7

manifest only when the aliments or the blood come intoimmediate contact with the organ destined for their recep-tion and alteration. Chemical power manifests itself pre-cisely in the same manner ; indeed there are no causes innature producing motion or change in bodies, no powersmore closely analagous to each other than the chemicaland vital powers. We know that wherever different sub-stances are brought into contact with each other chemicalactions take place. To suppose that one of the most

energetic powers of nature should take no part in the pro-cesses of animal organisms, although in those organismsall the conditions under which it commonly manifests itsactivity are united, would be against every establishedrule for the proper study of nature. But so far from therebeing any foundation for the opinion that the chemicalactions are subject to the vital power, so as become in-operative or imperceptible to us, the chemical effects ofoxygen (for example) are manifest in full activity duringevery second of life. Moreover, urea, allantoin, the acidwhich is found in ants and water-beetles, namely formicacid, oxalic acid, the oils of valerian root, of the spirese ’,ulmaria, of the gualtheria procumbens, are products of thevital processes, but is their production attributable tothe vis vital ?We are able to produce all these compounds by chemi-

cal processes. The chemist produces the crystalline sub-stance found in the fluid of the allantois of the cow, fromthe excrements of snakes and birds ; he makes urea fromcharred blood, sugar, formic acid, and oxalic acid fromsaw-dust; the volatile oils of spirese ulmaria, of gual-theria procumbens from willow-bark; the volatile oil ofvalerian from potatoes. Thus we have successful exam-

ples enough to justify us in entertaining the hope that weshall, ere long, succeed in producing quinine and tn01’phine,and those combinations of elements of which albumen and

librine, or muscular fibre consist, with all their character-istic properties.

Let us, however, carefully distinguish those effectswhich belong to the chemical, from those which dependpeculiarly upon the vital power, and we shall be in theright channel for obtaining an insight into the latter. Thechemist will never be able to produce an eye, a leaf, or a

hair. But we know, with absolute certainty, that theformation of hydrocyanic acid in bitter almonds, of sina-pine in mustard, and of sugar in germinating seeds, areresults of chemical decompositions ; we see that thestomach of a calf, when dead, with the addition of somehydrochloric acid, acts upon flesh, and upon coagulatedalbumen, precisely in the same manner as the livingstomach acts ; that is, these aliments become soluble, andare, in fact, digested. All this justifies us in inferring,that by this method of investigating nature, we shallarrive at a clear comprehension of the metamorphoseswhich aliments undergo in the living organism, and of theaction of remedies.Without a profound study of chemistry, and natural

philosophy, physiology and medicine will obtain no lightto guide them in the performance of their most importantoffices, that is, in the investigation of the laws of life, thevital processes, and the removal of abnormal states of the

organism. Without a knowledge of chemical actions thethe nature and effects of the vital force cannot be

fathomed ; the scientific physician can expect to deriveassistance from chemistry only when he shall be able toput his questions to the chemist correctly.Commerce and the arts have already derived immeasur-

able advantages from the progress of chemistry ; mine-ralogy has become a new science since regard has beenhad to the composition of minerals and the chemicalrelations of their constituents. If the composition andchemical nature of rocks and strata are not in likemanner investigated (and this has hitherto been muchneglected), it will be impossible to effect any considerableprogress in geology. Chemistry, moreover, is the foun-dation of agriculture, and it is impossible to accomplisha scientific consolidation of this important art without aknowledge of the constituents of the soil, and the alimentsessential to the life of plants.Without an acquaintance with chemistry the statesman

must remain a stranger to the vital interests of the state,to the means of its organic development and improve-

ment ; his attention cannot be sufficiently alive, nor hisperception adequately acute, to what is really useful orinjurious to his country,-to society. The highesteconomic or material interests of a country, the advan-tageous production and increase of food for man andanimals, the preservation and restoration of health, areclosely linked with the advancement and diffusion of thenatural sciences, especially of chemistry.Without the knowledge of natural phenomena, and the

laws by which they are governed and controlled, thehuman mind is capable of forming no adequate concep-tion of the goodness aud unfathomable wisdom of theCREATOR; for whatever images the most cultivated mindand the most exalted imagination may be capable ofinventing, these will appear, when compared with therealities of nature, but glittering and unsubstantialbubbles!The great desideratum of the present age is practically

manifested in the establishment of colleges in which thenatural sciences occupy the most prominent place in thecourse of instruction. From these schools a generationwill spring up, vigorous in understanding, qualified toaccomplish all that is truly great, and to bring forth fruitsof universal usefulness. Through them the resources,strength, and wealth of empires will be incalculablyincreased; and when, by the increase of knowledge, theweight which presses on human existence is lightened,the difficulties of obtaining subsistence lessened, andman is, in a great measure, disencumbered from thepressure of earthly cares and troubles, he will be able todevote his mind, with freer exertions and purer aim, tothe highest purposes of his being.

