THE NEW SYDENHAM

S OC IET Y.

INS T I TU T ED M D C C C L V I I I .

VOLUME VIII.

YEAR-BOOK

M E D I C I NE,S U RGE RY

AND THEIR

ALLIED SCIENCES,

you

1 8 5 9 .

EDITED BY

DR. HARLEY, DR. HANDFIELD JONES, MR . KULKE,

DR. GRAILY HEWITT , AND DR . ODLING,

P03

THE NEW SYDENHAM SOCIETY.

L O N D ON .

mcccnx .

LANt LIBRARY, STANFORD

EDITOR’

S PREFACE.

IN issuing the first volume of the New Sydenham Society’ sAnnual Compendium of Scientific and Practical Medicine,

’the

members of the Societymaynot deemit superfluous, if the GeneralEditor briefly explains the plan of the work, and the mann er inwhich it has been executed.

The volume is divided into five departments, each of which has

been entrusted to a separate editor. The first department, entitledthe Institutes of Medicine,” includes reports on Anatomy, Physiology, Histology, and Animal Chemistry, and is, in fact, an

epitome of science applied to practicalmedicine.

The second department contains the reports on Pathology,

Therapeutics, Clinical Medicine, and Psychiatry .

In the third department are the reports on General, Aural,

Ophthalmic, and Dental Surgery.

The fourth department is devoted to Midwifery and Diseases of

Women and Children

W hilst the fifth and lastdepartment includes Legal Medicine andSanitary Science .

Each department has been systematically divided, and the

materials so arranged, that the members will be able to find almostanysubject without the trouble of referring to the Index, when

\i narron'

s mass es .

are! are amus inted with the general plan of the volume. The

w ine et'

a N uiplete Index, however, has not been lost sight of,

an ! fluv ial care has been taken to arrange it so that the reader

w m hlv tind the information sought for, although it be only

the N uue ut'

the author, the organ , or the disease, with which he is

thuuhsr.

“he title ateach work or paper is given in full at the commencem t et each subdivision, and in all cases the foreign titles have

M u hrietly translated.

”the re ports themselves consist of concise abstracts of the original

Nutter contained in British and American medical journals and

“mu te treatises, and of the epitomes of continental year-books .

Mneug the year-hook s to which we are chiefly indebted may benieutiene d (

l

ttltstatt’s Jahresbericht,’ Schmidt’s J ahrbueher,

’

"min and Meissner’s Bericht,’and the French Annuaires

’of

Neire t. e l'

Jnmnin andWalter, and of Bouehardt and Sandras . As

“Wh i Nelnnidt’s Jahrbueher,

’the GeneralEditor gladly embraces

the uppertunity of acknowledging the obligation due to its editors,l‘mt'tmmrs Winter and Richter, as well as to the proprietor, Mr.

“tin Wigand, for the generous assistance they gave himand his

milengues in furthering the publication of the present volume, bylmtl tuitting directly the revise sheets of their valuable work as thev

issued frmn the press.inmak ing their abstracts, the Editors have generally avoided

INN! an opinion regarding themerits of anyof the papers. Thev

“it? " merelyehwsiiled them, so as to bring into juxtaposition theinlmurs on each particular subject of medical men, scattered in“I" ! "fi rner of the earth, and have thereby placed the reader in a

la rnhle pe sitian for drawing his own general conclusions.

“in nut-hers whose material has been made use of, and whomavk themselves restrict ed in the space assigned to them, are

Hated to hear in mind that the reports of the Editors were

Ba rron’

s PREFACE.

res tricted by the space at their disposal ; whilst members who

may require fuller information on any special_subject than could

be here introduced, can readily refer to the original source of

information which is in all cases indicated. Embarrassed by a

superabundance of material, the Editors found it difficult to select ;

but in cases where it was absolutely necessary to choose one for

abstract from among the several papers on analogous subjects,

preference has been given to the. labours of foreign authors, in

order that the members of the Society might receive informationof that kind which they could not otherwise easily obtain .

l ls a u n ' S ra s s r ,W4

J uly,

LIST OF ABBREVIATIONS REFERRED TO .

Bulletins do l’Aeadémic Royals Media te Belgians.Bulletin do l

’Académie de Médecine.

as, par Jamain

Imp. de St. Peterabon rg.

Portaehritte in der Gmmm

(cm ) Vtuteljahra ebrift filr gedehtliehe andm eans Medecin . von 8. n

m 8. B.

dc.

B eale and Pfeuler'a Zeitaehrift Mfiller’a Archiv.

Zeitacbrift fi r die l’hamu zie von Dr. H. “in cl.

Ca z . Medina ltaliana. Stati sardi.

Medical Circular.

The Medical Times and Gaz ette.Microscopic Journal.W '

s Unten uehungea xur Natnrlehre and dcr

(Prenssen ) Media. Zeitschrlft herausgqeben von der Van ia fiir Heilkunde inPreussen.

(Proe. Roy. Soc.) Proceedings of the Royal Society.(Schmidt)

ySchmidt's Jahrb iieher derGesammten Medical .

(Trans. Roy. Soc. Transactions of the Royal Societyy.Wien Aerat.) eitsehrift der Kaiserlich Konigs. Gesellsehafi der Acu te zuWien.

Wiener) Wiener Med. Wocbenscbrift.

(Wittstein) Vierteljahrsschrift ftir practisehe Pharmacie von Wittstein.

(Wnrtemb.) Correspondu isblatt des Wiirtemberger iratliehea Vereins.(Wur

‘agiurg) Verbandlnngen dot Physicaliseh Mediciniaehen Gesellaehaft an

urz burg.

(Zeitéchrift for v isa. Zeal.) Staheli and Kellik er’a Zeitsohfi ft furoologie.

E B B A T A.

62, line 2

1

7, f or Cz ermack78,78. 4. Eek ard

125,203, line 21,220, 85,236, 21,286D sr 26)268, last line but two

281, lin e 9,

286, 17

288, lastlinebutthree

292, 12,

£75

:2

5: Hewitt

800, 9.am) Is Pemberton.

810, 9.810, 27 d ,

810, 81,810, 46,811. 1,812, 11,815, 28,816, 29,325. 34.828, 8,880, 8,380. 14.888,lastlinebutthree884, line 12,

D, 8,884, last line but one895, line 26, Gilette

408. l .

R E PO R T

OI! 7 8 .

INST I TU TES OF MED I C INE,

ANATOMY, PHYSIOLOGY, HISTOLOGY,CHEM I STRY, AND

PHYSICS .

GEORGE HARLEY,M .D

" snow or m s ou r. cau s e s or mu rmu rs or s omeon e s ; n au s e a or

u s s own . en su es or e n r s rcu xs 01 se a s on ; e aom so a or u nre s t.

w arsr ann sue s mc am e l" comma s ; awn e a r-routs1 0ms s ea

-cm rum in ant . LONDON.

MANUALS , GENERAL TREAT ISES , AND LECTURES .

W h eaties on Human Physiology. PM 1859. pp. 608.

W fl ew a Anatomyand Physiology. Parts li and lii. London.

mma— Os the Human Skeleton (including the joints). With numerouswoodcuts. pp. 61o. Cambridge. 1859.

W mm of u atomy to Physiology and Patbology; being a sequel

to tbc ‘w e and b aboon ol Xavier Biehat.’

(A short essay in the Laneet.

r 479 .Mar. 18590ef Heman Oncology. sd edq pp u o. London, 1859.

Helm-Mansfi el d"! Dissection of the Human Body. 8vo. London , 1859.

—Blcmeatc def Spcaiellen Anatomic. [Elements of Special Anatomy.] 5th

ed. Wm , 1858. (Canstatt’s Jahresbcricht. 1859. vol. 1. p. 19. A pock et

anatomical remembcrer for tbe usc ot‘ practitionm and stndcnts.)Le Gu i se — Anatomic Ch imsia le Bomb er-W Par is. 1858. ea 45.

(Schmidt’s Jahrbncher, vol. n o. No. 4, p. 1 16. A deem of the principallegions of the human body. illustrated with twenty-five plates, natural siz e,

than fromsectiommade on from bodies.)W mAnM yand Physiology. Second part, pp.86— 177.

Glass-11. 1858. (Schmidt. vol. 103.No. 4.p.

W of Topographical Anatomy, withM aine and Surgery. 3d ed. M . 1857. Vol. 1. pp. 594; vol. 1 .

pp. 513. (Schmidt, vol. 103, No. 8. p.

2 REPORT on THE INSTITUTES or MED ICINE.

Pon ono.— Trattato Elementare d

’Anatomia Speciale. [An ElementaryTreatise

on Special Anatomy.] Napoli, 1857. In four vols. xsmo, pp. 495.459.777 and 266.

Bil. -Conservation der Leieheu for W und Chirurgische Operationsn

ungen. [On a Method of Preserving Anatomical (Virchow ’s

Archiv, vol. xv, p. 1 73, 1858. Schmidt, vol. 103, No. 5. p.Ambrogoli.— Ou the Preservation of AnatomicalPreparations bymeans of Glycerin .

(Gas . Lomb., No. 39, 1858. Schmidt, vol. 103.No. 5, p.E lton — Contributions to Physiology and Pathology. Ph tes.sto. La den. 1859.

Koala — Treatise on Vital Causes. 8vo. London. 1859.

Ludwig— u h rbuch der Physiologic des Menschen . [Text-Book

Second and improved edition. Leipz ig and Heidelberg, 1858.

Long'

et-Traite de Physiologic. [Treatise on Physiology.] 8vo. ad ed . Par is,

1858. (British and Foreign Medico-Chirurglcal Review , April,Punk s — Lemuel.dcr Physiologic tiit Akademische Vorlesungen und sumSelbst

stadium. [Text-book of Physiology.] ad ed. 2 vols. 8vo. Leip z ig, 1858.

(British and Foreign Medico-Chirurgical Review . April,sow — Lehrbuch dcr Physiologic. [Text-book of Physiology.] (First three

P1110.) 8vo. Lai r. 1858. (Csnstatt, vol. 1. p. 38.

Ad. Pick — Compendiumdcr Physiologic dea Menschcn. [Compendium of

Human Physiology.) (First part.) 8ve . Vienna. 1859. (Comm VOL 1.

p. 38, 185Alumn a

-D ie9Physiologische As stalt der Univ. Heidelberg von 1853-8. [The

Physiological Institution attached to the University of Heide lberg.) Heidelberg. 1858.

“ 110°Edwardl .— Locona sur la Physiologic et l’Anatomic compares de l'Homme

et des Animaux. [Lectures on Comparative Anatomy and Physiology.] 8vo.

Paris, 1858.

Hannover.— Statistisk e Undersiigelscr sf laegevidensk abcligt Inhold. [Hospital

Statistics.) W 1858. (Canstatt, vol. 1 . p. a8.)—

’

l'

ha Faots sad Laws of Life . l enders. 1859. (An introductoryLectnne dslivsred at ths epenh g of the uedical School sf the t tn inster Hospital.)

“ Ghan a —Studies dss Physiologiasben Instituts an man. may. 1858»

(Contains. among other things, the author’s papsr on the Circulation in Fish ,

which will afterwards be referred to .)Ariz on a-w on Bbmentsires d'Anatomie at de Physiologis Hus-sine at compares sous lea pai ns a. rue de ramsno et de Pro duction agricole. (are.

msntaryLectures on Comparative Anatomy and Physiology] 8vo. Paris, 1858.

(No abstract.)Th. Bischofi-Ueher den Untan chied zwischen Mensch and Thier. 8vo. Braces

solweim1858. (C amu s, vol. 1. p. as. Scientific diseas rss oa ths dim-csbetween Man and Beast, delivered in Munich h the winter of

n eurons — Do la vs. a d. l’ lntelligcrscs. [On Lifis and h a rm ] 8vo.

Par is, 1858. (No abstract.)-Das ein‘aohste thisaische Le i a . ate. Zurich, 1858. (A sketch of

animal life.)Pimd-DM cllungs

-versueh siniger der Besiehmgca der Physiologic nor Patho

logie 11nd Therapie. [Some Physiological and Pathological Experiments ] 8vo.

Ws rz bssrg, 1856. (No abstract.)

MANUALS , GENERAL TREATIBES, rare . 8

W ham m lq pfletfi Physiologiqm et lss Alten tiomPatholoo

giqnes des Liquides de l’Organiame. [On the Animal Pluirh .) Vols. i and ii.

M 1859.

M oat— C ebu Johannes Muller and sale Verbaltniss sumjetsigen Standpunktder Physiologta. [Discourse ou Professor Muller.) “w hen. 1858. ate .

W — J .ohannss mlllcr Bine Gedl cbtnissrede. [Discourse on Protessor

Ew en ] M 1858. 8vo. (Caastatt, vol. (No sbstract )

W a m d the ll stsphyd eal Aspeots of Physielogy. (Edinburgh uenthlyA k ctnre delivercd at a eonversaz ione held

on the invitatioa ol ths Prel idmt anc Uows ot the RoyaI Coflege of Physi

Jam — W n camb gue ol the pau tions in the Hmeumd St omu ‘

s

Hospital. Vola ii sad ili. M 1859.

M m , pp. a43. 1859.

Lem -Zoochemie. [Animal Chemistry ] HM . 1858. pp. 734.

(W M H F M )m ,

— Chemiachs Brielc. “b ed. (l emmas Letters on

Cbemiatry. translsted byDr. Blyth. “b ed. M 1859.)-Oompendinm der 8iochemle. Vienna, 1858. In two parts, and

with eh ven plates. (8chcrer gives a critical rcview of this work on AnimalChemistry, aad dlrects attention to a number of defects. Canstatt. vol. 1,

n u s )Sa d — M ute di Chimica Organicsapplied to ldediciae.) M 1858 ”. M i. (No abstract

given ia Canststt.)— Oa tbe laducnce of tbe Microscope inMcdicine . W 418”.

(An lnuodnctoryLeeture dcl‘

ivercd at the open ing of tbe fl edical School in

Liverpool. )Rom -( im bala n des uemhen. [Human Histology.) 3d ed. m .

W P DR Celluh rpathologie in ihrer begrtindung auf Physiologiscbe llud

Pathologische Gewebelehre. [Cellular Pathology-J Berlin , 1858. (Britk hand Foreign

M — Mik resh plaehs Netiscn fiber die Thermen voa Ems. [Microscopiu l Observations on Ems? Waters.) (Virchow'

s Archiv, 1858, p. 163.

Caustatt. vol. 1 , p.— Uebm' Thisrk nospen uad Zellen . Sitsungsbcrichte d. mathemata naturw.

Kiss-e d k fi serl. Ak sd. d. Wisscnsch. [Histology.] Vol.m . 1857. pp. 185.

(Can ton. vol. 1, p. sag.)M — h smck holm. w smngen du uik ra hops sum eche der ln tllchen

M [Practical Application of the “M a con to Clinical Medieinm](‘

l'randated into German by Dr. L. Tutsehek .) mam, 1858. (Canstatt,

vol. 1 , p. so r.)— Belwiigs sor nsnen ltik roskopic. [On the I ieN sospGL] Dresden,

1858. (Can ton , vol. 1, p. ac x.)

l ia osoope.)M 1859. (Cassiatt, vol.

4 REPORT ON THE INSTITUTES OP MEDICINE.

Whack — Usher das Verhalten der Parbstofl e, insbesondcre dcr Carminliisnng hBen

‘

ihrung mit todtcn organiscben Zellen. [On the Colouring of Tissues bymeans of Carmine.) (Klinigsb . med. Jahrb., i. Parts 1 and s , p. 197.

Canststt, vol. 1 , p.“ by

— Ueber die Symphysis cesium pubis des Menaeben nebst Beitrlgen mLehre vom hyalinen Knorpel und seiner Vcrk niicbcrnng. [On the HumanPubis and Ossidcation of Cartilage.) (Heals und Pfcufer

's Zeitschr. f. rat. Med.

Vol. iv, parts 1 and a, p. 1 . Canstatt, vol. 1, p. HM , 1858.

Gu lgoh .— Mikmsk opiscbe Studien ans demGebiete dcrmenschlichen Morphologie.

[Histological Besearches .] Eris-gen, 1858.

Hu tu— Usher die Epithelialaellen der Proschaunge, sowie fiber den Ban der

Cylinder und Flimmerepithclien und ibr Verhi ltniss sumBindegewebe. [OnEpithelium.) (Mi ller

’s Archiv. 1858. Cansta tt, vol. 1 , p.

Berlin — Usher die Blutk arperchen halligen Zellcn Archiv f. d. belli ed. Bettr. s .

Natur u. Heilk undehcransg. v. Donders 11. Berlin. [011 Cells containingBlood-corpuscles.] Utrecht, 1857. pp. 356. (Canstatt. vol. 1, p. s03.)m ama

— Usher die wahre Natur dcr Dottcrplattchenfl [The Ovum.) (Siebold’a

u. Kollik cr’s Zeitschr. f. wiss. 2001. Vol. ix, p. 519. Canstatt, vol. 1, p. so3.)

Bou gh -Ucber die Theilung der Blutz ellen beimEmbryo. [On the Dividingof the Blood-corpuscles in the Embryo.] (Muller’s Archiv, 1858, p. 1 78.

Eight plates. Canstatt, vol. 1, p.

Damon’ s work on physiology is a large book of more than six

hundred pages, illustrated with 254woodcuts . He adopts Robinand Verdeil

’

s plan of dividing the constituents of the body intoimmediate principles and anatomical elements . The work contains

several original observations. In the preface the author says thatit is ofl

'

ered to the profession of the United States as a means of

communicating, in a condensed form, such new facts and ideas in

physiology as have recently marked the progress of the science.

Many of the topics discussed being of great practical importance tothe practitioner, as likely to influence in various ways his views on

pathology and therapeutics . Of the 254 illustrations in the book,only eleven have been borrowed fromother writers.

In the chapter on food, the author calls special attention to the

importance of the inorgan ic ingredients ; points out the inefficiencyof amylaceous and fatty substances, when used alone ; describes thebad efl

'

eets of an exclusive non-nitrogenous diet ; and, lastly, alludesto the advantages, and even occasional necessity of cooking. The

nature of the digestive process, the apparatus by which it is aecom

plished, both in man and the different species of animals, as wellas the successive changes the food un dergoes in the intestinal canal,is fullygone into.

The existence of sugar in the liver of all animals, its percentage,

humans, oas es “ . rasm sus , m . 5

disappearance is briefiy allnded to .

Dd ton mde an artificid dnodenal fistula ou a dog and with its

aid studied the biliary function . He says that bile passes into the

intw tine in byfar the largest quantity innnediately after feeding,

and v ithin the fi st'

hour. After that time, its dischargc remains

pretty constant ; not varying very much from sixteen grsins

of solid biliary matte rs per hour. The discharge of bile into

the irfiestincs continues even after the animal has bccn k ept formany days without food . From these facts Dalton concludesthst the bile is simply an mm entifiou fluid, containing only

sad s ot intended to performsnyparticular function, digestive or

Section 2 is devoted to the consideration of the nervous system,

and Section 3 to reproduction ; both contain much interesting

Tom’

s Orcnor z nu or As aroxr AND Pavsxow cr, a workwhich has been no less than twenty-four years in progress, is now

in the parts just published.

Hun rn ar, in his large work on the descriptive anatomy of theskeletou, tclls us rody such a bone is of such a form— « ah it has a

inserted into this, and not into thatridge— mby the inner plste of theFromthis it will be seen

that the book is intendcd for the use of those who wish to learn

something more than the hm facts of anatomy. (‘British Medical

Journal,’ p . 2 28,

Want) , and How s s’s works are new editions ofmanuals already

in thc hsnds ofmsnyof our readers . Theyare chieflyintended bytheir authnrs for the use of the student.

In the second part of Ecmaan’s

‘Contnb utions to Anatomy and

Physiolog’ane to bc found original papers on the nerves and

mose of common salt, and on the theoryof the cause of the heart’s

action.

The fi stedition of Hm r.’8 Anatomy ’ appeamd in 1847, and not

its siz e and price, before te n years have elapsed a third

cdition hss been called for. The first half of the work is devoted

6 as poar ON ran msrrrurns or immers e .

to the consideration of the head, neck, thorax, and abdomen ; andthe latter half to that of the pelvis, back, and upper and lower

extremities . Pl asmm’s work on anatomy is merely a compilation .

Bus es strongly recommends, for the preservation of bodies foranatomical purposes, an injection consisting of two ounces of woodspirit, four ounces of sulphate of z inc, and seven pounds ofwater . He

says that this will preserve a body during a whole summer, and hasthe great advantage of neither destroying the colour of the muscles,injuring the knives, nor preventing the employment of coloured

Ausnosom, on the other hand, recommends the putting up of

specimens in glycerin, and the preservation of entire bodies byinjecting it into the vessels . The first plan is neither unk nown nor

new in England. The second is of little value, as it is attendedwithsuccess only in cold weather.

LIs'rs a’s Contributions to Physiology and Pathology

’consist of

communications made to the Royal Society in 1857-8, and publishedin their ‘Transactions .

’The first is entitled ‘An inquiry regarding the

parts of the nervous systemwhich regulate the contraction of the

arteries the second, On the cutaneous pigmentary systemof the

frog and the third, On the early stages of inflammation .

”The

author says, that the first and second papers were read as supplements to the essay on the last ; but that in accordance with a

recommendation from the council, be extended his investigationsinto the subject of the presentmemoir.

Some cases are mentioned to show that in the early stages of

inflammation occurring in the human subject, as, for example, afterthe application of an irritant, such as mustard, the minute vesselsbecome abnormally loaded with red blood, the corpuscles of whichultimately become arrested, prior to the occurrence of efl

’us ion . He

afterwards says, that the conclusions which he arrived at fromstudying the process on the frog apply equally well to the samemorbid process in man . The rouleaw , he thinks, are simply theresult of the shape of the corpuscles, together with a slight degreeof adhesiveness which retains them pretty firmly attached

,when

their flat surfaces are applied to each other. The aggregating tendeney of the red discs is thus regarded as a phenomenon similar inkind

,though inferior in degree, to the well-known adhesiveness of

the white corpuscles, and varies according to physical circumstances,and slight chemical actions .

https://www.forgottenbooks.com/join

8 s e ronr on wa s ms'rrrnrss or immers e .

In his text-book on physiology, LUDWIG limits himself almostentirely to the consideration of the chemistry and physics of life,and thereby presents a striking contrast to the views advocated byHeals, in his book on the vital causes . Ludwig remarks, in hispreface, that pathologists are often complaining of the unpracticaldirection of physical physiology, forgetting that physiology can

never be of much use to pathology until it has solved the problemof healthy life .

” When the medical practitioner thoroughly understands a healthy process, he will readily discover the conditionsrequiring to be changed in order to reproduce in a diseased part anormal healthy action . It is not, he says, in the dead-house, but inthe physiological laboratory, that the fundamental laws of diseased,as well as healthy, action must be studied.

In the first section of the first volume, the elements, and the

organic compounds out of which the human body is built, are

considered, and in the second part, the nerves andmuscles, as well asthe physiology of the senses, are treated of. The second volume, onthe other hand, is devoted to the development and decay of the

tissues and fluids of the body, and concludes with a chapter on

animal heat. When on the elements entering into the compositionof the human body, the author remarks, that as often as we analysethe animal organs and tissues, we are forced to the conclusion thatthey are ultimately composed of a very small proportion of chemical

circumstance we are forced to conclude, that the animal phenomenaare the result of the same forms of simple attraction and repulsionwhich are observed in all elementary bodies . It having been asoer

tained that by the action of heat, light, electricity, and other chemicalagents, all the organic animal compounds maybe decomposed, andthat this decomposition does not directly yield the elements themselves, hut only the immediate principles,

” physiologists as well

as chemists have come to the conclusion, that the complex organiccombinations which we find in the tissues are not the result of the

direct union of simple elements, but of a series of compounds, whichare themselves aggregations of individual atoms . The first ele

ment which Ludwig considers is oxygen— a gas which, as is wellk nown, is found in every part of the animal body, in the fluids as

well as in the solids, both in a free, and in a combin ed state ; but

which was not supposed until very recently to occur in the formof

oz one. Schonbein was the first to call attention to this fact ; and a

n asum , os s saar. rau msss , are . 9

few months ago M. de Luca has shown that the oxygen exhaled hythe leaves of plants in tbe sun

’s light presents the properties of oz one .

certain mushrooms changed oxygen gas into that substance . Ludwig

can easily comm'ebend how substances are therein consumed without

not onlyon that aceount, but also bccause of ite products being

thelm resemble each other in several important particulars ; forexample, urea is a product of animal combustion in thc healthybody, and it can be formed artiflcially fromalbumen hy a process

of slow comhustion, efl'

ected bymeans of a solution of permanganateof potash, at a temperature of 176

°Fahr.

source is most prohablyto he found in the chemical deoompositionof the substances oomposing the nerves. In psoof of this, he says

that nerves only retamtheir irritabfiity so long as thcypossm a

sa well as in a non' exeited, condition , gradually lose their normalcomposition . For example, heat, which evaporates the water fromM am m their irritabilityjust ss mueh as an excess of

water, whieh removes their salts. The same effect is produced by

Loxem’ s treatise on physiology has bew coming ont in parts

during the last eight or nine years, and is onlynow com[ileted. It

is a large work , in two volumes ; and altbough, lik e all text-books,it is more or less a compih tion , it yet has a considerahle quan

tity of original matter scsttered througb its pages . The author,although of thc advanccd school, does not advocate the ultra

to steer a middle course ; fior when treating of the properties and

funa iomof thc nervous system, he remark s thst sorne observcrs,

perhaps the majority, are stronglyinclined te the opinion that nerve

thinlt thst, altbough it closelyresemhles electricityin manyrespects,it is neverthelcss a pcculisr principle . But after having examined

(omdcfi it appears to himthst there are not at the presentmomentsafi cient groonds to authorise his adopting the views of the former .

10 s urcar on ma w arrrursa or immers e .

He therefore inclines to the opinion that the active principle of

nerve-matter is a force sci generic.

c xs’s manual is a new and modified edition of Wagner

’s

Physiolog ,

’which had for some years been out of print. The last

edition of Wagner’s book was published in 1844, and five years

ago a new edition of it appeared, edited by Dr. Funke. The latter

differed so much fromthe former edition, both as regards plan and

substance, that the editor replaced Wagner' name by his own .

Funke, as is well known , has paid considerable attention to the

formation of crystals in blood . While upon this subject, be re

marks that, under certain external influences, the organic colouringmatte r, which is an essential part of the conten ts of the red cor

puscles, can be made to assume, in anyanimal’s blood, a crystalline

form; the blood of each species of animal possessing, however, itsown characteristic formof crystals . So much, indeed, is this thecase, that by the shape of the crystals alone it is in many cases

possible to tell the species of animal fromwhich the blood was

taken . Funk e still adheres to his former opinion regarding thenature of these crystals, and has filled no less than three pages intrying to prove that hmmato-crystalline is not a compound, but ash ple body. Some of his own arguments are, unfortunately,opposed to his theory ; for in the end he has been forced to admitthat the crystals have no very definite chemical composition, andsometimes contain a lesser, sometimes a greater, proportion of inor

ganicmatter,— which they leave behind on incineration .

Of Scnl rr’s manual, only the first three parts of the first volume,

and of Flcx’s only the first part, is published ; so that we can at

present give no extracts. ARNOLD, after giving a description of the

Physiological Institute at Heidelberg, relates the results of some of

the experiments performed in it from1853 to 1858. These willafterwards be referred to under their various heads .

Mi nna-Enwanns has published the first two volumes of a large

work On Comparative Physiology.

’ They treat of respiration, andcirculation . Kw om gives the statistics of births, deaths, and

diseases treated in the hospitals of Copenhagen .

BERNARD state s, in his lectures on the animal fluids, that on

injecting 1 1 20 c.c. of water into the jugular vein of a dog weighingfive pounds, the secretion of the submaxillary gland and of the pancreas gradually ceased. Also that, after a short time, the urinarybladder was found empty. The biliary secretion was the only one

m oans , s aunas ]. TREA'HSEB, are . 11

more on a

h the mond psn of the mlume a i speak ing d hh already

in the carotid artery increases, the temperature of the part of. the

remains red . Galvanism applied to the cut end of the nerve

removes these eflects . In the next scction, be trests of the eflects

of sceretion on the‘

colour of the blood— a point to he afterwards

allndcd to under the head “ 8ecretion.

”

In voL ii Bernard remark s that he found the urine of the rabbit

of anotha experiment, he says the quantity of m'ine which the

k idneys of s dog secreted increased as tbe pressure of tbe hlood iu

the carofids sugmented . The chapters on the pmpiration , the

bile, the milk, the saliva, and the pw creatic juice, contain ,Valen

fine n ya scarcely anything new . In several of them Bernard

defends lns cwn vicws, which have been sttack ed by other writcrs.

Lu om ’s book “

comprehends as much of the elements of

cha nistry as may, with moderate atte ntion, he acquired within a

reasonable time bythe younger class of students, and cven ss muchas msy sufi ce for thosc who, bcing more advsnced in life, desire

merelyto obtain a general knowledge of the elmen ls of the msterial

M s work s on animsl chemistryare so well k nown ths t it isonlynecu saryto indicate the contents of the presentvolume . Ittreats,

fi st, of the nature and properties of the animal fluids ; secondly,of the tissues ; and thirdly, of the metamorphosis of tissue, 8m.

Lama’s ‘ ChemicalLetters’ are familiar to our readers, in the formof Gregory

’s tramlan

'

oma later edition of which has now sppemd,M byDr. Blyth, and, as statcd in the prefsca besides extendingconsiderably the former letters, the author has , in the presentedifimadded a number of new lettera which refer to general scientific quw i ousmnd to the most remark abls discoveriea recentlymademfi e departments of chemistry and physics . Among these are,

correlation of the forces of inorganic nature ; Lette r 15th, on the

alteration of pmperties in bodies ; and Letter z3d, on mater-ialismin

connexicn with natural inquiries .

12 anroar on ran ms 'rrru'rs s or immers e .

Konu xna’

s work on the microscopic anatomy of the tissues embraces a wide range of subjects, and the literature of almost everyone of them is extended by the author's own researches . Therebeing an English translation of the first edition of this work, forfurther information, we must refer our readers to it.Vmcnow expounds a new theory regarding the process of inflammation, and the first steps in the formation ofmorbid growths . He

says that the spindle-shaped corpuscles of tendon, and of all con

nective tissue, form an anastomosing network, by means of fine

tubes which proceed out of them in all directions . The first stepin the inflammatory process is the enlargement of these corpuscles,together with an increase in siz e, and subdivision of their nuclei.

The nuclei then go on enlarging and multiplying by endogenous

growth, till the formation of pus is the result. Pas-cells are never,he says, formed by an aggregation of granules, as has been repsented as occurring in the smallpox-pustule . A cell can only beformed froma cell.

In the suppuration of mucous membranes, it is the epitheliumcells that become transformed into pus-corpuscles . Such, for ex

amPle, is the case in gonorrhts a, where we have the formation of

pus without ulceration . The cylindrical variety of epithelium is

much less disposed to formpus . On accurate observation, theyellow matter which it produces is found to be only modified epi

thelium, though of a very purulent appearance . (Example, diphtheritic exudation .“ In the suppuration of muscle, the pus-cellsformin the so-called nuclei of the sarcolema, which, according toVirchow,

are the nuclei of the connective-tissne-corpuscles . Fattydegeneration, he says, also commences in these corpuscles.

Attentionwas called to this fact in the discussion which followed the reading ofa paper on diphtheria at the meeting of the Royal Medical Society, 1 7th January,1859. One of the speakers said that the exudation on the fauces in cases of diph

theria was composed of an excessive and modified secretion of themucus-cells andepithelium-scales proper to the part of the throat fromwhich it was removed. It

has since been observed that a diplitheritic false membrane fromthe eye, althoughit had all the external appearance of pus, onmicroscopic examination proved to beentirelycomposed of enlarged and modified conjunctival epithelium-scales.

0882008 SYSTEM , I NCLUDING CABT lLAGE AND TEETH .

Own — Ou the Vertebral Characters of the Order Pla nn e r-ia as enemfl i .ted in the Genera ”M eaty!" (Cum) and Dmm (Ow .) (Proc. Roy.

80a .N0 34. P

Mammals of Australia G’art t). Description ot'

a mufi lated skullet a large “mupial Carnivore. M M W WW ) (Proc noyal

Soc No. 34. r

w mu fificial l’rfi uetion of Bouq hy the‘

l‘

ransplantation ol the Peri

esteem, and byOsaeovss Grafts. (Med. Timcs and Gas ..7th May. 1859. p. 476.

Journal de PhysioL. Jan. 1859. Gas . Med. de Paris. 3859. Nos. 14

W mmfl'mnt‘

rypes in the M icroscopic Structure of the Sk eleton ol'Osseous M es. (Prue. Royal Soc .No. 34. p.

-Die mineraliachen Bestandtheile junga Menschenknochen.

[On the Earthy Constitutents of Young Dom ] (Virchow's Arch" vol. xiv.

parts 5 and 6. Schmidt. vol. 103. No. 3. p. 385 ; and Scherer’s report in

Canstatt. vol. r. p.M id — Des chemische Skelett der Wirhelthiere. [On the Chemistry of the

Sk eleton.) (Zeitsehr. f. Wiesea. Zoolog . 1858. pp. sac— 469. Schmidt.

vol. l O l .No. 3. p. as3.)

W P UM die Brni hrung der Knochen . [On the Nutrition of

(Deutsche Klinik.Oct. 1858. p. 393M — a snchungen ueber die flmehen der xnochenformen. [On the Laws

whieh regulate the l'ormol Bones ] 4to. Hes-M . 1859.

W u the Synarthrosis (Halhgelen lxe) of the Human Body. A Mono.

graph.w ith aix copper-plstes. Berlin. 1858. pp. r44. (Schmidt, vol. re l .

No. 1. p. res. )Imam-Usher Halsrippen. [On Cerv ical Riha ] (Extract from the Vien .

Weeheaab . No. 5. read hetero the Vienna Academy. e rst Jan..

M tg — Du Nehenthri nenhein des Mensehen. [On the Human LachrymalBones.) (Muller’s Archiv. 1858.No. 3. Canstatt. vol. i. p.

[ um — ammo d’un Memoirs sur la Oomparaison des Hombres Pelviens et

Theraeiques de l’Bomme et des Mammiferes. [A Comparison betw een the

Thoracic and Pelvic Memhc a in Man and other An imals.) (Gas . Rehd ..

N“ 47v

Wm ! Grainy— Der Panhandeelnenk nochen des Menschen. [On the HumanOsaieulumW tympanL] (Bulletin dc l

’Aead. imp. 8t. Petershurg.

vov ii. hlo. a n. ” 334—9. Schmidtn ol. roe.No. 4. p.

Knochsnvarieti ten . [On Abnormal Bones.) ( it. u. Pt's Ztsehr"

3d autea.vol. v. pp. 383— 319. Schmidt. vol. 103.No. 7. p. rr.)Note sur l

’Angle Parietal et sur un goniometre destine l le l i en

su'er. [On an Instrument for Measuring the Parietal Angle ] (Compte Rendu.

36 Avril. saga. No abstract.)

den Bau rhachitischer l aoehen. [On the Development ot’

Bonq and on

Rick ety Bones ] ( v. Siehold ‘s u. Khllilter'

s Zeitschr. f. wiss. Zool .. vol. ixs.m.)

14 ns ronr on me msrrru'rns or MEDICINE.

Huxley— Ou the Development of some parts of the Skeleton of Fishes. (Micros.

Jour.. 1859. p.Rainer

— Ou the mode of Formation of Shells of Animals.of Bone. and of severalother Structures . 4to. pp. 153. London. 1858. (Reviewed in Micros. Jour..

l 8591 PP'

CARTILAGE.

Webb — Microscopical Examination of a Loose Cartilage fromthe Knee-joint.(Micros. Jenn . 1859. p.

M en. Ou the Nutrition. inflammation.and Ulceration of Articular Cartilage.(British and Foreign Med-Chin item. Oct. 1859. pp. 486

Emmi — 2mHistologie der Rippenk norful in Normalem nud Pathologlschen

Zustande. [On the Histology of Rib-cartilage ] With three plates. M ist .

1858. (Canstatt.vol. 1. p. any.)u hy

— Usher die Symphysis OsaiumPubis dca Menschen.arc. [On the Puli a

and Osaification of Cartilage ] (Benin u. PL’s Zaitachr, vol. iv.p. 1. Can

statt, vol. 1. p. say.)

M ay— Ou the Structure and Mode of Formation of the Dental Tissues.

(Micros. Jour.. 1859, p. are.)“ tot — Etudes sur le Developpement et la Structure des Dents Humains.

[On the Development and Structure of the Human Teeth.) (Archiv. Gen. ds

Med.. Jan .

M inot — Recherches sur le Developpement des Dents. [On the Development ofthe Teeth.) (Compt.Bend” March 39th.

Owen says, the question of the vertebral characters of the Hero

dactyles is specially interesting with reference to the carrying out

the comparison of their skeleton with that of birds. Fromhis

investigations of the species of Pterosaam'

a, extending fromthe

period of the Line, as exemplified by the Dim /laden macronyz , totheUpperGreen-sand, as exemplified by thePterodactylus Sedgwiclcii,and Pm. Fittom

'

. The author has ascertained the fact that,with respect to the cervical and dome-lumbar vertebra , the terminalarticular surfaces of the vertebral bodies are simply concave anteriorlyand convex posteriorly ; and that they consequently manifestthe earliest known instance of the procmlian

”type which now

prevails in the reptilian class . But in no other reptile, he says, arethose articular surfaces so narrow vertically, in proportion to their

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16 u pon or: run msrrrurs s or u smcms .

the skin of fishes and of the rays of the fins ; and found that the samelaws which hold good in the structure of the endo-skeleton applyequally to the exo-skeleton .

Bs c monaussN made a quantitative analysis of bones, and

found that the inorganic matter, at various ages, differed verylittle either as regards the relative or absolute quantity present.The difference of age is chiefly seen in the quantity of accessorysubstances . The analysis of the spongy, and of the solid parts ofthe bone resembled each other very closely. The results he obtainedare therefore seen to be in many respects different fromthose of

previous observers, Heintz , Bibra, &c., as well as of Bez old, who

found that the chemical composition of the skeleton of vertebratedanimals varies at different ages . The quantity of chlorine diminishesas life advances, while that of sulphur and phosphorus increases,especially the latter. Magnesia increases in relative proportion tochalk and organic substance . The iron also increases proportionately with the organic matters. The fixed alkalies, on the other

s rson placed silver rings on the periosteumof the leg-bones ofpigeons, and on killing themfromtwo to eleven months afterwardsfound that they had caused an exudation, and a cOpious deposit of

Fl ex relates some experiments on animals, the results of whichled himto the conclusion, that the formof particular bones greatlydepends on mechanical influences. As a general rule, bones have atendency to grow in the direction of the least resistance.

In his monograph, Luscnm treats of the development and rela

tions of the vertebral, eternal, and pelvic joints. He divides all

the joints of the body into two great classes, one of which he calls

hollow joints (defile k nochenverbindungen) and the other solid

(solids k nochenverbindungen) The hollow joints he again dividesinto perfect (pandiarthrosis), and half joints (hemiarthrosis) The

latter are those usually termed synarthrosis, and it is of these thathe principally treats on the present occasion .

In seven skulls out of sixty, Luscnn found a small, irregular,four-sided bone in front of the os lachrymals . In two of the skullsthere was a bone of this description on both sides of

Wittich says, this bone is neither the os lachrymale extemum ofRousseau, nor the satura longitudinalis imperfecta ofWeber.

osseous SYSTEM . 17

The twist is of 180 degrees in the terrestrial and aquaticmammalia

iu the mammslia. In order to compare the humerus with the

femur, which is a straight bone, it is necessaryto untwist it 180

degrees. This alone is sufi cient to reduoe the thoracic to the type

of the pelvic member. He also compares the tibia, the pelvis, the

German found the oss iculum tegmenti tympani seven times insix ak ulls ; in one of themon both sidss He also describes, as a

b equmt occun ence a pons cuneifmmia and gives to it the name of

Sem en . describes all the abnormal hones that came under hisnotice during the three years that he acted as demonstrator in the

Momma , in his researches on the development of bone, has con

firmed the statementmade bySharpeyin 1845, regarding themanuerin which osseous tissue is formed in cartilage. Nisbet, in 1736,

in a membrane others originating in oartilage, and that in the

latter csse the catilaginous tissue did not constitute a part of

the bone , but was removed by absorption. Little attention was

paid to the latter view, until Sharpey demonstrate d, by histo logicalinvestigation, that it was correct. Moreover, he pointed out

M M ugh a portion of the cM age is in the first insh nce

od yet it dom not remain to w nsfimte anypm't of the per

mam t bone. The latte r is, in fact, produced bythe ossificatiou

parietal bones of the hmd . Milller has gone into the suhject veryfully, and traced the changes which occur in the temporary vascularcanals of ossifying cartilage . He agrees with Sharpeyin saying that

m thfl theyare formed out of cells which are the descendants of

remark s on the comdition of the bones in rick ets .

sk eleton of flshes were chieflymade upou the stick leback (0asteo

mk ss leism ). He first speak s of the development of the tail

givmg a full account of the literamre of the subject— and then

that of the palate-pterygoid arc, and hyomandibularIn speak ing of the homologies of the bomes of the fish

’s face,

18 REPORT on ra n ms'rrru'rs s or msmoms .

Huxley says, that in it, Cuvier’s palatine is the homologue of thepalatiue of the abranchiate vertebrata , and his pterygoid is thehomologue of their pterygoid, and that his jugal is their quadratumor incus . Huxley cannot, however, find anyhomologue ofthe temporal and symplectic. They appear to be specially piscineelements

, only traceable as far as the amphibia, where theyrepresented by that part of the suspensorial cartilage, to which thehyoid arch is attached, and by the temporal” of Cuvier. In the

abranchiate vertebrata , if the hyoid is connected with the skull,

its insertion is quite distinct from that of the mandibular arch.

Huxley believes, therefore, that the branchiate vertebrata , the

oviparous abranchiate vertebrate , and the mamma lia , present a

series of well-marked gradations in the mode in which the ramus ofthemandible is attached to the skull. In the fish it is separated bythe os articulare, the quadratum, and the temporo-symplectic. In

the amphibia the latter becomes less distinct. In the abranchiatecu

'

yara it disappears ; and finally, in the mammalia, the ramuscomes into direct contact with the squamosal element of the skull .Bu rner studied the mode of formation of bone, of shells,

of starch-corpuscles, and several other organic structures . He

has, in the first place, pointed out a process by which carbonateof lime can be made to assume a globular form, and saysthat it is produced by molecular coalescence .

”In the second

place, he gives an explanation of the probable cause of crystalliz ation . Thirdly, he has discovered a process of moleculardisintegration” of the globules of carbonate of lime — by in

verting the mechanical conditions upon which their previous

globular form had depended. And lastly, he deduces from his

observations, that the rounded forms of organiz ed bodies do not

depend upon vital causes, but on purely physical agencies .

Wane , in his examination of a loose cartilage ; found on the surfacea condensed layer of fibrous tissue ; further in, there was an arrangement of cells in a matrix, somewhat resembling what is seen in

ossifying cartilage . Some of the cells contained opaque granularmatter, and were so attached together by their margins as to givethe appearance of short tubules . In the centre was a quantity of

cretaceous matter, soluble in hydrochloric acid.

It has been generally supposed that articular cartilage receives itsnutriment fromthe vessels of the synovialmembrane ; butBARWELLthink s — 1 That although in the articular cartilage itself there are

museums srsrsm.

lamella' a set of arteries destined to supply the cartilage wi thnutriment. 2 . That the articular lamefla is composed of a finelytubular structure, which allows the nutrient fluid to find its waytothe cartilage in minutely divided streams . 3. That the cartilage has

Fanmmlooks upon the granular condition of the matrix, in thecartilages of the ribs, as being due to the presence of a quantity offine fat-globules. Thcycan be removed by ether, which circumstancehe thinks establishes the correctness of his view .

ABBY describes the development of cartilage in the foztus, and

its omification in later life . His description of the developmenta nd incrw e of the cartilage o corpuscles is clearly given ; but doesnot differ materially fromthat of other writers . In the process of

diminish in number, while the matrix increases in quantity . The

corpuscles themselves somewhat change their appearance ; theybecome granular, and contain fat-globules, as is well seen in rib

The rmearcbes of Ma orror and Gmw r can scarcelybe said to

have furnished us with anynew faets regarding the development ofthe teeth . Magitot says that the enamel is composed of ossifiedcells , and agrees with Tomes as to the artificial nature of its supposedmmbraue . Guillot think s that the teeth are developed out of a

blastsma similar to that which forms thematrix of hone .

MUSCULAR SYSTEM .

No’ sc rn fiwmil -Re searches into the nature of the Involuntary Muscular Tissue of the Human

Bladder. Transaction al -417, plates xxvi and

— Snr la erniasance des mnseles. [On the Growth cf uusclesJ (Compt.587-5890

Tnynhne calls the h yer cf bon e u parating the cancclli of the mslfied epiphyd

m the trne articular eartflamthe f‘articular lamclla.

"

20 REPORT on rn s ms '

rrru'rs s or msn rcma .

Heisman — Um“ das verhalten der musculiisen Fasen ellen im contrahirten

Zustande . [On the Involuntary Muscular Fibres during Contractiom] (Henleu. Pf.

's Zeitschr., vol. 11, pp. 52 1

Valentin — D ie Wirkung der Zusamrnengez ogenen Muskeln auf die Atmosph i re.[The Action of Contracted Muscles on the Atmosphere ] (Archiv f. physiol.Heilk os 1857, pp. 385

—366. Canst., vol. 1, p.

Amoli — Ueber die Irritab ilitat des Herz ens und Gliedmusk eln. [On the Irritsbilityof the Heart and other Museles.] (Die Physio]. Anstalt von Heidelberg. pp 98

— 104)Canibnroea,— Sur les mouvements péristaltiques da tube digestif. [On the

Peristaltic movements of the D igestive Canal.] (Compt. Rend., 1857, Dec.,

9

Kupf er,

— Ueber dasHemmungsvermogen derMusk eln gegenueber localerErregung.[On the Power possessed by Muscles of limiting the local Action of Electricity](Henle u. Pf.

’s Zeitschr., 1858, pp. 160— 163. Canst., vol. 1 , p.

wnndt — Ueber Muskelbewegung. [On Muscular Movement ] (Brem eh q

Feohner ,

— Ueber der Musk eluhung. [On Muscular Exercise ] (Verband. Sachs.Ges. Le ipz ig, 1858, pp. 1 13

— 1 30. Canst., vol. 1, p.

Thonvem- Influence de l’

exercise musculaire aur la constitution . [The Influenceof Muscular Exercise on the Constitution] Paris , 1858. (Known already.— Vale11tin .)

Heme ,

— Haudbuch der Muskellehre dea Menschen . [Text-book on the HumanMuscles.] Braunschweig , 1858, pp. 315. Schmidt, vol. 102 , No. 5, p. 247.

Bou nd — Da mode de terminaison dea fibres longitudinales du rectum. [On theTermination of the Longitudinal Fibres of the Rectum] (Compt. Bend. de la

Soc. Biol.,

Lmhk a — Ueber den Vordern innern Theil dea Afterhebers (levator ani) beimMann. [On the Male Levator Ani.] H. u. Ff.

’

a Zeitschr., Bd. iv, Heft 1, z .

1858. Schmidt, 10 1, No. 1 , p. 2 7.Lw m— Ueber den weiblichen Afterheber. [On the Female Levator Ani.]

H. u. Pf.’s Zeitschr., vol. v, pp. 1 13

— 131. Schmidt, vol. 103, p. rs .

m hk a — Der Musculus transversus colli des Menschen. [On the HumanTransversus Colli Muscle ] Sitz . Ber. d. k. Akad. z u Wien math. phys. KL,xxxiii, p. 18. Schmidt, vol. 102 , No. 4, p. 8.

H — Ueber den Musculus sternoclavicularis. [On the Sterno-clavicularisMuscle.] Sitz . Ber. d. k. k. Akad. euWein ; Math.-phys. Kl Bd. n ix, p. 265.Schmidt, vol. 10 1 , No. 1 , p. 39.

Lim a— Anatomic et topographic da pli de l'aine. [On the Anatomy of the

Anus.] A translation from the German by M . Donnetta, in the Monit. deaHopit., No. 137, 1857.

Brneok e,

— Ueber den Bau der Muskelfasern. [On Muscular Fibrille J Moleschott’s Unters., vol. iv, p . 89.

Sa lim— Usher die quergestreifte Muskelfaser. [On Striated Muscular Fibres]Archiv, Holland. Utrecht, 1858. Vol. 1 , p.41 7. Canstatt, vol. 1 , p. 234.

Budge,

— Ueher Strulttur und Wachsthumder Muskelfasern . [On the Structureand Development of Muscular Fibres ] Wunder.'s Archiv, 1858, p. 7 1 .

Canstatt, p. 234.

Bottcher ,

— Ueber Erni hrung und Zerfall der Muskelfasern. [On the Nutritionand Decayof Muscular Fibres.] Virchow

’s Archiv, vol. iii, p. 237, plate v,

figs. 1-4.

smsm'ma s vs r s i i . 2 l

Kancum begin s by observing that the signs of electrical action

in living muscle die out, par-i paramwith the signs of irritability ;

“am m qf rigor m tis . He adds, that it seems that there

Dn Bois Reymond has shown ,there is a partial dissppearance of

electrical action . If the muscular current be presen t, rigor mortisis absent. So it would appear that the state of muscular con

traction is antagoniz ed by the muscular current. The author sayssuch a view is supported, rst, by the fact recently discovered byEck hard, viz ., that the state of tetanus is put an end to by thepassage as a constant galvanic current through the tetan iz ed parts ;ed, by the investigations of Harley on the modes operandi of

strychuia, which prove that this poison acts bymak ing the bloodIn able to appropriate oxygen, and by imn the irritability ofthe musolw . Radcliffe finds, also, that strychnia exercises it directlydepressing influence upon the nervous and muscular currents . He

concludes by saying, that according to the results obtained from11

'

s own, as well as other observers experiments , it appears that

simple cessation of the action of certain agents— e lectricity, nervous

influence , and others— which had previously kept the muscle in 11

Ea s e says, that the involuntary muscular tissue of the bladderand the voluntary muscle in other parts of the human body,have a lik e composition , and that Professor Kiillik er

’s view,

that

involuntary or smooth muscle is in all cascs made up of fusiformcells , is incorrect. For the muscular substance of the bladder is

composed ol'

lengthened fibres with fixed and te ndinous te rminal“tachments . The fasciculi of muscular fibres in the bladder are

interwoven into a network, and are marked at varying intervalsby tendinous intersections, like those of the rectus abdominis on a

The author terms what are usually called the nuclei of the

muscular tissue corpuscles,”

and distinguishes two varieties of

them, the oval and the fusiform. The latte r are the more numerous,and are the rod-hire nuclei of Ke

’

lliher . Two or even three of thesemay be observcd in the length of a single fibre . If a single muscular

22 armour on ma msrrrvras or usnrcmn .

fibre of the bladder be isolated,it w ill be found to terminate as in

voluntarymuscle ; connective tissue inves ting not only the fibre, but

each of the separate portions into which it ultimately divides.

The author considers that the sarcous elements of voluntarymuscle are represented by the lines of dots visible in the muscularfibres of the bladder.

Bone s counted the muscular fibres in the gastrocnemius of thefrog, and found that their number increased as the animal grew ;he could not

,however, find how the increase took place .

Mmssxnn says that the non-striatedmuscles, when in a state of

contraction,have striaa upon them; he noticed this in fibres from

the bladder of the cat and rabbit, and the spleen of the dog and

sheep . VALENTIN found that during active contraction the musclesabsorb oxygen

,and give out carbonic acid gas . AndARNOLD observedthat the heart of a frog, whether cut out or left in the body, heatslower and less forcibly in proportion as the surrounding air becameratified. If chloride of lime be placed along with the heart underthe air-pump, the pulsations cease altogether as soon as the organ haslost 15 per cent. of its water. Mechanical and electrical stimuli canstill, however, induce the heart to contract. Muscles, under the air

pump, gave out a very considerable amount of carbonic acid.

Arnold says that the want of oxygen , and of water is the cause of

the cessation of the muscular contractions .

CALLIBURCES made some experiments on the influence of heaton the peristaltic movements of the intestines, ureters, bladder,and pregnant uterus of animals . He found that a moderatewarmth greatly increases the force and number of the peristalticcontractions . In the separated uterus of a bitch the con

tractions induced by gentle heat are powerful enough to expel afoetus .

KUPFFER calls attention to the fact that tendinous attachmentslimit the effect of nerve stimuli on muscles . Thus, in the rectus abdominis a stimulus applied to a nerve supplying one part of themuscle w ill not cause contraction in another. FECHNER experimentedupon himself in order to ascertain what increase of muscular powerexercise induces . He used dumb-bells during two hours after breakfast for two months ; in which period his strength so increased, thatinstead of 104 he was able to make 692 movements before feelingfatigued . WuNnu

’s researches were made upon the elasticity of the

animal tissues in general ; he found that the tendon of a calf has

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24 Re ports on me mea sures or unnrcmn.

In 1856, Luscnn described a small muscle under the name ofmus . sternoclavicularis . Since then Hyrtl has looked for it in eightythree bodies , and found it in six. Four times it exactly agreed withLuschka’s description, twice differed slightly fromit.Bens on examined muscular fibrillmwith polariz ed light, and

distinguishes two substances in them— one isotrope, and the

other anisotrope .

” MUNK says that the fibrilla-z consist of a homo

geneousmatrix, in which is a row of shining balls, the whole beingsurrounded by a structureless, transparent, elastic tube— sarcolema .

Bon anz a has specially directed his attention to the nuclei in the

sarcolema, and concludes that they are corpuscles of connectivetissue, and conn ected together by a system of fine canals, as in

tendon .

RIGOB MORTI S .

— Ueber die lrritabiliti t der Muskeln und deren Zusammenhangmit der T tenatarre. [On the Irritability of Muscles, and its relation to

Rigor Mortia.] (Deutsche Klinik, No. 3, 1858, pp. 430Brown-Se u — Sur la rigidité cadavérique. [On Rigor Mortis.] (Jom . de

PhysioL, vol. i, 1858, pp. 38 1Kuhno,

— Ueber die Entstehung der Todtenstarre . [On the Development of RigorMortis.] (Allgem. med Centralz eit, No. 70, 1858, pp. 553,

w hen — De nature cauaiaque rigoriamortis. [On the Nature and Cause of RigorMortia.] Bertha, 1857. (Already known.)

Em u — Ueber die Ertiidtung der Gliedmaaaen. [On the Death of the

Limba.] (Virchow ’

s Archiv, 1858, pp. 289

Hamon having cut the sciatic nerve in two rabbits, and in

thirty-six hours afterwards killed themwith strychnia, found thatthe muscles of the sound limb ente red into a state of rigor mortissooner than those in the limb with the nerves cut. The irri

tability was also soonest lost in the sound limb . The sameresults were obtained on rabbits killed by strangulation . Whenthe muscles of a limb were killed by electricity the rigor mortiscame on more rapidly . Brown-Séquard relates some experimentson the return of rigormortis after it has been removed by forcibleextension and fiexion of the limb . He killed a healthy dog byligaturing the trachea at 8 o

’clock ; at I I rigormortis began, and

v ascunaa sr srnn . 25

at 12‘ it was complete . One of the limbs was now moved backwards and forwards till it became flaccid . In from two to five

minuta the rigor mortis returned . The same experiment, with a

a'

n ilar result, was performed at 1 o’

clock . At 3o’

clock the resultwas less satisfactory. In twenty hours the rigor mortis did not reappear after being removed by forcible means . Korma examinedthe empressed juice of muscles in order to ascertain the cause of

after a time, had an acid reaction, lik emuscles when they are in a

state of rigor mortis, or beginning to putrefy.

Kosm m. found that the injection of a few drops of chloroforminto rmarte ry caused permanent rigor in the muscles supplied by it.

He thinks it acts by causing coagulation of the muscular fibrin .

Amuscle in this condition of rigor is more easily torn across thana healthy one . The injection of healthy blood does not restore the

act in a somewhat similarmanner .

VASCULAR SYSTEM .

Wm — Ou the Intimate Structure and the Distribution of the Blood~vessels of

the Human Lung. (Proc. Royal Soc .No. 35, p. 16. Med. Th ea and Gan ,

July 16th. p. 7 1 .

Su m-y— Ou the Shape of Transverse Wounds of Blood-vessels ‘

in relation to theirPhysiology. (Lancet. vol. 1. 1859, p. 3M .)

Scott — Ou themeets of Rupture of the Internal and Middle Coats of the Arteries .

(British and Foreign Med -Ch it . Rev July. 1859. pp. a i lLigh t — Ou the Coagulation of Blood. (Bdin. Monthly Med . Joura” Dec. , 1859,

— De la fissure sternale congenitale de M. Groux. [On the Stem !

in M. Groin .) Na ssau“. r857. (Canstatt, vol. i. p. The

follow ing are taken fromthe same source.Bauer -Usher M . Groux. (Jahreah. d. Schles . Oes. f. Vaterl. Cult , 1857.

a £460— 8tndier i Krets loppets. [Researches on the Circulation ] 8vo .

Hak im/hr s, 18578 . (No abstract.)m — QM Ques Rxpériencea relatives an choc do cmur. [Experiments on theimpulse of the Heart.) Parts, 1857.

— Du choc du cmur. [On the Impulse cl the Heart ] ato.

Fi rth. t857.

Colin — De la détermination experimentale dc la force do occur. [On the Forceof the Heart ] (Gas use. de Paris, August, pp. 493— 495 . Oar. Bah .

M an» . a

26 across ON THE me a sure s or MEDICINE .

Infl ow — Die fibrosen Bi nden des Hen beutels. [The Ligaments of the Periwdium.] (H. u. Pf.

’s Zeitsch r., vol. iv, parts 1 and a. No abstract.)

Margy,

— Recherches sur la circulation du sang. [On the Circulation of the

Blood.] (Gaz . Med No. 12 , pp. 17 1— 173,

Hu ey,

— Recherches hydrauliques sur la circulation do sang. [Hydraulic Erpetiments on the Circulation of the Blood.] (Annal. des Sciences Nat” 1857.

vol. viii, p. 329. Compt. Rend., 10th March, 1856, p. April, P; 680°

Gaz . M6d., July, 1857, p. 416, Oct., p.Harem— Interpretation hydraulique du Pouls dicrote. [Hydraulic Interpretation

of the Double-pulse ] (Compt. Rend. , Nov ., 1858, p.Budinger,

— Ueber die Mechanik der Herz klappen. [On the Mechanism of the

Card iacValves.) (Froriep’s neue Notiz . , vol. ii, 25— 2 7. No abstract.)

a piam— Recherches sur la durée de la contractilité du emur apréa la mort.

[On the duration of the Heart's Action after Death .) (Gas . Med. de Paris,

1858. pp 479

Bodtenbacher,

— Zur Kritik des Hemadynamometers. [Some Critical Remarkson the Hemadynamometerq (Archiv f. Physiol. Heilk 1858, pp 135.

Hoilin ,

— De la pression du sang. [On the Pressure of the Blood.] 4to. Par is,

1858. (No abstract.)Verneuil — De la suspension du Pouls radial dans l’extension forcée du bras.

[On the Steppage of the Radial Pulse during forcible extension of the Arm.](Journ . de Physiol., 1858, pp. 506

Guerfin ,

— De la fréquence du Poula de l etat physiologique. [On the NormalRapidity of the Pulse ] 4to. Par is, 1858. (Mos tly all already known .

Valentin .)BI OWn-Sequard.

— Notes aur l’Association des efi'

orts inspiratoire avec une diminution ou l'arret dea mouvements du cmur. [On the Diminution or Suspen

sion of the Heart's Action during forced lnspiration.] (Journal de Physiol.,1858, pp. 513

Henry— Des eflccts produits sur la circulation par l ’applicatiou prolongée dc l’eau

froide ii la surface du corps dc l'homme. [The efl'

ect of the Cold Douche onthe Circulation .] (Journ . dc Physiol. , 1858, p.

a pign ,

— Expériences sur la contractilité dea vaisseaux. [On the Contractilityof the Blood-vessels.] (Gaz . Med . de Paris, May, 1858, p.

a pian,

— Sur les efl'

ets des excitations produites directement sur is foie et les

reins. [On the effect of Stimuli directly applied to the Liver and Kidneys .](lb . , p.

Gunning— Unm die Ursache der Blutbewegung. [On the Cause of the Move

ment of the Blood.] (Froriep’

s neue Notiz en, No. 2 , pp. 20Bah — Usher die Wirkung der Salz e auf die circulirenden rothen Blutk orperchen.

[On the Action of Salts on Living Blood-corpuscles.] (Virchow ’

s Archiv flitpath . Anat. , 1858, vol. xv , p.

Bmh ,

— Ueber retrograde Blutbewegung in den grosses , demHerz en nahelie

genden venen . [On the Retrograde Movement of the Blood in the Large Veinsnear to the Heart ] (Verb. dea Preuas . naturhiator. Vereins, vol. xiv , 1857,

pp 95. 96

Bez old,

— Zur Physiologic dcr Herz hewegungen. [On the Physiology of the

Heart’

s Action .] (Virchow ’s Archiv fur path. Anatomic, vol. xiv, 1858,pp. 280

VASCULAR srs'rnx . 27

Wittich — Cebu die Abhi ngigiteit dcr rythmischen Bewegungen dea Her-sens vonden Hersgaoglien . [On the i nfluence of the Cardiac Ganglia on the Move.

ments of the Heart.) (Kfinigsherger med icin. Ishthitcher, vol. i, parts 1 and a,

1858. pp. 15— 19. No abstract.)

“ hunt-Bin Beitrag cur Theorie der Ursachen der Herz bevregung . [On theM ’

s Action.) (Dessert Bcitri ge xur Anatom und Physiologic. Part 3.

430 M 185& w 145— Zur Theorie der Hemmungsnerven . [On the Influence of the Vagi on

the Heart'

s Aetion .] (Arch. f. Anat. u. PhysioL,

m u m— Zn: Physiologic dea B lutes. [On the Physiology of the Blood. )(Wundcrlieh

’

s Archiv. part iv , pp. 507— 543.

wank er ,

-Be stimmung de r Mange dea Korper blutes. [Estimation of the

number ol Blood-ompmelu .) (Hen le und PL'

s Zeitschr., 1858, vol. iv, pp. 145

Ham-Des canaeaet dea symptoms de la coagulation dusang. [On the Coagulation of the Blood.) Strasbourg , 1857. (A compilation of known facts.

Valentin. )Eamon— Dc Sanguinis Analysi Chemica. [Chemical Analysis of the Blood.)

Berlin, 1857. (Already known .)un i — Recherches experimental“ sur le sang. [Experiments on the

Blood.) (Journ. de PhysioL, vo l. i, pp. 95— 123,pp. 353 Notes sur lea

modifications que subissent lea gloubles circulaire du sang dea mammiieresinjceté dana la ayateme circulatoire dea Oiseaux. [Blood of Birds injected intoAnimals . are .) (Journ. dc PhysioL, vol. i, pp. 173

M ot — Stu la coulw r de sang. [On the Colour of the Blood.) (Compt.Beach, Pub». 1858, p. An historical reclamation. (Valentim)

Cha rm-O bservation s sur la couleur da sang de Chevre expose nu contact dea

gaa atmospherique. ac. [On the Action of Cases on the Colour of Goat's

Bleed.) (Gas. Hebdom. , No. 39, 1858. p.m— Sur lea relations qui existent entre le sang ct l

’oz one. [The Relations of

Oz one and Blood. ) (Journ . dc Pltysiolq vol. i, pp. 634M eghan — Ush er die Gletchhcit dea Bintluases, vrclchen in gew issen Fi llen die

Blutk orpcrchen 11nd Eiscnoxydulsslae auf die chemische Thi tiglteit dea gehnodenen Sauerstofiesmadben . [On the influence of the Red Blood-corpuscles onOz one .) (Verband. tier Nat. Gesel. in Basel, vol. ii, part s. pp. 9

— 13,

M — De lingue tans: textura disquiaitionea microscopicte . [On the Frog’s

Tongue. ) Derpah’

c. 1857.

Hyrtl— Die Rami performtca der Art. men inges media. [On the Perforating

Branches of th e Middle Meningeal Artery.) Ocaterr. Ztschr. f. prak t lleilk q v ,

r859. Schmidt, vol. to a, p. a84.

Hyrtl— Vermehrung dcr primitiven Aorteui ate. [On an Abnormal number ot

Aortic branches .) Oester. Ztschr. L prak t. Heilh , v, 1 1, 1859. Schmidt, vol.to?” P' 395

mm— Verlaul dea Art. Subclavia in einemValle von deutlich entwick eltenRaisrippen. [On an Abnormal Distribution of the Subclavian Artery.)WienerWechenschrq No. 30, 1838. Canstattn ol. 1, p. 23.

Pu n— Am alie dc l

'

aorte et de sea branches. [On an Abnormal Aorta.) 8 111.

Soc. Am No. 6, 1857. Canstatt, vol. i, p. 23.

[Oa ths PM Formen Ovale in the Adult ]M M 396.

28 REPORT on THE ms'rrrurEs or MED ICINE.

M h — Ueber Communikationen Zwischen denHerxvcntrik eln. [On a Communication between the Ventricles .) Verb. d. naturh.-med. Ver. au Heidelberg, vi,p. 185. Schmidt; vol. 103, p. 297.

Hu m -Da Hera und scimBewegung. Pray, 1858. [Acontribution to theanatomy, physiology, and pathology of the Heart.)

— Note sur lea corpuscules aanguins du Cryptobranchns japonicus.Veralagen en Mededeelingcn der k oninltlijlte Akademie van Wetcnachappen .

Afd .Natnurk unde. [On the Blood-corpuscles of the Cryptobranchus Japonicua ]c ende Decl. 1858. Assam-d” 1 258. pp. 368. Canst., vol. 1, p. 2 13.

Buch ar und Simon — [Interauchungen iiber Himink ryatalle und ihre gerichtlichmcdicinische Bedeutung. [On Blood Crystals.) Virchow ’

s Archiv, vol. xv ,

p. 50. Canst., vol. 1, p. 2 13.

Pollock — Ou Granulated Blood-discs. Microscop. Journ., Oct. , 1859, p. 4.

WAT ERS begins by saying that the bronchial tubes terminate in a

dilatation, into which the air-sacs of the lung Open . Six to twelveair-sacs, with their ves sels, &c., connected with a terminal bronchialtwig, constitute a lobulette . The air-sacs are somewhat elongated,and separated from each other by thin walls, without any la teralOpenings, covered by a number of small, shallow, cup

-like depres sions-e ight to twenty .

B lood-vessels .— Those of one lobulette do not anastomose with

those of another. The radicles of the pulmonary veins issue fromthe periphera of the lobulettes, collect into larger vessels, and thenrunning in the interlobular spaces, proceed to the root of the lung.

Savoax agrees with Liston, Miller, and others, that a longitudinalwound in an artery appears as a slit ; an oblique becomes fusiform;a transverse circular. He further says that wounds assume thesame shape in the dead as in the living artery, and therefore theirshape is due to a physical property— elasticity. The elasticity is,however, greatly assisted in its effects by a natural state of tension ,

for when the artery is dissected out, even the gaping transversewound becomes a mere slit. Wounds of veins assume similarshapes from the same causes . Their form is slightly modified

,

however, by the greater delicacy of their coats .

Scor r experimented on animals, and the conclusions he cameto were— 1 When the internal and middle coats of a healthyartery in a dead animal are ruptured, either regularly all round thevessel, or irregularly at different places, there occurs

,in by far the

majority of cases, no inversion or coiling up of the cut edges of thetunics . 2 . Rupture of the inner coats of the arteries of healthyliving dogs is also, for themost part, unattended with anycoiling up

VASCULAR. SYSTEM . 29

of the edges ot'

the divided inner coats . 3. Rupture of the in timaand media of the arteries of living animals, whether in one line

round the mead, or in several circular lines closely apposed to each

other, or irregularly at difl'

erent parts of the inte rior of the artery,is not of itself sulhcient to cause coagulation of the blood in, and

4. Inflammation of the arterial walls of such a degree as to cause

great thick ening of the snmc, is insnfi cient otitself to cause coagu

Lmaa says that the ammonia theoryis far frompresenting a satisfactorycxplanation ot the cause of the eoagulation of the blood. For

among other things he finds that blood, the ammonia in which hashem neutraliz ed by acetic acid, still remains fluid when kept in

soon as the temperature is slightlyin part to supp

'

ort Brueck e’s state

which the coats of the blood-vessels have

upper part of Groux’s sternum. The

the ascending aorta, the latte r the right

p oints out the dcfect ofmcnsuring the foroe of the

that the arrestof the radial pulse, when the armis

80 napoa'

r on THE Insrt'w ras or MED IC INE.

fi rniblyextended, is on account of the aponeurotic termination of

h e biceps and brachialis internus compressing the humeral artery.

BROWN-SEQUARD tries to explain the reason of the heart’ s pulsations being reduced, or even arrested, during deep inspiration . If,

he says, a rabbit, in its natural position, has the respirations at 90,and the pulse at 144 per minute ; the pulse maybe raised to 160,

and the respirations reduced to 60, by bending its head backwards .

If, on the other hand, the head is bent forwards on the breast, therespirations are reduced to 44, and the pulsations raised to 180

perminute. After the two vagi are divided in the neck, the bending of the head backwards alte rs but slightly the number of pulsations and respirations ; but the bending it forwards reduces thenumber of respirations very considerably, although it merely raisesthe pulsations a few heats . This is another proof that the vagihave a powerful influence on the heart.

M . FLEUax claims the priority of investigating the efi'

ects pro

duced by the prolonged application of cold water to the body . He

does so in consequence of Dr . Bence Jonas having published a

paper on the same subject a short time ago .

VULP1AN tried to measure the contractility of the vessels of the

liver and kidney— by the application of mechanical stimuliimmediately after death. He poisonedmost of the animals (dogsand rabbits) with wourali, kept up artificial respiration, and thenapplied the point of a needle to the surface of the liver. Afte r a

second or two the tissue round where the needle was appliedbecame injected with blood, which did not readily disappear on

pressure . Galvanic did not act so well as mechanical stimuli.A similar effect was obtained with the kidney. At first the vesselsdilated ; then, after a time, contracted.

GUNNING calls attention to the fact that, on diminishing the

watery part of the blood by means of salts and other substances,the circulation becomesmuch slower. BOTKIN thinks that this arisesfromthe saline solutions causing a Change in the formand elas

ticity of the blood-corpuscles, and thereby giving rise to greater

friction in the vessels .

Buscu strengthens Meckel’s view regarding the possibility of

substances in the blood passing backwards from the right auricle

i nto the hepatic vein . He proved this experimentally, by injectingfinely powdered charcoal (mixed with water) into the external

jugular vein of a dog (P). The capillaries of the lungs became

https://www.forgottenbooks.com/join

32 REPORT on THE IN STITUTES or MED ICINE .

na n cao Dar-we an

1 1

Amphibia 1 1 159 1 2o'

s

Amphibia (scaly) 1 1 rm; 1 17'

s

1 1 10 9 1

Mammalia (man includcd) 8 1 t 1 147

Thus, it appears that fish have proportionally least blood ,amphibia less than birds , and birds less than the mammalia.

Young have proportionally more blood than old animals . The

female, too, he found, has less blood than the male of the samespecies .

BROWN-SEQUARD says that the only difference between arterial

and venous blood is in its containingmore oxygen and less carbonicacid. The proof of this is, he says, that when venous is well

shaken with air, and becomes red, it can, when injected into thevessels, equally well with arterial blood, restore to muscles theirirritability, after they have been in the condition of rigormortis. In

a similar manner the sensibility of the nervous system can be

restored. Brown-Sequard gives it as a general rule, that the irritability and sensibility of the tissues can be restored by the injectionof blood longer afte r death, in large than in small animals . In the

guinea-pig until the eighth, in the sheep until the tenth and a

quarter, and in man until the twenty-seventh hour . When defibriniz ed blood is injected into the artery of an amputated limb, it ison its return by the vein found to contain fibrin . When the

muscles are galvaniz ed during the injection, the fibrin increases inquantity . Moreover, he thinks that the fibrin formed by themusclesis decomposed by the liver and kidneys .

When a quantity of the oval-corpuscled-blood of a bird is injectedinto the circulation of a dog, cat, or rabbit, it is foun d that in the

course of an hour all the oval blood-cells disappear ; whereas, ifthe examination bemade only a quarter of an hour after the injection they are to he foun d in all parts of the circulation . On the

other hand, if the small round blood-corpuscles of one of the

mammalia (dog, cat) be injected into the circulation of a hen, the

VASCULAB. SYSTEM .

round cells may be detected in the blood amonth afterwards, thoughin greatly diminished quantity.

Carm e l. observed that, when the venous and arterial blood of

the goat is shaken with atmospheric air, oxygen , nitrogen, or carbonicacid gas , the effect is always the same . The venous blood thus produced, howev er, is in all cases a little browner than the arterial. Hecalls attention to several inte resting facts regarding the relations

between the blood and oz one . SCHiiNBEm says, that fresh and

way to the salts of the oxide of iron ; and that this most probablyarises fromthe circumstance of the blood-corpuscles containing a

small quantity of thatmetal.Fu ses recommends the old method of studying the circulation

of the blood on the frogsHYR’

I'

L found by injecting the middle meningeal arte ry, that itsperforafing branches are not lost in the diploii of the skull ; but that

LE, who believes thatindividuals, and thatnot occur oftener, if

that the

proc ef the fourth to the sixth eervical vertebrm,that of the sixth and the neck of the snper

muscle, belonging

Paras found in the body of a man, at . 33, the aorta, whichrose as usual, bend over the right bronchus to the right side

84 arrow on w e msn rurns or u smcms .

carotid. Opposite to the sixth dorsal vertebra there the aorta

gave 03 a vessel about the siz e of a goose quill, which passedup through the fifth intercostal space to the neck, and thereshowed a curious distribution . The (esophagus lay to the rightside of the trachea .

WALLMANN says, among other things, that cases of open foramenovale are more frequent among women than men . That the foes:ovalis is not unfrequently divided into two by a band of muscularfibres . (Otto, Breschet, and others .) That occasionally openingsare found in the semilunar valves, &c., &c. Duscn relates the case

of a boy eleven years of age in whoma commun ication existed

between the ventricles . He afterwardsmakes some general remark supon this peculiar condition of the heart.HARTING found thatthe red blood-corpuscles ofthe Cryptobmad u

J ama ican measure mm. long, 328 mm. broad . The nucleus

by 14mm. The colourless corpuscles, on the other hand,

measure by 15 2mm. The surface of the red blood-corpuscluin this animal is therefore twenty-nine times greater than the

diameter of the blood-corpuscle of the human subject. They are

the largest known .

Bucmvs n and SIMON prepare blood-crystals by evaporating a few

drops of blood, with an excess of strong acetic acid, to dryness in a

watch-glass . Crystalsmaybe obtained by this process even fromdried blood removed fromcloth, &c. The methodmaybe employedin medico-legsl investigations, as the only crystals likely to be con

founded with those of haematin are crystals of murexid. The

latter, however, differ fromthe former in being soluble in water, anddilute hydrochloric acid, and in giving with potash a blue insteadof a dark-green solution . p.

PoLLocx sought for granular blood-discs in blood circulating inthe living vessels— l at, in the web of the frog

'

s foot ; ad, in the

gills of the tadpole of the water-newt ; and 3d, in the small arteriesand veins in the mesentery of kittens and rabbits while the animalswere under the influence of chloroform; but in all three cases withn egative results . The cause of the corpuscles assuming a crenatedappearance after the blood has been drawn froma vessel he cannot explain ; buthe says, that it is not on accountof its exposure to the air.Spirit of wine, when added to a drop of blood, causes all the cor

puscles to disappear, and in their place is to be seen a large quantityof extremely minute particles, of no definite shape,

— apparently theamof the former discs .

NERVOUS SYSTEM .

m m f-Ou Inhibitory Influence. Brit. Med. 101m, Feb. sth. 1859.

1' W4;

Sph aI Oord and uadulla Obh agata. Tmalated for tbe New SydenhamM 1859.

M ol Lecturu ou ths Phyaiotogyand Patbology of tbe

Nmom System. (Dublin Hospital Gaz ette. June 15th, and following numbera tfil Auguat rsth, x859.)

Da nn i — Lego» cur la physiologic et la pathologies da Syatbma Nerveux .

[W ou tho Nervoua SJateua] Vole i aud ii. Par is. 3858.

W W ou tha Stroctm and Relatiomofi he NW u Sp tm at the

M M J aclnfi ng the NW of the organa ol special aenae. (Lancet.t8§9. p. 181.Auguat aoth. aad following numbers.

der Physiologic. [Text-book of Physiology.] Parts 1— 3.

Ca t a ri na 103.

Ham -Bin mechaniacher Tetanomotor fi r Vlvlaectloaea. [A MechaniMoleaebott

'

a Upton . voL iv. r858. pp. 134— 133.m u g— Usher dla Vitalttat dsr nsfl earohren dsr M obs . [Oa tht talityd ihe Na n -GhreaJ M t wb emw me SOnpp u

s— “s .

W — M Wm dar aer-n a ia phmlogh eher uad

[Oa tha laflueaee ofl he Water la the Nm ] W . 1857.m ag — Mm mange in der Nervenaubatance. [On the Molecular

Cho lin e-sheath ] Zeitaa 1858.pp. 168

M — Umm hunmmba fi amm da kM Wm t cbe da

[Oa tt M of Cold Watu oa tha Nen oca syatem]30 85 1858.

Gem-Usher Modificatioa der Embark eit durch sk i tti sh. Brn guag. Pro

ficph m e NM mL fiL rSfi Na rg pp aog— n o. W M

m -oeber die Va-i oderuag der Brregbark ett derNarven dureh etaeu con.

m w sm [Tbe BM ol a eonataut Blectrical Cm L]Men talist . der Berliner “ admin. March. 1858. pp. 198— 305.

m — Oume Actioa ol the Blectfic ent upon the Moto e aud

Muscles. Med. Times and 1859. pp. 109. 207.31 1.

-&eeherchea electro-phydologiquea. [Electra-physiological BaperLn u ts.) (Jona de M ot , pp. 404

m — mM ade ira locall. [Electricitylocallyapplied ] Vrd b h rb . r858.

(Scientific and practical.)m — De vafl omodo alectricltatia M ums quad ad (her-plain. [Ths varloua

n odes su pplying Bled rletty.) Ba otou. 1858. (A careful summation.

W )

36 care er on w e memo-re s or u smcms .

Lem-at ctGmfi olot — Anatomie compares do systems nervous considerée damsea rapports avec “intelligence. [The Comparative Anatomy of the Nervous

System.) 8vo. Par is. 1839— 1858. Journ . do Physiol. vol. i, 1858. pp. 368

—37 1. See also Theile in Schmidt's Jahrb ., vol. 99, 1858. pp. 346— 249.

Valentin.

Unn i — Deg“ Studi elettroo fisiologici presso l’antichita. [Electro-physiology.)Perms . 1858.

I attouc — Cours d ’electrophysiologie . [On Electro-physiology.) Paris, 1858.

Duboil-Reymond,

— Untersuchungen iiber th ierische Elek tricit‘

a'

t [animal electricity) . (Moleschott

’s Unters ., vol. iv, part. 1 , pp. 1- 15,

Duboir Reymoni — Ueber Polarisation an derGrease nngleichartiger Elek trolytc.

[Polariz ation of Dissimilar Electrolytes.) (Ih.. part 2 , pp. 144Duboip noymoni — Ueber die innerePolarisation poriisermitElektrolyten gen-i nk

ter Halbleiter. [On the Polarisation of Porous Electrolytes.) (Ib .. pp. 158— l 77

Bernard — Sat lea quantites variables d ’electricité necessaire pour exciter lea pro

priétés dea diflérents tissus. [On the Amount of Electricity necessary to

excite diflerent tissues.) Gas. Méd , 1858, No. 8. pp. 1 16. 1 17 .Barnum— Sat l

'

excitabilite. [On lrritability.) Journ. do PhysioL, 1858, pp. 563—565°

M o,— De l

'

infiuence do galvanisme our 10 systéme nervous moteur. [On theAction of Galvanismon Motor Nerves.) Par is. 1858. (No abstract.)

Rom an, Leann ,et l m . l m n ,

— Actions dea courants elects-ion s sur

les nerfs. [The Action of Galvanismon Nerves.) Gas. was ,April. 1858.pp. 330— 233,No. 15 ; pp. a4s— a4y.N0. 61 pp. 332— 335.No. 2 1.

Pfinger ,

— Ueber die tetanisere nde Wirkung dea constantenstromea. [Tetanuinduced bythe Constant Current.) Virchow ’

s Archiv, vol. xiii. 1858, pp. 45 7

Bomtlml,— Ueber die Modification der Erregbarkeit durch geschloasene Kettenund die Volta’schen Abwcchselungen . [On the Effects of Difl

'erent Batteries.)

Monatsber. der Berliner Akademie, December. 1857. pp. 639— 641 . Moleachott

’s Untersuch.. vol. iv. 1858, pp. 347— 350. The same paper is given

more fully in Beale u. Pfeutfer's Zeitschr. fur rationelle Medicin, vol. iv. 1858.

pp. 1 1 7— 141 . Froriep’s neue Notiz en, vol. iii, 1858. No. 13, pp. 198, 199.

Canstatt, vol. i. p. 103.

Being — Verhandeling over de galvanische Polarisatie met betrek k ing tot de Leerder dierlijk e electriciteit, so over de middelen our hare n invloed b ij het Ondertz ozn ta voork omen . [The Action of Galvanism.) Grouisgea. 1858.

Duboip noymond ,

— Ueber einen nach Berlin gelauten lebenden Zitterwels.[On the Electrical Shad-fish .) (Moleschott

’s Untera . vol. iv , pp.oi

—96. Also

in the Monatsber. der Berlin Akad.. January, 1858, pp. 84— 1

Bon n-d ,

— Ein Beitrag z ur Physiologic der elektrischen Organs beim Zitterrochen . [On the Electrical Organ of the Bay.) (In his own Beitrige zu

°

r

Anat. et part 1 1, pp. 157— 177 . 4to. Gia n a.

Bonnefin ,— Recherchea experimental“ sur la possibilite du passage 3travers lea

centres,nerveux dea courants electro-magnétique 1 la peau chea l'homme. [On

the possibility of passing Electric Currents through.

the Nerve-centres.) (Jour.

do PhysioL. vol. 1. pp. 545

NERVOUS SYSTEM . 37

etudier les élémcnts de lamoelle épinmweProcess for examining Mieroscopimlly theCompt. Bend . “ l

’

Acad des Sc“ t. 47.

[On the Perb heral Ganglia in the AlimentaryCanal.) Muller’s Archiv, 1858,r 189.

Qu in t — Bears” z ur Structurlehre der Windungen des Kleinh irnes. [On theW e! the Ce rehellum.) In his Mik roahopische Studien. Erlangen, 1858,p. 1.

M — Eis ige Beohechtungen iiber ansgedehntes Vorkommen von Nervensn

sstno sssn irii Trsctus inteadnalis. [The Nerves of the lntestines.) Miiller'

s

Archiv, 1858. p. 148.

OW L-Von demBane und Mr physiologischen Bedeutung der ‘

l'

sstltbrpmcben.

(0.W M ] In his Mik rosk Opischc Studien, p. 39.

[ n u — (Jew Nerveaendigungen. [On the Mode in which Nerves terminate.)

Mittheilung dea B erra J acobovritsch.

Virchov'a Archiv, vol. xv, p. t50.

Nerve-dime ; (Microecopical Journal,

of the PomVarolii. (Medical Times

Untstsuchungen ,vol. iv, 1858. pp. 84

Bowl — Experiences relatives 1 la sensibilité tactile des cordons posterieuresde lamoélle. [On the Sensibility of the Posterior Column .) (Gas .use , 1858 ,

Mum N0 33. 1» M )— lnfiuence de l

'

oxygene sur les propriétés vitales de la moclleepisters et dea nerfs moteurs ct sen sitits. [On the Influence d ozsygen ou

Nerve-substsnce.) ( lb., pp. 6 17 ,

88 REPORT ON rm; mea sures or m i crxs .

m -Sur qualqnes characteres non u na s signalb dcamreflexes chea leamammifi rcs. [On M ax Nov-mats.) (Jo-111. ds Phyn'nl,vol. 1. 643

Brown M — Exposé critique dea idées de ll .Chanvean snr la physiologicdc

lamoel epiniere et faits nouveaux i l’appni dea thioriu que j'ai p upa“ I

l’

egard de la transmission dea impressions sensitives. [On the Physiologyof the Spinal Cord.) (ih., pp. 1 70— 189. Bullet. dc l

'Acarl. do use .

vol. xxiii, Oct., 1857. pp. 7m m é-Notc snr l’induenceqn

’nnem0iti6 later-sle ds lamoiillc 6pini§re

cxsrce ans certains cas snr la moitié correspondants ds l'ancsphale et dc la

face. [On the influence of the Lateral half of the Spinal Cord on tha oppositeside of the Head .) (ih., pp. s41 ,m M — Nouvelles Bccherchca snr la physiologic de is man.

[New xperiments on the Spinal Cord.) pp. 139M olt — (Jew die gchrensten Wirkungen dea Riick cnmarhes. [On the Crud-g

of the Nerve-fibres in the Cord .) (Siebold und Kiillik u ’s W in:

wissenschaitl. ZooL, vol. ix, 1858. PP. 307

7 111 — Dca cflets croisés dc la moi llc epinierc i pmpos d’nn travail (10 ll . dscanid. [On the Crossing of the Nerve-fibres in the Ca rl.) (Gas Hebd.

vol. v, 1858, Nov., No. 48, pp. 832Joittolgr ,

— Wer ist der Begrunder der Lehre von den Bedsxbewegangeu ?

[Who discovered Bede: Action ?) (Pragcr Vierteljahrschrifl , 1858, vol. iv.

pp. 50 — e[ cyan

— Selhststk ndigk eit dea Eiick enmark es . Verhandl. dea naturhistor. Vereins

dsr Rheinlands, vol. xiv, 1857-8, p. 8, lxxv [On the Independence i the

Spinal Cord . Already known. Valentin .)M — Becherchca sur la physiologic ct la pathologie dc la protube

ance annulaire . (Journ . dc Physiol. vol. i. 1858, pp. 533 [A collection

of cases in order to disprove the crossing of the nerve-fibres high up in thespinal cord.)

Fofl llo.— Consldsrations physiologiques sur l’accés d’cpilepsic. 8vo. Paris, 1857.

[Some Remark s on the Physiologyof Epilepsy.) (No abstract.)Brown un i — Note sur des faits nouveaux concernsut l’apilepsic consecutive

aux lesions de lamoelle epinibre . (Jonrn. de Physiol. vol. i, 1858, pp.47a

[On the occurrence of Epilepsyafter h imto the Cord. No abstract.)Bmwnfl oqu ri — Eceherches sur lea causes dcmort specs l’ablstion do Is partic

de la moelle allonges , qu'on nomme is point vital. [On the Cause of Deathafter Removal of the Vital point.) (Ih ., pp. 317

fl ow n — Noun s“ details sur le nmud vital. [Some New Observations on theVital point.) (Compt.Rend., vol. xlvii, N0. 2 1, Nov., 1858, p.

Rom-Redessioni e sperimenti per servire di materiale alla fisiologia del cerve

letto. [On the Physiology of the Cerebellum.) (Continuas ionc ) (Gas . ll“ .

ltal. Lombardla, N0. 49, Dec., 1857, pp. 415— 437 ; Feb ., 1858, pp. 35— 39,and 1 13— 1 15 ; April, pp. 196

— 198 ; Aug., pp. 365— 267 ; Sept , N0. 40.

pp. 343, 344. Canstatt, vol. i, p.[mum — Monogramdelle vertigini c richerche di dsiologia neurologica. [On

the Physiologyof some Nervous Diseases .) (Annali Universali di Med , vol. clxiv,1858, Giugno, pp. 449— 483 ; Luglio, pp. 45

h yping — Bur l'

action du Co nurus snr is cerveau. (Journ . dc Physiol. vol. v,pp. 565, [Pathological observations on Parasites in the Brain.)

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40 REPORT ON THE IN ST ITUTES or MED IC INE.

HANDFIELD JONES adopts Lister's views relative to the action of

certain nerves in meeting or diminishing action . And fromphysiological as well as clinical data (many examples Of which hebrings forward), he believes that it maybe regarded funda

mental truth, that one and the same afferent nerve may, accordingas it is acting mildly or energetically, either exalt or depress thefunctions of the nervous centre upon which it acts . Upon this

theory of inhibitory influence he explains the distant efi'

ect of manymorbid states, as well as the action of counter-irritants and certain

external stimulants .

Sea scap es VAN DER KOLR’S work forms the fourth volume of the

New SydenhamSociety’8 series . As stated by the translator in hispreface, the chapters devoted to the consideration of the influence

of the corpora Olivaris in the articulation of words, and on the

variety of lesions of speech which accompany morbid affections

of different parts Of the brain and medulla Oblongata, are par

ticularly worthy of attention . His remarks on the intermittentcharacter of many convulsive and neuralgic attacks, which are yet

dependent on persistent causes, are calculated to afford importantaid in the establishment of the diagnosis in diflicult cases, wherethe most regularly recurring fits of severe sufl

'

eriug, though trulyintermittent, are nevertheless the result of organic disease. The

histological part Of the work is illustrated by plates .

BROWN-SEQUARD, in commencing his lectures in Dublin, statedthat his object was to explain the origin of four kinds or groups ofnerve-fibres, their course in the cord, and their place of decussation .

[ I What are usually termed conductors, he asserts, contain severalspecies of nerve-fibres, conveying various sensitive impressions, suchas tickling, pain, touch, muscular sense and direction, and temperature . Besides these there are still other species of nerve-conductors .

The voluntary motor. The vaso-motor. The nu

tritive, concerning whose separate existence he is as yet dubious .

That the phenomena of changes in secretion and nutrition are

referable to nerve-influence can, however, be proved. Thus, by

irritating the lingual, the salivary secretion is increased . Thisinfluence is distinct fromthe vaso-motor, as galvanismapplied tothe nerves of vessels diminishes both secretion and animal heat. Hemoreover says, that all sensory fibrils, except those conveying thesense of muscular contraction, pass into the posterior roots of the

Spinal nerves . That it is doubtful whether some of the excepted

NERVOUS SYSTEUI .

the hw of functiou in these nerves enunciated by Sir C. Bell.

Hencq in some rim s and injuries in whioh the poste rior roots

stating tbat the roots of the nerves can be traced i nto the grayM d the cocd, and that its posterior column s pass into the

cerebellum, but not into the cerebrum, Brown-Sequard mentionsM M a M sectimi of the posta ior mlumna in some“ the seusib ility is incmsed instead of being lost ; hencetha e cmnot be the only channels tor conveying sensitive impressions to the bn in . If

, cn the otber hand, all the cord exccpt the

posta ior oolumn be divided, all sensstion, as well as muscular

Tha mbjcd of tbc mcond b ctme is paraplegimtwo forms of

Séquard th'

mk s a third may be added, which occurs whenever an

irritation is so transmittcd to the spinal marrow froman organ as

to pmdnce psn lysis ; example in wasting palsy, which Roberts says

inflammation of the cord bythe paralysis of voluntarymotion beingcomplete , while the reflex power is augmented ,

it is further dis

tinguisbed bythe spine being tender on pressure at tbe seat of the

Hm orrhage into the substance of the cordmaybe dismil fromhemorrhage around it, by the sensibility graduallydca u sing, and there being no convulsions . When the hmmorrhage

m a ise fimn stfi ctnmof the methmmlargement of the prostste ,and discaac of the bladder or of the k idneys .

Séqumd u ys the spinal cord mayact either on the nerves going

to the blood-vessels, or on those producing changes of nutrition .

Thmfi omhmd be dipped into a frcez iug mixturefi he other hand,as first pointed out by Milne-Edwards, will become reduced in

temperature ; not, however, as be supposed, by a reduction of

the general temperature of the body, but simply from its vesselsbeceming w nmmd through a reflex nervous influence .

The sixth and last lecture is chiefly devoted to the consideration

of thc'

subjcct of poisoning. In treating a case of poisoning, mth

'mp m as Sir B . Bmdie u id mbc donc— flmt, to spply

42 REPORT ON THE I NST ITUTES OF MED ICI NE .

antidotes ; and, secondly, to keep the patient alive until the poisonis eliminated by the excretions . All the excretions ought, therefore,to be encouraged— aweating by heat, evacuation of the bowels bypurgatives, and the removal of the urine by passage of the

EsaNm ’s lectures on the nervous system fill two octavo

volumes, of above five hundred pages each. In the first volume heconsiders the general property of the nerves and nerve-centres,reviews the various theories regarding reflex action, indicates thepresence of reflex sensibility, and explains the electrical propertiesof the nerves, muscles, and skin . While speaking of the efl

'

ccts

of a continuous galvanic current upon nerves, he says, that ifthe current be made to pass centrifugally (that is, by placing thepositive pole next to the nerve-centre) the nerve will rapidly losethe property of being excited by the electricity. At first sight

this might appear to arise fromsome disorganiz ation of the nerve

elements . Such, however, is not the case ; the property of the nerveis enfeebled, and exhausted, but not destroyed ; for, on changingthe direction of the current bymerely reversing the position of the

poles, in a very short time the stimulus applied to the nerve will

call forth as energeticmuscular contraction as before .

It has been long known, that when a feeble current is passedthrough a nerve, the muscular contraction which it induces mightmanifest itself in a variety of ways . Atone time the contraction takesplace when the current begins, at another time when it is arrested ;and again, there occurs a contraction at both the Opening and theclosingof the galvanic circuit — none, however,during its continuance.

Now, if the nerve be first exhausted, it will be found, that on

applying to it a direct current (that is, from the centre to the

circumference), contraction only occurs when the stumulus begins,not during its application or at the moment of its removal.Whereas, if the indirect current be applied (fromthe circumferenceto the centre), no contraction takes place except at the momentof its interruption . It has been still further observed, that thw eresults vary when the stimulus is applied to different parts of the

same nerve. Thus, it is found that, on applying the galvanismclose

to the divided end of the nerve, contraction occurs, as has just beensaid, at the moment of its application in the case of the direct,

at the moment of its arrest in that of the indirect, current,

while if the stimulus be applied near to the periphery of the

NERVOUS sr srxu .

nerve, contraction occurs both at the Opening and clom'

ng c

Bernard says this is on account Of the disorganiz ation c

nme beginning at the cerebral end, and it is onlyon the weal

nerve that the eflects first spok en of are observed. WhCJ

pneumogastriea are galvaniz ed, the pulsations of the heart

and tln'

a is followed frequently (in the dog) bythe appeampa il talfic movements in the intestine . Bernard think s tha

nia n be applied to the upper end of the divided nerves, no act

stopped throngh reflex action. And by the same mcans a cl

in the chemical composition of the blood and urine maybedosed. Thus, galvanismapplied to thc pneumogastricsmay

’

In his twenty-fourth lccture Bernard calls attention to the

that if the circulation in the liver be arrested by ligaturin

vessels, a stimulus applied to the nervous systemfails to pn

M whatever increases the circulation in the

m ie n ction of the sympathefia is lik elyto produce art

of the cranial nerves on certain secretions, and a very con

mun-d ot all that is known regarding the influence

by the great sympathetic over the circulation, and ternpel

of diflierént parts of the body, but more cspecially of the

The mtlwr alao points out tbe influence it exercises indirectly

performed upon thc thon d c and abdominal portions, and the r

m mmm , describes in detail the nature c

other organic syatems in the body. This involves a descripti

the various modes i h which the distal cxtremities of tlm1

fibres terminate, Of the modifications in formwhieh theyumand the special structures which are found appended to

peripheral a ids. He reviews all the recent researches that

been made in this field, and gives special attentiomto the oh

tions cntinental physiolon ho bavc thrown much hg

44 REPORT ON THE INST ITUTES or MEDICINE .

the anatomical connexion Of the nerves with the various tissues,glands, and other organs of the body . The author, in his introductory remarks, says, that he purposes to consider the peculiar nervestructures in the organs Of special sense, Of which the retina formsthe highest member. A peculiar difl

'

erentiation prevails amongstthem, corresponding to the nature Of the stimuli which act uponthem, and this he intends specially to consider.

Scn l rr’s treatise on the nervous system contains muchoriginal matter. While speaking of the degeneration of the peri

pheral part of a cut nerve, he says that the vascular supply has avery great influence upon it, as the following experiment shows. He

exposed the sciatic nerve of a cat, drew the upper end out of the

pelvis, and laid it in the bottom Of the wound. On examiningthe central end three or four weeks afte rwards, it was not foundto have undergone any degeneration, whereas the lower portion of

the same nerve had, in several parts , become changed in structure .

Schitf says that wounds in the nerves Of warm-blooded animalsheal very rapidly, and if the nerve is cleanly cut through, reunionw ill take place in a few days. The power Of sensation returns

in those cases sooner than the power of motion, the diflerencein time being as eight to fifteen . If a sensory and a motorynerve be divided at the same timc -e xample, the infra-orbitaland the facial, or the lingual and hypoglossal— it will be foundthat the sensory unites and regains its function before the

motory. Schifl’ could not satisfy himself as to the regeneration

a.

In some favorable cases he succeeded in making sensory unitewithmotory fibres, but no physiological effect was thereby obtained.

The difficulty experienced in causingmotory to unite with sensoryfibres shows that there must be an important difference in the constitution of the two kinds of nerves .

HEIDENHAIN describes and has employed a little hammer toexcite nervous action . The instrument is so arranged as to give aseries ofgentle blows on the nerve . The effectthus produced is foundto be similar to that of galvanism. Kollik er, in reply to Ordenstein,save that a nerve, after it has been dried and has lost its power ofconducting a galvanic current, can be restored to life again,— byimmersing it in water for a short time . BIRxNER estimated thequantity Of water present in different nerves . He found in the

sciatica Of a decapitated woman aged thirty, from to per

NERVOUS SYSTEM.

cenh of water ; in the crural nerves of one aged fcrty, from6 t0 64

°

0 per cent. ; in the hrachial of a rabbit, from 6567 , and in the sciatic of the same animal, fi'

om 68°

r t0 69°

2 ,

Hanu ss says, that the sciatic of the frog, on an average, conductsclearicity u

'BO times better than water . This he attribute s to the

chemical composition of the nerve. He confirms KO'llik er's statement regarding the power Of water in restoring the properh

'

es of

nerves afler theyhavc been lost through the nerve becoming dry.

believes that sensory nerves can conduct centrifugal as well as

The object of Althaus’s communications to the ‘Medical Times ’

is to prove that the muscles possess an inherent muscular irrita

the pspers is devoted to an historical review of the subject. He

concludes by saying that Bernard’

s researches hav e been confirmedby Kelliher, who experimente d both with woorara and conia, and

h wmg experimmit shows . If the crural arteryand veins be tied

in one limb, so that the circulation of the blood is stopped, andthe mimal poisoned, by inserting some woorara under its skin .

When galvanismis applied in a short time afterwards to the motornerves of the limb, no muscular action ensues ; but if the galva

are immediately induced . Finally, he mentions that the microscopic observations of Dr. Wundt are likewise in favour of an

innate muscular irritability. He (Wundt) found that the muecular fibres are shortened when the poles of a galvanic battery

are applied directly to the muscular tissue . This phenomenon is

thinks that inhere nt muscular irritability is proved by— l st. The

of muscular fibres , which have been entirely insulated from everya tw ew a tissue . 2d. Bythe experiments of Bernard, KOHik er,and himself,‘ with woorara, which kills the motor nerves, and

leaves the muscles intact. 3d. Bythe microscopic observations of

“ the editor pointed out the same thing three yeara ago, (‘Bdim Monthly

tw at: Rh ,

46 an on or: run w arm or manicure .

thc mw nh r fibrq when the d ectmdmare direcflyapplied to ths

muscles, and no such action when thc d in ulna ia cmveyed b ths

musclee through the instrumentalityof the nerves.Gn u om treata of the relation of the outward firmof the ak ull

to that of thc brain . The ra uhs d his ohsa vafiong which extend

over a great part of thc animal k ingdmn, are quite opposed to

Rousseau, Lu cas , and Macros state that, if h e opposite cur

renta be allowed to act upon difl'

ercnt points of a nerve at thc sametime, only the peripheral part of the nerve will exert any influence

upon the attachedmuscles . Bm xnn calls attention to the diflerence

between a constant and an interrupted current. During the formerthe leg of the frog remains still, -during the latter thcmuacles are

Prw on says, that very weak, constantcurrents of electricityneverinduce tetanus— moderate currents call it into play, and strongcurrents arrest it. Bos Tm ’

s experiments show that if a constantcurrent be kept up for several minutes, at the moment of breakingthe circuit tetanic spasmtakes place . If the circuit be again closed

in the same direction during the spasm, the tetanus ceases. On the

other hand, if it be closed in the Opposite direction, the spasmisincreased. Then, again, if one waits till the spasmhas passed, andthen closes and reopens the circuit in the same direction, the tetanicspasm comes on just as strong as if it had been closed in the

opposite direction.

J i cusowrrscn has adopted Gerlach’s method of imbibingtions of brain and spinal cord with carmin s solution . He says that

he can distinguish between sensory, motory, and sympathetic ganglion-c ells in t he spinal cord. The firstare spindle shaped, the second

star-shaped, and the last round or oval. En n in again raises the

question regarding his right to be considered the discoverer of the

peripheral ganglion. He says that as early as 1840, he discoveredthemin the digestive canal of man, and in 1843, in that of birds .

(inexa ct! describes the nerve-fibres of the brain as terminating incells and granular masses. As there are many more fibres thancells several of the former must terminate in one of the latter.

Kahu n a says that he has been unable tomake out the arrangement described by Gerlnch.

Brahm a revives the old views regarding the plexiformtermi

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48 rumour ox rm: msr rrurs s or nmrcxs s .

confirms Schwann’ s statement regarding the nervus trochlearis

giving off a motor branch to the lachrymal. He further says,that he found it give a branch to the nasal by which the

lachrymal sac and duct are supplied ; and lastly, that the lachrymalbranch of the ophthalmic and of the superiormaxillary do not alwaysanastomose .

03m. says the olfactory nerve (pigeon s, hens, &c.) spreads itselfout into a fine plexus under the nasal mucous membrane, and

that the nerve-fibres ultimately end in club-shaped bodies (ganglioncells P), lying immediately beneath the mucous epithelium. Further,he says that the yellow colour of the upper part of the nasal

mucousmembrane does not depend upon a deposit of pigment in theepithelium-cells

, but upon a peculiar secretion of the mucous glands.

a xenn describes the distribution of the nerves in the ligaments, capsules, and synovial membranes of the joints . Theymostly all, he says

, of the cerebro-spinal origin .

Luscnxa makes an historical addition to Dr. Krause’s work on

the termination of nerves .

Scams found that among small mammalia the reflex movement, after section of the cervical portion of the spinal cord, isstrongest in the hedgehog. In eels and carp it is more markedthan in mammalia, and in amphibia even more so . The sala

mander seems to feel pain after decapitation ; but Schifl'

is still

doubtful on the point. The posterior columns, he says, althoughalone sensitive, are not the only ones that conduct sensory impressions . It is rather the gray substance which conducts these .

Longitudinal section of the spinal cord does not destroy the sensibilityof the posterior columns . He denies that there is anycross

ing of the sensory fibres in the cord, and says that the graysubstance can conduct motory as well as sensory impressions .

There are no separate motory bundles in the cord whichcan, by a direct (not a reflex) stimulus, cause muscular movement.BROWN-SEQUARD says thatthe functions of the brain, cord, and themotory and sensory nerves, are increased by oxygen and diminishedby carbonic acid gas . Hypertesthss ia, he think s, maybe inducedby the action of oxygen on the sensory nerves . Most of the factsstated in the other papers are familiar to our readers since their publication in the Lancet,

’1858. BEZOLD says, that — l at. Voluntary

motion in amphibia, birds, and mammalia, is conducted directly

NERVOUS SYSTEM . 49

eitherthat opinion . 3d. In the spin al cordsnot find any vase-motory fibres .

the erou ing of the sensory fibres in

It does not occur when the vital point isof the ru piration hc aceounts for in a similarreplies to thia, and cites experiments to prove

paper is cn the cause

that he made on the

be iuduced. Section of both vagi is followed by a similarresult. After flnding that two and a half grains of tartar exn etic

div ided the vagi in another dog, and then made a similar injecn'

on .

observed. He also noticed that section of both vagi is followed

byparalysis of the lower part of the weophagus , so that during tbe

act of respiration food is frequently forced back through thecardiac orifice of the stomach . Lastly, he found that thestomach, during the efforts at vomiting, becomes passively filledwith d r.

Lemmas , under Bre nna and Kurrm , tested the effects of

section of the vagi on the respiration. He says that the quantityof carb onic acid exhaled after the nerves are divided, at first

4

50 REPORT ON THE INSTITUTES OP I EDICINE.

increases and then diminishes. He made some observations on

the efl'

ects of galvanismon the cut vagi, but found nothing very

new .

Hzmsm x cut the vagi and recurrent laryngeal nerves of frogs.Six lived 4 weeks after the operation, two lived 18, one 10,

one 8, two 7, and one 6 days . Bmmr r made some expe

riments on dogs, with the view of ascertaining the eflects of

the vagi on the sensation of hunger, but with unsatisfactory

results . Ke en an and Lunw m’s experiments , on the other hand,were made with the view of ascertaining the influence of the vagi

on the movements of the digestive canal. They found that galwnism applied to the peripheral ends of the cut vagi inducesperistaltic action in the intestines . Galvanism applied to the

splanchnic nerves is followed by a similar result.Wa em ’

s observations on the sympathetic were made upon a

decapitated woman, net. 28. He foun d that galvanism appliedto the cervical sympathetic caused the eyelids to open, the pupilto enlarge, and the other results usually noticed on the lower

Lmosors found that, after tearing out the facial nerve, the

movements of the cheek continue for an hour .

BUDGE concludes, fromhis experiments on rabbits, that e theriastion does not diminish the sensibility of the cmliac or of the

superior mesenteric ganglion to mechanical stimuli. Brown

Sequard thinks that galvaniz ing the splanchnic nerves causes an

increase in the peristaltic movements of the intestine only when

the current passes through a portion of the bowel as well as the

nerve.

Jascnxown z foun d that section of the nerves of the spleen, indogs and cats, cause an increased flow of blood to the organ, anda copious deposit of hematin-pigment in its cells .

THE FIVE SENSES— SEEING, HEARING, TAST ING, SHELL I NG,

AND FEEL ING .

Herschel,— Remarks on Colour-Blindness. Proc. Roy. Soc. , No. 35, p. 73.

Wright— Ou the Cause of Long and Short Sights, and on the Voluntary Contrae

tion and Dilatation of the Pupil. N . Amer. Med Chir. Rev July, p. 705.Med. Times and Gaz ., i 7th September, 1859, p. 293.

Jago,

-Ou Bntopica. British and Foreign Med.-Chir. Rem, April, 1859, p. 465 ;

July, p. r65.

on ma one /ms or sense . 51

Senses ] W ig. 1858. (No

Nat-M a . 1858. (Series of

of the Eye ] (Gas.No abstract.)dea Thranensack es.

vol. iv, pp. 70— 98,

Underafigelse

1857. (A description

l am -M m sur la peraistauee des impressions de la retine. [On thePa aisteace of Impressions on the Retina.) Bullet. ds l

'Acad. dc Bruxelles,

$58 1» 738.— Eine Lichteracheinung imAnge. [On the Appearance of Light in the

Eye ] Pug. M icah. vol. roa, p. 175.

AM — UM Aecomodation des Auges. [On the Accommodation of the Eye ](Jahsesbu , No. 35» def Sebles. Ges. f. vaterland. Cultur. Bu ck s . 1858.

pp. say Already know s — Valentin.)“ ha — De oculi accommodations , experiments nova. [On the Accommodation of

the Eye.) Baf fin. 1857.

-<De musculi ciliaris in oeulis mammalinm structura et functionibus.

On the Ciliary Muscle.) Berlin, 1857 .-Betnerk nogen ilbe r den Aeeomodstionsmnskel und die Accomodation.

[The Accommodation of the Rye ] Grsefe’s Archiv fur Ophthalmologievol. iv, part 1. 1858. pp. 369— 385.

[ gua r a ntee Seme rkungen fiber die Binnenmusk eln dea Anges. The same.vol. iv, part 3, pp. 377— a85. (Acontradietion to some of the anatomical detailsin “annhart

'

s pawn — Valentin .)M um-Usher daa Aceomodationsphosphen. Sim-Ber. der Wise . Akad .,

November, 185mmxxvii. pp. 78— 80.

52 REPORT ON THE INST ITUTES OP HEDIC INE .

m — Anawmheh-phydologiwhe Unten nchnngsa filler dis Accumulation doFischauges. [On the Accommodation of the Eyes of Fish ] 8vo. M M l.

M am, 1858.

Lnbimofi — Recherches sur la grandeur apparante dea ohjets. [On the Apparentsiz e of Objects .] Compt. Rend., vol. xlvii, 1858. No. 1, July, pp. a4

— s7.

Annales de Chimie, troisiéme serie, vol. liv, pp. 13— 38.

— Notes sur les couleura accidentalcs. [On Accidental Colecta] OomphRendus, vol. xlvii, 1858, No. 5. August, pp. 158— 300.

Chem - Notes snr quelques expe'

n‘

ences de contrasts simultanee dc conlell .

[On the Contrasts of Colours.] The same, No. 5,Aout, pp. 196— 198. (Alreadyknown —

'

Valentin

Baumgartner — Ein Pall ungleiehaeitiger Wiederk ehr des Sehverlnbgens fiirverschiedene Parben. [On a Case in which one Eye regained the Power ofdistinguishing Colours before the other.] Sitxungsher. d. Wien . Akad., 1858,

vol. xxviii, pp. 357 , 358.

Woiok er ,— De nonnullis colorihus complementariis quales aingnlls hominihns

apparent. [Some Remarks on the Complementary Colours .) 8vc. Lysic ,1857. (Compilation.

— Valentin.)[m i — Smlea efl ets produits sur la vision par la Santoninec [On them

of Santonine on the Vision .) Gax. Hebdom., 1858, No. 39, p. 593.

l ifl he,

— Sur la Santonine. [On the Effect of Santonine on the Vision ] “unit.

dea Hdpit , No. 109, p. 869.

Volkmann,

— Ueber Irradiation. [On Irradiation] Bericht der Sachs. eu nuch.

d. Wlssenseh. an Leipz ig, 1858, pp. 129— 148.

Hanscnan’s remarks on colour-blindness originated in a reporton Mr. Pole

’s paper. He says he considers Pole’s communication

exceedingly valuable, because it is a clear and consecutive accountof the affection by one suffering fromit, and who is in possession of

a knowledge of all that has been written on the subject by others,and who,moreover, fromgeneral education and habits ofmind, is ina position to discuss his own case scientifically. Pole refers all his

perceptions of colour to three primary or elementary sensations, thesemaybe red, blue, and yellow, as Mayer proposed, or red, green, andviolet, as suggested by Dr. Young. It is as necessary to distinguishbetween our sensations of colour as it is to distinguish betweenbitterness, sweetness, soumess

, &c. In looking at green Pole doesnot recognise the sensation either of blue or yellow, but somethingsui generis . Maxwell has lately announced his inability to form

green by the combination of blue and yellow . The union on the

retina of the yellowest yellow and the bluest blue, in such proportions that neither shall be in excess, so as to tinge the resultinglight either yellow or blue, is notgreen, but solute.

Herschel, fromnumerous facts, concludes— 1st. That in no case

can the sensation of green be produced by the joint action on the

on w e oceans or sense . 68

eye of two lights, in ueither of which, separate ly, prismatic green

dud ng the most liv ely sensation s of blue and yellow, does not giverisc to that of green, con soles m gf tfim coate imin its compcM ac h iafi tyg

'

yrm h'

gfit ia us specm . And gdly. That all

the rays, of wbich those separatcly exciting the ideas of red and

extends the field of“ The true cause

the suhjcet, the sight of the myopic improves as he advances in

B ef hecame the pupih become largerd n eonseqnence of the circular

fihxu cf tbe iris loah g in a greatmeasure their irritability.

J aeo mflmamethodical proeeeding to show bow oeular smctres,

flud it impossihle to give a condensed abstract of this article ; but

byqnoting the fi st paragraph our readers will have the opportnnityof foming some idea both of its style and eontenta .

“ Our visual

nhjeets upon a membmnc in peeuhar relation with the braimbutu n furnished with or involve many adjuvant structm'

es. Thus it

hapm that they reveal to us a number of adventifionsM u we call thsm— w hether caused by light at the parts

54 REPORT ON THEmsmu'rs s or n smcmn .

that cover the cornea, or by any stimulus whatever aflecting the

special nervous tract. Besides the ordinary interest that we feel intracing subjective illusions to their sources, the accurate eliminationof these is a physiological necessity, if we would avoid the risk of

ascribing effects begotten by subordinate to more integral portionsof the apparatus , and thus forming wrong conceptions of the laws

which regulate the conduct of the latter. Finally, a diligent studyof these accidental appearances may be made serviceable for thesolution of certain important points of ocular structure of too

delicate a nature for the microscope or other usual meansof investigation, as also for determining important questions of

function .

”

Henn aproposes to divide the orhicularis palpebraruminto threemuscles — orbic. orbitalis, lachrymalis anterior, and lachrymalis postariot . The lachrymalis anterior, acting upon the lachrymal duct,causes its enlargement, and thereby induces the entrance of the

tears. The lachrymalis posterior, on the other hand, compresses theduct and forces the tears into the nasal cavity. Bans. thinks thatthe accommodation of the eye depends entirely on the change in theform of the lens. The adjustment, MANNHABT says, is broughtabout bythe ciliary muscle (alone) acting on the lens. a r gives

a somewhat similar explanation of its action . While 02m m says

that the adjustment of the eye for short distances most probablyarises froman increase in the antero-poste rior diameter of the crystalline lens . Mam thinks that the eyes of fish are capable of

adjustment, notwithstanding their possessing no ciliary muscle, andthe iris being scarcelymobile . The adjustmentmaybe induced, heimagines, by the action of the muscular fibres of the campanula onthe lens .

Lusmorr made experiments on the apparent extent of objects,by looking at themthrough variously-siz ed openingsmade in slides,and SEQU IN on the extent of the post-impression with the closedeye . The latter looked at a red square on a black ground, andafter projecting the given post-impression on a white screen, shutthe eyes and walked backwards. He found that by so doing thepicture appeared to become larger as he receded.

Ausnn'r and MBLSENS’s communications contain remarks on the

probable cause of post-impressions, and WILLIGEN’s on the effects

observed on looking through slits .

MARTINI states that for some hours after taking a dose of santo

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56 as soa'r on me ms'rrrurs s or I BDICINB .

Toynbee ,

— Ou the Mode in which Sonorous Undulations are conducted fromtheMembrana Tympani to the Labyrinth in the Human Bar. Proc. Roy. Soc"

No. 35, p. 33. Lancet, and Med . Times and Gas . 18th June, 1859.W ham— Ou the Mathematical Theory of Sound. Proc. Roy. Soc , No. 34.

P 59°

Llison (Scott),— Ou the Intensification of Sound. Proc. Roy. Soc . No. 34.

p. 4

Wi

t— Memoirs snr lea oaselets dc l’oreille et snr la membran do tympan.

[On the Bones of the Bar and Membrana TympaniJ Compt. Bend” vol. xlvii,1858, Oct., pp. 614, 615 ; and more fully in the l

’lnstitnt, 1858. Oct., No.

-s4l . a4tClaudia — Physiologiache Bemerkungen iiber das Gehororgan der Cetaceen und

das Labyrinth der Si ngethiere . [Remarks on the Organ of Hearing in the

Whale .) svc. Kid , 1858. l'roriep's neue Notin , 1858, vol. iii, pp. 335— 333.

Canst. , vol. i. p.Bonnafont — Reflcxions medico-psychologiquea snr certaines conditions de sens

dc l’oule et de la me. [On certain conditions of the Bar and Eye.) Revue

Méd. Pranqaisc ct Etrangére, June, 1858, pp. 705Bu dget — Annotation“ anatomico-physiologicm de sure exten t [On the

External Ban ] 4to. M ason“, 1857 .

Mooan san thinks that the membrana tympani is normallythrown into vibration in a twofoldmanner— rat, by sonorous undulations reflected upon it fromthe walls of the meatus ; 2d, by vibrations directly prepagawd to it fromthe external ear ; and that thesevibrations maybe impeded bymany causes, occasioned byan aperture in the membrane . Such as impaired elasticity of the membrane, diminished excursion of its vibrations , 8m.

Toms s s’s conclusions are not unsimilar, for he says— 1st. That.

the commonly received opinion in favour of the sonorous undulationspassing through the chain of ossicles to the vestibule is correct.

2d . That the stapes, when disconnected from the incus, can still

conduct sonorous undulations to the vestibule fromthe air. 3d.

So far as our pres ent experience extends, it appears that in thehuman ear sound always travels to the labyrinth through twomedia,viz through the air in the tympanic cavity to the cochlea, and

through one or more of the ossicles to the vestibule.

Eamvsnaw says, that the principal feature of his communicationis the discovery of an integral of a certain class of differential equations . This class includes the differential equation ofmotion whena disturbance is transmitted through a uniformelasticmediumcon

fined in a horiz ontal tube . He discusses wave-motion, when the

temperature is supposed to be unaffected by the passage of a wave,and when the change of temmrature is allowed for.

on wa s ow n s or s ense . 5 7

With respect to the velocity of sound, which bas hitherto beenfound experimentafly, to exoecd the velocityobta

'

med by theory, itia shown thst the value obtained byapproximative methods is theM W of aound-velocity, so that the actual velocitywill be

always greater ; the excess depending on the intensityand genesis

of the sound. It is shown that all thc parts of a wave do not travcl

at ths same rate— a circumstauce which leads to the formation of a

mm such as the doubler eport of firearms heard at a great dis

tsnce, the outrunning of one sound by another, observed by Capt.Parry, the comparative powers of difl

'

erent gases of transmittingsounds, and the laws of transmissinn of sound fromone medium

and velocity is shown to be that which is expressed by the

P=P¢7 5 L i

4a

Sem Au sox found that sounds which are faint when heard bya hearing-tube directly applied to solid sounding bodies, becomeaugmented when water is interposed between these bodies and the

dists l estremityof the hearing atube . He hss been able to hear, bythc employment of water, the sound of a solid hody, euch as a table,

in water. A picce of wood not thick cr than a papa -cutten when

mta posed between thc water employed and the mouth of the hearingotube materially iuterferes with the augmenting power of thc

of the experiments were perfiormcd with his diil‘

erential stethophone,Thbes

closed at their distal extremitywith solid material, such as glass,

do not answer so well as those clo ith membrane . A water

ststhoscope, if it be plaoed between the fiat ear-piece and the

external ear. The name of hydrophone has been given to it.Domin oes? says that he examined the drumof the ear with a

speculum, and could never detect it Vib rating, even when powerful

58 nsron'

r or: va n.mea sures or l aments .

militarymusic was being listened to. He noticed, however, thatin these cases the blood-vessels became somewhat congested .

Cu unms made some original observations on the ear of the

Cetacea, and came to the conclusion that the whale does not hearthrough the outer car, the Eustachian tube, or the bones of theskull, but that the sound is communicated indirectly fromthe waterto the air-filled tympanic cavity through the bones of the head.

Ben s on’s paper contains a critical notice of the anatomical and

physiological relations of the external ear.

SHELLING AND TASTING.

M and Stick — Usher den Ort der Geachmack svermittlung. [On the

Locality of Taste ] Virchosv'

s Archie fiir Pathol. An ton . vol. xiv, 1858.pp. 335— 343. Canst., vol. i, p. nos .

Stick — Usher das Ek clgefiihl. [On Nausea ] Annalee des Chart“ JahrgasgVIII, Berlin, 1858, pp. 2 2— 43. Ih., vol. i. p. roa.

m orn — 8m lea organs dea sens et en particulisr de l’odorat. da goht et da

l’ouie dana lea poissons. [On the Organs of Smelling.Tasting, and Hearing inFish.) Compt. Rend.. vol. xlvi, 1958, No. 19, pp. 867— 879.

ot — Su'l nervo ct su l'orgsno olfattorio. [Remarks on the OlfactoryOrgan and

Nerve ] 8vo. Mila n, 1858. (No abstract.)Bum— Note sur lea papilles de la langue. [On the Papilla of the Tongue.)

Compt. Bend , vol. xlvii, 1858.No. 16. pp. 61 2-614.

Kma 'rscn and Sn cn made a number of experiments with the

extract of quassia, a solution of white sugar, salt, and tartaric acid,in order to ascertain the exact seat of taste. The solutions were

applied to different parts of the month by means of a fine hairpencil. They found the soft palate ; but neither the uvula nor

tonsils, sensible to taste . The trachea was equally insensible .

This experiment was made on a patient with a cut throat.”

Klaatsch and Stich confirmthe opinion of old writers, that certainsubstances are only tasted in particular spots .

Bun s en . thinks that fish possess the sense of taste, but only bymeans of their organs of smell. Be an

’s paper on the papilla of

the tongue contains nothing new of any interest.

FEELING.

the Diphacmetric Compass. Beale’s Archiv. of Medicine, No. 4. 1859.

W op-On a Sixth Sense. Edie . Mouth. Med. Journ., 1859, pp. 733and 99a.

ON THE ORGANS SENSE.

— Beohaehtnngen. welehe su beweisan scheiaemdass durch die liehnngdu Gib da du m a dis du andm sngicieh mitgefibt werden. [On the

Efleet of Practice in Pertecting the Sense of Touch in the oppoaite Umb.)

nu Leipsig. vol. i. i 858. pp. 70— 76. Lem. i 858.

Yaw n — Usher den Biudnas der Uchang auf das Rrbenneu der riumlichenDistn aen . [On the EM of Practice in Becogniaing the Distance betweenTwo Points placed on the Limb at the same moment.) The same. pp. 38— 69.

M — Ueher Innervation in tn naplantirten Hautiappen. [On the Loss of

Sensibility in Transplanted Skin.) Verhandl. d. natun hiator. Vere ina d. lthein .

lands. vol. xiv. i 857. p. 94. (No abstract.)Win n -Bettin a snr Theorie der Sinneswahrnehmung. [On the Tactile Recog

nition of Distance.) Brate Abhandlnng. Usher den M blaainn mit besondererW cht auf deasen rafimliche Wahi-nehmt ngen.

’

Heolc uud Pfeul er’a

Zeitschritt fi r M otions -393. Canst., voL i,p. nos.

virtu e. [On tha Pov er poasessed by diirerent Parta of tbe Sk in in DetectingSlight Weights.) 8vo. Vn tislss ia n 858.

