Effects of injury to the substance of the brain.--A deep wound into the right anterior lobe of the brain, attended with inflammation and suppuration, produced no sensation whatever; the senses remained entire, and the person did not know that the head was injured.

The brain shooting out in the form of fungus, after the dura mater is wounded, has no effect upon any of the nerves, nor is it attended with sensation; but the inflamed. pia mater gives great pain.

Loss of a portion of the medullary substance of the anterior lobe of the cerebrum, produced no symptoms. Loss of a portion of one of the hemispheres was attended with difficulty of swallowing for twenty-four hours, and slight delirium of short duration. Ulceration of the anterior lobe of the brain, as low as the anterior cornua of the lateral ventricle, but not communicating with it, paralysis of both arms.

In a case of a penetrating wound into the right hemisphere of the brain, with bone forced into its substance, while there was an opening for the discharge of matter, no effects were produced, except when the circulation was much increased, and then only head-ache and numbness in the left side.

Effects of alteration of structure in the brain.-In a case in which the tuberculum annulare had undergone a change in its texture, and become so hard as with difficulty to be cut with a knife, a considerable quantity of earthy par ticles being intermixed with the medullary substance of the crura, and other parts of the cerebellum, and the cerebrum and upper part of the cerebellum unusually soft; the effects were, the boy had been an idiot from his birth, never walked, spoke, or understood what was said. Went often three days without food. At sixteen, when he died, was no bigger than a child three years old, except the head, which was as large as it is usually at twelve.

Effects of injury to the medulla spinalis.-Pressure upon the medulla spinalis in the neck, by coagulated blood, produced paralytic affections of the arms and legs; all the functions of the internal organs were carried on for thirtyfive days, but the urine and stools passed involuntarily.

Blood extravasated in the central part of the medulla in the neck, was attended with paralytic affection of the legs, but not of the arms.

In a case where the substance of the medulla was lacerated in the neck, there was paralysis in all the parts below the laceration; the lining of the esophagus was so

sensible, that solids could not be swallowed, on account of the pain they occasioned.

Where the medulla in the back was completely divided, there was momentary loss of sight, loss of memory for fifteen minutes, and permanent insensibility in all the lower parts of the body. The skin above the division of the spinal marrow perspired, that below did not. The wounded spinal marrow appeared to be extremely sensible.-Philos. Transact.

INTELLIGENCE.

On Wednesday, the 14th of June, Mr. Johnson, one of the Editors of this Journal, opened the body of a man who had been ill about fifteen months, and died the preceding day of a tumour which had been felt for several months above and to the right of the pubis, accompanied with excruciating pain in the groin, hip, and thigh of that side. During the last three months, the right thigh and leg were enormously swelled and edematous; the functions of the bowels were greatly deranged; the bladder could not bear distention with water, and the miserable victim dragged out a protracted existence in a state of the greatest sufferings that can well be imagined. At length, emaciated and worn out, he was happily freed from torture by the kind hand of death.

A very minute dissection could not be executed, as it was with difficulty that leave could be procured for inspecting the body; but the following were the principal morbid appearances.

The omentum wasted, and adhering in several places both to the peritoneum above and the surface of the intestines beneath; the colon, near the caput coli, was thickened in some places to three-quarters of an inch, and firmly adherent to a large tumour which touched and adhered to the pubis, the lower lumbar vertebræ, the sacrum, and right ileum. On the left side, where the colon ends in the rectum, a finger could scarcely be squeezed down into the pelvis along with the latter gut, so completely was the basin filled with this tumour. The external iliac artery of the right side passed over it in a groove on the left side of the tumour, while the anterior crural nerve traversed round it on the opposite side, and was pressed close into the hollow of the ileum in its way to the groin. An arm of this tumour, as it were, descended under Poupart's ligament with the great vessels, and there blended itself with the surrounding parts. The tumour had several coverings or layers of condensed cellular substance, which being stripped off, and the intestines, which also firmly adhered to the tumour, being dissected off, exposed a white irregular mass of the consistence, in some places, of hard suet; in others, and indeed

most places, nearly as hard as cartilage. It required the whole strength of Mr. Johnson's arm to tear it from the lumbar vertebræ and sacrum behind, and from the pubis before. The psoas magnus appeared entirely wasted and destroyed. Could it have been all carefully dissected out, it would probably have weighed three or four pounds.

The great displacement and tension of the anterior crural nerve accounts for the excruciating pain which this poor man suffered; and the pressure of the tumour on the trunks of the absorbents of that extremity sufficiently accounts for the vast oedema and swelling of the member. The firmest attachment of the tumour was to the lower lumbar vertebræ and upper part of the sacrum, from whence it unquestionably first sprung, as it rose between the anterior crural nerve and external iliac artery, separating them to an immense distance before they came in contact below Poupart's ligament. Various remedies were tried, but of course none gave more than temporary relief. Pills composed of ex. conii, submur. hyd. and ex. hyoscyami gave the greatest. The bowels were obliged to be kept soluble, otherwise the pain was much aggravated. In low. states of the barometer, and towards full and change of the moon, he felt exacerbations of suffering; at times he was quite easy. But what appeared most singular is, that notwithstanding the soli ty and firm attachments of this tumour, the size, and even the situation of it appeared often to vary materially. This, however, may be accounted for by the mass of intestines, and particularly the colon, attached to this tumour, where fæcal accumulations occasionally took place, and caused the variety of appearance. There were some very large nutrient vessels ramifying through this tumour. The apparent alteration, at times, both of position and size, occasioned much variety of opinion respecting its nature, and the above dissection and explanation may serve to put us on our guard in prognosticating on such occasions.

