under almost constant pain in the head and many sleepless nights. Although the boy was much emaciated, and had a livid countenance, he seemed to possess a good original constitution.

"Dr. Wuth's diagnosis led him to a favorable prognosis. He showed the patient to the Hanover Medical Society. The views of the members on the nature of the disease were much divided. Some thought it medullary fungus, other exostosis, osteo-sarcoma, a tumour in the orbit, &c. Dr. Wuth gave it as his opinion that a large polypus occupied the frontal sinus, which he trusted he should be able to remove by an operation. To this he proceeded next day, by making first a vertical incision, two inches long, from the root of the nose upwards through the soft parts, and then a horizontal one, also two inches long, close above the eyebrow. He next dissected off the triangular flap thus formed, so far as to permit the frontal sinus to be trepanned. In the middle of the superciliary arch was a small hole in the bone, scarce a line in diameter, opening into the sinus, and explaining the source of the fluid already mentioned, which had kept the soft parts in an inflamed and fungous state. This state of the soft parts caused a considerable bleeding in the course of the two incisions. In consequence of the great dilatation of the sinus, it was necessary to make two openings into it with a small trephine, whereupon an immense quantity of polypi protruded, being connected together like grapes, and covered with a milk-white fluid. Dr. Wuth removed the greater part of the polypi with cutting instruments. After washing away the slimy, milk-white fluid, he remarked that the polypi internally were of a yellow colour and partly transparent, and that within each polypus there ran two or three vessels, giving off branches on all sides. The upper portion of the cavity contained mucous polypi, which felt partly soft, and yielded readily to pressure, but were partly firmer and of cellular texture, so that out of the cells a white, slimy fluid could be pressed. In the middle of the cavity the morbid product became denser and more opaque; posteriorly and towards the parietes of the cavity, it assumed a fibrous structure. The cavity terminated towards its inner and outer sides in small sinuses, or cellular spaces, in which the polypi lay firmly imbedded. "Dr. Wuth next directed his attention to radically destroying the remainder of the disease, attached to the parietes of the cavity and contained in its cellular spaces, selecting such means as were not likely to act injuriously on the very thin osseous partition, separating the cavity from the brain, and which was felt to yield to gentle pressure with the finger. He felt with his finger, lightly applied, the pulsation of the brain, and was afraid lest so thin an osseous partition might yield to the movements of the brain, now that the counter-pressure was removed by emptying the cavity of its contents. He now bored through the osseous parts from the cavity of the nose to the frontal sinus, as the ethmoid cells, conchæ, &c., and introduced a silver canula, so that the fluid collected in the sinus might flow off unconfined. Further, to remove the stillicidium lacrymarum which had arisen from the compressed state of the nasal duct, he perforated the nasal bone from without inwards, so as to meet (if we understand him right,) the artificial canal just mentioned, and here put in a second tube. After a time, being convinced that the tears had a free passage, he removed the tube from the artificially-formed nasal duct; and feeling assured of the healthy state of the frontal sinus, he removed also the canula, leaving the opening into the sinus to close.

"The healing of the parts occupied twelve months, the frontal sinus being by that time considerably lessened in all directions, and the eye having partially returned into the orbit. The ulcer of the cornea cicatrized soon after the operation, leaving a leucoma, which during the succeeding years diminished considerably, so as to permit the sight to improve. The physiognomy of the body became much more tolerable. From the first night after the operation he enjoyed sleep, such as he had not had for years. The first six weeks he spent chiefly in sleeping and eating, whereby his exhausted constitution was speedily restored. After this Dr. Wuth saw the lad twice a year, and each time found the disfigurement to be diminished.

"With regard to the applications made to the parietes of the sinus, in order to restrain any new growth, Dr. Wuth was afraid to use lunar caustic or kali causticum, and employed laudanum, Goulard's extract, and kreosote, pencilling the parietes with a mixture of equal parts of the two former, and then applying a salve, composed of an ounce of zinc ointment and ten drops of kreosote, spread on lint."

From the above case, Dr. Wuth draws the following physiological and pathological conclusions :

1. The possibility of the continuance of the power of vision under gradual traction and elongation of the optic nerve.

2. The enormous enlargement of which the frontal sinus is capable,— equal in this case to the containing of three hen's eggs.

3. The return of this osseous cavity almost to its normal form.

4. The complete division of the supraorbital and frontal nerves did not in this case injure vision.

5. Pain is not a pathognomonic sign of the malignant or benignant nature of a swelling, a fact illustrated also by cases of induration of the mammæ and other organs, which by their spontaneous disappearance show their non-malignant nature.

ART. XVI.

The Lost Senses-Deafness. By JOHN KITTO, D.D. (Knight's Weekly Volume for all Readers.)-London, 1845. 12mo, pp. 206.

