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Observations on the History, Use, and Construction of Obturateurs, or, what have hitherto been called in this Country, Artificial Palates; with Cases, illustrative of recent Improvements. By James Snell, Surgeon-Dentist, Member of the Royal College of Surgeons in London.- London, 184. pp. 52.
Ir is rather extraordinary, considering the number of dentists who practise in this metropolis, as well as in every principal town in the kingdom, that a branch of surgery of such importance as that connected with the mouth, especially as it regards the supplying of natural defects, has been so much neglected in this country; or, if not thoroughly neglected, that so few cases, where these defects have been supplied, have been laid before the public. The boundaries of the mouth are not very extensive altogether; nevertheless, the attention of those who make this part their particular province of surgery, has been directed almost exclusively to the teeth and gums, and those parts the defects of which render the individual less fit to form an agreeable member of society, and which render his life in a degree burthensome to himself, inasmuch as they destroy his power of articulation, and produce an almost incapacity for swallowing nourishment for his support, have been left in the state in which nature, by some extraordinary caprice, formed them, or into which the ravages of disease have reduced them. But we can, in some degree, account for the deficiency in this branch of surgery, when we consider that the greater number of those who practise it are men, and likewise women, of no education, and who are perfectly ignorant of the principles of surgery and of art, in whom, therefore, the love of gain is the actuating principle,that of science, and of relieving the miseries of human nature, being seldom present. Why it should be considered that one branch of Surgery, more than another, can be practised by ignorant individuals, it is difficult to tell; but it is a fact that the greater number of those who pretend to cure the defects and diseases of particular organs, have never received a regular education. We by no means say all of them; for, within the last fifteen years, the profession has, in a degree, taken a turn; and diseases of the eye, mouth, and ear, are now considered to be governed by the same laws as those of diseases of other parts. We are glad to find such an able member of the profession, as we know the author of the present little volume to be, take in hand a subject of such importance, and a subject which has been so much neglected in this country.
Mr. Snell, in the first chapter of his little work, gives an
"historical account of the progressive improvement of Obturateurs." The substances originally made use of for stopping up deficiences in the palate, were wax, sponge, cotton, and the like, sometimes attached to plates of gold or silver; all of which were very ill calculated to answer the intended purposes. Mr. S., in the next chapter, gives the history of cases of congenital defects of the soft palate and uvula, where he successfully supplied them by mechanical contrivances. As an instance of these cases, we beg leave to extract the following:"An interesting young lady, has laboured under this distressful malformation from her birth. When an infant, it deprived her of the support of the breast,-the milk, when any could be drawn, having invariably escaped through the nose; and her articulation, from a later period to the time of my seeing her, was so defective, as not to be understood but by those who were constantly about her. On her application to me, the appearances were as follow:-The fissure commenced immediately behind the two anterior incisores, extending backward through the palatal portion of the maxillary bone, through the os palati and velum pendulum palati, dividing the uvula, and giving rise to an unlimited communication between the nose and the mouth."
"When the case first came under my care, I was desirous of making an attempt to unite the edges of the soft palate, according to the suggestion of Mr. Roux; but this mode of proceeding being al together objected to by the parents, I was induced to try how far success might be obtained by mechanical means. With this view, I obtained a correct model of the deficiency, from which a gold plate was formed to fit the roof of the mouth, reaching as far back as could be worn by the patient, to the posterior part of which, two pieces of flaps of Indian rubber were attached, thus filling up the deficiency of the soft palate. A small moveable piece of the same material was also attached, by means of a gold hinge, to the centre of the lower piece, to imitate, as near as possible, the natural uvula. A piece of ivory was next fitted to the upper or back part of the gold plate, and carried upward until it came in contact with the remaining part of the septum narium; this was, of course, firmly attached. The whole was held in its situation by means of two gold springs soldered to the plate, which were fixed round one of the molares on each side."
"It may readily be supposed that the introduction of such an apparatus would, in the first instance, cause great inconvenience. This was, however, overcome by perseverance on the part of the patient, who soon experienced a most material improvement in her speech, as well as great increase of comfort while taking her meals: and the parents were most unexpectedly and agreeably surprised to find her possessed of considerable musical power, a qualification which none could have presumed to hope for. As the apparatus required to be frequently removed, that it might be cleaned, she was provided with two, the exact counterpart of each other.”
Mr. S. has since, from ample opportunities, by gratuitous
practice, made considerable improvements in his obturateurs; and we had an opportunity of seeing some of them, which were of a most ingenious contrivance.
The author, in the third part of the work, treats of "defects of the velum pendulum palati, uvula, &c., occasioned by. disease." Here he gives the history of two very interesting cases, where he supplied the defects with suitable obturateurs. In these cases, the patients, after the application of the apparatuses, could swallow their food without inconvenience, and their power of articulation was so far restored, that it would have been difficult to ascertain that there had been any defects.
