REV. IX.—1. De l'Anesthésie Hypnotique. ('Gazette Hebdomadaire de 2. Note sur le Sommeil Nerveux ou Hypnotisme. Par le Dr. AzɅM, Pro- fesseur suppléant à l'École de Médecine de Bordeaux, &c. ('Archives 3. Etudes sur le Somnambulisme envisagé au point de vue Pathologique. Par le Dr. E. MESNET, Médecin de Hôpitaux. (Archives Générales On Somnambulism examined in reference to Pathology. By Dr. E. MESNET ib. 4. Neuro-Hypnotism, or Artificial Nervous Sleep. By R. T. DWIGHT, M.D. (Charleston Medical Journal and Review,' Sept. 1850). . ib. REV. X.-Eight Cases of Ovariotomy, with Remarks on the Means of Dimi- nishing the Mortality after this Operation. By T. SPENCER WELLS, ABT. II.-Essays on Medical Science.-1. On the Nature of Inflammation. 2. On the Encephalic Circulation and its Relation to the Physiology of ART. IV.-On Chronic Alcoholic Intoxication, or Alcoholic Stimulants in Connexion with the Nervous System; with a Synoptical Table of 2. Extracts from the Records of the Boston Society for Medical Improve- ment, published in the Boston Medical and Surgical Journal. By FITCH ABT. VI.—Stricture of the Urethra: its Complications and Effects. A Prac- tical Treatise on the Nature and Treatment of those Affections. By ART. I.-On Contraction and Obliteration of the Aorta near the Junction of the Ductus Arteriosus. By THOMAS B. PEACOCK, M.D., &c. ABT. II.-On the Morbid Actions which constitute Osteitis. By RICHARD ART. III.-A Glance at the Present State of Ethnology, with Reference to the Form of the Skull. Read at the Seventh Meeting of the Scandi- navian Association of Naturalists, held at Christiania in 1856. By ANDERS RETZIUS, Professor in the Carolinean Institution at Stock- THE BRITISH AND FOREIGN MEDICO-CHIRURGICAL REVIEW. JANUARY, 1860. PART FIRST. Analytical and Critical Reviews. REVIEW I. 1. Des Inflammations Spéciales du Tissu Muqueux, et en particulier de la Diphtherite. Par P. BRETONNEAU, Médecin-en-chef de l'Hôpital de Tours.-Paris, 1826. pp. 540. On Specific Inflammations of the Mucous Membrane, and on Diphtheritis in particular. By P. BRETONNEAU. 2. Addition Supplémentaire au Traité de la Diphtherite. Par P. BRETONNEAU, &c.-Paris, 1827. Supplement to the Treatise on Diphtheritis. 3. Memoirs on Diphtheria; from the Writings of Bretonneau, Guersant, Trousseau, Bouchut, Empis, and Daviot. Selected and translated by ROBERT HUNTER SEMPLE, M.D. With a Bibliographical Appendix by JOHN CHATTO, Librarian to the Royal College of Surgeons. (The New Sydenham Society.)-London, 1859. pp. 407. 4. Clinical Lectures on Angina, delivered in the Hôtel-Dieu by Prof. TROUSSEAU. (Gazette des Hôpitaux.'-1855.) 5. Rapports Généraux sur les Maladies qui ont régné en France pendant les années 1852-1856. (Mémoires de l'Académie de Médecine.' -Paris, 1853-57.) General Reports on the Diseases which have prevailed in France during the years 1852-1856. 6. Relation d'une Epidémie d'Affections Pseudo-Membraneuses et Gangréneuses qui a régné à l'Hôpital des Enfants Malades de Paris dans le cour de l'année 1841. Par A. BECQUEREL, D.M. (Gazette Médicale de Paris.'-1843.) Account of an Epidemic of Pseudo-membranous and Gangrenous Affections prevailing at the Hospital for Sick Children in Paris during the year 1841. By A. BECQUEREL 49-xxv. 1 7. Des Accidents Consecutifs de la Diphtherite. Par M. Faure. ('L'Union Médicale.'-1857.) On the Sequelae of Diphtheritis. By Dr. FAURE. 8. Observations on Diphtheritis. By WILLOUGHBY F. WADE, B.A., M.B., T.C.D., Physician to the General Hospital, Birmingham.— London, 1858. pp. 32. 9. On Diphtheria; its History, Progress, Symptoms, Treatment, and Prevention. By ERNEST HART, Surgeon to the West London Hospital. (Reprinted from the Lancet.')-London, 1859. pp. 36. THERE are a few names in the history of medicine which are inseparably connected with the diseases which their possessors have been the first to discover or to distinguish. It is in this way that the name of the eminent physician who has within the last year passed from among us is most widely known and will be longest remembered; and it is thus that for years past we have remembered the names of Hope, Rayer, Laennec, Corvisart, and many others who have been the first to break ground each in his own special field of pathology. Like honour is due to M. Bretonneau, of Tours, for his admirable investigation of the epidemic disease to which he has attached the name Diphtheritis. Profoundly impressed with the truth of the aphorism of Laennec, that diseases can only be certainly distinguished by their anatomical characters, M. Bretonneau based his inquiry exclusively on post-mortem investigations, and prosecuted this line of research so far as to arrive at the conclusion with respect to several important diseases previously supposed to have no relation to one another, that they are connected either by identity in their accompanying anatomical