application of leeches. In one case of icthyosis, the employment of sulphur baths was very successful.

Several tertian agues, of one, two, or even three weeks' standing, yielded to one or two general bleedings, without having recourse to the quinine. A case of chorea, of 8 month's standing, in a girl aged 13, received much benefit from a venesection, cupping between the shoulders, baths, and the use of valerian; she entered the hospital on the 21st May, and went out on the 9th of July, so well that she could work with her needle.

A patient, while in the hospital, was seized with erysipelas of the left fore-arm and hand, accompanied with violent pyrexia and much cerebral disturbance. He died on the 4th day. On dissection, several enormous abscesses were found under the integuments of the left arm, the veins of which were inflamed. Morbid appearances were discovered in most of the joints of the body.

Arteritis. A man, aged 34, had experienced for 15 days a sense of numbness in the right arm, and at times a most acute pain, extending from the hand to the elbow; the limb was swollen, but there was no redness; in the course of a few days, no pulse in the radial artery was to be felt, and the vessel was hard and motionless under the

finger. A few days subsequently the humeral artery, up to the axilla, became also pulseless; leeching and fomentation abated the pain, but the pulse did not return; the patient, however, left the hospital nearly

an

considerable. [Were we to hazard opinion on M. Bouillaud's practice, which, on the whole, we much approve of, we should say that large depletion by bleeding, &c. in the early stage of small-pox, or indeed, of any of the exanthemata, is seldom borne well. In the cases of fatal confluent variola, mentioned in his "clinique," one patient had been copiously bled twice from the arm, and had 36 leeches applied. On dissection, the lungs were found engorged, and the cavities of the heart empty; the other was bled once freely from the arm, upon the second day of the eruption, and when the pulse was only 84 and the skin was moist.

The exanthemata ought not to be too much interfered with; they have a course to follow and the object of a prudent physician is rather to regulate and control, than to arrest or to divert.-ED.]

Inoculation of Small-Pox Matter in a Person who had been previously vaccinated. The virus was taken from some ripe pustules on one of the preceding cases, and inserted into the arm of a young man who had been vaccinated when young, and in whom the cicatrices of the vesicles were very distinct. Four days after the operation he felt himself not well; but there was no fever. On the 5th day, a small papula appeared on the site of the inoculation; it was hemispheric, depressed in the centre, and surrounded by a red areola. On the 6th, several small papulæ, having the same characters, appeared around the first one. On the 7th, the pustules had lost their umbilicated form, and were more rounded. On the 8th, scabs had been formed; and, on the 10th, these had fallen off, leaving slight traces, which disappeared in the course of a few days.—

Journ. Hebdom. Nov. et Dec.

LXXV.

FOREIGN BODY IN THE TRACHEA FOR

FIVE MONTHS.

A CHILD, 5 years old, in frolic swallowed a French bean; immediately all the signs of suffocation came on, and, after continuing for two hours, they ceased, and the little patient was cheerful, and apparently well: but again the same distress in breathing and the shrill croaking voice returned, and again they vanished-these attacks every now and then came on. After the lapse of 5 months, the child was seized with a violent paroxysm of cough and excessive dyspnoa, which had been brought on by leaping, and in the course of a short time the child died suffocated.

On dissection, two pounds of serum were found in the left pleura, and there were numerous adhesions between the lungs and ribs upon this side; the left lung was much congested, and did not crepitate-its colour was a deep purple. Where the bronchus enters the lung, an inflammatory ring of six lines in diameter was observed; here, no doubt, the bean had lodged during the five months, till it had been displaced by the shaking of the body from the leap, into the right bronchus, where it was found hermetically plugging up the tube.-Révue Med.

LXXVI.

EPIDEMICS INDEPENDENT OF ANY APPRECIABLE CHANGES IN THE ATMOSPHERE. Earon ALIBERT very justly observes, that we cannot well account for the suddenness of the invasion, the quickness of the transition from perfect health to most formidable and fatal disease, the inefficacy of all prophylactic as well as of curative means and many of those inexplicable symptoms, which mark the history of most pestilences, by reference to any alterations in the physical or chemical condition of the atmosphere. He does not deny that these alterations may

eases

seriously affect both man and the lower animals, and may considerably modify the type and general character of many of their dis; but then daily observation abundantly proves that these very alterations may take place rapidly, and to a great extent, without bringing along with them that host of horrors and that desolation which marks the invasion of a pestilential scourge. Tacitus mentions that, during the terrible plague at Rome, in Nero's reign, there was "nulla cœli intemperies quæ occurrerit oculis," but that some earthquakes and dreadful storms had been experienced about that time. The weather which preceded the invasion of the plague in London, in 1665, was pleasant and healthful, according to Sydenham; but while it raged, there was also great mortality of the lower animals, especially of sheep and cows; and it is worthy of remark, that in the years 16645-6, three comets had been visible, and Mount Etna was in a state of constant activity.

