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THE ACID OF THE BEZOAR.

This acid (says M. WÖHLER) proves to be the ellagic acid ofM. Braconnot. This is a remarkable fact. It proves that thematter of the bezoar is produced from the food of the animals,

containing, doubtless, the ellagic acid already formed, or tannicacid. The analyses of ellagic acid, formerly made by M.Pelouze, assigns to it the formula C7 H2 O4 which differs frommine only by half an equivalent of hydrogen-C14 H2 O7 + H0The last is probably the most exact.-(Letter from M. Wöhler toM. Dumas, Comptes Rendus.)

ACTION OF SUGAR UPON THE TEETH.

FROM researches made on this subject, M. Larrey has come tothe following conclusions :-

1. Refined cane, or beet-root sugar, is prejudicial to the teethmore from its direct contact than from the evolution of gaseousmatter during digestion.

2. If a tooth be allowed to macerate in a saturated solution ofsugar, it is so decomposed as to acquire almost a gelatinouscharacter, while the enamel becomes opaque and spongy, andcrumbles down under the slightest pressure. Sugar ought not,therefore, to enter into the composition of tooth-powder.3. The erosion of the teeth by this substance does not dependon an acid, for none is present in sugar, but on the affinity whichthis organic principle has to enter into combination with the cal-careous base of the tooth.

4. If the enamel be less attacked than the osseous part of thetooth, the reason is, that it contains fluoride of calcium, a bodywhich resists chemical agency even more than the sulphate of lime.[Remarks.-That sugar easily combines with lime, and forms

a compound out of which the lime may be obtained crystallizedas carbonate, has been long known; but it is something new thatit should thus exert a solvent power over the phosphate and car-bonate of lime. M. Larrey’s last conclusion does not appear tous to be sound: the enamel contains only traces of fluoride ofcalcium, while the phosphate of lime forms seventy-eight percent., and the rest is chiefly animal matter. A better reason willbe found, probably, in its hardness and close texture. It wouldbe interesting to know whether these chemical results are borneout by observations made among those who are in the habit oftaking large quantities of molasses and saccharine substances.-ED. Medical Gazette.

BRITISH AND AMERICAN MEDICALJOURNALS.

ON THE IMPORTANCE OF A CORRECT PHYSIOLOGY OF THE BRAIN,AND GREATER ACCURACY IN REPORTING POST-MORTEM EX-

AMINATIONS. By N. S. DAVIS, M.D., Binghamton, New York.THE followiug remarks we consider worthy of careful perusal.Perhaps no one thing tends more to degrade the medical pro- ’i

fession, in the estimation of enlightened men, than the various I,uncertain and contradictory testimony often given by medicalmen on the same case in courts of justice. A great variety ofcases are continually occurring, in which the testimony of physi-cians is required; and what other inference can be drawn fromtheir conflicting statements and conclusions, made up ostensiblyfrom the same facts, than that the whole is a mere system of"guessing"-" a science without a single well-established prin-ciple for its foundation." For instance, in testing the validity ofa will, the attending physician is called, testifies that the testator,-while making the will, was labouring under inflammation of thebrain sufficient to confine him to bed, and to render active anddirect depletion necessary, and that individuals, under such cir-cumstances, would be likely to retain full possession of their mentalfaculties.

Another, of equal celebrity, is called, and testifies, with muchapparent certainty, that a patient under such circumstanceswould not be likely to possess his mental faculties. A third,equally entitled to confidence, maintains that the brain is com-posed of a number of distinct organs, performing different func-tions ; and that all would, therefore, depend on the particularorgan or organs affected. If we suppose that the witnesses areequally entitled to credit, is it not evident that no conclusion canbe legitimately drawn from their testimony. And yet more con-tradictions than in the case supposed are almost daily occurringbefore our legal tribunals. To what, then, are they owing? Tocarelessness of observation, and want of candid investigation, orto some radical defect or uncertainty in the science itself?By far the most prevalent cause is carelessness and want of

minute investigation on the part of the great body of physicians.Being often taught, as a part of their primary education, themental or metaphysical philosophy of the schools,- and thus habi-

