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"nution, and continual alteration of parts, to which the flesh, "the blood, and the whole vascular system is subject." Now, I am sure bone is the last part of the human body to which an anatomist would compare skin. In the next page, in a note likewise," Anatomists know that people of colour have their "skins thicker than people of fair complexion in proportion to "the darkness of the hue." As the Doctor has not given us his authority for these two opinions, and as I never met with any thing like them, I conclude he quotes from memory, and, therefore, is liable to be mistaken. The former is certainly erroneous, and I believe the latter. One would have thought his own observation would have taught him better. Did he never observe that the skin bleeds upon being punctured with the finest instrument? So very vascular and sensible is it, as to appear to be almost a tissue of blood-vessels and nerves. The bile does not, as far as I know, tinge the rete muscosum, as Dr. Smith supposes, but remains in the cutis, and colours that in the same manner that it does the opaque cornea of the eye. Thus much for the Doctor's anatomy; now for his illustrations. "If," says he, but in a note, "the force of fire be "sufficient at a given distance to scorch the fuel, approach it as "much nearer as is proportional to the difference of heat between our climate and that of Africa, and it will burn it black ;' that is, as a sufficient degree of culinary heat will darken the colour of wood, so will a sufficient intensity of solar heat blacken the rete mucosum!

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Were I to follow Dr. Smith through his whole work, you might suppose I have some enmity to that gentleman, which is certainly not the case; nor should I have mentioned him at all, had I not conceived it my duty. The execution does less credit to his head, than the intention to his heart.

That climate does produce great changes on all animals, and in man among others, no person will deny. Thus, if you transplant a sheep covered with wool from England into Syria, the wool will be changed into long silky kind of hair; but if you

re-convey it to England, it will recover its wool.* Not so the African; he approximates not to the European by changing his climate, as is fully evinced on this continent. But what satisfies me that the colour does not depend upon climate and mode of life solely, is, that we find persons of such different complexions in the same latitude, and under nearly the same circumstances, and such similitude of appearance in the inhabitants of such extensive countries.

Ulloa informs us, that the unmixed descendants of the Spaniards at Guaquil, though inhabiting a warm country, within two degrees and a quarter of the line, are yet fresh coloured. The inhabitants of the deserts of Arabia are not at all like the Africans, though Bruce saw Fahrenheit's thermometer at 112o in the shade. Their country is sandy, and they are savage, and on these circumstances Dr. Smith lays great stress. On the contrary, the aboriginal inhabitants of this extensive continent were nearly of the same colour, the Esquimaux excepted. What is the reason that in all the latitudes and climates of the old world there were no red men? The inhabitants of high northern latitudes are tawny, cold producing the same effect as heat upon this hypothesis. But suppose all difficulty about the complexion and hair gotten over, can any man suppose that climate can affect the shape of the bones? Dr. Smith says indeed, that cold makes the heads of the Laplanders grow to an undue size, by contracting the face and the extremities—the head having more life.

I am afraid then the causes of these effects are unknown; and, as too frequently happens in physiological disquisitions, we are, for the present, obliged to confess our ignorance of them: that they were secondary, as I before said, there can be no doubt; perhaps, like the causes which have produced small-pox and syphilis, they may have ceased to operate. But on this subject, as

This is mentioned on the authority of Mr. Ashley Cooper, by whom the fact is stated in his lectures.

on every other which may occur, I hold it my duty to lay before you all the facts which are relevant, all the opinions which are plausible, leaving you then to judge for yourselves. Different minds are satisfied with different degrees of evidence; and far be it from me to fix the bounds of your faith.

We shall in this as in other respects follow the same general plan which was pursued last year, except that the course now to be delivered, must necessarily be more extensive, as the Regents, since our last meeting, have done me the honour to appoint me to the Surgical as well as the Anatomical Chair. The treatment of burns and gun-shot wounds, not touched upon last winter, will now be laid down. We shall then, in the first place, demonstrate the structure of every part of the human body; next explain their functions as far as they are understood; and, lastly, the diseases and accidents to which they are liable, and the surgical treatment these may require.