According to Fernel, the pestilential dysentery which desolated Europe in 1538-9, was not accompanied by any appreciable changes in the state of the atmosphere; but violent earthquakes and eruptions from Mount Vesuvius occurred at the time. He comes to the conclusion, that it is needless to search for the germ of an epidemic in the air; that it is a poison sent from Heaven upon earth-"inquinamentum a cœlo demissum." In 1580, Egypt was visited by a a plague more terrible than any since the time of Pharaoh; in Cairo alone, half a million died in the course of eight months; and, during the same year, Rome, Hamburgh, Lubeck, and many other towns in Europe, were ravaged by a most fatal epidemic catarrh or influenza; there was also great mortality among all sorts of cattle, and, moreover, a comet was visible for two months. An interesting feature in the history of epidemics is, that they are often present in numerous places, widely remote from each other, and each having very different climates, at one and the same time; and, on the other hand, certain places or districts frequently escape, while all around

is the scene of their ravages. Similar occurrences are met with in the vegetable world; one field of corn will sometimes be found destroyed by the blight, while the adjacent ones are sound and productive, even although their soil is alike, and they have been treated in exactly the same manner. The plague of 1576 depopulated Verona and Padua, and spared Vicenza, situated between them; on the following year Vicenza was visited, and the two other towns escaped.

Again, sudden and very terrible changes in the atmosphere have been known to occur without inducing any pestilential disease. The famous epoch in the 6th century, when storms and tempests so utterly confounded all distinctions of the seasons, that the end of the world was deemed to be at hand; when the sun became pale, and gave only a feeble light for twelve months'toto anno eo, lunæ instar sine radiis lucem tristem præbuit plerumque defectam patienti similis,' when eclipses added to the darkness and horror, when the plants of the earth were dried up and withered away, and when famine stalked abroad among the nations, even then no pestilential disease existed. Many other instances might be mentioned, but it seems unnecessary. We are, therefore, justified in our conclusion, that the air may serve as a vehicle for the dissemination of the germs of pestilential diseases, but that it is not the source which gives them birth.-Ibid.

LXXVII.

LECTURE ON TETANUS. BY MR. MORGAN.

THIS terrible disease seldom occurs in this country, except after wounds or contusions. Mr. Morgan observes that, when it comes on after the healing of a wound, there is generally a premonitory pain in the part, or an increase of pain, if the part be not healed. We need not stop to state any of the symptoms of the disease, as they are too well known. Mr. Morgan doubts whe

ther, in the succesful cases, the remedies or the constitution effected the cure? He has never seen an instance of recovery from acute tetanus, nor heard of one! This seems rather strange. Mr. Morgan must exclude printed reports from under the head of hearing, otherwise he might hear of nume rous cures of acute tetanus, by making one of his pupils read to him for half an hour. We recommend to his perusal Dr. Morrison's little book on the subject. Mr. Morgan considers tetanus as a disturbance in the functions of the brain and general system, caused by their connexion or sympathy with the nerves of the injured part—and by that only.

"Now, whether all diseases, and all morbid phenomena, do or do not owe their origin to nervous sympathy alone, is a question that will never be settled in our time. So far, however, as my own opinions go, I firmly believe that every disturbance in the system may be fairly traced to the sympathy of the brain with a local impression, and not necessarily to absorption, or to any other agent. Let me not be misunderstood; I do not dispute the well-known fact of the absorption of morbid matter by the veins and absorbents, nor of the necessary subsequent conveyance of this matter (whether it be gaseous, fluid, or solid) through the whole circulating system; but what I contend for is this-that neither its contact with the brain, nor its entrance into absorbent vessels, are essentially necessary to its opera tion on the living body. I believe that the sentient extremities of nerves are the parts upon which an impression is first made; and that the different degrees of morbid susceptibility, observed in different structures, may be more satisfactorily accounted for (whether in reference to the application of a poison to the inner coats of absorbent vessels and veins, or to the cellular textures around them) by the theory of nervous communication, than upon the hypothesis of the necessity for the absorption and the contact of the morbid agent with the brain."

Mr. M. was able to produce every symptom of tetanus in animals, by the introduction of chetik, an Indian poison, into

wounds. He next endeavoured to counteract these phenomena by the introduction of other poisons of an opposite nature. This was the ticunas.

"I found, that in cases of artificial Tetanus, brought on in dogs by the means I have mentioned, I could readily control the severity of the spasms, and prolong life by the subsequent inoculation of the ticunas; but that the influence of the remedy depended upon its early application. In more than one case, I have perfectly restored the animal to health by bringing this antidote into operation as soon as the first effects of the chetik were observed, and by regulating its after-consequences by partially, or altogether, cutting off, from time to time, by means of a ligature, all nervous communication between the wound into which it was inserted and the brain. If this latter precaution was not observed, I always found that the ticunas, being the more powerful poison of the two, inevitably occasioned death in a few minutes. In all cases, I took care to insert a quantity of the tetanic poison more than sufficient to destroy life, provided no remedies had been used."

Mr. M. does not indeed recommend his readers to inoculate their tetanic patients with ticunas. His only object is to draw attention to the possibility of obtaining, at a future time, some one or other of its (now unknown) ingredients, a useful remedy for disease, instead of a moans of destroying life.

