339

ing and softening of the mucous coat of the colon. Di the morechronic cases the colon seemed hard and thickened, and didnot collapse when the abdomen was opened, and the liningmembrane slate coloured, hypertrophied, and hi places rotten,the surface being studded with small depressions, giving themembrane the appearance of charred sponge. These appear-ances were strictly confined to the large intestine, for while themembrane covering the ceecal surface of the ilio-ccecal valvewas affected, the disease was never observed on its other sur-face. He did not regard any of these appearances as causedby gangrene, because there was never observed any perforation,because there was never present any of the fcetor of gangrene,and because they were compatible with a considerable degreeof health. He attributed dysentery to the injurious effects ofsudden alternations of temperature upon the soldiers, many ofwhom were weakened by the previous attacks of the remittentfevers of the place. The faulty construction and situation ofthe barracks, conduced to render this cause more active, as themen to avoid the heat of a small room constantly slept out inthe verandahs, exposed to the chilling influence of a cold wind,which blew from the mountains at night. With regard to thecomplication of hepatic disease with dysentery, he never metwith any abscess in the liver in any of these cases, and, withthe exception of occasional congestion of that organ, he neverfound another appearance. The treatment was conducted upongeneral principles, leeches, venesection, calomel, and opiumbeing the chief agents employed in the acute cases. In the morechronic cases, blue pill and ipecacuana were generally givenin conjunction with blisters and full doses of opium. In ad-vanced stages of the disease, turpentine, opium, and camphor,and the mineral astringents afforded much relief in many cases.

’. In conclusion, he advised change of air on land in preferenceto a sea voyage, as productive of much good in many cases, andin -the administration of calomel recommended the exhibitionof large doses of the remedy in the early stage.

Dr. CAHILL remarked upon the prevalence of small-pox at thepresent time, even amongst the vaccinated; and observed, thatas the disease had yearly been becoming more prevalent, hefeared it might become epidemic again in spite of vaccinationand inoculation. He urged the necessity of upholding the sys-tem during the suppuration of the vesicles, and remarked uponthe danger of treating the secondary fever with the same anti-phlogistic remedies as we might the primary, and recommendedthe application of nitrate of silver (twenty or thirty grains tothe ounce) to the face in confluent cases, to control the cuta-neous innamiB.ation, and to prevent the occurrence of scars.He remarked also upon the absence of boils and abscesses inthose cases in which nourishment and stimulants had beenfreely given at an early stage.

Dr. ALDIS exhibited the brain of a child, aged seven, whohad died fr-mi idiopathic arachnitis. There was a very exten-sive effusion of coagulable lymph, and much congestion of thebrain. The duration of the disease had been about four days.

Reviews and Notices of Books.

Pathology and ’.·ec’rfaent of Stricture of the Urct76i,a. TheJacksonian Prize for the year 1852. By HENRY TH01tIPSON,Esq., M.B., F.R.C.S. London: Churchill. 1854.

IT is a remarkable fact, when we consider the frequency ofurethral strictures, the difficulties that are often presentedin the treatment of these diseases, and the dangerous con-sequences that they so commonly entail, that no distinct treatiseexisted in our language, which embodied all the known factsconnected with their pathology, and discussed their treatmentin a candid and philosophic spirit. Hitherto our surg1callite-rature has been deficient in this most important point; for,with the exception of a few &/’oc7tM;’M containing expositions ofspecial modes of treatment, no work whatever has appeared oflate years to which the practitioner might refer in order to findan exposition of all that was known on this frequent and import-ant affection. It is this gap in our literature that Mr. Thompsonhas endeavoured to fill, and he has, by the publication of a workreplete with original investigations in the anatomy and patho-logy of the urethra, and of sound practical expositions on thetreatment of this afFer’tion, left little to be desired or done onthis subject.

In his first chapter, Mr. Thompson gives a full, and, indeed,

the best account with which we are acquainted, of the Anatomyand Physiology of the Urethra, chiefly derived from his owndissections; and as an illustration of the labour that he expendedin testing disputed points, we may state, that in order toascertain the single fact of the existence or not of a verticalfibrous septum in the bulb, he dissected no less than fourteenbodies. The next chapter, on the Seat and Pathology of Stric-tures, is replete with matters of practical interest, deducedfrom an examination of more than 300 preparations in variouspathological collections. Of these, he found, of cases in whichthere was one stricture only, 185 examples of the disease

between the membranous portion of the canal and bulb, theremainder anterior to this, and no instance of " prostaticstricture. "

The Symptoms and Pathological Effects of Stricture follownext, and are admirably discussed, and we then come to theconsideration of the Causes of Organic Stricture. The materialsfor these chapters are obtained partly from the author’s ownexperience, and from an analysis of published cases; butchiefly from unpublished records in the case-books of UniversityCollege Hospital. A chapter is then devoted to the Pathologyof Strictures of Transient Duration, which presents some mostvaluable practical information in relation to the history andmanagement of spasmodic affections of the urethra, and diffi-cult micturition of a temporary character. The section on the

Diagnosis of Stricture, next in order, may be pointed out asfull of useful hints to the practitioner.

