GENERAL RETROSPECT. 2. We are not as yet sufficiently acquainted with the solubility of the fibrin of human arterial blood, but it is less soluble than that of venous blood. The fibrin of both the venous and the arterial blood of the ox is Dearly insoluble; that of the dog is very soluble. In the horse the arterial fibrin is more soluble than the 249* "Description of the Operation.—The rectum must be previously evacuated; the patient placed as for the operation of Boyer. An assistant raises the buttock of the side opposite to that in which the section is to be made; this is always done on one of the sides of the anus, in order to cut the sphincter in its middle; an ordinary tenotome, or a particular bistoury proposed 3. Heat favours, and cold retards the solution of by M. Blandin, may be employed. The first is inconcoagulated fibrin. venient from not being long enough, nor sufficiently venous. 4. Dissolved fibrin resembles albumen, as being guarded, and it may cut or tear the mucous membrane, coagulable by æther. the perforation of which might be the cause of serious accidents. 5. Fibrin is rendered insoluble by boiling water. 6. The fibrin of exudations is as soluble as that of venous blood. "M. Blandin's instrument is a bistoury, with a strong handle, and a moveable plate on one of the faces of 7. The inflammatory crust of the blood is very the blade; the plate is rounded at its extremities, a sparingly soluble. 8. Putrefaction favours the solubility of fibrin. 9. Compression of fibrin renders it more insoluble.Archiv. für Physiologische Heilkunde. MICROSCOPICAL OBSERVATIONS ON ICTHYOSIS. The following observations were made upon a woman, aged 70, who had laboured under icthyosis of the leg for five years. The scales which detached themselves, seen with the naked eye, appeared to resemble shagreen; viewed on their adherent aspect, they appeared to be areolar; viewed in their perpendicular aspect, they appeared to consist of small columns, one extremity of which rested on the skin, the other forming the superficies of the eruption. Under the microscope the same columns were noticed, but it was farther noticed that they were tubular, and were united by some intermediate substance. The investing membrane appeared destitute both of cells and fibres. In the interior of the tubes were seen cells of 1-60th to 1-100th of a line in diameter, with nuclei of 1-240th of a line; each nucleus contained a nucleolus. Of these cells, some were oblong, others many-sided; each contained from one to five nuclei. The intertubular substance was composed of cellules of 1-100th to 1-150th of a line in diameter, with nuclei, but no nucleoli. This substance, as well as the tubes, became transparent under acetic acid. These investigations throw some light on the pathology of icthyosis. Most authors state that in this disease the epidermis alone is implicated, but the preceding results appear to show that the new production of icthyosis has a greater affinity to certain horny growths. For this reason M. Nicolucci suggests that the disease should be called Keratosis, from Keras, a born.-Gazette Médicale, Mars 6, 1847. SURGERY. SUBMUCOUS SECTION OF THE SPHINCTER ANI IN VARIOUS SURGICAL DISEASES. [This simple operation has been successfully performed by Blandin, Guerin, Velpeau, and Demarquay, in spasmodic stricture of the sphincter ani, permanent contraction of the muscles, fissure of the anus, &c. The latter author has published a long paper upon the . subject, a translation of which appears in Dr. Ranking's Half Yearly Abstract," from which we quote the following extract.] little longer than the blade, and when closed it covers it completely. There are marks on the handle which indicate the direction of the edge. The operation is performed with this instrument alone. When it is required only to puncture the skin, a small part of the blade is uncovered; when the bistoury is to passbetween the muscle and the mucous membrane, the blade is hid by the moveable plate, and the instrument' acts as a smooth and slightly flattened stilet. When it is required to cut, the plate is drawn into the handle, and the instrument is used as an ordinary bistoury. "The operation is simple; it is necessary-1. To make a small opening in the skin. 2. To introduce the finger into the rectum at the same time that the skin of both sides of the anus is made tense. 