the fifthday afterthe operation I left my room, and Finally, in twenty-three cases of chronic muscular
a well known and highly-esteemed member of the on the thirteenth I returned to Salisbury. Saliva rheumatism, which had resisted every species of
Medical Profession, practising at Salisbury. Abont escapedat firstfrom the wound on taking nourish- ment;
treatment, and the most celebrated mineral waters
five years ago, this gentlemandiscovered a small, this has gradoally ceased, and on this,the of the cold douches after sweating
the wound is en-
Europe, effected
elastic, moveable tumour the rightside of his thirtiethday after the operation, tirely
The average time of treatment was
closed. The last drop of saliva continued complete
on cures.
face,justbelow the zygoma. At firsthe took little four months ; the minimum one month; the inaxi"
obstinately to escape, until my friend Mr. Wilkes,
notice of it ; but,finding that it gradually increased
in size,he subsequently
house surgeon to the SalisburyInfirmarv, proposedmum seven.
came up to London to con- sult
and practised an injectiona solutionof two grains
of Here, it must be confessed, we have a rational
the surgeons of the old Hospital in which he of the nitrateof silver to an ounce of distilled water, method of treatment, applied according to the rules
had been educated. They were unanimouslyof when itceased entirely. The onlyexisting evidence of art,and as successful as the mincles of Hydro*
opinion, that the tumour was one of a class com- monly of my having undergone this operationare the pathy.
called parotid, and that,since it was cicatrix,
gressively
pro- a diffioultv in winking with my righteye, MODE OF ACTION OF CHLOROFORM.
enlarging, it oughtto be removed. Upon and a very slight difl'erence in the distance between ETHER, "a
this opinion, however, gentleman question
t he in did the eyelias, those of the righteye being the most M. Robin is of opinion that sulphuric ether,chlo-
roform,
separated, and even these results of the bruising a of
not feel disposed to act, because the tumour caused and other analogous substances,produce
him no painor inconvenience. In this respect, his
branch of the portio dura are rapidly subsiding." theirdeleteriouseffectson' the
oeconomy, by modi- fying
IN THE BURSA OVER THE
decision was probablybiassed by the fact of his SUPPURATION the blood. M. Robin was led to this idea
beinghimself the patient,for we are sure he would PATELLA,
"

OF THE KinSI-JOIlIT,
originally, by reflecting, that substances which enjoy
WITH IRFIAMMATtON
have been the lastman in the world to have allowed ACOOKPAmED the propertyof preserving animal matter from pu"-
AHD THE CEIXULAR TISSUE*AROUND IF.
the slightest weightto such an argument in any trefaction, do so by preventing the matter from un- dergoing
other case but his own. In this state of uncer-
". Grimes, a housemaid,eighteen years old,was slow combustion at the ordinary
tainty,
Sitwell ward, under the of Mr. tempera*
he sufiered five years to elapsebefore admitted into care
ture. Hence, if these substances were introdneed into
the 30th October,1849. She was fering
suf-
mour. Stanley,
on
he made up his mind to part with the tu- the circulationduring life, it seemed not improbable
from acute infiammation of the bursa,over
Meantime, it had slowlygrown larger, that they would oppose the slow combustion which
the patella, and the cellulartissue in the neighbour-
hood.
so that it has now attained the size,and pretty takes placein the blood,and, finally, giveriseto
There was also considerable efi'nsion into the
nearlythe shape,of a large walnut,with the long asphyxia.Being desirous of ascertaining the pre-
cise
so that the patella elevated from the
axis in the direction of the masseter muscle. In knee-joint, was
symptoms which precede this kind of death,
other respects condyles of the femur. The disease had been about
no other change had taken place. It and also those that accompany it, the Author gradu- ally
was stillelasticand moveable,yet not so moveable a week in progress, and had created much general reduced the quantity of oxygen supplied to cer-
tain
after admission con-
of the jaw could be felt behind it. disturbance. The treatment
sisted
that the ramus animals,untilhe suppressed italtogether. ing
Dur-
in a free application of leeches to the joint in
This circumstance led to the infexence that a partof theseexperiments he ascertainedthat the quantity
firstinstance,with the internaladministration of
the tumour at least was probably embedded in the the of lifeis proportionate to the quantity of combustion,
substance of the parotid saline purgatives. After a few daysthe bursa sup- purated,
gland. and hence concludes thatthe agentsabove mentioned,
The operation was performedby Mr. Stanley,
and was freelyopened. This relievedthe if theyexercise the same action on the blood as they
ablyassistedby Mr. Paget,whilst the patient was symptoms, and the case went on subsequently most
do on animal matter, must diminish the quantity of
The patient discharged cured on
keptunder the influenceof chloroform by Dr. Snow. favourably. was
life, that is,seisibility and contractility, at the same
An incision was the 19th November. time that theydiminish the quantity
made over the long axis of the of combustion.
The chief pointof interestin this case is the co-existence
tumour. A very littledissection was sufi"cient to Hence, according to the dose,theybecome sedative,
of the two affections, " ^inflammation of the
show that the tumour was seated in the substance capableof producinginsensibility, or even death,
patella bursa, and inflammation of the knee-joint
of the parotid gland, and that the primary branches from asphyxia.
of the facial nerve It is a rare occurrence.
not onlycrossed in front of it, Applyingthese remarks to ether and chloroform,
but that they were also firmly united to it. This M. Robin is inclined to admit,that when introduced
circumstance,of course, complicated the operation in sufficient quantityinto the blood,they oppose its
PROORE8B OF MEDIOAIi 80IBNCE.
exceedingly.To remove the disease without divid- ing combustion "
that is,its changefrom venous to ar-
terial
the nerves, it was necessary to cut it away ; and he also thinks, that their ansstheniaing
FRANCE.
piecemeal.On the firstincision into it, there e^cts dependin great measure, if not entirely, on

escapeda quantity of thin fiuid ; thus itprovedto (ParisCorrespondenoe.) this circumstance. Experimenthas provedthis,
be a cyst,and itswalls immediately collapsed. The and enables the Author to afiirm, that the action of
subsequent part of the operation was indeed a very NEURALGIA AND RHEUMATISM TREATED BY these substances on animal matter is precisely that
tedious and delicate af"ir, and can be easily ined
imag- COLD DOUCHES AFTER SWEATING. which has been justmentioned. After death,they
by those who are familiar with the dissection At Bellevue,near Paris,there is a fine establish- ment, preserve animal matter, in the most perfect maimer,
of the portio dura in the parotid gland. While the in which everything of practical value con- nected from every species of putrefaction, or, in other
opentor was cuttingout, bit by bit,the several with " the water-cure" " be it hot or cold " words,from combustion by moist oxygen ; and this
portions of the cyst, which extended irregularly is in to the treatment of various obstinateaffec- tions. preservative action is exercised by sulphuric ether
applied
thisand that direction, the nerves were stretched The advantages obtained from a rational and chloroform eitherin the liquid or gaseous form,
and drawn out of the guished or by water, containing onlya small proportion of
way by hooks,and therefore employmentof several powerfulagents,as distin-
unavoidably rather roughly handled. It was curious from the empirical use of one alone,are these substances in vapour.
to see how one or other of the muscles of the face in an excellent Finally, it would seem to be proved, by the re-
searches
very great. They were pointed out
twitched,as this or that branch of the facialnerve which M. Flcury presented at the last of M. Robin at least the Author regards
Memoir "

disturbed. Every partof the cyst havingbeen it as proved that, independently of all nervous fluence,
in-
was
meetingof the Academy of Sciences. The Author "

at length removed, there remained wide gap in selected at the establish-

ment small doses of ether and chloroform
cases, observed very
a
forty-six
the situationof the parotid gland,and an excellent the last four and from their sults neutralisethe action of moist oxygen on the blood,
during years, re-

display of what we had never before seen in the liv- ing conclusions: and on animal matter generally ; and that, when in- troduced
deduced the following "

subject, the so- called/"e" anserinua of the portio Five under attacks of acute in sufficientquantity into the circulation,
patients, labouring
dora. from four to fifteen days,(facial, costal, theyoppose, more
inter- or less,the oxygenation of the
neuralgia
From a letterrecently received from the patient, cured by one to three applica- tions blood,thus powerfully contributing to, if not en- tirely
sciatic,) were
we quote what remains to be told of the case, as well of the cold douche,both general and local, em-
ployed causing,the symptoms of anssthesia which
as a very graphic account of his sensations during after the use of the drystove,which had pro- duced accompany etherisation.
the inhalation of the chloroform. Here the revulsive ALIMENTATION." GELATINE.
**
For the firstfour or fiveinspirations,
copioustranspiration.
I felta slightaction of heat followed much The questionof alimentation, broughtofficially
by cold was more
sensation of constrictionopposite the first bone of
the sternum. energetic than that of flying blisters or the cautery. under the notice of the Academy of Medicine,has
This was followed by an overwhelming muscular againintroduced the subject and given
Eleven patients, attacked by acute of gelatine,
noise resemblingthe combined sound of many
rheumatism, fixed in its seat and very severe, were rise to a remarkable report,the substance of which
threshing machines or steam carriages, so near as to
constitute
bewilder me. This increased untila sudden shootingrapidly cured in the same manner. I transmit, b ecause this Report must long
sensation passed down all the limbs, In fourcases of obstinate neuralgia, which had an authority on the question. Whether consi4iered
conveyingthe
conviction that sensation was gone ; and,lastly, an resisted every known method of treatment for four physiologically or economically, it is one of the
agreeableecstasy, endingalmost instantly in com- to ten years, a cure was obtained by cold douches very highest importance, yet,I fear,has not yet re-
 f8 THE M JfiU i U A L 1 1 M J!i25.

of lead;and, in addition to these, there dyingof phthisis, takingthe oil, which he has
ceived a satisfactory solution in either point of view. by acetate
has found a congested state of the
ample, exartined,he

tient
In France, as well as in England,econuuiists and are several other extractive principles; for ex-
zomidinff"c. Ozmazome isa compound of lungs,as he expected, not only near the tubercles,
physiologists have been long in search of a cheap
the with sufficient of them and the creatine of M. Chevreul but through the entire of both lungs.Three marked
arjticle of diet To supply poor many ;
with drachm
food at the cheapest possible rate,was the problem existsin meat broth,but not in that made with gela- tine. cases are cited,in which he began
doses, carrying it up, however, to an ounce and a
laid down by the economists, and the physiologists
of
fancied they had solved itwith the gelatine contained Finally, it may be asked, does the insufficiency half in the day. Dr. Benson, with the majority
the fact of practitioners, considers the oil quite invaluable in
in bones. To the famous diChesterof Papinwe owe of gelatine, as a nutriment,dependon
of these cases ; and perhaps the caution which he aug-
the facility of obtaining this substance in largeits beingbadlydigested, or, because the product
and the idea of applying it to alimenta-
tion its digestion, is not a substance fit for nutrition ? gests will be of use, thoughit is,perhaps, able
question-
quantities; bears in the phenome-
was quickly seized by many of tlie French To this M. Berard replies, gelatine
that i s capable
in- what part the oil really non.
At the Surgical Society, where the paper was
chemists, who flattered themselves that one pound of beingdigested like other albuminous
read,Dr. Bagot corroborated, to a certain extent.
of bones would go as far to make good soup matters, and concludes his reportwith a series of re- solutions,

the sum of which is,that gelatine sents Dr. Benson's views; and
Dr. Spear said, he had
as nx pounds of meat. The digester, however, pre-
and it would probably have advantage, as a nutriment,on the scoie of met pneumoniaof both lungstraceable to the same
spoiledthe gelatine, no

been abandoned as an article of diet, had not M. economy, and that its preparation in public blishments
esta- cause ; hoemoptysis, too, as remarked by Dr. Ken- nedy,
should not be encouraged by the State. beingnot uufrequeut also.
d*Arcet,in 1817,discovereda better mode of extract- ing
This new In the short discussion which followed the reading It seems a matter of no uninteresting discussion, (if
it,by means of steam. preparation what part
attumed the imposing name of ** alimentary of this report, M. Gaultier remarked, that the only the facts be as suspected by Dr. Benson,)
could f or the the action of the oil bears in the inducing this in- flammatory
gelatine.** M. d'Arcet announced, that he could substance which be employedsingly
state of the lung. It is, perhaps, too
now "turn four oxen into five." The Old purpose of nutrition was gluten ; and, in supportof
curred much when a patient is made to take the
Academy of l^fedicinelent its approbationto this,M. Villerm6 mentioned a curious fact that oc- a custom,
to the neglect of
the thmry, "nthout sufficientexamination of the during the war in Spain. The division to oil, to look on it as a last resource,

the prevail- which he was attached,had been compelledfor allother means ; and,as well
remarked by Dr. Ben- son
subject, and gelatine soup became ing
live animal food sively
exclu- himself, the apparentsymptoms improve much
diet of the day. Enormous sums of money eight or ten days to on

were laid out on establishments in every part of ; the soldiers were soon attacked by diarrhoea quicker than the physical signs; in other words, the
France,and the sick as well as the poor were sub- mittedand other disorders, which did not disappear until tubercular irritation and inflammation are allowed
to go on, under the false show of returning health.
to- an infusion of gelatine, every ounce of the diet became mixed.
In such a state of things, it is not diflficult to ima-
gine
which was supposedto representthirty ounces of
overthrew the hopesof the even the sound partsof the lunggetting^ one
meat. Experience soon
IKBXaAND. pendent
inde-
made homogeneous appearance of engorgement,
cKeapsoup men : numerous complaints were
which every
Hotel -Dieu the of the normal action of the oil,
by the physicians attached to the ;
and the theory [DablinCorrespondence.] practitioner must confess is most beneficial. The
poor refused to fatten on the new diet, value,
The Aaedemy of observation of Benson, is one of deeppractical^
began to ial\ into disrepute. THE PROVINGIAL COLLEGES.
ficiencesnow took up the question and may be the means of takingthis medicine out
seriously, and, of the Provincial of that terra
The anxietyfor the success incognita t hat divides mere empiricism
afterhavingexamined it for ten years, produced the
remains unabated; despite the dreadful from true
well-known reportof M. Magendle. The Academy Colleges practical medicine,and lead to a true
that surround them
had been jealousies every point, they studyof its realaction on tlicanimal economy.
on
of Medicine,to which the same question
later could seem, however,to continue theironward course. In
fubmitted,though at a period, not cently
de- IRISH MEDICAL CHARITIES.
Cork, Sir Robert Kane has been assailed, for some
act with greater dispatch.It took ten years, rather remarks with respectto the A highlyvaluable Reporthas been justfurnished
injudicious
likewise, and at the expirationthat period
of brought, of Louvaine and Ghent In Belfast, the to the House of Commons, recommending
in the
forth the reportto which I have alreadyalluded. Colleges
of the Colleges, has been set forth in no very strongestterms, among other changes,that a sepa- rate
In this complete document, the reporter, M. Berard, object for of the sick,aged,and im- potent,
while in Galway, the rate the support
tine, flattering
terms ; most licious
ma-
commences by askingtwo questions** Can gela- "

mis-statements have found their way into be availableat alltimes,and that it be forth- with
extracted by any of the usual processes,be the
representing the scholars lately estimated and struck, thus preventing
employed with advantage for the alimentation of circulation, in Belfast. As straws indi-
passed
cating highly valuable medical charities through
the
as those rejected
man ?" "
Can a certain quantity of gelatine be there, Parliament of
the wind, such thingsportendanything but country from falling pieces.
to course
in
substituted, making soup, for those soluble ters
mat- sanction the arrangement,and it is onlyhoped
for the Institutions. Let the Govern- must
wotild have favourably
ment,
which a givenquantity of mAt fritteredaway
however, but remain firm, which itis deter- mined that too much of its time may not be
eontributed to the soup?" but really less called for measures.
Before appealing on, and such things will pass away. As by more noisy,
to experience, the only certain medical of Ire-
land
Medical Schools, it is,perhaps, to be regretted, that It would be desirableto see the men
test in matters of this kind, M. Berard presentsa
pronouncing on the exact wants of these
" "

the Colleges have been severed from the parent

few remarks of a theoretical nature. Thus we than coun-
trunk ; yet the high character of the diilerentPro- fessors, institutions. It would be more practical tenancing
might a priorifhave reasonable doubts of ge- latine
and the good feeling in any way our late political hurricanes,
generally entertained
forming a good aliment. In the first so much to be regretted.
in Dublin towards them, reconcile one to the
place,it di^rs in several respects from the
other azotised substances, which contribute to the change.
supportof man. Our organs, as is well known, do PNEUMONIA FROM COD-LIVER OIL.
0EIi|SCTXON" FROM FORSIGIf
not contain any gelatine ; but merelycertain sub- stances The value of cod-liver oil as a remedial agent, JOUKNAX.S.
which are capableof beingconverted into and itsmany characteristics, are so well understood
^
gelatine, eitherby the chemist,or duringthe pro- cess at presentby the Profession, and so generally
nised,
recog- PROOFS THAT IT IS ONLY THE
of cooking.We have no proofwhatever that that it appears a littlesuperfluous to allude
ORGANS OP TOUCH WHICH INFORM US OF
this artificidl productctLTi here-converted into organicto them at any length.A pointnot long since THE SENSATIONS OF WARMTH, COLD,
tissueby digestion. Besides,gelatine is not a com-
pound mooted,however,by Dr. Benson, with respect to its AND PRESSURE.
of protein ; it does not contain any sulphur exhibitiou, and not suspected very generally, is of
By ". H. WEBER.
or phosphorous ; and we may hence conclude that considerableinterest. The oil has longbeen a fa- vourite
it is incapable of beingtransformed into muscle, medicine in Dublin, so that ample opportu- That this question has not been previously de-
cided
nities
brain,^rin, albumen, or any of those elementary have been afibrded of comparingthe
rience
expe- is mainlydue to the manner in_which the
matters which contain the two substances just of the difierent practitioners who have used skin,which is the seat of the sense of touch,sur- rounds
namdd. But experience has determined the ques- tion it. As early as the year *44, Dr. Graves tried it, all the inner parts,which are not. Thus
in a manner which may be regardedas con- with the most marked benefit,in some cases chexia; it becomes
of ca- difficultto separatethe share taken by
cUsive. The experiments of MM. Edwards and and Mr. Wilde, who had seen it used pre- viouslythese latterin the production of the sensation.
Balaac were the onlyones which lent any authority in Germany, tried it extensively, too, in 1. The firstmeans of deciding this question isthat
to the idea of gelatine being available as a good cases of pannus, long-continued ophthalmia, lar
granu- offered by the results of accident or surgical operations,
aliment ; but the conclusions drawn by tliese])hY- lids,and analogous eye-cases. The other chief in which a portion of the skin (theorgan of touch)
Biologists have been completely overthrown by the medical men, too, have had reason to be satisfied has been destroyed. The author and his friend, Dr.
more careful researches of the Academy of Sciences,with it ; and the inde"tigable Donovan has given Giinther, Professor of Surg^ery in Leipzig, instituted
of the Holland Institut, of M. Doune, M. Duficholin,us itshistory and various properties and modes of observations ou three persons in whom a larg^ tion
por-
and M. Devienne, Apothecaryto the Hospitalof preparation, with which eveiy one now is quite of the skin had been destroyed b^ a bum, and
St.Denis. But, it may be asked, " if the gelatine familiar. had not advanced so far towards heahng as to ofier
contained in meat, and that extracted from bones be, Nearlya year ago, it seems. Dr. Benson prepareda renewal of the sense of touch.
chemically speaking, one and the same substance,a paper on the uses of the oil,but press of other Two metallic spatulas were dippedin water of
why should they not be equally n utritious 2" business prevented his making it public.Possessed differenttemperatures, so that one nad a heat of 48^
To thisthe reporter answers, that meat contains of such powers of invigorating the system, it did to 544" Fahr.;the other of from 113^ to 122", and
several other matters besides gelatine, which are not appear to him very extraordinary if, under the surface deprivedof skin was quicklybrought
extracted by water. Thus, Berzelius showed, that if particular circumstances,the oil might undo the into contact with these successively. To the ques
we treat a watery extract of meat with pure alcohol,verj' thingit was intended for; in other words, tion, whether tlie body in contact was warm or cold,
wc obtain two azotised substances, one of which
"
might induce a congestedcondition of the lung,and these persons gave quiteas often the wrong as the
is precipitated by the chloride of mercury, tlie other induce pneumonia.Accordingly, in almost every pa- rightanswei ; so that one or the other thrice
 THE MEDICAL TIMES. 79

maintained that he was heingtouched hy the cold opinion, that we onlyappreciate heat,and cold,and functions ; and that those of the special senses irri-
tated
body when itwas the wafm, and the reverse. pressure by means of the organs of touch ; fbr,in in their trunks, produce the corresponding
When these experiments were repeated neigh- o n bouring the muoous membrane of the nose, which is the special sensations of light a nd sound.
portions of sound integument, the tempera- seat of smell,and also possesses a very lively mon
com- The valuable essay of Czermak abridged in our
tiiTC was quicklyand certainly detected. sensibility, the contact of a solidbody does not Number of December 15,while it tends to contradict
When the spatula was in one instancemade some- what producethe sensation of pressure, and the contact the notion of the specialapparatus,stillfurther
warmer, and broughtinto contact with the of cold water does not give rise to the sensation of corroborates the idea of the essentialunityof pain
soriace devoid of akin,the patient feltpain, which cold. and touch. It shows, that numerous and repeated
not the case in the previous 3. A third method of clearing up the question is as branchings of nerve fibresexist; and the authoi's
was experiments.
Thus, from these experiments, it results, that follows:" In the Author's well-known experimentsown experiments prove that an increased surface of
these patients could not distinguish warm and cold on the Touch, (during the year 1829,) he measured nerve heightenstactile delicacy.Now, the enor- mous
with those parts in which the skin provided with the and comparedthe fineness of this sense in various increase in this respect, which Czermak's
aense of touch had been destroyed ; while heat be- yond parts of the body, and showed it to be of very different researches prove, is,perhaps,quite sufficient to ex-
plain
how merelysensitivetrunk becomes by its
a certain degree producedpain. degreesin difierentsituations; while those parts a

2, Another means towards determining the ques-

tion of the organ of touch by which we appreciate the thus heightenedsusceptibility a delicate surface,
isa"R"rded by the inhaustionor injection of a large comparative pressure of two weights were also more alive to the slightest changes,and thus,cognizant
cold fluidinto the stomach or capableof distinguishing differences of tempera- of heat and pressure.]
quantityof warm or ture
intestinalcanal. ; and in both these respects
the sense was the F0I8O.NING BY BITTEB ALHONDa
llie lips, the tongue,the teeth, the upper part of more acute, accordingas the nerve-filaments ending Dr. Putelli states some insUncee in which the
the cavi^of the mouth, the palate, and the oeso- in a given extent of skin were more numerous. prussic acid contained in bitterahnonds
phagus
appeared to
providedwith the sense of touch ; but Heat, also,made a greaterimpressiou when the
are producegastro-enteritis and peritonitis. He also
thenceforwardit is either lost, or at leastbecomes whole hand was plungedin warm water, than when alludes to coiroborative cases, in which an antiphlo- gistic
so imperfect, that one may doubt whether it isreallyonlya finger was inserted ; so that water of 100" treatment was attended with success. Giaoo-
presentin the stomach and intestines. The author Fahr. seemed warmer than the same fluidat 106^. nini,however,is inclined to attributethe observed
dmnk off rapidly glass(8^ oz.)of water at S2" Here againthe impression is weaker when fewer eflfects, either to the mere
a indigestible mass which
Fahr. The cold was feltin the mouth, in the palate, nerve-fibres were acted on. So, in the case of vision,the ingestedalmonds formed in the alimentary
and ossophagus, but the gradual passage of the cold where the colour of a large space, previouiily visible canal,or to the rancid oilsgivenofffrom them
; and
water into the stomach could not be discerned. enough,was rendered very indistinctby looking at not to the prussicacid itself. {Omodei Annali
"

In the gastric vegionthere oertainly was a slightonly a small part of it through a tube. UmvertaH (U Medicina,Vol. CXXIV., p. 278.)
sensation of cold ; but,as itonlyoccupied the situa-
tion This aflforda us a means of ascertaining whether
PRACTICAL APPLICATION OF THS
of the anteriorwall of the stomach, it is attri- butablewe feel pressure and heat throughthe nerve-trunks EEDUOTION IN SIZE,
to the largequantity of cold water having lyingin the skin,or whether this endowment is ob- tained
^ PRODUCED BT DEEDLITATIlfO ISFLOZHCn OH TBI
abstracted heat, not only from the stomach, but throughthose ends of the nerves which,by FCBros IN umo.
from the wall of the belly in contact with it,and means of special adjuvantorgans, are made sub- servient There
appears littledoubt that debilitatmg fluences,
In-
throughthis,from the skin of this part In an op- to "e reception of slight impressions in the such as repeated
posite bleedings, low diet, ftc,
experiment, the author drank quickly three function of touch. acting on the frame of a pregnant woman, impede
(9 oz.)glasses of milk ; the temperatureof the flrst In the case of moderate pressure by a weighton the natural growth of the foetus. M. Depaul re- commends
being 158* Fahr. ; the third,145*5**; and the second the forehead,it matters not whether it be placedon that advantagebe taken of this fact in
between the two. Heat was felt in the mouth, the the hundred filamentsof the supra-orbital and supra- of
trochlear cases
moderately contracted pelvis.Two cases
palate,and the ossophagus, but nowhere else. At nerves, which here cover the bone,or on are related in which this method seems to have
the moment when the fluid entered the stomach, a neighbouring part Hence, we must suppose been very useful. In the least equivocal of the
there was a feeling which existed some time, but thatsuch slighter is only appreciated by the two
pressure cases, a woman, aged 26, with the posterior
antero-
was not a sensation of heat,being mistakeable for ends of the nerves, which are fittedtheretoby a and lateraldiameter diminished by rickets,
cold. In order to discover.thesensationsproduced special apparatus;and is unfelt by the fibres in had had two deliveriesin which instrumentewere
on the largeintestineby oold water, this fluidwas their course. A stronger pressure,however, can be used. The third delivery was premature. In the
in two subjects administered as an enema at a tem-
perature feltby these latter ; but itis as a pain, and not as a fourth,Depaul put his regime into practice. The
of 65%^ Fahr. In one instance, in which pressure,that theytake cognizance of it. patient was kepton low diet,and was bled at three
14 oz. of water were ii\jected, some movement, and The same holds good of the sensationsof heat months, at six months, and eight months and a half.
a scarcely perceptible sensation of cold was feltin and cold. The partsof the skin in which lietrunks She was allowed soups, greens once a day,i lb, of
the belly ; this gradually set towards the middle of of nerves are not more sensible to moderate heat or bread per diem, and meat once a week. Sne be-came
the region. In the other instance,21 oz. were in- jected, cold than any other part : while a greaterdegreeof pale and somewhat emaciated. At eight
and nothing felt. In both instances, on the either causes considerablepain. A mixture of ice months it could be distinctly perceived that the
evacuation of the enema some minutes after, siderable and
con- water in sixteen seconds attacks the ulnar foetuswas small. Delivery took placeat the usual
cold was feltat the aniil. nerve, and producesa severe pain; a painwhich time without difficulty. The childwas female,very
A lower temperature of 45*5 "" produceda very cannot be excited by the same cold,applied any small,weighingonly5 lbs.,but was lively
t o and did
distinct sensation of oold in the immediate neigh- bourhood other region, and which has no resemblance to cold. welL The mother, under a more generons diet,
of the anus, but onlya very feeble flutter- ing So the tooth pulpis equallyand similarly a"cted soon recovered her ordinary state of health. (I,*
" Union
in the bowels. Some littlewhile after, there by water of 43" and 112"" Fahr.: either result M4d,, Jan. 12.)
was a weak sensationof cold,chiefly in the anterior in a pain, exactlylike that producible by pres-
sure. EPIDEldC OF HUMPS AT GBNBVA IN 1848
waU of the belly.This sensation remained after the AND 1849.
retam of the water ; and hence itwould appear due In short, as the sensationsof light, sound,smell, By II. EILLIET.
to a gradual extension of the oold frconthe water to and taste,all require a q"ecial apparatusat the ex- tremities In March, 1848, liomhard noticed a case of
the neighbouring parts,and to the skin, a view "
of their nerves, " so the sensations of mumps which occurred in a young man arriving at
which is corroborated by the fact,that,under these heat, cold,and pressure, are only producible Geneva from Paris. Shortly afterwards other cases
circumstances, the anteriorwall of the bellyhad its at the ends of the nerves of touch, where they were seen, and, in June, the disease had become
It continued to prevail, without intermis-
sion,
tempentiivelowered by three degrees (Fahr.) And are (probably) providedwith an adjuvantappa- ratus, common.
not onlyare the ooata of the intestinesinsusceptible which is as yet unknown to us. Other sen- sitive tillMarch 1849 ; in December and Januaryit
of the feeling of cold,but the muscles of the belly, nerves, and the trunks of the nerves of touch, was very prevalent. Prodromata were usually sent
ab-
of heat or pressure : ; when they occurred they lasted twenty-four
'
which are providedwith animal and not organic are inefficient to the production
nerves, evince the same incapacity ; for,were this when greatly acted upon, theycan, at most, only to thirty-six hours, and consistedof pyrexia, wither
not the case, there would be an unmistakeable sens- giverise to the feeling of pain. E. H, Weber,in without vomitings.Generally
"
the attack began at
auion of eold producedon this extensive surface of MuUer'tJrckh, 1849; Heft. iv. pp. 273, 288. once, with painand swelling in the parotid regions,
contact. [We wiU only add to the above abstract of this extending d own under the jaw. Sometimes the skin
So, also,the cavityof the nose be that, while it clearly lishes
estab- became red over the swelling; irasciTsipelatQHS,
may pletely
com- very important paper, " o nce
fijled with water without the entryof any the tactilecapacity and incapacity of the par-ticular generally was, however,pale. The degree of swell-
ing
into the pharjmx; and, in such experiments, it may surfaces and parts of nerves alluded to, ^it " was variable; sometimes slight, sometimes enor-
be observed,that the ooldneas of the water is only appeals liableto objection in two respects $ in theory mona. Pain was aometimea very severe ; in oases
feltin the neighbourhood of the nostriUAnd in the aqd in fa^t; inasmuch as itmakes out the sensations in which the swelling was great,some pointa were

pharynx,while, in the higherpart of the cavity, of heat and pressure to be distinctin kind from especially painful, viz.,the temporo-mazilUr arti-
which is richly provided with nerves, and subserves the ordinary sense of pain,and supposes a special cidation, between this and the mastoid process,and
the sense of smell,itis not discernible, for the cold apparatus to existat the extremitiesof the over the submaxillary gland ; the pain was ous,
spontane-
nerve^
water gradually ascends on one side,and fills the That these two sets of impressions are identicalin but was augmented by pressure ; the lower
other,without the slightest sensation of the kind. kind, and differmainly in degree, that heat and jaw, in many cases, was in a veritablestate of tris-
"
mus;
When the water is very cold,to wit,4il^ Fahr. cold require onlyhigherdelicacy of common tion,
sensa- there was no salivationor angina. Lombard
a peculiarpain arises in the upper part of the " is rendered probable by the facts, that on the examined the saliva, b ut found no alteration. The
fossa,and invades the regions of the forehead and supposition of these beingdifferent senses, the irri-
tationswelling occurred generally in both parotids. General
lachrymal canals. But this feeling altogether
is of the trunks and ends of the nerve would fever attended the swelling, and lasted two or three
difierentfrom that of cold. producedifierentimpressions: while in opposition days.The durationof the maladywas from fiveto ten
Re eated experiments of this kind verifythe to thi8" we findthat no other classof nerves has two days.The swollen parotid never suppurated. As far
 80 THE MEDICAL TIMES.
as age was concerned,hardlyany under 2 or over 40 human mind, as it must be remote from the ingsby one bold line of treatment. We have
years were attacked ; yet one case was seen at 60 geniusof different nations. Look at the politysaid before,that theydid not ask the permis- sion
and one at 70 years. The following Tahle is given of the Spartans in their laws respecting theft, of Old Sarum to be placedin Schedule A,
of 73 cases : Under 2 years, 0 ; from 2 to 5 years,
"

and contrast it with the sternness of the British and let them now, and in like manner, establish
7 ; from 5 to 10 years, 18 ; from 10 to 15 yeaors,19 ;
from 15 to 20 years, 8 ; from 20 to 30 years,9 ; from code. a superior Government Board, to examine and
30 to 40 years, 8 ; and from 40 to 70 years, 4. Of We have been led into these remarks by the to legalise the claims of each individualto act
the 73 cases, 38 were male and 35 female. The dis- ease
perusalof the authenticated papers in this as a Practitioner of Medicine.
did not oocur twice. Rillietohseives that this
journal, by Dr. Bushnan, on the state of Medi-
cal Let the existing Universities and Colleges
epidemichas been the most severe that has ever been
known in Geneva, and that evidently the longerthe Education throughout Germany. Described maintain each their respective privileges and
time between the epidemics, t he more severe are by his faithful
pen, theypresenta state of legis-
lationauthority, save and except that their degrees
ihey when theydo come. Season exerted no influ-ence totallydistinct from ours ; and, if we shall be purelyacademical, and not authorising
upon IL During its prevalence a kind of
in one the recipient Let no man be ad-
mitted
joseola was common, which was suspected to be con-
tagious.
judge not hastily, essential and para-
mount to practise.

element,stand out in bold relief,as to the finalexamination for permission

The
"omplieatiens of the disease were, among forminga model to other States if not to be to practise,
"
unless he previously has obtained,
men, afiectionsof the scrotum and the testicle; exactly copied, at least to be emulated. We afterexamination,the recommendation of one
adiong women, jd"ctions of the bres^stand ovaries,allude to the perfect unityand harmonyof the or other of these Boards a rule never to be
"

and in one case of the labia majora. The se- condary

organisation of the Medical portion munity, dispensed
of the com- with ; and thus the public will have
orchitis hardly ever commenced by
violent qrmptoms; generallya dull pain and where it may be said to act as one, and a band of able and competent men,- reared for

weight was felt in the testicle, which when by which means it offers to the public a degree their service, and confirmed in theirconfidence
examined, was felt to be alreadyenlarged.The of security and protection againstthe claims by the searching examination of the State or
tumefaction was at its height about the fourth and
pretensions of ignorantadventurers and Government Board,whose guaranteeand sanc-tion
or sixth day; it affected the body of the testicle
rash quacksreadyto prey upon the community must be held as finaland conclusive.
rather than the epididymis, and was not attended
oedema of the scrotum. Only once did the and fatten the ignorance a nd stupidity of In matter vitallymomentous as that of
by didymis
epi- upon a so

presentthe hardness common in gonorrhceal the masses security and protection health, the publichave a right to claim security
a"
totally
orchitis; when it was swollen,it was alwaysincon-siderably
unknown in our country. This
point is essen-
tially for the qualificationsof its Practitioners ; and it
so, compared to the testicle. Sometimes
obtained by the law pervading the whole is not necessary to remark,that the different
on the third,sixth,or eleventh day the scrotum
became pufiy, with or without redness. The orchitis of the Germanic Confederation, by which it is degrees of Physician,Surgeon, and Apothecary,
was sometimes accompanied by generalfebrile decreed and enforced that,independent of any thoughthey may be combined in some indivi- duals,
symptoms and vomiting.In twenty-Uiree cases, the degree or diplomawhich an individual may are not positivelyunited in every Medical
Tighttesticlewas attacked thirteen times, the left have in medicine That there should be a liberty to adoptany
six, and both four times. Sometimes the orchitis
acquired " ^and which,in fact, man.

wasprimitive,
e.,t. did not followthe is merely honorary ^he cannot
swelling.
parotid "
practisein branch of the Profession a practitioner may
Its occurrence was not connected with accidental any branch of his Profession, unless he has think proper, there cannot be a question ; but
falls or blows ; it seemed, except in the cases just obtained the license and authority of the that the publicshould have a guaranteefor his
referred to, to be a true secondarylesion. The
State ; and this can only be acquiredby thoroughacquaintance with all and each of the
treatment of the orchitis was simple; cataplasms,
compresses dippedin goulard, baths,and in three undergoingthe ordeal of a special and most thousand-and-one contingencies to which the
or four of the worst cabes, bleeding.(GazetteMid,, formidable examination. human frame isliable from the precincts
" of the
Jan. 12 and 19.) This we consider the pointpar excellence in cradle to the lastscene of all ^beforehe should
"

the German system ; one that mightbe adopted be held as qualified for that charge,
can onlybe
TO SUBSCRIBERS. with infiniteadvantagein the British domi-
nions, a matter of doubt with those whose knowledge
New Subeenben will obligeby forwardingtheir and that would constitute directly,
as of the structure of the human body and its
Names dhreet to the Office,147,Strand, or to the well as indirectly,
a powerful lever,
annihilating sympatheticorganization, and
is most imperfect
News Agents or BookuUers. AU Post-office quackeryin itsvery cradle. incomplete.The division of the Profession
Orders should be made payableto the Publishers, It is
scarcely into the two sdepartments of Medicine and
necessary to remark,thatin our
Wm. S. Obb ahd Go.
country we possess abundant and most perfect Surgery, thoughfraught with many advantages
means for the
studyof the healing art. Our under one aspect,can never be contemplated
Colleges are liberally endowed,and our Halls, by the enlightened medical mind as otherwise
THE MEDICAL TIMES. and Museums, and Libraries amplysuppliedthan a falseview of the real nature of the heal- ing
with all the appliances of science and of art. art,and its ultimate philosophy.They are
SATURDAY, FEBRUARY 2, 1850, Dissatisfactionand malcontent, nevertheless, one and indivisible," and he who assumes to

prevail, not silently but loudly"even be a goodSurgeon,without a thorough ledge

know-
fiercely
Discord and corruption, rottenness and death,among the mixed members of a mixed Profession. of internal, or so-called medical disease,
minglelargely with the elements of all human The pure Surgeonopposes the as false as the Physician who
pure Physicianis in a position
institutions.Incessant change is the greatlaw trespassing upon his ground, and warring with for
prescribes a case of enteritis without a tho-
rough
of nature ; new forms are demanded by new him on his boundaries ; while the Apothecary knowledge of the kindred maladies,
ages, and thus the wheel of Time is kept in looks on the while, luxuriating in the contest surgical as well as medical, for which it may be
continuous moyement. Thei^e is nothing manent
per-
often eatingthe oyster,and
"
leavingthe mistaken. The idea of a pure Physicianis a
; and the great art of mankind is to combatants the shells. Hence,new ments
establish- metaphysicalabstraction, which, perhaps,
giyeto the yaryinginstitutions which it rules are proposed, new associations arranged,Berkeleymight have acknowledged.Nor is
and regulates that degree of perfection and the esprit de corps of the Professionbroken up the proposition of a pure Surgeonless absurd ;
harmonywhich the successiyeadvances of ages and scattered, and lostamid endless wranglingfor the art of Surgery never stands so brilliantly
require and sanction, without precluding, how- and dispute.To-dayhails a plan to be pulledand prominently forward, as when it saves a

cTer, those further changesand modifications down on the morrow, and the scheme of the limb from the painful necessity of the ampu-
tating
which succeeding ages may in their turn dis- comingday awaits the like fate in the worship knife.
coyer to be necessary, and naturally desire to of its successor. That such a state of action
engraftupon these existing systems.No method and of feeling as detrimental to
is the well- REGISTRATION OF DEATHS.
is BO faultlessbut it may receiye improvement ; beingof the Profession, as it b injurious to the It was stated in the Reportsof some of the
and no plan is so perfect that it can be said to true interests of the public, there can be no Superintendent-Inspectors of the Board of
be incapableof advantageousmodification. question ; and, since it is unhappilymanifest Health,that the Medical Officers who were
But that there should be an unanimous consent that the Corporations will not reform them- selves,appointed to make the house-to-house visita- tion
among the various races of mankind as to ihelr why, we ask with all deference,should duringthe prevalence of cholera, disco-
vered
almost endless legislative measures, is as hope- not the Government seek to heal these wounds, the bodies of numerous persons who had
leu from the nature of the constitutionof the still thesejarrings, and soothe these heart-hum- perishedwithout receiving medical aid, and
 82 THE MEDICAL TIMES.
iiig
to Greek and Roman History, as theyhave 1709,the population of the hospital reached the allycreated for them. By these wise measures
not been published, we can oflfer no remarks. enormous amount of 9000. the number of beds was gradually reduced to
Why were theynot published ? The candidate It is almost impossible to imagine how such 745 ; the neighbourhood, also,was greatly im-
proved,
must also givesatisfactory proofs that he knows crowd could receive accommodation within the removal
a
by of old houses, "c. ;
somethingabout Arithmetic, Algebra, Euclid, the walls of the hospital, the more particularly private rooms were given to the hospital ants,
serv-

Statics, Hydrostatics, Optics,and the French when we remember, that even so late as 1790, who formerlysleptin the wards
; the
language. itcontained, in addition to its ordinary tion, hospital
popula- was properly heated ; and now, with
Now, this classical curriculum is very showy, a slaughter house, an establishment for the exception of its site, which is too close to
and may be very useful ; but we have strong meltingsuet, and a candle manufactory.The the river,the Hotel Dieu is not inferior, in
doubts whether it will not prove an insurmount- able persons connected with these different trades point of hygiene, to any of the hospitals of
barrier to many clever young surgeons often occupied the beds destined for the sick, Paris.

obtaining the Fellowship. We think,therefore, the greatestconfusion pervadedthe admini- stration The Hotel Dieu at presentconsistsof three
that the College has committed a serious error of the hospital, and itsmortality which
was pro- separatebuildings,
portionate are connected gether
to-
in requiring every candidate, if he to itsmisrule. by bridges.The principal
even possess building
the Member's diploma of a later date than 1844, When Tenon wrote his famous Report, in faces the square of Notre Dame, and presents
to be skilled in Classics, Mathematics, and 1789, the Hdtel Dieu contained 1219 beds; nothingworthy of notice. It runs alongthe
French. It is fencingthe Fellowship with a of which 733 were fn?Vcdlled large beds,being right bank of one of the branches of the Seine,
hedge in which there is no gap for a skilful 4} feet wide, and holdingsix patients at a which bifurcates justbehind the Cathedral, and
Practitioner, with a defective general education,time ; 486 were very properly called smaU beds, it is connected
by a covered bridgewith the
to obtain an entrance. The consequences for theywere not quite 3 feet wide,yet held second building, which runs parallel it on the
are to
easilyforeseen;the Fellows may he the best four patients together.The description which left bank of the river. The principal wards in
scholars, the Members will he the most accom- plished Tenon has left us of the state of the Hospitalthe Hospitalare the sallet St. Marthe, St.
Surgeons, and the College will neither is worth recording, for it explains the excessive Charles,St. Paul, and St. Joseph. The aalle
enjoythe confidence of the Profession qor the mortality of the house, which then amounted St. Marthe was founded duringthe reign of
respectof the Public. to 1 in 4, and enables us to show that the mor- tality Francis I. by Chancellor Duprat. St. Charles
The Physicians have already tried the exps- has gradually diminished in proportion was erected in 1602 by a donation fVom the
riment of making classicallearning a passport as the plain rules of hygiene have been attended President of the Parliament. In 1625 the
to corporate honours ; and so complete was the to. Since 1789 thousands of lives have been Governors obtained permission to build tbe
failure, that their College was onlysaved from saved by merelyimproving the sanitary con-
dition salleSt. Joseph, and a bridge which passed from
ruin by a repeal of the bye-law which confined of the Hdtel Dieu, the mortalityin the Archbishop's Palace to the third division of
the Fellowship to Oxford and Cambridge duates.
Gra- which has been reduced by one-half. the Hospital in the Rue de la Boucherie. The
Why, then,should the Surgeonsperil That it was formerly so high, can be readily
greaterpartof the other wards were added in
their Corporation, when they have a beacon to understood. From four to six patients occupied1714 when the tax on the theatreswas increased
them of their danger t We are advocates the same bed. Nay, more ; on pressing
warn sions,
occa- by Is. 9d. for this purpose.
of a liberal education for all the members of the beds were placedone over the other, The general aspectof the wards in the Hotel
our Profession, but we would condemn any " a mattrass being stretched on the roof of Dieu is clean,but some of the saUes appear
stringent regulations, which would exclude each bed ; so that the wards became, as it were, dark,and rather low. The bedsteads are all of
worthymen from collegiate rewards. double stories. The quantity of air for each iron,fVirnished with clean white curtains, and
patientwas thus reduced fVom fifteen cubic nothinghas been neglected to render the estab-lishment
THE PARISIAN HOSPITALS. metres to three or four. The dead and conva- lescent worthyof the highreputationit has
h6tel dieu. remained mingled with the sick,for enjoyedsince the daysof Desault. A marble
Having in a former article given a generalthere were neither dead-houses nor convales- cent monument to the memory of this celebrated
wards. Patients recovering from the
sketch of the Parisianhospitals, we shall notice surgeon, and of Bich"t, was erected in the
each of these establishmentsin its turn. The severest maladies were compelled to walk out, vestibule of the Hospital in the
year 1803.
Hdtel Dieu, as the oldest and roost important, without shoes or stockings, even in the depth There is likewise here a fine statue of M. de
firstattracts attention. The foundation of this of winter, on the bridgeof St. Charles,to get Montyon,and some goodportraits of Desault,
venerable establishment appears to have taken a mouthful of fresh air. There was no operat-
ing Moreau, Pelletan, Bichat, Dupuytren, "o.
placeat so remote a period, that historiansare theatre,and, accordingly, most painful But,perhaps,
the one of the objects most worthy
tainty. or prolonged
unable to fix the epochwith any degreeof cer- operations were performed in the of notice in the H6tel Dieu is the linen-room,
The m^orityof writers inclineto think wards,where lay,indiscriminately, those who where an immense depdtof linen is preserved
that it was founded about the had been already m utilated, and the nate
unfortu- under the care of the Sisters of Charity.Here
year 660, by
patients awaiting their filte; the cries and the visiter will see some
Landry,Bishop of Paris ; but no historical 5000 sheets, 2000 cur-tains,

proofof the fact can be cited. All we know is, groans of the sufferers awaking,in the former, 14,000 shirU,28,000 napkinsor pillow
that the Hdtel-Dieu is perhaps the oldesthospi- reminiscence of what theyhad undergone, 7000 towels, a nd of
tal a cases, a variety other lioeii,
in Europe,and that it occupied its present and,in the latter, a dreadful apprehension of carefully arrangedand perfectly aired, in
site on the banks of the Seine,ever since the the torture in store for them. The insane ward wooden racks of enormous magnitude.
of itsfoundation. was next to the operating ward,and the shouts The annual expense of the Hdtel Dieu does
period
Before the time of St. Louis the Hospitalof the ill-treated lunatics rendered sleep sible. not exceed 20,000/.;a small sum, when wc
impos-
oonsistedof three small buildings only, and was Finally, the lying-in women of the St. consider the greatnumber of patients relieved
altogether insigni^cant. St. Louis took the Josephward were placedthree or four in a therein. Within the last thirtyyears the
establishmentunder his protection, increased it bed,thrown together without any distinction, annual expense for ei^h patient has been re- duced

considerably, and may be regardedas its real and few,if any, survived. by nearlyone- half. With this greatim- provement,
founder. The Hospital at first rather a Such the condition of the Hdtel Dieu the mortality,
was was as we remarked,has
house of refuge than a receptacle for the sick. under Louis XVI. The greatrevolutioncame, likewise been gradually reduced. In 1816 it
In the time of St. Louis it contained 900 and,as a necessary consequence, the state of was 1 in 4i ; in 1826 it was 1 in 7; in 1836

patients, chiefly made up of pilgrimsand the poor in the publichospitals attracted im- mediate 1 in 9 l'3rd ; at the presentmoment it is about
with a few sick, admitted all hours, attention. 1 in 10. The staff the H6tel Dieu consists
of
beggars, at
the The slaughter-house and candle manufactory of physicians, surgeons, 32 internes,
and without any control. During reignof 10 3

Henry the Fourth, thehospital contained 1300 were removed ; the beds were divided by com- partments124 externes,60 Sisters of Charity, who act as
under Louis
inhabitants; the Xlllth 1800; ; the insane were drafted ofi*to other nurses, and 140 servants of all kinds. Clinical
under Louis the XI Vth 1900 ; finally, hospitals
towards
nvof ; the lying-in
Avmg-iu wvrvmcu,
^i^ato omen,
,
the children.Lectures on Medicine are delivered by MM.
*.u^ ui^ uuiimcu,

the of the
beginning 18th century,in the year |and venereal patients, to establishments sped Chomel and Louis ; those on Surgeryby Rouz
 THE MEDICAL TIMES. 83
aod Jobert. From the centralsituation of the phenomena of matter
intimatelyconnected ; the wide distinction between man
are and animals that
the surgical
hospital, service is extremely
active,naked lichen can be traced up
to the most perfectmake the nearest approachto him, in pointof
and it may be calculated that an operation is plant, and the humblest medusa to the most giftedlongevity, the extreme term of the orang-outaug's

performedat least for every day throughoutof creation. beingestimated at not more than thirty years ; but
the year. ** the capacity for longlife is not greaterin one tribe
Descriptive Botany,"says De Humboldt, " no
confined the narrow of tae human than another, is there any
Exceptin cases where the student or medical longer oT to circle of the deter-
mination race ^nor "

and species,leads the observer, differenceas to its average duration,under equal

practitionerdesiresto followup some speciality, traversesgenera distantlands and lofty
who mountains, to tion,
habita-
the Hdtel Dleu isin allrespectsthe best hospitalthe studyof the geographical
circumstances as to climate,food,clothing,
distributionof plants
the earth's surface, and the sanitaryaids which civilization
for the of diseasein Paris.
study over accordingto the distance
from
the equator and vertical elevation above the furnishes.
It is further necessary to investigate
sea. the laws The same generalcoincidence prevails with re-
ference
which regulatethe difierencesof temperature and
REVIEWS- to other physiological characters,as the age
climate, and the meteorological processes of the at-
mosphere,
before we can hope to explain the involved of puberty, the periodof gestation,the signsof ad-
vancing
causes of vegetable distribution; and it is thus that life,and the diseases to which the human
Atlas ofPhysicalGeography,Constructed by Au-
gustusthe
observer,who earnestly the path of ^
pursues frame is subject,the greaterpart of which are
Petermann, F.R.G.S.; with descriptiveknowledge, is led from one class of phenomena to
to all communities,modified by differing
Letter-press,embracinga General View of the another,by means of the mutual and common
dependence
connexion existing
between them."
climates and local position.
PhysicalPhenomena of the Globe. By the Rev.
Thomas Milner, M.A., "c. Illustratedby 130 Nor isthisall. The Rev. Mr. Milner
justlyre-
marks, It is the studyof these latterdifierenceswhich is
London that physical
geographydeals not
only with to the medical man. The
Vignettesin wood. : William S. Orf of imperious necessity
and Co. subjects fraught with interestto the inquiring mind ; medical topography of the locality of his own mediate
im-

Of all branches of human but aho with such as are important to the pursuits labours ought to be the subjectof every
knowledge, Physical
of commerce, and the social advance of mankind. practitioner's most careful investigations.
Geography is probablythe most captivating. The
mind of youthclings The barometer is a familiar exampleof the benefit It is only within recent years that the numerical
instinctively to the picturesque
conferred by the science of meteorology. The laws
contrasts of nature, and more sobered manhood is method of investigating diseases has been strictly
ennobled by the contemplation of storms, as developed by Colonel Reid, and at- mospheric
to the investigation of
of the same pheno-
mena adopted. Its application
electricity,as grappled with by a Harris, morbid actions has
in their wider aspect. The cave and the alreadyprovedso successful,
the mountain and the are also examplesof what has been done,even
in
waterEall charm the observer, that the doctrine of averages has been not unaptly
The poet and the recent times,
towards improvingthe safety of com-
flood fillthe mind with awe. mercial
termed the mathematics of medical science. Medical
in the ever-changing navigation, and,as a consequence, the social statistics of
artistfind inspiration moods may be defined to be the applicalion
and advance of
nations;but the fact is,that man, with numbers to the elucidation of the natural history of
ever-varying aspectsof nature. The spiritually
all his dignity and greatness, is so intimately pendent
de- of
endowed enjoythe stillhighergratification of trac man in health and disease. As the experience
on and connected with external nature, that the civil is on too limited a scale,and
ingproofsof wisdom and goodnessin the relations practitioner
is
it impossible to giveimpulseto the study of the
of an external world. his observationstoo unmethodical to warrant general
latterwithout signally improving his condition, and
Looking at the beautifulWork before us, which conclusions, itis onlyby extendingsuch observa- tions
benefiting mankind generally.
througha series of years, and over vast masses
speaksto the eye as much pictorially as it does by
its letter-press, There is one point of view in which physicalof individuals, that correct conclusions can be at-
tained,
the characters of igneousrocks,
geographystillremains to be contemplated, coverable
dis-
"
graniticveins, and basalticcolumns, ^themore
"
"
and as well as importantrelationsdisclosed,
characteristicforms of organic one which is more peculiarly fittedfor our pages ; in no other way. As a test of the truth of
remains,and the pe- culiarities
of stratification, that is,in reference to the influence of climate on theories, statistical investigations are of vast im-portance.
are at once fitmiliarised
to the mind, which is led,by the easiest man and its endemic influences. Ethnography,or Could allmedical opinions be submitted
possible of
transition,to the studyof fissuresand caves, glaciers, the physical differencesof mankind, undoubtedlyto the searching ordeal of numbers, the substance

volcanoes,and other of the rarer more or less dependenton climate,exposure, and many a ponderous volume mightbe condensed upon
geological nomena.
phe-
To these again succeed the consider* other circumstances,as well as with a more its title-page.

ation of water under its various aspects,springs, mysterious dispensation, is a study without which in thediseasesof pulmonary
It is more particiUarly
the education of a medical man would be trulyin- complete. still wanted.
rivers,lakes, and oceans. Then, again,the at- mosphere, organs, that observationsof thiskind are
with its winds and clouds,and storms The Rev. Mr. Milner takes up,
we are
It was onlythe other day that we read a littlebook
rational view of this
and hurricanes,its hot and its cold regions,
and happy to see, a interesting recommendingthe Arctic regionsfor the cure of
branch of inquiry."Various considerations," he
its many peculiaropticaland electricalpheno- mena. phthisis pulmoualis.This appearedvery extrava- gant,

says,
"
decisively show that the distinctions of but it is generally admitted, especially by
colour exhibited by perfectly
But on the face of the earth, in the ocean beneath,
the human race are
American etiologisU ("The Climate of the United
o f
independent diversity origin of the cause." S. Forry,
and in the air above,there is
organic life, and Phy-
sical "
as
States,and its Endemic Influences," by
Geographyespecially occupiesitselfwith the
Anatomical investigation proves the true skin to M.D.) that phthisis prevails less in hot and very
distributionof forms, a branch of studyno less in- be similar in allnations." And further on he re- marks, countries. The influence of
"
teresting cold, than in temperate
''
than that of making acquaintance the argument againstthe unityof man- kind, moisture in the production of catarrh, pleuritis,
with the
fonua themselves. Prom the Banian tree,multiply- founded upon difierencesof colour, com- is pletely has also been too ex- clusively
ing pneumonia,and phthisis,
itselfinto a forest, to man into explodedby the considerationthat varieties considered. So,also, in regard to rheumatic
congregating
of hue, quite as strongly marked, occur in animals to
nations ; there is a scale in organic causes, viz.,exposure
the exciting a
creation quite diseases,
of the same species." must be con-
snffioiently delineated for ordinary purposes in the cold,moist,and variable atmosphere,
presentWork. If thisis the case in regardto the more manifest sidered in their subordination to the predisposition
how much more is itthe case in re- induced by the extremes of summer and winter.
These are themes of infiniteinterest, but they differences, so gard

have also farhigher to those differences of strength, stature,propor- The difficulties inherent in the studyof diseases of
bearings. In a philosophical point tion,
of view, the boast of the form of skull, and character of hair,to which malarial origin are stillmore formidable.
greatest physical geogra-
pher
of the so much importancehas been attached,as indicat- ing A correct knowledgeof endemic diseasesis still
age" Humboldt" is to make an attempt
in his " Cosmos** to trace the phenomena of variety of species, but which are, in fact,to a a desideratum in our literature. The
physical professional
.

objects in their generalconnexion,and to certainextent,met with among one particular lace, subject is intimatelyinterwoven with those sanitary
represent
Nature as well as among races, as contrasted one with considerations which have of late excited so much
as one greatwhole,moved and animated by
internalforces. It is no more another. and which are of so much importance to
in the power of the attention,
of
uninitiatedto comprehend all the
special bearings It is importantalso to the medical man, the welfare of our species.Nor can the study
of this greatgeneralisation, without a considerable easily carried away by the theoristswho advocate a such subjects be commenced with greater prospects
amount of study,than it is to solve a problemin variety in the human species,that he should fa- of success, than by such a work as that now before
miliarize
fluxions without
any elementary mathematical himself with this fact,that while the us. The elements of a branch of knowledgewhich
knowledge. To facilitatesuch a study,had we physical difi!erences of mankind are not onlycon-
sistent is now entitledto take its rank with other depart-
ments
been writinga work on Physical with the anatomical phenomena exhibited by of Natural Philosophy, indeed so ad-
mirably
Geography,we are
would have begun with the simplest known species, their imityis strongly confirmed by
conveyedin Mr. Petermann' s maps, that
meteorological
phenomena,and traced the first drop of rain tillit a common conformity to the same physiologrical we cannot use too strongterms in recommending
became a river, a delta; a rock,a mountain. All laws. There is,as Mr. Milner justlypoints out, a them to the Profession.
 84 THE MEDICAL TIMES.
to the Physiology
Contributions qf the Alimentary alongthe lesser curvature ; and when we currently received doctrines,
and his chief argfumenl8
Canal. By William Bbinton, M.D. London : recollectthe situationofthe openinginto the viscus, in favour of the theoryhe advocates ; but Dr. Brin-

pearance,
from which his observationswere made, it is evident
of the
Liceptiate Royal College Physicians,
of
that a movement
ton's itselfis free from
alongthe real axis of the organ paper so verbiage,
superfluous
Demonstrator of Anatomy in King'sCollege,would be 80 nearto the curved border,and com-paratively and every sentence
bears so directlyon the pointhe
London. so far from the point of view, that he wishes to establish, that to givethe fullscope of his
could scarcelyhave avoided imputing to it the course
Dr. Brinfon's articlesin the Cyclopaedia of Ana-
tomy arguments it would be necessary to transcribe the
which he has done."
and Physiology have earned for him a high whole paper. We can assure our readers that,whe- ther
It is by thisbackward axial current, and not by
placein Medical Science. The paper before us must the physiological noveltyof the views pro- pounded
the commonly received idea of an anteperistaltic
still further increase his reputation. It was originally be considered, the styleof reasoning, or
movement of the stomach, that Dr. Brinton ex- plains
published in a contemporaryJournal ; but we gladly, the ingenuity of the experiments, this paper well
the share which that organ takes in the pro- duction
because of its intrinsicmerit,avail ourselves of its deserves seriousattention.
of vomiting; the regurgitation of fluid
appearance in a separateform,to bringit under the
notice of our readers. The opinions enforced in it during
the digestive process; and the easy kind of
witnessed in very young
The Medical Directory for1850.
are as sound as theyare novel. vomitingoccasionally
We have received " The London and Provincial
In the firstpart,which treats of the movements
children while feeding.
Medical Directory." It is the fifththat has been
part of the paper is entitled,On
"
The second
of the stomach, Di. Brinton shows, that the so-
offered to the Profession, the members of which
the Physiology of IntestinalObstruction."
called oblique layerof muscular fibre of that organ
remarkable cannot failto acknowledge to be well worthy of
it
Foecal vomiting, one of the most
is really a transverse layer transverse, that is to it is in-
dispensable
has the patronageit has received. We think
"

" symptoms of occlusion of the Intestine,

say, not to the apparent horizontal axis,but to to the Medical man, and it oughtto be
been, up to the presenttime, explained by a aup "

to that real axis of the tube which occupies its

the library-table of every one, whether he be a
posedanteperistaltic action of the bowel above the on
centre, and is terminated by itsorifices." or Apothecary.The Directory
occluded point Having exposedthe very slightPhysician, Surgeon,
By the aid of experiments on dogs and cats, Dr.
evidence on which the anteperistaltic for 1850 contains the name, place, and residence of
Brinton appears to have very clearly made out
theoryrests,
Practitionerin England; if he has a private
that"
the Author ofiers the following very powerful argu- every
ments,
from his placeof business, both ad-
dresses
"
which show it to be in the highestdegree residence apart
Soon after ingestion the peristaltic movements of all are
the whole of the organ ; but, even at that improbable.
are given; the qualifications
engage
insertedin the order of their importance ; the degree
time,there is a manifest preponderance in the pyloric 1. Irritation jthe supposedcause of anteperistalsis
half;the pylorusis at thistime firmlyshut. To- wards of M.D. is in no case appendedto a name, unless the
occurs in every morbid affectionof the bowels,and
the termination of digestion, the cardiac ex- w hence it was derived is given;the
tremity
yet occlusion is the only condition in which foecal University
experiences less movement, but the peristalsis
holders of foreign diplomas are not omitted ; and the
of the pyloric portion becomes much more rapidand vomitingoccurs.
vehement." 2. After death,the most distended part of the public appointments and officesheld by allMedical
The well known men in England are enumerated in a word, it
experimentsof Beaumont bowel is that immediately above the pointof ob- struction,
"

have led physiologists to regard as an estab- lished if the foecalvomiting from antepe-
contains the name, address, qualification, pointments,
ap-
arose ristalsis,
fact,the idea that the food, duringstomach then a sufficientquantity of the contents and published works of every known
physician, surgeon, and general practitioner
digestion, after passing the cardia, is carried along oughtbefore death to have been carried
upwards qualified
the greatercurvature of the organ from leftto right, to render the distensionat leastequalthroughout in England. The weekly,bi-monthly, monthly,
and then alongthe smaller arch from rightto left. quarterly, half-yearly, and annual medical dicals,
perio-
3. Certain phenomena,observed in cases of inva-
gination.
Tlie explanation. Dr. Brinton says, usually with theirpublisbers' names, are eniunerated.
givenof
the phenomena observed, involves an apparent in The public medical In^itutions, and Poor-law dical
me-
4. The supposedanteperistalsis is a continuous
consistency, because there is onlyone movement of movement staffare, as it were, gazetted.The regula- tions
; the vomiting onlyan interrupted nomenon.
phe-
the stomach, a peristaltic of the London Collegesof Physicians and of
" movement uniformly for-
wards, To this objection, however,Dr. Brinton
while the ingesta Surgeons,and of the Society of Apothecaries are
"
have, it is alleged, two attributes little weight
detailed, also those of the Universities and
opposite movements, viz.,"one forwards to the 5. While an anteperistaltic action is alleged to take
as

of the three kingdoms. To review

pylorus, and one backwards to the cardia." placeabove the point of obstruction, a peristaltic action Colleges
This Dr. Brinton itis obvious,must have gone on in the partbelow such a work were impossible; and no praisewe
apparent inconsistency may.
conceives, be thus explained bestow upon it would compensate for the toil
:"
the strangulation ; that this ordinary action of the can
"The most simpleand obvious course, and one intestinecontinues in many cases, is provedby the and labour which have been given to it We re- peat,
which, to some extent, will reflect lightupon the of the solid contents of the bowels. From every Medical man should possess it Mr.
data,as well as on the result, is to imitate the natural expulsion
Churchill, itspublisher, deserves well of the Medical
conditions and to observe and compare the effects. one and the same point, then,two opposite move-
ments
*'
Thus takinga long membranous then have set forth; the one upwards Profession; but
he has bestowed no more acceptable
tube,prefer- must
ably'of considerablesize and width, such as the pre- and useful boon upon it than " The London and
"

pared toward the stomach, the other downwards towards

weasands sold to the sausage-makerSf"and Provincial Medical Directory for 1850."
the rectum.
filling it with water, to moderate but not extreme
We have,however, one fault to find: an asterisk "

distension, by tying up both extremitieswe tolerably 6. The time at which the symptom firstappears,
of persons who, as the
is prefixed to the names
approach to the condition of the simplestomach of oughtsimplyto
vary with the distance of the stric- ture
some animals. Editors say, have not made any return of the nature
from the stomach ; t. e,, if the anteperistaltic
"The opposed and semi-flexed forefinger and of their qualifications, and whose names cannot be
thumb willproduce a transverse circularindentation, theorybe true; but extended observation shows, found in the authenticated London listsof licensed
which, earned slowly forwards, will similarly come that it depends on two things ^length
"
of cavity
to a peristaltic Practitioners. We think the Editors would have done
near movement. By previouslyin- troducing
and quantityof contents. And further,that
any sufficiently visible and flexibleobject, better to have omitted altogether the names of the per-
sons
of considerable length, distension is not only essential to the rence,
occur-
littlediameter, and a specific and that more since some
but is that which chiefly
in question, especially
gravity somewhere about that of water, and by at- taching regulates its ac-cess.
this to the centre of one extremity, shall
of theirnumber " and, in comparison, theyare but
we Now, distensionis no more a condition ne- cessary
obtain an index of the current developedm this few
"

mighthave been in practice before 1815, or

part to anteperistalsis than to peristalsis, while it
of the interior. Ordinary black tape fulfils these re- members of the Scotch Irish Col-
leges.
quirements.
is essentialto the theory which the Author seeks
actually are or

"
And now, producing
While others, again, althoughmedical men,
the transverse constriction to establish.
in the manner may not profess to practise. We hope,however,
just mentioned,and moving it rapidly That
and frequently from the one end to the other,an theoryis as follows : "
with the Editors,that ** every gentlemanwill sup- ply
elongation of the black stringatUched to the centre When any part of the intestinal canal has its his qualification for correct entryin next year's
of that extremityto which the movement is con-
stantly
cavity obliteratedby a mechanical obstacle, the or- dinary and also that Mr.
carried, indicatesthat a backward current of (1851)Directory;" we trust,
liquidin the axis of the tube is a coincident of the peristaltic action of the intestineabove,by Churchill will devise means to include Scotland

forward one which occupiesits periphery ; and, like

propelling onward its contents, gradually distends and Ireland in thismost useful medical Annual.
it,is the directresult of the peristalsis. the whole intestinebetween the stricture and the
"
Transverse contractions, of uniform direction, Continued tends
pylorus. peristalsis to develope Mr. 50/.to
oecnrring'in a closed tube filled with a liquid, and Burder, of Liverpool, has presented
in the fluidcontents of the dilatedportion an axial the
falling snort of obliterating its calibre, necessarily Eye and Ear Infirmaryof that town.
implytwo currents" A superficial or peripheric, in the reversed current, and, in this way, the intestinal We understand that Dr. Costello has withdrawn
direction of those contractions, and an axial or fluidpasses into the stomach, and is subsequently from the management of Wyke-house Private Lu- natic
centric,havingprecisely the reverse course. We
Asylum,and has been succeeded by Dr. Bat-
thus have at once
ejected by vomiting.
a complete elucidation of the re- volutions cumbe, under whose care and superintendence we
of the food,which Dr. Beaumont wimessed We have thus endeavoured to giveour readers a
may augur favourably of the future success and
The return of the alimentary bolus,wag, to allap- general outlineof the Author's objections to certain prosperity of thisestablishment.
 THE MEDICAL TIMES. 85
HBPORTS OF SOCIETIES. matter beingtaken up by the mucous
the morbid he thought, the cause of the symptoms, by prevent- ing
engagedin the disease. Influenza was
membrane the chemical changeswhich oughtto take place

ROYAL MEDICAL AND CHIRURGICAL formerly regarded contagious,

a s but the opinion of in the body,by which animal heat is generated.If
SOCIETY. the profession in this respecthas since changed, and the blood retained itsusual quantity of serum, and
as itsepidemics in some respectresemble those of yet respiration were imperfect, and the renal fluid
Tuesday,January22, 1850. cholera, it has caused,in some fluidwould be loaded
degree, the belief,unsecreted,the circulating ,

that cholera is not contagious. It is difficultto with carbonic acid and urea, and the brain would
G. Macilwain, Esq.,V.P.,in the Chair.
prove the spreadof the disease by contagion in all be affected, but this is not the case in cholera, cause
be-
cases, but in some itis very clear. In cholera tlie during the cold stage of the disease,the
CHEHIGAL RBSEARCHES ON THE NATUBE
poison has to be applied to the mucous membrane chemical changes are not carried on in the body,in
AND CAUSE OF CHOLERA.
of the alimentary canal,and to efl^ect that it must consequence of the' absence of the serum of the
Bj ROBERT DUNDAS THOMSON, M.D., Olaigow.
[Commimicated by Sir B. C. BRODIE, Bart.] firstbe swallowed,and, consequently, its progress blood,so that there is not the usual amount of urea

In the firstpart of the paper the author detailsthe must be slower than that of influenza, which is pagated
pro- and carbonic acid generated. Under these stances
circum-
results of chemical analyses of the blood,urine,and by the breath. Where the habits of per- sons the functions of the brain remain nearlyin- tact
intestinal discharges, in the cold, or ''lymphatic" are very dirty, or water contaminated by sewage to the lastmoment Dr. Baly then referred to

stage of cholera ; and in the

'*
biliary," or febrile fluids is used, the disease spreadsmore rapidly.certain experiments instituted by Mr. Barlow re- specting

stage. The main results arrived at are 1. That in The Report of the Hegistrar-General
"
shows, that the occurrence of muscular action, and the
the cold stage of the diseasethe specific gravity of the those districtsof London which arc supplied with generationof animal heat longafterdeath in some
blood,and of the serum separated from the clot,is water from the Thames, water
notoriously
"
taminated cases.
con-
increased ; that the proportionof water is lessthan tliatthe
with sewage matters, the cases of choleia Mr. W. F. Barlow was not of opinion,
in health by at least9 per cent., and in some cases
were of more frequent occurrence, and greaterse- verity failureto demonstrate the existence of poison in the
by as much as 17 per cent ; that both the organic
and the inorganic
and fatality. During the prevalence of lera,
cho- atmosphere w as a proof that such was not the cause
components of the blood are pro- portionally
it is manifest that the Thames water must tain
con- of cholera. Its existencecould not be demonstrably
increased in amount ; but that the increase
of the insoluble saltsis much greater than that of the a greater or less proportion of choleraic ations.
evacu- proved in diseases which were clearly so caused, as

soluble salts. 2. That the intestinaldischarffes, in In the neighbourhoodof Bridge-street, small-pox and scarlatina. The extreme irritability
the cold stage, when of the true "
rice-water" cha-racter,Blackfriars, the epidemicwas very fatal ; its se- verity of the muscular fibres in cholera duringlife, a nd
resemble closely, in their chemical compo-sition, was attributed to the use of the water of St. after death, constituted a remarkable fact in the
the fluids of hydrocele and hydrocephalus; Bride's pump, the well beingcontaminated by leak- age historyof the disease. A true explanation of the
that their flecculiare formed of epithelial scales, and from the Fleet Ditch. This pump had since cause of the changes could not,perhaps, be given; but
the watery part of water, containinga small pro- portionbeen closed. All the factsconnected with the dis- ease he (Mr. Barlow)referredit to the condition of the
of organic matter (albumen)and salts
(chlorideof sodium, carbonate of soda,earthy being taken into consideration.Dr. Snow blood in the cold stage of cholera, duringwhich car- bonic

there was reason to conclude that the dis- acid,and, consequently, animal heat,were not
lime). thought
ease
phosphate, alkaline sulphate,and some
was propagatedby somethingwhich was swal- lowed, generated.The elevationof temperature after death
3. That the small quantity of urine some- times
found in the bladder, in this stage, and thus applied to the mucous membrane of is very difficult to explain.It does not depend on

presentedno apparent aberration from an ordinaryalimentary canal,on which it acted as a poison. the post-mortem muscular contractions, because ex- treme

standard. 4. That in the biliary, or febrilestage Di. Coplandremarked,that, as the analyses made elevation of temperaturehas occurred when
of cholera,the blood soon regains its normal pro-portionby Dr. Thomson, had been at the suggestion of the the contractions have not been met with. There
of water, or even of it ; and that Board of Health,he was that they were of this at the British Infirmary, and
an excess surprised was a case
the other constituents resume their natural relation not more numerous. They were institutedin three somethingof the same kind is seen in yellowfever,
to each other. 5. That the urine,in the biliary the There
cases only. [Dr. Baly here observed,that in some as is also muscular irritability. was an
stage, in several cases contained albumen,but pre- sented experiments there were seven cases examined.]The actual formation of heat after death ; in cases where
scarcely any other deviation from the urine cold at the tiipeof decease,
of health,except in the amount of urea, which at
condition of the blood, excretions, "c., of persons the body was actually
to the the temperature has risen to 109*^* He (Mr.
firstwas deficient. In the second part of the paper in good health varies very much, according
the author describes some experiments, instituted state of health preriously enjoyed.On this point Barlow)thoughtit must be referred to chemical
by htm, with the view of determining whether any the paper did not aflbrd any information. In the changesgoing on in the blood after death, such as

poison could be detected in the atmosphere. In analyses of the feeces, there is not any notice of the occur duringlife. He threw this out merelyas a
one seriesof it
experiments was ascertained that no medicines which had been givenpreviously, which suggestion.
solid matter existed in the air; but ammonia was must have caused some modification. There is not Dr. Webster, with reference to the effectsof the
obtained from it in the proportion of 0*319 grainsof either as the cause of cholera,mentioned,thatr
any analysisof the fluid frequently found atmosphere
caustic ammonia, or 0*731 grains of carbonate of intestinalcanal. He thoughtthat the that disease hayingbroken out among the 2nd Life
coating tne
ammonia to 1000 pounds of air. By another series
paper, as far as itwent, conflrmed previous tion,
observa- Guards at Kmghtsbridge, the regiment was sent to
of experiments itwas determined that no carbon or
but was not so satisfactory as it ought to have Canterbury, after which no more cases occurred.
hydrogenexisted in the atmosphere,except in the from the pancity of the analyses. The analysesSeveral of the women the next nightin the bar- racks
states of carbonic acid and water ; while carbonic been, slept
acid was of the atmosphere had all been carried on in the that had been vacated, and two were seized
obuined in the proportion of one volume
to 6650 volumes of air. In his concluding College of Glasgow, and the results were negative. with cholera. This,he thought, was an illustration
remarks,
the author ai^es that the cause of cholera is not a They oughtto have been performed in the wards of of the effectsof the locality.
specific, tangiblepoison,introduced into the body a cholera hospital or in the sick chamber, and the Dr. Basham referred to Dr. Thomson's analyses
from without,but rather a vicarious transferenceof breath and emanations of the body should have of the blood,and to his statement, that that fluidin
the cutaneous excretion to the intestinal mucous been examined. In allthese points, the paper, as a cholera contained more saline ingredients than in
membrane, dependentpartlyon atmospheric in- fluence,
guideto discover the causes of the disease, was a health. Dr. Thomson had taken Lecanu's standard
and partlyon a predisposinff state of the
complete f ailure. The information it afibrded was as his guide; but this was univerally held to be too
system, in those who are affectedwith the disease. ease, low. Becquerel's
quitenegative.As to the means of curing the dis- analysis was more correct. He
Dr. Snow observed that the experiments the he should not applyto the emissaries of the (Dr.Basham) was D r. Thomson should
on
surprised
blood and evacuations described oy Dr. Thomson, Board of Health,who are have made Lecanu his and c aused
employedto supportpre- conceived authority, thereby
confirmed those which had been previously instituted opinions, and not to elicit truth. He an impressionwith respect to his analysesat
by Drs. Garrod and Parkes ; while those on the atmo- (Dr.Copland)believed there was now evidence to variance with the experiments of Garrod and others.
air
ipheric showed that there did not exist any par- ticularshow that their opinions were greatly modified,and Fibine,also,was considered by the author as being
poisonin the atmosphereduringthe preva- lence the of
question contagion generally admitted. Many in excess ; but he did not ascertainwhether the in-
crease
of cholera. Dr. Thomson had ablypointedmis-statements had been made on this real or relative. He (Dr.Basham) had
point The was
out the fanciful reasons which had led others to at- tribute with in in
disease was reported to have broken out in a work- house, met urea tlie blood two cases during the
the outbreak of the epidemic to atmospheric where it could not have been introduced, lateepidemic. One patient died duringcollapse, and
poison, but it appears that he himself attributescho- lera but this provednot to be the fact Several cases of the other in the stageof re-action. 'Hiisoccurrence
to some abnormal condition of the atmosphere,the disease,reported as such by the surgeon, had the author did not idlude to. When there was onlya
by which the excretion of fluids from the lungsand been admitted into the workhouse, and had there small quantityof urine in the bladder ; its analysis
skin is impeded. The state of the atmosphere which provedfatal. Others followed afterwards. All this was very differentfrom that of healthy urine. It did
ii productive of such an efiectis well known, and, had been suppressed. not contain
any urea or phosphatic salt,and traces
althoughit may have existed in Glasgow while Dr. Baly read an extract from the paper, showing onlyof the chlorides.
cholera was presentin that city, it certainly was not that the experiments on the atmosphere were in two Dr. Baly,in reply to Dr. Basham, remarked,that
the case in London in Augustand the earlypartof sets,one occupying and the othereleven days.Dr. Thomson had quotedEndeilin and Marchand's
eight,
Septemberin last year. In fact,cholera has pre- vailedHe then added,that the author considers suppression analyses of the blood,as well as referredto Lecanu.
in difierent placesunder every condition of of the perspiration to be the probable cause of Dr. Coplandwas inclinedto attributethe elevation
the atmosphere. The chemical analyses of choleraic cholera, the fluid beingtransferred by the intestinal of temperature, which is occasionally found twenty-
blood prove that ithas been so thoroughly deprivedcanal,but he (Dr.Baly) did not believe that so ex- cessivefour or thirty-six hours after death,to commencing
ofitsserum, as to be unable to circulatethroughthe a discharge could be thus produced. Besides,decomposition. same thing met The i s with in all ma-
lignant
Capillaries, and to thishe (Dr.Snow) attributedthe in of the worst cases, the perspiration is not diseases, in yellowfever, and in malignant
many
occtrrrence of collapse, and of the other symptoms
suppressed.Dr. Snow had said, that the coldness puerperal fever.
characteristic of the disease.Dr. Thomson had drawn was caused by the non-circulation of the blood,but Dr. Stewart mentioned thatDr. Garrod had found
a parallel between cholera and influenza;he (Dr. the blood does circulate, the blood acid in two cases.
althoughnot so rapidly as
Snow)believedboth diseases spreadby contagion, in health. The loss of the serum of the blood was, Meetingthen adjourned.
 8r" THE MEDICAL TIMES.
WESTMINSTER MEDICAL SOCIETY. breasts,and some other glands. The diseased could not, when I once triedto inject the bladder
ovaries were supplied with blood by the spermaticwith warm water, get the fluidto pass,although the
F. HiRD, in the Chair.
Esq.,President, artery, branches from the colic and internal iliac. catheter was fairly b eyond all possibilityof prostatic

Malignantulceration was also discovered in the obstruction." My patientwas now him. in a much worse
P0TAS8A CALCB. The bladder was condition than when I last saw He was ex-
ceedingly
NEW PREPARATION OF CUM rectum. not examined. The
who had been in St Giles' Infirmar}', sunk
emaciated; the pain in the back and
Dr. Henry Bennett broughtbefore the Societya patient, regionof the bladder was constant and intense. He
new preparation of caustic potash, which he had exhausted from hemorrhagefrom the rectum. It was
passed his urine
more frequently than ever.
prepared, hy combination with lime, in order to BONE IN THE LONGITUDINAL SINUS. occasionally bloody, but sometimes clear. Oirstand-
avoid the inconvenience attending its fusibility and Dr. Woodfall mentioned the case of a female, ing for a short time it depositeda thick sediment,
tendency to diliquescence. It is made by melting sixty years of age, who had fallendown in her room, which consisted of HthatM, mixed with amorphous
two parts of potassafusa and one of lime, which, and was unable to rise, althoughquitesensible. A organicmatter. Nitric acid and heat showed a large
when dulymixed together, can be run into moulds, few hours afterwards she became comatose, and quantityof albumen. His iMwels were very much
and used as safely as the nitrateof silver. He has whei)he saw her she was completely with relaxed,and he was troubled with vomiting. The
insensible,
purging was arrestedin the coarse of a few days,but
used itin three sizes : one about the sizeof a crow- stertorous breathing, flapping of the lips and cheeks,
the sickness continued. He took i gr. doses of mor- phia
quill ; another as largeas the cylinders of lunar "c. The pulsewas at firstfeeble and irregular, but
thrice a day,which in some measure subdued the
caustic, and the third much larger, for cauterizing afterwards full and strong. She was said to have
pain,but he graduallygot weaker, and sank on the
deeply. This constitutesa caustic as manageable as been subject fits,
to mipposedto be epileptic. The
2nd of January following.
the nitrate of silver, and its action may be equallyattack provedfatalin nineteen hours. On examin-
ing Post-mortem excm/huUitm "The lungsand liverwere
limited,if the part he previously wipeddry. He the head, two pieces of bone were found in the healthy. The heart of natural size ; slightdeposiu
(Dr.Bennett) had used it chiefly in uterine disease ; longitudinal sinus, one loose and the other attached upon the mitral and semilunar valves. Both kid- neys
but he believed it would be found equally applicable but slightly. Two other pieces were found on the were enlaiiged, the leftmuch more than the right.
The capsulewas easilyseparable from the mass of
as a caustic for chancres,the fauces,and all other membranes. The substance of the brain was rally
gene-
and the cornu in the left ventricleespe- the kidney. The tissue of the whole kidneywas
parts of the body. Althoughthis preparation is not soft, cially
softand easilybroken down, but there was no version
con-
like
deliquescent, potassafusa, stillit will attract so.
of tissue. The pelvis contained some puri-
moisture if exposedto the air,and should not be MALIGNANT DISEASE OF THE BLADDER. form fluid, which was traceable down the ureter.
leftuncovered. It will become pulveresceut, and Dr. Lankester read the particulars of a case of the smaller;its pelviswas
The rightkidneywas
useless. Dr. Benntftt'sexperiments carried on malignant disease of the bladder, recalled to his highly ; parts of the kidney presented
were
injected matter
in conjunction with Mr. Squire, from whom this mind by some cases of haemorrhagefrom the granulardegeneration. The coats of the bladder were
preparationmay be obtained. bladder,broughtbefore the Societyby Mr. Nunn : "
firm when grasped from the outside.It was empty, and
CARIES OF THE HBAD OF THE FEMUR. In the springof 1843 Dr. Lankester was consulted on openingit throughthe urethra a loose organised
Mr. H. Smith exhibited two specimensof caries by a gentleman sixty-twoyears of age,a small man, mass of a yellowish colour was found free. Attached
of the head of the femur, both of which had been of active habits, and temperateall his life. He had to a pointnear the neck of the bladder, was a gra-
nulated
excised. The first had been removed by Mr. Morris, neverthelesssuffered much from dyspepsia, a nd had mass, highly injected, presenting portionsof
of Spalding, from a youth,eighteen of latterly been compelledto attend to his diet with a red colour passing on* into white. It was easily
years age. more tnan usual care. He had frequentlyfhad recourse broken down with the knife,and yielded to aliccht
The case has been so accurately detailed in the
Medical Times,that there was
to medical advice for his dyspeptic
occasion to allude twelve months
attacks. About pressure. Higher up the bladder,on one side the
no
before I saw him, workini^ in his Fundus, another tumour presented itself, of lanrer
to it further,especially as he did not intend to garden,he was attacked suddenly with % painin his size, and havingthe same character as that below.
describe the operation, which he considered was back, followed by a desire to make water, on passing The mass that was loose had evidently been sepa-
rated
now establishedin This instance was emi- nently which he found it coloured with blood. He imme- diately from one of the portionsstillm connexion
surgery.
successful. The other specimenwas obtained soughtmedical advice,but the pain in the with the bladder. I had not the opportunity of exa-
mining

from an adult, between thirty and fortyyears of back continued,with a fresh appearanceof blood in these growths by the microscope,but no
(Mr. the urine. He wasted,lost nis appetite, became doubt can exist of theirbelongingto that varietyof
age, formerly in the Grenadier Guards. He
Smith)had removed the diseased bone two years sleepless, and the desire to pass his water frequently, carcinomatous growthswhich have been designated
increased, and the pain in the back continued, with medullarysarcoma, fungus hsematodes,"c The
ago ; the patient survived the operation six months.
in the inside of the t'highs. thickened.
great pain Under these coats of the bladder were very much
This last-named specimen, which had been rated
mace-
circumstances it occurred to bis medical attendants The prostate was considerably enlaived, and, on
in warm water for three months, exhibited the that stune in the bladder was the
cause of his sym-ptoms, cuttiujj^ into it several pointspresented themselves,
earlystageof caries; the disease had onlyexisted and he was sounded more than once, but no in which matter precisclv similar to that of which
eighteenmonths ; the globularshape' of the head stone could be found. When seen by Dr. Lankester the growths in the bladder were composed,was
was unchanged, but it was carious (honey-combed) he was very thin,with an anxious countenance, and found. The glandsof the abdomen, spleen,pan- creas,
all over. The neck of the bone was altogether affected
un- a peculiar stoop in his gait He suffered much from stomaeh,"", were examined,but presentedno
; it remained of the usual length, and at the dyspeptic symptoms, taking food being frequently trace of malignantdisease.
Dr. Lankester remarked,he had brought this case
ordinary oblique anglewith the head. In the other, followed by severe gastrodynia.The bowels were
the diseasehad been in existence six years, and the habitually constipated, and never relieved without beforethe Society, rather as an example of a serious
medicine. He was restless at night, and obliged t o and interesting disease, than on account of its in-trinsic
head of the bone was completely flattenedout, the
get up very frequently to relieve the bladder. He merits. When its historyis taken into consi- deration,
neck beingalmost destroyed. Instead of an oblique
sufferedgreat pain in the back ; but referredthe seat it is evident that diagnosis of malignant
arch it presented a rightangle,with the head. of itto the regionof the bladder in front above the disease of the bladder is somewhat difficult.The
In his own case, all the symptoms of dislocationof pubes. Pressure in this region evidently
gave him symptoms present in this case, and which seem to be
tliehead of the femur existed,and the operation The arine,which he passed every hour or very constant in the cases which have been reported,
provedhis diagnosis to be correct In Mr. Morris' Eain.ouranda half, was sometimesmore coloured than at are painin the back, painat the neck of the bladder,
case, it was supposedthat dislocationhad taken others. It gave an acid re-action to test paper, referred to the regionof the pubes, blood in the
place, that this was provednot to be the case when and, after standing a considerable time,threw down urine,and a frequentdesire to void it Other cases
the operation was performed. A difficulty was perienced deposit
ex-
a which, under the microscope,presented present additional symptoms, such as difficulty in
lithate of ammonia and organic shreds,apparently passing of the water, on account of the tumour ing
obstruct-
in dislocating the head, owingto a small
mucous and flbrine. Blood and pus globulescould the passage into the urethra, "c. The painin
piece of bone which had separated from it,and lay also be plainlydistinguished. On applyingheat and the back may arise from disease of the kidney,
m one of the sinuses. It was this which caused nitric acid,albumen was precimtated. With these or irritationfrom disease in the bladder ; the pain
the symptoms simulating dislocation. There was
symptoms it was somewhat difficult to come to a in the bladder itselfmay be produced by stone or
very great shortening of the limb,in consequence conclusion with regardto the disease. There was no inflammation. The bloody unne may be the result
of the destruction of the neck of the bones. doubt sufficient ground to suspect stone in the of hannorrhagefrom the kidneys, from congestionof
He believed, that afterthe removal of the diseased bladder,but no stone could be discovered. Although the bladder, stone, or uloeration. The frequent desire
bone, inflammation set in, lymph was thrown out there was albumen in the urine, there were no general to pass the water is also a symptom of many other
in the acetabulum the head the symptoms of disease of the kidneys and other sym- forms of the disease so that neither one nor the
(ifhealthy) of ptoms, ;
femur became rounded such as the blood in the urine were suflScient whole of these symptoms will serve as an unerring
oflf,and fibrous tissue
to indicate that the albumen might occur, as the guide. There are, however, some points wiih regard
was formed,from which resulted an entirely new
resultof other causes than renal derangementThere to the blood and other products in the urine,which
capsule.In fact there is a supplemental joint.To was no disease of the prostate gland. Under these serve to assist our diagnosis. When blood
may
show how quickly the reparative process of nature the
circumstances^ I was inclined to regard the case as flows after the introduction of sound,or passes in
goes on, he mentioned that Mr. Morris' patientwas one of chronic inflammation of the bladder,with small quantity from the urethra after the flow of
able to flex the thighthat had been operated ulceration. With the view of alleviating
on, on the pain, urine has terminated,we may conclude that the
the pelvis, as readily as the other, weeks after
seven
opium and henbane were given, and mustard cata- plasms hoemorrhage is not firom the kidneys, but from the
the head of the femur had been excised. He had appliedover the regionof the pubes. He bladder. Sir Bei\jamin Brodie,states,that it is not
seen, last Thursday, a patient who had been operatedseemed to get a littlebetter under this treatment, uncommon tor small portions of the fungoid growth
on by Mr. Fergusson a year ago, and she was able and I subsequently gave liim copaiba. In the to be passedwith the urine,which will discover the
he went into the country, and I lostsightdisease. This,however, does not always occur, and
to walk, with the aid of a high-heeled shoe,without summer
of him for a few months. 1 was again sent for to it was not observed in the case I have related. It
a crutch.
see him on the 21st of December. In the mean time thus appears, that thus far we are without any abso- lute
HALIGhNANT DISEASE OF THE OVARIES AND I found he had consulted an eminent surgeon, who diagnostic of the presence of this disease. There
RECTUM. had passed a catheter, and endeavoured to inject the is still, the microscjope.
however, one mode of inquiry,
Mr. Nunn broughtbefore the Society two ovaries bladder.This operationhad been attended with At the time this case occurred to me, we were not so
affected with malignantdegeneration. The right great pain,and an increased amount of blood in well acquainted with the microscopical appearances
was generally hard,the left full of cysts. Malig- nant the urine. In a note I subsequentlyreceived from of carcinoma as we are at present; and h appears to
deposit waa found on the peritoneum, in the a surgeon, who was then consulted, he says, '' I me the use of thisinstrument affords"he most avail-
 THE MEDICAL TIMES. 87
abl" means for diagnosis
in this disease. The fact, Mr. Hird wished to direct the attention of the the urine should be ascertained, as the persistence of
that the form of carcinoma in the bladder isgenerally to the
Society means of arresting hemorrhage fVom alkalinescence might tend to irritationand disease
of the softer kind,and that this orean is seldom affect-
ed the bladder. He
alluded to a patient under Mr. of the mucous coat In Dr. Lankester's case, he
by analogous formations, whicn,occurringon the Dupasquier's old man of seventy, who
external parts of the body,present appearances simi- lar
care, an thoughtthe disease originated in the kidney,and
passeddailya pint of blood for a longwhile,and descended thence to the bladder. Turpentine, in
to those of carcinoma,renders the diagnosis of
used many medicines, including gallic acid in large small doses, w ill arrest renal and vesical hemo*
malignant disease of the bladder, by thismeans, much
cells,doses, and
more decided. In the absence of the peculiar the muriated tincture of iron, but rrhage.
which,although not specially characteristic of,are yet without benefit No disease of the bladder Mr. Gower, of Hampstead,said,that he had re- lieved

constantly foond in carcinomatous growths,I have could be detected. Whether it were the effect of pain,in two cases, by gitinggum arabic. A
been able to draw the inference of the disease not the drug,or of accident, he could not tell; but the quarterof a pound was consumed weekly.
beingmalignant,where bloody arine has been passed,haemorrhage ceased while he was taking the oxide of Dr. Lankester,in reply, said,it was difficultto
firom the absence of these bodies. Professor Jenner silver. define the exact line between
Informs me, that Dr. John Taylorwas able to diagnose
medullarysarcoma
Mr. Dampier observed,that the diagnosis tweenand fungushematodes, unless in well-mariced cases.
be-
the presence of malignant disease of the bladder, by stone and malignantdisease of the bladder He thoughtthey were transitiondiseases, and still
the presence of the peculiar nucleated and ftisiform
be aided by remembering, that in stone there considered his case one of fungus. The principal
ceUa. Mr. Lane also states,that in two cases he has might
been able to recognize verydistmctly the presence of was
seldom hseraorrhage after passing the catheter,malignantdiseases of the bladder are of a soft
carcinomatous cells in fungoid diseaseof the bladder. or in the quiescent state ; the contrary occurring in kind,in which the cellseasily break down, and are
disease. found in the urine.
With regardto the treatment of this disease, njec- malignant Dr. Sibson seemed to doubt the
tiona of warm water have been recommended; but Mr. Child commented on the absence of the discovery of malignantdisease%nder the micro-
scope
theygave BO reliefin thiscase. Opium,as in so many characters of the malignant diathesiswhen ; the finding nucleated cellsis not a diagnostic
other forms of maH^ant disease, seems to be the "e)ieral
le bladder is affected. In Mr. Coulson*s case, sign,as they are met with in fibrous and other
medicine which offersthe greatest resource which he had seen, the patient
as a was a stout, hale, tumours, interspersed among other cells;when,
means of alleviating the sufferings of the patient
healthy-looking man, and no one would have sup- posed, however, these cells are very numerous, then we
Astringents, such as ^lllc acid and acetate of lead.
fimn his appearance, that he was labouringmay conclude that malignantdisease exists. We
which act fovourabljrmhsmorrhage generally, would
under so serious a disease as was goingon in his cannot, however,affirm,that their absence is a
probablybe of service where the hnraonhagewas
an alarming qrmptom in fungoiddisease of the bladder proofof the non-existence of malignantdisease,
bladder. Mr. Nunn stated, with reference to the use of the because the diseased growth may not have been
Mr. Coulson agreedwith Dr. Lankester as to the microscope detecting
in malignantdisease of the broken down. In cases of hemorrhage,the micro- scope
urinaryorgans, that in a case of Mr. Simon's, of may aflbrduseftilnegative evidence. A gen- tleman
diSeultyof distinguishing morbid growthsin the
superficial carcinoma of the prostate, the microscope had vesical hemorrhage,and his medical
bladder. There Was firstdie simplepolypus, which
was employed, the malignant character of the disease attendant was much alarmed,as he dreaded malig- nant
mightbe of small size,or might occupy the entire disease. The nucleated cellsnot beingdisco-
discovered,and the catheter,in consequence, was vered,
cavityof that viscus. There is, also, fungus not Sir B. Brodie had seen the case, he was treated for simplehemorrhage,and
hematodes, againpassed.
a very rare disease, and generally com-
and remirked that it was the firstin which malignantwas now recovering. In Mr. Walton's case, there
^cated with calealus. A man
known about town, snflfetedfrom thisdisease,and
who had been well disease of
the urinaryorgans had been detected ought to have been the caudate cells in the
had nomenms duringlife. urine (laughter)
" " but unless theywere especinlly
eahmli besides. He sunk at last
Mr. Kesteven mentioned a case of haemorrhagesoughtfot-, they might have escapednotice. Mr.
frma esiiaiistioii) and there was tisedisease which
was met with itiDr. Lankester's ease, which he be-
from the bladder,which he published some time Simon's case was very important Mr. Lane had
lieved since in the MetRati Qazetie. The diagnosis lignant diagnosed
of ma- malignantdisease in two cases by the
was medullary sarcoma. Mr. Coulson* men- tioned
disease was not clearly made out, and some microscope; in one, the patient had improved, under
the case of a gouty subject, who was suddenly
""2ed with haemorrhagefrom the bladder,
thought there was gouty disease, others stone. The cautious treatment ; the dther was fatal. A large
com-
plaining
muriated tincture of iron was of most service. It cerebriform mass was found in the bladder. There
also,of a wearing,achingpain in the loins. looked upon as malignant,
was because the he- morrhage was neither renal nor vesicalcalculus in his case, as
There was afterwards, almost invariably, blood in continued while the patient was at rest. Dr. Daniell supposed.None ever passed, nor was
the urine, at first difiused throughthe fluid,and
Mr. Hancock referred to Dr. Lankester'scase, any discovered afterdeath. Disease does not often
psssedwitfioutpain,and subsequently, in the form with
He recommended the descend from the kidneyto the bladder ; the con-
a view to the treatment. trary
of eoagula, with great pain. The discharge of blood
non-use of the catheter, and the adoption of remedies generally takes place ; and so, he believed, it
suddenlyceased, and he was then afiectedwith the to arrest the further Dr. Sibson's remarks on bella- donna
progress of the disease. The was in his case.
symptoms t)f chronic inflammation of the bladder, best of these was
with indicatiottsof calculus. He was sounded, opium. He described a case in he thought rery important ; he (Dr.Lankes-ter)
but which had not seen it used extensively sedative.
no stone could be discovered. There was great
malignantdisease was suspected, the he-
morrhage as a

difficulty in passingthe catheter,

continuingwhile the patient was at rest. Opium sometimes caused bad results; and if bella- donna
and moving it There much The acted
nnnd the bladder; while doing this,a portion
was not pain. patient was laid on as a sedative, and more efiectually,
of of lead given to arrest the without those bad results, it had greatclaims on the
his back, and acetate
morbid growth came away, which proved to be ma- lignant.
He
yaemorrhage. He became apparently well, and profession, and should be had recourse to.
was not sounded afterwards. The
continued so for eighteen months. The disease Dr. Sibson,in answer to questions, said,with re- spect
use of the catheter was attended with
exquisite pain.then returned,and the same treatment was adopted, to the doses of belladonna, he gave the extract
The patientdied in twelve months, worn out by
with a similarresult. He would now be regarded as iki half-grain doses three times a in
da^', neuralgia,
intense suflfering. For ten or twelve days before
death the urine escapedinvoluntarily cured,but the anxiety of countenance causes the fear which, if there be no disease in the nerves, invaria- bly
and without that He now
malignantdisease stillexists. He (Mr. Han- cock) yielded in a week. gave two doses of
pain. The abdomen only was examined. The
could not see any reason the ca- and then gradually
for passing theter, half a grain, reduced to a quar- ter,
bladder and surrounding
partsfilledup the entire unless there were other symptoms of stone one-sixth, and one-eighth. In sciatica, he em-
ployed
pelvis.The former was so soft,that it gave way in which is not the case in the generality it externally internallyit is of The
present, of ; no use.
taking it out ; itsinteriorwas filledwith a mass sembling
re-
instances of malignant diseases of the bladder. of dyspepsia is greatly relieved by it Persons
cauliflowerexcrescence
pain
of the uterus. It
Mr. Kesteven said,in his case there were some who are very sensitive, easily roused and easily de-
appearedto have arisen from the mucous and sub-
symptoms indicativeof stone,but not all. than usually infiuenced by bella-
mucoas tissue of the organ. Malignant
the bladder is only relievable by
disease of Dr. Sibson thoughtthe microscope to be of more Sressed,
onna,
are more

and must take it in smaller dos^. Its use

opiates, and the
1"" done the better for the patient The
use in discovering the source of the hemorrhage, should be given up when diynessof the throat
diagnosisthan the presence of malignantcells. If it came comes on ; tifiat symptom precedes dilatationof the
in this case was only obtained by bringing
away a from the coats of the bladder,it would not
portionof the diseased growth. The microscopethe tubular casts from present pupil,
the kidneys.The source being The following is Dr. Sibson's prescription for
mightcertainly be of use by detecting the existence
discovered, would serve as a guideto the treatment external use : "

of nucleated cells otherwise there are no

; positive With regardto the pain, the exhibitionof belladonna 9" Linim. sapon., co. ; linim. opii, p. e. ; ex.
ngnsbywhich a malignant diseaseaffecting the blad-
der
or stramonium would prove of considerable service. belladonne,gt. x., xv., xxx. M. solve.
can be detected l^fore death,except from a for- He (Dr. Sibson)had employed belladonna as a
tuitouBoccurrence, snch as was met with in his case.
sedative, and found it completely controlled pain;
Mr. Walton mentioned a case of carcinoma of the
it was not necessary to giveit as often as opium, as ROYAL INSTITUTION.
prostate,which occurred in his practicetwo years its action it ever,
how-
was more permanent; required,
"go, and was supposedto be merelyenlargement of
that organ. Tlie diagnosis
to be watched.
carefully It would be useful On the 25th,Mr. Brande delivered a highlyin-
structive
of its malignantcha-
to give opium with it, as the combination of cotics
nar- address,on Dr. Scoffem's new mode of
rtcter was not made. The
passage of the catheter is more powerfulthan even a largedose of purifying
sugar. After some elementary remarks
slways caused greatpain. TTie urine was examined
any one singly. on the difference between cane and grape sugar, the
on several occasions by Dr. G. O. Ilees, who did Dr. Daniel! thought, that as, in Dr. Lankester's former obtained from the maple,maise, palm,and
not discover nucleated cellsin it After some time and Mr. Coulson's
cases, there was considerable ordinary cane, the latter firom fmits,honey, "c.,
l^ood was passedwith the urine,and severe suffer-
pain in the loins,there might be a renal calculus the lecturer explained the process of boiling, which,
^ attended micturition,causingthe belief,that passingalongthe ureter, and givingrise to the to economise heat,is now, it seems, done in vacuOf
uleert^ion of the bladder had taken place. A few
He added, that,in disease of the blad- lime water being added to remove set of impu-
dajrsheivtedeath an immense abscess burst in the symptoms.
der, one rities,
the urine is alkaline, and not acid ; this sign blood and albuminous fluidsanother and not
perineum. After death the bladder Was found full
was an additionalmeans of diagnosis. In all cases less obvious one. The pointthe lecturerseemed
of earcinomatoui
growth* of disease of the urinaryorgans, the condition of anxious to demonstrate, was Dr. Scoffem's improve*
 88 THE MEDICAL TIMES.
ment, which consistsia using, in place of these not it as his opinion, that she died from diseaseof the that Society.Whether the policy that failedthevi
heart,and a verdict, Died from Natural Causes," will succeed now
" is yet to be determined ; but, if
very sightly, but,we believejtruly orthodox chemi-
cal
salt lead the was returned accordingly, there be any consistency in the councilsof the ruling
compounds,a of "
sub-acetate "

which removes the colouring I thoughtit but right, as a juror, to ask whether powers of the College of Surgeons, no imporunt
efTectnally matter and
be expected.In such case the
acids, the 1"mph quite clear.The very obvious
the child was dead,and was told by the medical gen- tleman,concessions can
leaving in reply: The instant pulsation
**
ceases in recent Memorialists are onlythrowingimpediments
danger, of course, is that of any of the salt of lead that have
the mother itceases in the child." Thereby conveying in the way of a settlement upon principles
remaining and it is impossible
"
to say what the to our minds the
presumption, that the death of the been acceded to,and arrangedonlyaftera longand
chapter of accidents might bringabout This it is mother and childwere simultaneous. Now, although I arduous contest,and thus allthe fruit of a five year's
proposedto remedy, by passingsulphurousacid felta doubt at the time, as to this being true, still, agitation will be losL I do not think,however, that
through it, the sulphite falling to the bottom. The obstetrics not beinga part of my profession, J allowed such a resultcan possibly ensue, if the good sense of
sulphurous acid Dr. Scoffem proposes to make by the assertionto pass uncontradicted, considering that the Profession willonlybe true to itselC
passing a current of air over burningsulphur, a plan a medical of
practitioner, man]r years'experience,
so Mr. Bottomley's party requirea fair represent-
if it ation in the Council of the members of the College,
not imknown in the Arts. We sincerely hope that would not have made so positive a statement
with restitution of the rights of the members who
the views of Dr. Scoifem will prove correct,and it were not founded on authority.However, not being
givesus infinitesatisfactionto find his plan sanc- quitesatisfied, I afterwards consulted an authority or were degradedby the Charter of 1848.
tioned
two, and some professional friends,and was led to They also desire the establishment of an examin*
by so eminent a chemist as ProfessorBrande. believe this to have been a proper case to attempt the ine Board in medicine^ surgery, and midwifery.
At previous meeting,Mr. Grave explainedCesarean
a
Now, Sir,the National Association have been
'

of the lateresearches of Regnaulton PLespira-

operation. made an efibrtto obtain
some
Having ttius stated the fact, I should feel obliged oftenreviled for not having
tion,of Matteuccitton the Relation between the by your opinion, whether a medical man is not in such a settlement ; but,vritn how much justice these
"
Direction" of the Electric Current,and its Effect dutybound to performthe Csesarean section under statements have been made, the followingquota- tion
on the Nerves,and alluded briefly to a discovery the circumstances I have detailed. from their letter,bearing d ate March 20, 1845,
of Pasteur's on the molecular condition of some I am, Sir,your obedient servant, to the President and Vice-Presidents of the College

salts. With respect to the first, JUBATOR. of Surgeons,willshow :r"

Regnaulthas The National Association "'
request the favour of
coiroborated,by actual experiment,some ideas Chatham, January 23,1850.
[Itis certainly to be regretted that the Csesarean an earlyanswer to the following inquiries
"
:
floating
about the medical world. Warm-blooded "
First." Is the Council of the College prepared
animals exhale nitrogenin proportionfrom operation was not performed in thisinstance. The those mem-
to reconsider their Charter,and to place bers
1-1 00th to l-50th of the oxygen breathed. Animals Surgeon,however,might have been a pupilof Mal- who were in practicebefore it was grantedon a
deprived of food distinctly absorb nitrogen ; animals thus." Ed. Med, Times,"] levelwith the Fellows ?
unwell absorb more nitrogen;in animals fed "
Second.~l8 the Council of the Colle^ disposed
on farinaceous food the carbonic acid exhaled to admit to its Board a fair representation of the
THE COUNCIL OF THE COLLEGE OF
is generally equivalent to the oxygen inhaled. Fed SURGEONS.
members of the College i n general practice?
animal food,the proportionof
"*
Third." Would the Council of the Collegebe
on carbonic acid is
willing to co-operate with the National Association
much lessin some animals, not more
"
than 6 to 10 [To the Editor of the Medical Timei.l in the formation of a Court of Examiners in medi-
parts of the oxygen inhaled. The consumption of Sir, At a private
"
meeting of a few friendsof the ci
Medical Profession, held to-day in this town, the ne, surgery, and midwiferyT"
oxyyen, as one might d prioriexpect, is many The replyto this communication willbe ever me- morable.
has been mooted, whether the Council of
times greater in small animals than in large, owing question of
It was in this well-known document that
no doubt to the exposure of a greater proportionate the College Surgeons have not violated the con-
tract
the Council described the members as practitioners,
entered into by their bye-laws,at the time of **
surface,and,consequently, to greater cooling effects requiredto possess at leastf\ but not necessarily
the granting of their diplomato the members,
priormore
of the air demanding more rapidrespiration to to the than that amount of mformation and skill
obtaming of the Charter of 1843, and have forthe ordinaryexigeneie*
keep up the animal heat. With hybernating mals rendered themselves thereby liable to
ani- which i%absolutely required
proceedingsof ministrations."
Regnault found less,oxygen of course con- sumed. both in law and equity for damages? If the Council surgical
They giveoff little carbonic acid,and ab- sorb of the College,at the present juncture,do not feel The replythroughoutwas distinguished by the
same supercilious tone, and ended with a rigoction
oxygen and nitrogento such an extent, that themselves disposed to confirm and ratify the mutual
of the proposalsof the National Association. Let,
they increase in weight,actually fatten on sleep.obligations sworn to by a solemn ocUhtwould it not be
therefore, due justice be rendered to thisbody for
In "cold-blooded" animals very little a matter of policy as well as expediency to advise every
oxygen is its efforts, andfif Mr. Bottomley's party should
consumed; they breathe chiefly throughthe skin. member in generalpracticeat once to return to that succeed, the Profession willbe piepared to do justice
his diploma,and demand
that College a return of his
Regnault makes the curious observation, to them too. It must not, however, be forgotten,
hydrogenmight be substitutedfor nitrogen twenty euineas,the license of the Apothecaries'that Mr. Bottomiev would never have put his foot
in ordi-
nary
atmospheric air,with littleor no effecton the Society
being,in most cases, sufficientfor the pro- tectioninside the threshold of the
Collegeof Surgeons if
of General Practitioners? An opinionin
economy; and Mr. Grove actually showed some the National Institutehad not handsomely lent him
your next publication will kindlyoblige, Sir,your the influenceof itsname
birds very lively in such a medium. He recom and character; and by the
very obedient servants,
mended carbonic acid to be more frequently act of calling a Conference,made a second attempt
used as John Spence, Manchester.
to open the Colle^ of Surgeonsto its members.
a narcotic, a dangerous
" one we should fear. Na- ture, Georoe Gibson, Ulverston. I am. Sir,your most obedient servant,
who does nothing without a meaning, givingus Edward Hall, Dalton-in-Furness. A Member of the National Institute.
more of thisgas at night. Ulverston,Jan. SO, 1850.
Brighton, January 9, 1849.
Matteucci's observations related to the fact, that [We think that there is some groundfor assuming
when an electriccurrent is passedwith certain
cautions an actionwould lie against
that the Council of the
pre-
in one direction, throughthe muscles of an Collegein consequence of the injury sustained by THE CHOLERA.
animal, the motor nerves alone are those affected, the members by the creation of the Order of Fellows
the
limb^ being convulsed without pain; while the under the Charter of 1843. If the contract implied [To the Editor of the Medical Times.]
current directedin a reverse direction, the nerves of by the Bye-laws be understood as conferring Sir," On the 7th of the current month I was called
can cific
spe- who was reported as beingvery
sensation become affected, the animal cries from upon to see a woman
advantages upon the Members, which have been ill.On my arrivalat the house,to mv surprise I found
pain,but there is no muscular convulsion ; in the lost or
former instance the current impaired by the provisions of the new ter,
Char- her labouringunder a severe attack of algid cholera.
being directedfrom the but
surface towards the great nervous
there would be some tangible ground for pro- The appearance of the patient was
ceedings anything
centres. How
much of this is a mere physical
againstthe Council. If a special injurypromising.The attack came on duringthe night,and
consequence, how could be much the better. was sufferedto go on duringthe severalhours inter- vening
much physiological, itis not easy, perhaps, shown, so Law is, ever,
how-
to say. my visit and the advent of the disease. The
The observations of M. Pasteur, a dangerousthing to meddle with. It is a very
as we said before, countenance at this time had the peculiar cadaveric
had reference to the intimate molecular good weapon in prudenthands ; but if our Corre- spondents expression which is onlyseen in persons thus suffering.
antagonism
exerted by some salts, should happen to take hold of the wrong The eyes sunken,the face pinched, the voice husky,
preserved even in theirfluid
state, one of those things not dreamt of up to the end of the iron they mightburn their fingers. No-
thing the extremities cold,the Angersshrivelled, with con-
siderable

present in our " philosophy," would be more to us than to see some cyanosis; the pulse quick and thready ; in-
cessant
yet destined to shed pleasing
dejections of a milk-and-watery character,and
some light, perhaps, on the uses of the iron in the public-spirited surgeon obtain a verdict againstthe
contracted with rigid
blood, the cyanides in saliva, "c. Council upon this ground; and we venture
profuse ; the legs and thighs
to pro-
spasm, and the thirst intensely urgent; shortlyalter
phesythat,in such case, the applications for redress this, vomitingset in of a clearserous nature,and abun- dant

OORRESPONDENCB.
would be so numerous, that the Council would be ; there was no urine secreted; in fac^ there was
but too happyto vacate theirseats,and a new Char- ter a case of pure Asiatic cholera. I immediately pre- scribed
would be obtained within a month." Ed. Medical palv.opiigr. i.; hyd. protochlorid. gr. ij.
PRESUMED DEATH IN UTERO. every hour,with small doses of the mist creta \P-}-)t
Times.'] with sp. ammon. hours ; fnction
co. 5ss., every two
[To the Editor of the Medical Times.] to be used to the parts suffering from spasm, the
Sir," On the 10th init an Inguest was held in MR. BOTTOMLEY AND MEDICAL abdomen to be covered with mustard poultices, and
this town on the bodyof a female in humble clrcum- REFORM. to abstain from fluidsas much as possible. Matters
sUnces, hourlyexpecting her confinement. She had went on without any improvementuntil night, when
eaten supperabout half-past ten o'clock, and imme- [To the Editor of the Medical Times.] began to be less frequentand not 8"
after prooeeded to bed ; she undressed and
diately thepurgings
Sir," So far as I can understand the proceedingsprofuse; but the vomiting seemed to be increased f"7
laydown, but sac up again directly, sayingto her of Mr. Bottomley's party, theyappear to me to be the creta mixture,which was omitted. Durii^
the
husband," Oh I feelmy heart, I am going !" vomited fallingback upon the positionoccupiedby the Na- tionalnight the state of the patientbegan to iMSume a
blood and froth, and expired. The memcal practi- Association in the year 184^ ; and are, there- much better aspect ; the cramps in a gr""t measure
tioner fore,
who arrived wittun a quarter of an hour,
gave merely the imitators of the original policyof abated, less vomitingand purging; "nd from tbis
 90 THE MEDICAL TIMES.
MEDICAL NEWS. disease; 27 saicides" of these,9 by hanging ; 8 cut-
throat; TO CORR"SPO:NDENTw
3, poison; 2, shooting; 1, jumping from
window ; 3,felode se. The rate of mortality was StQdens" ask^ our advice as to what books he aht*
"

of gentlemen highest in Scotland and Vauxhall Wards, where it to noanteract the tendencies to infidelity to wlu".
Apothecaries' Hall." Names
of study leads.
who passed (heir examination in the science and was nearly 1 in 14; and lowest in Rodney-street sa"Mt bis praseat ooune
in [We will not here enter into the quostloa to Hi* lendeaej
practice of Medicine, and received certificates to and Abercromby Wards, where it was nearly 1 as

38. For the entire borough the rate of mortality of Profeaaiooal studies to iofldoUty.We da not believe
practise, on Thursday, Jan. 24, 1850 Samuel " " was

William North, York ; Henry Trpgelles Fox, Dun- about 1 in 21. that such is the ease ; sod we will take some oppostusdtgr
of this veiry impoitaot questloa. Neltlier
mow, Essex; Charles Wilham Latham, London; Gratifying Testimonial. On We"lnesday, will oonsideiing
"

to our Correspondaat.
James Hamilton Davies,as an Assistant, Haverhill. January 16th, there took placein the publicschool- we here tnut ourselves to reply.
rooms
IM others answer fi"rus. And, flnt. Young :"
Obitdary." At Exeter, of chronic bronchitis, at Putney a meeting of a very interesting scription,
de-
Read Nature 1 Natnm is a Mead to truth;
""

Edward Oxley, M.D.. aged 80." On ilie 22nd ult., convened for the purpose of present!
nff a
Nature ia Chxislian" psoaohesto mankind,
at Worcester, Samuel Good, the
Esq.,one of testimonial to the medical officerof the district.
surgeons Mr,
Andbids dead nuMsr aid us in our ereed."
in ordinaryto H. R. H. Prince Albert,and formerly R. Harland Whiteman. The testimonial, for the
And now Baoon :"
BtirKeon-major to the Scots Fusileer Guards. On the purchase of which several hundreds of inhabitants
"

"There are two books hildbefiNs us to study,to pseveat

25tl) ult.,suddenly, Mr. House.surKeon, of Walham- from the peer
" to the peasant had subecribed,
" sisted
con-
of a handsome silvertankard and salver, ourlfalUngInto error: irst,the volume ef the Scm"-
Kreen, Fulham, aged53." Di\ Fitton,and Mr. Gale, nufactured
ma-
for the occasion, with VUEBS, which ceveals the wiU of God; then the voluae
siu-geon, drowned in the wreck of the Richard Dart, expressly together
each of which gifts of the CasAToa, whioh expreaset His power; t^e latter
transport ship. a valuable gold lever watch,upon
indicativeof the of which is a key to the fonner, opening, not (wly our
A larger was engraved a suitable inscription,
Evaporation from the Thames. "

iatellect to conceive the geauine tense of the Scriptona

sense entertained by the subscribers of Mr. White-
quantityof matter is raised from iho Tliaiups by eva- poration
"which is to be drajva oat by the geaeralrolee of leason
man's zealous and efficient
"
services as the medical
than is generallysupposed. Upon Mr. Ihiikh
officer of the district duringtliolate visitation lera." sad Uwc of speech,"hot, beside* th/tt,
of cho- uoiockhigoux:
Glashicr's estimate, 678,505 gallonsevaporate from
The presentation by a suitable also, to eater into a serious meditation of the Omnipo-
tence
an acre of water in a year, which is at the rate of was prefaced
address parish, of God, the charactors whereof are chiofty signed
1857*6 gallons daily. The bed of the Thames in from the officiating minister of the
the Rev. Edward East, to which Mr. Whiteman sad his
sequently engraven on
sub- works."
London is estimated approximately
at 2245 acres;
replied at considerable length, Xhe gseat truths of Chrtotianlty rest oa fsuodations fltf
consequently, 4,170,000 gallonsare raised on an aver- age
mofe aoUd than that of Physiology;sad we agree with
dailythrough the year. The qnantity evaporated Pbivatb Lunatic AsyiiUbis. In the course of an
"

ao emineat writer and one of the Arst surgcoas of the

at low water is, perhaps, much less than this ; on the investigation at the Middlesex Sessions, on Friday
other hand,the evaporation in summer is more active last, respecting the removal of a pauper lunatic, it day,that if these could,be eadaogeredby physioto^ic^
had discu"aions, it would be by uaseuUng tbem fsom their
than in winter; and the proportionof decomposingappeared that the authoritiesof St. Marylebone
been engagedin making a profitable of natural and firm esUbliibmeat,and erectingthe" aaev
organicmatter in the water, and on the banks ex- posed speculation '

to evaporation, is greater at low than at high the lunaticpaupers belongingto other parishes, but on the artificialand rotten batii of uoaubAtantial specula-
resident in theirs. They had, it seems, converted a tions,or on the equallyunsafe ground of ahatruse meter
water. Upon the whole, it is probablethat in sum- mer
4 million gallons, or about 18,000 tons of water, building, which the judge averred *to be part of the physicalresearches. " I have no hope of a future exist*
ence," says a late Cambridge Profeuor of Divinity,*' ex-cept
are raised from the polluted Thames dailyand dis- chargedworkhouse,although a distinct and separateerection,
that which lafottodedoa the truth of Ghilsiinajty.''
into the atmosphere which is breathed by into a nauper lunatic asylum,for which theyhad For ouraelvea, we think no one oould prove the fiTJefeaes
the inhabitants of London, ft remains to determine obtainea a license in the joint names of the of an immortal soul from any phenomena of thought.]
how much of the organicmatter in the water is raised resident physician and the master of the work-
house, **
A WinglessBee" need only produce for the College,eec-
with the vapour at different temperatures. Mr. who were the registered proprietors. The tiflcaieeshowing he has been five years io the acquire-
ment
Glashier was requested to make an estimate of the Legislature has provided, and very wisely, that pau-
per of pr.ites8ionalknowledge. For the HaU we

of vapour raised by evaporationfrom the lunaticsare not to be detained in workhouses ; believe the indenture is necessary.
amount
*' A Young Surgeon.""An advertising
Thames, and has favoured the Rpgistrar-General contrary to the spirit, yet,perhaps,in obedience to surgeon is anything
with the subjoinedstatement: "For the letter,of that law, have the \Iarylebone ties
authori- but respectable. In a small locality such as our conw-
"
some years
spondentalludes to,there can be no dlflicuityIn bceakiag
past I have made dailyexperimentsupon the- acted. Their proceeding was characterised b^ ground in a nu"re legttlmatoOMuiner.
amount of water evaporated ftrom a surface of the judge as a direct evasion of the law. On this
A Physicianand Reddeat Proprietor."" We will publish
water, and the amount exceeds 30 inches annually. point, however,we wish not to 'dwell, but would ra- ther
letter next week.
oui Corxespoudent's
A depth of water of fully 30 Inches must evaporate draw attention to the extraordinary conduct of
'" Aa Old Subscriber to the " AUdical Times' " wiU be pri-
vately
from the surface of the Thames annually; indeed, the resident physician, who, with the master of the
written to, if he forwards his name and addiasa.
the quantitymust be larger than this flrom the cir- workhouse,
cumstance has lent the sanction of his name to the
Dr. James Sievcna' " motarks oa Dc. Jeonec'e papeoa on
of its relative high night temperature. perpetration of a dirtyjob. We know not whether Typhus Fever wUl leoeive earlyattonlloa*
Take it,however, at 30 inches,and we shall have the parties seekinga licensefor a lunatic asylumaze The remarks of Dr. Duncan and Mr.
Nunn, of Colohester,
108,900 cubic feet in
evaporated a year from an area obliged t o swear that they are the bona fideproprie-
tors on the applicabihty of the common Sweet Almond Oil to
of water of one acre; 678,505gallonsof water evapo- rated ; at all evenu, we presume that,either viva vocBj all cases in which Cod's Liver Oil U prescribed, will be
in one year from an acre of water ; 244,480,500 or illwriting, theystate themselves to be such,and, publishedin our next Number.
cubic feet of water evaporated from a surface of 2245 in eithercase, the registered proprietors of the Mary-
lebone '" Bishop'sStudy of the Miiid " has been consigned to a
acres of water in one year; 1,523,242,991 gallons Parish Lunatic Asylum have committed a geoiiemaa for review. U willbe noticed ia due course.
**
of water evaporatedIn one M.".C.S.''"
year from a surface of gross breach of the law against leasingmakers, The obliging note has been received.
water of 2245 acres in extent, or more than 1523 which was in force in Queen Elizabeth's time,and, We have to aoknowledge the receipt of a report oo choleta,
millions of gallons. The salt water affectsthe water perhaps, is not yet repealed. was proved,at
It the as uccurring in the 5ifth Begiment, on board H.M.8.
trialthat neither oj the peartiet Apollo, on the voyage from Cove to the Cape of Qood
at Woolwich : it is usuallywhat is termed brackish named at ftroprieiors
there. Lieut. Sanders states that at Greenwich, at had any interest in the buUding,
Hope, by Dr.Fraser,Assistaut-Surgeon 10th Koyai Hus-sars,
and that the amount in medical charge of the 59th Regiment, obligingly
high-water spring tides,tlie water is frequentlynamed as having been paid to them bu the overseers oommuoioated by Sir James McGregor.
brackish. Tne dirt and filthin solution must be (namely,the amount charged for the alleged lunatics) Mr. Harvey'sCases we hope to publishnext week.
very large. The 'Dreadnought' experiments are had not been paid. There are fifty female and thirty- Mr.
Yearsley's paper has been received, and will 1
made under my direction chiefly, and I can assure fivemale lunaticsin the asylum, and the cost is 9b.
diaiely follow Mr. Harvey's,on the same subject.
you that to read the instruments is a serious affair,per week for each. The parishoharge is 12s. foreach "* Mr. Gibbons' " contribution '" On the Microscopic L^
owing to the filthof the waters; on first pauper lunaticmaintained by them, if belonging
pulling to
anoes of Bone and Cartilage," will be publishedas soon
,

them up they are covered with a slimy aahesive other parishes ; making thus a clearprofit of 3s. per aa possible.
mud ; they firsthave to be wiped,and if the wind is head weekly. How can the Profession expect to be
blowing strongly,this muddy water is blown about held in esteem by the public, when its members lend We must take a more comprehensive view of
and the observer. A new trunk is now being the snnction of their names to such dirty proceed- cutaneous
ings.
over
maladies, and studythis class of afi'ections
made, with a perforated copper-bottomturningdown- wards The case, however,will not end with the public more in the lightof generaldiseases, if we wish to
upon hingcii, so as to get rid of the enormous ex{)0sure it has already received. A case has been arrive at an accurate knowledge of their nature ; for
deposit."WeeklyReturn qfthe Registrar-General. grantedfor the Court of Queen's Bench, and then observatiou proves, that the study of diseases of the
"

Mortality It will be seen whether the parish of Marylebone skin cannot be detached from that of generalpatho-
in Liverpool during IS-W. cording
Ac-
"
are
logy,
to the Report of Dr. Duncan, the Medical to ride rough-shod over law and justice, and drag and of the many morbid conditions with which
officer of health, the deaths in Liverpool, the down members of the medical profession into the they have such numerous and varied relations. In-
during deed,
52 weeks endingDec. 29, 1849, were mire in which they themselves choose to wallow. it would be a grave error
17,04(3, bting to separate certain
4500 more than the preceding year, and 3900 more Singular Occurrence before a Coroner. cutaneous eruptions from lesions of other systems,
than the average of the previousfive years. If we An
"
extraordinaryand, perhaps, unprecedented wiien both derive their originfrom the same cause,
exclude 1847, the year of the Irish fever epidemic, circumstance occurred at the village of Whitchurch, and are, in reality, but different symptoms of one and
thft excess is 6200; comparedwith that year there is in Bucks, a few days since. An inquest was held the same disease. The eruptivefevers and the
a decrease of 3800,the mortality in that year amount-
ing before Mr. J. Parrot, one of the coroners for the sypluiides, for example, are constitutionaldiseases,
to 20,850.Of the 17,016. 8400 were males,and 8646 county, on the body of a female infant, of which the or rather the sequels of constitutional diseases, and
females. Cholera destroyed 5245; diarrhcea and mother, Sarah Evans, the wife of a labourer, had to view them in the light of special or local afiec-
dysentery, 1271 ; typhus, 567 ; measles, 419 ; hooping-been recently confined, and which, it was supposed, tions,would be to mistake theirnature altogether.
cough, 376; scarlet-fever, 317; croup, 113; small- pox, had died shortlyafter its birth. After the surgeon, Erysipelas and acne frequently supervene in cases uf
68 ; and syphilis, 42. The larger proportionof Mr. Spencer,and the mother's nurse had been ex- amined, derangement of the uterine functions. Strophulus
deaths from cholera was among females, to the tent
ex- the jury returned a verdict to the effect that IS associatedwith the process of dentition. Urticaria,
of 23 per cent, more than the males. The sud- den the child had died from natural causes. The jurv had acheu urticatus,and severalvarietiesof herpes, ar-
and violentdeaths requiring inquests amounted not been long dismissed when it was discovered that often the results of a disordered condition of^ ^0"
to 460 ; of which 316 were males, and 144 females. theymight have been saved all inquiryon the sub- ject, digestive organs. Psoriasis and lichen agrii"* quently
fre-
64 of these were by drowning ; 54, burns and scalds; for the infant was found to be alive, in good occur duringthe progress of g^^ "Uicl
30, overlain ; 144,accidentally^killed ; 4,accidentally health, and likelyto live longer than many ot the urinary diseases; and the hereditary ua*""re of cer-
tain
poisoned; 11, wilful murder; 7, manslaughter;10, jury who returned a verdict that it had "died from diseases, as lepra, psoriasis, licheivis beyond ail
excessive drinking ; 5, want of food ; 104, natural natural causes.'^ doubt." ZV. ^nr^eison JBnqttions "r' "*" J^ace,4c.
 THE MEDICAL TIMES. 91

OSiaiHAL LECTVBE8. modificationsand varieties in the course of develop-

ment stances which rendered the suoceoive generations
The progeny of the primaryimpregnatedfrom virgin Aphidespossible and conceivable,and I
germ -cellare the "secondaryor derivativegerm- have the greaterconfidence in the trufh of that in"-
HUHTEBIAN LECinSES cells," and the whole is the " germ-mass." sightfrom havingfound it equally explanatory of
ON THE The progeny of the impregnatedgerm-cell re-
semble the analogous phenomena of " Ludna rine con-
GENERATION AND DEVELOPMENT their parent in all respects, save that they cubitu" in other animals.
OF
THE INVERTEBRATED ANIMALS. show a diminution of size. When they cease XA It is now more than a centurysince Bonnet,in
existas germ -cells, eitherby coalescing with others his " Traits d'Inaectologie,'* 8vo.,1745, flnt at- tracted
By RICHARD OWEN. F.R.S.,
Hantexlan ProfMsor aod Curator of Museum or by liquefaction, they do not lose their vitality ; the attention of physiologists and natoimlists
of Royal
CoITe^ of Snrgeoni, GorreBpondiogMembor of tho In- as individuals, indeed,they may be said to die,but to this mode of generation in iStJfMdet or plant-
"tltate of PraQce,fte.
by theirdeath theyminister to the lifeof a being lice. And because it waa the firstof a large classof
[Reported expresslyfor the Medical Times," and revised higherthan themselves ; theycombine to construct phenomena,tillthen utterly
" unknown and unsus-
pected,
1"ytbe Lecturer.] its tissues, or dissolve and impartproperties to its it was received with considerable doubt, or
fluids;these metamorphosesbeing mysteriously met by totalincrednlity.
LECTURE XVL governedby a plastic nature or mode of force ope- rating The factsare briefly these :-""
GsvxKATjos unconsciously upon the matter; but,accord- ing The impregnatedfeOva of the Aphis are deposited,
OF IvsxcTS.~DeveIopment of the ova ; Tlrgln

pueratlon of the aphides: itstrue conditions and ana- to a law of order and harmony,and directed to at the close of summer, in the axilsof the leavesof
logieeexplained"Supposedparthenogenesis of the Psyche a fore-ordained and definite end, resulting in a the plantinfestedby the species, and the ova retain- ing
explained by the peeuliarities of their impregnation"
distinctand specific form of animal,adapted its theirlatent life throughthe winter,are hatched
Various forms and appendaxes of the ova of insects"
by
Coeoona and other nidi -Oviparous, larvipsrous, for
organization a particular sphere existence,by
of the returning warmth of spring i a wingless
and
puptparous insects" Strikingevidence of design in the and forminga more or less valuable,but not, as hexapodlarva is the result of the development
iastlncta of ovlposition" Development of the embryo: ouce was
various grades of this at which It quitethe ovum.
thought,an essentiallink in the great This larva,if circumstances, suoh as warmth and
chain of organic life. food,be favourable, willproducea brood, and indeed
Mr, Prbsident and Gentlemen, So far as It is important, however,to bear in mind, that not a succession of broods,of eightlarvas,like itself
"

r^ards the organicmachinery for propagation, allthe progeny of the primaryimpregnated germ " without any connexion with die male. In faet, no
that mechanism has reached its highest gradeof cellare requiredfor the formation of* the body in wingedmales,at this season, have appeared.If the
complexity in the class of insects. In the male in-
all animals ; certain of the secondary germ-cells, virginprogeny be also keptfrom any access to the
diridaala we have found "
testes/* "
epididymys,"or their nuclei,may remain unchanged, and become male, each will againproducea brood of the same
**vasa deferentia," "vesiculae seminales," " pros- included in that
body which has been composed of number of aphides ; andcareftilly prosecuted ments
experi-
tetet," "penis," and "claspers:** with a hundred-
fold their metamorphosed and diverselycombined or have shown that this procreation from a virgin
varietyin the forms and proportions of the confluent Jl)rethj:en. So included,any such cell,mother will continue to the seventh,the ninth, or the
"eTeral pwrta. In the female individual we have and repeatthe same eleventh generation before the spermaticvirtue of
or itsnucleus, may commence
seen, besides the ovaria and oviducts, special and of propaga- the ancestral coitus has been exhausted.
processes of growthby imbibition,
e
largements
n-
tion
of the latter, to which the name of When it is so exhausted,a greaterproportion of
by spontaneous fission, as those to which itself
"uterus" might be applied, seeingthat in certain owed its origin;followed by metamorphosesand cellsin the germ-masses developedtnm tbe rem- nant
insectstbe embryo was developed therein ; and the combinations of the cellsso retained the last larve used
produced, w hich concur by procreant are
vaginawas complicated with a spermatheca,bursa to the
development of another individual; and this up ; individual growth and developmentproceed
copulatrix, coUeteria, vulva,ovipositor, and copula.
may be, or may not be, like that in which the furtherthan in the parent; some members of the last
As might be expectedfrom the very common form larval brood are metamorphosedinto wingedmales,
secondarygerm-cell was included.
of tbe OTaris, as longand slender tubes,
theyoffer In the previous Lectures we have seen that, in others into oviparous females ; the ova are
nated
impreg-
peculiarfacilitiesfor tracingthe development of
proportion as the subjects of anatomical investiga-tion and oviposited, and thus provision is made for
the ovum as such. Professor Wagner has ably descend in the scale of animal life, the number disseminating the individualsand for continuing
^
'

the
availed himself of this peculiarity in tracing out the of the derivative nucleated cells which retain their existence of the species over the severs famine-months
progressive stepsin the formation of the ovum, and individuality and spermatic power is greater, and of winter.
has given good descriptions of the process in his the number of those that are metamorphosed into These phenomena,firstobserved, as I have said,
work, entitled," Beitragezur Geschichte der tissues and organs less. by Bonnet, in the genus Aphi"twere the firstto
Zeugung nnd Entwickelung,** illustratedby figures Cells predominate in the tissuesof the vegetablewhich the thoughtsof physiologists were bent to
of the parts,and the progressive of a strange
stagesof the ovum kingdom, the lower members of which consist ex- explain.
clusively But, beingviewed in the light
in the feviale dragon-fly {Agrionvirgo,) The germs of them, and have been thence called and anomalous exception, and at a period when the
of the ova first appear in the capillary beginning" plantae cellulares;" the lowest of allconsist of a phenomena of embryonic developmentwere not
of the ovarian tube as a single fileof minute ellip-tical single known, the earlieststepsmore especially, success
cell.
granulesor nuclei : as the tube expandsthe We have seen that the animal kingdom starts could not be expected.
cell-wallappears surrounding the first part,and the from the same Reaumur eluded the difficulty of the fact which
elementarybeginning:a cell-wall
""vum i" now in the condition of a minute pellucidforms the smooth elasticand contractileintegumentBonnet had discovered, by affirmingthe Aphides to
-vesicle, having a central nucleus. Such nuclei of the Gregarina: a fluid and granules, with a firm be androgynous. The vaginain the perfect oripar-
and nucleated cells make their appearance in the nucleolus ^the ous females has appendages called spermathecs and
nucleus,containing sometimea a "

capillary beginningsof the ovarian tubes,where ordinary cell-contents are

" the sole representatives colleterium;and Reaumur might have even ap- pealed
they are drawn out to microscopic tenuity.From of organs or viscera. Yet the power of the Ore- to the microscope in supportof his idea,for
these extremities the ova successively pass into the gariruB he might have detected, by ite aid,spermatciosin
to live and grow independently by assimilat-
ing
wider part of the tubes,and in this course crease
in- of their the spermatheca.But thiswould not have proved
foreign nutriment,the vitalcontractility
in size by the expansionof the nucleus, and the hermaphroditic structure ; for the spermatheca
tegumentary tunic,their chemical composition,
and by the multiplication of vitelline granules their definite
forms, with such well-marked specific receivesthe intromittentorgan of the male, and re- tains
around the primitive cell: at first the ova the semen in store for the successive impreff-
are characters,in a few instances,as the Greg, brevi-
separatedfrom each other by an amorphous rostris and Greg. SUholdii present, render their in- nation of the ova
terpretation, as theypass out; the ova at the
granularsubstance of equalsize,which is called as a low and primitive form of parasitic same time being coated by the adhesive and pro- tective
a placentula, but lower down by mere strictionsanimal,the most
con- accordant with actual physiologi-
cal matter of the colleterium. These append- ages
of the ovarian tube. Here the ova of the vaginaare found in most oviparous in-
sects
and zoological knowledge.
acquirea distinctvitellinemembrane, and then, A ; and the true male Aphis is as well known
largeproportion of the nucleated and impreg- nate*^
continuing to increase in bulk by the addition of now as that of any other species of insect More- over,
cells is retained unclianged in the compound
vitelline matter, theyreach the converging end of it is found,that the viviparous virgin larvn of
the ovarian tubes,and enter the shorter and wider
hydriformPolypesand in the parenchymatous En the Aphideshave not got a trace of those appendages
tozoa : a smaller proportion in the Acalephseand
oviduct. Here theyreceive additions to their ex- ternal We find derivative germ-cells
of the vagina, which Reaumur supposed be maleto
cavitaryEntozoa.
surface from the secretions of the colleterial
and masses of nuclei like those resultingfrom the organs. They were not requiredin her mode of
organs, and admit into their interior the mysterious final subdivision of and are not developed; the germ-cell
germ-cells retained unchanged generation,
principle of the male fluid, which would seem exists in her,with sufficientspermatic and
of the flabelliform already
to be
at the filamentaryextremities
assimilated into their substance,more
especially plastic force for its development : no semen, fore,
there-
uterus, and forming the ovaria of the larval Aphides.
into that of the central nucleated germ-cell. was required to be retained, and there is no
the observation of this phenomenon in the
It is essential to the developmentof the embryo, By ; the embryonic development
is com-
pleted

that the germ- cellreceive the matter of the sperm-

newly-hatched larval Aphisfrom the ovum depositedspermatheca and secretion for the protective
atozoon in uterof no
the oviparousspecies, and by reflection on the
; the ovum is then said to be impregnated- by covering of ova was needed. The structures, fore,
there-
relation of the observed germ-masses to the suc- cessive
The phenomena that thence ensue are essentially which Reaumur, under a misconception of
spontaneous fissions of the primary nated
impreg-
the same up to a certain pointin all animals,and theirnature, cited in order to solve the problemof
germ-cell, and to the effect of such taneous
spon-
eonsistin the propagationon the partof the impreg- the alleged virginprocreation, are present only in
nated fissions in the subdivision and dlfiusion of
germ-cell, by a series of reiteratedspontaneous the that perfect form of Aphiswhere no such phenomena
of a numerous spermaticforce,I arrived, some years ago,(a) at
divisions, ofispriug. The rightand
into the circum- are manifested.
what I felt to be a clear insight
clear comprehensionof the purpose of this Leon Dufour,whose extent of research and com-
cess,
pro-
or the objecteffectedby it,is essential, as I
(") "* L*"ctureB on the ComparativeAnatomy and parieonof the generaktveorgans of insects led him
of the nature and function ci
have alreadyendeavoured to show, to the elucida- tion Physiologyof the Invenebrate Animals." 8vo.^l843. to a true appreciation
of the nature and relationsof the subsequent Pp.23ii the appendages to the female organs of the oviparous
No. 541, Vol. XXI.
 92 THE MEDICAL TIMES.

