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Action for Libel.--Syme v. Lizars.'-Mr. Syme, who, our readers are probably aware, is Professor of Clinical Surgery in the University of Edinburgh, recently brought an action for libel against Mr. Lizars, Professor of Surgery in the College of Surgeons. The following is the article complained of, and is contained in Lizars' System of Surgery, Part II:

"In every operation about the anus, however unimportant it may seem, the operator cannot be too careful in averting hemorrhage, as many have died from such neglect. This was the fate, indeed, of a respectable apothecary in this city. Nor is it improper, as an additional warning, here to mention another case, which was under the care of our Professor of Clinical Surgery a few years ago. He operated on a gentleman, for a slight fistula in ano; left the part inadequately defended, and dreadful hemorrhage ensued. The professor was sent for, arrived, groped about in the anus with his knife, searching for a needle in a hay rick--I mean, for a blood-vessel to be tied. Meantime, the life of the patient was saved by deliquium animi ; but to this day the wound remains unhealed, and the unfortunate man a miserable, nervous invalid, from the excessive loss of blood."

The damages were laid at £1000.

The defence consisted in denying that the passage was false, calumnious, or injurious; or that it was written with the intent of imputing want of skill to Mr. Syme, or with a wish to hurt his good name and reputation. It was then admitted, on the part of the defendant, that he had been misinformed as to Mr. Syme being the party who "groped about" for the vessel; because, though sent for, he was not to be found.

The Lord Justice Clerk summed up, giving an opinion in favour of the prosecutor; to whom the jury, after retiring for a few minutes, awarded £50 damages.

Nerves of the upper extremities.-By James Douglas, Lecturer on Anatomy, Glasgow. One of my students this forenoon was dissecting the superior extremity, and asked me to point out to him the nerve of Wirsberg, as it was not, he said, mentioned in his book. On looking at his book, Quain's Anatomy, it is not so much as mentioned; and, in Harrison's Dublin Dissector, the best manual with which I am acquainted, and which I recommend to all my students for their companion at the dissecting table, it is not described; but the name of the nerves of Wirsberg is applied to the two, or sometimes three branches, which come off from the second, third, and fourth intercostal nerves, at the greatest lateral projection of the ribs, and generally lose themselves on the skin which shuts up the base of the axilla. These are more properly called the intercosto-humeral nerves.

The nerve in question is described by Sir C. Bell, in the second vol. of his Anatomy, p. 571-a book which is not in general very minute in its details, though it has many other valuable qualities. It is there called the nerve of Wirsberg. I forget who gave it the designation of the cutaneous minor, by which I am accustomed to demonstrate it.

In the subject looked at to-day, it arises from the lower of the three divisions of the brachial plexus-from the same root as the internal cutaneous and ulnar, internal to which last it lies. It runs down along the inner side of the basilic vein beneath the fascia, perforates it about a hand's breadth above the elbow, and divides into two branches, one of which runs in front of the inner condyle, and the other, rather larger, behind it, and both lose themselves in the skin a little below the elbow. In some subjects I have seen its origin very small from the axillary plexus; and then it derived an additional root from some of the intercosto-humeral nerves.

When writing, at any rate, I may add a remark on a set of muscles said

Lond. Med. Gaz., May 8, 1840, p. 281.
Lond. Med. Gaz., May 1, 1840, p. 228.

to have been discovered by some German, and noticed in one of the numbers of the Gazette last winter, under the name of Rotatores dorsi. I must confess that, when I read it, I disbelieved their existence, from what I knew of the structure of the dorsal spine, where rotation is impossible, on account of the form of the articulating processes of the vertebræ, and on account of the ribs being superadded. Nothing, however, is too absurd for a German periodical.

If the multifidus spine be dissected away with care, its deepest fibres will be seen arising from the lower edge of the arch of one vertebra near its spinous process, and passing obliquely down to be inserted into the root of the transverse process of the one below; but these have no more claim to be considered distinct muscles than the outer fibres of the lower fasciculi of the same muscles have, which pass over one, or sometimes two transverse processes, before being inserted.

Premature labour artificially induced in a Dwarf.-By M. Dubois.'The subject of this case is a dwarf, æt. 23, 3 feet 2 in. 9 1. high, whose father was only 3 feet 6 in., but whose mother was of ordinary size. These, her parents, had six children, of whom three were dwarfs. Two years ago, M. Dubois attended her in her first labour; when he was called in she had then had pains for 48 hours; on the previous evening she had had convulsions, and she lay in a kind of stupor in a cradle. The labour appeared in an advanced stage, for the child's head could easily be felt in the hollow of the pelvis; but further than this it could not pass, and the forceps could not be applied. The child was evidently dead, and M. Dubois, therefore, perforated the head, and it passed on to the vulva. Here, however, there was a fresh difficulty, for the vulva was narrow in correspondence with the stature of the individual. Happily, it soon enlarged spontaneously by a rupture which passed backwards and on one side towards one of the ischia, and the labour was terminated. The child, without its brain, weight 54 lbs; its length was 7 inches. The patient went on satisfactorily after the labour, and soon recovered. The state of stupor in which she was at the time of the accouchement almost prevented her feeling the pains.

