684

have been recommended from time to

time ; but experience always proves theirinsnfficiency. Such is the case with theuva ursi, the tar-vapour, the hydrocyanicacid, as well as many others. With re-spect to the latter substance, of late so

much vaunted, I have often found it pro-ductive of much disorder in the system ;luch as nausea and vomiting; head-ache,and disordered brain ; without finding iteven a palliative for the disease.When we have abandoned all hopes of

cure, it is still of importance to palliateparticular symptoms. The cough at timesis so severe, as to call for opium to relieveit ; but in general, opium does harm, bychecking expectoration, and aggravatingthe febrile symptoms ; while it cannot

effectually remove the cough. Even in anadvanced stage of the disease, when thepain in the chest is unusually severe,

bleeding to a small extent, either generalor local, may be nsefnlly resorted to. The

night sweats are sometimes abated by thedilttted sulphuric acid, though at thehazard of inducing diarrhœa. This lastsymptom, (diarrhœa), which is one of themost distressing, requires for its relief,first, a small quantity of rhubarb, thenopium, chalk, or other astringents. Theextreme restlessness experienced towardsthe close of the disease, makes the use ofopium almost indispensable.More is to be expected perhaps from

change of climate towards curing the

disease, than from the use of medicine.To give it a fair chance of success, how-ever, the removal to a warm climateshould take place early, and the residencebe long-continued, perhaps for two or

three years. To attempt it when the ma-lady is far advanced, is only to consignthe patient to incalculable suffering andprivation. A sea voyage, of itself, ap-pears to have been sometimes beneficial.

As a substitute for change of climate,a removal from bleak and exposed situ-ations, to one that is sheltered, is often ofconsiderable advantage. It is said that

consumption occurs far less frequently inlow and marshy places, than in elevatedregions. This fact will of’ course influ-ence us in the choice of situation; butthere are nevertheless exceptions. Somecases do better in town than imthe conn-try, and some in hilly countries than in

valleys. This can only be learned bytrial.

FOREIGN DEPARTMENT.

PHYSIOLOGY.

Reproduction of Bone.

Whilst in England, Italy, and princi,pally France, the re-prodnction of bonewas made the subject of investigation,little since the time of Köhler had been

done in Germany to advance this inte-

resting subject. In 1823, two young

physiologists, Meding and Kortnm,enteredon this field of inquiry, and by a series ofexperiments placed beyond all doubt the

process by which the re-production of

bone takes place. We will give an ac.

count of their experiments in our next

Number, but have thought it best to pre.cede them by a brief statement of whatothers hall before done in the same subject.Onr information is taken from a work byDr. Richter of Berlin, on necrosis, the sub-stance of which work previously appearedin the 7th and 8th volumes of Giafe’sand

Walther’s Journal.

Towards the middle of the last centurythe experiments of Duhamel* on the for.mation and re-formation of bone, excitedttie greatest attention. The opinion ofGaten,t which had reigned for many hun.dred yeais, namely, that the nelllytormed osseons substance was iuorgamc,alld quite different from the original bonymatter, was overturned. The favoariteopinion with regaid to the original for.mation of bone- arising by lamellæ fromthe inner surface of the periosteum, wasalso entertained respecting its regenera-tion. Consequently Dahamel has themerit of bringing into notice this opinion,which till very lately almost universallyprevailed. As Haller, however, enter-tained views different in many respect.from those of Duhamel, he instituted anew set of experiments along with Detlef,

Memoires de I’ Academie Royal desSciences, 1747.

t De Meth. Medendi, Lib. v. cap. 7.t Opera Min tra Lans, 1761. Tom. ii.

460, 588.

