45

and, within a few years of his decease, a work on Hernia, and some of the diseases of the urinary organs, which contains a large number of observations, derived from his own practice.

His views of the medical profession were of the most exalted characterhe believed it the most dignified pursuit, which could engage the attention of man, and he despised any attempt to render it subservient to selfish or sordid ends.

His standard of medical ethics was truly elevated, and his sense of honour and propriety in his intercourse with his medical brethren was delicate and refined. In a most extensive private practice for a period of thirty-five years, during part of which time he was in the occupancy of important public stations, he perhaps had not-certainly he ought not to have had-an enemy in the medical profession.

His fostering attentions to the junior members of the profession secured for him their warmest regard, and his numerous acts of disinterested kindness towards many of them will never be forgotten.

Dr. Parrish enjoyed to a remarkable degree the confidence of the community, and, until within a short period of his death, was laboriously engaged in professional duties. His medical correspondence was very extensive, and his opinions highly valued over the whole country.

As a philanthropist and Christian he held a conspicuous rank, and contributed largely of his time and his means, in advancing those objects which were calculated to relieve the sufferings of his fellow beings. He died in his 61st year, on the 18th of March, 1840, universally beloved and regretted.

On the treatment of acute rheumatism by opium.-By. D. J. Corrigan, M.D.'-[We have used the opium practice in acute rheumatism, as well as the various narcotics and acro-narcotics. When pushed so as to affect the system, we have found them all to be occasionally beneficial. The opium practice has, we think, been as serviceable as any, and its use is entirely philosophical.-ED.]

Eight cases of acute rheumatism cured by opium alone are given in detail by Dr. Corrigan, and as the practice appears to be novel, whilst it recommends itself from its simplicity and general applicability, a short notice of these cases may be read with interest. When he first commenced the opium treatment he was afraid to trust to it alone, and therefore combined it with calomel; but finding that no good resulted from this combination, he dropped the calomel, and continued the opium alone.

Three of the cases are selected to illustrate the mode in which the remedy was administered.

Mr. R., aged 30, was seen on the 19th January, 1938. For several days he suffered from flying pains, but for the last three days he has been under the most acute suffering from pain in the shoulders, in the back of the neck, along the loins, in the knee, wrist, and ankle-joints. The knees, ankles, and wrists were swollen, and exquisitely painful. He had slept none for three nights; the pulse was 132; the bowels free; the tongue covered with a thick white coat; the urine very high-coloured, and depositing a pink sediment; and the skin partially perspiring. One grain of opium with two of calomel were given every third hour, and opiate fomentations were applied to the joints. On the next day the pains were less, and the pulse had fallen to 120; but he had not slept. The opium was therefore increased to a grain and a half every third hour.

On the 21st he had slept some, and the pulse had fallen to 104. The pains were greatly diminished, and the swellings of the joints somewhat lessened.

'Dublin Journal of Medical Science, November, 1839, and Edinb. Med. and Surg. Journal, January, 1840, p. 243.

The opium was continued in the same dose. Next day he was found to have slept well, and the pulse had fallen to 92. The opium without the calomel was continued for three days longer in the dose of a grain and a half every third bour, at the end of which period, being quite free from pain, and with a quiet pulse, he was put on bark.

Dr. Corrigan attended his friend Dr. Aldridge, who had a very severe rheumatic attack of three days' duration when he was first seen by Dr. Corrigan. Nearly all the large joints were swollen and acutely painful, and the pains were shifting from joint to joint. The pulse was 120; the tongue very foul, but moist; and the want of rest from the agony of the pain was most distressing. He was immediately put on the opiate treatment. He first got one grain every two hours; the quantity was then increased to one grain every hour; and this was continued for thirteen days, with the administration of an occasional purgative. On the fourteenth day he began to take the Mist. guaiaci c. sulph. quince; and on the fifteenth day he was walking about his parlour, complaining only of not being so strong as usual, but free from pain and swelling. Dr. Aldridge calculated he had taken about two hundred grains of opium during the treatment.

Mr. H. aged 26, had suffered for three days under a very acute attack of rheumatism. The shoulders, wrists, and knees were swollen, and very painful; and the pains had been so severe that for three nights he had not closed an eye. His pulse was 120 and full; and his tongue moist. He was put on the opium treatment, and took every day for six days from eight to ten grains of opium. On the seventh day, he began to take along with the opium the Mist. guaiaci c. sulph. quinæ, and on the eighth day of attendance, he only complained of some stiffness in the affected joints. His pulse had fallen to 76, and his appetite was good.

