"The case was attended with singular interest, in consequence of the exalted position of the patient, his advanced age, and the circumstance of there being upward of one thousand calculi taken from his bladder. It is well known that for several years previous to this period, Dr. Physick had declined performing extensive surgical operations. He felt somewhat reluctant to operate on Chief Justice Marshall, and offered to place the case in my hands. Taking all the circumstances into consideration, and knowing well that this would be the last time that he would ever perform a similar operation, I felt desirous that he should finish with so distinguished an individual, and accordingly urged him to do it himself. Upon the day appointed, the Doctor performed the operation with his usual skill and dexterity. I do not think I ever saw him display greater neatness than on that occasion. The result of the operation was complete success."

His last operation was for cataract, which, from a record in his private Journal, seems also to have been his first. It was performed on the 13th of August, 1837, with a steady hand, while he was the subject himself of much mental and physical suffering. He never saw his patient after completing the operation, for the attack which terminated his laborious life occurred on the afternoon of the same day. On the morning of the 15th of December, at twenty minutes past 8 o'clock, the Father of American Surgery expired without a struggle. The immediate cause of his death was probably hydrothorax. For whole nights together he was unable to lie down in his bed, and was supported by assistants standing upon the floor. Anasarca was developed some time previous to his death, and in consequence of being obliged to stand so much upon his feet, his lower extremities became greatly swollen, the integuments gave way, and at length ulcerated and became gangrenous. He died in the 69th year of his

age.

It is a little remarkable that he enjoined that no examination should be made of his body after death, and that a rigid

watch should be kept over it for six weeks, during the night, to prevent disinterment.

"So protracted an illness," remarks Dr. Horner," attended with such suffering, impaired also the vigor and clearness of his mind, and exhibited it not unfrequently in strong contrast with its natural traits. He left a paper directing the disposition of his body after death, as follows: a dissection was absolutely prohibited, no one was to touch him but two females who had been his domestics, for the last twenty years. He was not to be taken from his bed for some time, but to be wrapt up in it warmly; the room was to be kept well warmed till putrefaction commenced. He was then to be covered with flannel, and placed in a wooden coffin, painted outside, with a mattress at the bottom; and this coffin was to be placed within a leaden one, and it soldered up closely. A public notice was to be given of the period of his interment, but no invitation issued."

Dr. Horner's description of his appearance in the prime of life is graphic, and will be read with pleasure:

"Five and twenty years ago, I saw him who is now a mass of decomposition, returning from the same place in the afternoon at the interment of Dr. Rush. He was then in the vigor of manhood and of reputation, the universally acknowledged centre and head of the surgery of this country. An indescribable interval separated him from every body else, and yet attracted every one to him. I remember with perfect distinctness, as he turned off from the ground, his quick and thoughtful step; his inclination of the head: as either musing on what he had seen, or ruminating on some case of profound interest then under his charge. His appearance such as in his most palmy days-his head highly powdered; his hair overhanging his ears in a thick long brush on each side, where it was clipped straight below. The head, face, and neck, exhibiting the most finished and statue-like appearance; and his costume being a paragon of neatness, and of appropriateness, without any undue effort at effect. I never saw him before or since more completely himself. The attack of typhus fever, which he had the next winter, altered sensibly for the remainder of his life, the face-the forehead never recovered its fullness."

As a teacher of surgery Dr. Physick acquired a wide popularity; for the lectures of one whose experience had been so diversified could not be otherwise than instructive, while his character for integrity and strict veracity caused all to be believed which he professed to have done or seen. His manner is described as having been eminently dignified, grave and impressive, without being what is styled eloquent. He seems to have had little imagination, and to have indulged it sparingly. But he was judicious and tasteful; his style was clear, comprehensive, simple and concise. He wrote his lectures out with care, never trusting himself in extemporaneous discourse. His choice of language is represented as having been happy; his person was fine, and his whole air striking and agreeable; from which qualities it resulted that he was a most pleasing as well as instructive teacher. He attempted no display of oratory, but spoke clearly and forcibly from the stores of his memory and the dictates of his sound understanding.

If he had no great veneration for the recorded experience and learning of the profession, he had less disposition to give to the public the results of his own observation and experience; and the student of a future day will search in vain through the medical literature of our country for evidences of that superiority which while living was universally conceded to him. A description of a few surgical instruments invented or improved by himself, and brief histories of a few cases cured by novel modes of treatment, make up the sum total of all that his pen has contributed to the profession. His fame will rest upon what he did-not upon what he wrote. He was one of the first to make post mortem examinations; he introduced the operation of passing a seton between the ends of bones remaining long ununited; he introduced the

animal ligature for arteries; he first recommended the use of blisters for the purpose of arresting the progress of mortification; the excision of the uvula and of the tonsils in particular cases; the invention of several instruments, and the improvement of more-these are some of the achievements to which he was indebted for his great name. Y.

ART. VI.-Elements of Pathological Anatomy; illustrated by numerous engravings, etc. etc. By SAMUEL D. GROSS, M. D. Boston: 1839.

(Continued from the October No.)

OUR present number will finish what we have to say on the first part of this comprehensive work.

The second section of the chapter on heterologous formations, is devoted to melanosis. In classing this with those productions, our author has conformed to the prevailing arrangement of pathological anatomists; but, we must confess, that we do not clearly see the propriety of such an assignment. In fact it is made in violation of the great division of morbid structures, into those which are like, and those which are unlike, any of the existing tissues; inasmuch as the melanotic substance seems most closely to resemble, if not indeed to be identical with the brown or black pigment met with in some parts of the body, as a normal element-for example, in the rete mucosum of the negro, and in the choroid. Its

secretion and deposit where it should not be found is, at most, but an error loci, and cannot render it a heterologous production. Again-it can scarcely be denounced as malignant, as its history with a few exceptions, shows it to be destitute of the attributes which belong to that class of tumours. And these exceptions, it is probable, are but apparent, the melanotic secretion being, perhaps, associated with spongoid, carcinomatous or tuberculous action. The reference of the melanotic tumour to this or that class of morbid productions is not, however, a matter of much consequence; especially as no rule of practice is founded upon its classification.

In the six or eight pages which our author has devoted to melanosis, he has given to the student a lucid and comprehensive view of its natural, chemical and pathological history. It has been observed in several domestic animals. Professor Gross has seen it repeatedly in the ox, and others have met with it in the dog, cat, rabbit, rat, mouse, and some birds; but the horse has presented it more frequently than other animals, and in larger masses. White horses are oftener affected than those of any other color; a fact which seems to show, that the coloring matter of the skins of these animals, is developed in the blood, and not being deposited in its proper nidus is accumulated in masses in other parts.

In the human subject, it affects both sexes and all ages, but is far more frequent in the old than the young. In its chemical constitution, melanotic secretion bears much resemblance to black or venous blood; but offers in this respect considerable variety. In its physical characters, it also presents diversities of color and consistence; varying from brown to jet black, and from the consistence of ink to that of fibro-cartilage. When exposed to the action of the atmosphere it dries and becomes brittle. Now and then it is punctiform, or in