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MEDICAL AND PHILOSOPHICAL INTELLIGENCE.

Exposé of the State of Medicine in France during the year 1814, being the Anniversary Discourse of BARON DES GENETTES, as President of the Faculty of Medicine of Paris. [From the London Medical and Physical Journal, for April, 1815.]

GENTLEMEN,

A year has elapsed since one of our number, according to custom, opened the schools of medicine, by taking a view of the progress of medical knowledge during the preceding year.

I shall confine myself to the exposition of our labours; afterwards do homage to the memory of such of our colleagues as have been recently taken from us; and lastly, fix the public attention of their fellow pupils on such of our students as shall receive the prizes this day awarded.

Baron Boyer, our colleague, has published in the course of the year a "Treatise on Chirurgical Diseases and Operations." The author of this important work thinks that the progress of modern surgery has been so rapid and remarkable, that it seems to have attained the highest degree of perfection of which it is susceptible. The greater part of surgical diseases are now perfectly well known, both with respect to their phenomena or the indications which they present. We may even frequently ascertain their proximate causes, determine their essential character, and consequently the best treatment. Instruments and apparatus are simplified from day to day; and the application of medicaments is better understood.

Therapeutics and Hygiena, which sometimes of itself supplies their place, and always aids them, belong to both branches of the medical art; the improvement of the therapeutic and hygienic methods, therefore, equally ensure the success of internal and external applications; a new proof among many others, of the indispensable necessity of rendering common to medicine and surgery the same institutions, and consequently the same sources of instruction.

Improvements so great, admitted by the whole world, and the chief glory of which is cheerfully conceded to the French,

have rendered necessary the new publication of an entire body of chirurgical doctrine, to unite, in a treatise of a size at once convenient and elementary, knowledge scattered in books which would form a library.

M. Boyer, after the example of some of the restorers and promoters of the art, divides surgical pathology into two great parts. The first is dedicated to the diseases which appear in every part of the body, and is subdivided into several chapters, in which he treats of inflammation in general, of abscess, gangrene, burns, wounds, tumours, ulcers, and the various diseases of the bones and articulations.

The second part, drawn up after an arrangement purely anatomical, embraces the diseases peculiar to each organ. Most of the diseases which require surgical operations are referred to this division.

The author informs us, that it never was his intention to annex a complete treatise on operations, which would require immense labour. For these he refers to particular works on operative surgery, more especially to that recently published by M. Roux; adding, that the union of this work with his own will form a complete system of surgery.

On witnessing this association of a man of consummate experience with one who is still young, let those who are ignorant, or pretend to be so, of the state of our present method of instruction, cease to indulge in absurd declamations! Let them no longer repeat, in the face of direct evidence, that our school has never formed, and never will form, surgeons. We shall answer them by telling them that Richerand, Dupuytren, and Desormeaux, were seated on the benches of this school, before they sat among its professors; and that the former students of this school, such as Ribes, Tartra, Marjolin, Baffos, Beauchêne, Murat, Beclar, Baren, Brechet, and several others, promise to be the worthy successors of those who are now at the head of French surgery.

On reading M. Boyer's work, as well for my own instruction, as to give an account of it at this meeting, I could not refrain from making some reflections on the chapter entitled "On the Gangrene produced by Freezing." An eye-witness of the disasters which attended the retreat from Moscow, I

had an opportunity of observing, in an almost innumerable mass of men, the effects of the most rigorous cold.

I pass over in silence that perfidious sleep which fixes the body on a frozen bed, and induces inevitable death.

The doctrines of M. Boyer are entirely conformable to my own observations. To describe our sufferings would be to copy his whole chapter. Let us merely quote a few lines: "A sudden augmentation of very intense cold," says M. Boyer, "particularly when it is accompanied with wind, frequently occasions gangrenous affections and sudden death." We saw all this but too well verified, when, on the shores of the Beresina, a very violent north wind covered our faces with flakes of snow. The thermometer then stood at 21° below the freezing point; and it fell a few days afterwards to 24°, and even to 27°.

