that between the years 1817 and 1820, the intervals between the attacks of hæmoptysis varied from six to ten weeks; and in the very next page but one, apparently under the date of 1820, Dr. B. informs us that the lady had no attacks of hæmorrhage for six years. We suppose he means, from the date of his communication at the end, but he ought to have been more perspicuous. We gather from the account, however, that after 1820, the periodical attacks of hæmoptysis were changed into sense of fulness merely of the chest, which was generally removed by opening a vein in the foot. The otorrhoea must have continued for several weeks, but when it ceased we are not informed. About 12 months ago an issue was made in her leg, from which she appeared to derive much benefit, in respect to head-aches and spasmodic pains of her extremities.

Many medical men were consulted on the case of this young lady, personally and by letter. Among others, the late Dr. Gregory was waited upon, with a written statement of this malady. The doctor said it "was a long-winded story, and a hopeless case," but in this last part the doctor was rather out of his reckoning, though we suspect he had some reason for the epithet applied to the narrative, if we may be allowed to judge by the specimen now laid before the public. In respect to the nature of the affection of the head, and the discharge from the ear, the doctor professed to know nothing-which was candid enough. He recommended attempts to restore the function of the uterus, by pediluvia and open bowels; but he had no faith in what are called emmenagogues.

Dr. Barnes adduces as a reason for considering the hæmoptysis vicarious of the catamenia, the circumstance of the former having come on "after the menses had been suppressed." Such, however, does not appear very clearly on the record; for we find the first hæmoptysis came on when the intervals varied from three to six weeks; and, moreover, that during the first six months after the commencement of the pulmonic and hepatic affection, she "menstruated three or four times." Here is a manifest inconsistency, if not a complete contradiction. It is true, the menses after this became suppressed, and the hæmoptysis returned; but it can hardly be justifiable to conclude that the first attack of hæmorrhage from the lungs was of a vicarious nature.

In respect to the otorrhea serosa, we fear that most of those who speak candidly, will give the same answer as Dr. Gregory did—namely, that they know nothing about the matter. It is curious that Dr. Barnes never could get a sight of the patient when the aural discharge was flowing. It is possible, therefore, that some error crept in. The learned editors of the journal in which the case is detailed, have quoted examples of otorrhoea serosa alternating with the menstrual and hæmorrhoidal discharges. The same is noticed in Buchanan's Acoustic Surgery.

Dr. Barnes' case is interesting, as shewing the advantages which were derived from blood-letting in the foot, when the tendency to fulness in the chest occurred, and which Dr. B. considers as a much more effectual mode of relieving the upper parts of the body than bleeding from the arm. The case also shews that, in these vicarious hæmorrhages from the lungs, there is not near so much danger as in idiopathic hæmoptysis.

36. SILK-WORM-GUT LIGATURES.

In the second volume of the Edinburgh Medical Transactions, Mr. Fielding, surgeon, at Hull, has published a short paper on the above species of ligature for securing divided arteries Mr. F. remarks that Mr. Lawrence's

plan of using small silk ligatures, and cutting them off very close to the knot, has not been found to answer the expectations formed of it. In a great variety of cases where he has seen this plan tried, the knots of silk were not absorbed, and were ultimately thrown off unchanged after a slow suppuration, attended with pain and irritation for several weeks or months, to the great annoyance of the patients. As the ligatures now used are attended with inconvenience, and not soluble in the fluids of the body, our author presumes that any attempt to obviate or remove these incon veniences, is deserving of attention. Time alone can prove whether the substance proposed by Mr. Fielding shall be attended with all the advantages and security which he anticipates; but he assures us that hitherto it has answered his expectations. The silk-worm-gut was suggested to our author by his assistant, Mr. Heseltein. It is much used by fishermen at the end of their lines—is apparently an animal substance-will sustain a weight of several pounds without breaking, and may be softened by being steeped for half an hour in warm water, so as to be easily formed into a knot, either single or double, as may be required. Or it may be placed in cold water over night, before it is wanted. This substance retains its tenacity long enough for union of the coats of the vessels to take place.

Twelve cases of surgical operations are briefly detailed by our author, in which this species of ligature was used with perfect success. They prove satisfactorily, that the substance secures the vessels effectually. In no case have we seen any appearance of the knots, though carefully looked for at every dressing; and in no case has any abscess, or other inconvenience followed its use, as far as I know." It appears, therefore, to Mr. F. that the vessels are as secure-that the wounds heal sooner-and that the patients suffer less pain during the cure, than by the methods in common use. The gut may be procured at any of the shops where toys or fishing tackle are sold. We think the proposal of Mr. Fielding is worthy of further trial by operating surgeons.

37. MOXA IN PHLEGMATIA DOLENS.

In the second edition of Mr. Boyle's work on Moxa, we observe, among numerous cases where great benefit was derived from this remedial agent, a case of phlegmatia dolens, in both the lower extremities, to which mora was applied.

