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speedily be an end to all St. John Longs, Eadys, even when countenanced and supported by "regulars," and to those infamous disclosures which so frequently occur in this city.-Journal Univers. et Heb.

VIII.

CURIOUS FETAL MONSTROSITY.

THE abdominal muscles were entirely awanting, so that all the viscera were exposed and floating loose. They had been contained in a very delicate membrane, which was ruptured during parturition.

The ribs on the right side were almost of their normal developement; those on the left were merely rudimentary.

The left upper extremity was very imperfect, presenting only a trace of the arm and of two fingers.-Journal Univ. et Hebdom.

IX.

GONORRHEA IN FEMALES.

RICORD, surgeon of the Lock Hospital at Paris, has communicated an interesting memoir, wherein he proves that, in all contagious and obstinate vaginal discharges, small ulcers, in every respect like true chancres, are to be observed on the mucous surface of the vagina and of the os tincæ. The speculum uteri must be used to examine the parts. His treatment consists in introducing plugs of lint, wet with astringent and mercurial washes, and in exhibiting internal antisyphilitic medicines.

No such appearances are to be seen in leucorrhoea, and other innocuous discharges. -Journal Univ. et Hebdom.

X.

POISONING BY ARSENIC.

We request the attention of our readers to the following case for several reasons; viz.

the importance and difficulty of the subject -the errors and ignorance so frequently manifested by medical men on toxicological subjects, and the possibility of crimes of assassination being overlooked and mistaken, during the prevalence of any epidemic disease. Such is possible at the present time, as the following short statement will prove.

M. and Mme Caillette having eaten some bouilli and other meats at dinner, were seized, two hours after, with sickness and vomiting, which, however, by degrees ceased, and did not again return till next morning. Purging now supervened, and the stools were inodorous, and unhealthy. On the following day, the vomiting was attended with much anxiety and great prostration of strength, and a sensation of tightness at the throat.

The day after the above patients were seized, a domestic, who had also eaten of the bouilli, became dangerously ill, with extreme exhaustion-feeble, whispering voice -pulse scarcely to be felt-involuntary twitchings of the muscles-vomiting and painful purging. She died 36 hours after seizure. Also a beggar, who had applied to the first patients for charity, had received some of the bouilli, which he voraciously devoured. Soon afterwards, violent vomiting and purging, extreme thirst, and universal tremors came on, and were succeeded by a state of coma. He, however, slowly recovered; but not so M. and Mme Caillette, who lingered, the former for 13 days, and the latter for 4 weeks. Before death, both suffered much, from a sense of burning in the throat, dysphagia, fever, aphthous ulcerations on the mouth and tongue, and a remarkable insensibility of the hands and feet; in short, the symptoms of chronic gastro-enteritis. Dissection revealed nearly the same appearances in all three.-Marks of vivid inflammation in the stomach and duodenum, and a morbid developement of the glandulæ Peyeri and Brunneri in the ileum.

There was discrepancy of opinion among the two medical attendants as to the cause of the deaths-one suspecting that poison had been swallowed, the other referring the

symptoms to a choleroid disease. The ig norance of chemical manipulation prevented the former from satisfying himself.

Some of the ejected matters, and also the stomachs of the deceased, were sent to Orfila for examination; and the presence of arsenic was speedily detected by him in the vomitings of the domestic, but not in those of the master and mistress. This is not surprising, if we consider the lapse of time between the seizure and death. It is to be remarked that a packet of arsenic was afterwards found in the house of Caillette, and it is supposed that it had been used for salting meat.-Journ. Univ. et Heb.

XI.

ELECTRICITY AND CHOLERA MORBUS.

M. CONVERCHEL read a memoir to the Academy of Medicine, wherein he endeavours to prove, that electricity diffused through the atmosphere is the "source of life," and that, therefore, it must act a very important part in the production of all diseases, but especially of cholera; which he attributes to the deficiency or withdrawal of the electrical fluid from the organs of the body. He recommends warm bath, frictions, and galvanism.-Archives Gener.

When will some of our mercurial Continental brethren be satisfied with patient attention to facts, and a sober deduction of theory from these, and from these alone? If electricity be really, as M. Converchel alleges, the "fons et origo vitæ," every cehmist, with his machine, might become a Frankenstein!-ED.

XII.

APPLICATION OF ASCULTATION TO MID

WIFERY.

Is the majority of females, whose pregnancy is advanced beyond four months and a half, and in all during labour, under certain favourable circumstances, the pulsa

tions of the heart of the foetus may be distinctly made out, at least by those who are at all conversant with the use of the stethoscope. We must not be discouraged if, upon our first trial, we fail to recognize the sound of the foetal heart, and the murmur of the uterine circulation, especially in the early months of gestation; we must repeat our experiments with assiduity and zeal, and our labours will surely be rewarded with results both interesting and important. We must expect to meet with difficulties of various kinds; we have already adverted to the faint obscurity of the sounds in early pregnancy; besides this, an inexperienced auscultator is apt to be deceived by the transmission of murmurs which are not seated in the uterus or its contents. The following is an interesting specimen.

