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last he entitles, "the third form of marasmus:”—the one intended to mean "simple disturbance of the intestinal canal without organic derangement;" the second, to mean "ulcerations both of the great and small intestines;" and the third, to mean "a primary disease of the peritonæum :" all which significations will be admitted to be pretty extensive when applied to the puny word "marasmus,” originally meant to imply simply a wasting of the body, or emaciation!

En passant, we may beg to ask Dr. G. Gregory, whose opportunities for dissections have been numerous, no doubt, what he means by 66 mucous and serous membrane of the abdomen?" We know, of course, that the abdomen is internally lined, and the viscera within it externally covered by a serous membrane; and we also know that the viscera themselves are lined within by a mucous membrane: but we have yet to learn where and how we are to look for "a mucous membrane of the abdomen."

We shall be more brief in what we have to say on the subject of Dr. G. Gregory's two other papers.

II. Case of Malformation of the Heart. By GEORGE GREGORY, M.D.

&c.

III. A Case of Chorea, successfully treated by Arsenic. By GEORGE GREGORY, M.D. &c.

The pith and matter of the first of these two memoirs is positively and wholly concentrated in these few lines:

"The lungs were found adhering every where very firmly to the pleura costalis and pericardium. Tubercles and vomica were scattered through their substance. The cavity of the pericardium contained four ounces of serum. The heart was very firm, and of a natural size. The aorta and pulmonary artery arose from the right ventricle. The septum ventriculorum, at its base, was wanting for an extent somewhat larger than the diameter of the aorta. The pulmonary artery was not much smaller than natural, and at its origin was surrounded by some cartilaginous-like fibres, between which and the semilunar valve a small sac was formed."

Dr. G. Gregory's merit in this case consists in having been an accidental spectator to a dissection which took place at the Hospital of Saint Pierre, at Bruxelles, in 1817. Not so with regard to the second case, which forms the subject of the third and last paper from Dr. G. Gregory's prolific pen. Here the author had the good fortune of treating successfully a case of chorea, in a girl seven years of age, by arsenic, giving the liquor in doses of three drops, gradually increased to seven, three times a-day. Mr. SALTER had done so before him in four instances, as it appears from the tenth volume of the Medico-Chirurgical Transactions: and this fact Dr. G. Gregory himself acknowledges; but he forgets to add, that even Mr. Salter had not been

the first publicly to acknowledge the benefit to be derived from arsenic in the treatment of chorea, for he imitated Mr. MARTIN, who several years before had read a similar case of chorea, successfully treated by that medicine, before the same Society: so that the practice, as far as it goes, had already a tolerable share of authority for its support, before Dr. G. Gregory gave us his solitary case.

We now proceed to a more congenial and a more pleasing task, regretting that the narrow limits of our Number will not permit us to do justice to the other very valuable papers contained in the present volume.

IV. Cases of Bronchocele or Goitre, treated by Seton; with Observations. By A. COPLAND HUTCHISON, Esq. Surgeon Extraordinary to his Royal Highness the Duke of Clarence; Surgeon to the Westminster General Dispensary; Medical Superintendant of the Penitentiary at Mill-bank, Westminster; and late Surgeon to the Royal Naval Hospital at Deal.

Mr. Hutchison, than whom no surgeon has the improvement of his profession more at heart, having read the account of Professor QUADRI's practice in cases of bronchocele, availed himself of the first opportunity to submit its expediency to the test of trial. A middle-aged Irish woman presented herself to him in September, 1819, with a goitre about the size of a large orange, of rather a firm and hard structure, extending more to the left than to the right side of the neck, the lobe of the thyroid gland being most enlarged, and the disease occasioning pain and uneasiness in the left ear; without, however, impeding deglutition or respiration. Mr. Hutchison passed a long and narrow seton needle, armed with half a skain of silk thread, obliquely through the substance of the gland from the left lobe upward, leaving a space of nearly two inches between the entrance and escape of the instrument. A trifling hemorrhage succeeded the operation, but not such as to create the least anxiety. A few days after the operation, a slight degree of erysipelatous inflammation supervened, which was followed by a profuse discharge of a thin acrid matter. As soon as the inflammatory action subsided, the discharge was kept up by occasionally besmearing the seton with savine ointment. the 5th of December, a fresh seton was applied in an opposite direction. During the following inclement season, the poor woman was attacked with fever, but recovered; and, the tumor gradually diminishing under the action of the discharge, which continued notwithstanding the accidental removal of the seton, she was ultimately discharged cured. The disease is scarcely perceptible, the patient is well, and the skin which covers the tumor of its natural colour.

On

Mr. Hutchison thinks that the operation by seton in cases of bronchocele is not to be considered as dangerous; but, in irritable habits, and in the hard lobulated species of the disease, he cautions practitioners to weigh well the necessity of such an operation before they attempt to perform it.

The writer next proceeds to give some instructions respecting the employment of setons in bronchocele, and states his own views with regard to the manner in which the cure of that disease, by means of the operation in question, is effected. On the subject of the probable causes of bronchocele, Mr. Hutchison, instead of wasting his time in idle conjectures, or in a mere compilation of what others have fancied on the subject, very properly observes, that, "before we can reasonably expect to arrive at the causes of the diseased structure, our inquiries should be first directed to obtain a knowledge of the functions of the gland itself, which are at present involved in mystery."

The paper concludes with notes on a case of bronchocele operated upon by Mr. Gunning, in St. George's Hospital, which proved fatal; with a report of cases successfully treated by Mr. A. T. Thomson, of Sloane-street; and with a letter from Mr. James, of the Devon and Exeter Hospital, in which the details of another instance of success are given, obtained in a case of bronchocele by means of the seton.