685

the results of which were in favour of thecorrectness of his previous notions, andagainst those of Duhamel. These expe.riments led the attention of these two

phvsiotogists to the process which ratnreemployed in cases of fractures. Ko one,however, pursued this further ; no onethought of observing whether the samephenomena were to be seen in necrosis

artificially produced, until Troja* beganto turn his attention to the subject. Hisnew ideas completely destroyed the no-tion of Dnhamel.Troja destroyed the marrow in eleven I

pigeons and dogs, and in this way proved Ithe importance of this part for supportingthe life of the bone. The centre of thecan..1 died away as far distant as the de-struction reached. As soon as the seventhday, these parts were frequently coveredwith new bone, to which the muscles andother soft parts had fixed themselves.After this operation the shin bone beganto swell, as well as the periosteum tothicken. On careful dissection, a jelly-like substance appeared to him to bepoured out in the parenchyma of this

covering, which had numerous vesselsrxnnins; through it, representing theform of the new bone.t On the third daythe mass began to assume a bony consis-tence. From the fifth to the tenth in the

pigeons, and from the eighth to the twelfthin dops, the structure of the bone was

apparent, and presented internally a thinfine vascular membrane. The epiphysesof the medullal canal of the dead tibiawere entire, separated from the necroticportion, and united with the newly-formeddiaphysis. Besides numerous smallerholes for the passage of the principal nu-tritious vessels, Troja remarked otherswhich he named " great ;" and the deve-lopment of which he could not explain.§To learn what changes wolild result whenthe periosteum was injured, he destroyedthi membrane completely round to theextent of tonr lines, and above this placedetached the soft parts from the bones.In eighteen days he examined the tibia ofthe pigeons, and found that when the soft,parts had been separated from the peri-o.teum by an intervening substance, a!new matter surrounded the bone, and that’.where the periosteum had heencompletelyremoved, the external surface of the bone:’

Troja de novorum ossium in integrisaut ’naximis ob morbos deperditionibus, &c. Paris, 1775. Strasburg, 1780.t Ibidem, Tab. 1. Fig. 1.; L, c. pag.9, 11, 34, 40. !L. c. p. 39. ,

was black and dry, and contained in it a newbone, probably from the medullary matter.Trojafrom these experiments considered

him-elf entitled to conclude tlrat therewas poured out between the two lamellæof the periosteum a t1uid resembling jelly.That this substance kept the two mem-branes separate, and that it became firstcartilaginous, and afterwards osseous;and that the membrane which surroundedthe inner surface of the new-formed partand the dead portion like acapsule, is theinner lamella of the periosteum, althoughin structure it is very different from theexternal lamella.

In a supplement* to his first treatise,he confirmed his former experiments byseveral new ones made on dogs.

This opinion ofTroja on the productionof bone by the swelling and ossification ofth" periosteum, prevailed for severalvears. Brun would not adopt this view,and declared it to be erroneous, on whichaccount David felt himself called on byhis experience on necrosis to supportTroja, and refute Brun’s opinion, Ac-

cording to David, the periosteum becomesinflamed, a pnriform matter is thrown outbetween it and the bone, and separatesthem from each other. As the periosteumcan no longer carry to the dead bonenutriment, it becomes overloaded with

it, swells, thickens, and then graduallyforms the body of new bone.t It the

openings in the periosteum formed bythe matter are too large, the new bonewill be imperfectly formed, and the defectin the formation will be found to be in

proportion to the extent of these open-ings. David, therefore, differed in so farfrom Troja, that he did not think theosific matter deposited between the la-melloe of the periostenm, and that thesewere separated from one another, but thatthe periosieal covering itself becomes con-verted to bone. Chopart repeated alsosome of Troja’s experiments, and coin-cided entirely with him, although the ap-pearances were not uniformly the same.He thought, in addition, that when thebone was not destroyed in its whole cir-cumference, but only in part, granulationssprung forth from the remaining livingparts, which gradurtlly ossified, and thenrepaired the loss. Richtert was also ofTroja’s opinion.

De la Regeneration des Os, in theHistoire de la Societé Koyate de Medi.cine. Paris, 1776.

t Observation sur nne Maladie deaOs connue sous le nom de Necrose. Paris,1782.

; Chirurg. Biblioth. Bd. VI. s. 501.