Last year, she again became pregnant; but this time, (says M. D.) in conformity with my recommendation, she came to announce it to me early. She had, when she came to me, been pregnant since about last June; and I found by the examination of the pelvis, that its diameters were not proportioned to the presumed dimensions of the fatal head, for the pubo-coccygeal was not more than three inches.

Admitted to the obstetric clinique, we found on examination, that the uterus was but little developed and the fœtus small. In February, she was in the eighth month of her pregnancy; and the abdomen then enlarged considerably in the space of a few days, so as to cause some fear that the accouchement might be rendered difficult by a superabundance of liquor amnii. Having decided on inducing premature labour, I had to choose between rupture of the membranes, dilatation of the neck of the uterus with prepared sponge, and the administration of the ergot; I decided on the two last. The patient having taken a bath, was placed on the edge of the bed, and a speculum was introduced; a portion of prepared sponge, an inch long, and cut in the form of a cone, was placed in the neck of the uterus, and over it another moist sponge to keep it in its place; they were fixed by a thread, and six grains of ergot of rye were administered. The patient was then put to bed. Four hours after, she felt strong pains, and was in active labour; it appeared indeed to be going on so rapidly, that I withdrew the sponge. At nine in the evening, there was a full protrusion of the membranes, and I ruptured them and found that the buttocks presented. The fingers were

'Gazette Médicale, Mars 14, 1840, and Lond. Med. Gaz., May 1, 1840, p. 237.

applied on the haunches to facilitate their exit; the head remained at the superior aperture; drawing downwards a few times, and movements of flexion, brought it into the hollow; and at last it came out entirely. The child breathed immediately; it was 15 inches long; the biparietal diameter was 3 inches; the occipito-frontal 3 inches and 2 lines: it weighed 3 lbs. 12 oz. The size of the child was therefore small: yet it was not a dwarf. The mother nourished it for a few days, but the secretion of milk soon ceased; on the twentieth day the woman was perfectly recovered.

M. Dubois adds some details as a supplement to this history. The father of the child is a man of ordinary stature; he is about 5 feet 7 inches high. The first sexual connections were very painful: but the periods of pregnancy were easy.

Nothing is more rare than the accouchement of dwarfs: for there is but a single authentic fact, which is related in the work of Geoffrey Saint-Hilaire. The woman, who was to have been confined at London, died. It is to be observed, that the child of this woman is not a dwarf: dwarfs are born much smaller. The mother herself was born extremely small; she passed all her infancy on a table seated on a cushion. There is but one exception to this rule, an English dwarf exhibited in 1770; he was born of the usual size, but at the age of one year his growth was suddenly arrested.

I have, of course, no need to justify the measure which I adopted in this case. It cannot be compared with an operation, of which the result would be to sacrifice the mother or the child, or both at once. More than two hundred cases that have now come to my knowledge, prove that the plan I adopted is not so serious a thing as might be imagined; half the infants, and an immense majority of the mothers, have survived it. Still, the cæsarean operation is certainly not in all cases to be superseded by the production of premature labour; each of these operations, as well as the division of the symphysis, and embryotomy, has its own special iudications.

Successful treatment of a congenital umbilical hernia.-By Professor Cederschjold, of Stockholm.-The umbilical ring was open in this case, and had probably a diameter at least of an inch, through which the intestines, covered only by peritoneum, protruded, and formed a mass as large as a fist. The umbilical cord came out from the most prominent part of the tumour. The protruded intestines could not by gentle pressure be returned into the abdominal cavity through the ring, and it was by chance discovered that they were full of meconium, which the child had not yet evacuated. A laxative medicine was therefore ordered to be introduced, before the intestines were replaced. Five teaspoonfuls of castor oil were given before the bowels acted; the hernia then became soft; and by placing the child on its back, its reduction was easily accomplished. The sac, consisting of the peritoneum only, being emptied, a ligature was tied close to the umbilicus, which falling off after 14 days, the navel was found completely healed, and just like that of a healthy child.

Medical department of Kemper College, St. Louis.-A new school of medicine has been institutsd at St. Louis, which will go into operation in the fall. The following gentlemen constitute the Faculty.

Joseph N. M'Dowell, M. D., (late Professor of Special and Surgical Anatomy in the Cincinnati College,) Professor of Anatomy and Surgery; J. W. Hall, M. D., (late of Kentucky,) Professor of Theory and Practice of Medicine; Hiram A. Prout, M. D., (late Professor of Chemistry and Botany in Lagrange College, Ala.,) Professor of Materia Medica and Medical

'Schmidt's Jahrbucher, and Lond. Med. Gaz., May 1, 1840, p. 238.

