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ing the child in a proper position for the operation, I madethe necessary incision, and with some difficulty, owing to thedepth of the trachea and shortness of the neck, completedthe operation. And here I would mention the great utilityand convenience of drawing the windpipe up a little with atenaculum, when properly exposed, as its extreme mobilityand small diameter, in the young subject, render it no easymatter to make a suitable opening there. The bleeding wasslight, and easily restrained by sponging with iced water.The tube being introduced, and the patient placed on his side,a violent fit of coughing came on, and some bloody mucuswas expelled. Respiration, which at this time was extremelyhurried, became easier by degrees. Enemas of beef-tea wereadministered at .intervals, and by the next evening the childwas able to swallow a few drops of milk.

Rapidly improving in every respect, on the fourth day thepipe was removed, and the upper part of the wound broughtcloser together. Respiration was now nearly natural, foodwas easily swallowed, and great hope was entertained of hisultimate recovery. But unfortunately the family were poor, sixliving in this one room, and the little patient being sometimesexposed to a severe draught, at others enduring a suffocatingheat. On the tenth day laryngitis came on, and the poorlittle fellow died at last.London-road, Southwark, Oct. 1850.

CASE OF VIOLENT CRAMPS AND CONSTIPA-

TION, IN WHICH STRYCHNIA WAS SUC-CESSFULLY ADMINISTERED.

BY W. FORT VIDAL, ESQ., M.R.C.S., Aveley, Essex.LATE HOUSE-SURGEON TO THE LONDON HOSPITAL.

A SINGLE lady, aged thirty, of an exsanguine emaciated ap-pearance, who has for fourteen years been subject to fits, ("acomplication of hysteria and epilepsy, for the last four years,terminating in catalepsy,") had a severe attack, on the 29thof August, and remained in the cataleptic state for five days,during which time the bowels were not relieved, although re-peated enemata were administered, as nothing could be takenby the mouth. The urine not being passed was drawn off.Consciousness returned on Sept. the 4th, when she complainedof great pain in the head, burning pain in the spinal column,more particularly in the region of the lower dorsal vertebrae:at the same time severe cramps in the legs, (" which weredrawn up, and unable to be moved,") chest, and abdomen; butno tenderness on pressure; skin cool; pulse 90, and weak;tongue covered with a thick white coating; anxiety of coun-tenance, dyspnoea, and dysphagia. Ordered a warm bath, acataplasm of mustard to the chest and abdomen, an anti-spas-modic mixture, and purgative pills of calomel and compoundextract of colocynth, and an enema.

Sept. 5th.-No relief, as the symptoms were as severe; nodejection from the bowels. Ordered a blister to be applied tothe whole length of the spine, and the part dressed withstrychnia, in form of ointment, mixed with lard: the strength,two grains of strychnia to half an ounce of lard; and, as themeans already tried to relieve the other symptoms were un-successful, it struck me that the strychnia given internallymight be beneficial. I therefore gave it in doses of one-six-teenth of a grain every four hours, in pills.

6th.—Much better, as pain and cramps, as well as thedyspnœa, were much relieved, and all pain in the head andback totally gone; the urine passed freely, but as yet no actionfrom the bowels; has slept for two hours during the night,which she has not done since consciousness returned, but com-plains of numbness in the extremities; pulse the same; tonguenot so coated. Omit pills; ordered croton oil, half a drop,mixed with soap, every four hours, until the bowels should berelieved; and also enemata.

7th.—Much worse, as the cramps and pain have returned,as distressing as on the 4th; had a restless night; pulse 88;no febrile symptoms, but the bowels, in opposition to all themeans used, still were unmoved. Ordered warm bath, andthe strychnia repeated as before, every four hours.8th.-Again better: pain, cramps, and dysphagia have sub-

sided ; bowels acted copiously; urine passed naturally; sleptbetter; pulse 90; tongue almost clean. Pills to be repeatednight and morning.