— De la mesnre de ia iimite dc sensibilite nem muaeulairs de

l'

honme etudie compan tivement l sa forcemeehaniquc. [Ou Ncuro-muscularSensibility.) Compt. Read” vol. xivii. i 858, No. 3. (Noabstract.)

— 8nr la sensibilit6 taetile et sur uumoyen de ls mesurer dansl'

ct l'hypsreathesie. J onm de Phyaiolog” voL i.

“ 6. (Repstition oi’

a fomcr communication on the meana ot' measming

mettle sensibility.— Valentin .)

reviews the observations made with regard to the powerpossessed by difl

'

erent parts of the sk in, in a physiologicalcondition, of detecting (so to say) the double impression madeon its surface when two points are madc to touch it within a

given distance of cach other. It was shovrn byE. H. Weber, in

1834, that difi'

erent parts of the sk in were unequally endowed with

Allen Thompson , Belfield Lefevre, Graves, &c. Ogle considers the

the geua'

al eubjeet of tactile sensib ility in a state of health, aud itsvarious subdivisions into the subordinate tactile senses of temperap

pathological instances, in which, owing to afiections of the nervous

Bequn d, Sievek ing, 8vo., of the physiological law established by

60 an on or: runman-n urse or m icw s .

Weber, as respects the contactilc scnsibilityof the skin . He uertretera to oaaea of diaeaaefi n which the contactile disa im

'matingpower maybc either increased or diminiahcd, and in which variations

extent the degrce in which the nervous systemis aficeted, and also

what advancesmayhave been made towards a re-establishment of a

healthy condition. He also shows what carcumstances exist capableof rendering the instrumentmpplicahle as ameans of diagnoa s.The nascaimos of the Diaphemetric Oomm is as follows :

The insk umenh which is about four and a half inches long cono

sists of a pair of mathematical compasses, with the usual joint,furnished with a circular dial-platc, whose circumference is dividedinto inches and te nths and twentieths of an inch, and provided with

any direction , so as to point to

the vm'ious subdiv isions. Thisdial is attached to the anterior

surface of one oi'

the legs ot'

the

its surface is moved by meansof a small-wheeled pinion be.

hind the diaLof which the pivotis connected with it through the

dial. Into this whceled pinion

(6) behind the dial work s a seg.

ment of a tooth-wheel (c), whichis attacbed to the other leg of

the compass in such a mannerthatwhen the legs are seperatcd,

is

working in the pinion moves the indicator on the face of the dial,andmali ce it point to the various subdivisions . Thus, as these subdivisions nro calculated and constructed with reference to the fact

that the legs of the compass open round the centre, and not in a

straight line (and consequently are not made equal), the exact distance at which the points of the compass are separatedmay at once

‘ l in thls iigurs shows ths froet vicw ol the graduated dial-plate. with

the indicator. No. a shows the posterior view.with the tooth-wheel working in the”w ”litmus

ON THE ORGANS OP SENSE.

he “read oil ” on the graduated face of the dial-plate . The ad

for similar purposes consists in the neadiness of measurement, owingto the great length of the graduations on the dial-plate, the facilityM whichn rith one hand, themessurementsmaybe tak emand the

about the joints or parts where irregularity or convexityof the

snrface exista .‘

into the existence of a Sbrth Seuse. To which are added Besearches

upon the Psychal Functions of the Cerehrumin relation to all the

Senses .

’

The author’s sixth sense resides chieflyin and ahontjoints,

u sh nding in opposition to ou'

residing in muscles—“resistance or

strmgth hd ng considered the normal stste of the sense, snd weight

as the ahnormal.”

q and Vou m n’s experiments were made with the view

of asoertaining if the power of distinguishing the interven ing dis

tanee cf two points plaeed on the sk in could he increased hytraining .

{Bicy found that afiermak ing several experimen ts on the lyi‘arm,

fire f it ecame more sensihle to distamm— and so with the sense

ol touch. Afiu pu ctising with the fingeu of one hand thosc of

the other gained in sensitiveness . From’

this they conclude thattraining chiefly affects the central nervous system. Fechner addsthereto, that training o

f the muscles of one side of the hodyto anyparticular movement increases the same powers on the Oppositeside . Volkmann found that removing the scarfisk in rendered the

sense of touchmore acute .

Wunm’ s psper is entirelydevoted to a theoretical exposifion of

the sense of touch. Kammlec, on the other hsnd, relate s experi

m u to show that the sk in of the hrow and neck is the mostsensitive to alight v eights, while thst of the palm and hack of

the hand is to heavier ones. This, he says, is a proof that thc

acuteneas of this sensc doea not depend upon the numher of tactilepapilla .

“the instrumentmayhe obtained atMessrs. Elliott and Ooh . instrument makers,

62 u pon or: runmarrrurns or MEDICINE.

RESPIRATION.

h im(mm ,— Bxperlments on the Phenomena of Bespiration. Proc. Roy.

soc” No. 34. p. 61 1. lancet, 39th Jan ., p. 1 10.

[ men — Beitfi ge ‘ snr Theorie der Respiration. [A Contribution to the Theoryof Respiration.] (Wiener Med. Wochenschr., 1858, No. 44, pp. 770, 77 1 .

Annal. der Chem., vol. cviii, p. 357. Csnst. p. 54. Beale and “sin ner,

“ J'

mgya ,

— Ueher die Diffusion der gases dnreh fenchte llamhranen. [On theDrfl usion of Gases through Moist Membranes.] Munich, 1857-8.

Wh am-hold,Die Ansscheidung tester Stod'e dnrch die Lnngen. [On the

Excretion of Solids by the Lnngs.] Dentscbe Klinik, No. 18. Heals and

Meissner, p. 358.

rm — Sur l’absorption et ‘

le dégagement dea gas de la Respiration at par les

dissolution salines et is sang, arc. [On the Absorption and Exhalation of

Gases by the Blood and Saline Solutions.) These. Par is, 1858. (00aBend , 1858,No. 13, pp. 630— 634 No. 14, pp. 644 B eale and lleissner,p. 358, 1859, part 3. Canst., vol. i. p. 54.

Smith (Edm d) ,— On the Action of Food upon the Respiration. Proc. Roy.

soc., No. 34. p. 638. Lancet, Feb. s6th , 1859, p. 316.[ qua

— De Sanguine oxydo carbonico in facto. [On the Expiration of CarbonicAcid ] 4to. Va l id a te , 1858. Canst. , vol. i, p. 54.

mold — Usher die Wirk ung der Brnstmnsk eln bei der Athmnng. [On the

Action of the Thoracic Muscles in Respiration.] (Die physiol. Anstalt inHeidelberg, pp. 146

Turk — Der Kehlk opfrachenspiegel (Speculumfor the Larynx) und die Methods

seims Gebranches. (Zeitschr. d. Gesel. d. Acu te in V iew . 1858, No.

w Physiol. Untersncbungen mit Garz ia’s Kehlk oplspiegel. [On theLaryngeal SpemlnmJ (Sitz nngsber. d. Wien h ad , 1858, No. 13, pp. 557

(Schmidt, vol. 10 1, No. 3, p.rm-Ou a Convenient Instrument for examining the base of the Tongue and

Epiglottis. Lancet, Dec. 34, 1859, p. 643.

EDWARD SMITH gives the results of a series of experiments on thequantity of air inspired and carbonic acid expired, with the rate of

pulsation and respiration . 1st. In the whole of the twenty-fourhours, with and without the excretion of food ; 2d, the variationsfromdayto day, and fromseason to season ; and 3d, the influence

of some kinds of exertion .

The apparatus he employed consists of a spirometer to measurethe air inspired, capable of registering anynumber of cubic inches ;and an analytical apparatus to extract the carbonic acid gas and

vapour fromthe respired air. The former is a small drygas-meter ;the latter, a desiccator of sulphuric acid to absorb the vapour, a

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64. s n ow on ma Insu re-ms or u smcma .

grains of carbonic acid per minute, and at three miles perhour of 3 grains . While the effect of the treadwheel at

Coldbath Fields Prison was to increase the quantity to 48 grains

perminute .

MULLER analysed air in which rabbits and small dogs had beenasphyxiated, and found that when the volume of air was exceedinglysmall the oxygen disappeared almost entirely from it, while thecarbonic acid gas rose to from10 to 15 per cent. If the volume ofair was greater than the volume of the animal, the oxygen remainingwas seldomunder 5 per cent. When the experiment was somadethat the animal always breathed fresh air— the expired gases beingremoved— it was found that from6 to 7 per cent. of oxygen in theatmosphere sufi ced to support life . When the animal was put intoa small volume of pure oxygen gas and allowed to die there, nearlythe whole oxygen disappeared ; whereas if the volume of oxygen inwhich the animalwas placed was considerable, it became asphyxiatedwhen the carbonic acid gas amounted to from56 to 58 per cent.,and the oxygen had diminished to from30 to 36 per cent. Amorecomplete account ofMiiller's experiments is to be found in the ‘Ann.

(1. Chem. 11. cviii, pp. 357— 312, Dec., 1858. The conclu

sion drawn fromthemis, that nearly the whole of the oxygen can be

extracted by the living blood fromthe inspired air, and so quick lytoo that it is highly probable that it enters into direct chemicalcombination with the constituents of the blood, a small portiononly remaining physically absorbed . In this respect Muller's resultsare Opposed to the theory of Magnus, and confirmthe experimentsof Harley .

l The chief features of respiration lie, it appears, inthe fact, that while the constituents of the blood go on absorbingthe oxygen, and thereby diminishing its volume (and consequentabsorption-pressure) they at the same time continue to yield up a

constant supply of carbonic acid, which, gradually surmounting theabsorbing capacity of the blood, becomes exhaled.

Bamn sran’s experiments on hydrogen, oxygen, carbonic acid,

and atmospheric air, led himto believe thatgases, in passing throughmoistmembranes, obey the law of absorption .

WIEDEBHOLD says, that from a number of careful observationsthat he has made, he has come to the conclusion that the lungs, likethe sk in and kidneys, excrete inorganic as well as organic sub

stances. On collectmg a large quantity of expired air, and testing

Brit. and For. Med Chir. Ren ,

’vol. xxxvi, Oct. 1856, p. 413.

nes r rna rlon . 63

it w ith suitable new ts , he found that it contained chloride of

as a small quantityof urea . He was even able to obtain these sub

starices in a crystalline form.

Pm and Mam have both studied the influence of the salts

ments with carbonic acid and an aqueous solution of carbonateof soda fi owrad that while one part of the gas is chemicallycom

remaining in solution is, how ever, smaller than (according to

Dalton’s law) it would be in pure water. The more con cen

by combining with the carbonic acid, becomes a bicarbonate . A

ph ce-phyxical absorption onlyoccurs .

The serumof ox-blood behaves towards carbonic acid gas in the

same way as the solutions of carbonate and phosphate of soda.

A solution of carbonate of soda, or of phosphate of soda, tak es up a

quantity of oxygen greater than that tak en up bypure water. A

solution of ccmmon sd t on the other hand, absorbs less ; and serum,

again, chemically unites with a quantity of oxygen, over and above

law only. If hlood be long exposed to a stream of carbonic acid

gas, the blood-corpuscles are destroyed, whereas they are not aflectedby either oxygen or hydrogen gas .

Sl rm’s aimin this commun ication is to show the variations in

the influence of food . His method of inquiry is, to talte a

whilst the bodyis at rest and in a sitting postm'

e, and to deter

mine the influence everyten or flfteen minutes during a period of

about two hours . The results obtained led the author to conclude

1 st. That pure starch scarcely increases the amount of carbonicacid evolv ed ; but with the addition of gluten and sugar, as in the

cerealmcauses an increase of about two grains per minute . 3d .

Fats la w the amoun t of carbonic acid evolved, but increa e

pulsation . 3d. Sngara increase the exhalation of carbonic acid

to the mn imum extent of from to 3°

5 grains perminnte in5

66 Reports on ma ms'rrrurs s or MEDICINE .

about half an hour. Cane is more powerful than milk sugar, and

still more so than grape . Acids increase the maximum influence

of sugar. 4th. Milk increases both the pulsation and the carbonicacid, the latter to a maximum of nearly two grains per minute .

All the component elements have a similar efl'

ect, but new milk ismuch more powerful than anyof its elements separately, or thananyartificial combination of them. 5th. Tea and coffee increase

the production of carbonic acid to the extent of fromone and a halfto three grains per minute. Tea is more powerful than coffee,

and coffee than chicory. Cocoa is as powerful as cofl'

ee . Acidadded to tea makes it more stimulating ; alkalies make it moresoothing . 6th. Alkalies differ in their efl

'

ect, both as regardsthe kind and difl

'

erent M ple. Spirits of wine always increasesthe quantity of carbonic acid evolved to amaximumof less thanone

one and a half grain per minute. Ale and stout increase it to

upwards of one grain per minute . Sherry wine (three ounces)commonly increases it. Brandy and gin, and particularly the

latter, always decrease it. Whisky varies in its effects . The

inhalation of the volatile elements of wine and spirits, and par

ticularly of fine old port, lessen the quantity of carbonic acid, andincrease the amount of vapour exhaled.

The non-mitos is are starch, fat, some alcohols, and coffee-leaves.Ilia resp iratory exciton“ are sugar, milk, the cereals, potato, tea,coflee, chicory, cocoa, alcohol, rum, ale, some wines, gluten, casein,

All the respiratory excitauts increase the depth but not the

rate, of respiration . Some of themproduce much greater effect

when a small dose was given, and frequently repeated, than whenthe whole quantity is taken— such as tea. The evolution of

carbon is greater than the amount contained in the excitant.ARNOLD made a number of experimcnts on animals (stunned by a

blow on the head), in order to ascertain the movements of the

thoracic muscles during respiration . The raising of the ribs andthe widening of the thorax is still possible after section of the pec

toral and serratusmagnus muscles, which proves that they are not

essential to respiration . During gentle respiration the abdominal,move much more than the thoracic ribs . This is in consequenceof the action of the diaphragm. The first rib does not moveat all,-,cxcept in deep inspiration . During the raising of the

vmu. cars crrr or run LUNGS . 67

true ribs the internal as well as the external intercostal muscles

to stndythe movements of the varions parts of the larynx during theamd mpin fiomawaflowing and speak ing . Themirror of the spemlmn is a four-cornered glass or metal plate, fromsix to fourteen

lines (Ausu'ian) in diametqr ; it is attached to a piece of wire, bywhich it can be passed into the back of the throat. In order that the

breath maynot dim its surface, it is slightlywarmed before beingused. It was ascertained that — rst. In normal respiration the

vocal cords are so wide spart that the fingers may be passedbetwem them. 3d. In forced inspiration the Opening is widened.

3d. In forced expiration slightly conne cted. 4th. In speak ing, the

Parcx’s instrnment is almost the same as Grasia’ s .

m -Altsssvereodernngen der Athmnnp cspaeittt. (Profi ep’s neue Notincs ,

1858. No. 31. pp. 331— 336 ; No. 33. pp. 337— 346. (An extract fromthe

aathos’ s work on Old Age— d cct ofmn the Vital Capacity.)

M — Cspacité vitale do Ponmon , ses rapports physiologiques et pathologiquessvec lesmslafi es de la pcitrine. [The Relation between the Vitsl CapacityandPulmonarym uons-J PM “. 1858.

Cam ] (Die pbpmi u w mnads ba gmn 146— tst l

Em u — Du b b suivent les quelles les dimensions du corps dans eertaines

elassu d'

aaimamdeterminent la capaeité et des monvements fontionelles deaPoumons st dn Ctenr . [On the h ws which negnlate the Capacity ol the

M M ] m . 3857.

— De la eireonference de la poinine et de l'

elasticit6 ds la cage thorseiqne

par rspport h ls espacité vitale dc Poumon. [The lnduenes ol the Circnmo

fu eaee andmasfieiq ct‘

the‘

l‘

horsx on the Vital Capacity.] (Ba l la deM “357.No st. 9

The preceding articles treat of the vital capasityof tbe lungs as

measured bythe spiromete r, and the value of that instrument in thediagnosis of pulmonary discu s . Ans onn

’s monograph requires

made on the hnman subject he has shown that thc quantityof airinspired by a heslthyindiv idual can be calculated with

like mctitnde if the foflowing facts be k eptmview— rw'l‘

hc

68 neronr on ma msrrrurss or MEDICINE .

vital capacity of aman increases with his stature, in the proportionof cubic inches for every inch in height. If, therefore, a manof 62 inches in stature possesses an average vital capacity of

cubic inches, another of 68 inches stature will have a breathingcapacity of cubic inches, and a third person, 72 inches inheight, a capacity of 288 8 cubic inches . 2d. In men the vitalcapacity increases with the circumference of the chest in the sameratio, namely, cubic inches for every inch of increase in thoraciccircumference. If the chestmeasures 26 inches, the vital capacitywill, on an average, amount to 165

°

12 cubic inches . With a thoraciccircumference of 32 inches it will increase to 2 2 27 cubic inches ;and if the circumference be asmuch as 36 inches, the vital capacitywill be no less than 2 26°

l 2 cubic inches . 8d. The mobility of the

chest has a great influence over the vital capacity . Its valueincreases with the stature and with the circumference of the chest.

4th. The vital capacity increases from the fifteenth to the thirtyfifth year of age nearly cubic inches, and sinks fromthe thirtyfifth to the sixty-fifth about 57

°

5 cubic inches, at different periodsand in different proportions . 5th. The position, occupation, and

mode of life have an undeniable influence on the breathing-capacity .

It is at itsmaximumamong sailors, soldiers, and strong youngmenwith out-door occupations ; at its mediumamongmechanics, com

positors, and pressmen ; and at its minimumamong paupers and theupper classes . 6th. In women the vital capacity is absolutely and

relatively less than in men . It increases in the female sex at the

rate of cubic inches for every additional inch in height, andwith the circumference of the chest in similar proportion .

Arnold gives a very complete set of tables for calculating thevital capacity of any individual ; the height, thoracic circumference,mobility, &c., being taken into account.

DIGESTION .

Gilbert— Ou the Composition of the Animal Portion of our Food and its relation

to Bread. (Quarterly Jour. of the Chem. Soc., April, 1859, vol. xii, p.M ega n — Guide to the Food collection in the South Kensington Museum.

London , 1859.

COM M — 0° an imperfectly known Function of the Pancreas. (Lancet, 36thFeb., 1859, p.

Rafa-stein and Baum -Usher die einwirkung dea pancreatischen Saftess td Eiweiss. [On the Action of Pancreatic Juice on Albumen ] (Giittinger

gslshrte Anz eigen, August, 1858, pp. 145— 15

monsr ros . 69

Brigham— Os the Digestion of Protein Substances by the Pancreas. (DublinQuarterly Journal, August. 1859. p.

M tg — Usher die Function des Pancreas. [On the Function of the Pancreas.)(Schmidt's Jahrb s vol. 97. pp . s x— as.)

M et Colin — Memoire snr l'catirpation do Pancreas. [On the Extirpationof the Pana cea.) (Bullet. de l

'Acad. da MM" Feb., 3858. pp. 2 50 — 164.

Canstatt, vol. i, p. 35, and following.)sw im — Some Remarks upon the Criticisms late ly made upon the Digestion ofAlbuminous Bodies by the Pancreas. (Lancet. s8th June. 1869. p.

“ m u — Lem der Nehru gsmmel fur das Volk. 3d ed. Erin ” , 1858 .

[A Popular Treatise on Food.) Tbe first edition of this work was translated

into English by Dr. Brenner.

Selim-Usher die Bewegnngen des weichen Gaumens beimspreehen und Sehluek en .

[On the Movements of the Soft Palate during Speaking and Swallowing.)(Wren . Med. Weehensehr” No. 3, pp. 33— 36,

Tronsseau — Rl ppofl m h Um“ do VGM M [0u Helm of the

(Esophagus) (Bullet. dc l’

Acad . de ma . vol. xxili. pp. 999. xo6s , ro7s.l“it" : l 858-l

mug — Lip ton de l’

tBsophage. [The same.) (Gas. dea nap. May. 3858.

p .

mutant — 30! quelques perfectiennements h apporter dans l'etablissements deafistules gastriqnes artificielles. [On an improved method ofmak ing an ArtificialGastric Fistula.) (Jour. de Physiol., vol. i. 1858. pp. 89

w ot — Nonsense Beeherches snr la Digestion. Premier Pattie. Snr le principe acide du suc gastrique. [New Baperiments on Digestiom On the Acid ol

the Gastric Juice.) (ih.. pp. 308M t]; et un i — Bur la Transformation dc l'Amidon en Glucose dsns

PM [On t Transformation of Starch into Sugar in the Stomach.)(ih pi»ml

M eaghan — UM den Einduss dea Msgensaftes an! die umwandlong dea

stsrkmebls in Zuelter. [On the influence of the Gastric Juice on the ‘

rrans

formation of Starch into Sugar.) (Deutsche Klinlk , No.

mum-Usher die verdauung dea thierischen Biweisses. [On the Digestion of

As tana! Albumen.) (Die physiol. Anstalt v. Heidelberg, 1853

comm a-Gulls digestion. dell’ Albumina Vegetabile . [On the Digestion ofegetahle Albumen.) Tor-inc. i 858.

rim — Smin digestion . [On Digestion.) (Cornpt. Bend .Jan .. 1858.pp. s7. s8.)— Zur Physiologic dea Dickdarms. [On the Physiology of the Large intes.

tines.) (Schmidt's Jshrbneh., vol. 98, pp. i s3 and 858. Valentin says thatit contaias nothing either elear or new.)

Bun k — Being aur Physiologic der Verdanungs-organe. [Contribution to the

Physiology of the Digestive Organs.) (Virchow's Archiv, vol. xiv, pp. sac

h u m — Usher die mineral. Nfihrstofl ’

e, insbesondsne liber die Brdpbcsphsteslsmemoirs dea jungen thief . Organismns. [On Inorganic Food. especiallyon the Earthy Phosphates in the Food of Young Animals.) Mob . Annal.,‘Ol. '°8s P‘ 357'

Gu nner’

q ier ooutains the results of expm'imental data, showing that the largest part of the solid substsnce of the animal body

70 arrow on ran l iss'ri ru'rss or MEDICINE.

is fat. On the other hand, the dry, nitrogenous matter, even including the wool in the case of sheep, is less than half

,and

sometimes even less than one third, of the quantity of dry fat.

Only a small proportion of the increase of a fattening animal isnitrogenous substance. Therefore the relative value of fatteningfoods depends more on the digestible, non-nitrogenous, than on the

nitrogenous material they contain . It appears, therefore, that theadmixture of animal with farinaceous diet does not increase, but

diminishes, the relation of the flesh-forming to the fat-formingcapacity of the collective food.

Convrsan'

r'

s experiments upon the pancreatic fluid have led himto the same conclusions as those arrived at by Pappenheim and

Purk enje many years ago, namely, that the pancreas, as well as thestomach, secretes a substance capable of transforming proteinmatters into peptone . He thinks that the pancreatic juice is intended to act upon that part of the albuminoid substances whichhave left the stomach before being transformed into peptoneand that a secondary duodenal dyspepsiamayresult from a faultypancreatic secretion . It may be cured, he says, by treatmentsuited to gastric dyspepsia.

Knrs nsrmN and HALLWACHS experimented with pancreatic juiceobtained froman artificial pancreatic fistula ; but did not find thatit possessed the power of digesting albumen, and transforming itinto peptone . On the contrary, they thought the efl

'

ect Corvisartdescribed was simply due to putrefaction .

The title sufficiently indicates the object of M. Corvisart’ s secondpaper. He relates onlyone new experiment in support of his view sregarding the power possessed by the pancreatic juice of digestinghard-boiled white of egg. He says that thirty-five grammesof albumen were completely digested in a dog

'

s duodenum in the

space of fifteen hours, and that the reason why Keferstein and

Hallwachs failed in their experiments was on account of their employing pancreatic juice secreted un der abnormal circumstances .

Be rox finds that the action of an infusion of the pa ncreas on

coagulated albumen is very irregular . It sometimes dissolves a

large quantity, and sometimes none at all. The pancreatic solution,he says, is much slower in its action on albumen than gastric juice,requiring fromtwo to six times longer time for its efl

'

ects to be well

marked. He says, too, that the action of the pancreatic fluid isaccompanied in some cases by a putrefaction, which in others is

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72 a n on on r a n mea sure s or MED IC INE .

SMITH and BROWN-SEQUARD call attention to a fact already wellknown— namely, that starch is transformed into sugar in the

stomach. BABDELEBBN imagines that the gastric juice itself has thepower of producing this transformation . Other observers believe,however, that when starch is changed into sugar in the stomach,some saliva or mucus secretion from the oesophagus or otherpart of the digestive canal must have mingled with it, for pure

gastric juice out of the stomach has not the power of changingstarch into glucose . Arnold found that uncooked white of egg

is not coagulated in the stomach, and that, other things beingequal, it is more rapidly digested than hard-boiled. FLORENT

PREVOST confirms the fact that many birds alter their food at

diflerent periods of life ; some begin by living on in sects, then

change to corn , afterwards returning to insects . All of the fore

going papers contain valuable information . We have not, however,space to give a fuller abstract of them.

Boson relates the very interesting case of a woman , wt. 3I , with

a jtijunal fistula (wound made by bull’s horn), on whom he

made a series of experiments . He ascertained— I st. That the tem

perature of the intestines does not increase during digestion . 2d.

That the sensation of hunger does not depend on the stomach beingM pty. (She felt hungry even when the stomach was quite full .)3d. The peristaltic action of the intestines is not constant. (It

entirely ceased fromI I o’clock at night to 4o

’clock in the mornin g.

This state of repose occurred whether she was asleep or awake ;whether she had taken supper or gone to bed fasting.) 4th . Anti

peristaltic as well as peristalticmovements exist. 5th . The intestinal

juice is always alkaline . 6th. It transforms starch into sugar,

but does not change on e into grape-sugar. 7th . Albumen and

fibrin are dissolved in the intestines . 8th . A mixture of gastric,pancreatic, and intestinal juices along with bile, dissolves albumen,even when the mixture is neutral or alkaline.

LEHMANN made a number of experiments on calves, with the viewof ascertaining if their food contains sufficient earthy salts for the

growth of their bones . He has given his results in a tabularform. The following is one of the most instructive of the tables, asit shows That the metamorphosis of the tissues duringfour days is tolerably regular. That the quantity of the solidsexcret ed in the first forty-eight hours is about the same as in thelast, although the quantity of water is less .

DIGEST ION . 73

74 REPORT ON THE INs'rIrurss or MEDICINE.

Fromthe results given in this and other tables, Lehmaun con

eludes — I That calves often receive too small quantities of limeand phosphoric acid ; while they, at the same time, receive an

excess of magnes ia. 2 . That hay is the food which furnishes to

the calf the greatest amoun t ofmaterial for the growth of the bones .

3. That the mineral substances required for the growth of bone

(lime, magnesia, and phosphoric acid), when given in the formof

powder, are digestible. (‘Canst. J p. I

AB SORPT ION.

want — Experiments on some of the various circumstances influencing CutaneousAbsorption. (Proceedings of Royal Society, No. 36, p.

t ank er -Deb“ das endosmotische Verhalten der Peptone. [On the EndosmoticEquivalent of Peptone .) (Virchow ’

s Archiv, vol. xiii, pp. 449 Canstatt,

vol. i., p. 43, and following.Ludwig

— Physiologic der Endosmose. [Physiology of Endosmose.) (Froriep’sneue Notiaen, vol. iii, r858, Nos. I and s . This paper is an extract of the

chapter on Bndosmuse in his Text-book.)

mam -Die Absorptionswege des Fetter. [On the Absorption of Fat.)

(Moleschott's Untersn vol. iv, p. ssr.)

M m — Baperimeutal-Untersuchungen ueber die Ursache der Chylus und Lymphbewegung und der Fettresorption. [An Experimental Inquiry into the Originof Lacteal and Lymphatic Circulation .) 4to. Le ip z ig and Heidelberg, 1858.

Bu ng— (Jew d ie Chylusgefi sse der Voge l. [On the Lacteals of Birds.)

(Zeitschr. f. Wissenschaft. Zoologie, vol. ix, pp. 3o I—3o3.)

xohlgr, Usher den Unterschied inder aufsaugung z w ischen hungernden und

get'

utterten Thieren. [On the Relative Rapidity of Absorption in Animals Fasting and Digesting.) 8vo. Marrow , r858.

1 0d“ .

-A0mabdominall subligata, vasa lymphatice non resorbere experimentisdemonstratur. [Experiments on Absorption by the Ia cteals.) 8vo. Gryp lss

’

c ,

I858.

Bchm dg — Ueber diequantiti t der in bestimmten Zeiten und unter verscbiedenenUmsthnden ahgesonderten Lymphe. [On the Quantity of Chyle formed in a

given time.) (Wiener Med. Wochenschr., I858, pp. 236Kohnhom— De Cataracts aqua inapla effects. [On the Artificial Production of

Cataract.) Gryp hia , 1858.

WALLEB says that one of the simplest modes of demonstratingthe existence of cutaneous absorption is by immersing the leg of a

young guinea-pig in a mixture of equal parts of chloroform and

tincture of aconite . In fifteen minute s the part w ill be foundinsensible, and, after a short time, symptoms of poisoning supervene— even death. The influence of age, or of thickening of the cuticle,

can be demonstrate d in the same way; if an adult animal be

ABSORPTI ON . 75

disturbance of the respiration , &c., supervene . If the chloroformbe omitted (under the same circumstances as flI-st related), neither

are observed. Section of the sciatic nerve iu the adult animal

of the lsmed extremity in simple tincture of aconite . Waller-thinksthis arises fmm the paralysis of the blood-vessels, allowing the

blood to flow faster within them. . The foot, after division of the

Ligaturing the limb,although it imp da the pom of ahw rpfi on, is la s efi d ent thm

On substituting atropine for acouite, and an albino rat for a

A sclntion d atropine in chloroform (half a grain to a drachm)dilata the pnpil after the foot has been irmnersed in it from two

to five minutes . Immersion of one limb dilutes both pupilsequally. The local effects of the immersion are— heat, rednem,

cf blood frcsn sonie of the smaller vessels . The pa rt is less sen

sible ; but in uo case insensible . When a solation of atropine in

turpennfne is employed, the pupil scarcely, if at alLdilates during

suimal shows signs of pain, and mnch inflammation of the part

Atropine and alcohol .— Dilatation of the pupil can only beobtained in this csse after homtwentyto thirtyminutes .

Atropine iuwater,with the addition of sufficient acetic acid for itssolution — M on onIyoccurs in this case after thirtyminutes .

Waller found thst, contraryto what might have been expected,we papfls dilste when the foot of ther at is k ept five minutee ina mlntion of half a grain of the w etute of morphia tv eutydrops ofalcohoh and one drachm d chloroform.

' With a solution of

strychnine and chloroform, the pupils dilate after three minutes’

immersiou ; sfter five, spasms come on ; and in two minutes after

the removal of the foot fromthe mixture death ensues . In atrydh.

nine snd aleohol the foot may be nnmersed thirty-five minutes

REPORT ON THE I NSTITUTES OF MED ICINE.

Horn the above-cited observations it appears that the rapidity of

cutaneous absorption greatly depends on the menstruumemployedfor dissolving the poison .

As albumen undergoes during the digestive process an importantchange before it passes through the walls of the intestines into

the blood, it is possible that the object of this change is to renderitmore easy of absorption . FUNKE put this theory to the test, andascertained that peptone has a very much higher endosmoticequivalent than simple albumen . A solution of peptone, made bydigesting white of eggs in artificial gastric juice prepared fromthe pig

's stomach, is as rapidly absorbed by the intestines as a

solution of sugar, whereas only the smallest quantity of pure albumen passes through the intestinal walls .

BAIDENHAIN says that the roots of the epithelium-cells lin ingthe frog

'

s intestine have long, fine fibres attached to them (likewhat Gerlach described in the brain ) which ente r the mucousmembrane, and end in little swellings . If the frog is made toswallow oil, and the intestines be afterwards examined, the epithe

lium-cells, the fibres, and the swellings at their extremities , are all

found filled with oil. Fromthis he concludes that these fibres forma system of hollow tubes, which communicate with the lacteals.

This communication has not, however, been observed.

RECLAMmade a number of experiments in order to show that theexhalation of watery vapour fromthe lungs and skin excite s a cur

rent (of fluids) in the tissues . An d further, that the rapidity of in

testinal absorption depends upon the rapidity of the cutaneous and

pulmonary evaporation . (His experiments scarcely admit of thisconclus ion — VALENTIN .)BASSLINGER observed a network of lacteals in the intes tinal walls

of the goose, and a quantity of fat-globnice in the chyle .

KCHLEn’s experiments were made with the view of ascertaining

whether poison acts quickest on animals while digesting or fasting.

He foun d that fasting animals were most slowly poisoned, and this

he supposes arises fromtheir circulation being slower. The efl'

ect

was most marked when the poison was not introduced into the

stomach, but into the subcutaneous cellular tissue .

MEDEB. found that after ligature of the abdominal aorta, the

lymphatics do not take up strychnine.

SCHWANDA calculated the quantity of Chyle passing through thethoracic duct (of dogs) in one hour. The maximumquantity he

sEcaE'rw N. 7 7

found to be 7'839 grm. in an animal weighing 774C grm. The

minimum gun . in one weighing I3,3o3grm.

He foun d that frogs live until they lose fromthirtyto fortyper cent.

water be rapidly given them,the animals take it up, and actually

became heavier than they were at first. The fluids of the eye do

not appear to be p roportional/y affected . The cornea becomesflattened, and the lens sometimes dim. On giving large quantitiesof a lt to dogs, cats, and rabbits, he found, as Kunde said, that

SECRET ION .

Imam— Os the influence of Vitality on Secretion. Brit. Med. Jour., 30th April.is. 350 . And on Excretion. n th June, p. 46 s. 1859.

— Remarks on Dr. lnmn’s Paper, ath June, 1859. Brit. Med. Jour.,

P' 442

M — Beeheeehes sur la Transpiration dite insensiblc. [On lnsensibleration.) ate. Paris , 1857. (A compilation of known facts — Valentin.)m -Beitri ge aur Kenntniss der Schm u cretion. [Contribution to our

Knowledge of Cutaneous Persptrafion.) (Moleschott's Untersucbungen , vol. iv.

was. as» 36— srolet “ pa

— Memoirs sur les phenomena pathologiques. physio.

logiques, et chin: ques, produits par les injemions d'air, d ’

ssote , d'

oxygene ,

d‘ecide u rboniquq et d'

bydrogéne , dans le tissu cellulaire et le peritoine.

[On the Sfleets of the Introduction of Air, Oxygen.Carbonic Acid, and Hydrogen into the Cellular Tissue and Peritoneum.) (Compt. Bend , vol. xlvi,March. I858. pp. ( us

W — Sur les varis tions des conlenrs dsns le sang veineux des organes glandu

laire. [On the vas-iation ot Colour in the Venous Blood ol Glands.) (Compt.

Bend . vol. xlvi. Jan ., 1858. pp. I59— 165. Jouru. de Physiol.. 1858. pp.

ass-u h )

M — De l‘iaduence de deux ordres de nerfs qui déterminent les variatious de

couleur du sang veineux daus les orgaues glsndnlaires. [On the influence of

the Nerres iu Detennining the Colonr of the Veaons Blood of Glands.)(Cou rt M July. 1858. pp 245

Da nn i — 8m la quantite d’oaygeue qui sentient is aang veineux dea organes

glandulaires i l'etat de fonction et 3Past de repos. [On the Quantity ofOxygen in the Venous Blood of Glands during the period of Active Secretion

M 01m } (Cou rt Read Assn“. pp 393

“mm — Notesmr la colos‘i tion rouge de ssng veiaeux. [On thect

Colour of Venous Bleoil.) (Bulb h de l’Acsd de Bs-uxelles, i 858, No. 6,

m» 1— 7

78 REPORT ON THE INSTITUTES or unmow n.

Cu rmach — Ueber die Beihi lfe der nerven z ur Speichelsekretion. [On the In .

fluence of the Nerves on the Salivary Secretion.] (Moles. Unters., vol. v, pp.

73—

9°

Bum -The same. H. u. Pf.’a Ztschr., vol. 7 , p. 334.

Ludwig und Bpim— Vergleichung derWarme dea Unterkiefer Dn’

iaenspeichels

und dea gle ichseitigen carotidenhintes. [On the Dil erence in Temperature of

the Saliva fromthe Submaxillary Gland , and the Carotid Blood.] (H. u. Ff.'

a

Zeitschr. fur ration. Med.. iii Reihe, vol. ii, pp. 361

HILK .

Schloubergor ,— Menaehliche Milch von ganz enormen Fettgehalt. [Human

Milk containing an immense Excess of Fat.] Annal. der Chem. u. Ph ., vol.

108, p. 64.

Trum an— Der Biweissgehalt der Kuhmilch. [On the Albumen of Cow ’

s Mills ]Deutache Klin., 42 , 1858.

I onian — Nouvelle methode pour l’analyae da h it an moyen de liqueurs titrées.[New Volumetric Method of Analysing Milk ] Compt. Read , vol. xlvi, 1858,

pp. 336 and 435.

mouon mmr.

‘

ewfl — Dc Substantiarum. qua liquoribua Amnii et Allantoidis ineunt

rationibus diversis. [On the Composition of the Allantoid, and Amnioticl'luids.] D issert. inang. Dupe“, 1858.

In his first paper, Inman points out that exces sive secretion is a

more frequent concomitant of debility than of strength, and bringsforwardmany cases in illustration of his views. Su nnnn, in his

remarks on the paper, thinks that Inman has confounded two

essentially different processes— a ctive and passive secretion, and

believes that whenever we have an augmented secretion, as the resultof weakened power, we ought to regard it, not as an exaltation of a

physiological act, but rather as a purely physical process. In his

second paper, Inman implies that all excretions have a certain

degree of vitality, which prevents their undergoing decomposition ,and that the decomposing process begins when the vitality isdestroyed ; consequently he regards the vitality of an excretion as

the criterion of a patient’s strength ; the quicker the excretion

decomposes, the weaker being the vital power of the individualwho passed it.FUNK! calculated the quantity of sweat given out by diflerent

parts of the body during an hour or an hour and a half of active

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80 answ e r on me ms'n 'rurns or MED IC INE .

results follow the injection of the before-named gases, either intothe peritoneum or subcutaneous cellular tissue, although some of

the gases (especially oxygen ) did not entirely disappear for a weekor two.

In experimenting on dogs and rabbits, BERNARD observed thatthe blood returning from the kidney by the renal vein was of as

bright a scarlet colour as that going to it by the artery. He furtherobserved that this state of things only existed so long as the secre

tion of urine continued. If fromany cause the urinary secretion

was temporarily arrested, the blood return ing from the kidney hadthe usual venous hue . The same thing was observed to occur in

the blood of the submaxillary gland. That is to say, during thetime the gland was secreting saliva, its venous, had the same colouras its arterial blood. On the other hand, while the gland was in a

state of repose, in as far as the secretion of saliva was concerned,the blood in the vein was of the usual purple tint. Bernard further observed that section of the nerve-twig which the gland re

ceivas from the lingual branch of the fifth— this twig, properlyspeaking, comes fromthe seventh, and only accompanies the fifththrough a certain part of its course — immediately arrested the

salivary secretion, and caused the blood in the vein to resume theusual dark colour. Whereas, when galvanismwas applied to the

peripheral end of the divided nerve, the secretion was resumed, andthe venous again resembled the arterial blood in colour . Thus

, it

would seemthat the effect of functional activity, upon the colour of

the blood of glands and ofmuscles, is reversed ; for it is well knownthat the more actively a muscle contracts, the darker is the hue of

its venous blood. Bernard promises to explain the peculiar actionof the gland-tissue above alluded to in a future communication .

One on and Tnmnnxssn obtained somewhat different results fromthose just mentioned . They studied the question on the kidneysand maxillary glands of two dogs, on the kidneys and parotids of

four horses, on both submaxillary glands of a sheep, and lastly, onthe kidneys of a rabbitand another dog. The conclusions are that

I st. The venous blood of the kidney during repose is as dark as

that in the inferior cava. 2d. During the time the kidney issecreting urine, the blood becomes purple-red, but never attains thebright-scarlet hue of arterial blood . 3d. The venous blood fromthe parotid and submaxillary glands remain s dark in colour evenwhen the secretion is active.

sacarrros . 81

Itmust be left to future research to clear up the discrepancies of

the flow of saliva fromthe submaxillary gland. o m found thatthe secretion differs in appearance and in chemical properties

Louv re and Spu es found that the temperature of the salivasecreted by the submaxillary gland, when galvanismis applied to

proves that the process’

of secretion, like many of the other animal

On analysing themilk fromthe hypertrophied breast of a woman,a t. 26, Scm ssanncnn found it of a specific gravityof 0

H

98— o 99,

whereas that of normal mflk is rwo z — l ofl i The milk containedin roo par

'ts

Water

Sop r and emtractive}

Inorganic-alts

Tm confirms thc opinion of Heynsius regarding the presence

of albumen in the normal milk of the cow . (Schmidt, vol. 103,No 7. p 5

this he has founded a method of estimating the quantity of thesesubstances . Sugar-of-milk and butter have no effect upon the

colour . The albumen, for example, hc calcuh tes bytak ing ma c.

ofmilk at a temperature of 45— 5o'

C ., adding to it a drop of acetic

acid. which separates the casein and butter, filtering, and then add

ing his standard solution of cameleon. The author, in his second

82 REPORT ON THE ms'rrru'

rEs or MED I CI NE .

MAJEws found that the pure liquor amm1 collected fromthe

cow and the sheep is at first fluid and colourless . After standing,it becomes of a slightly opaque-yellow colour, and glutinous feel.The allantoid fluid is more or less Of a brownish-yellow, accordingto the age Of the

'

embryo— something Of the colour Of urine .

Fromthe pig, it gives a deposit. Both fluids are alkaline ; bothcontain sugar (not found in the human subject), albumen, and urea .

18

ON PARTICULAR. oncan s— Lrvna , HEART, SUPRA-RENALCAPSULES, ETC .

I‘Donnell — Outhe Physiologyof Diabetic Sugar in the AnimalEconomy. DublinQuarterly Journ. of Med. Science, August, I859.

n y,

— Ou Lesions of the Nervous Systemproducing Diabetes. Proc. Roy. Soc. ,

No. 35, p. 37.“mum — Ueber die Bildung dea Zucker in der Leber. [On the Saccharine

Function of the Liver.] (Schmidt’s Jahrb ., vol. 97, I858, pp. I— I4.)[ organ — Experiences relatives 3 la glucogénie, drc. [Experiments on the Glu

cogenic Function .] (Gas . Med., May, I858, p.h elm— The same, Oct., p. 630.

Poisoning et Lefort — De l’existence da Glucose dans l’organisme animal, the .

[On the Existence of Glucose in the Animal Body.] (Compt. Bend , I858,

April, pp. 34x and 379 3March, p. 565 ; July, p. I I 3 Dec., p.com- De l

’origine da sucre da chyle. [On the Origin of the Sugar in the Chyle .)

(Compt. Bend . June , 1858. p. I 364.)Salmon — De l

’origine do sucre dans l’économie animals. [On the Origin of Sugar

in the Animal Body.] (Journ . dc Physiol., p. 344,Poggiale.

— D0 do . I» 549

Poggiale ,

— Rapport snr is memoirs de M . Sanson. [Report on Sanson’s Paper.]

(Bullet. de l’

Acad. de Med., July, 1858, p.l m — Untersuchungen usher die z uck erhildende Function der Leber. [On the

Saccharine Function of the Liver.) (Archiv f. Gemein . Arbeit , vol. iv , 1858,pp. 37— 76. Canst., vol. i, p.

Euchrioht, Bak u-ling og Hang over ,

Priisafhandling tilstillet Selsk ahets

physislIe Klasse . [On Diabetes. The Origin of the Sugar.] Oversigt over detKgl. dansk e Vidensk . Selsk . Fouhandlinger, 1857, No. 8. Canst. , p. 63.

Sohotfin ,

— Ueber einige k iinatllche Umwandlungsproducte durch die Leber. [Onthe Artificial Formation of some Hepatic Substances.) Wund. Arch., part ii,p. 336, part 3. Henle und Meissner, p. 356. Canst. , vol. i, p. I67.

Benvenigfi — Sulla formaz ione per metamorfosi regressiva dello z uck ero e dellamido, drc. [On the Retrograde Metamorphosis of Sugar, &c.] Annali univ. ,vol. clxvi, p. I60 . Canst., p. I 59. Scherer's report.

BortheloL— Sur la transformation en w ere de divers principes immediate con

tenua dans lea tissue dea animaux invertebrés. [On the Transformation of

Sugar into difi‘erent Immediate Compt. Read , 1858, vol. xlvii,p. 337.

L IVER, HEART, Erc . 83

sur le fiiie et ls rein gras phyaiologique. [On Fatty-Lim ami(Bullet. de l

'Acad . de Bruaelles. I85S. pp. 393

l u g — Usher einige Verschiedenhe iten imVerhalten der Lebu hungernder und

gemterter'

l'

hiere. [On the Difl'erence in the Livers of Animals when Fasting

and Digesting. (Archiv f. Gemtrin. Arbeit , I858. part I , pp. 77— 98. Healsand Meissner, p. 356. Canst., vol. i. p.

W eb— Bur Kenntniss der Leher. W atery. t857. (Chieflyupon the cfl’ects

of ligaturing the hepatic vessels.) Canst. , vol. i, p. 63.Arnold — Usher the Galleamenge. welche hei Hunden mit Gallenblasenfiateler

imverhi ltaiss z nr art der Nahrnng. [On the fect of Food upon the Secretion of Bile ] (Die Physiol. Anan it z u Heidelberg. pp. 91m ,

— Untersuchnngen neher den Uebergang von stol en ans demBlut in die

Guile. [On the Paasage of Substancsa from the Blood in to the Bile.)(Virchow '

s Archiv, voi ii, pp. 39— 46, I85S . Canst. , vol. i, p. 63. Meals

and Meissner, p.

Imp — Usher die Function der Gallenblaasenschlcimhaut. [On the Functionof the Mucous Membrane of the Gall-Bladder] (Schmidt's Jahrh., vol. 97.

I858. pp. 38 x. 383. Canst., vol. i. p.Analyse dcr galls dea Wela. [On the Bile of the Whale ]

Liehig'a An al" vol. cviii, p. 66. Canst., vol. i, p. I8I .

Imam- Die Drusen dcr Gallenhlase dea Menschen. [On the Glands of theHuman Gall-BladderJ II . n. Pf.

’s Ze itschr.. 3Reibe, vol. iv.

OM — Die unorgan ischen Bestandtheilc der IA ber und Mil: und mehrerersntleren Dri

‘

Isen. [On the Inorganic Constituents of the Liver, Spleen, and

other Glenda ] Von der med. Fak ulti t tu Wiin burg gek riinte Preisschrift,M et. I858 . Canst. , vol. i, p. I68.

J ou ph— Die Rings and Klappen dea Menschlichcn Herz ens. [On the Valves

of the Heart.) Virchow’s Arch ., vol. xiv, pp. 344— 370, I858. Schmidt,

vol. I03, No. 7, p. I3.

-Ueher die Lsge dea {ordern Bandes der Lungs . [On the Position of

the Anterior Margin of the Lung ] Deutache Klinik, No. 38. 1858. Canstatt,p. 24, vol. I.m en

— Usher die chem. Bestandtheile dea Gehirns. [On the Chemical Comps .

sition of the Brain ] II Abhdlg. new . Annal., vol. cv, p. 36x. Canst.,vol. i, p. I6S.

BLOOD-GLANDS .

snr l’extirpation successive dea deua capsulesm usics.

the Supra-renal Capsules .] (Cornpt. Bend , Feb., I858.

pp. 430 Beale and Meissner, p. 356.

W— v fl lu recherches sur les capsules surrenalea. [New

Draw on the Supra-renal Capsulu j (Compt. Bend , Dec., I857.p. I036.Journ. de Physiol ., vol. i, pp. 360

— 8ur les eapsnlss surrenales. [On the Supra-rcnd CspsuM ] (Gas .

611. de Paris, I85S.No.

nomaux des capsnles surrenales. [On the Presence otFat as a m al ais

Im t osmsupw mu cqm j

84 REPORT ON rm; or MEDI CINE .

” wager,Uutersuchnngen usher die Nebennieren. [On the Supra-renal

Capsulea.] M M , 1858. Canst., p. 74.

remark — Sui“ les functions du corps thyreoid. [On the Function of the ThyroidGland .] (Gas . Med. Sard i., I858. No. I 3, p. 89. Gas . Hebdom., No. 4I ,

1»

Friedlebm— Die Physiologic der Thymusdrusc in Gesundheit, und Krankhe it.[On the Physiology of the Thymus Gland.] W t, 1858. Henle and

Meissner, p. 357.Saharan — Usher das Vorkommen dea Guanine in der Pancreas-Drum dea

Ochen. [On the Presence of Guanin in the Pancreas of the Ox.] Verhandl.

der k gl. buyer. Akademie der Wiesenschaften und Virchow’s Arch ., 1859.

Canst., vol. i, p. I68.

Saharan — Knuthicoxyd, ein normaler Bestandtheil dea thier. Organ. [XanthicOxide a normal constituent of the Animal Body.] Sarkin u. Hypox. identisch.Liebg. Annal., vol. cvii, p. 3I4. Canst. , p. I6S.

Ch echen— Usher das Sarkin . [On SarlIin.] Liebig'

s Annal. , vol. cl I, p. 139.

St anton — Ueber die Verwandlnng dea Guanine in Xanthin . [On the Trans

formation of Guanin into Xanthic Oxide ] Liebig’s Annal., vol. cviii, p. I4I .

Canst., p. I6S.

M‘DONNELL endeavours to give a simple and, at the same time ,faithful account Of the history and present condition of our knowledge Of the origin of sugar, and the changes it is liable to in the

animal economy. The paper, which occupies twenty-seven pages,will be found, he believes, Of peculiar value to those whose multifarious professional occupations prevent themfrom searching out

for themselves, fromthe immensemass Ofmaterial which has duringthe last few years accumulated on this subject, what is substantiallytrue, and what is incorrect.Pavv says, that the sugar formed in the liver is due to a post

mortemoccurrence, and that during life there is a force capable Of

overcoming the chemical tendency to a saccharine metamorphosis .

Division Of the spinal cord, as high up as between the second and

third cervical vertebre , does not produce saccharin e urine. After

poisoning an animal by strychnine, the circulation beingmaintainedby artificial respiration, the urine becomes strongly saccharine .

According to the author’ s views, it would appear that the medullaOblongata is the centre Of the force preventing the formation of

sugar in the living an imal . Division Of the cervical sympathetic, orof the ascending branches Of the superior thoracic ganglion on bothsides of the neck, occasions an intensely marked diabetes . The

diabetes is stillmore marked after removal Of the superior cervical

ganglion .

Dl\ ision Of the sympathetic in the chest he several times found

ON THE L Iv IsR.85

cervical ganglion in the rabbit, with division Of the pneumom

fromthe skull, is, he says, followed by diabetes .

Lm umgives a rcview Of the recent researches on the gluco

genic function of the liver. Mom s examined the portal blood Of

two dogs that had becn restricted to a flesh dict during some time,and found sugar absent. Whereas, in the blood of the hspatic vcin

Of one of them,sugar was detected . He accounts for the absence

Of eugar in the blood of the hepatic vein of the other, by sayingthat the animal was in a sick ly condition . It being a known fact,

that in sick ly animals the liver secrctcs little or no saccharine

POISEUILLB and LErOR'r confirm the existence of sugar in the

of sugar during digestion, but not during fasting. From eupe~

riments made upon dogs that had been fed during six week s

on flcsh only, they conclude that the sugar found in the bodies

manufactured by the liver. Moreover, they still hold to Bernard'stheory, that it disspp

'

ears in the lungs through an oxidiz ing

the origin of animal sugar. Although he does not denythe exist

ence of the eaw hfi ine function of thc liver, yet he says that a certain

quantityof saocharinematter is absorbed into the systemfrom the

food, and that the sugar found in the lactesls and in the thoracic

duct owes its orign entirely to the food. He made a quantitativeanalysis of thc sugar containcd in the chyle and in the llml’h. and

86 REPORT on ma ms'rr'rn'rns or MED I CINE.

SANSON says that fresh healthy blood does not contain any sugar,but that after standing from four to eight hours exposed to theair, sugar can be detected in it. This is in con sequence of freshblood containing glucogene, which, by fermenting, becomes transformed into sugar. Sanson further states that the animal bodyhas not the power of forming glucogene . That the herbivoraobtain it directly fromthe vegetable kingdom; the carnivore indirectlythrough the flesh of the herbivore .

Pos s um gives a report on the researches of Bernard and

Benson . He states that the Commission appointed by the Academy of Medicine, consisting of Bouley, Longet, and himself, afterperforming several experiments on different animals, came to the

conclusion that the liver possesses the power of forming gluco

gene, irrespective of the kind of food. That it is formed in greatestquantity, however, when the diet is vegetable . They agree still

further with Bernard, in saying that glucogenic matter holds a

middle place between starch and dextrine .

Moos made a quantitative analysis of the sugar in the livers of

healthy rabbits and dogs, and compared it with the quantity foun din the livers of the same species after section of the pneumogastricnerves . His results are confirmatory of the previously known fact,that the quantity of sugar in the liver diminishes rapidly, and

finally disappears, after section of the cervical pneumogastric. He

further found that galvanism applied to the spinal cord of frogs

renders them diabetic, while at the same time it increases the

quantity of urine . He also. states that whatever increases theaction of the sympathetic, especially its cervical portion , augmentsthe formation of sugar in the liver. The quantity of sugar in the

liver fluctuates greatly. During digestion it is at its maximum;during fasting at its minimum. In the livers of pregnant rabbitsthe quantity is small, and it -is frequently entirely absent in thosekilled by poison . The food which tends most to in crease the

quantity of sugar in the livers of rabbits is bread, potatoes, and

boiled starch . Nassn says that glucogene appears in the cells of

the liver in the formof small granules .

The Commission appointed by the Danish Academy to examineScn l rr

’

s memoir on Diabetes, consisting of Hannover, Eschricht,and Scharling, report that the paper show s— 1st. That sugar isactually formed in the liver, and not collected there from other

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88 an on on ranms'rrru'rns or MEDICINE .

period of digestion. The livers of fasting animals, he found, weighmuch lees than those of the same species of animal killed during thetime of digestion.

ARNOLD has repeated his researches on the effect of different

k inds of food on the quantity of bile. He foun d that a dog, for

every two pounds of its weight, secreted in twenty-four hours

Food.

57 to 60 grammes black bread96 grammes fresh meatMixed dietWhile testing

The solids in the bile in the case of the bread diet weighed 0 356 grammes.

In the flesh diet o 541

In the fasting o 360

Arnold’s experiments weremade on dogs with biliaryfistulas.Mosnsa injected fromfive to ten grammes of grape-sugar into

the jugular vein of a dog, and failed to detect it either in the urine

or in the bile. When twenty grammes were injected into a vein itreappeared in the urine, but not in the bile. The same result was

obtained after the injection of thirty or forty grammes of sugar. It

was not until fromsixty to eighty grammes were injected that itreappeared in the bile. With cane-sugar forty grammes were foundsufficient to impregnate the bile . One gramme of iodide of potassium injected into the blood can afterwards be detected in the

bile, whereas ten grammes of nitrate of potash cannot. Sulphateof copper, when taken into the stomach in the formof pill, appearsin the bile in four days. Calomel, when given in doses from one

and a half to three and a half grammes, cannot be detected in thebile ; neither is the quantity of bile secrewd thereby augmentedBenz oic acid, when given by the mouth, is not afterwards found inthe bile .

Kmrr finds that the mucus of the gall-bladder causes neutral

bile to become alkaline, and give a deposit with weak acetic acid.

FUCHS injected bile into the veins of animals with the intentionof giving themjaundice ; but itmade the animals ill without producing that result. He believes, therefore, that jaundice is not the

eflect of a reabsorption of bile, but a non-secretion of it.

on w e L IVER . 89

Sa ossnnnGnn found the bile of the shad-fish of a yellow-browncolour and peculiar fishy smell. On analysis (compared with the

python’s bile) it gave in 100 parts

Water

Biliary acid saltsFat

Mucus and colouringmatter

According to Luscnm’s observations there are from six to

fifteen grape-shaped glands in the mucous coat of the human gallbladder. They consist of a tunica propria, surrounded by bands ofmolar tissue . No epithelium is found lining their irmer walls,

but their cavities are filled with fine granular débris .

Omm sr analysed the liver, spleen, and several other organs,the results of which analyses Scherer (in his review of the mono

graph) has given in the following table (see nextp age)

IC INE.O! MEDN THE INSTITUTES0REPORT

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92 an on on THE msmu'rs s or usmcmn .

Brown-Sequard’s idea, do not require supra-renal capsules . An

explanation since shown to be quite untenable, as Philipeaux and

Harley were equally successful in their experiments on colouredanimals .

VULPIAN again calls attention to the peculiar red colouringmatter of the medullary substance of the supra-renal capsules . He

has not yet been able to isolate it ; but he finds that it is not contained in the cells (Virchow), but in the blood. It is soluble inalcohol. The colour is not so marked in man as in sheep, oxen, &c.

In diseased capsules it is occasionally entirely absent, and in thoseof the fcetus it is very slight.In his other paper VULPIAN confirms the statement of previous

writers concerning the presence of fat-granules in healthy suprarenal capsules .

ZELLWEGER. analysed chemically the supra-renal capsules, and

found that in the new-born child they contain in 100 parts— 77 4water, organicmatter, and 0 4 ashes . The ox

’s, on the other

hand, contains in 100 parts— 72 1 , 25 6, and 23 ; the pig‘

s

257 , and 2°

1 . The ashes consist chiefly of phosphates .

Forums revives the opinion that the thyroid gland is a diverticulum for the excess of the cerebral supply of blood. This, hesays, is particularly the case during sleep, at which time the glandbecomes so distended with blood that it increases considerably thecircumference of the neck .

According to FRIEDLEBEN the thymus increases in siz e up to the

time of puberty ; although after birth up to that time its siz e to

that of the body is relatively less . Frompuberty to manhood it isstationary ; and after this it begins to disappear. Friedleben saysthe same thing occurs in the lower animals . Like Bischofi

'

, Friedleben observed it to be occasionally absent in well-developedchildren . The juice of the thymus, Friedleben says, has alwaysan acid reaction which disappears when the gland begins to

putrefy and the ashes left after incineration are only in partsoluble in water. They consist of chlorides, phosphates, and sul

phates of soda, potash, lime, and magnesia . The organicmatter isalbumen, gluten, sugar, fat, colouringmatter, and lactic acid. The

quantity of ash is greater in the calf than in the ox ; the thymus of

a calf, te n days old, contains per cent. of inorganic matter ;whereas that of an ox, eighteen months old, has only 33r7 per cent.The quantity of water is also greater in the thymus of the calf. A

camro-usmanr oaoans . 93

rich diet, of albuminous, fatty, and saline food, increases the siz e of

the thymus and the amount of its secretion but an entirely fattydiet canses it to disappear. Sta rch diet first increases the secretion,then diminishes it, and at length causes atrophy of the gland, ashappens in starved animals .

Friedleben found that extirpation of the gland is not fatal to

young dogs ; and that when both the thymus and spleen

bodyare defective ; so much so that after a time all the animalsoperate d on die of a species of inanition. When the thymus aloneis mnoved the spleen increases iu siz e . The uriue is also found to

be diminished in quantity .

80m m detected guaniu in the pancreas of the ox . He saysthat there can be no doubt of the substance found in the pancreasbeing the same as that obtained from guano, — x. From the

reaction with nitric acid and potash .

S'rascxsn found in the juice of flesh a substance which he namedmh

'

s but which is in reality the same as Scherer

The testfor it is, — when heated on a spatula with weak nitric acid, itforms a yellow substance, which, on the addition of potash, gives 9.

leaves a fine dark purple-red matte r. Scherermd Strecker are now

both of the Opinion thathypoxanthin and xanthic end s are identical.

The latter substance Scherer found in normal urine , liver, spleen,pancreas, brain, andmuscle ; and in the blood in disease . Strecker,in his last communication, says that guanin can be transformed intoxmthic oxide through tbe agencyof nitric aoid.

010”c 4

zs — N A /

Guanin.

+0 =M tMc oxide

-i. HO + N

ON THE GEN ITO-URINARY ORGANS .

Haga n— The Urine in Health and Disease. Plates svc.pp. 83. London. i 859.

ton — Ou the Natural Constants of the HealthyUrine in Man. Dublin0m” Vii ! P' 374‘

94 ar row on THEmar l-w r its or usnrcms .

Gallon — On the Natural Acid Reaction of the Urine, and on the Determination of

the Proportions therein of Uric Acid and Urea, as applicable to PracticalMedicine . Bdin . Monthly Med . Journ., Jan ., 1859.

Carton — Ou lndican in the Blood and Uri ne. Edin. Monthly Med. Journ., Aug.,

1859, p. 1 19.

Fleming — C linical Observations on Injuri es and Diseases of the Urinary Organs.

Dub . Hos. Gan , p. 5, vol. vi, Jan. 1st, 1859.

High — New Tests for the Kieateiue of Pregnancy. Lancet, 17th Sept.

, 1859,

p. 281.Ba lm— Ou the Preservation of UrinaryDeposits as permanentMicroscopic Objects.

Archiv. of Med. , No. 4, p. 331 .

Ba lm— Ou Blue Deposit in the Urine, froma patient a t. 83, sent by Dr. Eade .

Ih., p. 31 1 .

Ba lm— Remarks on the Formation of certain Urinary Calculi, and of the Dumbbe ll Crystals of the Oxalate of Lime. Ih., p. 305.

Ba lm— Ou the Straight Vessels in the Pyramids of the Kidney. Ih., p. 300 .

Ba lm— A Course of Lectures on the Urine, Urinary Deposits, and Calculi. Pub

lished in the Brit. Med. Journ , 1859, beginn ing at p. 2 7 1 .

— On the Connexion of the Heat of the Body and the Excreted Amountsof Urea , Chloride of Sodium, and Urinary Water, during a Fit of Ague. Trans .

Med-Chin Society, vol. xiii, p. 361 .

Na hum: und VogeL— Anleitung z ur qualitativen und quantitativen Analyse des

Harm. [On the Analyaia of the the Urine .] Wieabaden, 1858. Third edition ,

dp. 372 . Henle and Meissner, p. 260. Canst., p. 191 .

Liohig ,

— Ueber Kreatin und Kynurenaaure imHundeharn. [On the Presence of

Creatine and Cynuric Acid in the Urine of the Dog.] (Annal. der Chemieund Pharm., vol. cviii, p. 354. g enie and Meissner, p.

W — Zur Nachweiaung der Harnaiiure. [On Uric Acid.) (An . Chem. 11. Phar. ,

vol. cviii, p. 65. Henle and Meissner, p.

7 , Babe und Meissner,

— Um“daaVerhalten der Harnaiiure an der Fehling'schen

Kupferliisung. [On the Behaviour of Uric Acid towards Fehling’s Liquid forthe Detection of Sugar.] (Zeitachr. Rat. Med ., vol. ii, p. 32 1 . Hen le and

Meisaner, p.

mmm,

— Ueber den Un prung der Hippuraiiure imBarn. der Pflanz enfreaaer

[On the Origin of the Hippuric Acid found in the Urine of the Herbivora .]

4to. Gettingm, 1857.

Weisnnann — Ih

M W M — Da uebergang der Bernsteinaaure in den B arn . [On the Transit

of Succinic Acid into the Urine.) (Lieb ig’a Annal., 1858, vol. cvi, p. 160 .

Canst. , p. 191 . Henle and Meissner, p.

weiumm — Ueber die Bildung der Hippuraiiure beim Menschen . [On the

Origin of Hippuric Acid in Man .] (Henle u. Pt.’

aZeitachr., vol. ii, pp. 331

343. Canst., p.n ach — Zn Genesis der Hippuraaure im Organiamua. [On the Origin of

Hippuric Acid in the Animal Economy.] (Archiv f. gemeina. Arbeit. , vol. iv,part 1. Canst. , p.

— Ueber ein neues muthmaaslichea Vorlrommen dea Xanthins. [Onthe Presence of Xanthic Oxide ] ((Estr. Zeitachr., No. 18, Canst.,p. 191 .

Roldan — Usher das Vork omrnen dea Allantoins im li aru. [On the Presence ofAllantoins in the Urine ] (Zeitach. fiir die gee. Naturw., 1857, p.

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96 REPORT on THE INST ITUTES or MED ICINE .

m,

— Ueber die Entstehung deaUreums. [On UrremicPoisoning ] (Froriep'sneue ii, 1858.PP. 194

— 198, and 209

Vulpin— Sur le contractilité des urétrés. [On the Contractility of the Ureters .]

(Gan. Med. de Paris, July, 1858. PCum ve

— De l’nréthre. [The Urethra.] Jonr. de Med. Bordeaux, 2me série,

No. 7, 1858. Gives apparently nothing new . (Valentin )

Bark ow ,

— Anatomische Untersuchungen ueber die Harnblase (Researches on theUrinary Bladder) deg Menschen , nebst Bemerkungen ueber die mi nnliche und

weibliche Harnrbbre. (On the Male and Female Urethra.) Fol. 1858.

Gil-aldeg, Note sur nu nouvel organ glanduleux , situé dans le cordon sper

matique, et pouvant donner naissance i des Kystes. [On a new GlandularOrgan in the Spermatic Cord.] Gan. des hdpit., No. 45, 1858.

HASSALL says that the object of his little work is to afford an

explanation, as simple as possible, of the physical properties, composition, and uses of the urine ; of the frmction of the k idn eys ; and,

more especially, of the principles of treatment of the chief urinarydisorders . The volume is illustrated with twenty-four plates of the

various deposits, organic asw ell as inorganic,met with in the urine .

A few of the plates are cOpied fromRobin and Verdeil’s Atlas

the remainder are original.Hassall states that unwholesome and adulterated food operates as

a cause of renal disease — 1st. Bymany of the substances employedin the adulteration of food being in themselves injurious to health,by impairing and deranging the digestive frmction . 2d . Byreducing the dietetic value of the articles consumed ; examples ofthese are furnished in bread, milk, and coffee . An other fruitfulpredisposing cause to renal disease are unhealthy occupations,especially employments entailing the working in ill-lighted, ill-ventilsted, over-crowded rooms . He says, too, that the mere density ofthe urine afl

'

ords an indication of treatment, as it is mainly due tothe presence of an excess of urea or sugar. The former denoting anundue waste of tissue, the latter the existe nce of a special disease .

An extremely acid condition of the urine is in general dependent onthe nature of the food ; but mainly on some error of digestion .

A persistent alk aline condition of the urine, on the other hand, isuallynot so much dependent on a faulty digestion as on general

or local debility .

As regards the nature and treatment of cystine deposit, our

author says, that as it contains more than 25 per cent. of sulphur,and thereby bears a close resemblance to taurine, it is probable thatits presence in the urine is due to some disorder of the hepatic

BENITO-URINARY ORGANS . 97

not been traced. Bird thought that it was a product of the scrofu

frequentlyoccurs in tbe urine of chlorotic women . The best plan

of trentment is to correct any thsorder of the assimilative functions,and attend to the general health.

89amIrvsvity

Sem estimates the acidityof the urine byobserving how muchis required to neutraliz e a solution of caustic soda of given strength .

He uses a capillary syphon, which delivers the fluid, drop by drap,

of such a strength that it will neutraliz e an equal quantityof water

containing l per cent of dry oxalic acid. He recommends theordinary method of oollecting uric acid from urine ; but pro

a stmidard hcap of the snme substance . For the estimation of uren

he reconnnends Liebig'

s method.Cam gives an historical sccount of the colom'ing matter of

98 REPORT ON TEE INsTITu'

rxs or MED ICINE.

ment that has been obtained fromit.1 He relates some cases thatoccurred in the Edinburgh Infirmary.

FLEMING observed that the urine of a child, sufi’

ering fromretention during an attack of remittent fev er, resembled, in colour

and consistence, substantial chicken-broth, was feebly acid, and had a

specific gravity of 10 18-20 . Itbecame a tremulous jelly on cooling ;

cleared on heating ; but again became turbid when the boilingpoint was reached. The addition of nitric acid rendered it again

transparent, and caused it to efi'

ervesce with the disengagement of

ammonia . It contained no albumen . The child recovered.

HICKS recommends the employment of rennet as the bestmeansof dete cting k iesteine in urine (two teaspoons of rennet to three

ounces of urine). The advantages of the rennet, he says, arH I st,

saving of much time ; 2d, increase of the deposit ; 3d, the depositis nearly free fromphosphates ; and 4th, nearly free from smell.Rennet has no action on healthy, diabetic, albuminous , or phosphatic urine . If, to the lower portion of urine containing the depositof k iesteine, a few drops of a strong solution of ammonia be added,and heat applied, the deposit is transformed into a semimucusmass, causing the urine to become almost tremulous .

BEALE says that the principal points advanced in his communication may be summed up as follows — I That the dumbbell crystals are formed in the uriniferous tubes, while the octohedralcrystals of oxalate of lime are not deposited in the kidney at all, andin many cases not un til the urine has left the bladder. 2 . Thatun der certain circumstances the dumb-bell crystals, if retained in thetubes of the kidney, become aggregated together, and form the

nucleus of a calculus . 3. The nuclei of oxalate of lime, of uric acid,of urate of ammonia, phosphatic calculi, &c.

,may be composed

of dumb-bells . 4. Dumb-bell crystals, lik e urinary calculi, occur

at all periods of life . 5. The chemical composition of the dumbbell is, doubtless, the same as the oxalate of lime calculus, of whichit is but an early stage, and consists of oxalate, and not oxalurate of

lime . 6. As it has been shown that dumb-bellsmaygrow into smallcalculi, it is very important to promote their expulsion fromthekidney as soon as possible.

In his paper on the kidney Beale says that his researches are

confirmatory of Virchow’ s views, viz ., that the case recta, in many

‘Verhand. Phys. 11. Med. Gesellseh. an Wurz burg,’ M . v, 1854; and Budrnann ’

s

vol. xliv, pm5. i 855

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100 nEroar oN TEE Ins'

rrrurss or MED ICINE.

urinary water was also definitely increased, and this was quiteindependent of the quantity of fluid drunk . Much more water wasdrunk than was excrete d. The author next relates the observaticas

made upon the same patient when quinine was given . A scrupletaken before the fit, and just as the temperature commenced to rise

delayed the rise for an hour but had no other efi'

ect on the temper»ture on that day, and none on the urea, chloride of sodium, and

water. Another scruple given at night, after the fit, cured thepatient as far as the subjective symptoms were concerned ; but didnotprevent the increase in the urea and chloride of sodiumoccurringat what would have been the fever hour. An effect first noticed byRedenbock er .

In the case of tertian ague almost similar results were obtained.

The rapidity of the pulse closely corresponded with the temperature .

In addition to these cases of ague, the author subjoins one of

hectic fever, occurring in a phthisical patient under the care of Dr.

Walshe . The subjective phenomena were similar to those of ague,there being a cold, hot, and sweating stage . The temperature followed the same rules as in ague, and there was also an increase in

the urea and Chloride of sodium during the cold and hot stages .

There was this difference, however ; the urea fell before the rise in

the temperature commenced, and increased less after it than in ague .

NEUBAUER and VC CEL’s work on the urine is highly thought of

in Germany . The third edition is much improved ; it includesall the newest researches, and a chapter on the chemical analysisof urinary calculi.

LIEEIC obtained fromthe urine of a dog that had been, during a

length of time, fed solely upon meat a large quantity of creatine .

The urine, mixed with milk of lime, had stood nearly six weeks,and, as is known , under these circumstances all the creatinine musthave become changed into creatine . The same urine, when fresh,yielded only creatinine . The dog, when fed on fat, passed cynuric

acid in the urine . The formula of this acid is CmNH705 .

SCHIFF says the best test for uric acid is freshly precipitated carbonate of silver, a little of which will detect 1-47,500th grm. of

uric acid by the gray colour which it forms .

VON BABO and MEISSNEE repeat Leconte and Bonnet’ 8 statement,that uric acid in healthy urine reduces the oxide of copper.

HaLLwacns’andWEIssru NN

’s papers are priz e essays . Although

their researches on the origin of hippuric acid in the urine of

GENITO-URINARY ORGANS . 101

herbivore weremade independently, yet both as regards the mannerin which the experiments were conducted and the results obtained,there is a general resemblance . The method of extracting the hippuric acid adopte d by Weissmann is as follows -From 10 to

20 c.c. of urine is evaporated nearly to dryness, after oooling fromfive to ten drops of concentrawd hydrochloric acid are added,and then an extract of the whole is made with pure ether,on evaporating which more or less coloured crysta ls of hippnric

nearly disappears. The average daily amount of hippuric acidd rw n gives at 2 170 grms ., and on pure animal diet it fell to07 65 grma. He found that after living for sev en days on nothingbut bread and water his urine contained less hippuric acid than

experiments that he made on typhus patients, that the acid is not

only derived fromthe food, but also fromthe protein compounds ofthe animal body. In three cascs of diabetes the quantityof hippuric acid was very considerably diminished . Mack says, as

Bonssin found, thathorses when standing in the stnble pass verylittle

hippuric acid and a large quantity of urea, whereas while workingthey pass little urea and a large quantity of hippuric acid, it isnot improbable that the acid comes froman oxidation of the uw a .

This theory, however, is contrary to known facts , namely, that ureais the leu t oxidizable product of the animal-tissuemctanmrph

acid, and found that sfter tak ing it in quantity it neither reappearedin the excrements nor in the ufine nor did it in anyway augmentthe excretion of hippuric scid.

Km mn examined the cacrements of the chameleon, and saysthat he found therein nric acid, traces of urate of ammonia, smallquantities of oxalata and phosphates, traces of biliphain and biliaryacids, together with xanthin and prophylamin . Scherer regardsthe prcsence of the two latter as veryproblematical.Khm a found that allantoine is present in the urine when the

Naonam shows how oxalic acid ic one of the indirect productsof the retrograde metamm'

phosis cf tissue and prcte in food. It is

109 acros s on ma w arn s-res or immers e .

increased in the urine after— 1st. Vegetable food. 2d. Efi’

ervescingv ines and bicarbonates of the alkalies . 3d. Salts of the vegetableacids . 4th. Highly nitrogeniz ed food (Beneke and Bird) . 5th.

Constantly in cases of imperfect respiration — emphysema (Lehmann)In convalescence from severe diseases— t yphus, 8m. The chiefcause of the presence of oxalates in the urine is the imperfectoxidation of uric acid.

Cause compared the relative value of the “ fermentation and

Fehling'

s method of quantitatively estimating sugar, and cameto the conclusion that the one method is as good as the other.

Bunsen calls attention to the fact that nearly all urines fromhealthymen become slightly brown when boiled w ith potash. Also,that when the sulphate of copper and potash test is employed, thereis in general a slight browning, thereby indicating the presence of a

small quantity of sugar. Brueck e says that the existence of sugarin healthy urine can be put beyond a doubt by adding to every10 c.c. of urine 54 c.c. of strong alcohol, filtering, and adding tothe filtrate a little spiritmade slightly alk aline with potash . After

standing twenty-four hours, when the liquid is decanted, the bottomand sides of the glass will be found covered with crystals . Thesecrystals, on being dissolved in water and tested, will be found to be

LOWENTHAL proposes the use of a salt of iron instead of one of

copper, as being amore delicate test for the detection of sugar. It

has no advantage over copper, however, and it has disadvantageswhich the copper does not posThe object of Vmanon'r

'

s paper seems to be to correct someremarks made by Badick e on Kaupp’a researches upon the effect ofsalt on the constituents of the urine.

Sl cx studied upon himself the variations in the amount of phosphotic acid in the urine . He took different quantities of phosphate

of adds in the twenty-four hours, and afte rwards examined the

urine, in order to see if all the salt taken reappeared in the urine ;

and in what form. He began by taking one gramme, and graduallyincreased the dose to three grammes . The result of the experimentled himto believe that all the phosphoric acid taken is excreted bythe urine, and in the same form that is to say, it does not appear

in the urine as an earthy, but as an alkaline, phosphate .

HAlmonn’8 experiments were also made upon himself. He

divided the dayinto three parts . The first from7 am. to 1 pm.

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104 REPORT ON THE INSTITUTES OP MEDICINE.

Gigon shows that urine, fromwhich all the mucus has beenremoved, acquires amilkiness with chloroform, and still further, thaturine which never contained anymucus at all, gives the samereaction . He obtained the latter by tak ing it directly from the

pelvis of the kidn ey of the living animal. The urine of the ox,

after themucus has been removed by filtration, gives no precipitatewith chloroform. To prove that the precipitate fromhuman urine

is really composed of albumen, Gigon collects, dries , and after

wards redissolves it in acetic acid. The solution gives the reaction

of albumen with ferrocyanide of potassium.

The quantity of albumen daily passed in healthy human urine,

the author says, is about grammes .

Rnmsms says that normal urine contains no albumen . On account

imagines, becomes albuminous as soon as it is alkaline .

VULPIAN confirms the existence of a peristaltic action in the

the ureter is separated fromthe kidney, which proves that it is not

the stimulus of the urine which calls it into action .

Banxow’s anatomical researches on the human urinary bladder,

together with his observations on themale and female urethra, are,

Gmamas describes a small, glandular-looking organ in the

te

spermatic duct. He found the organ in children as well as in

ON THE PHYSIOLOGICAL ACTION OF CERTAIN POI SONS .

Weston — Ou the Poison of the Common Adder. Lancet, arat May, 1859, p.

52 2 .

— Sur la Taétaé. [On the Taétaé ] L’Inatitnte, No. 1 296, p. 364.

the Means bywhich the Actinie kill their Prey. Proc. Roy. Soc ,

No. 34. p. 733.

Harley— Ou the Treatment of Tetanus by Woorara Poison. Lancet, 1st Oct. ,

1859-p-a4sWells (Spencer),

— Three Cases of Tetanus in which Woorara was used in the

Treatment. Med. Times and Gaz ., 3d Dec., 1859, p. 564.

Bruce. (Paul),— Sur is traitment du tétanos par le Curare. [On the Treatmentof Tetanus byWoorm ] Gaz . dea Hdpitaux,Oct 29th and Nov. 3d, 1859.

rnr sronoexcar. ACTION or CERTAIN rorsos s . 105

PM andW an — Untersnchong fiber die Eiuwirlmng eioiger Gifts auf dieLeiatu gafi higlteit der Muskeln. [On the Action of certain Poisons on the

Mon ica ] Vcrhandl. der Whraburger phyaik aL-medicin . Geaellach .. 1858.

Canst. , vol. i. p. ma. Schmidt. Vol. to r, No. 1 . p. 35.

W ,— Zehn neue Veranche mit Urari. [On Woorara.] Siebold u. Koflik er

’a

Zeitachr., vol. ix. 1858. pp. 434— 438. Schmidt. No. r, p. 35.

men— Quas i vim venenum Carare exerceat to m ou rn cerebro-apinalium

systems . 8vc . Vmfi sh s ic . 1857. [The Action of Woorara on tt crvea.]Schmidt.No. r. p. 35. Cara t , p. 104.

m ,

-Binige Bemerkungen zur Geachichte der physiolog. Unteracchnngen

iiher daa Urari. [Physiological Experiments with Wooran ] Verhaad. Wunburg Get . January, 1858, pp. 1-3.

— Verauche fiber die Wirk nng dea Urari. [The Action of Woorara.)ten . Zeitachr. der Geaellaehatt der Acu te. 3858. pp . 1— 66. Prorlep

'

a neue

Notices , vol. iv. 1858. pp. 83— 83. Canst., vol. i. [L 104.

— Die spontane Erho lung der Nerves nod Muskeln vergitteter Thiere nachSection. [The Recovery of the Nerves and Muscles after Section. in

Poisoned Animala ] Allgemeine medieta . Centralaeitung, Oct. , 1858, No. 87.

pp. 689— 69 1. Canst. , p. to4.

-Obaervatioaa physiologiqnea faitea ear dea animaux empoiaonnéa par lecon re et n nn ia 1 la respiration artificialle. [Artificial Respiration in Pet

ach ing w ith Woorara.) On . am. July. 1858, No . 37.— De l

’action physio logique da curate. Biblioth. Univereelle de Geneva.

convene periods, vol. iii, 1858, pp. 35— 61 . [A review on the Action of

Wool-are].

Fajita — Actions physiologiquea dc 1’

Upaa Anthiar et de l’Anthiarine. [On

the Anithiar and Anthiarine Poisons.) Gas . use” March. 1858,No. 13.p. ac t.

now nod Pam -Physiologiach-toxik ologiachc Untersncbungen fiber dieWirkung dea alk oholiaehen Extractea de r Tanghinia veaenifsra. [Experimentswith the Alcoholic Extract of the Taoghinia Venenlfm j Verhandl. der

phyaihaL-medicin. Geaollach. in W’

urz burg, vol. ix. 1858. pp. 33— 43. Canst.,P» i °4~

D0 M — De quibuadam experime ntia, quibua quantam vim habeat

acidnmhydrocyanicnmin nmorurn ayaterna cerebrospinale atqne in musculoasystematis verwbralia probator. [On the Action of Hydrocyanic Acid.) 8vo.

Va l ida te . 1858. Canst. , p. 104.

m ,

— Zur Kenn tniaa der Wirimng dea Urari und einiger anderer Gifts . [Onthe Action of Woorara and some other poisons.] Ber. Sacha. Geael. d. Win .

eh . l, 1859. See also Punk c’l Report. Schmidt. Vol. ro r, No. 1 , p . 35.

v — Obaervatiooa de greoouillea cmpoiaonnéea par dea emanation an irnalea.

Gar. w e. de Paris, No. 33. p. 509. [Observations on Frogsby Animal Exhalations. Already known .

— Valentin .]Jm — liydrargyn m hichloratum cormaivum quid in respirations cordlaqne

action eaciat. [On the Physiologiu l Action of Corrosive Sublimate ] 8vc.

Ow “ . 1858.

.

_B¢ itrtgs cur Lehre von der Wirkung dea Schwefelwaaacratod'ea.

[On nlng with Sulphuretted Hydrogen ] (Mm ,

Wm s relates his own case . His fingcr was bitten by an adder

(Gals ber eem) . In fifteen minutes, notwithstanding that the wound

106 “ roar on ranmsrrrorns or n xmcms .

had been sucked, the finger became swollen and painful, numbnesspm eded up the arm, the limbs became weak , he felt giddy, and

vomited. Next day, spots of purpura hz morrhagica appeared on

difla 'entparts of his body, and erysipelas attack ed his arm. He te

Lrvmosrona says, that the sting of the tsétsé, although fatal

to the dog, ox, and horse, is not so, either to man, the goat, or theass.

Wann a repeated McDonnell’s experiment of allowing the actina

to seiz e the sciatic nerve of a galvanoscopic frog, and on so doing

muscular contractions are obtained ; whereas when he presented, inlieu of a galvanoscopic frog, a nereis to the actina, the result was

invariably the death of the animal. The first symptom observedis a writhing, as if the creature felt great pain , and in the mostmarked cases to this is succeeded paralysis and flaccidity of the

muscles, like what is seen in a frog poisoned by woorara. It

appears indifferent whether the cephalic or the caudal extremity of

the nereis be attacked by the actina— similar symptoms are pro

duced in both cases. In order to elucidate the real power of theactina-attcr having in vain exposed the finger with the cuticle

softened— Waller presented his tongue to the te ntacles of the

animal . The result was such as to satisfy him respecting the

offensive weapons with which it is furnished . The animal seiz ed theorgan, and was with difi culty detached. The injury was followedby a pungent, acrid pain, the part becoming inflamed and muchswollen . After an hour these symptom abated, and in about fourhours they entirely disappeared. In a day or two afterwards an

ulcer appeared on the tip of the tongue, but it soon healed. Fromthis experimentWaller concludes that the actine kill their prey bymeans of an acrid irritantpoison— similar in some respects to that ofthe wasp, or of snakes— which quickly spreads through the systemof the annelida, producing the above-mentioned results. Byspreading a thin india-rubber membrane over a glass tube, and

allowing the actina to grasp it, he found bymeans of the microscopethat the poisoned darts are left stick ing in the wound .

HARLEY, in his letter to the Lancet,’

says, that in 1856, he

pointed out the antagonistic action of woorara and strychnine,citing three experiments to show that these substances have thepower of reciprocally neutraliz ing the efi

'

ects of each other, according

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108 naros r on ma insu ran ce or MEDICINE.

muscles except those of respiration . In this way he was able toallay the tetanic spasm without destroying the intelligence, or

arresting the performance of the organic functions, — and by continuing the thus-moderated action of woorara until the kidneys hadtime to eliminate the strychnine from the system, he had been ableto save the life of the animal. The theory of its action in tetanus

is, he considers, much the same . That is to say, you try to

keep the spasms fromkilling the patient by their violence, until themorbid state calling them into play has exhausted itself. Sibsonsaid that in 1838 he experimented upon an ass, to show that

animalmight be resuscitated by artificial respiration after whatwouldotherwise be a fatal dose . For more than an hour the animallayapparently dead, with no sign of life except the beating of the

heart. At length it breathed, and in an hour afterwards walked roundthe room. In a subsequent experiment Sibson gave woorara to a

horse labouring un der tetanus . As a dose proportionate to that

given to the ass did not produce in this case any effect, more was

given, and in increasing the quantity the animal was destroyed. In

another case the animal breathed at the end of three or four hours,but it died before the apparatus could be applied a second time .

The animal was free from tetanus during the whole period of the

experiment. In order to overcome tetanus, it is necessary to give anadequate dose, and Sibson fears that an adequate dose will be suchas to call for artificial respiration . Radcliffe suggested the employment of conia in cases of tetanus .

PAUL Baoca lately read a paper on the treatment of tetanus bywoorara, to the Surgical Society of Paris . He began by givinga résame' of the literature of the subject, and then entered upon thequestion as to the bestmode of administering it. He does not likethe plan of inoculation, and prefers, he says, giving it by the mouth,which is a less troublesome and equally effective method. For al

though the poison does not act so rapidly, nor in such small doseswhen taken into the stomach, yet if given to fasting animals its absorption by the digestive canal is notto be doubted . Baocs further says,that he would not hesitate to give a man every half hour a tablespoonful of a six-ounce mixture, containing in solution fifteen

grains of woorara. The paper contain s many practical hints of

importance .

KoLLIKI-mand PEIJ KAN found that the muscles of frogs poisonedwith woorara have, as first pointed out by Bernard, and afterwards

rn rstonoolcar. acn ox or en trant Pe rsons . 109

denied byRoeenthaLa greater irritabilitythan healthy on es . More

over, theyfound that the poisoned muscles can sustain un equalweight with the others . With Upas antiar, ven trin , and tanghin ia

poisomwhich act in the reverse wayto woom namely, byk illing themusch s, md not the nerves, similar experiments to the above showed

healthymuscles . (Stfs J.) Haber, under Beichert, confirmed the fact

after a time the trunk . That the poison onlyacts through the

motor nerves ; and that the muscles obey direct stimuli atterthe nerves have ceased to conduct. He found,moreover, that when

Ham says, that the fact of the motor being so much sooner

poisoned than the scnsory nerves proves that theyare chemically

Kfim confirms the statemcnt that the spinal cord is in

nerves have been poisoned . He made ten experiments, and foundthat the refiex action lasted from one and a to four and

a qun ter hourmat a temperature of 17— 18° R.

, and from six to

twenty-five hours at a temperature of 5— 6 " R.

Hon s found that the nerves of frogs poisoned with woorara,

whether dividod or entire, after a time regain their lost ih

fiaenoc over the muscles . He also observed that the rapidity of

the action of the poison depcnds in a great measure on the rapidity

a m relates a series of experimen ts made upon animals

poisoned with woorara, in which, by artificial respiration, he wasable to k eep the heart beating for some hours.Fonxn deuies that the motor anymore than the sensoryncrves

lose the power of conducting stimuli in animals poisoned with

the stimuli to the muscles . In proof of this he cite s several

manner to woorara.

Penman says that antiar and antiarine arrest the heart’s action ,

110 arrow on runms'rrru'rlss or MEDICINE.

and destroy the irritability of themuscles. They affect the nerves,but slowly . These poisons are active when tak en by the mouthas well as when applied to the sk in or introduced through a wound.

Kow xnn and Pl um found that the Tanghinia venenifera at

fi st quick ens the action of the frog’s heart, thenmakes it irregular,and at last stops it, in fromfive to fifleon minutes. There is notetanus . The voluntary action ceases before the reflex, and the

Section of the sciatic does not prevent the muscles of the limbslosing their irritability. The conclusion Kiillik er and Pelikan cameto is, that tanghinia acts upon the muscles like antiar, and uponthe nerves lik e woorara.

Kmnnowsxr says that hydrocyanie acid, when introduced by a

wound or by the mouth, first acts upon the gray substance of the

brain, as is seen by its destroying sensation, and voluntary motion .

The white substance of the brain, on the other hand, remains forsome hours unaffected. The motor nerves furthest fromthe brainand spinal cord die first, and those nearest the nerve-centres last.The 1103e action soon senses, and usually the organ is found fullOf red blood.

JOSEPH found that in frogs poisoned With bichloride of mercury,the action of the heart soon stops. The topical application of the

poison produces the same cfiect.Aa UNG found that perch die when fifty per cent. of sulphu

retted hydrogen solution is added to the water in which they are.

h uge in an atmosphere of the gas die in twenty to thirtyminutes .

Pigeons are killed by 3 c.c., and rabbits by 6 c.c., of a waterysaturated solution given by the mouth.

The gas can be detected in the expired air (as Bernard previouslyshowed) when 5 0-0. of the solution are injected intoa vein, 20— 40

into the stomach, or 39— 50 into the rectum, of dogs. In the first

case in five. in the latter in 55— 1210. seconds.

ANEBTB BSIA.

Rieman n — Ou Voltaic Narcotismfor the Production of Local Ane sthesia forSurgical Operations. Med. Times and Gan , Feb . rsth , 1859, p. 156.

Waller.

— Experimeats on Dr. Richardsen’s Mode of performing Painless Open .

tions by Voltaic Narcotism. Med. Times and Gan , roth March, 3859. p. 285.

n jpr,— Additional Observations on Voltaic Narcotism. Med. Times and Gaz .,

May i4th, p. 491 .

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112 ae ron'r on THE ms'rr'ru'

rns or MED ICINE .

wrist of a girl, in the neighbourhood of a bursa, and after makingthe application twice for a period of sixteen minutes, the parts to beoperated on were white, and so insensible that the patient, whosehead was averted, was unconscious that anything was being done .

WALLER repeated Richardson’s experiments upon himself and

several other persons, as well as animals, and came to the conclusionthat the local insensibility obtained in the above-described manneris quite irre spective of the electricity employed, and is simplydue to the local absorption of chloroform and aconite . The

non-influence of the electricity, he says, is demonstrated by the fact,that the simple topical application of

“

the narcotic mixture inducescomplete insensibility of the skin in a shorte r time thatwhen electri

city is superadded. The effect of the electricity is neither to accele

rate the absorption of the narcotic, nor to produce per as local

insensibility of the skin . In his second commun ication,Waller says,that the so-called process of voltaic narcotismis a luau: p /lysiolo

pious, and all the effects obtained are solely referable to cutaneous

absorption . Further, that the insensibility is entirely confined tothe integuments at the spot of application, and that the contact of

the narcoticmixture for ten or fifte en minutes is almost invariablyfollowed by vesication , and even destruction of the superficialparts of the cutie. The inflammation being sometimes of a

very painful and obstinate character. The cicatriz ation of the

suppurating surface being more difficult than in the ordinary mode

In his commun ication of the 25th June, Richardson says that hehas continued his experiments on the subject of voltaic narcotism,

several of which he relates, and he considers that it may be

accepted as a fact, that such a degree of local insensibility may beproduced by it as shall enable the surgeon to perform a large

number of Operations without pain . He makes no allusion to

Waller’s res earches, but remarks that he is aware that the local

application of narcotic solutions produce a certain degree of

local anaesthesia . The addition of the voltaic current, however,mak es the insensibility extend more deeply. The process, he says,has certain disadvantages : 1 It requires a long time, for itsapplication to be successful ; 2 . It

.is accompanied with a certain

amount of pain ; 3. The apparatus necessary is cumbersome and,

4. The production of cutaneous vesication is objectionable .

Waller, in his commun ication of the 3oth July, brings forward

a xsn r s .113

further evidence to show that the local production of anmsthesia bynarcotics is not accelerated by electricity, and positively denies theexistence of an interpolar variety. Moreover he shows thatnarcoticsare very rapidly absorbed by the skin when dissolved in chloroform(see chapte r on and attribute sDr.Richardson ’3resultsentirely to the employment of thatmenstruum.

Pram s and SAm IBFE'made a number of experiments with a

great variety of substances, such as the iodide of potassiumforexample, but it is quite unnecessaryto cite anyof them, as thcyall

led the authors to the same conclusion, v iz . that the idea of

introducing medicines into the organism bymeans of galvanism,arose froman imperfect understanding of the physical laws, and a

Todd’s instrument is so constructed that the vapour of chloroform is freely diluted with air before ente ring the lungs , and thatthe warma pired gases are prevented from coming in contact with

the narcotic. The advantage of the instrument consists in its

permitting the chloroformto be inhaled in a gradual and uniformmanner.

Osman experimente d with carbonic acid on animals, and foundthat at first theyremain still, then get uneasy, begin to breatherapidly, and have violentpalpitation of the heart. Immediate ly afte r

this state they show no signs of pain, even on the application of a

hot iron . The pupils are moderamopen . Brought into fresh air,theysoon recover. Animals after a time get so inured to the action

of the gas , that in order to render theminsensible theyrequire amuch greater quantity. Ha rm’

s results are nearly similar to theabove.

PARASITES .

Bu ck y (John) ,— The dependence of Tape~wormon the use of raw or underdonemeat. Med. Times and (Baa , March 36th. 1859.p. 309.

Peacock -Theme. “M ammy. wa s a 55°

M — h tal Case of Sarciaa Ventriculi. Brit. Med. Joan n, sth Feb., 1859,p. 100.I oni an — Ou the ficqm toccurrenca of Vegetable Parasites in the Hard Struc

tum of Animats. Proc. Roy. Soc , No. 36. p. 95.

I‘

n — On Substances discharged fromthe Human UrinaryBladder. Archives of“d id “ .N0. 4. p. 190.

Bragg— Ou the Vegetable Parasites of the Humtn Skin. Lancet.sth Pg

» , p. 143.

114 anroa'

r on THE ms'rrrn'ms or usmcms .

Pox — ou the Identity of Parasitic Fungi afl'ecting the Human Surface .

Lancet, roth Sept., 1859, p. 260.

Lowe .

-On Parasitic Fungi. Lancet, soth Oct., 1859.

Ha gan — On Fungoid and other Organ ic Productions generated in Alk aline and

Alhuminoua Urine. Lancet, Nov. 19th, p. 503.

Knchenmeil ter,

— Bericht iiber die Le istungen auf demGebiete der thierischen

Parasiten dea Menschen. [On the Parasites afl'ecting the Human Body .]

( 1856, Schmidt's J ahrbiicher, vol. 99. 1858, pp. 89— 105.

Elma— De Entoaois corporis humani. Bemls'ai , 1857

-8. [On the Entoz oa

found in Man.] (Known already.— Valentin.)

Lefimm— Dhquh ifionea nonullc de Echinococcis, adjecta historiamorbi. Gryp hic ,

1857-8. (Valentin says this is a very carefully w ritten paper, relating someexperiments on Echinococci, and illustrated w ith plates.)

M om -Weitere Beobachtungen iiber die J ugendz uati nde und die Entw ich

lungsgeschichte von Pentastomumtaenioidea. Henle und Pfeutfer’s Ze itachr.

fiir rationelle Medicin, Dritte Reihe, vol. iv, 1858, pp. 78— 10 1 . (A goodabstract of this paper on the Development of the Pentastoma tc nioldee,

will be found in the Microscopical J ournal. 1859, p.Van Baum -8m la reproduction dea Echinocoquee. [On the Reproduction

of Bchinococctl Bullet. de PM . do Bruxellea, ann6 1857, p. 319.

Brats-ell“ , 1858.

Van M odem— Note snr quelques Pentastomes. [On some kinds of Pentas .

toma.] The same, pp. 349— 35s . R. M . Diesing. Zwei Worte iiber D iporpaund Diploz oon. Sitz ungsbericht der Wiener Mud , 1858.No. 4, p. 269.

Jolly,

— Mémoire aur une nouvelle espece d’hématoaoaire da genre Filaire , observ éedans ls ouaar d’un Phoque (Phoca vitnlina, L .) [On a New Species of Entoz oafound in the heart of the Common Seal,] Compt. Rend., vol. xlvi, 1858, No.

8, Feb ., pp. 403— 405.

Wagoner,

— Beitriige z ur Entwicklungsgeschichte der Eingeweidewurmer. [Contribution to the development of Entom ] Natunrlrundige Verhandelingen van

de Ho llandsche Maatachappij de Vetenschappen te Haarlem. Twealfe Decl .4to . pp. 1 u s . Har lem, 1856. Vgl. Pror. neue Notiz ., 1858, vol. iv, No . 1 ,

pp. 3— 6. Canstatt, p. 130.

Laycock .— On the Parasitic Nature of Diphtheria. Lancet, vol. 1, 1859. p. 1 20 .

Harley— The same. lh., p. 1 73.

Bancmv relates no less than ten cases of persons, at variousages, who were affected with tape-worm, and who, on searchingexamination, admitted that they were in the habit of occas ionallyeating raw meat.A case in St. Thomas ’s Hospital, under the care of Dr.

PEACOCK, was also traced to the same cause . The man, a bootmaker, aged thirty-six, had only been affected with the wormfor eightmonths, and said that he became first affected with it afterbeing for some time in the habit of eating raw bacon . Before this

he had, however, been troubled with ascarides . T his,and the ten

cases related by Barclay, support Von Siebold and Kuchenmeister’

s

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116 a s soa'

r or: run w arn s-res or n smcms .

body. In some parts, cells closely resembling cartilage-corpusclesare observed. Some of the worms measure several inches in

length, and are fromone to three lines in breadth. Farre calls it

the Diplosoma crenata.

Hoe s says that it is wrong to attribute certain special diseasesof the skin to a vegetable parasite peculiar to each. The samefungus is peculiar to all, and ought rather to be looked upon as

the result, and not the cause, of the disease .

Fox, on the other hand, looks upon parasites as the real agentsin the production of diseased hair, which, in his opinion, is the true

parasitic affection . In all cases of skin-disease, if there be a parasitepresent in a state of growth, the hairs will be found diseased ; whenthe growing fungus is absent, the hairs are unaffecte d. Otherstructures besides the hairs are, however, involved. Eruptivedisease maybe present, although not necessarily. Ep le Tin a

decalvans . Eruptions are evoked by a host of irritants bes idesparasites, whereas affection of the hairs, which Fox says is the trueparasitic disease, can only be produced by the presence of a fungus.Remove the affection of the hairs, and nothing diagnostic of the

ravages of the parasite remains take away, on the other hand, theeruption, and the true parasitic disease is still there. He believes,moreover, that the existence of an eruption is necessary for thedevelopment of the parasite . Lows

’8 views are similar to the

above, and he also, with Fox and Hogg, look s upon the fungiaffecting the human surface as mere varieties of one commonspecies .

Ha ssu n says the Vibrio lineola are not exactly linear ; butslightly enlarged, and rounded at either extremity, like a dumbbell. That they are endowed with the power of voluntary motion,and are rapidly developed in feebly acid or alkaline urine, especiallythat containingmuch animal matter (albumen) . The Bode urina

r z'

us are round or oval-shaped bodies, possessing two or three cilia .

They multiply by fissiparous reproduction . They are developedunder similar conditions to Vibrio lim b . Lastly, Hogg describesa peculiar fungus, occasionally met with in alkaline urine . Ex

posure to the air and the presence of albumen accelerate its

development.VAN BENEDEN took a quantity of Echinococci fromthe liver of

a pig, and put themintomilk in one, and into albumen of the heu’segg in another, case. Bykeeping themat about the temperature of

s ans aarxos a s !) numomsxv . 117

the living bodyhe was sble to preserve themalive, and study theirdevelopment up to a certain point.In dissecting the heart of a specimen of the common seal— Pm

0M “ , J ew found several female nematoid worms, measuring

He found nomales . Jolythink s that the embryos enter the animalalong with its food, find thcir way into the ciroulation, and are

Valentin says tin tWu nnnn’s researches on the development

of cestoid worma, as also on Echinococci, &c., are exceedinglyportant, and are illustrated wi th thirty-seven fine large plates . He

LaYcocx found the Oid z'

umalbicamon the exudation from the

fences of a patient labouring under diphtheria, and thought that theparasite might be the cause of the disease . Hanan examined

he says, due to accidental circumstances . In one of the cases

eight hours after its removal fromthe patien t.

GENERAT ION AND DEVELO PMENT .

Thom — Ou the Omnpararive Influence of the Male and Female Parent uponthe Progeny. Bdinb. Month. Med . Jam . Feb., 1859.p. 696.

-Ou the Laws of Organic Pom. British and Foreign Med -Ch it . Rem,J am, 189.

Dom-0a the Influence of White Light. of the d imrent coloured Rays . and of

Darkness . on the Development. Growth. sud Nutritioa of Animals. Proc. soy.

Soc .No. 34. p. 644.

M — Note re lative l l‘tnfluence de la lumiere snr lea snimsux. [ou theInfluence of Light on Animals.) Compt. React, vol. xlvi. pp. 441— 443.

D‘ -0a the k lsctriml coadltiou of tha Egg of the eommon l'owl. Pm l oy.

No . 35. p. 31 .

W — Ou the m txoteny of Comets“ w e (Lihet.) Proc. Roy. Soc .

No . 34. p. 600.

M ariam -On the Aqaifsm aad Ovidnetal Sysums i-thema m mals“Drum — O u the Development of the Female °

Pelvis. (Ediub. Med. Journ..Oct.,1815s a are )

— 0u the 0n w d l’ scudovs of lnrects.

Rama — De u g‘s‘u fi on spouts-60. m h m, £058. (a compilation in

W or thc spoomm p amfiu of pmeut sod u tinct u im

118 an on on run rnsrr'ru

'rrs or immense .

M u tan Gsnerstionswechsel und Parthogenu is der Pdsnsen nnd Thicre

Froriep’s neue Notiz en, 1858, vol. iii, No. 1 , pp. 1, z . L'

Institut, April, 1858,No. 1 268, pp. 139, 140. [Parthogenesis in Plants and Animals. Alreadyknow n

— Valentin ]Com-Usher das Wicderaudeben der durch Austrocknen in Scheintod versctz ten

Thiere und H ansen. 35. J shresber. d. schles. Grs. fiir voter]. Cultur. Ans

demJ ., 1857. 4to. Bram, 1858. pp. 48— 50. (A rev iew of various knownfacts regarding the resuscitation of dried and apparently dead animals.)

Ka — Von der Ueberwanderung des msnaehlichcn Eies als eincr Ursacheder Eileitcrschwsngerschalt. [On the Emigration of the Human On ]Froriep's neue Notiz en, 1858, vol. ii, No. 3, pp. 41, 42 . Gas. Méd” August,1858, No. 32 , p. 649.

[Contribution to our knowledge of Tubal Pregnancy] 4to. Ala-burg, 1858.

THOMSON quotes a number of cases in man, and other ani

mals, to prove that themale parent has the chief influence over thepropagation of the texture, cob ur, and other cutaneous peculiarities

of the progeny. The following table shows this in man

11a ca n nul a .

Black. Albino.

Black children .

Albino child.Black child.

White. Black child.Twins— l black, 1 white .

Number whose colour of skin was due to the fatherDitto, mother

The hair takes on the characteristics of themale. The hair iscrispy when the father is a negro sleek, when the male parent isa European . Thomson quotes the following casesIn a young woman residing in Edinburgh, born of Scottish

parents, but whose mother, before her marriage, had a child by a

negro,Dr. Simpson found that the fla ir l ad tile negro characteristics .

Congenital alopecia is extremely rare, and in the only case on

record Bayer tell us that it was transmitted by the father to

the son .

In the lower animals, the marked influence of the male on the

colour of the skin and hair is particularly remarkable . When thespawn of the salmon is immegnated by themale trout, the progeny

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120 REPORT ON ra n INSTITUTES or MEDICINE .

conditions are alike only on the Opposite sides of one axis, while

they are un like in all other directions, as in the majorityof leaves,

in many flowers, and throughout the Vertebrate , there we havesymmetry of one dimension, bilateral or linear symmetry. 4. Thatwhere the conditions, widely unlike in all other directions, are onlypartially alike on the opposite sides of one axis, as in the sole, &c.,

there we have unsymmetrical bilateralness. And, 5 Thatwhere the

larityin anydirection, as with the viscera of the higher animals,then the structure is asymmetrical.DOBELL thinks that wemayaccept of the following propositions,

all otter conditions being tile same. 1 . Tile ova of insects are not

directly influenced in their development by white light,by the

different coloured rays, or by darkness. 2 . Ti e la rva of insects are

not directly influenced in their development, growth, nutrition, or

metamorphoses, by white light, by the different coloured rays, or bydarkness. 3. Tfie tom of Batrac/h an rep tik s are, in a similarmanner, influenced by the same causes . 4. Ti emateria ls necessaryto tile colour of insects and rep tiles are equally well prepared underthe difl

‘

erent kinds of light or in darkness .

DoaaLL says that, speaking generally, it must be admitte d thatlight is essential to the development, growth, and nutrition of ani

mals, but only indirectly. In his experiments, the usual coincidentsof light, a proper supply of food, a due aération of the respiratorymedium

, a properly regulated external temperature, &c., having been

provided, the direct influence of light only being changed, no corresponding change occurred in the animal life.Bacmu relates researchesmade upon the development of the fly(Musca oam ria ), by means of coloured glass. The animals were

most rapidly developed under blue and violet, least under green,light. The order of development was, I under violet ; 2 , blue ;

3, red ; 4, yellow ; 5, white ; and lastly, green . The quantity of

carbonic acid exhaled by birds andmice under coloured glass does notvary ; whereas with frogs it is very different— they give out one

quarter, one third, or even one halfmore CO2 under green than un derred light.Davr says, that the structure of the egg suggested to himthe

idea of its exerting electrical action, which was confirmed on trial.

Using a delicate galvanometer and a suitable apparatus, on plunging

one wire into the white, and the other insulated, except at the point

GENERATION AND s snormaNr . 121

of eontact, into the yolk , the needle was deflected flve degrees. On

changing the wires , the course of the needle was reversed. When thewhitc andyolk were tak en outofthe shell, theyolk being still immm'

sed

in the white , the eflects on trial werc similar ; but not so when thetwo werc wellmixed ; then uo distinct eflect was perceptible . Indica

starch, and a small quantityof iodide of potassinm, especiallywhenrendered very sensitivc of change bythe addition of a fcw drope ot

'

libm'

ated appeared at the pole connected with thc white. In that of

eggs that had been k ept some time, it appa red at the pole con

Taon sON describes the male and female reproductive organs of

the comatula. The mature ova, before impregnation, are protrndedand remain hanging fromthe ovarian orifiee, eutangled iu thc

meolar tissne of the everte d ovary. In this positian immgnstionusuallyoccura. Aftm'

segmennfion of the yd h s solid nuclsus is

formed in the centre of the mulbelry yolkmi ass ; tliis nnclens

becomes invu ted bya membrana and into this mass the remainderof the yolk is gradually abw rbed. The embryo is ciliated. The

yellow colour, girded at intervals with about five broad, ciliate dbands. The digestive organs are rapidlydevelopcd, and the larva

at the same timc becmncs vermiform. Under circumstanceo favorabla

larva ruaybe arrested in anyot’

its earlier stagert bsfore the complcte diflemtiatioa of its internal organs .

Romss'l'ON and Boasarsos say, that the commonly receivedOpinion as to the oriflces at the ontlet of the ovarian systemis

a wata -vu cular system. In the second psrt of fiie oommunicatioathemuctures are indicated which the snthors hold to be the tmaoviducts. At the spawning seu ama prominent ridge projectinginto the lower segment of thc intcstine is seen, whicb, with two

unfl k rmea u e said w discharge this funetioa .

w allndes to tbe manifold inflneuces whieh determine theformat the pelvis . M umfancymd aduk sge, u it n e in

siz e, it gradwally changee in shape. In carlylife, the antero-pos

122 naros r ON ran msrrruras or MEDICINE .

terior diameter of the brim is greater than the transverse ; thesacrum is nearly vertical ; the iliumalmost flat and straight, fromthe posterior tuberosities to the acetabulum. While in adult lifethe transverse diameter of the brim is greater than the antero

posterior ; the sacrumand the iliumhave both assumed an obliquedirection . The horiz ontal rami of the pubic bones also forma less

acute angle in the adult.Lunaocx endeavoured, in I 857, to show that the organic eggs of

Dapfinia are formed on the same type, and consist of the sameparts as other eggs . In the present paper he says, that in all

female insects there are two ovaries, each consisting of at least two

egg-tubes opening into a common chamber, the uterus . The egg

originates and attains to nearly its full siz e in the egg-tube, and itis with this portion of the generative organs he chiefly occupieshimself. The egg

-tubes differ very much in number and length,and the number of egg-germs they contain varies . It is, however,probable that in each species the number is defin ite . Each eggtube generally consists of two membranes . The outer muscular,the inn er delicate and structureless, and lined with a layer of

epithelial cells . These probably take an active part in the score

tion of the yolk in all insects, and are the principal, if not the

only, organs which formthe yolk in the OrthOptera, Pulsar, and theLibellulina .

In the earliest stage of development, the egg-cell cannot be distinguished from the vitelligenous cells (those that secrete the yolk),and at the upper end of the egg

-tube maybe found cells which are

neither the one nor the other, but which are apparently capable of

becoming either the one or the other. Themacula germinativa is asmall, roun d vesicle in the Orthopetra . In Pulea' the germinalvesicle is dark, and the macula germinativa, which is distinct in theyoung egg

-germs, soon disappears . In the Coccus , the germinal

vesicle makes its appearance after the vitelligenous cells . It is about‘

0008 in diameter. About the same time the oil-globules also

make their appearance, and soon become the most conspicuous partof the egg. The vitelligenous cells, Huxley and Leuck art say, are

well developed in the oviparous Aphides but less apparent in theagamic or viviparous forms . It is generally stated that all the

Ap/lides are, in spring and summer, self-fertile and viviparous, andbecome oviparous in autumn . Lubbock, however, thinks it probablethat in cold regions some species maybe always oviparous .

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RE POR T

PRACTICAL MEDICINE, PATHOLOGY,

AND

THERAPEUT ICS.

CHARLES HANDFIELD J ONES, M .B .,

r aLLow or r un norm. 001.1.t or r a r arc i a x s ; rn r axcu N so an s u n’

s

HOSPITAL ; dz c.

GENERAL PATHOLOGY AND SYMPTOMATOLOGY .

Win g — Lectures on Pathological Anatomy. delivered at Guy ’s Hospital duringthe Summer Sessions of 1857 and 1858. pp. 472 .

Virchow ,

— Das wahre Neurom. [The True Neuroma.] Canstatt’s Jahresbericht,

1859, vol. ii, p. 33.

Lonbngohor ,

— Pathologische Bindegewebs entwicklung imGehirn . [PathologicalDevelopment of Connective Tissue in the Brain.] Canst. Jahrber., 1859, vol. ii,

p. 39.

Bneflm— Experimentelle untersuchung uber den Biudnas der nerven auf den

Entz iindungs-Proceas. [Experimenta l Inquiry respecting the Influence of the

Nerves on the Process of Inflammation .] Canst. Jahrber. , 1859, vol. 11, p. 44.

(The experiments were made under Douders' inspection .)Gm ing ,

— Untersuchungeu iiber Blutbewegung und Stasis. [i nquiries respecting

the Movement and the Stasis of Blood.] Canst. Jahr., vol. ii, p. 45. (UnderDonders ’ superintendence .)

SamueL— Ueber den B iudnas der Nerveu auf den Entsundungs process. [On thei nfluence of the Nerves on the Process of Inflammation .] Canst. J ahrber.,

vol. ii, p. 48.

Virchow ,

— Zur Geschichte der parenchymatiiseu Entz findung. [On the Historyof Parenchymatous luflammation .] Canst. J ahrber. , 1859, vol. ii, p. so .

Emmi — Sui fenomeni iniz iali delle flussione sanguigna specialmeute secondo irisultati delle osservaz ioni ed esperienz e microscopische, uuovi studii sperimentali. Peruer.— Iutorna di fenomeni iniz iali della dussions sanguigna specialmente secondo i resultati delle osservaz ioni ed esperienz e microscopischeNuovi studii sperimenta li e consideraz ioni intorno all

'essenz a della fiogosi.

[On the Initial Phenomena of Determination of Blood, particularly accordingto the results ofmicroscopical observation and experience : New ExperimentalStudies . Further.— Respecting the Initial Phenomena of Dete rmination of

Blood. particularly according to the results of microscopical experience and

Observation new Experimental Studies and Considerations respecting the

Essence of ludammation .] Canst. Jahrber., 1859, vol. ii , p. 53.

GENERAL PATHOLOGY AND SYMPTOMATOLOGY . 125

l

Lima— ou the Early Stages of Inflammation. Canst. Iahrber.. 1859, vol. it.

F 53°

Robin — Memoire sur une mode particuliese et non deer-lie de la production de laparvi (d o) dea Kystes autour da certaines Collections de pus et d ’autresquldeadan s les organes protonds . [Memoh on a particular and undeacribed Mode of

Production of the walls ol'

Cysts around certain collections of pus end other

liquids in deep-seated Organa ] Canst.v -Recherehes sur la durée de la contractilité da cmur aprts la mort.

hes on the Duration “ the Contractihty ot the lleart afi er DeathJCanst. Jahrber" vol. ii, p. 55.

Km u — Ueber die Brtédtung dsr Gliedmassen dureh Biaspfi tt ung von Chlorvformin die Schlagaderu. [On causing Death of the Limbs by injection of

Chloroforminto the Arteries.] Canst. Jahrben . 1859. p. 56, vol. ii.

Hot Climates on European ] Canst. Jahrher.. vol. ii. p. 58.pathologiques de la flbrine dans le sang. [On the

the Fibrin in the Blood.] Canst. Jahrber., 1859,

vol. ii , p. os .

Begu m — Klein Beltri ge z ue perlmw tal Pathologie . Drnek stiegerungln An al-impetus! and Albuminurie . Hershypertrophie hei verme hrtemDruck imAortensyttem. [Small Contributions to Experimental Pathology.

I.) On Increase 0! Pressure in the Aortic System. and Albumiunria. (a ) OnCardiac Hypertrophy in increased pressure in the Aortic System] Canst.Jahrber .. vol. ii. p. 63.

M gr ,

-Modideation apport6e'

au reaetif de 88ttger ponr reconnaitre la pr6sence.

da sucre daus lea urines diabet. [Modification of Bdttger's Reagent for detectlngthe presence of Sup r in Diabetic Urine.) Cantt. Jahrberq 1859 : vol. ii ,

P 75

m — Ueber cine Behinococcus

Plaid . Canst. Jahrber., i 859. vol. ii. p. 86.

em u — Merw in sur l'hydropisine. nouvelle matiere albumineuse. [Memoir on

Bydmpisine. a new albumineus substance.] Canst. Jahrhe r., 1859. vol. ii,p. 86 .

puma — Note snr la suppuration bleue. [06 Blue Pus .] Canst. Jahrber..

vol. ii. p. 81.

CONTRIBUTIONS TO MEDICAL DIAGNOSIS AND sn rm xwmme r .

m am-Des Ben and seine Bewegung. [The Heart and its Motion. )Canst. Jain-hen , 3859.Vol. ii. p. 90.

Gama — Untersncbung uher die Hen dfimpfung und die Ven chieln ng ihrenGreasen bei Gesunden. [An i nquiry respecting the Duluew n ea of the

Heart, and the alteration of its limits in health ] Canst. Jahrber.. t859, vol. ii.P 97

Lmhk g — Uebar die Lamagsrerhiiltniss der verderen mittelfelle. [os thePosition oi the Anterior Med iastiuumJ Canst. Jahrber.. 3859. vol. ii, p. w e .

Pigg y— Influence dea respirations pretend“ at accelérees sur les maladies do

Oth er. do fete, des poumons, die. [The Influence Oi deep and accelerated Respiration on Diseases ol the Heart, Liver. Lungs, as ] Canst. Jahrber” 1859.vol. ii, p. te a.

Ritual — ( lia ison Fragmente. [Clinical Pn gments.) Canst. Jahrbern vol. ii,p. 103.

126 EEEOET ON EEAOTIOAI. MEDICINE.

— Capacité vitale du poumon , sea rapports physiologiques et patho logiquesavec les maladies de la poitrine. [Vital capacity of the Lungs, and its Relationsto the Diseases of the Chest.) Canst. Jahrber., I859, vol. ii. p. Iog.

W — Ueher den KehIk Opfspiegel. [On the Laryngeal Speculum.) Canst.Jahrb., 1859, vol. ii, p. I I I .

Funk — Den Kehlk opt’

raehenspiegel und die Methode seines Gebrauchs . [The

Laryngeal Speculum. and the mode of using it.) Canst. Jahr., I859, vol. ii,

p. I I 3.

Burk — ZN verwerthuug dea Kehlk opfraehenspiegels. [The value of the Laryn

geal Speculum.) Canst. Jahrb . , vol. ii, p. I I 7.

M edan — Beweglicher Brillenspiegel an laryngosk opischeu untersuchungen .

[Moveable Spectacle-Mirror for examination of the Larynx .) Canst. Jahrb .,

vol. ii, p. I IS.

Wunda fich — Ueber Hypertrophen bei typisch verlaufenden Krank heiten. [On

Relapses in Diseases running a typical course.) Canst. Jahrb ., I859, vol. ii,

p. 1 23.

Dr. WILKs’lectures on pathological anatomy do not admit of

more than bare mention . The work is divided into two parts,the first describing the various morbid states of the severalorgans and systems, the second treating of associated morbid conditions and essential diseases . Reference is made continually toillustrative specimens in Guy’ s Hospital Museum,

which is underthe charge of the author, and which, together with the numerousautopsies he has conducted, has furnished himwith amost copiousstore of facts on which his statements are based.

GENERAL PATHOLOGICAL ANATOMY.

FOSTER, after quoting Virchow’s description of the state of the

nerves of an amputated stump, says that it is probable that thefascicular neuroma with fibroid characters is to be regarded equallywith the true neuroma as a tumour consisting of nerve-fibres . In

it, however, the fascicles of the perineuriumare filled with nervetubes devoid ofmedullary substance, but broad and rich in nuclei.

WEEEE describes the formation of new vessels in and on cartilage

during chronic articular inflammation, as occurring in two differentmodes . In one club-like processes of fusiform nuclei or cells

shoot out fromthe margin of a capillary loop, and give of!“

freshprocesses . These enter the gaps made by the perishing of the

cartilaginous structure . The original capillary becomes the trunkof a vessel which ramifies through the new-formed arborescentprocess.

BILLROTH gives an account of the mode of ossification in

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128 REPORT ON PRACTICAL MEDIC INE.

latter did for physiology. We can do nomore than refer to it. SO

also with another essay of the same author, on Irritation and

Irr itability,’we have to quote the remark of Kussmaul, that we do

not see how,with advantage to the reader, we can give a summary of

the contents, at least within the limits allotted to us . Snellen hasexamined experimentally the influence of various nerves upon the

inflammatory process . He states, fromobservations on the ear of

the rabbit, that the relation Of the sensory nerves to the vascularnerves is similar to the ir relation to the motor nerves . Irritation of

the sensory nerves causes increased action of the vascular nerves of

the same side upon the same part. When the irritation is intense,this reflex action, just as is the case with the motor nerves, extendsalso to other regions ; moreover, it is the spasmodically contractedcondition of the wall of the vessels which essentially conditionatesthe succeeding state of stony, so that the force of the heart remainingthe same, vascular dilatation must follow contraction without thenervous influence being lessened. He further ascertained thatsection of the sensory nerves did not essentially alter the process of

inflammation, while section of the vaso-motor to some extent

promoted it, and quite positively promoted the absorption of

extravasate d fluid, and the occurrence of cicatriz ation . So alsowhenhe inflamed both eyes, by dropping strong acetic acid into each, thecourse of the inflammation was shortened in the eye of the side on

which the sympathetic cord had b een divided. Snellen opposes theold view that section of the fifth pair produces corneitis by paralysingthe nerves that preside over the nutrition of that part. He believesthe corneitis that ensues to result frommechanical irritation, &c., and

shows that if the animal’s ear is fastened in front of its eye, and themucous secretion carefully removed, the comes is kept free frominflammation .

GDNNrNG has studied carefully the motion of the blood, and itsstasis . With respect to the influence of the nerves on the diameterof the vessels, he found, that in frogs, division of the rami communicantes of the sympatheticproduced nomarked effect ; division of thesciatic plexus n ear the spinal cord had amarked efl

'

ect in producingvascular injection, and increasing the rapidity of the current ;

pinching of the skin he foun d to cause contraction of the smallarteries, but does not feel satisfied to assume a reflex action fromthesensory or the vaso-motor nerves, because arterial cOntractions occur

both spontaneously (even after division of the nerves) and associated

GENERAL PATHOLOGY AND SYMPTOMATOLOGY .

withmuscularmovements .With respect to the effectof irritants I

A weak galvanic current constantly contracts the greater and smallerarteries lying in its course, sometimes in spots , sometimes completely, and usually so perfectly that the Channel is obliterate d .

The veins of the web were never positively contracte d, only thelarger ones running at the sides of the toes . The circulation in the

capillaries was not slackened or arrested, unless the degree of

the same efl'

ects asWharton Jones observed. Warmthimmediately increases the rapidity of the stream, and distends thearte ries, capillaries, and veins, without causing contraction or dilatation . A highcr. temperature at first increases the rapidity of

'

the stream, but soon it slackens, and stasis occurs . The arteries

wa s not contracted. Cold had no effect. [The editorremarks that some observations of his own were very positive as to

the arterial dilatation produced by warmth, and the contraction

cold. Both the higher and lower temwrature were

Dilute acids for amoment increase the rapidity ofthe eunent then it dcclines and stasis sets in . Stronger acids cause '

accumulation of the blood in the veins, and an emptystate of the capillaries and arteries . Dilute caustic alkalies act in the same way

’

same way. A drop

without visible arterial dilatation , which in aretardation and arrest. The stas is aflects ,

Gunning concludes that stasis has no con

state of the vessels or of the heart’s action . He

s resiflts as to the efl'

ects of irritants after ligature

posterior part of the

180 Rascar on PRACTICAL n euroma.

tricel. True stasis was produced, notmere stillstand of the current.Samuel concludes that nerves originate fromthis centre which

gulate the nutrition of the posterior limb.

VIRCIIow describes a specimen of inflamed cornea, and one of

inflamed endocardiumof the chords: tendineae, as illustrating his viewsof parenchymatous inflammation . The lamellmin the former wereunaflected, the corpuscles were enlarged to fromten to twenty times,and rendered opque by a fatty, albuminous, granularmass . In the

latter the inflammatory alterations did notappear in the vicinity of thevessels, but rather at the most remote parts , where the tendinouscord is most exposed to tension, at the point of bifurcation .