Botany; John S. Moore, M. D., (late of Tennessee,) Professor of the Institutes of Medicine and Obstetrics; John De Wolf, M. D., (late Professor of Berkshire Medical School,) Professor of Chemistry and Pharmacy.

By order of the Board,

GEO. A. UNDERHILL, Secretary.

Magendie on the physical phenomena of life.-A translation of this interesting work is in course of preparation for the "Library," by Dr. Benjamin Dennis, of Cincinnati.

Simulation of disease.'-Some diseases or disabilities, such as deafness stammering, are much more easily feigned than others, and, consequently, the imposture is more difficult to detect. In all diseases of which the symptoms are obscure, periodic, or intermitting and uncertain, much care should be taken not to come to a wrong conclusion. "Melancholy instances," says Mr. Malcolmson, "have come to my knowledge where men have died in making exertion above their strength, after having been looked on as malingerers." Some diseases are not indicated by a change of the pulse, or by any remarkable alteration of the body, or evident derangement of its functions; and it ought to be recollected, that patients suffering under real disease are apt sometimes to exaggerate their lesions. A malingerer is constantly prone to overact his part; but the inventing of symptoms is a much more difficult operation than frankly to state the feelings. Two soldiers were transferred to the hospital in Dublin, to be discharged, in consequence of alleged incurable disabilities. The designation of a disease was affixed to each name; but the appearance of the men indicated little, if any, derangement of the body. The medical officer made them stand up together, and requested one of them to describe his complaint, which he did very minutely. By his account, it appeared that he suffered under disease from the head to the foot. The other man was then asked, "what is the matter with you?"-"The same as this man," was his reply. He was evidently not prepared with a set of symptoms, and, without perceiving the trap, instinctively availed himself of the ingenuity of his fellow impostor. They were sent back to the corps; "but I have no doubt," says Mr. Marshall, relating to the anecdote, "that each of them succeeded eventually in working out a discharge."

BOOKS RECEIVED.

From the Author.-Medical and Physiological Commentaries, by Martyn Paine, M. D., A. M. 2 vols. 8vo. pp. 716, 814. New York, 1840. (See Bibliographical Notices.)

From the Publishers.-Treatise on the Physiological and Moral Management of Infancy. By Andrew Combe, M. D., Fellow of the Royal College of Physicians of Edinburgh, Physician extraordinary in Scotland to the Queen, and Consulting Physician to the King and Queen of the Belgians. With notes and a supplementary chapter. By John Bell, M. D., Lecturer on the Institutes of Medicine and Medical Jurisprudence, Fellow of the College of Physicians of Philadelphia, and Member of the American Philosophical Society, &c. 12mo. pp. 307. Philadelphia, 1840.

From the Author.-Psychology; or a view of the Human Soul; including Anthropology, being the substance of a course of lectures delivered to the junior class, Marshall College, Pennsylvania. By Frederick A. Rauch. 8vo. pp. 388. New York, 1840.

'London Lancet, March 7, 1840, p. 902.

THE

AMERICAN MEDICAL INTELLIGENCER.

Vol. IV.

August 1, 1840.

No. 9.

ART. I.-COAGULATION OF THE BLOOD FIFTEEN HOURS

AFTER DEATH.

BY THE EDITOR.

From a late number of the Bulletin of the "Proceedings of the American Philosophical Society," (No. 12, for May, June and July, 18mo. pp. 216,) we extract the following notice.

"Dr. Dunglison gave the particulars of a case in which blood that flowed, on dissection, from the arteries of the brain, coagulated fifteen hours after the death of the individual.

The patient died after a severe agony, and after an illness of some duration, for which mercury had been administered so as to affect the system freely. On opening the head the arteries of the brain were found turgid with blood, and on removing the brain the blood flowed from them and coagulated.

Dr. Dunglison made some remarks on the singularity of this phenomenon, and its relations to physiology and medical jurisprudence, and stated that it completely overthrew the views of those who believe that the blood is either possessed of a vital influence or receives some influence from the living vessels that contain it, which maintains its fluidity, and that so soon as it is removed from these influences it coagulates or dies. In this case the blood remained fluid, and coagulation took place fifteen hours after the total cessation of respiration and circulation, and after the blood had become cold; circumstances showing that the phenomenon is wholly physical in its nature."

Of this case we had not an opportunity of seeing any thing until after death; nor was an accurate history of it attainable. The patient had been delivered about a month previously, and had suffered under symptoms, as it was believed, of peritonitis, for which she was bled generally and locally, and had taken small doses of calomel, which produced severe salivation with considerable ulceration of the gums. Two or three days before her dissolution she was affected with diarrhoea, with heat and dryness of skin, quick and feeble pulse, and considerable stupor, passing her urine and fæces involuntarily. Under these symptoms she gradually sank.

It was especially in consequence of a very offensive discharge from one of the ears, that we suggested the propriety of examining the head with the view of discovering whether the patient had died of cerebral otirrhoea, when the phenomena above described were noticed, but there was no evidence of encephalic inflammation originating in the disease of the ear.

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