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North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826
Author: Various
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We regret very much that we have been unable to procure a copy of GLISSON'S treatise de vita naturae, which, so far as we know, can not be had in this country. We shall, therefore, furnish our readers with the following passage from the Biographie Medicale, from the pen of JOURDAIN.

"The name of GLISSON occupies an honourable place in the history of medicine, because to him we are indebted for the first elements of the physiological doctrine of the present day. Instead of directing his attention to movements alone, as the iatro-mathematicians, and even, to a certain extent, the animists had done, he referred to vitality all the phenomena of nature, of whatever kind, and attempted to reduce them to one, common principle. To this end he admitted, that matter is originally endued with forces inherent in it, and that living bodies in particular, are invested in their organs with a radical force, which, put in play by stimulants, whether internal or external, gives rise to all the phenomena of life. He even went so far as to assert, that sympathy may be explained by referring to the intercommunication of this force, to which he gave the name of irritability."

We shall also cite from SPRENGEL, a passage which throws some light on his theory.

"When they became unwilling, like DESCARTES and STAHL, to have constant recourse in their explanations, to the soul, they tried to find a philosophic proof of the existence of material forces, to show that matter, as mere matter, is endowed with particular forces, with which they might satisfactorily explain a great many of its phenomena. No one had hitherto sought for a similar proof; for ARISTOTLE had contented himself with an axiom, that all natural things contain in themselves the sufficient cause of their movement and rest. GLISSON and LEIBNITZ set themselves in search of this proof; but it was reserved for the immortal KANT to find it in the nature of matter itself.

"FRANCIS GLISSON may with propriety be considered as the precursor of LEIBNITZ. What he tried to demonstrate by scholastic subtlety, and by thousands of syllogisms, was developed by LEIBNITZ with a clearness and ability, which secured the suffrages, even of the unenlightened. Both of them went too far, in attributing life and sensation to matter, instead of claiming for it the two simple and primordial forces of attraction and repulsion.

"GLISSON sets out with the idea of substance, but he does not explain it with sufficient precision. Every substance has three substantial rudiments,—fundamental substance, by means of which it exists,—energetic substance, by means of which it acts,—and additional substance, which determines its accidental qualities. All matter, as substance, must have an energetic substance or nature, which is the internal principle of movement. Therefore whatever moves spontaneously, and in virtue of an internal force, must feel this motion, and desire it. All matter feels that it is, and that it exists by itself. It has therefore, consciousness of its own nature. Life consists in the activity of the internal substantial energetic nature. Death is the dissolution of the triple alliance of the internal energetic substantial nature, with the vegetative and animal natures, which two last belong to the additional substance."[28]

In applying his theory to physiology, GLISSON'S idea is, that the fibres of the human body are endowed with a force, which he divides into three kinds; to wit, natural or inherent force, (robur insitum)—vital force, (robur vitale)—and animal force, (robur animale.)

Natural or inherent force, is a part of the constitution of the fibre, and is as much a property of its organization as are its tenacity, tensibility, &c. The sum of this force varies, in proportion as the constitution of the fibre is more or less perfect. It is strongest in athletic men and strong animals, and weaker in relaxed and debilitated persons. It may be compared with the contractilite de tissu of BICHAT.

The second, or vital force, is something superadded to the inherent sort. It is an influxus, derived to any fibre or set of fibres, from that greater sum of force, which arises out of a more elaborate, complex, and exalted organization. It varies in proportion as the vital spirits flow with more or less freedom; and in proportion as their quality is more or less perfect.

The third kind, or robur animale, may be supposed to depend on the organic constitution of the brain and nerves, and varies according to the state of that organization. We cannot help adverting to the resemblance between these two latter kinds, and the contractilite organique, and contractilite animale, of BICHAT; and this robur comprises, as we shall show hereafter, both the contractilite and sensibilite of the French physiologist.

GLISSON, in his chapter de Irritabilitate fibrarum, commences by remarking that a motive faculty existing in any fibre, unless it were of an irritable nature, would leave such fibre in one of the two following states: 1. It would either never cease from action, or 2ndly, being once at rest, its motion could never be reproduced; but the varieties and differences which we see in the actions of fibres, clearly demonstrate them to be possessed of irritability: i.e. if a fibre may be by turns in a state of action and repose, it is evidently possessed of a quality, whereby it can be induced to move if in a state of rest; this quality he terms irritable, or irritability. The next inference from this power of alternate activity and repose is, that the fibre is possessed of a faculty, whereby it can perceive an irritation offered to it; but this perception of irritation further implies an appetence for a change of its actual state, before the motion can really take place. Perception, appetence, and motion, make a triunit. "In the mean time, says he, as sensitive appetence, and sensibility, are frequently confounded with natural perception, in this irritation of the fibres," he divides it into three kinds, viz. Natural Perception, Sensitive Perception, and Perception regulated by animal appetency.

Natural Perception is that principle whereby a fibre perceiving any alteration offered to it, whether pleasing or displeasing, is excited either to accept that change, or to avoid it, and moves accordingly.

Sensitive Perception, is that kind, in which a fibre, perceiving a change effected in some other organ, is impelled ad aliquid appetendum, and to move conformably.

The third sort, or Perception regulated by animal appetency, is that in which the brain directs from within, such movements of the muscular fibres, as are requisite for the execution of any purpose.

"Some persons," says GLISSON, "may doubt whether there really exists a natural perception of irritation in the fibres; but we have elsewhere asserted in general the reality of natural perception, to wit, in my work, de Vita Naturae; and whoever has known it, will readily admit this quality in fibres imbued with inherent, influent, and vital spirits. We do not expect, in this place, to establish it as a general principle; but if any proof, derived from a knowledge of the structure, uses, and actions of the fibres, can be adduced, it may be here attempted."

"It is indubitable that the fibres are alternately at rest and in motion; for, during sleep, they are all relaxed, with the exception of such as subserve the functions of respiration and circulation, and even these are by turns quiet and active. During waking again, they are all in a state of moderate tonic motion; and moreover, during all movements of the limbs, the antagonist muscles yield spontaneously, the abductors being active, while the adductors are relaxed, and vice versa. Hence it is manifest, that the fibres are alternately quiescent and active: but, since they are not principal or sui arbitrii agents, it is necessary, in order to the new movement, that they should be irritated from some source: for, it is impossible that a fibre in repose, can be set in action without an irritating cause; nor can we conceive of a part being irritated without perceiving the irritation. It is like speaking to a deaf man, or trying to awaken a dead one."

"If you say, fibres are possessed of sensibility, and can be excited by virtue thereof, I confess that they are sensible parts, and may thereby perceive some, not all irritating causes; but whether sensation excites them immediately, or rather, is transmitted to the brain, and irritates the animal appetency; and further, whether the animal appetence, effects a movement in them directly, and to what sort of perception this irritation may be properly and immediately ascribed, is detailed in order below, when we come to explain sensitive perception, and perception a phantasia imperata."

"Let us now go on to point out those cases, in which no suspicion of sensation can be entertained. The pulsation of the heart is neither effected nor affected by sensation; its fibres, in virtue of the irritation occasioned by the blood in its ventricles, are excited to contract, and thus occasion the pulsation, but when the irritation is remitted they relax, and recover the natural state. Now it cannot be denied that this is an evident case of irritation of the fibres, for according as is the irritation, so is the rythm of the pulsation, which varies at times, as in febrile and other affections: nor is it right to pretend that there is any sensation in this case; because this perception of irritation per vices, is exercised as well during sleep, when the senses are all locked up, as in the waking condition. The fibres do not, therefore, perceive in these actions by a sensitive, but by a natural perception, the irritation of the vital blood, which animates them to alternate contraction and relaxation. This is corroborated by those tumultuous irregular motions which continue in animals after decapitation; so also the intestines when still warm in a recently opened animal, move and twist about; the muscles in dead animals also, excited by the perception of cold, contract with a strong tonic movement, and render the body rigid. The hearts of some animals too, when torn out of the body, and even when dissected, continue their endeavours to pulsate. Is there any further evidence wanting? We may hence infer with sufficient confidence that the fibres (without the aid of the senses) may perceive irritation, and move themselves conformably."

In the next place he examines the nature of sensitive perception of fibres, and goes on to show how an impression made on an external part, or a natural perception, becomes converted into sensation, and thus made known to the sensorium. But his disquisition is not only very long but very dark, and we shall therefore pass it by with the exception of the following.

"Natural perception includes within itself a rationem positivam, and a negationem formalem.

"The ratio positiva is the perception of the idea, or image of the object moving or changing the fibre.

"The negatio formalis is a denial or refusal to communicate this image to the sensorium. In the process of transformation into sensation, the positive ratio is not changed, but remains the same, and is the first part, or basis, both of internal and external sensation.