In relation to the subject of Treatment, which is discussed atconsiderable length, the author concludes his observations withthe statement, " that the process of dilatation, carefully andperseveringly employed, is the most safe, efficient, and gene-rally applicable of all means for the treatment of permanent andorganic strictures." With regard to caustics he is of opinionthat " no agent should be employed in any case for the

purpose of making a slough or eschar in the urethral canal."With reference to internal division, that it is " applicableonly to strictures which are situated in that part of theurethra which is anterior to the bulb, and which have beenfound to resist dilatation."The work also contains a most valuable appendix " On the

Examination of the Urine for Clinical Purposes," illustrated byseveral excellent plates on steel of the principal forms of urinarydeposit.

’ In conclusion, we may state, that Mr. Thompson has giventhe profession by far the most complete treatise on urethralstrictures that it possesses, and has produced a monoe-raphthat for laborious pathological research and originality of

investigation does him infinite credit, and establishes hischaracter 2s one of the ablest pathologists of the day in thatdepartment of surgical practice which he has undertaken toelucidate. It is a work that ought to be in the library of

every surgeon.

A Treatise on the Diseases, Injuries, and lrIalfor’fnations of theRectum and Anus. By T. J. ASHTON, Surgeon to theBlenheim-street Dispensary, Fellow of the Royal Medicaland Chirurgical Society, &c. 8vo. pp. 356. London: aChurchill. 1854.

THE structure and functions of the rectum claim for this

portion of the body a more respectful attention from the patho-logist and practical surgeon than it has at any time received.

Highly sensitive, very vascular, embedded in loose and mobiletissues, intimately associated with other important organs inboth the male and female, brought into relation by its externalorifice with the cutaneous surface of the body at a point, theseat not only of sensitive and voluntary, but of excito-motoryphenomena, there can be no wonder that the rectum and anus

: should be the seat of a variety of morbid conditions. The

functions, too, of this organ, fortunately or unfortunately as itmay be, controlled as they are by that uncertain agent, thehuman will, impose risks and dangers, the results of which

340

are manifested in the chapters of " Accidents and Offences" tobe found in the volume before us.To attempt by its aid to analyze or to trace these is not our

purpose, which is rather to indicate a source from whence the

busy practitioner may obtain all the information he requireson the subjects set forth in the title. Suffice it then to say,that Mr. Ashton’s work is divided into twenty chapters, eachcomprising a description of one or more of the lesions to whichthe rectum and anus are liable. We find, for example, the firstfive devoted to a consideration of Irritation and Itching; of In-flammation and Excoriation ; of Excrescences ; of Contraction,and of Fissure of the Anus. Then follow fourteen chapterson Diseases of the Rectum itself, including Neuralgia, Inflam-mation, Ulceration, Hcemorrhoidal Affections, Enlargement ofthe Hsemorrhoidal Veins, Prolapsus, Abscess, Fistula, Polypi,Stricture, Malignant Diseases, Injuries, Foreign Bodies in, andMalformation of, the Rectum. The work, which is abundantlyillustrated by cases, concludes with a chapter on HabitualConstipation. After a careful perusal of the whole, we canconscientiously declare that we find in it more informationthan is to be obtained from any single volume yet publishedon the subjects of which it treats. Mr. Ashton has proved bythis work that he is an attentive observer and a most able andzealous surgeon.

TTital Statistics. Part 1. On the Computing a Rate of jVIor-tality among Persons Afflicted with 17m’ions Diseases, andon a Set of Tables ZJ1’eparecl by the tl ut7ao-r. By R. THmíP-SON JOPLING, Esq., F. S. S., Actuary of the Athenaeum LifeAssurance Society. 8vo. King: Queen-street.THIS pamphlet, though written evidently with a view of ex-

tending the operations of the commercial assurance of lives,possesses much to interest medical men. The statistics ofdisease have been but comparatively little attended to, andany aid in that direction should be diligently encouraged bythe profession. The author, an actuary of repute, has thefollowing apt remarks on this subject:-The advantage of computing into tables the chances of

individual life affected with various maladies would be valuablenot only to the public, but to the medical profession, and ofcourse to assurance companies, who could then take every lifepresented to them, it being necessary only to fix the class towhich each proposal would belong.

" The medical profession will be benefited by seeing the resultof a large number of diseases tabulated according to age andother circumstances ; and very important deductions may bemade by physiological inquirers. The arrangement of so largea mass of medical facts cannot fail to suggest to active mindsthoughts and perceptions of much value.

