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after long and laborious efforts of two accoucheurs, who were successively tired out. The child was very large and still-born.
It is highly probable that in this country several of the latter children would have been delivered by craniotomy. It may be said that under the method pursued the children equally died; but it may be'urged that a revolting operation was avoided, and that the children had a chance of life.
5. Dr. Maftei has introduced a new form of forceps, which, from its assumed gentle action, he calls the Unieeps. The instrument consists of two similar blades, having the single cranial curve, which nearly accurately fits the cranium. The curve is therefore great. The blades do not lock, but fit into a bar of wood having several notches to admit the stalks at various distances. The blades and stalks are very short Amongst the advantages claimed are that its moderate size enables the accoucheur to use it without the knowledge of the patient; that the blades being more curved, the tissues of the mother are less liable to dragging; that the head cannot be exposed to compression; that it does not require an assistant to help in the introduction. It may be observed that all these objects, except the first, which is not to be commended, are accomplished by properly-constructed forceps, which are moreover capable of effecting what the leniceps cannot do—namely, the bringing a head through a narrow pelvic brim. In the latter case some amount of compression by the forceps is necessary, and may be safely employed.
6. Dr. Martin relates five cases in support of the proposition that inflammation of the Fallopian tubes and discharge of the purulent secretion into the abdominal cavity is a cause of pnerperal peritonitis. He refers to a passage in Cruveilhier's ' Anatomie Pathologique,' in which that admirable pathologist suggested this explanation of some cases of peritonitis. It is right to reproduoe this passage:
"The presence of pus in the Fallopian tube being an extremely frequent phenomenon in peritonitis, I have asked myself if it were not possible that peritonitis was in some cases the result of the passage of pus from the cavity of the tube into the cavity of the peritoneum; if capillary attraction or vital suction be exerted in the act of conception upon the spermatic fluid by the Fallopian tube, might not it bo exerted as well upon the pus or any other liquid contained in the cavity of the uterus?"
, It is desirable to give briefly the cases of Dr. Martin, so as to expose the evidence upon which his proposition is based.
Case I.—A primipara, aged twenty-two, delivered in the Jena Lying-in Hospital on the 8th April, 1839, after a natural labour, of a strong living child. She felt a "chill" a short time afterwards. Suddenly, on the 2nd May, pain set in in the left abdomen; on the 3rd May, this was more intense, and fever was added; on the 6th, diarrhoea and delirium; on the 7th, death. The treatment consisted of twelve leeches applied on two occasions during the first days; castor-oil, opium, camphor, and ipecacuanha.
Autopsy.—A sero-purulent effusion in the lower part of the abdominal cavity; the omentum was glued to the peritoneum in front by puriform gelatinous masses. The uterus and lower intestinal convolutions were also covered with purulent exudations. The uterus was of the size of a large fist; the left tube was considerably enlarged in its outer third, and filled with purulent mucus; the fimbriae were swollen. The right tube had also swollen fimbriae, but its canal was not enlarged. The substance of the uterus was pale, normal, the inner surface reddened and covered with purple blood; there was a muoo-purulent discharge at the placental seat. (It is not stated at what part of the uterus the placenta had been seated.)
Case II.—A primipara, aged thirty-three, was delivered in the Jena Lying-in Hospital on the 5th November, 1853, of a living child, after a natural labour. On the evening of the 6th, there was tenderness in the right side of the abdomen, and fever; ten leeches were applied. On the 7th, there was an offensive discharge. On the 9th, general symptoms worse; hurried breathing with bronchial secretion, diarrhoea, headache. On the 10th, death.
Autopsy.—The uterus rose above the promontory of the sacrum; its muscular structure was anaemic, containing no pus; its cavity, especially at the placental seat at the left angle, was covered with a grey-red pulpy mass, entangling shreds of vessels and pings of blood; the cervical canal was filled with sanguinoleut purulent fluid. At the abdominal extremity of both tubes was a purulent exudation, which was continued throughout the entire mucous membrane; the right tube was much enlarged, the mucous membrane loosened and partly covered with a yellow, purulent secretion; the right ovary was united to the posterior wall of the uterus and the rectum; the left tube was affected in a lesser degree.
