the presence of the larger amount of oxalic acid, part of which existed in an insoluble condition, probably as an alkaline salt. The experiments performed with tartaric acid and its salts prove that part of the acid passes into the urine, whenever it is taken in large quantity, but the amount contained in the urine forms only a few per cents. of the total amount taken, the rest having probably undergone decomposition during its passage through the organism. The circumstance of the acid being taken as such, or in the form of one of its salts, appears to exercise no influence on the amount excreted. Citric acid, when taken alone, or in its combinations with soda and magnesia, in doses from ten grains to sixty grains within a few hours, was not found again in the urine. Benzoic acid, as observed already by others, is excreted in the shape of hippuric acid. The benzoates of soda, of ammonia, of magnesia, and oxide of iron, lead likewise to the excretion of a corresponding amount of hippuric acid in the urine. Hippuric acid appeared in the urine in the quantity in which it had been taken; the whole amount of the acid was likewise found in the urine, when it had been ingested in combination with alkalies. After the ingestion of fifteen grammes of succinic acid within ten hours, no trace of this acid could be discovered either in the urine or in the alvine excretions. The same negative result was obtained in the experiments with succinate of soda and succinate of lime. We may therefore conclude that succinic acid undergoes a rapid decomposition in the human organism.

V. NERVOUS SYSTEM..

1. CHAUVEAU: On the Functions of the Spinal Marrow. (L'Union Méd., tomc xi., 1857.)

2. SCHIFF: On the Ethesodic Nature of the Spinal Ganglia. (Moleschott's Untersuchungen, Band ii., p. 56, 1857.)

3. PINCUS: Experiment on the Pneumogastric and Sympathetic Nerves. (Vratislaviæ, 1856; and Canstatt, 1. c., p. 136.)

4. SAMUEL: De vi Nervorum ad Vasa, Temperaturam et Secretiones. (Berolini, 1856; and Canstatt, 1. c., p. 136.)

5. KNOCH: De Nervi Sympathici vi ad Corporis Temperiem. (Dorpati, 1855: 1. c., p. 136.)

Chauveau endeavours in the present paper to refute two of Brown-Séquard's principal statements-1. The crossing of the sensitive impressions immediately after their intromission into the spinal marrow; and 2. Their conduction to the brain by means of the central grey substance. With regard to the crossing of the sensitive impressions immediately after their entrance, Chauveau shows, by section of one-half of the spinal marrow in horses and pigeons, a, that the sensation of the parts of the same side supplied by nerves from below the point of section is destroyed; b, that the movements caused by pinching or other irritation of this side, are reflex movements; c, that the sensation of the side opposite to the section is not destroyed, as it ought to be, according to Brown-Séquard's view. Concerning the grey substance, the author repeats his former assertion,* that it has nothing to do with the transmission of sensitive impressions. He performs the principal experiment on which Brown-Séquard's view is based-i.e., the dissection of the anterior, lateral, and posterior columns of the dorsal portion of the spinal marrow, so that only the central grey substance remains intact; he explains the phenomena observed on such an animal, and interprets them as caused by reflex action. The phenomena of real pain, whenever they are manifested, follow the purely reflex movements. "Il y a," Chauveau adds, encore ici irradiation de l'excitation dans la partie antérieure de la moëlle, par la substance grise centrale, et réflexion de cette excitation

41-XXI.

66

* Conf. this Journal, vol. xxxix. p. 251.

16

non sentie sur des organes sensibles, où les contractions qu'elle suscite causent de la douleur." The author farther makes, in a pigeon, a transverse section of the whole lumbar portion of the spinal marrow, with the exception of the posterior and lateral white columns of the left side. He then shows that the sensation of the left foot is preserved, although not a trace of grey substance had remained uncut.

"Ethesodic," Schiff calls, with Brown-Séquard, those parts "which are endowed with the faculty of conveying sensation, the local irritation of which, however, does not cause any sensation." As Brown-Séquard had contended that the spinal ganglia themselves are not sensitive, while he had found the posterior roots on either side of the ganglia very sensitive, Schiff exposed several spinal ganglia in frogs, and found in every instance so marked a sensibility in these ganglia, that he appeared at a loss to explain how BrownSéquard could have arrived at another inference.

