533RUSSIAN CHOLERA.—HYDROPHOBIA.—DEAFNESS.

9 of the evening of each day. A new col-

lege, Master BROOKE, will clear these pesthouses, but a little, a leetel, phlebotomisingwill prove a salutary preparative to the

worthy inmates.

CHOLERA MORBUS.

ACCORDING to the last reports of the Me-dical Society at Moscow, the number of

patients, from the 21st of September (oldstyle) to the 3d of November inclusive,amounted to 5390, of whom 2849 died, and1718 recovered. From the 4th to the 8thof November, there were 154 new cases,and 88 deaths.In the Russian provinces on the other

side of the Caucasus, the epidemy had en-tirely disappeared ; from the 23rd of Augustto the 21st of September, the number of

patients was 1224, of whom 902 had died.From most of the statistical reports on thedifferent districts on this side of the Cauca-sus, it appears that in general more thanhalf of the cases were fatal. In the Ukraine,of 213 patients, 124 died ; in the district of

Novgorod (where the disease broke out justat the time of the fair), 1863 cases were

observed, 968 of which proved fatal.

HYDROPHOBIA.

In one of the late numbers of the’° Journaldes H6pitaux de Lyon," a M. Chardon pro-poses a new method of treating hydrophobia,which, however, we are afraid will not be

very acceptable to 11 hydrophobes," as itconsists in nothing less than drowning. Herelates that a rabid dog, after having beenapparently killed by drowning, had reco-vered, and was subsequently found to be

quite free from the disease. This fact, ofwhich M. Chardon was an eye-witness, in-duced him to try the effect of asphyxia inhydrophobia, and he says, that of five rabiddogs, two were actually cured in this man-ner. Shortly after these experiments, hemet with a female who had been bitten by arabid dog, and offered all the symptoms ofconfirmed hydrophobia. He immediatelyproceeded to try his new method, and, after I,having bled her, placed her in a warm bath, I,which] however, unfortunately did not con- I

tain a sufficient quantity of water to makethe immersion complete; moreover, shebecame so violently agitated, that she wassoon taken out of the water in a very alarm.

ing state, and died in a few minutes.

PRACTICAL OBSERVATIONS ON THE

PATHOLOGY AND TREATMENT

OF

DEAFNESS.

By JOHN FOSBROKE, M.D., M.R.C.S.,N.R.P.S. Edinb., &c.

My essay on the Pathology of the Kid-neys, having been favourably received bythe profession, I, in compliance with a wish,which has been very generally expressed,that provincial practitioners should makeknown more frequently the results of theirpractice, offer these observations, whichwere announced as the next in successionof my inquiries. They formed the subject-matter of an inaugural thesis at Edin-

burgh; but to have published them in thatform, would have been to throw what-soever was useful in them into a vault.In the first announcement of this essay,

five years ago, I stated that it was my de-sign 11 to show most disinterestedly the de-gree of dependence which is to be placed onthe treatment of deafness according to realexperience, for which purpose I have goneinto the inquiry." I have endeavoured al-ways to place the stability of my own cha-racter and professional communications,humble as they may be, upon the founda-tions of actual observation, and the unso.phisticated and independent averment of theplain truth. No bias of interest has induced,or ever shall induce me, knowingly, to exag-gerate the favourable, or conceal the dis-couraging results of my inquiries. An oldwriter observes, " I always, thank God,look upon it as most injurious, and one ofthe worst of wickednesses, in serious things,to impose upon the living, but much moreto banter and hand down a falsehood to pos-terity ; a fault, I doubt, too many of our

physic-observators have been guilty of."I endeavour also to draw my pictures andcolourings from nature, that those who tracethe same path may find their own observa-tions the picture and reflection of mine.

