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that the case was closely allied to the ordinary form of malformation in which, with congenital contraction of the pulmonary artery, the septum of the ventricles is defective at the base, so as to allow the aorta to receive its supply of blood from both ventricles. Its great interest, however, lay in the division of the right ventricle into two cavities communicating with the aorta and pulmonary artery respectively, and the free admixture of the venous and arterial currents of blood, which must consequently have taken place throughout the whole of the boy's life. So far, however, from this having been productive of marked cyanosis, it was stated that there was but little peculiarity in the boy's appearance till the supervention of secondary disease in the pulmonary artery after the fall, twelve months before. his death. The cause of death was also, it was remarked, unusual. Though obstructions in the terminal branches of the pulmonary artery had been shown by Baron and Paget to be of frequent occurrence, the writer was not aware of any other case in which the trunk of that vessel had become obstructed.--Lancet.

On Porous Rarefaction of the Bone, consequent upon gout. By ALEXANDER URE, Esq., Fellow of the Royal College of Surgeons, and Surgeon to the Westminster General Dispensary. The author ob. served that, upon making a transverse section of a digital phalanx, taken from a gouty subject, a peculiar speckled appearance was perceptible. The inedullary canals were seen preternaturally enlarged, and filled with a cretaceous matter, which effervesced with acids. The Haversian canals were, in like manner, irregularly enlarged and choked up with this substance. The osseous lacunæ or corpuscles were, in some places, increased in size, and rounder than ordinary, but, for the most part, less distinctly marked. The canaliculi, more especially in the vicinity of the medullary canals, were replete with the above deposit, thicker than normal, and in obvious communication with the medullary canals. There was thus induced porous rarefaction of the bone. The author stated that the matter in question consisted chiefly of carbonate of lime, while a portion of tophus, detached from the adjunct phalangar joint, was almost wholly composed of urate of soda. In reference to the above peculiar condition of the osseous structure, he remarked, that Dr. Gerlach, of Mayence, whose co-operation he had in the above research, subsequently ascertained that precisely the same appearances were present in the section of bone taken from a person who had been afflicted with morbus coxæ senilis. Arthritic osteoporosis is an affection of a very insidious character. It commences almost imperceptibly, creeps on stealthily, year by year, and is accompanied by occasional pain and swelling Although usually occurring in individuals hereditarily predisposed to gout, it is not necessarily preceded by a fit of that malady. While the author believes it to be but little amenable to treatment, he is of opinion its progress may be somewhat retarded by judicious hygienic measures; and the attendant pain and uneasiness relieved by topical steam baths, in conjunction with the vapour of mineral naphtha, and by various other soothing means.—1b.

Alleged Presence of the Plague in the Metropolis.-Dr. Tweedie has addressed a letter to the Times, in reference to the prevalence of typhus fever under a severe form in the metropolis. After stating that the admissions to the Fever Hospital during the present year have been but little above the average of the last five years, he says:-"In regard to the character of the cases received since January last, it is important to observe, that a very large majority have not been cases of typhus fever, but of inflammation of internal organs, more especially of the lungs, which every medical practitioner knows to be invariably accompanied with more or less feverish disturbance of the system. Indeed, for some time past, the proportion of cases of genuine typhus fever has been unusually small, much smaller than, from the late scarcity of provisions, and consequently inadequate supply of food, could have been anticipated.

"London, therefore, affords at this time a striking contrast to many of the large provincial towns, in which typhus fever, from causes which it is unnecessary to advert to at present, prevails to such an alarming extent.

"And lastly, with respect to the tendency to inflammation of the glands of the face and neck-the circumstance on which the apparent connexion with plague is founded-it may be remarked, that this symptom is occasionally observed in very mild cases of fever, but that it has not been a very frequent occurrence lately, is evident from the fact that it has been observed in only five of 452 cases received into the Fever Hospital since January last; and that of these five only two have died, the fatal event in one being the result, not of the glandular inflammation, but of old standing diseases of the chest.

"From these facts I think it may be deduced,-1st. That typhus fever is not at the present time alarmingly prevalent in London; 2d, that in its character it bears no analogy to the plague; and 3d, that the inhabitants of London have great cause of thankfulness that as yet the metropolis has been visited with a much less proportionate amount of epidemic fever than any other city in the kingdom."