A young woman, whose catamenia had ceased for five months, the abdomen enlarged, the cervix uteri soft, spongy, and flattened, and who stated that she had distinctly felt some motion, as if of the child, was admitted into the "Hospice de la Maternité." The stethoscope, applied to the lower and left side of the abdomen, transmitted a distinct noise of double pulsations, the number of which in the minute was 128. This is a slow pulse for a fœtus of the 6th month, and the physician, therefore, made a memorandum of the case, as rather singular :-Fortunately he examined the pulse of the young moman at this time, and found it to correspond in frequency with the pulsations heard. The stethoscope was re-applied to different parts of the abdomen, and the double beats were every where discovered, and becoming more and more distinct the nearer to the epigastric region that the instrument was put, proving that they arose from the accelerated action of the heart of the mother. On careful examination, no other sounds could be recognized, and the woman was declared not pregnant. The result shewed the accuracy of the diagnosis.

The above case shews that the sound of the mother's heart may occasionally be heard over the abdomen, and may easily lead the ausculator into error. The usual number

of the pulsations of the fœtal heart is from 140 to 150 in the minute; and this appears to be nearly the same at the different stages of pregnancy. Authors have disagreed as to the accuracy of the last conclusion; but we feel quite satisfied from the very numerous investigations which we have made, that it is perfectly correct; indeed we have repeatedly observed that the pulse was quicker at the full time than during the 6th and 7th months. It is very remarkable that when the pulsations of the fœtal heart are very distinct, we may frequently recognize a bellows-sound, very similar to what is heard in some diseases of the heart and large vessels-probably it is owing to the meeting of the two columns of blood in the aorta and pulmonary artery.

During a protracted labour the pulsations of the foetal heart have been observed to become weak and to intermit, and these phenomena have been deemed by some as indicative of the suffering and danger of the child; but this conclusion is not very tenable, and it would be highly dangerous to assume it as a guide of our conduct; for often during gestation we find the pulsations to be strong and vigorous at one minute, and perhaps the next they are feeble and faint; and besides, we are well aware that the circulation of the child while still attached to and connected with the placenta may be active and undisturbed, and yet no sooner is the child born, but it dies, in consequence of the lungs refusing to act. Now we conceive that the most frequent causes of this palsy of the respiratory organs is an injury done to the brain, and thereby to the whole nervous system, during a tedious and severe labour from the compression of the umbilical cord, and the consequent congestion of blood in the head. A case will best illustrate this view. A woman was delivered by the forceps after a severe labour; the stethoscope indicated the life of the child immediately before it was born, and when the cord was divided, two distinct jets of blood were thrown out; the heart was felt to beat for a few minutes, but no attempt at breathing was made, and the child therefore died.

Dissection showed the cerebral vessels enormously distended with blood, and the substance of the brain, lungs and liver to be much congested. In similar cases effusions have frequently been detected in the ventricles. Arch. Gener., Janv. 1832.

XIII.

UTILITY OF ACTUAL CAUTERY.

In this country, we believe that the excellent effects of this remedy are overlooked; it is very much more alarming in anticipation, than in endurance :-some patients, Frenchmen we may guess, have even assured M. Jobert, that during the application of the hot iron they have experienced only a tickling and agreeable sensation!! [We recommend the Harley-street quack to visit Paris immediately, in search of such a delectable discovery.]

M. Jobert has employed the actual cautery, and also moxas in numerous cases of scrofulous swellings of the knee and other joints, with much, and very decided success. Many limbs condemned to amputation have been thus saved; and when the bones had not become carious, the motion of the articulation has been restored. Local palsies, and neuralgias, have been speedily cured; but our chief object in this notice is to direct the attention of our readers to the employment of the cautery in the treatment of that very intractable disease of the eye-lids, trichiasis. A man who had suffered from this complaint for ten years was speedily cured by one application of the cautery. The thin edge of a red-hot spatula was drawn along the eye-lid from one commissure to the other; the eschar formed was about 1 lines in breadth; and was sufficiently deep to destroy the skin, cellular tissue, and palpebral aponeurosis, without affecting the tarsus and ciliary bulbs. Delpech, who first proposed the cautery in trichiasis, has treated many cases successfully by its use.

M. Jobert narrates a case of ulcer of the cervix uteri which he speedily cured by one application of the actual cautery.

It is proper to mention that our author distinguishes three different methods of employing the heated iron, either by applying it to the part with such a pressure as to destroy the texture deeply; or by drawing rapidly and very lightly the edge of the instrument over the part; and thus not disorganizing all the thickness of the skin; or lastly by applying the point of a conical cautery, so as to make several small eschars. The pain felt after the application is best assuaged by cold water.-Journ. Univ. et Hebdom.

XIV.

The fracture is sometimes not complete, or the rough projections of the broken surfaces fit so closely to each other, like mortised work, that no displacement takes place for several days or even weeks. Sabatier reports a case, where twenty-two days elapsed, before the symptoms of fracture were apparent. The length of time necessary to the solid knitting of fractured cervix femoris is from 100 to 160 days, during the whole of which period, the extending apparatus must be constantly applied. Dupuytren has more than once seen cases where the provisional callus has given way when the patients were permitted to rise after two or three months; and thus shortening and deformity of the limb were occasioned. We must not always expect to find the foot turned outwards in this accident; the very reverse has frequently been noticed, and Bichat goes so far as to state that it occurs

FRACTURE OF THE NECK OF THE FEMUR. in the proportion of two cases in 10; a

[Extracts from Dupuytren's Clinical
Lecture.]

