Billeder på siden

ceased. This symptom had occurred suddenly, and had been followed by collapse. Turning was now effected with unusual facility. Child still-born. The placenta removed, the uterus contracted and remained as a hard body. Little blood escaped. Without rally, the patient died on the following morning. Autopsy not allowed. The rent was not felt during life. The diagnosis rested on the symptoms.

CASE IX. In May, 1854, Dr. Lehmann was called to a multipara, aged thirty-eight, on account of a shoulder presentation. An obstetrist called in had failed in turning on account of the strength of the contractions. The patient was collapsed, abdomen much swelled and exceedingly painful; the uterus loosely drawn around the child. The pains had entirely ceased, and the foetal heart could not be heard. The presenting shoulder was easily pushed back, and the version and extraction effected. Child dead. The placenta with a great quantity of blood followed spontaneously. The uterus contracted well, but collapse increased, and death speedily followed. Autopsy refused. Diagnosis rested on symptoms.

CASE X.-In November, 1856, Dr. Lehmann was called to a primipara, aged twenty-six, on account of retention of the placenta. The breech had presented and had been expelled by the uterus; the head had been delivered by the forceps. Child dead. The patient was much exhausted, and the uterus contracted. Blood flowed continuously. In passing the hand for the placenta, Dr. Lehmann found a large cross-rent in the lower segment of the uterus where the vagina is connected behind, through which the entire hand passed into the abdominal cavity. The pelvis was contracted at brim, the conjugate diameter being scarcely 4". The visceral convolutions projecting through the rent were replaced, and as efforts to open the os uteri could only endanger the widening of the rent, the separation of the placenta was left to nature. This was effected on the fifth day. Endometritis followed, and malignant puerperal fever carried off the patient on the tenth day after labour.

CASE XI.-On the 2nd May, 1858, a woman aged thirty-five was in labour in the Lying-in Hospital with her second child. Gestation had been normal. The belly showed an unusually strong pronation of the uterus. The fœtal heart was heard in the right side. The os was open 2" with a thick, soft edge, the head presenting but lying much over the symphisis. The labour went on tediously, notwithstanding strong pains. At 10:30 of the 3rd May, the os was fully expanded, but the head had not altered for many hours; a miscoloured, stinking fluid escaped from the vagina; the pains had ceased. The uterus was strongly contracted round the foetus; the abdomen was of irregular form, but free from pain. With the lever the head was first brought into the pelvic brim, and then delivered by the forceps, dead. The uterus contracted well. For the first few days the woman did well. The uterus, however, preserved a large size, but remained painless. The labia pudendi began to swell, and gangrene appeared in the mucous membrane of the vulva. Sloughs fell. On the seventh day a light fever appeared, with shivering resembling ague. This was successfully encountered by quinine. On the tenth day, when the patient seemed doing well, the uterus having sunk into the pelvis, a copious flooding suddenly came on and destroyed the patient. It was concluded that, through a gangrenous softening at a higher part, vessels had been injured, and caused the flooding. The uterus was found at the neck and the upper part of the vagina, especially at the left, and behind, quite gangrenous, and a large round hole with sharp edges quite through. The muscular fibres were fatty. About 1:50" from the neck was a second smaller hole; in this divided vessels were seen which had given rise to the fatal flooding. At the posterior side of the body of the uterus, which had lain against the promontory, was an incomplete rupture of 1-50" long. The

pelvis was narrowed at the brim; the conjugate diameter measured 3-20". The symphysis pubis was very thin and softened; the ossa pubis through diastasis separated more than an inch. Purulent fluid escaped from the articular cavity. The ossa pubis and the innominata were moveable. [One cannot help observing that several of these women were in labour too long, and that delivery by perforation or turning at an earlier period would have saved the lives of some. -REPORTER.]


A Manual of Medical Diagnosis. By A. W. Barclay, M.D. Second Edition. London, 1859. pp. 616.

