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placed gut, in order to discover the natureof the obstacle. Here is another question.Does strangulation situated at the superiororifice of the canal, differ from that si-tuated at the inferior part? Yes; there isa manifest difference. In the first case,the parts engaged are soon attacked withgangrene, on account of the thinness pre-sented by the edges of this orifice occa-sioning a tight constriction on the neck Iof the sac ; while the intestine is muchless strongly compressed at the external I,orifice, whose edges are blunt and widelyseparated. A common ring will exemplifythis sufficiently well; when round and

large, it exercises little or no compressionon a certain mass of parts passing throughit; but when small, with sharp edges, itcuts rapidly through them.As strangulation at the neck of the sac

readily occasions disorganization of the

parts, we should lose no time in operating,because it is difficult to reduce the herniacompletely; and, on the other hand, thesharp edges by which the intestine is

pinched, constantly tend to produce gan- ;grene. The resistance offered by differenttissues merits attention; the peritoneumresists, for a long time, pressure; but themucous membrane is soon divided in acircle ; when the strangulation has existedfor two or three days, the cellular mem-brane is cut across, and finally, in somecases the peritoneum is divided, so thatthe least traction is sufficient to separatethe two ends of the intestine. Hence,when we operate on a similar hernia, weshould never draw the intestine before the

parts are fully and freely divided, other-wise we expose the patient to an effusionof stercoral matter in the abdomen.[We will, on another occasion, lay be-

fore the reader some cases illustrative ofthe principles laid down in the foregoinglecture.]

DISCOVERY OF

AN INSECT IN ITCH,

By Experiments lately made at the HopitalSt. Louis, Paris.

Tun antiquity of the disease vulgarlydenoted the itch will not he contested,and nearly of as ancient a date has beenthe popular opinion that it is accompa-nied by an insect to which the appella-tion acarU8 scabiei has been given. The

popular supposition has always existed,not so that of the learned ; for although atperiods it has hy some authors beenzealously adopted, it has at others been asobstinately repudiated. The existence of

the acarus, however, as an attendant onthe itch, is now placed beyond doubt bylate experiments at the Hopital St. Louisin Paris.

Gale, the French word used to expressitch, is by some derived from the Latincallus, but according to a more judiciousetymology it takes its origin from the

Latin galla, a nutgall,—a suppositionwhich, if correct, would show the an-

tiquity of the belief that an insect is pre-sent in the itch, just as the nutgall is

produced by the cynips quercusfolii on theleaves of the quercus inftetoria. The Ara-bian physicians, and particularly AVEN-ZOAR, firmly believed in the presence ofan insect in the itch. It was distinctlydescribed by MOFFAT, an English author,who wrote in the beginning of the 17thcentury. Among the Italians, REDI andBONONIO have noticed this insect, andthe latter author has given a particulardescription of its physical characters andits habits. After these writers came

LINNÆUS, who confounded it with themite of cheese. It was subsequentlymade an object of special research by DrGEER, who described it so well, and gaveso accurate a drawing of the insect, thatit was called the acarus of De Geer. M.LATREILLE has placed it among the genussarcopte.

In 1812 the subject again became amatter of dispute, and a series of experi-ments were instituted in Paris, the resultof which was, that the acarus was found,and exhibited to the eves of both thecredulous and the incredulous, and itsexistence was once more considered anarticle of medical faith. However, at asubsequent period, M. LUGOL, who hadfor six years taught the existence of theacarus in his lectures on diseases of theskin, on being appointed to the HopitatSt. Louis, considered it unworthy of anhospital professor to call on his pupil tobelieve anything in the absence of oculardemonstration which was within reach.