Ban al , (late) of Florence, denies that the capillaries have any

power except that of elasticity. Active hyperemia he ascribes tothe greater activity with which the tissues exert their function .

Inflammation he refers, and did as long ago as 1844, to secret

disturbances of the interchange taking place in the process of

nutrition between the blood and the tissues. He think s that no

explanation can be foun d in the derangements of the circulation of

the phenomena of inflammation . Neither does he consider indammation as an increase of organic activity and nutrition, but ratheras characterised by the reverse.In a paper on the early stages of inflammation, LISTER shows that

irritation of a certain part of the spinal cord of the frog producesconstantly contraction of the arteries of the web, and that destruction of the same is followed by permanent dilatation . Neither state,however, causes anyarrest of the blood-current, or alteration in the

quality of the blood. Fromthe circumstance that the same changesare produced in sucw sm

'

ve portions of blood passing through thevessels of a spot which has been subjected to mild irritation, viz .,

increased tendency of the red and white corpuscles to adhere togetherand to the walls of the vessels, Lister concludes that the irritatedtissue is the original seat of the inflammation, and that the alterations in the blood are secondary. He observes, further, that the red

and white corpuscles are nevermore inclined to adhere than they are

in healthy, fresh-drawn blood, and concludes that the tissues of a

healthy part exert an influence on the blood whereby the red and

white corpuscles are kept free fromtendency to adhere, while ininflamed parts this influence is more or less lost. Lister believesthe inflamed parts to be in a state of diminished functional activity,fromthe relaxation of the arterial coats and the difl

'

usion of the

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132 REPORT ON PRACT ICAL MEDICINE.

heart, which must be felt even in that vascular system. More

irritation, as shown by experiments with dead organs, does not causea salt to penetrate speedily into the interior of themass . The prac

tical conclusions which Kussmaul adopts are thata putrid limb isnot to be considered as amere dead appendage, even when all circula

tion has ceased ; that, on the contrary, there maygo on an activeexchange of fluids between it and the living parts ; that the mecha.

nical and even the chemical actions are different in sphacelus andin post-mortemputrefaction ; and lastly, that the magnitude of the

danger in gangrene of a limb does not only depend on the siz e of the

contact-surface of the living and dead parts, but on the siz e of the

whole putrefyingmass .

G leam maintained a thesis at Paris in I857, on the influence of

and does not admit of abbreviation for our limits .

Pancm rn has made numerous examinations relative to the

pathological variations of the fibrine in the blood. He finds thatin acute inflammations, attended with fever, the blood contains twiceas much fibrine as in the normal condition ; he states, as the generalmean, parts per 1000 of liquor sanguinis . In chronic indammations the increase was very little 51 0 to per 1000 . In variousdiseases attendedwith impoverishmentof the blood, where the fibrinehas been apparently increased, Parchappe show s that the increaseis only relative, and that there is an absolute decrease .

G. MEYER in thirty-one persons dying of different diseases, foundtraces of sugar (or hepatin e yielding sugar) five times only,while in theremaining twenty-six there was no trace . Vernois found sugar sixtyseven times in I 73cases Stokvis only once in eleven cases, the sugaryielding case being that of a man who died from fracture of the

skull while in perfect health . In a case of death fromcommon car

buretted hydrogen no sugar was found, though the patient lived onlyfour hours . It does not appear that the age, the nature of the disease,or its duration has anypositive determining influence on the pre

sence or absence of sugar. Meyer ascribes its absence, in accordancewith Bernard’s views, to an alte ration of nutrition occasionedthrough nerve-influence .

In a dog whose thigh-bone had necrosed after obliteration of the

aorta, BECKMANN observed the muscular fibres of the heart in someplaces calcified so as to formrigid, glistening cylinders ; only hereand there were the calcareous salts deposited in the formof small,

GKNERAL PATHOLOGY AND SYMPTOMATOLOGY . 138

round granules between the fibres . In the kidneys , the cortical

tubes in several places were complete ly filled with calcareous salts

the Malpighian bodies, the stroma, and the pyramids, were free .

PATHOLOGICAL CHKHISTRY.

Belative to the detection of sugar in the urine, in the normal and

information on this subject (pp . 93 We can only cite thefollowing. Bottger

’s new test for sugar is, according to Behier,

one of themost delicate and reliable, if slightlymodified as he pro

poses. The urine is boiled with an equal volume of one part of

crystalliz edCarb . Sodmin three parts of water, and a little basic nitrateof bismuth sdded. Behier adds also a very small fragment of

caustic potash. If sugar is present, the bismuth is reduced, givinga black colour to the mixture ; if there is noue, it remains white .

Echinococcus fluid examined by Rscn msmua was colourless,

sp. gr. free from albumen . In 100 parts there were

97 998 of water, of solids . The latter contained nearly halfits weight of chloride of sodium.

Th ey requested Gannal to examine this substance further. He

cflusions of the pleurs and peritoneuma substancc is found coagu

lable byheat and nitric acid. It is distinguished fromscmm and

coagulated ; fromcasein bycoagulstion on heating ; and frompan

Brightii. In Ioo parte of pleural effusion there were I6 '

7C parts

of moist hydropisine, 2 1 15 of moist albumen . In 100 parts of

peritoneal serumthere were I4ofmoist hydropisine, z4'

46 ofmoistalbumen .

greenish colonr, snd stains the dresdngs blue . The colouringfl

184. an on on raac'mcu . u z nrcms .

matter has been isolated by Cour s e s-r, by steeping the bandages incold distilled water, and expressing the liquid . This is mixed withsome alcohol, heated to boiling, and filtered. After driving 06 the

alcohol by heat, chloroform is added, which takes the blue colour

from the wate r. The chloroform-solution being separated and

evaporated, a deep-blue powder was obtained, which became greenon shaking with a ther, and remained blue in water, thus provingthe identity of the blue and gw en colouring. The general opinionis, that the colouring matter is amodification of biliary pigment.

CONTRIBUTIONS TO MEDICAL DIAGNOSIS AND SYHP'DOMATOID GY.

In a paper on the position andmovements of the heart, Ru w rx

Itates it, as a greatmystery,wall of the chest instead of He thinkshe can explain this by reference to his observations on the positionof the heart and the fixed point afforded it by the contraction

tendency of the lungs . If the heart is examined by touching itthrough the diaphragmafter opening the abdominal cavity, throughthe pleura by removing the fifth costal cartilage, and through therightlayer of the anteriormediastinumfromthe rightpleural cavity,the observer becomes convinced of the firm, immoveable position of

the heart, fitted into the angle between the diaphragmand anterior

wall of the chest. If a small Opening is made into the pericardiumthrough the rightmediastinal layer, the air rushes in with a noise

,

the heart loses its fixity, the sharp edge of the right ventricle startsfromits recipient angular bed, the heart becomes easily moveable,takes another position and direction, while the ante rior wall of the

chest between the fourth and sixth cartilages (left) changes its reso

nance, and (in place of a dull) gives now a clear note .

” This firm,immoveable position of the heart only exists in young, healthyindividuals ; in old persons and in various morbid states it is lost.

Hamernik maintains that the apex of the heart takes no part in theimpulse, the tongue-shaped extremity of the upper lobe, or the anteriorborder of the left lung, lying between it and the anterior wall of the

chest. Hence the determination of the site of the heart’ 8 impulse cannotdetermine the position of the heart. Hamernik describes particularlythe sup erficial and the deep position of the heart, the chief differencebetween thembeing the close approximation in the former of the

anterior or superior convex wall of the ventricles to the wall of thechest. The former is the position which exists in early life, until

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186 an on on ras c'

rrcar. n euroma .

duln ess . (z .)— Thatmurmurs depending on the contactof roughenedspotsmaybe developed, increased, or abolished, by change of position .

If it should be shown in a case of simple pericardial adhesionthatthemobilityof the heartwas lost,this latterwould become a usefulsign of such adhesion having occurred . In the person of a female,who had an external fistulous opening,Gerhardt observed distinctly,by introducing his finger so as to be in contact with the ete rnal

part of the diaphragm, that the heart descended at each inspiration

(tranquil), and altered its position with rightor left lateral decubitus .

He also assured himself of the occurrence of a systolicmovementof the heart’ s apex downwards and to the left.HAMERNIK having stated that the whole posterior surface of the

sternumwas covered by the right pleura, and that no part of thepericardiumwas left unlined by the two pleura , Luscnxa examinesthe exact positions and attachments of the two layers of the anteriormediastinum, and finds that the individual varieties are very con

siderable, but that as a rule there exists certainly a triangular spaceat the lower end of the body of the sternum devoid of pleuralcovering, and therefore accessible to the trocar in hydropericardium.

The width of this at the level of the stew al extremity of the fifth ribis 1

'

5 centim., at that of the sixth rib 2 centim., at that of the seventhrib centim.

Plonmr recommends frequent and deep respiratory efi'

orts as a

means of relieving dyspncea dependent on a congested and dilatedstate of the heart, congestions and inflammations of the liver andalso of the lungs, as well as dmpsical effusion resulting fromcardiac disease .

In his clinical fragments, Hmscn accounts for the vocal fremitusbeing sometimes abnormally increased, at others dimin ished, by thevarying state of the tension of the thorax, or by the too greatpressure of the swollen lung against the pariete s . Condensation of

the lung will always, he believes, intensify the vocal vibrations .

In examinations of the vital capacity of the lun gs, and its

relation to chest-disease, SCHNEPF finds that expiration alwaysoccupies a longer time than inspiration , and that in three out offour cases a quantity of air greater by 50 250 c.c. is expired thanis inhaled. He does not think this increase can be explained byexpansion of the air from heat, and addition of carbonic acid, forthese conditions exist in all persons. He state s, further, that thequantity of air put in motion during the respiratory act does not

msxxss s arrscrmo ms GENERAL srsrsm. 137

depend on the breathingmovements there does not even appear toexist any close relation between the two . Re lative to the influenceof age, Schnepf concludes that before the age of ten the capacity ofthe lungs increases yearly about 140 c.c. , so that atthe age of ten themean is about 1400, and that to obtain approximatively the capacityM an age below this, it is suflicienttomultiply the given number bythe age . Between the ages often and twentytheyearlyincrease amountsto above 260 c.0., except for the first years . At the age of twentythe

capacity reaches its maximum, and afterwards declines, but inmann er, so that no yearly number of decrease can be

stated . In the female sex the pulmonary capacity is considerablyless than 111 the male . The capacity increases in general with theheight, yet pmons of the same heightmay differ in their capacities1 200 — 1300 c.c. The circumference of the thorax (taken at the

nipples) has no determinate relation to the capacity . In one fourthof the observations made to determine the point it was found thatthe capacity was the same when the stomach was full as when it wasempty ; in another fourth the inspiration and expiration were both

greate r when the stomach was empty; in the remaining half thecapacity was greater when the stomach was full.Cz aanu x strongly recommends the use of Garcia

’s laryngeal

speculum for the examination of the larynx and adjacent parts .

The instrument consists of a small, oblongmirror, fixed to a suitablybent wire . The mirror is introduced deeply into the throat till itslower margin meets the posterior wall of the pharynx, the soft palatebeing pushed upwards . With a little practice the whole base of the

tongue, the epiglottis, the upper and lower chordie vocales, the

ventricles , the mucous lining of the aryte noid cartilagea, and the

posterior pharyngeal wall as far down as the (esophagus, nay, ondeep inspiration a considerable part of the interior of the trachea, canhe brought into view . By turning the reflecting surface of the

mirror upwards, a view can he obtained of the poste rior surface of

the soft palate , and of the upper part of the pharyngeal cavity.

Titan gives a description , with figures , of the laryngeal speculumheemploys, with copious details of directions for its use . For thesewe must refer to the paper, only remembering that it is necessary toheat the speculummoderate ly before introducing it into the mouth,to prevent the condensation of vapour on its surface .

138 REPORT ON Pa ac'rrcan unnl cmn .

proved means of illuminating the part of the throat which it isdesired to see with the speculum.

In some remarks upon hypostrophes, as WUNDERLICH termsrelapses, and various deviations fromthe normal course of recovery,he observes that no sign gives such sure and early warning as the

increase of the temperature of the body. So long as in diseasesthat subside slowly the temperature falls uniformly, or with suchvariations that the morning temperature and the evening are eacha little below that of the preceding dayat the same hours, there needbe no fear that the improvement is interrupted or if the temperaturewhich has fallen to the normal figure after rapid or slow subsidenceremains normal, or after having fallen below this point it ascendsto it

, there is no ground for anxiety, even if the other conditions

should not become healthy as soon as was expected. If, on the

contrary, through several days, the temperature keeps up beyond thenormal figure (at least at the corresponding hours of differentdays);if even a little increase of temperature is apparent, comparingsimilar hours of succeeding days, there is every reason to be on one

’

s

guard . If an increase of a degree ormore takes place fromeveningto mor ning, or fromone evening to the next, the occurrence of a

relapse of fever is by nomeans improbable, and the utmost precaution necessary, even if the patient feels well. If the increase lasts

several days, and advances, one may be certain that a fres h morbid

process, or a recurrence of the past, has set in .

D ISEASES AFFECTING THE GENERAL SYSTEM.

rum-The Causation and Prevention of Disease , show ing the innocuonsness of

putrid eahalations, and pointing out what are the real and efi cient causes of

disease . pp. 191 . London .

Gan-om— On the Nature and Treatment of Gout and Rheumatic Gout. pp. 60 1 .

Altbau. — A Treatise of Medical Electricity, Theoretical and Practical, and its

Use 1n the Treatment of Paralysis, Neuralgia, and other diseases. pp. 35s.London .

Mark ham— Remarks on the Uses of Bleeding in Diseases . Brit. Med . Journ .,

April 9th and 16th , 1859.

“ tha w — Ou the Action of the Electric Current upon the Motor Nerves andMuscles. Med . Times and Gaz ., Jan. 29th, 1859.

Huntar ,

— On the Hypodermic Treatment of Diseases, with Cases and Experiments.Ih., March sth and a6th, and April 16th , 1859.

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140 an on on PRACTICAL MEDIC INE.

Pleilohl, Michael“,und Daniell en — Zur Syphilisation. [On Syph iliz a

tion.] Schmidt's Jahrh., vol. 10 1 , pp. 56—59.

Stenberg.

— Ueber Syphilisation, nebst einigen mit derselben angestellten ver

suchen. [On Syphiliu tion, with Experimenta ] Ih. , pp. 59— 60 .

M um— Zn Lebre von der putriden oder septischen lnt’

ek tion . [On Putrid or

Septic Infection ] Ib., pp. 2 13— 2 1 7 .

Clark — Ou Selenite as a Bebrit’

uge. Med. Times and Gas ., June 1 1th , 1859.

Rumba-gen — Ueher Combination von Blattern und Syph ilis. [On Smallpoxcombined w ith Syphilis.) Schmidt’s Jahrb ., vol. 102 , p. 31 .

Lorin”: und Beder ,

— Merkur und Syphilis. [Mercury and Syphilis.] Ih.,

p. 31.

Dnehek — Ueher Wechselfleber. [On Ague .] Ih . , pp. 169, 170.

Sohmmm— Ueber das genuine Wechseltieber. [On Ague.] Ih., p. 1 73.

Roughing— Summary of Tables of Cases of Diphtheria. Brit. Med. Journ .,

June asth , 1859.

B oughton ,

— Ou Diphtheria. Dublin Med. Journ., Feb ., 1859. p. 94.

Murchison — Ou Origin of Typhus fromOvercrowding ; illustrative cases . Med .

Times and Gaz ., July ad, 1859.

Baa — Intestinal Fever essentiallyContagious. Lancet, July z d , 9th, 16th, and

23d, 1859.

M ela— Clinical Nona — Fever. Edinb . Med. Journ., July, p. 45 ; Sept.,

p. 238, 1859.

Budd — Ou Intestinal Fever ; Nature of Intestinal Afl‘

ection . Lancet, Aug. 6th

and 2 7th, 1859.

Sigmund,

— Neuere Beobachtungen iiber die Einreibungsltur mit grsuer Salbe beiSyphilisformen . [Recent Observations of the Cure of Syphilis by Inunction .]Schmidt's Jahrb ., vol. 1os , pp. 300 , 30 1 .

Gmba ,

— Ueber den organischen Stoflwechsel syphilitisch Erltrank ten unter demGehrauche von Merlturialmitte ln . [On the Organic Metamorphosis ot

'

the

Syphilitic under the use of Mercury.] Ih., p. 302 .

Dann i — Some Account of Diphtheria and Epidemic Sore Throat. Med . Timesand Gaz ., July 16th and 23d, 1859.

Eula — Cases of Paralysis as a Sequela of Diphtheria. Lancet, July 16th , 1859.

Smith, and others .— Ou Diphtheria. Brit. Med . Journ ., July 16th, 1859.

Bom,

— A Report on Twenty-two Cases of Diphtheria. Lancet, July3oth, 1859.

l m hh om— Ou the Simultaneous Existence in the Human System of two or

more Diseases, w hich are supposed to originate fromspecific morbid poisons.

Brit. and For. Med -Chin Rev., July, 1859, pp. 178— 20 1.

Laban — On a Case of Scr ot'ula cured byIodiz ed Food. Ih., p. 244.

Lebert — Aerz tlicher Bericht aus dem k . k . Allgem. Kranltenhause z u Wien vomCivil Jahre 1856 u. 1857. [Medical Report of the Royal Vienna General Hospital for the years 1856 and Schmidt's Jahrb ., vol. 103, pp. 124

— 147.

Bfi gtowe,

— Cases of Diphtheria, w ith remark s on the pathology, symptoms, andtreatment of the disease. Med. Times and Gas ., Aug. soth and 2 7th, and

Sept. 3d, 1859.

I n chin g — Ou the Causes 0! Continued Fevers . w ith special reference to the

recent Windsor Epidemic. Edinb . Med . Journ ., Oct., 1859, p. 297.

Lawson — Observations on the Outbreak of Yellow Fever among the Troops at

Newcastle, Jamaica, in the latter part of 1856. Brit. and For. Med.-Chir. Rev .,

Oct., 1859, p. 445.

D ISEASES APEECTING THE GENERAL SYSTEM .

Virchow .

— Ueber die Natur der comtitutionell-sypbflitisehen aflek tionen. [On

the Nature of Constitutional Syphilia ] Schmidt's J ahrh ., vo l. 104. pp. 65

68.

PW — Ou the recently prevalentMalarious Affections. Med. Times and Can ,

Oct. sad and Nov . 5th and 12 th , 1859.

Whitley— Cases illustrative of the Treatment of Rheumatic Rem . Guy'

s Hosp.

Reports, vol. v . 1859. pp. 187— 303.

Beam— Treatment of Acute RheumatismbyQuinie Intoxication . Med . Times andOct. s9th, 1859.

Ra m a— Diphtheria el ecting the Throat and , to a slight extent, the Air-Pas

sages ; Paralysis ; Recovery. Brit. Med . Jour., Nov . 13th, 1859.

Sim -Tab le of Cases of Acute Rheumatismtreated with large doses of Opium.

Ih., Aug. s3th , 1859.

l ay— O bservations on Diphtheria. Lancet. Sept. 1 7th . 1859.

M — Bd tfi gs z ur Lebre von der Scrofeln und Tuberlteln. [On Scrotulaand Tuberculoaia ] Schmidt's J ahrb ., vol. 103. pp. 309

— 313.

-Zum Wmn der Beri-Beri. [On the Nature of Beriberi.] lb

9 31+

W en — UM W ehungen und lrrth iimer in Erk enntnisa der AllgemeinenSyphilis. [On deceptions and errors in the Diagnosis otGeneral Syphilis .]Ih. , vol. 104, p. 1 73.

Ew ing— Um“ die Natur der Schleimpppel. [On the Nature of Mucous

Tuberclea ] Ih ., pp. 1 76— 178.

Roach — Unber Syph ilisstion . [On Syphilisation .] Ih. , pp. 31 1— 315.

— On the Connexion between the Heat 0t'

the Body snd the eacreted

amounts of Urea, Chloride of Sodium, and UrinaryWate r, during a Bit of

Ague. Mei -Ch in Trans" vol. xiii, 1859. p. 361.

8ibley,

— A Con tribution to the Statistics of Cancer, collected fromthe Cancer

Records of the Middlesex Hospital. Ih ., p. 1 1 1 .

Ch um— Action physiologique ct therapeutique de la solanine et de la douce-smere.[Physiolofi cal and Therapeutics ] Action of Solan ine and Dulcamara ]Annuaire de Therapeutique , p. 14, 1859.

mtg-Diphtheria at Crowle, in Lincolnshire. Lancet, Dec. s4th , 1859.

In his work on the prevention and causation of disease, Pa mcontroverte the accepted views, as to the influence exerted by decom

posingmatte rs of all k inds in producing both endemic and epidemicdisease, and ascribes the chief potency to malaria, the some agent

that produces intermitte nt and remittent fever all over the world.

He entirely dissents fromthe View that this agent is the result of

vegetable decomposition, and propounds the opinion that it

rather proceeds from volcanic action, applying this term not so

as to the cause which givee rise to them. He citee various instances

emanation s are by nomeans unhealthy, indeed appear actually condu

LAM: LIBRARY STANFORDU'

142 REPORT on PRACTI CAL n euroma .

cive to health (s ide the cases of Mr. Rose’s 1 18 labourers, employed

in emptying ashpits by dayand cesspools by n ight, and that of the

k nack er’s yard at Montfaucon, near Paris) . Dr. Perk in does not

seemto recognise the distinction between typhus and typhoid fever,nor between these and malarious fever, nor does he believe thatanyparticular district has been preserved fromvisitations of eitherepidemic or endemic diseases by the removal of nuisances or bythe establishment of new drains . Indeed, he entertains the opinionthat drain s may act directly as promote rs of disease, partly byaffording a passage along whichmalarial emanations fromthe bank sof rivers maymake their way into the interior of the houses, and

partly, when they become dilapidated, by allowing gaseous (malarial)matter to enter the drain fromthe soil. The chief remedies whichhe proposes are, paving or flagging the surface of the ground, so as

to prevent the escape of the malarial emanations, and the use of

charcoal and carbonic acid, to absorb and neutrali z e themwhen theyhave escaped. In an appendix he gives various suggestions as to the

bestmethod of dealing with the question of the drainage ofLondon .

He argues forcibly for the application of the sewage to the purposesof manure, instead of allowing it to be thrown away into the

GARROD’S work is divided into fifteen chapters — Chapter I is in

troductoryand historical 11 and 111 describe the symptoms and phenomena of acute and chronic gout Iv treats of the blood ; v , of theurine in gout; VI and v n, of the morbid anatomy of gout; VI II, of itscauses Ix, of its pathology x, xx, X II, andmm, of its treatment ;x1v , of irregular forms of gout ; and xv, of rheumatic gout. The

scanty space at our command induces us to give the following extractfromthe chapter on the nature of gout, as conveying in a condensedformthe principal views set forth by the author.

“First, in true gout

uric acid is invariably present in the blood in abnormal quantities, inthe formof urate of soda, both prior to and at the period of theseiz ure, and is essential to its production but it can be equallyproved that this acid may occasionally exist largely in the circu

lating fluid without the development of inflammatory symptoms,as, for examfl e, in cases of lead-poisoning and a few other instances .

Itsmore presence, therefore, does not explain the occurrence of the

gouty paroxysm. Secondly, the investigations recently made inthe morbid anatomy of gout prove incontestably that true gouty ln

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144 Re roa'r 0N PRACTICAL MEDIC INE .

the liver and digestion are considerably at fault. The diseasetermed rheumatic gout he look s upon as diverse both fromgout and

rheumatism, and states that much injury is frequently produced bytreatment directed by a wrong view of the nature of the case, and

especially fromits being confounded with gout or rheumatism. The

great object is to strengthen and give tone to the system, and to

promote the due assimilation of the food . The appendix contains

some valuable information as to the tests for urea, the influence

of colchicum, the composition and influence of various mineralwaters .

AL'rmus, in Chapter 1, treats of the forms of electricity ; Chapter

11, of electro-physiology ; Chapter 111, of medical electric apparatus, and its application ; Chapter Iv , of electricity as a means of

diagnosis ; Chapter v, of electro-therapeutics . The informationunder the several heads is verycomplete, but we have not space toattempt anyanalysis .

In a paper on the uses of bleeding in diseases, MARKHAMmaintains the following thesis : That as regards internal inflammations, venesection is of service, not through anydirect influence

which it exercises over the inflammatory process, but in consequenceof its removing certain of the secondary consequences which arise

accidenta l/{y out of the inflammation ; that venesection, in fact,

acts in internal inflammations as it acts in all other diseased condi

tions in which it is of service, viz ., by relieving the oppressed and

congested condition of the heart which has arisen as their couse

quence ; and that the direct abstraction of blood is of service in

those internal inflammations in which anatomy shows us that it ispossible .

A paper by AL'

rnaus on the action of the electric current uponthe motor nerves and muscles maybe referred to with advantage,but it is immssible to abstract it with advantage .

HUNTER affirms that to produce an immediate or a decidednarcotic effect in any case, no method is more efl

'

ectual thanthe hypodermic injection of the cellular tissue . The proceeding is the same as in Dr . ALEXANDER. Woon

’s treatment of neu

Hm r records several cases of purpura hwmorrhagica treatedsatisfactorily by tincture of larch bark . Dose of tincture, from

The addition of Bismuthi Subnitras to copaiba and cubebs oh

DISEASES arrsc'

rmc w e cansnar. srsr sn . 145

vista the gastric and intestinal disturbance theyare apt to pro

in the followiug liquid placed in the meatus of the ear of the

afl'

ccted side : Morphine Acct , gr. iss ; Acid. Acct , mu; Eau de

Cologne, sij. M.

Bu rea u treats the moot question of the day, as to the

value of bloodletting in acute diseases . He recognises plainly a

rcsist or’ to bcar up under disease, and scems to admit the truth ot'

the view that disease is nowmore of an asthenic characte r than insome former times it has been . He considers the phenomena of

cinemas under two largc groups— one formed by the action of the

morbid influencc on the body, the shock , or the force of the impression ; the other the reactional, or such as belong to the process of

repair, taken in the widest sense. Venesectiou can render no

service to diminish thc injurious eflect of the shock ; itmay be of

gmt vd ue to la seu the reactiomif excemive. It does not influence

the course of the inflammation as a local disorder, but only theexcess of the reparatory process in the accompanying fever. Vene

gestion and in relicving pain . The whole paper is well worthperusal.Heste r KENNEDY writes on the change of type theory of

disease . He argues decidedly in favour of the view in opposi

tion to Bm w , con sidering scriah'

m the propositions maintained by the latte r. He state s it as a patent fact, that both

animal and vegetable life is subject at times to epidemic influences,which at one period raise, and at another depress , the standard of

werc carefully noted by the older writers, and their practice

shaped accordingly. It is den ied that inflammation is necessarily

maybe so, but its results vary exceedingly with the state of the

system in which it takes place . Instances are cited in whichhleeding is both useful and necessary. Aa regards the influence of

treatment over inflammation, Dr . Kennedy assigns to it a muchhigher position thsn Dr. Bennettdoes ; he is convinced that diseases

viously had wholly resisted the via medical/ris na ture . Ho also

strongly insists on the need for a discriminating therapeutism.

In

146 REPORT oN rasc'rrcu . n nmcrnn .

affirming that no single plan can possibly meet the ever-varyingshades of disease, some inflammations requiring wine (alone), somemercury, some bleeding, general or local, or both .

An account of a fever epidemic prevalent lately, at a village

named Great Horwood, is given by a nan . Out of a populationof 700, 1 25 were attacked, and 28 cases proved fatal. The fever

came on either with rigors, pains in head and limbs, and consecutivesymptoms of typhoid fever ; or with bilious diarrhcca, followed hv

gr‘

eat prostration and petechiae or with slightmalaise, followed on

the third day, by dyspnte a and inte stinal hmmorrhage . “Tine was

essential in the treatment, but in the second form of disease

required to be given in sago or arrow-root.

The treatment of the anaesthesia of hysterical patients, especiallyby means of Faradiz ation, is described in some detail, as practisedby M . BRIQUET . It mayaffect the sk in, the eyes, the ears

, nasal

and buccalmucous membranes, the muscles, or the bones . The

anaesthesia of the muscles, is quite independent of that of the sk in .

Patients thus affected have no consciousness of the action of theirmuscles, if their eyes are averted fromthe object. This paralysisis cured by a current made to traverse the part, through moistsponges applied to the surface ; while the cutaneous anaesthesia iscured by the electric brush being moved over the in sensible surface

,

amoist conductor being applied to a neighbouring part.

ROSTAN reviews the various methods of treatment that have beenemployed in typhoid fever, enumerating themas the expectant

, anti

phlogistic, evacuant, revulsive, and tonic. He often employs thefirst only . Venesection he employs rarely, except in the first week of

the disease, in robust subjects, with well-marked febrile reaction .

Emetics andp urgatives he considers no universal panaceas their

use must be regulated sagement.”

Revuls ives mayact serviceablyto bring about general reaction . Tonics he uses in all states of

Gnmr communicates some interesting instances of perniciousfever in young children . One in particular is very strik ing, fromthe extreme prostration, emaciation, constant vomiting, and paralysis of the right arm,

which all yielded rapidly to the administration of quinine at first, in the formof enema. The author believessuch occurrences to be more frequent than is generally supposed

,

and quotes the remark that pernicious fever is seldommark edlyperiodical, butmost often presents some prominent symptom, which

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148 naroa'

r ox r a scr rcar. MEDIC INE .

of digitalis in inflammatory diseases, and in pneumonia particularly.

(1, Digitalis, given in large doses (two and a half to three and a

half grains secundis lion'

s) during the progress of an acute inflammation

, has not only the power of reducing the pulse, but also of

lowering the temperature of the sk in, whichmayfall below the normalfigure . The lowering of the temperature is independent of thecoexistent slowing of the pulse . The slowing of the pulseshows itself before, or simultaneous]y w ith, the diminution of tem

perature . The slowing of the pulse commences in 24 to 48

hours, and the lowering of the temperature 36 to 60 hours, after thecommencement of the medication . The frequency of the pulseand the temperature continue to fall after the omission of the

remedy. Together with the above-mentioned phenomena, thereoccurs comcidently a cessation in the progress of the local disease .

The value of the exanthemsometimes produced by digitalis isamatter for further inquiry. The influence of this drug uponthe stomach, and in producing bilious vomiting, ought also to be keptin mind . A highly important warning is given, that during thetime when the pulse and temperature are lowered, and the diseaseis yielding, it is dangerous to sit up, on account of the frequentoccurrence of syncope .

LABORDE affirms the local employment of chlorate of potash, as

gargle, &c., to be of superior eflicacv to its internal administrationin purely local diseased conditions . He also finds it to be a pro

phylactic ofmercurial stomatitis .

Bu rma?) has obtained very good results from the injection of

chlorate-of-soda solution into the trachea, in cases of croup, after theoperation of tracheotomv . It produces the expectoration of shreds

of false membrane .

Fueus amylaceus is recommended bv ALBERT, of Bonn, as vielding a superior jelly to that obtained fromcetraria or carragheen .

BERTULUS recommends very strongly the employment of quin inein all forms of typhoid fever. It does not cure, but k eeps off asthmad had symptoms, and leads to a favorable convalescence .

Potas s . iodid. is found by M . Ro r ssn'

r eminentlv effectual in ar

resting the mammary secretion .

In lead-disease, (ELTINGER confirms the beneficial effect of pota ss .

iodid . tak en internally, and insists on its a dministration until the

presence of lead is no longer demonstrable in the urine .

Bremen has observed very great benefit fromthe employment o f

DISBASBS arrscrmo r n s caxaua i . sver en . 149

drycupping in typhoid fever, with chest complication . He appliesfrom40 to 80 (l) cups in the day, half in morning, half in the

In Algeria, the best remedy for the bite of the viper Bicorna, isfound to be the expressed juice or the decoction of the EuphorbiuGuyoniana, a plant which grow s abundantly in green tufts, in mostof the places infested by these venomous reptiles . For the first

dose, eight to ten drops of the juice in wate r ; an hour after, a second,with five drops ; and two or three hours afte r, a third, of five drops ;a fourth and fifth, of the same strength,maybe given at intervals of

three or four hours, if the symptoms continue. The decoction is tobe made with a small handful of stalks to about two pints of water,

The tympanitis of typhoid fever, according to M . Cochenil, is

treate d successfully by repeated fomentations of liq. sod . chlorinat ,diluted with wate r, applied to the abdomen .

Eisner believes that, in melanotic cancer, the urine maybe madeavailable as a means of thagnosis . If treated with nitric or clirmnicacid, or exposed for some time to air and light, it becomes of a darkcolour, without losing its transparency.

Hemmvnm , who has practised for twenty-eight yea rs atMarian

werder, in Western Prussia, where intermittent fever and its con

geuers are rife,makes some interesting observations w ith respectto the relation between malarious disease and epidemic cholera. On

the men tion of cholera in 1831, intermittents ceased entirely in

mittents did not appear. But in 1849, with the cholera, all the

forms of intermittent fever returned with greater frequency ; in 1850

and 185 1 theyincreaeed stillmore ; and i n 1852, the bad year of thecholera, they were at theirmaximum, but did not, as in 1831, dis

appear with the cholera, but remained the prominent form of

disease until the autumn of 1856, since which time they have

Gu nmen ,in a paper on the treatment of gout, recommends i n

sthenic cases a nafl bleedings fi omthem or cupping to the ueck ;

the employment ofmild, warmpurgatives ; the vegetable aalts of thcelh lia ; tonics in the later parts of the disease. He does not seemto have a high opinion of colchicum, advising it onlyto be used

150 an on on raacrwu . MEDICINE .

when themalady is declining, as, e. g., in sthenic cases two days afterthe venesection.

Nam, or Maryora (Meliaceae), found abundantly in India, is a treewhose bark is extensively used by the natives as a tonic and anti

periodic, in skin diseases, old ulcers, &c.

Orro Vm gives a good description of hamorrhagicmeasles, asobocrvcd by himself. Hemetwith iteleven times in 160 cases. Bad

hygienic circumstances did not appear to exert anynotable influencein producing it, nor were the cases in which it occurred particularly

grave, or in anyother waypeculiar. The spots, about the second orfourth dayof the exanthem, assume a deeper colour, and graduallybecome dark, or even black . Their dimensions vary, some are lik eflea-bites, others as large as peas or beans (split). Some formbandsor patches of large siz e. They retain their deep colour for a dayortwo, and then undergo the same changes as ecchymoses. The at

tendant fever was generally sthenic.En ow and Bronz e recommend the old but disused practice of

applying ligatures to the limbs in intermittent fever. Byinter

rapting the paroxysm, the habit of continuance of the disease isbroken . Itmaybe sufficient to ligature two limbs, but in obstinatecases it is better to act with four.

H ummer. observed, at the Military Hospital atHelsingfors, andat the Workmen’s Hospital at St.Petersburg, a general prevalenceof diphtheritic exudation on the wounds of the patients . An ill

looking, whity yellow layer formed on their surfaces, which adheredbeneath to the tissues, was sometimes dryand consistent, sometimesof pultaceous aspect.

‘

In crowded, unhealthy hospitals, the morbidstate was evidently contagious, its spread being averted by removalof those affected, and originating fromthe introduction of a sufferer

into a ward previously free from it. Crusell’s pyro-caustic, and

Pagliovi’s hemostatic fluid, were found very useful.

Gunssnao has used colchicine for five years in the treatment of

gout. He gives one-sixtieth grain tar die. It purges briskly, andmakes the attack s of much rarer occurrence. In acute rheumatismit has been of no avail.

Ban n ers. records the following interesting facts relative to

variola, and its cc-existence with other diseases . A scarlet-fever

patient was taken to the ward set apart for variolous cases, whichhad been unused for six weeks, continually aerated and fumigatedwith chlorine. As soon as the patient had arrived at the stage of

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162 an on on ru crrcu . immers e .

of silver. Liq. sodmchlorinat. has also been found very useful .

The Lancet Sanitary Commission Report on Diphtheria will well

The historical introduction, amongmany facts of interest, contain ssome showing that the disease is not solely dependent on the nu

healthiness of the localities where itprevails . Wherever it has existed,amongmany varieties of its seat and symptoms, it has always pre

meut. As yet, no influence or condition has been detected to whichthe production of diphtheria can be ascribed. It has prevailed at

all seasons, and in all weathers but it appears that exces sive alterna

tions of temperature, or of the density of the air, favour its development. Its spread, the writer believes, to be occasioned in greatmeasure by contagion ; and relates some remarkable instances inwhich it was evidently thus communicated. Diphtheric affection of

the sk in (after the epidermis had been removed) was ofte n observedin the French epidemics ; acre s of this kind are peculiarly inapt toheal. The first appearance of diphtheria in England (at least, of the

ginning of 1857 Almost simultaneously a disease, which probablywas diphtheria, prevailed in Cornwall. It spread throughout thecountry, not appearing by anymeans to restrict its ravages tomarshvand unhealthy districts, though in Essex and Somersetshire it provedvery fatal. In some places scarlatina was prevalent at the sametime ; and there is much reason to suspect that cases of this disease,of diphtheria and of other throat affections, have been confoundedtogether. The writer corroborates the usual Opinion, that, as a rule,there is no loss of substance of the affected part ; the surface, after theremoval of the diphthericmembrane, being found intact, butmore orless congested and bleeding at the points where the exudation was

adherent. Sometimes, however, ulceration does occur. The struc

ture of the diphtheric membrane shows that it is chiefly to be re

garded as altered and thickened epithelium, than as a fibrinous

exudation . It consists of molecular particles, matted epitheliumcells of all kinds and shapes, pus, and blood-corpuscles . As to con

sistence, itmaybe hard or soft, variously coloured, andmore or lessputrid. Three distinct forms may be distinguished under whichdiphtheria has appeared . The firstmaybe called simple . There issome fever and headache and difficultyof deglutition . The exuda

lus sas s s s urna me run oas e s“ . s rsran 153

tion is chieflyconfined to the tonsils and sott palate . The besttreatment is by nitrate of silver locally (3s : ad Sj) with Tr. FerriMoriat. and Pot. Chloras . internally. The second formis croupa l

diphther ia, which is more frequent in children than adults,mad hasoccasioned the greater part of the mortality from this disease. It

sets in with active fever, intense headache, engorgenwnt of the glandsbehind the jaw, and perceptible ditlie ultyof deglutition . The throatand month are found covered w ith yellow ish leathery exudation .

Symptms of croupal suffocation soon supervene, fromthe extension

of the diphtheric formation to the airpassages ; aud when this is thc

case, recovery is eaceptional. Violent fits od

'

coughing sometimes

bronchi ; but this only affords a temporaryrelicf ; the merbid processsoon renews the obstruction , and, afte r repeated struggles, death

closes the scene. The besttreatment is bv diligentcauteriz ation with

combination of Tr. FerriMoriat. andPot. Chloras , beforementioned .

Thacheotomy should be performed before it is too late, if the symp

domhas gravelyafleetcd tbe larynx. The third formis thcmalignant, in which the most prominent feature is profound adynamia.

The glands, submaxillary, parotid, and cervical, and the areolar tissuebecome prodigiously swollen, and the interior of the throat is covered

mayocour earlythrough sudden and extreme adynamia, or late r iu a

state of coma . The treatmentmust be aimilar to that of tlw second

form, but support bywine and such nutriment as can be administeredmust be dfligentlypressed. Liquor Sod . Chlorinnt. is a highlyuseful local applieation . Convalescence in such cases is tedious and

difimlt ; there is often loathing of food ; and swelling is inter

ficred with to some extent bypuralysis of the soft palate or pharyn

and headache.

ment of cases of diphtheria, 111 which difficulty of swallowing and

breatln'

ng does not occur very early— not before the end of the third

tion of strong caustics, which causes rapidly increasing swelling of

the cervical submaxillaryand neighbouring glands, is bad, and surc

to be attended bycorrcsponding exteusion of the disease within and

154 an on on su mo“ .m lcmn.

below the fences, by declension of power, and increase in the dithculty of breathing, swallowing, He recommends, in such cases,syringing the throat by Coxeter

’s laryngeal syringe, with Liq. Calcis

Chlorinat. in chamomile infusion (3ij ad 3xv) or with a few drops ofcreosote in the same . The vapour of these liquids is also to be ihhaled, and the throatwashed out three or four times a day. A pooltioe of chamomile flowers is to be put round the throat, and quinine,in infusion of the same, given internally.

A report on diphtheria, by Ems, fromCrowle, Lincolnshire,

gives a total of 133cases in sixmonths, the disorder not prevailingepidemically for the first two. Out of these 29 were adults, or abovethe age of 13. The number of deaths was 17 . The soil is alluvial,well drained, and highly cultivated. The usual treatment was

employed, and its effects were sometimes magical. No scarlatina

Broom: furnishes a report fromCanterbury, stating the numberof cases occurring in his practice, of the following morbid states

during the two years 1857, 1858 — Of diphtheria 55, of pharyngitis14, of stomatitis 5, of croup3, of cancrumoris r, of scarlatina 57 . Of

the diphtheria cases 24were adults, or above the age of r3. The total

number of deaths fromdiphtheria were 13in Mr. Rigden’s practice,

and r3more occurred in Canterbury during the same time. All the

deaths in Mr . Rigden’s cases occurred among the children, and only

one adult is found among the other 13fatal cases . The scarlatina and

diphtheria cases were perfectly distinct.” In several instances the

urine was examined, but no albumen was found.

Una recommends followingM . Gamberini’s recommendation— the

employment of iodide of sodium in place of the potash salt in all

cases in which the latter is found useful . It is blender,more assimilable, and better borne by the stomach .

Ma ncn'

r has found oxide of z inc an efficient remedy in cases of

chronic alcoholic intoxication . It induces sleep, removes tremblingsof the body and limbs, headache, giddiness, and hallucinations . The

dose at firstwas two grains bis die, one hour after ameal, increasingit gradually to six or eight grains bis die.

Moncn rson shows, fromthe records of the London Fever Hos~pital, that while typhus and relapsing fevers (the epidemic) have,during eleven years, varied considerably, and recently diminished infrequency very much ; the endemic fever, typhoid or pythogenic,maintains, and has throughout, a much more uniformnumber.

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156 auroar ON PRACTICAL mtmcw n .

lous pustule passes into the equally specific product of constitutional

determined when the efi orescence ceases to be the one and begins tobe the other. It is impossible not to assume that the individualefllorescence, as soon as it is placed under the influence of the two

forms of disease holding sway over the system, contains also in itselfthe product of both. According to this, it seems undeniable thatif a healthy child were inocu]ated with vaccine matter fromanother

labouring under constitutional syphilis, the latter disease might alsobe communicated as well as the vaccine infection .

A highly interesting controversy is debated between Lom snn and

Biron , as to the evils arising fromthe use of mercury in syphilis .

The former considers such symptoms as chronic extensive periostitis,circumscribed tophi, caries, necrosis, nocturnal osteal pains, serpiginous skin ulcers, and various skin eruptions, to be the resultof chronicmercurial poisoning. He aflirms that on testing the urine of various

patients who had taken mercury before and after the administration of pot. iodid., themetal was detected in the secretion after and

not before the use of the iodide, so that it appeared to have remainedin the systemuntil eliminated in this way. Beder replies that on

careful examination of the urine of various syphilitic patients whohad tak en mercury, and were under the influence of potass . iodid.,

the metal in no case could be discovered . He points out that suchsymptoms as Lorinsermentions develops themselves without the iafluence of mercury, and are then equally ameliorate d by potass .

iodid that in other cases where mercury has been tak en, they arecured by further administration ofmercury ; and that potass . iodid.

does not, though ever so long continued, obtain always a certain cure,

although it effects the removal of mercury fromthe system. F

ther, he remark s, that patients who have taken no mercury forsyphilis have just the same relapses as those who have taken it ;that patients who tak e mercury for other diseases (as of the eye) donot have such symptoms as syphilitic ; and that workmen who are

exposed tomercurial influence suffer in a very differentmanner fromthose who are the subjects of constitutional syphilis .

The following are some of the results obtained by Ducnnx, atLemberg, fromI 20 autopsies of persons dying of intermittent fever .

The blood was scanty, contained dark pigment in the formof small,roundish, well-defined granules, which were present in nearly equalamount in all the vessels ; they were not contained in pigment cells ;

msasana ar rscrmo rn s c annula . svsrsn . 157

there was no increase of the colourless corpuscles . The spleen wasconstantly enlarged only in fifte en cases was there any amyloid or

bacony degeneration of it, which always then existe d also in the liver

free fromparoxysms for some length of time . The liver was mostlyof normal siz e, small only after many relapses, but without alterationof its substance, except that it contained much pigment. Cirrhosiswas never observed ; fromwhich, as the Lembergians are prone toexcessive indulgence in alcoholic potations, Duchek concludes thatthc efi cacyof this cause hs s been over-estimated. The stomsch andthe lower part of the ileumwere frequently in a state of chroniccatarrh . The large intestine presented the catarrhal state in all

degrees of severity, up to follicular ulceration, the ulcers being often

so close together, that they were only separated by narrow bridgesof healthy mucous membrane . The muscular cost was sometimeshypertrophied a little, or its inner layers were destroyed ; sometimesthe serous membrane was inflamed. In the lddneys pigment wasobserved deposited in the capillaries and urinary tubules, thoughalbuminuria was not con stantly present. Morbus Brightii onlyoccurred in cases where the paroxysms had long ceased . Recent

tubercles in the lu ngs and other organs were not rarely observed,together with traces of by-past intermittents , which hsd ceased long

0

before the appearance of the first symptoms of tubercle . It was

more rare to find fresh or relapsing intermittents together withhealed pulmonary tubercular disea se . There was nothing very remarkable in the symptoms or course of the disease ; the type wasusually tertian . Diarrhma constantly occurred in all the cases of

dropsy of notable duration it was speedil y followed by marasmus,and if it lasted fourteen days was fatal. Dropsy occurred in themajority of patients, began usually in the legs, and extended to the

after the fifth to the tenth attack, passed away again usually, if suit.

able treatment'

was employed, except in individuals who were alreadylowered by relapses, and in themwas almost constantly fatal. It

occurred not uncommonly in individuals convalescent from acute

diseases , who had previously suffered fromintermittents , but had no

fresh attacks , as well as in others, as the mere expression and con

sequence ot'

the malarious cachexia. The dropsy sometimes left theskin

,but persiste d in the cavities sometimes the reve rse occurred .

If the dropsy exceeded three weeks’ duration, it was almost con

158 REPORT ON PRACTICAL MEDICINE.

stantlyfatal. The skin was constantly the seat of pigment depositin different degrees, increasing with the duration of the disease

,but

present. even during the prodromata. Wh en dropsy set in,it he

came paler. The cachexia did not always yield with the fever, butsometimes increased in spite of favorable external conditions ; itscause did not appear to be simply poverty of blood, but rather itshould be regarded as the result of disturbances which are certainly

present during the fever, but precede and survive it, and, independ

ently of it, interfere with normal nutrition . T hese disturbances probably consist in the destruction of the cell-constituents of the bloodin the spleen . In an appendix, Ducheh states that 8 per cent. ofthe hospital patients at Lemberg suffered fromtuberculous disease

,

although ague was endemic in the vicinitv . Diseases of the nervous

systemwere verv rarc.

Scnnsn n ,in recording his experience of genuine intermittent

fever at Bodenwiihr, in the Upper Palatinate, mentions that in theyear 1856 the cold stage was often uncommonly short

, while an

abundant sweat came on early, attended with consuming heat ; thesweat gave no relief, and was attended w ith an eruption of shinglesof varying intensity, according to its degree, but always abundant

,

which occupied the abdomen and forearms, and appeared to berather the cause than the consequence of the sweat.The following conclusions are deducible fromthe tables of cases

of diphtheria published in the British Medical Jour nal.’ (L ) Sexdoes not appear to influence the liability. Age is positivelyinfluential, childhood and early youth being farmore often attackedthan more advanced age . Hygienic conditions, occupation,food, and clothing, purity or impurity of air have not been shown tohave much effect, the disease hav ing occurred in many in stanceswhere the surrounding circumstances were favorable . Me

teorology. Our k nowledge on this head extends no further than thatthe disease has prevailed during the most opposite states of the

weather. Contagiousncss . It appears that, though the diseasemaybe communicated in this way sometimes

, this is not the usual

mode by which it spreads . Scarlatina . The evidence is entirelynegative as to anyconnexion between the two diseases . The

symptoms, when first seen, have usually been those of depression

,

accompanied by dysphagia, and generally external swelling of the

neck, either from(edema or enlarged glands. Rigors and feverishness were only occasionally present. Sometimes the disease com

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160 a rzre n'

r on PRACT ICAL MEDICINE.

the exudation, forming a gummy product. The free a nd persistent

use of nutrients and stimulants was all-important.MURCHISON records two instances in which it appears very pro

bable that the origin of typhus fevermaybe traced to overcrowding .

In the first, seven human beings occupied I I39 cubic feet of space ;in the second, eightoccupied I378 feet. The drainage, in the first instance, was good ; in the second, it is not speciallymentioned. The

disease spread by contagion to several persons in the second instance, onlyto one in the first. No source of contagion could betraced in either.

BUDD discusses at some length the question as to the contagious

ness of intestinal, alias pythogenetic, alias typhoid fever, maintaining the affirmative side of the question . This has been donebefore by Bretonneau, Louis, Gendron, Ruef, and Piedvache . The

evidence adduced by the author himself consists of a number of

cases, minutely observed and recorded, with the express object of

showing that this form and the maculated typhus are totally distinct species . The following is a brief abstract of part of thisevidence . Fromthe village of North Tawton, where fever was rife,A returned to his home atMorchard, took to bed, and died in fiveweeks . Two of his children took the disease. B also went to Mor

chard, and had fever, communicated it to C, fromwhomit spread tothree other persons . L went to Chafi

'

combe, and lay ill thereseveral weeks with fever ; her nurse T, and the husband, T

‘,

‘

and

seven other pers ons, took the same disease. One of these seven was

sent to Loosebeare, and from her the disease spread to a large

proportion of the inhabitants . FromChafi'

combc another was sent

home to one of two cottages, lying between Bow and North Tawton . He communicated the disease to two persons in the one wherehe lay sick, whence the disorder extended to every one in the otheradjoining .

i

Another married daughter, who had come from a

distance to take care of her rich relatives, being at length infected,became on her return home themeans of largely propagating the feverin yet another quarter.

”In all the localities where fever appeared as

above detailed, there was no other apparent cause that could have

given rise to it except the arrival of a diseased person. The sani

tary conditions were just what they had been for years past. The

existence of a period of latency, and the immunity afforded by anattack of this fever against recurrences , are dwelt upon byDr. Buddas characteristics identifying the disease with the exanthematous

DIssASES Arm rINo re s GENERAL sr e ar. 161

group, which“require in the human body, not only a subject for

their action, but conditions for their growth and development.”

disease by infection ismuch less likely to occur, because thc intestinaldischarges are at once removed and swept away in the sewers. It is

ness of typhus, and enteric or typhoid fever, remarks on the greatcomparative rarity during late years of typhus, as, indeed, of allkinds of fever. During the twelve years preceding 1849, the

admissious of fever cases to the Boyal Infirmarywere in fimr yearsbelow Iocc, ia three between 1000 and 2000, in two between z ooo

and 3ooo, in twomore between 3ooo and 4ooo, and in one theyamounted to 4693. The immense majority of these cases were

either typhus or relapsing fever . During the four years following1849, the aversge number of cases of epidemic fever was fromsz oto 96o s yesr . In 1854 the number of cases admitted diminishedto between 100 and z oo, and it has never since risen above thelatter of themnumbers. Dr. Gairduer

‘

s experience of the fever

cases admitted during the last four years has led him to the

following conclusions as to the differences of character msnifesh d

or synoclm, which formed so large a pmof the epidemics of 1843-4and 1847-8, has absolute ly disappeared. Typhus fever hashom e less fatal to those attacked, than it was ten years ago .

Among Dr. Gairdner’s cases the mortality has been about one in

fifteen ; while in the 1848-9 epidemic it is stated by Dr. Robertson

one in five . (3. The eruption and course of typhus fever have beenmodified. The eruption has been peeuliar in the earliness of its

appesn nee and disappearance . The course in rcspect of the earlier

occurrence of crisis : This crisis is rarely rapid or sudden , usually

has been forty-eight hours ormore in progress . Nor is it a crisis

by sweating, or byanyother form of discharge, in the majority of

critical and injurious ; and the same maybe said of diarrh ea and

other so In all these respects, to saynotlfing of the eruption, typhus fever difiers greatly fremrelapsing

l l

162 arroa'r ON rnAc'

rIcAI. MEDICINE .

fever ; and the differences are as perfectly preserved in the typhu

of 1859 as they were in that ofBUDD argues for the specific difference between typhoid and

typhus fever from the circumstance that not only in Paris, butthroughoutFrance, typhoid is the constantly prevailing form, excepton some rare occasions, when typhus is imported, as was the ease inI 854, on the return of the army from the Crimea . Similarly inBristol typhoid is the indigenous and common fever of the town,but during the Irish famine typhus was imported by the hundredsof starving and fevered immigrants who came over. This fev er wasat once recognised by those who saw it, as distinct fromthe diseasewhich usually prevailed . He regards the intestinal exanthem as

the specific eruption of a contagious fever, and argues that themostvirulent part of the poison by which the contagion tak es effect is

cast off by the diseased intestine of the fever patient.Srmm gives a full detailed account of themethod pursued by

himfor a long time in the treatment of various forms of syphilisby inun ction with mercurial ointment. He premises a preparatoryand enjoins an after treatment. The method seems to require a

considerable interruption of the ordinary course of life . He has

never seen anybeneficial effects produced on the infants of syphi

liticmothers, subjected to themethod, by means of theirmilk.

GnUEImexamines the influence exerted by mercurials on the

nutrition of the human body, while affected by syphilitic disease .

He took the weights of thirty males and thirty females sufferingunder blennorhceal discharge, or primary syphilitic symptoms, towhom no mercury was administered, and also of 103 patientsaffected with secondary disease, who had been subjected tomercurialtreatment fromthe date of their admission into the hospital. The

first question examined was , how the weight of the body at theperiod of recovery stands, as compared to that at the commencementof treatment in patients to whomnomercury was given . Itwas foundthatout-patients in poor circumstances increased remarkably in weightgaining often five to nin e pounds in twenty to thirty days . On the

contrary, those who were better 06 lost in weight. The secondquestion regarded the difi

’

erence between the weight of the patientconvalescent from syphilis and his weight before the mercurialtreatment was commenced . Some of the patients lost, someremained the same, others gained. The author concludes that the

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164 nupoar on Paacrrcan n euroma.

39males and 28 females ; and that in ages above ten years, thepreponderance of fatal cases was in females, the numbers being 2

males and I I females . As to the duration of the disease, in four in

fants under one year, themain duration was four days at each of the

other ages, itwas fromnine to eleven days . As to the modes of death,and the period at which they prevailed, itappears fromDr. Ballard

’s

tables, that the danger fromwhich a fatal result is mainly to beapprehended, in the course of the first week of the disease, is extension of the latter to the upper part of the air-passages, and consequent asphyxia. The sudden deaths in this week are probably dueto the same cause, giving rise to spasmodic closure of the glottis .

As the malady advances into the second week, the chances of deathfromthis cause are only equal to those fromthe general prostrationof the vital powers . In the third and fourth weeks, the latter is thecondition mostly to be dreaded the sudden deaths at this timebeing probably due to syncope . As to the social position of the

patients, it appears that the fatality of epidemic sore-throat and

diphtheria appears to have been half again as great in the middleas in the lower ranks of society, when a comparison is made withthe mortality arising out of diseases of all kinds .

”As to the rela

tion of scarlatina to diphtheria, Dr. Ballard’ s researches are opposedto the views of their identity. Of forty-seven cases no less thantwelve were persons who had suffered an attack of scarlatina pre

viously. He mentions a case in which scarlatina attacked a childand proved fatal three or four months afte r its recovery fromdiphtheria . In no case has diphtheria been communicated from a

patient having scarlatina, unless the latter disease was also communicated. The mortality of diphtheria and scarlatina has not varie d

in a like man ner. The relation of diphtheria to other forms of

sore-throat appeared very similar to that of diarrhcea to malignantcholera . Out of forty-seven families in which a death fromdiphtheria occurred, there were only fifteen in which all the othermembers escaped either diphtheria or sore-throat. Several instances

are adduced in which the infectious nature of diphtheria was verv

apparent. In more than half the number of houses which were

examined the sanitary arrangements were more or less defective, inmost the drainage was at fault.

EADE, of Norwich, after recording several cases of paralysisoccurring as the sequel of diphtheria, subjoins the following

D1SEASES Arrsc'rma ra n GENERAL SYSTEM. 165

observations : “ In conclusion, I would observe that the phenomenaproduced by the presence of the diphtheric poison in the systemappear to be separable into two distinct classes— the one referable tothe throat and air-passages , and showing themselves in the irritationand familiar membranous exudation upon these parts ; the otherreferable to some special chemical influence exerted upon the nervousmatter, which shows itself in the first instance, (a ), by depression of

this system, in common with (and probably as the primary cause of

that of) the other powers of life ; during the whole of the acuteStage of the diseas e, by the relaxed and often perspiring skin, thefeeble pulse, the listless and often indifl

'

eren tmanner, &0. 5 (c), at alater period, by the occasional rapid and sudden sinking, when thepatient appears to be steadily progressing towards convalescence ;

(d), at a still later date , by the occurrence of various degrees of

And in rem-once to the light reflected upon the nature of the diseasebythe results of treatment, I would say, that as all appear to beagreed that this, even in the early stages of the malady, should betonic, and in every waysuch as to stimulate and support flaggingnervous pow er, so the fact that these forms of palsy which occur

during convalescence— after failing to get well with alteratives or

when left to the unaided powers of nature— readilyyield to the inflneuce of the nervine tonics, such as steel, z inc, and quinine, is a

further proof of what I have endeavoured to illustrate, that the diphtherio poison is essentiallya nerve-poison , ous of the effects of which

In the ‘British Medical J ournal’ for J uly l 6th, 1859, besides

nings , there is a longar communication fromMr. T. H . Summof

St.MaryCray, Kent. His remark s are in the main eonfirmatoryofthoee of other observers . He testifies to the remark able exemptionof the paupcr class of patients, to the distinctness of the disease

of the disease in the haunts of fever and cholera. The testimonywhich he gives as to the change of type of disease, after an expe

ricuce of upwards of thirty years, is as follows . After stating thathe had seen no case of diphtheria before 1857, he proceeds :

“ In

observing the progress of this epidemic, 1have been instinctivelyledto refiect on the altered type of disease in general. I have mvself

166 amour on ru c'n cu . n euroma.

no doubt of that alteration in the type of disease, observed since theyear 1832, in England. Fromthat date there has been a departure

fromthe old sthenic type, and this has been more pronounced

is almost, if not quite, unknown amongst us. We have instead lowtypes of inflammation, low forms of cutaneous diseases, low types of

fever, havingmore andmore a tendency to the remittent form; anda verymarked increase in localities where it was before almost nu

known, and where no known local causes have arisen to occasion it,of intermittent fever. What was before amere chill, a slight cold,thrown off with the first reaction, becomes now an attack of ague .

”

Boson, of Newthorpe, gives a report of twenty-two cases of diph

theria, occurring for the most part in the village of Kimberley,Notts. The soil is ferruginous and sandy, but the sanitaryarrangements generally very defective . All the patients were children, fromfour to nine years of age, and sufl cientlyfed. Measles prevailed ex

attacked simultaneously, or in succession, the measles generallytaking the lead. A. table gives the following particulars 12 femalesto 10 males ; 4cases of simple diphtheria, 8 of croupal, 10 ofmalignant ; total number of deaths, 7 ; average duration of fatal cases, 6}days longest period, 12 ; shortest, 5 ; 9 cases were idiopathic, with6 deaths ; 13occurred in connection withmeasles, with 1 death ; ofthe idiopathic cases, 7 weremalignant, and 2 croupal.Muacmson has examined the question as to the possibility

of the coexistence in the human systemof two or more diseaseswhich are supposed to originate from specific morbid poisons .

(a) As respects the coexistence of variola and scarlatina, he quotesexamples of the primary appearance of scarlatina, of the simultaneousmanifestation of the two diseases, and of the primary appearance of

variola . At the SmallpoxHospital, seven cases have been observedby Mr. Marson in which u nequivocal scarlatina supervened on

variola. (6) Of the coexistence of variola and rubeola, he gives tenillustrations, quoted from various authors. (c, d, e) Variola hasbeen observed coexisting with erysipelas, pertussis, and varicella.

(f ) Numerous cases are recorded of the coexistence of variola and

vaccinia, the variola being modified in some cases, but not in all.

(g, 11, i, and 1c) Vaccinia may coexist with scarlet-fever, rubeola,

pertussis, and varicella. (l and m) Rubeola and pertussis mayexisttogether, and even variola, rubeola, and pertussis. (n) In Paris, the

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168 u pon or: raacrroar. immoral .

the individual ones were perceptible fromfive to eight days. Two

or three fresh crops often came out at various later periods . Far

more fre quentwas the populous eruption, which was present in nearlyeverymarked case . The usual seatwas the surface of the abdomm,

or the thorax. No connection could be ascertained between the

mined nor excluded the manifestation of the other. Herpes meteroccurred with about the same frequency as usual, and occasionallyherpes labialis . Inflammation of the lungs wasmore frequent than informer epidemics, not hypostatic only, but rapidly issuing in exuda

tion, which solidified a large extent of the lungs. In some cases

this was preceded by violent pulmonary hemorrhage . Diarrhoeaand bloody stools occurred very often . Enlargement of the spleen

was frequent, but by nomeans corresponded in degree with the severity of the disease . In almost all the grave cases the chlorides of

the urine were considerably diminished ; their complete absence wasalways ominous ; if it lastedmore than twenty-four hours, itwas oneof the very worst signs . Albumen was also more than usuallyfre.

quent in the urine ; it was rarely followed by Bright’s disease, which

however appeared in several cases in which the urine containedmuchblood . In one remarkable case (typl us emu la tor-ins), the patient, astout journeyman baker, died suddenly, after three weeks of slightfeverish disorder, with apparently rheumatic pains not severe enoughto confine himto bed . Typhous ulceration was found in the inte stines, with a minute perforation, through which some fmcal matterhad escaped. In numerous cases infiltrations of the subcutaneousareolar tissue took place, never before the third week , and not during convalescence, but while the disease was at its height. Theywere very painful, extensive, and attended with stony induration .

Suppuration in most cases succeeded, though tardily. Their appearance was attended with aggravation of all the symptoms . The arms,legs, and especially the vicinity of the parotid gland, were the partsoftenest affected. In several cases sudden shrinking of indistinctlyfluctuating tumours was followed by absces s in the lungs, the

spleen, and the kidneys, and by speedy death. Sometimes thereoccurred eruptions of pustules and purulent vesicles scatteredover the body, attended by increased or relapsing fever, and increaseddanger. Re lapses were not uncommon, and patients suffering withadvanced tuberculosis and with intermittent fever sometimes wereattacked in the hospital by typhus. The post-mortemappearances

D i seases arm rms ran en suan sr srs u . 169

were those of typhoid fever, with the usual intestinal ulcerations.

In cases proving fi tal very early, nothing was observed beyondhypercmia of the bran and lungs, some enlargement of the spleen,and a verythinlyfluid condition of the blood . In the matter of

treatment, nothing of particular interest is mentioned, except thatquinine was very often administe red in full doses (3i in twenty-fourhours) in severe typhus,and even in cases of high reaction . The remedydid not fulfil all the expectations that had been formed, but nevertheless some of the results, especially in mes of severe oerebral

symptoms, were so surprising as to encourage stronglyfurther trials

cent. of the whole population souls), and the mortalityamounted to 25 per cent. of the whole . The districts selected bycholera and typhus were not closely identical.A detailed account is given of the cholera epidemic of 1855 .

All the observations go to make the contagiousness of the disease

very doubtful. An experiment is related, proving that even in theadvanced stage of choleraic collapse absorption of ingesta still takesplace. In several fatal cases, shortly before death, small doses of

blood. Under the head of rheumatism and gout, it is mention edthat scme cases were observed which showed at first all the symptoms of acute or chronic rheumatism, and did not betray their essen

tiallydifferentnature till a later period . Ice locally, tincture of bryony,and aconite, seemto be the remedies employed in the acute dis

ease. In cases of pulmonary tuberculosis , enlargement of the cer

vical glands was always observed. [The contrary has been the

experience of the Brompton Hospital — Em] Numerous cases wereadmitted of ages and agnish cachexia, a large number being work.

men employed on the railroad in Hungary. Theywere all highlyeaohectic, and suflered fromall k inds ot

'

dropsy. Tltese were plsced

paroxysms came on periodically, following the increasing phase of the

moon . The cycles ended at fullmoon, after having lasted fromeight

to twelve days. Each cyclemostly consisted of three, five, or seven pamyeme, the smaller number occurring in the tertian, the larger in thequotitfian type . The first attacks in a cycle were very difficult to suppress bymedicine ; the latte r yielded readily . In one case,whiz z iug was

observed in all the arteries sceessrb le to touch on the fever days, and

on those oulv. Three times a systolic cardiac murmurwas noticed,

170 an on on re scu es ].m rcml .

period of the disease the capillaries were found obstructe d by pig

the brain, in the tissue of the liver, in the splenic pulp, in the Mal

pighian bodies of the kidneys, and in the glands ; andmany of the

In none of these cases was anytrace of tubercle discovered at the

autopsy. In the treatment of various neuralgia , croton oil exter

form. In pneumonia it is stated that affection of the right lung was

more fatal than thatof the left, in the ratio of twenty-one to five. Tartar emetic and ipecacuanha were the principal means employed, indoses varying according to the severityof the dyspncs a. Venesection

was employed in individual cases with good results, according to theknown indications for its use. With regard to pulmonary amplysma, it was observed that dyspncea, even in extreme cases, was byno means a constant symptom; nor was hypertrophy of the recti

abdominal muscles ever discovered. Turpentine inhalations weremore useful than anyothermeans in the treatment of the actual disease . A case ismentioned in which the heartwas already displacedfar beyond the median line, and resumed its normal position com:

plete lyunder the use of these inhalations . One young patient wasquite restored by the cold douche ; and another, a middle-agedfemale, by strychnia carried to the degree of producing slight poisonous effects . In inflammatory affections of themouth and throat,tannin washes were usually sufficient ; but in severe cases, threatening suffocation and suggesting a. resort to tracheotomy, ice-lumps andpencilling w ith tincture of iodine proved uniformly successful. Of

cases of variola, there occurred, in 1856— vaccinated, 412 , of which

8 died ; non-vaccinated, 5 1, of which 1 2 died . In 1857 there were

368 vaccinated, with 24 deaths ; 59 non-vaccinated, with 8 deaths .

Psoriasis was treated with applications of soap and tan, and with a

weak calomel and iodine ointment. Arsenic was of little avail. In

lupus, repeated paintings with strong tincture of iodine were foundmost useful, or nitrate of silver with full doses of 01. Menth. in

ternally. In acne rosacea the application of the following was veryuseful : Liq. Sulph ., 3j Alcohol. Rectif

, zEther Sulph., ana 358.

A report of the results of numerous examinations of the urine

and other secretions by HELLER contains some inte resting state

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172 acroar ON raacrrcan rumours .

sons under the age of thirty, and that both sexes were about equallyaffected . That both the upper and lower classes suffered alikeand therefore that famine and destitution, the especial causesof typhus and relapsing fever, were not influential here . Thatthe fever was most prevalent in districts consisting of middle and

first-class houses . That recent residence in an infecte d localitypredisposed to the fever. As to exciting causes, it appeared— (L )That the prevalence of the disease could not be attributed to con

tagion, though in several instances itwas undoubtedly communicatedfrom one person to another. That there was conclusive evi

dence of its having been produced by the putrid emanations fromdecaying animal matter, and more particularly fromthe sewage in

the drains . The unusually high temperature of the year 1858, and

the protracted drought, are the causes to which Dr. Murchisonascribes the epidemic, which raised, or contributed to raise, the

mortality froman annual average (of fourteen years) of 265 to 375.

For the details of the ev idence on which the above statements arebased the reader must consult the paper itself.A report by Lawson: on an outbreak of yellow fever atNewcastle,

in J amaica, will be read with much interest. The principalconclusions he arrives at are 1 That yellow fever prevailedatNewcastle in 1856, in well-defined z ones, alternating with otherswhich pres ented a much smaller amount, and for the most parta different form of fever, attended with a much smaller mortality.

That bodies of men moving from an unhealthy to a healthylocality soon lost the disease, though they carried most of theirbedding and their clothing with them, and in the healthy spots didnot communicate the disease to others who were fromother healthyspots . Persons going fromhealthy to unhealthy localities toreside caught the disease . T he activity of the causes of the

fever seems to have been much diminished by a course of wet

weather, commencing on November 4th, accompanied by a severe

stormand heavy rain on the 5th and 7th and yellow fever disappearedafterDecember 2 1st, on the accession of strong, cool, northerly winds .

The disease showed itself in its mostmalignant formin person swho had not been away fromNewcastle for many months, and whowere not exposed to others previously affected with it, or to theirclothes, or othermedia usually considered as likely to convey con

tagion . Persons in contactwith the sick in a healthy locality didnot contract the disease more frequently

,or indeed as frequently, as

DISEASES APPECTINGms Gasman . srsrmr. 173

those in barracks . Mr. Laws on behaves the disease to have originated fromlocal causes, butthat these would not have been eflective

had not an epidemic constitution also prevailed which favoured theiraction. Yellow fev er prevailed during the summer of 1856 prettyextensively in the West Indies and around the Gulf of Mexico. It

does not appear that there was anything u peeiallydefective in thesanitary arrangements . Although the privies were frequently offen

sive, yet the rooms nearest to themwere not those where the feverprevailed most. The occurrence of yellow fever at a level about

4000 feet above the sea is an unusual circumstance, such an eleva.

tion having been generally considered to give immunity.

Diphtheritis appeared at Albany, 150 miles to the north of New

York, during the end of last year. Scarlet fever at the same timewas rare.

Vracnow enters at length into a discussion as to the nature of

constitutional syphilitic affections . He dissents from a completeseparation of the secondary and tertiary accidents, stating thatthough a distinction in a certain sense is justifiable, yet it cannot be

to the date , the seat, or the nature of the morbid process . The

primary disease of one organ may correspond as to time withthe secondary or tertiary of another. He divides the constitutionalsymptoms into two great groups, one of which has a passive, theother an active or irritative, character . To the latter belong all the

various forms of inflammation and new growth metwith in secondaryand tertiary affections ; to the former syphilitic marasmus, loss of

hair, and anemia, with, in some cases, bacony or waxy degeneration of glandular organs . Though he is no antimercurialist, be admits the following facts as reasons for limiting the use of mercury

( l .) Mercury mayproduce a cachexia pa ce, and so give rise to

fresh local disease . There is no certain crite rion of amercurialambeing complete . Virchow thinks that the special abiding place ofthe syphilitic poison is in the tissues, to which, however, it isconveyed by the blood .

In a paper on the recently prevalent malarious affections, Dr.

Pnaoocx states, and illustrates, the increased prevalence of ague

during late years . He compares the mortality from,this cause in

three districts , viz ., North Aylesford, in Kent, Huntingdon, and

“Waba sh, in Oambridgeshire, since 1850, all these being aguishlocalities, with a nearly stationary population . The general result

174 REPORT ON PRACTICAL “ DION .

is, that the prevalence of ague was high at the commencement ofthe period ; very high in 1852 and 1853; low in 1855 ; and again

high in 1856 and 1857 ; and the higher ratio was continued in

North Aylesford and Wisbeach throughout 1858. A high temperature and dryweather seemto be the most influential conditions incausing the prevalence of ague and its congencrs . Dr. Peacock classesthe forms of malarious affection recently prevalent under the headsof— (I ) ordinary intermittent fever (2 ) remittentfever ; (3) spontaneous anaemia, probably dependent on malarious poisoning ;(4) various painful and spasmodic affections, assuming a regular or

irregular periodic character. After a detailed description of the

attacks of remittent fever, which chiefly vary in being more or less

active or acute, the author gives some instances of the third class,which he states are characterised by marked and rapidly increasingsuzemin, sometimes combined with purpura and jaundice, and occasionallywith paroxysms bearing a more or less close resemblance toanyordinary attack of ague, or of an epileptic or syncopic character,and recurring at reg ular periods . Sometimes the paroxysms havebeen absent, v ery imperfect, or irregular.

“ In the fatal cases of

this and the last formof disease the only peculiarities detected onpost-mortcm examination have been the extreme paleness and

thinness of the blood, bloodlessness of the different organs and all

parts of the body, and con siderable enlargement of the spleen .

”

IVB ITLEY gives cases (twenty-three) illustrative of the treatment ofrheumatic fever. He thus sums up : In fifteen of these cases salts ofpotash were given, either at first or after the failure of othermeans .

When cardiac complications existed, these remedies were combinedwith calomel, antimony and opium, and ‘

with blisters, while inseveral of the simple cases of joint-affection they were administeredquite alone . In no cas e did they fail to effect a cure, which even in

some cases was sometimes attained very rapidly . T he latter remarkapplies, indeed, to some recent acute cases treated with lemon-juice,but in many instances this remedy unfortunately proves ineffectual.”

Large doses of SodmBicarb . (svj ad 3j in twentv-four hours) infifteen cases treated by Dr. Weber produced very good effects in

five, which were of the acute type, in five or six others only somerelief was afforded, and in the remaining no effect was observed.

Three cases of the treatment of rheumatic fever by quinicintoxication, as practised by BEAU in Paris, at La Charité, are

given in the Medical Times and Gaz ette,’ October 29th, I859.

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176 s urcar on re scu e“ . n euroma.

cynth given with the opiummay, of course, have prevented theconstipation . No prophylactic virtue against cardiac affection was

exercised by the opium. The average duration of twelve eases

recorded as cured is twenty-six days.M u gives a brief but able communication on the subject of

diphtheria . He strongly commends the use of turpentine (mxvfor a dose) in the advanced stages of the disease. Tinct. Ferri Mutistis he finds the best local application .

Mrcm ms endeavours to show that scrofula and tuberculosis arenot the results of a generalmorbid state affecting the whole system,but of purely local causes . His essay maybe usefully referred to ,but we cannot give his arguments in our narrow limits.

Hem nx describes Beri-Beri as a combination of acute rheu

matism and intermittent fever. The symptoms were regular or

irregular febrile paroxysms, surprisingly great debility, with pareticand hypemsthetic phenomena, sometimes bilious diarrhoea and

vomiting, swelling of the ancle knee and hand-articulations, seldom

tinued fever. The only constant alteration observed in autopsies

was a thin-fluid, dark state of the blood.

A short statement of all themost importantparticulars in nineteencases of diphtheria is given by a wm. His experience corrobo

rates that ofmost other observers . He records an instance in whichit seems probable that the disease was communicated by contagion .

Lonmsnn endeavours to show that the phenomena usually con

sidered to prove the existence of constitutional syphilis are often

really owing to the effect of mercury which has been taken for thecure of the primary affection . He thinks the natural course of

constitutional syphilis has never yet been duly studied, and thatthere is danger of error in too hastily admitting that a patientis not suffering fromthe effects of mercury in his system, althoughhe may not have undergone regular mercurial treatment. Hethinks there is no positive sign whereby to distinguish a syphiliticfroma non-syphilitic eruption .

B aasmo, of Christiana, sums up a long discussion respecting thenature ofmucous tubercles by the statement that theymust not beregarded solely as a secondary syphilitic symptom, but also as a

primary and local accident ; and further, that it remains for futureinquiryto decide whether in the last case they are to be consideredas of syphilitic or of bleunorhoic character. He says that in

D IS EASES AFFECT ING THE GEHERAL SYSTEM.

Cepenhagen the prostitntes are carefully examined every three or

papules have developed in the interval between the visits, no chancre

observed, not uncommonly, mucous papules existing for monthsabout the arms and genitals, and especially in children fromseven

to thirteen years old, without their presenting anyother symptomofsyphilis or their constitution suffering in anyway. Local treatmentsuffices to cure these .

as a remedialmeans has been held at Christiana. The lead was

taken by Professor Boon, who gave the results he had arrived at

after four ymrs’trial of the procedure. These maybe summed up

as follows : (r .) It is positivelyuseful as a remedy against syphilis ;it is the only sure means we know which has no injurious eficot onthe organism, and thns enables us to rejectmercury, which Bockbelieves to he often positively injurious . It is to a certa in

extent useful as a remedy against syphilis which has been treated bymercury ; but itmust also be always used to counteract the latter .

The application of syphiliz ation against'

other diseases besides

wm to a certain extent confirmed bya commission of three other

available in cases of hereditary syphilis, or congenital, as well as

in acquired. The general health seems almost always to improveconsiderably during the successive inoculations .

In a report of diphtheria prevailing at Crowle, in Lincohmhire,Ennis states that, “

with respect to the communicahility of the

disease fromperson to person, there have been the clearest and mostirrefragahle proofs, the period of incubation varying fromthree orfour days to nearly a month .

”It is remarkable that the Irish

residents, whose sanitary condition is utterly defective, have escaped

The following are the conclusions arrived at by 813m in a

paper on the statistics of cancer . (L ) In respect of age, it was

observed that nearly all the patients had arrived atmaturity, fouron ly being attacked under the age of twenty years . The average

age of those attacked with the disease iii the uterus was forty-threeyears and a quarter ; in the breast, forty-eightyears a nd a half. The

cancer were somewhat older than those with12

J

178 narosr on Paacrrcar. n euroma.

uterine or breast cancer. Childbearing appears as one of the

predisposing causes to the formation of cancer, sterility being to a

certain extent a protection against it. Among the female cancer

patients, 55 out of 315 were single ; and among the uterine patients,

taken separately, there were 1 2 single women out of 135. Of the

married women 86 per cent. among the uterine patients, and 7 1 percent. of those suffering from cancer in other organs, had bornechildren . The average number of children produced by eachmarried woman was 5 2 among the uterine cases, and 389 amongthose w ith cancer in other situations . The duration of life

was found to vary greatly, according to the seat of the disease.

In the cases of cancer of‘

the breast, those who had been ope

rated on lived 53months, whilst those in whomthe disease wasallowed to take its natural course lived only 32 months. As

regards the hereditary nature of the affection, it was found thatcancer was traced m 82 per cent. of the cases . There were five

instances in which the patients had two cancerous relations, and in

one very remarkable case five relatives were affected with cancer.

Phthisis was traced in 37 per cent. of the families of the cancerpatients . In reference to secondary cancer, it was found thatthe disease was either local or did not extend beyond the lymphaticglands in about half the cases . There were secondary tumours in79 per cent. of the breast cancers, in 23per cent. of the uterine

cases, and in 54per cent. of the instances of true cancer in otherorgans. That a great variety of diseases was found in thebodies of those dying with cancer. Tubercle was found in I5 out

of 17 2 examinations ; it was recent in I I . That cachexiaappears to be rather an effect of ulceration than the sign of a state

of svstempreceding the evolution of cancer.

NERVOUS SYSTEM .

Brady,

-Ou the Medicinal Action of Glonoine. Med. Times and Gaz ., Marchr z th , 1859.

Kidd,

— Ou the Diagnosis of Hysterical Puerperal Convulsions. Dublin Hosp.

Gaz ., March 15th. 1859.

Handfield Joust — Ou Inhibitory Influence. British Med. Jour., Feb . 5th ,1859.

Park es. -Case of a Blow on the Head followed by Diplopia and Cerebral Symp.

toms ; Death fromComa. lb Feb. l gth, 1859.

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180 neronr ox PRACTICAL 11110101311.

Bamberger,

— Saltatoriseher Redexk ratnpf, eine merk wiirdige Form von Spinalirritation . [Cases of Reflex Saltatory Convulsions.] Ih., vol. 102 . pp. 23.

24.

Tm m— llyaterisebes Zittern tind aein Unterschied von der Chores . [OnHysterical Tremor, and its difl'

erence fromChorea.] ih., p. 24.

Briquet— Die Anaesthesia der llysterischen . [The Antesthesia of the HystericaL]

ih., pp. 25, 26.

Spring— Pall von Gehirnembolie. [Case of Emboli in the Cerebral Arteries.]

Ih., p. 293.

l ad en — A Case of Convulsive Sneez ing. Med . Times and Gas ., June asth. 1859.

On the Therapeutic Uses of Electricity. Brit. and For. Mei -Chit . Rem,Jan., 1859. pp. 92

- 1 10.

Watson — Crotch Oil as a Counter-irritant in llvdrocephalus. Brit. Med. Jour.,

July 9th , 1859.

Levick — Remark s on Sunstrok e. American Jour. of Med. Sciences, Jan., 1859,

PP 40—55

PMM — Remark s on some Afl'ections of the Spinal Column. Ih., pp. 62— 67.Dria t— Ou the Treatment of Lead Colic by Paradiz ation.

— Case. Med. Timesand July 23d , 1859.

Martin — The Inhalation of Chloroformalways attended with Danger. Brit. lied .

Jour., July 23d, 1859.

Hmey,

— Ou the comparative value of Bloodletting and Purging in the EarlyStage of the Acute Hydrocephalus ; and on the extent to which each of themshould be carried. Glasgow Med . Jour. , April, 1859.

Ew en— Treatment of Nervou's Headache by the llydrochlorate of Ammonia.

Ed inb . Med. Jour., Aug , 1859, p. 1 73.

Oppenheimer,

— Ueber e inige Fi lls von Neuralgia trigemini. [Some Cases of

Neuralgia of the Fifth Pain] Schmidt’s Jabrb ., vol. 103, p. 1 78.

Barwink el — Antesthesia dolorosa N. trigemini, Paralysis NN. abduc.. olfact. , etpetros. major. dextr. [Case of Painful Ane sthesia of the fifth nerve, w ithParalys is of the sixth, olfactory, and right greater petrosal .] Ih. ,

p. 1 79.

Robert— Fall von syphilitischer l lemiplegie der rechten aeite . [Case of Syphilitic Right llemiplegia.] Ih. , p. 189.

Bri net,— Ueber die hysterischen Convnlsionen. [On Hysterical Convulsionm]b., pp. 306— 308.

Moore.— Report of a Case of Reflex Paraplegia, in which Strvchnia was success.

fully exh ibited . Lancet, Sept. 1 7th , 1859.

Stone ,

— Cases of Chores treate l by Sulphate of Zinc. Med. Times and Gaz .,

Sept. 1 7th, 1859.

Hook er ,

— D iv ision of the Popliteal Nerve for Neuralgia in the Leg. Lancet,Oct. 1st, 1859

Sloane ,

—Neuralgia of the Brachial Plexus, simulating Wasting Palsy. Brit. Med.

Jonr., Oct. 1st, 1859.

On the Treatment of DeliriumTremens. Brit. and For. Med -ChinRev . , Oct. , 1859 , p. 355.

Fleming — Ou the late Accident bv Lightn ing in the “'

est-end Park , Glasgow .

Glasgow Med. Jonr., Oct., 1859.

Wilk g ,

— Sanguineous Meningeal Efl'usion (Apoplexy), spontaneous and fromi njury. Guy

's llosp. Reports, vol. v , 1859, pp. 1 19

— 12 7.

Gull — Cases of Aneurismof the Cerebral Vessels. Ih.,pp. 28 1— 304.

Nanvous s t ar ter. 181

autumn-Die alternirenden Li htnnngen , und die altern. Hemiplegie imBesondcrn, als Polge yon Leiden dea Pons. [On Alternating Palsies, and especiallyAlternating Hemiplegia. as the result of ad’eetions of the Pena ] Schmidt'sJahrb .,

vol. 104, pp. 37. 58.

DummiL-Li hmung der Bewegnngsnerven dea Gesichts. und der obern Ex tra»

mits ten theils mit, theils ohne Atrophie der betren‘endeno

hlusk eln . [Paralysis of the Motor Nerves of the Pace and of the Upper Extremities, he ] lb

p. 58.

89h -Dsa Roematoms dammatris bei Brwachscnen. [Haematoma of the

Dun ates in Adults .) Ih., pp. 164, 165.Ulrich — Pi lls von Gesiebtsli bmnng. [Cases of Facial Palsy.] ih., p. 166.Pom .

-Bacephalopathia rheumatica. [Rheumatic BM W ] lb

167.

Sala am — Dis Neuralgia isehiad iea. [On Sciatica ] Ih ., p. 167.W ot — Usher die Besiehung gewisser Krsnltheits herds dea grossen Gehirns aur

Anaesthesie . [On the relation between Anc sthesis and the site of certain

Diseases of the Cerebrum.] Schmidt's Jahrb..vol. 104, p. 36.Landry

— va c die Paralysis adscendens senta. [On Acute Ascending Paralysis. )ih.. p. 307.

M and Lm— Ffille von Interessanten Nervenleiden. [Cases of lntea

resting Nmem etions. ) ih., p. 308.

cough-em — Ou the Employment of Pot. lod . in Diseases of the Brain inChildren. Bdin . Med Jonr., Dec. , 1859, pp. 503-50 7.

— Report of a Case of Paralys is Agitans removed by the ContinuousGalvanic Current. Lancet, Dee. 3d. 1859.

— Obaervations on Partial Paralysis. Brit. Med. Joan , Dec 3d, 1859.

m -Ou the Treatment of Chores by Arsenions Acid. Brit. and l’or. Med .

Chir. Rem, July, 1859, p. 251.

m — Ou the State of the Mental Powers in Chores . Ib ., p. 256.

— Cases illustrating the Pathology of Mental Disease arising fromSyphl.tie Infection. Ih., p. 256.

Dam -On Ataxia Locomotriee Progressive . Ih., p. 256.

Durin g — Die Apoplexie der Medalla Spinalis. [Apoplexy of the Spinal Cord.]Schmidt’s Jahrb. , vol. 103. p. 2 1.

aw n— m am gagen Chores. [Canterisation in Chores .) i h., p. 23.

B anach — Usher den eonsensuellen Kopfschmerz . [On Consensual Headache. )lb » or» as. 340

m Rheumatismus cerebralis. [On Cerebral Rheumatism] ih.,

p.

‘

25.

BM W — Die Neuralgie der V. Nerves pastes. [Neuralgia of the l'ittb Pair ofNam ] lh , p. 1 1 7.

m ,

— Cerebro4 pinal Meningitis. Dublin llosp. Gaa. , Sept. 1st, 1859.mom-Case of Rotatory Convnlsions. lb.

Ogh— Caae of Paralysis as to Voluntary Power of the Limbs on one side of theBody. attended by ll ypemsthesia as regards the impressions of pinch ing and

prick ing en the correspond ing side of the Face ; with observations on inducedCerebral Paralysis . Med -Chin Transact., vol. xiii, pp. 403— 42 1.

m ,

— On the Administration of Belladonna, and on ee11ain Causes whichmodifyits Action. Ih., pp. 289— 308.

Am — A new Mode of producing Ane sthesia. Lancet, Dee. i yth, 1859.

182 s aron'

r ON rnacn cu . l anterns .

Katha — ou Heat-Apoplexy, Coup de Solsil, or Sun-fever. Ih., Jan. 1st, sth ,

and 15th, 1859.

— li émorrhagie Cerebelleuse. [On Burners-bags into the M ann]

Annuaire de use. at Chir. pratiq., par Jamain, 1859.pp. 39— 63

Bn .1nr states his experience of glonoine as confirmatory of Mr.

Field’s ; sickness, faintness, and unconsciousness, being produced byan over-dose neuralgia pain being speedily and sometimes permauently relieved by a smaller. One minimof Morton

’s solution is

a sufficient dose .

In speaking of the diagnosis of hysterical puerperal convulsionsfrom epileptic, Kmo says, that he observed in two cases the

symptoms to be quite the same as in epileptic attack s, exceptingthat consciousness was retained, and therefore agrees with Dr. Toddas to loss of consciousness being pathognomonic of epilepsy.

HANDH ELD J oxEs publishes a paper on inhibitory influence, inwhich the view is maintained that sensory or afferent nerves beingaffected by some injurious, abnormal impression, induce a paralyticstate of the ner v

ous centre with which they are connected, and thatin this waymusculo-motor nerves, vaso

-motor nerves, or nerves of

special sensation, or common ,maysuffer paralysis more or less com

plete . This v iew is a modification of the one previously adoptedby Mr. Lister.

A case which came under the care of Panxns affords a goodinstance of the important truth, that the mostmarked and sevgre

cerebral symptoms, proving ultimately fatal, mayoccur without anyanatomical change discoverable on the most careful inspection .

CAMPS, in his remarks on hysteria, says that he regards it as a

connecting link between bodily and mental disease. He considersthe functional activity of the brain and spinal cord to be perverted,and rather fromsome morbid state of the blood than from organic

change of the nervous tissue .

BRITTAN records a most interesting case of entoz oon in the brain .

The creature had the head of a Twm'

a solium, and a long, segmented

neck ; it was enclosed in a cyst lodged in the fourth ventricle. The

symptoms were, pain in the head, irritation of the stomach, and

frequent vomiting, prostration, loss . of appetite, and some febrileexcitement. At a later period she was unable to lift her head fromthe pillow, fromthe dead, dull, heavy pain, and sen sation of weight ;

nor could she move it, on account of excessive pain and stiffness

of neck . On two occasions she had vomitedmuch blood. She died

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18a an o n on w omen . u mcrxn.

Gmma findn gres adn atg e fr trel ing eha u bythe fol

tit'

r s increasing from3§ grains.

tll fi st b yto s graina the third.

Then thm da rs’

rest. After this three ma e dava d tartar u id ic,

the v iew ot peodneing vomiting ; the object i to obtain tolen nee

sl it.

Bor t s r rnsos fi n speaking d the trm fl chmu fi nai h on

the good ef eets of reguh ted gymmtie emh bafln d mlphmetof poh ssium. and electricity, aseociated, if need be, with other

Plu m des cribes the various forms of sunstmk e a'hieh he has

witnessed in lndia, their W mm the pathd ogy of the

disease and its treatment. l a the severest foun death occnrs v ith

great rapidity. preceded by perfect uncomcioumess and gasln'

ng re

spiration . ln the others the respiration is embarrmed, hurried, and

gasping ; there is extreme prostration, and giddiness « confusion of

all such as prodnce exhanstion,

and the want of acclimatin tion . Extreme e nga gement of the

lungs was the mm: mark edmorbid appearance observed in autopsies .

In all except the most rapidly fatal case s death is by apne a ; in

themit occurs as the result of a shock to the brain . "connection,

in his experience, was always prejudicial, but persevering cold efl'

u

sion to the head. diligent friction to the limbs, brisk purgation, andthe administration of ditl

'

usiblc stimuli, with sinapisms, Sun, to the

chest, were of much avail. Continual amus ing the patient, as in

coma fr omopium, seeme d to be advantageous sometimes .

Wr rmts record s three ew es of apoplexy occurring in voungchildren who previously had been in good health, except a pain

about the left instep of the first. There was effusion of bloodwithin the skull in all three, and marked softening of the brain inone .

Case of tetanus recorde d by SEBES in a girl, aft. 9, who recovered

under treatment by Indian hemp, nourishing broths and wine .

She took from4 to 18 grains daily, and was kept in a continual

state of narcotism.

NERVOUS SYSTEM. 185

recorded byfl uom.

Bonus eu has never failed for thirtyyears to cure tic douloureux

w ith the followingmedication : Hyd. bichloridi, gr. A te 3. Tinct.Semiu . Colch., m8, adis horis . It is essential to give the bi

chloride iu the liquid form.

DI FRANQUB records thc following curious instsuce of loss ot

smell aud tsste .

md hadmcomequeme a stifl mh whieh got well v ith poultices .

Some dsys sfta wards he was found to hsve lon the senses ofmell

h st cu vical vertebra. Bepested blistering of this tumour restoredfirst the taste snd afterwsrds the smcll.An iuteresting case of epilcpsytrcated bytracbcotomyis recorded

by Brccsnu. A siugle female, mt. 3o, had sufl'

ered for seveu yesrs

fromattack s, latterly occurriug two or three iu a day. Tracheotomywas performed October 5th, 1856, and she continued free fromdc.

cided fits tillthe begiuniug of May, 1857. She had then some severcfits

, aud it was found thst the tube had eocaped fromthe traches, aud

and she died on May3I st.

An iuteresting case of chores, associated with hysteria aud fol

lowed by temporary dementia, is recorded in the ‘Lancet,’ March

n th, 1859. The patientwas cured by Liq. Arseuic., show er-baths,and some doses of morphia.A case of hydro phobic is recorded by Win g er , occurring

in an artillery soldier at Aldersbott. Death occurred about six

m k s sfter he was bitteu by a dog which had apyeared sicklyand had foamed at the mouth . The symptoms lasted about four

Los ouoas reports his observations on sixteen cases of heat-apo

plsxyoccurring at Barrackpore, bew een May 23d, aml June 14th,

1858. Now : of the officers who wore solar helmets, were attacked .

Onlythree ot'

the mes ocourred iu meu exposed to the direct rays

of the sim. Teu cases occurre d between 2 and 5 p.m. ; live be

tween 5 and 9; pm. The weather was exceedingly hot, sultry,md oppressive, the thermometer at 97

°

or During the periodin quesfim ninety-four cases of remittent fever occurred . Boththis disme md heat-spoplexz were put a stop to by the first

heavy fall of rain in conjunction with a thunderstorm. Nervous

186 nsroar on ru c'rrcar. u p tow n.

depression seemed to predispose to the attack s. In itabilityof the

bladder was a constant and early symptom. The symptoms and

treatment were similar to those observed by others. Venesection

was not found useful.

Mnnz reports that he has found hs-icranial pain, attended withincreased determination of blood to the head, permanently removedby compression of the corresponding carotid artery. The pressure

may be applied by the thumbs, or by a k ind of truss.SCHLEGEB records a case in which paralysis of the right facial

a nd hypoglossal nerves appeared to depend on dilatation and rigidityof the external carotid.

BANG devotes a paper to the consideration of the forms and

treatment of giddiness . Besides giddiness arising from various

or nervous ; (3) dyscrasic ; (4) sympathetic ; (5) traumatic ; (6) or

ganic. As well as the ordinary measures, he recommends, as a

specific in certain cases, guaiacum.

MAX-SIMON, in his priz e essay on nervous giddiness, considersthe idiopathic, the sympathetic, that occasioned by venereal ex

cesses and attending on hypochondriasis, thatoccurring during couvalcscence from serious diseases and that accompanying sea-sickness . In his treatment there is nothing remarkable.

FORGET dissents from the Opinion that rheumatic meningitisshould be considered a distinct species frommeningitis of a differentorigin . Its symptoms, its perils, its treatment, are the same as i n

simple meningitis . He recommends the free use of opium, whichhas proved itself most effectual in meni ngitis attending on typhus,pneumonia, and erysipelas . The presumed hypermmia of the brainis no counter-indication, and is not always present.FRANK relates the particulars of five cases of facial neuralgia,

in which section of the affected nerve was practised with a suc

cessful result in four. In some subjoined remarks the authorexpresses his opinion that congestion of the trunk of the nerve is

one of themost frequent causes of neuralgia, and that the pulsationof the accompanying arteries affects the nerves injuriously. Central

neuralgia, he thinks, ismore common than peripheric or sympathetic.

He strongly recommends resection in severe cases of neuralgia,even though the disease be diagnosed as central. The objectionfromthe law of peripheral nervous action, he thinks, is set aside bythe results of the operation and by the cutting off external causes

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188 as poar ox rnaerrcan n euroma .

curred in a female, a t. 30, who sufi'

ered fromchlorosis and gastralgia .

Treatment was of no avail ; she recovered spontaneously.

Tnov sssan publishes a case of hysterical tremor a good dealresembling chores , but distinguishable, as he remarks, by the

greater power of coo rdinating the movements .

Barqun'

r gives the following description of the anaesthesia of the

hysteric. It does not occur in all cases ; leaving out of considera

tion the very frequent anaesthesia of the left conjunctiva, itwas onlymet with in 60 per cent. It occurs not only after paroxysms, butsometimes before their occurrence . Psychics] influences favour itssupervention, and so do cutaneous hypermethesia or muscular. It

maycome on gradually as an alteration of the quality of sensation,or suddenly, and is then usually attended by lowering of the temperature and weakness of the circulation in the ane sthetic part.A case of convulsive sneez ing is recorded by Mosmrn, in which a

scrofulous female, art. 2 2, long subject to disease of the right ear,

suffered during eighty hours fromattacks so frequent and violent,

that she is computed to have sneez ed times, and the wholeneighbourhood was alarmed ! She was amenorrhceal, and amonthafter the first attack the sneez ing returned . It often reappearedsubsequently, and appeared to be relieved by discharge from the

diseased ear. lVarmbaths, with cold applications to the head and

alternate cold and warmdouches to the spine, seemed to control the

paroxysms . Chloroformproduced a very temporary effect.Lavcocx argues strongly against the ordinary plan of treating

delirium tremens by opium and stimulants . He finds that theordinary cause of the attack is not the w ithdrawal of the accustomedstimulus, but a prolonged debauch. The patient should be keptquiet

,the elimination of the alcoholic poison promoted, food adminis

tered, and complications mainly consisting in sub-inflammatorvstates of the stomach, duodenum,

liver, or k id neys, should beattack ed by mild sedatives a nd depurants . Experience has shownrepeatedly that sleep will come on naturally wi thout having recourseto anynarcotics .

“i

arsox, of Southampton, bears strong testimony to the eflicacv

of croton-oil liniment applied to the scalp in grave and almost desperate cases of hydrocephalus . In one case where leeching, coldlotions to the shaved head, calomel, and a ntimony, had beenemployed imavailingly, improvement soon took place after pustulation had been produced in this way, and subsequent recoverv .

rtenvous ersran . 189

Fa tw a has lately observed a remarkable circumstance connected

much largcr doses than adults ; it seems that a much larger dosethan is usuallyprescribed is well borne, fromthe first, by childrcn

a f tendcr yeara, aud that the dose maybe safely increased, rapidly,

daily, and a total amount of 10 19 grains in twenty-six days ; whileanother, wt. 14, took 37 grains of atropine in eighteen days .

This extraordinary tolerance, on further research, did not appw to

depend on the existen ce of chores , as in the above cases, seeing thatother children took similar dem w ithout experiencing anyremarkable d iod e . The chorea was not benefited by it somuch as mightbe expected . T he drug~was found in abundance in the fzeces and

urine, proving that it was not decomposed in the alimentary canal,unabsorbed into the blood . Fuller suggests the

of belladonna in larger doses than are usually given

of swallowing return. If, how .

the cold alfusion must be usedsame condition ice to the headtely . In some cases oil of tur

thc mouth and rectum. Frictionshave proved advantageous .

some remarks upon sunstroke, comparesin this disease with that observed inan astonishing identity in the symp

there is in typhus fever, a poisoned conditionit is to this that we are to refer the various

the disease, an explanation which has also

belief that in sunstroke this unnatural con»

a secondaryafl' °

on , not thc pzrimaryone ;au exha

°

u or depression of thetrition, respiration , circulation, and

In the wayof treatment, he conn

190 REPORT ON PRACTICAL MEDICINE.

paraplegia. She recovered under the use of phosphate of iron, withpowerful counter-irritation bymoms to the spine . Shortly after,the rheumatism recurred severely, affecting all the limbs and the

pericardium. In the fall of 1858, after she had shak en off the

rheumatism,the paraplegia recurred, and continues still. Sensibility

is lost, as well as motor power. The author asks, can we assumeanyconnexion between the two diseases ? And if so, why is it

that pain is so insignificant a symptom in the former, and so

excruciatingly severe in the latter ? Why is it, moreover, that thetwo conditions come on at different times, yield to different remedies, and disappear i ndependently of one anotherBarQUET, afte r considerable experience of lead colic at La

Charité,” has discarded all other theories as to the seat and production of the pain in favour of that originally promulgated byGiacomini, who affirms that the pain in lead colic “ has its seat,

not in the digestive tube at all, but in the muscular parietea of theabdomen and the diaphragm. His reasons for holding thisOpinion are thatmoderate pressure, affecting only the sk in and

subjacent muscles, will produce in patients suffering under thisdisease acute pain, identical with that of a paroxysm (2 ) thatacutepain can be produced in these patients by pressure over parts of theabdominalmuscles beneath which there is no intestine ; (3) thatthe pain of colic often extends to the muscles of the back and limbs .

The constipation, he think s, has no connexion w ith the abdominalpain, and the nausea and vomiti ng he look s on as sympathetic disturbances . The treatment he employs is cutaneousFaradiz ation to removethe abdominal pain, sulphur baths every other day, sulphuric acidlemonade (Giv daily), sss— 3ij of alumin solution, and gr. j of wateryextract of Opium each night. The pain does not disappear until

the Faradiz ation has well reddened the skin, which, we are warned, isoften a pretty severe proceeding .

In some remark s on the danger attending the use of chloroform,

MARTIN observes, that it must not be supposed that the shockof an operation is altogether annulled by obtaining antesthesia . He

rather considers that this is lik ely to be greater when the powers ofthe great organs are depressed by the influence of chloroform.

MARTIN contributes some valuable experience w ith respect to thedisease k nown as coup-de-soleil.” He points out, that direct exposure to the sun

’s rays is by no means necessary, many fatal seiz ures

occurring in one division of soldiers about 8 e .m., long before the

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192 naeoar ox eas ement. n umera ls.

no practice will save, and which at the first no head can clearlydiagnose .

” These the author excludes fromhis consideration . He

passes in review the treatment practised by Dr. Maxwell, of Dumfries, Dr. Abercrombie, and Dr. Watson . The first bled largelyand more than once from the jugular, employing at the same timefree purging as an accessory means . The second seems to haverelied chiefly on purging, while not neglecting bloodletting. The

third recommends onlv moderate local depletion, and the regu

lated exhibition ofmercury in small doses (as a purgativeAfter reference to the facts that bloodletting greatly facilitate s theoperation of purgatives, and allays the irritability of the stomach,Dr. Harvey contends that bloodletting displays its chief emcacyinthe early stages of the disease in question, while purging is moreappropriate to the later stages when the more alarming symptomhave declared themselves . Dr. Maxwell

’s treatment is said to hl ve

been remarkably successful, the results showing sixty recoveries outof ninety cases . In answer to the first question, then, Dr. Harveyconcludes thatbloodletting is to be regarded as the chief, and purging as a secondary, reme dy. With regard to the second question,there exists no doubt that purging should be used to the fullestextent consistent with ordinary prudence,

”while bloodletting, both

general and local, in acute cases, is to be employed, not only early,but as fully and repeatedly as can be considered safe . In the later

stages free bloodletting maybe injurious by increasing the astheniawhich the state of the brain has induced . In cases ofmore chroniccourse also bloodletting has less control over the morbid action and

is less tolerated.

a as u an recommends the hydrochlorate of ammonia as the

best therapeutic agent in cases of nervous headache . It is to be

given during the paroxysm,three doses at half-hour intervals . If

administered during the absence of the headache, no remark ableeffects are produced . Besides the temporary relief, itwas observedthat in cases of headache return ing in periodical paroxysms several

times amonth the intervals gradually became longer, the attack s

diminished in intensity, and ended by disappearing completely, afterhaving been several times arrested by the ammoniacal potion .

”It

has proved effectual in idiopathic hemicrania and menorrhagia, inheadaches consequent on repeated attack s of i ntermittent fever,,those occurring in the decline of low fevers, and in the period of

irritation in typhus.

xs avovs sr srsu . 193

Orram rm draws attention to the cure of obstinate neuralgia

of the fifth pair by previouslv curing existing catarrh of the nasal

Ba nwrs xm. records a case of anmsthes ia dolorosa of the right fifthnerve, with paralysis of the sixth olfactory and nerv . petros . superfic.

major of the same side . The symptoms had lasted six months, andwere attributed to a chill, but as there was a histo ry of constitutionalsyphilis eighteen years before, and some swelling as fromcaries of

the hard palate , the diagnosis of a bony enlargement pressing on

and irritating the nerves involved was made . Under Iod. Pot.

almost complete recovery ensued .

Bonner records a case of syphilitic hemiplegia affecting the rightside, which was caused by Potass . Iod . c. Hydr. Prota

'

od . The rightside of the face was paralysed, there was continual v iolent pain inthe hi t side of the head, radiating fromthence over the whole . The

organs of sense were unaffected .

A well-marked case of reflex paraplegia, resulting fromprolongedexposure to wet, is recorded by Moons . Strychnia was administered to produce its special sfl

'

ects, and recovery ensued in two days .

810m; communicates shortly the details of sixteen cases of

chores treated chiefly by Zinci Sulph ., and compares the results

with those of other cases treated by ferruginous and arsen ical

remedies . In mod cases the cold or te pid shower bath was alsoused.

“ The general statistics are as follow s : Of 16 cases treatedby sulphate of z inc, 13went out cured, 3 relieved, but 2 of the

latter were in a fair way of recovery, andmayprobably be set to the

credit of the medicament. On the other hand, three of thoseultimately cured owed their improvement partly to ferruginous

preparations, and in on e case the z inc had no effect whatever. It

may, then, be stated generally, that advantage was derived fromthez inc in 14out of 16 cases . The longest stay in the hospital amongthu s cases was 1 23 days ; the shortest, 14. the average stay,days . Fourteen cases were treated during the same period wi th pre

parations of iron ; all were cured . The longest stav in hospitalwas

( 6 1 days ; the shortest, 6 days ; average stay, days . Twentycases were treated with Liq. Potass . Arsenitis 18 cured, r relieved ,

I died . The longest stay in hospital was 55 days the shortes t, 6

average stay, 263 days. Average stay in hospital of the 50 cases

submitted to three principal remedies, 2 7 2 days .

”The cases

put under th e arsenical treatment were rather more severe than

194 arroar rnacn cAL usmclxs .

the others, vet its action seems to have been more certain and

speedy.

Bnrqmrr endeavours to show that the occurrence of hyste

rical paroxysms is only apparently accidental and arbitrary ; that, onthe contrary, all the phenomena depend upon positive conditionwhich can be predicte d, and which belong to the simplest laws ofpathology. (2 ) That in the great majority of cases hystericalparoxysms can be accurately distinguished from those of epilepsyand eclampsia . And (3) that art possesses means capable of suppressing them at our pleasure . He entirely dissents fromthe viewwhich regards the uterus as the starting point of themorbid process,as in his cases 254) indications of this could only be traced in nine .

lle considers, that in its simple form the hysterical paroxysm is

nothing but a n expression of some psychical affection, or painfulsensation, and he derives all the manifold varieties of the phenomena fromone of the five following conditions Certain groupofmuscles are either of thems elves unduly irritable, or subserve theexpression of some habitual temper, or by frequent use have cometo act semi-automatically . Certain physical or moral peculiarities may determine the prominent features of the paroxysm.

Thus, the spiteful bite and strik e those around them, the violent

tempered have violent convulsions, &c. T he exciting cause of

the attack is influential. So is the age . The impres sionsduring the intervals of the paroxysms have most influence of all ;they determine the prevailing character of an epidemic. T he

material and psychical symptoms are only the unrestrained, invo

luntaryrepetition of the regular bodilyand mental condition duringthe period of health ; in short, an analogue of a dream. The

diagnosis turns on the following points : the limitations of the

convulsions in epilepsy compared w ith those of hvstcria ; the sud

denuess or slight warning of the epileptic seiz ure contrasted with the

precursorv phenomena or manifest cause of the hysterical ; the

presence of foaming at the mouth in one, and. its absence in theother ; the shorter duration and consecutive sopor of the epileptic,compared with the frequent prolongation, rarity of sopor, sobbi ngand crying, and following depression, which distinguish the hvsteric .

M. Briquet gives chloroform in the way of inhalation during the

paroxysms, and also applies it locally to anypainful part during theinterval.

INZANI relates a cure of a very severe neuralgia of the lingual nerve

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196 narosr on raacrrcan unmew s .

neons and frominjury, draws attention to the occurrence of dubiouscases, in which, except disease of the blood-vessels, the autopsyaffords no means of determining whether the hemorrhage was

spontaneous or not. The symptoms during life, being also entirelysimilar, afford no assistance in the inquiry.

In a paper on aneurismof the cerebral vessels, GULL first alludesto the causes which led to the erroneous opinion that the diseasewas extremely rare . His following observations are partly statistical, partly descriptive, and do not admit of abbreviation, but thefollowing numbers, relating to the seat of intra-cranial aneurism, are

important. Vertebral arteries and their branches : vertebrals, 4hasilar, 20 ; small vessel in substance of pons ; posterior cerebral, 3.

Carotid and branches : internal carotids by sella turcica, 8 ; middlecerebral, 15 anterior cerebral,6; anteriormmmunicating, I ; posteriorditto, 4. Whole total, 62 . After a synopsis of symptoms observed intwelve cases ofbasilar aneurism,

the author proceeds : “The symptomsof an eurismof the basilar artery, though not diagnostic of the natureof the particular lesion, form, upon the whole, a natural group indicating its presence and its seat. It is not so, however, where themiddle cerebral arterv is affecte d, for itwill be seen (vidc Tables) thatin such cases there was often no clinical history previous to therupture of the sac ; or if any, none to indicate unequivocallythe presence of organic lesion . Exceptions to this there are when the sac

has become large, so as to compress the central parts about the base,as in Case Iv . Where the arteries of the circle of Vl

'

illis are the seat

of the aneurism,theremay also be the same vagueness in the indica

tions of organic disease but in two cases, where the posterior communicating arterv was affected, ptosis from compression of the

third nerve was an earlv symptom. As w ith other tumours, so

with intra-eranial aneurism headache, though difficult to estimatestrictly, is one of the most important symptoms . The one characterof it which should most arrest our attention is its constant recur

rence, and its after distressing severity, with concomitant disturbanceof the cerebral functions . All care

, however, wi ll often fail to

enable us to forma correct opinion, even should we, as some havesuggested, auscultate the craniumfor an aneurismalmurmur ! Intracranial aneurismoften serves to illustrate to us how much the wholenutrition of the brain may be affected by the operation of a stri ctlv

local lesion . Itmav lead to subarachnoid and ventricular effusion,

and produce symptoms of in sanitv and epilepsy .

”The morbid dis

NERVO US SYSTEM

turbunce maybe very various, according to the quality of the normalaction which is damaged by the special cause .

Scnuasnc gives an lustorical sketch and an account of the pathology aud symptoms of hmmatomata of the duramater. He assen ts

to the view of B each], Virchow, and Cruveilhier, as to the affection

being the result of a fibrinous inflammation, attended with a cepious

development of new vessels, fromwhich the hazmorrhage proceeds .

The disease usually is ofmonths ’ duration, and always ends fatally .

It is most frequent in advanced life, and in the male sex . The

symptoms at the commencement are, diminution of in telligence and

memory, with giddiness and head-pain, sometimes with intervals ofremission . At a later period the power of speech is impaired, thehands and legs are enfeebled ; there is mental dulness and stupidity,combined with an excessive appetite . Paralysis mayoccur on one

or both sides, and hemiplegia may exist, with effusion of blood on

both hemispheres . Facial palsy is crucial to that of the paralysedside . The closing symptoms are gradual and sud den loss of con

sciousneas, with or without convulsions .

Two cases of facial paralysis are recorded by Un ion . In one the

cause of the paralysis appeared to be a tumour in the right anteriorcerebral lobe . In the second there was found an interstitial tumourof the right half of the pe ns and medulla oblongata.

Pusan records an interesting case of articular rheumatism,in

which the disorder tw ice quitted the joints and attacked the brain,as evidenced by violent delirium, pain in the head, and slow pulse .

After the cessation of the second cerebral attack, the articular affec

tion subsided in about a fortnight.A paper on sciatica is published by Sennan n, containing the results

of five years’ experience . He treated 34 acute and 7 chronic cases .

The age of the patients was usually from40 to 60 . The disease wasmost frequent in the early summer and late autumn . The pain wasintermittent in 1 2 , remittent in 18 cases ; in the latter, fever was

usually present ; in many cases all the three stages of an ague

paroxysms . The treatmen t was by quinine and arsenic.

M um paladin : is found efficacious bym in epilepsy. ll e

gives one to four ounces of the powder in the course of a week , and

continues this severalmonths .

Titncx states that in four cases, carefully examined by him, in

which ane sthesia continued along withmotor paralysis for a lengthof time, or after the latter had disappeared, the following was the

198 intros-r ox ru e

-n ear. m rcmn.

situation of the morbid alterations, viz ., the tract superior and

external to the optic thalamus, for the space of eight lines to twoinches .

Las nnv describes a formof paralysis, which he names acute

ascending.

”It begins at the extremities, advances slowly towards

the centre, then quick ly invades the muscles which are important tolife

, and sometimes k ills quite suddenly. The bladder and the

rectumare usually spared, and the mental faculties are unafl'

ected.

Sensation and motion mav both be alike iinpaired, but usually thelatter is most so. The muscular power becomes gradually lost, andthe limbs become flaccid, without any twitchings, contractions , convalsions, or r eflexmovements . The palsy affects themuscles in thefollowing order : those of the feet and toss ,

the posterior surface ofthe thigh and the pelvis, of the anterior and inner part of the thigh,then those of the fingers, hands, shoulders, and elbows, next the

trunk, the respiratory muscles, the tongue, the throat, (asephagus.

The course of the disease is always rapid— fromeight to fourteen daysdown to some hours . If improvement tak es place, the phenomenadisappear in the inverse order of their appearance . In the only twolutopsics that have been made, nothing was found to explain the

symptoms . Nothing positive has yet been ascertained respectingits aetiology, exceptperhaps that it generally seems to follow on somedebilitating disorder.

Case of paralysis of the left facial and sixth nerve, in consequenceof tuberculous meningitis, recorded by Tnl ssrsn .

A case of peculiar alteration of the gait in walking, recorded bylll LLAl ltB’

l‘

. The patient in walk ing took ten regular steps,then

s tood still, raised the right foot somewhat above the grou nd, raisedand lowered himself several times upon the left, then stamped twoor three times with the right foot, and went on . He had previouslysuffe red from apoplectic seiz ures, inducing paralysis of the rights ide

, which in greatmeasure had passed awav .

Luvs records the alterations found in the n erves in three cases ofcontractions of the limbs . These consisted chiefly in fatty degeneration of the nerves of the paralysed and wastedmuscles .

“man ner and Luvs record a case of paraplegia fromamyloiddegeneration of the spinal cord.

Connsruuan reconnnemls the use of iodide of potassiumin inflam:

nuttory diseases of the brain in children . In all cases in which,fromthe course of symptoms, I have reason to believe that the cen

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200 ar row]: ox rnac'

rrcar. n smcrs s .

Mane}; adopts the following conclusions with respect to the state

of the mental powers in chorea. The moral and inte llectualfunctions are very commonly affected in choreic patients ; at leas ttwo thirds show some affection of the k ind. The immunity enjoyedby the remain ing third cannot be explained either by the age or the

sex of the subjects, by the acutea or chron icity of the disorder, norby the extent or intensity of the convulsions. Fourmorbid ele

ments, which are Sometimes isolated, butmost frequently associated,should be studied together in themental condition of chorea patients .

-(a) Derangements of the moral sensibility, consisting in a notablechang

eof character, which becomes irritable and ca pricious, and

maybe unusually animated, but is more frequently depressed. (b)Derangements of inte llect, characterised by a loss ofmemory, by toogreat a flow of ideas, and by the impossibility of fixing the attention .

(13) Hallucinations which occur in the state intermediate betweensleeping and waking,

’commonly limited to the sense of sight. (d )

Choreamay, fromits commencement, be complicated with maniacaldelirium; this frequently terminates in death, or if recovery takesplace, intellectual disturbance remains .

”

CHAPIN argues that the defective nutrition of the brain resultingfromthe syphilitic diathesis mayproduce insan ity . He bases hisopin ion upon a series of cases, partly culled fromhis own experience ,partly from that of other writers, in which the subsidence of the

mental alienation coincided with the effect of the treatment directedagainst syphilitic manifestations .

DUCHENNE relates the follow ing illustrative case of the disorderwhich he has termed “

ataxie locomotrice progressive . A painter,wt. 28, has double but incomplete paralysis of the sixth pair of

Itcrvca characteristic boring and flying pains, recurring especially atnight ; integrity of the muscular force, contrasting w ith the comdata loss of co ordination of the lower limbs, which rendered walktug impossible, even when as sisted by the eyesight formication and

“lllltlllwl l of the last two fingers of each hand of only a few months’data ] nannihility in the feet and legs much diminished ; electrotttttl t‘tllttl'mutttactility intact. The disease had commenced two yearsbtd

'm'

a. ltl apparent cause was syphilitic disorder. An autopsy wasaaalu a ttlt gr eat camafter death had occurred from an intercurrentall

'

t'

vtiaa. but no appreciable lesion could be discovered in the brainand spinal curd.

case of softening of the spinal cord in its lower half, with apo

Ne avov s s vsrs n . 201

plcctic effus ion, is recorded by DURLAN. The symptoms came on

suddenly, as severe pd n in the loins, extending like a girdle roundthe abdomen , not increased by pressure on the vertebral column , and

complete paraplegia with unimpaired sensation . Death occurred on

the eighte enth day. Post-mod emshowed no other essential diseasethan is above stated .

Harrow records two cases of chores treated by numerous cauteris ing applications of concentrated nitric ac id to the dorsal and lumbarspinal regions . Fromsixty to eighty slight ulcers were made, whichhealed without apparent cicatrices . Othermeans had been tried invain . Improvement speedily ensued, and after two repetitions of

the proceed ing the first case (a severe one) was cured in three

weeks .

113a directs attention to the occurrence of pain in the head,depending on disorder of the female sexual organs . The pain maybe fronta l, vertical, occipital, or un ilateral. The uterus is most ftcquently the organ in fault. lIe mentions two cases, in one of whicha head pain had continued for four and in the other six years . In

both a cure was effected by treatment directed to the ha ling of

eros ions of the uterus . He remarks on the efficacy of emetica inheadaches, but contests the v iew that they act as mere evaeuants.

After relating a case of cerebral rheumatism, Tnovssnau subjoinsthe following general remarks. There are three forms of cerebralrheumatism. The first andmost dangerous is the ao-called apoplaclc

'

c

(in the sense understood by older writers), characterised by collapseand w arn alone, without paralytic phe nomena . Trousseau, however,himselfmet with a case in which, afte r pu ns in the back and paraplegia, there came on suddenly hemiplegia and amauromS of the opposite side, while the dorsal pain disappeared . These latter symptomssoon gave way, and recovery ensued . A second formis the menin

geal, as in a case related by Gosset, in which, after delirium and

violent excitement, coma came on, and the autopsy showed acute

meningitis . The third formis the delirious ; it is the most important, but the most difi cult to diagnose, because it is easily eon

founded w ith similar states . Thus, such cases are to be excludedin which deliriumensues in the course of acute rheumatism, because

in many individuals all notable febrile movement is attended withdelirium. The same is true of deliriumoccurring in topers . On

the other hand, many cases are to be included of insanity ormaniawhich Show themselves in the course of acute rheumatism. Even

202 aaroar on PRACTICAL MED IC INE.

the possibility of a primary rheumaticmania cannot be denied, sincethere is certainly a primary rheumatic endocarditis . Moreover,rheumatic chorea, so common in children, is closely related to cere

bral rheumatism. It is not unfrequently complicated with delirium;and in a case reported by Mesnet, together with rheumatic deliriumand insanity

,persistent clonic convulsions were present.

A case of tetanus, not apparently traumatic, in which the patientbecame extremely emaciated and exhausted, but recovered under the

pretty free use of stimulants, is recorded in the British MedicalJ ournal,

’ August acth, 1859.

A case of rotatory convulsion in a child, aged four and a half years,suffering under strumous hydrocephalus, is recorded by Mrs cmx .

In the surface of the left cerebellar hemisphere was a firm, ovaltubercle, of the siz e of an almond, adherent to the duramater, andat the corresponding point on the right there was a rough, tubercularelevation of the duramater. The daybefore death the body rolledlongitudinally from left to right for several minutes at once fourtimes in the course of the day.

SCIIRAMM, from1854 to 1858, observed 195 cases of neuralgiaof the fifth pair, of the particulars of which he gives a summary .

l lis field of observation was Bodenwiihr, in the Palatinate, wheremalarious disease is endemic. The affection sometimes supervenedinstantlyon the cessation of some other disorder. Quinine and car

bonate of iron, given in small doses, quickly succeeding each other,were successful in the majority of cases . In obstinate cases , arsenicwas invaluable .

In Ounn’

s case the symptoms were the result of compress ionof certain lateral parts of the brain , from an intra-cran ial aneu

rism. Ogle believes that the aneurism produced irritation of the

tr ue ce rebelli, fromwhence the morbid inhibitory action was trans

mitted to certain motor fibres on the other side of the brain, whichn are consequently prevented fromdischarging their function . Theterm

“ induced cerebral” he prefers to those cmploved by BrownNN llNN

‘d : who first proposed this hypothesis to account for cases of

paralys is occurring on the same side as the lesion . The aneurismtn the mumin question was of the siz e of a small nutmeg, proceeded“N H the anterior cerebellar artery

, and rested immediately upon theinterior surface of the left middle crus cerebelli . The fifth andw w nth norw s were pressed upon by the aneurism, the latter being“ t“

‘mlh implicated and stretched .

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204 anronr on Paac'u can MED ICINE.

physical andmoral, ofmental disorders ; and the third is devoted totheir treatment, medical and general . After quoting the statistica lstatements of various authors as to the greater influence ofmoral orphysical causes in pro ducing insanity, the author affirms that his“own experience is wholly in favour of the idea that in the great

majority of cases insanity is directly or indirectly the effect of

sources ofmental disturbance originating in the w ill or feelings of

the persons affected, and which maytherefore properlv be consideredas moral in their nature .

”As physical causes of insanity, he rank s

hereditary predisposition, temperament, scrofula, fever, and the

metastasis of gout, rheumatism, erysipelas, &c. On the subject of

the nervous temperament he quotes some admirable remarks of Dr.

Trotter, Dr. Gillies, and Sir J . Sinclair. He approves highly ofthe practice of the Greeks and Romans in enforcing the cultivationof athletic exercises . Great stress is laid on the importance of

train ing the mind to habits of self-control, of the education of the

moral affections, and the avoidance of all kinds of v ice, dissipation,and excess. Recognising the great influence of intemperance as a

cause of insan ity, especially among the lower classes, he looks for itsremoval rather to the improvement of their homes and of theirmoral education than to anypledge or promise given at amoment ofexcitement or remors e . Under the head of treatment, he speaksvery favorably of the effect of oil of turpentine in purgative doses(388 to 3j) as a means of cutting short attacks of acute mania. A

solution (saturated) of phosphorus in chloroform he states is an

excellent stimulant (dose,mj— x). With regard to general treat

ment, he entirely approves of Dr. Buck nill’

s caution, that betweenamusements and occupations a due proportion ought to be

observed,” and cites a case fromhis own experience to show how a

suicidal purpose may be cherished and contrived at the very timethat a patient is joining in dances and festiv ities . Finally, herecommends various means for checking the progress of insanity inthis country.

