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almost quite concealed in the angle of the orbit, and was visible at those times only when the squint was made to cease. When this was done he could see near objects, by carrying them towards the nose, and then turning the eye as forcibly as possible outwardly. The anterior chamber of the cornea was normal, and the pupil was quite free and readily contracted on exposure to light.

On the 30th of June I divided, says M. Cunier, the internal rectus muscle; and immediately the pupil occupied the centre of the orbit, and the squint vanished. The eye being, however, not sufficiently drawn outwardly to enable the patient to see objects conveniently, I denuded the sclerotic as far as the attachments of the superior and inferior recti, but without causing the slightest degree of squinting outwards. Founding my practice on the experiments made by myself and Mr. Duffin, I divided the inferior oblique muscle; this was no sooner done, than at once the eye was drawn outwards and somewhat upwards. The ecchymosed blood in the cutaneous wound was rapidly absorbed ; but the healing of the conjunctival wound was rather tedious, in consequence of the very considerable retraction of the muco-serous membrane induced by the displacement of the eye-ball. Immediately after the operation, the patient was able to guide himself through my garden ; and six days afterwards he came alone to my house.

He now sees so well that he can distinguish the smallest objects, when they are brought near his eye. What is remarkable is, that the pupil has become displaced in such a manner that it is now immediately opposite to the transparent portion of the cornea.

CASE 2-A middle-aged man, who had been blind for 12 years, was my second patient. The left eye was completely wasted; and only a part of the outer half of the right one remained transparent. By compressing the left eye, and turning the right one forcibly inwards, he could perceive the form of large objects. I divided the external rectus muscle, and denuded the sclerotic as far as the insertion of the superior and inferior recti ; the eye was immediately drawn inwards so as to cause a squint in that direction, and I was gratified to find that the patient was able to see much more distinctly. Eight days afterwards, he could spread out in the market-place his wicker-baskets, which he made to earn a subsistence.

In the third case, in which the operation for forming an artificial pupil had previously been attempted, but without success, M. Čunier divided the external rectus; and, although the case was certainly a very unfavourable one, considerable improvement of the vision was effected.-Gazette Medicale. REMARKS.-This application of ocular myotomy is certainly one of the most ingenious and scientific that has been proposed. The operation for making an artificial pupil being always hazardous, and seldom successful, surgeons will gladly avail themselves of the practice suggested by their Belgian confrere.-Medico-Chirurg. Rev., Jan. 1842, p. 211.

NECROLOGY.

We regret to announce the death of Professor DAVIS, of University College, London, well known as the author of some valuable works on Obstetrics-and also that of Dr. BIRKBECK, to whom the merit is due of having originated the Mechanics' Institution, in Great Britain and elsewhere.

Dr. Birkbeck was highly estimated as a physician and a philanthropist ; but has not left behind him any important contributions to medical science.

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The value and importance of quinine in all paroxysmal and congestive diseases have secured for it a high place in our catalogue of therapeutic agents. In the latter condition of any of the important organs, it is the safest and most efficacious agent in the materia medica. From its happy influence in relieving congestion, in our autumnal fevers, I was, à priori, induced to administer it in asthma. In every instance in which I have given it, or known it administered, the complete relief of the dyspnea, and termination of the paroxysm, have succeeded in an hour. Subsequent attacks have been warded off. The paroxysm is as tractable to the influence of quinine as the slightest quotidian.

In the forming stage of croup, two grains of quinine, and a snuff plaster to the breast of a child, two years old, parried the attack.

My friend John A. English, M. D., of Cohaba, Ala., has used it with complete success, in a long standing case of asthma, which had resisted the usual remedies. Four grains of quinine "operated like a charm,” and relieved the patient in thirty minutes.

I communicate to you this important effect of quinine, in order that the profession may scrutinise the high claim I set up for it, and, by further experience, direct in what cases it may be most beneficially administered, in one of the most distressing and intractable diseases "which flesh is heir to." From two to eight grains of the sulph. quinine at a dose, to be repeated in an hour if not relieved. B. R. HOGAN.

Cambridge, Dallas Co., Ala., Jan. 31, 1841.

ART. II.-DEATH FROM ERYSIPELAS: PRICKS BY A SCALPEL-SLIGHT RAZOR CUT-SCRATCH BY A NAIL-PULLING OUT A MOLE-REMEDY FOR BEE STINGS.

BY JAMES MEASE, M. D., of Philadelphia.

In the month of December last, it was stated in the newspapers, that a young man had died at Framingham, Connecticut, in consequence of using the same razor, (without wiping) to shave himself, which he had just before employed to shave his deceased father. The impression was, that some morbid matter on the face of the father had been applied to that of the son, and had caused his death. The principle of action-humani nihil à me alie

num puto, might have been sufficient for me to inquire about the fact, but more was concerned than the indulgence of professional curiosity, or a benevolent feeling ::—a life was in question; I therefore determined to ascertain the particulars, and accordingly addressed a letter to a gentleman resident in the town, requesting a communication of them. From him I received the following printed article, by the attending physician, Dr. Whitney, which appears to have been addressed to the editor of the newspaper, published in the place where the parties resided.