686

Blumenbach* repeated Troia’s experi-ments, and found on the destruction ofthe medsllarv canal the same results. In

doves, on which he left the medulla un-hurt, he observed that the cor tical sub-stance did not die, and no new cylinder ;of bone in the old one, but the bone was

swollen, and in so’ne degree united withthe periosteum. Any sign of pain on

the destruction of the medulla was notobserved. Kohierf i epe,tted the same ex-periments, and came to similar rusnlts.

Brunt laid before the Academy of Sciencesat Paris in 1781, Ills opinions, whichbeing contrary to those of Troja, werewarmly attacked by David. Iu his paperhe observed. that on the destruction ofthe medulla, a part only of the bony sub-stance was destroyed, and not the wholecortical part; a line of demarcation esta- biishes itself between the inflamed part, Ithe dead portion separates itself from ithis, and by the exuded nutritions mat-ter a swelling was produced, an exosto-sis at the same time formed, which pro-bably represented the regenerated part.This theory, by which a regeneration ofthe bone was denied, has been in generalascribed to Weidemann, who, however,

. did not originate it, but only afterwardsadopted it. The opinion of Brun respect-ing the swelling of the cortical substance,and at the same time the denial of the

reproduction of new bone, have been de- fended by several others, and are even a.tthe present day received by many.The greatest advantage for science was

obtained in the last centnry from thelabours of Macdonald, who by a seriesof interesting experiments, refuted the

prevailing opinions on the reproductionof bone, and shewed, by close observa-tion of nature, what a great similaritythe process of regeneration had with theoriginal or primary formation of bone.He gave madder to birda, destroyed themedulla, filled the canals with lint, andexamined at different times the extre-mities of the pigeons and hens sabjectedto the experiment. On the second dayafter the operation, he found the perios-

* Richter’s Chirurg. Biblioth. Bd. VI.st. I. 10i. ’

t Experimenta circa regenerationemossium. Gett. 1786.

t Histoire d e la Scciete Royal de Me-Idicine. Paris, 1781 ; Memoires de Toii- tiouse, tom. i., pag. 65 ; and Diet. desSciences Medicale-, tom. xxxv., p. 356. t

§ Disput. Inauguralis de Necrosi ac

Caiio. Edin. 1799, p. 39. f

teum inflamed in several parts, swollenand separated from the hone. On thethird day a gelatinous fluici was observedthrown out between the two, even as taras the epiphyses ; this had a reddish ap-

, pearance, which, however, disappearedon separating one part of this fliiid 1’1 1mthe bone. On the fourth day, the iNl,;n-tion of the soft part had increased ; the

periostenm presented a cartilagenousappearance, which was given to it by negelatinous and transparent mass. Onendeavouring to separate the periosteumfrom this substance, he observed whitethreads, which he took for vessels, as theyexhibited red points on being to Ti.egelatinous ma,s stuck very cluse to the

bone, and was in no respect separatedfrom it by any membrane. Macdonald

i conld not detect in the neighbourhood ofI the epiphyses, the slightest trace of (

separation of the lamellæ of the pun..-teum. He found on the 7th day a’tcrthe removal of the skin, the soft utt.;u.ments and the periosteum, the !ii*L,i!i,iisoft and flexible bone already conside-ably coloared by the madd r; this sur-

rounded, and was firmly connected withthe periosteum. In the fifth animal whichhe submitted to the experiment, andkilled on the 11th day, (mad;lernwerhaving been given,) the new bone wasfarther advanced in its formation, heiu,cellular, and of a firmer structure. Afterthe 12th day, there was no seperation ofthe dead from the new bone, which pos-sessed a cellular, cartilaginous, aud red.dish appearance.On the IHth day the new bone wascompletely formed but still uneven, beingthicker in some places than in other.

After the third week the periosteum wasno longer so considerably swollen, die

newly-formed bone was overloaded unhblood, and presented a cellular appear-ance. After the fourth week, the deadbone had already become very moveableand could be drawn out; it had no epi-physes, was rough, and thinner thanusual. Ten days after the removal of the

; bone he killed the pigeon, and saw thecentral canal of the new bone filled withmarrow ; the internal membrane was very

thin, and provided with several vessels ;the new bone was hard, and presentedthe appearances above mentioned.

