HOPITAL DE LA CHARITE

305

sensibility of the affected side not at allaltered. The patient heard well with bothears, and nothing of a morbid nature couldbe observed near the foramen stylomastoi-deum. After the fruitless employment ofvenesection and tartarised antimony, ill.

Dupuytren ordered the oxymuriate of mer-cury, with opium and gum guaiacum, the de-coction of sarsaparilla and spare diet. Under

this treatment, no immediate alteration tookplace, but, at the expiration of a week, theparalytic affection of the face was all at onceobserved on both sides ; the mouth was notdistorted; the lips motionless ; the eyelidscould not be closed, the tears ran continuallyover the cheeks ; the whole countenance,which was usually very animated, seemedlifeless, with the exception of the eyeballs,which were moved without any difficulty.The tongue was readily protruded, and notat all distorted; speech, as far as dependenton the movement of the tongue, appearedunimpeded, and the sensibility of the affect-ed parts, as well as smell and taste, werequite natural. The above treatment was

regularly continued, and, moreover, blis-ters repeatedly applied near the ears, and alarge seton made at the back of the neck, Iwhich at first caused violent inflammation,and remained nearly a month before it beganto suppurate. At. the end of February, thepower of motion began very slowly to bere-established in the face ; the patient nolonger slept with her mouth open, the dis-charge of tears ceased, and the eyelids couldbe more completely closed. The greatestinconvenience which she felt from the lossof muscular power in the lips and cheeks,was during the act of eatmg, when the

greater part of the food always remainedbetween the gums and the cheek, until shehad learned to carry the morsel, by meansof the tongue and the fingers, into the pha-rynx, where it was swallowed without anydifficulty. When she sneezed, the mouthwas opened as usual, but during sternuta-tion itself, the features exhibited no altera-tion whatever.

After remaining four months at the hos-pital, she went out in the following condi-tion:—The exostosis had entirely disappear-ed, and the gonorrhoea was completelycured; her general health, which, duringthe whole time of her illness was but

slightly affected, was very good ; the power iof motion in the facial muscles was, for thegreatest part, restored, but some coldnessand torpidity were still perceivable in the

features, especially when they ouglit to havebeen strongly excited, as in laughing, &:c.; ithe eyelids could he closed, but with someeffort, and she had completely regained the (power of mastication. She was stronglyrecommended to Keep the seton in for some Iweeks.—Ibid.

HOPITAL DE LA CHARITE.,

ANEURISM OF THE AORTA.

Louis BOURNER, setat. 51, was admittedon the 17th of March, 1329; he complainedof violent pain in the back and abdomen,and an oppressive sensation in the epigas-trium ; the action of the heart exhibitednothing of a morbid nature; the pulse wasslow and regular there was a slight cough,with little expectoration, and the patientwas unable to lie on his back. The thoracicorgans having been carefully examined byboth the stethoscope and percussion, nothingwas found which could have excited the sus-picion of any deep-seated disease in them,and, accordingly, not much attention waspaid to the case. The chief pain was seatednear the lower dorsal vertebra, and pre-vented him from sleeping. On the 20th, ablister was applied to the chest, but withoutany effect. On the 22d, he was suddenly

I seized with, syncope, dyspnoea, and ex-

treme agitation, and he died in a few mi-nutes. On examination of the body on

the 23d, the face was found swelled andlivid ; the vessels of the brain gorged withblood ; the brain itself healthy ; the lateralventricles contained a small quantity ofserum. In the left side of the thoraciccavity, about four pints of liquid and coagu,lated blood were found, by which the leftlung had been forcibly compressed, and

pushed upwaids and inwards; the bloodhaving been removed, an aperture, abouttwo inches in diameter, was found in thelower and posterior part of the lung, by

means of which a communication was die.covered to exist between the extravasation,and a large aneurismatic sac on the posteI rior surface of the inferior portion of tlaerior surface of the inferior portion of thethoracic aorta ; the sides of the sac wers

collapsed ; the bodies of the ninth, tenth,and eleventh dorsal vertebrae, with which itwas in contact, were carious, and destroyedto a considerable extent; the intervertebralcartilages were softened, and had also, insome degree, been absorbed ; anteriorly,the aneurism was covered by the left lung,the pleura of which being destroyed for aspace of nearly two inches had given pas-sage to the blood through the lung into

the anterior part of the thorax. The aortacommunicated by means of a circular aper-ture with the sac, which consisted princi-

pally of the di:ated external membrane, and

of layers of fibrine ; only a small portion ofit, contiguous to the circular aperture, wascovered by the internal serous lining. Thointernal coat of the aorta, up to the heart,was covered with osseous scales, and con-siderably dilated ; the left ventricle of the

heart was hypertrophic; the abdominal vis.cera healthy.—Journ. Hebdomad.