that the patient was affected with nervous delirium (delire nerveux). Nevertheless he examined the chest, of which he so much complained, and found no disease there. A few drops of laudanum were immediately thrown up the rectum, and the patient was secluded from all visitors, so as to be kept quiet. In half an hour, the patient fell into a profound sleep, from which he did not awaken till the succeeding day, when he was completely tranquil. No accident afterwards occurred. Case 2. An old man was operated on for hernia by M. Dupuytren, and was put to bed in the most promising state In a few hours afterwards, it was discovered that he had torn open the wound, in a fit of delirium, and actually lacerated some portion of intestine, which he had strained down! He died in terrible torments, from the supervening peritonitis. Case 3. A stone-mason fell from a stage, and luxated the left femur. He was taken to the Hotel Dieu, and M. Dupuytren reduced the bone. The next evening the patient was found in a state of alarming agitation-his eyes glistening, injected, and red-face flushed, and covered with perspiration. He vociferated aloud -tried to tear off the bandages-and endeavoured to escape, as he said, from the hands of justice. In the midst of this disorder of the senses, the pulse was regular, full, and of natural frequency-the skin cool. The sister of the ward, accustomed to these accidents, immediately administered laudanum in injection, and tranquil lity was quickly restored, without any return of the nervous delirium. died of hemorrhage. Many surgeons, indeed, have related cases, where patients have torn open their wounds after operations, and thus destroyed themselves, but none have investigated the cause of this strange proceeding. Most surgeons, too, have considered the phenomenon as inflammatory, and, consequently, have resorted to wrong measures. M. Dupuytren thinks that, if left to itself, it would only produce a temporary exhaustion; but, in the mean time, irreparable injury might be done to the wounds produced by accident or operation. It is of great importance to be able to foresee or predict the supervention of this curious nervous commotion, and the author thinks that, by the following signs, we may prognosticate its approach. If, then, within 12, 24, or 48 hours after a fracture, a luxation, an attempt at suicide, or a surgical operation, the patient appears in unusually good spirits, with talkativeness, glistening eye, and quick movements--if he affect an unusual degree of courage and resolution ;-be on your guard! Do not irritate or excite himkeep him quiet, and exclude all but his nurses, as well as light and noise. Very soon he will assail you with all kinds of questions-he will flatter, menace, abuse, sing, cry, and give way to unceasing lo quacity. This is not always the most innocent kind of insanity. Our author has known men in this state, get up in the middle of the night, seize some weapon, and commence a war of extermination on all within their reach. He has known others throw themselves out of the windows, or commit suicide in some horrible manner. The most remarkable phenomenon, in these cases, is the calmness of the circulation, and the total absence of any febrile symptom. It is a veritable mania, of short duration. He has rarely known it last longer than five or six days. The treatment is very simple. Quietude, security, some laudanum, by way of injection. M. Dupuytren prefers this mode of administering the remedy greatly to that by the mouth. He avers that, from six to ten drops, given in this way, produce more effect than triple the quantity, given by the mouth. This fact we have repeatedly witnessed of late, and we could not have believed it, had we not had the evidence of our own senses in proof. It is probable, as M. Dupuytren observes, that many medi cines taken into the stomach are considerably changed or neutralized by the gastric juice and other matters with which they must be necessarily mixed in that digestive organ. In the lower bowels it is different-and the pure effects of opium may commonly be reckoned on with more certainty when applied to the intestinal surface at once. Here absorption, and not digestion, is the process that is going forward. It is evident that the former process is that which is most favourable for the operation of medicines. There is no doubt, too, that the impressions made on the nerves of the lower intestines are soon communicated to the general nervous system. We shall not advert to the speculations of Messrs. Dupuytren and Sanson, on the nature and proximate cause of this traumatic delirium. The paper itself is very curious and interesting.—REPER TOIRE. 