340 are manifested in the chapters of " Accidents and Offences" to be found in the volume before us. To attempt by its aid to analyze or to trace these is not our purpose, which is rather to indicate a source from whence the busy practitioner may obtain all the information he requires on the subjects set forth in the title. Suffice it then to say, that Mr. Ashton’s work is divided into twenty chapters, each comprising a description of one or more of the lesions to which the rectum and anus are liable. We find, for example, the first five devoted to a consideration of Irritation and Itching; of In- flammation and Excoriation ; of Excrescences ; of Contraction, and of Fissure of the Anus. Then follow fourteen chapters on Diseases of the Rectum itself, including Neuralgia, Inflam- mation, Ulceration, Hcemorrhoidal Affections, Enlargement of the Hsemorrhoidal Veins, Prolapsus, Abscess, Fistula, Polypi, Stricture, Malignant Diseases, Injuries, Foreign Bodies in, and Malformation of, the Rectum. The work, which is abundantly illustrated by cases, concludes with a chapter on Habitual Constipation. After a careful perusal of the whole, we can conscientiously declare that we find in it more information than is to be obtained from any single volume yet published on the subjects of which it treats. Mr. Ashton has proved by this work that he is an attentive observer and a most able and zealous surgeon. TTital Statistics. Part 1. On the Computing a Rate of jVIor- tality among Persons Afflicted with 17m’ions Diseases, and on a Set of Tables ZJ1’eparecl by the tl ut7ao-r. By R. THmíP- SON JOPLING, Esq., F. S. S., Actuary of the Athenaeum Life Assurance Society. 8vo. King: Queen-street. THIS pamphlet, though written evidently with a view of ex- tending the operations of the commercial assurance of lives, possesses much to interest medical men. The statistics of disease have been but comparatively little attended to, and any aid in that direction should be diligently encouraged by the profession. The author, an actuary of repute, has the following apt remarks on this subject:- The advantage of computing into tables the chances of individual life affected with various maladies would be valuable not only to the public, but to the medical profession, and of course to assurance companies, who could then take every life presented to them, it being necessary only to fix the class to which each proposal would belong. " The medical profession will be benefited by seeing the result of a large number of diseases tabulated according to age and other circumstances ; and very important deductions may be made by physiological inquirers. The arrangement of so large a mass of medical facts cannot fail to suggest to active minds thoughts and perceptions of much value. " We cannot, indeed, cite a better authority, or quote a more apt illustration of the advantage of such labours, than is expressed in the following statement made by an able writer in the journal of the Statistical Society. " ’There is no science in which statistical investigation is more necessary than in medicine; and there are few to which it has hitherto been less applied. The physician knows that certain medicines produce certain effects; that certain diseases usually last a certain time; and that some are more fatal than others; but he has never or rarely ascertained this by numerical computation; his knowledge is the result of an experience de- pendent on memory alone, and if he were to be asked what was the average duration of the disease, or in what proportion one disease was more fatal than another, he would be at a loss for an answer. On the Continent, the true value of statistical investigation, in ascertaining the results of diseases, has long been fully estimated; but in this country, the advantage of em- ploying enumeration to obtain those results, and to investigate general facts, has only of late years come into importance.’" The entire pamphlet is worthy the attentive consideration of all persons interested in the results of disease, and the data of the principles that govern life. It is written in a clear and scientific style, and with as much deference to the talents oj others as with ability of its own. We cordially recommend this welcome instalment on a subject of such profound interesi as vital statistics. The Odontaluist: 01’, How to Preserve the Teeth, Cure Tooth- ache, and Regulate Dentition from Infancy to Age. By J. PATExsov CLARK, 1T. A. Post 8v o. London; Churchill. FROM the extensive experience of the -author we naturally expected to gain considerable information in perusing the " Odontalgist," nor have we been disappointed. The contents of the little book before us are divided into several heads. The first is " Toothache : its Seat of Pain, its Causes, Prevention, and Cure ;" to which we wish to call particular attention, being evidently written by a gentleman of great practical ex- perience. " Stopping or Filling Decayed Teeth" is another part of the treatise well worthy perusal. Mr. Clark has pointed out under " Dentition," the great importance of preserving the temporary teeth for the full period of their intended career, not only for the purpose of preserving due room for their successors, but to prevent the pain insepara- ble from caries. He strongly recommends the stopping of diseased deciduous teeth. The " Odontalgist" being written in a popular style, it is to be regretted that more had not been said on " Artificial Teeth," a subject in which so many are interested. Only two pages are devoted to the subject. The author states, however, that a substitute for ivory has lately been found-gutta pe1’cha, and adds, " but this, like most irazzovations, must be decided, W3 usual, OK its own mer.its by the public themselves, who are the real pcs-rties concerned." We wish, therefore, that Mr. Clark had advised his readers more fully on this ’’ innovation," which is at least four or five years old; its being so little known and used, does not speak much in its favour. When, again, so much lately has been said on the deleterious effects of bad gold and other metals used in the construction of arti- ficial teeth by c7aecch dentists, the meagreness of the contents on this head is to be regretted. Again, no mention is made by the author of the various im- proved instruments for extracting teeth, which have so com- pletely superseded the use of the old barbarian key instrument, fitted to belong to the dark ages, and used now only by bunglers, being the many beautifully adapted forceps to the shape of the various teeth and stumps, also the operating-chair and fulcrum invented by Mr. Gilbert. Nevertheless, there are many valuable and useful hints relative to toothache, stopping, cleaning teeth, tartar or iur, dentition, &c. Foreign Department. Treatment of Yccricocele by the Direct Cauterization of the Diluted Veins. M. GAILLARD, of Poitiers, has just published, in the Gazette Médicale de Paris, a case in which he cured his patient by a very ingenious and safe operation. The subject was a young man eighteen years of age, who was very anxious to get rid of the deformity, as it prevented him from entering the army. M. Gaillard, not being satisfied with the operations of Breschet, Velpeau, or Vidal, thought that he should endeavour to fulfil the following indications:- 1. To obtain the obliteration of the dilated veins without any danger of phlebitis. 2. To include all the veins of the cord, to prevent a relapse. 3. To avoid with certainty the vas deferens and the spermatic artery. 4. To obtain a sym- metrical cicatrix, owing to the peculiar situation of the patient. To obliterate the veins, M. Gaillard resolved to use Canquoin paste;* and to fulfil the other indications, he proceeded as ’ follows:- An incision, about three inches long, was made from the . ring to the scrotum, and the cord laid bare; the latter was , then raised upon a spatula, by tearing the cellulur connexions existing posteriorly with the sheath. M. Gaillard now dis- sected the different parts of the cord from each other. (One of the veins was much hypertrophied, and adhered to the vas deferens ; much care was required to isolate that vein.) The , * Chloride of zinc, two parts; c’uloride of antimony, one part; flour and water, in sufficient quantities.
Transcript
340
are manifested in the chapters of " Accidents and Offences" tobe found in the volume before us.To attempt by its aid to analyze or to trace these is not our
purpose, which is rather to indicate a source from whence the
busy practitioner may obtain all the information he requireson the subjects set forth in the title. Suffice it then to say,that Mr. Ashton’s work is divided into twenty chapters, eachcomprising a description of one or more of the lesions to whichthe rectum and anus are liable. We find, for example, the firstfive devoted to a consideration of Irritation and Itching; of In-flammation and Excoriation ; of Excrescences ; of Contraction,and of Fissure of the Anus. Then follow fourteen chapterson Diseases of the Rectum itself, including Neuralgia, Inflam-mation, Ulceration, Hcemorrhoidal Affections, Enlargement ofthe Hsemorrhoidal Veins, Prolapsus, Abscess, Fistula, Polypi,Stricture, Malignant Diseases, Injuries, Foreign Bodies in, andMalformation of, the Rectum. The work, which is abundantlyillustrated by cases, concludes with a chapter on HabitualConstipation. After a careful perusal of the whole, we canconscientiously declare that we find in it more informationthan is to be obtained from any single volume yet publishedon the subjects of which it treats. Mr. Ashton has proved bythis work that he is an attentive observer and a most able andzealous surgeon.
TTital Statistics. Part 1. On the Computing a Rate of jVIor-tality among Persons Afflicted with 17m’ions Diseases, andon a Set of Tables ZJ1’eparecl by the tl ut7ao-r. By R. THmíP-SON JOPLING, Esq., F. S. S., Actuary of the Athenaeum LifeAssurance Society. 8vo. King: Queen-street.THIS pamphlet, though written evidently with a view of ex-
tending the operations of the commercial assurance of lives,possesses much to interest medical men. The statistics ofdisease have been but comparatively little attended to, andany aid in that direction should be diligently encouraged bythe profession. The author, an actuary of repute, has thefollowing apt remarks on this subject:-The advantage of computing into tables the chances of
individual life affected with various maladies would be valuablenot only to the public, but to the medical profession, and ofcourse to assurance companies, who could then take every lifepresented to them, it being necessary only to fix the class towhich each proposal would belong.
