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would have been equally important. As it now is, the student may in vain look for information on some of the most interesting diseases; and even his reference to what the work really does contain is greatly impeded by the want of an index. In the first American edition the index was sufficiently brief, but still it was an aid; whilst every one who refers to the edition before us is compelled to wade through a long table of contents before he can find the reference he desires. Yet Dr. Bell has been industrious, the additional lectures occupying upwards of 170 pages of the volume, and containing-as every thing proceeding from him must contain-information of much interest to the profession.

MISCELLANEOUS NOTICES.

Paine's Medical and Physiological Commentaries-We are requested to state, that Dr. Paine will soon reply, in a pamphlet, to all the strictures of H. J. B. which have appeared in the Boston Medical and Surgical Journal, in relation to Dr. Paine's Essay on the Principal Writings of M. Louis, contained in his valuable "Commentaries."

Philadelphia School of Anatomy.-The annual announcement of this school of anatomy, under the superintendence of Drs. James M'Clintock, and J. M. Allen, contains the names of 135 students, who formed the class of 1839-40.

Philadelphia Hospital, Blockley-Dr. M'Clintock-The Board of Guardians have recently appointed Dr. M'Clintock as one of the obstetrical physicians to this institution, in the room of Dr. Charles Bell Gibson, resigned. Dr. Gibson will, in future, practise his profession in Baltimore, where we trust he may meet with eminent success.

On the structure of the Macula Lutca (Foramen of Soemmering) of the Human Body. By Dr. Grube, of Konigsberg.-The author had previously made many observations on the structure of this part, but their results had been unsatisfactory, in consequence of the length of time that had elapsed after death before the eye was removed. The examination here described is that of an eye taken from a body a few hours after an accidental rupture of the spleen.

The retina adhered so firmly to the vitreous humour that the greater part of the latter could be removed only by carefully cutting with scissors. With the naked eye it was at once easily discerned that the level of the macula lutea was not a little raised above the surface of the retina. On placing it and the part around it under a microscope magnifying 300 times, and compressing it but slightly, the maculata lutea presented exactly the appearance of shagreen. Longish-round corpuscles, which were smaller the nearer they were to the centre, and there not more than one fourth or one fifth of the size of the medullary corpuscles on the surface of the rest of the retina, were arranged close together and with great regularity, like rays passing from the centre to the circumference of the spot. Towards the circumference they became larger, and gradually merged into the form and size of the corpuscles of the rest of the retina. The circumference, however, did not form a regular circle, but the small medullary bodies radiated beyond it at some parts, to different distances from its outline.

'Muller's Archiv. Heft. i. 1840; and Br. and For. Med. Rev. July, 1840, p. 255.

New method for the radical cure of Varix, and especially of Varicocele. By M. Ricord-After pointing out the errors of believing that varicocele affects only persons of twenty or thirty years old, and imagining it to be a common consequence of gonorrhoea or epididymitis, whereas in fact it is more generally a predisposing canse of the latter disease, and instead of being produced by it, is more often cured by it; M. Ricord proceeds to describe his mode of operation.

"The hair must be shaved from the genital organs on the side to be operated on, and the veins must be dilated by making the patient walk about a little, or by enveloping the scrotum for a few hours in hot poultices, or by fomentations. This being done (though if the swelling is at all times considerable these precautions are unnecessary), the vas deferens must be separated from the mass of veins, and the latter being taken up with a fold of the scrotum, a flat lance-shaped needle armed with a double-looped thread must be passed beneath them. When the needle has been passed completely through the skin from one side to the other, the veins are to be let go, the skin alone being now held up, and then a second needle similarly armed must be passed through over the veins, entering at the same hole by which the first needle was thrust out, and passing out at the same hole by which the first entered. The bundle of veins is thus fixed between two double threads, of which one passes over and the other beneath it. The ends of each double thread on each side are then to be passed into the loop of the other, and now, by drawing these ends in opposite directions, the vessels are tied beneath the skin. By this kind of ligatures the vessels may either be suddenly constricted or be tied gradually in a manner something like that adopted by M. Breschet, or most conveniently by a properly adopted serrenaud after the fashion of a tourniquet.

