pletely hepatized; when cut into a sanious matter flowed out. The left lung is partly atrophied, being compressed by the heart, which lies transversely, and occupies a great part of the left side of the thorax. The pericardium contains a bloody serum; its inner surface is villous and unequal; where it is reflected over the heart, it is mamillated, red, and presents several small depositions of coagulated blood, and of false membrane, which form a thin easily separable coating, or layer. of the heart; since there is reason to suppose that this latter affection commenced during the patient's youth. In other cases, we know that pericarditis will ultimately induce enlargements of the heart, just in the same way that chronic cystitis and gastritis will in course of time cause the muscular coats of the bladder and stomach to be amazingly thickened.—Journ. Hebdom. XXXII. SCARLET FEVER. The left ventricle, towards its base, is nearly an inch thick; columnæ carneæ much enlarged; its cavity of the CAUTION TO THE PUBLIC, OR HINTS ON size of a goose's egg; aortic orifice is contracted by cartilaginous incrustations; and the contraction is more obvious, in consequence of the increased capacity of the ventricle. The right ventricle is equally hypertrophied, and its walls are at least five lines in thickness, towards the base. Both auricles are dilated proportionally to the augmented size of the ventricles. All the cavities of the heart are filled with blood, partly liquid, partly in clots. The auriculo-ventricular orifices, and likewise the orifice of the pulmonary artery, are quite pervious and free; only a few trifling incrustations are to be observed on their valves, and also on different points of the aorta. The weight of the heart, when all the large vessels are detached from it, is nearly one pound and three quarters, (800 grammes); its size is double that of a man's fist. Reflections. This case is interesting on several accounts. The walls of the right ventricle are five lines thick; Laennec never saw them to exceed four lines. The frequent inflammatory attacks on the lungs are probably refer able to the blood having been driven into the pulmonary vessels with greater force; the bloody sputa, and copious expectoration, owed their origin to the same cause. The present case also proves that in a progressive enlargement of the heart this organ, by pressing on the inner surface of the pericardium, may induce a chronic inflammation, the pericarditis being thus probably consecutive to the hypertrophy THE author of this brochure appears to be gifted with qualities somewhat akin to those of the late Lord Castlereagh, of whom it was said, that his chief merit consisted in maintaining an immoveable equanimity of temper, and in being able to discourse on any topic for an hour or two at a time, and when he had finished, none of his hearers could say what he had been speaking about. So it is with our unknown Durham friend; he has been anxious to make a book, and in this he has succeeded, for we have got no fewer than upwards of 150 pages of well-printed letter-press. Why, then, should he have concealed his name? and why should he voluntarily deprive himself of the "summi honores" of authorship-of seeing his name in print? The sum and substance of the book is, that scarlet fever is infectious (who doubted it?)—that its virus is peculiar (who thought otherwise?)-and absolute (pray explain what is the meaning of an absolute virus ?)—and that it is specifically infectious in its mildest, as well as in its most malignant form; an assertion which will not be contradicted. The author does not deem it worth his while to establish the truth of the above positions by any facts or observations drawn from experience; but vehemently commands conviction, by very copious snatches from multitudinous books. The readers, who, by the bye, are assumed to be chiefly the non-professional public, are referred to Heber den, Willan, Binns, Rosenstein, Maclean, Paley, Bacon, Herschel, Salt, Adams, Jameson, and a host of others: they are favoured with a few poetical extracts on metaphysical subjects, and their attention is particularly directed to the analogy and close affinity between the cholera morbus (that prolific parent of octavos and duodecimos) and those swellings about the anus vulgarly denominated "piles," or "emerods" in the language of the Old Tes tament. We hope that none who peruse this sage Durham work may be, as we confess that we are, sitting in the shadow of darkness: we have strained our minds to cracking, in order that we might be able to comprehend the said analogy; but we have hitherto woefully failed; yet how can we refuse to yield our credence when such mighty men as Bishops Hall, Warburton, and Wilson; Ostervald, Pyle, Bryant, Lucian, and that most surprising author Gyraldus "de Miscellaneis Deis" are adduced to vouch for the correctness of the opinion!! Our motive for alluding to this very curious disquisition is that we are afraid that very few, if any, may ever chance to see, and if they see, to have the taste to read, our Durham friend's book. Moreover cholera is too interesting a subject to be passed over; our author's opinion is at least quite new, viz. that this scourge is probably the same as is described in the 1st Book of Samuel, wherein it is written, " And he destroyed them, and smote them with emerods, even Ashdod and the coasts thereof," "and ye shall make images of your emerods that mar the land." It may be observed that the affinity of the two diseases is made more striking by the very curious fulfilment of the command; as may he witnessed in the devices of the caricaturists of the present day, representing cholera, at one time as a "blue devil," and at another as an "emblem of starvation," for no other purpose, than to fright the land from its propriety, and to seize upon and maltreat the doctors. But this allusion to the cholera is only incidental; it is one of the many subjects which the author, in the pleni