"The negatio formalis is destroyed or abolished in any case of impression communicated to the sensorium. Natural perception, in its ratio positiva, is not abolished or degraded by being converted into sensation, but is rather exalted, or gifted with a more dignified nature. By as much as public or general knowledge is preferable to private, or public advantage to that of an individual, by so much is sensation preferable to natural perception. Hence nature formed so many organs of sense, that the phantasy might have notice of what ought to be done, desired, or avoided."

He does not doubt that external sensibility is inherent in the nervous parts of the external organ, whence he infers that it may readily incite the fibres of such organ ad appetendum et movendum; for, as external sensation is communicated to the brain by means of the nerves, it must of necessity be true, that these nerves and nervous parts (such as the fibres,) are the subjects of it. Since then sensibility causes its subject to feel, it consequently enables it to desire and move comformably. For perception in any subject is vain, unless it can desire, and appetence is useless, unless it can move. External sensibility, therefore, may be said to render the fibres actu irritabiles, for example, as often as the irritating cause is perceived; but as the irritation is perceived, not by a sensibility, but by a mere natural perception, this it is which constitutes their irritability.

Thus we may perceive that the triunit consisting of perception, appetence, and motion, constitutes the celebrated irritability of our author. But he has been too latitudinarian in his application of the theory; for he did not limit it, as HALLER has subsequently done, to one sort of fibres, or indeed to fibres alone, for he says in cap. IX., "It is to be remarked that natural perception belongs to other parts of the body besides fibres; to wit, to the parenchymata, bones, marrow, fat, blood, recrementitious juices, humours of the eye, and such like, all which are irritable, and increase the irritable constitution of the parts, but these parts hardly admit of the existence of animal perception." HALLER blames GLISSON for having gone so far in his application of the theory, and it is well known that he himself restrained it to the single tissue of muscular fibres, and denominated it vis insitum, or inherent force; whereby he distinguished it from his vis mortua or elastic contraction, on the one hand, and the vis nervosum or voluntary power, on the other; the former being something less, and the latter something more than irritability. GLISSON'S theory, when fully explained, which we cannot for want of space do here, will be found to bear a very strong resemblance, in many points, to that of BICHAT, who has invested the matters of the body with vital powers, far beyond those attributed by HALLER; and as we are not furnished in the present article with sufficient space, we hope in some subsequent number, to place this matter in a plainer light before our readers. In the mean time we may remark, that GLISSON seems to be the first of those who have placed the subject fairly before the medical public; for although faint traces of a similar theory may be perceived before him, especially by translating terms into their equivalents, yet he has the merit of using a term which, in spite of all subsequent modifications, is in daily use.

GLISSON'S latitudinarianism may be contrasted with HALLER'S rigid application: for the latter says, "I call that an irritable part of the human body, which on being touched by a foreign body, renders itself shorter;" thus while GLISSON attributes his triunit of perception, appetence, and motion to all the tissues and fluids, HALLER confines it to muscular fibre alone. No one can doubt that the membranes of the body are endowed with vital properties, but yet they do not shorten themselves on being touched by a foreign body. BICHAT has distinguished their vitality as organic vitality, and the contractile qualities displayed are divided into insensible organic contractility, and into contractility of tissue: but these sorts of contractility mount up by insensible gradations. He says, that "entre la contractilite obscure mais reelle, necessaire a la nutrition des ongles, des poils, &c. et celle que nous presentent les mouvements des intestins, de l'estomac, &c. il est des nuances infinies, qui servent de transition: tels sont les mouvements du dartos, des arteres, de certaines parties de l'organ cutane," &c. We will close with a comparison between GLISSON'S irritability, and BICHAT'S contractility. At page 70 of the Treatise sur la Vie & la Mort, BICHAT supposes that a "muscle enters into action, 1st. by the influence of the nerves which it receives from the brain, and this is a case of contractile animale," (which differs in no respect from perception regulated by animal appetency of GLISSON). 2ndly. According to BICHAT, the muscle enters into action "by the excitation of a chemical or physical stimulant applied to it, and which artificially determines a movement of the whole muscle, analogous to what is natural to the heart, and other involuntary muscles. This is sensible organic contractility or irritability," and corresponds to the sensitive perception of the old English physiologist. In the 3d place it enters into action by the stimulus of the fluids which circulate in it, and this is insensible organic contractility or tonicity of BICHAT, and is nothing different from GLISSON'S natural perception. BICHAT makes a fourth case; as for example, when a muscle is divided across, it contracts by a contractilite de tissue, or par defaut d'extension. We do not perceive how GLISSON'S natural perception can be applied to this case, but he treats of it in his fifth chapter under the head of Cessatio: it is that state to which a fibre is reduced when left to itself, and freed from all stimulus.

BICHAT has attributed to some fibres the power of active elongation. On this subject GLISSON says, "Impossible enim est, ut simplex fibra, sua sola actione, se secundum longitudinem distendat, nec modus quo haec fiat concipi nedum effari queat non negavero quin in distensione hac, aliqualis fibrae actio includatur, sed ea tota contractiva est, & distensioni ab extranea causa factae reluctatur." A doctrine as sound as that of the 47th proposition; a doctrine too, without admitting which, we think no man can understand the theory either of simple inflammation, or of the febrile affections. We hope to resume this subject at an early period.

FOOTNOTES:

[25] Haec ei generatim videbantur, ex igne omnia constare eodemque interire. Diogenes Laertius.

[26] Quatuor aeternus genitalia corpora mundus Continet; ex illis duo sunt onerosa, suoque Pondere in inferius, tellus atque unda, feruntur, Et totidem gravitate carent, nulloque premente Alta petunt, aer atque aere purior ignis.—OVID—Metamorph.

[27] Lib. de Carnibus, HIPPOCRATES says: Quod Calidum vocamus, id mihi immortale esse videtur, cunctaque intelligere, videre et audire, sentireque omnia, tum praesentia tum futura: cujus pars maxima cum omnia perturbata essent in supremum ambitum secessit; quod, mihi veteres aethera appellasse videntur. Altera pars locum infimum sortita, terra quidem appellatur, frigida et sicca multas que motiones habens, et in qua multum sane calidi inest. Tertia vero pars medium aeris locum nacta est, calidum quid existens. Quarta pars terrae proximum locum obtinens humidissima et crassissima. His igitur in orbem agitatis cum turbata essent, calidi magna pars alias in terra relicta est, partim quidem magna, partim vero minor, alias etiam valde parva, sed in multas partes divisa. Et temporis successu a calido resiccata est terra, ista in ea tanquam in membranis contenta circumse putredines excitant, ac longo tempore incalescens quod quidem ea terrae putredine pinguedinem sortitum est et minimum humidi habet, id citissime exustum ossa produxit. Quae vero naturam glutinosiorem sortita sunt et frigidi communionem habent, ea neque calefacta exuri potuerunt, neque etiam humida fieri ideo formam longe ab aliis diversam nacta sunt et nervi solidi exciterint, cum non multum in iis frigidi inesset. At venae frigidi multum habebant cajus pars circumcirca ambiens et quod erat glutinosissimum, a calido exassatum membrana extitit. Quod vero erat frigidum, a calido superatum, dissolutum est ideoque humidum evasit.

[28] K. SPRENGEL, Hist. de la Medicine.



QUARTERLY SUMMARY

OF MEDICAL AND SURGICAL INTELLIGENCE.

I. ANATOMY.

1. Papillae of the Tongue.—At the upper surface of the tongue, say MM. LEURET and LASSAIGNE, in their recent work on digestion, the mucous membrane presents projections of three different species; and these are, the sensitive papillae, the epidermoid papillae, and the mucous cryptae. The sensitive papillae are numerous. They occupy the anterior four-fifths of the tongue, on which they are implanted by a narrow pedicle. The rounded head of these papillae is much more prominent in the living subject, than after death; but injections are capable of restoring them to their pristine form. Nervous fibres from the lingual branch of the fifth pair have been distinctly traced to their roots. These papillae are of various sizes; at the root of the tongue they form a V. They are all vascular and nervous. The sense of taste is referred by these writers almost exclusively to the above papillae.

The epidermoid papillae are of a nature similar to those retroverted prominences so remarkable on the tongue of the cat; as well as in the lion, and some other animals. They are larger in many species than in man, and, in general, the sensibility of the tongue appears to diminish in proportion to the remoteness of the subject from the human structure. The epidermoid papillae are separated from the tongue along with the epidermis, or rather, epithelium, by maceration for a few days in vinegar. They are pyramidal in form. They are grouped round the sensitive papillae, except on the edges and point of the tongue, where they are rare. Their base is perforated, and always gives outlet to a crypta. In an epithelium separated from the tongue, these minute and numerous perforations are easily distinguished from the larger ones left by the sensitive papillae.

The office of the epidermoid papillae appears purely mechanical.

The only cryptae which produce, of themselves, a visible projection on the surface of the tongue, are situated at its base. They are formed by the mucous membrane, like other cryptae, and are scattered between the sensitive papillae.

