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Title: The Montreal Medical Gazette, Volume 1, Issue 11

Date of first publication: 1845

Author: William Sutherland (1815-1875), Francis Badgley (1807-1863) (Editors)

Date first posted: Jan. 29, 2018

Date last updated: Jan. 29, 2018

Faded Page eBook #20180154

This eBook was produced by: Marcia Brooks, David T. Jones, Howard Ross & the online Distributed Proofreaders Canada team at http://www.pgdpcanada.net





THE

 

MONTREAL MEDICAL GAZETTE,

 

BEING A

 

MONTHLY JOURNAL OF MEDICINE,

 

AND

 

THE COLLATERAL SCIENCES.


Edited by Francis Badgley, M. D., and William Sutherland, M. D.


Vol. I. MONTREAL, FEBRUARY 1, 1845. No. 11.

MEDICO-LEGAL REPORT.

Having examined on Tuesday, 17th inst., at the request of the Coroner and a sworn Jury, the remains of a human body discovered by some labourers in the process of excavation in the rear of a new building lately erected in St. Paul Street, I have to make the following report:—

The body was interred in a bank, and according to the report of the labourers, about four feet below the surface of the earth, close to or upon the foundation of an old privy, and when observed was covered by a couple of boards. The earth having been frozen, the bones of the skeleton were removed by the aid of a pickaxe in detached fragments, so that nothing is known of the position in which the skeleton lay. An old leathern mitten and three half-pennies of a comparatively recent coinage were at the same time disclosed. No buttons nor other vestiges of wearing apparel were found though strict search was made. When first seen by me, the bones were promiscuously mixed together in a box, in the possession of the Beadle of the French Cathedral; several of the vertebræ were wanting, but in other respects the skeleton was entire. The bones of the leg were disarticulated from the feet, which were concealed by boots. These were of the Wellington shape, of a common description, and of British manufacture, and in contact with the feet were socks of coarse grey worsted, considerably decayed.

On examining the different parts of the skeleton more minutely, the following appearances were noted:

A complete absence of all the soft solids, whether muscular or visceral. Lumps of a whitish substance adhered to the bones in various places; they were soft and greasy, inflamed readily on approach to a candle, and otherwise gave every appearance characteristic of Adipocere. The ligamentous connection of the bones, and their cartilages had all disappeared; and with the exception of the bones of the feet, and two of the Cervical Vertebræ none were in apposition. Two masses of decomposed animal matter of a blackish tint occupied the Orbits. At the Occiput was some matted hair of a "fair" colour mixed with earth, on raising which a reddish tint was clearly perceived, as if produced by the coloring matter of blood. Some of this was diffused through water, but the colour imparted to the water was brown. A portion of brain was perceptible through the Foramen Magnum, and therefore the skull was removed to a warm room for the purpose of thawing it, and permitting of closer examination. The Atlas and second Cervical Vertebra were frozen together in such a position that the posterior edge of the lower articulating surfaces of the Atlas rested on the anterior edge of the superior articulating surfaces of the second Vertebra, throwing the Odontoid process backwards into the Spinal Canal, which was filled with medullary matter in a state of decomposition mixed with earth. On cutting open the boots, the soft parts of the feet were found converted into Adipocere, from which all the bones of the Tarsus and Metatarsus immediately separated or fell asunder.

Skull.—In the centre of the Parietal bone on the right side, and towards the posterior inferior angle of the Parietal of the left side, were two large irregular openings, evidently of recent origin, from the whiteness of the fractured edges, produced undoubtedly by the blows of the pickaxe employed during the work of excavation. On the Occipital bone close to the Additamentum Suturæ Lambdoidalis was a depressed fracture of about an inch and a half long, in a transverse direction from the suture, and about two inches deep, forcing the bone inwards in a pointed manner upon the Right Lateral Sinus; the anterior point of the fracture being formed by the suture at its juncture with the Squamous, from which five fissures proceeded in a radiated manner through its extent, the lowest of which extended to the Foramen Magnum, and traversing that opening, continued itself on the Occipital bone on the opposite side, extending from near the Condyloid Foramen to the Lambdoidal suture. The depressed Occipital fracture was not of recent origin, as proved by the darkened appearance of the fractured edges, and the quantity of earthy matter found in it.

The occipital protuberance, and left side of the same bone to which the matted hair was attached, was of a deep purplish black colour, as if stained by a long maceration as it were in blood. A blotch of a similar color was noticed also on the Right Superior Maxillary bone, extending from the inner angle of the Orbit downwards.

On removing the Calvarium, the Brain was found shrunk to about two-thirds its natural size, and emitted the most offensive odour. Not the slightest trace of organization was observed, but the Cerebral Substance, with its membranes, formed a pultaceous mass, and with the exception of that part corresponding to the middle lobe of the left hemisphere, which was blood red, and that in immediate contiguity with, and adjoining to, the fracture, which was blackish bordered by red, it was generally of a pale leaden hue. The centre of the Brain, in the line of the Corpus Callosum, had degenerated into a purulent looking fluid, which was evidently Cerebral matter far advanced in decomposition, or in its last stage.

The inference which appears clearly deduceable from the above premises, is that the deceased met his death by violence, and that he was soon after interred, denuded of all upper clothing, but with his boots on.

The blackish tint on the brain, in the neighbourhood of the Occipipital fracture, is owing to decomposition of extravasated blood mixed with brain, a more rapid decomposition taking place there in consequence of more direct exposure to the causes inductive of decomposition, The blood here extravasated must have proceeded from the Right Lateral Sinus, which must have been most extensively lacerated.

The blood red tint of the brain, corresponding with the left middle lobe, may be referred to extravasation from rupture of, probably, the Middle Meningeal artery, from contre coup: and its retention of the red colour, the result of non-exposure to direct decomposing agencies.

The remarkable relative position of the two Cervical Vertebræ, might have been the result of accidental causes, after decomposition had severed the ligaments which united them together; but, though this is possible, yet it is far more probable that it was the result of the severe blow on the Occiput, which threw the head and Atlas forwards, producing a complete dislocation of the neck, with pressure on the spinal cord, and instantaneous paralysis of the whole body. The presence of medullary matter in the spinal canal, although not absolutely confirmatory of this view, yet considerably strengthens this supposition.

The blow on the Occiput must have been inflicted with some heavy instrument of metal, probably by an axe; the Occiput being the strongest and thickest part of the Cranium, would have resisted such a fracture by instruments of a much lighter description.

The blow must have been given transversely, and from its position, must have been received unawares by the individual.

The question of the time of inhumation is involved in difficulty. It is not possible to determine this with any accuracy. The complete disappearance of the soft solids, would appear to extend the period of inhumation to eight or ten years, while the existence of brain, decomposed although it was, tends to limit it to a much shorter period. Probably five or six years may be regarded as approximating to the truth.

Judging from the appearance of the Sutures, and the hair, the age of the individual may be estimated at about thirty-five years.

A. Hall, M.D.

Joseph Jones, Esq., Coroner.

Montreal Gazette.


TO THE EDITORS OF THE MONTREAL MEDICAL GAZETTE.

Gentlemen,—On the 7th inst. the Montreal Gazette contained a "Medico Legal Report" which was communicated to that Journal by A. Hall, Esq. M. D. and which I am certain will be found well worthy of a perusal by all your subscribers. I am, therefore, induced to request you will favour them, as well as me, by transferring it to your pages—as I am perfectly certain that the majority of them have not met with it. My object for soliciting this favour is principally to direct the attention of every member of the profession to the necessity of paying more attention to subjects having reference to Medico-Legal investigations, and also that remarks on such subjects should be made known to the profession generally through the proper medium.

The manner in which Dr. Hall has drawn up his report redounds much to his credit; he has shown ingenious reasoning and drawn very scientific inferences. No part of the report can be actually found fault with; nevertheless, in a Medico-Legal point of view, it would have been additionally satisfactory to have been informed of the nature of the soil wherein the remains had been found; whether gravelly, sandy, or of a clayey character. Also, whether it indicated a current moisture or a stagnant one; as all these circumstances are known to affect materially the slow or the rapid process of decomposition. To me it seems from the tenor of the Report that the decomposition must have been rapid and that the inhumation of the body was not at a period so far removed as the Doctor infers it to have been. True, he says there were no vestiges of clothes, yet a mitten, money, and boots were found. The money distinct and the quality of both the mitten and the boots still preserved—the latter sufficiently so as to enable him to state they were of British manufacture. Had the deceased been stripped of his clothing, it is difficult to conceive how the mitten could have been in the grave, and still more so, the money. Therefore, I would be inclined to infer that the soil was favorable to rapid decomposition; and it is well known that the more rapid decomposition goes on, the more simultaneously do all the parts, whether muscular, integumental, membraneous, ligamentous or cartilageneous disappear. That the mitten and the boots remained, may be owing to the tannin in the leather; hence also the reason why the soft parts of the feet were converted into adipocere.