"Framingham, Oct. 29, 1841. “Mr. Editor.—Having seen different accounts in the newspapers respecting the death of our very worthy and esteemed townsman (Mr. Henry W. Coolidge) and knowing the circumstances of the case, I take the liberty of stating them to you as they occurred. The aged father, who had been sick for some time, died of a hepatic disease. He had too, as is frequently the case, at the termination of many diseases, a very bad thrush or canker in the mouth, attended with frequent hemorrhages. The son, who had always enjoyed good health and was well at this time, (with the exception of what he termed a cold sore or two on his lip) shaved the father after his decease. Then with the same razor, brush and soap, he shaved himself immediately. This was on Tuesday and by the Saturday following, one of the sores upon the lip became very troublesome, affecting it internally and externally. On Sunday his disease progressed and thus continued daily to increase producing a most hideous swelling of the head and face, till the next Saturday, when he died. The disease was no doubt gangrenous erysipelas. Was it an idiopathic disease, or was it communicated from the father by means of the brush? Should think the latter highly probable.

"Yours, with respect,

S. W."

I presume the sores on the lip must have been irritated by the edge of the razor, and given rise to the erysipelas. That the cause suggested was quite sufficient to produce this often unmanageable disease, is probable from our knowledge of its frequent occurrence after apparently slight local affections, and of serious consequences, and even death from them. Many anatomists have died from the irritation roused in the system by pricking a finger with a scalpel. Falck, an English author on syphilis, and of other medical works, and two professors of the Medical School in Dublin, died from the effects of the first accident. Falck, many years since, and the two last within ten or twelve years. Another lost his life from scratching his hand with the sharp edge of a rib. A few weeks since, a man cut one of his fingers when strapping his razor, and died shortly after, from inflammation and gangiene in his hand and arm. Another scratched his finger last year, with a nail in a barrel which he was handling, and died in the same way. I knew a dreadful and mortal cancer which destroyed the lower jaw, and finally life, to follow the pulling out a small mole in the chin; and I have recorded several cases of death from the poison of honey bees, an humble bee, and wasps, which they had manufactured from the sugar, or saccharine fluid sucked by them from flowers, fruits, or sweet cider. Death took place in 10, 20, and 30 minutes after the stings were inflicted.' The poison of spiders has been equally mortal as that of bees. But what was the modus operandi of these venoms? why, you will say, they destroyed the vital principle,—certainly, -but what is this? the answer leaves the inquirer as wise as before he asked the question. Here is a fine and new subject for a prize essay, by some learned medical corporate body. By the way, since the publication of my paper just referred to, a case occurred in the vicinity of Philadelphia, of a bee-sting which was attended with spasms and such high excitement as to require venesection twice. Aqua ammonia was also liberally given with good effect. This remedy should be applied immediately to the part after a sting, and also given internally, every ten or fifteen minutes, in doses of 10 or 15 drops in water, and the vapour inhaled by the nostrils.

Amer. Journal of Med. Sciences, for Nov. 1836.

ART. III.-ON THE PSEUDO-MORBID APPEARANCES OF THE BRAIN AND ITS ENVELOPES.

BY ROBERT PATERSON, M. D., &c.1

Physician to the Leith Dispensary.

The object of the present communication is to take into consideration the pseudo-morbid changes which take place in the brain and its envelopes. These changes present themselves under the forms of colourations and softenings, appearances with which, as arising from disease, every medical man is familiar; but which sometimes are noticed, and bearing a very marked character, when few or no symptoms have existed during the life of the patient, to give rise to the suspicion, that such a state of matters would have been found after death. In such cases, we shall find a ready explanation of the phenomena in pseudo-morbid changes.

During the course of a series of experiments on pseudo-morbid ramollissement or softening, as occurring in the brains of the lower animals, we had occasion to draw up a table showing the different parts of the brain which were successively affected with pseudo-morbid softening, and, upon comparing this table with others which were drawn up after a similar manner from the works of Abercrombie, Andral, Louis, Bright, &c., some striking similarities were noticed with regard to the parts which were first found softened from disease and from pseudo-morbid change.

This similarity at once suggested the idea, that, in consequence of this source of fallacy, some mistakes may have occurred; more especially with the authors in this country, as here the same facilities for the examination of dead bodies does not exist, and often a much longer time is allowed to elapse between death and dissection.2

It shall be our object to point out the circumstances connected with this source of fallacy, so that it may in future be guarded against.