Croup. The general fatality of this disease must render every successful instance of treatment interesting. Mr. Johnson, one of the Editors of this Journal, was lately called, at a late hour in the night, to a child labouring under this distressing complaint. The croup could be distinctly heard before entering the house, and the symptoms were perfectly unequivocal. The child, 3 years old, was immediately put into a warm bath, at 98° F. a large blister applied to the neck, and the following powder to be taken, repeating it and the bath every two hours. R. Submur. hyd. gr. ij. pulv. antimon. gr. i. pulv. digital. gr. ft. pulvis secunda quaque hora sumendus ex melle vel vehiculo crasso. Till five o'clock in the morning there was little alteration. At this time the blister began to take effect, and by eleven the next day, or twelve hours from the commencement of medical treatment, there was a plain and great remission of the discase; twelve grains of

calomel, six of antimonial powder, and three of digitalis, had now been taken without either vomiting or purging. A laxative mixture was exhibited, which opened the bowels, and the same remedies, but at six hours intervals, were continued for a day longer, when the disease was subdued.

Dr. Lithgow has published two cases of the successful employment of the oil of turpentine in epilepsy*; the one a female, ætat. 23, had been subject to the attacks for six months, latterly they came on once or twice a week:-The second day after taking the remedy she had a slight attack, the menstrual flux was increased in quantity, and she never had a return of the complaint. The other a man, ætat. 28, subject to the disease ten years: purgatives and the more powerful anti-epileptic remedies had been tried in vain. Four drachms were diffused in a pint of peppermint water, of which a wine glassful was given four times a day. A week after, he had a return of the paroxysm, but in a slighter degree; at the usual period of return he had a few attacks, but so slight, they were scarcely perceptible, since which time he has been perfectly well. In the course of his recovery, he made use of upwards of two pounds of turpentine, without any sensible effects. A case of obstinate gleet of two years standing, has been cured by an injection of sea water; a variety of remedies had been previously tried without effect.-Edinburgh Journal, July.

Fresh testimonies of the utility of blood-letting in the ardent fever of the Tropical Climates are daily brought before the profession. In addition to those already published in our Journal, from various quarters, we subjoin the following extract from a paper of Mr. Allan, contained in the Edinburgh Journal. The disease frequently commences with symptoms similar to those described in Hogg's Case; yet, when it proves fatal, besides the peculiar yellowness of the skin, and the vomiting of a black coffeelike fluid, it is known to exhibit all the symptoms of debility and putrescency with which our descriptions of typhus (gravior) abound. Again, when it terminates successfully, the patient frequently, as was the case with Hogg, is not for a single day entirely confined to bed, and is commonly restored to health in a few weeks. Very few survive, when what is usually called the second stage has come on; that is, when essential relief has not been obtained within three or four days. But when the proper measures have been adopted at first, there very seldom appear symptoms,

* The use of the remedy was commenced February 15-period of publication July.

+ Vide, Dr. Lara's paper, vol. ix. p. 201.

Shivering, sickness, vomiting; violent and sudden starting; extreme heat; violent pain of head, neck, and eyes; delirium; lips and tongue parched and furred, &c.

either of putrescency or of remarkable debility after that period. If I were to speak entirely from my own limited experience, I should have said that the symptoms of extreme debility ought never to appear in the yellow fever, for I have met with no in stance of it, except in two cases, which proved fatal; and, with respect to both of these, I must candidly express my petsuasion, from what I now know, that both would, in all probability, have been saved by as liberal and extensive a use of the lancet as was practised in the other cases. One of them was partly, the other wholly, under my own management; and in both I had occasion to observe, with extreme but unavailing regret, the inevitable consequence of permitting, through inadvertence or mistake, the proper period for bleeding to pass, without taking the full advan tage of it, in a disease which runs its course with such amazing rapidity as the yellow fever. If, in such circumstances, the ef fect of blood-letting is tried, either on account of the irritation of the stomach, affected with perpetual vomiting, or from a belief that it may relieve the head, it produces a transitory quiet; but, as a friend of mine describes it, "local congestion has taken place irremoveably, the patient looks like a man intoxicated, staggers and faints; his pulse wants tone; and, though venesection gives temporary relief, the symptoms of an oppressed senserium always recur, and at last terminate in death."

"Blood-letting, therefore, will rarely admit of being employed after thirty-six or forty-eight hours, from the attack of the fever; but, when used, it ought to be large, and repeated frequently, at short intervals, till it has relieved the symptoms.

"If we examine the arguments against this practice, we find that we are cautioned not to be too free in the use of the lancet at the commencement of typhus fever, even in books pretending to give rules for the treatment of the yellow-fever, called typhus ícterodes, not on account of the debility existing at the time we prescribe it, but for fear of that which is to supervene in the latter stages of the disease. Nothing can be more absurd, nor productive of greater mischief in practice, than this doctrine is, as applied to the yellow fever. Indeed, it ought to be a maxim, that cannot be too strongly impressed on the minds of those who have to conduct the cure of this disease, that the debility resulting from the most copious blood-letting, employed in the early stages of the disease, is not to be compared to that which is the consequence of the disease, when allowed to riot unchecked for two or three days. The debility attending the attack of the disease, may truly be called indirect. It is like that debility in kind, though not equal in degree, which disables a man from performing all the actions of health, when he is comatose from pressure on the brain in apoplexy, or in accidental effusions of blood. The effect of bloodlet ting is to relieve this fulness of the vessels of the brain, to remove the pressure from the sensorium, and, in an indirect manner, to restore strength.