letter of Mr. Brodie curiously explains now needles may get into the body." The deuce it does! Now, to our minds, it seems to be much more satisfactory as to the methods of getting them out. But to the point. A farmer's wife, accompanied by her crony, came to Mr. Bell, complaining of excessive pain and pricking in her hip, near the left labium. After much to do, he was allowed to examine, when he found an abscess pointing, with something like a foreign body in it. He opened the abscess, and extracted four of the coarse teeth of a dressing comb. Mr. B. was surprised, but the good ladies were absolutely petrified, and, all at once, became exceeding anxious to depart, as. igning no reason whatever for the presence of the body in that situation. Mr. Bell observes, that bones occasionally lodge in the rectum, and excite great irritation in the bladder. One case was mistaken for cancer, but, on extracting the bone, all the symptoms disappeared. In another instance, a phlegmonous tumour formed on the hip, which was opened, and a great many bones of small birds taken away. Here, however, there was scirrhous contraction besides. Whenever during stricture of the rectum, there is much increase of pain, &c. Mr. Bell recom mends introducing a sound, to detect any substances which may have been entangled above the obstruction.

troduced by Mr. Hunt, who gave a very concise account of five cases, three of which, we understood, proved fatal. These were treated chiefly on the antiphlogistic plan. In these cases, there were febrile symptoms, and some other phenomena, which threw a suspicion on the fact of their being pure specimens of the disease. The fifth case was more particularly detailed, and the patient had several attacks of this peculiar malady, from which he recovered by small detractions of blood, in the first instance, and then opium and other diffusible stimuli. This was the mode of treatment which the author recommended, steering a middle course between those who look upon the disease as an inflammatory affection of the brain or its membranes, and those who consider the phenomena as dependent on an exhausted condition of the sensorial energy. In one dissection made by Mr. Hunt, there were marks of inflammation in the brain, as coagulable lymph and serous effusion.

the

The discussion then turned on pathology of the disease. Dr. Johnson maintained, from many cases which he had seen of delirium tremens, and some dissections, that pure specimens of the disease were not necessarily connected with inflammation of the brain, and, consequently, that the basis of the treatment was opium to procure sleep, and diffusible stimuli to equallize the circulation and excitement. He stated two cases that had recently fallen under his observation, and in one of these, the most minute dissection could not detect the slightest mark of turgescence, or previous increased action in the brain or its membranes. A gentleman who resided in a northern part of the kingdom, where the disease is very common, stated that diffusible stimuli, and more especially large doses of ammonia, were found the only remedies on which any reliance could be piaced. Mr. Lambert asked if a disease resembling the one under consideration, did not often occur, after wounds and accidents? This was admitted by Dr. Johnson, Dr. Stewart and others. It constituted the delirium traumaticum, of Dupuytren, described in our first

Fasciculous. Dr. Stewart remarked that he had seen the disease 1 on a large scale, in the United States of America, and that almost all those patients who were treated on the antiphlogistic plan, died, while those who were treated

by opium and stimulants, recovered. Dr. Copland related some cases which he had recently witnessed. They were saved by moderate local depletion-calomel and opium-and then smart doses of castoroil and oil of turpentine. In these cases, there was much epigastric tenderness, and the motions were very black and fetid. The most important practical information, however, was elicited from Dr. Arye, who, while practising in Hull, had extensive opportunities of witnessing the complaint. He agreed entirely with Dr. Johnson, as to the pathology of the disease. He considered it the very reverse of inflammation. He observed it to arise from several other causes than intemperance in drink, though this last was the most frequent of all causes. He had seen it result from the emanations of lead-from starvation-and from some other sedative causes. In the mode of treatment, he differed somewhat from those who had delivered their opinion in the Society. The plan which he had found most successful was that of giving opium, not in very large doses, but in smaller, and very frequent ones, combining the opium with diffusible stimuli, especially wine or spirits, whichever the patient had been most accustomed to before the commencement of the disease. Dr. Ayre mentioned several curious cases of this mysterious malady. He was asked what were the pathognomonic features of the disease. He answered, that the tremor of the hands, the coolness of the skin, the perspiration, the irascibilty of the temper, the loquacity of speech, and, above all, the false images that were presented to the mind's eye of the patient, were the distinctive characters of delirium tremens. There were several pertinent remarks made by other members of the Society, as Dr. Gregory, Dr. Shiel, Mr. Lambert, Mr. Mackelcan, Mr. Chinnock, &c. but the general experience of the Society was evidently in favor of the stimulant and narcotic treatment, in uncomplicated cases of delirium tremens. pathology of the disease was universally pronounced to be that which was stated by Drs. Johnson and Ayre.