" We cannot, indeed, cite a better authority, or quote amore apt illustration of the advantage of such labours, than isexpressed in the following statement made by an able writerin the journal of the Statistical Society." ’There is no science in which statistical investigation is

more necessary than in medicine; and there are few to whichit has hitherto been less applied. The physician knows thatcertain medicines produce certain effects; that certain diseasesusually last a certain time; and that some are more fatal thanothers; but he has never or rarely ascertained this by numericalcomputation; his knowledge is the result of an experience de-pendent on memory alone, and if he were to be asked whatwas the average duration of the disease, or in what proportionone disease was more fatal than another, he would be at a lossfor an answer. On the Continent, the true value of statisticalinvestigation, in ascertaining the results of diseases, has longbeen fully estimated; but in this country, the advantage of em-ploying enumeration to obtain those results, and to investigategeneral facts, has only of late years come into importance.’"The entire pamphlet is worthy the attentive consideration

of all persons interested in the results of disease, and the dataof the principles that govern life. It is written in a clear andscientific style, and with as much deference to the talents ojothers as with ability of its own. We cordially recommendthis welcome instalment on a subject of such profound interesias vital statistics.

The Odontaluist: 01’, How to Preserve the Teeth, Cure Tooth-ache, and Regulate Dentition from Infancy to Age. By J.PATExsov CLARK, 1T. A. Post 8v o. London; Churchill.FROM the extensive experience of the -author we naturally

expected to gain considerable information in perusing the" Odontalgist," nor have we been disappointed. The contentsof the little book before us are divided into several heads. Thefirst is " Toothache : its Seat of Pain, its Causes, Prevention,and Cure ;" to which we wish to call particular attention,being evidently written by a gentleman of great practical ex-perience. " Stopping or Filling Decayed Teeth" is another

part of the treatise well worthy perusal.Mr. Clark has pointed out under " Dentition," the great

importance of preserving the temporary teeth for the full periodof their intended career, not only for the purpose of preservingdue room for their successors, but to prevent the pain insepara-ble from caries. He strongly recommends the stopping ofdiseased deciduous teeth.The " Odontalgist" being written in a popular style, it is to

be regretted that more had not been said on " Artificial Teeth,"a subject in which so many are interested. Only two pagesare devoted to the subject. The author states, however, thata substitute for ivory has lately been found-gutta pe1’cha, andadds, " but this, like most irazzovations, must be decided, W3usual, OK its own mer.its by the public themselves, who are thereal pcs-rties concerned." We wish, therefore, that Mr. Clarkhad advised his readers more fully on this ’’ innovation,"which is at least four or five years old; its being so littleknown and used, does not speak much in its favour. When,again, so much lately has been said on the deleterious effectsof bad gold and other metals used in the construction of arti-ficial teeth by c7aecch dentists, the meagreness of the contentson this head is to be regretted.

Again, no mention is made by the author of the various im-proved instruments for extracting teeth, which have so com-pletely superseded the use of the old barbarian key instrument,fitted to belong to the dark ages, and used now only bybunglers, being the many beautifully adapted forceps to the

shape of the various teeth and stumps, also the operating-chairand fulcrum invented by Mr. Gilbert. Nevertheless, there aremany valuable and useful hints relative to toothache, stopping,cleaning teeth, tartar or iur, dentition, &c.

Foreign Department.Treatment of Yccricocele by the Direct Cauterization of

the Diluted Veins.

M. GAILLARD, of Poitiers, has just published, in the GazetteMédicale de Paris, a case in which he cured his patient by avery ingenious and safe operation. The subject was a youngman eighteen years of age, who was very anxious to get rid ofthe deformity, as it prevented him from entering the army.M. Gaillard, not being satisfied with the operations of Breschet,Velpeau, or Vidal, thought that he should endeavour to fulfilthe following indications:-

1. To obtain the obliteration of the dilated veins withoutany danger of phlebitis. 2. To include all the veins of thecord, to prevent a relapse. 3. To avoid with certainty thevas deferens and the spermatic artery. 4. To obtain a sym-metrical cicatrix, owing to the peculiar situation of thepatient.To obliterate the veins, M. Gaillard resolved to use Canquoin

paste;* and to fulfil the other indications, he proceeded as’

follows:-An incision, about three inches long, was made from the

. ring to the scrotum, and the cord laid bare; the latter was, then raised upon a spatula, by tearing the cellulur connexions

existing posteriorly with the sheath. M. Gaillard now dis-

sected the different parts of the cord from each other. (One ofthe veins was much hypertrophied, and adhered to the vasdeferens ; much care was required to isolate that vein.) The

, * Chloride of zinc, two parts; c’uloride of antimony, one part; flour and

water, in sufficient quantities.