As to the fact, that the deceased met his death by violence, and probably received the blow unawares, no one can doubt; but we get no idea of the probable position in which the deceased may have been at the time the injury was inflicted. For my part, after having, through the kindness of Dr. H., carefully examined the skull, and listened attentively to his oral description of the relative position of the atlas and dentata, and connecting this with the fact of the discovery of a mitten and coin, I am disposed to infer that the deceased must have been asleep with his face on a table, or perhaps sitting on a chair with the back of it to his front so as to make a resting place for his arms, that he might sleep upon them; or, what is perhaps more likely, he was sleeping with nothing to rest his head upon at all, a circumstance which would naturally enough drop his chin towards his chest and bring his head in that position, which the evidences of the fatal blow clearly indicate it had been in at the time.

Some may deny the possibility of a dislocation of the dentata without fracture, but I think, with Dr. Hall, that the direction and violence of the blow, connected with my supposed position of the deceased at the time he received it, will clearly establish "not only the possibility but also the probability" of a dislocation.

With these few remarks I beg to hand you a copy of Dr. Hall's Report, and request you will favor me by publishing both in your next number,

Respectfully, I remain, yours truly,

FRS. C. T. ARNOLDI, M. D.

20th January, 1845.


ON A NEW MODE OF DRESSING WOUNDS AND ULCERS.

By Dr. Langier, M. A. M., Surgeon to Beaujon Hospital.—This method consists in applying, on the surface of the wound or ulcer, a solution of gum arabic, and on it a bit of goldbeater's skin; thus dressed, a wound, an inch in diameter, was reduced in the space of eight days to one-third or one sixth of an inch in extent. Cicatrization took place so rapidly, that the granulations, covered with a thin epidermis, were as numerous and visible as before, but could be touched without causing pain. A wound, produced by amputation of the breast, highly inflamed, about four and a half inches in breadth, under this treatment, healed rapidly, and purulent secretion did not take place.—London Medical Times.

ON SOME OF THE DISEASES OF THE EAR.

From Mr. Liston's recent Lectures on the Operations of Surgery.

With regard to the ear, I have already spoken of foreign bodies in the meatus, and I stated that they were to be removed in much the same way that you would extract foreign bodies from the nostrils. You must not attempt their removal by forceps, but put a fine bent probe, or a scoop, behind them, and, with a slight motion of the wrist, you turn them out of their place. Before you make the attempt, you must be very sure that there is a foreign body in the ear. This you can ascertain by using a speculum, which enables you to see perfectly into the bottom of the external meatus. The patient must be placed in a proper light, or the part may be illuminated by a good lamp. The rays of light may be brought to a point, and thrown into the bottom of the tube, as ingeniously devised by my friend Dr. Warden, through the medium of a small prism, adapted to the speculum.

You meet with cases of inflammation of the meatus from various causes—cold, &c. These inflammatory affections often end in abscess; you endeavour to prevent it by the application of leeches to the part; but when matter is formed, its escape is to be favored, and for that purpose fomentation should be applied. You may meet with cases where the abscess is apparent, and then you can puncture it. These abscesses are always attended with very great suffering: the parts are highly sensitive when in a state of health, but still more so when diseased; the abscesses, however, generally burst spontaneously in the course of a very short time, and then the patient is relieved.

Deafness, of course, will arise from the presence of foreign bodies, or from the swelling of the meatus or parts around it. It frequently takes place in consequence of the accumulation of cerumen, and, indeed, this is the most common cause of deafness, and nearly the only one that you can with any certainty count upon removing. Old people are often relieved from deafness of long standing, by having foreign matters washed out from the external meatus. There has been a discussion as to what is the best solution to employ for dissolving the accumulated secretion. You will, in one of the volumes of the "Edinburgh Medical Essays," find a very good paper on the subject, in which are detailed trials with various alkaline and other solutions, and the conclusion arrived at is, that tepid water will answer as well as anything else. You use for the purpose a tolerably large and well-valved syringe, with a properly-fashioned nozzle; now and then you use a scoop, and pull out portions that would not otherwise come away. You often find large plugs of cerumen mixed with cotton and wool, which patients have put into their ears, to prevent cold air getting in, as they say. It is also said, that deafness arises from there being too little wax, from the ear being dry, and in these cases all sorts of stimulating oils have been dipped into the ear, with, I believe, but little advantage. Then you find deafness arising from obtuseness or paralysis of the nerve, and that is thought sometimes to be remediable. You may endeavour to rouse the sensibility of the parts by blistering over the mastoid process, and sprinkling the raw surface with strychnine in minute quantities.

Deafness also occurs to a greater or less extent (and this is irremediable) where suppuration has taken place in the internal ear, and where the bones of the tympanum have been destroyed. You cannot restore these parts, and you cannot expect the functions to be restored, for there is a great change of the structure of the organ. Patients often continue to have a discharge from the ear for a long period; there has been an attack of inflammation and suppuration during some inflammatory affection or fever of childhood, as scarlatina; it goes on for a long time, and parents desire to have it dried up; but beyond having the part kept clean, I advise you not to interfere. If you employ a strong injection, you may give rise to disease in deeper seated parts, and endanger life.

There are discharges from the external ear now and then connected with abscess situated deep in the temporal bone. I have seen two or three cases where the matter which had formed within the cranium was discharged by the ear. There may be abscess of the brain, or abscess between the dura mater and the anterior aspect of the temporal bone; and this certainly cannot be remedied by any external application. I have seen the discharge checked by long exposure to cold and wet; fever has ensued, and the patient has speedily perished.

The functions of the ear are sometimes interrupted in consequence of affections of the throat. Common people know that when the "almonds of the ear," as they say, come down, they are deaf. If the tonsils remain enlarged and swollen, the hearing is obtuse. The same thing occurs from polypi and other tumors of the throat. In cases in which I have removed them, the patient had been deaf for years. I have mentioned in one of my books the case of an old gentleman who had been deaf for very many years; he went regularly to church, for form and example's sake, it would appear; for after a great many polypous tumours had been extracted, he declared that he never, till then, heard one word of the service. The tonsils have been removed now and then with great advantage in cases of deafness, but though relief has been thus afforded, I would not by any means advise you to resort to it in all cases. You are not warranted in cutting away the tonsils or uvula under the assumption that they are the cause of the deafness, more especially when there is but little, if any, abnormal change in them.

After all, there is not a great deal to be done for the cure of deafness. There are many cases easily remedied, but a great many others are quite irremediable. The deafness which ensues in consequence of the deficiency or destruction of parts cannot be remedied; in many cases where the nerve is affected, no relief can be afforded; but where it arises in consequence of obstruction of the Eustachian tube, or the presence of tumors, the surgeon may sometimes afford considerable relief. It has been said that deafness arises from the Eustachian tube being closed up by mucus, and in order to remove it, all sorts of quacks have been in the habit of injecting air and fluids into this passage; but the only effect of this process, so far as I can see, would be to drive the vitiated secretions further into the passages, and impact them there.

In some cases of permanent obstruction of the Eustachian tube, in cases of thickening and induration of the membrane of the tympanum, and in collections of blood in the cavity, the drum of the ear has been perforated. This is an operation not attended with difficulty. The only trouble is in keeping the opening from closing again. The operation may require repetition unless it is performed in such away that a portion of the membrane is wholly removed. This may be accomplished by means of a sort of punch dexterously applied. The instrument must be so guided as to avoid the attachment of the handle of the malleus. I have, in a few instances, seen patients thus slightly benefited, but great success cannot be anticipated from the proceeding.—London Lancet.


SMALLPOX AND VACCINATION.

J. Curtis, Esq., one of the Parish surgeons of St. Pancras, London, gives the following among other results of his observations:

"With respect to the power of vaccination, I am of opinion that it modifies smallpox, if performed at any period previous to the appearance of the eruption, and probably even a day or two afterwards. Therefore, whenever an opportunity occurs, I always vaccinate persons infected with smallpox, even though the eruption shall have begun to make its appearance.