FOREIGN DEPARTMENT.--Iw-

ACADEMIE DE MEDECINE, PARIS.ON THE FRACTURE OF THE INTERNAL AND EXTERNAL

MALLEOLI.

THE memoir of M. Lasserre on this subject is foundedon four cases, of which the following is the summary:-

First case.-A woman fell from off a horse andfractured both malleoli on a level with the articulatingsurface of the tibia. Both the tibia and the fibula

escaped from the soft parts to the extent of three inches;the foot was pushed up towards the knee. The boneswere reduced, and during eight days the limb wasretained in a fracture-apparatus. Unfortunately, the

patient had then to be carried a long distance. Thebones again escaped from the wound. Amputation wasproposed, but refused, and she died shortly after.

Second case.-A lady jumped out of a carriage, fell onthe left foot, and fractured both malleoli. The bones

escaped, as in the former case, about three inches.

Amputation was at first thought of, but it was afterwardsdecided that an attempt should be made to preserve thelimb. After a few days treatment, however, the bandageshaving been imprudently slackened, the bones escaped.The limb was amputated, but tetanus manifested itselfeight days after the operation, and carried her off.

Third case.-A woman, seventy-two years of age, fellfrom an eminence nine feet high, and fractured bothmalleoli, as in the preceding cases ; both bones escapedby a wound, several inches in length, situated on a levelwith the tibio-astragalian articulation. The sole of thefoot was turned upwards and the foot was pushed back-wards as high as the calf. M. Lasserre reduced it; thepatient then entered the hospital of Agen, submitted toamputation, and died.

Fourth case.-A man falling from a height of twenty-five feet fractured, transversely, both malleoli of the leftfoot. The bones immediately escaped by a wide wound,situated at the external side of the articulation. Themedical man who was first called in thought amputationindispensable, and left him as he was, telling his friendsto take him to the hospital of Agen, some distance fromhis residence. This was only done the next day, so thatthe limb remained exposed to the air from three o’clockone day until seven, p.m., of the following. Moreover,

8

during part of the above period his wife exposed thebones to the rays of the sun, under the impression thatthe heat would relieve the pain. M. Lasserre found thebones protruding as much as in the other cases, and theexternal malleolus fractured in four unequal fragments.The fracture was reduced, and the parts retained in

juxta-position by a starch bandage. On the eighth daythe suppuration was so abundant that it was found

necessary to renew the bandage. A large abscess formednear the calf, and was freely opened. The suppurationwas profuse for two or three months, and several frag-ments of bone were thrown off. The cicatrisation wasnot completed until eight months after the accident, andthe patient was not able to resume his labours as a

quarry-man until six months later. At first his generalstate was such as to cause alarm, but he soon rallied,and remained in good health during the remainder of thetreatment. M. Lassere thinks that the tibio-tarsal arti-culation retained slight mobility ; but this is not pro-bable ; the slight motions which he observed took place,no doubt, in the other articulations of the foot.M. BERARD, the reporter,* remarked that the above

cases give a very correct idea of the pathology of thisform of fracture. The cause was always a violent fallon the feet. The fracture occurred on the level of thetibio-tarsal articulation, the malleoli were rupturedtransversely, and there was considerable protrusion ofthe bones of the leg. Although the protrusion was so

considerable, it does not appear that there was any diffi-culty in reducing the fractures, but there was great diffi-culty in keeping them reduced. This constitutes themost important feature in fractures of the malleoli. The

analysis of M. Lasserre’s cases shows that the serious

symptoms only manifested themselves when it becameimpossible to maintain the exact coaptation of thefractured surfaces. We are, therefore, warranted in con-cluding that could the coaptation be rendered certain ’,by art, it would be better to attempt the conservation of Ithe limb than to amputate at once, the plan of treatment z,now generally adopted. M. Berard then proceeded to istate that in fracture of the leg, accompanied by disloca-tion of the foot, he had divided the tendo-Achilles, and ’,,then placed the limb on a gutter-frame of iron-wire,padded with cotton, which allowed the wounds to bedressed with the greatest care. This operation had been ’,performed by him three times, and also, about the sametime, in 1842, by M. Laugier, and by M. La Vacherie.In all the cases in which it had been performed it hadmuch facilitated the reduction. Some of the patientshad died, but owing to the very serious nature of thelesions which complicated the fracture. In one case hehad also divided the lateral peronei muscles. He thoughtthat this plan of treatment, which had been successful inhis hands in very serious cases, would apply equally wellto the lesions described by M. Lasserre.M. VELPEAU agreed with M. Berard that the section

