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cured—that is, dissolved, removed, either by local applications or by general treatment."
Of " localized cancer of the cervix,” treated by amputation, he witnessed no better results. “The cases in which it (amputation) has been performed successfully, are generally considered to have been merely cases of inflammatory induration of the cervix,” in which he thinks deep cauterization is a much safer remedy.
The Dog. By William YouAtT, Edited, with additions, by E.
To the lovers of the dog, (and who does not love that brave and devoted animal?) this is a most acceptable volume. Not only to the sportsman and the naturalist, but to the physician, and the housekeeper of every grade, the history of this faithful and sagacious animal,-his diseases and his habits,- is full of interest. “The dog, next to the human being, ranks highest in the scale of intelligence, and was evidently designed to be the companion and the friend of man." "Man,” says Burns, “is the God of the dog; he knows no other; and see how he worships him. With what reverencc he crouches at his feet, with what reverence he looks up to him—with what delight he fawns upon him, and with what cheerful alacrity he obeys him!” An animal that guards us while we sleep, enjoys our pastimes, and watches with almost parental care the tottering footsteps of our children, has strong claims on our benevolence, and it is the duty of those who exact his services to minister to his wants not less in sickness than in health. To do this effectually, they must study his constitution, his habits, his diseases and their remedies. To all such we commend Mr. Youatt's book. The medical reader will be surprised to learn from its pages “how many ills that animal shares in common with the human race;" whilst the general reader will find its pages rich with anecdotes and varied information. No inconsiderable part of this has been supplied by the
editor, who has, indeed, performed his part with much care and ability.
The work is beautifully got up by the Philadelphia publishers -paper, typography, binding-every thing is in keeping. The engravings representing the varieties of the dog are by Gilbert & Gihon, and are well executed.
A System of Human Anatomy, General and Special. By
Erasmus Wilson, M. D. Lecturer on Anatomy, London. Third American, from the third London edition. Edited by PAUL B. GODDARD, A. M., M. D. Professor of Anatomy in the Franklin College of Philadelphia. With two hundred and thirty-three illustrations by Gilbert. 8vo. pp. 610. Lea & Blanchard: Philadelphia, 1847.
Since the publication of the former American edition, a third cdition has been issued by the author in London, containing some additions and improvements. The present edition, we are assured by the editor, “is a careful and exact reprint of the English work, with the addition of such other illustrations as were deemed necessary to a more complete elucidation of the
Thus it will be seen that the value of the present edition is materially enhanced over that of its predecessors, and in its present improved form offers to the student all the assistance that can reasonably be expected from such a work.
Second Annual Announcement of the Medical Institute of Cin
cinnati, Session of 1947. The lecturers of this Association are Drs. Judkins, Woodward, Warder, Kendrick, Vattier, Mendenhall, Raymond, and Stuart ; several of whom are advantageously known as contributors to the Medical Journals, and all, we have no doubt, well qualified for the duties they have assumed. The lectures are to commence on the first Monday in March, and continue four months, embracing all the subjects usually taught in summer schools.
We are glad to see our younger brethren in “the Queen City of the West,” exerting themselves in increasing the facilities for gaining instruction in their beautiful town. We have ever regarded such enterprises favourably, and can see no reason why the attempt should not succeed in a city of so large a population as Cincinnati, when made in the right spirit and sustained with becoming energy. From the impossibility of carrying on dissections, and of giving demonstrations in anatomy on the recent subject, during warm weather, a full and complete course on all the branches of medical education, such as is necessary to qualify a young man for graduation, cannot be expected, even if it were possible, which no one will pretend, for the student to undergo the fatigue, in hot weather, of following the requisite number of lectures each day to complete the whole in four or even six months but attendance on one or two lectures a day will hardly be too great a tax upon his health, while it will materially assist his comprebension of what he reads; and when the subjects taught are collateral, and not mere repetitions of the winter lectures, great advantage must accrue to the industrious learner.
RECORD OF MEDICAL SCIENCE.
Remarks on the use of Quinine in Intermittent and Remittent Feders. By L. A. Dugas, M. D., Professor in the Medical College of Georgia. Having received during the past season a number of coinmunications requesting my views on the use of quinine in the treatment of our autumnal fevers, I beg leave to reply to them through the medium of this Journal.
The fevers of this section of our country being almost exclusively paroxysmal, it may be well to premise, very briefly, my views of their pathology, by which it will be perceived that I regard them as essentially different from those continued fevers more commonly encountered in colder latitudes, and which have been denominated Typhoid, Typhus, Follicular enteritis, Dothenenteritis, Jail fever, Ship fever, &c.
