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consider five shillings per diem ample pay for any amount of toil, and any risk of life.-Ibid.
Election by Concours.-It is stated, that the three Faculties of Medicine, of Paris, Montpellier, and Strasbourg, have given their voices, in answer to the request of their opinion, made by the Minister of Public Instruction, in favour of the maintenance of the election to vacant professorships by concours. The French Reform Bill just passed the Chamber of Peers, annulled the mode of election by concours for professorships, which had existed for some years, and it is on this ground that most of the opposition to the Bill is raised by the French profession.-Ibid.
On the Internal use of the Nitrate of Silver. By MR. RICHARD Southee, Cambridge.The nitrate of silver being much more frequently prescribed ihan heretofore, it may not be uninteresting to some of your numerous readers to learn that the discolorization of the skin is not of that frequent occurrence generally supposed ; in fact, large and repeated doses may be given without producing such effect. In the year 1831, when the cholera raged to a frightful extent at the port of St. Petersburg, I ordered it in grain doses in every case of collapse, and frequently repeated the same quantity every quarter of an hour, without in one instance discolouring the skin. This remedy was mentioned as being very successful, in the report of the Government Commissioners, Drs. Russell and Barry, at the time; and I know of no medicine capable of producing reaction with so much certainty, though this sometimes was sudden and violent, requiring the immediate use of the lancet; and in several cases the inordinate excitement was difficult to suppress, but no discolorization followed. - London Medical Times.
Congenital Imperforation of the Urethra the whole depth of the Glands. By E. WHITEHEAD, Surgeon, Dakinfield.-Mrs. B. gave birth to a male child on Christmas eve, 1846. I called the following day, but no remark was made. Being a distance of a mile and a half, I omitted visiting on the second day, but intended doing so on the third. However, early on the morning of my intended call I was hastily summoned. On my arrival, I found the infant screaming vehemently, and apparently in great pain. Upon inquiry, I was in. formed its bowels had been moved repeatedly; but the nurse could not say it had ever passed any urine. Upon examination this was verified, the glans penis being imperforate ; bladder considerably distended. Not having my pocket-case with me, I ordered the little sufferer to be brought to my house, where, assisted by my friend Mr. Hunt, surgeon, of Ashton-under-Line, an opening was made with a lancet in the place where the orifice of the urethra is usually situated, and an attempt made to pass a probe; the lancet and probe were again used, but without success.
The incision was then carried through the inferior length of the glans, upon which urine escaped freely. Not the slightest vestige of
an opening could be found in the glans other than the one made by the operation, which was allowed to heal. The artificial outlet now supplies the place of the natural one.--Ibid.
Case of Strangulated. Inguinal Hernia, reduced on the New Method recommended by Dr. Andrew Buchann, Professor of Institutes of Medicine in the University of Glasgow. By ARCHIBALD WALLIS MACKIE, Cupar, Fife.-G. M., aged seventeen years, railway labourer, of a stout habit of body, and enjoying previous good health, whilst employed lifting some heavy railway sleepers on Friday last, felt something to give way at the lower part of his abdomen. The patient was unable to walk, and was carried to a neighbouring house, where he remained till next day, when he was conveyed to his father's residence, a distance of eleven miles. I was called to visit him on Sun. day morning, and on examination found a tumour the size of a hen's egg, situated in the right iliac region, the general characters of which led me to conclude that it was a case of strangulated oblique inguinal hernia. The patient had not had his bowels opened since the morning of the accident. I ordered him an enema, and, after waiting till it was expelled, I applied the taxis, but unsuccessfully ; I then had recourse to the usual remedies adopted in such cases, but without any effect. I bethought me of the plan recommended by the talented Professor of Physiology in the Glasgow University, and I was glad to see iny efforts crowned with success.
The mode is very simple. I placed my patient on his back, flexing the thighs on the pelvis, and putting the muscles of the abdomen in as relaxed a condition as possible. I then desired the patient to empty his lungs of as much air as possible, and having an assistant at hand, who immediately held his nose and mouth to prevent inspiration, I applied gentle pressure over the tumour in the proper direction, and had the satisfaction to feel it give way, and, as it were, draw up into its natural cavity.
The rationale seems to me to be, when the lungs are emptied of air, the diaphragm is, as it were, sucked up to fill the diminished thoracic cavity ; it (diaphragm) exerts a tractile power over the floating viscera of the abdomen, and draws the protruded intestine upwardsnaturally assisting, if not altogether accomplishing the reduction of the heroia.