In the tongue of birds, there is always a bone or cartilage; and the external membrane is dense. In reptiles the tongue is soft, possessed of little sensibility, and capable of great elongation. In fishes it is endowed with little motion, and is often wanting.—Bulletin Medicale.

2. Villi of the Stomach and Intestines.—MM. LEURET and LASSAIGNE state that the villi can be easily injected; most conveniently from the vena portae, though the arteries may be employed. In the latter case, the matter of injection is effused into the intestinal or gastric cavity. The villi are peculiar to these parts; they are inversely conical, adhering to the membrane by their smaller end. The best mode of exhibiting them, is to tie the vena portae of a living animal, when they erect themselves by the afflux of blood. These diminutive organs, about 3/100 of an inch long, then exhibit distinctly, under the microscope, four red longitudinal lines, being probably vessels.

Injections made retrograde from the thoracic duct, pass through the villi into the intestines. When the stomach of a man, who died of some complaint not deranging its condition, is examined, we sometimes find its lining membrane covered with a multitude of minute white points. These are the villi in a flaccid state. In those who have died during digestion, they are erected, and of a rosy colour.

When the intestine of a living animal is examined under a microscope, after being carefully washed, a great number of orifices are seen, from each of which exudes a minute drop of a transparent fluid. These rapidly disappear; and then the villi attract attention. What these foraminula are, the reviewer, M. DU FERMON, does not tell us.—Ibid.

3. Minute distribution of the Vessels of the Liver.—M. CRUVEILHIER gives, in his lectures, an account of the results he has obtained from a minute injection of the liver. He finds, 1. The acini surrounded with a dense, cellular texture, paler than themselves; 2. The ramifications of the hepatic artery distributed to this cellular envelope; 3. Those of the vena portae spread around the acini, or granulations of the liver; and 4. Those of the biliary ducts, and of the hepatic veins, emerging from the cavities of these bodies.

Our readers will observe a great similarity, in this, to the arrangement of the lobules of the kidneys.—Ibid.

4. Trachea perforating the Aorta.—This odd distribution of parts, was observed by M. ZAGORSKY, at St. Petersburg, in 1802. The aorta divided itself, at its arch, into two branches, which received the trachea between them, and again united, exactly fitting the organ they received. They were found to have compressed the trachea, and probably produced difficulty of breathing.

In another case, in 1808, the right subclavian artery, instead of its usual origin, arose from the left extremity of the arch of the aorta, and crossed behind the trachea, thus including the latter between it and the aorta.

Why do we call the common trunk of the right subclavian and carotid, the arteria innominata? Is coining words so difficult a task, that we cannot find a proper and expressive name for it? The French call it brachio-cephalic, and this expresses its office and distribution.—Ibid.

5. Monsters.—These productions, hitherto considered as mere objects of wonder, from the study of which no useful inference could be drawn, have recently attracted a good deal of attention in Paris. There seem to be some close affinities discoverable in many of them, not only with the natural and complete forms of animals of various tribes, but even with the actual condition of their own species, while in the foetal state.

The views of M. GEOFFROY ST. HILAIRE seem to us rather mystical and vague. Those of BRESCHET, and the other practical anatomists, we can understand much better.

6. Malformation of the Heart.—Drs. BAILLIE,[29] LANGSTAFF,[30] and FARRE[31] have each published cases; and M. TIEDEMANN, in his journal of Physiology, now adds a fourth, in which the aorta and pulmonary artery were found to have changed places. In professor TIEDEMANN'S case, the two circulations were entirely distinct; the systemic blood passing from venae cavae to right auricle, from right auricle to right ventricle, and from this, through the aorta, to the body at large; while the pulmonary blood ran through an equally simple circle, by the route of pulmonary veins, left auricle, left ventricle, and pulmonary artery. The only communications between the two circulations, were the foramen ovale, the ductus arteriosus, and, in the opinion of M. TIEDEMANN, the inosculations between the branches of the pulmonary and bronchial arteries.

The infant is recorded to have presented no peculiar appearances till the ninth day; when attacks of suffocation came on, attended with the blackish blue colour, and followed by death, at the end of twelve days. Similar histories are said to be given of the cases mentioned above, and the references to which we have copied. We have not the time to consult them.—Ibid.

7. Acephalous Mummy.—M. GEOFFROY ST. HILAIRE has read a memoir of some length to the Academy of Sciences, on an acephalous mummy. It was found in a catacomb, destined, with this exception, exclusively to animals. It had an amulet suspended round its neck, being an earthen figure of a cynocephalus, for which it was very probably mistaken by the Egyptians. The collector, M. PASSALACQUA, who obtained it, showed it to M. G. ST. H. as a monkey, of which he wished to know the species. Yet the latter observes that these amulets were only put on human mummies.

M. G. concludes that the monkeys, elephants, &c. said by Livy, Valerius Maximus, Pliny, and others, to have been born of women in their times, and considered as omens of public calamity, were acephala.

8. New Anatomical Plates.—Messrs. E. W. TYSON and GEORGE SIMPSON are publishing anatomical plates, in London. They are spoken of with approbation. The labours of the latter are designed for the use of painters.

9. A Manual of Osteology has been undertaken by Dr. WEBER, of Bonn, and one volume published.

10. Soemmering's fine work on the anatomy of the ear, has been translated into French, and his splendid folio plates copied in lithography.

11. Does the conjunctiva run over the cornea? Messrs. LECOQ, LEBLANC, and ARTUS, state that they have each seen a case in which regular skin and hair were seen, forming a small patch on the cornea of the eye of a quadruped. This is considered as a proof of the existence there of a membrane naturally analogous to the skin; which must, of course, be the conjunctiva. An officer saw another case, in which a hair was seen in the middle of the eye of a horse.—Bulletin.

II. PHYSIOLOGY.

12. Electro-Galvanic phenomena of Acupuncturation.—M. POUILLET, after making a complete circuit, through a needle introduced in acupuncture, through wires, and through the patient's mouth, found, by means of a multiplier of SCHWEIGHER with a magnetic needle, that the electro-magnetic rotation could be readily produced; at least so far as to effect small vibrations backwards and forwards. On repeating it with two needles, one of them run into an artery and another into a vein, or one into the medulla spinalis, at the neck, and another into an extremity, in a rabbit, no effect whatever took place.—Magendie's Journ. de Physiologie.

13. Variations in Milk.—Milk, says M. VALLOT, in his memoir read to the Academy of Dijon, may be red. The cause of this is unknown, though it has given rise to superstitious fears. Some have observed that the cow's teats are then tender. Whether this be cause or effect has not been ascertained.

Yellow milk is said to have been produced by the cow's eating the caltha palustris, (marygold.) Blue milk, from a cause still unknown, in the departments of Seine-inferieure and Calvados. Some have ascribed it to the hyacinthus comosus; others to butomus umbellatus.

The green milk of some writers is supposed to be only blue. Milk not coagulable is produced by feeding on husks of green peas, and on mint. Bitter milk, from wormwood, sonchus alpinus, and the leaves of the artichoke; and in goats, from eating freely of elder, (sambucus nigra,) and potato-tops; a disagreeable taste, from turnips, in Upper Canada. Garlicky milk, from causes well known. Insipid milk, and lead-coloured butter, from equisetum fluviatile. Milk unnaturally sweet and luscious, (sucre,) from alpine clover, (trifolium alpinum;) and red butter, from the ripe berries of asparagus.—Bulletin.

14. Hyoscyamus dilates the pupils of the eyes, the same manner as stramonium, several Eastern species of datura, and belladonna, which the Europeans use. The strongest species was datura fastuosa.—Oriental Magazine, apud Du Fermon.

15. Worms in the Eye.—Several cases of worms in the eye are mentioned in the Bulletin des Sciences Medicales, for Feb. 1826. DEGUILLEME saw several in the eye of a cow; and the case was published by GORIER, a veterinary teacher, in his memoirs. In the report of the proceedings of the veterinary school at Lyons, in 1822-3, there is the case of a mule, in which a knot of worms (crinons) was seen in one eye. Two were extracted; (why no more is not said;) and another subsequently. No inflammation was produced; but a violent nervous agitation of the head, and a turning of it to the left side took place. Next follows an account of a memoir read before the Medical Society of Calcutta, but of which the name of the author is not given. He is represented as stating, that the strongylus armatus minor of RUDOLPHI, and the filiaris (filaria) papillosa, are frequently found in the eyes of the horses in India, but much more so in the cellular membrane, particularly about the loins. He believes that they make their way into the blood-vessels, and, through them, into the eye. Their most ordinary seat is the cellular membrane of the loins; where they exist for years, producing emaciation, and, at length, paralysis of the hind legs. This last the Calcutta author is represented as ascribing to the penetration of the spinal marrow; but he does not appear to have verified it by dissection. TREUTTLER says, he has seen the strongylus armatus in aneurisms of the mesenteric artery of the horse; but the writer in the Bulletin doubts whether any have ever been found in sound arteries.

