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DISEASES IN SURGERY.
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There was nothing uncommon in the nature of the service on which the ship was employed at the time these diseases occurred. The stations were the Bay of Biscay, and coast of Newfoundland. A considerable number of the men had lately entered the service, amongst whom several cases of fever appear. ed, chiefly of the low kind. The depression of spirit in men newly impressed, I have some reason to believe, often excites the appearance of low febrile action. In one case treated under my care, and which terminated fatally, I was unable to assign any other cause than incessant sorrow, produced in the mind of the unhappy man, on being torn from his friends and relatives.
In cases of pneumonia, I remarked the happy effects produced by extracting blood, in very large quantities. In any important case, I have frequently taken away twenty-eight ounces with great relief, and without bringing on syncope. On an early complaint, I have extracted blood to a large amount, even more than what the symptoms present would seem to indicate, with a speedy return to health. I have also been told by several en
lightened surgeons, that they followed a similar practice, but bled at first to a greater extent.
A case of chronic hepatitis occurred, in which I had an opportunity of observing an extreme lentor of the circulation con, nected with accumulation, and symptoms which indicated a degree of inflammation not very inconsiderable. I endeavour, ed to point out the great necessity that existed for extracting a moderate quantity of blood, but by reason of objections from a certain quarter, I was not permitted to do this. However, the patient being sent to Deal Hospital, I had the pleasure of seeing what I had recommended in vain, practised with the greatest relief. It was, in this case, a singular circumstance to observe, first, an extreme slow feeble pulse, languid and dejected appearance; secondly, the great and revivifying effects produced on the first blood-letting, which amounted to twelve ounces.
Four cases of erysipelas phlegmonoides appeared at a period when we had been a considerable time on salt provisions. The persons affected were of an irritable constitution naturally, which was increased to a great degree, by the unavoidable peculiarities of a naval life. Cold applications agreed best with these complaints in the first stages; and spirituous ones in the last.
August 25, 1815.
Dr W. Philip has presented to the Royal Society of London the Third Part of his Experiments and Observations on the Relation which subsists between the Sanguiferous and Nervous Systems. This part relates chiefly to the nature of secretion, the use of the ganglia, and the cause of animal temperature. It appears from the experiments related in it, we understand, that secretion, as several authors have supposed, is wholly a function of the nervous system, the vessels only supplying the fluids to be operated upon; that the combination of the influence of the whole brain and spinal marrow, by means of the ganglia, is necessary for the due performance of secretion, thus demonstrating why it is necessary to combine the influence of these organs; that galvanism is capable of performing the more complicated as well as the more simple functions of the nervous influence, from which he infers its identity with that influence, and that the evolution of caloric from the blood, which supplies animal temperature, is occasioned by the same laws by which the secreted fluids are prepared, and consequently must be regarded as a secretion. It appears from his experiments, we are informed, that the evolation of caloric from the blood is little, if at all, connected with the change of colour from that of arterial to that of venous blood.
On Premature Births. By a Physician Accoucheur. Dr Rodman, P. 455 of the last Number, has given a very instructive narrative of his judicious and praiseworthy endeavours to preserve the life of a premature infant, who was born particularly feeble and debilitated.
From the report of its mother, Dr Rodman believes that this child, at the time of its birth, had not attained quite 19 weeks of · uterine gestation ; he admits, however, the probability of scep
ticism on this point, and I must confess that I am one of the sceptics.
My reasons for differing in opinion from Dr Rodman are drawn from the dimensions and weight of this infant, compared with those of others at a similar period of pregnancy.
Dr Rodman informs us, that at three weeks after its birth, the child measured thirteen inches, and weighed one pound thirteen ounces avoirdupois. Now, it must be supposed, that, during the first three weeks after its birth, the child could not have increased much either in length or weight, for it was ex. tremely difficult to get it to swallow nourishment the first week;' • the yellow gum soon came on;' • the thrush seized him by the eighth day,' and was not cured till the end of the third week. We may therefore fairly infer, that the child, at this period, could not be so large as if it had passed those three weeks in the womb. It remains then to be inquired, what ought to be the size and weight of a fætus at twenty-one or twenty-two weeks after conception ?
Mr Burns, in his Principles of Midwifery, first edition, p. 116, says, that in the fourth month the fætus is about five inches long; in the fifth month, six or seven inches; in the sixth monih, eight or nine inches; in the seventh, eleven or twelve ; in the eighth, about fifteen inches.
