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FRENCH JOURNALS.

Gazette Medicale de Paris, Jan. and Feb.1835.

THE numbers of this journal for Janu-ary, and the 1st half of the month of

February, contain the following originalarticles :-1. On the use of cold waterin several surgical diseases, by MM. JossE,father and son, surgeons to the Hotel Z)!6Mof Amiens. 2. History of an epidemicof cholerine observed at Dieppe, duringthe summer of 1834. 3. Practical ob-

servations on ulcers of the neck of the

uterus, by l-i. MAGISTETL. 4. Observation

of a case of the sense of music very highlydeveloped in an idiot, with some remarkson phrenology, by M. LEURET. 5. Re-,searches on the nature and varieties ofaccidental ossifications, by M.ROGNETTA.

Art.-I. UsE OF COLD WATER INDISEASE.

The authors of the present articlehaving given a short sketch of the medi-cal history of cold water, develop the the-ory upon which they believe its beneficialeffects are explained. Inflammation, asCooper observes, in the first volume of his " Lines," is connected with almost all sur-gical diseases, either as a cause, a symptom,or a complication, or even as a means or imode of cure. Hence, in order to under-stand the action of cold water in variousmorbid states, and regulate its applicationin a rational manner, it is absolutely neces-sary to determine the mechanism and na-ture of the phenomenon generally calledinflammation. M. Josse defines this af-fection according to the views of Hal-

ler, Hunter, Bichat, and Burns ; and re-gards it as consisting in an augmentedaction of the capillaries, by which theblood is attracted more or less forciblyfrom the surrounding parts. Besides this,he conceives that at a certain period ofinflammation the capillaries lose their ac-tive extensibility, and are merely distendedin a passive manner by the blood, which issent to them too forcibly and in too greatquantity by the larger trunks ; hence heconcludes, that if, by any means, the in-pulse of the blood towards the inflamed

part be sufficiently diminished, the capil-laries are enabled to recover their contrac-tility, and the disease is cured.Such is the theory of the mode of action

of various antiphlogistic remedies, and

principally of cold water. As to the bestmethod of employing this latter means,M. Josse prefers a constant stream of wa-

ter on the part : but this is so inconve-nient in many diseases, that the surgeonis forced to substitute compresses dippedin cold water, and constantly renewed, insuch a manner that the evaporation of thefluid may continually carry off caloricfrom the surrounding parts, and thus actas a powerful sedative on the circulatingsystem.When the inflammation was situated in

a leg, an arm, &c., M. Josse employed themethod of effusion which we have some.times seen used in the Parisian hospitals;viz., by a bucket containing cold water,suspended over the lirnb laid on oilcloth, toprevent the bed from being wetted, and asecond bucket to receive the water whichdrains off from the end of the cloth. Thewater first used is of the temperature ofthe surrounding atmosphere, and then

gradually lowered, according to the sen-sations of the patient. When compressesare employed, the author properly cau.tions us against an error into which manysurgeons fall when they treat inflamma-tion in this way. Thus the increased tern-perature of the inflamed part soon evapo-rates the water imbibed by the compress;which becomes dry, or at least contains afluid whose temperature is elevated. On

renewing the water the temperature issuddenly changed; and when this takesplace several times, instead of a constantapplication of cold, we have a successionof cold baths, each of which is followed bya certain degree of reaction.In the early stages of local inflammation

the use of cold water is attended with themost beneficial results : and even whenthe disease has existed for some time in thetissues, the general symptoms, as pain,fever, agitation, &c., immediately disap-pear, although the local phenomena seemto resist the action of the cold.

Finally (and here we cannot help quot-ing the author’s words), " when coldetfu-sion is employed before the iatlau:zu: torysymptoms have declared themselves, itsaction is most rapid and decisive. We are,indeed, able to affirm, that whatever maybe the extent of the injury, whatever theimportance of the injured organ, no mat-ter in what way the wound may have beenproduced,-by contusion, laceration, gun-shot, incision, puncture of a sword &c.,whether it be a comminuted fracture,or an opened articulation, &c., if the lifeof the part or parts have not been actuallydestroyed by the operating cause, the em-ployment of cold effusions will certainlyprevent all local and sympathetic reac-tion." In a second part M. Josse pro-mises some prac.ical c . servations on theabove principle.

