Having consequently spoken favourably of the two first volumes, we can unhesitatingly recommend this also to the attention of our readers. It is replete with interesting practical instruction. MISCELLANEOUS NOTICES. Pennsylvania Asylum for the Insane Poor.—It affords us heartfelt pleasure in being able to state that the bill for the establishment of an institution for the insane poor has passed the legislature by an overwhelming majority, and has received the sanction of the governor; so that it is now a law. It is a glad triumph to those whose philanthropic exertions have been instrumental in the result; and a bright spot in Governor Porter's administration. Albany Medical College.- The number of students, as per catalogue, was 122 during the last session. The number of graduates was 29. Vacant Chair in the Medical Department of the Transylvania University. The chair of the theory and practice of medicine in the medical department of the Transylvania University is at present vacant, and with a view to fill it in the best possible manner, applications for the appointment are invited from the members of the medical profession. The communications on the subject must be addressed to the Dean of the Medical Faculty of T. U., and come to hand before the first of June next, when the appointment will be made. The name of no one but the successful candidate will be made public. Jefferson Medical College of Philadelphia.—At the annual commencement, held on the 6th of March, the degree of doctor of medicine was conferred on fifty-six graduates. The honorary degree was granted to one. The names will be given in our next. Pennsylvania College, Medical Department.—At the annual commencement of this institution, held on the 2d of March, the degree of doctor of medicine was conferred on thirty-nine gentlemen. Besides these, three received the honorary degree of doctor of medicine. Spring Course of Lectures at the College of Physicians and Surgeons, New York.-An association has been formed, for the purpose of offering to the students of medicine in New York a course of instruction, which, it is hoped, may profitably occupy a portion of their time during the ensuing spring and summer. Lectures will be delivered at the College of Physicians and Surgeons, in Crosby street, on the following subjects: On the pathology of the chest, auscultation, and percussion, by John A. Swett, M. D., lecturer on diseases of the chest. This course will be fully illustrated by clinical cases. On club feet and analogous deformities, by Detmold, M. D. On the diseases of the eye, by G. Wilkes, M. D., surgeon of the New York eye infirmary. Clinical instruction at the infirmary. On the pathology of the uterus and its annexes, by C. R. Gilman, M. D., lecturer on obstetrics and the diseases of women and children in the College of Physicians and Surgeons. On operative surgery, by W. Parker, M. D., professor of surgery, College of Physicians and Surgeons. On the anatomy of the nervous system, by James Quackenboss, demonstrator of anatomy. On surgical anatomy, by R. Watts, Jr., M. D., professor of anatomy, College of Physicians and Surgeons. The lectures will commence on the first Monday in April, and continue about three months. Two lectures will be delivered daily. Hours, from one to three o'clock. The fee for the whole course is ten dollars-a movement downwards in the rate of fees which does not meet our approbation. Dissection of a Club-Foot.'-Sir, I enclose you an account of the dissection of a case of club-foot, in which the sole was turned inwards and upwards, the patient treading on the upper surface of the os cuboides, which had become rough and irregular, giving rise to an extensive ulceration on the instep, for which the limb was amputated; but the case did not do well, owing to the formation of abscesses in the thigh, and a subsequent attack of hemiplegia. I am, sir, your obedient servant, Thame, November 27, 1840. PHILIP B. AYRES, M. D., M. R. C. S. Tendo achillis very much shortened, preventing flexion of the ankle-joint. Tendon of the tibialis anticus very short, preventing eversion of the foot. Tendon of the extensor longus pollicis rather shortened, but nearly natural. Tendons of the extensor longus digitorum natural. Tendon of the peroneus tertius elongated and expanded. Extensor brevis digitorum flabby and very thin, but otherwise natural. Tendon of the flexor longus pollicis rather shortened. Tendons of the flexor longus digitorum somewhat shortened, but very slightly so. Tendon of the tibialis posticus slightly shortened. Tendons of the peronei natural. Short muscles of the foot natural. The bones of the foot, although the patient was 27 years of age, and the disease congenital, were apparently in a natural state, and would certainly, judging from their appearance, have allowed the foot to have regained its natural position had the opposing tendons been divided. The principal opposing tendons were those of the gastrocnemii and soleus, and the tibialis anticus, so that by dividing these tendons, the remainder, which were nearly in their natural state, would have permitted the foot to have righted itself. I am not aware that there is any novelty in this case; but as in new operations every fact possesses some value, I have sent this dissection for publi cation. 