Our paroxysmal fevers are either intermittent or remittent at their onset; but, if not arrested, the former may, more or less early, become remittent, or the remittent assume the intermittent type; thus showing them to be only different degrees of the same disease. They both present the same paroxysmal phenomena, that is to say,
have regular periods of recurrence or exacerbation, and of declension; they are both preceded and accompanied by a general disturbance, more or less marked, of all the functions of the system, but more especially of those usually termed nervous, as those of sensibility and muscular motion. Lassitude, pains in the limbs, back and head, loss of muscular strength, are premonitory and persistent in both. The activity of the circulation, however great, is not continuous as in the phlegmasiæ, but partakes of the same paroxysmal character as the other phenomena. Indeed it may be established as a maxim, that no inflammatory disease even assumes the paroxysmal character, inasmuch as all inflammations pursue an uninterrupted course, whether they terininate in resolution, suppuration or gangrene. Wherever inflammation is exposed to ocular observation, it is never seen suddenly lo disappear and to return at stated intervals, or otherwise ; but it runs a uniform course which cannot be suddenly modified by the efforts of nature nor by any agent with which we are acquainted. Pure inflammation of internal parts, as pneumonia, pleurisy, acute articular sheumatism, enteritis, &c., observes the same course; there is nothing paroxysmal in these diseases ; the febrile action is not attended with daily or periodical exacerbations, but gradually progresses to a certain point, and then gradually declines with the subsidence of the inflammation. Periodicity or the paroxysinal peculiarity is characteristic of the neuroses properly so called, of diseases of the nervous system, which modify the functions of remote organs, and which may be dependent upon congestion, but certainly never upon inflammation. We know of no organ, whose inflammation could furnish us any rational explanation of the varied phenomena of intermittent or of remittent fever. Let us however look to the nervous system for the solution of the problem of these fevers, and all becomes perfectly plain. The languor, lassitude, general and local pains, tremor, modifications of the capillary as well as of the general circulation and of the secretions, and, above all, the abrupt transitions from a normal state to one of great perturbation, and from this again to comparative health, together with the periodical returns of the morbid manifestations—all indicate manifesily great disturbance of that pervading system whose condition is reflected in every part of the body--the nervous system. There is no other system whose impairment could by any possibility yield us the phenomena above related; still less is there any single organ that could by any modification of its condition, produce such general perturbation of the acts of the economy. Intermittents and remittents then are unquestionably the manifestations of deranged innervation; and if arrested sufficiently early will be attended with but little injury to any organ. A continuance of frequent repetition of this derangemeni, however, may more or less seriously implicate the parenchymatous and secerning structures, inducing inflammatory action, and may even terminate in fatal congestions.
With these views of the pathology of paroxysmal fevers, we are led naturally to the use of such remedies as are calculated to arrest or to modify the perversion of innervation. Theory alone would indicate a resort to any agent known to blunt the nervous sensibilities, and thus to diminish their mobility or tendency to perturbation. Narcotics would present themselves in the first line. Every one knows that opium, morphine, camphor, alcoholic liquors, sulphuric ether, &c., are valuable reinedies in intermittent fevers. Indeed a favorite prescription with me in such cases is a combination of 2 parts of sulphuric ether, 1 part of tincture of camphor and 1 part of tincture of opium, of which I give a tea-spoonful in a wine-glass of cold water two hours before the expected paroxysm, and half this quantity again at the expected hour of attack; the patient remaining in bed during the effect of the remedy. This rarely fails in uncomplicated cases of intermittent fever; if it does not completely succeed ihe first day, it will the next. I have frequently averted, or favorably modified even a paroxysm of remittent fever by the administration of a full dose of morphine (4 to é gr.) half an hour before the expected exacerbation. But the efficacy of narcotics is not so fully borne out by experience as is that of quinine, an agent which as yet holds a position unique in the materia medica. The most striking peculiarity of quinine is its power to prevent the return of periodical affections, and this appears to me to be effected by blunting the susceptibilities of the nervous system. The senses whose acuteness of perception we can most easily observe, are manifestly blunted. Audition is very soon impaired, and so is vision, if the dose of the remedy be large. The effect of quinine on the heart, in our fevers at least, is unquestionably to diminish the force and frequency of its action, and if the quantity administered be large, a general relaxation, attended with a profuse cold sweat, will be produced, resembling and therefore mistaken by the inexperienced for a collapse of fatal tendency. Having tried it in cases of pure phlegmasia, in pneumonia and acute articular rheumatism, for example, without any aggravation of the febrile action, I cannot regard it as a stimulant.
There is, I believe, no difference of opinion in relation to the value of quinine in the treatment of intermittent fevers. I will, therefore, now confine my remarks to Remittent fevers, comprehending under this term, bilious, malignant, congestive, and country fevers. These are usually preceded by premonitions, which if properly attended to, would enable us to avert their developement with great ease. It is, however, exceedingly rare that medical aid is invoked thus early, and the physician is generally called in only during the first or second strong paroxysm; often much later. The paroxysm, when once fully developed, will usually run its course despite of any efforts we may use to check it. I therefore generally direct merely a foot-bath, and the free use of cold drinks, as water, lemonade, or soda water, until the period of remission. Should there be, however, such a determination to some vital organ as to threaten serious injury before the equilibrium of the circulation be restored by the subsidence of the exacerbation, I abstract blood with cups to the spine, sometimes (though rarely) deplete from the arm, and urge the use of revulsives,