The woman was a patient of Mr. Allan's; and the disease had made its appearance at the usual period after confinement. It had been treated judiciously by Mr. A. but although the symptoms were mitigated, they were not subdued. The lower extremities were enormously swollen-skin tense, hot, and transparent, with traces of extravasated blood in some places. The parts had an elastic rather than an oedematous feel, and there was much pain in the erect posture, particularly in the groins. As it was considered that a sub-acute inflammation existed, the moxa was first cautiously applied to the least inflamed limb, near the foot and ankle, and was followed by a pit or depression of the part where it was applied, together with a relaxed appearance of the surrounding skin. After this a bandage was applied, and a most profuse perspiration in both limbs succeeded. On the following day she pronounced herself relieved, and the swelling of the thigh was evidently lessened. The pain of the groin was still severe. In pursuance of Dr. Davis's Theory of Phlegmatia, Dolens, Mr. Boyle applied the moxa in the line of the femoral artery in the groins, in addition to the foot and leg-and this also was attended with much advantage.

The effect

of applying the moxa on alternate days was tried; but it was found the disease was aggravated on the intermediate days of application. The moxa was therefore applied every day, and sometimes twice in the same day. In about three weeks the patient was able to leave town for the benefit of country air, having but little remaining swelling in her limb.

For a variety of cases in which Mr. Boyle applied the moxa with great advantage, we must refer to the second edition of his work, which is much enlarged, and is well worthy the attention of the surgical practitioner.

38. SUDDEN AND MYSTERIOUS DEATH.

A case lately occurred under Dr. Latham, in Bartholomew's Hospital, where a young married woman, who had been received in a febrile state, with great debility, oedema about the ankles, and pain, on pressure, in the epigastrium, was suddenly seized with something like spasm about the heart and in the bowels, a few days after she entered the hospital, and expired in the course of two or three hours.

On dissection, we understand, no organic disease or trace of inflammation could be detected in any part of the body, except near the fundus uteri, where there were some appearances of phlogosis. One of the ovaries contained hair and other extraneous matters, and was enlarged to the size of

an egg.

39. REMARKABLY Severe guN-SHOT WOUND..

The following case is not brought forward by Dr. Boggie as an example for imitation, but rather as an uncommon instance of what Nature is sometimes capable of effecting under circumstances apparently desperate.

Case. Lieut. Col. L. while in the front of his regiment, in the battle of Waterloo, was deliberately aimed at by a rifleman of the enemy, and struck in the leg, by which he was felled to the ground. He was carried to Brussels in a car, and seen the next day by Dr. B. It was found that the ball had entered the fore-part of the leg about the middle, and was lodged there. It had struck upon the internal flat surface of the tibia, close to the anterior ridge, causing an oblique fracture and splintering of both bones. The colonel was 30 years of age, of slender form, temperate habits, sanguine temperament, and active mind. He was not ruffled by the accident, and the pulse was calm. An opinion was given that the leg ought to be amputated, although the operation was not indispensable at that moment. It was even proposed to make an attempt at saving the limb. There being no inflammation present, the wound was simply dressed, and the antiphlogistic regimen prescribed. Except constant pain in the fore part of the leg, there was no material change for several days. There was a splinter of bone threatening to ulcerate the skin, and causing much irritation. On making an incision over this piece of bone, a large portion of the tibia was found quite loose. This was removed, after making an incision to within an inch of the ankle-joint. The portion removed measured 4 inches in length, involving, at one place, nearly half the calibre of the tibia. It was now the opinion that so large a portion of bone could not be regenerated, and that amputation ought to have been performed. But the patient was averse to the operation, and Dr. B. was not anxious to put it in force. The limb was simply dressed-there was no tendency to fever-suppuration came on

* Dr. J. Boggie. Ed. Med. Chir. Trans. vol. ii.

freely, and every thing went on well. The aperture by which the ball had entered was so small that it was found necessary to dilate it by the sponge tent, and several portions of fractured bone were removed. The ball lay concealed for some weeks, but was at length discovered on the fibular side, just under the skin. It was easily removed. The limb had hitherto remained in the extended posture, resting on the heel, and was now (after six weeks) changed to the bent posture, and placed on the outside. Inflammation quickly succeeded to this change, accompanied by violent fever, and threatening of gangrene. The posture was changed again to the original, and 20 ounces of blood were drawn. Cold lotions, saline cathartics, rigid antiphlogistic regimen. The inflammation and fever abated in a few days, and the patient was brought back to his pristine condition. The purulent discharge was copious but healthy. No appearance of consolidation was perceptible at the end of three months. After this period, the discharge lessened, and very soon afterwards, osseous matter was secreted, and the union of the bones became so complete, that the leg could be moved with safety, and handled with the greatest freedom." In little more than four months the large piece of bone "was completely renewed, its regular shape preserved, and the wound cicatrized." The colonel has a very tolerable, or even perfect use of the leg, and enjoys good health. The case was seen by Dr. Thomson, Dr. Somerville, Mr. Guthrie, Mr. Bell, Dr. Hennen, and others.

