After this exquisite specimen, which shews the Augustan age of medical literature in which we live, we shall make a few calm observations.

We are not "toad-eaters," or "sycophants" of the College. The regulations that have been rescinded never had our approbation,-quite the contrary; but we cannot put ourselves in a fury because we see the liberal portion of the cabinet prevail over the illiberal. That this ascendancy may continue to gain strength is our sincere wish; and we rejoice at this unequivocal indication of such ascendancy.

That item of the new regulations which requires attendance on two courses of anatomical lectures, and two courses of dissections, previously to county hospital time being allowed, is designated as "most diabolical." These are hard words; but then we must make allowance for the intense morality of the Press. "Will any prudent parent," says this exemplary monitor, "allow his child to be on the pavé of this metropolis without a protector, at the age of fifteen or sixteen?" This reminds us of the soldier's anxiety for the safety of the church, în Goldsmith. What dreadful risks must the youth of 15 run, in this metropolis! He may be allured to his ruin by some warbling syren-or transformed into a hog by some enchanting Circé—or, what is far more likely, he may be MACADAMIZED while crossing some public thoroughfare in his way from one lecture-room to another!

None of these things can possibly happen when he has attained the mature age of 19 or 20. But as hospital practice is only a counter-part of private practice, and as many people have thought that some knowledge of anatomy, and some acquaintance with the principles of surgery, were absolutely necessary as preliminary steps for seeing, with advantage, the one, or acting with safety, in the other, we venture to say that, not only the county hospital time, but the metropolitan also, should be subsequent to a certain attendance on anatomical and surgical lectures. It would be a most edifying sight to behold a youth of 18 or 19, coming up to town with certificates of his hospital education complete, before he had performed a single dissection, or attended a single lecture! We would recommend, on the contrary, that the youth should be kept at his general education till he is 17 -that the next two years be dedicated to the acquirement of pharmaceutical knowledge-that one year's study of anatomy and surgery, at least, should precede his attendance on hospitals-and that the choice of hospitals, whether in town or country, be guided by the circumstances of the individual.

62. IRON BLISTERS.

Sir Anthony Carlisle has invented a new mode of metallic blistering, which he considers to be superior, cheaper, quicker, and, on the whole, less painful than the common mode of proceeding with the emplastrum lyttæ The process consists in immersing a piece of polished iron in boiling water, for five or six minutes, and then applying it to the part which is to be blistered, interposing a piece of wetted silk. The hot instrument is to be kept on the part for three or four seconds. The pain is considerable—an inflammatory process is set up-serum is exuded-and the cuticle detached. We do not deem ourselves justified in hazarding any opinion on the comparative merits of this mode of blistering, as we have not yet put it to the test. It may be useful in hospital practice, and in private life, where great dispatch is desirable. We do not apprehend, however, that it will ever come into general use in private practice, on account of the prejudices which are entertained against instrumental operations--in short, against

the perils that environ

The man that meddles with hot iron.

63. IMPORTANT ANATOMICAL DISCOVERY!

Two columns and a quarter of the LANCET are occupied with a most profound enquiry, “Whether the thumb has a metacarpal bone and two phalanges, or no metacarpal bone and three phalanges?" After ransacking a host of authors, from Aristoteles (who was a great anatomist in his day) down to Blumenbach; it is at length determined that the thumb is the longest as well as the strongest finger of the hand, although it disdains to walk upon stilts, like its four ambitious neighbours.

64. NEW PATENTS.

The Radical Press Company have obtained a patent for VITUPERATION, and are determined to prosecute with the utmost rigour of the Law, all those who dare to invade their property.

65. NON-JURORS—RETARDATION OF MEDICAL SCIENCE.

A luminary of the Radical Press, a soi-disant fellow of the College of Physicians, has discovered that the great impediment to the march of medical science is the subscription to the 39 articles of the Church of England, enjoined by the College on its members. He, therefore, calls upon the medical profession to rise, en masse, "physicians, surgeons, and apothecaries, either to establish a new and more liberal College of Physicians and examiners, or to ameliorate and rescind the offensive regulations of the old one." The Radical Press has unquestionable power to call spirits from the vasty deep-But, query, will they come ?-Nous verrons. There may be defects in the College of Physicians, as in all other human institutions; but, Heaven defend us from the democracy of the Medico-Radicals! There is little danger, however, that these gentry will be listened to, either in or out of Parliament.

Non tali auxilio, nec defensoribus istis,
Tempus eget.

