mately to dropsy. There is nothing new, in the remedial way, brought forward by Dr. Carter. The quinine and arsenic were, of course, the most effectual remedies for stopping the paroxysms-but every relapse deteriorates the organs and their functions, rendering it necessary to give aperients, mercurials, bitters, and vegetable tonics. We learn from Dr. C. that his colleague, Dr. Chisholm, has successfully practised the plan of Dr. Mackintosh-bleeding in the cold stage. Three fatal cases of organic disease of the liver are detailed; but they present only the usual phenomena of that dire affection.

2. Phlegmonous Erysipelas. Mr. Evan Daniel has published some observations on the treatment of the above species of erysipelas tending to show the utility of abstracting blood locally-against which practice, most writers on this disease appear to be very much prejudiced." Mr. D. we imagine, labours under a mistake. No modern writers or practitioners are prejudiced against local bleeding in phlegmonous erysipelas. It is in the treatment of the superficial or cutaneous erysipelas, that there is considerable discrepancy of opinion. All parties are agreed as to the utility of local depletion in the phlegmonous form-but each has his favourite mode of proceeding. Mr. Lawrence makes a long cut, (he is a cutting kind of a chap at all times,)-Mr. Hutchison makes short cuts-Mr. Travers cuts both plans, and leaves the operation to leeches-Dr. Babbington and his Greenwich friends make small cuts or punctures with the point of a lancet. These different parties have different views of the modus sanandi of local depletion. The long cutters believe that it is of as great importance to take off tension, as to empty the vessels of the part-the leechers, lancers, and short cutters evidently look to simple depletion as the main benefit to be derived from the measure. In this class Mr. Daniel ranks himself-and this is the whole of the business.

3. THE LONDON MEDICAL GAZETTE.

After a considerable note of preparation, and with an address penned (if report be

true) by no less a personage than the POET LAUREAT, the MEDICAL GAZETTE has come forth, to be conducted on the "ideal model" of "JUDGMENT, KNOWLEDGE, and GOOD FEELING,"-in short, to be the strennous advocate of philosophic views and liberal sentiments. For these good intentions we give our cotemporary full credit; and as far as it is concerned in the laudable endeavour to counteract the baleful influence of the ORGAN of defamation, it will find in us a zealous, though a very humble auxiliary. As there appears to be a greater leaning, however, in the MEDICAL GAZETTE, towards "things that be," than comports precisely with our sentiments, so, it is not impossible that we may have some little collisions in MEDIn our differences, however, with the MEDICAL GAZETTE, we hope to conduct ourselves with proper attention to that "ideal model," which our cotemporary has judiciously placed before its eyes, for constant imitation. The Lancet has now got its match in the field. For some time we feared the MEDICAL GAZETTE would wrap itself too much up in its own dignity, and thereby prove tame. It seems to have taken the hint thrown out in our last number. It is now

ICAL POLITICS.

showing spirit, and we predict that the reign of the Lancet is over! The Hospital Reports, constituting the chief value of all weekly publications, are given in the Medical Gazette infinitely better than in the Lancet, with the incalculable advantage of being TRUe.

MED. GAZETTE, Nos. 4 and 5.

CLINICAL LECTURES.

The first article in the 4th number of our new cotemporary is the substance of a clinical lecture by Mr. Charles Bell, on diseases and accidents of the hip-joint. We may take this opportunity of expressing our opinion, that clinical lectures are the only proper lectures for reporting in a medical Journal. They are like the debates in a medical society, mere verbal comments on a given subject, which would be lost, if not recorded, and which may be serviceable if noted faithfully and published correctly. Not so with elementary lectures that are constructed for the purpose of annual delivery. These are

as much a man's private property as the coat on his back, or the watch in his fob : -and whoever publishes without license such lectures, is guilty of literary spoliation, according to the laws of honour and conscience, however incognizable such an act may be by the laws of the land. For the truth of this sentiment, we appeal to the breast of every unprejudiced man in the profession.

But, to our business. Mr. Bell after referring to five or six cases in the wards of the Middlesex Hospital, presenting various specimens of hip-disease-some with the leg of the affected side longer than the other-some with it shortersome appearing to be on the point of anchylosis-and two in a state which rendered it doubtful whether there was fracture or dislocation of the femur-proceeded to make some general observations on hip diseases.

