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Dr. NEGRI made some remarks on themode of prodnction of the disease. InItaly, where it was not unusual, theyalways alluded to it by an expressionwhich implied that the atmosphere wasthe source of the attack,—that it was owingto the influence of a peculiar condition ofthe atmosphere. This he thought wasright, averring that we ought not to speakof it as a specific disease, but as a diseaseproduced by the atmosphere, evincingparticular symptoms according to the partof the body on which the air had moredirectly acted. Thus, he had a patientunder his care, who, when on horseback,always rode with his head leaning forwardsand downwards, so that the back of his

neck was exposed to the current of airthrough which he might be passing. Ashe was lately riding out, he suffered anattack of the epidemic, and came homecomplaining especially of great pain inthe back of his neck, for which he wishedleeches to be applied there. With thii he(Dr. N.) did not comply, but administeredsudorifics, produced free perspiration, andthus freed the patient at once from thecatarrhal symptoms, the prostration, andthe pain in his neck. The protaan cha-racters of the disease might in this waybe accounted for, each person evincingsome symptom more prominent than therest, according to the part most exposed

Ito the poisonous influence of the air. !Mr. BLENKARNE remarked that the

north-west winds had a great effect in

producing the disease ; but Mr. CLIFTON,who spoke as though he had been observ-ing the changes of the vane during the36,st two months, considered, that it had

prevailed during every wind throughnearly the whole of that period, and thatall diseases this spring had assumed a morevirulent character than usual. Dr. BURNE

thought that electrical variations in theatmosphere were closely connected with Ithe epidemic, and intimated that electricity might ere long be discovered to exert aninfluence in the production of human dis-orders as yet quite unsuspected.

NEW STOMACH-EMPTIER.

The time of the meeting was thus

brought to a close, when an additional tenminutes was devoted to the examinationof an apparatus for emptying the stomachin cases of poisoning, invented by Mr. (orDr.) Williams (a visitor on the presentoccasion), and intended as a rival or sub-stitute for the common stomach-pump. Itconsisted of an enema pipe, attached tothe extremity of a caoutchouc tube twofeet long, at the other end of which wasaffixed a second pipe. At the base of the I

latter pipe was a small flat circular brassplate, ground fine, like the table of an air.pump, upon which a large cupping-glasswas intended to be placed. When thetube is passed into the stomach, the inte.rior of the. glass is heated with spirit ofwine. It is then placed on the plate, apartial vacuum is produced, and the liquidin the stomach passes up through the pipecovered by the glass, and flows over uponthe brass plate. A wooden plate, with a; greased groove for the edge of the glass,was shown, and seemed to be the handierof the two. The apparatus was simpleenough, but would under no circum.stances, probably, be adopted in prefer-ence to the air-pump ; for although fluidmay also be injected with it, the trouble of

j replacing the plate and pipe with an in.jecting bladder, would prove very vexa. tious to the practitioner who allowed him., self to be thus hindered when a stomach-’ pump was at hand. Mr. Williams says,that "cupping-glasses are generally withinreach when pumps are not." True; butair-tight plates and suitable pipes are

usually absent. The exhibitor displayedhis contrivance with great politeness, andwas listened to with equal attention, butthe apparatus is hardly worth carrying tothe medical societies.

The observations in last week’s redport assigned to Mr. Blenkarne, were madeby Mr. Robarts.

DUBLIN MEDICAL JOURNAL,

May, 1833.

HYSTERICAL DETERMINATION TO THEHEAD.—The utility of both nitrate ofsilver and spirit of turpentine in suchcases, was suggested to me by the goodeffects these medicines are found to pro-duce in epilepsy, particularly when it oc-curs in persons of a nervous and delicatehabit ; and since I have employed them inhysterical determination to the head, Ihave been able to overcome these and simi. lar affections with much greater facilitythan formerly; of these, as has been al-ready observed, the spirit of turpentine isbest suited to the violent stages of the dis-order, and may be given in doses of one ortwo drachms, to be repeated according toits effects. The best vehicle is cold water,some will bear and derive advantage fromtwo or three doses of this medicine in theday, experiencing from its use a diminu-tion of headach, and removal of flatu-lence, together with a moderate action ofthe bowels and kidneys. In some cases,as occurs also occasionally in the treat-ment of epilepsy by this medicine, it can.-