66. PREGNANCY COMPLICATED WITH HYDATIDS.

Dr. Thuillier, of Amiens, has published a case of this kind, in a late No. of the Journal General, of which we shall give a brief abstract in this place. Case. Mad. Hec.—aged 40 years, had been plunged in misery and distress, from her own bad conduct, for some years. She was subject to attacks of lipothymia and vomiting after eating. For four months the menses had been wanting, and it was supposed she was pregnant. Dr. T. examined, but could not decide on this point. The woman herself, who had borne nine children, did not consider it as pregnancy. She believed, from the vomiting after food, that she laboured under scirrhus of the stomach, of which complaint her mother had died. Low diet and diluents were prescribed. There was now developed much irritation about the uterus, and leeches were applied to the groins and vagina. The irritation was removed. The stomach complaint was now much relieved. A month or more after this, our author was hastily summoned to Madame H. who was said to be in labour. The uterus was now much larger than when last examined, and seemed to fill the pelvis. There were bearing-down pains, and in these, the uterus felt very turgid. The os uteri, however, was close, and no discharge from thence. The pains persisted, without any alteration in the cervix or os uteri. This state continued three days more, when it was perceived that, at each bearing-down pain, there was some discharge of clear water. This was followed some days afterwards, by a large number of hydatids, of various sizes, from an inch in diameter downwards. She continued to pass these

bodies for fifteen days. In the mean time the size of the uterus rapidly increased, and rose out of the pelvis. It was now ascertained that there was a fœtus in utero, and yet the hydatids were discharged daily in considerable quantities. Three or four months after this, she was delivered of a child at the full term, the hydatids having never ceased one day to be discharged. There were one hundred and forty-eight of these bodies collected, and the number broken and unobserved could not be estimated. The patient recovered and did well. She has since become pregnant.

67. CURE OF PHTHISIS BY MERCURY.

Our readers will be able to draw their own conclusions from the following case. A young man, a West-Indian, 25 years of age, had suffered severe attacks of pulmonic inflammation, for which bleeding and other antiphlogistic measures were employed. After this, symptoms of phthisis were developed in a very unequivocal character, when he came under the care of Dr. Dufau, of Mont de Marsau. The symptoms need not be detailed here. The principal were copious purulent expectoration-hectic fever-perspirationsdifficulty of breathing-pain in the chest-emaciation to an extreme degree. The right side of the chest emitted a very dull sound on percussion. In this condition, symptoms of constitutional syphilis appeared, and determined Dr. Dufau to put the patient on a course of sarsaparilla and the oxymuriate of mercury, as his case could hardly be rendered worse, the course of a month, the phenomena of phthisis gradually subsided, and the young man was ultimately restored to complete health. The sound of the right side of the chest became as clear as that of the left.

In

The author comes to the conclusion that the phthisis, in this case, had something special in it-in short, that it was of a syphilitic character, and that, on this principle, the cure was effected by the sarsaparilla and oxymuriate.

68. NEW OPERATION FOR PILES.

Dr. J. C. Rousseau has proposed, in one of our American contemporaries, a new mode of removing those fungous excrescences around the anus, which are occasionally found to exist when piles have become permanently protruded, giving rise to troublesome ulcerations, hæmorrhage, fistulæ, &c. The mode of removal proposed by Dr. R. is by a multiplicity of ligatures, between each of which only a small portion of the excrescence is to be included. For this purpose, he arms a needle with two different coloured threads, and then thrusts it through, from the verge of the anus to the outside of the tumour, and again from this side to the former, and so on alternately until the whole bulk has been stitched all around, observing between each passage of the needle to keep a distance of about one-third of an inch, on the outside, and much less on the inside. When this process is finished, (leaving a loop of ligature loose at each pull of the needle,) the ligatures are to be divided in the loops, and then each tied to its corresponding branch. By this means the whole mass, without any intervening portion, is inclosed in ligatures.

We cannot but consider this as a tedious and somewhat difficult process, and moreover unnecessary. For where old piles are thus consolidated into external fungous excrescences, there can be little danger in removing them by knife or ligature. This, however, is not the opinion of Dr. Rousseau, and to him we must bow. At all events, this mode of operation will not do for the more difficult and dangerous removal of piles which come down only occasionally, and which are of far greater detriment to the patients' health and comfort than the external tumours.

