Remarks. We have no fault to find with the practice here pursued by Dr. Elliotson; but we have some doubts as to the disease being pure phrenitis. We have seen several instances of this kind, where furious delirium was produced by intestinal irritation, and we think the above case was one where the said irritation bore a considerable share in the production of the symptoms. Probably too, the young man had been making free with "Barclay's ENTIRE," and a dash of delirium tremens might have entered into the composition of the malady. The pulse at 60-the black stools-the varying state of the cerebral affection-the syncope from small detractions of blood and the previous history of the case, incline us to this opinion, but we may be wrong. MEDICAL JURISPRUDENCE-CORONER. On Saturday, the 2d February, Mr. Barrett Marshall read a learned and eloquent paper on Medical Jurisprudence, more especially in relation to wounds and to Coroner's inquests. There was no professional discussion, but a stormy debate ensued, respecting the propriety, or rather the necessity, of the office of Coroner being vested in a medical man. This subject has lately been canvassed in one of the weekly journals without much benefit, we fear, on account of the intemperate and passionate manner in which the question has been approached. For our own parts, we never wish to see the medical character mixed up with the administration of the laws of the land. The only power which the physician or surgeon should aspire to, is KNOWLEDGE. It was maintained by some of the members, that the duty of the Coroner required no legal knowledge. This we apprehend to be a mistake. In the article CORONER, in Ree's Cyclopædia, it is stated that his "authority is judicial and ministerial"-that " he is to commit those to prison, who are found guilty, by his inquest, of murder or other homicide;" he must also, enquire concerning their lands, goods, and chattels, which are forfeited." "Another branch of his office is to inquire concerning shipwrecks -and find out who is in possession of the goods." In short, we conceive that the Coroner's office is a judicial situation, which is by no means adapted to the medical character. But we admit-it cannot be denied, that, in almost all cases of Coroner's inquests, the KNOWLEDGE of the medical man is required. This knowledge may surely be put in requisition, without any necessity for the surgeon being himself a Coroner. The whole of the objections now urged against Coroner's inquests might be easily removed, by the appointment of a well-informed surgeon to assist the Coroner, not only by careful examination of the body, but by interrogating the witnesses on such points as fall within his department. It should be, and we believe it is, in the power of the Coroner, to summon, in difficult cases, several medical men, in order to have the benefit of their united knowledge. A great outcry is made, as to the necessity of minute medical knowledge in the Coroner; but we apprehend that, before we urge the legislature to appoint medical men to the Coroner's office, we should first see that medical men are themselves properly qualified. Minute medico-legal knowledge is necessary, and yet medical jurisprudence forms no part of the system of medical education (if system it can be called) in this country! Let us lay the axe to the root of the tree-or rather of the evil. The whole profession should unite in one general petition to the legislature, for a One regulation of medical instruction. uniform system of medical education should be instituted, and enforced by law -and then let individuals practise such branches afterwards as their genius suited, or their circumstances and inclinations rendered eligible. We shall immediately proceed to the subject of medical education generally, and hope to show, in a calm and argumentative manner, the baneful effects of the present system-or rather systems, in this country. We shall also endeavour to direct the profession to the only legitimate path of reform-a parliamentary investigation. Periscope; OR, CIRCUMSPECTIVE REVIEW. "Ore trahit quodcunque potest, atque addit acervo." [23₫ FEBRUARY, 1828.] 1. INFLAMMATION BY CONTIGUITY. By Drs. altogether altered from their natural state, GRAVES and STOKES. There are many reasons for believing that inflammation is sometimes propagated by the mere contact of a sound with an inflamed part. Drs. Graves and Stokes furnish us with the following curious fact. In the dissection of a fatal case of enteritis, it was observed that one the omentum, which lay extensively over the intestines, was healthy, except where it was in contact with the inflamed portions of the latter. These portions (of intestine) were circumscribed and limited in extent-some being highly vascular and red-others gangrenous-and perforated. The inflamed portions of omentum were very vascular and red, about the size of a dollar, and lay exactly over the inflamed portions of intestine. Similar phenomena have been often observed in other parts of the body, but no explanation has been attempted. Thus, when the pleura costalis is much in flamed, a portion of the pl. pulm corresponding or opposite to it, is always found inflamed also. So, when inflammation spreads from the pleura to the lungs, it does not follow the reflections of this membrane, but passes directly from the pleura of the ribs to the pleura of the lungs, without any communication of vessels. The following explanation is offered by the gentlemen in question. "When a portion of a serous membrane becomes inflamed, it is rendered highly vascular; it becomes at first dry and rough, but afterwards exhales either a morbid fluid secretion, or coagulable lymph; there is some reason to believe that its temperature also increased. Now in this state of things, that portion of the opposite membrane which corresponds to it, is thus exposed to the contact of a membrane, whose sensible properties are VOL. VIII. No. 16. and which may therefore be now considered to be as it were a foreign body, which presenting a surface quite different from that to which the sensibility of the opposite membrane had been accustomed, must of course act as a stimulus to it, and thereby excite in it an inflammatory action." This explanation seems at least as satisfactory as Mr Hunter's "Sympathy of Contiguity." 