SCHLAGER states that in maniacal hyperphrenia constant and

palpable anatomical changes are not always found, though he doesnot consider this to disprove the dependence of mental disorders oncerebralmorbid alteration . In fifteen cases of the above kind thedisease ran its course during the first stage w ith the phenomenaof cerebral hyperaemia, and there were found in three (after prev ions epileptic attacks and furious delirium) serous infiltration,

and opacity of the internal membranes, with ecchymos is and by

permmia of the brain and serous effus ion in the ventricles . In the

remainder there was serous infiltration of the brain and its mem

there were men ingeal tubercles . In the cases of periodic mania,which perished in the third stage, the author mostly observed ope»

cities and serous infiltrations, adhesions of the inner: membranes,

the brain, except where, after epileptic attacks, a greater degreeof firmness of the cerebral substance was observable .

In the asylums and hospitals for the insane in Russia, there weretreated in the year 1856, on the whole, 3616 patients, of whom2087 (57 4per cent.) were sent out cured or improved, 388 (107per cent.) died, and 1 150 remained under care . The formof the

insanity in one sixth was drunkard’s delirium, in four sixthsmania or monomania, and in one sixth melancholy or imbecility.

Alcoholic intorn'

cation was by far the most common cause, so that

in Poltowa, ontof 108 patients, 95 (5 2 males out of 55) owed theird isease to this cause . Among these patients there prevailed a

special tendency to imbecility, attended with phenomena of motorparalysis and hallucinations of v ision .

i n

the States of the Church, it appears that there exists about onelunatic to every 2364 inhabitants . In regard to treatment it ismentioned, that a case of intermittentman ia, which had been in no

waybenefited by a seton in the neck, was completely cured byvalerianate of atropine . In this form there was less apparent ad

vantage from the use of valerian and oxide of z inc . Valerianateof atropine effected also con siderable improvement in two w ees

of epileptic mania . In two cases of lypeman ia stupida, sulphateof strychnine was of extraordin ary benefit ; and in a third, Ol.Morrhute , with cold allusion and bitter ton ics . In cases of pellagranot yet arrived at the third stage, not only themental disorder wasmany times removed, but also the dyscrasia to a very great extent,bythe use of vegetable juices, especially those of vine branches andcrucifcrae, and also by the administration of chloride of iron . The

chronic diarrhnza was arrested by tann in and opium, and the sleeplessncss and unrest combated by hyoscyamus and morphia, with theresult of curing even the disease itself in some cases of lypeman ia,especially the hypochmidriacal.

206 REPORT ON PRACT ICAL MED ICINE.

In a report fromthe asylum'

for the insane at Aatino, drawn up byLa a oxoxr, for the year 1857, it is stated that the number of

admissions was 1 20 (74 males, 46 females), the whole numberunder treatment was 236, the majority being cases of man ia, me.

lancbolia, and chron ic dementia . Of the whole number,62 were

improved, while 26 (17 males, 9 females) died. Most admissionstook place in the summer months, the fewest in the autumn . T he

greatest mortality was in the spring, the least in the autumn . In

125 cases, pellagra appeared as the predisposing cause ; in I35, he

reditary influence . Of the fatal cases, 1 7 died ofmarasmus in con

sequence of slow (creeping) cerebro-men ingitis ; of tuberculosis, 1 ;of cerebral apoplexy, 2 ; of pulmonary phthisis, 1 ; of intestinalulceration, 2 of sphacelus of the bra in, 1 of inflammation of the

brain, 1 ; of inanition, 1 . At the autopsy of these 26, there was

found thickening of the dura mater and adhesion to the skull-capin 14; serous and sew -plastic exudation between the men ingesand the brain in 17 ; extraordinary vascularity of the pin materin 2 1 inflammatory injection of the brain-substance in 12

induration of the cerebral medulla in 9 ; soften ing of the graysubstance in 9 ; puppy, pale-red softening of the whole cerebralmass in 1 .

HOFFMAN) ? gives a report of his experience at the Frankfortasylumfor the insane, during a period of six and a half years . In

this time there were in the asvlum336 cases (53of themrelapses),including 45 epileptics with 4 relapses ; of these 283 indiv iduals139 were males, 144 females . The new cases amounted to 180

(84males, 96 females) ; and of these there suffered frommelancholia, 50 (2 1 males, 29 females) ; frommania, 65 (29 males, 36females) ; from partial insan ity, 23 (8 males, 15 females) frommental confusion (verwirrtheit), 9, (7 males, 2 females) ; fromimbccilitv, 33 (19males, 14 females) . While, on an av erage, the ad

mission s of epileptics remained the samc, tl1c increase in the numberof insane was so surprising that the number of admissions was

almost doubled, the relative proportion of males and females re

maining unaltered. Of the whole number, there were 63recoveries

(23 males, 40 females), and 26 improved (9 males, 1 7 females) ;comprising 34. mclnncholics, 36 maniacs, 7 cases of partial insan ity, 7 of mental confusion

, 4 imbeciles . There were 2 2 not

cured (18males, 4 females) comprising 5mclancholics, 10maniacs,4cases of partial insanity, 4ofmental confusion, 1 imbecile . There

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208 aaroar ox rnw rrea t. n euroma .

muscles, inducing paralysis,mayarise— (L ) Frompropagation of a

similarmorbid process fromadjoining organs (myopathia propagata) .Frommechanical injury (myopathia traumatica). From

sudden change of temperature (myopathia rheumatiea). Fromdiseased conditions of the blood (myopathia dyscrasies ) Fromdiminished supply of blood and diminished exercise (myopat-hiamarasmodes) . Fromcauses which are beyond our reach (myoputhia simplex) Instances ofmyopaMia propayata are paralysis ofthe abdominalmuscles in peritonitis, of the intercostals in pleuritis,of the heart

’s fibre in pericarditis . Excessive fatigue or a sudden

strain may, in myopatk ia traumatica, so alter the nutrition of the

muscles that they subsequently degenerate . Myopath’

a f l eumtica

Friedberg defines as that variety of the affection in which degsneration of the muscles results from exposure to sudden changes oftemperature . It maybe acute or chronic, and lead to un iversal

degenerative atrophy and palsy ot’

the muscles . He seems to con

sider that it affects invariably the interstitial areolar tissue of the

muscles . Myopatl ia dyscrasica is noticed by Friedberg as a sequelof cholera, dysentery, typhus, gastric fever, and the exanthemata .

Myopat/ u’

a marasmodes is not necessarily caused by deficient exer

cise of themuscles, but occurs when this element of disease exists,and is accompan ied by other morbid tendencies in the muscle .

Myop at/cia simplexmayaffect single muscles or numerous sets . It

has usuallv been regarded as resulting from paralytic affections of

individual nerves . The chief remedy for the protracted nutritivedisturbance of themuscle consists in stimulating it methodically tocontract.

” This is best effected bv electricitv and suitable gymnastic exercises .

CIRCULATORY SYSTEM.

0313 and Meadows,— On Clubbing of the Finger-ends as a Sign of Thoracic Dis.

ease. Med. Times and Gaz . , March xgth and 26th , 1859.

Mark ham— On Rupture of the Heart. Med. Times and Apri l 9th , 1859.

Ing ram— Ou Functional Afl'

ections of the Heart. Brit. Med. Jour., Jan. u t,

1859.

Gail-finen — Ou Pericarditis. Edin . Med . J oan , April, 1859. p. 904.

sappey,

— Ou the Anatomy of Cirrhosis. Ih., p. 938.

M an— Two Cases of Aneurism of the descend ing Thoracic Aorta, producing

obstruction of the Thoracic Duct. Ih. , May, 1859. p. 1003.

C IRCULATORY srsrnn . sou

M — Case of Chlorosis— Anrmie murmurs at apex of heart. Dublin Hosp. Cam,

June u t. 3859.

Beam— Normal Hypertrophy of the Heart during Pregnancy. Bdin. Med. Jour.,

June. 1859, p. 1 138.

Ch amm— Ueber die Gertiusche in der Gefl ssen und ihre semiotische Bedeutung.[On Murmurs in the Vessels. and their semiotic import ] Schmidt’s Jahrh.,

vo l. 102 . p. 2 38 .

Kalisk o,

— Ueher das continnirliche Halsgeri usch . [ou the Continuous Murmurin the Neck ] Ih. , p. 233.

— CumryRemark s on the Diagnosis of FattyHeart. Edie . Med . Joan ,

July. 1859. p. t3.

M ey.— Ulceration of the Aorta. (Case ) Brit. and For. Med -Chin Ben , Jan.,

1859. r» 259

Du Com-011 the occurrence of a Blowing-Sound in the Pulmonary Artery,associated with affections of the Lung ; on the Sounds of the Artery in Health ,and on the efl

'

ect on them and on the Heart of the act of inspiration.

American Journ . oi‘

the Medical Sciences, Jam, 1859. p . 1 19.

Km — The Formation of Clots in the Venous Systemduring Life. Brit.

ed . Journ. , July 33d and 30th, Aug. oth and 13th. 1859.

M ead — Case of Angina Pretoria, w ith remark s. Lancet. July 30th, 1859.

Willebrmd,

— Ou the Secale Cornutum in Disturbance cl the Accommodationpower of the Eyes. Edie . Med. Jour., Aug" 1859, p. 1 75.

e i — Ou the Treatment of Inflammation byDigital Compression. Brit. andFor. Med-Chin Rem, July, 1859 , p. 148.

m tg — The Pathology. Diagnosis , and Treatment of Cardiac Diseases.

Pericarditis. Brit. Med. Joan , Aug. soth, Sept. toth, Oct. 1st and 1sth,

Nov. sth, Dec. 10th , 1859.

Pom— On Cyanos is, and the nature and value of temporary Basic Systolic Murmur.

Med . Times and (h s., Aug. 37th, Sept. 10th , 1859.

M — Zur Aetio logic der Periltard itis. [The E tiology of Pericarditis]Schmidt’s Jahrb ., vol. 103, p. 313. 1859.

-Ou a Case of Rupture of the Right Auricle of the Heart. Lancet,1st, 1859.

”ii — Cases “ Aneurism, with Remark s. Dub. Hosp. (h s..Oct. tsth. 1859.

Rom -Ou some Obscure Cases in Medicine. (Aneurism) Brit. Med .

Joan , Oct. 8th, 1859.

a ler,

— Ou the Sudden Increase of the White Blood-corpuscles during the lastStage d Cachectic Diseases. Brit. and For. Med..Chir. Reva Oct., 1859, p. 543.

wnlmm — Ou the Foremen Ovale ot'

the Adult. lh. , p. 543.

M ot — A Brief Report of the Pathology of Angina Pectoris, with Cases. Brit.Med . Jour..Oct. 15th, 1859.

w h im— Ou some Po ints in the Diagnosis and Treatment of Heart Disease .

Guy 's Hosp. Reports , vo l. v , t859. pp. 341— 347.M un

— Cases illustrative of the M e lon of Enlargement of the Heart. lb

rum—366

PM and Bu g— M M " der Kranaschlagader des Heracns . [Laces

ration of the Coronary Arteries of the Heart.] Pal l von l len rnptnr. [Case

of Rupture of the Heath ] Zerre issung der Schncnfadcns einer dcr Columns.Carnea! der Mimlk lsppe . [Rupture of the Cordse tendinese of the Mitra lValve ] Schmidt‘s Jahrh.. 1859, vol. 104, pp. 168, 169 .

7310 REPORT ON PRACTICAL MEDICINE.

Wom ,

— Ueber Entz undnng des Ductus Thorac. [On Inflammation of the Theracic Duct.] Ih., p. 169.

FlageL— Pleuritisches u. periltardiales Bxsudat, Eintritt der Qoergrimmdarms in

die Brat ih-nhle. Thrombose heider Sebenltelarterien , n. e ines The iles de rgemeiuschaftlichen Hiiftpulsadern . [Pleuritic and Pericardial Exudation, theTransverse Colon intruded into the Thorax, Thrombosis of both Cr ural, and o f

a part of the common Il iac, Arteries.] Ih ., p. 171 .

M ay— Ou a Case of Purpura, readily yielding to Gallic Acid and Mercury.

Lancet, Dec. 10th , 1859.

Cock le,— On certain Points of Physical Diagnosis in Mitral-Valve Disease. Ih

Dec. l yth , 1859.

Gairdner,

— Case of Aneurismof the Thoracic Aorta,which Opened into the Tracheaand Left Bronchus ; Hemoptys is four years before Death. With Remark s onthe Rupture of Aneurisms. Med.

-Chir. Transact., vol. xlii, 1859, p. 189.

Cluébiug of tile finger-ends as a symp lomqf Moracic disease.

OGLE and a ows each relate a case bearing on this subject.

As a con sequence of aneurismal tumour pressing on one side, thefingers of the corresponding hand presented the appearance inquestion .

MAltKHAM contributes an analysis of twelve cases of rupture of theheart recorded in the first seven volumes of the ‘Transaction s of thePathological Society .

’

In eight, symptoms of disordered circulationor respiration, or both, preceded the rupture . Two only enjoye d

good health . Two had suffered previous attacks of hemiplegia, andin these two intracranial disease was found after death . Fatty

degeneration of the heart, in one instance limited to the seat of rupture, was in all cases the cause of the occurrence . In nearly all, if

not in all,the cases, the coronary arteries w ere diseased, and the

circulation especially obstructed in that particular branch whichled to the seat of rupture . Markham draws attention to the

probab ilitv of the finer cerebral arteries being diseased in suchcases

, and considers that the symptoms mav in part proceed fromimpairment of the actions of the brain, in consequence of suchdisease .

A paper is published by GAIRDXER on pericarditis . He does nottreat the subject in a systematic manner, but offers his experienceon various points connected w ith the diagnosis, prognosis, and treatment of the disease . “i th regard to the first, he observes

That though friction-sound is perhaps always present at someperiod in the course of pericarditis, yet it mav be so fugitive and

tran sitory that we cannot at all reck on upon finding it. The

amount of efl'

uscd fluid will not alwav s account for the inconstancv

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t .

‘

itis t'v ifl f PRAC TICAL MEDIC INE.

a“ w " tumult. J l l.) That dilatations in the course of a vessel

a “ ; mamurmur. That contraction s in the course of a

mySig n |muluce amurmur, but not fromthe circumstance of

tn NM Hpas ting froma wider channel into a narrower one, or

”M 4.m ute dspace, but fromits passing into the w ider part

in : beyond the contraction . T he result is the same whether the

«h a ve experiments are performed on veins or arteries . Abso

lute ar relative dilatation alone does not suffice to produce amurmur : for this it is further requisite that there should be— (t ) a

«xtusiderable excess in the original diameter of the vessel above that

of the constriction ; (2 ) a certain strength of the blood-current.

.\n experiment with the carotid artery of a horse shows that, with a

degree of contraction sufficient to produce a murmur, none will beheard if the heart

’

s impulse, fromanycause, is too weak, or, on theother hand, w ith a contraction inadequate to generate p er se a

murmur, one maybe produced if the heart’s action is increased as

hv a dose of strychnine . (VL) If the communication between the

contraction and dilatation is proportionally too small, the murmur isthereby weakened in its intensity ; this decreases w ith the volumeof the blood-wave, and is considerable when the blood passes with a

great wave into the wider part of the tube . Thus if an artificial

aneurism is formed on the course of an artery, as by insertingan india-rubber ball provided w ith an ia-and-out-leading tube, themurmur is far less distinct when the entrance into the dilatation isconstricted.

KOLISKO assigns various reasons for his belief that the venous

murmur proceeds fromthe vibrations of the cerv ical fascia, whichwe excited by the changes in shape of the artery, and have themagnitude of their individual excursions determined by traction

fromthe thoracic cavity, and the degree of tension of the sheath of

the vessels .

KENNEDY contributes a paper on the. diagnosis of fatty heart,a summary of which is contained in the following propositions, withuhieh the paper concludes . (L ) That fatty change in the heart is

mwly attended w ith valvular disease . That, with our present

lmnvledge, the proportion seems to be as six to one . Thatwhen mlvular disease exists w ith fatty heart, it is commonly the

mi le valves that are affected, and these are thick ened and fatty.

J .

‘ That this state of the valves rarelyallows of regurgitation .

th at itmay give rise to a soft souffle with the first sound of the

t: lRC t5LATU ttY s rsrs n . 213

heart, leaving the second healthy, as observed by Dr. Stokes .

That there are grou nds for supposing that this fatty state of the

aortic valves maygo on for years without affecting the duration of

life . That visible pulsation of the arteries often attends thisstate , but as there is no regurgitation, it so difiers fromthe diseasedescribed by Dr. Corrigan . That enlargement occurs in morethan half the cases of fatty heart. That in keeping with this, alarge ditlluent pulse is the

'

most common kind tomeetin fatty heart.(to.) That either a very slow, unequal, or rapid pulse is only metin exceptional cases . (1 That the French wayof es clusion is, inthe absence of valvular disease, the chief way of arriving at the

diagnosis of fatty heart. That there is often amarked dispro

portion between the complaints of the patient of dyspnaza and the

physical efi’

orts made to relieve it. That this is possiblymost marked when the right heart is the farthest advanced in

Tamar records a case of ulceration of the aorta near its

origin , which caused death suddenly by opening into the pericar

dium. T he orifice was as large as the end of the middle finger, its

half to the origin of the vessel, of a dark-red colour, and coatedwith lymphy deposits . There was no aneurismal dilatation of the

aorta . The patient was in the third stage of phthisis .

DA Co s ta has recently studied the blowing sound in the

pulmonary artery, which was originally pointed out as a symptomoccurring in tuberculous patients by Dr. Latham. After givingthe particulars of eight cases in which this physical sign occurred,

he proceeds to dw cribe it as amurmur attending the impulse of

the heart, almost always soft and low-pitched, although occasionallv

harsher, of higher pitch, and simulating a sibilant rate . Its situa

tion is in the second intercostal space on the left side, not an inchfromthe edge of the sternum. It may be audible higher up, or

again opposite the third rib, or the sternum. The space it occupiesis usually very limited, and can be accurately circumscribed withthe stethoscope . It is not heard during a full inspiration ; butvery distinctly after inspiration, or w ith expiration . It takes the

phce of the first sound at the spot it is heard, but is followed bya (fistinct second sound. When the patient is breathing quickly,and the heart’s action excited, it is best distinguished. It is not

always of equal distinctness, or of equal pitch ; but it is not tran

214 ns ronr on PRACTICAL usmcrxe .

sitory, as itmay be observed extending over a long space of time .

The sounds of the heart are not influenced by it. They are heardwith the usual clearness at the apex, immediately above the ensi

form cartilage ; at the third rib, or second intercostal space, on

the right side ; atmidster num and even at the third costal carti

lage and edge of sternum, on the left side .

In a paper on the formation of clots in the venous systemduringlife, by HUMPHRY, after detail of some cases, and general facts

observed, the author describes the process of formation of the clot

as follows It appears that, as a general rule, the formation of

the clot commences on the outside, that is, near to the costs of the

vein, where the currentmust be somewhat slower than in the axis

of the tube ; and the first stage in the process is the settling of a

patch or layer of fibrine upon the inner surface of the vein . Thisis increased by the addition of successive layers upon the interior,

whereby the channel for the blood is diminished. Soon the tube iscompletely obstructed this result being commonly accelerated,more or les s, by the clotting of the blood, in addition to the settlingof the fibrine. The two processes— fibrinous deposit and bloodclotting

— which differ, probably, only in the circumstance that the

greater rapidity of the latter causes the entanglement of the red

globules with the fibrine, go on somewhat irregularly, whence themottled appearance of the coagula but as a general rule, the clots

are firmcr and more fibri nous near the exterior,softer and darker

in the middle . The exterior of the clot is usually smooth ;sometimes havi ng quite a polished appearance, except at the pointswhere it has become ad herent to the side of the vein . These ad hes ions are not usuallv very extensive ; theyaremost commonly foundwhere the clot began to form, and varv in their firmness with the

period of the ir duration .

”

Moonn nxn records a case of angina pectoris, with fatal result, inwhich the post-mortcmshowed a large heart, vcry fatty, weighingseventeen ounces, with all its valves healthy, but the coronaryarteries, for an inch and a half from their origin, converted intorigid tubes by calcareous deposit. Lungs healthy, but congested.

Death probably occurred by way of syncope during an asthmaticattack . Symptoms of angina had existed fifteen years, and he hadhad two or three slight paralytic seiz ures . The patient was a male,set. 63.

WILLEBBAND, of Hels ingfors, finds the use of secale cornutum

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2 16 a eroar ox PltACTl CAL usmc l xn.

was used) . The man was aged 38, robust, in good health, and wastting still in an easy chair at the time of his fatal se iz ure .

Mu xm discusses the physical signs and general symptoms ofpericarditis .

REID records four cases of thoracic aneurism,with clin ical

remarks, especially relating to contraction of the pupil, and

the modus operandi of belladonna in producing dilatation . The

third case is one of that peculiar disorder of respiration, in whichevery few seconds the movements become greatly accelerated and

laboured, and again in a few seconds decline to the normal rate .

The pulse was accelerated remarkably fromthe latter half of the

period of respiratory distress to the end of the first half of the sameperiod. Orthopncea existed. After three week s’ rest in the hospital,the respiratory distress almost entirely disappeared. Autopsies wereobtained of the second and fourth cases ; in the first and third theywere refused.

In some remarks on some points in the diagnosis and treatmentof heart disease, BARLOW contrasts the differences of the pulse andother symptoms in aortic and mitral-valve disease . The latter far

more than others gives rise to pulmonarv and hepatic congestion,and to impeded biliary and urinary excretion . Stimulants are far

more useful (especially senega) in aortic disease than in mitral, i nwhich we must chiefly look to reliev ing the engorged portal circulation by catharsis, and the pulmonary by inducing expectoration .

Barlow remark s that a dilated ventricle in an anaemic person w ithlax arteries w ill presentmost, if not all, the symptoms of aortic-valvedisease, and the same maybe said of disease of the ascending aorta .

Other forms of pulmonary obstruction maypresent all the symptomsof diseased mitral valve,murmur inclusive .

A case of latent thoracic aneurism is described by ROBINSON.

The patient sufl'

ercd from pai ns referred to the left side of the

chest, and to a spot opposite the fourth or fifth dorsal ver

tebra . He had puriformexpectoration and paroxvsmal cough, of avery peculiar sound. After many months a low, deep-seatedsystolic murmur was detected, certainly not proceeding from the

heart. Death occurred suddenlv but not from bursting of the

aneurism.

GUBLER records two cases in which, after the preportion of whiteand red corpuscles had been observed during a cachectic maladv to

cracumroar SYSTEM . 2 17

remain normal for a long time, the number of the former suddenlvincreased to such an extent as to constitute well-marked leucocythazmia. The first case was a scrofulous male, azt. 2 1, who suf

fered fromintermittent fever rebellious to quina . Pneumonia set

in and proved fatal in three days on the first day a great increaseof white corpuscles was observed, which was still greater on the

second.

“E LLMAXN, in 300 autopsies of persons of all ages , and dying of

the most various diseases, found the foramen ovale patent in 130 ;c b, in 2 24 out of 500 .

Musnm‘ publishes a brief rev iew of the pathology of anginapectoris, w ith two cases (one fatal, w ith autopsy) fromhis own ex

perience. He considers angina pectoris to be a neuralgic affection

alwavs comiected w ith some heart disease, in which respect it differsfrom simple neuralgia, bei ng an accidental complication of the

latter,” induced generally by the usual causes which excite neuralgia

in other parts . He believes that it is not the peculiar pang (theneurosis) which causes death in fatal cases, but the coexistingorganic disease . The intercostal nerves he regards as those speciallyimplicated .

Bu mw gives various cases illustrative of the aetiology of enlargement of the heart he enumerates the follow ing causative conditions

Obstruction fromchanges in the orifices of the heart, or in thecourse of the circulation . Obstruction arising fromchanges

in the quantity or physical properties of the blood. Deficiencyof strength in the parietes of the heart itself. In several of thecases narrated, there was no apparent organic change that could

account for the hypertrophy . He refers to Gairdner’ s v iew,that

cardiac hypertrophy may result frompulmon ic adhesions preventingthe due expans ion of the lungs, and so necessitating an ex

pansion of the heart to occupy their place . From this he

dissents .

Manna“ , on the treatmentof pericarditis, emphasises the necessity for distinguishing between rheumatic and non-rheumatic instances . The latter is a secondary affection, and is rarely of suchintensity as to require special modification of the general treatment.The former generally becomes the prominent phenomenon , and theobject of especial care . Venesection is to be employed w ith moderation and caution it cannot step the inflammation, or prevent

2 18 REPORT ON PRACTICAL MEDIC INE.

exudation, but it may give temporary relief to the sufferings of

the patient, and relieve the congestion of the heart and lungs .

Local bleedi ng by leeches or cupping is much more safe, and often

of great serv ice ; yet in feeble subjects even this mode maybe injurions . Markham has seen it produce puerperal haemorrhage,or choreal symptoms, in each case followed by death . Mercury usedto salivation Markham regards as altogether mischievous and

useless, quoting an analysis of Taylor's cases by Bennett.A case of laceration of one of the coronary arteries of the

heart is reported by Fmoxmux . The tendinous centre of the

diaphragm was also torn . The author ascribes the occurrence tov iolent efforts in vomiting. A case of rupture Of the heart byBur s, and one of rupture of some of the corda tendineae Of the

mitral valve, is given by Allix .

A highly interesting case of acute inflammation Of the thoracicduct is related by Worms . The whole length Of the ves sel fromthe cisterna chyli to the subclavian vein contained an extraordinaryquantity of pus ; its walls were thickened, Opaque, and adherent tothe surrounding tissue . The inner surface was

“

rough, like felt,denuded of its epithelium, and presented numerous red, ecchymosedspots . Numerous swollen glands surrounded the cisterns chyli, theefferent lymphatics fromwhich contained pus. There were purulent collections ih the left kidney and spleen, but the author doesnot regard these as hav ing set up the inflammation in the duct.

The symptoms were those of fever, severe pain, enormous swelling ofthe left arm, and distension of the superficial veins . There were alsointense jaundice, delirium, and finally death by coma.

a LLm'

relates a case of severe purpura, the urine being loadedwith blood, which was arrested in two davs bv calomel and gallicacid

, ana gr. ij— iij, 4~tis horis, with gr. j of quinine . Ptyalismwas produced. The patient was in robust health before the attack,and had not been w ithout v egetables .

COCK LE observed 178 cases of cardiac valvular disease, being90 males and 88 females 90 hadmitral disease, 7 1 aortic, 1 7 bothmitral and aortic. In 58 rheumatic fever was the assigned cause,

viz ., in 35 with mitral, 16 w ith aortic, and 7 w ith both mitral andaortic disease. After citing the opinions of Skoda, Ludw ig, Budgeand Schifl, Weber a nd Brown-S equard, as to the causes of the

heart’3 rhythmic action andmovement, and the mode in which it is

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REPORT OX PRACTICAL MED IC INE.

Turnbnll — Ou the Causes of Pulmonary Consumption. Brit. Med . Joan , May

7th and s rtt, 1859.

Green — Smles les ions de l'epiglotte. [On Lesions of the Epiglottis.) Annuaire

par Noirot, 1859, p. 147.

Quick en— Sm les retréeissements da larynx. [On Contractions of the Lsrynx.]

Ih., p. 1 76.

Green,

— Sur l’

sntsgonisme de is nevre intermittente et de is phthisic pulmonaire.

[On the Antagon ismof Ague and Phth is is.] Ih., p. 304.

— De is vaccination comme réméde contre la coqueluche. [On Vaccinationas a Remedy in Pertussis.) Ih ., p. 307.

Pa g er,

— Glossoplegie et slalie guéries par l’électricité. [Paralysis of the Tongueand Loss of Voice cured byElectricity.] Ih., p. 308.

Schiele,

— Observation d'abcés an larynx i in suite d’une fiévre typhoids. [Case ofAbscess in the Larynx utter Typho id Fever.] Ih., p. 314.

Kemp— Observation de pleurésie du caté dro it svec embolie do l’srtére pulmo

ns lre droite. [Case of Pleurisyof the Right Side, with fibrinous concretion inthe Right PulmonaryArtery.] Ih., p. 316.

Debenhm — Sur l'

utilité des inlials tions dc vsp’

eur d’

esu chez les suiets quiv iennent da subir ls trachéotomie. [On the Utility of the Tracheotomiz edinhaling Steam.] Ih., p. 340.

Lum ,

— Du traitement do croup. [The Treatment of Croup.] Ih., p. 331 .

Cotton — Action of certain substances upon Phthisis.-Chloride of Sodium. Med .

Times and Gaz ., May 38th, 1859.

Hyde Sulta n— Ou some Points in the Treatment and Cl in ical Historyof Asthma.

Ed in . Med . Jour., June, 1859, p. 1 109.

Bamberger.

— Bronch iek ts sis sacciformis. [Succulsr D ilatation of the Bronch i.]Schmidt's J s hrb . , 1859, vol. 103. p. 37.

n artini, Ueber Tracheotomie. [On Tracheotomy. Report.] Ih., pp. 731 10.

Gen uine-Der Katheterismus des Larynx und sein Verhi ltniss snr Tracheotomie ,nsch den neuern Verhsndlungen besprochen. [Catheterismof the la rynx, and

its relation to Tracheotomy, according to recent inquiries.] Ih., p. 335344.

Buney,

— Surgical Reports and Observations — Acute Laryngitis ; Laryngotomy;Remark s. Med . Times and Gs z . , June 18th, 1839.

Ew en-Clin ical Lecture on Asthen ic Pneumonia. Brit. Med. Jour., July3d,1859.

Peacock — On the supposed Antagonismot‘ Consumption and Ague. Brit. and

For. Med -Chin Rev., Jan., 1859, p . 303.

Willemin ,

— Ou the Inhalation of Carbon ic Acid in Granular Pharyngitis. Ih

p. 345.

Semeleder,

— 0n the Practical Use of a Laryngeal Speculumin the Diagnosis andTreatment of D iseases of the Tongue. Ih., p . 357.

Hyde Salter.

— Ou the E tiology of Asthma. Brit. Med. Jour., July9th, 1859.

Keyser ,

— Pal l von Pleuritis und Embol ie der Arteria pulmonal is. [Case of Pleurisyand Embolia of the PulmonaryArtery.] Schmidt’s Jahrb ., 1859, vol. 103, p . 394.

Hyde Semen — Some of the principal Events in the Clin ical Historyof Asthma.

Brit. Med. Jour., July 16th , and Aug. i3th and 37th, 1859.

Runwa

y-Ou the Treatment of Pneumonia. Edin. Med. Joan , Aug., 1859.

p. 1

nasrruaroar svsrmr. 221

nereL— Diphtherous Larvae developed in the Frontal Sinus and Nasal Fossz 0!

Man . Ih., p. 17 1 .

M ug— Ou the pecul iar Eflicacy oi

'

Sulphate of Copper in exciting Vomiting inthe Treatment of Group. Brit. and For. Med .-Chir. Rev ., July, 1859, p. 345.

l oom,

— Case of Pleuritis and Empyema terminating by Vicarious Secretion.

Dubl in Hosp. Gaz . , Aug. 1st, 1859.

h arm— The Treatment oi’ (Edema G lottidis byScariticatious. Lancet, Aug. 13th ,

1859.

Conway Evans. On Tracheotomy in Group. Med. Times and Gaz ., Aug. 37th ,

1859.

Pollock — On the Elements of Prognosis in Phth isis. lb Sept. 17th , 1859.

Sk odg — D ie resorption Pleuritischen Exsudate . [The Resorption oi'

PleuriticBfl

‘

usion .] Schmidt’s Jahrb ., 1859, vol . 103. p. 185.Hyde Staten

— The Consequences of Asthma. Brit. Med. Journ., Sept. 17th,

1859.

Treatment of Asthma by Sedatives . lb Oct. 1st, 1859.

Notcs.— Pleuritic Ef’fus ion ; its cure by remedies and by

Thoracentesis. Bd in . Med . Journ . , Oct. , 1859, p. 339.

Flint— Clin ical Study of the Heart-sounds in Health and D isease . AmericanJournal of Med. Sciences, July, 1859, p. 393.

Baum— Ou the Causes of the Independence of Bronch itis in Relation to Pneumon ia. Med . Times and Gaz . , Oct. 33d , 1859.

M y,

— Ou the Use of the Preparations oi’ Larch Bark in PulmonaryHemorrhage.

Ih Nov . 13th, 1859.

Budd,

— Ou some of the Efl‘ects of Primary Cancerous Tumours w ithin the Chest.Med -Chin Trans ., vol. xiii, p. 315.

Goodfellow ,

— Two Cases of Empyema, illustrating the Advantage ofmak ing twoOpenings , and adopting the Plan of Drainage in the Operation of Paracentesisin that D isease . Fol lowed by some Remark s on the Operation and on the

Plan of Treatment by Drainage generally.

Cotton ,

— Ou the Action of certain Substances upon Phth isis. — No. II, Iod ide of

Potass ium. Med . Times and Gaz . , Dec. 34th , 1859.

— Report on the Results of Tracheotomy. Ih. , Oct. 15th , 1859.

— Comments on Tracheotomy for Scalds of the G lottis.— Comments on

Tracheotomyfor Croup.— Tabular Statement of Fifteen Cases of Tracheotomy

for Croup .— Tabular Statement of Fourteen Cases of Tracheotomy for Scalds of

the Glottis. lb ., Oct. 33d, 1859.

— Comments on the Series of Tracheotomy for Foreign Bodies .— Comments

on the Series for Laryngeal Atl’ections (exclusive of true croup) .— TabularStatement of Thirteen Cases of Tracheotomy for Foreign Bod ies in the Wind .

pipe — Tabular Statement of Thirty-seven Cases of Tracheotomy i'

or LaryngealAfl

'

ections . Ih., Oct. 39th , 1859.

Gnll ,— Ou the Destructive Changes in the Lung fromD iseases in the Med iastinuminvad ing or compressing the Pneumogastric Nerves and Pulmonary Plexus.Guy

's Hosp. Reports, 1859, vol. v , p . 30 7

—315.

Wm'

rmlmn adduces evidence to prove how much the duration oflimping-cough can be dimin ished by treatment. Thirty-five cases,

not treated till the disease had lasted three months, were cured, on

tumour ox Paacrxcan stamen s .

an average, in less than twenty-five days ; and eighty-seven, whosetreatment was commenced w ithin fourteen days after the on set, werecured in the same time . O pium, usually as Dover

’

s powder, andbelladonna were the principal remedies, the latter being given sometimes ia the formof a salt of atropia. Emetics and repeated smalldoses of calomel were associated w ith the other remedies occas ionally with very good effect.

Boxaros-Laz nnn ns records a good example of bronchial affection, with asthmatic paroxysms succeeding to an habitual perspiration of the feet, and resisting all treatment except that of the hydro .

sulphurous baths at Amelia. The mode of application was bv

vapour baths and inhalation of the vapour.

HOLL recommends the application of small blisters to the back ofthe neck, encroaching a little on the scalp, as exceedingly efficaciousin the treatment of pertussis . One or two bliste rs will generallvsuffice .

HYDE Sau na publishes a paper on the varieties of asthma.

He starts from the assumption that the essential state in asthmais always constant, whatever may be the cause or complication . T he bronchial constriction is always there, whether there bebronchitis or none, whether the paroxysmhe apparently causeless orcreated by ipecacuanha, hay emanations, or gastric irritation or

uterine . He gives the following table, which we modify a little(I.) Idiopathic, uncomplicated, or spasmodic asthma . Intrinsic

,

e . irritant applied to the lungs themselves As from fog,smoke, (2 ) fromipecacuanha ; (3) fromhay (4) froman imalemanations (5) from certain airs (6) toxhazmic. (B . ) Excitomotory or reflex asthma Peptic asthma ; (2 ) asthma fromorgan ic nervous irritation ; (3) asthma from peripheral cerebrospinal irritation . (c.) Central asthma (epileptic, emotional) . Peri

odic asthma, w ithout any apparent exciting cause, forms a subdiv isionof the above . (IL) Symptomatic, complicated, or organ ic asthma .

Organ ic cause, vascular (asthma complicating bronchitis, humid,sen ile, cardiac asthma . Organ ic cause

, nervous (Heberden’

s

case,

Vanna nonn shows, fromthe results of his experience at Ostend,compared w ith that of others in inland town s

,that Laennec’s

opinion as to the comparative rarity of phthisis on the sea-coast is

correct. In the interior, the deaths fromphthisis amounted to 19

per cent. The deaths fromphthisis in the civil hospital at Ostend

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221 s avour ox ras crrcax. n anncrxa.

every quarter of an hour, or hour, and the two substances are to beused alternately. No medicine is given, but a generous diet and

wine.

Consox strongly recommends the adeption of certa in positions ofthe shoulders and the tension of certain thoracic muscles as an

important aid in physical examination . He thinks that “ theseexpedients for thinn ing, condensing, and tightening the fleshy wallsof the chest, add fully one third to our power of detecting theearliest signs of consumption .

A quotation fromTnoussmv’s report on the treatment of croup

(which is evidently purely diphtheritic, not our inflammatory disorder) maybe referred to with advantage . He shows the utte r use

lessnes s of leeching, blisters and emetics, and that topical treatmentis the only one that avails .

MANDL recommends, in the forms of bronchitis which he denominates séche (dry), fumigations with the following mixture : aceticacid

, 3iss creosote, 3iss ; water Oj. M . This is to be placed ina two-orificed glass balloon, to be heated, and the vapour to beinspired .

Bouaems directs attention to jerking respiration, as one of theearliest physical signs of puhnonary tuberculosis. He gives thedetails of a post-mortemto show that it is not necessarily dependenton the presence of adhesions .

GRIES INGER describes his experience of injecting n itrate of silversolution into the bronchi, after the manner of Horace Green .

He truly remarks that the operation is not without its difficulties,and that it requires a previous preparation of some days to accustomthe larynx to the i ntroduction of the foreign body . Further, hesees nomeans of determining the pas sage of the tube into the rightor left bronchus, but he believes it w ill usuallv enter the right, foranatomical reasons .

ULRICH records two cases of asphyxia fromthe inhalation of chloroform, in which life was saved by artificial respiration .

HORACE GREEN describes the les ions of the epiglottis as consistingeither in erosions

‘of the mucous membranes or ulcerations of it

and of its glands, or in (e dema of its areolar tissue. The erosionsand ulcerations are sometimes of tuberculous character, but often

not. Unchecked disease of the epiglottis mav, he thinks, originatepulmonary disease .

O reonz an cansiders shortlv the various causes of laryngeal cou

nasrma '

ronr SYSTEM . 225

traction or impediment. Acute catarrh may cause the well-known(edema circa glottidem in the aryteno-epiglottic folds . The

efl'

used material is sometimes fibrinous, and produces abscess . In

flammation of the perichondriumis not very rare ; it occurs chieflyin connection w ith typhoid fever, or pyaemia . Chronic catarrh maycause laryngeal contraction by inducing hypertrophy of the mucoustissues . So maydiphtheritic exudation . Epithelial growths, fibrouspolypi, lipomata, syphilitic disease, the Greek leprosy, tuberculousulcerations, typhoid ulcers, variolous pustules (the cicatrices of ),scurvy, spasmof the glottis, foreign bodies, external tumours, &cmayall have the above efl'ect.Games relate s the following fact relative to the antagon ismbe

tween phthisis and ague . A marsh in Rutland hav ing beenconverted into a pool, ague disappeared, but pulmonary phthisisbecame so rife that, at the request of the inhabitants, the marsh wasrestored, whereupon the fevers resumed their sway and phthisisceased.

In pertussis, vaccination has sometimes had a beneficial efl'

ect,

the vaccine pustule pursuing its regular course . Tann in in dosesof about five grains daily, with saline infusion of scans, has beenvery successful .A case is recorded byPosxxn in which a phthisical girl, of scrofu

lous habit, suffering under pulmonary phthisis and hysteria, togetherw ith a perfect paralysis of the tongue as to motion and sensation,and complete aphonia, was cured of these latter symptoms by continned Faradiz ation .

Case of pleurisy of the right side, w ith emboli of the right pulmonary artery, recorded by KEYSER . T he patient lived five daysafter the first symptoms of arterial obstruction . There was sometuberculosis of the lungs . Dense fibrinous clots existed in the

right ventricle, in the pulmonary artery, and especially in its rightdivision , which was completely obstructed by them.

The diffusion of wate ry vapour in the air is strongly recommendedby Dnaaxnau as a means of warding-off bronchitis in patients whohave undergone tracheotomy .

Luz svxsxr, fromhis large experience at the Vienna Children ’sHospital, regards croup as a disease depending on a particular crasisof the blood, which determines pseudo-membranous deposits,these be ing only the local and simple expression of the general

15

226 naroar ox raacrrcu . MED ICINE.

diathesis. To modify this crasis of the blood he relies on alk alies,the carbonate of potash or soda, the doses of which should be3as to gijin the day. To prevent the localiz ation of the inflammation in the

larynx, he does not adv ise leeches, but the cautious application of

cold to the throat, the rest of the body be ing kept warm, and smallspoonfuls of milk and cold water being given internally. If coldcannot be applied, blisters should be placed over the sternum. He

gives opiates to lull laryngeal spasm. To destroythe false membranes, or expel them, Luz sinskyemploys a solution of Arg.Nitras,or, if this fail, emetic doses of sulphate of copper. During three

years, among children, 30 cases of croup have occurred ;and during three other years, 60 took place among Of

these 90 cases, 55 wereboys, 35 girls . Among children one year

old there were 1 1 cases fromone to two, 16 cases ; from two

to three, 16 cases ; from three to four, 8 cases ; fromfour to five,9 ; fromfive to six, 15 ; fromsix to seven,mean s ; I occurred at

the age of nine . Of the 90 cases, 75 recovered, 15 died. The

earlier the treatment was commenced themore success was generallyobtained.

Common, experimenting w ith various substances at the BramptonHospital on cases of phthisis, comes to the following conclusionsrespecting chloride ‘

0f sodium. In some cases it increases theappetite and acts as a general tonic, equivalent to the bitter drugs .

In doses of one to two drachms, gradually admin istered, it does notusually derange the digestive organs or occas ion thirst. It doesnot appear to be a substance deficient in the tuberculous crasis, or tohave anydirect efl

'

cct upon phthisis when fully developed.

HYDE Samar. has some remarks on the treatment of asthmaby coffee and mental excitement. He thinks that both act in

the same way, viz ., by exalting the voluntary power, and preventingthe dominance of excite-motory action .

In a long report on tracheotomy, MARTINI quotes the fol

lowing observations, made by Neudorfer, respecting a conditioninducing laryngo-stenosis . There exists a pathological conditionof the air-passages, consisting in an infiltration and subsequentshrinking of the cartilages, entirely analogous to the shrinking of

the cartilage of the eyelids in tracheotoma . This shrinking may te

main limited to the larynx, or extend also to the air-tubes, even as

far as themostminute (that are prov ided with cartilages). Such

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228 ar ronr ox PRACTICAL MED IC INE.

n ism between phthisis pulmonslis and ague . After noticing theobservations of previous writers, he remarks that the questionwould appear to admit of ready solution, by comparing the

mortality from phthisis in different districts of a similar cha

racter, except that in some, aguish afl'

ections should be prevalent,and in others, that they should be absent or only rarely seen . He

objects to a comparison of this kind made by Greenhow, that no

account is taken in it of the relative number of persons atdifferentages, nor of the influence of climate , though these are most im

portant considerations in estimating the relative prevalence of con

sumption in difl'

erent localities .

”He then proceeds : “ To effect a

satisfactory comparison, the districts compared must not only con

trast as regards the prevalence of ague, but they must possesssimilar climates, and must correspond in the densityof the popalation, the proportion of persons at the ages most prone to con

sumption, and in the social position and occupations of the inhabitants . The population must be but little affected by immigration,and the mortalitymust not be modified by the existence of large

public hospitals, or institutions in which persons are received fromother localities .

”Peacock believes that he finds the requisite ia

stances in certain districts situate near each other in the countiesof Cambridgeshire, Northamptonshire, Huntingdonshire, and Bedfordshire, and has constructed a table showing the annual proportion of deaths from ague a nd remittent fever combined, fromague only, from phthisis, from other diseases of the respiratoryorgans, and fromall causes, per persons of both sexes, and

of each sex separately. The table also includes a statement of thepopulation in 185 1, the extent of the districts, the proportion of

persons to the square mile in each, and the relative proportion of

persons between the ages of fifteen and forty-five inclusive . The

general result afl'

orded by these data is this : “While as a general rule alarge prevalence of aguish afl

'

ections coincided w ith a low rate of

mortality fromconsumption, and a small prevalence of ague with a

high rate of mortality fromconsumption, this rule is liable to suchmarked exceptions that we are not warranted in inferring that thesusceptibility to phthisis is in anygreat degree influenced bv the

causes which give rise to ag ue .

”

WILLEM IN states that diluted carbon ic acid gas, employed in

inhalations, is especially efficacious in chronic inflammations, w ithttonyof themucous membrane and exaggerated secretion, and in

RESPIRATORY S i S’

l’

lflhi .

nervous affections of the respiratory passages, but that it is injurious in phthisis. Its primary action is to produce excitemen t,which is followed by a sedative effect. In addition to this generalaction, the gas possesses an am thctic power over wounds and partsdenuded of epidermis . It is recommended in granular pharyn

Su z a nna recommends the use of the laryngeal speculumemployed by Garcia and wermak for the examination of thefauces and larynx. Not only the entrance of the larynx and the

epiglottis , but the chordmvocales, the inner surface of the trachea,and even its bifurcation (occasionally): maybe recognised .

Karena relates how a man, wt. 28, convalescent frompleurisy ofthe right side, after v iolent mental emotion was seiz ed bycorpselik e puller and icycoldness of the whole body, w ith cold sweat and

difl cult breathing. The action of the heart was stormy and irregular, its sounds normal. Death occurred on the fifth day, in the way

some small tubm'

culous deposits. The left ventricle was empty, the

branch, but cnly a little into the left.

A continuous musicalmurmur, at first of piping character, after

wards more like the rattling of a wheel, stronger at each inspiration,

the ste rnum, and also in the back , is connected by its observer,m a, with the condition of the liver, which was greatlyshrunken by cirrhosis, and left the vena cava exposed to the pressure

Ni z iu rnn has the followi ng observations on the treatmentof pneumonia. After remark ing upon its eminently cyclical

recovery when the patients are strong and the disease ofmoderateseverity, as well as on the danger of undiscriminating venesection,be proceeds :

“ In the treatment of pueumonia, I have made exten

sive use of cold, and can confidently recommend mymethod, fromthe highly favorable results which I have obtained during a

lengthy series of observations . I cover the chest of the patient onthe d ected side with napkins wrung-out of cold water, and I orderrenewal of the cold application s every five minutes . In almost allcases the patients feel greatly relieved after a veryfew hours, the

280 nnroar on rnac'rlcu . neuroma .

pain and dyspnma are diminished, the pulse becomes less rapid,and the high temperature falls, often as much as a degree. The

improvement is often surprising, and generally is permanentthroughout the illness, so that the attendants, who may at first object tothe somewhat troublesome mode of treatment, gladly persevere inits application . In very few cases does the use of cold epithemsfail in giving relief.

The experience of the French surgeons at Cayenne has proved thepossibility of diphtherous larvae being developed in the nasal fomand frontal sinuses of human beings. Fromone of the larva a

perfect insect has been obtained, to which the name M ia M ini

voraz has been given . The symptoms are itching in the nasal fome,

intense supra-orbital headache, (edema of the nose, extending to theface, abundant epistaxis, indications of intense inflammatory action,Which may extend to the membranes of the brain and occasion

death. In favorable cases a cure may be effected ; but less ofsubstance, more or less extensive, and consequent deformity in the

nose and its neighbourhood,mayalways be looked for.

” Injectionsof liquid which may destroy the larva , as chlorine water, solution

of corrosive sublimate, constitute the best treatment.Mmsoux considers sulphate of copper of peculiar efficacy 1n the

treatment of croup, not only on account of its emetic action, whichis attended with less prostration than that of antimony, but becauseit possesses the property of somodifying the secreting surfaces, that1fter the false membranes are detached they cease to be re-formed,or if they are formed, they no longer possess the plasticity which

renders themso adherent to adjoining parts .

” This topical actionmaybe observed in cutaneous diphtheria, and in that of the vulva

and nose. To young children he administers one eighth of a grain

in a teaspoonful of wate r every ten minutes, until vomiting is produced . To adults he gives half a grain in the same way. Out of

thirty diphtheritic cases, Missoux only lost two.

Moons records a caseof pleuritisand empyema occurringin a femalechild, set. 8, in which the efl

'

used fluid appeared to be removed by avery profuse, fetid expectoration . The left side of the chest gave,on auscultation, a muco-crepitating rfile down to the mammaryregion in front, and themid-scapular behind ; below these pointsnothing but indistinct tubular respiration could be heard. Therewas bulging of the side and some displacement of the heart. In

the course of recovery themuco-crepitating tale pervaded the lower

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2322 REPORT OX PRACTICAL MEDIC INE.

ments, without, however, being able to state the special indicationsthat should determine the use of one rather than another.

PoLLocx has a paper on the Elements of Prognosis i11

Phthisis .

’ He is inclined to consider the average duration of the

disease as much greater than has been usually stated, exceeding theperiod of three years, which is about the mediumassigned by highauthorities . The disease always proceeds by a succession of attack s,

even when most rapid. In chronic, difl'

used tubercle, the depositoften proceeds in the following order first, one apex ; next, the 0p

posite ; third, the base of the side lastattacked. The most chronicis, however, often diagonal, as right apex, left base, left apex, rightbase, successively. A curious result of some thousand observationsmaybe thus stated : When the observed and customary order ofphysical signs is reversed, or in any important respect anomalous,the chances of prolonged life are greater The more each case

approaches to the ordinary type of the disease, the more rapidlyfatal is it sure to be .

”The presence of the conditions antagonistic

to tubercle, or rarely coexist-ing with it, indicates great prolongation . This is especially true of the complication with emphysema .

In 190 cases, hereditary predisposition was observed in 69, all

these having lasted upwards of four years. An absence of haemoptysis was noted in 65, and of diarrh ea in 15 1 . Moderate or

great emaciation was present in 92, slight in 97.

HYDE Sau na reviews the principal remedies we possess for therelief of asthma, enumerating tobacco, chloroform, opium,

India nhemp, stramonium, lobelia, tether. Chloroform he considers toarrest the asthmatic paroxysmmore speedily and certainly than anyother remedy. It is to be inhaled, but not to the extent of pro

ducing deep insensibility . It is not safe to allow patients to inhaleit themselves . Stranwuium is sometimes marvellously efficacious

,

but often disappoints the practitioner . This great inconstancy of

efl'

ect he think s may depend on the mode of preparing the drug .

The varieties Datumf erox and Da lura ta lula are more powerfulthan Datum stramonium. He state s, 011 Alexander’s authority,that the seeds are far more potent than the leaves ; they are to be

used in smok ing cautiously, in small and gradually increasing quantities . Salte r is in favour of the practice of smoking a pipe everynight on going to bed, whether the asthma is threatening or not.

Lobch'

a has not proved of much benefit in Saltcr’s hands,but he is

RESPIRATORY SYS l‘

ll lf .

inclin ed to believe that it may be very efficacious if given in the

v ery large doses employed by some American physicians . It then

produces symptoms identical w ith those of tobacco-poisoning . It

is tolerated very differently by different indiv iduals . IIe approves

of Elliotson’s plan of giv ing small and gradually increased doses

frequently . E ther has only acted well in a single case of Salter’

s,

but in that it was lik e a charm. The use of op iumhe discounte nances in to/o. Of tobacco, employed as a sedative, he states thatasthmatics are very commonly smok ers, andmany of themfind in

the habit an almost unfailing antidote to their disease . But it is

rather useful as a prophylactic than as a remedy for the spasmwhen present.GAIRDNER, in his clinical notes, relates two cases of pleuritic

effusion , in one of which thoracentesis was employed, both re

covering about equallywell . He regards the operation as usually

performed as merely a palliative measure, to be employed for thesak e of obtaining temporary immediate relief in cases of great dis

tension . Onlv that portion of the fluid which distends and bulgesthe cav ity can be drawn off bv the simple trocar, though by mean sof an exhausting syringe, employed hv Bowditch, evacuation can

be effectedmuch more completely . Gaardner is inclined to expect

good results fromthe use of this instrmncnt.In the ‘ Buffalo Medical J ournal,

’

FLINT has given a cli

n ical report on fifteen cases of pneumonia . Ten of them were

complicated w ith delirium tremens . One proved fatal. Quinn,opium, alcoholic stimulants, and nutritious dict, constituted thetreatment. The first of those remedies w as rather used as a

preventive of intermittent fever, which is a dangerous complication,

than as a remedy for the pneumonia . Opium, he think s, lessens

the perturbatory effects in the economy of the local inflammation, ifindeed it does not diminish its intensity . All the patients were

allowed to tak e food as nutritious in quality and as freely as theydesired . Neither bloodletting, general or local, tartar emetic, mercury, cathartics, or counter-irritants, w ere employed. The authormak es some useful observations on the use of these means

, and

remark s, in conclusion, that the natural history of a disease, and itsintrinsic tendency to life or death, con stitute the true point of

departure for the study of its therapeutics .

ROB IN, remark ing on the independence of bronchitis in relation

to pneumonia, dwells at some length 011 the modification of struc

284 aeron'r ox rnacrrcan immerse .

ture which themucous lining undergoes, and on the different sourceof the capillaryplexus of the bronchi and air-cells, which he thinksare fully adequate to account for the distinctness of the two diseases .

O’Damr speak s very favorably fromhis experience of the use of

tincture of larieis (larch-bark) in pulmonary hemorrhage and in

successfully performed, recorded by Wnanrox.

In a paper On some of the Efi'

ects of Primary CancerousTumours within the Chest,’ Bum) draws special attention to the

inflammatory changes which had occurred, such as pleural thick ening, inflammatory disorganiz ation of the pulmonary tissue and the

formation of pockets of pus, adhesion of the pericardium, and abundant effusion of lymph on its outer surface. He attributes thesechanges to the destruction of the pulmonary nerves bythe canceroustumour, which in all the cases was situated at and involved the rootof the right lung, and states that inflammation of the gall

-bladder

is probably also caused sometimes in the same way, bycanceroustumours in the portal notch of the liver.

GoonrnLLow records two cases of empyema, illustrating the

advantage of mak ing two openings, and adopting the plan of

drainage,”in the Operation of paracentesis. The pus flows ofl' as

it is formed, and does not decompose .

Corron, after carefullyobserving the action of Potassii Iodidmnupon twenty-five phthisical patients, found that it was productive ofno noticeable effect, except that it occasionally caused dyspepsia andsome loss of weight.GULL records three cases in which gangrenous pneumonia appears

to have supervened in consequence of aneurismal, cancerous, or

fibroid tumours having involved the root of the lung and the corre

spending nervous plexus . In each case one lung was affected.

DIGESTIVE SYSTEM.

Brinton — The Diseases of the Stomach. pp. 406. Churchill, 1859.

I‘m -Ou the TreatmentofTapeworm. Med. Times and Gaz ., Jan. i sth.3859.

f laming — Note on a newmode of treating Severe Dyspepsia and Chronic Inflammation of the Stomach. Ih., Jan. 39th, 1859.

Hillier,— Ou Diphtherite. Ih., Jan. s9th, Feb. sth and 13th, 1859.

Hutchinson — l l Ulcerative Stomatitis” a Diphtheritic Affection ? Ih.,March

ryth, 1859.

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236 ns ron'

r ox rns crrcan imme ns e .

Gradenwita.

-Verengerung der Speiserohre ueber der Kardia, und bedeulendeBru e iteung oberhalb derselben. [Contraction of the (Esophagus near the

Cardiac Orifice , and considerable dilatation just above.— Case.] Ih., p. 398.

Beta — Usher lntus. susception . [On lntus-susception.] Ib . , p. 318.

Frommann , B onnet, Cabaret, Theile und Aberle, Brugnoli, and

Straubel ,— Fall vomIntus-susception .— Abstossung des k alendes dea Dick

«fume in Polge einin Intus-susception.— Invagination des Colon bei einem

Kinde , rcpon irt nach Le Pelletier’s Verfahren.

— Fi lle von obstructio stereo

racea.— Ileus durch verwachsung dea l leummit der Hamblase bedingt — Fall

von Achsendrehung amuntern cnde des Dunndarmsmit Verschluss . [Case of

Intus-susception.— Detachment of the Cc cumin consequence of an Intus-sus

ceph e n .— l nvagination of the Colon in a Child replaced by Le Pelletier

’

s

method — Cases of Stercoraceous 0l1structiom— Ileus produced byAdhesion of

the Ileumw ith the Urinarymadden — Case in which the lower end of the

Small Intestine was twisted on its axis and the canal closed ] Ih., pp. 3s0

3s5.

Lan ai — Ou Pepsin. Med. Times and Gaz . , June 18th, 1859.

mob ,

— Schw ielige Degeneration der Submucose des Magens . [Cicatricial Degeneration of the Submucous Coat of the Stomach .] Schmidt’s Jahrb ., vol. 103.

p. 176.

Oppom — Aetiologic des Ascites. [E tiologyof Ascites.] Ih., p. 333.

Lujebom,

— T6dtliches Blutbrechen in Polge von Geschwiiren im Duodenum.

[Fatal Vomiting of Blood fromUlcers in the Duodenum.] lh., p. 296.

Weisse ,

— ou the use of Raw Meat in the Colliquativc D iarrhwa of Children at theBreast. Brit. and For. Med -Ch in Rem, July, 1859, p. a53.

Beam— Ou Treatment of Acute Idiopathic Peritonitis by Quinine. Med. Timesand Gaz . , July 2 11, 1859.

Eastom— Case of Obstruction of the Bowels, continuing during five days and a

half, accompanied byprofuse Stercoraceous Vomiting, and terminating favorablv .

Glasgow Med . Jour., April, 1859, p. 41.

Com— Death from Impaction of the Small Intestine with Lumbrici. Edin. Med.

Jour. , 1859. p. 168.

Corrigan ,

— Clinical Observations on Pica, or Dirt-eating of Children. Dublin“0811. Gaz . , Aug. 1st, 1859.

Wallman — Pert’

orirende Gescbwure des Duodenum. [Perforating DuodenalU lcers Schmidt’s Jahrbuch . , 1859 vol. 103. p. 2 7.

Girdw ood ,

— Ou Diarrhma and Dysentery coetaneous with Conception. Lancet,Sept. 3d , 1859.

B ank ing ,

— U lceration of the Duodenum, causing Death byErosion of the PyloricArte ry . Brit. Merl. Jour. , Sept. 3d , 1859.

Heglopg— The Cerebro-spinal Symptomatology of Worms, especiallyTapeworms.

Dublin Med . Jour., May.p. 2 57 Aug., p. 133; 1859.

Firth — Soft Medullary Cancer of the (Esophagus, wh ich ulcerated into the

pericardial cavity, producing Pericard itis and Death . Lancet, Sept. 17th ,1859.

Bergeron ,

— Ueber die Stomatifls ulcerosa der Soldaten. [On the UlcerativeStomatitis of Soldiers.] Schmidt’s Jahrhucher, 1859. vol. 103, p. 315.

Batty_— Stricture of the (EsOphngus . Brit. Med. Jour., Sept. s4th , 1859.

Sturges,— Report of a Case of Intestinal Obstruction. Lancet, Oct. xst, 1850.

n i c rzsr rvn s vsr rzn . 237

Thomhfl l,— Peculiaritics regarding the Location of certain Organs of the Abdo

minal Viscera, in a Case of Dysenterycomplicated w ith Aneurismof the dorsal

portion of the Aorta. Dublin Hosp. Gaz . , Oct. rst, 1859.

canton — On a Case ofDigestive Solution of the (Esophagus. Lancet, Oct. 8th , 1859.

Bovero,

— Ueber die organischen Verengernngen des Mastdarms in Folge von

Syphilis. Schmidt's Jahrb ., 1859, vol. 104. p. 69 .

wa g — Clinical Illustrations of the D iagnosis and Treatment of Ulcer of the

Stomach. Brit. Med . Jour. , Oct. 2 2d , 1859.

Eam on— Malposition of the Abdominal Viscera, in relation to the Causes

and Diagnosis of Disease . Guy'

s IIosp. Reports , 1859, vol. v , p. 164.

WM — Chronischer Katarrh der Darme . [Chron ic IntestinalCatnrrh .] Schmidt’sJahrb ., 1859, vol. 104. p. 1 7 1 .

8“inberg,

— A Case of Inflammation of the Venn Portm. Dublin IIosp. Gaz . ,

Nov . 15th , 1859.

Habemhom— Ou Pain as a Sign of Disease of the Stomach . Med . Times andGaz ., Nov . 36th , 1859.

Donfl d'on ,

— Ou the Diarrhoea and Dysentery of Ind ia and China. Edin . Med .

Jour., Dec., 1859. p. 583.

(”u h — Clin ical Illustrations of Mucous Disease of the Colon, from notes of

various cases. Lancet, Dec. i 7th , 1859 .

Wang — Alk ali“ or Acids in Stomach D isorders ? Brit. Med. Jour., Dec. 24th, 1859.

Bnmmn’ s work on diseases of the stomach consists of a series

of lectures, preceded by a chapter on its anatomy and phvsiology.

The first lecture treats of the symptoms of gastric disease generally, partieularising pain, cructation, regurgitation, vomiting,hemorrhage, and flatulence . Lecture It examines circumstancesconnected with the examination of the stomach after death

gastritis, gastric catarrh, hmmorrhagic. erosion, and follicular

ulceration . Lecture III treats of ulcer of the stomach . Lecture

w of cancer. Lecture v comprises cirrhotic inflammation, or

plastic linitis of the stomach,suppurative linitis, tumours, hyper

trophy, atrophy, dilatation, secondarv inflammation . Lecture v 1

treats of dyspepsia. \Vith regard to vomiting, he propounds thegeneral rule,

“that the facility with which an irritation produces

vomiting varies (other things being equal) with the closeness of

alliance between the stomach and the irritated part.

”The pro

duction of flatulence by secretion of gases from the mucous membrane itself he entirely rejects . On the subject of gastric catarrhhe observes, that a careful revi ew of details perhaps justifies us insuspending our judgment as to the nature (or even the substantiveexistence) of gastric catarrh, until larger and more exact infor

mation is before us .

” Hemorrhagic erosion he. think s is often

distinguishable during life, and may be regarded as ulcerative

gastritis . Yet he entertains doubts whether, in many cases“which

238 aarour on enac'rrcu . uamcrns .

can scarcely be distinguished fromit, the post-mortemappearancesare not in a greater or less degree the result of change occurringshortlybefore or after death. In ulceration ofthe stomach, Brintondoes not believe there is anything special or peculiar, such as to

distinguish the process entirelyfromulceration affecting other parts .

Itmaycommence froma variety of morbid states, none of which

per so would have been sufficient to cause the destruction of tissue .

The circumstances which interfere with the healing of the gastric

ulcer are paralleled by those that interfere with the healing of one in

exte rnal part. The treatment of the vomitingmost frequent in anycases of gastric ulcer is best arranged by limiting the amount of

ingesta, relieving flatulence, and neutraliz ing acidity . If the sto

mach is extremely irritable, it is better to afford it as complete and

prolonged a repose as possible, forbearing the administration of

drugs, which oftener fail than do good. A properly regulated

diet the author considers all-important ; without its aid, drugs are

powerless for good. In the commencement of the treatment, milk,given in small quantities and at frequent intervals, ismost beneficial,and afte r some immovement has been obtained, ground ricemaybemingled with it advantageously. As a rule, all alcoholic stimulantsshould be forborne . Bismuth and ice internally, and blisters, &c.,

externally, for the purpose of relieving pain, gallic acid, with dilutesulphuric, to arrest h emorrhage, and tonics to improve the strength,are the chief remedies which the author advises . Opium he also

believes to be endued with the same efficacy in the cure of gastric

ulcer that it has been known to possess in the case of ulcers of the

limbs. The pathology of gastric cancer is very fully inquiredinto . The author finds that the maximum liability is between the

ages of 60 and 70. Up to the age of 20, the whole risk is less thanone-fiftieth of what it reaches between 20 and 30 . The latter lia

bility, again, is multiplied in the following decades of years by 3, 6,

8, and 10, respectively. The maximumthen seems to sink to littlemore than half for the two next decades

, ending at the extremeage of 100 . Comparing the risk of gastric cancer w ith that of

gastric ulcer, it would seemthat the former is, on an average, barelyone fourth of the latter ; and that though much more distinctly and

exclusively a disease of old age, its climax or maximum of risk

occurs at least twenty years earlier than that of the gastric ulcer.

The greater liability of the male to gastric cancer is shown by thedivision of 784 cases among 440 males and 344 females. As

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2 10 n s ronr ox re s cu e s ]. n umcrxn.

fromother abdominal tumours, bymeans of observing the effect ofa deep inspiration upon the tumour.

BANKS records an interesting case of ascites apparently dependingupon hepatic disease, in which tapping was performed twenty timesin the course of fifteen months . After the last tapping there has

been no recurrence of dropsical accumulation, and now, at the expi

ration of seven months, she declares she was never in better health .

Bank s look s on the case as important, as showing that We oughtnot to despair in every case of ascites appearing to depend on Oh

structiv e disease of the liver . No remedy was of any avail to

irrcst the peritoneal effusion . T he strength was well sustained by1 generous diet.Two cases of severe and dangerous diarrhma are quoted fromthePresse Med . Belge,

’which were cured by the administration of half

an ounce ofwhite sugar everv four hours . No other food ormedicine .

A paper of interest by DIX, respecting the diagnosis of renal andhepatic tumours in the ‘British Medical Journal,’ J anuary l st, 1859.

Chlorine inhalation (Liq. Chlorin . in boiling water) found veryuseful in a bad case of diphtheria, by Honsox .

Some papers 011 the ailments of the stomach are contributed byORE .

He describes the following states the neuralgic, the arid, the acid,the bilious, the inflated, the depraved, the spasmodic, the humorrhagic, the inflamed, and the cancerous.

Some remark s are made by lla '

rruar on the acute dysentery of

China . In two autopsies, the large intestine was found to be the

chief seat of the disease ; the mucous membrane highly inflamed,cxtcn sivclv ulcerated, andmore or It ss gangrenous . Themost common cause of the disorder is a chill caught by sleeping in draughts,uneo vcrml. or on deck in the open air.

l lnmrox. in the‘ Croonian Lectu r

es,

considers the pathology,varieties, and treatment of intestinal obstruction . lIe demonstratesthe incorrectness of the opin ion, that faecal vomiting is due to an

antiperistaltic movement, and shows that the ordinary propulsiveaction w ill, under circumstances of obstruction, produce a central

returning current. The paralytic state of the bowel for some distance above the obstruction he refers partly to distension of the

muscular lover, partly to inflammatory action . The pain whichsutl

'

cre rs expe rience is, he think s, of two k inds— one occasioned bydis tension ot

'

the vessels telling upon their nervous plexuses whichaccompanythem. the other produced bv distension of the intestine .

D IGESTIVE SYSTEM . 241

The latter is the more characteristic of obstruction . He believesthat rupture of the thinned and softened intestine is not so frequentduring life as the records of its occurrence seemto show, since suchrupture might very easily be produced by the intestinal gases developed after death, or in post-mortemexaminations .

Lecture 11 treats of the chief varieties of intestinal obstruction .

Bleeding fromthe lingual veins is recommended by Mna'

rrv rnn

in inflammations of the throat admitting of depletion . As a directlocal evacuant it is particularly useful in the cases of w omen, children, and lymphatic individuals, proving a perfect abortive even in

many cases of anginamaligna .

”

Bancroex recommends the employment of belladonna in cases of

frecal incontinence in children , attended or not with incontinence of

urine . The remedy is tak en internally, and in some instances also

applied locally bymeans of a sk ein of thread introduced into theanus .

St. Germain tea in habitual constipation , lauded by HUFELANDand Tessmn

The senna leaves are to be steeped for twenty-four hours in alco

hol, which is to be allowed to evaporate spontaneously . The wholeis to be made into pack ets, containing each seventy-five grains, a ndthe patient is to tak e a cup of infusion prepared with one of themevery morning.

Vmcnow finds, as the result of his examinations, that in secon

dary and metastatic parotitis, the gland-tissue is the essential seat ofthe morbid action . The acin i appear as red grains, and graduallyfuse down into small abscesses . Subsequently diffuse phlegmonousinflammation may tak e place .

LEHMAXN records a case of excessive gastric irritability, in whichall food tak en was vomited together w ith frothy mucous fluid, fromfive minutes to two hours after swallowing it. A vast variety of

mean s were fruitlessly employed, but finally, when the plan was

adopted of resting the irritable v i scus entirely by administering purestarchy matter, which could undergo no gastric digestion, improvement commenced ; and by perseverance, with cautious additions, at

l 6

242 caree r on rnac'rrcu . immers e .

first ofmilk, afterwards of bread, the patient completely recovered.

The absence of emaciation in this case shows, however, that all theingesta could not have been rejected.

Tinctura Iodinii has been found effectual in some obstinate vomitings, including that of pregnancy.

In a clinical lecture upon vomiting, Dumas points out, aproper

of a case, that vomiting is a very common accompaniment of inflammation of the lungs, both acute and chronic, and is best removed bythe treatment appropriate to the pulmonary disease .

WALLMANN describes submucous gastritis as a purulent, diffuseinfiltration, sometimes forming abscesses with cribriform openingsin the superjacent mucous membrane . It extends to the peritoneum,

or even to the pleura: and pericardium. Itismostly observedas a secondary phenomenon in pyaemia, grave puerperal fevers,malignant variola, S

e

c. Its occurrence is also favoured by certain

epidemic influences. Its immediate cause is probably the formationof emboli in the vessels .

Bonn divides retro-pharyngeal abscesses into idiopathic ;(2 ) such as result fromsuppuration of lymphatic glands ; (3) thoseconnected with disease of the cervical vertebrae. The symptoms are,difficulty in swallowing, stiffness of the neck , nasal voice, reversion

of the head . Abscesses connected with bone run a slower course

than the others . The prognosis is favorable usually in the first

class if the pus is evacuated early .

a rrnaur'r describes the occurrence of considerable displace

ments of the large intestine occurring consecutively to typhoid fever,and attended with obstinate constipation and gaseous distension of

the gut. It does not appear that the distension was occasioned bythe contracting cicatrices of ulcers .

CLEMENS records the following curious case . A male, eat. 23,was freed froma tertian ag ue by an attack of diarrhe a and teams

mus, having previously suffered from severe gastric derangement.A year later he consulted Clemens for c0pious vomiting of chylousmatter

, which was preceded bv borborygmi, malaise, and colick ypains, and was followed by a copious sweat. It occurred alter nate

days, and was attended with constipation . One eighth of a grain of

arsenic with potash, daily, effected a cure in eight days .

HARLEY related to the Pathological Society the results of experiments made on two young puppies, 9. sick ly dog, a healthy dog, anda common snake. The object was to see whether inoculation with

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2M anro a'r on PRACTICAL MEDICINE.

tion and intestinal torpor do not appear to have any notable influence . Eight cases occurred in themale, two only in the female sex .

Eight of the patients were below the age of thirty, two above . As

to symptoms, in most cases the disease set in with sudden, violent

pain in the right lateral region of the abdomen . Fever occurredearly . Constipation was not constant, nor vomiting. Almost all

the patients had manifest tumour when they came under inspection .

At a later period diarrhma ofte n occurred, even under the use of

opium, but it was by no means of favorable omen . In five cases

there occurred, in the course of the second or third week , a deceptive

improvement of some days’ duration, quick ly followed by a v iolent

increase of the malady . As to duration, in seven cases, whosecourse could be clearly traced frombeginning to end, the periodvaried from twenty to fifty days, the mean being thirty-one .

Prognosis and treatment — In persons dying of other diseases, thetraces of by-past infl ammation have often been discovered in the

shrunk-up remnants of the vermiform process . In these cases,

however, it does not appear that actual perforation had occurred .

It seems,however, probable that even afte r perforation a complete

curemight tak e place, though Bamberger has not yet met w ith a

positive instance of the k ind . The treatment which Bambergerapproves ofmost is that of opium,

join ed with leeching and poultices to the part. Purgatives, appropriate to cases of faecal accu

mulation free from periton itis, must in those here considered be

employed very cautiously .

ULLMAN describes a case of cicatrix-lik e formations on the

tongue . Thev formed patches of inten se-white colour, sharply

defined in some places,i ncapable of being peeled off, and when

removed by the k nife, leaving the subjacent papilla: swollen and

red. W'

hen portions were separated, they were soon reproduced.

The patches consisted of layers of epithelial scales, with a few

patches and fungi-filaments . There w ere no symptoms .

Two interesting cases of vomiting of blood,in consequence of

varicose veins in the (a sephagus, are recorded byLE DInEnnnn and

FAUVEL . In one case the liver was cirrhosed, and the k idnevs

degenerated in the other, the organs appear to have been healthy,except a double pn eumonia . The dilated veins were prominentupon the mucous surface, but no rupture could be detected as the

source of the bleeding .

A case is recorded by GRADENWITZ,in which the (Esophagus was

D IGEST IVE SI STEM .

notably contracted, and its walls greatly thick ened, for some spaceabove the cardia, while still higher up itwas dilated . The stomach,liver, and intestines

,w ere atrophied . The general nutrition had

been wellmaintained during the whole period of forty-three years,

during which the patient had suffered from a difficulty in swallow

ing. He was obliged to force onward the food which collectedabove the obstruction into the stomach, by stretching his bodyupwards . The accumulation then passed with a loud gurgle .

BE'

rz , in a memoir on intus-susception, has the following observations . He think s the peristaltic movements have not somuch todo with the occurrence of invagination as has been supposed. He

rather refers to such circumstances as the smaller diameter of one

segment of intestine than that of the succeeding, the impulse of gas

on fazcalmasses , the weight of thesemasses, or of polypi, the higher

position of a portion of bowel than of the part succeeding, the pressure of the diaphragm and intestinal walls, as the causes whichproduce and increase intus-susceptions .

An interesting and w ell-recorded case of intus-susception is communicated byFnon n axx in which recovery ensued after the separa

tion and discharge of a volvulus consisting of at least thirty-twoinches of small intestine . Improvement commenced immediatelyafter the administration of enemata, quick ly repeated, the last of

which was retained . One hour after there was a copious dischargeof gas and of pultaceous

,fzecal matter . After the discharge of the

volvulus an elongated, resisting, scarcelymoveable, very sensitive

swelling, which had existed in the right lower abdominal region,

vanished.

A case is recorded by Ca nanE'

r in which the colon was invagina

ted and prolapsed through the anus for a distance of twelve inches,while at the same time a sound could be introduced a long wayupwards between the margin of the anus and the prolapsed mucousmembrane . After other attempts had failed, Cabaret succeeded byemploying the proceeding recommended by Le Pelletier .

A case of ileus is recorded by BRUGNOLI, in which the obstructionseems to have been occasioned by a band of adhesion formedbetween the bladder and the lower part of the ileum. The con

traction of the bladder, by stretching the intestine, brought its wallstogether, and so formed an obstacle to the onward passage of the

contents .

A case is recorded by STREUBEL in which the small intestine,

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2 18 armour on PRACTICAL n umcrnn .

food, which produced nausea or vomiting . After the administrationof turpentin e five lumbrici were vomited ; after this the vomitingbecame continual. Although evidently sink ing, she was buoyantand cheerful in spirits

,and walked down one flight of stairs two

days before her death. A tumour,of the siz e of an orange,

extremely sensitive to pressure,was discovered the day before she

died, but it van ished in a few hours . At the post-mortemthe onlymorbid state of any consequence that was found was a mass of

round worms, 365 in number, occupying the small intestines, excepta few which were in the caecum.

In some observations on pica, or dirt-eating of children, CORRIoax records three cases, in two of which it came out that the childwas in the habit of swallowing gravel, and in the third, clay and

tw ine. The symptoms often resemble those that usher in tubercularmeningitis, hydrocephalus, ormesenteric disease .

Case of perforating ulcer of the duodenum, recorded by WALL

MANN. The subject was a soldier, who had long suffered from

periodic gastric pain . One day he suddenly fell on the groundduring a paroxysm the symptoms for a short while were incondatable, but soon fatal peritonitis declared itself. The stomach

was healthy ; there were two ulcers in the duodenum,one of

which, on the posterior wall of the gut, had made a small perforation .

Gmnwoon records some cases illustrating the occurrence of

diarrlur a and dysentery coctancouslv w ith conception . In one

patient diarrhoea set in, together w ith pregnancy, on eight successive occasions . In a second intractable dysenteric diarrlne a set in,and continued until abortion occurred at the fourth month . In a

third, severe dysentery and vomiting, with burning in the throat

and stomach, appeared soon after the cessation of the catamenia.

Repeated leeching of the abdomen, over the tender caput cmci, wasmaployed, and the symptoms gradually subsided. Delivery took

place at the full period.

case of ulceration of the duodenum,proving fatal by erosion

“f the pyloric artery, is recorded by RANKING . The symptomsw a s chieflythose of chronic functional dyspepsia, with loss of fleshand strength. until lnnmorrhage set in

, and caused fatal prostration .

The patlentwas a male, wt. 50 .

llmor matrilmtcs a paper on the cerebro-spinal symptomatology“f or“ . All“ tlt’lltllll lg lll abstract fifty cases, I

'

mdescribes as

DIGESTIVE SYSTEM . 249

follows the phenomena of a typical case of verminous disorder“ A man, with a pale face, but fair embonpoint, presents himself,complaining of dull headache, not limited to anyparticular regionof the cranium, but perhaps more mark ed in the frontal region thanelsewhere . This headache does not offer anymarked exacerbationsor remissions, but is almost constant, and sufficiently severe, without being excruciating, to render life, if not a burthen, at least

unhappy . Giddiness is so severe that he often staggers about likeone intoxicated, and when this symptomis present to a less degreethere is still almost continuously a sense of confusion and insecurity,which renders walking a serious effort. The cars are affected witha constant buz z ing and a great variety of noises, described sometimes as being like that produced by the boiling of a teak ettle,sometimes lik e the letting-off of steamfroma boiler, not rarely lik ethe rumbling of thunder. The acuteness of the sense of hearing isat the same time unimpaired. His vision is dull. Fine webs seemto be constantly before the eyes, so that every object wears a haz yaspect ; at other times dark spots, or brilliant flashes, obstructVisIon .

Case ofmedullary cancer of the (e sophagus, which ulcerated intothe pericardium,

producing pericarditis and death, recorded byFIRTH. The patient was a female, act. 36 ; her illness extendedover seven months . On admission, she could only swallow thin

fluids, but after dilatation with (e sophagus bougies, she was able totak e finely minced solids . In spite of a liberal diet she did not

improve ; the us e of the bougies had to be discontinued, on account

of acute pain, and soon even swallowing became so distressing thatbeef-tea enemata were resorted to . At the post-mortem a massy

,

shining, milk y growth was found, of annular form, commencingOpposite the bifurcation of the trachea, and terminating four and a

half inches below . At about the middle, on the left Side, a round,

ulcerated opening led into the upper part of the pericardial cavity.

The stomach was healthy .

BERGERON, fromobservation of an epidemic of stomatitis ulcerosain the French army, describes the disease as a specific, contagiousmalady, characterised by ulcers of various form and extent, whichmay develop themselves on all points of the buccalmucous membrane, but principally attack the gums and the inside of the cheek s,and are constantly attended bv an abundant flow of saliva, mostoffensive breath, and more or less marked swelling of the sub

250 REPORT ON PRACT I CAL MEDICINE .

maxillary glands . Direct experiment shows the disease to be contagious . The aggregation of soldiers the author assigns as the

chief originating cause of the disease ; moist heat is the most favorable meteorological condition for its development. The afiection is

quite distinct from diphtheritis ; its ulcerations, the character of

the false membranes (limited to the ulcers), its non-extensionbeyond the buccal cavity, and the absence of toxic phenomena, are

positive points of difference. The treatment is by Potass . Chloras .

A case of stricture of the (emphagus in a female, wt. 19, is

recorded by BATH . The post-mortemshowed an annular stricture,of cartilaginous hardness, just above the cardiac orifice of the

stomach,withmasses of soft,grumous,tubercular substance extendingdownwards behind the msoPhagus fromabout the cricoid cartilage .

A bougie was passed, which at first produced no remarkable efi'

ect,

but in about two hours symptoms of collapse appeared, and M physema soon followed, and became very extensive. Death ensued in

S'runans records a case of intestinal obstruction, terminatingfavorably, by the use of opium, on the seventh dayof the attack.

The patient was a female, a t. 65. The obstruction appeared to beseated in the small intestines .

Tnonxmm. records a case of fatal dysentery, with a small aneurismof the abominal aorta, in which, on autopsy, the spleen and the

stomach were found in the usual site of the liver, and vice ven d .

CANTON records a case of digestive solution of the (esophagus,the stomach remaining in every respect healthy, and being full ofsoaked bread. Some small particles of food were found in the leftpleura. Two openings were found in the (e sophagus, nearly a

quarte r of an inch from the diaphragm, having thin, fringedmargins . The mucous membrane corresponding to these openingswas filmy and almost difiluent. The rest of the (e sophagus washealthy. Miliary tubercles were scattered through the lungs, and

enlarged, suppurating glands were found in the thorax . The trachealined by a very thin pellicle of lymph . Two hours after a

meal the child, sat. 6 months , became insensible, and remained so

till death, eight hours later.A paper on the organic contractions of the rectum, resulting from

syphilis, by Bovnao, is of some interest. He states the diagnosisfrom cancerous constriction, as determined by the age, the less

amount of suppuration, the formation at first of plates and hard

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252 n sroar on res cu e“ . IIEDIC INE.

as the food ente rs the stomach, and in some cases conveys the ideaof disease at the (esophageal orifice . (8, In some peritonealdiseases of the stomach there is no pain, in others it is very severe .

(I I , I 2, I Pain maybe absent in consequence of des truction of

the pneumogastric nerves . (I4.) Pain at the epigastrium, simulating disease of the stomach, often arises from spinal disease .

(I Severe pain at the epigastriumis frequently present in anystate which leads to over-distension of the right cavities of the heart.

(I 6.) In abdominal aneurism(aortic) pain of amost intense kind issometimes observed.

DONALDSON, Madras Army, advocates powerfully the treat

ment of dysentery (Indian) by repeated doses of ipecacuanha,with general and local bleeding. He condemns the treatmentby calomel as most injurious. The paper contains many valuableremarks.

CLARK describes mucous disease of the colon as an affection of

frequent occurrence . He divides it into three stages : in the first,

the characteristic discharge from the bowel consists of flakes or

masses ofmore or less inspissatedmucus ; in the second, of tubularcasts of the gut ; in the third, of membranous shreds of lymph,mixed with blood and pus . The circulation in this disease is feeble,giving rise to local capillary congestions ; the nervous centres are

very excitable ; the blood is thin, deficient in fibrin, and red discs ;the sk in dry and acting imperfectly, and all the mucous surfaces

excrete an excessive quantity of vitiated mucus .

W’

ELLS contributes a paper entitled ‘Acids or Alkalies in

Stomach Disorders ? ’ He states,that pain situated at the cardiac

end of the stomach is best relieved by alk alies, while pain at the

pyloric end, depending on derangement of the liver, ismost amenableto acids .

The bark of the fresh root of the Sambucus n igra, squeez ed to

yield a juice, is an excellent purgative in dropsy ; it does not cause

pain, and gas w ill produce twenty to thirty stools . If boiled, thejuice becomes diuretic i nstead of purgative .

SEC RETORY SYSTEM. 203

SECRETORY SYSTEM

Davey— Cu e of Complete Disorganiu tion of both Supra-renal Capsules, w ithout

discoloration of the sk in. Med . Times and Gaz . , Jan . 8th , 1859.

Kin — Terminaison insolite d ’une ascite par secretion es tense des mammelles.

[Unusual Termination of a Case of Ascites b y a serous flow fromthe Breasts.)Annuaire par Noirot, 1859. p. 324.

J ack son — De l’

oxyde de Zinc contre les sueurs profuses des phth isiques.of Zinc in the profuse Sweats of Phthisis.] Ih., p. 326.

Hem — Some Pacts in relation to the Nocturnal Incontinence of Urine in

Children . Brit. and For. Med .-Ch ir. Rem. J an . 1859, p. 260 .

Hgmmoni — Ou the Action of certain Vegetable Diuretics. Amer. Quar. Jour. of

the Med . Sciences, J an., 1859, p. 2 75 .

Dick inson — Two essentiallydistinct Conditions of Kidney, giving rise to what is

called Bright’s Disease. Brit. Med . Jour. , July3oth , 1859.

M en— On the Employment of Tann in in large Doses in Albuminous Anasarca .

Brit. and For. Med.-Chir. Rev . , July, 1859. p. 241

Scott — Ou the Influence of Mercurial Preparations upon the Secretion of B ile .

Beale’

s Archives of Med., No. 3.

J ack son — Notes on the Management of Abscess of the Liver. Lancet, Aug. r3th ,

1859.

Harardp — lk terus gravis. [Dangerous JaundiceJ Schmidt’s Jahrb .. I859,

vol. 103, p. 2 7.

Willshire ,

— Chronic Diuresis in a Man aged 40 , who passed fifteen pints of Urine

daily; employment of Belladonna, &c. Lancet, Sept. 3d , I 859.

Alam der,

— Cases of Suppression of Urine. Edin. Med . Jour., Sept. , 1859.

Goodwin — Case of Hematuria ; Cancer of Bladder and Kidneys ; Tubercle in

Lung. Brit. Med . Jour. , Sept. ryth , I859.

Patn a— Ou the Value of Albumiuuria as a Symptomof KidneyD isease. Med .

Times and Gaz ., J an. I st, 1859.

Ba ham— Ou particular forms of Renal Dropsy— Suppurative or Non-tubular

Formof M . Brightii. Lancet, April 9th , 1859.

Hinds,— Paraplegia in relation to Renal Diseases. Brit. Med. Jour., April 9th ,1859.

Kennedy— Taro Cases of Albuminous U rine treated byMercury. Dublin Hosp.

Gaz . , March 1sth , I859.

Budd — llydatid Cyst of the Liver ; Withdrawal of the Fluid byTapping ; Permanent Collapse of the C) st. Brit. Med . Jour. , April 2d, I859.

Note sur le traitement de la Maladie dc Bright (albuminurie chronique ) .[Note on the Treatment of Bright

’

s Disease.) Annuaire de Thérapeutique,1859. p. 260 .

Observation de diabete traumatique. [Case of Traumatic D iabetes.]Annuaire par Noirot, r859, p. 43.

Bow en — Sm ls traitement de l’hydmpisie symptomatique de la Maladie de

Bright. [On the Treatment of the Symptomatic Dropsyof M. Brightii.] ih .,

Hagge ,

— Catarrhe vésical ; emploi de l'eau froide ; guerison . [Vesical Catarrh

cured by the use of Cold Water.] Ih ., p. 2 r3.

254 an on on PRACTICAL n smcma .

— Moyeu sur at facile decouvrir ls pseseuce do sucre dsns l’uriue.

ertala and easymode ot’

discovering the presence of Sugar in the Urine ]lh., p. 315.

Bonn ier,

— Pi lle vou Wachsleber. [Cases of Waxy Liven ] Schmidt’s Jahrb .,

1859, vol. 10 1 , p. 51 .

Pleischl und Folm omy,— Ueber akute Leber atrophie. [On Acute Atrophy

of the Liver.] Ih., p. 51.

KmQ— Beitrage sur Lebre vomIkterus. [Contributions to the Knowledge of

lcterus.] Ih., p. 52 .

mm — a Aetiologie der parenchymattiser Nephritis. [On the E tiologyof Parenchymatous Nephritis.] Ib ., p. 186.

Bortulns.— a Aetiologie und Diagnose der Hepatitis. [On the E tiologyandDiagnosis of Hepatitis. Ib ., vol. 102 , p. 176.

mbou-Panltreatitis suppurativa. [Case of Suppuration of the Pancreas.] lb

P-l 77Roma,

— Ou the Employment of Extract of Belladonna in the h eatment ofIrritable Bladder. Lancet, June asth, 1859.

h om m— Ou the Diagnosis and Treatment of Hepatic Colic. Edin. Med.

Jour., July, 1859.

wmderficL — Ou General Enlargement of the Lymphatic Glands. Med. Timesand Gaz ., Julyoth , 1859.

Ward — Clinical Illustrations of Diseases of the Abdominal Vism — Jaundice.

Lancet, July9th and 16th, 1859.

Davy— Case oi

‘ Anemia Lymphatica, a'

new Disease characterised by enlargementof the Lymphatic Glands and Spleen. Lancet, Aug. 2 7th, 1859.

Bouohu dgt — llygienic Treatment of Diabetes . Dublin Hosp. Gaz ., Oct. 1st,

1859.

org — Case of Bright's Disease, in which permanent recoverytook place ,the resultsbeing verified by d issection, the patient dying of obstruction of the bowels

eightyears after. Glasgow Med. Jour. , Octobe r, 1859, p. 263.

nogonatoin — Ueher parenchymatiise Nephritis. [On Pareuchymatous Nephritis.]Schntltlt s J sltrh., vol. 104, p. 6o .

mubo,— Ueber den Zusammenhang von Herz und Nlerenk rank heiten. [On theConnection between Cardiac and Renal Diseases.] Ih., p. 62 .

Wilk l .‘ Cases ofMorbusAddisonii, Melanemia, Anmmia Id iopathies , Leucocythe.

ntia Splenica and Lyntphatica. Guy's Hosp. Reports, 1859, vol. v , p. 89

— 1 18.

Ballot — Bpidemlscher lk terus. [Epidemic Jaundice.] Schmidt’s J ahrb ., 1859,

vol. 104, p. 1 72 .

Schnitz ler ,Leber atrOphie mit gunstigemAusgange . [Acute Atrophy

of the Liver terminating t'

avorably.] lh ., p. 1 72 .

Thudichum,

— The Pathologyand Treatment of Gall-Stones. Brit. Med. Jour.,Nov. 19th , 1859.

nu dgu om— Moveable Kidneyin connection w ith Spinal Disease. Med. Timesand (h s., Nov . 19th , 1859.

imm t‘sss of Great Enlargement of the Spleen, with Observations. Dublin

Ne w. tim..Nov. 13th , 1859.

Brightii. [Bright's Disease ] Schmidt's J ahrb ., 1859,

M “144 k

h alal. Waw unna in Marsh Fevers. Med. Times and Gaz ., Dec. 3d, 1859.

Howl“. ease of N phl and considerable Increase of the Volume of the Liver.Dublin Hosp. “at . Dec. 1st. 1359

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256 unronr ox PRACTICAL MEDIC INE.

Normal standard 102430 75-31

Digitalis 10 t5°87

Normal standard 1 2375 102 25 0

Juniper 1 7631 10 16 28

Normal standard 1358 0 1023’

51

Squill 1533°

5 601 5

Normal standard 1 102 s

Colchicum 1556 8 1023'

58 77 28

Fromthe foregoing investigations he deduces that neither digitalis, juniper, nor squills, increase the total amount of solid mattereliminated by the k idneys, and that the organicmatter is considerablyreduced through their influence . Although they do increase theamount of inorganicmatter removed through the urine, yet, as it isthe organicmatter which is generally considered as contaminatingthe blood in disease, it is evident they exert no effect whatever indepurating this fluid, but, on the contrary, are positively injurious .

Colchicum, on the other hand, acts in amaterially differentmanner,

eliminating an increased quantity of organic and inorgan ic matter .

DICKINSON maintains that “there are two essentially distinct

conditions of k idney giv ing rise to what is called Bright’

s dis

ease, and these may be distinguished from each other by the

presence or absence of external granulations .

”In one

, the non

granular, the disease is essentially tubular, and is mark ed by altera

tions of the epithelium. In the other, the granular, the disease isinter-tubular, and is mark ed by thick ening and adhesion of the

capsule, and the extension of fibrous processes from it into the

k idney ; it has two periods, one of enlargement, that which is commouly seen ; one of diminution, which is rare . Of 357 cases

, 250

were granular, 107 smooth . Of the latter, the average age w as

twenty-eight years ; of the former, fifty ; “

proving that the one

disease is not a sequel or stage of the other.

”In 1 7 cases of

granular disease the gouty or rheumatic diathesis existed ; in 1 onlyofthe smooth variety was there anytrace of such having been present.

GARNIER, fromhis own experience, as well as that recorded byothers, is led to recommend the administration of tannin

,in doses

of half a drachmto a drachm,dailv 111 cases of anasarca developed

SECRETORY SYSTEM .

passively in connexion with albuminuria . Its curative action is

characters, by perspiration, early alvine evacuations, return of appe

tite, &c.

”Its primary action seems to be on the fluids of the

economy, “the albuminous principles of which it coagulates and

renders plastic,”while its secondary action on the solids appears to

Sca rr records the results of experiments made on dogs whose

galLbladder was made to open externally bya flstulous orifice after

the common duct had been tied. After the normal amount of bilesecreted in twenty-four hours had been determined for two days, a

large dose of calomel was given, and then the average amount of

bile accreted during the two succeeding days was ascertained. The

result in all the four experiments was the same, viz .,that there was

a diminution in the amount of fluid bile and bile-solids secretedafter the administration of large doses of calomel.

ment of abscesses of the liver. He warns earnestly against continning amercurial course after suppuration has taken place .

11mmrelates two cases of rapidly fata l jaundice, death occur

ring ia one on the sixth and in the other on the eighth day. The

auto psy in both showed local jaundice of the liver in scattered spots ;the hepatic cells were normal. There was bloody extravasation

into the cavity, and in the mucous membrane of the stomach and

intestines. No other important alteration, except considerable pulmcnary congestion . The disease set in, during Oppressive, hotweather, with headache, vomiting (subsequently bloody), and deepdepreadon . Jaundice occurred on the third day. The liver was

not enlarged . The cerebral functions were unimpaired .

A case of chronic diuresis, in which the absence of sugar was

positively determined, is recorded by WILLSHIRE. The urine

amounted to fifteen pints in the twenty-four hours, very pale, sp.

gr. 1002, quite clear. There was great thirst, bad appetite , dry

opium, the urine was reduced to six and a half pints daily. Two

cases of Addison’s disease are reported in the same number.

two proved fatal. The last was specially remarkable, as for four

week s not one ounce of water was passed by the patient, a boy,rat. to . It did not appear that any deception was practised. No

17

258 narosr on PRACTICAL MEDICINE.

urinary smell was observable either in the traces or perspiration,which was little, if at all, increased . The secretion graduallyreturned spouts sud.

a w r recommends one of our indigenous plants, the Erodiumcicutarima, or Stork

'

s-bill, common in sandy situations, as an effi

cient diuretic.

Goonwnv records the case of a male, set. 60, who died under hiscare with cancerous formation in the liver, kidneys, and bladder,and with suppurating tubercular deposit and small cavities in the

left lung. The urine contained pus-globules, red and white cor

puscles of blood in large quantities, squamous epithelium, withlarge, granular nuclei and nucleoli, large, round epithelium, containingmany resplendent granules, probably from the fundus of the

bladder, and caudate and round cells, with resplendent granules .

”

The disease seems to have run its course in about three months .

H e value of albuminuria as a symp tomof k idney disease — As

the result of his hospital experience, Psa lms concludes that theexistence of permanent albuminuria indicated kidney disease inthirty-two out of thirty-six cases ; and if heart disease be excluded,it indicated k idney disease invariably. Temporary albuminuria wasobserved in six out of ten cases of acute pneumonia, in all of three

cases of acute morbus Brightii, in four out of nineteen cases of acute

rheumatism, in one out of eight cases of subacute, in five out of

nineteen cases of typhoid fever.

In a clinical lecture on a case of renal dropsy, attended with a

copious, purulent deposit, not containing any tube-casts , BASHAMconcludes with the following remarks : We may, therefore, con

sider that when the symptoms of renal dropsy are associated witha purulent, non-tubular sediment in the urine, in proportion to the

amount of that purulent sediment will be the probability that theinterstitial structures of the k idney are the source of the pus ; and

that as this condition is consequent upon the destruction of the

wnnl parenchyma, the prognosis must necessarily be unfavorable .

”

in a paper on paraplegia in relation to renal disease, HINDSndw inw the opinion that the paralysis is produced by the extens ion

at"

the renal disease to the lumbar plexus .

h nxxnnv publishes two cases of albuminuria treated by mercury,M“ mans interesting remarks . He lays stress on the fact that

M inimal inMmcntly united to organic disease of the k idney, andstates thatN h» k nown instances in which albumen was present

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260 REPORT ON PRACT ICAL MEDICINE.

degeneration . In two other cases death was preceded by gastricdisorder, vomiting of blood, and cerebral symptoms .

Kiimmhas studied carefully the pathologyof icterus . He doesnot adept the view of Frerichs amd Stadeler, that the biliary acidsare changed in the blood into bile-pigment, but shows that bloodpigment is changed into bile-pigment under the influence of the

biliary acids . By adopting the method of Hoppe, he was able todetermine constantly the presence of the biliary acids in the urine

of persons sufl'

ering under icterus, as well as in that of dogs whosebiliary ducts had been tied . When dog

’8 bile, or solution of the

biliary acids was injected into a vein, bile-pigment and the salts

were detected in the urine . Even in large quantities of healthyurine no biliary acids could be found.

Rosans'rnmhas studied the aetiology of parenchymatous nephritisin 162 individuals, of whom85 were male, 77 female . The majorityof cases occurred between the twentieth and fiftieth years of

life, viz ., 100 out of the whole number. The most frequent causeof the disease was found to be intermittsntf sm— it was noted in23per cent. In some of the cases dropsy set in as soon as the

febrile paroxysms ceased, and preceded the occurrence of albuminuria. This dropsy and the formation of splenic tumour, byincreasing the watery constituent of the blood, gave a further impulse to the renal disease .

Baumw s states, as the result of his experience of hepatitis, thatit is principally induced by malaria and alcoholic or other irritatingingesta. Persons who live temperately are much less liable to thedisease than those who cannot forbear stimulants . Alkaline waters,as those of Vichy, he thinks, are the best remedialmeans .

A (use is w vnr dcd by Rlnom, in which the pancreas was found,after death, destroyed by suppuration . The patient was a female,wt. 54, who had suffered w ith symptoms of the diseasemore thantwenty years . These '

consisted in continuous fever, with evening

exacerbation, vomiting of salivary fluid, deep-seated pain, subicteric

thawing of the skin, stools whitish, non-offensive, saliva-lik e, sometimes antenna, in salivation, heartburn, burning thirst, and emacia“fl“h

N ahum; records a severe case of irritable bladder, in which,at“ the failure of other remedies, extract of belladonna, adminis

wml in invm ing doses till the specific symptoms were fullv develupcd. prw nml an almost complete and a permanent cure.

smnm nr sr srn r. 261

two cases of general enlargemen t of the lymphatic glands , occurringin the practice of Wrxnmmcn . In the first case , a male, thelungs contained tubercles ; in the second, a female, they did not.

“ The most remark able circumstance in both of the cases was the

enormous enlargement of such g reat numbers of lymphatic glands .

To such an extent had they increased, that they not only disfiguredthe formof the body, but fromwant of spam to develop in, becamethemselves squeez ed and flattened into various shapes . The change

which the glands had undergone was in nowise of a carcinomatousor of a tuberculous nature, but consisted in an enormous hypertrophy produced with great rapidity, a portion of the nutritive

material being deposited in an amorphous condition in the hypertrophied gland. The increase of the peculiar glandular parenchymawas les s in the second than in the first case, there being in theformer a good deal of coagulated fibrine, and infiltration of incompletely organiz ed matter. The change observed in the spleen is, asfar as the author is aware, peculiar, and hitherto undss cribed. To

the unaided eye, itmost re sembled innumerable points of suppuration, save that it was nowhere soft and fluidiform, but, on the con

trary, very firm, and almost of cartilaginous hardness . Exactly thesame change, but in far less numerous spots , was observed in the

liver. The resemblance of this infiltration with the condition of the

swollen lymphatic glands leads to the inference of both being dueto a common constitutional afl

'

ection, and itmight be indicated as

spleen or liver scrofula . The causes of the affection were discoverable in neither case . The glandular swellings were not secondaryto a peripheric afl

'

ection . They might be regarded, in fact, as theexpression of a constitutional disease . The general condition wasone of extreme amemia ; leucemia was suspected, but repeatedmicroscOpic examination of the blood set this v iew aside.

”

Want) records a number of cases of jaundice arising from dif

ferent functional and structural derangements of the liver, whichmaybe referred to with advantage by any one studying the subject.Wrists has applied the term anaemia (ymp /latica to a morbid

condition of not very rare occurrence, which has hitherto been un

named. The essential features of the disease are the most extremepallor or anaemia, enlargement of one or more of the various groupsof lymphatic glands, either internal or external to the body, and a

peculiar morbid condition, with occasional enlargement, of the

262 REPORT ON PRACTICAL “ DICINE.

spleen ; the last depending upon the deposition of an opaque, white ,lardaceous material, in isolated masses, or diffused throughout thesubstance of the organ, and resembling bacon-rind.

” There is no

excess of white corpuscles in this disease, but a deficiency of the

red. The structure of the enlarged gland 18 fibro-nucleated. The

disease mayoccur at all periods of life, mayextend over a period of

two or more years, and proves fatal by slow prostration . Wilks has

given an account of the affection in Guy’ s Hospital Beports,’

vol. ii, series 3.

In some remarks on the hygienic treatment of diabetes , BOU

cnanna'

r states that the replacing of the feculent food by alcoholicdrinks is as important as the abstinence fromfeculent foods . He

prefers the red Burgundy and Bordeaux wines, but all red wines

which are more astringent than sweet do equally well. In the

twenty-four hours he gives a litre (one pint and three quarters)or more. Bordeaux wine alleys the thirst of the diabetic betterthan anyother liquid.

Case of tuberiformcancer of liver, combined with a large aneu

rismof abdominal aorta. (Vida‘Glasgow Med. Oct. 18

In a paper on parenchymatous nephritis, Rosms'

rsnv gives the

results of his observations on the urine . The average amount of

was grammes per day, contrasting with that of healthyindividuals, 25 16 grammes . The amount of chloride of sodiumfellv ery rapidly, on the coming-ou of fever, from17 2 grammes to r e5

gramme and towards the end of the disease itsmaximumamountedto 15 3graimnes, its minimumto gramme. The quantity of

albumen varied between and O’

50 grammes per day; it wassometimes absent, even during dropsy, for week s, once formonths.

About the middle of the course of the chronic cases decrease of theamount of chloride of sodiumcorresponded to increase of the albumen . The amount of urea showed no con stant ratio to that of thealbumen and chloride of sodium, and certainly no inverse ratio to

the former.

TRAUBE states, that in sixty-one cases of insufficiency of the car

diac valves, and similarly operating affections of the circulating and

respiratory organs, renal disease leading to granular atrophy occur

red only once . After noticing Bamberger’s contrary opinion, he

concludes that the renal disease, consecutive on valvular insuffi

ciency, is a disease sui generis, which onlv arises when the disturbances of the circulation find no equalisation, or cannot retain it. In

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264 an on on rnac'rwu . n euroma .

larypuncture of an hydatid tumour,made even without the exist

ence of adhesions,may be curative when followed by as completean evacuation of the liquid as possible . That this resultmaybe obtained by a single puncture, or by two or three successive

punctures . (3 That the treatment commenced by capillary puncture must sometimes be completed by another method, as in the

case of Bees, in which a larger trocar was used at the third puncture, and a gum-elastic sound left in the orifice .

”

CUTANEOUS SYSTEM .

Hooter -Ou the Sapo Laricu in Cutaneous Diseases. Dublin Burp. Gaz .,

March 15th , 1859.

l oam— Ou the Nature and Treatment of some of the more OrdinaryDiseases ofthe Sk in. lh., April 15th , 1859.

valefi u — Trfi ument da Lupus. [Treatment of Lupus.) Annuaire de Therapeut., 1859, p. 353.

metz imk y,

— Sur l’

emploi Dermato-Thérapeutique de l’Acide Hydrochlorique.

[On the use of Hydrochloric Acid in Sk in Disea se ] Annuaire par Noirut,1859, p. 109.

Poor ,— Lupus Erythematodea. Schmidt's Jahrb ., vol. 103, p. 38. 1859.

schonheit und [ 31mm Pemphigus Chronicus, Cases of. ih., pp. 39, 30,

1859.

Barengpmng ,

— Ueber Area Celsi. [On Porrigo Decalvana.] Ih., p. 183.

Harvey— Case of Stearrhtea Nigricans. Dublin Med. Jour., Feb ., 1859, p. 333.

Flechsig ,

— Bericht iiber die neuern Le ittungen aut’

demGeb iete der Balneologie.[Report on the more recent Contributions to the Science of Balneology.]Schmidt Jahrb . , vol. 103, pp. 333

—363 vol. 103, pp. 73— 93 ; 1859.

Lowe,

-Ou the True Nature of Parasitic Diseases . Lancet, Aug. 13th. 1859.

Bourguignon— Glycerine Ointment tor the Itch (Formula). Lancet, Aug. 37th,

1859 .

Dua — Treatment of Boils. Brit. Med. Jour., Sept. 3d, 1859.

Ludk iewicL — Heilung cine hautniichigen Flechte durch Wein Dimpfe. [Cureof an Obstinate Eruption by the Vapour of Heated Wine.) Schmidt's Jahrb .,

vol. 103, p. 187, 1859.

Edwardg,— Human Horus. Edin. Med. Jour. , Nov., 1859, p. 430.

Smith — Some Remark s on the Action of the Sk in in the Production and Treatmentof Disease. Ih. , Dec., 1859, p. 513.

Hutchinaosn

— Cliuical Report on Faves. Med. Times and Gaz ., Dec. 3d, 1oth,31 : 1 59.

Scontot‘ten.— Preservative Treatment against Consecutive Effects of Measles and

Scarlatina. Dub lin Hosp. Gaz ., Dec. 15th , 1859.

On the Influence of Baths ou the Excretions. Brit. and For. Med-Chit .

Rem.r 135. Jam. t8so~

curausous SYSTEM. 265

Thom — Ou the External Use of Medicines. Edin. Med. Jour., July, 1859,P 4'

Gull-Ou Factitious Urticaria. Guy’s Hosp. Reports. vol. v , 1859, pp. 316

—318.

— Uebcr Prm'lgo. [On Prurlgo.] Schmidt's Jahrbuch ., 1859, vol.

103, p. 130.

Ca nto of opium (Opu, 3911, ad Gee-ate simpl ., highly reeom~

mended in carbuncle .

Sapo Laricic is found by Mooun very efi cacious in the local

dry. The ingredients of the soap are— Wheaten bran, 3iv ; white curdsoap, gra iv ; pure glycerine, giij extract of larch-bark, 3iv— 3j

Tnomx shows, by a number of facts which he has collected,that themale has the chief influence over the propagation of the

Moos e details several cases of skin disease which may be referredto with advantage . He seems to shun arsenic, and to employ

Knmmexr recommends the use of hydrochloric acid as a powerfulmeans of increas ing the cutaneous circulation and the excretion

of carbonic acid by the skin . It is very useful in acne and chilas

strong as can be home without causing vesication . After it has

been in eontact with the sk in fi'

omfifte en to sixty seconds, it is to

be washed oil and soap applied . Glycerine is the best diluent.Several cases of lepra, underWrmnms’ s care, are noticed in

the ‘Lancet,’ March 13th, 1859, in which amate rial part of the treat

liquids, with a diet including plmi tyof watercreases and sometimeslemon-juice .

Two cases of chronic pemphigus are relate d, one by Scuoxns rr,the other by Me asures . The first ended in recovery after three

diarrhma . Bran and sulphur baths were beneficial in the first casearsenic failed, although the eruption was complicated with chronicintermittent fever.

A case of stcarrlaa a im-tease is recorded by Hanvs r, in which

266 u ros r or: ruaor lou . MEDICINE.

both lower eyelids were afiected. Under a general tonic plan of

treatment the disorder ceased. Themenstrual function was normal.In a paper on the external use of medicines, Tnouson asserts

the great efficacy of narcotic‘

and other drugs rubbed into the

skin, and observes, that the effect produced is greater and morerapid when they are applied to the epigastrium than to other partsof the cutaneous surface . In deliriumtremens he has adopte d formany years endermic medication by opium, in preference to itsinternal use . He confirms Deschamp’ s observation , that iodideof potassiumcan be detected in the urine after friction of the skinwith a soap or ointment containing it.A very full and complete report on balneology is contained in

Schmidt’ s Jahrbucher,’ p . vo .l 102, and pp . 73

—92, vol

Jassa s itch-ointment : R. Flowers of sulphur, 3ss sulphate ofz inc, 3iss , p

owdered root of white hellebore, 3j soft soap, 3x1ijhog

'

s lard, gij essence of caraway, 3ss. M . A soap bath°

1s always to

be premised, and is themost essential condition of the treatment."

Dunmrrr advises the following treatment for boils Extr. Col. cc.,

Pil. Hyd .,Batr. Acet. Colch., alt. acct" with a warmaperient, if ne

cessary, the following morning. During the day, Pot. Acct, withsmall doses of Tr. Colob . and Spt. Ammon . co. On the first appearance of a fresh boil, it is to be painted with a strong solution of

Arg. Nitr . (sij ad 3i). If the boil be already formed and indolent,the nitrate is to be used, and poultices .

Lumtmwrcx (himself the patient) relates the cure of an obstinateskin eruption, designated as llerpes squamas . humid , by the use of

vinous-vapour baths, after all sorts of treatment had failed. The

eruption he attributes to the spurting of a drop ofpuriformfluid intohis right eye during the autopsy of a patient dead fromglanders .

A case of acute purpura treated by venesection, alkalies,muriaticacid

, and lemon-juice, is recorded by ALnsns ox . The case terminatedfavorably in about six week s . There was a good deal of rheumaticpain . The venesection appeared to be decidedly beneficial.s s aem speak s well of the effect of c/lloriodide qf mercury in

acne rosacea and in the other forms of acne.

GRAND-CLEMENT recommends the juice of Cfielidouiammy'

us in

itching eruptions. The juice of the fresh plantmaybe k eptmingledwith equal parts of glycerine .

SMITH makes some remarks on the action of the skin in the

production and treatment of disease. From his own experi

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268 REPORT ON PRACTICAL MEDIC INE.

Scours '

rrsx praises the preservative effects of frictions with oil,

alternated with baths, against morbid sequele of scarlatina and

measles . It is rare that more than four frictions and two bathsare required.

GULL points out the fact, that in persons whose skin is veryirritable, slight friction produces phenomena similar to those of

urticaria . This depends, he believes, on contraction of the musculartissue of the skin .

Bm xsrnnxc considers prurigo as a dermatosis rather than as a

neuralgia, and locates the morbid action in the papillary bodies of

the sk in . The latter, he believes, minister to the sense of touch ;the nerves alone either at their extremity or in their course to common sensation . Hypem thesia of the nerves gives rise to neu

ralgia, hyperzestheaia of the papillary bodies to itching or burning.

In support of this view, he refers to cutaneous eruptions, the deeperseated of which, as furuncles, never occasion itching, but only pain ;while the more superficial are attended with severe itching. The

author specially recommends baths containing Hyd. Bichlorid. (twodrachms to a bath), which proved speedily curative in a verysevere case of four years’ duration, in which a variety of othermeans had been employed without success . Sulphur baths and

sulphur ointment, tar ointments, and huile de cade, diluted withtwo parts of fat, have proved alsomore or less useful .

SUBJECTS OF GENERAL INTEREST.

Kareem— Medical Notes fromthe Continent ; or, Sk etches of the Universities.Hospitals, Lunatic Asylums, and Mineral Baths of Holland , Belgium, Germany,and Austria, Bavaria,Wurz burg. Edin . Med . Jour., Jan ., 1859. p. 595.

On Fore ign Substances in various parts of the Body. Ih., Feb ., 1859, p. 769.

(mam a— Case of Poisoning by drink ing water froma Leaden Cistern . Brit.

Med . Jour., April 33d , 1859.

Nam— Ou Idiosyncrasies. lh., June 1 1th , 1859.

Webster,

— The Influence of Weather on Disease and on the Human Frame.

Lancet, June 1 1th, 1859.

Thompson — Observations on the Medical Administration of Oz oniz ed Oils.Med .

-Chir. Trans., 1859, vol. xiii, p. 349.

Beddoe ,

— A Comparison of the Mortality from different Causes in Australia and

England. Edin . Med . Jour., Aug., 1859. p. 101 .

Cleland,— Ou the Use of Saccharated Lime in Medicine. lh., p. 1 13.

answ ers or GENERAL w raassr . 260

Chron. Katarrhe. [Turpentineovspour Baths in Gout.Rheumatism, Neuralgis,and Chronic Catarrh .) Schmidt's J shrh .. 1859. vol. 103, p. 26.

Pom — Ou the Ch lorate of Potash . Med . T imes and Gaz . , Aug. 37th , 1859.

W ag — Ou Destruction of Animd Poisons by Disinfectants. Canst. Jahrh..

1859. vol. ii, p. 130.

Bacon — Ou Elimination of Lead fromthe System. Med . Times and Gaz . , Sept.

s7th, 1859.

new -The 1.1mmEmployment of Medicines in Vapour. Brit. Med. Jour.,

14th , 1859‘

Jack son — O11 Cold u n ion in Narcotic poisoning. Med. Times and Gaz ., Oct.81h. 1859.

Brunt— Houses in relation to Health . (Lecture ) ih .

— On Two Cases of unusual Discharge of Carbonaceous Mstter fromtheNara and Intestines . Lancet, Oct. 15th, 1859.

Coon — Cancer of the Stomach associated with Tubercnlsr Disease of the Lungs.Medical Times and Gaz . , Oct. 15th, 1859.

Gm -‘

l'

he Smcific Chemical and Microscopical Phenomena of Gouty Inflammation D». 1» 393.

Schroeder m deg Kalb — Bingo untersnchungen sumBeweis dass Entrandung nur von demArteriellen systemausgeht. [Researches proving that in.

flammatloss has its Starting-point in the Arterial Systemalone .) Schmidt'sJahrb. , 1859. vol. 104, p. xo 1 .

M M — Enm dnng durch Neryenreis. [inflammation produced byNervous

Irritation.) lh., p. 10s .

Barnum— Usher das Pieher. [On Pen n ] Ih ., p. 1o3.

— Die Armei wirkungen dea Tsrtsrus stihiatus an den irritsheln Gebilden.and an der Nervensubstanz . [The Action of Tartar Emetic on Contractfle

Tissues , and on the Nerroua ] ih., p. 161.

l oam — Suns yirth igieniche e Medicinali delle Coca. e sugli alimentinervosi in general. [On the Hygienic and Medicinal Virtues of Coca. and on

Nervous Foods in genes-ah] Ih., pp. 348-357.

Birch — Ou Oxygen as a Therapeutical Agent. Brit. Med . Jour., Dec. 34th and

31st. 1859.

An instructive group of instances of foreign bodies lodging invarious parts of the body is afl

'

orded h y a discussion which tookplace at the Medico-Chirurgical Society of Edinburgh, with rela

tion to a case in which a needle was extracted fromthe pharynxafter penetrating the neck .

THOMPSON hasmade trial of oz oniz ed oils in phthisis , the oils beingoz oniz ed by exposure for a considerable th e to the direct rays of thesun, after previous saturation with oxygen gas. Out of fourteen

cases there were only two in which the frequency of the pulse wasnot reduced ; in the majority this cli

'

cot was very marked, and this,too, independent of the particular kind of oil which was employed.

270 REPORT ON PRACTICAL MEDICINE.

Bennons contributes a paper entitled A Comparison of the

Mortality fromdifferent Causes in Australia and America.

’The

following is the summarywhich he supplies himself, but the wholecommunication is replete with facts which scarcelyadmit of condensation . The principal features of themedical geography of Victoriamaynow be summed up shortly as follows Excess of

violent deaths . Excess of deaths fromdiseases of the bowels

(alvine flux) and of the liver. Excess of diseases of the heart.Excess of some affections of the nervous system. Small

proportion of deaths from tubercular and pulmonary diseases andfromcroup. (6 Small proportion of deaths fromthe exanthemataand from hooping-cough. Absence of malarial fever.

Gradual decrease ofmortality fromdysentery, typhus,measles, 85C .

The death-rate of Victoria in the year 1856-7 was 167 2 per 1000 ;that of England, and of Scotch towns, On account

of the paucity of aged persons in the Australian population, thedeath-rate appears lower than it really ought to be ; when corrected

for this peculiarity, it is raised to 20 43 per 1000 . Themost frequent causes of death are violence (accidents and the like), anddysentery, debility, phthisis, and typhus follow in the order named.

All malarious diseases are absent, or very nearly so . Aneurismappears to be remarkably frequent— 86 in Australia, I6 in England;this the author thinksmaybe owing in part to the equestrian habitsof the settlers .

Macanro praises the virtue of turpentine-vapour baths in cases of

gout, rheumatism, neuralgia, and chronic catarrh . The baths arenot to be tak en more frequently than every other day they causeconsiderable sweating, and usually acceleration of the pulse . Nerv

ous excitement is sometimes produced, and contra-indicates the use

of the baths . The appetite becomes vigorous ; sudamina and often

furuncles formon the skin . The results do not seemto have beenvery brilliant.Lnnwnss performed several experiments with rabbits, the result

of which was to show, that freshly prepared chloride of limeand chlorine liberated by Guyton Morveau

’s process can alone be

relied on for the destruction of animal poisons, such as is generatedin gangrene of the spleen (Milz brand). Rabbits inoculated withthis poison died in twenty-four to forty-eight hours, although thedeadmatter fromwhich the poison was taken had been exposed fortwenty-four hours to the action of amixture of ordinary chloride of

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272 as sonr on ru crrcan usnlcw n.

the same time the capillary network surrounding the air-cells was

entirely obstructed .

BERNARD considers fever always as a pure nervous phenomenon,since the organic conditions of it can be produced by acting on the

nerv

ous system alone. The cause of itmaybe an internal, as a

poison absorbed into the veins, or an external, as an influence ope

rating on the sk in and through sensory nerves on the nervous centres . In all cases the effect is produced of paralysis of the sympathetic. The facts to which Bernard appeals are chiefly the wellk nown results of division of the sympathetic, as well as that of

galvanic irritation of sensory nerves, which at first produce lowering,and subsequently, by exhaustion, elevation of the temperature .

Horns relates the results of numerous experiments on frogs, madefor the purpose of determining the action of tartar emetic on con

tractile tissues and on the nervous substance . The heart was at

first excited to increased pulsation, and afte rwards enfeebled. On

the vessels it seemed generally to have a contracting power. The

nerves, brain, and spinal cord were enfeebled, and semi-paralysed byits action .

Maxrs eaz z a, in an elaborate treatise on coca, describes the

plant, its mode of culture, and the preparation of the leaves ; (2 )the mode in which it is used ; (3) its physiological action, and itshvgienic application (4) its therapeutic action and employment ;and (5) gives illustrations of its use in practice .

B IRCH, in a paper on oxygen as a therapeutic agent, states,

that abundant evidence can be brought forward to prove, beyondmoral doubt, that in certain lowered conditions of the v ital forces,this gas can not unfrequently exercise an alterative and tonic influenceupon the entire animal economy which no othermedicinal agent atpresent known can exert.

”

REPORT ON SURGERY.

J . W . B U LKE,F .R.C .S

aas rsr a sr-suaosox ro u nu'a coa t as a n osm aa, a rea so ra t aor u . tom s

or n ra au n c n oarrr an.

TEXT-BOOKS .

Drain-The Surgeon's Vadc Mecum. London. John Churchill. sth edition.

M — A Manual of Operative Surgeryon the Dead Body. 8vo. cloth. London.1859. Longman , Green .and Co.

fi lm -M ite Studien fiber die Bcnrtheilung and Behandlung der Schuta.

wunden vomfunfnehntcn Jahrhundert his auf die ncncatc Zeit. [An HistoricalSketch of the opinions which have prevailed respecting Gunshot Wounds. and

of their treatment. fromthe fifteenth century to the present time ] Berlin,

3859.George Rain er.

— Notea on the Wounded fromtheMutinyin lnd ia,with a descriptionof the Preparations of Gunshot Injuries contained in the Museumat Port Pitt.

8vo. cloth. London , 1859, John Churchill.Appig

— Chirurgicn h l'ambulance, on qnelqnea études pratiques aur lea plains par

crmca i fen, auiyiea dc lettrca i un colléguc aur lca blessés do PaleatroJ l agenta.Marignan , et Solferino. [The Surgeon at thcAmbulancc ; or. Practical Studiesof GunshotWounds, accompanied byLe tters to a Colleague about theWounded

at Palestro. Magenta, Marignan, and SolferinoJ Pol. Grain . Cherlmliea.Paris, 1. B. Bailliere.

Dnurrr’

s new edition contains a fresh chapter on inflammation,and that on gunshot wounds has been enlarged and rewritten ;those on the eye, on the radical cure of hernia, on ovariotomy, and

Brannon : gives an interesting historical sk etch, with especialreference to the views respecting gunshot wounds, and the prin.ciplen regulating their treatment, which have prevailed during thelast four hundred years .

Wru w usos has drawn up a statistical analysis of 743received at the Invalid Depdt, Chatham, from the Indian Mutiny.

274 REPORT ON suucaar .

during the Indian Mutiny, as contrasted with the orperience of the

Crimean campaign, is interesting.

APPIA’S is a short practical treatise . According to himde'

bride

ment is no longer practised in gunshot wounds by Frenchmilitarysurgeons, except for a specific object, as the removal of the ball, &c.

Instead of it he recommends long cuts through skin and fascia whenthere is much inflammatory swelling ; the muscles bulge throughthe cuts, but this is of nomoment. If the bullet can be extracted

without a grave operation, this should always be done ; but if not,it should be left. It was the French practice in the Crimes toremove all splinters of bone immediately, and Baudens insists uponit ; but Stromeyer waits till large splinters have become loose

, as

by so doing the periosteum is spared, and he also shows that

gun shot fractures often heal with very slight exfoliation .

The first dressing should he simple— a handful of charpie soakedin cold water. Continual irrigation is especially useful in moderating the first inflammatory swelling.

In secondary hasmorrhage, requiring deligation, the arte ry shouldbe tied above the wound. During the Revolution in Paris, 1848,and in the Crimea, primary amputations were more successful thansecondary. In 1848, fractures of the femur were barely curable,and in all comminuted fractures in the lower two thirds immediateamputation should be performed ; but this rule does not apply tothose in the upper third, because amputation near the hip, or dis

articulation, is so generally fatal, that it is better to tryto save the

limb. After the battles ofAlma and Inkermann thirteen amputationsat the hip were performed, and all the patients died ; but of ten

fractures at the hip, unamputated, three recovered. In his letters

from Italy, Appiamentions that amongst wounded in Turinand elsewhere he did not see a single case of resection . Tetanuswas not infrequent ; one case, which was treated with a lotion of

curara, I gramme to 80 centigrs . of water, recovered. Penetratingwounds of the chest were frequently left open, and in general noespecial care was taken to close them; but he subsequently addsthat few of these patients recovered.