Aerztlicher Bericht des Allgemeinen Krankenhauses in Wien. Vom Civiljahre, 1857. Wien, 1858.

Hemorrhoids and Prolapsus of the Rectum. By Henry Smith, F.R.C.S. London, 1859. pp. 46.

Localised Movements, or Muscular Exercises combined with Mechanical Appliances for the Treatment of Spinal Curvature. By H. H. Bigg. London, 1859. pp. 120.

A Letter to the Earl of Shaftesbury on the Laws which regulate Private Lunatic Asylums. By E. J. Seymour, M.D. London, 1859. pp. 59.

What shall we do with our Lunatics? By Alfred Eccles. London, 1859. pp. 16. Chloroform and other Anæsthetics; their History and Use during Childbirth. By John Chapman, M.D. London, 1859. pp. 51.

The Army in its Medico-Sanitary Relations. Edinburgh, 1859. pp. 84.

Handbuch der Historisch-Geographischen Pathologie. Bearbeitet von Dr. August Hirsch. Erste Abtheilung. Erlangen, 1859.

The Boston Medical and Surgical Journal. Jan. 27, 1859.

Report on the Sanitary Condition of the City of London, 1857-8. By H. Letheby, M.B. London, 1859.

A System of Dental Surgery. By J. Tomes, F.R.S. London, 1859. pp. 599. Three Reports relating to the Hastings Water. Hastings, 1859.

On the Hygienic Management of Infants and Children. By T. Herbert Barker, M.D. London, 1859. pp. 120.

Healthy Skin; a Popular Treatise on the Skin and Hair. By Erasmus Wilson, F.R.S. Sixth Edition. London, 1859. pp. 288.

The North American Medico-Chirurgical Review, March, 1859.

American Medical Monthly, Feb. 1859. Diphtheria; a Lecture delivered at the Norfolk and Norwich Hospital. By W. H. Ranking, M.D. Norwich, 1859. pp. 30.

An Essay on the Action of Medicines on the System. By F. W. Headland, M.D. Third Edition. 1859. pp. 447.

American Journal of Insanity, Jan. 1859. Third Annual Report of the United Lunatic Asylum for the County and Borough of Nottingham, year 1858. Nottingham, 1859.

The Journal of Mental Science. Edited by Dr. Bucknill. April, 1859.

Quarantine as it is, and as it ought to be. By Gavin Milroy, M.D. London, 1859. (Reprint).

The Emotions and the Will. By Alexander Bain, A.M. London, 1859.

Ophthalmic Hospital Reports, Jan. 1859. Eighth Annual Report of the Wilts County Asylum. Devizes, 1859.

The Cyclopædia of Anatomy and Physiology. Edited by Robert B. Todd, M.D., F.R.S. Five Vols. London, 1835-59.

Art versus Nature in Disease. By A. Henriquez, B.L.P., M.R.C.S. London, 1859. pp. 281.

On Diphtheria. By Ernest Hart. London, 1859. (Reprint.) Gazette Hebdomadaire, Avril, 1859. The Assurance Magazine, April, 1859. Gazette Médicale d'Orient, Avril, 1859. Reports in Operative Surgery. Series the Third. By Richard G. H. Butcher, Esq. Dublin, 1859. pp. 50.

A Treatise upon Penetrating Wounds of the Chest. By Patrick Fraser, M.D. London, 1859. pp. 140.

On the Cervix Uteri in Pregnancy. By J. M. Duncan, M.D. Edinburgh, 1859. (Reprint.)

On the Influence of the Variations of Electric Tension on the Remote Cause of Epidemic and other Diseases. By William Craig, Consulting Surgeon to the Ayr Fever Hospital. London, 1859. pp. 436.

Clinical Lectures on the Principles and Practice of Medicine. By J. H. Bennett, M.D. Third Edition. Edinburgh, 1859. pp. 1005.

Gooch on some of the more Important Diseases Peculiar to Women, with other Papers. Prefatory Essay by Robert Ferguson, M.D. London, 1859. pp. 235. (The New Sydenham Society.)