2. FRACTURE OF CERVIX FEMORIS. [Mr. Langstaff-Dr. Brulatour.] Some considerable portion of the last volume of the Medico Chirurgical Transactions is occupied with the almost wornout dispute about union of bone, in cases of fracture of the cervix femoris within the capsule. We have seen all the specimens that have been presented at the Society's meetings, and we freely declare that there was not one which appeared to us by any means unequivocal on the affirmative side of the question. This was also the opinion, as far as we could collect, of the majority of those members present, who examined the specimens and could make up their minds on the subject. The specimens brought forward by Mr. Langstaff are, indeed, of the mendicity family-namely, beggars of the question. Mr. L. had opportunities of inspecting eight cases of the above accident after death, and he has “long been satisfied of the possibility of union by bone, from noticing the near approaches Nature had made to effect this end in the specimens he possesses.' But why the ossific union of fractures within the capsule should be of such rare occurrence, Mr. L. cannot divine, unless it be owing to the difficulty of keeping the fractured surfaces in steady juxta-position. The case of Dr. James, an English physician, resident at Bourdeaux, and transmitted to the Society, together with the bone itself, by Dr. Brulatour, was considered by the ossific party as proof positive. But unfor tunately it wanted, as all the others did, the sine qua non-the opposite thigh-bone, in order to show whether the angles made by the cervix with the shaft were different in the two sides. Knowing the changes which naturally take place in these angles by age, and by inflammation, no dependence can be placed on insulated specimens. The accident which happened to Dr. James had doubtless produced considerable injury to the coxo-femoral articulation; but the appearances in the bone, and the want of the other thigh-bone, for comparison, rendered it impossible for any unprejudiced person to pronounce it a case of ossific union after fracture within the capsule. Our own opinion is, that this was a case where the neck of the bone was driven, as it were, into the head of the shaft, by the fall, with consequent shortening of the cervix. But this, we opine, is a very different thing from a fracture which completely separates the articulating head of the bone from its connexion with the rest of the femur. He P. S. When the above was written, we received Mr. Bell's clinical lecture on diseases of the hip-joint, as published in the 4th number of the MED. GAZETTE, where this eminent surgeon observes as follows:-"When an injury has been done to the hip-joint, and inflammation follows, this process is apt to soften the textures of the neck of the femur; and consequently the head of the bone sinks downwards, and is flattened, thus dimin ishing the length of the whole." then gives a wood-cut of this shortened appearance, and difference in the angle of the bone, exactly resembling that in Dr. James's case, and several others that have been produced before the MedicoChirurgical Society. Mr. Bell shows that stiffness and lameness result from this change, “because the head of the femur, which naturally stands out free from the trochanters, and thus permits extensive and easy motion in the limb, is now by the process of absorption of the cervix, approximated to these processes, and hence lameness results." We are glad to have the authority of Mr. Bell for the strictures which we have deemed it our duty to make on these supposed examples of fracture with ossific union within the capsule of the joint. 3. MORAL AND PATHOLOGICAL EFFECTS OF GAMBLING. In a late sitting of the Royal Academy of Medicine, M. Gasc read a memoir on the aboye melancholy subject. This terrible passion or propensity, is not so much out of the boundary of the medical philosopher's study as, at first sight, it may appear. Whatever raises a storm of conflicting passions in the human mind, must induce a corresponding tumult in the organic functions, and thus lead to violent disorders, fatal diseases, and not seldom to self-destruction. M. Gasc conceives that the propensity to gaming takes its source in two of the most dominant pas. sions of the human heart-SELF-LOVE and SELF-INTEREST. Hence he accounts for the habits of gambling in all ages and in all nations, savage or civilized. Hence, too, says he, the total inutility of the lectures of the divine, the exhortations of the philosopher, and the penal statutes of the legislator, in stemming the evil! In depicting the effects of gaming on the animal economy, M. Gasc exhibits the gamester a prey, alternately, to delirious joy, despair, and rage. It is no wonder that the tremendous shocks which the brain and nervous system must receive in these paroxysms, should frequently destroy the intellectual faculties, and thus lead, as they actually do, to imbecility, insanity, and even furious mania. It is in the approaches to these conditions, that the frequent acts of suicide are committed. The circulating system often suffers in these direful conflicts of the passions, and aneurisms and other diseases of the heart, are not seldom traced to the gaming table. But no parts of the animal economy suffer more directly and unequivocally than the organs of digestion-partly from the tortures of the mind, which destroy appetite and suspend digestion at once-and partly from the stimulating potations which the gamester swallows to support his courage or drown his reflections !ARCHIVES. The foregoing facts have long been familiar to the medical spectator; but it is not so generally known to the profession-and it is but little known to the public at large, how nearly the wideextended system of speculation, in