Dr. KENNEDY, in the Edinburgh Philosophical Transactions, describes a worm, which he calls ascaris pellucidus, (pellucida,) as being common in the eyes of horses in India. A review of BREMSER'S work on worms is expected in our next, and inferences will then be drawn from these singular facts.

16. Digestion.—MM. LEURET and LASSAIGNE, in their very interesting and valuable experimental essay on this subject, have met with many curious results.

They found no remarkable difference in the saliva of carnivorous and herbivorous animals. The purest saliva was obtained for their experiments directly from the parotid duct, in man, the horse, and dog. The composition was as follows:

Water, 99 parts; mucus, traces; albumen, soda, chloride of sodium, chloride of potassium, carbonate of lime, and phosphate of lime, 1 part. Total, 100.

Their experiments on the bile confirmed the results of THENARD and CREVREUIL.

The pancreatic juice is of the specific gravity 1.0026; at 15 deg. of the thermometer: (centigrade, we presume.) Its composition is:

Water, 99.1 parts; animal matter soluble in alcohol, animal matter soluble in water, traces of albumen, mucus, soda, chloride of sodium, chloride of potassium, and phosphate of lime, 0.9 parts. Total, 100. This greatly confirms the analogy long observed between the pancreatic liquor and the saliva.

In the gastric liquor, there are:

Water, 98 parts; lactic acid, muriate of ammonia, chloride of sodium, animal matter soluble in water, mucus, and phosphate of lime, 2 parts. Total, 100.

Dr. PROUT and Mr. CHILDREN have announced the gastric acid, of which so much has been said, to be the muriatic, while M. CHEVREUIL had stated it to be the lactic. MM. LEURET and LASSAIGNE confirm the results of CHEVREUIL, and that with great confidence in their own accuracy. They found the contents of all the four stomachs of ruminating animals acid. MM. PREVOST and LEROYER had stated those of the three first to be alkaline. The observations of LEURET and LASSAIGNE agree with those of MONTEGRE, (vide Dict. des Sci. Med.) who believes digestion to produce acidity as a result of the regular process.

The faeces become alkaline.

Substances which contain no azote, from whatever class they are obtained, cannot serve for nutrition. We cannot understand this, especially when compared with what follows. "If, on the contrary, they are soluble, one part is absorbed and another is expelled, either by urine or by the anus; such are sugar, gum, &c." This seems to us like a contradiction.

It is impossible, in the present state of science, to determine the chemical change which aliments undergo in the digestive organs; both on account of their mixture and the insufficiency of our means of analysis.

"The absorption of chyle takes place by the villi." "These communicate directly with the lacteals and the vena portae."

"The transference of the chyle takes place by the lacteals; nevertheless, if they are obliterated, this may be done through the vena portae."

The section of the pneumo-gastric nerves does not stop the dilution of aliments in the stomach, or chylification.

The juices secreted by the liver and pancreas, are poured into the intestines in greater quantity during digestion than at any other period; in consequence of the contact of the acid chyme with the biliary and pancreatic orifices.

The pancreatic juice is analogous to the saliva.

The spleen is an appendage to the liver; it swells during the absorption of liquids by the vena portae.

Liquid aliments are digested, just as much as solid; but they do not require so great a quantity of gastric and intestinal juices.

Watery drinks are absorbed in the stomach and intestines, by the radicles of the vena portae. Spirituous drinks occasion an afflux of the gastric juices, become acid, and are absorbed.

Excrements owe their colour and odour to the bile, and their consistence to the absorption of a portion of the water they contain. They carry off a large amount of the nutriment.

Great obscurity still remains as to the cause of hunger.

Thirst is thought to be produced by the drying which the pharynx undergoes, from the passage through it of the air used in respiration, and at a time when the supply of mucous fluid is scanty.

Our readers will have perceived, long ere this, that here are several propositions at war, not only with our received opinions, but with the experimental researches of some others among the modern physiologists. We do not know what Dr. WILSON PHILIP would say to his observations being so cavalierly dismissed: they seem scarcely to condescend to mention his name in France. Not having the original, we could do no better than translate, almost literally, the conclusions of these experimenters, as stated in the Bulletin; and the result of this is what we have just given our readers. From the words "the absorption of chyle," to the end, is nearly verbatim the language of the review.

III. PATHOLOGY.

17. Dothinenteria. Pustules of the small Intestines.—From [Greek: dothine], a pustule, and [Greek: enteron], an intestine. This name is given to a disease which has been described by M. BRETONNEAU, of Tours, and, after him, by SERRES, BROUSSAIS, ANDRAL, and several others, and consists in pustules, generally situated at the lower end of the ileum.

We are constantly lamenting to ourselves the contracted bounds allotted to our Quarterly Summary. Indeed, were it not for other objects, it might occupy, with advantage, half of the number, and most of the time employed in the preparation of the work. Every thing must be curtailed, though cut off at the most interesting and valuable point; and the painful exertion of the attention, necessary to condense information for our readers' use, of the amount of which they cannot possibly be aware, can only be equalled by the constant feeling of disappointment at rejecting so much important matter.

We are told that this pustular disease is as common and as destructive as the small pox, (indeed!) the measles or the scarlatina; that few persons spend the whole of their lives without having, at some period, suffered by it; that it never affects individuals but once; and that it is suspected of being contagious.

M. BRETONNEAU has prepared a set of specimens, taken from the bodies of those who have died in various stages of this complaint. He traces the malady day by day, with a precision which we will not copy here. The seat of this affection is the glands of PEYER and BRUNNER. The former are found in groups, throughout the lower half of the jejunum and the whole of the ileum, gradually increasing in the size and number of their clusters, till they reach the valve of the colon, where they cease. They have been mistaken by some dissectors of the modern school for the effects of inflammation. They are found in honey-combed patches; which are agglomerations of mucous glands. The glands of BRUNNER are thinly dispersed mucous follicles which are scattered singly throughout the whole length of the small intestines, with nearly equal frequency. These organs are well described by HALLER in the great Physiology. They are not seen well, unless in a young subject, and by cutting into the intestine very close to the mesentery.

When inflamed, they swell and thicken, and, after some days, the membrane around them assumes a reddish tint. The mesenteric glands are enlarged. M. BRETONNEAU has seen one as large as a hen's egg: they generally equal in size that of a pigeon. The disease spreads and affects an additional number of glands. It reaches its acme generally on the 9th day; after which sometimes all, and always a part of the affected glands return to their natural condition, by resolution of the inflammation. Those which are to run the full course of the disease continue to augment in size and projection into the intestine. On the 13th and 14th days they are discovered tinged with bile, which penetrates their substance, and thus proves the occurrence of disorganization. On the 15th and 16th, the sloughs separate, and leave from one to six ulcers. These penetrate the gland, and with it the mucous membrane, of which it forms a part, and next, the cellular tissue of the intestine. In numerous instances they perforate the muscular coat, leaving nothing but peritoneum at the bottom; and frequently, passing this, they induce inflammation of the cavity of the belly, and death.

The cases of simple resolution terminate in three weeks: those in which sloughs are formed, in from 30 to 40 days, if not fatal. If death be from peritonitis, it is of course soon after the 15th and 16th days; if from exhaustion, at periods varying according to the strength of the sufferer. Dothinenteria occurs in many of the cases commonly called typhus fever, gastro enteritis, &c. It is proper to remark that both the author and the journal are in opposition to Dr. BROUSSAIS.—Archives.

18. Dr. Broussais.—While the opinions of this celebrated reformer have been gradually becoming more extensively known among our countrymen, the war has prevailed with increased heat in his native land. The most vehement attacks are made, from various quarters, upon his system of medicine physiologique. No one appears to deny that he has clearly proved the existence of mucous gastritis and enteritis in many or most fevers, or the propriety of directing a part of the remedies to them. Criticisms and invectives are freely emitted: but they are only levelled against the too extensive application of this doctrine, and the inconsistencies, unquestionably often real, of the system of which he has made it the foundation. Indeed, if the quotations given are correct, we think no one who has not assumed a party, can refrain from concurring in their condemnation.

"Those who understand our doctrine never attack it; they speak of it only to express their admiration: above all, they never think of wishing to modify it, because they know that its fundamental dogmas are unshakeable." "Surtout ils ne s'avisent jamais de vouloir la modifier," &c. A man who assumes such ground as this, had need be very careful in assuming his positions, indeed; and should particularly avoid any thing like self-contradiction.

The Lettres a un medecin de province, in a style of lively criticism, labour to show a great variety of inconsistencies in this immoveable doctrine. The review of this publication in the Revue Medicale, including copious extracts, coincides with, and evidently wishes to aid, the author's satire. In the same journal are a series of criticisms on some of the elementary propositions of Dr. BROUSSAIS, published in a late edition of his Examen; (nearly the same which were published here, some time since, in the American Medical Recorder, having been translated by Dr. ATKINS.) In these critiques, great severity is shown, in dealing with the new dogmas, and the doctrine is treated as one of dangerous tendency; while, at the same time, high praise is awarded to their author, for his discoveries in the diseases of the alimentary mucous membranes.