tuated to contemplate the mind unconnected with its physicalorgan, the brain, they often become eminent in their profession

without ever investigating closely the connexion between themind and brain, much less arriving at any clear and rationalconclusions concerning it. But if it be true that the cortical orgray substance of the brain is the seat of the mental operations,and the white or fibrous portion, like the nerves, only transmit-ting its functions, then we should infer, à priori, that diseasein those respective portions would be accompanied by derange-ment of the corresponding functions. And further, if the corticalportion be made up of as many distinct organs as there are sepa-rate mental faculties, then we should equally expect to find diseasein any one of those organs always accompanied by derangementof the corresponding faculty. And hence, we not only arrive atdefinite conclusions concerning the functions of different portionsof the brain, but we are prepared, on the appearance of certainsymptoms, or the derangement of certain mental faculties, topredict the location and extent of the disease; or, on the appear-ance of certain morbid changes after death, to determine, withsome degree of accuracy, the symptoms and mental disorderswhich must have preceded. The practical bearing and import-ance of these views cannot be doubted. The orly question is,whether the propositions on which they are based are true? Ifwe appeal to morbid anatomy, the two following questions meetus for a candid examination :-

1st. Is there a case on record in which morbid appearanceswere observed in corresponding portions of the cortical substanceof the brain, in both hemispheres, where the patient had notpreviously manifested corresponding mental derangement?

2nd. Is there a case on record in which the morbid appear-ances had been confined exclusively to the medullary substance, inwhich mental derangement had been present to any considerableextent? -

Having carefully examined everything within our reach,touching the subject, we answer the first question in the nega-tive. The question is, not whether lesions of greater or lessextent had been found in one hemisphere, without mental dis-turbance ; neither is it whether organic lesions are perceptiblein the brain in every case where death takes place during theexistence of insanity. As well might we suppose that pluckingout the right eye would invariably destroy vision in the left also;or that organic lesions in the lungs would be found in every caseof death during difficult or disturbed respiration.

Destroying one eye might indeed lessen the field of vision, andso might destruction or disease of a portion or the whole of onehemisphere of the brain greatly lessen the vigour of the mind.But have corresponding portions of the cortical substance of bothhemispheres been found diseased, without derangement or

destruction of some faculty of the mind? We have yet been un-able to find any such instance.But it must be confessed that the subject is attended with

some difficulty, on account of the ambiguity and indefinitenesswhich characterize many reports of cerebral disease.

This want of precision exists in many cases related by Aber-crombie, in his work on diseases of the brain, pages 105, 108,112. And, indeed, almost halt of the cases reported in the vari-ous medical journals of the day are equally indefinite. Theymay prove what every pathologist already knows-viz., that cer-tain parts of the brain may be diseased or destroyed, withoutproducing mental disturbance. Or they may even prove, whatProjessor Sewell and other opponents of phrenological prin-ciples have asserted with apparent trinmpli -viz, that everypart of the brain has been destroyed by disease and injury, with.out producing mental alienation-a fact of’ as much physiolo-gical importance as would be the assertion that in ten men allthe organs of external sense were destroyed, and yet every indi-vidual of the ten could feel, see, hear, taste, and smell.

In studying the pathology of the brain, it is not enough to as-certain that half a pound of water has been effused ; or that" there is an abscess in the right hemisphere," or a "coagulumof blood in the left;" but we must first, if possible, rightly un-derstand the symptoms during life, ascertaining not only thatthe intellect is sane, but that all the moral faculties and propen-sities are equally normal. And after death we must bestow the

necessary labour to ascertain, with minuteness, the precise seatand extent of the disease. If this were done by every observer,pathology would not long remain barren in its contributions to acorrect physiology of the whole nervous tissue.Of the importance of greater accuracy in the detail of cases,

every one will be convinced who examines those already re-corded, with the intention of drawing therefrom general conclu-sions. In the present state of our knowledge, we believe there isno case on record contradicting the general rule that disease inthe cortical substance of the cerebral convolutions, in correspond-ing parts of both hemispheres, is invariably attended with de-