"In the spring of the present year I had fifteen cases of smallpox among my parish patients. One was sent to the Smallpox Hospital, and therefore must be left out of the calculation. Of the 14 remaining patients, 1 was 30 years of age, the others under 8 years; not one had been vaccinated previous to infection by smallpox; 5 were vaccinated after infection, and had the two eruptions going on together; and 1 out of the 14 died.

"Upon looking back to the account kept of my parish patients for the last 12 years, I find the mortality in cases of smallpox among the unvaccinated to be about 1 in 6.

"Supposing my calculation of the proportion of the population vaccinated to apply generally, and also Dr. Gregory's account of the relative mortality of the vaccinated and unvaccinated, the relative chances of death from smallpox of the two classes may be stated thus:—

"Of 300 of the population, 200 are vaccinated; 100 take smallpox naturally, and 20 die.

"Of the vaccinated, an equal number, or 100, take smallpox, and there die 10, being 5 per cent. of the vaccinated. Therefore, the vaccinated have six times the immunity from smallpox that the unvaccinated enjoy.

"I have seen many cases of smallpox after vaccination, but very rarely a death from that cause; in fact, many of these cases required no medical treatment at all."


INFLUENCE OF LIGHT ON VEGETATION.

Philosophers have long ago determined that light consists of vibratory, undulatory, or wave-like movements, which take place in an ethereal medium existing everywhere. It is a more recent discovery that these vibrations are the first origin of the vegetable world. In the work to which I have alluded, I have given the details of this most interesting connection. Out of a limited number of ponderable substances, such as carbon, nitrogen, hydrogen, oxygen, and a few others, all kinds of organized structures are formed, and there is an extensive machinery to collate and group together these different bodies. Light in itself can produce as many different effects as there are possible combinations of color, for each one of its rays has peculiar powers of its own, and it is also attended by other invisible and imponderable principles which have their modes of action. An organized structure of a given kind is therefore the result of the operation of many of these forces, and is an expression of the aggregate action. In the full development of a perfect tree there has been expended a measured quantity of forces of light or of heat, and the organized mass, as it stands before us, in the product of those forces, is the resultant of millions of vibrations of the luminiferous ether, which have acted upon ponderable atoms; vibrations, which have stood in a certain relation to each other, as the symmetry of the vegetable parts indicates. In the operation of human agency something of the same, though of a grosser kind, may he seen. We have not, it is true, the power of calling into existence, or of determining in an enduring shape, or of giving an embodied form to material atoms; but in the same manner that nature, operating through ethereal undulations, creates the various forms of vegetable life, there has been committed to us a control over those grosser undulations which move in atmospheric air, and constitute sound. The imagination, the genius of the great masters of music, have already grouped together combinations of these waves, which are destined to an earthly immortality; combinations, which, when once heard, leave their indelible impression on the memory, and are to us an embodiment of symmetry and harmony. These ideal creations which exist only for the mind, are analogous, in very many points of view, to those more tangible creations which are formed by ethereal waves, and which nature has reserved in her own hands. The symmetrical or beautiful forms which are transmitted to the brain by the eye, appeal at last to that same, that common principle which receives melodious or harmonious sounds transmitted by the ear; and the creations of human genius, whether they be expressed in the language of music or painting, whether they are heard in the cathedral or seen on the canvass of Claude Lorraine, give us pleasure, because their final impression is made on a mathematical organ, which is so constructed as to appreciate whatever is symmetrical in position, whatever is graceful in figure, whatever is harmonious in movement.

From this point of view, therefore, I look upon the vegetable world as an embodiment of the action of ethereal agents. A tree, when covered with blossoms in the spring, or laden with fruit in the autumn, is a resultant of the play of those active forces which have been emitted by the sun; an expression of what has been done by vibratory movements operating on ponderable molecules. As soon as the young plant has exposed itself to the solar beam, growth rapidly begins to take place, and organized matter to be condensed from the air, and now a green color is developed, and the stem elongates, and leaves are put forth. In carrying forward all those multiplied operations which have ended in these events, its leaves and its stem have gone upward in search of light—light which has symmetrically arranged their parts and furnished their substance. But these general views are far from giving us an accurate idea of the forces that have been expended or the motions which have been executed in producing the result we contemplate. A forest tree, from its magnitude, rising perhaps a hundred feet from the ground, and spreading its branches over hundreds of square yards, may impress us with a sense of sublimity; a section of its stem might assure us that it had lived for a thousand years, and its total weight could only be expressed by tons. An object like this may indeed call forth our admiration; but that admiration is expanded into astonishment, when we come to consider minutely the circumstances which have been involved in producing the result. If we conceive a single second of time, the beat of a pendulum, divided into a million of equal parts, and each one of those inconceivably brief periods divided again into a million of other equal parts—a wave of yellow light during one of these last small intervals has vibrated five hundred and thirty-five times. And now that yellow light is the agent which has been mainly involved in building up the parts of the tree, in fabricating its various structures, and during every one of a thousand summers, from sunrise to sunset, the busy rays have been carrying on their operation. Who, then, can conceive, when in the billionth of a second such enormous numbers of movements are accomplished, how many have been spent in erecting an aged forest oak? Who also can conceive the total amount of force employed, from century to century, in arranging the vegetation of the surface of the globe?

I therefore regard a planetary body like the Earth, in its orbitual revolutions round the sun, as a predetermined focal centre, on which the emanations of that star shall be expended, first in producing vegetable organization, and finally in lending their aid to the evolutions of animal intellect. The forces which Newton revealed, as urging such a body forward, or causing it to glide in its elliptic path, appear only as an incidental though essential part of the mechanism of the universe, the interest of which disappears in that higher interest which must attach to whatever stands in intimate connection with organization and vitality. Those many-colored luminous wavelets, which are ceaselessly crossing the interplanetary spaces, go forward on an appointed errand, and sooner or later discharge their final task; nor are the planets in the solar system a colony of opaque globes, rotating without purpose or end around the central attractive mass. The solar system is an orb of movement and light, full of vibrations of every tint, visible and invisible, which here and there envelopes and enshrouds revolving points of organization and life.—Dr. Draper's Introductory Lecture.


USE OF THE FORCEPS.

In general it is a very good practical rule, and well calculated to prevent the rash and unwarrantable use of the forceps, "that the head of a child shall have rested six hours as low as the perineum, that is, in a situation which would allow of their application, before the forceps are applied, though the pains should have ceased during that time."—Dr. Robert Lee.


SURGICAL OPERATIONS IN THE MOUTH, &c.

I have already spoken of the bad effects of decayed teeth and stumps, and have told you that an abscess occasionally forms at the fangs of the teeth. You will find now and then, on taking out the stump of a tooth, that there is a swelling, and on examination you discover that it is a cyst, containing puriform matter. Sometimes these cysts are of a very large size. I have seen a cyst—a complete abscess—as large as the tip of the finger, come away on removing a tooth. These abscesses even break externally, and if any of the cyst is left, matter will continue to be discharged for some time. These abscesses sometimes so increase in size as to lead to a swelling of the jaws. An abscess formed at the socket of a tooth, now and then makes its way along the tooth. If the sockets have been a great deal absorbed, the matter at last comes up and presents itself under the gum. It is described under the name parulis—gum boil. There is a superficial swelling of the gum, followed by suppuration; but the troublesome cases are those in which abscesses form in the very sockets of the teeth; they are attended with great pain, swelling of the face, and so on. The abscess gradually advances, and may be discovered fluctuating very distinctly. You open the mouth, and see a large swelling on the upper or lower jaw, which you find to be elastic, and on putting a lancet into it, there is a great escape of putrid matter, which is attended with much relief to the patient. If a patient has suffered from this once, the cause ought to be taken away to prevent the recurrence of it. He is unwilling to have the teeth taken out when the parts are quiet and doing well, but some of these collections form deep in the jaws; they go on increasing, the parietes of the abscess expand, and cavities in the bone are at last formed, of considerable size. When formed in the upper jaw, the abscess may burst into the antrum, and sometimes there is a cavity, independently of that in the upper jaw, a large chronic abscess. The same thing occurs in the lower jaws. Sometimes the plates of the bone separate to a great extent, and if neglected for some time, you find tumors formed, of a very large size, which are gradual and slow in their progress. These cases are known under the name of spina ventosa. It is only in patients who have been neglected, and in whom the disease has been allowed to increase from month to month, that any thing of this kind is observed.