69. FRACTURES of the CERVIX FEMORIS.

To the strong phalanx of cases brought forward by Sir Astley Cooper, proving the want of bony union in cases of fracture of the cervix femoris within the capsular membrane, Mr. Mayo has lately added another. A woman, 50 years of age, had a violent fall on her hip. The limb was not sensibly shortened, but was rendered useless. Pain and swelling succeeded, and she was confined to her bed for five months, when she regained some degree of strength in the injured hip, and gradually became enabled to walk, with the assistance of a stick. Thirteen months after this accident the woman died of apoplexy. On examination, the case was found to have been fracture of the cervix femoris within the capsular ligament. "Union had taken place by means of an intervening layer of soft but tough substance, from two to four lines in thickness; in which, however, nothing like commencing ossification was detected."

For some speculations on the causes of this non-union, we refer our readers to the 6th number, new series, of the Medical and Physical Journal.

70. INTERNAL STRANGULATION.

If dissection followed death in every case of what is called fatal enteritis, or obstruction of the intestines, several would be found to depend, not on inflammation, nor yet on accumulation in the cavity of the intestine, but on a mechanical obstruction-in fact, on an internal hernia. It is not long since we recorded a curious case of this kind, in the person of Mrs. Belzoni's servant and fellow traveller. Some cases are on record where the appendix cæci vermiformis had strangled a portion of intestine. Dr. Brown, of Sunderland, has lately mentioned a case where "the vermiform appendix had contracted an adhesion to the mesentery, and thus formed a loop, or noose, by means of which, a portion of small intestine, about two yards in length, was completely strangulated." The symptoms resembled those of strangulated hernia; but, as there was no external tumour, bleeding, purgatives, enemata, &c. were properly employed. All means failed, of course, and the foregoing phenomena presented themselves on dissection. In this case, and in that also of Mrs. Belzoni's servant, gastrotomy would, in all probability, have saved life, if performed before sphacelus had taken place. But who will be so bold as to perform this formidable operation on the chance of there being a mechanical strangulation capable of liberation ?

71. PHLOGOSIS OF THE RETINA.

It is probable that many cases of amaurosis depend on inflammation of the retina itself, as well as on affections of the optic nerve within the head. There are instances on record where the sight was suddenly lost, by this species of phlogosis, and as suddenly restored by proper means. Two cases of this kind recently occurred in Bartholomew's Hospital, and are reported from that institution. The first was a man who went to bed without any affection of the eye, but, in the morning, found the sight of the right eye much impaired, and, in a few hours more, almost entirely lost. There was some inflammation of the conjunctiva-the pupil natural-pain in the head and eye. He was bled ad deliquium, and had a cathartic of calomel and jalap. After the operation of the medicine, he was directed to take calomel and opium every six hours. Next day, he was bled locally from the temples, and in another day he could read the smallest print.

The other case was nearly similar but of longer standing, and required, besides the sanguineous evacuations, some days' continuance of the calomel and opium.

In such cases the treatment should be prompt, otherwise the delicate structure of the retina may be irrecoverably disorganized.—LANCET.

X.

EXTRA-LIMITES.

I.

MR. LIZARS' OBSERVATIONS ON LITHOTOMY.

TO.

The Editor of the Medico-Chirurgical Review of London.

SIR, Although, probably, more has been written on lithotomy than on any other surgical operation, yet, judging from the writings of our most learned modern physicians and surgeons, we seem to be still ignorant of its fundamental principles. I am led to these observations by two papers lately published, by Dr. Monro and Mr. Allan, in the 3d and 4th numbers of the New Edinburgh Journal of Medical Science, in which I am obscurely alluded to.

In the 3d number, Dr. Monro states, "Mr. Allan informed me, that he had met with an instance, in which there were two stones lodged within the bladder. One of these was readily removed by the forceps, but the other could not be extracted at the time; it, therefore, occurred that, as the groping for a considerable time with the forceps in the bladder proves extremely dangerous, it would, at the moment, be more prudent to desist from further attempts to extract the stone, which was then firmly grasped by the contracted portion of the bladder, and that the stone would probably come away of itself along with the urine, in consequence of the subsequent relaxation of the contracted part of the bladder."

In Number 4, the Doctor says, "since the publication of my observations on spasm of the passages for the food, the bile, and the urine, I have received the following important communication from Mr. Allan, surgeon, which affords a striking illustration of the spasmodic power of the bladder of urine. I WAS PRESENT AT THE OPERATION to which Mr. Allan has alluded, in the performance of which, the dexterity of the operator was no less conspicuous than his coolness and sound judgment.

IMPORTANT COMMUNICATION.

'Letter from ROBERT ALLAN, Esq. F.R.S. E. Surgeon to the Royal Infirmary, and Lecturer on Surgery in Edinburgh, to ALEXANDER MONRO, M.D. F.R.S. E. &c.

VOL. VI. No. 11.

T