AfMdu, referred the phenomena of the generationfrom that union." They adduce,in order to show gibility in the Aphides as one of a simple i

of the larviparous Jphidei to **

spontaneous or that such a supposition is not contradictory to the sion of single individuals, but itis much more marvel,
Now, if consider what general of in the production of animals, lous in nature. The first-formed larva of earlv
equivocal generation.*' we course nature

we actnallT learn from these words, ^that " the larra 3iecase of the hive-bee, in which a single
" inter- spring
course procreates not one but eight larvaelikeitseUT
producedhy tho virginAphides are producedhy with the male fertilizes allthe eggs that are in successive broods, and each of these larvae peats
re-
"
spontaneous"or equivocalgeneration, "^it will laid for the space of two years ;" and the case of a the process ; and it may be againrepeated in
seem to be little more than another mode of statingcommon spider, showing that the sperm preserves the same
**
geometrical ratio until a number which
the iact The condition or mode of the fact,the its vivifying powers unimpairedfor a longperiod,figures onlycan indicateand languagealmost faUt
phenomena rendering it possible, are not explainedindeed a longerperiodthan is requisite for the to express, is the result The Apludesgenerated
by them ; M. Leon Dufonr, however, meant to impregnation of allthe broods that a female Aphis from virgin-parents, by this process of internal
record his belief in a hypothetical mode of genera-
tion, can produce." But these instances do not touch gemmation,are as countless as the leaves of a tree,
in which, as he expresses it, the act of im- the question
*'
how one of such a brood,insulated from to which theyare in some respectsanalogous.
in no degreeconcerned." Hsving all connexion, should givebirth to others. Ad- mitting It generally happens that the metamorphosis
Sregnation was
etected the male Aphis,and well scrutinized the that this phenomenon may depend on the which I have described as occurringafter the
stracture of itsorgans, havingwitnessed the coitus inheritanceof the impregnating principle transmitted seventh or eleventh generation takes placemuch
with the wingedfemale,and carefully excluded the from generation to generation, the problem for the earlier in the case of some of the thousands of in- dividuals
male in repeating the observations and experimentsnatural philosopher to explain is,how this is brought so propagated : just as a leaf-bud near the
of Bonnet, M. Dufour satisfied himself, and about. The superaddition "
of the spermatheca" t o root may develope a leaf-stem, a flower and seed-
affirmed, that impregnation had no share whatever the vaginaof the queen-bee, as of other oviparouscapsule, with much fewer antecedent generations of
in the phenomena of the development of the larval insects, plainly accounts for the fact in the economy leaves from buds than have precededthe formation
aphisin the body of another virgin larval aphis. of that insect which Messrs. Kirby and Spence of the flower at the summit of the plant; or justas
With regardto ^e hypothesis of spontaneous quote,according to the function of the partdeter- mined one of the lower and earlierformed digestive polypes
generation, the reasons which have led me to concur by the well-devised experiments of Hunter may push out a bud to be transformed into an ova- rian

with most physiologiststhe presentday in reject-

of ing on the silk-moth. (On Bees, Philos. Trans. 1792, sac and a generative medusa. The analogy ii
it were fully givenin a former Course of Lec- tures p. 175.) To say that one conjunction of the sexes beautifully and closelymaintained throughout
on the subject of Generation,nine years ago, sufficesto impregnate the females of the successive The wingless larval aphidesare not very locomo- tive
and every exact observation and experiment quently generations
subse- of Aphides springing from that union, ; theymight have been attached to one another
recorded serve to render that hypothesis is little more than a statement of the fact ; and it by continuity of integument, and each have been
less tenable and more gratuitous. seems to have been so felt by the able entomologists fixed to suck the juices from the part of the plant
Professor Morren, a comparatively recent and cited,who conclude theirremarks by confessing where it was "
brought forth. The stem of the
yery exact observer of the anatomy and generative It is,however,one of the mysteries of the Creator rose might have been incrusted with a chain of
"

economy of the Aphides,retaining the hypothesis that human intellectcannot fullypenetrate." (a) such connected larvaeas we see the stem of a fiicns
of spontaneousgeneration as it has been applied The completion of an embryonic or larval form incrusted with a chain of connected polypes, and
to the Entozoa, propounded, though not wiUiout by the developmentof an ovanan germ-cell, as in onlythe last developed wingedmales and oviparous
reserve, a theory that the larval aphides were veloped
de- the Aphis,without the immediate reception of fresh females mighthave been set free. The connecting
in the body of the virginparent,like En- tozoa,spermaticforce, has never been known to occur in medium might even have permitted a common eur-
"
by the individualisationof a previously ganised any vertebrateanimal.
or- rent of nutriment contributed to by each individuil
tissue." Now here also is a phrasewhich, The condition which renders this seemingly to circulate through the whole compound body
when the meaning of it is analysed, does little strangeand mysteriousgeneration of an embryo But how littleof anythingessential to the animal
more than express the old facts in a new way. without precedent coitus possible, is the retention of would be afiected by cutting through thishypothe-
tical
When a larval aphisis developed, a new individual a portion of the cells of Uie germ-mass unchanged. connecting and vascular integumentand set- ting
exists ; in other words,ithas been "individualised;" One sees such of the germ-mass each individual free ! If we performthisope-
portion taken into ration
and, as nothingcan come out of nothing, it must the semi-transparent body of the embryo Aphis, on the compound zoophyte,the detached
have been by the individualisationof a previously like the remnant of the yelk in the chick. I at polype
may live and continue ita genuniparons production.
re-

existing something. The questionto be solved is, firstthoughtthat it was about to be enclosed within This is more certainly and constantly
what is that something, and what has happened to the alimentary canal ; but it is not so. As the em-bryo the resultin detaching one of the monadiform in- dividuals
that somethingto make its individualisationunder grows it assumes the position of the ovarium, which assistsin composing the seeming
the form of a larval aphispossible and conceivable and becomes connected with the filamentary extre- individual whole called volvox globator
mities "
;" and so,
by us accordingto the known analogies of other of the eightoviducts. Individual develop- ment likewise,with the leaf-bud. And this liberation
embryonic developments or individualisationsf is checked and arrested at the apterous larval Nature has actually
performedfor us in the case of
That would be the explanation of which we are in condition. It is plain, therefore, that the essential the Aphis,and she therebyplainly teaches us the
quest,"an explanation going as far as that which condition of the developmentof another embryo true value or signification in morphologyof the
we sre able to give, for example, of the developmentin thislarva is the retention of partof the links that remain to attach together the
progeny connecting
of an ordinarily impregnatedovum ; and, by the of the primaryimpregnated germ-cell. differentgemmiparousindividuals of the volvox, the
provedanalogyof the essentialcondition of the de- velopment What is really sui prising in the phenomena of the zoophyte, and the plant.
in the virgin aphiswith that conditionin Aphidesis the potency of the mysterious virtue of The phenomena of parthenogenesis have not been
the impregnated ovum, capableof havingevery ad- vance the quintessential excretion,which sustaining so manifested in any articulate animal of higheror- ganisation
of knowledge of the operation of such essen-
tial greata degreeof subdivision, and of dilutionwith than insects: theycease at a lower grade
condition applied to it the material incorporated in the successive genera- of the parallel series of the molluscous invertebrata.
tion
When, however, M. Morren affirms que la gfti6-
"
of cells, is nevertheless equalto the renewal and In some lepidopterous insects, which have been sup- posed
ration se faitici, comme chez quelques Entozoaires,repetirion of embryonicdevelopmentthrough so to have the faculty of producingfiertile eos
par rindividualisationd'un tissupr^cldemment ganist,"many
or- generations. without sexual intercourse, closer ol^ervation hsi
the objection inunediatefy arises,that no The generationof a larval Aphismay be repeatedshown the mistake to have arisen from the unusual
one has ever seen a portionof mucous membrane, from seven to eleven times in as many successive circumstances under which the act of impregnation
muscular fibre, or other
organisedtissuedetach and virgingenerations, without any more
transform itselfinto an entozoon : such a
accession to place. This isthe case with the moths of the
takes
is the primary spermatic virtue of the retained cells call
process ptyche,which the German
genus entomologists
as gratuitously assumed, and as littlein accordance than in the case of the successive developmentof "sac-trager" from the remarkable cases or sacs
with observed phenomena,as "
spontaneousgenera-
tion" polypesin the compound zoophyte, or the successive which the larvaeinhabit The true state of the case
in the abstract. In a former Course I ob- jected,
buddingof the individualleaves in the equally pound
Com- has been explainedby the observations of Von
that ** The fissiparousnucleated cells of the plant: one might call the generationof the Scheven and Siebold. The females of these moths
ovum, once metamorphosedinto a tissue, can duce virgin
pro- aphidesan " internal gemmation," but this never acquirewings,but develope their ova under a
nothinghigher, and nothingelse save by their phrasewould not explain the conditions essentialto grade of metamorphoses of
very littlebeyondthat
decay,which producteare excreted;but the cells the process, unless we previously knew those condi-
tions the larval state.
which retain their primitive state amidst the various in regardto ordinary or external gemmation. Tlie larvaewhich become females fabricatean en- tirely
tissueswhich the rest have constituted in
building At length,however, the last apterousor larval differentcocoon from th"t of the larv" which
up the bodyof the new animal may, by virtue of Aphis, so developed,
proceedsto be "metamor-
phosed," become males,and the sexes of such larvie are readily
their assimilative and fissiparous forces,lay the it is termed,into a winged individual, Von Scheven
foundation for a new
as
distinguishable by such cocoons.
organism." I shall not, how-ever, in which onlythe fertilising filaments are formed,as secluded one of these virginfemale larvae of the
here pursue the argument, which is carried in the of the barren
out in my published case^ stamens of the plant;another PsychevestUot and found that she laid only
"
Lectures on the Anatomy and larval Aphis perfects the generative organs, and de- eggs.
Physioogy of the Vertebrate animals." velopes the ovules,as in the case of the pistil. W e Certain female larvaelive quite from the
The * learned and ingeniousauthors of the de- separate
servedly
have,in fact,at length" male and female indivi- duals," males on special When
peculiar feeding-localities.
popular"Introduction to Entomology" preceded by procreative individuals of a about to become most of the cccoon-bearers
admit it to be " an incontestiblefact that female lower pupae,
or arrested grade of organisation, analogousleave those localitJAs, and attach the mouth of the
Aphideshave the faculty of givingbirtiito
young to the gemmiparouspolypes of the zoophyte and the cocoon to branches of trees,to stones,, or rocks.
ones without havinghad
any intercourse with the leaves of the plant Befbre becoming pupae, the grub turns itself in
other sex," and they
supp"HH5" that one conjunction I have described the process for itshett"r intelli- the cocoon, and brings its head oppoasite the hinder
of the sexes sufficesfor the impregnation of all the or lower free of the cocoon.
females that in a succession of openmg
generations spring (a) Introduction to Entomology,vol. iv .p. 161. The female pupae manifest very little moiionfbut
 THE MEDICAL TIMES. 93
remun paniyeat the upperend of the sac, by which two parts of the sheath of the ovipositor, makes a to the required conditions for the development of
it is snspended; whilst me actire male pup" pro- little canal by which the ova are transmitted and the future insect The eggs are cylinorical in
trade their thorax from the lower opening of the lodgedunder the skin ; she then fliesoff to seek Bembyx everia; conical,with tubeiculate ribs,in
cocoon shortly before emergingas the perfect moth. another. Sometimes the female ichneumon, when Pcmtia napi; hemispherical in Bombyx dttmeti ; len- ticular
The almost apodalmaggot-shaped females cast she has found a larva,seems to take no notice of it ; in Nociua pei; cup-shaped in Orgyiaamiiquag
their papa-akin without quitting the cocoon ; they and, in that case, it has been found that another flask-shaped in (hilex ptpiene ; petiolate in Uemerp'
wait,in ue hinder or lower free end of the cocoon, ichneumon has previously oviposited there,and, by hkuperla; providedwith diverging processes like
the approachof the male, which accomplishes the some peculiar sense, she ascertains that there is no ears in Scaiophagaputris,to prevent their sinking
act without ever seeing the female of his choice. for more
room ova, or not food enough for such too deep in the soft dung ; provided with a speciid
The male Psyche has not the penisof markablewhen hatched. After the ichneumon has de- positedadaptation for fioating in some aquatic insects; with
any re-
length,bnt he is able to elongate con-
siderably the ova, she plasters over the wound with numerous other modifications.
the abdomen ; the skin of that part is soft the eolleterial secretion. In the insectsof the genus When impregnation has taken place, the germ-
and extensible;he inserts the abdomen into the Cynips, which are nearlyallied to the ichneumons, yelkbecomes condensed,as in the Ascaris, receding
hinder openingof the female cocoon, and brings the the female has an ovipositor very similarly modi- a little from the vitelline m embrane at its poles. The
external genitals into connexion with the copuTatory fled; its placefor oviposition is the leaf of the usual processes of subdivision take place, but in ao
canal of tibefemale. After the coitus,the female, willow ; and the ova excite an action in the cellular much
greater degree
a at the peripheral layerthat
which has no ovipositor, pushesherselfback again tissue of the leaf,which results in the formation of the subdivided vitellinemass becomes invested by
into the east papiu"skin, and there oviposits. Also, a warm and nutritiousbed for the larvae. The ducts a stratum
pro- of minute and nucleated cells. Kol-
if such a female,awaiting the male,be disturbed at called " nut-galls" result from a similar pro- cedureliker, who has observed these earlystagesof inaeet
the dosed end of the cocoon, she returns and betakes of the Cynip* Querci, In an insect alliedto developmentin the Chtnmomue triemdus Schrank"
herself whollywithin her old shed pupa-skin.In Jphit, the Chermes, or Psylia abtetitt the last act givesthe following account of the procen. Hie
the allied genus Talaporia, the larviform females of the oviparous female, at the close of summer, primordial cells,at firstround, and provided with
emerge from the hinder aperture of their short is,to deposit her ova in the rudimentary leaves one nucleolus,become afterwards elliptical, and
cocoon, and creep, by means of their well^developed of the fir-tree, when these leaves,instead of growing generally two nucleoli can be discerned in them ;
legs,to the under side of the cocoon ; the generative to the length of the others,become thickened,and afterwards two cells exist, of smaller size than the
act being performedin
open day. These femsles are converted,by the irritationof the ova of the parent cell. He concludes,that this flsuparoua
have a long ovipositor, and 'bymeans of it theyfill Chermes, into a series of cells of a compact struc- ture. generation of cells, which accords with that ob- served
their old pupa-dun with the impregnated ova. The In this specimen(showing No. 2972) a sec- tion by Siebold and Bagge in the Ascaris,is
procreant female of is
Psyche maggot-shaped, has has been removed, showing the cavities taining
con- the general mode of their multiplication: " ^''Haec
no frilly-developed legs,no articulateuntennse,nor the larvae. Here (showingNo. 2975) is a omnia, etsinunquam cellulasin abis inolusas ofifandi,
distinct eyes; neither has she a trace of an positor
ovi- specimenof the article in the old Materia Mediea, ne ad sententiam adducunt,posteriores a prioribm

; the last abdominal segment consistsonly called " Bedeguar." It is a twig of the common gigni,ita semper binse in unaque cellula matre
of a short fleshy cylinder,on which a short oviduct wild rose, from the end of which a tuftof mossy onantur."(a)
opens. The oolleterium is a double pyriformfibreshas shot out, in consequence of the irritation The vitellinemass becomes elongated and vermi-
glandularsac, with a short common duct A induced by the
presence of the ova and larvae of the form, and, by further subdivision and coalescenoe
spermatheeacommuuicates, by a short convoluted Cympt Roea. Hunter has made a section of this of the peripheric stratum of the derivativegerro-cella
duet, with the common vagina,which has two monstrous growth, exposing severalof the nidamental ("cambium" of Herold), a small transparent gument
inte-
latenl fleshy folds,and is connected with a round cavitiesand their small white larvae. is formed, like that in the Entosooo, flrst
bursa copulatrix, with thin and delicatewalls. In the gad-fly (JZshuhovit) the ovipositor is like alongthe ventral aspect,then aaoendin|f up the
Sueh accessories to the flabelliform ovaria and a telescope, terminated by boringinstruments ; by sides to the dorsal aspect, which is likewise closed
short ovidnota of the Psycheare of themselves suffi- means of these the integumentof the ox is per- forated, in by the reciprocaUy approximating folds which
eiant to show that'her ova are destined to be impreg- nated. and the egg is then deposited underneath cover first the cephalic and then the caudal seg- ments.
The idea that the females of this genus of the skin ; a peculiar kind of inflammation is set up, The portion of the germ-mass romaina
moth were parthenogenetic would,however,naturallyfollowed by hypertrophy and condensation of the longunchanged in the anal segment of the larva of
arise from observation of insulated facts in the sin- gular cellulartissue, and in Uie nidus thus producedthe the bee. No part of the yolkcan be properly said
series ofher generative processes. Our science larvae are developed.In the Bott-aestrus (Oastero- to enter or be taken into the body of an insect It
ever presents a pictureof truth evolving itselfby philuiequi) the ova are destined to be incubated in never was out of the body: it is a "germ-yolk;"
slow degreesfrom the misapprehensions of observers. the alimentarycanal of the horse; and one and forms the basis of the future body: there is no
An entomologist collecting the female Psychein her might wonder how their passage could be insured appended or superadded vitellns, aa in the shark or

unusuallyearlyarrested stage of metamorphoses,into such a locality. The instinct of the female bud. The division of the integument into the thir-
teen
and without cognizance of the singular mode of her impelsher to attach the ova to the hair of those segments commences at the ventral aspect,
impregnation, would at firstconclude, from the partsof the body which is most readilyreached which is convex, the vermiform body of the embrjro
sn^ogyof other moths, that she was a virginpupa; by the horse's tongue ; the irritationof the attached being,at first, bent upon the back.
and, keeping her carefully insulated,would be ova excitesthe action, and so theyare licked offand In the capitate larvaethe entosoal type is quickly
astounded by her abundant production of fertile ova. swallowed. Many insects deposit their eggs in the left by the cervical constriction, and the develop-
ment
Or, if ignorant of the peculiar placeof her natural earth,and the females of such are provided with of a distinct head,which commences by the
oviposition he might well mistake the shed pupa- instruments for digging.( preparation A of a locust formation of the part forwards retained aa the
ease, filledwith fertile eggs, for an actual pupa in was exhibited,showing the peculiarly modified labrum. The mandibulae and antennae next ap- pear
which such eggs had been developed. shape of the ovipositor.) It consists of two elon- gated behind the labrum as convex lobes ; and the
There are many striking and beautiful manifesta-
tions valves ; ^ese,in close juxta-position, are part of the head in the lower interspace of the man-
dibles
of instinctiveprescience in the modes of ovi- position,thrust into the earth,like the gardener's dibble; forms the labium. The maxiUsB nextboA
and in the location and attachment of the the valves are then separated by musclesfand the forth between the labium and the mandibles, and
ova. Observe ths actions of the common white eggs are protruded along the outer sp"ce and de- posited
the median fissure, surrounded by the rudimental
butterfly. Its food is the nectar of flowers ; but, like a seed in the ground. The analogoustrophi, sinks deeperinto the substance of the head,
afterimpregnation, she flitsabout with a purpose partin the bee is that which forms the sting, wUch, and, meeting a slender anterior production of the

quitedistinctfirom anythingconnected with the act as the defensive instrument of the nursingfemale, internal vitelline sac or cavity,establishes the
of supplyingherself with food ; but, if the plant has a certain relationto the well-being of the young. mouth and oesophagus.Whilst these stagesaroia
suitable for the food of the larvae to be developedMany insects not only providethe germ with the progress, the peripheral seriesof included vitelline
from her eggs happento be within the range of her nutntive vitellinemass, or the material for the first cells have undergonea seriesof spontaneous fis- sions;
flight, it vrillsoon be seen what her object is. The development of the embryo,(if, indeed,the parent whereby the remainingmass becomes in- cluded
laiTseof most Lepidoptera infest,and can onlybe can be said to be concerned in tJiat supplywhich is vrithina second stratum or cambium, whicha
nourished by,the leavesof particular the result rather of a seriesof spontaneousfissions by coalescence and further metamorphoses of the
properly plants :

thus,the mulberry is suitable to the silk-worm,and with an inherent power of assimilation of the primi- tive cells, is transformed into the tunics of the alimen*
the cabbageto the Pieru brauiea; when that com- monest germ-cell itself,) but,in some cases, the parent tarycanal,the interspace between which and thi9
of OUT butterflie"has found the cabbage, she havingselected a fitplace for the deposition of her outer integumentforms the abdominal cayity.A
has attained the end of her quest, and proems to precious burthen, continues the maternal officeby certain proportion of the vitellus, not inoladedin

the work of oviposition. But a more striking trationplacing

illus- near the ovum the kind of food which the the ellipsoid alimentarycanal, has undergone
is found in the ichneumon-fly, which is re- markablelarva will necessarily require in order to complete transformations, by which the foundations of the
for the greatlength of the anal append-
ages. its growth. muscular system, the ventral nervous chord,and
Her food,also, is nectar ; but her chief occu- pation Some insects, as bees and ants,feed the larva ; the dorsal vessel, are laid. An atteniuted posterior
in crossing over the leaves of trees and supply them with the requiredfood from time to prolongation of the ellipsoid vitelline or alimentarj
plants, after beingimpregnated, is to discover the time,as nurses satisfy the cravings of a child ; but sac forms the rectum, and opens upon the thirteen^
larvae that may be lurking ia the bend of the folded these cares rarely devolve upon tibe mother in the segment, while it is bent ujMn the dorsal aspect
lea^preparatoryto its changeInto the pupa-state.insect class: thev are performedby a distinctrace In such a condition, but without the cephalic anil
The ichneumon, by means of her peculiarly long, of individuals, of the feminine sex, but incapabletrophaldevelopment, the eatoziform of thefleak-.
slender the excluded from the parent: in a similar
sharp, and ovipositor, pierces sldu thom Helves of exercising procreative
the faculty. fly i" bom or

of the larva, and, in spiteof their writhing, The forms of the eggv uf iuaecu are very vanable ;
and the qection of an acrid fluid,she succeeds often beautiful and regular, like the seeds of plants; (a) Observationes de prima Insectorum Qeil"li
in perforating that gkiny and,then,by divaricating sometimes yery singular; alwaysperfectly adapted 4to. Turici. 1842.
 94 THE MEDICAL TIMES.
Oondition the larya of the hee and of the parasitic time than this,however, the patient has suffered Passingfzom the cavitiesand the muscular sub- stance
Hymenoptera quits the vermiform ovum, but from palpitation ; he has never had rheumatism, and to the orifices, we have the following physical
without the external communication with the di- gestivewe can discover no cause for the cardiac disease signspresented by the case before us : At the apex
"

or vitellinesao having been established at under which he labours. is a blowing murmur with the impulse, which has its
the posterior extremity. Leaving out of view, for the present,all the maximum either at the apex or immediately out^
In some Coleoptera developmentproceeds to the symptoms unconnected with our present inquiry,side ; it is heard foi some distance both inside and
fimnation of the appendagesof the head, as above the sig^ of the cardiac disease are as follow : "
outsidethe apex ; and in the former directionroaches
described,and a capitate but apodallarva is ex- The patient has, first, a slightly enlarged heart; to the righto[ the sternum, and even very faintiy to
eluded,aa in the nut- weevil. this is provedby three signs, viz. : a moderatelythe right nipple.The intensity of the second sound
In the other Coleoptera, as the Donacue (a),the strong impulse,combined with a littleincreased at the apexis exactly the reverse of this ; at the point
ventral arcs of the second, third,and fourth seg- ments,laterid dulness on percussion, and slight loweringwhere the systolic murmur is loudest, the second
send out bulbous rudiments of the thoracic of the apex of the heart. Thus, the heart's apex is sound is extremelyfaint; it is,however, distinctly
legs, before the tergal or notal elements of the seg- ments beating at the sixth rib,2) inches below the nipple,heard,and is not coveiedbyihe murmur. From this
are completed ; the abdomen is closed above, and } inch inside, instead of between the fifthand point, towards the sternum, it gradually increases in
whilst the development and at the rightof the sternum is sharp
of the extremitieshas pro- ceededsixth ribs,and 2 inches below the nipple.This mtensity,
to the formation of obscure joints and ter- slight lowering would not, however,have been con- sidered and accentuated. In fact, it is as iffrom this point
mmal hooks. The rudimental palpibegin to bud as abnormal, without the presence of the of maximum development, the second sound were
fiom the maxillsB and labium ; the mandibles ac- other signs, viz.,a strongerimpnlsethan is natural, transmittedtowards the leftapex. This is a pointI
quim their hard terminal hooks, and closely re- and increased precordial dulness. The dulness wish you to notice, as we shallhave soon to allude
tcmble the thoraeic feet In this state the larva is extends laterally from a little insidethe left edgeof to it again.The systolic murmur is not transmitted
txduded. the sternum to outside the left nipple, and mea- upwards so well as it is laterally ; traced upwards
At an earlierperiodthe simplebulbous antennae, sures Si inches ; superiorly it risesto just above the it becomes gradually fainter,and is at last lost
mandibles,and maxills, indicate three cephalicfourth rib ; the oblique and vertical diameters each at the fourUi left cartilage.It is referrible to
segments, equalin sice and distmctness to those of measure 8f inches. Supposingthat the direction regurgitant disease of the mitral valve,which is,
the thorax. The labrum and labium miffht of the heart's axis unchangedby liquid
is doubt, of old date, probablyanterior to the
perhaps or gaseous no
be regardedas indicative of two other abortive mours,pulmonary tubercles. Although it has co-existed
ments pleural
seg- effusion, by emphysema, by abdominal tu-
( but with this concession not more than five ascites, "c., these three signs, when they with tubercles,it does not seem to have much in- creased
cephalic segments can be defined by observation of occur together, are nearlyabsolutely certain. In the tendency to hsmoptysis, as there has
the earlydevelopment of the insect. The biliary increased dulness from fluidin the peri- been no spitting of blood for six months, and only a
precordial cardium,
Mid other tubular glandsresultfrom before that time. From this ftict,
juxtoposition the dulness is more upwards than late- rally, moderate amount
in a Imear seriesof derivativenucleated the impulseis rather weakened than strength- and, perhaps, from the softcharacterof the murmur,
germ-cells, ened,
which coalesce by liquefaction of the partsof the there be consider the mitral disease moderate only.
(unless pre-existent hypertrophy, we may as
cell-wall in contact with each other,the nuclei re- when other
thingsmust be considered,) and the When from the apex we proceed upwards,we find
nsininglonger apd indicating primitive
the ation
separ- heart's apex remains at the normal point, or is even that almost immediately we commence to hear a
ofthe cells. The ovarian tubes have the very distant diastolicsound ; this increases in in- tensity
appearedsomewhat raised. If there be dilatationsimply,
***.*"?". *"**^" ^*"^ ^ ^^ silkworm, to retain the impulseis weak, and the apex seldom lowered. But, until,at a pointequi-distant between the left
primitive seriesof nuclei of the germ-cells at their if there be any displacement of the heart,any tend- ency nippleand the sternum, it is very loud and rough;
capillary beginnings; whilst coalescence of the to a verticalor horizontaldirectionof its axis, at this pointit cannot be positively affirmed that
cerm-cells themselves, has taken placeto form the as in the diseasesof the lungsand abdominal organs there is any systolic murmur; above this,at the
lower part of the tube : such and at mid-
persistent, primitive, justreferred to, then the three signsI have now third left interspaceand cartilage,
Jttdei, or granules, seem
formationof the subsequent
to form the basis for the mentioned are liable to fallacy. sternum, the diastolicmurmur is at its maximum ;
ova. In the case before us, itis evident,also,that the above this it diminishes gradually in intensity, but
slightenlargement, indicated by the above signs,can be still heard loudly under the firstbone of the
affectschiefly the left ventricle. This is proved,sternum and to itsright, and much more faintly to
lECTUBES 1st,by the extension of the dulness to the left,and its left. In fact,in some of the reports, the second
ON not to the right, and by the strongestimpulsebeing sound at the second left cartilage is noted as sharp,
CLINICAL MEDICINE. at the leftapex ; 2nd, by the fact, that there is dis- ease without murmur. At the thirdleftcartilasea veiy
of the orifices of the left, and not of the right soft systolic murmur can be heard, and aoove this
BELIY"RSD AT UNIYERSITY COLLEQB
HOSPITAL. heart. Sometimes,in enormous hypertrophy of the point is audible,both to rightand left of the
right ventricle, the extension of dulness and of im- pulse sternum, and under it. It is much softerthan the
By E. A. PARKE8, tf.D., Lond.:
are to the left as well as, or instead of, to the mitral murmur. In the neck there are loud ar- terial
''JH^ ,"/,***" **^ ^^'"B* "' Phyaielani,ProfeMorof
right;but, in such cases, we have always other murmurs with the impulse ; but no second
ainteal M"dicliie In Unl?enlty
College, and Phytidan to
the HospItaL signs derived from such extreme hypertrophy, and sound or murmiur. The systolic murmur, no doubt,
from itsinvariableaccompanyingvalvular diseases. indicatesaortic obstruction.
LECTURE IV. Also, in order that increased impulseat the left The diastolicmurmur presentsseveral points for
nippleshall be attributed to lefthypertrophy, and consideration,1^. Its maximum is at the lower
Sigm "f Awrtic lUgurgitatum^Potsible FaUaciet, increased
impulse at the sternum to right h ypertro- margin, or a little to the rightof the lower maigin
Exceptumt, 0md occasiomd Difficulties.
be no displacement or justbelow this,and it
GsNTLKMSN, In the cases of valvular disease phy^here
must or change of axis. of the thirdleftcartilage,
"
When the heart it actingquietly, the impulse is almost as loud at the fourth leftcartilage. The aortic
broughtto your notice in the two firstLectures, I is almost entirely confined to the apex ; when valve israther deeplyunder the sternum to the right
selectedexamplesillustrating, more or lessperfectly, the heart acts strongly, the impulse can be of and ratherbelow the thirdleftcartilage, or occasion-
ally,
lesions of the anriculo-ventricular
openingsand seen and felt all over the cardiac region;it is especially in enlarged hearts, a little lower than
Talves,and the antecedent or consecutive changes not and
in the cavitiesand walls of the heart
undulatory, is unaccompaniedby thrill. this; therefore the maximum intensity the mur-
of mur
In the third We cannot the valve,or justbelow it
very well decide whether the muscular is immediately over
Lecture,we discussed a well-marked example of tissueof the heart is We 2^. The transmission of the murmur is downwards
that disease of the aorticvalves in which the flow of
healthyor not can at aU
times onlyinferthis from the nature of the impulse,towards the left apex for a considerable distance ;
blood passing from the heart is impeded. In this the character of the
sounds,or the general history of in fact,almost to the apex, and upwardsalong the
case, we had also some amount of insufiSciency of the case. Murmurs to which we is often
the aorticflaps
must immediatelyrightborder of the sternum ; the murmur
; but,as thislesionwas onlysecond-
ary, and which are dependent on valvular lesions,not heard at all at the second leftcartilage, where
and was
allude,
not very complete, itssignswere not destroy the possibility of judgingfrom the nature of we get, when the heart is actingquietiy, only the
broughtout in a form of sufficientsimplicity to the tone, as to the of hypertrophy and dilata-
tion. second of the pulmonary valves. 3^. The
enable me
degree sharp
to bring before you the characteristic
I may mention here,that the objection which time of its occurrence is immediately afterthe sys- tolic
marks of regurgitant aortic disease. A case we has been made to Laennec's opinions regardingthe sound,and it continues nearlythroughoutthe
have now in Die wards, illustrates this afibctionre- muffled tone of the firstsound in hypertrophy,
markably and intervalof rest ; there is, however, a very short pause
well,and iU discussion will also lead us the clear note in dilatation, Skoda, viz.,that the before the first sound re-commences. 4^. Its note
to a brief generalconsideration of diastolicmur-
by
murs rule by no means invariablyapplies, may possiblyis pitched lower tiianthat of the systolic sound ; it
at the base.
be justified by the knowledgewe are, at present, is rough, and the roughnessis, perhaps, most
The ease referred to is that of Thomas North,
acquiring respecting the fattydegeneration of the marked at its commencement.
aged 50, admitted for phthisis. We need not occupy heart Pure hypertrophy, and thickening of the I need scarcely say, that the pointof origin of
"urselves at presentwith the particulars of the dis- ventricularwalls
by fat deposition, external to the this murmur, and itsmode of transmission upwards,
me which sent him to us. It may be simplymen- orifice, while the
tioned, sarcolemma with which fat deposition in the sarco- its
imply production a t the aortic
that there is a large cavity, apparently vrell lemma is sometimes combined,are, in allprobability, time of its appearance proTCs itsdependence on sufficiency
in-
coated over with a fibrous
cap at the left apex, un- attended by appreciable differences in the character of the aortic valve. Its transmission
softened scattered tubercles at the right
apex, and of the firstsound, and cannot be included in the downwards would also prove its connexion with the
ulceration of the lary"x: there is no appreciable
same rule,yet both are, at present,designated by Itfftheart ; it is transmitted downwards and to the
abdominal disease at present. The symptoms of the terui In judg- left,
hyp"itrophy. Another difficulty viz.,in the course of a line drawn from the
phthisis commenced a year
ago ; for a much longer of hypertrophy from the nature of the sounds is, centre of the third left cartilage to the place where

(a) Kolliker, loc cit.p. 15.

Iing
that valvular leBlons
murmurs.
are often present,producing the apex is seen.
I
It is soon lostin a verticaldirec-
alongthe edgeof the sternum.
tion
 THE MEDICAL TIMES. 95

Hus diaflnosisof aorticinsufficiency isfullyeon- There are yet some circumstances con- nected Let me now sum up the very marked signsof
firmed b^ Uie presence of certainsignsderived from with this case to which I must allude. From aorticinsufficiency, which this case has givenus ;
the artenes,

arteries,
lently.
joa have in perfection
ao
particularly
upper extremities. Our patient

poise. In the carotids,

brachial,radial,
those

and,in a less degree,

the vessels are seen to be pulsating
Place the finger upon any
the terking,
well described by Corngan. The artery one
presents,

treme).
of the neck and the the extreme pulsation o f the

in the femoral from such a valveu Yet there is a very marked

of them,
thrilling
arteries,
in a high marked character of the diastolic sound,we have cases
decree,the phenomena of the vibratileoilocomotive considered the aortic regurgitation
in the subclavian,axillary, Of course no
and

vio second sound at the lower end of the sternum carried must
and faintly to the left apex. Now, this
from

ia,doubtless,
pulse,attributableto the pulmonaryvalvules which,at the maximum
second leftcartilage, can be heard producingeven
the from

have
it

to be very great from this standard,

we

are
must form a standard to which allother

to be referred. Deviations may

normal second sound can be derived cause, which is to be foimd either in the circum-
already
but never

hereafter consider. In this maa" then"we

a murmur

cartilage
over
through
at
a
without appreciable

mentioned, or in others which we

the base of the heart,havingite

line drawn from the third left
the stemum, or immediately
ocour

stances

be-
low
moment seems suddenlv filled : the next moment it sharply ti^eir normal sound. This isproved by the point thu line; occurring at once after the syatolia
eoUapsesaa if as suddenly emptied.It is quitea dif- ferentwhere it is heard loudest, viz.,over the sound, and abolishmg, at the pointnamed* the tfud
pulmonarr
pulsefrom those cases, as in anoemia, great valves,by the directionia which the sound ia carried,second altogether, not,as it were, growingout of iL
debility, "c., in which a thrilling, or slightly jerking and by the existence of the aortic disease. In this From this point, the diastolicmurmur is transmitted
character is givenby the rapidpassage of an undu- lation case, as in many others, we have,it appears to me, upwards in the course of the aorta, downward*
or wave ; in aortic regurgitation the wave a decided proofthat both aortie and pulmonary towards the leftapex. At the apex of the left veik-
does not seem to pass by the finger, but when at its valves producea second sound,that one sound may triclethe aorticsecond sound ia wanting, since wt.
maximum suddenlyto stop and recede. In fact, be arrested, the other continue,and by beingtrans- mitted have seen reason to believe that the famt second
I need hardlymention, that blood does literally from its pointof maximum development,sound heard here is from the pulmonaryartery. In
recede into the left ventricle Uirough the patent may, as it were, supply, in auscultation, the place fact,was there not some mitral regurgitation* and
aortic orifice. of the other. Here, at the leftapex, there appears consequent increase and accentuation of the pul-monary
This kind of pulse taken in connexion with a no doubt that the faintsecond sound isfrom the pul- second sound, might have here had aa
monary we
dSastolic murmur the of the usual rule, viz., thatthereialosa
having its maximum over artery. This audibleness of the pulmonary exemplification
third left cartilage oratmidstemum, is an absolutely seoond sound at the left apex, the aortic seoond of the second sound at the left apex in spreataortio
certain indication of aortio insufiiciencv. In re- sound beingdestroyed by dieease, is interesting by insufficiency. In addition to this(UastoUc muxmux
gnrgitation from the aorta into a ventncle or the reason of itsprobable connexion with a phenomenonover the aortic valve,the patient preaente loco-motive
pahnonary artery, the diastolicsoimd is heard best we must hereaftermore fullyconsider, viz.,the oo and visible pulsation in axteriea removed
higherthan the vjJves. But, eithersignmav rately currence
sepa- of double second sounds at the apex. You from the heart He presents, also, the iipaof
occur without such insufficiency, and tbere are aware, that,at the base,a phenonkenon not un-
commonlythe allbut invariablesequence of aorticinsufficiency "

of tiieleft ventricle, and the

may be insufficiency without the jerking pulse, and occurs, which has been termed redupli- cation dilated hypertrophy
even without the diastolicmurmur. It may not be of the second sound. Instead of the normal frequent sequence of this condition, viz.,mitralin*
useless to allude briefly to examplesof these facta. tic-tac, we have tic-tac-tac. This kas been attri- buted, sufficiency. Another condition, whkh ia ofteutbiU
Thus, the jerking locomotive pulseoccurs in arteries for a long time, to a non-synchroniam tweenby no means
be- an invariable aocompanimtnt of neat
which have become tortuous^ aa is often the case the fallsof the aorticand pulmonary valvet. aorticinsuffioienoy ia presenthere,viz.,a soft, low,
with the brachial and radial. This is even evidenced To use the apt phraseof Skoda, the second sound systolic murmur at the base,causedt doubtless, by
in the presentcase; here the right brachial ismoder-ately becomes ** cleft." At the apex a double second impedimentto the outflow of blood, from the dia*
the right sound is sometimes heard,and has been attributed eased valves. This is common in bad case*
tortuous; the left b quitestraight; more

of the leftis to variouB causes, such as a rub duringdiastole of than a harsh systolic or an absMCe of all
B pulsatingstrongly ; the pulsation murmur,
onlyjustvisible; if the arm is bent, the pulsations the heart on the pericardium, or of the pericardiumsound with the systole,
which signsare also oocft^
in both brachials are much augmented,beingstill on the thoracic walls,to some disease oif the mitral sionally coincident with aorticinsufficiency.
most marked in the right therefore, if an artery valve, "c. These causes reallybe acting You will peroeive, that in layingdown these
, may
is not well stretched between its points ments, sometimes, but also,if the pulmonary second is precise
of attach- rules, I am following those ohserrera who
be
its pulsation seems to become more visible. thus so easily heard at the left apex, there is no believe that a very highdegreeof accuracy can
Again, occasionally without sound the attained to in the diagnosis of diseased cardiac oa*
in greathypertrophy, reason why the double second at apex
firm partizan of thia opinien, with
any aorticdisease,there is sometimes visible pul- shoiUd not be referredin some cases, as at the base, fices. I am a

tttion. In ancemia also the arteriesare occasionally to a want of synchronism in the playof the semi- lunar the proviso, that the signs shallbe aocurateW noted*
fulfilled.
slightly moveable. Also, sometimes, in the most valves. We ought then to have, in such and allthe conditionsof the givenrules
healthy be cases, a re-duplication also at the base,but I do not Before passing from this case, let me ask yon to
persons, the arteries at the wrist oan
the generalsymptoms are not severe*
seen visibly to beat. In allthese cases the pulsa- tion know whether thisis always the case, as I have my- self observe,that
at Conddering the amount of lung-disease, the dyspnoea
is,however, slight, and very different, in many
very few and imperfect cases of reduplication
from ihe extreme example have to-day the apex, and have found no decided observations is trifling ; the palpitation
is not great ; there U no
leapects, we
referred to. the sounds at the base,in the recorded dropsyor signof obstruction in the generalcircu-lation;
respecting left ventricle still
On the other hand, there may be a diaatolic cases I have noticed. In two of my own oases, the for the hypertrophied
murmur at the base without aorticinsufficiency, reduplication was noticed both at base and apex. throws itscurrent with sufficientforce to prevent
lliismay arise from aorticaneurism, in which case stagnation. Could we remove the pathisiSf
The extension,or the non-extension of a moiety venous
the maximum of the sound is generaUy above the of the second sound, (ifI may use such a phrase,) this man would go on many years yet with that heart,
provided the nutrition of the muscular tissuewaa
aortic valve; or it
may arise,in some very rare the other moie^being abolishedby disease, may
cases, from causes which are at presentunknown. in part Uke discrepancies to be found in re- corded well preserved ; in foct, aorticregurgitation ia,aftec
explain valvular difr-
Cases are sometimes seen in which there is a dia- stolic cases as to the presence or absence of a aortic obstruction, the least senous

murmur at the base, without sufficient second sound at the in cases of mitral or ease of the heart perse: itis formidable, howevei^
any apex,
evidence of the existence eitherof aneurism, or of aorticdisease. The general rule seems to be, that by its consequences, for itinduces, almost invariabW,
of the leftventricle, and subsequently
aortic insufficiency. In these cases the sound seems in mitral insufficiency the second sound at the apex hypertrophy
; then slowly the lunga and the
to arise in the aorta* and sometimes can be heard is not lost, thoughit may sometimes be obscured by mitral regurgitotion
become implicated, and each apecific
some way alongit. a longrumblingsyatoUomurmur ; while in aortic rightheart
As visible arterial pulsations the second sound at the left apex is lesion complicating itselfwith disorderswhich aie
may be present insufficiency,
without aortio insuffieiency, a second secondary or primary to it, impresses upon them ft
so aorticinsufficiency very faint or wanting. When, therefore,
influence, which necessarily reverta uwm
may exist without visiblepulsation. This seems to sound iaheard at the left apex in, great aortio in- pernicious
sufficiency,
derived from the itself. Aortic insufficiency becomee formidabUf
happen under three circumstances : 1st.When the "
may it not be simply
2nd. The the rule also, ifthe general health breaks down, and dilata*
insufficiency is very slight. According to pulmonary valves? exceptions to are
Hope, when tJiereis free mitral regurgitation^ or at presenttoo numerous to allow us to giveitmuch tion of the leftventricle occurs.

mitral contraction. 3. When the quanti^ of diagnostio valuer Thus Skoda refersto a ease of Let ua now, however, leave thia case, wluch wf
peat
olood ia in any shallhereafterhave to consider from another poial
diminished, and the heart's aortic insufficiency, in which the seoond sound was
way
action is "Beble,as m chronic exhausting diseases; louder at the apex than elsewhere,so that we oan of view,and allude to an instance of diastolicnauf*
who has justleftthe
here also,generally the diastolicsound is indistinct or hardlyrefbrit in this case to the pulmonaryvalves ; mur at the base,in a patient
even wanting,and then there ia no physical signof and it is a matter of pretty frequent observation to hospital.
aortic regurgitation. find in simplemitral regurgitation an occasional The case I refer to is that of Hamett Haieke^e^
With regard to mitral regurgitation and contrac" lossof the second sound at the leftapex. 21," thin snare girl, who haa never menatrafted,
are perfectly veloped.
unde-
Another pointconnected with the case is the fact, and whose hreaste and nipples
^

tion.Dr. Hope referredthe non-appearance of nul'

sation to the blood being so much She waa adnutted in the beginningcf
impeded or that the pulmonarysecond sound is alightly ened,
sharp-
forced so freelythroughthe mitral orifice, that with the rule of Skoda, that December, on the 9th day of a mild attack of arth-
agreeingherein
with mitral cular rheumatism, which came on afterexposuFs to
enoughdid not get intothe aorta to distend it fully.accentuation of this sound corresponds
There are some Skoda cold and wet Five daysafter'adnussionallrhemap
difficulties In this explanation, and regurgitation ; Indeed,such imnortance does
attach to this sign,that it is almost necessary for atio symptoms disappeared ; and, though
we k^
we may accept the observed fact,without attempt- ing
it I may remark, her in the hospital tUl Oie end o" December, thiswaa
at presentto interpret the diagno^sof mitralregurgitation.
afiectionwhich presented
Returningfrom this digression to the case before that ihia eutement of Skoda must, I should think, merely to watch a cardiac
difficulties. With the exception of sli"^
ua, we have diagnosed slight eccentric hypertrophybe received with the reservation, that in the most some
this patient
of the leftventricle, mitral regurgitation, aortic ob- healthypersons the second sound at tiiesecond left rheumatic twinges two days
struction for lately,
after her admusion,
(aligbt), and aortic regurgitation (ex- cartilage is occasionally very much accentuated. |considered herself, shortiy from
 96 THE MEDICAL TIMER
in perfect health. On admission , and on discharge, then, were they owing? Before answeringthis we regardthe importance of the opinion, itsdecided
"he presented several cardiac physical signs, which question, let us return to the second point we just character, and itsgeneral reception ? I can do no
be thus briefly summed mooted,viz.,as to where the murmurs than very briefly discuss this question, but I
may up : A very weak now
"
were more

impulsefeltat the upper border of the 5th rib,1^ generated. am unwilling to pass it by without notice.
inches inside nipple, and i inch below,and a small That the sound at the apex was produced by mi-
tral The prevailing opinion of the Profession has been
and narrow pnecordial dulness, in the absence of insufficiency, seemed unlikelyfrom itssituation, better expressed by no one than by Dr. Latham. (")
any lungaffection, indicated a small and feeble act- ing which was insidethe apex, and from the want of any His exposition is remarkable for its elegance, ness,
clear-
heart. At the point where the apex was beatingsymptoms of hypertrophy of the leftventricle, or of and precision, as far as the subjectadmits of
was an extremely faintsystolic murmur, and a very implication of the pulmonary circulation; that itwas precision ; and I think I shall best accomplishthe
riiarp second sound. Passingtransversely to sternum, not derived from insuficiency of the tricuspid valve, object I have in view,by ofiering a few brief com-
; diese-
the systolic murmur increued in intensity seemed provedby the want of symptoms derived ments upon the principal arguments adduced by
eond preserved its sharpness. At the right of the from the neck,or from the generalcirculation, aiid "him. I select Dr. Latham as the best representa-
tive
sternum the firstsound was normal. At the base was from the presence of a normal sound alongthe right of the opinions which he holds, and from no
both a systolic and diastolic murmur; the last of the sternum. The murmur could not, in fact, be personal considerations, unless it be the highrespect
loudest, seeming, a s it were, to arise out of a very easily referred to either orifice. which I entertain for his authority a nd character.
"harpsecond sound,and to occupy the whole of the Again,the murmurs at the base were above the I might refer to many passages in which Dr.
interval of rest,becoming, however, gradually fainter aortic valves;if the diastolicindicated regurgita- tion, Latham expresses his strongconfidence in the anti- phlogistic
towards its close. The exact pointof maximum it did not abolish the aortic second sound; it and reparatorypowers of mercury in the
development was at the junctionof the firstand was transmitted too much to the leftof the sternum, cases in question.For brevity's sake,I will content
leoond bones of sternum,and it was heard better to and was not attended with visiblearterialpulsation. myself with one. Speaking of the treatment of
the left than the riffhtof this bone. Below the In fact, here also the
symptomsdid not square with pericarditis, he says (Vol.I., p. 303): "And, "

junction, and at the third leftinterspace, it was not the rigid diagnosis of aortic insufi"ciency we allowing
which bleeding a nd common antiphlogistic sures
mea-
heard ; at,and all over the cardiac to be needful,
regionbelow, have laiddown. and even indispensable, I am
these points, only very sharp let them do allwhich
was a second. In the The onlypositive 83rmptoms we had, viz.,the fully persuaded, that, theycan
post-sternal hollow was a systolic murmur, increased,maximum of intensity beingover the junction of do, mercury can do something more; somethinff
but not altogether developed by pressure ; no dia- stolic, the firstand second bones of the sternum, and the towards saving life,and inducingreparation whi^
onlya sharpsecond sound could be heard. slightpulsationfelt here, were not sufficiently nothing else can do so well. "lfthU ther* is at iotit-
There was no anaemia ; no jugular marked to allow any great stress to be laid upon factory evidence at we have of mast pointtin practical
pulsation ; no
arterialoulsation, except very slightly in the post- them. medicine which are thought tettled.**
sternal hollow and the carotids; Dr. Latham certain oonditions as aiding
no cyanosis;no Coming, then,without more detail, to the dia^ specifles
oedema of any part; no palpitation or pain in the gnosis of this disease, I think itis clearthat itwould or insuring efficacy
the of mercury. These are,-*
cardiac region ; no irregularity of the heart'saction ; be imprudentto diagnose disease of either aortic First,the form of the inflammation. **
The more
110
pulmonary symptoms of any kind except very or mitral valve. In fact,I would not, myself, in itis adhesive, or has itstendency to the deposition of
"light cough,"in fact,no positive symptoms which such a case, giveany decided opinion either on the lymph, the more does it admit the curative impres- sion
could be taken hold of,exceptone which I am about of the murmurs, or of the antecedents of mercury."
organic causes
to mention. The maximum of the diastolicmur- of these conditions. In practical
mur medicine,it is Secondly, the part which it afiects. " All experi- ence
was, we have already said,immediately beneath better to make no diagnosis than to make a wrong bears testimony to its more generalutility in
the sternum,at the junction of its firstand second it better inflammation of serous than of mucous membranes.
one, or rather, is] always to be aware to
b"me8 ; and from this
pointit was hardlytrans- mitted what extent our diagnosis is a certain one. There In pleurisy, in peritonitis, we are accustomed to give
either upwards or downwards. Just at this are, however,one or two pointsin the history of mercury without much d^riminationof the kindof
point, on eitherside of the
sternum, a little pulsationthe case which enable us to make a suggestion as inflammation we have to deal with, or whether its
could be felt, and there was decidedly a little more to the remote causes of the morbid sound. We had predominanttendencybe to Ijrmph, or serum, or
dulness than above or below. At the
top of the a patient who presented cardiac murmurs, which pus, or blood ; and success has attended the prac- tice."
sternum the percussion note was perfectly normal. could not, without violation of the strict rules of
The murmurs present in this case were no doubt diagnoas, be referred to the well-known lesionsof Thirdly, the state of the conttihUitm, "
The con-
stitution
omnic. We had,then, two questions to ask our- these valves. These murmuis which bears mercury
selves co-existed with a the best,and most
; First, was the endocardial murmur weak and small heart,and occurred in a person readily
recent and
accepts appropriates all the goodit li
"ad of ihenmatic origin, it antecedent to the who presented
or was many marks of incomplete develop-capableof doing,is that which is natunllyand
ment
riieitmatism, which had existedfbr
eightdays ? condly,
Se- Thus, althoughtwenty-one years of age, habitually the most healthyand the most free
whether recent or old,
aflEbcted
what partsof the heart country bora and bred, and derived fh"m heal"y from allspecific taintorweakness,whether hereditary
were f
parents,she was ver^ diminutively formed,only or acquired." **
The constitutionwhich bean
In answer to the firstquestion, we had two facts 4 ft 6 in.in height, without the least appearance of mercury the worst, and is most apt to convert the
in fkvour of the rheumatic is that wtdchishabitnally
originof the murmur; mammse or nipples, and with no normal uterine ac- tion. goodit mightdo into evil,
ifrst, the frequencyof endocardial murmur in Puttingall these circumstances together, it unhealthy, and has acquiredor inherited some
rheumatism ; second, the circumstance that there "All
may be thrown out as a possible case, whether there specific taint or weakness,as scrofula."
had been no previous attack of rheumatism to which is not some malformation of the heart, remedies applied in such a con-
congenital to it(inflammation stitution)
the cardiac aflfectioncould be referred. On the not
enough to produceany of the more formidable are of doubtful efficacy." (P.262"4.)
other hand, we had some grounds for
doubtingthe efiects of arrest of development, but merely the But, may I not be allowed to ask, are not diese
correctness of this view. The mere
slightness of comparatively slightmorbid signswe were able to precisely the inflammations and the circumstances
the jointafiectionsignified
nothing, as cardiac com- plication note. But this is a mere conjecture.I have in which inflammations get well,under any kind of
may come on in the least severe cases. broughtthe case before you, onlyfor the purpose of treatment, and without any treatment at all? Is this
Bu^ Ist.,the general symptoms were exceedinglyenabling us to discuss more fullvthis important sub- not an exact description
ject of the cases which I have
"light; 2nd, the murmur at the apex could not be of organic murmurs of the heart placedin my Jirttelatt^and which nearlyall
imequivocally referred to the mitral valve, as I shall ended in recovery, as distingfuished from thosein
presently mention,nor could the murmur at the my teccnd class, all of which ended in death ? Are
Use be unequivocaUy referred to the aortic valve ; OKIOINAIi OONTRIBUTZOMB. they not, therefore, the cases from which it is the
"ttd yet murmurs arising in,and easily referred to, ^ most difficult to extract precise information in sup- port
Ibese structures, are the common
murmurs heard in ON THE of any planof treatment 7 The danger of idio- pathic
tte recent endocardial
complication of rheumatism; TREATMENT OF ACUTE PERICARDITIS ; inflammation of serous membranes in a
Srd, the diastolicmurmur at the base, if attribut-
able ESPECIALLY ON THE healthysubjecthas, probably, been much gerated,
exag-
to recent endocarditis, have been indi-
must cative EFFECTS " if we except,for obvious reasons, inflam- mation
of aortic OF BLOOD-LETTING AND
reguigitation, and this could hardly within the skull, and that of the lining brane
mem-
liave been produced MERCURY IN THAT DISEASE.
by eightdays'diseasewithout of the vascular system. As thisis a pdot of
"enons and djstrwaing By JOHN TAYLOR, M.D.,
generalmiptoms ; 4th,the some importance, I will take the liberty of quoting
niurmuis did not have the Fellov of the Roysl Colleg*of Phyttdans in London, and
peculiar timbre common one or two highauthoritiesin supportof the opinion
to recent endocardial Physioianto the Haddenfleld Inflmuur. Formorly Pio-
murmurs; but this aigu- fostor of Clinical If edidno In tho UnlversitjCollege, which I have expressed.
nent, depending on a judgment of sense
of little
merely, '
M. Louis says, that " a fatal acute peritonitis,
was weight which was not secondary to some other disease,was
Altogether, the weightof the reasoning
appeared (Concluded from page 75.) a thinghe had not seen for flveor six years,and,
to be againstthe
supposition of recent "sease, and The analysis, which I have now completed, of perhaps, never."(b) Dr: Jackson, jun.,writes as
this opimon was
supportedby the progress of the these cases, does not seem to me to sustain the follows :"
case ; the girlwas
keptin the hospital twenty-three generalfeeling of the Profession in favour of "
1. Pericarditisis called a very fatal disease.
fv ^l:" ^*^"^' ^" ^'^^ ^ '^^ ^ould
stay,and during the curative powers of mercury in inflammation 2. Peritonitisthe same. 3. Pleuritisoften the same.
tnat ttm", no more changeoccurred in the cardiac of the pericardium, and of serous membranes 4. Gastritisthe same. 5. Erysipelas the same. And
r^t'htS'raTon"*"^*"'^'"""*"^'^^^^^^^
but rather,I think,tends
generally; to produce

Suppoamg,
It a contrary impression. becomes, therefore, kb (a)Lectures on Subjectsconnected with CUoicsl
then,these old, they
murmurs to be
imnortaut question to dotormine what that Medicine,
oouM not have been of rheumatic upon let Ed., 18", Vol. I.
origin,
since the feelingis based. Is the evidence so clear,and of (b) Memoir of James Jackson,Jun.,M.D. **
, ^ ^

P"uent had never had rheumatismbefore.To what, fuch

an amoimt, as we have a right when Bofton,
to look for, America. 188^. P. 168.
 98 THE MEDICAL TIMBJ^-
of the heart. There is no evidence to show
about the severity of the caBes compared,"the ages tally." (a) The results obtained by M. Bouillaud region
Endocar-
ditis, will appear to be more favourable, when itis remem-
bered, that they did eithergoodor harm.
and other circumstances of the patients.
in a mild form, is a very common, and, pro-
bably, that the cases reported are taken indisciimi- Sinapisms. In the onlycase in which this remedy
"

distinctionbeing made between the was used (No.20), it relievedpain.

a comparatively trifling disease; but, in its iiately, no tients
pa-

more severe forms,it assumes a differentimport-

ance, who were previously in good or in bad health. Purging, Free purgingwas producedin several
"

Dr. Latham considers " it is a great thingfor cases, and, probably, co-operated with the blood-
letting
and is capable of destroying life, as I can tify,
tes-

and salivation, the exocardial murmur to begin and cease in a in its effects. The benefit of each cannot
in spite of both bleeding ever so
week." He can referto three cases onlyin which be separately distinguished. In several cases ing
purg-
promptlyand actively employed.
Dr. he is sure that such was the fact ; and there was not caused considerable depression.
In respectto the treatment of pericarditis.
Latham's statement is not less strong: " one of them in which the patient was vated. Opium was of servicein relieving
not firstsali- spasmodicdys- pnoea,
"
Here mercury seemed to me to display its in one case (20),and convulsive movemcnta
"
These,moreover, are the cases in which foreign also givenwith the calomel, in
and Englishpractice, in the management of peri- carditis,highest antiphlogistic power. But, if others doubt, in another. It was
and let it be a question for future observation, whether, various cases, but the onlyeffects specially noticed
may be fairly broughtinto comparison,
in which it may be seen where and how the one to where the murmur of pericarditis rapidlyceases, are those juststated.
and Spontanemu Curt. Seveml of the cases show that
qftenftUU, and the other is ao qften wccearfuV and the danger rapidly disappears, convales-cence "

the disease may its course, and probably nate

termi-
"
In foreignpractice, no mercury is used from rapidly follows,salivationis or is not a pre- ceding run

favourably, without treatment Cases 30

ibstto last, but allthe power of common gistic
antiphlo- condition,in all,or in the vast majority of any
remedies is broughtto bear apon the disease ; cases. There is no question of practical Medicine and 36 had terminated in universal adhesions. Tho
to have rightly settled."(b) disease had not been discovered, and therefore not
uid thus iti symptoms are mitigated and subdued : more important
died of other diseases. Case
and I hopethat,ere long, shall be furnished with treated. The patients
yettheyretoni againand again,and are again we
18 was not treated for the firstnine days, and then
"gain mitiffated or subdued. And so the patients the means of answering t his important q uestion equivocally.
un-

the the employed were so trifling, that it ta

In the time,a reference measures
an keptalivefor a week or ten days,and then they mean to
of the disease was very little
of cases:' of M. Bouillaud,treated by bleedingand probablethe course
Hs^imtke greatme^eritv cases
modified by them.
**
In Englishpractice,mercury is given from without mercury, will make it appear very probable
ftrttto last But itis for a long time as if it were that several of them may have begun and ended
sot gim at all, for it produces no sensible effect within the time specified by Dr. Latham. One of
to have done so, HYPERTROPHY OF THE THYMUS GLAND,
Gmnimm antiphlogistic remedies,however,are able, them, at least,seems distinctly
cAUStfro
agAiaand again, to mitigate and subdue symptoms ; Among my own cases, there is not one in which the
and 80, at the end of a week or ten t he
days, patients disease ran its course within a week, although, in LARYNGISMUS STRIDULUS
atiH alive. Yet readyto die ; but) in severalof them, very free bleedingand earlysail AND DEATH.
are they
are

te gveatm^orityof cases, theydo not die. Sali- vation were conjoined in the treatment. ByV. T. KEAL, M.D., O"kham, Rutland.
vatioB arriveslate,and seems to save them." (a) We are not, therefore, I think,in a position to
I do not know where Dr. Latham finds the proof assume, that we have obtained more successful Mary Anne B was bom healthy,and continued
ef Hie statement,that,under foreign treatment, the results, by combiningsalivationwith bleeding, than so for six months, with the exception of a protracted
gnat majority of cases of pericarditis prove fatal. the French have obtained by bleeding without mer-
cury. sore mouth, accompanied with occasional diarrhoea.
It is in direct opposition to the explicit statements Some intelligent French physicianmight She was then observed to be frequently seized with
ik' tke most respectable French physicians them- confer a great benefit upon science,by making a short catchings of the breath,with momentary sus- pension

aelvesw Louis^(b) from the collection of a able

consider- numerical analysis of a suflicient n umber of rately
accu- of respiration. These attacks came on quently
fre-
aumber of cases, baa calculated the mortality reported cases of inflammation of serous mem- branes, by night,as well as by day ; at one period
td be about 1 in 6. This is exactly t he same as in treatedby bleeding a nd other means, unaided amounting to twelve or thirteen times duringthe
Dr. Latham' sown cases. I have already quoteda by mercury; and by comparingthe resultsof such night; producingsometimes onlya flush of her fiice
atatement of M. Louis,that he had never seen peri- treatment with those obtained in this countryby and slight perspiration about the head ; at others,
alcditifl prove fatal when occurring in a subject pre- mercury and bleeding combined. I need scarcelylasting until the whole countenance became livid.
minly eiyoyitig goodhealth. add,that ithas formed no partof my object to de-
fend The pulfte, it may be observed, was very variable in
Oorvlaart indeed states,that " acute and chronic the treatment of M. Bouillaud ; on the con- trary, frequency power.a nd
perictfditis lead to a rapid or slow, but, almost my generalimpression is against bleeding to the The parents had lost a child in Mav, 184^
alwaya,to a eertaindeath.*' But there is no longer extent to which he has carried it But I cannot affectedwith the same dii^ease, which probably arose

mij ioabt that this great physician was mistaken,permit my general impression to have any weight,from the same cause, although no post-mortem exa- mination
in oonteqiieilce,very probably, of the imperfecteven with in
myself, an examination of the real took place. The paroxysms in the former
means of diagnosis in his time. evidence,for or against any planof treatment case w^ere, however, more distressing, and the
ChomeI'"""me of the most experienced French I had marked one or two other portions of Dr. respiration duringthe same excessively croupy, so
pfa]jrtioians, observes: "
"
Pericarditisis certainly a Latham's argument forcomment, but I have alreadyas to be recognized at some distance;the attacks
aerious dSaeaee; nevertheless, the prognosis is less noticed the thingsmost material for my purpose. also in that case were less frequent, but more midable
for-
serious than itwas formerly believed to be. Ezpe- In the enumeration of his cases Dr. Latham has in character. There were no carpopedal
rienca i^rovea, In fact,that cases of simplepericar- ditis met with the same obstacle which I have found in contractionsin eitherof tliechildren. In the present
most commonly get well, whilst the compli- mine, viz.,that in them both bleeding and mercury case, a routine of mild antiphlogistic treatment was
Mted oases are oftenfatal."(c) were embloyed,and,therefore, it is the more diffi- cult adopted, and duringthe paroxysms, dashings of cold
Boiiillaud,-"whoae practice h as been more espe- to determine the separate value of each. water to the face were always r esorted to. But no
MfeUy refenvd to, qieakingof the results of his
" In conclusion, I wish to g^ard myselfagainstmarked benefit resulted, with the exception of a less
metirad of treatment, says :" "* What I am able to beingsupixised to advocate the disuse of
mercury in fVequent recurrence, after the application of a small
"flim is this,that I have oared the greaternumber the cases in question.If I were asked, whether blisterto the upper partof the sternum, which was
of oaaes of pericarditis that I have had oooasion to salivation is useful in controlling or repairing flammation
in- once repeated. ,

meet with!' duringsome years past." (d) Again: of serous membranes and its conse-
quences, The attacks, however, soon returned with their
^
Pericarditis, we must repeat,is reallya very I should answer, that its utility may pos-sibly former frequency.As dentition was at the same
"erious and rapidly fataldisease, onlyin thoae eases be great,but that it has not been provedto time progressing, lancing the gums was repeatedly
in wlBOh itis complioated with carditis, with very my satisfaction.As long,however,as the questionhad recourse to, with the impression that it might
intCMe endoearditis, or with violent pleuro-pneo- admits of debate, I should not feeljustified in advo-
cating in some degreeremove a source of irritation; but the
"lonia* fitttthen the principal dangerarisesmore the disuse of mercury. In dealing with dan-
gerousoperation latterlv brought on a seizure;it was,
fnm the complication than from the pericarditis forms of disease, we are all anxious to use therefore, abandoned. The child was in good
itself."(e) Nearlyallthe oases of pericarditis that those measures, duringthe administration of which spirits, and took its food freely, yet seemed to be
I have met with, I have seen yield rapidly to free the disease has often been observed to terminate inconvenienced by exertion, or by being suddenly
Moodlettiiig, repeatedseveral times, within the well; and we can seldom feeljustified in omitting moved. She could not, afler the commencement of
tpftto of tftkrte, four,and five days."(f) He states, one or other of these means, fi"rthe purpose of being the symptoms, lie on the nurse's lapresting on the
f\lt11i"r, that,of the 18 cases oC acute pericarditis enabled to award its precise share of merit to each. abdomen whilst beingwashed, as is usuallyprac- tised
iHrfoh he faas reported in his work, 6 died, and 12 This end is only to be attained by comparing the with infants. Stretching her hands above her
ttww^ered. Of these 6, 8 were not treated accord- practice of physicians whose views,and consequent head on firstwaking, or reaohing her arms forward
fait to Us nvtbod, and 1 died of tetanus. Exdud- treatment, difi^i and I think that most valuable in- to take hold of anything,
formation the nurse's hand at the
ng these,then ranain 14,^ onlyof whioh died, respecting the value of mercury, mightbe time being pressed againstthe chest,broughton an
Mrt cvMi Hieae two were accompaniedwHh very extracted from an adequatecomparison of the treat-
ment attack. T^e voice was clear and the breathing easy,
"rmt complioatlons. He then concludes^*" that of French and English physicians, in infiam -
thoughrather quickerthan natural. Notwithstand- ing
tout* Miearditis,if properly
"lfll)ili treated,(l.e., mations of serous nsembianes generally. "e repeated attacks,the general health of the
by bleeding,) would hardly ever terminate ia- Several other remedies were employedin some of child continued good up to the time of the last
the oaaes of perioarditis, but net with sufficient fre- seizure,which was on the 18th of May, at 4 p.m.,
quency,
|a) Leotufos,Vol. I. p. 319*20.
Memoire la
or in such drcumstances as to furnish mat- ter when, without warning or perceptible change,the
fb) wm Pericardite, p. 291.
for more Uian a passing reference. catchingof the breath came on, and she died almost
(c)Dictionaire de M^icine. Art. Perieardfte. the instantaneously, of the features im- mediately
(d) TraitsClin, dot MalUd. du Goeur. Paris, 1835. BUetert were applied in several nasas over great lividity
Vol. I.,p. 476. following.
(e)Id.,p. 490. (a)Id.,p. 525-6. Autopsy. May 19,8 a.in.
" " The body of the child
(Old.,p. 479. (b) Lectures,Vol. I.,p. 306-7. healthyin appearance; the countenance placid s
 THE MEDICAL TIMES. 99

tbe brmin rather turgid, with dark blood ; mem- H-f:MOMETERS. TREATMENT OF CHOLERA IN PERSIA.
bnnea healthy ; there was no fluidin the ventricles, At the last meeting of the Academy of Sciences, The French consul in Persia has communicated
or at the base of the brain. On openingthe chest, M. Guettet read a long Memoir on the respective for publication the mode of treatnoent found most
(removingthe stemnm and some portionof the ribs values of the haemometers invented by M. Pois- efficaciousagainstcholera in that country. On the
OD each side,so as fully to expose all the viscera seuille and M. Majendie. In order to render the first appearance of the symptoms, the patient is
and cavityof the thorax,) tbe thymus glandwas subjectmore intelligible,it may be well to subjoinplaced in a cold bath for two or three minutes,care
fonnd to occopy a largespace, covering the heart the accompanying sketches of tliesc two instruments. beingtaken to immerse the head for a second or so
almost to its apex, and a great portionof the left Fig. 1 represents that of M. Poisseuille; Fig.2, On beingrenooved from the bath,he is wrappedin a
,

Inng. On its rightedge it was thickened,and that of M. Majendie. wet sheet, over which is placed a blanket. As soon
dippeddown into the chest,so as to compress a part Fio. 1. as the skin becomes hot, firom 10 to 16 ounces of
of the rightlung. The gland seemed to compress blood are drawn from the arm, according to the
the whole of the base of the heart and largevessels. strength of the patient The wet sheet is kept on for
On lifting its bottom edge the aorta was seen lying four hours at least, duringwhich time the patient
nndemeath, or perhapsit might be said within it, drinks a cold infusion of some aromatic,as sage*
and seemed to have undergonesome degreeof mint,"c.: and takes pills of calomel,opium, and
dilatationwhich extended from the heart nearlyto ipecacuanha.If benefited, the pills may be omitted
the arteria innominats. The aorta was and on the second day ; if not, theymust be repeated
empty,
its coats apparently
and of normal
healthy.The heart was healthy,
size,but turgid with black blood,as
.
'"^^^ frequently. The sun-worshippers,
have heard of hydropathy.
it would^seeni*

were also the vena? cavse ; lungs healthy ; the dominal

ab- NEW CAUSTIC.
viscera the same ; the edge of the th3mans M. nivalin has proposeda new canstic,fioraMd
gland on the leftside teemed almost to surround by imbibinga pieceof cotton or lintwith mono-
the aorta justwhere the arteria innominata is hydrated azotic acid. This acta on tha aubstanet
given
ofl^and had the appearance of producingconstric- tion of the cotton, and converts it into a kind of jelly,
there,givingrise,I presume, to the apparent somewhat similar to collodium. Accordingto the
dilatationof the aorta. The gland appeared to be author,this new preparation poiaesaea the following
nomial in its stractnre,and weighed 630 grains. The advantages over the Vienna caustic
immediate cause of death was asphyxia, but whether
K"-^ 1. It is more easily limited in its action,be-cause
j)roduced directly by the pressure of the enlarged it does not become fluidlike the potaia.
glandnpon the cava, intemipting the circulation, or 2. It producesa deeper eschar,which remaint
Fio. 2.
by spasm of the glottis, induced by the pressure of soft,and does not prevent the caustio firom con*
the enlargedthymns npoo the inferiorlaryngeal tinning itsaction on the subjacent parts.The eschar^
Borre, which ramifies over the aorta, may be a also,thus produced,are easily removed, and we
matter of doubt,thoughI am fullyinclined to the can carry the action of the caustic to the preoiA
latter supposition. A lucid description of laryn- desire.
gismus extent we
stridulus, arising from precisely the same NEW AKiESTHEnO AGENT.
cause, hypertrophyof the thymus gland,is given M. Rames has diacovered, that the bronwurct of
by Dr. Copland,in his Medical Dictionary, mencing
com- potassium enjoysthe propertyof bringing on a de-
gree
at page 676. of insensibility, littleless than ^t poeaeited
by ether. When administered to the extent of five
PROORBS8 drachma duringthe day,itthrows the patient inio
OF MEDIOAIt
"
SOIBNOE.
^ a kind of drunken torpor, which continues foraeroral
days.In one ctae, at the Venereal Hospital,the senai-
FBANOE.

(ParisComspoodenee.)
J bilitywas

be pierced
patient
so much dhninished, that the akin could
with a flat stitching-needle
experienced no
; 'yet the
pain; while tickling the
COLLEGE CLASSICS. conjunctiva and foueea were unaceompaniedby
Now that the College has thrown open its gates smtigM glass tube bent at m and at o. It is winkingor desire to vomit But the moat remark-
able
to the Ktera humaniorettand admitted Homer filled with
mercury, say to n n',and the extremity, point waa, that the intellectual facultiesre-mained
on a
level with Hippocrates, we I make furnished with a turn-cock, is adapted to the artery unafiected. M. Rames is now eootinuing
may, suppose,
of an
an occasional digression the digamma, examine animal at b. Tliis done, the stop-cock is his experiments, the results of which will soon be
on
the various values of ydp,or even ascend to the open, the blood admitted,and its pressure on the made public
column of mercury at n, indicated by the elevation PRESENCE OF SUGAR IN THE LIYEB.
questionof points, without wanderingaltogether
of the column
beyondthe subject of Chimrgy. Were it not for n, will measure the force of the circu-
lation. MM. Bernard and Barreswill have asceitained
this excuse, I must have pastedover in silence the To prevent the blood from coagulating, it that the liveralwsyscontains a considerable quan^
is necessary to
ai^tarition of Lord Brougham at the Institut, a placea small quantity of carbonate tity of sugar, even in animals which .havebe"i for
of soda in solution, in the tube n o, animal food,and
short time ago. His Lordshippresented a learned a longperiodfed exclusively on
M. Majendie's instrument is small bottle, of every kind of nutriment containing
paper on Light,and endeavoured to uphold the a m, deprived
Newtonian doctrine of emission againstthe more filledwith mercury, and furnished with two tubes, saccharine or amylaceous principles. This circum-
stance
modem idea of undulation ; but,though he spoke one s Sf which communicates with the artery ; the disting^shes the liver, in a chemical point of
fluently, it with such that it other, perpendicular, to indicate the height to which view, from every other organ. The fact has been
was an accent, was
the mercury
quiteimpossible to followhis reasoning. Whatever may rise. As this tube is very small, confirmed at the laboratory of Qiessen.
the
the latter may have been,it did not make much pression variations can be readily
im- seised,and, in many
on Arago,who hinted,that the experimentsrespecU the instrument of M. Majendie ap- pears IRBIUkND.
and doctrinet of Lord Brouglkammight be more superior t o that of M. Pouisseuille. This
reconciled with the doctrine of interferences, was found to be the case in practice also,for [DobllaCoRvspoBdeoee.]
readilj
than with the theory the'author,assistedby M. Bernard,made numerous
which he professed to support.
coniparative with the two instruments FUNGUS OSMATODES.
We shall, therefore, I conclude, have a regular set- experiments
of ** Fungoid" diseases of "e
to between the Ex-Chancellor and the astronomer, duringthe lastyear. In the firstplace, the haemo- The subject
E^
hii meter of M. Poisseuille and this is a curious fact has lately attracted much attention hi Dublin,
MM soon MM Parliamentary duties will permitthe "

Ibrmer to return among ut. "does not oscillatein correspondence with the from some practical observations of Dr. Jacob's,as
systole and dyastole of the heart,but in correspond-
ence to the true nature of certain tumours of the oiftn
DIlCINiniOH OF THE FIBRIKE OF THV BLOOD of vision, not very well understood, not
with the inspirations and expirations. The cause or, perhajps,
BY AGITATION. is
of this evidently lies in the faulty c onstructionof the hithertowell described. Now that the subject
M. Marchal (deCalvi)reminds the Academy of instrument when the column m m, falls, it dis- started, every one, of comae, has seen the disease
; for,
Sciences that he had shown, in a former note, how turlw the column m n', and, as the respiratory over and over again, like every one who haa seen
the quantity of fibrinein the blood is generated by pressure is more ample and more sustained than the the boors in a Dutch picture, and made notiiing of
heat Hence he was naturally led to conclude that cardiac,it graduallyovercomes the latter. In them. To the eminent practitianer above named we
the increase of fibrine duringinflammatory aflec- M. Majendie's fall are indebted for bringing this sulject so promi-
nently
instrument,the mercury may
tioni depended,as Rasori teaches us, on the in- creased from the tube / m, into the little bottlem, without in forward.
heat and movement of the blood. It would the contents of the tube ta, True Fungua Hmmatode* of the ori"it, it need
any way afiecting
appear, however,that the second cause attributedby scarcely be said,is one of the most fataland fearfid
Rasori does not produce the eflect which he CHOLERA CONTAGIOUS. diseases with which we are familiar. Originating,
rappoted, but directiy the leverse. In twelve ex- periments At the Academy of Medicine M. Pellarin com-municated perhapa, as an ordinary rule, in the tissuesbehind
performedby the author,he found ten an important case, which seemed to prove the eye, it not unfrequently destroysthe entire"^tie
where agitation of the blood gave rise to sensible in a very clear manner the transmission of cholera nerve, the eye-ball itself remaining, for a time,
diminution of the fibrine. Does this explainthe throughmeans of clothes, and particularly through comparatively sound ; or attacks the latter, pro-
ducing
great reduction of fibrinenoticed in animals that a mattrass on which some persons aflected with that hideous appearance of the organ whioh,
bftTebeen wozried befinredeath ? cholera had slept once seen, isneyer to be forgotten.
 100 THE MEDICAL TIMES.
Nearly related colloid and scirrhus,
to it is,of unfreqnently givingthe glans a perfect cauliflower this public statement, assented to by the Board
course, allbut incurable. Cbaracterised, like these, appearance. A variety of the disease of the con-junctiva
itself, it will not be safe or becomingfor the
by the same gradual transformation or destructionof not unfrequently met, is a set of warty ex-
crescences,
Board to profess sympathy for snflferings it has
tissues, the same fatal reproductive peculiarities, red and granularlike a bunch of cur- rants,
the same generic cells and stroma, that mark true these of course the to relieve,but reAises to exercise;
differing materiaJly pearance power
in ap-
cancer, and which have hithertob^ed the varied from the disease broughtunder notice by and should the Board continue to decline the
resources of our art Dr. Jacob.
regulation of the salariesof the Medical Officers,
The tumour mentioned by Jacob, though to ap- pearanceAs to the malignantcharacter of tumours. Dr.
a very formidable affection,
in accordance with the powers theyhold,the
has none of the Benson thinks that colour has
nothingwhatever to
peculiarities mentioned. The surface of the eye, we do in the matter. The ordinary run of Society-goers, Profession will understand who are their real
need hardlysay, more correctly,the structure of the by the way, thoughtthe microscope had longsince enemies, and will not be slow to adoptsome
conjunctiva, is subject to injuryfrom allvarietiesof settled the question; but Dr. Banon has given a other mode of obtaining redress than that of
eztameous bodies, from the larva of insects,
"
with complete knock-down to the histologists, as he de-
clares
their regiments humbly proffering their petitions to a Board so
of flies
; to horns,and actual locks of he gave partsof the same tumour to different
wool and hair dependingtherefrom. Its epidermoidmen eminent in such reluctant and wary in forming its decisions.
researches,
who all gave
structure accounts for such things. of
at once opposite opinions as to the presence of the peculiar The Deputationalso urged the injustice
Melanosis is another of the diseasesof the
^
eye, of a cellsso characteristicof malignantgrowths. It is the orders issued by the Board of Health, in
distinctly fungousnature, and frequently found with barelypossible, however,that theyail had not the reference to the extraordinary medical service
the other diseasejustspokenof," the latter, however, same magnifyingpowers at command. The exact
is alwaysattended with pain,sharp,and lancinat- ing, required to meet the exigencies of the public in
line of demarcation between " warts" and " malig- nant
with evidences of constitutionalexcitement, and tumours," singularthough it may appear, consequence of the lateepidemic.The idea of
towards the latterstageswith mischief in the neigh- bouringseemed also a puzzle Dr. Jacob himself lookingplacingthe superintendence
"
of the Poor-law
glands, and greatexhaustion ; in melanosb,
upon it as more apparentthan realI
the contrary,there is none Medical Service under the Board of Health was
on of thisdreadful pain,
"the disease seems PATHOLOGICAL PEBPABATIONS. broached, and many considerationswere offered
more benign,so to speiJc It
protrudes throughthe eye, and may be cut off;it A sort of spherical glass, containing that this alteration might he bene-
pure water, to show ficial.
in the has been used in Dublin,by Dr. Jacob,for putting
may occur eye-lids, under the conjunctiva, on The Committee have done wisely in taking
the cornea, or in the cellularmembrane of the orbit up extemporaneous preparations. The latter are
thisstep. It is one of a practical onward racter,
cha-
itself. It seems to have a powerfultendencyto better seen ; the water preserves theirnatural ap- pearance
spread, and the liver, and even the bones,will be ; and theyare not, of course, so expensive and has the advantageof anticipating
fbnnd full of it afterdeath ; itis not, however,so as the spirit preparations ; the flocculent and more resultswhich events are of themselves tending
fatal as fun^shsematodes. delicatedetailsof some preparations are better pre-
servedto accomplish.Forwamed is forearmed. The
The particular than in alcohol, which invariably injures and
growth to which Dr. Jacob has
drawn attention, is a spongy, black, flattenedtu- whitens. Perhapscreosote or sublimate would be a Committee will not, of course, stophere ; bat
mour,
not unlike melanosis, stillgreater improvement. will set to theirwork manfully, and endeavour
growingfrom the front
of the eye-ball,lappingover the eyelidsso as to to realisea changeindicated by the resolutions
dose up the entire openingof die
oigan of vision. TO SUBSCRIBERS. adoptedat the very commencement of their
Mackenzie has seen the same thing, ifwe remember
career. There is an opportunity of converting
rightly, as well as Travers and
Waidrop.It appears Kew SubteriUrs will obligeby forwardingtheir
to grow from the eye 'ball, but Dr. Jacob,cutting on
Namee direeito the Office, 147,Strand, or to the
theirtheory into practice; and we shallbe glad,
it,was surprised to finditmerelyattached to the con- New AgenU
Bookeellen. AU at any rate,if one stephe made to rescue them
junctiva"the or
Poet^ffice
rest of the eye was sound. In the first Ordere ehould he made payableto the PublUhere^ from the degrading bondage in which theyare
case mentioned by Jacob some doubts arose as to
itsmalignant
Wm. S. Obb akd Co. now held by Boards of Guardians. The plan
character ; but thisseemed to set it at
rest,to the delight of all parties ; Dr. Jacob giving
suggestedis that wt have advocated in this
it as his opinion, that it was a mere cutaneous Journal;and, as we are convinced of its good
tegnmentaipr growth ^no very "
distantrelative
or

of the
THE MEDICAL TIMES. policy, we heartily wish for its success. cal
Medi-
"wart" tnbe. The woman has gone out well. reliefshould be separated from General
The second instance of the disease alluded to
by SATURDAY, FEBRUARY 9, 1850. Relief, a nd administered by perfectly
a distinct
Dr. Jacob,was a tumour removed by Dr. Banon ;
black ; in the opinion of both not malignant
; per-
haps,
Board,which should he composed of well-in- structed
however, calling for the knife as loudlyas if A Deputation from the Committee of Poor-law Medical men. There can be no doubt
it were.
Medical Oflicerahad,on the 2nd inst., a most im- that the Superintendent
portant Inspectors, appointed
A third very striking case was met by him also, interviewwith the Poor-law Board. We under the Board of Health, would be members
that of an old man ^thetumour
"
considered at the
time to be carcinoma. have inserteda reportof the proceedings in an- of the Medical Profession, and thu alone would
Lookingmore closely at it, other
however,Dr. Jacob discovered that it had nothingin column. For lome time pasttherehaibeena he a great improvement upon the present
cominon with malignantgrowths of this
family.lullin the agitation forredress of the grievances system. Mr. Liddle,itwill he seen, although
Consuting of coarse fibres, sUnding out perpendi-
cularly which this Committee was extreme views,pressed the con-
from the eye, the surface seemed not at all originally formed to adopting some sideration

ulcerated but the ; of seat a peculiar press upon the notice of the
organisation, Legislature, but of thissubject upon the Board.
capableof throwing
up a singularcream-coloured the openingof another Session of Parliament A matter of great immediate Interest was
matter. has againcalled forth their exertions,and we referred to by Mr. Ross. He inquired whether
It was pronouncedcancer by some doubt-
people, trust that some realimprovementupon the pre- by Mr. Baines,during
Jess not very wise on such matters ; but when it sent the intentionexpressed
came to him he called ita " system will ere long be the
severancelastSession,
eflTected.Per- of bringing into Parliament a
wart," a rather difler-
ent,and not quite and firmness are
no learned a diagnosis,but
perhaps necessary for the BUI for the formation of a SUPERANNUA-
TION
the true Clearly
one. sort of epidemic
some growth success of every publicquestion,and in none FUND for PooMaw Officerswould be
of very dangerous
no character j the glandsof the will
these qualitiesbe more required than in carried out, and whether such a Bill was in
vicimtyin no way implicated.Even in the healthiest
that of Poor-law Medical Reform,whose advo-cates actual progress. The Board replied, that the
people,
especially
elderiy
persons. Dr. Jacob has
noticed a tendency to deposits of thisblack matter have to contend against the obstinatepre- BUI was under consideration,that the mode
judices "

in the otherwise normal and sordid greed of local authorities,

coveringsof the eyeball, of formingthe fund would he by kvymg a pbr"
a pointof no littlepractical value aa coming from and the immobility of a cautiousCentral Board. cEMTAOE
of such extensive upon sslaries,and that the Medical
a man
opportunitiesof eye The
seeing Deputationwas Officers, in considerationof their in being
courteously
received
Warts,we need scarcely
say, have a tendencyto by Mr. Raines,the President,
and Mr. Ni- privatepractice,
toere NOT included within ita
appear where the skin is thin and sensitive.Travers, choUs and Lord Mr. Ross presumedthat the Bill
Ebrington,members of the provisions.
11 we mistake not, long since assimilated
sundry and the grievances
growths of this kind to the obstinate warts that Board, they felt it their would be modified, to give such Medical
growmside theprepuce, attributing them, with what
duty to complain of were listened to with Officersthe OPTION of joiningthe Fund aa
truth It IS difficult to say, to the same attention and interest. It will be seen that Mr. shallagree to a reduction from tbeir salaries
cause" tion
irrita-
from diseased secretion the Lord
; peculiarse- urged upon the notice of the Board the beingmade.
cretion, mdeed, from warts of the
prepuce, wonld fact,that they had fliU power to regulate the If the Board should not act upon the latter
appear to have somethmg of a contagiousordinarysalaries of the Medical Officers" the claim of the Medical Officers
cnaracter whercvft it makes its
appearance, pecially
es-
a suggestion,
on the female genitol pointof considerablemoment, aa it placesthe to the advantages of a Superannuation Fund
organs, pro-
ducing
thick cron
very unmanageable odium of the present system of low payments
a of these willnot he barred, and perhapstheywould be
and troublesome productions in the peni?itself, not theupon shoulders
of the central
Board. After in a position to seek better terms under a re-
 THE MEDICAL TIMES. 101

constitatioiiof the entire Bystem. There ii, England; we suppose, therefore, few of their giantsout of windmills. The Fellows of the
howeveryno time like the present,and the in- number
difference could expect seats in the Council. Collegeof Physicians have never been called
to the interests of the Medical The London University has a Senate ap- upon to express an opinion^-collectively
pointed they
Officersshown hy the Board in this their most by the Government. Are its graduateshave never had an opportunity" with reference
recent act, does not aagur very favourably for satisfied with its constitution ? The onlyplea to the adjudication of the "
SwineyPrize ;" and
their good-will to this body, and is a bitter urgedfor refusing them the privilege, nay, the consequently theycan have neither supported
comment upon their friendlyprofessions. right, of electingthat Senate is,that at present nor identified themselves with the gentlemen

There is no class of officers that deserves so theyare too few in number. Can such a plea who awarded that Honour.
well of the publicas the medical officers of be urged for denyingto the whole Profession The President of the of Physicians,
College
the rightof electing their governingCouncil ? since he has at last condescended to vindicate
Unions. Exposed to dimatal vicissitudes, and
to pestilence; harassed by anxieties of mind Perhapsthey are too numerous. If so, we his honour, might have informed Mr. Syme
and bodily fatigue,theirhealth is more severelyshould be gladto know what really isthe happy "
by his longsilence he appears to have despised
tried than that of most other professional number suitedfor an electoral body. the oft-repeated opinion of the Profession
" who
men,
and yet theyare requited more shamefully than But supposing a Medical Council formed, as nominated the three Fellowt of the Collegeto
mon-loving Mr. Syme proposes, should we
the veriest drudgeto the necessities of our mam- be any nearer act as judgesin the matter referred to. What-
ever
community.Redress must be given an amicable settlement of the points in dispute Dr. Paris may imagine,we know that,
unless the whole affair is explained, blot will
to them ; and, if theyboldly persevere in their than we are at the presentmoment? Not at all. a

sacred cause, it will come soon. We have not By avoiding the details, Mr. Syme onlypasses remain on his escutcheon, so longas the records

the least doubt,that the Committee sitting in over the whole difficulty instead of solving it. of the College over which he presides exist.
Hanover^square will exert themselves with that Lotus,by way of illustration, refer to the third

energy which, on all important occasions, has function of the proposed Council. Every mem- ber THE PRACTICE OF PHARMACY BY
characterisedtheirproceedings, and will find a of the Profession allows, that a good*regis- GENERAL PRACTITIONERS.
reward for theirlabours in the ultimate success tration would be a boon. But examine the It may be expedient to refer to a few more

of their cause. evidence given with reference to the defunct points in the Memorials presented to the Coun-
cil

Registration Bill, and the practical difficulties in of the RoyalCollege of Surgeons by the Shrop-
shire
the details are seen to be almost insuperable. and Manchester Associations ; and that be- cause
MR. SYME ON MEDICAL REFORM.
The General Practitionerclaims to be placed on there are views expressed in these docu-
ments
Ant scheme of Medical Reform which does
the same page with the Presidents of the exist- ing which, if carried into practice, would,
not acknowledgeas its basisthe right of the
Colleges, while the Pare vehementlyex- claims,in our opinion, under presentcircumstances,be
members of our Profession to elect the body
"
Odiprofanumvulgus! It is follyfor the most deadlyblow that could be inflicted
to presideover their welfare, will experience
Mr. Syme to pointto Edinburghwith its one upon the General Practitionersof this country.
oar strongest opposition. confess at once, that not less by our previ- ous
purtf and declare the matter easy to adjust ; in We
Mr. Syme's scheme is exceedingly simple.London, practically as well as theoretically,labours, than by inclinationand conviction,
Its' great merit,according to itsautiior" is its there
are Physicians, Surgeons,and General we are pledgedto the advocacyof the interests
freedom* Practitioners, and a Medical Reform Bill must of this order of practitioners. Encouraging
"I would pro]K)se," Mr. Syme, ''that Go- be framed the of London science wherever it may be found,and resolv- ing,
says to meet requirements
VERHMBNT SHOULD CONSTITUTE s Board, which, that the
for the sake of distinction, might be named the as well as
the wishes of Edinburgh. )^or is so far as our influence can extend,
Medical Council,and be charged with the followiDg the difficulty to be got over by referring the de-
tailstrue respectability and justrights of all orders
duties: 1. To determine what amount
" of education
to a Council based on Secretary of State of the Profession, such as by the customs and
should be held requisite for obtaining the license of
practioe. 2, To sanction or constituteBoards patronage; a Council,the dicta of which no necessities of society they have been created,
Sneral
"
bestowingthe licenseof generalpractice in Lon-
don one would respect,because it would lack the shall be maintained,we stillregardwith predi- lection
and Edinburgh, and also in Dublin, if the of the old Corporations, the numerous and long-injured class of
while it would
measure should be extended to Ireland. 3. To preitige
to General Practitioners ; and we, therefore, feel
publisha register of qualified practitioners, togetherhave no popularelement in its composition
with the decrees, diplomas,or other honorarydis- compensate for the absence of that prestige. sensitive and indignant, when pro-
particularly positions
dnstioDB which theyhave acquired."
The Regius Professors, being Government are broached,and professedly hymen
In this scheme there is no trace of a repre- sentative nominees, would,in a Board framed as Mr. of their own order,which can have no other
principle. The Government are to the effect than that of inducing persecution and
Syme advocates, constitute, probably,
appointthe controlling Council,and that body medical members. Mr. Syme is a Regius debasement. We must, however, express the
is to determine everything.There is no Professor. The President of the Edinburgh conviction,that while it is the duty of the
guarantee,that a single member of the Council,Board be a Pure. Mr. Syme Journalistto give utterance to his opinions re-
garding
would, doubtless,
much less a majority, shall consist of Medical in the pamphlet class,or even individuals of that
modestlyalludes to himself, a
men. There is no security that its President still it would be a more noble pursuit, and
before us, as the "
one pure,"the onfy pure class,
may not be a titled Mesmerist,or an honourable surgeon in Edinburgh. Can it be ? Hmc ilUe much more congenial with our taste,to view
Homoeopathist. lacryma. the whole Profession as one body,aimingat
Mr. Syme says, "Confidence must be re-posed In conclusion, we entreat the Lord Advocate one end, and the interests of the individual
in Government,and the distinguished not to be beguiledby the glowingpicture of beingalso the interests of alL When shall
men who would doubtless be selected for an the medical millennium with which Mr. Syme such a devoutly-wished-for consummation be
office of so greathonour and responsibility." has closed his letter, for we can positively assure realised? We fear.Echo will merelyanswer
Let the members
of our Profession beware. his Lordshipthat a scheme of Medical Reform, "When?"
What have theyin the distinguished
confidence based on State patronage,would be as distaste-
ful The two Memorials referred to, placean in- terdict
to the rights and
members of the Board of Health? If that to Scotch graduates as to English licentiates; upon the advancement
Board could be framed much doubt if the Regius Professor honours of the College o f those members who
by the Government nay, we
without one Medical member, with scarcely a could persuade even one graduate of Edinburgh,practise Pharmacy, ^in other words, who pre- scribe
"

Medical appendix,what reason have they to not stimulated like himself by the desireto get and dispense medicines for their own
direct the vernment,
Go- the of his crude and patients. We understand how the officers
expect, by appointmentfrom pupils, second
to adoption can

a better constitutedMedical Council ? illiberal scheme of Medical Reform. of the Shropshire Association can agree to fix
None I The foundation of Mr.
Syme'sscheme We had intended to have passed by in silence such a stigmaupon the General Practitioners,
will,we by the Profes-
be condemned
believe, sion Mr. Syme'sQuixotic attack on the Fellows of since,in point of fact, theydo not belongto
with one voice. Who could anticipate the Collegeof Physicians, but the letterswe the same order. They describe themselves as
have published in another column force it on the Physicians and Surgeons(Fellows?) of the
better Medical government under the new
Association; and, in a question of
Council than under the old Corporations? Mr. our notice. Truly,the Regius Professor must Shropshire
(o create thiskind,it must not be disguised, that Phy-
Syme snoon a^ ihe Genernl Practitionersof be blessedwith a pugilistic spiritthiis
 102 THE MEDICAL TIMES.
"cian" are inflaenced by the wants of societykeepingcommunity; and perhapsit is to be this class, in theirdaily practice, from the scan-
dalous
in differentmanner from the General Prac- deplored,
titioners, in
that, localities, the prejudices of quacks,and chemists
a some aggressions
and governed by different mo- tives. of society are so strong that patients would and druggists. The latter order,especially, by
Their interests, too, are often directly decline to pay a billthat did not comprise the means of their open shops, trench largely upon
hostile to those of the General Practitioners. particulars of the visits and of the medicines the peculiar provinceof the General Practi- tioners,
We have a hif(h respectfor the learning and administered to them " that medical men and deprive them of many thousands
of the Physicians of this country,but are constrained to succumb to so inveterate a of pounds annually compelling
ability " the legally
we can'not consent to their being received as custom. Where is the General Practitioner qualified man to enter into an undesired com- petition
the re'presftntatives of the interests of the Ge- nera).who would condescend to the toil and trouble with these wrong-doers, for the sole
Practitioners; and,inasmuch as the latter of making up his Christmas accounts, if his
purpose of earningan honest, though a bare,
ord#r do not often busy themselves with the patients would pay at a mere tion
notifica- livelihood. Yet the Manchester Committee,
of the class of Physicians, from him of the amount? It cannot, of without
pef:uliar privileges seekingfor the slightest protection
it would be quite as becomingif the Physicians course, be admitted by any practical man that from these unjust practices, would coerce
refrained from volunteering unwise counsel to a surgeon in generalpractice can be paidby thpusaods of their brethren to come under the
the 'General Practitioners. We hope that a dailyfees in the same mode as his more fortu purviewof a system that would entail either
"

collision between the several classes is far dis- tant nate confrere the physician, althougha con- trary their utter and immediate ruin as men, or

; but one of the surest

modes of accom-
plishing opinion may be the source of the delusion theirdegradation and disgrace as surgeons.
such an issue is that adoptedby the under which allfee-takers appear to labour upon In the 2nd Provision, the Memorialists follow
Physicians of Shropshire, who address their this question.The middle classes, and, d out their proposition to itsultimatum, and desire
to a College of Surgeonswith fortiori, the poor of the country, will always to for the Council all
remonstrances disqualify "
Fellows gaged
en-
demand as they have hitherto done by im-memorial
whom theyhave no corporaterelations, and, at "
in the practice of Pharmacy." We, at
the same time,take the opportunity aspers- of usage the rendering an account
o f learn from this clause,that a Fellow
ing any rate,
"

the General Practitioners, for whom they for medicines; and it would begrossly^unjust to may practise Pharmacy,though he may not
If those gentlemen deprive who forcedthus to act in ance
accord- trade in
have no sympathy. are m en, are Pharmacy. Would that some good
the desire of all class with the traditionsand customs of society, would
actingupon abolishing genius clear up our faculties, and enable
it would be better for them to of their legitimate corporate right. to understand these refinements ! We
distinctions, fine
con- us are
themselves to the duty of breakingdown No legislation alter the habits of very straightforward,
can ever plain-speaking people,
the barriers hemming in their own society in thisrespect; for, although and do admire perspicuity,
privileges, some men especially in pliilo-
" a task which theywould discover to be suffi- cientlymay be enabled,in particular instances, to ob-
tain sophers and legislators. We have already
arduous and honourable for the exercise payment for their services as General givenour reasons for disapproving of restric*
of their ingenuity and ambition. Practitioners, without rendering a billof parti-
culars, tions upon those members who charge for
Let us come, however, to the Manchester yet at present there are exceptional medicines ; and we now unhesitatingly expresa
"Memorial," a copy of which latelyap- cases, and perhaps their immunityfrom the our unequivocal oondemnatioti of a proposition
peared
in onr columns. The firstprovision in bondage under which the rest of their brethren that would,if converted into law, exclude one
that document sets forth, that all existing bers
mem- labour, is rather owing to local circumstances and allof the leading General Practitionersin
hereafter than to their independent spirit. While this and the Provinces,however
who have attained, or may attain own Metropolis
shall be the the custom continues, it must be tolerated scientificand in social station they may
a fifteen years' standing, eligible to ; high
the restrictionsproposed
Fellowship,providedthat the candidate do otherwise,
""
by the Man-
chesterbe,from the superior honours and privileges of
not openly trade in medicines." This reserva- tion, Committee would constitute one of the their own College.
taken literally, providesa premium on most odious and oppressive of tyrannies-' a It is hardlynecessary to enter into an expo- sition
hypocrisy. The candidate must not openly ir^^em moneyed oligarchydetermined by the accident
" of the expediency of a knowledge of
but he may do it secretly if he please. of connexion,property,or situation. In a
medicines, fession
pro- Pharmacy to a Physician.Every sensible
The objection is not against the trading in me-
dicines,
like ours "
undoubtedly the most intelli-
gent Physicianmakes an effort to acquiresuch
but against the candid and manly pro- and scientificin the country the only knowledge, and therefore confesses to its im-
fession "

of it. We presume" for we desire,for aristocracy should be that of learning, science,importance.It was the monks of the Middle
the purposes of argument, to attach a more and genius; and these highqualifications Ages who first separated
cannot Pharmacy from the
creditablemeaningto this clause, that the re- "
be
servation degraded in the person of a General Practi- tioner. art of prescribing; and the present outcry
means that the"member of the College The truth is, the necessities of societyagainst their union is a mere monkish judice
pre-
shall be permitted to send medicines to his pa- are gradually increasing the number of those and unprofessional affectation. The real
tients,
but that he shall not chargefor them ; persons who dispense their own medicines ; and interests of the Profession and the publiccan- not
bnt then we remember, that the Manchester know in this metropolis graduates of be sacrificed to vainglorious of
we many aspirations
gentlemenpermitthe tradingin medicines,universities, of highrepute,and generally posed gentility
sup- ; and when men become ashamed of
and, therefore, can have no objection to charg-
ing by the readingpublicto be Consultingtheir Profession, it is time for them to quitit,
for them,^thi8 being,as Manchester men Physicians, who, having failed as mere fee- or its advantages will soon quitthem.
especially oughtto know, the principle of trade. takers, have joinedthe order of General Prac- Our readers will see, that there are too many
We fear that the medical politicians chester titioners,{and
of Man- send out their own medicines or, serious objections
" to these Memorials to permit
will not do much credit to their city,in the words of the Memorialists, more or less of their beingreceived as the
exponent of the
and we would advise them to eschew subjects openly
"
trade in medicines. "
wishes and interests of the General titioners.
Prac-
with which theyhave so imperfect an acquaint-
If such legislation that proposedby the If had
ance. as they been drawn up by per- sons
We really c annot understand the tence.
sen- Manchester Committee could be effected, it unused to the development of their ideas,
The truth is,there [isa wicked animut would drive the majority of the Profession out or personally w ith manifold
unacquainted the
In the provision, which the Memorialists of its ranks;for,as we all influenced by relationsof the subject
were are
upon which they had
afhud to imbody in words; hence the ob- private
scurity. interests, there are thousands who would undertaken to offer counsel,we might have
prefergettingrich by accommodatingthem- selves regarded them with leniency ; but we fear that,
We have a greatobjection to shop"keeping, to the wants of the community,than in this
case, there is a strong class-biasin
; becomingpoor by qualifying
as a morbid growthin the profession of Surgery for the Fellowship operation, which demands from us an phatic
em-
and we also regretthat medical men are in the of the College of Surgeons.These restrictions
exposure of the errors to which it desires
habit of charging for the medicines supplied premature,
are and therefore impracticable. to giveeffect
rather than for thefr skill. But we must protest There is,also, a great oversight in this Me- morial,
this
against practice being made the ground of which entirely deprives it of the confi-
dence Drs. Campbell and Hooker have been released
inasmuch by
of the General Practitioner; the Rajah of Sikkim,and permitted to return to
exclusion from the exercise of their rights as
Darjeeling. They had not arrived at the time the
memben of a Corporatioo. We are a shop- as it makea no condition for the protection of report was sent off.
 THE MEDICAL TIMES. 103
REVIEWS "
class applying
at General Hospital.
Needle-
women half of this period.The disease was
same a more rapidly
and milliners were also more numerous. fatalamong males than females.
Tkt First MttUcal Reportqf the Hospital for Con- Thus, if at a General Hospital, 13 needlewomen ap- ply The results of treatment were very favourable.
smmpHoH! pTvaented to the Committee of ManagA- for relieffrom all diseases, the numbers ing
apply- In the esrlystagenearly half the patients were lieved
re-
ment by the Officer*of the Institution. London. at Brompton for consumption alone would be to a greateror less extent In not less than
1849. Pp.42. 18. With regardto in and out-door occupations, 12 per cent of males, and 7 per cent, of females,
Hiis my able Report does great honour to the there does not appear to be much difierencebe -
the disease was arrested. In the second stage
Medical Officers of the Brompton Hospital.Tt is tween the number of persons following these em- ployments,rather
more than half were relieved from their dis-tressing
drawn up, and although onlya limited who applyat the Consumptive, at a
"ery carefully or
symptoms. In the third stage,t.".,aftercavi- ties
number of pointsare discussed, it is hardlyto be General Hospital.The next pointdiscussed is had fully formed, the symptoms were mitigated
desired that it should be otherwise in a firstReport. hereditarypredisposition. It appears, that out of every in about 25 per cent of both sexes. These favourable
It is not adniable that the whole subject sumption100 consumptive
of Con- males, 18 could be provedto have results are attributable to the excellent site of
should be broughtunder review until a had consumptiveparents; while, out of every the the
Hospital, t o regulatedtemperature of its
few more years shallhave collecteda greateramount 100 consumptive females,36 were descended from
wards,in common with the judicious treatment of
of material than could be the case at present. The phthisical progenitors. Hereditary influence seemed the medical officers. In speakingof individual
firstReport of the ConsumptionHospitalis,then, thus more marked in females than males. paring
Com-
remedies,allusion is made to naphtha,which had
wiselyconfined to those points which can be most these numbers with those which are obtained no and althoughoccasionally
specific effect, useful
readily decided by the observations already made. from insane persons, who are descended from in- sane in bronchitiswith
profuse secretion, sometimes acted
We shall attempt,at present, to givesuch an ab- stract parents,in the proportion of about 12 per
very ii^jnriously ; to iron, which was found a very
of the Report, as may place the pithand mar-row cent., the reporters argue, that consumptionis useful auxiliary, and to cod-liver oil,which was
of it before our readers. The points elucidated clearly proved to be more often transmitted from decidedlythe most useful singleagent that was
the age, sex, social condition,one generation to another,than insanitya disease
the following} employed. The symptoms of. the disease were
"

are
which every one believes to be very firequently so
asd trade most liableto consumption ; the influence generally mitigated, sometimes arrested by its uset
transmitted. It is not a littlecurious,that Dr.
of hereditary predisposition t the indications of the weightwas frequently gained, and the improvement
and the occurrence of haemoptysis in Walshe, in his admirable^Report(a) gives numbers thus gainedwas
spirometer, sometimes permanent In other
results of treatment and the which closely correspond t o these, (viz., 19 and 33
phthi^ i the general cases the improvementwas temporary,and in some
influence of certain medicines, such per cent,) and yet arrives at an inferencediame- trically there was no melioration at all.
special as

opposite to that stated by the Reportnow

naphtha,cod -liveroil,"c. The observations are In concluding this briefabstract of a very in- teresting
and before us. Dr. Walshe, with the same numbers,
made duringthe years 1842 to 1848 inclusive, Report,we cannot but feelgratified at the
"
determines that phthisis in the adult hospital
on 688 in and S470 out patients. During this pe- riod, lation mode in which the
popu-
Report has been drawn up.
admitted into the hospital of this countryis to a slight amount only,a Classifiedobservation has been
more males were and with
This
attempted,
than females ; in every 100 patients, 61 were males disease demonstrably derived from parents.*'
considerable success. We would onlybeg to impress
the is certainlya singular discrepancy. We are dis- posed,
and 39 females. Taking both sexes together, upon the Reporters the necessity of a strictattention
liablewas in the decennial periodfrom 25 after a careful considerationof the subject,
age moot to the accuracy of their items. There is this dis- advantage
to S9 ; but separating the sexes, it was found,that to consider Dr. Walshe in the right, and to regard about the numerical method, that its^
liablethan at the comparison o f phthisis with insanity as errone-
ous.
women were comparatively more men mistakes, if such exist,are perpetuated.If an
a younger period, and men more liablethan women But our limited space does not permitus to
individual enunciates a wrong opinion, it may be
at a later period.Thus, under 25 years of age, the enlarge on this head. The hospital reportersad "

repeated for some time,but will necessarily soon be

of women 10 per cent more than duce some very interesting evidence to prove, that
liability was
forgotten in the multitude of other opinions that are
that of males ; over Z5 the liability for males was, when transmitted, the phthisical parents are "more
continually broached. But numerical observations
the contrary,12 per cent more than for women. likelyto transmit the disease to children of their are used
on
by writer after writer,and are joinedto
After the age of 85, the liability for both sexes own
clined,
de- than of the other sex.
other observations which are supposedto be of a
and diminished regularly for each successive The spirometer observations were made by Dr.
similar nature, and, consequentiy, if the original
decennial period. The decrease,of coarse, appeared Hutchinson, and imply a gradualdiminution in observations are not correct,
"
onset of the disease
they must necessarily
than it really the vital capacity" (b) from the
much more was, if correction was not vitiatethose factswhich may be really true. This
to its termination. The chapter on Hsemoptysis is
made fordiminution of population, but when thiswas is no objection to the numerical method ; it is only
Of every 100 consumptive
done,it was still found that,at each decennial period very interesting. sons,
per- additional reason for
an accuracy.
after85,the rule was, that fewer persons were attacked
63 suffered from haemoptysis at some periodof
Therefore we should desire to see, in the next
with consumption,
out of those who
were alive at that the disease. Sex exerted little,age a siderable
con-

Report,the observations assigned to their respective

in any of the for- mer efiect In males, under 35, heemoptysis
age, than would have been the case
authors, that each observer may be answerable fof
occurred in 64 per cent. ; in females,under 35, in
decennial periodsafter25. Below and up to 25,
his own facts. Not that we in the least question
of the decennial periods
67 per cent In males, over 35, haemoptysis curred
oc-
the liability rose, as gradn the accuracy of the statements made on the common
in 64 per cent ; but in females onlyin 54
allyas they afterwards fell. With regardto the of the Physicians to the Consumption
eflbet of marriageon the developmentof phthisis, per cent. Thus, while in males age exerted little authority
Hospital ; onlyas a general principle, in matters of
the or no influence ; in females the tendency to spitting
the numbers are not sufficiently great, nor should be able refer every assertion
of blood was in the earlier periodsof life. science, we to
other elements of comparison sufficiently accurate greater
who may be for it sponsor and autho*
to lead to any certain results; but it appears, that
The period of the disease had a great effect Thus, to some one

if we distrust the sponsor, we

females weie married than in both sexes,
before softening of tubercle had rity.Then, may
under the age of 25 more his facts.
males tlian females ; the occurred haemoptysis was three times more frequentneglect
malea,but over 25 more
than after softening. It must not be supposedfor a moment, that,in
"ingle consumptive females under 25 were more nu-
In regardto the duration of phthisis, it was rarelythese remarks, we are refeiring to the excellent
nwTOUs than consumptivemales, over 25 the sexes
reviewed; we are takingour stand
fatalunder 8 months (inonly1 case) ; 10 per cent., Report now
weite neariyequal. Comparing the married per- sons
in round numbers, died under 6 months ; 16 per merelyon a generalprinciple, which applies to all
under 25 with the married patients at a General

under 25, it appearedthat the consump- cent under 9 months ; 13 per cent under 12 months ; of us.
Hospital tive
in 15 per cent under 18 months ; 10 per cent
under
married peoplewere rather more numerous,
2 and 10 per cent under 2 years and 6 LiYBiPoot DisPBNSARiBB." The number of
the froportioB of 9 to 7* Over 25 the proportions years;
cases of cholera attended by the medical officers of
This Would tend to show that months ; only per
2 cent under 3 4
years ,* per cent, these
were nearlye"|ttal. institutions, during the past year, was 1017*
under 3^ years; about 2 per cent under 4 yean ;
marriage had littleefifect.With regardto trades, 7211,178. Ud. was the amount collectedm theirbe- half
and 6 per cent at nil ages above 4 years. the day of fissting and humiliation. The
"e ^fficulties of classifying and of puttingto- gether on

So that the great mortality of phthisis fell on the subsoriptions, for some tune
past, have fallen off
various employments, have not allowed
b etween the first months and greaUy ; the annual income, which, three years ago,
It would period 3 2^ years
any decided inferences to be made. was 2fmlt is now only 1722/. Last year, however,
clerks and the pr"^rtionbeingrather greater in the earlier the 3,1552.lis. 7d.,leaving a balance
that printers and compositors, receipts were

numbers at the Con- sumptive of 3341. 16s.3d. over the expenditure.

