deed in every point of view so conspicuous, that I have long ranked it as one of the most perfect surgical operations we are in the habit of performing."

Though a decided preference is given to the treatment of hydrocele by injection, the principle upon which it has been adopted is rejected. The obliteration of the cavity of the tunica vaginalis testis, which has been considered as a sine qua non in the radical cure, our author contends is neither essential to that cure, nor does it always or frequently happen, unless the curative process has been carried to unnecessary severity.

"The effect of throwing injection into the tunica vaginalis is of two kinds. If a very strong stimulating injection be used and retained within the cavity for an unreasonable length of time; it occasions a painful enlargement of the testicle, and places the patient under all the distressing symptoms of the hernia humoralis.

"If, on the other hand, an injection be used of more moderate strength, be retained but a short space of time, and special care be taken to prevent the cannula of the trocar from rubbing against the testicle; it produces a slight inflammatory excitement of the excretory vessels without any enlargement of the gland itself, and places the pa tient under symptoms very much resembling those I have stated to be present in acute hydrocele.

"In the former instance, where the inflammation is so severe as to occasion the hernia humoralis, the surface of the gland and the surface of the tunica vaginalis are in contact with each other, and frequently be

come adherent,

"In the latter instance, where the injection produces an effect nearly similar to acute hydrocele (which is the only effect a judicious operator should aim at), and the surface of the gland and the surface of the sacculus are carried away from each other by the immediate effusion, and any adhesion between them is mechanically impossible."

The fact of the surface of the gland and the surface of the sacculus being kept apart by an intermediate effusion, is con sidered to be ascertained by a transparency of the tumour existing during the whole process of cure.

For the support of the opinion that the cure of hydrocele, when effected by discutients, does not arise from the application exciting an increased action of the absorbents, but from a suppression of the "excretory vessels," we must refer to the work itself; as well as for a detail of the process of curc by injection and be content with observing that the principle of this cure rests on exciting a moderate degree of inflammatory action.

:

The cases of aneurysm, with which the volume concludes, are, a case of axillary aneurysm, in which the subclavian artery was tied behind the clavicle. Case of aneurysm of the femoral artery, for which the artery was tied immediately be

low

low Poupart's ligament. Case of popliteal aneurysm. Case of aneurysm of the femoral artery between the ham and the centre of the thigh.

ART. I. Observations on two distinct Varieties of Ophthal mia, prevalent in the Army. By HENRY WALKER, M. D. Assistant Surgeon, 2d Batt. 71st Regt. The Edinburgh Medical and Surgical Journal. No. 25, 8vo. Edin. 1811.

THE disease of which Dr. Walker here treats, prevailed to a great extent in the 71st Regiment. From the 22d of April to the 24th of June, 114 persons were admitted into the hospital with it, out of 600 men and boys of which the battalion consisted..

This malady is stated to have attacked in two forms or varieties, modified by circumstances, which are not pointed out. An attempt to distinguish these varieties by the terms acute and chronic, he asserts, would only mislead. The first variety is thus described.

"In the place where the redness is originally discovered, the disease first gains its height, and the vessels of the tunica conjunctiva, by their minuteness and number, give to the eye something of the appearance called chemosis, (chymosis,) though that state has not yet taken place; for, at this time, on pressing the eyeball with the finger, the eyelid being interposed, and removing it quickly, the whole surface becomes white and, for the first time, the vessels of the sclerotic coat are seen increased in size, carrying red blood, and running in straight lines towards the cornea. On removing the presure, these are first filled, and present a purple rather than red tint, immediately afterwards; those of the conjunctiva more tortuous and large, are longer of filling, and become of a deep red. Soon after the first appearance of the symptoms now detailed, purulency commences, constituting, according to those who have described this disease, its second stage, at which time the eye puts on an appearance which I have not seen described, nor have 1 ever remarked it in the more violent forms of inflammation, to which the organ is liable from external injury. In different points, under the conjunctiva, covering the eyeball, small patches of a scarlet hue appear of different sizes and irregular figures, which no pressure can remove, and which, I apprehend, are formed by extravasated blood; these, by a very gradual increase, unite, and thus chemosis is formed. This state of the eye gives to the countenance of one affected with it a very striking appearance, bnt I am far from wishing it to be understood, that this account of the early appearance of chemosis, is drawn out with the desire of its forming a pathognomonic feature; certainly, the most prominent symptom is the very early and copious effusion of a purulent-like fluid, though this can with difficulty be admitted as characteristic of the complaint, since it is by no means uncommon in the more severe attacks of inflammation of the eye, from great violence done to that organ, as in the operation of

couching and extracting."

. In this variety of ophthalmia, it has been observed that exposure of the eye to light, is not productive of much uneasiness. This Dr. Walker considers to be a fact of high importance as affording ground for a diagnosis: but if he intends to explain how it happens that the eye in this disease bears the stimulus of light, his description is deficient in perspecuity.

In every case of this variety of ophthalmia, it was observed that,

"The sclerotic coat had an increased vascularity, a fact which has been overlooked from the symptoms having been drawn out at an advanced period of the disease."

Copious bleeding, repeated as often as the pain required, was attended with the happiest effects. In every case where this treatment was adopted, the patients escaped derangement of vision.