Case ILI.—A primipara, aged twenty-five, was delivered in the hospital on the 12th July, 1854, after a tedious labour, of a living girl. In the night she felt suddenly severe pain in the abdomen, which increased; the belly became distended, hot, and acutely painful on moving; ten leeches applied; calomel and opium. Death early on the 14th.
Autopsy.—The abdominal cavity hold a brownish flocculent pus. The lymphatic vessels of either side along the spermatic veins were much distended ; the lymphatic glands enlarged; the larger lymphatic vessels contained pus and small purulent foci. The uterus was strongly contracted; muscular substance pale; vessels empty; the placental seat was on the anterior wall, two inches above the inner os uteri; the remaining part of the inner surface was uniformly reddened, without traces of exudation or suppuration. The tubes, especially the left, were much enlarged; the vessels of the fitnbrire injected; the mucous membrane loosened, thick, and covered at the outer end with a creamy secretion. On the left ovary and tube the veins were distended, and tne lymphatic vessels were filled with whitish fluid.
Case IV.—A primipara, aged twenty-five, was delivered in the Jena Hospital on the 19th November, 1857, of a living boy. In the afternoon of the following day, she had pain in the abdomen, and took ten grains of calomel, and on the 21st, ten grains more. Several stools followed the last dose. On the 22nd, the symptoms had remitted. On the 23rd, however, when seemingly quite well, she got out of bed, and being surprised, leaped suddenly back again. Shortly after this, shivering and acute pain in the abdomen came on. On the 24th, the pain was especially severe in the right side. Twelve leeches applied. On the 25th, the abdomen was distended; everything was worse; twelve more leeches applied. Bronchitis, tympanitis appeared, and death ensued on the 27th.
Autopsy.—A large quantity of bloody purulent exudation flowed from the abdomen when opened. The omentum, where glued to the right iliac fossa, was inflamed. The ovaries were covered with exudation; both tubes at their outer extremities much distended with purulent contents. The inner surface of uterus showed remains of endometritis.
Case V.—A primipara, aged twenty-nine, was delivered in the Jena Hospital of a living boy—labour natural—on the 26th May, 1858. She was quite well for the first weok, excepting that the lochial discharge was profuse and offensive. On the 3rd June the abdomen was painful, and she had three stools. During the 4th and 5th, the diarrhoea continued; she took an infusion of ipecacuanha with acetate of ammonia. On the 6th, the diarrhoea had ceased, and the patient got up to dress; while stooping for this purpose, she was suddenly seized with an acute pain in the abdomen, which increased from hour to hoar; the severest pain was in the right side. It was concluded that this sudden pain was caused by the escape of pus from the Fallopian tube, brought about by the sudden compression of the abdomen in stooping. Ten leeohes applied. Tympanitis, delirium, and collapse followed, and death on the 10th.
Autopsy.—A considerable quantity of purulent exudation was found, especially in the right half of the abdomen, and the principal focus was seated in the right iliac fossa. There was pus in the cavity of the uterus, but no pus in the vessels or muscular wall. The right tube was much dilated, and contained a considerable collection of pus. The left tube was quite normal.
Dr. Martin insists upon the necessity of keeping women who exhibit any symptoms of metritis perfectly quiescent, so as to favour one of the terminations of tubal inilammatiou, which is closure of the fimbriated extremity. Professor Virchow, in some observations upon this paper, said it was a very difficult matter to determine the starting-point of a peritonitis. Every inflammation of the abdomen, no matter how arising, had by the law of gravity a tendency to involve the pelvic organs. Thus in perforation of the stomach or processus vermiformis, inflammations of the tubes and ovaries occurred as much as in primitive disease of these organs. The clearing up of this question did not rest with anatomy, but with clinical observation.