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We regret that our space does not per-mit any examination of this doctrine,which, though new in France, is cer-

tainly not so with us. We cannot, how-ever, avoid calling to mind the beautiful

theory now for many years advocated bythe professor of anatomy in the Univer-sity of Dublin, nor the physiological rea-soning and practical facts which he is

in the habit of advancing in its sup-port. The doctrine that inflammationis not necessary for the union of wounds, ;and that its development may be success-fully prevented, belongs undoubtedly to

Dr. MACARTNEY, although it has been

republished without any acknonvledgnientby Mr. SYME of Edinburgh, and forms thebasis of the treatment recommended in

the ingenious memoir before us, by MM.JossE of Amiens.

Art. 3.—ULCERATION OF THE NECK OFTHE UTERUS.

The excellent lectures of M. LISFRANC,which we have lately published on this

subject, and which contain the results ofhis vast experience in diseases of the

uterus, relieve us from the necessity ofmaking a lengthened analysis of the pre-sent paper. It contains eight observa-

tions of ulceration of the uterus, arisingfrom a variety of causes ; such as the useof the pessary, venereal infection, scir-

rhus, &c. The following conclusions re-sult from what the author has observed : -.

lst. On the least symptom of disease ofthe uterus the surgeon should have re-

course to the use of the speculum.2nd. When the ergot of rye has failed

in the treatment of a metrorrhagia, thevagina should be immediately plugged,before the other means, generally em-

ployed in such cases, are exhausted.3rd. The slightest ulcerations of the

uterus should be combated by caustics.4th. The best that can be employed for

this purpose is the nitrate of mercury (ni-trate acide de mercure, the proto-nitrateof mercury dissolved in nitric acicij.

5th. In chronic catarrh of the vagina,the use of a tampon of charpie, allowed toremain for some time in the vagina, maybe attended with the best results, by sepa-rating the parietes of the canat, and ab-sorbing the altered secretion of the mu-cous membrane or ulcer.

Gth. A female may survive for a great

length of time, though affected with can-cer of the uterus, provided no hemorrhagesupervene.

Art. 5.—NATURE AND VARIETIES OF

ACCIDENTAL OSSIFICATION.

This is one of those papers which weoften meet with in the French and Ger-man journals, containing rather a displayof research on the part of the author than

any new or practical information. M.

ROGNETTA la3-s down as a principle,which no pathologist of the present daywill we should think be inclined to con-

test, that every osseous substance is notthe effect of a transformation of cartilageinto bone. M. HOWSHIP was generallysupposcd to have been the first who

pointed out this fact, but M. ROGxETTAtraces it to REICHEL.

Accidental ossifications may be consi-dered under the double view of the tissueswhich they may occupy, and the materialcomposing them. With respect to the

first head, they may be found in everytissue of the body; and according to DUN-CAN and BERZELIUS, their chemical com-position differs little from that of ordinarybone, except that they contain somewhatmore of the carbonate of lime.

Journal Hebdomadaire, J an uary 1835.

The numbers of this journal, for the

past month, contain, as usual, very littlethat is worthy of notice. The greaterpart of the medical periodicals of Europenecessarily pass through our hands, andwe have not as yet- met with one, whether

indigenous or foreign, which can comparein insignificance with the journal of MM.BOUILLAUD and FORGET, a circumstancewhich can only be attributed to its direc-

tion being solely left to the latter gentle-man. The five numbers before us con-

tain the following so-styled " OriginalMemoirs :"-

1. Case of fibrous cancer developed inseveral regions of the medullary organ,by M. Dubruil, l;rofe.aor at Montpellier;2. Case of poisoning by belladonna;3. Case of ligature of the subclavian ar-tery for traumatic aneurysm of the axil-lary, by ill. Segond. (In this lattercase aneurysm resulted from a fall on the

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shoulder producing compound luxation 01the joint and laceration of the axillaryartery. The blood was arrested by com-presses dipped in spirit of camphor.,and in a month the wound healed. An

aneurysm now formed in the axilla, andthe subclavian artery was tied above theclavicle. The ligature, composed of twothreads, came away on the Ilth day, andon the 20th the wound was healed.)4. Report on the diseases of Cayenne ;this fills the greater part of Nos. 3 and 4.Finally, an observation of premature la-bour, by M. C. Gerrard.

