Society, etc., etc. Philadelphia: T. K. & P. G. Col- 2. Necrological Notice of Dr. Philip Syng Physick; de- ART. VI.-Elements of Pathological Anatomy; illustrated by numerous engravings. By SAMUEL D. GROSS, M. D. Boston: 1839. - 353 - 367 ART. VII.-Transactions of the Medical Society of the State of New York.-Parts II and III, Vol. IV. 382 SELECTIONS FROM AMERICAN AND FOREIGN JOURNALS. Ph. Ricord on the Special Treatment of Phimosis and Paraphimosis. ORIGINAL INTELLIGENCE. Summer and Autumnal Diseases for 1840. Scarlet Fever. - 393 - 396 Licking County Medical and Philosophical Society. Green County Medical Society. A Pin retained in the Body Nineteen Years and then discharged - 402 THE WESTERN JOURNAL OF MEDICINE AND SURGERY. NOVEMBER, 1840. ART. I.-Reports of Cases, treated in the Louisville Marine Hospital. By GEORGE W. BAYLESS, M. D., Demonstrator of Anatomy in the Medical Institute of Louisville. AMONG a considerable number of cases, treated in this house during the months of July and August, 1840, the following are considered to possess sufficient interest to merit a brief notice. In presenting these cases, we shall not pursue the usual plan of noticing the daily condition and changes, with the prescription, for the reason that we deem it better to abbrevi ate by giving the general features and results, than to enter into such a detail, which is not called for by their particular character. CASE 1ST. ANEURISM OF THE AORTA.-James M'Guinnative, of Ireland, aged about twenty-six years-a stout muscular man about five feet ten inches high-a stage driver by occupation, and of intemperate habits, was admitted July 2d. Stated that he had always been healthy up to last winter-that in January last, from exposure incident to his occupation, he took a severe cold, attended with cough and pain in one side, could not recollect which-that he was puked, purged, &c. and that he got better, but not entirely well. That he was able to go about in a short time, but continued to have a dry cough, attended with some dyspnoea, &c. which prevented him from resuming his occupation. That this state of things continued through the remainder of the winter and spring, and that he began to get worse about two or three weeks before he entered the hospital. Symptoms when admitted.-Surface-skin in good condition, inconsiderable emaciation.-Head, normal.—Thorax— cough troublesome, occasional slight dyspnea, inconsiderable mucous expectoration, pretty good resonance, and nothing unusual discovered by auscultation. Circulation not well distributed to the extremities-pulse eighty, small and feebleno particular examination made of the heart.-Abdomen— tongue slightly covered with a whitish fur; appetite not good, but the stomach retained and digested very well whatever of food was taken; bowels, in a good condition, no pain nor tenderness, upon pressure, in any part of the abdomen. Diagnosis uncertain; most probably chronic bronchitis, consequent upon the cold taken last winter. Directed vegetable diet--cupping over the anterior parts of thorax brown mixture, and mucilaginous drink. Found him at next visit somewhat relieved of the dyspnoea, but cough still troublesome. Brown mixture continued. There being no manifest change in two days, he was ordered ung. tart. emetic, to free pulsation on anterior thorax; brown mixture to be continued. A copious crop of pustules was produced in a day or two, when we discovered great force in the action of the heart, communicating a considerable impulse to the hand, and attended with acute pain upon pressure. Tinct. digital. was added to the brown mixture, and cups were applied to the præcordia. The pain was mitigated by the cupping, but this great activity in the pulsation of the heart having continued unintermittingly for several days, and the dyspnea, dry cough, and feeble pulse, which was very small considering the activity of the heart, still continuing, led us to believe that there was contraction of the left ventriculo-aortic valves, nowithstanding we could detect no morbid alteration in the sounds of the heart. We could not only easily account for the symptoms just named, upon the supposition of this lesion of the aortic semi-lunar valves, but we were compelled to suppose this or some affection of the aorta itself, which was not then indicated by any particular symptom. Brown mixture discontiued. Pulv. digital. gr. 1-morning, noon, and night. This was continued several days, when we were called to him early in the morning, and found him laboring under extreme dyspnoea-heart beating violently-pulse much fuller and stronger than we had ever seen it, and had only changed within a few minutes, as we were informed by the house student-surface cold, and covered with a cold perspiration; face livid and turgid with blood-eyes semi-closed, and pupils dilated-jugulars stuffed-total insensibility-brain evidently greatly engorged and oppressed with blood, and apoplexy seeming to be momentarily threatened. Before we reached the house, sinapisms had been applied to the breast and extremities, and an effort made to abstract blood: only two or three ounces could be obtained. A large orifice was immediately opened in the arm, and about thirty ounces of blood soon abstracted, with almost entire relief. His condition just described, together with the effect produced by thus rapidly diminishing the quantity of blood in circulation, confirmed us in the view which we had taken. These paroxysms continued to recur daily, and frequently two or three times a day, and always required the abstraction of blood before relief was obtained. We found that relief was afforded more speedily and with the loss of a smaller quantity of blood, which became desirable from the necessity of its frequent repetition, by opening a jugular. So satisfied was he that blood-letting was his only source of relief, that he implored it as an act of mercy, when a paroxysm was about to come on. A few days before death, the nature of the affection became apparent from an increased fulness which was observed to make its appearance, extending two or three inches by the side of the left edge of the sternum,-commencing at the topfrom a palpitation which became very obvious at the intercostal spaces of the part, and from his complaining of a "lump which choked him" about the top of the sternum. Death took place on the 8th of July, during one of the paroxysms already described. Examination of the Body Nine Hours after Death. Head. No cerebral symptoms having been observed since |