(The lieporter would remark that all the cases occurred in hospital, and that no history is given of the sanitary condition of the institution. If puerperal fever—especially that form urising from hospital air-»-be the consequence of a "blood -poison, the theory here set forth of a fatal peritonitis caused by the accidental escape of a little pus from a localized inflammation of the Fallopian tube, does not appear sufficiently proved.)
On the Mode of Preparation and Preservation of Normal Hydrocyanic Acid.*—M. Dannecy, of Bordeaux, has adopted the plan proposed by Everett, for obtaining hydrocyanic acid, which consists in decomposing a quantity of cyanide of silver by its equivalent proportion of hydrochloric acid diluted with water. The formula which M. Dannecy employs is founded upon that of Everett, and it has the advantages of being easy and very rapid in its application, and of furnishing a perfectly pure acid with proportions which are always exactly alike.
On the Best Form to be given to certain Pharmaceutical Preparations intended for External Uee.f—In an article in the 'Bulletin General de Therapeutique,' it is remarked that greasy applications to the skin do not possess in general, any great therapeutical efficacy, and it is therefore suggested that they might be advantageously replaced in many instances by saponaceous compounds. In studying the action of the latter, M. Deschamps composed a soap with iodide of potassium, and rubbed it in four times upon his epigastrium. He analysed his urine in the intervals of the frictions, and found it to contain appreciable quantities of iodine. He afterwards washed with water the part which had been rubbed with the soap, and ho found in the liquid some fatty acids arising from the decomposition of the soap by the fatty acids secreted by the skin, together with iodide of potassium in solution. These washings were continued for five days successively, and every day some iodine and fatty acids ,were obtained. These facts prove that the skin is easily penetrated by saponaceous compounds; that the skin rejects a part of the principles which it absorbs; and that therapeutical agents may pass through the skin, diffuse themselves in the system, produce physiological effects, and be expelled by the ordinary passages. M. Deschamps has therefore proposed to employ certain saponaceous compounds, instead of liniments and pomades, in cases where the surface of the body, where these preparations are to be applied, is not denuded! These soaps contain respectively iodide of potassium, laudanum, ammonia and laudanum, extract of belladonna, sulphuret of sodium, and digitalis, combined with an alcoholic solution of soap.
Adulteration of Valerianate of Iron.\—The valerianates are often adulterated, the adulteration consisting of the mixture of some salt with a certain quantity of essential oil of valerian. M. Monnerat has given some easy methods of detecting these adulterations. He found that the false valerianate had a deeper colour than the true, and that it was insoluble in alcohol and ether, and that, when treated with boiling water, it gave after cooling, a deposit of Bubcarbonate of iron and a considerable quantity of essential oil of valerian floating upon the surfneo of the liquid. Besides, the true valerianate of iron is insoluble in water, but on the contrary, is entirely soluble in alcohol. Another character of the true valerianate is its acid, disagreeable, persistent smell, which is very different from the penetrating odour of valerian presented by the false valerianates formed by the addition of the essential oil of the plant.
Arwdyne I.iniment in Otitis.^—M. Trousseau recommends the following liniment in acute otitis, namely a mixture of the alcoholic extract of belladonna in water, with glycerine. A cotton ball, soaked in the mixture, to be placed in the external auditory canal.
A Homely Substitute for Cod-liter Oxl.\—Mr. McSherry, of Baltimore, relates the case of a patient who was suffering from phthisis, and for whom cod-liver oil was prescribed; after some time he again came under notice very much improved in health, and it was ascertained that he had made use of dog fat, which remedy he hail tried at the suggestion of some of his friends. On auscultation it was discovered, that there was a cavity in the lungs with its walls cicatrized. Mr. McSherry does not assert that dog-fat has any virtues superior to other animal fats, but he states that this inelegant remedy appears with certain classes in America to be both popular and successful.