It will be remembered that Brown-Séquard, as well as Schiff, had attributed this curious "æthesodic" nature to some parts of the grey substance of the spinal marrow, while Chauveau's experiments make the existence of such a quality in the grey substance at all events very doubtful.

Pincus communicates a series of experiments on the influence of the vagi and the sympathetic nerve on the organs of nutrition. Section of both pneumogastric nerves, below the diaphragm, in rabbits, cats and dogs, was not followed by loss of the motile power of the stomach; but the gastric juice secreted was alkaline: did not possess the virtue of digesting albumen and coagulating milk. Hyperæmia, as well of the stomach as also of the upper part of the small intestines, was among the prominent symptoms. Some small effusions of blood and ulcerations were found on the mucous membrane, espe cially in the rabbits. Extirpation of the solar plexus is always followed by more intense alterations than are observed after section of the vagi. Extirpation of the mesenteric and aortic plexuses acts in a similar manner on the phenomena of nutrition of the lower part of the duodenum and the upper part of the colon. Transverse section of the spinal marrow on various points does not cause any alteration in the circulation and nutrition of the intestinal tube. The author from this concludes that new nutritive fibres for the intestines are formed in the ganglia of the abdominal cavity. He finds no proof of the existence of a common centre for the nutritive and vascular nerves of the intestinal tube.

Samuel corroborates the experience of others, that a high degree of hypermia of the intestines, with increased secretion (fluid, diarrhea-like contents), is caused by extirpation of the solar plexus.

The dissertation of Knoch, composed under the auspices of Bidder, gives evidence of the correctness of the observation, that section of the left sympathetic of the neck is followed by increased warmth in the corresponding half of the head. This increase of temperature did not always appear immediately after the operation. In one case the warmth in the nose reached its maximum only on the following day. Knoch describes the influence exercised by the sympathetic on the ear of rabbits and on the condition of their eyes. He further describes some experiments regarding the irritation of the regio ciliospinalis, which show that only irritation of the anterior, and not of the posterior, roots influences the pupil. His researches lead him likewise to the view that the fibres acting on the pupil are derived from the spinal marrow-not from a spinal ganglion. Regarding Meissner's important communication on the richness of the areolar tissue between the muscular and mucous coats of the intestinal canal in nerves and minute ganglia, we refer to page 510 of the preceding volume of this Journal. [We regret that we are compelled to postpone the remainder of this Report.-ED.]

* Conf. Comptes Rendus, tom. xxxviii. p. 930.

HALF-YEARLY REPORT ON MATERIA MEDICA AND
THERAPEUTICS.

By ROBERT HUNTER SEMPLE, M.D.

Licentiate of the Royal College of Physicians, and Physician to the Northern Dispensary. I. On the Value of Mineral Waters in the Treatment of Paralysis. By Dr. DURAND-FARDEL. (Bulletin Général de Thérapeutique, April 30th, 1857.) THE author of this paper, after dividing paralysis into two kinds, one being dependent upon disease in the brain, and the other associated with some general constitutional disturbance, as hysteria, chlorosis, &c., proceeds to point out the special objects to be attained by the use of mineral waters in the treatment of paralysis caused by disease of the nervous centres. His views are as follows:-The indication of treatment by chemical waters during the period of reparation of cerebral lesions, is perfectly well understood. This kind of medication, considered generally, increases organic activity, and if it does not exceed due bounds, appears to be proper for favouring and hastening the phenomena of reparation, at the same time that it promotes by direct action the return of the injured functions. It appears legitimate to admit that such is the case, and it may be conceived that when this favourable action coincides with the formal and spontaneous progress of the organism in the same direction, very striking and satisfactory results may be observed of chemical medication in the treatment of paralysis. It must be admitted that this kind of treatment succeeds only in proportion as it proceeds in a consentaneous action with the curative tendency of the organism. If it developes this tendency, or if it only assists it, we believe in this principle, that the excellence of any kind of treatment can be judged only in so far as it may be combined in its action with the spontaneous progress of the organism in the direction of cure. If there should result any confusion in our analysis, and if we do not know exactly what to attribute to the treatment and what to refer to the organism, it is certainly an inconvenience, but one of secondary importance, the chief point being that the results are as satisfactory as possible. Dr. DurandFardel then shows the particular kinds of mineral waters which should be employed in the different forms of paralysis.