We use the term pseudo-morbid in the consideration of this subject, not only as it has been employed by the most recent writers on these phenomena, but because it includes the many appearances, (unconnected with disease,) which may take place immediately before death, at the moment of dissolution, and subsequent to that event. The terms cadaveric, post mortem, pseudo-inflammatory, inflammatoidal, and M. Andral's cadaveric or post mortem hyperemic appearances, have each been applied to the phenomena in question; but the term which we have adopted seems preferable to any of these, on account of its more extensive signification.

CAUSES OF PSEUDO-MORBID PHENOMENA IN THE BRAIN.

The causes which operate on the brain, and give rise to pseudo-morbid colourations and softenings are four in number.

I. Obstruction in the course of the Venous Circulation occurring shortly before death.-Cases of slow asphyxia furnish illustrations of this. Dr. Bright has given a beautiful instance of it in a case of obstructed circulation through the large veins ;3 and M. Andral, speaking of his mechanical hyperemia, says, "Thus, in such a case, the brain, when sliced, presents numerous red points, which are nothing else than the divided orifices of the congested vessels."

II. Gravitation of the Blood to the more dependent parts (the hyperemia by hypostasis of M. Andral).-This cause comes into operation most frequently at the posterior parts, in consequence of the manner in which bodies are generally laid out after death. M. Andral believes that we may produce

1 Edin. Med. & Surg. Journ., Jan. 1842, p. 106.

2 Some of the authors of this country do not even mention the length of time which elapsed, which consequently gives us no room for judging. 3 Bright's Medical Reports, Vol. ii. Part 1st, p. 6.

a colouration of the substance of the brain, by simply making the head more dependent than the body. This assertion is contrary to the statement of Drs. Kellie and Abercrombie, and also opposed to experiments which I myself have witnessed on dogs which were suspended by the hind legs, immediately after death. The blood was thus allowed to gravitate towards the head. But on comparing those animals with several others which had been suspended in a contrary direction, and where, of course, the blood was allowed to gravitate towards the posterior extremities, little difference was observed in the quantity of blood which the brains of each respectively contained. The same fact is taken notice of by Dr. Kellie. Whether the result of these experiments is to be accounted for by the difference existing in the method by which the brain of the lower animals is protected from pressure, in consequence of their horizontal position, I am unable to say. But there can be no doubt that in the human brain, colouration is frequently produced by the gravitation of the blood to the depending parts; and it is obviously a most important duty to note the position of the head in the examination of bodies found dead, as well as in many other cases.

III. Extravasal transudation and imbibition of the Blood, or of some of its component parts, after death. This is a cause which is well known to produce ecchymosed spots around the vessels of the scalp, and bloody-serous effusions in the cerebral and spinal arachnoid membrane; and we shall presently have to direct the reader's attention to another pseudo-morbid phenomenon resulting from it.

IV. Spasmodic action of the muscular system, occurring towards the close of life, may be enumerated as another cause of the appearances which simulate the phenomena produced by disease. It operates during infancy, when the fontanelies are open, by pressing the blood into the cranial case from the rest of the body; and we shall have further occasion to refer to it as a cause of pseudo-morbid appearances.

Pseudo-Morbid Colourations.-Every medical man accustomed to the inspection of dead bodies must have felt the difficulty of determining, when the substance of the brain was to be considered in a morbidly congested state. Colouration in its various stages has frequently been observed, while the most careful inquiries have failed to detect the previous occurrence of corresponding symptoms; and too often, we believe, have pseudo-morbid injections been regarded as the effects of some inflammatory action supposed to have been going on in the brain.

The appearances which cerebral colouration presents are two in number, the spotted or the "injection sablée" of M. Lallemand, and the diffused or uniform. The spotted redness is allowed by all authors to be simply an increase in the number and size of the red spots which naturally occur. It is best seen in the medullary substance, while the diffused almost always occur in the cortical. The spotted redness is by far the most frequent pseudo-morbid appearance; and it is remarkable that it is also a much surer indication of inflammatory action. It is to be seen in those who die from slow asphyxia, from an impediment to the circulation in the right side of the heart, or in the veins of the upper part of the body. It also happens as a consequence of convulsions, when these take place before the fontanelles are closed. The brain is then exposed to pressure, not only from external agencies, but also from such as act through the circulation, without a cor

1 My friends, Professors Reid and Simpson, who were present at the experiments referred to, were satisfied that little difference existed in the actual quantity of blood in the vessels of the brain. Although in the animals hung up by the tail, and where, of course, the blood was allowed to gravitate to the head, there was such an enormous quantity of blood in every minute vessel of the external parts and bones themselves, that it was impossible to keep it from rapidly passing over and colouring the brain. This gave rise to very fallacious appearances, which, however, were easily proved to be so by taking a clean knife, and making a new slice of the brain, when it was seen of its natural colour; but very soon became red, from the causes formerly mentioned.

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