Formula for a New Elixir of Pepsine.H—The syrup of pepsine, recommended by M. Corvisart, not being capable of preservation for a long time, and the elixir of Garus having a disagreeable taste, M. Mailhe has invented a formula of pepsine associated with wine, alcohol, and sugar, in sufficient quantity to conceal the peculiar taste of the ferment. The proportions are six grammes (about 3 iss.) of amylaceous pepsine, twenty-four grammes of distilled water, fifty-four grammes of white wine of Lunel, thirty grammes of white sugar, and twelve grammes of spirits of wine. This elixir has a very agreeable taste, and women and children
can take it with pleasure. It is administered immediately after each meal, in the dose of a tablespoonful, containing exactly the qnantity of pepsin necessary for digestion, namely, one gramme (about fifteen grains).
Ready Method of Recognising a Mixture of Citric and Tartaric Acids*—M. Bnrhet recommends that a slight layer of caustic potash, should be laid upon a plate of glass placed horizontally, and that then a part of the mixture of the doubtful crystals should be thrown upon it. At the end of a few seconds the crystals belonging to the tartaric acid become white, and even quite opaque, becoming covered with little microscopical crystals of bitartrate of potash, while the fragments of citric acid remain diaphanous, being partially dissolved in the alkaline liquid. The difference is so well marked, that the relative quantity of both acids may be very accurately determined.
A New Mode of Preparing Hydrate of Magnesia as an Antidote to Arsenious AcidA— The hydrate of magnesia having been proved to bo superior to peroxide of iron as an antidote to arsenions acid, M. GueYin has proposed a new plan of preparing the former, which consists in substituting ammonia for potash in the precipitation of the magnesia. The sulphate of magnesia is the salt employed. The hydrate of magnesia may be prepared extemporaneously by rapidly dissolving a considerable quantity of sulphate of magnesia in common water, and adding to it some caustic ammonia, until the ammoniacal smell is perceptible; then the whole is to be filtered, the hydrate of magnesia collected, and administered in a state of suspension in water. Tho superiority of tht mode of preparing hydrate of magnesia is said to consist in the entire absence of potash in the preparation; for in the treatment of arsenic poisoning, if any portion, of potash should be present, an arsenite of potash would be formed, and the risk of the patient would be increased instead of being diminished.
Ethereal Oil of Horse-Chestnut as a Local Remedy in Gout and Rheumatism.\—The bark of tho horse-ohestnnt, from its containing a bitter principle, forms a tonic medicine which has been classed among the substitutes for quinine; the roasted pulp has been recommended in atonic uterine haemorrhages, and the ethereal oil has been indicated as a topical agent at the commencement of gouty and rheumatic attacks. This oil is obtamed from the powder of the horse-chestnut by treating it with ether, which takes up tho oil, and afterwards evaporating the ether. This oil is employed as a mild inunction on the inflamed part, and when there is great sensibility, the inunction is employed in a circular course round the inflamed part, so as to arrive gradually at the centre. Dr. Masson, who has made numerous experiments with inunctions of the ethereal oil of horse-chestnut as a method of arresting the local symptoms of gout, states that he has remarked an exasperation of the pain during the first half-hour following the application, but that after this period there was manifest relief.
Formula for the Combination of Nitrate of Btmuth with Copaiba and Cubebs.§—According to the observations of M. Caby, the nitrate of bismuth combined with balsam of copaiba and powdered cubebs, possesses the property of neutralizing the irritating effects produced habitually by these medicines on the digestive canal. The formula which is employed at the Hospital of St. Lazare is a mixture of equal parts by weight of balsam of copaiba, powdered cubebs, and nitrate of bismuth, with some essence (of peppermint as a flavouring ingredient. This combination is said to be supported easily by the most delicate stomachs; there is no excitement, epigastric heat, or diarrhoea, so that the action of the medicines being entirely concen-. trated upon the genito-urinary passages, the desired results are more rapidly and easily
On an Inexpensive Mode of Administering the Protiodide of Tron.j—The protoxide of iron has been given in the form of pills, syrup, or oil The first two furnish good preparations, but they are expensive, and as the treatment with iodide of iron often requires to be long continued, the poorer classes of patients are sometimes obliged to abandon its use. The mode of administration recommended by a Belgian pharmaceutist is by preparing a solution of iodide of iron in such proportions that one or two drops represent five centigrammes (about one grain) of the iron salt . Thus is preserved in a stoppered bottle, and some iron filings are added, in order to preserve it from decomposition. When the solution is to be used, one or two drops of it are poured either upon a piece of sugar or in a spoonful of water, beer, or gruel. *
On Vie Combination of Iodine and Sulphur by the Medium of Oil.H—The combination of iodine and sulphur having very little stability, M. Vezu, a pharmaceutist of Lyons, has proposed to combine the iodine and the sulphur by dissolving them each separately, beforehand, in oil of sweet almonds. The sulphur is heated in the oil until it is dissolved, but the iodine is dissolved in the oil while cold. The resulting compound has the taste and smell of heated oil, and has a chestnut colour.
