MISCELLANEOUS NOTICES. Sir James Clark.-The statement, with which this distinguished and estimable physician has favoured us, completely exonerates him, in our opinion, from the charges that had been brought against his professional as well as private deportment. Placed in the most trying situation, that can well be imagined, in the case of Lady Flora Hastings, he appears to have acted throughout with signal delicacy. It has been suggested, that on no account ought he to have sanctioned the suspicions that were entertained in regard to the pregnancy of the lamented lady; but the statement-which bears all the marks of being as ingenuous as it is able-shows, that he went no farther than the circumstances of the case warranted, and that under the equivocal appearances which Lady Flora presented, and in the court of a virgin sovereign, it was both delicate and judicious in him to state to his patient the suspicions that were entertained, and to be anxious that her character should stand forth unsullied. In the execution of this painful duty, Sir James, we repeat, appears to have acted with the most scrupulous delicacy ; nor can we see the slightest reason for the opinion, that he has suffered himself to be made a tool of for the furtherance of political or private malice. Medical Convention at Philadelphia.-This has turned out an abortion. Not even the mover of the resolution in the Medical Society of the State of New York was present, and but few delegates presented themselves, among whom was Dr. Beck, of Albany-the well known author of the best book we possess on Medical Jurisprudence. Personally we are thankful for the proposition, inasmuch as it brought among us our distinguished friend even for a short period. Chorea in New York.-We had not the least idea from our own not very limited observation, that chorea was so frequent in any part of the country, as we see stated in a late number of the New York Journal of Medicine, (ii. 275), in which Dr. Reese affirms, that he himself has employed arsenic in over two hundred cases."! The number treated by other remedies he has not stated: yet chorea is not a common disorder anywhere; of 32,976 children admitted into the Hôpital des Enfans, of Paris, in ten years, 189 only were affected with it.—(Rufz.) Worm in the Eye of the Horse.'-Dr. Dunglison referred to a curious but not unique case, of a worm in the eye of a horse now in Baltimore. The particulars were contained in a letter to him, from Dr. Joshua J. Coben, of Baltimore. This entozoon is a species of filaria, (see Filaria Papillosa, Rudolphi, Synops. p. 213,) probably from three and a half to four inches in length, and situate in the aqueous humour, in which it moves about with great activity, but its motions are so constant, that it is difficult to appreciate its exact length. The great size of the anterior chamber of the horse's eye, affords it ample space; and through the transparent cornea, it can be observed as well as if it were in a glass vessel. The horse was sent up from Calvert county, Maryland. Bulletin of the proceedings of the American Philosophical Society, vol. i. No. ii. p 200, for March and April, 1840. Dr. Dunglison made some observations on the difficulty of accounting for its presence in this shut sac, and alluded to the different views of distinguished naturalists as to the generation of many of the lower tribes of the animal kingdom-some presuming that they may be formed spontaneously, whilst others consider that the germs must always be received from without. The difficulty, he observed, applied to all the entozoa that infest the animal body; and this case was certainly not more difficult of explanation, than that of entozoa found in the intestines of the fœtus in utero. Dr. Bache referred to a similar case, which was published in an early volume of the Transactions of the Society, (Vol. ii. p. 183: by F. Hopkinson, Esq., and Ibid..p. 393, by Dr. Morgan.) On the ethereal solution of Ergot. By J. C. W. Lever.'-[We would refer our readers to Dr. Hooker's views on the effect of an ethereal preparation of Ergot, which he regards as narcotic but not ecbolic. Boston Med. and Surg. Journ., x. 298; American Medical Intelligencer, Dec. 15, 1837, and the Editor's New Remedies, p. 409. Philadelphia, 1839.-ED.] Having made repeated trials of a preparation of ergot given to me by my friend Dr. G. O. Rees, I have been induced to request from him the method of its preparation, in order that I may lay it before your readers. Although by no means a strenuous advocate for the common employment of the ergot, yet I am prepared to admit its efficacy and value in cases of protracted labour, where the presentation is natural, the pelvis of standard size, where the soft parts are dilated and fully prepared to admit the passage of the child, where uterine effort alone is wanted to complete the labour, and where there are no contraindicating circumstances forbidding its exhibition. In cases of this description, I have used the preparation, and have seen it employed by others, with complete success. I have also tested its efficacy in hemorrhage occurring after the birth of the placenta, when the uterus has not contracted well, or where its contraction and dilatation alternated. In cases of this description, the exhibition of the ergot has been followed by a permanent contraction of the viscus, thus preventing inordinate discharge. In passive menorrhagia, when there exists no organic lesion, this form of medicine will be found of great value; the discharge is generally lessened after the exhibition of the second dose; and in no case in which I have given it, has it failed ultimately to put an end to the bleeding. All the other preparations of ergot with which I am acquainted not unfrequently produce nausea, sickness, headach, falling of the pulse, dilatation of the pupil, &c.; but in