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Involuntary movements have sometimes been observed, butrarely, because the most gentle pressure on a sensory nerve issufficient to excite pain, whilst, on the other hand, a motornerve will suffer considerable pressure without giving rise tothe spasmodic contraction of the muscles which receive theirramifications from it. The compression of the ulnar or mediannerve causes pain, but not spasms, unless voluntary action issuspended. We know that sensibility is involuntary, and thatmotion is voluntary.

2. Headaches have been observed to result from decayedteeth, and to cease after their extraction.-Answer: Pain isan element of irritation, which in this case is often a causeof congestion. Pain, especially of this kind, causes wake-fulness, which in its turn becomes a cause of congestiontowards the head. I would observe that pain resulting fromcarious teeth resembles hemicranial pains without being ofthe same nature. The diagnosis of hemicrania, according tomy definition, offers occasionally some difficulty.

3. Often, during hemicrania, we find tinnitus aurium, andeither great susceptibility or dulness of hearing.-Answer :These symptoms are explained by the relations of the Gasserianganglion with the supra-petro-sphenoidal flexus, by those ofthe auditive and facial nerves with the inferior petrosal sinus,and especially by the relations of the glosso-pharyngeal nerve,which sends ramifications to the Eustachian tube, and which isalso in connexion with the internal jugular vein. I would alsoadd, 1. That the mastoid portion of the temporal bone isabundantly provided with foramina, some of which commu-nicate with the mastoid cells, whilst others less numerouscommunicate with the lateral sinus. 2. That between theupper surface of the petrous portion and the squamous portionthere exist foramina, giving passage to veins which emptythemselves also into the lateral sinus. 3. That the aquae-ductus vestibuli and aquæductus cochlese are traversed by twoveins which empty themselves into the internal jugular vein,or into the lateral sinus very near the commencement of thatvein. The circulation of the tympanum is thus intimately con-nected with that of the lateral sinuses, and internal jugularvein. The relations of the facial nerve with the inferiorpetrosal sinus explain also the involuntary contractions ofthe muscles of the face, of which some authors speak.

4. Pains are sometimes experienced during headach in thecourse of the nervus occipitalis major, and even along theneck and arm, as far as the elbow.-Answer: Large veins tra-verse the intervertebral notches in the cervical region con-jointly with the cervical nerves, and these veins have commu-nications with the sinuses of the base of the cranium. Whyshould not the relations of these veins with the sensory por-tions of the vertebral nerves account for phenomena identicalwith those resulting from the relations of the sinuses withthe sensory portions of the cranial nerves ? Besides, thecommunications of nerves with each other ought to betaken into consideration in the explanation of the propagationof pain.5: Since the whole trunk of the trifacial, or at least its

ophthalmic branch suffers pressure, how is it that the pain isnot propagated in the direction of all the ramifications of thecompressed nerve.-Answer: It may happen that pressure,although existing at the trunk of the nerve, is only made onthose filaments of the nerve which go to supply the painfulparts; but without admitting this, facts quite as inexplicableabound in the archives of science, touching other diseases.For instance, the entire pleura is inflamed, and pain is felt inone point only. The spine is deeply, and to a great extent,affected, and nevertheless pain is localized on a portion ofa limb.

6. Headach is often a symptom of difficult digestion.-Answer : I think this is true in the majority of cases; but mustwe not admit that unwholesome food introduced into thestomach, or wholesome food introduced into a diseased stomach,determines an abnormal stimulus, the result of which is an in-complete action of the organ, and the production of an imper-fect chyle ? Now this chyle is converted into blood, but intovitiated blood, which produces a languid circulation, and it isby the participation of the sinuses of the base of the craniumin this state of the circulation, that headach is produced.If, then, persons subject to disorder of the stomach are notall subject to headach, it is because each person has hismorbid predispositions, and that which in one person causesheadach, in another produces some other affection. I am farfrom denying the relations of headach with disorders of thestomach; nor do I deny its relation with the nervous suscep-tibility of individuals. I am aware that sometimes headachdeclares itself immediately after the ingestion of food into thestomach; but I question whether headach and gastric disorder

are not in many instances under the influence of the samecause, and consequently not produced one by the other.