,

In order to ascertain by what process! bone was reproduced, when the peri.,.team, after being destroyed, could con-ttibute nothing to the reproduction. Mac-donald instituted another series of expe-riments, in which he removed the perios-tenm trom several portions of bone,brought together the integument!.. andfed the animals with madder. on the

687

fifth day after this operation he found,after the removal of the muscles, the

bone, in every place where the perios-t°nar had been taken away, covered by anew membrane ; on removing this, a ge-latinons unseemly mass, united with thenewty-formed periosteum, was to be seen.In a later examination, a quantity of ves.sels, in the gelatinous fluid, could be observed, and afterwards some dark spots,which marked the first traces of ossifica-tion. From these observations, and theexamination of some specimens affordedhim hy SIonro, Macdonald refuted theopinions of Troja, David, Blumenbach,Kohler, and Russel, and believed thatwhen the periosteum is preserved theformation of the bone proceeds from thegelatinous mass, as, according to Haller,the pjiiiiitive formation of bone alwaystakes place, and that this change of theshapeless mass proceeds from the vessels.of this membrane. When, on the con-

trary, the periosteum has been injured,the divided vessels ponr out blood, thiscoagulates, and after absorption of thered particles, the gelatinous mass is left,ont of which the bone is afterwardsformed. From various experiments hebelieves that the integrity of the perios-teum is necessary to the reproduction ofthe periosteum, and that after its destruc- tion the regeneration is more difficultand tedious. This opinion of Macdonald’s,that the periosteum is throughout neces-sary to the production has since beendenied by many. Cruveilhier,* who maybe classed among the number, endeavour-ed to convince himself of the part theperiosteum took in the regeneration ofbone, and introduced foreign bodies be-tween this membrane and the bone ; thesewere always covered with a cartilaginousor osseous deposit: where there was no in-teivening body the separated periosteumadhered to the bone. Crtiveilhier alsodestroyed the medulla, but did not expe-rience the same results as Troja andothers, for the bone swelled only to acertain extent, and did not become ne-crotic. After the space of some monthsthe medulla was regenerated in rabbits ;but if the medullary canal were filled withlint, a very considerable swelling follow-ed, the bone died throughout its wholeextent, and between it and the perius-teum a gelatinous mass, which graduallynedrrwent the same change as had beenobserved bv liacclonaid. In pigeon, heremarked that the deep layer of muscles,as Hell as the periosteum, was overload-

Essai sur l’Anatomie Pathologique.Paris, 1816.

ed with this mass, which became con-verted first into cartilage and then intobone. Cruveiihter repeated the experi-ments also on dogs, and plugged up themedullary canal ith lint; but all theseanimals died within the twelfth day, andon examination the periosteum was foundseparated, and d sanious matter between -it and the bone, without the least trace ofregeneration being observed.

Another opinion, differing in manyrespects from the preceding one, hasbeen advanced by Troja, in his work en-titled, Osservazioni ed experimenti sulleossa, (impressa nel 1775 e net 1779. Napoli,1814, 8vo.)—The number of experimentsof different kinds made by this physiolo-gist on birds, rabbit-, sheep, goats, andpigs, is very considerable. He has, how-ever, recidted the erroneous opinion whichhe formed respecting the formation of theinner membrane in new hones, and ac-knowledged, in the second edition of hiswork-,* that the existence of the perios-teum was not absolutely necessary to thereparation of the dead by new bone. Hesays, sec. 132, " Nelle grande scoper-ture delle ossa, succeduta la squama-zione, sorgono de’ granellini carnei, ca-paci di coprire lo spazio scoperto." Fromnumerous experiments, which he subse-quently made, he became firmly convincedthat, after the destruction of the mar-row, the periosteum and the externat’lameUa of the bone, which in the largerquadrtipeds amount to about half a Imein thickness, but in birds are scarcelyperceptible, become inflamed, present anappearance of new vessels, and depositon its inner surtacp a gelatinous mass,Mhich goes over, first into the sttte ofcartilage, then into that of bone. Thethin, external, lamella of bone, which hasremained entire, becomes softened by theinflammatory process, loses its phosphateof lime, and passes over into the state ofmembrane, in order to line the inner sur-face of the new bone. Troja also betifv-ed, that by the destruction of the pel iO8-teum, new bone forms itself in the mudul-larv canal of the bone. As before in thedestruction of the medulla the lamella ofbone nearest to the periosteum is con-verted to the inner membrane of the new