no one instance have I seen these symptoms produced by the ethereal solution: they most probably are caused by some constituent in the drug which ether does not dissolve. I have given the solution to puerperal women in doses varying from gtt. xv. to gtt. xxx. dropped upon a lump of sugar, and have found that uterine action has commenced in twenty minutes or half an hour. In cases of menorrhagia, I have given gtt. v. to gtt. viij. three times a day, and have not had reason to persevere in its employment more than four or five days. The advantages of this form of the drug may, I think, be stated as, first, the convenience of its exhibition; secondly, the certainty of its operation; and, thirdly, its non-production of those unpleasant and sometimes dangerous symptoms so frequently caused by the other preparations of the ergot. With regard to the method of its preparation, Dr. Rees writes to me as follows: "The ethereal solution, the properties of which you have so well tested, was prepared by digesting 3iv. of the powdered ergot in f3iv. of ether during seven days. The result was a solution of the fatty matters contained Lond. Med. Gaz., April 10, 1840, p. 108. in the drug this was poured off, evaporated to dryness, and the residue again dissolved in f3ij. of ether. I have since tried to re-dissolve in alcohol, but the fatty matter appears to contain myricin, which resists that menstruum even at a boiling heat. The solution should be kept in a well-closed glass-stoppered bottle, to prevent evaporation. Each ounce of the preparation may be considered as equivalent to two ounces of the ergot, or gtt. xv. to a half-dram dose of the powdered drug. Should there be any objection to the administration of the ether, the practitioner has only to drop the required dose upon a piece of lump sugar, and expose it to a current of air for a few minutes, when the fluid will completely evaporate. I regret that I have not had leisure to procure the different fatty matters of the ergot in a separate form, and so subject each to trial as a medicinal agent. If this were done, there is little doubt but that a still more convenient form for exhibition might be obtained, and the peculiar action of the drug traced to its true source. It appears highly probable that the fatty matter contained in the ergot is peculiar in character: from one specimen which I examined, I obtained a fat which, when treated with strong sulphuric acid, became a fine green colour-a reaction which I am not aware has ever yet been noticed as occurring with any fatty substance either from the vegetable or animal kingdom." Yellow Liquor Amnii.'—Dr. Purdon, in a paper read before the Dublin Obstetrical Society, mentioned a case, in which, on rupture of the membranes in a woman affected with jaundice, the liquor amnii exhibited a deep yellow colour. Treatment of Syphilis.-M. Ricord has recently made some observations on the treatment of syphilis, in a French journal, of which the following is the substance. M. Ricord divides the progress of syphilis into three stages or phases. In the first, the action of the virus is completely local; in the second stage, the accidents are confined to the skin, or mucous membranes, and are characterised by the fact that the morbid products are incapable of producing the original disease, on inoculation. The symptoms of the third stage rarely occur before the seventh month, and are incapable of being transmitted by hereditary disposition: this is their characteristic mark. M. Ricord considers the mercurial treatment to be more frequently injurious than useful in the first stage. On the contrary, mercury is absolutely necessary in the second stage. Where the tertiary symptoms alone exist, M. Ricord has generally recourse to the ioduret of potassium. He begins with doses of ten grains in the following manner : Distilled water, 33; Ioduret of potassium, 10 grs. ; This potion is taken in three doses, during the day, with sarsaparilla, the quantity of the ioduret gradually increased every five days, until the patient takes 100 grains a day. Whenever secondary symptoms coexist with the tertiary, M. Ricord administers the proto-ioduret of mercury in the dose of a grain, gradually increased to six grains. New Treatment of Cancer.3-M. Jobert has endeavoured to check the progress of this terrible malady, by tying all the vessels and dividing all the Dublin Journal, and Lond. Med. Gaz., April 10, 1840, p. 128. 2 Abridged from L'Experience, No. 141; and London Lancet, April 11, 1840, p. 112. 3 L'Experience, l. c.; and Lond. Lancet, April 11, 1840, p. 112. nerves which are distributed to the affected part. His efforts, however, have not been crowned with success. In four cases of cancer of the lip M. Jobert tied the facial and coronary vessels, and divided the branches of the fifth nerve, which pass to the lip. The ligature of the vessels caused some improvement in the appearance of the ulcers, and on dividing the nerves the pain was removed; but in all cases he was compelled to extirpate the disease, at last. Peculiar Intestinal Concretion.'