M. Gardien, an eminent accoucheur at Paris, in his Traité d'Accouchemens, Tom. I. p. 481, gives nearly the same dimensions. He says, at two months, the fætus measures rather more than two inches long; at three months, three inches and a half; at four months and a fortnight, four inches and six or eight lines ; at five months, seven inches and a half; at six months, nine inches six lines; at seven months, eleven inches.
According to these scales, therefore, it appears that Dr Rodman's fætus, at twenty-two weeks after conception, measured considerably more than is usual for infants at seven months.
The weight of the fætus likewise was greater than common. Mr Burns says, that the ordinary weight of a fætus in the sixth month is one jound Troy; but the infant in question, at twentytwo weeks, weighed one pound thirteen ounces avoirdupois, which is more than double the weight stated by Mr Burns.
Upon the whole, it is to be wished that this matter should be reconsidered; for if the authorities I have quoted are to be relied upon, there must be a very considerable error in the account given to Dr Rodman. Should that intelligent physician have time and opportunity of pursuing this curious and interesting inquiry, he will doubtless be enabled to throw much light upon a subject at present very far from being well understood.
London, October 11, 1815.
The following law report, inserted in the Morning Chronicle, 9h December 1815, is worthy of attention, as a confirmation of a similar opinion given by the Court of King's Bench a few months ago.
• The King versus John Taunton. This was an indictment against the defendant, a surgeon, for inoculating children with the small-pox, and causing them to be carried to and from his house, through the public streets, while labouring under that disease.'
The trial, however, was allowed by the Attorney-General to stand over, parıly in consequence of the absence of the senior counsel for the defendant, and partly in consequence of a promise from the latter, that he would desist from this pernicious practice. But Mr Justice Bayley, in granting this permission, yave the following exposition of the law.
• I hope it is sufficiently notorious, that the causing persons to pass through the streets, who may have that disorder (smallpox) upon them, although they are going for medical advice to some person in wliom they have confidence, is an indictable of fence; and if that person, instead of attending them at their own houses, as he might do, chooses to direct that they shall from time to time be bronght or come to him, there is no question but that he is liable to an indictment.'
The Attorney-General added, " The few sentences which your Lordship has now pronounced, are of the highest importo ance to the community.
We are glad that opinions, which we have long considered as founded in common sense, should be declared by such high authority to be equally founded in law. In most countries on the Continent, even before the discovery of cow-pox, inoculation was subjected to certain restraints; and, since vaccination has been known, it has been utterly abolished. In Britain alone, from a false notion of liberty, has the pestilence been perpetuated and disseminated by a set of interested individuals. But the liberty of doing mischief is not the birth-right of any man ; and, with the precedents afforded them by the highest authority in the land, we trust that Magistrates, in every part of the country, will prosecute inoculators, indifferent about the lives of their neighbours, with all the severity necessary to put an effectual stop to the commission of a nuisance of so aggravated a nature.
A Society has lately been formed in Worcester, under the name of The Medical and Surgical Society of Worcester,' consisting of about 50 members, and including almost all the medical men of the city and county, which meets once a month. Its objects are the dissemination of Medical Knowledge amongst its members, the discussion of points of practice, and the keeping in the view of its members the principles of the profession. Each member, in his turn, gives in a subject of conversation, to which the attention of the Society is confined for one or more meetings, according as the subject is more or less important and interesting. The Institution admits of honorary and corresponding members, in the hope of receiving communications from medical men who reside at too great a distance to attend its meetings.
Nero Publicatiims. In the Press, and shortly will be Published, Rudiments of the A. natomy and Physiology of the Human Body, in a Saries of Progressive Lessons, consisting of several Tables, &c. ; accompanied with appropriate Explanations. Designed for the Use of Students of Medicine, at the Commencement of their Anatomical Inquiries. By T. J. Armiger, Member of the Royal College of Surgeons in London, &c. late Demonstrator of Anatomy at the London Hospital.
Young on Consumptive Diseases. 8vo. 12s.
Elements of Pathology. By Dr Parry of Bath. Svo. 148. T. Underwood, 32, Fleet Street.
ERRATA. Vol. XI. Page 431, line 1, between the word should and differ insert not.
449, line 29, for know read one.
+++ Communications have been received from Mr CRAWFORD, Mr EDMONDSTONE, Mr Moore, Mr MURRAY and Mr BARLOW.
Communications be addressed to the Editors, to the care of Messrs CONSTABLE & Co. Edinburgh ; Messrs LONGMAN, HURST, Rees, ORME, & Brown, London ; and John CUMMING, Dublin.
No. XLI'I. will be Published on the 1st of April 1816.