bone, so in this case the inner layer otbone, closest to the medullary lining,is converted into a membrane which at-terwards becomes the petiostenm of thenew bone. The medulla, on the contrary,dis appears, and from the vessels ot its

membrane a gelatinous fluid is thrown

Experiment. sur lit rigeneraz. delleossa. Napoli, 1779.

688

out, which forms the basis of the newhone, always preserves a firmer consis-tence, exhibits afterwards true bony sub-stance, and issupplied with a medullarycanal.

Charmeil,* from observing the repro.dnction of dead bone where the perios-teum was destroyed, instituted some ex-periments for the purpose of ascertainingby what process the bone is reproducedwhen the medulla is destroyed, and theperiosteum removed at the same time.He tried this experiment on eight pigeons,and found, in a few hours afterwards, avery considerable inflammation of theneighbouring soft part, and of the epi-physes of the bones ; the bone, deprivedof its marrow and periosteum, was sur-rounded by a deposit of lymph, whichsoon acquired a yellowish, then a reddishappearance, going over to the state ofcartilage, and, lastly, to that of bone.As the progress of ossification advanced,the inflammation and swelling of thelimb decreased ; and the new bone, whichincluded the old, was, on the 90th day,sufficiently strong to allow the functionof the limb to be performed. Internallythe new bone was hollow, smooth, andlined with a membrane ; the externalsurface presented an uneven and granularappearance, and was intimately connect-ed with the muscles and tendons in the

vicinity. Charmeil tried also other ex- ]

periments, by which he found, that notonly the soft part, but the bone itselfcontributed to the reproduction of thenew ossific substance.

PATHOLOGY. j

Case of a Woman bitten by a Mad Dog-Vesicles observed under the Tongue.t

The following case by Dr. Oppert, ofBerlin, is interesting, inasmuch as it addsto the testimony already advanced infavaur of exciting suppuration in partsbitten by a rabid animal, and maintainingit for some weeks, at least, after the in-

jury.Madame N., 29 years of age, of a c

weakly constitution, was on the 16th De-cemher, 1825, bitten on the ring finger of; iithe right hand by a dog. Immediately

* Recherches sur les metastases sui- 8vies de nouvelles experiences sur la re- 9generation des Os. Metz. 1821. n

tH ufeland’s Journal der Practischen,He;ikunde, Mai, 1826.

afterwards, the dog was carried to theveterinary school (Berlin,) and died cuthe 18th December, with all the symptomsof hydrophobia. As the animal had shownno signs of this disease previous to beingtaken to the school, the medical attend-ant was not sent for till the 18th.On examining the wound, there xar

found on the posterior surface of the tintphalanx of the ring finder of the nghthand, a bluish spot of the size and formof a shilling. There was no excoriation.In the middle, however, of this contusion,if it may be so called, there was a small

point, similar to what might have beenexpected from the impression left by apointed tooth. It was considered properto take all the steps necessary to preventan attack of hydrophobia. The spot wasfirst of all scarified with a lancet, wellrubbed with caustic, and afterward!covered over with pulvis cantharadis,and unguentum cantharidnm.After this had been done, the tongne of

the patient was examined, and there wasfound, to the astonishment of the medicalattendant, close to the frænum and theopenings of the ducts of the sublingualglands, two small vesicles about the size ofa poppy or millet seed, filled with a kindof lymph, similar, in short, to what Maro-chetti has described. They were con.