For instance, the anatomical structure of the eye will first be demonstrated, then the manner in which its humours refract the rays of light so as to produce vision. The hypotheses will then be mentioned which have been brought forward to explain the way in which the eye adapts itself to the distinct perception of objects at different distances; and, lastly, I shall describe the diseases and accidents to which it is liable, and the remedies and operations they require. There are some accidents not peculiar to any part; with these then we shall conclude.

With regard to the opportunities which you will have of acquiring anatomical information, I am happy to inform you that we have made arrangements, owing to the liberality of the Legislature and of the gentlemen more particularly concerned, which will, I hope, prove satisfactory. But this is a subject on which I cannot now enter into detail. At our next meeting, gentlemen, the lecture will be on life, when I shall more at large lay down the plan to be pursued.

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For the Medical and Philosophical Journal and Review.

A CASE of LUXATED HUMERUS reduced after it had been displaced for one hundred and twenty Days. Also a CASE in which a LUXATION of the CLAVICLE at its Scapular Articulation was successfully treated. By JAMES COCKE, M. D. af Baltimore.

SOME time in the year 1805 I was requested by Dr. Potter

to see a patient with him. The person was a Swedish sailor, who had embarked on board a brig bound to Baltimore from Bristol. He had been only a week at sea, when a flaw of wind gave a sudden and violent agitation to one of the sails, to which a rope that he held in his hand was attached. The motion of the sail was so unexpected and considerable, as to put it out of his power to disengage his hand, which was carried upwards with much force. The shoulder soon became very much pained, and in a short time was highly inflamed and swelled, with an inability of motion. There was no person on board of the vessel who could afford him relief, and he remained in great distress during the remaining part of the passage, which was not accomplished until eleven weeks after the accident. Immediately on his arrival in Baltimore he applied at the office of a physician, who happened to be at that time out of town. An apprentice of the physician undertook to manage the case, but from the swollen condition of the parts, or from some other cause, he did not discover that the head of the humerus was dislocated, and contented himself with making such local applications as he supposed would remove the swelling and inflammation. The patient was kept on that plan for some considerable time, when the physician returned and discovered the nature of the accident, which he attempted to relieve in the ordinary way, after having bled the man until he fainted; but from the force used being too small, or from so much of it VOL. 1.

being wasted on the muscles which attach the scapula to the body, the attempt did not succeed. When I saw the patient there was still some swelling about the shoulder, but the depression below the acromion was very evident. The head of the humerus, which had been thrown downwards, had made a socket for itself, in which it was so well accommodated, that the arm had become in some degree serviceable; the person was able to lift a chair from the floor, although the motion at the shoulder was very limited. The injured arm had lost its plumpness, and was much reduced in size. The pain about the shoulder had ceased, and being apprehensive of his sufferings being renewed, the person seemed disposed to continue in his crippled condition, rather than submit to another attempt being made to relieve him, unless we would give him almost positive assurances that he should not suffer in vain. However, after some hesitation and further delay, he gave himself up to our management. Discouraged as I was by a confession which I had heard made by Mr. Astly Cooper, of London, that he never had been able to reduce a luxated shoulder after eight weeks from the time of the accident, and knowing that Dr. Physic had acknowledged that he had never succeeded in a similar case after nine weeks, I undertook the reduction with much hesitation, and some little mortification at the man's having consented to a repetition of the experiment. I had seen some of the ablest surgeons foiled in their attempts to reduce luxated shoulders where the disorder had been of considerable duration, notwithstanding the aid of pullies, ropes, cushions, and other formidable apparatus. I had seen distracting force applied to a great extent; but from the difficulty of keeping the scapula in its natural situation, (which was attempted by cushioned bandages and other means) a very considerable part of the force was expended upon the muscles connecting the scapula to the body. To obviate this loss of force, and to retain the scapula in its place, appeared to me to be the principal points to be attained. For this purpose I rolled up a common coarse

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