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General RetrospectSource: Provincial Medical and Surgical Journal (1844-1852), Vol. 12, No. 23 (Nov. 15, 1848), pp.641-642Published by: BMJStable URL: http://www.jstor.org/stable/25500567 .

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GENERAL RETROSPECT. 641

which is taken from the "Confessions of an English

Opium-Eater" :

"I must mention one symptom which never failed to

accompany any attempt to renounce opium,-viz., violent sternutation. This now became exceedingly troublesome, sometimes lasting for two hours at a time, and recurring at least two or three times a day. It is

remarkable also, that during the whole period of years

through which I had taken opium, I had never once

caught cold, nor even the slightest cough, but now a

violent cold attacked me, and a cough soon after."

TRAUMATIC TETANUS.

A man died from traumatic tetanus, following an

injury of the foot, produced by his treading upon an

upright nail. On a post-mortem inspection, the plantar nerve was found torn through one half its diameter, and there was lodged between the extremities of its

lacerated fibres, a portion of boot leather, which had been pushed inwards by the nail.

THE INTENTION OF HICCUP.

In the convulsive movement of hiccup, the diaphragm is depressed; the larynx is raised , and the glotttis is

closed. What would be the effects of these conditions? The depression of the diaphragm would tend to

expand the cavity of the chest; but the glottis being closed, no air can enter the lungs. The two extremities of the esophagus are, however, still open, and if the

hiccup be strong enough, air will enter the esophagus at both ends. If a person will make a prolonged

voluntary effort of the conditions which occur in hiccup, he will find' a portion of air sucked, as it were, into the

esophagus, from the pharynx. Now, spasmodic hiccup is a reflex movement, excited, in general, by gaseous irritation of the stomach; under these conditions the

hiccup will suck the air of the stomach into the lower

extremity of the cesophagis. This, then, is the inten.

tion of hiccup,-to pump off the air of the stomach.

The movement of the hiccup sucks the gaseous contents

of the stomach into the lower extremity of the

esophagus, and an inverted action of the esophagus

propels them upwards, and discharges them at the

pharynx.

Q(enuraI I8etro~ psct.

PATHOLOGY.

ON THE ARTIFICIAL INFLATION OF THE LUNGS, IN

NEW-BORN CHILDREN, AND ON ATALECTASIS

PULMONUM.

Dr. Eulenberg adverts to the discrepancy of opinion as to whether the lungs of a still-born child can be so

inflated as to swim in water. The affirmative has been

maintained by Bohn, Lieberkiihn, and Hunter; the

negative by a greater number, and is the prevailing

opinion. The present author has repeated experiments, and as the result, has found that the effect of inflation

much depends upon the period at which it has been

commenced. He states,-l. That the inflation is always easy if undertaken shortly after birth, before

rigidity has taken place; the effect being complete in

proportion to the force used. 2. Inflation is difficult after rigidity has commenced. Dr. Eulenberg then reviews the points of difference which are usually said to distinguish inflated lungs from those in which

respiration has taken place.

1. Inflation produces a complete distension of the

organ. This in fact depends entirely upon the degree and duration of the inflation, and from its not being delayed until collections of mucus or other causes offer mechanical obstacles to the admission of air. 2.

Abscence of crepitating sound on section.--3. Expulsion of air by pressure. Air is expelled with as much diffi

culty after artificial inflation as after respiration. In neither case is the buoyancy of the lungs destroyed, but by such an amount of pressure as destroys their

texture.-4. Bloodless colour of the lungs. This is too variable to form a ground of distinction.--5. Colour of the distended lung. This is a greyish dirty red, very

different from the bright red of a lung which has

respired.-6. Substance of the lung. Upon the surface of the inflated lung, just under the pleura, are to be seen small flat rouudish vesicles, the size of a millet

seed, disposed in groups, forming a vesicular emphy sema. The stronger the inflation, the more numerous are the isolated vesicles which are caused by the

rupture of the texture of the lungs. When inflation induces this emphysema over a great portion of the

lungs it cannot fail to be recognized; but when a small

portion only is so affected, it has the greatest resem blance to a pathological condition of the lungs of new born children. In children born with atalectasis

pulmonum, and who have lived for some time, are often found under the fetal portions of lung, certain

emphysematous spots like those produced by inflation. The following are the chief points of difference:-In

atalectasis, the emphysematous portions project more

from, the surface, the lung is of a brighter red, richer in

blood, closer in texture, its dark colour being but little influenced by pressure; the mucous membrane of the bronchi is red and swollen. However, in emphy. sema from inflation, air is found in other parts as in the cellular tissue, near the thymus, esophagus, &c. In a child with atalectasis, that has lived some time, the lungs, though in a fetal condition, shew little

tendency to sink, while in the inflated lung, all parts not distended sink immediately.

In three cases of atalectasis the author found the

bronchial tubes obstructed by viscid reddish mucus, which he is inclined to regard as the main cause of

their non-inflation by ordinary respiratory efforts, and

for this reason considers tartar emetic as a remedy He objects to artificial inflation in the new-born infant, as if air is blown forcibly, an emphysema will always result.

The author's conclusions in reference to the lung test are:-1. That we possess sufficient characteristic

signs of a lung having been inflated. 2. That decom

position nullifies all tests.-Medicinische Zeilung, No. 6,

7, 8, 1848, and Brit. and For. Med. Chir. Rev., Oct.

