for it would be altogether a most dangerous and improper practice that steel should be administered in every case of disease which was attended with pallor of the surface, and of the mucous membranes, with muscular weakness, and bodily and mental depression, with out reference to any other malady which might be co-existent. Every experienced physician knows that these symptoms are every day witnessed in uterine cancers, in chronic gastroenteritic affections, in indurated liver and spleen, &c.; and neither steel, nor any other medicine can minister to such diseased systems, the bloom, and strength, and activity of health! But, in uncomplicated chlorosis, long experience has taught him to regard almost as a specific, the combination of the sulphate of iron and subcarbonate of potass.-Revue Médicale. XL. HISTORICAL AND CRITICAL REMARKS ON THE MEANS EMPLOYED TO STOP HÆMORRHAGE AFTER AMPUTATIONS. M. VELPEAU prefers the forceps to the tenaculum for laying hold of and drawing out the artery; and it appears that the latter instrument is very seldom used in France. He states that the main artery of a limb is sometimes so hard and calcareous, that it will crack, like glass, if a single small ligature is applied, as recommended by English surgeons; the better plan, in such cases, is to previously introduce a cylinder of linen, cork, or elastic gum into the vessel, or to employ the "rouleau de Scarpa," by interposing something between the artery and the thread. The medullary arteries of the bone will sometimes continue to ooze out for a considerable time; pressure with lint for one or two minutes will generally arrest it. M. Velpeau does not approve of the practice of delaying to close the wound for some hours after the operation, in the view of guarding against hemorrhage from the small vessels, a practice which has been adopted by Dupuytren, Klein, and others. It appears that M. Koch, surgeon of the hospital at Munich, has never used a ligature after any amputation for the last 20 years :-he trusts to graduated compresses on the artery, and to a bandage rolled firmly from the trunk to the wound, which is then to be immediately closed. From 13 experiments performed on dogs, the inference drawn was, that if any foreign body is introduced into the divided end of an artery, the vessel speedily takes on a morbid condition, which renders it incapable of receiving blood, although it is not mechanically obliterated. Another hæmostatic method, and one which is less objectionable, is to pull the bleeding vessel out, and then twist it a little back, or in a direction contrary to its course; in excision of the mamma, the arteries may be easily secured in this manner. M. Velpeau has tried torsion of the vessels after operations, and has found it to succeed very well. He states that, whenever the artery could be easily laid hold of and drawn out, so that it might be separated from the surrounding tissues, and retained either by the thumb and finger, or by a second forceps, while, with the other forceps, it could be twisted from three to eight times round on its axis, the chance of secondary hæmorrhage was not greater than if a ligature had been applied; and that he has not met, in his practice, with the inflammations and suppurations which MM. Delpech and Lallemand have urged in objection. He thus compares the two methods of torsion and of ligature:-The former is not always quite so secure; it is not applicable in all cases; it requires very considerable practice to execute it well and effectively; and, lastly, it occupies more time in its performance than the application of ligatures requires. On the other hand, no foreign body is left in the wound, and it should, therefore, favor primary union; but we must acknowledge that experience has not yet confirmed and sanctioned the correctness of this presumption. The patients operated on by M. Amussat himself have not recovered more quickly than after the usual method; and a result more favourable has not yet been obtained by any of the numerous surgeons who have given torsion a fair trial. On the whole, M. Velpeau gives the preference to the ligature; but admits that, occasionally, especially in operations in soft yielding structures, the hæmorrhage may be securely checked by simply twisting the vessels.-Revue Médicale. XLI. MEDICAL JOURNAL OF BRAZIL, PUBLISHED AT RIO DE JANEIRO. THE first Number of the "Semanario de Sante Publica," or Weekly Journal of Public Health, has recently issued from the press at Rio, and augurs well of the zeal and observation of the medical men there. "Tis, indeed, refreshing to the mind, to mark the benign influence which liberty diffuses over the intellectual, as well as over the moral energies of mankind; for, while the parent countries of Spain and Portugal are oppressed with despotism and sunk in apathy and indolence, their children of the New World are animated with a generous rivalry of scientific distinction. France, before the first revolution, had only one medical journal of any importance, and now she is the most prolific mother of periodicals. We shall extract one or two short articles. the abdominal parietes is rendered more secure, and all danger of effusion prevented.) The suppuration was encouraged for a few days, and soon after, under