INFLAMMATION.

t fi — Ou the Treatment of External Inflammation by Digital Compression .

(Padua, l’Union, u s, Schmidt’s Jahrb ., No. a, 1859.

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REPORT ON SURGERY .

AUPUTATION.

m .— ou the Causes of Frequent Deaths after Amputation. (Deutsche Klinik .,

as. as, Schmidt’s Jahrb .. p. are. 1859.

Hancock — Practical Clinical Remark s on Painful Cicatrix and Irritable Stump.

Lancet, July s3d. 1859.R owa n— Epithelial Cancer occurring in the Cicatrix ot

’

a Burn on the Arm, ne

cessitating Amputation at the Shoulder-joint. Ih., March 26th. 1859.

Johnn a — Malignant Tumour ot‘

the Arm at'

ter Fracture ; Amputation at the

Shoulder-joint. Ih., March a6th , 1859.

M IL— Clinical Lecture on Partial Amputation of the Hand.

“

Ih ., Jan. set,

1859.

-Case of Partial Amputation ot’

the Hand. Ih., April ed, 1859.

— Partial Amputation of the Hand. Ih., Jan. sth, r859.

00 — Reeurrlng Fibre-plastic Tumours ; Partial Resection of the Hand. lb

Peb. s6th, 1859.

W ok — Amputation at the Ca po-metacarpal Articulation. Med. Times andmr m 1859

Clement — Tumour of the Upper Third of the Thigh ; successful Amputation at

the Hip-joint. Brit. Med. Journ ., Jan. set. 1859.

cool — Epithelium of the Right Leg and Tibia ; Amputation ; Recovery. Lancet,Jan. 15th. 1859.

wa gon — Clinical Remarks on Pirogofl '

s Operation. Ih ., June 1 rtb , s859.

Onra ‘.— Pin gch

‘a Amputation . Med. Times and Gaz ., p. 59, 1859.

litraow performed 62 amputations in the course of twenty-fiveyears, and 3 only were fatal ; r5 were amputations of the forearm,

20 of the arm, 15 of the thigh, 1 r of the leg, and 1 through thefoot. The great success is ascribed to the after-treatment. No

bandage should be applied, and the wound is not to be closedimmediately, but exposed to the air for tw enty or thirtyminutes .

Circular amputation is alone permissible when suflicientmaterial forflaps is wanting.

l lancocx points out that the excision of painful scars of stumpsand neuromata frequently fails ; and he proposes instead the subcu

taneous separation of the cicatricial tissue fromthe bone . By sub

sequently moving the part over the bone daily, union is to be

prevented.

FLowaa’s patient, a pale, delicate woman, wt. 2 7, had been

severely burned when nine years old. She had extensive scars uponthe right arm, shoulder, back, chest, and neck . There was an opensore upon the inside of the arm, having all the characters of epithelialcancer, and reaching fromtwo inches above the elbow almost to the

amuramos . 1277

armpit, and in breadth it occupied nearly one third of the circumference of the limb . The axillary glands were enlarged, and the

diseased contents of the axilla were removed. The patient, at thetime of this report, was doing favorably.

Jounsozv’s patient, int. 28, had broken his armabout the middle,

nine months previously. A tumour, of the siz e of a cocoa

nut,

formed at the site of fracture . It was considered to beAmmtation, with lateral flaps, was performed at the shoulder, withlittle loss of blood, but an hour afterwards free hmmorrhage,requiring thirty ligatures to arrest it, took place . The patient

recovered.

Sonnr’s lectnre contains reports of flve cases ot

’

severe injury

fingers left entire is strongly insisted on .

Buncnss reports a severe accident froma threshing machine.

The first, second, and third fingers of the left hand were whollycrushed, and the little finger and thumb partially so . The palmand back of the hand were greatly lacerated. The mutilatedphalanges were alone removed, and an excellent hand was preserved .

Enema says a powder-flask had exploded in the hand. The little

finger was blown ofl’

; themetacarpd bones of the other flngers werebroken the thumb was dislocated. Amputation was rejected. The

torn joints were adjusted, and amoat useful hand was preeerve d.

Counson describes a tumour, as large as a small apple, over themetacarpal bone of the thumb . He removed the growth with the

twice removed .

Smewrcx says the palm of the hand, the third and fourthfingers, were shot away, and the second finger hung hy the skinonly. The metacarpal bones of these flngers, together with the

os magnumand unciformbone, were removed. The thumb and

forfi nger were saved ; fair movement was preeerved.

the tumour reached to within two inches of Poupart’s ligament;its circumference was thirty-four and a half inches . A short

anterior flap was made bytransfixing the limb, and a longer one

out frombehind . On the third daythe line of incision had unitedin nearly its whole extent, and at the end of a month she was on

crutches. The growth was a soft, liver-like substance, inta sected

278 arrows or: scanne r .

by fibrous bands. It extended to the periosteum, but the bone was

WATSON reports a severe injury of the foot, for which he amputated at the ankle in the manner practised by Pirogofi

'

. He

suggests a modification of Pirogofi’s operation, by which the foot

is removed without disarticulating at the ankle-joint.Com e out the os calcis obliquely, after Bush

’smodification .

SUTURES .

Avoling,— Antiquityof Metal Sutures. Med. Times and Gas., r859. 8r.

AVELINO quotes Fabricius Aquapendente, to show that heemployed flexible needles of iron or brass, which he passed throughthe lips of the wound, afterwards twisting their ends together.

He says that Fabricius Aquapendente was aware of the advantagesof these sutures over those of thread.

HEAD AND NECK .

W OM ATIONS, DISEASES, AND INJURIES OF THE MOUTH, PHARYNX,

AND (ESOPHAGUS.

Friedbergp-Ou the Pathology and Treatment of Hare-lip. (Prag. Viertel

jahrscb ., vol. lxi. 1859, pp. 91 Schmidt's Jahrb No. 7, 1859.

Wank -Congenital Pissure of the Right Cheek ; Operation ; Recovery.Lancet,

May 28th. 1859.

DeMaria— Syphilitic Gangrene oi'

theMouth.with impending Sufl'

ocation ; Laryn

gotomy; Recovery. Lancet.Feb. 36th , 1859.

Ward,

— Laceration and Detachment of the SoftPalate ; Resdjustment bySutures ;Perfect Union. Med. Times and Gaz ., June i 8th, 1859.

Baiz eam— Ou Perforations and Clefl s of the Palatial Vault. A report by 11.Larry on Bs iz eau

’

s work on this subject. (Union , Nos. 13 and 15,Schmidt's Jahrb ., No. 7. 1859.

Fiddeg — Csse of Es timation of the Tongue. Edin. Med . Jour., June, 1859.Thompgom— Severe Hemorrhage fromthe Tonsil arrested bythe Solution of the

Perchloride of Iron. Lancet, Nov. 19th, 1859.

Jobert do Lamballe,

— 0n Polypi ot'

the Nose and Faucea. (Gaz . dea H6p.,

No. 85, Schmidt’s Jahrh., 1859.

Roman— A Polypus of the Pharynx removed by Twisting and Tearing it ofi'

,

(Wiirtemb. Corn , vol. xxi, Schmidt’s J abs-b .,No. 9, 1859.

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280 arrow on suaoanr .

which was done freely two or three times . A return of the bleeding,a quarter of an hour afterwards, was checked in the same way. The

patient did well.DB LAD ALLE reports a case of fibrous polypus, attached by a

broad root to the base of the skull. He removed it by firstdividing the soft palate, which was drawn upwards with a forceps byan assistant ; then seiz ing the polypus with Museaux

’s forceps, he

cut through its root with a curved bistoury, and caute riz ed the rest.

Rosana describes a tumour of fibroid structure, which grew fromthe lower part of the back of the pharynx. The patient’ s head wasbent forwards, and anyattempt to sit upright caused a paroxysmof

wards, and then forcibly wrenched it awaywith a lithotomy forceps.

There was hardly anybleeding, and a rapid recovery ensued.

Emcnsnx points out eight conditions, independent of stricture,

are— 1 . Tumours of the pharynx . 2 . Morbid states of the larynx .

3. Tumours in the neck. 4. An eurism of the innominate artery.

5. Aortic aneurism. 6. Intra-thoracic tumours in the posteriormediastinum. 7 . Dislocation of the eternal end of the collar-bonebackwards . 8. Impaction of a foreign body in the wsophagus .

Three kinds of stricture are described : I Hysterical or spasmodicstricture. 2 . Fibrous stricture . 3. Carcinomatous stricture.

ADDISON and Fons'mn’s patient was a child, four years old, whohad swallowed, nineteen weeks before his admission, a corrosive

alk aline fluid, which caused an almost impermeable stricture of

the oesophagus . He was apparently dying from starvation, whenForster performed gastrotomy. From that time he took foodfreely, and his sense of hunger diminished ; he became more lively,and seemed to be doing well. Four days afterwards, sudden acute

pain in the bowels, followed by death in about five hours . The

contents of the stomach had escaped into the peritoneum, and

caused inflammation .

sm—rassaos s . 281

AlR-PASSAGES .

“ tint— On Tracheotomy. Schmidt’ s Jahrb.. vol. ros , 1859. pp. 73— n o.

— Catheterismof the Larynx. and its Relstion to Tracbeotomy. lh.,

No. 5. usso.

esults of Tracheotomy. Med. Times and Gaz . ,

M on— Ou the Treatment of Edema Glottidis by Sw incation. meet, Aug.

33th, ‘859'

ma g

— Acute Laryngitis ; Laryngotomy; Remarks. Med. Times and Gas.,June i 8th. 1859.

Bum,

-Chronic Laryngitis ; Sudden Asphyxia s Tracheotomy; Recovery. ih.,

A08. 6th. 1859.

Poz nan-Chronic Ulceration of tha Larynx ; Death byAlphfl i‘v fromfood become

ing impacted in the Glottis. Dub . Hosp. Gaz ., lurch 1st, 1859.

JM ,

— Syphilitic la ryngitis ; Recovery; Inability to dispense with the

Canola. Med . Times and Gaz . , 1859, p. 8.

W and smog — Diphtheria ; Impending Snflooation ; Tracheotomy; Death ;Autopsy. lh., u s .

rou ter — Foreign Bodyin the Trachea ; TracMotomy; Death ; Autopsy. Guy’s

Hosp.

y performed fcr the Removal of a Tamarhid-stone fromtbe

Tinnes and Gaz ., July30th, 1859.

W e memoir commences with a brief historical sketch of

this operation, and contains reports of a large number of cases,systematically arranged under— (a) croup ; (6) (edema of glottis,

trachea ; (a) foreign bodies in the air-passages ; (d ) tumours com

ments .

Gmnrus thinks that tubage of the larynx may be indicatedwhenever the free passage of air into the trachea is immded ; or

flexible, male catheter is most useful. Recently the introductio nand retention of a short tubc in the larynx has been proposed byBouchut as a substitute for tracheotomy in croup and other obstructions of the air-passages . The tube is slightly conical, and has a

double belt about the middle . It is to be pushed down into thelarynx, so that the lower vocal cords lie in the chink of the belt,and the epiglottis moves freely above it. The commission appointed

282 arrow on sos onar .

by the Academy of Medicine of Paris to investigate the value of thisproceeding passed an unfavorable opinion upon it.ThisREPORT contains particulars ofe ighty-eightcases , comprising

1 Tracheotomy for laryngeal disease, not including true croup (thisseries containsmany cases of syphilitic) laryngitis . a . Tracheotomyfor scalds of the glottis. 3 Tracheotomyfor croup— fourteen cases,

with four recoveries . 4. Tracheotomy for foreign bodies in the

tempts to seiz e the foreign body with forceps were generally unsuccessful ; in the cases which recovered, it was ejected by coughing .

TUDOR. confidently recommends, from personal experience, thescarification of the cedematous submucous tissue over the epiglottis,and figures a curved bistoury for the purpose . This treatment haslong been practised at the Dreadnough

Bom a’s patient was a stout but scrofulous woman, a t. 2 1

Suffocation was imminent. The operation was dimoult, fromtheswollen state of the neck Several arteries and one or two turgidveins bled profimely. Complete recovery took place. Some criticalremarks upon inflammatory afi

‘

ections of the larynx, and the aftertreatment of laryngotomy, are appended.

Bu rma’s patient, fifty-two years old, had had syphilis thirty yearspreviously. Laryngeal symptoms had existed for four months.

Several week s after he entered the hospital, he fell one eveningnearly suffocated. The trachea was at once opened by the housesurgeon immediate relief followed the introduction of the canola.

Theman was discharged amonth afterwards.

Poa'

rnn tells us that symptoms of laryngeal disease had existedtwo years . Sudden death . A piece of mutton was found firmlyimpacted in the rims . The epiglottis was destroyed, the stemof it

only remaining.

Jau ras sox describes a case of laryngitis in a prostitute, whohad first contracted syphilis fourteen years previously. Hoarsen essfirst noticed n ine week s before her admission into the hospital.Never any cough . Leeching, antimony, and mercury had beenalready tried, but the symptoms were so urgent that tracheotomywas proposed, but not performed till two days afterwards. In the

interim the mercurial treatment was persisted in, and temporaryrelief was obtained by two bleedings to twenty-four and eighteenounces. The patient recovered, but could not breathe when the

tube was removed.

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284 REPORT ON SURGERY .

attracts the notice of the patient, and gives a fallacious idea that

they are superficial.In illustration of this, a case is related of an apparently super

ficial cyst in the neck, an incision into which was followed by suchprofuse haemorrhage that a temporary ligature was placed on the

common carotid artery . This did not arrest the bleeding that camefrom a large vessel running forward from the back of the cyst,which overlaid the vertebrae, to the upper angle of the wound. It

was an offset fromthe vertebral artery, as large as a crow-quill.Other cases of cysts in the thyroid gland are reported, which

all remarkable for the dangerous hmmorrhage which took placewhen they were opened. Pitha recommends iodine injections.

Tm nmv quotes fromWerner a case of thyroiditic suppuration,which was treated by incision and terminated favorably, and one oflarge extravasation of blood in the thyroid region, which formed aprominent livid swelling on the right side of the neck . It burst,and blood freely ooz ed away. The opening was enlarged, and a

quantity of black, broken coagulum was removed ; the cavity

granulated and healed. Fromthe direction which a probe took , itmust have been situated within the substance of the right lobe of

the gland. A case of parenchymatous bronchocele, in whichWerner tried to extirpate the tumour, which reached fromthe chinto the sternum, ended fatally. The attempt was abandoned after

having lasted an hour and a quarter. The bleeding was very free ;twenty-four ligatures were used. Gangrene set in, and death followed ou the twelfth day. Schuh recommends the injection of

cystic bronchocele with iodine . Chelius treated eleven cases of

cystic bronchocele by free incision ; he stitched the cyst to theedges of the external wound.

The memoir contains a collection of remarkable cases of cystic,cavernous, and colloid tumours . The injection of cystic bronchoceles with iodine is certainly preferable to incision, which in all the

reported cases was followed by very profuse and dangerous hemorrhage .

Dmm ’s patient had a congenital cyst, reaching fromthe chin to

the sternum, and outwards on both sides of the median line beneaththe sterno-mastoidmuscle . Its extirpation was difficult, on accountof its connexion w ith the hyoid bone, the larynx, and trachea. The

childmade a rapid recovery .

NELATON removed a. fibro-fatty tumour, which reached fromthe

Caner-wounns . 285

chin to the sternum, and fromthe middle line outwards on the

right side of the neck to the spines of the vertebrm. Its extir

patiou was effected with small loss of blood. The external and

internal jugular v eins, the carotid and subclavian armies, were

exposed in the dissection .

q ssox’s patient, a young woman, had had, during fifteen

years, a progressive enlargement of the thyroid gland, whichformed a considerable swelling in front of the neck . The chief

pmof it consiste d of a large fluctuating cyst. This was punc

tured, and then slit up. Several ounces of dirty-brown serumes caped. The cyst was filled with lint, but free ooz ing from the

interior continued for some time . Fergusson thought that thetendency to bleeding fromthe inner surface of these cysts rendersthemunfit for injection with iodine.

Jack son — Case of GunshotWound of the Heart.are , where the patient survived

three hours and s half. Lancet,Nov. 19th , 1859.

Johnam— Laceration of the Lung withoutPrseture of the Ribs. Brit. Med. Journ.,

l imb sth. 1859.

J amison relates , that the man, whilst sitting at his door, wasshot, November 3d, 1856, at a quarter before eight o

’clock p.m.,

with a pisto l, fired by a person in front of him, at several paces’

distaw e . Two bullets struck the centre of his sternum; one

pierced the bone, and the other glanced off. The hmmorrhage wasinconsiderable. There was great dyspnma, and much pain in theloins and about the bladder, with an intense desire to pass urine.

He died at a quarter past eleven o’

clock p.m., three and a halfhours after the injury. The ball which pierced the sternumhadtraversed the pericardium, struck the apex of the heart, andmade ahole in the

'

right ventricle, through which the tip of the little finger

could be passed . The pericardiumwas nea rly full of clotted bloodand serum. The ball afterwards passed through the diaphragm,behind the stomach, and lodged loosely in the recto-vesical pouch

several places without perforating them. The bullet which glancedoff the sternumwas traced for some distance between the abdominal muscles, but had not penetrated the cavity.

286 REPORT ON suacnnr .

J onnson’s patient, a little boy, a t. 7, was struck down by a cab,

and the wheels passed over his chest. He had great pain in thebelly and left side of the chest, which was dull, and over which no

respiratory sound could be heard ; he also vomited blood. Fourhours afterwards the intercostal spaces were distended. Great

dyspnma, and death on the followi ng day. The ribs were foun dto be uninjured ; but the lung was extensively lacerated, and thepleural cav ity was full of blood.

ABDOMEN

INTERNAL INTESTINAL OBSTRUCTION, PROM ADHESIONS, INN S-SUS

CEPTION, TORSION, IMPACTION OF PE CES, AND STRICTURE OF

THE RECT'

UH.

aw n— liens caused byAdhesion of the Ileumto the UrinaryBladder. (Press.Med ., 37. Schmidt’s Jabrb ., No. 3. 1859.

StrauhaL— Case of Twisting, with Obstruction at the lower end of the small intestine. lb.

Kenneth— Exfoliation of the Ce cal End of the Large Cut in consequence of an

intus-susception. (Pr. Ver. t . n. l'. r, 31, lb.

Cabaret — Invagination of the Colon in a Child replaced bythemethod of Pelletier.(Rev. de Ther. Lied-Chin , 13, lb.

H‘Kidd,

— Case of Imagination of the Oc ean: and Appendix. Edin. Med. Journ.,

March, 1859.

Ben — Ou Intus-susception. Mém. a. d. (Prsxis r r, 33. and 34, lb .

Thane and Aberlo.

— Cases of Stercoraceous Obstruction. (Oesterr. Ztschr. f.

prak t. Heilk ., vol. iii, pp. 40—52 , l b.

Thompson — Stricture of the Sigmoid Flexure ; Constipation during fortyoone days,relieved byopening the colon behind the peritoneum Death fromperforation

above the seat of stricture. Med. Times and Gaz ., April s3d, 1859.

Todd — Remarks on Stricture of the Rectum. lh., Aug. oth, 1859.

Frommann ,

— Case of lotus-susception. (Deutsche Klinilt,No. 35, Schmidt’sJ ahrb ., No. 3, 1859.

Banoxom says the obstruction was preceded by diarrhoea and

great pain in the belly. Three inches fromthe ileo-caecal valvethere was a firmadhesion of the ileumto the summit of the bladder,which prevented the passage of the contents of the gut. The

mucous membrane of the bowel presented eight oval ulcers, and a

perforation had taken place at the ad herent part.SranusnL

’s patient was an infant. The symptoms set in a few

hours after birth, and persisted despite of the rupture of an

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288 nnroar on suacear .

was quite sure that she had not passed a motion since the 31 st of

J anuary preceding. Two or three days before that time she felt

something give way in her abdomen whilst lifting a heavy weight.She had tak en croton oil and other purgatives without relief.

Large quantities of fluid fasces were discharged through the artificialopening. She sank on the afternoon of the second day. The

sigmoid fiexure of the colon was drawn across to the right sideof the spine, and fixed there by constricting bands of lymph to themesentery. Above this part there was a small hole in the gut.

There were signs of general peritonitis .

TODD describes and figures an instrument which dilates the

stricture without distending the anus .

FROMMANN reports this remark able case from the practice of

Professor Lehrbuschen . The passage of 32"

of small intestine peranumwas followed by rapid amendment and recovery.

HERNIA .

Jamel — Practical Observations on the Operations for Strangulated Hernia. 810,

cloth. London, John Churchill.Pan —

'

l‘

he Resection of the Omentumin Operations for Hernia. (Bull. dehen , vol. iii, p. 502 , Dec., Schmidt’s Jahrb ., No. 5, 1857.

Heath — Strangulated Umbilical Hernia ; Removal of the Sac and adherent

Omentumwith Success. Lancet, April ad, 1859.

Eriohpem— Practical Clinical Remark s on Congenital Hernia complicated with an

Undeacended Testis. lb July9th , 1859.

Bavoth — Successful Operation for Strangulated Hernia in an Infant. (DeutacheKlinik , No. 39, Schmidt's Jahrb ., 1859.

curling— Direct Inguinal Hernia in a Female . Med. Times and Gaz ., p. 264,

185

[ mg— Successful Operation on a Strangulated Inguinal Hernia in aWoman ,

fiftyyears old . The Strangulation had existed four days. Journ. de Bord .,

Junc, 1858.

Rampa n t — Fe cal Fistula after the Operation for Strangulated Hernia. (Journ .

de Toulouse, March , Schmidt’s Jahrb ., No. i , 1859.

Bez z onioo,

— Cure of an Artificial Anus by Palliative Treatment. (Ann. Univ.,

April. Schmidt’s Jahrb No . i , 1859.

Schmidt — Strangulated Crural Hernia, with Rupture of the Coverings . (Bayer.

acrz t. Intell. , vol. xlv , Schmidt’s J ahrb ., No. 5. 1859.

Legendre.— Crural Hernia through Gimbernat

'

s Ligament. (Gaz . dc Paris, 13,

Schmidt's Jahrb ., 1859.

Adam; and Wood ,

-Strangulated Inguinal Hernia ; Descent of Intestine in a

distinct Sac behind a large Hydrocele. Lancet, Feb . 26th , 1859.

Dieulafoy,

— Three Cases of Inguinal Hernia reduced “enmaaae.

”(Journ. dc

Toulouse, May, Schmidt's Jahrb ., No. i , 1859.

HERNIA. 289

Parrin ,

— Scrotal Hernia ; a second Sac. (Soc. Med . d emulation. L’

Union, 33,

Schmidt’s Jahrb., No. i , 1859.

M ung— Formation of a Pouch or Pock et of the Sac in Strangulated l nguinal

Hernia, by the separation of the fascia transversalis from the muscl. transv.

(Deutsche Klinik , 20, Schmidt's J ahrb ., No. i . 1859.

M a n Daviog — Femoral and Ventral Hern ia Radically Cured . Med . Timesand Gaz ., p. 158, r859.

Redfern Davies — Ou the Radical Cure of Hernia, with an Account of an lmo

proved Instrument, and Notes of FortyCases . lh., Aug. 6th , 1859.

Linen — Two Cases of Radical Cure of Hernia. lh., p. 31 , 1859.

Jax es’s memoir contains an analysis of thirty-six cases operated

on by himself, and an inquiry into the causes of death . He

notices the extreme rarity of strangulated inguinal hern ia in

females, though this form of hernia, without strangulation, has

been shown to be not infrequent. The difficulty of diagnosis inthe female, when the hernia is so large that Poupart

’s ligament

cannot be traced, is alluded to, and an additional sign is pointedout, viz .,

if true inguinal, the hernia, escaping through the ring,

must descend into the groin and labium; but when femoral andlarge, the tumourmounts towards the spine of the ilium. With a

single exception, James had Opened the sac. As an auxiliarymeans to the taxis, he think s that tobacco cannot be replaced bychloroform, as the latter does not un load the capillaries or excite

the peristaltic action of the bowels .

I’our z n'r discusses the treatment of omentum which cannot

be reduced on account of its volume, induration, and adhesions,

or its gangrenous condition . Richter and many others are quoted,to show that deligation is not only unnecessary, but even injurions ; minceessary, because the bleeding after excision of the

omentum is slight, and injurious, because the ligature provokessuppuration . If the spontaneous separation of the gangrenous

omentum is waited for, a dangerous suppuration is maintained,and the recovery is tardv . Haemorrhage, which is regarded as

the great danger of resection, is shown from several authoritiesnot to be a cause of anxiety ; but whilst deligation an

is reprehensible, it may be requisite to tie the vessels separately.

Richter advises the cut to be made through the gangrenous tissue,without interfering with the healthy portion the omentumshouldthen be returned, leaving the gangrenous margin to be thrown off

w ithin the belly . Sir A. Cooper, on the other hand, strongly

recommends the incision to be carried through healthy tissue .

19

890 REPORT on suaosnr .

Demarquay has remarked that dangerous inflammation oftens follows

the reduction of omentum, in confirmation of which he cites threecases.

Hnarn’ s patient, wt. 55, had had an umbilical hernia for twentyyears . It was as large as the fist, and had been strangulated two days .

The aperture in the abdominal walls was immediately below the

nave], and its margin having been divided downwards, the gut wasreturned . Heath then dissected the sac from its connexions and

pa s sed a double thread through its base ,and through a large pie c e

o f adhe re nt ome n tum, afte r u hie h he on ! bo th the sue and ome n tum

s wan . The subsequent tre atme n t cons is ted of the free n hib ition o f

opium. The wound healed w ithout an ) appe a rance of protrus io n .

I‘lntensns , after alluding to the common form of congen ital

hernia in which the testis is in the scrotum, calls attention to a

second and more uncommon form of hernia, where the testis hasbeen retained above the external inguinal ring, and adduces somecases of this nature .

Raven ! reports an inguinal hernia in a boy fourteen months old.

A truss had been worn from the sixth month, the spring brok e,the bowel came down and became strangulated. Forty-eight hoursafter the onsetof the symptoms Ravoth operate d. The large siz e of

the swellingmade it probable that the cascumformed part of the protrusion . The sac was unopened, the ring dilated with a blunt hook,and the contents returned without further difficulty. Cicatriz a

tion was complete on the twenty-first day. Re ference ismade to

seventeen cases of herniotomy in children, nine of which proved

CURLING’ S patient, wt. 60, had had an irreducible hernia for nineteen years. Strangulation during four days ; the swelling, as largeas an egg, occupied the left labium. The sac was opened ; thestricture was v ery tight ; some dark , congested omentum was re

turned, and a portion that was adherent and irreducible was cut off.She died twenty-one hours afterwards. The neck of the sac was

internal to the epigastric artery ; the conjoined tendon was to itsinner side. The strangulated gut was three inches long, claret

coloured, and coated with lymph .

In Mussm’ s case, the bulk of the hernia] tumour,which was

as large as a fist, consisted of omentum, closely adherent tothe sac. A small loop of gut was returned, but the omentumleftdown . It came awav in shreds, without any dangero us symptoms.

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292 REPORT ON soncs ar .

measure was successfully adopted. In each Of them, afte r slittingup the inguinal canal, the sac was found behind the interior ring,

drawn down and Opened.

Pannlx’s case was an old, strangulated, scrotalhernia. Reduction

in a warm bath on the fourth day. T he inguinal canal free fromswelling, but a moveable membranous fold could yet be felt i n it.Symptoms unrelieved ; death. The sac contained a little serum;the neck , greatly contracted, admitted a goosequill only it cor

responded w ith the exterior ritig . There was a second, narrow sac

occupying the whole length of the inguinal canal, and in it a flaccid,brownish-red loop Of gut, attached to the sac by recent adhesions .

Ilarmxa says, the hernial tumour, when first seen, consisted

of an upper and a lower part, separated by a constriction ; the lowercould be partly reduced, but not the upper. At the time of the

operation, On the third day, this distinction no longer existed . A

brownish-red loop of gut outside the external inguinal ring was

returned after div ision of this part, but came down again with everymovement of the patient. The symptoms persisted, and deathensued. A large Ioop of bowel was found in a pouch of the sac

formed bv the detachment of the fascia transvers alis from the

transversalis muscle .

DAVIES reports four cases Of femoral and two of ventral hernia,treated by invagin ating the integument wi th a metallic suture .

One death took place on the fifth day fromperforating ulcer of the

colon, u nconnected with the operation . The other cases were all

successful.

He think s the occasional failure Of ll'

utz er’s Operation depends

on the non-obliteration Of the back of the inguinal canal the

gut slips down behind the plug . This happens because the pressure Of the instrument is almost whollv exerted upon the front Ofthe canal. By adopting a plug, the lower part Of which expandson turn ing a handle, and so presses upon the back of the canal

,

Dav ies has sought to overcome this cause of failure . He appendsan analytical table of forty cases .

Lrsrnn’

s first patient, a dock -labourer, set. 56, had had a right,Oblique, inguinal hern ia eight years . The external abdominal ringwas relaxed, and the inguinal canal much shortened . Wutz er’s

operation was performed, and Rothmund’s instrument employed.

This was reapplied with a longer needle on the third day, havingslipped on account of the shortness Of the needle first used. On the

ran URINARY BLADDER. 293

eighth day the instrument was removed, and the adhesions were

already strong. One month after the operation there was not theslightest disposition to a return Of the hernia.

The second, a labourer, forty-nine years old, had a reduciblebubonocele twenty-four years, on the left side . The same operationwas practised as in the previous case . The instrument was discontinned on the tenth day. In both cases a small slough formedroun d the exit-hole of the needle.

DISEASES OF, INJ URI ES TO, AND OPERATIONS UPON, THEURINARY BLADDER .

PROLAPSE OF THE VESICAL MUCOUS MEMBRANE.

Patron — Do renversement de la muqueuse de l’

urétre , ct de la muqueuse vési

cale. Seconds partie. [On Prolapsus of the Mucous Membrane of the

Urethra and Bladder.] (Archiv. Gén. de Med., Dec. , Canstatt’s

Jahrb ., 1857 .

PATRON found only a single example of prolapse of the mucousmembrane Of the bladder on record . He communicates the following remark able case z— An otherwise healthy girl, fourteen years Old,began two years before to experience difficulty in passing urine ; thestreamwas sometimes brok en, and occasionally

f a few drops of bloodflowed with the urine . A year afterwards, she noticed a small, redtumour between the labia, which prevented the escape Of the urine, butwhich disappeared spontaneously after two hours . The tumour soonreappeared, and caused retention, which did not yield till next dayonthe subsidence Of the tumour . At that time, when Patron examinedthe patient, he found only a relaxed state Of the vaginalmucousmembrane ; but a month after wards, when the tumour again madeits appearance, with great pain, he saw a roundish, smooth, red,bleeding swelling, Of the siz e of a walnut, between the labia majoraseated at the meatus urinarius, resembling a swollen hemorrhoid .

It was ten se, transparent, and could be returned without difficultythrough the urethra into the bladder ; the introduction of a catheterat once relieved the retention Of urine . Patron diagnosed a prolapseof the vesicalmucous membrane, and ordered a decoction Of cypressberries for a lotion , cold hip-baths, and iron inter nally . In spite Ofthis

,the vesical complaint progressed ; the girl wasted and became

294: REPORT ON SURGERY.

chlorotic. The tumour repeatedly showed itself, and was found tobe pedunculated ; the peduncle was encircled by the urethra, and a

sound could be passed on all sides between theminto the bladder .

The tumour became swollen when it was not immediately replaced .

The vagina was normal. Horiz ontal position, the introduction of a

large catheter, injections Of sulphur-water, cauteriz ation Of the neck

of the bladder, and sea-bathing, all failed. Her general condition

grew worse, and periodical accessions of fever, headache, and

sickness, set in . To relieve this constant distress, Patron decided toremove this tumour by ligature . T he extruded tumour was oneircled with a loop of thread, which was tied round the peduncle withinthe urethra, at the depth of nine centimetres . On puncturing thetumour, a urinous fluid escaped. A thread was then passed throughthe collapsed tumour, which,togetherwith the instrument,was pushedfurther into the bladder . The loop was tightened daily ; it cameawaywith the instrument on the ninth day. Flak es came away withthe urine ; and lastly,the shrunken fetid tumour, still eight centimetreslong, was expelled . The reaction, at first considerable, graduallydecreased the patient made a complete and perma nent recovery .

Patron think s that prolongations of themucousmembrane, when theyoccur at the neck of the bladder,maygive rise to tumours of this kind,which can be distinguished froma prolapse Of all the coats by theirtensity and transparency .

EPISPADIAS .

Vou ,

— Iuversio vesice urinarite os Luxationes femorumcongenitimhoe someJ n(livid. [Inversion of the UrinaryBladder and Congenital Luxation of the Hips

in the same person ] Christiania, 1857. (Schmidt's Jahrb ., 1858, Na 7, and

Virchow ’s Archiv, vol. xiv, r n . z .) Canstatt

’

s Jahrb ., 1859.

The coexistence of congenital luxation of the hips with epis

pedias constitutes the peculiarity of this case . The child was a

female . The umbilicus, as usual, was verv low, only one centimétreabove the horiz ontal rami of the pubes . T he symphysis pubis wasabsent.

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296 armour ox s cncnnv .

source of danger, Wise suggests— first, the evacuation of the

urine before the operation, and its substitution by mucilage ;secondly, the drainage of the bladder by a gutta

-percha siphonfastened in the wound. The siphon to contain a cotton wick, whichis to remove the urine fromthe bladder bycapillary attraction .

The cases reported in the Medical Times and Gaz ette occurredin London hospitals . Of a total of 186 cases, 146 recoveredand 40 died. Twenty-six of the fatal cases were adults ; whilstof 137 cases under twenty years of age, only fourteen died .

The influence of age on the prospects of lithotomy is strikinglydemonstrated by these facts . The rarity of renal complicationsin children explains the comparatively little risk of the operationat this age ; and conversely, the frequent co-existence of k idneydisease with vesical calculus in adults accounts for the higher rate ofmortalitv . T he heav ier the stone, the greater the danger, is a fallacions idea . As

,

a general rule, children have smaller calculi thanadults their immunity, however, does not lie in the smaller siz e oftheir calculi, but in their freedomfromk idney disease . The tablesadduced show that at all ages renal disease is the most importantcause of death . m orrhage, pymmia, and peritonitis, rank next.

“

ADAMS recommends the use of a beaked k nife in dividing theneck of the bladder.

The Medical Times and Gaz ette’ draws a comparison between

London and provincial practice .

The Medical Times and Gaz ette’report on lithotrity embraces

cases treated in London hospitals between J anuary, 1854, and July,1857 . Of these cases— twenty-one in number— twelve recoveredand seven died. In five of the seven fatal cases death was causedby pye'mia.

BROWN performed Allarton’s operation on a boy, set. 13,

who had had stone symptoms two years . He left the hospitaltwenty-eightdays afterwards . The stone was one and seven eighthsinch in its greater circumference, and one and a half inch in itslesser.

BROWN operated by Allarton’s method on a boy, wt. 6. T he

stone weighed 1 25 grains troy . Hmmorrhagc occurred to the extentof a teacupful on the third day, and recovery was complete on the

eighteenth .

Two of WHEELHOUSE’

S cases were children ; the third, 11man,act. 57 . All recovered.

aros e, Li rnoron r , AND Ltrnoral rr . 297

a catheter, by the usual incisions above the pubis . The water was thendrawn 03, the flaccid bladder, raised on the point of the catheter,was opened, the incision prolonged downwards, and the ston e

readily removed . The wound in the bladder was closed with foursilk sutures, and the external wound was secured with stitches

M ug deeply through the abdominalmuscles . The accumulationot arine in the bladder was provided against byan clastic catheter

passed through the urethra. More reaction followed than is common after the usual lateral operation . The bladder acted independentlyon the fifth day, and the catheter was removed, but somedifi culty was soon afterwards experienced by the boy, the bladderbecame distended

, the new adhesions were broken through, and

urin e flowed out by the side of the ligature . No harmfollowed ,the

tracks had already become fistulous . On the tenth daythe threadcame away. The patient was convalescent on the twen ty-dret day.

Dun n’s patient, a pallid lad,mt. 17, had had an irritable bladder

almost frombirth, but had never before been sounded. A large stone,weighing fourteen drachms, was discovered and removed by Bryant.The boy died at the end of a week with symptoms of peritonitis .

The left kidneywas atrophied, and the right urether much dilated .

In Wonuann’

s case, the whole inner surface of the bladder wascoated with a mortar-like concretion . The kidneys were tuberculous, and the urethra was ulcerated. The patient, a boy, set. 19,had been ill a year only. On several occasions impaction of the

mortar-lik e matter in the urethra had caused retention of urine .

In Cm sn’

s case, t he tube, a capillary one, for holding pencil-leads,had been pushed into the urethra by the patient, a boy, wt. 1 2 . The

ca lculus which ha d formed round it was two and sh elf inches long.

Bnowa'

rz’s patient, set. 50, had passed a bone pin, part of the handle

of a crotchet needle , down his urethra a few months before . Phos

phates had been deposited around it, and the calculus removed byAllerton

’s operation by Bnowxz measured two and one eighth

inches long, and one and a half inch in circumference .

llo aaa'rs relates a case in which a piece of slate pencil, whichhad been swallowed six months pren

'

ously, was two and a halfinches long, and bluntly pointed at one end. The calculus whichhad formed around it was fromthree and a half to four inches long,by fromone and three quarters to two inches wide. It was removedby lithotomy .

298 arrow on suaoaar .

SAUTESSON relates that a man fell upon a pointed stake, whichran into his perinezum, just in front of the anus . Shortly after thehealing of the wound symptoms of stone in the bladder appeared,and on sounding himtwo large stones were detected. They wereremoved by lithotomy, and their nuclei consisted of two large piecesof cloth which had been torn fromhis trousers .

Counsox’s patient had passed the tube as a bougie into the

bladder, and it broke whilst trying to withdraw it. The piece,extracted by lithotomy,measured between three and four inches inlength .

OPERATIONS FOR STONE IN WOMEN.

gum t of Twenty-four Csses. Med. Times sud Gaz ., July 33d. 1859.Gendron,

— Spontaneous Escape of two considerable Urinary Cslculi, in s Cu e of

Vesico-n insl Bernie. (Bull. do l’Acsd .. vol. xxiv, p. 47, Oct.,Schmidt's Jshrb., vol. 103,No. 8, p. s rB.

l am — Stone in the Bladder of s Pamela ; Fistulous Opening from the

Bladder into the Left Groin ; Operation ; Recovery. (Brit. Med. Journ.,Aug. 13th, 1859.

Ges naox says the stones were discharged through an opening inthe wall of the vagina, after long straining. Bladder symptoms hadexisted during eight years.

In McEwr-m’a case the neck of the bladder was occupied bya verylarge calculus, which obstructed the orifice of the urethra, so that allthe urine was passed through the groin . Lithotomy was performed,and a stone weighing two ounces minus eighty grains was extracted ;after this a second was discovered ; the bladder seemed to be tiedaround it, and it layin the right iliac fossa. It was removed withsome difficulty. Its weight was one ounce five scruples.

PARACENTESIS AND INJURIES OF THE BLADDER.

Coote, Holm“ .— Extrsmstion of Urine. St. Bartholomew'

s Hosp. Brit.Med. Journ ., Nov. 14th, 1859.

Pmt— Ou Retention of Urine, Puncture of the Bladder. sud Perincsl Sectiolt.Ih., July 3d, 1859.

Holt— Puncture of the Bladder through the Rectum. Lsncet, Jan. 8th, 1859.

I on ian— Observation de retention d’urine, causée par nn engorgement de isprostate, dstsnt dc nedt

‘

snuées ct guerie rsdicslement. [A Case of Retentionof Urine, csused by sn Bngorgement cf the Prostate of nine years' date, andradically cured ] (Soc. Med. Prat. de Paris, et Union Méd ., 1857,No.

Csnststt's Jshrb., 1859.

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300 asronr on sunes ar .

Cusacx reports a fracture of the pelvis, with extensive lacerationof the peritoneumand bladder ; extravasation of urine ; and deathon the third day. Commenting on the fatal nature of this accident,he suggests the advisability of opening the abdominal cavity, washingout the extrav urine with pure water, and afterwards stitchingup the wound in the bladder.

URBTHRA.

s'

rnrcruans, CALCULI, INJURIES, E'rc .

man n ing — Clinical Observations on Injuries and Diseases of the Urinary Organs.Illustrated by Cases. Dubl in Hosp. Gaz ., January 1st, 1859.

Wade ,

— Practical Observations on the Treatment of Urethral Stricture. Med.

Times and Gaz ., June i 8th and asth, 1859.

Thompson — The Value of Internal Incision in the Treatrmut of Obstinate Strietures of the Urethra. Lancet, Oct. 15th and s ad, 1859.

Thompgom— Two Cases of old-standing Strictures of the Urethra successfullytreated by Internal Urethrotomy. Lancet, p. 107, Jan. 29th, 1859.

Leroy d’Efi oneg, Pu g

— Observation sur nu cas de rétrécissement de l'urethrecause par nurupture de cc canal, et traité par l'uréthrotomie. [Observations ona Case of Stricture of the Urethra caused by Rupture of the Canal, and Treatedby Urethrotomy.] (Bull. de l'Acad. de ma. de Belgique, ad series, 1, a.)Csnstatt

’

s Jahrb ., 1859.

Uytterhoevem— Nouveau procédé de guerison dans les cas de rétrécissements del’urétbre infranchissables. [A new Method of Cure in Cases of lmpenetrableStrictures of the Urethra.] (Journ. de Med . de Bruxelles, February.) Can

statt’s Jahrb ., 1859.

Civigle,

— De l'

appréciatiou dea principales méthodes de traitement dea ooarcta

tions de l’urethre. [On the relative Value of the principalMethods of TreatingStrictures of the Urethra.] (Bull. de Therap., March 15th.)

Civiale,

— De l'urethrotomie interne on section intra-urethrale. Apercu Historique.

[On Internal Urethrotomy. or Intrs-urethral Section. An H istorical Sk etch ](Moniteur des Hdp., 1859, Nos. 138, 140, 144, 145, Canstatt

’s Jahrb .

1859.

Boinet,— Nouvel urethrotome snr conducteur pour pratiquer l’urethrotomie

d'svant en an iene et sans dilatation préalable dsns les rétréc issementsrebelles a. la dilatation . [A New Urethr i tonie, or a Stad

'

for dividing theUrethra from before back wards, w ithout prev ious Dilatation, in Strictures

which do not yield to Dilatation .] (Gaz . Mcd . de Paris, pp. 41 Can

statt's Jahrb ., 1859.

sedjnot — De l’nréthrotomie interne. [On Internal Urethrotomy.] (Gas .

Hebdorn ., 35, 37, 39, 41 and Soc. de Med . de Strasbourg, May 6th. Gaz .

Med. de Strasbourg, Canstatt’

s Jahrb., 1859.

Heath — Ou a Case of Large Calculus removed fromthe Urethra of a Boy, on

whomLithotomy had been performed five years previously. Med. Times andGaz . , Aug. 2 7th, 1859.

uarrnaa . 301

-Urethrotomy tor Impacted Calculus. Removal of {our other Stonesfromthe Bladder. Ih. , p. 136, 1859.

M — A Case od’ fi stula in Perineo. Lancet, Jan. 1. 1859.

Wormfl i -Retention orUrine in a cane ; Death ; Extensive Tuberculosis ortheGenitoo urinsryOrgans. Med . Times and Gaz . , Nov. 19th, 1859.

W ,

— Mémoire sur la contusion et déchirure de l’urethre ; nouveau pro.

operatoire pour rétsblir la continuite'

de ce canal. [A Memoir on Contusion and Laeeration of the Urethra ; a new Operative Procedure to te-esta.blish the Continuity of this Canal.) (Union M6d ., Csnststt

'

s Jahrb .,

1859~— Obstructiou traumatique de mam [Traumatic Obstruction of

the Urethra.] (Bull. do is Soc. As st , July, Canstatt'

s Jahrb ., 1839.

Famnus o illustrates the dangers of forcible and unskilfulcatheterism by two cases of extravasation of urine follow ing the

formation of false passages, and narrates the case of a child with re

mittent fev er who had complete retention of urine during twenty-fourhours. The urine contained a flocculentprecipitate , probably lithateof ammonia. Its scrotumand prepuce were much swollen . Somecases of retention of urine from the impaction of calculi in the

urethra are also described. In one very violent hteumrrhage was

tion and division, with remark s on the use of Potassa fusa.

Tnoatrson advocates the treatment of stricture by incision inthose exceptional cases in the management of which dilatation

proves only a slight palliative . These cases fall into two series

first, long, unyielding strictures, of many years’ duration ; second,

by dilatation , but which recur in an aggravated form. In the first

series of cases incis ion meets the existing evil ; in the second seriesit is used with the additional object of preventing the accession of

those bladder and kidney affections whic h tend to shorten life insevere stricture. The complete division of the stricture is essential

to success . Internal division is only applicable when the induratedtissue does not require a deep incision for its complete division ;when it does, external urethrotomy is the less haz ardous operation .

The unyielding character of certain strictures seems to be developedin proportion to their nearness to the external orifice of the urethra.

Internal incision should not be performed unless an instrument ofsome siz e can be passed through the stricture into the bladder.

302 nnron'

r on suaorzar .

The incision should be made frombehind forwards, and great care

should be taken to divide the whole length of the contracted part.

This is absolutely essential to success, and the lips of the wound areto be maintained apart, and healing by first intention prevented bysubsequent catheterism. The non-dilatability and contractilityof astricture, and not its mere narrowness

,constitute its gravity .

Thompson has generally employed Civiale’s urethrotome, the bulbof which nearly equals No . 5 ; for smaller strictures, Thompsonfigures an instrument of his own contriv ing . [fromnotes of forn

mo case s, he as } s , that in tw o onl\ in which incis io n s u ere made III

the bulbous port io n o f the ure thra “a s the re free hmuorrhage : and

in all the othe r va ses it w a s slight. He had never see n perine alabscess, extravasation, or pyaemia, follow incisions of the k ind he

recommends .

LEROY reports a case of traumatic stricture, which was twice

treated by division through the perinmum; a relapse, attended bythreatening symptoms, followed each operations which was the

boutonniere” performed without a guide .

Umnnnonvnn has added a sort of cutting cork-screw to (Xviale’s

scarificator. He has employed thismodified instrument with advantage in one case of impenetrable stricture .

CIv uLB draws a parallel between the principalmodes of treatment,and defends the internal division of strictures, because it is simpleand certain to divide the morbid tissue without touching the healthy,and because the wounds, not being exposed to the air, heal withoutsuppuration or general symptoms .

BOINE’I‘ had used seven times, with success, a slightmodificationof Bonnet

’s scanf cateur perf oré.

SEDILLOT figures Maisonneuve’s instrumentwith the improvement

that the blade is concealed during its passage to the stricture . He

does notemploy dilatation with the bougie afterwards, and considersthe patient cured directly, in proof of which he reports eleven suc

ces sful cases . T he first of these were operated on two years ago,

and in none has a relapse taken place .

HEATH says the calculus, impacted in the urethra, formed a tumourof the siz e of a walnut, in the median line at the back of the scrotum.

It was removed through an external incision, and resembled thehead and beak of a bird ; it measured rather more than two

inches in length, and rather less than one inch and a quarteracross.

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304 REPORT ON suns nnr .

portion of the urethra, till be encountered the obstruction in

the membranous portion . The end of the catheter was cut

upon, and through this opening a pointed director was thrustthrough the obliteration . The vesical end of a large catheter waspassed through the wound backwards into the bladder, and its freeand passed forwards through the penis . The abdominal and perinealfistula closed, and the boy recovered.

DISEASES OF THE TESTICLE, SPERMATIC PASSAGES, PENIS,

AND SCROTUM .

GM — Etudes snr la monorchidie et la cryptorchidic chez l'homme, avec quatreplanches et tignres dans is texte. [Researches in Monorchidismand Chryp.

torcbidismin Man, with four plates and figures .) Paris, 1857. Canstatt’

s

Jahrb ., 1859.

Atrophy of the Testicle after an Operation for Hernia on an Infant. Med. Timesand Gaz ., 1859, p. 291 .

Holthom ,

— Epilepsy for thirty-two years in a Man, aged forty-four, with Dis.coloration ot

'

the Sk in fromNitrate of Silver ; Castration. Lancet, Jan. sad,

1859.

Report on Malignant Disease of the Testis . Med . Times and26 am, Sept. rothand 1 7th , 1859.

Tabular Statement of thirty-six Cases of Malignant Disease of the Testis.lb ., Sept. ryth, 1859.

De Moria — Fungus of the Testis i n Syphilis. Lancet, March 19th, 1859.

Curling— Malignant Cystic D isease of the Testicle, the Cysts contain ing Cancer

cel ls, Cholesteatoma, and Bone Successful Removal. Ih., Sept. 10th, 1859.

Hogan— Des obliteratioas des voles spermatiques et de la retention spermatique .

Thése p. l. d. [On the Obliteratioas of the Spermatic Passages and the Re

tention of the Semen.] Par is , 1857. Canstatt’s J abrb ., a8s9.

Pitha ,

— Galvanok austiscbe He ilung der Varicocele nebst prak tischen Bemerk nngeniiber diese Krank he it. [The Galvano-caustic Treatment of Varicocele, w ithPractical Remark s upon this D isease.] Vortrag gehalten in der Sitz ung derSection fiir Therapie. April 23, 1858. (Zeitschr. der It. It. Gesellschaft d.Aerts z uWien., Nos. so , at .) Canstatt

’

s J ahrb ., 1859.

Lee.

— Casc of Varicocele treated by Subcutaneous Section of the Veins. Brit.Med. Journ ., Feb . sth , 1859.

Kenton — On Varicocele. (Gas . des Hdpit., No. 88, Schmidt's Jahrb .,

No. 4, 1859.

Gillespie,

— New Treatment of Hydrocele. Med. Times and Gaz ., Sept. roth ,1859

Young,

— New Treatment of llydrocele. Ih. p. 207.Quinlan — On the Rad ical Cure of Hrdrocele by the Introduction of Iron Wirc.

Dublin Hosp. Gaz ., April i st, 1859.

DISEASES or run rs s'

rrcw . 805

Vory.— De l

'hydroeele de la tunique vaginale , et de la cure radicals par un nouveau

precede. [On Hydrocele of the Tunica Vaginalis, and of its Rad ical Cure byaNew Method .) Parts, 1858, These. Canstatt

's Jahrb ., 1859.

Report on Amputation of the Penis for Epithelial Cancer. Med. Times and Gaz . ,

Oct. rat, 1859.

Walton — Elephantiasis of the Scrotum— Operation and Result, with Remark s.lh., Aug. 6th, 1859.

Gommn gives a complete account of the undescended testis, andall the circumstances associated with this condition . He states, thatundescended testis does not secrete spermatoz oa .

Homnousn castrated an epileptic patient, but the fits continuedafte rwards .

T he Medical Times and Gaz ette ’

gives a summary of the cases

which have been recorded in this journal during the last six

DE Memo points out the rarity of this complication of syphilis,and reports a case in which he had removed the protruded fungusand degenerated testis. A similar case is quoted fromBa llet.In CuRLING

’

s case the cysts were numerous, and varied fromone eighth to one inch and a quarter in diameter. Some meshes ofthe tumour were filled w ith colloid, others with encephaloidmatter.

ROGERS classifies the causes of obliteration of the seminal passagesunder— I . Anomalies of development ; z . Wounds ; 3. Inflammation ; 4. Compression 5. Calculi ; 6. Tuberculosis ; 7 . Degeneration of the walls of the canal. Obliterations fromthe first cause arevery rare ; they are explained by the separate development of the

testis and its excretory duct. The author thinks, that many casesof irritable testis (Cooper) depend on retention of semen in con

sequence of obstruction of the duct.Prrna first encircles the bundle of enlarged veins with a strong

platinumwire, which he then heats with a galvanic battery and cutsthemthrough . He does this at two points . The section is easy, andthe divided surfaces as smooth as ifmade with a sharp knife . Thereis no hiemorrhage .

LEE having passed two needles three-quarters of an inch apartbeneath the dilated veins div ided themsubcutaneously between theneedles . The principle being, to allow the cellular connections on

each side to forma vascular union across the divided ves sels .

NELATON in most cases advocates palliative treatment by an indierubber ring. The testis should be pushed upwards towards theabdominal ring, the dependent portion of scrotum, emptied by pres

306 REPORT ON sunesar .

sure and encircled by the ring, the ends of which are to be madefresh, in order that theymayjoin . Nelaton says he had Oftenmadecures in this way.

Gmmsrmrelates two cases Of hydrocele which he had treated bythe wire-seton . Suppuration ensued in both cases .

YOUNG records two cases of hydrocele of the tunica vaginaliswhich he treated successfully with a seton of fine iron wires.

QUINLAN treated a case wi th a seton of eight threads of iron wire .

The inflammation was as great as usually follows the treatment byiodine-injection, which he had undergone two years previously for abydrocele Of the left side.

DEPER, adopting Metz’s proceeding, caustics lightly the interior

Of the tunica vaginalis with sulphate of silver, introduced upon a

probe through an ordinary trocar. He reports ten successful cases .

The Medical Times and Gaz ette’report contains particulars of

thirty-five cases .

WALTON reports a case of elephantiasis, where the scrotumweighed eight or n ine pounds . He removed as much Of it as

he could, having provided against haemorrhage by previously tyingthe parts beyond the line Of the intended incisions . The patientmade an excellent recovery.

WOUNDS, AND DISEASES OF THE BLOOD-VESSELS .

rotten — Case of Penetrating Wound of the Abdomen. Division of the LeftRenal Artery. Dublin Hosp. Gaz ., April 1st, 1859.

Patten om— Aneurismof the Left Internal Carotid Artery. Edinb . Med. Jour.,Feb ., 1859.

8tanley,

— Ligature of the Common Carotid, on account of Hemorrhage followingthe Puncture of an inflamed Tonsi l . Med . Times and Gaz ., 29th Oct., ( 859.

Stanley,

— Axillary Aneurismof Seven Months’ Growth in a Soldier ; Deligationof the Subclavisn Artery in the th ird part Of its course ; Death on the

third day. Lancet, p. 55 : July 1sth , 1859.

Clark e (Le Grog) ,— Successful Deligation of the Subclavian Artery for AneurismOf the Axillary Artery. Med . T imes and Gaz ., April 9th, 1859, p. 365.

Clark e (Le Gros) , -Axillary Aneurism; Ligature of the Subclavian Atterr ;Death ; Autopsy. Ih., 1859, p. 237.

Green — Femoral Aneurismin a Man, seventy-dve years of Age, cured by Pressure .

Brit. Med. Journ ., rst Jan., 1859.

Teale,

— Popliteal Aneurism treated by Compression and Manipulation . Med .

Times and Gaz ., 1859, p. 265.

Childg ,-Popliteal Aneurismtreated by Compression . Ih., 1859, p. 59.

Bone,— Ou a Case of Aneurismof the Right Popliteal Artery, terminating in Re

coverywithout Ligature of the Vessel. Lancet, p. 314, March s6th, 1859.

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308 REPORT ON SURGERY .

artery above the collar-bone, and it immediately ceased when the

v essel was tied . The ligature separated on the nineteenth day, andthe patient recovered rapidly.

CLARKR’s second patient, set. 40, was an engineer, Of dissipated

habits . The aneurism occupied the upper part of the axilla. It

seemed to have commenced four or five months before, suddenly,whilst at work . The subclav ian artery was tied in the third part ofits course . NO chloroformwas given . Secondary hemorrhage occurred Ou the fourteen th day, and recurred several times on the threefollowing days, the patient dying on the fourth. Sec-tic cada veris.

The subclavian artery was completely divided. The ends, half-an-inchapart, and both open, the proximal without anyclot ; but the distalend, one inch distant fromthe aneurism,

contained a semifluid clot.

Semifluid blood surrounded the end Of the vessel and filled the

clavicular triangle . The sac was thin and contained but little clot.In GREEN

’s case, the tumour, the siz e of a small hen ’s egg, was

at the lower end of the superficial femoral artery. Pressure was

made w ith two pear-shaped leaden weights over the upper part Ofthe vessel. A complete curewas obtained.

TEALE treated an oval aneurism,about the siz e Of a small lemon,

in the left hamby digital compression of the femoral artery againstthe pubes, from the 26th to the goth Of October, during twelvehours each day. After this date, a ring tourniquet was applied.

The swelling became a little smaller, harder, and pulsation was lessstrong. November 1 sth and 14th, Tealemanipulated the sac, with a

view to disturb the fibrine within it ; and, an hour and a half afterthe lastmanipulation, pulsation ceased, and the tumour had becomesolid.

CHILD’

S patient was young and healthy . The aneurism at first

filled the ham,bulged prominently, and pulsated v igorously.

After one week’s compression, the tumour had considerably solidified, and a favorable result was expected .

BONE’

s patient, eat. 37, was in broken health fromlong service in

the East I ndies . T he aneurismwas recent. The treatment consisted in compression and the exhibition of salines .

PEMBERTON treated a case by light pressure upon themiddle thirdo f the femoral arterv with a tourniquet, the leg being flexed upon thethigh. In twelve hours the tumour had become hard and perfectlv

free frompulsation, and a perfect cure resulted.

WOUNDS, AND DISEASES OF THE BLOOD-VESSELS .

“Time ’s patient, a coal-whipper, set. 5 1, had noticed the swellingthe ham for one month before his admission . Pressure was applied alte rnately with ameat-weight a nd Bigg

'

s instrument. Not

withstanding great care, on the fourth day, the skin over the artery,at the lower quarter of Scarpa’s triangle, begun to slough ; and

when the eschar fell away, an inch and a-half Of the artery could befelt at the bottomof the wound cov ered by sloughy connective tissue .

Granulation commenced, and on the fourteenth day after separationof the slough, the artery was tied in two places— above and belowthe wound ; the distance between the two ligatures was two inchesand a-half. Good recovery .

The British and Foreign Medico-Chirurgical Re view contains

a case Of popliteal aneurism— a quarryman,set. 24. The aneurism

increased rapidly, inflamed, and suppuration impended. The

femoral artery was tied, with immediate relief— locally and con

stitutionally. Thirty-one days afterwards, when he left the hospital,the tumour had disappeared, except at the upper and inner partOf the ham, where it was about as

.

large as an egg. Somemonths afterwards, it enlarged again , and burst into the kneejoint, when amputation was performed . Death followed on the

fifth day.

In BULTERL’s case the femoral artery was wounded near its

termination with a gouge . Profuse haemorrhage took place, andlife was nearly extinct. Deligation of the vessel in Scarpa’s triangle, four inches above the wound was preferred to searching for,and tying the vessel at the wound . NO secondary haemorrhage .

Recovery.

Hawxrxs’ case is amachinery accident, followed immediately by

great ecchymosis and swelling of the ham, w ith great pain . Four

teen days afterwards, gangrene Of the leg having occurred, amputation through the lower third Of the thigh was performed . The

artery and vein were both found torn across, and the ends w ere

about one inch and a half apart.

310 REPORT ON SURGERY.

DISEASES AND INJURIES OF THE BONES AND JOINTS .

smug — Cases of Acute Necrosis followed by Pyemia. Med. Times and Gaz . ,

s6th and ssd Jan., 1859.

curling— Practical Clinical Remark s on Acute Periostitis. Lancet. Sept. 3d,

1859.

mu g — Die Epiphysentrennung, cine Kranltheit der Entwicldungseit. [On the

Separation of the Epiphyses , a D isease of the Period of Development.](Prager V ierteljahresschrift, vol. i.) Canstatt's Jahrh., r859.

Goga in — Mémoire sur les osteitis epiphysaires des adolescens. [Memoir on Inflammation of the Epiphyaes in Youth.] (Archives Gen. de Med" Nov.) Can

statt's J ahrb., 1859.

Dow n— Consideration snr quelques tumueurs pulsatiles dea Os. [An Investiga

tion of some Pulsating Tumours of Bone.] Thése, Paris, 1859. Canstatt’s

J ahrb . 1859.

Meier ,

— Pulsating Tumour of the Bones of the Right Side of the Pelvis ; Ligatureof the common i liac Artery. (Deutsche Klinik ., 47, 48, Schmidt’sJahrb ., No. 7. i 8s9.

Bowman — Medullary Tumour of the Clavicle ; Successful Removal of the outer

half of the Bone. Lancet, Feb. 5th, 1859.

Flower ,

— Fibrous Tumour of the Scapula, expanding beneath the Bone, and projecting into the Axilla ; Successful Removal . Lancet, July r6th, 1859.

Hamfl tom— Cases of D iseases of the Bones requiring Operation. Dublin Hosp.Gaz ., rat and i 5th June , 1859.

Weber,

— L eber d ie Veraenderuugcn der Knorpel in Gelenk k rank heiten. [On theChanges in the Cartilage in Diseases of the Joints.] (Virchow ’

s Archiv,vol. x i i i, part Canstatt

’

s J ahrb ., 1859.

Bonnett,— New Methods of treating Diseases of the Joints. An Exposition and

Demonstration given at Paris, 1858. J . Bailliére and Son. Paris, 1859.

Schmidt’s Jahrb NO.

Bonnett-Immcdiate Stretching and Cauterisation beneath a Starch Bandage inthe Treatment of Inflamed Joints. (Gaz . des H6p., 90, Schmidt’sJahrb ., No. 3, 1859.

Bryant— Clin ical Lectures on Diseases of the Joints, delivered at Guy’s Hospital.

Lancet, pp. 1 28— 155, r859.

Bryant,— Ou some of the Injuries and D iseases of Joints ; illustrated byCases

fromGuy's Hosp ital. Med . Times and Gaz ., April 2d , 1859.

Sk ey,

— Practical C l in ical Remark s on Hysterical Afl'ections Of the Joints, deliveredat St. Bartholomew'

s Hospital . Lancet, March 1 2th, 1859.

Gjor ,

— On the Formation Of Callus. (Norsk Magaz in, vol. n , parts 1 and

Schmidt’s Jahrb ., No. 7, 1859.

Lawson ,

— Case of Fractured Femur in a Child, and Post-mortemExamination of

the Bone eight week s after the Injury. Med. Times and Gaz ., Feb . r9tb ,1859.

Ferguggom— Ununited Fracture of the Thigh ; Three Operations without benefit ;Amputation . Ih., July9th , 1859.

Kinlock ,

— Surgical Cases. Amer. Journ. of Med. Sciences, July, 1859.

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312 a sroar on snaosar .

Sony,

— Clinical Lecture on Excision of the Knee-joint. April ed, 1859.

Wuh an — Ou Excision of the Knee-joint. Glasgow Med. Journ ., Oct., 1859.

Erich'm— Strnmous Disease of the Knee-joint, w ith deposition of Tubercle inthe Osseous Structures ; Excision ; Death fromErysipelas. Lancet, April 9th ,18

Erichifm— Excision of the Knee. Brit. Med. Journ., March sth , 1859.

Ferg uson— Excision of the Knee-joint w ith a single Incis ion. Ih., Feb. s6th ,

185

fl avors— Excision of the Knee-joint ; Subsequent Amputation ; Death. Med .

Times and Gaz . , July 30th, 1859.

“ loch — Resection of the Knee-jo int for Disease of the Synovial Membrane andCartilages, in aPatientfifty-eight years of age . Amer. Journ. of Med. Sciences,

July, 1859.

Listen — Excision of the Patella. Brit. Med. Journ., Sept. roth, 1859.

Adm — Practical Clinical Remark s on Surgical Openings into the Knee-joint.Lancet, Aug. s3th, 1859.

Dod son — Penetrating Wound of the Knee-joint in a Girl, w ith escape of SynovialFluid ; Successful Treatment by Irrigation. Lancet, Jan. 8th , 1859.

Hodge.

— A Case of llydrarthrosis of the Knee-joint treated by Tapping and Iodineexternally. Ih., Jan. 29th , 1859.

Brigham— Practical C linical Remark s on Diseases of the Tarsus. Lancet. Junei 8th, 1859.

Stillman — Extensive Caries of the 0s Calcis cured by Operation . Ih., April16th , 1859.

Hancock — Practical Clinical Remark s on Resection of the Ankle-joint. lh., Oct.

1st, 1859.

Hum -Excision of the Ank le-joint in a Child for extensive Disease ; Recoverywith a Useful Foot. Ih., April 9th , 1859.

STONE describes three cases of very acute necrosis of large bones,terminating fatally frompymmia .

CURLING advocates the treatment of acute periostitis of deepseated bones by early and free incisions, and illustrates its udvantages by successful cases.

KLOSE describes under this title acute inflammation, commencingin themedullary-membranc, extending to the periosteum, and terminating in the separation of the diaphysis fromthe epiphyses. In

the first stage of the disease, dissection shows hypermmia of the

medulla with scattered apopletic extravasations, and exudationsunder the periosteumwhich partially sloughs . Subsequently suppuration takes place, and the epiphysis becoming soaked with pus,its connection with the shaft is loosened. Death takes place fromexhaustion or pyazmia.

GossnLIN shows Klose’s Epiphysentrennung to be identicalwith Chassaignac

’

s Osteomyelitis,” but considers both namesobjectionable ; the first because it only indicates the consequence

msnasxs AND INJURIES or run BONES AND JOINTS . 313

and not the nature of the disease the second because it has beenhitherto applied to quite another affection . Gosselin agrees withKlosse

’

s remarks on the absence of oil from the pus, a sign uponwhich Chassaignac insists . Gosselin describes two forms— the one

acute and suppurating, the other chronic and unattended by theformation of pus .

BOU ISSON says the characteristic sign of these tumours whichhave been also termed Erectile bony tumours,

”and aneurisms

by anastomosis, is the union of cancerous and vascular elements .

The cancellous tissue is always their primitive seat, the compacttissue is only secondarily implicated. They have an especial preference for the head of the tibia . The existence of true aneurism of

bone without cancer is doubtful, and, at all events, extremely rare .

Pulsating tumours beg in beneath the periosteum, or within the

bony tissue which they expand and destroy . They never attackarticular cartilages, and when they break into a joint it is by an

extension along the synovial membrane . The author shows fromsix cases, treated by deligation of the main vessel of the limb on

which the tumour was seated, that thismode of treatment is useless,and recommends early amputation before the establishment of a

cancerous diathesis .

MEIER relates that the iliac fossa was filled with a firm,pulsating

swelling which also extended downwards beneath Poupart’s ligament, and occupied the whole buttock . In some parts obscurefluctuation was felt. The whole swelling pulsated synchronouslywith the heart’ s impulse, and the pulsation was attended by a

bellows’-sound . The neck of the femur was broken . A pulsatingbony tumour, aneurismof the arteries of bone,

”was diagnosed.

Deligation of the art. iliaca com. was practised as the only meansof checking the destructive process in the pelvis . Directly thevessel was tied the tumour ceased to pulsate and diminished veryconsiderably. On the following day gangrene commenced in the

foot and leg ; it involved the whole limb, the wound also became

gangrenous, and death took place on the thirteenth day after the

In FLownn’s case the tumour formed a rounded projection

in the armpit, which was quite independent of the humerus, butfollowed the movements of the scapula. During its removal itwas found to extend as a broad, thin lamella, bttween the ventral

surface of the scapula and the ribs, nearly to the dorsal border of

314 REPORT ON SURGERY.

the bone ; it was not connected with the axillary margin, as hadbeen previously supposed.

HAMILTON reports three cases of exostosis ; one of the metatarsal bone of the great toe, the other two of the humerus.

One of WEBEn’s principal objects is to explain the intracellular

production of pus and the formation of vessels in diseased articular

BONNE T recommends the treatment of white swellings by immediate extension and canteriz ation beneath a plaster-bandage ; theemployment of an exercising apparatus in distortions of the trunk ,and the embarrassed respiration dependent on them; and the treatment of chronic disease of the hip-joint. Bonnett points out the

difference between traumatic luxations and those which result fromstrumous diseases of the joints . In coxalgia there are two principal positions, in one of which the thigh is commonly placed. It

is flexed and turned outwards, in which case it appears to be lengthened ; or turned inwards, when it seems to be shorter than natural.

Bonnett’s plan consists in the forcible rupture of the adhesion,

under chloroform; the limb is rotated, flexed, and extended duringa quarter or half a hour ; the adductors, flexors, and extensors are

to be cut, if resistant. The limb is afterwards to be retained in a

proper position by plaster of Paris bandages . When bony anchylosis is present, or when the scars of numerous healed fistulas indicate a too strong fibrous union, this treatment is inapplicable .

BONNE'

IT advocates immediate forcible extension in all deformitiesof joints, unaccompanied by organic changes (P). The limb is tobe immoveably fixed for several weeks afterwards. Bonnett treats

subsequent inflammation by cauteriz ation, beneath a starch bandage,w ith caustic potash or chloride of z inc. The application is almostpainless, and the suppuration very slight.BRYAN'

r’s article embraces dislocations and fractures of the

phalangeal joints . Mr. Bryant shows that however praiseworthythe general rule to save as much of the thumb and finger as pos

sible, yet this rule has its limits. Two cases of luxation of the

ungual phalanx backwards and one forwards are narrated. In

compound dislocations of the last phalanx backwards the projectinghead of the second phalanx was removed when the reduction couldnot be otherwise performed. Earlymotion was enjoined to favourthe formation of amoveable joint, but this result was not usuallyobtained.

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316 REPORT ON SURGERY .

ADAxs’

s patient was a boy, wt. 14. Reduction was difficult, but

firmunion was obtained.

Cos'a s has made a collection of recorded cases of emphysematous tumours on the skull, with remarks. These rare tumoursoccur in the temporal region and are due to erosion of the outer

table of the mastoid process, which permits the escape of air fromthe mastoid cells and fromthe tympanum. The characteristic signsare crepitation and tympanic resonance, and the tumour disappearswhen compressed. The surface of the snbjacent bone becomes

LUNN’s patient, a boy, eat. 10, fell down the hold of a vessel a nd

fractured his skull. Symptoms of cerebral irritation having set

in, a portion of bone was removed with Hey’8 saw . Hernia cerebri

followed, and after death . About four ounces of pus were foundunder the duramater.

CURLING’s patient had a fracture in the right frontal region,

loz enge-shaped, about three quarters of an inch broad. It was

caused by the kick of a horse. The patient, an ostler, wt. 40 . The

trephine was applied the following day, and the depressed bone wasraised. No symptoms of compression had occurred ; convulsions

and death on the seventeenth day. Nearly the whole left side of

the belly was found filled with blood, which had been poured out

froma rupture of the left renal vein, near its union with the lowercava.

MURNEx’s series comprises three cases of fracture of the base of

the skull and one of fracture of the parietal bone . In two the

middle meningeal artery was torn ; and in two rupture of the

kidney happened, one of which recovered.

Kmm removed several large portions of bone and other smallerpieces exfoliated. The patient left the hospital in six months withthe wound quite healed.

The Medical Times and Gaz ette’report contains a summary

of the cases which have been recorded during the last six years .

NUSSBAUM describes an abscess in the lower jaw resembling a

cystic growth . He removed a portion of the bony wall with a

chisel and forceps, and effected a cure .

COO'rE’s patient was a wax dipper, azt. 39, and the duration of

the disease was thirteen months . The lower jaw was denuded of

periosteum, quite black, and slightly moveable ; it was sawn

DISEASES AND INJURIES or THE DONRs AND JOINTS . 317

through at the symphysis, and the halves were pulled out separately ;the left condyle remained. The periosteumbegan to throw out

new bonymatter, and a new jaw was in process of formation whenhe left the hospital.

QUINLAN removed the whole of the upper maxilla including thefloor of the orbit. It was laid bare bv two incisions, one from the

inner canthus, along the side of the nose, and through the middleof the lip ; the other from the same point outwards, along the

lowermargin of the orbit. The bone was divided with a chain-saw .

BEREND speaks very decidedly against opemng psoas abscesses ,

maintaining an expectant treatment to be the best. They shouldonly then be Opened when the sk in is thinned and inflamed.

Iodine injections are not to be practised till the diseased conditionof the bone has ceased to exist, and the abscess only remains .

At a meeting of the Société de Chirurgie, Paris, on the 14th

June, the beneficial action of iodine directly applied to carious bonewas maintained by Boinet and Vernueil. Chassaignac and Mar

jolin , on the other hand, held that in abscesses connected withcaries iodine injections were quite ineffective, and the latter relatedthe case of a child with psoas abscess, which be injected twice withiodine ; the second time, at the moment of injecting, the child gavea loud scream, and died two hours afterwards, fromperitonitis and

iodine-poisoning. At the upper third of the abscess the peritoneumhad burst ; the iodine had not reached the carious vertebra.

BIRKE’

I'

I‘reports five cases of fracture and dislocation of the

vertebrae.BROOA reduces the various forms of Pott

’s disease to two heads

tuberculosis of the vertebrae without antecedent inflammation ; and

caries, necrosis, and arthritis, resulting frominflammation of the boneor its appendages . Tubercular infiltration of the spongy tissue of

bones is extremely rare, and he had notmet w ith any instance of it

in the vertebrae ; but encysted tubercular deposits in the vertebmare frequent. The differential diagnosis between caries and tuberculosis of the spine is carefully given .

FRRGUSSON’

S patient had sinuses about the shoulder-joint duringfourteen years . Grating could be distinctly felt on moving the

humerus . The head of the bone, denuded of cartilage and mucheroded, was first removed, and then some exfoliations were takenfromthe glenoid cavity .

BRYANT exposed the joint by a single long incision, parallel to

318 REPORT ON SURGERY .

the fibres of the deltoid ; then cut ofl'

the head of the humeruswith Butcher”s saw . The cartilage had almost wholly disappeared,and the bone was acutely inflamed. The man was up on the

eighth day, and out of doors on the fourte enth.

BRYANT sketches the different forms of dislocation of the shoulderjoint.a r narrates four cases ; the first of which was a severe com

pound comminuted fracture Of the upper part of the humerus . The

lower fragment projected to the extent of four inches through a

large, lacerated wound. Two and a half inches of the bone wereremoved before reduction could be effected. This and the othercases happened in boys . A case of dislocation of the sternal end of

the clavicle is also mentioned. The reduction was not difficult,but the bone constantly resumed its faulty position ; it was sub

sequently kept in place by a truss, and the integrity of the jointwasres

Emcna ’s lecture contains the history, diagnosis, and prognosis

of this disease, which may be mistaken for neuralgia of the

hip, sciatica, spinal disease, coxalgia, and disease of the pelvicbones .

PRIOR reprints several articles, which, during the last two years,have appeared in the Medical Times and Gaz ette’ and the Lancet,

’

on the treatment Of strumous disease of the knee-joint by excision ;on the mechanical treatment Of the limb after the operation ; and onsome of the causes which have occasionally rendered the operationunsuccessful.

WaTSON’s analysis comprises eleven cases which had been treated

in Glasgow, four of which succeeded and sev en failed. Watson

Operates by a single incision across the patella, and he cuts the

bones with a bow-saw in such a manner that the surface of the

femur is convex, and fits into the opposed surface of the tibia, whichhe makes concave .

SOLLY gives an historical review of the operation, with a report ofthe cases treated in St. Thomas’3 Hospital, and directions for the

operation and the after-treatment.EmcnssN’s patient, wt. 80, was a maid-servant. She had alto

gether a tuberculous aspect. The commencement Of the disease of

the knee dated from four years previous to her admission . The

structures Of the joint were extensively destroyed, and there were

large deposits of tubercle in the tibia and femur. She caught

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320 REPORT ON sUROERr .

behind the malleoli, across the instep ; this goes through the skinonly, and should not divide the fascia. He raises the flap of skinthus marked out, dislodgss the peronei tendons frombehind theexternal malleolus, one inch above which he divides the fibulawith bone-forceps, and removes it, after cutting through the inferiortibio-fibular ligament. The foot and leg are now turned on the

outside, and the tendons of the flexor communis digitorum and

tibialis posticus are dissected from the malleolus internus, after

which the internal lateral ligament is divided . The end of the tibiais now to be dislocated through the wound, and removed with an

amputating saw ; and afterwards the upper articular process of theastragalus is sliced off with ametacarpal saw placed between it andthe tendo-Achillis . Hancock remarks that the success of thisoperation depends on not injuring the anterior and posterior tibialarte ries, and on no account should the sheaths of the tendons beopened .

HANCOCK’S patient, a boy, set. 6, who had had slight pain in the

ankle for several months, leaped froma wall and injured the painfuljoint, which became acutely inflamed. When admitted into

hospital, there were sinuses leading to the interior of the joint,which was disorganiz ed. The articular surface of the tibia, withboth the malleoli and the astragalus, together with the upper articular surfaces of the os calcis, and a large portion of its cancellous

tissue,were removed . Six months afterwards he could stand and

walk without pain . The wound was quite healed.

NEW-GROWTHS AND CYSTS.

Birk ett,— Contributions to the Practical Surgery of New Growths or Tumours,Series i i i . Cysts. Guy’s Hosp. Reports, vol. v , pp. 247

— 2 79.

Guzman — Report of Cases occurring in Pithe ’s Clinie,’ 1854-9.

Johnson ,

— Sebaceous Tumour causing Absortion and Perforation of the Cranium.

Brit. Med . Journ ., March, 1 2th, 1859.

Foncher,

— The Treatment of Cystic Tumours by the Application of SulphuricAcid. (Rev. de Thér. Méd. Chir. No. 2 , Schmidt’s Jah rb ., No. 6,1859

BIRKE'

I'I‘reports a series of cases Of cysts Of the skin andmucous

orifices . He says, sebaceous cysts Of the scalp are peculiar in having a

dense horny capsule in contactwith the tunica propria. This is notthe

srrn rms . 321

true cyst-wall altered by pressure, as formerly supposed, but it consists of laminated epithelium

,as was demonstrated by Prescott

Hewett in his lectures at the Royal College of Surgeons . The ex

cision of the fibrous tunic does not seemto be so necessary in these,as in other tegumentary cysts ; but when large and Of long duration,and when they have been inflamed, its removal 1s necessary. He

points out the resemblance of some cystic and follicular growths whichhave suppurated, and are filled with granulations, and which exude afetid sanies, to some varieties of cancer, and insists on the excision of

every portion Of the new growth . Small growths fromthe mucousfollicles Of the lip occasionally simulate epithelial cancer, and Birkettthinks many cases Of ulceration Of the lip stated to be cancer, havebeen Of this nature . He thinks that ranula, formed by dilatationof Wharton’s duct, is extremely rare, and he does not record anycase of this kind. He believes that, in most instances, sublingualcysts depend on a morbid state Of Rivini

’s glands which are small

vesicles in the mucous membrane Of the floor of the mouth, and at

the sides of the tongue . The injection of stimulating fluids Oftenfails, and the most certain mode Of cure is, by exciting suppuration .

GuNTER’s report includes three cases of unusually large ranula.

In two of them, a bristle could be passed through the orifice of

Wharton’ s duct into the cavity of the cyst.

JOHNSON’ s patient had a small subcutan eous dermoid cyst”

(Lebert) upon the forehead. It adhered firmly to the periosteum,

and after its removal, a perforation was found in the subjacent bone .

FOUCHER firmly presses a pen dipped in the acid upon the centreof the swelling for four or five minutes . Simultaneously w ith theseparation Of the eschar, the cyst itself becomes separated from the.

surrounding tissues, and both may be pulled awav together withoutpain or bleeding.

SYPH ILIS .

Lee — Clinical Lecture on Syph il itic Inoculation. Lancet, Jan. soth, 1859, p. 103.

Ricord,

— Lectures on Chuncre , del ivered by .\i . R. , Surg. to Hap. da M idi, Paris.Published by Mr. Fourn ier, w ith Notes and Cases and translated fromthe

French by C . P. Maunder, &c. 8vo, cloth, 8s. London, 1859, J

Church ill.

LEE teaches that those primary syphilitic sores which are characterised by specific adhesive inflammation, and which do not, unless

21

322 REPORT ON smneaar .

irritated secrete pus,are not readily inoculable in the ordinary way

but that the same sores, when irritated, do furnish a secretion,

inoculation w ith which produces some formOf specific inflammation .

RICORD insists upon two distinct kinds Of chancre -the simpleand the infectingfof these the simple chancre is the more commonit is very often multiple ; and occurs upon all parts of the bodyexcept on the head. It is in the highest degree contagious, and

confers no immun ity agai nst subsequent ones . Its propagation isfavoured by a breach of surface in which case the inoculation is

immediate ; but, the unbroken surface of the sk in ormucous membranes maybecome vesicated in consequence of the acridity of thechancrous pus, and the cuticle being raised, the denuded surface is

contaminated ; this is what Ricord terms “retarded inoculation .

”

Chancrous pus long retains its virulence . Ricord has inoculate dsuccessfully with pus, which had been preserved in a stopperedbottle during seventeen days . Both the simple and infectingchancres commonly, though not invariably

,commence as pustules .

The diagnosis is founded on the state of the base, and of the nature

of the buboes which accompany them. In the simple chancre this issoft ; or if it be firm,

its hardness resembles the brawny consolidationaround a boil, and is very different fromthe cartilaginous indurationOf the infecting chancre . The bubo froma simple chancre is acute ;it occurs in the superficial glands Of which one only is inflamed, andthis does not contaminate its n eighbours . Itmaybe caused— first,

by simple irritation, in which case it is a simple adenitis thatmavbe resolved, ormav end in abscess or, secondly, itmay result fromthe. direct tran sm1ssion of virulent chancrous pus fromthe surface of

the sore along the lymphatic vessel to the interior of the gland

which’

it inoculates . The gland thus contaminated, necessarily suppurates, and furn ishes a v irulent pus . The edges Of the simplechancre are perpendicular as if punched out it tends to spreadsuperficially, and is more prone to phagedena than the induratedone . The only certain s ign is its inoculability . The simplechancre is a local, and never a constitutional affection hence localtreatment is alone necessarv . The destruction Of the specificity Of

the chancre, and its consequent change into a simple ulcer, is

best attained by cauteriz ation . For this purpose, Ricord prefers a

paste made by mixing sulphuric acid with vegetable charcoal. If

cauteriz ation fail, or it be objected to, simple astringent lotions willsuffice in case the chancre be not spreading ; but if it extends, the

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324 REPORT ON SURGERY.

ration is present, Ricord gives mercury at once . He prefers thei nternal exhibition

, but when this is inadmissible, he employs inunction or fumigation . Salivation is not desirable, but if it shouldhappen , he arres ts it with chlorate Of potash, two scruples to one

drachmof which are to be given daily. The mercurial is followedby a course of iodide of potas sium, one scruple to three scruplesa day. In a resume Of these lectures, Ricord teaches the unity of

the syphilitic virus, and the existence of a second venereal or chan

chrous pus, which gives rise to the simple chancre, and is independent of syphilis. The latter half of the book is an appendix of notes

and cases,to which is tacked on a description of a urethrotome con

trived by the translator.

TETANUS .

Erichgon ,

— Practical Clinical Remark s on Tetanus. Lancet, Feb . a6th, 1859,

p. 206.

Canton — Traumatic Tetanus froma Lacerated.Wound of tbe Forearmand RadialArtery. Treatment by Belladonna and Chloroform. Fatal result. lb Feb . 5th ,

1859, p. 133.

Hugheg— Traumatic Tetanus follow ing a Simple Fracture of thePore Arm. Median

Nerve found stretched over the spiculated upper fragment of the U lna. Dublinllosp. Gaz ., Feb . 1st, 1859.

Cm; ot‘ Traumatic Tetanus. Glasgow Med . Journ ., July, 1859, pp. 197

— 304.

H‘Ghie,

— Two Cases of Traumatic Tetanus. Ih ., Oct. 1859. p. 32 1.

ERICHSEN advocates the division of the nerve leading fromthe.wound in acute traumatic tetanus .

HUGHES relates that a girl, act. 7, fell and broke her forearm.

She w ent on well for several days, when acute tetanus set in, and

death took place two davs afterwards . The median nerve was

found stretched over and 111 close contact with the spiculated superior fragment of the brok en ulna .

T he Glasgow Medical J ournal’

gives a report of three cases ;

one treated with cannabis indicus, one with chloroform, and one

with digitalis . All died.

In both M‘GmE’s cases tetanus followed a severe crush of the

foot, and both were treated w ith cannabis indicus . One recovered .

D1SRASES AND WOUNDS or THE EYE, ETC . 325

DISEASES AND WOUNDS OF THE EYE AND ITS APPENDAGES .

Dixon — A Guide to the practical study of B iestes of the Eye . Post 8vo.11t 9s.

London, John Churchill.Coupon

— Ou Wounds and Injuries of the Eye. 8vo. cloth u s . M Johu

Churchill.Kath — On Diseases of the Rye, theirmodifications, &c., as observed in India.

Brit. l ied. Journ.. Jan. 15th and s ad. 1859.

SicheL— Ou Epithelium of the Eye and its Appendages. (Caz . Hebdom. 1858,

vol. v, pp. 9, Schmidt, Jahrb. , No. 7. 1859.-Re .

°herchcs sur les ophthalmies contagieuses. Quelques mots sur

les urethrites contagieuses. [Researches in the Contagious Ophthalmic . Afest words on Contagious i nflammations cf the Urethra.] Thése, p. l . d. in11amParis. Schmidt's Jahrb” No. 4, 1859.

Vu no ,

— Betrachtung iiber die Entwick lung’s uud Verbreituugswcise der Ophthalmia granulosa, purulenta, contagiosa. [An inquiry in to the Origin and

Mode of Propagation of Granular, Purulent, Contagious Ophthalmia.] Ans.

Prat. Phiry's Klinik .) Journ. de Méd. Bruxelles. Canstatt

’s Jahrb., 1859.

Da da — Que lques considerations sur la nature de l'

ophthalmie militaire par rap.

port 3son apparition dans l‘armée danoise en 1851. [Some Reflections upon

the nature of Military Ophthalmia with reference to its appearance in the

Danish army in M6111. presenté an Congres d'Ophthalmologic dc

Bruxellea, session 1857. Copenhagen, 1858. Canstatt's Jahrb., 1859.

VdmfinL— Ueber die in Pueselier Bataillon dea lt. Prensa. Frans. Regiment'sbeobachteten uud behandelten Erk rank ungen der Conjunctiva. [On the Diseasesof the Conjunctiva observed and treated in the Pusilier Batallion of the RoyalPrussian Franz Regiment ] (Deutache Klinilt. No. Canstatt

's Jahrb .,

l359~

— Bericht dea Prof. Bends an des k . daenische Kriegsministerium ilber

die Verhandlungen des Opthalmd ogischen Congresses zu Bruessel, 1857, die

Militaer Augeultrank heit betrefi‘end. [Prot

’

. Beudx’s Report to the Royal

Danish Wmhi inh try on the Proceedings of the Ophthalmological Congress.held at Brussels, 1857. w ith reference to Military Bye Diseases.) (DeutscheKlinik , No. Canstatt

'

s Jahrb., 1859.

Warm — Die sogen Ophthalmia militaris auf den Congress ah Bruessel.

Antwort an J. P. Vlemiuelts . [The ao-called Military Ophthalmia, at the

Brussels Congress. A Reply to J. F. Vlemincka ] Annales d 'occuliat, Mai,Juin, vol. s ar is . Canstatt

’

s J ahrb.. 1859.

PgulL— Mémoire sur la nature de l‘Ophthalmie d’Egypte. [Memoir on the nature

of Egyptian Ophthalmia.) War-126m. 1858. Canstatt’

s Jahrb., 1859.

am en— De Ophthalmia z gyptiaca. [On Egyptian Ophthalmia.] Dias. lu ng.

Birn i. S. in 8. Canstatt’

s Jahrb., 1859.

l imer ,

— Binspruch snr Abwehr irriger Lehrsaetae bei Beurtheilung der con

tugioesenAngenliderlxranltheit ; nebst cinen dareut’ folgenden De iik schriftueberdenselhen Gagenstand. [A Protestation against Faulty Principlu relative to theContagious Disease of the Eyelids ; with a consequen t Memoir on this con

dition ] Annalee dea Charite-Kranltenhauses u. s. w. z u Berlin. vol. viii, Jahrgs3Heft. Canstatt

'

s Jahrb ., 1859.

REPORT ON SURGERY .

Costetti,— Ueber die Ophthalmia militaris 11nd ihre Behandlung. [On MilitaryOphthalmia and its Treatment.) Lo Sperimentale, No. a, Febr. Canstatt

's

J ahrb ., 1859.

Cordier ,

— Etiologie de l’Ophthalmie purulente spontanée. Considerations sur as

nature et son traitement. [The Etiology of Spontaneous Pendent Ophthalmia.

Reflections upon its Nature and Treatment.) Thaas p. l. d. de Méd. Paris.

Csnstatt’s Jahrb ., 1859.

Stenwag Von Cafi om— Ueber die Behandlung dea Bindehautschleimflusses beiNeugebornen und Kindern. [On the Treatment of the Conjunctivitis of the

New ly Born and of Children.) Jahrb . fuer Kinderheilk . vol. xi, No. 3.

Canstatt'

s Jahrb., 1859.

De Conde ,

— Ueber e ine neue Behandlungsweise der Ophthalmia pnrulenta. [Ona New Mode of Treatment of Purulent Ophthalmia.) (Ann. de la Soc. de

Med. d’Anvers. Sept.) Canstatt

'

s Jahrb ., 1859.

De Condo,

— Ueber ein neues Curvent'

ahren bei der Ophthalmia pnrulenta. [On a

New Method of Cure in PurulentOphthalmia.) (Annales d’oculist. Jul., vol. xl.)

Canstatt's Jahrb ., 1859.

Wilde,

— On Gonorrhceal Ophthalmia. Med. Times and Gaz ., Feb . 2 7th, 1859.

Pack — Inoculation des blennorrhoischen secrets als Heilmittel dea Paunus. [Onthe Inoculation with the Blennorrhceal Secretion as ameans of CuringPaunus.)(Lo Sperimentale de Pirenz a, Jan.) Canstatt

’

s Jahrb., 1859.

um oL— Pannus der Hornhaut. Heilung durch inoculation blenorrboischenSecrets. [On the Cure of Pannus of the Cornea by Inoculation with Blennorrhceal Secretion.) Schre iber an Prof. Paoli. (Lo Sperimentali di Pirena ,

Oct No. Canstatt’s Jahrb ., 1859.

Hancock — Cases oi‘ Gonorrhmal Ophthalmia cured under Stimulant and Supporting Treatment. Lancet, Sept. 1 2th, 1859.

Hulme ,

— Obstruction of the Lachrymal Passages. A newmode of Treatment byD ilatation .

” Med. Times and Gaz ., May, 2 1st, 1859.

Wharton Jones,— Unguentumsulphuris as a Remedy in Granular Ophthalmia.Med. Times and Gaz ., Jan., 1859.

Pean,

— Ou a peculiar Tumour oi'

the Cornea. (Gas . dea Hdp., 1859, No.

Schmidt’s J ahrb ., No. 9, 1859.

Noiz ot, — Ou Staphyloma Posterius. (Gaz . Hebdom., 1858, No, 1 7, 2 1,Ih., 1859,No. 1 .

J aeger ,

— Glaucoma and its Treatment by Iridectomy. (Wien Zeitschr. 1858.

n . F. 30, Schmidt's Jahrb ., 1859.

Hildige.

— Ou a Case of Intraocular Hemorrhage consecutive to the operation forCataract by Extraction. Lancet, Sept. 1 7th, 1859.

DanielL Suppurative Iritis and Continental Practice, with its results. lb

March a6th, 1859.

Geiu ler ,

— Hmmeralopia and its Treatment. A Report of Papers , &c., by Deval,goussagrives, Baiz eau, Doumie, B espout, Netter. Schmidt’s Jahrb ., 1859,o. z .

Know n— The Oblique Illumination oi

‘

the Eye as a diagnostic aid. (DeutscheKlinilr, 1858, No. l b.

Oman da Villards,

— Ou the Difi'

erent Kinds of Exophthalmos. (Ann. d'oculist

Sept. et Oct , lh. , No. 3.

Foucher.

— Ou a Peculiar Formof Orbital Tumour. Caz . des H8p., 1858,No. 141,

lb .

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328 REPORT ON SURGERY.

WRARTON JONES scarifies the conjunctiva, and then insinuates a

small piece of the sulphur ointment of the Pharmacopoeia beneaththe upper eyelid, which he rubs over the eyeball with the finger for

a minute or two, in order to spread the ointment over the wholeconjunctiva. Jones was led to employ the ointment by the ideathat the disease might depend on, or bemaintained by the presenceof a parasitical organism.

PEARCE says, the development Of the tumour is attended by indammatory symptoms. The growth fills the ante rior chamber, andis connected with the cornea and sclerotica at their junction, whichseems to be its starting-point ; corresponding to it externally a

ciliary staphyloma (P) appears . If the front Of the globe be te

moved, the posterior part is found to be healthy. The growth issemitransparent, semi-elastic, and homogeneous .

Norm remarks that the very frequent occurrence Of posterior sta

phyloma inmyopia renders it important that every surgeon should befamiliar with this condition . His description Of this afi

'

ection is verycomplete, and embodies the results of forty dissections byFrench andGerman observers. The antero-posterior diameter of the globe isalways lengthened so that it has more or less the shape of an egg or

pear. The staphylomatous projection when single, which is mostcommon, is always at the outer side of the optic nerve, encircling it.Occasionally the nerve is compressed or pushed to the inner side Ofthe fundus . It has been found atrophied. When a second staphyloma coexists at the inner side of the optic nerve, it is alwayssmaller than that at the outer side. The whole posterior hemisphere has been found projecting, with the Optic nerve inserted intothe centre like a stalk. The sclerotica is much thinned, like paper.

Seen fromwithin, the staphyloma is marked by a pearly-white spot,rarely Of a dirty-yellowish colour. Early in the disease its shape isa crescent, accurately encircling the margin of the Optic nerve at itsouter side . As the white spot enlarges it loses the crescentic shape,and its edge is ill-defined. The sclerotica always retains its fibrousstructure . The choroid is stretched, and has lost its pigment. In

advanced cases there are black patches at the edge of the whitespot ; they are irregular collections of new pigment. T he retina

generally preserves its integrity, even over the pearly-white spot,except in very advanced stages of the disease . The vitreous humouris more fluid than in health, and the back of the lens becomesmore opaque in advanced cases.

DISEASES AND wounns or run are , are . 829

Symptome — Noiz et follows Jiiger’s division into three stages .

rst. The eyes soon tire ; and after looking at anything for a little

while lachrymation occurs, and a sensation Of tightness in the eyeball is felt. Objects are distinctly seen . By far the majority of

patients are shortsighted. The optic entrance embraced by a whitecres cent. 2d. Myopia notably increased. The elongation Of the

antero-posterior axis is apparent when the eye is turned stronglyins towards the nose. The white crescent enlarges at its con

vex border. T he macula lutea is yet aintact. Looking at near

Objects, even with a concave lens, is painful . 3d. The secondaryphenomenamake their appearance . These are varying dimness Of

v ision ; great sensitiveness to light ; dark spots and clouds ; pupilsluggish and dilated ; anterior chamber large.

Slapfiyloma posterius is a common disease . It Occurs most frequently in young persons.Nature — Widely difl

'

erent opinions are held. Sichel regards itas an inflammation Of the choroid. J tiger assumes an intra-uterinesclerotitis as the cause. Arlt mechanical distension by muscularpressure . Graefe designates it sclerO-choroideitis post. Noiz et

retains the name originally given it by Scarpa, Staph . post., whichinvolves no theory.

Treatments — Careful avoidance of all occupation which demandsefl

’

orts of accommodation, attention to the general health, and localabstraction of blood.

JAGEB. understands by glaucoma that morbid state Of the eye in

which, with or without inflammation, in addition to the symptomsrecognisable by the unaided eye, excavation of the Optic nerve

exists . J tiger considers the arterial pulse Of little value, because itis not in direct proportion to the degree Of tension of the globe, andOccurs in other diseases. The excavation of the entrance of the

Optic nerve cannot be dependent on intraocular pressure, forthe following reasons. 1 It frequently occurs without increasedintraocular pressure. 2 . It does not take place in other inflammatoryand other proces ses which are attended with increased ten

3. It does not lessen after iridectomy, whilst other staphy.

lomata recede after this operation . The res ults Obtained by Jtigercoincide with those by Graefe, only he does not give quite as favorable a prognosis in acute glaucoma.

B ILDIGE relates that the hemorrhage began during vomiting an

330 REPORT ON SURGERY .

hour after the Operation, and continued for upwards of twenty-fourhours .

DANIEL gives a critical review of three cases of suppurative iritispublished by Dr. Hildige, in the ‘Dublin Hospital Gaz ette,’October 15th, 1858. Daniel remarks that the disease is quite unknownin this country . He recommends a tonic treatment, and deprecatesparacentes is of the comes and iridectomy, which had been employedbyArlt and Jager, under whose care the cases had occurred . Danieldoubts the value of iridectomy in glaucoma.

KiiCE LEB strongly recommends the Oblique illumination of the

frontof the eyeball, by throwing a cone Of lightupon it with a convexlens, when a careful examination of the cornea, iris, &c., is usees

sary.

CARBON DU VILLARD follows the usual division of this subjectinto the following heads, which are illustrated by cases. 1 Emphthalmus caused by change in the bony tissues of the orbit. z .

Exophthalmus caused by tumours in the orbit. 3 Exophthalmuscaused by tumours in the neighbouring bony cavities. 4. Trau

matic exophthalmus. 5. Haemorrhagic efl’usions not traumatic in

origin .

FOUCEER reports a case Of a very remarkable tumour at the innerpart Of the roof Of the left orbit, which he supposed to be a dilatation of the ophthalmicGIOPPI

’

s patient was a woman, aft. 42 . The symptoms appearedsuddenly during labour . All the chief signs of aneurismwere pre

sent. The pulsation and bruit ceased when the carotid was com

pressed, and the eyeball receded . Digital compression was maintained by relays of dressers . Four days after wards the patient wasfree fromthe beating and rushing, and the bruit could not be heardw ith the stethoscope . The tumour gradually diminished.

VANZl-rrn ’s case, also a woman, act. 49. She had had dilatation

of the heart and aorta for five years . The orbital aneurismappearedafter the third paroxysmOf a severe intermittent with cerebral con

gestion . A cure was also Obtained by digital compression .

TO these a notice is appended of published cases of protrusion of

the eye by dilatations Of the orbital vessels, by WINTER.

WORDSWORTH says, the cyst had existed during several years ; itprojected fromthe roof Of the orbit, and had thrown the eye for

wards and outwards . Its close relation with the eyeball, and its

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332 REPORT ON SURGERY.

and causes of contractions of joints. His analysis Of the complicatedcontractions of the tarsus is based on the assumption of two joints,with independent motions and separate axes between the leg and

the foot. Of these— the upper one, called by him the springjoint,

”has flexion and extension ; and the lower one, the foot

joint, abduction and adduction . The contractions are grouped inthree series

I .-Coutractious of tile Sp ri ng Joint.

1 . Pee fierw .— The foot is kept in a pointed position chiefly by

the approximation of the bones Of the leg, by reason of the decreesing breadth poste riorly of the trochlear surface of the astragalus,which become fixed by fibrous adhesions . The posterior portion of

the trochlea, wedged between the bones, forms an angle with theanterior portion which projects beyond the bones of the leg, and

gradually loses the character Of an articular surface, and becomesadherent to the capsule.

2 . Pee er tensus .— The heels point downwards, the toes upwards .

A lateral displacement of the astragalus, upon which common clubfoot depends (according to Cruveilhier and Stromeyer), does not

occur.

IL— Gmtractions of tile Foot J oint.— (Calcaneo-astragaloid.)

1 Pea adductus .— The toes are turned inwards ; the inner border of

the foot looks upwards, the outer downwards. In excessive adduction, the astragalus presses on the SustentaculumTali, and causes

its absorption a defect which Henke has found in all preparationsof club-foot. The ante rior articular surface of the astragalus en .

larges in the inner side, and becomes impressed so as to forman

obtuse angle with the neck Of the bone . This change is broughtabout by the inward displacement Of the scaphoid bone.

2 . Pee abductus .— The most important change lies in a subluxa

tion Of the scaphoid upon the astragalus . The inner border of thefoot looks downwards, the outer upwards . The foot is pointed outwards and somewhat upwards .

3. Pee inf er na — An excessive arching of the sole of the foot.

4. Pee recursus.— The inner border of the foot becomes flat, the

outer convex. The plantar muscles are too weak to support theweight of the body.

ORTIIOPE DIC SURGERY

III .— Cbm_pound Contractions .

1 . Pee fiestas, adductus, inf er no, or p . earns — The most common form Of distortion . T he distinction of a simple varus, and

equino-varus, is considered unnecessary, because there is no case of

varus in which the position Of the ankle-joint is not that Of equinus .

The cuboid bone is twisted inwards upon the 03 calcis .

2 . Pcsfiemus, { ft/Imus or p . egw’

ans, does not occur as a congenital

deformity.

3. Pee er teusus, infiez ua, or p . calcaneus .

4. Pee abductor, infier us .— Exceedingly rare . Henke ack now

ledges this formonly froma drawing by Little .

5 . Peef er ns , abductor, rqflerus, or p ea valgus .— Flat-foot. In

all recent cases Henke recommends Boeser’s plan of treatmentwhichconsists in overcoming the contraction Of the antagonisticmuscleswith chloroform, bending the foot into the position Of equino-varus,and fixing it so with a plaster bandage .

6. Pee cr tens us, abductua, refi n e — An exceedingly rare form.

The dorsumOf the foot lies upon the front Of the tibia.

HEIBERG reports thatthe valgus was due to weakness Ofthe plantarligaments and aponeuroses, con sequent on rheumatism. Heibergsought to Obtain contraction of the relaxed fascia by the introduction Of an irritant ; and from previous experience, he employed forthis purpose wooden pegs, which he introduced through the canulaOf a trocar, and then snapped themshort Ofi

'

,closing the wound with

collodion . One was placed in a line fromthe heel towards the greattoe, and another fromthe same point towards the little toe . Suppuration with cicatriz ation and contraction Of the fascia took place,and the valgus disappeared. The operation was repeated on account

of a too great laxity Of the ankle joint, in consequence Of whichin walking the foot had a tendency to twist outwards . One

peg was introduced in front, and another behind the malleolusinternus . Moderate reaction ensued and convalescence was established, when tetanus supervened.

(The patient escaped with his life and the cure was imperfeet.— TRs .)DELOSE shortly gives the signs, causes, and treatment of this

deformity, and reports a few cases .

BRODHURST’s case is a badly-un ited fracture of the femur. The

rectus fem. was so contracted, that the knee-joint was nearly im

3349 REPORT ON SURGERY.

moveable . The tendon was divided subcutaneously about twoinches above the patella, to avoid wounding the bursa . The legcould be subsequently flexed at a right angle, and the motion of the

knee was so far free .

BORELLI says that, on extending the forearm, a tight threadcould be felt under the skin at the spot where the vein had beenopened. T his was divided subcutaneouslv, and extension was at

once accomplished.

DENTAL SURGERY .

Tama r-A Systemof Dental Surgery. sro. cloth. London, John Churchill.

Grimshaw ,

— Lectures delivered in Steeven's llospital, Dublin. Dublin Hosp.Gaz ., 15th June, 1st and 1sth July, 1st Aug., 1859.

Bun k — Die scrupbulose Zahnafl'

ection. [Scrofulous Affection of the Teeth.)Leip z ig, 1859. Canstatt

’

s Jahrb ., 1859.

Ton xs’

richly illustrated manual embraces descriptions Of the

development and irregularities, the minute structure, and the diseaseOf the teeth, with their treatment.Bnucx makes a distinction between scrofulous cases and that

fromother causes . He adopts an anatomical classification of dis

eases of the tooth-pulp.

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336 REPORT ON n rnwrraRv , ETC .

uterine sinuses . T he term maternal portion Of the placenta,he rejects altogether.

PRIESTLEY’S lectures on the development Of the gravid uterus

contain a summary Of the more important recent res earches on thissubject, with which are incorporated the results Of personal Observations . The histology Of the subject has received particular attention in this work .

In reference to the early development Of the placenta, Priestleyfound in an ovumOf the second month that the villi Of the chorionrooted in the decidua serotina became each of themsurrounded byamaternal vascular loop, which ramified into capillaries around thechorion villus . He concludes that by continued growth these ca

pillaries increase in siz e and number, and each chorial digitationbecomes wrapped in the coats of the mother’s vessels . On the

condition of the interior Of the uterus after delivery he Offers the

following conclusions : The muscular substance of the uterus is

nowhere laid bare, nor is there anyinflammatory false membranespread over the surface when the membranes are thrown Off at the

end of labour, a portion of the decidua remains attached to theuterine surface, as a protection again st external agencies ; a new

mucousmembrane begins to be formed in the lattermonths Of pregnancy between the decidua and muscular coat, which undergoes a

rapid development after the uterus is emptied Of its contents ; and

as it is gradually perfected it assumes the functions of the original

mucous coat. T he work is illustrated wi th numerous drawings on

wood.

Scnwa z’

s essay is an inquiry into the causes, nature, and

effects Of respiratory movements Of the fcetus before complete delivery has occurred . Dubois had Obser v

ed that compression Of the

funis excitedmovements on the part Of the child, and that when ,the compression being continued, the mouth approached the ex

ternal genitals, inspiratory efforts took place, and air, or in breechcases

,meconium and amnionic fluid, pas sed into the air-passages .

Krahmer pointed out that fmtal respiratory movements have an

effect varying according to the surrounding medium, and the pa

tulous or non-patulous state Of the respiratory orifices . Thus, theOpenings being free and the foetus in the amnionic fluid

,the

latter will pass into the lungs . If the openings be closed, the enlargement of the chest will produce certain alterations in the lungs,traces of which Krahmer professed to have seen . Inspiratorv

PREGNANCY AND PARTURITION. 337

efforts are produced, according to Krahmer, by access Of cold air tothe skin, or impediment to the umbilical circulation .

From the fact that the placenta is the mediumof respirationfor the fmtus, it is argued that respiratorymovements are a constantresult of impeditmmt to the fcctal placental circulation .

The alterations in cases ot’

asphyxia neonatorum arc to he sepe

symptoms of gaseous poisoning of the blood ; the other, theeffects ofmechanical disturbances Of the circulation . Themuscularaction of the uterus is the chief cause of impediment to the fcs tal

inspiratory efforts follow, and these being fruitless, life becomesextinct, the meconium escapes , &c. The author believes that therhonchus heard in stillborn children in process of being recovered

also,meconium, blood, &c., have been found in the bronchial tubes .

The meconium and urine are evacuated, as a rule, in stillbornchildren before or during birth. The absence Of this phenomenonis not conclusive as to the fact of the fmtus being still alive ; its

presence indicates death or danger thereof.

TREArrs ss, PAPERS , are , nAv REPERENCE TO SPECIALBRANCHES or OBSTETRICS.

ON PREGNANCY AND PARTURITION,

IAN — Prolonged Gestation . Gas. dea ildp., 61 , 1859. (Set , 9. p.Case ot Protracted Gestation . Boston Jour" 40,

36

na di

r-23: Schwargerscbalts diagnostik. [On the Diagnosis of Pregnancy.)

Mom-Sch . f. Gehurtsh, xii, p. 40 1 , Dec., 1858. (Sch . 3,

Kuh n — Der Muttermund der En tgeschwfingerten amEnds der Schm gu'sebl fi .

[The Os Uteri of Primipara at the end of Pregnancy .) Mom-Sch. t. Geb.,

xiv, 33. (Sch , 1 1,

l iattbews Duncan — Os the Cervix Um! in Pregnancy. Edin. Med. Jour.,bla ck and April, 1859.

“ mm -New Tests for the Kiestcine of Preguau y. M B, fi t,

18

Bohma-Beitrl ge sur Lebre von der Entstehung and Bcdcutun; dea Nabsl

scbnurgesi asches. [On the Cause and Significance of the h nic Senna ]Scamat

'a Beitri ge, vol. iii, p. 173. (Canst., vol. iv, p.

338 REPORT ON mmwrrERr , E'rc.

Mattel — On the Diagnosis of Pregnancy. Journ. dea Conn. Méd Ch in , July andSept. (Canst., vol. iv, p.

k enhanu r ,— Ueber die Herz tiine der Frucht, und ihre Benutz ung z nr

Diagnose dea Lebens, der Stellung, der Lage n. dea Geschlechts derse lben[The Sounds of the Fa tal Heart as Diagnostic of the Vitality, Position, andSex of the Pa tna ] Mon. Sehr. f. Geb ., xiv, 161. (Sch., 12 ,

Adams — Ou Fa tal Auscultation . Med. Times and Gaz ., vol . xiv. p. 615.

t riem— Ou the Retrogression of Labour. Gaz . dea llfip., 1858, No. 12 .

Schubert — Ou the Phenomena of Delivery, ac. Bull. doWho. do Med. de Belg.,a ser., i, 5. p. 335. (Canst., vol. iv, p.

Simpson.— Ou the Nature of Spurious Labour-pains. Edin. Med. Journ., Oct

1859-9-37 1 .

Bnfignon— Ou the Prevention of Laceration of the Perine umduring Delivery.

Gas . dea H6p., 70, 1859. (Sch ., 8.

Bohnltu ,

— Ueber Erhaltung und Zerreissnng dea Dammes bei der Geburt. [OnLaceration of the Periae umduring Delivery.] MomSch. f. Geh., vol. xii,

p. 341. (Sch , 6, 305, and Canst., vol. iv, p.sm oni — Zerre issung der rechten Synchondrosis sacro-iliacs wi hrend der

Geburt. [Laceration of the Right Sacra-iliac Synchondrosis during Labour.)Allg. Wien. Med .

-Ztg., 8, 1859. (Sch , 7.

Bishop— Case of Extensive Emphysema occurring during Labour. Lancet, 1859,

vol. i. p. 41a.

In one Of LIEOARD’S cases pregnancy was presumed to be pro

longed thirty-eight days, and in another the term extended to 303days . In the case of protracted gestation, pregnancy had lasted

330 days . The osseous systemwas remarkably developed.

HECKER finds that, as a general rule, the os uteri is open and

pervious shortly before labour begins ; in a primipara the perviouscondition may in most cases be tak en as a Sign of approachinglabour. In a multipara also labour mayin most cases be expectedfourteen days after the pervious condition has been arri ved at.

Hecker's conclusions are founded on Observations on 7 23multiparae and 2 23primiparae.

HUTER, in order to determine the disputed point as to whetherthe 03 uteri is open or not in primiparse at the end of pregnancy,examined the condition Of the OS uteri at the end Of pregnancy in1000 primiparas. The general conclus ions are, that in most cases,the external 03 uteri opens in the last four weeks of pregnancy ;that in most cases the internal OS uteri Opens i n the last week

before birth, and that in only a few cases the external 03 uteri

remains closed up to the period of the commencement of labour .

In multz'

parce the os uteri,internal and external, opens a little

earlier.

Marrunws DUNCAN states that— 1 The law/l of the cavity of the

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340 REPOR'

r ON mnwrrERr , are .

With reference to the nature Of spurious labour-pains, SIMPSON believes that they have their seat in the uterus itself, and are produced,like true labour-pains, by contraction in the walls Of the uterus .

BUTIGNOT recommends that in cases where the vaginal outlet is

so narrow that laceration is threatened, small incisions be made on

one or both sides,near the posterior commissure Of the labia .

In ScHUL'rz E’S essay the mechanism Of the causes or circum

stances leading to perineal rupture are pointed out.SCANZONI relates the particulars of a rare Obstetrical accident.

The patient experienced very severe pain in her second labour, thepain being situated in the sacral region . The head was unusuallyresistant, and all the diameters greater than usual. Severe pain inthe right hip and back Of the thigh was felt after the labour, gradually increasing in intensity crepitation was recognised duringmotion, which latte r was very painful. Finally, an abscess ap

peared atPoupart’ s ligament, which was evacuated ; a probe havingbeen introduced, passed into the sacrO-iliac articulation, and the

diagnosis was thus clearly established.BISHOP relates a case in which extensive emphysema occurred in

consequence Of severe straining during labour. The patient rccovered.

PATHOLOGY OF PREGNANCY AND PARTURITION.

A. ON DEFECTIVE CONDITIONS ON THE PART OF THE MOTHER.

a L— Die Ueberwanderung desMenschlichen Eies als Ursache der Eileiterschwangerschaft. [On the Migration of Ova as a Cause of Tubal Pregnancy.]Verhandl. des natnrh. med. Ver. z u Heidelberg, iv, p. 103. 1858. (Sch . 5,

Pierson-43amof Fallopian Pregnancy. New York Journ. of Med., July. 1859,p. 141.

Harley,

— Case of Tubal Pregnancy. Obst. Trans., vol. i, p. 10 1.Harmon — Tubal Pregnancy. Brit. Med . Jour., 1859, p. 102 2 .

Rin o,

— Extrauterinscbw angerschaft mit fast re ifem Pb'

tus, Durchhohrung der

Scheide durch einen Armdesselben. [Perforation of the Vagina by an Armof

the Fmtus in a Case of Extra-uterine Pregnancy.] Gaz a. Sarda., a, 1858.

(Sch ., 9:

Van 69a und Schmnt— Graviditas extra-uterine. Verband. Pb . van het

Genoosschap der verbordering der Geneesen Heelk nnde te Amsterdam, ii, I ,

p. 17. (Sch., 2 ,

PATHOLOGY OP PREGNANCY AND PARTURITION.

[ fillet — Pall von Extrauterinschwangerscbaft. [Case of Extra-uterine Pugnancy.] nests. Mittheil. ans Baden . xii, 5, 1858. (Sch ., 1 ,

Waller,

-Case of Extra-uterinemutation. Obstet. Trans , vol. i. I» 99.

— Geburtshfilniche Pi lls . [Obstetric Cases .) Pr. Ver. Ztg. N. E , ii,

13, 1859, (Sch., to ,

Cuban — Pall von Gravid. t rauterin. [Extra-uterine Pregnancy.] Allgem.

Med ic. CenL-Ztg" No. 9 1. (Canst., vol. iv, p.

Chevillom— Csse of t rs~nterine Pregnancy. Gas. use. de Paris, 33. (Canst..vol. iv, p.

Hall Du n — Ovarian Gestation. Obstet. Trans , vol. i, p. 341 .

I ra — Over bet scheel vernaauwde bek lten . [On the Obliquely Distorted Pelvis.]8vo. pp. 146. Leyden, 1858. (Sch ., 5,

[ M en— milfswege fiir den Geburtsbelfer in Pi llen derartiger Verunstaltungen

des miitterlichen Beckens dass imreifes Kind unverk leinert nicht hindurchgeleitet werden k ann. [On the Treatment of those Cases in which. the Pe lvisbeing deformed, a Mature Child cannot be delivered intact ] Mw Sch. f.

Gebmk , xi, 1858. (Sch .,3,

— On a Rare Pelvic Deformity. Allgem. Wiener Med. Ztg., No. 40 .

(Canst. , vol. iv, p .

“ bl — Usher das Wesen uad die Batstehnng der Spondyiolistheais. [On theNature and Origin of Inter-vertebral Inflammation ] Scanw ni

's Beitri ge , vol.

iii, p. 1. (Canst ., vol. iv, p.m gm — Case illustrative of the Influence of Angular Curvature in the Lum

bar Region on Delivery. Moustach. f. G. B. S., 35. (Canst., vol. iv. p.W ha t— On a new Pelvimeter. Journ. demed. de Bron ,Feb., p. 138. (Canst.,

vol. iv.Po 4730Obstructed Labour fromOcclusion of the Vagina. Dub.

859. p. 133.

Smog— Stricture of the Vagina impeding De livery. L

’Unlos , 80 , 1859. (Sch .,

13,

Karin — Gabon in der Vagina bei volliger Verwachsung desselben. [Delivery ina Case of complete Closure of the Vagina.) Mon. Sch. f.

(Sch., 13,

— 0n Prolapsus of the Bladder before the Child's Hesd ia bour.

Med . Times and Gaz ., vol. xxxix. p. 3.

Om — Pmlapsns of the Bladder during Labour. lh., p. 17 1.W and Imam-Pi lls von Retroversio Uteri Gravidi. [Cases of Betrover

sion of the Gravid Uterus.) Mon-Sch. f. Geburtak , Oct., 1858. Zeitscb . f.

Wondfirta. u. Geb ., xii, 3, 1858. (Sch. 3,

nlt— Retmversion des schwangern Uterus, reposition. [Retroveraion and

position of the Gravid Uterus ] Rev. rue . do Midi, xii. p. 535. (Sch., 3.

Nagging— Ou Retroversioa of the Pregnant Uterus. Gas. de Paris, 38 and 39.

1859. (Sch ., 1 1,

Gra ver-Labour complicated,by Bctroversion of the Uterm. Brit. Ned. Jour.,

Gunman — Case of Retrotlexion of the Gravid Uterus during Labour, “ Term.

Obstet. Trans , vol. i, p. 317.Emu — A Cl inical Lecture on Betrovsrsion of the Uterus in Pugu aoy. Iancet,

1859. ii.55s

342 REPORT ON MIDWIFERY, ETC .

Godefmy,

— Repositionsverfahren bei Retroversio Uteri in der ersten Hi lfte der

Schwangerschaft. [On the Reposition of the Retroverted Uterus during thefirst half of Pregnancy.] Gas . dea H6p., 54, 1859. (Sch ., 10,

Ewu — Ou Retroversion of the Uterus and Retention of Urine. Lancet, 1859, i,556

Bu hm — Retroversion of the Uterus, causing Retention of Urine. Ih ., p. 439.

Hal l Bak ewelL— Ou a Case of Retroversion of the Uterus and Retention of

Urine. lh., p. 363.

Lehmm — Ueber die Ruptur dea Uterus und der Vagina. [On Rupture of theUte rus and Vagina ] Mom-Sch . f. Geburtsk , xii, p. 408. (Sch., 5,

n orm— Rupture of the Uterus before Delivery. Rep. of Obstet. Soc. of Edinb .,

Edinb . Med . Journ ., Oct., 1859, 370.

“ plan— Fall von spontaner Ruptur des Uterus. [Spontaneous Rupture of the

Uterus ] Wien . Zeitsch . N. F., i , 50. 1858. (Sch ., 5,

n eum ,— Rupture of the Uterus. New York Jour. of Med , March , 1859,

p. 287.Bru tonmam-Cases of Ruptured Uterus daring Parturition. Guy

'

s Hosp.Rep., 1859. p. 84.

Athing, -Case of Ruptured Uterus. Dub . Med . Press, 1859, p. 1 16.

Todds — A Case of Laceration of the Uterus. N. Amer. Med Chir. Rem, Nov,1859, p . 1053.

Boggy-Rupture of the Cervix Uteri. Med . Circ., xv , 138.

Aveling,

— Difl cultyof Del ivery in Rupture of the Uterus. Med . Times and Gaz .,xls P. 503.

Pagensteoher.

— Ruptur dea Uter us bei osteomalachischer Beck en . Bathindungen

be i huchgrad iger Beck cnverenge rung. [Rupture of the Ute l ua in Osteo-malaeh ial Pelv is ] Monats. f. Geb ., xn , p. 146. (Sch . , 3,

Wardlewonh — On a Case of complete Invers ion of the Uterus. Lancet, 1859,it, 83.

Lyell— Is the usual treatment of Post-partumHemorrhage correct ? Bdin. Med.

Jour., July, 1859. 84.

Please — Case of severe Post-partumHemorrhage. Brit. Med. Journ., 1859.

P 43

Waller.

— ou Transfusion of Blood ; its h istory and application in cases of severe

hmmorrhage . Obstet. Trans ,vol. i, p. 61.

efoy.

—Cases Of Labour compl icated w ith Hemorrhage. Duh . Quar. Journ.,

Nov .. 1859, 307.

-Zur Iliagnostik der Uterushiimorrhsglen . [A Case illustrating theiagnosis of Uterine Hemorrhage ] Mom-Sch . f. Geb ., xiv, 55. (Sch., 1 1,

map-oth — Hemorrhage during Labour fromthe neighbourhood of the Clitoris.Muns tscli . f. Geb . , 1 1 , p . 81 . (Canst., vol. iv . p.

Godfrey— Case of Internal Uterine He morrhage . Med . Circ xv, 49.

Holst — Pall von Schwangerschaft bei uterus bnlocularis. [Pregnancy in a case

of Uterus Bilocularis.] Scanz oni ’s Beitri ge z . Geb ., vol. iii. p. 158. (Canst.,vol. iv , p.prom— Two Cases Of Labour, in which Fibroid Tumours of the Uterus werepresent. Monatsch . f. Geb ., vol. xi, p. 85. (Canst., vol. iv , p.

apiegelberg ,

— Labour complicated w ith Carcinoma of the Cervix. Monatsch. f.

Geb ., vol. xi, p. 1 10. (Canst., vol. iv, p.

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844 REPORT ON umwrrs ar , s 'rc.

Mu seumgives a critical account of the severalmethods of treatment applicable when pelvic deformity prevents the delivery of a

mature fmtus . These are — 1 Paracentesis, when dropsy of the

head or abdomen of the fmtus, or cysts, are present. 2 . Diminishingor perforation of the head. 3. Cephalotripsy, or corrie of the

head generally, after perforation only. 4. Embryotomy, rarelynecessary. 5. Symphysiotomy and pelviotomy, not to be recon

mended. 6. Artificial abortion, admissible when the patient is notin a state Of health to allow of the performance of the Ce sarean sec

tion with the prospect of a good termination, or when the con

tinned growth of the fetus would imperil the life of the mother .

7 . Artificial premature labour, best undertaken at the thirtyfifth or thirty-sixth week of gestation . Or, 8. The Ce sareansection, concerning which the author makes several interestingremarks.

Sem en . describes a pelvis in which the ilia were spread out

and flattened, increasing the siz e of the greater pelvis . Such a

deformity is likely to lead to transverse positions of the child.

Lu nar. gives the results of his inquiries into the nature and

origin of inter-vertebral inflammation .

Blm aun relates a case in which angular curvature in the

lumbar region anteriorly prevented the head passing into the pelvis,and cephalotripsy was performed.

Cnrmms s and Em co relate the particulars of cases in whichthe vagina had become nearly closed by adhesions after delivery .

In the former, these adhesions were cut through, and labour followed normally. In the latter, the septumwas cut through, a nda calculus an inch long was found between the septumand the child

’s

head ; the calculus is supposed to have escaped fromthe bladderthrough a fistula subsequently healed.

Ran sso'

rm relates a case in which the bladder was prolapsedduring labour. The treatment adopted, and which was eflicacious ,consisted in the use of the catheter. Cansox also relates a case

a m relates a case of retroversion Of the uterus during pregnancy, discovered and reduced at the sixthmonth. Miscarriage,however, followed. In Kl rnnmc’ s case reduction was effected at thethirdmonth, and the pregnancy went its full time . In Pmoaum’ scase reduction was effected at the same period.

Nnemn states, thatprimiparaaare rarelyafl'

ected with retroversion

ramonocr or rm xancr sun ranrumrron. 345

during pregnancy . The cause is generally a sudden shake or exertion,or fall ; the disteusion of the bladder is an efl

'

ect. Themethod of reposition recommended is by the introduction of the hand into the vagina,and pressure upwards . v ss

’s patient was six months preg

nant. The displacement was corrected, and a dead fmtus extracted.

