CASE XIX.-Apoplexy, insensibility, complete paralysis of the lefi side. Dissection:-Effusion of blood into the right lateral ventricle; calcareous deposit in the arteries at the base of the brain.

Mr. Norman exhibited the brain of a man, 75 years of age, who had suffered about six years before his death from what seemed an apoplectic fit; he recovered perfectly, but has since been subject to occasional ́threatenings of a similar nature, which, in more than one instance, seemed to have been warded off by depletion. On Friday, the 1st of January, he had an attack similar to the first, followed by almost complete insensibility and perfect paralysis of the left side; he remained in this condition about forty-eight hours, when he died. On dissection there was found a large clot of coagulated blood, occupying chiefly the right lateral ventricle, the pressure of which, against the roof of the ventricle, had given rise to the appearance of softening; but on making a section into the nervous matter, such did not seem to have been the case. Some blood had found its way into the left lateral ventricle, but not into any of the other cavities of the brain. The precise source of the hemorrhage did not appear. The arteries at the base of the brain were much diseased, especially the basilar, which was merely a rigid tube from the deposition of calcareous matter.

CASE XX.-Chronic rheumatism; some degree of lividity of countenance; physical signs of obstruction of the left side of the heart, with hypertrophy: sudden death. Dissection :—Aneurism of the left ventricle. Dr. Davies exhibited a heart taken from the body of a young man, 21 years of age, who was admitted into the hospital suffering under chronic rheumatism. It appeared that about three months before his admission he had had an attack of acute rheumatism, for which he had not received any medical advice. He had no recollection of having suffered from pain in the region of the heart, but thought that lately he had been less able to exert himself than formerly. On examination, the countenance appeared rather livid and anxious; respiration quick and shallow; the pulse was small, frequent, and gave a thrilling sensation to the finger. His position in bed was on the back, with the shoulders raised. Percussion over the region of the heart gave a dull sound over a larger space than natural, whilst the impulse of the heart was attended by a general heaving of the left side of the chest.; the second sound of the heart was obscured by a distinct but not very loud bruit. The respiratory murmur in both lungs was feeble. A few ounces of blood were taken from the arm, which did not separate well into clot and serum, but formed a dark-coloured diffluent mass, much resembling blood drawn in typhus fever. His symptoms underwent no change during the four days he was in the hospital, when, on rising from his bed he fell suddenly back, and died within an hour. On dissection, eighteen hours after death, the heart was found much enlarged; the pericardium universally adherent, and greatly thickened. On laying open the left ventricle, there was found, immediately within the left aortic valve, an aneurismal sac, about the size of half a walnut; the other two valves were thickened and contracted;

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the aneurismal sac was filled with partially decolourized lymph and coagulated blood, the lymph being external. The endocardium around the aneurism was covered with thin layers of lymph, and at one point distinct from the aneurism, there was a small ulcerated opening through that membrane. On opening the left auricle, there was found a patch of lymph, exactly opposite the aneurism, showing where rupture would have occurred, had not death prevented such an event; the wall between the two cavities was at this point very thin. The right cavities did not present anything uncommon; the lungs were much congested, otherwise healthy; the liver and spleen were enlarged, the former weighed six pounds ten ounces; the brain was congested, and the blood fluid, so that several ounces flowed out whilst dissecting that organ.

Dr. Davies remarked on this case as being one of by no means frequent occurrence, and as furnishing a clear example of aneurism of the left ventricle, arising from inflammation of the endocardium, terminating in ulceration and rupture of that membrane, and probably softening of the muscular tissue beneath, and thus, by means of the successive impulses of the blood, permitting a cavity to be hollowed out in the muscular structure of the wall of the heart.

TOTAL ABSTINENCE, AND MEDICAL

TESTIMONY.

TO THE EDITOR OF THE PROVINCIAL MEDICAL AND SURGICAL JOURNAL.

SIR,

Nothing could be farther from my intention, than to excite the angry feelings of your intelligent cor. respondent 6, by any apparently harsh observations on the important subject of his letter: I intended no such thing; and much regret that should imagine for one moment such to be the animus of my expressions. The cause of truth needs no such vulgar an attendant as anger, and I leave all irritation,-all suspicion of offence, to the steady defenders of an established error. I am content, if my observations should elicit thought on this momentous subject; and although a considerable number of observing and experienced physicians and surgeons differ toto cælo from my opinions, yet that is no reason for their incorrectness.

I need not remind your correspondent, that all new opinions which make breaches in the citadel of our established habits, must of necessity be adopted slowly; and I only wonder that the principles of the four disputed propositions have been so largely sanctioned and adopted—a pretty sure proof of their correctness, and that in time they will be generally believed.