tude of his riches, touches upon and embellishes with his great learning. The trunk and main branches of the treatise bear the fruit of his opinions on scarlet fever, which we are informed was "one of those judicial visitations which were imposed upon the Egyptians in the time of Pharoah," and which has devastated the different countries of the world ever since. The section on the treatment informs us that at one time the lancet has been recommended, at another time, cinchona bark; and that the author highly approves of the cold affusion. But we have not leisure, or patience to extract any more common-place statements. We are verily of opinion that the marrow of the book might be put into a couple, or three pages. The author is no doubt a young man, at least in composition: his style, as well as the meagreness of novel matter, betrays him;-strained, verbose and grandiloquent, on a subject that requires only a homely and concise narrative. He must in future guard against this error, and not introduce any similes about inundations and torrents to illustrate the course of an epidemic!! "Res, non verba," are wanted in the present day. XXXIII. DEFICIENCY OF THE CEREBELLUM. M. COMBETTE has communicated a very extraordinary case, in which the cerebellum, the crura cerebelli, and pons Varolii were altogether wanting. The patient, a young girl, was 11 years old when she died.-Archives Géner. XXXIV. ORGANIZATION OF PAGANINI !! Ar a late "seance" of the Royal Academy of Sciences at Paris, the sapient auditory were entertained by a memoir on the above subject. Dr. Bennati thinks that the modern Orpheus owes his excellency, not so much to practice, as to an original peculiarity in the organization of his outer man; he tells us that all the machinery of his arms is so beautifully pliant and moveable, that Nature evidently intended him for a great fiddler! Moreover, the trumpets of his ears are marvellously adapted for the reception of sound!! His cerebellum is unusually large; (indicating his love for music we suppose !!) In short, ends Dr. Bennati, Paganini is an inimitable violiniste by the necessity of his corporeal structure !!!—Archiv. Géner. XXXV. PATHOLOGY OF EPILEPSY. MARY L. aged 61, had been subject to epileptic fits, ever since her childhood. At six years of age, she lost the perfect use of the left arm and leg. Menstruation commenced at the usual period, but the frequency of the fits did not abate. On dissection, the parietal portion of the dura mater on the right side, was converted into hard bone. The right hemisphere of the brain was nearly one half smaller than the left; the right lateral ventricle so much dilated, and full of water, that the cerebral substance forming the walls, was only a few lines thick; the thalamus opticus wasted on this side; the left hemisphere was nearly quite normal; the corresponding ventricle of its natural smallness, and the thalamus and corpus striatum healthy. The frontal and parietal bones of the right side were a great deal thicker than those of the left.-Archives Géner. above the os coccygis, which was but imperfectly developed. From the arch of the aorta, was given off, first, a trunk common to the two carotids; next the left subclavian; and lastly the right subclavian arising from the extremity of the arch, and then crossing to the right side, between the œsopha gus and the vertebræ; the abdominal aorta having supplied the cœliac, superior mesenteric, right renal (the left was wanting, and likewise the kidney of this side) and spermatic vessels, divided into two branches on the second lumbar vertebræ. One of these, by far the largest, and appearing to be the continuation of the trunk, gave rise to the inferior mesenteric, and then crossed to the posterior surface of the bladder, along the median line of which, it ran to the umbilicus, where it divided into two. The other branch situated behind the former, first followed the course of the sacrum, then was reflected upwards to the right sacro-iliac synchondrosis, having first supplied branches to the left lower extremity, and left side of the pelvis. The continuation of this vessel, formed the right femoral. The system of the sympathetic nerves appeared to follow the irregularities of the arterial distribution-there being only one sacral ganglion, and no coccygeal. M. Jodin, who has reported this case, is of opinion that the imperfect development of the rectum was dependent on and caused by the imperfect development of the pelvic blood vessels, and very properly directs the attention of medical men to examine whether the connexion always exists.—Archives Génerales. XXXVI. CURIOUS ANOMALY IN THE DISTRIBU TION OF THE BLOOD VESSELS. THE infant was born with imperforate anus, and lived for seven days. Dissection shewed that the rectum terminated in a cul de sac, about an inch XXXVII. RETENTION OF URINE CAUSED BY A FOREIGN BODY IN THE RECTUM. A man aged 67, had suffered for several months from tenesmus and strangury, the urine dribbling away very slowly, and the desire to void it being very frequent. Many surgeons had attempted, but in vain, to sound him, with the view of curing a supposed stricture. On examining the rectum with the finger, a hard substance was discovered, pressing by one of its ends on the urethra; by the other on the coccyx; when removed, it was found to be the bone of a partridge, which, from the patient's account, must have lodged there for two months at least. He was immediately restored to health.Archives Génerales. XXXVIII. INFLAMMATION OF THE MEDULLARY SUBSTANCE IN LONG BONES. THIS accident is by no means unfrequent after amputations of the extremities; and is of a most serious, and too often of a fatal result. If we examine the stump, we observe fungous granulations of a dirty grey colour from the divided surface of the bone; these are tender, if touched by the probe, for the membrane which lines the medullary canal is always inflamed in such a case. The morbid changes going on speedily effect the health