was maintained in apposition by simple agglutinatives. Four months after the operation, the wounds are cicatrised, the new eyelid is perfectly vital, and of a tint precisely similar to that ordinarily seen in the situation which it occupies. Jaundice from Non-Elimination, together with Remarks on the Pathological Condition and Chemical Nature of the Bile. By W. H. Lowe, M. D.1 -Dr. Lowe rejects the doctrine as purely hypothetical, that when jaundice appears suddenly, and without premonitory symptoms, it is due to spasm, or to the opposite condition, paralysis of the gall-ducts. Jaundice from nonelimination may take place, either with the liver in a state of disease, or when there is no appreciable disease in that organ. Of the latter species, Dr. Lowe furnishes a single case of his own, and refers to others. According to Le Canu, three views are entertained by chemists of the condition of the blood of icteric patients. Some believe that it always contains bile; others, that it contains none, but only a particular colouring matter; others adopt a middle view, and think that the blood of such patients, without containing all the constituents of bile, holds its colouring principles. Dr. Lowe, without attempting to offer an exact analysis of the bile, gives the result of some experiments of his own, "which have been conducted on a somewhat extensive scale." He endeavours to show that the resin of Gmelin, the picromel of Thenard, and the choleic and choloid acids of Demarcay, are one and the same thing." We must refer our readers to the author's paper, for the experiments on which he grounds this view. 66 Observations on Dropsy of the Pericardium. By John Mackenzie, Esq., Surgeon. The diagnosis of hydrops pericardii is still involved in obscurity and uncertainty. The difficulty connected with this subject arises from the rare occurrence of the disease unassociated with effusion into the pleural cavity, and to the still rarer opportunities of verifying such cases as do occur, by post-mortem examination. Having for several years been attached to a large military hospital in Russia, where chronic inflammation of the pericardium and consequent effusion were frequently met with, and where every facility of examining the bodies of those who died was afforded, I observed that, in those cases where there was co-existing effusion into the pleural cavity, the patients, from the commencement of the disease, could not bear the horizontal posture; and that, where the effusion was confined to the pericardium, the patients preferred to be with the head remarkably low, till general effusion took place, and the breathing became laborious: of these, some preferred to sleep on their face, inclining to the left side, in such a manner as to make the region of the heart the most depending part, whilst others lay on their back. After death, I found in some of these cases that the pericardium occupied nearly the whole of the chest, and contained from six to ten pounds of fluid. In two cases there was not a vestige of the left lung to be found, except a thin layer of cellular substance. The reason why the horizontal posture was preferred in these cases, appears to be, that the weight of the pericardium was taken off the diaphragm and rested on the spine or the ribs. It is to be observed, that in hydrothorax, when the patient lies with his head low, the water in the chest flows back and presses on the root of the lungs, preventing a fresh ingress of air, and thereby causing dyspnoea and sense of suffocation; and that in hydrops pericardii this cannot take place, in consequence of the water being inclosed in a firm bag, which is bound down in its place by its attachment to the diaphragm. A very singular case of this disease came under my observation, 1 Edinburgh Medical and Surgical Journal, April, 1841. where the patient could lie in all postures equally well, and experienced no inconvenience whatever; yet after death, which was caused by a sudden attack of inflammation of the right lung, the pericardium was found to occupy the whole of the left side of the chest, from the clavicle to the diaphragm, and contained ten pounds of thick brown fluid. New Method of employing Iodine in Phthisis. By A. Leigh, M. D., Jersey.'-I direct the patient to apply a sufficient quantity of iodine ointment on the ribs, under both axillæ, and to cover the head with the bed-clothes, to breathe the iodine volatilised by the heat of the axillæ; the ointment produces counter-irritation on the skin where it is applied, and is to be repeated according to circumstances. This method has appeared to me to arrest the progress of the disease. Case of Neuralgia Facialis cured by Operation. By T. T. Lambert, Surgeon, Hull.