Such is the mode, I conceive, in which the reduction is accomplished ; and I have no doubt that, in addition to the mechanical influence, the temporary suspension of the breathing must have a powerful sedative effect, and consequently a relaxing influence, on any part morbidly constricted. Before operating I would always give this plan a fair and impartial trial, and I am confident, if practitioners would adopt this method, they would have the satisfaction of relieving their patients, and thus averting the dangers of a painful and often fatal operation.-Ibid.
Typhoid fever and Smallpor. By M. SERRES.-On a former oc. casion we mentioned the treatment which M. Serres considers most efficient in typhoid fever, viz., the black sulphuret of mercury; and, also, how the profession was led to adopt this method, from the good effects of mercurial preparations on the eruption of smallpox. In another communication to the Academy of Sciences the learned professor continues the same subject.
The intercurrent affections, says M. Serres, two diseases progress. ing at the same time in the same individual, each preserves its phy. siognomy, its special characters, although the intimate nature of boih may have undergone a considerable modification. The most severe of the two almost invariably communicates its gravity to the other, and diminishes if it does not destroy the chances of recovery. In the treatment, therefore, of intervening disorders, the most dangerous must exclusively occupy the attention of the therapeutist ; in order to judge n curative method, it should be put to the test of these intercurrent affections, and to this test I have submitted the method I pro. pose for the cure of typhoid fever; and have chosen the most severe complication-variola. The dangers of confluent smallpox are known to all; vaccination has considerably diminished them, but within certain limits. Thus, at the Hospital of La Pitié, during the epidemic of 1825, out of 162 vaccinated subjects attacked by the epidemic, twenty-five died. From the statistics published by Dr. Bousquet, it appears that in the thirty epidemics of smallpox observed in France between the years 1816 and 1841, 5963 vaccinated persons were attacked, and sixty-two died. Analogous results have been noticed in England, Germany, Italy, and Sweden. This revival of smallpox was attributed to the inefficiency of vaccination-a conclusion which we consider erroneous : “It is,” continues M. Serres, “to the influence of intercurrent disorders that this impotency of vaccination to prevent variola should be attributed, and chiefly to typhoid fever. During the epidemic of 1825 we were struck principally by two facts : the first was the progress of the pustular eruption, which was the same in the vaccinated subjects as in those who had not been vaccinated ; and the second was the presence in the intestines of the facial characters of typhoid fever. The epidemic, in one word, was double ; it was at the same time variolic and typhoid. The mortal influence of typhoid fever in cases of smallpox has appeared to us still more evident in cases of non-vaccinated patients. We may
ask ourselves if, before the discovery of vaccine, the interference of typhoid fever was not one of the great elements of the danger of variola ; and we will find in the symptomatic history of ancient epidemics abundant proofs that such was the fact. Typhoid fever is not, therefore, a new disease, but smallpox and typhoid fever were, perhaps, coeval: the cutaneous eruption of the former struck more forcibly the observer, and concealed the complication. It would seem that, after Jenner's discovery, variola was in a great measure arrested, and typhoid fever, being unmasked, was at last recognised." After having established that in most cases the complication of typhoid fever was the principal source of danger in cases of smallpox, the learned professor proceeded to say that he had watched attentively the effects of the black sulphuret of mercury in such cases, and that, in proportion
as the medicine relieved the symptoms of the typhoid fever, it also weakened the violence of the smallpox.-Ibid.
Antidotes of Arsenic.-Insoluble salts of arsenic, after remaining a certain time in the stomach, are at last absorbed, and act as violeni poisons. The cause of this fact is to be found, according 10 M. Caventou, in the presence in the stomach of a ceriain quantity of muriale of ammonia, by the action of which the arsenical preparation becomes soluble. In order to ascertain the different degrees of facility with which the muriate of ammonia dissolves the arsenites of lime, of magnesia, and of iron, M. Caventou instituted experiments, the resuit of which was to prove that the arsenites of lime was readily dissolved in 115 parts of a saturated solution of muriate of ammonia, the arsenite of magnesia in 330 parts, and the arsenite of iron in 600. Consequently the hydrate of sesquioxide of iron is the antidote which will resist for the longest time the dissolving action of the gastric fuids, and which it will be most proper to exhibit in the first place in cases of poisoning by arsenic.-Ibid.