"It is usually from the tenth to the twentieth day that the vessels are divided by this means, and their division may be easily recognised by the freedom with which the ligatures may be drawn from one side to the other without being, as they were before, retained by the parts which they inclosed. It sometimes happens, that at the instant of the first constriction the patient suddenly feels rather an acute pain in the course of the spermatic cord; it is usually less severe than in the other operations for the same purpose; and though it often recurs at the successive constrictions, yet it has never been long continued, nor given rise to any accident. It is sufficient to keep the scrotum raised, to employ some anodyne frictions on the inguinal canal or the lumbar region, or to apply some emollient poultices, to effect its removal. Sometimes a slight œdema of the scrotum supervenes, and I have twice observed rather a considerable serous effusion in the tunica vaginalis. In one patient, also, who went out of the hospital and in a few days after the operation exposed himself to great fatigue, a slight abscess formed in the cellular tissue; but with these exceptions, there has been no important accident.

"It must be clearly understood, that if the patient is strong and plethoric, he is to be bled from the arm directly after the operation; that the horizontal position must be maintained till the vessels are cut through; and that the bowels must be carefully kept open.

"Twelve patients have now been operated on in this manner at the Venereal Hospital, and in all the most complete and satisfactory result has been obtained. The three last of them were presented at the Academy of Medicine; two completely cured, and the third, who was operated on only two days previously, still wearing the ligature and the serre-nœud.

"I have employed the same method for varices of the legs. I have already operated on nine patients, some having simple varicose swellings, and others

Bulletin Générale de Thérapeutique, Mars, 1840; and Br. and For. Med. Rev. July, 1840, p. 271.

varicose ulcers. In some a single ligature was sufficient, in others as many as four were applied. In none have there occurred any symptoms of phlebitis; the varicose veins have been obliterated and the ulcers speedily cicatrised; and in one of the patients whom I saw six months after the operation, there was no relapse. Still, however, I do not think that this method is likely to be so successful in all cases of varices of the lower extremities as in those of varicocele."

Revaccination in the Prussian Army in 1839. By Dr. Lohmeyer.' Total revaccinated

Of this number there were distinct marks of previous vac

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Out of the number that remained unaffected in the first instance, the operation was repeated with effect in

without effect in

41, 181

33,225

5,889

2,367

19,249

8,534

13,698

2,105

7,886

Out of the number revaccinated, in whom the disease ran a regular course (19,249), there were produced perfect pustules as follows:

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Of those revaccinated with effect in 1839 and previously, there were attacked in the course of the same year,

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The revaccinations, as in former years, were made partly from arm to arm, and partly (in the beginning of the process) from dried lymph. In the operations from arm to arm, the lymph was taken partly from fresh-vaccinated children, partly from adults vaccinated or revaccinated. The results, as in former years, were so far similar in the two latter cases, that true pustules equally followed from either source; but it appeared from the testimony of several of the surgeons that there ensued a more powerful reaction, with considerable fever in the stage of maturation, from the insertion of the lymph from adults than from children. The inoculations from dried lymph often failed.

As had also been formerly observed, the disease was often remarkably well characterised in individuals in whom the scars of previous vaccination were strongly marked, while it often failed, and after repeated trials, in others who showed no trace of a former disease.

By way of experiment, many individuals, in whom there existed more or less distinct scars from smallpox, were vaccinated, and frequently in these there ensued perfectly good pustules both as to appearance and course.

Berl. Medic. Zeitung, April 22, 1840; and Br. and For. Med. Rev., July, 1840, p. 276.

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[The following communication was recently received from the zealous author, who left his country as a missionary, to bestow his valuable services on the benighted inhabitants of oriental regions. We hope his health may permit him to live long in his useful and benevolent career; and that we may receive from him—from time to time-the fruits of his observation and reflection.

We have likewise from him a History of Vaccination in China, which shall appear in our next number.-ED.]

Macao, May, 1840.

To the Editor of the American Medical Library and Intelligencer. My Dear Sir,

The following history of the "Treatment of Snake-Bite by the Native Practitioners of Bengal," was originally printed in a Bengali paper, called Bhaskar, or The Sun, and subsequently translated and published in the 91st number of the Calcutta Christian Observer for December last. It treats upon a subject of much importance in itself, and makes us acquainted with some native alexipharmics, as well as with the views and practice of the Baidyas, or medical men of Bengal, in regard to the action and counteraction of serpentine poison. It is for practical men to decide how far the Esculapius of Bengal is either rational in his theory or judicious in his treatment of his patients.

