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where they are placed? In the latter case, do they lie quietly in the parts? are they surrounded by a cyst containing matter? or may they be absorbed ?" He has never seen these ligatures come away; and there has been no abscess in any case after the healing of the wound, nor any other symptom that could be ascribed to the ligatures. He believes that the layer of lymph, which is so quickly effused on cut surfaces, covers and incloses these small threads, which must therefore be retained. But hitherto no opportunity has occurred of examining parts at a sufficient distance of time from their application to elucidate this point fully. He has, however, adduced, in the sequel of this paper, considerable evidence of the safety with which these little ligatures may be retained. Sixteen cases of various operations, and several experiments on animals, are related, in which this result was ascertained. "During the last ten months," he says, "I have employed this method of securing the arteries, in ten or eleven cases of amputation, in six operations on the breast, and in the removal of two testicles. The cases all did well, excepting a man who lost his thigh, and who died of an affection of the lungs: the wounds healed readily, and nothing was seen of the ligatures." The various kinds of silk used for these purposes are described, and the different degrees of accuracy with which they divide the internal coats of the arteries stated from experiment.
Mr Lawrence has contributed another long and valuable paper on the subject of those affections of the larynx, which require the operation of bronchotomy. The result of the numerous facts, which he has collected, is, that this operation is in itself altogether free from danger, as it has been performed many times with complete success, and has not in any instance produced unpleasant consequences: but that it is seldom effectual, unless performed very early; because the disturbance and debilitating influence of the impediment to respiration are of themselves fatal after a certain time, even if the original obstruction be removed.
Mr Brodie, continuing the investigation of diseases of the joints, has here made a long and valuable addition to his former communication, in a paper entitled "Further Observations on the Ulceration of the Cartilages of the Joints ;" and Mr Travers, in farther prosecution of his former proposal to remove a ligature within a short time after its application, has communicated some additional observations on the subject. He has continued to prosecute the subject experimentally, both with ligatures, and the compressor of Assalini, and obtained some conclusions, of which he intends to shew the practical application in a future communication.
Mr Howship has contributed an experimental paper, containing the result of some microscopical observations relative to the first processes of ossification in the growth and formation of the fœtus.
Among other interesting practical papers, those which exhibit the successful operations of tying the great arteries are not the least important. Mr Dalrymple of Norwich has added another case to that of Mr Travers, which was printed in the 2d Volume of these Transactions, of" aneurism by anastomosis in the orbit, cured by tying the common trunk of the carotid artery." After a lapse of two years, the cure appeared to remain complete. A case of axillary aneurism, occurring at Kingston, in Jamaica, in which the artery was tied below the clavicle, is related by Mr Chamberlaine: the operation was successful, and as the author observes, " affords a striking example of the competency of the anastomosing channe's to nourish the limb, when its principal artery has been obliterated at nearly the highest possible point that dissection can reach it, and that, too, at an early period of the disease."
Mr Chevalier briefly relates the success of the operation of bronchotomy in a case of croup, in a boy of seven years old, who appeared to be sinking, on the third day of the disease, from impediment to the breathing, with a livid countenance, and cold sweats. The child was speedily relieved, after the gushing out through the opening of about an ounce or an ounce and a half of a frothy mucus, of a reddish brown colour, which was followed by a full inspiration, which enabled him to cough up more of it. Mr Chevalier is of opinion, that the use of bronchotomy in croup results chiefly, therefore, from emptying the trachea of mucus, and thus enabling the patient so to cough, as to clear the branches of the bronchiæ, and admit the air to the lungs.
An extremely well-pictured case of cynanche laryngea is given by Dr Roberts, of Bishop Stortford, in which by his good management the disease was arrested. This is the more interesting, that the same patient, a distinguished physician himself, afterwards fell a victim to another attack of the disease. This we learn from a paper of Sir G. Blane, which follows, containing some remarks on this and other cases of the same malady. The patient was Sir John Macnamara Hayes, whose fatal case (with that of another amiable and excellent physician, who perished by the same disease about the same time) has been described by Dr Baillie in the 3d Volume of the Transactions of a private Society for the improvement of Medical and Chirurgical Knowledge. We do not fully accord with the
summing up of the President, in his paper which follows, upon the evidence of the good effects of particular expedients in the successful cases; inasmuch as he appears to us to put into the back ground the very remedy by which the disease was apparently subdued, in this first attack, namely, free blood-letting. And in the successful case, related by Mr Wilson, in the last volume of these Transactions, the patient was bled nearly to fainting. Surely, if the patient is seen within 48 hours of the attack, bleeding must be deemed the first remedy, and a large blister the second.
