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matter was taken up by Dr. Simpson. No unprejudiced personcan read Dr. Simpson’s papers on this subject without comingto the conclusion that turning may be performed in cases ofmoderate pelvic distortion at the full term, with comparativesafety to the mother, and with a reasonable chance of safety tothe child. It is also shown to be applicable to cases of greaterdeformity, in combination with the induction of premature i,delivery. Nothing has ever occurred in the history of turningwhich has so strongly tended to enlarge its usefulness as the in-oduction of anaesthesia into obstetric practice. Under chloro-

form, we can turn with comparative ease in cases of excessivesensibility of the os uteri and vagina, in arm cases in which thewaters have been long expelled, and the uterus has closed uponthe fostus with spasmodic force. It renders turning practicablein cases of convulsions or maniacal excitement, and in all in-stances it makes the uterus comparatively quiescent, and thusaverts the dangers depending on contraction and resistanceduring the operation. Turning is performed nearly threetimes as often in France and Germany as it is in thiscountry. After turning, the next great step in oppositionto craniotomy was the discovery of the forceps. Before thetime of Chamberlain, whenever turning was impracticable,there was no resource in cases of difficulty except in cranio-tomy. But it may fairly be questioned whether the wholepowers of this instrument have ever been fairly broughtout, especially in this, the country in which it was produced.If we examine our standard works, we find more pains takento show when this instrument is not to be used, than when itmay be. The cases in which the forceps may be used are thoseof moderate disproportion or distortion, whether the arrest is atthe brim, in the cavity, or at the outlet of the pelvis ; cases ofarrest from failure of the labour pains, without any morbidcondition of the parturient canal; cases of convulsions in whichthe os uteri is dilated, and the head sufficiently low to bewithin reach of the instrument ; cases of occipito-posterior pre-sentation, not otherwise admitting of rectification, and facepresentations ; cases of accidental haemorrhage; and cases ofrupture of the uterus, in which no great recession of the headhas taken place. It should also be used at a comparatively earlyperiod in many of the cases which, if not assisted, run on toimpaction from swelling of the fœtal head and tumefaction ofthe soft parts of the mother. The outlet and middle straits ofthe pelvis are the limits within which the short forceps shouldbe used; at the brim, the long forceps is the proper instru-ment. The forceps is used more than twice as often in Franceand Germany as it is in this country. The last, and it

may truly be said the greatest, opponent of craniotomyis the induction of premature labour. The largest singlesource of craniotomy is deformity of the pelvis. Now, it maybe asserted, without the possibility of contradiction, that inthis great mass of cases, it would be right and practicable at onceand for ever to abolish craniotomy in the case of the livingand viable fcetus. In all cases of suspected deformity, an exami-nation should be made in the early or middle months of preg-nancy, and the proper treatment of such cases should be theinduction of abortion or of premature delivery. In cases ofexcessive distortion, where it would be altogether impossiblefor a viable fœtus to pass, abortion should be induced beforethe time of quickening. It would be quite impossible for in-tercourse and impregnation to take place in any case in whichit would not also be possible to induce abortion with safety tothe mother. In the very considerable number of cases ofmoderate distortion in which the diminished capacity impedesdelivery at the full term, but would allow of the passage of achild at the seventh or eighth month with a chance of living,the induction of premature labour is the only justifiable prac-tice. Besides the great operations of turning, the forceps, andthe induction of premature labour, there are other means bywhich, in special cases, the necesity for craniotomy may besuperseded. One of the most simple is the rectification ofoccipito-posterior presentations. When the occiput descendstowards the sacrum in the third and fourth positions, insteado turning towards the right or left acetabula, great difficultyis produced, particularly in first labours, or when the head islarge. Recorded cases of craniotomy show that the want ofthis rectification, which is generally possible with the hand,the lever, or the forceps, often leads to perforation. Cases ofhydrocephalus in the foetus are amongst the most difficult todeal with in an attempt to abolish craniotomy; but here wehave the proposal of Dr. Simpson to tap the hydrocephalichead, and in this way reduce it, so as to allow of delivery with-out the destruction of the foetus. In actual occlusion or insu-perable rigidity of the os uteri, incision is a safer and betterpractice than craniotomy. While it is the object of the present

paper to advocate the abolition of caniotomy in the case of theliving and viable fcetus, there is undoubtedly a class of cases inwhich perforation may be practised beneficially,-namely, inlabours where the child has died during the course of partu-rition. No woman should be allowed to remain in difficultlabour after the death of the child has been satisfactorily ascer-tained. Considering, then, the various means at our disposalin the way of preventing the necessity for craniotomy, theauthor unhesitatingly expresses his conviction that, as a ruleof practice, craniotomy in the case of the living and viablefcetus should be abolished; and he believes that if all the re-sources of obstetrics in the way of prevention, management,and alternative treatment were properly wielded, the necessityfor the operation would not arise.

(To be concluded.)