The mortality from typhus fever is at present much above the average! the deaths last week were 52 to a spring average of 34.— London Medical Gazette.

Production of Albuminous Urine by Cantharides.—In a communication on Cystitis from cantharides, made by M. Lavallee to the Academy of Medicine, at its sitting on the 15th inst., it is stated by the author that under the use of this vesicatory, at whatever part of the body it may be applied, and however distant from the hypogastric region, albumen is liable to show itself in the urinary apparatus, under three forms: 1, in solution: 2, as a deposite in the urine: and 3, as a false membrane produced in the bladder. The albumen is contained in the urine under these circumstances in much greater proportion than in Bright's disease:-the author states that in some instances, after a day's rest, the deposite constitutes more than half the height of the liquid. As an exception, the urine may contain no

traces: but then vesical symptoms, such as pain and tenesmus, are absent. This is a new form of artificial albuminuria.”—Ibid, from L'Union Médicale.

The Gastric Juice.-Lehmann has confirmed the statements of Pelouze and of Bernard and Barres will, regarding the absence of free hydrochloric acid in the gastric juice, and has further indisputably proved the existence of free lactic acid in that secretion. To prevent any fallacy in the experiments, dogs were kept fasting for 12 or 16 hours, and then fed about a quarter of an hour before death with bones freed as much as possible from skin and fat. The gastric juice was almost perfectly clear, being scarcely opalescent. From 100 parts there were obtained 1.808 of solid matter, 0.25 of hydrochloric acid, and 98.097 of water. This hydrochloric acid is formed by the decomposing action of the lactic acid at a certain degree of concentration, even in the cold, upon certain chlorides, especially those of calcium and magnesium, but not those of potassium and sodium. To prove the presence of lactic acid itself with certainty, the gastric juice was concentrated in vacuo to one twelfth of its volume, the residue mixed with alcohol of 0.85, the spirituous solutions from several stomachs evaporated to the consistence of a syrup, and the residue exhausted with absolute alcohol. The residue of this was exhausted with ether, and the ethereal extract mixed with water, to remove the fat, and filtered. On further concentration, more drops of oil separated from the filtrate, and the fluid still contained hydrochlorate of ammonia. The liquid was partly saturated with lime, partly with magnesia, and the salts formed were purified by several recrystallizations from alcohol and water. The magnesian salt gave results approximating very closely to the formula Mg O, La+3 HO."—Ibid, from Dr. Day's Report on Chemistry.

Turning a Substitute for Craniotomy.-Dr. Simpson states that he has practised turning as an alternative for craniotomy and the long forceps, in several cases in which the head had been morbidly detained at the brim of the pelvis, from the slighter forms of disproportion between the two; and he believes it to present various advantages over embryulcio. It gives the child a chance of life; it is more safe to the mother, because it can be performed earlier in the labour, and more speedily; it enables us to adjust and extract the head of the child through the imperfect pelvic brim in the most advantageous form and direction, the head flattening laterally under the traction; the neck of the child (if it were living, or only lately dead,) is so strong as to allow us to exert such a degree of traction upon the obstructed head, that the sides of the cranium might become very greatly compressed, or even indented under it, and that without necessarily destroying the child; and, lastly, he observes, it is a practice which can be followed when proper instruments are not at hand, and the avoidance of instruments is generally desirable when it is possible. Prov. Med. and Surg. Journ. from Monthly Journ. of Med. Science.

Syrup of Hydrocyanic Acid.-At the request of several medical practitioners a very elegant syrup of prussic acid has been devised by Dr. Reich, affording an eligible means of administering that potent substance in a certain dose. He prepares it by adding to a syrup of sweet almonds a definite quantity of amygdaline. His recipe is as follows:-Take of sweet almonds two ounces; immerse them for the space of a night in cold distilled water, and in the morning remove the skin by the pressure of the finger and thumb; then pound the almonds in a deep mortar, adding two ounces of the purest sugar. Pound together in a mortar, either of porcelain or marble; then by degrees add distilled water two ounces, and strain, with the application of slight force. To this emulsion add sugar of the purest kind two ounces, and promote the solution of the sugar by mixture alone, heat being avoided. To four ounces of this syrup add seventeen grains of amygdaline, and rub together in a porcelain mortar. Much of the syrup need not be kept ready prepared, as its extemporaneous formation is so easy. An ounce contains a quarter of a grain of real prussic acid.-Ibid. from Buch. Rep.