"The second variety of attack commences in the whole surface of the convex conjunctiva; in the course of a very few hours, that membrane becomes loaded with enlarged vessels, running tortuously towards the cornea, which in a little time may be seen affected, to the extent of a line in its whole circumference, with a slight elevated vascular border; the eyelids, of a red colour in the place occupied by the conjunctiva, feel stiff and uneasy; exposure of the affected organ to light gives considerable irritation; but it seldom happens that pain warns the patient of his complaint; lachrymation, but no purulent discharge takes place; and chemosis is never present, nor can the vessels of the deeper seated membranes be discovered affected, as in the former variety. If the disease be permitted to go on, and, as I have noticed, still more if venesection be employed, it presents day after day the same appearance; the eyelids become thickened, and slightly everted; and the cornea begins to suffer, either from the encroachment of the border affecting its circumference, already described, or from the deposition of matter between its lamina, and consequent ulceration, hypopion, and staphyloma, generally pretty near to the place corresponding to the pupil.

In the first variety copious bleeding from the system afforded the surest relief; in this, so far from curing, it tended to weaken the vessels of the conjunctiva, and render the disorder more obstinate. Scarifying the vessels of the tunica conjunctiva, and dropping immediately afterwards on the eye-ball a stimulating material, is recommended. Dissappointed in every method, our author endeavoured to make the eye, affected with this variety, assume the inflammatory action of purulent ophthalmia, and then applied the usual remedy venesection. This practice is said to have proved successful, not a single enlarged vessel remaining at the end of a fortnight.

ART. 2. An Essay on Staphyloma pellucidum conicum. By ROBERT LYALL, Surgeon, Paisley.

Mr. Lyall considers the first notice of this disease to have .occurred in Leveille's French translation of Scarpa's work on Diseases of the Eye. It has since been slightly noticed by Dr. Edmonstone, and more distinctly by Mr. Wardrop, who describes the disease at some length in Essays on the morbid Anatomy of the human Eye.

The Staphyloma pellucidum conicum, is here considered as being nothing more than an alteration in the form and size of the cornca, in consequence of an increased quantity of aqueous humour being contained in the anterior chamber of the eye; and the same causes are assigned for this increase of fluid, as those which give rise to dropsies in general. This complaint is characterized by the conical form of the cornea, its peculiar lucidness, and the derangement of vision. It is considered as incurable by Mr. Lyall; but attempts were made to relieve it, by puncturing the cornea, and by the application of astringent collyria. The confused state of vision may be partially corrected by the employment of concave glasses; the power of those employed has been from No. 4, to 20,16. Four cases of the disease are given.

ART. 3. Case of Tetanus successfully treated. By Mr. GRIMSTONE, Surgeon, Royal Navy.

This case of Tetanus arose from a pistol-ball passing through the palm of the hand, and fracturing the middle metacarpal bone. The cure is attributed to the combined effects of ardent spirit and opiumi.

ART. 4. Brief Outline of a Plan for diminishing the Prevalence and fatal Tendency of Hooping-cough. By H. EDMONSTONE, Surgeon.

Mr. Edmonstone forms his plan for diminishing the preva lence and severity of Hooping-cough upon certain peculiarities of action to which the contagion of that disease is known to be subjected.

"One of the best established and most remarkable of these peculiarities in the history of hooping-cough, is, that the severity and danger attending the disease, are in the inverse ratio of the age of the patient; or, in other words, the younger the patient, the greater is the hazard to which health and life are exposed. In proportion as the constitution acquires vigour and stability, the danger becomes comparatively trifling; and after the age of puberty ceases almost entirely, together with the susceptibility

susceptibility of the disease. Another circumstance, with regard to the operation of the contagious principle, particularly deserving of attention, is, that hooping-cough is observed to be much milder in warm than in cold climates; and it would seem to be in conformity to this law, that the disease is found to be more severe in this country during autumn and winter, than during spring and summer. It is not necessary here to enter into any discussion respecting the causes of these differences, in the degrees of danger and severity, arising from age, climate, or season. It is sufficient that experience has established the fact of their uniform occurrence. The two important practical rules which result immediately from them, and to which I am, on the present occasion, particularly anxious to direct the attention of the public, are the following:

I.-To use every precaution to guard against the hoopingcough, during the very early stages of life.

II. To avoid its attack during the unfavourable season of the year.

To ensure a selection of the favourable period with respect to age and atmospheric temperature, it is proposed that every one having the disease shall wear such a distinguishing mark as will enable those who are liable to take it, to keep beyond the sphere of contagion.

ART. 5. Inquiry into the Exactness of some Statements made by Messrs. Nagle and Wilson, Naval Surgeons, respecting their extraordinary Success in the Treatment of the Yellow Fever. By a Naval Surgeon.

In the second volume of Dr. Currie's Medical Reports, Mr. Nagle gives an account of the employment of cold affu sion in a fever that occurred on board the Ganges, in the West-Indies. One hundred and twenty cases of this disease, denominated Yellow Fever by Mr. Nagle, and of which, under this treatment, only two persons died. Mr. Wilson, Surgeon of the Hussar, gives (Trotter's Medicina Nautica) a relation of a still more successful employment of cold affusion in a fever, also called Yellow Fever, on board that vessel for of eighty-three cases none were fatal.

The object of this naval surgeon's inquiry is to point out the probability of these gentlemen having mistaken the dis(To be continued.)

case.