This affection is common to infancy as well as age. Mr. B. illustrates its occurrence in the former state, as follows:an infant was suddenly seized with convulsions, and the fits returned again and again, so that the child was considered to be in great danger. Dr. Denman thought it was owing to dentition, and requested Mr. B. to lance the gums deeply and completely round the jaw. He did so, but no benefit resulted. On careful examination of the naked infant, the disease was found to be in the hip, which was much swelled, tender, and painful on motion. The disease went on, and suppuration surrounded the whole joint. Punctures were often made, and after a long illness, the little patient finally recovered, though he is lame, from wasting of the head of the femur.

There is another way in which the disease may present itself. A boy at school is observed to limp, and, in the evening, complains of pain and stiffness. He returns to his exercises, and when warmed by these, his lameness and stiffness disappear. Still in the evenings he complains-and, after a time, he is observed to hobble more in his gait. He will now probably acknowledge that he suffers a good deal in the limb-and now it is that medical advice is sought. The examination is to be conducted in the following

manner :

"The first thing you are to do is to make him walk before you, and observe

the direction of the toe. You are then to strip him, and place him with the but tocks directly before you. You will observe that on the affected side there is a fulness and a greater breadth betwixt the fissure of the nates and the trochanter major than on the other side; and if the trochanter be firmly pressed inward against the acetabulum, pain will be felt. The patient may in the next place be made to stand erect on both his legs; you then ask him to rest upon the sound limb only, and throw out the other as in abduction. This you will probably find he cannot do without great pain; because, during this movement of the limb, the muscles press the hip-joint, and the head of the bone jars against the delicate and inflamed structure of the acetabulum. If he be now laid straight upon his back on the carpet, you will find an inequality in the length of his limbs. If the patient and others of the family exhibit the peculiar signs of a strumous diathesis, then there is every probability of this being the commencing stage of that very dangerous disease, which is called by authors Morbus Coxarius."

Another boy returns from school, and is observed by his mother to be lame or awkward in his gait. He is not conscious of it, and affirms that he played a match of cricket yesterday. On examination, the surgeon perceives that the boy walks lame yet he can throw the leg about in every direction, without pain. On laying him prostrate on the floor, one leg appears shorter than the other. The short leg will also be found smaller than the other. This depends on scrofula. a certain period, the boy's leg stops growing, a frequent occurrence during dentition, when the bowels are much disordered. This affection is liable to be confounded with disease of the hip, but it is totally different. Leeches, blisters, and the usual means, are here sometimes applied-with no good, but, probably, bad

effects.

At

In certain cases, (one of which was then in the wards,) the child complains solely of the knee, a common occurrence in disease of the hip-joint, owing, Mr. B. the obturator nerve, as it passes through thinks, to inflammation having spread to the thyroid foramen. The pain is felt in the branches of the nerve, according to a general neurological law. In such

cases,

when pressure and kneading of the knee occasion no pain, we may suspect the hip-joint to be the seat of the disease.

In respect to the shortening of the limb, Mr. B. makes many excellent observations, and we have quoted a passage from this part of his lecture, when speaking of a paper on supposed fractures of the cervix femoris, within the capsule, by Mr. Langstaff. When the disease commences within the joint, it extends its influence to the surrounding parts, which become inflamed, and abscesses form. The patient lies with the body inclined forward, and the knee raised towards the belly. In this way he twists the spine, and inclines the pelvis, drawing it obliquely up. wards on the affected side. This apparent shortening of the limb is sometimes erroneously attributed to absorption of the neck of the bone. In the case before him, the limb, on the diseased side, was longer than the other-yet still it was owing to twisting of the pelvis. But the apparent shortening of the limb is the common occurrence, and if this be perceived on the second or third day after the commencement of acute inflammation of the hip, the surgeon may begin to fear that he had made a mistake-that there had been a fracture or dislocation of the femur that had not been detected.

"In order to satisfy yourselves whether there is real, or only apparent shortening of the limb, make the patient lie even upon his back, in as straight a position as he can, and then search for the superior spinous processes of the ilium on both sides. By drawing a tape be tween these two points, it will be seen whether the pelvis is situated obliquely or not. If the pelvis be placed exactly in a straight position, then the difference in the length of the two limbs no longer exists: the heels may be made to meet and correspond exactly. But whenever the examination is over, the patient gradually resumes his former position of ease, and then you find that the limb is drawn upwards, and appears shortened just as before."

A case in elucidation is given, and also a wood cut, showing the alteration in the bead and neck of the femur produced by inflammation. This clinical lecture is creditable to Mr. Bell, and affords him opportunities of showing his ingenuity in the explanation of morbid phenomena

connected with the mechanism of the human frame.

