Dr.Gregory's patient was seven years old, and had suffered with the disease above six weeks. Several remedies had been tried in vain. She appears to have taken liquor arsenicalis about sixteen days, beginning with three drops, and gradually increasing the dose to seven or eight. The medicine twice produced sickness, and was suspended, and in about three weeks the girl was discharged cured. For the use of so active a medicine as arsenic, we are astonished that minims are not preferred by Dr. G. to drops, which vary ac cording to the size and shape of the aperture through which they pass. Indeed on all occasions we think the minim-measure ought to supersede the use of drops. We have seen several cases of chorea, in which the digestive organs have not appeared to be affected, but, after a careful examination of the intestinal discharges, we have found reason to believe that the liver has been torpid; the fæces having been well formed, but not exhibiting that complexion, which is the result of a due admixture of healthy bile. Whether the hepatic disorder may have been primary or secondary, we cannot determine; but we have, in these cases, observed such a debility in the mental powers, as to occasion temporary idiotism. Both the mental and physical infirmities have however always been removed by the exhibition of a grain or two of calomel, repeated twice or three times a day, until the stools have a natural aspect, and the circulation, which was before slow and interrupted, has been accelerated for a sufficient length of time to insure a wholesome energy in the viscera, which were oppressed. 1 VIII. On the Efficacy of the Bark of the Pomegranate-Tree in EIGHT cases of tænia are related, in four of which a decoction of pomegranate was employed, and in the others the powder, with equally good effect. The decoction was prepared by boiling two ounces of the dried bark in a pint and a half of water, until it was reduced to twelve ounces. Of this two ounces were given every half hour, until four or five doses were consumed; when vertigo, sickness, and uneasiness in the bowels commenced. The medicine was then suspended, and at some time within twelve hours the worm was expelled. The powder was administered in the dose of a scruple to a boy, and two scruples to an adult, every haff hour, for five or six times, when the same symptoms and effects resulted, as when the decoction was exhibited. IX. On the Efficacy of the Bark of the Swietenia Febrifuga, as a effects will be found analogous to those of any other vegetable astringent. The cases which are brought forward, and the praises bestowed upon it, by no means satisfy us that it possesses any specific property in the cure of disease, besides what might be expected to result from its astringency. The pathology of fever is now so much better understood, than it was when cinchona was first introduced, that few modern practitioners will, we apprehend, be solicitous to obtain any substitute for a medicine which is likely soon to be nearly exploded. X. On the Physiology of the Ear. By JOSEPH SWAN, Esq. Lincoln. THE Medico-Chirurgical Society some time ago published a paper of Mr. Swan's respecting the physiology and pathology of the ear, in which he presumed that people born deaf and dumb, and who had no defect in the auditory nerves, might be made to hear through the medium of the facial nerves, and thus have their unfortunate situation amended. To substantiate this opinion, he has in the present volume adduced a case, in which the external passage to the ear was imperforate, and sounds were heard through the nerves on the face. The person can also speak intelligibly. Mr. Swan thinks that the reason why those who are born deaf are not more frequently able to acquire a degree of perfection in heating, is because their whole attention is apt to be taken up with signs, and no methods have been generally used to increase the power of the provision usually made by Nature for supplying the defects occasioned by imperfections of the tympanum. "Presuming that what I have said is well founded, it is not reasonable to expect that the powers of the facial nerves should. ever be fully developed in dumb children, if their instructers do not direct the whole, or by far the greater part of their attention to the proper exercise of these nerves. And if this is to be done effectually, it must probably first be by the assistance of instruments, to increase the effect of sound; and when these have been properly used, and have answered the intended purpose, then by gradually lessening their power until common sounds can be heard." P. 336. XI. Case of Amputation of Part of the Tarsus and Metatarsus, and Preservation of the Shape and Usefulness of the Foot. By JOHN DUNN, Esq. Scarborough. A BOY had suffered more than two years with caries in the bones of the tarsus attended with hectic fever. A tourniquet being applied to the thigh, Mr. Dunn cut through the extensor-tendons of the foot, and removed the os cuboides and the external cuneiform bone." No serious hæmorrhage followed. An improvement having taken place in the boy's health, about three weeks afterward the two other cuneiform bones, and the os naviculare were dissected out, and the diseased tarsal ends of the metatarsal bones of the second and third inner toes were sawed off. A profuse hæmorrhage and syncope followed. A part of the astragalus in front being diseased, was scraped away, and the hæmorrhage was restrained by dry lint and a roller. On the third day after this second operation, the bleeding returned, and the wounded vessel was secured. Sinuses made their appearance, but the foot was quite healed in two months by means of adhesive straps. The boy now walks without any pain or apparent lameness, and the natural appearance of the foot is but little altered, excepting that it is an inch and a half shorter than the other. Remarks on this case are subjoined by Mr. Copland Hutchison, in which he mentions an instance, where he removed several bones from the tarsus, after which his patient recovered with the use of his foot. XII. An Account of a Case in which numerous Calculi were extracted from the Urinary Bladder, without the Employment of Cutting Instruments. By Sir ASTLEY COOPER, Bart. F. R. S. "WHEN a great number of calculi are found in the bladder, as was the case in the Rev. Mr. Bullen, the circumstance is generally attended with an enlargement of the prostate gland, and it depends upon a sacculus being formed in the bladder directly behind the enlarged gland. In these cases the bladder is rarely completely emptied of its contents, and the calculi crystallize from the urine retained