" The medical profession will be benefited by seeing the resultof a large number of diseases tabulated according to age andother circumstances ; and very important deductions may bemade by physiological inquirers. The arrangement of so largea mass of medical facts cannot fail to suggest to active mindsthoughts and perceptions of much value.
" We cannot, indeed, cite a better authority, or quote amore apt illustration of the advantage of such labours, than isexpressed in the following statement made by an able writerin the journal of the Statistical Society." ’There is no science in which statistical investigation is
more necessary than in medicine; and there are few to whichit has hitherto been less applied. The physician knows thatcertain medicines produce certain effects; that certain diseasesusually last a certain time; and that some are more fatal thanothers; but he has never or rarely ascertained this by numericalcomputation; his knowledge is the result of an experience de-pendent on memory alone, and if he were to be asked whatwas the average duration of the disease, or in what proportionone disease was more fatal than another, he would be at a lossfor an answer. On the Continent, the true value of statisticalinvestigation, in ascertaining the results of diseases, has longbeen fully estimated; but in this country, the advantage of em-ploying enumeration to obtain those results, and to investigategeneral facts, has only of late years come into importance.’"The entire pamphlet is worthy the attentive consideration
of all persons interested in the results of disease, and the dataof the principles that govern life. It is written in a clear andscientific style, and with as much deference to the talents ojothers as with ability of its own. We cordially recommendthis welcome instalment on a subject of such profound interesias vital statistics.
The Odontaluist: 01’, How to Preserve the Teeth, Cure Tooth-ache, and Regulate Dentition from Infancy to Age. By J.PATExsov CLARK, 1T. A. Post 8v o. London; Churchill.FROM the extensive experience of the -author we naturally
expected to gain considerable information in perusing the" Odontalgist," nor have we been disappointed. The contentsof the little book before us are divided into several heads. Thefirst is " Toothache : its Seat of Pain, its Causes, Prevention,and Cure ;" to which we wish to call particular attention,being evidently written by a gentleman of great practical ex-perience. " Stopping or Filling Decayed Teeth" is another
part of the treatise well worthy perusal.Mr. Clark has pointed out under " Dentition," the great
importance of preserving the temporary teeth for the full periodof their intended career, not only for the purpose of preservingdue room for their successors, but to prevent the pain insepara-ble from caries. He strongly recommends the stopping ofdiseased deciduous teeth.The " Odontalgist" being written in a popular style, it is to
be regretted that more had not been said on " Artificial Teeth,"a subject in which so many are interested. Only two pagesare devoted to the subject. The author states, however, thata substitute for ivory has lately been found-gutta pe1’cha, andadds, " but this, like most irazzovations, must be decided, W3usual, OK its own mer.its by the public themselves, who are thereal pcs-rties concerned." We wish, therefore, that Mr. Clarkhad advised his readers more fully on this ’’ innovation,"which is at least four or five years old; its being so littleknown and used, does not speak much in its favour. When,again, so much lately has been said on the deleterious effectsof bad gold and other metals used in the construction of arti-ficial teeth by c7aecch dentists, the meagreness of the contentson this head is to be regretted.
Again, no mention is made by the author of the various im-proved instruments for extracting teeth, which have so com-pletely superseded the use of the old barbarian key instrument,fitted to belong to the dark ages, and used now only bybunglers, being the many beautifully adapted forceps to the
shape of the various teeth and stumps, also the operating-chairand fulcrum invented by Mr. Gilbert. Nevertheless, there aremany valuable and useful hints relative to toothache, stopping,cleaning teeth, tartar or iur, dentition, &c.
Foreign Department.Treatment of Yccricocele by the Direct Cauterization of
the Diluted Veins.