I am not what is called an 11 aurist." Theinterest which I have taken in the subjectwas casual in its origin, and the objectswhich I have in view in publishing thisessay, both in relation to the profession andto the public, are as follow :-,

534

As respects the profession, deafness and could never have existed, and have beendiseases of the ear generally, have formed invented solely to impose false notions ofa field in this country for an absurd and the necessity of " aurists" upon the publicsuperfluous subdivision of the profession, mind, whilst, in the same popular treatise,and the public themselves have been the descriptions and treatment of the differ.brought in a great measure to conceit ent cases are so artfully disjoined and dis-that as requiring division of labour and ex- cussed, that the reader can get no clue to

elusive attention to ensure the perfection of rules of practice. The article on the ear, inskill, they should not be attempted by the Mr. Cooper’s dictionary, which is the most

practiser of general surgery. A more inte- scientific account of the diseases of thatrested or ideal absurdity was never advan- organ which 1 have seen in our language,ce’d nor received; it has too much, it is to treats of the diseased action in this and thatbe feared, opened a way for extortion and portion of the auditory tract, with the signsimpositions, for which no return could ever characteristic of it in each particular situs-be made, or be pro-supposed, by the inte- tion, as if the diseased action were alwaysrested party; in other words, nine out of so bounded and limited, and always to be soten of what are called aurists are but swin- distinguished, which i3 nonsense, and notdlers under another name—impostors get- true in nature.

ting money under false pretences. An im- There are two classes of aurists in thisportant purpose of the discussion of this country, stationary and sham, or vagrantsubject will be, to show that the diseases aurists. This last class is part and parcel ofof the ear should no more be resigned to a the numerous miscellaneous and irregularparticular class of pretenders than the diseases vagabonds under various medical denomi-of the eye, which form a far wider and more nations, who are tolerated by law and customdifficult field than those of the ear, em- in this island. The vagrant aurist pursuesbracing a great variety of practice and many exactly the same system as the vagrantvery nice "surgical manipulations." Ever oculist. The plan of both is to cure slightsince Lawrence, Travers, Green, Guthrie, cases for the lower orders, draw up grossand a number of other surgeons in town exaggerations of the cases in whole columnsand country, have taken up the eye and of the newspapers, and make the patientsadded it to general surgery, there has been pay for them in return for the benefit re-an end to the charm and attraction of the ceived. By this method these swindlers

pure oculist. It does not require more than lay hold of numerous and even respectableone month’s application to teach the prac- dupes from all parts of the surroundingtitioner of general surgery all that can be country, whilst they silence the provincialknown of the causes and modes of treating press, which, for the most part, has reacheddeafness, and to show him, that from the the lowest pitch of infamy, servility, andconstant connexion of this affection with venali.y, and prevent the publication of ex-constitutional causes, he is best qualified to posure s by the indirect bribery of the ad-give attention to it in practice. The men vertisements. I offered Mr. Wright’s verywho have added really to our knowledge of proper " caution to the public" respectingthe ear in this country have not been pro- these vagabonds to a provincial paper, in afessed aurists, but general surgeons and neighbourhood where one of them waspathological physicians, among whom the prowling about ; but the newspaper peoplenames of Saunders, Bell, Earle, Sym, Parry, refused to insert it, because they consideredand Abercrombie, are conspicuous. On the exposures of quackery offensive to the pub-continent, in Germany and France, as the lic taste. The announcement of their ex-references in the course of this essay will traordinary cures by coup de main gene-prove, the matter has stood exactly the rally runs under the title of Doctor, or Mr.same. The exclusive treatises of the day, So-and-so, in sundry great towns, " wherewritten by professed aurists, have been got he intends to de’ay his stay for a few weeksup chiefly from materials furnished by ana- longer," &c. Among these trampers is atomists and surgeons. One of these books, monzzzn-aurist, who heads her advertise-which it seems is a leading work in England, ments with a wood-cut of a large ear andand has passed through several editions, its organs. To reason against such rankthough I am pretty sure it would not bear imposture is superfluous, since of all de-the light any-where else, is a bold and rangements, universal experience has provedmiserable compilation from Bell’s Elements that none, under the most able individualsof Anatomy and Mr. Saunders’ Essay. I who have given particular attention to thehave seen others affeotinga preteuded acute- subject, are more immoveably stubborn,ness and depth of observation, full of re- and less frequently treated with success,finements in theory and practice, minate than ca3es of deafness. It is part of thedistinctions of seats and causes, and a parade admirable svstem of medical legislation inof difficulties which I am certain, from the France, which is an example to every othercases which I have myself investigated, country, and which, ere long, in the pre.

