and insensible; he did not feel the prick of a needle, and was speechless and mo tionless. The usual means of restoring sensibility were tried without success. On examination, there was found a swelling over the squamous part of the left temporal bone, into which M. Wunsch wished to make an incision, to ascertain the state of the cranium; but this was opposed by the father,. Eight leeches were then applied to the swelling, and fomentations; still without any change being produced in the state of the boy. The persuasions of the surgeons having no effect upon the father, the patient remained twelve days soporose, insensible, and unconscious; he had, however, the power of swallowing liquids. On the twelfth day after the injury, the operation of trepan was commenced. On reaching the bone, there was observed a stellated fracture, with depression of the squamous part of the os temporis, of the form of the letter V, from which there proceeded two fissures through the os bregmatis,-one going to the lambdoidal, the other to the coronal suture. The pericranium of the depressed portion was torn and drawn into wrinkles. The trephine was applied to it, and the bone removed without any extravasation appearing; but on attempting to separate the dura-mater from the remaining depressed bone, there issued a quantity of black uncoagulated blood. This was carefully removed with a sponge; the depressed bone was raised into its place by the elevator, and the edges of the wound were simply brought together with a bit of plaster. During the operation, no sensibility in the patient was manifest, and his state remained unchanged. After two days, having received a dose of jalap and calomel, which opened his bowels, he became towards midnight very restless, tossed from one side to another, but neither moaned nor spoke. To the morning he slept till six o'clock, when he opened his eyes and called on his father. After this time he got better, not however without experiencing considerable fever, which required the use of the lancet. In seven weeks the wound had healed without any exfoliation, the depressed portion of the bone which had been raised remaining in its proper situation, and the opening made by the trepan so well closed, that on applying the fingers to the part, the pulsation of the brain could not be distinguished, The recovery from the operation of trepan has been stated by Dr. Merrem to be accelerated by replacing the osseous disc, separated by the trephine. · To prove this, M. Walther, Professor of Medicine and Surgery, at Bonn, having, by a crucial incision, laid bare the left parietal bone of a dog, applied to it a small trephine. The teeth of the instrument, after perforating the bone, had torn the dura mater, and opened the ensiform sinus. On removing the disc of bone, hæmorrhage rapidly occurred, but it was checked by means of dry charpie pressed on the wound. The portion of bone which had been separated, after having remained on the table for five minutes, and being also deprived of its periosteum, was replaced in its former situation. It did not entirely fill the hole, a space of about half a line remaining free, between the circumference of the disc and the surrounding edge of the parietal opening. The flaps of integument were drawn over it, and retained by a suture. The animal had slight fever on the second day; on the third he regained his appetite. The edges of the scalp united by the first intention. The dog remained healthy for a twelvemonth afterwards. After his death, the cranium presented the following appearances. The portion of bone which had been removed and replaced, was so completely united to the margin of the opening, that it was difficult to discover its limits in the dry and blanched cranium. The callus which produced the union, so closely resembled osseous substance, that it Animadversiones quædam Chirurgica, Experimentis, in Animalibus factis. Giesse, 1810. could not be distinguished from it. The re-nuited portion was of a more blanched and shining colour than the surrounding bone, so that its appearance afforded matter of doubt whether, after its union, it had preserved its vitality, or whether, having lost this principle, it had been retained by the callus formed from the edge of the parietal opening. In the case which follows, there can be no doubt of the replaced bone having preserved its vitality. A labouring man, aged thirty six years, of a robust constitution, addicted to the use of spirituous liquors, was wounded on the head by a stone, which fell from a considerable height. The symptoms of concussion were moderate. He was blooded on the second day after the accident; on the sixth, he was so far recovered as to pursue his occupation. ~~ Pain of the head, which at first was slight, became so violent that he left off his employment, and had recourse to various medical men. Bleeding, blisters, and setons; cold applications to the head, purgatives and emetics were all prescribed without effect. He presented himself at the hospital at Landshut, begging for the operation of trepan, the pain being at that time excessive. The head having been shaved, M. Walther perceiving some protuberances over the right parietal bone, and conceiving he might find under it some organic lesion, applied the trephine, and removed the osseous disc. The dura mätter was sound, as was also the internal surface of the vitreous table, and there was no exudation between the lamellæ of the bone. The periosteum was entirely removed from the