M. GAILLARD, of Poitiers, has just published, in the GazetteMédicale de Paris, a case in which he cured his patient by avery ingenious and safe operation. The subject was a youngman eighteen years of age, who was very anxious to get rid ofthe deformity, as it prevented him from entering the army.M. Gaillard, not being satisfied with the operations of Breschet,Velpeau, or Vidal, thought that he should endeavour to fulfilthe following indications:-
1. To obtain the obliteration of the dilated veins withoutany danger of phlebitis. 2. To include all the veins of thecord, to prevent a relapse. 3. To avoid with certainty thevas deferens and the spermatic artery. 4. To obtain a sym-metrical cicatrix, owing to the peculiar situation of thepatient.To obliterate the veins, M. Gaillard resolved to use Canquoin
paste;* and to fulfil the other indications, he proceeded as’
follows:-An incision, about three inches long, was made from the
. ring to the scrotum, and the cord laid bare; the latter was, then raised upon a spatula, by tearing the cellulur connexions
existing posteriorly with the sheath. M. Gaillard now dis-
sected the different parts of the cord from each other. (One ofthe veins was much hypertrophied, and adhered to the vasdeferens ; much care was required to isolate that vein.) The
, * Chloride of zinc, two parts; c’uloride of antimony, one part; flour and
water, in sufficient quantities.
341
vessels were thus separated from the vas deferens and the
spermatic artery to the extent of one inch. The two latter
portions of the cord were then pushed backwards, and keptout of harm’s way by small pledgets of lint. Little strips oflinen were now passed under the veins, and between thelatter and the former a thin plate of lead was glidecl, on whichwas spread a thin layer of the cauterizing paste, the latter not,however, reaching the margins of the plate. This plate wasthen folded over the veinous mass, which was thus surroundedand compressed by the sheet of lead, the ends of which werebrought over one another, or, as it were, imbricated. The
strips of linen, first passed under the veins, were then broughtover the plate to maintain the latter ii?, situ, and the wholesecured by a thread.M. Gaillard states that his patient was thus radically cured,
without a bad symptom; the cicatrix was linear, and hardlyperceptible; and when the young man applied again to themilitary authorities, he was admitted into the service.
*
Tonsillotome, which may be used with one hand.M. MAISONNEUVE lately brought before the Academy of
Medicine of Paris an instrument presenting a few modificationsof the well-known guillotine tonsillotome, by which changesthe instrument may be used by one hand only, At the next
meeting of the Academy, M. Blatin writes a letter to say thatthe same instrument-maker (M. Mathieu) had made for him(M. Blatin), two years previously, exactly the same instrumentas that put forward by M. Maisonneuve as his discovery, afew omissions only being made. Who is to blame? Theseare not creditable transactions.
Common Salt in Intermittent Fever.
The use of common salt in ague has now for some time beenadvocated in Paris, especially by M. Piorry. It now appears,from a long report addressed to the Board of T-2aJ..- of theFrench capital, by M. Willemin, late Sanitary Physician inthe East, that the chloride of sodium is decidedly efficacious.The report concludes thus :-
" 1. Common salt has well-marked febrifuge properties."2. In Damascus this salt stopped the fever six times out of
every seven cases; and even very small doses, as from two tofour half-ounce doses in six ounces of water, were in mostcases sufficient.
"3. This therapeutical agent is especially valuable in aneemicindividuals, upon whom the marshy influence acts most se-verely ; and the great cheapness of the salt should induce theprofession to give their serious attention to its virtue in inter-mittent fever. "
A Collyrium for the Solzctioiz of Metallic Particles impacted irathe Corazece.
A French provincial paper states that a blacksmith, whohad been suffering from the impaction of a metallic particle inthe cornea for a -week, was relieved by the following collyrimn,after every attempt at extracting the splinter had failed:—
Iodine, one grain; iodide of potassium, ten grains; rose-water,three ounces. As soon as this solution was applied to the eye,oxydation of the metallic particle took place, and its brilliancydisappeared; the distressing symptoms about the eye abated,sight was restored, and nothing but a microscopic fragment ofmetal left in the cornea. A soluble iodide of iron had beenformed.
Contemporary Medical Literature.GOITRE.-The fact that goitre does not occur in Havannah
or any part of Cuba, led Casaseca to conjecture that the river,water, land, plants, and atmosphere of tropical countries wouldprove rich in iodine ; his experiments have, however, given anopposite result. The water of the Almendares contains butone part of protoiodide of iron in fifty million parts of water,or one-fifth milligramme in ten litres. Casaseca likewise ex-amined the ashes of bananas, mais, &c., but did not find anyiodine. He detected it in very smail quantity in the ash ob-tained from one kilogram of fresh cress gathered on the banksof the Almendares. He did not find the least trace in the rainwater collected in June.—Pharmaceutical Journal.