nen appliedin greftter
classes (a) British and ForeignMedico-Chirurgical^Re- GLAsot)W IifPmMARY.-^Tlie workmen on the
Hospitals, tiian do the same at
view,January,1849,p. "5, Clydeclubbed together at the commencement of the
other hospitals for noA-consumptive diseases. Th^
(b)The phrase employed by Dr. Hutchinson to present year, ana sent a sum amountingto nearly
pro|"ortion is nearly4 to 1. In-door servants ap- the utmost quantity of air which a person can eaqidre800/. to the Olasgow Infinnary. This was a noble
plyiqg at Brompton were twice as numerous as the aftera forced iospiratton. way of welcomtDganoiher yew of exutence^
 104 THE MEDICAL TIMEa
mBPOKTS OF 800ISTIB8. under Mr. Child's as possible. Mr. Nunn opposedlargeincisions ot
aperture. When he
came
care, there were sinuses in the walls of the mammary
two abscess, and thoughtthe practice of laying
WESTMINSTER MEDICAL SOCIETY. in tbe centre of the umbilicus, open extensive sinuses of the breast uncalled for.
abdomen, one
February 2, 1850. The tissueof the gland,he averred,should not be cut,
the other a littlelower down ; the latter yield- ing and quotedDr. Gibson, of Philadelphia, to show that
the fecal discharge.His health was not
F. HiRD, Esq.,President, in the Chair. sinuses may be obliteratedby pressure. Tbe import- ance
much impaired.On the 16th of last month, the of preserving the integrity of the gland, he
plum-stoneexhibited was dischargedfrom the (Mr. Nunn) observed,cannot be overstated. He
CABIES OF THE HEAD OF THE FEMUB. wound, aftergreatsuffering, and it appeared, that it concluded by narrating severalcasts in illustration
Mr. Haynes Walton exhibitedthree specimens of must have been in the intestines since the lastfruit- of his position.
caries of the head of the femur, removed during season. After this the fsecaldischarge of the use of mer-
was greater; Mr. J. B. Brown disapproved cury,
life, to show the alteration in form and structure and, on and also of bleeding, in mammaiy mation.
inflam-
probingthe wound, the instrument passed
efiectedin the thighbone by morbus coxarius. The
in, leasttwo inches in depth,
at backwards into the Women, after parturition, requiredg^ood
firstwas taken from a girl nine years old. In place abdomen.
There was no wasting, and the appetite diet and strengthening remedies,rather than deple- tory
of the head and neck, there was a rounded and
good; bowels acted freely,and the stools were measures. One great cause of inflammatioiL
spongy portion of bone,projecting littlemore than normal. Mr. Child thoughtit a question, whether of the breast was, the not applying the child to the
half an inch from the femur. She made a good the cause of the abscess and fsscalfistulain this breast early enough,in accordance with the dogma
recovery. The second was from a lad twenty years case arose from the presence of the foreign body in of nurses, who objectto its beingdone for the first
old ; the head was nearlygone ; the neck was of the
intestine, or from the previous ill health of his twenty-four hours. The small quantity of milk in
the natural size,but so soft that it broke in two
little patient In his further comments, he quoted the breast duringthat time acts as an irritant, and
duringthe operation. The third was from a boy the
opinions of several foreign writers on the forma- tion causes inflammation,which can be overcome hy
eleven years old ; part of the head was lost,and horizontal
the neck was
and treatment of artificial anus. general remedies, " the position, keeping
shortened and reduced in size. He Mr. Haynes Walton mentioned five cases of Uie breast supported, causingthe skin to act, and
(Mr. Walton)remarked, that he was anxious to foreign bodies lodgedin the appendixvermiformis, by warm-water dressing.He objected to drastic
discover some diagnostic signs by which the presence four of which terminated fatally* better than before,
of dislocationcould be ascertained. Without going
One a case de- scribedpurges ; would allow good diet,
into the question as'tothe proper time for operating,
by Dr. Peacock, was that of a clergyman,and nature will do the rest Parturient women cannot
who presented the signsof incipient hernia. An bear to be lowered, nor the depressing action of
but taking it as a settledquestion that we should abscess
formed, was opened, and a cherry-stone mercury, in whatever way it may be given. He
wait for dislocation, it was importantto be able to came often caused
away. He died subsequently, from some thoughtmammary inflammation was
come to a correct diagnosis. The changesin the cause of this disease. Another case, by keepingthe when theyrequire
independent patients on ffnxei,
form of the bone he had shown, would cause all also one of afterpar-
cherrystone i n the appendix, ended fatally, improved
an raUier than an impaired diet, turition.
the symptoms of dislocation. The limb would be flammation,
in-
from acute peritonitis. In two others,the offending If this were attended to, mammary
shortened and the trochanter elevated, and brought
body was a biliary concretion, which had been ar - puerperal fever, be
"c.,might prevented,
nearer the pelvis.From the position of the limb, of nature to over-
rested in the appendix,and caused death from as theywere caused by the eflforts come
nothingcould be learned ; it may be turned in- wards
peritonitis. the effectsinduced by the lowering diet Most
or outwards ; the thigh flexed on the]pelvis UAMXABT ABSCESS. patients subject to inflammation of the breast were
or extended. Those most conrersant with hip dis- ease
Mr. Nunn then read a paper on mammary scess.
ab- of the strumous diathesis, and could not bear mer- cury,
had fallen into error on this point. The condition of the
which would alterthe healthy
patient from whom the second specimenwas taken
His object, he stated^ to be,to make known a par- milk, and aflTect the ofi"pring. Mercurial ointment
died threemonths after the operation, from consump- ticular
tion. line of practice, and the reasons which in- ducedmightbe useful in chronic mammary inflammation,
The end of the femur, which was shown was him to have recourse with comments in
to it, on but itcould not be used with safety, he thought,
rounded off and filledup, like the end of a bone the mode of treatment adopted in such cases, an acute attack.
,
usually
after amputation, of which an example was pro- duced, namely,hot fomentations and poultices, oold appli-
cations,Mr. Gay agreedwith Mr. Nunn in the general
taken from a patienton whom he (Mr. leeches, and pur^ngs.The success ing
attend-
principles of treatment ; mammary abscess was of
Walton) had performedsecondaryamputation, these measures vanes considerably, but Mr.
common occurrence amongst the poor, who are in
which was also hard and healthy. When the ope- Nunn concludes: "

ration bad health,and cannot bear leeches nor depletion,

was performed, it was soft like the neck ; a TliBt suppurationtakes place in a great propor-
tion
and support It generally
employment but requiretonics
^

of cases, in spiteof their energetic oc-

curred
ligamentunited it to the anterioredgeof the aceta- bulum.
in persons of strumous habit He (Mr.
He objected to the use of hot fomentations, as likely
to favour suppuration; to cold applications, Gay)
pecially
es- did not think the lacteal vessels were cated
impli-
FIBROUS TUMOUR OF THE UTERUS. the loss of valuable mo- in the disease ; the abscess was situated in
to ice,as risking ments,
Dr. Ogier Ward broughtbefore the Societya while itseffectaon the system of the patient the cellular tissue; for,after recovery, the breast
specimen of fibrous tumour of the uterus, taken constitute an obstacle to its use. Leeches m suf- ficient resumed its proper action. He was in
generally
from a patientwho had been under his care for number to modify the circulation, must pro- uvour of the early use of the lancet in openingthe
haemoptysis, and who died the day before in Ken- singtonduce a lossof blood injurious to a lactatin/^ woman, abscess, to preventthe burrowing of the matter, and
Workhouse, not havingpreviously presented and theirbites may act as a localcause of irritation.the formation of sinuses, which are difficultto treat
Purgatives, by diminishing the fluids of the body,
any signsof uterine disease. On examming the lessen The fascia,in some cases, becomes more dense in
the secretion of milk, and consequentlyare
body, there was discovered a fibrour tumour internal of the inflammatory action,and the
not to be spoken of slightingly ; theyshould not be consequence
to the womb, filling up its cavity, attached to the it its
given depress
to the system. Having thus disposed abscess cannot burst through ; early opening,
greater extent of itswall,and havingitsorigin from of the usual therefore, he thought the best plan to be adopted.
the left side,near
planof treatingmammary inflammation,
the base of the broad ligament.and then healed without laid
strengthened bis views in most points, by Sinuses generally being open.
It was lobulated, and consisted of spherical cells; a quotationfrom Br. Clarke's Essav on diseases Dr. Kmg spokeof the necessity of the horizontal
caudate cells could be discovered. In the Mr. Nunn proceeded to describe position,
no
cellulartissue connectingit with the walls of the Kecnliar
is own
to women,
plan,namely,to confine the patientto the neutral salts,in treating
and a certain amount of depletion,
this disease. He com-
by
mended
uterus, there were a number of small tumours, horizontal position, to prevent, by every possible Mr. Nunn's practice, but thought more
which presented under the microscopethe same precaution, any extraneous irritation of the inflamed
needed with respect to the use of
information was
characters as the largetumour. That which he organ, to envelopthe breast in mercurial oint- ment
Abscess of the breast was frequently
exhibited arose from the cervix,and was not lobu- lated. spread on thin linen, and to cover this mercury.
with caused by the separation of the child from the
a tei"id in
poultice; cases, when the zontal
hori-
The tumour was well supplied with blood-
vessels afterbirth. He did [notthink leeches
position cannot be maintained,to support mother soon
from the uterine walls,which were healthy,the would be required if neutral saltswere
gland b^ a suitable bandage: after the or bleeding
except where the growthwas attached,and there constitutional irritation inseparable from an attack of given, and fluids abstained from. Thirst might be
they were somewhat thickened. inflammation has been allayed by a brisk purgative relieved by rinsingthe mouth with cold water.
FOBEIGK BODY IN THE INTESTINE" F-fiCAL and effervescing salines, and proper regimen, the T^is plan he had invariably found to succeed ; he
FISTULA. state of the pulse should be most jealously watched, mentioned the case of a woman, for whom ithad been
Mr. Child read the particulars of the case of a and the proper moment for the administration of
twice practised with success, but the third time it
little patient recently under his care, and exliibited tonic meaicines carefully looked for ; wine and
was not carried out owing to the negligence of the
plum-stone, which had escaped from a fistulous stimulating articles of diet should be allowed only
a
with great caution. In the minority of cases nurse, and abscesses formed,and were very trouble- some.
Mr.
openingat the umbilicus,which, he believed,had Nunn isof opinionthat,after Uie firstday or The use of mercury was a very important
been lodgedin the intestines for five or six months. two,
the needs bark and ammonia, quinine consideration, and he would be inclined to try it
His patient,a boy four years old,had sufferedfrom and patient
more
iron,than depletive drun. The strengthof the He could not agree with Mr. Brown, in its condemn- ation;
hooping-cough, measles,and scarletfever,some time mercnrial application should be adaptedto the con- dition its employment in puerperalperitonitis
priorto his presentillness. The last-named disease and natural texture of the skin covering the showed that parturient women could bear it
had been followed by dropsy,from which he re- gland. In some
covered, instances the ung. hydrarg. fort Mr. Gi-eenhalgh confirmed Mr. Nunn's ments
state-
and seemed to enjoy goodhealth afterwards. will not be found too powerful; in others it will be
by his own experience. He had tried the
Some months since the umbilicus became swollen necessary to dilute it with an equal proportionof
and found it successful. Sore nipplesfre- quently
ceratum resinse. A combination of the extract of plan
and red,and an abscess formed, which burst,and caused mammary abscesses. He had treated
continued to discharge for several months. He was belladonna, hyoscyamus or opium, in the proportion
scess
ab-
of 5i.to the ji.of ointment will be most effectualin nine cases by this plan, and in only one had an
admitted into a hospital, where the openingwas formed. He (Mr.G.) did not object to the
and another made about two inches below The
allaying the intense
agon;^frequently complained of.
enlarged, leadingidea in treating inflammation use of leeches or fomentations, but was unwilling to
it. He remained there a fortnight, and while in the should be the preyentionof mammary the spongio-pih'ne. The
suppuration ; when that use poultices, prefering
)ioepital, feculent discharge occurredfrom the lower cannot be ayoiaed, tbe rendering itas sircumscribeci horizontal position and supporting the breast were
 106 THE MEDICAL TIMES.
the discrepant interests of the parties concerned, the care of the Union Surgeonthan the real poverty A discussion then took placeupon the mode of
that it appears more and more difficultof adjust-
ment of the applicants render necessary. striking a scale of payments upon the elements of
the more it was looked into. Mr. Ross stated,that the gravamen of the com- plaints population and area.
Dr. Hod^kin sUted that,althoughhe was not a of the Union Surgeonsrested upon the fact, Mr. Ross then inquired whether the Board had it
Poor-law Medical officer, he had for many years that there was not a fixed standard of payment for in contemplation to bringforward any measures of
miven much professional attention to the poor, and medical services. The Medical officersrequiredredress duringthe presentsession of Parliament f
had, at the requestof his medicalfriends, heen a that the system should be placedupon a new basis, The President replied, that he was not in a tion
condi-
member of the Committee of the Convention from and that payments should be made upon a plan ap- plicable to make any pledgethat he would be able to
itscommencement, and was fully aware of the diffi-
culties to Uie labours of each particular individual,do so.
of the subject,as well as of the painfulso that equaljustice mightbe administered to all. Mr. Ross then sUted,that it was very generally
position in which the Medical officers were placed. Mr. Balnea inquiredwhat plan the Committee understood, that the Poor-law Board were preparing
The occurrence of the late epidemic of cholera, and proposed for that end ? a Bill, providing for a superannuation fund for
the measures to which it had givenrise, might be Mr. Ross replied, that there was a very generalunion officers, and, as the subjectwas one of the
said to divide the subject into two periods.These opinion in the Profession, which had been also sub- mitted highestinterest to the Medical ofiSceraof unionsk
were measures of relief which the Convention in evidence before a Committee of the House the Deputationwould like to be informed if they
were seekingfrom the Poor-law Board priorto of Commons, by men of great intelligence and ex- were
perience, to be included within the purview of the Bill!
the epidemic, and there were further grievances and assented to by the old Poor law Com- mission, The President replied, that it was true sucks
originating in the requisitions of the Board of that an average payment of 6s. per case measure bad been in process,but that he had sot
Health, growing out of that event. Hence com-plication throughout t he countiy would be an adequatepay-
ment yet seen it It was not mtended, however, te em-
brace

and need for distinctionas to the points to The Committee had anxiously deliberatedon the Medical officerswithinits provisions. Lord
which observations were directed. The Committee this subject, and believed that the sum named was a Ehrington stated the principle of the Bill was that
was quiteaware of the difficulties with which the tolerably accurate approximation to a fairstandard of levying a per centage upon the salaries, for the
Poor-law Board had to contend, and did not desire of payment ; stilltheywere not bound to adoptthat purposes of a fund,and was of tJicnature of an in- surance,
to come to it as frequentand troublesome com- plainants, amount exclusively; and if the Poor-law Board on the same principleas was acted on in
but respectfully to urge that, having,from would take this matter into its seriousconsideration, the Treasuryand other offices.
Its position, the power of takinga comprehensiveand collectthe data whereuponto form an opinion, Mr. Ross sUted, that the CoouBaittee had not yet
view of the subject, and of knowingallthe bearingsthe Medical officerswould feel confidence in the had an opportunity of consulting their constitnenls
of the case, itmight at once seriously and in earnest effortsit might make, and give it every assistance upon this point,althoughthey felt it their dutyto
applyitselfto the construction of a new and better in their power to form a justestimate. bringthe claims of the Medical officers under the
system ; in doingwhich the data alreadycollected Lord Kbringtoninquired, by what means was it considerationof the Board at the preseiit^ intervier.
by the Committee of the Convention,and the know- ledge understood that the value of a case mined? Meanwhile,perhaps,
could be deter- the Board would devise a means
which it possessedof the minds of Medical of jenabling the Medical officers to receive the ad- vantages
officers, might materially assist. He had hopedthat Mr. Ross explained, that the two elements in of such a fund,if theyshould so wish,by
some progress mightalready have been made in the constituting the value of a case were populationadmitting them to it as members at their ontion.
maturing of such a plan. He observed,that a more and area, as already set forth in the Resolutions of Mr. Nicholls remarked, that this view had sug- gested
just and liberalpayment of Medical officerswould the Committee, and that,as allMedical service was itselfto them, and promised that considecation
not be altogethei additionaloutlay, as the expenditure comprised these
of two elements,there would be no should be givento the subject.
caused by widowhood and orphanagemight be con- siderably real difficulty in contriving a scale of payments Dr. Bamett, in replyto a questionfrom Mr.
lessened by an improvedadministration of upon this basis. The Deputationwere
perfectly Nicholls,as to the mode in which salaries should be
Medical relief. He noticed,that the extra duties aware of the difficulties which surrounded the Poor- computedfor Unions " the districtsof which dilfeied
requiredduring the prevalenceof cholera by the law Board, and of the delicacy with which they as to the amount of pauperism, said,that the basisof
directionsof the Board of Health had been feltto be were obliged t o exercise their powers, which, being calculation being detemuBed, namely, population
very oppressive by Medical officers, the ordinarybeingfor the most part discretionary, were resisted and number of cases attended (onan average of three
salary beingeverywhereso exceedingly low. the Boards be for the Guardians or sn In-spector
by of Guardians, who considered the years),
terference
in- itwoiUd easy
Mr. Nicholls replied, that, but for the inter- ference of the Central Board as an intrusion upon to affixthe amount to be paidto the several
of the Poor-law Board, the salarieswould their justrights. Still the grievancesof the Medical districtMedical officers. Thus, in a metropolitan
be much lower than at present. officerscould not be sufferedto remain ; and it had 2d. per head
district, on the total populatioo of s
The President stated,that the Board had no been suggested to the Committee, who had not yet, union (varying as to the amount of pauperism in its

power to interfereand order payment for such ser-

vices however, adoptedthe opinionas a principle upon might be apportioned
several districts) in the follow-
ing
be paid
as the Board of Health required; the Guar-
dians which they were preparedto act, that the trans-
ference manner :" Three halfpence per head to
had, however, by the proviso to Art. 172 of of the jurisdictionover Poor-law surgeons to to the Medical officerof the more wealthydisUiet,
the General Consolidated Order. the Board of Health would be attended with bene-
ficial 2}d. to be ,tothe Medical officerof the more
paid
Lord Ehringtonstated,that what had been done results. It was believed,that the Poor-law pauperised district
in this way by the Board had been hy way of sugges- Board, being governed in its proceedingsby The Poor-law Board considered that the readi- ness
tion,
as it were, to the Guardians. precedent, and viewed with jealousy by the locid with which Medical men sought the appoint-
Boards would be able,with the same facility, a formidable difficulty to further
Mr. Liddle stated that,for some years past,he to
not menU, j^resented
obtain redressfor the Medical officers and the burthening, in these times, the rates. The Presi-
dent
had paidmuch
"

attention to the suhject, but that he

experience of many years had confirmed thisopinion having incidentally made allusioD^ to the
held,^ and had published views thereon,somewhat
as a new Board,empoweredto carry out objects of Queen's' Speech,in reference to sanitaryinaprove-
differing from those generally entertained. He did
"

to inquire
not consider that the application publicinterest,
onlyfor medical great with them in the
and who might have public menta, Mr. Lord took leave pointedly,
of a compre- of the President, if;in his opinion, a union of Poor-
reliefshould constitutea pauper ; thiswas the spiritopinion organization hensive
of the Vaccination Act. It"would be well if the plan of sanitaryadministration. The law duties and sanitaryobligations might not be
administration of medical reliefto the sick poor Boaid
of Health had alreadyrequired Boards of carried out under the General Board of llealth, id

Guardians to employ Medical Officers to perform as to combine justice to the Medical officers, and
were confined to a class of gentlemen to be re- stricted
extraordinary services during the recent epidemic, advantage to the nation, with a wholesome r^iio
from private practicethe dnigs being
The President begged to be excused
"

and would no doubt againfrequently act upon their to finance?

found by the Government. The duties now formed
per-
nnder the Registration and Vaccination
nowers ; but theyhad no power of rewarding the expressing an opinionon this point Much con- versation

Acts might be added to those of the medical c^cer ; Medical officersfor their services; and the conse- quence having ensued on the 8ub)ect generaJiy,
in this manner a fund might be formed,with an was, that, in most instances, remunera-
the tion the President stated, that he was not in a positun
allowance for the performanceof sanitary was upon the same niggardlyscale as for to pledgehimself to sny particular course, observ-
ing,
duties
of the proposedchange. ordinary
services. The Poor-law Board had already that great difficulties were in the way of a sa-tisfactory
equal to the requirements
stated, that it had no to order payment for of the question.
One greatevil of the present control by the Poor-law powirr adjustment the
services, connected with itsown On the Deputationretiring, and thankui|
Board,is the absence of a medical Commissioner at extraordinary directly
department, and it could not be supposed, therefore,Board for the patientand lengthened autSenoe
that Board. The Board of Health had been considered
that otherwise than by advfce, it would exert itself granted,Lord Ehrington replied, that they "lt
hy some as best adapted for this service, inspectors
"

and
would be required, and the number of medical men to procure adequatepayment for work done by the obliged for the many valuable oonsideratiQas
demanded forthe sick-poor order of another Board. Thus the Medical officers suggestions afiforded by the Deputation.
would be much lessened.
The present system of annual election was were sacrificed. There was a great necessity for
very
had, as it keptthe medical man alwaysin thraldom. simplifying the administration of medical reliefto
the sick poor ; and, if sanitary duties were added to MEETING OF THE METROPOLITAN
The President said,that it was a matter of yearly
the strictly medical duties of the Medical officers, SANITARY ASSOCIATION.
eontract
and theywere placedunder the authority of one
Mr. Nicholls feared that if medical relief were
Board, it is conceived that many of the grievances A highlyinfluentialmeeting of the Association
rendered gratuitous to all,itwould be open to much of the Medical officerswould be redressed. The took placeat the Freemasons' -hall on the 6th inst.)
abuse,and throw great responsibility on the reliev-
ing Committee would not, however,move in this matter for the purpose of procuring from the Legislsturcan
officer. until they had consulted with the Poor-law Board, Act of Parliament,to provide for the improvemo^
Lord Ebrington said,even now, where there is no and ascertained what probability this Board could of the sanitary state of the metropolis. The Loid
Jixedtaliuy, a lax Board of Guardians,and a lax offer of a removal or amelioration ]f}" their gxier-Bishopof London was in the chair,and stated the
reUevingofficer, placemany moie cases under ances.
often object of the meetingat great length. He wasfol-
 THE MEDICAL TIMES. 107
present." I a^e
(infiammation)
were
of the *" Swiney Prize, by a joint- appearances
"

adjudication who has studied it so

lowed by the Bishop of Chichester,Lord Ashley, (!ommitteeof the Society of Arts and of the College of with him, and so willevery one "
Dr. he seems to have done, that the asser-
tion
LordBoheit Grosvenor, Jas. Wyld, Esq., M.P., and that,without the prudent precaution
carefully as
of typhus fever are due to
Dr. Fair,and Physicians, as to its truth,you have unscrupulously that the symptoms
Camming, Charles Dickens, Esq., in
of an inquiry
the false and inflammation of the brain rests qp as untenable
other gentlemen who have taken an interest and transferredto your pages,
adopted, disease in gastro-enter-
libeller, lishedgroundsas that of the same
pub-
enthusiasm was ex- of an anonymous
allow it to be supposedthat
hibited
sanitary matters. The greatest scandalous statement
medical itis." Yet I cannot
by the meeting,and the following
tions
Resolu- throughthe medium of an English inflammation of the brain and its membranes
never

were unanimously passed; "

periodical. in occurs as a complication of typhus.
Such is the grave charge reiterated againstwith
me
1$L That, with the exceptionof the City
of Lon-
don,
oi the brain and its membranes
has long
this " Letter on Medical Reform."
I meet it Congestion in the
containingonly 125,000 inhabitants, your
of money, to the amount of been known to be of frequent occurrence

Metropolis, with more than 2,000,000 souls,forming a fiat denial. A sum course of this disease. An injected or unusually
left to the Societyof Arts, upon con*
proportionof the town population Eng-
of land, 5,000^.was of the vessels within the head| e specially
alarge turgid state
in every five years that Society and substance of the brain,with an
is destitute of any adequate provisionor dition that once the pia mater
with Fellows of the Collegeof ferent
dif-
^

effective organization, whereby t he comfort,health, should, in conjunctionthe Author of a publishedincrease of the natural serous exhalations on the
and lives of the peoplecan be watched over and pre- served.of Physicians, present to of surfaces, particularly in the ventriclesand be- neath
of a silvervase the
That, althoughthe strenuous efforte made work on the subject jurisprudence, the arachnoid membrane, beingprobably
inthe Metro]M"litan districtsto procure a sanitary the value of 100/., containmga purse of the of same
the most frequent of the morbid appearances detected on
of the I ever was a member
the passing value. am not, nor
settled by examination of fatalcases.
to
enactment mainlycontributed
the only Societyof Arts the whole matter was
the symptoms
PublicHealth Act ; yet these districts During the lifeof the patients,
"
were
of that enactment. the Societyof Arts and three Fellows of the manifested are dingyredness
parts ezcladed from the benefits officers, in by which itis especially
Thw exclusion has led to much misery and a great College of Physicians, all College and heat of the face and head,minute injection
of
held at the room of the former
"aerificeof life. In the opinion of this meefinr, a Committee extreme stupor,aggravatedmutter- ing
Bill the proceedings and decision of the coiyunctivae, and feebleness of
therefore, it is expedient that a comprehensive Society, over
either direotly delirium, increased frequency
X had no control, clammy
be forthwith introduced into Parliament,to remedy which Committee the the pulse,coldness of
the extremities,
the ^evous evils which afflict and oppress the
habitants
in- or indirectly. The positionwhich you hold in which cannot be pro- truded.
in Society, makes it an imperativesweats, and a dark,dry tonsue, is indicated
but more particularly the work-
ing-classes Profession and In short, cerebral congestion
generally, that you will make your tractation
re-
of this vast Metropolis. duty upon me to require developed state of typhus ; and
as you have made your
unrounded by the most highly itis not till the
as public
2nd. That the Reports of the Medical Superintend- in most cases which terminate fatally,
late visitation, in their most aggra- vated
employedduringthe most statement.
superventionof these s)rroptoms
,

iQg Inspeetora humble servant,

have broughtto light evilswhich fall heavily o n I am. Sir, your form that the patients die.
John Ayrton Paris. the cranium can
the labourinff population, who are leastable to sus- (Signed) Congestion of the parts within
and totally unable to remove them; evilscalling To James Syme Esg., F.R.S.E., of opinion,be regarded
^n scarcely then,as some are
time de- Professor of Clinical Surgery, in typhus patients ; but is
for the deepest sympathy, and at the same as an accidentalaffection
and President of the lUyal
and careAilly-
probablyto be considered as merely system
a conseqnenoe
maodingthe most prompt, eneigetic, of Surgeons of Edm- which
devised means of reliet College of the depressedstate of the nervous
the lateepidemicde- stroyed burgh. disease. Indeed, in the
3rd. That in the metropolis is so characteristicof the of con-
gestion
which number it is mated
esti- the symptoms
16,000 persons, or
had the MR. SYME TO DR. PARIS. experience some observers, ana have appeared
of
not one-half would have perished 4th Feb.,1860. have been so common,
been Edinburgh, disease to have im- parted
measures of prevention finally adopted timely the receipt ot your in so early period a of the as
led
resorted to ; and that more than 13,000 persons an- Sir," I beg to acknowledge a peculiar character to it,and to have
letter; and regret that absence
from town yesterday the distinctive
j"erish f rom disease, whose livesmight,under describe [such a fever under
"ualJy of the prevented me from them to
the Divine blessing, saved by be efficient sanitary in a distant part country, of congestivetyphus."
*'
name
of human life replyingto it immediately. the sym-
precautions. That thisgreat sacrifice afiairin rov letter Several writers, however, have regarded ptoms
degradation In referringto the Swiney" not of con-
"
gestion,
IS accompanied by an amount of physical three above enumerated as evidences,
aad mental depravi^, which act as effectivebarriers to the Lord Advocate, which was published but of genuine inflammation i and some
the fullest persuasion,
to the Inculcation either of socialobligations or of months ago, I entertained observing their frequent ooourrence,
which had pathologists,
Christian virtues. from your silenceduring the long periodin the Me- dical have been led to imagine,
that fever consists e6sen"
dicussed
4"h. That the total want of efficientmachinery elapsed since the subject was
in tiallyin inflammation of the cerebral membranes.
the of Cholera Journals, that you admitted the allegation such a view is erroneous. Neither
whevewith to meet recurrent ravages This allegation But, undoubtedly,
and the consUnt devastations of Typhus, and other questionto be substantiallv
correct
the the phenomena observed during
life,nor the ap- pearances
induced by the state of the dwell- ings being, that the prizehad been bestowed through found dissection, p resent anything
epidemic diseases, officials of the College of Phy- sicians, on
be referred to
of the poor and of the mve-yards, by the de- of certain with greater propnety
agency influence had which may not,
and that your presidential life, meningitis
feotive water-supply and arainage,by the over- crowding
its direction.
congestion. It is true, that, during in respects
of houses, by the imperfect paving and guided by symptoms many
of not whispered or insinuated by is manifested morbid ap-
cleansingof the streets and the non-removal
This charge was
and re- similar, and may leave,after death, no
and by the prevalenceof nuisances and
of " an anonymous libeller ;" but was openly peatedly
besides congestionsand serous
effusions.
r^efiise, im- set forth in the leading Articles
of a re- pearances
spectable
that in cases of typhus
ofiensiveand noxious tradesand manufactures," Medhal Ga- But it is to be remarked,
interference. This Medical Joornal,(the Ltmdm is commonly met with among
calls lor legislative effusion more
Sratively
eeting, therefore, consideringthe vastness of the zeiUf)which
has always been supposed possess
to
the London Colleges.those advanced
serous
in lifethan in young and previously
in
of the the confidence and support of while the opposite is ttiecase
evilssought to be remedied,the importance and receiving no tradictionvigorous
con- 8ut(ject8{
the influence been thus established, of the meninges.
remedial measures contemplated, and Having it was, I believe, credited idiopathic infiammation
Is generally
which the improvement of the Metropolis
would or explanation, not ex- Besides the effusion esses in of typhus
of the Medical Profession, cepting whether
exert throughout the British empire, resolves, that a by every member if I may lessthan in fataleases of pure meningitis,
of the Fellows of your own College, .In the absence,then,
of effusion
Memorial be addressed to the General Board which I have had acute or chronic.
from the correspondence and other positive signs,we are not ranted
war-
Health, prayingforitssupport and co-operation. jnoge of them in regardto it. In
stances, of lymph,
these circum-
effusions alone,any
with some
the in drawina, from serous
how it was possiblefor me- to doubt to the existence
of inflammation ; and
what steps you may have evidence as well known writer on
CORRSSPONDENOB. truth of the statement, and I add, in the words of a
to take for ascertainingmay are cha-
racteristic,
deemed it incumbent upon me thissul^ect :" "'* Even where the symptoms
at a loss to imagine. life is shown to
DR. PARIS AND MR. SYME. itsaccuracy, I am altogether the pleasure and the diagnosisduring
It now only remains for me to express of the have been justified by unequivocalappearances
I have received your contradiction admit of doubt,
LTo the Editor of the Medical;Times.] with which that I afterdeath, itmay,
in most cases,
imputed to you, and to assure you, in than
to the Editor whether the affectionwas ever anything
conduct more
Mr. Syme presents his compliments meant my
his be happy to every proper
of the ifedicalTimet" and will feel obligedby shall use
a primary localinflammation.
the enclosed lettersto the pubhc. power to ffiveitthe most extensive publicity.
We should, moreover, be impelledto doubt the
communicating I am. Sir,your most obedient Servant, when
of the observations they have made,
Edinburgh,February4. (Signed) Jambs Syme. accuracy of this doctrine
it is remembered, that the supporters
To Dr. Paris, President of the RoyaLCoUege to be altogether ignorantof,
PARIS TO MR. 8TME. of inflammation seem
DR.
''A Letter to the of Physicians of London. attention to the
**
rash," which is,
Sir, In a pamphletentitled or have paidno
of typhus fever.
"

Lord Advocate of^Scotland on

Medical Reform," indeed,the characteristicmark doubt of the fever
I find the there be no
with your name appended as itsauthor, TYPHUS. In cases where can
DR. JENNEBC ON referribleto contA^ion,
following passage :" beingprimary, and clearly within
which has been of well-marked inflammation
** It
is not longago since a College, [To the Editor of th" Medical Timet.] the occurrence
Stillcases do now and
the loudest in its demands for exclusive privileges, Dr. Jenner's papers on
"
Typhusand other the head isin cRtremely rare.
of a large hospital t and
it the bestowal of a large sum of Sir, "

the Mtdieal then oceur the practice

had confided to forms of Fever," latelypublished
in
in a fieldof litera-
ture
a largeclassof should the subject
seem Ukely to " interestyour
as a reward for distinction instructive to two
money, eminence, TimeSfmust be highly submit one or
cultivated bv authors of the highest and are extremelysatisfactory, ing
point- readers,I will,with pleasure,
the President,practitioners, theirperusal.
and yet, incredibleas it may seem, do, the distinctive characters of the cases fi"r
thejoint authorship of an out, as they of Typhus. I am, your obedient servant,
without any claim,except this disease which alone deserves
the name
Jamss Stbvxhs, M.D.
old nearly forgotten publieation, appropriated which a re- mark Glasgow, Jan. 26,1850.
the lawyerwho had been his To prevent, however, the impression
himself^ and produce, a few words
prixe to he makes is oalculated to
It is hardlynecessary to re- mark,
partner in the work. where typhus is at alltimes present, DEGREES.
which supported theirPresident from a quarter of ABERDEEN
that a College be submitted to the readers
with, the perpetration may not improperly
ID} and identifiedthemselves
and could this publication. [To the Editor of the Uedieal Times.]
of such an outrage on decency propriety, in closing his remarks on his 14th of Medical Reform
or controlling Dr. Jenner. Mr. Editor," The subject
not be safelytrusted with any power made an examination is almost
case, says, "I
have never before your readers thatit
the members of a liberalprofession."
of of typhusfever, in which such has been so long
the after death a case
Mow, Sir^ there can be no doubt you allude to
 108 THE MEDICAL TIMES.
becoming tiresome ; yet, as it seems at lengthto be parchmentof no greater value than qualifying its I quote the Barrister'swords:"'' Your application
taken up press, I beg to send holders to practise the departments they have beep is a very fair one. I do not see why you should not
by the non-professional
a copy of the Aberdeen Herald, of the 12th inst., to examined on. The immediate effectsof thiswould be paid;your time is as much lost to you here aa at
time be, that Graduates of London and Edinburgb, who the assizes,and v^iatever rule the Judges are in ike
you, and at the same request your earnest tention
at-
geons habit ifmaking foryou, I wiU do the tame:*
than the Sur- If the
to the Editor's remarks on the Aberdeen require more
surgeijfor their degrees
system of doctor-dubbing. If you peruse them with do for their license would be at once eligible plaintiff's attorney thought he waa savinghia client
opinionindicated as for the Army and Navy without submitting, at the fees payable to the medical witness, by declining
care, you oannot failto see an as

to the legality of Universitiesconferring de^es on present,to a second examination before the Deacon to examine him, a process forthe amount would aoon
men who have not been educated within their walls. and Box-master of the Edinbui^gh Collegeof Sur- geons, open the eyes of both parties.
If it should turn out, as the able editorof the Herald whose Charter really only extends to qualify I am, Sir,yours, "c.,
seems to think,that such a practice is illegal, then for practice in four or five counties, or the London William Polet, M.D.
this of itselfwill be a great and beneficialreform, College, whose Charter is shifting almost every year. Kilrush,January27,1850.
without the aid of the Legislature. The question is Students would cease asking for parchment which
certainly one very well worth putting to test in a court only qualifiedin part, and your obstinate College SUBSTITUTE FOR COD-LIVER OIL.*
of law, as the practice in these rival Colleges has would soon be an institutionresembling in some
become a perfectscandal to the Profession. At the measure the Royal Society,whose Fellowshipisonly the Kdltor of the Medical
[To Times.]
risk of becomingtedious, I will give one example of asked by, and conferred on, men of some note in the
Sir," Will you have the kindnesa to insert the
the readymanner in which an Aberdeen M.D.'shipwalks of science,and justlyesteemed an honour. followingremarka upon the applicability of the
may be got. A verv short time ago a physician in Beggingagainto refer you to the Aberdeen Herald^a
almond oil"oL amygdal. to all
common sweet didc.)
England,who had chargeof a small hospital, with a remarks on UniversityReform, and also to a con- sideration
cases in which cod liveroilis prescribed.
salary of 80^ or 100/., took to wife a young ladypos- sessed of the subjectin the same paper of this In a flatand damp a^icultural district, where,
of 40,000useful accomplishments, and took a day, I ma, yours,
amongst a certain
class,inter-marriage very is quent,"
fre-
marriagejaunt,which was so pleasant that he sent Mors. where intermittenta, and allKinds
scrofiila,
home his resignation, alonj;withan intimation to his Rottensloch,Jan. 26, 1850. of disease, characterised by the presence of an ad- ventitious
friends,that he did not intend resuming practice. [We shall next week allude to the subject of our product in the system are very common,
Anxietywas now felt to have a man of some perience
ex-
Correspondent's letter Ed. Medical Timei,'\
" and where, on account of scanty food and clothing,
to settlein the place,and a gentlemanof diseases are, ffenerally. of an adynamic type, it la
some local influence wrote to the north, asking a not to be wondered at thatmedicines, whien enhance
friend if he knew of any respectable medical man MEDICAL WITNESSES' REMUNERATION.
the nutritive powers, should be very largely pre*
worthy of confidence,aa they were afraid of some scribed.
inexperiencedpersons settlingamong them. As a [To the Editor of the Medical Timet.] We have always subscribed to that opinion, which
matter of course, the person written to thoueht his Sir,-"The importance of the annexed Reportto denies the specific agency of the oleum jeooria in
own attendant was the very man to suit, ana made my professional brethren in Ireland (amongst whom and attributeathe be-
ilouaand like diaeases,
tuberculouai
immediate intimation aceordingly, with the necessary your Journal has largecirculation) dispenses with
nefitconferred to its infiuenee on the aaaimilatiye
recommendations,to which a replywas sent, that the necessity of an apologyfor occupying a portion
have prescribed the cod liver oil
processes. We
althoughnot actuallyindispensable, yet the ^ntle-of your columns. with great success, both in hoapital and in general
man ought to be possessedof an M.D. to insure ftshould be the dutyof our Profession to hailwith and consider that its only drawbacka are iu
success. This,however,he had not ai the ihiUfbeing delightever so small an acknowledgment of itsrights practice,
nauseous flavourand highprice.
only an M.R.C.S. He postedoff immediately and privileges it should be also the duty of each
en ; In June last,we agreed to prescribe a vegetable
route to England, vU Aberdeen ; lefthisown domicile member to communicate, with as littleloss of time
oilinstead of the oleum Jecoria, and our experience
on
Wednesday per coach, arrived in Aberdeen the as may be, the happytidingsof even one step in the is highlyfavourable to the therapeutical virtues of
same evening late,and next day started by the mail right directionby the ''authorities," as affectingour
have to de-
clare,
the oleum amygdalae ; we every reason
for England, with the importanttwo additional interests. that the almond oil and the cod'a liveroil act
lettersto his name. Unfortunately, itwas known to Our British professional brethren may not be and that the iirat-
precisely in the same manner,
the partiesto whom he had lettersof introduction aware, that up to a very late period,we had been mentioned oil has but a diaagreeable
anything taate,
that he was not an M.D. when theymade their first treatedmost unceremoniouslyby many of the publicand can be obtained for at least one-third of the
inquiries^ and when he produced hisoredentialsthey authorities,particularly at Quarter Session, which
be considered district of assize
priceof the best cod liveroil.
were perfectly thunderstruck, and whatever took place may aa courts on a
Our experience of the beneficialeffectaof almond
1 know not further than the mere rumour, that this small scale. A Medical witness was liable to be oil has been derived hx)m upwards of 250 well-ob- served
hasty-made ready document proved an insurmount- summoned to any court of session within the county, has it purged, and the
cases ; in no one case
able objection, and my colleague returned to his without any compensation whatever, either for loss We are
in thisoutlandish locality. In default of attend-
contrary effectis very frequently produced.
practice There is nothing of time or travelling expenses. ance in the habit of prescribing the oilwithout any ad- junct,
more common than for country surgeons attending he was liableto a fine, to be laid at any amount
in 51 doses, half an hour afterevery
at first,
the Circuit Court held half-yearly in Aberdeen, the court pleased, ifthe ease was within the criminal meal the dose is increased.
; gradually
layingout their fees for professional attendance in jurisdiction; if in the "civil,"to be limited to one essentialoU,
A dropof eau de colosne,or of some
any criminal case on the College vellum,and return-ing pound,late Irish currency, or eighteenshillings renders the neat oilanything but diaagreeable to the
home veritabledoctors, to the no small delight and fivepencehalfpenny of present or British cur- rency.
taate.
of their respectivefriends and It was idle for the witness to complainof
snpporters.What It is an excellent vehicle for the exhibition of
will your correspondent, who signshimself M.D. " the hardship he endured by absence from his profes- sional iodine in small doses,the latterbeingtrituratedwith
Lond., M.R.C.S./' say to tliis? If he denies it,I avocations, bywhich he mighthave sustained a small quantityof olive oil,and then added to a
will prove it. irreparable loss; the replywas, ''I acknowledgelargeramount of oleum amygdalae.
I know for a fact,that a few months since two of your grievance,but I cannot remedy it. I have The foUowing^B,01. amygdalae, te. ; oL olivs,
these country Aberdonians, aftergrave consultation, no power."
3ii.; iodinii, gr. f. M. Cap. l-3rd ter die.,haa
actually tappeda married woman quickwith child A few years ago (probably five), the authorities
been of great use m several syphilitic diseaaesof the
for dropsy. Not obuiningwater the firsttime, they enabled the Crown Solicitor to pay Medical Wit- nesses bones and
skin, in chronic pleurisy, and in many
plunged the trocar deepenough next day to produce summoned at his instance, one guinea in each cases of chronic enlargement of the glandsof the
a quickdelivery of twins, a few hours after the ope- ration.case, but that is irrespective of the time he may be
neck.
We think nothing of these great featsin the detained,or tke distance he may have to travel.The
The infiuenoe of ^sa. of this almond oil taken
far north. If they happened near
you, theywould witness for the Crown was so far protected : there
daily,upon the weightof some patient's progresaing
be blazoned forth as somethinggrand,and your cor- protectionwhatever for the witness sum- moned
"
respondent,
was no
in health under its exhibition, is very remarkable.
M.D., Lond.," would no doubt chal- lenge by the Traverser,though he was equallyIn one case there was a weeklyincrease of 21b6., in
his particular friends, the EdinburghM.D.'s. liableto penalty as his more fortunatebrother. another of 4lbs.
to
attempta like masterstroke of professional skill, I am delighted to announce that the Rule I have
Care must be taken to attend to the biliary aecre-
betokening a degreeof acuteness of observation by now the pleasureof directing attention to, and pro- nounced, tion duringthe exhibition of the oil,which ia contra-
It is said there is no royal I believe, for the firsttime by
no means common. any assistant Indicated, when there are evidences of symptoma of
road to learning, but the Aberdeen Colleges have barristerin Ireland, not alone placesall Medical local
made
congestionor of inflammadon.
a royalroad to the highesthonours given to witnesses on the same level,but amply protects
of leaminff, by their
P. Martin Duncah, M.B., Lond.,
men unjust r ule, that all who their rights f or remuneration in civil as well as minal
cri- to the Essex and Colcheater Hospital.
Physician
possess a certificate to practise any departmentof proceedings. Roger S. Nunn,
the Profession,may at once appear before them on It may be sarcastically asked,' What did the ness
wit-
Surgeon to the Essex and Colcheater Hospital.
trialfor their highest degrees.Now, Sir,it is well gain in thiscase,as he was not paidor examined ? Colchester, Jan. 25, 1850.
known, that however many classesthe Collegesof He gainedthe onlypointhe aimed hX-^ihe aetertum
of Surgeons
may order candidates to attend,they and acknowledgmentqf a highlyimportant prineipie,
have onlyauthorityto examine on two or three de- whereby,thoughnot then paid for his loss of time,
partments, WHY SHOULD COD-LIVER OIL
and the students know this well. The he secured -groundof action for the recovery of his BE THE ONLY OILY REMEDY IN
public,however, do not ; and it is a deception tised
prac- fee for attendance at Court^ on a summons, no ter
mat- CONSUMPTION?
on the public by these Colleges, ana the parties whether the attorney directing bin^ to be sum- moned
holding their licenses to set themselves up in all chooses to examine him or not. He can [To the Bdltor of the M edksl Ttanes.]
parts ot the country as gentlemen(?)dulyqualified for the sum he is entitledto, and, without Sir,"In the review of ** Mutter's Atlas of Physical
and certifiedto practise every departmentof the Sroceed
oubt,obtain a decree for its payment If,on any Geography," in the Medical Times of February2, al- lusion
Profession. To remedythis fraud nothingmore is future occasion, a medical witness, on application for was made to the work of J. Forry, M.D., on
needed than a short Act,fixinga minimum lum
curricu- an order forremuneration for lossof time, may re- ceive
*"
The Climate of the United States and ita Endemio
and examination, to fit allwho |)as8 that exa- mination from the presiding barristersuch a reply as, I Influences;" and it was
**
trulyobserved,that it ap- pealed
for holding
publicProfessional appalnt- have" no power ; show me a precedent,"let theanswer extravagant to recommend a journey to the
ments of every description, as well asacting as Medi- cal be, The rule made by Mr. Major,the Assistant- Arctic Regions for the cure of phthisia pulmonalia;
officer!in the Army and Navy : the Act not to Barrister for the county of Clare, at the Kilrush the ground of this recommendation neing, that
interferewith any of the existing bodies, Quarter Session for January, 1850, in the action phthiaisprevails least in the Arctic and Torrid
licensing
but leave them as theyare, oiuy declanog their of Dillon against Reidy.' "
Zones. 18 not a hint to be gainedirom this in the
 THE MEDICAL TIMES. 109

tretttment of phthisis by cod liver, and, perhapi, other onlyepidemicwhich exceeds the average ; it was
"8f ^/*^ f Fa^ in the form of blabber, forms,as fatal to 11 children and 10 adults ; the average of
is well known, a great portion of the food of the thisperiod isnot more than 9 ; the fatality of measles
Eaqaimaiiz.Does not this tell us, that as we ad- is of the usual amount; and small-pox, scarlatina,
Tanee towards the north, the non-azotized portion and typhuscontinue to show a de- crease,
of food should be more of the oleaginous and lessof
hooping-cough,
which,however,is most considerable as re- gards
the fa^naceons kinds? ^Why should cod-liver oil
the firsttwo of these epidemics.
be the only oilyremedy in consumption ? " Is bro-
mine
The mean dailyreading of the barometer, at the
the active agent?" asks Dr. Pereira ; and "* as
the oilcontains iodine, and as it proves most success- Royal Observatory,Greenwich, was above 30in. on
inl in those maladies in which thiselement proves Sunday and Wednesday. The mean temperature
successfiil, it has been suggested that iodine is its rose from 33" on Sunday, to 44" on Tuesday,de- clined
active principle. Taufflieddenies this,and asserts to about 36^ on Wednesday and Thursday, Rain in Inches.
that the properties of the two are not identical, for and rose above 50^ on Fridayand Saturday. On So?
m
Che one succeeds where the other fails." I have not Sunday and Wednesday, it was lower than the Amount of Hori-
"282$ SI "^ .-

been able to findwhether any trialsof other oilsor sontal Movement Dm "

Should itbe found

average of the same daysin 7 years ; and on Friday of the Air.
ftts have been made in phthisis. than 15^ above it.
and Saturday,it was more
to be a prmdpfe in the treatment of thisdisease in
The deaths in the several hospitals of London oc-curred
"Mir elimate,that mon aUy and less starchyfoodsmust I*. i ". a ^ ^
of the diet as follow : "

be used, (the nitrogenous portion being 00 "

be KensingtonHouseAsylnm 0 St. Lnke 0
"opposed to remain the same,) it cannot easily ... ... ...

aeen why other oilysuhstitutesmav not be found, Lock

0 Cityof London Lying-in 0
Consnmptlon, Brompton 2 St. Bartholomew.^ 18 ...

whether the animal or

among vegetable oilsand fats
Munster-honse Lun. 1 Miles' Lunatic Asylum... 2
soeholive,almond, cocoa-nut, rape, palm,seal, Nonnand-hou"e
as Lun.
...

0 Warburton's Lunatic
o
a
e
* "
^ ^ s M ^
I
"

m"
""
train,spermacetioils, "c. This suggestion can only Otto-hoase Lnn. ...
0 Asylum ..'. O no ^
be best put to the test in a hospital
for the consump- Brandenburgh-honseLu- natic London
tive,
wherenumber of trialsand patients
a could Asylum 0 Portuguese Jews' Hos- Ditfercnce between
afford safiieientdata on which to form a correct Royal MilitaryAsylum 0 piUl the Mean Tempera-
ture "8
BlacIclands-houseLunatie Lunatic Asylum, Bow of the day and M e
opinion. Fat,says Ascher8on,ha8the physiologicalAsylum
...

0 Guy's the s^me day on

power of
coagulating albumen it,the oil being, 8t. George
around 4 St. Thomas
an average of I + + +
as it were, necessary " to formingthe nucleoliof the Coldstream Guards Hos. 1 Bethlem 7 years.
primary cells of ordinarytissues." The importaneeGrenadier Guards' pital
Hos- St. Peter's Hospital
Ditto.
of this,(iftrue,)in reference to the preventionor ...
0 Lunatic Asylum, Brixton Dew Point.
Westminster 4 Retreat Lunatic Asylum
arrest of tubercular willbe
deposit, readilv seen on ... ~

0 New County Lunatic Mean of

tuoercle differsfrom "ordinary Charing-
cross "" ...
in what
eonsidering Thermometer.
Middlesex 6 Aged Pilgrim'sAsylum
tissue." I remain,your obedient Servant, Queen Chsrlotte'sLying Peckham House Lunatic Dry.
F. W. P. J AGO, M.B., London. in HosplUI 2 Asylum
_

Camberwell Hoiue Lu- Mean of

Lockyer-terrace, Plsrmouth, University College 0 ...

Barometer.
Small Pox 1 natic Asylum I
February 4^ 1850. ... ... .^

Free Hospital 0 Dreadnought Ship i

P.S. Analyses nave been latelymade of the ood- Royal ...

Devonxltlre Ship (
...

Fever Hospital 0
llver oil in America; and. In addition to the iodine, Nortlinmberland hotxse -
Unit6 Hospital Ship i ...

"c., (which is most abundant in the light-brown,) it Lunatic Asylum 0 Royal Ordnance ...
( ^ ...

ia said to contain phosphorus,another peg to hang Invalid

"
Asylum, Stoke
a pretty theory on. Newington 0 Royal Hospital,Chelsea 1 "
German Hospital... 1 (SOQtll) m.
i
King'sCollege 1 Royal Hospital,Green-wich
CAUTION French Hospital 1 (East) ...
\ ... ^

MEDICAL NEWS.
MORTALITY TABLE.
[To the Editor of the Medical Times.] Feb. 2, 1850.
Week endingSaturday,
SiK, It may be of service to my professional Deaths in the
"
Royal Society of Edinburgh. " Dr. S'leridan
brethren of the Metropolis to caution them againsta (Metropolis.) Muspratt,who has, on several occasioris, furnished
person who called at my house on Monday, the 4th Average of
ourjournalwith valuable scientific communications,
inst, during my absence from home. Being ad-mitted Causbs"f Death. Total. Ten has been unanimouslyelected a Fellow of this
,
to the parlour, the servant was imprudent Weeks. Society.
enough to leave him there alone,on the usual pleaof Intelligence.
Naval Assistant-Surgeon
W. "

writing a note to me. Having done so he retired, All Caubss 1094 1031 ... M'Dermott, MD., (1840.) to the Blenheim, 46,
takingwith him variouslittlearticlesmost convenient SracirisD Cavsbs 1082 1023 steam pusrd-ship at Portsmouth. W. V. E. Rey-
nolds,
for removal. Zymotic (or Epidemic, Endemie, and since
ActingfAssistant-Surf|reon Jan. 27,18^9,
By inserting this you will oblige Contagloui)Diseases 168 1S8
the confirmed. Alex. Mitchell. M.D.
SpoaAnic DisBASSS :
to Raleigh,
Your obedient Servant, Surgeon to the Philomel,8, sloop,at
(18*9), Devon-
Thomas Dropsy,Cancer and other Diseases of
Liohtpoot, M.D. uncertain or variable seat 46 53 port.
14, Keppel-street, Russell-square, Feb. 7,1850. Tuliereular Disaases 179 17S
""-.". Obituary " On Frid.ny,the 1st, Mr. Duncan
Diseases of the brain, SpinalMarrow,
Fergusson,after a severe attack of typhus. This
(Cop^of the note left.) Nerves, and Senses 138 119
gentleman had onlyjustfinishedhis medical studies,
"
Mr. W. M. Hams requeststhe fovourof Dr. Light- Diseases of the Heart and Blood- and hfldlatelyheld the office of Physician'sAssistant
vessels 45 81
foot'sattendance as soon as he ean conveniently ...

call, DIsenses of the Lungs, and of the other

...

at King's College Hospital,where he particularly

either to-morrow morning or afternoon." Organs of Respiration 247 213 distinguished himself by his unremitting .md humsne
Diseases of the Stomach, Liver,and exertions amongst the numerous cholera patients
other Oreans of Digestion 61 54 ...
under his charge. He exposed himself night and
HEALTH OF LONDON DURING THE Diseases of the Kidneys,"o. an 7 ...

WEEK ENDING FEB. 2. Childbirth, Diseases of the Uterus, "c. 9 10 day,and escapedthis dreadful ma'ady, but too sirely
Disrases of the Bones, fell beneath the attack of that disease which has
The Register of Deaths for the past week exhibit Rheumatism,
Joints "c alreadyconsignedmany of the best and bravest ot
an increase of 60 on those of the previous week, and Diseases of the Skin, Cellular Tissue, our ranks to an untimelydeath.
likewise an increase of almost the same amonnt on
"c 1
Mr. Yearsley Deafness.
Malformations
on The Academy "

the average of the corresponding 3

weeks of tlie 10 ...

of Medicine, at Paris, have named a Commi.^sion,

Premature Birth and Debility SI
previous years, (1840-9,) the o f
mortality these Atrophy 13 consi"tintr of MM. Tifirtgier,
Rc;?in,Bt)illarger,Gu6-
weeks havingranged from 780 deaths, in 1843, to Arc 75 neau "leMus.^v, ct Pinrry,to inniiire into and report
1478, in 1848. But ifa correctionis made for in- creaseSiitUlen :2 upon the merits of Mr. Yearsley's
new made of
Violence, Privation, Cold, and Intern deafness by the hydrated cotton, on which
of population, the estimated average becomes
pcrance 21
treating
subject Mr. Yearsleyhad addressed a memoir to the
,

1126, and the deaths now returned are lessthan this Causes not Specificl 8
number by 82. The causes of death prevailing at The following is the number of Deaths occurringfrom some Academy.
of the The Ciiolcra. \Vc find it stated in the AVw-
the present time,are fonnd in by far the largest more importantspecial causes:"
"

portion
pro- 81 castle Guardian^ that cholera Ftillcontinues to infest
in that class of diseases which affeetthe Apoplexv
Heart
Bronchitis 126 Hooping-cough 33
... some of the collieryvillagesin South Durham.
organs of respiration. In this class,of which the Cholera 2 Hydrocephalus S3 Seven deaths occurred in So"th Church last week
bronchitis, Childbirth 7 Influenza
most important
are phthisis, pneumonia, 3 from this disease, and three or four in BishopAuck-
land.
the deaths of Convulsions....
SO Liver 8
and asthma, there are now enumerated
Diarrhcea 21 Lungs 6
384 persons, than one-third of all who died
or more Plymouth Naval Hospital. A Court,c^vn-
Dropsy 23 Measles 22
"

in the week; the corrected average of 10 correspond- admirals and one naval
ing Erysipelas 10 Paralysis ... 34 poscdof two captain,w.is
weeks is 376. On the other hand, the deaths BIRTHS AND DEATHS. held at Plymouth, last week, to inquire into certain
from the zymotic or epidemic class of diseaseswere charges broiigiit by the Captain-Superintendent of

only168, the corrected average being216. A girl Births. Deaths. Births over Deaths.
the Naval Hospital,againstDr. Rae and the naval
of"g^rs of that establishment. The result, we believe,
of 5 years died of "Asiatic cholera,"after 14 hours*
is stilla profound secret; but the charges,so far as
illness,in Portman-place, near the Edgeware-road ; Males ...
770 52S 241 can understand them, seem not to be of a very
we
and in Fenchurch-street, a boy of 9 months died of Females 718 509 152 serious nature. It appeans, that when cholera was
"cholera, hooping-cough, teething, and convul- prevalent in Plymouth,many admitted
iions,"alter a month's illness. Diarrhoea is the
ToUl... 1488 1091 m Iinto the hospital
cases were
before the disease was fullyde-
 110 THE MEDICAL TIME"

veloped.These were diarrhcsa; but. on

designated of 80/. The castingvote of the
salary601, instead TO CORRSSPONDENTS.
the oocurrence of rice-water evacuations, with spasm Chairman alons carried this lastalteration. Kirkdale,
and and, in
collapse, some cases, death,the name salary
was 50/.,instead of 20/. This officeralso had 12s. Mr. Morrli'i Case of Morbus Coxarius'* has been trans-
"
ferred,
changed to cholera. This gave ^eai offence to the a week extra ; his real salary, therefore,was 51/. 4s. without acknowledgment, fyom the Medical **

Superintendent, who was detcnnined that every caseBootle, salary20/. AKerton, salary2/.2s. instead of Tiroes,"of January 19. to the "Provincial Medical
and Surgical Journal," of February 6, under the head of
should retain the name given it by the officerwho 5L Garston,15/. Childwall,2/. 2s..insteadof31.Ss. The utagee of reepeetiibto
months after Dr. OriginalCommunieationt." "

sent in the patient;conseouently, two Gutta Percha Soles for Chilblains."

Journalismmight have induced the editor of the vincial
Pro- "

the diseasehad disappearea, he has accused the Me-Turnbull has at lengthfound a rival. The Gutta
dical Journal'* to acknowledge the aoorce from wheoee
officers of making out falsereturns,in order to Percha Company addressed to him a letterupon the the case in questionwas obtained. We are unwillingto
enhance theirreputations. Another chargewas, that subjectof his proposed remedy for chilblains"which suppose Mr. Morris would imitate certain advertising

A case of cholera had been admitted late at night, we were not the onlyeditors good-natured enoughto quaeks, and send his case to mere than one medical
Journal.
and treated by an extra Naval Surgeon, specially publish.In reply,the doctor acknowledges, that
CommuuicationB ftom Mr. Maybury, Little Tower-street;
appointed to take charge of cholera cases, without all planshitherto have been inferiorio gutta percha Mr. Barrow, 19th Regiment; Mr. Oibom, Southampton ;
sendingfor the Inspector, who had leftthe Hospital, soles for the prevention of the disease. After all, Dr. Hastings, Stokenchurch ; Cbirurglcus, and others,
having previously airected that he vras not to be sent there is nothing like leather. By the way, why did will receive earlyinsertion. We are not In the habit of
for unless the surgeon deemed it necessary. This not Dr. Turnbull, while he was about it, favour the gaxettingthe receiptof communications proceedinafrom
all the letters of the alphabetand something more. We
gentleman, it further appears, had three as- ProtHneial Medical and Surgical Journal with a copy of
have neither time nor space for such ad eaptamdum hibitions.
ex-
sistant-sur^eons to aid him in the performance his Letter on Chilblains? When do not acknowledge the receiptof
we
of his duties,one of whom was constantlyin the Water Supply Our excellent
for London. "

papers, it Is because we have handed them over to the

cholera wards both day and night The case, too, contemporary, the Weekly Newt^ remarks : ** We "
printer to appear, In due coarse, in our Journal.
was a slight one, and the man soon recovered. These have more than once recurred to the danger we Our anxiety to complete,for the benefit of our readers, the
admirable of Dr. John Taylor,on Pericarditis, and
simple matters have been made by the Caf'tain-Londoners are exposed to of gettingnothing to papers
the length and importanceof the report of the intervtew
Superintendentthe basis of n serious charge against drink. There seems to be no doubt upon the minds
of the Committee of the Poor-law Convention, on behalf
the medical officers of the hospital, necessitating the of any who have turned their minds to the subiect,
of the Union Surgeons, with Mr. Balnea, oblige ue an-
formation of a Board of Inquiry,and requiringthe that there is no deticiency of water in the immediate to omit unual Edinburgh corre-
willingly this week our spondence,
presence of SirW. Burnett,the medical chief of the vicinity of the metropolis.But everyone has a way our Selections from Foreign Journals, and
Navy, from London. We shall look with great of his own to get at the supply. Dr. Buckland puts Reports from the London Hospitals. We much reirret
that we also obligedto orolt. until next week, a
anxiety for the decision of the Court on tliese an anathema on artesian wells,maintaining that the are
memoir of the late Mr. Cllft,and Dr. Jenner's paper on
knottypoints, which, however, we have reason to half dozen which exist suffice to drain the vast area
also,most
Typhus Fever Several eorrespondents, accept
believe, is adverse to the Superintendent.This gen- tleman of chalk which surrounds and underlies London. stand until
our apologies,and their letters over our
should have borne in mind, that his duties Two engineers,appointed report on to the Henley next.
do not requirehim to interfere with the medical de- scheme, declare that the river cannot bear the drain A Corre"pondent,In answer to Quaeso, of December
partment 12th,
in any way. Why does he not remember which would be appliedat that particular "
I should say he would be Justified in accepting
spot, if says :"
4". per member; for this fcum he could do fnU
the old adage, Ne sutor ultracrepidam." Dr. Ilae that company were, like Aaron's rod,to devour
** per annum
the
Justiceto the members, without damaging his standing la
is one of the oldest and most respectahle medical other Companies, and furnish water only to the the profession; in Leeds the usual fee is 2s. 6d per annum
officers in the Navy, and there cnnnot be a doubt of this great City. A third scheme
thirsty is now per member, and this pittance is aeoeptedby Fellows of
but that he willcome oot from this inquiry, not only broaehed, founded upon experimentsmade pursuant the College, as well as M.R.C.'s, L.A.C's, "c."
cleared from the charges so invidiouslybrought to an order of the House of Lords in 1840. Mr. R. ""J. B." writes :-" Studens wishes to be informed what
againsthim, but fully iustified in every step be has Paten, to whom this order was addressed,sank a books he can resd to ward off*infidelitywhile dissecting.
taken. We understana that CaptainToup Nicholas, well in the chalk formation in Bushey Meadows, Let him read Genesis xv. 18"16, and learn in Joshua
whether that prophecy was fulfilled. Let him read the
the superintendent, has, since the above inquiry,near Watcrford,and, it seems, met with an abundant promises made to the Jews if they obeyed the Lord their
been permittedto retire. supply of water at a depth of 34 feet. On boringto In this
God, and their punikhments they forsook Him.
if
Westminster Medical Society. The mem-
bers the further depth of 130 feet, four holes of small king, or country, or
case, they were no longer to hsve
"

of this Institution and their friends were most calibreyieldeda supplyof 1,800,000 gallonsper day nation, but to be dispersed among all nations" deitpised,
agreeablyentertained by theirworthy President, Mr. of twenty-four hours. These experiments were neglected, persecuted, "c. "c. And have we not now
thU day before our eyes, the fulfilment of this wonderful
Hird,at a conversazione at the rooms of the Society conducted under the inspection of Mr. R.Stephen-
son, Know of
which prediction, made nearly 3,000 years ago? we
tn Saville-row, were crowded by the elite of who reported on the results to a company the
the Proression. then any nation or country In the which, and among
projected,and which it is intcndea to which, they are not dispersed t and are they not a marked
Royal Colleqe op Surgeons. "The Council revive. Our object in recapitulating these factsis to and peculiar people1 The same God who foretold these
have not been idle duringthe past week, on the all- show,that a mere theoretical opinion,such as has events has also said, ' At the last day all shall stand be- fore
Ilim in Judgment" those that have done well shall
engrossingaffair of the new Charter. We stand
under- been pronounced by the Dean of Westminster,
go into everUsting happiness, and those who have not be- lieved,
they sat for three hours on Monday, and again might be of weight wliere no practical arguments into everlastingcondemnation.' Sir, let Studena
on the following day. could be opposed to it. But the learned Dean
read and compare the Old and New Testament^let hina
Statistics of the Diplomas of London would,doubtless,himself be the firsito acknowledge, read Keith's book on the Prophecies," and lastly,let him
Physicians." A Correspondent of the Pronncial that the best-founded theories are constantly modi-
fied learn from his present studies and pursuits, that none
Medical and SurgicalJournal gives the following and corrected by the results of experiments; but God could have made man so
*
wonderfully and fear- fully,'
Table as to the source whence the diplomas of Lon and, in the case of scrutinizing the nature and ex- any more than a watch or steam-engineoould have
tent
don Physiciansare been msde by chance."
derived. of a subcerranean water- basin,whatever theory
178 might do towards estimatingits probableposition Mr. Ogilvie, of Ridgway-house Asylum," has written na,
"
Edinburgh M.D.
TM.D. 36} and character, yet nothing short of actual experi- ment complamlng of injiutlcedone him in our Artiele of Jan.
hondon 66
...
IM.B. 30J could furnish convincing details
upon to which 26. From the generaltenor of his communication, we

FM.D. 24) work. The Bushey experiment is higlily

valuablewould readily have inserted it,but Its enormous length
Oxford 25 reoonunend
supplyis locally utterlyprecludes our doing so. We strongly
...
I MB. 11 as the water
tendingto show, that
IM.D. 38) different. It appears
be very various at various
to Mr. Ogilvie to publishthe psper in the form of a pamphlet,
Cambridge 41
when, if a copy be sent us, it shall receive due attention
iM.B. 81 depths in the same locality.Upon this head we
Dublin tM.D. 6} 11
recommend Mr. Homersham's (C.E.) Report,which in our Review department. Meanwhile, we quote the
...
M.B. 5J is publishedas a pamphlet, with two beautiful maps ; dosing paragraphof his JustiReation, convinced that we
St. Andrews M.D. and do not doubt that allwho peruse it will not should only be doing Mr. Ogilvieinjustice by curtailing
Glasgow M.D. only share our opinion,that the few wells already the details of his communication : "

Aberdeen M.D. sunk to any considerabledepthin London and itsvici-

nity
"
Having the satisfaction of mv own conscience, the assur-
ance

Paris of satisfaciion and goodwillon the part of all my

MD. are altogether insufficient to test the nature and
who have thus been driven, in almost every
German M. D. of the subterraneous poor patients,
?rman extent channels which perforate instance to their own
Various regret, from my care," the unani- mous
irious Continen-'J the vast chalk bed below and around There
us. thanks, sympathy, "nd regretof their friends,and
tallUniversities f
tal "
exists,therefore,both a motive,and,on Mr. Homer- the condolence of my own friendssand my former patients
M.D. their aato-
Austria Prussia,
Austria, f sliam'sand Mr. Stephenson's showing,fullencourage-
ment "several of whom have written to express
all the
Italy, "c ) likewise, to pursue the researches which have nishment, that I, who have so carefullyeschewed
evIlM and abuses incident to such establisbmenfs, shou'd
America and U S.. M.D. often been pri)poeedinto the receptacle which is at
have b"'cn singled out and held up to the world aa an
Nondescript (".e., our command. The parishes of London have now example of such abuses;" with this consctousneas and
the degree being i taken up the matter, and we have faith in any effort
M.D. such testimonials as these, I take leave to say, I would
given without the
Universitybeing
M.B.
|
Vs which theyseriously make. No greater boon can be
bestowed upon both rich and poor, than means of
not excitanpe my position or my feelingsfor those of Mr.
Purneli.prosperous as he maybe, successful In his schemes,
mentioned , cleanliness. A supplyof clean water will prove as and flattered by the support and suffrages of his syco- phants
a-id admirers, and of ail who, from prejudiceor
Total W4 useful as good means of getting rid of it when it has
Bupinenew, have degradedthemselves so far as to give
Middlesex Hospital. Dr. A. P. Stewart has
" been used ; and the success which will infalliblytheir sanction to his proceedings,-coupled as all this
been electedthe Assistant- Physicianto this Hospital.attend a well-judged effort for obtaining a pure sup-
ply be with his own consciousness of the unworthy
roust
There was not any oppt^sition. that have actuated him, and the unjustifiable
may excite to an attempt to regulate the discharce ture
na-
motives
West Derby Board op Guardians. The oftlie foul water.
" Until the parishes themselves take of the measures he has adopted."
Board has considered a proposal laid beJore it,and it up, it is useless to expect that anythingeffectual
"
N.P."~We regret that our space will not this week allow
has adoptedthe following us to publish a much shorter, though stilltoo lengthy
recommendations: a dis- will be done in either direction."
pensary
subject, from "" A Physicianand
"

letter upon the same

to be established for the township of Tox- Suicide of Mr. Rouse. We regret to state, Resident Proprietor."
"

teth Park,a dispenser ^ ... ,

to be appointed at 7ol.a year, that the decease of Mr. Rouse, surgeon, of Fulham, "Un Chlrurgeon.""A privateletter has been waiting for
and 10/. for an assistant. Districts 1,2,3, salary to announced in our last,was an act of suicide. He OUT Correspondentat our office. It would hava been
the Medical Officers instead of 80/. District 4.
60/., ; himself
destroyed acid. When
by takingprussic forwarded by post,but his address has been nnfortnnately
40t instead mislaid.
salary Derby, municipal discovered,it is presumed, he nad been dead many
of 80/. West
Mr. Wardrop'sWork on the Heart."" We
received a com-
munication
"

division,
salary80/. per instead of 40/. ^This
annum, hours. Mr. Rouse had been very actively
engaged from the Author, on the 6th instant,to the
officer has for some
time past had 12s. a week addi-
tional,duringthe late cholera epidemic,and subsequently effect,that he was bestowingall the time and attention he
so that his
salarywas 71/.4s,annually.West condition
drew up a valuable Reporton the sanitary could give to the sul^eet; and we hope,therefore, soon
Derby,rural,salary50/.,as at present. Everton, of Fulham. to present our readers with the remainingportion.
 THE MEDICAL TIMES. Ill

THE HTrHTEEIAN OBATlOIT. no time to stepout of the direct

path of inquiry to explore the mysteriouB agentof lifei ^thestudyof "

DELIVERED IN THE THEATRE OP THE ROTAL indulgeangiy passionsorquestionmotives. those phenomena which charaetetiiethe local or
to

COLLEGE OF SURGEONS OF ENGLAND, Their eyes arc fixed on one object, and,to reach this general defectsin the body,*-thetkttdy of pftjrehologyi
On Thursday, Feb. 14,1850, goal,theypursue theircourse in a straightfbrward demandingthe highestorder of int^koti ^thedia* "

BY direction. The excellence of Hunter is to be looked covery of agents obtained from tlM vegetable^
FREDERICK CARPENTER SKEY, ESQ.,r.R.a, for in his untiring e ffortsto advance the cause of animal, and mineral kingdoms^" the lesearches U
Lecturer Anatomy,and Ansiatant-Surgeon
on to physiological science, ^hiauntiring"
industry,^his the chemist,whose operations
" are eoiuieetedwith
81. fiarthoJomew'i Hospital.
indifferenceto the acquisition of riches,and in the almost every branch of medical science, we can "

benevolence of his nature, which ever identified hardlypointto one departmentthat is not, In a
(Reportedby our own Short-hand Writer.)
itselfwith suffering, and which inspired feelings of greateror lessdegree,necessary to the setvioe of
Mk. I*JliEsiDE*tf AND Gentlemen, "We are love in the breasts of all his friends. (Mr.Skey medicine, ^these are
"
the oeclipati""is of
, among
"

a"setnbledon thisoccasion to do honour to the genius here

quotedan autographletterof Mr. Hunter's, medical men, and theyblend into the wider eircles"
of ttunter, a name celebrated throughoutthe written in 1786, to the Master,Wardens, and Court both of and science, forhere there is no
philosophy
"

civilisedworld,and also to record the merits of of Assistantsof the Corporation of Surgeons, giving boundaryto the seope of studyt Nor are his moral
those *ho, deceased since our last anniversary,
evidence of his desire to extend the advantages of requisites less indispensable. The praetitioner in
hare claitnson the respectful remembrance of their medical literatureto all.)The Orator then pro- is a member of each socialcircle. To
ceededrural districts
brethren. The periodof Mr. Hunter has formed to notice several of the celebrated links him the father resigns the health of his family he
;
an epochin the history of Medical science. His which connected Hunter with the Medical Profcs* is admitted at all times and in all
seasons; and
nnceaung ardour,his spirit of investigation,
and sion,and firstnoticed the name of William Clift,here he
may exercise even a parentalauthority.
his intellectualgreatness,demand the homage of whose name, he said,next to its great founder, He thus becomes an adviser and a friend,and
our veneration,and in the search of science leave was more fullyidentifiedwith the Hunterian Mu-
seum acquiresextensive rights and peculiar privileges*
competition far bfehind. In the range of modern than that of any other man livingor dead. The pathto medical knowledge, also,is dangerous^
physiologicalscience,no one has approachedhis The Memoir of this gentlemanhas so recentlyand its requirements are often repugnantto delicacy.
eminence or participatedin his glory. No thought appearedin our columns, and is againmore fully It involves intereourse from which the senses will
of privateinterest,no aspirations after fame, no referred to in another partof our .Number, often revolt Often the Medical Man pursues his
present
ambition after distinctions,
could divert his mind that we feel it unnecessary further to report that labours,unchequeredby recreation for a single
from the pursuitof truth and the investigation part of the Oration. day,in companionshipwith sorrow, disease,and
of nature and her laws. On the almost un- trodden Mr. Charles Aston Key was next referredto,as a death; and while his family seek the repose
ground of his researches,his mind re-
velled name class of scientificwhich Nature
identifiedwith the highest demands, he is" perhaps,sum-
moned
in the luxuriance of intellectualriches. Mr. was
surgery. Key
appointed
one of the chief to a distant villageto mmister to
That his mind imbued with the very spirit of
was
surgeons to Guy's in 1824, which office he held to the relidf of incurable disease,and devoting to
earnest inquiry, his gigantic productions will testify his death,or twenty-five years. terised reflectionthose hours in which he should invi-
Mr. Skey charac- gorate
to; that his researches were
"
conceived and car- ried him as possessed o f a mind in which a his mind and body forthe duties of the row.
mor-

out by superior intelligence, I pointto the refined common sense was the most striking feature. For the influenceof such occupations on his
philosophy of his written works* It was said of His knowledgewas his own. He studied disease at health,I referto the billsof mortality, which show
Bacon by Ben Jonsou,that his words were so the most advantageous place the bedside of the that he too often sinks into an earlygrave. Mr.
"

full of meaning, his hearers could not look aside patient.He evinced a deepinterest in the cultiva- tion Skey considered that this condition was altogether
from him without loss; and even so did Hunter's of Professionalknowledge. Possessed of a re- unmerited,and continued :" With largeresources,
markably

reflectingmiud teem withoriginalityof conception. He cool judgment,a generalinquiryinto the Profession df Medicine is at the presenttime a
wingedhis way from the infancy to the mature age of cases did not satisfy him ; he pursued his investiga-
tions degenerate science. The rank of a selectfew may
science,discovering and maturing every subject that into every detail. He aspired onlyto that level yet remain, bnt the Profession has ceased to be
engaged his fixed attention. His intellect has been which would subserve the treatment of disease. sustained to the level of its real value by the
the frequent theme of eulogiumin this theatre, and During nineteen years, he met a largeclass of voice of the public.The eauses for thisare various,
upon wliich my numerous predecessors have ex-
patiated Medical students, instructing them in his favourite but I conceive the greatest of allto be,the wtmi rf
with eloquence.Combined with his intel- lect, subject, the principles and practice of surgery. Mr. edttcaiian. It is mind that does the greatwork of
were also certain moral qualities, which Skey then eulogised him as a surgicalwriter, the world. He who would studymen in his mental
equallydemand our praise, while they fortify our especially on the subjectof lithotrity ; while he ob-served,and physical conditionmust cultivatean aequaint-
convictions of his claims to the gratitude and ad-
miration with some regret, o n his rather eccentric with the writersof antiquity. He willtake nothing
of posterity.Ingenuous,disinterested, opinions as to food and diet He died of cholera upon trust, but will trace the stream of kno'wledge
unreseived,in communicatingknowledge, hibited in its worst form, in the 57th year
he ex- of his age, re-
grettedto its sotttce. The languageof ancient Bx"me is
many of the excellenciesof the true philo- sopher. by the whole Professionalbody. that of the greatCongressof Medicine. It is the
He surveyed, as from an eminence,the great Mr. John Goldwyer Andrews and Mr. Thomas languageof Celsus,and the adoptedlanguageof
book of Nature, and his thoughts expandedby a Morion next came' under review, the latter being Haller and Boerhaave. Its cultivationis more in- dispensable
natural elasticity, as he became elevated above the characterizedas distinguished by an ardent love of to Medicine than to any other department
grovelling influences of the world. To a love of his profession, and the accuracy of his observations. of science. Yet,for allthis, the excessivecultifation
Nature,he added,a stillstrongerlove of truth. It Certain changesoccurringin University College,of c^fuWra/ knowledgegeneratesa learned folly, qualifying
dis-
is impossible to read of him, without believing that produced an impression, thathe was deprived of the its possessorfor the acquisition of thit
to the ardour and enthusiasm which incited him to of further advancement, and in and
despair, knowledge which is for our intercourse
prospect necessary
toil over the greatfieldof Nature, he added an un- by his own hand, he soughtrelieffrom his suffering with the world. No roan is fittedfor the task of
deviatingadherence to truth. A spirit of arro-
gance, in his S7th year, leaving with his contemporaries education whose mind is not stored with getiertU
and a disposition to depreciate the works of the reputation of a talented surgeon, and with his knowledge.Another important branch of studyis
a rival,is the characteristicof the pretenderto friends the memory of a kind and amiable man. that of the exact teieneet. It is thus that we leam
science, while theyexpose the motives which carry Mr. Pennington was noticed by the orator as a to
compare and analy8e,'and then to expose the fal-
lacies
him forward in its pursuit. And the cause is plain man unknown as a writer,and Unconnected with under which false reasoning lurks. Logic
;
for,if animated by a true love of science,any con-tributionpublicprofessional life,but pursuinga career of is also an important source of discipline,ing
invigorat-
to his favourite study is hailed with glad-
ness almost unexampledactivity in the departmentof the facultiesby its applicationboth to the right
whereas, it would be received by the em-
; piric privatepractice. He never sullied his integrityby interpretation of terms, and to the higherpurposes
with coldness, and, perhaps,disapproba-
tion. a singleungenerous or sordid act during a long life of abstract reasoning. To the neglect of these it
How often does the desire of distinction of unexampledprofessional activity^and died in was to be attributed, that the Science of Medicine
dictate our efforts,and produceenvy. In the March last, in his 85 th year. was degraded ; and the Orator considered, that un-
less

great temple of knowledge there should be Mr. Skey then proceeded From the earliest
" some measures were adoptedby our Colleges,
no contentions for
place, a spiritof fraternity
"

periodof the world,the scienceof medicine has been requiring education in these branches as necessary
should prevail.Every degradingthought and esteemed one of the noblest occupations; the entire removal of all other
and it for qualification,
passionshould be thrown aside,as derogatory and would be difficult
to find one more adapted inspirecauses
to combined would failto remedythe evils ex-isting.

injurious. Between two students of Nature there the mind with ardour, or to kindle the energies of Mr. Skey then observed,with much point
arc no motives for rivalship or ill-will.They are thought.The study of physiology, whether appliedand some severity,upon the prevalent system of
directedby one common and highmotive, and have to tlie structure of the body,or to the attempt to education,so called,by means of apprenticeship.
No. 542, Vol. XXI.
 112 THE MEDICAL TIMES.
he said, four or more invaluable years award legitimate compensation, he is driven to an should pass unrewarded ; while itisalmost singular,
exhauBtmg,a8
lifeof the student. After characterising excuse for subjecting his patient to a course of that thisfact should escape the propounderof the
ofthe early
this system, to which, he ph"sic,with a view to prevent a recurrence of Malthusian doctrine.
and somewhat satirizing
in opposition the malady. The objections to all this cannot In alluding to the impracticability of extending
ohserred, the Professionhad lent itself,
and of common he be oveicharged. It is inseparably i nterwoven the advantages of education to the presentgeneration
to the laws of moral right sense,
said : This (the age of his apprenticeship) is the with the rank of our Profession, our characters, of practitioners, Mr. Skey said: Thus "t the evil
and the onlyseason in which and the well-being of society.It upholdsthe isirremediable ; but much good may be efifected by
springof his existence,
the mind takes impressions for a whole life. The doctrine,that Medicine is the great antidote the agency of a refining spirit, employedfor the pur-pose
child is said to be father to the man."
" I have against disease, inviting empiricism,
"
and weak-
ening of rooting out the vulgarisms in conduct that
sketched his education,look at the result The the allegiance of our Profession to Na- ture unhappilyprevail in our Profession. A better
w hile the author of disease and the worker of its
giantevilofthe day was a want of education, as spirit should be infused into our vocation ; one which

all should be educated in mind and manners up to treatment: we thus forgetthe operation of first will tend to avert those evils of conduct between
the level of good society; and he rejoiced to think causes, in our reliance on second,and strikea fatal man and man, founded on questions of mere profit
that the Council of the Collegehad acknowledgedblow at the rank and respectability of our Profes-
sion. and loss. To thisend,he would suggestthe cultiva- tion
The placinga pecuniary v alue the drugs of a more refined taste, the power of appre-
by takingthe initiativehere,by insti-tuting on
the necessity ciating
"

dispensed, is a feature most injurious to the rank of beautyin any form. Good taste and good
examinations in classicaland mathematical
candidates for the rank of the General Practitioner ; and with quite as much feeling found in dailycompanionship ; while,
knowledgefrom alljunior a re

reason might the Surgeonclaim compensation in without it, a blank is left in the circle of man's joyments,
en-
Fellow.
tioned,
before-men- the name of the instruments he uses. Medicines and his intellectualframework is incom- plete.
Another cause degradation
of the
sUndard of should not be dispensed at their adventitious value. The studyof the beautiful forms one of the
was founded ondegenerate
the
Medical Ethics, Taking the body corporate of the The whole Profession' should cry aloud and diate most elegant
repu- resources of our minds. It embraces
a practice so derogatory and vicious,and ob- tain a wide range of human knowledge,fh"m its
Profession, we find a want of that high tone which
is from the Legislature a title to a remuneration primitive f orm to the highest manifestations of
distinguishes other professions. There no sion,
profes-
more consistentwith their services and their high refined and cultivated taste in the poet or the
the conventional refinements of which are more
of the law, calling. Mr. Skey next observed upon the ambition painter.Such objectsare within the range of
stringent than in the higherdepartments
to acquire rank as an incentive to attaining ority every man's
superi- observation. A country life espe-
" that being a purelyartificialpursuit.In the cially
of mind but it was a stimulus, he said, far furnishes materials for the development
abstract, law is an inflexibleand impartial prin-
ciple, ;
less available, on grounds, to the Professors of of thought, while objects of beauty calculated
devised by sages to protectsociety against many are

selfi^ness and power, and no principle is more de- Medicine,than to any of the other professions.
serving He to take men oat of the sphereof personal occupa-
tion,
would layclaim for eminent superiority, and for and to directtheirthoughtsto objects which
the veneration of the world ; while,by the
Order of Merit to be grantedby Government, tend to calm and elevatethe mind. Who can be*^
progress of knowledgeand civilization, medicine, some
to such distinguished themselves in Medical hold (said the speaker)
havingenlarged the circleof its utility,has become as the gorgeous draperyof a
in rank ; that law has gainedan ascend-ancy Science. goldensunset,or the variegated colours decomposed
degenerate
in proportion- as it has lost its early plicity.
sim- In the removal of Professional evils, society by the common prism, without pleasure ? Who can

The instrument has become a machine, would not render aid, unless the Profession it-
selfbe indififerent
to the delicate traceryof masses of

ponderous and unwieldy,and has ceased to be the rooted them out purgingthemselves of the ferns,
" of heaths,or to the grandeurof the sturtly

; and
justice
tribunal of impartial in the same gree imputation
de- of littleness, themselves on
and throwing oak,the gracefulsweep of the willow,or the light
have the conventional laws the
of its professors, highest of their Art. Pointing
resources to the pencilling of the ash, the undulations of distant
"

iheir learning and education obtained an ancy

ascend- grandestdiscoveries in generalscience,or to the hills, or the more sublime form of ponderous clouds
in the world immeasurablysuperior
to those deductions of the profoundestphilosophers and ma- againstthe blue sky, or, as theymay be, fringed
thematicians,

of in
medicine, the estimate of truth receding
"
Mr. Skeysaid,that in the limited circle with light reflectedfrom the sun, or the broad ex-
panse
"

value in proportionas the world advances in civilisa-

tion. of our own Profession we may boast names and dis-
coveries of the boundless ocean ? the relish for such "

The profession of the law at the presentday not inferior,and which greatly exceed them enjoymenthas a tendencyto adorn the acquisitions
exhibits as great a prostitution of intellectas was in their intrinsic value, if gauged by their sub-serviency
of the student,and he may be said to breathe a new
ever imposedon the human understanding ; and it to the happiness of mankind ; and in jus-
tification
existencein the novel associationsof every day and
is for the mind, imbued with a love of this statement, the speaker noticed, in hour. The aptitude for such studies is possessed
impossible
of truth,to witness the mock display torial succession,
of gladia- many points in which the studyof Medi-
cine in various degrees of perfection duals
by differentindivi-
talent shown in our Courts of Law without had proved, in the hands of some of its ments,
orna- ; but the germ is in all,and, by earlyculti-
vation,

regretting that there the highest i ntellectual

powers the handmaid to health and happiness; it may be made
"
to perceive and enjoy
are enlisted in the cause of moral degradation, and discoveriesworthyof any age or any science,and the highest artisticpowers, from the simplebeauty
a smile of contempt, or shed a tear
either indulge benefitingalike the peasant and the king. In of an arabesque,
to the sublimity
of geniusexhi-
bited
with the philosopher the remuneration
of Ephesus over the vices of a considering of our Profession, he in the Theseus and other adornments of the
redundant civilization. It is matter for rejoicing, not lose sight
did of the fact,that the necessities of greattempleof Athens. The studyof the sublimity
that the mind and the habits of the Medical man increase in
society to its
proportion
inability to com-
pensate of art must always exercise
a influence
refining
are constituted,with
differently " truth as his field us, " that poverty is the very
nursery of over the character ; and that man was to be pitied
of action,good his aim, and the world his and
study.disease, Hospitals,
that inDispensaries, or in who could see unmoved the marbles of Nine- veh,
The dutiesof the Professionof Medicine have dency Unions, a iftrge
a ten- portion of our time is devoted to the without attaching to them a sacred cha-
racter,
to keep alive the best emotions, and a reliefof human suflering. We may justly boast of forming,as they do, the great link of
warm sympathy with the sufierings humanity.of our noble and
hospitals infirmaries, erected by the evidence of the Biblical history of a former world.
Stillthe practice of thelaw is regulated by a sense of benevolence of private individuals. The practice of A man's taste.for what is elegantand his right
decorum and even of refinement, which in a far less charityis stampedupon the national character. In moral conduct,are one and the same sense, ing
operat-
degreeare practised by the Medical Profession. the Hospitals of the Metropolis about 300,000 per-sons on the s.ime subject,a love of beautyand pro-
"

priety,
In the next place, the stait ofthelaw has an im- portant annually obtain relief from suffering. But what extended to all intellectual exhibitions.
influencein depressing the rank of the fession
Pro- would tliese endowments be but for the active What Mr.
(said Skey, conclusion)
in are the sites
requi-
of Medicine. On this point Mr. Skey re- marked, agency of our ProfesRion? The Medical mind of your Profession ? Tested by the claims ;

that the general bious infuses a spirit'

Practitionerwas an amphi- of life into the otherwise of other Professions, could it be said that our duties
link between a profession and a trade,and, in inanimate body, and is thus the instrument of demand a lower standard of moral excellence, are "

itsexercise, the law awards him a tardy, haps incalculable good to thousands
and per- the pride of vir-
tue, we content with mediocrity ? Or, rather,does any
"

questionable remuneration a system fraught

"
and the boast of the world. Without doubt,tlic pursuit demand a higherorder of intellect, a deeper

with the greatest evilsboth to the Pwfession and to motives dictating these services are composite in fund of moral courage, a greaterboldness in action ?

soeiety.The law awardingpayment for physic their nature ; still, the world is our debtor,and we The medical man is,under Providence,the arbiterof
only,the doctor disposes of as large a quantity as feelthat we have some claim for an honorarydis- tinction.
human life. Ars corporis
"
curandi tuendique,
is consistent with the capabilities of his patient. The Sovereignencircles the warrior's atque utilitasDeorum immortalium, inventioni est
The question is,how much of this physicwill repay brow with the victorious wreath ; his bruised arms consecrata." A pursuit which, in its very infancy,
the daily lossof time of the medical man ; while,in are hung up as monuments of glory;and it is per-haps was esteemed so greatas to claim descent from the
many ca";es, it is difficultfor him to be remunerated natural, that the Professors of Medicine, gods,and is so interwoven with the welfare of every
but by actual dishonesty. If the law does not devoted to the purpose ofextending human existence^ member of society, and on which even oui national
 114 THE MEDICAL TIMES.
slight congestion of the vesselsof the piamater / and
headaohe.
ptomatic In thiscase, however,the con- tinuance anxious ; the tongue, dry and cracked in the centre,
wasiyoistat the edges;the abdomen was full and a few more red points than usual in the white sub-
of the headache appeared to be sympathetic,
The consistence of the organ wa* normal
or dependent on thestate of the stomach and liver.It resonant, there was no tenderness nor gurgling ; stance.

there had been two or three relaxed stools during the throughout
disappeared when the vomiting ceased. The cessa- tion
The iflfyiw
,
and irqtAea weje healthy
, "^ .
"
in all parti-
preceding twenty-four hours,from a dose of castor
of the vomitinprf and the consequentdisappear- thirst oulars.
oil; there was po appetite, some .

aaee of the ]|eadaohe" was probablydue rather to The pulsewas lt(), and possessed some power ; the Rightfa"^." There were no adhesions and no flmd
the wine thap to the hydrocyanic acid. Vomiting 40 in the minute, quiok and short; in the pleura.The most depending part of the pos-terior
respiration was
m typhm fevpi^mmcoompanied by tenderness at there was a littlecough,and some sonorous and portion of the organ was dark red,flabby ;
contained much thick dark bloodyserosity, and little
the epigastriom, often ceases at once on the admiqi- sibiloiurftlesof er the whole chest ; the percussion
rather too readily
"trationof stimulants. Louis,speaking of headache note was normal,and therewere no abnormal heart air; sank in water; broke down
under the finger. This abnormal condition ex- tended
in typhoid fever, says, that its cessation, when de- lirium sounds. ,

spotted
,
the about 1 in. into the substance of the lung.
or somnolence supervened, could not be The skin was hot, dry. and ; spotswp re
L0 fang" The pulmonary and costal pleura wore
attributed, in all cases, to the imperfect perception rather numerous, of a dullpinkhue ; on the abdomen
united throughout their whole extent by old
of the patients, because thev often complained of and chest were many a quarter of an inch in diameter,firmly
but flaton the surface; theirshape adhesions. The morbid appearances
resembled thoee
pain)n other of the body when they declared slightly elevated^
parts was somewhat irregular; they were effaceableon described In the opposite lung,but were rather more
tl^ey had no headache. This is true of typhusfever, resumed their extensive.
pressure, but previous appearance ^ ,

(indI may remark,that,on the firstcommencement when the pressure was removea ; on the arms were The branehiql tubescontained much frothymucous,
of the delirium, the patient, while declaring he had some and theirlining membrane was rather more vascular
very small,half a line in diameter, and not
at that moment no pain in the head,will add, but elevated; there was no eruptionto be seen yesterday. than usual.
'*
I have had terribleheadache." The truth of On the 9i" day qfdmate,the slight anxietyin the The peHottrdsum. which contained about one ounce
Louis's remark is confirmed by the fiiot, that in expression, observable on the 7th,had disappeared, of transparent yellowserosity, was healthy.
The heart was somewhat flabby,but otherwise
meningitis, the patient will complain bitterly of and was replaced by a dull,heavyaspect Tae con- semi-fiuid dark blood,
still imected,and the normal. It contained a little
headachewhile talkingin other respects, most in- junctivie
coherently. were more eruption, of aU",probably duced
intro-
which disappeared under the finger on the 7th day, frothy from the admixmre
in the act of openingthe organ ; large dark
2nd. The continuance of ^he delirium after the
now onlyfaded on pressure ; that is to say, the spots i n both auricles and in the large veins at the
grew paler, but could not be effaced; fivegrains of coagula
fallin the pulse, and generalimprovementin other root of the heart, and largefibrinouscPHjWla ing
extend-
sesquicarbcnate of ammonia every six hours weresub-
respects.This symptom is not a very frequent one. stitutedfor the tartrate of soda. In the evening she from the ventriclesinto the aortu and pulmonary
contvpcd much fluid
When present the delirium generallydisappears became very delirious, and continued so at intervals artery.The descending aorta
aftera profound till the termination of the disease. On tl^ l(Hh day and dark semi-coagulated blood.
sleep.Like some of the oases pre- viously The and healthy.
detailed, this man became deaf about the the headache had disappeared, nor did itreturn; the aesophapu pharynx were
The stomach ^9A normal in allparticulars, ing
except-
termination of Uie second week. flush of the cheeks was purplish.The debility was
minute injection of the cardiac extremity.
so great thatshe could not turn in bed,and had to be
some
Case 21. Trifling
"

sense of illnessfor a fortnight The large and smaU intestinescontained much

liftedout when the bed was made. On the parietes
r" sud4en debility^rigors "
on 6th day headache
" "

of the abdomen were two brightpurple spots,round, flatus. Their mucous

membrane was palethrough-
out;
distiurbanceof mental functions, at firstconfusion and unaffected by pressure, t. e., pete- its consistence and thickness being ^rfectly
not elevated, chia.
found with difficulty.
only,then delirium muiberry-rash "
on 7th day- The pulsewas now 130; the bowelsrelaxed.natural. Peyer*s patches were

"
somnolence "
"
I
heaviness of expression^muddy i.e,, threeor four relaxed stoolswere passed daily. On There was no enlargement of the meseniertc glanOM,
hue efface tongue dry,brown, and finally
"
black " the lUh day somnolence commenced; 'and. for the The Uver was flabby,and sowjwhat softer than
tendernessof the natural; otherwise normal.
confined bowels fulness and tenderness of abdo-
" men firft time, there was slight andomen, " ". ,
containedfrom 2 to 3 ot of pale
,, "

and the following note respecting the spots was The gaU'bladder
^rapid
"

pulse extreme piostration

" " death on number of small gall-stones
"
The centres of some are unaffected thin bile,and a large
the 20th day non-granular
"
consolidation of the made : "
spots of inspissated bae);.its.lining
by pressure the circumferences ol which fade,u e., (cholesierine with nuclei
most depending partof the lungs increased vascu- larity
on pressure.Other spotsare lessaffected membrane was normal.
"

of the Imingmembrane of the urinary blad- grow paler than Paricreo* healthy.
by pressure before." On the next day the
4er other organs normal.
"

urine and stoolswere passedinto bed unconsciuusly.The ^leen weighedonly5| oz. It was flabby,
but
did not break down with abnormalfiicility ; its colour
Mary H., "ged 44. A stout, dark-coraplexioned The prostration bepame extreme : her cor\junctivae
a widow, the mother of three children,
woman; the stillmore injected ; she dozed almost constantly ; was natural.
twelve years old,all living. Her mother the duskyor muddy hue of the face grew dailymore The kidneyswere large, but healthy?
Soungest
led when very young Her fathera^ed 70 ** of old intense ; the tenderness] of the abdomen more cided,
de-
Unnary bladder." There was minute capillary
jection
in-

age;" a native of London; of sober habits; night- and etpedally marked in the hypogastric re- of the whole liningof this organ, especially
nurse at the London Fever Hospital. From tne 16th day of disease till her death on intense on itsanteriorsurface.
Pr"vhu8 Healik.'^She stated, that,althoughnot the 20th day the urine had to be removed by The uterus and ovaries were not removed ; they ap- peared
very strong,she generally enjoyedhealth ; ceased to catheter;its quantityvaried from two to three as seen in situ healthy.
menstruate at forty-cwo. She was once, many years pintsdaily ; it was acid, and contained a few crystals
confined to her bed,in consequence Tlie reader's attention is especially directed to
tinee, of an in-jury of uric acid; itsspecific gravity was 1016.
to her back,and once since that time from On the 16th day she lay on her back immoveable the progress of the spotsin this case ; their three
^ its
lumbago." The other nursss stated, that she had, constantly sleeping, (said, when roused,that she felt stages; the continuance of the same spot,from
^urinffTierresidence in the Hospital, frequently much better;) her mouth open; cheeks sunken: firstappearance tillthe termination of the disease
complained of painin the back,ana was in the habit tongue dry,baked,black ; her bowels were conflned,andin death and, finally, the persistence of the spots
;
of
sleeping
witn a pillowunder her loins. Seven she took 3 drs. of castor-oil. On the 18th day therewas after death. In order to direct attention to the
.
yean smce was cuppedin consequence of headache, mutteringdelirium when aroused,and she generally same during its varyingphasesbefore and
to which she is subject She suffers, more or less lay in a semi -comatose state. The pulse had risen to spot
afterdeath,a circleof ink thus O was placed around
"onstantly, from cough,accompanied with expecto-
ration. 150,and wasVery feeble.There was abundant mucous
rftleoverthe anteriorsurfisceof the chest She was too several when first seen, f.e.,when theydisappeared
PresentJttaek.'^On the eveningof August 22nd, prostrate to be raised for the purpose of examining on this mark was changed into a mond
dia-
pressure ;
1849,she was exposedto wet ; from that time she the back.
felt slightly unwell,thoughunable to state any par-
ticular She died on the 20th day of thedisease. ^
thus when the spotsfisdedonlyon pres- sure
symptoms. Her bowels were regular, and 4 02. of wine were givenon the 11th day, and in- creased ; thisdiamond was surrounded by a square,thus
she had no headache. On Monday, Sept.6, she felt to 6 oz. on the 14th day. A pint of porter
unaffected by pies-
decidedly worse, and during the night was too ill to was added on the 15ih day. On the loth, 2 pints of Pl
when the centre was
while a simple
assistthipatients eyento a little water, althoughshe poiter,8oz.ofwine. and 1 oz. of brandy were nistered.
admi- sure, and the oiicumfisrence faded ;
stillsat up. At thistime she had neither headache,
vertiffo, singing in the ears, nor epistaxis, her The examination of the body of M. H: was made square, thus Q
indicated the spotsunaffected by
bowels were connned. On Sept J^th she took to her 50| hours after death ; the weather was daveric pressure. Without some
cool ; ca- such contrivance it is impos-
sible
bed, on the 8th had an emetic of ipecacuanha, which rigidity was well marked ; there was no ap" to feelconfident, tliatthe same spotis observed
producedcopious vomiting of bitterfluid, and acted of decomposition, and no emaciation, on succeeding days,or that particular spotspersist
on her bowels. On the 11th she had some rigors, ?earance
for 'here was 1| in.of fat on the abdominal parietes. after death. The tendernessof the hypogastric region
the firsttime. In addition to the emetic,she had On the anterior surface of the trunk, the spots
was explained by the conditionof the bladder. The
f^ken before I sa^ her some simplesaline efier- marked duringlife by ink, to indicate that they abnormal vascularity of that organ could not have
vescing mixture, t. e sods sesquiparb.
, and acid,tart faded or grew paler, without beingobliteratedon
been due to the retention of urine,because that
When she came und^r observation, Sept 12th,i.e., pressure, were stillvisible as pale reddish- brown 16th day of
the seventh day qfdisease, the symptoms were as fol- lows stains;of those marked in such a manner as to in-
dicate symptom did not appear tillthe 15tlior
disease, while the tenderness was firstnoted on the
t"Decumbency dorsal, unconstrained ; twicp that the circnmference faded,while the centre
duringthe nightof the 11th she lefther bed un- was
assisted, unaffected by pressure, the latterpart retained 11th day. The urine,it may he remarked,was, as
but was, at the time these notes were taken, the appearance it presentedduring life; the former it usually is in typhus fever, quiteas abundant as
of
quiteunable to assistherselfon to the dose-stool, or resembled the pale reddish-brown stains above in health,and acid. The presence of a deposit
even to situp in bed unsupported. There had beep described ; while the spots which,dming life,were uric acid is worthyof note. Its specificgravitywas
no delirium,and she answered question^ rationally, entirelyunaffected by pressure, t. e., the petecbiae, but not abnormally, low. The sonorous and
rather,
l)Vlher memory lyas rather defective, aqd her mind preservedthe charactersdescribed as belonging tp
sibilous raleswere probably proper to the chronic
generally rather dull. She had had some sleepthe them before death. The traces of the spotswere appearedto have
bronchitisfrom which this woman
preceding night,undisturbed by dreams. There was much more distincton the inferiorthan the superior
sufferedbefore her.attack of fever. Peyei's patches
a little frontalheadache ; the coi\junctivae were slightly portion of the lateralregions ot the trunk ; while on
in
and the mesenteric glands were, as theyalwaysare
ipjected, the pupils normal in appearance ; there was the back theywere of a deeppurple colour.
DP deafness, singbffin the ears, nor vertigo; the Head. There was
" a littlecolourless serosity at fever, accompaniedby the mulberryrash,perfectly
Here flushed) the expressionwas the base of the brain,
slightly and in the lateral ventricles; healthy, a nd the whole gastro-intestinal raucous
 THE MEDICAL TIMES. 115

membrane in a state that completely excluded the various sorts of forceps for extracting balls,I used, the mode of fighting was from one side to another, "

idea of this havingbeen,in any sense of the word, a with some modification, those invented by Balassa, so that lai^e portions were often taken away.
case of gastro-enteritis. It is not usual for the ca-
davericand in many hundred cases with great success. A Immediately after the battle of Thaz, a Uhlan,
rigidity to be well marked,so many hours handle like a pairof scissors; blades half round; only22 years of age, was broughtto Passa,both his
afterdeath from typhusfever. the fiat surfaces closing upon one another,with parietal bones cut clean away by a sharpsabre ; one
The lesion of the li^ngs was that which is so fre- extremities rough,like a pairof dissecting forceps.nangingstillby a piece of muscle ! At the battleof
qocntly f ound afterdeath from typhus fever,i.c, non-
granular
WOUITDS.
Teth, a soldier, 82 years of age, got three incised
consoUda(^pn of their most depending cuts on the head,which,forminga triangle, lefta
parts. That accidental position is the determining Incised wounds occurred very often among the piece of bone separated from the rest of the skull "

of the consolidation appea^rs to be provedby men of the Hungarian,Russian, and Austrian

cause insulated, as it were ; it was quite moveable, and seen
the that the unless it involves armies. No one part of the body could be excepted, to risewith the
fact, solidification, pulse of the middle
meningealartery.
where these, superficial or deep,did not occur.
some depthof the pulmonarytissue,is limited to On July11, 1849,a Honved,19 years of age, of
The brain escaped, as if by miracle I and he was
the most depending part of the inferiorlobe ; the well in nine weeks.
the 45th Foot, was broughtinto the Hospital of Incised wounds seemed to heal sooner in winter
extreme apex, base, and root of the lung stillre-
maining

crepitant; t. e., the consolidated part lies

Passa,after the battleof Oxoma, whose leftthigh,than during the summer. If I hazarded an ex-
planation,
in the hollow formed by the fourth, and sixth
fifth, along the vastus extemus muscle,was incised from itwould be, perhaps, that in the former
ribs,between theirtuberclesand angles; that it is the trochanter migor to the knee-joint This wound,
season, after the retractionof the bleeding vessels, a

not due to cadaveric congestion is provedby the half an inch in depth, was made by the lance of an
proper coagulumwas at once formed,which afforded
Uhlen. After sufiering from the wound duringfive a bond of union.
frequency with which physical signsindicativeof its Not so in summer ; the general
existence can be detected duringlife. days,he was attacked by cholera,and died. relaxationof the entiresystem prevented the healthy
Death in this case After the battle of Teth, Cuirassier was brought If
could not be ascribed to the a
process by the "
firstintention." largevessels
condition of the longs; the lesion of those organs into hospital, with an incised wound across the back, were
injured, itwas the best mode of proceeding to
was too slight, and of too small an extent,to account more than half an inch in depth;a suture was pliedtake them up at once, even
ap- if it was necessary to
for the fatal termination. In fact,there was to bringthe parts together. In longitudinal Continued
no make a wound higherup to tiethem.
lesion revealed by the scalpel which could be re- garded superficial
wounds, even an inch in depth, union was
pressure, indeed,on the vessel,duringa coupleof
as the cau^e of death. It is not common for accomplished. with the greatestcelerity, the blood hours, sufficed to in many
stop the haemorrhage
to survive tillthe 20th day of typhusfever, itself quiteplainly the firstbond of union. At the battleof Hatven, a Cuirassierarrived
patients cases.
and then exhibit so little A Hussar,who wore his dressings all throughthe at the whose shoulder
localmorbid changeafter hospital, left was openedat
death. battle of Czoma, (11thJuly,1847,)was brought the joints by a sabre. He was lyingin the same
The lengthened into Hospital with thirteen incised wounds, made by of whom, as it
duration of the disease, conjoined wagon with five dead soldiers, one
with the totalabsence of anythingapproaching three Cuirassiers, who set on him ; his continued
to a happened, lyingand pressing heavily on the trachial
lesion of Peyer'spatchesis important, for certain movement duringthe encounter explained the cause
artery,preventedhaemorrhage.The momeni he
German writers have asserted, of the wounds on each side. He received two cuts was removed from the fatal hoe-
that the cause of wagon, however,
Peyer's patches beingunaflTected in typhusfever with between the shoulder bones ; two between the fifth morrhage set in.
esanthematous rash,is the early periodof the dis- ease and sixth ribs of the right side ; two on the exterior (To be continued.)
at which such cases of the thighof the leftside ; and another alongthe
prove fatal signifying
"

that time sufficient for the deposit in those organs inferior part of the vastus extemus of the right The
OXALIC ACID
does not elapse between the commencement of the onlyapplication was cold water, and a few plaister DEATH BY TAKIl^G ;

disease and death. Now, as I have said,this case strips, removed after three days; all his wounds DETECTION OF IT IN THE HEART;
did not prove fatal tillthe 20th day of disease,were healed on the sixth. It was generally cient SMALL
suffi- PORTION OP FREE ACID IN THE CONTENTS
to bringthe wounds together, and to sustain
(Cases5, 8, and 22 survived the 20th day,)and OF THE STOMACH.
there was them in situ with strips of plaister, that were never
no deposit i n the glands, while 1 shall By H. OSBOBN, Southampton,
have hereafter to refer to a case of typhoid fever in renewed. In deeptransverse wounds of the upper
which the deposit and back partdf the thighwe could most readily A few weeks since a about 20 ^cars of
was very abundant on the fourth woman,
day of diseasei(a) and others which provedfatal,bringtogether the divided surfaces by bendingthe
age, residing in this town, determined to destroy self
her-
with very extensive ulceration, limb at the fore part, course, by extending
of i t.
longbefor the termi-
nation ; by takingoxalic acid. It appeared, firom the
of the third week. These cases, in con- The chief difficulty layin approximating the edges evidence, that death took placeabout twenty mi- nutes
of wounds when they occurred on both sides; in
jnnctionwith the one I am here considering, and or half an hour after sendingfor the poison,
Cases 5, 8, and 22, which survived the 20th day of these even sutures were of littlebenefit, and union and before medical assistance
was procured.
disease, appear to me conclusive against the argu-
ment by the firstintention almost impossible. Mr. Ware, a surgeon, beingsent for,performed a
The 30th December, 1848." Going to Pesth,I
adduced in support of the identity of typhus post-mortemexamination,by the request of the Co- roner,
and typhoidfevers, founded on the assumption that met on the road a body of recruits, joining head-
quarters. about forty hours afteydeath. On opening
nature does not allow time enough before death for. Havingfollowed them a quarter of an the stomach, this gentlemanfound about three
the deposit to take place in the agminatedand me- senteric
hour, T got off my horse to walk, it being ex- tremely
ounces of dark-coloured matter, lesemblingcofTcc
cold ; suddenlyone of them, havinghad and the coats of the stomach and duode-
num
glandsin the latterdisease. grounds,
a dispute with his comrade, took out of his boot blood.
[To be continued.] were highlyreddened from congested
a huge Bursch knife (an instrument not unknown The membrane of the stomach was ened,
soft-
mucous
in Germany) and made a cut at him ; a trans- verse friction.
and broke up with the slightest
SURGERY OF THE LATE WAR IN wound through the deltoidensued : the intense From these appearances, Mr. Ware requested me
HUNGARY. cold prevented my sewingitup ; plaisters were pliedto analyse
ap- for the suspected noison. I first tested
By Dr. 6LUCK, Sargeon-ln-"hief to tho as well as could be accomplished, and in nine the contents of the stomach with litmus paper,
Huogtritn Hussars. daysit was perfectly healed. when I was surprised to find onlya trace of acid
In the battleof Hatran, (April6, 1849,)I had to re-action, the paper remainingin contict several
(Continuedfcom page 76.) attend many Cuirassiers who were wounded by seconds before it became reddened. As far as
Of medicaments, we had at all times enough, our Nicolaus hussars. The rightshoulder of one could be ascertained, there had been no vomiting,
with the exception of quina,which was
very much young cuirassierhad a long transverse wound, and excepta little frothy matter which exuded from the
used in Hungary, but of which we were sometimes another along the outside of the fore-arm. Having mouth, consequently, the whole of the poison could
in want; tiien employed tinct. lobeliae with tied the bracnialis,
we I tried to sew the edges; but not have escapedby this means, and if vomiting
great benefit. the lossof blood was considerable, and,during hasty had taken placeimmediately
a aftertaking the poison,
INSTBUMENTS.
retreat,he died. life would probably have been saved,or, at least,
From May, 1848, to October,of the same year, In incised wounds, made by sharp sabres,the prolonged. I suspected, at first, that the acid might
we were very well furnished with allkinds of instru^ haemorrhage healed sooner have confined yriih alkali, alkaline eartli,
was very great; but they some or
ments, which we obtained from France and Austria. than did not appear to show
contused or puncturedwounds, in which but a fiiruierinyestigation
After the boundaryhad been closed,however, the and no antidote
there was littlebleeding.Incised wounds of the that much, if any was neutralised,
raised army were deficient, but this deficiency was the contents in
in some
scalp,if no remarkable contusion was present,had been administered. On boiling
measure supplied by those made at Pestb, wanted littlebut distilledwater, the litmus paper became immedi- ately
and later at Nagy-varad.After havingtaken Pesth proper adhesive dressings. The
incised wounds of the Honveds, who wore hats, reddened,and the filteredliquid gave a small
and Buda, we were supplied by instrument-makers, or a sort of round bonnet, and those of the precipitation, with a solution of sulphate of lime
who^ providedthemselves firom France and Vienna. huge helmeted cuirassiers, difTered in this parti- cular,presenting the appearance of oxalate of lime, in- soluble
Besides the usual instruments for amputation, and that those'of the latterdid not heal so soon, in acetic acid,soluble in nitricacid. A so- lution

(a) The preparation of the intestineof thispatient

because almost alwaysaccompaniedby contusion of (sulphatecopper produceda
of turbid pearance
ap-
from the pressure of the weightyhelmet It oc-curred and no precipitation until after evapora-
tion,
was sabmitted to the PathologicalSocietyby my of a
friend, Mr. W. H. O. Sankey,M.B. I was very often,as at Altcnburgh,that the when a heavy powder was deposited
present dead from blucish or greenish white colour. The upper layer
indebted to cuirassiersfell simple concus-
at the examination afterdeath,but am
down sion

him for the particulars of the ease. The patientwas of the brain caused by the mere blow of the of the precipitate contained organic matter, which
npder the care of Dr. Tweedie. I have thisweek sabre. Among the Uhlans, again, whose heads were was poured off,and the residue well washed with
examined the intestines of a subject, dead from defended by a slight helmet, besides mere incised distilledwater, until all soluble matter was moved.
re-

tvpboidfever,which exhibited extensive deposit in wounds, I often met dreadful cases where the scalp The suspected oxalate of copper thus ob- tained
Peyer's patches on about the 10th day of disease. was cut away, and slicesof the diploe of the bone, "
was difiRised in distilled water, and sulphur-
 116 THE MEDICAL TIMES.

etted hydrogespassedthroughthe liqmduntil the and doughyon the occiput and right side, with very clysters, and taken some openingmedicines without
gas ceased to be absorbed. After separating the great swelling over the right temporalmuscle ; and effiict ; no attemptshad been made to return the in- testine.
of^
salphuiet copper by filtration, the liquid.re- quired immediately behind the rightpanetal eminence was The house surgeon, by exertinggentle
eyapor"tion and a second filtration, when it observed a contused patch,of the size of a half- pressure for four or five minutes, succeeded in re- ducing

became colourlessand acid. On applying the three crown. the tumour, and the patient havingbeen
tests,sulphate of lime precipitated oxalate of lime ; As death seemed inevitable if no operativetransferred to Queen Ward, shorUyafterwards had
sulphate of copper, the greenish-white oxalate ; and measures were undertaken,Mr. Lloyd,with the a healthy and copious alvine evacuation,and ex- pressed

nitrateof silver, a white precipitate which fulminated concurrence of Mr. Wormald, at once proceededto herselfas beingfreefrom pain.8 p.m. "
Has
when dried. make an incision throughthe contused patchof in- teguments,
no pain; bowels have acted againtwice; feelscom- fortable.
The precipitate obtained by lead was decomposed exposingthe bone denuded of its peri- cranium.
with hydrosulphate of ammonia, but,owing to the Posterior to the parietal protuberance On the following day,at noon, it was foiud that
presence of animal matter, the solution was not so there was found the termination of a fissurethrough a sense of sickness had returned; the abdomen
readily obtained in a state of purity, from the which
plication
ap- blood was constantly oozing, a nd which was was tumid, tympanitic, and tender ; countenance
of the tests. traced forwards sinkingtowards the base of the anxious; features pinched;pulse 140 and small;
A portion of the stomach,intestine, and contents skull,in front of the zygoma. The fissureitself tongue dry.
were boiled in a solution of carbonate of potashto was, in many parts,so wide as to admit the finger- nail, Upon examiningthe case, Mr. Lloyd feltan in- distinct
remove any of the add existing in an insoluble and in its course were presented one or two tumour in the femoral region, like a half-
state. The filtrate was saturated with nitric acid, irregularities, like spiculse of bone. The tissues emptied cyst,and in concurrence with the opinion of
filteredand treatedwith solutionsof acetate of lead around were loaded with extravasated blood,but Mr. Pagetand others, decided upon cutting down to
and copper ; the precipitate obtained by the former the pericranium was detached only opposite the examine it,although from the severity of the symp-
toms,
was decomposed with sulphuric acid,and the latter external bruise,and as there onlywas blood oozing, and the greatprostration of the patient, there
with sulphuretted hydrogen,but the quantityof it was chosen as the proper placefor the application could be but little hope of relieving her.
acid extracted by the potashdid not exceed that of the trephine. Operation, "
After dividing the integuments by
which was obtained by boiling in distilledwater, A pieceof bone of the size of a shilling was taken pinchingthem up, there was exposed a mass re- sembling

consequently, an insoluble oxalate could not have out, itscircumference bordering the Assure,and the a piece of omentum ; but, upon cutting
existed^A piece of the stomach,afterbeingwashed brain,deprived of its dura mater, was exposedto deeperthan this,there was found the peritoneal
and boiled m the solutionof potash, and treated as view. Upon making gentle pressure with the finger, sac ; on openingthis,some matter of an ofiensive
before, gave a trace of the acid. a small quantity of half coagulated
" blood came out, odour,like fluid from the small intestinesescaped;
The heart was lastly examined, but this and the same resulted from a repetition of the no intestine nor omentum was seen ; the ringwas vided,
di-
organ
was not removed for chemical inquiry ; it appeared pressure, tillat length the brain,which previously and the wound leftopen. At 7 p.m. she sank.
quitehealthy, and, after beingwashed, was cut in felttense and resistant, became much less so; but 1^0 post-mortem allowed.
small pieces, boiled for some time in carbonate of the more to facilitate the escape of blood,a triangular Remarks. "
In the absence of information, which
potashwater, and,when treated as before,gave the pieceof bone was taken away by means of Hey's an examination afterdeath could alone have sup- plied,
same turbid appearance with solution of sulphate of saw (the fracture forming side of the triangle it to that previous
one seems
necessary suppose,
copper, and a precipitation on evaporation. The and the anterior margin of the circular opening to the reduction of the hernia, processes had been
oxiuicacid was ultimately extracted in a pure and another side) by which means exit was givento three set up, which subsequently terminated in perfor- ation
crystallised state in a watch glass, and, when re- or four ounces of semi-fluid blood ^e blood wel-
"
ling of the intestines, speedily bringingon severe
dissolve1, produced the characteristicprecipitate out each time pressure vras made on the brain. peritonitis, with characteristicprostration ; a part of
above described. In some cases of poisoning with The pulsewhich, previous to the operation, had the escapedmatter getting into the femoral canal,
oxalic acid,the blood has been found free from the become very small,seemed to recover itself, coming
be- and exposed in the course of the operation. Had
poison, but the blood, in this case, was not keptfor more frequent soft, and and the the
breathing swelling, which was felt, provedto have been a
examinaton. less stertorous ; but no material reliefwas obtained, small pieceof the intestines, held by adhesions to
The chief objectin publishingthis case of and, as there exuded with the blood, masses like the ring, (asoccurs in many cases,) by establishing
poisoningis to "ow,that death may be caused by broke-upbrain,it was suspected that more mischief a free external openinga happierresultmighthave
oxalic acid and itspresence be too small to be de- tected had accrued than mere extravasation. The pupilsbeen anticipated, and the discharges containing
without minute investigation, owing,to ab- lemuned
sorption, the same ; breathing more stertorous ; cir* some blood.
or other causes. Had the quantity been culation failed, and at nine p.m. he died.
estimated it would only have amounted to a few Sectio eadaueris fifteenhours after death. The "

grainsin the whole. There was, however, every fracture extended from behind the parietal nence
emi- KING'S COLLEGE HOSPITAL.
proof of the acid being taken as far as stantial
circum- forwards in a groove formed by one of the
evidence could testify; not only was the principal branches of the arteria meningeamedia, On Saturday last Mr. Fergussonperformedtwo
possession of ittraced to the deceased, but a witness towards the zygomaticfossa,and ending in the operations of importance : lithotomy and amputation
provedthat an attempt had been made the same greaterala of the splenoid bone near to its root. at the ankle
joint
afternoon to drink a solutionof the poison
tion. Dura matter lacerated at the part corresponding
in ques- to The firstcase was one of a somewhat unusual
The finding of a small portion of the poison,the separation of the pericranium externally, with character, somewhat dififerent
requiring an operation
together with pott-mortemappearances, should at all great efiusionof blood on the right side,between the from that usuallyput in force by Mr. Fergusson.
times be sufilcientevidence to account for death, brain and dura mater, chiefly in the anterior and There was here a stone in the bladder,combined
although, I believe counsel sometimes require the middle fossae ; also on the outer surface of rightwith a bad stricture of the urethra,and abscess in
chemist to discover the quantity required to cause hemisphere. The substance of the brain seemed the perineum. The patient, had
an elderly man,
death,and thus to frustratethe ends of justice. firm and healthy, except opposite the seat of the been sent into the hospitalfor stricture of the
chief hsemorrhage, where it was extensively ened urethra simply,under which he had
soft- laboured
and broken down. several years. Latterly, however, there were some
HOSPITAIa RBPORT8.
Renutrks, This case presents us with a well-
symptoms of stone, and, when an instrument was
"

ST. BARTHOLOMEW'S HOSPITAL.

marked exampleof a definiteclassof cases of injuryenabled to pass into his bladder,it was discovered,
to the head,in which an improvementin the circu- lation, that a calculus was there. Dilatation of the stric- ture,
and a return to consciousness, are the har-
bingers which was situated at the bulb, was carried
CONCUSSION FOLLOWING A BLOW ON HSAB
STMPTOIIS
of symptoms, sealing, but too the
surely, on, but it advanced somewhat slowly,and, as this
OP OOICPBX88IOH BUFJUiVMUJIO AVTIB
"te of the unfortunate sufiferer.As to the propriety was the case, and the patientextremely anxiona
of an operation, it appeared thatthere was a chance, to have the stone removed from his bladder at once,
"
Hedges,a strong,lusty-looking man, aged however unpromising, of relieving the compression^; Mr. Fergusson determined to so modi^his mode of
75, was admitted under Mr. Lloyd into Colston and the evident external contusion,the separation operating as to divide the contracted canal, and
Ward, Jan. 29, 1850,havingbeen knocks down by of the pericranium, and the escape of blood fiK"m at the same time cut into the bladder and take
a cab half-an"hour previously. When broughtto one partof the fracture, allpointing to one spot,left out the stone. The proceedingwas plished
accom-
the Hospital he appeared as one that was recovering but littleroom to hesitatein the choice of a part at in this manner: " A small groovedstafll^
fhim concussion ; attempted to getoffthe stretchei^- which to open the skulL (No. 6,) was introduced through the stric- ture
bnsied himself unnecessarily about his stick and into the bladder; an incision was then be- gun
STRANGULATED FEMORAL HERNIA
shoes" and insistedupon beingallowed to sit on in the perineum, higher and more in the
up REDUCED ON THE SIXTH DAY. up
a chair. Pulse somewhat accelerated; left pupil PEBISOXIKEB GBMAT PnOiTKAT10H--OnRAnOH centrallinethan Is usual in the lateral operation ;
WITB
oontracted, the right dilated. After havingbeen in AMD DEATH. this was carried down on the left side to near the
bed a short time,he ralliedfrom these i^mptoms in A tolerably healthy looking woman, aged45, was anus, and another incisionwas made from the centre
a measure, and gave his name and address accu- rately; broughtto the surgery on the morning of Mon- day, of this by the right side. The knife was then car- ried
but about two, p.m. (three hours after the January28, 1850, with a small femoral hernia, deeplydown upon the groovedstaff, and the
accident), another train of symptoms supervened ; which had been strangulated ever since Wednesday stricture was freely divided. A beaked knife,with
his breathing became stertorous; there was total evening. a cutting edgeon each side,was then cautiously troduced
in-
insensibility, with loss of motion on both sides,the Her bowels had not been openedsince Wednes- day. into the groove of the staff, and carried into
muscles on the leftside of the face appearing more She had been vomiting matters described as the bladder. The forceps were then used,and the
lax and flabbythan on the right ; the pupils in the being of the odour and colour of faeces; did not stone, which was of the size of a largechestnut, was
same state as before,the iridesacting duggishly ; complain of much painnor tenderness ; countenance seized,but beingvery soft,it easily broke,and it
pulse70, largeand labouring. The scalp feltpuffed somewhat anxious, and pulseaccelerated; had used was necessary to resort to the scoop before the whole
 THE MEDICAL TIMES. 117
of it eonld be got away. The bleeding was freer in typhoid fever, "c, the general sensibility issome-
times disease advances,vegetations may springup from
than usual,and, of couise, the operation was both diminished either so far as regardsthe senti- ment the diseased sur"ce, or, in bad constitations, even

more difficult and more lengthy. of pain,or of pain and touch together. In carcinoma.
The other case was one of disease of the ankle- cases of this kind, when the nervous centres and The progress of the disease may be rapid, or it
jointof fifteenmonths' standing, occurringin a nerves are free from organiclesion,and the pro- perties may disappear, to recur under the influence of the
young man who had served in the army. As there of the skin remain intact,the following causes which originally gave riseto it The consti-tutional
evidence that the disease extended higher observed,whenever the aJfected symptoms giveway with the local disease,
was no

np than this articulation,

Ithenomena are

Mr. Fergussonthought imb is embraced by the copper or galvanic rings. snd itis diese variationswhich have givenvogue to
fitto put in practice the operation recommended by Firstly,The patients
"
feel a creeping sensation so many modes of treatment Thus, in some cases,
Mr. Syme, and it was performed in the fol- lowingunderneath the rings, which often radiatestowards cauterization, or emollients, or calmants,or deriva-
tives,
msnner : " The leg being firmly held the head or trunk. This sensation may not, at may succeed at a moment when other modes
by an assistant, who at the same time pressed
com- flrst, commence until an hour has elapsedafterthe had failed; but this success should onlyteach na
the tibial arteries, Mr. Fergussonmade application ; but the interval gradually diminishes the necessity of beingapropot in everything.
an incision across the front of the ankle, going with each application, and soon does not exceed a Erectile engorgement of the uterus, like the ana- logous

from the inner to the outer malleolus. This was few minutes or seconds. disease of the rectum, is often chronic, and
continued round the sole of the foot,until it joined Secondly,This creeping " sensation is always a the patient remains in a cachectic state of suflbring
its commencement at the inner malleolus; the forerunner of the return of sensibility, which is ge- nerally untO relieved by art The means of reliefare various,
jointwas then cot into in front,and the foot restored to its normal state in one or two and by turns successful; emollients and calmants
eeparateda flapbeingsaved from the integumentsdays.
" in the drink ; as liniments, injections, "c.,together
eovering the os calcis. As the disease was found Thirdly, Some time after the retam of the sen-
"
sibility with rest and a
properregimen.
to involve the upper surface of the articulation, a we observe a third phenomenon,which con- sists Local cauterisation.
thick slice of the tibiaand fibula, together with the in a feeling of heat,radiating bourhoodRevulsives to the groinor loins.
from the neigh-
two malleoli, was removed by the saw, and the flap of the ring, and mose intense beneath it Tonics and preparations of iron. Excision ; li- gature.
of skin, which were found to be ample,brought Some patients even fancythat a warm body has
over the divided extremities. On examination,the been appliedto tbe skin,and the development of For cauterization, M. Recamier prefers the nitrate
Joint was found to be extensively diseased. heat may be detected by the thermometer. of silverto the acid nitrate of mercury, because the
The above conclusions have been drawn from former producesa drier eschar,and giveslesspain.
made by the Author at the The solidcaustic of Filhos (a) presents many ad- vantages;
PROORB88 OF MBDIOAIi 80IBN0B. numerous experiments
but we should reserve itfor cases requir-
ing
" Hospital of Salp^tri^re, duiingwhich he had occa- sion
great destruction of parts. Many precautions
FBANOS. to observe some curious particularities. Thus,
in cases of recent and complete loss of sensibility are, necessary duringthe use of uiis powerful
caustic.
[From our Paris Correspondent.] from cerebral concussion,the mere placing in the
hand of the affected limb a few copper coins will
The ligature is required for fungous vegetations
SECONDABY SPASMS DURING for a short time. In springing by a pedicle from a healthy sur"ce. The
often restore the sensibility
OOKYALESCENCE FBOSI CHOLEBA. b'gature should always be tightened g raduaUif to
other cases, when the paralysis of sensibility is re-
cent,
It sometimes happensthat patients, avoid the dangerof peritonitis, which M. lUcamier
recovering superficial, and apt to pass from one point of
firom an attack of cholera,are seized, without any the skin to another,it is quicklyremoved by fre- quently has seen producedby the opposite practice ; or the
be removed by torsion,with a
evident cause, with nervous symptoms of a par- ticular approaching' a pin, or any metallic wire vegetationsmay
nature. These consist in muscular spasm, which is a good conductor of electricity, to the polypus forceps.
which M. Burg distingushes After having cited a great number of cases in
into symptomatic and afiectedpart
enentiaL The former speciescommences support of the precedingdoctrines, M. lUeamier
with Nay, more, in some cases of deep-seated paralysis
stiffiieas of the wrist or elbow-joints, terminated his interesting lecture
" ^fbrs uch the course
dis-
accompaniedwhich occurred in old hysterical afiections, the sensi-
bility
by a sensation of heat,and soon terminates in per- restored by the mere of a
reslly was
"

by the following conclusions : "

manent of the arm was us^

contracture. When this has been esta-blished, 1. There are certain engorgements of Che uterus
common thimble. This curious eSbct was remark^
the shoulder-joint remains free ; but the ably witnessed in the case of an epileptic capable of beingresolved, which are neither inflam*
patient
other aiticulationsof the fore-arm and hand pre- sent named Yalois,at Salpltri^re. matory nor connected with hypertrophy, scirrhus,
a most perfect state of contracture. The hard tubercle or fibrous tumours, but depend on elastic
and contracted muscles are the seat of violent TREATHENT OF DEAFNESS. tumours, and ordinarily bleed as soon as the epi-
thelium
very
pain,and the leastattemptat motion increases the At the same meetingof the Academy, a memoir which covers them gives way.
torture. In seven cases of this singular
afiection was read from Mr. Yearsley,of London, " On a new 2. These engorgements follow the same course at
observed by the author,
the Deafness in cases of Perfora-
tion the analogous disease of the rectum.
spasms were ceded Method of Treating
not pre-
by any symptom,
nervous and remained fined
con- of the Tympanum." The author's view and servations,
ob- 3. They are of freouent occurrence; and when
to the upper extremities. which appeared to be quiteunknown to untilatt
they have been established, never cease
The essentialspasms are met with less frequently the majority of the Assembly, were listened to with the erectile capillaries which compose them have
than the former, and generally commence with much attention;but it is unnecessary to allude been destroyed.
some slightcramps,soon followed by nervous further to them here,as the Englishreader is fiimi- In a subsequent discourse, M. Rteamier pro- poses
twitchinga; these,mstead of beingconfined to the liarwith them already. examining this condition, when it exists
upper extremities, may attack the moscles of the ENGORGEMENT OF THE UTERUS. within the cavity o f the uterus.
hce or of the lower extremities; but the
cramps At the Academy of Medicine M. Recamier occu The Committee of Public Assistanee, a body
soon subside of themselves, and nothingremains
the whole with discourse somewhat analogous to our Poor-law Commission,
except the muscular twitchings. The latter were piednearly sceance a on
As the views of the has recentiy adopted an excellent measure private
subsultus of typhoidengorgements of the uterus.
;
exactly similar to the spasmodic
learned Professoron this subject are rather peculiar, rooms for patients able to pay 2 francs (Is. 8d.)a
fever,and were easily observed in the superficial
muscles. They were and his authority g^at, the following analysis, may day,are to be openedat St. Louis and the Venereal
accompaniedby a creeping Hospitals. The best care and the advice of expe-
sensation, but the joints remained be acceptable. M. Recamier holds, mat many cases rienced
supple, and the
physicians will thus be secured to persona
afilected of uterine engorgement are not merelyinflanunatory,
partsfree from painon pressure. of the middle-class at the most moderate rate.
When the nervous but depend on a certain condition of that organ,
accidents, thus described, had
continued for about three weeks, they often disap- which he denominates erectile. After having de- scribed
peared RULE FOR ADMINISTERING CHLOROFORX.
just as suddenlyas theycame on, leaving at some lengththe erectilecondition of the
M. Dudart,a dentist, who has had very extensive
margin of the anus, so frequent in women, and companied
ac-
nothingbehind exceptslight stiffiiess.
experience of chloroform, the following rule
by so much generaldisturbance,M. proposes
The treatment adoptedby M. Burg, and fol- lowed the which the inhalation
Recamier passedto the same condition as it idFects for determining degreeto
up by many of the hospital physicians, cially
espe- of this energetic agent diould be carried.
at the Hdtel Dieu and Cochin, consists in the the neck or mouth
of the uterus. It may occur at
of life, but is most f^quent after deli- very. On the one hand, itis necessary to producea cer- tain
emplojrmentof galvanism, which is applied either any period amount of insensibility, and on the other,'"it is
in the usual way, or through means The tumefaction producedby the engorged
of metallic far.'
bands. This is rapidly vessels gives riseto an elasticity quitedififerent from dangerous to push this insensibilit^r too By
and almost universally cessful
suc-
^
that of inflammation scirrhus. It is seldom what signare we
companied
ac-
to know that the inhalation has
in cases of symptomatic spasm, but failed to
or
M. Dudart
thoughoftenso considerablethat been carried to the proper
extent?
relieve that form which the author denominates by fiever,
cannot embrace the os tincsewithin the speculum thinks we may flnd this sign in the species of
essential. we

The neck of the iiterus is more or less panful, and tritmut which afiects the elevator muscles of the
THERAPEUTIC EFFECTS OF SOME HBTALa lower
morrhage,
hae- jaw. When the jaws and teeth are pretty
discharges of a leucorrheal nature, or even
M. Burg,the author of the above memoir, take placewith more or less abundance. firmly pressedagainsteach other, and some force
which is publishedby the Gazette Medieale,Feb. These local symptoms are soon attended by generalis required to separate them, we should suspend
2nd, presented another paper on the same disturbance. The labours under the inhalation, and may performthe most painful
subject, patient a great
in fidl security, for the patient has ceased
at the last meetingof the Institut. The influence
variety of dyspeptic or gaatralgic derangements;operation
of certain metals on loss of sensation was headache, ver- to feel.
examined nausea and palpitations,
vomiting, tigo,
in this memoir. numbness of the limbs,spasms, hystericsym- f
The author commences by observing,
that in a inflammations of dilferent
ptoms,and secondary kinds. fused and moulded
(a) This is the Vienna caustic,
great number of nervous diseases,
hysteria,
"c.,and Local hsemorrhagesoon causes anemia, and, as the |In a leaden envelope.
 118 THE MEDICAL TIMES.
DIFFBSENGE OF THB BEFLEX FUNCTION, means freei also,that there v(as condensation of the The excavations for the foundation of the addition
AOOOBxmre to tbb sneciss ahd aob, in the five lung around the bronchi,adjacent to the aperture to our SurgicalHospitalare alreadycommenced.
CLASSES OF VEBTEBBATED A1IIMAI.8. by which the air had escaped; and further, that the At a meetingof the Managersof the Infirmary on

All authorB agree, that the reflex function is immediate cause of death was severe bronchitisof the 28th of January,Dr. Tliomas Wright, a young
weaker in waiifl-blooded animals than in the cold- bloodedthe
opposite side of the chest Dr. Robertson gave fenglist physician, appointed
was one of the ordinary
; but this does not hold good,ifwe compare iome account of Skoda's views on the two symptoms physicians to the Infirmary, in the room of Dr.
the mammalia and birds with reptiles and fishes. referredto, which he said had met with too little George Paterson,who has leftEdinburghto esta- blish

M. Brown-Sequardhas insistedon thispointin a attentionin this country,and stilllessin France ; the himself in the south of England.We have
memoir recently addressed to the Biological SocietyFrench pathologists, for the most part,stillretaining been much gratified hetc by a visit from Monsieur
of Paris* He likewise shows, that the differences the original idc"as entertainedby Laennec as to the Lemercier,with a collectionof the wonderful ana- tomical

of the reflexfunction in tlie various groups of verte- conditions on which metallic

tinkling and amphoric models invented by Dr. Auzouse, of Paris.
brated animals dd not depend, as many writers
su|"- breathing arose. He dwelt particularly on an perimentIt is really
ex- impossible to exaggerate their men ts.
po6e,onthe difierencesofanimal heat ; neitherisitm desctibed by Skoda. In this experiment
inverse proportion to the rank which the classholds both sounds are of an infiated
producedby means IRBItAND.
in the scale of animal organizations. Is the energy of stomach removed from the body. Two stethoscopes
the reflexfunctioninversely proportionate to the age of sides of the inflated
are applied at opposite stomach ;
[DublinCorrespondence.]
the animal,as allphysiologists assert? M. Brown- one person speaksor breathes into the one stetho- scope,
Sequardsays no. It diflerswith the species. Thus, and another applies his ear to the other,when HOSPITALS AND MEDICAL CHARITIES OP
in birds the function predominates in adjilts; while the one or the other sound is heard,or both together. DUBLIN.
in the cat,dog,and rabbit species, it is strongerin This short of the Medical Charitiesof Dublin
Paperled to an interesting discussionas The subject
the young. M. Sequard, however, thinks that the to the conditionson which these two sounds are attention in highplaces.
duced,continues to arrest no little
pro-
energy of this function is in direct proportion to the and how far there isevidenceof the existence Sir William SomerviUe has not yet, in his placein
quantity of grey matter in the spinal marrow, and of pneumo-thorax,independently of communication Parliament,hinted at any sudden extinctionor any
to thisinteresting fact he proposes recurring at a between the bronchi and the cavityof the pleura.organicmodification of these Institutions. A meet- ing
futnre period. In regardto the latterof these two questions, itwas of no ordinary character, however,has justtaken,
well exemplified how much more easy it is to be place,to consider the subject for him ; the rate- payers,
SCOTLAND. than to weigh the difficulties of the
sceptical of evidence ; or, rather, their representatives,
for it was veiy generally maintained, not onlythat South and North Dublin Unions having been
[EdlnborghCorreBpondenee.] there is no proofof the existence of idiopathic puttingtheir heads together,for the purpose
pneumo-thorax, but that there is equallylittleof opposingthe proposedsteps of the Govern- ment
PATHOLOGICAL SOCIETY.
proofof the occurrence of abdominal tympanites, dependently A sum, about one-fifthof that expendedon
in-
The 16th of Januarywas a})pointed for a patho-
logical of a communication between the intes- tines the British Museum, has hitherto sufiSced for the
meeting of our Medico- Chirurgical Society, and the peritoneal cavity.It is plain, that supportof these establishments ; it was stated that
but it proveda failure; the attendance of members
both are rash opinions, and in the face of testimonythis was about to be withdrawn. Such a change,
was so
scan^, that an adjournment t ook place, no
of much weight it need not
business bemg entered on. There was matter
(inthe presentcondition of the country)
With regard *tothe question, as to the conditionson be said,the Government dare scarcely make out
with-
enough,but no suflicient audience. Several causes
which metallic tinkling and amphoricbreathing some due compensatingarrangement,so that
concurred to this result, the chief beinga plan,re- cently
occur, it is quitetrue,that most French authorities, much virtuousindignation was thrown away. It was
adopted, of intimating the patholo^rical ings
meet-
up to thistime, have followed Laennec in regardingstated,that two hospitals would afibrd sufficient
(whichalternatewith the regularmeetings) by the presence of both air and liquid, in the cavityof accommodation to the poor of the city.The Go- vernment
one tabular card,at the commencement of the ses-sion,
the chest,as well as a perforation in the lung, should not lend its ear to such cheese- paring
instead of announcing each meetings as in the
that the
as essential to their production;but in this economists. It must be confessed,
case of the other meetings, justbefore it is to take country a diflferentopinionhas been not unfre- time for withdrawing the grant is a most unforttmate
place. The pathological meetingsare extra meet- ings,
quentlyexpressed. Thus, in the year 1830, one ; and except the Hospitals are put on a better
instituted by the present President,and Dr.
Spittal, of Edinburgh, described the sound foundation by so doing, itwould be better to "Jeave
hithertothev have been very successful. There has of the
dropping of a fiuid, and metallictinklilig, that well alone."
been no lack of matter of the greatest interest, and is the sound
like that producedby striking a metal COMPRESSION IN POPLITEAL ANEURISM.
the audiences have been, up to this last occasion,
than could have been anticipated.
cup with a pin,as indicating the presence of air and At the Dublin Surgical Society, a somewhat teresting
in-
more numerous
a liquid ; the metaUic resonance, heard afterspeak-
The President was not among the absentees, ing case of popliteal a neurism, treated by
though coughing,as denotingthe presence of air pressure, has been lately
of think he should have been absent.
or under discussion. It oc- curred
some us He
of the guests at the Royal
only; while he considered amphoricrespiration alone in the practice of Dr. Madden, 43rd Light
was to have been one
as requiiing perforation of the lung,along with the Infantry, and suggestsone or two points of novelty.
Medical Soci^'s Annual Dinner, which took place of
presence air and liquid f or its production.So, The tumour was very large; allthe usual marks of
the same evening,but excused himself,as being also.Dr. Williams that metallic tinkling
says may aneurism present On the 7th January Dr. Carte's
under an obligation to attend the Medico-Chirurgi-
attend both the voice and cough in pneumo-thorax, instrument for pressing the artery was put on below
cal Society.The Medical Society's Dinner is too
when there is neither liquid efl^sionnor perforation the fropciMffl, Read's higherup, where the vessel
by the seniorresident members. It of the pleura; but he also
"

little patronised
would be well if theyrefreshed theirmemories regardsthe amphoric passes oyer the pubis. The most remarkable point,
once
breathing of pneumo-thorax as dependent on
foration
per- perhaps, in the case (lost sight of in a very useless
a year with youthful recollections.The Medical
of the pleura. Dr. Watson,however,
Society, like the other Institutionsin Edinburgh
seems discussion, got up by t)r.Hutton, the lastman In
connected with Medical Education, is prosperous
completely to have anticipated Skoda's view of the Dublin, by the
way, to originate a row)was this
"

only indispensable condition of these symptoms; that the aneurism was cured,but the min died from
thisyear.
MEDICAL
for, speakingof "metallic sounds and amphoric the burstihg of the vessel as itpasses alongthe psoas
GALYANIBM.
resonance,"he says:" "They are very singularmuscle. The instruments were put on on the 7th i
The firstFebruarymeetingof our Medico-Chi- and
they are perfectly decisive (asfar as my ex- perienceon the 9th, some pain and cedema ensued ; on the
mrgicalSociety took place on the 6th current,wheil has gone)of the presence of air in a con- siderable nth, amendment
; on the 12th,the tumour ing
lessen-
jyt.Wrightread a paper on the mode of applying
cavity within the thorax ; which cavity with fever,however,and rigors the pulseat "

Galvanism in the treatment of Diseases. Dr.