"Taking this view of the subject, my own plan of treament, in cases of Acute Tetanus, has been, and always will be, to exhibit the most powerful remedies, in every possible way, until the constitution becomes obviously effected by them, and not to begin by half-measures. If, therefore, the stomach appears incapable of conveying the influence of a remedy to the brain and nervous system, I consider it right to make use of it in the form of an enema; and, failing in my object, then I would introduce it into the veins by means of injections. I have never yet had a case under my care in which the last mode of treatment became necessary; for, by the use of

strong enemas, I have always been able to accomplish my purpose; though in most cases of Chronic, and in all cases of Acute Tetanus, without finding that the obvious and powerful impression, produced upon the system by the use of remedies, was of any avail in checking the progress of the disease. I have of course met with a few exceptions; but I do not feel justified in recommending as remedies the medicines which appeared beneficial in these instances; for, in other cases I have found them perfectly inert. Of one thing, however, I feel confident; namely, that more hope of relief is to be expected from a steady perseverance in the use of one remedy than in wavering or confused practice. By a wavering practice different medicines are changed daily, and even hourly; and by a confused one, all manner of powerful agents (sometimes producing opposite effects) are thrown into the stomach together, without rhyme or

reason."

LXXVIII.

ON THE PHENOMENA OF HEARING.

"A GENTLEMAN was slightly deaf, but with the aid of a trumpet he could hear tolerably well; sufficiently to enable him to collect every word uttered in the debates in the House of Commons. He could distingush sounds best with the left ear; and into this the point of the trumpet was generally placed. On the occasion of a more than ordinary subject being debated, and his attention completely engaged, his trumpet was accidentally and suddenly thrust into the meatus, to some considerable distance, which caused great inflammation; the effects of which rendered him incapable of ever hearing again with that ear; and the other being so much impaired as to incapacitate him, but with the greatest difficulty, from carrying on a conversation even with the use of the trumpet. I have observed him frequently to apply one extremity of a cane to a piano and other musical instruments, and to place the other between his

teeth, and by this conductor to distinguish with great accuracy which was being performed. This means of assistance did not long avail; for after a while, and to the time of his decease, (which was some years after this accident,) the conductor became useless, for by it he could neither hear note

nor tone."

"A plan which Mr. Abernethy used to recommend to be adopted for the removal of peas and such like from the meatus, and which I have more than once found useful, was that of placing the side of the head, on which the ear is situated that contains the pea, on a pillow, holding it close whilst the pillow is struck with considereble force, thus to shake it out as it were. I have removed a cherry-stone and a glass bead in this manner. Peas become moist, and swell if they remain any length of time in the meatus, and produce excessive pain, and are with considerable difficulty extracted. The hardened cerumen, if it has long existed in such a state in the meatus, requires some time before it can be completely removed by syringing; and a plan to be observed is, to moisten the meatus and cerumen with a few drops of oil a day or two previous to using the syringé; and a common syringe is of no utility whatever: the one recommended by Mr. Abernethy (and which bears, as characteristic of its superior merits and its inventor, the name of 'Abernethy's Ear Syringe'), is much the best for the purpose."

"The Eustachian tube is sometimes nearly obstructed at its pharyngeal extremity by enlarged tonsils. I remember a case of this kind when House Surgeon of St. Bartholomew's.-A young woman was admitted with enlarged tonsils, which enlargement had existed from birth,—at least she had been deaf in some degree since that period; but when she was admitted as a patient her hearing was much more inpaired than it had ever been till within a short time previous. She had had remedies innumerable applied to her ears, and the adjacent parts; such as blisters, setons, various sorts of medicaments applied within

Mr. Lawrence, however, saw that the affection originated from pressure on the pharyngeal orifice of the Eustachian tube, by which it was made impervious, and recommended the incision of the tonsils. The operation was performed by him, and the deafness was immediately and completely removed."

The preceding Extracts are from an ingenious Essay on the Physiology of the Organ of Hearing, by Mr. Caswall, of London. It evinces very considerable research, and is creditable to the author's industry and zeal.

LXXIX.

ON A SINGULAR AFFECTION OF THE OR-
GAN OF LANGUAGE, PRODUCED BY THE
ACTION OF MORPHIA.
By WILLIAM
GREGORY, M.D. F.R.S. E. Sec. Phren.
Soc.

"THERE can be no doubt that different remedies produce different effects on the mind as well as on the body; and, if medical men, acquainted with the principles of Phrenology, were to direct their attention to the action of remedies on the minds of their patients, a new and interesting field of inquiry would be laid open, and much light would probably be thrown on many obscure points in the history of mind.

Every one is familiar with the fact, that ardent spirits excite strongly the feelings of those who indulge in them. It is stated in the works on Phrenology, that the predominant organs are commonly excited more than the others; but I think we must all have observed, that this excitement is most frequently observed in the lower propensities and the sentiments, while the intellect rarely participates in it.

On the other hand, the intoxication of opium is generally manifested by an increased vividness of intellectual perceptions, without that activity of the lower propensities especially Combativeness and Destructiveness, so often observed in ordinary drunkenness.