Then, again, in removing decayed teeth, or portions of them, which have been allowed to remain long, you will now and then perceive a fungous growth on the extremity—a soft, pulpy swelling, adherent to the apex of the fang. Again: if you notice a carious tooth when extracted, you will sometimes find a soft fungus in the hollow of it, and if you take the trouble of splitting it up with a pair of cutting pliers, you will find that the whole canal is filled up by a swelling, which expands like a mushroom. These swellings often increase in size; they fill up the remainder of the crown of the tooth, and sometimes form a connection with the spongy gums. In other cases the swelling commences at the gum, by the side of the decayed tooth, it gradually increases in size, and perhaps involves the gums of the adjoining teeth. Some of these swellings are as hard as the gum; some are soft and pulpy, and bleed on a slight touch; and some again, though very seldom, assume a malignant character. These tumors are generally of a benign nature, they are firm in their consistence, and, if thoroughly extirpated, are not reproduced, but if any portion is left, they return. If the socket of the tooth, in which the disease commenced, is not taken away, and indeed the whole gum, the disease is sure to come back in a few months, following the analogy of tumors in other parts. I have told you that, however benign in its nature a fibrous or fatty tumor may be, if any portion of it be left, it will be reproduced; but take away the whole, and there is little chance of the patient being again troubled with it.

These tumors sometimes are of a bad character; but even in those of a contrary nature, where the operation is imperfectly performed, there is a return of the disease. The patient, much annoyed of course, again recurs to his surgeon; caustic is perhaps applied from day to day; becoming alarmed, he at last places himself under a person of more experience; the whole is then taken away, and there is no further trouble. Here are some drawings from preparations belonging to Mr. Nasmyth, of Edinburgh, showing tumors of the gums. One represents a tumor occupying the posterior part of the upper jaw, with all the stumps stuck in the middle of it. The teeth are all in a bad state. Those persons who are foolish enough to allow useless portions of the teeth to remain, may lay their account to suffer from this disease. The pain has gone off, the nerve is destroyed, and they think there is no occasion for interfering with the teeth or having them taken out. They do not care about the fœtor of their breath; they have perhaps arrived at a time of life when they think nothing of it; but there is always a deal of mischief if these stumps in the jaws or gums are not taken out. They keep up the swelling and the tumors in the gums. Here is another drawing, showing a tumor of the gum, where the swelling has gone up from the interior of the tooth, and has spread over in a mushroom-like form, and becoming adherent to the spongy gums, has formed a large swelling.

In order to get rid of these tumors effectually, you must take away the whole of the growth. Most frequently you find them connected with the decayed fangs of the small grinders upon one side or other of the jaw, and most frequently the lower jaw. Sometimes you find them far back in the lower jaw, growing from the decayed roots of the last large grinder, and spreading their influence to the gums of the wisdom tooth and the grinder anterior to it. It is then a difficult matter to get quit of the swelling. If it be of larger size, the patient can only open his mouth with difficulty, and you get but an imperfect view of it. In the fore part of the mouth there is no difficulty at all. All you have to do, then, is to extract a tooth, sound or unsound, on each side of the tumor; the gums are more or less involved in the disease, and you can take them out with the forceps. If the disease were connected with a canine tooth, you would then take out the first small molar tooth, and the lateral incisor; or suppose it were confined to the gums of the canine and first molar, then you would take away the lateral incisor of that side, and the second small molar. You then apply a small saw (such as this) to the socket, and cut down the jaw, with a view of getting rid of the part from which the disease has commenced, of removing the alveoli and the diseased sockets of the teeth. Before you apply the saw you carry your knife round the base of the tumor, and having applied it, and cut down the bone on each side, then, by the means of cross-cutting pliers, you remove the teeth and the sockets, together with the tumor. When the gums of several teeth are affected, you must take away a tooth on each side, and cut away the sockets of all the teeth. If you do this, there is no necessity for any further proceeding. Some surgeons recommend that you should employ an escharotic, as the potassa fusa, to remove the disease more effectually, but this is unnecessary. It is better to go far enough with the saw and the forceps. In order to get rid of tumors far back, and to avoid the necessity of cutting open the cheek, it is necessary to have forceps of various sizes and forms. Although these instruments look very large and coarse, and such as one might say farriers would employ, yet they enable you to remove the affection with less trouble and pain to the patient than if you use small and inefficient forceps. If you were to apply forceps half the size, you would find that you could not cut the sockets through cleverly; that they would bend, and you would have to repeat the operation; whereas, if you go properly to work, you will have no difficulty in accomplishing your object.—London Lancet.

Robert Liston.

SINGULAR EFFECTS OF LIGHTNING.

"Charlotte, an adult woman, aged twenty-nine years, was standing about five feet from the root of the tree. After remaining in a state of insensibility for some time, she gradually recovered her consciousness. A dose of castor oil was then administered. The skin on her right shoulder was abraded for a space as large as a dollar. Her clothes were rent into shreds; on the right side of her body, the skin was blistered and marked with discolored streaks, which extended anteriorly on the lower portion of the abdomen towards the pubes. A small streak likewise extended along the interior aspect of the right arm. She complained of pain in the stomach and bowels for three weeks. No vomiting or burning in the hands and feet, as was experienced in the next case. She has been married several years, but has never been pregnant. Her menstruation was perfectly regular prior to the reception of the shock; but has since that time been very irregular; sometimes having two periods per month, and then escaping two months. The flow has also been much diminished in quantity. Her health has not been very good since she was struck; manifestly resulting from her menstrual irregularity. A recent copious bleeding has afforded her evident and immediate relief. Her reproductive functions appear to continue dormant."

"Sarah, a woman aged, at least, seventy years, was standing immediately beside the last. She likewise gradually recovered her consciousness. No medicine was administered. Her clothes were rent; and after a few days, marks of discoloration were manifested along the right arm and right side of the trunk. A violent paroxysm of vomiting followed the restoration to a state of sensibility; which continued, with occasional interruptions, for ten or twelve hours. As in the preceding case, she complained very much of pain in the region of the stomach and bowels, for at least two weeks after the accident. A troublesome sensation of burning was experienced in the palms of her hands and the soles of her feet; and in the course of two or three weeks a swelling made its appearance under the right foot, which ultimately resulted in the exfoliation of a portion of the thick indurated epidermis of that part, about one and a half inches in diameter."

"The catamenial discharge, which had, in accordance with the ordinary arrangement of nature, ceased for more than twenty years, was completely, and thus far, permanently re-established!! At least, a discharge from the genital organs, having all the obvious and sensible physical characters of the catamenia, and observing, with vigorous exactitude, its peculiar law of periodicity, has been established, and continues to recur, with the utmost regularity, up to the present time (August, 1844.) after the lapse of more than a year! She has not missed a single menstrual period since she was struck by lightning. To use a liberal paraphrase of her own language, her "Moons return as regularly as when she was a young woman." The flow comes on with the usual premonitory symptoms. Her mammæ have undergone on obvious preternatural enlargement, apparently originating in a sympathetic irritation, emanating from the establishment of the reproductive functions. This woman has had but one child, to which she gave birth, soon after reaching womanhood. The catamenial flux is represented to have been regular up to the period of its natural cessation, between forty-five and fifty years of age; subsequent to which epoch, she has presented all the appearances ordinarily attending the gradual approach of the state of senility in a vigorous constitution. The electrical shock, likewise, completely relieved her of a troublesome strangury which had harassed her for four or five years. Very recently she has, occasionally, had a slight recurrence of the same complaint; although under a much milder form. Otherwise, her health continues perfectly good; there being, so far as symptoms show, not the slightest indication of the supervention of organic disease of the uterus."

"I regret that no opportunity has been afforded for examining, in a critical manner, the condition of the genital organs, and the character of the fluid which is periodically discharged; as it would have effectually removed any degree of scepticism which might possibly arise in the minds of some persons, on the score of the vagueness of negro testimony. I trust, however, that the system of minute interrogation and rigid cross-examination, which was adopted in eliciting the facts, has precluded the possibility of the occurrence of any material error; especially when it is considered that there could be no possible motive for practising deception, in a matter of this kind, on the part of a faithful old slave. Under any view of the question there can be no reasonable doubt concerning the strict menstrual periodicity of the phenomenon; and it would be difficult to assign any other than a functional origin to a discharge observing such a law."