7. Infusions of coffee and other stimulants have been usedwith very good effect in preventing and dispelling attacks ofheadach.-Answer: These stimulants give to the stomach,and more particularly to the organs of circulation, the activitywhich they wanted. An arterial congestion would have beenincreased by their use, ergo, a venous congestion is diminished.The relations of the vertebral, and more especially of the

carotid arteries, with the great venous reservoirs of the headand neck, show how much their circulation, accelerated bystimulants, must react on the venous circulation.

8. Food taken in moderate quantities, and well masticated,has dispelled attacks of headach.-Answer : This explanationis the same as that given to the preceding objection; besides,as I have already observed, the movements of the lower jawproduce a vacuum in the pterygoid venous plexus, which isinstantly filled by blood from the cavernous sinus.

9. Narcotics have, it is said, cured headach: Answer : Iam more disposed to think they have relieved pain by strikingthe nerves with stupor. They have acted on the effect, with-out favourably modifying the cause, unless they have beenable to displace the existing congestion. Besides, I havenever stated that every engorgement of the sinuses was accom-panied or followed by headach, but that headach is under thedependence of the engorgement of the sinuses. I do not bythis deny the existence in nerves of a certain predispositionwhich may be modified by the action of medicines. I willadd, that narcotics more often cause headach than they cureit.’, 10. Certain headaches pass from one side of the head to theother, or from the anterior to the posterior part of the head, &c.-Answer : Many other kinds of pain are subject to thesemigrations, without our being able to explain the reason.Here, on the contrary, the communications of the sinuses frombefore backwards, and from side to side, admit of no doubtabout the explanation to be given to the greater part of theerratic headachs. These headachs are not generally very ob-stinate, because the easy displacement of the blood in thesinuses, whatever may be its cause, regularizes the intra-cranialvenous circulation.

11. The day after a headach, the person feels in better gene-ral health, and is free from the affection for some time:Answer : This is not always the case; besides, it can be ex-plained by the salutary repose to which the organs have beencondemned.

Conclusions.

1. Hemicrania implies moderate compression of a sensorynerve, and particularly of the trifacial.

2. The causes of this compression are some venous reservoirsgorged with blood, and particularly the cavernous sinuses.*

3. The treatment ought to consist, lst, in preventing thecompression, which constitutes the prophylaxis of headach.It borrows its means of action from hygiene. 2nd. In pal-liating its effects by movements and positions of the head, &c.,this constitutes the palliative treatment, and its means ofaction are borrowed from gymnastics. 3rd. In removingthese effects, this is obtained by the co-operation of gym-nastics and of stimulating, depleting, and other medicinal sub-stances.

4. The cause of the accumulation of blood in the venousreservoirs of the base of the cranium ought by no means tobe neglected.

_____ ___

Reviews.

The Scalpel; a Journal of Health adapted to Popular and Pro-fessional Reading, and the Exposure of Quackery. Edited byEDWARD H. DixoN, M.D. Published by the Editor. NewYork: Ring; Marriner & Lockwood; Dewitt & Davenport.

WE have before us two numbers of this periodical, which hasbeen established within the present year. We rejoice to per-ceive that the editor is a fearless castigator of abuses; tread-ing in our footsteps. In fact, both in name and nature, wemay look upon this Journal as a descendant of our own pro-duction. Had there been no LANCET in Europe, there wouldhave been no Scalpel in America. Our semi-namesake ope-rates boldly, and no doubt with good effect. In his very first

* In certain cases there probably exists a true congestion of the trunks ofthe trifacial nerve.

