THE

AMERICAN JOURNAL

OF THE

MEDICAL SCIENCES.

COLLABORATORS.

Jacob Bigelow, M. D. Professor of Materia Medica in Harvard Univer- sity, Boston.

Walter Changing, M. D. Professor of Midwifery and Legal Medicine in Harvard University, Boston.

N. Chapman-, M. D. Professor of the Institutes and Practice of Physic and Clinical Practice in the University of Pennsylvania.

John Redman Coxe, M. D. Professor of Materia Medica and Pharmacy in the University of Pennsylvania.

William C. Daniell, M. D. of Savan- nah, Georgia.

John Beale Dayidge, M. D. Professor of Anatomy in the University of Ma- ryland.

Elisha De Butts, M. D. Professor of Chemistry in the University of Mary- land.

William P. Dewees, M. D. Adjunct Professor of Midwifery in the Univer- sity of Pennsylvania.

S. Henry Dickson, M. D. Professor of the Institutes and Practice of Medicine in the Medical College of S. Carolina.

Benjamin W. Dudley, M. D. Profes- sor of Anatomy and Surgery in Tran- sylvania University.

Gouverneur Emerson, M. D. of Phila- delphia.

Thomas Fearn, M. D. of Alabama.

John W. Francis, M. D. Professor of Obstetrics and Forensic Medicine in Rutgers Medical College, New York.

William Gibson, M. D. Professor of Surgery in the University of Pennsy l- vania.

John D. Godman, M. D. late Professor of Anatomy and Physiology in Rutgers Medical College, New York.

It. E. Griffith, M. D. of Philadelphia.

Robert Hare, M. D. Professor of Che- mistry in the University of Pennsyl- vania.

Isaac Hays, M. D. one of the Surgeons of the Pennsylvania Infirmary for diseases of the Eye and Ear.

George Hayward, M. D. of Boston.

Thomas Henderson, M. D. Professor of i/ie Theory and Practice of Medi-

cine in the Columbian College, Dis- trict of Columbia.

William E. Horner, M. D. Adjunct Professor of Anatomy in the Univer- sity of Pennsylvania.

David Hosack, M. D. Professor of the Institutes and Practice of Medicine in Rutgers Medical College, New York.

Ansel W. Ives, M. D. of New York.

Samuel Jackson, M. D. one of the Physicians of the Philadelphia Aims- House Infirmary.

Samuel Jackson, M. D. of Northum- berland, Pennsylvania.

Frederick G. King, M. D. of New York.

William J. Macneven, M. D. Profes- sor of Therapeutics and Materia, Me- dica in Rutgers Medical College, New York.

Valentine Mott, M. D. Professor of Surgery in Rutgers Medical College, New York.

James Moultrie, Jr. M. D. of Charles- ton, s. c.

Reuben D. Mussey, M. D. Professor of Anatomy, Surgery, and Obstetrics in Dartmouth College.

James M. Pendleton, M. D. Lecturer on Midwifery and Diseases of Women and Children, New York.

Philip Syng Physick, M. D. Profes- sor of Anatomy in the University of Pennsylvania.

Nathaniel Potter, M. D. Professor of the Theory and Practice of Medicine in the University of Maryland.

Thomas Sewale, M. D. Professor of Anatomy and Physiology in the Co- lumbian College, District of Colum- bia.

John Spence, M. D. of Dumfries, Vir- ginia.

John Ware, M. D. of Boston.

John C. Warren, M. D. Professor of

Anatomy and Surgery in Harvard

University, Boston. N. W. Worthington, M. D. Professor

of Materia Medica in the Columbian

College, District of Columbia. Thomas H. Wright, M. D. Physician to

the Baltimore Aims-House Infirmary.

THE

AMERICAN JOURNAL

OF THE

MEDICAL SCIENCES,

VOL. Ml

PHILADELPHIA:

CAREY, LEA AND CAREY CHESNUT STREET,

1838.

SKKRHETT NINTH STREET, PHILADELPHIA.

TO READERS AND CORRESPONDENTS. Dr. Wright's communication has been received.

Dr. Bartlett's paper has been crowded out of the present number; it shall appear in our next.

Our other correspondents shall receive private answers.

We have received the following publications:

Transactions of the Medico-Chirurgical Society of London, Vol. XIV.

Transactions of the Medico-Chirurgical Society of Edingburgh, Vol. Ill, Part 1.

Laws of Physiology; translated from the Italian of II Signor Dott. B. Mojon, Professor Emeritus in the Boyal University of Genoa, and Member of many learned bodies. With additions, and a Physiological Table of Man. Dedicated by permission to Sir Astley Cooper, Bart. F. K. S., Surgeon to the king. By George R. Skene, Member of the Royal College of Surgeons in London, and of the Medical and Chirurgical Society, &c. &c. &c. London, 1827, (from the author.)