In the other journals, there is a division; some favouring the new opinions, while others oppose them with more or less of vehemence.

That the doctrine of gastritis has made a great impression at Paris, that almost every one believes in it, to a greater or less extent, appears undeniable; but there, as well as here, most of the more rational, and moderate minded men are evidently of the only school a physician ought to belong to, the eclectic. Borrowing largely from BROUSSAIS, and having had their minds powerfully stimulated by the succession of striking and novel ideas which he has introduced, they think it unmanly to "bind themselves to his chariot-wheel," but form conclusions for themselves from every resource within their power. If the great French reformer really wishes to establish as absolute a power over the minds of his followers, as MAHOMET or PYTHAGORAS did, and as the above-quoted extract seems pretty fairly to indicate, he must certainly undergo many mortifications. Notwithstanding the "inebranlable" nature of his dogmas, M. MIQUEL has furnished us with several variations from them, in the writings of Messrs. BOISSEAU, ROCHE, SANSON, REMUSAT, RICHOND, and BEGIN; and the last-named individual has had a public dispute with his preceptor.

M. BEGIN has produced his promised work on surgery, according to the principles of the new school. We have not seen the volume, but have read a review of it in the Revue Medicale, by M. BELLANGER. The latter describes it as a cursory work, having for its object the adaptation of surgery to a set of general principles, rather than a detailed system of instructions how to proceed in each individual case. It contains only what is easy to be remembered, and omits those matters for which it is usual to refer to books. Thus two pages only are appropriated to fractures of the body and neck of the femur! and twenty-six for the whole subject of fractures, wounds, and six or eight of the most important diseases, of bones! Yet all this criticism is not without a compliment, well-merited at least by the former productions of the same author, to his talents and ingenuity.

19. Whooping-cough.—"There is no disease of children, in which the resources of medicine are more manifestly serviceable than in an obstinate whooping-cough." Such, in amount, was the opinion of Dr. UNDERWOOD, and Dr. WATT uses language almost equally strong. Certainly, we are not at all times equally successful or equally sanguine in America.

Dr. A. CAVENNE considers whooping-cough a true bronchitis, a pulmonary catarrh; accompanied with greatly heightened nervous symptoms, owing to the irritable period of life at which it occurs, and particularly to its frequent existence in nervous constitutions. Professor TOURTELLE calls it a pneumo-gastric, pituitous catarrh; and certainly, the pupils of a modern school will find no difficulty in recognizing symptoms of gastritis in its severer forms. The further inferences drawn by Dr. CAVENNE, are as follows:

1. That the whooping-cough, in an individual of a sanguine temperament, requires, in general, the use of bleeding, and a debilitating regimen.

2. That bleeding and a debilitating treatment are equally necessary, whatever be the temperament, in whooping-cough of the chronic form.

3. The antispasmodics are necessary in nervous constitutions.

4. That blood-letting and the debilitating treatment should be rejected, when the subject is endowed with a lymphatic temperament. This observation, says our author, is equally applicable to early infancy, in which lymph predominates over the red blood, and the fluids are more diluted.

Finally, if the disease be obstinate and there be disturbance in several functions, there is certainly reason to believe that a lung, a viscus of the abdomen, or the brain, is in an unfavourable condition; (the author means of the inflammatory kind;) and this is ground for the moderate abstraction of blood.—Journ. Univ. Feb.

20. Antiperistaltic globus. Globus hystericus.—Dr. TROLLIET, of Lyons, observes that hysteria cannot, with propriety, be said to exist in the male sex; that it arises, as its name imports, from derangement of the uterus, and that CULLEN and SYDENHAM have done wrong, and stand alone, in teaching the contrary. When there exists a real hysteria, the contractions are not confined to the intestinal regions, but invade the neighbouring parts; (quere, which of them contract?) they are always accompanied, when existing in a high degree, with convulsions and loss of the mental powers. In the intervals, the patients affected can satisfy their appetite.

Antiperistaltic globus may occur from various causes; and either in the intestines or the oesophagus.

That of the intestines is met with chiefly in advancing age; and is generally produced by daily and often-repeated pressure on the abdomen, as practised in various professions. Hard labour and bad diet also greatly aggravate it. At first pain in the intestines occurs, aggravated by labour; together with derangement of digestion.

The sensation of a globe then appears on the lower and left side of the abdomen; and, after performing various circuits, finally reaches the stomach; from which is soon after discharged, with great relief, a quantity of gas, issuing from the mouth. Vomiting of an acid and burning fluid, as also of the food, is not uncommon as an accompaniment. This ball is about the size of a man's fist, and is sensible to the external touch, and even to the sight. The patients possess the power, to a certain extent, of controlling its motions, and relieving the pain, which is often extremely violent, by pressure.

Indigestible food always aggravated the disease. Some could only tolerate milk, broth, and other fluids. A weaver was obliged to quit his profession, from the pressure on the abdomen which it required, occasioning the paroxysms.

The treatment consisted in

1. Avoiding the original causes.

2. The use of a species of corslet, (plastron,) to prevent future pressure on the abdomen.

3. A rigid diet. We do not understand why, firstly, articles containing a great deal of fecula, and, as it is said, "requiring a great action of the intestines," are forbidden, while, in the second place, rice is recommended. "Bouillon aux herbes," (a laxative decoction,) rice-cream, and milk, were found the best. Wine was injurious. Assafoetida and camphor were useful, and were administered in boluses. Purgatives were injurious. Emolient enemas were useful.

Of antiperistaltic globus in the oesophagus our author saw only two cases, which were not complicated with hysteria. The patients had both been subject to rheumatism; and, in one of them, this had been supplanted by an eruption Of tetter: on the disappearance of which last the globus appeared. These cases were cured, the latter by a severe, light diet, and some antispasmodics, the names of which are not mentioned; the other by curing the rheumatism.

Dissections are somewhat difficult to obtain; unless where some other more mortal disease exists. In one, scirrhus of the pylorus was found; the stomach greatly enlarged; the small intestines contracted, red outside and gray within. (Where was the redness situated; in the peritoneal or the muscular coat? We must guess the latter.) The stomach was pale gray, and thickened. The large intestines were dilated, and gray.—Journ. Univ.

21. Non-contagion of Yellow Fever.—Dr. VALENTINE, of Nancy, has printed a pamphlet of a single sheet, in which he finds himself involved in all the turmoil, through which American physicians passed during the period which intervened between 1793 and 1805. Dr. V. gives his authority decidedly in favour of the non-existence of a contagion in this disease; and grounds his opinion upon the innumerable cases of patients affected with the disease and otherwise, who have escaped from infected districts, without communicating the malady in any instance, to the persons with whom they lived; upon the healthiness of ports, from which it has been said to have been introduced, &c. Dr. V. is not, as some of his countrymen have been, unwilling, from some unimaginable cause, to make use of the immense mass of American evidence; though he observes, and with justice, that experiments should be repeated in France, in order to set the public mind at rest in that kingdom. He proposes the employment of criminals for this purpose; and recommends every mode of the most close contact which his imagination could suggest. He mentions experiments of this kind having been made in the United States; and by M. GUYON, of Martinique, on his own person.

He quotes Dr. CHERVIN's labours, with great and just applause. This indefatigable and daring physician has now spent upwards of ten years in accumulating proofs upon this single question.

At the commencement of the pamphlet, the arrangement of which does not seem to us to be quite clear and easy, Dr. V. gives a sketch of the situation and localities of Leghorn. He traces the fevers of that place to putrid matters, perceptible by the sense of smell; and principally to obstructed drains. He does not give the exact degree of heat, but merely states that it was excessive, and followed by heavy rains.

IV. THERAPEUTICS, MATERIA MEDICA, AND THE PRACTICE OF MEDICINE.

22. Iodine.—In the former numbers of this journal, we offered some observations respecting the medicinal properties of iodine, intending then to present in one of our future numbers an elaborate analysis of a valuable work on this subject, by Dr. Manson, which appeared in England sometime last year.[32] Fearing, however, that the want of room and time will prevent us from fulfilling this task, as soon as soon as might be desired, we have thought that a condensed notice of its contents would be acceptable in this place.

It appears that previously to the discovery of iodine as a medicinal agent, our author used the burnt sponge in bronchocele, a disease very common in the neighbourhood of Nottingham, where he practices. But when the effects of the former remedy was announced, Dr. M. prepared a tincture composed of one drachm of iodine to two ounces and a half of rectified spirit, (spec. grav. 916.) and prescribed it very extensively in doses of from 10 to 30 drops three times a day, according to the age and strength of the patient. Dr. MANSON has presented a tabular view of 116 cases of bronchocele treated by iodine, and also a detailed account of 15 more cases, with appropriate remarks. Of the former, there were, viz:—

Males—Cured, 10 Much relieved, 1 Discharged for non-attendance, 1 Improving under treatment, 3—Total 15 Females—Cured, 66 Much relieved, 9 Not relieved, 2 Discharged for non-attendance, 10 Improving under treatment, 14—101—116

Whilst using the tincture internally, Dr. MANSON occasionally had recourse externally to a liniment composed of

Liniment. Sap. Comp. [Symbol: ounce]i Tinct. Iodinae, [symbol: dram]i m.