I quite agree with e, in his right of investigating and judging for himself in this matter, but he must also grant me the permission to put his opinion in one scale, and the recorded views of the eminent men before-mentioned in the other scale, and then we shall see whether the argumentum ad verecundiam, whose support, he says, my cause appears to need, does not apply to himself, and his position: perhaps, indeed, belongs to that class described by Cicero as "Homo timidus virginali verecundia.”

I must beg to correct a statement in reference to

OF ETHER.

an observer not to see that a man's position may be weak, while his opinions may be very well expressed, although ever so erroneous.

It would require a volume to receive the evidence in favour of the truth of what says is unproved, and

every man's experience, I believe, would afford him abundant testimony in favour of the fact "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." I rejoice, however, that "freely grants" there are persons to whom total abstinence is both on physical and moral grounds

desirable, and I surmise that after all we are perhaps only differing in degree rather than in principle. I am no advocate for universal pledging, but I know, in many cases, the pledge is the only security for a man. It is only

the other week I sent a patient (a medical man,) to an asylum, who, had he taken the pledge some time since, would in all probability have been now at his daily

duties; but no, he would not pledge himself, because be thought the use, and not the abuse, of a little stimulus, could do him no harm. I must again request 0 to read

Liebig's tenth letter before referred to, as evidence that beer and spirits are not elements of nutrition, and therefore do not promote the formation of blood; neither are they even necessary elements of respiration, else how would all the tribes of animals exist? They drink not

but at Nature's stream. The North-American Indian, before he saw the white man, lived long, and was happy, but the demon of ardent spirits came, and poisoned him by thousands. I trust the equanimity of your correspondent will not be disturbed by any of my observations; if it be I must really throw down my pen in despair, and believe that a delusion has hold of his mind, which nothing short of teetotalism will

[The following observations on the injurious effects of the inhalation of æther, are extracted from a letter lately published by Dr. James H. Pickford, of Brighton.]

The blood, robbed by the æther of its oxygen, impoverished by the solution by the same agent of myriads of immediate contact, depreciated as a consequence, in the corpuscles, of those especially with which it comes into quantity and deteriorated in the quality of its fibrin, intensely blackened by the solution of its corpuscles and their contained hæmato-globulin, is chemically deprived to a considerable extent of its powers of coagulation and rendered unfit for the purposes of life. A black vitiated blood circulates through the system, analogous in many particulars to that in putrid and malignant fevers.

This impaired condition of the blood is not even partially corrected until respiration of atmospheric air has been permitted for some considerable time, and until lymph corpuscles have found their way into the circulation to replace those of the blood destroyed by the æther. Many persons, especially those who are out of health or enfeebled by long previous disease, are hours, days, nay weeks, recovering from the state induced by the inhalation; many die from its direct effects,-from the want of oxygenized and vitalized blood to stimulate

healthfully the brain and nervous system.

With a view to counteract some of the ill consequences of ætherization, it has been proposed that the patient should inhale oxygen gas, “as an antidote." This, of necessity, presupposes the exhibition of a poison. So that a patient about to undergo operation is to inhale a poison, be subjected to its deleterious effects, and then to swallow an antidote, as though the operation were not of itself sufficient, without all this extra complication of poison and antidotes, suspended animation or actual death, proximate or remote.

But what are the facts? Etherized blood cannot be

reddened by oxygen gas, simply because its black red colour is not dependant alone on a chemical change in the hæmatin. The æther has also dissolved the bloodcorpuscles, and thus permitted the escape of the contained hæmato-globulin ; and these it cannot restore. Had the blood been merely rendered artificially venous by the absorption of its oxygen, or by cutting off its ordinary

supply, its arterial colour would be restored by agitating it with oxygen. In the following experiment, these facts are pretty clearly established.

In each of two vessels I caught eight and a half ounces, by weight, of arterial blood; both vessels were instantly plunged in water at a temperature of 98° Fahrenheit. The blood in one vessel was exposed for three minutes to the influence of the vapour of æther. The blood became of an intensely black red colour, whilst coagulation was to a very considerable extent interrupted. Subsequently, oxygen gas was diffused through the ætherized blood; but no restoration of colour could be produced. Placed in the field of a powerful microscope, numerous flocculi, the remains of the capsules of the corpuscles, were observed floating in the fluid portion of the blood, which was rich with these remains. At the

expiration of 72 hours, the blood in both vessels was weighed—that which had been subjected to the vapour of æther yielded five and a half ounces of black red fluid. and three ounces of a stringy clot, conclusive evidence of the small amount of fibrin. The fluid portion of the blood (serum) in the other vessel, in which neither flocculi nor corpuscles could be detected under the microscope, weighed half an ounce, the clot, eight ounces.