There are several other papers, each possessed of some interest, but of which we have left ourselves room for little more than an enumeration of the subjects. The dilatability of the female urethra has been manifested by many facts on record, and which are referred to by Dr Yelloly, in a short communication, in which he describes the case of a woman, through whose urethra a calculus, weighing upwards of 3 ounces troy, and measuring 74 inches in its larger, and 5 in its smaller circumference, passed, and was at length removed by the fingers only. One useful paper of Mr Barnes of Exeter details some cases and observations on the incontinence of urine, consequent to sloughing or ulceration of the bladder, from injury during labour. And a case of mortification of the uterus, occurring a few hours after delivery, is related by Mr Graham of Turnham Green. Dr Gumprecht, a Saxon physician, has contributed an account of the use of the Lactuca virosa, in hooping cough, with two cases, in which it appeared to be beneficial, after the inflammatory stage had subsided. It is impossible to abridge either the experiments or results of a chemical analysis; and we must, therefore, refer to the volume those who wish to be acquainted with the constituent parts of chyle and chyme, which Dr Marcet has subjected to analysis, and here described. He has also added a note, in reference to the use of silver as a test of arsenic, which he had mentioned in a former paper; having since discovered that the presence of phosphoric acid might produce a little ambiguity, which he here
Of the remaining papers, the most interesting is Mr Earle's account of the use of nicotiana in certain cases of retention of urine. The powerful effect of this medicine, administered as an enema, in strangulated hernia, led Mr Earle to the suggestion, in cases of retention of urine from spasmodic stricture. These cases are related illustrative of the sort of retention, and of the effects of the medicine.-" A case of Locked Jaw, cured by oil of turpentine given as a clyster," is related by Dr Phillips. This locked jaw was of an hysteric character, and was accompanied
by general convulsive paroxysms; and after warm-baths, antispasmodics, and purgatives had afforded but temporary relief, a glyster containing half an ounce of oil of turpentine, seemed to excite a rapid and general relaxation both of the jaw and the other spasms. The remaining papers consist of" a Case of Obstruction in the large Intestines, occasioned by a biliary calculus of extraordinary size," by Mr Thomas; "a Case of Incontinence of Urine of nine years duration, cured by external pressure," by Mr Hyslop; "a Case of an extraordinary enlargement of the Scrotum, with an operation successfully performed for its cure," by Dr Titley of St Christophers; "an account of a Case, in which parts of a fatus were found in a tumour situated in the abdomen of a girl two years and a half old," by Dr Phillips of Andover: "Two Cases of the true Elephantiasis, or Lepra Arabum," by Mr Lawrence and Dr Southey ;-and a " Case of Hernia Ventriculi from external violence, wherein the diaphragm was lacerated without fracture of the ribs," by Mr Wheelright.
From this brief and rapid sketch of the contents of this interesting volume, the reader will be able to form some idea of its value, and to determine the propriety of adding it to his library. Without occupying all the space allotted to the reviewing department in our Journal, we could not easily give the substance of these multifarious communications: we have endeavoured, however, to analyse those, which appeared to us the most important, and to mention the leading facts of the shorter and less comprehensive papers, so as to exhibit the character of the volume. And we congratulate the profession on the prospect of the continued additions to medical science, which we may confidently anticipate from the same source.
A Treatise on Hernia, by Antonio Scarpa, Professor of Clinical Surgery in the University of Pavia. Translated from the Italian, with Notes and an Appendix. By JOHN HENRY WISHART, Member of the Royal College of Surgeons, and one of the Surgeons to the Public Dispensary of Edinburgh. Illustrated by Fourteen Engravings. Edinburgh, 1814. 8vo, pp. 548.
E have on a former occasion given such a full account of this work, that nothing now remains for us to do, but,
in justice to Mr Wishart, notice his translation. The English reader is indebted to Mr Wishart not only for the translation, but for bringing within the reach of the public a book which, in its original form, is too expensive ever to be generally circulated. The translation possesses all those merits derived from the translator having a perfect knowledge both of the subject and of the language from which the translation is made. Besides, he has, we think, with great success shown the application of the anatomical language of Dr Barclay, by adding his terms in the form of notes; so that, whilst the common language of anatomy is used in the text, by referring to the notes any want of precision in the description is removed, and the reader familiarized with the new nomenclature. In no part of anatomy or pathology could the utility and advantages of this nomenclature be more strikingly illustrated; and it seems only to require time for the ear to become accustomed to the terms (some of which do not seem to have been the offspring of a very melodious ear), to introduce them into general use.
In an appendix the translator has treated of several useful topics, the omission of which was a defect in the original work, and has given an abridgment of a memoir added by the French translator M. Cayol. The value of this appendix will be appreciated from the following enumeration of its contents:
"Definition of hernia. Different names given to herniæ from their contents, situation, and the state in which they occur. General diag nosis of hernia. Diagnosis of inguinal hernia. Of the taxis. Of the operation for inguinal and scrotal hernia. Of the treatment after the operation. Of femoral hernia. Of the diagnosis of femoral hernia. Of hernia of the perineum, of the foramen obturatorium, of the vagina, and of the sacro-sciatic notch. Of hernia of the urinary bladder. M. Cayol's cases of mortification, occurring in an intus-suscepted portion of intestine in hernia."
In short, the translation is preferable to the original, except in regard to the plates; which are very poor indeed. But the fault is not Mr Wishart's, nor even the publishers; for engraving is, in this country, so expensive, that if fine plates had been indispensable, the translation could not have been published; and, after all, very indifferent engravings will readily supply all the defects of good description, which is their real purpose.
VOL. XII. NO. 46.