tained in the small duplicature of themembrane which covers the month of theduct, under the tongue. A knitting pinwas now made ret hot, and both thesetumours were completely destroyed bi theferrum candens, a work of no small diffi-etilty, as the patient was very restlessdur-ing the operation. The netva and radix

genista tinetorias, in the form of a decor-tion,were given internally. The latter bothas a gargle and internally, to the extentof several cupfuls daily. On the 19th. thecauterized part on the finger was coveredwith a scab ; the inflammation extendedall over the first phalanx of the fourthfinger, produced much pain, extendingas far up as the axilla. Want of sleep,weariness, loss of appetite, came on. Thepatient had flatnlence and indigestion,after taking the decoction of the genista.but still continued to use it till the end ofthe fonrth week. On the fourth ortiithday, suppuration came on after the scabhad fallen off. The wound being muchinflamed, and very painful, only unguent.hasil. wa. applied as a dressing, uniess itshowed a disposition to heal, when theling. canthar. was again applied. In the8th week the wound was closed, and in be9th week, when this paper was written,no symptoms of hydrophobia had shownthemselves.

689

Hydrophobia.

Huzart first made the observation. that

borses, sheep, and cows, which had be-come mad from the bite of a rabid dog,did not possess the power of communi.

cating the disease to other animals bybite, even if they laboured under hydro-phobia in the highest degree.

Swelling of the Breasts.The breasts of gipsies, whilst suckling,

frequently swell to a size larger than thechildren themselves. They have this incommon with the Egyptian and Ethio-pians, particularly the women of Meroe,of whom Juvenal says," In Meroe crassa majorem infante

mamillam:’

Small Pox.

The first who introduced inoculation

into Europe, was Immanuel Timonis, aGreek physician at Constantinople, whovoluntarily communicated the art to theuniversities of Oxford and Padua, of

which he was member.

’

SURGERY.

Dislcation of the Spine, with Fracture,cured by M. JULES CLOQUET*

A mason, 45 years of age, of a strongconstitntion, fell from a house on a num-ber of stones that had been huddled toge-thcr, and was, in consequence, imme-diately deprived of his senses, and affect-ed with I’omplete paralysis of his lowerextremities. Being removed to an hospi-fal, and treated secnndum artem, the sen-sibility of the limbs began speedily to re-appear. His locomotive powers, how-Her, remained suspended ; the emissionof his urine was made with difficnlty, andhe had ob-tinate constipation. The.-eromplamts were treated for a time bymexd’, cupping glasses, cauteries, andother remedies employed in these cases,without any decided advantage. After

* Nouvelle Bibliotheque Medicale. Mai,1826.

several months, however, he became cer-tainly somewhat benefited. He was able toturn himself without assistance, raise hislimbs a little, although with some diffi.culty. In this state he remained for se-veral years, enjoying rather a good stateof health. But having no means on whichhe conld subsist, and being attacked withrheumatism and indigestion, he resolvedto enter the Hospital of St. Louis. Therehe remained for five months, when hedied ot marasmus.On examining the body, the inferior

extremities were found to be very muchwasted away. There was a slight in-

equality in the lumbar region. In theinterior of the spiual canal, the secondlumbar vertebta was found to be carried

a a little backward.;, and to the right side,sliding on the third and carrying along

with it the npper part of the chord. This

vertebra, which had suffered the princi-pal displacement, was found in the fol-

lowing state. The superior surface ofthe body was turned a little upwards andforwards, and to the tefthide. It remainedunited with the upper part of the column,and had very nearly the same direction.Its interior surface turned downwards andbackwards a little to the right side, restpdpartly on the transverse process and bodyof the following vertebra. The anteriorsurface was turned a little down, and to

the right, corresponding to the exostosisthat had been formed in front of the ver-tebra. Its posterior surface was turnedbackwards, and a little to the left, and sn-periorly would have obliterated the canalif it had not been broken, and thns clefcinto two parts. The left extremity wasdirected towards the left side, a little.downwards, and in front appeared as itit were crushed and fixed between the firstand third lumbar vertebrae. Its right ex-tremity was turned towards the right, anda little above and behind had nearly thesame direction as the upper part of thecolumn, while it passed over more thanone half of the body of the inferior ver.tebra. The right lamina of this vertebraappeared to be broken, and united ly anirregular callus, so as to be longer thanin its natural state. The articulatingprocesses of the left side had their usual

relations, and appeared to be the fixed

point on which the upper part of the spinehad been moved from left to right. The

articulating ones of the right side weredestroyed, and separated as far as half aninch.From this disposition of the osseous

structure, it appears that the vertebralcolumn had undergone certain very int-portant changes. These parts were con-solidated by a large exostosis that had

