if choking, the jaws were set, foam proceeded from the mouth. The body was bent in a bow-shape resting upon the occiput and heels (opisthotonos.) Upon examining the foot after the spasm subsided, we could find no point where the nail had entered, but excessive tenderness on the anterior part of the sole within a space of the size of a dollar. Within this space I made two incisions crossing each other at right angles, into which lint saturated with spirits of turpentine was inserted, and the lye poultice re-applied. We directed her to take a pill containing two grains of opium and two of calomel every hour. We saw her again at half past 9 o'clock. She had taken two pills; had had no spasms-ordered one pill every two hours through the night, unless asleep. 19th, 9 A. M. Had taken four pills; had no spasms until six A. M., then had two, but not so severe; we applied at this time a solution of caustic potash along the spine. She was sick at the stomach this morning, and vomited light green fluid. To continue the pills, and as the bowels had not been moved since the attack, we directed a laxative enema. Evening. No spasms through the day; still sick, and vomiting occasionally; some pain in the limb extending up the back; neck and jaws better. The bowels have been freely moved three times. Mouth sore from the calomel. To discontinue the pills, and take two grains of opium at 10 o'clock, with nourishment through the night. 20th, 9 A. M. Slept some during the night, but was much distressed by sickness--vomiting the same light green fluid. Much more prostrate. The pulse, which had been nearly natural, till this morning, was frequent and feeble. To take a mixture containing 5 grains carb. ammonia and twenty drops tinct. opii every two hours; blister to the epigastrium. Evening. Much better; pulse full and soft. Sickness nearly gone. The blister had drawn but slightly. 21st, 9 A. M. Has slept well. No sickness-says she feels very well. To take the ammonia, &c., occasionally-from this time she continued to recover, and is now at service. The wound from the incision made in the foot continued sore for several days; but we could not say it suppurated.

I offer this case for publication, not because there was anything new in the means used for its cure; there certainly was not, but rather as additional evidence that this dreadful malady, so often fatal, will sometimes yield to the ordinary method of treatment. A case occurred to me many years since, in which the tetanic symptoms were very decided, though not so strong as in the case just related, which recovered by the liberal use of opium and stimuli and the dilatation of the wound.

March 24th, 1847.

Congenital obstruction of the Colon in an infant. By JAMES BRYAN, M. D.

April 2d, 1847.-On the 31st ult., I was requested by my friend Dr. L. P. Gebhard to make a post obit examination of J. B., a male infant three days old, who had died without having had any discharge from its bowels after birth. The child had been cheerful and took the breast at first, but gradually became languid, and sunk without evident cause, except the want of a discharge per anum.

On inspection of the body, the abdomen was found very much enlarged and of a greenish colour. The capillaries of the skin were injected, and the cuticle of a purple colour, as low as half way down the thighs, involving the genital organs, groins, &c.; the abdomen was tympanitic; the os frontis was freely separated down to the root of the nose; the general appearance of the infant in other respects was that of health.

On making an incision through the integuments in the direction of the linea alba, a large quantity of foetid gas escaped from the abdominal cavity. The bladder appeared healthy and contained a little urine; the uracus was attached to the umbilicus and bladder; the peritoneum in every direction was engorged with dark coloured blood, and the circulatory arcades of the mesocolon with the small vessels of the colon were filled with blood, and easily seen when the intestine was held between the eye and the light. The greater part of the hypogastric region was filled by a tumour about four inches in diameter. On opening the colon above this tumour (which proved to be situated in the sigmoid flexure of the colon,) large quantities of meconium and focal matter were discharged. The peritoneum when divided was found to cover a smooth surface of the tumour; this surface proved to be the outer coat of the intestine, which was very much distended and contained the tumour in the form of coagulated blood, as black as pitch. The descending colon was distinctly traced into the covering of the tumour, and was found to adhere to the margin of the pelvis, and to be entirely imperforule in the direction of the rectum.

The anus was in a natural condition; a probe would pass without difficulty, and had been passed during life up the rectum to the tumour or obstruction. A few drops of blood had followed the introduction of the probe. The genital organs were well developed; so also the liver, stomach, and small intestines. The tissue of the intestines around the tumour was found apoplexied.

The explanation of this case would appear to be, that a rupture of some of the vessels of the sigmoid flexure of the colon

took place during uterine life. A gradual discharge of blood into the intestine and between its coats took place, producing pressure on the surrounding parts, and in this way, inducing adhesions to an extent to close the passage of the blood towards the rectum, and causing the general adhesions which were found outside of the intestine.

The treatment of this case, provided the diagnosis had been made out, would be, to make an opening into the tumour through the rectum; this failing on account of the adhesions, we might perhaps resort to the production of an artificial anus in one of the situations usually recommended; in this case the latter operation would probably have relieved the patient, at least temporarily.