• Bulletin 06n6ral do TMrapeutlqne, Sept . 80th, 1S58. t Ibid., Aug. With, 1858.
BOOKS RECEIVED FOR REVIEW*
The Book of Prescriptions, containing 8000 Prescriptions. By Henry Boazley. Second Edition. London, 1359. pp. 548.
The History of Prostitution, its Extent, Onuses, and Effects throughout the World. By William W. Sanger, M.I>. London and New York, 185S. pp. 685.
Archives of Medicine. Edited by Lionel S. Boale, M.D.. F.R.S. No. 111. Loudon, 1858.
Ophthalmic Hospital Reports. Oct. 1858.
rntereuchungen Ober Ursprung und Wesen der Fallsuchtartigon Ziickungen bcl dcr Vcrblutnng, so wie der Fallsucht uberhaupt. Von Prof. A. Kussmaul and Adolf Tenner. Frankfurt. 1857. (Reprint.)
A Handbook of Chemical Analysis. By F. T. Conington, M.A., F.C.S. London, 185S. pp. 290.
Tables of Qualitative Analysis to accompany Conlngtonss Handbook. London. 1858.
Memorial ,le Sanldad del Eicrcito y Armada. No. I.— IV. Madrid, 1858.
Observations and Notos on tho Arteries of tho Limbs. By Thus. William Nnnn, F.M.C.S. London, 1853. pp. 27.
Medicines, their Uses and Mode of Administration. By J. Moore Nclignn, M.D. Fifth Edition. Dublin, 1858. pp. 020.
On Stricture of the Urethra. By Samuel G. Wilmot, M.D. Dublin, 135S. pp. 219.
Reports relating to the Sanitary Condition of the Strand District, London. By Conway Evans, M.D. Loudon, 1858. pp. 82, and Appendix.
Medico-Chlrurgical Transactions. Vol. XLI. London, 1S58.
Princlpes de Meeanlquo Animate. Par Felix GlrandTeulon. Paris, 18.VS. pp. 488.
An Expository Lexicon of tho Terms, Ancient and Modern, In Medical and Ooneral Science. By R. G. Mavne, M.D. Tart VIII. London, 1868.
The Liverpool Medico-Cbirurgleal Journal. January, 1859.
Annual Report of the Kent Lunatic Asylum. Maidstone, 1358.
A Manual of tho Philosophy of Volco and Speech. By Jamos Hunt, Pild. London, 1859. pp. 422.
A Treatise on Fractures. By J. F. Malgalgno. Translated from tho French, by J. II. Packard, M.D. Philadelphia, 1859. pp. 675.
Johann Muller: an Eloge pronounced in the Hall of the University of Berlin. Bv R Vlrchow. Translated by A. Mercer Adam. M.D. Edinburgh, 1859.
Membranous Croup: a Paper from the Boston Medical Journal. By George (Jay, M.D.
Portsmouth Times and Naval Gazette. Jan. 8, 1859.
Edinburgh Veterinary Review. Jan. 1859.
Chloroform as an Anaesthetic By Thomas Skinner, M.D. London.
The Healing Art the Right-hand of the Church. By Therapeutos. Edinburgh, 1859. pp. 279.