simple dressings, the cure was completed. II. PURULENT CYSTS IN THE CAVITIES OF THE HEART. A. C. aged 21, had long suffered from indolent ulcerations of the legs, and presented a most cachectic appearance. He had symptoms of hydrothorax, and of diseased liver. On dissection, the left lung was found completely wasted, and the left cavity of the pleura filled with a flocculent, serous fluid. The heart was enlarged, and when its cavities were laid open, numerous purulent cysts, varying in size from that of a millet-seed to a hazel-nut, were observed to line the sur◄ face of the left ventricle and auricle.Revue Médicale. XLII. STATISTICAL RESEARCHES ON THE INCREASE OF POPULATION IN EUROPE. M. MOREAU de JONNÉS states that the prolific powers of the human race are such, that from every marriage we may estimate, on an average, the birth of six children, of which two die usually in infancy, and the remaining four survive, marry in their turns, and become thus multiplying nuclei of population. I. HEPATITIS, ENDING IN AN ABSCESS, To exhibit the ratio of increase in fi WHICH WAS DISCHARGED OUTWARDLY. A. M. aged 20, had a smart attack of acute inflammation of the left lobe of the liver, which gave way to antiphlogistic treatment; but, although the febrile symptoms vanished, some tenderness of the epigastrium and right hy pochondrium remained, which, in a few days, was followed by a soft, fluctuating swelling. In 15 days, the abscess was ripe for discharge, and it was, therefore, opened by the lancet. (N.B. The better method is that recommended by Dr. Recamier; viz. to employ caustic instead of a cutting instrument, for thus the adhesion of the cyst with gures-the offspring of one couple is supposed to be 6 children in 33 years, 12 in 66 years, 24 in a century, 192 in 200 years, more than 98,000 in 500 years, and upwards of three thousand millions in 1000 years. According to this estimate, provided there was no impediment to the natural order and course of events, and no obstacle to propagation, a single family, living at the time of Charlemagne, might have peopled the whole of the inhabited world. The experience of nations, however, gives a very different account of the increase of man in any given country: thus Gaul, at the time of the Romans, contained about four millions of inhabitants, and it has required no fewer than 1860 years to raise the population to its present census of 32 millions; instead therefore of a couple doubling its numbers in 33 years, as above stated, 615 years, or about 18 times as long a period has elapsed, before such was effected; a calculation which supposes that the annual excess of births over deaths, is only one in a thousand. If, as we have reason to believe, the population of the world does not exceed a thousand millions, it follows that it has doubled itself only 28 times since the period of the deluge; and that the average interval between each duplication has been 150 years. XLIII. NUTRITIOUS SOUP PREPARED FROM M. COSMENY states that, in consequence of the events of July, 1830, the working classes in Kheims were reduced to great want, and means had to be taken to afford relief to upwards of 4,200 families in extreme indigence. An assessment of 23,000 francs was therefore laid on the inhabitants. M. Cosmeny had the direction of the whole. He established an immense apparatus for preparing soup from the boiling of bones; and in 133 days he distributed 301,910 rations, as follows. There were 212,800 rations of broth (potage) and bread; 35,000 rations of ragouts made of potatoes with the fat of bones; and 26,600 rations of boiled meat; and lastly, 9,310 rations for the support of the cooks who were employed in the 39 kitchen. The expense of each ration, including the charge for the apparatus, 44 he estimates at 74 cents; the quantity of bones used every day was 480 pounds, which yielded 600 rations of soup, 18 ounces to each ration.-Revue Médicale. The following is supposed to exhibit an accurate view of the progressive increase of population in the different countries of Europe. In Prussia the population has been doubled in .... In Austria In European Russia In Poland and Denmark In Britain..... In Sweden, Norway, Switzerland and Portugal In Spain.... In Italy..... In Greece and Turkey In the Netherlands.. In Germany ... ..... Years. 62 68 70 84 120 125 In France..... XLIV. Dr. ESQUIROL gives it as his opinion that all contagious diseases near the period of their decline, lose the power of propagating themselves; and he illustrates the truth of the remark, by the curious fact, that towards the termination of an epidemic variola, the matter of the pustules may very frequently be inoculated without effect; and that, as a general rule, all pestilences are more destructive and fatal when the miasmata are yet in small quantity, than when they afterwards become more diffused, and consequently more diluted.