this country, approximates, in its ruinous effects on the constitution, to gambling. We lately saw a gentleman, of high probity, temperance, and respectability, who mentioned to us the following fact, and was curious to hear our explanation of it. One day, on the Stock Exchange, when the rumours of failures at home, and commotions abroad, were producing such terrible vacillations in the public funds that his whole property was in moment. ary jeopardy, he found himself in such a state of nervous agitation, that he was obliged to go out and apply to wine, though quite unaccustomed to more than a glass or two at his dinner. To his surprise the wine had no apparent effect, and he drank glass after glass, in quick succession, till a whole bottle was consumed. Not the slightest inebriating influence was induced by this unusual quantity taken before his dinner. His nervous agitation, however, was calmed, and he went back to the Exchange, and transacted his business with great steadiness and equanimity. None of the common effects of wine were produced at the time-but, the ultimate consequence, several days afterwards, was a severe attack of indigestion, to which he had not previously been subject. Now, this curious fact shows, we think, that, although the mental agitation masks, or even prevents, the common exhilarating effects of wine and other stimulants at the time, and thus induces and, indeed, enables men to take more than under ordinary_circumstances, yet that the ulterior effects are worse on the constitution, than if the stimulants had produced their usual excitement at the moment of their reception into the stomach. It is thus that the nervous systems and digestive organs of thousands in this country are ruined, and that without the victims being conscious of the channel through which they are poisoned. 4. INJURY OF THE HIP-JOINT. Mr. Stanley observes, that fracture of the trochanter major, combined with fracture of the cervix femoris, often bears a strong resemblance to dislocation of the caput femoris. "Whenever the fractured portions of the trochanter can be brought into contact, a crepitus will be produced which may enable the surgeon to ascertain the precise nature of the injury. But when, from the direction of the fracture, one portion of the trochanter has been drawn by the action of the muscles towards the great ischiatic notch, no crepitus may then be discoverable, a direct source of mistake will then arise from the positive resemblance of the fractured portion of the trochanter to the head of the femur, the former occupying the same place which the latter would do in dislocation; and if, with these circumstances, there should happen to be an inversion of the injured limb, the difficulty of the diagnosis must be considerably increased. This obscurity, while it affords a strong motive for extreme caution in such cases in our own practice, should at the same time teach us to be slow in citing a mistake in the practice of others, as proving either ignorance or inattention." Mr. Stanley is nearly five years behind the level of professional feeling on this point. The fashion now is, to condemn the practice of your contemporaries, whether it is good or bad-and the more skilful they are, the more copiously you must pour on them the epithets of dolts, ninny-hammers, &c. This is the way to get on in the world. Mr. Stanley's ethics will never do for the 19th century! But to return to injuries of another kind. Case. A woman, aged 60 years, fell on her right hip in the street. The limb was found slightly everted and shortened three quarters of an inch; yet it was moveable in all directions. The extremi. ty of the shaft of the bone was in its natu ral situation, but behind the femur, and at a little distance from it, a bony prominence was discovered resting upon the ilium, towards the great ischiatic notch, strongly resembling the head of the femur. Various opinions were entertain. ed as to the nature of the accident-some considering it a dislocation, others a fracture. After a confinement of some months to her bed, the woman recovered sufficiently to walk with the assistance of a crutch, and in this state continued till her death, three years afterwards. On dissection, Mr. Stanley found that there had been a fracture extending obliquely through the trochanter major, and through the basis of the neck into the shaft of the bone. The prominence mistaken for the head of the bone, was occasioned by the posterior and larger portion of the trochanter drawn backwards towards the ischiatic notch. Several other cases are related from Mr. Stanley's practice, and some from that of others. He concludes by observing that, in many cases where the nature of the injury is doubtful, we ought to impose on the patient a strict confinement to his bed, for as great a length of time as if the fracture had been ascertained. The circumstances attendant on the accident should also be carefully investigated, as these are often our only guides. 