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rangement of some faculty or propensity of the mind. Thecases which seem to militate most strongly against this rule, arethose of superficial ulceration of the brain, related by Aber-crombie and others. But in those cases the ulcers were confinedto one hemisphere, or affected different parts of both, and wereevidently of a strictly chronic and local character. And themore recent investigations of pathologists would induce us tobelieve, that in every case where death results from insanity,there is well-marked disease of the cortical substance of thebrain. Thus, Mr. Davidson, house-surgeon to the Lancaster

County Lunatic Asylum, " has examined with much care thebodies of more than two hundred patients who have died in thehospital since his appointment, and the result is, that he hasscarcely met with a single instance in which traces of disease inthe brain, or its membranes, were not evident. Again : M.Foville, Calmeil, Fatret, and Bayle, agree in asserting, that " inmental alienation, the brain invariably presents lesions which canbe distinctly recognised." And Sir William C. Ellis, ResidentMedical Superintendent of the Pauper Lunatic Asylum at Han-well, states, .. that of one hundred and fifty-four male patients,examined after death, one hundred and forty-five had diseasevery strongly marked, either in the brain or its membranes. Ofthe nine remaining, two were idiots from birth; one died of dys-entery ; another of epilepsy ; the other five had not been insanemore than a few months, and died of other diseases. Of thefemales, sixty-seven were examined, and sixty-two found withdisease in the brain or its membranes. Two of the other fivewere idiots from birth ; and, with one exception, the others wererecent cases. The present list of cases on record would lead usto the equally important conclusion, that disease affecting thecentral parts of the brain, as the corpora striata, the opticthalami, and the upper portion of the medulla oblongata, invari-ably deranges the powers of voluntary motion and sensation.For many cases illustrating this conclusion, see " Abercrombieon the Brain."

In these cases, the disease is generally insidious in its ap- proach, and often fatal, without any other marked symptom ofcerebral disease than paralysis of some one of the extremities,and sometimes convulsions. A third conclusion, of no less

practical importance than the preceding, is, that disease in a partof the medullary substance which forms the commissures or con-necting fibres between the convolutions and the central partsmentioned above, when confined to one hemisphere, is seldom, ifever, characterized by either mental derangement or disturbanceof the powers of sensation or volition ; and hence its existence isoften unsuspected, until revealed by a post-mortem examination.Those cases usually (though not always) commence with pa-roxysms of severe pain, generally of limited extent, in somepart of the head, and not unfrequently vomiting ; the skin is hotand dry, the pulse either slower than natural, or small and fre-quent ; and though there is no real mental derangement, yet thepatient almost always feels an unpleasant sensation in the head,either more marked or different from what is usual in attacks ofordinary fever. Of this description are many cases of chronicabscess, related in Abercrombie’s work on the Brain. Many ofthese cases resemble, in the prominent symptoms, mild attacks offever; and it must be confessed that we yet possess no certainmeans of diagnosis. But may we not hope that a more carefulobservation of symptoms will yet enable us to detect disease inthis part of the cerebral substance, as well as on its surface, or inthe medulla oblongata? Practitioners have been too much inthe habit of considering the brain normal, so long as the intel-lect remained sufficiently sane to answer questions correctly, andthere was neither paralysis nor convulsions; and hence thosehitherto less intelligible sensations, as pain, heaviness, dulness,vertigo, and other feelings in the head, have been too little at-tended to. To report accurately cases of cerebral disease, wemust first study, minutely and correctly, cerebral anatomy. Itis proverbial that medical science abounds in false theories; butwe believe even a slight examination will show that false factsare far more numerous than theories.-American Journal of In-sanity, No. III.

It may be here remarked, that microscopical observations,which have been carried on with great activity for some yearspast, particularly on the Continent, are likely to throw muchlight on the pathology of the brain. Dr. John Hughes Bennett,in a lecture on Histology and the Use of the Microscope, pub-lished in THE LANCET, of the 10th of May, 1845, says,--" Inpathology, how vague are the ideas attached to inflammation,softening, tubercle, and other morbid processes. On these aflood of light has been thrown by the microscope. This subject,indeed, has been comparatively little studied, and yet I know oinone which is likely to yield such interesting and important re-sults to a microscopic inquirer. The apathy of the profession,however, on this point, has hitherto been most singular....