-Dr. Bright exhibited an intestinal concretion or calculus, chiefly remarkable from its being composed simply of phosphate of lime, surrounding a neucleus of fæces. The patient from whom it was taken was under the care of Mr. Stone, and was six years of age. The symptoms presented were those usually observed in fæcal abscess; there was a swelling on the right side of the abdomen, attended by gradual emaciation, and there was a discharge of pus and mucus, occasionally, from the bowels. In addition, however, to these symptoms, there was a discharge of puriform fluid from the bladder. The child died in twelve weeks after the first attendance of Mr. Stone. On examination, great suppuration was found at the caput coli, in which were two calculi; the one exhibited, which was about the size of a pigeon's egg, and another about half the size. From the composition of the calculi, it was at first suspected that they were formed in the kidney, and had escaped by ulceration through the right ureter; careful examination, however, proved this opinion to be erroneous. The calculi were formed of successive layers of phosphate of lime; the nucleus was a small portion of fæces. In another instance, under the care of the same practitioner, a number of calculi, of the same composition, had passed away from the rectum with the fæces. Mr. Alcock remarked, that the phosphate of lime calculus was usually the result of chronic irritation of the mucous membrane of the bladder. Might not the intestinal irritation account for the formation of the bodies in the case under discussion? Mr. Erasmus Wilson had in his possession a portion of a colon in which there were a number of pouches containing calculi, probably composed of the phosphate of lime. Statistics of Insanity in France.3-During the last eight years 1045 insane patients were received into the Lyons' Hospital. Of these, 503 were males, and 542 females. The various causes of insanity, amongst the patients, were as follows: Females, 542.-Physical.-Hereditary disposition, 56; drunkenness and debauchery, 43; puerperal accidents, 45; disordered menstruation, 25; venereal disease, or mercury, 5; retrocession of cutaneous affections, 23; onanism, 17; injuries of the head, 3; solitary confinement (isolation), 6. Moral.-Domestic afflictions, 65; poverty, 47; loss of fortune, 31; love and jealousy, 33; fright, 8; religion, 29; politics, 11. Males, 503.-Physical.-Hereditary disposition, 62; drunkenness, 54; apoplexy, 25; onanism, 21; syphilis, or mercury, 5; injuries of the head, 6; solitary confinement, 9; retrocession of cutaneous diseases, 14. Moral.-Domestic trouble, 65; poverty, 56; loss of fortune, 36; politics, 16; jealousy, 14; religion, 12; fright, 6; excessive study, 8. Of the 542 females, 114 were discharged perfectly cured; 91 were withdrawn by their friends, improved; 162 died; 175 remained in hospital on the 1st of June, 1839. Of the 503 males, 149 were cured; 61 withdrawn; 158 died; and 135 remained in hospital. Hence the proportion of cures for the females, was 1 in 5; and for the males, something more than 1 in 5. 'London Pathological Society, in Lancet, March 28, 1840, p. 26. Midwifery Practice. The following is a summary of the labours which occurred in the practice of Janson the elder, of Ghent, during forty-one years, from Jan. 1, 1797, to Dec. 31, 1837. Thirteen thousand three hundred and sixty-five women bore 13,439 children, of which 6,611 were boys, and 6,828 girls; out of 157 cases of twins, in 38 they were both boys, in 62 both girls, and in 39 one of each sex; eight twins were born dead; there was one case of triplets, all girls; 859 were natural children. Three hundred and forty-one labours required the forceps, and 484 preternatural labours were terminated by the hand. In 150 the foot presented, in 30 the hand, in 97 the breech, in 20 the breech had descended into the smaller cavity of the pelvis ; 2 breech presentations required the application of instruments. In 15 cases the face presented; in two face presentations the forceps was required. In 86 cases the funis presented, and 46 of these children were delivered alive by turning; 38 died through the compression of the funis; and 6 were delivered alive by the forceps, in cases where the funis preceded the head. Seven times the placenta was upon the os uteri. Perforation was performed five times; once the symphysis pubis was divided, and a cure took place; once both mother and child died suddenly, the child being thrown into the abdomen by a spontaneous laceration of the uterus. Superfætation occurred twice; one child was at its full time, the other three months old. Convulsions and sudden death occurred thrice, and serious hemorrhage before delivery four times. It is to be remarked that M. Janson practised for 15 years before 1797, without keeping notes. Mammary Abscess mistaken for Scirrhus-The best surgeons, it must be confessed, are sometimes mistaken in the diagnosis of disease. The following is an example: C. C., 28 years of age, not married, perceived, about two months ago, a tumour in the left breast. She consulted M. Roux, who advised her to enter the Hotel-Dieu. M. Roux examined the breast on several occasions: there was no apparent knottiness or fluctuation; the colour of the skin was normal; nevertheless M. Roux determined on operating for supposed scirrhus. Two semielliptical incisions, about four to five inches in length, embraced the greater part of the mamma, and the surgeon was about to extirpate the gland, when an accidental touch of the scalpel near the lowest point of the tumour, gave issue to an immense quantity of pus. The operation was, of course, suspended, and simple dressings were applied. The patient soon recovered. BOOKS RECEIVED. From the Author.-An Essay on the means of improving medical education and elevating medical character. By Andrew Boardman, M. D., (Presented to the Faculty of Geneva College, January, 1840.) Extracted from the Eclectic Journal of Medicine, for April, 1840. Svo. pp. 23. Philadelphia, 1840. From the Society.-Transactions of the Medical Society of the State of New York, Vol. iv. P. 3. 8vo. pp. 290. Albany, 1840. From the same.-Report of a Committee of the Medical Society of the State of New York on the subject of Medical Education. 8vo. p. 23. Albany, 1840. From Dr. Warrington.-Twenty-third Annual Report on the state of the Asylum for the Relief of Persons deprived of the use of their reason. 8vo. pp. 24. Philadelphia, 1840. 1 Bull. de la Soc. de Méd. de Gand and Schmidt's Jahrbücher, and Lond. Med. Gaz., March 6, 1840, p. 893. 2 French Lancet, No. 10, 1840, and Lond. Lancet, March 21, 1840, p. 968. |