01mm relates a case in which the patient had gone her full time,

flexed . Much difficulty was experienced in efifectiug the repositionof the uterus, when delivery easily followed . The retroflexion

had existed apparently throughout the whole period of pregnancy .

Bamms describes four cases of retroversion of the uterus during

him, occur gradually or in a sudden manner.

In effecting the reposition of the retroverted uterus, Gonn aox

places the patient with her hands and head on the floor and the

pelvis and legs on the bed . Three or four fingers are then intro

Evas s, Basnan , andHam.Ew ww record cases of retroversion

of the uterus in which retention of urine formed the prominen t

Lsnnaxs states that, of 7000 women delivered in the ‘ Gebi ranstalt

’at Amsterdam, rupture of the uterus occurred on ly three

times : in private practice he has Observed eightmes . In all the

rupture took place during labour. It is in the third or fourthstages of labour that the uterine wall gives way, seldom until

after the membranes have been broken. The author divides cases of

accidental or mechanical ruptures . Under the first head are ih

cluded cases where the cause is a pathological condition of the

uterus its elf, a degenerated state of the uterine tissue, fibroidformation combined with irregular contraction, or abnormal thinness of the uterus, softening, hystcromalachia, or thickening of certain parts on the fundus and body combined with great tenuity of

the cervix . But rupture may occur when these pathological conditions are absent, as in cases Of pelvic deformity, disproportions

tions, or in cases of hydrocephalus in which the pains are ex

tremelyviolent. Here, howev er, the uterine tissue is rarely in a

normal condition at the timc of the rupture. The author believesthat rupture only occurs in such cases whe a Of the uterine

346 aarou'r on mnwrrnnr , are .

wall has, in consequence of pressure, undergone contusion, soften

ing, detritus , or even gangrene . To the accidental or mechanicalclass of cases belong those in which the rupture occurs in conse

quence of operations badly or roughly performed, such as turning,

perforation, the use of hooks, tearing of the vagina by splinte rs ofbone, &c. Rupture of the uterus occurs more frequently in multipuras. The lower segment of the organ is generally the seat of therupture ; the placental surface is not more liable to rupture thanother parts ; it occurs more frequently on the posterior than the

anterior wall ; its direction is more generally horiz ontal than longitudinal ; the body maybe entirely torn fromthe neck . The edgesof the rupture are jagged, the extent various. There maybe simplysmall perforations in a portion of the uterus, the texture being theresoftened fromcontinued pressure. The mpture maybe complete orincomplete ; in the latter case the whole thickness of the uterus isnot torn through. The cervix uteri and the vagina are frequentlyinvolved in the rupture ; more rarely the bladder and rectum.

The rupture occurs suddenly, severe pain in the abdomen , followedby cessation of pains, escape of blood fromthe vagina, fainting,pulselessness, coldness of extremities, The abdomen is changed,the parts of the foetus can be felt. Emphysema of the cellular

tissue the author has not observed. Theprognosis is very unfavorable,death generally occurring soon after the rupture . In rare cases the

foetus has been retained in the abdomen, as in a case of extra

uterine pregnancy. In reference to the prophylaxis, it is recommended that the uterus be supported fromwithout. As \to the

treatment, the foetus is to be extracted as quickly as possible ; if ithave escaped into the abdomen and is alive, the Csesarean section

is to be performed.

In Tnonx’s case of rupture of the uterus, the patient had been

in labour two days . The child was delivered by the forceps . Deathtook place four days after, when it was found that the uterus wasruptured transversely at its lower and anterior part, the rent cdmitting all the fingers of one hand. There was no contraction of the

KarLEB’s patient had been the subject ofmetritis, after a forceps

delivery, four years before . On examination, it was found thatthere was pelvic deformity, prolapsus of the cord, and rupture ofthe uterus . Finally, turning was performed, and the child ex

tracted, the head having been perforated. Death fifty-one hours

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318 an on on mnwrrnnr , are .

sion of blood.

”He relates cases ofM partumhemorrhage suc

Pt‘u rox relates six cases in which hemorrhage complicated

on the general treatment of harmIn Hurst

’

s ease of uterus bilocularis, labour supervened on two

pnnqpmancy, «nae iof rrhdchwendki l fhtahbn

In Srmsm n o’s case of carcinoma uteri, a living child was ex

trachul lxytluafb rceps. Inna inunfiunrdfieduof tdnsdhouuueteni nmonths

3. ON UNUSUAL CONDITIONS ON THE PART OF THE CHILD.

aponm— Ueber mehrfaehe Geburten. [On Plural Births ] Mom-Sch. f. Goburtsk , xii, p. 4456. (Sch ., no,

puma-ley— Cn e of Triplets. Gaz . de (Sch., u ,

M gr— Case of Triplets. Wurtemb . Corresp. BL, No. 1. (Canst., vol. iv,

M ora— Case of Triplets. Monit. dea H6p., a. (Canst. vol. iv, 9.

l u g — Case of Triplets. Journ. de Bord, Oct., 1858. (Sch., 3, r93.)Gama — Case of Triplets. Gar. dea H6p., 139. 1858. (Sch. 3,

I nn ing-Pour Children at a Birth. Monatsch . f. Geb ., rs , p. 134. (Canst..vol. iv,

— Report of a Case of ArmPresentation terminated by Spontaneous Evolution. Lancet, 1859, i, 535.

h erd ed — Case of ArmPresentation terminated by SpontancousExpulsion. lh.,p. 487.

r a glan — Pall von Selbstentwicklung. [Case of Spontaneous Evolution.) Met.Ztg. Ru sh, 43, 1858. (Sch., 3,

no — Ou a Case of Spontaneous Evolution. Lancet, 1859, vol. i, p. 36.sl, agel

— Ou a Mechanical Impediment to Labour not sufi clentlynoticed .

Moustoc . .f Geburtsk , 1858.

Lin -Tedious Labour in a Case of Pelvic Presentation Bmphysematous Condition of Fe tus, for some days previously dead ; Sudden Death of “other.L’Union, 57, 1859. (Sch., 8,

l yrdQ,

— Obotetric Cases. Med . Journ. Aug. 1859, 1 78.

M 8-The Result and Treatment of Cross Presentations. Med. Times and Gaz .,

xl , .637

PATHOLOGY OP PREGNANCY AND PARTURITION.

Pom -Death and almost entire Absorption of a Pa tna of sixmonths’ deve.lopmen t. New York Journ . of Med , May. 1859, p. 418.

I‘M — Ou the Difficulty of the Diagnosis of Hydrocephalus in Cases of BreechPresentation . L

'

Union, 7 1. 1859. (Sch ., 8.

N utmeg-Die Gebnmgeschichte und section eineswasserk tipflgen Kinder. [Delivery of an Hydrocephalic Pa tna ] Moustach . f. Geb ., xi, p. 1o5. (Canst.,N i. W.P’

— t re|ae Siz e of the Pa tna considered as a Cause of Dystoeia.

u. do use. at Chin , Jama in et Wahn . 1859. p. 395.— Verjsnchung dea Uterus. [Suppuration of the Uterus .) Allg. Wien .

6d. 46 “la470 (Sch ., 31 d h? )M u g

— Birth of a Double~headed Monster. Monatsch. f. Geb., xi, p. 431 .(Canst..vol. i,

[ grain — Birth of Tw ins united at the Trunk . Org. nir die ges. B elik . deaMed

Chir. Vereins. Jahrg . , 6. part 4, p. 197. (Canst. , vol. iv, p.m und “ gnu — Pall von Doppelmisb ildung . [Double Malformation.)

Aerta. Int. Bl. Bayerns.No. 8. (Canst., vol. iv,Koch — Death of the Pastas at the twen ty-fourth week ; Retention in the Uterus

for twentyofour week s afterwards . Wurtemb. Med . Corresp , No. 17. (Canst.vol. is . 11 4780

Srosrnu states, that in the Vienna hospital, triplets only occurredthree times in births . Itmost commonly happens that twoof the three, present by the head, the third by the pelvis . The

prognosis is unfavorable formother and children . The con tents of

the uterus should be removed as quickly as possible.

In Fm am f s case the placenta were connected bymembranes .

There was no vascular connexion between them. c h child had a

special chorion and amnion. The children were living.

In Manx’s case the diagnosis was made out before delivery. The

woman was safely delivered of three boys ; the first two were each a

cranial, the third 11 breech presentation. Two of the placenta were

did well. In the case of (h arm, the first child was a femaleand the second a male, both cranial presentations. The third a

the third 11 distinct placenta . The mother and children all did

well.

In MARTIN’S case a woman, at. 43, was delivered prematurely of

four children. There were twomales and two females . Three of

the children lived a few days .In Evnasn no

’

s case of spontaneous evolution the child was

putrid. In Mm en’s case, the conjugate diameter measured

The cord was twisted round the neck , and still pulsated, but the

850 nsroar ON umwrrsnr , are .

child could not bemade to breathe. The whole delivery took placein ten minutes . In BOGG

’s case the child was stillborn .

SPmGELBEBG calls attention to the fact, that labour is frequentlyarrested in its course by a too great flexion of the head upon thebreast. It rests on the perimeum, and the labour is delayed unnecessarily. In such cases, heretofore considered as cases of weakute rus, the careful use of the forceps is recommended.

In each of the two cases related by MYRTLE, the presentation wasfacial. The usual term of pregnancy was believed to have beenexceeded in each case fourteen days, and in both, too, it was necessary to apply the long forceps .

In Foumam’

s case the expulsion of the fcetus did not take placeuntil five months subsequently to its death .

In a case of hydrocephalus recorded by l é,there was a breech

presentation . He remarks on the difficulty of the diagnosis in thisand similar cases . In ScHULTZE

’

s case the breech also presented,the head was perforated, and delivery easily effected.

Jacqunmsn relates two cases in which, the head having been delivered, the extreme siz e of the body prevented the completion of thelabour. In one case, the abdominal viscera were removed ; in the

other, the woman died undelivered. In the first case, the weightofthe child was 5600 grains (about I 2 ; in the second, 9 lbs. In

the latter the symphysis pubis was divided (after death) before extraction could be performed .

SALZGEBER records a case in which the fcetus appears to have temained in the uterus for nearly two years, at the end of which timea purulent discharge from the vagina, and froman opening at the

umbilicus, occurred. The remains of a fwtus were found in theuterus . The umbilical opening communicated with the uterus .

The patient died.

In Loscnnn’s case of double-headed fe tus, one head being de

livered, it was necessary to amputate it, in order to performtheOperation of turning .

In MARNITZ’

8 cas e the tw ins were united fromthe sternumto theumbilicus . There was a single funis umbilicus and placenta .

In Rams and BRESLAU’ S case the double child was born alive,

but both died shortly after, the death of one preceding that of theother by sevenminutes.

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852 an on on umwrrsnr , are .

In 9 cases, the accouefiementf orcs’

was necessary ; two of themothersdied.

Banxns relates fourteen cases of placenta pmvia. The deduc

tions drawn by himare as follows Arrest of haemorrhage occurs

when the placenta has become detached for a certain distance fromthe cervix— physiologically, therefore. The posterior or usual position of the placenta in these cases favours the occurrence of trans

verse presentations . When the cord is attached to the edge of theplacenta, it is very liable to be prolapsed in these cases . Uterineinflammation and puerperal fever are likely to ensue in cases of pla

centa praevia, a danger increased by forcible manual efforts, and thenow very vascular condition of the lower part ofthe uterus . In somecases, the hmmorrhage having ceased and the 03 being dilated to thesiz e of a crown-piece, interference in labour is not necessary gua rd theplacenta. It is expedient to hurry the period of dilatation of the 08in these cases, as after a certain point of dilatation is reached no

hemorrhage occurs. Rupturing the membranes, plugging the cervix, ergot and galvanism, often sumec to produce the requisite ex

pension . In those cases where forced delivery or artificial total

detachment of the placenta are dangerous operations, the separationof the cervical z one by the index finger is safe and feas ible.

STEPHENS and RAINY record cases in which separation of the

placenta was performed, and no haemorrhage followed. InMonms’ scase, the haamorrhage continued after such separation . Janum] ;MURRAY records a case in which the air-pessary was employed usefully as a plug and dilator of the cervix uteri. In two cases of pla

centa pnevia treated by the use of the colpeurynter, Srl sennns aestates that the children were born dead, and that he would preferusing linen on the next occasion .

In Ran sso'rnau’s case of twins there was an exces sive quantity

of fluid present, but in one amnionic cavity only.

The point in Fam’s case to which attention seems to be directed

is the fact of an ovum froman ovary affected with cystic disease,giving rise subsequently to an hydatidmole .

HAMON records a case of hydatidmole . The uterus was as large

as at six months. In addition to the usual symptoms, the womansuffered fromalbhminuria and anasarca.

GRAILYHEWITT, after describing the particulars of a case in whicha veryperfect and early specimen of the hydatidiform or vesicular

mole was expelled fromthe uterus, offers the following conclusions

os srs rni car. orsaar ions . 358

respecting the nature andmode of origin of the change in question .

He dissents entirely fromthe “cyst” view of Mettenheimer and

Paget, and considers that the bladder-like enlargements are merelyaltered chorion villi not a new formation, but simply an alte ration

and degeneration of previously existing structures. He contendsthat the generally received opinion as to its mode of origin is ia

thus arrested in their development, but not in their growth, theeffects witnessed result. After the villi have passed a certain periodof development, no hydatidiformchange can take place . Lastly, theauthor considers — r. The question as to the possibility of a portion ofretained placenta taking on the change in question . 2 . The questionas to whether true hydatids can be expelled fromthe uterus, and themeans of distinguishing the true, fromthe vesicq bodies the resultof chorionic degeneration.

Bythe term“ internal abortion of the ovum,

”Kosn z nnt under

stands the death of the fmtus in ute ro at anyperiod of pregnancy .

In such cases the ovumis notalways expelled its coverings continue

do not remain in the uterus longer than nine months, seldomlongerthan six. Mostly, those expelled before the thirdmonth contain no

festus. Such fmtal ova become later “moles .

”The growth and de

velopment of the foetus are arrested suddenly, ormaynot have begunat all. The crimes of this arrest are disease or death of the ovum,

frommechanical disturbance thereof, fromdisease of themother, orother unknown causes . These moles generally contain a good dealof fluid, which maybe expelled in consequen ce of the bursting of

the amnionic sac, and the bag collapsing, the mole mayremain inthe uterus a considerable time. After the fifthmonth, ballottemea lenables us to distinguish between a fcetal and an afmtal ovum.

The author does not believ e in the existence of hydrometra withoutprevious conception .

ON OBSTETRICAL OPERATIONS .

God -Iuciaion of the OsUteri. Journ. deaConnaia. Med , p. 540. (Canst. ,VOL 't

Bram— Die uterinale Katheteriaation mit Darmaarten behuf der Erwechung derkuaatlichen Fruhgeburt. [Induction of Artificial Premature Labour by the

use of Catgut.) Wien. Med. Wchnach.,46, 1858. (Sch., 5.

854 an on on mnwrrsar, arc.

-Kiinstliche t eburtmittels Press-Schwamtu. [Induction of Artideisl Labour bythe Sponge-tent ] Pr.Ver.-Ztg.N. F., ii. 31, 1859. (Sch ., 8,

x93.)Hgnsmann und Brook — Kilnatliche Priihgehurt nach Cohen’s Methods. [In

duction of Artificial Premature Labour byCohen’s Method ] Wiirtemb. Corr.DL, 33 und 39, 1858. (Sch., 3,

Gnordm— Die Kfinatliche Priihgeburt als Errata dea Kaiserachnitta. [ArtificialPremature Labour aa a substitute for Craniotomy.] Aertz l. Mittbeil. aua

Baden, 34. 1858. (Sch., 5,

Mammary— Induction of Premature Labour in the eighth month bymeans of

WarmInjectiona into the Neck of the Uterua. Gaz . de Paris.3. 1859. (Sch .,

St

“anum,— Ou the Induction of Premature Labour in a Case of Distorted Pelvia.

Obstet. Trana.. vol. i, p. 336.

Germa n-Pi lls vou ltfinatlichen Erregung der Priibgeburt, &c. [Caaea of Induction of Premature Labour.] Mom-Sch . f. Geb ., xii and xiii. (Sch ., 1 1

mum — Cases of Artificial Premature Labour. Deutach 1 7. 19. (Canat.,vol. iv,

[mm — Caaea of Artificial Premature Labour. Wiener Wocbena , i, p. 10.

Canst..vol. iv,model, M gr, Grade, and Hum — Cases of Artificial Premature

Labour. Monatach. f. G., xi. 1 . 1 1 , 136, and 388. (Canst.. vol. iv.en sign — Artificial Premature Labour. Medic. preuaa. Zeit., No. 9. (Canat.,

vol. iv ,

Groeningm— Artificial Premature Labour. Orig. f. die gea. Heilk . deaMed-ChinVereina., 6 Jahrg., part 4. p. 313. (Canat., vol. iv,

Stag — Artificial Premature Labour. Gaz . Med. (10 Straab., No. 3. (Canst.vol. iv ,

Godefroy.— Six Caaea of Artificial Premature Labour. Journ. dea Conn. Méd..

Ema— Artificial Premature Labour. Gaz . dea Hfip.,No. 34. (Canst. vol. iv,

Mayan— Ou Artificial Premature Delivery. Monatach. f. Geburta., xi, 100.

(Canat., vol. iv,

mama — Artificial Premature Labour. 0113. Med. Ital. Lomb., N0. 51 , p. 444.

(Canat., vol. iv.Bum— Case of Premature Labour. Med. Ciro , xiv, 98.

W hamm— Notea of a Caae of Cancer of the Uterua and Rectum, in whichAbortion was produced. Obstet. Trans., vol. i, p. 1 1.

Esterle,

— Beobachtungen uber die aussere Wendung. (On External Turning ]Ann . Univ ., April. 1859. (Sch ., 10.

Noeggemth — The Operation of Turning byExternal Manipulations. consideredfroman historical and practical point of view, with caaea. New York Jour. ofMed., Nov ., 1859.339.

mamwicz — Umwandlung-einer Geaicbta in eiue Beck euendlage, as. [Tuming of a Poem! into a Pelvic Presentation. &c.] Oesterr. Ztach. f. Praltt. Heine .v, 30, 31, 1859. (Sch ., 8.

Alex. R. Sim OIL— Tum"! 0 the Long Porcepl t illustrative cam. Med .

Times and an , xxxix,465.

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856 naronr ON MIDWIFERY, arc.

Brunt — Case of Craniotomy. Obstet. Trana., vol. i, p. 81.

-Ueber die Abliiaung dea Schulterb lattea vomKorper als Methode der

Embryotomie. [On the Separation of the Shoulder-blade fromthe Body as amethod ofEmbryotomy.] Bibliothek for Laeger, vol. 10, p. 431 . (Sch., iv,

M en— De Cephalotripaia. Dissert. Inaugur. Leipz ig, 1858. (Sch.,

Schultl Q — Ueber dei lndikation z ur Kephalotripaie. [On the Indications for the

Performance of Cephalotripsy.) Med. Centr. Ztg., 50, 51 , 1858. (Sch., i,

Dubon — Cu e of Cephalotripsy. Rev . M6d., Janv ier, p. 89. (Canat., vol. iv,Richard — Ou Cephalotripsybythe combined use of the Perforator and the Hand .

Monatach. f. Geb ., xi, 389. (Canat., vol. iv,Wolfi— Kephalotripsis nach Perforation dea Kopt

'

ee,wegen Beckenenge. [Cephalotripayafter Perforation of the Head ] Aertz . Mitth. auaBaden, xiii, 8, 1859.

(Sch., 1 1 ,

Nasser.— Trepanation und Enthirnung dea Kindeaaehiidels wegen Stimlage bei

einer Zehntgebiironder. [Trepanning and Excerebration in a Case of Frontal

Preaentation.] Oeaterr. Ztachr. f. prak t. Hcilk ., v, 28. (Sch., 13,

W ork — Die Resectio Pubica subperiostea als Braatz fiir die achwerern

geburtahiilflichen Operationen. [On Subperiosteal Pubic Resection as a Sub

stitute for the Severe Obstetric Operation ] Ann. Univ. Agosto, Seth , 1858,Gena. 1859. (Sch., 8.

R ed irect-Cu e in which Synchondrotomy was performed. Lo sperimentaleOk he 10. (Canat., vol. iv, 48

GODEFROY relates two cases in which the os uteri was incised incases of convulsions . Bothmothers did well.Bmux

’s new method of inducing premature labour consists in

the introduction of a piece of catgut, several inches long, into theuterus

, between themembranes and the uterine parietes, and allow

ing it to remain until the membranes have been ruptured by thepains which are excited by its presence . The catgut is fromtwo tothree lines in thick ness, its extremities softened by hot water, andwell oiled previous to the introduction . Labour begins in fromsix

to twenty hours after the operation .

REYMANN relates two cases in which the sponge-tentwas succes sfully employed for the purpose of inducing premature labour.

Cohen ’s method of inducing artificial premature labour consists

in the injection of warmwate r into the ute rus . In two cases

reported by HAUSMANN labour set in after two injections in one

case, and after three injections in the other. In Bnocx’s case

three injections and two doses of ergot were employed. The

children were born alive, but one died soon after.

In GUERDAN’S case, Cohen ’s method was had recourse to in two

successive pregnancies, at the thirtieth week and at the thirty-fifthweek. The first child survived seven hours only, the second didw ell.

os srsrai can ors aarions . 357

In the case related by Marmounr, warm injections into the

neck Of the uterus were employed, and the child preserved. The

patient had previously been delivered by the forceps, the child not

In Taomvcmt’s case, premature labour was successfully induced

uteri.

Gum records, as the basis of an elaborate paper, twenty-threecases Of the artificial induction of premature labour, out of 339operations and 10 19 labours, the large proportion of which he explainsby the unusual frequency Of rachitic pelvic distortion in the particular neighbourhood the scene of his observations, and his practiceof ascertaining by examination the state Of the pelvic diametersduring pregnancy. The greater mortality for the children the

earlier the operation is performed, is not dependent, he remarks,entirely upon the degree of pelvic contraction, state of development, &c., but is partly explainable by the fact that the prescutation is Often found defective in Operations performed too early.

The general indications for the Operation, to be gathered fromthe

examination as to the state Of the pelvis, are given . The n ode

adapted in the twenty-three cases was various ; in only nine of

themwas one method exclusively adopted, viz ., one by the method of

Kiwiseh, five by that OfCohen, two by thatof Braun, and one by thatof Scanz oni (mammary). In the other cases, a combination ofmorethan one method was necessary. Cohen ’s method was employedsingly or otherwise in nine cases, and of these nine cases the

labour. Laur a gives the preference to the ao-called Cohen’smethod,

employed also in cases related by RUBDBL, Hz cxsa, Cach e, and

Co esm n . The latter uses water colder (so— 59° Fahr.) than that

usually employed, by which the effect ismore rapidly produced . In

the cases by Gniim omv, Snow , and Gove rnor, the uterine douche

(Kiwisch’smethod) was employed . m o records the first case of

the induction of artificial premature labour in Naples . Themethodemployed was the use of the warm douche . Gw anano employedcanteriz ation of the condutto uterine

”as a means of inducing

labour in a case of pelvic deformity.

The principal conditions in which the operation for the induction

858 REPORT ON mnwrrnnr , arc .

degrees of pelvic deformity ; extreme narrowing of the vagina

presence Of large tumours in the rectumand vagina ; retrov ersion Of

the uterus, where the reposition cannot be efi'

ected. In Boss’

s case,

other measures having been unavailing, the membranes were punctured. In Macm zm’

s case, abortion was induced atthe fourteenthweek bymeans of the warmdouche and galvanism.

ESTERLE, in an essay on external turning, states that from the

sixth to the eighth month Of pregnancy, he has frequently noticedspontaneous turning to occur in cases in which the position was

unnatural. He proposes the operation Of external turning in thosecases where the position is, towards the end Of pregnancy, ascertain edto be not natural. Full particulars are given as to the bestmethods Of performing the necessary examination and Operation .

In 500 cases examined in the eighthmonth, 2 2 instances Of cross

presentation weremet with ; Of these 9 were rectified spontaneously,and in 10 the external turning was performed. In 2 cases the

turning upon the head was performed by internal combined withexternal manipulation, and in 1 case internal turning upon the

breech was performed. In the 10 cases Of external turning, placenta

preavia was present once ; in 2 cases, pelvic narrowing Of the first

degree ; in 3, excessive obliquity Of the uterus . Of these 10 cases,

9 had been delivered regularly, the tenth was still undelivered.

NOEGGERATH gives an historical account Of external turning, andrecords the experience Of obstetric Operators in reference thereto.

The chief difficulty in reference to the operation is in the diagnosis Ofthe position this is only to be got over by great care and attention .

In a case related by Mammaowrcz , the presentation was a facial

one, and Braun’s colpeurynter was used to prevent the escape of the

liquor amnii. At the end of a certain time this presentation waschanged, under the influence of the contractions of the uterus, froma facial to a pelvic one, and the delivery efi

'

ected.

ALEX . R. SIMPSON relates three cases in which turning was had

recourse to, with success, in place Of the use Of the long forceps .

BUB BLEN relates a case Of turning, followed by the accouchementforcé, in a patient suffering fromconvulsions at the eighth month.

There was great rigidity Of the os uteri, but the delivery of thechild (putrid) was effected in two hours . The mother did well.In MACKENZIE

’S case, the conjugate brim-diameter was two and

three eighths inches. Craniotomy was performed, and delivery sfi'

ected

after subsequent version.

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860 REPORT ON MIDWIFERY, mo.

tion had been already performed once, with a favorable result.

The patient was much deformed from osteo-malachia, and diedeighty hours after the operation . A fourth case, reported in the‘Mém. de 1858, p . 468, by Borie, had a favorable issuefor mother and child. The patient was rachitic, and the conjugatediameter fromtwo to two and a half inches .

In ALONso’s extraordinary case, nomeans were effectual in over

coming what appeared to be rigidity of the os uteri, and after a

time portions Of a fcetus, withmuch puriformmatter, were expelled.

The uterus could not be made to contract, nor could the 08 be

dilated. Finally, the Ce sarean section was performed, and the re

mains Of a fcetus extracted. The result promised to be a favorableone as regarded the mother.

M‘CLELLAND reports a case successful for bothmother and child.

The anterO-posterior diameter was one inch and five eighths, thetransverse one inch and a half, the sacrum curved, and the pubicangle veryacute .

In Han na’s case the child was saved, the mother died six days

after. The antero-posterior diameter was 1" transverse, 4"

Oblique, (Wurtemburgmeasure).In Munrnv

’s case the conjugate diameter was barely two

inches ; the space round the brimwas hardly larger than a florin ;

the cause Of the deformity was mollities ossium. The child was

dead before the operation was commenced. The mother died twodays after. The author discusses the general question of the

necessity and justifiability Of the operation . The paper concludeswith a table Of cases Of Caesarean section reported in Britain and

America.

In DucLOS’s case, fibrous tumours Of the uterus impeded delivery .

Mother and child were saved. GUILLAUME reports a case Of

Caesarean section under lik e conditions . The child was saved ; themother died in six days. Gnonss s cx and Fem-James report successful cases . GALLIOANI

’

s case was successful for mother and

child. GIORDANO has Operated four times in sixteen years. The

children were saved ; the mothers died. Es'rnnLE’ s was a postmortemoperation . The child lived for two hours.

TYLER. SMITH endeavours to show that, with the proper and

scientific use Of all the means at our command, itmaybe laid downas a general rule, that craniotomy should not be performed in thecase Of a living foetus after the period Of viability has been reached.

”

OBSTETRICAL OPERATIONS . 361

He contends that up to the present time themeasures which are

the alternatives Of craniotomy have never been carried out in practice to their full and legitimate extent. Turning, the use Of the

might be adopted verymuchmore extensively than they have been,

Gmmu w u contends that there is little, if any, difi'

erence in themortality to the mothers fromcraniotomy in great distortion Of the

commencement of labour ; whereas there is a great saving of foatal

life in the latter case.

trepan, followed by the use Of the cephalotribe .

the base of the fcetal sk ull behind the foramen magnum and at

other points. After perforating the sk ull in the nsual manner, apair of forceps is applied, one blade within, the other outside, thesk ull, so as to grasp the occipital bone close up to the foramenmagnum, when, by a slight twisting movement, the fracture isaffected and the head diminished at its firmest and most unyielding

Dacrrr relates a case in which, after the Operation Of turning, the

head could not be extracted, and craniotomy was had recourse to .

The head was extremely hard.

he scapula and arm, as a substitute for the expedients usually hadrecourse to . After the separation in question has been efi

’

ected, turn

ing can be easilyperformed. The method has been found hyexpericuce to be practicable and useful.

formed. He rejects the instrument Of Bandelocque, and prefersthat of Busch. The result, so far as themother was concerned, wasfavorable in the three cases . 80110132 1: considers that a conjugatediameter of 2

" is not an absolute contra-indication to the use of

the cephalotribe . In one case the conjugate diameter was 2"

362 REPORT ON mnwrrsnr , are .

and after the use of the instrument amature fe tus was extracted .

Dus ors and WOLF also record cases of cephalotripsy .

Ne ssnn’s case was one of frontal presentation, in which, the for

ceps having been unsuccessfully used, the trepan was employed, anddelivery effected.

Cnrsroromsproposes as a substitute for symphysotomy,pubiotomy,and the Cwsarean section, a new operation, viz ., the partial or total

superiosteal resection of the os pubis, atthe horiz ontal and descendingrami. He describes sixmodifications of the operation, adapted todifferentcases, in each ofwhich differentparts of thebonesare toberemoved,according to the varying degrees Of narrowing of the pelvic cavity .

These several operations he has performed on the dead body, andhas practised them on living bitches . He believes that he hasproved, that the operation is practicable, the chief difi cnltycon

sisting in the separation of the periosteumbehind the pubic bone ;that it answers its purpose ; that itmust be considered a priori as

less severe than the Operations it is proposed to be substituted forand that the parts removed are replaced subsequently.

Jocomcor relates a case in which, at the eighthmonth, synchondrotomywas performed, to allow the head to enter the pelvis. The

conjugate diameter was 23" The child died soon after delivery,

themother eighteen days subsequently.

ON EMPLOYMENT or cnnonoronu, specu n murmu r.AGENTS, are .

— Ou the Employment of Chloroformin the Royal Lying-ia Hospital at

Copenhagen. Bibliothek for Laeger, vol. 10, p. 443. (Sch ., 4, 4c .)Kidd Chloroformin MidwiferyPractice. Med. Circ., xiv, 1859, 290.

Sflbert — On the Employment Of Local Bloodletting in Pregnancy. Ann. de Méd .

et Chin , Jamain andWahu, 1859, p. 2 72 .

Deann a -Ou Uva Un i, considered speciallyas an Obstetrical Agent. Ann. de

Thél’l p., l 859 : 49°

Devifl e.— Statistical Researches on the Action of Ergot in Parturition. Arch.Gen.,

March, 1859. (Brit. and For. Med -Oh.Rem, July, 1859,

LEVY details the general result Of the employment Of chloroforminhalation in a number Of cases of natural labour, in most of whichthe full narcotismwas produced . Chloroformhas the same effect onpregnantwomen and on women during labour as on other individuals .

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364. enron'r ON umwrrnnr , are .

srarrsrrcs, are .

Clay,— Statistics and Observations on the Liabilityto Abortion. Glasg.Med. Journ .,

Jan., 1859, 408.

Em u— Clinical Historyof the Eastern Division of the Royal MaternityCharity

duri ng the Year ending Sept. 30, 1858. Dubl. Quart. Journ. of Med. Se .,

Aug., 1859.

Bun — Analysis of 2 157 Cases of Labour. Brit. Med. Jour. 1859, 46.Gm ,

— Porty-third Annual Report of the Lying-ia Hospital of the Royal Med..

Chir. Acad. at Dresden. Monats. f. Oeburta, xii, Dec., 1858.

[ um— Report Of the Obstetrical and Gyne cological Clinic of Jena. Monatsch.

f. Geb., xii. 3, 1858. (Canst. vol. i,p.

N it— Annual Report of the Obstetric Clinic forMidwives in Vienna for 1859.

Zeitsch. d. Gesell d. Aer-ta. z uWein., 2 1, 2 2 , 23, 1858.

Schmidt — Report Of the Obstetrical Clinic of Prof. Scanz oni atWiirsburg, fi om1853to 1856. Scansoni

’s Beitr. z . Geburtsk ., 3, 1858.

[ n on— Report on Practical Obstetrics for the year 1858. North Amer. Med .

Chir. Rev., May 1859.

Leg — Clinical Midwifery. Med . Times and Gaz ., xxxiv, 440 ; xl, 330, 377, 474.

mu m— Contributions to the Statistics of the Mechanismof Delivery. Archiv

f. d. Holland Beit., i, p. 144, (Sch. 7,

Rom — Report of the Obstetric Clinique at Bordeaux for the years 1855-56.

Journ. de Med. de Bordeaux, Mai.

M en— Report of the Lying-in Hospital at Stuttgart, fromJuly. 1856, to July,

1857. Med.Wurt. Corresp., Bl. l .

Smith — A Statistical Report of thirteen hundred Midwifery Cases attended inprivate practice. Lancet, 1859, ii, 481.

Dunn — On the Statistics of MidwiferyfromPrivate Practice (4049 cases). Obst.Trans., vol. i, p. 2 79.

mam— Au Analysis of 2000 consecutive Cases in Midwifery Practice. Brit.

Med . Journ., 1859, 867.

nan-insom— Statistics of 1000 Cases in Obstetrics. Brit. Med. Journ. 1859, 869.

3311, — Ou the relative frequency of the difierent Positions Of the Child’s Head at

the Commencement of Labour, &c. Glasg. Med. Journ., Oct., 1859, 295.

B , Uvedale West — A Statistical Studyof the causes and relative preportions

of Still-births in Private CountryPractice . Lancet, 1859, ii, 478.

nadaway.

— saubomchildren. Lancet, 1859, n, 431.

nrseass s or WOMEN. 865

DISEASES OF WOMEN ;INOl INO run PHYSIOLOGY AND rarnonoor or w e

reru ns sme ar. onoan s.

GENERAL TREATI SES, PHYSIOLOGY, ETC .

Ha ving — B latant; philos0phique etm6dicale de la fcmma, consider“ dans toutales epoques principalea dc la vie, &c. [A Treatise on the Philosophical and

Medical Historyof Woman.c.c.] Second edition, Paris, 1858, 3 vols. (Sch.,

to,

[ gm-Appearances of the YearlyRia of Ova in Woman. Gas. dea Rep ,

2 3, 1859. (Brit. and For. Med-Chit . Rev ., Oct., r859.

Erectile Organs of Woman, and on the Muscnlar

it their Relations with Ovulation and Menstruation.

Brown-Sequard's Journ. dc Phya , Oct., 1858. (Brit. andPer. Med-Chit. Dem,

Al’fl l' l 8590F— Clinical l.cctures on the Diseases “ Women. Med.

‘

l‘imes and Gm

1859.

Bu m — Ou the Development of the Rentals Pelvis. Bdin. Med. Jour.,Oct. andDec., 1859.

Harvey— Ou the twins in Utero as inoculating the Maternal with the peculiarities

ot the Paternal Organism, and on the transmission thereby ot Secondary or

Constitutional Syphilis fromthe Male to the Female Parent. Glasg. Med.

Jour. , Jan., 1859.p. 385.

Good y— Ou some of the most important Diseases peculiar to Women ; with otherpapers. Prelatory Bessy by Robert Ferguson, MD . New Syd. Soc , 1859,

PP 235.

Arm— Coup d’

c ii sur la therapeutique generals deamaladies de PM et de sea

annexes. [Therapeutics of Uterine Diseases , Ac. ) Bull. de Theraps April3oth and May 15th, 1858. (Canst., vol. iv,

occurs . This yearly ripening, for which the months of January,February, March, and April are most favorable,mostly ceases at thesame epoch as the germination of plants and the rut of animals .

The body of the uterus is, according to RONOt r, an erectile

organ ; the ovaryhas also an erectile bulb attached to it. He findsthat in all vertebrate, especially all mammifera, a special muscularapparatus embraces the oviduct an d ovary, and effects their mutualadaptation . The action of this muscular apparatus has the effect Ofretaining the blood within the erectile structures, and this con

866 REPORT ON mnwrrsar , arc.

traction persists during the periods of ovulation . Menstruation isa consequence of this erection .

SIMPSON’S lectures (twenty-six in number) on the diseases of women

comprise dissertations on, and clinical illustrations of, the follow ingsubjects : vesico-vaginal fistula, cancer of the uterus andmamme ,

dysmenorrhma, closures and contractions of the vagina, caruncles

of the urethra, neuroses &c. of the vulva, abscess of the vulva,

surgical fever, phlegmasia dolens, coecyodynia, pelvic cellulitis, pelvichaematomata, pudenda] varix, spurious pregnancy, and ovarian

dropsy.

DUNCAN, in an inquiry having reference to the developmentof the female pelvis, states his belief that the ultimate formassumed by the adult pelvis is greatly determined by themechanicalforces to the action of which it has been previously subjected, andat a time when the bones have been themselves softer and the partsof the os innominatumonly connected by cartilage . The nature of

these mechanical forces the author then proceeds to explain . The

normal development of the female pelvis having been thus eluci

dated, the same principles are illustrated by a reference to the conditions present in the pelves of Naegele and Robert, and it is contended that the whole phenomena of the diseased pelves in questionare explained by, and support the theory of

,the natural develop

ment of the pelvis maintained by the author.

HARVEY, having in the first place shown, by an appeal to facts,

that the peculiarities of amale animal which has once had fruitfulintercourse with a female,maybe, more or less clearly discernible inthe progeny which that female may subsequently have by othermales, reasons therefrom, that morbid qualities maybe transmittedto the female in lik e manner. With reference to syphilis, casesare cited in which it would appear that the kind of transmissionreferred to did actually tak e place .

A reprint of Goocu’s celebrated work has been super-intended

by Ferguson, who, in a prefatory essay of forty-seven pages, introduces the various subjects treated of in the original treatise . Fer

guson furnishes at the same time original and critical remark s on

these several subjects, bringing the state of k nowledge respectingthemup to the present time, and incorporating therewith the resultsof his own experience.

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868 nnroar on mnwrrnar, are .

youn g — Oh a Case of Prolapsus Uteri cured w ithout Operation or the necessityof wearing a Pessary. Lancet, 1859. vol. i, p. 81.

Gafl lari — Complete Prolapsus Uteri ; Cauteriz ation ; Cure. Gaz . de Par., 14,

1859. (Sch., 7.

mad am— Prolapsus des uterus durch ein grossesFibroid der vordern Lipps bedingtbemement. [Prolapsus produced by Fibroid Tumour of the Cervix ; Bcrasement.] Mon. Sch. f. Geb., xiii, 435. (Sch . 1 1 ,

v ea,— Procidentia Uteri fromLacerated Perine umcured by I . B. Brown

’s

Operation. Brit. Med . Jour., 1859, 363.

neum,

— Complete Prolapsus Uteri. Lancet, 1859. ii.389.

Dillon Kelly,— Recnrrenee of Retroversion of the Uterus after two years and a

half. Dub. Hosp. Gaz ., 1859, p. 70.

Vimhow 11nd Bok ih nl kyr Ueber die Entstehung von Uterusfiexionen . [Onthe Origin of Uterine Plexiona ] Allg.Wien.Med. Ztg.,4

— 6, 17, 18, or, 1859.

(Sch ., 9,

M aya— Da diagnostic diflérentiel des Polypes utérines, et des renversements

de la Matrice. [The Differential Diagnosis of Uterine Polypi and Vers ions of

the Uterus.] Journ. de Méd. de Bordeaux, Nov ., 1858. (Canstatt., vol. iv,

Teale,

— Case of Chronic Inversion of the Womb reduced by Taxis. Med. Tin esand Gaz ., xiv, 181 .

West — Account of a Case in wh ich the Inverted Uterus was Replaced after a lapseof nearlytwelvemonths. lh., 425.

Big ilL— Inversion of the Uterus. Transact. of the Med. Soc. of the State of New

York , 1859, p. 170.

Quack enbuah — A Report on Inversion of the Uterus. Ih., p. 16s .

I cClintook .— Extirpation of an Inverted Uterus by Ecrasement. Dub . Quar.

Jour., Feb., 1859, p. 137.

Kussmmr. finds that in the uterus unicornis, with or without a

second imperfectly formed cornu— r . Menstruation appears to proceed as regularly as in the case of the symmetrical uterus . 2 . Thatit does not produce sterility. 3. That the impregnated ovummaybedeveloped in the imperfectly formed as well as in the perfectlyformed cornu. 4. That pregnancy in an imperfectly formed comu isusually associated with impervious condition of the passage leadingto the other comu ; probably this apparent imperviousness is dueto swelling of the tissues only. 5. That women with one ovary and

a uterus unicomismaygive birth to children of both sexes . 6.That

it is not incompatible with the existence of repeated pregnancies,and does not predispose to abortion . 7 . That abortion

, viz ., rup

ture of the ovumand its escape into the abdomen, always happens

when the ovum is developed in the second, imperfectly formedcornu . In four cases of uterus unicornis, without a second cornu,

the right side of the uterus was the one developed. Pregnancy in

msnass s or women . 869

the imperfectly formed cornu is frequentlymistaken for tubal pregnancy.

TUPPEB‘

I‘

records a case of congenital closure of the os uteri. Thewoman was twenty-nine years old, and had never menstruated. Bymeans of a trocar, five ounces of fluid were evacuated fromthe

uterus, but the Operation was performed three times before the

opening was made complete . Finally, she became pregnant.According to An n

’s researches, the uterus is held in its place

by the utero-sacral, the broad, and the round ligaments, and by thebladder and vagina ; the junction of the body with the cervix of the

uterus is a fixed point axe dc suspension ,”

about which the

diflerant movements of the organ occur. Of thirty-seven women,in seven tenths of those under twenty-nine years old, the uterus wasantcflexed ; of women above that age, only one fifth. Antcflexion

wasmore often prment when pregnancy had not occurred.

Bonn“ proposes deep canteriz ation of the upper and back partof the vagina with Vienna paste and chloride of z inc, so as to cmterate the recto-uterine fossa, for the cure of retroflexions of the

uterus . In three cases the excessive sufferings of the patients wereremov ed, in a fourth the result was not so satisfactory .

A ease is recorded bySomme, in which a pessaryof wood was

retained in the vagin a for thirty years . Its extraction was verydiflicult. Some remarks follow on the best formof pessary to beused in cases of prolapsus .

Mam gives statistics referring to 300 cases of prolapsus of

the uterus and vagina which occurred in the practice of his father.

In 203cam Zwank’s pessary was used, and in 179 with consider

able benefit. It is necessary, in order that good results may beobtained fromthe use of this instrument, to carefully adjust its siz eto the width and direction of the pubic arch .

Mam reports four cases, in which he amputated the cervix

uteri for hypertrophy of this part of the uterus .

Enema , in an elaborate memoir on the subject of prolapsusuteri, takes up a position widely antagonistic to previous ideas, contending tlmt what is usuallyconsidered to be prolapsus is, in mostcases, only hypertrophy and elongation of the cervical part of the

vaginal. The author recommends amputation of the cervix uteri

when thc sease gives rise to serious symptoms, and we are certain

870 napoa'

r ON mnwrraar , arc .

0mm recommends the employment of leeches to reduce thebulk of the organ, in preference to the employment of pessariee, forprolapsus uteri.BONOBDEN, with the same view, recommends ergot, galbanum, and

inunction .

Nounsn relates a case cured by wearing a pad, bandage, and

tann ic-acid suppositories .

Gu nman reports a case of cure by canteriz ation of the poste riorwall of the vagina by the hot iron, at intervals of one to two

months .

Gu am and Room record cases of cure of prolapsus uteri byplastic Operations .

DILLON KELLY records a case of retroversion of the uterus recur

ring after two years . The tumour produced prolapsus of the pos

terior wall of the vagina. Reduction was easily effected.

Vmcnow, in explaining the tendency to retrofiexion, calls atten

tion to certain anatomical facts ; the extension of the recto-uterine

pouch lower down than is usually supposed, and the adhesion of

the cervix anteriorly to the neck of the bladder . Betroflexion

very frequently follows childbirth. He does not find that relaxationof the uterus is specially present in such cases, on the contrary,often hardness and hypertrophy. The natural movements of the

uterus about the bladder produce a certain amount of bendingforwards of the fundus, easily increased by undue fulnecs of therectum. Peritonitis is a frequent cause of fiexions, and congenital

shortness of the ligaments, over distension of the bladder, longretention of its contents, have also an influence of the same chareeter . Bomrmsxr agrees with Virchow on three points, viz ., as

to the internal os uteri being generally the seat of the flexure, as

to retrofiexions occurring more frequently after the puerperal state,and as to anteflexions beingmore frequently found in young womenor those who have not had children . Rok itansky thinks, however,that at the seat of the flexion there is a real primary atrophy of thesubstance .

In the case of cl rom'

c inversion recorded by Tu ms, the inversionwas partial, and had existed for two years and a half. The recumbent position, chloroform, pressure by the air-pessary and hand,formed the elements of the treatment. In Wns

'r’s case the inver

sion was also not complete, the sound being admitted to the

extent of half an inch . Efforts made by manipulation and the

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372 amour on umwrrner , n'rc .

h am— Note aur l'

emploi dea lavements purgatifs dans lo traitement du catarrheutérin . [On Purgative Enemata in Chronic Uterine Catarrh .] Bull. do

Therap., March 15th. 1858. (Sch ., 1. 60 ; and Canst., vol. iv , p.

Becquerel— Ou Neuralgia of the Uterus. Gaz . dea H6p., 47. 1858.

00811111,— The Pathology and Treatment of Irritable Uterus. Glasg. Med. Journ .,

July, 1859, 1 77.Naming and Do Christoforip,

— Ou Tuberculosis oi'

the Uterus and Appendages .

Ann. Univ. Agost. ct Sett. (Sch., 9.

Langston Park er ,

— Ou Primary and Secondary Syphilis of the Uterus. Brit.

Med . Jour., 1859.484.

Kouoch — A Case of Chancre of the Uterus. Charleston Med . Journ. and Rev

March , 1859. (Brit. and For. Med -Chin Rem, July. 1859. p.

Lu genbook— Ueber die Extirpation der interstitiellen Uterusfibroide. [On the

Extirpation of Interstitial Uterine Fibrous Tumours.] Deutsche XL. 1 , 1859.

(Sch .3.

Elk ington— Reports of Cases of Polypus of the Uterus , with Clinical Observa

tions. Obstet. Trans.. vol. i, p. 1 13.

Hu dy,

— Remark ab le Case of Uterine Polypus. Dub .Hosp. Gaz ., June, 1859. 163.

men— Ueber Polypenbildung imUterus. [On the Formation of Polypi in the

Uterua ] Verhandl. d. Naturi‘

. S ee. an Freib.. i, 309. (Sch ., 4.

Wagner,

— Fibrinous Polypus oi'

Uterus. Schmidt's Jahrb ., 1859, vol. 11, p. 37.

(Sch .4.37Du crayon do charbon caustique et des principales applications dont

'

il est sus

ceptible. en particulier an traitement dea aflections de l’utérus. [The

Crayon da Charbon Caustique" in the treatmentof Uterine Aflectiona ] Bull.de Thérap., May 15th, 1858. (Canst.. vol. iv,

sw am— Bin Todesfall. hervorgerut‘en durch das Binstromen von Kohlenaiiure

in d ie Uterushiihle. [Death from the injection of Carbonic Acid into the

Uterine Cavity.] Scan z oni'

s Beitr. a. Geburtsk , vol. iii. 1858. (Canst..vol. iv.

Noeggorath ,

— Ou Uterine Injections. New York Journ. of Med .,May. 1859.

Sack — Ueber das Sitz bad be i Frauenk rank heiten . [On the Hip-bath ] Monetach.

f. Geburtsk . xi. (Canst.. vol. iv,J acoboviog — Zur Behandlung der chronischen Gebfirmutterentz iindung. [Treatment of Chronic Inflammation of the Uterus.) Oester. Zeitsch . f. prak . Heilk ,

28. 1858. (Canst.. vol. iv,Bmsim,

— Ueber Uterinal Congestion und Gemuthsleiden. [Uterine Congestionand Cerebral Adections.) Allg. Med . Centr. Ztg., April 311, 1858. (Canst..vol. iv.

Rough — Hysteria te retention d'

urine symptomatiques d'une metrite interns ct

d’un phlegmon peri-utérin. [Hysteria and Retention of Urine symptomatic

of Metritis and Perimetritia.] Gaz . des Hdp.. 31. 1858. (Canat., vol. iv ,

Stunt — The Use and Abuse of Uterine Tents. Amer. Journ. of Med. Science.J an 1859.

BocquereL— The Chronic Inflammations of the Uterus. Gaz . deaH8p..87.93.

1859. (Sch ., 1 1 ,

De Maria — Cass of RecurrentFibroid Tumour attached to the Os Uteri. Lancet,1859. fi . r 14.

D IS EASES or women . 373

M — Scirrhus dea uterus. fibrdm Polyp. Pyometra. [Scirrhus and FibrousPolypes of the Uterus ] Mon. Sch . f. Geb., xiii.435. (Sch., 1 1.Bin Pall von Bcrasement linéaire einer Carcinomatiisen Vaginalportion. [Case

in which Bcrasement of a Cancerous Ce rvix Uteri was performed ] Sesnaoni'

s

Beitrfige a. Geb ., iii. (Canst., vol. iv.yu m— Successful Amputation of the Cervix Uteri tor Carcinoma. Gaz . dea “Op .

40 . 1859. (Sch. 8.

Ben — 2mTherapie dea Clark e'scben Blomenlrohlgewi ehses . [On the Treatment

of Clarke’s Cauliflovm' Bxcrescence of the Uterus. ) Memorab. a. d. Praxis V,

s 1859 (Sch 8 ti n )— Remark s on Chronic Metritis granulosa intern s, and its treatment by

Cauta iaation. Gaz . Habd .. vi. a. 1859.

Tilt— Chronic Uterine Disease ; Hemorrhage fromthe Bowels for the last twenty

years ; Internal Homorrho ids. are. Lancet. 1859. ii. 559.

Chu ng — Considerations sur l'ampntation do col do l

’utérua par l

'6craseur linéaire .

[On Amputation of the Cervix Uteri by the Ecraseun ] Monit. dea ildp.. 13

et 14. 1858. (Canst.. vol. iv,40 7 .)M m ,

— ou the Frequency, Importance. and Treatment of Ulcerations of theOs and Cervix Uteri. Ba ngor . Maine. U.3. . 1859. 8vo.. pp. 46. (NorthAm . Journ. of Med. Science. July, 1859. 9. u s.)

In Boston’s case ofmenstrual deviation, an ulcer on the leg was

the seat of monthly recurring pain and discharge of blood, which

In Bu l l’s case, hmmoptysis was observed on three successive

occasions at the time the catamenial flow would otherwise have

In Laura’s me, menstruation continued duripg

v

seven months of

m ay.I

Moses relates several cases in which “vicarious

occurred, fromthe umbilicus, the skin, ulcers, lungsI

and stomach ; also cases of amenorrhma associated

Ba con reports a case of epilepsy following on amenorrhcea, curedsupervention of dysente ry and restoration of catamenia.

TAYLOR records a case of amenorrhcea, associated with mania .

Electricity.bymeans of Pulvermacher’ s apparatus, was had recourseto , and with a ben eficial result.Tnoussmu, in reference to the use of ergot and digitalis, states

that, when given just after delivery, ergot produces an effectof a very

of carcinomatous origin, ergot acts very beneficially . Trousseau’ s

874 an on on mnwrrnar , arc .

,experience of the eflicacy of digitalis is limited, but so far he is

dissatisfied with the results obtained.

BEAU affirms that me has a specific action on the uterus, as

digitalis has on the heart. He combines rue with savin, in doses

of rather less than a grain of each.

BURNS insists on the efi cacyof arsenic in cases of hemorrhagiaand leucorrhma.

In the treatment of uterine catarrh, Am recommends the

injection of enemata containing aloes, gamboge, rhubarb, jalap,scammony, castor oil, croton oil, or purgative salts .

BECQUEREL considers an idiOpathic neuralgia of the uterus to be

not unfrequent. The disease is chronic, mostly intermittent, anddifficult of removal in anaamic subjects .

COGHILL considers that the affection known as irritable uterusconsists in a disordered state of the innervation of the organ . An

increased vascularity, always present, brings with it morbid emaibility. This vaso-motor irritation has a further result in the

excessive activity of the sensitive apparatus, accounting for the

presence of leucorrhcea . This doctrine is founded on considerationssuggested by Brown-Sequard

’s recently expressed views .

Nama s believes that tubercle occurs in the genital organsmorefrequently than is usually supposed, and that it does not often occur

p rimarily in the genital organs . He has usually found tubercle inthe uterus in the crude stage . When the Fallopian tubes are

affected, the canal is not obliterated. In the ovaries the author hasfound tubercle in great quantity. DE Cna l sroroms contests thevalidity of some of the above generalisations .

On the subject of syphilis of the uterus, PARKER arrives at the

conclusion that the uterus is capable of being primarily inoculatedwith syphilis, the sores being situated on the external surface of the

neck , within the us or canal, or more deeply ; that the uterus is

liable to be attack ed with the symptoms of secondary syphilis, whichconsist in discharges fromthe canal of the cerv ix

, general or partialenlargement of the neck and lips of the uterus, with congestion,

inflammation, and superficial ulceration and that the affection often

persists for years .

KOLLOOK records a case of chancre of the os uteri, proved byinoculation to be a genuine syphilitic sore.

In cases of fibroid tumour of the uterus, Laxonnnacx advocate s

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876 REPORT on mnwrrs ar , are .

excrescence of the uterus is not admissible, Em recommends thefrequent use of caustics .

COSTILHES recommends the use of nitrate of silver, applied in thesolid state, for the removal of the fungus-e granulations presentin chronic granular metritis .

TILT relates a case of chronic uterine disease and internal

hmmorrhoids ; a tumour of the uterus was also present. The

patient had lostmuch blood, the source of which was not perfectlyclear .

MORUBE believes that simple ulceration of the uterus is no so

formidable amalady as it is maintained to be by certain writers.

”

The author advocates cleansing of the vaginal passage by emollientor slightly astringent fluids, attention to the general health, rest, &c.,

in order to remove the leucorrhma. Caustic agents ought never tobe made destructive, and the demonstrative use of the speculumisseldomjustifiable or required in the diagnosis .

m. nrsm ns or m ovaams, are .

Eulenberg,

— Ovarian Cyst ; Pregnancy; Compression of the Tumour by theUterus ; Radical Cure . Wien. Med nz in. Wochenschrift, Med. Neuigk eiten,Feb . s 7th, 1858. (Noirot

'

a Annuaire,

Lumpe,

— O varie nc3ste hei e iner iichnerin in Folge spontaner Ruptur und Entlee

rung durch den Dick darm gehe ilt. [Spontaneous Rupture of Ovarian Cyst

into the Large Intestine ; Cure ] Zeitsch. d . Gesell. d . Aerlz . z u Wien., No. as ,

1858. (Canst., vol. iv .

Clay,

— Ovarian C ) at coexisting w ith Pregnancy, &c. Obstet. Trans.. vol. i. p. 2 26.

Prouss,— Radik alhe ilung eines Hyd ro varium. [Radical Cure of Ovarian Dropsy.]Deutsclie Klin lk , 48. 1858. (Sch 3.

Hergott,—Ovariot01ny. Gaz . de Strasli .. z . 1859. (Sch . 6.

Simon — Znsammenste llung von 6 1 in Deutsch land theils ansgefiihrten , theils ver

such ten Ovariotomien . [Report of S ixty-one Cases of C variotomy.] Scan

z oni’

s Be itrage z . Gehurtsk . in , pp. 98— 142 .

Spencer Wells,

— Fn e Cases o f Ovarian D isease , in three of wh ich Ovariotomyw as performed successfully ; “ ilh remark s on the means of dimin ishing the

Mortality after th is Operation. Proc. of Roy. Med. and Chir. Soc. Lancet,1859, vol. i, p. 186.

SpencerWells. Three Cases of Ovarian Disease. Med. Times and Gaz .. xl, 159.

Three Cases of Ovariotomy. lh ., 1 1.31, 59.

Unilocular Ovarian Cyst ; Injection with Iodine ; Successful result. Ih. ,

um 5480

n1ss ass s or women . 37 7

Wong, Two Cases ol Ovariotonu. Med . Times and (h s.. al, 605.Right Cases 0! Ovariotomy.w ith remark s on the means of diminishing the

Mortality of this Operation . Dub . Quar. Journ .. Nov .. 1859. 37.

Buck — Ou a Case of Ovarian Dropsy; Iodine injection ; Cure . Lancet, 1859. ii.363.

Ovarian Diw sse ; Bnptore ot’

Cyst d tecovery; Subsequent reaccumulation ;Death. Med . Times and Gaz ..m ix. 343.

m Brown — fi ve Cases ol Ovariotomy; Three snccesst‘

ul ; with practical re.

mark s. Brit. Med . Journ . . 1859. 433— 440.

Case ov arian Disease ; Operation ; Death. Lancet.

Death after Paracentesis for Ovu iaa psy at St George’s fi ospital. Reported in

Mad. Times and Gaz . . xl. 183.

Holt — Polycystic Ovarian Tumour ; Tapped fourteen times ; Ovariotonw ; Fatalresult. Lancet. 1859. ii.461.

3011380 Childg — Ovariotomy. Med . Circ. , xiv.m ,

— Polycystic Ovarian Tumour ; Ovariotomy; Death. Med. Times and Gaz ..

su it . 599.

Patterson — Case of Encysted Tumour of the Ovary. Dub. Hosp. Gaz .. July,3839. 309.

Poa ases oi Ovariotomy. Med Times and Gas a n xiL u u

mug— Two Cases of Encysted Tumour of the Ovary successfully treated by

Excision. and an attunpt to justify the Operation of Ovariotomyunder certaincircumstances . North Amer. Journ. of Med. Science, April. r859, 318.

crouch — Childbirth after Ovariotomy. Lancet. 1879, i, p. 143.

M yHewitt— Description of the Ovarian or Abdominal Sound , a new instru

men t for the Ru mination of suspected Ovarian Cystic Tumours, h e. Lancet,; 859, i. 363. and Obstet. Trans .. vol. i. p. 55.

B . Uvedale wept — A Fatal Case of Puerperal Peritonitis. complicated with

Ovarian Disease. ac. Obstet. Trans .. vol. i. p. 187.

n ach o

— Ou Hm orrhage of the h llopian Tubes. Gas .Hebd..vi, 3, 1859. (Sch.,

9— Acute Dev elopment of Tumours within the Pelvis. L

'union , 38 and 30,

1859. (Sch., 10.

Tilt — Ou Peritonitis in relation to Uterine Pathology. Lancet, : 859. i.367 ; ii,

m -Hmmatocele retro-uterina catame nialis. Gas. dea nap. 75. 1858.

M — Uebu Haematocele retro-uterine . [Retro-uterine Hmmatocele ] Inaug.

D ias. Rostoclt, 1838. (Canst.. vol. iv.vm — m i

’hematocéle retro-uterine. [Retro-uterine Hematocele ] These,

Pan . 1858. (Canst.. vol. iv.

Roma— Note snr l’

hématocele peri-ntérine. [Perin nterine Rz matoceleJ Gas .

Hebd , 33. 1858. (Canst., vol. iv.Omani — Smles hematoceles pert-utérines. [Peri-uterine HaematocelesJ Bull.

de la Soc . Anat. de Paris. April. 1858 . (Canst., vol. iv.— De l

'hématocele pert-M ae. [Pea teries Hematoeele.) Gas.

dea use . 1858. (Canst., vol. iv.madam— Recto-Vaginalahscess. Mastdarm Scheidenflstel. spontane Heilung.

[M ote-vaginal Abscess ; Reese-vaginal f istula ; Spontaneous cure ] Monats.

i. Gehurtsh, xi. 5. (Canst.. vol. iv.

878 an on on mnwmnar , are .

Eum nnne records a case in which a tumour of supposed ovariannature disappeared during pregnancy, and had not appeared againafter a year fromthe time of delivery.

In Lun a’s case, paracentesis was about to be performed for the

second time, when diarrhoea set in and lasted for nearly five week s .

The tumour disappeared. The matters passed resembled, after a

time, those which had been evacuated fromthe cyst by the operation .

CLAY records a case in which the ovarian cyst had apparentlyevacuated its contents through the bladder.

In Pnsuss’s case, paracentesis had been performed twice . Inflam

mation followed the last operation, and thirteen years after, the

patient was perfectly well and the mother of four children .

The report by En ron, of ovariotomy in Germany, contains 61cases, 23of which have been before published. Of the 6 I patientsa radical cure was obtained in 12 cases (193 per cent.) In s

(Bf ; per the operation was useless or of transitorybenefit ;and 44 per cent.) died from its immediate effect. The

operation was complete in 44 cases of these 44, 32 died (7 per

1 died subsequently of cancer, and 1 1 (25 per cent.) wereradically cured . In I5 cases the operation was attempted, butabandoned or incomplete ; of these, in I , radical cure ; in 3, noadvantage ; in death. In 2 cases, diagnosis at fault ; I died.

HERGO'I'I‘records a case of ovariotomy in a woman,mt. 50 ; death

took place twenty-three hours after.SPENCER WELLS had, up to the end of the year 1859, performed

the operation of ovariotomy in hospital practice ten times, with a

result of seven recoveries and three deaths . These cases are re

ported at length. The mortality after this Operation is to be dimih ished, he remarks— (r) by the selection of proper cases ; (2) bydetermining the stage of the disease proper for operation ; (3) bycareful precautions against unn ecessary sources of danger ; (4) bythe use of anaesthetics ; (5) by various precautions in the operationitself ; (6) bycareful after-treatment. The propriety of the operation he justifies by the results of experience and by comparison of

the results of this and other surgical Operations, as lithotomy. In

jections are suitable only for cases of unilocular disease, or cases inwhich the secondary cysts are few and small. Spencer Wells re

cords also three cases of ovarian disease, in two of which iodine wasinjected and a cure followed. In a third, death took place after

the operation of paracentesis fromcyst-inflammation .

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880 s avour ON mnmrnnr , arc .

and the uterus . The neck of the uterus is thereby pushed upwardsand forwards . The first symptomis pain, and there is great paleness of the skin, which symptoms occurring in a young woman at

the menstru al period, the usual discharge being absent or less thanusual, indicate that uterine hmmatocele is present. In the treat

ment of menorrhagia, which is believed to he often followed byhmmatocele of this character, the author recommends quinine inlarge doses .

Vorsm has collected forty-two cases of retro-uterine ham»tocele, ten of these observed by himself. The haemorrhage is, hebelieves , always intrap peritoneal . The most favorable time for itsoccurrence is at the time ofmenstruation, especially in conjunctionwith traumatic influences, such as blows, falls, &c. The diagnosticpoints are— the commencement of the disease at the time ofmenstruation, the profuseness of the flow, the sudden occurrence of

attack s like those of peritonitis, the sudden formation of the retro

uterine tumour, the quickly following anmmia, &c.

IV . DISEASES OF TH] VAGINA AND EXTERNAL GENRE-ATMORGAN8.

Simon — Ueber die Heilung der Blasen-Scheiden und Blasen-Gebi rmutterdsteln .

[On the Treatment of Vesico-vaginal and Vesico-uterine Fistule .] Monatsch.f. Geburtsk , July, 1858.

HonmL— Ou the Treatment of Vesico-vaginal Fistula. Arch. f. Physiol. 11e

1858.

Taxman — Ou a Case of Vesico-vaginal Fistula. Lancet, 1859. vol. i, p. 360.

M — Vesico-vaginal Fistula cured byBoz eman’s Operation . Ih. , p. 389.

MaoGhio.

-Cases of Operation for Vesico-vaginal Fistula. Glasg. Med . Journ..

July, 1859, p. 191. and Oct., p. 318.

Pennan — Vesio -vaginal Fistula. Am. Jour. of Med. Science, Oct., 1859,

P-353Bak er Brown — Four Cases of Vesico-vaginal Fistula. Brit. Med. Journ.. 1859.

367.

Case of Vesico-vaginal Fistula of seven years’duration ; Twenty-four opera

tions ; Ultimate cure . Lancet, 1859. vol. i, p. 143.

CoghiIL— Case of Successful Operation for Vesico-vaginal Fistula. Lancet, 1859.

i. p 455

Pollock — Two Operations for Vesico-vaginal Fistula ; Death. At St. George's

Hospital. Med . Times and Gaz ., xxxix, 315.

Watson — Ou Vesico-vaginal Fistula. In s ect, 1859, vol. i, p. 333.

DISEASES or wounh . 881

Bak er Brown — Ou Vesieoo vsginal Fistula. illustrating a new Mode of Operation .

Lancet, 1859, ii. 58 1.

— A new Principle of Treatment and Apparatus for Vesico-vaginal Fistula.

Trsns.. vol. i. p. 375.

— Case of Vesico-vaginal Fistula. in wh ich a accond Operation was success

performed. Dub. Quart. Journ. of Med . Science, Feb., 1859. 87 .

m Hem -Vesico-vaginal Fistula of fifteen years'duration ; Successful

u ployment of a Pessary. Brit. Med. Journ. . 1859. 770.

Brogan — Grease Blasenseheide nflste l. are. (On e of Extensive Vesico-vaginalFistula ] Mom-Sch. f. Geb. , xiii, 435. (Sch. , 1 1.

tt — Deus observations de fistulas vesico-vaginales guériea. Pune 3la suitel'opération et de la cauterisation, l

'autre spontanément. [Two Cases of

Vesico-vaginal Fistula ; one cured by Operation. and one by C mterixation.)C an. Med. de Strasbourg.April 33d, 1858. (Canst.. vol. iv, p.

xnchlgr ,

— Vortrag liber die Wirk ung de Doppelnaht zur Sicherung der Herstelolung eines soliden Dammes und Scheideneinganges bei der Episiorsphie . [Onthe Operation for Ruptured Perineum.] Monatsch. f. Geb.. xi. (Canst.,

vol. iv, p.

M ag— New Methods der Bpisioraphie. [On the Operation for Ruptured

Perineum.] Monatseh . f. Ge b., xi. (Canst.. vol. iv. p.

— Lacerstion of the Pa ineum. Dub. Med. Press. 1859. 10 1.

M am— B enn“ einer vollkommenen Incontinens des Urins durehbeider hypertrophischen Nymphen . [Hmfl rophy of the Nymphs : causingIncontinence of Urine ; Cure by removal.) Beitrige aur Geburtslt. und

Gynmk oL. 1858.No. 3. {L 89

v icini — Atheromatous Cyst of one of the Lab ia Majors. removed bymean sof the Bcrn eur. Ann. Univ. Agost. e Sett.. 1858 . (Sch. 9.

Thoma — The Hyman ; an Essay delivered before the New York Medical Union .

New York Journ., March. 1859. 196.

Og ingL— Cas remarquable d'

imperforstion de l’hymen . [lmperforate Bymen .]

Gas . des Rap" 1 7. 1858. (Canst. , vol. iv. p.

— lmperforate Hymen ; Fatal result after its Division. Brit. Med. Journ..

1859. an

Henson — Retention of the Memes fremtamer-fon ts Hymen. Lancet.1859. i.

Amolmier,

— Ou Narmwing of the Vagina after tho usa nd th Actual Cautery in

the treatment of Uterine Al ections. Gas . des 70. 1859. (Sch ., 9.

mgls

ty.— On Pruritus PndendiMuliebfi s. xxxix.4; and xl.

Pam -O u the Bmployment of Glycerine in Casss of Vulvar Hypemcthesia.

135.

Ladreil de la Charriere .— Sur lu mm sfi '° dw t ” mum“

(in vagin. [Cysts of the Walls of the Vagina ] Arch. ca: May. 1858.

iv. p.

Smoer operated on nineteen cases of vesico-vaginal fistula, and of

these, ten were healed completely ; fiv e incompletely, requiring subsequent caustic treatment ; only one sen t back uncured . Two women

882 nnroa'r ON umwrrsnr , arc .

died after the operation, and a third after a preliminaryoperation .

The suture used was of silk .

Mom proposes to treat obstinate cases of vesico-vaginal fistula

by obliterating the vagina altogether, and allowing the menstrualdischarge to pass through the bladder.

Taxman records a case of cure by Boz eman’s operation . The

Opening was high up and of long standing. In Mu s eum’s casealso Boz eman’s operation was successful . In MacGnm’

s cases,

Operate d upon after the method of Boz eman and Simon, of nine

hospital cases, seven were cured by an Operation, and two partially.

Of three private cases all were cured . FENNEB. cured two out of

four cases by the same Operation . Ban tu BROWN records four

cases of Boz eman’ s operation performed by himsuccessfully. The

operation successful in a case of seven years’ standing was also

Boz eman ’s . Coca lm. rejects the button of Boz eman and the circular

ring of Simpson ; he employs iron-wire sutures, and simplifies theprocess of paring the margins of the fistula by employing onlyone convex k nife for the purpose, and bent-steel spatula . The

success of the operation depends, he believes, on the iron-wire

suture . In Warsou’s case, a leaden plate was used, perforated

as in Boz eman’ s button, but having little leaden tubes soldemd tothe holes, whereby the use of shot is avoided. Ban tu BROWN

uses a separate bar-clamp to each suture, the suture being a

metallic one. In seven cases thus treated, six were cured. Bam r

proposes a new modification of Boz eman ’s operation, by whichmore perfect coaptation and greater readiness in the performance ofthe operation are secured. In Tnonr

’s case, the quilled suture was

the means used to effect the cure of the fistula.

Nnvms succeeded in preventing the escape of urine, in a case

of vesico-vaginal fistula, by the employment of a gutta perchapessary .

Ban smo believes it to be very difi cultto obliterate the vagina, as acurative measure, in cases of large vss ico

-vaginal fistula . A case is

related in which the attempt was made .

Bacor relates a case of laceration of the perineum,produced

during a first intercourse, in a young lady, set. 18. The perineumwas torn as by a sharp instrument, the hymen torn, and the vaginacompletely laid open .

BRESLAU relates a case in which excessive hypertrophy of the

nymphet was associated w ith incontinence of urine, the urethra

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884 arpoa'r ON umwrrsnr , arc.

SM — Anti-lacteacent Properties of Compressed Sponge. New York J ourn .

of Med . Science, Nov ., 1859. 347.

Coma— Cystic MammaryTumour. Dub . Hosp. Gaz .. 1859. p. 56.

flatten — Two Specimens Of MammaryTumour. Ih., p. 33.

Stay— Ou Tumours of the Mammary Gland in Females, and the Degeneration

into Malignant or Benign Growths. (A Clinical Lecture.) Med. xv.

36.

B ass records the case of a patient, wt. 2 1, in which both breasts,one weighing 10 lbs . the other 5 1bs ., were removed. Menetruation, previously absent, soon after commenced, and later, pregnancy supervened.

FANO succes sfully treated a cu e of lacteal fistula by carefullyapplied compression of the breast bymeans of strips of plaister.

For the treatment of sore nipples during lactation, Ansnmnmt recommends the employment of nipple shields, which must not be toothick or resistant. Collodion to be used locally. When deepfissures are present finely powdered benz oin is employed with

advantage.

Boom describes three varieties of defective lactation : x Thatdue to hyperwmia . 2 . That due to summia. And 3. That due tofunctional paralysis or inertia of the breast, usually present inmasculine women or those married late in life . The remedies forthe latter condition are local, hygienic, dietetic, and medicinal.Treatment includes suction

,titillation of the nipple, &c. The sepa

ration ofman and wife during the suck ling period is, he considers,prejudicial to lactation . As lactagogues, the leaves and stalks ofricinus and fennel are spok en favorably of.

Srnwan'r relates a case in which the breasts were covered by com

pressed sponge, ia order to prevent the formation of milk. The

treatment was completely successful

VI . DISEASES OP PREGNANCY AND CHILD-BED .

Bmck o -Ueber die Glycosurie der Wiichnerinnen. [On the Glycosuria of Lying.

in Women.] Wien . Med. Wocb ensch ., 19 and so , 1858. (Canst., vol. iv,1)

Die Driburger Kur bei Schwangeren. [On the Emcacy of the DriburgBathsduring Pregnancy.] Monatscb . f. Geburts ., vol. xi. (Canst., vol. iv , p.

DISEASES or women . 385

— Pall von habituellemAbsterben der Prucht. [Repeated Death of the

Fe tus ] Med. Ztg. Russh, 34, 1859. (Sch. , 1 1,

mam— 2mPathogenic der Hydrorrhe a gravidarum. [On the Pathogenesis of

Hydrorrbma gravidarum.] Zailach. d. Ges. d. Aerts. a. Wien, 17, 1858.

(Canst., vol. iv, p.[ m l

— Baotophalos, in which the Gravid Uterus formed the Hernial Mass.

Obstet. Trans" vol. i, p. 77.

Cooperm -Ou After.pai11s. Lancet. 1859. vol. i, p. 130.

Hannah — A Case of Uterine Bumorrhage three week s after Delivery. North

Amer. Med-Chin Rev., Jan., 1859, p. 89.

l eClintoch — Ou Scarlatlna after Parturition. Dub. Hosp. Gaz ., 1859, p. 55.

Draw Huma n— Sudden Death fromOcclusion of the PulmonaryArteriesseventeen days after Parturition. Obste t. Trans., vol. i, p. 313.

Chamt and M — Sudden Death during the Puerperal State fromEmboliePlugging of tbe 'Pulmouary Artery. Gaz . Hebd., v, 44, 46, 49, 1858. (Sch.,

1 1.

M — Pall von Phlebothrombosis bei einer Neuentbinden. [Case of Bhisho

thrombosis in aWoman recentlyDelivered ] Nader] . Tijdschr., pp. 167— 1 74.

(Setu 9.m )Baf fin — Ou the Treatment of Syphilis in PregnantWomen. Gaz . lleb. , Dec. so,

1858. (North Amer. Med -Clair. Reva March.M a n

— Ou Normal Hypertrophy of the Heart during Pregnancy, and its Patho.

genetic i nfluence. Arch. March, 1859. (Sch., so,

M m— lntoxik atiou zweier Schwangern suit Leuchtgas. Tod, und verseitige

Oeburt eines kindes. [Toxic Effects Of Coal Gas on two PregnantWomen.)Mon-Sch. f. Geb ., xiii, 435. (Sch., 1 1,

W -lntoxik ation mit Kohlenoxydgas. [Toxic Efi‘ects of Carbonic Oxide

Gas during Pregnancy.) Monstsch. f. Geb. , xiv, 31. (Sch. 1 1,

Martin -De l'

incontineuce d'urine apres les couches, et do as retention. [On In .

continence and Retention of Urine after Labour.] Abeille use . 5. 1858.

WWW " VO1 iv’ M 7oixrtsh C [A Case of-Zar geh iilfiichen asuistik .W HOM f. Geburta , xi. (Canst. , vol. iv , p.

Limi ng— Rene Beitr

‘

a‘

ge xur Lebre von der Uriimie der Schwangeren Gobi .tendon and t hnerinnen . [On Ummia during Pregnancy, Defivery, and

Climbed.) Monauch . f. Geb ., xi. (Canst. , vol. iv ,M t (h is Roche).— Cas remarquable d

'6clampsie. [Case of

dea 369" 14, 1858. (Canst., vol. iv, p.

moment — Abortion, with Albuminuris and Convulsions, in Six successive Preg.

nancies. Obst. Trans., vol. i. p. 108.

Pawn— Pall von Eclampsia puerperalis mit gluchlichemAusgange. [EclampsiaPue rperalis ; Recovery.) Monsts. {fir Geburtsk , xii. (Sch ., 3, 313; and

Canst. , vol. iv, p.

BM — Eclampsia on the Thirteenth day after Delivery, with consecutive

Nauru-pneumonia. Ann. Univ. Agosto.Sett., 1858. (Sch., IO,

BumiS- Bclampsia Puerpers lis. Gaz . hiéd. d

'

Orient , May, 1858. (Sch., 3,313.

Bon nier,

— Bclampsie ao huitieme mois de la grossesse, guérison ; secoucbementde deux enfants réunis sur les cotés. [Bclsmpsia at the Eighth Month of

Pregnancy; Recovery.are.) L’Union use” June, 1858. (Canst., vol. iv ,p.

Rain bow -Puerperal Convulsions. Med. Times and Gas., xxe , 333.

886 u sers ON mnwrrsnr , arc.

M erton — Puerperal Convulsions successfully treated byCrotOn-Oil Suppositories .

lh., 430.

Dumm— Chloroform-inhslstlon in the Treatment of Puerperal Convulsions. Gaz .li ehd vi. 9. 1859. (Sch., 10,

Keen — Case of Convulsions during Pregnancy. Lancet, 1859, vol. i, p. 318.

E di — Ou the Diagnosis of Hysterical Puerperal Convulsions. Dub . Hosp. (h s.,r859, p. 86.

Mama — Traits de la folie de femmes enceintes, dea nouvelles acccuehéa at da

nourrlces, Puerperal 1858,p.394. (Sehm., 11

Bal k an— Case of severe Vomiting and Dysenteric Diarrhe a in the earlymonthsof Pregnancy; Abortion ; Recovery. Brit. Med. Journ ., 1859. 600.

Girdwood.

-ou Disrrhms and Dysentery cu taneous with Conception. u nset,l 859. ii. 334.

Tyler Smith — Case of extreme Emacialion, the result of obstinate Vomiting inPregnancy. Obstet. Trans., vol. 1, p. 335.

tt— Hartniick iges Erhrechcn wahrend der Schwangerscbat'

t, Kunstlicher

bortus und Heilung. [Obstinate Vomiting during Pregnancy; ArtificialAbortion ; Cure.) Gaz . de Strssb., 8, 1859. (Sch., 13,

D080]! (do Toulon).— Vomissement des femmes grosses guéri par des applicationsfroides. [Vomiting during Pregnancy cured by Cold Applications.) Journ.

des Connais . M6d., 17, 1858. (Canst., vol. iv, p.

Ulfl ch,— Lethslcr Fall vou vomitus gravidarum. [Fatal Case of Vomiting during

Pregnancy.) Verb . d. Gee. f. Geb . zuBerlin . Monstsch . f. Geb ., xi. (Canst.,vol. iv,

Agostino M lio.

— Sur la causa dellamorte dl una puerpera primipera. [Onthe Cause of t e Death of a Primipera during the Puerperal State.) (in .Mcd.

Ital. Lomb., 38, 1858. (Canst., vol. iv,Discussion sur la fiévre puerperale. [Discussion on the Subject of Puerperal

Fever.) Bull. de l'

Ac. imp. dc Med., t. xxiii, Nos. 1 1— 30, 1858. (Canst.,vol. iv, p.

Autism— De la fiévre puerpérsle, devantl’Acsdémie de Medecine Par., 1858. [Onthe Puerperal Fever discussion at theAcad. of Medicine.) (Canst., vol. iv ,

Behier,

— Lettres sur lamaladie dile fievre puerpérsle, h M. Trousseau. [On theDisease known as Puerperal Fever.) Un. Méd Nos. 31-64, 1858. (Canst.,

iv, 417)Pidong — Notes sur la lievre puerpérsle, i. l

'

occaslon des débats acsdémiques .

[Puerperal Fever, 8m.) Un. Méd., Nos. 48— 81, 1858. (Canst., vol. iv,Kauai — Du rule que ions is precipitation de la lymphe plastique dans la produc

tionjdes flévres puerpérsles, des résorptionspurulentes etdes résorptions putrides .

[Exuded Plastic Lymph as a cause of the Production of Puerperal Fever, are.)Mon . des iliip., Nos. 36

—44, 1858. (Canst., vol. iv,

Chavanne ,

— La fiévre puerperale h l’Academie dc Medicine. Gaz . Med. de Lyon ,

Nos. 7 and 8, 1858. (Canst., vol. iv,

Legroux ,— Considérstions sur in nature et is traitement de la fiévre puerpérsle.

[On the Nature and Treatment of Puerperal Fever.) Bull. gen. de Therap. ,

July, 1858. (Canst., vol. iv,Don — HOpital d

’accouchement de Prague ; Epidémie de fi n e puerpérale. [Puer

peral Fever at the uapnn d’

Accouchemeut at Prague.) Gaz . Hebd., No. 9,1858. (Canst., vol. iv,

Pecholier.

— Observation de fiévre puerperalc. [Case of Puerperal Fever.) Rev .

Méd.,March, 1858. (Canst., vol. iv,

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888 arroar on mnwrrnar , are .

pregnancy by repeated.venesections, and the result was favor

able .

BRAUN was led to believe, fromexamination of a case of hydror

rhma gravidarum,

”that the exudation in question proceeded from

a delicate membrane situated between the placenta and uterus.

MURRAY records a case of exomphalos, two thirds of the bulk of

the gravid uterus at eight months passing through the umbilicalring. It was reduced, and the patient did well.MCCLINTOCK found, that of twenty-eight patients treated in the

Rotunda Hospital for scarlet fever after parturition, twenty-five percent. died. He attaches great importance to the early administration of stimulants in the treatment of such cases .

Macm DEB. relates a case in which a large, branching, fibrinousplug was found completely stopping up the right pulmonary artery,and a less considerable one in the left, in a patient who had diedsuddenly seventeen days after parturition .

In Can cer and BaLL’s case, the patient died a few days after

labour . There had been phlegmasia dolens, and the pulmonaryarteries contained clots, some recent, others older. The clots in the

pulmonary artery had, it was inferred, been transported fromthe

common iliac vein .

In Bas a'

r DE LA FAILLn’s case, phlegmasia alba dolens occurred

twelve days after labour, and death five weeks later. The uterine

and pampiniformvcnus plexuses contained coagulated blood, thecommon iliac veins, the hypogastric and crural, as far as examined

,

contained clotted blood. So also, the inferior vena cava for a shortdistance contained a coagulum. No pus was found, and the uterus

is described as healthy.

Bnar mrecords facts and observations to show that the anti

syphilitic treatment of the mother by mercury is not injurious tothe fmtus, and should not, therefore, be postponed on accountof the

presence of pregnancy.

LABCHER examined the heart in 130 cases of death soon after

labour, and in all found the organ hypertrophied. The hypertrophywas limited to the left ventricle, which was fromone quarter to twothirds thicker than usual, and was also firmer and more red. If

several pregnancies follow quick ly one on the other, the hypertrophymay, it is contended, become permanent. The disturbances of thecirculation, &c.

, to which women with large families are so subject,are set down to this cause.

DISEASES or women . 889

Banan a states, that two women who slept i n a roominto whichcoal gas was escaping were found in the morning in a state of

considerable danger, and one of the women aborted the next day.

In Panmw ’e case, carbon ic oxide gas, inhaled for some time, is set

down as the cause of the death of a fwtus of seven months, and itssubsequent expulsion .

In Baoanaarrr'

s case, the association of albuminuria and emul

sion: was noticed in six successive pregnancies .

pregnancy ; the woman was sammie . After delivery the cborea nearlydisappeared, but not completely until after the lapse of two

months .

e z um records a case in which marked urmmia was presentduring the last week of pregnancy, but the quantity of albumen inthe urine was inconsiderable . The intensity of the anemia is, hebelieves, in relation to the degree of the interference with the excretion of urea.

In Pasca’s case of eclampsia, (primipara), the convulsions began

with labour, and continued after delivery by the forceps . The

urine was highly albuminous . Small doses of opiumwere given for

two hours after delivery, and afterwards chloroforminternally. The

patient recovered . Bm rn’s patient was a primipars, set. 17 .

Atropine was administered, and to it the cure which followed isascribed . In Banoz z r

’s case, convulsions set in during labour, so.

companied by perfect loss ofconsciousn ess and righthemiplegia . The

convulsions continued for seventy hours fromtheir commencemen t,and consciousness was perfect for the first time six days afterwardsconvalescence after five months’ illness . The urine was not examined .

(Edema of the legs was present. Bounsum’s patientbecame affected

atthe eighthmonth with convulsions, preceded by (edema of legs andhands . She was largely bled, and delivered of twins united together.

In Ran ss ormm’s case the convulsions occurred at the seventh

month of pregnancy, preceded by drowsiness, puffy hands and face,

&c. They were frequently repeated and there was insensibility andstertorous breathing. The patien t was freely bled, and later the

membranes ruptured, and labour completed . No albumen was foundin the urine . Recovery M eet. In Ovan'

rox’s case, crotch-o il

suppod tories were of service . Anasarca was present. B ureau foundthe treatment by inhalation of chloroformeffectual. KEEN

’S patient,

890 REPORT ON mnwrrnar , are .

hearty meal, and died in five hours. The os was undilated

throughout.K mn relates two cases observed in the Coombe Lying-ia Hospital,

in which the diagnosis of hysterical from epileptiform convulsions

was difficult. The only reliable diagnostic point in these cases wasthepreservation of consciousness by the hysterical patients throughout.Manca’s work on puerperal mania is a complete analysis of

psychical derangements in women during the periods of pregnancy,parturition, and lactation . The pathology and treatment of these

afi'

ections and the medico-legal bearings of the subject are fullydiscussed. Details of seventy-nine ew es observed are incorporatedin the text.

Bu rma, in relation to a question raised in the course of discussion respecting the late Smethurst ” trial, relates the case of a

patient, set. 42, pregnant for the first time, who became affected

immediately after conception with vomiting, and two months and

a half after, with dysenteric diarrhcea. Abortion occurred at the

end of the fourthmonth, and recovery followed. Gmnwoon also

cites four cases in which dysente ry or diarrhoea was associated

with vomiting during early pregnancy .

In Tru ce Surm’s case, obstinate vomiting set in coincidently

with conception, and the patient was so reduced as to weigh only

forty seven pounds . With great difficulty she was k ept alive . At

the end of five months abortion occurred. Death, some monthssubsequently, fromphthisis .

Baz ox found benefit in three cases of vomiting fromapplicationsof cold water to the epigastrium. ULRICH records a fatal case of

vomiting in pregnancy.

In Paris a discussion on the subject of puerperal fever occupiednumerous sittings of the Imperial Academy of Medicine. DEPAUL,who contended for the non-essentiality of the disease, stated thatcases were not rare in which local alterations were quite wanting.

The unk nown poison affects not only women in childbed, but pregnant women , the fmtus, and even women not pregnant. He had

only seen two or three recoveries out of some hundreds affected .

BELPECH had found no good results fromthe use of quinine . The

disease is developed, he contends, almost exclusively in lying-inhospitals ; is seldomfatal in private practice . BEAU stated that thereason other observers had notbeen successful with quinine was thatthey had not used it in the propermanner. Hismethod was to give

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392 naron'r ox mnwrraar , are .

l 857, the state of the weather had a considerable influence . A

much larger proportion of the women delivered in cold and wet

days were affected than others .

Scnun'

rsx records the microscopic appearances of the blood of

several women suffering frompuerperal diseases . The chief of thechanges observed was a fatty condition of the white corpuscles,but this was not present in all cases .

Vmcnow states ,that from the autumn of 1856 to the spring of

1858, eighty-three fatal cases of puerperal disease occurred in the

Charité of Berlin . The disease was most fatal in the wintermonths,a fact attributed by the author to sparing ventilation . Then followsan account of the chief post-mortemappearances observed.

Man'

rmbelieves that there is a form of puerperal fever dependent on a propagation of the endometritis into the Fallopian tubes,and an effusion of the purulent products of this inflammation intothe peritoneal cavity. It is important not to use toomuch palpation

, or the contents of the tubes maybe pressed into the cav ity.

DISEASES OF CHILDREN.

GENERAL TREATISES , HYGIENE, STATISTICS, ETC .

Balk an — Ou the Hygienic Management of Infants and Children. Churchill,London . 8ro. pp. u 5.

Plath — Briefs eines Arz tes an cine junge Mutter. [Letters froma Physician to aYoung Mother.] Hamburg, 1858. (Sch 10,

West — Lectures on the Diseases of Infancy and Ch ildhood. 4th cd., pp. 755.

London . 1859.

h aunt — Hygiene des enfants nouveau-nés . [Hygiene of Infancy ] Parts, 1858

59. pp. 316

Bamson ,

— Hygiene oculaire de l’enfance. Paris, 1858. pp. 48. (Sch., 12 .

Ki ttner,

— Ueber den Einfluss des Geschlechts auf Kinderk rsnk heiten. [The In .

fluence of Sex on the Diseases of Children.] Journ . f. Kinderk r., r and a, 1839.

(Sch . , 7, 3a. )

Gerhardt,— Krank lieiten dea erstcn Lebensjahres. Mittheilungcn aus der Polik lin ik

z n Wiirz hurg. [Diseases of the First Year of Life.) Deutsche KL, 9, 1858.

(Sch ., 6,

DISEASES OF CHILDREN. 393

cum-m on the Diseases of Children . In North Amer. Med.~Chir. Deva

Jan. 1859, p. n o.

Lnu insk yf-Dritter Jahresberieht dea dd

'

entlichen Kinderltrsnlieninstituts an

Mariahilf in Wien. [Th ird Report of the Hospital for Children, Vienna.)Journ. t

’

. Kindest ,3 and 4, 1859. (Sch. , 8,

Amman -Die ersten Mutterpdiehten and die erste Kindespdege. [Pin tDuties ofthe Mother, are.) 810. durchgesehene Audage . Leip z ig, 1858.

I cing-Da Kind in wh en ea ten Ie hensjahrsn. Sh iatsu fiber Leihev und

Ce istesen iehung. [The Infant's First Year.) M , 1858. (Canst., iv.

Chm -Soles hygieniques a dunner l l'

enfant depuis as naissanee jusqu'an

sevrage. [Hygiene of Infants.) Pa ris, 1858. (Canst., iv,Alum -De l’allaitetnent. [On Lactation.) Par is , 1858. (Canst., iv,Nandeam-De l'allaitement. [On Lactation.) Par is. 1858. (Canst., iv,Pam — De l

'allaitement maternel. [On Lactation.) Paris, 1858. (Canst.,

iv.4380W hen — Zur physlachen Emehnng der Kinder. [Physical Education of

Children .) J ahrh. f. Kinderheilk ” part iv, 1858.

Streng .— Die einti chsten und natfirlichsten Mittel. die Kinder ohne Anwendung

der An neien fortwih rend gesund z u erhalten. [The Preservation of the Healthof Children bysimple and naturalmeans.) ad ed. M a y, 1858. (Canat.,iv,

W — Populi res Handbneh der Diiitetik . [Popular Handbook of Die.

tetica.) Le ip z ig , 3858. (Canst.. iv,Polliuer a-Ideen snr Anbahnung einer wissenschamichen Diiitetik nnd physischen

Ers iehung des Kindes. [Physical Education, &c. , of Children.) Jahrh. f.

Kinderheilhunde, Jahrg. i, part iii, 1858. (Canst.. iv,Panama— 2m Therapie der wichtigsten k ranhheiten dea kindlichen Alters.

[Therapeutics of the more important Diseases ot’ Childhood.) Jahrb . f. Kin

m o ii, ‘859‘ (Sch . , '3r

m m and Spam- Ueber den Uebergang medilmnenti rer Stod‘e ans

demKreislsut'e der Si ngenden in ihrer Milch. [On the Conveyance of Med l.

eines fromthe Mother to the Child bymeans of the Milk.) J ahrh. f. Kinder

heilk . , Jahrg. ii ,psrt i, 1858. (Canst., iv,Lehm a n

— Onsh ues observations sur les nouveau-nés. [On New-horn Chilpdu n.) Par is , 1858. (Canst., iv,-Ueher Semiotilr und das Verfahrcn bei der Untersncbung kranlxer Kinder .

Semeiologyand Investigation of Diseases of Children.) J. t'. Kinderi " 7, 8,1858. (Canat., iv ,

h p .

— Ueber Unterauehung und Semiotik dea ltranlten Kindes. [SeineiologyandInvestigation of Diseases of Ch ildren. ) Jahrb. f. Kinderheillr.. J ahrg. ii, part i.

M ess, 1858. (Canst., iv,Hermann

— Die Veri nderungen in der Physiognomie und den Geberden liranlterKinder. [On the Alteration in the Physiognomy and Gestures ot

‘

Sick Children .)Journ . f. Kinderltrank ., t n. s , r858. (Canat. iv.

Loam ,

— 8eehsehnter Jahresbericht fiber den Stand und die Wirk aamk eit deaW oseph-Kinderspitsles in Prag in h im 1857. [Sixteenth Report of theHospital for Ch ild ren at Prague.) (Canst., iv,

“ annex — W id e Mittheilungen ans demSt. Anneal inderspitale in Wien .

[Reports fromthe St. Anne’s Hospital at Vienna.) Journ . f. Kinderk q r, s ,

1858. (Canst. , iv,

894 REPORT ON umwrrsnr, arc.

.l mL— ZweiterBericht iiber das k linischeHospital tiir l indsl'lu'

ank hi tsn

ao Manchester. [Second Report of the Clinical Hospital for Dias. “ of Chil

dren, Manchester.) Journ. f. Kinderk n nh , 9, so. 1858. (Canat., is ,

Fagg— Das Kinderhospital in Christiania v i brand der Jahrs 1855— 1857. [The

Children’

s Hospital at Christiana during the years 1855 Journ. l. Kin

derltrank ., 1 1, 13, 1858. (Canst., iv,Human— Therapeutisches ans demKinderhospitale z u lfi inchen. [T

at the Children's Hospital, Munich.) Jahrb. f. Kinderhd lb , ii, p. 49, 1859.

(Sch. rs,

The treatises of Bu n s , Pmrn, Dncna'r, An ton, Mama,Cameraman, Scnnnsnn, Smears , and Pou r

-mm, have reference to

the hygiene of infancy, and the various precautionary and other

measures to be taken in order to preserve the health of children .

The new edition (fourth) of Was'r’

s Lectures on the Diseases

of Infancy and Childhood,’ contains additional and new matter ondiphtheria, disorders of themind in children, idiocy, &c.

Valuable statistical information is contained in the several

reports of children’

s hospitals, above enumerated, by Ru'

f fNEB,

Grammar, Lnszmsxv, Lonscnnnn, Man'

rmvsn,&c.

srscu L rasarrsss, are.

1. DISEASES or run BRAIN, smut. com) , usavas, AND enema

or run snxsns.

Vogt— Die essentielle Li bmung der Kinder. [On the Essential Paralysis of

Children.) Borne, 1858. pp. 86. (New York Journ., Jan ., 1859,

West — Ou Cerebral Symptoms independent of Cerebral Disease. Med . Tin es and

Gaz ., xl, 623.

Kidi — Ou Distortion of the Features in NewlyBorn Infants. Dub. Quar. Journ.,

Feb . , 1859. 155.

Phib an — Chronic Hydrocephalus. Lancet, 1859, vol. i, p. 19.

Roldan— Pi lls von opisthotonus, abhl ngig von Riick enmarlrserk rankung bei hydrocephalisch erhrank ten Kindem. [Cases of Opisthotonos dependent on Diseaseof the Spinal Cord in Ilydrocephalic Children .] Journ. f Kinderk r., 5 and 6.1859. (Soh o.

BM — Ou the Treatment of Chronic Hydrocephalus by Injections of Iodine .

Chicago Med. Journ., April, 1859. (North Amer.Med .-Chir. Rev.,July, 1859,

Wam p u mon as a Counter-irritant in Hydrocephalus. nae Med. Journ.,

l 859r 54°°

Bang— Ueber der Heilbark eit der tuberk ulbsen Meningitis. [On the Curability

of Tuberculous Meningitis.) Biblioth. for Larger, vol. vii, p. 341. (Sch., 5,

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896 REPORT ON mnwrrnnr , arc.

essential infantile paralysis : That formof infantile paralysis whichhas been called essential, is a nervous paralysis, the residue of a con

gestivo or inflammatory condition of the nervous centres or nerves,

and this condition, together with the paralysis, may be removedsooner or later by natural processes .

K mD believes that the distortion of the features occasionallynoticed in newly born children is caused by paralysis of the portiodura, differing fromMcClintock , who is disposed to attribute it tospasmodic tic.

In PHILSON’S case Of hydrocephalus, Gdlis

’s treatment, by small

and repeated doses of calomel, was found efi cacious .

KOHLEB. states that the condition of the spinal cord in cases of

hydrocephalus has been too frequently overlooked ; the convulsions,&c.

,observed in cases of hydrocephalus are not always due to cere

bral irritation . Three cases are related exemplifying these views .

BBA INABD relates two cases in which iodine was injected into thelateral ventricles of the brain, one by himself, the other by Towmesk o,Of Bucharest. In neither case was the injection followed by seriousconsequences . The permanent good effected does not appear tohave been considerable .

WATSON observed symptoms of hydrocephalus a few weeks after

the cure of an ecz ematous eruption of the scalp in a child, net. 2 .

Croton oil was applied with perfect success .

BANG remark s that although tubercular meningitis is consideredincurable by some authorities (Camper, Trousseau), he has been ableto collect eighteen well-authenticated cases of cure . Tuberculousmeningitis is characterised by its attacking scrofulous children . A

cure is only to be hoped for when improvement can be effected in thestate of the blood. Bleeding is only admissible at the commencement.Prophylaxis

,by the use of anti-scrofulous remedies and derivants, is

very important. Blisters, cold afl'

usion to the head, and, if the disease has reached the exudative stage, blisters, croton oil, or tartar

emetic, rubbed in over the shaved scalp, are recommended . In the

early stage of the affection, to which period alone IIARVEY’S Observa

tions refer, this author considers bloodletting as very important, itsaction being subservient to the action of purgatives, and the benefitderived fromit being that it

’

reduces the irritability of the stomach,and thus allows purgatives to be given .

“ A case which does not

admit of bleeding does not admit of cure . This remedy has of

late, it is contended, been too much neglected.

DISEASES or CHILDREN. 397

COLDSTRBAM has found iodide of potassiuma very valuable re.

medy in the treatment of those'

numerous ailments of children indicative of a te ndency to hydrocephalus . It is more especiallyserviceable when there exists more or less of the scrofulous diathesis .

CAnsox records a case in which a patient in the lnst stage of

hydrocephalus was cured by the administration of two grains of thismcdicihe every two hours . Othermeasures had been tried unavail

infnnts is exposure to the bright light during the day.

WALLMANN proposes the name hydromeningocele for that pathological condition in which there is an external tumour filled withserous fluid and communicating with the arachnoid cavity. VALENTA

describes a me of this kind in which the tumour was of considera

Bm states that the hypersesthesin in rachitis is situated in the

nerves of the periosteumand bones . A painful condition of the bonesis,according to this author, an early symptomof rachitis.

Gm speaks very highly of the efficacy of chloroforminhalationsin the treatment of chores . The chloroformis given with safety in

and access of fresh air . This remcdy is stated to have amuohmorerapid efl

'

cct than othermethods of treatment.

11. DISEASES OP THE ORGANS OP BESPIRA’

I'

ION AND CIRCULATION.

W — Ou the Marshall Hall-Method of Treatment in Asphyxia. Lancet, i.1 18

WM ,

— Ueber Angina pharyngea redematosa imKindesalter. [On theAngina Pbsrynges (Edematosa of Childhood.) Journ. f. Kinderiu, 1 and 3,

1859.

— 8ehvvellung der demVague auliegenden Drfisenpaquete als warsehein

Ursache dea Asthma Miliari. [Enlargement of the Glands near the n us

as a probable Cause of Millar'

s Asthma.) Men orah . a. d. Pres iii, 7, 1858.

(Sch., 4sSam -Ueber Asthma thymieum. [On Thymic Asthma ) Arch. 1. Physiol.

Heitk . N. P., iii, p. 305. (Sch . 7,

Jam -Ueber den Ban der Thymusdriise. Jahrb . f. Kind , part 3, 1858.

(0mm. iv.4st o)Friedm -Die Physiologic der Thymusdriise in Gesundheit und Krsnlrheit.

[The Physiology ol the Thymns in Health snd Disease.) h a w -u m.

1858. (Canst., iv,

898 aarou'r ON mnwrrnnr , arc.

l oam— M ona of the Cheat in Young Persons and Children. Duh. Heap.

Gaz ., June and Aug" 1859, pp. 181— 2 26.

Bund lin g — Ueber die Lungenerweichung der Sauglinge. [On Softening of the

Lungs in Infants at the Breast.) Journ. l. Kinderh , 3 and 4, 1859. (Sch .,

6,

Demand — Usher die chroniache Heiserk eit der [Kinder-g dereu Ursache und

Behandlung. [On the Chronic Hoarseneaa of Children.] Journ.tiir Kindest ,

9 and re , 1858. (Sch., 1 ,

west — Ou Sudden Death in Infancy and Childhood. Med. Times and Gaz ., xl,

331.

M anna— Ueber die Symptome und die Behandlung der Koryz a dee Neugeborenen. [The Symptoms and Treatment of the Caryn of Infants.] Journ . f.

Kinderk ., 5 and 6. 1858. (Canat., iv,Forsyth Ed ge

— Ueber acute and chroniache Koryu der Kinder. [The Acuteand Chrome Coryz a of Children.] Journ. f. Kinderlr., n and rs. 1858.

(Canst., iv,Bah — Die Croupepideruia 1856-57 z u Konigsberg in Pr. [The Epidemics of

Group at Kanigsberg in 1856 Kdnigsh. Med. Jahrb., parts a and a.

(Canst. , iv,Kern — Studien und Brfahrungen in Betrefl dea Croup, dea Pseudocroup und dea

Millar’achen Asthma. [On Group, &c.) Deutsche Klinik , 1858, No. 5.

(Canst., iv,Bouchut etEmPiog,— M6moire sur l

’alhuminurie danale croup. [Alhuminuria in

Croup.] Compt. Rend., No. a, 1858. (Canat., iv,Bouchut — Sur la mortalité da croup a domicile et dans les hdpitaux de Paris.

[On the Mortality of Group in private houses and hospitals at Paris ] Gaz .

dea H6p. , 1858, No. 1 18. (Canst., iv,Kortfim,

— Prak tische Bemerlrungen z ur Behaudlung dea Croup. [Treatment ofCroup.] Deutsche Klinik , 1858, No. 20. (Canst.

, iv,

Pndom— Behandlung dea Croup durch nassk alte Umschliige 11nd Kupfersulphat.

[Treatment of Group byWet Applications and Sulphate of Copper.] Journ .

fiir Kinderk rank h ., 1858, parts 1 and z . (Canst., iv,Banner ,

— Einige Bemerk ungen z u der Dan tellung dea Dr. Lusz iusky in Wieniiher den Group and dessen Behaudlung. [Criticismof Dr. Lusz insky

’s State .

ments in reference to Groupand its Treatment ] Journ. fur Kinderk ranhheiten ,1858, parts 3and 4. (Canst., iv,

Bouchut,— D’une nouvelle methods do traitement da croup par le tuhage du

larynx. [A new Method of Treatment of Group by Tuhage of the Lax-yum]Moniteur dea H6pit., 1858, No. n o. Union, Gaz ette, &c. (Canst., iv,437

Grog — Crow , Cathétérisme da Larynx. [Catheteriaru of the Larynx in Croup.]Union Méd., 1858, No. 109. (Canst., iv ,

Barthes — De l'emploi da chlorure de potasae en instillationa dans la trachée artére

apres l’operstion de la tracheotomie dans la croup. [On the application of

Chlorate of Potash to the Trachea after the Operation of Tracheotomy forCroup.] Jour. de Connaiss. Med. cl Th., 1858, No. 2 7. Union, Bullet., &c.

(Canst., iv,Croquy,

— Notice sur le croup et les afiections diphthéritiqucs , observes a l’hdpital

St. Eugenie, &c. [On Group and Diphtheritic Afi'

ectiona at the St. EugenieIlcspital.] Paris, 1858. (Canst., iv,

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400 s avour on nmwrrnar , arc.

CormgL — Ueber die Natur und Behandlung der Lungenachwindsucht. [On theNature and Treatment of PulmonaryConsumption .) Erin-g, 1858. (Canst.,iv,

Sohnh — Blutgef‘

a'

sschwimme l1e i Kindern. [Vascular Tumours in Children.)Jahrb. l. Kinderi ., 1858, part 3. (Canst., “0

dro,

— Beseitigung der Gefiissmutter-mi ller durch Vaccination. [Vaccinationfor the removal of v i Materni.) Archiv. 6611. J. I. Kinderk ., 3and 4, 1858.

(Canat., iv,Bok gL— Kephalohmmatoma der heiden Scheitelgegenden . [Double Cephalo-hmmatomata.) Jahrb . f. Kinder., 1858, part 3. (Canst., iv,

Bierbgm — Encephalo-hematoma verum. M. Z. v.V. f. H. in P. Jahrg., i, 1858,No. 38. (Canst., iv,

fi shy— Two Cases of Cranial Blood-swelling, with remark s on the Nature of

these Tumours. Obstet. Trans " vol. i, p. 331.

Prcxrom) relates a case of asphyxia neonatorumsuccessfunytreated on the Marshall Hallmethod.

Under the term angina pharyngeamdematosa, Wnn'rnnmnn dis

tinguishes an inflammatory serous infiltration of the submucouscellular tissue of the throat. The respiration is quickened, diflicult,and accompanied by a peculiar gurgling sound. It occurs

chiefly in sickly children, with white skin and immrfect osseous

development. Emetics are of great efficacy in the treatment of theaffection .

Pmocn relates the case of a child, otherwise healthy, wt. who

was affected with enlargement of the glands under the right ear .

Laryngismus set in, and was cured by the application of iodine over

the cervical enlargement.As examples of thymic asthma, SCHO'IT IN relates three cases, two

of which were fatal. The superior part of the thymus was enlarged,thickened, and structurally altered. The pressure of the thymus on

the vagus , or the large vessels in the neighbourhood, and inducedprimary or secondary irritation of the vagus or of its recurrent

,

which latter, reflected on the glottis, produced the disease .

Jnxnnassmconsiders that the structure of the thymus gland isanalogous to that of the organs connected with the lymphaticsystem, especially with that of the follicles of Peyer’s glands in theintestine .

The work of Fnrnnw sm is an elaborate inquiry into the history,

structure, diseases, &c., of the thymus gland. A very cepious

analysis of the work is given in Canstatt’s 1858,

vol. iv,p. 443.

Moons relates a fatal case of bronchitis in a child, net. 9months.

In subsequentpapers cases are related, and remark s appended by the

DISBASES or cmw nsn . 401

same author, on various points in the pathology, &c., of bronchitisand broncho-pneumonia, and on pleuritic aflections, in children .

Baccarnss gives the results of his investigations on the patholo

gical or cadaveric nature of softening of the lung, as described by

da it formof the affection was found only eight times . Soften ing of

the lung was found in twenty-nine cases in all. The age in the eightcases varied fromten days to sixmonths. The other post-mortemappearances in these cases are described in detail. The conclusions

of the author are, that there are two kinds of soften ing of the lungsubstance— the one dependent on local and general pathological conditions, the other of a cadaveric nature, and due to the acid contentsof the stomach passing into the trachea (confirming Bednar

's

original views on this subject) . That these two kinds of softeningmay exist together.

Brennan records three cases of obstinate hoarseness in children

the mucous membrane of the throat and entrance to the windpipe .

The author considers that there is a mild formof mdema of the

mucous membrane present in such cases, perhaps identical with thatk nown as

“clergyman

’s sore throat.

”

Wns'

r remark s on the extreme frequency of sudden death duringthe first year of life . Of 627 cases of sudden death in London,in 1854, 336 were cases of infants under a year old. Such deathis oftenest produced, the author believes, by sudden interference

with the respiratoryprocess, and in three out of four cases it is

probably due to laryngismus stridulus . Any spasmodic disorderof respiration, sudden impressions on the nervous system, suddenchange of temPerature, position , &c., may, by exciting convulsions

,

cause death in this sudden way. Another cause of sudden death ininfancy is extensive and sudden invasion of the respiratory organsby disease

, as where large portions of the lungs become collapsed,or where ser ous effusion tak es place suddenly into the cavitv of the

pleurtu.

Boncnm recommends the insertion of silver, curved canulas in

the nostrils in cases of coryz a in infants, in order that the act of

suck ing may not be interfered with, this being contemporaneouswith other treatment.Bonn describes very {mi epidemics of croup in Kiinigsberg .

The mortality was seventy-six per cent. Falsemembranes, varying26

402 arrow on mnwrrnar, arc.

in thick ness and character, occupied the upper portions of the respiratorypassages, extending lower down in most cares. The lungs

exhibited hypostasis, lobular and lobar pneumonia, collapse,mdema,and emhysema. The durationday to ven days . The bronchial and lung affections were, in

the author’ s opinion, the chief efficient causes of death. Tracheo

tomy was employed in four cases, without success in all. Lus

ainky’

s method of treatment, viz ., by carbonate of potash, was notfound to be of service.

Boocnnr and Exams found, that in eleven out of fifteen cu es of

croup, albuminuria was present, disappearing with the disease.

Bouorm'

r states that themortality fromcroup has been increasingvery rapidly during the last fifteen years, which he attributes to thesurgical treatment of this disease of late in vogue.

Boocmrr proposes a new method of treatment in cases of croup,viz . catheterism, or tubage of the glottis . The silver tube used forthe purpose is cylindrical, straight, nearly an inch long. Two

rounded projections receive, as in a kind of slit, the inferior vocalcords on each side. and the tube is thus kept in situ. The tube isintroduced by means of a male catheter, open at its two ends.

In Bouchut’s cases the treatment was, however, not successful.

Gnos reports a case of croup treated by Bouchut’s method, and

which ended favorably.

MAYER states that favorable results have followed the applicationof glycerine to the interior of the larynx in cases of croup .

BOUCHUT describes a new phenomenon in the latter stages of

croup— anaesthesia of the skin . This, which is the commencementof asphyxia, is, he states, the period for operativemeasures .

Bnoananx'

r records a case of tracheotomy for croup in a childten months old. The operation was for a time successful, but deathtook place without anyapparent cause thirty-three hours after.

In reference to the operation of tracheotomy i n croup, ConwarEvans contends that the objections entertained in this country and

in America to the operation are without valid foundation . Theseobjections he severally examines and discusses, with the view of

showing .that the operation is really less dangerous and difficultthan usually supposed. T he early performance of the operationis insisted on ; the causes of death

,when death occurs after the

Operation, examined, and the circumstances which tend to diminishthe chances of success from the operation referred to. On the

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404 REPORT ox mnwrrsnr , u'rc.

Schwarm— Pathologischcanatomisches Bild der cholera infantum. [Pathologi

cal Appearances in Cholera IntantumJ Journ. f. Kinderk ., 5 and 6, 1859.

(Sch., 9.33s .)8mith,

— Post-mortemAppearances in Cholera lnl'

antum, with Cases. New YorkJourn. of Med , Jan., 1859, p. 61.

Knttnor ,— Einige Bemerk nngen tuber die Dystrophie der Kinder. [On the Dys

trophyof Children .] Jour. f. Kindcrk ., 1858, parts 3and 4. (Canst., iv, 4SO

Steinberger ,

— Ueber Bildung der Milchz '

i hne und die ihren Durchbruch beglei

tenden Brscheinungen. [First Dentition, its accompanying Symptoms.) Jahrh .

f. Kinderlt., 1858, part 1 . (Canst., iv,Blmdjm— De la premiere dentition et de ses accidents. [First Dentition, its

EflcctsJ Paris , 1858. (Canst., iv,Emm i — Des accidents de la premiere dentition. [ht ] Parts, r858. (Canst.,

iv,

Rm— CanmmOris. Med. Circ. , xiv, 75.

Hem — De la gingivite ulcéreuse chez les enfants et de son traitement. [Ulcerativs Gingivitis ; its Treatment.] Journ.; dc Med. de Bruxclles, March,

1858. (Canst., iv,Daw n — Apropos dea considerations de M. ls Dr. Henriette sur la gingivite

nlcéreuse des enfants. [Remark s on the foregoing paper.] Journ. de use.

de Bruxelles, April, 1858. (Canst., iv,Resultate der Heilvcrsnchemit Pepsin imSt. Joseph-Kinderspitale. [Results of the

use of Pepsin in St. Joseph ’s Hospital.] Jahrb. l. Kinderbeilk a 1858, part 3.

(Canst.. iv,(infl ux— Ueber den Ursprung und die Bedingungen der Entwick elung des Soor

.

pilz es. [On Thrush .] J . f. Kinderk ., 1858, parts 5 and 6. (Canst., iv,

Briquet— Ueber die Ansteck ungsfi higk eit dea Soor. [On the Communicabilityol

'

Thrush ] J . t'

. Kinderk ., 1858, parts 5 and 6.

FlngoL— Behandlung des Soor bei jungen Kindcrn. [Treatment of Thrush ]

Basgcr iirtz . Int. BL, 29, 1859. (Sch ., as .

Fan g— Ueber die Nachk rank heiten der Diphtheritis. [The Sequels of Diph

theritis.) J . f. Kinderlt., 1858, parts a and z . (Canst., iv,Dom- Die Retropharyngealabscesse bei Kindern . [Pharyngeal Abscess in

Children.] Jahrb. fiir Kinder., 1858, 4. (Canst., iv,Bellma n — Die Behandlung der D iarrhoe bei Kindern in den ersten Lebensjahren .

[Treatment of Diarrhata in Infants ] J ahrb . f. Kinderh., 1858, part3. (Canst.,iv ,

Guerdm— Die Diarrhoea ablactatorum, Brechruhr und Gastromalacie dcr Kindernebst deren spcz ifischer Heilmethode. [Treatment of Diarrhe a, &c., in

Children.] IIcs’

lbroms, 1858. (Canst., iv ,Blondeam— Du sevrage et de ses rapport avec ls cltoléra enfantile . [Weaning,

its relations to Cholera Infantum.] Gaz . desHorn , 1858,Nos . 28, 29. (Canst.,iv,

B icordeam— De l’entérite cholérit

‘

orme, survenant chez l'snfant nouveau-né dansles cinqpremiers jours de nsissance . [On the Choleroid Enteritis occurring inInfants during the first five days of Life .] Par is , 1858. (Canst., iv,

Reu nion— Die Kinder-Cholera oder Summer-Complaint in den Vereinigten

Staaten , ihre Natur, Verh iitung, &c. [Cholera Infantutn in the United States.)New York , 1858. (Canst., iv,

DISEASES or CHILDREN.405

V ein s-Rad ium; aul den Gehrauch dea rohcn Fleisches in der Diarrhoeentwhhnter Kinder. [On the Employment of Raw Meat in the treatment ofDiarrhoea otweaned Children.] Journ. fi r Kindefl a , 1858, parts 1 and 3.and

5 and 6. (Canst., iv,Karena — ashramfiber diemonster des Bandwnrmes nach demGenusse dea

w hen Pleisches, are. [Frequency of Tapewormafter the use of Raw Meat ]J . t. Kinderk , 1858, parts 5 and 6. (Canst., iv,

Rama -run Obstruction of the Bowel byMeconium. Lancet. 1859, a, 663.

I'm — Acidumnitro-rnuriaticnmgegen gastrische Fieber der Kinder. [Nitromuriatic Acid in the Gastric Fever of Children.] J . f. Kinderla. a858, parts

s t and rs. (Canst. , iv,[ cream— De Pictere ches les nouveau-nés. [lcterusNeonatorum.) Paris, 1858.

(Canst., iv,On Kamals as a Vermifuge for Young Children. Med. Times and Gaz .,m ix, 599.

HM — Vier Fi lls von Verachwi rung und Durchlacherung dea wurtnf'

ortnigmAuhanges. [Perforation of the Appendix Vermiformim] J . L Kindcrk rank ..

1858, parts 3 and 4. (Canst.. iv,Clan— 3mPathologie nnd Therapie einiger der wichtigsten Dicltdarmk rank beitcn

imk indlichen Alter. [Pathologyand Therapeutics of Afi’

ections of the Large

Intesiiaes in Children.] ma) . 1. madam , £858, pm4. (Canst., iv.

4se )Gm t,— Ueber die Mastdarmvorfall bei Kiudcrn. [ProlapsusAni in Children.]

J . I. Kladerla . t859.parts a and z .

W ilmer die Anwendung dea Strychnins gegen den Mastdarmvo rt'allbei Ki [On the Employmentof Strychnine in Prolapsus An i in Children .]J. f. Kioderk ranlth ., t858, parts ar and rs . (Canst., iv,

Littre,

— B ildung eines k unstl. Afters bci einen: neugeborenen Kindc. [Formationof an artificial Anus in a New-born Child .) Journ. f. Kinderh , 1858, parts

3“ d 4 (m o it”

,

The object of Bonrn’s paper is to show that defective assimilation is a chief cause of the mortality of infants , and that this isalmost always the result of want of breast~milk and the use of injudioicus food.BALLARD believes that the exercise of the in stinctive actof sucking

by infants, under circumstances unfavorable to the infant obtainingthe necessary supply fromthe breasts, is attended by an excessive

reflex secretion of gastric juice ; that the effect of the action of the

secretion in question on the mucous membrane of the intestinal canalis the production of frequent green and loose stools . The author

a persistence of this morbid state .

In forty children who died of cholera infantum, Scmvam u

’

fonnd

i nmany cases a hypermmic condition of the cerebral coverings, sometimes extravasatious . As a rule, the sinuses of the durnmater werefilled with fresh blood-coagula, and with fibrinous formations,more or

406 REPORT ON mnwrrnnr , are .

less adherent and firm. In one case the venous thrombosis affectedall the cerebral veins. The author concludes that, owing to the

rapid loss of water by the blood, interference with the circulation of

the brain and lungs is produced, and that this explains the rapidmode of death in such cases . The thrombus-formation in the

veins of the head and elsewhere is thus favoured, and the fatalresult ensues .

Surrn relates four cases of cholera infantum, with their satopsies. In all the cases there was inflammation of the colon, which

he considers a constant element in the disease.

Gonn a states, that the aphthous patches appearing in themouthof infants

, known as muguet or thrush, and constituted by thepresence of the parasitic growth Oidiumalbicans, appear only inthose diseases accompanied by an alkaline condition of the oral

cavity. Strong alkaline washes and mechanical removal of the

patches are the means recommended. BnIQtnrr considers the inflammation of the mucous membrane of the mouth to be the firstcondition present in cases of this afl

‘

ection. FLUGEL recommendsthe use of a strong solution of common salt in the cure of the

Fauna alludes to a peculiar condition following attacks of diph

theritis in many patients, characterised by excessive prostration,paleness of the skin, pains in the limbs, faintness, inability tomove,&c., a condition liable to have a fatal termination . Bretonneau

considers this condition to be one of chronic diphtheritic poisoning.

Retro-pharyngeal abscesses mayarise, according to Bow , fromidiopathic inflammation of the parts themselves, fromsuppuration of

glands in the neighbourhood, and fromdisease of the adjacent vertebrm. Diflicnltyof swallowing, alteration of the voice, stiffness of

the neck , redness and swelling of the throat, are the chief signs .

Twelve cases of this affection are related.

Wmssn has extensively used raw meat as a remedy for diarrhoeain children, and, it is stated, with great success. The remedyappears to have become, as it were, naturalised in the town of

St. Petersburg.

BARNES relates the case of a child who died two days after

birth . The lower part of the ileumwas filled withmeconiumin a

very hardened state ; the bowels had never acted.

GUEnsax'

r applies the actual cautery very lightly at opposite

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408 REPORT ON mnwrrnar , arc.

scarlet fever. In 1 7 there was no consecutive dropsy ; in 13of these

more or less albumen and epithelial scales were found at the periodof the eruption and desquamation i n 1 case fibrinous casts as w ell

as blood-corpuscles, and in 3cases no albumen, casts, or epithelium.

In 5 out of the 7 dropsical cases, casts, globules, and albumenw ere found during the attack , and in the other 2 cases albumen and

epithelial scales .

Bancroux remarks that the good effects of the use of belladonnain cases of involuntary micturition depend on its giving tone in

muscles previously in a relaxed, atonic condition . Other remediesthe application of cold, the administration of iron, &c.

— he believesact in the same way.

V. DISEASES OF THE BONES AND JOINTS.

Schu ber,—Ueber Verhiitun; der Kyphosis osteopathica. [Angular Curvature

Jahrb . f. Kinderk heilk ., ii, 3, 1858. (Sch ., 8,

K ilauea — Ueber die Entw ick lnng der Knochenanhatanz nebst Bemerk ungen iibe rden Ban rachitischer Knocb en . [The Development of Bone in relation to

Rachitis.] Leip z ig, 1858. (Canst., iv,Goutay,

— Du rachitis ou rachitisme etmieux ostéomalacie. [Rachitis, &c.] Paris ,1858. (Canst., iv,

Bouchut,— Du rachitisme . Gaz . des Hfip., 1858, No. 82 . (Canat., iv,Huachk e,

— Ueber Craniosclerosis totalis rach itica und verdickte Schiidel fibe r

haupt. [Cranial Rachitis, &c.] J ena, 1858.

WedL— Einige Bemerk ungen iiber rachitische Rohrenk nochen und Rach itis. [OnRach itis of the Tubular Bones, &c.] Zeitsch . f. die k . k . Gea. in Wien, March ,

1858, No. 1 1 . (Canst. , iv,Elana — Die Epiphysentrennung eine Kranlcheit derEntwick lungsz eit. [Separation

of the Epiphyses a Disease of Development.) Allg. Med . Centralz . B., 1858 ,

Jahrg. 2 7, S l iick ro . (Canst., iv,Behrend — z ur Geschichte der Spina b lfida. (See p.

Flemming — Die Riick gratak riimmungen . [Spinal Curvatures.] Dresden , 1858.

(Canst., iv ,Friedberg,

— Behandlung der Huftk ontrak turen . [Treatment of Contractions ot‘

the Hip.) Wochb . der Zeitsch . der Gesells . d. Aerts . in W. and J ahrb. f. K. .

1858, part 4. (Canst., iv, 45Ueber d ie guten Erfolge der Ausschne idung dea l lut

’

tgelenk es bei Huftgelenltk aricsder Kinder. [Good Effects of Excision in Caries of the Hip-jointJ J . f.

Kinderk . , 1858, 5 and 6. (Canat. , iv,Enlenberg ,

— Ein ige iiber Pathologie und Therapie der Deformitiiten des Fuascs .

[Deformities oi'

the Foot.] J . f. Kinderk ., 1858, r and a. (Canst. , iv, 45Bonfi er.

— Leqons cliniques snr les maladies chroniques de l’

appareil locomotm'

r

professées a l’lifipital (les enfants malades pendant les années 1855, 1856, 185 7 .

Par is, 1858. pp. 531.

DISEASES or ca n v ass . 409

W en-Leech ! elm &e. Deviations de la eolonne vertebrale, Atlas de ao

planehes. [Clinicalmotion, at the Hospital for Children, Paris.) Par is , 1858.

Angular curvature of the spine begins, according to 8m m,

mostly during the first de ntition period, in dyscrasic, scrofulous,

weak ly children ; sometimes in those of good constitutions alter

attacks of measles, scarlet fever, &c. ; also in children placed underunfavorable hygienic conditions . Absolute rest, good food, exposure to air and light, are. the chiefmeasures recommended.

substance, and of the softening processes which occur in rachitis.

Vl . DISEASES OF THE SKIN AND CELLULAR TISSUE.

M ,

— On the Treatment of Par-pun Hemorrhagica by the Administration of

Tineture of Larch Bark . (Dublin Hosp. Gaz ., 1859.p.