"

mostlycontains liquid also ; and of the presence of 110; 17th, tumour stillbetter,but all the other
Wright's methods are highlyingenious, and the air and
liquidin the cavityof the pleurain par- He died on the
apparatusconstructed by Dnnh, under his direction,
ticular. symptoms aggravated exceedingly.
I do not know that the liquid is essential; 18th of well-marked
has the advantageof being at once cheap and I do not believe itis; but commonly there is some gangrene.
On K post-mortemexamination,the aneurism was
effective. A desultory conversation ensued on the
liquid, and a gooddeal of air. Almost always, too"

as largeas the doubled fists ; the sac perfect, and

evidence of the utility of electricity and galvanismbut that
is not indispensable the cavitycommuni-cates quitesolid; its contents pure unorganised-looking
"

in various forms of disease,regarding which, as with the external air,eitherthroughthe walls with the exception, of of
might be anticipated, there was but little fibrin, i n layers, course,
harmony of the chest or throughthe bronchi." the centre,in which there had not been time for the
of opinion. It cannot be said that the farther elucidation of
change. The artery itself was pervious t o witliin
SKODA'S VIEWS OP METALLIC TINKLING metallic sounds and amphoricrespiration is of very an inch and a half of the aneurism. There seemed
AND AMPHORIC BREATHING. high practical importance, since,in so far as they no injurywhatever from the pressure kent up by
Dr. William Robertson then read a short account are diagnostic of pneumo-thorax, they arc ciently the instruments
suffi- also of interest;but fur- ther
" a point
of a case of pneumo-thorax in a woman, who had understood ; yet itis an opprobrium medicina had giventvay in the
died fourteenhours afterbeingreceived intothe In- that so ij^uch
firmary.
up an aneurismal tumour
discussion should have taken place abdomen. The case at once suggeststhe necessity
The case was broughtforiR'ard chiefly to regarding these,through a long series of years, of care and watchfulness under similar circum- stances,
illustrate Skoda's views of the conditionsunder without bringingabout any general unanimityof and other in- quiries
and the need of stethoscopic
which metallic tinklingand amphoHc breathingopinion.
before havingrecourse to the clamps. It is
occur. During the short time the patient was in EDINBURGH MEDICAL NEWB. a question, indeed,Whethet, if such another case
the Infirmarybefore death,both these ptoms
sym- Under the head of Medical News, Dr. Bennett,happened, itwould not be the best practice to letit
were distinctly present The post-mortem who was in the chair, afterwards
gave a short alone. We have- been perfecting our instruments,
examination showed,that there was an aperture of description of a case of paralysis confined to the perhaps too quickly, and not considering sufficiently
communication between the cavity of the pleura and extensor muscles of one arm and one le^^which, the dangerof suddenlyturningthe tide of the cir- culation
the bronchi,but that the communication was by no after a course of simpletreatment,
disappeared. back into other channels. Much creditit
 THE MEDICAL TIMES. 119
due to Dr. Bellinghunfor gifinga new cha- 2. The capsuleis a diiect continuation of the suitsof which were communicated by M. Becquerel,
racter to the subiect,and, hj a sort of metem- psychosis, membrana propria of the tubule, constituting a "t the lastmeetingof the Academyof Sdences.
a new lifeand form to the crude fancies flask-shaped dilatationat the end of the tubule,in M. Schoenbein procures ozone in latge quantitiet,
of Todd and the Paris grocer mentioned by which hangsthe Malpighianglomerulus. t)y enclosing a small quantity of water in a balloon
Richerend, the original diseoverer of the thing. S. No interstitial areolartissue is presentbetween havinga capacity of ten to fifteenquarts.Small
Into the troubled waters of the controversy after the tubules. Only the larger
" blood-vessels are ac- bitsof phosphorus,
companied of one centimetre in diameter,
the late dispute, whether we are llringin the middle by thistissue. are then placed, half in the water, half in the air of
of next year, or onlytbe beginning of 1850 "
we are 4. Capsulesappendedlaterally to the tubules the balloon ; the lattetis closed iihperfectly, and its
Tcry liilVillihg \6 enter. That Mr. Todd firsttried,have onlybeen seen by thf;author in the kidneyof contents raisedto a temperatureof 60 to 68 degrees
and successfully too, the pressure plan, there can be the fish. Fahr. Wlien the operationis completed, A "

no doubt ; but it seems justas clear, that,with the 5. There is no second capsule proper to the tuft circumstance readily known by the peeufiar smell d
old traditional veneration for the knife in their (suchas Bidder describes). In breaking the Mal- the air in the balloon, the latteris turned down ovtf
minds, the men before Bellingham were half aiVaid pignian capsule of the frog,the tuft often protrudes water to get rid of the phosphorus, and then agitated
of the spirit of innovation theyhad called from the through the ruptured neck ; but no such coveringto wash the compound. A cork, supporting two
*"
vasty deep,"of pure unadulterated surgery. To can be seen. The cells found here are not to be tubes,is now attached to the balloon,and through
Dr. Bellinghamis fairly due the credit of giving regarded by the author as proving even an epithelial one tube some water is introduced, while the other
shapeand form \o one of the most valuable disco- veries layer ; although he has never seen the vesselsabso- lutely givesexit to the ozone. This substance, when con-
centrated,
in surgery, and we willingly concede to him naked. has an odour resembling that of chlorine ;
the prsise bestowed by Sir Philip Crampton. The author recommends albumen instead of water when mixed with air,it gives out an odour like that
for examiningthe ciliary movements in the kidney emitted from an electricmachine, While in motion.
GANGEEITE OF THE LUNG.
A highly valuable paper, from the pen of Dr.
of the frogand carp. In comparative anatomy the Air, thoroughlycharged with ozone, pniduees
the diameter of the tubules the lesser the some difficulty of breathing,and, according to
Stokes,has justmade its appearance, if our friends size of greater
the Malpignian tuft. M. Schoenbein,is often the cause of catarrhal
of the Qmarteriy would not hide their illuminative
llie pathological examination of the kidneyis afiections. Small animals placed in it die
powers under a bushel. Perhapsthe chief points
equally assistedby this method. Tlie author men- tions quickly.Ozone is insoluble in water; it destroys
may be glancedat. Dr. Stokes, it need not be said,
two cases of Bright^s disease and renal abscesses rapidly organiccolouring matters,as well as thbse
is known wherever the Literature or Medical His
respectively. In the former,the capsules were rounded havingalbumen
sur- and ligneumfor theirbase. Ac- cording
tory of Ireland is valued. The diselseunder con- sideration,
a fibrous matrix ; in the latterthe sup- to the author,it is the substance which has
he does not consider as fotal as its name
by puration
appeared both tubular and interstitial in the greatest a ffinity for oxygen of all known bodies.
would possibly imply. A longtime studying it,his
originand situation. (Von Wittich, Beitrage zw As it is invariably producedin the air by the action
papers, perhaps, comprise everything known on the
Anatomie der Niere. Abridgedin Schmidt^s Jahr- of aitificialelectricdischarges, itmust be produced
subject.It is rarer than mightbe expected, ing
accord-
No. II, 1S49.) in the atmosphere under the infiuence of the same
to his experience, in estUenic affections. Fetor
bucher,
cause, when natural. Nothing is more easy than to
of the breath is not essential. Pain of the most MUD IN THE LUNGS.
determine the presence of ozone in the atmosphere, *

extreme kind sometimes attends it; it is increased, The following case illustrates the passage of mud and the variationsof quantity it presents. For this
rather than diminished,by over-stimulating the into the extremities of the bronchial tubes,during
purpose we have merely to test the air with some
system, and contact with air is not necessary for its the act of drowning: "

with a solution of sulphate

paper impregnated or
formation. With respectto haemoptysis, he says, it Hurree Balloo, a Hindoo cow-herd boy, aged muriate of
atteiidait chiefly in the "
remittent"
magnesia. The ozone decomposesthe
form. At an 13 years, was found dead in the great open drain salt a nd the brown tint
rapidly, paper assumes a
earlyperiod,when the disease is forming, tion
ausculta- of Bombay, where it passes through the marshes to
Generallyspeaking, this, action on the paper is
and percussion fail in detecting Uie mischief reach the sea on the outer side of the island. On
found to be strongerin winter than in summer.
alreadyimpending. Evidences of congestion seem a post-mortem examination,no marks of violence or
M. Schoenbein observed, that it was alwaysstronger
to follow,father than precede,the more manifest traces of disease appearedthroughoutthe body.
duringfallsof snow than at any other period.Up
symptoms of gangrene. Dexiocardia,from dimi- nished The head and face and upper part of the trunk were to the presentmoment this curious body has defied
volume, occurs where the right lungis the swollen,congested, and discoloured,as in cases of chemical
seat of the disease. Gangrene may attack a lung asphyxia.A bloodyfluid,
analysis.M. Marignacthinks that itis a
mixed with black mud, modification of oxygen. M. Sehoenbela
peculiar
previously hepatised, or in a chronic tubercular con- dition was issuingfrom the mouth and nostrils. The regards it as a bis-oxyde of hydrogen, or a substance
; it is rvtrein typhuSf but often met in "* typhoid,*' hands and nailswere covered with mud, the lungs of oxygen
and is sometimes quiteevidently
probablycontaining a greaterquantity
the result of were distended,and the diaphiagmdepressed; the
than oxygenated Gaz. M6d.,Jan.
water.
"

pressure on the nutrient vessels of the lung.Added blood fluid,and the right side of the heart gorged.
to what know of this disease, DIAGNOSIS OF BILIARY CALCULI.
we already these par-ticularsOn opening the trachea from the larynx downwards,
are of very greatpractical value. mud was observed in it similar to that which flowed M. Faucouneau-Dufresne has addressed a letter
from the mouth and nostrils, and to that in the to V Union Medicate, pointing out that he had al- ready
SBXAOnONS FBOM FOREIGN
drain ; it was in largequantity, and extended into mentioned,in his Work on the bile,the sign
JOUBNAIaS. the minute branches of the bronchi,so as slightly to considered by Martin Solon,when present,as diag- nostic
impartits colour to the substance of the lungs. of gallstones,viz.,a crepitation ffeltby the
"
There was a littleof the same kind of black hands ot the stethoscope in the regionof the gall
STRUCTUKE OF THE KIDNEY.
mud in the oesophagus, but none had reached the bladder, when a strong inspiration is made. In the
Since Bowman's discovery of the structure of the
letterit is stated that the most painful period
kidney, his views of the connexion of the Malpig- stomach. same

Observations. AlthoughMarc, Orfila, and others in the passage of gall stones is as they traverse the
nian body and urinarytubule,have been confirmed "

and have established the fact, that froth and water may be cystic duct. When theyhave passedinto the ductus
contradicted by many observers. The author
made fowid in the trachea of the greaterpartof those who communis coledochus, the painbecomes lessintense
use of a method hitherto littleapplied ; and
are drowned, yet Orfilastates,that the presence of and jaundice ensues in many cases. The painsin- crease
had for his object to determine the mode of termina-
tion
that out of fifty againtemporarily when the calculus passes
of the tube and its junctionwith the capsule. sand or gravelis so uncommon,
dissections he had onlyseen it once. "While De- into the duodenum. The influence of the remedy
Injection of the urinary tubules is difficult ; in-
jection
that mud only exists in the tra- chea of Durande, viz., a mixture of ether and turpentine,
of the arteriesunsafe ; and finally, it is ini- vergeiobserves,
after very prolonged submersion. It is obvious in the case of calculiin the gallbladder is doubted.
possibleto obtain iine sections without violent recommended.
that the latter autlior should not have restricted the The alkaline treatment is more "

rupture and tearing of the structures. For these

reasons the author was led to the use of dried pre- passage of mud into the trachea to that period,VUnUm Medicate,Jan. 10.
parations.
when from the decomposition of the bodyitbecomes CHOLOROFORM in ORCHITIS.
To these putrefaction, and permeationan
accidental occurrence, but rather to have allowed Af. Bouisson, who has latelystrongly
shrinking, mended
recom-
with the blood, constitute the main that, under certain circumstances,its presence, the exh^mal and locAlapplication of chloro-
form
objections.
They were obviated by the use of nitricacid. He botliin the trachea and in the lungs, may be occa-sioned
in various painful affections, employs it in
washed the objects in a very dilute warm also by a vitalact. This is provedto have
solution, hernia humoralis,in the following way : A com-
" press
raised it to the boiling and then,removing
been the casein the present instance, and not to have of several folds of linen is dipped
point, made
the mass, dried it in the open air. In twenty-four been from prolongedsubmersion,from the force in chloroform and placed on the part, covered
hours the preparation The kidney,with which
the mud must have been sucked up to
was compl^Jte.
the extremities of the bronchial tubes,
over with a piece of gummed silk, and
similarly heated with commercial acetic acid, is longerhave reached the whole is supported by a suspensory bandage.
indrying, and contracts more, and has the vesselsob- and from the short interval which must have elapsed
scured The chloroform is renewed every three hours during
but the smaller constituents of the tissueare between the drowning of the boy and the time when
; the firstday, and on the second day,if necessary.
much clearer. Hence itis preferable he was discovered dead and draggedout of the
to use both. The When first applied, a sensation of considerable
brittlenessof the mass renders it advisable to damp ditch by a policeman." TVan^ocMon^ pf the Medical smarting is felt, which lasts onlya few minutes,and
it before cutting.The application of a drop of
and Physical Society ofBombay, the skin becomes red. Then the sensibility nishes,
dimi-
water expandsthe section; and the substitutionof OZONE. firstof the skin, and subsequently of the
a little weak carbonate of potashmakes the object This peculiar substance,the nature of which is deeper seated parts. The lumbar pains ^sappear
almost as clear and distinctas the fresh specimen.yet far from beingunderstood, has recently attracted at the same time. 1\ is singular bow rapidly this
The author concludes that "
much attention on account of its supposed connexion diminution of pain leads to diminutioh in the size
1. The urinarytubules increase their diameter with if the usual internaltreat-
epidemicdiseases. M. Schoenbein,of BEle, of the organ, especially ment
in the corticallayer. has submitted it to some new experiments^ tbe re" is eaizied on at the same time. The onlyin-
 120 THE MEDICAL TIMES.
bUs*
conyeniences ue occasionalredness and slight at a moment when itrequired
no little
exercise presentedby Mr. Bottomley,is conveyed
of
tering ihe scrotunu (L*Union Med.,Jan. 8.)
" of moral courage. It was the warrant of throughthe Council of the National Institate.

PRIZE FOB THE DISCOVERY OP AN his name that enabled us to attract those con- The College,however, clearlydiscriminate
tributors
ARTIPICIAL MODE OP FREPARINO QUINIKE. to whom we were personallyunknown, between the National Instituteand the Conn
The Soci^t^de Pharmacie of Paris have declared ^men who would have indignantly
" refused to mittee of Associated Surgeons, and giveto Mr.
prizeof 4000 francs, to the chemist who shalldis- cover to Bottomleythe whole responsibility of the pro-
a
aid us in the success of a Journal likely positions.
a mode of making quinine without employing
become the organ of a partyor Ihe panderto The brief notice of Mr. Bottomley
cinchona bark, or any organic matter containing
formed. The formation of several malignant passions. and his scheme is what might have been pected.
ex-
quininealready
organic bodies,in the lastten years, has givenrise To the Editor, the resignation of That gentlemanhas been unceremoni-
ously
personally,
to the hope,that quinine, or a substitutefor it, may snubbed. Both in the of the
Mr. Orr as Publisher of this Journal, is the manner
be thus formed.-H(L' Union M"i,, Jan. 8.)
severance of a tie of the utmost kindlinessand address and the matter of it,Mr. Bottomley can

regard;he readily acknowledges the assistance find no ground for complacency.We really
We have to repeatour request, that gentlemen, when
all occasions, he derived from his sympathise with this gentleman,and if he will
which, on
they favour us with communications,will have promiseto make no more blunders we will
the candour to inform us, if,at the same
advice; and it is with the highestgratifica- tion
time,
he now announces, that the arrangements strain a pointin his defence.
they have forwarded f or
copies publicationany to
made for the future publication of the Medical Mr. Bottomley*s propositions are, however,
of our Contemporaries. Every Editor ought to
be allowed to exercise his own judgmentas to a
Times meet with his entire concurrence and onlya secondary matter, for the whole labour
Communication of sufficient
being value or im- approbation.
portance of tiieCouncil has been expendedin the effort
to warrant With respectto any inuendos which may be to justify
its appearance neously
simulta- theirtAandonmetU of the "" Principles"
in than Journal. For
part, set afloatby interested parties for a Bill agreedupon at the Collegeof Phy- sicians,
more one our
as to the subsidiary
we claim the right
to use our editorialdiscretion influencewhich the relationsthat exist and to deprive the proposedCollege of
so ex-
tensively
as to the admission of such papers into this between and the General Practitioners of the right
to exaadne in
Mr. Churchill fession
Pro-
Journal ; and the columns of the Medical Times Surgery. We do not intend to argue this
may exercise over the honestyof our
will be closed against those who may ofiendin with the
Criticisms "
we do not think it necessary to matter Council,for to argument they
thismatter. Moreover, we would remind whoever
do more than refer toinsensible. We tellthem that the General
the conduct of the Medical are
it may concern, that the act of sendingthe same
Times duringthe past Practitionersdemand the legalreeogniUon ofthe
"
paper to contemporary Journals has a very
year ; and to assure our

readers that an equalimpartiality and freedom right of controlling

the curricula of study and
quackish, and, therefore, unprofessional ance
appear-
; it seems as if the writer soughtmore to
from partybias will be preserred by the Editor examinations for their own class;and that
circulatehis own name than to advance science ; and his coadjutorsin the time to come. Our their claims in respectto surgery they will
foregoI Choose,then. Concede a Col-
lege
and, when such a motive influences an author, Publisher would as little desire as we should NEVER
Che Medical Times to become of General Practitioners,with a rightto
then, in our opinion, an column of
advertising permit, a party
the dailypress is the hiost medium examine in Surgery,or convert yoor own In-
stitution
appropriate agent,or a mere Tehicle for the ment
accomplish-
for his purpose. of and private into such a College.The Profession
personal ends.
willnot be Council-ridden any longer
; but are
The
Medical Times is not the Journal which
resolved, in some form, to have the manage-
ment
TO SUBSCRIBERS. can be
justly chargedwith the constant aban-
donment
of theirown affairs.
New Subtcriben unll of principlefor the sake of attaining
dbUge (y forwardingtheir
direct to the the objectof a vulgarand unprincipled The National Institute have done noble
Namet Office,
147,Strand, or to the bition.
am-
Newi Booktellen, All service in the cause of the General Practi-
tioners,
Agents or Post-office
Orders should he made payable to the Publishers, and we trust that they will remain
Wm. 8. Obb avd Co. THE EEPLY OF THE COLLEGE
faithfulto their trust. Let them nail their
OF
colours to the mast, and* the Profession to a
SURGEONS.
man will rallyround theirflag. We call upon
The Council of the College
THE MEDICAL TIMES. of Surgeonshave
Profession
at lastdone their deed. They have been longin the to re- consider theirposition,to "

their if need for

hatched a cockatrice. change
incubation,
and have policy, be, a more

SATURDAY, FEBRUARY and fundamental arrangement,

ment comprehensive
16, 1850. There is mischief enoughin their
progeny to fo-
"and to unite,with a resolute purpose never
an Iliad of quarrels. The Council have
We have to announce to our readers an im-portant, to separate until theyhave conquereda peace.
thrown down the gloveagainst all comers. Mr.
and we would hopeprogressive, ehange President Green and Mr. Guthrie hurl defiance Be faithfulone to another, and the Council of
in our Cabinet ^inofficial language, to gazette the Collegeof Surgeonsmust succumb. Let
againstallcombatants,
"
of whatever mightand
John Churchill, of No. 46,Princes-street, Soho, mettle. We hope the Council will there be but one will and one voice, from John
lay them-
selves
to be Publisher of the Medical Times, vice o 'Groat'sto the Land's End, and the College of
out for the work,for we promisethem a
William Somerville Orr, of 147, Strand,and will be shaken to its foundations.
stouter contest than any in which theyhave Surgeons
Amen-oomer,Paternoster-row, resigned. Unite I unite I The Collegehas published a
ever yet engaged. Their arrogance will be
and the friends of justice
We have no doubt that not only will this met with firmness, and theircunningwith equal defiance, must show
variance of opinion ^no pusillanimity.
changenot impair,but even increase, the use-
fulness skill; and perhaps thejwilldiscoverin the end, no
"

of the Journal and itainfluenceon the that the battle is not

alwayswith the strong.
Profession. The well-known character of Mr. What! does the Council think,that because PROFESSIONAL NATIONALITY.
Churchill is a sufficient guaranteethat the duties thej are HospitalSurgeonsand privileged It has been stated in ContemporaryJournals,
of the Publisher will be performedin future teachers, they have a Charter to be disdam- as an illustrationof ProfessionalNationality,
with as much care and exactitude aa theyhave fiil and unjust? Do thej think,that the that the majorityof appointmentsof Army
hitherto been by Mr. Orr, whose resignation, members are to be deprived of theirrights, in Medical Officers
are given to our friends of
bowever, we cannot thus briefly pass orer. order that theirisolateddignity
may stand forth the '" Land o' Cakes." This,supposing it to be
The with falselustreto the world ? How
appearance of that gentleman's name on many of
true,would perhapsbe of little consequence,
our Journal, at once affixed to it that stamp of these men are really eminent as Surgeons?for so far as real talent, properlytested,is
respectability which we would fain hope the And suppose all were, would that be a justi- ficationallowed to be the stepping-stone to office, a
Medical Times has faUy sustained. It was for disfranchising the Members? If Kamschatkan,in our estimation, might assert
justly t o be expected that a Journal of which these Councillors are all men of highrepute, equalrightwith Paddy, or an Esquimaux with
he was the Publisher would be conducted on why should theyfear the unboughtand unhribed an Englishman. But has the statement to
highand honourable principles. suffrages of the members ? Patience, gentlemen,which we have alluded any claun to credit?
The consciousness that we should be thus we have not yet come to the issue. Not the slightestWhen the last listof the
supported, gave us strength to take the reins, The answer of the Council to the propositions Medical Department of the Army was made up.
 122 THE MEDICAL TIMES.
in the management of prirate
perietice Lunatie receive her here at any time " even at midnightfbrm. To obtain the second medical certificate
Asylums. " in fact,noisypatients are betterbroughtat the husband crosses the road,and calls upon a
A gentleman about Tcrty years of age, having night, it saves exposure in the public streets." i^Yj worthyMember of the Collegeof Sur- geons,
neither profession noi^ fortune, married,a few to whom he relates the grievous
flere, again,we wish that the sections of the calamity
years ago, a ladysomewilat older than him- self, Act 8 and 9 Vict c. c, should be brought that has befallen him. He dVlrells upon the per-
fection
who enjoysin her own rightabout 400/. closely to beair upon every step of this narra- tive. of his wife ; if she i"nly had retained her
per year, winch is paidto them by her Trustees Nothinghas been done, or shall be done senses ; he enlarges upon the deep affection he
for their conjoint maintenance. Tiie husband entertains towards her,and the 'distresswhich
in the slightest degreeillegal, and yet,under
Is fond of society ; his wife beinga little passee the very provisions of this Act the ladywill be her removal to an Asylum will give him ; he
prefers sitting at home, where their life is made unjustly a prisoner. The
"
Sovereign," explains that hef fhtal maladyhas been progrea-
chequeredby those domestic storms which singgradually since the very day of her
snys Macaulay, cannot nowadays immure
"
a ever

spring suddenly they subside, a nd in defiance of the Writ of Habeas Corpus,*' and now that the poor creature is so
up as as vail, subject
pre- marriage,
it issaid, more or leas, in all quarters of the No ! but relation or friend, who will sign completely estranged from herself that he would
any
globe. Unhappily, the ladywas by birth more such an order as the above,backed by a couple hardlyknow her to be the same person ; be
highlyconnected than he^ husbiind ; hence a of medical certificates, can do so, and without thinks her attending a Methodist Chapelimbued
constant disparity in tastes and opinions; she the of any judgeor jury. But to her mind with some delusions which
interposition religious
had been,also, on account df her personal at-
tractions, his own house, forbidher leaving her fireside; and he has ob- served,
proceed.Upon arriving near

a spoilt child, and had acquired almost the husband the corner that at about the change of the moon
steps round into
every accomplishment, exceptingthe art of the shopof an apothecary, and, affecting the she bos alwaysone of these maniacal paroxysms
governingher temper. She was therefore the greatest distress, tellshim that his wife is in a under which she is now labouring ; finally, ha
Xantippeof her own domestic hearth,where slate of mental derangement nay, he proves implores " him to' step over the way, and certify
she might have exhausted the philosophical it by relating a thousand acts of indefensible according to his conviction, lestshe do herself,
patience cf Socrates himself. The husband violence and irrationality, and winds up his or him, or some of the servants, some bodily
would gladly have lefther,but then her income that,under the best medical harm duringthe night. Tlie friendly
case by stating, surgeon
the pecuniary chain which bound him, like
was advice,he has been to a Lunatic Asylum, consented to see her ; but,when the parlour-
Ixion, to his wheel of torment. There was "
so where he has arranged the terms for her admis-sion, door was thrown open, and another man ceremoniously
un-

it appeared to him "

no escape, until, one and, producing the printed paper, he re- quests walkingin, she was literally
evening, wilylawyer suggested t o him, that the apothecary will frantic. She stood before him in the attitude
a
kindly stepacross,
he might easily enough shake off his matri- monial^ and
certify the state in which he finds her. o7~afury, her hair hung dishevelled round her
burthen,yet still preserve its only He consents, and theyproceed. The parlour neck and shoulders, for she was undressing to go
advantage his wife's income.
" "But how? door opens, and she stands before them to bed ; her face was flushed ; her eyes, which
In what way?" "
By getting her shut up," both, flushed and indignant. What ! in- "
trudewere injected, seemed to flash*fire from their
was the reply, "*in a madhouse ; nothingcan upon me a strange man bille!*' inmost sockets ; and her quivering
in my desha- lipsonly
be easier, if you onlyknow how to set about it:" and never wind whistled louder in half-articulated the torrent of invective which
whereupon followed a conversation, the tenor the shrouds of a man-of-war than did her "he tried to utter. In vain did the surgeon at- tempt
of which may be easily inferred fVom the cir- cumstance,
voice round the corner of that small room. to appease or soothe her; she would hear
that a fbw evenings afterwards the The husband " to satisfy the 45th section of nothing he had to say, and certainly answered
worthyhusband presented himself at the gates the Act "
precipitately retired, leavingthe him very incoherently ; she said that her hus- band
of a Lunatic Asylum in the neighbourhood of apothecary to deal with her alone,who had not not her husband
was ; that she was under
London, and asked to the Proprietor. H e the sagacity to discover that some of the anathema of her family; that she was
see portion
18 forthwith introduced to him,and gives a very this hysterica pasnio was perhapsdue to a cer- tain married and not 'married ; that she should be
exaggerated and ex-parle account of his wife's of kill him firstand herself afterwards.
quantity wine,which her husbatid,an- goadedto
ticipating

state of mind, professing, all the time,the most the consequences, had considerately In truth, she had the physiognomy and de- meanour
ardent affectionfor her. Hereupon the Pro- prietor left within her reach. In a aoft and silken of a mad woman in the eyes of any
of the Asylum sympathises with him, tone of voice,the her person who might not look a little deeperinto
apothecary, approaching
and tells him, that the best authorities in lunacy
gently,says, "
My dear Mrs. B., don't you the secret cause of her excitement, or who had
are now convinced,that the disease is most know me?" at the same time endeavouring to not an opportunity of visiting her more quently
fre-
readily eUrable in its Incipient and early stage, pat her playfully be it observed, and
on the shoulder. She starts ; for, that a single
and that she should be placedimmediatelyfrom him with all the
gestures of a tragedyshort visit from a physician, surgeon, or apo- thecary,
under medical treatment. "
And bow Is this to is sufiicientto justify
queen, flings open the door,and orders him, his signing the
be done?" The Proprietor rises, goes to his upon peril of his life, to leave the house ! [The certificateprescribed by the Act. The surgeon,
writing-desk, producesa bundle
and of printedapothecary, too happyto effect liis escape, we need scarcely say, was conscientiously fied,
satis-
folio papers. "'There (he observes)are the hastens out of the room, and turning round the and wrote the following certificate: "

forms for the admission, which may be bought comer of the passage, is beckoned by the hus- band "
I, Robert Hunter Parry, beinga Member of the
by the quireat any law stationer's. You have of Surgeons,dulyauthorised to prac-
into the adjoining study. She is in a KoyalCollege
" tise
as such, hereby certify, that I have this tiight,
to fillup the first page, entering^ at the placesdreadful state," exclaims thehusband. Very separately
"
from any other praetitioner, visited and
marked, the particulars required her Christian sad," adds the and thereupon examined in the
"
apothecary, he personally A B, the person named
and order; and that the
name, age, social condition, placeof abode, fills up the printed Medical certificate, which accompanying statement
said A. B. is a lunatic, and a person to be
persuasion, "c., and direct the order proper
religious runs as follows:^ confined ; and I have fbrtned this opinion from the
fbr her reception to me." "This can easily be " followingfacts, vis.,that she is obstreperous and
I,William Dioscorides CuIIen, beingan apothe-
cary violent,abusive and incoherent, and is said to labour
done," cries the husband, cheerfully. You "
duly authorised to practise as such, hereby under
that I have tliisnight,separatelv religious delusions, and threatensboth her own
must then get two medical
men to visit her certify, from any
and her husband's lif^.
other Medical Practitioner, visited and personally
when
separately, she is in of her paroxysms,
one " Name"
Robert Hunter Parry.
examined A B, the person named in this statement "
who will fillup thes# certificateson the oppo- and order,and that the said A B is a lunatic, Place of abode" Great Road.
site and a **
be Dated this Twenty-eighthday of October,One
in proper person to confined, a nd I have formed this
page ; so that there is no difiiculty
opinion from the following facts,viz.,that she is Thousand-eight Hundred and Forty Eight."
the matter. When was she last in one of labouring under great cerebralexcitement, We have how allthe forms completed whldh
very noisy
these states?" "Oh!" replies the husband, and incoherent, and appears to be dangerousto her-self for the transferenceof any one of
are prescribed
and to others.
** she
Wa" in a highstate of exaltation when I left Her Majesty's into a Lunatic Asylum.
"
Namer-William Dioscorides Cullen, subjects
her,and I shall find her certainly in allher glory "
Place of abode street. " "
The husband now hastens, with this warrant
upon my return." Then," the
"
said Proprietor," Dated,this Twenty-eighth Day of October,One (ifwe may so designate it)in his hand, to the
thoughtfully,you " had bettercall in a couple Thousand Bight Hundred and Forty-eight." of the Asylum ; who looks over it
proprietor
df Medical men on your way home. We can All this (videschedule c. sec. 45) is in strict much as the Governor of the Bastile
very may
 THE MEDICAL TIMES. 12a

the Lettret de die A clergyman"i^e

magistrate) there others than those who, as surgeonsof hospitals^
be depictedexaminingone of see h
emitient Practitioners,
do **
A shower-bath," the
wbi8|)0frs tfescherS) or original
inquirers
Cachet^signedbjrLouis XIV. And is not the t"olicef" in maintain its seientiflccharacter,the
"
willbe of service." " Not yet," Stltgtry,
document to all intents
itself, and purposes, a proprietor, would losethe high estima-
Diplomaof the College tion
Lettrt de Cachet ? The person accused of being interposes the superintendent^ "
she'll be which has hitherto induced thoserpreparinjir
insane is kept in utter ignorance that sUt*h a quietpresently!"And, at length, after a themselvesfor general practice,to seek it mlnntatity

veal jreat deal of argumentation, pertiiasion, and as the best guarantee of their surgical qualifications
proceM is pending, nor is it necessary to re-
"

and professional chilracter.

who signedthe Order of Rcceptioh, or circumlocution, intermixed with remonstrance
They cannot, therefore, consistently with the ob-
ject
either of the MedicalCertificates. On the ciih- dnd some threatening, the poor creature is half fbr which the College of Surgeonswas tuted,
insti-
rule in allasylums,io led and half carried up stairs, when she might consent to
any proposal for introducing ihto
trary,it is the general
dnd have been put to sleepin a dormitory the Council those who practise pharmacy.
-refuse any information on these points; sur-
The Council of the College are ho less adverse tO
patients are constantly heard hazardingall i^ounded by other lutiatics, had not her husband
the proposal of instituting a National Collegeof *'

manner of conjecturesas io who can possibly he generously been induced by the proprietor (who Medicine and Surgery,"intended,more or less,to
the authors of their detention ! The proprietor, made an extra chargefor it)to allow her a supersede the Colleges Physicians and Surgeons^ "

glancing over the signatures,observes that it is private room, which was about the size of a cell Society Apothecaries. They and the of are vinced
con-

that the proposal of the Chairman of the

all en riffle; and forthwith gives orders that a in a common gaol,with a narrow Iron bedstead
Associated Surgeons, viz. : "

stout Amazonian attendant,and an ex-police-

man runningalong the side of the wall,covered That the new Collegemust be independent of *'

engagedas keeper,shall go with with the usual quantity of bedding. Here she all others,and must possess the rightof granting
recently
down diplomas in Medicine and Surgery, which shall en-
all possible expedition for the refractory lady, was quickly undressed,and, lying on a title
the holders to practise in all the departments
taking along with them a strait waistcoat,harder mattress than she had been juditorn of Medical and Surgical science,and to fill all
straps, pair wriat-locks,
of "c. With all due Irom, thoroughly exhausted, she fell,
into a dis" Government and publicappointments," tend^ in-
evitably

diligenceas fast as the Asylumhorses can keep torbed and unrefreshing

"
sleep.She aWoke in to abolish those distinctionswhich have
^theattendants proceed, but do not arrive k few hours,and raising her head wistfully from been hitherto beneficially recognised as marking
pace "

the relative claims of Medical Practitionersto the

at the house of the unfortunate ladyuutil she offher pillow ^inthe grey dawn of the morn- ing "

confidence of the public, and which,bypreserving the

is in bed and asleep.Her attentiveservant, she looked around the narrow room with
"

highest standard of education in those who have the

being on the watch, opens the street-door a shudder ; there was no furniture excepting a means of attaining it,maintain and elevatethe cha- racter

quietly, and shows them directly up to her mis- chair in it,and the window, which was
tresses high of the whole Profession. And theyespecially
bed-room. They soon rouse her from tipin the wall,she perceived was secured with hold that it would most injuriously aflect the inte-
rests
of himself Medical Practi every one calling a -

her her
slumbers,telling she must get up and iron bars ;
"
she remembered all that had pired
trans-
tioner to diminish the authority,
or contract the in-
fluence
What!" she^ " the for the
night,
previous fumes of the
go with them. cries
"
are you of the College seeingthat the
of Physicians,
wine had vanished and the excitement of her generalcharacter and respectability of the Profes-
sion
goingto murder me? Help I help!" " but she
sanguinetemperamenthad subsided,and those whoonlydepends
not greatly upon the character of
can onlyoppose a fbeble resistance to her power-
ful over
are distin^ishcd members of it,but that
assailants. They sooit pullher out of bed, she sat up in her bed alone,contending with
the Fellows of the College of Physicians have ever
her her griefand askingwithin herself Who "
"

hurry on her day-clothes clumsily over been distinguished by the same education and"

hath done this?" "Can it be he ?" "By traming as the gentry of the countrj', by their
night-dress, and,in accordance with a humane
"

of the male attendant, that theyhad whose authority am I here ?" Alas ! poor learning and attainments in literature, by the aid
suggestion which theyhave givento the progress of science,
better put on the straitwaistcoat to prevent her lady! These are hut vain questions, which it
and by their association with the learned and scien-
tific
breakingthe windows of the carriage and cut- will behove none to answer. A sudden appre-
hension bodies of the metropolis.
well her warm,the of heavier calamity fell upon her, Further, the Council of the College, in relationto
tingherself, as as to keep coarse some
the amended Charter proposed by the Chairman of
brown holland sack is pulled over her,and her and,in a state of utter bewilderment and dread, the Associated bound that
she hurst into tears
arc
and
to
laid her head down Surgeons, state,
hands drawn into its longsleeves,
which are thev have assented to certain **
heads," dr "
ciples,*'
prin-
secured tied three or four times upon her pillow with a hursting brain and a
by tapestrings agreedto at the Conferences held at the
under her arm-pits.In this helpless state, breakingheart! Talk of "the rack having Collegeof Physicians, conjointly with the repre-
sentatives
of the College of Physicians, of the So-
ciety
kickingand plungingas well as she could,been in use in England before the greatma- jority
of Apothecaries, and of the National Institnte,
she is of the nation had the least suspicion of
"
callingfor help and screaming," and designedto be incorporated as a Bill for the
carried down and thrust into the vehicle it," What excruciating mental tortures have of the Profession ; and,as this Bill is in-
"

regulation tended
been inflicted the cruel operationof this
at the street-door. A policemanlipon duty not by to provide for the institution of a College of
comes up to know what is the matter, Act of Parliament,(8 and 9 Vic. cap. c.) General Practitioners, theyare precluded, by their
presentengagements,from re -opening the question
when the male attendant draws himself up "The wretch," says Junius, "who suffers on
of the
of any organicreform in the Constitution
with the air of a man of authority,
and, pro- the
ducing
rack is passive;" but when the mind is so corporatebodies of the Medical Profess!on.
his Lettre de
Cachet,says,
"
humanitysinks under the greatest At the same time,the Council of the College
By order tortured, take
of the Commissionersin Lunacy a mad lady possible amount
"
of suffering. leave to impress on the attentionof the Council of
the National Institute, that the College of Surgeons
"
carryingher away to an asylum." The can in fairness be held responsible fbr the perform-
ance
policeman looks over the printedpaper, which THE ULTIMATUM OF THE ROYAL of such engagements onlyunder the acknow-
ledgement
he does not understand,supposes that it is all COLLEGE OF SURGEONS. by the other contracting and, in
parties,
and
right, desires them to shut the door and this instanceby the National Institute, of their re-
ciprocal

drive away as quietly as possible. Arrived at the TO THE COUNCIL OP THE NATIONAL INSTITUTE OP responsibility.
MEDICINE, SURGERY, AND MIDWIFERY. The College of Surgeonsconsented originally to
Asylum which the husbiind hai onlyjustleft
"

Gentlemen, In addressing the Council of the " the institutionof a new College
as one forthe more "

"they alight, and the patient is ushered into National

Institute, the Council of the Collegeof efficientperformance of the duties confided td the
a small parlour, Where the matron, proprietor, Surgeonsdesire to express their regretthat they Society of Apothecaries."
cannot adoptthe views set forth in the ''
and superintendent receive her. Where am "
tions"
sugges- That the principles of the Bill in question " "

of Mr. Bottbmley as Chairman of the Com-

mittee were framed in accordance with thisintentionis in-
I,"she cries in distraction, Who are yOU ?"
"

of Associated Sturgeons of England. contestably piovedby the provision, that no one

"What are you?" In reply to which,the The Council of the Collegethinking it unneces-
sary shallbe legistered as a General Practitionerunless
matron, assuminga winning manner, says, to consider the detailsof the measure therein he shallalso have been examined and admitted as *^

"
Poor child ! let us take this nasty thing proposedfor the amendment of the Charter of the a Member of the RoyalCollege of Surgeons." If,

off," (meaning the strait-waistcoat,} which Collegeof Surgeons, are of opinion,that the ad- mission
then,according to the provisions of the projected

the attendants begin to untie,and, as the

of Surgeons in generalpractice" "
to the Bill,no one can be licensed for generalpractice" "

Council of the Collegewould, in converting the except by possessing a double qualification, that is.
sleeves are loosened, and she emancipates
Collegeof Surgeons into a Collegeof General letterstestimonialfrom the College df Surgeons, ana
her arms fronl the restraint, "Oh I" she ex-
claims,Practitioners, prove to he injurious to the best terests
in- letterstestimonial from the College of General
And let of the Profession, and of the general Prac- Practitioners th^ Council need not pointout the
titioners
"give me pen, ink) paper "
"

me Write to sister or brother." A of " inclusively. They believe that the Col- lege inevitableconclusion, that the object of the Billever
my cup as the Institu-
tion, would then
has been,that the qualification to be
in Surgeryshall be
regarded
Will do
cease

says thi matron,

"
tea,my dear," desigticd
especially you
fbr the promotion of Scien- determined by the Collegeof Surgeons, and the
more good!" "Oh no!" she ejaculates,
"let tiiicSurgery,
and that by admitting to the Council qualification in other branches of Medicine by the
 124 THE MEDICAL TIMES.

College of Oeneial Pnctitionen,and that itnerer members of the Collegeat the date of the Charter
coald have heen contemplated to transferfrom the of Her present Miges^,
and of twentyyears'stand-
ing,
The Zoitt,a Journal of Cerebral Physiology and
Collegeof Surgeons to the proposedCollege who shall be desirous Ihereof, and shall be re-
commended

of General Practitioners the legaltight,or any to the Council by six Fellows. Mesmerism, and their Applications to Human

be the terms of inch recom- Nature. January,1860. No. XXYIII. Pub.

part of the legalright,of regulating the educa-
tion That the following mendation,

of Surgeons, of institutingexaminations of their viz. : "

lished quarterly.
qualifications, and of granting to them letterstesti-
monial We, the undersigned Fellows of the Royal Col The History of Mankind clearly proves thatthere
of theirfitness to practise Surgery. legeof Surgeonsof England,do, from our personalhave, in different ages, existed epidemics of the
Nevertheless, it cannot he doubted by the Conn- knowledge of the high moral character and fessional
pro- mind as well as of the body,popularsuperstitions,
cil of the College, after a careful consideration of attainments of A. B., of C, declare, diat, which have
strangely obscured the understanding
the proceedings of the National Institute, in con-
nexion in our opinion, he is deserving of the honour of the
and perverted the judgment The weak in inteDect
with the Conference held at the Hanover- Fellowship, and that he does not openlytrade in
the said A. B. have always been most liable to be affectedby the
square Rooms, on the 20th of November, togethermedicines. We thereforerecommend
with expressions reiterated in their Third Annual to the Council, to be admitted a Fellow of the evil influence of credulity, for which reason Lord
Report, of August 1849, that it is the intention of College. Bacon trulyobserved that," in the opinion of the
the National Institute to obtain,if possible, the That members in the army and navy be admitted ignorantmultitude, witches and impostors have
rightof regulating the education of Surgeons, and to the Fellowship under the like conditions, their with physicians."
alwaysheld a competition happily,
Un-
of inquiring by examination into their qualifications certificateand recommendation beingto the same
however, physicians have sometimes not
for practice, in the Charter which theyseek to ob- tain efiect,and signed by six Fellows,or by the heads of
from Her for
Majesty, their As-
incorporatingsociation
the Medical of the Department services. disdained to changeplaceswith impostors
reipectiTe ; hence

under the styleand title of a Royal Col-

lege. That members in the service of the East India Paul us ^ginetatellsus that the Arabian physieisn
And the Council of this Collegefeelit in- Company be admitted to the Fellowship
cumbent under the Rhases dedicated an entire chapterto " profesaonsl
on them to declare that,consistently with like conditions, their certificateand recommenda-
tion impostors,"with the view of exposing theirfrauds,
theiroaths and their dutyto the public,they cannot being the same effect,
to and signed by six lows,
Fel- and cautioning their misguideddisciples against
surrender any portionof the rightsand privileges or by the Secretary of the Military ment
Depart- their craftycounsels. The portrait of Thessalos,
which theypossess, of being the sole publicbody in of the Company.
the Roman empiric, as drawn by Galen, is nized
recog-
England entitledto the education of Sur-
regulate geons, That members resident in Colonies be ad-
mitted the
and to authorise them to practise Surgery to the Fellowship mider the like conditions, by Dr. Paris to be the very prototypeof the
throughoutHer Majesty's dominions,and, there- fore, their certificateand recommendation beingto the charlatans who, in the present day,practise moeopathy,
ho-
the Council feel not onlyjustified, but called same efifect, and signedby six Fellows, or by the hydropathy, and animal magnetism,
upon, -to require t hat the Colleg^e of General titioners
Prac- Governor of the Colony, a nd certified by die Colonial which isnow covertly mystified under the designation
shall, in conformity with the practice of the Secretary.
of "mesmerism" and "" cerebral physiology," the
College of Surgeonsand the Society of Apotheca-
ries, That the application of every member for admis- sion
and aim-
ing
state in their Diploma or certificate of qualifi- to the Fellowship, in the maimer above pro-
lattertitle being animpertinent assumption,
cation, vided fiction
engrafting a repudiated
the subjects on which their members or for,shall be accompaniedby a declaration, atinsidiously upon
.licentiates shall havo h?' n examined and found signedby himself, that he does not openlytrade in a recognixed branch of legitimate science. The lore
qualified, namely,Medicine, Phirmacy, and wifery.medicines.
Mid- of dealingwith the supernatural "
^the principle
That thisCouncil do, from year to year, admit to which Buggested to Goethe the compact between
Considering, moreover, that the Council of the the Fellowship, under the foregoing conditions, the has consUntlyurged
Faust and Mephistopheles"
Royal College of Surgeons have taken steps,which members of the Collegeat the date of the Charter
to transcend the boundaries
the curious in futurity
are publicly known to be in progress, for the re- moval of Her present Majesty, as they shall respectively
experience. Not more than a couple
of those grievances declared,both by the become members of twenty years' standing, untU of ordinary
one-half of the 'potenutes and
National Instituteand the Associated Surgeons, to the whole of the list of members at that date shall of centuries ago,
have been the cause of their original formation,the be gone through. philosophers in Europe believed in mag^c and
Council of the College mightrattier have expected That when the sanction of Sir George Grey astrology. Next came the wonders of witchcraft
that the incorporation of any new medical body,to shall be obtained to such proposed application to
and sorcery; and, althoughwe plume ourselves
be endowed with surgical privileges, would have the Crown, the several foregoingresolutions be
and flatterour-
upon the advancement of science,
selves
been deemed unnecessary ; but,at all events, they made public, in such manner as the President shall

will consider it to be their dutyto oppose every at- tempt direct.

that we are living in a more enlightened
which may be made, either by the National we are surrounded by superstitions as absurd
age,
the Associated Surgeons,or any other We invitethe special attention of our readers to and as any which called forththe re-
Institute, incongruous probation

leges the above series of Regulations."They difier

"
body of gentlemen, to usurp the rights and privi- of the Roman satirist. It may well be
of the Royal College of Surgeons, whether it but littlefrom the terms of the Resolution agreed said of "
mutato nomine de te fabula nanalur:*
us,
be soughtto be accomplished by means of a charter to a few weeks since
by the Council. It will be Instead of consulting the stars, and askingthe
or by an Act of Parliament.
observed,that the Council do but reserve to them-
selves
astrologer to cast our nativity, the modem meto-
Finally, if it were thoughtadvisable that any alte- ration
the right of electing such candidates as may phrenological organs, and re- ports
should be made in the measures projected, and poscopist fingers our
be recommended, in accordance with the terms of the cranial indicationsof our destiny;" stead
in-
now in progress,for the re-organisation of the Medical
Profession, the Council of the College of Surgeons thefar regulations. of consulting .thepriests who officiated in the
have no hesitationin saying, that theywould greatly These proposedRegulations are intended as con-
cessions
temple of JEsculapius, the susceptible votary of
preferto th^ establishment of any new corporate to the justclaims of the Members,but they modem witchcraft permitsthe mesmeric oracleto
body,that the examinations into the medical qua- lifications
are exceedingly imperfect, accompaniedwith performthe mystic ceremony of manipulation,"
and "

of General Practitionersshould be en- trusted

to the of Physicians,
restrictions that will be found irksome and offensive as it is called, and consisting in the operator passing
College as more sonant
con-
number of worthyand skilful men who his extended digital extremitiesdownwards and up-
with the dignity and interests of the Profes-, to a large wards

sion,and especially of the generalPractitioners. are fairly entitled to the honour of the Fellowship. at a little distance before the eyes, nose, and
And should the College of Physicians and the So- ciety We acceptthe Resolutions for what theydenote,and mouth, until the most marvellous effectsare pro- duced.
of Apothecaries agree in the requisite Ublets
pre- what theyare worth, the tardyrepentanceof un-
conditions, "
just These,instead of beingregistered on
the Council of the College of Surgeons and slight forinnumerable in- of marble,are recorded in the Zoiet^tL quarterly
judges, reparation
would cordially concur in a planfor a re-construc-
tion
juiies inflictedupon the great body of the Profes- sion. journal, the history and objects of which demsnd
of the Medical Profession, which theydelibe-rately
special attention.
and conscientiously believe would best con- duce
The Council must not delude themselves with the The Quarterly and Monthly Journals which ap- pear,
to the peace and permanent well-being of the
Profession, whose efficiency is inseparably ciated
asso- idea that those Regulations comprehendthe tolution are, for the most part,presumedto represent,
with the needs and welfare of the country. of the Medical Reform Question. If the Council in a peculiar manner, the interests and progressof
I have the honour to be,Gentlemen, anived
wish them to be regardedin this light, cation legitimate
their publi- science. Anew era, however,has
Your most obedient servant,
is an insult to the intelligence of the Profiss- in periodical literature. Instead of itsfieldsbeing
Edmund Belfour, Secretary.
of England, sion. The Council are embarked at lastin the good set apart,and dedicated to the cultivationof know- ledge
RoyalCollege of Surgeons
from them in- formation
5th February, 1850. ship",Reform," and theymust go with the wind or ; and instead of our deriving
suffershipwreck.Their interestswill prompt them respecting such new discoveries as may
PROPOSED NEW REGULATIONS to throw overboard many old prejudices, in order to be revealed to us in the pursuitof tmth ; the
OF TUB COUNCIL OF THE COLLEQE OF SURQEONS, come safe into haven. We are resolved that they arena is now invaded by a host of eelf-adverdsiiig
RELATIVE TO THE shallhave no peace, until every branch of the Pro- fession charlatans, who aim onlyat disseminating lar
particu-
ADMISSION TO THE FELLOWSHIP
whose well-being dependsupon theirwilland doctrines which they have an interest a "

OF MEMBERS OF TWENTY TEARS* STANDING.

movements shallhave received ample justice, and personaland worldlyinterest" in disseminating.
The tWs new Charlatanerie of self-advertising
To admit to the Fellowship,upon payment of the
are guaranteed the full possession
of their invalu-
able
to a cer-
those gentlemenwho were
Qsual fee of ten guineas, rights. system is very obvious,althoughit may,
 THE MEDICAL TIMES. 125

tain extent, impose When, therefore, he has the

upon the public.It is well Mesmeriser and the Mesmerised; between sional no longerdignified.
profes-
known that the facilities
which a"R"rdedby the We must, presumption to talk of his being ashamed of the
aie sagacityand subjective
inspiration.
of into the retort,that the
means publicadyertisements are so great,that however,here pause and requestDr. Elliotson to Profession,
we are provoked
every impostorwho wishes to palm upon the descend for a few moments from the empyrean Profession has much greaterreason to be ashamed
world his belief in discoyeryto which (query,empirical) in of him.
any new heightsof his philosophy,
he may pretend,has onlyto adyertise- order that he may meet us on terra ftrma,for we We next, in the Article entitled Medical Anti-
"
pay a steady
ment-dutyand chargefor a giyenperiod, and he would fain have "a few words with this learned Mesmerists,** meet with a curious exampleof Dr.
may, with impunity, trumpet forth the infallibleTheban." Elliotson*6perversity of reasoniiig. He insistsupon
remedies he possesses,and the wonderful cures he The ZoUt for January,1860, opens with an takinga false position, and hairing usurped the
has performed ; and, by persisting this forthwithhe
in course, itis article on "
CapitalPunishment," or Killingvery ground of his adversaries,
" tends
pre-
notorious that he will succeed in imposing to have achieved a victory in maintaining it.
upon the according to Law ;" and which, as the titlemay
he
credulity of ignorant people,and greatly promote indicate,is.conceived in an extremelyribald and Thus, with somethingof a savage exultation,
his own pecuniary interests. A more ingenious of the draws a comparison between some two hundred and
me"
vulgarspirit, evincing a profoundignorance
thod,howeyer, of entrapping such disciples is at pre- mesmeric cases, which were attended with no
sent subject in allits bearings.It is,indeed,ludicrous fifty
adopted. Instead of honestly and boldly tising and pitiable,
adver- the faUl consequences, and twenty-five cases which,
to find Dr. Elliotson arraigning
of
theirpretensions, the founders and apostles of Secretary of State for the Home Department, the unhappily, provedfatal under the admiidstration
what
eyeiypseudo science now-a"days, start a quarterly or
Judgesof the land,and the usually constitutedjuriesether and chloroform. Now, this is exactly
monthlyjournal, under thepr^Hgeof which,a tone of of the of the physiology his adversarieswould have predicated ; theydo not
coimtry,for beingignorant
authority is usurped,which appears to giyea
spe- of the brain,and not apportioning the sentence upon accuse mesmerism of beinga sthenic or an ansBS-
cioas weightto the apocryphal fbctsand sophistical condemned criminals according to the measure of thenic agent They do not suppose ever cured or
it
principles thus surreptitiously enunciated. Hence their guilt"weighingthe same in the visionary killed any person, but aUegethat the confederated
we haye mesmeric, homceopathie, and hydropathic of Dr. Elliotson'sscianees pretend to sleep,
scalesof Phreno-mesmerism. The articlebefore us patiente
journals.Nor is this novel mode of appealing to treats the question physiologically, psychologically, and talk, and walk about, and writhe their
publiccredulity so expensive as might appear j nay, in ehort, views limbs into all manner of contortions; but, like
phrenologically, and mesmerically;
itis an economy rather than otherwise. Take, for said to have a
it in eveiy lightexcepting the one under which it P^ff in the CrUie, they are
example, a quarterly journal, consisting of five oughtto be considered viz.,the social policyof strong objection
"
to be kept
"
dying all day ;*'
"beets pica, with an impression of 760 copies. therefore, home, eat a good dinner,
exactingthe vlHmum euppliciumas a warningto they, return
We may, at' a rough guess, say that each deter others firom the commission of the like of- enjoytheirhalf-and-half (being
fences. in a mystical sUte),
Elliotson will take the trouble and are alwaysreadyfor their work next morning.
number will cost SOL, or 120/.
per annum ; and If Dr
even supposingnot a singlecopy sold,nor an ad- vertisement
to inform himself upon the subject, he will find, Die of mesmerism I Who ever heard of anybody
killedby a flash of clairvoyance t
paidfor,we have a very moderate out- lay, that the statistica of crime irrefragably prove, beingsuddenly
comparedwith the enormous which such that the diminution of capital Were such untoward
" event" ever to happen,
sums
punishments has been an
orthodox Practitionersas Messrs. Morrison, Curtis, invariably increase of the we think the very magistrates of Middlesex,even,
followed by a very large
Solomon,Holloway, or (whatis called)
punishablewith death. The would order a Crowner's quest,'*
et hoc genus omne, spenddaily offences "
previously
in advertisements. Such journals these we de-nounce. sit on "
the body.** Ntf,we have no fear of
of socialpolicy ; and to select
as is purely
question one

Theyare not legitimate contributions to it as a mesmerism" whatever may be its anssthenic effects
peg upon which to hang a raggeddisquisi- tion
scientific literature; and their object is as palpable, albeit we mesmerisers with their
upon pbreno-mesmerism, is a mere ruse to "
may meet
and as notorious, with the mystic fluid.
as the monster advertisement-vans
appenda subjectof popularinterest to one which nervous systemssurcharged
which perambukte Fleet-streetand the Strand.
Dr. Elliotson has greatdifficulty in keepingalive They have never yet, as the Lord Chief Baron
"
dangerous either
The ZoUt is one of those empiricalquarterlyat any cost We, however, at once proceedto would observe,proved to be
Journalswhich emphatically belongsto this class. the grand coup of the presentNumber," ran attack,to themselves*' or dangerousto others ;'*there-
" fore
It is put forth solely to advertiseMesmerism. It is by Dr. Elliotson himself,on those professions] men they are permitted go abroad without
to
Dr. Elliotson, in
an amuiringrecord of pretendedmiracles,which who persist in disbelieving Mesmerism ; and here, proper conductors. Accordingly,
onlytend to show how tax human assurance will go we must say, we regretto find Dr. Elliotson losingcontending for the negative effectsof mesmerism, is
the of
in attemptingto impose presume unwittingly, very
case
upon human credulity. that sweet equanimityof temper which becomes arguing, we

It contains fictionsso palpable^ the Medical Press

that the very ex- his serener
travagance nature. ''AngerI" exclaims Brutus, his opponents. After abusing
which we hope may have given Dr. Elliot-
son
of their detailsnullifiestheir effect. ''What's anger? 'Twere a brave passion ter generally,
in a bet-
But a Journal established
upon the advertising But Dr. Elliotson is inconsolable, and some relief, he records,we think very unwisely
ciple
prin- cause !"
has been given against
we have above explained, does not dependfor refuses to be comforted. He, therefore, givesvent for his case, the verdictwhich
its support upon public opinion.The Proprietor or to his agony in the foUowingexclamations^ " The mesmerism by professional
" men, whose opinions are

Editor,independently of subscribers, pays all ex-penses, Editors of the Medical Journals preserve a dead entitledto our respect,and will alwaysdeservedly
and may perform before the mirror of his silence have greatweight in society. Thus Dr. Elliotson
upon allthe mightymesmeric facts . . .

own self-complacency he pleases, not for the informs the publicthat Sir
James Clarke did not
any vagaries theirhearts are hardened,
sembling,
re- and theycare
in a strildng the madman welfare of their fellow-creatures appreciate the "wonders of the Okeys,"and "smiles
manneV, de- . "
/ feelshame
in mesmerism.*' Dr.
"cribed by Horace,who impersonated at once actor thatlbeUmg iothe Medical Frqfesshn,'* (P.368.)Poor with pityon those who believe
and audience : H. Holland "
considersit folly." Dr. Bright tells "
"
Dr. Elliotson repudiating his Alma Mater ing
eschew-
"

who ask his opinion mesmerism

Fuit baud ignobilis Argis, his diploma ashamed that he belongs
" dical those patients
to the Me- upon
Qni ae credebat miros audire Tragsedos because he has entered the cloudy that it is allchicanery." Dr. Ferguson eontinually
"
Profession,
In vacuo Icetusseasor plausorque theatro. discourages its use.*' Sir Benjamin Brodie,seeing a
sanctuary of mesmerism ! Time was when Dr.
Epistii.128. declared his opinion that it
Elliotson was respected,and honoured,and ladybeingmesmerised,
told Baron de
As the Members of our Profession generally, esteemed; time was when he devoted the great and was "all nonsense." DrJ Chambers
we have the Zoist,and Gh"ldsmid he considered it allhumbug." " Professor
presume, never seen commandingtalentshe possesses to the pursuit
are of a
of Edinburgh,also considers mes- "
But he swerved Christison,
merism
unacquaintedwith its physiognomy, we may, by high and honourable profession.
way of further preliminary add, that itis a goodly-firomthe straightforward course which was before quackery." Hence it appears, according
sised 8vo. Journal,printed on goodpaper, and in a him. He was tempted,with gipsy-like to the evidence which Dr. Elliotson has himself
credulity,
dear type. It is stitchedin a sort of whity-brownto wander into
pathsof darkness,which so sadly placed upon record, thatthe most intelligcnt,scientific,
Mackintosh wrapper, and adorned with a strik- ing obscured his vision, that he mistook even his duty and experienced professional men in this country,
wood*cnt representing Dr. Elliotson, disguisedas a professor. He converted the wards of the Lon- don repudiate the doctrinesof mesmerism; and although
such is their
as a bearded sage, sitting down between the two Hospital, where laythe sick and the dying, into Dr. Elliotson may feelvery sore that
Okeys, ponderingupon the Book of Fate. The an arena forthe exhibitionof the Okeys and a set of verdict, from ithe eannot in any way escape.
desgn is beautifully executed,and reminds us of impostors, whose mountebank tricks distressedthe A falcon,towering in its pride of place.
some of the choicest hieroglyphics which are to be patients, shocked the spectators, and called forth Was, by a mousing owl,hawked at and killed^
found in the Vox Stellarum, ot Moore's Propheticonlyone feeling of common indignation against the but no obscure writer in the Zoist,with all the
Almanac. Nor is this all. The conception of the repetition of the grossest vituperation which thisjournal has at itscommand,
outragethat ever was per-petrated
pictureindicates admirablythe contents of the within the walls of a charitableinstitution.will ever tarnishthe reputation, or shake the autho-
rity,
JoumaL It is characteristicof a combination be-tweenDr. Elliotson was consequently called upon to lay of men who are an honour to the Profession.
EUiotsonism and Okeyism; between the| aside his Professor'sgown, and resign the Chair he j Dr. Elliotson loudly complainsthat no Medical
 126 THE MEDICAL TIMES.
periodical will notice him. Dr. Elliotson may find, Similar granules were found in the ovaries and that the operation was not onlyjustifiable but neces-
sary

perhaps, that it is wise at all times to let sleepingbroad ligaments.The leftside of the uterus along for a speedyand perfect cure ; for, althoughthe
dogslie. We will,howeyer, gratify his ambition, the line of the broad ligaments, beingmuch thicker proceeding was both difficult and dangerous, at the

than the right, incisionwas made into it, which same time it was more dangerousfor the patient
an
and take occasion, time and opportunity permitting, to go about with an impermeable stricture,
laid open the cavityof the uterus almost in its as he was
to examine the so-calledscience of mesmerism.
but considerably
constantly exposed to being suddenlycut off by ex- travasation
naturi^l condition, elongated ; thus
or urine,as was nearlythe case in the
proving, that the tumour had origmated in the sub-
stance
lastpatient, and as also nearly ocourred in anotber
of the right wall of the uterus, and having instance, the particulars of which he briefly related.
BBPORT8 OF 800IBTIE8.
grown into the cavity, had produced the same The operation of dividing the urethrathrough the peri-
neum
changes in the shapeand size of the organ, as an was only generally considered necessary when
ROyAL INSTITUTION,
ovum of the same dimensions would have done. no instrument could be passedthrough the strioture,
We have seldom heard a morel acid or interesting The patient, aged 56, never complained of any ute-rine but latterly it has been recommended by Professor
Address than that of Mr. Faraday, affection; she died of phthisis. Syme, of Bdmburghithat a nree division of the
a few evenings stricture should be thus made, even in instances
since,at the Royal Institution, on the ElectricityM ALIGNAHT
" DISEASE OF THE OYABIE" where an instmment could be introduced. IF the
of the Air." Having alluded,in brief terms, to the Mr. Oreenhalgh exhibited a specimenof malig- nant operation of cotrinffinto the urethra were free ftom
progress recently made in the subject of electricity disease of the ovary, taken from the body of a danger, this would,doubtless, b" the readiestand
generally, the lecturer commenced Uie matter under female,who died the preceding day. She had been most effectualmethod of tfe^tingthose obstinate
discussion by mentioningthat the atmosphereex- tends tappedin the linea alba a few days priorto her forms of stricturewhich Professor Syme had alluded
far beyondthe fivemiles popularly but no fiuidwas to ; but when they recollected that such an opera- tion
considered decease, discharged.Another tap- ping
ito limit, and that the empyrean,*'
"
with a similarresult For some mightbe attendedwith faulresults, tbey should
in which elec-
tricity was practised,
is excited and exists, pause before theyfollowed such a doctrine. He (Mr.
stretches stillfurther,daysafter this,she went on well,but suddenly ptoms
sym-
Smith)thoughtthat the surgeon was not justified in
filling, according to Peltier,the planetary
"
spaces," of collapse came on, and she sunk. The
cuttingso fireely into the urethralcanal in such cases,
and that,in duly studyingits amount, we must post-mortem examination of the body showed the and he thought that the surgeon should look for some
take this into our calculations$ the obvious fact existence of a large
" ovarian tumour, of a malignantmilder means than the use of the knife. He was
suggesting itselfto the mind, thoughnot mentioned character, on the right side. Mr. Greenhalghpro- mised fully borne out in this opinion by the resultof a pase
by the lecturer, that disturbances caused,even at to enter more at lengthinto the case on a in which the operation had been done,and a fatal
such distances, by comets, "c., may have more to future occasion. termination had taken place. He would mention the
do with engendering epidemicdiseases than we are, Mr. Henry Smith then read a paper on Stricture,case itwss that of a fine young msn, who had su"
perhaps, aware of. The characters of the electricity of which the following is an abstract:^- fered forseveral years from a stricture in thei^etbra,
which was resisungthe
of the air were entered into. The Lecturer (with very obstinate and irritable,
his divining
TBBATMENT OF STBICTtJRH BY THE ordinary methods of treatment. The patienthap-
pened
rod in his hand, properly insulated) PEBIHBAL SECTIOK. to be under the care of his surgeon, a very
chargedthe air of the Lecture Theatre with elec- tricity He stated
that this was a sul^'ect which had, at all skilfulroan, soon after'ProfessorSyme's work came
and broughtitdown again,A "
messenger," times,been of great importanceand interest; but it out. The operation for dividingthe stricture was
"
an insulatedball, was sent up, and examined was
"
so at the presenttime,as the attention resorted to, a small grooved staff havingbeen first
especially
afte?descending. By another method,"-the old of surgeons had been drawn to it lately by one of the passed through the stricture. The operation was well
one of a wire, the same
"
eflTect was producedj the most eminent men in the Profession.The obiect the done; the patient had some bleeding in the night,
electricity in one instance, however,negative, in Author had in view was threefold. In the first in- but went on prettywell forsome dsya,
stance when bad sym-
ptoms
the other the former ^byinduction,
"
of course, po- he should endeavour to show that stricture, set ip,which rapidly took a low form"^nd be
sitive.
"

It was shown, that in the atmosphere a hori-

which is so obstinate as not to allow the passage of sunk within a fortnight after the operation, with all
a nd which is so complicated the sjrmptoms of irritable fever. At the pott-mortem
Eontal motion made littlediflerencein the amount an^ instrument, a s to

of electricity but resist the ordinarjr modes of treatment, should be examination,no extravasation of uslne, nor any in*
; a vertical movement at once gaye divided by firee perineal incision. Secondly, that, a" fiammation within the pelviswas found, and the
rise to electricalnhenomena. The higher the in-
strument
the cuttinginto the urethra is not unfrequently tendedbladder was
at- perfectly healthy. This case spoke forc- ibly
ascended the more electricity
became veloped.
de- wiui fatalresults, should
this operation not be againstdivisionof a stricture,
except when it
in force in those cases where an instrument, was absolutely necessary, and he deemed it so only
Mr. Faradaynext entered into an account of M. Eut owever small,ean be passed.Thirdly,that, in se- vere when no instrument eouJd be passed.The question,
Quete1et*s observations, already noticed in the cases of stricture, srhcn ordinary dilatationis then, was, had the surgeon an^ means at his disposal
Medical Timet, in connexion with the subject of impossible, caustics, and especially the potassa ftisa, to reme4y those cases of stricturewhich Profi^ssoir
eholera. He alludpdto the singular factelicitedby will producethe best results, and win frequently Syme has described as beingundilatable, and so ob- stinate
the Belgianphilosopher, that in summer, in June obviate the necessity lor the knife. He had had under that they cannot be cured by the catheter
the his observation, within the last two years, several alone. He ooosidered they had a valuahleremedy
especially, amount of electricity in the air is
almost nil; the force in the several months being cases where th" perineal
"
sectionhad been resorted to in the potassa fusa, which, although a troublesome,

the following
with the happiest results;he should mention the and perhaps dangerous agent if incautiously used,
;" January, 605 ; February,578 ; in
particulars of two of these to the Society. The first when employedwith proper precautions was of much
March, falling off suddenly to 200 ; in April, 147 ; was a case where stricture had existed for a service, and, it was bis (Mr. Smith's) firm con-
in May, 84 ; in June, 47 ? in some
great viction,
days of this number of years, and where there was such an amount would often obyiatethe necessityfor the
month, as at the time spokenof duringthe cholera of disease that fistulaexisted, throughwhich the knife. Caustic had been much abused b^ some
in Paris,when the instruments could not be charged,whole of the urine was evacuated. The condition of surgeons, and,therefore, ithad falleninto discredit,
the amount almost nil ; in July,much the same on the the patient's health,both bodilyand mental,was but thiswas no argument againstthe remedy.He
average of fiveyears, amounting only to 49 i August, such as to callfor some decided plan of treatment was surprised t o see that Professor Svme, in his
62 ; September, 70 ; October,131 ; November,219 ; No instrument whatever could be passedinto the work on Strictureh^d denied the benefit of cauatic,
bladder,and none had been passedthrough the stric-
ture and had stated his beliefthat it could not remove
December, up againto nearlythe same as the be-
for some time before. The urethra was, there-fore, an organicstricture. But without referring to the
Inningoftheyear, 507. It was a "fine thing,**
Si' divided at t\tepointof a catheter passed down numerous cases which had been treated by a Fellow
Fiaradaysaid,for M. Qaetelet to
prove this, in the
the stricture;the fistulous tracts were laid of thisSociety, and which had been published bim,
able manner he had done, the dawn of some
to by
new
open, and a catheter retained in the bladder. The -;-he
meant Mr. Wade." he (Mr.Smith) could vict
con-
discovery,possibly, in the law of epidemics.As to patient
rapidly improved,"a full-sizedinstrument Mr. Syme of an error by the relationof the fol-
lowing
the qualilyo{ the electricity of the air,in 1800 ob-
servations
could, in a short time,be passedinto the bladder, case. A gentleman,aged forty, appliedto
it was positive ; in only25 negative ; the and he was cured in about a month. The second case Mr. Smith at the end ot November last. He was
best observers considering the normal state of the he should mention was one of a very interestinscha-
racter,
one of the last patients of the late lamented Mr.
earth negative; the air rendered positive as it strikinglyshowed the benefitsof this Morton,under whose care he had been for some
by induction.
operation, and also indicated the danger that was to months. He had sufferedmany years from stricture.
be apprehended from neglecting to put this opera- Mr. Morton had passedan instrument once into his
tion
WESTMINSTER MEDICAL SOCIETY. m force in circumstances where it was lutely bladder; hm of late he had not been able to get
abso-
February 9, 1850. necessary. The patient had had stricturefor anything through the stricture; and, when Mr.
several years, and applied to his surgeon about two Smith saw him, he was suffering much. He had
F. HiRD, Esq.,President, in the Chair, years since. No instrument whatever, aftera careful had some attacks of retention,a nd his urine occa-
sionally
trialof three months, conld be introduced. It was came away only in drops.He tried very
submitted to the patient, whether he would undergo cautiously several times to introduce a catheter, but
FIBROUS TUMOUB OF THE UTEBUa
the operation of urethrotomy, hut he declined,and nothingwould go in ; and he told the patient, that he
A letterfrom Dr. OgierWar4" addressed to the of for some be either cut, or have
was lost sight months, when the surgeon mast caustic applied; the
Secretary, respecting a specimenexhibited by him was suddenljr summoned, and found hia patient in latterplan was agreedupon. The potassa f\isawas
at the lastmeeting, read. condition from extravasation of used by means
was the most perilous of a wax bougie; and, on the seventh
The tumour, which was then exhibited,was at- urine. The urethra had givenway.
tached By extreme application, he passed a No 6 instruraei^t i he can
to the Cervix uteri the
; organ itselfcontained care, however,the man rallied, but was leftin a most now pass with ease the largest in \{is pase. This
a largerone, which had caused a distension and deplorable condition ; his perineumand scrotum were instance showed the efficacy or caustic ; but he would

growth of the organ equal to that of the fourth ricldledthroughwith fistulae, and no instrument not resort to it unless it were actuallynecessary;
month of pregnancy. The tumour was readily
whatever could be got into the bladder. The opera- tion yet he thoughtthat it should be appliedin those
of cuttingthroueh the strictureat the pointof cases of stricture which would not dilate by the
separatedfrom the cyst in which it was contained,the and of layingopen the fistuloustracts bougie;where Professor Syme recommended
catheter, ting,
cut-
exceptat one or two points, where it adhered, by was resortedto with the
happiest results. In a few he feltit was the duty of the surgeon to use the
fibrousbands,to the walls oif the cyst,which were weeks the patient and could use
was at his business, caustic, and he (Mr.Smith)believed that the knife
studded over with granules of fibrousmatter, vary- a large-sixed catheter. It was in such instances as might, to a great degree,be dippensed if the
'
vrith,
in size,from a millet-seed to a grainof wheat. thosemura^edyof whichbe co\ild mentionseveralmore, potassafusa were employed.
 THE MEDICAL TIMES. 127
The periodhaving arrived at whiclithe meeting which many such establishments are conducted In my knowledgeby many able, faithful, and philan-
thropic
of the Society uaaalTy terminated, Mr. Brown pro- posed,thiscountr]^, or you would have been less sweeping men, who are actuated by no other ipotivc
and Mr. Travew,jun., seconded,the adjourn-
ment and uncharitable in your remarks,carefitUy drawing than a desire to do theirduty. \f J may be per- mitted
of the debate, which was carried. the distinctionbetween the use and the abuse of such to speak from my own experienceonly
institutions.You have not hesitated, in those re- marks, duringthe last week, I am sure you willextend to
AUDIT0B8' MPORT. to availyourself of the roost rare and unusual me your commiseration, when J tellyou, that for
In the course of the evening, the Auditors' Report
abuses,in order to denounce the system, and bring acts of gross in^e^ency, general unfaithfulness of
was read,from which itappeared that the balance in itbefore the publicmind
arrayedin allita deformities. conduct,I have ^eenobliged to discharge from my
hand at the commencement of the past year was And if. Sir, I were to sit down with the intention of house my superior male and female attendants,
"W. 17s, 5d.} subscriptions received,52/. lis. ; adoptinga similar course, and, extending my ob- being left,at the shortest notice,without the ser-
servations vices

admission-fees, 68/. Ss.; donation,1/.; total re- ceived, to every sjrstem,profession, or polity in of these functionaries, and that at a time of
166/. 18s. 6d, The expenditure amounted the country, to the legislature, and even to the Con- stitution more than usual domestic anxiety.( can faithfully
to 92/. 15s. 2d.; leaving a balance in hand of itself, I could doubtless paint a very florid assure you, firommy own experience, that there are
71/. 18s. 3d. Among the items of expenditure picture of such abuses there,as would shortlycon- vince with allthese, and many other difficultiesto contend
were,
pent,29/. 5s.;coffee, 19s. your readers that some speedyremedy is of with, many privateasylums in this country, the
"c., 18/. 2d.j publication
of proceedings, 23/. 198. 11 4.
paramount and indispensable importance for the orderly conduct of which would put co shame the
Sjifety of the country. It is most painful, for establishmentsof many private individuals, who have
CANDIDATES FOB OFFICB. example,to behold the presentstate and workings no such formidable impediments to domestic order
It was then announced that,at the next meeting,of all our to bontend with. I know nothingof ^r. Ogilvie,
incorporations, whether they be eccle- siastical,
a President, two Vice-Presidents, and fiveMembers other. nor will I uphold any man who acts unlawfifHyt
municipal,collegiate, or any
of Council were to be elected. The Fellows of the We cannot take the commonest view of them, with- out whether the law he infnngesbe a goodor a bad one.
Society were invited to nominate candidates forthose beingmost utterlydisgusted to think that our But,you must remember, there is no law to regulate
offices. fellow-man who are filling the very highest offices bathsin lunatic asylums;and one man has as much
Dr. James that can be awarded them, are acting, in a corporate right to have them moveable,as another has to have
Bird, in animated language, moved,
and Mr. Greenhalghseconded,a vote of thanks to capacity, that part in the stage of life which they them fixed.You ou^ht not,therefore, to have used this

the retiring would be ashamed and unable to do as individuals. pointto turn itligainst one who is already fallen. I
President, Mr. Hird,which was carried
Shall I point out to you the abuses of our ecclesias' think, ^Iso, hisej^planation how the egg got into the
unanimously. ticalcorporations ? Shall X tellyou how they have bath,should have drawn forth some expression of
Dr. Murphy was then nominated as a candidate succeeded heretoforein
for the Presidency,
takingestates of dyingmen, sorrow from you* that you made a kindly-intentioned
and Dr. Garrod and Mr. Clarke under the plea of religion, and appropriating them act of a proprietor towards a weak patient to appear
for the Vice- Presidencies. Dr. Sibson, Dr.
Tyler to theirown purposes f Shall I recount to you the in an odious and contemptible light beforethe public,
Smith, Dr. Cormack, Dr. Tilt,Dr. Lightfoot, Mr. longand black catalogue of enormities perpetrated for you have no rightto assume that the bath in
Hird, Mr. Travers,jun.,Mr. Greenhalgh, and Mr. bv those very corporations appointed, i n the first question was the only one in the establishment.
Walton,were named as candidates for seats in ths place,with the benevolent intention of surrounding With what kind orjustice can you affirm* as a rule,

Council. The electionof officerstakes placeat the the weak and defenceless members of society with that in these institutions*' Mammon has triumphed
from injury, violence, and fraud ? Shall over Mercy ?" I expect, if you were to go a little
next meeting.
frotection
proceedto pointout to you thatmost of our corpo- rate more into business, you would not have much trouble
THE UNION OP THE MEDICAL SOCIETIES. and collegiate instead of extendingto discover the fact,
institutions, that many men, hayingno other
The Secretary ^hen read an account of the proceed- protection and round the weaker members than the most honourable intentions, have found
ings support
of the Council,with reference to the fusion of of that
portionof societyto whjch they apply, are themselves, after a few years, shorn of allthe pro- perty
the Medical Society of London and the Westminster lesorting to the most craftyand unjust m^ans theypreviously possessed, after having em- barked
Medical Society, with the view to found one large So-
ciety, to ke^p those members in oppressive tion,
subjec- in these responsible undertakings. Ask Mr.
tramplingupon their reputations, subsisting Homer how many thousands he sunk for ever at
possessing a library and reading-room.The
tenure by which the Medical Society of London holds upon
theirmoneyi and exactingeven from the Legis- lature Denham Park.
itsproperty,estimated at the value of 2,000/., the means by which their injustice may be Your remarks upon mechanical restraintate cal- culated,
forbids in a similar manner,
its name legalised, in order to feed the insatiable avarice of to betraythe public
beingchanged,and it appeared, that con-
sent
men who, if they had lived in heathen Rome, would into the idea that the rule, and not the exception, is to
had been giventhat the united Societiesshould
have been excluded from rank and honour by the confine patients with strait waistcoats and hobbles.
be known by the name of that which holds its natural conformation of theirminds. But it is use- less, Probably your own experience has told you there is
meetingsin Bolt-court A willingness to unite ap-
parently as it is sickening, to point out such abuses. I not even a use lor such baibarities,and that, not even
exists on all hands. The Medical Societycannot behold the august and nobJe members of oar as ap exception, they are to be resortedto. If this is
of London has seventy-five
payingmembers. The Legislature, those on whom we are taaghtto believe the case, perhapsyou willinform me what I mqat do
Beportof the auditors, justpublished, will show the our matchless constitutiondependsfor its wise and in the case of a delicateyoung lady, who will not'
condition of the Westminster Medical Society. The equable conservation, I cannot, I say, behold such hesitateto indulge in the practiceof masturbation
laws of each Society are to be revised, and a new
men. dressed out, as I see them, like those monkeys before my face. Is it merciful or isitcruel to secure

code drawn up ; the Fellows of each are to be ad-

I see ii) the public streets,perched upon the tops of the hands of such patients, tillthe excitement has
mitted.
barrel-organs^ and manifestingabout as much intel- lectualpassed over; Perhaps you will insuuct me, what
And their seniority to dependon the date of
capacity as they do. without feeling certain course is the best te pursue with a patientwho takes
their election in their respective Societies: Ho- that the abuses of private lunatic asylums, like all it into his head to stand on his legsallnight, so that
noraiy Fellows of each Society to have a similar other abuses,will never be removed tilljudgment,theybecome painful and much swollen. Is itkind- ness
rank in the new Society; but not to hold office, unless justice, and truth take their proper placem the or not to secure such 4 one by a strap in the re- cumbent
contributing (tothe funds,we presume.) In future,councils of oqr nation. Till that time arrive, I am postureduringthe hours of sleep 7 These
members of the Profession, not students, as heretofore persuaded
that the^ only course leftfor one in your are questions hard to be answered by expedient men,
in the Westminster,
onlyto be eligible for election. position to pursue, is to try to placethe office prietorwho feed the ignoranceof the public,
of pro- whose minds
lunaticasylum in such a position
Societyas to commandprivate misguided by such remarks as those
The Librarian and Treasurer of the Medical to a are constantly

of London the servicesof those who endeavour, contained in your Journal;instead of which they
to be retained, (to this there was an
by God's help,to discharge theirduties without re- quiringshould know that there are cases, and plenty of them,
amendment on the
part of the Westminster Society,
that there be two Treasurers,
the
very feeble and imperfect supervisioneven in Hanwell,and the other largecounty asylums,
theirown beingalso which our laws nave the power to placeover them. which are placed almost constantly under mechanical
retained :)all other officesto be declared vacant on You willdo much restraintof some sort or other,
the junctiontakingplace.The President of the by
more goodto your fellow-creatures, '

encouraging the proprietors of such institutions,Having made these few remarks,which suggested
London Medical Society, itis recommended, should and givingthem credit for fulfilling themselves as I read your observations upon the
^ many painful,
have the chair the firstyear, and the President of the difficult, and dangerousduties with judgmentand abuses of private Lunadc Asylums,I shallconclude
Westminster the second year. Saturdaynight is kindnets. If you knew what it was to undertake the by observing, that I think you are in justicebound
proposed for the meetings.These propositions, charge of that part of the societyof this country to speak more faithfully upon the real sUte of the
with some which usually finds its way into the privatelunatic case, and not allow prejudice to carry you away from
others, are stillunder consideration, and
asylum, where the worst feelings of our nature have the truth, t he whole truth, a nd nothing but the truth.
some littletime may yet elapse, ere the union tokes theirfling.
" where reason and conscience have been I remain,Sir,yonr faithful serviint,
place, as, afterthe Councils nave agreedupon the
so fearfully marred that virtue and truth can scarcely
terms of union, they must be submitted to, and A Physician and Resident
be recognised," you would, I think, be more ritable Jan.28,1850.
cha- Proprietor.
approvedby the Fellows of the Societiesthemselves, towards all proprietors,kindlyadvising, but
at meetingsto be specially
convene^ for that pur- pose. not overlooking such as do wrong, and very thankful,
in the name of the public, to those who, for con- science' DR. BRINTON ON THE PHYSIOLOGY OF
sake*and in obedience to the commands of THE ALIMENTARY CANAL.
One, whose authority is higher than man's,
OORE^BPONDQNOB. are discharging faithfully, and without a de- sire fTo the Editor of the Medical Times.]
for gain, one of the most trying and con- flicting Sir," In your Journal for Feb. 2, is a review of
PBIVATE LUNATIC ASYLUMS, duties that, perhaps, can rail to the Dr. Brinton's work on ^he
lot of any man who has fully
Physiology of the Ali-
mentary
made up hismind to Canal. It appears that Dr. Brinton ex- plains
rTo the Editor of the Medical Times.] act with integrity. If you knew in how many ways the symptoms usually attributed to inverted
BiK," You express yourself, as a public censor, to the mind and the feelings of a residentproprietor,
he desirous of holding peristaltic action, by the supposition, that the ordi-
nary
the balance of justice with an and particularly apl)ysician,are tried, and how many
even hand ; and although I cannot read your recent
pcristiltic action continuing a reflex current
he has opposed to him, not only amongst his is established, when thefluidcontents of the intestine
remarks upon privateLunatic Asylums generally patients, hut amongst those to whom he is obliged are preventedfrom passingonwards
without much feeling of sorrow and disappointment, by any mecha-
nical
to look for assistance, if he attempts to make any obstruction.
yet I will not permitmyself to believeyour intention stand againstwilful neglect, to
or suppress any Does Dr. Brinton deny the occurrence of anti-
11 otherwise than good. You
cannot, however,be wickedness he may be cognizant of,you would cer- tainly peristalsis in any case?
"ery ezteniiyely acquainted with the wanner in upholdmore than you do, an officefilledto I remember attending % patient gome yean ago.
 128 THE MEDICAL TIMES.

in whom, after the ordinarysymptoms of enteritis, don't care about the omission ; neither do I believe frightened by imaginary lionsin the path. If,m all
irritabilityof the stomach, with constipation,came that itwas wilfully done. I am disposedto view it the chief towns, a respectable agent be appointed,
Other remedies failing, injection oversight, and my sole reason for addressingwhose dutyit would be to solicitsupport from the
on. a
turpentine as an
in the medical of the and district would
was administered per anum, which came up at his you on
this is
subject merely to show that, men town success

mouth within ten minutes afterit was administered. compilation !ofsuch a di^ointed and unconnected be certain.
Will Dr. Brinton's theory account for the above work, the greatest diligence is absolutely quisite
re- By the term Medical Reform, should not be derstood
un-
very
fact? There could not have been any wechanical to make it correct on every point merelythe improvement or re-construction
obstruction. 1830. A Friend. of our existing Medical Institutions; for,althoiigfa
February4, alluded to in my former letter
I am, Sir,your most obedient servant, the three questions
R. U. West. would be those which should be firstdiscnsaed and
Feb. 9, 18f0. MEDICAL settled,
there are others which it would be well to
Alford, Lincolnshire, CONVENTION OF POOR-LAW
OFFICERS. take opportunity of throwing some light upon. What
course of studies (fromfirstto last) wan nest suited
APPARATUS FOR FUMIGATING THE for those intendingto enter our Profession might
[To the Editor of the Medleal Times.]
SCALP, IN CERTAIN CHRONIC DISEASES be considered, and some code of rules mightbe sug- gested
OF THAT REGION. Sir," Will you do me the favour to correct,in to regulate medical etiquette, promote more
your next number, a trifling inaccuracywhich occurs cordiality among medical men, and lessenthe chances
in your report of the interview of the deputation of of takingplaceamong them.
[To the Editor of the Medical Times.] unpleasant occurrences
the Poor-law Medical Officers with the Poor-law offered to insert in the Medical
Sir, ^Will you do me the favour to insert this Board?
" You have liberally
note in an earlynumber of the Medical Timet f Times such remarks regarding Medical Reform as
I stated, that,in my opinion, the dn^s which are
Several Practitionershave written to me, for the may be sent to you ; but scattered sunestiona, ap- pearing
of where could required for the sick poor should be found by the varied intervals in a periodical which is
purpose ascertaining they procure an
Union (not, as you have reported, *'
by the Gtjtfem-
at

apparatus for the application of vapour to the scalp, chieflyoccupiedwith other matters^ do notatrike Uie
described in a work whiqh I have recently published menL") mind with the same force,or admit of the same rail
The salariesof the Medical Officers might,with
on
**
Diseases of the Skin of the Exposed Surfaces."
be' paid by the Government out of
comparisonwhich they would do if they appearedm
propriety,
Through an oversight
the surgical
I did not give the address of
instroment-maker from whom itmi^ht be
Seate Consolidated Fund, and the whole of their time
one devoted to a singlesubieet ; itis for this reason
that I still wish to see an exclusively Medical Reform
the omission
should be devoted to the publicservice. Journal started. Should, however, none be found
procured ; but I hope now to rectify
As the health of the labouringclassesaffectsthe there is another,
by stating,that the apparatus may be had at Mr. welfare of society, good and prompt medical willing to undertake itspublication,
general in which the matter
Ferguson's, 21, Giltspur-street, City,surfpcal ment-maker
instru-
reliefshould be furnished gratuitously to all per-
sons
though less perfectmanner,
to St Bartholomew's Hospital. might be managed. To the Medical Times there
who are unable to pay for it It the labour- ing month, added,
The vapour apparatus is extremelysimple. It
to a district
might be, once a a Supplement
population could have reader access
consists or a tin iar,about ten inches by four,with which might be calledthe Medical Reform Supple- ment,
Medical Officer when sufferingfrom sickness, it be conducted in a similarmanner
8 conducting tube, on which is placed stop-
a cock, without and might
submitting to the degradation of becoming
for the purpose of diluting the vapc"ir,or turn-
ing to that proposed for the journal ; your arrangements
I do not think the privilege would be
it off, ana an elastic cap of vulcanized India- paupers, for printing the Medical Times would, I suppose,
abused. The great facility which allclassesnow have
ruober, which fitsclosely to the beac^ "o as to enable you to produce such a Supplementat a much
of obtaining medical advice at the hospitals and pensaries
dis- could be conducted
preventthe vapour from escaping.The great ma- jority less expense than a new journal
18 injurious to the morals of the people ;
of diseases of the skin are constitutional, and at. Besides the copiesof this Supplement,which "

those of the scalpare not an exceptionto the rule. whereas,

if the State were to
pay districtMedical would be supplied to your regular subscribers,there
Officers, the necessitouspoor would have at all times
Yet every Practitioneris familiarwith the difficulty should be others on sale, at a penny or two pence j
immediate medical asstsunce, and the dispensaries
of removing the latterby the unaided influence of and you might also solicitfrom your subscribers,
and the out-door reliefat hospitals (which are now
and other friendsof Medical Reform, donations to- wards
constitutionaltreatment
Faoust (thepcrrigo of Willan,) for exapiple, so much abused by well-dressecf ladies and gentle-
men) of this Supplement, and of the
favota with. The money which
the expenses
which is one of the most well as the might be dispensed out of the Medical Reform question.
unsightly, as
would be thus savea might be judiciously expended carrying
most inveterateof the eruptions of^that region,may I am, Sir,your obedient Servant,
for the accommodation of
relieved by tonics and fomentations, enlarging hospitals
in the
be temporarily Grorge Fearon, M.D.
of in-door patients, or in increasing
and the skin even made to appear clean and healthv ; a greater number
but the vims stillremains,and, consequently, the
the number of such valuable institutions. Birmingham,January31,1850.
'*
cure" will be but of short duration. In this, as in 4, AUe-place, Feb. 10. John Liddle.
other inveterate diseases of the scalp, of constitu-
tional OF ANIMALS.
HYBERNATION
origin,the skin,from the forceof habit, adapts MEDICAL REFORM.
itselftothe morbid condition,which itretains, with
[To the Editor of the Medical Times.]
singular tenacity, against all the usual methods of
treatment [To the Editor of the Medical
Times.] Sir," I have justread,in the last Number of tbe
of for the space allotted Medical Times,Feb. 2,pace 88,the following
Sir,"While thanking you passage,
In all such cases, the application
vapour, received opinion
the to my letter in your Number of last Saturday, I which beingcontrary to the usually
simpleor medicated,as case may require, to the
columns. If, as concerning the changes which animals underjp
diseased scalp,willbe found a very efficient remedy. must beg againto trespass on vour
and variance with the experi-
ments
Where the objectis,to aUer the vitality qfthe parts, you state, there are so few who take an interestin during hybernation, Iat to make
it can be done more effectually by the repeatedap- Medical Reform, it would be better that the subject
plication
of physiologists, beg permission a

should be dropped, for the necessitv which remarks the subject from my own tions.
observa-
of stimulating vapour (theskin beingpre-
viously entirely few on
worth
cleansed with any detergent wash) than by is onlyfeltby a very small number is scarcely this " ,-r.
With"_ ,hyberw
.

the employment of causticlotionsor ointments. In- deed,attending to. But I cannot agree with you in The passage alluded to runs thus :"
of every kind may be opinion, and the deduction from it, viz.,that a Jour-
nal natinganimals,Reynault found less oxygen of course
greasy applications
devoted exclusively to the question of Medical consumed. They giveoff little carbonic acid, absorb
advantageously dispensedwith in the treatment of
diseases of .thescalp. Reform would meet with inadequate support; the oxygen and nitrogen to such an extent,that theff
fatten I**
That varietyof naldness,which is the result of Petitions which have been annuallysent to Parlia- ment, inerease in weight,actudOtf on sleep

atonv, or disordered nutrition of the hair-foUicles and the letterswhich have, from time to time, About three years ago I watched very attenthrely
appearedon the subject, in the Medical Journals, the with regard in the
a"id bulbs,will be materially benefited by the use change of condition, to weight,
of the would seem to show the contrary. Were the Journal AveUanarius,duringits hybernation, but am
vapour apparatus. Myoxus
Thomas
of a moderate size,publishedat a reasonable price,sorry 1 cannot now find the notes I took on tbe
Buroess, M.D-, "c. I subject.
and,above all,conducted in an impartial manner, However, I accurately weighed the creatur^
12,Half-moon- street,Piccadilly, persuaded, t hat, when time for its
Feb. 8, 1850.
am flilly came without i ts
disturbing torpor, nearlyevery morning,
discontinuance, it would be found to have paidits for the space of about six weeks previously to the
with perhapseven a small profit is termination of its and found its weight
expenses, ; nor sleep, ^;radQ-
THE MEDICAL DIRECTORY FOR 1850. this a rash expectation, when we considerthat there allydiminishing.Dunng the above penod it lost
are nearly30,000medical men in England,Scotland,from 25 to thirtygrains. I cannot be exact,as I am
[To the Editor of the Medleal Times.] and Ireland. There are a largenumber of practi- tioners writingfirom memory : but of the fact of loss of
Sir," I am well aware that the compilationof the who never take in a weekly Medical Period-
ical weightI am certain, and am no"v surprised to findthe
"
Medical Directory" must have involved a tremen-
dous ; but circumstances lead me tobelieve, that many assertion,that animals,duringhybernation, not only
labour ; but at the same time I must say that, of this dass would readily subscribe for a year to a increase in bulk, but fatten. Prunelle found that
in some instances, it has fallen short of all that it Medical Reform Journal,in whose pa^es the^r could bats lost 1-32 of their between the 19th of
weij^ht
proposed to accomplish. When the Publishers issued have an opportunity of explaining their sentiments
February and the 12th of March. It is generally
the *" circulars"to be filledup, theytherein stated,upon the question, and of reading those of others in known, that during hybernation a part of the fat
that no Degree would be noticed,unless the Uni- versity return. formed in the autumn is consumed to nourish the
whence it emanated was stated,and that I must express my regret,that the Medical Re- form body. I found,likewise, that defecation went on
every published work of any physician, surgeon, Societyof Manchester should, as they appear slowly, but regularly, duringtbe winter.
"c., would be inserted. Since, however, I re- ceived to do, confine their idea of Reform merely to the I cannot look upon hybernation as aleep, in tbe
the Directory, I find that, by looking through facilitating the requisition of Fellowships for the I regardit as a very
usual acceptation of the term.
its pages, I can discover many instances in which Profession, of which few would,probably, fa" one whit
differentphenomenon,and one net generis. Some
the firtt and the latter propositions are neglected. the better.This is a trifling unworthy of Manchester
organs in animals ma^ be said to hybernate; that is,
For proof,see *" Little,Robert. Wolvwhampton, men, and only fit to be shown in that citywhere their function is inactive duringwinter,
to be found exhibiting
principal
A.M., M.D., 1824." We are here totally in the dark, numbers of men are a child-
ish
whilst, iu other creatures,the whole system puts on
as to where Dr. Littleprocuredhis Eioctorate. In gleeat their button-bolesbeingadorned with the thispeculiar *
condition.
my own case, as I happen to be an author,I returned bauble calledthe Riband of the Legion of Honour.
I am, Sir, your obedientservant,
a listof my publications, and not one of them is ap- pendedWhy should not this Society, eitheralone or in con-
junction
in the undertake the of J. W. Moses, M.D.
to my name Directory. with others, publishing
NoW| I by no means state thisas for I such
a grievance, a ? Let it not be
journalas I have proposed St. Asaph,Feb. 2, 1850.
 130 THE MEDICAL TIMES.
MORTALITY TABLE. MEDICAL NEWS. as to the practical means of applying the-fore-
going
principle to the metropolis, it is inexpedient

tions
Death$ in the Week endingSaturdayFeb. 9, 1850. ^

to sanction the investment of fresh capital i n the

(Metfopolte.) Kiva'8 College Hospital." During the past same fieldof
tear, 22|309patients have been received, incluuing supply,as itis probable that Ibe new
Average of 1261 urgentoases admitted into the wards. A debt, works will have to be re- purchased, and thert ean be
CAxim Dkith. Total. Ten that these will be applicable to the ar-
Of
Weeks.
amounting to nearly530^,has been incurred, partlyno security
in consequenceof me expenses caused by the ravages rangenlents that may be hereafterreooitimended."
of the epidemic. Thb Chol bra." Letters from Tunis, of the last
All Causes ; 957 1048 Mr. Hale Thomson month, report the cholera making great ravages in
Westminster Hospital."
Spscivivd Ciusss 949 1048 that city,the deaths averagingfrom 20 to 25 a day.
and havingresigned the Surgeoncy to thisHospital, Mr. "

(or Bpldamic, Endemic,

Zjfinotie
B. Holt has ^ivenup the Assistant-Surgeoncy, in The charitY of the Dey has mod most munificenL
Contagloiu)DlMeases ... 152 196
Spo"adic Disbasbs: order to be eligible as a candidate for the Surgeoncy.
He has,at his own expense, establishedthree cholera
Dropsy,CftQcer and other Diseases of Mr. C. G. Guthrie and Mr. Holthouse are candidates hospitalsi and distributed among the f^eople 400
uncertain or rariable seat 44 58 for the Assistant-Surgeoncy.Mr. Brooke, who camel loids of corn, 500 skins of fine oil, and 10,000
Tubercular Dlse"sss 170 187 piastres.
"m m. ^
sought,some time since, for the appointment, clines
de-
Diseases of the brain. SpinalMarrowi
being a candidate on the present occasion ; Athens." The MilitaryHospitalat this place,
Nerres,and Senses 115 128
Diseases of the Heart and Blood the Committee havingunanimouslydecided in favour which cost nearly300,000 dracnmes, has been en- tirely

Tessels M.
... -"
of the claims of Mr. C. G. Guthrie,who formerly destroyed by fire. The patients were, hapi^y,
DisoMes of the Lungs, and of the other held that appointment, and whose chance of election laved.
Organs of Eespiratlon 175 207 is very great, Mr. Holthouse's connexion with the
Diseases of the Stomach, Livef,and
Hospital beingmerelyby the medium of the School TO CORRESPONDENTS.
other Oreans of Digestion ... 66 62
Diseases of the Kidneys,ftc. II f
of Medicine,we believe. We have heard,since this
...

Childbirth,Diseases of the Uterus,"c. 6 10 paragraphwas in type, that Mr. Holthouse has re- signed,"A Correipondent,Teignmouth," writes :" "I have re-
Etheumatlsm,Diseases of the Bones, and, consequently, Mr. C. G. Guthrie willbe ceif ed a circular and pronpeetui from The Isdustiial *

Joints ftc electedwithout opposition. and General Life Assurance and Deposit Company,' con- taining
Diseases of the Skin,Cellular Tissue,
London Fever Hospital. The propos"lswhicli I am induced to think would l"
compensation"

of so favourable operation on the classes for whose

fte 1
money for the old Fever Hospitalat King'sCross benefit theyare professedly
Malformations 8 put forth,that they appear to
Birth and amounted to 20,000/.; 28. 9d. of which was
19,438". to deserve the attention of the masses less than
Premature Debility 19 me no
Atrophy H" 14 spent in building
the Institutionin the Liverpool-that of our Profession, to whom yon will,on referring to
The number of patients the documents in question, see that these proposalsare
Age " 72 road,Islington. admitted
Mudden 13 last year was 714," a great diminution from the psrtleularly recommended" our kindlyofficesare solicited.
Violence, Privation, Cold, and Ihtem These most of us sre likely enough to bestow if we feel
number in 1843,when 1462 cases were received.
23 assured that all is as represented. Will you, then, aa our
perance ,
The average number per month, admitted last year Argus, peep Into the matter, and, when convenient, aay a
Causes not Specifled ., 18
was 54. Of the 714 natients,586 were cured,4 sent word er two. In order that no principle, inoral or pro-
fessional,
is the number
The following of Deaths
occurringf^om tome
to other hospitals, 106 died,18 remainingunder treat- ment. may be endangeredby too readya response to
of the roor" Importantspecial
causes:^ the call of benevolence."
Heart :. 27
The income for the lastyear was 2754^ 7s.
Apoplexy..., Phthisis 1SS
Bronchitis ." o" Hooping-cough 96 Pneumonia ...
69
4d. ; the expenditure, including the investment of '*
Cholera Honours.'*" "
Justitia "
writes"" It was with sin-
cere
Cholera Rydi-ocephalus28 Scarlatina II 750/. in the 3 per Cent. Consols,amount to 2.696/. ; pleasure that I observed in your paper of the Ind,
fndttenaa that a testimonial had been presentedto R. Whiieman,
Childbirth 4 2 Small-poz
...... 8 leavinga balance of 58/. 6s. 4d. in the hands of the
Conrulsions... 49 Liver 9 Stomach 8 Esq.,for his sealous and efficient services as a medical
............ Treasurer. officer during the late visitation of the cholera;but bow
Diarrhcca 20 Lungs 6 Teething 10 Northern Dispensary. Mr. Davis has been
IS Measles
"
seldom are we allowed to be so gratified. Certainly, week
Dropsy 18 Typhus 27
elected one of the Surgeons to this Dispensary. after week we have read of public thanks, and eve" pttblie
Erysipelas ...
10 Paralysis 81 Uterus ......... 1
tjERUAN Hospital. "
^The largesum of 1784/. giltsbeingawarded to Governors. Lieutenant-Governors,
BIRTHS AND DEATHS. subscribed as donations, and 54/. as annual con- ftc. ftc, for their great exertion during that fatal disease,
was tributions
which no doubt were due ; but amidst all the ruin, the
illbehalf of this Institution, at the annual
desolation caused by the late epidemic,how has stood the
Births. Deaths. Births over Deaths. dinner held on the 7th inst. medical man t" scarcely noticed or rewarded. He, the
A.RT1LLERY COMPANY OP LoNDON. Her
"
soother of painand 8or*-ow has had no publichonnurs,"
Majesty has appointed Dr. Henry Jeafireson x" be no briftht stars of Napoleon glittering in the horixou to
Males 785 477 308
Females 712 480 Physician,and Messrs. W. W. Cooper and Law to urge him on to face death and disrate in their moat terrifle
232
...

be Surgeons, to thishonourable corps. forms ; to endure bodilypain and mental anxiety. What
has atoimated, consoled him in his wearied path but tlie
Total.... 1497 640 Naval Appointments. " Assistant-Surgeons G.
pure love for mankind. His soul is great, and, though
Gordon (1846), and E. W. Pritchard (1846), to the faint and worn, be remains unconquered still."
Asia, 84,flag-ship. Mr. Harvey's wishes will be attended to.
METEOROLOGY OF THE WEEK. The Medical Officers op St. Luke's, Chel- sea." M.D.t of King's College,"writes us in replyto our corre-
"

Mr. Warder and Mr. Keen, the Medical spondent "Mors." We regretthat the communication
officersof this parish,made an application to the reached us too late for the present Number. "M.D.,
Guardians for additionalremuneration for their ser-
vices Lend, M.R.C.S." on the same subject,will also find a
in our Journal of next week,
duringthe late epidemic Mr. Warder stated, glace
r. Turley"next week.
that he had attciidecf 3199 cases of sickness,in- cludingWith every wish to oblige, we fear It If111be utterlyim- possible
72 of cholera,and many of diarrhoea; the to comply with Mr. Ogilvle'a request, and make
gross number exceeding that of 1848 by 961 ; and of room for his communication, unless considerablyshort- ened.
1847 by 1308. Mr. Keen had been obliged to engage We "trongly recommend him to lay the matter in
an Assistant, and had incurred other expenses,be- sides questionbefore the Profession in the form of a pamphlet.
A Correspondentinforms us, that Dr. Tumbull, not con-
tent
suffering in health and privatepractice.A pro- posal with sending his ^Moii-cure for chilblains to three
was made to pay each Surgeon 15/., (!)but was English Medical Journals, effected its insertion in the
" repudiated by 9 votes against 7. Liberal-minded Dublin Medical Press. Also, that Dr. Keal'a paper on
Rain in Inches. ?
2o^ guardians! Hypertrophyof the Thymus Gland, and -the letter of Dr.
Martin Duncan and Mr. Nunn, on the Substitutes for Cod-
Edinburgh. " On the 5th of February, Dr. Forbes liver Oil, appearedin cuntcraponiry Journals.
Winslow, Editor of the Jonrnal qfPtycholofiicai cine^
Medi- Mr. McDougall's"communication
"
it in type.
was balloted for and dulyelected a Fellow of " A Reformer of Abuses" will receive Insertion as soon aa
the Royal College of Physiciansof Edinburgh. the 8"ate of our columns will permit.

Naval and Military Medical Honours. "

Dr. J. Stevens, Glasgow."" We shall be happy to receive
"

the cases to which he refers.

Sir De Lacy Evanshas a notice of motion on the
H. L. B., CaHibridge.""
"' Weare not opticalenough to de- cide.
books of the House of Commons, to ask the First Frauenhofcr's discovery, however, is in all the
Lord of the Treasurythe result of the consideration ordinaryclass-books. Is our Conespondent aware, that
of Government, promised last session, re- discoveries have led to the opinion, that it is
during specting some recent

the conferringthe militaryclass of the the prtitnce of certain gatet in tbe atmosphere of the
Order sun which occasions the dark lines; and. after all. he
of the Bath on medical officerswho may have
may not even be fighting with a shadow * It has been re-
cently
been present, and proveddeserving, in important shown, if we remember correctly, that,by paatsingr
naval and military actions. lightthrough nitrous acid vapour, you may get aa many
The Board op Health. The
following
" is an of the so-culled black lines as you please.
extract from the Minutes of the proceedingsof the
""
Endymion."--Staie the case again.
"
not operate in such a case.
General Bo"rd of Health. Resolution :" **That it "" A., Guy's.""We would
M.B., Cork."" You are right,the division Is into three
has been established by the Commissioners for in-
classes. Oval, characterizingthe civilised nations of the
inquiringinto the means of improving the health of world. Pyramidal,the mark of Nomadic tribes. Prog- nathous,
towns, as a generalprinciple ot legislation which has of course, all the negro families.
been confirmed by subsequentinquiries made under " A Beginner.Broadstairs,"asks." I. Is the attendanee en
for M.R.C.S. and L.A.C. cheaper at Edin-
the Metropolitan SanitaryCommission,and adopted Lectures, "c.,
bugh tbau in London f 2. "Do the Edinburgh diplomas
by the Legislatureas a fundamental provisionot the of a generalpractitionerqualify him for Poor-law appoint-
ments
Public Health Act,and which,so far as this Board
in England ! S. Is tbe Hunterlan School of Medi- cine,
has proceededwith its own investigations, appears Bedford-square,considered a good one, and ono
to be equallyapplicable to the metropolis, that the where every necessary instruction and advantage is
works rbr supplying the publicwith water should be affordedr
under the same public jurisdiction or management I. Yes. 2. A candidate for a Poor-law appointment must
with works of drainage, paving, and surfacedrainirg. possess two quallficBtions, one medieal and one surgical.
That, apart from the merits of any particular scheme Any Bri:i8h qualification will suffice. 3. Yea. It is
of new water-works, aud pendingfurther investiga-withal the cheapestSchool in the metropolis.
 THE MEDICAL TIMES. 131
OSIGIVAI lECTTTBES. commencingthe cases which are to occupy apex. Dr. Hope thoughtit never occurred,but it
Before
us to-day, it may be useful to review our steps, and has been recorded.
to givea brief summary of the signsof the valvular 7^ The pulse, as in mitral regurgitant, is weald
IiEOTUBES lesionswe have discussed, and of the rules by which unequal, and,from accompanying dilatation
general
ON their diagnosis is to be made. of the heart,may be irregular.
We have seen one
CLINICAL MEDICINE. exampleof that comparatively infrequent disease, A co-existentsystolic murmur is very oommoni
DBI.IVAEBD AT UNIVERSITY COLLEGB contractionof the tricuspid orifice,and two exam-
ples from accompanyingmitral insufficiencnr, Fre-
HOSPITAL. of tricuspid regurgitation. We have seen also the diastolicsound is wanting{ perhaps from
By PAEKES,
B. A.M.D., Loud. ; an instance of mitral contraction, and several of tie nature of the auently
contraction, perhws from the
llimbw of the Eoyal Collegeof PhysicUns, Profettorof that common disease, mitral insufficiency. A feeblenessof the current of blood. Tds pulmonary
CUnleal Medicine in University
College,and Physicianto marked case of aorticobstruction, and as marked a symptoms which are present, may appear refemUe
the Hospital.
case of aorticinsufficiency, have givenus the signsto a co-existent mitral regurgitant disease,and it
peculiar to these afiTeotions. Let us, before proceed*then becomes almost imposdbleto diagnose mitral
LECTURE V.
ingfurther, e ndeavour to laydown the rules of sical
phy- contraction. In such a case, the flow of blood
Gweral Summary qf the signsqf Valvular Lesions "

diagnosis which are applicable to these Sec- tions.throughthe aorta,as judgedof by the character of
Case of Aortitis and qf Obstructive and Regurgi- the aorticsecond sound, and the state of the pulse,
iasU Disease ^ the Pulmonary Valve Alterations be accounted
1. Mitral insi^fficiency, presenting all itscharac-
ters may be more impededthan can easily
"

m the Cavities following Valvular Lesions "

Case qf in perfection, givesus " for by the existent mitral regurgitation. Then wa
General Dilatation producing both Anasarca and 1". A systolic and mitral
murmur, having its maximum may suspect, carefully examine again for,
Hmnoptysis General Rule as to Affection
"
qf In-
dividual (^r the leftapex, or just outside this,and being contraction.
Cavities. followed generally the following
by a second sound. 8. Tricuspidinsi^ffieieney may give
Gentlemen, " An organicmurmur arising in 2^. An accentuation of the pulmonary second signs: 1**. A systolic
"
murmur at the rightapex;
the heart itself/does so, with some exceptions, at the sound " the aortic second sound weakened. The 2^. Pulsation and refilling from below of the ex- ternal

expense of a healthy sound. It abolishes, more or accentuation of the pulmoQarysecond sound may jug^ilars; 3o. Signs of hypertrophy, and
leasperfectly, this sound,accordingas it destroys not occur if there be coincident tricuspid insuffi- dilatationof the ventricle,
ciency. and often of the auricle.
the geneticelements of the sound with greateror The weakeningof the aortic second sound 4o. Second sound at the right apex often lost ; the
lea completeness. It becomes,then, important to is said to be most marked in old cases in which the cause of this deviation from the common rule in
determine at what point a murmur supersedes most size of the aorta is often notably diminished. mitral insufficiency is obscure. It may dependon
perfectly the sound or sounds which arc normal to 3^ The signs of dilated hypertrophy of the left a lessened column of blood in the pulmonaryartery.
that special locality. By this observation another side sometimes those of the rightside.
" The almost inevitable consequences of any
s^ of some importance is added to that valuable 4". The signs of pulmonary congestion from amount of tricuspid regurgitation are impediment
diagnostic mark, the direction of the sound. For ex- ample, reflux. to the general circulation and anasarca. The sya-
in extreme aorticinsufficiency, a diastolic mur-
mur 5*. Thrill at tiieapex. tolio murmur is not always present; nor are the
over the aorticvalves, is found to have destroyed 6". A feeble, small, and unequal^ but not neces-sarily jugular pulsations; but if there is decided evidence
thenonnal second sound over the course of the aorta. an irregular pulse. The smallness of the of dilated hypertrophy of the right h eart, and general
On shifting the stethoscope over to the pulmonary pulseoften contrasts with the vigour of the heart's anasarca, which cannot be referredto another cause,
aitery, the diastolicsound may stillbe heard,but it impulse. then the diagnosismay be made of tricuspid ease,
dis-
now succeeds to,or, as itwere, arisesout of,a distiuct Such a disease,when uncomplicated, is not at- tended either regurgitant, as it almost alwaysis,or
second sonnd. The inference, consequently, is,that by dropsical symptoms, or by any signs rivedobstructive,
de- as it is in some very rare instances.
thediastolic murmur is simplya transmitted one, from the general venous system. If,in such a case of diopsy, there are no signs even

and that the pulmonaryvalves are competent. It is (a)Of these physical signs,the two last may be of dilated h3rpertrophy, then the generalvenous
true that in this case, the other signsof aortic in- sufficiency
eliminated without weakeningthe certainty of tbe congestion may be owing to an exceedingly weak
are usually so marked, and the lesionsof diagnosis ; nor, without at leasttwo others, are they and dilatedheart. Often the diagnosis of tricuspid
the pulmonaryarteryare so rare, thatthisadditional of the least diagnostic value for this special lesion. insufficiency must be drawn altogether from the
diagnostic inctication is hardly necessary. It gives (b) If there be no evidence of pulmonary en- general
gorgement, symptoms.
me, however, a simple illustration of what I mean, that is,cough,haemoptysis, (not de- pendent4. Tricuspid contraction is so rare a disease,
and,indeed,might,if we encountered one of those on its other known causes,) expectoration, that its signs are not yet known. A diastolicmur- mur

singular examplesof insufficiency of the pulmonary "c., nor of dilated hypertrophy, the diagnosis of at the rightapex from this cause has not, to
valves,be of diagnostic value. Possibly, in such a mitral insufficiency still remains sound, if,with a my knowledge, been recorded. Possibly we might
case, it might be found that the second sound would systolic murmur at the left apex, the pulmonary suspectsuch a lesion,if,to the siffns of general
be heard over the aorta,and would be abolished over second sound be more accentuated,than can be dropsy, there were joinedevident dHatationof the
the pulmonaryvalves and artery, a diastolic murmur considered normal, even in those who presentna- turally right auriclewithout the signs of ventricularhyper- trophy,
existing at both points. Thus we should have the verse
con- a sharp pulmonary second sound. and without the murmur of tricuspid insuffi-
of a well-known fact, in the case of aorticinsuf- (c)If the onlysignbe a systolic murmur at the siency.
5. Obstructive Aortic Disease. l.o A murmur
ciency.I do not assert from personal observation that left apex, this proves, in all probability, disease and " at
this would be the case, as I have never seen a case of alterationof the mitral valve, but perhaps not the base,with its maximum over the valves,or just
regurgitation through the pulmonaryorifice diag- nosed necessarilyregurgitation. This statement posedabove,and carriedalongthe aorta. If the contracted
is op-
duringlife; it is merelya suggestion and an to the usual rule laid down by writers, and orificebe very smooth,the murmur may be wanting.
illustration.But there are some cases in which it especially to the opinions of Hamemjk, and is not to 2^. Hypertrophyof the leftventricle, in a degree
is really of diagnostic importance to determine be considered a certain one. In fact, I have not determined by the extent of the contraction and
whether an aortic second sound can be heard. I scnapled, and shall ont scruple, to speakof systolic the general health and occupations of the individual.
allude to cases in which, with a double murmur at murmur at the leftapex as diagnostic ciency. 3^. Aortic second sound very weak, even
of mitralinsuffi- wanting,
the base, really due to aneurism,which presents But there are some cases on record, and in but not superseded by murmur. 4^. Occasional

hardlyany other signs, or more rarely to roughnessthis Hospital we have lately seen two, in which purringtremor. 6o, Pulse unafiected, till con-
traction

and coarctation of the aorta, it becomes a question thickening and vegetations on a competent valve be extreme, then small and rather hard,
whether these murmurs may not be simplyowingto apparently producedthe systolic murmur. not soft and unequal.

obstructive and slight regurgitant disease of the (d)Occasionally, but rarely, mitral regurgitationVery nearlythe same signsmay be givenby
aorticvalves. Now, in such a case, it appears im- possible is unattended by any murmur, and must then be roughness of the lining membrane of the aorta, by
at firstto say that there is no aortic tion
obstruc- diagnosed by its other signs, if present. If not pre dilatation or aneurism, by pressure from a tumour, or
; but if the aortic second sound is well and sent,the disease is latent. even from a tuberculous lung; onlyin such cases,
plainly heard,and in many of these cases it is even 2. Mitral Contraction is diagnosed with much if the valves are healthy, three circumstances will
the signs often fix the diagnosis; Ip. That the sound is at
sharplybroughtout, we might be warranted,pro- vided greater difficulty. The following are

other signsof aorticinsufficiency were ing,

want- sometimes noted : " its maximum above the valves, and is hardlyat all
in eliminating regurgitant aortic disease,and, I*'. A diastolic murmur at the leftapex. heard below them. 2o. That the aorticsecond sonnd
consequently, in referring the diastolicsound heard 2". Pulmonarycongestion and haemoptysis. is of good tone. So, That the morbid sound is
under the firstbone of the sternum to diseaseof the 3". Second sound in pulmonaryarterysharpenedcarried a long way down aorta, and can often be
aorta itself. The systolic murmur would,therefore, (unless there is also tricuspid insufficiency) in the heard better in the back than over the heart
be probably referred to the same cause. aorta enfeebled. Hamemjk, of Prague,doubts whether a murmur
In the case of the first sound, which arises ap- parently4**. Frequentlyconsecutive enlargement of the will arise from a roughened aorta,but this cause is
from more compositecauses than the second, right heart. usually admitted in this country,and I believe pro- perly
and which is transmitted even more readily than the 5". If there be no absolutediastolic murmur at the so.

second,to differentparts of the heart,it is not so apex,'there may be severalsounds,two or three, follow-
ing Systolic murmurs may ariseat the aortic orifice and
the e^ent to which itis destroyed in which there isno reason to
easy to determine ; the systolic sound. Sometimes these may be re- in the aorta in some
duplications cases

but even here valuable aid is frequently given to onlyof the normal second sound, but suspectorganic change,viz., in ansmia, in tjrphoid,
diagnosis by notingthose partsin which the natural often theyproceedapparendyfrom the mitral valve and probably in typhus fever, in puemeralfever, and
sound is purest. In a case, then,of diseased heart, itself, and are, perhaps, attributableto cleavage of it is said in the exanthemata. So also in cases of
itis not sufficientto observe and record the morbid the first sound, or such moietyof the first sonnd pressure from below,as in abdominal tumours and
sounds alonei The healthy sounds,when theyexist,may be heard with a second sound. pregnancy, or from the dde, as in some cases of
ahonld be alwasrs included in the description. 6". There is sometimes purring tremor at the tumour not directly pressing on the aorta,inorgaaic
No.M8,VoLXXI.
 132 THE MEDICAL TIMES.

murmurs will occur. It is not alwayseasy to diag- nose there were no spots. The patient layon eitherside the aorta, where it was so oopiouaas to give the
these from aorticdisease, exceptin the case of indififerentiy ; breathed rather hurriedly, yet not lining membrane almost ascabrous appearance,which
ansBmia. An inorganic murmur thus arising, is very mnch so, and had a dull, heavy,inattentive, was partly by stretching.
effiiced The normal smooth-
ness
calledby Hamer^jk ** diffuserton/'but the murmur but not sufifering, cast of countenance. The pulseat and polished appearance of the membnme was

is often as perfect as any arising from obstruction. the wrist was small and irregular. As the nurse lost throughout The .calibre of the aorta was^
It is said,that in rheumatism a murmur will occur said she had been heard to cougha good deal,we throughout, diminished in some placesmore than
at the aorticorifice, without endocarditis. liftedher up at once for the purpose of examining others. Owing to a mistake the huge arteriesof tho
6. The signsof aortic insi^fficiency were given at the bases of the lungs. There were signsof generalneck were not examined.
the last lecture. I need onlymention one more of bronchitis,but none of pneumonia. From the third In the abdomen the spleen was the organ most
littleimportance, viz.,a lengthening of the interval dorsal vertebra quitedown to the lumbar region,diseased. It was greatlvenlarged, (weighing SOos.
between the heart's impulse, and the beat at there was an extremely loud roughsystolic murmur. 2dr.,)hard and rounded; the tissue was without
the wrist Neither of these diseases of the aortic This was much louder than cardiac murmurs ever fibrinous deposits, was dark and unusuallyfirm
mouth are necessarily attended by obstructionto the are in this situation. On examiningthe heart,we under the knife. The liver was large,(65oz.Osoft
general circulation. found amoderate impulse, and a normal position ; the and fiabby;there was no atheroma in the voBa
7. Obstruction and regurgitation at the pulmonar amount of dulness was not marked out All over portsB. Both kidneyswere large, (viz.,
li^t,SJos.,
orificeare very rare. The signs of such states wij the cardiac region, base,and apex, was a loud rasp- "left,7oz. 2dr.,) flabby, with capsules readilyse-
parable

be analogousto similar conditions of the aortic ing systolic murmur. This was decidedly much from pale, smooth surfaces. On section, the
orifice. louder over the aortic valves, and up the aorta,than at corticalsubsUnce was very white,flabby, broadened,
Such beingthe generalsummary of the physicalthe apex ; but it was heard at thispoint also. There without injection anywhere;there was a small e^
signs, provisos
the following should be home in mind was no jugularpulsation. There was no diastolic on each kidney. Stomach, intestines, and fanun
in examiningcardiac affections. murmur ; but I have no notes of the changes the presented
in nothingabnormal.
1. These rules presuppose that the heart is in its second sound. At the base of the heart was extreme This case is almost valueless to us, as fiu:as phy*
natural position, has an unchangedaxis,and is not purringthrill. There was no oedema of the feet sicalsignsgo, as we had not time to consider it with
to an abnormal extent covered or uncovered by nor other marked symptoms of any kind. sufficient minuteness. We had recognised easily, OQ

lung; in fact,that there are no circumstances pre- sent It was clear that in this case there was somethingaccount of the murmur, some aflfection implicating
which may falsify, so to speak, the elements wrong about the aortic valves,and probablythe a greatextent of the aoita ; but we had not deter- mined
of the problem. If such changesare present,it aorta itself; but whether this was old or recent,or the old or recent origin of this. But, aa re- gards

must be seen what amount of uncertainty they what the nature of the presentattack might be,was aortitis, we had here no violentpulsations of
cause in the diagnosis. not very clear. At the next examination we should the aorta, no angina,no heat of surface,and no
2. In the matter of murmurs more especially, it no dcubt have made out more about the case ; but great distress;but these symptoms might have been
should be alwaysremembered, that to cause tions the patient
vibra- died before we had an opportunity of absent from the near approachof death. We hi^
of valves and muzmurs, a strongcurrent of examiningher again. no oedema, a symptom which Bisot noticed in his
"

blood is necessary. If,therefore, with an extremely After death we found the lungscongested, but three cases of aortitis. If we had seen more of the
feeble heart,there are no murmurs, should we have diagnosed the aortitis ? This
we cannot say without lobular,or other kind of,pneumonia. The patient,
that there is no affectionof the valves with the same pulmonaryartery the of left lung presented large I cannot undertake to say. I think,possibly, not
certainty, as if with a strongpowerful heart and a deposits of firm grey atheroma ; these disappeared I think, unless we had had other symptoms, ve
good current of blood,there was an equalabsence as the smaller branches were approached.The should have diagnosed old roughening the aortic
of
of murmur. In this last case we might be all but pulmonary artery in the rightlung showed a few liningmembrane. The sigpas of the pulmonary-
certaintherewas no valvular disease, but not so in the points onlyof atheroma. Between the patches the valve lesionalso were concealed by the loud sortie
former case. Therefore, with an extremely feeble natural glistening of the lining membrane was well bruit, and in the single
" examination we made we
heart,the diagnosis must be qualified. You will preserved. There were no tubercles. The pericar-
dium had hardlyany chance of distinguishing the two
find itstatedby a writer of authority on diseasesof had evidently, at some former period, been lesions. The systolic murmur at the apex wss, pxo-
the heart. Dr. Blakiston,that mitnl regurgitation infiamed. There were a few small patches of old bably, transmitted (torn the aorta. The case msiy
is ''sometimes, but not often," accompanied by lymph in the rightventricle ; on the rightauricle be valuable, in spite of itsmeagreness, as putting yon
systolic murmur at the apex. I must confess, that were numerous points of old lymph,and towards the in mind that these rare afliections, aortitis, and diseoae
as far as I have myself been able to examine cases, appendixregular layersof lymph, which could be of the pulmonaryvalves, may yet come before ua in
and to consider those recorded by others,I should peeledof. The heart weighed 16 oz. ; it was not our clinicalexaminations, and are, therefore, to be in-
cluded
doubt whether this statement is not too broadlyrounded ; the apex was formed entirely by the left in that listof diseaseswhich ws have to con- sider
put. It appears to me, that except in cases of ventricle. The right auricle and ventricle were both when we flnally fix the diagnosis. I f we omit
manifestly weak hearts,or failure of circulation dilated and hypertrophied ; curiously enough,the them, on account of their rarity, we may, pxobaU^,
from arrest of the current of blood,if the other signs hypertrophy in the ventricleseemed to have occurred some day or other,pay the penaltyby an error in
of mitral regurgitation exist,the systolic murmur chiefly at tiie apex ; thus the walls were onlytwo diagnosis.
at the apex is never or very seldom wanting.lines thick at the base,three in the centre,and five (To he continued.)
Among the great number ot instanc-.sof systolic at the apex. ITie tricuspid appearedhealthyand
murmur at the apex which daily present themhelves, competent On passing the finger into the pulmo-
nary
it appears to me, is to decide whether
LECTUBES
the difficulty, artery,it was found that it scarcely admitted
ON
the murmur is to be referredto regurgitation, the little finger at itfrom above,the fiaps
; on looking
or to
other conditions of the mitral valve,not involvingwere seen to be muchthickened, adherent to THE CHEMISTRY OF THE POISONS;
very
insufficiency.But there is seldom any difficulty each other,and to form,by their union,an irregular OR, ON
in the murmur
finding in decided insufficiency. triangular opening, at one pointof which was a little PRACTICAL TOXICOLOGY.
3. When two or more cardiac diseases are com-
bined, nodule of lymph. The valve was decidedly petent
incom-
SHOWING THE APPLICATIONS OP CHEMISTRT TO
the signsmay be "lightly modified ; thus, as well as obstructive. Above the valve the
THE DISCOVERY OP CRIME.
extreme mitral regurgitation, with a rather weak artery was of its normal size ; there were patches B7 H. LETHEBT. M.B.. Lond:
heart,may prevent an aortic obstrnctive or regurgi-
tant both of old lymph and of atheroma on and between Loolarer on Chemlitryin the Medioal Collegeof the Loaten
murmur, by greatly diminishing the flow of itscoats. The atheroma was not so abundant as in Hospital.
blood throughthe orifice.Such a condition, however, the left pulmonary artery ; there was no redness.
LECTURE XIV.
does in reality fall under the rule givenabove. The left auricle and the left auric ulo- ventricular
Impurities in Nitric Acid, their sources and modes of detec-
tion,
Again,tricuspid insufficiencymay preventany in- creased
openingand valve were healthy and competent l^e
(a) Oxides of Nitrogen; (h) Muriatic Ac!d|
sharpness of the pulmonary second sound left ventricle was slighUydilated ; its walls were (c) Iodine and Iodic Acid ; (d) SulphuricActd ; (e) Iran :
in mitral insufficiency. onlythree lines thick at the base and two at the (f)Potash. Soda, and other fixed tubstancet ; (g) Arsenic.
Let me call your attention to a case which, apex ; the muscular Tlie Methodti of Purifying the Acid, and of obuiniog
now substance was and did
flabby,
pure Monnbydrate. Hydrochloilc
a Acid; lu synonyma.
althoughunfortunately very poor in detail, is yet not present the firm,dense feelof the rightventricle.
Properties of ihc GnHeous Acid. Its action Plants ami on

interesting as beingan exampleof two most uncom-

mon The aortic valves allowed water very slowlyto re-
gurgitate Animals. I he Physical Propertiesof the Oaa. Ita
affections, aortitis and
viz., obstructive and the orifice admitted the Chemical Affinityfor Water.
characters. Action oo lit-
gurgitant
re- through them; Li-
disease of the pulmonary artery. This middle fingerwith some mni! i"aper, inonia, luetal.'i,and metalHc oxides.
an
difficulty ; stretched out
quiilMuriatic Acid, C'-mpositlons of the several varieties
will almost complete the series of valvular lesions. it measured only 2A inches ; the valves wcit Graham's, Dalton's. Phyaici*! Propertira
of, H" I"a\'"'".
Some few months ago, a woman, aged about 30, thickened,rather rigid, and of a most vivid red of the Liquid Acid. Ure's Table of Dcnstty and centage
Per-

was admitted into the Hospital.She was unable to colour. From this point to its bifurcationinto the Composition. Daltoii'v Table of Boiling-polnta.