1 London Medical Gazette, Dec. 11, 1840, P. 448. ART. I.-CASE OF PNEUMONIA SUCCESSFULLY TREATED BY LARGE DOSES OF TARTAR EMETIC. BY JAMES H. MAY, M. D., OF WENTWORTH, NORTH CAROLINA. Dr. Dunglison, I was called on the 12th of September, 1840, to see Green, a negro boy, the property of Mr. Samuel H. Walker, of Rockingham county, N. Č. The boy lives where the various types and grades of bilious fever are very prevalent; and this season the neighbourhood was exceedingly subject to bilious remittent. This boy had complained of feebleness and indisposition for some days previous to the 7th inst., which led to the belief that he was to be a subject of the disease then prevailing. On the 7th at night he was very active hunting, and in a profuse perspiration lay down on the ground late at night (which was nearly frosted) and slept till day. From this time he was prostrated. On the 12th, when I first saw him, he was labouring under typhoid pneumonia; these were the symptoms:-frequent cough, with no expectoration; pain on inspiration; and pain on pressure through the whole chest, particularly on the right side; breathing short and hurried; skin of a pungent warmth, and dry; occasional delirium, with that sharpness and quickness peculiar to such cases; pulse 120, rather small, soft, and feeble; bowels very active from having been purged too much before my arrival; tenderness of the epigastrium, with an irresistible desire to throw back his head; tongue thickly coated with yellow, of a fiery red beneath, and dry on the tip. Although I considered it doubtful whether I should take blood at the arm, yet the pulse appeared to have sufficient firmness to bear it. I bled him between 8 and 10 ounces; prescribed small portions of calom. and pulv. Dov. every two hours, and an expectorant and sedative mixture every four hours of spts. nitre, paregoric, and ipec., and applied a large blister, covering the epigastrium and lower part of the chest. 14th Sept., afternoon, saw him; something better, pulse 110, rather more full; delirium less; some expectoration, though very bloody and yellow; blister had drawn well, and bowels were more quiet; otherwise he was pretty much the same. Cupped him extensively round the chest, but did not get much blood from the want of free capillary circulation. Other prescription of the 12th continued. 15th, at night, sent for; much worse; pulse above 115, smaller and feebler; bowels again become very active; more constant delirium; remarkable shrinking away of the flesh; countenance haggard; expectoration small in quantity, painful, and of the same colour; tongue dry, one side where the fur had worn off, smooth, dry, and glazed; skin of that warmth termed calor mordax. Cupped him again, without much blood; applied a blister over the right side of the chest; continued the other medicines, with lessening the cal. in the powders and increasing the ipec. in the drops. 16th. Remained over night; still worse; spent a restless night; pulse above 120, more contracted; constant delirium; idle talking and imaginary sights; still greater shrinking of the flesh; features sharp and haggard; hippocratic countenance; expectoration small in quantity and extremely bloody; tongue dry and parched, a portion of it smooth and glazed; articulation difficult; restlessness and jactitation; breathing short, with the tracheal rattle. In this state of things I should have pronounced him hopeless under the usual practice; his rapid decline since the 14th showed how futile my prac tice had been, and indicated, I thought, how utterly useless the ordinary practice would still be if pursued. In this dilemma what was to be done? The practice of giving repeated emetics, after the manner of Riviere and Stoll, and the Italian practice of giving large doses of tart. emet., so highly extolled by Laennec (the highest authority), occurred to me. He was, I thought, too feeble to pursue the former with the least hope of success, and there appeared to be as little hope of success with the latter. But the account of Laennec, in his chapter on Peripneumony, of his remarkable success in patients thought to be moribund, determined me to make trial of the latter remedy, without the least expectation that it would succeed. His usual practice was to give one grain every two hours till he gave six grains, then to rest twelve hours; but my recollection not serving me well on this point, I gave him four one grain portions at intervals of two hours, attending to its exhibition myself. After the two first grains he vomited once a considerable portion of green bilious matter; save this he took the four grains without any other evident effect but that of great sickness of the sto mach. I left him this evening, ordering the same course to be pursued the next day, of giving the tart. emet. in an infusion of common tea, the best vehicle I had at hand, suspending all other medicines while doing this. 18th. Saw him at one o'clock; astonished at his improvement; pulse 85, more full and soft; cerebral congestion and delirium completely gone; countenance more natural; expectoration easy, and without pain; tracheal rattle gone; breathing more full and slower; tongue inclined to be moist; skin a more natural warmth; in short, every symptom showing a removal of cerebral