The

Mr. Duncan begged to tresspass one moment on the Society, in order to inquire what were the appearances on dissection of Nowlands, the young man, whose carotid artery Mr. Wardrop had

tied, for an aneurismal tumour on the head. The facts which we stated on the cover of our last Fasciculus were fully verified by Dr. Somerville, the President, and Mr. Arnott, who as well as Dr. Johnson, had inspected the parts.

4. DISEASE OF THE PERICRANIUM.

Sir

The affection to which Dr. Abercrombie has lately alluded, in his work on Diseases of the Brain and Spinal Marrow, appears to correspond with the periostitis of Dr. Crampton, as described in the 1st volume of the Dublin Hospital Reports. Everard Home published a paper, many years ago, in which several cases of this disease are detailed. The symptoms, in these cases, were head-ach, with various uneasy feelings about the head-painful tenderness of the scalp in some particular part, with some degree of swelling or thickening of the integuments there. In several cases, there were epileptiform fits. They were treated by dividing the integuments and pericranium freely down to the bone and then allowing the wound to heal slowly. In making these incisions, the pericranium was found morbidly sensible, as well as thickened-and, in some cases, indurated, so as to resemble cartilage. This treatment by incisions was followed, in some instances, by immediate relief-in others, the patient remained liable to fits or head-aches after any excess or irregularity. In some of them, the incision healed without any affection of the bone being discovered in others, a portion of the bone appeared white and porous, or honey-combed, and a limpid fluid appeared to percolate through it. In one of these cases, the porous piece of bone exfoliated after the wound had been dressed with dry lint for six weeks. In one fatal case, Sir Everard Home found the pericranium thickened into a mass of a fibro-osseous texture, and corresponding to this internally, there was a similar thickening and induration of the dura mater. Most of these cases had been treated by long courses of mercury, without success.

Mr. Crampton, among other cases, relates one or two where the pericranium was affected. A boy, aged 14 years, had a small angry tumour on one side of the

nose, which extended to the forehead, with erysipelas and fever. On the 9th day he became suddenly comatose, then convulsed-and soon died. On dissection, the pericranium of the frontal bone was found red, thickened, and detached from the bone, there being much purulent matter lying between them. The dura mater was detached from a corresponding space of bone internally, and a greenish fluid was effused between them. Some other cases are quoted by Dr. Abercrombie, who does not introduce any instance as happening in his own practice.

5. COUP DE SOLEIL, OR ICTUS SOLARIS.

of

In a long, but certainly not uninteresting paper on this subject, in our Northern cotemporary, Mr. Mitchell, a surgeon in the navy, has given the results of his experience in this curious complaint. It was on the banks of Lake Champlain, in Canada, that Mr. Mitchell's observations were chiefly made, in the summer 1815. He had a great number of cases of ictus solaris under his care-almost all marines who were taken ill on their posts, with their muskets in their hands : -"and such was the fury with which they were seized, that they actually made a charge.' He observed three kinds of this disease-1st. Sudden and complete insensibility, with total loss of power, stupor, and stertorous breathing-the apoplectic species: 2dly, with symptoms of violent phrenitis and delirium: 3dly, with symptoms of chronic phrenitis. It is the first species that we shall notice, as it is that which most commonly attracts attention, and which is most certainly traced to the cause in question. It most commonly occurs in plethoric habits-in men exposed on service (with the stomach distended with food, and the vascular system excited by ardent spirits) under a burning sun-or while sleeping in a drunken fit, exposed to the solar rays. In such cases, it is very difficult to say whether apoplexy has actually taken place, or whether the patient is merely intoxicated. Our author does not attempt to lay down any diagnostic marks. In coup de soleil every thing depends on speedy and energetic treatment. Our author effected a large depletion from

the jugular vein, in preference to any other part-then shaved the head, and poured on it cold fluids from a heightthirdly, he placed the lower extremities in very hot water-fourthly, administered stimulating purgative enemata-fifthly, be caused the whole body to be rubbed with stimulating embrocations. If these means prevent a fatal termination in the onset, the after-treatment is the same as for the other species. These other spe cies assimilate with acute and chronic phrenitis, the treatment of which need not be detailed.