To the Editor of the Medical Examiner.

Sir,-Permit me, through the pages of your journal, to direct the attention of the younger members of the profession to a practice, which prevails more or less with many of them, of asking for farther advice in difficult cases of their seniors, by letter, and thus subjecting them to manifest inconvenience and responsibility, without accompanying their request with the wonted, or any, honorarium. Where special relations exist, or have existed, as between preceptor and pupil, there may be apparent, if not real, propriety in the latter seeking occasionally for farther enlightenment; but wherever the patient can afford to remunerate the consulting physician, it ought most assuredly to be the pleasure-if not the duty-of the attending physician to suggest the appropriate accompaniment. The undersigned has been subjected to repeated inconvenience on this head, and he knows that others have been equally annoyed.

Philadelphia, April 17, 1847.

IATROS.

[We publish the foregoing communication with pleasure, in the hope that it may be useful in correcting an evil of which we hear many and just complaints. We often receive communications complaining, indeed, of eminent physicians for not having answered letters asking counsel, and invariably we have found that the letters sent contained no fee, and sometimes were not even postage paid.-EDITOR.]

BIBLIOGRAPHICAL NOTICES.

Six Lectures on the Uses of the Lungs; and causes, prevention and cure of Pulmonary Consumption, Asthma, and Diseases of the Heart; on the laws of longevity, and on the mode of preserving male and female health to an hundred years. With twenty-eight illustrations. By SAMUEL SHELDON FITCH, A. M., M. D. 12mo., pp. 324. New York, 1847.

We take up the notice of this production with feelings of contempt, not unmixed, however, with sorrow. Nearly twenty years have elapsed since its author published "A system of Dental Surgery." He was then a reputable dentist; holding a position amongst the best of the "craft;" and his "system" was esteemed so creditable to him in all respects, that it obtained encomiums from those whose good opinion it must have been his pride to possess. And now-quantum mutatus! The auri sacra fames has, we fear, induced him to quit the path of credit; to abuse the profession of which he is an enrolled member; and in the production before us to exhibit an amount of ignorance, both on general and medical topics, which must excite the wonder of every one how he could have been entitled to the suffixes of A. M. and M. D., which he attaches to his name.

We are apt to despise the miserable mercenary, who, without any claim to medical attainments, endeavours to gain a wretched subsistence on the gullibility of his brethren; but what ought to be our feelings, when a licensed member of the profession quits its honest paths, and wanders into the devious wilds of empiricism. Nor is the author of these lectures the only one to whom these remarks apply. We have reason, indeed, to believe, that the fancied success of others, a few years ago, led him to turn his attention to this subject; and that bromine was to be one of the hacks on which he designed to ride into notoriety and pelf. The example of Ramadge-the great archetype for the smaller fry that have succeeded him-himself belonging to the Royal College of Physicians of London; and yet a greater empi

ric perhaps hardly exists, as we had occasion to hint when noticing the translation of Läennec, with which his name has been connected-has led to a host of inhalers and consumption curers, who not only blazon amongst the public their own false or fancied [?] statements of success, but obtain from men in the ranks of the profession-as we shall mention more particularly hereafter-testimonials for the furnishing of which-if they have a spark of interest remaining in their noble calling-they must, by this time, be heartily ashamed.

The "Lectures" before us are evidently addressed to the people, not to the profession, whose members, indeed, they grossly slander and abuse. This fact, as well as the meretricious title, would have prevented us from taking the slightest notice of them, were it not that the " A. M., M. D." might mislead some of our readers, and induce them, in their want of information, to send for the work. We cannot refer to all the examples of gross ignorance and misrepresentation that pervade it; but it may be well to cite a few, with the view of showing, that these charges against the author and his production are not only sustained, but that our expressions have been even too guarded. "In 1827," he remarks, "whilst pursuing some investigations in Philadelphia upon nervous influence, preparatory to my graduation thesis, I discovered what I conceive to be the grand uses of the lungs, and their first great purpose. In these researches I was led to ask, what it was that gave support and power to the nervous system. I traced this support to the lungs; and at once and forever, to my mind, all darkness upon the uses of the lungs disappeared." p. 28. And what does the reader suppose was the essence of this immortal "discovery"?—that the lungs "give to the human machine its power of action. This power exists in the atmospheric air; and the lungs are the medium by which, and through which, that principle which gives the human machine its living power is conveyed to it." This immediately accounted to him for the fact that women are weaker than men. "The lungs of women are one-third smaller than those of men ;"-and why one man is stronger than another. "Were you required to select the strongest man of your acquaintance, would you select a man with a flat, thin chest, long neck, and narrow, round, stooping