-E. L., a female, aged sixty-three, had for several years been affected with a most painful condition of the nerves of one side of the face, coming on in paroxysms of the utmost severity, mostly towards night. At various times she had tried most of the usual remedies, without experiencing any thing but temporary alleviation. Under these circumstances, as the branches of the facial nerve seemed to be principally affected, the pain shooting across the cheek down towards the lower jaw, and occasionally upwards towards the temple, I proposed the division of the facial nerve in the parotid gland, after its exit from the foramen. To this the poor woman gladly consented, and I proceeded to perform the operation by making an incision betwixt the mastoid process and the lobe of the ear. My next incision brought me in contact with a nerve, which I supposed, from its situation, to be the auriculus magnus nerve, one of the ascending branches of the cervical plexus. On raising this nerve with my forceps, a state of tension seemed to be produced upon all the nerves of the face which were affected with the pain, and the patient exclaimed that was the place from whence all her pain proceeded. Under these circumstances, as the operation for the division of this nerve is trivial, compared with the division of the facial, and as it was just at hand, I determined to try the effects of its division; and the result was most satisfactory: the woman passed a delightful night, and enjoyed some good sleep. The next day she had a little pain; and from that time to the present she has been perfectly well, except having, on one occasion, a very trifling degree of pain. Four months have elapsed since the performance of this operation; and during this interval the patient has been exposed to the intense inclemency of the recent winter. I am not one of those who would pay too much attention to a solitary case; yet, as a single fact, this seems to me to be important, inasmuch as the means employed have effectually cured, for four months at least, and I hope permanently, a very severe case of neuralgic pain. On the Use of Splints in Chorea. By G. Southam, Surgeon, Salford."I was led to try the experiment of confining the affected limb in splints, having frequently observed, in those instances where the convulsions had continued in spite of all remedial means, that if the patient's attention be directed to the deranged muscles, as, for instance, when in the hand and arm, causing him to grasp the sides of a chair, the motions comparatively cease; and this, when frequently repeated, proved a useful auxiliary in 1 London Medical Gazette, May 28, 1841. 2 Ibid, March 12, 1841. 3 Ibid, May 7, 1841. removing the disease. Upwards of two years ago, a case came under my notice where the convulsions had existed in the hand and arm for six months, though a variety of means had been adopted for their removal: believing them to depend on habit, from the control the patient had over the motions, and his apparently excellent health, I had recourse to the splints. For the first few days, the twitchings, from their violence, caused some difficulty in keeping the splints firm, but they soon diminished in force, and in three weeks had entirely disappeared. I have tried the same treatment in four other cases. In three, after attending to the bowels, I applied the splints, and continued them until a cure was established, which occupied in none more than a month. The convulsions were confined to one of the upper extremities, with slight dragging of the leg of the same side; but as the symptoms left the arm, the power over the leg returned, The other case occurred in a youth fifteen years of age. The convulsions were more severe, and rendered it extremely difficult to keep the splints firm with an ordinary bandage: to obviate this inconvenience, I used the apparatus recommended by Velpeau for fractures, with the addition of small splints to keep the limb extended and at rest during the consolidation of the apparatus. This was removed in a week to allow of exercise; and the severity of the convulsions being subdued, a common bandage and splints were again used. Though the convulsions affected both arm and leg, and splints were only applied to the former, the boy had recovered the use of both extremities in six weeks. NECROLOGY. The late Dr. Hope.-We regret to see, by the last number of the British and Foreign Medical Review (July, 1841), that the able author of the work on Diseases of the Heart, which is known by reputation to most, if not all, of our readers, died on the 15th of May last, at the age of 40, of pulmonary consumption. Dr. M'Nevin.-We announce with regret the death of Wm. James M‘Nevin, M. D., of New York, late Professor of Chemistry in the College of Physicians and Surgeons, and Professor of Materia Medica in Rutger's Medical School. He died on the 12th of July, at the advanced age of 79. ART. I.-CASE OF CYNANCHE LARYNGEA. BY JOSEPH PANCOAST, M. D. Professor of Anatomy in Jefferson Medical College of Philadelphia. George Faus-a child of four years, healthy, well formed, and activehad been subject, occasionally, for two years, to tonsillitis, with enlargement of glands of the neck, and a tendency to laryngeal inflammation. In one of these attacks, I attended him some months ago. I was again called to him July 5, 1841. He had been three days sick, with sore throat, swollen tonsils, and enlargement of cervical glands. For the last twentyfour hours, be had had stridulous breathing, the inflammation having extended into the larynx. He was bled, leeched to the neck-puked with a combination of calomel, tartar emetic, and ipecacuanha-blistered at the nape of the neck, and over the top of the sternum; swabbed