3. To pass the tenotome or bistoury between the mucous membrane and the sphincter. 4. To divide the latter. "The puncture of the skin is generally made two or three centimeters from the anus. The instrument should pass gently, in order to detach the parts as little as possible. This is the most delicate part of the operation, especially as the instrument passes the level of the sphincter. In one case, to avoid the difficulty, M. Velpeau cut from below upwards, but this practice is attended with inconveniences. At the moment when the division is made, a kind of snap may be heard, and immediately after the operation a space is distinctly felt between the divided parts of the muscle. "After the operation the cutaneous incision is dressed with cerate, or cold-water compress, and in a few days the cure is complete. The patient should be kept in bed, and defæcation prevented for several days. Hæmorrhage or inflammation occasionally supervene, but have never been found to prevent a favourable result. Occasionally, as in one of the instances quoted, the operation is required on both sides." TURPENTINE COLLYRIA. M. Laugier has lately made use of this application in several cases at the Hôpital Beaujon. His experiments were made upon cases of conjunctivitis, both acute and chronic ptosis, dacryosistis or inflammation of the lachrymal sac, and also sclerotitis, all of which had been (we will not say correctly,) already treated with a collyrium of nitrate of silver, and consequently appeared to the author to be the most appropriate for judging of the comparative effects of the two remedies. The formula which he gives is as follows:-To twenty the higher sulphurets of ammonium are instantly deprived by the cyanide of ammonium of the excess of sulphur they contain above the monosulphuret; for instance, if a mixture of prussic acid and ammonia be added to the pentasulphuret of ammonium, the solution of which is of a deep yellow colour, and the grains of Venice turpentine, heated in an earthenware | This metamorphosis depends on the circumstance, that mortar, add, when sufficiently fluid, twenty drops of the essence of turpentine, and triturate: three or four drops of this to be dropped between the eyelids night and morning. Its action was most beneficial, and seemed preferable to that of the nitrate of silver, employed in the strength of fifteen centigrammes in thirty grammes of distilled water. M. Laugièr after-whole gently heated, the sulphuret of ammonium is wards tried it with a number of externe patients attending the hospital, and affected with acute disease of the conjunctiva and cornea, who had not been submitted to any previous treatment, and their cures were sufficiently numerous and rapid to testify to its harm lessness and efficacy. The proposer of this remedy suggests the propriety of employing the turpentine in the form of an ointment, by mixing it with some fatty substance. He has used the pure oil of turpentine; it however, increased the pain exceeedingly; he therefore recommends its administration in the formula already given.-Dublin Quarterly Journal, 1847. TREATMENT OF ENLARGED SUBCUTANEOUS soon decolorized; and when the clear colourless liquid is evaporated, and the admixture of sulphuret of ammonium expelled, a white saline mass is obtained, which dissolves entirely in alcohol. The solution yields, on cooling or evaporation, colourless crystals of pure sulphocyanide of ammonium. Only a small quantity of sulphuret of ammonium is requisite to convert, in the presence of an excess of sulphur, unlimited quantities of cyanide of ammonium into sulphocyanide; because the sulphuret of ammonium, when reduced to the state of monosulphuret, constantly re-acquires its power of dissolving sulphur and transferring it to the cyanide of ammonium. The following proportions will be found to be advantageous:-Two ounces of solution of caustic ammonia of 0.95 specific gravity, are saturated with sulphuretted hydrogen When matter is formed in these bursa, the only means is the evacuation of the fluid by a free opening; this is gas; the hydrosulphate of ammonia thus obtained is unattended with danger, and followed by a rapid and mixed with six ounces of the same solution of ammonia, complete cure. When, however, the bursal