This indisposition of the blood to coagulate after the inhalation of æther offers another very serious consideration. Fatal hæmorrhages must occur, and do occur; and as-the whole circulating fluid is deteriorated by the æther, is it matter of surprise that the lips of wounds evert, that the discharge is unhealthy, that stumps become flabby or gangrenous, and that patients sink and die ?

Ætherization, it is to be feared, exerts also a baneful influence directly upon the respiratory organs. A medical friend in Dublin informed me recently that of thirty fatal cases following operations in which æther had been employed in the various hospitals of that city, eight were found to be the subjects of recent tubercles of the lungs, the undoubted product, it was believed, of inhalation.

The endeavour to alleviate human suffering under one of the most trying of all situations, the knife of the surgeon, is highly praiseworthy, and the public must feel deeply indebted to those medical gentlemen who have devoted their time and talents in the attempt to achieve so desirable an end. It becomes us, however, to ascertain, as far as we are able, whether the means employed are compatible with the health and lives of those about to undergo operations.

Pain during operations is, in the majority of cases, even desirable; its prevention or annihilation is, for the most part, hazardous to the patient. In the lying-in chamber nothing is more true than this: pain is the mother's safety, its absence her destruction. Yet are there those bold enough to administer the vapour of æther even at this critical juncture, forgetting it has been ordered that "in sorrow shall she bring forth."-Brighton Guardian, June 2nd.

General Retrospect.

ANATOMY.

VULVO-VAGINAL GLAND.

M. Huguier has given a description of a gland situated at each side of the junction of the vulva to the vagina. It was discovered by Gaspard Bartholin, and was generally described by older anatomists; but of late its existence has been almost forgotten. According to M. Huguier, this gland is about the size and form of an apricot kernel, and is provided with an excretory duct, about seven or eight lines in length, the external aperture of which is situated in the angle between the vulva and the border of the hymen. This gland is small until puberty, when it is developed with the other organs of generation; it becomes turgid during sexual excitement, and secretes a quantity of clear mucus-looking fluid, which it is said to ejaculate with some force, M. Huguier agrees with former anatomists in regarding this gland as closely analogous

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to Cowper's gland in the male subject, for it is situated in about the same part of the perineum as this latter is, and presents the same anatomical relations and connexions. It is an appendage to the vulvo-vaginal. cavity, a part which is analogous to the urethra in the male; it receives the materials for its nutrition and its sensation from the same vascular and nervous sources. as does Cowper's gland; it presents also many varieties in form, size, and situation, and it may be absent on one or both sides, as is often the case with Cowper's gland.-Archives d'Anatomie.

PHYSIOLOGY.

INFLUENCE OF THE PNEUMOGASTRIC NERVES ON

DIGESTION.

The results of some experiments performed by MM. Bouchardat and Sandras, to determine the influence possessed by the pneumogastric nerve over digestion, shew clearly that division of both these nerves in the neck, at once arrests the process of digestion so far as the stomach is concerned, but has no influence over that part of the process which takes place in the intestines. After feeding dogs with a mixed diet, and then dividing both pneumogastric nerves, they found, after twenty-four hours, that those substances, the digestion of which is effected principally in the stomach, such as albumen and fibrin, were quite unchanged, whereas those substances which are digested in the intestines, such as the amylaceous and fatty principles, had been dissolved and absorbed just as though the pneumogastric nerves had been undivided. In several of these experiments they found that, although no chyme is prepared in the stomach after division of the nerves, yet the starchy principles which pass into the intestine are there converted into glucose, and that the fatty matters are absorbed by the lacteals, just as in the ordinary state of health; so that the digestion and disposal of these principles appear to be quite uninfluenced by the operation. They found also that it is not by compression of the trachea, by the distended cesophagus, that rabbits die when fed after division of the pneumogastric nerves as high up as on a level with the larynx.-Comptes Rendus, Jan., 1847.-Medical Gazette, April, 1847.

ON THE FOOD OF CHILDREN.

By Dr. Thompson.

[After some remarks on the relative quantities of nutritive matter in various articles of diet, Dr.Thompson makes the following useful observations on the appro priate food of chidren.]

"Milk, in some form or other, is the true food of children, and the use of arrow-root, or any members of the starch class, where the relation of the nutritive to the calorifiant matter is 1 to 26, instead of being as 1 to 2, by an animal placed in the circumstances of a human infant, is opposed to the principles unfolded in the preceding table. In making this statement, I find that there are certain misapprehensions into which medical men are apt to be led at the first view of the subject. To render it clearer, let us recal to mind what the arrow-root class of diet consists of. Arrowroot and tapioca are prepared by washing the roots of