in the throat with a tincture of honey and sulphate of copper, and touched with lunar caustic. The disease yielded in the fauces, the swelling of the tonsils diminished, but, after thirty-six hours of apparent improvement, reappeared, without any known cause, with increased energy in the larynx. The breathing became gradually, in spite of the treatment, more noisy and oppressed, with heaving of the sternum, congestion of veins of neck, and suffusion of face. He expired on the 11th of July, suffocated by the false membrane in the cavity of the larynx. There was no indication of disease of the brain. The child's intellect was good to the last. From auscultation, there was no reason to suspect inflammation of the lungs. The child might probably have been saved by tracheotomy, which I urged on the parents, but to which they did not consent till it was too late to be of any avail. Dissection of Thorax and Neck, July 12.-All the large cervical veins, and all the cavities of the heart, filled with black coagulated blood. The thymus and thyroid glands were larger than usual at that age. The deepseated cervical and bronchial glands were unusually large, several being of the size of an almond shell. There were no pleuritic adhesion, no water in the chest, and but a teaspoonful or two in the pericardium. The lungs of both sides were every where crepitant, but engorged with blood and serum, exhibiting no manifest signs of pneumonia. The tonsils but little enlarged. Some superficial excoriation at the lower part of pharynx, caused, probably, by the use of caustic. The epiglottis red and injected; the mucous membrane, surrounding the upper opening of the glottis, swollen and of a pur plish red hue, from the intensity of the inflammation. The whole cavity of the glottis was blocked up with a secretion of creamy tenacious lymph. On opening the trachea, the false membrane was seen to terminate abruptly about half an inch below the cricoid cartilage. The mucous membrane of the trachea and bronchia was slightly red, and injected as in catarrh, and much frothy mucus was seen at the bifurcation of the trachea. Not a flake of false membrane was found lower than half an inch below the larynx. The sound emitted by the child in breathing, was sharper and dryer; in other words, more laryngeal, and less tracheal, than in ordinary croup. ART. II.-ENDERMIC USE OF SULPHATE OF QUININE IN INTERMITTENTS. [Extracts from letters of Dr. G. Lane Corbin, dated Laneville, Warwick Co., Va., to Dr. John Redman Coxe, on the utility of the external application of sulphate of quinine in the cure of intermittents.] "I have lately had a long standing and tormenting patient with intermittent fever of two years' continuance, during which period, every article hitherto recommended was tried with little or no perceptible advantage. Twenty-four hours before the expected ague, I applied five blisters, which were kept on eight hours. They drew very well; the places were washed with soap and water, and the dead cuticle removed from each sore, which were then coated with sulphate of quinine, which was reapplied as long as they continued to discharge. The patient has had no return of his ague, and has enjoyed very good health ever since. "A few days ago I was called to a child with ague and fever, as its parents informed me, of six months' standing. I applied a single blister over the abdomen, which raised the skin sufficient for removal, and after ablution, as before, the quinine plaster was applied with the happiest result. Now both of these patients had taken many different articles previonsly to the employment of the quinine plasters, and possibly this previous treatment might have aided in the ultimate cure," &c.-May 29, 1841. July 20.-"In my last, I mentioned the success that had attended the use of sulphate of quinine in old cases of intermittent fever. I now add two more to the number. "E. S., aged twenty-eight, complains that for eighteen months he has been a martyr to ague and fever. At no one time during that period has he been free from it three weeks at a time. Appetite good-bad complexiongreat weakness, and occasional shortness in breathing. Ague every other day at 11 o'clock-bowels open, dischargés thin, and not very bilioustongue clean, and of a bluish hue. Ordered five blisters to the stomach and each extremity, to be applied an hour before the expected attack, and to remain on eight hours; the skin to be then removed, and the following plasters applied-of sulphate of quinine 5 drams, simple cerate 4 oz., incorporated well together, and spread of the thickness of a blister. The application to the abraded surface was continued until the places became well. If the patient complains very much of the irritation, the plasters to be removed after the first twenty-four hours, the parts to be bathed with milk and water, and then reapplied. This patient has had no return of the ague, and only one disagreeable symptom, viz. strangury, which was relieved by nitre and demulcents. "A girl of seventeen, irregular in her menstrual periods, had been treated by a physician with aloetic pills, and vol. tinct. of guiacum, for eight months, with partial relief as to the menstruation, but none as to the ague; feet |