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not be persevered in, in consequence of the injections, in preference to the usual me-violent dysuria and hapmaturia it occa- thod of giving it by the mouth. The two

sions; slighter degrees of these affl’ctions following cases exhibit striking proofs ofshould not, however, prevent our conti- the utility of this practice, and its greatnuing it. When the paroxysm has abated, superiority over the common method :—_or when the spirit of turpentine has failed, j CLl.le 1.-.J. F3., aged .30, by profession athe greatest benefit may be derived from surgeon, was admitted into Sir Patrickthe nitrate of silver continued for five or Dun’s Hospital on the 8th of Februarysix days at a time, in doses of half a grain last, in an extreme state of emaciation andfour times, or even six times a day. When debility, in fact, a complete skeleton; in-the bowels are constipated, there is no bet- deed he considerably resembled the livÎl/gter combination than nitrate of silver with sheleton, lately exhibited in France and inminute doses of compound colocynth pill, a England. He had not the least fever ; hisformula, I believe, first recommended in digestive organs appeared quite healthy,dyspepsia by Dr. James Johnson, of Lon- his breathing natural, and he had no cough,don, and which I have found invaluable, nor did he complain of any pain in the head.not merely in theheadachsof hysterical To what then was the reduction of flesh andyoung women, but in those of men, parti- strength owing ? Partly to the effects ofcularly the habitual stomach headach, to disease, but chiefly to abuse of those twowhich delicate and literary men are so powerful medicines, mercury and opium.subject.—Dr. GraM;;. His constitution became more and more

- impaired, and a cutaneous eruption, in

DRY CuppiN&.—The suction should be every respect resembling the milder varie-powerful, and should be sufficient to nx the ties of rupia prominens, made its appear-cup for at least ten or fifteen minutes. In allce, while an ulcer commencing inside

. a young lady in Grafton-street, in whose the left nostril, completely destroyed thecase I first tried this method, its good nasal cartilage, so that the tip of the noseeffects were most striking; she had been had fallen in. From his account it would

lying for twenty-four hours, with her face appear, that some portion of the spongysomewhat swollen, her eyes open and un- bones had been also destroyed; one of the

- meaning, unable to speak, and frequently spots of periostitis had evidently producedagitated by violent hysterical convulsions. extensive exfoliation of the os frontis, butAfter the cups had been some time on, she the part is now healed; he has no sorerecovered her consciousness and was able throat; his gums are sound, and his tongueto speak. This result was the more re- perfectly clean and moist ; he has no thirst,markable, as she had, a year before, la- and his appetite is good; bowels quite re-boured under a similar but less severe gular. The few remaining spots of rupia,attack, for which she was treated, by two the arthritic swellings and pains, now be-of the most eminent practitioners in Dub- come chronic, extreme debility, and anlin, by means of shaving her.head, leeches, utter want of sleep, except when underice, &c. &c., a mode of treatment which the influence of enormous doses of opium,left her in so weakened and nervous a form the catalogue of his present com-state, that her removal to the country be- plaints. For the last two years he has

came necessary, and she did not recover never had sleep at night, except in conse-her usual strength for several months, quence of an opiate: he was first inducedMr. Barker has given me the particulars to take this medicine in order to relieveof a very curious case: -A lady of rank, his pains, but latterly it is not pain, butliving in the vicinity of Dublin, was occa- the impossibility of sleeping except whensionally attacked by violent determination under its influence, that has forced him toof blood to the head, and each of these use it constantly. He has often taken two

paroxysms was sure to induce before it ounces of Batley s solution iu the day! Veryended a violent propensity to suicide, large doses of opium act on his bowels aswhich she very nearly succeeded in grati- an aperient, and the use of this drug neverfying on more than one occasion. This produces headach, duhiess, furred tongus,propensity, and the cerebral congestion thirst, nausea, or the least disturbance ofwhich caused it, were afterwards removed, the circulating system. For a few nightsor rather prevented, by the timely appli- after his admission into the hospital, hecation of dry cupping, as soon as the well- got two drachms of black drnp every night,known premonitory symptoms of the pa- but it was not enough to procure anyroxysm made their appearance. sleep, and he consequently entreated me