V. Case of Fractured Os Pubis, successfully treated. By HENRY COATES, Esq. Member of the Royal College of Surgeons, and Surgeon to the Salisbury Infirmary. Communicated by Mr. EARLE. A lady was overturned in a coach which had fallen several feet from the road side, three gentlemen, likewise passengers, falling on her at the same time, so that the pubis was forced against the seat. She was lying in bed, incapable of motion, when the author saw her, and the least jar of the bedstead, or a quick and heavy movement across the room, increased her sufferings so much that she screamed out from exquisite pain. Upon examining her, Mr. Coates found but little tension of the pubis; but, on moving the left lower extremity, he could distinctly feel, and even hear, a crepitus. The fracture was situated at the junction of the ra mus of the pubis with the ischium. Mr. Coates had a bandage constructed of wide woollen girth web, with buckles and straps placed closely, which was drawn under the pelvis, as the patient could not be moved, by means of pieces of tape attached to bandages, which were insinuated by a plate of elastic steel, and then buckled as tight as could be borne; with directions to tighten it still more, as the bandage should stretch.

"Two straps from the back part were passed between the thighs, and buckled to the anterior portion of the belt, to retain it in its situ. ation. Pads were also placed on each side the pubis. Notwithstand

ing all the precaution and gentleness used, several severe spasms occurred, which displaced the fractured bones, with great increase of pain. I directed that her diet should be of the lowest description; and, in the event of any recurrence of pain or tension of the abdomen, that she should be immediately bled. She was also to take some antimony in saline mixture, and an opiate when necessary."

After an interval of between five and six weeks, she was able to walk about with assistance, and eventually recovered.

VI. Case of Sudden Death, in which a Hydatid was found in the Substance of the Heart. By DAVID PRICE, Esq. Communicated in a Letter to the President.

A boy, ten years of age, a pauper, who had never given any signs of being affected by the complaint of which he ultimately died, fell suddenly one day on the pavement, after having been exposed to the splashing of cold water on his naked body, and expired. Mr. Price examined the body, and found in the muscular substance of the heart a large hydatid. In the pericardium there were two ounces of a dark-coloured fluid; the rest of the viscera appeared to be healthy.

VII. A Case of Aneurism of the Carotid Artery. By HENRY COATES, Esq. Member of the Royal College of Surgeons, and Surgeon to the Salisbury General Infirmary. Communicated by Mr. EARLE.

This paper is illustrated by a pláte representing a man having an aneurismal tumor of the carotid artery, the largest, Mr. Coates believes, to which a ligature has been applied in this country. The patient did not eventually recover; but the author thinks he lived long enough to prove the success of the operation, and, under this impression, he considers the case as highly instructive. We must quote the author's own account of the operation.

"The patient being scated in a chair, with his head supported by assistants, and the chin in a line with the sternum, I made an incision, commencing on the base of the tumor, near the posterior edge of the mastoideus, and terminating at the clavicle, about an inch and half in length. It was continued to the same distance, in a line with the clavicle towards the shoulder. The head was then turned to the left shoulder, and the muscle was detached from its cellular union, as well as some of the fibres at its insertion into the clavicle. The divided parts were held separate by two blunt hooks, the tumor drawn upwards, and the dissection continued down to the sheath of the ar. tery, which, from the pressure of the aneurismal sac, lay very deep. This was attended with much difficulty, in consequence of the small space which I could obtain to reach the vessel. The jugular vein presented no obstruction, as in the case recorded by Mr. Astley Cooper, the return of blood being stopped by the pressure of the

tumor.

"The sheath of the artery being opened, a moderately-sized ligature of waxed thread was passed under it, by an aneurismal needle, and tied. The pulsation in the tumor instantly ceased, and the patient grew faint, but he soon recovered. The wound was drawn together by straps of adhesive plaster, and he was placed in bed. He, however, continued faint for some minutes, but afterwards became composed. Scarcely an ounce of blood was lost during the operation. He was ordered to take some gruel."

The operation was performed on the 3d of January, and the patient did not die till the 15th of March, and then, apparently, from other causes.

VIII. On the Efficacy of the Bark of the Pomegranate Tree, in Cases of Tania. By P. BRETON, Esq. Surgeon to the Rhamgur Battalion in the East Indies. Communicated by Dr. RoGET.

Commu

IX. On the Efficacy of the Bark of the Swietenia Febrifuga, as a Substitute for that of the Cinchona. By P. BRETON, Esq. nicated by Dr. ROGET.

The insertion of these two papers from the same hand, in the present volume, might, we think, have been spared. Dr. FLEMING, in his catalogue of Indian plants, had observed that the decoction of the bark of the pomegranate tree was an efficacious remedy for the removal of the tape-worm. Mr. Breton tried this medicine in eight cases of tænia, in which he administered either the dry powder or the decoction, with an equal

success..

As for the pretended substitute for cinchona in the swietenia. febrifuga, we shall be glad to find that subsequent experience confirms the reported success which the author has obtained in the treatment of remittent and intermittent fevers by means of that bark.

Qur readers will not lose sight of the fact, that the above paper, and documents annexed to it, were transmitted to the Society through a commercial house, with specimens of the medicine in quill, powder, and extract; and with a notice that a cargo or two of it had arrived in England, and was ready for sale.

X. On the Physiology of the Ear. By JOSEPH SWAN, Esq. of Lincoln. Communicated by Dr. ROGET.

In a former communication to the Society, Mr. Swan had endeavoured to prove that, when the meatus auditorius externus is stopped, and a sounding body is applied to the face, sound is "not mechanically conveyed to the portio mollis of the seventh pair of nerves; and, likewise, that it was probable that in fishes the sense of hearing was produced from the nerves spread on the external parts of the head receiving the impressions of sound, and conveying them to the auditory nerves; and that

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