Some patients can bear this quantity rubbed into the tumour once, and sometimes twice a day; though in some, the skin is so tender, that the liniment cannot be so frequently used. Dr. M. prefers this liniment to the common iodine ointment, as less liable to evaporation. In France, we believe Dr. RICHOND prefers rubbing in the tincture itself. The following remarks are useful:

"In some individuals, after the preparations of iodine have been given internally for some time, they are apt to occasion headach, giddiness, sickness of stomach, with some degree of nausea, langour, and inaptitude for exertion; when these unpleasant sensations and effects occur, the best plan to remove or obviate them is to suspend, for a time, the use of the medicine, or to reduce the dose, as may seem most expedient." A reduction of dose, from fifteen to twelve drops, was the plan adopted by our author on this occasion.

2d. Paralysis.—Want of success with the ordinary modes of treating this disease, induced Dr. MANSON to try the effects of iodine.

"The wonderful powers of iodine, which I had recently witnessed; and a long previous acquaintance with the same remedy as it exists in burnt sponge, in reducing morbid enlargements of the thyroid gland, led me from analogy, to think, that in cases of palsy, from tumours or fluids pressing on the brain or spinal cord, or from morbid thickening of the investing membrane of the cord itself, iodine might prove a useful remedy not only by stimulating the nervous system, and removing morbid tumefaction and effusion, but also by correcting the strumous state of the constitution that often gives rise to the disease."

The following interesting case as abridged in the Medico-Chirurgical Review, for January 1826, we take the liberty to transcribe.

"J. Watterton, aged 19, was admitted into the General Hospital of Nottingham, on the 27th of March, 1821, having been ailing since October, 1819. Stated that he had at first been attacked with pain in the bowels, which having ceased, the lower extremities became swelled and painful.

"After this, his neck became stiff and painful, with shooting pains from the neck into the left side of the head. These also disappeared, and did not afterwards return. This was about nine months ago, and, at that time, he suddenly lost the power of the left arm, and in a short time afterwards, that of the left lower extremity. Some time after this, he recovered, partially, the use of the left arm; the leg remaining paralytic. About this time, the right half of the body was instantaneously and completely palsied. He has continued ever since in this wretched state, getting worse rather than better, passing his stools and urine, involuntarily. He lies on his back, and, with the exception of the left arm, he is completely paralytic on both sides, from the neck downwards. The sense of feeling is very much impaired—there is no distortion of the face, nor impediment of speech. Is troubled with twitchings in the lower extremities. Purgatives—blisters to the nape of the neck, and to be kept open.

"It appears that, about two years ago, he had a bloody purulent discharge from both ears. The left still continues to discharge a purulent looking matter. Purgatives were continued till the 6th of April, when the tincture of iodine, in doses of 15 drops, was given thrice a day. April 9, can raise the right arm nearly to the head; but the power of the lower limbs has not improved. The twitchings have decreased. Purgatives—the tincture of iodine to be increased to 20 drops ter in die. 10th. Evinces some muscular power in the lower extremities to day—feels stronger—can retain his urine for some time. 14th. Continues to improve. The left foot is become exquisitely sensible, and that extremity is often drawn up spasmodically towards the body. The iodine to be increased to 25 drops. 16th. The paralytic symptoms continue to yield to the powerful influence of the iodine. When his meat is cut, he can now feed himself with the left hand;—can raise the right hand to the chin, and draw the right upper extremity up towards the body. He continues to hold his water. The iodine is increased to 30 drops, thrice a day—from this date to the 7th of May, the medicine was occasionally obliged to be intermitted and again commenced in smaller doses. At this period, however, the patient could walk from his bed room to the day ward with very little assistance. 19th. He can walk without any assistance, except that of a stick to steady him. June 9th, can walk without a stick. He is gradually recovering the power of motion and sense of feeling. Drops agree. Appetite good, and is allowed full diet. July 3d, the patient was discharged cured."

Besides this highly interesting case, 24 more of paraplegia, hemiplegia, and partial paralysis, are given in detail, in which the iodine was exhibited with various success. In his prefatory remarks to this chapter, Dr. MANSON observes, that although he has been able to cure only a proportion of the cases of palsy that have come under his care since April 1821, yet he has been much more successful in his practice since that time, than he was previously with the use of all the ordinary means.

Having succeeded so well in paralysis, Dr. MANSON was induced to try the effects of iodine in chorea, which he thinks is more closely allied to palsy than is supposed, and is linked to it by that species of the disease called shaking palsy. Of chorea treated with iodine, and showing the efficacy of the remedy, Dr. MANSON details eleven cases, and concludes this section with a tabular view of 72 cases treated at the General Hospital near Nottingham, between the 6th of October, 1812, and the 5th of October, 1824. In all the cases detailed by our author, the iodine was administered after purgatives, and throughout the treatment, the bowels were carefully regulated by aperient medicines.

Dr. MANSON next records the results of his experience with iodine in scrofula—detailing three cases of scrofulous enlargement of the conglobate glands—two of scrofulous ulcers, and four of scrofulous ophthalmia; in all of which, the most beneficial effects were obtained. Our author details eleven cases of fistula lachrymalis, in which iodine produced the happiest results. He was led to prescribe iodine in this disease from the circumstance, that one of the individuals to whom he gave it for paralysis, laboured under the fistula, and was promptly relieved of it, whilst under the use of the remedy.

Dr. MANSON has likewise detailed nine cases of deafness cured, or greatly relieved, by iodine. In most of these cases, the disease originated from obstruction of the Eustachian tube, the consequence of swelling of the tonsils, or of the membrane of the tube itself, from previous inflammation.

Seven cases of dysphagia, eleven of white swelling, four of morbus coxarius, and eleven of distortion, form the subjects of the four succeeding sections. The medicine in all these cases, manifested so very decided a power in arresting the progress, and even in curing the disease, that we think ourselves safe in recommending a trial of it in similar cases. As the iodine, however, is a powerful stimulant, we would advise it not to be prescribed when there exists any fever, and especially when there are any decided signs of gastric irritation, as it would be likely to aggravate it.

23. Non-mercurial treatment of Syphilis.—In the first number of this Journal, we inserted an essay on this subject, by Dr. THOMAS HARRIS, of this city, in which the author confirms, by the results of his public and private practice, the statements of the British army surgeons respecting the efficacy and safety of the non-mercurial treatment. Since that period, having noticed that, by the worthy editor of a respected cotemporary, it is asserted that though mercury fails, "yet from the most ample experience in Europe, the present practice of Paris, England, Ireland, and the Continent generally, we must lean to the idea, that its use, under proper regulations, must be always adopted, as the only safe mode of cure in these diseases," we deem it but justice towards Dr. H. to call the attention of our readers to the result of the extensive experience of some physicians on the continent of Europe. Not to mention BROUSSAIS himself, who appears to have rejected mercury almost entirely in the treatment of primary or secondary symptoms, we may cite Mr. RICHOND, who reports that he treated, at the military hospital of Strasburgh, nearly 3000 cases of syphilis in all its grades, the vast majority of which were completely cured without mercury, and simply by means of antiphlogistics, emollients, and revulsives. Mr. RICHOND, besides some essays in the Archives Medicales, and a summary of his experience in the preface to his work on apoplexy, has lately published an elaborate work on the subject. In the October number of the Annales de la Medecine Physiologique, Mr. BECQUART of the military hospital of Bayonne, details twenty-six cases of gonorrhoea, inflammation of the testicles, chancres on the glans and lips, buboes, excrescences around the anus, &c., all of which were cured without mercury, and with the same remedies as were employed by Mr. RICHOND. We might adduce the testimony of other French physicians, and particularly of M. BEGIN, but we deem it unnecessary, as the above will be sufficient to show that in France the practice meets with the support of many very intelligent physicians. We annex the conclusions of Dr. OTTO of Copenhagen, drawn from an extended personal experience, and from his researches on the subject. Dr. OTTO'S essay is contained in a late number of Graafe's and Walther's Journal, and the conclusions are published in the Edinburgh Medical and Surgical Journal. Dr. O. remarks:

1. That the cure of syphilis, without mercury, has been asserted by so many authorities, that the fact can no longer be doubted. If, then, the disease could formerly be cured without mercury, it may certainly now be much easier, as it has lost much of its violence and obstinacy.

2. Syphilis can undoubtedly be radically cured in this manner; but then the cure is of longer duration, and the diet requires considerable restriction.

3. The secondary symptoms, and a return of the complaint, are certainly more frequent; but the symptoms are not so difficult of removal; and the treatment has a much more speedy effect.