Baum-Cod-livero oil Soap in the Treatment of Chronic Ecz ema of Children.

Ann. de Theron , 1859, 135.

[ fi lm— Tenn cured in eightminutes . Ann. dc Therap. 1859. a59.

M ann— Trampratique dea maladies de in pos ts chez les infants. [Disease ofthe Sk in in Children .) Par is, 1858. (Canst., iv.

Ban — Leech : theoriques et cliniques sur les affections cutanées parasitaires.[Parasitic Cutaneous M entions.) Par is. 1858. (Cans t. , iv,

— Leqons sur les maladies de la peau. Dartres, Syphilides, &e. [Diseasesthe Sk in .) Paris , 3858. (Canst. , iv,

rough — Ueber die acuten contagibsen Bxanthernc in Tcheran und seiner Hinge

bung. [Acute Contagious Exanthemata in Tehersn, &c.) Woehenbl. der Z .

d. 0. d. Aer-ate in Wie n, 1857, 44, 45. J ahrb. d. Kinderheillr., 1858, part 1 .

(Canst. , iv ,PM — M M tiwhe Mittheilungen. [Pe diatric Contributions.) J . t. Kinder-la ,

1858.parts 3. 4. (Canst. .Jump — Practical Remark s on the Recession of the Eruption in Scarlet l'ever.

Lancet, 1859. i, u) .

W m— Ueber de n Scharlach— eine klinische Vorlesung. (Hfitel Dieu inParis. ) [On Scarlet Fever.) J . t

’

. Kinderk ., 1859. parts 3, 4. (Canst.. iv,u nbngoher ,

— Beme i k nngen ilher eine Scharlach Epidemic imJ 1857, his Antang.i 858.in Jena und Umgehend. [Epidemic of Scarlet Fever B MW in i S57Pr . Ver. Zig . N. B., i, 26— 38, 1858. (Sch., 5,

Org ilyHewitt— Ueber das Verbhltniss der wasners iichtigen Ergtisse z umSchu

lach. [The Relation ct Dropsy and Scarlet Feve r.) J. t'. Kinderh. , r858,

parts 5, 6. (Canst. . iv ,[ M L

— Die schiittende Kraft der Belladonna gegen Scharlaeh. [The ProtectivePower of Belladonna against Scarlet Fever. J . f. Kinderli ., 1858, parts i s, u .

(Canst. , iv ,M am a

— Bettina zur Therapie dea Scharlaehfiehers. [Therapeutics in ScarletFever.) J . f. Kindest , 1858, parts 9, so. (Canst.

, iv,

410 ns roar on mnwrrnnr , are .

[ attach — 2m Verwandtschat'

tsfrage awisehen Schsrlseh nnd Mason . [The

Afllnities between Scarlet Fever and Measles.) J. f. Kindest , 1858, parts 3, 4.

(Canst., iv,swam — Ou the Prevention of the Sequels of Measles and Scarlet Fever.

Gas. Rehd., vi, 13, 1859. (Sch., 6,

M hW ,— Das Incubationsstadium der Mason . [The Incubation Of

Measles.) Jahrb . f. Kinderlr., 1858, part 4. (Canst., iv,a num— Ueber Rubeola. Jahrb . f. Kinderh ., 1858,part3. (Canst., Iv ,

[ mm-Beohaehtungen bei einerMasernepidemie. Wurtemh. Com.Bl.,35, 1858.

[Observations on Measles.) (Sch ., 5,

0mm,

— Notiz en iiber die Masernepidemie imBreslau imJ ., 1857. Giinsb.

Ztsch.. ix, 4, p. 2 74. [On Epidemics of Measles in Breslau.] (Sch., 4,

Von — Ueber h imorrhagisehe Maseru. Virchows Archiv, xiv, 1, a, p. 64, 1858.

[On Hemorrhagic Measles.) (Sch., 3.

Truma n— Ou Measles and its Complications . L

'Union, 106, 1 1 1, 1 16, 1858.

(Sch., 1 1 ,

gonna — Bosn fige Maseru. [Virulent Formof Measles.) Wurtsmh. Corr. BL,5, 1858. (Sch., 1 1,

[ gym— Erythema nodosum bei Kindern. [Erythema Nodosum in Children.)Jahrb . f. Kinderh ., 1858, part a. (Canst..iv,

Qmm — Betrachtungen tlher dle fragllehe Verwandtschaft der Varicella mit derVariola und den Varloloiden. [Relations of Varicella, Variola, and Varlolold.)Journ . f. Kinderln, 1858, parts 3, 4. (Canst., iv,medium,

— Ueber die Blnftlhrnng einer neuen Genltur der Kuhpock enlymphe,sowie fiber den Werth und die Geschlchte der Regenerirung. [On the Introduction of a new source of Cowpock Lymph, its Value, &c.) Wien, 1858.

(Canst., iv,

an um,

-Die Schutz pock enimpfung, eine brennende Frags der Gegenwart. [OnVaccination, &c.) Breslaa , 1858. (Canst., iv ,

Andy-W 5,— Aufl 1ewahrung der Vaccinalymphe. [On the Preservation of Vaccine

Lymph .) J. f. Kinderlr., 1858.parts 7, 8. (Canst., iv,Landon — Innere Anwendung der Vaccinelymphe wahrend einer Pock enepidemie

[Internal use of Vaccine Lymph during an Epidemic of Smallpox.) J. f. Kinderk ., 1851 , parts 7, 8. (Canst. , iv,

Friedinger,

— Mittheilungen aus den Kinderheilanstalten. [Contributious. &c.)Jahrb . f. Kinderh., 1858, part a. (Canst.,

h mm eam— Quelques observations sur les nouveau-nés. [New-born Children .]Paris, 1858. (Canst., iv,u

— Emploi dumassage dans le traitement du scléreuse dea ent‘ants. [Shampooing in the Treatment of Sclerema.) Gaz . dea Hdpit., No. 1 18.

(Canst., iv,Chapelle,

— Behandlung der tines favosa dnrch Oleumnaphae. [Oil of Naphthain Tinea Faw n .) J. f. Kinderls., 1858, parts 5, 6. (Canst., iv,

Nd igmp —Gegen den Kopt’

grind (Porrigo). J. f. Kinderk , 1858. parts 3, 4.

(Canst., iv,Hnwmm— Clinical Report on Fsvus. Med. Times and Gaz ., al, 353, 577,

653.

In the treatment of the ecz ema of children, Ban ana disapprovesof an exclusively local treatment. The crusts are to be removed by

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412 REPORT ON mnwrrs ar, ETC .

Vnrr describes a formofmeasles characterised by the presence of

petechial patches instead of an eruption of the normal characte r,and which the author designates as hmmorrhagicmeasles . It occurs,according to his experience, chiefly amongst individuals in indigentcircumstances . In 160 cases it occurred eleven times . In suchcases the fever is of a sthenic rather than of an asthcnic characte r .

The course of the disease was in all cases mild and without complications . Cases of acute hremorrhagic formof measles must not beconfounded with those in which petechise appear at a later periodduring convalescence .

TROUSSEAU remarks, that during the eruptive period of measlesdiarrhcea, occasionally bloody

,is not uncommon . The appearance

of croupous affections is unfavorable. Capillary bronchitis isalmost always fatal when occurring in children under two months .

Convulsions, at a later period of the disease and in young children ,are of very unfavorableSCHU'

I‘Z reports that in Nagold, in the year 1856,measles, of a

very virulent character, carried off 10 per cent. of those attack ed .

Re spiratory complications had a large share in producing the

mortalitv .

Mara states that erythema nodosum is occasionally observed inin fants, butmore generally in older children . In its simple formitis chiefly seen on the leg and forearm, appears suddenly, lasts fromfive to seven days, and is unaccompanied by general disturbance .

A hemorrhagic formis also described.

Gl x'

rnac examines the relations subsisting between varicella,

variola, and varioloid . Varicella, he concludes, does not originate

fromvariola, but varicella may arise under the same conditions as

variola . He does not think it proved that varicella can producevariola . With respect to the actual relation of the two, variola

does not exclude varicella ; the one may follow the other in the

same person ; they have the relation of two independent poisons .

Lastly, there is no apparent analogy between variola and varioloidon the one hand, and varicella on the other.

LETOURNEAU believes that the sclerema and (edema of new-born

children is a condition depending primarilyon congenital weak ness,

imperfect expansion of the lungs, and defective haematosis . It is

a slow asphyxia, the body becoming gra dually cooled down , and the

child remaining in a state of organic torpor 1mtil death occurs . To

establish his positions, the author adduces histories of seventeen cases .

DISEASES or CHILDREN . 413

Hurcmxson gives a tabulate d account of forty-four cases of favus,collected fromvarious sources, the sporules and thalli of a fungusbeing in all cases present. He believes that the fungus (the

Arteries &donlein ii) deve10ps itself within the hair-follicles . The

dim is very inveterate, occurs only amongst the poorer (ti c.

uncleanly) elm ; it is very rare, occurs for the most part in persons of good health ; may be inoculated, but does not spread

on the differential diagnosis, the author state s that the only treatment available is the employment of sulphur, creosote, or mercury,combined with epilation of the parts affected .

m. nrscnasue ; m oons .

Im am— A on e of Infantile Syphilis. Obstet. Tu na , vol. i, p. 131 .

(rpm — Cu e of Infantile Syphilis . Dublin Quar. Journ .,May, 1859. 308.

— A Treatise on Syphilis in New-born Children at the Bren t. Translated

fromthe French byG.Whitley,MD . New Syd. Soc , 1859. pp. 2 73.

und ZeigL— Die Syphilidcn imKindcaalter. (Syphilis inf. Kindcrbeilk .. r858. part i . (Canat., iv,

BOW -9 ° in “w e intermittente chez les enfanta. Gaz . dea Hop , 1858.No.

56. ( intermittent Fever in Childhood .) (Canat., iv,m — QW QW considérationa our la fiévre typhoide on general, &o. Paris.

‘838' (Canat., “0

PM — Beoln cbtungen fiber der Scropbelltrmk hcit. Jourmf. Kinderk ., 1858,

r.a. [On Sci-ohm.) (Canat. , iv,

Lam -Die angeborcnen Geacbwiilatc dcr hinteren Krcu gegend. M a i,

1858. (Canat., iv,

Taverna relates the case of a child who died sudden ly about sixweeks after birth, having been just before treated, apparently suc.

cessfully, for syphilis derived fromthe parents .

O’

Doxovax relate s a case of syphilis in an infant, the parents ofwhich had had no secondary symptoms, but the father had sufferedfrom gonorrhma .

”

The first or (etiological part of the treatise of Dmar, now translated and published by the New Sydenham Society, is devoted tostudying the mechan ism of the development of the disease, itsdifferent origins, and the respective part played by each of themin its ulterior evolution . In the second or sémeiologicd part, wefind a description of the various forms and no less variable pro

gress of the disease . The third part, having reference to proguosis,

414 cancer on MIDWIFEBY, are .

treats of the dangers peculiar to syphilis at an early age, of the

transmissibility of the lesions which it occasions, and of the mor .

tality which it causes . In the fourth part, the medico-legalbearings of cases of this kind and in the fifth part, the subject oftreatment in all its details are considered.

Lm nncx gives an elaborate account of the various forms of

tumours which are observed in the sacral region in new-bornchildren .

vin . nu rom rrons, are , or run roams.

m u n— Fe tusmonstreux (Derodelphe). Gaz . Med. de Strasb ., 1858, No. 4.

(Canat., iv ,Rainer ,

— Glilck lich vorgenommene unblutige Trennung z weier z wischen Sitz k norrenund Steissmiteinander vern achsener Kinder. [Successful Separation of Two

adherent Fcetus.] Wiener Wochenscb ., 31—33, 1858. (Canst., iv,

Lu chk a,— Ueber ein angebornes llygroma cysticumperineale mit Foetus in Fe tu.

[Case of Congenital CysticHygroma ; Fattus in Forth ] Virchow’s Archiv, xiii,

p. 41 1 . (Canst., iv,

[ en ou gh — Ueber eine Zwillingsbildung der Medalla spinalis. [Double SpinalCord .] Wochenbl. d. Zeitsch . d . Wiener Aerts, 1858, No. 53. (Canat.,iv,

Flog91,— Ueberz iihlige Hoden. [Supernumerary Teaticles .) Oeaterr. Zeitsch . f.

prak t. Heilk ., 39, 1858. (Canst., iv,Charcot,— Rupture of the Spleen in a Fe tus. Gaz . des i16pt., 144, 1858. (Sch .,

4.

Virchow ,

— Hydrops ascites bei einem neugebornen Kinds . [Ascites in a Newborn Child .] Mon-Sch . t

'

. Geburtsk , xi, p. 161 . (Sch . , 6,

smallmun ,

— Cystic Discu s of the Liver in a Fe tus. Lancet, 1859, ii, 573.

Clay,

— Ou Anasarca of the Fe tus. Wien. Ztsch ., N. F., n , 13, 1859. (Sch., 6,

Widerhofer,

— Ein Fall von Ileus bei einemneugebornen Kinds. [Ileua in a Newborn Child.] Jahrb . f. Kinderk ., ii, 1 , 37. (Sch., 1 1 ,

Bmi,— Unusual Twisting ot'

the Cord, and its probable cause. Ann. Univ., Feb

1859. (Sch., 8,

HoneL— Mémoire sur les adherencea du placenta ou des enveloppes i certaines

parties du corps. [Adhesions of the Placenta or Membranes to certain parts

of the Body.] Gaz . Med No. 3, 1858. (Canst., iv,Goldberg,

— Seltene Zwillingsgeburt. [Unusual case of Twins.] Oeaterr. Zeitscb .

f. prak . Heilk No. 39, 1858. (Canst., iv,

Bernard — Case of Superfe tation. Dublin Quart. J Feb ., 1859, an .

n on wh— Recherches sur le cataracts congénitale. These. [On Congenita lCataract ] Paris , 1858. (Canst., iv ,

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416 REPORT ON mnwrrnar , n'

rc.

Hone) etm un,— F(etns Pseudencéphalien. [Paendencepballc Pa ton ]

Bull. de l'Acad . de Me

'

d ., No. 10, p. 298 ; and No. 24, p. 1 153. (Canst., iv,

Behreni — a Geschichte der Spins b inds, deren Verlauf nnd Behand lung, nebstMittheilnng einer gliick lichen Kur dnrch Anwendung der Collod ium. [TheHistory, Progress, and Treatment of Spins Binds ; Case of Cure b y means of

Collodium.] Journ . fiir Kinderlrr., 1 1 , 1 2 , 1858. (Sch . , 5,

Robin — Du Spins bifida. [Spina B ifida.] Thése , Par ., 1858. (Canat. , iv ,Bobcat — Coup d

'te il snr l

'etat de la thérapeutique concernant is spina b ifida.

[The Therapeutics of Spiua Bifida.] Bull. de Therap., March, 1858. (Canst.,iv ,

Ebm— Da traitement du spina bifida par les injections iodées. [Treatment ofSpins Binds by Iod ine Injections.] These , Par ., 1858. (Canst., iv,

AlliL — Case of Congenital Hydrocephalus, with Spins Binds. Presse Med ., 31,

1858. (Sch ., 1 ,

Meagan — Description of a Fmtns w ith Spina Binds , Umbilical Hernia, and twopeculiar Supra-scapular Bones. Edinb . Med. Journ.. Sept., 1859. 331 .

Shogu n — Case of Malformation of the Abdomen in a Child. Ed. Med. Journ.,

Sept., 1859, 237 .

Sedgwick— Fmtns in wh ich the Abdominal Wall was deficient. Obstet. Tran ,

vol. i, p. 239 .

Widerhofer,

— Hernia diaphragmatica sinistra bei einemSaugling. [Diaphragmatic Hernia in an Infant ] Jahr., f. Kinderh ., ii, 1 , 39. (Sch., 1 1 ,

Mesnet ,

— Fin ura sterni congenita. Konigsb . Med . J ahrb., i, parts 1 and 2 .

(Canst. , iv,Bobcat — Rapport de la commission charges d

'examiner is memoirs de M. Debont

re latif 1 la hernie ombilicale congenitale . [Report on M. Dehont's Memoir on

Conge nital Umb ilical li ernia.] Bull. de l’Acad . de Belgique, 2 sér., i, 4.

(Canst., iv,Rem- Description d

’un cas remarquable d

'

exstmph ie de la vessie . [Extrophiaof the Bladder] An . de la Soc. Med.

-Chir. de Bruges, An. xviii, ser. ii.

(Canst., iv,

Emmaxx describes amonstrous fcetus— monocephalous, with twobodies . T he double character was first ev ident at the base of thesk ull. The vertebral canal double ; two spinal cords ; msophagussingle stomach single and small, giving off a single small intestine ; this intestine ended in a pouch, fromwhich were given off two

small inte stines, each ending in a separate czrcum and large intes

tine . The sexual and urinary organs double ; both females . Res

piratory apparatus perfectly double . One heart supplied the twobodies . REINER gives the description of a well-formed child, havingan excrescence situated between the ischial tuberosity and sacrum.

This excrescence proved on examination to be a foetus of aboutthree week s, which had become adherent to the body of the healthychild. A ligature was placed round the pedicle of the excrescence,

DISEASES OF CHILDRFN.

and its removal safely accomplished . In Luscnxa’s case of hygroma

cysticumperineale, a very large cyst was attached to the lower partof the body, whereby the labour was so protracted that the ch ilddied. The pelvis was filled with cysts, varying in siz e . There werealso found within the tumour the remains of a fwtns, viz .,

bones,

intestines, &c. The case was one, not of simple hygroma cysticum,

but a combination of the same with inclusion of a fmtns. Lmvnossrrxdescribes a case in which the medulla spinalis was double in a femalefratus, born dead at six months old. In FIISGEL

’S case a man

labouring under syphilis was found to have a double testicle on eachside . The testicles were arranged on each side one above theother, the lower one being on both sides the larger.

In Ch auce r’s case a woman was delivered of an eightmonths’

child, which survived its birth half an hour only. The spleen was

found ruptured, and blood etfused into the abdomen. The rupture

appeared to be due to one of two falls which the patient hadsustained, the first one month, and the second a fortnight, be fore

In a case of congenital ascites related by V incnow,the mother

had previously given birth to six children, three of which had died

In Snamaru ’s case the abdomen was greatly enlarged, and in

the centre of the liver was a large cyst, covered, not completely, byskin anteriorly. The child lived ten minutes after birth.

CLAY relates two cases, in each of which the forms was (edematous and dead. In one case the placenta was soft, thickened, and

partly covered with so~mlled lymph in the other case the placenta

s u tom records a case of ileus and death in an infan t, pro .

daood by a cyst in the wall of the lower end of the ileum,so situated

as to prevent (cecalmatters passing into the colon .

reports the case of a woman who suffered in the eighthmon th of her pregnancy fromlively and painful movements of the

took place, after two weeks, of a dead child. The cord was verymuch twisted and rendered impervious. The cerebellumof the

fmtus was smaller on one side than on the other. The author sup.

poses that this unequal development of the cerebellum caused the

movements of the child, as in animals in which one side of the

cerebellumhas been removed, and that these rotatorymovements,27

418 ar row on mnwrrs ar ,me .

cord.

Houm. states that there are only two points of the body of the

foetus atwhich adhesions of the placenta ormembranes are found toexist, viz .

, the head and the abdomen ; of these, the former are byfar themost common . Prolapsus of the intestines is always noticedin conjunction with these adhesions, the cause of which the authorbelieves to be the shortness of the umbilical cord, and the consequentconstrained position of the fmtus .

MEYER. believes that when narrowing or oblite ration of the pul

monary arteries coexist with a ventricular communication, theformer is a cause of the latter ; and that the deviations in respectto themode of origin of the sorts, the foramen ovale, &c., are de

pendent on the same circumstance . Donscn describes a case in

which the inferior vena cava passed through the diaphragmand

upwards on the left side of the aorta, finally crossing over and joining the superior vena cava. Bocnmmcx gives the particulars of avery interesting and rare variation in the arrangement of the pulmo.

nary veins and other vessels of the heart in a child, who, nevertheless, lived four days . LUTON relates a case of congenital hydrocephalus which was punctured three times. The two ventricles were

found on the death of the child to be very largely distended with

DELACOUSB believes that the albinos of the equatorial region of theNew World are individuals in whom the scrofulous or lymphaticdiathesis exists . There is a grade intermediate between the

albinos and normal individuals, viz ., p eti tes— individuals whosesk in exhibits patches of colour, giving it a mottled aspect. Bothvarieties are of weak constitution . The albinos are not capable ofpropagation.

In DELACOUB’

S case, the lower part of the body was normal, butterminate d above the umbilicus. There were only five dorsal vertebras and five ribs ; the liver large ; the k idneys, pancreas, heart, aorta,umbilical arteries, internal genitals, wanting. The fmtus thus formedlived till the fifthmonth. In MACLACHLAN’ S case, the craniumwasalmost entirely absent. The case related by Ws s

'r was that of a

fratus in which the brain and the superior part of the craniumwere

wanting.

Msn rmrelates a case in which a child was born with the leftarm wanting. The placenta and the spontaneously amputated

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4 aarou'

r on mnwrrnur , are .

In Vi s a’s case of enecphaloeele, the tumourmeasured nine in ches

round, and the greater part of the contents consisted of cerebellum.

The patient lived five weeks. The fmtus described by HM and

Anxavur was seven months old, and presented several defects ofdevelopment, the greater part of the cranial vault being wanting,the upper lip fissured, the fissure extending through the nose, thebones of which were absent, the :eyes unequally developed, the ringand middle finger of the right side had but one phalanx, on the

other side the little finger was provided with onlv one phalanx, theright leg fractured, the skin unbroken .

Bunnmvn states that spina bifida most frequently affects the

lumbar region or the junction of this with the dorsal,more rarelythe sacral region, still more rarely the cervical, butmost rarely theinferior part of the sacral region . Generally the siz e of the externaltumour is proportionate to the extent of the osseous defect, but notalways. According to Chaussier, it occurs in the proportion of one

in a thousand cases . The number of vertebrae affected varies ; eventhe whole canalmaybe affected. It is often fatal soon after birth,andmore quickly if seated high up. If life continue, the child isweak and thin, often paraplegic, and affected with involuntarymicturition and defmcatiou, club-foot, &c. The rupture is generally

gradual, preceded by inflammatory attacks and convulsions . Life

is rarely prolonged over the third year, but cases are on record oflife continuing to ten, twenty, and even fifty years . An Operationshould only be attempted, when the child is otherwise healthy

, the

tumour pedunculated and single, the integument covering it not

ulcerated, not painful on pressure or on being moved, and fluctuation is distinct. Of all the various preposed operations

, simplecompression, w ith or without pun cture, appears the best. In the

case of a child seven weeks old, who had a spina bifida over the

last lumbar vertebra, the tumour was painted with a mixtureof castor oil and collodium, andwhen it had become hard, a waddingcompress was applied. The next daythe application was renewed,the proportion of collodium being increased. Calomel was now

given night andmorning, the head being hot and the child restless .

The tumour quick ly diminished in siz e, and after a few days wasno longer visible. The cure was complete . Dnaon'

r gives the

particulars of several cases in which iodine injections have been usedby various surgeons, in the first instance by Brainard. Of eleven

cases, eight were cured. The results appeared to show that the

DISEASES OF CHILDREN . 42 1

injection of the tincture of iodine, when in the proportion of a third,is at all events not an i njurious operation . It is recommendedthat the injection be made by a very small canula that the injectionbe at first of very slight strength, gradually to be increased, theobject being to excite a slow process of inflammation only in theeyst. The cases in which the tumour is pedunculated are themostfavorable. Compression forms a subsequent part of the treatment.In ALLIx

’s case, spina bifida, affecting nearly the whole canal, but

during life apparently limited to the lumbar region, was associatedwith hydrocephalus . In Msssnn

’

s case the spina bifida was associsted with umbilical hernia and two peculiar supra-scapular bodies.In two cases related respectively by Susanna and Snnowrex, the

anterior abdominal wall was deficient. Wms nnornn relates the case

of an infant who lived only two days . On examination, the left sideof the thorax was almost filled by intestines, an opening existing in

the diaphragm.

RE PO RT

LEGAL MEDICINE, PUBLIC HYGIENE,

AND

DIETETICS.

WILLIAM ODLING, MB

" snow or run nou s. coar s e : or PRYI KC IANI ; r aor s sson or m es-scar.

cl assics-n! a

‘r car

’s nosrrr aa ; n ononanr ss car ra ar noma

ca n non . socrsr r ; ar c.

MANUALS AND GENERAL TREATISES .

Omen— Practical Manual of Forensic Medicine, based upon original experience .

Thanatologics l part. With an atlas and nine coloured plates. 2d edition .

Biological part. Berlin, 1858.

Wald — Forensic Medicine. A Manual for Medical Jurists, based upon A. S .

Taylor’s Medical Jurisprudence.

’ Vols. i and ii. Leip z ig, 1858.

Nugget — Medicine of the Present Day, in its relations to the Administration of

Justice . (Oestcrr.,4,

Albert — A Defence against the Reprosches which Lawyersmake to Forensic Physicians. (Henk e, 38,

On the Definition of Mutilation . (Friedreich , 9.

Badman — What Injury is immediately Fatal ? and what Injury is Fatal by an

intermediate Cause, put into activity by the Lesion itself ? (Henk e, 1858, 47,Supplement.)

Hofinam— Replyto the Question of Buchner,w ith special reference to Buchner’

a

Reply ab" 38.3Boeck er,— Inability to Work ; Serious Injury, threatening Life. (Deutsche, re,

a.)On Matrimonyand Divorce. (Friedreich , 9,Jw an ,

— Meutsl Diseases, considered as Reasons for Divorce. (lb., 9,

THE handbook of CASPER is avowedly based upon original re

searches and experiences ; which the author, as the principalmember .of a scientific commission, that in Prussia, has finally todecide allmedico-legal matters, has had the best opportunities for

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42 k aarou'

r ox LEGAL namerxr, are .

As lawyers now and then reproach medical practitioners forjudging forensic cases w ith exaggerate d humanity, ALnna'rdeavours to show,

by examples, that these reproaches are unfounded.

The article on the definition of mutilation ” advises the legislature to avoid this expression, because it is capable of many inte rpretations .

B t cnxnn comes to the conclusion that those injuries are immediatelyfatal which do not cause death by an intermediate agency.

This negative definition is criticised by Herman’ s , who correctlydefines, as immediately fatal, those injuries which, fromtheir nature,are necessarily fatal.The paper of Boson-mcontains remarks about legal and other

defin itions of the words forming its title .

The essay in Friedreich relates to diseases whichmaybe cousidered, or alleged to be, sufficient reasons, either for legally preventingmarriage altogether, or for breaking a promise of marriage, or for

epilepsy, deaf-dumbness, psychical diseases, female hermaphroditism,narrow vagina, absence of vagina and womb, anomalies in the formation of the pelvis,mole-pregnancy, excessive sexual desire, andexcessive age . Of these last two points, the natural legal standardis not indicated .

T he debates in the Prussian House of Deputies, relative to a billon the law of divorce, caused Jessex to consider the medicalgrounds upon which a dissolution of marriage might become requisite, particularly ia reference to mental disorders . He finds thatmost practical arguments are against a ny dissolution in these cases,

but brings forward some few reasons for which a dissolution, undercertain limited circumstances, might be granted.

SOMA'I'

IC INJURIES AND MANSLAUGH'

I‘ER,

INCLUDING IN

J URIES OF T IIB HEAD, ABDOMEN, SPINAL MARROW, ETC .

Blfimleim— Can a ny Legal Conclusion, relative to the intention of any person

wounding another, be drawn fromthe situation and nature of the injuryinflicted ? (Casper, 13, r.)

Historv of Critical Days. (Friedreich, 9, a.)On Poisoned Wounds (poisoned anus ; gunshot wounds ; bites ; cadaveric poison) .

( lbw 90 4

SoMA‘l‘

lC lNJ U ltt AND n axsmw nraa . 425

— Desth byAccide11t, or Morder byCrhninsl Negleet. A remsrb bleTrial by Jury. (Casper, 14,

AIM — A Case of Murder of a Mother (matricidc). (Henk e, 38,Death by inhalation of Sulphuric Ether. (Friedreich. 9.W W s to Forens ic Med icine . l macology. and Pharmacoo

dynamics. Experimental Phys ics of Gunshot Wounds, in which the missile issupposed to wound bymeans ol cosnprcssed air. (pp.

[ gin — Wounds in general. House-Library“ Practical Surgery. J ack ed, 1858.

W — Report on Med ico-Juridical Examinations , instituted between May 1st

and Aug. 31st, 1857. I . Lesions observed upon living per

sons, twe ntv e in numba .

Forensic-Medical Communications. (Casper, 13. a. ) Case 1. llhtrcatmcntol

’

a man suflcring fromsevere diseasc ot'

the heart. Deathmer six daysmot

capable of being brought into immediate con nection w ith the illo trestmcnt.“ Forens ic Medical Opinions. (Henk e. 38, Alleged ilLtreatmcnt of a

factory woman , forty-two years of age. who had not me nstruated ibr eightwccits ; the homorrhage fromthe womb , and catarrh of the bladder, could not

be proved to be direct consequences ot‘

them-treatment. l l l . Complicatedinjuries in consequence of continued brutal ill-treatment ; residuarydisease of

brain and spinalmarrow, w ith loss of speech.

Tum -Medioc lcgal Report on the Attentat of the 14th ci l anuary. 1858.

(Ann. d'Hyga April.

Du per,

— (Loc. A. Serious injuriesF -r. Mutila tion. Case 101. Bite ot'

linger ; amputation. 103. Knock ing in the peg of an artificial tooth : does it

constitute mutilation ? 104. Amputation oi'

the breast : is it mutilation ? 11.

Lou gm 1os. Temporary loss of speech after injuries. 106. Non.

development of speech, in consequence of general ill-treatment. 111. Loss oft ip“. 107. Loss of both eyes through milk of lime. 108. Loss of an eye bysulphuric acid . 109 . Loss of an eye by a k nock or punctttre w ith an instru

ment. 1 10. Loss ot'

an eye bya miss ile. 1 1 1 . Alleged loss ot sn eye by a

strike on the face. 1 11 . Apprehended loss cl’

an eye by strok es of a wh ip.

sr . Loss d i e-r ing . 1 13. Whether a box on the car has caused loss ot hcaringupon one car. 1 14. The same question. in consequence of two boxes on the

car. 1 15. The same bya h‘

noclt with the dst. v . Lass o/ M m 1 16.

Strangulatiou oi’

the penis. 1 1 7. Alleged loss ol'

virile power after a k ick .

B. Lcss serious iujuries .— 1. (W eider-M W QI M A c c m

of limbs . 1 18. Multifsrious illness, and alleged inability to mak e a living.

1 19. Fiss ion of the knee-joint, and alleged inability to malts a living. n o.

Alleged considerable disadvantages fromextractions ot teeth. 1 1 1. Fracture

after having been thrown out of window . 131 . D id the fracture occur beforeor after the 3d of October ? 11. [ sol id ly to work continued f or some l ime.113. Manycuts and punctured wounds. 134. Cut into the armbya knife .

115 and 1 16. Blows on the head ; peculiar inability to work .

”11 7. Blows

on the head : alleged tearing out at hair. 118. Blows on the head with a

hatchet. 139 . Dog-bites. 130. Man-bite oi the right thumb. 131. Punc

tored wound of the back , w ith dilatation of the wound . 131 . i ll-treatment bythrowing down. 133. Locking a person to a log of wood bymeans of a chs in.

C. Light Marin — 134. Accidental poh ooing by caust ic ley. 135. Blow s

by fist and stick . 136 . Afiusion cl eoid water a boxcs on the car ; nervous

(cm. 137 . Kicks in the abdomen ; inflammation of the liver. 138. Kicks ;

426 aspoar ON LEGAL n euroma, arc.

inguinal hernia. 139. Blow s with the handle of a broom; abortion. 149 and

141 . Punctured wounds of the chest bymeans of a k nife and poniard. 142 .

Throw on the chest ; peritonitis. 143. Throwing down ; peritonitis. 144.

B lows w ith a list on the head ; alh ged concussion of brain.

autumn— Case ofFracture of the Skull, with Medico-foremicRemarks . (De-tart s1 1, a.)

Emma— Some Observations fromthe Criminal Court. (Wiirtemb, 38, Nos. 7,

and

Both — Fatal Disease of the Brain, caused by Blows of the Hand agfl nst the

Temples. (Henke, 38,On the Fatal Consequences of a Box on the Bar. (Ih.)

“ ohm-Contributions from Medico-forensic Practice. (Deutsche, as ,

Fatal injuryof the head, very probably accidental. Wounds of the head, in a

person with wet clothes ; unexpectedly rapid death ; necessarily fatal injury.

Dead body found suspended by the neck ; discovery of fractm'a d the sk all,together with several other injuries, probably caused byviolence of a second

person ; exclusion of suicide .

(Henk e.38, Ill-treatment of a Man seventy-four years of age. consisting in blows upon the head ; supervening pneumonia ; death ; no connection

traceable.

(Casper, 13, a) . Wounds of the Head ; unexpected death alla some dayscopious extravasatiou of blood in the pericard ium; no connection traceable ;serious injury. Injuries on the head and thumb of a drunku i ; cold and

irregular living ; tetanus ; death ; lesion which, fromits general natu e, is notnecessarily fatal.

On the Psychical Consequences of Lesions of the Head. (Friedreicb, 9, a.)Birk ett — Compound Fracture of the Sk ull bya Hatchet, with hemorrhage ; removal of loose bone, and exposure of the dura mater ; recovery. (Lancet,1859, z ,

Hmhk g — Inguinal Hernia, alleged to have been caused by an assault ; connec

tion not evident ; slight injury. (Deutsche , 13, z .)Tonlmonche,

— Ou Mortal Wounds of the Abdomen froma Medico-legal Point ofView . (Ann . d

’Hyg., July, 1858, Rupture of the anterior partof the ca cumbya k ick , followed bythe escape of fecalmatter into the abdominal cavity; rapid lyfatal peritonitis. Rupture of the anteriorwall of the ileumby a k ick upon the abdomen ; escape of fecalmatter, casing peritonitis and death. Detachmentof thejejunumfromthemesentery,and rupture of the k idney,bya carriage whecl pass ingover the abdomen ; rapidlyfatal peritonitis . Rupture of the iliaca,with effusion

of blood into the abdominal cavity, caused bygreat compre-lou of the belly, andaccompanied by hemorrhage fromthe labial artery, and other rapidly fatal

injuries. Comminuted fractures of the last seven right ribs , incomplete fractureof the fifth , seventh, and eighth left ribs ; rupture and contusion of the liver ;rupture of the ureter, of the left renal arteryand vein ; caused bythe passing of a

cartwheel over the body; almost immediate death. Comminuted fracture of thepelvis and sacrum, denudation of the cauda equine, and extensive extravasatiou

of blood, caused bythe passage of a cart-wheel ; almost instantaneous death .

The belly ripped open by a k nife ; prolapsus of the intestines ; unmethodicalreduction ; acute fatal peritonitis. Perforation of the ileum in four places ;

lesions of branches of the upper mesenteric artery, and of other more considerable arteries ; the intestines, which had prolapsed through a cut wound

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428 naroa'

r ox LEGAL n amcmn, are .

Robin — Memoir on the Medico-legal Examination of a Blood-stain , n hich con

tained human adipose tissue. (lb .)Gaultier doW uhan

— Ou the Appearance of Arms discharged with Gun-cotton,or with Powder made w ith Perm-cyanide of Potassium. (lb. , Jan. 1 7,

Bunch — Obstetric Malpraxis ? Prussian Snperarbitrium. (Casper. 14. x.)

_In a case of gunshot wound reported by him, BLiiMLmN answers

his question in the affirmative .

T he article in Friedreich’ is a historical relation of the doctrinesconcerning critical days after injuries, which are of no practicalvalue in our present courts of justice.

The article on poisoned wounds is a recasting of knownmaterials.

The case reported by EULENBUBG is thatof a girl eight years old,who died of suffocation and apoplexy, in consequence of having beenobliged to force herself into a cupboard.

The case of death fromsulphuric ether is that of an illegitimatechild . The father ack nowleged its death to have resulted fromsul

phuric ether, which he himself hadmade the child inhale . Accordingto the reporter, however, the murder was not proved, because the

child might have died from the effects of the vapour which was

dispersed in the air of the room.

PELIKAN finds by experiment that a cannon-ball, or othermissile,can only cause injury by immediate contact.

TARDIEU enumerates the injuries caused by the attentat uponthe life of the Emperor Napoleon , and gives an account of theirnature, importance, and ultimate results .

Mam, in the chapter entitled Wounds in General, makes someremark s on theirmedico-legal relations.HAFNER reports the case of a man who, in consequence of blows

with a stick , had sustained fractures of the lower angle of the rightparietal

,and the squamous part of the right temporal bones ; which

detached seven pieces of bone, and produced four fissures, runningin various directions . He died on the third day, probably froman

tensive extravasation . He got up during the second night afterthe injury, for the purpose of passing urine .

The case reported by Kiinxan is that of a fatal fracture of the

k ull, in which the injury extended to the base of the cranium. A

wound of one of the men ingeal arteries caused an enormous extravasation .

The first case of Born is that of a girl, net. 1 1, who died on theamt of November, after having received a box on the ear early in

son ar lo mw ama AND al axsnauan rna .

ceration in hrnimmemhmmand bones. It is sought to connect

these lesiomwith the box ou the ear. The second case is that of a

girl of the same age, who also received a box on the right ear, and

upon whose petrol bone, a fungus of the duramater was discoveredat the post-mortemexamination.

In the leading article in ‘ Friedreich’ it is maintained, that all in .

juries of the head are capable of producing psychical anomalies ; andthat in some cases these anomalies appear a long time afte r the injury.

The case om xm refers to a had beenattacked by her husband with a hatchet, whilst she was asleep, herhead being on a pillow ; There were three scalp wounds, and

coma-canon set in, which necessitated the removal of two large

There was repeated hmmorrhage . In the course of the case some further pieces of bone came away. But granulatious springing upfromthe sides of the wound, it became ultimately cicatriz ed. The

woman, who had been admitted on J uly a5th, 1858, left Guy’

s

Hospital'

in March, 1859, and was then able to give evidence at thepolice court.From his series of observations Toumrooona draws some

In the ease of Nii'muxo, the left brachial plexus and some lymphatic glands had been injured in the course of a puncturedwound, passing between the third and fourth vertebrae of the neck .

Sm axnnna reports on an injury of the spinalmarrow, conse

quent upon a punctured wound near the third dorsal vertebrathere was paralysis of the right foot, shortness of breath, and ia

voluntary discharge of fmces and urine. An impaired function of

the foot remained permanently.

Cm r-Lacnorx gives a laborious compilation of the physiolo

gical,morbid, anatomical, and forensic relations of death by hanging.

Ka iionrs '

rmx has furnished a complete amount of the materialsby which the question of priority of death can be decided .

Kansas is of opinion that no conclusion can be drawn fromthe expression of the face of dead persons, as to anycircumstancespreceding death .

Hosea points out that the presence.of fissures in long bones

480 aarou'r on LEGAL n euroma, me .

does not necessarily involve dislocation of fragments, which maybe only a secondary effect of voluntarymuscular contraction . He

states that most malformations in bones and joints, subsequentto injuries, are due to undiagnosed, and badly treated fissures .

The essay of a n contains a reconsideration of known factsrelative to rigor mortis .

WALLMANN has never observed rupture of the internal and inter~mediate membranes of the carotids in hanged persons, nor was heable to produce their rupture experimentally ; from which axperiences he comes to the conclusion that such an occurrence mustbe veryAccording to HELLER, hmmatine is best extracted fromblood by

sulphuric acid and alcohol. After neutraliz ation of the acid, thealcoholic extract is evaporate d. The watery solution of the residueismixed with an equal volume of healthy urine, the mixture heatedto boiling in a test-tube, and concentrated liquor potassmthen

added. It thereby becomes of a green colour, and a blood-red

precipitate of earthy phosphates forms, which under the microscopeappears yellow and amorphous. If the mixture is afterwards

shak en with air and allowed to stand, the hmmatine-phosphatesbegin to discolour fromabove downwards, and the green colour of

the fluid gradually fades .

Of all tests for blood, Bavcx behaves the production of the

characteristic crystals to be the best. Dried blood is soaked inwater, and afterwards treated with glacial acetic acid. In

this way, blood on linen, wood, metal, clay, and lime, can be recogn icad. If the blood is dried in substance, itmaybe scraped off

the surface on which it is found. The powder is placed upon a slipof glass, ground down with a glass rod, and covered with a pieceof thin glass . One or more drops of glacial acetic acid are n extbrought in contact with the powder, and the preparation is then

gently dried on a sand-bath . When all the acid is evaporated,the

preparation is allowed to cool, washed cautiously with a little

wate r, and submitted to microsc0pic examination . The rhombic,brown-red crystals of basmino, discovered by Teichmann, are ev i

dence of the presence of blood . Bryck adverts also to somemodifications of the test

, and to the so-called polychroic test,

viz .,the changes of colour which residues of blood undergo by

the alternate action of glacial acetic acid, caustic potassa, and

concentrated sulphuric acid.

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432 armour ox w e ar. manicure, are .

111. POISONS AND POISONINC .

A. Dimmer simulating Poisoning.

On ApparentPoisoning. (Priodreich, 9, a.)

In this article, it is assumed that symptoms simulating extraneouspoisoning maybe produced by spontaneous generation of organ ic

poison in the human body during life, by indiosyn crasy, and bynatural diseases having symptoms analogous to those produced bypoisons.

B . Alleged Poisoning , mu poison not identified .

(Pharm., Dec.,

At the Central Criminal Court, on October a7th, 1859, G.

Rogers was indicted for the wilfulmurder of Z. Wright, a female,with whomhe had cohabited, and who died about a week after her

confinement. The scientific evidence of Letheby went to show

the absence of mineral poison ; but froma quantity of treacle

like fluid he obtained about a drop of an oily body, which was

very acrid, and on application to his lip produced blisters : some ofthe same description of oilymatter was found in the vomit and in

the contents of the stomach. The oilv matter was not fromcanthu

rides, as he had once supposed. A guinea pig was killed bvsome of it, and the same substance was again extracted fromthe

guinea pig, and then killed several sparrows . Letheby, togetherwith Baker and Garrod, were of Opinion that death in thiscase did not arise from anynatural disease, but from the administration of some foreign irritant. For the defence it was urged,that as the real nature of the acrid matte r discovered in the stomachcould not be determined by chemical experiment, itmight have beengenerated by disease . The jury returned a verdict of Not guilty.

(See remark s upon this case in a leader of‘MedicalTimes } November

5th, p .

On Poisoning byCigm. (Friedreich , 9: So)

In relation to a case which occurred in Italy, and is repa i r

in the Gaz . di Tribunali,’BUNSEN made some experimel

POISONS AND rorsoms c . 483

the result of which he affirms, that the possibility of a personbeing poisoned by cigars , impren with as much arsenic as

they will bear w ithout presenting a spoiled appearance, cannot

be denied ; and tbat the smoking of one such cigar introduces a

notable quantityof poison into the mouth ; but that it is umwith a view to

of a cigar so poisoued, as t0 produce a fatal result ; for tbe taste of

such cigar-smoke is horrible beyond description .

Special Poisons, in aéol abetioal order.

Case of Death fromAconite. (meet. i.

Suicide byAcontte Root. (Lancet, ii,

In January, 1859, Mr. Alfred Dowsom, surgeon, died at Nor

wich. H—e had misrecd the labels on the bottles, and tak en as a

M a dme n-omwhat he believed to be fl‘n . Aurant., bnt

what was reallymarked Tra. Aconit. Shortlyafterwards the usual

symptoms of poisoning by aconite commenced, and terminah dfatally, in spite of the most prompt and efiieient medical as.

A gardener had dug up some aconite root, and dried it. One

evening he purposely ate some of it. Three hours afterwards hecalled in some neighbours, and complained of most severe pain inthe stomach. He had vomiting and purging, was occasionally very

was sensible . He was admitte d into St. Mary's Hospital, under

the care of Dr. Alderson, five hours after eating the poison . He

was in a state of collapse, and notwithstanding antidotes, diedtwentyminute s after admission.

2 . 4100501.

ng about a gallon of

contents run into

28

4311 REPORT ON LEGAL MEDICINE, ETC .

a gutter. He stooped down and drank his fill, when, on again

attempting to rise, he staggered and became totally intoxicated .

At the police-station, the stomach-pump and emetics were admin istered. Continuing insensible, he was brought into Guy

’s Hos

pital. He was collapsed, cold, and unable to swallow . He livedtwenty-two hours after his debauch, and died with dilated pupilsand slow respiration . The post-mortemexamination showed intensecongestion of all the organ s, particularly of the lungs and brain .

3. Antimony.

Lu ng-no,

— Diagnosis of Antimony in the Dead Body, after Poisoning. (Ann .

(P y 1 1.

Lassaronn, fromexperiments made in conjunction with Lorain ,has come to the conclus ion that antimony cannot always be discovered by Marsh’s method for arsenic. Of all the organs of an

individual who had been poisoned by repeated doses of antimony,the liver alone yielded faint traces of antimony with Marsh’s apparatus. But when the organs were incinerated, and the carbon and

ashes extracted with nitric and hydrochloric acids, this extractyieldedan orange precipitate with sulphuretted hydrogen . In this waythe liver, spleen, and k idneys yielded considerable amounts of

antimony (liver 15 grains of tartar emetic) ; the stomach and

intestinal canal gave traces .

4. Arsenic.

Huber,

— Historyof a Case of Poisoning, in which the poison could notbe detected .

(Oesterr., 4,

Chfi gfi gom— On the Quantityof Poison which has been found in the Stomach , inMurders byPoisoning with Arsenic. (Edinb ., Dec.,

Blondlot — Analyses for Arsenic byMarsh'

s Method . (Acad . Med Dec. 4,

Odling.

— On the Failure of Marsh’s Process for the Detection of Arsenic. (Guy

's,

18571

schaofl‘

er,

— Detection of Poisoning byArsenic in a Burnt Body. (Casper, 14,mm— Poh oning by Arsenious Acid. Medico-legal Researches. (Gaz . Iidp. ,

1857, No.

The Bradford Poisoning Cases. (Pharm., Jan . 1 ,

Trial of Dr. King (America) for the Murder of his Wife. (Edinb . ,

Rose (H, Cooper , )— Case of Poisoning by the Arsenite of Copper in an Infant.(Lancet, 1 ,

Abegg,

— Case of Poisoning byArsenic and Strychnia. (Schmidt, 6,Trial of Dr. Smethurst for the Murder byPoison of Isabella Bank s. (Central Crim.

Court. Short-hand Report.)

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436 anroar on LEGAL n euroma, are .

The poison was manufactured into loz enges . T he juryacquittedthe prisoner , by direction of the judge, as there had been no criminalnegligence of the druggist, but an ignorantmistake of his boy only,who had been duly cautioned. At the date of the trial, De

cember M et, 1858, this sad mistake had resulted in the death of

twenty-one persons .

In America, a Dr. King, having had adulterous intercourse withan unmarried young woman,murdered his lawful wife andmother ofhis child, by administering to her repeated large doses of whitearsenic, of which, after death, as much as eleven grains were foun din the stomach by Professor Croft, of Toronto, to whom the in

testines had been transmitted for analvsis . King was condemnedand executed.

Ross reports the case of an infant nine months old, who after

sucking a green cake of colour from a child’s paint-box, was

taken severely ill, but under treatment recovered. The paint wasarsenite of copper.

As soc observed a case of what appeared to be poisoning bystrychnia. Theman died, notwithstandingmedical aid. After deathlarge quantities of arsenic were found in the stomach, and absorbedstrychnia in the tissues . The suicide had tak en arsenic first, and

hastened his death by a subsequent dose of strychnia.At the Central Criminal Court, Dr. Smethurst, a married man,

was arraigned for the murder, by poison , of Isabella Bank s, a ladywith whom, after a shammarriage, he had cohabited. The prac

titioners who had attended the deceased during life, as also the

gentlemen who had performed the postmortemexamination, andthe medico-legal chemists retained by the prosecution, by whomarsenic had been detected in one evacuation, and small quantitiesof antimony in portions of the intestines , contended that the deceased had died fromrepeated doses of irritant poison . The defenceurged, on the other hand, the probability of natural disease, complicated by pregnancy, which themedical attendants of the deceasedhad not diagnosed, together with the absence of several leadingfeatures of arsenical and antimonial poisoning ; and accounted fortheminute portions of antimony found in the body, by suggestingthat itmight have been contained in the gray powder or trisnitrateof bismuth, which the deceased had taken as medicines. The

arsenic in the evacuation they also contended might have been de

sol sona AND roxsomao . 487

rived, if not fromthe copper gauz e used in the analysis, fromone or

other of the drugs above mentioned. The jury returned a verdictof guilty, and the prisoner was condemned to death . A considerable portion of the press was opposed to the verdict, and the HomeSecretary, after hearing all appeals, granted a respite . The whole

cided,that although the case was full of suspicion against Smethurst,yet there was not complete and satisfactory evidence of his guilt.

convict by the Queen. In the course of the analyses for the

prosecution an error occurred. Owing to the use of copper gauz e

in the prisoner’ s possession, was alleged to contain arsenic. The

mistak e was discovered before the trial.

5. Atrop ine.

Holthom ,

— Cu e of Poisoning byAtropine . (Med. Times, a,Five Cases of Poisoning byExtract of Belladonna. (Lance t, 3,Beams

— Poison ing byBe lladonna. (Med. Times. a.Lem ,

— Poisoulog byHyoseyamus and StramoniumSeeds. (Ca per, 34, z .)

Homaousn gives the deta ils of a case of poisoning by atropinein a child three years and eightmonths old. The dose was froma

drachmcnd a half to two drachms of a solution coutaining two

grains of atropine in an ounce of water ; so that the child, who gotat the bottle accidentally, took less than half a grain of atropine .

The child, when first observed, was strange, irritable and excited, but

unconscious, with its face in maniacal distortion . The pupils werefully dilated. Sulphate of z inc andmustard and water were giv en,but vomiting did not tak c place till three quartcrs of an bour aftcrwards. Some of the vomited fluid entered the author’s eye, and,

ammonia were now given promiscuously every quarter of an hour,but the attempts to make the child swallow almost suffocate d it.The child was insensible till 1 o

’

clock p.m., or till four hoursafter the commencement of symptoms ; the pupils were widelydilated and immoveable, the eyes open, and the lids not aflected

them; there was occasional

hot and dry, and covered with a

488 nxron'r on LEGAL uamomn, are .

the pulse was 170, and somewhat feeble. After that the child

gradually recovered, under symptoms exactly like those of delir iumtremens. He vomited twice in the course of the afternoon, and

had two evacuations of the bowels after an enema of two drachmsof turpentine with two drachms of castor oil in six ounces of gruel.

More evacuations were produced by jalap, calomel, salinemixture,&c., during the night. He also passed urine . Aboutmidnightthe little fellow was out of danger, but the pupils remained dilatedfor nearly a week . The excreticus and vomited matters were

analysed by Dr. Marcet, who found traces of atropine in each.

Some cases of poisoning by extract of belladonna occurred in theCharing Cross Hospital, under the care of Dr. GOLDING. These,and one occurring in the Middlesex Hospital, were the most severeout of sixteen cases which occurred to some little boys who hadpartaken of extract of belladonna which they had pilfered fromCovent Garden Market. In all cases there was delirium, in none

coma ; dysphagia in few, cutaneous eruption in one. In the firsttwo cases the urinary organs were affected, little or no urine beingpassed, even with the catheter. The pupils were remarkablydilated, but in two cases, one being the severest of all, the pupilof one eye was described as partially contracted .

”The stomach

pump, emetics, and cutaneous stimulants were employed : all the

cases recovered. The dose of the extract actually swallowed couldin no case be ascertained, but in the majority it must have beensmall, as out of sixteen who partook of the poison, only five soughthospital relief ; the extract had been taken mixed with water.

Su 'ron reports ten cases of poisoning by belladonna berries, one

only, in a scrofulous subject, being fatal. There was dryness of

mouth and throat, dilatation of pupils, and subsequent delirium.

Emetics were given . The delirium was successfully treated bytincture of Opium, which made the patients sleep. There were nocutaneous symptoms .

In the case reported by LEISTNER, a man, seventy years of age,

had been feloniously poisoned by seeds of datura and hyoscyamus .

Nine days after death the body was exhumed, and m the intestinal

canal were found fifty-four grains of datura, and five grains of hyos

cyamus seeds, which were identified by microscoPical examination .

Death had ensued twelve hours after the administration, undersymptoms characteristic of these poisons.

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4m an on on LEGAL unmcrns , arc.

9. Cole/licum.

Case of Fatal Poisoning byColchicumWine. (Pharm., Feb .,

A child, aged nine months, was taken ill with diarrh ea, torelieve which, the mother sent for a pennyworth of antimonialwine . But the shopboy served colchicumwine instead, and of thisthe child took successively fifteen, twelve, and ten drops . After

the discovery of the mistake, by the non-production of vomiting,emetic was administered. But the child died early on the fol

lowingmorning.

Orondgre,

— Cue of Catalepsyfroman Overdose of Indian Hemp. (Med. Times ,r, r

Bohr of Poisoning with Hu chisch. (Pharm., Aug., u s ; fromDublinQuart. Journ.)

The case by Cacumnn is that of a young Indian, eighteen yearsof age, who in the morning had been seen smoking bhang, or

gunjah, i . e. Indian hemp . He was found unconscious . The

limbs could be placed in any position, and remained in it untilmoved again . This lasted for three days. After that he graduallyrecovered.

Sen sors reports at great length the symptoms experienced byHeinrich, his assistant, who had taken ten grains of a new

description of Indian-hemp extract, called birmingi,”which had

been obtained through an apothecary, Dr. Steege, of Bucharest,

and was labelled, besides the name,with produces laughter, ten

grains .

” Irritation of the throat, cructation, and slight nausea,

followed the chewing of the extract. After two hours he beganto talk irrationally. The excitement passed into sadn ess, anxiety,and a feeling as if of approaching death. Paroxysms of nu

consciousness followed. Water had been drunk in large quantities .

The flow of ideas wasmost extraordinary, confirming the opin ionthat preparations of Indian hemp exceed those of every otherk nown agent in their immediate exciting action upon the imagination . But they seemto be so uncertain in their remedial action,that the physician must, in every insta nce, use themwith greatcaution .

rorsons AND rorsomxc . 441

1 1 . Hydroel lorie Acid .

Budd — W ol Poisoning by Hydrochloric Acid, batt en ounce proving fatal in

eighteen hours. (Lancet. 2 ,

A feeble woman, a t. 63, took half an ounce of the acid for the

an antidote administered to her. Burning pain in the tirroat and

stomach, retching, and collapse were the leading symptoms . She

were found swollen and corroded ; and, from the symptoms , it isprobable that death was immediately due to suffocation caused by

12 . Hydrop/lobia .

— Analyaia of Blood in Hydrophobia. (Clinique Empéenne. Lancet,

Gu iyang-go Laryngototny in Hydrophobic. (Lancet, 1,Wright— Report o! a Case of Hydrophobia. (ih.,M um-On Babies and Hydrophobic. (Schmidt, ror,

No conclusion can be drawn fromRae sxr’ s analysis.The cases of hydrophobia in animals are so numerous, that

our space will not allow us to record them. They present, moreover, no peculiarities .

80mm reports at length a case, which, although not referable toa bite of a dog, closely resembled hydrophobia, and was saved fromdeath by prompt laryngotomy with a penk nife .

Waronr’

s case was fatal ; the subject a soldier, who had beenbitten by amad dog. It is to be regretted that laryngotomy wasnot performed in this case .

THAMRAYN gives a very complete resume of all that is at presentknown on the subject. The article, being itself a condensed report,admits of no extract.

13. Mercury.

A dministration of MetaIlie Mercaryin Cofl'

ee to a’

l'

aherculomChilds no eonaection traceable. (Casper. 13, a

t. r .

442 REPORT on LEGAL msmcma, R'

rc .

Bobem,

— Poisoning byCorrosive Sublimate. (Med. Times, r, are .)Suicide byBichloride of Mercury. (Pharm., July,

In the first case of PRINCE, a woman took, with suicidal intention, two scruples of the precipitate powder. She complain ed of

pain in the stomach, had an emetic given her, and afterwards a

laxative. She rapidly recovered, and but slight salivation resulted .

In the second case, rather over two drachms were taken . Vomitingwas early induced : blood was present in the vomited matters and

in the ejects per anum. Effervescent droughts and opiummitigatedthese symptoms . On the third daymost violent salivation ensued,so that the tongue protruded about an inch from the enormouslyswollen month. This state lasted for about a month, in spite of

all treatment. The whole of the anterior portion of the mucousmembrane of the cheeks, gums, and under surface of the tongue,

sloughed away, and four teeth were lost. As the parts healed,the jaws became completely closed, and the tongue adherent to thefloor of themouth and check s .

Realms records the case of aman who took about half a drachmof the bichloride. Ten minutes afterwards white of egg was freelyadministered . Copious vomiting ensued. He passed liquid, dark,and subsequently bloody stools. The month, fauces, and (esophaguswere corroded, and became very much swollen . His aspect wascholeraic, and he had cramps

'

in his legs . During the next ten

days there wasmuch purging, ulceration of the month, and mercurial fetor. The patient died on the eleventh dayafter the mistake . Stomach generally inflamed, pulpy and gangrenous at the

pyloric end. (Esophagus denuded of its liningmembrane . Intestinal canal presented the appearance of intense inflammation passinginto gangrene.

Aman, set. 70, was found dead in his counting-house . In his

stomach were found large quantities of corrosive sublimate, of

which he had no doubt, partaken, with suicidal intention .

I4. Nicotia .

Mek ong — Note on the Search for Nicotine in Dead Bodies which have been in .

terred for a long time, and after pntret’

action of the animalmatter. (Acsd .

Belg., rs ,

Tefl on— Ou Poisoning byNicotia, and Detection of the Poison. (Pharm., June,

Suicide byNicotia. (ih., Sept.,

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444 Rsronr ON LRGAL unnrcmn, arc.

agency of an emetic. The patient tasted themorphia in the vomited

A woman was found dead : the verdict of the coroner’s jurywasthat she took poison (Dover

’s powder) bymistake, and that she

obtained it at some institution or shop, but there was not sufl cientevidence to identify the person or persons who supplied her.

”

nug get— Poisoning byOxalic Acid. (Gas. Hdp., 1858,

Webb — Case of Poisoning byBinoxalate of Potash. (Med. Times, a,

A healthywoman, wt.49, took about half an ounce of oxalic acid,which a druggist had given her instead of creamof tartar. She

died, after a quarter of an hour, with pai n in the stomach, colic,diarrhoea, vomiting, convulsions, and stertorous breathing.

Aman, wt. 40, took by mistake a quarter of a teaspoonfnl of

the binoxalate of potash. Two hours afterwards he was attack edwith vomiting, burning in the throat, and heat in the chest and sto

mach. Afterwards, there were muscular weakness, cramps, and

head affection . The vomiting continued for several days, althoughso small a dose only had been taken .

17 . Pimp/la ma.

Ow en— The Chemical Criterion in Cases ofPoisoning. PoisoningbyPhosphorus.

(Superarbitrinm, &c.) (Casper, 14, s .)men ingk y,

— Ou the Analysis for Phosphorus, in its Diagnostic and Forensic

Relations. (Oesterr., 4,Lag g in g

— Chemical Observations made upon the Occasion of an Attempt atPoisoning bya Preparation containingPhosphorus. (Ann. d

’Hyg., April, 1858,

Rub en— Some Observations on the Poisoning of Animals with Phosphorus, in

relation to recognising it in the dead body. (Casper, 14,Lewinsky

— Case of Acute Poisoning byPhosphorus. (Wien Aerz t., 1, 5a.)

In a case of poisoning, apparently by phosphorus, this poisoncould not be found in the body by chemical analysis. Nevertheless,CASPER. and his colleagues in the deputation assumed that deathwas due to phosphorus, upon the basis of the symptoms during life,the post-mortemappearances, and certain signs upon the articles offood, of which the deceased had partaken .

s rnsk x believes that, in real cases of poisoning by phospho

rorsons sun Porsosmo . 445

ms, some of this poison always remains unchanged, and gives elaboo

rate directions for finding it. Of the three difierent processesdescribed, two are very troublesome and uncertain, while the third

Bmxxxn shews by experiments, that the process of Lipowitz for

the property of phosphorus to form a peculiar compound withsulphur, i s very safe and certain .

In the case of s msxr , the poison (phosphorus) produced noviolent symptoms in the digestive organs during life, nor yet any

of the blood seemed to be the cause of death .

18. Picrotocine.

Gfink d — Analysts to: Pirrotoxine in Cases of Poisoning, (Archiv as Pharm.,

144.w )

Gunm a n-acts the organic substances with alcohol, after acidulation with tartaric acid. Picrotoxins (and strychnine) pass into

while tartrate of strychnine remains undissolved . On evaporation ,the ethereal solution deposits picrotoxine, which can be recogn isedby the usual tests .

19. Prussia Acid.

Poisoning byEssential Oil of Almonds. (Pharm.,May.

Two Suicides byPrussia Acid. ( ih., July.Death fromPrussia Acid. ( ih ., Nov., s94. )

m -me d msth fromPrussic Acid ; Discovery of the Poison in the bodythree week s after death . (Schmidt, 1os. 292 .

M d”-Case of Poisoning byCyanide “ Potassium. (Med. Times, 1.So.)sw am— Ou Poisoning with Cyanide of Potassium. (Wien. Am , 1 , 1

In the first of the above cases, a child died after a dose of essen

druggist’s assistant.

In 'me case of death fromprussic acid, the jury found that thadeceased died fromthe eifects of an over-dose of prnssic aeid, tak en

446 arrow on LEGAL MEDICINE, are .

Baumfound prussic acid, three weeks after death, in the stomachof a youngman who had killed himself with it. The contente d the

stomach did not smell of prussic acid. The details of the analysis

leave many desiderata .

Honxmon describes the postmortemappearances and analysis ofthe contents of the stomach of aman, who had destroyed himselfby tak ing about a drachmof cyanide of potassium. Vomiting hadtaken place . Themucous membrane of the stomach was intensely

Sonaunxsmmfurnishes notes on five cases, in which cyanide ofpotassium produced almost immediate death with tetanic symptoms, which appeared with apoplectic alacrity.

Poisoning bySoap-lees. (Guy's,

A child, wt. 1 } year, had drunk about a mouthful of soap-leesfroma cup. The alkali had the greatest effect upon the lower partof the (e soPhagus. The child died after eleven hours. The postmortemappearances are minutely described.

2 1 . Stryc/lnia .

Bennett— Poisoning byStrychnia ; Recovery. (Lancet, 3,PindelL— Ou the Prevention of Strychnine

— Poisoning by Fat. (Wittstein.

Edinb ., Jan.,

Smith — Case of RecoveryfromPoisoning byStrychnia. (Edinb ., Dec.,

Simon — Case of Poisoning byStrychnia. (Lancet, 3,Suicide byStrychnia. (Pharm., Oct.,

A lady took, in despondency, a packet of “ Battle’

s rat poison .

BENNET I‘ was called in, who administered emetics, but withouteffect. 011 the occurrence of the spasms, be administered tinctureof iodine in water. Vomiting afterwards came on . The patientrecovered, probably because the dose was small. Bennett believesthat the tincture of iodine did act, but how there is no evidence toshow . One of the rat powders was analysed, and yielded a grain of

strychnia.

PINDELL states, thathalf a grain of strychnia will kill a dog, butthat three grains,mixed with fat, produce no effect. In eleven dogsstrychnia alone caused death each time ; in nine dogs, who had a

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418 aeroar on w e ar. n euroma, are .

spoonful of oil of vitriol. The mouth and msophagus were muchcorroded, and the stomach extremely charred .

The reportof these cases winds up with a description of the efiectsof sulphuric and nitric acids upon themouth, of each ofwhich lesionsa case was observed.

23. Snake Poisons.

Weston — Ou the Poison of the Common Adder. (Lancet. 1, 53s .)

The author caught a viper, coluber berm, and holding it up bythe tail, was instantly bitten . He strangled the bitten finger and

sucked the poison fromthe wound. In about fifteen minutes thefinger became swollen and painful ; a sense of numbness and rigi

dityextending up the arm,with giddiness and confusion in the head

ensued ; violent retching came on, and he staggered home lik e a

drunken man . His mouth and tongue became swollen and pro

trading. Diarrhoea supervened. Next dayerysipelas of the handand armshowed itself, and spread over the body down to the hips .

That subsiding, he got bettei'

, when, after a fortnight,abscesses formed on the bitten arm, and had to be opened. He

gradually, but perfectly, recovered.

24. Upas Antiar.

Kouik orr -Ou the Nature of the Action of the Upas Antiar. (Wiirz bnrg, 8. i

This poison acts in the same manner, whether introduced by thestomach or a wound. It first causes a loss of the power of voluntarymovement, and after a time, the animal (frog) dies without tetanus.

The mostremarkable symptom consists in the motionless state of

the heart. The first effect of the upas on the frog is paralysis ofits heart, exactly as Brodie, in 181 2, had observed with regard tomammalia.

25. Urari.

“Hik er, (Virchow’s Archiv, x. Edinb ., Jan.,

Betz old andHaidenhain. (Schmidt.Summaryof Literature on Urari. (Edinb., Dec.,

Urari has been corrupted by English writers into wourali, by theFrench into curate. Schomburgh says that the Macusis, who

Porson'

s AND Porsomxe . 449

mak e it, call it invariably urari. (Christison, note, April,

According to KO LLIKER, the urari causes death by paralysingthe nerves of respiration ; it destroys the excitability alike of motorand sympathetic, but does not affect the functions of sensory nerves .

It does not destroy muscular irritability, or arrest the action of

the heart.Concerning the action of urari, the discussion between Bu '

z on ) ,

HAIDENHAIN, and KiiLLIKl-zn, is of so complicated a nature that,owing to the pressure of space, we are prevented fromeven noticingits principal points . Ithas increased in dimensions since the publication in 1859 of an article by Funk c.

The periscope in the ‘Edinburgh Monthly Journal ’ gives thehistory of the poison, its preparation, analysis, and the theories ofits action, by BERNARD, KiiLe en, and others . Its employmentas a remedy mtetanus 1s extensively discussed. Some informationby Haamormand MITCHE I L relative to the varieties of urari— the

one called corroval,”the other, less powerful, termed vao — is

of great importance, as suggesting caution in the application of thisagent in the practice ofmedicine .

26. WrZ-lsau.

Christiaon — Ou a New Poison fromthe Interior of China. (Edinb ., April,

This new poison, described in the ‘Northern China Joumal of

April 4th, 1857, as possessed of marvellous properties, most of

themfabulous, was sent to Cnnl sr l sox by McGervan, an American

physician residing atNingpo . Itwas accompanied by the leaves androots of the plant, which Christison found to be. a species of

Aconitum, not A.Nap ellus of Europe, nor A.f ero:r of the Himalayas,but a new species . When a piece of the root, the siz e of a pin’shead, is chewed, it produces intensely that strange combination of

numbness and tingling which characterises all poisonous speciesof the k nown Aconites . The extract sent from China producedprecisely the same impression as the plant, fromwhich it had no

doubt been made . The Wii-tsau is also called Tsau-wr’i .

450 nnpoar on LEGAL MEDICINE,mo .

27 . Zinc.

Case of Poisoning byBurnett's Solution (Chloride of Zinc) . (Guy’s,Ogle,

— Poisoning bySulphate of Zinc. (Lancet, 2 ,Sw a nson — Poisoning by Impure Sulphate of Zinc. (Schmidt, 102 ,

The first case proved fatal after the expiration of fourteen weeks.

Vomiting had occurred ten minutes after tak ing the dose of poison

(in mistak e for gin), and had continued during the whole time, notwithstanding suitable treatment. In the stomach, which was verymuch contracted, were discovered two perforating ulcers .

The case of 001m, under the title of “ Death from slow poi

soning,”refers to aman who was found dead, with wounds in his

throat,which, however, did not account for death . The stomach

looked like tripe, and on analysis was found to contain sulphate of

z inc. The man had used this salt as a wash for his eyes, and hadduring several years made frequent attempts at suicide .

SANTs ssox’s case is that of a poor, reduced woman, who got a

large dose of impure sulphate of z inc instead of Epsom salts .

She died aftermuch torture . The case is very complicated, and

teaches little . The impurities of the z inc were not further inquiredinto, and seemto have had no share in the result.

Appendix.

Formedico-legal analyses the following statementofm xornn,

concerning the solubility in chloroformof the following alk aloids,

is of great interest : 100 parts of chloroform dissolve ofmorphia, of narcotia, of cinchona, of quina,of strychnia, of brucia, of atropia, of veratria.

IV. SUICIDE.

Several cases of suicide by prussic acid, cyanide of potassium,

essential oil of almonds, corrosive sublimate, laudanum, nicotia,strychn ia, and oxalic acid, have already been noticed under thehcad of poisons To those cases of suicide by poison wemust addthe followi ng

Gmbbaoher,— Fatal Case of Poisoning byArsenic. (Oesterr., 4,

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452 anroar on Luau . 111101011115, s'

rc .

podu, and fragments of oil silk obtained by rubbing ; to each of

which he gives a long commentary .

Scum-11111111, byfrequent personal observation, convinced himselfthat a person accused ofmany thefts simulated epilepsy.

m reports the case of a youngman 1 7 years old, who was conv icted of ravishing and murdering a girl, wt. 9 years . Bydexteroussimulation, he caused the jury to believe himof unsound min d

,

although the forensic physicians had given evidence to the contrarv .

VI . DOUBTFUL SEX ; ILLEGAL AND UNNA'I‘URAL COITUS ;

ILLEGITIMA'I‘E PREGNANCY AND PARTUBI

'I‘ION.

Caucus Comtantino,

— Medico-legal Question. (Italian, 8,Goldberg

— “mowthe Father ? (Oesterr., 4,

M ilk a — Two Cases of Stuprum. (Prag.

Ham — Ou Ravishing and the Attempt at Ravishing. (Wiener, 1857,M en — Medico-legal Studies upon Immoral Assaults (Ann. d

'

llyg., July andOctober, 1857 ; 15th and 16th Jan ., 1858, Indecent assault ; negativesigns ; constitutional leucorrhma. Ditto, with incomplete rupture of the hymen .

Ditto, w ith simple and veryacute inflammation of the vulva and vagina. D itto

upon a child tive years of age ; considerable disorder ; inflammation and blen

norrhagic discharge. Ditto on a girl four and a half years old ; inflammationof the vulva ; discharge from the urethra ; gonorrhmal infection . Ditto committed byan old man of seventyupon a child eight years old ; violent indammation of the vulva ; gonorrhe a] infection . D itto on little children ; inflammation of the vulva ; injuries to the sexual organs ; injuries to the mouth and

lips. Ditto ; injuries of the vulva. Repeated assaults by a father upon h is

child ; relaxation of the hymen , admitting, notwithstanding its integrity, complete introduction of the penis. Ditto repeated bya father upon his daughter

incomplete sexual connection , followed bypregnancy. Determination of vir

ginity; malformation of the vagina ; deformed vulva. Ditto ; partial rupture of

hymen by forcible introduction of finger. Ditto and v iolence committed upon

two young children ; complete defloration ; inflammation of vulva and vagina.

Attempted violation ; traces of great violence . Ditto ; suicide of the victim;traces of violence . Violation and complete detloration of a child twelve years

of age. Violation and complete decoration ; the signs present after three

week s. Violation ; complete defloration , w ithout retraction of the ruptured

hymen. Violation ; complete defloration ; false allegation of magnetic sleep.

Violation ; complete defloration ; the hymen retracted ; syphilis communicated.

Violation ; complete defloration ; turning in of the fragments of the hymen.

Ditto, with impaired general health. Ditto. Violation , followed bymurder, ofa woman sixty-eight years of age ; deep wounds. Violation , followed bymurders. Immoral assaults upon six young girls. Sodomy, of a husband with hisw ife ; characteristic signs ; grave disorder. Active and passive sodomy; characteristic signs. Ditto, active. Active and passive sodomy; peculiar shape of

nous rrox. sax, m . 453

penis. D itto ; peculiar shape of sexual organs. Inveterste habits of active

po darasity; syphilis communicated ; pulmonaryphthisis. Murder bystrangula

tion, committed bya pc darast.Emma

— Ou Premature Births, in their Forens ic Relations. (Henke, 14,— Birth after Death. (ih., 13,

M en— ( bod cit , part ii.) Cases 1 7 , 18, 19, and 20 . Whether husband and

wife are of an age capable of begetting children ? 2 1. Questionable sterility.2 2 . Questionable capability to impregnate a woman, on account of juvenile age .

23. Questionable capability to cohabit and impregnate, on account of old age.

24. Questionab le abfl ityto cohabih on account of old age. as. Questionablepotence . 26. Aman denies having got h is daughter w ith child, pleading impotence. 2 7

—30. Actions of married women against their husbands for

impotence. 31—33. Actions for refimd connnbial duties. 34 and 35.

Alleged impotence, on accountof deformcd sexual organs. 36 and 37. Allegedimpotence , on acconnt of the absence of teaticles. 38 and 39. Alleged excessive

sexnal daaire in a man. 40. Alleged inability to cohabit in a woman. 41.

Virginityand pregnancy. 42 . Alleged violation of pudicity. 43—47. Rape of

adult women . 48. Repeated criminal intercourse with a consanguine adult

woman. 49. Alleged rape of a woman forty-seven year-s old. 50. Alleged rape.

51. Violent gradual dilatation of the sexual organs of a child. 52 and 53.

Rape before eye w itnesses. 54. How the rape was committed. 55—57. Dis

coveryof spermatoz oa. 58— 60. Whether and when rape was committed on a

former occasion ? 6 1— 66. Alleged syphilitic infection as alleged proof of rape.

67— 72 . Gonorrhe a in differen t stages as consequence of rape. 73— 79,

Sodomy. 80. Forced sodomy. 8 1— 86. Irritations frommasturbation in

boys and girls. 87. Forced sodomy of a boy upon a boy; spermatozo a ; puberty? 88. Sodomydiagnosed upon a corpse . 89. Whether the woman I'has borne flve or six months ago ? 90. How old was the M us, whioh was

born three weeks ago ?Km — Ou the Evidence of Rape on Infants. (Med. Times, 1, 361. 4171

Wilda — Observations on Kesteven's paper. ( ih., 1, 518,

The question, discussed by CANELLA, is answered upon the basisof the opinions of various authors .

In the case relate d by GOLDBERG, amarried lady was confined2 78 days after the departure of her husband, who had been sufferingfromdeliriumtremens andmental alienation, with great excitementofmind and body; maniacal attacks had alternated with clear i n

tervala. It could not be doubted that he was the father of the

The paper ci ‘Hansm contains meditations on the definition of

rape . The observations of Tasman, based upon an immense mate

peculiar descriptions of crime, which are not met with so often in

other countries as in France, and seemthere to be upon the increase .

Thus, public seduction of pudicity, practised in public places bymen

454 an on on LEGAL MEDICINE, arc .

of old age, appears to be a frequent crime. Immoral assaults uponchildren, and cases of rape on infants, are increasing at a terrible rate .

From1826 to 1830 there occurred annually about 130 cases of

that k ind but from 1830 to 1850 the average of thes e cases, of

which the majority happened at Paris, was 420 per annum. The

medical diagnosis of these crimes isminutely described.

ELsansssa considers premature births, and their relativ e fre

quency among married and unmarried women . The latter mostfrequently bring forth stillborn children ; amongst 540 prematureextra-matrimonial births, 1 25, that is, almost one fourth, were of

dead children ; and of these, two thirds at least had died in the wombbefore the beginning of labour. The diagnosis of death in the

womb fromdeath after birth is elaborately given .

Losscm reports the case of a woman who, after having beenrepeatedly confined before, suddenly died during labour. The child

was expelled spontaneously twenty-four hours after death.

A similar case is reported by TaaN'rnor .

Ke s'ms ’s paper is elicited by the case of Amos Greenwood .

The introductory remarks are those of caution to the forensic physicina , as lesions, similar to those from rape, are sometimes intsutionally produced for the purpose of extorting money. In Indiasuch cases are frequent. The crime of rape is, according to

Chevers, more common in India than in England. Hence our

Indian possessions have afforded a more profitable field for oh

servations upon this crime . Crimes of all kinds, and of the deepestdye, are revealed as common practices, in Chcvcrs

’s work on Medical

Jurisprudence for India.

’

A person namedAmos Greenwood was convicted at the LiverpoolAssiz es, December, 1857, of rape upon an infant. Wilde publishedanimadversions upon the case, believing the verdict to be contraryto evidence . Upon this Kesteven publishes the present paper,in which he discusses the opinions of twelve medical men, whichhad been given in reply to a series of questions addressed to themby Wilde . The paper concludes w ith a reprint of a paper byKinder Wood, fromthe seventh volume of the Med -Chir. Trans

actions,’ou N0mmpudendi.”

Upon this WILDE publishes observations, in which he show sthat Mary Johnson, the alleged victimof the above charge of manslaughter by rape, died of noma pudendi that the charge of

violence committed by Greenwood, and abandoned by Kesteven,

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456 a eronr ON LEGAL MED ICINE, arc .

which floated on water ; when the vesicles filled with gas were punctured , an

the lungs slightlypressed, they sank again. Did‘

erence fromlungs w h ich havebreathed . There were also present in these lungs the peculiar ecchymoseswhich formin utero.

l anolin — (Casper, 13, z .) New-born Child , w ithout signs of having b reath ed ;several mark s, which w ere interpreted as indicating the existence of non

breathing life having been terminated by violentmeasures.(Deutsche, n , z .) New-horn Child, found dead in a Dung-pit. Interrup

tion of breathing caused death ; cause of interruption not ascertained.

Caspian— (Loo. cit., ii.) Case 9 1 . Disputed Criminal Abortion . 9s. Doub tful

Abortion after ill-treatment. 93. Whether mechanical attempts at Abortion

have beenmade, and whether St. has home repeatedly? 94— 96. Three Accusations against Medical Practitioners of Criminal Abortion. 97. Black Soap,

Pepper and Savin used as Abortive Remedies. 99. Pulv. Jalap. and Sapo

Jalap. used as Abortive Remedies. roe . Redstone and Brandyused as Abortive Remedies. tor. A Midwife accused of repeated Criminal Abortions.

DUNCAN replies to some criticisms which weremade by the editorof the Medical Times and Gaz ette,

’upon his evidence for the de

fence in Reid’s trial.Tasman gives descriptions Of the various

minal abortion is produced, and the means by which attempts at

abortion, and their consequences, maybe distinguished fromnatural

disease . Powdered savin can sometimes produce abortion, but itnever causes symptoms Of poisoning .

Baomn'

rox reports a case Of criminal abortion, in the fifth monthOf pregnancy, Of a woman fifty years Of age . After death, the pointedpiece Of wood, by which this crime is usually accomplished in India,was found still impaled in the uterus .

DARIEN believes that saffron and green soap can , under certain

conditions, have an abortive action .

W'

ILLLu ISON draws the attention Of Observers to the conditionOf the umbilical cord in cases of infanticide, as itmay so strangle

the child’ s neck as to make respiration impossible .

Biinn mak es some Observations on the bony nucleus in the thighOf children, and infers the age of the fcetus fromits absence or siz e .

His conclusions are based upon 186 Observations, of which fortyare by himself.VOGLER. gives a case in which the lu ngs of a child, which had

not breathed, floated . It is reported that the midwife“ blew air

into the child, whose face was still covered by the fmtal membranes,

”so that it is not clear whether she only endeavoured

unsuccessfully to do so, or whether she partially succeeded.

roannstc rvscnow or . 457

Am w r observes, that the presence Of coagulated t Od iu the

caput succedaneumwould on ly prove that the child was living at

the time when the caput was forming .

o rou rr’s dissertation once more discusses, and approves of the

hydrostatical test for newu born lungs .

The pages ofm e o defend the proposition, that a chfld whichhas notbreathed shall be cons idered as not having lived.

The q uisition of LOWENHARDT combats this view of forensic

medicine, and sustains the counter-proposition, that a new-bornchild, even if it has not yet breathed, maylive, and conseque ntlymay be k illed and murdered. The proposition of Zeissing is

well adapted for the convenience of those who wish to confine the

evidence Of life to the floating of the lungs on water .

Alma remarks, that the cordmay be tied in two ways, namely,efi ciently, so as to close the blood-vessels, and inefficiently, so as

to leave thementimor partly Open .

Liiwn examined the bony residues of an almost entirely decomposed corpw of a child, and pronounced themto be derived froma

ftrtus which had probably died in utero, and had consequently been

Locus remarks on the signs by which accide ntal stra ngulation of

thechild, by the cord,maybe distinguished fromintentional strangulation after birth .

Bans cmnmunicates the case of a new-born child which haddied Of apoplexy, caused probably by an inflammatory condition of

VI l l . FORENSIC PSYCHOLOGY .

WM — Manual of Forensic Psychology, for the use of physicians and jurists.

Erb ium, t858.

Sam -Ou Legal Respons ibility. in the sense of the new Criminal Code.foroomedicallyconsidered . (Casper. I4, 3.

l d g — On the Present Stste of the Question oc gi esponsihility. Bayer’

sebes i rati. Intel]. Blath , May, 1858, No. as.

8M “ ,-The Position of Psychology relative to Criminal Law and Practice.

represen ted bythe discussions of the Psychiatric Section of the Thirty-fourth

Meeting of German Naturalists and Physicians. (Deutsche , i s. a.)— Aphoristic Thoughts on the question— is the assumption of reasons for

l responsibilityadmissible or necessary in practice ? (ih.)“ m ag— (Loo. cit. , p. First Examination of the Question— ls a d imi.

nished,”or, as others call it, a conditional,

" legal responsibilityto be assumed

458 REPORT ON LEGAL MEDICINE, ETC .

in practice. and what advantage can be expected to some fromits introductioninto criminal law ? A contribution to the doctrine of legal responsibility ineneral.

Schliger,

— Ou the present Scientific Starting-point of the Media —forensic Pay

chologist. (Oesterr.,4, so .)Roa ch — Ou the Functions of Judge and Physician in the determination of Legal

Responsibility. (Henk e, 38,On the Legal Responsibilityof Juvenile Criminals. (Friedreich , 9,On the Legal Responsibility of Drunk en Persons (according to the Prussian laws) .

(ih.)On TransitoryMania. (Freidreich. 9, a.)mok tar ,

— Revision of the Doctrine on the Fore-media l Relations of Mania.

(Casper, 14, a.)I nman — (Loo. cit. Wiirtemb., 28, Legal Responsibilityof a Person convicted

of Arson.

Ka rim- (Loo. cit. Bank s.38, Opinion on the LegalResponsibilityof A.0

mt. 16, being of sound mind, accused of Arson. 8. Opinion on the State of

Mind of a Married Woman V. N accused of Arson, but being of sound

mind.Ham — Ou the Mental Condition of Seven Persons committing Arson.

(Henk e, 47, Suppl.)Brannon— Are not the A— s, husband and wife. legally responsible ? or is the

h ighest weakness of intellect to be assumed, which does not exclude legal

responsibility? (ih.)Yam-Did the Proprietor, L. H atW who otherwise appeared of sound

mind. commit the Breach of the Peace, of which he stands accused, during a

sudden Attack of insanity. (lb .)gentlemen— (Loo. cit., iv.) Supreme Pore-medical Opinion on a Case of Question

able State Of Mind . (Deutsche, r r,Supreme Fore-medical Opinion on a Case of Arson. (ih., i s. a.)

M ar,

— Medico-forensic Opinion on a Case of Attempted Murder and Suicide

byamelancholic person, through Poisoning w ith Arsenic. (Ih., u , z .)Fall-at and De PietIQ Santa,

— Assassination of M rs. Lonlier by her Husband

during a Pit of Alcoholic Delirium. Repeated attack s, increasing in numberand severity; general intermittent alienation ; complete feebleness. (Ann .

d'Hyg., April, 1858,

Ponfi er ,

— Medico-legal Report on the Mental State of Marie Pons, accused of

Attempts atMurder. (Annal. Médico-psycholog., 1858, tom. iv.)

DragoneL— Medico-legal Report on the Mental Condition of B. A accused of

Murder. (Ih., April.)

Cu enave,— Medico-legal Report on the Mental State of C. B accused of Devas

tations of the Harvest and Assaults on the Public Force. (Partial insanity.)(Heid ., April.)

Levincart and Billodf -Medico-legal Reports on theMental State of one Charles.Attempt to Murder a Magistrate. (lb.)

Schubert,— Inclination to Murder (or Impulse=a Mordtrieb) . (Berliner Med.

Zeitung, 1858, No. to .)

Mahnert — Report on the Bodily and Mental Condition of a Woman accused ofArson. (Casper, 13, t .)

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460 REPORT ox t GAL ammon i a, Ere .

decisions upon this point in courts of law ; as also the right and

duty to give evidence,o not only in accordance with the letter, butalso the spirit of the law .

Mara reports the discussions upon the question of legal responsi

bilitywhich occurred in the Bavarian Representative Chambers, andpoints out the great difference of opinion which existed upon the

principles involved in the question .

SCHNEIDER details ninete en propositions, which were made byFleming, and discussed by the meetingmentioned. Fromthemwe

gather that the forensic physician, in psychological cases, has, ormayhave, two distinct functions— namely, the first, to determine how fara case ofmental alienation is dependent upon somatic disease3 and

the second, to ascertain whethermental alienation in reallypresent.Those who believe that mental, are always the consequences of

somatic diseases will not agree with this proposition .

PLAGGE, starting from certain speculations, assumes that theremust be several degrees of legal responsibility.

Liiwnxnann'r combats the views of diminished legal responsi

bility, which had been assumed by Ideler in two Prussian superar

bitria,”

and shows that the proposed distinctions and gradations

would lead to great practical difficulties .

SCHLAOER publishes some psychiatrical speculations.

Biic n, after considering the German law,

comes to the con

elusion, that, in questions of legal responsibility, the judge must putspecial questions to the medical witness, referring to the individualcase, and that a formula for putting questions relative to legal te

sponsibility does not exist.a nnmcn reports the case of a boy, ten years old, whomur

dered his sister. Poverty, immorality, and a tendency to beg and

steal, with absence of all instruction, were urged as mitigating con

siderations .

The contents of the remaining articles of this section appear to besufficiently indicated by their headings .

PRIVATE HYGIENE. 461

REPORT ON HYGIENE AND PUBLIC HEALTH.

A. PRIVATE HYGIENE.

I . DIETETICS .

a . Journals .

The Treasury of Health ; a Journal edited by Luaacn and Bou nce . Em lm,

C. Zwaardemak er.

Hygiene seems at last to make some progress in Holland, whereformerly it was little cultivated. The States General want a reformof the laws concerning the medical profession and public health .

Meanwhile scientific men are endeavouring to informthe peopleon matters of hygiene. The above journal is popularly written,and appears calculated to fulfil its object.

lack lu— Hand-book of Dietetics for Friends of Health and Longevity. 3d edit.

Wittmaaok — Popular Hand-book of Dietetics. W e.

Reich — Manual of General Etiologyand Hygiene. Erma».

Wmmacx, well known as the author of a book on rational

therapeutics, has entitled his work a popular one ; but it is so

scientifically written that few laymen will be able to read it with.

out a commentary. The section on the evil consequences of premature study and over mental exertion, and on the prematurepractice ofmusic, is full of useful warnings . In another chapter heproves to youth of both sexes, that early fruition is the grave of alllate enjoyment. The author, lik e IDEIE R, is a greatadvocate for gym.

nastics, which he terms the principal agent for the rejuvenescenceof body and mind. It is satisfactory to find that gymnastics, whichduring the last half century have mainly been reintroduced byenlightened schoolmasters, are now being warmly advocated bymedicalmen.

462 ns roar on LEGAL MEDICINE, are .

Rmcn ’s book has a political tendency, whence it has become thesubject of a legal prosecution in Bavaria. He wants to take education out of the hands of the clergy altogether, and to have it eu

perintended by a centralmedical council. His book is one of those

unpractical declamations, which, being useless to the people, meetwith no support, and being offensive to the parties in power, bringdown persecution upon the authors .

II. FOOD .

M mmm(Captain on the Stafi' oi‘ the Imperial Austrian Engineers, and Professorat the Military Engineering Academy, Kloaterbruclt). -

‘

l‘reatise on road.

The author begins with the elementary chemistry of the generalmaterials entering into the composition of plants and animals, anddescribes in outline their compounds and alterations. The principleof the conservation of force he illustrates in a practical manner,and then passes on to the consideration of nutrition . A definitionof food and nutritive materials is then arrived at and it is statedthat experience only can teach whether a substance is food or not,

and that, w ithout experience, science could not teach it. Thisdistinction between science and experience, though doubtless nu.

philosophical, mayperhaps be pertinent to the position fromwhichthe author’ s intended readers maybe supposed to regard the sub

jcet. He then treats of albuminous substances, their qualities andpowers . Alcohol, the author believes, has the property of retardingthe decomposition or disintegration of matters in the body, as w ellof the fluids as of the tissues : by thus lessening the n

amount of food it acts as a saving agent. But beyond this hypo.

thesis, and an admission of the usefulness of alcoholic drinks as

general and special stimulants, we meet with no specific knowledgeon this most important subject. According to the author, alcohol,in the formof the usual beverages, excites the imagination morethan the other forms of cerebral activity ; while tea and coffee raise

the intellect. But while alcohol excites not only the brain but

also the rest of the body, tea and coffee have a sedative effect uponthe rest of the body . The author enunciates the general principle,that food mustbe so adapted to the individual that he can attain

therewith the highest development of his physical and spiritual

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464 s erum on LEGAL unnrcms , E'

rc.

salaries, and prescribes special charges for services ren dered to

individuals. The salary is generally small, while the charges

ridiculously small. In consequence, the financial condition of

Nassovian practitioners is bordering upon poverty, particularly since

the great rise in price of all the necessaries of life which has takenplace in Germany during the last te n years . A more intolerableinterference with the natural laws of free trade and professionalliberty, or amore abject slavery than that of a Nassau practitionerofmedicine, cannot be imagined. T he sooner the Representative

Chambers leave the practice ofmedicine a free profession, as in therest of Germany, the better.

Hoan’ s work affords proof that the medical laws in Prussia are

good and well administered. There is, no doubt, a little too muchscope for interference fromabove, but it is generally not abused.

The collection of laws concerning the medical profession in Prussiais complete and well arranged, and accompanied by good commentaries and suggestions for improvement.The article of WEENERT shows that the hygienic condition of

theDepartmentofthe Upper Rhine (Alsatia) 18 far fromThe condition of lying-in hospitals, foundling hosp

itals, asylums fororphans, the blind, and the deaf and dumb, is either deficientor badly arranged and managed. The condition of the poor, of

pauper lunatics, and of convicts, is successively described and dis

cussed. The laws concerning the certificates of the causes of

death which prevail in country places prevent the collection of

useful statistics upon that subject. The laws regarding burials arevery deficient. Thus, only five years are fixed as the period whichmust elapse fromone interment before another can take place uponthe same sp ot. From all this we gather, that, while in Paris

,

hygiene interferes in all public and private arrangements w ith

exaggerated assiduity, on the Upper Rhine it requires much ad

vancement.Lena desires thatmedical police should be taught at the un iver

sities in amore practical manner than has hitherto been customary.

BLOEPELD reports the lectures on public health, forensicmedicine,and allied sciences, which are given at the University of Kasau.

The different branches are laid out in a very systematicmanner.

The Bavarian medical officers of health and state medicine havepetitioned the Bavarian Chamber of Representatives for an increase

of their salaries.

PUBLIC HYGIENE. 465

II. MEDICAL STATISTICS AND TOPOGRAPHY.

On Statistics of Mortality and Morbility. Report of the Royal Prussian Scientific

Deputation for Medical Affairs, relative to a Schedule to be used for Registers

of Mortality. (Casper, 14. a.)Gnomi — Nosological Statistics of Deaths. (Ann . d

’Hyg.,

I d ea— Ou the Fluctuation of the Population in Middle Pranconia during the years

1851 to 1856. Promomcial sources . (Henk e,On the Fluctuation of the Population in the Grand Duchyof Baden during

the period from1853 to 1855. (Deutsche, 13,8 la g— Medical Meck lcnburgh ; Notes collected during a Journeyin 1855-56.

b

Zelfi ng ,

— Registers of Population, Births, Marriages. and Deaths, in the Principalityot

’ Ostfriesland. from1837 to 1852 . (Henk e. a.)Baum-Statistics of Diseases which have caused Death in Belgiumduring the

period from 185 1 to 1858 inclusive. Fromthe newest Ofllcial Documents.(Ann. d

’IIyg., No.

On the Movements of the Population in France and Algeria, according toOfficial Documents. (ih.,

Trebuchetp — Researches on the Mortalityof Paris in 1853. ( Ih.)Report on Public Health, and the Activityof Civil Hospitals in the Russian Empire,

for the Year 1856. Berlin.

I d ea — The Sanitary Condition of the Bavarian Penitentiary, Lichtenau.

(Deutsche, 1 1,Fonu agrivea

— Medical and Hygienic Visit to La Trappe de Notre Dame deGrace de Bricqueber. (L

’

Union Méd No.

Dub onleam— Medical Topographyof Intertropical Climates. (Ann. d’Hyg.,

[Concerns six French Colonies.]KmpL— Studies concerning the Medical Topographyof the Kingdomof Bavaria.

and the application to Pathogenesis of'

Tables of Mortality.

Our limited space does not admit of any extracts fromthe abovestatistical articles .

SPECIAL TREATISES .

Pappenheiym— Hand-book of Sanitary Police, based upon original Researches.

3 vols. Berlin .

This work is a compendious dictionary, considered to be of use

to German officers of health.

466 REPORT ON LEGAL MEDICINE, are .

I . PUBLIC INSTITUTIONS .

a . (Rarities.

BlondeL— Ou Public Assistance, and its Relations to Hygiene. (Ann. d’Hyg"

1 7)

BLONDEL’s paper gives a description of the administration of the

poor-laws in France, includi ng hospital relief, which there is afi'

orded

by the communes. In 18 the total sumofmoney expended at

Paris by all the charitable institutions amounted tofrancs, equal to

6. Fon dling Institutions .

Baum— Ou the Mortality of Infants in Foundling Institutions, and generally as

influenced bythe absence of Breast-milk . (Brit. Med.)

Rom is of Opinion that foundlings should not be brought upin towns, but in the country, whereby the mortality is lessened.

He advises the transformation of large wards into smaller, well-ventilated, rooms, to hold not more than four cribs each, to the

inmate s of which the entire attention of one nurse should be

devoted. Wet-nurses are to be provided, but preference is to be

given to the mothers of the children themselves . The extensive

inquiries of the author have yielded hima rich harvest of statistics,which serve as the basis of thoroughly practical advice .

0. Dead-houses .

Bru net — The Constitution and General Arrangements of the Dead-house at

Volk ach-upon-the-Maine. (Henk e, 47, Supplement.)

A cou ntry practitioner describes how, wi th limited means and

againstmany Obstacles, he contrived to build a dead-house, and toinduce the people to deposit their dead in it previous to burial.Those who are acquainted with the evils arising fromthe man nerin which the London poor keep their dead relatives and friends

,

would wish similar institutions to be provided here . The onlydead-houses we possess are the sheds of the work houses, which are

both insufficient and inappropriate for the purposes of a sanitarv

institution .

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468 ar row on LEGAL MEDICINE, Erc.

8now ,

— Drainage and Water-supplyin connection w ith the Public Health . (Med .

Timea, No. 398,

In Vienna there is great dearth of drinking-water. KNOLZ

considers the construction of a large aqueduct for bringing a supplyof wholesome water into the town an absolute necessity. There

are many rivulets near the town, fromwhich an abundant supplymight be procured. Their water comes fromthe glaciers and snow

of the high mountains, which are onlv about fiftymiles (English)distant fromVienna .

11. Sewers, b rains, and Prim'

a .

Bu t ch — Ou the Influence of Emanatioua fromDrains and Ceaapoola.

a omheL— A new Systemof Cloaeta for great Public Establishments, particularlyBarrack s, Militaryand Civil Hospitals. (Ann . d

'ilyg., No.

Hofinann and Frank h ni — Report on Sewage. (Lancet, 3,Bemyg,

— Diaint'

ection of the Thames. and of Sewage . (Med. Timea, a, r

BARKER subjected animals to the influence of the foul air fromprivies and sewers, and foun d various pathological conditions produced, which he compared with, and found similar to, the effects

produced upon animals by diluted sulphuretted hydrogen gas .

DUPONCHEL’S systemwould be an improvement formost parts of

France, but ofiers no new features of interest for this country.

HOPMANN and FRANKLAND have presented an elaborate reportto the Metropolitan Board of Work s on London sewage. An

enormous variety of suggestions were passed in review . They hadto consider proposals for disinfection by protosulphate of iron ; bysuperphosphate of magnesia and lime by galvanic or electric

agency by the manganates and permanganates by the ferruginoussulphate of alumina by chlorine ; by

“the antiseptic hydrochloric

acid, liquefied protosulphate of iron, and chloride of sodiumcombined ; by perchloride of iron ; by sulphuric acid ; by the abolitionof waterclosets, and the substitution of boxes containing peat charcoal (G. Garbett, by cendre noire,

”a pyrite-aluminous

lignite much used by the scavengers of Paris ; by pyritous peatby dosing the river at various points with common salt

”

(C . N .

Gattolo, Esq.) by carbolate of lime in solution, and the use of a

solid mixture of sulphites and carbolates ; by the use of scrap-ironand subsequent filtration ; by the separation of the sewage fromthe rainfall, a plan hitherto impossible, but rendered feasible “ bythe discovery, in November last, of something in the nature of

steam, which was hitherto u nknown ”

(Rev . H. Moule) by a.

PUBLIC HYGIENE. 469

mixture of sulphate , cleats, and chloride of z inc and of sulphateof manganese ; and by other chemical and mechanical methods,either unexplained or too elaborate for description . The trials

made byHofmann and Frankland led them to recommend a con

centrated solution of perchloride of iron , to which Ellermau hadcalled their attention . It is superior to chloride of lime, bothin its immediate and permanent effects . Moreover, it effects a veryrapid clarification of the sewage . The authors propose to add one

gallon of the perchloride to gallons of sewage, and, s limsubsidence, to separate the clarified liquid fromthe deposit of filth,and run it only into the stream. The cost of the disinfection is

estimate d at a probable sumof per annum. The actual

process of deodorisation will prw ent less difi culty than the

separation of the spontaneous deposit by filtration or subsidence.

The reporters suggest that the disinfecting Operation should, as faras possible, be conducted at a distance from densely populated

BElw ars found that sewage of the worst description, emittingthe most deleterious gases, could be rendered perfectly sweet and

harmless, emitting only the odour of the immre coal creasote,

by the disinfectant of Messrs . Smith and McDougall, of Manches

ter, namely, amixture of carbolic acid and bisulphite of magnesia .

At the suggestion of Miller, experiments on a large scale were

instituted in the sewer of Tavistock Street, TottenhamCourt Road.

same reagent to the Thames . The details of these experim& 1ts are

given in Bernays’ paper.

II . CLIMATES AND THEIR INFLUENCE.

mum -Medical Topography of Intertropical Climates. (Ann. d'

Hygu

$ 10

2d of Mountain Sites for Barracks in Hot Climates. (Lancet,_ :

s

: olu on Barracks and Military Hospitals in Rot Climates. (ih., 1, 531 :h

and Kirk -African Pcver on the Lower Zambesi. (Med. Tim“ , 2 .

The paper of Duraounaau is an inquiry into the climaticpeculiarities of the stations possessed by France between the tropics .

The nature of the soil and the localmeteorology are summed up as

the principal conditions of salubrity.

470 napoar on LEGAL unmcms , arc.

About twenty years ago the mortality among the English tr00psin Kingston, Jamaica, amounted to 1 28 in 1000 per annum. The

barracks were in consequence removed to a high,mountain station ,

about3800 feet above the level of the sea. In the first ten yearsthe mortality remained as low as 14per 1000 per annum,

scarcelyexceeding the mortality at Rome . But since 185 1 the new station ,

Newcastle, has been visited by cholera and yellow fever successively,teaching the important lesson that mere elevation and healthinessof a site will not sufi ce as safeguards against the deadly diseasesof the plains.

During the first ten years fever and dysentery prevailed amongstthe troops, which diseases diminished, however, as the groun daround the cantonment was freed from underwood and rank

vegetation, and well trenched and drained .

When MILROY visited Newcastle, in 1851, the latrines of the

barracks were in a very offensive state, although fifty pounds hadbeen spent for quicklime to improve them.

Newcastle is situated at an inconvenientheight. The cantonmentof Maroon Town is only about 2000 feet high. Stoneyhill barrack sare 12 00 feet high, and though, lik e Maroon Town, situated mostsalubriously, have nevertheless been abandoned. It is clear that

local and domestic hygiene only can k eep a good climate and a goodsite salubrious .

LIVINGSTON} : and KIRK describe some cases of fever observedduring their latest expeditions . They are not very typical insymptoms, and are amenable to treatment, purgatives and quinin eproving generally successful. Quinine did not prove a preventiv e .

They found existing within a short distance fromthe coast 9. healthyregion, well suited for the residence of Europeans .

III . HYGIENE OF ARTS, TRADES, MANUFACTURES, AND PROFESSIONS .

The Medical Times of J anuary 2 2d, 1858, gives a leadingarticle on the health of the English army and navy.

a . Lucifer-mated mamgfacture.

Measures which are to be tak en for the protection fromPhosphorous Disease of the

Work people in Lucifer-match Manufactories. Report of the Royal Prussian

Deputation for Medical Afi‘

aira. (Casper, 13, a.)

This is a compilation of the results of the reports of all the

provincial governments, and the presidency of police, upon the

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REPORT ON LEGAL MEDICINE, ETC .

d. Manufacture of Silk .

Beyband.

— Report to the Academy of Moral and Political Sciences upon the

Moral, Intellectual, and Material Condition of Workpeople who live by the

Preparation of Silk . (Ann. d'Hyg., 18,

This interesting report is based upon original observations whichthe authormade during a journey on which he had been sent bythe academy. The journey extended over France, Rhenish Prussia,and Switz erland

,the principal seats of industry in silk .

e. Trades in sol id dust is inl ak d — Coall eaoers and Hera l

Vernon — Ou the Influence of various descriptions of Dust on the Health of theArtisans. (Ann . d

'Hyg., No.

The author arranges the various descriptions of dust under

three categories, corresponding to the materials fromwhich it is

produced . We have an imal, vegetable, and mineral dust, and

various descriptions of mixtures,most of which the author enumerates . The author mainly confined his statistical inquiries to

coalheavers, or dealers in coals, and to metal-founders, whichtrades were reported in Paris to predispose to tuberculosis and

asthma . He found that the inhalation of coal-dust does not in

crease the proportion of persons suffering fromphthisis or emphysema over that existing in the ordinary population of the same rank ;that phthisis, instead of being favoured, was rather arrested bycoal-dust ; and that the proximity of coal seemed to protect thosetradi ng in it froma variety of diseases to which other persons livingunder similar circumstances of an unfavorable k ind, e.y. in M p,

ill-ventilated, and badly lighted houses, are more liable.

In 1855, an examination of 96 foundries was instituted, at the

request of the President of Police . In 67 only was there anywork

going on, while 29 were on the eve of closing their career. The

number of artisans employed in the active establishments was 1476 .

Of 1089 workmen employed in 41 manufactories, only 98 were

engaged in moulding, a process in which coal, or coal and clay, areemployed . Fromthe particulars given by Vnaxors, it appears thatthe coal-dust produced in the course ofmoulding is not detrimentalto the health of the moulders .

PUBLIC a roma s . 473

i v . roon, srnmm '

rs, as p n euroma .

The ‘Lancet’of October 29th, 1859, p . containsa leading

article advocating legislation on the subject of the adulteration of

food . Passages fromspeeches of Lord Broughamand the Hon . W .

Cowper are quoted in support of a bil l introduced into the

House of Commons by Mr. Scholefield.

a . Flour and Bread.

the Medium-legal Impaction of fl our and Bread . (Henke,Ergot of Rye. and ot other Graminea . (Casper. 13, r.)

of the Medical Councilfor the Prussian Province of Saxony. relative to the Noxious Influence of Ergotof Rye. (ih., u , s .)

”m u— Bread of Quiclugrass and Potatoes. ( lb ., r3.

Besides the accidental admixture of the flour of wheat and rye

with the flour of the seeds of other graminete, which, lik e diseasedrye or ergot, are very unwholesome, Knfie em'

rma' enumerates a

variety of adulterations . asoribed to the malice of man . Thus wehear of a nd, ashes, bone, lime, and white lead, as frequent ia

gredients and are informed that in England the cheap sulphate of

baryta is daily bought by millers and bakers in quantities ofmanyhundredweights, to be mixed with flour and bread. These groundless denunciations are but the echo of the gross exaggerations of a

portion of our English press . The author, after having shown that

good flour may spoil by undue exposure to moisture, enumeratesthe methods of testing flour for its qualities . One is to make amass of dough with water, and test it for its elasticity ; anotherconsists in pressing a handful of flour, and placing the cosnpresscdlump upon the table . To be good, itmust retain the shape givenit by the band, and not collapse . The admixture of gypsumor

sdiate collapse of the lump. (The best flour,if very dry and not over-finely dressed, will frequently not retain

its shape, but collapse, while flour rendered moist by exposure tothe atmosphere, or preservation in a damp place , will retain it.)The addition of prepared chalk maybe discovered by adding hydrochloric acid to a mixture of flour and water ; the addition of

common salt and alum, by the taste .

The author then refers to the traces of copper naturallv found

474 nnroar on LEGAL n euroma, are .

in flour, and the ashes of vegetables in general. Finally, he des cribesthe properties of bread, good and bad . The elasticity of bread, thecrispness of its crust, the whiteness of its crum, and purity of its

flavour, constitute its four cardinal virtues.

In two districts of the south-western part of the Duchy of

Brunswick , on the slopes of the Hertz and Lolling Mountains,epidemic of ergotismoccurred during the years 1854to I 856, which

was throughout of the convulsive type . Of the patients who cameunderGamPENKERL’s care, notone died but in other districts, wherethe cor n contained as much as 25 per cent. of ergot, many personssuccumbed to the disease . Among nearly inhabitants, therewere 155 cases of ergotism, of which 25 terminate d fatally. Of

the I55, 62 were persons below fourteen years of age, and of these 1 1died ; so that almost half of the

.

fatal cases were those of children .

Infants at the breast did not take the disease, although the motherswere severely affected.

According toGriepenk erl, women are less predisposed to ergotismthan men, while the reverse is state d to be the case by NM ANN.

According to the former,muscular exercise favours the productionof ergotism. It is evident that the largest quantity of ergot of ryetaken in the shortest time produces the most certain appearance ofpeculiar toxic symptoms, and is doubtful whether there is anyspecialpredisposition on the part of individuals.

The paper of Ar: om us contains impracticable propositions formaking cheap bread in hard times .

6. Vegetables.

Chevalier and Son — Chronological Researches on the Means forPreserving Foodfromthe Animal and Vegetable Kingdoms. (Ann. d

’

Hyg., No.

The authors enumerate in chronological order the means whichhave been adopted up to the present time for preserving vegetablefood. They next demonstrate that green vegetables can be completelypreserved by drying. The process, however, in order to beprofitable, must be carried on on a large scale. Bya new extensive

industry, they are of opinion all classes of society could constantlybe supplied with sound vegetables .

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476 REPORT ON LEGAL MEDICINE, arc .

The platrage of wine consists in strewing gypsum over the

grapes just collected. It is a very ancient process, and is saidto offer the following advantages — 1 It gives a more brilliantcolour to the wine, by

'

preventing the solution_of the whole amountof colouring matter contained in the pellicle of the grape, the

gypsum probably forming an insoluble compound with the red

matter. 2 . In consequence of the diminution of colouring matter,the wine is more easily pres erved. 3. The abstraction of wate r

fromthe juice increases the relative quantity of alcohol, an d, consequently, the vinosity or strength of the wine.

The soldiers of the French army, particularly the army of Algiers,receive a ration of wine . It having been learned that the con

tractors supplied plastered wine, the Minister of War requested

men of science to give their opinion , whether or not the use of

plastered wine was detrimental to health.

Several distinguished chemists examined a variety of wines, comparing the composition and properties of plastered with those of

unplastered specimens .

CHEVALLIER reports, with great care and acuteness, upon theseresearches, which show a great harmony in their results, and drawsthe following conclusions . Non-plastered wine contains water,

alcohol, tartrate of potassa, chlorides, phosphates, and sulphates insmall quantity . Plastered wine, on the other hand, contains water,alcohol

,sulphate of lime, sulphate of potassa, acetate of potassa,

and, in case the plaster contained alum,sulphate of potassa and

alumina, acetate of alumina, acetate of magnesia, 850. There is,therefore, a considerable difference in the composition of the w ines,

and their influence upon the human economy must also differ.

If the plastered wines are injurious to health, the operation of plastering should be interdicted ; if they are not injurious, it shouldbe publicly announced, in order to protect the makers of thesewines against the imputation of adulteration or falsification . The

directquestion, whether or not these wines are injurious, Chevallierhas not answered .

f . Beer.

m— Ou the necessityfor Control over the Purityand Genuineness of(Henk e.

The author informs us that he has found great difficulty in esta

blishing what should be normal or standard beer, and describes the

rusmc HYGIENE. 47 7

influences which necessarily occasion varieties of beer. Thus, ifbarley

'

be used for malting which has grown on a fleld‘manured

become elem' and bright, and is easily spoiled . After hav ing described thc properties of good beer, he enumerates the causes of ite

business, and advocates the interference of the sanitary police. Whensic-called turned, or spoiled, acid beer has been made sweet again

and causes colic, diarrhe a, and affections of the urinary organs .

tions. After all, the organs of taste seemto be the principal andmost infallihle judges of beer, as theyare of wine .

Mineral sealers.

meg-sadm — Prneticsl

‘

l‘

restise on the Chemical Analysis ofMineral Wntemnnd on their principal Applications to

Hygienic and Industrial Purposes. Paris, Germer-Bs illiére.

This work is a sort of encyclopwdia of all that is known relative

to the chemistry of mineral waters, their hygienic and industrialapplications, the geology of the environs of springs . It comprises

drinking-water. The chapter, on themedical efl‘

ects ofmineral watersin general, is very interesting to the practical physician . An entire

chapter is devote d to the description of animals and plants whichlive in mineral waters. The sixteenth chapter treats of the puri~fication of unwholesome waters . The work comprises the wholescience of water, is written in a very practical style, and will no

doubt prove interesting and useful to the medical practitioner,the chemist, farmer, geologist, andmanufacturer.

V . CONTAGION AND masses.

Gum-flan (of Biltigheim) . -On the Genesis organics”_of Contagious. end the

Genesis telluricn"of Miasmata. (Deutsche, l t, r.)

the Doctrine ot' Contagion. (Casper, 13, r.)yRelstions of the Trade in Msttresses, Beds, and

When an author begins an inquiry into a subject of natural andmedical science with such a sentcncc as this : “ thatordinary generation is nothing else but an act of infection of the female bythe

478 REPORT ON LEGAL MEDICINE, ETC .

genital virus of themale,”the reader is naturallyprejudiced against

him. And despite the elaborate character of Gum arl’s argument,

the prejudice finds ample justification in the entirelyspeculative andhypothetical character of all that he advances relating to these greatcauses of disease .

HENNIGSON relates some cases fromhis own experience, which

go to prove, that when healthy persons are for a short time inone and the same roomwith patients suffering from cholera, thisdisease maybe transferred to them, although theymaylive in a

place where cholera is not epidemic.

Kniicnns'rambelieves that phthisis is propagated bythe beddingof persons who have suffered or died of that disease ; fever, sk indiseases, ulcers, particularly cancerous ones ,

syphilis, and gout, hebelieves capable of similar dissemination . In support of this proposition he adduces various results fromhis own experience and

that of others.

VI. ENDEMIC AND BPIDEMIO DISEASES.

a . Idiotism.

K1m,— ou Idiotismin Silesia, a Politico-medical Sk etch. (Henke, x.)

T he author draws a line of distinction between cretins and idiots,and allots the former exclusively to mou ntainous districts

, the latte r

to the plain . Idiotism thrives where water and vegetation are

abundant, where the atmosphere is quiet, and the evaporation con

siderable . In the rich, flat portion of Silesia there is one idiot toevery 340 2 inhabitants . Idiotismin Silesia has a predilection forthe male sex, of which every 8942 include one idiot, while as manyas I females are required to furnish one . Idiots are onlytak en care of when they become dangerous to public security . But

the author desires that in stitutions should be established, in whichthey might be trained andmade more useful.

6. Ep idemic O l t/lalmia .

Laval-an and Lustremm— On the Epidemic Ophthalmia of European Armies,(Ann. d

'

llyg.,

The authors weremembers of the congress whichmet atBrussels

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480 naro s r ox LEGAL usmcrns , are .

c. Sma llpox and Vaccination .

I . Pamphlets .

Boofd d (Breslau).— Vaccination or Inoculation ? A word to establish a good

understanding relative to the Smallpox Question. Bream, Goachon k y.

Nit — The Season of Vaccination, and the Proteatanta agalnat the Po ison

and Witchcraft of Jenner before the Wiirtemberg Chamber of Deputies in September, 1858, and before the English Parliament in July, 1858. W e .

Gustav Brauna.

BOEFELD wishes to mak e vaccination more protective, by lettingit he succeeded by inoculation within a twelvemonth. The pro

posal is discussed in a quiet and impartialmanner, and the discourseshould be studied by those who have given the subject their special

Nrrrmonn has, during several years, obtained a small but deplorable notoriety by his unmeasured attack s upon vaccination .

The above outburst is less violent, but, if possible, more perverseand ludicrous, than anyof his earlier performances . He concludes anaddress to the authors of the English Blue Book on Vaccination

with a chorus, to be sung by schools, the police, church, andmedicine,

”in which there is a refrain, of which the following is a

translation0'Vaccination is the monk ey

's duty

Apes,mybrethren, therefore let us be.

2 . Papers in Journals .

M g — Ou the Value of Vaccination. (Henke,031156 (Gensingen ). -On Vaccination and Revaccination. Aplumdecider-5am from

the Grand Duchyof Hesse . (Ih.)

BamiHy,

— Ou Re~vaccination in Public Schools (Lyceums). (Monit. H6p. ,

n‘

Doa IL— On the Statistics of Smallpox and Vaccination in Ireland. (Dublin

Ilosp. Gaz ., No. 1 r.)Winter ,

— Vaccination and its Compulsion . (Deutsche, n , a.)Faber — Vaccination in 1858. (lbid ., 13,

Fu n . supports compulsory vaccination upon the basis of an

experience of forty-one years, and refutes certain imputations againstvaccination which had been uttered before theWiirtemberg Chamberof Deputies by a person named Hochstetter.

RIECKB believes variola and variolois to be identi .cal Variola, he

ruamc HYGIENE . 481

believes,can be generated, whence the circumstance that the se

elusion of patients affected with smallpox rarely prevents the spreadof an epidemic. Vaccination is the main remedy, w ith which re

vaccination must be combined. Bythese twomeasures the dangerand fatality of variola are reduced to the narrowest limits .

Causfimak es a series of good proposals for securing the efficiencyof vaccination . He also urges the propriety ofmak ing revaecination,ll intervals of ten years, compulsory .

Of 241 pupils in the Lyceumat Versailles, 63, on revaecination,had genuine, and 78 spurious, pustules . REMILLY believes revue

cination in lyceums to be highly necessary .

The mortality in Ireland during the ten years preceding the

3oth of March, 185 1, was Of these, were

due to smallpox . This gives an average of 29 deaths fromsmallpox in 1000 deaths from all causes

,which is nearly double

the proportion of deaths fromsmallpox occurring in London, and

from ten to fifteen times greater than the mortality from thisdisease in many European states . M‘DONNELL discusses the causesof this state of affairs, and fears it will be long before it can be

amended .

WINTER is an antagonist, sub rose, of vaccination . He wants

the government of Hanover to abandon compulsion in vaccination .

The medical council properly replied to his request to put certain

questions to be answered officially by all medical practitioners ofHanover, that long and favorable experience had sanctioned the

practice and compulsion of vaccination .

7 . Arrannx'

r DEATH. INSPECTION or me DEAD.

Kogchgte,

— Ou the Certain Signs of Death and ApparentDeath, and on the Meansfor preventing Premature Burials. Bream, L. U . .Kern .

Canongueg— Application ot

'

the Dynamoscope for ascertaining the Occurrence of

Death . Memoir presented to the Academy of Sciences. (Gaz . Med. de Paris,No.

The disquisition of Koscna'rn reveals no new or striking intelli

genee .

COLLONGUES has constructed a peculiar instrument of ausculta

tion, with which, in many persons only just dead, a peculiar noise ormurmur bourdonnement,

”is heard . W hen complete somatic

death has tak en place, thismurmur ceases . He savs that in various

cases of apparent death, in which the heart had ceased to heat, but

31

482 REPORT on LEGAL MED I CINE,mo.

in which this murmur was yet apparent, he succeeded in restoringlife . Now that the dynamoscope is invented, Collongues says thatthe dead-houses in Naples and Germany maybe abolished.

8. PRos'rrru'rmN.

Pu ea uchfitelot — Prostitution in Paris, considered in its relation to Public

Hygiene , Morals, and the Administration. Third edition, completed by Tom.

s oon e r and Po rn ar-Duv a n , Chefs de Bureau 3 la Prefecture de Police.

With an Account of Prostitution in the principal Towns of Europe . WithMaps and Tables. Paris , 2 vols., Bailliere and Son.

Sa g an— The History of Prostitution ; its Extent, Causes, and En‘ceta throughout

the World. New York . 8vc, pp. 683.

We cannot give an extract of this comprehensive and, so far as

France is concerned, no doubt, accurate work . It gives an account

of one of the saddest aberrations of the natural impulses of man ,and reveals social conditions of an appalling nature .

But the information relating to England, and particularly to

London, contained in this volume is of a very unreliable nature . The

following passage will, no doubt, be con sidered a curiosity : In the

quarter [of London] called FleetDitch, where nearly all houses havebrothels on the ground-floor, there is an enormous aqueduct, whichstands in commun ication with the Thames. Into this aqueduct theproprietors of brothels, or their helpmates, throw the dead bodiesof their victims

,which are carried by the water far out into the

river, so that it becomes impossible to ascertain where the murderhas been committed.

”Some more material of this k ind is heaped

together in the production of SANGER. Its first part is amere ah

stract of the work of PARENT-DUCKATELET . It is, moreover, as the

reviewer in the‘Medical Times and Gaz ette

’for April 2d, 1858,

expressed it, an accumulation of all the dirt and filthiness whichmaybe gleaned by diligent search in the storehouses of antiquity .

The last 230 pages are devoted to the history of prostitution in thecapital of the New World. They are full of the most astoundingand evidently groundless assertions . Thus, the average duration of

life of a New York prostitute is said not to exceed four years fromthe time she begins her career, an assertion which is as ridiculous

as the assertion of Parent-Duchtltelet, thatat Edinburgh the av erageage attained by prostitutes was fromtwenty-two to twenty-five years,which only few outlive .

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I N D E X .

IKE .— Ref e 1ences to the contents of divis ions a nd sections aa re p rinted in ita lics . The

numbe rs of the p ag es a re a r ra nged in two columns ; the fi rst column ref ers to the titlesof the work s a nd p ap ers, the second to the reports on them.

Abdomen, intestina l obstructionAbdomen , malformation of (Shearer)

416, 421

mortal wounds of (Toulmouche) 426enetrating w ound of (Porter) 306, 307

Ah ominal w all, deficiency of (Sedgw ick )416, 421

AEEGG, poison ing by arsenic and strychnia

434, 436

ARERLE. See T heile .

Abortion , statistics of (Clay) 364

w ith albuminuria and convulsions (Broadben t) 385

Abortion , crimina l 455

Abortion (B roughton, Casper, Darien ,Maschk a , Tardieu) 455-6, 456

Abscess of brain (Chaplin) 395

in larynx, after typhoid fever (Sch iele)220

of liver (Jack son) . 253, 257

pharyn geal, in children (Bok ai) 404, 406post-pharyn ea], in ch ildren 242

recto-v agm (B reslau) 377bone, mlow er jaw (Nussbaum) 311, 316

A bsorption 74Absorption , relative, i n animals, fasting and

d igesting (Kohler)of fat (He idenhain ) 74, 76by the lacteals (Méder) 74, 76cutan eous (Waller) 74

Acid , ben z oic, influence on metamorphosisof tissue (Kletz insk y)carbon ic, expiration of (Meyer) . 62, 65

cynuric, in urine of the dog (L ieb ig)

h ippuric, in man (Mack , Weissmann)94, 100

do. in urine of herb ivore (Hallw achs, Weissmann )hydrocyanic, action of (Kiedrow sk i)

oxalic, origin of (Ncubauer)phosphoric, excretion of (Hammond)

95, 102

pe phosphoric, as reagent for albumen(Q igou) .

succin ic, transit into the urine (Hall

Acid, uric (Schid'

) 94, 100do. proportion s 111 urine (Seller) 94, 97do behav iour towards Fehling

's liquid

for detecting sugar (Babo)do., absence of, in urine of yellow fever

(Porcher)Acon ite, cases of pO1son ing by 433Actin im, how they k ill their prey (W

'aller)

ADAMS, fracture of neck of femur . 311, 315

lithotomy in children 295, 296separation of epiphysis of tibia and fibula

surgical Openings into knee-joint 312, 319fmtal auscultation . 338

ADAM S and WARD, stra

ngulated inguinal

hern ia 288, 291.

Adder, poison of (Weston) 104, 105Addison

’s disease (W

'

ilk s) 254

ADDISON and FORSTBR, str icture of oesopha

gus fromcorrosive fluid ; gastrotomy279, 280

Ad ipose tissue found in blood-stains (Robin)

428, 431ABBY, symphysis pub is and ossification of

cartilage 4

do.

