552 sion. For this purpose she was placed on a table, and when the abdomen was laid open, the fcetus appeared to lie behind a thin mem- brane, probably the peritoneal covering of the uterus, the muscular substance alone having given way. Mr. Barlow divided the membrane and removed the fœtus, which was dead ; and a fortnight or three weeks after the woman was well enough to engage in her domestic concerns. - I give you the case as it used to be narrated by Haighton, and to me it appears to have been a case of rup- ture of the muscular substance of the uterus without rupture of the uterine peritoneum, the patient recovering, after delivery by ab- dominal incision. Does success, in this case, belong to an anomaly or a general principle? Would extirpation of the uterus, with or without inversion, be of service in these cases ? This question may be answered better next century. There is a great deal to be done in abdominal surgery, but neither by dogmatists nor empirics; a well-balanced spirit of caution and enterprise-this is what is wanted to improve it. FOREIGN DEPARTMENT. ON HUMAN SPONTANEOUS COMBUSTION.* FROM a paper recently read at the Royal Academy of Medicine of Paris, by M. Julia Fontanelle, it appears, that those who have died of spontaneous combustion, always in- dulge to excess in alcoholic liquors; se- condly, that this combustion is almost al- ways general, but sometimes partial ; 3dly, That it is very rare in men, and that the women in whom it has occurred were of all ages; 4thly, That the body and viscera are constantly burned, whilst the feet, hands, and top of the cranium, have been almost always preserved from combustion ; 5thly, Although it has been demonstrated, that several loads of wood are necessary to in- cinerate a corpse, this incineration takes place without the bodies of the most com- bustible nature, close by, being burnt; 6th, It has not been demonstrated that the presence of an inflammable body is ne- cessary for the development of spontaneous human combustion; 7th, Water, instead of extinguishing the flame, appears to give it more activity, and when the flame has disappeared, the internal combustion conti- nues ; 8th, These combustions take place more frequently in winter than in summer; 9th, No cure of a general combustion has yet been effected, only of partial ones; * Revue Medicale, Juen, 1828. 10th, Those in whom this phenomenon oc, curs, experience an intense internal heat; lith, The combustion developes Itself sub- denly, and consumes the body in a few hours; 12th, Those parts of the bodv which are not attacked become spbacelous. lle will proceed to examine for a momett u the theory of combustion throw any on the subject. ’ . Theory of Combustion. Combustion is defined to be a combina- tion of oxygen with a body emitting heat and sometimes light. In no case is there emission of light without the escape of Leaf. It is, however, discovered, that sevtral bo- dies may, by uniting, disengage caloric and heat, and simulate combustion, without ao- sorbing oxygen. Lavoisier has attributed the escape of caloric to the condensation oi the molecules of the absorbed oxygen. B- vertheless, although this absorption be well demonstrated, it is not ’the fact, that all the caloric, disengaged by combustion, is produced by it in all cases. According t) Berzelius, caloric and light, which are pro- duced by combustion, are neither owing to to variation of the density of the bodies, nor to a less degree of specific caloric in the uew products, since it frequently happens that the specific caloric is stronger than that of the constituent principles of the bodies that have been burned ; from this fact, and the action which the electrical fluid exercises on combustible bodies, Berzelius thinls, that at the time when they unite, free and opposite electricities are developed, the force of which increases in proportion as they approximate to the temperature at which the combination takes place; up 0 the moment of this combination, electrici- ties disappear in giving rise to elevation of temperature, such as is produced from fire. In every chemical combination, says the author, there is a neutralisation of the op. posed electricities, and this neutralisation produces fire in the same manner as it is produced in the discharges of the elec. trical bottle, of the electrical pile, and of thunder, without being accompanied, in these phenomena, with a chemical com- bination. Theories of Spontaneous Human Combustions, Several authors have attributed the cause to spirituous liquors, which, being MBML- ally in contact with the stomach, and pere- trating through the tissues, become an- sorbed to such extent, that the a?prt)tcli ,:’ an inflamed body is sufficient to cause com- bustion. In support of their opinion. ty cite the spirituous smell observed by MM. Cuvier and Dumeril, in the bodies of send
sion. For this purpose she was placed on atable, and when the abdomen was laid open,the fcetus appeared to lie behind a thin mem-brane, probably the peritoneal covering ofthe uterus, the muscular substance alone
having given way. Mr. Barlow divided themembrane and removed the fœtus, which wasdead ; and a fortnight or three weeks afterthe woman was well enough to engage inher domestic concerns. - I give you the caseas it used to be narrated by Haighton, andto me it appears to have been a case of rup-ture of the muscular substance of the uteruswithout rupture of the uterine peritoneum,the patient recovering, after delivery by ab-dominal incision. Does success, in this case,belong to an anomaly or a general principle?