Accordingly, pins, needles, and variousprobing instruments, together with micro-scopes, were again in requisition, and em-ployed most assiduously by M. Lucoi. andhis class, but, strange to say, the acarus,formerly so complaisant, evaded every re-search. Other microscopes of greaterpower were provided, but after severaldays of scrupulous examination nothingwas found.M. LUGOL, from being a firm believer

in the existence of the acarus, became,from this time, a decided sceptic, and sofully was he convinced of the impossi-bility of finding this insect, that, in a con-versation with M. ALBERT, who ratherleant to the opposite doctrine, he declared

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he would give a prize of three hundred (thirty in number), reminding them, at thefrancs to the first student who should ex- same time, of the 300 francs offered by M.tract an acarus in his presence. This LUGOL.challenge was thrown out in 1828, but not A short account of the discovery ap.until 1834 was it met. Not that the in- peared in one of the medical journals, andterval was allowed to pass without re- elicited a reply from M. LucioL question-peated attempts to discover the insect. ing the reality of the occurrence, andSeveral students sought for it in vain. treating it as a fresh mystification. ButM. GALES, the head apothecary at St, M. RENUCCI was not to be deterred fromLouis in 1812, showed what he described pressing his claim to the merit of theas the acarus, and wrote a thesis thereon, "discovery," and, backed by M. Ai-iBEM-,accompanied by a drawing, but the in- inserted a rejoinder, offering to extractsect figured by him was recognised to be the acarus alive before M. LUGOL him-nothing more than the mite of cheese. self, or the whole faculty.BB hether he found the real insect or not .

is a matter of doubt, but no doubt can The affair now began to cause some ex-exist as to the incorrectness of the draw- citement; nothing was talked of, or look.ing he has given. ed for, in the hospital, but the acarus ;Three days were devoted to a further in- the wards allotted to itch patients, hereto-

vestigation at the Hotel Dien,-a doctor of fore so quiet, were now thronged withthe faculty of Paris presicling, M-RASPATT. students and visitors, anxious to discoverbeing present, but the three sittings were or view the long-disputed insect. The

unavailing. Some time afterwards M. day appointed for convincing M. LuGOLMEMER, a naval surgeon, came to the arrived, and with it a number of scientificHohital St. Louis, and boasted of having persons; amongst others was l. RASPAIL.found the acarns; but what he exhibited Several acari were extracted, placed un.was nothing but the mite of flour. Be- der the microscope, and seen as plainly aslievers in the acarus now lost ground, and an insect of that magnitude could be. M.said little about it, referring to it at all in LucoOL’s doubts vanished before the masstheir lectures only very cautiously. Even of living evidence, and, addressing M. RE-the courageous AnBERT preferred laying NUCCI, congratulated him upon his suc-before his class the host of great names in cess and upon the benefit he had thus con-favour of the acarus, to declaring to his ferred upon science, at the same time as-pupils his own conviction on the subject. suring him that the prize of 300 francsThus matters stood, when, about the should be forthcoming, as soon as he

beginning of August last, a girl presented wished to claim it. Upon this occasionherself at the consultation room of the M. AMBERT declared that the rewardHopital St. Louis, to be treated for what should not be limited to :300 francs, butshe called the itch. Some doubt arising that he would add a gold medal, bearingas to the exact nature of the eruption, the name of the discoverer and the date ofM. RENUCCI, an Italian student, offered the event. Praise is due to M. ALIBERTto remove all difficulty as to the diagnosis, for his efforts on this occasion, and his en-by ascertaining the presence or absence of couragement of M. RENUCCI, whose exer-the acarus, which he said was so common- tions would otherwise most probably notlyfound in cases of itch in his country, that have been successfully made. But fewthe peasants extracted them from each insects were found during the first expe-other with pins or needles. riments, but, stimulated to perseveranceNo objection being made to the experi- by the persuasions of M. ALBERT, the