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article, he thus shows up the claims of the University andState Medical Society of New York to public notice:-"The writer of this article will answer for himself, that the

examination he underwent at the State Medical Societywould have excited a smile among a company of grandams;yet he found himself duly invested with the honours of theState Society, that venerable dry nursling of medical learn-ing, and privileged to practise medicine and surgery, for thesum of twenty-five dollars, and an examination of fifteenminutes’ duration.

" Now, what is the consequence of this easy attainment oflicence ? Eight hundred physicians, if not a thousand, existin New York. How do they get bread ? Turn to the quackadvertisements in our papers, and be satisfied. One individual,a licentiate of the State Society, vends two thousand dollars’worth of an article which should give him a passport to theState Prison, and would do so, in any country whose municipalregulations- were governed by a desire to prevent crime, andnot to nurse popularity. Where do the hags, who comeamong us to buy and sell the virtue of our females, by publicadvertisements so plain that he who runs may read their ob-ject, get their knowledge ? There are, at this moment, twoindividuals in this city who are intimately connected in busi--ftess with- these heartless wretches, and both hold licencesfrom the State Society, and one possesses a diploma 1"Medical ethics seem to be as much at a discount as literary

honesty, amongst some persons in the Union. Apropos ofliterary honesty, a glorious rebuke is administered by Dr.Dixon to his- piratic countrymen, in a department of his-Journal which he has called "Soda Powders," but which hemight, with at least equal propriety, have named " AcidulatedDrops," or " Cayenne Lozenges," since the contents of thatsection are both sharp and biting. We extract the followingparagraph entire: it shows no small amount of pluck in Dr.Dixon, to beard, as he has-, done, the burglars around his owndoor.

" LITEELARY ACCOUCHEURS.—There is a class of medical gen-tlemen in this city, belonging chiefly to the obstetric depart-ment, who show their-zeal in the cultivation of their peculiarscience, by issuing into the new world the works of their dis-tinguished brethren on the other side of the Atlantic. Theyare a sort of literary chiffoniers, not exactly of the scissor orpenny-a-line character, indeed, not quite so honourable asthat; for they attempt to shine, like the jack-daw, in bor-rowed plumes. They get up’ books on midwifery, diseasesof the skin, &c., and are wondrously skilful in making title-pages. One of this genus, not long since, donned the skin ofa lion in a most ingenious manner-but, alas ! for him, it wasnot so skilfully adjusted but his ears from their magnificentlyasinine proportions shot out. This man published a transla-tion of an elegant German physiological tract, announcingthe demonstration of a fact of extreme interest, and forgot toput the author’s name in the title-page, his own with his pro-fessorial title occupying the most prominent line. But thatis not the best of the joke. It is well known here that theprofessor does not read the German language; to save ap-pearances a little, a very eminent German scholar was lastmentioned in the title-page as his coadjutor. There is asecond title, in which the name of the author appears in verysmall type at the bottom of the page. Then follows a letterfrom an individual equally distinguished as the discoverer ofthe facts detailed in the tract, (who, by the way, the modesttranslator, with peculiarly good taste, calls very familiarly byhis surname,) with a request that the obstetric professorwould translate the book ! This is paraded, of course, infront of the pamphlet. Oh! modesty, where art thou ? Trulythe phenomenon may shake hands with his illustrious brother.Soon we shall have another lecture-from Southwood Smith, orWilliam Lawrence. Well, well, par nobile fratrum."

The following indicates plainly enough that justice, thoughtardy, is still sometimes done to the claims of discoverers. It

indicates the opinion which we may presume to be nowpretty generally adopted in the States relative to the truediscoverer of the anaesthetic properties of ether.

" Did Dr. Jackson, or Dr. Morton discover it ? Dr. Mortonpetitions Congress for a sum of money as a compensation forhis toils and sufferings, because he couldn’t defend the patenthe obtained for his compound. (?) Don’t forget that it wassaid to be a compound. Dr. Jackson is certainly a most un-

fortunate man; he says he also-discovered the Magnetic Tele-graph !