giveany account of herself, and she had no friends illacs the aorta was evidently violently infiamed To-day, gentlemen,I shall direct your attention
to the impurities which have been discovered in nitric
to giveus any information. She was, in fact, ap- there was intense patchyredness,
parently of a brighter co-
lour
acid, and to the methods which are to be adopted
dying; was apathetic, torpid, and indiffer-
ent. than that of imbibition, and there were through-
out
With some learned that she was low, for the rectification of thisliquid.
difficulty we also thickenings of the inner coat and partsbe-
unmarried, a servant of all work, had lived in a and bulgings on the inner surface of the vesi^cl IMPURITIES IN COMMERCIAL AQUA FOBTIfi.
damp kitchen,had been badlyfed and overworked, from large patchesof atheroma which were, probably, (a) Lower Compounds of Nitrogen and Ojnfgtn,
and some indefinite time before, h ad had rheuma-
tism. old,and from extensive deposits evi.lently
of recent such as nitrous acid,hyponitroua acid,"c. These
All we could learn about her presentattack lymph thrown out upon the lining membrane, and impuritieB, so commonly presentin nitricacid,are

was, that she had been ill only two or three days, in some parts below it The aUieromatous deposit produced, in many instances, by the spontaneoiis
that she had shivered, and had, at the time of the wus most marked in the thoracic aorta. The recent decomposition "of the fluid. In pointof fact,it is
inquiry, severe painin the head. The skin was cool ; exudation-matter was moU abundant in the arch of hardlypossible to keepa sample of strong nitricacid.
 THE MEDICAL TIMES. 133

eren for a few days,without its beingacted on by nitricacid. It owes its origin to the alkaline chlo-
rides The process which I shallnow describe to you is
solar lightand resolved into oxygen, and one or contained in the rough saltpetre from which founded on the resultsof these several observations.
other of the impurities in question. An eleTation the acid is prepared. This impurity is easily recog-
nised Dilute the acid with about its own bulk of water,
of temperaturewill stillfurther promote the decom- position. by its givinga white precipitate with a soluble so as to reduce it to the density of 1200. Make the
salt of silver. mixture hot, and dissolve therein a portion of bi-chromate
Both of these impurities are easilyrecognised, (c)Iodine f or Iodic Acid, have also been detected of potash, using about one grainof the
when theyexist in any quantity in the acid,by the in this liquid.M. Lembert states,that he is able to saltto every 100 of the strong acid. Then add a
colour which they communicate to it; for nitrous detectiodine in most samplesof commercial aqua solution of nitrateof silver as long as the liquid
acid,or, as it is sometimes named, hyponitrlc acid, fortis, and his statement has been confirmed by produces a curdyprecipitate. Set the mixture aside
givesa 3^11ow, an orange, or a red tint to the liquid ; Hayes, Gmelin, and other chemists. This fact is for twenty-four hours,and carefully pour off the
and hyponhrousacid imparts to it a green or a blue accounted for by the circumstance, that the Chili clear supernatantliquor.Introduce itinto a retort,
eoh"ui,the intensity of the shades being, in each nitrateof soda,so often employed in the manufac- ture and distilitat a very gentleheat until it is almost
case, in directproportion to the quantity of impurity of nitric acid, contains a greateror less pro- portiondry,taking care to reject the firsthalf of the dis- tilled
present. of alkaline iodides;these salts undergode- compositionliquid.By operating in this manner, you
Hie experiments made by Sir Humphrey Davy duringthe process of distillation, and will obtain a limpid, colourlessfluid, havinga density
lel him to conclude,that the colouration of aqua yield their haloid element to the acid contained in of about 1400,and beingperfectly free from every
fortis was doe to the presence of binoxide of nitro- gen the receiver. The impurity may be detected, either kind of impurity.
; for he found that the addition of 1*2 per cent, by distilling the acid with strong oil of vitrioland Millon has shown, that you cannot rectify an acid
of this oxide to colourlessnitric acid gave it a pale watching for the violetvapours of iodine which ap- pear in this way whose density is above 1480 ; hence the
yellowtint; that 2'96 per cent, of the gas communi- cated after the nitric acid has passedover, or by necessity of diluting the aqua fortisbefore it is in- troduced
a bright yellowcolour ; 5*56 per cent, a dark neutializing the acid with carbonate of soda,mixing into the retort
orange; 6'45,a light olive;7*0,a dark olive;7*76, it with a littlestarch, and then cautiously adding, Should you have occasion to employa very strong
a bright green ; and 8 'percent, of the binoxide, dropby drop,a small quantity of strongsulphuric solution of nitric acid,it may be obtained by dis- tilling
imparteda deepblue colour to the liquid.But, as acid ; by which means you will obtain the character- istic the productof the preceding operation from
I"r. Ura very trulystates,these shades of colour blue colour of iodide of starch. Chlorine added its own bulk of strong sulphuric acid. The two
cannot be dependenton the amount of binoxide to the liquid does not produce this effect; showing acids should be mixed before theyare introduced
present,for frequently the addition of a little water that the iodineexists in the acid in the form of an into the retort, and theyshould be distilledat as
to a paleyellow strong add will instantly make it of oxide. low a temperature as possible, usinga hood ovfr
a deep orange colour; while the dilution of an (d)Sulphuric Acid is another common impurity in the body of the retort,so as to prevent the acid va- pours

oiange-coloured acid will often producea green tint aqua fortis; and,like the preceding, itJs derived from condensing on the sides of the vessel,
And, to judge from the results obtained by other from the materialsemployedin the preparation of the and returning into the boiling liquid.The acid thus
chemists,it would appear that binoxide of nitrogenliquid.It is to be recognised by diluting the acid obtained has a density somewhere about 1500 ; and
cannot exist,or rather,that it cannot preserve its with three or four times its bulk of water, and then it may be still further concentrated, by re-distilling
integrity, in a strong solution of aqua fortis ; for, testing it with a solution of nitrate or muriate of it from a second portion of strong oil of vitriol. If
from the circumstance of this oxide havinga great baryta, either of which saltswill occasion a white the process is carefully conducted,the fuming red
affinity for oxygen, it will instantly re-act on the precipitate if sulphuric acid is present product is alwaysfree from sulphuric acid ; in point
liquid, and form a greateror less quantity of the two '

(e)Iron is very frequently contained in nitric of fact, the onlyimpurity contained in it is a lower
other compounds to which I have been referring, the acid, and the impurity may be detected by super- saturating oxide of nitrogen, which gives it its orange red tint
intensity of the changebeing,in great part, de- pendent the liquidwith liquorammonise; by This impurity may be separated, and the acid de- colourised,
on the strengUiof the fluidacted on. In which means you obtain a brown or yellowish brown by introducing it into a flask or bottle,
proofof this,I mightquote the experiments made deposit of peroxide of iron. Some chemists recom- mend heatingit to the temperature of 170** of Fahr.,
longsince by Mr. Phillips, more recentlyby the employmentof sulphocyanide of potassiumand then treating it for two or three hours with a
M. Thenard, and lately by Millon ; from which it is as a means of discovering the presence of this im- purity, stream of dryatmospheric air,or drycarbonic acid.
evident, that,while a weak acid,as, for example, inasmuch as it strikes a deep blood-red By operating this manner, Millon obtained a pure
in
Hiat havinga density of 1050 is not discoloured by colour with the merest trace of a persalt of iron ; but, limpid, colourlessacid.Whose density was as high^
a stream of nitricoxide,the stronger acids are ; for as Tromsdorfr has pointed out, there is some culty as 1521 at 50^ Fahr. ; and Smith
diffi- also procured a*^
an acid,whose specific gravity is 1150,is made blue in applyingthe test to strong solutions of liquid, as limpidand colourlessas water, thoughit
when it is saturated with the gas ; an acid of 1350 is nitric acid. I have, therefore, made choice of the had a specific gravity of 1517,at 609 Fahr. In
rendered green by it; that of 1400 is converted into volatile alkali. both these cases the fluidobtained was a pure mono-
a yellow Uquid; and an acid,havingthe density of (f)Potash and Soda Salts, Aluminaf and otlierfixed hydrate of nitric acid.
1500,is coloured of a deepred tint So, again,it is substances^ may also be contained in commercial I now leave this subject, and proceedto the con- sideration

found,that the addition of nitrous acid to colourless aqua fortis; but they are easily recognisedby the of another mineral compound,namely,
aqua fortis will instantly commimicate a deeporange saline deposit which is leftafter the volatilization of HYDROCHLORIC ACID :

colour. And from the circumstance, that both the the acid. which has also been named Clorhydric Acid,Muriatic
oliveg^een and the blue solutionsevolve nitrons acid, (g)Lastly, I ought to state, that some chemists Acidf Spirits of Salt,and Marine Acid,
and binoxide of nitrogen, when they are heated or have latelyspokenof the existence of arsenic in The recorded instances of poisoningby liquid
diluted, there is every reason for believing that the nitricacid,derived from the impuresulphuric acid muriatic acid are very few. This "U will strike
higherkinds of colouration are due to the presence from which it has been distilled; but I have never you as beingrather remarkable,when you consider
of hyponitrous acid,and the red tints to the presence succeeded in detecting the existence of thisimpurity, how easily the poisonis obtained,and how com- monly
of nitrous. otwithstanding that I have purposely distilled the it is in the hands of carelessand ignorant
The chemical tests by which you may recognise acid from many grains of white arsenic. persons. It happens,however, that chemists and
the existence of these impurities are based upon some THE PURIFICATION OF NITRIC ACID. medical jurists are occasionally consulted respecting
experiments recently made by Millon ; who states, In your search for chloridesand sulphates in or-ganic the ordinary effectsof gaseous hydrochloric acid on
that pure diluted nitric acid is entirely without matters, it is necessary that you should em- ploy livingand brute matter. To giveyou a case, by
action on the iodides, the monosulphurets, the pro- nitric acid. So in
also, conductingway of example. In the manufacture of carbonate
very pure
tosaltsot iron,prussiate of potash, and bile; many salt by the Englishprocess,
indigo, processes of the arts, it is equally necessary of soda from common
but that,ifit contain a trace of a lower oxide of ni- trogen,that the aqua forfismade use of should be perfectly largequantities of gaseous muriatic acid are per*
itwill then liberateiodine from the firstand freefrom chlorine : hence itis,that many chemists, mitted to escape into the atmosphere, and so to de- stroy
sulphurfrom the second of these compounds; it will as, for instance, Mohr, "Wackenroder,Wittstein, and the surrounding vegetation, and otherwise to
also discolour the third,give a green tint to the Millon,have devoted much attention to the means damage the health and property of those who reside
fourth,bleach the fifth, and occasion a remarkable wherebythis acid may be easily and effectually fied. in the immediate neighbourhood.
puri- From time to
play of colours with the sixth named body. It is All these chemista have shown, that,when time,various law-suits have been instituted, upon
difficult, however,to obtain an acid so pure as to be crude nitric acid is diluted and distilled, the various the ground that this acid is a noxious poisonous
free from all these re-actions ; and you may rest impurities pass -over at differentstages of the pro- cess: compound,and compensation, to a very considerable
satisfiedthat the amount of nitrogenous impurityis thus,chlorine,water, and hyponitrous acid amount, has been claimed for the annoyance suffered
not very great,when the liquid fails to producea are the earliestproducts of the distillation ; then and the damage done. It is,therefore, very desir-
able,
turbidity in. a strong solution of sulphuretted drogen.
hy- follow nitric and nitrous acids,and, in the end, oil that you should be made acquainted with the
In performing this experiment you are to of vitrioland iodine make their appearance in the leading*properties of this gas.
dilutethe nitric acid with three times its bulk of receiver. Takingadvantage of these circumstances, 1st. As regardsUs Physiological ^ects, Gase-
" ous
water, and then to add the test liquor.Unless you we may effect a moderately good rectification of muriatic acid is a powerful irritant, for it occa-
sions

proceed in this way you are very likely get t o cious

falla- crude aqua fortis, by simplydistilling the liquid, spasm of the glottis and a sense of aufibcation
results, inasmuch as the strongacid will, let it and changing the receiver at proper intervals. But if you attempt to inhale it in a moderately pure
be ever so pure, instantly re-act on the sulphuretted you will notice, that,in the process here indicated,state. Even when the gas is largely diluted with
liquor, and, by formingwater and hyponitrous acid, the nitricacid comes over mixed with the red fumes atmospheric air it produces great annoyance to those
lead to the precipitation of sulphur.Accordingto of nitrous acid. To obviate this difficulty, Millon who respire it,causing a violent fit of coughing and
Leconte,an acid of sp. gr. 1330 will leadily sion
occa- has suggested the use of bichromate of potash, the a stinging painin the bronchial membrane directly
this change. acid of which yields its oxygen to the lower oxides it enters the lungs. Here is a mixture,consisting
Muriadc Acid,or, more properly speaking, chlo- of nitrogen, and so produces a pure and colourless of one partby volume of hydrochloric acid gas, and
rim, is very frequently met vpth in commercial product 1000 of air. If you breathe fron^ this mixtuxe.^ou
 134 THE MEDICAL TIMES.
will find that itcaiues much discomfort to yon, and The acid reddens litmus paper, even when it is streng^ of the add, and its density.Of theie
oecasionfla feeling of constrictionin the throatand diluted with 10,000times itsvolume of air. tables.Dr. Ure*s occupies an intennediate place;
chest In pointof fact, the irritating of the Like allthe volatileacidsitfumes with ammonia. And, as far as my experiments have gone, his num-bers
power
gaa is so great, that it manifests itself by itsodour This eflfectis very perceptible in an atmosphere appear to represent the truth. AUow me, there- fore,
when itis dilutedwith 10,000 partsof atmosphericwhich contains onlyO'Ol per cent of the acid. It to placebefore you the following, which I have
air. So, again,you will find that the gas acts acts likewiseon a solutionof nitrateof silver, causing taken from hia Dictionary of the ."rta and Maua-
itrongly on the coignnctival membrane, occasioning a white or opalescent appearance with a dropof this fiictures :"

pain in the eyes and a copiousflow of tears. It liquid when the gas is dUuted with 200,000 partsof
TABLa or Muriatic Acid, bt Db. Urk.
also irritates the sldn and producesdiscomfort on air. The gas slowly attacks many of the commoner
eyenr part of the body submitted to its action. In metals,as, for example,sine,iron,and tiiL It also
the Elements of Materia Medica, published by my effectsthe decomposition of many metallic oxides,
respectedpredecessor, Dr. Pereira, itis stated, that forming therewith water and a complimentary
*'
this gas acts injuriously on animals,even when chloride. With certain of these oxides,as, for in- stance,
mixed with 1500 times its rolume of atmospheric with the peroxides of lead and manganese,
air." Mice or birds introduced into the pure gas, it not only forms the compounds justmentioned,
"^SS^") gpBp,and die within two or three minutes. but it alsoliberateschlorine.
Diluted with atmospheric air,the effects are of Lastly, I have to inform you, that the composi- tion
course milder, and in a ratio to the quantity of air of this acid is,by volume, 1 part of chlorine
present. In horses itexcites cough and difficulty and 1 of hydrogen, making 2 partsof muriatic acid
of breathing. When animals are confined in the gas. By weightit consistsof S6 parts of chlorine
dilute gas, in addition to the laborious and quick- ened and 1 of hydrogen. Its equivalent, therefore, is
respiration, convulsions occur before death. 37,and its symbolis HC|.
Messrs. Rogersonstate,that *' in a legalsuitfor a LIQUID MT7BIATIC ACID.
^neral nuisance, tried at the Kirkdale Sessions All the varietiesof spirits of saltswhich are met
House,Liverpool, it was provedthat horses, cattle,with in commerce are solutions of hydrochloric acid
and men, in passmg the alkaliworks,were made, gas in water. And,notwith8tandingthat the strengths
by inhaling this gas, to cough,and to have their of these solutionsvary, and that Dr. Thompson has
breathing much affected. In the case of White- drawn up a Table exhibiting 15 definitecompounds
house V. Stevenson, for a special nuisance,tried of hydrochloric acid and water, beginningwith a
(some time smcc) at the StaffordshireAsmzes, it compound of 1 of acid to 6 of water, and terminating,
was provedthat tiiemuriatic acid gas from a soap in arithmetical order,with a compound consisting
manufactorydestroyed vegetation, and that passen-
gers of 1 of acid to 20 of this liquid; yet I do not know
were seized with violent sneezing, coughing,whether I am quitejustified in saying, that any of
and occasional vomiting.One witness stated,that these are fixed and well-defined chemical hydrates.
when he was drivinga plough,and saw the fog The following, however, are among those which
coming, he was obligedto let the horses loose, have the greatestclaim to such consideration.
when tiiey would gallop] away tillthey got clear Ut The strongestLiquidAcid, This mightbe
"

On making a carefulexamination of this Table,

named Sir Humphrey Davy's acid,for he first
you will hardlyfailto notice, that there is a pretty
With respectto the action of this temperatureand constant numerical relation between the specific
gas on livingshowed,that water will, atortUnary
vegetables, Drs. Christison and Turner have shown, pressure,dissolveabout 480 times itsvolume of this
gravity of the liquidand its per centagestrength.
that it is destructiveto plants when it existsin the gas, by which means it produces a liquid which has
This relation is made evident,by multiplying the
atmospheremixed with 20,000 parts of air. In a density of 1210, and containsabout 40*65 per cent
excess of the densityover 1000 by 0*2 ; by which
this stageof dilution, although it is quite able
undetect- of the pure gas. This indicates, that the strongest
means you invariably obtain a number tnat very
by the nose, it shrivelsthe leaves and killsthe liquid acid consists of 1 equivalent of gas equalto
the per centageamoimt of realacid
"plants which are exposedto its action for twenty- S7, and 6 equivalents of water equal to 50. Its
nearlyrepresents
in the liquid.To take one case by way of example :
four hours. The Messrs. Rogerson,however, state formula,therefore, is HCi. + 6 HO, and itsequi- valentAn acid of specific gravity 1 162 has an excess of 162
that itdoes not exert any injurious action on vege- is 91.
tables, over the 1000. This excess, multiplied by 0*2,gives
when itisdilutedwith 1500 times its volume 2. (iraham*s Acid* " Professor Graham states,
a product (162 + 0*2=32-4) which may be said to
of atmospheric air,but,as Dr. Christisonhas shown, that when the precedingis heated in the open air, indicatethe true
per centage strength of the acid ;
this statement is incorrect, the conclusion having a largeportion of the gas escapes, and a liquid is
for 32-4,the calculated number, is not very far from
been derived firom a few experiments, performedon leftbehind, which alwayscontains about 25*52 per
32*61,the experimental one, as shown on the Table.
a very limited scale. cent of acid. This liquid appears, therefore, to
In the London and Dublin Pharmacopceias, 1160
2. Ths Physical have some claim to the titleof a definitecompound.
Properties of Hydrochloric Add is mentioned as the density of the strongacid. The
6fa*.-" When this gas is examined in a dry bottle It is composed, accordingto Mr. Graham, of EdinburghCollege, however, have fixedupon 1170
it is colourless and invisible. It is heavier than 1 equivalent of acid,equalto 37 ; and 12 of water,
to 108. Its formula is HCi.
as its standard of specific gravity.But, you wiU
atmospheiic air in the proportion of 1270 to 1000 ; eqiial + 12HO, and fallinto is
its equivalent, 145. error, if you conclude that the druggist
consequently, when itis liberatedin the air,ithas a ever accustomed to furnish an acid of these exact
3. DaltotCs Acid."Dt, Dalton, Dr. Clark, and
tendencyto "eJ1down as a cloud upon the surface densities. On the contrary,nothingcan be more
of the ground. Takingadvantageof its others,have remarked, that strona: solutions of variable than of the commercial acid ;
great spe-
cific the strengths
gravity, this gas maybe collectedin drybottles muriatic acid become weaker by boifing, and that
for the specific gravityof it may range between
by displacement weak solutions become stronger ; so that,in each
1190 and 1100. Davy's acid has a specific gravity
is
case, a liquid obtained which contains the same
8. The Chemical Properties qf the Gas." It has proportion, of 1200, or, as some 1210,Graham's of 1126,
for water, so much 'so that it ab-
namely about 20 per cent of freehydro- chloricandDalton'sofl094. say,
a great afiSnity stracts acid. This liquidhas a density of 1094 ; it
The temperature at which the liquid acid boils
aqueous vapour from the atmosphere, and
boilsat a constant temperature, (232^Fahr.,) and dis-
tils
fionnsdense white fumes. If a bottlefullof the pure varieswith itsstrength.This fact was first demon- strated
unchanged. Its vapour consists, a ccording to
that both
gas is opened under water, the acid is so rapidlyBineau, of 1 volume of gas and 8 volumes of aqueous by Dr. Dalton, who showed
absorbed that the liquid rushes into the vessel with weaker and strong acids boiled at lower tempe- ratures
vapour. It appears, therefore, to be a definite pound
com-
than that of specific 1094. The
great violence. Again, its afilnity for water is
ofl equivalent of hydrocloric acid,a nd 16
gravity
made evident by dropping
valents
equi- differences being represented in the followini^
a small pieceof ice into
of water ; consequently, its atomic weightis
an atmosphere of the pure gas, when the absorption Table :"
181,and itsformula HCi -f 16 HO.
is so energetic that the ice is instantly liquefied. The other solutions of hydrocloric Tablb Foivts Liavzs
acid appear to Daltok's or the Box"ixo of
At ordinary temperature, and atmospheric pressure, be mechanical mixtures of one or other of the MuaiATic Acid.
water dissolves between 450 and 500 times its ceding
pre-
with water.
volume of the gas, producinga liquid which in-
creases
PHYSICAL PBOPBETIBS OF THE LIQUID
considerably both in bulk and temperature.
ACID.
Pure muriatic aoid gas is not a combustible body, Pure muriatic acid is colourlessand limpid, like
nor is it a supporter of combustion ; for the light of water. It is difficult, however,to procure such an
a taperis extinguished it is plunged into acid. That which is usually
directly met with in commerce
the gas. This faculty is preserved by the gas even has a yellow or orange tint,in consequence of the
when it is largely diluted with air. Yon see here many impurities contained in it. The liquid acid
that a taperwill not bum in a mixture consisting of has dieodour, the taste,and the general physiological
1 part of gas to 4 of ait; and that it bums properties of the Its
very gaseous compound. specific
dimly,with a smoky blue fiame, in air contain- ing gravityis alwaysgreater than that of water ; and Lastly,it is commonly stated, that the strongest
only20 per cent of the gas. In pointof fact, you will notice, that its density is in direct ratiowith liquid aeid boils at about 112^ ; and that it freezes
the influence of the below the con-
gas upon combustion is made the quantity of acid contained in it Kerwan, Dal- ton, at 60^ Fahr.,that is, at 92 degrees gealing
evident by the smokiness of the flame, when the pointof water.
Davy,Thompson,and Ure have each examined
atmosphere contains no more than 2*5 per cent of this subject, and have drawn up tables, showing the In my next lectureI shall commence the che-
mistry
hydroohloric aoid. relation which esosts between the per centage of thisadd.
 THE MEDICAL TIMES. 185
ORIOINAIi OONTRiaiTTXeNS. my desired
earnestly
patient to imdergothe opera-
tion air throughthe meatus.
capableof forcing He now

on that side also. This was done,and with de- sensation,similar to what
cided spoke of a particular
ON THE TREATMENT benefit,although not equalto that which fol-
lowedpeople when they inflatethe tympanum.
experience
OF PERFORATION OF THE MEMBRANA in the rightear. She is now free from dis- chargeBy placii^the patient in the lightof the sun, I
TYMPANI BY OPERATION. or any signsof inflammation in either ear ; perceived a septum,which I pierced and lacerated,

B7 WM. HABVET, Saq., M.R.C.S.L. hear very fairly

can with both,can eigoy the plea- sures after which he could perceiveat nine inches the
of conversationwith her friends, a nd can sue
pur- tick of a watch, which he was before obliged to place
In the spring of 1848 I was consulted by a young her ordinary avocations as a governess with grati- fication in contact with his ear. Some difficulty arose to

woman, a patient at the Dispensary, who infonned and profitto hersel" It is now nearlytwo prevent the re-union of parts. It waa at lastac*
me she had been deaf for upwards of twenty years. years since these operations were performed, and I complished, and the patient's hearingimprovedto
She was thirty-fiTe years of age, and had been have greatpleasure in stating, that when I saw her the degree in which it is usually possessed by those
luider the care of several Medical men, who had last, about ten daysor a fortnight since,her hearing who have lostthe membrana tympanL
tried every known remedyto^relieve cessfully. remained
her,but unsuc- as good,and her ears as freefrom disease [To be eontinned.]
Her deafness dated from childhood, as when she ceased her attendance at the Dispen- sary.
when she sufiered from an attack of scarlet-fever.
This was followed by severe and continuous The results of this case, the operationbeing TYPHUS FEVER, TYPHOID FEVER,
otonhoea; a symptom that persisted
" when she almost,if not quitean experiment, were factory.RELAPSING
very satis- FEVER, AND FEBRICULA,
presentedherself at the Dispensary.A rush of The diagnosis I had formed,as to diecon- dition
THE DISEASES COMMONLY CONFOUNDED
air through the middle ears, which passed out of the middle and inner ears, was confirmed, UNDER THE TEEM
through the external meatus when she blew her so greatan extent showed
for the recovery of hearing
to
CONTINUED FEVER.
nose, showed that the membrante tympaniwere that the nerves had not become paralysed by their AT TfiR
ILLUSTRATED BT CASES COLLECTED
peiibrated,and this,on examination,provedto be imperfect action for so long a periodof time. It
BED-SIDE.
the iact. There was a small openingat the bottom would,perhaps, be diflftcult
to t he
explain manner in
By W. JENNER, M.D., Lend.,
of each membrane, and the discharge was free and which the destruction of the membrana tympani Profsssor of Pathological Anatomy in UnivenityCoUsffs,
.mnco-purulent. The liningmembrane of the meatus acted in restoring audition $ it is far more easy to London, and AsslsUot PhytkUn to Univenity Collsge
was in a state of chronic inflammation,and some- what understand the manner in which itis impaired when Hospital.
thickened. Deafness was not complete, as the membrane is perforated. Sound is no longer
DURATION OP TYPHUS PETER
ahe could hear a watch tick when applied close to transmitted by a drum, when the parchment covering
the ear, but was well enough marked to render it it has been burst,neither can the membrane (Continuedfrom psge 115.)
for
impoaaible her gainher living the ossicula Case 22. Imperfect h istory delirium" prostra-
to by the employ" transmit it through the chain of " "

ment she had been brought up to that of a auditCks,when its continuity

" has been destroyed, tion" deafness ^lossof sleep"absence of abdominal
"

governess. All these thingsbeingconsidered, the by however small an opening. How, then, signs"quick pulse ^mulberry rash" erysipelatous
"

lengthof time the infirmity had lasted, the failure does sound pass when the membrane tirely inSammation
is en- of nose, pharynx, and larynx"dulness
of the ordinaryremedies to arrest the otorrhoea^ or lost? There have been many instances of right side of chest friction right pleura ^brain
"
"

fold
improvethe hearing, and the position in which my on record,in which such a condition of the ear has healthy"slough on aryt"no-epiglottidean "

diffusedabsces8--fluid and recent

unfortunate patient was placed, by her utter inability been co-existentwith tolerable, althoughnot per- haps postpharyngeal
to follow her employment,rendered it imperatively perfect a udition. Can itbe that, under such lympn in right pleura consolidation rightlung"
"

necessary to seek some means by which we might circumstances, the cavityof the tympanum itself DO lesionof gastro-enteritic membrane.
be enabled to restore to her degreeof hearing,acts merelyas a prolongation
some of the external mea-
tus, Mary W.. aged42, a native of London, mother of
ifpossible. In such a case, the old
adage," Ancept and conducts sound to the fenestrs rotunda and several ohiidren ; the wife of George W., (Case 8,)
is conveyedthrough and reoeived into the hospiul at the same time.
Ttmtdimm melius ett quam nulUtm,would be admitted ovalis,whence itsimpression
to have full sway. It was evident that the diseased the internalear to the brain T If such be the case, A thin woman, with lighthair and eyes and dark
before
She states thatshebasofteo been ill
condition of the meatus and t]rmpanum were the and it is the only feasible explanation
"
sents complexion.
that pre-
of the
the present attack,"the nature and severity
sole causes of the deafness ; the middle and internal itselfat present, it will be readily "
admitted,
illnesseswere not ascertained. Never bad rheuma-
tism
ears were sound, and the Eustachian tube pervious ; that a certain and important part of the orsan of
fever ; not subjectto cough. Affirms thather
nor
it waa equally evident,in my opinion, that the low in- hearingbeing rendered imperfect,
flammation it cannot oe ex-
pected
habits are temperate.
and ulceration of the membrane were that the fulness of the function would be re-
stored. or aiaid August 2nd. Her
Present Ulnese on began
the
partly cause, and sufficedto keep up the general A certain degree of imperfection in the bowels had been regular from the first ; she had been
mischief and impairment of hearing thatwas goingon. hearing might,and must be expected; but still, a vary delirioussome davs before her admission. Her
Under these circumstances, in consultationwith a greatstepis gained, if by this operation we are abled
en- husband,from whom tne above particulars were tained,
ob-
medical friend,well conversant with diseases* of the to assist our deaf patients to hear a watch assured me that ** it alllay in the head." No
farther history could be learned. On her admission
ear, who happened to be at the Dispensary at the tick at the distance of several feet,to joinin the
and to performthe ordi" under the care of Dr. Tweedie, the following
notes
tune, and bearingin mind the fact, that hearing, to pleasures of conversation,
were made : "

a considerable extent, has returned, wheu the mem-brane nary avocations of life. I believesuch an operation 16th,".e.,about the 15th dajof disease,
,
she
,

has entirely other August

disappeared, I determined to slit has never yet been performed by any surgeon ; was
very deliriousand slept but little durina the night ;
"p the membrane in the ear that was more eased the case, in mv
dis- opinion,as far as regardsthe little deep she had was disturbed, and she moaned
than the other,and try the effect of that ex- perimentthe destructionof the membrane of the tympanum much. Has not closed her eyes to-day1 the mind
to improve her condition. It was clear by a surgical operation, is unique. The onlyone is now dull and confused, the memory very defective,
that she' could not be rendered worse not at all bearing it,is one related by Saunders,in the expression heavy and dull, the complexion thick ;
; it was on

improbablethat her situation might be improved.his Folio work on Diseases of the Ear, p. 27. He there is much vertigo,but no headache as she lies
Accordipgly, I passedan irisknife throughthe ul- is speaking
ceration of the formation of a falsemembrane in quiet t but when disturbed, by a s loud talking,
she sufferspainin the head. She occasionally grinds
in tliemembrana tympaniof the rightear, the meatus, consequent on disease of the mem- brana
She is sli^tlf deaf,
and divided it close to itsinsertionin the bonyridge, her teeth and knits her brow.
tympani,and of the operation necessary for "*
in her
The he and affirms that she has a stupid" noise
extending afterwards the incision in another direc- tion, its cure. case narrates, although not conlunotivse scarcely more ii^ected
ears; the are
so as to leave two or three flaps of membrane preciselysimilar to mine, yet bears it out than natural,tne pupilsnormaL The nurse states,
floating loosely over the cavityof the tympanum, in its generalfacts,as, after the false mem- brane
that,occasionally, the whole fkce is covered with a
takingcare, when using the knife,not to injure had been destroyed, the paiient recovered his
duskyflush.Sbe liesordinarily on her back,but oan
any vi the delicatecontents of the middle ear. The hearing, althoughthe true membrane of the tympa- num turn in bed unassisted, thoughshe isunable to leave
bleeding very trifling.
w as Considerable tion,
inflamma- had H e
disappeared. says, p. 26, **
The it without aid. The tongue is pale-brown and dry ;
sage
pas-
complicatedeven, unfortunately, for a few of the meatus extemus, has occasionally been she has passedtwo stoolsinto the close pan and one
unnatural from into bed; much thirst no appetite. T here is nei-
ther
days by erysipelas, followed this operation. The obstructed by an septum,originating ;
of
dischargeafterwards diminished daily, and the an elongation or diseased growth of the cutis. As fulness, resonance, tenderness, nor gurgling
the abdomen. The pulse is 108" very weak ; the
hearing gradually improvedon that side; from not we have been informed,this was the state of the 28; trifling cough. There is a little
beingable to hear a watch tick at a few inches dis- tance meatus, in a case where the membrana tympaniwas respirations
sonorous file on deepinspiration.
from the head, she could distinguish itssound perfect, and hearing was restored by a lacerationof The surfisce is cool,the hands cold,the feet warm
at as many feet,and could also take her part in the partition. {Fide Mons. Maunoir's communica-
tion since a hot bottlewas aapliedto them. The skin is
ordinary conversation nearlyas well as if slxehad in the MedicaUowmal for 1800.)I believethese spotted ; the spotsare ausky red,
not elevated, nde
never been deafl The meatus was examined f^om cases are rare, unless the tympanum be diseased, but on pressure ; more abundant and darker on the pos- terior
time to time,with the aid of the speculum,and the are not unfrequentaftera suppuration and puriform than tiie anterior surface of the trunk; the
membrane was observed gradually to disappear, till discharge.The following is an instance of its subcuticularrash is very paleanteriorly; the whole
at laat scarcely any of it remained. It was, of havingformed after a puriform discharge : "J. Hal- dorsum has a somewhat purplishhue from con- gestion.
Mist. am. scet. 6ta q. q. hora ; Tin.alb. ^i.
course, necessary, after the operation, to guard lam applied at the Dispensary fora very considerable
too powerful impression beingmade upon and sudden increase of a deafness, with which he had 4ta q. q. hora.
r'nst
auditory
an

nerves, until they had become accus- tomed been many years afiiicted.The deafness had ori- ginally
The followingday somnolence set m, ana con-
with the exception of the ni^ht
tinued,
of tlie 18th
to the unwonted stimulus. been producedby a suppuration of the
day, when she was very delirious, singing, "c, till
Oratified with the success that followed the flrst tympanum; and he recollected, that, duringthe the 20th day, when she was much more inteUi^nt
operation*, and desirous to experience an equal discharge, air had occasionally passedthroughthe and wakeful. The prostration increased rapidly
amount of beneflt in the condition of the leftear, meatus in the act of blowinghis nose. The dischargefrom her entrance, so that on the next, i ".,16th day
whifihwaa In nearly as diseased a state as the other, had ceased to flow outwaruy, and ha was no longer of s he
disease, layconstantly on her hack,was quite
 136 THE MEDICAL TIMES.
unable to tnrn in bed,and permitted ber limbs to lie beneatb the liiuwmefnbrane qfihepharwuc A slough The pastereas was paleand normal in appearance'
at tbeywere placed. The stoolsand urine were, at the about I inch in length, and } i"ch in breadth, pied
occu- The "p2een weighed5^ ounces ; it was pale,
mach
same time,passed into the bed unconsciously. On the the free border and the pharyngeal surface of corrugated, moderatelytough and flabby.
17tb day,wnen told to show her tongue, she opened the rightarytano-epiglottidean told. This sloughwas The kidneyswere healthy in appearance,except
her mouth, but made no effortto protrude the organ. of a dirtybrown colour, tough,totally disorganized ; that there were about twenty small cysts on the sur- I
The bowels continued relaxed tillthe 20th day, from the margin of mucous membrane around was face and in the substanoe of the left The linipg '
three to five dark liquid stools being passeddaily. brightish red ; the sloughwas detached with facility, membrane of the urinarybladder was congested, iti
Some redness at the bottom of the spinewas noted leaving an ulceratedsurface,covered with purulent- rugn being dull red.
on the 18th day. looking fluid,exposed. The tonsils were rather The uterus and ooaries were healthy.
On the 20th day the pulse,which had never ceeded large,
ex- and firm ; the anteriorand posterior surfacesof This woman survived tillthe 29ui day of diseaie.
108, fellto 96, the spots had almost dis- appeared,the velum and uvula pale. On the under surface of Her case offersa goodillustrationof the impropriety
and she appearedon the verge of con- the epiglottU,
valescence; near its root, was a vivid red patch,of confounding the duration of the typhusfever
but on the 21 st day erysipelas set in. about half an inch in length. The mucous brane
mem- with the duration of the illness. The fever, pro.
affecting the tipof the nose, but chiefly the pharynx of the larynx above the chords vocales was had terminated justbefore the 20th
and larynx. thickened and roughened;below the chords,pale
perlyso called,
day of disease. Erysipelas supervened on the 22nd
The following note was then made :^Pu]se 120, and healthy,as in the trachea.
Doubtless the pleuritic disease was of the
very soft ; nose slightly red,and swollen at the tip ; There was no fluid in the left pleural ccmty, and day.
makes a noise in tne nose in breathing same nature as the erysipelatous inflammation of
; no cougn ; only a few old adhesions at the apex of the lung.
the skin of the nose and of the mucous membrane
expiration prolonged ; respiration, 30 ; a little derness
ten- ITie left lungYiM healthy a nd crepitant t hroughout
of toe larynx ; no swelling of the throat ex- ternally The rightUtngadhered to the pericardium by quite of the pharynx and larynx. It has been supposed
; swallows with difficulty some fluid, returns recent yellow1vmph ; the free edgeof the organ was that erysipelas of the head and face invariably has
back intothe glass; umdOf tfekan pend. palat, and pha- fringedby similarmatter. its starting pointfrom some minute abrasion of the
rynx^veryred. Tongue only partially and slowlypro- truded,Tne right pleora contained about 6 oz. or 8 ok. of surface. In fever it very frrequently, as in thiscase,
red,dry^and glazed ; one copious stool into slightly turbid serosity, floatingthrough which was a in the pharynx,and thence
appears to commence
dose pan. eonsidarable quantity of yeUow lympho-pimlent membrane of the nose, oat-
extend,by the mucous
On the morningof the 28rd day she appearedin substance. Examined by a i^inch glass,this sub- stancewards
to the skin,and downwards to the larynx.
every respect better: the pulsehad fallento 100; the was found to consist of lympb, containing in
Occasionally, however, it will commence in the
expressionwas improved; she swallowed with mnch its meshes much finelygranular matter, and nn- merous
pharynx, and a few hours after show itselfon the
lessdifficulty; the tongue was more freely protruded; non-nucleated granular c orpuscles, about the
ridg^ of the nose near the In such a case, the
lalredness of nose and tenderness of larynxhad dis- appeared size of pus globules. eyes.
; but there was a little vomitingof yellowish The nght lan^ itselfwas paleanteriorly, and of a erysipelas takes its start from two distinctcentres,
fluid. On the evening the the inferior for the membrane and for the skin.
of the same day breathing duskyreddish violetposteriorly,e8pecially one mucous one

again became noisy; a mustard poulticewas appliedportion of the inferiorlobe. On section, the posterior The dry,red,and swollen mucous membrane of the
to the throat. portionof the inferiorlobe,from base to apex, was of pharynx was visible duringlife. The noisy, pro-
longed
On the 24th day,at noon, the pulsebad risen to a brownish red colour,flabby,tough,non-crepitant, the whispering guttural voice,and
expiration,
126; the breathing was noisyand laryngeal ; expira-
tion sank in water, and pve exit to some palerieddishthe tenderness of the larynx, sufficiently cated
indi-
prolonged ; the voice whispering and guttural, serosity. of
The posteriorpart the superior was lobe
the condition of its liningmembrane.
and there was tenderness, on firm pressure, over the
crepitant, of a dusky red colour, and contained hut
The presence of the large slough found after
larynx;the tonsils, uvula, and velum, were red. little excess of serosity.
death the arytsno-epiglottidean fold did
swollen,and covered with mucus; fluids remained The anterior portion of the lungwas crepitant for on

some time In the mouth, and then were swallowed near four inches from itsmargin ; the anterior part not prevent the more prominentlaryngeal ptoms
sym-
with difficulty. of the inferiorlobe was coated with recent lymph. disappearing during life. The return of
I did not see her on the 25tb,26th, and 27th days; On removingthe lymph from the pleura, that mem-
brane fluidsfrom the mouth into the glass, and the hold-ing
but there from the hospital records, to have was seen to be dull white and opaque. The of fluids in the mouth for some time before
appears,
been littlechange in the seneral or local state. hue varyingfrom mere milkiness to absolute opacity. making an effortto swallow,were symptoms which
On the morningof the 28th day of disease I nuide There was a similarcondition of the posterior part indicated serious lesion of the pharyngeal mncons
the following notes : of the inferiorlobe.
"

membrane, and rendered ulceration or sloughing

Pulse ver^ rapidand weak, more than 150 ; respir-
ation The bnmdual tubes contained a moderate amount
of its surface, or purulent infiltration o f the suomu-
44,chiefly abdominal,the rightside of the ab- domen of aerated mucus; theirliningmembrane was pale.
movingmuch more than the left. There is There was no enlargementof the bronchial glands. cous tissue highly probable.The pharyngeal ceded
pre-
absolute dulness to about two inches above the angle the laryngeal disease in this case, as is the
The pericardium was healthy in appearance, and
of the riffhtscapula; comparative dulness to tne contained about 6 drs. of transparent serosity.The rule. It will be observed, that no pus corpuscles
of the same bone ; no breath sound,and dimi- discovered in the post-pharyngeal abscess.
spine nished substanoe and valves of the heart were healthy;were
vocal fremitus over the absolutely dull its consistence good. Much dark loosely coagulated The fluid presented the microACopic appearances
portion ; above that, friction and slightly in- blood escftped
creased from the vena cave and pulmonary generally discovered in similar cases. The dis-tinctive
vocal fremitus^ anteriorly dulness to upper veins on section. The right auriclecontained a large nucleated corpuscles beingrarelyor ever
border of the third nb, exceptingabout a hand's fibrinousclot ; the rightventricle a small fibrinous however closely the fluid may, to the un- aided
breadth next sternum
present,
; some frfcUon over the same clot,interlaced among the columna cornea. The The
eye, presentcharacters of true pus.
part; no obliterationof the intercostalspaces ; the latter clot was continuous with one in the pulmo- nary miliary vesicles, or sudamina, were preceded by
larvngealsymptoms had disappeared; there was artery. is very infrequmt
This eruption
trifling cough ; the coijjunctivae were pale, the pupils The left auricle contained a small black and profusesweating.
on patients than 40 years of age, and israrely if
larffe; there was occasional delirium ; profuse sweats fibrinous clot;the conus arteriosus of the ventricle more

broke out about 8 p.m., and continued tilldeath,at a a fibrinousclot, ever seen after 60.
extendinginto theaorta.where it was
quarter to 4 a.mn on the 29th dayof disease. During moulded to the sigmoidvalves. The endocardium was Cases 1,10, 12, and 16 presented no lesion after
the lasttwenty-four hours she did not speak. For unstatned. The oesophaguswss pale,covered for death ; they proved fatal before the 16th day of
two hours before death she rolledher head from side threeinches from the
pharynxby a dense white layer disease.
to side. There was other struggle or convulsive
no of epithelium; lower down the lining membrane was Cases 2, 11,14, and 21 offeredlesions too slight
movement. smooth and shining. to account for the fatal termination; these four
On the 18th day 8 oz. of gin were given, in The cellulartissue at the back of the pharynx and terminated before the 21st
addition to the wine ordered on the 16th day,and oesophagusas low as the 1st dorsal vertebra was infil- trated
day.
Cases 6,8, and 22 provedfatalafter the 2l8t day;
carbonate of ammonia, in 5 grain doses,substituted with a purulent lookingfluid. From this part examination of the internal
for the acetate. A blisterwas at the same of the 3rd dorsal vertebra, the organs sufficed to ex*
applied to the inferiorportion
of these three patients.
time to the forehead. On the 25th day,1 grain of organs contained in the posterior mediastinum, i.e., plainthe death
disulphate of quininewas given,instead of the car- bonate the thoracic duct,"c., were closelymatted together Cases 3, 4, 19, and 20 recovered from the fever;
of ammonia, and the quantity of wine was by dense false membrane and lymph. the rash in these cases began to fade respectively
reauced to 4 oz. and the gin increased to 4 oz. Examined by the microscope. This purulentlook- ing on the ISth, 15th, 14th,and 18th days.
Bxammaticn, August 31, 1849, of the body of fluidpresentedthe following elements :" Cases 6 and 7, in which no rash appeared, were
Mary W., 19|hours afterdeath. a. Fat globules. convalescent on the 12th and 18th daysrespectively.
Some EmadaHon, " Cadaveric rigidity well marked. b. Finelygranular matter. Taken conjomtly, all these cases illustrated the
Numerous miliarv vesicles along the sides of the c. Granular corpuscles about thejsizeofpusglobules.
fact that the ordinaryduration of typhusfeveris
trunk ; a few on the anterior surface. No discolor- ation Acetic acid dissolved or rendered transparent the
from 14 to 21 days;tliatuncomplicated typhus
in the conrse of the veins. Very little tion
conges- chief part of the granularmatter ; but broughtno at
of the posterior surface of the body. fever may tenmnate the life of the patient
nuclei into view.
Head" The dura mater any period before the 21 st day ; that afterthe 21st
was somewhat thicker SlomacK"The colour and consistence of the lining
than ususl. There was no marked increase in the membrane of this organ was day, local lesions, sufficientto account for death,
natural ; it was mam-

"ascularity of the piamater. The membranes rated

sepa- millated from near the pylorus to within about four are, as a rule,discoverable.
from the surtace of the convolutions with nor- mal inches of the cardiac extremity. It will be observed, that 13 of the 21 cases detailed
facility. There was very littleserosit^ in the The ccecum and colon were distended with flatus; in these papers were partof as many families,more
meshes ofthe pia mater. The plexuschoroideswas the lattercontained a largetapeworm. than one member of which suffered from the sane
pale.About half an ounce of transparent serosity was The larffe and small intestines were healthyin disease.
found at the base of the brain. The substance of colour,thickness, and consistence throughout,with The closeresemblance of thediseasein the brothers
the encephalon and the centralparts of the brain were the exceptionof a little increased vascularity of the andmfc,
J. and B. H., cases 3 and 19,andin the man
of normal consistence. sigmoidflexureof the colon. tte
The ton^ was dry and brown. Much purulent Peyer's patches were indistinctly seen.
Georgeand Mary W., cases 2 and 22, must strike
alluded
looking fluidwas infiltrated between the muscles as far The mesenteric glandswere healthy.
most careless observer. I have previously
as the leftgreat comn of the os hyoides and tliyrohyoid normal in appearance. to thisfact ; I will not here repeat
The Uoer was perfectly
membrane. Nnmerous minnte collectionsof a fluid The gaU bladder was moderately distended with Although I have stated the duration of typhus
that
resembling pus to the unassisted eye, were found thin orange bile. Its lining membrane was healthy.fever to be from 14 to 21 days" and I behcve
 138 THE MEDICAL TlMlSS.
that the bad treatment of the Hungarianprisoners, abstain from the use of the' lancet, when, with the the South northward. Thus, on the 6th of January,
transported into the different provinces of the Empire, increasing dyspnoeaand anxiety of the patient, I the temperature sunk in both places simultaneously
has been the principal cause of the epidemic. became anxious myself. Then, as in the majoritybelow freezing, and the mean on that day is one
THE TINCTURE OF IODINE. of cases, bleeding caused a marked relief.I returned degree lower for Edinburgh than for London,
Among the remedia mirabilia,such as chloro- form cured of my heresy to the old flag of antiphlogisis." namely,30** and 81". The lowest mean for any
and collodion, which are daily more and more "
From these fiicts the treatment by tartar-emetic day of January at London was on the 15th,when it
freely used in surgeiy, we may class the tincture of gainednumerous followers, and it was this which was 25*5" "
on that day the mean for Edinburgh
iodine. The following is an extract from a small firststrongly shook the faithin the absolute neces-
sity was 27"^. Two daysafter, or on the 17th,the mean
pamphletpublishedat Berne, containing a regumt forvenesection. " " " "
Seeing,accord-
ing for Edinburgh was 25^, and the mean for London
of the cures obtained by the external use of this to my experience, that even those recovered in on that day was 33".
tincturein the practice of M. Demme, Professor of whom taitar-emetic did not induce vomiting, and The weather allover Europe appears to have been
the Faculty in that city. havingno reason to seek for the efiicacy of this re-
medy particularly severe ; the accounts from Rome, and
M. Demme prefersa tincturemade with one otlier than in itsemetic power, I determined to even Naples,describing the cold as of unusual in- tensity.
drachm of iodine to an ounce of the strongest al- rejectboth bleedingand tartar-emetic,
cohol, restricting Even at Constantinople the cold is much
to the ordinary tincture, which contains about the therapeutics of pneumonia to an expectantand complained of, and it is announced that the report
48 grains of iodine in the same quantity of liquid. dietetictreatment. For, as regardsthe nitrate of of the inclemencyof the winter in Egypt has
He applies itto the healthy or diseased skin to any potash,neutral salts,and tartar-emetic in small detained,at Malta, not a few Englishinvalidswho
extent In acute cases he uses it twice or thiice doses,I had longsince ascertained that theyhad no were on their way to winter in that country. With
a dav, in chronic cases every second day. After it influenceon the progress of pneumonia. I have fol- lowedall this severity and inconstancy of the weather, the
has Deen applied he leaves the partuncovered until thispractice for three years without exception.publichealth is good with us, as it is in London.
it is quite dry; it is then covered lightly. Vesication Duringthat time I have not drawn one dropof blood Sanguinepeopleare apt to ascribe the decline of
is to be feared, because it preventsabsorption of the from a pneumonicpatient, nor administered other diseasesthis winter to the influence of the sanitary
tincture; when ithappens, itistreatedby fomentation medicines than the decoction of sago, infusion of measures taken duringthe late Cholera scourge,im- perfect
with GK"ulard water, wine,"c. It not unfrequently liquorice, an oilymixture,or an acidulated draught, as these undeniably stillare. Nobody can
occurs when theskin has been softenedbypoultices or unless there were complications compellingme to doubt the importanteffectof these measures. Bat
by the perspiration, as in the armpits, ";c. In such make an exception." we must not flatter ourselvesthat the explanation of
cases it is better to precede its application by an The re-establishment of publicbrothels is still the rise and fall of diseases lies so much on the
inunction with oil, which greatly assists the absorp-
tion sub judice.The Government, fearingto injuresurface. We are still far,very far,from beingable
of the tincture. its Christian character by sanctioning immorality, to connect what is called the EpidemicConstitution
The actionof the tinctureof iodine applied to the hesitatesto do justice to the solicitations of the of the year with causes that stand within our know- ledge.
sidn is essentially antiphlogistic. M. Demme uses Medical bodv. An association of Medical men, Variations in the composition of the atmo-
sphere,
it in all cases of inflammation falling within the urgedon b^the immense progress made by syphilis, in connexion with the disposition to par-
ticular
domain of surgery, no matter what may be the are about, it is said,to institute a Lock Hosptal. diseases, itis to be expected, willbe broujght
cause, degree, or period of development The to lightby more refined methods of chemical
serous exudations alone often resistthis energetic analysis. Ozone, to which the attention of the
BOOTLAMD.
treatment M. Demme has found it eminently readers of the Medical Times was calledin the last
serviceablein idiopathic and traumatic erysipelas, number, as alleged by Schoenbein to be a source of
[EdlDbuighConrespoDdenee.]
whitlow, bums, frost-bites, and in inflammation from catarrhal affections, must be further inquired into,
wounds or chemical agents. In inflammations of This winter has been remarkable,not merelyfor and more ozones in the atmosphere must be sought
the subcutaneous cellular tissue, the tincture of the severity of the weather, as regards cold,but after. One thingwe may rest assured of: every
iodine has been very successful. In the great ma- jority also for the suddenness of its vioissitudes. As is variationin the number and character of diseasesin
of cases, not onlyhas the inflammation been commonly the character of the different years must have its cause" what we seek
case, the general
rapidly cured, but the pus which had been alreadyweather has been
very much the same all over the aflermost surelyis not merelyan ideal existence;
formed has suddenly disappeareda greatadvantageisland,thoughnot a littlemodified in particular
" it is certainly in every case something real, whether
in mastitis, parotiditis, and other inflammations where places
by local causes. In the cold winters of it be or be not within the reach of man's powers of
itisadvisableto abstainfrom the use of theknife.The Great Britain at large,Edinburgh often suffers discovery.
arthrocaces, as also all sorts of inflammation of the less than
placesfurther south. And it has been But, independentiy of any assumed variationsin
joints, except arthritis, have 3rielded to the tincture remarked, not the composition of the atmosphere, the laws of
unfrequently, that the freezing perature
tem-
of iodine, so alsohave buboes,whether of a syphi- litic travels to Edinburgh from the south, atmospheric vicissitudespresents a subject of the
origin or not, phlebitis, and scrofulousinflam-
mations. owing,as it has been conjectured, to the proximitygreatest interestin medicine,to which it were to be
In gonorrhoea, the experience of the Pro-
fessorof the southern partof Britain to the Continent, wished that the Professioncould devote an efficient
isstilldoubtful ; he applies the liquid in a and to itsconsequent more readyparticipation in attention. By members of the Medical Profession,
line extendingbom the frcenum preputii to the the cold of the continental winter. For the science of physiology has been broughtto its
a number
anus. We may add, in concluding, that the tincture of 3rear8 past
Edinburgh has enjoyed a remarkable presentstate of advancement ; by members of the
of iodine so hostileto morbid plasticity, is of marked exemptionfrom deep snow ; and even thiswinter same Profession the great foundations of modem
servicein promotingossification, when the forma-
tion there has been but little.When high winds make laid; and meteorology is a scieooe
chemistiy were
of callus, afterthe fractureof a bone,is tardy a prominent includes truths of hardlyless im- portant
partof the winter,thistown, owing to which probably
or videos. its lofty than those of
position, fuUy
has its own share of them. bearing practical
on medicine
HOMCEOPATHT IN AUSTBIA. The mean temperatureof January forEdinburgh the two sciences justnamed. To most of us, in-
deed,
The Austrian Government haisjustestablishedan diflersso little from that of London, as shown by the problem of the weather seems to be too
institution for teaching homoeopathy. The direction the Greenwich observations, that the differencemay remote from solutionto be of much presentpromise
has been entrusted to Dr. Wurm, who possesses a depend solely on the mode of takingthe observ- ations. in regardeither to the eteology or treatment of dis-
eases.
highhomoeopathic reputation among the Viennese. That for Edinburgh, as indicated by a re-gister But there are practical benefits which could
This is, as faras we know, the firstoccasion on wUch thermometer and two additionalobservations, not but attend the mere pursuitof its solution.
thissect,which inthe eyes of laymencovers charlatans morningand evening, in an exposedsituationfadng Among these are a more extended knowledgeof the
by itsattractionsof the ec^Una pressa and martyr- dom, the north,within the .town,but one storeyabove the subjectof climate, with a view to the choice of a
willdescend into the ftdentiflcarena to prove street,i s a small fraction above 84** ; that for Lon- don winter residence for invalids appropriate to their
or not its rightto existence. Nowhere would the is a small fraction lessthan 84"",as of health. For, much as has been done to im- prove
may be state
therapiia minima have a greater chance than at found by the Tables appendedin tiieMedical Times this kind of knowledge, it is stillfar from
Vienna,where,as regards medicine, allis taughtin to the weeklyMortality Returns. The mean daily being understood sufificiently to prevent serious
perfection, exceptthe art of healing.There is not temperature on the flrsjt fivedaysof Januarywas errors beingvery oftencommitted ; even when these
any school in Germany which has betterProfessors for Edinburgh36o, 42*", 84**, 3S^ ; and for London do not arise from the difficulty of ascertaining the
for the use of the stethoscope, and for anatomico-, 81-8fl,8S'6"", 8r-6*", 48-4'', 84*0",givinga mean, dur- ing precise condition of the diseaseand the exact cbft-
pathological researches, and which at the same time thisperiod, for Edinburgh, of nearly 88", and for racter of the patient's constitution.
neglects more disdainfully the Hippocratic traditions, London, of nearlyS6^. During the next sixteen The point in the law of the weather,the discovery
than that of Vienna. Here is,by way of example, days,with considerable variations of of which would be of most immediate service in
ture,
tempera-
a passage from a book recently published by one though still generally below the freezingthe practice of medicine, is that which may he
of these etprits forts, M. Dietl,who is known by his point in both [places, the difilerence is stilla smafifound to determine the occurrence of severe winters
anatomico-pathological researches on the diseasesof fraction in fiivour of Edinburgh,the mean for in Italyand the other placesto which invalids
the brain,and who, in his lastwork, endeavours to Edinburghbeing 80-6", that for London
80-4*". resort to escape the inclemency of the ordinary
prove that in pneumonia,bleeding is superfluous, Duringthe remainder of the month the mean tem- perature winter at home. There can be no doubt that a
if not injurious. beinggenerally above the freezing point,severe winter in Italy, such as the presentis de- scribed
**
Coming from the school of Raimann," says the there is stilla small fractionin favour of London, to be, is much detrimental to many
more
author in his preface, "
I belonged to those rigorous the mean at Edinburghbeing87*9*, that at Lon- don invalids than a residence in this countrywith the
antiphlogistians, who believed theywere most suc- 88*1*". The comparison of the temperaturesfor ordinary comforts of an Englishhome. If we can
cessfiil in the treatment of pneumonia. In 1831, I January, in the two Tables justmade use of,hardly make no progrcBs towards this law, we may, at
dared treat some severe cases of pneumoniahomceo- bears out the remark referredto above,namely,that least, applythe calculation of chances to the ques- tion
pathically. But not havingyet the courage to wait the freezing temperature usuallyoccurs later at by summing up the number of severe winters
for the natural progress of die disease, I did not Edinburghthan at Londo^ior that it travelsfrom in Italy duringa givenperiodof years. But the
 THE MEDICAL TIMES. 139

problem itselfhas hardlybeen studied,with the Deaths, performingthe same duties as the were simultaneously the
to resign, moral effect
necessary seal,on proper grounds. The most
genious
in-
present Registrar, should be appointedand would be irresistible, and the injustice they
and Almanack-Makers
honest of our hare
empowered to convey the necessary informa-
tion sufferwould be broughtout in such bold relief
been mere visionaries. It is long since we were
to the Coroner, and also to make the mortem
post- that reparation would be speedily a ccorded.
sick of Murphy, et hoc genus omne. The problem,
however, does not appear to be beyond the reach of examination, in concert with the ordi-
nary Failing this,the Committee of Poor-law Medioal
inquiries stimulated by the hope of reachinga medical attendant, when an autopsymay be Officers have considered the propriety of separ
discovery practical
of benefit. A promising tion
direc-
This examination should be always rating the administrationof medical relieffrom
for inquiry is,in the variously modified effects required.
made in the presence of the medical attendant that of general relief,and of placing it under
of througha
gravitation of series years, as the equi-
librium
of the ocean is restored from the disturbance on the case, who should be remunerated for the the of a
jurisdiction distinct Board. We trust
of heat in the torrid trouble. Medical men have been ignominiously
application
caused by the unequal that the Medical Officers throughoutthe
and frigid zones.
shut out from Medical Coroner's Courts in countrywillgivethis matter their serious con-
sideration,

former times,on the groundthat theymightby and will support the central Com*
TO SUBSCRIBERS. possibility be the criminals. This excuse ought mittee in their philanthropic and judicious
to be permitted to govern the proceed-
ings exertions. They must not be supine,and
Neic Subscribers unll obligeby forwardingtheir never
Names direct to the Office,46, Princes-street, of a Coroner,for it regardsan innocent imaginethat thingswill go on well enough
8oho, or to the News Agents or BoohseUers. All man, against whom no chargehas been made, without their help.No man's aid can be spared;
Orders
Post-office should be made payableto the as a felon, and is an insult and injustice to the and as another Parliament has now assembled,
Publisher^Mr. John Churchill. whole body of the Profession. letit be shown what the Union Surgeons expect,
If Medical Inspectors were appointed there and what they are prepared to urge upon the
would be fewer inquests held than atpresent; attention of the Legislature.
THE MEDICAL TIMES. and althoughthe Coroners' office might not
continue to be quiteso lucrative, the change THE HUNTERIAN ORATION.
SATURDAY, FEBRUARY 23, 1850. would be a great boon to the Profession,and The usual routine of the Hunterian Oration
afford greatersecurityto the public.Coroners has been diversified by one or two cidents.
in-
singular
%* We have to requestthat allCommunica-
tions
also should be paid rather than In another part of our Paperwillbe
by tkfixedsalary
for the Editor be addressed to the the found a reportof an attemptwhich was
by fees. Wherever the fee system prevails
care made,
of Mr. John Churchill,Medical
Publisher,public are taxed for its support. The Court of immediately before the entrance of Mr. Skey
46, Princes-street, Soho, by whom, in future,Chancery is the beau ideal of the system,and into the Lecture-room,to induce the assembled
thisJournal will be published. is the great legaliniquity of the age. Mr. auditors to giveexpression to some manifestation
Payne, the Coroner for the City,has alreadyof disapprobation at the conduct which the Col- lege
The Coroner's Court is becomingthe theme of pronounced an opinion in favour of payment by had in
adopted respectof Medical Reform.
criticism. Its*utility, its abuses,in due time a fixed salary, and since he has accorded his The good sense and gentlemanlyfeeling of
will be tested. The adaptability of the ma-
chinery assent to the plan, itis probable that the change those who were witnesses of this ill-timed
to the end will be investigate4, and is not distant. If a fixed salaryshould be proceeding, at once put down the impertinent
such reforms effected as may seem to be most voted in the Citythe examplewould be speedily intrusion of the wotdd-be agitator. Whatever
urgent and desurable. This Court must be followed the
throughout country; and the sent might
pre- have been the feeling of the audience as
broughtwithin the sphereof modern improve-ments practice, so open to abuse and wrong-doing, to Medical Reform,every one feltthat it was
; and made to d ore-tail into the new would be abolished. not fairto make the Hunterian Lecturer expiate
Sanitarysystem. The cause of death is the Whatever opposition mightarisefirom ** vested the sins of the College, nor to allow the hour

subject of inquiry before these Courts, Medical interests"to changessuch as these,we are devoted to do honour to the memory of the great
evidence is the testimony to be examined and quite satisfied that theywould be approved by Hunter to be expendedin a noisyand useless
compared,and before all things we must have the Profession, and be advantageous to the demonstration. The most ardent Reformer
Medical Coroners, Lawyer Coroners, or Sub- Public interests. knew the battle between the College and the
Coroners, must be repudiated. Let Medical Profession was to be fought on other ground.

men, in every instance,

contest the officewith POOR-LAW MEDICAL OFFICERS. A curious coincidence gave some interestto
the lawyers,and if the Professionwill hold We hope that the effortsof the Poor-law Medi- cal this attemptto interrupt Mr. Skey in the dis- charge
stoutlytogether, and subscribe, if need be, to officersto obtain a redressof theirgrievances of his honourable duty. A
rary
contempo-
turn out Lawyer Sub-Coroners, as theyhave will not languish.They have a hard battle to Medical Journal anticipated its usual pub-
lication,
heretofore subscribed to bring in Medical fight ; the Boards of Guardians are their ene-
mies and issued its weekly Number on

Coroners,theywillvindicate their justrights in ; the Poor-law Commission is a lukewarm the morning of the day on which the Oration
a very efficientmanner, and inflicta severe sympathiser ; the [Parliament a is Convention was to be given. In the Leading Article of
blow upon meretricious office-hunters, who of Guardians, and, therefore, hostile to their that Journal,the Members of the College were

have no qualification for the duties theyunder-

take claims ; the public are indifferent, and, if they covertly incited to testify their disapprobation
but patronageand nepotism, exercised, run throughall sections'of society, theywill of the recent College Manifesto, and, in order
perhaps,in wilful betrayal of the sympathiesfind that theyhave no friends but themselves. to stimulateits readers stillmore, Mr. Skey wai
and interests of the Profession. EveryCoroner,They will be strong, however,if theyunite,for referredto by name, in one of those ingenious
too, should be required to attend personally to the Government must listen to the complaints ''Notices to Correspondents" in which our
his duties; or, if totally unfitted by illness, or of 3,000 of the most importantofficersof the Contemporary delights, as an obnoxious Coun- cillor
any other cause, he should resign.If he be a public.The annual electionof Medical offi- cers who had voted against the proposal for
Medical Coroner, his subordinate should be is theirweakness ; as it places the onus of a new Charter.
alsoa Medical man ; for a principle put forth the evils upon their own acts. The fact of The Editor of the Publication alluded to
as good in the majorinstance, must be equallycandidature is assumed as an admission of the and the discomfited agitator were then evi-
good in the minor^and must not be taken up equityof the terms of their office, and Boards dentiyof the same mode of thinking, and
and laid down as personal advantages may be of Guardians and the Poor-law Board do not we must beg to offer to both of them our
served. hesitateto retert this argument against every condolence for the very peremptorymanner
Under the presentsystem,the parishheadU of suffering and injustice. They in which their suggestions refused. The
representation were
isthe officer who informs the Coroner of cases willnot take into account the private fears that Journal mighthave saved itshurried publica- tion,
that may require a medico-legal investigation ; impelthe Practitionerto seek for the office he and have given a LeadingArticle in
and his information is often gatheredfrom the would otherwise disdain,but content them- selves grammatical English, Mr.
and Lee mighthave
mere gossipof the neighbourhood, and the with statinga fact, to excuse and spared his demonstration, and have avoided the
Coroner is required to adjudicate maintain the wrong that creates it. If mortificationof beingcordially hissed. Both
upon village-
pump scandals. A Mbdioai. Inspector of Ithe Medioal Officers throughout the countrymay leam^ from this littielesson, the wisdom
 140 THE MEDICAL TIMEa
of not exaggeratingthe influence they can havingmade one reputedmoist-eyedpubliccan decide. The law alone can settle
of the
exert,nor of deemingthat educated gentlemen audience,
we rather object,
sorry as we were for such questions, if a compromisebe resisted.
are to be excited like the ignorantaudience at Mr. Morton, to be represented to the publicAnd it appears that there is at least one legal
a election.
metropolitan with eyes red with weeping when bis death is decision bearingon the subject.In an appeal
Another still more strangeoccurrence has alluded to. We do not like to trust to the to the House of Lords,it was decided that the
since come tolight. In the daily Times appeared accuracy of a reporter who is carried away Degreeof Doctor of Laws, givenby Marischal
a Report of Mr. Skey's oration,in which by the intensity of his feelings. He may be College, was a sufficient qualification for an
occurred the following sentence " : very tender-hearted, but he certainly sees a officeto which such a degreewas a pre-requi-
"
The untimely end of the lamented Mr. Morton littlecrooked. Nor do we like to have our site. The King'sCollege party,however, offer
was dwelt upon with the most feelip? eloquence. faith shaken in the accuracy of the reports some technical objections to the effectof this
Several moist eyes were noticed,when the learned
orator alluded to the blighting influenceof Univer-
sity
in the Times, However, even Jupiternods decision. But among*reasonable peoplewhat
College in connexion witn the unfortunate de- ceased,sometimes,and yet is not the less, Jupiter. should prevent a compromise 1 We cannot
who, deprived of the prospect of advance-
ment Yet, if the Olympian Deityturned out very help telling the Professors of Aberdeen,that
at the Institutionto which he had been so long
attached, in a moment of despair, drowsy,there might be a conspiracy, even in the perpetuation of such a contest is not credit-able
sought,at his own
hand, relieffrom his suffering and anxiety, at the Heaven,to keephim wide awake. to them. Why do not theytake stepsto
earlyage of thirty-seven." have the two Colleges united into one sity
Univer-
When we read thissentence in the Timea,we than two hundred
THE ABERDEEN COLLEGES. ? It is already more
were not a little astonished. We had listened
Our attention has been drawn to sounds of years since such]a union was declared,by a
to the Oration we hadjmadearrangementsfor discord Royal Charter and an Act of Parliament
"

issuingfrom the quietcityof Aber- deen,

an accurate reportof it,and we had neither the subjectof strife being one which though accidental circumstances put an end to
seen moist eyes in the theatre, nor had we united by
somewhat interests the Medical Profession at their force. The two Colleges were
heard Mr. Skey adopt the ridiculousexpres-
of Aberdeen, each of a Charter grantedby Charles I.,afterwards
sion The two Colleges
of "Me large.
blighting influence of Univereity which includes a Medical School,are engaged ratified by an Act of Parliament. But, at the
College" If we were able to iorm any opinionin generalAct rescinded all the
deadlywarfare. We recommend this local Restoration, a
at all, itwas, that the audience generally provedcontest to the attention of the Peace
disap- Acts and publicinstruments made duringthe
of the allusion to Mr. Morton's melan- choly
Society.
Here is a case on which to try their 'prentice six years preceding1648 ; so that this union
death ; yet we could not have supposed fell to the ground.
hand. We do not, indeed,anticipate that the between the two Colleges
for a moment the reporterof a paper like the
will come to blows ; yet,to
We are not, indeed,acquainted with the secret
Ttmee would have infringed the well-known
belligerent parties
avert such an indecorum, we confess we trust history of the cabals and factions within the
rule, of never attributing any one
to words it is moat
more to the fear of the"
posse comitatus" than
two Colleges ; but we are sure seemly
un-
which had not been used. Knowing well the for two bodies of instructors of youth
to the discretion of the two factions. Aberdeen
anxiety of respectable editorsto procure always
has the singular good fortune to possess two to -go on fighting, year after year, like rival
faithfulstatements of what passes at public both
each of which claims to be an inde- pendentshopkeepers. In the eye of the public,
Colleges,
meetings, and to coirect any accidental errors
are on an equality, and we cannot see
which may creep into their reports, University.Each has longexercued Colleges
we could in the position of either to prevent it
the privilege of granting Degreesin Arts, Me- dicine,anything
hardlyconceive that the Times reporterwould from joining cordially with the other. We can
Law, and Divinity.The elder sister,
have gone out of his
way, and have attributed has the advantageof fancy that King'sCollegepiquesitselfon
its
to Mr. Skey not onlywords which Mr. namely,King'sCollege,
Skey did itsfoundation from a Papal Bull,not greater antiquity, and on the honour of beinga
not use, but which, from its constant
deriving
use by far from 400 child oi the PapalSee,while Marischal College,
one of the Medical Journals, has become very years ago, and its authority to
in all departments,is undeni- beingin the new city, stands upon itsgentility,
familiarto the members of the Profession.
grant Degrees, able.
The younger sister, Marischal College, wishingto keep aloof from its neighbour.
Yet actually this appears to have been the should tryto
is about a century*, younger. It owes its The Professors of both Colleges
case. When the sentence in the Times was
origin to a Scottish nobleman, his charter see themselves
with the same eyes with which
broughtto the notice of the authoritiesat Uni- versity then
beingconfirmed by Royalauthority and by the the rest of the world looks upon thenifand
College, two members of the Senate
Parliament of Scotland,at the time of its theywould soon discover how necessary it is to
were directedto wait on Mr. Skey,and request their real dignity and respectability that they
erection. In the original charter, an express
an explanation. Mr. Skey,as appears from a
authority is givento Marischal College to con
should return to that state of quietudeand
Letter in the TimeSy from Professors Maiden
fer the Degreeof Master of Arts,and the con- peace which alone becomes a seat of learning.
firmatory
and Key, at once "
gave his authority for stat-
ing
Act of Parliament grants "
all the
that the terms,the blighting
*
influence of ORDER OF THE BATH AND NAVAL AND
freedoms,franchises, liberties, free privileges,
University College,' proceededfrom the Re- porter
and jurisdiction, that to a free College
MILITARY MEDICAL OFFICERS.
ivithin We
only." The words actually used were have repeatedly called the attention of the
this realm,by law and practice, is known to Goveniment
givenalmost verbatim in our report. to the rightful claim of the Pro*
appertain." llie partisans of King'sCollege,
It does, then,really fession to share in the distributionof the
appear that the TtinM Re- porter
the apparently
notwithstanding a mple sion
conces- honours awarded for meritorious publicsei^
interpolated a sentence, and, curiously thus made, have all alongcontended,that
enough,this sentence happensto be thaf pet Marischal vices ; and it is with pleasure, therefore, that
College has no authority to grant
phrase which Mr. Wakley seeks, on all oc- we quotethe following from the Ihnes of Thurs-day
casions,
to apply to University
Degrees, except in Arts. The presentcontest,
last
College,We then, is an old feud,stirred into life ":

have,on a former occasion,referred the

by some **
Sir D. L. Evans asked the First Lord of the
to
recent circumstances. We have before us a Treasury the result of the considerationof Govtfo-
absurdity
of this term, "blighting
influence," ment, promised duringthe lastsession,respectioa
which pamphletof fiftypages, issued
latelyby a the conferring of the
means nothing,but seems to mean a
Committee of the Senate of
militaryclassof the Order of
greatdeal,and, therefore, King'sCollege, the Bath on Medical Officers who mighthave been
just suits our
all the naval
detailingknottypoints of thiscontro-
versy present and proved deserving in important
worthyContemporary,
who is always
; two Aberdeen newspapers, showingup and military actions?
"
Full of sound and fury, Lord J. Russell "
said,the subject had been
signifying
nothing." the delinquencies of both parties ; and letters broughtunder the consideration of the Commander-
To say the least, thisinterpolationis very sin-
gular,from private in-Chief, t he Duke of Wellinffton, who had paid
individuals, urgingon us their
and would tend to show,that the Times attention to it; and, a tew days ago, he bad
respective opinionsof the merits of the case, greatmade a recommendation to the Government^ which
and the Limeet occasionally employ tlie same as well as the alleged demerits of both Colleges. was now under their consideration."
imaginative pen. If so, we hope,for the credit We wonder that two bodies, viduals We
composedof indi- have little doubt that His Grace the
of the daily Press,that the Times willlook out Duke of Wellington, in
so respectable as the Aberdeen sors,
Profes- who has experiemced
for some common-placeindividual, who
more cannot solder up their difierences without his own person the sweetness of well-dcfsrved
will content himself with ordinary
reporting, appealingto the publicby pamphlets.The reward,will have recommended to the Coverii'-
and not wander into the realms of fancy. As points at issue are not of the kind on which the roent to confer upon Medical men in mh set-
 THE MEDICAL TIMES. 141

"ices those honorarydistixictionBto which they a ; and although,

greatresponsibility for some from the lastConference. This letterwas published
our pages last week.
in
are entitled. It is true that their duties
ftilly time past,in consequence of the attractionof N. Clifton, the Vice-President of the National
Esq.,
are not of a kind to call forth the loud and more interesting its duties have been
questions, voted to the Chair, and called upon
Institute,
was

generalacclaim which attends His Grace allowed to slide from notice, if

yet, anew tion Mr. Ross, the Honorary Secretary,
agita- to read the Report

wherever he
appears the sons of Surgical
" should commence, this bodywill be called Deputation.
of the

and the more immediate alleviators of upon to playa prominentpart, and we hope a lengthened
Mr. Ross read Report of the inter-
view
science, and the Council of the
Deputation
between the
sofibring, pursue their course in a more silent that it will respondnobly to the wishes of its and also the letter received by
Collegeof Surgeons,
manner; hut, unquestionably, for that very Licentiates. The Act held by this Society
is the the National Institute from the Council of the
reason are stillnot the less deserving of all comer-stone of sound Medical legislation,
and College.
Mr. Clifton said,in openingthe subjectfor dis-
cussion,
the benefits it is in the power of the Go- must not be surrendered unless all the good
that the letter read showed that the just
Temment to bestow. We with
wait,therefore, which itcontains be imbodied in a new measure.
Collegeof Surgeonswas the sole impedimentto a
and
patience confidence, the result we expect For the rest,the Professionmust unflinchingly settlement of the Medical Reform question; that it
to arise from His Grace's recommendation, and persevere in their effortsto make such measure was manifest that theyhad not been sincere in their
professions,and that they had continued the tiations
nego-
the goodsense of the Government. as liberal and complete possible.
as
at the Collegeof Physicians onlyto gain
We need
hardlyreiterate, that the proposed to frustratethe exertionsof the
time,hopingthereby
THE REGULATIONS OF THE COLLEGE "
Regulations" of the Collegeof Surgeons do General Practitioners. The members of the College
OF SURGEONS. not touch the questionof Medical Reform. There have now an additional claim on that body,from
SiscB the theirdishonourable conduct and evasion in the last
Collegeof resolved never was such an abortion,
Surgeonshas and the old nurse "

transactions. It was for the Conference to consider

to treat withindifference
the wishes of the great whose functions were
performed by a Contempo-
rary what steps theywould take in reference to those
body of its members, there is no measure left is actuallyashamed to acknowledge
" the matters.
to the latterbut a steady and uncompromisingbantling.She threatens to leave her placein Mr. Bottomley said,that he should henceforth
agitationfor theirrights.There must be a coali-
tion the service of the and to offer herself contend for an independent
College, College,with full
of powers ; for was no use go again it of to to the Col-
lege
parties,as was originallyeffected by once more to the General Practitioners. It is
the National Association. If the principles
of Surgeons. He, therefore,begsedto move : "

probable that she has not been paidher wages; "That after the receipt of the letter from to
agreed to at the Conferences at the Collegebut we can assure her,that her faculties are not Council of the College of Surgeons now read, it is
of Physicians to be contemptuouslydisre inexpedient
to make any further to the
applications
are keen enoughfor more activeduties. She must Council of that College."
garded,let all earnest men unite once more continue to dry-nurse the College Regulations. Mr. SeptimusRead seconded the resolution.
upon the wise and fundamental principles,
This
"
is the onlyofficethat befits her incapable Mr. Famham Flower (ofChilcompton,) thought
and equal rights, that havingopened a negotiation with the College,
represenUtion, protection, old age.
it might seem more consistent to communicate
upon which all are agreed. Particularviews To return to these Regulations.
into generalprinciples.
T hey vide further in replyto the letter that had been received.
pro-
must merge This
onlyfor a small section of the older mem- The Chairman explained,that the letterwas, in
time there must be no eoncessions. Never fact,addressed to the Council of the National In- stitute,
bers of the College ; but do not regardthe fu
again, for the sake of peace, will we arm the tttre necessitiesof the and the replywould,therefore, more priately
appro-
Profession. The Council,
Council of the College of Surgeons come from that body.
with weapons
indeed,assume that the regulations are only The resolution was then put and carried una-
to destroy ourselves. In a contest with honour-
able
subsidiary, or, rather, preliminary,to a generaln imously.
men, magnanimity a is virtue ; but with Dr. Webster considered, that the answer of the
measure ; but what that generalmeasure is to
Buch opponents as those whom we have hitherto Collegewas uncourteous, unfriendly,and unjust
be we can onlyimaginefrom the information
been matched against, it is a weakness. The The Conference oughtto stand up most strenuously
affordedus of what it is not to be. It is not to for an independent College, and he hopedthat the
experience of the past will make us wise for the
be liberal, just,or comprehensive ; so far we Profession throughout the Kingdom would unite
future ; and the College must understand,that know, and we shall,
in the coming war
therefore, tiencefor that object.He commented on the assumption,
wait with impa-
there shall be no com- the Council,that the College the sole body
the by
was
to be informed what new iniquity
PKOMISE ! for granting diplomasin Surgery. It was not so.
Council are meditating against the interests of In at any rate,the Universities had that
The local A$8oeiaUons attached to the
Scotiand,
their members and the whole body of the power ; and in England,the University of London,
National Institute must be re-organized, and
Profession. Stationary theycannot remain,for by their Charter,can examine for a Medical degree
preparedto move at the first warning. So in Medicine,Surgery, and Pharmacy. He moved "

theirreceipts are not equalto their expendi *'That the resolution,

soon as it shall be clear that the College, empowering the Deputation
ture ; and theywill be driven to attemptsome to wait upon Sir George Urey, passedat the last
or the Government, intend to take a cided
de-
kind of legislation maintain the ciency
effi- meeting of the Conference, be acted on, and that a
merely to
step in Medical legislation, the Home
of their Institution. The neceasities of
letterbe written to Sir George Grey, requesting him
Office and the House of Commons to appoint a time to receive the Deputation."
should be the
College are the hope of the Profession. Mr. Bowling, (Hammersmith), seconded the reso-
lution,
assailed with PglUumSfso that the will of the
The indignation which the Letter from the and suggested, that the titleof the College
Profession may be thoroughlyunderstood be a subject for future consideration.
Council has evoked is displayed in our Report might
upon the question. If the Profession are apa-
thetic,of the Conference The Chairman thoughtthat it should be one of
at the Hanover -square-rooms, the first objects of "e Deputation to obtain a
theywill be defeated, and will have to
in The
published another page. speakers, rally, pledge,
gene- that no legislation should be entered on
groan for another generation, under the incubus
of the General Prac-
condemned the illiberaland arrogant without the representatives titioners
of corporatemisrule. It would be easy for us
conduct of the Council of the College beingreceived as concurrent parties ; that
to show, that the Council of the College ; and we
of Sur-
geons it was more than ever necessary to seek an interview
has ever been systematically selfish and
hope tiiat this feelingwill spread rapidlywith the Home Secretary, as, duringthe last week,
throughout the country, and constitute the bond the Colleges of Physicians and Surgeonshad had
unjust,and has more than once broken faith of union between all sincere who have at an interview with him, and it was desirable that
men
npon public questions for the purposes of self-
heart the honour and interests of their Pro- their
fession. representations, if made in a narrow spirit,
aggrandisement.We may do this hereafter, should be neutralised. The Home Secretaryshould
but we shall now remain content with 'assuring be requested to suspend the grant of a new Charter
to the College, until the terms of it had been
the Profession, that no trust can be reposedin
SECOND CONFERENCE OF DELEGATES, made known, and a generalarrangement had been
that body.
AT THE HANOVER-SQUARE ROOMS. agreedto.
Meanwhile the Licentiates of the caries'
Apothe- Mr. Ancell said that it was necessary to know the
Societywill not remain indifferent to circumstances in which those gentlemen were placedt
theirposition.Let them move in this matter as meetingof this body was held on the 19th inst, who represented
A the Institute. They were acting a
at the Hanover-square Rooms. Several General presentin pursuance of the terms of an arrangemend
becomes them, and demand a re-organization Practitioners of respectability and influence were in which mutual concessions were demanded an
of the Profession upon a basis that shall secure both from the Metropolis and the province:!.
present, given. They were doing so at Sir GeorgeGrey's
alltheir presentrights,not to themselves alone, The Conference was convened to receive the Report request,but that,notwithstanding theyfullycon.
of the Deputation to the College, and also the com-
munication curred with the other partiesin the demand for a
but to the General Practitionersat large, and
addressed to the Council of the National Charter for an independent College.It might no
that shall advance also their Corporate re-
spectability.
Instituteby the Council of the College of Surgeons,be possible to get this,and should these arrange-
ments
The Apothecaries' Society isunder in answer to an application made by a Deputation fail,they^wouldfeel more at liberty than
 142 THE MEDICAL TIMES.
eyer, and were quiteprepared to make the claim for youth,with ample front erect, as at page 138, of the upper third of the oesophagua was found much
an independent college with redoubled force. Mr. Hare's book. Where the heads of young gen- dilated, and its coats thickened. Between the first
tlemen
Mr.Bird explained, that Mr. Ancell appeared to apd second stricturethe tube was contracted to about
are diminished or increased at the will of the the diameter of
a No. 8 catheter. The second ture
stric-
understand by the words "independent College/' a

of practising pendently
inde-
artist, Nature havingperformed no part in the me-
tamorphosis, would not admit a probefrom above ; it was only
power to confer the privilege
fanciesit from below upwards that could be obtained.
of any other Institution, but that the
one just possible, justbarely " a passage
The Author noticed tlieseries of symptoms and pa-
that similar liberties may have been
Colle"[e hitherto soughtby the National Institute possible, "

thological changes attending the formation of the

would be equally independent, although not possessed taken by the artist with their spines. stricture, and oaoted severalother examples related
of those absolutepowers, as it would be independent by Sir C. Bell,Dr. Cummin, and Mr. Dewar, in
in its internal government, althoughco-operating Practical Remarks on Asiatic Cholera, By F. J. which the same were observed. In conclusion,
of commencing,
he
with the College of Surgeons in giving the necessary suggested the propriety in such cases,
MosQRovE, M.R.C.S., Eng.-Assist-Surgeon the use of the oesophageal bougie as soon as the in-
flammatory
certificatesqualifying for a license to practise. They
Bombay Army. American Mission Press. condition of the parts has been subdued,
had never swerved from claimingthe rightof ap- pointing
their own curriculum and standard of exa-
mination. Bombay Pp.43. 1849. though no positivesymptoms of dysphagia yet pre*
This littlepamphlet contains a brief account of sent themselves, and ot continuingitsuse oailyfor
In other respectsit was a scheme of
months, with the view of the formationof
preventing
mutual concessions. He stated, that the letter from the symptoms of Cholera,and of tlietteatment ad- vocated
stricture.
the Council oJTthe College had been laid before the
by the Authoi. Among the premonitory Mr. Macilwain commented on the remark made
Conference of the College of Physicians, and that by Dr. Basham, that,in these distressing
symptoms, Mr. Mosgrove mentions "
a peculiarly cases, no
the Delegates from the National Institute had re** to be successful,
strange prickingand tlirobbing sensation in the other treatment was likely than the
pudiated the interpretationput by the Council of of the bougie. Cases of strictureof the
hands and feet,"which, so far as he has been able daily use
the College on the " Principlesfor a Bill" that had oesophagus of unfrequent and be
are ocourrence,
been agreedto. to ascertain, has never been noticed by any writer
(Mr.Macilwain,) should speakcautiously respecting
It was intimated to the meeting, that the Council on Cholera, although he thinks it is very common.
their treatment His views,however, were very
of the National Institutehad transmitted an answer The remedyhis own experience leads him to preferdifferentto those of Dr. Basham. Practitioners, in
to the communication from the Council of the Col- lege, after the commencement of collapse,is an abundant such cases, relied too much on mechanical mea-
sures,
which will be published on an earlyoppor-
tunity. supplyof cold water internally. and not sufficiently on those of a constitutional
such as would bring the tube itselfinto
A generaldiscussion thereuponensued, and,
The following remarks,which the Author thinks character,
of extreme importance, novel:
a more healthystate. He (Mr. Macilwain) had
after a vote of thanks to the Chairman for his ex- cellent are "

of stricture of the oesopha-

''
seen a greatmany cases gus,
conduct in the chair,the meetingseparated. The patient should never be allowed to doze for and had observed that but little benefit was
a moment, or even to lie down, untilre- action has
derived from the too frequent use of the bougie.
fairly set in. He should be propped up in bed by a
Its occasional passage was certainly necessary ; but
REVIEWS. person sitting at bis back. Every case of severe
cholerashould be treated as a person who has been other measures were also required, such as are likely
"
exposed to intense cold,or wtio is under the to cause
fluence
in- a quiescent condition of the tube and sys- tem.
Underutood'i Medical Appointment' B ook for 1850. of an over dose of t^pium.To allow him to Passinga bougiedaily is very undesirableia
We have much pleasure in recommendingto our
sleep,is to allow him to die." stricture of any canal : once or twice a week is quite
readers Mr. Underwood's Medical Appointment- The Author
appears to have had large experienceas often as itshould be done in strictureof the obso-
Book. Last year the work was very popular, and in the treatment of the disease
concerning which he phagus. The circumstances which led to the form- ation
most liberally supportedby the Profession. The writes. of stricturein this case were certainly different
volume for this of from those in which the disease is of constitutional
year is no lessworthy patronage;
origin ; but he did not think that they greatly
while itsusefulness is increased by beingpublished
BBPORT8 OF SOCIETIES. altered the nature of the case, which essentiaUy lowed
fol-
in three differentsizes,with and without tucks and
" the same category.
pockets, containing
test papers and pencils.It has ROYAL MEDICAL AND CHIRURGICAL Mr. Lloydagreedwith Mr. Macilwain, thatthese
also a Midwifery
Register, and many other valuable SOCIETY. cases rare, but many
are such may be seen during
additions. It contains an almanack for the year ; a lifetime at large Institutions,and such had been
ratesof postages,
meetingsof medical and scientific February 12, 1850. his experience, the result of which did not corre-
spond

societies;the London University, with either that of the author or of Mr. Macil- wain.
Colleges, and
Dr. Addison, President,
in the Chair. He (Mr.Lloyd,) then referred to the cause of
Company; the Medical Men-remu-
Apothecaries' nerating
the swallow-
ing
CASE OF STRICTURE OF the disease, as stated by Dr. Basham, "

Insurance Offices and their officers; rections

di- (ESOPHAGUS,
FATAL TWO YEARS a certain alcali which, by its irritating
" and
AND THREE MONTHS /^FTER
for making wills, and notices of
many other ACCIDENTALLY SWALLOWING SOAP-LEE8.
corrosive action on the mucous membrane, caused
matters of importance and utility to the Professioni the stricture. In one case, cited by Dr. Basham,
By W. R. BA8HAM. M.D.,
from whose patronag^e we hope much forMr. Under-
wood's Physicianto the Westminster Hospital. twenty years elapsed before the symptoms of stric- ture

Medical Appointment-Book. The suhJect of thiscase was a woman, occurred. He (Mr. Lloyd,)could not con- ceive
aged twenty-
two, who was admitted intothe Westminster Hospital that after such a considerable lapse time,
of
July 16th, 1W7. the stricture could be fairly referred to that
Practical Observations on the Prevention, Causes,and suffering from the ordinary ptoms
sym-
of poisoning by a corrosive irritant.Five cause. As far as his experiencewent, no treat*
Treatment qfCurvatures qfthe Spine, By Samuel days previouslyshe had taken by mistake some of ment of these strictureswas so generallysuc- cessful
Hare, Surgeon. Third Edition. Pp. 245. the soap-lees used in marble polishing, consisting of as the use of alkalis: if,therefore, they
London : John Churchill. a caustic solutionof impurecarbonate of soda. An could cause the disease,he could not understand
who make
oesophagus tube at that time passed readily into the how
theycould be so useful in relieving it There
Surgeons, deformed young ladies and stomach. Under
a soothing plan of treatment,with
was a patient in St Bartholomew's,about a month
gentlementhe especial objects of their attention,blistersand calomel with opium, she steadily im-
proved,
ago, who had not been able to swallow solidfoodfor
appear to feelbound to presentthe Profession no- minally, and was discharged, at her own request, ten
time previously. There was decided ob-
struction
the publicreally, with a book on the sub- ject
days after admission. Eleven months afterwards,some a

June 8th, 1848,she was again about the situation of the cricoidcarti- lage,
on admitted,emaciated
of curvatures of the spine. It is to the classof and weak, and unable to that no instrument could pass ; but, after
swallow either solids or so

productions that owe their origin to some such mo-

tive fluids. The oesophagus being examined by a small applying the nitrate of silverto the part,and giving
that the work before us belongs.It contains gum elasticcatheter, (No. 8,)a triflingobstruction the liquorpotassae,in twenty minim doses, three
was feltat a pointcorresponding to about an inch times a day,the bougiecould be passedthrough the
nothingnew ; nothingtold better, or explained more
below the cricoidcartilage; and about an inch and a stricture. The
liquor potassae was continued in in- creasing
clearly, than it had been times and often before Mr. half or two inches lower down, another
impediment doses; the patient was gradually enabled
Hare " took up" the subject was met with,which it required steady and prolonged
to take solid food,and ultimately returned to the
Tlraddle about regimen,common-placeremarks pressure to overcome. The catheter was passed into
the stomach daily, the size of the instrument being country quite cured. For many years past it had
the symptoms and treatment of curvatures of the to give alkalis, the liquor
increased. After the firstday of this been his practice po-
on
gradually "

spine, and cases to illustratethe Author's surgical

treatment, the patientwas able to swallow liquidtasse, internally, and to mop the stricturewith the
food,but she could not obtain a passage for any undiluted liquor, appliedby means of a piece of
powers, constitutethe book. We expected, ere we
solid portions of food. She increased in flesh and sponge, fastened to a whalebone stem. He had
opened it,to see horribly distorted backs on one
and on June 30th was made an out-patient, and had
strength, never seen any harm from this practice,
page, for the purpose of showing what objects of but
neglectedto attend^ and on July18th was been led to adoptitfrom its beneficialemployment
admitted,
re-
pitythe patients were when theysoughtthe aid of with aggravation of the symptoms. A in cases of irritable stricture of the urethra, where
the spinedoctor ; and, on the opposite blisterwas applied, and the catheter again passed he and
page, well- had alwaysfound itsuse followed by relief,
with the same good effectas before. At the end of the
formed, plump, soncy figuresto demonstrate the
August she was made an out-patient, ability to pass a largeinstrument He had
but remained
skill of the same spinedoctor,in making the as a nurse in the Hospital.In January,1849, she found it very serviceablein strictureof the oesoph**
dependenton nulignant ease,
dis-
crooked straightSuch pictures are the stock in leftit On the lOth of September. 1849,she was ad- mitted gus, except in cases
trade of thisgenus of writers. But we did not ex^ forthe fourth time. She was now attenuated in which no treatment could be successful.
and exhausted ; was quiteunable to swallow even When the stricturewas caused by irritation or in-
flammation,
pect to see the idioticdoll,witli conical head and fluids, and the stricture could not be passed.She died the local and generaluse of alkahs
shelvingforehead, converted into the intellectual on the 19th of September. The bodybeingexamiDed, Iwas the practice moBt likely to be beneficiaL
 THE MEDICAL TIMES. 143
Dr. Bwham obeerved,that,in drawiogupthe Dr. Addison referred to a point not hitherto has been successfully resortedto, itisnot mentioned
paper which had juatbeen read, his object was to noticed by any of the speakers, namely,the difficulty that mucus was found ; from which fact, in connexion
ca]lattention to the results of accidents irom the of diagnosis, and named severaldiseasesfor which it with others,the Author of the paper is of opinion,
of caustic alkalis,rather than to that the cause of deafness in such cases consistedin
ingestion the had been mistaken,and afterwards alluded to the
a peculiar disease of the membrana tympaniitself,
treatment of irritable stricture of the oesophagus, or hysterical varietyof the disease,of which he men- tioned
rather than in disease of the Eustachian tube. The
of strictureof the cesophagus at all. He would, an instance, describing as one of the symptoms
concludingpart of the paper consistedof observations
therefore,onlystate, that the case of stricturein the capability of passing a bougie on the firstappli-
cationon the use of the otoscope in the diagnosis of diseases
which twenty years elapsed, after the takingthe to the su^eon, with, perhaps,failure, or of the ear. This instrument consists of an elastic
alkali,before the disease declared itself, was corded occasional success,
re- on subsequenttrials. tube, eighteeninches long,and about half an inch in
by Sir Charles Bell, who speaksdecidedly of Mr. Macilwain believed that permanent stricture diameter, e ach extremityhavingattached to ita piece
itsbeingtraceable to the action of the causticalkali. of the oesophagus of ivoryor ebony. One end of this tube beingplaced
may be occasionally aggravated,
It is evident,therefore, that a longperiodof time but he had never seen a case in which a bougie in the external meatus of the patient, the other is in-serted
in that of the surgeon, and by this means
may, and does, elapse, after the ingestion of the could be passedthe first time of tryingit,and
poison, before those changes take place, which cause without previous
sounds emanating from the tympaniccavitry o t the
preparation. If such a case were
be distinctly heard by the medical man.
death, to occur to him, he should doubt itsbeingan instance patient
can
stricture of the oesophagus, and ultimately The sound produced by the passage of air into the
by the impassible condition of the tube. Dr. Cnm- of stricture.
when the
min's
tympaniccavity organ of hearingis
successftiltreatment of a case of strictuie, Mr. Solly mentioned the case of a poor woman healthy,consists of a series of very faint cracks,
similar to that which he had narrated, by the daily who died recently in St Thomas's of malignantwhich are distinctly appreciableby the use of the
of a bougiefor months, was the reason why he strictureof the oesophagus.Nine months ago she otoscope. The author states it as his opinion,
use that,
had drawn the attention of the Society to these cases. was admitted as an out-patient, when a bougiewas as a general rule, when the Eustachian tubes are
force air into the tympanic cavi-
He (Dr.Basham) was of opinion, that that plan of passed, with greatrelief, and she was not seen again open, patients can ties
treatment was the only one which would reallyfor a fortnight^ when the instrument was re-passed. by attempting to make a forcibleexpiration while
the mouth and nostrilsare closed. Exceptions to
arrest a fataltermination to the case. He was prised
sur- The disease, however, continued to make progress;
this rule are found in children,and in certain adults
to hear Mr; Macilwain' s objections to it,for she was admitted into the hospital, and there died.
who cannot be taught to make the foroible
each cases could not be cured by constitutional Mr. Barlow stated that he had watched the case necessary
expiration.In these cases, recourse must be had to
treatment. Without the use of the bougie, patients described by Dr. Basham, and was present at the the Eustachian
catheter, which beingintroduced into
can only be keptalive by the infiltration of a small post-mortem examination. He regretted that the the Eustachian
tube,and another tube,very light
quantityof nutritious fluid throughthe stricture, discussion had turned on the generaltreatment of and elastic, (the explorer,) being attached to the
when it can pass, or else by means of enemata taining stricture of the oesophagus,
con- which was by no means nozzle,the medical man can blow through it,and
nutriment. Mechanical applications are the desireof the Author,who had been desirous to distend the tympanic cavity at the same time that he
absolutely this disease. draw the attention of the solely the is listening with the otoscope insertedin the meatus
necessary to cure Society to sequences
con-
externus.
Dr. Black explained the piocess of formation of of swallowing caustic alcalies. So com- pletely
a strictureof the oesophagus, after the ingestion of a was thishis wish,that he had not even men- tioned Mr. Harvey inquired of Mr. Toynbee,whether
caustic alkali, as not beingthe result of the ganising
disor- the strongmineral acids as causing ease. the tonsils were
the dis- ejigaged in the disease in this case,
action of the alkali, but of the subsequent He (Mr.Barlow)then alluded to a case of and whether he had found theirexcision of service
healingprocess. He had seen six oases of stricture poisoning by sulphuric acid ; the same resultswere in cases of deafness arising from obstruction of the
of the oesophagus, one of which resembled Dr. Ba- found after death,as in Dr. Basham' s case, and in Eustachian tube ?
sham's. The patient was a young woman, eighteen that instance the stricture occurred long after the Mr. Toynbee, in reply, o bserved,that when the
years of age, who, for the purposes of suicide, had poison waa taken. In Dr. Basham's case, the pa- tient, tonsilsbecame enlarged, it was inwards and not
up*
swallowed a strongacid,and was taken to the hos- pital. a strong, healthy-looking woman when mitted,
ad- wards. Deafness was rarelyproducedby their
After the symptoms caused by the acid were although ihe could not swallow solidfood, pressing on the Eustachian tubes; he had lately
subdued, those of stricture set in, and ultimately yet could take fluids very well. She did her duty, seen cases in which the tonsilswere enlarged to six
terminated fatally. When she died,she looked like and went about her avocation as a nurse in the or seven times theirusual bulk,and yet there was
an old woman of eighty.She had been kept alive hospital ; but stillshe was not safe, as the re- sult littleor no attendant deafness ; while,on the other
for acTen weeks by springwater only. The post- showed. Dr. Basham, in recommending band, deafness might and does exist, without any
mortem appearances were the same as in the case the use of the bougie,he (Mr.Barlow)thought,enlargement of the tonsils. There is generally a
before the Society.The onlyremedy he believed referred to it as a preventive of the tion
forma- space existing between the Eustachian tubes and
at all likely to be useful in these cases, was that of a stricture rather than as a means of cure ; the tonsils, and when deafnebs is coincident with en"
mentioned by Dr. Basham, whose comments on his and this he regarded as a very important feature in largcment of that gland, it is because the thickening
case be (Dr.Black)considered to be
very judicious.his communication. The surgeon, after the symp- toms has extended to the membrane liningthe tympa-
num.
Mr. Lloyd explained, that the remarks he had of poisoning have passedaway, should use the Excision of the tonsils is,consequently, of
made were intended to applyto stricture of the bougiecarefully, and at proper times,duringthe very little service in relieving deafness.
oesophagusgenerally. When the contraction was piocess of cicatrization, to preventthe occurrence Mr. Streeterwished to ask Mr. Toynbeewhether
the result of cicatrisationfrom injury^ dilatation of contraction of the tube. This,he believed, there are any means of distinguishing
was temporary
by the bougiewas the onlyremedy that was ap- the practice
plicable. pursuedin Dr. Cummin's case, and it deafness from thickening of the mucous membrane of
was successful. the throat, f rom those more seriousdiseases for which
Mr. Sollybore testimony to the utifity of bougies catheterism of the Eustachian tube has been prac- tised
A CASE OF STRICTURE OP THE
in th^e cases; if properly used, it waa a most ? He asked the question, because he believed
EUSTACHIAN TUBE,
Talnable instrument. Great delicacy was sary
neces- Aim THE APPEABANCES PRESENTED ON A MORTEM
POST-
that attentionto the state of the mucous membrane
in its employment; in many instances it should EXAMINATION; TO WHICH ARE ADDED of the throat, in incipient deafness, would enable us
be passeddaily, or, at least, to arrest its progress, and prevent its becominga
very frequently. SOME OBSERVATIONS ON THE USE OP THE OTOSCOPE
Mr. Bosseywished to ask Dr. Basham a question
IN THE DIAGNOSIS OP DISEASES OP THE EAR. permanent disease in the orificeof the tube itself.
relative to the lengthof time the bougieshould re- main
By JOSEPH TOYNBEE, F.R.8., Senior Surgeon to the Mr. Toynbeehad made a great number of post-
St. George'sand St. Jamei' General Dispensary.
in contact with the strictureon each occasion. mortem examinations of patients deceased from scar-
let
Dr, Basham In thispaper the author first alluded to the various
replied, that he believed about a fever,who were also deaf. In many cases he
held by writers on diseases of the ear, as to
minute would be the time for the bougieto remain opinions had found ulceration of the mucous membrane of
the causes of oostruction in the Eustachian tubes ;
in the tube. He did not know whether the length the throat,and also ulceration of the tympanum
he then proceeded to give the particulars of a dis-
section,
of time the bougiewas used was mentioned in the and its membrane, but in of the
in which the source of obstruction was one none, any case,
narrative of Dr. Cumin's case, but it must be evi-
dent which has not hitherto been alluded to" viz.,a Eustachian tubes. He believed, therefore, that the
that the eflect of the mechanical pressure in thickeningof the bony parietes of the tube. The cause of deafness in scarletfever was not so much
the treatment of strictureof th""oesophagus, could case was that of a man, aged forty-five, who died a diseased condition of the Eustachian tube, as of
not be the same as in stricture of the urethra, where from scrofulous disease, and in whom the ear was the membrane and the cavity of the tympanum,
the instrument could be retained in the examined duringlife, the appearances of which were and a collection of mucus
passage for in it With regardto
a much longertime. detailed, and the peculiar effects of stricture of the the means of diagnosis, he know nothing better than
Mr. Lloyd mentioned a case Eustachian tube on the membrana tympanipointedthe use of the speculum-lamp,
of cut-throat, in by the light of which
oot. Upon dissection, the internal portionof the
which a tube was keptin the oesophagus for three we can ascertain the condition of the membrane,
Eustachian tube,for the leneth of half-an-inch, was
weeks or a month, the patient recovering. F ood while by the otoscope the state of the cavityand
found to be quitehealthy, but about that distance
was admitted throughit. from the tympaniccavity there was tube can be discovered. Instead of the usual
a sudden con-striction,
Mr. Macilwain remarked that the observations of which,for the lengthof about a line and a healthycrackling sound,we should have a puffing
Mr. Sollywould seem to imply that he (Mr.M.) half, was so contracted, that even when the anterior or bubblingsound,when the cavityis contracted,
prqscribed the use of the bougie. That was not the wall of the tube was removed, it was with difficulty or contains mucus.

case ; he wished to draw attention to the necessity that an ordinary-sized bristle could be introduced into Mr. Harvey inquired into the results of Mr.
for constitutional treatment, and to express his the opening. The cause of the stricturewas described Toynbee's
experience, relativeto the application of
opinion that there were few cases in which the dailyas bemg an enlargementof the external and internal hydrated pellets of wool in perforations of the tym-
panal
osseous wallsof the tube. The presence of mucus in
passage of a bougiewas either necessary or proper. membrane ?
the tympanic cavity, in cases of obstructionof the
In cases of severe and extensive injuryto other Mr. Toynbee replied, that in the majorityof
Eustachian tube,was pointedout as an important
canals, the urethra, for example, the daily
, . ,, ^ V^- ,
passage
t, .
'
".-
of
1 symptom ; and it was remarked, that in those in- instances the application of the cotton did not do any
a bmigie would not be found serviceable, while stances where perforation of the membrana tympani good; in some itcaused mischief, while in a very few
benefitwould be derived irom itslessfrequent use. |(supposed eases of strictureof the Eustachian tube) instances it seemed of benefit He did not believe
 144 THE MEDICAL TIMES.
that the advantagederiyed ever dependedon the the catheter isoftienpassedfora longtime uselessly; five cases died very soon after, as did also the seven

perforation beingcovered by the pellet, for in one of therefore, aftera fairtrial, if a cure be not efl^cted, cases subsequently operated upon.
the cases, in which it seemed of use, there was not the operation should be performed.It is a difficult Mr. Acton observed,that either cutting into the
any perforation in the membrane at all. The planwas operation, from the natural condition of the parts urethra, or usingcaustic, is very seldom required,
not a new one ; he had known of it for eight or ten beingmuch altered. It is not, however, more dan- gerousand sufficient time has not yet elapsed to prove the

years. He was not able to say in what condition of than lithotomy. The operation of cutting is real advantageof either. M. Ricord and others
the membrane the application of the pellet would be advisable, where a catheter can be introduced, if the considered potassafusa a dangerous caustic, and in
of service, and he thoughtit should be used with stricture be undilateable. He desared to hear Mr. applying it to the cervix uteri,great difficulty is
caution,because the presence of this*foreign body Wade's opinion upon these cases. found by practitioners in preventing itseffects ing
spread-
may cause considerable cerebral disturbance, and Mr. Childs could find but littleto say after Mr. to other contiguous parts. Oil on potassa fusa
even induce an attack of meningitis. Deafness is H. Smith's excellent ting preventsitsaction : itseffecton the stricturein the
paper. The operation of cut-
not necessarily the resultof an aperturein the tym- panal open the urethra should not be undertaken urethra may thereforebe very slight, or none at all.
membrane. until all other means fail. The cases brought to Mr. H. Smith havingreplied, Dr. Manson cupied
oc-
The meetingthen adjourned. have usuallybeen badly treated. The the few remainingminutes by exhibiting a
surgeons
A new form of hernial truss, invented by Mr. contentrated solution of made by Mr.
operation advisable two classes of strictures,
is in " aqueous senega,
Teale,of Leeds,was exhibited to the Fellows of the the cartilaginous, and in extravasation of urine by Baxter,of Islington, ^. in f^'. of water: making a
."Society, prior to the adjournment solution strongerthan the decoction of the phar- macopeia
ruptureor ulceration at the stricturedpart
Sir B. Brodie disapproved ; and one the strength of which is known.
of cuttinggenerally,
The following is the li;;Loi" papp'-*'to be read at He added,that it may be used in chronic bronchitis
but proposed a subcutaneous division (by StafiR"rd'8
the ensuing meetingsof the Society : "
with profuse frothy expectoration.
stilette ?) He considered that many of Mr. Syme's Messrs.
On the Proximate Cause of Albuminous Urine Childs and Baileyspoke to its use in
cases would have yielded to the use of caustic. He
and Dropsy,and on the Pathologyof th" Renal the diseasesof children, and in ^arrhoea.
the subcutaneous operation to Mr. Syme's,
Blood-vessels in Bright'sDisease. By George preferred ELECTION OF OFFICERS.
and observed, that he was the firstto divide the
Johnson,M.D., Assistant-Physician to King'sCol-lege The scrutineershavingpresented their reportof
muscles of the back in distortion. He uses caustic
Hospital. the the President announced
experiencedthe ballot,
three or four times a week, and never the election oi
On Fatty Diseases of the Heart By Richard following
bad efiects from itsapplication. John Hunter was gentlemenas officersfor the year en- suing:
Quain, M.D., Assistant- Physician to the Hospital
not the firstto recommend caustic, but Mr. Wise-
man, "

IforConsumption. PRESIDENT.
in Charles the Second's reign.Whateleydid
An Account of a Case of Scrofulous Abscess of E. W. Murphy, M.D.
not use it in impermeable strictures, but onlywhere
the Anterior Mediastinum, communicatingwith could enter. Mr. Wade was the first to use
a bougie VICE-PRESIDENTS.
both aidesof the Chest,the Pericardium and Trachea, ,
it in impermeable cases. He had never found ill E. Lankester, M.D., A. B. Garrod,M.D.
forminga Tumour above the Clavicle, and Simu-
lating
effects from the use of nitrate of silver. He then F.R.S. J. F. Clarke,Esq.
Aneurism of the Innominata Artery,or related a case in which nitrate of silverhad been J. F. Marson, Esq.
the Arch of the Aorta. By D. Maclachlan,M.D.,
used by him in a case of pyelitis with impermeable COUNCIL.
Physician to the RoyalHospital, Chelsea.
stricture. After four or five applications of the W. Harding, Esq. F. Hird, Esq.
Case in which Hydatidswere Expectorated, and
caustic, a No. 12 bougie had been passed. In an- swer
F. R. Manson, M.D. F. Sibson,]Vf.D.,F.R.S.
one of Suppuration in an HydatidCystof the Liver,
to a question, he replied, that the subcutaneous T. H. Tanner, M.D. B. Travers,Esq., Jun.
communicating with the Lungs. By T. B. Peacock, W. R. Rogers,M.D. J. R. Cormack, M.D.
method of cuttingis by passinga grooveddirector
M.D., Assistant-Physician to St. Thomas's pital.
Hos- W. Harvey,Esq. R. Greenhaigh, Esq^
down to the stricture, introducing a knife into it,
and, at the proper time,turning it round,and divid-
ing Note. The first
" column of Vice-Presidents and
Case of Mollitiesand Fragilitas Ossiiim,(Osteo- Council contains the names of those who continue
the partagainst which it comes.
Malacia Fragilis Rubra,)' accompanied with Urine for the second year of office, and were not elected at
Mr. Wade considered the perineal section as very this
stronglycharged with Animal Matter. By W. meeting. Dr. W. Merriman and Dr. Routh,
serious, and sometimes fatal. Sometimes it does not the Secretaries,
Macintyre,M.D., Physicianto the Westminster are appointed by the Council.
General Dispensary. producea continuous cure, as, after about two Dr. Murphy having taken the chair,a vote of
A Case of Gunshot Wound, and Subsequent traction
Ex- years, the parts will often contract as previously, thanks was givenby acclamation to Mr. Hird fiw
of a Bullet from the Bladder. By E. M. and require the passing of bougies.He had the his conduct as President
duringhis periodof office.
of Mr. Aston Key in recommendingthe
McPherson, Assistant-Surgeon to the 9th Royal authority
Lancers. caustic treatment in a case of impermeablestric- ture,
Case pf very largeHaematocele of the Spermatic where he advised the patient to recruit his CORRESPONDENCE.
health in the country,and then return to Mr.
Cord, provingfatal after Ten Years. By W.
Wade to be treated. The cuttingoperation should ABERDEEN DEGREES.
Bowman, F.R.S.,Surgeonto King'sCollege spital;
Ho-
Case of very large never be performed,save to relieve a patient
to which is added, a
[To the Editor of the Medical Times.]
Hoematocele of the Tunica Vaginalis in an Old from immediate danger. If a stricture can be
Will you permit me to say a few words in
Esq., passedby a
catheter it may be left in with pro- priety. Sir,
"

Man, terminating fatally. By T. R. Curling,

He held the doctrine of Mr. Symetobe very defence of the Aberdeen degreesof M.D., in replyto
Surgeonto the London Hospital. your Correspondent " Mors ?"
dangerous ; many strictures are with difficulty passed, It is but fair,
so that the operation is likely to be very frequent
that those who have some practical
; of
two planswe should alwayschoose the less danger-
knowledgeof the nature of the ordeal throughivbich
'WESTMINSTER MEDICAL SOCIETY. ous, candidates for the M.D. degree have to pass, should
and never undertake the cutting t ill
the caustic
February 16, 1850. be heard on the subject. The letterof "
Mors" is
has been tried. He now never uses the nitrate of calculated to do much mischief to the character and
F. HiRD, Chair. silver, as the potassa fusa allays irritation,besides of the University,
reputation and to deceive those
Esq.,President,
in the
doinggoodotherways. He recommended the caustic who contemplategraduating there as doctors of
MISCARRIAGE :REMOVAL OP THE OVUM to be used in very small quantities, and that there medicine. If Medical men are Jed to suppose that
UNDER THE INFLUENCE OP CHLOROFORM. should be no hurryin urgingthe cure. He does parties themselves for examination at King's
offering
not use the potassa fusa in sufficientamount to CollegeUniversity,Aberdeen, are not subjected to
Mr. J. B. Brown relatedthe case of a lady,the examination,many incompetent
a testing men might
mother of seven children,who had flooded very
cause a slough.(After the meeting Mr. Wade be induced to present themselves before the Board
showed how he uses the caustic on the pointof a
much in three of her confinements, notwithstanding with the certainty of rejection; thus great expense

every care. She felldown in the sixthmonth of her bougie.) would be incurred,and mortification follow. For
last pregnancy, and had signsof miscarriage a few
Dr. Knox, of Edinburgh, said: That surgeons this fact I can trulyvouch, thai no igfwronltilU
"

daysafter. Mr. Brown was sent for,and found her abroad,especially at Hamburgh, use caustic fteelyinformed f or
incompetentman can pass the ^txammation ai
Aberdeen, Tlie candidates are expected be
flooding, the ovum protruding throughthe cervix of in strictures and in gonorrhoeaits employment, "
to

the uterus. He gave secale comutum, and appliedtherefore, is not so objectionable as has been
thoroughly, practically, and theoretically acquainted
posed.
sup-
with every department of the Science of Aledicine.
ice,and wished to remove the ovum under the in-fluence Sir E. Home made great paradeof his The examination
but his greattact and skillenabled him
generallylastsfor an hour,and is
c^ chloroform,but the patientreftised. At operations, vive voce in character. Occasionallythe candidates
night, violent hsemorrhagecame on, and he found to distinguish those cases which would be amenable examined on two separate occasions. They are
are
to the treatment,and hence he did not use caustic expected to be well acquaintedwith
her pulseless ; he used ice,"c., as before, and, hav-
ing anatomy "

as under other circumstances he might have

gainedher consent, gave chloroform. The os so often, microscopic, general,and relative. He is also ex- amined

out the done. Dr. Knox preferred small silvercathetersto minutelyin physiology, pathology, chemistry,
uteri was relaxed immediately ; he scooped
ovum easily, and had her placedin bed before she bougies ; by their use a good anatomist can avoid surgery, and pharmacy. He isalsorequired to wntc
falsepassages, which the bougieis likely to enter or a Latin prescription in full. I defyany man not
awoke. There has been no haemorihage sin\ce.
Dr. TylerSmith and Dr. Cormack both bore tes- timonymake. He agreed with Mr. Syme that no strictureis well up in all the modern views as to the treatment
of diseases, c hemistry, physiology, pharmacy, and
to the sufliciency of turpentine enemata, in strictly impermeable, as mucous passages never en-
On the strength
It is necessary to be on one's guardin ac- surgery, to pass the examination.
such cases, to promote the expulsion of the ovum. tirely'close. cepting
of the assertions made
the published
by your Correspondent, many
statements of surgeons, as the
ADJOURNED
Medical men possessingthe minimum amount of
DISCUSSION. cases are frequently too recent for the cure to be de-
pended
knowledge, and without proper preliminary tion,
prepara-
Mr. Haynes Walton considered the dangerin fis- tulous
upon ; and he instanced the case of a surgeon, might flatterthemselves with the idea,that
sores rather to dependon the probable exten-
sion who published the firstfive cases of lithotomy he they have only to jump into a tail way carriage, start
of the disease into the prostate. In Hospitals, I of
operated on, as allbeingsuccessful; but one of these for Aberdeen,and, having the requisite
,
amount
 THE MEDICAL TIMES.
146
indebted
aided many hours. And for these truths we are
this alone, nor even his own
form, without its bein^
cholera,
to glean some Taluable facts on to Dr. Stevens.
his servations
ob- other remediw, fearing the saline planwas incom- petent
reader of your Journal,and, as 1
subject I read and re-read by As a constant
all-important I a writer and a practitioner in cholera, I
with all due patience. At length his eases died from con- secutive have been
? Can it be, that this is 2. That the maiorityof conceived it to be an incumbent duty
on me to guard
said, Can this be possible though "
the salines helpedthem misled by such aa
in his tures,
Lec- fever, subscribers from being
the tabular Mr. Ross of 1848 ?" he who, of collapse;" stillhe saw no benefit your makes
of cholera of over the stage as Mr. Ross, who, unintentionally,
condemned the saline treatment authority and obscures the first
and, in from their use. confusion worse confounded,"
Dr.Stevens as the worst method possible,
**
active remedies, at length, to '*
Stevens's Book
from
thesame 3rd Table, praised the saline treatment of 3. He used more clear rays we have received
arrest the disease; yet
he has givenno opinionat and which have been acknowledged
Dr.Marsden, at Greville-streetHospital, as the best the Blood,"
of the disease itself; and, on the first physiologists and
possible, and the two modes of treatment being allof the nature or cause
of active or inactive reme- dies as such by some of
tion
inten-
actually the same !! According to this Table of Mr. hence,the administration chemists here and in Europe. My present
unfold itsnature. this letter, c ontentiog
Ross,Dr. Marsden only lost 14 per cent.,
whilst Dr. did nothing to
of salines is,to answer no reply to
of 76 4. He has no
" confidence in the powers
with showing, that Mr. Roas's present im- perfect
Stevens'streatment was attended by a mortalltv thoughhe constanUy myself views of the treatment of cholera,which hti
In other places,in Mr. Ross's 5th Lec- ture, to arrest thisterribledisease,"
percent. he proved in his published Tables and hia confirmed,
them, and has sanctioned, reason
Dr. Stevens's plan was said to be attended by a gave cases experience
Dr. Marsden cured hu their meant
more

mortality of 88 per cent, and Dr, Marsden's toHnes that He also admitted the throw
no lighton thisdark subject.
also added, that than any other practitioner. I have the pleasure to remain,
byonly8 per cent ; and Mr. Ross in favour truthfulness of the Tables,open
now to the public Yours very truly,
hethen found an almost universal opinion and verifiedby the H. TURLBY, M.D.
ofDr. Marsden's salineswith cold water. He sub- at the Cold-bath-fields Prison, in
the Governor there, and the VisitingMagistrates, Worcester, Jan. 27,1860.
aequentlvsaid, that the saline treatment was Ivy-house,
it be believed, 1832. add. that neither Dr. Stevsni*
bestmethod of cure possible.Will salineswas, [tore- P.S. I am desirous to
5. His avowed objectin giving has anythingto do isiththe
then, the same Mr. Ross, in 1850,states,that he has iu lostnrineiples, and to bring nor any other friend, for
friend the blood with I alone responsible
now tried the saline plan of his esteemed supply This principle above remarks, and that am

Dr. Stevens, but found it inferior to his own saline itby theiraid,into its normal state. alltheir ftultsand imperfections."
H. T.
it he abandoned, and then appears to have trusted to
form with nitrate of silver, when, in reality, pears,
ap-
he must have been
principle at all,although
he neither used the plan of Dr. Stevens nor no
where
aided aware of the rapidchange m collapsed cases
thatof Dr. Marsden, but his own prescription, into the blood itself; and know-
ing DR. JENNER ON TYPHUS.
salines injected
byother remedies. He has not, itseems, been lately
were
all secretions, he gave six
to learn there the results that opium arrests
at Greville-streetHospital,
within the firsthour,and one, two, or three [To the Editor of the Medical Times.]
of the saline treatment in 1849. For the sake, then, grains an illus-
tration
of silverwith it to arrest the dia- rrhoea
may serve as
of his "'excellent friend," Dr. Stevens,he uses his grainsof nitrate Sir," The following case
comunication
treatment, exceptingthat he omits
the recipe of Dr. " one symptom of the disease. curative
of what I advanced in a former
of the cere-
bral
6. That of silver exerts more
regarding inflammation
Stevens^ike the countrymanager who got up the nitrate to this Journal, of
than any other medicine. occasional complication
of Denmark," only he powers in eholera membranes as an
tra^dyof The Prince
"

7. Ice the cramps of cholera more effectually

omitted the character of Hamlet. Out of kindness stops typhusfever. 24, and married,
else. labourer, aged
to his patients, he did not, it appears, give them the than anything therefore
Wm. F ,
a
1847. Six days
8. Calomelneither does goodnor harm ; under my notice September 1,
salines of Stevens,for these contained too much heels are tripped
came be
he " saved the bacon" of the itmust be useless;
and so Dr. Ayre's having been exposed to contagion,
salt; and, therefore,
sick by coringthem with saltpetre ; and this mild up by Mr. Ross.
as bearing
Ereviously,
ad become affected with tne ordinary symptonM
at the above
9. No one remedy can be relied on on
which mark the ingress
of typhus, and,
powder was ^iven throughout the whole
"
cunnff
of the disease, or nature of cholera ; hence characters of that period
period of the epidemic." Nevertheless, he found the the essence date,he presentedthe usual
die,after beinghelped its essence must be
a compound.
of the disease, without any indications of peculiar
niajonty of his eariy patients
from the con- 10. The wet sheet (eold,I presume) proves
useful in the case. The rash was copious.
over the collapse by his own salines, secutive gravity had a warm bath,
to his own words, he in incipient collapse, but is of no service in deep His head was shaved. He
fever. Yet,according cold, a laxative
eould perceive no probable benefit from the use collapse. with proper precautionsagainst
have full in the premonitory stage administered, bis bowels being rather con- stipated.
of salines. He did expect the salts would cited
ex- 1 1. Opiumin doses, was
"

but it wholly failswhen

the kidneys," as well mighthe expect to obtain of the disease, is beneficial, he seemed to
of the fever,
vesiclesfrom blistering a wooden leg, as to expect a the purging is profuseand collapse settingin,and Up tillthe eleventh day taken of the
lifebefore If then given in largedoses,is highlydangerous: go on so well that no special note was
"chemico-nhy Biological" signof returning he observed mosn-
the natural vital powers were sufficiently restored nothingthen does good but nitrateof silver. case tillthat morning,when was
in bed^whilebe
from temporary death In collapse.It then appeared will be, firstto ing,and apparentlyunable to move
12. His future plan of treatment by any means.
Mr. Ross to employ other restraining and vegetable astringents, and to use the could not be roused to intelligence
necessary to giveopium the head, and
remedies over the stage of collapse, as the saline
oold wet sheet ; then,if nursing supervene, nitrate
of A blister was at once applied over
without benefit.
ordered tor him, but
most frequently followed by death, silverand the steady exhibition or saUnes (thesetwo mercurials were
treatment was
of the day, all the symptoms taken
though the salt did helpthe cases over the collapseincompatible) with solid ice and beef-teainjections.In the middle of matters within
that other"
leftno doubt ot the state
stage. But itappears by his statement, he had in practicemade him together,
13. The difficulties There was hemiplegiaand occasional
gentlemenhave declared to a differentexperience." abandon the tabular form of estimatingdifferent the head. movements of the muscles of the eyeballs.
Poor Steven's! how art thou overiaid by thy One-half died of allhis collapse cases, convulsive coming
be-
treatments.
very weak,
and the respiration
death by thyfriendsI " Save does not wish His pulsewas
nurses, and cuddled to and by publishinghis own opinionshe oppressed,he died
in the
toe from my friends !" Yet some kind soul did sug- gest, In the way of his gradually more
these adventi-
tious
to increase the embarrassments twelve hours after
the employment of other remedies to the evening, justabout
that perhaps
Profession coming to a just conclusion
as
had been observed.
interfered with the action of Mr. Ross's salines, treat this fataldisease. Surely
it symptoms eighteen hours after
proper method to was made
thoughhe says they were
"" not
practical men." So
would have been easier for Mr. Ross to
do this by An inspection in regard to the
and the substance of the notes
Mr. Ross does not at lastbelieve that the blood can not publishing at all.
death,
particularly OTer
follows:" The dura mater,
be suppliedwith the lostsalinesthrouRhabsorption, shall now conclude by asking you, Mr. Editor, head than usually vascular.
in I left hemisphere, was more
althoughhe must have witnessed the fact patients as well as your readers generally, what benefitthey the of dark blood issued from
the
who have had enemata given to them,consisting of
Mr. Ross's observations T whether
A very largeQuantity itopen. On removing
the
by the thirsttheycomplained of after- have derived from longitudinal sinus on laying
grueland salt, derived one clearidea of physiology, granular-looking
you or theyhave dura mater, a layerof light-brown
wards,and the salt taste they experiencedgenerally therapeutics firom hia contribution? shreds of lymph, was seen on the
hours. Now, if he had tested the urine in pathology,
or with
mixed
for some
Yet Mr. Ross, no doubt, means kindlyto all his fluid, arachnoid coat,over the centre
of the lef^hemisphere
such persons for salt, he would have been soon deceived.
un-
to me to be a most dish
red-
the friends. He has ever appeared the brain. There was, also, very abundant,
Mr. Ross appears to esteem tion
restora- of truth of and in
of the renal secretion his sheet anchor in cho- lera, active, candid,and useful officerin the army serous eflUsionsbeneath the arachnoid, the
and fmlsehood; and the subsunce of
againstthe old enemies,prejudice
althoughhe permits himself to give opium hot his zeal in the good cause has pushed him into both lateral ventricles; in sections apparently more rous
nume-
largelyto cholera patients," a medicine well known brain presented
He has not reflectedon the first
VBscular pointsthan in its heal by
the enemy's camp. i state.
to arrest this secretion as well as others,and to viz., that blask carbonized rssh
of animal life, of inspection, the peculiar typhus
paralyse the visceralfunctions generally. The poison
the sole cause
Crinoiples
lood, or blood deprived of its salines, cannot tain
main- At the time
stillpersistent.
retained in the system was probably the muscular contractions of the heart, and
was
of what I desired to bring
of the consecutive feverand subsequent death. Then
in all the visceralfunctions;
This is a goodexample in so far
of vitality in
his new discovery of the nitrate of silver in hence a loss before you ; but it is peculiar one respect,not well
comes induce this state of blood, which
administered every that all fevers the accession of the head disease
was
cholera ; one, two, or tbree grains to the vitalnerves. Well as
from the few remain*
hour with saUnesM and he trusts,in ftiture, that this becomes then poisonous to do is marked.
To judge,however, served,
ob-
emoloyedin this disease. to proved as this is,surely,then,the firstthing salts ing instances of thiscomplication which I have
drugmay become largely maintain the primum mobile by supplying the
the occurrence of meningeal inflammation in

He speaks most favourably or the beef-tea iniections, of the

which are rapidly carried out be determined,
considers it a qf the blood,
so
and, like his predecessor and friend, in the course of typhus, may, in general,
by vomiting, and especially by purging, of toe whole of the sym- ptoms
most valuable nutrient adjunct body most unwilling again to from a
elose examination
impossible to
cholera. Now, Sir,I am truly But it is,perhaps,
For the sake of your space, I will not quote more this subject, present
could warrant mere
in- enter the field of controversy on
which
from Mr. Ross's Paper. I will only suggest the any number
that no good will be effected in point
out "eem
persuaded this This may
ferences which must be drawn by those of our Pro- feeling
of such an event
fessionthan a suspicion
words on matter, before our Pro- yet itwill be admitted
by those
feasionwho have read his contribution. multiplying further on the modus agendia strange
statement and
learns something
who have paid much attention to the sabject;
and the vital law of the have seea
INFERENCRS. of poisonousmiasmata, those who have not done so, if yet they
1. That Mr. Ross tried Dr. Steven^a plan of animal
for selves
them- will, pet-
body; tillphysiologists prove
patientsin the laterstages of typhus, of
treatment in cholera, and found it of littleuse; al- that common salt is an antidote to prussicacid many It is the observauon of cases
the haps,admit it
too.
thoughhe admits he never used Dr. Stevens's salines and morphia, that it is able instantly change
to
"
violent delirium, and of deep coma, and jiosMmv^ for
into arterialblood" thatcarbonized cas^
nature or venous
make examination of these the most promisio^
(a) See " Nitrate of Silrer" in Thompson'a Con-
"* blood can killthe heart,and saltand water can the numeroui ezampleaof oaatt
itbeat agaiti even when nmoTed firomthe body for diacoTery,^-^hile
ipecttts."
 THE MEDICAL TIMES. 147
fiiommere prostration are leftunexamined" that have calledinto existence thou and the panorama before bom at the full time,with a weight either much
led to the notion of the inflammatory nature of thee ; and, thooghthe retinaof thyeye does not ex- ceed above or much below the average, would be propor-
typhus fever. the size of a shUlmg,yon church towers which tionably eitherabove or below the average,Uiroughout
Kegfirdto the valuable space on which I am en- are
croaching overtopping the hillsand woods,or overlooking at leastthe betterhalf of utero-gestation. V iability
has preventedme givingthe foregoing case the villages, the farmers and labourers at their work, must, I think, depend more on uterine ago than on
at greater length ; and forthe same reason it is I do the sheep and other cattlereposingunder the shade, size and weight ; out I believe it impossible to de-
termine
not submit to you some notes on other cases of the and even yon coach, which thou seeth farin the dis- tance, the age, in premature cases, from eitherthe
same nature. laden with passengers and luggage, together weightor the measurement, for the reasons I have
I am, "c., with the whole extensive tract of country before given.I once had a case of twins,where the first
James Steven, M.D. thee,are all vividly portrayed upon it Well might loetus bom weighed onlya pound and a half, while
Glasgow,February,1850. "
Studens" now exclaim with the Psalmist, when ne the second weighed more than three pounds. Both
was meditating upon the works, majesty, and power lived several hours. Their uterine must have
a^
of Jehovah," O Lord,how manifold are thy worlu;in been the same, unless we are to believe in snperfoeta-
PRIVATE ASYLUMS. wisdom hast thou made them all; the earth is fullof tion, which I, for one, do not. And I recollect
thyriches;" or, with the poetAddison, " another premature twin case, where one child weighed
rro the Editor of the Medical Times.] *'
'There is,' all nature criesaloud two pounds and a quarter,and the other two pounds
Sir, The case with which you have illustrated
"
the Through all her works." and three-quarters. In this latter case, the child
Article on the law of lunao]^ is not one bit over-
drawn. Let " Studens" procure a bullock's eye, and dis- sect that weighed the least lived several hours longer
An instance of precisely similar character, it vtTj carefully, and examine minutelythe than the other.
but accompanied by worse features, has recently beautiful harmony and arrangement of au its I am. Sir,your most obedient servant,
under my own personalknowledge; the par- R. U. West.
come ticulars partsfor producingvision,and then let him ask
of which, if we can properly do so, we will nimself, can this be the effectof chance f Or will Alford, Lincolnshire, Feb. 16,1850.
nimish vou with. he say that the bee,in the construction of its hive,
In order to show the gross and fearfulabuses that has been carrying into effect, from time immemorial,
are perpetratedin private lunaticasylums, I should one of the most difficultmathematical problems, MORBUS COXARIUS.
like you to see two affidavits of Thonuu Marks and merelyby chance. There is no such thingas chance.
kit wife,which, some time since,we preparedand The same power that rules the planets, and causes [To the Editor of the Medical Times.]
sent to Mr. Bolden, Solksitor, of 44,Craven-street, the sun to shme byday and the moon by night,also Sir," In your Number of the 25th Januaryare
Strand, in a case which was then before the Lord governs etery action in the animal,vegetable, and some remarks made bj Mr. Henry Smith, on the
Chancellor. mineral worlds. But it is in vain that I adduce in- stances,lateoperation for excision of the head of the femur,
Mr. Bolden, on using the names of my firm, eitherfrom physiology or natural history, to by Mr. Morris,of Spalding. I agreewith Mr. Smith,
"
Sunlev and Wasbrough,-would lend it to you show " Studens" that there is a God, unless his mmd as to the success or the operauon in this instance ;
most willingly. is in a state similar to that of David's when he ut- tered but beforethe operation, how was it possible to form
In this case, both certificatesand order the above araphic sentence; or that of Galileo, a correct opinionas to the stote of the acetabulum ?
appear
to be quiteregidar, althoughone of them was not when he said, tnat the formation of a singlestraw This must be anything but an easy matter, even in
given for some hours afterMarks was taken to the would convince him that there Is an AlmightyPower ; cases where the head of the femur is dislocated.
Asylum. And I have not the slightest doubt,that or that of the magnanimous Newton, when, in his Many cases will be found,I suspect, where both the
the treatment he experienced, after he was taken lasthours,he said that he was onl^like a little child femur and bones of the pelvis are diseased. The fol- lowing
there, was, that he might be in a proper state for the gatheringpebbleson the shore,while the great ocean case, and recent dissection, you may consider
second surgeon to see him. of truth lay before him unexplored ; or that of the worth recording: "

Yours,faithfully, immortal bard, when he exclaimed," Books in the Private Denis Byrne, aged 20, (Irish,) a recruit,
Henry S. Wasbrough.
runningbrooks, sermons in stones, and good in of faircomplexion, blue eyes, and rather slight frame,
Bristol, Feb. 18,1850. everything ; " or when, in raptures at the wonderful was admitted into hospital in Au|[U8t, 1847,with dull
constitutionof man, he said, What a pieceof work-
**
manship pain in the rightknee joint, which soon turned into
is man ; how noble in reason, how infinite rheumatic fever, therebeingmuch pyrexia, and severe
"STUDENS"AND INFIDELITY. in faculties; in form and moving how express and pain in almost every joint of his body. By October,
admirable ; in action how like an angel; in appre- hension the pain was confined to the rightknee-iomt,which
[To the Editor of the Medical Times.] how like a God ; the beauty of the world,the was not, swollen, and painful to the touch. All acute
Sir, Your answers
"
to thi^ inquiring youth, who paragon of animals." For mv part, I cannot see symptoms subsided by active treatment. In Novem-
ber,
seems to be hovering on the brinlc of that horrible anything In our studies calculated to lead to infi- delity. 1847,1 firstremarked stiffnessof the right hip-
abyn intowhich the eruditebut unfortunate Voltaire Certainly,if our minds are bent on scepti- cism joint,but there was no pain,even on pressure, round
sunk and wallowed,are trulyChristian and excel- lent, find ample scope for the exercise or it, the joint The knee was slightly and
we can enlarged, stiff,
and, so longas the Editor of a leadingMedical eitherin the volume ot Revelation or Nature^as there painfulon motion. He was now cupped along the
Journal continues to give such advice to mysteries in each, which giganticthigh; given the compound decoction of sarsaparilla.
vouths
erring are the most
enteringour Profession, I confess that I minds cannot comprehend. But this shoulaiead us with a blue pillat bed time,to improve his general
have no fearswhatever of our studiestendingtowards to adore the wisdom of theiromnicient Author, and health ; at the same time a generous diet was scribed.
pre-
infidelity. Common sympathy for the present and bow, in meek submission, to what they teach. In January,1848,there was actualswelling of
eternal welfare of this youthalone prompts me to The books which I would advise "Studens" to the righthip-joint, with pain on pressure ; the legwas
a space in your columns to give a kindly apparently lengthenedabout an inch
erave word take home to his lodgings and studycarefully, are,"
; but,on mea- suring
ot advice to "
Studens." I fear much that he is one "
Locke's Conduct on the Understanding," " Locke the limb, this was found in reality not to be
on
of that,alas! too numerous class,whose )routhfulChristianity," "
Butler's Analogy,"edited by either the case. On striking the heel,much pain was felt
mind has not been instructed in the principles of Lord Brougham or Dr. T. Chalmers, and "
Dr. in the knee, though but trifling in the hip-joint.
Christianity, and who, in after years, has mane little Paley'sNatural Religion;" and, if these will not An attack of dysenterynow came on, which reduced
if any use of either his Bible or and show him, that instead of him a good deal. By May, 1848,there was really
who commit
prayer. Parents irradiatehis infidelity,
such youthsto minglein the giddy and his studies leadingto scepticism, they are perfectlyslight shortening of the limb,stiffness of the hip-Joint,
destructive whirlpool of London follies, temptations,calculatedto disabuse his mind of the leasttendency flatnessof the nates on the side affected, loss ot pro-minence
and vices, have a serious responsibility towards it,and teach him, of the trochanter major, and much pain in
restingupon "

them ! How many young men, fresh and innocent "

To look throughNature up to Nature's God," the jointon any motion. An issue made below,and
from their country hearths,have been wrecked and for him in front of the joint,quite removed the pain ; a
Then, Mr. Editor,there is no other resource
ruined by the seductive nature of its allurements, but the Holy Scriptures, to which you have verv perly leather splint
pro- was also applied. The man's health
for the want of wholesome paternal ntroeillance? directed him, and which is able to make the wonderfullyimproved, and he was dischargedfrom
This much premised,I shall now allow Science, simple wise. hospitalin seven months, as a convalescent in bar- racks,
who is the handmaid of religion, to conduct '* Stu- It mightnot be amiss for"Studens" to attend the preparatoryto beina dischargedthe service.
dens" to the summit of some lofty e levation in the ministry o f such a man as the Rev. Dr. Cummings. The joint was anchylosed; there was some use of the
country^ on a beautiful summer's day, when the air Crown- court. Coven t-garden; and the Doctor would limb, and the man got about well with one crutch ;
is limpid"
pregnant with the perfume of ten thou- sand soon enable him to see, that even in the discovery of but unfortunately, in March, 1840,became to me
odours,and filledwith the warblingsof the chloroform the being of a God is mani tested. An complaining of a return of the pain to the joint.I
feathered songsters. Here let "Studens" gaze on apology, Mr. Editor, is due for the unhttentionallength found suppuration had taken place; an abscess was
the gorgeous panorama, extended widelybelore him of this communication ; but the importance of the pointingbelow and in front of the joint.I gradually
fc^ miles and miles. " Stndens" is enrapturedwith subject will evacuated the matter by making several small punc-
pleadmy excuse. tures
the scene, and Scicncs addresses him thus :" I am, Sir,your obedient servant, with a needle. In Septemberslightcough
"
The scene, oh,young man, issublime and grand H. Hastings, M.D. made its appearance, the sputa being mucous, and
^

in allitsparts,and is fully calculated to display the occasionally tingedwith blood ; no naln in the chest
Stokenchurch,Feb. 4, 1850.
hand of an omniscient and omnipotent God ; but in or febrile
symptoms. There was dulness on percus- sion
thyetfe"oh, vouth 1 there is a far more grand mani-
festation over the rightlung,and a diminished quantity
of the being of a God. Lift up thy eyes ON THE SIZE OF A F(ETUS BEING A of air admitted into the lung.The purulentdischarge
again and survey the prospectbefore you. You see TEST OF UTERINE AGE. from the hip-joint now became large.In December
the plainextending tar and wide, undulatinghere hectic fever and diarrhoea appeared, from which he
into the lovely valley,and rising yonder into the [To the Editor of the Medical Times.] died on the 19th January last.
noble hill, studded with villages, woods, and farm- steads. Sir, Your Correspondent,
" Mr. Warren Finoham. Post-mortem Appearances," The body was almost a
At the bottom of this elevation is a town
; certainly givesus an example of a very small child skeleton. Thorax. The rightlungstronglyadhering "

you perceive its shippina lyingupon the bosom of its living severalhours. But I can hardlyagree with to the ribs from old disease { congestion and softening
phcid waters, and the ain of its bus^trafficgrates him in the opinionwith which he concludes,that of the lung; bronchial glandsenlarged;heart pale,
npou thyears. Now, oh,youth ! allthis magnificent the weight or measurement of a foetusought to be small,and flabby. Abdomen^^Li^ev large, pale, and
landscapeis minutely depicted upon the retina of ihy taken as evidence of its uterine age. At the full of very firm texture; scrofulotisenlargementof the
eye,by th" exquisite and beautifuladaptation of that time the weight varies from four pounds to twelve, mesenteric glands ; thickening of the transverse colon ;
noble oamertb-obscura, placedthere by the desigmng and even more; and it is only reasonable to sup- the mucous membrane of a pinkish colour. The
aoger of that OmnipotcDtBeing who framed ana \ pose, aa respects the otrliw monthlythat % fcilu9" rightlegWM ahortened one ineb,the knee ttigfatty
 148 THE MEDICAL TIMES.

bent, and turned inwards ; anasarca of the foot and loriedme upon an obelisk, I should have sustained from pneumonia there were ^76, whilst 96 forms the
ankle. There was an ulcerof the skin the size of a It with uncomplainingand philosophic fortitude, had average. Diarrhcea was fatal to 18 persons, which
found that had entered the lists, and had
crown piece, below and in front of the righthipjoint, I not you exceeds the average by 7f thoughthe number who
throughwhich a probe eould be passedto the rough thrown down the gauntlet in his defence,recom- mending
died of this complaint iu the same week of lastyear
neck of the femur. On cutting down to the joint, the him not to stop at these lesser punish- ments, was 27.
ligament not to be found ; the head of but altogether to extinguish and annihilateus.
capsular was
The mean height of the barometer at the Royal
the femur was retainedin the acetabulum chiefly by Knowing you the defender rather than the op- pressor
Greenwich, during the week was
a layer uf thin,but dense fat,mixed up with a few of the injured, I have no doubt that,when Observatory,
of us 29*754 in. The mean temperature exceeded the
fibrousbands. About half the head (withthe li^a-you hear the motive which has influenced some
the Mr. Churchill's average of the 7 years by 6** 9^ ; on Sundayit was
mentum teres^ had been removed by ulcerative in withholding return to tions,
ques-
leniently, 9",and on Friday U** 9^ above the average. On
absorption ; what remained appeared as if chopped you will be induced to judgeus more
short off with a hatchet ; the bone was black and and advise a lesssummary proceeding. It is this. Wednesday,when the mean temperaturewas 35^ T,
of Surgeons create unjust it was slightly below the average of that day.
very roughfrom the caries; the neck was shortened The London College
an
a portion
and in a similar state of disease ; the cotyloid ligament distinctionin theirbody. By raising to the The deaths in the several hospitals of London
the acetabulum widened, dis- distinctionof Fellows, they depressed
coloured, and disgraced
was destroyed; was occurred as follow : "

and rough I detached several loose all the rest. No sooner have they created this un- fair
very ;
Northnmberlaad-honse
spiculse of bone with my fingers.At the bottom of and fraudulent, because retrospective distinction, GBITBRAL.
St. Lnke
throu^phthan Mr. Churchill has a book printed, pointing it St. George ...
4 ... ... ...

the cavitywas a large, irregular perforation, Westminster ^

2 Miles'
which I passed a nd touched fascia the world. Mr. Churchill is, of course, at
two fingers, the out to
Charing- erosB ^ ...
2 Warbarton's
This was to do as he pleases in such a matter, but he
covering the iliacus intemus muscle. liberty Middlesex ...
7 Lunatic Asylum, Bow ...

to assisthim in reoording University College 4 Bethlem

healthy;the muscles surrounding the joint were cannot expect me my own ... ... ... ".

degradation. Royal Free Hospital 0 Lunatic Asylum, Brixton

greatlydisorganized. ...