—Revue Médicale. XLV. ᎻᎬᎪᎡᎢ . tablished his opinion that dilatations of the heart are much less frequently de DILATATION OF THE CAVITIES OF THE pendent on some contraction of its orifices than has been generally believed. -Revue Médicale. CORVISART and all preceding physicians supposed that the invariable, and the only cause of dilatation of any of the cavities of the heart, was some mechanical impediment to the exit of the XLVI. COMMUNICATING BETWEEN THE TWO JUGULARS. blood from them. MM. Louis, Bouillaud, VARICOSE TUMOUR IN AVENOUS BRANCH Andral, and Pigeaux have, however, clearly shewn that this explanation will not always hold good. The cavity most frequently dilated is the right ventricle, and yet of all the openings communicating with the heart, that of the pulmonary artery is the least often found diseased; hence we may safely conclude, that there is no direct connexion or dependence of these two morbid states, the one upon the other. We must therefore search for a cause more general; and we shall probably be led to discover it in some change of the muscular and moving powers of the walls of the affected cavity. M. Pigeaux has observed that the right side of the heart is generally dilated in those who have died of asphyxia; and that the left ventricle when dilated, is usually hypertrophied at the same time; and that these morbid states most frequently co-exist, especially in old persons, with a diminished firmness and consistence of the substance of the heart, and with an ossification of the arteries of the trunk, or extremities. M. Piorry, who was appointed by the Academy of Medicine to report on M. Pigeaux' Memoir, thinks that an increase in the size of the right side of the heart is very often dependent on the circulation through the lungs being obstructed by tubercles, by hepatization, or by simple asthma, by fits of coughing, or by the efforts of vomiting. It is of great importance, therefore, in reflecting upon the causes which may give rise to dilatations of the right ventricle and auricle, to consider well, whether the pulmonary circulation has probably been exposed to an occasional or to a permanent interruption, or impediment of any sort; but M. Pigeaux deserves well of medicine in having es A MAN, aged 23, entered the Hôpital been ruptured and had caused the death of the patient by the effusion of blood into the right cavity of the pleura. Mr. Cline once met with a case of varix of the internal jugular, which burst and occasioned death by hæmorrhage. Journ. Hebdom. XLVII. Universal emaciation; weight of the body about 58 pounds. Brain of a paler colour than natural; no water in the ventricles; cortical substance of healthy consistence; medullary substance of the cerebrum, cerebellum, and the medulla oblongata considerably firmer and denser than is usually observed. Heart of the ordinary size, but very pale in colour; soft and easily torn; lungs TUMOR THE REMAINS OF AN OLD HER- nearly normal; œsophagus contracted; NIAL SAC IN THE SHEATH OF THE A MAN, aged 29, had a tumor in the spermatic cord, situated between the inguinal ring and the testicle, of the size of a walnut. It has been there for 15 years and given little annoyance till three months ago, when it began to increase in size and to become more painful. When carefully examined, it conveys to the finger the sensation of an enclosed fluid; the ring, cord, and testicle are not involved with it. The patient states that at first the swelling might be pushed up to, but never within, the original canal. It was considered to be either an encysted tumor of the cord, or the remains of an omental hernia, or a fleshy or scirrhous tumour. M. Roux extirpated it. On puncturing it, a quantity of pale yellow serum flowed out. Death, from fever, took place a fortnight after the operation, and on dissecting the inguinal canal, the omentum was found adhering all round to its circumference. M. Roux gave it as his opinion that the tumour which was removed, had been an old hernial sac, the open neck of which had been in course of time obliterated, and stated, that what tended to confirm this was, that during the operation it was found to be very much more coherent at its upper than at its lower part. Journ. Hebdom. stomach of its ordinary size, and containing an ounce or two of greenish fluid; mucous membrane adhering strongly; the thickness of the walls of the stomach and intestines sensibly diminished; valvulæ conniventes very distinct; hardened fæcal matter in the right portion of the colon; the rest of the intes tines empty. The omentum reduced to a mere serous web, which was traversed by blood-vessels. Mesentery containing no fat. Liver of a healthy colour and size; its substance denser than usual. Gall-bladder distended with a black, thick bile, which was very like a strong solution of extract of liquorice. Spleen exceedingly small, almost round, with a diameter of about two inches; texture very dense and resisting pressure. Kidneys reduced in size, and of very firm consistence. Muscular system almost "annihilated," so shrivelled were the fleshy "ropes of life." Though no trace of fat was to be observed, the marrow was not deficient in the long bones.-Archives Géner. XLIX. ERUPTION OF ROSEOLA CAUSED BY THE USE OF COPAIBA AND CUBEBS. A YOUNG man was ordered by M. Velpeau a mixture containing the balsam of copaiba, powder of cubebs and magnesia: he took it for six days, when he began to experience troublesome itching and smarting on the neck, chest, &c. &c. and next morning there was a full eruption of roseolous patches over his body. These patches very much resembled the rash of measles. By discontinuing the medicine, and keep |