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sent moment ; for, when the cry against irregulars is sounded 80 loudly over the island, we should at least expect to find, if not infallibility, a degree of correctness and knowledge commensurate with the high pretension of the regularly ini. tiated, the perhonorifici mystagogi of the Warwick Lane
Edinburgh Med. and Surg. Jour.
. (Concluded from Page 360.) Art. VI. Description of a very singular and complicated
Case of Malconformation of ihe Genital Organs, Rec. tum, &c. By T. CONQUEST, Surgeon.
" The whole body of the child was emaciated, and great deficiency of vigour was perceptible; the lower extremities were considerably distorted, the feet being turned completely in. wards. On the second and third lumbar vertebræ, there was a spina-bifida of the size of a common orange.
« The umbilicus was lower than usual, and on the right side; it did not appear to perforate the linea alba in its natural place, but came out nearer the rectus muscle; there was a considerable eleva. tion, both on the upper and lower part of its perforation.
“ The anus, in its natural situation, was imperforate, nor was any appearance of the termination of the rectum perceptible, when exer. tions were made, by urging or voiding the urine. About midway between the umbilicus and symphisis pubis, the rectum protruded about three inches from the abdomen, and was covered by the common integuments, which were regularly continued on from the ab. domen, and reflected over its whole length. The peristaltic motion was constantly going on, and the meconium were (was) voided through it. It was much thicker than the rectum of an adult, sup. posing it to have the addition of a cuticular covering. It ap. peared to be surrounded with a strong muscle, which, when the internal or villous coat suffered the least attrition, contracted with an unusual degree of force, amounting to a temporary obliteration of the canal. The sphincter was perfect at its termination, where it was for a small distance inverted. The inversion of its lower part rendered the internal coat so distinct, as to admit of being minutely examined. The villous coat was extremely red, vascular, and tinged with blood of a florid hue. It was so extremely sensible, that when slightly irritated with a probe, a determination of blood took place to the part, and the peristaltic action increased almost to an erection; it was studded with innumerable and very large glands, which secreted a large quantity of mucus.
“The genital organs presented an appearance equally singular with that of the parts already described. Their structure was so com. plicated, it was almost impossible to form any correct opinion of
the sex ; neither predominated, and there appeared an adnixture of both. That which would at first sight have been pronounced to be a scrotum, was considerably larger than one of the common size. It extended above the -pubis, and was smooth on its surface, with out the least appearance of raphe, nor was any perinde um to be distinguished. Nothing which bore the least resemblance to testis could be discovered, the scrotum or tumour was filled with cellular substance, of a spongy texture. On the most minute examination, it evidently was not an adhesion of the opposite sides of the labiæ. On the upper part of this tumour was a small prominence, perforated with a fissure, so small as to render the introduction of a probe im. practicable : this was the orifice of the urethra, and bore a near resemblance to the meatus urinarius ; it had no appearance of prepuce; and was not in any respect similar to the penis. The urethra could be traced through the soft cellular substance, with which the tumour was filled as far as the symphisis pubis; it was unusually hard and felt like a curved probe. There was a constant involuntary discharge of urine, which exuded from the fissure guttatim, except on any vio. lent exertion of the child, when it flowed in an excessively fine stream or jet. . In cases which have been described in some respects similar to this, a separation of the bones of the pubis has been mentioned; but in this case there was no such appearance."
ART. VII. Sketch of a Plan for improving the Medical . . Department of the Navy,
Earnest as we have always been in recommending an assiduous attention to the collecting of facts, which we hare considered as materials hereafter to be used in the construction of a true system of medicine, and as the foundation of a practice that may, possibly, at some future period, overcome diseases now intractable; we cannot but give our approbation to the comprebensive views of this anonymous writer. At the same time we must observe, that they require a too constant attention ever to be generally executed, except under the direct command of the government. 1
After some preliminary observations following a very appropriate motto from Horace,
“ Tu, dum tua'navis in alto est,
Si patriæ volumus, si nobis vivere cari.”
"I would have him (the naval surgeon) consider the body of men, of which he is the medical superintendant, as the subject of an experi. ment placed within the influence of all external bodies. I would have him mark the changes which these reciprocally undergo, endeavouring,
with unceasing attention, to ascertain thecauses of the different changes that arise on this subject of experinent, and to explain the mode of action of which these are the result. When the effects are disease, he is to note its whole phenomena, still remarking, in a particular manner, its relatton with external bodies, and the effects of these on the subject in this altered condition. In other words, I would have the surgeon to pay particular attention to the whole ship's company, as well in health as in disease, observing and marking their mode of living, as to food, drink, clothing, exercise, &c. ; their dif. ferent conditions and habits, and the effects of these on health and disease; particularly noting the state of the weather, and endeavouring to ascertain its influence. When disease occurs, he is to pay great attention to every case, so as not merely to benefit 'lis patient as much as possible by the best practice, but to instruct him.' self from every additional sample of disease.
" All this is a inatter of the easiest attainment, and may be very well accomplished in the following manner: In a journal, kept for the purpose, the surgeon is to commence by inserting a list of the ship's company, as divided into the different classes of seamen and marines, subdivided into forecastle men, top men, afterguard, &c.; in short, into as many divisions as different occupations may be supposed to give rise to difference in health. · After every name (as obtained from particular inspection, observation, and enquiry), the man's appearance or temperament, habits, character, nature of employment, years at sea, former condition of life, previous state of health, &c. are to be marked ; particular attention being paid to every thing which may be supposed to influence health.