Sulle Virtu Igieniche e Medicinale della
Coca, e sugli Alimenti Nervosi in generale.
Milano, 1859.
Del Dottore Mantegazza.
pp. 75.

A Guide to the Practical Study of Dis-
By James Dixon,
eases of the Eye.
F.R.C.S. London, 1859. pp. 435.

A Digest of the Vital Statistics of the
European and Native Armies in India.
Joseph Ewart, M.D. London, 1859.


By pp.

Hufeland's Art of Prolonging Life. Edited by Erasmus Wilson, F.R.S. Second Edition. London, 1859. pp. 271.

Die Erkenntniss und Heilung der Harnröhren Verengerungen. Von Dr. Heinrich Lippert. Frankfurt-am-Maine, 1858. pp. 236.

Allgemeine Pathologie der Seele. Von Adolph Wachsmuth. Frankfurt-am-Maine, 1859. pp. 348.

A Treatise on Syphilis in New-born Children and Infants at the Breast. By P. Diday. Translated by G. Whitley, M.D. London, 1859. pp. 272. (The New Sydenham Society.)

Memoirs on Diphtheria, from the Writings of Bretonneau, Guersant. Trousseau, Bonchat, Empis, and Daviot. Selected and translated by R. H. Semple, M.D.; with a Bibliographical Appendix by J. Chatte. London, 1859. pp. 407. (The New Sydenham Society.)

The Physiological Effects of Alcohol.

Manchester, 1859.


On Dislocations and Fractures.


Joseph Maclise, F.R.C.S.

Fasc. VIII. and

IX. (conclusion) London, 1859.

and Treatment of Sciatica.

Practical Observations on the Nature

By H. C.

Roods, M.D. London, 1859. pp. 56.

The Treatment of Obstinate Ulcers. By
H. T. Chapman, F.R.C.S. London, 1859.
Third Edition.
pp. 161.

Observations on Strabismus. By J. G. S. Coghill, M.D. Glasgow, 1859. (Reprint.) Lunacy. Supplement to the Twelfth Report of the Commissioners in Lunacy to the Lord Chancellor. (Blue Book.)

A Treatise on Medical Electricity, Theoretical and Practical, and its Use in the Treatment of Paralysis, Neuralgia, and other Diseases. By J. Althaus, M.D. London, 1859. pp. 352.

An Essay on the History, Pathology, and Treatment of Diphtheria. By Edward pp. 47. Copeman, M.D. Norwich, 1859. Manchester Walks and Wild Flowers. By Leo H. Grindon, Lecturer on Botany, &c. London.

A Tract on Neurolytic and Agueish Dis-
orders, and on Malaria and Remittent Fever.
London, 1859.
By C. H. Jones, M.D.

The Psychology of Shakespeare. By
London, 1859.
J. C. Bucknill, M.D.
pp. 264.
Extracts from the Records of the Boston
Society for Medical Improvement. By
Vol. III. Boston,
F. E. Oliver, M.D.

Norsk Magazin for Lægevidenskaben, xii. Band, 7 to 12 Hefte; xiii. Band, 1 to 4 Hefte.

How to Improve the Teaching in the Scottish Universities. By John Struthers, M.D. Edinburgh, 1859. pp. 36.

Charleston Medical Journal, May, 1859. On the Structure and Functions of the Hairs of the Crustacea. By Campbell de Morgan, Surgeon to the Middlesex Hospital. Phil. Trans., 1858.

Five Essays by John Kearsley Mitchell, M.D., late Professor of Practice of Medicine in Jefferson Medical College, &c. Edited by S. Weir Mitchell, M.D. delphia, 1859. pp. 371.





OCTOBER, 1859.


Analytical and Critical Reviews.


Die Cellular-Pathologie in ihrer Begründung auf Physiologische und Pathologische Gewebelehre. Von RUDOLF VIRCHOW, Prof. der Pathol. Anatomie der Allgemeinen Pathologie und der Universität. -Berlin, 1858. pp. 440.