5. ON THE NATURE AND TREATMENT OF TRAUMATIC TETANUS. [By M. Le Pelletier, Chief Surgeon of the Hospital of Mans.] The author of this Memoir appears to have been placed in circumstances favourable for the observation of facts and the investigation of phenomena-and he thinks he can offer something more positive, as to the nature and treatment of tetanus, than has hitherto been given to the public. M. Pelletier takes a course opposite to those who consider tetanus as an affection of the nervous system, and consequently as affording no appreciable physical lesions as the cause of the symptoms. He looks to the material and palpable alterations in the organs of the body, as the basis of our investigations. He asserts that, in all the dissections that have been made of well-marked traumatic tetanus in the Hospital of Mans, there were unequivocal traces of inflammation in the vertebral meninges, especially at the origins of the nerves, and during their course in the spinal column. Two cases are narrated as a preliminary step, the bearings of which will be readily seen. Case 1. Nourri, aged 17 years, was seized, on the 16th October, with headach, fever, and pains in his joints, espe cially the hip-joints. After being a fort to have the authority of Mr. Bell for the strictures which we have deemed it our duty to make on these supposed examples of fracture with ossific union within the capsule of the joint. 3. MORAL AND PATHOLOGICAL EFFECTS OF GAMBLING. In a late sitting of the Royal Academy of Medicine, M. Gasc read a memoir on the above melancholy subject. This terrible passion or propensity, is not so much out of the boundary of the medical philosopher's study as, at first sight, it may appear. Whatever raises a storm of conflicting passions in the human mind, must induce a corresponding tumult in the organic functions, and thus lead to violent disorders, fatal diseases, and not seldom to self-destruction. M. Gasc conceives that the propensity to gaming takes its source in two of the most dominant pas. sions of the human heart-SELF-LOVE and SELF-INTEREST. Hence he accounts for the habits of gambling in all ages and in all nations, savage or civilized. Hence, too, says he, the total inutility of the lectures of the divine, the exhortations of the philosopher, and the penal statutes of the legislator, in stemming the evil! In depicting the effects of gaming on the animal economy, M. Gasc exhibits the gamester a prey, alternately, to delirious joy, despair, and rage. It is no wonder that the tremendous shocks which the brain and nervous system must receive in these paroxysms, should frequently destroy the intellectual faculties, and thus lead, as they actually do, to imbecility, insanity, and even furious mania. It is in the approaches to these conditions, that the frequent acts of suicide are committed. The circulating system often suffers in these direful conflicts of the passions, and aneurisms and other diseases of the heart, are not seldom traced to the gaming table. But no parts of the animal economy suffer more directly and unequivocally than the organs of digestion-partly from the tortures of the mind, which destroy appetite and suspend digestion at once-and partly from the stimulating potations which the gamester swallows to support his courage or drown his reflections !ARCHIVES. The foregoing facts have long been familiar to the medical spectator; but it is not so generally known to the profession-and it is but little known to the public at large, how nearly the wideextended system of speculation, in this country, approximates, in its ruinous effects on the constitution, to gambling. We lately saw a gentleman, of high prob. ity, temperance, and respectability, who mentioned to us the following fact, and was curious to hear our explanation of it. One day, on the Stock Exchange, when the rumours of failures at home, and commotions abroad, were producing such terrible vacillations in the public funds that his whole property was in moment. ary jeopardy, he found himself in such a state of nervous agitation, that he was obliged to go out and apply to wine, though quite unaccustomed to more than a glass or two at his dinner. To his surprise the wine had no apparent effect, and he drank glass after glass, in quick succession, till a whole bottle was consumed. Not the slightest inebriating influence was induced by this unusual quantity taken before his dinner. nervous agitation, however, was calmed, and he went back to the Exchange, and transacted his business with great steadiness and equanimity. None of the common effects of wine were produced at the time-but, the ultimate consequence, several days afterwards, was a severe attack of indigestion, to which he had not previously been subject. Now, this curious fact shows, we think, that, although the mental agitation masks, or even prevents, the common exhilarating effects of wine and other stimulants at the time, and thus induces and, indeed, enables men to take more than under ordinary circumstances, yet that the ulterior effects are worse on the constitution, than if the stimulants had produced their usual excitement at the moment of their reception into the stomach. It is thus that the nervous systems and digestive organs of thousands in this country are ruined, and that without the victims being conscious of the channel through which they are poisoned. His 4. INJURY OF THE HIP-JOINT. [Mr. Stanley.-Med. Chir. Trans.] Mr. Stanley observes, that fracture of the |