535

sent day of rational reform, I trust, will becopied in all its leading points in this coun-try, that all quacks, under the denominationof aurists, or any denomination whatever,are seized by the police, and shopped up injails by no means so comfortable as our,vo-luptuous houses of correction. Moreover,no encouragement is given by court appoint-ments to any superfluous subdivisions of theprofession. Whoever takes upon him as

aurist or oculist must have been regularlyeducated previously as physician, surgeon,or officier de sante. But the assumption ofsuch appellations as

" surgeon-oculist,""surgeon-aurist," is considered in thatcase extremely degrading, and whoeverassumes them is excluded by law from theconcours for the election of agreges, andfrom all public appointmeuts. None but

officiers de sante grace their sign-boardswith these names, and they are a denouncedandrepudiated body. In England there isno means of extirpating quacks, whetherrogues, vagabonds, strollers, or otherwise,except only the London press, which, bypromulgating such remarks as these in theircolumns, can always accomplish a great dealfor the public safety.To speak again of this subdivision, there

is, it must be acknowledged, another and areasonable cause of prejudice in the pub-lic mind against the interference of the

practisers of surgery in the diseases of theear, viz., the mischief and blundering whichmany of’ them commit, from wilful and dis-graceful ignorance of the most common prin-ciples upon which they ought to proceed.If a man, upon the strength of his generalreputation, and the confidence which it has

acquired for him with his patients, ventureto take a dangerous liberty with particularparts like the ears, without, first acquaiut-ing himself with the diseases and specialtreatment of them, as he may do with a

little application, and as he would do with

any other part of surgery and medicine, heis not only a rash blockhead, but he de-serves every punishment which publicopinion, and even the laws of his coun-try, can inflict. It is an idle excuse,under such circumstances, to call mutila-tion, and perhaps eventual murder, 11 a

venial offence," 11 a mere error of judg-

ment." It is downright wilful ignorance,and criminal self-conceited temerity. Sucha man undertakes the case voluntarily, andknows at the time whether he is qualified toundertake it or not. He has no right to gocreeping round his patient, and pour ing hisleperous and poisonous distilments into hisears.

With respect to lIte public, the informa-tion which I shall convey will not be sovaluable for its novelty, or for the successfulcures it shall bold out, a3 for gi dug them

the means of forming a correct judgment oftheir own cases, and for its helping to placethe unsettled mind upon a rock, instead ofevery-where alluring it with flying fanciesand fallacious promises. It will serve to

warn those who have itching ears, how theycommit them, in cases without help or hope,to promises and suggestions as hollow as thewind and deceitful as a stair of sand. Hewho deems these descriptions barren in falsetemptations, may bethink him that to knowin what manner of cases treatment may beof service, and’in what not, and how muchmay be rationally obtained from such meansas we actually possess, are grand points.The reader .may rise from these pages confi-dent that the whole truth has been toldhim, that nothing is magnified or diminisli-ed, that his hopes are not raised to be dis.appointed by his histories of cure never per-formed, by means that could never perform.them,a species of quackery which, unprin-

i cipled as it is, is more general and success-ful in this country, than in all the othercountries of Europe together, from the sus-ceptibility to every bubble and impostureamong the people.Men like Heberden, Baillie, and others,

who have occupied the highest pinnacles ofthe profession, instead of boasting theirhundred cures. knew bv experience that

they had a hundred cases every day of theirlives, for which they had no cure at all, andcould do nothing. Their occupation in greatpart, and the application of their influenceover medical practice, consisted as much inpreventing men of inferior knowledge andexperience, and downright ignorance andcharlatanry, from going too great lengths andcommitting mischief, and in preventing thefolly of patients themselves, than in work-ing miracles and taking a trading advantageof credulity. The last pages of Heberdenand Baillie, written in the deep set of their,lives, when they had nothing more to fearor to hope from the world, are amulets

against quackery, teaching men, accordingto the most extensive experience and thebest in its kind, how little in chronic dis-eases can be done by the most competentskill of the physician. The temple is not tobe made perfect and whole when the prin-cipal supporting columns are shaken andrent.

74, Sudeley Place, Cheltenham.November 2. 1830 ..

OTORRHEA IN CHILDREN.—Dr. Amelungstates in G’raefe and Walther’s Journal,that he has employed with great success inthis disease, especially when the dischargeis foetid, au injectiost of a weak solution ofcorrosive sublimate.