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of these tissues. How could inflammation exist in the perspiratory apparatus without involving that of inhalation and absorption; or how could the minute vesels of the mueous tissue be affected without implicating those of the colouring matter? for the space occupied by each of these systems is so small as to defy detection with the naked eye, requiring the assistance of the most powerful glasses to render them evident to the senses. Daily experience shows the impossibility of inflammation existing in one or the other organ of the skin for a considerable time without extending to those adjacent. Thus, in eczema, the most common vesicular affection of the skin, the first and simplest form presents a slight elevation of the cuticle, filled with clear serum, and apparently without inflammation; a degree farther we find a partial change in the character of the serum, and evidences of inflammation, as in eczema rubrum. Still farther, we have the serum entirely altered, becoming purulent, and covering the surface with scabs, as in eczema impetiginodes, which soon becoming pustular, presents a genuine impetigo. The same condition prevails in scabies, which, if neglected, at different periods of its duration exhibits every variety of cutaneous disease, from the simple vesicle, its type and origin, to the severest forms of pustular and papular affection, followed by universal desquamation. These facts illustrate the position assumed, and warrant, we think, an attempt at some simpler and more practical classification.

In the following plan a distinction is drawn between syphilitic and venereal cutaneous affections; this is not the proper place to give the reasons for such a distinction. Syphilis is used to express chancre and its special consequences; venereal implies all other diseases, the results of impure coition, not dependent on chancre. We propose to follow Plumbe in part, arranging cutaneous diseases under two general divisions. First, those of local origin, or dependent on the skin alone: second, those of a constitutional character, produced by some cause affecting the general system and developed through the skin.

FIRST DIVISION.-Diseases of the skin proper, or those originating in the skin, independent of, though modified by, constitutional causes.

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SECOND DIVISION.-Diseases produced by causes acting through the con

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Venereal and S The most common form of venereal and sy

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philitio cutaneous affection.

E. glandulosa-acute glanders Conta-
Farcy glanders, generally chronic

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gious.

Non-conta

gious, and

E. of the face, mistaken fre- (perhaps saquently for crusta lactea, or lutary. impetigo

{Very rare-chronic

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Furuncle

Scrofula

Not properly a disease of the skin, but of the sub-cutaneous cellular tissue.

Incapable, perhaps, of originating, yet complicating and modifying all the diseases embraced in the second divi

sion.

Variola, varioloid, and vaccina; varicella, with military fever; rubeola and scarlatina, are omitted. With the exception of vaccina, they are essentially fevers, and belong to works on general practice. Vaccina, if classified, would be considered as confined to the skin proper; it is not introduced on account of its intimate relations with variola.

Stokes on the Chest.-A copy of this work, sent to us by its distinguished author upwards of two years ago, has, from accidental circumstances, only just reached us. Messrs. Haswell & Barrington have, we are informed, some copies of the English edition for sale.

Philadelphia Medical Society.-At the annual election held on Saturday, 2d January, the following officers were elected for the ensuing year:— President.-Thomas Harris, M. D..

Vice Presidents.-George B. Wood, M. D.; Robert M. Huston, M. D. Treasurer.-J. Brewer, M. D.

Corresponding Secretaries.-B. H. Coates, M. D.; W. Poyntell Johnston, M. D.

Recording Secretary.—Joshua M. Wallace, M. D.

Orater.-Isaac Parrish, M. D.

Librarian.-J. F. White, M. D.

Curators.-Joseph Peace, M. D.; John B. Griscom, M. D.

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ART. I.-CASE OF SEVERE COMPOUND FRACTURE.

BY S. T. NEWMAN, M. D.

St. Francisville, La., January 4th, 1841.

Dr. Dunglison,

Sir,-If the following case is worth a place in your journal of medicine, it is at your disposal. Respectfully,

S. T. NEWMAN.

On the 24th of February last, I was called to visit Esther, servant-girl, living six or eight miles from Amsterdam, Miss. The girl, I was informed, had broken her leg. When I arrived I found her suffering extreme agony; and upon removing the covering which had been thrown over the affected limb, my sensibilities were shocked at the mangled appearance it presented. I found instead of a fracture (which I expected to see,) a luxation of the joint, made by the foot on one part, and the tibia and fibula on the other, in which the foot was almost torn from the leg; it being torn from the external malleolus upwards and across the instep, down to the tendo achillis; this tendon, however, was not injured. The accident occurred in the following manner: the girl was sitting on the axletree of a wagon, with her legs hanging carelessly down; while in this situation the wagon was driven over a stump, and she not observing it, permitted her foot to be caught between the stump and the axletree. The consequence was, that as the leg was pushed forward and the foot held back, the tibia and fibula were forced through the capsular ligament, tendons, and integument, externally, to the distance of nearly two inches, while at the same time the surrounding soft parts were contused and lacerated (by the cutting edge of the stump) to a wonderful extent. It was the left limb that was implicated, and notwithstanding the foot was driven toward the external malleolus, with a force that will be easily conceived of, yet the tibia and fibula did not lose their attachment, contrary to what might have been expected, when we take into consideration the manner the fibula is allied to the astragalus, so as to form the external malleolus.

The extent of the injury was such as to induce me to think that amputation would be proper. Before modern improvements in surgery, amputation would have been looked upon as inevitable. But bearing in mind the precepts inculcated by Professor Dudley on this subject, viz. that a surgeon

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