Journal des Connaissances Medico-Chirur-gicales. Feb. 1835.

It is a relief to turn to this journal fromthe one we have just left. The presentnumber contains,- :

1. A memoir on the cauterization of the ! larynx in certain cases of chronic apho- nia, by M. Trousseau. 2. Case of face- fpresentation, which required the Caesarean koperation, by M. Halma-Grand. 3. Re- marks on the simultaneous use of bleeding and tartar emetic in pneumonia, by M.Teissier. 4. Considerations on diseases of the eye; anatomical researches on the leheight and breadth of the nasal duct in Bvarious nations, with a table, and a mo-dification of M. Dupuytren’s canula, byM. Bourgot St.-Hilaire, late chef de cli-

nique for diseases of the eye at the HotelDieu.

Art. 1.—CAUTERIZATION OF THE LA-RYNX IN CHRONIC APHONIA.

When we analysed the interesting ob-servations of M. TROUSSEAU on croup, iand the employment of the nitrate of sil-ver as a local remedy for that fatal disease,we were unacquainted with the fact, thatfour years ago lie had succeecled in rapidlycuring a case of chronic aphonia, by ca-terizing the larynx. Since then he has Icollected a sufficient number of facts torecommend with confidence this novelpractice. Ulceration of the larynx is oneof the most frequent causes of chronicaphonia, and the former depends, in mostcases, either upon phthisis or syphitis ; ihowever, the mode of treatment recom-mended by M. TROUSSEAU is scarcely ap-plicable to aphonia resulting from an ac-tual loss of substance, and must, therefore,be limited in its application. The author

distinguishes two forms of chronic aplio-nia,- one generally affecting females, andof a nervous character, the other comingon more slowly, subject to variations, andfinally becoming complete. This form is

often seen in singers, public speakers, &c.

Either of these varieties of aphonia may,or may not, be accompanied with inflam-mation of the mucous membrane of the

pharynx and larynx. They are combatedby several remedies, but particularly bycauterization of the affected parts. M.TROUSSEA U gives a full description of themanner in which this may be effected witha small twig of whalebone, armed with amorsel of sponge, half an inch in diameter.The cauterization may be performed witha saturated solution of nitrate of silver,and repeated once a day for a fortnight without any danger of eroding the mucousmembrane, or producing anything morethan a slight degree of nausea. M.

TROUSSEAU insists forcibly on the inno-cencc of the nitrate of silver thus em-

! ployed, and supports his assertion by seve-ral valuable cases. We give a hastysketch of one as an example :-

B Case.-H. Maiblet, 20 years of age, re-ceived into the Hotel Dieu on the 29th ofAugust 1831. During the course of men-struation she was exposed to cold; themenses ceased, and a complete aphonia su-pervened. General and local bleedingwereemployed. In two months the menstrual

discharge returned, but no modification inthe state of the voice. The disease hadnow lasted three months. On being re-ceived into the hospital she was bled tosyncope without any benefit. M. TROUS-SEAU now resolved on cauterizing the

pharynx and upper part of the larynx.The operation did not take up more thantwenty seconds ; it was followed by somecough but no pain of throat. On the fol-lowing morning no change, but 48 hoursafter, the aphonia began to di-appear, andthere was some slight pain in the laryx.On the fourth day the patient could speakdistinctly, and on the 10th September sheleft the hospital perfectly cured, and sincethen there has been no relapse.

In addition to this case M. TROUSSEAUdetails three others in which cauterizationwas employed with equal success. In onethe patient was cured on the third day ; inthe two others the treatment extended toa month.