" P.S.-Neither of ’em got any money—it’s all right, forpoor Wells discovered it, as the people of Hartford have clearlyproved:’ .

Dr. Dixon is rather fond of mottoes and quotations to headhis articles. There is none appended to the above, but wemay recommend for the purpose Palmam qui meruit ferat.There is good taste in this-"FEMALES AND THEIR DISEASES—By Charles D. Meigs, of-

Philadelphia, Professor of Midwifery, &c. We never did likethe word females, I woman’ is far nobler."

’, Lady Bulwer, in her novel, " Cheveleigh," we think, (anauthority for the sentiments of women themselves upon thispoint,) decries the use of the former term with much-sorenessof mind on behalf of her sex, and she places us Anglo-Saxons,in this respect, in unfavourable contrast to our more politeFrench neighbours. Lady Bulwer and Dr. Dixon are right :a hound and a cat may be "females," and if language have anyinfluence on ideas—which it has-to designate women, in com-mon parlance, under the same term, will naturally enoughcause them to be regarded as domestic animals of only a little.more importance than the rest.

In the third number of the "Scalpel,"-is a very amusingpaper on the

" Characteristics of the Different Genera and

Species of New-York Physicians ;’ and although its interest. ischiefly local, some portions of it may suit this side of theAtlantic. Dr. Dixon is’a bold man, to " scalp" and anatomizehis countrymen after the fashion he does, and we wonder thatlynch-law, in the 11 land of liberty," is not put in force againsthim. We hope, however, he will escape for some time tocome, as we should like to have a little more from his pen.

’, " Our first grand division is that of-the reptiles; they are ofcourse cold-blooded, with hearts adapted to their necessities.Indeed, it would be contrary to Nature’s wisdom to maketheir blood hot-for they will borrow a box on the ear, if £they can see a fee at the end of it. Like eels, they are slimy,and work their way with sinuosities along. Commencing’their studies’ without an education, they observe carefully-their seniors, and wisely hold their tongues in presence oftheir superiors, from inability to converse. They never knowa fellow-practitioner if asked, unless his position is immeasur-ably above their own, and then they are intimate, even ifkicked at a chance interview. Not being particularly self-possessed in the drawing-room, their prehensile and progressive-organs are at a loss for employment; they busy themselves,and collect assurance by inspecting the contents of a lady’sbillet-doux, or work-box, and occasionally essaying thestrength of the spokes or legs of a chair, particularly if costlyand fragile. They are curious in their inquiries of relation-ships, and the extent of families, and what medical predilec-tions their patients may have. Their pocket-handkerchiefsare in frequent requisition, and sometimes their pen-knives ortooth-picks. They get over this in time, but never theirprying and inquisitive propensities. They often come to tea,because the influence of the herb is serviceable for the comesmunication of such little useful matters of gossip as they can’ pick up.’ If asked their opinion of the ability of an absentphysician, they wait somewhat upon the countenance of theinquirer, and if-they can gather nothing, usually couple an ad-mission of talent with some drawback of eccentricity, thatwill serve their turn if obliged to recall their opinion.

" The next division is that of the Simiae, or monkey. Thisis characterized not only by the physical peculiarities of size,low forehead, and projection of the jaw, but also by greatrestlessness of the hands and feet, and a peculiar disposition:to mimic great men. They generally put on spectacles, be-cause it looks learned, and hides their mean-looking, piggisheyes. There is one in this city that has a passion for adoptingwhatever is recommended by the European cognoscenti. Hecarries about with him a uterine sound, assuring his patientsthat it is exceedingly important to ascertain the axis of theuterus; what effect this is to have in replacing it if its positionbe deranged, he does not condescend to say. He has poslsibly discovered its use in obtaining credit for profundity.Stethoscopes are much in favour with these gentlemen; theirears are probably in the way from their length, when obligedto listen to the movements of the heart and lungs....."Some of these people attempt surgical operations; but

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- .these they -never do like their brethren on this side of theAtlantic. One of them, a few years ago, cut out the cornea,or pelluoid part of a pig’s eye, and attempted to stick it intothe eye of a poor Irishman, whose cornea had become opaque;from suffering and starvation; some insane foreigner had pre-ceded him, and the case was quite extensively published inthe private circles of this city as successful ! .... The samegentleman boasts a trophy, consisting of an immense tumourtaken from the abdomen of a poor woman. In recountingthe feat, he usually forgets to say she died from the opera-tion.