Second Annual Report on the Health of the Parish of Mnrylebone, year 1857. By K. D. Thomson, M.D. London, 185a
Man and his Dwelling-place. London, 1859. pp. 416.
The Soul and FuturcLife, By Thomas Cromwell, MD. London, 1859. pp. 807.
Practical Observations on the Operations for Strangulated Hernia. By J. H. James, F.K.C.S. London, 1859. pp. 95.
On the Prevention and Treatment of Mental Disorders. By George Robinson, M.D. London, 1859. pp.228.
On the Kelatlon of Psychology and Physiology. Glasgow, 1859. (A Review.)
On the Fartus in TJtero, as Inoculating the Matornal with tho Peculiarities of the Paternal Or-anisms. By Alex. Harvev, M.D. Glasgow, 1859. (Reprint.)
On Hospital lustruc tion. Bv J. M. OsFerrall, M.R.LA. Dublin. 1S59. pp. IS. (Reprint.)
The New York Journal of Mediclno. Jan. 1S59.
Observations on the Historv, Pathology, and Treatment of Cancerous Diseases. By Oliver Peu.oerton. Loudon, 1858. pp. 88. (Reprint.)
Veterinary Medicines, their Actions and Uses. By Finlay Dun, V.S. Second Edition. Edinburgh, 1859. pp. 520.
The Irritable Bladder. By Frederick S. Gant, M.R.C.S. London, 1359. pp. 186.
On the Treatment of Anchylosis. By B. E. Brodhurst, Senior Assistant-Surgeon to the R. Orthopaedic Hospital. Second Edition. London, 1S39.
The Diseases of the Stomach, with an Introduction on its Anatomy and Physiology. By William Brtnton, M.D., F.R.O.P. London, 1359. pp. 406.
Engravings of the Ganglia and the Nerves of the Utorus and Heart. By Robert Lee. M.D., F.R.S. London, 1858.
A Treatise on Diseases of tho Air-passages. By Horace Green, Ml). Fourth Edition. New York, 1S58. pp.848.
Selections from Favourite Prescriptions of Living American Practitioners. By Horace Green, M.D. New York, 1858. pp. 206.
Lectures on Chancre. Delivered by M. Ricord, Translated by C. F, Maunder, F.R.C.S. London, 1359. pp. 244.
The Transactions of the American Medical Association. Vol. XI. Philadelphia. 1S5S. pp. 1027.
General Debility and Defective Nutrition. By Alfred Smee, F.R.S. London, 1859. pp. 9S.
On Poisons, In relation to %ledlcal Jurisprudence and Medicine. By A. S. Taylor, M.D., F.R.8. Second Edition. London. 1859. pp. 868.
A Practical Treatise on tho Diseasos of Chlldron. By D. F. Condle. Fifth Edition. Philadelphia, 1858. pp 762.
A Treatise on Human Physiology. By J. C. Dalton, Junior, M.D. Philadelphia, 1S59. pp 608.,
The Causation and Prevention of Disease. By John Parkin, M.D. London, 1S59. pp.191.
The North American Medico-Chlrurgical Roview, Jan. 1859.
Charleston Medical Journal. Jan. 1859.
Medico-Legal Observations upon the Case of Amos Greenwood. By W. R. Wilde. F.K.C.S.I. Dublin, 1359.
On Wounds nnd Injuries of the Eye By W. Whito Cooper, F.R.C.S. London, 1559. pp. 880.
The Mortality after Operations of Amputation of the Extremltios. By Arthur E. Sansom. Prize Essay. London, 1359. pp. 28.
Sehiff, Lehrbuch der Physiologic, naft 8. 1858.
A Handbook of Hospital Practice. By P.obort D. Lyons. K.C.C., M.B.T.C.D., M.R.I.A. London, 1S59. pp. 187.
On Dislocations and Fraotures. By Joseph Maclisc. F.R.S. Fasclc. VII. London. 1859.
American Medical Monthly. Dec. 1*58. Jan. 1859.
Third Report of the Clinical Hospital, Manchester. By James Whitehead, M.D. London, 1859. pp. 117.