4. THE MEDICAL AND PHYSICAL JOURNAL.

This Journal originated in cow-pox, in Its the last year of the last century.' success was far beyond that of any other medical journal that had previously ap peared. It became nearly as epidemic as vaccination. We have seen documents, in the possession of the late Mr. Thorne, the original printer of the journal, proving that its circulation, for some years, amounted to nearly 3000 copies per month! It will soon have attained its 60th volume -a grand climacteric in periodical literature! A list of its editors would nearly cover a page of our work-and the various tints and hues which the Medical and Physical Journal received from its successive directors, are far beyond our power of painting. We wish it every success.

The Number for Jan. (19, New Series) opens with a paper on the physiology of the circulation, by Mr. James, of Exeter; in which nothing new is advanced, and nothing old is established or refuted. Mr. James seems to come to the conclusion, (to which we long ago came, and which we have repeatedly published,) that the blood does not go along the arteries in waves, but that, at each ventricular contraction, "a shock is diffused over the whole arterial system, which propels the blood in a longitudinal direction." There is, no doubt, a very trifling instantaneous dilatation of the whole tree of arteries at the same time, the recoil of which feeds the capillary system till the next ejection of blood from the heart. Mr. James affects to treat the suction-influence of the chest and heart as chimeras of the imagination. It is needless to say, that he offers nothing like facts to substantiate this negation.

In the second article, Sir George Gibbes continues his speculations on life, on animalcula, on monades, on ultimate living particles, terminating rudiments, &c. through which speculations we dare not follow him. Sir George appears to be enamoured of the following "very novel and most curious" doctrine.

"All the tissues of the animal body are ehown to be ultimately resolvable into

minute globules, and that these globules, as they are successively disengaged from the mass, exhibit distinctly a power of spontaneous activity, moving about rap. idly in all directions. In short, they become animalcula, possessing the power of locomotion, and have been named monades. It appears that these bodies are capable of existing as animals or vegetables, and of forming elementary parts of either. Thus, according to the above view of the subject, we arrive at the singular conclusion, that the human body, with all its organs, is built up of animalcula, and that it is a congeries of countless millions of organized beings, each capable of living in a separate state, and, perhaps, exercising some of the functions of individual life, whilst incorporated with our system. It is not certain, but it is at least probable, that these monades form the last link in the chain of organic life, and that, beyond them, there is nothing but the ultimate gazeous elements."

The author of this curious theory believes the process of digestion to consist merely in the operations necessary to separate these monades from the combinations in which they existed in the animal and vegetable substances that form our food, while assimilation is the mere transport of the monades to the various parts of the body.

How will Sir Gilbert Blane, Professor Brande, and Doctor Reece chuckle, when they peruse this theory, so beautifully corroborative of their doctrine, that Thames water is both wholesome and fattening! No wonder that it is so, when it contains so many millions of animalcula, all ready disengaged to fly to the different parts of the body, without any digestive process being necessary!

Vaccination of the Sultan's Children. Dr. Baron, of Gloucester, has transmitted the important information, that three of the Grand Seigneur's children have undergone vaccination. It appears that His Turkish Majesty has been inoculated with the contagion of European discipline, ever since the destruction of the Janissaries. Nothing is now heard, in Constantinople, but military music-nothing played except European airs-nothing seen but drum-majors, great canes, muskets and bayonets-and the Grand Seigneur himself, in a General's uniform,

ordering manoeuvres! This fine flourish introduces us to the important intelligence, that Dr. Auban has had the honour of vaccinating three of the Sultan's children, in order to complete the revolution that has been effected among the followers of the Prophet.

Paraplegia. Dr. Thomas, of Devonport, has detailed a case of this kind, which occurred in the person of a sailor, aged 43 years. He had suffered an attack of fever fifteen years previously in India, and one of acute rheumatism in the Winter of 1824. After sleeping in a damp room last Spring, he felt pain in the left side, extending to the back. This was followed by weakness and numbness in the lower extremities, constipation of bowels, dysury, soon amounting to retention. There was no affection of the head. We need not detail the treatment. For a time the patient improved-but afterwards he became completely hemiplegiae. Ulceration took place over the sacrum, and then the paralysis of the lower extremities diminished-till it might be said to be almost gone. Ulceration of the bladder, however, occurred, and of this the patient died. No dissection could be obtained. The head remained free from disorder all the time.