disc, which, separated from the soft parts, had been laid upon the table. It was returned into the opening, and the flaps of integument were placed over it, and retained by adhesive plaster. The patient bore the operation well. The febrile symptoms were moderate. The signs of inflammation of the dura mater were not severe, and were entirely local; but the flaps did not unite. Suppuration supervened, the discharge from which continued some months. The patient, however, got better; the pain of the head gradually diminishing, at last disappeared. At the bottom of the wound, the osseous disc could be felt free and moveable. Conceiving, at the end of the third month, that it ought to be removed, the professor seized it with the forceps, but instead of bringing away the entire piece of bone, only a very thin, angular, and ragged portion of the external table, came away. The surface of this portion was rough and unequal: one of its margins was round; the other pointed and serrated. In a word, the vitreous table of the separated disc, and part of the external lamella, were re-united, while the larger portion of the latter was exfoliated. On attentive examination of the bottom of the wound by the probe, the parietal` opening was found thoroughly closed, and filled by ósseous matter, bard and covered by healthy granulations. As exfoliation and granulation, cannot take place unless from a part which pos sesses an active state of its vessels, so it becomes evident, that the re-united portion of bone, in this case, retained its vitality, formed vascular connexions with the dura mater and with the diploe, and became subject to the usual processes of nutrition and vascular action. After the removal of the exfoliation, the suppuration gradually diminished, and in a short time the wound cicatrized in the usual manner. Case of Monstrous Birth.* Tuis infant was born in Val de Olivas, a town of Spain, and came into the world after a very tedious and difficult labour. It had on each hand six fingers; on the left foot six toes, and on the right seven. It lived three days, but never opened its eyes. The eyelids were separated with some force, when there was seen a transparent horny membrane, covered with a thick yellow skin, producing a sanguineopurulent discharge. * Décadas Médico Quirúrgicas, Vol. iv. No. 6. Case of an Extraordinary Number of Calculi in the Bladder, A MAN, sixty years of age, who had long suffered from dyspepsia, had, in 1804, the first attack of gout, and soon after, conjuined with it, some symptoms of gravel. These last he at first disregarded, but they gradually increased, until at length violent inflammation of the bladder supervened. He now applied for medical advice, and various remedies of a palliative and antiphlogistic kind were employed; and the return of the gout was solicited. At length alleviation of the symptoms was produced, and several calculi were passed by urine. The circumference of the swelling of the bladder was also diminished, and the progress of the inflammation checked; nevertheless, this severe malady did not cease. It assumed every day, more and more the symptoms of chronic inflammation of the bladder, which, after thirty days of intolerable torment, ended in death. On DISSECTION, the coats of the bladder were found unusually thick, and there were discovered within it 398 calculi, of different forms, and from the size of pea to that of a Spanish olive. This number of stones exceeds any that has yet been remarked. Three hundred have, however, been passed by urine by a female, as recorded by Tulpius in the Observ. Med. 1. ii. c. 47. By a chemical analysis of the stones, instituted by Professor Moyon, they were found to consist of phosphate of lime, phosphate of magnesia, and úric acid. Suggestion respecting the possibility of destroying Cancer, by the application of intense Cold. An expedient has suggested itself to my mind, by which I think that the application of artificial cold to a diseased part might be rendered very manageable; that is, by employing masses or plates of metal, cooled down to the requisite degree in a frigorific mixture, and then applied, for a sufficient time, to the part upon which it might be wished to induce mortificaion. I suppose that this effect would certainly be induced, by the application of heat, after withdrawing the cold appli cation. Such metallic masses might be formed to any shape or size that might be wanted, and would have the advantage of limiting the application of the cold correctly to the surface intended. -The section of Van Swieten, which I mentioned to you to-day, upon the subject of cancer, is 449. His speculation about curing the diseases, by inducing mortification, commences with the words, "Sed an non possit totus cancer emori?" or, in the translation," But is it not possible for a cancer to mortify?" and is continued to the end of that paragraph. The view he takes of the subject seems most sound and rational; and it appears to me, that we possess an agent in artificial cold sufficiently powerful to execute his views. Having barely suggested the idea, I shall content myself with recommending it to your mature deliberation. It would seem to correspond pretty correctly to what Van Swieten was in quest of; but in deep-seated diseases, where the preservation of skin by the knife so much contributes to the cure, it would seem to be less suitable. In more superficial affections, or in prominent tumours, especially those with circumscribed necks or bases, it may have fewer