A Manual of Modern Surgery, founded upon the Principles and Practice lately taught by Sir Astley Cooper, Bart. F. R. S., Surgeon to the king, con- sulting surgeon to Guy's Hospital; and Joseph Henry Greek, Esq. F. R. S.9 Professor of Anatomy to the Royal Academy, Surgeon to, and Lecturer on Sur- gery, St. Thomas's Hospital. Embellished with a portrait of Sir Astley Cooper, Edited by Thomas Castle, F. L. S. Member of the Royal College of Surgeons, &c. London, 1828, (from the editor.)

Se la Febbre Gialla sia o no un Contagio, quistione Agitata dai Medici Eu- ropei ed Americani. Memoria del Cav. Dott. G. Palloni, Livorno, 1824.

Compendium of Operative Midwifery; or the Manual and Instrumental Ope- rations of Preternatural Labours, reduced to the greatest simplicity; preceded by an Investigation of the Mechanism of Labour. From the French of Julius Hatin, M. D. P. &c. &c. Translated by Richard Tuite, M. D. &c. New York. Charles S. Francis, 1828, 12mo. pp. 171, (from the publishers.)

Remarks on the Importance of the Teeth; on their Diseases and Modes of Cure; with directions for Forming Regular and Beautiful sets of Teeth, and for the Preservation of their Health and Beauty. By Samuel S. Fitch, Dentist. Philad. 1828. Pamphlet, pp. 27. PI. I. (from the author.)

Journal des Progres des Sciences et Institutions Medicales en Europe, en Amerique, Sec. Vols. IX. and X. (in exchange.)

Annales de la Medecine Physiologique, for April, May, June, and July, 1828, (in exchange.)

Revue M^dicale Francais et Etrangere, et Journal de Clinique de l'Hotel Dieu, et la Charite, et des Grands Hopitaux de Paris, for May and June, (in exchange.)

viii

TO READERS AND CORRESPONDENTS.

Journal General de Medecine, dc Chirurgie, et de Pharmacie Francais et Etrangcres, ou Recueil Periodique des Travaux de la Societe de Medecine de Paris 5 Redige. Par A. N. Gendrin, l'un de ses Membres, from January to July, 1828, (in exchange.)

Archives Generates de Medecine, January to June, 1828, (in exchange.)

Bulletin des Sciences Medicales, from January to July, (in exchange.)

Revue Encyclopedique, April, May, and June, 1828, (in exchange.)

Journal der Chirurgie und Augen Heilkunde, herausgegeben, von C. F. v. Graefe und Ph. v. Walther, February, 1828, (in exchange.)

Notizen ans den Gebieteder natur und Heilkunde gesammelt und mitgetheilt. Von Ludwig Fr. von Froriep, 1827, (in exchange.)

The London Medical and Physical Journal, for July, August, and September, (in exchange.)

The London Medical Gazette, Vol. I, Nos. 16 to 33, (in exchange.)

The London Medical and Surgical Journal, for July, August, and September, (in exchange.)

The Medico-Chirurgical Review, for July, 1828, (in exchange.) Nuovo Giornale de Literati, for 1827, (in exchange.)

The Transylvania Journal of Medicine and the Associate Sciences, Nos. 1, 2, 3, (in exchange.)

The Western Journal of the Medical and Physical Sciences, for April and July, 1828.

The Boston Medical and Surgical Journal, Nos. 23 to 36, inclusive, (in ex- change.)

The New York Medical and Physical Journal, Nos. 1 and 2, (in exchange.)

The North American Medical and Surgical Journal, for October, 1828, (in exchange.)

For the gratification of our contributors we continue the references to the works, in which they will find notices of their communications; these references are, of course, restricted to the Journals received during the preceding three months.

Professor Phtsick will find his instrument for excision of the tonsils and trun- cation of the uvula, noticed in the Medico-Chirurgical Review, and the London Medical and Physical Journal, for July, 1828; and in the Journal des Progres, Vol. X.

Professor Chapman's Observations on the use of Tobacco in Croup, are co- pied into the Nouvelle Bibliotheque Medicalc, for July, 1828.

Professor Dkweks's paper on Secale Cornutum is copied into the London Medical Gazette, Vol. I. No. 24, and noticed in the Medico-Chirurgical Review, for .Inly 1828. His paper on Bloody Infiltrations into the Labia Pudendi, is noticed in Froricp's Notizen, for January, 1828.

TO READERS AND CORRESPONDENTS.

ix

Professor Mott's paper on Amputation at the Hip-Joint is noticed in Froriep's Notizen, for November, 1827, and his Case of Calcareous Degeneration of the Scrotum, in the same Journal, for January, 1828.