The waters containing chloride of sodium are specially adapted for the treatment of paralysis. They present themselves in the form of strong waters, as those of Balaruc, Bourbonne, Bourbon-l'Archambault, La Motte, Wiesbaden, &c.; and weak ones, as those of Néris, Luxeuil, Bourbon-Lancy, Wildbad, Gastein, &c. The sulphurous waters, although generally regarded as among those which are suitable for paralytic cases, have no claim to such a merit, according to Dr. Durand-Fardel. The weakly mineralized waters are especially applicable to paraplegia, and the strong waters containing chloride of sodium appear to have a special action in the treatment of hemiplegia or cercbral paralysis. The thermal stations where the special treatment of hemiplegic paralysis is conducted, are those of Balaruc, Bourbon-l'Archambault, Bourbonne, and La Motte. These waters are very hot-between 48° and 60° Cent. rather unequally mineralized, but all containing a predominant quantity of chloride of sodium. M. Caillat recommends the following thermal treatment at Bourbon-l'Archambault in hemiplegia: one to four glasses of water to be taken internally every day; a bath, of from 34° to 35° C., for ten minutes to a quarter of an hour; douches upon the paralyzed limbs from ten minutes to a quarter of an hour, from a height of two metres, and from 33° to 34° C.; legbaths in the evening, in mineral water at 47°.

In 390 cases of hemiplegia from apoplexy, 26 were completely cured, 317 were decidedly relieved, and 47 were treated without success; one only died during the treatment.

The waters of La Motte are administered at a very elevated temperature, in baths and in douches, with sweating. The patients are subjected in general to the use of the baths at 35° to 37° C. for about three-quarters of an hour, and to six to twelve general douches at 45° to 48°, followed by wrapping in a woollen blanket, and sweating. During this time they take the mineral water internally in the dose of some glasses, with a purgative effect, which is sometimes very considerable. In 14 cases of hemiplegia, of which the history has been related, 4 were cured, 5 very much relieved, 3 a little relieved, and 2 have not experienced any appreciable effect.

The waters of Niederbronn are distinguished from the preceding by being cold, and although more feebly mineralized, are more distinctly laxative. It appears, in fact, that the laxative properties of the waters containing chloride of sodium are very far from being in exact relation with their general degree of mineralization, or the quantity of chloride which they contain.

After a brief exposition of the difference in the causes and progress of hemiplegia and paraplegia, Dr. Durard-Fardel concludes that the use of mineral waters is likely to be more advantageous in the latter affection than in the former, because in hemiplegia the cause of the disease is a serious, and sometimes incurable, lesion of the cerebral mass; while paraplegia, although often depending upon disease of the spinal cord, is sometimes due only to the irritation of nerves which come from the cord.

Rheumatic paraplegia is one of those affections which are most certainly benefited by thermal treatment. The waters of Toeplitz, in Bohemia, enjoy in Germany a great reputation in the treatment of paralysis; their efficacy is said by Dr. Schmelkes to depend upon their high temperature, and this author recommends baths to be employed at 28° to 30° R., with a simple excitement of the skin of half an hour's duration, and baths above 30° R., with brisk stimulation for fifteen minutes at most. Hysterical paralysis, according to M. le Bret, and in general every kind of paralysis depending upon nervous irritation, ought to be removed from the influence of the stimulating waters, that is to say, the active chlorinetted waters. M. Raoul-Leroy d'Etiolles advises the use of the sulphurous mineral waters in hysterical or chlorohysterical paraplegia, and insists particularly on the efficacy of the waters of Baréges in rheumatic paralysis; but Dr. Durand-Fardel, while admitting their value in the latter class of cases, does not admit them to be equally efficient in hysterical affections. In paraplegia caused by exhaustion of the nervous system, the waters containing chloride of sodium have succeeded perfectly well; in such cases, M. le Bret has administered the waters of Balaruc in baths at 38° to 40°, or rather immersions of some seconds' duration, up to fifteen or twenty minutes at most. On emerging from the bath, each patient was wrapped up in a common blanket, and carried, if he could not walk, into his bed, where he soon experienced a powerful reaction. Senile paralysis without organic lesion, characterized by a general weakening of contractility, marked above all things in the lower limbs with palsy of the bladder and rectum, is sometimes remarkably modified by the strong waters containing chloride of sodium; in such cases a true restoration of the organism takes place. As to the treatment of paraplegia consequent upon organic lesions of the spinal cord, it is admitted that the thermal treatment, like every other method of medication, is unsatisfactory, because the diagnosis of these diseases is very difficult; but the monographs on mineral waters often mention beneficial results after treatment in cases of spinal irritation, spinal congestion, and particularly of myelitis. The mineral waters appear generally to be contra-indicated in cases in which abolition of movement is attributable to a mechanical cause, as displacement of the vertebræ, and tumour inside or outside the spinal canal. Nevertheless, M. Lhéritier relates some few observations in which the waters of Plombières have been employed with advantage in cases of paraplegia dependent on deviations