"A comparison of the details of the two cases which survived the electric shock, manifests a remarkable analogy in the appearances presented, and in the symptoms which supervened. In both instances the clothes were similarly torn—marks of discoloration indicated the passage of the lightning over the surface of the skin; and the same persistence of pain in the region of the stomach and bowels, existed during the progress of convalescence. This latter symptom, common to both—together with the continued vomiting in the last case—doubtless arose from the violent shock which the solar plexus of the ganglionic system of nerves sustained, by the powerful operation of the electrical energy."

A remarkably striking impression was made upon the uterine functions in both instances: in the one case, causing manifest derangement of the functions of menstruation, as indicated by the irregularity of its recurrence, and the paucity of the flux:—in the other, we observe the abnormal phenomenon of the apparent re-establishment of the catamenia, after more than 20 years cessation under the natural progress of superannuation. Here we find a remarkable example of the production of diametrically opposite effects from the operation of the same agent—under, apparently, identical circumstances—and acting, seemingly, with equal degrees of intensity on the animal economy. Perhaps this may be considered a natural illustration of the truth of the homœopathic aphorism, "similia similibus curantur;" admitting the validity of the axiom, it is quite clear that Nature did not, in these instances, accomplish the end by administering infinitesmal shocks of electricity!! Nor does this fact present anything either novel or paradoxical in its aspect, except when observed through the microscopic optics of homœopathy.


THE MONTREAL MEDICAL GAZETTE.


Omnes artes, quæ ad humanitatem pertinent, habent quoddam commune vinculum, et quasi cognatione quadam inter se continentur.—Cicero.


MONTREAL, FEBRUARY 1, 1845.


The course adopted by the Medical Faculty of McGill College, in reference to the petition of the College of Medicine and Surgery, has been, to say the least of it, unwarrantable; an interference with the undoubted rights of the subject, an attempt to convert a measure of liberal and catholic application into a contest of a purely personal character, and striving to sway the opinions of the Legislature as well by unjust means as by untenable conclusions.

That that Faculty had a right to petition Parliament we admit, but whether that prerogative should have been exercised is we think questionable: having however gone thus far, action here should have ceased; because it would have been manifest that the intended purpose of the petition was effected, namely that inducing members to deliberate before sanctioning an act which might place undue power in the hands of men capable of unwisely exercising them: the Faculty by such a mode would have taught those who took an interest in the case, that it placed perfect reliance in the judgment of our representatives, satisfied that having put them on their guard it had exonerated itself from any responsibility, should, in the event of the Act being passed, immoral results ensue. Now what has been done by the Faculty of McGill College? It addressed a circular letter, (dated in December,) to the members individually, setting forth their claims and at the same time attempting a defence of unfounded accusations; this is not delivered till the very day on which the Report of the Committee, to whom had been referred the petition of the College of Medicine, was to be made, thus by a ruse introducing and forcing upon the House circumstances with which it had nought to do, and upon which it was, as such, profoundly ignorant; for the Faculty were not at the bar pleading their case: in this trick of fence there was a complete failure; by the accidental absence of Mr. Scott, to whom the petition had been entrusted, the report was postponed. We must go back a little.

The petition of the McGill Faculty had been entrusted to Mr. Moffatt; by him it was presented, and by an order of the House this, together with that of the College of Medicine, was printed; Mr. Moffatt at the same time naming two medical men, members on his own side of the benches, to sit on the Committee named by Mr. Scott; on reading the counter petition, the lecturers had but one course to adopt, namely to meet the allegations of the counter petition, and respectfully, in writing, submit them to the Committee, composed, it will be remembered, of nominees from each side, thus exhibiting to the members comprising it, their reasons, and to one of these, too, who from his seat in the House, had expressed his disapproval of their petition; what was the Report adopted unanimously by the Committee? It was favorable to the prayer of the petitioners of the new school.

On the very day then on which the Report was anticipated, the circular, of which mention has just been made, was issued: on perceiving the course in which the McGill Faculty persevered, and by means which we pronounce unwarrantable, we determined that in the extra promised to our readers the month previous, (in which we had not the slightest idea of introducing these subjects,) the whole matter would be placed before the Medical public, and also before the Members; we did so and we cheerfully abide the verdict of the former and the decision of the latter.

We have been induced to dwell thus long because of another counterblaste having been issued, the aim and patent purpose of which is to bias the prejudice, not to direct the judgment of those unacquainted with the merits of the case; this too was published and issued six days after our extra, to which it purports to reply, and was distributed to members on the evening on which it was known that the second reading of the Bill was to take place, and of course on which the discussion would be held; here again the ruse failed; owing to the Bill not being printed, it was postponed for a week; the reply is however of a character so puerile so lachrymose withal, that we reserved all notice of it till this moment: and we shall touch on but two heads of our offending, the alpha and omega of their charges against the lecturers of the new school in general in the former, and against ourselves in especial in the latter.

We are accused of ingratitude and having acted with bad grace, in having undertaken to deliver lectures in Montreal, and why? Because all of us last year had benefited by the sacrifices, the Faculty of McGill College has yearly made since the establishment of the Medical Institution in 1822. Than this opening parental larmoiement, scarce anything could be more touching; the suggestion of such a grave accusation must have been taken from Plato, who complained, philosopher as he was, of his pupil Aristotle, because he taught in the same city; but surely the Faculty do not intend us to understand that we individually caused them a sacrifice, or that we did not do justice to their teaching? Now, conversant as we are with the affairs of that School, we hesitate not to assert that we owe them not a debt of gratitude in their public capacity of lecturers. We are wrong in using the plural, for we knew but one of them as a teacher—the present professor of Medicine; the fees were paid, and thus far we, at all events, contributed our mite in rendering less the sacrifice; but independently of this, that very school is indebted to two of the present Lecturers of the College of Medicine, for services rendered at an early period by the one, and at a more recent period by the second; certificates of which are in the possession of the parties; no mention, therefore, should have been made of benefits granted without their having been returned; should we ever live to count twenty years of existence—aye, or ten—there will not be anything more flattering to us than the knowledge, that any of our pupils were capable of teaching a science, the rudiments of which we had reason to think we ourselves had inculcated. We must, while on the subject, be allowed to say a few words in regard to the sacrifices; positive outlay of money we mean. We know that up to the time of the leasing of the present house, the expenses for each Professor seldom exceeded £25, and this sum perhaps only by the Professor of Chemistry, and we ask all unprejudiced men—is not to a young practitioner the circumstance of lecturing in connection with an institution of any kind—is not the almost certain appointment as a consequence to the Montreal General Hospital—are these not considerations? And we ask of those who know what was the position, twenty-two years ago, of the gentlemen triumphantly mentioned in the last rejoinder—was lecturing and preparing lectures, (the chief labour of which is in the first two years,) such an immolation by them of time? It was not.

This unfortunate journal, ourselves, are said to be the organ of the New School—grave charge; we are criminal in raising our voices in directing the science of Medicine, doubly so in directing our efforts towards the making of the new school known—and what has forced us to be in appearance exclusive? for it is but in appearance? What encouragement did this journal receive from the Faculty of McGill College? We are almost tempted to exhibit how deeply indebted we are to them individually and collectively, and yet the immaculate Faculty call us the organ. We are the organ and we grind it to some tune. The Faculty is appalled, and well it may—for we are almost morally confident that a just appreciation of the petition will grant, with but few modifications, the clauses in the Bill incorporating the New School of Medicine, which consummation, if it bring not with it grace to us, will savour much of disgrace to those who have unjustifiably opposed themselves to the passing of an Act which they have not yet shewn has injured—except in anticipation. Further we recommend to the Faculty to give time for another opposition—what will they think when we inform them that some other ungrateful gentlemen are about forming a school, and intend petitioning for an Act such as ours—not, of course this Session, but next—do they now look upon the ball as fairly in motion? Gladly and joyfully have we been informed of this—and cheerfully offer what assistance we may to the pioneers.

By the way we hear that the Faculty are about establishing an organ; we trust that it will be double barrelled—and we hereby offer our services as a hand at the bellows—if accepted we'll wager our old editorial chapeau against any of the collegiate tiles, that we will blow a blast that shall make the organ skirl.