“In another part of the journal he is daily to note the state of the weather, as ascertained from general observation, and from in. struments. In addition to the account of the state of the atmo. sphere, the particular state of things, as shewn locally between decks, &c. as with regard to moisture, air, &c. is to be mentioned, Then are to be marked the nature of the duty carried on, and the diet and drink of the ship's company for the day. When any uncommon or very particular duty is carried on by a small number, such as wooding, watering, &c. the names of the men employed are to be marked in the daily reports, and the particular nature of the duty to which they have been subjected, detailed.' Then the sick. list is to be reviewed, and the number and names of the men and diseases admitted and discharged are to be marked. At convenient times, the general character of the prevailing diseases is to be in. serted, referring for a detail of the particular cases to another journal. This other journal is to contain a detail of every case of dis. ease which is entered on the list : not a cursory enumeration of the most prominent symptoms, as caught from the first glance at the patient, but a regular and leisurely account of all the complaints of the patient, the present state of the usual criteria of disease, the me. dicines tuken, and their evident effects ; in short; a true and full history of the disease, from which may be learned the actual stale of the patient's system, and a portable opinion formed of the effects (No. 147.)
of the remedies employed. This account is to be taken at stated times (once or twice a day) and fully given at each time.
- The plan now proposed, carried on privately, would doubtless contribute greatly to individual as well as to general improvement ; but it would be far from producing all the great effects to be ex. pected from it, were the perfection of it left to the polition of indi. viduals, or to observations formed from partial reports. To accomplish the end in view, it would be necessary that surgeons should be obliged, by their instructions, to transmit the two journals above mentioned, at stated times, to the board, or to some persons appointed for the purpose. The duty of these would be to collate the immense body of evidence, to condense the general facts, and, in short, to reduce to a manageable volume, the whole of the facts and observations contained in the journals, either drawing from these the general results, or leaving this to the discretion of the reader. This might be published annually, or at any convenient times, and would be drawn up in whatever form might appear most advantageous for purposes of general improvement. The gentle. men, whom the nature of their situation points out as best qualified for this task of arrangement, are the physicians of the different fleets. They being on the spot where the observations were made, and having probably visited every ship, have on many accounts ad. vantages which none others can possess. Each physician would collect the reports of his own station; and thus we would have an. nual reports of the Channel, North Sea, Mediterranean, West In. dia, and East India stations. Reducing the magnitude of the undertaking, we would expect the reports to be more correct; at the same time we would have a better opportunity of comparing the effects of the different climates.
“The advantages resulting from a faithful and persevering prosecu. tion of this simple plan, it is evident, would be great. Let us suppose that a suite of remarks and observations on the above plan was carried on for a few years, say ten only, by seven hundred sur. geons, in vessels of every class, in all variety of circumstances, in every climate of the globe ; that these remarks and observations were compared and collated by some person capable of the undertaking, in the manner it has been proposed. Need I waste time in stating, what must appear at first view to every one, the valuable acquisition such a work would be to medicine in general, and to nautical medicine in particular? But leaving such bounded views, when we consider the effects of this plan, faithfully pursued for centuries, amended by the progressive increase of improvement, and enriched by the discoveries of so many years, we are surprised at the im. mense views of improvement that open on us, and cannot help regretting the inactivity of man, and blaming the indolence and care. lessness of our predecessors, who have left a work of such mighty import for the speculation only of the present day."
ART. VIII. Account of two Cases of Gonorrhea, altended with unusually severe Symptoms, relieved by the employment of Calomel and Opium in combination. By Mr. LANGSTAFF, Surgeon.
In the first of these cases, the inflammatory symptoms, the distention of the penis, and the suppression of urine, were most alarming. Many methods were had recourse to, with temporary relief only : at length a combination of opium and calomel, in equal parts, was given in the quantity of two grains of each, night and morning, with the most evident benefit. Opium by itself did not relieve the disease, but when combined with calomel, its effect was quick and decided. The other case of suppression of urine, relieved by opium and calomel, is given from Dr. James Curry. The effect said to be produced by this combination of two active substances, is of sufficient importance to excite the attention of the faculty.
Art. IX. Remarks on Sore Nipples. Anon.
This writer proposes a prophylactic for this distressing complaint. The shield and teat so commonly used in and about London, is the mcans he recommends to secure the mother. The shield may be had at the instrument.makers, either in silver or ivory. The artificial nipple is the teat of a fresh slain heifer. This is prepared by carefully scooping out the inside, so as to leave the teat about the thickness of Morocco leather. The operator should be particularly careful that he does not make the smallest puncture in the skin of the sides of the teat; for if this happens it will not be air tight, and of course useless. The teat thus prepared, after being well washed in water, must be kept in spirit, till an hour or two before using, when it must again be laid in cold water to take away all taste of alcohol. Being wiped perfectly dry, it is to be sewn closely and firmly at the edge of the row of holes in the shield, and need not be removed from the shield until it becomes bad from use. The whole apparatus must be carefully washed after suckling, and kept constantly in cold water; or if the weather be bot, in spirit and water, with the precaution, in the latter case, of rinsing well before using