Reviews and Notices of Books.On the Identity of Achorion Schönleinii and other Parasites

with Aspergillus Glaucus, and on the Development of theYeast Plant. By JOHN LowE, M.D., and Fellow of theBotanical Society of Edinburgh. pp. 21, and two plates.Edinburgh: Neil. 1858.

WE lately gave a report of a paper read before the MedicalSociety of London by Mr. Jabez Hogg, having for its object tGshow the fallacy of a modern theory, which attempts to provethat certain diseases of the skin are due to the propagation andravages of vegetable parasites peculiar to each of the affectionsalluded to. " One cannot but conclude," said Mr. Hogg, " thatthe whole theory is erroneous, and that special parasites pecu-liar to, and productive of, special diseases do not exist."

Further, it was the author’s firm conviction, that the fungifound upon the skin and hair are not primarily the cause, butrather the 9-esult of the diseases in question. We believe itwas the opinion of some whose judgments are trustworthy, thatMr. Hogg worked out his argument in a very satisfactorymanner. But ten years ago, when the observations of Remak,Gruby, Berg, &c., were just coming into note, the general theoryof vegetable parasitism was opposed, both on theoretic and onpractical grounds, by Dr. Willshire, in an essay upon theaphthoid &c. diseases of the mouth in children, and for whichthe silver medal of the Medical Society of London was awarded.This writer maintained that the low vegetable organisms inquestion were the result, and not the cause, of the maladiesthey were seen in connexion with, and that their " developmentwas readily explainable according to well-known laws ruling.the so-called decomposition of organized matter." Wherever,said Dr. Willshire, you have decomposing organic matter,amongst it you will constantly find that low types of vegetableorganisms are produced. It is of no consequence whether such

organic matter, which is undergoing metamorphosis, be com-posed of " tartar" around the teeth, of the aphthoid and muguetexudations in the mouths of children, of the pultaceous mem-brane in " diphtherite," of the scabs of porrigo, the scurf ofpityriasis, or of the pustule of sycosis, &c., for all animalmatter is changing, and new though lower forms of life springup. This is the solution of the difficulty: the vegetable growthsarise in the crusts of porrigo as they do " if a piece of melon, ora bit of cheese, not over dry, be placed in a cupboard." Nowsuch doctrines as these, professed by Mr. Hogg and Dr. Will-shire, must sound highly heterodox to the polite ears of somemicrological pathologists; and no doubt many gentlemen withgood microscopes, and but slight clinical knowledge of disease,will vote for their being instantly " put down." But so fa rfrom being disposed to do this, we are happy in introducingDr. Lowe to their notice, who supports Mr. Hogg’s heresy invegetable parasitism respecting the " common identity of manyof the parasitic vegetable formations." Dr. Lowe writes-

"During the past winter a number of well-marked cases offavus have been treated in the Royal Infirmary of Edinburgh,and from one of these (a most unique specimen of porrigo lupi-

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nosa) a mass of the favus crust was obtained. I was thusenabled, by placing this in a position favourable to germination,to watch the development and fructification of the so-calledachorion Schonleinii, whose claims to be ranked as a distinctspecies I had long doubted."-p. 4.The results of Dr. Lowe’s interesting experiments and obser-

vations went to show

"That there is a probability of numerous forms now rankedas distinct species being nothing more than mere variations ofone or other species belonging to the two genera (AspergillusPenicillium] just mentioned; that the same characters arecommon to each, and that there are no legitimate grounds fortheir being considered as specifically, much less generically, dis-tinct.......That the spores are borne by the wind from somesource where they are produced in immense quantities seemsevident from the frequent occurrence of the plant in variousdiseased conditions of the body, as in aphtha, muguet, and inthe sordes which collect upon the teeth in fevers. The sporesmay be found in abundance on the tongues of healthy persons

if examined early in the morning; their development, however,does not ensue, except the person be attacked by a debilitatingdisease. "-p. 9.

Dr. Lowe does not commit himself to the other heresy of Dr.Willshire and Mr. Hogg, that the vegetable growths are alwaysthe result of disease, and not the cause of it. On the contrary,he appears to decidedly favour the more fashionable doctrine.In discussing " the development of the yeast plant," he says-

" Brewers, generally speaking, are not likely subjects for thegrowth of parasitic plants, but I have met with several caseswhich seem to me to prove that these are derived from the

growing yeast, and thus tend to establish the proposition laiddown in my last communication regarding the origin of skindiseases."

" In one brewery I met with two cases of lichera annulatussolitarius, and one of sycosis. They occurred in the only per-sons engaged amongst the yeast. I have recently met withanother case of like nature-namely, of favus, occurring in aperson engaged in a wine vault, which was densely covered withfungi. The former were both situated in the right upper extre-mity : in the one case on the back of the hand, and in the otheron the anterior of the forearm, about three inches above thewrist. The sores commenced as small red spots, and in eightdays had attained to the size of a shilling. On examining themunder the microscope, a distinct mycelium was obtained, differ-ing in no respect from the same growth in favus, with a recentspecimen of which it was compared. "-p. 20. IWe can safely recommend Dr. Lowe’s tract both to patho-

logists and to naturalists for attentive perusal. ’

Outlines of Human Osteology. By F. 0. WARD. SecondEdition. pp. 430. London: Renshaw. 1858.