disadvantages-Philadelphia Journal, No. 6. Feb. 189I. Magazin der Auslaendischen Literatur. Hamburg. Jan. Feb. 1822. Abstract of the account of a Case of Adhesion of the Labia Pudendi in a Negro obstructing Delivery, by William Russell, of Jamaica. MR. THOMAS GEOGHAGEN had, amongst his negroes in Jamaica, a woman named Avis, about 27 years of age, of the Eboe nation, who, on declaring herself in an advanced stage of pregnancy, asserted at the same time that she could not be delivered, as there was no external passage, and therefore expected that she should die in consequence. There was found, on examination, to be a cicatrix extending from the mons Veneris to within an inch of the anus, where there existed a small orifice barely sufficient for the introduction of a small female catheter, through which orifice the urine and menses exuded. This cicatrix appeared to have been the consequence of an operation which had been performed upon her in her native country when a child, and which she said was commonly practised with the female offspring of families of rank, as a security against improper connexions. The adhesion being removed by an incision with a sharp-pointed bistoury, the delivery was easily accomplished, and future adhesion prevented by interposing a bougie till the wound of the labia on each side had healed.-Philadelphia Journal No. 6. Feb. 1822. Annals of Name-coining and Medical Style.-No. II. We have put down, in the course of our medical reading for the last few weeks, the following list of outré and novel words: The new proprietors of Vauxhall Gardens have, we observe, caught the mania of word-making, and have been consulting their Greek lexicons; though we hope they may not fall upon so unpropitious a combination as Terence's Heautontimo roumenos. We give the following as an instance of sentence-making, in which the author seems to have a wish to make incomprehensible figures pass for ideas. “The same constitution of mind which favours implicit belief, facilitates also the influence of doubt. Those optics which are most easily dazzled by exterior splendour and artificial colouring, are, by this process, [what process ?] blinded to the interior and essential, when the exterior and adventitious [what?] is removed. The curtain is drawn, [by whom?] and all behind is blank. The awfully obscure of medicine is abrogated, [how and by whom?] and therefore medicine itself is a mere trick." Critical Characteristics of New Books. I.-A Natural Arrangement of British Plants, according to their relations to each other, as pointed out by Jussieu, De Candolle, Brown, ́&c. including those cultivated for use; with an Introduction to Botany, in which the terms newly introduced are explained; illustrated by figures. By Samuel Frederick Gray, Lecturer on Botany, Materia Medica, an l Pharmaceutic Chemistry. 2 vols. 8vo. Pp. 824 and 757. London, 1822. Price 27, 28. This is a very laboured compilation, but it does not appear for what class of readers it is intended. The minute and often trifling details in the introductory part would lead us to believe that it was intended as a text-book for junior students; but the method and arrangement followed in the work itself, and, above all, its high price, would suggest that the author intended to appear as a very scientific botanist, though we scarcely think that any of our amateurs will thank Mr. Gray for his elementary instructions. For example: "Tendril-bearing, cirriferus. Bearing tendrils." "Three-fingered, tridigitata." Five-fingered, quinque-digitata." "Seven-fingered, septemdigitata." "Hanging, penduli. Falling below its origin perpendicularly towards the earth." We could easily give a thousand examples of the same kind, which can be of no use to any boy who has mastered his accidence, much less to students of botany. It is the multiplicity of these trifling details which has not only swelled the book to so goodly a bulk, but which must make the rudiments of the science appear so formidable, that few, we predict, who look into it will be inclined to go beyond the two first divisions of his introduction. "If the student proceed to the body of the work, he will be puzzled at the very commencement with a long definition of plants, which is unique in its kind, as a specimen of scientific style~(see i. pp. 275, 276.) The plants themselves follow according to the involved and unnatural system of Jussieu, which does very well for amateurs to differ about, but must always be to a mere student utterly incom prehensible. In the descriptions of the individual plants, we observed several deficiencies and inaccuracies, at which we were rather surprised. No habitat of any plant, for example, is given, and the common plants are not distinguished from the rare ones, though this would have been certainly as useful as loading the pages with so many synonimes and references, often filling from twenty to fifty lines in a page. In some instances, indeed, we found these indispensable in comprehending what the author meant, as he seems to have been much more anxious to give all the most novel or most unknown names, than to keep to the usual beaten path. For example, he adopts from Haworth the new genus Robertsonia, divided from Saxifraga, of which he describes no fewer than six species, three of which are also from Haworth. Now, we will venture to say, that, with some care in diversifying the soil, Mr.Gray may raise all the six from the seed of any one of them. We have the authority of VOL. IV. NO. XV. GG G |