After pains 111 partur ition (Willis) . 385

Age, Old, effect Of, on the vita l capacity

(Geist) 67Ague, connection of heat of body w ith

excretion of urea, &c., during (Ringer)

do. 141, 177at Boderiw tihr (Schumm) 140, 158

at Lamberg (Duchek ) . 156

and phthisis, antagonismof (Green)

do. (Peacock ) 220, 227

AIKEN, exostosis of the orb it 327 , 331

Air, introduction of, into ce llular tissue and

peritoneum(Leconte) 77 , 79A ir-p ass ag es 281

ALBERT, fucus amylaceus 148

deferice Of forensic phystcians 422, 424

murder of a mother . 425

Albin ism in the equatorial regions (Delacouse) 415, 418

“ m m d’

ans-u s orm au l-rd “ (Ii

— tbr forelgn body in b1addee (Drov ne)N51, 297

Anu x, congenital hydrocephalus 416, 421

Au nm, new stereoscope . 55

Ammo, tutu -uterine pregnancy (if twentytwomonths W855,

Am avs,medical eleetrlcity 188, 144- action of electric current on the motor

_nerves and muscles 85, 45

188, 144

Alum111membranous angina (M inoan)219, 228

Aunnaao, lactation . 893

Alunwnou , preserving anatomical prezpara

tirmu by g lycs nrinAu t u mn , po isoning w ith sulphuretted hydrogen

Al ston , duties ofmother . 893, 394Amn ii liquo r) 78Amnii, lqtmr, composition of (Majew sk i)

Amnion , 11ropsy of (1tumsbotbam) . 351, 352Ampula /irm 276Amputation, causes of deathafter (Burow )

276, 276by d im11111111 (Maisonneuve) 275, 275" fi t“

of the hand (Burgess, Eager ,” 276 277

Itacarpal articulation (Sedg0 s a 276 , 271

“ M ad l y -m

4ANDRE W , vaccine 1

531111

Aneur ism, cases of (L Ro b in son) 2rupture of (Gairdn er) . 2

axillary,deligation Of subch v ian (L .

Stanley) .

of lefl : carotid arte ry(Patter son)of the cerebral vessels (Gull) 1m,

femoral, cured bypressure (Green)3m.

of hepatic arteryof the orbit (Van z etti ) 827,of ophthalmic artery, compression (Oi

popliteal, treated by compressionTeale)

do. compression and ligatu'

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Amm an , nitric aeid in

Am fl ptured uteruaA ol the fi ceM M “! (Gr

51, 54

“ m uf fl er-u ,mm

towarda Febling’ hqnld

’

arm or

lim e, ane sthetic 111

moor , laceration of perinarum 831.332Bu n, accommodation of the eye 51. 54

Bu t , poisoning chloroform 439, 439

Bum u, perforatmn of palatial vault

Baum “ , (H) . retroversion of uterollALL. See C

'ha rcot.

Du n no , diphtheria 140, 163Hall

i

},cause of purulen t ophthalmia of

in to 395, 39?diaeaoea o f in fant. 403, 405

BALLOT , epid emic jaund ice 25 1.lialneology. ” port on (Flech sig) 26 1Bas eme n t, saccular dilatation of bronch i

2 0

reflex sa ltatory convulsions 1g; 187variola in comb ination w ith other

d° w ith “Sphilis llg’ i312perforatw

u of vmuifom appendixr

Bum, forms of S ldflmm $33. 2122tuberculofl l memng itis 39 1

.

396Bu t“ ;

” c ites, r ecov"? after Paracentc’

sis

manor. typho id pm.

" 52 10

nm“a n ; mom"fitting in21

83553583213

139, 115

w . lapav u h . d

M m e-1.1m m

l am b-rt “ .

Bum smh cteala of bard.

vapillee o f th e ton gu e

Bu rn , vel ico-vag inal fistulaBu rr . stricture of e sophag us

Ram '

s , on a sixth sen se

Bu rn oann'

u , case of one eye

pow er of distinguishing colours

other 52

Ban s parasitic cutaneous a ffection s 409

BBALB, urine, minary deposita and ca lc

94.blue deposit

'murine 94

urinary calculi, and dumb-bell crysta lsoxalate of limestraight w sscls in the pyramids of

k idney .

BBAI'

, hype rtrophy of heart 1n preg nancy209. 2

n Q

INDEX . 489

399, 408141, 174236, 247 iodine injections in bonychangea871. 874 811, 817

Brno. sn icide in 8weden111 Bn e n ocr, ulcerative stomatitis of aoldim

125, 132

Broom nomahtence of albumcn in

normal nrine

87 7

Bear, control over purity“ (Emmafl

148

sugar in

125. 138

386, 391

— cod~liver oil in cbronic ecz ema— ehronic b0araeneaa of children

sugar in

235 ,

86

striated muscular fibres .

Bru n o, an imal fluids 8. 10

oxygcn in the venoul bloodofglands i’

?— variatioo of colour in tbe venous blood

on irritability 361 46

. 411

a xn'

s ,d1s 1nfection of the Thames 488, 489

“ immediate pies 88, 87Bm tx, syp11il£in pregnant women 385,Bl am v s, hepatitis

quinine 1a typhoid fi ver 148Ben , cauliflower excrescence of uterus

do.

Bx‘

rz ow , cu arari . . M8.449Bu ow . chemist oh k eleton 13, 16

physiology of heart’

s action 36, 81

crossing of nerveo fibres in the cord 38, 48

3322010 00, artificial anum cure 288, $1Bw uar (Xavie1 1

8 11 11111 1111, encephab hwmatoma verum

diseases of k idneys

o xam. eclamBile, function the

83,Arnold)

83, 88

analysis 04'

eil'

ect of food on 88

influence ofmercuryon secretion of Scott)8, 257

of the shad fish,, snulmsof the whale (Schloss rger) 83, 80

Bmm , men ta1mte ot a . .s . 459

131m, twisting of cord 414,41713114410111, on epithelium 4

nerves of the intestines . 37. M

gunshot wounds 273. 2 73

ossification 111 exostoses. &c. 126-7l a z mt

INDEX .

Birds, lacteals of (Basslinger) 74, 76

Exam ,compound fracture of skull 311, 316do. 426, 429

injury of the spine 311, 317n ew growths or tumours 320, 320

Bmxnrn, influence of the water in the

neu es 35, 44

poisoning of an imals with phosphorus

Bmxns ux , angular curvature in lumbarregion 341, 344

artificial premature labour 354, 357Births, plural (Spondli) 348, 349

premature (Elsaesser) 453, 454

unusual case of twins (Goldberg 414

triplets (Domere, Elshsser, ennerley,Gasne, Marx) 348, 349four children at b irth (Martin) 348 , 349

Bxscn orr ,discourse on Prof.Miiller 3

diil'

erence betweenman and beast 2

B lsn or , emphysema during labour 338, 340B ISBILL, inversion of ute rus 368, 371BLACK, ovarian dropsy, iodine 377 , 379Bladder, urinary (Bark ow)

involuntary muscular tissue of (Ellis)19, 21

B ladder, aris en-y, diseases, injuries, &c.

293, 298

Bladder,urinary,cancerof (Goodw in)253, 258extrophia of (Restin) 416

injury of (Cusack ) 299, 300

in version of (Voss) 294

1rr1tahle,belladonuam(Behrend) 254, 260prolapsus ofmucousmembrane of (Patron)

293, 293

do. dur ing labour (Carson , Ramsbotham) . 341, 344

rupture of (Gillespie) 299

glass tube m(Coulson , Cutler) 295, 297-8substances discharged from (Farre)

113, 115

puncture of, for retention of urin e (Puget)298, 299

through rectum(Holt,Tatum)298, 299

BLAIR, v icarious menstruation 371, 373

BLANDIN, first dentition 404

Bu s es , post partumhemorrhag e 342

Bleeding from the car in a child (Morvan)395

fromlingual v ein s (Mertivier) . 235, 241

in acute diseases Barclay) 139, 145

in diseases (Mark am) 138, 144

in acute hydrocephalus (Harv ey) 395, 396and purging in hydrocephalus (Harvey)

180, 191

local, in pregnancy (Silbert) 362, 363

Blindness, colour (Herschel) 50, 52

BLOBPBLD, state medicine at University of

463, 464

BLONDEAU, cholera in fantum 404

ob struction of urethra 301, 303

BLONDEL,publicassistance in hygiéne466, 466BLONDLOT, acid of gastric juice 69, 71

BLos nLor , artificial gastr ic fistula 69,— analysis ofarsenic,h[ arsh

’smethod 434,

Blood, experiments on (Brown-sequagl

}physiology of (Heidenhain) 27 ,table of average qumtity, in fish, amhis, b irds, and mammaliachemical analysis (Hemmer) 27difference between arter ial and v enous

absorption and exhalation of gases

(Fernet) . 62,cause ofmovement of (Gunn ing) 26,movementand stasisof Gunn ing) 241%

retrograde movement 111 large ve in s n

the heart (Busch) 26,circulation of (Marcy) 26,do. hydrauliccxperimentsQIarey) 26pressure of (Moilin) 26

passage of substan ces from, into the

(Mosler) . 83,relation to oz one (His) . 2 7colour of (Brachet) 27colour of goat

’s, action of gases on (Che

reul) 27 ,venous, red colour of (Gluge) 7 7,do. of glands, variation of colom

(B ernard) 7 7 ,do. influence of nerveson do. 7 7,do.quantityofoxygen incarotid, temperature of(Ludw ig)indican m Carter)pathologies variations of fibrin inchappe) . 1

in itial phenomena of

(Ran z i) 124, 1

coagulation of (Lister) 25,do. (Hecht) . 27

vomiting of, from ulcers in duoden

(L iljcborn) . 236,B lood corpusclesmumher of Welck er) 27 ,

cells contain ing (Berlin)action of salts on (Botk in) 26,red , influence on oz one (Sch iinhe in) 27 ,wh ite, in cachectic diseases (Gub ler)

in the embu o,dividingof(Radlk ofer)4of cryptobrauchus japon icus (Harting)

Blood-crystals (Buchn er) 28,formation of 10

forensic import (Bry . 427 ,B lood d iscs, granulated

c

(Pollock ) . 28,B lood-g la ndsBlood sta ins,micros00piccharacter &c. (Clier, Cl1ou1ette,Maschk a,Robin) 427 ,

B lood-vessels

Blood-v essels,contractilityof(Vulpmn)26,

of the lung (Waters )B lood-vessels , wounds a nd d iseasesofBlood-vessels, transverse wounds of (Sav

25 )

popliteal, rupture (Haw k ins) . 807 ,B low ing-sound in pulmonary artery 1

Costa) 0 o 0 s m3

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BBESLAI'

. See Rama'

s .

Bright’s disea se (Oppolz er) 25 1

for ms and stag es of (Johnson ) 255

tw o d istinct cond itions of k idney giv ingrise to (Dick in son ) 253, 256

w ith amyloid degeneration of Malpighian

bod ies (Harr is ) . . 255

suppurativ e or non tubular form Basham)253, 258

symptomatie dropsyof (Roeser) 253, 259treatmen t of . 253, 259

treatment recommended by a French

author 259

permanent recov ery in (Orr) 25 1

Bamn smn, d iffus ion of gases through

moist membranes 62, 64

Bn lx '

r ox, diseases of the stomach 23t, 237intestinal obstruction . 235, 240

digestion of protein substances by the

pancreas

11111Q1'

E'r,anm1thes1a ofthe hyster1ca1180 188

hysterical con 1 uls ions 194

Farad iz ation in lead colic 180, 190

do. in rheumatism 179, 183

commun icab ility of thrush 40 1, 406

BRISTOWE,d iphtheria 1 10, 171

BRITTAN, en toz oon in the brain 179, 182

B now nmv'

r , abortion w ith albuminuria385

tracheotomy 1n croupBnoca (Paul), treatment of tetanus byw oorara 101, 108

Pott’s [spinal] disease 311, 317

BROCK, d iabetes mellitus 95

See l l ausma nn .

Bnonn t’

nsr , div ision of tendon of rectus

femorisBac s as . See B ramc.

B ronchi, saccular dilatation of (Bamberger)

Bronch itis, its independence of pneumon ia(Rob in ) . 233

fumigation s 111 (Mandl) . 219, 2241— (cepillar1 ) h1 drosulphurous v apours of

Baths of Amelia (Bonafos-Laz en n es)219, 222

Bronchocele, se rous ; incision (Fergusson )283, 285

B aosn‘

s, uterine congestion 372, 375

Buor o n rox, impalementof uterus 1n criminalabortion . 455, 4

5 6

1311011 11, Allarton’3 operation for stone

B nowx (I. B .) cases of ovariotomy 377, 379

v esico-v ag inal fistula 380-1, 382

BROWN -3, lithotomy, Allarton’s operation ,

295, 296

Allarton’s operation for foreign bo dy in

the b ladder 295, 297

BBo11 x physiologv , &c. of the

spinal cord 38

cause of death after re1no1 al of the 1 ital

point

influence of the lateral half of the 8111101

cord on the opposite sideof thehc-ad 38

rigor mortison the supra

-renal capsulesSee Smith

BROOK, scrofulous afi'

ection of teeth

Baowx-Séqr aan , cases to disprov e the

ing of nerve-fibres h igh

'

111 th e eord 38— occurrence of epilepsy afi er injury to

cord 38

reflexmovements 38

nervous system 35,influence of oxygen on n erv e-substance

37 )on the splanchnic n erv 39,diminution or suspension of th e h

action during forced inspiration 2

experiments on the blood 27 ,-b lood of birds iqiected in to an imals 27means of measuring tactile sen sib ility

59

24

83.

334,Driburg Baths

‘

1n pregnan cy 384,BBUECKB , muscular flbrille 20,

sugar in normal urine 95 ,reduction of oxide of copper by healurine

glycosun a of lying-ia w omen 384,

BRUGNOLI, ileus, from adhes ion of ileumbladder 236,

do.

Bnt'

GNON1, report of asylum for insane

Astino

BBUNNER, legal responsib ilitydead house at Volk ach . 466,

BRYANT, diseases of Jomts 31 , 2

injur ies of joints 31 , 2

do.

resection of head of humerus 311, :r

— n 1is intcrpreted symptoms of stone 295,BRYCE ,

b lood crystals in forensic examitions for blood 4

BUCHNER, question of fatality of mjur ies422, 4

and SIMON, blood-crystals 28,B t’ DD,

hydatid cyst of liver,intestinal fev er 140

1

primary cancerous tumours, d ra inage 11

1

1

221,

poison ing by hydrochloric acid . 441,BUDGE, preserv ing anatomical “

subjects”

2,

gen ito-spinal centre of the sympath etic

39second spinal centre of the sympathetic

39sensibility of the abdominal ganglia

39,

grow th ofmuscles 19,structure of muscular fi bres 20

and LEWISON, nutrition of bone 13,

See He inek e .

BURL , on neuromata 1

B t’ nRLEN, forced labour 355,BU LATOW ICB, ra tion of the pneumin v omiting

220, 227281. 282

307 .30956 , 58

179, 185

254, 263

276, 277Bum m e ic in menorrhagia 371, 374

Bmww,deaths afi e r amputation .

8 178011, physiology of the digestive a

gar

”loss ol sensibilitymtran splanted skin

59

retrograde mov ement of the b lood in thelarge veins near the heart 26. 30

obstetricmalpraxis 428, 431

m r or , laceration of

diuretic

mwa, detachment of, fromin tus(Hem )

286. 287

296,W

M. 98

295.M295, 296

large, fromurethra (Heath) 300.302

in vu iem ag irmlbernMGendron )formed round fivrcign bod ies wsutcss

ggs)

295,fimned on alste pencil (Roberts)

M u b m opemh ou r

Calculus in bladder of female M‘Ewen

298

Cu mcacns, peristaltic movements of the

canal 20, 22

Callus, formation of (mo: 310, 315Cam's, hysteria, a 111 and bodilydisease

179, 182141, 177253, 258

wt), 271354, 358

in 11d

v

Cancer,melanotic, diagnosis byurine (Eiselt)189. 118

Cancerous tumours, cflects in thc chcst 811311)221. 23Canes-umoris (B oss) 404

011310 11, digu tive solution of (esophagus

237 . 250

form 324

Carn ation , chemistry applied to medicine3

tines (Gallw ey) 271Carbon ic acid, expiration of (Meyer)inhalation in granular pharyng itis (Willemin) . 220, 228

— i1\iection into uterus Beansmfi)gas, as an mmtbetie erpin, Oranam)

111, 113

legalquestions on ser ious injuries

crun in al abortion

murder or suicide 451, 451

741 77'

tal (Mou nd) 414

Cats rr of the stomacbnv ith cured241

281, 281

. 480 481

Csnstic pencil in uterine s licctionsCanterisstion in chorea (Ramon) 181, 201

Cu diac and renal diaeam oonnection be

254. 262

312 ,319

with (Wittich)

C mm a mu nne,

Cw , prolapsus ofmm841

iodide of pota ssiumin hydrocephalus396,

94, 97Cod ime 14

Cartilage, o

asiflmtion ofl Aeby) 4

9O

changes idn, in diaeaaea of jointa (Weber)

810, 811

articular nutrition , inflammation , &v .

18

18

19

494 INDEX .

Cu ms/WE, on the urethra 96

uterine polypi and v ersions of ute rus

368

mental state of C . B . 458

Cellular pathology (V1rchow)tissue, introduction of air, oxygen , &c.

(Leconte )Cells con tain ing blood corpuscles (Berlin )

Cephalo hwmatomata (B ierbaum, Bok

goi)

Cephalotripsy (B eck er, Dubois, Richard ,

Schultz e, Wolf) . 356, 361 2

Cerebellum, structure of (Gerlach) 37 , 46

physiology of (Ren z i) 38, 49

hemorrhage into (H1lla1ret) 182, 203

Cerebral symptoms (West) . 394

convolutions, structure (Berlin) . 37

Cerv ix uteri 1n pregnancy(Duncan ) 337, 338amputation (C harnal, Fano) . 373, 375

do. (Huguier, Mayer) . 367 , 369

cancerous (Fano) 373, 375

carcinoma of (Spiegelberg) 342, 348

ulceration of 373, 376

rupture of (Ross) 342 , 317CHAILLY, tracheotomy

'

1n croup 399

Cn axCEREL , hygiene of infants 393, 394

Chancre , lectures on (Ricord) 321, 322-3

Change of typemdisease (Kennedy)CHAPELLE, oil of naphtha 1n tinea favosa

410

CHAPIN, mental disease from syph ilitic in

fection 181, 200

C KAPLIN, cerebral abscess 395

rupture of spleen 1n fmtus 414, 417and B ALL , embolic plugging of pulmonaryartery

CKARIEN, retrogression of labour . 338, 339

Charities, pub lic Blondel) . 466

CHARNAL, amputation of cerv ix ute ri byécraseur . 373

CHAUVEAU, murmurs in the v esselsCHM “

1mm, puerperal fevcr 391

ASSE, poisoning by w’

ater from leaden

cistern 268

scarlet fever . 409

Chelidon iummajus in itch ing eruption s 266

Chemistry, letters on (L ieb ig) 3, 11

for schools (Lardner) 3, 11

of the sk eleton (B ez old) 13, 16

applied to med icin e (Cape z z uoli) 3

an imal (K letz in sk y, L ehmann )C hemistry, p a lholoqica l 133

Chest,affections of,mchildren (Moore)398, 400CM t wounds 285

CHEVALLIER, healthof workmen 1n colours

471, 471

on preserv ing food 474, 474

plastered w ine 475, 476

Cnnv smx-Coxqr ans r , impulse of the heart25, 29

Cnnvn nox, extra-uterinepregnancy341, 343

Cn avns on, action of gases on the colour of

goat’s b lood

CnEVB EUL , contrasts of coloursCn u rnnm, priv ate hygiene

Child ren, d iseases ofChildren , diseases of (Condie, Pollitz er,W

892-3,do. semeiology (Herman n , M1

Meigs)do. influence of sex on (K iittn er )

Child ren, hyg iéne , sta tu ticr, &cChildren , hygiene of (Bark er, PollitSchreber , Streng ) 392-3,

Children, d iseas e: of 6mm, sp ina l cord ,a nd orga ns of sense:du e-aces of org ans

:of resp ir a tion and

cula tion

d iseases of organs of digu tm a nd t

appendages

d is eases of k idney: and gene ra tive org

d is eas es of bones a nd j oint:d isea sesof sk in and cellula r tissuedyscras ioe, tumour :ma lforma tion , (yo.

CHILDS (B .) popliteal aneurmm; comprest

ovariotomy . 377 ,Ch1na,pre\ alentdiseasesof(Rattray) 235 ,Chlorate of potash (Founta in) 269Chloride of sodium'

1n phthisis (Cotton )2

Chlorine inhalation in diphtheChloroform, uncertainty of, in detectalbumen (Becquerel) 95, 1

admin istration of (Todd) 111, l

as an anaesthetic (Kirsten) . 111

danger of inhalation of (Martin) 180, ldeath by (B eck e)d eath of limbs by its injection

1

in

arteries (Kussmaul) 1

&c., emp loyment of , midnif efy— ia parturi tion (Kidd, Levy)poison ing by (Bain)

Chlorosis (Reid) 209, 2

Cholera infantum (Blondeau, HexamSchw artz e, Smith) 404, 405

Chord-a tympan i (Ziemssen) 39Chores , mental powers in , March) 181,

treatment (Bourguignon . 179,arsen ious acid

'

1n (Aron)aliqua plantago

'

1n (Hochstetter) 395cauter iz ation in (Hamon) 181,chloroform°

1n (Grey)tartar emetic in (Gillette) 179,

do. 395sulphate of z inc in (Stone) 180,dur ing pregnancy (Spiegelberg) 385,

Cn ovw rr s and MUSCULUS, diagnosisb lood-stains . 427,

Cnmsr l sox, poison in stomach in case

poison ing byarsenic

Chinese poison, Wti-tsau 449,Chryptorchidism

'

1n man (Godard) 304,Ch le, quantity formed in a n an

Schwanda) a a a

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496 INDEX .

Contractility of the heart, its duration

afi er death (Vulpian) 125, 131

of ureters (Vulpian ) 96, 104

Contraction of fingers after injuryof nerv

ous

fi lamen t (Borelli) . 331, 334

Con1 ulsions, reflex saltatory (Bamberger)187

rotatory (Minch in) 181, 202

hysterical (Briquet) 180, 19 1.

hysterica l uerperal (Kidd) 182

puerperal Dupeau, K een , K idd, Overton ,

Ramsbotham) 385 90

See E clamp s ia .

COOKE, pregnancy during uter ine phleb itis

387

COOPER, w ounds and injuries of the eye325, 327

Coormmes, digestion of v egetable albumen69

Coon : (C . T .) cancer of the stomach , &c.

extra1 asation of urine 299

necrosis of’

jaw fromfumes of phosphorus

Copper, oxide of, in healthy urine, on re

ducing (Brueck e) 95, 102

sulphate of, for exciting vomiting in

croup (Missoux) . 230

COQUEEEL, diphthcrous larv aa'

1n frontal sinus221, 230

Gonnmn, spontaneous purulent Ophthalmia326

Consu lt, pulmonary consumption 400

CORNER, separation of epiphysis of tib ia and

fibula . 311, 315

CORNOC IIAN, div ision of superior maxillaryn erv e 39

CORRIGAN, pics , oro

dirt eating, of ch ildren

236, 2 18

Corrosi1 e sublimate , physiological action

(J oseph) 105, 110

CORSON, management of shoulders'

1n examinations of 224

CORTES, urethralgia 195

Conw san'

r , digestion Of albuminous bod iesby the pancreas 68 69, 70

duo denal dyspepsia 235, 2 13

(‘oryz a, in in fants (Bouchut,Meigs) 398, 401COSTES, emphysematous tumours on sk ull

311, 316

COSTETT I, military ophthalmia 326

( fosru n ns , chron ic metritis 373, 376

COTTON, chloride of sod iumin phth is is220, 226

iodide of potassiumin phthisis 221, 234

COUL IEB , microscopic characters of b lood

stains 427, 431

COULSON, fibro-plastic tumours 276, 277

thermometer-tube fromurinary b ladder

295, 298

w ound of k nee-joint 312

Coup de solei]. See Sun-strok e.

COU TAB ET , identity of blue and green co

louring of pus 134

tracheotomy indo. (Evans)do. See Tracheotomy.

CEUSE, on saccharine urine

Cryptob ranchus Japomcus, b lood-corpusclof (Harting) 28,

Crystals, formation Of, in the b loodSee B lood crysta ls .

dumb-bell, of oxalate of lime (Beale)94,

CUMM INS, use of forceps 355, 3

CU PPAIDGR, occlus ion of vagina 341,Cums ,motor branch of the lachrymal

37CUEL ING, inguinal hernia in a female

acute periostitis 310,Pirogoff

’s Operation 2

”6

comp o fracture of sk ull , treph ine

311, i

cystic disease of testicle

Cur1 ature, angular (Schreber) 408,do. in lumbar region (Birn ba t

341,Cosacx , injury of bladder . 299,Cutaneous systemCUTLER, glass tube in bladder

Cox , impaction of small intestin e w ith lbrici 236,

Cran ial blood o sw elling (Rigby) 400,Cran iotomy (Braun , Druitt, Greenhal

Lehmann, Mack en z ie, Simpson )355, 358-9

abolition of (Smith) 355,CRAVEN, excision of k n ee-

‘

oint 312,Creatine in urin e of dog ieb ig) 94,CBEDE, artificial premature labour 354,

CEEOEEN, rupture of right auricle

Casour , croup and diphtheria 398

Cas t '

rz , paralysis of the muscles 51

Ca re'roroms , subperiosteal pub ic resectio1

356

Croton oil in hydrocephalus (Watson )1 9

do . 394,Cs or cn , childb irth after ovariotomy

377 1

Cs ovmna, catalepsyfromoverdose of Indhemp 440,

Croup, amesthesia a symptom(Bouchut)399

cryptogamic nature (Demartis) 399albuminuria in (Bouchut) 398,

mortality of, in Paris (Bouchut) 398,treatment of (Luz sinsky) 220,

do. (Assan is, Bellaspect, BoucCrequy, Hauner, Korli, Kortiim, Pnd

Trousseau, West) 398 9,topical treatment 219,catheterismof larynx in (Gros) 398

sulphate of copper in (Missoux) 221,glycerine in (Mayer) 399,io dide of potassiumin (Lusz insk y)

3

219, 2

221, 2

NDEX .

Cyanosis (Fox) 215

(‘

yn aric acid 1n urine of the dog (L ieb ig)3

C 1 sts, production of w alls of, round pus

(Robin ) 131

in the orb it, cured byiodine (Vi'

ordsworth)

of vagina (Ladreil) 381, 383

CZERMAK , accommodation of the eye 51, 54

influence of the nerves on the saliv ary se

cretion 78, 81

laryngeal speculum 62, 67do. 126, 137

DA COSTA, blow ing-sound in pulmonary

artery in afl‘

ections of the lung 209, 213

DALTON, human physiology 1, 4

DANIELL , suppurative iritis 326 , 330

DANIELSEN, syphiliz ation 140, 155

DANNENBEBG, spermatic stains 427 , 431DARIEN, abortive remedies . 455, 456

Dark ness , influence of, on

growth of an imals

(Dobell) . 120

DAUE , anaesthetics . . 111

DAVAINE, paras ites in the brain 38

DAVEY, disorgan iz ation of supra-renal capsules, 1v ithoutd iscoloration of sk in 253, 255

DAV IES (Redfern ) radical cure of hern ia289, 292

femoral and v entral hern ia radicallycured289, 292

DAV IS (Hall) ov arian gestation 341, 343

D w r , electrical condition of the egg of the

120

D ead bodies , physiognomy of (Hausk a)427 , 429

D ead-house at Volk ach (Brunn er ) 466

D eath , doctr ine of priority of (Kr iigelstein )427 , 429

fromfalling into boiling-pit of a distillery427

D ea th of new-born child ren, doubtf ul causesof 455

Death , sudden , in infancy (West) .

by ch loroform(B eck e ) . 1111

D ea th, app a rent, insp ection of the dead 481

Death , apparent, signs of (Collongues, Koschate ) 481

— do .,in an imals ; resuscitation (Cohn)118DEBENHAM , inhaling steam by tracheoto

1n iz ed 220, 225

DEBOO

UT , umb ilical hernia . 416

spina b ifida . 416, 420

DECAISNE, metrorrhagia fromfungosities of

uterus . 371DECLAT , hygien e of in fancy 392, 394Deformities of the foot (Eulenberg) 408Deglutition , d ifficult (Erichsen ) 279, 280DELACOUB ,monster Peracéphale 415, 418

DELACOU SE, albinismin equatorial reg ions415, 418

Deliriumtremen s 180

fromcold and w et (Fox) 179, 183against opiumand stimulants in 188

DELOEE, blue pus 125, l

pain ful fiat foot 331, 3

DEL1 AUx , ulcerativ e ging iv itis 404

DEMAEQUAY , contusion of urethra 301, 3

See L econte .

DEMAETIS, cryptogamic nature of croup399

DE MEEIC, fungus of testis in syphilis

3

syphilitic gangren e ofmouth 278,

fib roid tumour of OS uteri 372, 1

DE MORGAN, tetanus 179,D enta l surgeryDental surgery (Tomes) 334, 3

tissues, formation of (Rainey) . 14

Den tition , first (Blandin , Hannard , Steiberger) . 401

DESMARRES , purulent conjunctiv itis 395DESTOL' a S, incontin ence of urin e in oh

dren

Development 1

Dev elopmen t of animals, infiuence of ligon (Dobell) 117 . l

of the female pelv is (Duncan ) . 117 , l

DEVEEGIE, chloriodide of mercury in ac

rosacea

DEV ILLE, ergot 1n opart11rit1on . 362, 3

DEZON, coldmv omiting in pregnancy386, 3Diabetes (Brock , Stad feldt) 95-(Pav 1 . 255

origin of the sugar in (I)schriebt) 82,les ions of nervous system pro duci

(Pavy 82,h 1 gien ic treatment of (Bouchardat)

25 1, 2

traumatic 253, 2

D iabetic sugar (M‘Donnell) 82,

Diaclasis, amputation by (Maisonneuvel

D iag nosis ,medica l 125, lDiarrhoea of India and C hina (Donaldson)

sev ere, cured by sugar

coetaneous w ith conception (Girdwood )236, 2

do. . 386, 3

of infants (Guerdan , Schulter) . dot

do. use of raw meatm(Weissc)236, 2

do. . 405, 4D ICK INSON, conditions of kidney g iv ing r

to B right’s disease 2

DID 1T , infantile syphilis 413, 4

D ietetics

Dietetics (Ideler, Wittmaack ) 461, 4

for children (Wittmaack ) 393

D IETz , atresia ute ri 367D IEL

’

LAPOV, inguinal hern ia reduced

masse” 2

Difference betw een man and animals ( Bachod

'

) 2

D igestion

Digestion (Florent)experiments on (Blondlot)

498

Digestion of an imal albumen (Arnold)3 79, 2

of albuminous bodies bypancreas (Ce rvisart) 69, 70

of vegetable albumen (COOpmanns) 69Digestive canal, peristaltic movements of

(Calliburces) 20, 22

organs, physiology of (Busch) 69, 72

D igestive org a ns , dis eases of , in child ren 403

D igestive system 234

Digitalis in inflammation and pneumon ia(Schneider ) 139, 147

Diphazmetric compass (Ogle) 58, 60

Diphtheria (Ballard) 140, 163

(Hillier) 234, 239

(May)141, 176

(SmIth, &c. ) 140, 165

lecture on , by Rank ing 151

cases of (Bogge) 140, 166

do. (Bristow e) 140, 17 1

summary of cases (B oughton ) 140, 159

conclusions from tables of cases in Bri

tish Medical Journal ’ 158

Report of Lancet’ Commission on

139, 152

at Canterbury (Rigden) 139, 154

at Crow le (Ellis) 139, 154

do. 141, 177nature of the exudation in 12

parasitic nature of (Harley, Laycock)114, 117

paralysis ; recovery (Ransome) 141, 175

of traumatic surfaces (Heyfelder) 139, 150local treatment (Ramsk ill) 139, 153

tracheotomy (Bark er) 281, 283

sequehr of (Faure) 404, 406

paralysis as sequela of (Bade) 140, 164

D iphtheritic exudation, inoculation of (Har

ley)Diplopia froma b low on the head (Park eq)

178, 182

D iseases afi‘

ecting the genera l system 138

Diseases, simultaneous existence of two or

more, from specific morbid poisons (Mur

ch ison ) 110, 166

causation and prev ention of (Park in )138, 141

statistics ofmortality of 465

Dislocation , congenital, of the h ips (Voas)294, 294

Dissection ,manual of (Holden) 1, 5

D istance betw een tw o points on the limb ,effect of practice in recognising (Volkmann) 59, 61

tactile recognition of (Wundt) 59, 61

D istortion of features in in fants (Kidd )394, 396

Diuresis, chron ic (W'

illshire) 253, 257Diuretics, action of veg etable (Hammond )

253, 255

Divorce,mental disease as reason for (Jessen )422, 424

DR , renal and hepatic tumoursDxXON, diseases of the eye

INDEX .

DOEELL, influence of white li ht, colo

rays, and darkn ess, on growt of an i

;n

l l

Domnnc, case of triplets

Dom e, sk eleton ofman,made byand insects

Doxaw sON, diarrhoea and dysentery of

dia and China 237 ,DONKIN, placenta pre via 351,Don , puerperal fev er

DOBNBLUTII, senses 51

Donscn , anomalous v ena cave 415,Dov e , binocular v ision in calculatingtance 55

essential oils'

1n puerperal fever 387DRAGONET,mental condition ofmurderer

458

Drainagemparacentesis for empyema (Gofellow ) . 221,

Drains, emanations from(Bark er) .

DB I‘r'

rL, cystoid tumour of neck . 283,Dropsy smptomatic, of Brigh t

’s

Boeser

renal (Basham) .

Damn , Surgeon’s Vade Mecum’

273,craniotomyhouses mrelation to health 269

DUBEN,microscope in clinicalmedicin e 3DUBOIS, cephalotripsyBe ams-Ramon ) , animal electric1ty36

on the electrical shad-fish 36

polariz ation of porous electrolytes 36

do. dissimilar electrolytes36

De ca u'

ssor , strychnine in prolapsus an i

children 405

DU CHEK, on ague a

o

t L emberg 140,

pericarditis 209

Dt cn sNNs , atax1e locomotrice progressi

Dt’ cms, Cmsarean section 355,DUDTENB OPER, sen ses of educated people

51

Dumas“ , discharge of blood an d pus

liver into intestinal canal 235,DU IGAN ,absen ce ofvagina anduterus 367

Dulcamara, action of (Clarus) . 1 11

Dr ama , paralysis of motor nerves of f&c. . 181,

DUMBB IL , organs of smelling, tasting,hearing,

’

1n tlsh 5

DUNCAN, development of the female pelv117 ,

do. 365,malformation of urinary organs 415,cervix uteri in pregnancy 337,v omiting of food 235

W'

. Reid’s tr ial for abortion 455,

DUNN,statistics ofmidw iferypractice364Duodenal dyspepsia (Corvisart) 235,Duodenum, perforating ulcers of (Wmann) 236,

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DEX.

Emb ryogenyof comatula rosaceae(Thomson )

Embryotomy (Levy . 356, 361

Emphysema during labour (B ishop)338, 310

Ex rms . See B ond ed .

Emmema, terminating byv icarious secretion(Moore ) . 221, 230

plan of drainage 1n paracentesis for (Good

fellow ) 221, 231

Ems, w aters of (Spengel) . 3

Encephalocele, congen ital ines) . 415, 420

E ndemic a nd ep id emic d is eases 478

h idosmose , physiologyof (Ludw ig) 7 4

Endosmotic equiv alent of peptone (Fun k e)7 4, 76

ENonnr , histology . 3

EntOpics (Jago)Entoz oa, de1 e10pment of agener)— in man (B lume) 11-ih the b rain (Britten ) . 179, 182

in the heart of the seal (Jolly) 114, 117

Epiglottis, instrument for examining (Price)62

lesions of (Green ) 220, 224

Epilepsy, physiologyof (1'ov ille) 38

after 1njur1 to the cord (Brown-Seiqs

uard)

tracheotomy in (Riocard )castration for (Holthouse) 304, 305

simulated (S1hne1der) 45 1, 452

Epiphyses , separation of (Klose) 310, 312

do.

inflammation of (Gosselin ) 310, 312

of tib ia and fibula, separation of (Corn er )

(Adams)Ep ispad ias 29 1

Epithelioma of the eye (Sichel)of right leg and tib ia (Cock ) 276

Epithelium, on (B illroth ) .

Erectile organs of 11omen ( lionget) 365 , 365Ergot of rye , noxious influence (( i riepen k erl,Niemann ) 1

in parturition (Dev ille) . 362, 363

Emcn sEN, diflicult deglutition 279 080

congen ital hern ia, w ith undescended te stis

288 , 290

excis ion of the k nee 312 , 319

str umous disease of k n ee-jo int ; excis ion312, 318

sacro-iliac diseasediseases of tarsus 312, 319

tetanus 32 t, 32 !

Erod iumcicutariumas a di11reti1 258

Er uption , obstinate , cured bv 1 apour of

heate d w ine L111lk 1e1v 11 k ) 26 1, 266

Erythema nodosum(Mayr) 412

ESC RRICHT , SC11AB LIXG and HANNm£ 11, 011

d iabetes 82, 86

EsPINE (Marc d’

) eternal fissure'mM. ( iroux

25, 29

Esm u , Ce sarean section 355, 360

external taming 35 t, 358 FALRET, alcoholic delirium

ESTEVEXBT , lineal fistula after Operation

strangulated hernia 288,Ether, sulpb 11ri1 , death by . 425 .EULnxm-znc , 01 arian cyst, &c.

deformities of the footmurder by criminal neglect a

Evacuations, 1nvoluntary, of children . be

donna 1n (Bercioux) . 235.

EVANS, retrov ersion of uterus 342 ,

(Conw ay) tracheotomy in croup 221,do.

Evmsn z n , arm presentation ; spontan

expuls ion

E1 olution , spontaneous (Bogg, Ev ersh

Madge , Metz ler) 348, 319

Exanthemata, contagious, in Teheran (PollExcn non of ank le-joint (Hancock ) . 312, 3

of head of humerus (Bryant, Fergusson311, 3

of the k nee joint (Crav en , Erichsen , F

gusson, Price, Sally, 11 atson)311-12, 318

for disease of synov ialmembrane (K inloc312. 3

of the patella (Lister) . 312, 3

partial, of the hand (Coulson ) 276,Excretion of solids bythe lungs (Wiederhol

62

Exhalations,putrid, innocuousnessof P311138, 1

Exomphalos of grav id uterus (Murray)

Exophthalmos (Carron da Villards) 326, 3Exostosis of orb it (Aik en ) 327 , 3

Extrophia of bladder (Restin ) 416

Eye , the

Eye, the (Ran , Sturm,Vallee) 51

1 ertain 1ond itions of (Bonnafont) 56

appearan ce of light 51,accommodation of Aubert, Bahr,C z ermsMannhart, Muller) 5 1,

do. in fish (Man z ) 52,1lo. secale cornutum in d

turbance oi (1Villcbrand) . 209, 2

ob lique illumination of, in d ing-h

(Kuchler ) 326, 3

E ye, d isea s es a nd wounds of Me 3

E1 0, d iseases of (Dixon ) . 325, 3

do . in India (Martin ) . 325

epithe lioma o f (S ichel) . 325 , 3

w ounds and injuries (Cooper) 325 , 3

E1el1all, paralv sis of muscles of ( timeSchuft) 5 1

E) elids , mov ements of (Hen k e) 5 1,contag ious d isease of (Muller) 325

Fauna , vaccin ation in 1858

FACEN, in fantile men ingitis 395

PAGE, ch ildren's hospital, Christian ia

39 1»

Fallopian tubes, hmmorrhage of (Puech )77 , 3

mo ss . 501

FANG, amputation of cerv ix uter i for carc i

noma 373, 375

lacteal fistula? 383, 38 1

Farad iz ation in rheumatism(Briquet)79. 183

in lead colic (Briquet) 180, 190

121111112, substance-1 discharged fromb ladder

n itro-muriatic acid in gastl 11 fc1 er oi

1hil1lren 105

Fat, a normal element of supra-renal capsules11lpian )

excess of, in human milk (Schloss lmger )

ab sorption of He1denham) 7 1, 76Fattyheart diagn osis of (Kenn edy) 209,li1 er and k idneys (Gluge) 83, 87

FAUBE, sequels : of diphtheritis 401, 406Fav v s L . See Le Diberder .

Favus, report on (Hutchinson ) 26 1, 267do. 410, 412

FECHNEB , muscular exercise 20, 22

e ffect of practice in perfecting the sense

of touch in the opposite limb 59, 61

Fehling’

s liquid for dete ction of sugar (Babe )

1° elmJ , sense of 58

1 11 x and B1 1 3, 1aceratiou of 1oronaryarteries

11 5 11 , public s laugh

o

tmhouses 467 , 467l°e 111ur , t

'

°

ra1 tured, in a child (Law son )310, 315

PBNNER, vesico-v ag inal fistula 380, 382

FBNNEBLEY, case of triplets 318 , 349P‘

a t'

ssox, excision of head of humerus311, 317

excision of k n ee-‘

oint 312, 319

serous b ronchoce e incision 283, 285

unun ited fracture of thigh 310, 315

l-‘EBNET, ab sorption and exhalation of gases

by bloo d and saline solutions 62, 65

Fev er, clin ical notes (Gairdner) 1-10, 161

a nervous phenomenon (Bernard ) 269, 272selen ite in (Clark ) 155

v illage (New ham) 139, 146

Fev ers, continued, causes of (Murchison )110, 171

prev alence in 1858 (Murchison )139, 154epidemic,atWindsor (Murchison) 140, 171inter mittent (Buchek ) 140, 156

do. (Heidenha in ) 139, 149

do. (Schramm) . 1 158

do. in childhood (Bouchut)4113

ligature of limbs 11) (Brauw )139, 150

intestinal (Budd) 140, 162-175do . contagious (Budd) 1110, 160

marsh (Berchon ) 139, 147rheumatic (Wh itley) 141, 174

typhoid (Rostan )yellow (Bercbon ) . 139, 147African , on Zambesi (L1vingstone)

469, 470

Fibre s , lo ngitudinal, of recttun (Beraud)20, 23

Fibr illw ,muscular (Brueck e) 20, 24

Fib rin, pathologica l variations of, in the blood

l’archappe ) 125, 132

Fl ex , human phys iology 2

formof bones 13, 16

h our s, extirpation of tongue 278, 279FINIZ IO, ar tificial premature labour 35 1, 357Pla n ] , medullary cancer of w sophagus

236, 249

Pi sca na , nature of rigor mortis 2 1

abnormal subclav ian artery 27 33

Fish, circulation m(Reichert) 2

organs oi smelling, tasting, and hearing,in (Dumeril 58

sk eleton of (Huxley)osseous, microscopic structure (Kollilcexi

)13 o

Fissures in bones (Huber)Fissure, congenital, of right cheek (W

7

11

8

1-dg79

of ste rnum, congenital (Moeller) 416eternal, in M . Groux (M . d

’Espin e) 25,

Fistula, gas tr ic, artificial (Blondlot)lactea l, treatment by compression (Fano)

383, 384.

perin eal (Williamson ) 301, 303

recto-vaginal (Breslau) 377

ves ico-vag inal (Battey, Breslau, Brown,Cogh ill , Fenncr, l lergott, MacGhie , Marshall, Monun , Nev ins, Pollock , Simon ,

Tanner, Thorp, Watson ) 380-1, 381-2FIX SBN, on the frog

’s tongue 27, 33

FLEcn sw , contributions to ba ln eology264

FLEM ING, accident by lightning 180, 195

severe dyspepsia, &c. 234, 239injuries and diseases of urinary organs

9 1» 98

do. 300, 301

turning v. cran iotomy 355

sp in al curv atures . 408

FLEURY, effect of the cold douche on the

circulation 26, 30

FL Ix '

r, heart sounds, pneumonia 283

FLOGEL, pleuritic and peric‘ardial exudation,

&c. . 210

supernumerary testicles 414, 417

FLonBN'

r , on digestion 69, 72Flour, medico-legal inspection (Krugelstein)

473.473FLOURENS, life and intelligence 2

observ ations on the v ital point 38, 49

circulation nerv euse ,”recurrent sensi

b ility'mmotor roots of sp1na111erv es 39

FLOWER, epithelial cancer in cicatrix of

burn ; amputation 276

fibrous tumour of scapula 313

FLt‘

GBL , treatment of thrush 404, 406

Fluids, an imal (Bernard ) 3, 10

Fe tus , genera l a na tomy a nd phys iology 835

Foetus, premature respiration (Schw artz )

502 1ND 1111.

Fe tus, influence of parturition on (Schw artz )335, 336

anatomical relation w ith mother (Madge)335, 335

E nte r, unusua l conditions

Fe tus, emphysematous (Liz é) 348

hydrocephalic (Schultz e) 349, 350

pseudencephalic (Houel) 416, 420

M , mayoma tions, &c., of 414

Fe tus in faata (Luschk a) 414, 417

spontaneous amputation in (Martin )415, 418

separation of two adherent (Rainer)414, 416

acran ial (Maclachlan) 415, 418

monstrous (Ehrmann ) 414, 416

death in utero (Koeber16) 351, 353

do. and retention of (Koch ) 349

do. and absorption of (Foun tain )349, 350

repeated death of (Maydell) 385, 387

FOq cz xr . See Pleischl.

Foxmu s,function of the th roid land 84, 92

For en am e, hygien e 0 La rappe, Bric

462, 473

Food, treatise on (Artmann) 462, 463

guide to collection at 8. Kensington

(Lank ester) 68

popular treatise on (Moleschott) 69phosphates in (Sick ) 95, 102

action of, on respiration (E. Smith ) 62, 65efl

‘

ectof,on secretion ofbile (Arnold) 83, 88analysis of effect of, on bile 88

means of preserv ing (Chevallier) 474of young animals, earthy phosphates in

69(Lehmann )table of do. 73inorganic (Lehmann) 69, 72

an imal, composition of, and relation to

b read (Gilbert) 68, 69

Foot, pain ful dat-foot (Delore) 331, 333

Foramen ovale, patent, in the adult (Wall

27, 34

do. 209, 217Forceps, use of, in parturition (Cummin s,Harper,Kirsteller,Priestley,Ramsbotham)

355, 359

FORGET, cerebral rheumatism 179, 186

Foreign substances in the body 268, 269

Form, law s of organ ic (Spencer) 117 , 119FORSTER, fore ign body in trachea ; tracheo

tomy 281, 283

See Addams .

Fossilmammals ofAustralia (Owen) 13, 15Fossil marsupial carnivore sk ull (Owen )

13, 15

Foccmr , placenta pra via 351

Fouen an, orb ital tumour 326, 330

sulphur ic acid in cystic tumours 320, 321Foundling institution s, mortality of in fants

in (Routh) 466, 466

FOUNTA IN, absorptmn of fwtus 349, 350

chlorate of potash 269

FOUa m, w axyliver

FOV ILLB, physiology of epilepsy 38

pneumon ia of in fants . 3

Fox , identity of parasitic fungi of hamsurface 114, 1

deliriumtremens from expa nre to

and w et . 179

cyanosis, and temporary basic syst

murmur . 209 ,

Fractures of the sk ull

of sk ull, compound (Birkett, Curl'Lunn )

— compound,ofshoulder-joint(Skey) 311,radius and ulna, treatment bydrillingw iring (Sanborn )of femur ma ch ild (Lawson )

do. unun ited (Fergusson) . 310,

of neck of femur (Morgan) 311,

do. delayed un ion (Adams) . 311,FRANK, facial neuralgia , cure by n eu

gotc

1 9

FM KENHav en , diagnostic sounds of

fcntal heart

M oe'

s (De) ane sthesia of the olfac

nerv e

a UND, histology of rib-cartilage 14,toxic effects of carbonic oxide gas in

nancy 385,Fan , sk etch of ammal life 2

u ne as e , bare-lip 278,muscular paralys1s 207,contractions of h ip

a n iNoaa , children’s hospitals 410

cowpock lymph . 410

Fa l anu a a,1nv ersion ofv agma,&c 415FRIEDLBBEN, physiologyof the thymus g

841 92.thymus in health and disease 397 ,

FRIBDL INGBR, syphilis in childrcn 413

Fan s , hydatid mole 351,Frog, cutan eous pigmentarysystemof 7

tongue of (Fixsen ) 27 ,

poisoned by an imal exhalations (V ulp'

105

Fnomu NN, intus-susception 236,

do. 286,FUCHS , glucogen ic function 82

FULLER,admin istration ofbelladonna 181renal anasarca . 255

Fuumigations in bronchitis (Mandl) 2 19,Fungi. See Pa ras itic f uug i .

of testis in syph ilis (De Meric) . 304,Fun oid productions ia alk aline and a]

mmous urine (Hassa ll) 114,Fun ic souffle (Schmitt) 337 ,FUNK , laryngeal speculum 126

FUNKE, te xt-book of physiology 2 ,cutaneous perspiration 7

fun ction of the pan creas 69,endosmotic equivalent ofpeptone 74,action of w oorara, &c. 105

GABRIAC, impulse of the heart 25,(h uman, prolapsus uteri , canteriz ation

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504 1xnax .

( ilucosuria 111marsh fev ers (Burdel) 25 1, 263( iLUGE, on fatty liver and k idneys .

Gaus s and Tn xs nxssss , red colour of v enous

b lood

Glycerine,preserv ing anatomical preparationsw ith (Ambrosoli) 2, 6

in vulvar hypere sthesia (Paupert)381, 383

Glycerine ointment for the itch (Bourguignon)264

Glycosuria of lying-ia w omen (Bruek e)384, 387

GODABD,monorchidismand chryptorch id ism301, 305

absence of testicle 415, 419

GODEYROY, reposition of retroverted uterus

342, 345

incis ion of 08 uteri 353. 356

artificial premature labour 354, 357

GODFREY, internal uterine hwmorrhage342

GOLDBERG, ease of twins 414

question of patern ity 452, 453

(100011, diseases of w omen 365, 366

GOODEELLow , drainage in empyema 221, 234GOODWIN, haematuria, cancer of bladder , &c .

253, 258

Gossnu x,inflammation of epiphyses 310, 312

Gout (Garrod ) 138, 142

treatment of (Gairdn er) 139, 149

colchicine in (Gun sburg) 139, 150

rheumatic (Garrod ) 138, 142

Gouty inflammation (Garrod) 269

GOUTAY , rachitis

GM BBABHBB , poisoning byarsen ic 450

GRADBNW ITZ, contraction of (esophagus

236, 241

GRABFE, derangement of mutual v ision55

paralysis of the muscles of the eyeball51

diphtheritic conjunctiv itis 395

GRAND-CLBMBNT , Jnice of chelidomummayusin itch ing eruptions

"66

GBAT IOLB ’

I‘. See L euret.

GREAVES, procidentia uteri 368, 370

retrovoraion of grav id uterus 315

GREEN, antagon ismof ague and phth is is

femoral aneur ism cured by pressure

306, 308

lesions of epiglottis 220, 224

GBEENHALG II, cran iotomy 355 ,361

Gr eenwood, Amos, case of his unjust conv iction for rape

GRENSER, Dresden Lying 1n Hospital361

GRESSY, imperforation s of face 415, 419

GREY, ch loroformin chorea 395, 397

GR1EPENKERL, ergot of rye 473, 474

GRIES INGBB , injection of n itrate of silver

solution into the bronch i 219, 224

Gnmsmw , lectures on dental surgery33t

( iROENmuEN, artificia l premature lab or

do.

GUNss r RG , colchicin e in gout

dysphagia

epidemics ofmeasles 410, 4

GUNTER, cases in‘ l ’ itha

’

s Clin ie’

320, 3

GUNTR ER, dysphag ia . 235

(111 01111 111, contag ious ophthalmiw 325

contagious in flammations of th e a reti

Gnos ss s cx, Caesarean section 355,01108, catheterismof lamcroup 398

Groux (M . eternal in (B’

25Ruhle)Growth of an imals, influel fl

“lig ht

(Dobell) 117,Growth , new, a nd cysts

GRUBER, mercury in syphilis

See U’

eaz el.

GRUNDER, v accination 410

Guan in in pancreas of the ox (Schere r ) 84,transformation into xan th ic oa

(Streck er)GURLER, white blood-corpuscles '

1a

.

each

209.

alternating pals1es 181,thrush

GUEBARD, nosological statistics of deaths

465explosions of w ater apparatus for hing 46 7 ,

(10 11111) . ,LV genesis of contag ious 47 7 ,d iarrhoea In children 40 1

premature labour, a substitute for cra

tomyGUERSANT,prolapsus am111ch ildren 405 ,GUER '

I IN, normal rapidity of the pulse

26

QUIET, pern icious fev er in childr en 139 ,GUILLAUME , Caesarean se

ction 355 ,GI

’

ILLOT, development of the teeth 14,GULL , aneur ismof cerebral v essels 180,diseas es in mediastinum, &c. 221,factitious urticaria 265 ,

GuNxEL, analysis for picrotoxins m po i

ing(1q 1\ 0, cause of the movemen t o f t

blood

HABEB , action of woorara on the ner v es

105, 1

HABEBSHON, &c., on dysphagia 235

pain as sign of disease of the stomach237 , 2

malposition of abdominal v iscera 237 , 2HAB IT, Ob stetr ic Clin ic, V ienna 364

HADAW AY, stillborn ch ildren 36 11

m adynamonwter (Redtenbacher) 26,Hmmatemesis f1om v arices in aesopha

(Le Diberder) 235 , J

Hmmatine, d iagnos s of (Heller) . 427 .Hmmatocele,pen ute r in e (Becqucrel,GallNonat) . 377

INDEX .

Hm toa le, retro-uterine (Malia.Tra uma ,

181. 197

chloride of iron (Thompson )in to cerebellum(Hillairet)

(W )

L PurefoyM ‘M “m

— fracture of tbe akull

74» 76— oa1 urari

36

11m m , origin of hippm-ic acid in

nrine d berbivora 100a o 91»— Wansit of sueciuic acid into the urim

&c s ofthe hcart 28

m m a w z opers tion

310.314

W W M phosphoric a

ggl

loz

276, 27 7

Hi lton diseases of the sk in

35, 45

on Me mb tufig

application of

“ M Mand purging in acute

do.

-steatrha za nig ricaus .msss— tcammis1aion of syphilis frommale to

Hmsasn urine in health and d isease 93, 106in alkaline and albu

HassINo .mucous tubercles 141. 176muo aros , natural constants of healthy

93, 07— table of specific gravity of urine 97B a tman, Children ’

a Hospital, Munich

crou

Dr . on croupHausxa. on rav ish ing 452, 153

physiognomy of dcad bodias114117s and Baocx. induction of labourbyCohen

'

smethod 854, 366

307 , 809Head and sock , « c l/emotion ,411. 278Head, injuries of (Nan cy) 311.316lesions of (Hefner. Kurner, Maschh ,

blow on, foflowed by cerebral symptoms(Park er 178. 182

Headache, consensual (lim b)of

506

Hear ing, physiology of (Moorhead) 55, 56

organs of, in fish (Dumeril) 58

do. in the whale (Claudius)See E a r

Hea rt

Heart, anatomy, &c. (Hamernik) . 28

action of the (Be z old ) 26, 31

do. (Eck hard ) 27, 31

do. (Hamern ik ) 125, 134

do. influence of cardiac gangliaon W1tt1ch ) 27, 31

do., influence of v agi on (Pfiuger)

do., d iminution of, dur ing forced in spiration (Brown Sequard )do .

,duration a fter death (Vulp1an )26 29

do . do 125, 131— impulse of the (Cheven in Conqueret,Colin , Gabriac) . 25, 29

sounds of, in health and disease (Flint)

do., fmtal (Adams, Frankenhauser )338, 339

dulness-area of (Gerhardt) 125, 135

v alves of (Joseph ) 83, 91

disease of (Barlow ) . 209, 216

do. influence of deep respiration on

(Piorryfun ctional afi

'

ectmn (Durrant) 208

enlargement of (Barlow) 209, 217hypertrophyof, during pregnancy (B eau)

209, 211

normal hypertrophy, m.

pregnancy (Larcher) 385, 388

irritab ility of (Arnold )laceration of coronary arteries of ( Fe ign

eaux)I upture of (Fe ign eaux) . 209, 218

do. (Mark ham) . 208, 210

fatty, d iagnosis of (Kennedy) 209, 212

and k idn ey, connection between d iseases

of (Traube) 254, 262

Heat-apoplexy (Longmore) 179, 185

do . (Martin ) 182, 190

of the body, connection w ith excretion of

urea, &c ., dur ing ag ue (Ringer) . 94, 99

do . 111

HEATH, strangulated umbilical hern ia288, 290

calculus fromurethra 300, 302

B ECKER, d iagnosis of pregnancy 337 , 338artificial premature labour 354, 357tubal pregnan cy 118, 123

and K IFERLB, retrov ersion of grav id

uterus 341, 344

HEOH'

r , coagulation of the blood 27HEIDERG, Operated valgus pedis 331, 333

Heidelberg Un ive rsity, Physiolog1ca1 Institution of (Arn old) 2

HE IDENHA IN, physiologyof the b lood 27 , 31— in te rmitten t fevermechan ical tetanomoter 35, 44

HEINCRR and BUD GE, irr itab ilityofmuscles,and its relation to r igor mortis 24

HEINEMANN, pneumogastric nerve 39, 50

INDEX.

HELLER, examinations of ur in e l

simulated adulterations o f ur in e 451,hmmatine 427 ,

HELMHOLTZ, telestereoacope 55

Hemicran ia (Merz ) 179,Hemiplegia, alternating, fi

'om afl

'

cctiomthe us (Gubler) 181,syp 1ilitio right (Robert) 180,

HENDERSON, moveable k idney in spin al

HBNKE, mov ements of the eyelids 51,

contractions of the tarsus 331, 33

HRNLE, text-book on the muscles 20,HENNET, detachmen t of caecum in co

quenco of in tus-susception 236

exfoliation of ce cal end of larg e gut

286,HENNIGsON, contagiosityHBNOCH, consensual headache 181,HENB IBTTE, ulcerativ e gingivitis 404

HENRY, urethrotomy for impacted ca lcul

301,477,381,

(O.)min eral watersHENsON imperforate hymenHepatitis Berta ina)HBBARD , ugerous jaundice 253,HERGOT ‘

I'

, vesico-vaginal fistula 381

376, 3

obstinate vomiting in pregnancy386HBBBMANN, physiognomy of sick children

393

Hern ia

Hern ia, congenital, w ith undescend ed te(Erichsen)resection of omentum111 (Paupert) 288,radical cure (Dav ies . 289

do. (L istercrural, through Gimbernat’s ligam(L egendre) 288,d iaph ragmatic, min fant (‘V

’

iderhofer]

femoral and v entral (Davies) 289

inguinal, reduced en masse” (Dieulal

caused by assault (Maschk a)42 6

do. direct, in female (Curling)

scrotal, a second sac (Perriu) 289

umb ilical, of grav id uterus (M385,

do. in foetus (Messer) 416,do. congen ital (Debout) . 416

strangulated (James) . 288,do. in an in fant(Rav oth) 288,do. fwcal fistula after Operai

(Estev enet) 288,do. crural (Schmidt) . 288,do. inguinal (Adams) .

do. do. in female (Musse l288,

do. pouch of the

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INDEX .

Ht'rcmxsov , ulcerative stomatitis 2311, 239

HUTER, os uter i of primiparm . 337 , 338

HUXLEY, de1 elopment of the skeleton of

fishes 1

Hydatid cyst of the liver (Budd) . 253

do. puncture of, w ith

capillary trocar (Moissenet) . 255, 263

Hydrarthrosis of k nee-joint (Hodge) 312Hydrocele (Gillespie, Young)

radical cure , w ith'

1ron w ire (Quinlan)304, 306

of tun ica vag ina lis ery) 305

Hydrocephah c fmtus (Schultz e) 350

hydrocephalus, d iagnosis of, in breech

prese nta tion (L ize) 350

congenital (Allix) 416, 421

do. (Luton) . 415, 418

bleeding and purging in (Harvey)do

croton oil 1n ( Watson) .

-iod ide of potassium in (Carson , Cold

stream) 395, 397

chron ic (Philson) . 3 396

do. iniections of iodine'

in (Bra inard)39 1, 390

Hydrochloric acid in skin diseases (Kletz insk y) 265

do. poison ing by (Budd)411, 441

Hydrocyanic acid, action of (Kiedrow sk i)105, 110

Hydrogen , introduction of, into cellular tissue

and periton eum(Lecon te)sulphuretted, poisoning w ith (Amelung)

Hydromcn ingoccle (W'

ellmann) 395, 397Hydrophob ia (Thamhayn) . 179, 187

ca se of (Wr ight) 179, 185

cases, &c. (Ragsky, &c.) 411, 411

Hydrophone 57

H1 drOpisine (Gannal) . 125, 133

Hydrorrhoea grav idarum(Braun) . 385, 388

Hyg iene a nd p ublic hea lth, report on 461

Hygiene (Re ich) . 461, 162

Hygw ne , p ublic

p r iva te

Hygien e, p1 i1 ate (Chiapclli) 1163

Hyg ie ne of a rts, trades, ma nufactures , a nd

p rofessions

v roma, congen ital cystic (Luschka)4111, 417

Hymen , the (Thomas) 381, 383

imperforate (Caillat, Henson, Pug et)381, 383

Hyperms thesia of rachitic children (Betz )395, 397

of one side of face (Ogle) 181,

Hypertmphy ot heart during preg nancy

(Beau) . 209, 211

do. in pressure in aortic

system(Beckmann) . 125

H1poderm1c treatment of diseases (Hunter)

111 1111 , topographical anatomy 1, 5

Icterus (Kuhne)neonatorum(Moreen )

1111113 11,Idiocy. simulated (Zink)Idiosyncrasies (Nunn)Idiotism, 1n Silesia (Klose) . 478Ileum, adhesion of, to ur inaryb ladder (Brugnoli) 215

HYRTL, abnormal number of aortic b ranches

27

perforating branches of middle men ingealartery 27, 33

ste rnoo eler 1cular1s muscle 20, 21

Hystermamental and bodilydiseas e179, 18

2

Hysterical anaesthesia (Briquet) 180, 183

convulsions (Briquet) 180, 191

tremor, difference fromchorea (T rousscaul180, 188

411,417-from adhesion of ileum to ur in arybled

der (Brugnoli)do

. 236, 215286

I llumina tion q riea tc dwell ing : 463

Inperforations of the face (Greasy) 415,419See A trma .

Im ctenes ,questions of,&c . (Casper ) 453In a mutin1 , w ounds 1n (W illiamson)

273Indican

'

111 blood and ur ine (Carter) 91, 97Inf a nticideInfants, hygiene of (Ammon , Bark er , Chancorel, Declat, Meier) 392-3, 394diseases of (Condie, Gerhardt, W est)

392 3, 394

new theoryof diseasesof (Ballard) 403, 405Infection, putrid or septic (Pan nm)I nfl amma tion 27 11

Inflammation , origm of, in ar teria l system(Schroeder) 2711 irch011

’s theory of the process of 12

essence of (Ran z i) . 1211, 130

early stages of (Lister) 125, 130

influence of nerves on (Samuel, Snellen)124, 128-9

fromnervous irritation (Samuel) 269of articular cartilage 18

of thoracic duct (Worms) . 210, 218

interv ertebral (L amb l) . . 341.3411

acute, of parotid gland (Virchow ) 235, 241of vena porta (Steinberg) . 237 , 251

parenchymatous (Virchow) 124, 130

trea ted by digital commession (Van z etti)209, 215

do. 274, 275digitalis in (Schneider) 139, 117

Inh ibitory influence (Jones) 35, 40

do. 178, 182Injur ies, serious (Casper) 425

INM 1N, influence of v itality on secretion and

excretion 7 7, 78

remark s on ditto. See Sp ende r .

INDEX .

noculation of diphther itic exudation (Harley)235, 2 12

n san ity , statis tics of (Rob inson ) 201

med ico-legal ques tion s on (Casper )

do . in Russ ia 203, 205

do. in States of theChurch (Girolami)203, 205

nsects, ova and pseudova of (Lubbock )117 , 122

aspiration , e ffect on the heart and pulmonary artery (Da Costa) 209, 213

n te lligcnce and life (Flouren s) 2

nter mittent fever (Heidenhain) 139, 1119

ligature of limb s in (Brauw ) 139, 150

te stincs , influences of pneumogastric and

eplanchuic n erves onmovement of(Kupfl‘

er)39 , 50

nerv es of the (Billroth) 37 , 46

afl’

ections of, in children (Clar) 405

testinal catarrh , chron ic (Wold’

) 237

fontina lobstr uctionf romadhes ions , .S‘

e . 286 i

te stinal obstruction (B rinton ) . 235 2-10

do . case oi (Sturges) 236 250

do. and stcrcoraceous vou nting

(Easton ) . 217

testine , large , pb 1

.

siologyof (Colby) 69small, t11 isted on its axis, w ith obstruction

(Streubel) . 236, 2 15

do. do. (Streubel) 286 , 286

do. impaction of w ith lumbrici (Cox)236, 2 17

tus-susception (Betz , l'h-ommann) 236, 215

do . 286, 287 8

case of (Steele) . . 235, 243

detachment of czecumfrom(Hennet)236

do. (Hennet)NZAK I, neuralgia of lingual nerve 19 1

od ide of sod ium (Ure) 139, 151

od inc injection s, in bony changes and

ab scess es (Bere nd ) 311, 317

in cyst in the orb it 327 , 330

in chron ic hydrocephalus (Brainard )39 1, 396

action on carious bone 317

odiz e d foo d, in scrofula. (Lebert) 1110, 167

ritis, suppurative (Dan iell) 326, 330

ron , pe rchloride of, in hasmorrhag e fromton s il (Thompson) 278, 279

rrad iation (Volkmann) 52, 55

rritab ility (Be rn ard) 36, 46

of muscles (He ine k e) 2 1

ritab le stump (Hancock ) 276, 2761b , glycerine ointment for (Bomg uignon)

26 1

Juser ’s ointment

CKSON, abscess of liv er 253, 25'

7

gun-shot 11 011nd of heart 285, 285

cold ati'

usion in narcotic poison ing"69. 27 1

oxide of z inc in the sweats of phthisis

253, 255

J aconon cs, chron ic inflammation of uterus

37 2

Jacor n : siz e of fee-tus, as canse r f dycta-ia349 , 350

Jacc novn r scn , n ervous 111-stemof difl

'

eren t

anima ls 37

on examin ing microscopica lly the bra in

and spinal card w hile fres h 37 , 46

do. critique on ditto byOw ajann ik ow37 , 47

Janon , glaucoma iridectomy 326 , 329

J1 012 1 5 5 1, congen ita l luxation of hip-join t415

Jaco , en tOpics

JA ims , strangulated hern iaJ ascn xow rrzmn the splenic plexus 39, 50

JA82 8 , itch oin tmentJaund1ce , dangerous (Herard ) 253, 257

epidemic (Ba llot) 254

J aw s, tumour of 316

J a11 , upper , disease of, temmal (Quin lan )311, 317

lower , bone abscess in (Nunabaum)311, 316

do. necrosis of, fromphosphorus (Coote )311, 316

JBammox, syphilitic laryng itis 231, 282

J litm u s , w ho discov ered reflex action

38, 49

Jss na assxx . anatomy of thymus 397 , 400

J28838 ,mental diseases as reason for d iv orce22, 424

Jassoc, recession of eruption in scarlet fev er

409, 111

Je s sa r ns Launau s , pol111i of n ose and

fauces 278, 280

J ocou'

ccr, synchondrotomy 356,362

JOB NSO\ Bright’

s d isease .

encephaloid cancer of testicle reta ined'm

abdomen 255

lacer ation of lung 11 ithout fracture o f 1 il1-1285, 280

sebaceous tumour ; perforation of cran ium320. 32 ]

malignant tumour of the arm 276. 277Joints, contr actions of (Henk e) 332-3

J o ints , d iseases a nd inj ur ie s of 110

Joints, diseases of (Bonnet, Bryant) 310, 3] t

injuries and diseases (Bryant) 318

hysterical affection s of (S k ey) 310, 315

inflamed, stretch ing and cauter iratiou 111

(Bonnet) . 310 31

JOLLY, entoz oa in the heartof the seal

JOLY, suppression of loch ia 387J ONES (Handfleld) report on p racf ica l med i

cine , p a tho logy a nd the rapeutic: 12 L 272

inhib itorv in fluence of ner v

es 35 , 40

(10 . 17R, 182

nerv e disorder .

catalog ue of St.'l'homas’ s Hospital

Museum . 3

(Wh arton) unguentum sulphuris in gra

nular Ophthalmia 326, 3214

NDEX.

JOSEPH, valves of the heart 83, 91

physiolog ical action of corrosive sub limate105, 110

Kamala as a v ermifuge . 405

Ka n n u zn , pow er of different parts of the

sk in mdetecting slight w eights . 59, 61

Karma, spontaneous rupture of uterus

342, 346

KEEN,convulsionsduring pregnancy 386, 389

K s r s asr sm and HALLWACHS, action of

pancreatic juice on albumen 68, 70

KELLY, recurrence of retroversion of uterus

368, 370

K lmr , function of mucous membrane of the

gall bladder

KENNEDY, change of type 1n diseasemercury in albuminous urine . 253, 258

diagnosis of fatty heart 209, 212

tumours in the stomach 235, 239

KEB L I , croupK ERSCHBNSTEINEB , incubation of measles

410

K s srmEN, rape on in fants . 4-53, 454KEYSER, pleurisy of right side, &c. 220, 225

pleurisyof pulmonaryartery 220, 229

K IDD, chloroformin midw ifery 362, 363

hysterical puerperal convulsions 178, 182

do. 386, 390

distortion of features 396Kidney,stra ight 1 essels 1n pyramids of (Beale)K idneys , d iseases of, in children 403

K idneys , diseases of (B ierbaum) 407 , 407tw o conditions of, giv ing rise to B right

’s

disease (Dick in son ) 253, 256

cancer of (Goodw in)fatty (Glugo) az ,s 87mmcab le, w ith spinal disease (Henderson)

25 L

congenital malformation (Senftleben)415 , 419

e ffect of stimuli applied to (Vulpian)1,

K IEDROW SKI, action of hydrocvan ic acid

105, 110

K ieste in e of pregnancy (Hick s) 9 1, 98

do.

K IFERLE . See Heck er .

K ing , (Dr .) poison ing of his w ife by arsen ic

431, 436

K INLOCH , surgical cases 810, 315

resection of k nee-joint 312, 319

K INN, ascites terminated by serous flow

fromb reasts 253 2 55

K INNELL, v en tilation 467, 467KIRSTEL LER, forceps Operations 355, 359

K IRSTEN, chloroformas an an tcsthetic

111

KL AATSCII and Sn cndocalityof taste 58KL- ,

1 rnorn haemorrhage from clitoris, in

labour . 312

fib roid tumours of uterus, in labour312, 318

Kon ns n, presence of allantoin0 in urine

relative absorption'

111 animals fas tingdigesting 74.episthotonos in children 394,

KonNnonN, artificial production of ca

741Komsxo, continuousmurmur in th e neck

KLBTZINSHY, an imal chemistry 3

influence of benz oic acid on tissue

hydrochloric acid in sk in disease 26 1,

presence of xauthic oxide 94,analysis for phosphorus in poisonmg

414,KLINGNER, composition of human ur ine

95KLOB, degeneration of sub-mucous matstomach 236,

KLOSE, separation of epiphyses 310, 3

do .

— idiotismmSilesia 478, 4

Knee , 1njur1' iromfallupon (M asch k a) 427

Knee joint, loose cartilage from (W141

hydrarthrosis of (Hodge) 312

strumous disease (Erichsen) 312, 3

penetrating w ound of (Coulson ) 312

surgical Openings into (Adams ) 312, 3See Excis ion .

KNOLz , nox1ons influence of the W ien Riv467,

KNox , relation of anatomy to physiologypathology.

KOCH, retention of dead foetus 349Koas anLa, death of fmtus '

1n utero 351,KOECIILIN, cerebral tuberculosis in eh

‘

KOLLIKEB , human h istologyv itality Of the nerv e-fibresstructure of osseous fishes

on urari .

action of the upas antiar 448,

physiologieal experiments w ith w oorara

1 egetable parasites in hard structuresan imalsand PELIKAN, 31001I0110 extract of ta

gh in ia v enen ifera 105, l

See Pe lik a n .

ROLLOCK ,chancre of uterus 372, 8

Ko1mi 11, treatment of croup 398Koscn ATE, sign s of death . 481ROSTL IN,measlesKOTTMEIEB , ligaturcofhepaticv essels 83K B 1111111, phosphates 95KRIEGER, atresia ani, &c. 415, 4Kna r ss , mode in which nerves terminate

37 ,do. remark s on , byLuschk a 37

KRAUSS, legal responsibility of a libeller459

Kaorr ,med ical topographyof Bavaria465

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IND EX .

LBGBOU I , puerperal fever 386, 391

shampooing in sclerema 410

LEHHANN, an imal chemistry 3, 11

saccharine function of the liver 82, 85

inorganic food and earthy phosphates in

food of 1 oung an imals 69, 72

table of results of his experiments 73

catarrh of the stomach . . 235, 211

cran iotomy and turning 359

obstetric reports 387

rupture of ute rus and vag ina 312, 315

LEHWEss, d isin fectan ts for an ima l poisons269, 270

LEIEEN . See B ehrend .

LEISTNEB , poison ing byhyoscyamus 437 , 438LEMAIB E ,mus ica l murmur, connected w ith

cirrhosed liver 229

LENHosss x , double spinal cord 41 1, 417

Lemceps (Mattei) .

LEROY D’ETIOLLBS , stricture of urethra

,

urethrotomyLESUER. See Rousseau.

LETOUENEAU , new-born children 393

do. 412

L Et' Et' SCHEa , epidemic of scarlet fever409, 411

pathological development of connective

tissue in the brain 12 1, 127

LEUOEAE '

r, development of the pentastomataenioidea 111

L eucocythemia splen ica and lymphatics(Wilk s) 254

LEl'

POLDr , lung test 455, 45 7LEU nEr and GRATIOLET, comparative ana

tomy of the nervous system 36, 46

LEUTE, menstruation during pregnancyLevato r an i, the male (Luschk a) 20, 2 :

fema le (Luschk a)L E1

'

1cx , sun-strok e 180, 189

L E1'

1NCART ,men t al state ofmurderer 458L EV ISON, echinococci 11 1

LEVY, ciliarymuscle 51, 54

chloroform1n midwifery 2 362

embryotomy . 356, 361

LEW INs KY, po ison ing byphbsphorus 14LEW IRON . See B udJ e .

L I 111110 . letters on chemistry 3, 11

creatine and cvnuric acid in urine of the

dog 9 1, 100

L IEGAED , prolongedg estation 337 , 338

L IEGEO IS , ph 1 siolog 1 of the facial n erv e

39, 50

L ife , an imal (Frey)facts and law s of (Reynolds) 2

and inte lligence (Flourens) 2

L igaments of pericard ium(Luschlta) 26

Light, appearance of, in the c1c (Willigen)5 1, 5 t

influence of, on growth of an imals (Dobell,B et lard) 120

Lightn ing , accident by (Fleming) . 180, 195

L ILJ EBORN, \ Omit1ng of blood fromulcers 1n

duo denmn 236 . 217

L imbs, death of, by injection of c

into arteries (Kussmaul)L ime, saccharated , in med icine (Cle land

261

L 1NATI, electrO physiology 31M N11mm, fracture of lower Jaw byexpof pisto l 4151

L INHART, anatomy of the anus 20L 181‘EB , ph1siOl0gy and pathology 2,

earlv stages of inflammation 125, 1coagulation of blood 25,radica l cure of hernia 289,excision of patella 312,and TURNER, structure of nerve-fibres

37 ,L ithotomy (Smith)

statistics of 295,d ifferentmodes of 295 ,and after treatment (Wme) 295,in children (Adams)h igh Operation (Hewit) . 295,Allarto n

’s Operation (Brow n , Bro w ne)

median (Wh eelhouse) 295,L ithotomy a nd L ithotritye '

rm’

s, artificial anus

L IT z uANN, nrmmia during pregnan cy

Liver

Li1.

er , table of analyses of .

inorgan ic constituents (Oidtman n )

saccharine function (Lehmann , Moos)2.

effect of stimuli applied to (Vulpian)26,

artificial formation of substa n ces

(Schottin) 82,d iffe rence of, in animals fasting and

gesting (Nasse )— in ti11ence Of deep respiration on d i

of

b lood and pus in , discharged in to intinal canal (Dufresne) . 2235,rapid mcrease of (Howitz ) 2541abscess of (Jack son) 253, 2acute atmphy of (Pleisch l, Schn 1tz ler)

25 k 2l1vdatid ovata of, puncture of (Mo issene

255 ,cystic disease , in foetus (Smallman)

414,fatty (( vlnge) 83,

11 ex1 (1ourmer)ligaturing of hepatic vessels (Kottmei

83l s e NB , on the Tsétsé 101, 1African fever on Zambesi «16 9, 4

L IME, d iagnosis of hydrocephalus m breen

presentation 349,

pelv1c 111esentat1on , emphysematous fmt318

Lochia, suppression in puerperal d i

(J oly)

514

Ma s s , fluctuation of population in Fran

conia, &c.465

Mamma l , allantoid and amniotic fluids78, 82

31111400, te nia 409, 411

Malarious affections (Peacock ) 141, 173

Malformation , double (Ramis) 349, 350

Ma lforma tions qff a tus , 473. 414

Malformations of urinary organs (Duncan)415, 419

MALK BTRN. See Samba“.

Malpighian bodies, amyloid.

degenerggson of

MSlim-ris

bstetr i (Busch) 481a prams, o c

Man and an imals, d ifference between

(B ischofl'

) 2

MANDL, fumigations mbronchitis . 219, 224

Man ia,med ical relations of (Richter)458puerperal (M11c 390

Maniacal excitement (Schlager) 204

M 1NNm 'r , accommodation of the eye

5451,

answ er to do. See Mi lle r .

Manslaughte r

Ma nua ls , &c.

Ms o, w ater baths 111 operation wounds

275 275

MANz , accommodation of the eyes of t

s

ish

52, 4

MLBAOACCI, blennorrhceal inoculation in

pannus 326, 327

MARAGLIO, death of a primipara 386

Manet, state of mental powers in chores

181, 200

puerperalman ia 386, 390

chron ic alcoholic intoxication 139, 15 1

Mas ons, tape s am after use of raw meat405

MAB DUROWICZ, turn ing of facial into pelv ic

presentation 351, 358

MAREY, circulation

.

Of the blood 26, 29

hydraulic interpreta tion of the double

pulse 26

MARKIIu I, b leed ing 1n d iseases 138, 144

cardiac diseas es , pericarditis 209, 215-17

r upture of the heart . 208, 210

MARNIT z , tv11ns un ited at trunk . 349, 350

Marsh fev ers Berchon) 139, 117

glucosuria In (Burdel) 254

MARSHALL , ves '

co-vag inal fistula 380, 382

MARTIN, heat-apoplexy 182, 190

diseases of the eye 325

spontaneous amputation in fmtus 415, 418four children at a birth 3-18, 319

in continence of urineafi er labour 385

inflammation of Fallopian tubes 387 , 392

danger of chloroform 180, 190

obstetrical clin ic of Jena 364

MART IN-MAORON. See Rousseau.

MARTINI, effect of santonine on the vision52, 54

extirpation of the spleen 255

tracheotomy 220, 226

dos a o o 281, 281

INDEX.

MARI , case of triplets

blood-e stains

lif 456breathing, as test cl emin fanhdislocation of second verte bra of neck

post-mortemexaminations 427do. of infl at

examination of lnh atia

fatal injuries of the headinguinal hernia

fall upon the k nee

— metallicmercurygivcn in cofi‘

es to a tubsrculous child 4141

— atate ofmind df persons accused of m

— cases of 453-ill-treatment Of man with disease of the

heart

MASON, practical obstetrics 364

Mu ra l , leniceps 355, an

yearly ripen ing of ova 365, 365

diagnosis of pregnancy . 338

exuded plastic l

ymph, cause of puerperal

fever . 39386,MATTBUCCI,

MAUNOURY,iniections . 354, 357

MAUTIINBB , children’s hosp1tal, Vienna

393

MAY, diphtheria 176MAYB ELL , repeated death of fmtusMAYER, glycerine in croup . 399, 402

artificial premature delivery . 354, 357

Z11 ank e’

s pessary in prolapsus .

syphilis 111 ch ildren

MAYNE, cerebro-spinalmen ingitis . 181

Man , d iseases Of ch ildren 393

erythema nodosum 410, 412

Mnacn an , rupture of uterus 342, 347a ow s . See Og le .

Meas les (Gelmo, Gunsberg, Kerschen steiner,Koestlin , Schutz , d rousseau) 410, 411

hemorrhagic (Veit)do. . 410, 418

consecutive effects Of (Scoute tte n)Meat, raw

,use in diarrhma of infants

(Weisse) 236, 246

405 , 406

Mecon ium, Obstruction by (Barnes) 405 , 406MEDBR, absorption by the lacteal:Med iastinum, position of anterior (Luschka)

125 , 136

Med ical laws of Nassau (Voglsr) 463, 463notes fromthe Continent (Mercer )

M edical p ro/an ion, laws concerning

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516 INDEX .

Mineral “ te l , chemical analysis (Hen7q

'

)7747 4

111880171 ,sulphateot'

copper inc 221, 230

Mitral-valve disease (Cockle) 210, 218

rupture of cordmtendineo of (1-‘eigneaux)416

military eye diseases 325

l ow , pressure of the blood 26

Horseman , puncture of hydatid cysts of

liver 255, 263

l olqhydatid 351, 352

Molecular changes in nerve-substan ceglaze;3

Mom cnor r ,po ular treatiseon food 69

Molluacs, lamelli ranchiate (Rolleston )117 . 121

IIOKIRR, on analysing milk 78, 81

l ocum, vesico-vag inal fistula 380, 382

Moncrchidismin man (Godard) 804, 305

Monster, twins united at trunk (Marn itz )319, 850

anencephalian'

est) 415, 418double-headed Loescher) 849, 350

Peracéphale (Dclacour) 415, 418

Monstrosity, human (Milroy) 415, 419Hom e az u , v irtues of coca 269, 272MOORE, affections of chest 398, 400

reflex paraplegia 180, 193

pleuritis and empyema 221, 230

diseases of the sk in 264, 265

sapo laricis in cutaneous diseases 264, 265MOORRRAD , angina pectoris 209, 214

physiology of hearing 55, 56Moos, saccharine function of liver 82, 86HoRAr D , congenital cataract 414

MORRAU , motor and sensory roots of spinalnerv es in fish 39

glucogen ic function 8" 85

icterus neonator um 405

MORGAN, fi-acture of neck of femur 311, 315

Mon l 'r z ,closurcof vagina in delivery 311

MORRIS, bella donna, protective aga instscarlet fever 409

placenta prwvia 351, 352Mortality,statistics of 465

com re tive, in Australia and England

(Bed oes) 268, 270of Paris (Trebucbet) 465

MORVAN, bleeding fromthe ear 395

M082 8, disordered menstruation 871, 373MOSLER, passage \

of substances from theblood into the bile 83, 88convulsive sneez ing 180

, 188Motion, organs of, diseases (Bouv ier) 408M outb, pha rynx, and mop lmgue,mayo)h am, 0.

Mfillcr, rofessor (B ischofl‘

and Virchow )3

MfiLLRR, chemical composition of the bra in83, 91

accommodation of the eye 51contagious disease of eyelids 825extra-ute rine pregnancy 841 MUBHBT, angina pectoris

Mau ra, development of bone in rachitis

13,do. 4m,

theory of°

ration 62,Muncmsos , Vi dsor epidemic

continued fevers

do. . 140, 1

simultaneous diseases fromspecifi c mpoisons

typhus fromovercrowding 1

Murmur '

1n the vessels (Chauv eau)basic systolic (Fox) 1

continuous, in the neck (Kolishe ) 209,musical, in cirrhosed liver

Mt axn '

, injuries to the headMURPHY, Cmsarean section

Mc nu 1 , exomphalmMURRAY (J placenta prwv ia ; air

351,Muscles, human , te xt-book (Henle) 20,

growt h of (Budge)action of electric current on (Althaus)

do. 138, l

power‘

of limiting local action of e

city (Kupil’

er) 20,action of poisons on (Pelik an) 105

recovery of, after section in poison edmals (Happe) 105,

- irritability of (Arnold) . 20,do. inherent

do. in relation to rigor mo(Heineke)contracted, action of, on the atmosph(Valentin) 20,

paralysis of (Creutz ) 51

ciliary (Levy) 5 ,

of the 9 1 chall, paralysis of (Graefe , Sch51

transv ersus colli (Luschka) 20,

sterno-clav icularis (Hyrtl) 20,thoracic, action of, in respiration (Arnol

62,M uscula r sc/s fem 19 ;Muscular action , from electrical point

1 io1v (Radcliffe) . 19,exercise (Feclmcr) 20,in fluence on the constitution (T houv e

movement (\Vundt) 20,atmphy, syphilitic (Rodet) . 207 ,fibres, structure (Budge) 20

do. nutrition and deca v (Bottch er)

do. inv oluntary, during contracti

(Me issner) 20,

do. striated (Berlin) .

fibrillaa (Brucck e)paralysis (Fr iedberg)tissue of the bladder (Ellis)

Museums . See Choale ite .

Museumof St. Thomas’a Hospital (Jones)3

INDEX.

Mommstrangulated inguinal hcrnis in a

Na vi materni, vsccination fcr removal of

1858then) 425 , 428

Narcotism, voltaic, for local anu the sia110. 1l

d ifi'

eruwe in livers of animals fag’;83.

Nausea (Stich)Neck , {mean of theNecrosis. acute, and pywmia (8tone) 810, 812

of lower jaw , fromphosphorus (Costs)16811, 3

Neglw t aw mtmm byn gs)

Hm retw ru dw of pregnant uterin

“ electric currents

O 0 3640

spinal cord Whigh in spinal cord

0 C 88

188

18739

517

N ew

influence on movements of

do. hummi ccrv ics l (Wagner) 89.action of electric current— motor.

(Althaus)

do .

Nervous

Noreen

518 w o rx.

Nervous system, effect of cold w ater on

(Prciss) . 35, 45

NRURAURR, origin of oxalic acid

and Vooan, analysis of the urine 94, 100

Nsunonrsn , suicide 451

Neun lg .a, electricity’

111 (Althaus)of brachial lexus (Sloane) 195

facial Frank , Michel)5 6

of the fifth pair Oppenheimer) .

do. bremm) . 1

of lingual nerve 194

of uterus (Becquerel) . 372

in the leg, division of popliteal nerve for

(Hook er)Neurologyof organsof special sense (Coghill)

Neuroma, the true (V1rchowNav e-muscular sensibility tedesch i)

Neurotomin neuralgia (Michel) . 179, 188

in neu (Frank ) . 179, 186

v w ,medi history of woman865

Nms s,med1cines’mvapour 269, 271

vesico-vaginal fistula 882

Km , a fever Villa

ge . 139, 146

Nicotia, poisoning by elssns, Taylor)

Rum , ergot of rye . 478, 474

Na u ru , treatmentof pneumoniaNipples, sore, during lactation (Anselmier)

383, 384

Nitrate of silver, injection of solution in to

bronchi (Griesinger) . 219, 224

Nx'rrn tGRR, season of vaccination . 480, 480

Noxoe smrn , external turning . 854, 858

uterine'

eetions 872, 875

Noxz x'r , stap ylems posterius 826, 328-9

Noun , hysteria and retention of urine372

peri-uterine haematoceleNose, polypi of (Jobert) 280

Nornme , punctured wound of the neck427 , 429

Noun“ , prolapsus uteri pessaryNuns , idice ncrasies . 268

Nussasux , lions-abscess in lower jaw311, 316

NussRR, trepanning in frontal presentation

medicine in relation to administration of

j iceust 422, 423

Nutrition ofbone (Buudge) . 3,-of animals, influence of light on

.

(Dobell)6

120

Nymphe , hypertrophy of (Breslau)

Objects, apparent siz e of (Lubimc 52, 54Obstruction, stercoraceous (Theile 286

O’BALY, larch bark mpulmonaryhemorrhage221, 234

ODLmG (William) report on legal medicine,public hygiene, and dietetic: . 422-483

hthalmoscope (Reute)practical application (HanseutOpisthotonos in hydrocep

(Kohler) .

0p1umin puerperal diseases (Bonfilsgs7poisoning by

Orras aamn , neuralgia of the fifth“8

Onu xo (W . Marsh ’s process for detectiarsenic

O’Doxov an , infantile syphilis 418,(Edema glottidis, scarification of (Tudor)

221

do. 281:01311, on the olfiactorynerve 37 ,

do 58

(Eamon , potass. iodi

con

gractwn near cardiac orifice

swit:

hematemesu fi'

omvan ces in (Le D 1285,

digestive solution of (Canton) . 237 ,stricture of (Batty) . 286,

do. fromswallowmg corrosiv e fl

(Addison) . 279,ligature of (Orfils ,

diphmmetr ic compass 58,

paralysis and hypemsthesia of one si

181

poisoning by sul hate of z inc 450

and a now s, clubbing of finger on

thoracic disease

Om'

rm x, inorganic constituents of li

spleen , &c. 83, 89

On , stomach and its ailments 285,

Omnm, retrofiexion of uterus . 341,OLLIER, artificial production of bone 18,01.14v , pessaries in dev iations of a t

867 ,Omentum, resection of, in operations

hernia (Paupert) .Operations, larger bloodless (Michaelis)

27 ,

Orn rn amtu ,contag ious (n omar) 8253 52Egyp

tian (Pauli)(Sommer) 825

military (Coste tti) 325do. arlomont) 325

do. Laveran)do. in Dan ish army in 1851 (

25Moeller) .

granular, contag ious (Van Roye) 825do. unguentumsulphuris 1n (W . J o

826,

purulent (Condo)do. ofmfanta,causedbylight(B alls

do. spontaneous (Cordier) . 826

gonorrhwal (Wilde) . 826do. stimulant treatment (Hancock

826,5151

01111

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520

Paralysis ofmotor nerves of face (Domen il)5

of the sixth nerve (Barwink el) .

ofmuscles (Creutz ) 51

do. (Friedberg) . 207 208

do. of the eyeball (Graefe, Schufls)51

of tongue, cured by electr icity (Pgs

z

l

aer

gzd hypersesthesia of one side (Ogle)

202

agitans , removed by gal1'

an ic current

olds) 199

Paraplm

a in relation to renal diseasesai inds)

reflex, strychnia in (Moore) 180, 193

reflex and direct forms . 41

Pa ras ites 113

Parasites of human body (K iichenme ister)114

in the brain (Davaine) . 38

v egetable, of the skin (Hogg) .

do. in hard structures of an imals(Kb llik er) 115

Parasitic diseases (Lowe) . 264

nature of diphtheria (Harley, Laycl

ock )117

fungi (Lowe) 114, 116

do. of human surface (Fox) . 114, 116

Paas v xomx, section of denta l nerve 179 187atheromatous cyst of labia . 381

Pancn aer s , pathology of fibrine'

1n blood

Parenchymatous in flammation (V1rchow )

Parent, influen ce of male and fema le , on

progeny (Thomson)table, show ing the chief influence of the

male 118

Pans yr-Docmrsu r , prostitution mParis482, 482

Parietal angle , instrument for measuring(Q uatrefagcs) 13

PARKER syph ilis of uterus . 872, 374

Ps a lms , albuminuria as symptomof kidn ey. 253, 258

blow on the head, follow ed bydiplopia

Panmx, causation of disease 141

Parotid gland, acute inflammation of (Vir( how )

Parthogenes is in plants and animals (Lankester)

.

118

.Pa rh m'

h'

on

Parturition , phenomena (Schubert) 338armpresentation (Evcrshcd, Madge)

348, 349

cross presentations (Doig) 318

pelv ic presentation (Liz é ) 348

spur ious pa ins (Simpson) 340

difiicult, fromsiz e of foz tus (Jacquemier)319, 350

emphysema in B1sh0p) 838, 340

retrogression of (Charien) 338, 339

INDEX .

Parturition, chloroformin (Kidd. l a y)362.

cellular (Virchow )Parnox, lactation 3

prolapsus of mucous membrane of2!

Pam nsox, aneurismof left carotid a

306,377

(Butignot, Schultae)laceration of sacro-iliac synchon drcsi:

(Scanz on i)induction of premature, byca.tg l1t (?38

— do., by sponge-tent (Beymann) . 3541do., by Cohen '

smethod (Hausmann )

— do., 0. craniotomy (Gum-den ) 854,do., bywarmimections (Humour-y)do. (Bimbaum, Coesfeld, Credo, PiGermann ,Giordano,Godefro1

'

, G

Hanemann, B eck er, Lumpo, Ha;Riedel, Ro

'

as, Stolz , Trouncer) 354,Pan asox, suicidal poisoning w ith arseui'

451

Patholog ical experiments (Picard) . 2

Patho logy, report on, by Ha udfleld J

M .B 124

a nd svmptossa lo lPathology contributions to (La ter) 2,

relation of anatomy to (Knox)contributions to experimental (Bee

1

encysted tumour of ovaryPAU LI, Egyptian OphthalmiaPAU I’ERT, glycerine in vulvar hypermth

381,resection of omentumin hern ia 288 ,

Par r , diabetes— 1esions of nervous systemproducingbetcs

and ‘VILKS, anaemia lymphatica2 54,

Pas cocx, antagon ism of consumptionague 220,malarious affections 141, 1

tape-w ormfromuse of raw meat 113, lPBAN, tumour of cornea 326, 3

c n oms n, puerperal fev er 386

Psmu n’

, anthiar and anthiarine poisons105, 1

physics of gunshot w ounds 425, 4

poison ing by bichromate of potash

489,rigor mortis 427 ,and Kenmxs n, action of certain po

'

on the muscles 105,See Kalli/h r .

and Savmm-zr r , introduction ofstance s in to the body by galvan ism

11, 1

111111111. 541

Panam a’s method, in imagination of

Phosphoric acid, excretion of (!1auimond)

470

Lassaigne. &c .)

811, 816

chloride of sodiumin (Cotton ) .

iodide of potassiumm(Cotton ) . 221,

oxide of z inc, in sweats of (.1a1c1111o’r1

g8p

Kuehler)881, 382

ex .

periments 2

Pres sman, anomalies of urethra . 415 ,

c x roan , asphyxia, Marshall Hall’

ss

3

1

370thod

367 , see

current 85

86, 46 P1xosm , retsuven imcf w id uterus

81

13. 17

865, 366

W )-hs fbod 1uui in 1nnne (fifick )

31hndon, and

INDEX .

ou r , influence of deep respiration on dis

eases of heart, &c.

p ru sxow , researches on the circulation

25

fi’ s operation (Watson) 276, 278

do. (Curling) 276, 278179, 184

RA, tumours mthe neck 288

galvano-caustic treatment of varicocele804, 805

?itha’s Clinie,

’cases in (Gunter) . 820, 821

laceata and f a ta l app endages, abnorma l

adhesions of (Houel) 418

do. cold injections into umbilicalveins in . 851

ta pre via (Barnes, Donk in,‘

Foucart,liscz ynsk i, Morris, Murray, Rainy, Spiealberg, Stephens) 851, 851 2

egal responsibilityTn , letters to youngmothers . 892, 894

sa , syphiliz ation 155

and Fonwn cm , acute atrophy of the

iver . 254, 259

urisy of right side (Keyser) 225

and embolia of pulmonary artery

tic efi'usion, resorption of (Sk oda)

do.,me bythoracentesis, &c. (Gairdner)

exudation (Flogel) . 210

curitis, terminating by“ car ious secretion

(Moore) . 280

ovmz , incontinence of urin e in boys407 ,

eumonia, treatment (N1emayer)digitalis

'méSchneider) . 147

of in fants ennet, Fov ille) . 899

asthenic (Russet)?

227momma

-igm sugar in the body82,

report on Sanson’s paper on sugar in the

bodyorsxmm and Lxronr , glucose in the

body 82, 85

oison of adder (Weston) 104, 105

do. 448 , 448

icons amd p oisomng 432

sp ecia l (in alphabetica l order) . 433

hyd olog ica l action of 104

11sons, action on the muscles (Pelikan)

animal, destruction by disin fectants

hw ess) 270

11soning, treatment of 41

cold afi‘

usion‘

111 (Jackson) . 269

alleged, case of Bogers

.

for murder of P.

Wright 432

by arsemc in cigars 482

bywater fi'

omleaden cistern (Chavasse)

Poisoning, apparent 432

Polariz ation ofelectro lytes (Dubois-c mond)

Pom x, contagious exanthemata mTeheran

Forum s , physical education of ch ildren

898, 894diseases of childhood 398

PoLLocx , granulated blood-discs 28, 84

prognosis in phthisis . 221, 282Pol i of nose and fhuces (Jobert) 278 280— 0 pharynx, removed by twisting (Roeser)

278, 280of uterus (Elk ington, Hardy, Maier,Wagner) 872 875

do. diagnosis (Caz enave) 868fibrous, of uterus (Breslau) 873 875

leston ) 87, 47Portrum,mental state of Marie Pens

do. frommigra tion of ova (Kussmaul)340, 843

Pregnancy and pa rturition, illeg itimate 452Pan es , effect of cold w ater on the n ervoussystem 4585,

Preparations in St. Thomas’sHospita l Mu

Poor, lu us erythematodesP nlat10n , in Fra nconla, Baden, Mechlen

h, Bavaria, &c.

Pones s a , absence of urea and uric acid inurine of yellow fever 95, 103

Porrigo (Neligan) . 410decalvans (Barensprung) . 264

For um,d1y1s1on of lefiu enal artery 306, 807chronic ulceration of larynx 282

POSNER, paralysis of tongue cured by electricity 225rheumatic head afl‘

ectionPotash, bichromate of, as a poison (Pelikan)

489Potassium, iodide of, in diseases of brain(Coldstream) 181 , 198

do. in hydrocephalus (Carson,Coldstream) . 395, 397

do. in phthisis (Cotton) 221, 284Practice , effect of, in perfecting the sense oftouch (Fechn er, Volkmann)

Pregna ncy and p ar turition

.

337

p atho logy ofd is eases of

Pregnancy, diagnosis of (B eck er) . 337 , 338do.

(Mattei)

k ieste in e of Hicks) 94, 98local bloodletting 1n (Silbert) . 362, 363extra uterine, (Cahen , Chevillon , Muller,Van Geuns, Waller) 340-1, w

do. perforation of vagina in (Rizm)840

tubal eck er) 118, 128do. Hancox, Harley,

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524

Ram, cases of aneurism 209, 216

chloros is, anaemic murmurs at apex of

heart 211

Re id’s (W. trial for abortion (Dancau)

455, 456

REIXI R, separation of two adherent foetuses

l cxs , microscope 3

Re lapses 1n diseases running a typ1cal course

(Wunderhch)Rmu x , peripheral ganglia 1n the alimentary

3 , 46

div iding of blood-corpascles in the emb ryo 4

Rummy , rev aecination 480, 481

l z x, physiologyof the cerebellum 38, 49

Resection, subperiosted pubic (Cristofor is)856, 362

62

Respiration, theory of (Muller) 62, 64

phenomena of (E. Smith)action of pneumogastric in (Low insohn)

3 9

do. of thoracicmuscles'

1n (Arnold)

do. of food on (E . Smith) 62, 65

deep, influence on diseases of heart, &c .

(Piony) . 125, 186

jerking (Bourgade 224

premature, of fmtus (Sch wartz )artificial, in poisoning with woorara (Vulpian) . 105

397Respiratory system 219

Responsibility, legal, question of (Beecher,Mair, Schw eber, &c.) 458, 460

Resuscitation of dried and apparently dead

animals (Cohn) . 118

Rs srm, extrophia of bladder . 416

Retina, persistence of impressions on (Mel

sens) 51, 54

REUTE, n ew ophthalmoscope 51

REYBAUD, condition of w orkpeople in silk472

Rsn u xx, obste tric cases . 341

induction of labour bysponge-tent 354, 356REYHOLDS , facts and law s of life

paralysis agitans removed by galvan ic

current

Rheumatic head affection (Posner)fe1 er (Whitley) 17 t

Rheumatism, acute , treatment by quinicintoxication (Beau) . 141, 174

do. byopium(S ibson) 141, 175Faradiz ation in (Briquet) 179, 183

cerebral (Forget) 179, 186

do. (Trousseau) 181, 201

Rhonchus, infantile bronchial (Semanas )399

Rib-cartilage , h istologyof (Freand) 14, 19Ribs, cer1 ical (Luschka 13

R130L 1,mppuration of pancreas 260

INDEX .

Rxccann, tracheotomy'

111 epilepsyRICHARD , cephalotripsyRl cn aaDsox

'

, volta ic narcotism for

56

local

anmsthesia in operations 110-11, 111do. experimentson byWaller 110-11

RICHTER, feromedical relations of man ia

See Virchow .

ROLLESTON, comparative anatomy of the

pom a a a 37 , 47and Rons ar sox, aquiferous and ov iductal

systems in the lamelli-branch iate molluscs

Ros ana; erectile organs of woman, ao.

865, 865

RICORD,chancre ,kinds and stages of 321, 322RICOBDEAU , choleroid enteritis 404

Rum“ , &c., artificial premature labour854,357

RIEc , value of vaccination 480, 480

RIGBY, cranial blood sw elling 403

pruritus pudendi 383

RIGDBN, diphtheria at Canterburycases in midw iferypractice . 364

n or mortisRigor mortis, defin ition of (Pelikan )

(Brown-Sequard, Fischer,Kahne ) 24, 25

death Of the limbs 1n (Kussmaul) 24, 25

relation of irritability of muscles to

(Heineke) 24

RINGER , connection of heat of body with

excreted urea, &c ., in ague 94, 99

do. 141

RIz z O, per foration of vagina byarmof fe tus

ROBERT, syphilitic right hemipleg ia80, 193

ROBERT8 , V081031 calculus formed on slate

pencil 295 , 297

poison ing by corrosive sublimate 442 , 442Ros s ar sON . See Rolles to n .

ROB IN, bronchitis, its independence of pneumon iaproduction of walls of cysts roun d pus

spina b ifida 416

menstrual and other blood-sta in s427 , 481

stain contain ing human adipose tissue

428, 431

comparison of hairs found on locality of

a murder w ith those of v ictim 427

ROB INSON, aneurismmenta l disorders . 203, 204

1101131 3muscular atrophy Of syphilitic orig in

Ros ana , symptomatic dropsy of morbusB rightu 253, 259

polypus of the pharynx 2 78, 280

ROGERS, obliteration of spermatic passages304, 305

Roq Nsxr , atresia of uterus and v agina

415, 419

INDEX . 525

in the body. report

M 428

Savm n hape of trausvcm wounds of bloodvessels

acid into utcrus

W .411

410, 411

w w ww <m m82. 83 803mm , detcctiou of poha 1ing byan snic

34.— xmthic ox ide. normal in the bod 84,— tab le of Oidtmann‘a snalysea liver fi

e

s

Scam,d

-aamfbilityof thc posterior column

526 IND“ .

mflk coutaining Samu rz , respiratorymovements of fcatuexceu of fat 78 81 335,

Scu m , obstetr ic clinic atWax-shag}4

Scnwn 'rz s , cholera infantum f. 404,

Seam an , legal responsib ility 457 ,— strangulated crural hernia . 288. 291 Sem e n , abnormal bones 13,Scu m , fun ic soufi e 889 341,

181,373, 3410

of the arte ries 25Som rr , v ital capacityof lungs 126, 136 influence ofmercury on secretion of binfluence of the circumferenceticity of the thorax on the vital capa

zity

relation between the vita l capacigand

8011do.

in410,

pulmonary afiections Ivar , laryngotomy hydrophobiaScam p , puerperal fever 387 441,

141,

on oz one 27 , 83

Scam , artificial formation of hepatic

thymic asthma . . 397, 400Bonan z a , on ague at Bodemvbhr

neuralgia of the fifth pair 202

sciatica

Sca nne rs , physical education of children

angular curvature 409

8011110211113 var nan Konx, structure of

spinal co rd andmedulla oblongatainflammation , first in the arterial system

9, 271

80mm” , poisoning with haschisch440, 440

Som me , hmmatoma of duramater181, 197

Scnv annr , almond water in hooping-cough399, 403

henomena of delivery 338

mclination tomurderScaurr , paralysis of themuscles of the eyeball 51

80mm,mov ements of the soft palate

769, 1

vascular tumour in children 400, 403

SCHUL ‘

I’BN, blood in puerperal diseases

387 , 392

SCHU LTBR, diarrhcea in infants 404

Scn umz x, termination of the acoustic nerve37 , 47

cephalotripsy 356, 361

hydrocephalic foetus . 349, 350

laceration of perine umduring delivery

367 : 369Scam , virulentmeasles 410,412

given time 74. 76

427,429 doubtf ul

Su roN, poisoning by belladonna . 437,Secale cornutum in disturbance df thecommodativepowerof theeyes (Willeb

Secretion, influence of vitality on (ISpender) 77,

Sanewxcx, deficient abdominal wall 416, 42amputation at carpo-metacarpal joi

l

n t

2 6, 2Sap u nor , internal urethrotomy 300,SEQU IN, accidental colours 52,Selenite as a febrifuge (Clark)Sm u t,metaphysical aspects of physiology

natural acid reaction of urine, &c . 94, 983m m, infantile bronchial rhonchus

399Ss x at snsa , laryngeal speculum 126, 13

220, 2"

Semen, retentiond

ef (Rogers) 304, 30SBNFTLBBEN, malformations of kidneys

415, 41

35,on a sixth (Battye) 6

Senses, the organs of (Dornbluth, D5

11

8

1

dtehofer, Ran)

Sensibility, neuro-muscular (Zantedeschi)

of abdominal ganglia Budge) .

loss of, in transplan skin (Busch)9

uard

tactile, means of measuring (BroSés 59

St an: D’s e, ste reoscopic effects . 55

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528 mnsx.

Spermatic passages, Obliterations of (R ogers)304, 305

stain s, diagnosis of (Dannenberg, Las

sa igne )SPIEOBLBn iO , carcinoma of cervix 342, 348

chorea during.pregnancy 389

placenta pra via, treated byColpeuryn

351 gar

52

mechanical impediment to labour348, 350

Spins biflda (Behrend )(Allix, Behrend, Debout, Messed; Robin)

cure by collodium(Behrend)— iodine injections in (Ebra ) . 416

Spinal centres of the sympathetic (Budge)

Spinal cord, minute structure (Schroederv . d . Kolk)microscopic examination of,

(Jacuhow1tsch) 46

crossing of n erve-fibres in (Bez old , Vul

pian )non-crossing of nerve fibres b 1gh up in

(Brown-Sequard ) 38

physiology of (Brown S équard) 38

independence of (Meyer) 38

reflex movements (Brown-Sequard, Je1ttelor) 3

influence of lateral half on the Oppositesides of the head (Brown-Sequard)

38

poster ior column (Sch id‘

) 37 , 48

double (Lenhosse k ) 414, 417apoplexy of (Duriau) 181, 201

epilepsy afte r injury to (Brown-Séquard)38

injury of (Schw andncr) 427 , 429

Spine, affection s of (Packard) 180, 189

curvatures of (Bouv ier)do . (Flemming)

injury of (Bir k ett)Pott

’

s d isease of (Broca)Spleen , table of analvses of

inorganic constituen ts of (Oidtmann )83, 89 91

enlargement of (Lees) 254

extirpation of human (Martin i) 255

rupture of, in fmtus (Charcot) 414, 417Splen ic plexus of n erv es (Jaschk ow itz )

39, 50SPONDL I , plural births 318, 349Sponge, compressed ,anti-lactescent (Stew art)

384, 384SPRING, emboli in cerebral arteries

180

S '

ran r s nn r , diabetes 95

Summe r , ligature of common carotid in

hmmorrhagc fromtonsil 306, 307deligation of subclavian, in ax illary aneu

Staphyloma poste rius (Noiz et) 326, 328description, symptoms, 6111, 328-9

ST ICK , on nausea

See K la a tecls

Stillborn ch ildren (Hadaway,West) 364legal questions on (Maschk a, &c.)

or

Stone , h‘

lhotomy and lithotr ity

455-6

STONE, chores treated by sulphate of z inc

acute necrosis , pye'mia

sarcina v entriculiSTORBR, uterine tentsS'

roax , laryngeal speculum

180, 193

310, 312

113, 115

372, 375126

Starch , transformation of into sugar in the

stomach (Bardeleben , Smith)use in cat of the stomach (Lehmann )

235, 241

Statistics, hospital (Hannov er) 2, 10

medical (Vierordt) 95, 102

Steam, inhaling of, by the tracheotomiz ed(Debenham) 220, 225

Stearrhwa n igr icans (Harvey) 264,S'rn LB , ease of intus tion

S'rxm, modes of applying ectr icity 35

Su mmi t} , inflammation of vena porta

237 , 251Su mmon , first dentition 404

Sn u wa e v ex Cantos , conjunctiv itis ofnewly born 326

Su s anne , syphiliz ation 140, 155Su r n ame, placenta prmv ia . 351

, 352

Stcrcoraeeous obstr

éi ction (Theile) . 236

vomiting (Easton ) 236, 2 17Stereomonoscope (Claudet) 55Stereoscope (C laparede, D

’Almeida) 55Stereoscopic efl

'

ects (Siegert) 51

do. (Serra) 55Sterne-clav icularismuscle (Hyrtl) . 4

Sternum, congenital fissure of (Moeller)416

STEWART, compressed sponge, antilactescent

384, 384

58

See L ung-fest.STIL LMAN, caries of as calcis 312, 319Stimuli, electrical 35STOLZ, artificial premature labour 35 4, 357Stomach, diseases of (Brinton) . 234, 237

do. (Ok e) 235 , 240do. pain as a sign of (Haber

shon) 237 2 51

acids in

OVells) . 202catarrh of, curedby starch (Lehman n )

235 , 241degeneration of submucous coat of (Rich)

chron ic inflammation of (Leared)234, 239

tumours m(Kennedy) . . 235, 239ulcer of (\Vade)

Stomatitis, ulce ra tive (Hutchinson ) 234,do. of soldiers (Bergeron)

236, 249

295

11111311. 529

mm tramfimnation o! guanin into

84. 93on sarltin 84, 93

M o , health of children 398, 394m e n a, small intestine twisted on its

do.

13, 16

W e mtamorphmmenvenisti)”

in the 82, 86in the ohy 82, 85

in chyle aud analysis85

transformation of starch into , in the69, 72

82, 86

82. 84 Michaeha l’leiachl,(Bellie

s? . 141, l 77

Femag’s hquid for detsction ob o

zoo822-3

delicate tast ier (Lowenthal) 95, 103 87 . 47w as.

maest hxdiet 115

m ‘

r, ulceration of

m 1'Vade Mscum’m-uitt) .mm

530 INDEX .

Tartar emetic in chores (Gillette) . 179, 184

in contractile tissuest1ssues (HOppe) . 269, 272

M iocalityofl Klsats ch) 58

58

M l , stricturemd enlarged prostate ,299

Tam n, amenorrha a treated by electn‘

cit

y3 3

306, 308

chronic inversion of womb 368, 370

M 14

of (Johnson) 255atrophy of, in infant . 304malignant cystic disease of (Curling)

304,fimgus of, in syphilis (De Marie) 304, 305congenital absence of (Godard) .

supernumerary (Fl l) . 414, 417Tstanomoter,mec (Heidenhain)35,

324

Tetanus (Erichsen)induced bythe constant current (Pfluger)

36,treatment of (De Morgan ) 179, 183

do. bywoorara (Broca, Harley,_Wells) . 104, 106

by extract. canneh. indie.

Sk use) 184

traumatic, cases.

of 324, 324

do. (M‘Ghie) 324, 324

do. from wound of radial artery

(Canton) 324

(Hughes) 324, 324

Tm nam, rabies and hydrOphobm

do.

diseases of thyroid gland

Tfierapss tics , report by Handfic ldJ ones, M

'

.B . 124-272

Thermometer-tube in bladder (Comings;3

Ta n ne r , puerperal fever

Tn xsas xssr . See Glsge.

h, ununited fi-acture (Fergus on )

310, 3

381, 3

Tnoxrsos , on the prostate 1

stricture of sigmoid flexure 286.

300, 30]

268,h ouses , external use of medicine

;65

210,Thoracic members in man and in anim(Martins) 13,

Tnom nm, dysentery, w ith aneurismaorta 237 ,

Tnoar, vesico-vaginal fistulaTnom xm, influence ofmuscular exercisn

Thrombosis of crural arteries (Flogel)210

Thrush (Briquet, Flugel, Gubler) 404,Tnvmcn tm, gall-stones 254,

Thymus gland (Friedleben ) 84,

(Fried leben , JendramkThyroid gland, function omeris) 84,diseases of (Thamba 283,

T im e s,mechanismOgdelivery 364

TILT, pe riton itis 37 7 , u

chron ic uterine disease . 373

Tw ee favosa, oil of naphtha m (Chapelle)

Ti sssms , bite of v iper bicorne 139,Tissue, connective,mthe brain (lacubusch

colouring of, w ith carmine (Wittich )4metamorphosis of, influence of

acid on (Kletz insk y) 95,TODD, cyclopsedia of anatomy 1,

(A.) stricture of rectum 286,admin istration of chloroform 111,

(L. B .) laceration of uterus 342,

Ton e s, dental surgery 334,Tongue, papillze of (Beau) . 58

formation of cicatrices on (Ullman )235,

extirpation of (Fiddes) .

base of, instrument for examining (Pri

of the frog (Fixsen) 27 ,Touch, recognition of distance by (Wundt

5 J

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582 mun .

Ulceration of the aorta (Talley) . 209, 218

of articular cartilage (Barwell) 14, 18

chronic, of larynx (Porter) 281, 282

of duodenum(Bank ing) 286, 248

(L igeborn ) 247

perforating (Wallmann) 286, 248of the s tomach (Wade) . 287 , 251

of os and cervix ute ri (McRuer) 878, 876Un au x, cicatrices on the 285, 244

Um cn , asphyxia from0 cm 224

181, 197886, 890

455, 457414,417

Urwmia dur ing pregnancy (Litzmann )885

Ummic poison ing (Sirelius)do. (Heynsius) 96, 104

Urari (Betz old, Koellik er) .

Una, iodide of sodium 189, 154Urea, proportions in urine (Seller) 94, 97

excretion of, in connection with heat ofbody (Ringer) 94, 99

soda (Leconte)absence of, in urine of yellow fever (Porcher) 95, 108

Ureters, contractility of (Vulpian)U rethra (Caz enave) 96

congen ital anomalies P1cardat) 415, 419contusion and laceration (Demarquay)

con tagious inflammations (n omarf825

traumatic obstruction (Blondeau) 801, 803prolapsus ofmucousmembrane of (Patron )

293, 293

Urethra , str ictures, ca lculi, &c. 800

Urethra, stricture of (Wade ) 800, 301

do. (C iv iale) 302

do. urethrotomy (Leroyd

’

Etiolles) . 800, 802

do. internal urethrotomy(Thompson ) 800, 801-2

do. impenetrable (Uytterhoe i en ) .

Urethralgia 195l rethrotome, new (Boin et) 800, 802

for impacted calculus (Henry) 801, 308

internal (Civialc, Leroy, Sed illot,Thompson ) 300, 302

Uric 1101d (Schiff) . 94, 100

proportions in ur ine (Seller) 94, 97absenceo f, 1n urine ofyellow fev er Porcher)

95, 108

behav iour towards Fehling’s liquid for

detecting sugar (Babo) . 94, 97Urinary deposits, lectures on (Beale) 94, 98

asmicroscopic objects (Beale) . 98

Ur ina ry org ans 98

Urinary organs, injuries and

(Fleming) 800.415, 4

Urine, lectures on (Beale) . 94,

m ph of (Neubauer) . 94, 1

ts of examination of, byHeller 1

commition of human (Geist, K lmggs

uer

Urticaria, factitious (Gull)Uter ine fiexions (Virchow )tents (Storer)

Uterus, statics of (Aran)gravid (Priestley)

Uterus , &c., def ective cond itionsdevelopment, dislocations

3 normal, natural constants of (Ilaugh93,

do. presence of sugar in (Brocche )95, l

do. non-existence of albumen(Becquerel) 95, 1

in health and disease

(B aca ll) . 93,

natural acid reaction Seller ) 94,excretion of, in connection w ith heat

body (Ringer)uric acid and urea in (Seller) 94,allantoin e m(Kohler) . 94, 1

blue deposit in (Beale) . 94,

on reducing the oxide of copper

(Brueck e)phosphates

'

in (Sick)on discovering sugar in (Boettg erga : 2albuminous,treated bymercury(Kenned

253,fungoid productions in alkaline and alb

minous (Hassall) . 114, 1

diabetic reagent for detecting sugar

saccharine (Cruse) 95, 1

diagnosis of melanotic cancer by (Eise l139, 1

of yellow fever , absence of urea and

acid in (Porcher) . 95,of the dog, creatine and cynuric acid

(Liebig ) . 94,extravasation of (Coote) 298,retention of, in a child (Wormald )

301,do . fromengorgement of prosi

(Mercier)do., symptomatic ofmetritis (Nonat)

872

do. puncture of bladder (Page t) 298,suppression of (Alexander) 253, 2

incontinence and retention , after labo(Martin) .

do., in children (Hewson ) 258, 2

do. (Bercioux, Destouch

Pluv iez )simulated adulterations of (Heller)

265 ,868,872,867 ,885,

mm . 588

d m tbe heart’s actieu

27 , 81. 387 may ,

Mi?catarrh purgative enemata in urau)

chancre ofl Kollock )W i g w am-M M )

87 2

. 842 847 Vam action ol contractsd muacles ou

the atmosphsre . 20. 22’

Dialer,

BB B ULII I , m.

m0

0, the "?

-treatment of infiammstim by dig ital

do.

. 872 874Varieocclemeistou)

Vsrioia. combination with other diseases

(Gintrac) . 410 412Vast-ala rmVsina pulmouary. abnesmity d w

Veua cava auomalous course e!

mm am <w >°

maos m m m orand reracsinatiou (0auae, Pimen t o.)da in thc amymssd) .mm

34 INDEX .

(Guerard ) 467

entricles, communimtiou between the

Dusch ) .

annu a l“ , rarity of phthisis on seacoast

ermiformappendix, perforation of (Bamberger ) 235, 243

n us cmhtoppage of the rad ial pulse

during forcible ex tension of arm 26, 29

38 2 018, influence of dust on health of

artisans 472, 472

(Maschk a) . 427

ertebral characters of pteroaauria (Owen )

xxx, hydrocele of tunica vaginalis 805u m, question of sound mind 458

monD'

r , medical statistics 95, 102

m u m , lying-ia hospita ls 887nu s , congenital encephalocele 415, 420

.per bicorne, bite of (Tisseire) 139. 149mcnow , discourse on Prof. Mi

‘

iller 8

cellular pathology 3, 12

do. and on irritation 127-8inflammation and suppuration 12

ascites in new-born child 414, 417

parenchymatous inflammation 124, 180

acute inflammation of parotid gland

235, 241

the true neuroma 124, 126

puerperal diseases 887 , 392

constitutional syph ilis

andRox I'rax s ,uterineflexions

scera, abdominal, malpos ition of (Habershon ) 251

do. location of, iii case of

dysentery,d

.&c (Thornh ill) . 287 , 250

do. diseases (Ward) . 254, 261

sion, single (Siegert) 51

derangement ofmutual (Graefe) 55

efl‘

ects of santon in e on (Martin i, Mialhe)52, 54

binocular (Panum) 55

do., theoryof“relief

”1n (Giraud Teulon )

55

do. influence in calculating d istance

(Dov e ) 55

ta l capacityof the lungs (Arnold) 67do. relation w ith pulmonaryafl

’

ec

tion (Schnepf) 67do. efl

‘

ect of old age on (Geist)

causes (B eale) .

6

2

point, cause of death

.

after nemor al of(Brown Sequard )do., new observations on (Flourens)tality, influence of, on secretion ( Inman ,

Spender) 77 78

of nerve-fibres. (Konik er )

can . See Nesba ssr .

hydrostatic test for the lungs

5 456

medical laws of Nassaudo.

aneurismof hepatic artery

VOG ‘

r, paralysis of children 394, 395

Voice, loss of, cured by electr icity (Posn er )220, 225

Voxsn t, retro-uterine hasmatocele 37 7 , 380

Vonxm x , on irradiation 52, 55

efl'

ect of practice in recognis ing th e d is

tance betw een two points placed on the

limb at the same moment 59, 61

Voltaic narcotism for local an e sth esia

(Richard son ,Waller) 110, 111-12

VOL ‘

I‘OLINI, afl'

ections of the ear fromscarlet

fever 395

Vomiting , action of pneumogastr ic'm (Bula

towies)in catarrh of the stomach (Lehmann )

235, 2 41

in cy (Barker, Dez ou, Hergott,T . Smit Ulrich ) 386 , 890

of blood from ulcers in duodenum(L i GM ) 0 a 236, 2 27

of ood (Duncan ) 235, 242

stercoraceous, in

.

o

bstruction of the bowels

(Easton ) . . ,sss 247V088, inversion of tirinarybladder and luxation of h ips . 294, 294

e u , contractility of the blood-vessels

duration of the heart’s action after death

do.

crusaingof nerv e-fibres in the cordeflSct of stimuli applied to the liv er and

kidneyson the supra-renal capsules 83, 92

normal presence of fat'

1n the supra-renalcapsules 83, 92

contractility of urete rs 96, 104

frogs poisoned by an imal exhalations105

artificial respiration in poisoning w ith

105, 109

Vulvar hypermthesia, glycerin e in (Paupert)881, 888

WADE, ulcer of the stomachurethral stricture

WAGENER,development of eutoz oa 114, 117

WAGNER , physiology 10

human cervical sympathetic 39, 50

on uterine cancer 127

flbrinous polypus mute rus 37 2, 375

WALD , legal med icine 422, 423

WALLs a , transfusion of blood 842, 348

cutaneous absorption 74

extra-uterine foetation 341, 343

on section and degeneration of n erves

(Bernard ) 39

experiments on Richardson’s mode of

voltaic narcotism 110-11, 112— how actinimk ill their prey 106

WW W , patent foramen ovale in the

adult 27 , 34

209, 217

211

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104, 108-9Kellik er)

108

_Walls

). . 104.107

(Vulpian)Wom won'm, cyst

“mthe orbit 327.330Wonsam, symptoms d stone.&o. 296, 297— retention of urine in a childWorms, cerebro-spinal symptomatology of

Heslop)W0ou s, inflammation

210. 218

Wounds qf th ch st

Wounds,mmutiny in India (Willis?)

28

“m “ “m in a s

Billroth 273, 273-4

(J aeisou) . 285do. by conipresséd air P(Pehk an

425do preparations of (W1lliamson'

INDEX .

WRIGHT, es

;of hydrophobia

enlargement of lymphatic glandsWw w ,muscular movement

Xanthie oxide, on presence of (Kletz in sk y)194,

— normal in the body (8cherer) 84,transformation of guamn

'

into (Strecku

Yellow fever (Ba chon) 189, 1

at Jamala ,

’m1856 (Lawson ) . 140, 1

absence of urea and uric acid'

111 ur ine

(Porcher) 95, 1

304,

b ut , syphilismchildren . 413

Zn ssme , breathing of child as test of life455,

J . I . ADLARD, PRINTER, BARTB OLOH‘W

84,a s , isters in Ostf'riesland . 465

a sss s , c orda tympani 39

Zinc, poison ing by (Ogle, Santesson )450.

oxide of, in sweats of phthisis (Jack son253, 2

chorea (Stone) 180, 1

simulation of idiocy 451, 4