4. As the treatment without mercury requires a longer time, it appears more practicable in hospital than in private practice; and on the other hand, the patient can be better watched in a hospital, which, on account of the diet, is of great importance.

5. As ulcers on the genitals are often not syphilitic, and the use of mercury is contraindicated from a predisposition to scrofula or phthisis existing in the individual, it is consolatory to learn from the results of experience, that this medicine is not always necessary, and that a radical cure, by more simple and innocent means, can sometimes be effected. Where, however, the physician is anxious to avoid the possible evils which mercury is capable of producing, and also to prevent loss of time, there remains a middle way, namely, to employ mercury, whose specific action can scarcely be denied, in moderate doses.

It results from a report of the cases of syphilis admitted into the public institutions of Sweden, that 3,574 were treated in 1822; 3,465 in 1823, and 3,355 in 1824. During the course of this last year, 55-3/10 per centum of all the patients were treated by the mercurial method, and 35-1/10 per centum by the non-mercurial method, and by low diet; 2-1/2 per centum by means of fumigations. MM. KESSLER, WURSTER, RONBERG, and SANDMARK, prefer the dietetic method, and consider it as the surest of all those hitherto employed. Relapses are rare. In 1822 they amounted in relation to the whole number of cases, to 11-2/3 per centum; in 1823 to 10-1/4, and in 1824 to 10-2/3. After the treatment by starvation, they amounted in 1822 to 7-3/4 per centum; to 7-1/3 in 1823; and to 8-1/3 in 1824. After the mercurial treatment, in 1822 to 17-1/2 per centum; in 1823 to 14-1/16; and in 1824 to 14-1/2. Bulletin des Sci. Med.

We hope to lay before our readers at some future period, an analysis of Mr. RICHOND's work above alluded to, as well as of one on the same subject by Mr. JOURDAN of Paris, author of some essays on the origin of syphilis, translated and published here a few years ago.

24. Cancer treated by Antiphlogistics.—Of all diseases classed among the opprobria medicorum, cancer has hitherto been justly viewed as holding the most conspicuous rank, and it is only within a short time, that it appears to have been treated on correct principles, and that cures have been detailed by individuals of undoubted veracity. The idea of the inflammatory nature of cancer, and of the propriety of treating it by means of antiphlogistics, has been held many years ago, and supported by VASALVA in Italy, FEARON in England, HUFELAND in Germany, POUTEAU and VACHER in France, not to mention other high authorities. But, notwithstanding the success attending this practice, it was too simple for the supporters of cancerous humours and specific inflammations, and seemed, in consequence, to have been abandoned by them, in their search after anti-cancerous or specific remedies; and little was heard of it, until revived by the disciples of the physiological school of France, and particularly by its founder professor BROUSSAIS, and by professor LALLEMAND of Montpellier, the result of whose experience is published in a thesis, lately defended at Montpellier by Dr. MARESCHEL.

We have been led to these reflections from reading the above essay, and another on the same subject, published by Dr. J. A. PUEL, in a late number of the Archives Generales de Medecine. Dr. P. details many cases, which were treated by his father, by means of leeches, emollients, purgatives, &c. so early as 1807. In most of these cases, the practice appears to have been very successful. As it is our wish to impress our readers with the propriety of making a fair trial of this method, in cases of scirrhus and cancer, we shall select and translate a few cases from the latter essay. It is proper to premise, however, that the practice must not be viewed as completely successful in every case, and that the older the complaint, the less confident we ought to be, in respect to the happy results of the case. Nor is it to be expected, that boldness in the employment of the lancet and leeches, will answer as well as a perseverant, constant, but moderate use of these means. Chronic inflammations are not to be removed by storm, but by a chronic use of remedies, and particularly by attention to diet.

We cannot at present determine precisely the proportion of cures effected, by this method, of scirrhus or cancer, in a given number of cases, and how far it will surpass, in point of success, the common method of treatment by specific narcotics and escharotics; but, even supposing that it is not more successful, (which we are disposed to deny,) it has at least the vast advantage of being more comfortable, and much less painful to the patient.

Mrs. D. enjoying good health, and mother of three children, was brought to bed in 1823, of a healthy child, which, however, she did not suckle. With a view of suppressing the secretion of milk, irritating applications to the breast were resorted to, which brought on an inflammation of that organ. Emollient poultices were now applied; these, however, did not prevent the formation of an abscess, which was opened by means of caustic potash. The suppuration, for a few days, was abundant and the matter discharged healthy. Purgatives were prescribed, with the view of suppressing the discharge, and mercurial ointment was rubbed on the tumour, to produce its absorption. These remedies were not successful, because no means were employed to arrest the inflammation, which gave rise to the suppuration.

When the patient applied for advice, she had been sick already four months, and presented the following symptoms. She was very much emaciated, and laboured under fever, resulting from a gastro-enteritic inflammation, kept up by purgatives and deostruents, (fondans,) which, from the commencement of the attack, were prescribed for her. The ulceration of the mamma was of the size of a five frank piece, unequal and gray, and gave issue to an ichorous and foetid purulent matter. The edges were thick and everted, and surrounded with an erysipelatous inflammation. The whole mamma was large and hard, and the seat of lancinating pain. Thirty-five leeches were applied around the tumour, and gave rise to a profuse haemorrhage, which continued many hours. From this, the patient experienced so much relief from pain, as to be able to take some repose, of which she had been deprived for some weeks. Emollient poultices and drinks were prescribed, and a low diet enjoined. By all these means, the pain was lessened, and the swelling much diminished. Leeches were again applied, and the other remedies continued. The wound gradually improved, and in forty five days, was completely healed.

Mr. P. was called on the 25th of September, 1817, to attend a lady, who had been affected for two days with uterine haemorrhage, which he succeeded in arresting. The following history of her complaint was given to him: she had aborted about 18 months before, and since that time, had experienced every fortnight an uterine haemorrhage, which generally lasted five or six days. During the intervals, she complained of deep seated pain, numbness and cramps, in the lower part of the abdomen, in the thighs and groins. The pain was much aggravated when she had a stool—walking, especially when long continued, was painful, and attended with a sense of dragging, which was only relieved by repose. From the same period, her disposition had changed from gay and lively, to melancholy and morose—her digestive functions were slow and painful—she was affected with leucorrhea, and during coition, felt much pain, and often lost some blood. On examination per vaginam, it was found, that the neck of the uterus was elongated—the anterior lip of the same organ was soft to the feel—the orifice somewhat enlarged, and painful when the finger was introduced into it. On the inferior lip there was a small unequal and painful spot, which was regarded as a superficial ulceration; the uterus was a little prolapsed, and somewhat enlarged; the pulse small and frequent; febrile exacerbations every evening; sleep not refreshing, and interrupted by short lancinating pain in the uterus.

The disease was judged by Mr. P. to be a chronic metrites, with ulceration, and all the symptoms usually attending incipient cancer. Guided by this belief, and notwithstanding the already long duration of the disease, and the debility of the patient, the following treatment was adopted—complete repose in the horizontal posture—leeches to the vulva, repeated several times—vaginal injections, with emollient decoctions—hip baths—very low diet. After persevering in this plan twenty days, the patient appeared much better, and was allowed to sit up. General baths were substituted for the partial ones. The same treatment was continued, with the exception of the leeches, and at the end of thirty days more, all the symptoms of the disease had completely disappeared. Mrs. P. was allowed to spend the following spring in the country, from whence she returned in very excellent health. She has since continued to enjoy it, and has borne several children.

Cases nearly similar, are detailed by Mr. MARESCHAL, as having occurred in the practice of professor LALLEMAND. The same gentleman, also gives the history of two cases of external cancerous sores, in which the same treatment was adopted. The patients having died during the progress of the cure, of other diseases, an opportunity was offered, of examining by dissection, the changes that had occurred in the parts. We cannot enlarge on the subject in this place, and can only remark, that these changes were such, as to lead us to hope, that less difficulty will be experienced in the treatment of sores reputed cancerous, by the local antiphlogistic plan, than is commonly supposed. At any rate, recommended by such high authorities, the practice deserves a trial.

The Revue Medicale for February 1826, contains the details of a case lately cured at La Pitie, by Mr. LISFRANC. The patient, a woman, aged 36 years, of a strong and good constitution, had suffered the removal of a cancerous breast, 18 months previous to her admission into the Hospital, on the 10th October, 1825. The following symptoms were observed. On the whole surface of the cicatrix were felt a number of engorged ganglia, and an induration situated on the large and small pectoral muscles, and spreading from the clavicle to all the external and superior part of the thorax, and as far as the axilla, where other swollen ganglia were felt. The enlarged surface was elevated about half an inch above the level of the chest. Severe lancinating pains were at short intervals felt by the patient—which came on without any evident cause, and were particularly severe on the least pressure of the swollen part.