of the tendo-Achilles was calculated to render thereduction of the fracture easier, but thought that in manycases it was desirable that resection of the osseous extre-mities should be also resorted to, as the fracture was oftenoblique, and then it was nearly impossible otherwise toreduce it. The muscular contractions which so oftenoccur subsequently, in this form of fracture, were muchless to be feared when the length of the bones had beenshortened.M. Roux remarked that the traumatic opening of

articulations was not as dangerous as was thought, espe-cially when only opened on one side. He thereforeconsidered it a very good plan to extract a portion of thefractured bones in extensive traumatic lesions of thearticulations.M. GERDY stated that the kind of fracture described

by M. Lasserre was very common in the country, and,conseqziently, in the suburban hospitals. At the hospital

* At the Acadfmie cle Medecine of Paris all writtenscientific communications are entrusted by the Presidentto a committee of several members, for examinationand analysis. A report is by ticin addressed to theAcademic through one of their number, who is calledthe 11 rapporteur."

Saint Louis he had treated a case of fracture of themalleoli, with protrusion of the tibia, dislocation, andprotrusion of the astragalus ; he extracted the latter

bone, and the patient got well. In another analogouscase he had recourse to cold irrigations, and, thanks tothis means, no serious symptoms appeared. He wasinduced, by these cases, to think that amputation wasnot absolutely necessary in such forms of fracture.Resection of the osseous extremities appeared to him topresent great disadvantages, the articulation of the footrequiring equal support on each side. The section of thetendo-Achilles he should only advise when there existeda state of muscular contraction which impeded reduction.He tookthis occasion of alluding to an opinion whichwas generally admitted, viz., that in fractures of thelower extremity of the fibula the foot was turned out-wards. He had treated a great number of such cases atSaint Louis, and had seldom seen the foot turned out-wards. Even when this was the case he had never seenit necessary to carry the foot inwards. He had

always found it sufficient to maintain the foot in arectilinear position by means of the ordinary eighteen-tailed bandage.M. Roux agreed with M. Gerdy that, in fracture of the

fibula, very slight means of retention were all that wasnecessary. Dupuytren had evidently much exaggeratedthe importance of his apparatus.

FOREIGN MEDICAL JOURNALS.

CURE FOR EPILEPSY.

M. LEMOiNE has successfully treated three cases ofepilepsy by the administration of the following mixture:liquor ammoni22, twelve minims ; syrup of orangeflowers, one ounce ; distilled water of linden flowers, twoounces; and distilled water of cherry-laurel, half anounce-for a mixture. The first case was that of a man,thirty-six years of age, who was seized with epilepsy in1841, a month after a fall. When M. Lemoine was calledto him, in 1812, he had at least four or five fits duringthe week. He took four of the above mixtures in thespace of three months, and has not since had an attack.The second patient, a dress-maker, thirty-five years ofage, was seized with epilepsy, in 1838, a few weeks afterhaving been terrified by a drunken man, during men-struation. From that time she remained subject to veryfrequent attacks, which were, however, we may remark,suspended during a pregnancy. In December, 1842, shebegan the treatment, and had no fit from that time untilthe beginning of April. The third patient, a nail-maker,forty years of age, had been subject to severe epilepticattacks for the last twenty years. He had generally fouror five during the month. He began the use of themixture in the first days of January, 1843,-three table-spoonfuls a-day; and from that time to the 8th of April,1843, experienced no return of the epileptic fits. He

only once, in February, had a slight vertigo, which didnot last more than five minutes.The active principles in M. Lemoine’s formula, are the

ammonia and the prussic acid contained in the laurelwater. The quantity of the latter, however, is so small,that we cannot attribute to it much influence over themorbid state of the economy. Ammonia, as nearly everyother medicine, has been tried repeatedly in the treatmentof this dire disease, and has failed. Still we are so utterlypowerless in most cases of epilepsy, that no remedy,which is brought forward as a successful therapeuticagent, should be dismissed without having been tried inthe manner in which it is stated to have succeeded.-Rérue lUédicale.

GLANDERS IN A WOMAN.

M. BovRGEOis D’ ETAMpES has lately published, in thel3ulletiz Therapeutique, a case of glanders in a woman,the first of the kind which has been observed, owing, nodoubt, to women having seldom anything to do withlaorses. This female, twenty-nine years of age, of robusthealth, after long attencling to a horse labouring underacute glanders, contracted the disease, and died in

twenty-two days.