" There is a species of parasite, that lives by clinging to thebodies of its more sturdy brethren, and sucking their juices;we shall therefore call it the Mistletoe. This plan has apeculiarly nauseous smell and taste. On distillation, it yieldsno essential oil, and is perfectly inert as a medical agent. Itsorigin, like many of its human prototypes, is involved in ob-scurity....."The viscum querci, or mistletoe of the oak, used to be

common here, but they derived strength from their moremanly foster-fathers; they fell off, and found legs and a littlebrains of their own. The viscum album is now chiefly ob-served-so called from its white, or cream-faced visage, beingprobably connected with a similar state of the liver."There are-several good specimens in this city. The-first,

a viscum querci; he fell partially from his oak some ten yearssince, and is probably the last of his species we shall see, asmedical oaks are becoming scarce....."The order of the Chameleons comes next. These are

known by the great facility with which they change their hueto avoid detection, and the surprisingly small quantity of foodupon which they subsist during their novitiate. Moreover,

’they have, like their prototype, the ability to shrink almostmto themselves, or air, when in the presence of a real, or fan-cied enemy, more especially if he has his eye on them, andpublishes a journal; this is a merciful provision of-nature,-audoften saves them from, destruction. Like that curious anima!,their tongues are unusually flexible in the presence of fools.But here the resemblance ceases; for their -cervical vertebræare-equally so; their heads constantly bobbing- about to realand imaginary salutations, particularly from their superiors,like those Chinese mandarins our ingenious friends the Italianartists expose for sale to the gaping boys. One of -theseaffords a beautiful illustration of the,sympathy of habit. Heused to be a shoemaker, and has, to this day, a habit of look-ing sidewise, as those useful fellow-citizens have, to see if thewax-end is rightly directed; when he is excited, he alsothrows out his arms both ways, as if drawing it through."In this.tribe, the elevator muscles of the corners of the

mouth have uncommon freedom, and readily expose the teeth’to all observers. There is -little action in the corrugatormuscle of the eyebrow; hence .they never frown, because -itwould displease some one. They never go to the opera, be-cause it is. expensive, and, like Moses, having,once paid theirshilling, would feel badly if called out;’ this process costs,nothing at church, -because they must hire a seat; for thesame purpose they keep a horse and carriage=it is part ofthe paraphernalia of -their trade; these even twist themselvesinto our sanctum, to get a Scalpel’ gratis.....

" The genus Pachydermata, or thick-skinned animal, we ’,feel should be approached with great caution, for we shrewdlysuspect that honesty, and a proper appreciation of our ownfaculties, will compel us to occupy a place with them. Thesecreatures are characterized by their obtuseness to injuries,though they sometimes=turn furiously on their assailants; ourfriend Dr. Redfield, gives some of us credit for resembling therhinoceros (one of ’em) in the prominence of our nasal pro-tuberances. This is indicative also of attack, as our friendinforms us, being enlarged in that symmetrical animal into ahorn for that very purpose. There are several of these gen-tlemen in town, from the distinguished doctor, whose hornwas-lately exercised as orator of the Academy of Medicine, toour humble selves; butas they are not characterized by thepossession of any very fascinating qualities of mind, and arerepulsive chiefly by their exterior and excessive obstinacy,we dismiss them.

" There is a species we shall characterize as the Inflata, be-cause of their propensity, like the porpoise, to blow. Thereis something peculiar in the deportment of these gentlemen.They used to carry gold-headed canes wherewith to rub theirnoses, but now the universal prevalence of carriages deprivesthem of this characteristic. They are great formalists, andmostly pious, being very useful-at church; they always sit inthe middle aisle, and are frequently called out, .greatly to thedisturbance of the ladies, who wonder very much ‘ who it is.’