We have reason to congratulate ourselves upon our prospect of success in obtaining our Act—but independently of purely personal considerations, we are delighted to perceive that the Medical Faculty of McGill College are absolutely advertising that there are four Chairs to be filled in connection with the Medical Department—we are the more self gratulatory, when we reflect that we—aye we—have produced this—not only the proposed extension of the course, but the offering of the Chairs to a quasi competition, that is to those who are possessed of the highest testimonials. But we regret that this is but a half measure; in the first place, the Clinical Lecturer must be an attendant at the Hospital, and there are but two at present in that institution unconnected with the Faculty—the choice we conceive, irrelevantly of other considerations, must fall on Dr. Crawford. With this we are truly pleased, for tardy justice will thus be given to that gentleman; the Chair of Botany and of Medical Jurisprudence will, we predict, be filled by two of the Faculty, or by those in close connection with it. The entering even partially into our own views of a concours, is satisfactory, and presages further backsliding from the ancient regime. It is a curious coincidence that the advertisement should appear nearly at the same time, that stress is laid on the sacrifices sustained by the Medical Faculty; is it wished to unwittingly involve others in pecuniary loss, by becoming participators in the spoil, or is it thus honestly granted and a fortiori that there are advantages independently of the auri sacra fames, to be derived from these situations.

 

OBITUARY.

Died, on Friday the 24th January, Alexander Scott, M. D., a native of Banffshire, Scotland.

Dr. Scott had been for a long time suffering from a serious complaint, which, steadily advancing, completely exhausted his strength, and he expired without any of the acute suffering which characterizes more acute and rapid diseases; indeed, from the autopsy, the affection must have been gradually producing its results for years, and so imperceptibly that its nature was not suspected by himself, yet amidst this ruin of constitution in the meridian of life, (he was but 36 years of age,) the power and vigour of his intellect remained unimpaired to the last moment; during the whole period of a long illness, his calmness and serenity of mind marked his whole demeanour and rendered a bed of death, the throne on which sat patience and resignation, manifesting an abiding faith in the will of the Creator.

Dr. Scott was a man of liberal acquirements, not only in his profession, but in those departments of a gentleman's education, which shed a lustre on the individual; he was a good Greek and Latin scholar, and well versed in the classics of our tongue—in fact in a few moments conversation a stranger could at once recognize the man of attainments. He was one of the favorite pupils of the famous Dr. Knox, and had a train of unforeseen circumstances not intervened, he would have become his assistant, and would unquestionably have risen to an eminence far greater than that which fell to his lot in the land of his adoption; a position he was well qualified to occupy.

MEDICO-CHIRURGICAL SOCIETY.

We have been prevented by press of other matter from noticing the proceedings of this Society as regularly as we could have desired, nor can we do more in this number, than present our readers with a short abstract of the various subjects submitted to the members for consideration.—Eds. M. M. G.

November 2, 1844.—Dr. Fisher in the Chair.

Death from extensive fracture at the base of the skull.—Dr. F. had been called to the individual in question, who was in a state of coma, from a fall which she had had from the top to the bottom of a long gallery staircase. She remained comatose until death, six hours after the fall; no fracture could be detected during life, but on post mortem examination, a large extravasation of blood was found on the external surface of the cranium, with a comminated fracture of the basilar process of the occipital bone, including the posterior clinoid processes, a fissure extending nearly to the foramen magnum from the occipito temporal suture. The poor woman (æt. 60) had long been subject to attacks of vertigo, and had probably fallen while in one of these.

November 16.—Dr. Holmes in the Chair.

The subject of aortic aneuris was submitted, and three cases related. One at present existing in the person of a female of upwards of forty years of age, in whom the abdominal aorta is sensibly and palpably affected. Another which occurred in the person of a man, seen by Dr. H. in consultation with another member of the Society, and which was only detected after death; the patient labouring to all appearances under asthma, and the third in the person of a young lady æt. 17, now under Dr. H.' s treatment, in whom although the stethoscope announces the sound of aneurism, yet there are no constitutional symptoms present to confirm the diagnosis.

November 30, 1844.—Dr. Trestler in the Chair.

After relating the particulars of a case of placenta prœvia, in which the child was safety delivered and alive, the Doctor drew the attention of the Society to the child itself, who had an imperforate anus, and in whom after death a communication was found to exist between the rectum and urethra opening into the vagina. The child lived for six weeks and was then carried off by Smallpox.

December 14, 1844.—Dr. Crawford in the Chair, in the absence of Dr. Hall.

Dr. Crawford related the results of his further experience of the use of Tr. of Iodine in Smallpox, since his first announcement in this journal. He mentioned several cases which induced him to feel increased confidence in the remedy.

Dr. Bowie, who had been led by Dr. C.'s favorable notice of the remedy to employ it among several of the emigrants who had arrived during the past season, confirmed the good opinion entertained by Dr. C.—Dr. Arnoldi, Jr. contended, that the whole mass of blood being charged with the poisonous virus, this application could not be made to any particular portion of the body, without incurring the risk of very much increasing its influence on some other part, or from its astringent quality producing a revulsion to some deep organ. He cited a case in support of his arguments, which had occurred at the Self-Supporting Dispensary.

Dec. 28, 1844.—Dr. Macnider in the Chair.

The modus operandi of ergot was the subject selected by Dr. M. for the Society's consideration, and in addition to his own opinion, he stated that of Dr. Craig of Paisley, which had appeared in one of the late numbers of the London Lancet. After a full discussion of the merits of this agent in obstetrical practice, Dr. Badgley submitted to the Society the results obtained by chemical analysis by Wiggin, Bonjean and Abbène; and also the opinions entertained of its therapeutic effects, by Messrs. Perdu and Sachero, first published in the Annali Universali di Medecina, for 1844.

January 24, 1845.—Dr. Bibaud in the Chair.

Facial Paralysis, in a young lady from the country; all the muscles of the left side of the face had lost the power of motion, the cause was obscure, but it was the opinion of Dr. B. that the exposure of that side of the head to a current of air had been the exciting cause in an individual of a nervous temperament, although she had never suffered from hysteria or other nervous complaint; after the employment of counter-irritation combined with mercury, the Dr. had put her upon a course of Strychnine, and she was recovering gradually.


The proceedings of the Medico-Chirurgical Society of this city, at its last meeting, will long be remembered by us with sincere satisfaction, as proving, that however little such institutions may be as yet appreciated by members of the profession in Montreal, they are looked upon by our brethren in Canada West, as they are admitted by the profession at home, to be real objects of value and interest; and 2d. that the Montreal Medico-Chirurgical Society will prove, as we expected, in proposing its establishment, the parent of a general Medical Association for Canada. A letter from the Secretary of the Toronto Medico-Chirurgical Society having been read, expressive of the willingness of the members of that Society to co-operate with our own "in any measures which may be regarded as tending to promote either the mutual interests of these institutions, or the interests generally of the Medical profession in this country;" it was resolved, on motion made by Dr. Badgley: "That the Medico-Chirurgical Society of Montreal accept with great pleasure the proffered co-operation of the Toronto Medico-Chirurgical Society in their endeavours to carry out those general measures for the advancement of Medical Science, the elevation of professional character, and the establishment of union and cordial feeling among the members of the profession; the tendency of which cannot but prove of paramount advantage alike to the profession and the public." It was also resolved; that the Secretary be instructed to put himself in communication with the Secretary of the Quebec Medical Society on the same subject.

Verily, most of the prophecies made by us sixteen months ago are about being realized, as will be seen by the contents of this number.


Dr. Macnider has just published his 3rd report of the Montreal Lying-in-Hospital, established by himself three years ago; during the past year 62 patients have been received into the institution; several others were refused, from not being fit objects. We are very happy to add, that the subscription list was quite sufficient to meet the disbursements of the year, and we hope that this year's collection will be considerably larger. Many of the students of the College of Medicine availed themselves of this valuable channel for practical instruction; indeed, more applications were made to Dr. M. for cases, than he was able to meet.


SOME REMARKS ON BRONCHOCELE OR GOITRE.

BY BEVERLY R. MORRIS, A.B., M.D. OF TRINITY COLLEGE, DUBLIN—PHYSICIAN TO THE YORK DISPENSARY.

