VIII. The Substance of a Clinical Lecture on a Disease of the Valves of the Heart, producing Pulsation of the Jugular Veins. By George Pearson, M. D. Valves of the Aorta. By George Pearson, M. D. ART. I. Observations on the Utility of Bloodletting as the principal Remedy in Continued Fever. By Mr John Allan, II. Case of Mortification of the Appendix Vermiformis Cæci, IV. Observations on the Cure of Cancer of the Womb by Ex- cision. By F. Bj. Osiander, Professor of Midwifery in the University of Göttingen, V. On a Newly Constructed Sound, for the covering the Stone in the Bladder, (with an Engraving.) By Mr James Barlow, VI. Reply to Dr Monro's Observations on the Discovery of VIII. On Yellow-Fever. By Mr J. B. Sheppard, IX. Case of violent Contraction of the Uterus, threatening Abor- tion, cured by copious Bleeding, and enormous Doses of Opium. By Mr Edward Lloyd Knowles, XI. Appearances on Dissection, in a Case of Humoral Asthma. Medical Extracts. No. IX.-An Analysis of the Mineral ART. I. Critical Review of the State of Medicine during the last II. An Experiment to ascertain the Effects produced on Sound Eyes, by the application of the Discharge from Eyes af- fected with Ophthalmia, &c. By Mr J. Mackesy, By ART. VI. A Case, disproving the Doctrine, that the Surfaces of a Page VII. Observations, with Cases, illustrative of a New, Simple, VIII. Cases of Laryngitis. By Ninian Hill, M. D. XI. Some Observations on Mr Lawrence's Introduction to ART. I. The History of the Small-Pox. By Mr James Moore, II. Some additional Experiments and Observations on the re lation which subsists between the Sanguiferous and Nervous Systems. By A. P. Wilson Philip, M. D. &c. III. Commentaries on some of the most important Diseases in Children. By John Clarke, M. D. &c. IV. Reports of the Pestilential Disorder of Andalusia, which appeared at Cadiz in the years 1800, 1804, 1810, and 1813; with a detailed Account of that fatal Epidemic, as it prevailed at Gibraltar during the Autumnal Months of 1804; also Observations on the Remittent and Inter- mittent Fever, made in the Military Hospitals at Col- chester, after the return of the Troops from the Expe- dition to Zealand in 1809. By Sir James Fellowes, M. D. &c. &c. ART. I. Observations on those Diseases of Females which are at- tended by Discharges, &c. By Mr Charles Mansfield II. On Gun-shot Wounds of the Extremities, requiring the different operations of Amputation, with their After- treatment; establishing the Advantages of Amputation on the Field of Battle to the Delay usually recommend- ed, &c. &c. &c. By Mr J. G. Guthrie, III. An Inquiry into the Causes of the Motion of the Blood, IV. Medico-Chirurgical Transactions, Vol. VI. V. A Treatise on Hernia, by Antonio Scarpa. Translated ART. I. A Treatise on the Diseases of Arteries and Veins, contain- ing the Pathology and Treatment of Aneurisms and Wounded Arteries. Engravings intended to illustrate some of the Diseases of Arteries. By Mr Joseph Hodgson, II. Materia Medica of Hindoostan, and Artisan's and Agricul- turist's Nomenclature. By Whitelaw Ainslie, M. D. 430 432 439 448 455 454 109 ART. IV. A Treatise on the Medicinal Leech, &c. By J. R. Johnson, Page. M. D. V. Commentaries on the Treatment of the Venereal Disease, ART. I. An Introduction to Comparative Anatomy and Physiology. 364 367 458 II. Essays on Insanity, Hypochondriasis, and other Nervous 467 III. Professor Authenrieth on Animal Chemistry, 473 IV. Compendium of Medical Practice, &c. By Mr James Bedingfield, 489 V. An Analysis of the Mineral Waters of Tunbridge Wells, 494 Quarterly Report of the Carey-Street Dispensary, Mr Lyon's Case of Unexplained Fracture of the Ribs, Diary of the Weather in the County of Antrim, Meteorological Tables for Sidmouth and Derby, Report of Diseases Treated at the New Town Dispensary, Table of the various Species of Hernia which have occurred in the Gene- ral Infirmary at Northampton, between August 1813 and August 1814, &c. 249 Quarterly Report of the Carey-Street Dispensary, Letter from Mr Grainger on a Ball found in the Heart of a Buck, Observations on some Causes of Deafness, with the means of removing pearance, complained, in the month of December 1809, of a pain in the right side of his neck, attended with a soft pulsating cir- cumscribed tumour, about the size of a pigeon's egg, which dis- appeared and returned on the application and removal of pres- sure. He had observed it forming some weeks before, but knew no cause. I candidly confess, that a disease of this kind, new to me, so formidable in its nature, and alarming in its consequences, produced very uncomfortable feelings in my mind. I foresaw, that, without an operation, the continued impetus of a vast co- lumn of blood to a diseased artery so near the heart, must be fatal at no remote period; and, on the other hand, neither my library nor my friends afforded me hopes of success from any method of treatment; but arguing whether it would not be better to incur the risk of blame, and take the responsibility upon myself, rather than leave the patient to a certain fate, I ventured (after pointing out the imminent danger) to propose an operation. He, judging, I suppose, from the little comparative pain, that there was no occasion to submit to such hazard, and perhaps indulging a hope that my prognostic might be fallible, would not consent; and from a want of confidence in myself, which in this instance I am not ashamed to acknowledge, and cannot even now deprecate, I did not press it. Palliatives were therefore only recommended, -rest, an avoidance of every thing which might quicken the circulation or determine to the head, such as exercise, crying, coughing, sneezing, or stooping, and withal a gentle pressure on the tumour by a flannel roller. As might have been expected, the disease gradually gained ground; and although it continued soft, fluid, and compressible, in four months it got to a very alarming size. The swelling, extended from the ear to the clavicle over which it rested, became very painful and pointed at three different places. Deglutition was impeded, and his speech affected. He now desired surgical relief, which at this stage was impracticable; and the catastrophe took place on the 15th July 1810, by bursting at the most prominent apex. Although I was sent for on the appearance of blood, and reached his house in a few minutes, I found him speechless and insensible; the hæmorrhage had ceased, but the skin was cold, and the pulse at the wrist scarcely perceptible. To give him the only chance which now remained of preserving life, I run a bistoury up and down the whole length of the sac, while the syncope continued, for the purpose of securing the bleeding artery, but in vain. An immense gush of blood followed. It then poured more slowly and weakly, and with so little impetus, from the loss already sustained, that I could not discover the jets in a sac of great capacity, filled partly with clotted blood and membranous fibres, and in a few moments he breathed his last. On dissection, I found the common carotid, arising from the subclavian, perfectly sound, until where it branches into the external and internal of that name. Here the disease existed. The sac was deep and of large extent, occupying the whole side of the neck, pushing the muscles to one side, adhering firmly to, and bounded by the integuments externally, the thyroid cartilage, os hyoides, and trachea internally, and pressing strongly against the vertebræ behind. It seemed of sufficient capacity to hold 12 or 14 ounces. But to convey a better idea of the nature of the disease, and the probability of success, had an operation been judiciously performed, I accompany this with two views, an anterior and posterior one, of the diseased artery, taken by my friend Mr Burke, with great exactness, from the dried preparation. |