PATHOLOGY OF CHOLERA.—Some authors have referred themorbid changes to a catarrhal condition, others have regarded
the disease as a form of serozts hæmorrhage, and the Berlinpathologists, whose attention was particularly arrested by theoccurrence of amorphous granular fibrin in and upon theaffected surface of the mucous membrane designate it a destruc-tive diphtheritic inflammation. We believe that for the presentsuch generalisations, however plausible, are of little value, andthat we arrest inquiry by their adoption. The depression ofthe capillary power-the extreme exhaustion of the greatganglionic nerves centres in the abdomen—the passive charac-ter of the lesions of the mucous membrane-its normal actionbeing reversed to a fatal exosmosis-are peculiar to cholera,and give it an individuality which forbids our merging it forthe present in any general category.—Dr. GuLL’s Report onCliolerct.ANGINA PECTORIS.—Upon the whole, we may conclude that
the special group of symptoms described by Heberden, Parry,Percival, and Latham, is but the occurrence in a dennedmanner of some of the symptoms connected with a weakenedheart. Obstruction of tne coronary arteries may or may notbe present, and is probably not unfrequent; but as a cause ofangina its action is remote and its existence unnecessary. In
considering this subject, we must not forget that under theterm angina pectoris physicians have included, and still in-
clude, many examples of diseases which vary in their natureand combinations. Well marked instances of the affection asdescribed by Dr. Latham, are rarely met with, and the samemay be said of the purely nervous cases noticed by Laennec,I have never seen either of these forms. The disease which inthis country most often gets the name of angina pectoris mightbe more properly designated as cardiac asthma. It is probablethat thia a combination of a dilated heart with congestion andspasm of the lungs.—Dr. STOKES on Diseases of the Heart andthe Aorta.INFLUENCE OF MIND ON DISEASE.—It -would seem as if the
study of certain diseases sometimes favoured their real or
imaginary development. Laennec died of phthisis and Corvi-sart of disease of the heart. When the celebrated professor,Frank, was preparing his lectures at Pavia, on disease of theheart, his own heart became so disturbed that he was obligedto rest for a time. Rumour says that no less than five of theprofessors in one of the medical colleges of this city have un-justly suspected their hearts. Medical scudents, exhausted bya winter session, are apt to be special subjects of real or fanciedirregularity of the heart. A young friend attending our lectureslast winter, on diseases of the chest, felt an unusual knocking ofhis heart after ascending the long college stairs, and requiredseverai examinations to satisfy him that there was no disease.—Dr. CORSON on Affections of the Heart.
SIGNS OF COMMENCING PHTHISIS.—When a prolonged dys-pepsia is observed, accompanied by nausea and vomitings forwhich no evident cause can be assigned, or even an abnormaldevelopment of the liver without disease of the heart, or
inflammation of the former organ,-when these phenomenaare observed to manifest themselves independently of any otheraffection, or in the course of chlorosis, or after measles, ortyphus fever,-the physician should suspect tuberculous diseaseis going on, should examine his patient with care, and evenwhen he is doubtful of such morbid state being present, heshould act as if convinced of its existence, or at least employevery necessary precaution.—M. BOURDON in Archiv. Gen. deMédecine.
----
MR. HAMILTON’S CASE OF SUPPRESSION OF URINE.
ROBERT HAMILTON, JUN.
. To the Editor of THE LANCET.
SIR,—Will you allow me a small space to reply to Mr. Hakes’letter in THE LANCET of March 11, on the case of suppressionof urine. In thp first place I would thank that gentleman forkindly favouring those of your readers who might be interestedin the case, with his views of the cause of the symptoms whichthere presented themselves. Those views are, however, basedupon post-mortem appearances, somewhat different to those Irecorded.
That the account I gave of the autopsy was correct, withone exception, the following extract of a letter from Mr. E. W.Bickersteth will show:—" It was between the left kidney andits capsule that the blood was caused, not between the rightkidney and capsule as stated. With this trifling exception, Ido not observe any mis-statement."
Apologizing for intruding again on your valuable space,I am, Sir, your obedient servant,
ROBERT HAMILTON, JUN.Great George-square, Liverpool March, 1854.