This unsightly disease has at all times excited a considerable share of attention, and its origin has been attributed to the action of numerous causes. It is not my intention to enter upon a detail of these causes, (as they may be gathered from any book on the practice of physic,) but shortly to notice what I believe may be considered as a not unfrequent exciting cause of the disease. I believe that we shall generally find bronchocele to be developed in persons of a strumous diathesis, and many of the circumstances under which it has arisen, tend to favour this conclusion; among these I may mention its great prevalence in certain parts of North America before it was cleared of its woods, and its entire disappearance after their removal. This change, so favorable to a free circulation of air, could not but act strongly in improving the tone of the system generally, which must be greatly relaxed and weakened by a constant residence in a damp and close atmosphere of the dense primeval forests of that country. Certainly in this country, a large number of the cases of this disease occur in those with fair skin, and other indications of a strumous habit.

The disease to which I would call attention as an occasional cause of goitre, is rheumatism; and though the rheumatic and strumous diathesis cannot be considered as identical, yet there are points of similitude between them, and they are both occasionally found in the same individual. Indeed, in the three cases which I now bring forward, there were evident marks of the existence of a strumous diathesis.

The first case is interesting also, in another point of view, viz., as exhibiting the constitutional effect of iodine when it was only applied externally. The possibility of this has been denied by some writers, but I have observed its occurrence in numerous cases where the application was continued to any protracted time.

Case 1. August 10, 1842.—Mr. R——, aged 45, consulted me for a swelling in his neck, which he attributed to an over-exertion of the organs of voice. The tumour has been coming on for several months, and now gives him, at times, a good deal of pain, both fixed, and lancinating, when swallowing. There is no discoloration. The tumour extends from a little above the thyroid cartilage on the left side to the clavicle; it is oblong, being about an inch and a half wide, and of the length described. It is rather firm, smooth, and elastic. I found that he had been subject to rheumatism, chiefly of the hands, but also of the back part of the scalp and neck. On questioning him closely, I found that the rheumatism had left his hands suddenly when the tumour in the neck first appeared. May not this be rheumatic thyroiditis? The general health and appetite are generally good; the tongue is clean; the bowels are regular. He has a greatly enlarged prostate gland, which sometimes interferes with the passage of the urine, but is not troublesome at present; he has been under treatment for it, but only with temporary benefit. I only ordered half a drachm of hydriodate of potass in an ounce of soap liniment, to be rubbed into the tumour every night.

Nov. 2. He has continued very steadily using the liniment, but has occasionally been obliged to omit it for a day or two (particularly at first,) caused a good deal of nervous irritibility, and swimming of the head. The tumour in the neck has nearly disappeared; and the enlargement of the prostate gland is greatly lessened, so much so, that he now feels no inconvenience at all from it.

He continued to use the liniment up to the end of the month, when being entirely cured, it was discontinued.

Case 2. Sept. 18, 1842.—Mrs. W——, aged 31, ill ten years, has a bronchocele involving the whole of the thyroid gland. It extends on each side to the angle of the jaw, and is very prominent over the thyroid cartilage, but does not descend below it. It is firm and of even texture; she traces its first appearance to a rheumatic metastasis. She is of a decidedly scrofulous habit. About the time of its appearance she was worked very hard as a dairy-maid. It has always been much larger during attacks of rheumatism, to which she has been very subject. The other glandular structures appear healthy; the general health is good.—R. potassæ hydriodatis zss, linimenti saponis zj. M. Fiat linimentum, tumori semel in die applicandum.

Nov. 17. She has derived very considerable benefit. The tumor is smaller and softer; the skin over it is much wrinkled.—Pergat.

Case 3. January 30, 1843.—Mrs. S——, aged 44, ill four months. There is a general swelling of the thyroid gland to some extent. She says it enlarges most at the catamenial periods, and when an attack of asthma comes on, to which she is very subject; she has had repeatedly attacks of rheumatism, but cannot trace the disease to that cause.—Ordered iodine internally as well as externally.

Though in this case the connection between the rheumatism and the enlargement of the thyroid gland was not traced, yet I introduce it because of their co-existence.

Cases bearing upon this question might be easily multiplied, but I trust those I have brought forward may be thought sufficient to prove the position I have laid down; and to possess enough of interest to induce others to turn their attention towards the subject of rheumatism, as an occasional exciting cause of goître.—London and Edinburgh Medical Journal.

York, June, 1844.


ANTIDOTE TO PRUSSIC ACID.

Messrs. Smith have experimented on prussic acid, and have found that a sulphate of iron, consisting of four proportions of the per-sulphate, and three of the proto-sulphate, combined with a proper proportion of an alkaline carbonate, will neutralize hydrocyanic acid, the resulting compound being the insoluble Prussian blue. 210 grains of the salt of iron, and 144 grains of the carbonate of potash are required to neutralize 56.8 grains of real prussic acid, but they recommend that when used as an antidote, not less than three times the theoretical quantity should be given, as from the presence of food, mucus, &c., in the stomach, it is improbable that the antidote would mix immediately with the poison at every point; so that to render the action more certain, a large excess is advisable, more especially as this would be attended with no evil consequences, as the only effect that could follow an excess, would be the formation of sulphate of potash, and an insoluble mixture of proto-carbonate and peroxide of iron. Should there be reason to believe that the stomach contains much free acid, which might interfere with the decomposition of the salt, a dose of magnesia should precede the exhibition of the antidote, but not otherwise.—Med. Times, Oct. 12, from Lancet.


TREATMENT OF PLETHORA BY SALINE MEDICINES.

"The treatment of plethora is often not nearly so easy as that of anæmia. In many cases it will not suffice merely to abstain from animal food, and to drink large quantities of simple cooling beverages, in the hope of attenuating and impoverishing the condition of the blood. Then, again, the effects of bloodletting are generally only transitory; and, moreover, the very loss of blood seems not unfrequently to induce a more active proportionate formation of it. On the whole, the use of saline laxatives, and of the hydrochlorate of ammonia (sal ammoniac,) seem to be the most useful means that can be employed for the relief of plethora, when it gives rise to inconvenient symptoms.

"Dr. Lheritier, in his recent treatise on pathological chemistry, informs us that he has found that the proportion of the red globules in the blood of rabbits was decidedly modified by the internal use of this salt, in the course of two or three weeks.

"The nitrate of potash has similar effects; so also have the alkaline subcarbonates, and the liquor potassæ itself. Perhaps the latter is, on the whole, the most efficient impoverisher of the blood, provided, also, the diet is spare, and not too nutritious, and all malt liquors are avoided." —Medico-Chirurgical Review.


ASTRINGENT REMEDIES.

The following are the results of Dr. Gottschalk's experiments, as regards the astringent power of the sulphates of copper, zinc, and iron; acetate of lead; alum; sulphuric, muriatic, and nitric acids; creosote, &c. 1. The strongest astringents, as alum, acetate of lead, sulphate of iron, lose much of their constrictive powers, if employed in a liquid form. 2. The liquid form, counteracting astringency on the one hand, causes, on the other, a relaxation of the animal tissues, and thus affords an easier ingress to foreign matters. 3. The acids (muriatic and sulphuric) possess no constrictive power, beyond making the tissues a little denser. The vegetable astringents, according to the author's experiments, do not merit this designation. His experiments, performed with decoct. querc., ratanh., gall. turcic., &c., prove: 1. That the above remedies display no constrictive effects, if used in a form, in which they are prevented withdrawing the water from the tissues with which they come in contact. 2. They are the less constrictive, as they are received with greater facility into the organs (as in a liquid form,) thereby increasing the density and bulk, but without constricting the parts. 3. If we except substances, which cause contraction by their action on the nervous system (as strychnine,) we possess no vegetable constrictive agents, but merely exsiccatives and refrigerants.—Dr. Gottschalk in Schmidt's Jahrbucher.


BATHS AND WASHHOUSES FOR THE POOR.

A public meeting has been held in the city of London, under the presidency of the Lord Mayor for the purpose of forming an Association to furnish the labouring poor with Baths and Washhouses. The intention, as stated by the Bishop of London, is, that the workingman shall have a bath to himself, where, at a price within his means, he may perform his ablutions in private; and that his wife may have a public washhouse to resort to, where for the washing of her family's clothes, she will be supplied with hot and cold water, tubs and other conveniencies, at the rate of 1d. for every six hours—besides the use of a drying-room, furnished with all necessaries. A similar establishment, on a limited scale, has been for some time in operation in the town of Liverpool, and with such manifest benefit, that the corporation have determined to extend the system. We are friends to all proposals of the kind in favour of the working man; and we think that charity has got upon the right track, when she gives in forms that raise the moral man, while they comfort the physical.—Athenæum.