Would extirpation of the uterus, with orwithout inversion, be of service in thesecases ? This question may be answeredbetter next century. There is a great dealto be done in abdominal surgery, but neither
by dogmatists nor empirics; a well-balancedspirit of caution and enterprise-this iswhat is wanted to improve it.
ON HUMAN SPONTANEOUS COMBUSTION.*FROM a paper recently read at the Royal
Academy of Medicine of Paris, by M. JuliaFontanelle, it appears, that those who havedied of spontaneous combustion, always in-dulge to excess in alcoholic liquors; se-
condly, that this combustion is almost al-
ways general, but sometimes partial ; 3dly,That it is very rare in men, and that thewomen in whom it has occurred were of all
ages; 4thly, That the body and viscera areconstantly burned, whilst the feet, hands,and top of the cranium, have been almostalways preserved from combustion ; 5thly,Although it has been demonstrated, thatseveral loads of wood are necessary to in-cinerate a corpse, this incineration takes
place without the bodies of the most com-bustible nature, close by, being burnt;6th, It has not been demonstrated thatthe presence of an inflammable body is ne-cessary for the development of spontaneoushuman combustion; 7th, Water, insteadof extinguishing the flame, appears to giveit more activity, and when the flame hasdisappeared, the internal combustion conti-nues ; 8th, These combustions take placemore frequently in winter than in summer;9th, No cure of a general combustion hasyet been effected, only of partial ones;
* Revue Medicale, Juen, 1828.
10th, Those in whom this phenomenon oc,curs, experience an intense internal heat;lith, The combustion developes Itself sub-denly, and consumes the body in a few
hours; 12th, Those parts of the bodv whichare not attacked become spbacelous. llewill proceed to examine for a momett uthe theory of combustion throw any on the subject.
Theory of Combustion.Combustion is defined to be a combina-
tion of oxygen with a body emitting heatand sometimes light. In no case is thereemission of light without the escape of Leaf.It is, however, discovered, that sevtral bo-dies may, by uniting, disengage caloric andheat, and simulate combustion, without ao-sorbing oxygen. Lavoisier has attributedthe escape of caloric to the condensation oithe molecules of the absorbed oxygen. B-vertheless, although this absorption be welldemonstrated, it is not ’the fact, that allthe caloric, disengaged by combustion, is
produced by it in all cases. According t)Berzelius, caloric and light, which are pro-duced by combustion, are neither owing to to
variation of the density of the bodies, nor to
a less degree of specific caloric in the uewproducts, since it frequently happens thatthe specific caloric is stronger than that ofthe constituent principles of the bodies thathave been burned ; from this fact, and theaction which the electrical fluid exerciseson combustible bodies, Berzelius thinls,that at the time when they unite, free andopposite electricities are developed, theforce of which increases in proportion asthey approximate to the temperature at
which the combination takes place; up 0the moment of this combination, electrici-ties disappear in giving rise to elevation oftemperature, such as is produced from fire.In every chemical combination, says the
author, there is a neutralisation of the op.posed electricities, and this neutralisation
produces fire in the same manner as itis produced in the discharges of the elec.trical bottle, of the electrical pile, and of
thunder, without being accompanied, in
these phenomena, with a chemical com-bination.
Theories of Spontaneous Human Combustions,
Several authors have attributed the causeto spirituous liquors, which, being MBML-ally in contact with the stomach, and pere-trating through the tissues, become an-sorbed to such extent, that the a?prt)tcli ,:’an inflamed body is sufficient to cause com-
bustion. In support of their opinion. tycite the spirituous smell observed by MM.