The gallant officer had a narrow escape, unquestionably; but still we think Dr. Boggie was justified in the attempt to save limb as well as life, under the existing circumstances of the case. We have seen more than one instance where life and limb were preserved under circumstances at least as unfavourable as those detailed above. A case indeed lately occurred at Guy's Hospital, and is reported in No. 169 of the Lancet, where the injury was not less formidable than in Dr. Boggie's patient.

A young man had his right leg very badly fractured by the wheel of a loaded waggon going over it, and even resting some time on the limb. The tibia was broken close to the ankle joint, and it was supposed that the bone was split down into the joint. The bone was insulated from the surrounding parts for four or five inches, so that the finger could be passed nearly round it. The fibula was broken, and the soft parts were greatly lacerated. Mr. Lawrence advised amputation, but the patient would not submit to the operation. Aperients, lotions, repeated bleedings, and all the usual antiphlogistics, were sedulously employed. Suppuration and granulation went on kindly, and in two months the man was able to raise the limb, without any pain. The leg was taken out of the fracture box and laid on a pillow; but this change kindled up, as in Dr. Boggie's case, a severe fever and inflammation, so as to endanger the man's life. Happily these symptoms were got under by proper measures, and the man did well. Both of these cases shew the caution necessary in disturbing the position of the limb too soon after accidents of this kind.

40. SUBCARBONATE OF IRON.

Dr. Duparque has been testing (to use an American phrase, and by no means a bad one,) the virtues of subcarbonate of iron, in neuralgic affections, and it appears, from his testimony, that the nerves of Frenchmen are nearly as susceptible to the steeling process, so long employed in this country, as those of John Bull. Dr. D. has related a considerable number of cases in the July No. of the BIBLIOTHEQUE MEDICALE, where the carbonate of iron succeeded, after quinine and various other remedies had failed, in facial

and other neuralgia. We shall only give the particulars of one case, as an example.

Madame P. 68 years of age, had been afflicted, for 16 years, with suborbital neuralgia of the right side. The pains returned at irregular periods, but were seldom more than eight or ten minutes absent. The pains were of a tearing, burning character, accompanied by sneezing, lachrymation, and redness of the conjunctiva. The motions of the lower jaw, the tongue, and the pharynx, were sometimes almost annihilated, and the whole body rendered stiff, as in tetanus. All the means that could suggest themselves to some of the most eminent Parisian practitioners were tried, but all in vain, and it was contemplated to try a division of the nerve; but at this time Dr. D. administered the carbonate of iron. After four days, the intervals were lengthened to four or six hours, and the attacks were proportionally diminished.

Dr. D. remarks that this medicine has great advantages over most others; Imo. because it is easily taken, even in large doses; 2do. because it is not capable of causing any local or general disorder in the system. None of our author's patients complained of head-ach, flushings of the face, acceleration of the pulse, or any other unpleasant effect from the medicine. It generally increased the appetite, and improved the functions of digestion. It is gratifying to find this corroboration of the therapeutical effects of carbonate of iron in foreign countries. Indeed, we think that, next to quinine, the medicine in question is one of the most important we possess in the reduction of that morbid sensibility of the nervous system, so prevalent in this country.

41. PRINCE HOHENLOE IN PANTON SQUARE.

The prayers of this righteous prince have at length prevailed, for Margaret B, the mother of three children, has been miraculously cured of an ovarian tumour, the size of a child's head, of four years standing, (and which appeared suddenly at the beginning) by seven bleedings from the arm in the course of nine consecutive days, in the Surgical Hospital of Pantonsquare. This ovarian tumour occupied "the left lower region of the abdomen”—was soft and elastic, with a distinct sense of fluctuation, and exquisitely painful on pressure, or on making a deep inspiration. She had symptoms of fever, and disordered bowels. After one or two bleedings, she was suddenly seized with a convulsive fit-then talked incoherently—pulse sometimes almost imperceptible-breathing stertorous-abdomen tense and tender. She was bled day after day, and took calomel occasionally. On the ninth day, when the tumour was sought for, it was gone-having been cured by seven bleedings, "without any preternatural discharge from the rectum or vagina."

Is it in the 19th century that we are to be told such tales? The experience of mankind is the test of miracles. So said Gibbon-and so say we, especially as respects medical miracles. Is there a surgeon from the South Foreland to John O'Groats, who knows any thing of tumours of the ovarium, and who would, for one moment, entertain a thought that the above case was such a disease? Margaret B. had just as much an ovarian tumour, as she had an elephant's tusk in "the left lower region of the abdomen." We suppose the reporter, in this case, was one of those tender "youths of fifteen,' whose education is taken under the especial protection of the RADICAL PRESS. When he grows a little older, he will distinguish those deliveries, à la Johanna Southcote," from cures of ovarian dropsy by seven bleedings.

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More Miracles. A young man, aged 21, was admitted into the Hospital