of the bone itself; the vitality of which depends much more on its supply of blood from within, than from the periosteum outwardly. This is well illustrated by the difference in the results of injuries of the periosteum, from those induced by any lesion of the marrow and its membranes. In the former case, the depth of a thin shell, or exfoliation of bone is the extent of subsequent mischief; but in the latter, complete necrosis of the entire thickness of the bone is caused. Boyer relates an illustrative case. During the tedious healing of a stump, a cylindrical portion of the femur was thrown off spontaneously: the cause of this had been the ignorance of the dresser, who had every day been poking his probe into the medullary canal of the bone, mistaking it for a sinus. The patient ultimately recovered. The dura mater appears to supply the place of the medulla to the cranial bones; for any serious injury, which causes its separation from the internal lamella, is speedily followed by the death of the bone at that part.Archives Génerales. XXXIX. MEMOIR ON CHLOROTIC DISEASES. DR. BLAND thinks that medical men have always taken far too circumscribed a view of these diseases, by considering them simply as symptoms, or as the signal and result of amenorrhoea. "Do we not," says he, "observe them at all periods of life, in the male, as well as in the female sex, occurring too, even although the catamenia are regular; disappearing by the use of proper remedies, although this discharge remains obstructed? The real and specific cause of chlorosis, under all its Protean forms, is a vicious and imperfect sanguification; the blood being defective in crassamentum and colouring matter, and in consequence becoming less capable of imparting functional energy to the body. Four weighty reasons are adduced in proof of this doctrine. 1. Chlorotic maladies are almost always brought on either by whatever interferes with, or deranges the assimilation of the food and its conversion into the "pabulum sanguinis," as by living on unwholesome, and innutritious food, or by breathing a corrupted atmosphere, &c. ; or secondly, by whatever enfeebles the system of the ganglionic nerves, which, we know, regulate, and keep in health the organ destined to form and to circulate the blood; such as all depressing emotions of the mind, masturbation, excess of venery, sedentery employments, &c. 2. The doughy, waxy whiteness of the skin, the pale lips and gums, the scanty and serous discharges from the vagina, nose, &c. and the watery state of the blood when drawn, all indicate the real nature of the disease, whose progress, 3d, is denoted by an utter want of power and activity in the organic functions of the body, arising no doubt from a deterioration of the fluid, wherein, it is said, that life resides. 4th. The efficacy of steel medicines, which have the power of restoring to the blood the "excitative" properties which it has lost, and which chiefly depend on its colouring matter. So varied and so unsteady is the occurrence of symptoms in chlorosis, that it is almost impossible to define its characters within a single description. Sometimes the "anæmial" state of the skin, with slight general languor, are its only obvious characters; in some cases is added a lingering and wasting fever, which is not unfrequently attributed to visceral disease; in other examples, are intractable gastrodynia, not to be relieved by ordinary remedies; an asthma which defies all antispasmodics; a general tumefaction of the abdomen, and anasarcous state of the lower limbs; a restlessness and want of sleep, with, or without excruciating headaches, and murmuring noises in the head, against which depletion and counter-irritants are so commonly and so perniciously prescribed; or lastly, symptoms of diseased heart, which equally defy, what Hahnemann designates antipathic treatment, are a few out of the many ills and grievances, which have their time, seat, and origin in defective arterialization of the blood. the eyes; the gastrodynia, want of appetite, sleeplessness, headaches, &c. are quickly much mitigated, or quite disappear. The breathing becomes easier, the pulse less weak and frequent, the strength increases, the anasarca of the limbs abates, and to cheerfulness of mind is added the feeling of bodily comfort and "bien-être." From the long catalogue of cases enumerated in support of the author's treatment we shall select the following, one in a female, and two in male patients. 1. A. M. aged 21, had been remarkably pale ever since her birth; but the dirty waxen hue of the skin had increased for the last three years. The catamenia were regular, but very scanty and exceedingly light coloured. The health, however, was tolerably good; and neither the appetite nor the plumpness had decayed. By taking the steel pills in augmented doses for a month, she obtained bloom on her cheeks, lustre in her eyes, and vermilion in her menses !! 2. A. S. aged 57, had laboured under diarrhoea for eighteen months. He was excessively weak, and had a constant pain at the epigastrium. The skin, lips, and inside of the mouth were pale and exsanguine; pulse slightly febrile; no organic lesion of the abdominal viscera to be detected: the diarrhoea was checked by opiates; and the steel pills were afterwards continued for six weeks; the patient was restored to strength and health. 3. A. L., 27 years, had suffered from dysentery and ague during the late expedition to Algiers. His skin was blanched, his strength was utterly gone, his feet swelled at night; he suffered from oppressed breathing, and palpitations of the heart, and his sleep was uncertain and disturbed with dreams. No organic mischief was suspected, and therefore the symptoms were deemed chlorotic; the diagnosis was proved correct by the speedy cure under the use of the steel medicine. It will be observed that the author very properly mentions in all the cases, that there was no organic disease; at least search was made, and none found; |