appearances, or by so complete a similarity that they may be considered as phases of the same morbid process. An epidemic of malignant sore-throat which occurred at Tours in the year 1818, was the occasion of his earliest observations. His first memoir is mainly devoted to the consideration of the affections which had previously been described in France as epidemic croup, or malignant angina. The second contains in one section a careful description of the epidemic above mentioned, which is followed by a historical summary of previous outbreaks; while two others are devoted to the communicability of the disease by contagion, and to its treatment. In 1825 and 1826 the epidemic again broke out in the neighbourhood of Tours, at La Ferrière and Chenusson, and formed the subject of new researches. These four papers, with various appendices, constitute the treatise on Diphthérite, the first edition of which appeared in 1826. The word Diphtheritis,* first employed by Bretonneau in this form, [* We have no wish to enter upon a discussion as to the merits of the two words "diphtheritis" and "diphtheria," but willingly adopt the latter as being the shorter of the two, and in deference to the Registrar-General. For those of our readers who are interested in etymological research, we may state that dépa is the prepared skin of an animal; διφθερίτης, that which is covered with a fur or with a leathern coat ; διφθερίας has the same signification as the latter, dilepis as the former of these words.-ED.] and years afterwards modified to its present form, Diphtheria, in deference, as it would appear, to the objections of critics, involves in itself the kernel of his doctrine, the dominant idea of his whole writings, the specificity (to adopt a French word) of the pellicular exudation. Diphtheria, according to Bretonneau, is a diseased condition sui generis which may have its seat in the mouth, the fauces, the larynx, or on the blistered surface of the skin; and in all of these situations has the same specific characters. Its specificity consists anatomically in the formation of a pellicle of definite structure-pathologically or dynamically in the fact that this pellicle has the power of reproducing itself. Nothing is diphtheria that has not a pellicular exudation; no such exudation is diphtherical which is not capable of acting as a virus or contagium. The pellicular exudation is anatomically identical in all situations, but the disease is to be distinguished not merely by its anatomical characters, but by the additional fact that the exudation is the result or effect of the application of a specific virus to the affected surface, and is in itself capable of similarly affecting other surfaces. We have thus as succinctly as possible stated our author's doctrine; we will now place before the reader some passages in which it is laid down more at length in his own words. It is a serious inconvenience attending the arrangement of the "Treatise," that as each separate memoir is complete in itself, almost every question is discussed three or four times, and it is therefore necessary to refer to as many passages in order to arrive with certainty at the author's meaning. After observing (p. 20) that the organic alteration of which the pellicular exudation is the product, consists simply of redness of the mucous membrane without swelling or any other change whatever, he proceeds "I should not express my whole thought did I not add, that in this pellicular inflammation I see a specific phlegmasia as different from a catarrhal phlogosis as malignant pustule is from zona,- -a disease more distinct from scarlatinous angina than scarlatina itself is from small-pox,-a morbid affection sui generis, which is no more the extreme degree of catarrh than psoriasis is the extreme degree of erysipelas. In the impossibility of applying to a special inflammation so distinct as this is, any of the unsuitable names which have been given to its several phases, I may be permitted to designate this phlegmasia by the denomination of Diphthérite," &c. With the view of determining the value of the anatomical fact of pellicular exudation as characteristic of diphtheria, M. Bretonneau made numerous experiments relating to the effects produced by various irritant substances when applied to the mucous surfaces. He found that none of these agents was capable of producing a similar exudation, excepting cantharides. "The action of oil of cantharides,* when applied to the surface of the tongue and lips, is almost instantaneous. In less than twenty minutes the epidermis shrivels, and becomes raised and detached. It is soon replaced by a concrete pellicle, at first thin and semi-transparent, which speedily becomes more opaque and thicker. Like the diphtheritic exudation, this membrane, * Ethereal extract of cantharides dissolved in olive oil.-M. Bretonneau. |