Clapham
I am. Sir,yours truly, I remain, your obedient servant, King'sCollege ... ...
I Rtftreat,
St. Bartholomew^. II New County, Waodswor.
T. W. Babrow, Assist-Surg. Feb. 14, 1850. One of the *ed.
London
...

2 Peckham House
... ... ,".

Mullingar, Ireland. 19th Regiment. Guy's ... ...

5 Camberwell House ".

MIDDLESEX COUNTY ASYLUM, St. Thomas LTXiro-iv.

HANWELL. MILITAKT "!!]" VAVAL, Queen Charlotte's

THE COLLEGE DIPLOMA. Royal Hospital,Chelsea British ... ... ...

(Sonth) Cityof London

[To the Editor of the Medical Timetf.] Royal Hospital,Green- wich POK coavxcTB.
[To the Editor of the Medical Times.] Sir," Permit me to contradict, in the most phatic
em-
(East) ... Hospital Ship,Unii" m.

Sir," A subscriber in your Number for Dec. 22, manner, a statement made in your Journal Royal MilitaryAsylum Penitentiary Hospital,
1849,asks," Has a member of the College of Sur- the Hanwell Asjrlum. Coldstream Guards Hot. Millbank
on Saturday last, respecting
the same right to practise generallyas a Your Correspondent,"A Physician and Resident Grenadier Guards' Hos- pital FOa PABTXCOLAKCLASSXS.
geons
centiate of the Apothecaries' Hall,London; and Proprietor," "
states,that there are cases, and plenty Scots Fusilier Guards
Female Servant Invalid

which of the two is the legally ... Asy., Stoke Newlngton

qualified practitioner, of them, even in Uanwellj which are placed almost Royal Ordnance ^
German Hospitals. m.

strictly speaking?" You answer, and your answer is constantly under mechanical restraintof some sort DreadnoughtShip French Hospital
... ".

legaiiy correct : " A member of the College of Surgeons or other." This statement is utterlyfalse. No LUXATIC. Portuguese Jews' Hos"
is not legallv entitledto practisemedicine, yet both patient has been placed under mechanical restraint KensingtonHouse pitJ ... ... ...

member and,licentiate Munster-house (Fulham) German Jews' Hospital

are legally qualified ; the one at the Hanwell Asylum, for these ten years past
to practisesurgery the other generally." This is I am, Sir,your obedient servant,
Normand-houfle(Fulhain) rOK SPXCIAL DISEASKS.
Otto-house (Fulham) ...
Small PoXm.
the law, but is it just? The licentiatecan bleed, John Hitchman, Sussex ft Brandenburgh- Fever Hospital
blister, physic,set fractures, reduce dislocations, Resident Medical Officerto the Female house (Fulham) Lock
perform operations, and nobody knows what. In Department of the Asylum. Blacklands-house Consumption, Brompton
the Hall curriculum he is not called on to attend Feb. 19,1850. Total, 75.
either surgical practiceor surgicallectures. Under
such circumstances, itis eontrary to reason to infer
MORTALITY TABLE.
IODIDE OF POTASSIUM IN ENLARGED
such a conclusion as the licentiatepretends to,viz., Deaths in the Week endingSaturday, Feb, 16,1850.
BURSA PATELLA
that he has a perfect rightto attend surgical cases. (Metropolis.)
But to return, the member, poor soul,is put on an
"

[To the Editor of the Medical Times]

equality with the quack,by some knowing people, Sir, I know not whether I am
"
advancingany
though he has been required to studynearly allthat
thingnew ; but I have lately, on several occasions,
the licentiate has,medicine as well as surgery, chemis- try, found a strong solution of iodide of potassium so
materia medica,and to have been only one bursapatellae
year successfulIn the treatment of enlarged
less in the Profession before he can get a diploma,
or housemaid's knee, that I thought the subject
though, mind, a year older and one year'smore might not be uninterestingto my professional
sense. He cannot even legally practise, nor legallybrethren.
demand pay for his services, except in a surgical My plan is,of course, to enjoin rest,and apply
case. Every unprejudicedperson will allow,that a the solution constantly, by which simple means 1
member of the Collegeonly has Rjiut rightto prac- tise have found the swelling subside more quicklythan
in any way he chooses,and a rightto demand
by any other ureatment.
those very privileges which the licentiateenjoys. I am, sir, your obedient servant,
His education, if he entered the Professionin youth,
has cost as much, and,in some
George Rodwell, M.R.C.S. and L.A.C.
cases, more. He is Loddon,Norfolk,Feb. 19, 1860.
as respectable, and often more so, and, if he takes
the part of an apothecary, and dispenses medicine,
need I ask,whether the apothecarvdoes not borrow HEALTH OF LONDON DURING THE
and assume the name of surgeon f If one is liable WEEK ENDING FEBRUARY 16.
to prosecution under such circumstances, I do not
sec why the other should not be also.What is wanted, The publichealth, as comparedwith that of
is a collegeof generalpractitioners. Independent of former
periods, is in a favourable state. Last week
other corporations ; and I see no reason why such the
mortality in London continued to decline, and
an Institution should be considered second to any
in the kingdom, the doaths weie only938, showinga decrease of 19
rightly governed. But the name of
is on those of the former week,and of 159 on the weekly
generalpractitioner abominated by all classesof
practitioners. I am glad application has been made average of lastJanuary. In the corresponding weeks
to the College of Surgeons,and I am gladalso, that of 10 previousyears (1840-9) the average was 1041,
the Convention of the Institutehas come to the de- which,ifcorrected forincreased population,
termination becomes
of raising a new College, in case fusal 1136; the presentdecrease
a re- of mortality, as pared
com-
is given. One Collegeis,m my opinion, with former years, is therefore 198. In the
enoughfor the exiffenciesof the Profession, and to
epidemic or zymotic class of diseases, the deaths The following is the nurobeff of Deaths occurring ttota %
degreesof relationshipitsmembers I have no ob-
ot jection.
lastweek were 144; in the corresponding weeks of of the more importantspeoial causes :"'

the years 1840*9 they fluctuated between 129 and

I am, Sir,yours respectfijlly,
333 ; the corrected average is 209. From phthisis
A Reformer of Abuses.
(orconsumption) the deaths lastweek were 113 ; at
February2,1850. the same periodof previous years theyranged"rom
115 to 170. From other diseases that afTect the
THE "
MEDICAL DIRECTORY.** of hooping-cough)
respiratoryorgans, (exclusive the

ITo the Editor of the Medical Times.]

199 ; in previous years, at this time,
deaths were
theyranged from 115 to 330. To take particular
Sir, I am a subscriberto your valuable Journal, diseases
"

fatalto 6 persons,lessthan
: smallpoxwas
and at the same time one of those unfortunate per-
sons one-third of its former
to whose names an asteriskis appended, in the
mortality ; scarlatinato 13,
last Medical Directory."
" while the average is 34 ; hooping-cough to 31, the

I could have supportedthe weight of thisstar of average being46 ; typhusto 29, the average being
distinction with which the worthy Editor has 36. The deaths from measles were 21, a mortality
honoured me, and even if he had peltedme with which is about the usual amount From asthma and
periods,squeezedroe within a parenthesis, or pU- bronchitisthere were 110 deaths,the average is 100 ;
 THE MEDICAL TIMES. 149

of the Charter, and he thought itwonld be a disturbance,"a sentiment the members vehemently
"

opportunityfor the members to express their applanded. The lean Cassius of the drama looked
f^ood

ment eelings the on This address

matter. was cut short by more yellow; stillmore bent upon conspiracy, when
enormous hissing, mixed with shouts of approba-tion Mr. Belfour and Mr. Quekett privately remonstrated
; for there were some members present wlio were with him, and peace was restored.Do you ask,then,
evidentlyunable to discriminate between a manly why it was determined,that the mountain of Mr.
expressionof theiropinions, in a legitimate manner, Saville'sprinting-office should groan in premature
and an unmanlyinsult, on a great public occasion,labour forty-eis^ht hours before the usual termination
to a distinguished member of the Profession, because of what Dr. Tyler Smith would, in his facetious
he took the liberty of voting, upon tion, maimer, term the cycleof periodicity?Simply to
a public ques-

accordingto the dictates of his conscienee. givebirth to this very ridiculousmouse, and that Mr.
The confusion of the scene it is difficult to de- Edwin Lee might have the opportunity
scribe. of proving
Yells,cheers,hisses,reverberated through himself a very Dogberry," of confessingthat he be- longed
the Hall in admirable discord, successfully ing
drown- to that order ot animals of which the original
the voice of the speaker,who stood like character wrote himself down a member.
a clown in a Christmas pantomime,with mouth Mr. Coffey's Still and Condensing ratus.
Appa-
open, eyes expanded, and arm suspended in We
"
most earnestly callthe attention of our
mid air,in a state of mesmeric rigor. We fan-cied readers, particularly those engagedin pharmaceutical
we heard him say, " Here I am 1" At this operations or chemical manipulations, to Mr. Coffey's
juncturea very sensible young surgeon rose and sug-
"
gested, Patent Esculapian Stilland Condensing Apparatus,"
that *' that was not the proper placeto make a of which the annexed engraving exhibitsa section.

MEDICAL NEWS.

Afotbecarigs' Hall." Names of gentlemen who

PMjedtheir examination in the science and practice
^^*"^^^" ""^^ received certificatesto practise,
on Thorsday,14th February, 1850 "-William Henry
Thornton, Thornhill, near Devrslcy; George Hornby,
Pocklington,Yorkshire;George Philip Rugg,Maid-
S**^f,*5,'!!**"^ Hughes, Market-plaoe, Lanrwst,
N. W.; Wilham Tidmas,Manchester.
Army Appointments." 24th Foot : Assistant- B denotes a burner,
supplied^ with gas by a flexible drying, condensing, boiling.'distilled water, "c. The
Surgeon James Lewis Holloway,ftom the Staff,to be size varies,from 1 to 1000 gallons.
Assistant. Surgeon, yice pipe; which,lightedfor operation, boilsthe contents A One Gallon
Farlonge, deceased.-46th of the boiler or still, C, the vapour from which, Still has the following a ppendages" Decoctingpan.
Foot : Assistaiu-Surgeon Edward James Franklyn,ascendingthrough the neck of the still-head,
from the Staff,
F, into 9 inches oVer ; evaporating pan, 9 inches over ; sand
to be Assistant-Surgeon, vice Wool- the cnp-snaped vessel, G, heats the underside of the bath,dryingcloset, 9 inches square, steam and liquor
house,who resigns.Hospital Staff:ActingAssistant- vessel, H, and the evaporating'pan, 1, operating upon goages, safety valve and condenser, peculiarly novel,
Surgeon Horatio George Martelli, to be Assistant- their contents. The vapour, condensed by contact compact, ingenious, and most powerful in its refrigery ;
Surgeon to the Forces,vice Holloway,appointedto with the vessel H, will falldown the sides of the it has the advantages, taken to
nie 24th Foot. SurgeonGeorge Roche also,of beingeasily
Smith,of the vessel G, passing through the pipe, M, to a distills ting pieces,washed, or cleaned from any essential oil,
2nd Foot, has been placedat the bottom of the listof
condenser of novel form, contained in the chamber and put together cleansed in five minutes. We re- commend
Sunreons in the Army, on the 12th Dec. 1849.
Naval
beneath, the hot vapour ascending and passing our readers to visit Mr. Coffey'smanu- factory,
Appointments. Assistant-Surgeon throughthe pipe,
"

L, to the hot chamber,and circu- lating 19,Sidney-street, Commercial-road,and ex- amine

George H. Edwards (1847) to the Adventure store- around the oven contained therein, for themselves his very unique apparatus.
operates
ship at Deptford. on what may be therein; or in the evaporating Obituary. On the 14th inst., at Park"place,
Obituary" pan, "

On the 24th ulL,'at^Hull,Robert

Craven. Esc^., 01, provided with a lid, 02, and contained in 03, Chelsea,aged 82, Thomas Dixon, Esq.,many years
F.R.C.S.E., Surgeon to the Hull passingthroughthe pipeto the condenser, wherefrom surgeon of the Hereford Regiment. On the 15th, at
General Inhrmary." On the 13th inst., Cornwall itflows ofi by the pipeS. In conductingthe
Revnolds, Esq.,of Mare-street, process Newport,Isle of Wight, aged 88, Dickins Buckle,
Hackney,Surgeon, of distilling, it is necessary to fill the chamber con-taining Esq., Deputy Inspector-General of Hospitals.
Ji.N.
the condenser with cold liquid by the funnel- The Patent Portable Suspension Stove. "

The Mountain in Labour." Every one who pipe, T, the pipe, U, allowing any waste to flow off. Another most important invention claints our tion
atten-
takes an interestin such matters must|havewondered
By means of the pipe,V, communicating with the and recommendation " the patent portablesus- pension
at the cause of the announcement, that the Lancei of
interiorof the distiliating condenser,the superfluous stove, the construction of which secures nt
last week woidd be published on the Thursdayin- stead
gases pass off,preventingaccidents, the pipe and once two most importantadvantages, which, it would
of the Saturday,as usual. The secret is out.
cock, W, allowing any lodgment thereinto be cleaned seem, have never, until now, been realized in con- nexion
The thunderbolt, forged with great cunning and out when necessary. By shutting the valve, K and with each other. The Arnott and other hot
labour in the literary
smithyof Bedford-street, was
2,the pans or vessels, H and 03, may be used to heat air stoves throw out all the necessary heat,
launched by the newly constitutedJupiter Tonans yetafford
ot the Lancetfin the Lecture-room of the
a retort, or otherwise,first removing the moveable no means of pure ventilation, an evil which the patent
Collegeof pan. X, steam guage and thermometer. D and C, portablesuspension stove seems to remove. By a
Surgeons, on the celebrated 14th of February; and
the Lancei was publishedin time to
a
syphon pipefor chargingwith glass, liquor guage, simpleand most felicitouscontrivance, the patent
prepare for this and funnel. D D, furnace. A A, pipe for conveying portablesuspension stove produces a warm and
great event. Let us draw up the curtain. The
air. The interiorof condenser is not shown above. genialatmosphere. The top of the stove is of a
members were all assembled,patiently waitingfor The advantagesof Mr. Coffey's invention are many. conical shape,and is supportedby two standards
the entrance of the Orator,the Council,and their In the first
place,the apparatus is portable, and can fixed to an ornamental pan or bottom. The fire-pail
friends, upon the scene, when, lo I a very atrabilious be
put into action in a few minutes ; as itdoes not stands immediately under the cone, leavingjust
looking gentleman,with remarkably long ears, whom require coals, coke, charcoal, fuel of any kind, it sufficient
wa at firstmistook for a facetious
or space between the two, to allow a free pas- sage
effigy of Midas, yieldsneither smoke,
ashes,or other nuisanee ; and of air over the fire, and up the cone, into the
and ycleped,as we afterwards found, Edwin Lee,
Autboc of a book on Medical Reform, "c..
performs in an extraordinary small space, and in a chimney. By this means a steady and uniform
"c., got superior manner (as the heat can be regulatedto the "draughtis secured in the stove-pipe, keeping up
Bpon his\m, Lancetin hand, and informed the Com- pany
he observed, greatestnicety from 200" F. to 300" F.)the chemical perfect ventilation, and preventing the generation of
in that print,that the chosen
operations of distilling, decocting, evaporating, ment imurious gases. To Medical men, who are liableto be
oint-
v"rator "^ Uie C^Uegehad voted the
against amend- and pomatum making, sandlbath forglass retort, called, out during] the night this stove is a great
 150 THE MEDICAL TIMES.
acquisition. It gives a comfortable wannth, with to the Editor of the Lancet,Medicat Gazette, poblished. The Academy wished it should be in
free yentilatlon; it is perfectly safe,and will bum and Medicai Thnes, The Committee of the Man- chester French ; the Medical Commistion and the druggists,
throughthe nightwithout attention,
exceedingthree farthings.
fitthe stove,to supply

The Jirtt
smell
blacking,
time it is lighted,

but this does not again

at a cost not

hot water at any moment,

occur.
Messrs. Brown and Green, or Luton, the patentees,
deserve well of the publicgenerally^
in particular.
We

and the Pro-

To theirattention we oordially
lication,
Medical-Ethical Associationconceive itrightthat itshould be in Latin. To settlethe question^
Tin vesselsare made to to record the hi^hsense which they entertainof the Government
and justand impartial conduct of the Poor-law Board,in
thus a cup of cofiee may be obtained without delay.their recent refusal to sanction a proposalof the
there will be an unpleasantChorlton Board of Guardians
for a few hours,caused by the drying of the of their Medical officers.The Committee further
think would urge upon all members
to reduce the salaries

of the

fessioncordialassistanceto the central authorities in Lon-

by supplyingthem with statistical
Medical fession
Pro- ""The
the
decided it should be in both languages.

TO

Hunterian
tlie policy as well as the lusticeof giving letters upon the attempted row at the College
don,
and other
CORRESPONDENTS.

Orstion.""

and its total failure. Our Correspondent

that our dislike to hit a man
We

when
have

personalgood natnre, will not allow us to publish these

received several
of Burgeons,
swill pardon na,
he is down, and oar

reoommend this very useful apparatus. information when appliedfor;recent experience communications. All agree, however, upon the bad
Kino's College Hospital." The Secretary's havingshown, that is to them the
it Profession must policy and wretched taste of the oonspirators. Every dog
Annual Report states, that duringthe pastyear chiefly look for support and protection, in any con-
test has his day ; but now," Februaiy.1850, ^noone man eaa
"

say, I am "
Sir Oracle; let no dog bark."
22,309patientshad been received,including1,261 that may arise out of tne growingtendency of "
'" Dr.
Thompson, Surgeon to the Tyrone Infirmary, has
urgent cases admitted into the wards, and 424 poor Local Boards to depreciateMedical services. "

married women who attended at their own kindlytaken the trouble to inform us, that we" our Irish
were Signed" J. L. Bardley, M.D., President; J, Correspondent, rather" labours under a great mistake, in
homes duringconfinement. The increase of patients Aikenhead, W. C. Williamson, Hon. Sees. supposing that Dr. Jacob's suggestion, with regard to
duringthe last twelve months was caused m |B:reat John Hunter." In our report of the Hunterian putting up pathological preparations in sphericalglass
measure by the recent cholera visitation; mitigate
to Oration last week, we omitted to give the following vessels containingpure watrr, is intended to refer to their
the ravages of which the hospital authoritiesmade very interesting and unpublishea letter from the permanent preservation.We are aware that the natives
every possibleexertion,and in doingso increased immortal physiologist; it is from the collectionof
of the sister island^sometimes write,and read too, very
the outstanding debt to nearly530L Mr. T. M. Stone,the Librarian of the Royal Col- lege erookedly;but how so very ridiculous a readingcould
have been imagined,we are at a loss to conceive.
General Lyino-in Hospital. "The annual of Surgeons,and is addressed to the Master,
"CrichtOB Eoysl Institution for Lunatics."" We propose
report of this Institutionshowed that 311 in-patients, Wardens, and Court of Assistants, of the Corpor-
ation to take an earlyopportunityof noticingDr. Browne's
and 445 out-patients, had been attended to duringthe of Surgeons, as follows: Gentlemen," At
"
"
Tenth Annual Report of this Asylum.
past ^ear. The receipts from dividends and sub- scriptions
this period,in which the surgeons of Great Britain J. S., Sunderland." and
" other Correspondents,Inquire
amoantcd to 15151, 48. 4d.; the average have deservedly the highestreputation in when the remaining papers to complete the volume
acquired of ihe Heart, may be expected. We repeat the
on
annual subscriptions for the last five years being Europe, both by their practice andpublications, pears Diseases
it ap-
260L 14s. A resolution was that the in-
patients reply we lately made to the same question, vis.,that we
passed to be a reflection upon them, that the Corpor- ation received a eommunication from the Author, on the 6th
should pay 2s. 6d. each,for their washing "
of Surgeonsof London should not be possessed of
Inst.,to the effect,that he was bestowingall the^tlme and
rather a paltry proposal,and not even excusable by a public surgical library"a circumstance so extraor- dinary, attention he could give to the subject; and we hope,
a poverty of funds. that foreigners can hardlybelieve it. if a therefore, soon to present our readers with the remaining
London Fever Hospital. " The Secretary'scustom had been establishedat the time the surgeons portion.
Reportcongratulates the Governors upon the steady were that every member ehoald send We will endeavour to obtain a report of"
of
incorporated, a case some

diminution of fever cases since 1843, when the cases to the Company's library, it importance to the Medical Profession," decided in the
a
copv of his publications CityCounty Court, on the 22nd. We are obligedto Cor- respondents
admitted were 1462; the number during the past would have at present contained the works of many of who call our attention to these matters.
year only amounting to 714. The extraordinarythe best writersin surgery, which might have proved *" J. W.
Moses, St. Asaph."" The observations of Regnanlt
diminution in 1849 was partlyattributedto the fear- ful a valuable collectionof instructionsfor the improve- ment The
are to be taken, of course, for what they are worth.
ravages made by the cholera among the poorer of the Profession. As the smallest beginnings
eiperimentsof our Correspondenton the dormouse are

class of victims, amon^t whom fever generally predo- may in the end lead to the greatestacquisitions,
minates. I hiKhlyinteresting,and agree with those of Berthold. The
The admissions in the hospital varied from have done myself the honour of presenting to the animals specified by Regnaolt were marmots ; which, in
much less oxygen ; ean live in
43 in November to 83 in January ; the average number Company through your hapds, the few observations their torpidstate, consume

for each month an atmosphere which would not support them awake, "

being 54. Out of the 714 patientson anatomv and surgery which I have published ;
If we remember rightly, said,they could be
admitted duringthe year, 586 were discharged cured ; and should the other members of that body be in- duced (Spallaozanl, the most irrespirable
placed, without injury, i n even gas,)
sent to other hospitals, 4; died,106; remaining,18. to follow my example, and by presenting their "and, it was stated, absorb oxygen and nitrogento such
From the financialstatement it appears, that the works,establish a librarv, which 'hall hereafterbe- come an extent in this torpidstate,that they sometimes even
totalincome, includinga balance of 453/.,from last both a publicbenefitand an honour to the Cor- poration increase in weight by respiration alone. The fact was

of Surgeons,1 shallconsider it as one of the first sUted by M. Saee.of Neufchatel.

year, amounted to 2754/.7s.4d. The expenditure, The experiments of Lord
includingthe investment of 750/.in the purchaseof happiest events of my life to have been at all instru- mental *' J. H.
B., Middle Templa.""
Brougham were conducted, we believe, at Provence, in
Three per Cent. Consols, amounted to 2696/-, leaving in such an establishment.'^Ihave the honour
reference the
his o$ium ckm,- "/ cetera ; and had to
a balance ot 58/.6s.4d. in the hands of the Treasurer to remain,gentlemen, your most obedient humble deflexion" and "inflexion" of the rays of light and the
"

Southern andToxteth Hospital.Liverpool. servant, "'

John Hunter." formation of fringes. Except to the initiated, they are
" The annual Report of this Hospital has recently The Board of Guardians of St. Luke's, of little interest.
been produced, from which it appears, that the debt Chelsea, and their Medical Officers. The "
'Tyre.""You will find an account of the nature and cba-
"

stillowing amounts to 800/. The proceedsin favour Board of Guardians of the parishof St. Luke, Chel- sea, laeter of Bronehophomy in Laennec. Many physicians
of the Institution, from the fancy-fair, amounted to latelymet to consider the applications of the now make the patient whisper; the slower words render- ing
the phenomenon more perfectly.
3197/.; 2000/. of which were invested, to add to the Medical oflioers, Mr. Warder and Mr. T. Keen, for
A. N., Chelmsford."" In impending death f^om
"" form,
chloro-
income. A legacyof 500/.,left by the compensation for increased labour and expense in- curred
f)prmanent
ate Mr. Heyes, has also been received. 2722 patients by those gentlemenduring the prevalence of
sprinkling
had recourse
with cold water, fresh air, "c., are ge-
to. M. Ricord, of Paris, recommends
nerally

were relieved during the pastyear; of these,2133 the cholera. It appeared,from the letter of Mr. blowing fresh air at once into the lungs,by the mouth of
were out, and 589 in-patients. 370 were severe gical
sur- Warder to the Board,that his labours had been very an attendant ; he saved two patients by it.
cases; 1510 accidents and simple fractures. heavily increased during the year 1840; that he had "Invalid. Brighton."" The contrarstimnllsts were Borda,
Brera, Tommasini, and Rasori. They divided their me-
Seventybeds,besides two separate wards, have been attended 3,199cases of sickness, including73 oases
into stimulants and coDtra"stimulanu, in opposi- tion
added to the accommodation. The ventilation has of Asiatic cholera,and many of dtarrhcea, during dloines Brown who held the doctrine, we need scarcely
that to ;
been greatly improved. period; the number of oases exceeding those of
placein the excitable powers
say, that no change can Uke
The Board of Guardians of the Chorlton 1848 by 961; and those of 1847 by 1,308;the eases without previous excitement.
Union. About three months since the Guardians beingdistinctfrom those attended by the house-to-
The second edition of the Fifth Report of the National
"

of the above Union, in consequence (as is house visiter. The letter of Mr. T. Keen alluded Philanthropic Association shall receive our earlyattention.
of dispute with their medical officers the the number of attended, a nd Institution holds its locale at No. 40, Lei- cester-square
reported) a to returns of cases This exceUent
arisingout of the late visitationof cholera,pro- set forth the additionallabour and anxietyto which ; and we earnestlyrecommend It, as etta-
demic, blished to promote
social and sanitaryimprovemenu,
posed to reduce the payment to these gentle-he had been subjectedby the increase of the epi-
street cleanliness,and the employment of the poor.
inrn fVom fiveshillings (theexisting rate) to three as well as the increased cost of drugs,the
of sickness placedunder their expenses
"
Dr. Hastings"is answered.
shillings per case attendingthe employment of an assistant, Dr. the use of Chloroform
The for this said whom he had been the loss of his
"
Rigby's" communication on
care. grounds proceeding were obliged engage, to
will appear next week.
to be " that the of Poor-law
appointment Surgeon own health and his privatepractice. These gentle-
men, writes like
'" A Non-Reslrainer."" When our Correspondent
was analogousto of
Surgeon to a public
tnat charity, however,urged their claims for additional re- muneration
a gentleman,hii letter
shall have insertion.
and served as an introduction to privatepractice ; in vain. The letters having been read, W. Hutton, B. A."" It is quite out of our iwwer to give
"

that the rate of payment was higherthan obtained in Mr. Symons moved, and Mr. Soby seconded the advice in the columns of the Medical "
professional
resolution,that 15/. be presented to each of them Times." We observe, apparenUy a very able writer in the
neighbouringunions; and that other qualified titioners
prac- as
does so; but the
couldbe found who would take the ap- a gratuity, in considerationof the increased labour, "Domestle Economist," occasionally
pointment to hospital.
safest plan would be to send the person an
at the reduced rate. In communicating "c., incurred ; after a warm discussion, 9 hands were
Mr. M'Dougall'i"Paper is in type, but the crowded
" state
this proposal to the Poor-law Board, the Guardians held up againstthe resolution, and 7 in favour of it. forbids its appearance this week.
of our columns
further stated, that theywere fullyprepared to accept This apparentlyjust claim was thereforerej|)udiat"d, *:Vox."" We mu"t decline advising a remedy "for
weak
the resignntion of their Medical Ofncers, should they and the very modest sum which the divisiontook knees which Inclined to knook." Our name is not
on are
decline to receive the reduced payment. The Man- chester placerefused by the very liberalmajority of the Br. Medical Times." "

Medico- Ethical Association, togetherwith guardians.

" Aberdeen Degrees.""A Correspondenthas iavonred us
with the "Aberdeen Herald." The value of Aberdeen
the Union Medical Officers, memorialized the Poor- Post-mortem Burning. Mary Newton, the What the
degreesare fullyestimated by the Profession.
"

law Board againstany reduction of medical salaries alleged Bridgnorth matricide, it is believed,willbe
public think of them concerns us but in a very secondary
on such principles ; and, in consequence, the Board arraigned, for the third time, at the forthcoming manner. As for the disputesbetween the two rival col-leges,

refused to sanction the proposal of the Guardians:" Shrewsbury Assizes. This somewhat unexpectedcii^ to which we have in another place alluded, thef
tumbler.
"At a meeting of the Committee of the Medico- cumstance has induced Dr. Wright,of Birmingham, can only be compared to a storm in a
Researches Our Correspondent at
Ethical Afisnci^tion,hi'Id Feb. 7, it was unanimously to withhold, for the present, his on
"

a dirty town, "

"

rpsolved, Tbat the following

" minute be made in Vital and Prtst Mortem Burn'infii" "
which, we under-
stand,
A church without a fctceple."
the hooks of the Association, and that copit's be for-
warded imbody some results nugatory of hitherto re- ceived is thanked. _ . _ ...

to the Poor-law Board, the General Board of opinions. Our Irish Correspondent's letUr reaehed ui "o late for Uus
Health,4nd the Registrar-General ; and also for pub- Turn Bbloian Pharmacof"ia is about to be week's Kumber.
 THE MEDICAL TIMES. 161

OBIOIVAL LEOTirBE" in a lessened degree, and on quickmovement was lesionson the cironlation, without the physical
increased to an extent that was really frightful. The signs which denote theselesions, or theirfkeqiient

vular
"
tendants,
at-
pulse at the wrist was extremelyfeeble and small, dilatedhypeitrophies. In the place of such
LBCTUBES not locomotive, and of course irregular. Repeated signs, we had allthe localsymptoms of an enfeebled
ON examinations detected no murmur in the cardiac and dilated heart,viz.,a weak impulse, low and
CLINICAL MEDICINE. region. This at firstI tiiought might be attri- butableconfused sounds,and greatirregpilarity of action.
to the weakness of the heart and the small The course of the aflectionis easily explained.
DKUTBRED AT UNIVERSITY COLLEGE
HOSPITAL. current of blood, but after a fortnight's treatment The obscure pointis its origin.Perhapsuiis dis^
By E. A. PARKE8, M.D., Loud.: with expectorants and camphor,when the heart's ease, like fathrheart, may consistin a mal-nutrition
Member of the Royal CoUag* of Phytlelani, FioHMtorof actionhad become strongerand more regular, still of the muscuiarfibres, wfiichdiminishes theirpower
dtnkal Modldno In UalTonttjr CoUego,and PbyiMan to no [trace of murmur could be heard. The sounds and pennitsthem to yieldto the pressure of the
tlMHoq^lUL were, of course, as irregular as the action of the blood. But this point I do not wuh to touch on
heart; frequently nothingwas heard but short,now.
LECTURE V. feeble, systolic sounds, which had nothingabout It is seldom that we meet with a case so pure
them of the clearness and sharpnesssometimes and so exquisitely marked as thisone. I have brought
(Contimiedfirom page ISS.)
ascribedto the sounds of dilatedhearts. Sometimes it before you to state,that not onlymay this dilata- tion
Before qoittiDg the subject of valvular lesionsof
the second sounds could be feebly heard,more often be primitive, but may, in various degrees of in-
the heart,there are two points to which I must cidl
theywere lost All the signspointed, therefore, to tensitv, be secondary to vdlvular lesion. It may be
jour attention. The first of these points is the fol-
lowing:
this 3onclnsion, that the heart was extremely feeble,combmed with h3rpertrophy, and the degreeof pre- dominance
"

and,judging from the extreme irregularity,the and of either state causes infinite diflferences
Speakingin generalterms, the pulmonarycircu- lation want of
murmurs, that it was dilated, and without in every case of heart disease. But, once grasp a
is i"cted by lesions of die left auriculo- valvularlesion.
For the firstthree weeks,the man knowledgeof the states Uiemselves,and you will
"entricular opening, and the general circulation, by improvedunder the use chiefly of expectorants,find littledifiiculty in understanding their com-
binations.
lesion of the rightauriculo-ventriculu:opening.
campLor, and occasionalsedatives. Then, however,
The degreedependsnet only upon the lesion, hut the palpitation returned ; he had some These of valvular disease, v iz., di-
lated
fainting fits, two
sequences
on the conditions of the cavities. In valvularlesions and to the enlarged
b"ganto sufferfrom an indescribablefeeling of hypertrophy (thewalls bearing
of all kinds, the cavities on either side undergo uneasiness in the cardiac region. About three cavitiesa normal or excessiverelation,) and tion,
dilata-
changesaccording to the lesion, itslocality, itskind montiis afterI firstsaw him, the
legs beganto swell, (thewalls bearing to the cavities a lessenedrela -

and amount, "c.,and according to the general state of and iftera time had established tion,) follow more or less in every case of valvular
enormous anasarca
the system,which may favour the growthof strong,itseli A littlefiuid formed in the
peritoneum.diseaseof any amount ; and,of the two, pure dilata- tion,
poweirful, muscular tissue, or may, on the other Tfaei ensued terrible
painsin the cardiac region, as it is by far the most formidable, is,luckily,
hand, be unfavourable to nutrition, and may, there- fore, like
angina,which were temporarily relieved by the most infrequent
lead to that conditionin which a cavity, riencing
expe- stimulants. Thedyspncea deepenedinto orthopnoea, Dilatationis formidable in a somewhat different
at its outlet an obstacle which its own and for many weeks before his death he could not way from hypertrophy ; it does not so directly act
strength cannot overcome, and to overcome which lied"wn. About a fortnight before his deaUi,the on the valvular disease, but it, as it were, aids this
it cannot gainstrength, necessarily becomes dilated
expKitoration, which had been previously al'vniys of by the tendency it has itselfto producethe liko
by the pressure of its contained fluid, without a a
sinple kind,became streaked with blood,and sub- effects. Thus, for example,supposing that afteran
eompensating increase in the muscular tissueof its there were several attacks of copiousattack of endocarditisthere has been sufficientmi""
sequsntly
walls. Either of these conditions of the cavities All chief to cause some obstruction the aorticorifice,
hsennptysis. this time the heart'saction re- at
may, however, be primitive afiections.A cavity maited
extremely feeble and irregular, but without and moderate insufficiency at the mitral; in a young,
may become hypertrophied and dilated, or dilated bruit. There was no albumen in the urine,nor vigorous person the left ventriclebecomes mode- rately
merely,without valvulardisease. In the former of did the abdominal organs appear to be diseased. hypertrophied to overcome this obstacle at
theae cases, ifthe pulmonary, or general circulation, After death there was, as we anticipated, the aorta,and,by so doing, it preventsany stagna-
monary
pul-
becomes aflected to snch a degieeas to cause stag- nation, apoplexyto a considerable amount; and tion in the generalcirculation. It does harm, cer- tainly,
it is,in the vast majority of cases, if not in there was a little but
lobular pneumonia. The anterior by increasing the mitral regurgitation,
all, throughconsecutivelesionofthe valves.Valvular marginsof both lungs were emphysematous ; the then this, afterall, for a long
is time tnfling ; there
lesions are the connecting link between hypertrophy, fat on the is the auricle to bear the first shock of the refiux,
pericardiumwas healtiiy ; there was no
and impediments to the circulation.But, on the con- trary,
heart;all the cavitiesof the heart were extremelyand this cavity becomingdilatedand hypertrophied,
ifdilatation be the primitive disease, it may pro-
with blood ; the is as it were a safety valve between the ventrioleand
dilated, and were filled completely
foandly afiectthe pulmonaiy systemicor diculations valves 'of all were the lung. At length the mitral disease increases;
competent,exceptin the case
without disease of the valves,and, in fact, it then of the
which, though lai^ not but, comparatively, at a long distance of time.
tricuspid, could
pots on the general symptoms of valvular disease,close,perhaps, th.e opening, which had increased But suppose, on the other hand, that the ventiible
and without the stethoscopic signsis nearlyindis- tinguishable. in diameter. No aflectionof the endo- cardiumin rimilar conditions, from some cause, perhaps
considerably
For the same impedimentto the cir- traceable. The dilatationwas cannot become hypertrophied.
was g^reaterwant of nutrition,
culatiMi which is produced by large
a h eart drivingin the right than in the leftheart, and the thinness of Why then it cannot expelits blood throush that
the blood baekwards in itscourse througha patent the walls,as comparedto the largecavity, was more narrowed aortic orifice,the blood collects, ue tricle
ven-
orifice, is producedin the case of dilatationby the here. The walls of the right it becomes still less able
conspicuous ventricle yields ; as it yields
impossibOity of the weakened heart contracting with were eiroulation comes
be-
very flabby, not above one line and a-half in to force on the blood ; the systemic
sufficientstrength on its contents; the heart is thickness
at the apex; the muscular fibreshad a empty of blood; the blood collectsbehind
never properlyemptied;it is ever receiving, but yellowtint, but were not mottled ; under the micro- scope the leftventricle, in the auricle, in the pulmonary
cannot, pari pattu, discharge, and thisstagnation at the fibres were less distinctly and then calls into playthe rightheart,
striated, and arteries,
the eentral oigan is feltthroughout the whole extent seemed more
granularthan usual,but were not which alsobecomes dilated. Now, here mitral re- gurgitation
of itederivativevessels. as the weak heart may
fatty ; there was a yellowish mass attached to a may be trifling,
As an illustratioa of this point, letme relate a columna camea, near the blood back throughthe patent oriflce,
apex, about the size of a dirow little
case which occurred to me a short time since among small nut, the nature of which could not be made but pulmonarystagnation is greaterthan if the
the out-patients. We have had no case lately in the out On the leftside, the ventriclewas very large forcibly driven back into the auricle
; blood were
hospital which well the walls were and strongly heart
can answer our purpose so as thicker, but stilldisproportionably by a large, hypertrophied, acting
this one, as it isseldom we get a dilatedheart un- thin ; under the microscope the fibreswere slightly Therefore the practical
complicated pointis,that (putting
by something else. This time lastyear granular, but more distinctly striatedthan on the aside enormous nypertrophy) the prognosisin
a man came under my care for cough,dyspncea, rightside. The walls of both auricles were ex- tremely valvularlesionsisunfavourable in proportion to the
and palpitation. He was about thirty-five years of thin. The liverwas intensely in the prevalence of dilatationrather than hypertrophy,
injected
age, five feet eleven inches in height, sparely made, centres of the lobules; in fact,there were here and, in treating such cases, it is to be guarded
and had lived very fireely. He had never bad almost ecchymoses that we do not increase the tendency to
; the peripheries of the lobules against,
rheumatism,'nor any formidable disease,except, were pale, contrasting widi the red centrea Under dilatation. This may be done by pushing sedatives
apparently, pleurisy some months before. He had the
microscope, the cells seemed healthy.The to excess, and perhaps by lowering the system too
noticed for some months that he was short of breath, kidneys and the otherabdominal organs were healthy. much by general debilitating measures. The clinical
that he had cougheda gooddeal,and had, on the We had,then,in thiscase, the general from the gradual weak-
ening
symptoms sig^s dilatationare
o f drawn
least exertion, become subject to violentpalpitation. of valvular lesions of the auriculo-ventricularopen- from increasing
ings, of the impulse, irregularity in
He had no dropsy, no jugular pulsation, and no pain vis., arrestof bloodinthe systemic circulation, as the heart's action, and the alterationin "e morbid
in the cardiac region.The most careful examina- tion evidenced by the dropsyand hepatic and sounds which the weakened heart necessitatea.
congestion,
detected no pulmonarydisease. The action of alsoin the pulmonarycirculation, attributablealto- gether, In connexion with the subject of dilatation, I
tlieheart was most peculiar ; it was irregular in the or nearly, to simpledebility of the heart should wish to take up the question of the organic
higheetdegree,with an extremely weak, almost The largetricuspid openingmay probably, towards changes of the heart's fibres, of the deposit of oil
fluttering impulse.There did not appear to be any the last, have allowed regurgitation, but the weak globules within the sareolemma, or, of the other
alteration in the position of the heart or in the ventriclecould not have thrown much blood back, forms of degeneration, which,as in the case I have
amount of the praecordial dullness, and the impulseso that, for practical purposes, we may refer every- thing just related,are distinct from fattyinfiltration.
was felt almost entirely at the apex. Even when to the stagnation producedby an incapable But this subject must be deferred, as I must paM
the patient had been in a horizontal position for heart And the signs of this diseasestand out with on to the second pmnt, to which I alluded as con- nected
fifteen minutes,the irregularity continued, though remarkable distinctness; we had the efiectsof val- valvular and this
with lesions, is,as to the
No. 544, Vol. XXt,
 152 THE MEDICAL TIMES.
affectedby yalviilar on other and obscure causes, and these,of he is the victim of uneadness
general when the
OAvides which are immediately more

whether this effectbe hypertrophy latation.

di- here- bowels are not relieved. He passes throughvarious
have not touched at all. We must after
lesions, or course, we

attemptthese most difficultpoints. ordeals of treatment, both by the regularpraeti.

with few tionerand the charlatan, and he tries the effectsof
The nile here is and,
simple,
perfectly a

law. It is this :
is as certain as a physical
provisos,
all the quack medicines advertised for the cure of
ORiaiNAZa CONTRIBUTIONS. but without relief. In many of these
The cavitywhich, in the course of the circulation, constipation,
is anteriorto the obstacle, isthe one which isaffected, thoughtsbecome so wrappedup
cases, the patient's
RESEARCHES in himself and his complaints, that it is difficult
to
if any be. For example, aortic obstruction, or
ON
rc^rgitation, (which, a s far as the ventricleis con-
make him converse on any other subject, especially
acts on the left INVOLUNTARY SEMINAL DISCHARGES, if his companionbe in any way connected with this
eemed, is practically obstruction,)
AND THE DISORDERS ATTENDING Medical profession. The frequentuse of drastic
ventricle; or, ifthere be no disease at thispoint, any
condition of the aorta, as most frequently
or, pens, THEM.
hap- purgatives onlyincreaseshis malady, and, by irri-tating
of the generalcirculation, which acts as an By H. J. M'DOUOALL, SnrKeon, Fellow of the Royal the rectum, increases the disorder of the

obstructing cause, produces, according to the pre- sence to

Medical and Chf mrglcalSociety ; formerlyHouse-Soigeon bladder, prostate,and urethra, until pollutions,
University College Hospital. which at first, perhaps, only occurred during acti?e
of other conditions, and according to its own

dilatation, both,of the (CoDtinoedftom Vol. XX., page S78.) straining, now take placeat every evacuation of the
amount, hypertrophy, or or

leftventricle. bowels,and even sometimes during the passage of

It is my intention, in the presentpaper, to con- sider flatus.
Primarydiseaseof the mitral orifice, again,leaves
the ventricleimtouched. The left auricle now suf- fers; the effectsproducedby spermatic discharges How is the disorder above described,as caused
and this whether the mitral orificebe con- tracted on the digestive organs, lliese vary much. At by spermatorrhoea, to be distinguished from chronic
venereal excesses often attended br in- creased and gastro-enteritis 7 The originand his- tory
patent In the firstcase, the auricle first, gastritis
are
or

suffersmost ; it also drives the blood back more cibly

for- appetite ; the same may be said of turbation
mas- of the complaint are here of great service to us
and this, probably, arises from th3 loss in forming diagnosis. G astritis and teritis
gastro-en-
on the lungs, and produces greaterpulmonary ; a

than in the case of mitral regurgitation. to the economy requiring increased material forits are generally traceableto some exciting cause;
congestion
On the rightside of the heart, the causes of repair.But, if the excesses or masturbatiai be and even in their most chronic forms, do not present
or shorter time, acc"rding the slow insidiousprogress of this complaint Vo.
hypertrophyor dilatationof the ventricle, are to continued,aftera longer
of the patient's digestive organ, the mitingis generally presentin gastritis
be found in the pulmonary arteryat some partof its to the strength ; not so when

course ; rarely at itsorigin, very frequently, indeed, reduction of the food in the stomach becomes less the a"ctiondependaon sparmatorrhcea. Diarrhoea
the disordering be and the
in its smallest ramificationsin the substance of the easy. If,however, cause now accompaniesenteritis, appearance of the
discontinued, this derangementmay pass ofi^ and stoolsis characteristic; but constipation is, in sd-
lung.
the stomach may regain its tone. When involuiiary vanced cases, an almost invariable attendant of the
Tricuspid regurgitation would not, d priori, appear
discharges have been set up, however,this return to disorder caused by spermatorrhoea. The appearance
to give the requisite conditions for any effect on
health does not take place. Under these circim- of the tongue,too, is characteristic. Instead of the
the ventricle; and I believe that,in the great ma- jority
stances, th^ patients, feeling depressed and debili-
tated, red irritabletonguepresentin g^tritis, we have here
of caaes, the hypertrophy does precedethe re- gurgitation.
often endeavour to repair their strength by a voluminous paletongue,covered,in the morning,
But possibly the order of sequence
takingabundant and nutritious food, without Teeing with a thick yellowish white fur, and attended by a
may be in some rare cases reversed,from causes
a real sense of hunger, but rather a sensatiai of very disagreeable taste in the mouth.
with which we are not acquainted.
gnawing and heat referred to the epigastric repon, The state of the sexual powers is also an importsnt
Tricuspid regurgitation afiteets the auricle, which
or of sinking in the stomach,and generalfaintiess.pointin determining the diagnosis. When matters
is almost always dilated,and sometimes hyper-
This sensation of sinking in the stomach is a lym- have reached the condition I have described, flie
trophied.In tricuspid contraction, as in the case
have seen, the auricle is of course
ptom very commonly complained of,and, for its lief
re- sexual energy will always be found more or lessdi-
minished,
we even more
the stomach is frequently overloaded witl sti- mulating sometimes even to completeimpotence,
affected.
and savoury fcKod, and the meals are often with occasional periods of partial vigour.Inquiry
You will perceive, then,that for,ventricular hy- pertrophy frequently than is compatible with on thispoint should never be neglected.
repeatedmore
and dilatation following obstruction, we
sound digestion. Alcoholic and other stimulants, What is the state of nutrition of these patients !
look usually to the lungs as the cause of the diseaseof such also taken to assist Hippocrates
as strong tea and coffee, observed,that they eat well ; but,
'*
are
the right ventricle, and to the eommfficement of the
digestion, and, althoughsometimes these afford notwithstanding, they lose flesh." This is, no
aorta and to the general systemic ckculation for the
temporary relief, they assistin laying the founda-
tion doubt,true in advanced cases of the malady; but is
disease of the leftventricle. Now, as disease of one for farther and more serious disorders. This by no means the case in its earlier stages. Suck
side tends to affect the pulmonaryor the systemic state of stomachic irritation re-acts on the involun-
tary persons are often considerably inclined toembanpoitit,
circulation, as the case may be,itinfluences, through seminal discharges, and renders them moie and have every ap))earance of health and vigour.
one or other circulation, the other side of the heart
frequent,a resultmuch encouraged
"
by the stimu-
lants Hence their friends endeavour to rouse them by
Consequently, if all things were ^equal, we should
taken in hope of relief. Under such circum- stances, society, and often urge on them the necessity of
never have valvular diseaseand hypertfop)iy of the the patients lose the sense of comfort felt marrying. Their complaints often set down as
are
one side,without beingable to predicate the exact
after food by healthy and experiencefeelingimaginary, the
the other of
men, a or result of the regimentheypursue.
amount of disease which must ensue on
weightand oppression at the epigastrium, which They are advised not to "
take so much physic,"
side. But this foreknowledge is not possible, cause,
be- uneasiness and restlessness; the pulsebe- comesand to amuse or employ themselves. The patients
.
causes
in every case, three important elements of the and the patient themselves often regret their healthyappearance,
accelerated, is often threat-
ened
problem are uable to variation, viz.,the valvular with an attack of cerebral congestion, such as saying, that if theywere thin,pale, and yellow, they
lesionitself, theforceof thecontractionsofthe affected I have described in a
previouspaper. At a later would, at least, receive sympathy,and not be im- portuned
side,and the supplyof blood to both sides. Thus, periodof digestion, he often becomes torpidand to undertske what they feel themselves
mitral regurgitant, following hypertrophy, will not Eructations of acid and unable in the of
drowsy. burning taste now to perform.Marriageis, majority
affectthe puknonarycirculationsnfi"cientiy to cause
dis-
charges
occur, with constant burningpainabout the cardiac cases, out of the question, where involuntary
hypertrophy of the rightventricle, if the leftven- tricle diumsl
extremity the stomach; and I have seen the
of hive attained any frequency, or after
be not strong,and if the aorta be properlymatter
spitup blaze like oilwhen expectorated into pollutions have commenced. Numerous cases, in
open, or if the mitral disease be trifling, "c. And the fire. The chyme,badlyreduced in the stomach, which the advice " to marry," so commonly given,
so tricuspid regurgitation will not alwaysproduce irritates the duodenum, and this irritation extends to has been followed,have come under my notice.
hypeitrophy of the left heart,if the leftheart re- ceive
the liver and pancreas by their respective ducts, Much domestic unhappiness is,as mightbe expected,
onlya small quantity of blood in consequence
disordering the functions of these important organs ; the result; and the husband has either to submit to
of congested lungsor from other causes ; for then the secretionsof which, beingderanged,againpro- mote treatment which might have been previously ployed
em-
the left heart throws it easily into the circulation, disorder in the jejunumand uium, with dis- engagement with much better chance of success, or to feel
and experiences comparatively no obstacle. of flatus, causingthe sharp colicky the consciousness of havinggreatly, though unin-tentionally,
Therefore,the elements of the problem,are, the painsof which such patients complain.To these deceived a person who trustedner hap- piness
"igonr of the contraction of the hypertrophied symptoms are often added difficulty of breathing to his care.
cavity, the amount of blood which it can throw back, and palpitation of the heart ; the former,the result When, however,the diurnal pollutions have hten
and the amount of blood which, from cardiac or of the abdominal distention; the lattersympathetic and the digestive disorderis
some years establiriied,
other lesions, or constitutionalconditions, can reach of the gastric disturbance. It will readily be under-
stood, of old standing, the description of Hippocrates it
the non-affectedside. But these things complicate that such disorder in the functionsof the small applicable. The patienUcertainly "lose flesh/'
the questionso much, that as we cannot telld priori intestinesis followed by derangement haggardand jaded
of the large ; and theyalso presenta peculiarly
whether hypertrophy or dilatationwillfollow an ob- hence
constipation is a prettyconstant accompani- ment appearance. They appear in the morning unre-
atade,neither, in the case of disease of one heart, of these cases. At first, perhaps,the bowels freshed,and as thoughtheyhad not been in bed ^1
can we tellA priori the degreeto which the other will are
alternately over-relaxed and constipated, but, night The eyes become sunken, and surronnded
be affected. Actual clinical observation, in each after a short time,constipation and the breath is oftenvery oflensiw.
becomes permanent, by dark circles,
particular case, is necessary to deflne the extent of and the patient seldom obtainsrelieffrom his bowels Such patients have, by the older writers,been said
the secondary disease. without the use of purgative medicines. This state to waste, especially in the regionof the loins, *nd
I have alluded here merelyto hypertrophies and of constipation, which is of itselfsufficient to bring the inside of the thighs.My experience does
dilatationssecondary to obstaclesin the circulation, on pollutions, as might be expected, aggravatesthe not confirm this assertion, and M. Lallemand siders
con-

wastingof these psrtsisnot

"~

among which are valvular lesions. But there are

w.u^vmM^ TWI"1\,U "lX"i TMATUMU ACOJVUO. UUI, U"".AW O.kW dlSCha^eS.ThC patient
.
yttViMUV remarks, that after his
l.^MMUH.a.9f bUCkV BAM^I. XU9
that the special
primitive hypertrophies and dilatations which depend} stoolshe invariably feels more depressed, althoughgreater in thisthan in other "seases.
 154 THE MEDICAL TIMES.
skipping,
strained her left thumb. Before he saw subacute inflammation of the metacarpus; in the to be dissectedfrom the forehead, and also with the
the case the injury had been treated as a simple second,disease of the ulna and metacarpal bones line of incisionsin the nose. The patient beinglaid
and
sprain, liniments had been mbbed into it. followed a mere sprain;in the third,death of bone on his back, and Mr. Fergussonstandingbehind,
An abscess soon formed orer the metacarpalresulted frt"m a similar cause ; and in the fourth, an incisionwas carriedfrom the tip of the old nose,
bone,and, giving riseto much painand tension, was the extremity of the ulna came away, and was fol- lowed on each side,nearly as far as the root, and the alse
opened. The resulting sinus showed no tendency by complete anchylosis of the wrist joint, firom efiectually separated. The triangular pieceof leather
to heal,and, at the end of ten months afterthe in- jury,an attack resemblingacute rheumatic synovitis. was then placedon the forehead, and a corrmond-
two piecesof bone, having become partially Had similar injuries occurred in healthy duals, ingflap
indivi- of integument was dissected up sufficient
detached, were removed from the dorsum of the first the resultwould,in allprobabili^, have been to make ample covering ; it was left narrowlyat- tached

phalanxby a freeincision. The bone, at thistime, slightin amount, and unimportantm its conse- quences. between the eyebrows,was then twisted
was much enlarged, and softer than natural in the round, and by this means the cut surface of the
centre, as evidenced by the impression communicated In these cases, however, the secondary result latterwas placed in apposition with the edgesof the
throughthe probein endeavouring to detect more assimilated itself, as itwere, to the form of disease former incision, and its edgeson each aide brought
necrosed portions. of which the constitutionwas the type, and would closely into apposition with those of the divided als
The wound, resulting from the removal of the no doubt have been of a most serious character, had by means of sutures,and thus an ample covering
piecesof bone,did not heal for two years afterthe not the utmost attention been paidto keepingthe was allowed,which promisesa rery fair substitute
original injury, no more bone,however,havingcome limbs as quietas possible, and to the improvement for the original organ. There was necessarily a con-

away. The localand generaltreatment in this in- stance of the general state of health. siderable amount of bleeding, but this was chedced
in every way simOar to that adopted in These cases further pointed that the by to the air, and by one or two ligatures.
were out, osseous exposure
the previous cases. The limb all alongwas care- System in strumous habits beingpeculiarly liable ENCHONDBOKA OF THE FINGERS.
hilly confined in a splint, and on the subsidence of to diseased action,easily induced by direct or in- direct The next the remoTal of the two
operation was
the acute symptoms, cerat hyd. co. and strapping topical injury,even when vei^ slight in its middle
fingers, with the corresponding metacarpal
were applied once or twice a week, as circumstances degree, the greatnecessity ofcaution in mechanical bones,from a poor woman who had suffered for a
directed. Iodide of potassium in combination with interference. We should not unnecessarily probe longtime with some very painfultumours on the
the ammoniated citrateof iron, and cod-liveroil, were the wound in search of diseased bone,a proceedingdorsal She had
and palmar aspect of the hand.
alternately had recourse to, and, latterly, six weeks he had seen occasionally bringabout the very con- dition-it
sufferedso much pain,and had so entirely lostthe
in the countrymaterially aided the progress towards indirectly intended to remedy.The
recovery. probe,
was

if used at aU, should be employedwith ex-

use of her hand, ttiat^e was anxious to have it re-
moved
treme
; but as Mr. Fergussonconsidered that the
"CUTE SYNOVITIS OF delicacy and operations for the removal of disease involved he anxious to
THE 'WKIST JOINT, ; only two fingers, was
necrosed bone should not be had recourse to before
TBBMXirATINQ IH 8EPA"4.TI0N 07 THE XZnUBHITr save as many fingers as possible.The two fingen,
OF 1BX mMA, AXD AXCBYUmB. fullevidence had been obtained that the dead tions therefore,
por- with the metacarpal bones,were removed
William Barber,aged19,a bricklayer, of strumous loose, and capable of easy removal.
were
by the ordinary incisions; and on lookingat the dis- eased
habit, was admitted into the London Hospital with The longpersistence of sinusesconnected with the portions afterwards, it was found that the two
erysipelatous inflammation and great pam of the diseased bone,moreover, did not necessarily depend tumours were firmlyconnected with the bones,and
righthand and forearm. on the presence of sequestra, but very frequently on consistedof that fibro-cartilaginoas material known
He stated that, three days priorto the inflam- mation subacute inflammatory condition of the entire as enchondroma.
a
Specimensof this disease are
of the upper extremity, he feltintense pain shaft,or a of it. In the treatment of the somewhat
portion rare, and these,as Mr. Fergussonre- marked,
in the wrist without any assignable cause ; great last case detailed, the probewas not once had re- course were very well-marked inatances of it
swellingof the articulation almost inmiediately to, and to that circumstance,Mr. Ward
supervened, and terminated in erysipelas of the mainlyattributed the very fevourable termination OLUB FOOT.
whole upper extremity.The on Saturday,
arm was freely of it In the third case, notwithstanding the re-moval Several operations were performed,
and
acarifiedi placedin a warm bath, and subse-quently of the dead bone,the sinus did not close for a Feb. 23,by Mr. Fergusson.The firstwasa caseof diri-
warm water dressing was applied. year ; and it was only when the metacarpal bone had sionof the tendo adiillis in a lad who suflbred
young
On the subsidence of the erysipelas, abscess subsided to its original
an dimensions,on the cessa- tion from club foot, accompaniedwith very greatdistor- tion
formed around the joint, and was opened, with great of the inflammatory action which gave riseto of the ankle. Preparatory to other measures
reliefto the severe pain,which had continued ^th that a cicatrixresulted. Mr.
it, forrestoring the limb to its natural condition,
but littlediminution since the periodof his ad- mission. determined to divide the tendo achillis,
Fergusson
The limb was placed on an inclined plane, which he did in the usual manner.
the hand and forearm bemg lightly bound to a splint, ZINCS COLLEGE HOSPITAL.
CANCER OF LIP.
and generous diet, with bark and acid,were ex- hibited* A case of cancer of the lower lip,in an old
On Saturday, Feb. 16, a seriesof operations were imusual
woman, presented a somewhat ance,
appear-
At the end of four months, several small pieces of performed.The first, and not the least interesting inasmuch as the disease,which consisted of
bone came away, followed'i" a short time by the case brought under notice was a patient of Mr. Bow-man's.
a laige circumscribed tubercle, was situated
lower end of the tdna. A middle-aged woman had suffered for
about fiveyears with
exactiyin the centre of the lip. This disease
From thisdatethe discharge gradually diminished, attacking the lips, is generally marked by these
and the openingbecame much contracted, the joint circumstances : In the firstplace, it nearly alwavs
HAIOCABT ENLAB6EHENT. "

fti^ and the fingers perfectly rigid.He became It had commenced is found to be seated on the lower lip, very rarely
as a small swelling, maining
re-
"

an out-patient, and at the end of a year the wound

for her but the upper ; and itis for the most part placed on one
had become perfectly closed. passive some years, giving
littleuneasiness until'about three months side of the central line, very frequently at the com-
missure.
By passivemovement, the fingers ago,
gradually covered
re-
when she complainedof great pain in the tu- mour, It ismuch more favourable, o f course, for
their use, so that,in two or three months
now of considerable size. The swelling operation, when, as in this case, it ia seated in the
more, he could flexthem to within an inch of the the whole easilv be included in the
presentedthe features of sero-cystic disease. centie, as can
palm. He had, however, no power of extending the incisions, and there will be less deformity wards.
after-
Fluctuation was perceptible in the most
thumb or little finger.Two yearsliterthe original minent
pro- Mr. Fergussonperibrmed the operation by
attack of inflammation, he calledon Mr. Ward with a poition; there were no signs ever
what-
and
amall abscess over the ulna, apparently
of any malignancy in it; and, as the transfixing tiie lip below and
cutting upwards ;
connected then,by another incision,lemovmg the morbid
anxious to have it removed, Mr. Bow- man,
which became absorbed aftera patient
was
with the periosteum, of a V shape, the edgesof
mass, leaving a wound
littlecounter-irritation and rest of the limb. priorto performingthe operation, made an
exploratory and ascertained the which were broughtaccurately together by hare-lip
He stated that he could detect no differencein puncture, presence
of fluid. There was no retraction of the nipple pinsand sutures.
the useftilpowers of the two hands, beingcapable some
whatever, and no adhesion of the tumour to the dun. EHINOPLABTIC OPERATION IN ARTIFICIAL
of lifting as heavya weightwith the righthand as The whole of the morbid ANUS.
with the left, the original aflectionnot interfering in
mass was careftdly removed
by Mr. Bowman. It was discovered to be a very A patient was now broughtinto the theatre, ^
any way with his ordinarjr occupations. The hand
fairspecimenof cystic excited a considerable amount of curiosity and in-terest,
sarcoma of the mamma.
was perfectly in a straight line with the forearm, from various causes. It will be in the recol- lection
and a depressedcicatrix existed,indicating the FOEKATION OF A NEW NOSE. of the readers of the MedUsal Timet, that a

pointat which the ulna had come away. The next operation, performedby Mr. Fergusson,reportof an operation, to remedy an extraopdinaijr
jRemur^t." Mr. Ward observed, that the above was one which is now not vexy fi^uentlyseen, and rare instance of artificialanus was made ; it
cases, althoughpossesnng but littleof individual althoughnumerous operations of this nature have willbe found in the Number for August 4, 184-9.
interest, were of the highest practical importance, as been performed by Englishsurgeons. The proceed- ing This poor boy was now againbroughtforward,in
beingof a classwhich not unfrequenUy came under consisted in making a new nose for a man who order that ftirtherstepsfor his cure mightbe nn^f"
the care of the surgeon, and which, unless sedulously o( thu
some years ago had receiyed a severe ii^ury, in con-
sequencetaken. We shall againrun over the history
attended to,were prone to be followed by very serious of which inflammation and necrosis had remarkable,and, we may truly fii as our
aay, (as
results. The modification of the effectof the local taken and In reading, has
place,and the greaterportion of that useful own observation, both in practice
i^juj^ the peculiarity
l^ of the constitutionwas the member was lost The als remained; but, from informed us,) unprecedented case. It appearstSoA,
chief pointon which rested theirclaim to attention. the circumstance of the the of the right
bridge of nose being several years ago, the boy had disease
In the four instances above detailed, the dis-
paritydestroyed, theywere depressed almost on a levelwith hip-joint, which, havinggone throughits varioas
between the injury and the secondary the face. The operation conducted in the fol- lowing imd destruction
symp-
toms was stagesof ulceration, suppuration,
was very remarkable. In the first, a mere manner. A piece of leather was firstcut out, of part of the joint, had ultimately ended in a
laetration of Jthe hand was 8ufficient||to bringabout which corresponded with the flap of skin which was cure by an"diylodB. Whilst Oie diseasewas
perfect
 THE MEDICAL TIMES. 155
the pelvis
progntaing, became deeplyimplicated, Mr. Fergussontook the occasion to callthe at- d is next fixedwith corks } the condenser filledwith
tention
the rectum involved and ulcerated, and an of those around to this ingenious attack water, and arrangements made to renew the cold
opeaingin connexion with the gut formed be- tweenupon his planof treatment, which he read aloud,to water throughthe tube A. The crucible is now
the back part of the ilium and sacrum, " the great amusement of the numerous pupils and cautiously heated, and as the vapours cannot pass
oost probably, thislatterbone had been perforated, surgeons, who had before their eyes the best evi- dence readily through the perforated plateat c, they
or partially destroyed, as well as the great sacro- of the propriety of the treatment pursued.ascend throughthe metal tube d, are condensed in
sdatie ligament The consequence was an mense Those who pretend
im- to criticise practice,should take the worm, whence theypass into the tube g, and
chasm on the back part of the buttock, a littie more trouble to assure themselves of correct from this latter, into the cylinder, at k.

of nearlythree inches in lengUi, and from one-half frustsat least,a nd not distortthem justas it might This apparatus is very useful for the analjrsis
to three-fourths of an inch in breadth, through suit their own purposes. of substances eontaining active principles.
whleh the whole of the feeoes came away,--of For our own part,we are folly sensibleof the AITATOMIGAL OAFILLABT INJ"0TION"
course rendering this poor sufferera miseryto him- self, greatbenefitwhich has alreadyaccrued to this poor M. Hirsehfeld,a young anatomist,who made
and a burthen to every one around him. This youth by Mr. Fergusson's humane attemptsto refieve nearly all the preparations whence the greatwork of
state ot things had existed for four years, no fieeal his miseriesi and we shall earefolly wateh the pro-
gress Bourgerywas drawn, and likewise the beautifril
matter havingpassed per anum, when the boy was of the case. preparations at the Museum of the Faculty, has
iixBtbroughtunder the notice of Mr. Fergusson in recenUypublished an account of the way in which
the summer of lastyear. Althoughthere appeared he prepares his injections. For very ihie,micro-
scopic
but little hope for any measure producing benefit, PBOOmBBB OP MBDIOAI. 80IBN0B. ii^ections, Berres and his pupilrecommend
yet Mr. Fergussondetermined to attempt the ame- the following : Take some "
copalvarnish,and add
uoration of the case ; and, as we stated in a former a sixth of itsweight of mastic,melted in a sand-bath,
FBANOB.
report,an operation was devised for the purpose of with some spirits of turpentine. These are mixed
closinga portion of the opening. The e"ct of this [From our Parii Correspondent.] together until they have acquired the proper con-
sistence,

was not so greatas one could wish ; yet the opening which may be Judgedof by dropping them
was somewhat more contracted when, in Novemb^ KBW APPABATU8 FOB OOKTHrUSD on a flatstone, and watching how theyset If,in
last,Mr. Fergusson againparedthe edgesof a part DISTILLATION. the droppreserves the consistency of a drop
cooling,
of the opening,and broughtthem into contact M. Kopp, of Strasbourg, whose ingenious oon" of honey,itisof the proper thickness.
The boy remained in the hospital for some weeks, tinned syphon was exhibited at the last/National M. Hyrtt recommends the following : ^Take of "

to the country,and was again admitted a few Exhibition, has proposed usefol apparatusfat the the
went an
purest and whitest virginwax and Canada or
days ago, when the greatamount of benefit which constant distillationof substances with ether, Venice turpentine equalparts; dissolvethem in a
the operation of Mr. Fergussonhad producedwas aleohol, or water. When onee this apparatus has sand-bath,and then test the consistency according
been regulated, it requires littleor no care, and is to the meUiod of Berres. If too thin,add wax, and
very apparent The openinghad umted to quite
one-half of its extent,by a firm and healthy union ; more easilymanaged than any other of a similar viceuersd.
afiortion at each extremity stillremainingpatent. kind. The annexed cut represents it For colouring matters, Chinese vermillion is the
The openings, however, between the edgesbeing n a is glasscrucible^ best
a It is carefully ground with the spirits of
very narrow. But the most pleasing and inspiriting heated lamp ; turpentine,
by a spirit and the mixture is then filtered; after
oireumstance connected with this amelioration was, ft, a
a metal cylinder which it is heated again, care being taken not to
that as much of the faecescame away by the natural holdingthe suostance produceany air-bubblesi the syringe is also heated,
passage, as by the artificial opening, whereas none on which the extractive and the injection used. As soon as ,itis thrown in,
had come away per anum before for more than four fluidis to act At the the preparation must be placedin cold water, to
years. Under such encourag^g circumstances, lower part is a trans-
verse coagulate the injection.
then,Mr. Fergusson determined to perform a further platee, pieroed The beautifulinjections of M. LigneroUes in the
operation.The lower openingwas operated on, its with holes,which pre- vents Museum were made with an alcoholic solutionof
edgeswere carefully dissectedup, and a cross incision the substance gum-lac;and those of M. Guillot with coloured
made on each side ; they were then pared and ac- from
falling down into gelatine ; but thislatteris not unattended with in*.
"nrately broughtinto apposition by means of needles the orueibie. Below conveniences.
and twisted suture ; the upper openingwas left un- touched this plateis a short The splendidinjections of Malpighi, it is well
for the present tube, to which a oork known, were made with common ink ; but this, and
The operation beingconcluded, Mr. Fergusson is fitted, and thislatter all aqueous injections, are very liable to become
took the occasion to make some lengthened remarks supportsa leaden tube extiavasated from theirfluidity.
on this ease, which, to allwho have seen it,is a most df which establishes As for the processes peculiar to M. Hirsehfeld,

interesting one, both from the peculiar nature and a conununication be- tweenthey are as follow: He chooses," if possible, a
cause of the affection, and from the greatbenefit the cylinderand young subject, and warms it in a bath for eightor

which has already arisen from surgicalinterference. the condenser, e. This ten hours,and then throws in his injection. This is
However, there is another eause which has rendered tube ought to be suf- composed,for the arteries, of one quartof oil with
Uiis case peculiarly interesting in the eyes of Lon-don ficienUy
. large to letthe one pound and a-half of vermillion, carefully ground
^
surgeons, and that in consequence of an article vapour pass easilytogetherand warmed; for the veins,two quarts
that occurs in the Februarynumber of the Edin- through it e is the of linseed oil, and one pound of white lead, or

bm-gh Monihly Journal qf Medical Science, It ap- pears, condenser,and is tra- versed enoughof indigoto givea good blue. When it is
that the individuid who writes the surgical by a metal tube, desirable to pass the iigection into the very finest
C^
articles in that Journal, most probablybecause /,which communicates capillaries, M. Hirsehfeld adds a certain quantity
there is a lack of cases in his own cityto talk about, with the reservoir 6; of turpentine to it, which preventsit from running
and also for the purpose, we suspect,of indulging from its superior tremity out tlurough
ex- the divided vessels. A coupleof tea-
a littlefeeling of spleen, has taken the opportunity, ascends a loi^spoonsfol of softVenice turpentine to each injection
by selecting case,this and another which Mr. gusson
Fer- glasstube, g, which willbe enoughto make itset perfectiy. The micrO"
operated on, to accuse that gentleman of a de - enables us to ascertain scopic injections thus made by several pupils of the
partore from establishedsurgical principles, and to whether allthe vapours French school,and preserved in the Museum of
eoodemn, and even attemptto ridicule, the operative are condensed in the the Faculty, do not yield, either for beautyor ac- curacy,

inlerforenee iduoh was here used. This anony- refrigerator. Thislatter to the famous productions of the German
mons detractor, not steppingforward boldlylike is cooled with water, anatomists.
a man, and puttinghis name to his remarks, admitted through the AN '"
ntBELIGIOUS "
ICALADY.
has based the main point of his criticism upon an tube h, and which es- capes, Our nosological scale has been recentiy mented
aug-
assumption^ which is ridiculously ineorrect;for he when heated, by a class of disorders hitherto ttnknown
informs his readers that," as the matter proceeded through an opening at i. to the uninitiated; but which threatens, like the lean
from diseased bone,"it was very wrong, to use his The mode of using kine of Egypt,to swallow up all the rest The dis-
covery
veined expression, to *'cork the openingup." the ai^aratusisreadily we owe to the very reverend Jesuits into
llow" the foot is, that there never has been understood. The linder
cy- whose hands the destiniesof this country have now

any matter at all flowing from the openingsince is nearlyfilled foUen. These worthies, desirous of signalizing their
the patient has been under Mr. Fergusson*s care" with the leates, roots, advent to power, by startlingimnrovement in every
vinlessthe escape of freces may be termed a dis- "c.,on which we intend branch of civilizedknowledge, nave established a
ehaigeof matter ^nor have there been any appear-
"
operating.They are new classof diseasesunder the titleof irreligious !1 1
aeees or signs of diseased bone remaining since previously reduced to a coarse powder. A small and, what is worse, have reduced their inhuman
the patient has been in Hospital.There had been pieceof cotton, treated with boilingcaustic pot- ash, theory to practice.
at one time diseased bone; but this morbid and afterwards washed and dried is, how- ever, Last week, Ricord had occasion to requirean
action had longago oeased,and all that remained first placed on the transverse plate ; and some artificial palatefor one of his patients at the Lock

was simplyan arUfieial anm of a very interesting common cotton at the top of the powder; The Hospital ; he thereforegave an order to the Director
and peculiar character "
nothii^f more, nothingcylinder is next fixed by means of a cork to the tube of the Hospital, who referred, in his turn, to the
less with ** no discharge
" of purulentmatter,** and /,above and to the crucible below,which is three General Committee ; the answer
-
was,
'*
that no
"*no diseased bone,"as the **aeef* of the North fourths filled with ether,alcohol, or whatever fluidis remedies could 'be supplied to sinners labouring under
iwnld wish us to believe. intended to be used forextraction. The leaden tube irreligious disorders."
 156 THE MEDICAL TIMES.
It will hardlybe believedthat such a thingcould action is diminished by multiplying the elements in THE CHLOB08I8 OF PBBGNANT WOMEN.
have occurred in the middle of the 19th century, extent and surface ; by reducing the discs to their M. Cazeaux, a risingaccoucheur here,whoie
and in the heart of civilizedEurope,amongst a smallest dimensions,and employingisolatedcon- ductors. private lecturesare followed by a laive class, r"ad
peoplewho, with all their failings, have hitherto The decomposingforce is directly a
portionate
pro- memoir on this subjectbefore mt Academy.
been free fiom the weakness of blind submission to to the number of elements employed.Nothingis more familiar to Practitionersthan the
priestcraft. Yet the above is a fact;and we may, From these brief principles we can readily deduce seriesof phenomena, consisting in palpitations, diness,
gid-
perchance, have to congratulate ourselves, that the the scientificformula for the use of electro- headache,sufiR)cation, "c., which present
"
reverend fitthers" have not extended theirtheorypuncture. It is this "
multiply the elements; themselves in pregnant woman about the fifth or
to the whole range ofhuman disease, and annihilated diminish their surface, and transmit a constant cur- rent sixth month, and which,beinggenerally attributed
our occupation by a stroke of the pen. For under throughisolating conductors. From the above to plethora, are as generally met by bleeding and
tnch a theory, and with their elasticconsciences, it itisevidentthat we must no longer confound electro- purgatives. M. Cazeaux is of opinion that the acci-
dents
is impossible to foresee what disorder may not be puncture and galvano-puncture together.Elec- trical now alluded to depend,not on plethora, bat
comprehended under the class "
irrdig^ous." One machines, and the various apparatusemployed on a very opposite stats, nearly allied to chlorosis,
may catch a coughon comingout of a theatre, break with so much advantage in the treatment of nervous and it was this novel theme which he sustainedon
his legin a ball-room, fullin a fit at a card table,and paralytic disordera become useless when our Tuesdaylastin a very able manner. The aignmenu
"c.,when their reverences would exclaim,"fenum object is to coagulate the blood. Here we must employedby M. Cazeaux were chiefly drawn from
hab9t in comug" avoid him "
^lethim rot and die in address ourselves to the decomposingaction of the a considerationof the state of the blood in women
his iniquity^he has an trreUgimu disease. For-
" tunately pile; and, to render this more efiicacious, M. Petre-
quin so aflected, and from the symptoms. With respect
absurditiesof thiskind bringtheirown re- medy envelopes his conducting-needles with a layer to the blood,the author afi"rms that, when the
with them; and though the one now tioned
men- of isolating varnish. This not only preventsthe symptoms before alluded to exist,the quantity (tf
may be tolerated for a while,it will only lossof the galvanic fluid, but also the inflammation red globules is considerably diminished,a chaDge
hasten the downfal of those who have permitted its and gangrene of the soft parts traversed by the which we allknow to be characteristic of chlorosu.
perpetration. The old proverb) about a rope at one needles. The latter, also, have spiral heads,which The symptoms, also,are farfrom accordingwith the
end and a rogue at the other, has alwa^been appli- cable enable the operatorto fix the wires to them more idea of plethora. Many women are pale,and a
to the Jesuits, in spite of their munense tact readily, and thus keep up the constant current, well-marked hrvit de tovffie is heard over the carotid
which is so importantan element of success. arteries. Turningnext to the practical part of the
NOVEL MODE OF AMFUTATINa
Another point importance
of is, changethe direc-
to tion question, M. Cazeaux admits that vsenesectionis
Jpnpot of the Venereal Hospital, I may mention
of the currents,without altering theirnature. often found useful ; but,in the firet place, he does
that "h/LBicord performed an operation there,last
They must be made to traverse the mass of blood not denyabsolutely the existence of plethora; and,
week,which bru^fs to mind strongly the practice of
in every direction, to producea multitude of in the second place, is actually
our fore"thers during the in"ncyof the art Indeed,
so as as a serous plethora
filamentous concretions, which serve as the basis of present, the abstractionof a small quantity of blood
his operation seems to be embryonic rather than in-
the general coagulum; and,when the operation has may be advantageous. In the migority of cases,
fimtue ; that is to say, he has gone back a period
been properly conducted, from twelve to twenty however, M. Cazeaux sees no necessity of havisg
beyondthat of infancy.The older surgeons,as you minutes are sufi"cient for the purpose. to blood-letting, but combats the accidents
usually recourse
know, used to arrest haemorrhageby the actual to him, in a surer
not having arrived at the granddiscovery of HEAVB OF ASCEBTAINING THE QUANTITY
"
according and safer manner"
cautery,
the ligature AND QUALITY OF THE MILK IN WOMEN. by preparations of iron,tonics,and an invigorating
; but I do not remember to have read that
diet.
theyused to amputate with the cautery; thatis,bum Everybodywilltellyon that plenty of goodbreast-
TBEATMENT OF HTDBOCEFHALUS.
off members. Bicord,hdwever, amputated the miUc is an essentialrequisite for the health of your M. Lafibre, of Angen, announces that he has
penis with the usual cautery, " ^ifI may use the ex- infant; but when you come to ask Practitioners cured
seven cases of tubercular meningitis with the
presnon, in a case of phagedsnic
" ulcerationwhich what " good milk*' is,theyare woefully puzzledto ioduret of potassium. Several presentedthe
nothingcould arrest. He used a short, thick,blunt give a satisfactory answer. Dr. Donn6, before he
symptoms of the third stage. The dose of the
kind of a knife, heated to a white heat, and with became a Government officer, made an attempt to medicine
was carried to sixty grainsin the day.
tiiisremoved the organ close to the penis.It gave resolve the question with the microscope ; but his
M. GAY-LUSSAC.
way like a piece of cheese, and the patient did not discovery, "
like,^ indeed, to his sixty-two other dis-
coveries,
This distinguished chemist has been labouring
leem to suflerany pain. The case, I understand, is which have been sleeping for the lastten
for some time under alarming symptoms of ossifi- cation
proceeding fiivourably. In another case," ^me of years, in sealed packets, at the Institut,turned out
"

of the aortic valves. M. Majendiehas been

0B8TINATB rSBITABnilTT OF mere smoke. M. Lamperierre, of Versailles, has not
THE to see him in the country,and writes to say that the
BLADDEB, been discouraged by the failureof his predecessors,
M" Bicord empkiyedwhat we might almost call or the difficulty of the subject Whether he has symptoms
have been somewhat mitigated.We
"
shall however soon, I fear, have to record the decease
the
potential cautery, for he iiyected into the succeeded is another question ; but his ingenious
of thisgreatand amiable man.
bladder an ounce of nitrate of silverdissolved in attemptsare, at all events, worthyof reco^ To
an ounce of water. The injection was not allowed ascertain the quantity of milk secreted in a ^ten
to remain for more than twenty seconds, in the time,M. Lamperierre has actually made a little
Indian-rubber infant,or, rather, the mouth of one, BBIiBOnOIfS FROM FORBIGN
bladder, and had the effectof completely ing
remov-
JOUBNAIiB.
the irritable conditionof the mucous membrane. which sucks in a very respectable manner, and

TBBATHBNT OF AIHSUBISM BY ELBCTBO-

evacuates itscontentsinto a glass bottle. With this
CAFEINE.
FUNGTUBB. apparatushe examined the breasts of a greatmany Pure cafeine is fusible by heat, and volatilise-
and concludes that the average quantity of
M. Petrequin, Professor at the School of Medi- cine, nurses, without residue: itsvapours, when condensed, are res
milk secretedshould amount to 50 or 60 grammei,
Lyons, read a memoir on thissubject at the producedas sublimed crystals, in colourlessand dia- phanous
lastmeetingof the Institut Alludingto the ope- (12} to 16 drachms,)every two hours, for each prisms. Four results of
ration
breast analyses, the
of electro-puncture, the Author remarks,"at which approximate greatly, give the following as its
To ascertainthe quality of the milk, the Author
the remedial agent employedrequires to be studied ultimate composition : C16,HIO, N", OKSiptr^
in a more careful way than has hithertobeen done, (for his Memoir has had the honour of the Institut)
toire dePharmaeie,
because the action of electricity, employsthe following mode of analysis "
: Having
which is perfectly COMPOSITION OF COFFEE.
extracted, by means of his Indian-rubber mouth- piece,
simplewith respect to the physical world, is far from Cellular matter 34 parts, hygroscopic water 12,
allthe milk contained in one breast, he tests
beingsimplewhen applied to the living body. M. Its fatty m atters 10 to 13, glucose, dextrine, indeter-
minate
Petrequinhas, therefore, examined the effectsof specific gravitywith the lactometer of Que- caseins
vegetable acid 15*5, legumen,
venne. The milk is first carefully measured,
electricity in a searching manner, and concludesthat cafeine
and then brought to the temperature of the (gluten?) 10, chlorogenate potash of and
the pile exercisesthreedistinctinfluenceson the sys- tem 3*5 to 5, azotized organism3, free cafeine 0,3,
surroundingair. It is then poured on a com- mon
:"
filter, and in about a quarter or half an concrete essential oil, insoluble in water 0,001*
1. The electricfluidmay shske the whole nerv- ous
hour enough of serum is obtained to test the aromatic fluidessence, of a pleasant odour,soluble
system,debilitatethe patient, and communicate in and a less'soluble aromatic essence 0,002;
density of this latterfluid. Now, it is on the dif- ferenceswater,
very severe or painful shocks. This is called the mmeral substances, phoric,
phos-
of density between the milk and itsserum potash,lime,magnesia,
eiedricaction. sulphuric, and silicicadds, with traces of
2. It may have a ealor^action,
that the author founds his theory, each degree of
burningthe liv- ing by M.
beyondthe normal standard chlorine, 6,697. This analysis was made
tissues, and destroying them more less ex- density in the serum
or tensively,
in a marked manner to the richness Payen,
who gives the name, chlorogenic acid,to an
according to the intensity of the shock. corresponding
of the milk in butter. The author has constantly
acid he has discoveredin co^, because it imparts a
3. Finally, it has a deccmpoiing action, separating beautiful green colour to the crystalline substance
the elementary found the milk alkaline. In more than one hun- dred
molecules, and precipitating them of coflfee" the chlorogenate of potash and cafeine.
tmder various forms. experimentshe never found a singleexample
of acid milk. At the The acid itselfis of a white colour, solublein anhy-drous
Now, the latteraction isthe onlyone that can be alcohol,more soluble in dilute alcobol"
turned to account in the treatment of aneurism,and ACADEMY OF MEDICINE, with culty.
diffi-
very soluble in water, and crystallises
hence the should be to increase it, nothingof much
sui^ons object importancehas been brought Its aqueous solution, almost saturated at
while he diminishes the two former. The electric forward duringthe last two meetings. M. Le* 212, crystalhses in miscroscopic prisms
very slowly
action of the pileis diminished when the instru- ment blanc, a veterinary read curious and presents,
surgeon, a case irradiating from common centres;
is made to function without a multiplier or of true diabetes meUitus, which occurred in a after twenty or thirtydays, namerous merations
agglo-
sparks;when the' current is constant, and trans- mitted dog, seven years old. The animal had never in spherules of from 1 to 2 millimetres
throughisolating conductors. The calorifictaken any other food than raw bullock'sflesh. in diameter. Its aqueous solution hu " well*
 THE MEDICAL TIMES. 157
marked acid re-action. It is tlieactive principle and protracted lactation. He relates several cases TO SUBSCBIBERS.
of the differentcolorations in the normal salt of in support of this theoryof their origin.Western "

New Subscribers will obligeby forwardingtJieir

co^e. The aromatic principle is entirely
soluble Medical and Surgical Journal. 1849.
Names direct to the Office,46, Princes-street,
in water. "
Repertoirede Pharmacie.
PATHOLOGICAL EFFECTS FBOM THE USE OF
6AFFB0N OF MABS. IODIDE OF POTASSIUM.
Soho, or to the News Agents or Booksellers, All

M. Calloud,of Annecy, states that he has pur- Post-office Orders should be made payable to Mr.
chased Dr. Flagg asserts,the following morbid pheno-
mena
of the hydrated deutoxide of iron attend the use James Lucas, 46, Princes-street,Soho.
specimens occasionally of iodide of
(the old saffronof Mars) sixty
in -five differentshops potassium : "

at Toiin, Grenoble,Lyons,Geneva, and Savoy, and 1 Tumefaction of the gums, an increased flow of
THE MEDICAL
.

only fourteen were unadulterated hy copper. It saliva, and a saline taste in the mouth, subsequently TIMES.
had been preparedfrom th*i sulphate of iron of giving givingplaceto that of iodine.
commerce, which alwayscontains more or less cop-
per. 2. Pain in the cardiac portion of the stomach
One of tbirty gprammes he has found from afterlargedoses. SATURDAY, MARCH 2, 1850.
half a gramme to a
gramme and a half of the sul-
phate 3. Serous diarrhoea, unattended by febrileaction.
and alcaline carbonate. Repertoire de Phar-
" 4. Excessive secretion of urine,sometimes with
*"* We have to requestthat allcommunica-
tions
painin the kidney. for the Editor be addressed to the care of
PRESERVATION OP THE BRAIN. 5. Symptoms of severe coryza and of bronchitis,
M. Dorvault remarks,that a solution of sugar in with the exception of fever and muco-purulent
Mr. John Churchill,Medical Publisher, 46,
ex-
pectoration.

brandywill preserve the brain completely, and give Princes-street, Soho.

it a remarkable degreeof density." i{^;)^"oire de 6. Different forms of cutaneous disease, We must also impress
as acne,
upon such of our respondents
Cor-
Pharmacie. and
eczema, purpura. as address us anonymously, the
GANNAL'S PROCESS. 7. A condition of the eyes resembling catarrhal
M. Dorvault asserts, that M. Gannal preserves necessity of favouring us with theirnames ; not,
ophthalmia.
bodies by injecting a solutionof the acetate of alum 8. Augmentationof the secretive action of the of course, for publication, but as a pledgeof
through one of tike carotids, and then maceratingmucous membranes, especially of those lining the good faith.
the body for two or three daysin a similar saline genital
organs.
fluid. The injecting fluid is prepared by decom-
posing 9. Cerebral excitement, evinced by a mild intoxi-
cation, SIR JOHN FRANKLIN'S EXPEDITION.
the solution of 1,000 grammes of the sul-
phate and sometimes cerebralcongestion. ton
Charles- "

(CoDcladedfrom page 44.)

of alum, by a solution of 250 grammes of tbe Medical Journal^ May. In our last remarks we attempted to sbow the
acetate of lead. Another formula for M. GannaPs
IN FACIAL NEURALGIA.
liquidis as follows: 1,000grammes " of common
INDIAN HEMP
very greatdifBcultieswhich would attend the
Dr. Ruhbaum, of Potsdam, has employedthe
salt,1,000 grammes of alum, 500 of nitre,and endeavours of Sir John Franklin to proeure sus- tenance
Cannabis indica in facial neuralgia with the most
20,000 of water. Another solution, said to be em-
ployed for the crews of the Erebus and Terror,
results. Decided benefit was experi-
by him is a solutionof equalparts of the satisfactoiy
sulphate and chloruret of aluminium. M. Dupr^,
ence'lin more than thirtycases, and a number were supposing that no '"
perils by waters"^ bad long
relieved. He recommends from sixteen to ere this caused the destruction of the vessels
one of his competitors, injected the carbonic and entirely
twenty drops of the tincture, c ontaining about one
sulphurousacids,obtained by the action of sul- phurous and their men. We still believe in these difr
of the resinous extract,as a dose. Patients
acid on charcoal by heat ; and M. Sucquet grain the hopesbeld out by
under its influence were sometimes affected by culties, notwithstanding
used a solution of the chloruret of zinc. The
slight giddiness and lassitude; others were excited Sir John Richardson in his late narrative; the
last-named gained the prize.Repertoirede Phar- "

to greatmirth. more so, considering the number of persons to

CASTOR. INTEBNAL USE OF CBLOBOFORM. be provided for,and holding in view that it is a
M. Woehler has ascertained
t!iatfresh castor Dr. Hartshome has givenchloroform internally to
mere surmise that the missingexpedition has
owes itsodour to the presence
of a small quantity several patients
of in the It
Hospital Pennsylvania. found shelter at Victoria
of
diluted. In a painful
or Wollaston Lands,
phenic acid (phenol, hydrateof phenyle.)When must be largely neuralgic
castor is distilled with water, a few oily dropsmay affection of the head, a woman took 75 drops at the spotsto which Sir John Richardson states
be collected, which present the re-aotions of this nightwith much benefit, and continued to improve deer migrate over the ice in the spring, and which
body. The residue of thisdistillation givescrystals under itsuse. In rheumatism it provedan admir- able are the breeding-spots of vast flocks of snow
of benzoic acid and salicine. The mother waters substitute for Dover's powder, and in flatulent
geese. If this be so, at any rate it may be
of the crystallization of benzoic acid also present,colic it afibrded great relief. American Journal "

that here Sir John Franklin may be,and

with the ferric salts,the re-actionsof the salicylic of Medical Science. Dr. R. T. Strother gave 100 hoped
acid. Rkpertoire
"
de Pharmacie, dropsto a cholera patient.It relieved the cramp that he has not been iriven to like localities
and vomiting, and ultimately the man recovered. as was
RHEUMATIC AFFECTIONS OP THE STOBIACH- Parryin bis second voyage, of which it
Dr. R. B. Stone says, that affectionsof this kind "Western Journal, 1849. Dr. Brickell, of New
is stated, that during the months of March,
have been common duringthe pastyear in some Orleans, gave doses of 100 drops in a casejof
April, and May, when the Esquimauxdepend
partsof Illinois. He diagnosedthem from organictraumatic tetanus,without any decided advantage. "

disease of the organ, by observing,that a patientNew Orleans Medical and SurgicalJournal, 1849 ; mostlyon the capture of the seal and the

appearedworse every cold and damp day. He

and Dr. Wariner mentions a case of dysmenorrhoea, walrus, which is attended with the greatest culty
diffi-
treated them successfully with colchicum and bitter regarded as a neuralgia of the uterus, in which it and watchfulness on the ice,(notwith-standing
tonics. North- Western Medical and Surgical Journal, was resorted to with immediate relief. New Jersey "
"

tbe euriotity of the former animal,

1849. Medical Reporter,
OVARIOTOMY. Fide p. 44,) the whole tribe may be said
EPIDEMIC DYSENTERY.
Dr. Casselberry treats this disease with salines The ObstetricCommittee of the American Medi- cal to be literally in a state of starvation. We as
and cooling remedies. Instead of opiates he gives Association seem to approve of Dr. Tilt'spro- that neithermay such naked and
posal equally desire,
bicarbonate of soda,gr. xv. ; tartaric acid,gr. xii. ; to remove the dangerous and intractable
barren shores,as Parry, in his third voyage,
and Rochelle salts, 5j.every half-hour until free ovarian tumours, by cauterising one partof the ab-dominal
visited, be the resting-place of the Expedition,
evacuations are obtained. The action of the draught wall, and thus to excite an amount of in- flammation
he has found most benign,allaying febrilesym-
ptoms, which shallinsure adhesion between the and of which places it has been said diat they
and at the same time relieving the san-
guineous tumour and the parietal peritoneum, then to destroy were not but
merelydesolateof human beings,
engorgement of the mucous membrane of by the further use of caustic, the abdominal wall and
almost deprived of all animal and vegetable
the g^reat bowels. This treatment, he says, is in- that of tbe tumour, and thus evacuate the contents
finitely
the most efficient of any he has witnessed. of the latter. " The operation
" seems to the Com- life, a gloomy, sad, and melancbolyland.
"

Western Lancet. mittee to deserve-furthertrial." Transactions, 1840. (Barrow,

"
op. cit)We will trust,then,upon the
PATHOLOGY OP DYSMENORRH(EA. DIMINUTION OF FIBBINE BY AGITATION OF forlorn as
hopes, we may think them, that by
Professor Parker has treated a
lately number of BLOOD. other Sir John Franklin has pro-
one means or cured
cams of
dysmenorrhoeaupon the theoryproposed by In some experiments by M. Marchal, (deCalvi,) of an animal
the late Dr. John Macintosh,of Edinburgh,
that the itwould appear that agitationof blood out of the provisions"
provisions ture.
na-

lies in of fibrineappreciable But this beingeffected,

itis evident that
difficulty the narrowingof the os uteri ; body,diminished the quantity
great success has attended his practice.
He relieves methods.
by the ordinary Blood was animal food duringthe winter could not
drawn fh"m fresh
the strictureby introducing bougieof sufficient the in four divisions; the firstand last parts be obtained
; the summer must famish
a arm seasons
8126, precisely as in stricture of the urethra. He is drawn were mixed and agitated ; the second and
that supplywbich would require preserving for
satisfiedthat a great many cases of this distressing thirdparts allowed to stand ; in the first were
affection diminished in ten out of the greater portionof the year. It is true that,
dependupon mechanical obstruction, which, portion the fibrinewas
by this mode of treatment, may be relieved from twelve experiments.The two exceptions are not to some extent,animal flesh may be preserved
intense sufieringand the evils(?)of sterility. New explained.The degreeof diminution is not stated. fresh in northern climates,
"
by dmost freezing
York Annalist, The experiment beingreversed, a nd the second and
it and rubbingit externally with salt, as is
ORIGIN OF MOLE" thurd portions beingagitatedthe first and fourth
Dr. Lipscomb traces a close connexion between keptat rest-^the resultwas the same.
the development of these fleshy
masses in the uterus pitaux, Jan. 24.
Gaz, des Ho^ proved
in Parry's
"

also by the following fact,which oc-

"

second voyage. Referring

curred

to
I
 158 THE MEDICAL TIMEa

Christmas-day, it is said : "

Among the which Sir John Franklin must have been op-
"
posed Barrow) as itreally
" was " one continued nighty
luxuries was a joint of good English roast-beef, in the endeavour to maintain an ence
exist- lighted up only, and that partially, by the moon,
preserved by the outside being rubbed with for five winters in the Arctic Seae,we will and occasionally by the fleeting aurora borealis.
salt." "^e presume, however, that this was yet,for the sake of argument, suppose to be *fOn the 6th of October,"writes Parryof his
cooked before being taken from England; but, overcome. But, allowing it,what opinion, may second voyage, "there being now only an
under any circurastmces, we believe that ani- mal we ask, are we to give as to the conquering of hour's day-light remaining;" and of his third
"
food,prepared in the summer, even in the other obstacles, almost equally as great. The voyage, after an absence of 121 days the
"

would have to undergo such question relative to Sir John Franklin may visible at the ships. Perhaps,tiien,
polarregions, sun was

process in order to preserve

it for the longand assume the following position : Ts it probablefor four months
"
every year for the last ^^fe
Terror have
drearywinter,that it could not fairlycome that natives of Britain can maintain even a years, the crews of the Erebus and
under the denomination of freihmeat. Upon moderate standard of health,when subjected to not experienced the effects of solar light !

us, then,presses forcibly the question as to the the constant and often extreme diminution of We are not sufficientiy acquainted with the
means by which the crews of the Erebus and temperature, the negation for considerable actual arrangements made in Franklin's ships,
Terror have been protected from the ravages of periods, at intervals, of the direct rays of solar for the purpose of mitigating the inconveniences

scuTffy^ tL disease which

"
makes such havoc light, the peculiar hygienic, or rather anti- arising from the depositand accumulation of

amongst men when keptlongon salt dietaries, hygienicconditions, if we may so call them, moisture between the decks and in the berths,
and overwhelmed by which theyare obligedto live under, and the consequentupon the manner of sntifieially ing
heal-
wantingfresh vegetables,
the deprefsing emotions of the mind. No one will intense mental depressionas attendant or these places, and the necessity of confining
pretend, we assume, that fresh esculent vegetableconsequentupon a five years' residence in the the air, pregnantwith the exhaled vapour frosi
material is to be procured in the far North. Polar Seas,each successive year of which,in its the lungsand other sources, in order to main- tain
That the shipswere provided with the usual course, must exert a deteriorating influence a sufficienttemperature: to be able to say

preventives, likelemon-juice, citricacid,vine-gar, increasing in its ratio. In Parry's firstvoyage, what drawback such inconveniences may be
nitre, preserved yeast,sugar, "c. "c., ^in so early
"
as the 29th of October,the thermometer supposedto exert upon theircrews. But under
fine,with all those agentswhich may, in fellto 24'' below zero, that is,
some to a temperature any contrivances,
some must be exerted,we

way or odier,be made subservient to anti- 56^ colderthan the

freezing pointof the scaleof assume, since we believe that not onlymust
scorbutiopurposes," *no one will doubt; but, Fahrenheit. In the depthof winter it fell to the enclosed air be kept warm, but that the

admittingit to have of
been so, their period 44" below zero ; and on one day,a descent of atmosphere
outer must to a great extent be in- tentionally
duratioa must have had limit,we 55"" was experienced.Franklin, on the prevented from entering to displace
a presume, "
tinent
con-

longere ihis^ But, even if it had not, yet we of America, observed the thermometer to it. We have already alluded to Mr. Scsllen's
fresh the sur-
case, in which scurvy was ascribed by
know that such make-shifts as these for sink to 57^ and when the instrument was geon
; "

vegetable juises frequently fail,more especially hangingin his sleepingplaee, 16 feetfrom the fire, as partly due to the deposit of moisture in
when aien are living under very unfavourable but exposedto itsdirectradiation, it stood more his bed-place.In Parry'ssecond voyage, in
"
hygienioeonditions, and suffering extreme pression
de- than once, even in the daytime, at 47^ lower which Sylvester's
"
warming apparatus was
of the emotional faculties. In Bar- tiian the freezing pointof water. On two of employed,it is remarked, " We have never
row'i aeeount of Parry's firstvoyage, we read, these occasions the chronometers, which during been so free from moisture." This is sufficient,
that "
one case of scurvy was reportedon the the nightlayunder Mr. Hood's and Dr. Richar- however,to indicate tiiethen existence to sobm
2nd of January; Mr. Scallon, gunner of the son's pillows, stoppedwhile these officers were extent of the trouble.

