62LIGATURE OF THE CAROTIDS IN

INSANITY.

A PAPER in Kleinert’s Repert. 11 On Liga-ture of the Carotids as a Means of Cure inCertain Forms of Mental Derangement," byDr. F. BIRD, contains some interesting re-marks. The author has collected togetheia certain number of cases of ligature of thecarotid arteries, with the object of showingthe influence which this operation exerciseson the intellectual as well as bodily faculties.The first case refers to a female 32 years

of age, of weakly constitution. Dr. Bjer-ken tied the common carotid artery for a

pulsating tumour below the right ear; thepatient had suffered extremely from pain inthe head, was quite deaf and at times stu-

pid ; the sleep was uneasy, the menstrualdischarge diminished, appetite lost. Imme-

diately after the operation the patient re-covered her hearing, but was attacked bysevere pain in the head, which required theuse of leeches, cold, &c. For forty days thepatient was unable to leave her bed with-out bringing on violent vertigo, but afterthat period she quickly recovered her healthand intellectual powers. The second caseis reported by Texor in Chirou, bd. 2, heft. 2.The third by Mr. Mayo, in the London Jledi-cal and Physical Joi4trnal, December 1829.The fourth case of ligature of the commoncarotid refers to an operation performed byDr. Horner in Pennsylvania (see Repe1’/o-rium, Apri!, 7th year, p. 58). The fifth case

may be found in Froriep’s Notizen, vol. 36,Feb. 1833. A child four years and a half old,of scrofulous temperament, was operatedupon by Professor Moller of Copenhagen,who, on the 13th September 1831, tied onecommon carotid artery, and on the 28thJanuary, 1832, tied the other. The opera-tion was successful.From the above cases the author draws

the following conclusions :-1. One or even both carotid arteries, may

be tied without necessarily endangerillg life.2. The operation is not suited to old per-sons, in whom the venous system predomi-nates, but to young and healthy personswhose arterial system is active.

OPERATION ON AN INFANT’S HAND.

E. CRISP.

To the Editor.—Sir: The following case iis at your service for insertion. Your obe-dicnt servant, E. Cmsp.Walworth-road, Feb. 27, 1836.

Aug. 3rd, 1835, I delivered Mrs. Vane,High-street, Camberwell, of a fine healthyboy, but soon after birth discovered that thelittle, the ring, and the middle-fingers ofboth hands were united by a firm fleshysubstance; the junction between their ex-tremities was cartilagiitous.Aug. 17. I separated the little and ring-

fingers of the right hand, as far as the me-tatarso-phalangeal joints ; a small arterywas divided, but was easily secured ; a thickpiece of lint was placed between the fingers.The wound was dressed on the fourth day,and perfectly healed on the 25th of August.I operated in the same manner upon the re-maining fingers, Aug. 29th, Sept. 29th, andNov. 24th. The child had very little con-stitutional disturbance ; the fingers at theirbases are now united by a thin membranouswebb, but the child has the perfect use ofthem.

Had the operation not been performed atthis early period, I believe that bony unionwould have taken place at the extremitiesof the fingers. Indeed, in operating on theleft hand, I had some difficulty in cuttingthrough the cartilage. Mr. Wardrop (LAN-CET, 1833) says, " 1 generally prefer operat-ing on infants a few days old, to waitinguntil they have reached a more advancedperiod.’’ So far as one case can have anyweight, the above instance proves the judi-ciousness of this opinion.

GUY’S HOSPITAL.

To the Editor.—Sir: Amid the clamourfor equal rights, I beg to draw your atten-tion to the following piece of one-sided jus-tica.A few days since one of the porters of

Gu y ’s Hospital was dismissed for purloininya few coals, not for sale, but simply for hisown use, and for this offence he has beendismissed; while another porter, a colleagueof his, of the name of Mountain, is, and hasbeen for some time, allowed to physic halfthe dissolute frequenters of the Borough-market, with copaiba mixture, blue pill,compound decoction of sarsaparilla, sennaand salts, roses and salts, &c., &c.,-and allunder the very noses of the proper author-ities of the hospital, and this porter is

permitted to carry on the game with irar-

punity, - having the porter’s lodge fre-quently beset with people, for his opinion,"though when the case gets "beyond his skill,"he kindly transfers them either to the as-sistant medical officer or the proper medicalofficer for the week.

Ought these things to be permitted to