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Art.3.—USE OF BLEFDI-.VG AND TARTAREMEriC IN PNEUMONIA.

The relative merits of venesection, andwhat is called the " Italian method," inthe treatment of pneumonia, have long oc-cupied the medical world, and particularlythat of Paris. The object of the presentpaper is to place in a favourabie point ofview the utility of tartar emetic adminis-tered in moderate quantity after the moreviolent inflammatory symptoms had beenreduced by bleeding.

CASE OF DOUBLE UTERUS.

Malformations of the uterus, consistingin a division of the organ into two cavi-ties by a perpendicular septum, are rarelymet with in the dead body, and are

still more rarely recognised during life.The unfortunate termination of the casewe are about to notice, recorded by M. J.A. LE RoY, gives an addition to the interestdepending on it in an anatomical pointof view --

Erminia Trousin, 19 years of age, men-struated for the first time two years ago,and in a few months afterwards married.About six months back she commenced tofeel severe pain in the region of the uterusand vagina, which was aggravated at eachmenstrual period. The pain was relievedby the horizontal position, but continued toincrease every day. On the 1st of Maylast she consulted M. Le Roy. The menseshad appeared for three days, and with themintense pain in the uterus. On examina-tion he found, about an inch above theorifice of the vagina, a hard tumour fillingthe whole of the true pelvis; the neck ofthe uterus could not be touched. Exter-

nally a hard tumour was felt, extending ashigh as the umbilicus, and perfectly re-

sembling an uterus at the 6th month of

pi-egnanc3,. The tumour evidently con-tained a fluid, but the introduction of asound into the bladder showed that it didnot consist of that organ. The nature ofthe tumour was very doubtful. However,as the patient desired to be relieved, aftera consultation with three surgeons of the

hospital at Versailles, M. Le Roy openedthe most depending part of the swelling,by plunging a trocar into it. Some dark-colomed fluid can.e awaB’, The open-ing was eiilai--ell by a bistoury, and agreat quantity of the same fluid was dis-charged. The supposed body of the uterus and its vaginal orifice were now distin-

guished in the upper part of the vagina.For the first four days after the operationthe patient’s state was most favourable,but on the 19th symptoms of peritonitisset in; the abdominal inflammation maderapid progress in spite of the most activemeasures, and the woman died on the22nd.On examination of the body after death,

the peritoneum was found actively in-flamed, especially in the neighbourhood ofthe tumour. There was no trace of neckto the uterus; but the natural opening layquite upon the mucous membrane of thevagina. To the left and lower down wasthe artificial orifice. The body of theuterus presented an inch and a half inbreadth, and was terminated on eitherside by two horns, each a couple of incheslong. The cavity of the uterus was

opened from the external mouth to theextremity of the left horn, and it was nowseen that the uterus was divided into two! portions by a perpendicular septum, ex-tending from its fundus to the inner edgeof the utero-vaginal orifice, so that the

right cavity had no communication eitherwith the left one or with the canal of thevagina. This was more plainly seen whenthe right cavity was opened. The fibres ofthis part of the uterus appeared consi-derably enlarged; and at the lower partit formed the enormous pouch whichfilled the pelvis, and extended into theabdomen.-Jour. des Con. Med. Chir., Feb.

The nature of the tumour and cause of

the symptoms, so embarrassing during life,were thus easily explained. The case is

itself a most instructive one. It shows

the danger of our having recourse to whatare called operations of " complaisance ;"and, moreover, shows the necessity or at.tending to a point of practice much betterappreciated in England than in France. Oursurgeons are properly cautious in drawingoff, at the same time, any large quantityof fluid from a serous cavity. In the pre-sent case, more than three washing-basinsof dark fluid were removed, and this sud-den depletion of the cavity probably gaverise to inflammation of the peritoneumsurrounding it.

A DAILY paper states that some physi-cian has just resigned his office at a Dis-pensary to (-,iiter to the har. He workedas a doctor at the " Charity" for nothing.How much will he do as a lawyer for thesame reward?