A SECOND edition of Mr. Ward’s admirably accurate descrip-tion of the bones deserves a few words of notice, seeing thatthe work first appeared as far back as 1837. To the philosophicanatomist there is no book more thoroughly gratifying thanthe one before us; and although the student may pass it by atfirst, and give the preference to the more highly-decoratedworks of Holden or Gray, he will, if he really love his studies,soon have recourse to this, the most philosophic work upon thesubject in the English language. For accuracy of descriptionMr. Ward is unrivalled; in illustration of which, let anyonecompare his description of that difficult bone, the fibula, withthat by either of the above-mentioned authors. It is, however,in the mechanism of the joints that the author’s ingenuityand ability are most displayed. Many points in connexionwith these, though now commonly received and taught, werefirst worked out and demonstrated by Mr. Ward; and manyof the diagrams in his book have become standard amongst theteachers of anatomy.

Lest anyone should be deterred by the apparent dryness ofthe subject, we extract a few lines from the description of thehand, which show their author to be possessed of language, aswell as accurate descriptive powers :-

" Bring together the wandering Arab, the red warrior ofthe American forests. the feathered barbarian of Africa, the

civilized European: which of them will mistake the meaningof a hand, clenched in anger or shaken in defiance; stretchedabroad in the attitude of command, or raised to heaven insolemn attestation; waved triumphantly above the head, orpointing the finger of scorn; barring the lips to enjoin silence;calmly extended in benediction; flung wildly forth in despair;covering the face in shame; wrung in the bitterness of grief;spread, shuddering, in horror; folded tranquilly in the act ofprayer ?"

We are glad to add that the new edition is in a much morereadable form than the preceding one.

New InventionsIN AID OF THE

PRACTICE OF MEDICINE AND SURGERY.

NEW PHARMACEUTICAL PREPARATIONS.

IT is a fact well known to those engaged in the practice ofmedicine, that many of our most active drugs, as well as theirpreparations, produce when administered very variable results;.the same drug, or its preparation, sometimes failing to exerciseany influence on a patient, and at other times developing evendistressing symptoms. Without passing a general condemna-tion on drugs of the best quality, and the pharmacopœial pre-parations manufactured from them, we believe that the dis-cordant results in question arise from the variable quantitiesof the active principles necessarily present in such drugs andtheir preparations. For example, we are informed, on a reli-able authority, that both colchicum seeds and cormus containtheir active principle in such diverse proportion, that it is fre-quently necessary to administer double doses of one sample toproduce the therapeutic effect of another. Obviously, thisidentical variation of strength must ensue with the pharma-coposial preparations of colchicum, whatever the care or skillof the pharmaceutist. To remedy these evils, Mr. Bastick haspursued a system very different from that generally laid downin our Pharmacopoeias in the manufacture of most of its preparations. To illustrate his plan by an example, we will takethe tincture of hyoscyamus. Now it is admitted, on all hands,that the efficacy of hyoscyamus depends on the presence of analkaloid, hyoscyamine, in the plant. As the leaves of this

plant contain an ever-variable quantity of hyoscyamine, it ismanifestly impossible to prepare tincture of hyoscyamus ofuniform strength; but if we first extract the hyoscyaminefrom the leaves, we can easily make a solution of this alkaloid,of constant strength. This is the outline of Mr. Bastick’smethod for manufacturing the liquors submitted to our notice.At present, he has only manufactured three of these prepara-tions,-namely, Liquor Hyoscyaminas, Liquor Colchicinae, andLiquor Smilacinas; but it is evident that the series is capableof great extension. Mr. Bastick informs us that these liquorscorrespond in strength with the best samples that can be madeof tincture of hyoscyamus, vinum colchici, and ext. sarsae fluid.The idea of employing the active principle of colchicum and

hyosoyiunus in medicine is not new, for Liebig and the lateDr. Gregory threw out the suggestion some years ago to theprofession; but the credit of bringing this idea into a practicalshape is certainly due to Mr. Bastick. Moreover, we under-stand that, by improvements devised by him for eliminatingthe alkaloids, he is enabled to obtain these costly medicines atsuch a price that expense will prove no barrier to their generaluse in those cases where such considerations must be takeninto account.We may add that Mr. Bastick’s new liquors are quite dif-

ferent from any preparations that have heretofore come underour observation, and are certainly very elegant, being almostentirely free from taste and odour; and those who have triedthem pronounce them to be the most reliable remedial agentswith which pharmaceutical science has furnished us for com-bating disease.


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