2. ENCYSTED DROPSY OF ABDOMEN CURED In a late Fasciculus (II.) of this Number, Case. Twelve years before the date of report, William Cartwright, a labourer, had been attacked with some severe illness, followed by a great enlargement of the abdomen, and sense of uneasiness in the region of the liver. When seen by Dr. Morton, he had troublesome cough, accelerated pulse, scanty urine, costive bowels, and difficulty of breathing in the recumbent posture! There were tumefaction and fluctuation of the abdomenand sense of weight in the epigastrium. Various diuretic medicines were employed, but the disease advanced. An operation was proposed-acceded and performed on the 6th March, 1810. The trocar was introduced below the umbilicus, in the linea alba. About an ounce 65 10 of white purulent fluid passed through the canula, and no farther discharge could be procured. Next day, however, a portion of cyst protruded, and was drawn away piece-meal. On the 3d day, two other pieces of cyst were extracted-and the same occurred on the 4th and 5th days. After the extraction of a large portion of cyst on the sixth day, there gushed out two quarts of a yellowish white fluid, containing a number of hydatids, which were perfectly spherical, varying from a quarter of an inch to an inch in diameter. On the 7th and 8th days, nearly a quart of hydatids was discharged, one of which measured two inches in its longest diameter. On the 9th day, a large portion of thickened cyst was evacuated, followed by four quarts of hyda-, tids. This discharge of hydatids continued for two months, amounting to two gallons and a half. The contents of these cysts were as limpid as water, and no animalcula could be discovered in them. The orifice has never been entirely closed, but discharges, at intervals, small quantities of purulent serum, without any detriment to health. After a lapse of seventeen years, the patient is able to earn two pounds a week, as a paver of the streets of Huntingdon, ation of sacrum, vertebræ, or bones of the pelvis. There were, however, extreme anguish-pallor of the whole surface-cold sweat all over the bodyfeeble pulse-tremor and convulsive agitation of the limbs-all which symptoms led to the apprehension of severe lesion of some internal organ. There were, besides, a dull pain in the abdomen, and constant tenesmus. An anodyne medicine was exhibited, and warm embrocations applied to the abdomen. Lavealso ments of a soothing kind, were thrown up. A large quantity of blood was abstracted from the arm. The next day found the patient better than could have been expected. The anxiety was gone-the pulse was expanded-the agitation tranquillized. But there was great tenderness, with tension of the abdomen, hot skin, and quick pulse. Forty leeches were applied to the abdomen, and the patient afterwards put into the warm bath. From this time he rapidly recovered, with. out one bad symptom.-JOURNAL GENER. ALE DE MEDECINE. We think the large detraction of blood from the arm, during the state of depression and prostration in which the patient appeared, immediately after the accident, was a hazardous practice-and one that ought not to be imitated. 3. VIOLENT ABDOMINAL CONTUSION. M. Reveillé Parise lately reported a case to the Royal Academy of Medicine, which shows what a tremendous pressure the human frame will sometimes bear without destruction. On the 20th October last, a gentleman, of delicate constitution, was riding a horse that was subject to vertigo-when the animal fell, and in the endeavour to rise fell again, with all his weight, directly on the body of his master! The shock was terrible, and the animal was seen by M. Parise, to roll completely over the unfortunate gentleman and get up on the other side! M. Parise ran to his assistance, and thought him dead; but, in a few minutes, he revived, and spoke with a strong voice. He was quickly conveyed home, stripped, and carefully examined. The thorax was found to be uninjured, as the whole weight of the animal had been sustained by the abdomen. There was no fracture or lux 4. HYDARTHROSIS, OR DROPSY OF THE KNEE-JOINT. The following case of a rare disease is published by Dr. Vilette, in a late Number of the REVUE MEDICALE. On the 6th October, he was consulted by a gen tleman for a swelling above the left knee. It seemed to be divided into two parts by the rectus femoris. The inner swelling was the largest, and also the softest. The patella, whcih was nearly immoveable, was raised from the joint. Fluctuation was perfectly distinct in both sacs, and a communication between them was evident. Whether the contained fluid was synovia or pus, was the question. There had been no preceding blow or other violence-no inflammation-no pain. The swellings had appeared without warning, and gradually increased. Mercurial frictions and various other means were employed without any benefit-indeed the swelling had very much increased, with much pain, A very long train of pathological reflexions is appended to the above history, but we deem the fact to be more valuable than the commentary-and the former we present to our readers, leaving them to draw their own inferences. 