ment, M. RENUCCI examined the girl’s searchers for the acari produced them athand, and in an instant extracted a small last en, masse, and during repeated sittings,roundish demi-transparent body, of about and thus forced conviction on unbelievers.two-thirds the size of an ordinary cheese According to M. RENUCCI, the acarus, ormite, and exhibited it in presence of a num- itch ciron, is never to be found in the ve-ber of students of the hospital- On being sicle. It appears, however, that M. GERDYplaced on black paper, or on the nail, this junior has in two cases extracted the in-whitish speck exhibited the power of loco- sect from the vesicle, in which situationmotion, scampering about with activity, it has occasionally but very rarely beenunaware of the noise it might make in the found by others. In the great majority ofannals of science. On the arrival of M. cases the acarus is only to be met with inALIBERT (as it was that professor’s morn- a small epidermic canal, probably exca-ing for receiving patients), the facts were vated by itself, invariably terminated bydetailed by M. GERDY the interne, when one of its extremities in the vesicle, eitherM. ALIBERT ordered aproces verbed, or straight or tortuous, and varying inreport of the circumstance, to be drawn length from one to three lines. The raisedup and signed by the students present epidermis forming the vault of that canal,

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presents a grayish yellow dull aspect,which is interrupted most generally to-wards its non-vesicular extremity, by adull white opaque speck, betraying theposition of the insect, and owing the dif-ference of its hue to the same cause. Thisextra-vesicular position, combined withthe minuteness of the insect, partly ex-plains the fruitlessness of past researches.As it seems to be found that temperatureexercises much influence upon the activityand bulk of the insect, the season mayfurnish an additional explanation of thewant of success upon former occasions.Such being the remarkable position of theinsect, it is only necessary to take a fineneedle, and, having previously washed thevicinity of a vesicle, to penetrate the vaultof the subdermic groove as delicately aspossible, so as to avoid mutilating thelittle creature which it contains, and,having captured it, to withdraw it, clingingto the point of the instrument. Place thelittle shapeless, opaque, whitish body inthe field of a strong microscope, and youwill be amply gratified by finding this al-most imperceptible and inorganic-lookingmass start into an insect, having limbs,joints, feeler:, &c. We have repeatedlyseen and examined the insect by trans-mitted and reflected light, and can vouch

for the following description drawn up bythe celebrated RASPAIL:-

" The acarTr.s scaLiei, seen through themicroscope, presents the form of a tor-toise, a shining surface, more transparentin the centre than at the circumference,of a white opaque colour. Its other shadeswould appear to be the result of the divi-sion of luminous rays passing through thelens. The head, which may be consideredas a perfect retracting sucker, is providedat each side with two articulated feet, ter-minating, at the tarsus, in a funnel-shapedprolongation. The insect is armed withfour additional feet, longer than the former,but without the funnel-shaped append-age ; this articulation is not at the sides,like those of the horse-acarus, but under.neath the belly; on the back is per-ceived a number of eccentric lines at shortintervals, and having the appearance ofjoints ; the belly presents several dark-coloured spots ; the body and legs seemedfurnished with a quantity of hair of un-equal length."The following engraving represents

the Acarus Scabiei, immensely magnifi-ed.The actual size ot the insect is about thatof the mark which would be left on paperby the gentle insertion of the sharp ex-tremity of the finest needle.

Such is the appearance of the insect asit has been extracted from an immensenumber of itch patients (who had notcommenced any treatment—a necessarycondition), and as it has been seen andexamined by several distinguished medi-cal men in this capital. There is somedoubt as to the number of feet upon whichthe insect moves, some observers notingeight, and others only six, a differencewhich is attributed by M. CLOQUET to

the relative age of the insect, and by M.GALES to the difference of sex.The existence of the acarus is, then,

placed beyond doubt, but its relation toscabies is in clouds and darkness. Is itthe cause of the vesicle, and if so, how ?Is the vesicle caused by the deposition ofits eggs, the development of which deter-mines inflammation-or by the deposit ofa poison,-by irritation produced by its

members,-or by its bite ? Or does it

62

show itself in the individual merely in

consequence of the attraction produced bythe itch matter, or the nith attached to theperson ? ?A delirium of joy at this discovery every