affection is and to this mixture two ounces of flowers of sulphur recent, the skin thin, and the fluid probably a mere increase of the natural secretion of the cavity, the emare added; and then the product resulting from the distillation of six ounces prussiate of potash, three ployment of blisters, or the external application of the ounces of the hydrate of sulphuric acid, and eighteen tincture of iodine, is the best means of lessening the swelling; but it will probably return. For a complete bath until the sulphur is seen to be no longer altered ounces water. This mixture is digested in the watercure, or in those cases where the swelling does not yield and the liquid has assumed a yellow colour; it is then to the application of blisters, or to the external applica-heated to boiling, and kept at this temperature until tion of iodine, more especially if the swelling be not large, the best plan of treatment is to introduce a fine thread through the swelling, and use it as a seton. On the second day this generally causes considerable pain and requires withdrawal. A small quantity of puriform fluid passes for a few days through the opening, after which the swelling gets gradually less, and contracting is completely cured. Very frequently the bursa suppurates so freely as to require a free opening, the hole for the thread having closed. Although this is an extra source of pain, yet the cure is more complete, and quite compensates for this accident. Removal of bursæ simply for their inconvenience is a serious matter.-Ormerod's Clinical Observations, p. 90. HÆMORRHAGE FROM LEECH BITES. In order to arrest the hæmorrhage from leech bites M. Morand advises the application of a mixture of six parts of olive oil, and two of yellow wax; this is to be spread in a thin layer over the bleeding orifices, previously wiped dry.-Brit.and For. Rev., April 1847. CHEMISTRY. the sulphuret of ammonium has been expelled and the liquid has again become colourless. The deposited, or excess of, sulphur, is now removed by filtration, and the liquid evaporated to crystallization. In this way from 3 to 3 ounces of dazzling white dry sulphocyanide of ammonium are obtained, which may be employed as a re agent, and for the same purposes as the sulphocyanide of potassium. Of the two ounces of sulphur added, half an ounce is left undissolved. towards prussic acid furnishes an admirable test for MODE OF REMOVING THE STAINS OF NITRATE OF Mr. Herapath states that these stains consist of finely divided metallic silver, in intimate union with the tissue of the cloth. They are immediately removed by TOTAL ABSTINENCE AND MEDICAL TESTIMONY. the following plan :-The spotted linen is to be strained over a basin of hot water, and a few drops of tincture of iodine are to be dropped on each spot, previously moistened with water. Upon them is then to be poured sufficient of a solution of the hyposulphite of soda to dissolve the iodide of silver thus produced, and the tissue is immediately to be washed in warm water. The tincture of the pharmacopoeia, and a solution of one drachm of the hyposulphite of soda, in two ounces of water, are the preparations recommended. Taking into consideration the immense destruction of linen which is caused by the use of lunar caustic injections, the above suggestion is extremely valuable. -Pharmaceutical Journal, April 1, 1847. TOTAL ABSTINENCE AND MEDICAL TESTIMONY. TO THE EDITOR OF THE PROVINCIAL MEDICAL AND SURGICAL JOURNAL. SIR, My attention has been called to this important subject, by the letter of your correspondent 0, in the last number of our greatly improved Journal; and for the instruction of your readers, and the worthy gentleman's inspection, I beg leave to annex the articles of declaration to which he refers, and which he characterizes as containing "assertions unproved, and consequently, rash and dangerous." "We, the undersigned, are of opinion "I. That a very large portion of human misery, including poverty, disease, and crime, is induced by the use of alcoholic or fermented liquors, as beverages. "II. That the most perfect health is compatible with total abstinence from all such intoxicating beverages, whether in the form of ardent spirits, or as wine, beer, ale, porter, cider, &c. "III. That persons accustomed to such drinks, may, with perfect safety, discontinue