5. ON DISEASES OF THE FETUS, WITH THE MEANS OF Prevention and CURE. BY M HUFELAND. The venerable author of this paper has carried his philanthropy beyond the boundaries of this life, as commonly, but erroneously computed from the day of birth, and directed his researches to the connexion of the fœtus with the motherto the influence of maternal agents on the embryo-to the results of these agencies -and to the means of counteracting noxious by salutary agents. dant population in this country, it must always be the business of the medical profession to encourage the increase of births over deaths-and, consequently, to protect the fœtus in utero, as much as the independent being at any other epoch of its existence. At first sight it appears somewhat absurd, as well as impossible, to extend the aid of medical art to the embryo in the womb; but this is a false view of the case. Although the fœtus swims in a liquid, and is consequently secured, in a great measure, from external succussions-and although neither nerves nor blood-vessels can be traced from the mother into the fatal placenta ; yet, it is evident that the materials of organization in the little parasite must be derived from the nidus in which it resides, while facts are not wanting to prove that nervous agency or influence may be conducted from the mother to the child, whatever may be the medium or the mode in which it is conducted. Thus, sudden frights have destroyed instantaneously the life of the intra-uterine fœtus. Some experiments made on impregnated animals prove that substances introduced into the blood of the mother will find its way into the veins of the fœtus. Thus, oil was injected into the veins of a bitch with whelp, and, after a certain time, the animal was killed, when oil was detected in the umbilical veins of the fœtus. When the fœtus is detached, and put to the breast of the mother, we find that medicinal substances will act through the medium of the milk, with nearly as much certainty as if given directly to the infant. The itch, in a child at the breast, has been cured by sulphur exhibited to the mother. Hufeland maintains, that nervous and moral affections may be readily impressed on the suckling through the medium of the nurse. We cannot deny that the nutrition of the fœtus is equally derived from materual sources, while intra uterum, and during lactation. That the agency of heat, cold, electricity, magnetism, &c. may be extended from mother to offspring is undeniable. M. Hufeland thinks that metastasis also may play some part in affections of the fœtus in utero. There can, at least, be no doubt that the syphilitic virus may be communicated to the germ before it has assumed an independent existence. From these, and many other considerations, M Hufeland thinks we are autho Whatever may be the evils of a redun- rised to infer, that we can act on the fœtus in utero in seven different ways:namely, by the augmentation or diminu tion of nourishment-by the augmenta tion or diminution of the afflux of blood to the uterine system-by changing the qualities of the air and aliment of the mother-by mechanical means-by the agency of electricity, &c.-by medicines -and, lastly, by moral influences. Let us now pass on to the diseases of the foetal life. The first class comprehends monstrosities, deformities, &c. which our author thinks must proceed either from hereditary disposition or some defect in the primary developement of the foetus, through causes acting on the mother. This, however, is a knotty point to unravel. In the second class, he ranks the feeble state of vital powers, the effect of defective nutrition, and the atrophy of infants when first born. We see infants come into the world extremely small, feeble, and emaciated The causes are to be sought in diseases of the mother, as immoderate evacuations, fevers, accidents, wants, anxiety of mind, &c. In the third class he places hypertrophy, or excess of nutrition in the foetus whether of certain parts, or of the whole, thus rendering the birth difficult or dangerous The fourth class comprehends the dys crasiæ. M. Hufeland contends that, as the pabulum of nutrition in the fœtus must be supplied by the mother, so all vices in the blood, the secretions, and the fluids generally, must affect, more or less, the fœtus in utero Hence we see scrophulous mothers bring forth scrophu lous children, &c There is little doubt now entertained, that the syphilitic virus can be communicated to the intra-uterine progeny-and if this be the case, we can. not wonder that other maladies should be also transmitted, But not only are diseases thus communicated from mother to child, but death itself may be induced in the latter from morbid impressions on the former. A fright-a strong moral affliction, and many other influences, have been followed quickly by cessation of all motion in the foetus, and ultimate abortion. A contemplation of these causes of det riment, disease, or destruction of the child, will very readily suggest the prevention, as well as the remedy-where a remedy can be applied, The whole secret, in fact, rests upon abstracting all causes of ill health from the mother or, if ill health has been actually induced, to restore her. as soon as possible, to health It would be well for mothers and accoucheurs to reflect on these things, and preserve, if possible, the innocent foetus from the effects of irregularities and intemperance too often indulged in, from a false supposition among nurses, that pregnant females cannot live too generously.-JOURN. COMPLEMEnt. 6. BONY TUMOUR OBSTRucting thE PYLORUS. This is a very rare disease. Dr. Webster has lately recorded an example of it. The patient was an elderly gentleman who had enjoyed good health, with the exception of some attacks of dyspepsia. attended with costiveness, and relieved by diarrhea These attacks never assumed a formidable character till last Autumn, when he was, one morning, seized with excruciating pain in the epigastrium, accompanied by slight sickness and accele ration of pulse, anxiety, constipation, &c. These symptoms increased in urgency, and a fluctuation and fulness could be felt at the epigastrium, by Mr. Nicholson, who had been called to the patient.— Bleeding, cathartics, enemata, all failed, and the patient sunk in 22 hours from the commencement of the attack. Dissection. The stomach was found to be much disteuded. and a cartilaginous body, intermixed with numerous spicula of bone, was discovered firinly attached to the coals of the organ. close to the pylorus, into which one end of the tumour projected like a stopper, thereby prevent ing all egress from the stomach into the duodenum There were some marks of inflammation in the stomach, and a considerable effusion of serum into the cavity of the abdomen. 7. ASCITES CURED BY INJECTION OF WINE-VAPOUR. At a late sitting of the Academy of Medecine in Paris. M L'Homme related a case of ascites cured by the introduction of |