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642 QUEEN'S COLLEGE, BIRMINGHAM.

SURGERY.

INFLUENCE OF ETHERIZATION ON THE MORTALITY

OF SURGICAL OPERATIONS.

In the April number of the Monthly Journal, Dr.

Simpson has published tables showing the influence

of etherization on operations. From these it appears that of 230 primary amputations of the thigh, leg, and

arm, performed in the British Hospitals wihout the use

of ether there were 88 deaths, or 38 per cent.; of 38

secondary operations, 95 deaths, or 24 per cent.

Of 302 amputations of the thigh, leg, and arm, under

etherization, 73 were primary, and 25 deaths followed, or 34 per cent; 229 were secondary, 46 deaths, or 20

per cent. only. In amputations of the thigh alone the difference is

more marked, the per centage being as follows:

Without ether, in the Parisian Hospitals, 62 in 100; in the British Hospitals, 38 in 100. Under cetherization, 25 in 100.-Monthly Journal.

SUCCESSFUL AMPUTATION OF THE THIGH AT THE

HIP-JOINT.

M. Guersant operated, on the 28th December, 1847, for a cancerous affection of the femur by disarticulation

at the hip-joint. The child, aged 5, was very much

reduced. He was put under the influence of chloroform

-insensibility was complete in two minutes. The

operation lasted only two minutes. When the ligature was being placed on the vessels the child became pale, a little foam came from the mouth, the eyes were turned

up, and the pulse at the wrist disappeared. This state

of syncope was dissipated by means of active ventilation, and the introduction of a few spoonfuls of wine into

the stomach-and the child began to cry, much to the

relief of the surgeon. Twenty.two days after the

operation the child was as well as possible.-Journ. de

Med. et de Chir., Fevr., 1818.

DESCRIPTION OF A SIMPLE TRUSS IN CONGENITAL

HERNIA.

Mr. Coates, after noticing the difficulty in maintain

ing a truss or bandage in position, in the case of infants,

mentions a simple contrivance, from which he has

experienced uniformly good results.

It consists of a skein of Berlin wool, which is made

to encircle the pelvis, one end passing through the

other at a point corresponding with the inguinal ring;

the end thus passed through is then carried between

the thighs, and fastened to the cincture behind. This

can be worn at all times, and replaced and cleaned with

little trouble, and, moreover, is not likely to gall the

tender skin of the little patient.-Medical Gazette,

Sept. 29th.

NEW MODE OF DILATING STRICTURES OF THE

URETHRA.

M. Amussat, in a case of stricture which resisted

all treatment, and beyond which ordinary instruments

could not be passed, finally succeeded in introducing a very fine bougie of half a millimeter, (the millimeter

is equal to 1-26 of an inch English,) and, using this

as a conductor, on the following days introduced along

side of this successively several others, to the number

of six. Between these the urine passed. They were

left in for several days, being occasionally withdrawn

and re-introduced in a bunch, passing as easily as a

single bougie of the same size would. The stricture

was now readily dilated with ordinary instruments

and the cure rapidly effected. The advantage of this

method is, that when once we can introduce an instru

ment, however small, there is no liability to failure in

introducing the bougie a second time if once with

drawn, or in attempting to pass a larger one. What

ever is gained is maintained, and the first introduced

serves as a guide to other instruments of the same size.

The dilatation can thus be readily accomplished, and

the urine passing between the small bougies they can

be retained several days without inconvenience.-Journ.

de Md. et de Chir., Fevr., 1848.

QUEEN'S COLLEGE, BIRMINGHAM.

PROFESSORSHIP OF PASTORAL DIVINITY.

We have to record another instance of the munificence of the Rev. Dr. Warneford to this estabfishment, which,

though not immediately connected with the Medical

Department, cannot but tend materially to contribute to the efficiency of the College at large. The Rev.

Vaughan Thomas, in a communication to a special

meeting of the Council, summoned for the occasion, made the announcement of Dr. Warneford's intention of

endowing a Professorship of Pastoral Divinity. After

noticing the general objects contemplated in the establish.

ment of the College, and the means which had been

taken to further these objects, the Rev. Gentleman pro. ceeded to unfold Dr. Warneford's views in relation to

the special purpose for which the meeting had been

called, concluding his able address as follows :-" In the

offer about to be submitted to the Council, our ever

watchful benefactor was not unmindful of the Royal

example. Her Majesty the Queen, (to whose grace and

favour we are indebted for our collegiate existence-and

not for that alone, but for that new and increased power of usefulness with which her Majesty has entrusted us

by a Charter of greater amplitude,) by Royal Grant

to the University of Oxford, bearing date May 3,

1842, assigned out of the Church revenues a large annual

income to a Professor of Pastoral Divinity. The very course of his Lectures is set forth in the grant-they are

to comprehend instruction in the Ministerial duties, in

the composition and delivery of sermons, in reading the

Services of the Church, in the history of Liturgies, in the

reason and use of Rubics, and the like. He is, moreover,

to give professional instruction, and to make examinations

of the pupils according to such scheme or schemes as may

from time to time be revised and altered by the authorities

of the University. In these words and acts of the Royal care and concern for the due discharge of the pastoral

duties, Dr. Warneford beheld not only the brightness of

the Queen's example, but the power of her authority.

Having long entertained the pious wish of making the

senior department of Queen's College available for the

purpose of training good and sober-minded young men,

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