Heela,oomplained of painsin his legs, and the dressing.But what are even such extremes as The last burthen laid upon the endeavouring
of the the above to those felt
appearancQ of his gums left no doubt by Commander Baek ? to live, in these drearyregionsof everlasting

symptomsbeingscorbutic, which Mr. Edwards, On the 17th of January,he noted the ther- mometerice,is that which arises from the influenceof
the surgeon, ascribedto the deposit of moisture at " 70^, or 102" below the freezingthe depressing emotions of the mind. This is
in his bed-plaee.'* Speakingof Parry's second
pointof water ! Under these extreme degreesa source of trouble pregnantwith evil to the
voyage, the same Author says : " The appear-
""
ance of cold which we have mentioned,it is dis- vital energies,
tressing and the slow but sure sapper of
but unequivocal well-
of scurvy, in some slight to touch any metallic substance with the very groundwork of the health and
symptoms, could scarcely be a subject of won-
der, the naked hand in the open air, it producing a beingof the men. In almost every polar ex*

considering the lengthof time the ships'feeling ofinterue heat and taking ofi*the skin. pedition which has wintered but once even in
had no other dependence than upon tiieirOne of Parry's out, the Arctic regions, the ingenuity and wisdom of
crews men, who incautiously went
own resources, unassisted, as theyhad been,by '" not
havingtime to put on his gloves, had his the commander seems to have been taxed to the
supplies of freshanti-scorbutic plantsor otiier fingers, in half an hour,so benumbed,and the very utmost in maintaining mental quietude^
vegetables, a case unparalleled in the annals of animation so completely suspended, that on his hope,and cheerfulness, and in banishing de*

navigation." Commander Lyon also alludes being taken on board by Mr. Edwards, and spondency. And this "
among a set of persons
to " some very severe cases of scurvy.'* havinghis hands plungedinto a basin of cold (andthose persons seamen, too)secludedfor an
But here onlytwo winterswere passed amid water, the surface of the latterwas immediatelyuneertain and indefinite periodfirom the rest of
the ioe,and,in Franklin'scase, the fifthisnow frozen by the intense cold thus suddenlycom- municatedthe world,havinglittleor no employmenthot
progressing! It is true,that, in Parry'sfirst to it." "It was that which is created to preventidleness, and
necessary, some
voyage, the Commander raised, i n his cabin,a time after, to resort to amputationof a partof subject to a degreeof tedious monotony illac- cording

quantity of mustard and cress, of which, even four fingers on one hand, and of three on the with their usual habits." "
(Parry.) By
in the severity winter,o f he could generally other." Alluding to the trapping of foxes in dint of great foresight and ability, however,
insure a cApat the end of the sixthor seventh Sir James Ross's late " divert*
voyage, the followingmuch was done in these voyages, in
day. This was used as a successful remedy in statement oecurs in that particular narrative of ing the mind from the gloomyprospect which
the of Mr. Scallon. But,ifsuch resources
ease it which came before us : " The poor littiewould sometimes
" obtrude itself on the stoutest
were within the range of Sur John Franklin's animals, in attemptingto eseape, tried to gnaw heart" (Parry.)But,ifso much required
" to be

powers, still, seed must have a limit to its the iron bars,when,in and the
many cases, theirtongues done to keepup the buoyancyof spirit
"tore, even if such a deseriptionof Arctic hor-
ticulture
adhered to the iron, and were frozen off, when breath of hopein men who were wintering but
could be mAde subservientto the wants theywere killedfirommotives of humanity." for one or two seasons onlyin the North,and
of tiian a hundred men.
more In the same With regardto the diminution of light,and under circumstances which they knew, con*
voyage, an anti-scorbutiobeer was issued, but, the negationof the directsolar rays, we may sidering their position,were not more pregnant
when the weather became excessively severe, remark,that in Sir James Ross'slateexcursion, with dangersthan mightbe or really vai anti-
cipated
the beer would not ferment so as to render the sun was not seen from the shipfrom the 9th : that required to be effectedto enable
itselfpalateable. of November untilthe 9th of February.Parry,the men to supportthe despondency and gloom
The difficulties to which we have thus al-
luded,
in his firstvoyage, was whollydeprived of the of five long winters, under conditions, in all

greatas we suppose them to be,and by sun for 84 days,which may be reckoned (says, possibility,of the extremast danger, and most
 THE MEDICAL TIMES. 159
forlorn alone be surmiiedby been of that
opinion, the a third
Fury'spassing each other'semaciated figures."None of us were '
contingencies,
can
to receive assistance,although
the task was
th- 86 who, like bave
ourselves, been not un- winter in the country would be extremelywilling
disproportioned to our strength.'
"

students of the
d'ligent "
theoryand practice"hazardous. He was induced
thus to express
Though we would maintain, then,the factof
of the north-west passage. himself from the great change he had observed such deterioration as we have alluded to
above,
Obstacles as the above circumstances might in the constitution of the officers and men of
that who have
we are fullyaware, men passed
"eem, d priori, of natives of
to the permitting the Heda, and by the appeartmce of some very only one or two winters in the North,on re-
turning
Britain to maintain an average standard of severe cases of scurvy since the summer had to this country, rapidlyrecover on
health and enjoymentin the Arctic regions, commenced. Long continuance on one
cular their homeward
parti- fair standard of
voyage a
when forced to winter there,yet practice has diet,almost total deprivation of fresh ve-
getablehealth.
But, alas I of what availall this,to the
proved that the of
early anticipation Parry and animal food, and the necessary and
supportof Franklin in the Polar regions during
" that a shipprovided with sufficient
food,warm close confinement for several months of each fivelongyears !
clothing, and fuel, might winter in the highestsevere winter,were undoubtedlythe causes of
latitude we have been in without materially the general alteration of constitutionwhich had
THE ROYAL MEDICAL
suffering either from cold or disease/' is ap- for some
parently time past been so evident. He con- ceived
AND CHIRURGTCAL SOCIETY, AND ITS
quitea correct one, and the results of exposure to the same and
deprivations PUBLISHED AND REJECTED PAPERS.
several voyages may be quotedin its confirma-
tion. confinement, the solitude of a singleship,and Wb recently laid before our readers a series
Parrystates of his firstvoyage : I had the painfulmonotony of a third winter,to men
"
of papers by Dr. John Taylor, of Huddersfield.
the happinessof seeing every officerand man whose health is precarious, would, in all pro-
bability,
Those treat of one of the most difficult
papers
on board both ships(withonlyone exception be attended with very seriousconse- quences."
subjects that can engage the attention of the
out of ninety-four persons)return to their Lieutenant Liddoii, in Parry's first
scientificphysicianthe value of remedial "

native country in as robnst health as when they voyage, is spoken of as having suffered from
agents in the treatment of disease. Let any
left it, after an absence of nearlyeighteensevere rheumatism,caused by the harassingman attempt to prove the power of a given
months." Parry,in his second voyage, passed circumstances and the increased cold,which drug to check the progress of a givendiseaae,
two winters favourably in the North, and Sir reduced the mercury to twelve degreesbelow and he will be astonished at the small amount
John Ross wintered three whole seasons there, the freezing point,and which broughthim to of positive evidence he can adduce in support
besidei passing nine months in the springand a very debilitated state. Concerningthe prin- cipal of its curativepretensions. How often do we
sammer. The state of health of all parties exploring expedition in the late voyage fancyourselves the conquerors, when Nature
engaged in the above expeditions apptormg of Sir James Ross, which left the ships in the has gained the victory for us? How often,
fullyto bear out Parry's"anticipation." We month of May to investigate North Somerset, from error in do we shout victory
diagnosis,
say appearing^ because we have yet to consider it was stated in the report we read, that on its with a shadow f
when we have been battling
this pointa littlemore fully ; but with respect return, Every one was on the sick-list
"
with
We congratulate the Profession,then, in
to what we have justsaid, and the accounts we the exception of Lieutenant M'Clintock." In
havingbefore them a model in English to follow,
have also of the comparative ease and comfort fact,whenever a party left a vessel, itis de-
scribed
in the difficult investigation to which we have
with which the extremes of cold and negation as being soon exhausted and knocked referred. When the of the
importance object,
of solar lightare borne, and of the generalup. It was clear that the men were capableand the judgmentand skill exhibitedin solving
physical welfare of the crews who have wintered of little duty or exertion in that pitiless clime the
question examined in those papers are
in the northern icyseas, when they have been beyondthe decks of the vessels. considered, too higha place cannot be assigned
well providedwith food,clothing, fuel,and Finally, we would remark that, after attentive them among the scientificmemoirs of Medicine.
amusement, we are willingto admit their studyof this subject, we have ourselves become The value of the results obtained by the
proper weightin the balance in regardto Sir impressed with the belief that we should find numerical method must rest in medicine, as in
John Franklin, if the following, which we shall
that,after a second winter has been passedin every other science, on the ability and honesty
urge, is permitted to have itsdue influence also,the Polar regions,a slow but very sure dimi- nution of the observer, and on the number of the facts
viz. : ^We do not perceive
" it to be neceasarily of vital energy and power would be from which his conclusions are drawn. Of the
involved in the fact of Britishseamen being visiblein those who have passedit. That this honestyand ability of Dr. Taylorno one enter- tains
able to bear one or two winterings in the Polar
diminution,thoughtardyand very gradual at a doubt ; and we think the number of
Seas with impunity, that theycan also do it for
first, would be likely to progress in an increased the cases analysed ^forty-" "sufficient for hit
fonr or ^^% such inclement seasons. The as-
sertion both as regardsrapidity and power, in
ratio, purpose. At any rate, if,with such opportu- nities
that they can do so appears to us relation to the time of
furtherdetention in the he he could collect
as enjoyed, only so
in the light of a gratuitous and rather an im- probable
North Polar regions; nay, we feel somewhat many, what must we think of the conclusions
aesamption, when we consider the inclined, in spite of what has been asserted, to of those who, with far fewer opportunities for
effects which an endurance of anti-hygienic believethat deteriorationto some extent of the observation, have ventured to speakin general
conditionsexerts upon the human organism.
powers of the human organismtakes placeeven terms!
In maintainingthis position, we are not before the periodwe have alluded to above. We repeat, we do not know a series of papen
alone, as we conceive basingour judgmentThat tuch deteriorationof health and
power is in which are displayeda more philosophie
upon ^priori or theoretic grounds. Before at- tempting
not at firstand easUyperceptible to thosewho mind, in appreciating the correct method of
to pass a third winter in the ice, suffer
it,is a probable conclusion, seeingthat conducting
" difficultinquiries in the science of
Parry,in his second voyage, requested "'
the speakinggenerallyall suffer it alike, and Medicine,
'
"
more ability %b an observer, or a
medical officersof the Fury to furnish/Itrnwith thus have no standard to
trytheir physiological sounder judgment in drawing conclusiona
theiropinion, as to the probableeffectthat a it possible
powers by. But were tiiata few from the facts observed. Nay, we are
thirdwinter passed in these regions would pro-
duce individualscould the whole time maintain the acquaintedwith only three Medical Essays
on the health of the officers and seamen maximnm of the powers they took with in ovr own language,which prove their
and marines of that ship, taking into consider-
ation them to these regionsof eternal snow, and Authors to possess .the same combination
every circumstance connected with their by it weekly measure the energies theirof of the highestental attributesof a physician,
m
situation." Mr. Edwards and Mr. Skeoch re-
companions, once gifted with their own we allude
" to Dr. Taylor's o wn Paperon the
portedy''thatduringthe last winter and sub- high standard,we doubt not but that they Causes of Pericarditis, Dr. Walshe's Report on
lequently, the aspectof the crew of the Fury would discoverthatPolar has quicklyPhthisis, and Dr. Jenner's Paperson Typhus
wintering
in general, together with the increased number a malignant influence on the vitalpowers of Fever,now in the course of publication in tkii
and character of the complaints^ strongly in- the British seaman.
dicated We shall closethis me- lancholyJournal. Yet the Council of the RoyalMedieo-
that the peculiarity of the climate and declined the
subject with the following quotations Chirurgical Societydeliberately
service was slowlyeffecting a serious decayof from Richardson
: "
publication of Dr. Taylor's Paper,and not
their constitutional powers." Commander but of many others of highmerit
"
Our own miseryhad stolen upon us by de^irees, onlyof that,
Lyon reported, that he had, "for some time,and we were accustomed to the
contemplation of and have ^presented the Fellows with a tiny
 160 THE MEDICAL TIMES.
tome, containingand it may be said,with-
" out TERGIVERSATION OF THE LANCET: "

speakingin any way slightingly of them "

inferiorto the one we have pub- Wr have been so amazed at the barefiiced tergiversationof the Lancet upon the subjectof the
productions lished,
and in no respectsuperior to several proceedings of the Collegeof Surgeonsand the National Institute, that,as Journalists,jealont
others of the rejected.If the Fellows do not of the honour and dignity of our vocation,we feel it to be our duty to placebefore the Profession
interfere, their Transactions must inevitably the evidence of one of the most flagrant instances of inconsistency that ever disgracedthe public
become a mere collection of extraordinary press. Behold the result of three short months! The servile adulator of Collegeliberalityverted
con-

an English edition of the German into the most rancorous denunciator of Collegeselfishness, the envious detractor of the policy
cases "
Ephe- "

merides. Accounts of animals with half brains,and principles

of the Institutemetamorphosed into the humbled flatterer and success.
of its intelligence

and children with no brains,are sure of a Bah I A court jester never vindicated his right
to his officeby so ridiculousa parodyon common-sense

place, and"
no one can object
to and truth. No
their originality. man but the Editor of the Lancet could ever cant and recant in a manner so bold and so

The wonderful histories of wonderful women unblushing

! We simpleas to imaginethat even now he says what he means
are not so ; for his mouthy
who sweat black, or of strange-visagedmen professions
an about
Independent Collegehave absolutelyno meaningapplicable to presentcircumstances,

who look blue, find instant insertion ; while draw-

ings and his clamorous repentanceis falsified by his insincerity. He sheds crocodile'stears. If such a man
of such faces, at the Fellows' expence, are can secure the support and confidence of the Profession, there can be no hope for a truthful and in- dependent
made, if the contributions are but endorsed by advocacy of the Profession'sinterest; and politicalprosiituiummust be the rule of Medical
the name of one of the few who rule the des- tiniesjournalism.We, at any rate,will never stoopto such proffigacy, and are resolved to expose it,on all oc-
casions,

of the Society.We trust the Fellows to public contempt

will be up and voting. The question is, not "LOOK ON THIS PICTURE! AND ON THAT!"
whether Dr. Seth Thomson and Mr. Charles LeadingArticles. Leading Articles;^
PROPOSBD REFORM IN THE CHARTER OF THE COLLBOE
INSOLENCE OF COUNCIL
THE TO THE
Hawkins, or Dr. Bashamand Mr. Erichsen, are INDEPENDENT COLLEOE
COLLEGE OF SUROEONS ; CONTEMPTIBLE DOINOS MEMBERS.
AND A New
fitter for the SecretaryshipMessrs. Johnson
" OF THE SO-CALLED NATIONAL INSTITUTE. NeCESSART
DESIRABLE. AND
On lookingat the terms Lookingto the odious letter; to the proposed
" **
of the advertisement, it
and Lane,or Messrs. Hewett and Toynbee,for
is hni too plainthat the old leaven is at work, and new regulations transmitted to Sir Georob Gret"
the Council,^butthe frteatprinciple of self-
"
that it is the guilty objectof these parties to place which are valuelesschaff'; looking to the insulting
election by those in office, or freedom of elec-
tion the Council of the College of Surgeons in a false Oration of Mr. Skry, addressed to the College
by the Fellows. Had the present system position, in order to found a new claim for the esta- ' geese,' we coald almost recant all that we have
advanced the real interests of the Society, the blishment of an additional Apothecaries'HalL recently said in favour of the Council. It was evidence
Earnestly do we admonish the Council of the Col- of our earnest desireto obtain an amieable settlement
Fellows might be unwilling to move in the
legeof Surgeonsto be on theirguard,and not to be of the affairsof the Collegeof Surgeons,on a basis
matter lest thev should replace those now in to have made
entrappedby three or fourumihUss, subtle intriguers, sufficiently liberaland eomprebensive,
officeby less able men ; but it has not ; and the The Qnmeil have manfully opened the question qf the that Institutionthe greatest and most powerfulme-
Royal Medical and Chirurgical Society i s fast Charier, and the concession will be duly appreciated by dicaland surgical College i n the world.
mafty thousands qf the Profession. It would be a real **
The ' geese'of the Council,ifwe may retort their
becominga bye-wordfor u\ that is unwise in
the conduct of a Medical Institution. A nd^ortune, as well as a disgrace^ if the efforts qfthe own phraseupon them, are plumingthemselves unon
puny creatures who have set this new projectin a few sleek and silly periods, in the fine writing of '

beacon to warn others, and not a light to guide motion could mar the
what we hope and believe are the the letterto the Institute! But who are eigoying
them. Should the Council unfortunately possess just intentions qf the Council^ hnd the ardent expecta- matter most? We answer, the Council of the Im-
sufficientinfluenceto determine the next elec- tion, tions of a very great majority qf the Profession. Since stitute, which the Council of the Colleob are

we do not hesitate to assert,that they these remarks were written, and within a few hours striving to render National. 71ie men who meet at
will add largelyto the success of the time of sending our Journal to press, our at- Hanover-savare have obtained a victory over the
of a Society
tention was directed to the following paragraph, pures' who *
shine' at Linooln's-inn-fields,
'
and they
which bids fair, ere long,to surpass them in which appearedin the DailyNews of Wednesday." will not be slow to improve theirvictory. We coniiea
everything but exclusiveness. The Profession allold antipathies and remem-
Lancet,No?. 24,1849. that,notwithstanding
must and will have a scientificSociety of their *' An
early insight into the objects of its promoters branoes,our sympathies are witn them rather than
own ; they will not submit to be ruled ovei by forewarned and forearmed us ; and we consider that with (he College Council,who have grossly betn^r^
a favoured few who fancythemselves heaven of "
we have at least effectually done away with thescheroe the interestsand rights theyshould have fosteredand
the knavish 'Principles.'The originators of protected."
save the mark I "the iUie of the Profession.
the projected worthless College may mourn the loss **
We, therefore,in conclusion, call tt|"on ISJDOOof
All these quibbles, so lowering to the ttatut of place and officialhonours,"-itsscribbling advo- our professional brethren to arisein their might, in-
of a Scientific society, would be avoided,if a cates, from the abyss of vexation and disappoint- telligence, and profesaional that
dignity," to assume
listcontaining the names of those thouglit snarl at those who have contributed nobleattitudeandhign position which belong to them
by ment, mav to
the Council to be most eligible for seats in the this result"theymay bay the moon *
with their as men
'
of science, learning, and usefulnesSv"intf to
rabid law wMch
body,were circulated some four or five written liowlings,~but
the edict is gone forth^-Uit demand, as with one mind, thai the degrading
governing on the wail" the College i f Apothecaries* *
never excludesPractitioners qftheir own dassfirom seats at the
weeks prior to the day of election ; if between and for
was, and never wiU be I! Council-boardof their own College, be /orthtoith
that date and the week preceding the election "May the openingof the Session of Parliament ever annihilated; and that, faUingin that demand,
any two Fellows were competent to forward the ere long announce to us a bright prospective /" their voices be heard throughout the whole length
name of one Fellow to the Secretary for inser-
tion iMmoet, Feb. 2, 1 8M. and breadth of the land,in claiming a Charter for an
that list; and, finally, independent College, which shell be dedicated
on if,before the to the government and protection of Praetitioneisin
day of election, a second
paper were circulated MBDICINB, surgery, SUd MIDWIFERY.
by the Society, containmgthe names of all Lancet,Feb. 28,1850.
those nominated as candidates for seats at the have been
Our readers vrill remember that, throughout the struggle with the College of Surgeons, we
Council,with the names of their proposers,
with vigourand firmness.
precise and decided in our views,and have not hesitated to declare our opinions
thus : Dr. A. proposed by the Council ; Dr. B. What has been
the result? That the Editor of the Lancet has been glad to learn from us the first
proposedby Dr. C. and Mr. B. The Fellows
principles of Medical legislation. He has stolen our ideas without acknowledgment almost re-written
might then severally pass a pen throughob- noxious "

names ; and although, doubtless, in a our Articles, shambled afterus from week to week with halting footsteps, and has nude our cold meats
largemajority
of cases, the men proposedby furnish forth his " marriagefeast." The Lancet has at last discovered that the General Practitioners
the Council would have a plurality of votes,yet
oughtto be eligible to a seat on the Council of the College of Surgeons, and in this opinion he only
the Society,as a body,would have a real voice
re-echoes our sentiments, declared in the subjoined quotation, and reiterated over and over againin the
in the election,and Uie decisions of a Council
pages of thisJournal. We appendthe following quotations, merelyto show that they.form the text of all
so elected would carry with tiiem that weight
the lancet has written upon the subject ; and that without rendering any thanks,or appending
a
which they now evidently lack. It is folly to us "

say the proposed alteration would lead to

reference to our Journal, at the bottom of his lucubrations, accordingto the rule adopted by all
intrigue and cabal, as if the respectable Journalists he is decking himself
"
with borrowed plumes.
"
presentsystem " de-
tellthem that the General Practitioners
producedthose bitter fruits. vocaiAnd we now unhesitatingly
" We
had not already express our unemdr
Let those,then, who cordially condemnation qfa proposition that would, if mand the legalrecognition qf the rightof controlIin|S
desire, not the
converted into law, exclude one and all qfthe leading the curricula of studyand examinations for their
ruin,but the renovation of the Royal Medical General Practitioners in this Metropolis and the Pro- own clas9; and that theirclaims in respectto Surgery
and Chirurgical Society, record their votes fences, however scieni^ and high in social station they they will never forego!Choose,then. Conoede a
againstthe nominee listof the Council. Let may be, from tltesuperiorhmours and privileges ^ College of General Practitioners, wiih a rightto
them do this, their own College,"" Medical Times,Feb. 9, 1850. examine in Surgery, or convert your own Institution
moreover, uninfluenced by per- sonal
into such a College. The Profession will not be
feeing,but animated solely, as we are, by Council-ridden any longer, but are resolved, in some
the desire to vindicate that the
greatprinciple, form,to have the management of their own affsiis.
rightof every publicbody to self-government. Medkal Times, Feb. 16,1850.
 162 THE MEDICAL TIMES.
*'
Pendingth" abienc* of catalogues, the prepara-
tions the present condition of the Hunterian collection, stake than those appertaining to their rights under
of the Museum were orallyexplained to risiters and the great accessionsit has received duringhis the Act of 1815, they might have deputed,whh
by the Conservator,whose styleand matter bespoke sble conservatorship. From the duties of this office perfect propriety, representatives
the of the Society

the genuineHunterian source from which he had Mr. Clift was allowed to retirewith a ftill salary, of Apothecaries to act for them, in whose judgment,

derived his knowledge of the nature and scope of the which had been progressively increased to 400L per "scretion,and enlightened policy,the Council of
few years before his decease,which took the Institute had the most implicit confidence.
collection. On every occasion, also,Mr. Cliffs time annum a

six 2nd. The Council of the National Institute, in

and knowledgewere at the serviceof all who, in the place on the 20th of June, 1849, weeks after that
furtherance of repeated resolutions, adoptedby large
of any subject of anatomy, physiology, of his wife,to whom he had been tenderly attached
investigation and influentialsocietiesand general
had oecasion to consult the Museum and united more than fifty years." meetings, h ave
or palseontdogy,
upon every occasion maintaiiwd that theyconsidered
under his charge. His own immediate contributions itessentialto a satisfectory settlement of the Medicsl
to science, at least those bearinghis name, are but THE COUNCIL OF THE NATIONAL Reform question, that the General Practitioners
few. Two only appear in the Transactions of the INSTITUTE TO THE COUNCIL OF THE should have the unrestricted rightto regulatethe
**
Royal Society; the firstis entitled Experiments tQ COLLEGE OF SURGEONS. education and examination of the canmdates for
"

ascertainthe Influence of the SpinalMarrow on the admission into theirbody,in every branch of medical
Action of the Heart in Fishes,"and is printed in Gentlemen, I am directed,
"
by the Council of science, subject only, in common with other corporate
the 105th volume of the Philosophical Transactions the National Instituteof Medicine, Snrgery,and and educational bodies,to the generalsuperrisioa
in the year 1815 ; the second and last contribution Midwifery, to acknowledge the receipt o f a letter, of a controlling Council; and throughout "e whole
of some bearingdate the 5th of Februaryinstant, in which of the discussionswhich have taken placeat the
to the Royal Societywas his Description
"

the Council of the College desire to express their Conferences of the RoyalCollege of Physieians on
Fossil Bones found in the Caverns at Oreston,"
printed in the volume for the year 1823. regret, that ther cannot adoptthe views set forthin this subject, their representatives, aa the Counetl
the "Suggestions" submitted to the Council by of the Institute underatand, have uneauivocally
"
Both papers are characterised by the clearness
Mr. Bottomley, the Chairman of the Committee oifclaimed thisright on public and profesfdonsJ grounds,
And simplicity of the stylein which the "cts and
Associated Sorgeons of England,at the interview a rightwhich, in the opinion of the Council of the
experimentsare narrated, and by the soundness of
which took place between the President and Institute, has been rendered stillmore essentially
the eonclosions deduced from them. Vice-Presidents of the College, and a Deputationnecessary by the arbitrary establishment of ths Fel-
lowship
"
By the judiciom choice of the subjectof his appointed by a meetingof delegates from various in the RoyalCollege of Sorgeons.
experiments, and the care and skillwith which they Medical bodies desirousof promoting Medical Re- form, Furthermore, in all their communications with
were performed, Mr. Clift,in the first of these and at which interviewthe suggestions alluded the Government, the Council of the Institutehave
papers, established, in contravention of the conclu-
sions to were presented. invariably claimed the rightto test the candidates
to which M. Le Gallois had arrived, that the A copy of ibis communication has been laid be- fore for theirdiplomain all branches of medical science
action of the heart oontinues long after the brain the Deputation. theymight deem necessary, and the justice and ez-
The Council of the National Institutedeem it pe"uency of this claim has been invariably admitted.
and spinalmarrow are destroyed,and stilllonger
when the brain is removed without previous injuryunnecessary, on the presentoccasion,to make any 8rd. It has longbeen known to the Profession
to itssubstance: togetherwith some interesting
remark upon the reasons assigned
lateral
col- by the Council of that the Society of Apothecaries, with great pnblie
the College of Surgeons, in supportof theirdeter- minationspirit, and a disinterestedness that deserves Ae
conclusions.
to reject Mr. Bottomley's Suggestions."
"
highestcommendation, consent to relmquiahthe
"
Soon afterthe publication of these Menioin, Mr. The Council of the National Institutelimit
their powers deputedto them by the Apothecaries' Ast
Clift was elected a Fellow of the Royal Society, ohservatioiisin replyto that portion of the letter of 1815, solely
upon the condition that the GennsI
(May 8th, 1828,) and served on the Council of which bears reference to the heads" or
" '"
priu- Practitioneraare to possess an eflBeientcontrolover
the Society,in the years 1838 and 1834. He ciples" agreedto by them at the Conferences held the education and qualifications of their own diss,
communicated some memoirs to the Geologicalat the Royal College of Physicians, conjointly with and especially that "eyshall, in any future arrange*
Society,two of which, ''On the Fossil Remains the Medical Corporations, and designed to be in-
corporated
ment of the Profession, be under no restriction wl"t"
from the Irawaddi' and '
On the Megatherium,' are as a Bill for the^regulation of the Medi-
cal ever in the examination of theircandidates.
in the Transactions of that body. Most
published Profession. 4th. The Council of the Institute can have no
of the works or memoirs,however, on the fossilre- The Council of the National Institute againde- clare, hesitationin declaring, that the
mains most positively,
of the higher classesof animals, which have that theyfully a bide by the arrangement, as to the Conference Committee, holding
parties its
set forth in the ** heads" or " principles" adopted meetingsat the RoyalCollegeof Physicians
appearedsince Sir Everard Home's firstpaper on have
the Proteosaurus, in the Transactions of the Royal
by the Conference Committee, and that they are fully and completely recognised this principle. Not
willing to assist in obtaining a Legislative measure, onlywere the proceedings of the Conference Com- mittee
Society for 1814, until within a recent period,founded
Mr. Clift,either for upon those principles, providedthe other originally founded upon it,but the Resolu- tion
are more or less indebted to
assenting parties adhere to them in all their in- tegrity. of the 2nd of the formal act of
his determination of the fossils described In May,1849, last
the Conference,was framed and assented to for no
them, or for his aocnrate and beantiful figures It is,therefore, with feelings of the utmost sur- prise other purpose than to ratify this principle and to
of them. Numerous and hearty are the acknow-
ledgments and astonishment that the Council of the
satisfy the Council of the RoyalCollege "^Snigeoos
by their respective authors to Mr. National Institutehave
perusedthe eighthpara- graph as to Its operation as respects the diploma. In eoi*
Clift for this valuable assistance. In Dr. Man- in the letter recentlyreceived from the roborationof this
statement,the Coandl of the In- stitute
tell'smemoir on the Iguanodon, poblished in oar Council of the College of Surgeons, and which para-graph callthe attentionof the Conncil of the Boysl
Transactions in 1825, the author says, ' Among the is as follows: "

o f
College Surgeonsto the following Memorandum,
collected, some, however, were
''
specimenslately so 8th.The College of Surgeonsconsented originally read by the representatives of the General Piscti-
perfect, that I resolvedto availmyself of the obligingto the institutionof a new College, as one for the tionen to the lA)rdAdvocate, in the presence of the
to whose kindness and liberality I more efficient performance of the duties confided to other
ofierof Mr. Clift, parties to the Conference, on the 28th April*
the Society of Apothecaries."
hold myselfparticularly indebted,to assistme in 1849 :"
the fossil teetb with thoae of the recent
The Coimcil of the National Institute have no "
Copt Memorandum.
comparing hesitationin affirming, that thisinterpretation
of
of the Royal Collegeof of the of the General Pnctitioacn
Lacertse in the Museum "
"
The representatives
principles" is totally at variance with the tenor of
in the Conference Committee, respectfully represent
Surgeons. The result of this examination proved the at the nnmerons
for in Iguana discovered proceedings confbreneesfrom
to^our Lordship, that they consider it essential to a
highlysatisihctory, an we
which the "principles in question emanated, and satisfactory settlement of the Medical Reform Ques- tion,
teeth possessing the form and structure of the fossil
theyparticularly directthe attentionof the Conncil that the General Practitionersshould have the
specimens.' And Baron Cuvier, in the concludingof the the education and
Collegeof Surgeons to the following marks unrestricted rlaht to regulate
re-
volume of his great work on ' Fossil Remains,' ae" :" examination of the Candidates for admission into
knowledgeshis obligationafor many drawings, 1st The Council of the Institutewere invited to their body,in every branch of Medical science, ject
sub-
'fsitespar M. Clift,dont le beau talenta enrichiee nominate two General Practitioners, onlv to the general supervision of the Controlling
beingmembers Council and that throughout the whole of the dis-
cussions
reeneilde tant de planches non moins rsmarquabletof the Collegeof Surgeonsand Licentiates of the ;
which have taken plaeeon thissubject, they
par leur ex^ention que par leur fid4lit^' Society of Apothecaries, to act specially as the re-
presentatives daimsd
have upon every occasion unequivocally
"To return, however, to the more immediate of the General Practitioners at the
this rights on publio and professional grounds ; and
field of Mr; Clift'slabours,it is recorded in the Conference Committee, in accordance with the sug- gestion they believe it has been fully conaideredand con-ceded

Museum the of the RightHonourable Sir GeoigeG^y, by all parties.

editionof the Synopais o f the of Royal
the Secretary of State for tJieHome Department; **
They furtherrespectfully repretent to your Lord-
ship
College of Surgeons,published by the Council in
which invitationwas acceptedand responded to by that they'deemitessentialto the iMrmomoiis
1846,that,'under Mr. Clift'ssuperintendence, the
of a new Act of Parliament,and for the
the Council of the Institutein deputing two of their working
remoral of the collectionfrom Castle-street, Leu of any future misundentanding,tbstfor
the
body,possessing requisite qualifications, to present
re- prevention
eester-square, to a temporary place of deposit i n
them ; ^not as Apothecaries, who were
obvious reasons this right should be recordedsno
"
al* to be
Lincoln's-inn-fields; in 1806,and thence to the Mu- seum duly provided for in the Charter proposed
readyrepresented at the Conference, but as General
of the College 1818, was
in effected without Practitionerain ranted to the General Practitioners, and alsoio the
the slightest damage to any of the frailand delicate
medicine,surgery, and midwifery 5
; Let of Parliament.
thus clearly indicating the distinction, ab imtio,
snrgerv,on soy
**
"
Without such a record including
preparations of which it,in a great part,consists.'between the
Society of Apothecaries and the Ge- neral appeal to the Supreme Council they would be un- able
And the best testimony to the exemplary fulfilment Practitioners; had itbeen otherwise,and had to sustain thia right,and the omission of tns
by Mr. Cliftof his r"qponsible dutiesisaffordedby the Council of the Institute no other intaveitsat wocd ' fuiiery'
; aUogether i n these documentii voum
 THE MEDICAL TIMES. 163
pUee ie th" bands of any iwrty who mightoonsider Practitionersof Medicine,Surgery, and Midwiferyhoped that the Senate would maintain that hick
the interestsof the General Praetitionersas opposed do,and of the part of those whose
superiority on standard which they had so wisely established, as the
to their own interests, a power not only of depress-
ing education is limited to one branch,and whose prac- tice, onlysolid basisof the reputation of their University*
the education of the General Practitioneras re- spects
if the Fellowship be of any value at all,ought The University of London had existed twelve yearsw
sureery; but alao respects the other
is a mani"st its graduates
as
to be limited to that of between 500 and 600; it had
branches of Medical seience and practice, pure Surgery, were
comprisedinconsistency, and can but prove offensiveto every thirty colleges in the United Kingdom ; connected
in the terans saed'oine, or medicine and midwifery.

"James Bird. right-minded individual in the Profession. with it were numerous medical schools,and yet,
""
AprU 28th,1849. Henry Ancbll/' To that portion of the Letter from the Council of great and important as was the actual position of
The Te"ohition of the 2nd of May, above re- ferred
the College, in which it is suggested that the future their Metropolitan University, itsvery existence was
to, and agreed to by the Conference Com- mittee education and examination of the General Practi- tioners quite unknown to the great majority of intelligent
unanimoasly, was as follows : "
should be vested in the Colleges of Physi-
cians men in England. Why was their University known
un-

(CopyO and Surgeons, the Council of the Instituteen- tertain ? One greatreason was, that instead oi pos- sessing
"
Tliat the Council of the RoyalCollege of Gene-
ral the same objections as heretofore, which jections
ob- a noble edifice, becoming MetropoHtan
a
Practitioners shall have the power to directthe theirdwelling-plaee
wete most explicitly and efiectively placed University, was up- stairs,aoove
entire coarse of study to be followed, and to test the before the late Government, when Sir James Gra- ham's a School of Design;their apartments were quite
competency of the candidates for the diploma of the Medical Bills were under discussion. incapable of accommodating the candidates ; indeed,
College by such examinations as it may deem neces- sary In conclusion, the Council of the Instituteregret the senate had been obliged, for the matriculation
priorto their admission into the said College.
"
that an important and influentialbody, as the Coun- cil examination,to borrow one room firom the Schoot
Bat it IS clearly understood by all the parties
of the RoyalCollege of Surgeons undoubtedly is, of Designand another from King'sCollege.How
assentingto thisresolution, that the competency of
the persons examined should have repudiated t he "principles" u
mously
nani- could those examinations be efficientunless the
to practise surgery shallnot
be speci6edin the diploma, such certificate of com-
petency agreedto by the Conference Committee; examiners possessed an adequate Examination-hall /
in smrgery beingprovided for by the subse-quent and as, from the tenor of the Letter of the Council Many of the petty towns in Germany possessed
examination at toe Royal College geons."of the College,
of Sur- the course taken by the Council is magnificent edifices in their Universities, yet this,
likely to interrupt, if not to terminate, the existing the Metropolitan University of this greatkingdom,
The Council of the Institutedesire, without com-promising
negotiations, the Council of the Institutefeel it a in the greatest of cities, possessedno University
their opinions to the propriety of dutyto themselves and to the publicbuilding.Mighttheynot hopethat this greatwant
as
individually,
creating an Tnatitntionthat should comprise, within at large, who are most deeplyinterestedin would be speedily and that theywould, em
ing,
possess- supplied,
its own limits,the entire range of Medical and edifice worthyof thia
not merelya limited number of well-educated long, possess a University
Surgicalknowledge,to remind the Council of the practitioners in Surgeryf but a largeclass of com Metropolis, that would at once proclaim to sll the
Collegeof Surgeons, that theyhave,in conjunction pletely educated and thoroughly competent General existence of the University of London t The other
with the other bodies, admitted the fact adverted to Practitionen of Medicine,Surgery, and Midwifery,greatreason for the indefiniteposition of the Uni-
versity
in the letterof the College of Surgeons, namely,that "to declare that theyare firmly resolved to main-tain, was the want of completeorganisation. At
many of those persons preparing themsel vesforgeneral both in and out of Pailiament,their rightto presentthe graduates had no share in the govern- ment
practice, had, for years past,voluntarily soughtthe the unrestrictedexamination of the Candidates for of the University, and totk no recognised part
diploma of the Collegeas the best guaranteeof generalpractice, that such examinations comprisein promoting its weHhre. The OovemBsent and the
their surgical qualifications ; and the Council of the all subjects essential to or connected with the due Senate had founded the Univeivity with great
Institute, in adopting the '' principles'* agreedto and efficientpractice of the Profession, and that the judgment and success, and had createrilin the
at the Royal College of Physicians, consented to an efibrtsof the Institutewill never in the smallest existing 550 Graduates the means of assisting and
arrangement, by which it is providedthat every degreerelax untilthis act of justice is accomplished, strengthening the Senate by their co-opera- tion.
future General Practitioner, without exception, eitherby a completechange of the Constitution of of proper
Why should not the Graduates
should possess, in addition to his own diploma,the the Royal College of Surgeons, or by the institution standing and position be called into convocation t
diplomaof the RoyalCollege of Surgeons also. of a new of General Practitionersin Their interest in the honour, reputation, and use-
RoyalCollege "
A arrangement of the Medical Profession, inalienable. In nuun*
new
Medicine,Surgery, and Midwifery. fulnessof the Univenity was
now rendered absolutely indispensable by the ano- I have the honour to be,Gentlemen, taining the reputation of the University theymain"
maloaa state of the existing laws, the irregularities Your most obedient Servant, tained their own ; for to the Universitytheyowed
of practice^ and the discordant opinkmsprevailing, George Ross, Secretary, their academical statns. The Graduates unite
as well amongst the Corporations as the individual The National Instituteof Medicine, in the greatpurpose of beingadmitted to a
heartily
members of the Profession, must be,in the opinion and Midwifery, share in the government of the University, a posi-
tion
Surgery,
of the Council of the Institute-^sn arrangement in- volving4, Hanover-square, Feb. 16, 1850. to which they were entitled by their number,
mutual concessions, or a Ye-organisation of theirstanding, and, above all,their interest in the
the Profession upon an entirely new basis,irre-
spective welfare and high standing of the University. The
of Corporate interests. GENERAL MEETING
Chairman, in conclusion, feltassured that tiieGra- duates
The Council of the National Institutehave inva- riably OP THE at that meetingwould, their aagadty,
conducted their negotiations with the Medical GRADUATES OF THE UNIVERSITY
b]^
theirmoderation,and their resolution, in aimingat
Corporations in the spirit of concession, and have OF LONDON. the attainment of a groatpurpose, prove to the Go- vernment,
employed their best efRnrts to temper the sanguine the senate of the Univenity, and the
expectations of the greatbodytheyrepresent ; it is, A large and influential meetingof the Graduates world that theywere entiUed to that placein Con- vocation
therefore, with regret,and some serious apprehen-
sions of the Univenityof London was held on Tuesday which theyso earnestly desired.
for the future tranquillity and well-being of eveningat the Freemason's Tavern, " the chief
The Secretary in Arts and Laws havingread the
the Profession, that theyobserve that so little of this object of the meetingbeingto promote the admis- sion
Report of the Committee,
spirit pervades the Council of the RoyalCollege of of the graduates to Corporate powen in the
wheie theyhave at presentno voice. Dr. Storrar moved the flnt resolution: "

Surgeonsof England. University,

!nie Council of the Institute cannot avoid ex- pressing Dr. Sibson, on taking the chair,remarked, ''
That the Graduates approve of the courae sued
pur-
their surprise at the general tone of the that all present would feel witiihim that they by the Committee,in endeavouring to carry out

eommunication theyhave had the honour to receive had met, not in the cause of disorder and agi- tation, the principles agreedupon at the lastGeneral Meet- ing,
viz." That the Graduates shall in future form a
from the Council of the RoyalCollege of Surgeons, but in that of order and organisation,
part of the Body Corporate of the Univeraityr-that
and more particularly at the assumptiontherein All the graduates presentknew that their degreesthe of the Univenityshall consistof a
government
contained,that the recently created classof Fellows were of greatintrinsicvalue,havingbeen boughtat a Senate, and a Convocation : the lastto
Chancellor,
are of a highergradethan the greatbody of Medi- cal the highest price the priceof knowledgeand in-
" tellectbe composed of allGraduates of certain sunding ;
sjid Surgical Practitioners who have not been Notwithstanding this,the graduates were that eventually the Senate shall be elected by Con- vocation
admitted within the paleof that arbitrary tion.
distinc- placedin thisunfortunate positionthat while they
"

; that all alterationain the fundamental law

The Council of the Institutemost respectfully were themselves acquainted with the value of their of the Univenity shall require the assent of Convo-
cation
lemind the Council of the College of Surgeons, that degrees, theirimportance was unknown to the world ; that while the General Executive managa-
the gentlemen whom the latterhave thoughtproper at large.They had the mortification to find,that ment of the Univenityshall be oonfided to the
Senate,itshallbe suljectin certain cases to the teto
to regardaa belongin g to a gradeinfirior to that of the titleof M.D. conferred by the London Univer- sity,
of Convocation."
the Fellows, possess, in addiiitm to the quallfleations after examinations perhaps more testing of
in Surgerygiven by their College,certificates of knowledge than those of any other University, did Mr. GeorgeJessel,M.A.,in seconding *the ret"^-
ordinarylution, drew attentionto the factthat the Graduates
competency also in Medicine trndMidwifery,obtained not rank,in general estimation, beforemere
by a strict examination on those subjects. The degrees, conierred, after very slight exami had never asked to control the executive adminii-
perhaps,
Council of the Instituteregardthe statement of the nations, or even aflernone at all. The highintrinsic tration of the University. They would certainly
Council of the College of Surgeonsas calculated to value of their degrees was due to the severity of form as competentan electoralbody as most bodies,
mislead the publicat large ; and theyfeelthem- selves theirexaminations, which could onlybe answered by whether national or academical. The Senate,at all
compelled to ramind the Council,that,in a much mental cultivation, and for this theywere events, mighthave indicated when the time would
Profieasionwhich 4e facto, and even to grateful to the Senate and the Examiners. In the arrive for considering the claims of the Graduates,
according
of the highest as theymightnot have been found eitherprecipitate
one authorities of their own body, fnture career of the University, to meet the develop-
ing
'thelate Mr. Abernethy,) is one and indivisible, the wants of the times,it might be necessary to or unreasonable, had theyhad any fkir assurance
assumption of inferiority of gradeon the part of a grant degreesin Sciences as well as in Arts and on this point.
class of individuals who have been educated in,and Medicine ; but whatever degreeswere granted, Mr. Quain, LL.B.,moved, and Dr. Maekensie
actually practise,all its branches, as the General whatever their nature or title,
it was to be earnestly
seconded,the second reaolution.
 164 THE MEDICAL TIMES.
"That this meetingrecommends thatthe following for a new Charter,submitted to Sir GeorgeGrey hoemeopathy.A goodaccount of Dr. Semelweisa's
Declaration be signed by the graduates, viz. :" by the Committee. Observations on the causes'of the Puerperal Fever
***
That one great principle recognised by the Go- vernmentDr. Storrar stated what had been done. The
of Vienna, by Dr. Routh. An able paper by Mr.
on tne foundation of the Universityof Bill had been referred to a
of Sir James Graham of
London, was to accord to the new University "
an Rainey,on the Minute Anatomy the.Lung of
Select Committee, of which the Lord Advocate was
equality in allrespectwith the ancient Universities,
Chairman. The claims of Oxford and Cambridge,
the Bird.
freed from exclusions and religious distinctions."
as regarded the faculty of medicine A thhrd paper, by Mr. Toynbee,on the Diseasea
**
*
That,accordingto the present Constitution of whose position
the University of London, the Senate forms the Cor- insignificant, compared to that held by the of the Ear ; if possible, excelling his former Essays
poratewas
Body,and not only administers all itsaffairs, University of London, had been urgedbefore the in intrinsicvalue ; and some lengthyremarks by
but has practically a large power of itsCon-
altering stitution Committee. Nothing was done by the Senate till Dr. Webster, on the Causes and Morbid Anatomy
by petitioning for and accepting such new the Graduates moved. The Committee had in-duced
of Mental Diseases.
Charters as Her Majesty may be pleasedto f^ant the Senate to enter a caveat against the new
"'That the Members of the Senate not beingcon- Dr. Garrod has contributed a short paper, con- taining
nected Charter claimed by the Collegeof Physicians, to
with the University by education, have a less and Hodgkin, to be examined the importantannouncement, that he has
depute Drs. Billing
directpersonal interest in its prosperity than those before the sufier-
Parliamentary Committee, and to send discoveredoxalic acid in the blood of a man
dependent on it for their academic rank.
*' '
That the Graduates are the persons chiefly a Deputation
terested
in-
to Sir GeorgeGrey. The Committee ing from chronic hiccupand vomiting.
in the welfare and honorable reputation of had also sent him (Dr.Storrar) and Dr. Barnes, to In addition to the above, the Transactions tain
con-

the University, yet have no corporate existence, and be examined before the Lord Advocate's Committee, some four or five extraordinary or ordinary
are not admitted to any voice in University affairs. and had themselves sent a Deputation t o the Home
cases, which would have been as appropriately
*" *
That while the undersignedaclcnowledge, with Office. The Committee had also broughtto light
in the pages of a weeklyJournal.
gratitude, the services rendered to the Universitv a letter from Lord Monteagle, when Chancellor of the placed
by itsfounders and present authorities, and admit
Exchequer ,tothe Council of University College. This
that some Constitutionlike the present was neces- sary lettercontained the contract made between Govern- ment OORRE8PONDBNOB.
at its outset, theyare convinced,that such a the latter
and University College, when gave up
Constitution was not intended to endure beyond its claim to be made a University. It was then agreed, ERRATA.
the time when the number of the Graduates would
on the faith of the Government, that the new versity
Uni-
affordthe materials for establishing the University
and should have equal privileges with Oxford THE WESTMINSTER MEDICAL SOCIETY.
upon a wider mors permanent basis.
^ '
That the undersigned are of opinion Uhat the and Cambridge. Sir G. Grey admitted the con- tract. LETTER OF SIR B. BRODIB.

lapseof further time will not tend to secure a more Sir J. Graham's Bill was not proceeded [To the Editor of the Medical Timei.]
efficient assemblyof Graduates,as every year is,in with, and the Committee were now looking for a SiRy"A friend has just now called my attention
their present unorsanised state,loosening the con-
nexion promisedBill of the Lord Advocate this Session. to an articlein the Medical Times of thisdav, pur- porting
between the holders of degrees,weakening These were the claims of the Committee to confi- to be a report of observations made by my-self
theirinterestin the University, and lessening their fidence. It had made at a meeting of the Weitmiiiscer Medical So- ciety,
was quite true they not terms
which was then under
knowledge of itsaffairs. with the Collegeof Physicians. T he reduction of relating to a subject
** *
That, as the number of the Graduates now discussion.
fees which could have been obtained was very considerable,
in-
amounts to 546,and the number of Undergraduates Your reporter has laboured under a mistake. I
and the Collegewould stillhave
to 802, including112 who have passedthe first Ex- amination have not been present at a meeting of the West- minster
for the degreeof Bachelor of Medicine, required two out of their presentthree examina- tions. Societyfor a long time past ; and I never
the undersigned consider that tiietime has now come This would not have placedLondon Gra- duates made the observations to which I allude.
when they may justly claim to be no longerexcluded on a par with those of Oxford and Cambridge. I am, Sir"your obedient servant,
from the body corporate of the University. They would have insistedon extendingtheir power B. C. Brodie.
***
That the fact that the Graduates do not possess over Englandand Wales, thereby imposingburdens 14,SavUle-row, Feb. 28,1850.
or collective v oice in the University tends from which the latterwere
any power on country Graduates,
to impair the value of their degrees, and to lower at presentfree. Equalitywith Oxford and Cam- bridge, LETTER OF MR. HAYNB8 WALTON.
their social standingas compared with that of the [To the Editor of the Medlesl Timet.]
as guaranteed by express contract,was the
Graduates of the other English Universities; and
principle of the Committee. Obtaining that, and "
Sir, In the report of the proceedingsof the
that a change of constitutionin this respect is likely Westminster Medical Society,publiabed in your
for the dignity of the University
to secure for theirdegrees a higher and more widely-regard tively last
impera-
Number, there is a notice of my havingspoken;
required them not to make such terms as
spreadreputation. and so gross is the misrepresentation of theparu of
alone within their reach with the Collegeof
** *
That the simpleadmission to the present Senate, were my speechto which it refers,that I feelit neces- sary,
of individual Graduates, is not, in theopinionof the Physicians. to correct iL lam made to say, that/ con- sider
undersigned, calculated to secure an the advantages The resolutionwas then passed, onlythree hands the dangerin fistulous sores rather to dependon the
which would resultirom investing the Graduates with beingheld up for the amendment. probableextension of the disease into the prostate.It
corporate powers. Mr. Bagshot, M.A., and the Rev. R. H. Hutton, should be, *"That a patient, with perineud fistulse, is
" "
The undersigned, therefore, desire M. A., then moved a resolution, of regret by no means free from attacks of retentionof urine,
earnestly expressive
that such a change may be made in the Con- stitution that the Senate had accepted a supplemental Charter and its immediately attendant dangers; but, that
increaseof the almost certainly'
of the Universityas. shall at once lastJune. By that Charter theywere empoweredthe greaterevil is the
admit the Graduates into the Corporate to confer certificates existing disease of the prostate and bladder. In
of proficiency in mere ties
speciali- the catheter is i^ten
Body, with such share in its government as on men who were not graduates, and who had hoipitals passed fora longtime use"
a fair
'*
may be deemed proper.* lessly : Ihtrrfo^, after triai^tfacure be not effected*
not obtained a liberaleducation. This was sistent
incon-
Mr. Smith Osier,LL.B., in moving the third titeoperation shumid be performed,** **
My knowledgeof
with the character and position of a Uni-
versity. these cases is derived nrom hospital practice : until
lesolution, which was seconded by Mr. Greenwood, Mere licentiatesin practical engineering, there is a passage for the urine hy the natural chan- nel
B.A.,impressed upon the graduates that,while the mining,and such like,ought not to be identifidl there can be no true amelioration in the patient's
discussion proceeded between the Committee and with it. The
University required from graduates in condition;and I assert my opinion,that after
the Senate,individual graduates had less power of Law and Medicine, that they should have passed proper, sufilcient, but ineffectualattempts to enter
aidingthe movement. Now alltheirexertions were
introductory examinations showingthat theywere the bladder,our patient's welfare is best attended
wanted. He particularly called attentionto the im- portance
men of liberaleducation. to by making a penrasai division of the stric- ture."
of inducingthe Colleges of the Univer-
sity, The resolution was It is not, however, mose dangerous than
supported by Messrs. Case, ** It
is not equalin severitv to litho- tomy,
throughtheir authorities, to make representa-
tions M.A", Roscoe,B.A., and Robson, B.A., and excited Uthotomy.
to the Senate. He moved, nor is it as dangerous, in which the prin- cipal
"

the greatest interest among the graduates present,

**
That the Graduates, while they regretthe indis-
danger is connected wiUi the removal of the
positionbut owingto the lateness of the hour,and the pre- vious stone from the bladder.*' The operation
of the Senate to assistthem, pledge selves
them-
qfcutting is
depaiture of many of the graduates, Mr. Bag- advisable where a catheter can he introduced, tf^the
to continue their exertions to attain their shot consented to withdraw it
stricture be untUlatable, *" But I do think,where we
proper position in the University, and authorise the After a vote of thanks to the Chairman,which have a stricturethat is next to impassable, the
Committee to take such stepsas they shalljudgebest
was carried by acclamation, the meetingseparated.patient suffering severely from the use of the catheter,
calculatedto accomplish this object." the general health breaking, the urinary apparatus
Dr. Brinton and Dr. Manson moved and seconded posterior to the stricturediseased,the sooner the
the fourth resolution. RBVIBWS. perinsBum is opened, and the canal established, the
"
That the Committee be instructed to press the
betterfor the unfortunate sufferer." He desired to
Medico- Chirurgieal Transactumt. Published by the hear Mr, Wade's opiman on these cases:"'*! do uot
claims of the Medical Graduates upon the Lesida-
ture,inthe event of any changesbeing contemplated Royal Medical and Chirurgieal Society don. consider myself entitled to speak on the use of
of Lon-
in the existing constitution of the Medical Pro- fession." Vol.XXXIL caustio potash in the treatment of stricture, except
1849.
to abuse it. Of iu efficiency, I have had no expe- rience
The present Volume of the Society consists of several examples. I should
; of itsmischief,
Dr. Savageand Dr. Routh moved an ment,
amend- only178 pages. It contains a very indiflferent like to hear Mr. Wade's the subject."
paper opinion on
calling on the Committee to put themselves
by Dr. Basham, on the employment;of Nitrate of I am. Sir,your obedient servant.
in communication with the College of Physicians Haymbs Walton.
Potash in Acute Rheumatism. "
One,'two, or even
and other medical bodies. They entered into long
statements of their own endeavours to induce the three ounces of the nitrate, freelydiluted, (i. e., LETTER OF MR. WADE.
Committee to take this course. They had also ap- about 1 oz. to 1 qt of water,) may be taken in the
plied [To the Editor of the Medical Times.]
to the Senate on the subject, no notice twenty-four hours in cases of acute rheumatism. In your report of the discussion on Mr-
havingbeen taken of the matter in the Drail Scheme iSiR, "

Smith's paper, upon **

Division of Strictures by
 THE MEDICAL TIMES. 165
Perinieal Sectioo,"I am represented as having tioned
men- which,when fremoved,it presented a cast It is of female department of the Asylum, may not be in a
the ever-to-be-respected name of the lateMr. importance that medical men shoold remember that position to contradict the assertion I make ; but I
Aston Key as an authority forthe caustic treatment a simpleaperture in the membrana tvmpani causes cannot be mistaken about the fiscts.The attendant
Id a case of impermeable stricture. The truth is, scarcely any inconvenience. Sir Astley Cooper who accompanied me round,observed,tbat he sup- posed
tbat. when amiing a^nst the operation fordivision havingascertainedthis fact,was induced to suggest I had no wish to go into the refinsctory gallenr,
of a stricture oy pennsealsection," an operation at the operation of puncturing the drum in supposed where the more violentpatientswere ; and my reply
present,unfortunately, too much the fiuhion," I de-
scribed
cases of strictureof the Eustachian tube. In those waa, I wished to see everjrthing. When I entered
that proceeding of a most serious where the amount of deafness is diminished tbat gallery, which was of a semicircular form,badly
character, as havingoccasionally
as one

provedflital, which Eatienta

y the application of cotton wool, it appears that lighted by a dome-light fi-om the top of one of those
coold Dot^ in the generality of instances,be depended some other diseased condition co-existswith that of central turrets which Hanwell is rather celebrated
upon as a permanent cure of the disease, and which, the membrana tympani. for,I saw three or four patientawalkingup and
therefore, could onlybe Justifiable in cases of imme-diate I beg to add a word in reference to the subject of down, havinga dress on thai waa like a very short
or impendingdanger. I also stated,that die enlargMl tonmls. I stated that I not unfrequently round frock,and to the sidesof thisJacket, or frock,
best surgeons in this countnr resorted to the opera- tion saw patients where the ear on the same side with a the hands were secured,"I will not be positive in
only after the failureof all other means, unat" tonsilgreatlyenlarged, was not at all, or very slighdywhat way, but I think it waa by a small padlock.
tended with risk to life, except in urgent cases, where affected, at the same time the opposite ear was very At any rate, the hands were fastened so that thev
the bladder roust be immediately relieved at all deaf,and the corresponding tonsil was not at all en- larged.could not be undone by the patient ; and I observea,
hazards. I then alluded to a consultationwhich I that the arma beingin a positionstraight with the
had with the late Mr. Key, a few weeks before his I am, Sir,your obedient servant, body,they were lesslikely to be comfortable in that
lamented death,upon a bad case of impermeable Joseph Toynbee. position than in the old semiflexed one.
stricture, complieated with a false passage, when he 12,Argyll-place, Regent-street, Feb. 25,1860. Now thii was at a time when the general impres-
sion
was strongly urgedby thepatientto diride his stricture, on the public mind was that no restraintof a
hut declined performing such an operation, stating, mechanical nature applied to the person of the in- sane
that,according to his experience, itwas one of a very ABERDEEN DEGREES. was in use at that Institution. Dr. Conolly, 1
hazardous character, and most unsatisfoctory in its doubt not, at that time had learnt that,even in the
results. Mr. Key thought, at first, that there might [To the Editor of the Medical |TImM.l matter of mechanical restraint, there was a line of
be a possibility of dilating the stricture by the occa- sional
Sir,"I observe in your number of the Medkal distinction to be drawn between use and abuse;
introduction of a small sound; but, having Times for Saturdaylast, or the Saturday preceding, a
thoughhe had endeavoured to persuadethe public
failed with tbat instrument,its introduction on letterbearingreference to the mode of granting there waa no use even in mechanical restraint, he
hs- degrees M.D, at the University
of of Aberdeen, and
one occasion, having caused rather a severe was driven,in practice, to admit there were cases

morrbage, he recommended the gentleman to go more particularly alluding to one case, in which an where no other kind of restraint could be useful or
into the country for a short time to recntitbis healdi, individualarrivedin the afternoon ok Wednesday, and benevolent And with every desire to givethe praise
and then to placehimself under my lefton the following day with the degreeof M.D. due to him for having so noblyopposedthe abuses
care, that
the potassa liisa treatment The person who iwrote that letter is eithergrosslyinto which thismethod of treatment had been
might have a fair mitted
per-
trial, of which treatment, however,Mr. Key had no ignorant of the mode fof procedure, or is willingly to fall, I cannot believe he really thinks tncre
eKperienceof his own, never havingemployedthat misrei"resenting it. You must be aware, from the is no use in such a method
advertisements which have from time to time been ifhe is not aware
; and I am much deceived
remedy in stricture. I had no intention of shifting that it is continually resortedto by
the responsibility of recommendingthe emplojrmentinserted in the Medical Thnee,and one of which will the attendants at Hanwell. He may not openlyap- prove
of the caustic alkali in bad cases of strictureupon appear in the number for Saturday, March 2, that of it,but he cannot prevent it ; and my belief
others,beingwell content to take allsnch responsi*degreesof M.D. are not conferred at this University IS, that many of his own cases are so treated,though
unless the candidate submit to examinations, he he may not be aware of it
bility upon myself.Justice to Mr. Key requiresthis
explanation, and T should be trulysorry if any words having produced to the senators the necessary docu- ments I am. Sir,your faithfulServant,
of mine, beingmisunderstood, to show his standing in the Profession, and A Physician amd Rbsidbnt Proprietor.
were constructed into
a misrepresentation of the views of that admirable having, subsequentto that,obtained permission from Feb. 25,1850.
the senators to become a candidate. I trust that,in
smgeon and excellentman. [The writer of the above haa fiivouredus with his
I am, Sir,your obedient Servant, anv remarks that may be made on this subject, you name^" Ed. Medkal Timu.']
willcorrect the misrepresentation thathas been com- mitted.
R. Wadb.
68,Dean-street, Soho, Feb. 27,;i850.
I am, yours respectfully, THE POLAR EXPEDITION.
[Common honestyobliges us to publish the above Aberdeen,Feb. 19,185a A]a"REW FrrB.
letters; and we have to offer, both to our readers and
[To the Editor of the Medlesl Times.]
to our eorrespondents, many apologies for the errors
THE HUNTERIAN 17,SaviUe-row, 18th Feb.,1850.
ORATION.
that inadvertently crept into our last report of Sir," The periodhavingarrived when a search
the proceedings of the Westminster .Medical So- ciety. may be made for the Franklin expedition by an
[To the Editor of the Medical Times.]
The fact, however,is,that our reporter" who overland journey across the continent of America, I
Sir, I must beg to disclaim any unbecoming
"

am anxioua to refer my Lords Commissioners of the

hitherto, we are happy to say, has given much satia* agitation, and any intentionof offering an
*'
unmanly Admiralty, for
reconsideration, to my plan, dated
fiictionto the Profession" was unable to be present insult, on a great publicoccasion," to Mr. Skey, as
Feb. 1848, and published in a return to an address
to term the few observationswhich
in consequence of severe illness. Unwilling that the you were pleased of the Honourable the House of Commons of the 21st
I addressed to the assembled members priorto his
Society's proceedingsshould be passedover in entrance into the theatre. of March following.
silence, he procured the servieea of another gentle- man The opinion of CaptainSir E. Parry,published in
I am personally unacquainted with Mr. Skey, and
to furnish the report. Sir BenjaminBrodie that return, was highly favourable to the position |
enteruin no illfeeling towards him sndividaaljy. It
assigned to the lost expedition" the western land of
was not present at the meeting, nor is he in any was, however, because the occasion was public, and
North Somerset,and to the mode in which I proposed
way responsiblefor the opinionsattributed to the onlyone on which the bodyof the members and
to reach it (by the Great Fish River;) but the gallant
hhn. The paragraph the Council can meet, that, in my opinion,some
commencing with Sir Bei^amin marked and intrepid officer,
"
agreeing thusfar, was compelled
Brodie's name, and made to appear as his qimmRa disapproval of itsconduct was called for.
to differwith me to the readieti mode of reaching
as
What other fitting opportunity is there,I would
verba, in foct formed of the address of the preced- that coast, because he feltsatisfied t hat with the re- sources
part ing ask,forthe" expression ot feeling in a legitimate ner
man-
of the expedition then equipping under Sir J.
speaker, Mr. Childs,and was merelygiven by V Hare not allthe representations of the mem-
bers
him as the opinionof that eminent authority been on all occasions disre|;arded, and their
Ross, the energy, skill, and intelligence of that officer
with would render it a matter of no very difficult
claims to redress of abuses disdainfully enter-
prise
regardto cutting for stricture. rejected, so
to examine the coast in questionwith his ships,
as to produce a sentiment of exasperation throughoutboats,or travelling
We deeplyregret that this typographical error
the ri^ht-thinking portion of the Profession? parties."
should have caused any annoyance to the worthy In the planto which I am now askingtheirLord- ships'
I will onlyado, that having decided to leave town
Baronet" CEd.Medical TUnes,'] on the day of the Oration,my attendance was dental,
acci-
reconsideration, thisquestion, which I premised
be raised^ is thus argued by me : " Does the
and tiie remarks made, on the spur of the might
THE ROYAL MEDICAL AND attempt of Sir J. Ross to reach the western land of
moment, were, I conceive,fully Justified by the oc- casion.
CHIRURGICAL North Somerset in boats lirom his station in fiarrow
SOCIETY.
t hat Strait, render that proposal unnecessary ? (toreach
[To the Editor of the Medical Times.] Trusting your sense of will
Jsstice cause the the'westernland of North
insertionof this note in your next Number, Somerset by the Great Fish
Sir,-"Permit me to correct a slight error in your River.) Here the factswillspeakfor themselves: 1st,
last report of the proceedings I am. Sir, your obedient servant,
of the Medico-Chi- Barrow Strait was ice-bound in 1832; it may^ there- fore,
Edwin Lei.
nm^csJ Society.It Is there stated that I did not be ice-bound in 1848. 2nd, Sir J. Ross is using
believe the advantagederived firom the use of cotton London,Feb. 25,1850. the same means to relieveSir J. Franklin which have
in cases of perforated membrana tympani " ever de- pended led the gallantofficerinto his difficulty; the relief
on the perforation being covered by the UANWELL LUNATIC ASYLUM. partymay, therefore, become a party in distress.3rd.
pellet.*' This is not my opinion, for in those cases The land that is made on the south shore of Barrow
fand theyappear to be somparatively few) where the [To the Editor of the Medleal Times.] Straitwill be of doubtful character, the natural con-sequence
power of hearing has been improvedby the use of
the cotton, the lattersubsUnce, as stated by Mr. 16th
Sir,"The observation I made in my letterof the of discovery in ships ; the searching party,
inst., in
published your Journal,on the use of at the end of the summer, may therefore find they
Yeusley,required to be anplied with great nicety, mechanical restraint at the Hanwell Asylum, is have been coasting an islandmany miles distantfrom
so that where ihere isa small orifice in the membrana founded upon mv own personalobservation when I the western land of North Somerset,or navigating a
tympani,it may be completely filledby the pellet; last went round that Institution, which cannot be deepbay,as Kotzebue navigatedthe sound named
and when the entiremembrana tympani is absent,the more than three years ago. At that time I did not afterhim, and as Sir J. Franklin navigated the sea
cotton must be placed as near as possiblein the go by myself,and I doubt not the gentleman who called Melville Sound.
situationwhich it occupied.In one case under with me
my went will be able to confirm what I now *' The
plan which I have proposed is,to reach the
care several years since, the pellet of cotton required sute. It waa on the male side,and, therefore, Mr. Polar Sea across the Continent of America,and thus
to be passedabout half a line through the orifice, of Hitchman,beingthe resident Medical Officerof the to proceed from land known to be continent, where
 166 THE MEDICAL TIMES.

every footstep ie inre. Ifthat plan be laid aside,the I cannot, however, find time to bandy jestswith caution exhibited againin this sentence is very re
liTee of our lostcoontrymen willdapendvpon a amgh Dr. Turley i-^inore especially as he has brought a mote from the potential dogmatism which Dr. Tur- ley
throw,in the face of almost osrtainfailure." string of allegations aaainst me, which, ifthey were has, without compunction, ascribed to me.
This only pointof differencebetween Bir ". PanrT worth answering, would require a rejoinder as long Dr. Turley: " For the sake,then,of his * excellent
and myselfIn 1846,is now, in 1850, at an end. as the briefof a Chancerybarrister. The main scope friend,' Dr. Stevens,be uses his treatment, excepting
Barrow Straitwot iee-boutuL The tingle ihnwfsUfar of his letteris to fix upon me the chargeof huonsist- that he omits the recipe of Dr. Stevens,""c "
Letter
short pfiUmark, CapttdnSir J. Rou foKedin (Ofbrd- encffi and, although, in this instance,I deny its Jan. 27th,1850. (Herefollows in the letter, an ginal
ori-
higth" least sHtcow to the lost Expe"Ution, and I am Justice, yet I boldly tellhim, that the highest merit and remarkably cleverjoke about the character
thus spared the painful necessity of replying to the that any man can possess in my estimation, is to of Hamlet beingleftout of the playjfof that name In
ffallant officer's remarks expressedto theirLordships, hsve virtueenoughto be inconsistent. In my inter- course itspublic representation.)
in no BBsasured terms, npon that plan which,in fact. with men, I urge evermore, that every man Mr. Ross : " Being desirous of tryingthe saUne
Sir E. Parry has done for me " ^theplan of one who should speak his present thought,and make a clear jfianrecommended by my excellent friend. Dr. Stevens.
learnt his lesson in active diseovsry in an overland way for the truth that is in him. Sincerity is better 1 employedit in aU my firtteases ; not, however,
journeyin search of the gallant officerwhen the whole than knowledffe, and is the chief of virtues. The alone,but generally aided by other remedies. I
civilizedworld was as anxious for his fate as itisnow candour of childhood, and the wisdom of age, are the rarely administeredother agents until I feared that
for the gallant Sir J. Franklin. chief ornaments of character, and ifa man grow old the saline plan was incompetentto the cure. I
All that has been done by way of searoh since Fe- bruary,
without retaining the one, or acquiring the other^ he was unable to administer the saline remedies in the
1848, tends to draw attention closer and is,indeed,to be pitied.We may do very well with* form recommended by Dr. Stevens,in conseauence
closer to the western land of North Somerset as the out wisdom, but not without sincerity. Though a of the predominance of common aalt,whicn was
position of Sir J. Franklin,and to the Great Fish man should contradict himself, let him not be offeniiveto the patients, and caused the remedy fre- quently
River as the highroad to reach it. Snch a plan as ashamed: he will be the wiser and the betterforitin to be set aside. I,therefore, devised,""c. "

I proposed to their Lordships in 1848 is, conse- quently, the end. If he must speak,lethim not lieto him- self. Medical Times,Jan. 26, 1850.
of the utmost importance.It would be the The responsibility oftelling the truth now and If there be any amoiguity in these sentences it is
happiest moment of my life"fand my delight at alwayswill make him wise in due time. I think,if onlyapparent ; for I expressly say that I tried Dr.
being selectedfrom a long listor volunteers for the Dr. Turley had observed thisrule,he would not have Stevens^s saline planin all my firstcases ; and, al- though
relief of Sir J. Ross was very great)-~if their Lord-
ships written his letter. I state that I devised another formula,it was
would allow me to go by my old route, the Dr. Turley says that,in my lectures, I condemned because my experience of Dr. Stevens'splaninformed
Great Fish River,to attempt to save human life a Dr. Stevens's salinemode oi treatment, and praisedme that it was effexuxoe to the patients, and practioally
second time on the shores of the Polar Sea. What Dr. Marsden's, both "being aetuall]^ the same." useless. It would have been onlyfair, however, for
I did in search of Sir J. Ross,is the best earnest of The factis,that I collectedcertainofficial reports,in Dr. Turleyto have referred to my letter, pnblished
what I could do in search of Sir J. Franklin. one of which "
that of the Greville-streetDispensary, in the Medical Times,Sept.15,1849,in which I first
That the route by the Great Fish River will a positivedistinctionwas drawn between the two announced the treatment by nitrale qfsilver. He
sooner or later be undertaken, in search for Sir J. modes,by placing the mortality resulting firomeach would there have found this sentence ^"
Franklin,I have no doubt. That high road to the in separate lines of the Table. Had laltered this Mr. Ross : **
I began my operations against this
land where I have all alongmaintained that Sir J. arrangement I should have dealt dishonestly with epidemy by the employment of salineS| with the
Franklin would be found,and in which opinion I the Table,which impliedan actual differencebe- tween fullest r eliance on theiremcac'y : and exhibited chiefly

am now associatedwith manv others,including Sir the two modes oftreatment But,Dr. Turley common salt,at short intervals, in the condnnatUm
E. Psrryhimself, cannot much longer be neglected.savs, that theyare the same. In that case, it Is not recommended by Dr. Stevens.**
For some time pastit has been the cry, even in I,but Mr. De Grave, the reporter,who isguilty of the Dr. Turley has certainljr a charmingfacilitvat

the highest officialquarters, that the Government misrepresentation. Itisby no means clearto me, how- ever, misrepresentation. Here is another of'Turley's
will not againattempt the discovery of the North- that Dr. Stevens aided by any fixed formula own ;""
West Passage, and the fate of Sir Juhn Franklin is of salinesin the treatment of his cases. Dr. Turley Dr. Turley: " Nevertheless, he found the msjority
invariably referred to as an exampleof the fruitless-himself states, in one of the lettersof his last of his early patients die, after beinghelped over the
ness of such an attempt. correspondence, thst the quantity of the muriate of collapse by tiisown salines, from the consecutive
The fruitlessnessof Sir J. Franklin's attempt soda in the formula, rangedfrom a scruple to a fever."
ought not entirely to discreditthe service in which drachm, and this salt is,confessedly, the most portant My opinioii,
im- in this sentence, takes an affirmative
be has been engaged, but rather to awaken us to the ingredientof the mixture. It is very cer- tain form. The sentence assumes that the salines helped
grievouserror committed in the instructionswhich that,whatever may^ appear to be the case in the patients over the collapse.
he received, and upon which it is impossible to look the relative quantities of the components Mr. Ross : '* The greater number of my earlycases
back without the most painful frint,
feelines. The gallant )r.Stevens's prescription were not fixed in prac-
tice.
of
died in the oonsecntivejstage, and I was inclined to
officerwas, in fact, instructedto leaa a forlorn hope. Whatever may be the importanceof this mat- ter, thMc that it was owingto the salts, which helped the
The discovery of the North- West Passiige is the the quarrel resu between Dr. Stevens and Mr. patients over the collapse, but were unequalto ac-
certainresultof so overwhelming a catastrophe. De Grave, and I repudiate allconnexion with it, and compliah a finalcure," "
**
with the exception of the
In the absence of authentioinformation of the fate all responsibility or settling it. The case between appareni advanta^above stated, I could perceive no
of the gallant band of adventurers, the terra incognitaDr.
Turley and myself stands thus: "
probable benefitfrom theiruse."
of the Northern Coast of North America will not Dr. Turley :
"
He who, in his lectures, condemned I was inclined, and no more, to givecredit to the
only be trsced, but minutelysurveyed,and the solu- tion the saline treatment of cholera of Dr. Stevens as the salinesfor helping the patient over the eoUapse; but
of the problemof centuries will engage the word method possible, and in the same Third Table, this notion had so little hold on my mind that, as
marked attention of the House of Commons, and the praised the saline treatment of Dr. Marsdeo, at Gre- Dr.
ville-street Turley admiu, I had no reliance upon it,and
Lf^slative Assemblies in other parts of the world. Hospital, as (he bestpossible"c,
"
" Letter. felt it right to adopt more activeremedies. Is there
The problem is very safe in their hands t so safe, in- Jan. 27, IS50.
deed, any rational man that can disoover any impropriety
that I venture to assert,five years will not Mr. Ross: 1% would appear, that Dr. Stevens's in this conduct! Had I lost my rightto employ
that
dapsebefore it is solved. eombination of salts was highlyinjurious, the mor-
tality nitrateof silverbecause itmight be justprobable
1 may be allowed to in
state, urgingmy claims to beingas high, under his plan, as 76'8 per cent. salineseffecteda partial goodt The Doctor is a sen- sible

eonduct an expedition di"wn the Great Fish River, I find, too, that ithas been very qften condemned bu man, I doubt not, but he wants the skill to
whenever such a serviceisdetermined bv theirLord- ships, gentlemen who haoe emiployed it. On the other hana, show it
that,in addition to my intimate Knowledge of the GrevillC'Streetcombination woidd seem to be as Dr. Turley's allegations are of so contemptible a
that stream, I persisted, almost single-handed, for highly beneficial, that I do not desire to prolong this letter
14 per cent, being, under thissys- tem, character,
several years priorto the discovery, for three most the rate of mortality."Lectnre Medical Times, by noticingthem seriatim ; but there is one assertion
"

important featuresof the Northern Coast of North Nov. 25, 1848. made by the Doctor that surpasses all the others in
America, the Peninsula of North Somerset, the There is no confident opinionexpressed here its unmitigated hardihood. 'Thus it runs :"
Great Bay of Simpson, and Cape Britannia, all of either of praiseor blame. These expressionsare Dr. Turley : He also admitted the irutf^fidmaee
"

which are now established geographical facts. merely inferencesfrom the Tables, which wtay appear ^the Tabks,o^en now to the publioat the Coldbath-
I have,"c., and seem to be correct, and nothing more. The fact nelda prison^ and verifiedby the Governor there
Richard Knro. was yet to be decided,and, for allDr. Turley could and the visitinsmagistrates in 1832."
To the Secretaryof the Admiralty. know at that time,my personal opinionmight have Has Dr. Turleyreally forgotten my brief letter,
serted. written in reply
beeniust the opposite of what he has so boldlyas- to his longepistles in the spring of
Greater caution in statingthe case to the lastyear ! That lettercontained this sentence : "

MR. ROSS IN REPLY TO DR. TURLEY. Profession could not have been shown. Mr. Ross: ''The question, then, is, Are Dr.
Dr. Turley: *' He subsequently said,that the Stevenis Tables worthy qf reliasue f I found them
(To the Editor of tha ICedtealTIniM.] saline treatment was the best method of cure possible." iMi6(/W, and, without seeking to revive the discus-
sion,
Bi"r-*Dr.Turley'sletter, commenting upon my "Letter, Jan. 27, 1850. declined to use them. Notwithstandingyour
**
Observations on the recent Epidemic,'* is such a Mr. Ross : '* I have no uwA to dispara^ the saline very able pleadingfor the Doctor's talent,expe- rience^
singular concoction of Jestand science,that it is system oftreatment;on the contrary,/ 6"{teveit to and intsgrity (whosepossession of these high
exceedingly puzJingto know how to replyto it in a be the best yet tried,and would recommend it as such ; I am prepared to admit,)I stillbelieve
becomingmanner. He deals so funnily with a seri-
ous at the same time,it is my dutyto state facts aualities
faith- lat the creditor his Tables remains impeached."
suljeet, that I should imaginehim to be a very fully, of any apparent contrariety to the periodof my writingthis
odd kind of psychological
re^rdless that may Subsequently
curiosity.If he desire appear in the evidence."" Letter, Medical Times, letter Dr. Stevens came t% town, and I had the
me to understand that his science is all a Jest, I can Dec. 28,1848. pleasureof an interview with that gentleman, who
easily aeeept it as such,but I certainly cannot consent The above Is the sentence refeiredto by Dr. Tur- ley. submitted to me all the documents relatiog to the
to his Jests beingreceivedas science.He can find no bearing
I did not say that the saline treatment was the question. I thereupon publisheda letter,
wiser argument for the preference of common salt to best possible.Such an expression, delivered dog- date the 5th of June,1849,in the Medicai Timee,in
saltpetre in the treatment of cholera, than that it is mstiMlly,could have come onlyfrom a madman or a which, afterpaying Dr. Stevens such a compliment
betterthat the patient shovld be oversaltedthan un- fanatic. "There be more thinn in heaven and earth, as I believed his virtuesmerited, I wrote thus in
dersalted in the curingprocess. I can advise Dr. Horatio, than are dreamt of in ;" refereneeto these Tables :^-
your philosophy
Turley better stUi; it is, that he take his salt and I humbly subscribe to the wisdom of this senti- ment Mr. Rofs: "As a lasting reputation can, how-
ever,
out of his physic, and put itinto his wit,and both What I did write was, that I bOleved it to be be based only on truth,its claims are rather
willbe impmed. by doubifiU evidence.
the best yet triedI a very different matter. The damaged than sli"ngth"ned
 MEDICAL TIMES. 167
THE It
than he to form one.
of our institutions, infinitely competent
more
and be acted upon by
doubt of time,in that category to the would undoubtealyjprevail
yet of such an pointment
ap-
as I have no progress have done good service the Jury,we see the inexpediency
Dr.Sterens'i views are comet,
If in theirday, for the
that they must stand which, be diacharged a remedy
are, it ia umoUe
Acj
to profess
in Goldbath- State,but whoae ninctiona
may now
effectualorgan- isation.
beingresorted to as Court Suppose
the evidence of the practiee of simpler and more that prevail in the Coroner'a their
fall
or by 5,1840. by meant a abuses at issue in
Letter,Med. Timet,June in favour of these and the medical witness
flelds.""
of society, when policethe coroner "c.,
StroMer languagethan
this
In an early and rude sta^e interpretation of some post-mortemappearance,tribunal that is
how any individual and in ita modem baken, ftc,ia ths
Tables I hare never writtent and organisation was very defective, human a Jury of butchers,
that I have admitted their exist when t
^
to assert modification did not ;
difficult to decide between
them
I would
^trathfulneta" surpasses the possibilities
of compre-
There are several ifewas
I"reventfTe for lesssecure, and crime
much more
number of Finally^ a few words upon
the substitute
of things, and
heosioo of any ordinary mind. intro- of detection,
an assemblage of a certain propose,m
lieu of the presentstate
letten 1 have
in the Doctor's letter, to investigate the cauaes Coronera. In the
inaccuracies of a locality of Medical
ether
groas body to the inhabitanta a tribunalaa
the in place Medical Offioen,
doubtlessly, for the purpose of riving deatha,formed as good referredto,I proposed
that district
daead, of suspicious should be ap- pointed,
pointinghis stale Jests; admitted of,especially
as the limited
amount
unconnected witn privatepractice^
vapid arguments, and from
his further remark. period the Medical Profea- examination into their capa- bilities
they do not deserve me
of theirqualiflcationa prevented after careful hands
but difTerent ideas assistance in their
Tnrley and myselfentertainvery society much special and acqairementS|tha^nto and
Dr. it is for this aion from rendering But now that the escape the investigation of the causes
of science;and, perhaps,
thedlgnitt
of the frothy thisclass investigations.
of rendered should be consigned the various
that I am incapable of appreciating
the of crime haa been of allsuspicious deaths,theyoondbcting
reaaon of ad* from conaeouences
effective state of At pre"
fcebleneas of word-catching ana double notes
perate so much more
aifBcuItby the very
of medical anatomical,
chemical,"", investigationa. not, is a
of sincerity and a tem- and the great progress this is done efficiently or
"nration, as the exponents police organization, in ita sent, whether whom
machine so cumbrous chance,dependent upon
inquiaition on truth. the retentionof a matter of the merest by
both in my science, in itaworking, seems to select; but,
Now, 8ir, I have carefully
abstained, and Jurymay happen
word that structure, and so unsatisfactory well-distributed police, the coroner
the repeated o pportunities joyed
en-
and papers, from writing An activeand
a
lectures unadvisahle. the plan I suggested, enable
of Dr. Stevens; would aeem to offer Medical Officera would
might wound the ausceptibilities and a responsible magistraey, death would by these public become valuable
if I am umd much more upon thisfrivolous that no case of^suspicious them to perfect theirknowledge,and
hot, to every security fartherbe pro- far aa the Medico-
I shallbe constrained, in self-defence, but this nwy still vided
and referees ; ana, as
question, unreserved opinion u pon go uninvestigated
;
which I will presently suggest
authorities
of the case were concerned, their
to the Profession my bearings
in important caaes is le^
for by means the coroner and jury
give with the grounda" de- rived
should be considered by
this squabble, together a Coroner's inquest nesses
wit-
paltry from conversations with
Dr. Stevens At present its decisions not opinionsacted For official
aa much that work of supererogation, of final, and upon accordingly.would form no
Dr. Turle^s letter*"
for forming a mere
and only bavma the power compelling of this kind Medioal Coronen
as from being final,
also secure ; and that,
terest
In- even
This unamiable strifecannot
poasess
opinion. a trial which other means adeouate substitute. before sanitary
what is more material, Jury does not made
forthe Profession,and, the verdictof the Coroner's The above auggestion waa
but the officen
in
the caose of truth.
supposing On the other hand, in
how
in the ascendant;
cannot advance
itis not his Intention
indieata ita necessity. uncalled for, a reform was
"
for the public
that the inquest perfectly
is may, very advantageously
Dr. Turleyhas stated, good many cases death haa question officials that
I hope he willabide by cases in which of medical
so a
tonpijto me, and fooliahmatter of form," form part of the corpa
however, that one line, mere resulted from natural causes.
In other to work out any effectualsanitary
resolution.I do not forget, note of obvioualy of willbe required I would,
timid,quiet, little the prc;)udiaes or ignorance As a still greater improvement, of the
flanked by an unassuming, a former occasion,cases,
sgain, through of the grossest measures.
the entireabolition
elicited from nim, on
it becomes an instrument recommend
admiration, written in a manner the Jury, the most sistent
incon- however, now
in these matters. Let there
of recording
foAt long and tedious letters, and ao closelyoppression, or the meana Coroner's Jurisdiction of deatha
Medical Inspecton
"
that the learned call rigmarole," form, and ridiculouaverdicta. A be,as you recommend. whose duty
that, if spreadout in
the ordinary mU^t be expected. attached to the Registrar's department,
printed, volume. This is justwhat, a priori, the immediate beadles, at preaent, to
goodly it will be,in placeoT parish
as
theywould have constituted assembled nt"m
a
of
from such another bodyof tradesmen, with ita prc;judices, the authoritieato all
eaaea
Heaven spareme and your readers the time he locality, and hence Inoculated with the call the attention or
but in place of com-
municating

infliction f What willbecome of me by acquainted with or on bad terms

suspicious and unusual deaths;
I cannot conceive I The
often and usually profoundly with the Coroner upon
the aubject,
hasfinishedhis philippics,
with me by dis-
guising witnesses or the accused, pointa upon to demand at the hanoa of
Doetor began hia correspondence of the reallyimportant let them be empowered
of in a largepro- portionignorant will hereafter have to be de- cided,
Medical officen'reporta,founded
amall quantity cenaure the case decisions the district public
reveiaed the which
a which reporta
he has now form a tribunal whose examination of the body,
of
compliment: has become infl- scarcely and command upon careful the notice of the ma-
to be impartial be broughtunder
order,and, whilst his compliment to an enor-mous would be likely may blaat would then and any furthersteps
his reproachea have dilated the verdict or these men and police authorities,
mtssiasal,
that,if the oorrespond- respect.Yetfor condemn to a pro- S'strates
longed
requisite founded upon them.
magnitude; I presume, I shallbe cast out with die ana-
a character ever, or may
So senous a nower as that of
at might become
of suspicious cases beingori- ginally
soce be continued, imprisonment. but by persons
So, too, in the event notice of magistrates, they
of this despotic Doctor upon my
should never be wielded, before the
Ama marmiatha incarceration brought such Medioo-
abide the result,for I
under a sense of direct penonal
sponsibility,
re- of ordering
head. Well ! I can patiently who are acting should have the power
In this way, a tribunal
the con- so
blows I sufferin defence of truth.
dition
tsre not how many holdingtheirofficesonlyupon of their legalreporta to be made. Jurymighteasily
the Doctor should be temptedto write able and upright fulfilment
far behind the ase u the Coroner's
If, however, show veracity, desty,
mo-
of an
for the victim of an witL
he will more conaolation
snin,I traat that for he will findthat his aigu-
duties. It is a poor
that,after long delayand
be dispensed
the plan I am advocating
and candour,-" foolishverdict, It msy be said,that Profession,by
with these importantunjuat
or he ahonld
aenta cannot afibrdto diapense much expense, ithas
been ouashed ; or that
hit would act injuriously upon the render be- fore
good, but I sus- directing quittal,
ac- at present
be very while the servicesthey
aoxiliariea.Hia Jestsmay of his hear a Judge (as recently) that he had ever been
superseding and are remunerated
for.
ishimself the best Judge Coroner'a Jury,
peetthatthe Doctor m isgivings, he express indignation this.
a
of the Profession place any
own Jokes; and,if hia vanitybavejany the placed in a position requiring in the great
I believe few memoerd aource of
inlldo wiselyto forward
his witticisms to
be said,and with truth,
that, Coronen' loquesta as a

for that worthy's re- vision, It may put intolegal form dependenceupon would conaider receiptafrom this
mmpter at Sadler's Wells,
then majority of esses, the Jurymerely But income,and moat loss of time
It by the Coroner. for their
before he givethem publicity. may de- the opinion givenor hinted atmachine source a poor compensation

be worth hia while to consider,

whether the comer a
for giving pression
ex-
Moreover, the medical men
in a provincial paper,
news- why retain so cumbrous and other annoyances.
then, sgain,althoughthe who have been calledintoa case, and whose
testimony
totedto " Odds and Enda" to this! And
should be remunerated
suitable receptacle than an educated man.
(inmany pro- vincial isrequired,
may not be more
that Coroner is usually beforea magistrate
a
It is fiiUtime Umto more and he would simply
Ae pjttes of the Medical Times,
districta onlyslightly so,^ ana pro
as now he isbefore Coroner;
a
the post-mortemmedico- legal
Br. Turley and myselfshould
understand each reasonable verdict than the have to the conductinjt
Is it likely to directa more
b*) able to retun,yet
resign to the officials
I have alluded to.
stfaer, and decide forwhat we are contending. Jury without his aid would rate
invete- investigation to the
character, that is tne point have been known
to entertain
the openingof these important
posta
pncucaltruth,or private even coronen while, Surely ambition be a full
St issuef Let there be no mistake upon
thismatter.
and acquirea most unfair bias, of the Profession would
views of the ment
treat- prejudices there is no legitimate of their at present anomaloua
With respect,Sir, to my own of their appointment, fortheloss
to them no further from the mode qualification compensation Coronen' Juries. However
of cholera,I shall revert security that they possess any specisl of medi-
cal positionbefore ignorant there can be no
of their importance, whatever. A mere amattering
than to reiteratemv conviction
the for the office for this may be with the Profession, highly
them most aameady to tention
con- than none, of fullyexperienced,
inl to recommend or legal knowledgeisalmost woraeundue reliancein doubt the services like these, would be of great
of the Profession. an
it engendenin the poasessor entertain. educated individuals should be remu-
nerated
I am, Sur,your moat obedient Servant, might not
to the public, and they
Rossr hia own opinionahe otherwise of Coronen' Courta importance the exolusivedevotion
Gboroe ; so that
If,however,the present system the appointment
accordingly the ties of private tice,
prac-
Feb. 28,185a t not think unshackled by
24,Famngdon-street, is to continue, do of high talent,
desirable step, and conaider it,
functiona may.
be secured. Whatever
oi Medical Coroners a Several yean may future to public
Medical
one. in
INQUESTS. in some respecta, an objectionable
two letten in the Medkal
indeed,be confided performed by
COEONEKS'
since,(1839.)I published this view of Officers, theycan onlybesatiafactoriJy the necessitiesand
the
xxiii. and xxiv.)taking severingthem from
Medical Times.] Gazette, (vols, haa not duced
in- entirely
tTb the lAter of the reflection practice.
self temptationsprivate obedient servant
the question; and subsequent Coroner places of
at findingyou intimat- him-
Sis,"I was much pleased of con- me to alterit A Medical I am. Sir,your
John Chatto.
of witneas
higi in yoar lastNumber, the desirableness before the Juryin the double capacity Great Coram-street, Feb. 25.
a reform in the
Goroner'a Court with any the medical evidence re- corded,
Bstting be forthooming. I and iudge; for, on hearing opi-
legislation may that he expresses a critical
a nd professions!
^ sanitary aa to the mode and purposes,is IN THE
"."jot exactly agree with yon and ahall feel nion upon it^ which, to all intenta THE HEALTH OF THE COUNTRY,
and to influence the jury as
one.
which tbiaahould be ...^^^plished, to act as a witness, ENDING DECEMBER.
...
.-I-
to state my opinions us of his qoahficationa
QUARTER
bilgedby your allowing me
taken to assure
"pen the sufajfect, as the presentappean
a very op- Were means
thus to act. we might become From the Quarterly Reportof the Registrar-
in its and entire competency in the lastquarten
portnne time for examining
the question,
recondlea to what would
stillbe objectionable ;
General, itappean thatthe deaths
of the Profession and
the were 80,681,108,987,
thisis not the case, and that of the fiveyean 1846-6-7-8-9,
more
Msnags upon the Interesu but when we know that does not of mortality in
fact of his beinga medical man The rate
ptblic in the mere 103,479,92,447,97,778.
Inths firstplace, then,I have no hesitation be while yet, when hia opinion
u"
upuuuu slightly in ezcass
such qualification, {thequarterwas 2*181 per cent;
^..^
.*"w" f^
that this tribunal should imply
.".|,.j
."".. H-M".uv.".^",
medical witness, perhaps
^pressing my opinion by die ran counter to
that of a
at Ithat become
"tthwhhabolislicdtPlacad,
 168 THE MEDICAL TIMES.
of 1848; the V. South-Webtern Division." mortahty The
of the average rate (2'165) of the 12 DecemTjcr close of 1847 and the beginning
1-9- The lowest rate of rnortalilyAfiiaticfoim M ehi"lera sliowcd itself in 1 S49 was generally
ftrat disituictly lower in WiUt, and highei in
q"ftrteraJS3S"
in many placeswith DaiseUhire, Dewmthire, ComwaU, and Somersetshire,
(l^SSS)was experienced in llie December quarter^ ill Octohcr, 1848, and ratjed of 1848.
1 845," the hJg^hest (252y} m the corre"pouduig grea: violencein the mouths of July, August,Sep- than
tember, it was in the corresponding quarter
in where vac
districts
quarter of 1816. and a partof Octobei,1849, when itgene-rally Smallpox prevailedmany
subsided. Scarlatina
cination had been neglected. prevailed
If we take the complete years^^the deaths regie*
terpdin the B years, 1845 6 7-B-I",were 349,36(i, The returns of the other atates of Europe are in Heavitree, where is "great destitutionamong the
still much in that there of labouring p opulation firom want of labour." There
390,315, 423,304,""0.060v 441,458. The deaths BO arrear, are no means

in Ig49 exceeded the deaths in 1845 hy d2,W2. comparing them with those of England; hut it is were 2 deaths firom cholera in St Sidwell, IS in

The average annnal morUlityof the 10 years, 1H38 worthyof remark,thatthe mortality of Englandin St. David, Exeter (thelaston Oct. 30th;)and 18
e:sceeded from dysentery in the Exeter workhouse. Tbe
"47, was 2'213 per cent,^ of the 12 years, 1838" 184J),when cholera was epidemic^ scarcely
49, 2"243. l*he animal mortality was lowest {2080 the mortality of France and Sweden in ordinajy epidemic lingered in partsof Devon, Cornwall, and

lean tlianthe ordLaary Somersetshire, and broke out fatally in Taunton

per ceo 1. or 1 in 48) in the year 1S45 j highoiit
1 years, and was much mor-
tality

and workhouse and in Bridgcwater. The deadisin

(2-493,or 1 in 40) in the year 184^0 The high of Sa?:ony^Prussia, Italy, A ustria,
rate of mortality set m with an epidenrtie of what RuAsia. Bridgewater, from all causes, were 818 ; which is
iteai ly at the rate of 4 per cent, per annum
of the
"ra5 calleddrarrhtcaandJEngii$h ehokra m the sum-
mer The followingwill presentthe Meteorological
of 1846 I Jt was succeeded hy influenza at the Phenomena of the Quarter in various locations : popu lation. Cholera prevailed
"
in Plymouththrongb
October; fever in Bath.
VL W^EST Midland Division." The mortality
-5^
WiVD.
""
iia 111was
"
lower than the average in Gloucetterthire,
. Here-
V
fordikiref
a^
Shropshire, and Warwickshire: higher
than the average in SUnffordshire and Worcestershire.
^3 a^
NAMES DP THE
PLACES.
ill": U O
Scarktin* was rife in parteof Shropshire
V
and War.
General w { k ^]1ire. Several cases of cholera were fttaloter
L

Direct ion.
Stadordshire. The deaths in Birminghamwere
^ S *

lb
loati; in Coventry, 349; in Worcester, 148 ; Staf-
ford,
;Si 115; Shrewsbury,122.
YIl. North Midland Division." The mor-
tality
In. "rr. fpcL
iti Leicestershire and Rutlandshire, wai
20*703 *93 6-1 S-W, 0 4 3 0 lt3
osep 4 4 IDS above : of Lincolnshire and Nottinghamshire below
Hrltton ...
US 8.W. o-t"
4ft I 10-3 V*r. the average of the season. The mortality was low
be-
FaltflDUth ...

Truro .., ".

48-U 83 the average in Lincoln and Nottingham. The
TorquAj 4ft'9 4St*3 B.W, " E. D'9 ISO
above the average in the trict,
Basforddis-
,

4" 2 |3 3ji2S 0-5 140 mortality was

where were severalcases of cholera,as wellas

Cblchnttf ...
44'S JO 3 5 S.W.tN.W
44-9 lL}-3 14 9 0'3 55
SouthaniptoD ,,. " in Newark,
20-^04 433 13*1 4a-o S.W.pW.iE. 0-8
44 -" \r*y 4Q 0 0-5 J39 VI II. North-Western Division." The mor-
tality
Rojal Obs.,Gfwnwich
and Lancashire is considerably
""

MatdfDHone-hifc], " in Cheshire

337li 44-1
Green irich .h. / below the average. Scattered cases of choleraoc-
curred
47-3 to
Cbiiwell-itraet,
London., 39 2 B.W.
over the counties" cbiefly in October. The
Ut. John^A-wocd 44-" 41-4 S.W. Sc N.K. 0-3 200
and West Derby were 2681 ; m
t.."

Latloiei Aectoff ..^

4^-5 35 G 0-S .135 deaths inLiverpool
of
AjEsibury ."* 19 CSS iA'" m:i S. as N.W. 0-5 2!"0 and Salford 2415. The Registrar
Manchester
Btfinv ObaeTvutdry 4$-8 43M S.W." 04 320 sub^iiatnct
says, that the
"fr43 N.E.
Hartw"l|,Avleibury 3ft-"5l 4S7 13-7 0 4 im
Howjird street, Liverpool,
.,
from various causes. No
Hartwell Reettirj 43-4 s'w. 05 2G0 is depopulated one-*fl(f
Baffrou Wdldeii ."
432 S. deaths from cholera occurredin the Manchester
R%(icllfreObt., Oxford ..
43-9 4r-v %'ar.
workhouse,containing 1800 inmates.
Hererord l"-2 Var.
***

IX. Yore Division." The mortality was shore

Cardlnfton,
Bedford .. 29785 428 40"^ Vftf. 0*4 200
Norwicb ...
43 "^ 40 0 S.W. 05 30 the average in the West Biding;below the average
HolkLliEin in the East and North Ridings. Cholera l"w"keout
43-4 384 S.W. O-Q 31

Derby 43 6;37 '5 r7

."

i'i"3
tn Knaresborrtigh with some severity,and doubled
HLi^liAeld.
Notti 29 '^'SS+0 8 14 4 S8'J$ SW,n"WpNE 1-0
MAncti"t"r
...

43 5 0 3 110 the deaths in the sub-district The epidemic cholera

40 0
.

LftfrpoolObi. ""
44-5 5"387 S.E. 0-3 S7 wafl faU) in Leeds in October. Bradford and other
Wnkf fieldPriion 29'"ao 42-3 5 '3?-e S.W- 0-" 115
less from the disease.
4t 8 U 7j39 Ht
districts suflbred more or
Btouitoti-ladfffl,
Leeds 23^01 " 0-3
healthy.Hull suflfeied
.,

Slon]rbuntObi. ."
4 37 3 "
8.W. ft N.E. 0-4 3"I Sheffieldwas comparatively
Whitehaven ii 9 40 7 9.W. 0 5 heavily from cholera in the summer, and lostsome
DurliKm ,", .,. 4^
41-6 38-3 0-1 347
inhabi'tants in October; but the last two months
Newest tie... 4i^7 38-9 a.E. " N.W, OB til
... .^
of liie year were healthy. In Rillington only
m
4 out of 4000 inhabitentedied from any cause
L London," The deaths In London from spe- cified Reading ; measles, hooping-cough,and small-poxthe three months.
cause* were 12,818 j of which 3227 were by in Windsor, where 23 deaths from cholera were Division." The mortality of
X. Northern
diseases of the "ytnoticclaEs, 2035 by tubcreukr, registered ; tlielast on October 3 1st. above, of Ctu^er-
Ihtrharn and Northumberland was
and 2133 hy pultnonary diseaaea.Of the deaths 49 4 III. SotTTH MiDLAwn Division, The mor-
"
tality
ianri about,[ofWestmoreland below, the average.
were by cholera ; 4S2 by diarrhfEt. All cstcept was lower than in 1848 in Muldlftez and
The cholera epidemic terminated in many of the
about 20 of the deaths from cholera occurred in Buckinghamshire, slightlyhigher in Oxfurdsklra, diBtticts of Durham at the beginning of the quarter:
October. 99 deaths from sijiall*pox, 338 from Sorthmnptonjikirc, iifmtingdtf7ithir^jBcdfurd$htre^ and the epidemic broke out at Bedlington in November,
Measles,4S6 from scarlatina, and 273 from hoop- ing-cough,Camhttdgethtre*There was an excess in Hitchin and
killedon the hill-side 26 people a short tune.
in
registered ; the numberi are below from cholera and typhus; in Great Mar low. High There is a want of
drainage.Cholera alsoraged
were m

the average. Metria,er"'sipelas, and syphiUs, were W^'combe;,frotn cholera,measles, and typhus.Alnwick.
lesathan usuallyfatal. The deaths of the mothers Cholera,diarrhcca, and snialUpoi raised tliemor- tality what
some-
in and after ehUdbirth were
XL Welsh Division." The mortaUty w as
11 (J; or one death of in Northampton, prevailed In Titehmartih, from cho-
lera
the mother to 1168 children bom; much lower Tbrapston, and Petcrhoronghf and broke out
^ibovethe average in Wales ; chiefly
the 8C"ie
and scarlaUna. In Merthyr-Tvdfil,
in
thdtiit haa hecn at the same season in London, or, Bedford,and in about 1 1 ,0(^0inhabitants,0 deaths the deaths were
of the great tragedy in summer,
perhaps,in any other city, were registered in the last9 daysof September,2ti
470.
IL Soutn-EAstEttTH Division. Measles and deaths in October and November,
"
The Bnard of ^^,=^=

searlatitiaprevailed in some of the parishes of Guardians was liberal\ Medical reliefwas allbrded
Ep3om ; typhus and influenza in Guildford ; at in B2Q diarrhcE^a cases. The ejects of crowdingare HEALTH OF LONDON DURING THE
Farnham, Dorking,and theother disti-icts of Surrey, shown itiNortii Wiichford ; in the sub-districtof WEEK ENDING FEBRUARY 28.
the mortality wa" l"elowthe averige. The Registrar Chatteris the deaths in the quarters, Dec em her
of Prim ley only reglHtered ti deaths. of the metropolitan districtt, which
This is 1845*9,were
"
33, 39, 41, 42, 73: in the lastquarter The mortality
109*
lower,"he says, ''than I ever remember it to ha?e the tenenients were crowded by labourers on the in the last week of Januaryamounted to weeks
been. Owing to the alarm of the cholera,tbe liverworks. deaths,has, duringthe three subsequent
Division. The deaths in the five steadilydeclined. The number registered m tlie
peoplein thi" districthave been more guarded in IV. Eastehs "

theirmanner of livlni^, in consequence of the low cort caponding quarters of 1845^9 were 4525, fills,week endinglast Saturday, was 911 1 in the ow-
tne
priceof almost every articleof food and elothing." 4674, 5033, 5753, in Msied^Sujotk^and Nor/tilk. responding weeks of 10 previous years (1840-9)i
The generalmortality in Kent,Smt^^r and Hamp' The "excess was greatest in West Ham, Romfortljdeaths rangedfrom 961 to 1258, and the average
#Airr is lower than it was in 1848; yet iSTnall-po^, With am, Wood bridge,Yarinoutlj, and Norwich. was 1U68,which,if corrected for increase of popu- lation,
ararlatlna" and measles pravailed in many districts.Cholera was noticed in Went Han^,Chipping On gar, becomes 1,165," the resultof the companson
In Abingdon, Bradfield, Reading,Easth amp stead, Rochford union-ho use, Lowestoft, and Norwich. is a decrease in the presentreturn of 254 deatns.
and Windsor, (Herkshirej) dia* The improvement is most in thatclass
the mortality was in ex- Scarlatina and low fever prevailed in^ievcial conspicuous
^Mlk^ ScAilatiDa and am"lUpox in tnoti.
prevailed of diseaseswhich afiectthe organs q{ mj^inUoai
 170 THE MEDICAL TIMES,
don. Of the 167 cm^ 101 were discharsed cared, head,an inquestwaa
'
latelyheld on the body of Thames above Batterseai from the New River, and
equalto 6/Ohper cent ; 52 were discharged unoured, a female, aged 18, who was said to have died the Lea. The inhabitants of the south side of die
and 14 dieo. 4 died of typhoidfever and cholera. under peculiar circumstances. She had been a Thames are, on an average, only 5 feetabove Trinity
The receiptsduring the year amounted to 8,903/.patient at the Dispensary for dropsy,when it was high-water mark; and, as regardsdensity, in the
18s. 8d.,includinga balance of 1,8822. Oa. 4d. from discovered thntshe was pregnant, and she was accord- ingly proportion of 14 to an acre, 6 to a house; the hoosei
the former year. The expenditurewas 6,8222.8s. dismissed. She afterwards came under the averaging 25/. in annual value. The nooiiey expesded
4d.,the hospital expenses being 3,7952. 8s. 6d. ; the handa of a auack named Golightly, who gave tome on the reUef ofthe poor by the inhabitantsof thenodh
balance in favour or the Institution2,081/. lOs. 4d. medicines, which her mother stated at the inquestside was 12d, in tbe pound;by those of the south
A legacyof lOOL was received during the year. The were betony,agrimony, and raspberry leaves,and side 18d. in the pound of house-rent. The water ii
centenary festival will be held next year, the hospitalrhubarb,with white ginger.She also had cayenne- chiefly firom tbe Thames below Battersea,and firom
having been firstopenedfor patientson the 31st of pepper, accordingto the same evidence. The mother the Ravensboume. The generalmortality did not
July,1751. added,thatahe herselfhad taken some of the medicine differmuch on the north and south sides ofthe river;
Thb Metropolitan Police." Accordingto the supplied by Golightly, and that ithad not hurt her. itwas 251 annually in 10,000 inhabitants of the north,
PsrliamentaryReport just published, the medical Golightly, It seems, was a marine-store dealer. The 257 in 10,000 inhabitants of the south aide of the
expenses incurred on behalfof the Metropolitan mother stated, that the herbs were givento her,and Thames. The density islessin the SurreydiMricti
Police amounted, during the past year, to 23762. she was to boil them. The sisterof the deceased, of London, which have onlythis great advantage oi"
6s. 7d. The salary of the superintending-surgeon, however, said,that she went for the medicine, and their northern ndghbours. Tne mortality fron
Mr. Fisher,is 600/., and there are sixty- two distinct was
supplied by Golightly with it in bottles,of cholera was very differenti itwas M on the north, and
surgeons, at salariesvarving from 4/. to 72/.per an- num, which she had two. She also contradictedher mo- ther's 127 on the south side of the Thames in 10,000 in-
habitants.
making a totalof '1860/. 7s. 6d. Medical at. statement, that any one, besides the deceased, It is to be observed,that the value of
tendnnce,medicines, "0., for destituteprisoners, and had taken anv of Golightly's medicine. It was houses decreases very regularly in the bands of dis- tricts
for poor persons in cases of accidents, "c.,in the taken three times a-day. Mr. Robinson, of the proceeding eastward from MarvleboDe,
publicthoroughfares, cost 5192. 158. Id. Dispensary, said,that he wascall.ed to the deceased, Hanover-square, and St Martin-in-the-Fields to
A Public Cemetery for Briohton isin con-
templation.and found her in a fit He had previously told the Bethnal-green. Thus the average annual value of
mother she was pregnant, and he then charged her houses was, iu Hanover-square,153/.;in St James,
The New Brighton Dispensary. " This Dis-
pensary with having given her daughter some medicine, 128/L; St Giles, m.; Holborn, 521.; Clerkenweli, SSL r
will be opened next month. The arrange-
ments which she denied. When he saw her, the pulse was St Luke, 282.;Shoreditch, 20t ; Bethnal-green, 9L
of the new building seem to be very good. imperceptible ; it afterwards beaame intermittent. Insurance Offices." ^At the request of numerous
The Dispensary was establishedin 1809. The breathing was stertorous. Death soon took plaee.correspondents, we inserta listof those Life Assurance
A Surgeon at New Shoreham has been fined The conolusion to which he came was, that the de- ceasedOfficeswhich remunerate medical men for giving a
12.and costs for beating his errand-boy. The magi- strates had died from takingsome narcotico-acrid professional opinionon cases referred to them. In
said,that,althouf[h the law allowed a school- master poison,and not from natural causes. He founded thislistthere are several standingvery high, and all
to punish a boy,it did not sanction a master thisconclusion on the symptoms during life, and have a most respectable body of Directors. Haring
beatinghis servants. the appearances after death. The contents of the long advocated this pointwe consider ittliedutyofa
Suicide from Dread of Hydrophobia. " Mr. stomach and intestineswere now in his possession, professional man to recommend those officeswhich
Grant,a surgeon in the Honourable East India Com- pany's sealed up. He waa not certain that the pre- sence recognize the principle that he is as much eotidedto
servicestates, that he knew a roan of the name of the poison,if any had been administered,his fee as the lawyer :" Britannia,Princes-street,
of Grant,who* in infancy, had been made an orphan would be detected. It would requirea very careful Bank, 1837." Architects,Builders, "e., London.
by the decease of the parents from hydrophobia. analysis to detect its presence. Vegetable poisonsEstablished 1848." British Mutwil, New Bridge,
He was the son of a peasant. His father,with a were not readilydetected. Persons might die frohi street,BlackfHais, 184^ ; Church of England, Loth-
number of other men, was engagedon a finesummer them,and yet no trace be discoverable in the body. bury,1840; Commercial and General, Cheapside,
day in the labours of the husoandman. While thus Dr. Charlton expressedhis enture concurrence in the 1841 ; Eastof Scotland, Dundee ; Engineers, Masonic
occupied,a mad dog came among them, and bit se- veral evidence given by Mr. Robinson. The inquest was and Mutual. Strand f English Widows' Fund, Fleet-
of them in the face and hand. The cottage of adjourned, in order that Dr. Glover mightinstitutea street; English and Scottish Law Life, Waterkw*
Grant was near the field; and the dog (afterin- effectualchemical analysisof the contents of the stomaeh. place, 1889; General and Mining, Bridge-street,
attempts to overpower him) made directlyDr. Glover, failed, however, to detect any poison. Blackfriars, 1887; General Benefit.Farringdon-streen
for it. His wife was sitting near the door,with her He gave it as his opinion, however, trom the Great Britain,Waterloo-place, Pali-mall, 1844 ; India
infant boy at her breast. She saw the dog rushing
svmptoms daringlife,ana the appearancesafter death, Life, Waterloo-place, Pall-mall; Industrial andOe-
towards her,open-moathedkSuddenlystarting up, tnat her decease waa caused oy the exhibition of neral, Waterloo-plaoe, Pall-mall;Leeds and Yoiic-
she threw her infant into a basket or creel, which lobelia inflata. The factsclearlypointedto a nar- shire,Oewsbury, 1824; Legal and Commercial,
was suspended on the wall. The dog bit her se- verely, cotico-aorid poison,and particularly to lobelia. The Cheapside, 1845; London Indisputable, Lombard-
but missed the infant. There oeing no me- dical jury returned a verdict,that deceased died from street,1848; London Mutual Life,Moorgate-street^
or surRical aid available, allthose whom the causes the evidence failedto reveal. Golightly self 1884; London and Provincial Joint-stock,
him- Nicholas-
dog bit perished.It is worthy of record,however, attended the in"iue8t, and made a statement,in lane, 1846; Medical, Legal, and General,Strand,
that some of them anticipated a dreadfuldeath by a the course of which it was elicited, that five or six 1845; Medical. Invalid,and General,Pall-mall,
kind of excusable suicide. Havinga most tremend- ous young women had called on him for the same plaint
com- 1841; MetropolitanCounties,R("ent-street1848;;
impression of the horrors of dying in a as the deceased, to wit,the cessation of the Mitre,Pall-mall, 1846; National Loan Fund, Corn-
paroxysm
of hydrophobia. Grant and bis wife had theirveins menstrua. As his chaigesare very low. Is. a bottle,hill,1837: National Mercantile,Poultry, 18371
opened,that they mightbleed to death,which they this dealer in marine stores may drive a thrivingNorth of England,Cheapside,1844; Professional
did with the moat calm resolution." Ca/ctt2/aMedical businesib The coroner strictly cautioned him as to Cheapside, 1846; Prudential, Chatham-place; Royal
Transactions, his future proceedings. He (Golightly) acknowledgedExchange,RoyalExchange,establiahed1720; Royal
Baths and Washhouses." The Town Council that he dia not know the herbs he used when in the Farmers' and General, Strand,1839 ; RoyalInsurance,
of Preston have voted a sum of 8000/. for the erec- 1849 ; the Scottish
tion dry state. He appears to be connected with the Coffin London ; the Times,Ludgate-hill,
of baths and washbouses in that borough. They quackery. Equitable, Edinburgh,1831 ; the Sea, Fire and Life
are to contain 100 baths and 100 washing compart- Important to the Medical Profession. "
In Assurance,Cornhin, 1848 ; Sovereign, St James's-
raenta, and are to be erected after the plan of the a case of action for assault, (Dillone. Reidy,)tried street, 1845 ; Solicitors' and Generat Chanoery-lan"
model establishment in Goulston-square, White- before the Assistant-Barrister, W. ". Major, Esq., 1846; Star,Moorgate-street 1843; Westminster and
chapel. at the Kilrush Quarter Session for January, Dr. General,King-streetCovent-garden, 1836; York-
shire,
Health of Towns Bill." The inhabitants of Foley, of Kilnisb, was summoned by tbe plaintiff, to York, 1824.
Totness have petitioned againstthe application of testify to injuryreceived. On beingcalled
upon to
the powers of this act to their town, stating that the be to the barrister for an order for
sworn, he applied
Town Council has sufficient powers alreadyto do all remuneration for lossof time,and stated that he had TO CORRESPONDENTS.
that is requisite, and that,with theirabundant supplybeen frequently examined in the Superior Courts,as
of water, the town could be rendered perfectly clean, well civil as criminal;that in every instance the "'
T.N.M."" An application to the PoblfsherwUl doabUttt
bidding considerably to its present proverbial tion
reputa- Judgesawarded compensation for loss of time,and enable our Correspondent to completehis pagee*
for health and cleanliness, "
Dr. F. B. Courteimy"has written to ut regarding bU cl""m
at a much letscost than hoped his Worship would extend the same tion
protec-
ihe act would cause "
: hitie ilia lacryma* the cost is
"
to him. The Barrister replied, that the claim to the priority of having used potmssa fuaa in imperoMr
ble stricture. As Sir Benjamin Brodie did noi """{*"
the cause of the opposition, and these JushMiHest was a fairone ; that his time was as much lostto words attributed to him, there is no occasion lo pttollsa
bodies,as the Scotch would call them, are unwillinghim there as at the assizeor at any other court, and he Dr. Courtenay's letter.
to adopt a notoriously beneficialmeasure on account would award to him the same remuneration as the *'T. H. H."" The medicine is detrimental, not in iU um,
of the cost. They may have a sufficientsupply of Judgeswere in the habit of doine." He called on bnt its abuse, in serious apoplexy.
,
.

water, but theydo not use itproperly, or it would not the plaintifTs Attorney, Mr. Mat. Kenny, to pay the "M.D."" We are obligedby the suggestioDSof so valoM
a friend.
be necessar)r to say they could themselves adopt witness. Mr. Kenny asked the witness, what pay-
ment"
H. R."" We fear there is no radical cure tot
" the grow-
ing
measures which would add considerably to its present he required?The replywas, "At least a in at the sides of the toe- nails."but tbe very paintttl
proverbialreputation for health and cleanliness. guinea." The fee was refused. Dr. Foleytold the operation usually performed. ,,,
.

Proverbs are soon made, if Totness be so proverbi- ally Court, that his ol:(ject was to assert a principle. It "H. M." asks the best book to get up En|lUh History Jw
healthy and clean, and yet considerable addi- was now established; thanks to his Worship forthe
tions the Matriculation Examination at the London UniTsrsUy-
It is probablethat Pinnock's Catechism would suffiM.
can be made both as regardshealth and clean- liness. willingness and readiness he evinced to protect fessional
Pro- ""
the Heart."" To a Conatant Bubteribef
and 1^ the Court without being "Wardrop
on
We fear it is merely a comparativestate, rights, *'
other Correspondents we ean only say, as before, "J*^^
afterall. sworn.
was bestowing allthe time and attention he couWgiJ""
City Court of Sewers. " This Court has decided, The Cholera and tbe Districts of the the subject:and we hope,therefore,aoon to yfssenioiir
by a majority of 27 to 20, againstany increase to the Metropolis. "
By a Diagram accompanyingthe readers with the remainingportion." .
|^
""
of the Medical Officer of Health for the City. Registrar's "Mr. Couch's" communicaUoa will r"osir" ""'v
salary weeklyReturn, it appears, that the in- habitants
Mr. Simon, therefore, will receive 500^ a-year still, of the north side of the Thames aertion.
are at an
"Jacob."" Next week.
instead of 800^ as was proposed. Sir r. Laurie average elevation of 51 feetabove highwater mark ; __,.,. ""
"" Verax" will have the Unaness ^to liifour us wlta ns
threatened to calla meetingof the rate-payersin his and,as respects density, in the proportion of 52 to
name. ,
ward,if the proposal were carried. an acre, 8 to a house ; the houses avera^iig in annual We refer X.Y.Z to a Notioe over our Leading Artictoi.
!""
Supposed Death from Poison. " At Gates- value,ISl. Their water is supplied chienyfrom the The wishes of oui Paris Correspondentwill bs atteadsd
 THE MEDICAL TIMES. 171

OEICHHAI lEOTTTBEB. sequentchangesof the insectconsistin the growthof supposedthat,in the development of any insect
allthe parts,which takes placechiefly duringthe there was, " properly
speaking,
no changeof form,

HUHTEBIAV LBCTUXES periodof the moult,and in the gradualacquisition

of but merely repeatedcasting
a o ff of the exterior
the wings, which are developed, eitherwhen the in- sect skin."
ON THE
has reverted to the passive state analogous to With regardto the terms incomplete, obtected,
GENERATION DEVELOPMENT
AND OF
that of the ovum, as in the kinds of pupa above de- and coarctate,theyindicate, in fkct,comparatively
THE INVERTEBRATED ANIMALS.
flned; or the development of the wmgs, as,
e^,, in unimportant modificationsof the last moulted skin
By RICHARD OWEN, F.R.B., the Hemipteraand Orthopieraf is not attended with of the larva of those insects which are torpidor
Honterian ProfatsoT and Cantor of Museum of Royal
any lossof activity or diminution of voracity. quiescent at the periodof the development of the
Collcgo of Sorgoons,ComtpoiidiDg Member of the In- The
stitnie of Fnnce, "c
successive states of an apodalworm, of a wings. In the bee and beetle, and all Hymenoptera
expreuly for the "
Medical Times," and revised worm with feet,and of one with feet and wings, and Coleoptera, the legs,wings,and antennae bud
[Boported
by the Lecturer.] beingaccompanied likewisewith the acquisition and out and carry with them processes of the lastlarval
perfection of the antennal and visualorgans of sense, integument, which thus forms in the pupa special
LECTURE XVIL and of the internaland external orgransof genera- tion, sheaths foreach growingorsan of sense or locomo- tion
Ths MBTAMOKYKCflBB OP IiTSECTs." Entomologlcalde and oftenwith great changesin the digestive, in the perfect insect, and which organs are there- fore
flnltlons of the coarcUte, obtected,Incomplete,seml- muscular,and nervous in the development comparatively firee, a lthough the pupa be
systems,
eomplete,and eomplete modlflcations."The larva, ver- of one and the same insect, have been emphatically quiescent. Lamark calledsuch pupae
"
Mumiae."
mHarra. homomorphous and heteromorphous larva.
ohrysalls or aurelia, nymph" The termed ** metamorphoses." And entomologists,In the obtected Lepidoptera the growingwines,
"The popa, mnmla,
fanaffo" ne true character of these dedned stsRes and availing themselves of the neat definitionsof the antlia, antennae,and thoraciclegsare onlypartially
Tailetlea"Metamoiphoslsa course of development alike
In iu essentials,with its stanes varied aa to time and pupse by Linnseus, have defined various kinds of covered by the pupalintegument, beinglodgedin
larval types of metamorphoses under special heads, as the ** co- arctate,"
recesses on its inner surface,which make sponding
corre-
plaee* all inseets at first vermiform:
Entoaoa, Earth-worms, Nereids,Myrlapods and Crabs "obtected," "incomplete," **
plete,"
semi-com- projections on its exterior, where thrir
"Metamorphosis and development of organs In Lenl- and " complete" metamorphoses. form and position may thus be recognised.
doptera"Economy of social Hymenoptera. and of the The progress of the insect throughthese several In the coarctate metamorphosis of the Diptera,
pumsitio Ichneumones and BtrepsipteraReproduction
"

of parte: Mr. Newport's experiments" Comparison of stagesbeingin many species interrupted, and active the larva sheds itslast skin beforethe growinglegs
with mammalian phases of lifeenjoyed a longer
iosect-metamorphoses em- for or shorter period under one and wings have impressedtheir forms upon it,and
liryonlc development. or other of the immature forms, these have been the exuvium constitutesan egg-shaped hornycase,
Mr- President Gentlemen, I cannot
and "
sooner and more prominentlybioughtunder the upon which there is not the least indication of the
introduce my concluding observationaon the gene- notice of the naturalist, than if theyhad had to be partsof the perfect insect.
ntion and development of the claas of insects in soughtfor,as in the bird or mammal, in the early Under whatever form the insectbe excluded from
better languagethan in the words of our celebrated periods of the developmentof the minute embryo. the egg, if we trace its development further back,
countrymen, KirbyandSpcnce, the entomologists to
They have consequently had assigned to them a we sh^lfind that the tendencyof the mysterious
whom we owe the most useful and popular introduce character of singularity and exception which they multiplication, arrangement, and transformation of
tion to their delightful science. TTieysay : "
do not intrinsically deserve. The differentstagesof the hyaline nucleus and germ-cells is vermiform.
**
Were a naturalistto announce to the world the development have been likewise, for the most part, In all insects the embryo firstmanifests itselfas
discovery of an animal which, for the first five years studied only in the instances in which they are an apodal smooth Entozoon ; next as an Annellide of
ofitolife, existed in the form of a serpent;which manifested by insectsafterexclusion from the egg, thirteenrings: in all insects the firstsegment is
then, penetrating into the earth, and weaving a and thus their minor modifications and differences quickly m odified and the mouth established; and
ahroud of pure silk of the finesttexture,contracted have attracted more attentionthan their essential in this state the larva is excluded in some insects, as

itselfvnthin this covering into a body without ternal

ex- resemblances and relations to one and the same the bee and fly,without any appendages being de- veloped;
mouth or limbs, and resembling, more than type and course of development. and in the bee before the completion of
and which, the young insect breaks throughthe the intestinal canal.
anythingelse,an Egyptianmummy; As soon as

after remaining i n this state without food and egg-shell it is called, i n Entomology, Larva, ever
what- The of the order Diptera and Hymen*
lastly, a maggots
without motion lor three years longer, should,at the gradeof developmentit may have attained in optera typify the Entozoa ; they have no distinct
end of that period, burst its silken cerements, ooo. During the period when it acquires the wings, scaly head,and no thoracic legs; hence theyhave
throughits earthly covering, and start into and until their completeacquisition, it is called a been termed " vermilanres." lliose of the Diptera
struggle
day a vringed bird, ^what think you would be the 'Pupa,
"
and of the Ickneumomda represent the parasitic
aensation excited by this strange pieceof intelli. From the importance which has been assigned, in wonps, not onlyin structure, but in habits ; the
first doubts of itstruth pelled,
dis- estimable entomological treatises and classifica-
tions larvae of the GastorophiUcalled " hots,"pass that
gence ? After the were some

what astonishment would succeed ! Amongst to the developmental changesof insects, and the 8tage of their existence in the alimentary canal of
the learned,what surmises! what investigations! special denominations thathave been multiplied press higher
to ex- animals. The larva of the Anthorugia cani*
Amongst the vulgar, what eager curiosity and them, you might suppose the "
complete," the eufaris may be, in like manner, considered as entozoa
amazement ! All would be interestedin the history" semi "complete," the "incomplete," "
the obtected,** of the himian subject.There is a breeze-fly
of such an unheard-of phenomenon; even the most and " coarctate" metamorphoses, to be different de- ((Estnu
grees, hominis) which deposits its egg beneath the
torpidwould flock to the sightof such a pro- ifnot distinct kinds oftransformations.But the Integumentof the living body,and its larva there
digy."(a) insectswhich are said to be subject the semi-com-
to plete grows and flourishes like the Pilarisin the cellular
Now, a prodigy of thiskind, in all itsessential and incomplete metamorphosispass through tissue. The larva of a species of Cuterebra occasion-
ally
features,is manifested in this country under a the same kind and amount of change as those findsitsway into the human frontalsinus. Other
thousand modifications. You will witness it,if you characterisedby the obtected or coarctate pupa" The vermilarves, as those of the CSttri Bovis and Tarandi,

trace the lifeof the common beetle from the egg, difilerences resolve themselves essentially into the are developedbeneath the integumentor in the
or watch the same course of changesiu the silk- worm. placewhere, and the time in which,they assume nasal sinuses of the Ruminants indicated by their
and quitthe vermiform state. specific names. I know not to what 'othermodes of
The first form under which insects appear after The Orthopterousand Hemiptcrous insecta,animal lifethan that of the parasitic Entozoa we can
qitttting the ovum is called the larvaja name visedcharacterisedin entomology
de- by a semi-complete compare the habits of the voracious maggots of the
tamorphosis,
me-

^y Linnsus, to signifythat beneath this are, at one stage of their developmentfiesh-fly, the essentialcondition of whose existence
worm-likb or snake-like guisethere was marked a apodaland acephalous larvas, like the maggot of is the putrid fleshof higherorganised beings.Here,
higher form. The second stage is the jmpa or the fly; but instead of quitting the egg in this however,the development of helminthoid larva has
"krysaUs; and thts third and last stage is the stage,theyare quickly transformed into another, in been beneficially ordained in order to neutralisethe
imago, as being tht image to which all the which the head and rudimental thoracic feet are noxious effectsof the otherwiseinevitableprocesses
former stages tended. Lvnnseus gave, also,pre- cise developed, to the degreewhich characterisesthe by which dead animal matter reverts to its primitive
terms to the difiereniconditions of the hexapod larvae of the Carahi and Petalocera; the elements. Insignificant, indeed,do these larvae
pupa state of the insect; and these terms thorax is next defined and the parts of the head seem to be in the scaleof nature, yet Linnaeus used
have been appliedby some entomologists to cha-
racterise acquired, at which stage of development the young no exaggeration when he averred that three flesh-
metamorphoses generally. 'NVlieu the last Orthopteran correspondswith the hexapodantenni- flieswould devour the carcase of a horse as quickly
larval akin or sheath of the pupa shows no signs ferous larva of the Meloe ; but it differsfrom both as would a lion. The assimilativepower is so great
whatever of the limbs or appendages of the creature these kinds of Coleopteious larvae in beinginactive in the meat-maggot that it will increaseits own
within it,Linnaeus called it a " coarctate pupa." and continuing in the egg almost untilall the pro- portions weighttwo hundred times in twenty-four hours.
Wh^ the pupa-case shows,as ifby a kind of sculp- ture and characters of the mature insect are But the developmental eneigies are not exhausted
in relief, the character of the organs beneath acquired, save the wings. by the rapidgrowthof the larva ; some remain to be
it,the pupa is " obtected." When the pupa-case Oddly enough that developmentis called " a exercisedin the formation of the new and peculiar
fonn" a special sheath for all the projecting parts completemetamorphosis," which is permanentlyorgans which entirely changethe form and properties
*'
and i^pendages the pupa is incomplete.*' arrested at the stagein which the orthopterous insect of the creature. For this exercisetheyusually require
In allinsects the development of the embr^'o pro- enters life,
ceeds, and the onlyhexapod insects, as the ap-terousthe suspension of all the ordinary actions of life.
with a few secondary and unimportant cations,
modifi- Cimex and Pediculus, in which the metamor- phosis The larval skin is thrust off* by the new integument
in the order which was described and illus- trated is never completed, are those in which it is of the new organs, and is converted into an opaque
at the closeof the preceding Lecture. The sav~ "aid to be " complete." Burmeister,however,seems brown case ; the enclosed insect shrinks partly by
to be Um" only has pointedOUt the the loss of exhaled fluids,
RntoxxuklagiAt who partly by the condensation
(a)" Introductionto Entomology,"Vol. I.,]etter iii,inaccuracy of the Fabrician definition; but he failed of its former softtissuesinto the new and finn sub- stances
to firee himself from the thraldom of wards when he constituting the legsand vrings.A large
No.'646, Vol. XXI,
 172 THE MEDICAL TIMES.
and distinct head is now developed, with eyes, of a queen or fertile female,and perhapsa thou- sand quitthe egg witlia scalyhead and jaws,with three
cibaria;all which pro- attendant neuters. Thus the association, which is pairs of thoracic legs,short,and with claws, and

sist
antenne, and instrumenta cesses
are carried on in the quiescent concealment annually dissolved and re-commenced by the wasps, usually four pairs of tubercular prolegs, supported
of the opaque and dark exuvium, like the anidogousis permanent in the honey-bee, and the fertilefe- male,by the sixth, seventh,eighth, and ninth segments;

processes in the egg of the oviparous, and witiin the or queen, never shares with the neuters the sometimes there is also a fifthpairupon the anal
womb of the pupiparous, nivorous labours of the hive.
insect. The active car- segment The prolegs, which entirely disappear in
vermilave returns,in fact,a second time to The development of the bee is more speedythan the pupa, are, however, less constant than the tho- racic

the state of an ovum, when it becomes the coarctate that of the wasp; the larva is hatched in three days legs. The larvaeof the Lepidoptera are monly
com-

insect, splittingitscerement, after the exclusion of the egg ; it feeds and grows herbivorous, and devour considerable quanti- ties
pupe ; and the perfect
issuesforth as bv a second birth. five or six days; is then shut up by the workers, of vegetable matter. The coarsely masticated
The larvae ox the gnats {Culez) and crane-flies spins itselfa cocoon in thirty-sixhours,remaining a leaves are conveyed, by a short and wide oesophagus,
(Tipula)have a distinctcorneous head with jaws; passivepupa eight or nine days; then breaks to a much longerand wider chylific stomach. Six
the former have a plumose anal coronet, by which through the lid and emerges in its perfect state. pairsof capillary bile-tubes indicate, by their in-sertion,
sustain themselves the surface of the Thus the whole period development
of f rom the the commencement of the intestine, which
they at water ; clusion
ex-

the orificesof the tracheae are placedin the middle of the ovum is from eighteen to twenty days; terminates by a wide,short,and longitudinally cated
pli-
of this coronet. A pairof tracheal tubes extend this,however, relates to the neuter. The male or rectum, upon the last segment
slender,and extensileanal canal drone larva hours in In its perfect state,the butterfly, or sphinx, sub-
sists
through the long, spendsonlytwenty-four spinning
of the aquaticgrub of the Muica (Eristalis) tenax. its cocoon, and emerges on the sixteenth day afterits onlyon the fluids of vegetables : its maxillary

apparatus is converted,by the abrogation of the

By this mechanism, which is analogous to the tube deposition as an egg. A young queen is perfected
the rat- tailedlarva can derive its on the twenty- fourth day. It is remarkable,that homy mandibles and the extreme prolongation of the
of the diving-bell,
requisite supplyof air from the surface while groping the larva of the bee and of the parasitic Hymeuo" maxillae, into a longsuctorialtube,called antlia." "

for food in the mud at the bottom of the pool. have anal outlet faeces until A long and slender oesophagus the fluidsto
ptera no ; no are passed conveys
The economy of the Hymenopteraand the various the larva has acquired full growth,and has ceased the chylific stomach, and to a wide crop, which
ciicumstances attending the development of their to feed,preparatoryto the pupa- state: thus the duringthe pupa state has been gradually expanded
apodallarvs form the subjects of a longchapterin fluidsof insectsinfested by the parasitic larvae are from one sideof the end of the gullet.The chylific
of Insects. contaminated the of their stomach has shrunk into a con^paratively short
the History not by excrements sites
para-
I must be governedin the unavoidably brief ; and the bee-cells are kept sweet and clean fusiform cavity, which is stillcharacterised by the
selection from this rich storehouse of interesting the active life of the larva. transverse sacculi and constrictions. The small
during
facts by the specimenswhidi Hunter has left for In these preparations (Nos.3117 to 3123 inclu- sive) intestinehas diminished in width, but increased in
instruction. Here (exhibiting the preparation shown the irregular cellswith length, and now lies in several convolutions be- tween
our are subelliptical
No. 8104)we have a portion of the nest of a social the larvae and perfect insects of the humble bees the chylific stomach and colon, the upper
of the of of which has also been produced into a caecum.
hymenopterousinsect wasp tribe {Polutet(Bomhi terrestrls and lapidarhis.) The societies part
biliary vessels are diminished in length, but
major), showing the larvae and theircells in every this genus, which consistof about sixty, sionally The
and occa-
staffeof growth; the smallestlarvs and the shallowest of 200 individuals, continue,as in the wasp- stillcommunicate, by a short common duct on each
cellsare at the lower margins of the pendentnest ; tribe,onlyuntil the beginning of winter,and the tide, with the commencement of the small intestine.
and observe how, in these beginnings of cells, the few impregnated females which survive the frosts, In the bee the metamorphosisof the digestive
of the organs is stillmore striking than in the butterfly,
part of the incomplete circumference forms two, fonnd fresh colonies at the commencement
three,or more sides of a complete hexagon, strating
demon- following spring.The fertilefemale shares in the inasmuch as the alimentary cavity consists, beyond
that this is the form of cell originally and labours of the community which she has originated, the short and wide oesophagus, exclusively of a

made by the insect, and not the accidental and she is provided, like the neuters, with the dense largetransversely plicated chylific stomach out
with-
expressly
and inevitable result of the reciprocal the pollenplate of the intestineor vent.
pressure of fringeof hair surrounding
originally cylindrical cells, moulded upon the bodies hind legs, which the queen of the hive-bee does not The larvae of bees and wasps have from four to
of their simultaneously-working fabricators. The possess. The first progeny of the humble-bee are six biliary vessels, which shrink in diameter and
parent wasp of this colonybegan her labours in neuters ; the males are not developed until autumn, contract in length during the pupa state.
spring.A solitary mother and mdependentbuilder and theyare the produceof a smaller kind of fer- tile The gizzard is never present in the vermiform
of the required shelterfor her ofHtpring, she herself female. The whole economy of the humble-bee larvaeof the Coleoptera, (dthoughusuallypossessed
nursed and fed her firstbrood,which, being non- observed by Hunter,whose MS, by the perfect insect
was very completely
"

breeding labourers, soon aided theirparentin build notes on this subject

" have been published in the In the larvae of the Scarabai,Mehloniha,and
most herbivorous Coleoptera, the chylific stomach
ingthe cellsand rearing her larvs. You willobserve fifthvolume of the Physiological Catalogue.
that the full-grown grubs,which requireno more The larvae of the Coleoptera are active, althoughis shorter than in the imago; but it is furnished at
food,and are about to fall into the pupa state,are some, as the nut-weevil,are apodal, like the larvae both ends with caecalappendages, which disappeir
shut in by a transparentconvex pellicle, which of the bee. In most of the herbivorous species the during the metamorphosis,except in the genus
covers the mouth of the cell. thoracic legs are represented by fleshy tubercles; Ulster, in which some traces remain in the perfect
In the common wasp, the larva is hatched eight but the larvaeof the carnivorous beetles have the insect.
The salivary vef selsof the caterpillars of the Le- pidoptera
days after oviposition ; it grows to its full size in thoracic legs more completelydevelopedbefore
twelve to fourteen days,then spins its delicatehood, quitting the ovum. The head is homy, and the are of two kinds ; one pairis short and
casta its integument, which has grown with its trophi are well developed in all the jawsfrequently
: broad,sometimes vesicular, as in the Cossus ligni-
growth from the time of quitting the egg, and, after resemble those of the perfect insect,as in the Cara- perda, and their ducts terminate at the base of the
a passive pupa state of ten days,emerges a perfecthida, the larvaeof which likewise have antennae. maxillae. Those of the second pairare very long
insect. Tht males and perfect females are reared The circumstance of most physiological interest and slender,occupying,with their longitudinal
at the beginning of autumn; the abundance of food in the development of the Coleopterous order of in-sectscoils,the sides of the aodomen, and sendingtheir
is the great lengthof time during which the slender ducts forward to unite together and termi-
nate
yielded by the ripe fruitat that season may influence
the higherdevelopment of the larvae, which are fed species actively exist in the vermiform or larval upon a peculiar prominenceupon the under
w hich is called the spinneret(This ahowm
by the regurgitated contents of the crop of the stageof theirdevelopment The larvaeof the cock- chafer lip, was

the earth-worm in their habits,and in the preparations, Nos. 2985 to 2988.) 'Wieae
nursers. typify
The fertilefemales share with the non-breeders continue for three years burrowing in the soil and tubular glands,though classed with the salivary
or neuters of the rapidly increasing community,the devouring the roots of grass and other vegetables. apparatus,are peculiar, in their full Afvelopment,
" sprfcteria" or silk-
labour of rearing the young broods ; the males, or The larva of the stag-beetie bores its way into the to the larvue,and are called
thtyglutinous material
drones,performno kind of work. At the close of tnmk of a tree,generally a willow or oak, and re- mains tubes,because theyprepare
which the larva "pins to form its cocoon.
autumn, when provender is scanty, and hardlyto be there six years. It is furnished with two or silk,
got,the neuters,by a strange, and,as itwould seem, powerfuljaws,with which it gnaws the wood. It In the perfect insect, the remains of the salivary
and the com-
apparatus are limitedto the thorax, mon
perverted instinct, save the laterbrood of grubsfrom forms a cocoon of the minute chips or tan, to which

the pangs of famine by killing and casting them out it reduces the wood, and passes a considerableperiod duct opens beneath the tongue.
of the nest. The young females are impregnatedin the
pupa state ; duringwhich, the largehorns
of The epitiielial lining of the alimentery of canal
that of the closed
previous to the setting in of winter ; the males soon the male are folded upon the breast and abdomen, the larva is shed at each moult;
stomach in the bee maggot is evacuated in the
afterdie ; the females then disperse, seekingwinter protecting the antennae and legs.
the new foimed anus.
quartersin sheltered situations; and those which The anatomy of an insect in itsdifferentstages pupa state through
survive the rigours of the frosty season of development, and the changesof both the exter- nal The superabundant nutriment preparedby the
commence,
is stored up in the condition of
at the return of spring, the foundation of a new and internalpartsin the progress from the larva voracious larva
of fat which surround the viscera and
colony. to the imago state, have been most accurately and masses

The higherinstinctsof the honey-bee{ApismeU closely examined in Lepidopterous insects. Many occupy their interspaces.
teach it to layup a winter store of food,upon The parasitic Ichneumons introduce their ova
Ufica) of these changes are shown by Hunter, in his ex- tensive

of the silkworm moth. beneath the skin of the larvae of Lepidoptera.