Notwithstanding several years have elapsed since Ehrenbergdemonstrated the tubular structure of the brain and nerves;notwithstanding that his observations have been repeatedand confirmed by every minute anatomist. of the age, where isthe physician in the charge of lunatic asylums who has ever evenattempted to determine whether the minute tubes and structuresare affected in mental disorders? I would ask, does it not seemsurprising that pathologists would rather have recourse to thewildest theories, talk of molecular changes,. use terms whichhave no precise meaning, when for a few guineas they couldpossess an instrument by means of which they can see the mole-cules of which they talk, and observe structural changes of whichthey have no idea? 1 have lately had many opportunities ofsatisfying myself that death may be occasioned by structuralchanges in the brain, which are altogether imperceptible to ordi-nary sight, and which have escaped the careful scrutiny of thefirst morbid anatomists in Edinburgh."-Phrenological Journal,July, 1845.

A case very similar to the following, but of a more severe cha-racter, is at the present moment under our notice. The patienthad been run over. There was fracture of the ribs, and of one

thigh; the upper part of the trunk was emphysematous; the faceenormously swollen and livid. The patient is now doing well.There was no lividity of the hands.CASE OF PROBABLE INJURY TO CHEST-CONGESTED FACE-

DEPLETION-RECOVERY.

H. E-, aged five, admitted under Mr. KEY, July the 26th.Had either been run over by a cart, or jammed between thewheel and a post, and had apparently injured the chest. Whenhe was seen, about three-quarters of an hour after the acciden4,he was still collapsed, breathing with great difficulty, and unableto expand his chest. Pulse quick and feeble; heart’s action sharpand struggling, as if labouring to propel the blood. His face wasswollen, and completely ecchymosed with purple blood. He was

constantly endeavouring to cough, and was much distressed. Mr.Cock ordered a small quantity of blood to be taken from thejugular vein, which was considerably distended.-Nine o’clockP.M. Seemed altogether easier, but the breathing much oppressed;had not been bled. Three ounces of blood were then taken fromthe back of the hand; and mercury, with chalk, and James’spowder given.

July 27th.-Less distress of breathing, though still considerable;the face remains greatly puffed and congested. In the eveninghe had considerable fever; the skin was hot and dry. A salinemixture.

July 28th.-Better: all his symptoms subsiding.Aug. 7th.-Quite well; almost all the traces of ecchymosis

have disappeared, except from the conjunctiva.Left the hospital August 21st.An analogous case was admitted into the same ward a year or

two previously. It was that of a boy of about the same age, whomet with a similar accident, and had precisely the same symp-toms ; but in addition he had fracture of several ribs. Calomeland bandaging were the chief treatment. He got perfectly well.-Guy’s Hospital Reports.

MODIFICATION OF THE CHEST CALLIPERS.

If this instrument can be of any use, the following modification,proposed by Dr. SPITTAL, is calculated to promote it :-

Dr. Spittal exhibited two pairs of brass callipers, similar tothose described for ascertaining the diameter of the thorax. Theone had a fixed, the other a moveable spring, for the purpose ofkeeping the blades, with their flat disks or button-like extremities,applied to the chest; and both had a graduated scale below theattached extremity of the blades. Dr. Spittal called the attentionof the Society to a modification which he had found advantageousin using the instrument-viz., enlargement of the disks, whichshould not be less than from two thirds to one inch or more indiameter, and rendering these moveable in the direction of themotion of the limbs of the instrument. By this arrangement, theextremities of the callipers always adapt their flat surfaces to thethorax ; whereas, when the disks are fixed, their edges, in certainmeasurements, are presented to the chest, and sinking into thesoft parts, render the observation less accurate; a like objection,of course, applying to disks of small size. The amount of themovements of elevation and depression of any part of the thoraxduring respiration, is very easily ascertained by this modification.the moveable extremities of the instrument following the motionof the chest, the exact range of which is shown by the correspond-ing movements of the index over the.graduated scale."-EdinburghMonthly Journal.