day betrays itself in the amphitheatre ofthe Hôpital St. Lovcis. When it has snb-sided, a solution of these questions may beeffected by careful and continued re-

search. The only rational attempt as yetmade towards this solution, is that ofALBIN Grtns, a student at the hospital.This gentleman submitted his arm to a

troop of these parasitical insects, and ob-tained a development of some character-istic vesicles. A subsequent intolerable

itching, combined with the external clia-racters, left little doubt as to the powerof these insects to communicate the dis-ease. But still the question is not decided,because the matter adhering to the insectsmay have been the cause of the vesicles,instead of the irritation simply produced iby its presence. It has indeed been pro-posed by one of the professors (seriously ?) 1to submit the insect to the action of a warm-bath before inserting it under the’epidermis, and to pay particular attentionto washing, brushing, and drying its feet ! IThe experiments are still in progress.J. F. S. ,

Sept. 30th, 1834.

EMPLOYMENT OF

LAUREL LEAVES IN TICDOULOUREUX.

CHARLES LOUDON, M.D.

To tlte Editor of THE LANCFT.

SIR,—Having read in your last Num-ber (page 939, Vol. II., 1833-34) a reviewof Mr. Scott’s work on tic douloureux,and more especially on the subject of localapplications in that disease, permit me toadd another and a more gentle remedy,which I have found to be extremely effi-cacious during the paroxysms of the ail-

ment, and even to remove the affectionaltogether. It is simply to apply to thepained part a cataplasm of well-bruisedlaurel lea2es for a quarter of an hour or so,until a slight erythema is produced on theskin. It is somewhat curious that evenwhen this remedy is applied on the cheek,surrounded by a wineglass, the smell ofthe leaf becomes apparent to those whoare around the patient, during each pul..monary exhalation, and the peculiar tasteis felt in the mouth. It is thus manifestthat the therapeutical principle comesinto contact with the immediate seat ofthe disease.

Reasoning on this fact, and on the great,sympathy existing between the stomachand the remoter parts of the body, per-haps some of the readers of your widely-extended Journal would have the good-ness to try what efl’ect the internal use ofthese leaves would have in obstinate casesof this nature, of a purely dynamic cha-racter-of course as an alterative, begin-ning with a grain or so three times a day,and gradually adding to the doses until

some decided effect was produced. Fromyour well-known liberality, I feel confi-

dent you will be kind enough to publishthe results, even if unsuccessful. I am,Sir, your very obedient servant,

CHARLES LOUDON, M.D.Leamington Spa, Warwickshire,

Sept. 24, 1834.

MERCURIAL INUNCTION

IN

ERYSIPELAS.

2o the Editor of THE LANCET.

SIR Having been induced by the fa-. vourable notice taken in your journal ofthe treatment of erysipelas by means of " merc;urial inunction on the inflamedsurface," as lately adopted in some of the

- French hospitals, to try its efficacy whencombined with the administration of mi-nute doses of tartarized antimony, in se-

veral cases of that formidable diseasewhich fell under my care in Mercer’s Hos-

pital, in the course of the last spring andsummer, I gladly avail myself of yourpages, to bring the result to the observa-tion of the members of the profession, inhopes that they may be induced to followup the inquiry, by subjecting the practiceto a more extended trial, so that its claimsto preference over those in general use(if any) may be ascertained, and the pre-judices existing in the minds of someagainst the employment of unctuous ap-plications in this form of inflammation,obviated.The plan of treatment consisted (the

bowels having been previously well freedby a bolus of calomel and jalap, suc-

ceeded, when necessary, by a purgativedraught of salts and senna) in the in-unction of ss of mercurial ointment,night and morning, on the inflamed sur-face, over which warm fomentation clothswere applied, and the whole enveloped inoiled silk or prepared Indian rubber cloth,so as to prevent evaporation and retainthe heat, - saline draughts, containingfrom 1/16 to gr. of Ant. Tart., being pre-scribed every third or fourth hour, so long