them entirely, either at once, or gradually after a short time. "IV. That total and universal abstinence from alcoholic liquors, and intoxicating beverages of all sorts, would greatly contribute to the health, the prosperity, the morality, and the happiness of the human race. "JOHN BOSTOCK, M.D., F.R.S., F.L.S. "Sir B. C. BRODIE, Bart., F.R.S., Sergeant-Sur- 251 considering the high character, in science and morals, of the men who have appended their signatures; neither does it greatly indicate the philosophical acumen of this defender of drinking usages. The quotation from Liebig goes for nothing; indeed that illustrious chemist distinctly states that beer and spirits are not elements of nutrition, but merely elements of respiration. With regard to the opinion of Mitscherlich, that alcohol is formed in our system from the sugar of our ordinary food, I should like to know what the supposed quantity may be per diem? and even supposing the fact proved, which it never has been, the analogy is bad, and no more proves the benefit of these stimuli as daily drinks, than the physiological fact of free muriatic acid being formed in the stomach during digestion, would argue the importance of our drinking daily this corrosive poison. But, lest should be supposed to be an advocate of intemperance, he winds up his arguments by a qualified _ condemnation of the evils connected with these habits, at the same time solemnly cautioning his medical friends to pause!! "ere they bring their characters as men of science into question, by assertions which are not borne out by well ascertained facts in physiology and chemistry." Really there is something of the ludicrous in a nameless member of our Provincial Association, from his concealed retreat, uttering oracular cautions to such men as Bostock, Bright, Brodie, and others, and the absurdity of which, I think on mature reflection, he must acknowledge. The subject altogether is most important, and did I not fear occupying too much space in your valuable columns, I could show from the most undeniable evidence, that the generally-received opinions about the nutritive qualities of stimulating beverages are quite worthless; and also, that in very many cases, the only chance of breaking through the mischievous habit of drinking, is by total abstinence. I admit that temperance, in a well regulated mind, may be all that is necessary; but alas! for one man or woman who can stop at the right point, there are hundreds to whom the cup is truly Circean, and its draught a physical or moral poison. Excuse the length of my yarn, for I have a great horror of long letters, And believe me, "Sir W. BURNET, K.C.H., M.D., F.R.S., Physician General to the Navy. Bristol, April 23, 1847. See Familiar Letters on Chemistry," No, X. "W. F. CHAMBERS, M.D., F.R.S., Physician to the Queen and Queen Dowager. "Sir JAMES CLARK, M.D., F.R.S., Physician in Ordinary to her Majesty." Now it is but fair to ask your correspondent, which of the four very plain statements he finds so rash and dangerous? He talks of no consideration being given to the evidence on which "such propositions, regarded as scientific truths, may be supposed to rest;" again, that an easy good nature, hardly excusable, has caused the signature of many to be given, &c. Now, really Mr. Editor, these comments are not in very good taste, THE PROVINCIAL MEDICAL DIRECTORY. TO THE EDITOR OF THE PROVINCIAL MEDICAL AND SURGICAL JOURNAL. SIR, A very sensible letter appears in your journal of March 24th, signed "Candidus," in reference to the "Provincial Medical Directory," publishing the names and residences of persons as medical practitioners, leaving us to guess the grounds of qualification to any such title they may possess. I, for one, consider it the duty B. Gibbon; A. Ferguson; J. V. Hughes; J. Harwood; Admitted Members on Friday, April the 23rd: of the proprietors of that Directory, not only to omit all names sent to them, devoid of title through the modesty of their applicants, but also to ascertain that those, to whose names titles are affixed, do really possess such. This of course would entail on the proprietors of the Directory, the trouble of examining the printed lists of the various licensing bodies; but it would at the same time enhance the value of the Directory, which is otherwise a