690

been formed in front of the body of thedisplaced vertebta, which commenced onthe left side, and advanced to the infe-rior vertebra, where it was attached.These were also united by certain hard,fibrous, and irregular parts of new for-mation, which surrounded them com-

pletely, and extended to the pillars of thediaphragm. The lower portion of thespinal marrow was compressed, and thenerves arising from it compressed at theirroot, and diminished in size.

Mode of Operating for Cataract amongthe Indians.

A paper, by Mr. Breton, on the native

operation for cataract, was read on Satur-

day, Feb. 5th, (of this year) before theMedical and Physical Society of Calcutta,of which the following is an abstract :-

The operation for cataract is very com-monly practised by the Natives of Hin-dustan, both Mohammedans and Hindus,and with a degree of success that couldscarcely be anticipated from the rudenessof the implements and the ignorance ofthe operators, who are utterly unacquaint-ed with the anatomy of the eye. TheNative mode of couching, differs in somerespects from that which has been prac-ticed in Europe since the days of Pliny,and from that described after the Greekauthorities by the Arabs. Mr. Breton,therefore, concurs with Dr. Scott, whohas given some account of the operationin the Quarterly Journal of Science, inregarding it as of indigenous origin, andnot borrowed from Grecian or ArabianSurgery. Instead of the couching needlein use with European practitioners, thenative operator employs two instruments,a lancet and a needle ; the first is usedto perforate the coats of the eye, and toobviate the possibility of its penetratingtoo deeply, a guard of thread is boundround the blade at about I-10th of aninch from the point. After the perfora-tion is made, a kind of probe, or needle,is introduced to depress the lens ; thisinstrument is about five inches long, ofthe size of a crow quill ; the shaft is cir-cular, diminishing in diameter to withinabout an inch of the point, when it be-comes of a triangular shape, with bluntedges- the apex is also blunt ; just abovethe triangular part thread is wound roundit to prevent its passing too far. Theneedle is directed in the axis of the lens,and serves to depress it belcw the pupil :

the eye-lids are then closed, the needle

remaining in the eye, being supported bythe sort of shoulder which it forms whereexpanding into a triangle, and resting ona dossil of lint placed on the cheek.After a short interval the eye is examined:if the lens has risen, it is again depress-ed ; and this is repeated until the ope-rator is satisfied that the depression haibeen effected : the needle is then with-drawn, and some slight precautions aretaken against the inflammation that fol-lows.

After being satisfied of the safety andefficacy of the operation, Mr. Breton in-trusted its performance to several of hisnative pupils, who met with equal suc.cess. Above 100 cases were thus opt-rated on by different hands, of whichnot above eight were considered as

failures ; a few instances occurred, inwhich the repetition was necessary, butin a less proportion than similar occur-rences in Europe ; neither does Mr. Bre.ton think the subsequent inflammationmore violent in general than it is wherethe cataract has been depressed b) themost skilful of our own practitioners, Onthe whole he is disposed to conclude, that,although the native operation may not beequally successful with that of Europeansurgery in the hands of eminent andpractised operators, yet its simplicitv, aswell as efficacy, renders it worthy ofadop-tion where the opportunities of practis-ing with our own instruments have beencomparatively rare, and less manual dex-terity has been in consequence acquired.

We find that the second volume of the

Society’s proceedings was sent to the

press in February last.

ERRATA in the last week’s ForeignDepartment :

Page 649, left hand side, line 7, thewords " well," and "by means of thebladder," to be omitted.

Page 649, left hand side, lines 8 and 9,a comma should be placed after the words" accomplished" and "way."

Page 650, case 3, line 28, read mppu.ration for " separation."

Page 650, case 6, line 6, read ix for" on."