In one of his cases pericarditis was threatened, the pulse became affected, oppression and constriction across the chest were felt, the countenance became anxious, and the patient was bathed in profuse perspiration. These unpleasant symptoms subsided under the steady use of the opium combined with a grain and a half of quinine to each dose.

Dr. Corrigan remarks, that "the most important rule to be remembered in employing opium for the cure of acute rheumatism is, that full and sufficient doses shall be exhibited;" unless carried to this length it is sure to end in disappointment. He mentions it as a singular circumstance, that sometimes during the progress of the cure under the opium, diarrhoea should come on so as to require the exhibition of chalk and kino. He recommends the local application of flannel soaked in warm spirit of turpentine, or in camphorated spirit, or in simple decoction of poppy heads, to the inflamed surfaces. If the patient should suffer much from constant profuse perspirations, he recommends the conjunction of sulphate of quinine with the opium.

Dr. Corrigan thinks this plan of treatment superior to all others, because it shortens the duration of the attack, alleviates the sufferings of the patient, husbands the strength, and prevents the complications of endocarditis, pericarditis, &c., which so often complicate this disease, and are the cause of prolonged suffering ending only in death.

At the end of his abstract of Dr. Corrigan's paper, the editor of the Edinburgh Journal has the following note.

Several years ago we had an opportunity of testing the efficacy of this practice, and found it superior to every other. Large doses of opium were at first given, not with the view of curing the disease but of alleviating the intense suffering under which the patient laboured. Since then we have employed it in several cases, and always with the most marked benefit; the disease seldom lasting beyond a fortnight, and being much alleviated during the whole course of the treatment.

Experimental researches on the functions of the brain. By M. Nonat.' -The following are additional speculations on the yet unknown functions of various parts of the brain.-ED.]

According to M. Nonat the lobes of the brain, the corpus callosum, the fornix, the corpora striata, the optic layers, the cerebellum, and the crura of the cerebrum, are not possessed of general sensibility, as evidenced by touch. In the lobe of the fourth ventricle, as was shown by MM. Magendie and Desmoulins, resides the faculty of the perception of general sensibility. Physiologists are wrong in placing the seat of sensibility in the cerebellum, as an animal from which the whole of the cerebellum has been removed retains the faculty of seeing, hearing, tasting, feeling, and smelling.

With regard to the influence of the cerebellum over the movements of progression or of standing, M. Nonat has arrived at the following results:

1. The lobes of the cerebrum direct the movements. Thus, when we wish to go from one place to another, it is by the action of the cerebral lobes that we are enabled to execute the movements necessary for this purpose. A rabbit deprived of the lobes of the brain executes the same movements as before; it is only weakened; but it can no longer avoid any obstacle, it cannot find its food; in short, it is deprived of that principle which formerly gave to all its movements a determinate direction.

2. The corpora striata regulate the movements backwards.

3. The thalami optici exercise a considerable influence on the actions necessary for standing; they furnish in a great measure the principle which supports the energy of muscular contraction.

4. The cerebellum directs the regularity of the forward movements; it appears to direct the movements of the lower extremities; and probably bas also some influence on the equilibrium of the movements.

5. The circle formed by the cerebellum, its crura, and the transverse fibres of the cerebral protuberance regulates the movements of rotation around the axis of the animal.

6. The tubercula qualrigemina are necessary to the regular exercise of motion. Their lesion disturbs the harmony of the actions required for progression or for standing. This result agrees with that of M. Serres.

7. The lobe of the fourth ventricle contains a principle which overrules and regulates the respiratory movements, vomiting and crying. In this part of the encephalon resides a principle, in virtue of which an animal has the consciousness of tactile, and also of sonorous impressions.

On the causes of sudden death. By Alphonse Devergie.—It is the common opinion that apoplexy is the most frequent cause of sudden death. M. A. Devergie has endeavoured to ascertain how far this opinion is founded in truth, and has found that sudden death from affection of the brain is rare. Of forty cases which he has examined he has met with four only in which death resulted from an affection of the brain; three in which there was congestion of the brain and spinal marrow; and twelve in which the brain and lungs were simultaneously affected. Sudden death from an affection of the lungs alone is the most common. M. Devergie met with twelve cases of this out of forty; and if to these we add the twelve examples of sudden death in which the lungs and brain were both affected, we shall have twenty-four out of forty in which the lungs were affected in cases of sudden death. Death from affection of the heart was the most rare. M. Devergie met with it only three times.

It results from these researches that, if arranged according to the order

Gazet e Médicale de Paris, 19th October, 1839, and Edinb. Medical and Surgical Journal, January, 1840, p. 239.