It will doubtless interest your readers as well as serve the cause of humanity and science.

Most respectfully yours,

W. BECK Diver.

Treatment of Snake-Bite by the Native Practitioners of Bengal. "There are many varieties of snakes or serpents;-among these the four following abound in this province, viz. the Gokhura, or cow-hoofed snake, a species of Cobra di Capello, so called from a real or fancied resemblance in the spectacle to the prints of a cow's hoof; the Keütiyá, or black serpent, the black Cobra di Capello (Coluber Naja or Nága); the Kánor, or arrowsnake, a species of serpent which, attaching itself to trees, darts thence like a boll upon its prey; and the Borá, or large boa constrictor. The bites of all these are fatal to life.

"The poison of the three first, viz. the Gokhura, the Keütiyá, and the Kánor, is excessively virulent and rapid in its operation. When a person has been bitten by any of these, the virulence of the venom, so to speak, instantly affects the sight, the patient's eyes inflame, and presently he swoons away. Still the poison does not spread itself beyond the wounded part for the space of half an hour; after about that lapse of time it begins to make its way into the blood-vessels. For half an hour, therefore, following the bite, there is no danger to life; within that period, however, an iron, heated red hot, must be applied to the wounded part. If this cannot readily be done, then let a bandage, drawn very tight, be applied a little above the part; then as the poison begins to ascend the vessels, the surface over them will swell or puff up successively in spots, as if a small pea or similar nodule were passing on. The moment of swelling must be very carefully watched, because the subsequent subsidence is instantaneous. Keeping, then, the eye steadily fixed upon the passage within of the poisonous goutte, let an incision be made with a sharp instrument at the distance of three fingers' breadth above the rising or gibbosity it occasions, so as to sever the vessel, when the poison will spurt out at the opening and fall to the ground. If, however, the operator be unable from inexperience to detect this,—to a common eye, not very perceptible symptom, another easy course in that case is as follows. As the poison cannot readily pass beyond the place of ligature, it there causes a fulness like the gradual swelling or inflation of a leech in sucking, seeming to strike against the bandage, or against a barrier to its passage, and then receding from the shock. This appearance is easily discernible. Now, if an incision be made just at the point of retrocession, the venom will instantly flow out with force through the opening made. Then loosening the bandage, let some salt be applied to the wound. The patient will suffer no further inconvenience.

"The mode of treating the bite of the Borá (or Boa constrictor) is different, except in so far as regards the application of a red hot iron to the wounded part; this is the first process in any case. The reason for this difference is, that the poison of the Borá does not flow readily; two hours only after it has been introduced it begins to gather into globules or drops, to penetrate the muscles and pass into the system. If, however, it have passed beyond the wounded spot, then let the part directly above the wound be divided with the knife, to ascertain how far it has passed. For no blood will flow where the venom has reached, nor is the patient sensible to pain from any incision made there. Where, however, blood flows upon incision, let the hot iron be applied all round the limb, leaving an armlet, as it were, of cauterised muscle; whereupon the venoin will discharge itself through the opening, mingled with serous blood. This is the only certain mode of cure for the bite of the Borá,-failing which the patient runs the extremest risk of his life.

"Where, however, the above process has not been adopted, there is one mcde of treatment which is applicable in all cases of snake-bite. It is this. As soon as the patient is seen to totter and fall, let a strong fire be immediately kindled close to his head. Then let a couple of earthen pots (or cooking pans) be brought and laid empty upon the fire. When these are thoroughly ted, let one of them be taken up with a pair of tongs and held very carefully, mouth downwards, over the patient's head, so as, while it does not touch the head in any wise, yet to enclose it partially within its cavity. When one vessel cools, let the other be similarly applied. This course must be persevered in for at least two full hours, whereby a profuse perspiration will be excited over the patient's whole body, with which the poison will escape in a watery state. The patient will soon begin to open his eyes, and after a while will find himself quite recovered. Those who

'The actual cautery here prescribed is a favourite remedy in native practice on many occasions, as in treatment of disease of the spleen, &c. &c.-W. B. D.

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