9th.-Feels as well as she usually has been; had a goodnight,. Pulse 90; tongue clean. Pills to be taken at night,and then omitted.No further inconvenience was felt from the former symp_

toms until the 14th, when the cramps in the legs and abdomenwere again troublesome, but not so urgent as to allow of hercalling me in; but on the 17th they became so severe, andthe head painful, that fearing a relapse, I was called in to seeher. I found her nearly as bad as before, with the exceptionof the dyspnoea and dysphagia. On inquiry, I learned thatthe bowels had not acted from the time the cramps came on," which was for three days," although she had taken two dosesof castor oil, and applied fomentations to the abdomen; theurine also became less in quantity, and ammoniacal. Pulsestill 90; skin cool; tongue again loaded. Ordered a warmbath, mustard poultice to the abdomen, and an anodynemixture, with two minims of tincture of opium in each dose,every four hours.

18th.—Much the same. Had a restless night, as crampswere coming on in paroxysms about every two hours, and last-ing for about ten minutes; great anxiety; bowels had not acted;,tongue rather brown, which I attribute to the opium. Thestrychnia pills to be repeated every four hours.

19th.—Much better. Had some rest; bowels acted slightly;urine more abundant; no variation in the state of the pulse.Pills to be repeated.20th.-Had no return of pain or cramps since twelve o’clock

last night, from which time she slept well; bowels actedcopiously early in the morning; tongue much cleaner. Pillsto be repeated three times a day.

21st.-Feels well. Has had no return of pain; has passed’a good night; bowels acted well; tongue quite clean. Pills tobe taken night and morning.22nd.-Feels as yesterday. Slept well; no return of any

bad symptoms. Pills omitted.It is interesting to see the way in which the strychnia acted

in this case, which is one of no small interest,and where, moreespecially, all the symptoms were relieved through its efficacyin so short a time. The peculiar manner of its relievingcramps and spasms so severe, and thereby promoting theaction of the bowels and bladder, and their action still con-tinuing without the aid of any other medicine, is altogether-worthy of notice, when purgatives, enemata, anodynes, as well’as external applications, proved useless. It is also uncommonto have a case in which the symptoms were so urgent as theone before us, where the circulation was so little affected,,.the pulse continuing much the same through the whole case,both when the pain was urgent, as well as during its ab-sence. I have not named anything respectillg diet, as I didnot think it necessary to restrict my patient to any particular

food. Her usual way of living is so very simple, and the, quantity taken so small, that it could not in any way add taher discomfort.

Aveley, October, 1850. __ _____

ON A RECOVERY FROM ATTEMPTED SUICIDEBY OXALIC ACID.

BY W. ALLISON, ESQ., M.R.C.S., &c., East Retford.

ON March l0th, 1849, I was desired to see a man, agedtwenty-two, nearly three miles off, who had swallowed anounce of oxalic acid in half a pint of water, and had sincevomited several times.An ounce of castor oil, half a pound of prepared chalk, and

half an ounce of calcined magnesia, with a stomach-pump,were sent by the messenger.On arriving at the house where the man lived, the chalk

and magnesia were mixed in a pint of water; but it was.necessary to threaten the use of the stomach-pump, and toprovide men, ropes, &c., for confining the man before he wouldconsent to take frequent draughts of the mixture; he vomitedafter the first two draughts, the rest of the mixture remainedin his stomach.

After half an hour, a syphon (the stomach-pump tube) wasintroduced into the stomach; the man heaved to vomit, butno liquid came through the tube. The syphon was withdrawnand the holes were found blocked up with moistened chalkand magnesia.The man was desired to take some gruel for supper, and the

oil early in the morning.On calling the next day, he appeared to be as well as

usual, and he has remained so, to the present time.Remarks.—Probably the stomach had rejected the greater

part, if not the whole, of the solution of oxalic acid beforethe chalk &c. were taken. Perhaps the remedies were assuitable as any which could have been used; but the intro-duction of the syphon, under the circumstances, must be con-sidered a questionable proceeding. The vessels of the lining

503

membrane of the œsophagus and stomach might be veryturgid and easy to lacerate by the introduction of a foreign Ibody; the object in using it was to ensure the evacuation ofthe oxalic acid from the stomach, but I did not proceed to in-ject and withdraw water or thin gruel; first, because it mightbe better to allow the antidotes to pass through the intestinalcanal; and secondly, because much distention of the stomachmight have occasioned a laceration of congested vessels, andbecause the man’s heaving to expel the tube might have re-peatedly brought the coats of the stomach in violent contactwith the end of the tube, whilst I was fixing on the pumpfor injecting, &c.The chief object in publishing such an occurrence as

this is to afford an opportunity for useful criticism upon themanagement of the case.East Retford, Oct. 1850.