Cuvier and Dumeril, in the bodies of send
persons who died from indulging too freelyin the use of alcoholic liquors. This odour
does not always exist, since Dr. Baillie havingected, eight hours after death, an indivi-deal who died from having drunk a pint ofbrandy, found that neither the muscles nororgas had any alcoholic smell ; this, how-ever, would be no reason for attributing thiscombustion to such weak quantitiesof alcohol,since linen dipped in this liquid, experiencesno other alteration but that of remainingwet after the alcohol has ceased to burn.In the second place, if infiltration of alco-Mi through the tissues really takes place,spontaneous human combustions ought tobe frequent in men addicted to spirituousdrinks; lastly, it ought to be noticed, thatthese persons who have written on thesubject, do not regard the presence of anHorned body as necessary to occasionspontaneous human combustion ; but were!’proved, how could they account for thecom.5ustion of alcohol in the interior of thebody, without the presence of air or oxy-gen?first Experiment.—On the 15th of Alay,1937,1 took some very thin pieces of beef;I macerated them five days in alcohol at 360, ’,and, at the end of this time, pressed themwell, and put them into some fresh alco-hol, which I renewed on the 1st of August,and continued this immersion to the 15thoi’December, that is to say, for nearly fivemonths. The meat was more infiltratedwith alcohol than the human body, wheremfiltration is supposed to take place ; itis erident, also, that alcohol being strongerthan brandy, it ought to be more inflam-mable. I then exposed this meat, thus pre-pared, to the contact of an inflamed body,without being able to inflame it; I did more,I placed it in a capsule, and covered itwith four lines of alcohol at 38°, which Iset fire to. After it was completely con-samed, the meat was not acted upon inter-nail)-, and only a little scorched externally ;t’ie edges only, which were very thin, wereburnt; it had a very marked alcoholicodour; it did not take fire when exposed tothe flame of alcohol. The same took placeait!t meat infiltrated with alcohol, and sub-mittedto an electrical spark.Second Erperiment.-I repeated the pre-
cedinn experiments with sulphuric ether,acd obtained the same results.
Third Erperiment.-I took some pieces ofmeat which had been infused in alcohol andether, and I kept them for ten days in oilof turpentine. In addition I moistened themeat with the oil, and I inflamed it; thelutat was rather more burnt than in thefirst and second experiments. The presenceof alcohol, even in a large quantity, in themuscular tissue, was not able to set it on
fire, much less to produce the incinerationof the human body.
Secored Theory.-Dr. Alarc, and severalother medical men, from the developmentof hydrogen gas in the intestines, have beenled to suppose, that the same phenomenonmay take place in other parts of the body,and that this gas may take fire by the ap-proacli of an inflamed body, or by the elec-trical action produced by the fluid, which isdeveloped in the individuals thus burnt.
From this fact they have imagined—1st. Anidio-electrical state in these subjects ;2d. The development of hydrogen gas ;3d. Its accumulation in the cellular tissue.
I am far from denying the existence of in-flammable gases in the stomach, since, inthe meteorisation of oxen, the gases which
produce the light have been recognised as
carbonic acid gas, and sulphuretted hydro-gen, as well as carbonic oxide, which I haveshown in the " Journal cle Chinie Medicale."We know also that, in 1751, a butcher ofEnam killed an ox very much swollen, andthat, in taking the stomach away forcibly,he opened the paunch, from which thereescaped a flame of more than five feet in
height, and which burnt the hairs, &c.This gas had been inflamed by a light.Bonami and Ruisch saw, in 1797, the pro-fessor of anatomy at Pisa, place a light nearan opening in a stomach, from which thereescaped an inflammable gas. On anotheroccasion, Ruisch saw a gas escape throughan incision made in the stomach of a womanwho had not eaten any thing for four days,which inflamed with an explosion, on theapproach of a light. Lastly, Dr. Bailliemade a very curious experiment, in the pre-sence of more than twenty students, on abody, on the whole of which was observed,especially on the lower extremities, an ex-traordinary emphysema. Each time longi-tudinal incisions were made, a gas was dis-engaged, which burnt with a blue flame.On puncturing the abdomen, there was ajet which produced a flame of more than sixinches in height, &c. A fact, worthy ofremark, was, that the intestinal gases, farfrom being inflammable, put out the light.
Fourth E.zperimertd.-I kept, for the spaceof three days, some meat, cut into thinslices, in four vessels filled, one with hydro-gen gas, one with bicarburetted hydrogen,the third with carbonic oxide gas, and thefourth with oxygen. I, however, could notinflame this meat, either with a lightedbody or by an electric spark.