They sit in their capacious carriages with white neck-cloths’spectacles, and folded arms.

" They have much ado to make superficies seem body that-hath depth and bulk. As Bacon says, they are so close andreserved, that they will not show their wares but by a darklight-they seem always to keep back somewhat. They helpthemselves with countenance and gesture, and are wise bysigns.’ As Cicero said of Piso, when you speak to one ofthem, he will fetch one of his brows up to his forehead, andbring the other down to his chin, and then he will wrinklethem, and compress his lips consumedly, so that little, andeven grown children, are frightened at his portentous show ofwisdom. They write prescriptions in cabalistic characters,very good for the apothecaries, and much after-the manner ofthe witches in Macbeth. They use ointments of saving effi-, cacy, containing twelve ingredients, or more; formerly, theycalled them unguentum apostolorum—these are made uponthe principle that one must hit where there are so many.They carry all measures by big words, always despising whatthey cannot understand; yet they are never without a differ--ence. Their speeches- consist of distinctions from beginning:to end, and, when they are done, both you and they are aswise as you were before they begun."Go on " Scalpel,;" you have our hearty commendation.

A CASE FOR A COURT MEDICAL.THE following is the principal portion of a letter received

from Mr. Alsop, of Uttoxeter, in reference to a communica-tion in THE LANCET of’June 2nd last:-" I was willing to allow the matter to blow over, and con-

sented to meet Mr. Chapman in consultation, as requested-byMrs. -, my anger at the insult offered-by Mr. Chapman, inreturning my second note unopened, having considerably sub-sided."

’

After recapitulating some of his previous statements, Mr-Alsop adds-

" Mr. Chapman allowed himself to be overruled in his pro-fessional conduct, thereby committing what I consider breach of etiquette; and in order to get out of the matter, b&endeavoured to silence me by returning my -second note - un-opened."In the concluding paragraph of Mr. Cbapman’s letter he

has accused me of colouring my statement with a falsehood;in reply to which,I beg to-inform Mr. Chapman that the truthrequires no colouring; and to the truth of my statement can bring forward a third party, who heard Mr. - makethe avowal, and which, indeed, he repeated on Thursday last,.when I named the subject to him—viz., ’ That had he(Mr. -) been at home when Mr. Chapman called upon hiswife, he should have sent in for me.’ He also said that henever gave Mr. Chapman authority to make use of his nameto that effect; and that I was at liberty to contradict Mr.Chapman’s statement in my next communication." I do not wish to.prolong this unpleasant discussion; I wiK

therefore leave the matter in your hands; and conclude byasking whether my first letter to Mr. Chapman was so un-courteous, under the circumstances of the case, as to meritno explanation from Mr. Chapman, and the return of mysecond unopened ? I quite agree with you, and consider thecase a proper one for a court medical, feeling every confidencein leaving the matter to you as the judge."

-

’# In this case, as both the controversialists appear willingto abide by the decision of a court medical, we recommendthat each should nominate two fellow-practitioners, whichfour, after meeting, and hearing fully the circumstances of thecase, would have it in their power to state which of the two.

parties should, in their opinion, apologize to the other, andthus enable them to heal their mutual differences.—ED. L.

In a more recent letter on the subject, Mr. Alsop adds-" I have to state distinctly that I was not informed by any

one that Mr. Chapman proposed to send for me, when he

visited Mrs. -, until after my first letter appeared in THELANCET; for Mr. Chapman refused to give an explanation, andMr. - made use of the expression mentioned in my last..which reasons, combined, I considered sufficient for publish-ing the transaction in THE LANCET."

QUEEN’S COLLEGE, BIRMINGHAM.—Dr. Warn eford has recentlypresented another donation of £ 1000 to this institution.