Benzoate of Ammonia in Gout.--Dr. Seymour states that he has frequently used this medicine in cases in which the small joints were red and swollen, or where fluid was deposited in the joint of the great toe, and also in cases where the lithate of soda existed in the joints of the fingers, and that it was decidedly useful. He thinks that early depositions have been arrested, and large depositions diminished, under the use of this medicine. He regards it as a good diuretic, and as especially adapted to those cases of dropsy in which an irritable stomach renders the employment of ordinary diuretics impracticable. He has seen also the albumen in renal dropsey diminish under the use of the benzoate of ammonia.-Ibid, from Thoughts on Several Severe Diseases, &c.

Binoxide of Mercury in Skin Diseases.-M. Ibreisle has reported the results of his experience in the use of the binoxide of mercury as a local application, in diseases of the skin, especially those of a strumous or syphilitic origin. Indolent ulcers of the extremities have frequently yielded to this application, as have also phagedenic ulcerations. The author regards this preparation as an excellent remedy for the removal of the indurations which accompany syphilitic ulcers; he has likewise used it with success in pustular syphilides.

The formula is that of an ointment, consisting of one part of the oxide, to four or five of lead. Some caution appears to be necessary in its employment.--Ibid, from Gazette Médicale.

Relative Value of Different Medicines Ordinarily Empolyed in Syphilis.--A long memoir on this subject by MM. Boys de Loury and Costilhes closes with the following propositions :

1. The preparations of gold and silver are worthless in constitutional syphilis.


2. The iodide of potassium has no influence upon the progress and duration of chancre, particularly the indurated variety but in such cases mercury is to be preferred. The same may be said as respects buboes, mucous tubercles, papular and pustular syphilides.

On the other hand, iodide of potassium is invaluable in syphilitic disease of bones, and in syphilitic tubercles of the skin with or without ulceration. It may be stated in general terms that the iodide is successful in proportion to the anterior duration of the disease, and the degeneration of the constitutional powers.

Iodide of potassium acts like a charm in nocturnal pains. United with the bin-iodide of mercury, it is valuable in syphilitic cachexia, and in cases which have resisted ordinary mercurial treatment.

3. Mercurial fumigations are only available in healing local symptoms, and should not be employed as a means of affecting the system. 4. Mercurial frictions should be used only in those cases in which irritability of the mucous membranes forbids the internal administration of mercury.

5. The proto-iodide of mercury is the best medicine which can be employed as an antisyphilitic, as well in the primary as the consecutive symptoms of the disease.-Ibid, from Gazette Médicale.

Cod-Liver Oil.-M. Bretonneau has come to the conclusion, after many trials, that common train oil is quite as efficacious in struma and other cases in which it is given, as the cod-liver oil. This is an important fact, if true, and demonstrates that the virtues of the latter oil are to be ascribed to its fatty principles, not to the small portion. of iodine contained in it.-Ibid, from Bulletin de Thérapeutique.

New Muscle in the Eye.-The Oest. Med. Woch., No. 40, mentions that in the human eye and also in that of the mammifera, Dr. Brüche states that he has discovered a new muscle. This muscle appears in a manner to have the same power as that of the iris. It consists in the grey ring which is found in front of, and in the neighbourhood of the iris on the external surface of the choroid, and which has been usually known under the name of the ciliary circle. Brüche gives to this muscle the name of the expansor muscle of the choroid.-Monthly Journal of Medical Science, from Gaz. Med. di



On the Frequent Occurrence of Alkaline Urine in Health, and the Errors of Diagnosis occasioned by a Want of Knowledge of this Fact. By Dr. ADOLPH KRUKENBERG. Brunswick -The fact-first promulgated by Wöhler-that the internal use of salts of vegetable acids and fruits containing them, causes the urine to be secreted alkaline, has been too much neglected by succeeding physiologists and pathologists. Our author found that a much smaller quantity of fruit was necessary for the production of this phenomenon than has hitherto been supposed, viz.-2 to 4 oz. of apple pulp, or 12 plums, weighing without the stones scarcely 1 oz, sufficed to make the

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