THIS is a unique book. The autobiography of a totally deaf man, of one whose "deafness could not be more intense had the organs conducive to the sense of hearing been altogether wanting." The writer is an author much esteemed, we believe, by biblical critics. His powers of minute observation, and of vivid description, and his vast amount of information are displayed in the notes to 'Knight's Pictorial Bible,' which are his writing, and this little work leaves a strong impression of his intellectual power. We learn from it that he has secured by his own exertions an acknowledged place among men of letters, and that moreover literature is the permanent employment to which he dedicates his life, and that it enables him, like any other successful profession, to support his family. But we pass, at once to his own story.

Dr. Kitto sprang from the very poor. His father was a jobbing mason, in precarious employment. He was slating a house. This son, a boy of 12, who, to the neglect of his school-education, lent "his small assistance," was carrying up a load of slates, and was stepping from the ladder to the roof when his foot slipped and he fell backward, thirty-five feet into the court below. He was stunned. For a moment he was conscious whilst his father, followed by a crowd, was carrying him home; but the succeeding fortnight was a blank in his life, and when he "awoke one morning to consciousness, it was as from a night of sleep." He attempted to spring up in bed, marvelling he had slept so late, and was astonished to find that he could not even move. He was slow in learning that his hearing was entirely gone. His utter prostration overcame any curiosity; and it was not until some time afterwards on inquiring for a book that had

been promised to him, and was impatient at not comprehending the signs which were made to him, that one of his family wrote on a slate the awful words, "you are deaf." Awful, however, rather in retrospect, as he was a child, and knew not the future. "It was well I did not. It was left for time to show me the sad realities of the condition to which I was reduced." The recognized routine of remedies was tried. "They poured into my tortured ears various infusions, hot and cold; they bled me, they blistered me, leeched me, physicked me; and, at last, they put a watch between my teeth, and on finding that I was unable to distinguish the ticking, they gave it up as a bad case, and left me to my fate." Subsequently a seton in the neck, and electricity were tried, but "no good came of it." And with good sense he adds, "Indeed I have not sought any relief; and have discouraged the suggestions of friends who would have had me apply to Dr. This and Dr. That. The condition in which two thirds of life has been passed, has become a habit to me-a part of my physical nature. I have learned to acquiesce in it; and to mould my habits of life according to the conditions which it imposes; and have hence been unwilling to give footing for hopes, and expectations, which I feel in my heart can never be realized."

It was some time before he could leave his bed, and much longer before he could quit his chamber. Reading was his only resource. Before his accident he had been a lover of books; but this long spell at it went far to fix the habit of his future life, and the book he read (Kirby's Wonderful Magazine,') was well calculated from the strange facts it recorded to draw his attention "to books as a source of interest and a means of information, and this was precisely the sort of feeling proper for drawing me into the habits which have enabled me, under all my privations, to be of some use in my day and generation.”

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The

At this period the art of reading was not diffused among the poor. 'Many could read; but the acquirement was not in the same degree as now applied to practical purposes. It was regarded more in the light of an occult art-a particular and by no means necessary attainment, specially destined for and appropriate to religious uses, and Sunday occupations." The books at his command were but few and chiefly religious ones. Bible, which he read quite through; Fox's Book of Martyrs, Josephus, Bunyan, Baxter, Sturm, and a few more. Good books all, "but the thing was you could see no other books than these." Periodical and daily literature, now so abundant had not then flowed over the land. His instinctive taste and an existence solitary and cut off from all social enjoyments by deafness, led him to read much, and his circumstances compelled him to read a few books. Thus by necessity he was obliged to comply with the good rule, to read much in a few good books. He was unconsciously drilling himself in the best habits of mind--application to a few subjects. Winchester or Eton might not have done more for him.

"The day came," he adds, "when I plunged into the sea of general literature, and being able to get nothing more to my mind, read poems, novels, histories, and magazines without end. Another day came, in which I was enabled to gratify a strange predilection for metaphysical books; and with all the novelists, poets, and historians within the reach of my arm, gave my days to Locke, Hartley, Tucker, Reid, Stewart, and Brown. I think little of these things now, and my

taste for them has gone by; but although I now think that my time might have been more advantageously employed, my mind was doubtless thus carried through a very useful discipline, of which I have since reaped the benefit. But amid all this, the theological bias, given by my earlier reading and associations remained; and the time eventually came, when I was enabled to return to it, and indulge it with redoubled ardour; and after that, another time arrived, when I could turn to rich account whatever useful thing I had learned, and whatever talent I had cultivated, however remote such acquirement or cultivation might at first seem removed from any definite pursuits."

Having commenced with this sketch of his early life and mental training, he digests the remainder of his information under such heads as appear to him "calculated to develop the more striking facts and circumstances in the physical, social, and intellectual condition of one who has the chief entrance to his inner being closed."