record devoid of utility, and an encouragement to quackery and imposition. I think I could select a name or two, for which their owners (as men of letters,) can make no higher claim than appending to their patronymics now in that Directory, the letters M.S.O. F., that is to say, Member of the Society of Odd-Fellows. The Directory ought to be a true book of reference of quali-borough; William Palmer, Rugeley; William George fication, or cease to be at all. MEDICAL REGISTRATION BILL. On Tuesday, April 20th, Mr. Wakley obtained leave to introduce a Bill "FOR The RegistratiON OF QUALIFED MEDICAL PRACTITIONERS, AND FOR AMENDING THE LAW RELATING TO THE PRACTICE OF MEDICINE IN GREAT BRITAIN AND IRELAND." The Bill bas been printed, and is ordered to be read a second time, on Wednesday, May 5th. "Probably this is the last Parliamentary effort that will be made in the present generation to obtain an Act for the Registration of Qualified Medical Practitioners, and for amending the present anomalous condition of medical law. If an immense majority of the medical practitioners of Great Britain and Ireland unite their exertions in support of the Bill, they will obtain a law which will confer both upon them and the public inestimable advantages. If the profession be indifferent, Parliament will be indifferent, and the Bill must be lost."-Lancet, April 24th. SOCIETY OF APOTHECARIES. Gentlemen admitted Licentiates, Thursday, April 15th, 1847-Frederick Freeman Allen, Market Har Harvey, Penzance; William Mott; William Ellis Admitted Thursday, April 22nd :-Morgan Thomas, OBITUARY. Died, March 8th, at Vienna, the Ritter von Raimann, Chief Physician to the Emperor of Austria. April 2nd, in Gracechurch Street, London, Richard Casson, Esq., Surgeon, late of Hull, where, about twenty years ago, in conjunction with the late Dr. Alderson, he established the East Riding Lunatic Asylum. 13th, in Harley Street, William Maclure, Esq., Surgeon, aged 56. 19th, in Finsbury Circus, Thomas Bevan, M.D., aged 43. 24th, in Upper Stamford Street, aged 73, Forbes Macbean Chevers, Esq., a retired Surgeon of the R. N.. THE JACKSONIAN PRIZE. At the late meeting of the Council of the Royal College of Surgeons, the prizes founded by the late Samuel Jackson, Esq., were awarded to Mr. Thomas Callaway, jun., of London, for his Dissertation on Luxations and Fractures of the Clavicle, Scapula and Scapular End of the Humerus, and Treatment; and to Mr. Edward Hulme, of Exeter, for his Dissertation on Asphyxia, its various Causes, Forms, and Treatment. PROVINCIAL MEDICAL AND SURGICAL NOTICE TO MEMBERS. Gentlemen who have not yet paid their subscriptions. for the current year, or who are in arrears, are requested to forward the amount due, either to the Secretary of the district in which they reside, or to the Treasurer or Secretary of the Association. ROBERT J. N. STREETEN, Secretary. ROYAL COLlege of sURGEONS. Gentlemen admitted Members on Friday, April 16th, 1847-P. A. La Fargue; W. Yonge; F. Moore; S..Wilks; H. R. Rump; T. Webb; J. E. Ellerton; E. Adams; W. D, Michell; D. Hughes; C. Munday. Admitted Members on Wednesday, April 21st:-H. TO CORRESPONDENTS. Communication have been received from Dr.Chambers;. D. W. Davies; D. C. R. Hall; Mr. F. Buckell; Dr. Cullen. The Harrogate Inquest-case is in type, but unavoidablypostponed till next number. Surgeon to the Cheltenham Dispensary, and Female the Dispensary department from performing capital Orphan Asylum, Cheltenhamn. With the concurrence of my friends, Messrs. Fowler, Eves, and Fricker, I am induced to publish the following cases and observations on strangulated hernia. Twelve of the fourteen cases occurred in the hospital practice of the two former gentlemen, and one each in the practice of Mr. Fricker and the late Mr. Whitmore. Although not a principal, through the kindness of the above named friends, I had the opportunity of witnessing operations. The rules of the Institution demand that all such cases shall be admitted into the house under the care of the surgeon of the week. These appointments are ably filled by Messrs. Fowler and Eves, who are the Surgeons to the Hospital. There are three Surgeons to the Dispensary who have nothing to do with the Hospital, the appointments in the Hospital are filled up from those of the Dispensary according to seniority. |