The next, and last chapter treats of defects of the upper jaw-bone and palate bones. Mr. S. here relates several cases of defects of these parts, which he supplied with suitable instruments. One of these cases we had the satisfaction of seeing. It was that of a man, upon whom we performed an operation for a new nose with success. There was still, however, a deficiency of a portion of the upper lip, which could not have been well supplied by the knife; and the anterior portion of the lower jaw, with four of the teeth, was also gone. Mr. Snell remedied these defects in the following
"An obturateur, with bone, similar to those last described, carrying four natural teeth, supplied the deficiency in the maxillary bone. A cast was then procured of the lower half of the face, by means of which, a piece of ivory was accurately fitted to the deficiency in the lip, and was shaped and coloured, to imitate what the parts were in.. their original state. To this artificial lip was affixed mustachoes, which, intermixing with his own, that were permitted to grow, hid the line of union between the natural and artificial parts. It was held in its position by two pivots screwed into its under surface, which passed through the anterior face of the bony part of the obturateur. The artificial lip could therefore be removed without disturbing the obturateur, at the pleasure of the patient, and was found to answer almost all the purposes of the lost parts."
We have now given a short sketch of Mr. Snell's little volume. The subject of which it treats is important, and one which has been much neglected; as the present work, so far as we are acquainted, is the only one written on it in English. Mr. S., we have no doubt, will prosecute this branch of art much further, and will bring it ultimately to a comparate degree of perfection. He has ample opportunities of accomplishing that object, from the extensively gratuitous assistance which he renders to the lower classes of society; and we know well that no one is more prompted by a true love of art and science to bring about that end than he is.
A Practical Epitome and Exposition of the whole Stamp Law and Duties; specifying what Duties have been lately repealed, and all that are now payable; with Directions concerning Deeds and Instruments, in which Property in Ireland or elsewhere may be included, and Assignments of Mortgages and Reconveyances of Annuities; Legacies and Probates, or Administrations, Executorship Accounts, and Return of Probate Duty, &c. Illustrated with all applicable Cases and Decisions, some of them especially regarding Leases, Mortgages, and Purchases. To which are added, Copious Annotations on Material Points. The whole arranged in strict alphabetical order for easy reference. By J. A. Heraud, Author of the Digest of the Stamp Laws, dedicated to the Commissioners of Stamps, &c. &c.-12mo. pp. 138. London, 1824. Clarke. IT has been said, that the difference between a prudent man and an imprudent one consists in this; that, while the latter unhesitatingly gratifies every desire which he forms, the former refrains until he has sate down to count the cost. The stamp duties constituting a very considerable proportion of the expense attending the transfer of property, it is obvious that the present volume will be found extremely useful by those prudent men whom we have referred to; while, to the members of the legal profession it is almost indispensable.
The stamp law was originally extremely simple. The impost was levied merely upon the vellum, parchment, or paper, used; and was, in fact, only an occasional exaggeration of the excise duties upon those articles. Subsequently, however, other principles have been introduced; and the duty is now chargeable, not only with respect to the quantity of material employed, but to the number of words contained in the instrument,-to the value of the property, and, in some instances, to its locality, or to the residence of the parties contracting.
"With the distinction of verbal quantity, and the imposition of the ad valorem duty, new æras commenced in the stamp law. That distinction and imposition indicated the substitution of new rules for the aucient one. Two principles were thus implied. The Instrument of transfer, and the Value of the property, were both chargeable. To these has lately been added a third; the Locality of the property also determines the nature and degree of duty. Thus the nature of the stamp duty has become entirely modified. It is no longer an exaggeration of the excise only, but also a supervention upon every other tax to which every species of property may be liable. Care must be taken in future enactments that these modifications may not induce complexity and confusion,"
In such a labyrinth, it is obviously desirable to meet with a guide, conveying the requisite information with the requisite brevity. Such a guide is the work before us. It exhibits an
accurate and complete view of the whole law of stamps, corrected to Michaelmas term, 1824, illustrated by annotations and notices of important decisions in the Courts. The profession will find, collected within the compass of a few pages, all the information that can anywhere be acquired upon the subject, and which could previously be obtained only by wading through various acts of parliament, and numerous volumes of reports. The object avowed by the author he has certainly succeeded in attaining.
"The present epitome and exposition of the stamp laws and duties embraces the result of much diligent research. The cases cited will be found to clear away some of the solecisms and doubts created by subtle refinement on the subtleties of legislation. The insertion of all the cases reported respecting stamps had been superfluous and futile, many being applicable only to systems of law and duties long since repealed.
"The author has endeavoured to combine in this, as in each preceding publication, simplictty and accuracy in the means, with utility as the end of his exertions. The strict alphabetical order, as most appropriate for a book of general reference, has been adopted in the present work. To anticipate surmise, and prevent difficulties, each item now relieved from stamp duty, by the recent act of repeal, will be found under its proper head, distinguished by the word 'exempt.'
"Fortified by the accuracy that has obtained in all the author's former labours, and conscious of the care bestowed upon the present publication, he now ventures to assure the profession, for which it is peculiarly calculated, and the public at large, that this work will be found correct in its details relative to the ratio of duty, and to contain every thing necessary upon which to found a decision in any question of stamp law. His sole view has been to convey, if possible, an accurate and competent general knowledge of every subject connected with the law of stamps."
Time's Telescope; or the Astronomer's, Botanist's, and Naturalist's Guide, for the Year 1825.-London. Sherwood and Co.
THIS is the twelfth annual publication under the above title, and contains the usual melange of chronology, history, biography, astronomy, meteorology, botany, ornithology, and poetry. The biographical division contains, among others, notices of Lord Byron, Mr. Payne Knight, Mr. Bowditch, the African traveller; Davy, the composer; the late venerable Cursitor