The first chapter is on "Speech." It is the common opinion that the deaf and dumb are dumb because they are deaf. Our biographer believes from his own experience that there is a physical impediment to speech as well as to hearing. Before his fall his enunciation was remarkably clear and distinct, but after that he spoke with pain and difficulty, so as not to be easily understood, and he was told his "voice had become very similar to that of one born deaf and dumb, but who has been taught to speak."

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Although I have no recollection of physical pain in the act of speaking, I felt the strongest possible indisposition to use my vocal organs. I seemed to labour under a moral disability, which cannot be described by comparison with any disinclination which the reader can be supposed to have experienced. The disinclination which he feels to leave his warm bed in a frosty morning, is nothing to that which I experienced against any exercise of the organs of speech."

The force of this tendency to dumbness was so great that for years he habitually expressed himself in writing, and it was owing to the kindness of two passengers, his companions during a voyage, who,-seeing that dumbness was merely a bad habit, entered into a conspiracy with the captain to understand nothing except what was spoken, that made a wholesome compulsion, he again expressed himself orally in the ordinary intercourse of life. At first he was understood by strangers with difficulty, but practice has greatly improved his speech. The following remarks were written by a friend on it:

"It is pitched in a far deeper bass tone than is natural to men who have their hearing. There is in it a certain contraction of the throat analogous to wheezing; and altogether it is eminently guttural. It may be suspected that this is attributable to the fact that his deafness came on in boyhood, before the voice had assumed its masculine depth. The transition having taken place without the guidance of the ear, was made at random, and without any pains bestowed upon it by those who could hear and correct it."

His tendency is to express words which he has acquired since his deafness as they are written. This renders his English often more intelligible to foreigners than to his countrymen. To his own sensations he seems to speak in a loud whisper, but from the effect on others he finds this is not the case, but that his voice is loud and strange. It may be heard as a sound to an unusual distance, although the articulations can only be made out by a person quite near. He thus graphically describes its effect:

"If I happen to forget myself, and speak to a companion while others are walking just before us, it is equally annoying and amusing to see the sudden start and abrupt turn of the persons behind whom we walk, at a sound seemingly not of this earth, and so much beyond the range of all ordinary experience."

A friend has described his voice as if formed in the chest, and issuing through a tube without being much modulated by its passage through the mouth,—a definition which agrees well with his own sensations.

This unwillingness to speak is a common attendant on deafness, arising probably from many causes. Dr. Kitto is fully persuaded that in his case there was a physical inability to speak, and he is so accurate and truthful an observer that his impression on this head is good evidence of the fact. As the structure of his vocal organs was perfect before the accident, we have to look at the nerves alone for any physical causes of the inability. The injury to the brain at the origin of the auditory nerves, which produced the deafness, might have extended to the roots of the nerves which supply the muscles engaged in the production of the voice. And as the difficulty seems to be in modulating the voice, and not in producing the sound, the nerves supplying the tongue and lips might have been most jarred. "This physical difficulty in the formation of articulate sounds," of which Dr. Kitto is fully persuaded, however, is explicable on the greatly increased difficulties to the education of the voice which deafness produces. We learn to speak from imitating those we hear. Remove an English child to France, and in a very short time he speaks his own language with difficulty, and even forgets it. A child who suddenly becomes totally deaf is just in the condition to forget his own language without learning another, and if, as in Dr. Kitto's case, his parents' are poor and leave him much to himself and his books, he would in a short time have as much difficulty in speaking his own language as if he had been wholly among those who spoke another tongue. If in addition to this cause it is taken into consideration that he has lost by deafness his chief guide in the modulation of his sounds, and therefore the difficulty of speaking is very much increased, it is not surprising that his unwillingness to speak becomes a confirmed habit, and that in the course of time the difficulty in utterance becomes so great as to require great exertion and perseverance to overcome. Besides, the mutual cooperation of ear and voice in one act is at an end; this harmony is lost, and the pleasure that arises from it (the pleasure which each man derives from his own voice, musical to him, however discordant to his neighbour) is gone. That great spur to conversatiou, the love of approbation, can actuate him no longer from whom all social amusements are cut off, and who is compelled to find his own pleasures, not among his kind, but in the world of silent nature, of books, and of his own thoughts. It would be strange, therefore, if want of practice in speech, with absence of stimulus to its exertion, and of pleasure in its performance, did not very soon lead to an inability in the formation of sounds, as hard to be overcome as a bodily imperfection. Some letters and private memorandums of Beethoven (who, from possessing a most exquisite ear, the delicacy of which, he says, few could imagine, became deaf at thirty) reveal the mental sufferings and mortifications he underwent, which were set down to misanthropy and moroseness. He also avoided speaking as much as possible.