If we now return to the theories of Lavoi-sier and Berzelius to explain spontaneouscombustion by the combustion of alcohol orhydrogen gas, we perceive that they are
equally inadmissible. 1st. Because it is
very necessary that the presence of alcoholbetween the muscular fibres be shown ; and
when it is even, it is necessary to admit thatthe alcohol has been inflamed in the interiorof the body by the effect of the opposedelectricities of Berzelius ; it is necessary,I say, to admit also the presence of air inthe body to feed this combustion, whichis impossible, since air cannot penetratethrough the cutaneous tissue. We know,from the ingenious experiments of Davy onflame, that a simple metallic gause is suffi-cient to’intercept the heat and prevent theinflammation of the most inflammable gas.What we have said of the impossibility ofthe combustion of alcohol in the interior ofthe body applies also to hydrogen gas ; wesay more, it will happen, that the personwill perish without being incinerated. Iinflamed hydrogen gas, in which I placeda piece of meat, which was only slightlyburnt. It is a fact well worthy of remark,that hydrogen gas will not inflame by theelectric spark, however long Its action maybe continued, at least if it be not. in con-tact with oxygen gas ; and, surely, if it bemixed in the human body, it will cause anexplosion.
Conclusion.—From these facts, it appearsevident, that mere hypotheses on the theoryof spontaneous human combustions havebeen hitherto advanced. The parts of thebody the least combustible, such as theliver, spleen, lungs, &c., are always in-cinerated ; whilst, on the contrary, thehair, although extremely combustible, isnever burned.
If we now consider that a large quan.tity of wood, sufficient to incinerate a
house, is necessary to incinerate a body,we shall see that it is impossible that alco-hol, or hydrogen gas, which does not eveninflame linen, can produce this effect ; 2d,the products of animal combustion are a
spongy charcoal, very black, shining, fcetid,and only incinerating at a very great tem-perature, whilst spontaneous humau com-bustions only develop a low temperature,which does not inflame the most combusti-ble bodies. Human combustions are not
the effect of the combination of the ele-ments of the animal matter with oxygen ofthe air. Lastly, we think that, in somesubjects, especially in females, there existsa particular diathesis, which, joined to theasthenic state occasioned by age, by inactivelife, the abuse of spirituous liquors, maygive rise to spontaneous combustion ; butwe are far from considering alcohol, hydro-gen, or superabundant fat as the materialcause of this combustion. If alcohol has
any part in this affection, it is by producingthat degeneration of which we have beenspeaking, which engenders combustible pru-ducts, the action oi’ which causes the com-bustion of the body.
SURGICAL CLINIC OF THE HOTEL DIEU.*
Delirium Nervosum, or Nervous Det.
More than once, in the course of last wa-ter, we had an opportunity of seeing species of delirium in patients labouringunder fracture of the limbs, which M. Dj’
puytren has always succeeded in curing.
M. Dupuytren thinks delirium ne
very analogous to delirium ti-emens, it a un.accompanied with fever, often manifestsitself without any inflammatiou or nocnd,and cannot, therefore, in all cases be con-sidered as traumatic delirium. It is conse-cutive, without relation to age, sex, or tem-perament of the patient, on dislocations andfractures, which have, or have not been re-duced, on hernia, wounds, and all kinds ofoperations, during inflammation, suppura-tion, or the formation of a cicatrix.
Persons of a nervous temperament are
very subject to it; it attacks those indivi-duals who entertain a great dread beforean operation, or in whom the desire to showtheir courage has exalted the imagiaation;
. more especially those who are subject to
fits of despair, and to attempts at suicide.Its first appearance is marked by irregularand irrational gestures and movements, andby incoherent proposals. Persons labouringunder this disease are restless, both bymghtand dav.
s The superior parts of the body are cover-ed by a copious perspiration; the eyes
. become shining and injected, the face ani-i mated and flushed, and the patient utters, menaces and vociferations. Notwithstand-. ing all these symptoms, the pulse is calmand tranquil ; no fever exists; the fxces arevoided with the usual regularity, but the
, appetite is bad, and, at the end of two,three, four, or five days, this curious affec-tion terminates either in cure or death. Ifthe patient be cured, the calm returns with-out any apparent crisis ; a sound sleep comeson, and, at the end of ten or fifteen hours,the patients are quite well. This delirium
may return two or three times. On oper,ingthe bodies of those who have died fromdelirium nervosum, nothing is found whichcan satisfactorily account for the symptomsof the disease.
Sedatives of every kind, and in everyform, bloodletting, ad deliquium, and ailother means, have been used by 31. Dupuy-tren without any good efect.
The only means of cure, are injections upthe rectum of 16 or 13 drops of the une-ture of opium, repeated two, three, or fourtimes, every six hours.