of the spine or caries of the vertebræ. M. le Bret has, in the following terms, clearly indicated the conditions in which the thermal treatment may be applied in myelitis. At the end of certain acute cases of myelitis regularly and efficiently treated by habitual therapeutical means, when there remains a defect of harmony in locomotion, or, so to speak, a want of equilibrium between the muscular system of relation and the nervous incitement, a certain degree of inactivity of the intestine or the bladder; and in certain chronic forms of myelitis, it being understood that there is no advanced alteration of the spinal cord, or that, if it has existed, it is in course of reparation, as may be suspected by the absence of pain on the exploration of the spinous processes, on the return of the functions of the intestine and the bladder, and in subjects who are well constituted, and whose antecedents are favourable.

II. On the Employment of Tartarized Antimony in the Treatment of Chorea. By Dr. ADRIEN MARCOTTI. (Bulletin Général de Thérap., July 30, 1857.) The author of this paper gives an historical account of the various authorities who have recommended tartar emetic in chorea, for which it was first employed by Laennec, under the influence of Rasori, who was then administering this drug in large doses. The results of two cases under the treatment of M. Bouley, in the present year, at the Hospital Neckar, were quite favourable. In the first case, that of a young girl, the chorea had lasted a month, and was increasing in intensity. Large doses of the tartar emetic were given on two successive days, and thirty hours after the first administration of the medicine, all choreic movement disappeared. The patient was at first thrown into a considerable state of depression, but some moments of sleep sufficed to restore her, and the appetite was soon found to reappear. The muscular disorder disappeared, but a bad state of the constitution remained, and recourse was made to tonic medicines to improve her condition. The chorea reappeared under the influence of a fit of passion, but on the administration of the tartar emetic it again subsided. In the second case, the chorea was at first general, and almost immediately became partial. It resisted for six months and a half sulphurous baths, chalybeate tonics, and strychnine, and yielded in twenty-eight hours to the employment of tartar emetic.

III. On the Therapeutical Action of Chlorate of Potash, with a New Mode of Administering it. By Dr. DETHAN. (L'Union Médicale, June 4th, 1857.) Dr. Dethan considers that chlorate of potash is a powerful sialagogue, and that its elective action on the bucco-pharyngeal mucous membrane is well marked. To this physiological action is added a very remarkable and valuable success in pathology; its rapid and incontestable effects in mercurial salivation, by checking the formidable mercurial affection, have permitted practitioners to continue the mercury without fear, and thus to contend without remission against the constitutional infection. As an especial and incontestable remedy in ulcero-membranous stomatitis, this medicine need not, according to the physicians of the Hôpital Sainte-Eugénie, be swallowed; its topical application is sufficient, and in a short time the mucous membrane recovers its normal qualities and functions. Dr. Dethan concludes that the chlorate of potash, administered under a special form, which would permit the local action to be exercised slowly and certainly, although leaving the medicine to be carried into the stomach in a state of solution with the mixed liquids of the salivary, buccal, and pharyngeal glands, would be the mode of administration which would combine all indications and all opinions. He therefore suggests the use of the remedy in the form of pastiles, so that the patient may have at hand