Hair, Wool, Rags, and Threud expelled in a Mass from the Rectum.-Mr. Edward Spry, of the Royal Cornwall Infirmary, recently read, at the annual meeting of the South Western Branch of the Provincial Association, an account of the cure of a young woman, aged sixteen, who voided with excessive pain iwo large lumps of foreign matters—the first about the size of an ordinary pullet's egg, the second larger and longer-much compressed and very hard, having a thin albuminous coating which served to conceal the character of the contents of the lumps until forcibly separated After being washed they were found to consist of dyed wool of various colours; of thread, of worsted, and of cotton and linen rags, all compactly fitted together, and weighing one ounce and four drachms. The patient had never from infancy enjoyed a good state of health, complaining of severe pain in her bowels. In September, 1846, when first attended by Mr. Spry, there was a considerable swelling just below the margin of the right ribs, and occupying the whole of the right hypochondrium. This tuinour had a well-defined edge extending towards the epigastrium, and firm pressure on it occasioned pain. There were occasional vomitings. After the evacuation of the foreign substances, she steadily improved in health, and appears a fresh-coloured girl. It appears that this patient has no recollection of swallowing any part of the matters evacuated, but her mother stated that when a child learning to walk she would get at the seat of a settle in the kitchen, by the edge of which she held, and that the children often amused themselves by lurning over the contents of a box in which old rags of all sorts were deposited ; and that then the child must have swallowed the substances which after the lapse of many years were voided by the rectum.-Ibid.
Anencephalous Births.--Dr. Simpson states that, in his opinion, in anencephalous monsters the malformation arises from intra-uterine disease, viz., from the bursting of the head when hydrocephalic. The brain is opened up and distended by fluid so that it becomes gradually absorbed; at length the enclosing membrane gives way. The two small tubercles, always seen in anencephalous cases lying on the base of the cranium, seem to be nothing else than the remains of the membranes, shrunken up and almost obliterated.-Ibid.
On the Recent Differences of Opinion as to the Cause of Scurvy. By ANDREW ANDERSON, M. D., one of the Surgeons to the Eye Infirmary, Glasgow.-I have no intention of describing this disease. There has come under my notice but one fact in its history which I believe to be new : the occurrence of well-marked scorbutic amaurosis, and its cure by lemon juice. On this, however, I shall not at present linger, my object not being to fill up the history of scurvy, but to offer a very few remarks upon its cause.
Dr. Christison, in his interesting paper in the Edinburgh Monthly Journal (June, July, 1847,) proves that scurvy can, in certain cases, be cured by adding milk to the food, and concludes that fluid to be anti-scorbutic in virtue of the casein which it contains.
This opinion at once struck me as being at variance with that usually held ; and, thinking that I could reconcile the two, I drew out the substance of the following remarks.
Since then, it has appeared that Drs. Lonsdale and Curran (Edinburgh Montbly Journal of Medical Science, and Dublin Quarterly Journal, for August, 1847) have, as I did, thought Dr. Christison partly in the wrong, and advanced proof that milk is not essentially, or at least not in all cases, anti-scorbutic. But as neither of these gentlemen bas given that explanation of the matter which occurred 10 me, I venture to submit it still.
Dr. Christison's observation is, that in the Perth prison, scurvy broke out from treacle having been substituted for milk in the prison, ers' diet, and that it disappeared when milk was given. He found that there was no deficiency in the mere quantity of solid food provided to them, and none in that of its nitrogenous elements; but that (excluding gluten, which has been proved to be, when taken alone at least, not nutritious) there was in the food a marked deficiency of nutritive azotised matters, - viz. fibrin, albumen, and casein.
His deduction is, that it was the want of these which caused the scur. vy; and that it was by supplying such matter, in the shape of casein, that milk proved anti-scorbutic.
Now in the first place it must be obvious to all, that this doctrine will not account for every outbreak of scurvy, or explain every cure; for it is notorious that lemon juice, without a drop of milk, or any nitrogen, has prevented and cured the disease in instances quite innumerable. But the question is, may not scurvy be the offspring of diferent causes, and owe its origin now to the absence of fresh vegetables, and again to that of nutritions azotised food ?
It seems to me that this must be answered in the negative ; and that it is not very difficult to reconcile the opposite opinions, and 10