Dr. Thomas seems to have brought forward this case, with the view of assisting Dr. Burder in refuting the doctrine of the late Dr. Baillie, that paraplegia generally depends on affection of the brain. But there is hardly any one who maintains such a doctrine now-and the case of Dr Thomas is defective, from want of dissection. We have no doubt, however, that, in the above case, the disease was in the spinal marrow, and that the ulcer over the sacrum acted the salutary part of a caustic issue.

The hospital reports, in the Medical and Physical Journal we shall amalgamate with others under their proper heads.

5. LANCET. JANUARY 5, 1828.

It is not our intention, except on very extraordinary occasions, to notice the elementary lectures in the columns of the Lancet. They are calculated for two classes of readers-those who have lost

their dentes sapientiæ from old age-and those striplings who have not yet cut them. The lectures, indeed of a Cooper, an Abernethy, and a few others, did possess interest-but now-we have had satis superque. The clinical lectures, as we have elsewhere observed, are the proper subjects for reporting.

In this Number are given some clinical remarks, by Dr. Elliotson, on chronic affections of the brain. The subjects in the hospital were chiefly males, between the ages of 25 and 40-the causes in many instances were external injuries. The symptoms were, generally, pain in the head, drowsiness, vertigo, throbbing, dilated pupils, tinnitus aurium, &c.--in short, the symptoms of chronic inflammation-and the terminations were too often in hemiplegia, epilepsy, convulsions, &c. The post-mortem appear ances, in Dr. E.'s practice, were those which others have observed effusion, thickening of membranes, ramollissement, &c. The treatment may be very easily anticipated,-spare diet,-open bowels-cold, repeated blisters, cupping and leeching ("almost endlessly") to the head-abstraction of blood from the hypochondria or epigastrium-mercury, which should never be omitted. A case was related, and a brain exhibited where there was serous fluid found on the surface of the brain, as well as in the ventricles-also a quantity of limpid fluid on the medulla spinalis. The reporter makes Dr. Elliotson to say that the case in question is one not only instructive in itself but as "mulilating" against the opinion advanced by Majendie, that the fluid found in the ventricles comes from the spine entirely, or in the greater part; and, consequently, that our remedial mea. sures should be chiefly directed to that region. We do not deem it necessary to enter into the investigation here, whether or not there is a communication between the ventricles of the brain and the spinal canal.

COOPER versus LAWRENCE. Cantare pares, et recantare parati.

There is, at this moment, a tremendous conflict between two surgical instruments-the trephine and the scalpelthe Lancet being, of course, the bottle

holder. Mr. Lawrence appears to have thought that there would not be sufficient space on Mr. Cooper's head for a 14 inch incision-and therefore he has made several perforations to get at the spinous artery of his antagonist. Mr. Cooper, on the other hand, has taken up the scalpel, and, avoiding all attempts to get at the dura mater of Mr. Lawrence, amuses himself

by making short, but pretty numerous incisions into the soft parts of the enemy. How this deadly contest will end we cannot yet predict. Both parties appear at home in the use of their weapons, and, it is to be feared, that blood will be spilt and bones broken before the victory is pro claimed.

DUEL.

We have now to record a much more serious kind of fighting than that with the scalpel and trephine. A duel was fought, on Saturday week, between Dr. Forbes, of Argyll-street, and Mr. Thompson, a young surgeon, a pupil at the Eye-Infir mary, to which Dr. Forbes is physician. No blood was shed, but a ball went through Mr. Thompson's hat, when the seconds interfered. The circumstances that led to this meeting are pretty well known. Very late in the evening, before Mr. Guthrie's action was to have come on against the Lancet, Dr. Forbes wrote to Mr. Guthrie, intimating that, if interrogated in court, he would be forced to condemn certain parts of Mr. Guthrie's practice, or words to that effect. This, of course, stopped proceedings in court next day, and the business, we suppose is ended for ever. It seems that Mr. Thompson was indignant on this occasion, and insulted Dr. Forbes-hence the duel. join with our cotemporary in considering the above as a striking illustration of the tumultuous state of our profession, "It is one among the daily proofs of the incalculable mischief resulting from that system of depravity in the medical press, which has thus literally set man in hostility to man, for the profit of a

We

We dare not close the sentence from our cotemporary, lest we should have another judicial action on our hands. We confidently believe that the "system of depravity" is beginning to totter-and we hope to give it a shove before the end of the year 1828.