A curious pathological investigation would be the modus operandi of solar heat in producing the ictus solaris. The following passage expressive of the author's own feelings on an apparent accession of this affection, may not be without interest.

"On one occasion, when having landed on an island in Jarvis's Straits, which was hardly any thing but a naked rock, and that nearly white from the dung of sea-birds, I suffered much from the re flection of a burning sun, and indeed I thought I was on the point of having a stroke of the sun, as I nearly lost my vision, and my head felt distended as if ready to burst. I rushed towards a cave, in the rock facing the sea, and, finding salt water in it, I took an handkerchief, and with it kept my head in a constant state of evaporation." In a quarter of an hour he felt quite relieved.

The second species bears so much resemblance to acute phrenitis, that we need not dwell upon it here. The treatment must be very active. In one case our author took away five pounds of blood before deliquium animi could be induced, and consequent reduction of arterial excitement.

The third, or chronic species, was found to come on gradually and insidi ously-and to continue a long time, without destroying the powers of life. It had a tendency" to disorder the arrangement and association of ideas rather than to destroy vitality." In all the cases he had known, and where the patients had returned to Europe, "their ideas never became correct till they got out of the hot into cooler latitudes, when they awoke, as it were out of a dream, and wondered how they had remained in such a delusion." Mr. M. has only observed this

6. ENCEPHALOID TUMOUR IN THE LUNGS.

We were much gratified to peruse a case of this kind in our Gazette cotemporary, from the pen of Dr. Seymour, though it will deprive that talented physician of the pleasure of sneering at auscultation, since it proves himself a cultivator of the "inutile lignum." We suspect that a great many will follow the example of Dr. Seymour, and study auscultation and percussion, instead of attempting-vainly attempting, to "roll back the tide of knowledge to its source," and check the growth of improvements, so much needed, in the healing art.

A man presented himself to Dr. Seymour, with difficulty of breathing, violent fits of coughing, scanty expectoration, "wheezing noise on (in) the right side of the chest," which rises and falls in breathing, the ribs of the left side being fixed-" and the left lung impervious to air."* The pulse was 90 and weak, the tongue clean and moist-no hectic fever. "Complains of weight and tightness at the scrobiculus cordis, and want of appetite-bowels regular." An emetic was exhibited, 15th November. Next day, the sense of weight and tightness in epigastrio was relieved-the expectoration frothy-the respiration in the right side "attended with a peculiar harsh noise,

"On the

like the blowing of bellows." left side the sound is perfectly dull." The Doctor employs percussion-aud much to his credit. We cannot, however, see the accordance of the emetic with the physical and other signs exhibited the preceding day. There was the most complete evidence of extensive disease in the chest-but none (to our humble apprehension) of a disordered stomach, the tongue being "clean and moist-the bowels regular." If Dr. S. considers weight and tightness at the scrobiculus cordis, with such evidence of thoracic disease, and without any other symptom of stomach-affection, as indicating emetics, we beg to dissent from the practice. The patient was now bled and purged. The blood was inflamed. The venesection was repeated, and proper remedies, under existing circumstances, appear to have been judiciously administered. In two or three days, the symptoms being nearly the same, Dr. S. hazarded a diagnosis, that there was an aneurismal tumour, or a tumour formed by enlarged glands, at the origin of the bronchi, especially in the left side. As the diagnosis turned out to be wrong, on both points, we beg to offer the able author our humble tribute of praise for this candid and laudable confession. If all medical men, in all ages, but especially in this age, had followed, and did follow, Dr. Seymour's example, medicine would be a great gainer. We need not pursue the details. The expectoration became profuse-the breathing difficult-the pulse unequal in the two arms, and he died suddenly on the 2d December, sixteen days after Dr. S. was called in. We shall give the dissection in the author's own words.

"The examination was made by Mr. Cæsar Hawkins, in the presence of Dr. P. Latham, Mr. Stone, and myself.

"A tumour was found in front of the chest, above the heart, situated, for the most part, anterior to the roots of the lungs, but surrounding the lower part of the trachea and both bronchi, the trunk and branches of the pulmonary artery, the pulmonary veins of the left side, the arch of the aorta and left carotid and subclavian arteries, but leaving the anterior part of the ascending aorta and arteria innominata uncovered. Behind it was in contact with the oesophagus, and below with the upper part and left