THE head of the femur has in some rare cases been driven through the bottom of the cotyloid cavity and fairly lodged within the pelvis ;—and so firmly has it been impacted in this situation that even after death, it required much force to displace it. Falls upon the trochanter, and upon the soles of the feet have not unfrequently caused the head of the femur to be splintered, while the cervix was unhurt: but this accident is generally the result of contusions from shot; upwards of a dozen of such cases were seen by the Baron, in July, 1830.

The most common situation of the fracture of the cervix is not at its middle, where it is weakest and most slender; but at its base, where it is united with the trochanter, which is not unfrequently broken at the same time, and is sometimes completely detached from the body of the bone. Dupuytren advocates the opinion that bony union may and does take place in intra-capsular fractures. Many specimens preserved in the museums of the Faculty of Medicine, and of the Hôpital de la Pitié, he assures us, distinctly prove this.

proportion, however, considerably greater than is warranted by Dupuytren's practice. The eversion of the foot is, in the opinion of the Baron, referrible to the action of the adductor muscles.

In the treatment of this accident, the patient ought to be laid on his back, the thigh bent on the pelvis, and the leg on the thigh; moderate extension may now be used with much advantage, as the muscles, which chiefly resist the adjustment of the two pieces, are relaxed by the semiflexed position of the limb; the upper, or outer, or displaced portion is thus easily reduced, and brought in contact with the lower, or inner fragment; in which situation the object of the surgeon is to retain it. All apparatuses of continued and forcible extension are bad, and the following very simple contrivance, on the principle of permanent relaxation, is recommended as more simple and efficacious:-we must form a double-inclined plane with several pillars rolled firmly upon themselves into the form of bolsters, placed one above the other, and secured together by stitching; and along this double plane, we are to place another pillow lengthwise, extending from the hip to the heel-the leg and thigh are retained in their places by

sheets folded round the limb after the man

XVI.

ner of a cravat, and secured by their ends to

the posts of the bed. During the first month, A SAGACIOUS AND IMPORTANT REFLECTION.

the surgeon ought to raise the thigh a little almost every day, and gently to draw the limb downwards. When he has reason to believe that the consolidation is effected, the double plane should be gradually lowered, by removing the pillows, one by one.

By this simple contrivance Dupuytren has succeeded in obtaining numerous cures with little or no shortening of the limb.Journ. Univ. et Hebdom.

WHEN we assemble a number of facts and endeavour to draw legitimate inferences from them, we must weigh, not count them. "Non numerandæ solum, sed etiam perpendendæ sunt observationes."

XV.

OBSTINATE CHRONIC OPHTHALMY WITH ULCERATION AND OPACITY OF THE CORNEA.

M. LE PELLETIER strongly recommends the use of the argenti nitras as a caustic, and calomel to be blown upon the eye every second or third day. One example will suffice to shew his practice.

A man aged 30 years had for many years suffered from repeated attacks of chronic ophthalmy, which had left puffy swellings of the eyelids, opacities of the cornea. The vision of the right eye was lost; and that of the left one nearly so, as the inferior half of the cornea was quite opaque, and the upper half nebulous and dim; there were also two large ulcers on it. Constant pain, weeping, and intolerance of light distressed the patient.

Calomel was ordered to be blown into the

eye every second day, without any previous treatment; a calomel collyrium was also ordered. In five days the extreme sensibility had ceased entirely; the eyes could bear the light; the redness and swelling of the conjunctivæ were gone; and the opacities of the cornea considerably diminished. In a fortnight more he was so much improved, as to be able to leave the hospital,-Ibid.

XVII.

LETTER ON CHOLERA. BY BARon Dupuy

TREN.

February, 1832. THE history of this fatal malady is deficient chiefly in very exact information of the true seat of the evil, and of the nature of the organic lesions produced in the intimate texture of our bodies. Some authors have supposed that the brain is the original seat of the disease; others have referred it to the spinal marrow; or to the semilunar ganglia and sola plexus; or to the heart. It appears to me that these opinions are little probable; but it would be well to verify them by very careful dissection, and by a minute examination of any changes found in these viscera.

The seat and character of the pains, and the nature and profusion of the discharges, lead the mind to suppose that the stomach and bowels must be the organs which primarily and principally suffer. Hitherto, however, it must be confessed, no very constant, or uniform morbid appearances have been detected: but to account for this, it is well to keep in mind that most of the dissections have been only of such patients as have very rapidly been carried off: to obtain satisfactory information, we must direct our examinations especially to the bodies of those who have resisted the disease for some time, and in which, therefore, it is reasonable to suppose that more distinct and obvious effects have been produced. Moreover, it appears to me that the dissections have seldom been performed with a sufficiently inquisitive minuteness and accuracy.

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