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Foreign Hospitals and Schools.

HOSPITALS AND MEDICAL SCHOOLS OF FRANCE.MEDICAL education in France is placed under the control of

the Minister of Public Instruction. There is but one uni-versity, called the University of France; its seat is in Paris,and it is governed by a supreme council appointed by govern-ment ; of which the Minister of Public Instruction is ex officiopresident. The branches of this university, in the principalcities of France are called academies; they are governed byrectors, and generally possess faculties of letters, sciences,law, and medicine. There are but three academies, however,which have a faculty of medicine; they are situated in Paris,Montpellier, and Strasbourg. There are, besides, twenty-onepreparatory schools in provincial towns, where students inmedicine may spend the first two years. They are thefollowing: - Amiens, Angers, Arras, Besançon, Bordeaux,Caen, Clermont, Dijon, Grenoble, Limoges, Lyons, Marseilles,Nancy, Nantes, Orleans, Poitiers, Rheims, Rennes, Rouen,Toulouse, Tours. The number of professors of these prepara-tory schools is, on an average, about thirteen, and they areappointed by government.The expenses of these schools are defrayed by the cities

where they are situated, and the following branches of scienceare taught:-1. Chemistry and Pharmacy; 2. Natural Historyand Materia Medica; 3. Anatomy and Physiology; 4. Practiceof Physic and Pathology; 5. Surgery; G. Midwifery and Dis-eases of Women and Children. Each school has six pro-fessors, and two deputy professors.The faculties of Montpellier and Styasl)ourg are governed

in the same manner as the faculty of Paris; the fees, how-ever, are somewhat lower than in the capital. The School ofMontpellier is looked upon as advocating Vitalism, in contra-distinction to Paris, which is considered as the head of thePathological Anatomy School. The Dean of the Faculty ofMontpellier is M. Berard; of the faculty of Strasbourg, M.Coze; and the number of professors is fifteen in each, who,as in Paris, are elected by concours.

THE FACULTY OF PARIS

is composed of twenty-six professors and twenty-four deputyprofessors (agreges), all elected by public competition (con-cours); the former for life, the latter for nine years, at theexpiration of which they retire with the title of " agrégé libre."The dean is elected from among the professors for the periodof five years. Eighteen courses of lectures are deliveredthrough the winter and summer sessions, and these are gra-tuitously open both to registered and unregistered students,or to any foreign graduate or surgeon.

Winter Course, canametzcing Nov. 2.—Anatomy, Dr. Denon-villiers ; Medical Chemistry, Dr. Orfila; Forensic Medicine,Dr. Adelon; Operations, and application of Surgical Apparatus,Dr. Malgaigne; Surgery, Dr. Gerdy; Medicine, Dr. Dumeril;General Pathology and Therapeutics, Dr. Andral.Summer Course, commencing April 2.—Medical Physics, Dr.

Gavarret; Hygiene, Dr. Royer-Collard; Natural History, Dr.Richard; Midwifery, Dr. Moreau; Surgery, the late Dr. Mar-jolin is not yet replaced; Medicine, Dr. Piorry; Pharma-cology and Organic Chemistry, Dr. Dumas; Therapeutics, Dr.Trousseau; Pathological Anatomy, Dr. Cruveilhier; Dean ofthe Faculty, M. Ph. Berard.

CLINICAL PROFESSORS TO THE FACULTY.

Clinical Sit?-gery.- Dr. Roux, at the Hotel Dieu; Dr.Cloquet, at the Hospital of the Faculty; Dr. Velpeau at theCharite; Dr. Lankier, at the Fitie.