____

to double the dose; but I refused, and-

ordered the following treatment :—ThreeEXHIBITION OF Orzuh2 IN THE FORM drops of Fo2uler’s arsenical solution three

OF ENEMA.—Dupuytren has recommend- times a day. A nutritious but mild diet ;ed the exhibition of opium in the form of some wine at dinner ; sarsaparitla brvtla,

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one pint daily; a starch enema, with one danum thus used, when necessary, twicescruple of blac/. drop three times a day. or three times a day, effectually alleviatesThe good effects of this treatment became his suffering, and does not produce any ofsoon apparent; his sleep gradually re- the bad effects before enumerated. Histurned, and in t-he course of a fortnight appetite is now good, his spirits cheerful,was sounder and of longer duration than and his powers of mind unimpaired.--it had been for years. He daily gathered Dr. Graves.flesh and strength, and, in the course of a month, was so altered for the better, that, GURGLING IN FLATULENT STOMACHS.were it not for the depressed nose, no one -In fever I have witnessed several timescould have recognised him to be the being a very peculiar species of dysphagia, evi.whose misery, a month ago, had so strong- dently occasioned by flatulent distentionly excited our commiseration. The arthri- of the stomach to such an extent that thetic affection has rapidly subsided, and with lower portion of the oesophagus partook ofreturning strength he is regaining the use this condition ; at least, I conjecture so,of his limbs. for during the struggle of the dysphagic

Case 2.-The following case exhibits the paroxysm, a gurgling noise was heard, as

good effects of opiate injections in a man- if the bit of food was met by a portion ofner not less striking than that just de- air contained in the lower part of the C6SO.tailed. A professional gentleman of great phagus; my friend, Doctor Autenrieth, ofabilities and strength of mind, about ten Tubingen, has particularly remarked thisyears ago was attacked with neuralgia of a symptom, or at least something like it, invery severe description. The disease,which what he calls the abdominal typhus feverwas caused originally by cold, pursued a of young people ; for he says, if the pa.most anomalous course, giving rise to tient takes any drink, a peculiar gurglingamaurosis of one eye, ptosis and perma- noise is heard, as if the fluid was pourednent strabismus of the affected eye; con- into a lifeless bag. Now, in precisely suchtrary to the expectation of both Sir Astley a case, Mr. Rumly and I saw a youngCooper and Mr. Brodie, to whom he was lady affected, in addition to this noise,introduced by his friend the late Dr. NV, ol- with so great spasmodic dysphagia, pro-laston, the symptoms of cerebral disease hably from the entrance of wind into themade no further progress, but the neural- lower end of the oesophagus, that she al-gic affection of one of his lower extremi- together refused to drink. This pheno-ties became intolerable, occurring in pa- menon gradually disappeared, and theroxysms of extreme violence, and only to lady ultimately recovered; but it deservesbe alleviated by repeated doses of opium. to be remarked, that in general this symp-After the lapse of some years, the neural- tom and the gurgling noise, described bygia became complicated with pain and Dr. Autenrieth, are very bad ornens inswelling of the knee-joint, which still fur- feyer.—Dr. Graïes.ther added to his sufferings, and renderedhim a complete cripple. This joint is now

-

permanently enlarged, and within the last SMALL-POX AFTER INOCULATION.—two years the lower extremity of the fe- The following is especially authentic, andmur seems to have formed an enormous I publish it with the permission of Mr.exostosis of an equal growth all round its Barker, of Great Britain-street. Mrs.circumference, but not encroaching on Barker was inoculated with the small-the articulating surface of the bone, which pox in 1801, by Mr. Stewart, then Sur-still enjoys the slightest possible degree geon-General. The inoculation succeeded,of motion, although it cannot he moved and she had the disease favourably. Thefar from its flexed position. The neural- pustules were nowhere confluent, andgic pains, if such they were, have within were thinly scattered over her face, ex-

the last four years been worse than ever. tremities, and body. The disease ran itsDuring the paroxysms he has frequently usual course, and was sufficiently severebeen forced to take 100 grains of opium, as to leave marks or pits in several places.much to his annoyance, for he found that A few days ago, Mrs. Barker was attackedit occasioned subsequent nausea and vo- very violently with fever, which, after