VICARIOUS MENSTRUATION.

Dr. A. Forget communicated to the Societé Medicale d'Emulation, the following curious fact:—Miss ——, ætat 16, dark hair and eyes, general health good, menstruated for the first time at 15, since which period, the catamenia came on regularly every month, without pain, and lasted four days. On the 27th of March, 1844, two hours after their apparition, a fright caused them to cease suddenly. The next day, intense cephalalgia declared itself; face red and heated; continual drowsiness; throbbing of the heart to an unwonted degree; anorexia, &c. 1st April: Miss —— experienced considerable difficulty in opening the right eye, accompanied with the sensation of a foreign body under the lids, and spots of blood were soon after observed on the corresponding cheek. During the day, at different times, hæmorrhage took place from the inner canthus, the blood being of bright red, flowing, tear-like, drop by drop. On the succeeding days, it transuded, not only from the conjunctiva, but likewise from the skin covering the right cheek, the nose, chin, and back of the hand; once only from the meatus auditorious externus, the scalp, and the tongue. No precursory symptoms were manifested, except those already mentioned. The parts from which the blood escaped, may be classed as follows:—chin and nose; inner canthus; back of the hand; meatus auditorius; scalp, and tongue. The hæmorrhage ceased as soon as the patient went out, and the whole time it lasted, its consistence, color and temperature of the skin, were in their normal condition. On the 15th April, violent colics declared themselves which ceased as soon as the patient had evacuated a tumblerful of liquid, florid blood. Finally, in the beginning of May, the catamenia appeared as usual. The treatment employed consisted in mustard foot baths, fumigations of an infusion of artemisia vulgaris; fourteen enemas of warm water, and, an infusion of artemisia vulgaris.—London Medical Times.


MEANS OF ARRESTING HÆMORRHAGE FROM LEECH BITES.

M. Morand has lately proposed the following plan for arresting hæmorrhage from leech bites:—He forms a small ball, of a mixture of olive oil and yellow wax, six parts of the first to one of the last, and after wiping the blood from the wound, he rapidly applies it to the bleeding orifice. Pressing on it with his finger, he then spreads it around. If adhesion does not immediately take place, and the blood continues to flow, he adds a sufficient quantity of the oily mixture to form a cake, two-thirds of an inch in thickness, covering all the leech bites. The first time M. Morand tried this plan was on a child four years of age, attacked with pleurisy, who had had ten leeches applied to the chest. Several of the leech bites continued to bleed in spite of the various remedies that had been tried. The oil and wax mixture at once arrested the hæmorrhage.—Journal de Méd.


MANUFACTURE OF CASTOR OIL IN THE WEST.

Dr. Drake, in his Travelling Letters, gives the following account of the growth and manufacture of this important article in some of the western and other States.

"To pass from geography to pharmacy, I must tell you something about the manufacture of castor oil in this city, (St. Louis) and some of the neighboring parts of Illinois. It seems to have been commenced by Mr. Adams, of Edwardsville (Peck's Gazetteer,) about twenty years ago. The produce of the first year was 500 gallons, which he was then enabled to sell at $2,00 a gallon. In 1831, he made 10,000 gallons, which he sold at 75 cents. From a gentleman of this city, who owns a steam oil press, I have some additional statistics of this important manufacture."

According to his statement, the quantity now manufactured in Illinois and Missouri, is above 100,000 gallons a year; which is the produce of from 8 to 10,000 acres of land. The crop varies from 10 to 15 bushels an acre, each bushel yielding about 2 gallons of oil. Its price ranges from 72 cents to $1 a gallon. In these latitudes the crop is somewhat uncertain, being liable to injury from long-continued droughts and early frosts. Indiana, Virginia and New Jersey furnish, together, from 25 to 30,000 gallons a year: Tennessee as much, perhaps, as she consumes. The castor oil bean flourishes well in Mexico and the West Indies, but the importation of oil is greatly diminished from what it once was; at the same time the price is much reduced, and the quality greatly improved.—Boston Medical and Surgical Journal.


ACTION OF LIGHT ON VEGETABLES.

From a paper by Dr. D. P. Gardner, of New York, on this interesting subject, to which Dr. Draper has given much attention lately, we copy the following conclusions to which he has arrived. The paper referred to was first published in the American Journal of Science and Arts, and has also been printed or discussed in the London Philosophical Magazine, the new Edinburgh Philosophical Magazine, and the Bibliothèque Universel de Genève, and was reported favorably upon in the French Academy of Sciences.

"In conclusion, it appears that the following facts have been established.

"1st. That chlorophyl (the green matter of leaves) is produced by the more luminous rays, the maximum being in the yellow.

"2d. This formation is due to pure light, an imponderable distinct from all others.

"3d. That the ray towards which plants bend occupies the indigo space of Fraunhofer.

"4th. This movement is due to pure light as distinguished from heat and tithonicity.

"5th. That pure light is capable of producing changes which result in the development of palpable motion.

"6th. The bleaching of chlorophyl is most active in those parts of the spectrum which possess no influence in its production, and are complimentary to the yellow rays.

"7th. This action is also due to pure light.

"We have, therefore, an analysis of the action of every ray in the luminous spectrum upon vegetation. The several effects produced are not abruptly terminated within the limits of any of the spaces, but overlap to a certain extent, a fact which coincides with our experience of the properties of the rays. Whilst heat and tithonicity are capable of causing the union of mineral particles, light appears to be the only radiant body which rules pre-eminent in the organic world. To the animating beams of the sun we owe whatever products are necessary to our very existence."—Ibid.


NEW FILLING FOR TEETH.

By imitating, as nearly as possible, the constituent principles of the enamel of teeth, M. Ostermaier has obtained a compound, which at first soft, becomes hard after its introduction into the cavity of a decayed tooth, so that hollow teeth thus filled serve as well as sound teeth for mastication.

This compound is prepared as follows: mix quickly thirteen parts of pure and finely powdered caustic lime, with twelve parts of anhydrous phosphoric acid. This powder becomes moist during the mixture, and in this condition it is to be introduced into the cavity of the tooth, previously dried; and the surface moulded of the proper form. The mixture gradually changes into phosphate of lime, and becomes dry and very solid. It must be used within one or two minutes after being mixed. It remains to be seen whether its duration will correspond with its other advantages.—Gazette des Hôpiteaux.


CAMPHOR A PRESERVATIVE OF ERGOT OF RYE.

By John N. Simpson, M. R. C. S., &c.—I was not a little surprised to read some remarks by Mr. Rawle, stating camphor to be a preservative of ergot of rye. I can only say that I have been in the habit of using it for the last nine or ten years, but not exactly in the manner described by him. I order the camphor to be mixed with the powdered ergot, in the proportion of a grain in every scruple. By this means I think the camphor is more intimately diffused throughout the whole than can possibly take place by the plan proposed by Mr. Rawle. I do not give this either as a new, or, indeed, my own discovery; for I adopted the method by having seen it in the practice of Mr. Spurgin, an old practitioner also, at Saffron Walden, and from whom I have every reason to believe that your correspondent also obtained the same information, he having been engaged in the same gentleman's practice.—London Lancet.


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TRANSCRIBER'S NOTES

The following printer errors have been corrected:

p. 330 decompositon -> decomposition

p. 331 hemishere -> hemisphere

p. 331 booots -> boots

p. 334 speculun -> speculum

p. 337 vaccinnated -> vaccinated

p. 338 combinatious -> combinations

p. 343 lest -> least

p. 344 permomitory -> premonitory

p. 344 on obvious -> an obvious

p. 346 Missing word 'of' inserted in 'on his own side of the'

p. 348 —Was lecturing -> —was lecturing

p. 350 astupsy -> autopsy

p. 350 unforseen -> unforeseen

p. 352 Univerali -> Universali

p. 354 prostrate -> prostate

p. 354 thyriod -> thyroid

p. 356 Gottschald -> Gottschalk

p. 358 Jonrnal -> Journal

Additionally a small number of punctuation errors have been corrected. Otherwise, the text is as in the original.

[The end of The Montreal Medical Gazette, Volume 1, Issue 11 edited by Francis Badgley/William Sutherland]

[The end of The Montreal Medical Gazette, Volume 1, Issue 11 edited by Francis Badgley and William Sutherland]