Clinical Medicine.—Dr. Fouquier, (lately deceased,) Dr.

Bouillaud, at the Charite; Dr. Chomel, Dr. Rostan, at theHotel Dieu.The attendance of the professors is from seven to ten A.M.

in the winter, and from six to ten in summer; their lecturesand the practice of the hospitals are free to every one; at theHôtel Dieu, however, the passport must be shown. House-surgeons and house-physicians are called Internes; dressers goby the name of Externes; the former are remunerated, andboth are elected by public competition.

Examinations.—Students are required to pass an examina-

tion at the end of each of the three first years; at the expira-

tion of the fourth-viz., when the pupil has regularly regis-tered for sixteen consecutive quarters, he paying £2 for eachregistering- series of five different examinations begins;and these are followed by the thesis, written in French, anda disputation upon the same. After these trials have beensuccessfully undergone, the degree of doctor of medicine isconferred. The degree of doctor of surgery is obtained bythe same course of study; the fifth examination and the thesismust, however, be on surgical, instead of medical, subjects.The whole of the expenses for registering, examination, theprinting of the thesis, diploma, and stamp, are about £44.There are no special fees for hospital or lectures; and thedissections are carried on at a trifling cost, both near themedical school and at Clamart, a vast establishment at thesouthern extremity of the city, under the control of thefaculty. Every facility for operations on the subject can beobtained at Clamart. Very handsome prizes are held out toassiduous pupils, who, by competition, enter a special dissect-ing-school, called Ecole Pratique, where a great many privatecourses of lectures are given. A moderate fee is expected.

. No one is allowed to register as a medical student unless heproduce, first, a certificate of birth; second, the consent of hisparents or guardians; third, testimonials of good moral con-duct; and fourth, the diploma of bachelor of letters, (this is

. pretty similar to the A.B. of this country;) and he is expectedto become a bachelor of science at the end of the first year.Foreign students, who express such a wish, may obtain from

’ the professors whom they regularly attend, certificates of at-tendance on their lectures without regularly registering, fourtimes a year, as the French students are bound to do.

Hospitals.Regular clinical professors are appointed, as stated above,

at the Hotel Dieu, the Charite, the Pitie, and the hospital ofthe faculty. These professors deliver clinical lectures daily,after the visit. But the practice of the other physicians andsurgeons attached to these large hospitals is likewise open toforeigners. A list of the principal hospitals, with the medicalmen connected with them, will be found useful, as they areall very easy of access.

HOTEL DIEU,By the side of Notre Dame.

All kinds of patients admitted, except children, personslabouring under incurable diseases, the insane, women inlabour, or people affected with venereal or chronic affections.

Phtisacians - Drs. Husson, Honoré, Jadioux, Guérard,Caillard, Louis, Martin Solon, Choniel, and Rostan.

Surgeons—Drs. Roux, Jobert de Lamballe, and Boyer.Pharmacien—M. Bouchardat.

LA CHARITE,Rue .Jacob, south side of the Seine.

ADMISSIONS SIMILAR TO THOSE OF THE HOTEL DIEU.

Physicians—Dr. Fouquier, (lately deceased,) Drs. Cruveil-hier, Rayer, Bouillaud, Andral, and Briquet.

Surgeons—Drs. Velpeau and Gerdy.Pharmacien—M. Quevenne.

LA PITIÉ,Rue Copeau, near the Jardin des Plantes.

ADMISSIONS AS AT THE IIOTEL DIEU.

Playsiciccrzs-Drs. Serres, Piorry, Clément, Gendrin, Pied-agnel.

Surgeons—Drs. Laugier and Michon.Pharmacien—M. Guiart.

____

HOPITAL DES ENFANTS,Rue de Sevres, south side of the Seine.

EXCLI:SIVELY DEYOTED TO THE TREATMENT OF THE DISEASES

I OF CHILDREN.

I Physicians—Drs. Trousseau, Blache, Bouneau, and Baude-I locaue.

Surgeon—Dr. Guersant. Dentist—M. Delestre.