congestion and resolution of inflammation in the chest. Yesterday, the 17th, I was informed the tart. emet. purged him excessively, so as to produce syncope, and induce the attendants to believe he was dead. They gave him some laudanum and camphor, which checked his bowels and revived him; at the same time a slight moisture appeared on the skin. After prescribing a pill every four hours of opium, ipec. and calomel, with occasionally an expectorant mixture, I left him with the hope now that he would get well. 20th. Still improved; every symptom indicating convalescence. But on this day there appeared on the surface of his body a great many blisters about the size of a grain of corn, and larger; some contained a fluid clear as water, in others it was turbid; and there appeared under the angle of the left jaw a large tumour, which became an abscess, was ultimately lanced, and discharged a great quantity of matter. I left directions to keep his bowels regular, to use gentle friction with dry flannel; prescribed wine and wine whey and a proper diet. 24th. Saw him again; he had still mended. The course prescribed on the 20th pursued, under which he improved so much that he was able to walk across the house; when, on the 2d October, he was taken with epistaxis, and bled much till near night, when it was checked by cold applications to the neck, head, and scrotum. At one o'clock on the morning of the 3d it commenced again, and bled till four o'clock, P. M., when I saw him, having been absent from the county till then. He had bled a great deal, from the feebleness of his pulse and the disposition to syncope; his nose was the n dripping slowly Sulph. acid. dilut. and a solution of sulphate copper was directed to be injected into the nose pro re nata, and a pill of two grains sugar of lead and one fourth grain of opium given every two hours, which on the 4th succeeded entirely in stopping the hemorrhage. 8th Oct., prescribed friction with dry flannel; mild aperient pills when necessary; barks and wine, and properly regulated diet; and now, on the 20th Oct. the boy is well, and has but to get his flesh and strength. In reviewing the progress of this case, I am struck with the efficacy of the tart. emet. treatment; and so far as one instance goes, it is a complete triumph of the practice. It appears that his system did not acquire tolerance of the medicine the two days of its exhibition; it vomited him once on the first day, and purged him copiously on the second, besides creating a slight perspiration. Its effect had been sufficiently salutary I perceived on the 18th, and I gave no more. I will here quote a sentence from Laennec as apropos: "Although copious purging and frequent vomiting are by no means desirable, on account of the debility and hurtful irritation of the intestinal canal which they may occasion, I have obtained remarkable cures in cases in which such evacuations had been very copious." This, then, was one of the favourable cases which never acquired tolerance of the article, aud where the evacuations were copious. The treatment, indeed, snatched him from the grave. I have had numerous cases of pneumonia and pleurisy, and so far as my experience and the experience of other physicians with whom I have conversed show, every patient, when combining the symptoms of this boy's case on the 16th, has died. The wonder is now that I never used it before. I never have, nor has any physician, to my knowledge, in this section of country. It would seem he was about to take the malarious fever there prevailing, but his exposure on the night of the 7th Sept. rendered the thoracic disease predominant, in fact, made his a case of typhoid pneumonia. There was, when I first saw him, besides inflammation of the lungs and cerebral congestion, considerable gastric irritation: but thoracic and cerebral disorder were predominant throughout. In my view the stomach should not be much diseased when the tart. emet. is administered; the irritation in this case did not seem to be so great as to forbid its use. The only appearance of perspiration from the beginning of his sickness till his recovery was on the 17th, on the second day of taking the tart. emet., when he was so sick, and when-I omitted to state-some blood was discharged from his bowels. Might not the blisters which appeared on the 20th be intended by nature as a vicarious perspiration ?-at any rate they were novel and unaccountable to me. I have been minute in drawing up this case, but if it shall be the means of saving one from the grave, I shall be amply rewarded. It is a practice but little followed, I believe, in the United States, but I trust it will command more general attention from physicians. JAMES H. MAY. ART. II.-MORBUS BRIGHTII. Concluded from page 333. We pass on to the section of M. Rayer's commentary, in which the relation of this disease to other morbid states of the urinary organs are the subject of inquiry. The result of his experience on this matter is extremely important. "I have already," he says, "had occasion to point out frequently the striking analogies between simple and albuminous nephritis. The action of cold and damp produces both diseases. In the acute stage (with the exception of deposition of pus, which has either not been observed at all, or at |