In another place M. Boyer says: "It has been thought that the cold extinguished the vital action, merely by coagulating the animal fluids; but the phenomena which accompany freezing announce that the cold acts on the solids also, and particularly on the vessels and nerves. It acts on the former by diminishing and even extinguishing their organic action; on the latter by blunting their sensibility, and thus preventing the exercise of their functions." We may go farther, and indicate a mode of action of cold, little known, a very intense effect on the brain and nerves, even when congelation has not attacked any part of the body at a distance from the centre of circulation. We have seen men, marching with every appearance of muscular energy, and the most decided and soldier-like pace, and heard them suddenly complain that a thick veil was covering their eyes. These organs, at first for an instant haggard, soon became immoveable; all the muscular apparatus of the neck, and more particularly the sternocleido-mastoidei muscles, became rigid, and gradually fixed the head on the right or left shoulder. The rigidity next extended to the trunk; the lower extremities then tottered, and the unhappy victim fell upon the ground, exhibiting, to complete the frightful picture, all the symptoms of carelepsy or epilepsy.

But to return to M. Boyer and his work: he has not entered into any details respecting the history of the art; he has not even indulged in a quotation, for this would not accord with VOL. V. 3 U No. 20.

his plan. "He is anxious (I copy his own expressions) to show what is proper to be done, and not what has been done, upon this or that occasion."

A professor, who, like M. Boyer, has been long in the prac tice of lecturing, must occasionally find his own ideas in circulation. He has, in fact, recognised some, and has informed the public of them, that he might not pass for the plagiarist of those who have actually copied from him.

In a word, the work of which we have just given a slight sketch, is worthy of M. Boyer's high reputation.

Professor Richerand has also published, in the course of the year, the sixth edition of his Physiology. Although not essentially different from the former editions, and, although the same arrangement is preserved, yet several points of doctrine have undergone modifications, corrections, and important additions. Some articles, which were formerly too concise, have received the desired extension. Taking advantage, in short, of the labours which daily enrich physiology, M. Richerand has learned how to found them, and to appropriate them to himself, so as to justify the title of "New Elements," which his celebrated work bears, the preceding editions of which have been already translated into several languages.

M. Alphonsus Leroy, another of our colleagues, has published a little treatise "On the Contagion which lately raged among the Cows, Oxen, and even the Human Race, in some Parts of France." He has therein discussed the causes of contagion, with the means of remedying and preventing them; and concludes by some reflections on the utility of extensive public lazarettos.

M. Leroy confesses that his work was hastily drawn up, on the spur of the moment, arising from the alarm of an approaching contagion which threatened the department of the Aisne, where, fortunately, however, it did not break out. The treatise is as it were a detached portion of an extensive work, which presents ideas in many respects new, but which are not yet arrived at the degree of maturity to which the author proposes to extend them.

M. Leroy, in his ardour for the advancement of medical science, and more particularly that branch which relates to the

health of the female sex, has had the boldness to advise, in a case of schirrous uterus, the revival of the operation first practised by Osiander, and since executed by M. Dupuytren with all the dexterity for which he is distinguished. I merely indicate these subjects, leaving it to our colleagues to give the interesting details to the public, if they think proper.

Our colleague, M. Petit Radel, continues to be occupied in editing several articles for the Encyclopedie Methodique. We know that almost the whole of the surgical part of this grand dictionary has been executed of late by this laborious professor. We shall find, in succeeding numbers, several medical articles, by M. Petit Radel; among others, those which relate to hereditary, moral, nervous, organic, rheumatic, soporific, and sy philitic diseases. We shall also therein find the article "Ancient and Modern Physicians, as well religious as atheistical."

It could not be difficult for our colleague to prove the reli gious character of several of our professional brethren, but has he shown with equal clearness that others among them have merited the reproach of atheism? Is not this rather one of those outrages inconsiderately committed upon great minds by the intolerance of ignorant sectaries, or by the interested supporters of the most ridiculous superstition? We see, on the contrary, that, even in the days of polytheism, the religion of the physicians, in conformity to reason, rose above vulgar credulity. How exemplary and beautiful was the worship of Galen, when, exploring the remains of men and the animals, the structure of which he was studying, he said to the gods: "I shall describe these wonders and they shall serve as the hymns by which I shall celebrate your power!"

The alarm, more or less well founded, relative to the introduction into the capital of a contagious fever, which raged in several places where the armies were quartered and fought, or left sick behind them, gave rise to instructions which were drawn up by the Faculty of Medicine. I shall respect the modesty of those who drew up these papers, and omit, like themselves, to publish their names.

Many physicians and students of our faculty have been sent to give assistance to the menaced and actually diseased departments. Others have been of great service in the hospitals of

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