miting, stupor, and other unpleasant symp- three days terminated in a very copioustoms, while the constant repetition of this eruption of varioloid; she could trace thedrug had completely destroyed his appe- infection to a child in small-pox, withtite, and what he most deplored, had sen- which she had been in contact. Mrs.sibly impaired his memory and mental Barker was near her confinement at the

powers. At length he was advised to use time, and in three weeks after the acces-it in the form of injection. The allevia- sion of the varioloid, was delivered of ation produced by this change has been dead child, which was covered with theinost astonishing; half a drachm of Iau- j true variolous eruption, at about the stage

243

of pustular maturation. The same poison,therefore, gave varioloid to the mother,and true small-pox to the child. Thesmall-pox communicated to the child inutero is not necessarily fatal. I haveknown a child born with it, survive.Another remarkable and perfectly authen-ticated case happened within the circle ofmy acquaintance :-A young lady, residingnear Dublin, was vaccinated when an

infant. There is reason to believe thatthe vaccination was not properly watched,so as to ascertain whether it had succeeded.When eight years old, this young ladycaught the true small-pox from infection,the disease was not at any period of itsprogress dangerous, and left no pits. At

eighteen years of age, she was again at-tacked, but the disease was now varioloid,and not attended by secondary fever. Shedid not escape, however, so well with re-gard to its consequences, for she was

evidently marked. In such cases, as hasbeen long ago remarked, the pits on thesurface of the skin are very different fromthose left by the pustules of the small-pox.—Dr. Graves.

THE LANCET.

London, Saturday, May 18, 1833.

FRENCH CONCOURS.—MEDICAL JURISPRUDENCE.

WE have received the French journalsup to Sunday the 12th of May inclusive.The last No. of the Archives Générales de

3fedecirte was published on the 7th instant.the Journal de Chinzie Dledicale on the llth,and the Annales d’Hygeiene on the 10th.Of these, the last is the only one whichcontains a single article of interest to theBritish reader.

From the Lancette Française, Gazette ISIe-dicnle, and Joutyutl Hebdomadaire, as well asfrom the letters of our correspondent, welearn that the pseudo-concours is in pro-

gress, but that this paltry mockery of aconcours excites no attention. Why shouldit? Let the oral proofs turn as they may,the professor is already " appointed."Never was there a more odious, a more

iniquitous piece of humbug. But what

better could be expected, when the regu-lators of the proceedings, the Couseile

Royale de l’Université, consist exclnsively

of the creatures of the double betrayer

of his own foul blood, and of the liberties

of his country ?

ANATOMICO-LEGAL INVESTIGATION.

The medico-legal department of the An-nales d’Hygeiae, contains some very valu-able papers. The first is a series of re-

ports by MM. Chevallier and Boys de

Loury, on the case of Ramus, who wasmurdered in Paris last August, by the ad-ministration of a dose of weak prussicacid, and decapitation during the insensi-

bility induced by the poison. The mur-

derer, as soon as the deed was accom-

plished, cut up the body into several

pieces, some of which he threw into the

Seine, and others he hid in various drainsand private places. The principal pointsreferred by the authorities to the medicalexaminers, were the identification of the

pieces of the body, the determination ofthe question of decapitation before or afterdeath, and the analysis of the contents ofthe stomach and intestines. The first of

these was readily answered, by the uni-

formity of colour of the hair on all the

pieces, the identical texture of the skin,the apposition of the various sections, andthe fact of four of the cervical vertebras

remaining with the head, and three withthe trunk. It was concluded that the

decapitation had taken place during life,from the ansemic state of the viscera, theretraction of the divided parts, and espe-cially from the collapsed and bloodlessstate of the heart. Lastly, the analysisof the gastro-intestinal contents, guided bythe fact of a smell of bitter almonds existingin the stomach, led to the detection of

prussic acid by the ordinary process, fullydescribed in this journal. The chief in-terest attached to the chemical investiga-tion is the detection of the prussic acidseven days after death. The medical andchemical reports here alluded to were

drawn up before the apprehension of the

assassin, and the conclusions they con..

tained were subsequently fully borne out