in this sac. "Such stones do not in general acquire the magnitude of those formed under the usual circumstances, and, from their number and collision against each other, their surfaces are generally smooth, and their shape is commonly rounded." P. 357, 358. "When calculi are thus placed, they are so concealed in the bag in which they are contained, that, in sounding, the instrument is liable to pass over them without their being discovered, and it is therefore necessary to dip the point of the sound towards the rectum as it enters the bladder, in order to detect them, or to pass the finger into that intestine, to raise them from the bed in which they are concealed; and it is for want of attention to this circumstance that I have known a person pronounced not to have the stone, from whom I afterward removed thirty-seven by the operation of lithotomy." P. 358. The instrument, which Sir Astley made use of in the case which he has published, was in the shape of a sound, consisting of two blades, that acted like a pair of forceps in grasping the stones. "Mr. Bullen was placed across his bed, with his feet resting on the floor, and a silver catheter was then introduced, and the bladder emptied of its urine. I then passed the forceps into the bladder, and was so fortunate in my first operation as to extract eight calculi. "The instrument gave but little pain on its introduction, but when opened to its greatest extent, and the stones admitted between its blades, their removal was painful, more especially at the glans penis, which appears to be the portion of the urethra, which furnishes the greatest resistance to the removal of the stones." 359. A dose of opium was given after each operation, which was repeated seven times before the calculi were all removed. We have had opportunities of seeing this distinguished surgeon make use of this instrument, which appears an admirable invention, and perhaps capable of still farther improvement. XIII. On Sloughing Phagedana. By RICHARD WILBANK, Esq. MR. WILBANK has generally noticed this disease in the lowest class of prostitutes. It begins in the form of an irritable boil, elevated and surrounded by a dusky inflammation, seated generally in the clift of the nates, in the groin, or upper part of the thigh. The apex of the boil vesicates, and, bursting, exposes a stratum of adherent straw-coloured flocculi, with a viscid secretion resembling pus, which is interspersed with darker points of a brown or gray tint. The surface enlarging, the centre becomes depressed, and the oval or circular sore is surrounded by a circumscribed thickening and an increasing halo of dark inflammation. From the darker points of the ulcer hæmorrhage occurs at times, and a peculiar fetid odour is observable. As the putrescence of the slough advances, much foul secretion appears, and shreds of pulpy matter are detached by the removal of the dressings. The sloughs are gray or dark brown. The pain becomes constant and agonizing, and the patient is found lying on her back with the thighs separated and bent upwards. The disease now spreads with rapid strides and is highly contagious. At length the constitution participates in the mischief which is going on: restlessness, loss of appetite, furred tongues, anxiety, pains in various parts of the head, accelerated pulse, hot skin, thirst, bilious vomiting and purging present themselves. Delirium rarely supervenes. Treatment. Mercury has been constantly found exceeding hurtful. Bleeding, particularly, in plethoric habits, is proper in the early stage; but leeches are objectionable on account of the tendency of their bites to assume the morbid action of the adjoining parts. Large doses of opium at regular intervals are serviceable, particularly where the stomach is irritable. Bark is generally contra-indicated by the disposition to diarrhoea. The local means, on which indeed Mr. W. places his principal reliance, both for relief and cure, consist in the application of nitric acid and other stimulating dressings. "The method from which I have derived most benefit is as follows if the disease be not far advanced, I at once apply the undilute acid, after cleansing the surface with tepid water, and absorbing the moisture with lint. Where, however, there is a thick and pulpy slough, it is better to remove as much as possible with forceps and scissors, before the application is made. The surrounding parts being then protected with a thick coating of lard or cerate, I proceed to press steadily and for some minutes a thick pledget of lint, previously immersed in the undilute acid, on every point. XIV. An Account of a Case of Tetanus successfully treated in the York Military Hospital at Chelsea. By M. A. BURMESTER, Esq. THIS was a case of traumatic tetanus preceded by fever, from exposure to cold and moisture. It was treated by copious depletion, opium, mercury, and the warm bath; and after ptyalism had been produced, the patient was directed to take the compound powder of ipecacuanha. Another case is mentioned in which an unexpected recovery happened apparently from the supervention of gangrene in the wound, after salivation had been established, and opium and the warm bath had been employed, without any visible advantage. XV. Case of a Separation of a Portion of the Uterus during severe Labour. By P. N. ScoтT, Esq. Norwich. · DURING a tedious and very severe labour Mrs. Hall felt the uterus suddenly snap. The pains instantly ceased, and uterine hæmorrhage came on attended with syncope, cold perspiration, feeble pulse, and vomiting of a brownish fluid. On introducing his hand Mr. Scott found among the coagula a portion of the uterus, containing the os uteri and an irregular part of the cervix surrounding it. The delivery was completed with the vectis. For four or five days it was necessary to evacuate the bladder with the catheter, distention of the abdomen with fever followed, and the bowels became exceedingly costive; but the patient at length got well. She has a slight prolapsus uteri, and menstruates. XVI. A Case of Inguinal Aneurism successfully treated by tying the external Iliac Artery. By EDWARD SALMON, Esq. Surgeon to the First Battalion of the Third Regiment of Guards. THE aneurism had existed ten months, and extended to Poupart's ligament. An incision was made through the integuments three inches and a half in length from the spine of the ilium to the face of the tumour. The aponeurosis of the external oblique was divided to the same extent. The internal oblique and the transverse muscles were divided with a probe-pointed bistoury to the extent of one inch and a half. The peritoneum being pushed aside, an incision |