which, the males havingbeen destroyed on the per-
formance series of preparations
of their sole office, When hatched the Ichneumon larvae subsist u]"on
the queens, with a They were investigated by Lyonnet in the Couut
trated the fat of the caterpillars, which they infest. They
familyof neuters, subsist tillspring.The neuters Ugmperda. They have been described and illus-
the alimentarycanal, but evi-
dently
alone now recommence their labours of housing, in with much accuracy and detail by Herold in avoi"i penetrating
waxen cells, the eggs of the fertilefemale,and feed- ing the PapilioBrassireTfand by oiir own indefatiflp*''',*' destroy many of the minute branches of the
trachea which ramify in the adipose t issue. Such
the larveae. New colonies so raisedsuccessively entomologist, Mr. Newpurt, in the SfpMtu: Ligustrif
from the parent hive,or **
and other insecte. The larvae of the Lepidoptera wounded tracheae probablypermit the escape of
emigrate swarm' '
; they con-
 THE MEDICAL TIMES. 173

sufficientair for the respiration of the parasitic contractedby a universalspasm, would be irregularly artificially preparedby the larva. The valuable
larre ; for though the caterpillars so infestedsur- dislocatedor aggregated into one or more masses ; silken cocoons of the larva of the Bombtu mori,
meaud go intothe pupa state,theyare uneasy, and but, on the contrary,we perceive the nervous ticles
par- called, par excellence ,
the " silkworm,"are fiimiliar
evidently diseased ; the loss of the adipose store of moving forwards and re-arranging themselves examples of pupal chambers. In this cocoon
nntriment preventsthe completion of the metamor- in orderly groups, definite in their forms,in their (showing No. 3073)of a larger lepidopterous insect,
and instead of a butterfly, of small proportions, and in their relative positions; these lOikelicua Kirbyif) the larva, by one of those mar-
;hosis,
chneumons emerges from the cocoon.
a swarm

beingapparently regulated by a law of prospective prescient instinctswhich giveso much inte*

vellous

With respectto the outward form and integu- ments arrangementand arrangedprecisely in those situa- tions rest to entomological inquiries, covers the dose and
of the vermiform larva,these are contracted where the greatest supplyof nervous energy is thick web of fineand softrilk which ithas prepared
lengthwise, and partially dilated daring the pupa required to radiatefrom them in the active and
fect for its pupalrepose,with a stronger
per- outer defence of
state. The longitudinal muscles contract, and are insect. portions of twigsirregularly ""und togetherby
permanentlyshortened by interstitialabsorption: The generalprinciple of those changesis like silken filaments; thus suspended to a branch of the
they shorten the body by sheathingthe segments that which governs the modifications of the mus- cular tree,it deceives and escapes the attacks of preda"
one within the other,the intus-suscepted portions system,viz., a localisation of special masses at toryinsectivorous birds. The pupae whose cocoon
beingafterwards modified or removed. particular parts for special purposes, the result of remains partiallv open, as in Saturma and PAry-
The dorsal vessel, which is developed above the which is the departure from a common cular ganea, are usually
to a parti- called '* guarded," (pttpte cutto-
intestine, and beginsto pulsatebefore the larva type of arrangement. diaUe.)
quitsthe egg, undergoesa corresponding change One of the most obvious and remarkable pheno- mena I All pupae which are placedin dark situationsare
with the common integument in the pupa state. It in the larvallifeof an insect is the successive colourless, or of a yellowish white, and become
seems to be contracted by a seriesof intus-suscep- sheddings of the skin. The number and frequencydarker when exposedto the light The pupae of
tions;the abdominal part is slightly expanded, ecdysesof the v ariesin different species, and relates most butterflies, which are suspended in open day,
more definitely divided into chambers, and better to two circumstances,viz.,the rapidity of the are of a green or yellowish brown colour;some are

provided with valves ; the thoracic portion is plified,

sim- growth of the body, and the susceptibility or wise
other- speckled w ith glittering spots goldenhue, either
of
shrunk in diameter,and is more distinctly of the skin to be distended or to grow with the natural, or producedby Uie attacks of parasitic sects
in-
defined as an aorta sent off from the heart increaseof the body. ; and such pupae have obtained the name of
The respiratory system undergoesstillmore markable
re- The soft-skinned maggots of many flies, which " chrysalis" and " aurelia."
modifications. The branchiae of the acquirea vast increase of size duringtheir brief The active pupae of Orthoptera and Hemiptera
aquatic larvae either disappear or are developedlarval state,never moult until they change into are called "nymphs." These insects, which are
into wings: the long pneumatictubes of those when the exuvium forms the pupa-case. In alsosaidto have semi-complete pupae, and to undergo
which,living {"upae,
in water, breath air,shrink and disap- ike manner, the soft-skinned apodallarvae of the an imperfect metamorphosis, are subjected, as I
pear. The partial dilatationsof certaintracheaeto Hymenopterado not moult until theyhave acquiredtrust I have already proved, to the same law of re- petition
form reservoirs of air for diminishing the specific theirfull size. The caterpillars Lepidoptera
of the or analogy wnich is expressed conspicu-
s o ously
gravityof the bodv, beginto be formed in the pupa moult at least three times, and some more quently
fre- in insects to which alone a perfect phosis
metamor-
state of the flying msect. ; the Bombyx viUicOf for example, from five has usuallybeen attributed; for,although
Herold has diown that germs of the generative to eight times,and the tiger-moth (Arctia caja) ten moultingbe no metamorphoses, even when accom- panied,

oigana exist in the larvaeof the Lepidoptera ; the times. as it usuallyis in insects, with a certain
testes appear on each side as four nucleated cellsin With regardto the nature of the mutations and changein the form of the body,yet the course of
a longitudinal series, which, by progressive lescence ecdyseswhich
coa- culminate in the perfectinsect,the development of those insects which,after exclu- sion
longitudinally, and by approximating I should hardly have felt justified, after what has from the egg, are subject only to ecdysis and
transversely, and ultimately unitingat the middle been already detailedrespecting the development of growthof wingsduring an activenymph-hood, fests,
mani-
line,first ft"rm an eight-chambered, and after" the larva in the egg, in referring to the hypothesis priorto exclusion, the same analogies, which
wards a
spherical gland. The ovaria retaining of Swammerdam, ^that the imago was
"
actually cluded
in- Oken expressesin the following words : " Everyfly
"

their primitive separate state, increase in length, and in the larva,and that all new skins pre- creeps as a worm out of the egg ; then, by changing
assuoK the spiral disposition in the pupa state. exiatedbeneath the old one, if such opinionhad into the pupa, itbecomes a crab ; and lastly,
"
a per-
fect
The progressive change^which the nervous system not been adoptedto explainthe metamorphosesof fly."
of the Lepidopterous insect undergoes in its meta-
morphosesinsects in the admirable work, alreadycited,of It is not, indeed,true that eyexy flyinginsect ^

from the larvalinto the perfect state,have Kirbyand Spence, and maintained by Cuvier in the creeps, as a worm, out of the egg ; allthe Orthoptera
been beautifully and accurately illustrated by second and posthumousedition of his celebrated and Hemiptera are excluded under the type of the
Herold, in the cabbagebutterfly, and by Mr. New- port, *' Le9ona d'Anatomic Comparee," where, in the crab, ". e., with perfectly developedjointedlegs,
in a speciesof sphynx; but Lyonnet had sixth volume, p. 2, (1846,) he writes, "
des I'instant eyes, antennae, and maxUlary organs. The meta- morphoses
anticipated both these observers, in recognising as ou les corps vivants existent, quelquepetits qu'ils which the locust undergoesin iu pro- gress
well the principle as the details of these changes,soientencore, ils out toutes leurs parties : ce n'est from the potential germ to the actual winged
which he briefly describes at the termination of his point par Taddition de nouvelles couches qu'ilsand procreative imago are neverthelessas numerous
immortal monographon the Cotnu Ugniperda. croissent,maispar le d^velopement de parties toutes and extreme as those of the butterfly. The dif-ferences
The twelve ventral ganglions of the larva are sub- pre-existantes i tout accroissement sensible." The are relative, not essential; they relate to
equal,and, except the two last, at regular distances; accurate observationsof Herold on the changes and the placein, and the time duringwhich the morphoses
meta-
in the pupa, themtergangiionic columns are shorter,development of the organs, duringthe pupa state, occur, and to the powers associatedwith
but the body,becoming stillmore abbreviated and sho# these to be, likethe original processes of the particular transitory forms of the insect. The legs
concentrated, throws thosecolumns intocurved lines. develoi.'roentof the larva itself, Uic results of a of the worm-like embryo-locust were once unarticu-
The eleventh and twelfth ganglions coalesce;the transmutation, increase,and coalescence of primi- tive lated buds,like the prolegsof the caterpillar ; but
sixth and seventh disappear ; the fifth blends with elements of the difierent tissues, "
elements the creature was passive, developmentis not
and
the fourth,and the third with the second; thus which c'"nsist of nucleated cellsor nuclei, like*those superseded for a moment by mere growth;these
or rather,
leavingfour ganglions in the abdomen and two in the that resultfrom the spontaneousfissionsof the prim- ary organizing processes go on simultaneously,
thorax. Corresponding changes take placein the impregnated germ-cell, "elements which may be change of form is more conspicuous than increase
ceiehral portion of the nervous system. The max- illary viewed as partsof the original germ-mass, retained of bulk; the six rudimental feet are put to no use,
ganglion decreases with the diminution to be successively metamorposedinto the successive but constitutemere stagesin the rapidformation
and change in the maxillaryapparatus. The larval skins, pupa-skin, and imago. of the normal segments, which attain their mature
oesophagealc(AUr contracts, as does the canal The few instances of the reproduction of muti-
lated proportions and meir armature of claws and spines,
which itsurrounds. The brain enlarges, havingto parts in insects have been observed to take before the egg is left The flrstsegp:ient of the
supplyorgans of sense, especially those of sight,placeonly at the period o f the moult, and are never originally apodal and acephalous larva is as rapidly
which are perfected to correspond with the acquisi-
tion manifested by the imago.A young BkUta, in which and uninterruptedly metamorphosedinto the man-
of new and improved locomotive forces. both the antennae had been cut o^ moulted a fort- night dibulate and antennate head,with largecompound
Analogouschangeswe may naturally conclude to after the operation, and then acquiredtwo eyes.
take placein other orders of insects; and we find, new but shorter antennae: the legsand prolegs of Thus developed, the young Orthopteran or He-

indeed,in some of these,that the nervous system caterpillars are said to be produced in like manner mipteranissues forth into active life. Instead of
continues stationary at stagesof development which afterone or two moultings. fiiilher individual improvementor development, it
are progressive and transitory in the Lepidoptera, The passive and, as it were, embryoniccondi- tion may at once beginthe greatbusiness of itsexistence
and that further concentrationis discovered to have to which most insects(Coleoptera, Lepidoptera, by parthenogenetic propagation of itskind, as in the
taken placein the Melolontha, Cicada,Nepa, "c., Hymenoptera,Diptera, manv Neuroptera)return Ajiis, and feed and die without further changeof
than that which constitutesthe higheststage observed when, after an active larval life,the organising form ; but,generally, the active, ciab-likelarvae are
by Herold and Mr. Newport in the Lepidoptera. energies againsuperinduce the processes of develop- ment subject to^three moults. After the flrst the larva has
The nuurvel is, that thesechanges, due in part,appa-rently, those of mere growth, is calledthe pupa merely increased in size ; but the rudiments of the
upon
to mere mechanical influences, should be so state. The chiefmodificationsof the pupa have al- readywingsbeginto bud forthbeneath the second skin ;
regular, so orderly, so admirablyadapted, in their been explained in relationto the terms coarc- and, after the second ecdysis, theypresentthem- selves
finalresults, to the general condition and exigencies by which they are de- signated externally small leaves,which cover the
tate, obtected, incomplete, as
of the perfectinsect One mighthave that by Linnaeus. sides of the firstabdominal segment When this
supposed,
the particles of the soft and semi-fluid nervous Bonie pupae are protected onlyby the exuvial skin activepupa or nymph againmoults, the insect at- tains
matter,squeesed bv the pressure of the surroundingof the precedingstage, and have been termed its perfect condition ; the,at first, short, soft,
I
"
,_-, o

structures,when the body seems to be,as it were, I" naked ;" others repose in cases or "cocoons," and thick wingsrapidlyexpandto their full size,
 174 THB MEDICAL TIMES.
then dfy in the air; the ciiealation of the blood acquisition of jointed legsand wings,and thus indi- cate those that have broughtto lightthe corresponding
along Uie neprvnres ia anefted, and the metamor- the close and essentialafGbuty of the myriapods metamorphoses of man and the mammalia gene,
phods of the individnal is complete.Here,then,to the hexapod insects. Thus do insects in Uieir rally.
we aee that the pupa itage,which, in the butterfly, metamorphoses diversely typify a Divine archetypal By a premature exclusion and acttrity of
waa paniyeand embryonic, in the locoitis active pattern. the embryo,and by alternate periods of growth
and Tonuaons ; whilst theirrespectiye conditions in In the Coleoptera and Lepidoptera the generaland development, one small group of vertebrate
the larvalstate are reyersed. Hie whole periodof articulatetype is longer retained, and the particular animals,the anourous Batrachia, do actually
the lifeof the Orthopterous inaeot, ftom exclusion one lateracquired.In the Hemipteraand Orthop- manifest the correspondence with the metamor-
phoses
to flight, may, if itsorganization during that periodtera the morphological and histological changes of insects, which I have illustrated .bysa
be eontrasted with that of the Lepidopterous or more rapidlyand uninterruptedly enect the ascent instance of hypothetical possibility in man. Naj,
Coleopterous insects, be called an active nymph- from the common to the special form. Professor do not the Marsupial mammalia o"r an example of
hood. Burmeister,in his riohly*stored Manual of Entomo-
logy, the premature exclusion ? It needed onlythat
Entomologists, overlooking that stage of the Or- thopterous translatedby Mr. Schuckard,states that, In the yoimg kangaroo,"
with its equaland mdiroental
and Hemipterous insects, in which they insectswith an imperfoct metamorphosis there can-
not limbs,should possess,likethe tadpole or caterpillsr,
are masked by the vermifenn or true larval con- dition, consequently biea passage throughthe earlier the power of self-subsistence, and have gone on
have arbitrarily applied the term "larva" to forms and grades of the animal kingdom(Shuckard's feeding and growing, whilst the further and final
the more advanced stage in which these insects,Translation, 423.) The ferred changes of form were reserved for,and concentrated
p. consequence here re-
with certain Neuroptera, quit the egg. Kr. West- to appears to be, as far as I can understand in,a future brief period, to render the parallel most
al-
wood seeing, that at thisstagetheyare nearly similar the Author,a hypothetical necessity in Nature,for complete.The creepingor swimminglarva
in form to ihe perfiBct insect,thoughwingless, has a diffisrence insectswith respectto theirmeta-
morphosisof the Mammal would then have gainedits instra-
among
''
proposed to callthem
homomorphous," or
**
morphous
mono- ; but no insect, however metamorphosed,ments for leaping, as the caterpillar acquires its
;" and those insectsin which the larva is
passes throughthe forms and gradesof the radiate organs of flight and the concomitant development
generally worm-like, "o.,heteromorphous. Itneeds sub-kingdom.Commencing as a Hydatid,it quitsand metamorphosesof the organs of sense, of di- gestion,
onlyan acquaintance with the embryonicchanges that sub-kingdomby the analogyof the Entozoa, and of generation, would have been dossly
of a eookroach or cricket to feel how
inapplicable and itssubsequent gradesare throughthe forms of analogous in both animals.
is the term monomorphousor uniform to such an the Articulata exclusively. No insect ever is, or
insect or itsdevelopment resembles the ciliatedIxifusory, the Polype, or the
The chief business of an insect, for good or for Acalephe. The insects with a so-called imperfoct ORIOINAXi OONTRIBUTIOlfS.
evil,is performedin its larval state. The moth, metamorphosis, contraryto the statement of Bur- meister,
which destroys your clothes, does it not in itscom- do pass throughthe earlier forms of the
plete, A SUCCINCT HISTORY OF ASIATIC
but itslarval, stage. The cockchafer, which articulate sub-kingdom,but more rapidlyand CHOLERA,
makes the young wheat-blade wither and fall, is a uninterruptedly than those in which the metamor-
phosis A8 IT APPEARED IN NEWPORT PAGNELL
mere grub. Metropolitan dutiesshut out much of has been deemed more complete.In these IN AUGUST, 18t8.
the fleldof nature; but stillshe
may be found and the worm-like insect or larva is active,and the By EDWARD DANIBLL, Esq.,Sargeon,
studied everywhere. I firstlearned to appreciate the crab-likeinsect or pupa passive ; in those the larva Newport Pagnell.
true nature and relationsof the nominally various Is passive, and the pupa active.
and distinctmetamorphoses of insects, by watching If the difierentstagesin the development of man I beg to submit the following historvof the eho-
and ponderingover the development of a cockroach, were not hidden in the dark recesses of the womb, lera as it appeared in Newport Pagnellin the au- tumn
which quits the egg as a crustacean. I saw that it but were manifested,as in insects, by premature of 1833, and I shalldo so, commencingat the
passedthroughstagesthat answered to tho seat which birthand the enjoymentof active life, with a limita-
tion moment when there can be littledoubt the disease
other insectswere arrested: there was a period when of the developmental foroe to mere g^wth ; if really did enter,and describe the manner in which
itsjointed legswere simple, short, unarticulatedbuds, the progress of developmentwas thus interrupted I believe the poison was conveyed.
"when its thirteen segments were distinct and and completedat brief and remote periods, with I had some business with the perpetual overseer
equal, when it was apodal,"
"
when it was acephal-
ous. great rapidity, and duringa partial suspension of of this place, and was conversing with him at hia
active life; his metamorphoses
" would be scarcelyown door,when a man came up to us with a prison
Now, tfaediflbrences of the larrsewhich are distin-
guished less striking and extreme, as theyare not lessreal pass. He had been confined for vagrancy in the
by the entomological terms, Heteromor-
phous, than those of the butterfly. Coldbath- fieldsPrison,and this pass was an autho- rity
Homomoq"hous, Capitate, "c., essentiallyAs the insect must pass throughthe earlierforms entitling him to lodging and food for the night
depend upon their quitting the egg to enter into of the Articulate, so must man Uiroughthose of the As in most towns, so in this, there are in the suburbs
activelife at diOerent periods of development, ar" Yertebrate,sub-kingdom.The human embryo is places of resort for travellersof every description,
rested at diflbent grades.And it is most interest first tion
appella-
apodaland vermiform : not, however, at any bearing upon theirsign-boards the inviting
ing to observe, that these several gradesare ana periodan articulated worm. The metamorphoses of "Travellers' Rests," "Travellers' Homes,"
logonsto, or are typified by,the complete forms of of the germ-cells in the spherical (hydatid-like) "c. I need scarcely describe the characterof these
the difierent recognised classesof the great articulate ovum have laiddown the foundation of the nervous exhibit the squalid
dwellings,they,in ordinary,
"

sub-kingdom. system coeval with the firstassumption of a defitiiteappearance of destitutionand wretchedness, being
And these phenomena of the developmentare animal form ; and, by placing it alongthe back as the haunts of beggars, thieves, in
tramps, trulls,
most important to zoological classifiers.Theyesta- blish a rndimental spinalchord, supported tinousshort of allpersons who can be embodied in the epi-
by a gela- thet
satisfisctorily our ideas of the natural character noto-chord, have stamped the vermiform of the "refuse of mankind."
of a true natural group, as also the natural human embiyo with the characters of the apodal These." travellers' but places
gression
pro-
"
rests are anything
of the afllnities of itsseveral grades. fish. When the four undivided compressedex- of the perpe-
where men
tremities may rest ; for,independent tual
When we the entozoiform acephalous bud out,the form of the abdominal-finned there are importa-
see
type infinx of p:uests at all hours, tions
firstassumed by the firsttransformations of the of the Enaliosaur, villanous compoands d
fish, or is indicated. The de- velopment of vermm and filth,
germ-mass, we feelan assurance nothing else could of the heart,of the vascular arches,of smells,composedof the heterogeneous efflnriaof
give, that we are in accordance with Nature in com- mencing the generative organs with their cloacal comnuni decayedvegetables, onions,cheese,herrin|p, sad
the ascending seriesof articulate animals, cation with the rectum, typify the oviparous reptile. brimstone,and often times mixtures of poi^Jnoos
which are to culminate in the wingedinsect, from But these stagesare rapidly and the special firom impure sinks,foul drains, "od dung
passed,
the entozoa. character acquired. Sases caps. No wonder, then,theybeconie
the nudeus
When we find that the annulose worm, with a Let us suppose that man, or any mammiferous for the generation of malaria, t form food upon
modified segment for a head,and tubular feet, is the animal,quitted the ovum and the parentin the guise which a contagious malady n""y fatten,and dissem- inate
next form assumed, according to the type of the an- of the fish, with energy itsdestroctive elements.
passeda certain period in water, retain-
ing
nellides, we are thereby confirmed in our departure, the branchial structure,the undivided extremi- ties This poor man ws* directed by the overseer to a
in thisinstance, from the authority of the greatCu- and the cloaca, and acquiredonlyincrease of house of this description, keptat Uiat time bya man
vier, who,throughassigning undue value to a singlebulk under that guise; let us
suppose that then named William Leeke. The house was
situated in
character, the colour of the blood,placed the annel- such larva, seeking some safe hiding place, returned a damp locality, in a partof Newport Pagnell still
lides at the head,instead of near the is low
foot, o f the to embryonicpassivity and unconsciousness, and called " Mareh-end." The neighbourhood
articulateseries. was rapidlytransformed into the perfectstate. in every sense ; and at that time two ditchesexisted
When the next stepis seen to be the
acquisition Under thishypothetical modification of the course near it,into which waa thrown the refuse from the
of articulatelimbs,and jointed of human the changesof form would surrounding houses. These ditches were stagnant,
antennas,we con- clude, development,
that the articulatedanimals arrested at this be and in the accessory cir- and often times contained two or threefeetof accu- mulated
plainlyrecognisable, cumstances,
g^ade of outward form, crowdedwith hu- man
oughtto be the next in po- sition as well as the ^essentials,mamma-
the lian mud. The cottages were
in the series, notwithstanding and very few among them h*d habits
that,in the metamorphoseswould resemble those of the beings,
Crtutac$a, as the classiscalled, certainhighermem- bers insect of cleanliness.
manifest a high and concentrated character of If, on the other hand,every insecthad been de- velopedThe man had not been an hour in the house
heart, as the annellidesshowed a
high character in likethe Dipterapupipara,and the changes before he was taken exceedingly ill. On hisway
the red colour of the blood. from egg to larva and from larva to pupa had been but now was
from London he had had diarrhoea,
Other larvsB,by the successive development of hidden in the oviduct of the mother, a longperiodrery sick and cramped. The old lodgiDg-house
^

simplefeet (prologs) upon numerous segments, with might have elapsed before the recognition of these keeper was alarmed at these symptoms, and,being
aggregatedacellion the head,typify the myriapod- metamorphoses, and theycould onlyat lengthhave gifted with a very small measure of hnmanity, he
"UB order, and then pass on to the simultaneous been discovered
by a series of embryotomies, like would not allow the man to remain. The poorf"-
 THE MEDICAL TIMES. 175
iow,thereibre,soughtrefugein another lodging of bed, however, upon which the poor man died,was the men who won't think,and who practice a routine
the same descriptioD,
but lower down, and nearer to exposedin the front of the houses in the neighbour-
hood system,without reference to the influenceof reme-
dies,
those marshy spotawhich had earned for the locality of the last lodging-house, and close to the or results,
their probable and with a shallow
its name. road. Here an incident occurred worthyour con- understanding
sideration. of the enemy with which theyhave
I was not the Medical Officer for the parish that A poor woman, of the name of to combat
year, so I did not see this case; but the man died on Judge, found her grandchild, had come home My own experience and reflectionleans to the
the following day. Now" mark the peculiarity of minus a shoe. She immediately went in search belief, that cholera is a hemorrhagicdisease ; that
this visitation. The and, strangeto say, found in thisparticular uid specific racter,
cha-
morningafterthe death of this of this missingarticle, ithas a peculiar
Tagrant,I was sent for in haste to the wife of an iti- it under this very bed. She was very quickly aeting upon the vessels so that diey let out
nerant barber, living in a portion of "William Leeke's seized with the premonitory characters of cholera the liquid particles of the blood,which offby
"
pass
house,contiguous^nay,m close connexion with the sickness and diarrhcea ; she neglected
"
them : the the common excretions, and this view I regard aa

yard,and the room where the tramps lived. I had next day she was in the stageof collapse, and died a the great base and principle of practice. I con-
sider

not heard at thistime eitherof the illnessor death of few hours after being visited by the Medical at- tendant the liveras partially suspended in itsfimctions,
the firstpatient, but I learned the particulars in my and not onlythe liver, but allthe seoreting organs {
attendance on this woman. I found for the last Now, if the disease was trulybroughtby this that the brain,being deprived of its acoastomed
few hours she had been stlfferipg fVom diarrhoea, the vagrant, ^left "
(soto speak) at the placewhere he stimulus of quick-oireulating and healthyblood,
motions beinff colourless, likerice-water ; her coun-tenance first stopped, and around which the fiercenessof the losesiu power of eliminating electrical enemr, and
blue and ghastly; the heart and itsvesselsaie donblysos*
was she was fearftilly maladyraged, upon what principle
"
can the
propa^ that thereby
cramped,her pulse haiSly perceptible, extremities gation o f "e disease be accounted for,exceptby pended" first, by the black, grumons material by
cold vox chokrica,with incessant sicloiessand in- ; and secondly, by the deficiency
"
satiable
contagion f except
hj the fkct,that the seed of a which it is suppHed best
thirst poisonis lefton a sou suitablefor its development, of that nervous power, without wb4ch the snp*
As the treatment of this ease was necuHar, I -"a soil every way calculated to giveit activity and plywould be useless. Such resultsmost inentaUy
shall state it en pastant. Nothing in tne form of energy? It is no argument, that some are exempt ensue if the flrstposition be eoneet, viz.,the hss-
medicine woTild rest a moment on the stomach ; but from thispoison ; because in every diseasethere re- quiresmorriisgic character of the disease.
she intreated" she implored, she might drink cold fitnesson the partof the recipientA barrel The eold water enxe was a beantiftil illnstration
water. I directed a bucket of cold water mightbe of ice will not ienitewhen a lighted match is put to of thisprebable theory.The consUnt and reite- rated
placedby her bedside, and bade her drink as freely it ; but a barrel of gunpowderwill : so there may application of cold to the stomach,ao^ng as a
of it as she pleased. The gratitude of the woman be,and,doubtless, there is a resisting in some tonic to that organ, and by eontiguity givingtone
power
knew no bounds,for what she considered as this bodies, sufficient to overcome a poison when appliedand energy to surrounding organs. Althoughfoeble
great indulgence, for the people about her had pro- hibited to them. as may have been the absoAing power of the lac-
the use of it 2nd. Our experience tended to show that the re- moval teals, ftmay be fiurly inferred, Aat some portion of
She commenced in good earnest,drinking and of cholera patients concentrated the poison in this liquid was conveyedto the heart,gradually plying
sup-
"omitingincessantly, occasionally the wnich removed. that which lost; and lastly, the revulsion
passing copious Hospital to they were was

watery evacuations. She had consumed 52 quarts The National-school-room was converted into a producedby the incessant vomiting mighthave had
of water in 48 hours, and at the end of that period for cholera patients ; now observe the fol- lowing power in rousing the dormant liver, and thus
aliffhttingeof bile was discovered in her excretions,
a hospital some

case : " causingthat small flow of bile,which was the har-

" -fliesickness gradually abated,warmth returned A poor woman came to my surgery, imploring me bingeiof safoty, and which impartedto my mind
to the extremities, and the patient became conva- to intercede in her behalf with the the well-founded hope of a suceessful termination.
very earnestly
leacent The fever which supervened her a peremptory order to To show the utter ImpossibiHty of down un-
never assumed overseer. He had given laying varying
the typhoid form. go and act as nurse to the cholera patients in the rules in the treatment of cholera, I may re- mark,
In the evening of this day Mr. Kipling, the Medi-
cal in case of refusal, to with" tnat not one of our subsequent evinced
Hospital, threatening cases
attendant of the parish, called upon me, stating draw her weeklystipend. this Insatiable desire for drink, nor could the
his belief that Asiatic cholera had entered the town, I saw she was sadlyfrightened at the idea of en- tering patients be induced to take more liquid than sufficed
informing me of the particulars of the death in the the place, and knowing how readily fear pre-
disposes to quenehtheir temporary thirst
lod^ng-house ; and the fact that he had just left a the body to infoction, I did urge that she The cases which more immediately fellunder my
patienthaving allthe characters of thisfearful mightnot be sent However,the overseer was in own treatment had alwaysreforence to the doc- trine
demic.
epi-
He requested me to visitthe patient with fiexible, and I found her at her postthe next morn- ing. above stated. My flrstaim was, to check the
him. This man a tailor, in the house of She was very shortly seised with cholera, and diurhcea and abate the severe cramps. I did not
was Iqdging
a gardener, and only one door from Leeke's ; the died very rapidly. In this case I have no doubt but find the common chalk mixture answer nicelyin
ywds of each house beingonlyseparated these cases ; it always appears to me to cloffthe
by a low fear openedthe door tp the enemy ; but I cannot
fence. We found him in the stage of collapse; he bringmyselfto believe that foar will induce bowels,even if be it retained ; but,generally speaung,
died before the morning. From thistime cases were Asiatic cholera, without the aid of some subtlepoison,the stomach revolts at it I found the powdered
continually catechu,combined vrithopiateconfection, and com-
pound
presentmg themselves; and, with the having a specific power to induce the disease.
exceptionof one ladv, who was seised and died in 8rd. Duringthe concentration of the severe form spirits of ammonia, sweetened to make it
the Hi^h-street, the whole of the cases were confined of the disease in Marsh-end, diarrhoea prevailed tolerable, the best astringentI have alwayspre- ferred
to the immediate locality of Leeke's house. universally indicating,
" that however diluted the the powderedcatechu to the tincture; the
The parishbecame alarmed, the authoritiesas-
"
poisonmay be under the most favourable circum-
sembled, stances, lattercontaming the resinous jjart only,while the
and a Medical Board itnevertheless does induce a condition of powder possessing earthyparticles, seeins to act
was formed,
to which I was appointed Secretary.The weekly disorder, analogousto its own character, in one or more mechanically, and yet does not cloglikechalk.
documents then issued are now before me; from two particulars. Calomel was used in largequantities, in and
which it appears, that of mild and severe cases 4Ui. Very few of the cases removed to the Hos- pital small quanties, in combination with opium and with- out
we had 100,of which 45 died ; and, when itis con- sidered had a fortunate termination. If theyescaped it In some cases most delightful resultsfol- lowed
that our population does not number 4,000 the stageof collapse, they fellinto the consecutive each of these plans; but in other cases they
persons, it may be regarded as a severe visitation. fever,and died of aggravated typhus. altogether fiuled. The same may be said of the
I submit the following observations as the result I do not infer from this that patients should not salinetreatment, which was adopted to some extent,
of my own experience, and of the deductions which be removed ;,but,if removed, the hospital to which but certainly not in the systematic manner laid
I dnw from that experience. theyare carriedshould be replete with every neces-
sary down by Dr. Stevens.
lit As to whether the disease be contagious or requisite, amplehave ventilation, and its site In some instances I found advantage, in the very
not should be elevated. Unhappily^the public buildings first stage,by the administration of a mustard
The outbreak in Newport Pagnell is clearly able
trace- of our town do not possess these advantages, and emetic. One case I will record. A poor woman
to the arrivalof a vagrant, who was dischargedthe one used was in every sense unsuitable;but fie- of the name of Healeydied of cholera. The,morn- ing

from the Coldbath Prison; whether the disease was cessittu non habeat kges. afterher fhneral, I was passing the house,when
prvralent at that time in the prison, I am not pre- 5th. With to treatment In this cular
parti- I saw the husband standing at his door. About an
pared respect
to say, or whether it existed in any other
" I would be careftilto avoid that faultwhich I hour before he had been seized with diarrhcsa, and
place, where he mighthave sojourned after his dis- condemn, and be sparing eitherof nostrums or at the moment I passedwas writhing with cramps,
cifics.
spe- administered
ehaige. He had siidSTered from diarrnoea on the way. Cholera, like every other disease,is in- holdinghimself by the door-postI
It would have been impossible to have found a spot fiuenced both by habit,temperament, and idiosyn- crasy on the spottwo large teaspoonsftil of mustard mixed
better calculated for the development of any disease, absurd with nearly half a pintof warm water. I staid to
; and it does appear to me exceedingly
than the wretched placeto which the overseer sent to laydown rules in the treatment of disease, without watch the result A violentfitof vomiting ensued.
him. After staying about an hour in this house, especial reference to these peculiarides. The first (He had not been sick previously, but complained
continued for hour, at the
vomitingfreely, and, in all probability, usingthe pointessentialin the treatment of all maladies,is to of nausea.) This an

elo^a common to all,he is unceremoniously thrust thoroughly understand their true character, and to end of which time the cramps had left him ; and,
out,and takes up his abode at another lodging- form a correct judgmentas to theirimmediate seat although the diarrhoea continued most partof the
honae,perhaps700 or 800 yardsfrom the first; here This may be, on some occasions, extremely difficult ; day,no untoward symptoms presented ; he required
he dies. but well-informed men, conversant with the received but littlemore to perfect his recovery. By-the-
the bowels
Now, the cholera does not break out at his last principles of medicine,havingcommon sense, and way, largemustard cataplasms over

lodgings, where his corpse lay,of course, some inquiring minds, will not be longin chalking out for were found exceedingly useful.
IkOQXS ; but commences almost immediately in the themselves a proper pathway, and the chances are, I have ahready lei^ened this articlebeyond
mention another
my
Tidnity, and nnder the roof ot Leeke's house. The theywill not go far astray. The men who failare original intention. I will merely
 176 THE MEDICAL TIMES.
fact, which is interesting, and that has reference to cationsof the nitrateof silverto the seat of deaf fipom scarlatina, which had ended in destruction
the probable originof cholera,or at all events, to itself; but, as far as my experience goes, it has of the tympana. The hydratedcotton was entirely
the inflaence which electricalchangeshave upon generally been at the expense of the hearing, which successful, and for seven years she has used itwith
its virulence and extinction. A fearful storm of gradually became, under such treatment, more and the same happy effect as on the first day it was troduced.
in-
thunder and lightning, with torrents of rain,took more torpid ; " ^ina ratioto the success, has been the I may add, that, when removed from the
placetowards the close of August There had been deterioration the hearing.In speaking
of of mercury ear, she becomes as deaf as when she first came under
some abatement,certainly, both in the number and as a remedy in this or any other description ness, my observation. My success
of deaf- in this case prompted
severity of the cases, butUie truth is,afterthis storm I cannot forbear puttingmy veto against its me, to continue mv experiments, and, without ""ing
not another case presented itselfin " Marsh-end.'* employment Some of the extreme and most un- out of my way to look for appropriate cases, I lost
Three other cases did occur, but theywere at an-
other mitigable cases of deafiiessI have ever seen were no opportunity of tryingit in cases of ^seased
extremity of the town, two of which were distinctly traceable to its pernicious influence. If tympana, which presented themselves to my notice,
fatal there is in the Materia Medica a medicine which sometimes with remarkable success, sometimes
In presenting this succinct account of Asiatic has the power of actingas a poison to the sense of without any advantageto my patientIt was soon
cholera,as it appearedin NewportPagnellin 1833, hearingwhere there existspredisposition to deafiiess, made evident to me, that the remedy would onlybe
I am fearlessof censure, and regardless of criticism, I believeit to be mercury. Of course my strictures serviceable in cases where perforation existed, thus
for I have merelydetailed facts,and formed my are directed, not so much against itsexhibitionas a most mateiially limiting the range of its useful- ness.
theory on what appeared my to mind the legitimate purgative or alterative though
"
even here it is It was also evident, t hat I had much to learn
deductions of common sense. It is true no pott^ dangerous to the deaf" -but when givenwith a view in the mode of applying it,for in my earlierexpe- riments
mortem examinations were made, nor had we tiie to its tpeeifte eflect Mercury injures the sense of I found that,in the same case, I sometimes
opportunity of chemically analysing the alvine ex- hearingthroughthe medium of the mucous
cretions, surfaces succeeded admirably, and then againsignally foiled.
but the peculiar chajracteristics order,in the same
of the dis- manner as when the gutturaland aural This variability of success turned out to be attribut- able
the languorof the circulation, the singularmuco;is membrane isaffectedin influenza, dyspepsia, to the siceof the pellet of cotton I used, to the de-
gree
coldness of the extremities, and universal blueness and the exanthemata. After itause, an erythematic of moisture it contained, but mM" ejpecta% to
of the skin,seem to point out at once, that the error state of the throat and fauces remains,often, by its the dexterity and tact with which I could applyit
was traceable to a finulty condition of the vital persistence, affecting the Eustachian tube and to a particular spot; for I soon found,that unless it
fluid. From all I have read of the late prevailing tympanum, as when chronic catarrh has been the could be accurately and neatly adjustedon that
epidemic, there is no deviation in character from exciting cause. How often it has happenedto me identicalspot,no good efltect was produced; and so
that which existedhere in 1833,and my impressions to hear of the rapidaggravation of a previously slow longonlyas it was retained there,was the hearing |
continue as heretofore.Whatever may be the cause, and insidious deafiaessafter the use of mercury ! benefited. My patients have often expressed to me
|
the eflect is hsemorrhagic, and there can be no Not long since a most distressing case of this kind their disappointment experiencing
on a sudden less
doubt that the firststep to remedy the evil is,to came under my notice in the person of a lady,the of hearingfirom the displacement of the cottour
arrest the discharge of that portion of the blood wife of a medical man, who, some sulted which the action of the jaw in eating or pawning, or
years ag^o,con-
which escapes in the firststages. This, in
my me for a comparativdymoderate degreeof even a sudden movement of the body is liable4
humble opinion, can only be done by ^e most deafness. I laid down a course of treatment of any time to produce; but I may observe, that this
active and powerful astringents. When the bowels which iodine was the basis. This was followed up inconvenience is only momentary, when the appli- cation
staid, then,I opine, salinesand neutral saltsare taught, for
are for too brief a periodto meet with success, and of the remedy has been properly
indicated, with as much liquid matter as can be ad- another gentlemanwas
ministered, consulted,who unhappily then the patient is able to re-adjust the cotton in- stantly,
simplywith a view to supplythat which put her on a course of mercury, which was persisted and with unerring certainty.
has been lost If,indeed, as in Uie case of the in,as it was thought, sufficientJylong,but without Seeingthat so many littleobservances and ysiia-
barber's wife,an incessant sickness takes place, and any good eflectupon the hearing.The practitioner tionsin the mode of applyingit were essential to

an insatiablethirst, I should then consider that the thoughtthe mercury should be continued, and itwas success, I was unwilling to publish any account of
best remedy was, to follow nature,and, without so for many weeks, ending in total and hopelessly my novel remedy,until I could lay down rules j
beingchargedas a favourer of hydropathy, I diould irremediable deafriessI As a demier restort,the which would be a sufficientguideto enable other
rest quietly the unquestionable value of a cold patient broughtto me by her phy- to manipulate as efficientlyas mysclt
on was once more sician,practitioners
water cure. to undergo the operation of perforation For this reason, I held back for five years from
of the membrane. With no expectation my-
self, making it known beyondthe sphereof my imme- diate
ON A this operationwas performed,but without medical acquaintance, until a retired army
|
success. Here was a lady, whose deafiiess surgeon became my patient, in whom 'italsoproved
NEW MODE OF TREATING DEAFNESS that
possibly might have been beyond the reach of successfuL Fully alive to its importance,
WHEN COlfPLICATED WITH human means, even from the flrst; stillher hearing gentleman thoughtproper to send a communication
PERFORATION OF THE IfEMBRANA copied into
paper, whence it was
TTMPANI. would have failed, by such slow degrees, with com- to a provincial
mon
By JAMES YEAR8LEY, Esq., attention, as to have been very many if others, a nd attracted eventually deal of at-
a spreat tention.
years,
Suifson to the MetropolitanEye and Ear Tnflnnary.
ever, before it would have reached the extreme Nolens volens I was thus driven to
pointto which it was brought, in a few short months, bring the subjectbefore the Profession,and
Some months ago I promisedyou, on an early of observing
by the iigudicious administration of mercury. I here I may take the opportunity
day a communication on the singular fact which, have seen unmixed
so
many similar and lamentable cases, that it will at all times give me
many months ago, I had published to the Pro- that I should consider it a derelictionof
dutywere pleasure to demonstrate before any of your
fession in the pages of a contemporary Jour- nal; the subject of mercury, as a remedy in deafiiess, for I in justice
readers this most interesting fact, am
but which, up to this time, has not been ever to come under my consideration, without call- verbal description of the
ing bound to say that no mere
noticed in the Medical Timet, The of forth denunciation. willenable others to pulate
mani-
pressure my emphatic process,however minute,
other engagements has preventedme from it may appear, it
fulfilling Hoping to be excused this digression, I now re-turn with success. Trifling as
my intention until the present time. My task, to the subject of my paper. is no easy matter so to adjustthe cotton as to pro- duce
however,is,in a great measure an easy one, inas-
much It was in 1841 that a patient from New York the desired effect I have inquired among
as it is only
necessary to recapitulate the cumstances
cir- consulted me for a deafiiesswhich follow^ scarla- practitioners
tina most consulted in diseases of the car m
which led to my firstobservation of the
tympani this countryand in France, and theyhave had
in earlyvouth. tae
Both membranae
new mode of treatingdiseased ceeded.
suc-
which suggested to me
tympana, and were destroyed, and there appearedto be great candour to admit that they have but rar^
the expediencyof re- ducing general disorganisation, leading me to believe, that Mr. Barrett, Surgeontothe Bath. Eye *?d
it to practiceuntil, from enlargedex- little,
perience, if anything, could be done for him, when he Ear Infirmary, became aware of tie difficulties
soon
I am now enabled to announce it, surprised and feltit necessaiy
me by by saying,that he had the power which attended the uninitiated,
wiUi confidence,as a grand and importantad- ditionof of applying it
reproducing the hearing in one of his ears by very to pay me a visitto learn the mode
to our remedial in a class of and in a
resources simplemeans, namely,by moistening the extremityHe is now an accomplished manipulator,
cases previously supposedto be beyond the pale of a spill or roll of paper with his saliva, and then note recently received from him, he says :"
*
I tinue
con-
of art, and the
incurability of which had passed introducing it to the bottom of the meatus. times
Some- to use the remedy with full and satisfocwy
into a proverb. dis-
it '* openedthe ear ;*'in other words,
duced
repro- results, and never omit to speak of it as your
No successfulmethod had hitherto been wMie
brought the hearingfor some minutes only: at others, covery, and to give you full credit for the
forward for the relief of deafness,when been
tendedit was
at- "
opened"for hours, days,and even so long matter. Indeed, whilst writingthis,I have
by loss of the membrana tympani" the as a week. Whenever the ear closed, he had but interrupted by a visit from a gentlemanto
whom 1
utmost that was attemptedconsisted in applyingto 8Ul"-
repeatthe experiment to find it againsuccessful. mentioned I was writingto you on the very
remedies for the alleviationof such cases the had such bnght perience.
ex-
by My patient thus called my attention to an interest- ing ject,the good of which he
renioval of accumulated or offensive discharges " Mr.
by fact, which,it naturally occurred to me, might He said,with tears in his eyes, TeU
syringing, or rendering the cavity of the tympanum be turned to good account, in other and similar Yearsley I feel that to him, by your help,
free,by the passage of air throughthe Eustachian I I enjoy tne
cases; but, althoughI made many trials, I variably
in- am in a new existence. can now
tube. Although such measures used without and the other
were
fidled, until I adopteda planof my own, comforts of my friends, my family,
reference to the hearing, there is no doubt that great which consistedin the small God has but which for a
application of a piece blessings given me,
improvementdid occasionally take placein that of cotton wool, moistened in Yearsleyhis
pure distilledwater, time,tillit pleasedhim to make Mr.
respect; but never with any lasting effect Attempts warmed to the temperatureof the body. The first instrument for good, I was deprived of.* "
D'* ^"^\
made (and, I of
to the difficulty
were am sorry to say, with many it is case, in which I succeeded to my entire satisfactioD, gerath, of Brussels, afteralluding
tillthe practice) to attempt the healing s^^cceeded wdU
the per young lady placed under by Mr. the "
I have
forationby the use of
mercury internally, and appli"
was a

Sc^uibb, of Orchard-street
my care

She had also become Ia4justing cotton,says :"

in one case, and foiled in some others. Probably

 178 THE MEDICAL TIMER
"OOTUkMD. slender may be itsfoundation. It does not clearly arachnoid sac in a preparation taken ftom the body
appear who was the firstto call this so universal of a lunatic, who had received an injury of the head
[EdlDburghCorretpODdenee.]
opinionin question.Considerably before the end some years before death. This membrane Dr.
of the last century, CuUen is found to Gairdner pronounced to be an exampleof the mem- brane
IS CONSUMPTION CURABLE? say,
"
that it appears probablethat a catarrh is 1 in
produce serous cavities, by not inflamma*
At the Pathological Meeting of our Medico* very seldom the foundation of phthisis;*' again,toryaction but by the fibrineof extravasated blood,
Chirurgical Society on Wednesday, February 20lh, " that the beginning of phthisis so often resembles a a subject well described and illustratedby Dr. Pres-
another conversation arose on the Curability of catarrh that the former
may have been mistaken cott Hewett in the twenty-eighth volume of the
Tubercular Phthisis. This conversation followed for the latter;"and, '' that in the few cases of ca- tarrh, London Medico-Chirurgical TramactUmi*
the exhibitionby Dr. Spittal, of a portion of lung
which can be said to have ended in phtiiisis,
containing a considerable cavity, which had no it is
probablethat the persons affectedwere pecu- liarly
communication with the bronchial system. The IRBIaAND.
predisposed to phthisis." Considerably before
specimen was taken from the body of a woman who CuUen's
time,Hnxam made the singular and some-
what
had been found dead, and no account could be ob- tained
confused remark, that many cases of eonsump^ [DabllnCorreapondenee.]
of her previous state of health. An adhe- sion tion occurred after catanh, especially where tuber-
cles
between the pleuraehad been observed near BOTAL IBISH ACADEMY.
had been previously formed. Laennec's de- cided
the apex of the left lung; and the lungbeingcut A meetingof thisregalbody lately took phce,at
opinionagainst the long-supposed connexion
into at this place,a considerable cavity was covered.
dis- between bronchial inflammation and the origin of which, among other uiings, was a paper by Dr.
There was a good deal of dark matter AUman, on the Anatomy and Physiology of the
tubercles, is universally known to the Medical Pro- fession
deposited in both lungs, and near the cavity there **
Alcyonella ;*'which the Author regards as nearly
; yet ithas too commonly been assumed, that
were some nodules of grey consolidatedmatter, and, the allied to the Mollusca. An immense range of
controversy, as to the inflammatory o r inflammatory
non-
in itswalls,some white matter. The appearance of animal forms,itneed scarcely be said,range them- selves
originof tubercles, has no distinct
the cavity, however,was not such as to carry con- viction,
practical under this latter term, ^all "
t hose, where the
diatit bearing.But, as the general question
a closed tubercular cavity { while its homologous
was
plainly involves the special question, namely, whe- ther vertebrateand types are absent,in- cluding,
it was not more easy to pronounce tliat itbelonged
or not catarrh degenerates into tubercles, the of course, the radiate femilies, and tiiose
to any of the other known forms of pulmonary ca-
vity
decision of the latter, with the peculiardisposition of oigans round the
at least, is a necessary preli- minary
; namdy, a dilatedbronchial tube,an excavated to any exact reasoning as to the curability
mouth that distinguishes that section. The anatomy
abscess, or a cavity leftby circumscribed gangrene. of how can we determine whe-
and physiology of this large tribeof animals is not
phthisis ; otherwise, ther
Dr. Bennett exhibited a beautiful engravingon without interest. The lowest tribes, fixed like ve- getables
the so-calledcases of incipient phthisis, whieh
wood of the appearances presented by a lung,in are every year cured by a change of climate,be to a single spot,possess a beautifully plex
com-

which,according to his view, tubercular cavities of

arrangement organs adapted to digestion and
mere catarrhs, or cases in which there was already
had become cicatrised. The preparation from a limited
developmentof tubereles. If to cure a marked. Withoutrfespiratonr
circulation, with powers also very well
which this engravingwas made, Dr. Bennett had chronic any wet]-arranged type or sym-metry,
catarrh in a person constitutionally posed
dis-
formerlybroughtunder the notice of the Society. like the Radiate,the lower tribes are littie
to phthisis, be not tantamount to removing
The case was strikinga person employed as a the cause of successive crops of tubereles,
"
else than a mass of viscera, well seen in the Aplytia,
then we
clerk in Edinburgh, and who liveda dissipated shall be entitied to insist, often as a true inci-
tillwe come to the Cephalopoda the cuttiefishes"
"

as pient
life, became ai^cted. with very well-marked sym- ptoms where die character becomes better defined, merg-
ing
phthisismay be checked, that, however
of tubercular consumption ; but,at this time limited forthe into the highertribesof the animal scale. Many
time,the means, nevertheless, exist,
receiving the appointment of a parish schoolmaster,of other pointsof interest have been noticed in the
stopping directly the further formation of cles.
tuber-
he went to the country, where he recovered his structure of the Mollusca ; theirwhite blood,witii
But were this view firmly established, there
health, and lived a regular lifeabout twentyyears. is
a new fieldopenedup for the investigation of un-
tried
sparse corpuscles adaptedto their particular mode
He then returned to Edinburgh, and falling intohis of life; theirlow temperature,familiar, of oourse, to
therapeutical indications, and, in tiiesearch
former irregular habits,was cut off by delirium after such indications, must be taken not to lose the reader. It may be sufllcient, however, to note
care
tremens. The post-mortem examination showed
nght of what Laennec so much insists upon,
the interesting paper, which, of course, will appear
the decided appearances of tubercular cavitieslong in some other siiape.
namely,that tuberclesterminate fovourably, not by
before citcatnsed, as delineatedin the engraving. Dr. Todd, it was stated,read a communication at
abortion,but by changesconsequent on their fiill
The evidence now accnmnlated of the cura- bility the same meeting,announcinga discovery to " pre-
vent
development and the evacuation of tiieir cavity.
of phthisis is very imposing. Dr. Bennett evaporation" from open drains,tanks, and
called on the senior members of the Profession TUMOUB OF THE SJDNET: In such
ponds. a sanitary point of view a thing
present to state their experience on the subject. The discussion on this subject beingover, Dr. would be very valuable. A sum of 150/., also,was
The opinions expressed, thoughnot of a very de- cided Gairdner exhibited an enormous tumour, in- volving recommended by a Committee for a system of
character,were generally favourable to the the leftkidney and left suprarenal capsule. meteorologic observations, with the resources of tbe
idea of the curability oftnfaercuuir phthisis, when the It was taken from a man sixty-four years of age, magnificent Electric Observatory in the University,
diseaaehas not made greatprogress. who had been under the care of Dr. Craig, of Batho. and the coirespondence of its able conductor witii
He had suflered an injury thirtyyears before his allthe men of Europe engagedin similar inquiries.
It seems strange that any doubt should existas
to the curability of phthisis, when it has been the death by a wheel passing over his loins.^After some A set of such "observations would be highly
fh"m the earliest confinement he recovered from this^'urv, and led valuable.
usage of the Medical Profession,
recommend affectedwith this an activelifetill1846,when some signs of illhealth
times, to to persons PHTHISIS AND PULKONABT GAKORENE.
disease so strong a measure as the expatriation of appeared, the nrine being bloody.He recovered, In continuation of the
subjectof Dr. Stokes's
themselves to distant countries for the sake of a however,and, owingto a changeof occupation, he
paper, perhapsit may be mentioned, that he has
Celsttsadvises the phthisical to go to Egypt was for the next three years exposedto much exer- tion
of the Itmgbeix^
cure. changedhis opinion as to gangrene
" a piece of advice which has been revived in our by long walks. In the springof 1849 his more frequent in drunkards than in temperate indi- viduals;
of health began decidedly to fkil, his illnessbeing aC'
own day. Bearing on this step change of climate, his immense experience, since he fint
there are some pointsin the pathology of phthisis, companiedwith feverlshness tendingto periodic ; broached the
subject, havingbroughthim in contact
the attemptfinally to clearup which should be made and, finally, a very moveable tumour began to be with it as often in the latteras in the former. The
without delay. Why, then,are the phthisical sent feltin the lefthypochondrium, which,when he turned fetoref ^ expectoration and excetsioe pain,'with the
the belief, t hat on his right side, fellinto the epigastrium. There
abroad, notwithstanding prevailing exceptions already mentioned, seem the most pecu- -

tiiedisease is whollyincurable t To this questionwere no symptoms of disordered urinary function at liar

signsof the disease. The absence of physical
very various answers will be given some will say this time,with the exception
"
of the presence of ox- alate
signsis,indeed,quiteremarkable. From his expe-
that there is a cachexia phthisica antecedent to the of lime in the urine. Latterly, inability to
tienoe,he is led to believe,that the disease com- mences

formation of tnbereles, and that this cachexia may retain the nrine and fsces came on, along with in ** points of the lung,"with intervening
be eared by a change of climate i others will say paralysis of the lower extremities. Before death the
healthy tissue ; and he impresses deeply tical
prac-
that phthisis has its origin in obstinate catarriiaJthere was no other evidence of the kidney being conclusion, that,where sudden fitsof foetidex- pectoration
involved in the diseasethan the bloodyurine and
auctions,and that this precursory diseasemay be occur, even though the stethoscope
the like, which accompaniedthe patient's illness in n6 way pronounce
got rid of by a milder temperature; others,again, should detect nothing, we can
will say that tubercles are deposited in successive nearly four years' before. Dissectionshowed a very the and should look on the maUers in
lungshealthy,
crops,and tiiatthe constitution can relieveitselfof
largetumour, containing portions of healthy kidney the gravestlight
occupying the region o f the left kidney, and ing
extend-
one crop, provided that,by changeof climate,or by On the subject of Ph^Uns, two rather novel points
from that site in
some other means, the crops that so usually follow every direction. The lower have been mooted lately.In a highlyinteresting
are prevented from overwhelmingthe function of dorsal vertebne, the upper lumbar, and the adjacent
paper by Duncan, he says, following out the ana-lysis

respiration, and, throughit,the curative powers of ribs were in a state of exfoliation. The moveable of Simon, tiiattuberole is a minus or imperfect
the system. The firstand the last of these views tumour discovered before death must have been the protein, producedby mental causes ! actingon the
may be considered as one in tiiemeantime, the most
displaced spleen. The tumour probablycommenced nervous system. This seems a greatway off to go
vitalquestion at the presentmoment beinghow far in the leftsupra-renal capsule, and acquired itspre-
sent for the source of phthisis. The facts related, how-
ever,
finalcharacter by absorption of the chief part
bronchial inflammation is distinctfrom the tendency are ve/y striking. Every one, of course, is
to the production of tubercles in the lungs. It was of the leftkidney. of the action of mental causes in disturbing
aware

a very early opinion, that catarrh degenerates into FALSE MEMBBANE OF SEROUS CATITXES. the process of healthy digestion and assimilation,
consumption an opinion
" which still holds itsground Dr. Gkirdner next exhibited a singular instance and, as assisting an already strumous diathesis in
tenaciously^ enough with the Profession, howeyer of felsememlHrBne lining a great portion of the particular indiTiduala, should not be foigotten by
 THE MEDICAL TIMES. 179

the valves of cancerous construction, ischaracterisedby a gradual

the practitioner. The pointhas been noticed, per- originof the pulmonary artery,
haps,
before. On looking into Watson, for instance,v^ich were thickened and rough,but competent.sWelling of the membranes, havingthe proportion
speaking the contagion
o f of phthisis, he seems to This contraction, which allowed only quill pass,
a t o of their natural Increase of thickness towards the
explainit somethingafter this very ftshion : "
had, of course, produced the same impecQment to the pylorus ; while,on the other hand, cancer may be
"
Watching,the want of rest,confinement in the flow of blood as a contraction at the mouth of the situated in any possible partof the stomach, and al- ways
unwholesome air of a sick chambei,and, aboye all,pulmonary artery. Great hypertrophyof that exhibits a partial degeneration of the mem-branes.

protracted mental anxietythan which no single

t cause, ventricle, situated below the contraction, had suc-
ceeded.

perhaps, has more power to foster and forward the Above the contraction, between it and the 3. In hypertrophy, often only one membrane,
inbred tendency to phthisis." To Duncan, however, pulmonaryvalves,was a space about the size of a (viz., the muscular,) sufiers, and in itswhole extent.
we are indebted for the modus operandi, and other hazel nut. The case is particularly interesting, as In cancer, on the contrary, very often several branes
mem-

details,of mental influences. In the practice of beingan unique, or almost unique instance of disease, become transformed into one common after-
this disease, a second point has been broughtforward originating in the right side of the heart itself, and g[rowth.
He isinclined to think he has dis- not being consequent on, or simultaneous with, 4. Even where many membranes hypertro-
by Fitzpatrick. covered are

an additional physical sign in phthisis, disease of the left side of the heart,or of the lungs.phied,they are alwaysseen as particular layers,
available in the early stages. The discrepancy ^ {Fierteljahrschrift, Prag.Erst.Bd,,1849,p. 157.) lyingover each other ; while in cancer sometimes
the normal bronchi4xl respirationy on one side of the THE 8ABCINA YBNTBICULL any, sometimes all,are irrecognizable.
chest,comparedto the other,when tubercles are It is stated by Mettenins that the sarcina was 5. The divisionof the muscular coat into com- partments

forming,taken from a central line, not to be con- "

founded, described by Meyer in 1809 {Nov,Act, Acad, C, L, is not characteristicof cancer. On the
of course, with bronchial respiration so T. xiv.), and was afterwards termed Merismopediacontrary, even where it occurs in true cancer, it
often heard under the clavicle, in the more vanced
ad- Gonium onlysignifies hypertrophy of the muscular tunic.
punctata(Ehrenberg's glaucum,tranquil-
and less mistakeable forms of thisfearful lum, and hyalinum).Mettenius himself considers 6. In hypertrophy tiie coats are, at first, in spite
malady,the pointis one obviously of no little in- it to belongto the Palmalacea, the lowest order of of their thickening,
terest, separable from each other ; in
and, as available at the onlyperiodwhen Algae. (ZeUschrift. fur.rat. Med. 1849, vii.,8). cancer theyare fused in the after-growth.
human means are of use, it is doubly avulable. Frerichs describes the development of the sarcina 7. In general and pure hypertrophy, the stomach
Perhapswe might suggest a stethoscope for the as follows :" Firstoccur round cells(about 1-400 line is always narrowed and hardened. In cancer, espe- cially
purpose, of guttaperclui, in the form of a Y. in diameter), which gradually increase to 1-300 of the pylorus, there is usually considerable
TAPPING IN HTDSOGBPHALUS. line ; they enclose no nuclei,and are mostly dilatationand thinning.
The propriety of havingrecourse to thisformid^ isolated. They never are thread-like, and there-
by, 8. Hypertrophy may precedethe cancerous new

able expedient has been broughtunder discussion and by their size,are disting^hedfrom the growth, and occurs as a partial
hypertrophy of the
at the "
Dublin Surgical cells of the yeast plant.At first, in such cells,neighbourhood simultaneously with the cancer, or it
Society," by Dr. Battersby. of the pylorus,
As might,perhaps, be expected, much differenceof superficial indentations form, which are placed is associatedwith cancer as a second-
ary
opinionwas elicited;the more ardent members at rightangles to each other. These crucial event, when constrictionappears. In the latter
lines in the and the (general ?) dilatation remains.
looking upon it,with Ferguson and Conquest, as a always commence centre, pass case,
matter not to be given up ; others, less hopeful, as gradually to the circumference. In this way the 9. Chronic gastritis occurs as well in hypertrophy

cellgetsdivided into four equalparts, without much as in cancer ; but itwould appear that,in the first,
an operation never to be attempted.In the acute
form of the disease, the nearly unanimous feeling increasing in bulk. This four-parted cellis always it is more as a cause ; in the hist, as an efiecL
of 10. In hypertrophy, a large portion, or the whole
of the Society was againstit ; in its other forms formed in this way, and not by the disintegration
forms. Prom this elementary form, of the mucous membrane is more frequenUy dis-
eased
some littleevidence existing for it. more developed
the divisionof each primaryfourth into secondary ; while in cancer, a^great extent is commonly
BHINB WINE"
a nd of these into tertiary fourths, still normal.
The Editor of the Medical Press,alluding to the fourths, goes on,
composition of Khine wines,as lately but the division seldom reaches to sixty-four parts 11. The diagnosis duringlifeis trustworthy only
put forward
rather prominently by one of your contemporaries, before the sarcina breaks up. The shapeis not in those instanceswhere appearances of constriction
thus feelingly always square it is sometimes oblong. Frerichs are present; since,in other instances, hypertrophy
expresses his experience "
:
"
It has ;
been our misfortune to partake of some of these so considered the sarcina allied
to the "
Cladosporiumis scarcely accompaniedby any other symptoms
than those of chronic gastritis.
called Rhine wines,and our firm beliefis,that they fumago ;" ithas not been seen to Increase out of the
12. A sensible knobbed swelling,especially
nothingbut very sour cider and water with body eitiierin the vomited matters, or in bread or when
"

were
other substances. Pockels alsohad lately examined sharply defined, or many knots of a tumour
"

some whiskey," (nothing

"
half so good,say I,) "

*'
and, perhaps, a dash of alum. We shall never the sarcina ; he also has never observed any growth in the epigastrium, speaksdecisively for an after-
out of the body. He has obtained the blue colour growthof the pylorus, and againsta pure hyper- trophy
forget the treat as longas we live." Dura ilia mes-
with iodine, which Frerichs failedto do,by boiling ; while,on the contrary,a difiuseresistance
with nitricacid and caustic potash, neutralizing the and swelling of the epigastrium speaks f orthe latter
EPIDEMIC CONDITION OF THE ATMOSPHERE. when the hard partcorresponds
liquids, and adding sulphuric acid and iodine. condition, especially
Some singular phasesof epidemicdiseases, as of the the stomach*
In the sarcina stool,the sulphuric to the form pyloric p ortion of
dependingon vicissitudesof the weather,have been acid and iodine passedby
act at once. Simon, in a case (Thatthe swelling is impalpable, does not definitely
lately noticed in Ireland; in Carlow, something
in which a great quantityof the yeast plant exclude cancer.)
like cholera has broken out ; in Dublin, Dr. Ken- nedy of the stomach, with sensible
and the sarcina were vomited together, believed he 13. Displacement
and Dr. Benson have drawn attentionto the
could trace the development of the one into the hardness,speaks forthe greatprobability of an after-
growth.
nature of a peculiar form of fever for some time
prevalent. The former describesit,as marked byintense
other. The sarcina,however, can onlydevelope
within the body; itssuccessivedivisionsmay go on 14. A limited and permanent sonorous sound on
hoarseness and aphonia, with a singular tendencyto to a
great extent In a case lately recorded by percussion, speaksfor general hypertrophy, rowed
(nar-
relapse quitecharaeteriitic. A remarkable latency of chronic hydrocephalus, the sarcina and hu^ened walls ;)a diffuseand inconstant
of chest diseases, was also dwelt upon ; a stage of Horing,
was found in the vomited matters. This observer sonorousness for cancer, (dilated and thinned walls.)
incubation, as it were, "
if we may borrow from Sir
has found it also in a case of cirrhosisof the liver; 15. Vomitingat definiteperiods, especially many
Henry Marsh, in which the usual stetboscopic
in one of tubercle of the brain in an adult,and in a hours aftereating, speaksvery certainly for cancer-
"

ous
signsare absent; cases occurring that singu- of larly case of chlorosis. Sometimes food was mixed with constriction. (Dilatation of the stomach with- out
occult nature that we must judge of them by Continuous vomiting
it sometimes not.
"
Horingbelieves the sarcina to gastritis.) in the "sting
the rational symptoms. ''
No rile in well-marked
indicateno special diseaseseitherof the gastro-intes- state,or immediately aftereach ingestion, ratherfor
bronchitis, no crepitus in pneumonia, no groflfement tinal membrane, or of other parts. (Jahresherieht " hypertrophy, (t. e., for narrowing of the stomach,
in pleuritis," percussionalone detecting anythingwm Canstatt mnd JStMnfiMnm,1849, Vierter,Bd" and for chronic gastritis, " ^which latter certainly
wrong. Dr. Kennedy ascribesthese peculiarities to
p. 225.) becomes augmentedin the laststagesof cancer.)
the marked vicissitudesof the atmosphere,at one "

THE DIFFERENTIAL DIAGNOSIS OF CANCEB 16. The quality of the matter vomited depends,
time quitewarm, then suddenly cold, producing, AND
"

HTPEBTROPHY OF THE STOMACH. not so much on the form of disease, as on the con- dition
of course, electricand other changes.
The following pointsmay be of importanceto- wards of the gastric mucous membrane. Black (or
the dlflferential of these conditions.
**
coffee-grounds") vomitings signify nothing hot
diagnosis
8BXAOTZONB FBOK FORBZON But, it must be understood,that theyreferonlyto efiusionof blood in the stomachu cavity.
JOV^NAXiS. well-marked and thatfor the complicated 17. In the case of a cancerous softening and struction
de-
pure cases,
or combined instancesthere is no general rule,no- thing
of the mucous membrane, in which ele- mentary
HABBOWme OF THE BIGHT SIDE OF THE but the details beingsufilcient. parts of the after-growth may be evacuated,
HBABT" 1. Hypertrophy, or the increase of the normal the microscopic examination of the vomited matters
A longand able paper has appeared in the IVaffiiesubstance of an organ, with retentionof itstexture must not be omitted.
FUrteljahrschrifi, duration of the disease, and an un-
byDr. Dittrich,on an interesting and figure, appears in the stomach as a gradual, 16. A long broken
case of stenosisof the right heart succeeding injury.and more or less uniform swelling of the gastric progressive development, ^aks for h}j"er-
A strongyoung soldier, growth trophy.Cancer generally itscourse in front
twenty years old,received membranes. Cancer, which is alwaysa true after- runs
a heavyblow in the cardiac region and
; hsmoptysis or new structure,takes,with few exceptions, one to two years.
cough succeeded. Subsequently he became ana- the fbrm of a swelling ; and appears as a circum- scribed, 19. A sudden intermissionof the vomiting, and
sarcous, and fluid collected in the peritonaeum. prominent,often knobbed or tuberculated,of the other appearances of constriction, with sub-sequent
After death a circular, hard, callous contraction, after-growth, which destroys the normal structure return, accompanied by a sensible swellings
the result of an exudation, was found on tiie of the tissues. is one of the snxest indicationsof cancer, (com*
tifl^t aide of the heart,rix lines below the 2. Hypertrophy, eroi where it is the remit of a mweed softening.)
 180 THE MEDICAL TIMES.
20. The absence of appetiteis more frequent Sn that the changewhich Parkes producedartificially, Alas 1 when thisis done,the voice which has
hypertrophy, disease of the mucous
(diffuse brane;)
mem- may occur naturally in the substance which passes issued from the walls sounds feeble,
College
is
goodappetite more usual in cancer, tial
(par- off"
in the urine of cholera.)
vacillating,and uncertain ; it utters truths,
but
disease.) DIAGNOSIS BETWEEN ARTICULAR
21. Pain refers either to the mechanical incon-
venienceRHEUMATISM the truths are fruitless
; arrays propositions it
AND GONORRHCEAIi ARTHRITIS.
of the aftergrowth,or to chronic gastritis.M. Cazanave distinguishedbetween the affections which lead to nothing; it enunciates principles
It is thereforenot characteristic. above named by the followingrules : Gonorrhoeal which it leaves half way
"
on the road, as if
22. The constitutionaleffectdependson the nar- rowing, arthritis
developes itselfusually in the fifthor sixth afraid
the suppuration
that,like Saturn's ofispring, they may
the chronic gastritis, or ; week of the bleimorrhagia ; the painsare almost
their parent.
and on the secondaryevents of emaciation, pain,ob- alwaysin the knee,sometimes in the elbow or ankle ; destroy
stmotion,"c It is,therefore, altogether of relative
theydo not affect all the joints, and never affectthe What is the burden of the oration? The
import muscles. If articularrheumatism be uni-articu- giantevil of the day (asrespects the Profes-
sion)
23. With respectto aetiology, continual mecha-
nical lar i, e., confined to one joint it is usually
is,want of education ; therefore educate.
" "
more

ii^uries (local influences, as in shoemakers, severe and obstinatethan in gonorrhoeal arthritis. The "

curse of the Profession is,the fictitious

weavers, "c.) appear more to dispose to cancer. Gax* des Hopitaux,Jan. 26.
While spirit-drinking, gluttony, and nervous ditions
con-
DENTITION IN OLD AGE.
value placedon medicines ; therefore let the
morbid and continuous nervous
(especially M. Plessinck has lately witnessed, in a woman aged service be paid,and not the mere instrument.
vomiting), seem to conduce to hypertrophies. Acute 92
years, the successive appearance of three incisor The labours of the Profession are unrewarded
and chronic inflammation appear of equalefficiency teetii. Some weeks afterwards two molars appeared.
by publicdistinction; therefore, let us mark
for both. The teeth were loosely fixed in theirsockets. Gaz. "

24. The existence of an isolated swelling once with a titleof honour our eminent leaders. The
des Hopitaux, Jan. 24.
establiahed, the diagnosis of cancer from other after-
growths moral tone of the Profession is low ; therefore
is scarcely of much practical interest. But raise it by judicious instruction.
fipoma, fibroid,or alveolar gelatinous tumours, TO SUBSCRIBERS.
Is*there anythingto objectto in all this?
or the benignanttumours generally, are indicated New 8ub$crxbtrt will obligeby forwarding their
by tihemildness of theirphenomena and the more Not an iota; but, on the contrary,much to
Namea direct to the Office^ 46, Princes-street,
frequentabsence of constriction. Besides,they do
8oho, or to the Newt or Booksellers, AH
applaud. It is truth ; it is incontestable. We
not soften, and hence they lack those symptoms Agents
Orders should be made payableto Mr.
want education ; we demand justand proper
which dependon thischange.Disseminated deposits Post-office
with James Lucas, 46, Princes sireettSoho.
methods of remuneration ; we press our right
in other organs, namely,in the liver,together
die existence of a circumscribed swelling in the to civic honours; we wish to strive after
stomach,of course affirm cancer. " From an Essay true morality,
as regardsthe publicand our
entitled " UeUr der
Magenkrebs und Hypertrophie THE MEDICAL TIMES. brethren. But what then ? What isto follow ?
MagenhSutein Anatomiteher und KUnitcher Hm-
The Hunterian Orator cannot stop at such
surely
tieht" ron Dr, Carl Bruch, Privat Docenten in
platitudes. It needs no oracle to din these
Medizin,Band
Heidelberg,ZeitsckriftfurRationelle SATURDAY, MARCH 9, 1850.
homelyfacts into our ears. It is what we have
BLOOD AKD IN CHOLERA.
URINE have fifty
years. We admit known any time these
observationshave been recorded by
Hie following
*"* We to requestthat allcommunica-
tions
for the Editor be addreised to the care of your premises without pleadings.Eduoate the
Dettingen,(Warsaw.) In the aigidestage, the Profession ; leteach man be a scholar and a
John Churchill,Medical Publisher,
blood was found extremely very dark coloured, Mr.
thick, 46,
and forming a black, homogeneous,tarry mass. Soho.
Princes-street, gentleman; let each man work at his calling
v
as

The coagulability was generaUydiminished. The We must also impress at a divinely-appointed task ; let each man
upon such of our Cor-
dark colour was onlypartially removed by agitation
address us anonymously,the cultivate his intellect and his taste by as deep
gravityof the defibrinated respondenta
as
with air. The specific
a studyaa you like, of Nature and of Art ; let
blood varied from 1062 to 1077. The water was neceMity of favouring us with theirnamea ; not,
diminished and varied from 650*65 to 711*83,the of course, for publication, but as a pledgeof each man respecthis fellow-worker as an honest
mean being 680 per 1000 parts. Hie highestgood faith. labourer in a common cauae. Agreed,at once
figure of the fibrine was 4*61,the lowest 1*51 ; in and unanimously.We do not want such teach- ing
one very rapidsevere case there were only traces of
The Hunterian Oration is a dlacourse
nounced
pro- in this blessed nineteenth century,which is
fibrine, which were not weighable. The blood coi-

puscles were always increased, in directrelationto annually in the theatre of the Collegealready waxing old. What we do want is to
the intensity of the symptoms ; they varied from of Surgeons.During the first five minutes of know. How WE are to no that which you tell
141*4 to 157*3. The albumen was increased, also in itsdelivery,'the name of Hunter can be heard a us SHOULD be dome ? It secms to us we have
relationto the symptoms, from 110'9 to 153*6. (It
does not appear whether the extractive matters of
certainnumber of times, and reference is made asked this question at your College gatesthese
to those rare, but,by this time, well-known many times,but to our demand for bread your
the serum were separatedfrom the albumen,most
mined. qualities,
The saltswere not deter- which our greatSurgeonmanifested. surlyjanitors have alwaysgivenus a stone. It
probably
they were not)
Under the microscopethe red particles this duty,the
After havingdischarged orator seems to us that we have not been idle in urg^
were not found to be altered. In the urine,in the
usually abandons himself to the inspirations of ingthese great truths on your fellow-Council-
lors,
cold stage,when secreted,the sp. gr. was from
his genius, and diamisses, to sleep for another and in beggingthem to aid na in clothing
1013 to 1017 ; sediments were uncommon ; albu*
men, but in small quantity, was alwayspresent year, the vexed memory he had invoked. On them with shapeand action.
A blue colouring matter (blauer Farbatt^, Urogkm- the presentoccasion,Mr. Skey'sgenius has Unfortunately the Hunterian orator,at Uie
cin) was, with one exception, presentor increased led him to enunciate,for the benefit of the pointwhen he ought most to speak,suddenly
in an extraordinary degree. The nrophoein was

also increased. Uric acid,urea, and chloride of Profesaion,

his opinionsrespecting medicine becomes mute. Either bis words have been
sodium were constantly diminished. The two latter in general, and medical practice in England stifled, or he has not wished to speak, or has not

substances were, indeed,sometimes presentin mere in particular. The circumstances of the known what to utter ; or, more likely still, he
traces; the phosphates and sulphates were in nor-
mal, have givenunusual significance to the has never to their logical
moment pushedhis principles
or even increased proportion. In the stage of views of the orator,who
re-action, the urine had nearlythe same characters. may be said to represent conclusions ^but has bounded his view by the "

the evils of
^rierteijahrtekrift fir die prak.Heil. Prag.,1849. the feeling of the College which nominates him prejudices of his caste. To know
Fiert. Bd. Awdek., p. 12. for its spokesman. Mr. Skey is the voice of the Profession, he has onlyto look around him ;
(The observation made by Oettingen, of a blue the
College. What, then, says thisvoice respect-
ing therefore, he eloquently and truthfully ciates
enun-
colouring-matter in the urine of cholera,which is
the great topics it called
up before its them. To find their remedy he has to
termed by him the "
uroglaucin" of Heller,is pecu-
liarly
interesting, inasmuch as observations have hearers7 We hear it speak of the Profession's look within that narrow pale,throughwhose
lately been made in this country,by Begbteand degradation,"
"
of itslose of socialstatus,of its difficultentrance he has lately passed; there-
fore
Parkes,which prove the existence in choleraurine of depression, of its degeneration.'* "
Its accents bis sightsuddenly waxes dim. He com- mits
a substance derived, probably, from the bile, which
embody the acknowledgmentof great evils, the solecism of enteringon a subject,
a violet,or dark red re-action with nitricacid,
fives
t has been stated by Parkes, that this substance
the recognition of sad deficiencies, the expres-
sion which he knows beforehand he cannot conclude.
and that it is, of incontestable imperfections. Can we If we venture to criticise the Hun-terian
may be converted into a blue pigment, may
in fact,identicalwith the substance described by collect the meaningof these sounds,submit it to Oration,we should imagine that it
Heller as a normal urinary pigment,under the term mental analysis, itwith scales rightwas written with little
weigh the of premeditation or care.
ofuToxanthin. The observation of Oettingen, that
the blue pigment may appear at once in dieurine,
and truth, and see what lesson we can extract It is eloquent;it is ingenious; it is some-
times

tends strongly to confirm this opinion, and to show for our guidance and direction ? equal momentarily in thought and
 THE MEDICAL TIMES. 181

to highmodels standurd will have founded for themselves and for Friday,some curious tive
illustra-
details,
exprestioD among our very
writers ; hut it is without arrangement; it is the Profession. of the system hitherto pursued in the
illogical
Medicine
it now
"
; it intermingles

we

of our calling,
Heaven
as a
somewhat

and speedily we

to Apothecaries'-hall.
and irreparable
confusedly A weeklyContemporary,
Science with the practise
men

have an eulogiumon the grandeurcommendation

fall direct from
who
sense

geons,
whose
and nervous
from
word.^,exactlyindicated what the College
But the great Surgeons are now
strongcom-
masculine style

doing;theyare "reposing
mistake is,that Mr. Skey has the Medical care of the bulk of society
broached the subject of professional grievances, proscribed class." The Spectator
mon
need no

us, has, in a few brief were

management of this learned body,were men-

of sesmed
who
in a statements
in praising, must
by Dr. Webster.
not
As the facts stated
denied by any person present,but
to be admitted by one
took

y
made
of the Coun-

part in the discussion, the

by the former gentleman
be considered as correct and unanswer-
able.
tioned

cil,

and has shirked the topicof professional redress. and justly praising Mr. Skey'senumeration of Space does not permitour now enter- ing

He shootshis arrows from a practised bow, but professional errors/ has yet,with the instinct of upon the various topics alluded to by Dr.

theyrange idlyo'er the realms of space. His genius,indicated the very pointon which the Webster ; but, speakinggenerally, there must
oration will be but of little benefit, for it attention of Government will ere longbe fixed. be somethingrotten in the state of Den-
" mark,"

has no fixed and determinate aim. The College of Surgeons, in "proscribing" the when it is shown, that upwardsof two-
We are of opinion that Mr. Skey has missed General Practitioners, not merely thirds of the resident Fellows have never
are injuring,
but also that served
Profession, the Council ; that than half
a If, after his somewhat
great opportunity. the Members of the on more

bitter enumeration of he had whose health and lifeare the contributors to the Society's Transactions
short-comings,
our greatmass of society,
"

boldly to himself the.task of indicating The quar- the workingbees of the hive have never been
proposed committed to those Members' care. rel
"

theirremedy,he would have earned,whatever between the Members and the College is so honoured; while several Fellows have

mighthave been his opinions, the gratitude of all. no "internecine warfare;"no simplematter, filledoffice duringfive years ; some nine,and
At any rate we should have seen a man, who not which interests onlya small and insignificant others even for ten or more years ; thus ex-
cluding

onlyfeltour wrongs, but had energy to attempt class. On the contrary,societyitself is in- jured many from the Executive, what- ever
to repairthem in the way which seemed to him claims standing in the Society
by whatever tends to lower the efficiency or

fittest.We should neither have suffered the of the class of men who minister to itsinfirm-
ities. theymay possess. However,after the display
contemptuous sneer of those who say, '* thus Let Government, then, legislate for the at the recent and previous Anniversaries, espe-
cially
the great numerical array of arguments
you are, poor, degraded, uneducated,as we good of society, and disregard that pettyoli-
garchy,
deem you, and thus you will remain,"nor who have shown themselves petent
incom- in the form of votes, brought forward last
should we have had the stillmore sarcastic to meet the necessityof the time. Fridayin Bemers-street,and which mightbe,
lecture of the man who tells us that it is a
increased
perhaps, in number on a future
shame for to be to be degenerated, MEDICO-CHIRURGICAL occasion,we trust the rulingpowers, still
us degraded, THE SOCIETY.
to be uneducated, and yet while castigating Friday, the 1st of March, 1850, will long be in the ascendancy,will take warning and
the errors, holds out no friendly hand to cleanse memorable in the annals of the Royal Medical introduce such meliorations in the stitution,
In-

us from them. and Chirurgical Society of London. On that that all just cause of complaint
The inference which Mr. Skey mighthave eventful day,one of the largest meetingsof the among the Fellows in opposition, or wise,
other-

drawn, we are temptedto draw for him. We Fellows ever remembered took placewithin may be removed. It should also be re- membered,

have its halls. The a great statesman said to

are temptedto ask him, what his College questionat issue was self- as once

done to arrest this degeneracy,"'^

of which he government and his followers, in a well-known Assembly, that
independence or antiquated
speaksso bitterly ; what amount of anxiety and
usage ; and, although the contest terminated in a cloud was
"
risingin the West,which they
solicitude have his fellow Councillors favour of the party in power, their triumph ought not to disregard." We should regret
friendly
exhibitedin the degradation"
"
of their profes-
sional will be but temporary, since the victorywas exceedingly were any cloud in the west, or one
the east, to throw the slightest
brethren ? Have they not endeavoured onlyobtained,in a very fullhouse,by so small a coming from
"
are they not endeavouring, to lop off number, that a single figure, and that not a largeshadow over the RoyalMedical and Chirurgical
; and to avert such catastroph^
as a decayedand hurtful member, the great one, would express the actual majority. Nearly Society every
body of Practitioners, who are, in reality, the four score independent Fellows registered tlieir well-wisher of Medical Science should cordially
Profession, instead of aiding in the restoration votes against the system hitherto pursuedin unite, order, in byjudicious reforms, improve
to

of the limb to heslth ? Does not the Collegethis learned corporation, and notwithstanding and renovate its constitution. This proceeding
wish to raise itselfin the eyes of the public, by the active whipmade from almost every hospital appears the more necessary, as a professed
seTeriogall connexion, if it can, with these in London, as, likewise, the influence of ex- advocate, in a contemporary, acknowledges
'*
degraded,degenerated,and uneducated" officials, et hocgemisthat like the sun, there maybe some
"
spotson
expectants, private friends,
We acquiesce in the remark, and
General Practitioners ? Has it not sought does omnef the movement
"
partyalmost carried their itssurface."
it not seek, suicidally seek,to thrust aside that object ^physically wish to remove such blemishes.
"
theywere unsuccessful, though
al-
torrent of Reform,by the means of which the Should the new Council persist in traditional
morallytriumphant.
Ph"fesstonhopeseventually to remedy the evils We are no enemies of the Royal Medical opposition to the largeand independentmi- nority,

which have been inflicted on it by itsincapable, and Chirurgical Society, but zealous friends, we cannot doubt that,as new Fellows
are added,it will be forced to succumb. But
selfish, and misguided leaders? And if the an- swer desiring its reform and regeneration ; anxious
be a true one, we may then draw this in- ference
onlythat any feelings of dissatisfaction which if,as we anticipate, that body wisely yields, we

for Mr. Skey, that whatever

" be the now rankle in the minds of some Fellows may shallbe among those who will rejoice that its

evils of the Profession, his College must be,in be removed, and that all may members were saved from defeat by a majority
cordially work
a greatmeasure, accountable for them. together, to promote the advancement of Medi-
cal small enough to indicate, in no halting phrase,
And to this inference we may add this warn- ing"let Science,and the prosperity of that scientific the mind of the greatbody of the Fellows, yet
Mr. Skey believe that the daysof his Institution. If this desirable object is to be sufficientto save them those unpleasant feelings
be givento which ignominiousexpulsion from office
Collegeare numbered. In another quarterof accomplished, no preference must an

a century, let any one ask what has become of individualsexcepting according to their merits, would have engendered.
the old Corporation of the Barber Surgeons ? It and to the services theyhave rendered to the Let the members of the Council remember,

will be found dwarfed and insignificant beneath Profession. Fellows who have published that althoughby their majority of seren they
papers
the colossalform of itstriumphant rival ; or it in the Transactions, and those who are assiduous have gainedtime, theyhave in reality gained
will have been deprived of an existence which in their attendance at the eveningmeetings, or nothingmore.
had become useless,and have been merged have claims from seniority, oughtalwaysto be
and absorbed in the active, energetic, and effi-
cient preferred for any marks of distinction at the PARISIAN HOSPITALS.
Institution which the General tioners, Society's
Practi- disposal. ST. LOUIS.
who were denied admittance by the During the debate which ensued, after The Hospital of St. Louis is one of the oldest
narrow policyof the present College of Sur- the President's Address to the Fellows last and largestin the French capital.It was
 183 THE MEDICAL TIMES.

founded in the year 1607 by Henry IV.,the Medical Legist; Gibert and Cazenave, for as gentlemanand a man aof education,must
same of their works on Cutaneous
monarch who founded the old Hospital Disease. The Sur-
geons be eligible to vote for the governingbody.
Sfc. Anne, which has now disappeared;La are Boyerand Malgaigne. As a Clinical Upon this broad basis the Profession must take
Charity,and that partof the Hdtel-Dieu which Hospital,St. Louis is little frequentedby their stand ; and theyneed not then fear the
occupies the Rue de la Bucherie. An epidemic* students exceptduringsummer, on account of machinations of party, the treachery of false
and contagious disease,which prevailed in its great distance from the School of Medicine. friends and disguised enemies, the contume-
lious
Paris at the commencement tury, Hence the Clinical Lectures
of the 17th Cen- are generally arrogance of CollegeCouncils, or the in-
sincerity

suggested to the King the idea of creatinggivenfrom May to August. The Conferences and procrastination of Secretaries of
two specialestablishments destined for the on Diseases of the Skin are held in the open State. The longer this contest may last the
treatment of the malady. He therefore had air,under a tent erected in one of the Hospitalstrongerthe Profession at largewill become ;
two Hospitals built, one, " St. Anne's, on the squares, and attract,as theywell deserve to do, for every well-directed blow that is struck at

South side of the city, in the Faubourg St. a crowded auditory.The plan followed by the Collegewill make the Council more feeble
Morceau ; the other,St. Louis,in the fields on the Lecturer is to select some one variety of and irresolute, and convulse itwith new terrors.
the North -side* The Hospital, ceived skin disease,
however, re- on which he dissects for about There is no real strength in parchment.Char- ters
its presentname from Louis IX., who half an hour, and then directs the attention of borrow all their virtue and power from
made additions to it after his return from the pupils
to all the patients present, who may publicopinion, and if the Profession are re- solved
many
the Crusades,and assumed the patronageof the labour under this form,indicating the peculiari-
ties, that the present regimeshall be abo- lished,
establishment. ":c. This done, some twenty to thirty and new principles of Government
The circumstances that attended the founda- tion cases are examined, and the pupilsexercised adopted, as sure as the sun lights the heavens,
of St. Louis gave to the old Hospital the in the difficult art of diagnosis. No Medical the truth of theirprinciples will penetrateinto
than a cen- should the chambers of the Home Department,and
peculiar character which, for more tury, man, who visits Paris duringsummer,
distinguished it from all other establish-
ments neglectattendinga few of these interesting the demands of an indignant Profession will
of a similar kind. The most minute Conferences. From them he may learn more be submissively conceded.
precautions were taken to prevent the spread a in week than he could pick up duringyears In their recent Letter, the Council have not
of contagion, either internally or beyond the of privatepractice.They have been the honestly stated the case between themselves and
walls of the building.Hence its double circle foundation of the fame which St. Louis has the Members. They assume, that the College
of walls, ^itsdouble courts, cuttingoff all acquired
" as a School of Cutaneous Disease,and is theirtf and that the Members are not entitled

communication with the city,^itsstrange old have furnished no

" small contingent to the to the exercise of any rights in it,even upon
tower, and, above all,the mysterious
"
gallerysuperbwork, now in course of publication, by principles of equity.They say, that the Mem- bers
for the transmission of food, with other means M. Cazenave,on Diseases of the Skin. have neither been invited nor compelled
for converting it into a perfect Lazaretto. to jointhe College, but that theyhave '^ tarily"
Volun-

Yet, with all these precautions, one of the presented themselves for its diploma. '

DOES THE COLLEGE OF SURGEONS

simplest rules of hygiene was neglectedfor What a Jesuitical trick is not this ! Commend
BELONG TO THE COUNCIL OR THE
nearlytwo centuries. The patients in this, as MEMBERS? us to such casuists to assuage the terrors of an

well as in the other Parisian Hospitals, were The College of Surgeonsis at its old tactics. alarmed conscience! Voluntarily, forsooth!
placedthree in a bed," a practice the more jurious
in- Private influenceand officialintrigue have been Has not this Council procured from the Govern-
ment
and disgusting, since the Hospital was againresorted to for the purpose of biassing the enactment of certain laws,inflicting
devoted to the reception of persons labouring the Government upon the subject of Medical painsand penalties upon all General titioners
Prac-
under contagious diseases of the skin,itch, ^in legislation.
" These effortswill be vain. The who are not members of their College ?
its worst forms, ulcer, scrofula,"c. This tortuous paths of diplomacyare now
" well Is not every man educated for his Professionin
abuse was swept away by the greatRevolution, known, and the Profession hold the clue to the England,disqualified for an office under the
and an efficientsurgical service was added for official cabinet. Poor-law Board, or in the Medical departments
the benefit of the numerous workmen who Scarcely had the Council of the College re-
turned of the Army and Navy, and the Ordnance,who
abound in the crowded neighbourhood of the their answer to the Council of the Na- tionalis not a Member of the College of Surgeons?

Temple. Institute, than theyhastened to the Home Everyman who does not possess their Diploma
St. Louis can now accommodate about 800 Office to urge upon Sir George Grey the re* is actually shut out from all these important

patients affected with cutaneous diseases, fula,

scro- ceptionof their proposedregulations as the appointments, through the management and
and rheumatism. Syphilitic diseases of basis of a new charter; and, doubtless, also to intrigue of this very Council ; and yet theyhave
the skin are also frequently treated there ; and suggest other matters in relationto the general the unmisgiving temerity to telltheir Members,
the number of accidents that occur amongst the question, in accordance with the notions faintly that theyhave no justclaims upon the Council
workmen, located around,giverise to many in- shadowed
teresting forth in theirLetter to the Institute.for admission to corporate rights, as they
surgical cases or operations. We can believeanythingof the Council of the voluntarily offered themselves for their DiplomaI
The consulting practice, every morning, at College,except
"
one thing,
" that they will be The Members were compelled to join the College,
St. Louis, is most extensive, and of a kind which successful ill their grasping, artful, and under-
hand or suffer deprivation of office, injustice, and
distinguishes this Hospital far above any other policy.They may attempt what they popularsuspicion.There is no compulsory
of a similar nature. Out-patients, from every please, but theywill be obliged in the end to do power in their Charter,it is true ; but such a
quarterof Paris, assemble to receive, not only what pleases the Profession. There can be no power does exist in Acts of Parliament which
advice,but orders for medicine, baths,fumiga-
tions, mistake now as to what the Council desire, and this Council were instrumental in procuring. The
and other external remedies. From what the Profession demand; the two parties statement of the Council is a shabby evasion
seventy to eightycases of skin-diseasemay are at issue upon greatprinciples, and confront of the truth,and the more criminal because it
here be seen of a morning, and it has each other with stem and defiant gestures.was not necessary.
been calculated that more than 50,000 baths,The Council say that theywill not grant this A cause propped up by such arguments
40,000 fumigations, and 3,000 douches,"c., thing and the other ; but we tell them that it is must surelybe in a tottering condition. A
are administered every year. The expense of not in their power to withhold anything.The longand a strong pullwill make the College
this enormous service does not, however,ex- ceed College belongs, by right, to the Members, and rock on its foundations. We confide firmlyn i
20,000/. per mmum. The mean mortality before thisbattleis finished, theywill have re- coveredthe sagacityand stout-heartedness of the
of the Hospital for a period of ten years (1804 possession; and theywill make of it National Institute, the only body that can
to 1814) was 1 in 26, and the average duration such an Institution as theywill. This is a mere
govern the events of this great crisis. We
of treatment is 32 days. question of time. trust them with the helm,for none are so well-
The Physicians of St. Louis are all well- The Professionmust manage theirown affairs. acquainted as they with the rocks and shoals
known to the Profession: " for
Emery-Lugol, Our Councils must govern upon the principle
between which the Fh"fe8sion must steer,and
his Researehes on SeroMa the great of fiprsMiiteffOfi;
; Deyergie, and wtxj qualified
member, we haye confidence in dieSr good pilotage.
 THE MEDICAL TIMES. 183
Let ertty iiiftD, wlio liM not Joined it already, man shallstand upon an equality in respect to te Che ward speeial" as ftishere introdueed t The
**

was, that there should be a tf""eifiel

jointhat body Without loss of time ; fbr each collegiate rights, an^ where merit shall exer* raeaniag by the College
tion
examina-
of Surgeons on surgery, but that
man's name is a power of the highest value, cise an honoured ascendancy.Let the pro- posed ikatthetdd not preclude^ the College of General Prac-
titioners
whose strengthis much needed. There are meeting be in reality an Aoorboatb from examining in Surgery alongwith other
and subjects
of examination.
30|000 men whose interests are involved in Meeting, whose resolutions the Colleges
2011. That was stated to be the understanding f"
the settlement of this dispute, and every man, the Government may regardwith respect. Tiiat was the understanding.
from the youngest to the oldest, is bound to This evidence clearly affirms that the right
lend his aid to promote the righteous cause for THE CLAIM OF THE PROPOSED NEW tb examine in surgery was conceded to the new
which we are now doingbattle. If the daybe COLLEGE TO EXAMINE IN SURGERY. College of General Practitioners by the Confer-
ence.
lost, whose will be the fault? Your own I Re- grets We desire to placebefore the Profession, as Two opinionscannot be entertained
and recriminationswill be in vain when clearly as the case will admit,the point by reasonable men with respectto the meaning
you are degraded,ruined,and fbr ever dis- gracedof variance between the Collegeof Surgeons of the resolution, and the College of Surgeons
by defeat. The Secretariesof the heal and the National with
Institute, respect to the are unquestionably guilty of bad faith. What
AitoeiaHimi must prepare to re-organize their powers proposed to be granted a new College
to then? "Corporations h are no conscience, '*

respective bodies,for much will depend upon of General Practitioners.This point forms the and no sense of shame ; but theyhare power,
the voice from the provinces. Let the trumpet hingeupon which,at this moment, allthe efforts and theycan be combatted successfully only
blow no uncertain sound, for without deeitum of these bodies revolve. It constitutes an histori- cal by that strength and purpose which union alone
and flmtoft all will be lost ! crisis, and may form a precedent for future can confer.
agitation. The National Institute demand for the
THE DEPUTATION TO SIR GEORGE new College the unrestricted power to examine in PITBLIC HTGIEirS.
GREY. allbranches of studynecessary to general AS IT AFFECTS
prac- ON DRAINAGE,
tice, THE HEALTH^
A Dbpdtatior firom the Meeting of De- legates, including WEALTH, AND MORALITT OF SOCIETY.
iurgery : the College of Surgeons
No. IV.
held at the Hanover-square Rooms, are prepared to allow the demand in every re-spect
had an interview, the 4th instant, with
on
exceptturgery. Thus,there is a chasm Cotmtrg Ditches actingae Drains, Old System, rf
"

Sir GeorgeGrey, for the purpose of but drainitqf Lands. Most approvedmodem Methods.
senting dividing,
repre- apparently, contiguous territories, " "

to him the feelings and opinionsof in reality wide and profound. The National Surface Drainage and thorough Drainagecompared,
the Profession in consequence of the recent Construction ef Drains. Filla and"
Cottage "

Instituteassert that their claim was fullyad-

mitted
of the Counail of the College
Grounds. Importance qfproper Drainage. "

proceedings of by the Delegatesfrom the Collegeof It is certainly net geaeraUyknown, and as little
Swgeons. The Deputation, which waa large,Surgeonsat the conferences with the other sospeeted, that Fleet Ditch actually extends as fiir
received with great courtesy. The Letter bodies. The
waa
Collegeof Surgeonsdeny that into the coUntiy as Ftyem Barnet. So much has
addressed by the Council of the Collegeto the theyever made such a concession. The been said of late eonceraing London giiUles, with all
tion theirhorrid eAuvia,that they
posi-
Cottneilof the Institutefbrmed,of necessity, may be said to hare
taken up by the National Instituteis in attained
of comment, and ^e sentiments
a large amount of odious popularity ; but
the ittbjeet fact a practical aceuaation of breach of faith we cannot allow them to monopolise allthe interest
and views which it expressed underwent con- the of Under such of this subject Not to gainsaythe paramount im- portance
against College Surgeons.
nderadon. Hie Deputation claimed,fbr the circumstances we think it best to appeal to of attending to London gullies,a g^eatdeal

General Practitioners, remains to be atiidof countryditches. As ymi

the rightto control the neutral testimony,and now publishfor that pass
along the roads a few miles out of London,intmding
aflfairs
of their own class,and adhered firmly
purpose the evidence of Dr. Christison, one to enjoya salubrious walk,ride, or drive,you are
to the principles which the Conference have of the members of the and likelyto inhale a poisoned
Conference, atmosphere
very
a during
already
propounded. man whose ability will not
and impartiality be leastone-half of your excursion.
at
The drainage of the suburban districts of England
gainsay ed.
is in a very bad condition, and there are few localities
PUBLIC MEETING OF THE PROFESSION. MINUTBS or EVIDENCE TAKEN BEVOEE THE SELECT worse in this respectthan many portions of the
Our readers will observe, by a Notice in our COMMITTEE ON MEDICAL REOISTEATION, "C. lands which surround London. This is in some
12th May, 1848. attributable
advertising columns, that the National Institute respects to a comparative neglect of
R. Christison, Esq.,M.D., examined by Thomas drainage, and in others to the bad systemsby which
contemplate calling a Public Meeting of the
Wakley,Esq. ithas been soughtto efect the object To giveaa
Profeasionto taiceinto considerationthe present 2006. You read a resolution, dated April 8th ; are account of allthe exroneous methods that have been
at the lastexamination, it was found
aspect of Medical affairs. This is a wise you aware that, be attempted, because a
with adopted
must not now
that a difference of opinion had prevailed,
measure, and we trust that the Profession, description of the improvedsystems will claim all
/rom reference to what had been agreed to betwe^^n the
the space that can be allottedto this paper. We
aUparU ofthe Kingdom^willassemble on that Representatives of the College of General Practi-
tioners
with a glanceat
and the President of the Collegeof Surgeons? must content ourselves, therefore,
importantoccasion. This must be a great the old plan of "ridge and furrow," generally
"Yes.
meeting, for on it the interestsof Surgeonsin 2007. That the President of the College of Sur; adopted by agriculturists.
generalpractice, and of the Licentiates of the geons understood that it should be a me qud neti - This old system of " ridge and furrow" efiectsno
that the Collegeof General Practitionersshould not than to drain the surface,while it leaves Uie
Hall will,probably for many years, depend. The more
examine in surgery practice, and the representativesoilfullof moisture beneath. The water that flows
Colleges are busy with the Government ; and, of the College of General Practitionershad stated to
away by these means, carriesoff with it a great
unless the Profession displaynot only deter- minationthis Committee, that he understood that the Council portionof the finer particles of the soil; and with
of the Collegewere to have the unrestricted rightto
but numbers, their cause will be in these,of coarse, very much of the manure and fer-
tilizing
examine upon surgery ; the production ai the reso-
lution
matters, perhaps all those whichare soluble,
grave peril.Let the Government understand,
"

which is now before the Committee, leads

them infer that the sulject again introduced and have not alreadysunk beneath the surface.
that the Profbssioncannot be partitioned and to was
to the notice of the Conference at your lastmeeting;Duringperiods of a storm of rain,or other overflow
allottedexactly as the Colleges may, according to is that so f I of water,the greaterpastof a top-dressing of manure
merelyasked fbr a copy of the reso- lution
theirconvenience, arrange ; but that the claims which had been come to
upon that matter, in on these lands is frequently carried into the ditches
order to reconcile the apparent aiscrepancy of opi-
nion and water-courses.
so long advocated and contended for,must be
between the two gentlemen la question. The history of drainage in Great Britain, may be
respectedand enforced by legalprovision. 2006. Was not the subjectre-discussed? It was told in the words of Dr. Shier :
briefly "

The General Pmetitiimers, in particular, not

can- not, because it was considered that this resolution **
Till the time of Smith, of Deanston, draining
be dragooned settledit.
into a discipline which, in its regardedas themeansof freeing the
2009. You say, that it was considered to be settled was generally
land nom springs, oozes, and under-water, and it was
operation, may be oppressive and regardless of by this resolution? That resoiution empowers
" the
to lands palpably and producing
their interests. Whatever (f Oeneral PraeHtiimtrtto examine in Sttrgerff, applied o nly wet,
actual form the College rushes and other aquatic plants. The old method or
while there is to be a special examination in Surgery
organisation of the Profession may eventually the draining springs was to form a drain, or culvert, of
bf College of Surgeons.
sufficient capacity to carrythe water under groundto
assume, the Profesilon tnust regulate their own 2010. The resolution is as follows:-^" That the
General lower levels, thus preventingthe water from bursting
of Practitionersought be
affairsupon the representative principle, amply Royal College ofthe unrestricted rightto institute such
to
out on the soiface of the land. When several
possessed
acknowledged and freely exercised. Whether examinations as it may deem necessary for testingspringsoccurred in the name field, or vicinity, a main
drain was laid along the lowest levelwith a leader te
the College of Surgeons, or a new pendentthe competence of those persons who intend to prac-
and inde- tise esch eye."
as General Practitioners; but that it ought not
College, be the head, it must be also outbursts of
to institute specialexaminations in surgery? Oozes, Or water, gradually fbrming
the HoiM of the Profeation" in which every What meaning waa attaebed,at the Conference, marshes,or a line of springsmalungmarshyspots,
 184 THE MEDICAL TIMES.
were dealt withby cuttingoff the water as near its The best materials,'* says Dr. Shier, "fcr the he has made
'*
render the work more acceptable to

soarce aspossible, by an intercepting drain,which construction of the water-way of the frequent-drains, the student'* The circulationof the blood in the
it lower levels. are tubes, tiles, and soles, water-worn pebbles from
conveyed to
\
liverand kidneys does not belong to a treatise on the
the sea-beacb,harpedgravel,or broken stones.
As for the removal of under-water, well as
as
decided preference should be givento tubes over tiles Surgical Anatomy of the Aiteries,and the long
surface-water, the old system of frequent-drains may for the ligature of the
and soles." descriptions of operations
often be advantageously combined with the modern
Grass and tillage land may, by possibility, be vesselsbelongrather to a work on Surgerythan to
process of thorough-drainage. over-drained. The object of drainage is not to de-priveSurgical
The method now approvedby the practiceof Anatomy ; but we thank him for the cases
the land of moisture, but to adjust the quantity
our most experienced and scientificagriculturists, of aneurism treated by pressure which he recounts.
and which Smith, of Deanston, has systematized so as to produce the highest degreeof fertility. In
In 1828 Dr. Flood published his Anatomy and
and other
up to the presenttime, instead of draining over the regard,however, to villa occupations, the Nervous System, a book most
small suburban residences, the chief thingsoughtis Physiologyof
surfaces by ridgesand furrows,levels the whole and not unworthyto be read,even in
land as flatas possible, where raised for the
the immediate dryingof the soil. In these cases, clearly written,
(except laid drains may be requisite the presentday. His Anatomy of the Arteries has
growth of the plant,) and drams downward into un- therefore,
der-ground
closely to en-
sure

channels. By these means the fine a rapid(bsehargeof surface-water, larly now reached the second edition. His death from
particu-
from the footpatbi. It will, of course, be un- fever in 1848 has deprived
derstood, us of an excellent
earthypowder of the soilis left within it,and the drain
that roads and foothpaths cannot and we should have gladly hailed a larger
surface particles of manure, and loose animal or anatomist,
downwards by percolation, but over the surface.
vegetable matter, are carried down among the roots work on Anatomy from his pen, for we stillwant a
It is important,'* says a Reportof the Metro- politan
**
of the plants. It is this filtration, combined with the series of demonstrations more neatlywritten,and
of the manure in the soil, that renders Sewer's Commission, *'in reference to the
preservation suburban districts, to allude to the effectthat drain-
age more apt to teach,than those of Mr. Ellis.
thoroughdrainageso productive, independent of
would have on the vigourand ^wth of trees. It
the permeability, increased temperature, and better
has been determined by observations,thatif the an- nual
condition of the soil which thorough drainage duces.
in- qf Anatomy and Physiology, Conducted by
increase of trees on undrained land were 3 per AmmU
The action of a soil, made permeable to air cent., the increase on drained land would be 6 per John Goodsir, F.R.S.S.,L. and E., Professor
and moisture,has been ably elucidated by Dr. cent ; and on land both drained and irrigated no less of Anatomy in the Univereityof Edinburgh, "c,
Madden, of Penecuick,in a lecture on the prepara- tion than 12 per cent, or four times the amount of the
in growth the undrained land." "c.. Pp.96. Edinburgh: Sutherland and Knox.
of soilsfor the reception of seeds, published on
to be devoted to Anatomical
the Transactions of the RoyalAgricultural Societies The proper drainageof suburban villas and A Quarterly serial,
think,adeside-
ratum.
of Englandand Scotland. cottageplotsis of far greaterimporUncethan the and Physiological subjecU, was, we
The retaining of manure and fertilizing particles mere question of profit and loss in the gardenpro- duce, We are glad that it has been undertaken
in the soilwhich has been subject to thorough-drain-
age, or the growthof trees. Agues are frequently by so able a cultivatorof those sciences as Professor
and the flowing away of the greater partof those a consequence of the neglect of drainage in country Goodsir. The
present Number, the first, is a very
fertilizing matters by surface -drainagemay be residences, and sometimes fyphus fever and tery.
dysen- able one. It contains a most elaborate account of
easily tested by the followingfact : " Instances have occurred of the prevalence
*'
When there happensto be two outfollsinto the of typhusand dysentery in these and other un*
the muscles of the tongue, by Mr. J. Zaglas. A
the Anatomy of
same main from the same description of land,"the drained localities, and of their rapid subsidence Paperby Mr. H. D. S. Goodsir,on
one an outfkllfrom sorfsce-drained land, and the and eventu"i]
disappearance aftera proper drainageForbeaia. An Account of some Monstrosities, by
other an outfallfrom an(k*ror thorough-drained land, of the
had been effected. the lateDr. John Reid. A Good Description
the water from the thorough-dniiied Isnd (ifthe
drains be properly laid so as to eti'ecta perfect filtra-
tion) Structure of the Glands of the Alimentary Canal,
may be seen running as dear as orjrstal, while
REVXBWS.
by Dr. Allen Thompson. A note (ofthree pages)
the water from the surface-drainedland will be thick the Dimensions and RefractingPower of
respecting
and muddy from the solid particles which it con- tains."
Surgical Anatomy qf the Arteries, By the late the Eye, by the] learned Professor ot.Natural Phi- losophy

For the construction of drains we cannot do better Valentine Flood, M.D. New Edition. By in the University of Edinburgh;and an
than follow the rules laid down by Mr. Smith, of John Power, M.D. Dublin. 1850. account, possessing considerable merit, of the
which, in
Deanston,
and Mr. Josiah Parkes. We are very doubtful of the great advantageto Structure of the Spleen,by Dr. Sandere,
The firstrule for the position and direction of
the student, of treatisesupon particular divisions of a shorter form,has alreadybeen communicated by
drains is, that they oughtinvariably to run down
the steepest to each other. The anatomy. The study of descriptive anatomy is the Author to this Journal.
descent,and parallel
long one. It is the fhrstpursuit of A QuarterlyList of British and ForeignMe- moirs
water by this means has the shortestway to perco-
late necessarily a
and Papersis appended. This Bibliographical
in getting into the drain,and, when once there, the student,and it is the basis of all Medical
itsdelivery into the muns is effectedat the most practice; it must be acquired, therefore, as tho- Index appears to us very fulland complete.To
roughly
rapidrate. The parallelism of the frequent-drains and quickly as possible,and in a manner those engagedin anatomical, pathological, or siological
phy-
is onlyto be departed from when the nature of the which it may be retained the longest Now, for pursuits, this department willprove invalu-
able.
by
surface,or the direction of the boundarylinesof Work on Ana- tomy, Thegettingupof theWorkis excellent ; and we
this purpose, it is found that some
fields, renders it necessary to do so. In England
which may be used by the bedside of the sub- ject, strongly recommend it to the notice of our readers.
the irregular undulation of surface renders thorough
drainage liableto be badlyplanned, even when there which shall describe each part and relation There is one alterationwe would suggestforthe con- sideration

is the best relianceon the principle. as theyare broughtto view by the scalpel, is the of the conductor" it is,that the plates
the end of the to which
The directionof the mains and sub-nudns depends best ; the student's mind is by it directed to the should be placed at papers
entirely on the nature of the ground and levels.
generalrelations of muscles, vessels,and nerves theyrefer. We have feltthe inconvenience of their
When the surface is undulating,the rule is to laya from the descriptive letter-press. In
rather than to the particular of
descriptionone or beingseparated
main of sufficientsize along"he principal hollow,
learns these parts as theywould oc- Dr. Sanders's paper, this has been obviated by
hollows,the the other. He
cur
with sub-mains alongallthe secondary well the
the livingplacing the description of the plate, as as
small drains openinginto these generally at right to him in performing operations on

and he learns, besides,that roost importantplate itself,at the commencement of the Psper.
angles. Mains require subject,
also to be introduced when-
ever
lengthof the small drains becomes so great part,surface anatomy.
the
as givethem more water than they are capable We have read with great pleasurethe second
to "BPORT8 OF SOOZBTIBS.
of delivering. "
editionof the late Dr. Flood's Surgical Anatomy "'
With respectto the frequency of the small drains, ROYAL MEDICAL AND CHIRURGICAL
of the Arteries ;" and while we think that it,with
the distance at which theyare placedapartdepends SOCIETY.
on several circumstances. The nature and texture other like treatises, failsin usefulness to the student,
Febeuary 26, 1850.
of the soil; the depthat which the drains are to be we can most warmly recommend it to the surgeon.
put in ; and whether it is surface water only which It commences with the anatomy of the pericar-
dium S. SoLLT, in the
Esq.,Vice-President, chair.
Uieyhave to deliver, ^must all be taken into con-
" sideration. and heart,and givesthe most truthful descrip-
tion
them, and especially
of of the right
auricle,
we PBOFESSOB BOKITAKSKL
As for the depthsand distances of drains,stiff
have yet read. A certificate, recommendingthat Professor Ro'
clayshave frequently
been cut 2 feet deep,and 24
We would refer the reader to the sketch of the kitanski be elected an Honorarv Fellow of the
feet between the drains ; and porous soils 8 feet
terminations of aneurism of the aorta (p. 22); Society, was read amidst much applause, and ordered
deep, and 33} feet asunder,with goodeffect. But
the which to be suspended forthe usual time in the library.
drainage at 4 feet deep,wherever a sufiicientoutfall to account of the points in the right
PROXIMATE CAUSE OF ALBUMINOUS
can be obtained,has since been practised; and left common
gressive
pro- carotid differ in the firstpart OV THE
URINE AND DROPSY,
experience havingascertained, that depth of their course (p.32); to the relationsof the sub- AMD OH TOE PATBOLOOT OF TBE BElf AL
consistswith the economy of outlay, as well as with
carotid arteiy, ( p 56,) and of the abdominal aorta, BLOOD-TEMBLS IH BBIOBT'S DXIBASB.
iQperior efiect Hence, drians of 4 feet depth,in GEORGE Attiitant-Physleian to
soils of varied texture,have been found efificient at
as specimens accurate description,
of and of clear Bv JOHNSON, M.D..
King'sCoUege Hospital.
50 feet asunder. They may be executed at a cost of
and impressive style.The demonstrations givenof The author commenced bv an sllusionto his two
about 2/. 58. per acre; being18s. 4d. for871 pipes,the axillaand perinsBum are admirable. We do not
previous communications published in the Society's
and 1/. 6s. 6d. for 53 rods of digging. agree with the Editor, however,that allthe additions Transactions, in which attention had been directed
 186 THE MEDICAL TIMES.
bodies and canals,extending to the secreting: rar- and consequently temptinghim to foigetwhat is were made more liberal, he (Dr.Webster)was oon-
ftces of tbe organs, ttom deficiency of nerrons due to the Profession which does not protect vinced the Society would gain materially, instead of
power, and consequent deteriorationof the blood. him, and to rush blindly into the turbid losing. The amount to be paid by a new Fellow,
Iby-and-bye. he believed,we shall find the first stream of quackery. He alluded to the reserve compounding, would be 50/. 8s. The annual sub- scription
changeto be in the state of the organic nerves plyingthat had been shown lately
sup- with regard to the pro- duction is 3/. 3s. Now, the interest of 50/. 8s.
the kidneys. of papers for the society, which had caused alone would be 2/.; evidently, therefore, the compo-
sition
regret, but not surprise nor discoun^^ement, as the istoo large at comiAencement. He would not
ANNIVERSARY MEETING, constant struggle requisite to obtain even a petency, be led away
com- by any actuary,however "zperi"nocd.
March 1, 18^0. and the increasing occupation of the time In the RoyalSociety tiiey onlyrequire fifteenyean'
Dr. Addison, President, in the chair. of the Fellows by their professional pursuits would purchase from those who have not eontribated any
The Fellows of this Society mustered strong in fblly account for this, without calling into questionpapers; those who have, pay only ten years. In
the Library long before the hour of meeting,it eithertheirgoodwill or their industry. After some this Society there is no distinctionmade, as regards
beingexpectedthat there would be a determined further remarks, Dr. Addison terminated an elo- quent the payments,between those who have laboured for
in
struggle opposition to the House-list. At 4 p.m. address by a notice of the Fellows lost to the the Society, and those who have not. A Fellow of
the room was crowdinl to excess, every seat occu- pied, Societyby death duringthe past year. Among the Society, who bas belonged to itfor thirty year*,
and there was scarcely even standing-room, these were Mr. Varicas, Dr. John Somerton, Mr. will have paid97/. 13s. Now, afterpayingso large
while the noise and confusion arising from the dis- Goldwyer Andrews, Dr. Wright,Mr. Morton, Sir a sum, it is too much to be called upon fox 5/.5a.
cussions
which were beingcarried on in every partof D. Dickson, Mr. Roche, Dr. Burton, and Mr. more. After thirty years'fellowship, he should be
the room, rendered it a thoroughBabel of sounds, Clift. Of the two lattergentlemen he spokein the altc^ether free. He, (Dr.Websteri)at the anni-
although not of tongues. Soon after four, the Pre-
sident, highest terms. In his concluding remarks he ex- versary meetinglast year, had mentioned several
who was then in the chair,nominated Dr. his regretat the simultaneous retirement of points in which he objected to the house list It
Black and Mr. Coulson to be the scrutineers of the Sressed
oth the Secretaries, which he said could not failto contained twelve contributors and nine non-contri- butors
ballot-papers, were which declared to be receivable enhance the difficulties to be experienced by their ; in the list now before the Society, although
till5 pjn. successors. He regretted theirwithdrawal,as they there are some improvements in havingfewer junior
While the ballottinff was goingon, (he Report of were gentlemenof the highesthonour,feeling, and Fellows, and not so many from particular schools to
the Auditors was read,ftom which it appeared, that independence, and sincerely attached to the real in- the exclusion of others,
terests there are onlynine oontri-
the totalamount received lastyear was 12242. 8s. ; of the Society. butors,and twelve who have never published a paper

of which,216/. 16s. admission -foes, 261, 4s. com- The conclusion of Dr. Addison's address, of which in the Transactions. This he thoughta matter of
position-fees for the Transactions, 919/. 16s.annual we have givena mere sketch,was received with great great importance. Twelve of them have been
subscriptions, 98i 12s. lOd. dividends, U 148. applause. previously, one, for five years; three,for aix
flnes, and SSL 2d. 48. cash received from Longmans, Mr. Macilwain then moved the adoption of the new years ; and one, for nine years, on the Council ;
The expenditure amounted to 1289/. Is. 9d.,mclud- bye-law, which he read. The purpose of it was to althoughthe last-named was elected so late as
ing 140/. sub-librarian's salary, 212/. 158. rent, enable the Fellows to pay a composition fbe,varying 1837; whilst among the eleven hew Fellows now
130/.12s. publishing Transactions, and 213/. 15s. 3d. in amount accordingto the date of Fellowship, and recommended as officers, or for seats in the Council,

balance due to the Treasurer for the pastyear. The calculated by Mr. Neilson, the Actuary,after the seven have been formerly in office,-" two only, ever,
how-
balance now due is64/. 138. 9d. rate of fifteenyears'purchasefor newly-admitted beingcoptributors.Not one of the four whose
The Report was received, and ordered to be Fellows, with a proportionate reduction ror those of names are now proposed for the first time, have
printed and circulatedin the usual manner. longerstanding.A clause in the bye-lawprovidedpublished any paper in theirTransactions; and some
The Reportof the President and Council was for the investment in the Ainds of the money thus of the CounciUon have not even taken part in the
next read,announcing a slight increase in the num- ber received. He said,some of the propositions were discussions. He (Dr.Webster) thoughtit very de- sirable,
of Fellows; there were 578 in the previous year, not so acceptable, perhaps, as in the propositions thatthose who have contributed to the l"ana-
and theyare now 587, there being 26 new Fellows, originally before the Council. The amount to be actions, or have taken a part in the discussions, which
and 17 retired,i. e., 80 honorary,(11 British,
" and paid as a compositionhad been ascertained are dulyand very faithfully reported in the Medical
19 foreign,) 308 resident, and 239 non-resident The by an Actuary, up to the period of thirtyjournals, should have a seat at the Council-table.
Reportstated, that,while the aipountof the annual years' Fellowship.After that date, it had been There are eighty-five Fellows who have written one
subscriptions was larger than on any former occasion, intended that all future payments should cease. or more papers ; of these, forty-five, or more than half,
the expenditure had been lessened,more especially This was Dr. Baly*s proposition, but it was have never filledany officewhatever in the Society ;
as regarded the cost of the Transactions. Two-fifths objected to by the treasurer,who thoughtit would whilst the remaining 40 have allbeen on the Coun- cil,
of the sum thus saved had been expended on im- scarcely be safe in relationto the funds of the So- ciety. some three times,some four, and three have
nroving the Library : 800 works,about 1000 volumes, He (theTreasurer) had therefore proposed actually served on the Council on fiveseveral occa- sions.
had been purchased lastyear, and the library now thatthe scale of calculationshould be carriedon, and With regardto the whole 308 resident Fel- lows,
consisted of nearly 22,000volumes. The preparation that Fellows of thirty years'standing might com-pound it appears, that upwardsof two-thirds, or 220,

of a catalogue of the library by Mr. Williams, the for all future pajrments by one of 61. 5s. have never once occupied seats in the Council ;
sub-librarian, was noticed with highcommendation Mr. Le Gros Clark had proposedin the Council while, on the other hand, the governing body haa
as a work of greatlabour ; his energy and zeal were that the entrance foe (6/.6s.)should be reduced alwaysbeen selectedfrom among 88 Fellows^ being
spoken of as worthyevery praise. general T^e i ndex one-half; but it could not then be carried out, less than one-third the whole number of resident
to the Transactions was reported to be nearly ready,and he (Mr.Macilwain)thought that the Council Fellows. He mentioned this foot, to show the sys- tem
and it was hopedthat itwould be distributedamong had displayed a wise caution in acting on the sug-
gestion which had hitherto been pursued, and he had
the Fellows in a short time. It was furtiier announced of the Treasurer, so as not to impair their no doubt but that it would be changed in future.
that the Council had taken a lease of the house, funds. He had greatfaithin the e^Sciency of thisand He thought that those who laboured in their vine-
termioable at their optionevery seven years, at a of other liberalmeasures, and did not entertainany vard, should be encouraged; and added,thatUie
rental of 160/. per annum; they had reserved the fear that their funds would sufiEbr.He was of opi- late Dr. Clendinning, who was at one time one ot
rightto make any alterationsthat were necessary in m'on that when a member had paid Uie subscription their Secretaries, agreed with him in the opinion,
the library. The renort concluded by drawingat- for thirty with the fact,that after so that contributors to theirTransactionshad a claim
tention years, coupled
to a new bye-law, to be proposed to the meet-
ing, longa practice he must have attained a certain de- gree to a seat in the Council. This his proposition waa
allowing a composition to be paid in lieu of the of eminence in the Profession, and that the Quite in accordancewith the standing orders of the
annual subscription. measure would have the eflectof retainingUie older Society.(Dr. Webster here read portions of the
This reportwas also received, and ordered to be members in the Society, itwould be good policy to bye-laws to prove his assertion.) tliere is another
printed and circulated among the Fellows. free them from future payments,andhe believedtiiat, bye-law,that the names of at least twenty of the
Dr. Addison,the President, then arose, and de- if it were
livered found it could be done without iiguring senior Fellows who have never been in office, nor on
the annual address, in the course of which he the funds,that partof the bye laws would ere long the Council,should be read oyer, before the House*
congratulated the Fellows on the progress made by be withdrawn. listis prepared. Had thisrule been carried out, it
the Society over which he presided, as evidenced by Dr. Gregory, as a member of the Council and never could have happened that two-Uiirds of the
the reports justread,which,he said,aflbrded abun- dant one of the Sub-Committee, on whose reportthe Fellows should be debarred from office. After the
proofs of itsprosperity. He calledita Societybye-lawwas founded, seconded the proposition. He electionof the Council at the anniversary meeting
holding the highest rank among the Medical Societies had been for many years pastconvinced of the ad- last jear,a vacancy occurred,
vantages which was filled
up,
of the kingdom; a national representation of a noble that would attend the adoption of a fixed not from among the 220 residentFellowsalready
Profession a Profession distinguished
" for itslearn-
ing, payment, insteadof an annual subscription, as many spokenof,nor even from among the 45 contributors,
integrity, and disinterestedness. Dr. Addison persons could not alwayscontinue to pay the annual but from the Committee of Referees, and the sen-
then spoke of the medical practitioner, his education,fee. He (Dr.Gregoiy) believed the measure fore tleman electedhad formerly
be- been on the Council. A
alike classical, mathematical,and professional ; his them was as perfect as it could be made ; it similarthingoccurredthis year when another vacancy
career, and the estimation in which he is held ; and was based on the calculationsof an eminent actuary, happened in the Council. The gentlemanwbo was
he dwelt on the necessity for union and harmony and the most minute detailshad been entered into, elected,was certeinly very distinguished, and one
among the difierentmembers belonging to the Pro-
fession. in ascertaining the various sums which represented who has alwaysdone his duty; but he (Dr. Web- ster)
The want of union amongst them inflicted the respective dates of fellowship. did not think such a mode of selection fair,
the most deadlyinjury upon the Profession, para-
lysing Dr. Webster said, that the principle of the new nor encouraging to the other Fellows of the Society.
iU powers, allowing it to be humbled, libelled, bye-law was good; it was one he had contended for He was opposedto such a proceeding; he was, in- deed,
and lampooned, and permitting the honest prac- when in the Council ; but its application too a greatenemy to allHouse-lists ; itresembled
titioner was
to be plundered by unblushing quackery.stringent; it was not sufldently liberol. If it too closely the appointing one's own successors.
 THE MEDICAL TIMES. 187
Dr. Addison here reminded Dr. Webster, that it as composition fees : it oughtto be spent for that such men should now be told how to treat the
competentfor him to have a Oeneral the benefit of the existing Fellows. He would disease," toldtiiat hithertotheyhad been doing

ceived
WW perfectly what
some-

Meeting called to discuss the question, on the sition

requi- rather the Society possessedf,000/.'s worth of books wrong in their mana^ment of it,and told so,
of three Fellows. than the same amount in the funds. not by a leading physician in a metropolis" not even

Mr. Maciiwain said the Council had taken this by a Frenchman or a German* but by a man in
Dr. Webster was aware of that,but he did not
Huddersfield ; that this should be suffered to pass
wish to be an agitator. He desired merelyto express point carefully into consideration, and had come nimously
una-
without opposition by any Association of Medical
his opinion. With respectto the Committee of to the decision that itwould be better to
men would scarcely be expectedby lookers-on who
referees, seven had never been on the Council be- fore, fund it He then commented on the observations know of human of medical human
anything nature"
and nine are juniorfellows elected in or since made by Dr. Webster,and said that some of the nature. With these views I do not feel much sur- prised
1840. Eight or one -third are non-contributors;bye-lawsrendered it impossible to remedy the ob- jections by the refusalof such a paper by our Council ;
and two lastyear furnished a joint essay, and those he had raised, of which, however, he fullyand I do not know how a Societyshall construct a
he did not know how he should class, whether among approved. He next alluded to certain reportscur- rent, Council that shall be free from such influencesas I
the contributorsor not and stated that the Council were unanimous in have adverted to.
It was then announced, that the ballot had ter- minated their regretat the resignation of the Secretaries. But I regardthe matter as being,in the present
in favour of the house-liat 157 Fellows Mr. O'Connor observed,that there was only one case, of more importance to the Society than to the
Author. To hiro,and to such as he is,I would
had voted " 82 in favour of the house list; 75 againstGeneral Practitioner on the Council,and remarked
say, persevere in your valuable and honourable
it: majority, 7. that thishad been the case for some time past.
labours. When you aild to our store of knowledge
Mr. Phillips explained, that the composition-feeThe new bye-lawwas then adopted; a/ter which, factswhich are useful to humanity,you must know
had been fixed at fifteenyears*purchase, not trarily,on the proposition
arbi- of Dr. Copland,a vote of thanks it,and,knowing it,may rest satisfied, that,whatever
but, after the calculationsof a celebrated was givento Dr. Addison by acclamation, for hia may be done after dinner,by more or less learned
actuary,who had ascertained that that period repre- servicesas President duringthe pastyear.
sented Doctors, while they siptheir Medico-Cbirurgical
the average duration of Fellowship, and, con-
sequently, Dr. Addison briefly returned thanks, and the coffee, your useful work will he acknowledged,in
itwould not be safe to take a less period.meetingthen adjourned. time and for time, without stint and without limita- tion
If a more liberal measure than that proposed for ; and that,too,whether published in that I"ookor
the thirty the funds The following is the house-list:" President,
in this.
years'fellowship were adopted, Dr.
Is it to
And now, Sir, lor the '* Ballottinf-Ust."
would be endangered. It mighthappenthat twenty- Addison. Vice-Presidents, Dr. Burrows, F.R.S. ;
be supposed, that the changes which have been sug- gested
eightpersons mightcease to pay their subscriptions, Dr. John Thomson, Mr. Alexander,F.R.S. ; Mr.
to us in the ** amended" list, would have
causinga loss of 88/. By the proposedbye-law,Solly, F.R.S. Treasurers, Dr. Todd, F.R.S.; Mr. cured
any evil existing, or supposedto exist,in the
nnder these circumstances, theywould receive 147/., Phillips, F.R.S. Secretaries, Dr. Seth Thompson, I reallysaw no very strong reason to an-
the interestof which would not be more than 4/. ; Mr. Charles Hawkins.
Society. swer

Libiarians, Dr. Hennen, this questionin the affirmative* and I therefore

so that there would be an absolute loss of income, M'r. Dixon. Other Members of Council, Dr. proceededto satisfy myself whether I should best
smonntingto 84/. He doubted whether the SocietyCursham,Dr. Gregory,Dr. Macintyre, Dr. Suther-
land, perform the duty I conceive myselfto owe to my

would be able to bear a greaterloss. It must be F.KS.; Dr. C. J. B. Williams, F.R.S.; Mr. brother Fellows in the Society, by adopting the
F.R.S. ; Mx. Council's listor the amended'^ Accordingas
**
borne in mind, that every year more members would Clayton, Mr. Curling, Mr. Fergusson, one.
well to the laws of the Society as to my notions of
be approaching theirthirtiethyear ; and that every Henry Charles Johnson, Mr. Lane.
what is just,seniority must be taken into account,
v^ir diatwould add to the declension of theirfunds.
with other claims,in determining as to the members
The Council had,therefore, determined that it would who are to be placedin the roost conspicuous posi-
tions
be unwise to go furtherat present; perhaps subsequent CORRBSPONDSNGB.
amongst us ; and I thereforetook down the last
experience mightenable them to act more liberally " volume of the *'
Transactions,"to examine the list
hereafter. There was this differencebetween this ROYAL MEDICAL AND CHIRURGICAL of Fellows which itcontains, with the date of their
Society and the Royal; men enter the latterat a SOCIETY. admission into the Society. The names of the Fel-
lows
later periodof life; this at an earlier; the duration suggesud to us for election anonymouslywith
of the fellowship is consequently less in the Royal [To the Editor of the Medical Timet.] those proposed by the Council;and the year of elec*
Society. Sir, I have to thank you for a copv,in a sepa-
"
rate tion,in each case, are as follow: "

form, which I, in common with others,re- ceived 1844u Dr. Bashan. I 1839. Dr. Seth Thomson.
Dr. Webster remarked, that he disapproved of
on Friday mornincr, of your Leading Article,1842. Mr. "richsen. 1838. Mr. C. Hawkins.
secret reports beingmade on the papers sent to the the anairs ana the then pending election 1843. Mr. Hewett. 1837. Mr. H.C. Johnson.
respecting
Society. reason
Some should be alleged for the tion of offlcersin the above-named Society.Discussion 1843. Mr. Toynbce.
rejec- | 1840. Mr. Lane.
of papers from the Transactions. This was done will do good in this as in every other case, provided Thus we were invited to alter the Council's listby
in the National Academy of Medicine. The names of it be conducced in a fair spirit and, as I have no inserting the names of foqr Fellows who happen to
;
the reporters there are known, and they are obligeddoubt whatever that, on
your part, the discussion be from three to six years juniorin the Societyto
to defend their reportspublicly. He thought "at will not intentionally be otherwise than entirely fair,those recommended by the Council.
every Fellow had a right to see every public document I send you this letter, in the hopethat my observa- tions But, supposingit had been considered desirableto
may contribute to elucidatethe subject. changethe Council's list, had no Fellows joined the
belonging to the Corporation. That is,corporation-
law. At me RoyalSociety, Fellow And, nrst, I must express my hearty concurrence Society in those six years? My search was very
every was entitled
in a great part of your views. I look upon the re- fusal short i still I found the following "
:
to see the Minutes of the Council,and every docu- ment
to publish a paper of first-rate merit as a great 1837. 1841.
belongingto the Society.Many of the re- ports
evil,"an evil, however,mainly as regardsthe cha- racter A. M*Wbinnie. John Avery,
which had been made were very valuable, and of the Society; for,thanks to you, we have the William
1838. Bowman,
very creditableto the referees : they mightbe pub- lished Paper in full possession. Yet,while I fully admit H. Hancock. Holmes Coote,
with advantage.There was greatdissatisfac- tion that the refusalto publish a most valuable contribu-
tion 1839. M. A. N. Crawford,M.D."
respecting the smaUness of the last volume : to a department of medicine stillbut little reallyT. Graham Balfour, Campbellde Morgan,
thirty-two papers had been read: of these,nineteen under8tood,and one most difficnlt of cultivation,wa8,to T.H. Burgess,M.D. John Hilton,
were rejected, and only thirteen published.The say the least, a vitalmisiakeiI must at the same time 1840. James Ranald Martin,
which led express the opinion, (though i tbe little c alculated to Thomas Tatum. ". W. Murphy, M.D.,
causes to this should be made known.
He would suggest,that when papers were diminish our reprehensionof the act justlycom- H. Pitman, M.D.
not of
of,)that the Essayin questionwas in some others,before I
anfiicient importance to warrant theirpublication m Slained
egree calculated, as I read the present tastes and
All these names
approach
occur, with many
the years to which belongthe names of the
extengo, theyshould be givenin abstract, and pub-lished of the Profession,
feelings to challenge opposition Fellows whom we were called on to supportin oppo- sition
in the form of proceedings at the end of the
from a body of medical men, even the councillorsof to the recommendation of the Council ; and yet
volume. This would act as an inducement to their a Medical
Society. If ttie Essay concerned a gentiemen who speak about the impropriety of
authors to continue their exertions, and lead them pointof animal chemistry,telling for or against passingover"
"
certain Fellows, supportedthe
to furnish other papers which might be worthy of the theories of Liebig,or if it were occupied*' amen"d'* list, which leaped more nimbly over the
appearing in the Transactions. He threw this out with some more or less accurate microscopical Fellows than ever had been done before in my ex- perience.

as a suggestion, and trusted the Council would take observations," for example, a newly-found turn or Let theFellows look to the names carefully,
of thickeningin a blood-vessel,
itinto consideration. It was far better, at allevents, point or a new and, if I mistake not,they will not readily finda good
than publishing tail to a nucleated cell,or a new mote in some for putting of them aside.
a listof donations of books in large reason some
evacuation;nay, possibly, in the eye of the ob- server,"In truth, the proceeding on this occasion is but a
*^. Mooie thought there was a ftllacy in the cal-
culations
if Dr. Taylor, instead of working sedulously
for longdays and years by the bedside of the sick, the responsible
type of what would constantly be done if,instead of
,

Council whom we can blame forits

of the Actuary, who