This patient was treated by means of frequent and copious bleeding from the arm—the very frequent application of leeches to the inflamed part, and to the upper and interior part of the thighs, to bring on the menstrual discharge—digitalis to remedy the frequent palpitations—emollient applications, and low diet. On the 10th of January, she was considered well;—the swellings and pain having disappeared—the menstrual discharge being well established, and the movement of the arm (which during the progress of the disease had been impeded from the swelling in the axilla) perfectly free.

We are happy to learn that this practice is pursued with success by the Spanish physicians, as may be readily found by a reference to a late number of the Periodico de la Sociedad Medico Quirurgica de Cadiz, which contains cases of scirrhous mamma cured by the repeated application of leeches.

25. Essential oil of Male Fern, as, a remedy in Cases of Taenia.—The male fern has long been regarded as a valuable anthelmintic medicine; but, as every powder administered in large doses, its exhibition is difficult and disagreeable; so much so, indeed, that many patients refuse to make a sufficiently constant use of it to ensure its beneficial effects. Struck with this inconvenience, M. PERCHIER, a pharmaceutist of Geneva, has lately made some experiments with a view of discovering its active principle, and to see whether this latter may be administered with equal success with the powder or infusion of the plant. We are happy to learn that the result of his experiments are very satisfactory. We translate the following observations from a memoir on the subject, read on the 7th of October last, by Mr. GENDRIN, before the medical society of the department of the Seine. "This medicine, which is a fatty oil extracted by distillation from the aether, in which the powder of the root of the male fern has been macerated, has caused in many cases, the expulsion of the taenia, without occasioning nausea, colics, or any other morbid phenomena." "It is exhibited at bed time, either in an oily potion, in pills, or incorporated in an electuary, in doses of 18 or 20 drops. On the following morning, a similar dose is given, and two hours after, two ounces of castor oil are administered. In most cases, the taenia is expelled in the course of the day, but if this does not occur, the same doses of the oil are given in the same way, and followed by a similar quantity of the castor oil. The fatty oil of fern, has an aethereal and empyreumatic smell; its colour is brown, and its consistence rather greater than that of castor oil; it is, however, easier to separate in drops. Its taste is acrid, pungent, empyreumatic, and very disagreeable."—Propagateur des Sciences Medicales, Janvier 1826.

26. Tincture of Bastard Saffron[33] for the expulsion of Taenia.—Dr. CHISHOLM, of Canterbury, has lately used with success, in a case of taenia of many years standing, the vinous tincture of bastard saffron. The patient had already undergone various plans of treatment, and had especially used the oil of turpentine in very large doses. Dr. C. was induced to try the above remedy, from having noticed, that in a case in which it had been prescribed for the cure of rheumatism, a large portion of taenia had been expelled. He consequently administered two ounces of the tincture; advising the patient to take a table spoonful more of it mixed in a little water, two or three times a day. On the third or fourth day after commencing the use of this remedy, the patient voided a large portion of the worm, and has since been free from the usual symptoms of the disease.

27. Oil of Turpentine in Taenia.—Although the oil of turpentine is used in many parts of this country, in cases of taenia, we have good reasons for believing, that some physicians continue, notwithstanding the testimony in its favour, to hesitate exhibiting it in doses sufficiently large to destroy and promote the expulsion of the worm. Such being our opinion, we are induced to offer here a few remarks on the subject, and to notice a memoir published by Dr. DE POMMER, in a late number of Hufeland's Journal. The employment of this remedy in such cases, is not of recent origin, having been resorted to many years ago by the Swedish practitioners, and subsequently revived by the English. In Germany it has recently been used by Professor OSAN, and we believe particularly by Dr. DE POMMER, who appears to have prescribed it boldly in very many instances, and in some, after the ineffectual employment of all other anthelmintics. Dr. P. adds, that he never saw any bad effects resulting from its use, and that patients are very little liable to relapses when treated by it.

Among the cases detailed by Dr. DE POMMER, we select the following, as calculated to show the manner in which the Dr. uses the remedy.

"G.K..., a soldier aged 21 years, thin, tall, and who during his infancy had been subject to ascarides, has occasionally voided during more than 10 years past, portions of taenia. He had used several purgative medicines, by which several yards of this worm had been expelled; but annoyed with so many attempts at obtaining its total expulsion, he had ceased, three years before, the use of all sorts of anthelmintics. But the phenomena resulting from the presence of the animal being aggravated, the patient applied for advice to Dr. DE POMMER, who found him labouring under the following symptoms:—Frequent pain in the abdomen, and especially in the umbilical region, accompanied with a sense of burning heat, and alternate distension and depression of the abdomen. Appetite sometimes keener than in health; at others nearly lost. In the morning before breakfast, the patient was seized with extraordinary weakness, and general uneasiness, accompanied with trembling of the limbs, ineffectual attempts to vomit, a sense of constriction in the throat, and a profuse salivation. All these symptoms disappeared after K... had taken food; but reappeared two hours after. Milk and farinaceous aliments were the only articles of which he could make use without an aggravation of his disease. The pulse was febrile; sleep good, but attended with dreams. The pupils were in the natural state. From the symptoms, and from the history of the case, Dr. P. was induced to make use of the oil of turpentine in the following manner. The patient was ordered in the morning, before breakfast, three table spoonsfuls of the remedy, at half an hour's interval. The first doses produced only a few borborygma. Two more table spoonfuls occasioned a vomiting of mucous matter. Three more table spoonfuls were exhibited, and followed by a stool of solid faeces, mixed with which were five small pieces of taenia. The patient not finding himself incommoded, took in the space of an hour, three more table spoonfuls of the remedy, after which he experienced some pain in the head, and vomited about one pint of bilious liquid. An hour after, the same quantity of the medicine was taken, and followed again by vomiting, but after a repose of half an hour K... discharged, per anum, firm and greenish faeces, and with them five ells of taenia. The urine discharged had the smell of violets. He again took a few spoonfuls of the vermifuge, which were not followed, however, with any faecal discharge, and only with some vomiting of mucus, and slight vertigo. In the afternoon the patient felt well, and experienced a great appetite, in which he indulged. From this moment he recovered, and has ever since enjoyed good health. The quantity of the remedy used was six ounces."

It appears, from the observations of Dr. P., that the gastric irritation occasioned by the spirits of turpentine, has never amounted to phlogosis, and has generally subsided after the remedy had been discontinued. Nevertheless, as the spirit of turpentine is a very powerful stimulant, we would not venture to recommend its use, when there exists an inflammation in the gastro-enteritic system. We are aware that it is resorted to in burns, and highly eulogized in puerperal and yellow fever. In the first, it is certainly very useful, but on what principle we know not, except perhaps that its stimulus is different from that existing in the diseased part. But in the second case, it acts, not on the diseased surface, but by revulsion, on the mucous membrane; and as regards its virtues in yellow fever, we are rather sceptical in respect to what has been said on the subject. In this opinion we are supported by the testimony of our friend Professor RHEES, whose situation of house surgeon to the fever hospital, during the epidemic of 1820, afforded him ample opportunities of testing the propriety of the practice.

In the number for March 1826, of the Revue Medicale, M. MAUDRU relates two cases in which large portions of taenia were expelled, and the patients cured, by means of a strong decoction of the bark of pomegranate. The first patient took, in one day, two pounds of the decoction made with four ounces of the remedy. The second patient took six ounces of the bark in decoction, in the course of forty-eight hours. In neither case did the medicine occasion unpleasant effects, with the exception, in the second patient, of slight colicky pains.

28. Action of the Oil of the Euphorbia Lathyris.—At a meeting of the Academy of Medicine, (section of pharmacy) M. BALLY read the results of some clinical experiments made by him at the hospital of La Pitie, on the action of the oil of the euphorbia lathyris. The preparation used by him, had been made by means of alcohol and expression. It appears to be a little more active than the other preparations. Administered to fifteen individuals of different ages, it did not produce very various results, nor prove very active in its purgative effects. As a purgative, indeed, it is far less active than the croton oil, and requires to be given in much larger doses; as much as six or ten drops. It has also the bad property of exciting emesis, by which it is rejected from the stomach. On the other hand, however, it does not, like the croton oil, produce salivation, and is, on the whole, regarded by M. BALLY, especially when fresh, as a useful purgative in diseases of children.—Archives Generales, Decembre, 1825.

29. Medicinal properties of the Apocynum Cannabinum, or Indian Hemp.—In an essay on this plant, submitted to the medical faculty of Jefferson College, by Dr. M. L. KNAPP, we are informed, that in doses of 15 or 30 grains it possesses emetic properties. It was besides, on trial, found to be cathartic, expectorant, diuretic and diaphoretic. It appears to have been generally administered in powder, and Dr. K. remarks, that "in decoction, it seems to lose some of its emetic properties, and to act more upon the bowels as a hydragogue cathartic." "The root possesses all the medicinal properties of the plant, and is active throughout, both in its cortical and ligneous portions. Water or proof spirit is its proper menstruum."

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