Cellular Pathology, as the Foundation of Physiological and Pathological Tissue-Doctrine. By RUDOLF VIRCHOW.

THIS work consists of a series of lectures and demonstrations, delivered at the request, and for the benefit, of the practitioners of Berlin, who were anxious to be made acquainted with the progress of pathology, as taught by Rudolf Virchow. Expressly composed, therefore, for the benefit of busy men, who have long left the schools, and who have not been able to keep pace with all the microscopical debates of the day, this work is remarkably pleasant reading, for it proceeds from simple to difficult propositions, and from old to novel doctrines, with so easy a step that no one will have any difficulty in following it. It gives, too, at one view, a general summary of those opinions which Virchow has spent many years in working out, and which were previously scattered through a host of writings, and are not even adequately represented in the two large volumes of his collected essays which were published some three years ago. We were therefore glad to meet with an advertisement a few weeks since, announcing that a translation of the Cellular Pathology will soon be published; and we anticipate that this translation will excite much interest.

Few authors of our day have written so voluminously as Virchow, and it is but justice to say, that few have been so largely read. Another man would have tired the public with his incessant dissertations, but Virchow has thrown into every essay so much observation, 48-XXIV.




such numerous facts, and has looked at these facts with so much of the instinct and fire of genius, that we know not one of his works we should desire to see cancelled.

Let us, however, at once say, that while we appreciate his extraordinary powers, and admire the independence with which he looks at every fact and doctrine with his proper eyes, and without borrowing the spectacles of other people; and while we acknowledge most completely his many services to pathology, we yet hesitate to acknowledge in Virchow the coming man who is to gather up into one consistent doctrine the disjecta membra of the old medical creeds, so ruthlessly shattered by the application of the new methods of inquiry. It may be, to use his own simile, that he has shared in the flight out of Egypt; but we are afraid he is not the Joshua who is to lead us into the land of milk and honey. At any rate, before we get there, we can perceive that there are stern and determined enemies in the way; Philistines and Amalekites in walled cities, not at once, we suspect, to be laid defenceless by the mere blast of the trumpet. But let us put the rival hosts in presence, and we shall better see to which side victory will incline.

We had at first intended to present a succinct but complete analysis of this work; but on consideration, and bearing in mind that a translation will soon be made, we have determined rather to select the most original and fundamental points for discussion, and not to attempt an The work is itself very much condensed, and we exhaustive account. could hardly do justice to some parts of it in our space.

With regard to cells, animal and vegetable, of which a good account is given in the first chapters,* Virchow, following Remak, entirely discards the theory of formation given by Schleider and Schwann. He acknowledges no development of a cell in an amorphous blastema, by the successive formation of a nucleolus, a nucleus, and a cell wall; and refuses assent to the doctrine that a cell originates in an aggregation of molecules, which then undergo a differentiation, so that some cohere to form a nucleus, and others form the outer wall by a still In the place of these views, Virchow advocates more intimate fusion. the principle, that in every case, physiological and pathological, in the vegetable as in the animal kingdom, a cell arises only from a pre-existing cell. As regards animals, so also with cells, there is no generatio æquivoca, no spontaneous generation; one cell springs from another by endogenous growth, or by fissure and cleavage of nuclei and cells.

This doctrine, if true, would at once necessitate an entirely different reading of many pathological phenomena. We are in the habit of saying that, in inflammation, for example, an exudation of albuminous or fibrinous substance is poured out between the tissues or on the free surfaces, and that this exudation then organizes itself into cells by spontaneous generation; and it has also been a creed that the said exudation, in virtue of, or from the absence of, special physical organizing powers, might either form perfect cells, or might develop

* We would refer also to an article by Professor Huxley, in a former number of this Journal, on the Cell Theory. Virchow quotes from, and has evidently appreciated, this admirable essay.

« ForrigeFortsæt »