Annales d'Hygiène Publique, July, 1838, and Edinb. Med. and Surg. Journal, January, 1810, p. 242.

of their frequency, sudden deaths are occasioned, 1. from an affection of the lungs; 2. of the lungs and brain; 3. of the brain and spinal marrow; 4. from hemorrhage; 5. from an affection of the heart. It is consequently an error to regard apoplexy, that is circumscribed cerebral hemorrhage, as the most common cause of sudden death, since of forty cases M. Devergie observed an apoplectic effusion of blood only once. Sanguineous congestions of the meninges should not be ranked among cerebral hemorrhages. M. Devergie further ascertained that sudden deaths were more frequent during winter, and more common in men than women. Among the forty deaths noted only five were of women. He also observed that sudden deaths occur chiefly among persons from forty to fifty, and sixty to seventy years of age.

NECROLOGY.

MM. Biett, and H. Cloquet.—Our recent Journals' announce the deaths of M. Biett, one of the physicians of the Hospital St. Louis, well known for his valuable researches on cutaneous diseases; and of M. Hippolyte Cloquet, the author of many contributions to medical science, of which his Faune des Médecins, in four volumes, is the most elaborate.

BOOKS RECEIVED.

From Sir James Clark.-Statement of the case of the late Lady Flora Hastings. 8vo. pp. 15.

From Professor Horner.-Catalogue of the Trustees, Officers and Students of the University of Pennsylvania. 8vo. pp. 35. Philadelphia, 1840. From the same.-Catalogue of the Medical Graduates of the University of Pennsylvania, April 3, 1940.

From the Committee of Publication.-Valedictory Address to the Gradu-ates of the Medical Department of Pennsylvania College. By William Rush, M. D., Professor of the Theory and Practice of Medicine in the Medical Department of Pennsylvania College. 8vo. pp. 16. Philad., 1840. From Dr. Joseph S. Nancrede.-Notice sur le Monésia, par M. Bernard Derosne, Pharmacien à Paris. 8vo. pp. 16. Paris, 1839.

From the same.-Tableau synoptique presentant l'essai analytique l'indication de quelques préparations pharmaceutiques et les propriétés médi cinales d'une substance végetale nouvellement importu de l'Amérique du Sud, et counue sous le nom de Monésia, par Martin-Saint-Ange.

[We have already given a long account of this new remedy, by M. Martin-Saint-Ange, in the pages of this Journal. Intelligencer, March 1, 1840, p. 363.]

From Professor Frost.-Catalogue of the Officers and Students of the Medical College of the state of South Carolina, 1839-40.

'London Lancet, March 14, 1840, p. 396.

ART. I.-CASE OF FISTULA IN ANO, WITH OBSERVATIONS. Columbia, South Carolina, April 6, 1840.

Cornelius Morgan, æt. 26, a hatter, of an unhealthy aspect, was admitted into hospital, labouring under the above complaint, of which the following is an accurate history, at the time of his admission.

There are three fistulous openings close to the verge of the anus on the left side, two of which are very small, and will scarcely admit the point of a probe: the third and most external one is much larger, its edges are smooth and indurated, and the integuments around it are for some extent red, thickened, and detached from the subjacent parts. Upon introducing a probe into the most internal of these fistulous openings, a canal can be traced extending upwards towards the rectum about an inch and a half, but it does not communicate with the intestine. Neither of the other two extends so high up, nor do they communicate with the first mentioned fistulous opening, nor with the canal of the rectum. He suffers no pain, but great inconvenience from the discharge of matter, and experiences considerable uneasiness when walking, or whilst sitting on the part. His breathing is short, and he is troubled with palpitations of his heart, particularly after the slightest exertion. He labours under a distressing cough, which is attended with copious expectoration. The pulse is 112, and varies upon the slightest change of posture. He has nocturnal perspirations, which are principally confined to his head and chest. His appetite is tolerably good; he has no thirst, and his bowels are generally regular.

He states that his complaint commenced about fifteen weeks previous to his admission into the hospital; at which time he first observed two small swellings in the vicinity of the anus, which at times gave him a good deal of pain, especially when he coughed, sneezed, or went to stool, and in sitting he was compelled to rest upon the right buttock, that is, the opposite one. At the expiration of a month, the skin covering these swellings having become red, and the pain acute, he was obliged to apply to a surgeon, who, to relieve him, made an incision into each swelling, when a quantity of fetid matter issued from them, which afforded him instantaneous relief from pain. They have continued to discharge matter of an offensive nature ever since, but he has never observed air or faces to escape through the openings.

He has been labouring under a cough for twelve months, and he thinks it has been materially relieved, since the swellings were opened. By the assistance of the stethoscope it has been ascertained that tubercles exist in the superior lobes of each lung. He can ascribe no cause for his complaint. According to his own account, he has always lived in a moderate and regu