Professor Horner's Observations on Mucous Membranes are copied into the Journal Universel des Sciences Medicales, for March and April, 1828, and noticed in the Annales de la Med. Physiol, for July, 1828.

Professor Hare's Method of Detecting minute quantities of Opium is copied in the Archives General de Med. for January, 1828, London Medical and Phy- sical Journal for September, 1828, and Froriep's Notizen for December, 1827.

Professor Sewaee's Cases of Injury of the Head, are noticed in the London Medical and Surgical Journal for August, 1828, and the London Medical and Physical Journal for September, 1828.

Dr. Jackson's Clinical Reports are noticed in the Medico-Chirurgical Review for July, 1828.

Dr. Godman's Case of Anomalous Vision is noticed in the London Medical and Physical Journal for August, 1828, Archives General for April, 1828, and the Quarterly Journal of Science, Literature, and the Arts, for July, 1828.

Dr. White's Successful Ligature of the Internal Iliac, in the Medico-Chimr_ gical Review, and London Medical and Physical Journal for July, 1828, and Journal des Progres, Vol. IX.

Dr. Hosack on Removal of the Tonsils, in the Medico-Chirurgical Review for July, 1828; Western Journal of the Medical and Physical Sciences, April, 1828, and London Medical and Physical Journal, August, 1828.

Dr. Ives's Case of Poisoning by Cantharides, in the London Medical and Physical Journal for July, 1828; Revue Medicale, May, 1828, and Nouv. Bib. Med. July, 1828.

Dr. Moore on Volatile Alkali in Bites of Poisonous Serpents, in the Journal des Progress, Vol. IX. and Western Medical and Physical Journal, April, 1828.

Mr. Carpenter on Rhubarbarme, in the Journal des Progres, Vol. IX. On Piperine, in the London Medical and Physical Journal, August, 1828.

Dr. Stevenson on Charcoal, in Froriep's Notizen for December, 1827. Dr. Rush's Case of Pulsation of the Veins, in Froriep's Notizen for De- cember, 1827.

Dr. Beatty's Qase of Luxation of the Astragalus, in Froriep's Notizen for December, 1827.

Dr. Fea^rn's Experiments on Tendons, in Froriep's Notizen for January, 1828.

Dr. Comstock's Case of Aneurism of the Aorta, in Froriep's Notizen for October, 1827.

Dr. Heiskele's Case of Extra-Uterine Fcetation, in the London Medical and Physical Journal, and London Medical and Surgical Journal for August, 1828.

Dr, Waeton's Case of Organic Disease of the Heart, in the London Medical

X TO READERS AND CORRESPONDENTS.

and Physical Journal, and London Medical and Surgical Journal, for August, 1828.

Dr. Welis's Case of Scrotal Tumour, in the London Medical and Surgical Journal for August, 1828.

Dr. Stedman's Case of Apoplexy cured by Opening the Radial Artery, in the Archives General, January, 1828.

Dr. Arnold's Case of Paruria Erratica, in the Archives General, April, 1828, and Journal Universel for February, 1828.

Dr. Washington's Case of Gun-shot Wound, in the Journal des Progres, Vol. IX.

Dr. Skinner's Case of Tetanus, in the Journal des Progres, Vol. X.

Dr. Griffith's Case of Salivation from the use of Tartar Emetic Ointment, in the London Medical and Physical Journal for September, 1828.

Dr. Pennock's Experiments on the Use of Cupping-glasses in Poisoned Wounds, in the London Medical and Physical Journal for September, 1828.

CONTENTS,

ORIGINAL COMMUNICATIONS.

ESSAYS.

Abt. Pare,

I. On an Operation for the Cure of Natural Fissure of the Soft Palate. By- John C. Warren, M. D. Professor of Anatomy and Surgery in the Medi- cal Institution of Harvard University, Boston - 1

II. Account of the Dengue, as it appeared in Charleston, S. C. during the Summer of 1828. By S. Henry Dickson, M. D. Professor of the Insti- tutes and Practice of Medicine in the Medical College of South Caro- lina - - 3

IH. Reports of Cases treated in the Baltimore Alms-house Infirmary. By Thomas H. Wright, M. D. Physician to the Institution - - - 15

IV. Case of Axillary Aneurism removed by the application of a Ligature to the Subclavian Artery. By Dr. Edward W. Wells, Physician and Sur- geon in Maracaybo. Communicated by Felix Pascalis, M. D. of New York - r - - - - - - - - - - 28

V. On the Topography and Diseases of Western Pennsylvania. By L. Cal- laghan, Member of the Faculty of Medicine, and Licentiate of the Faculty of Physicians and Surgeons of Glasgow .... 34

VI. On Paruria Erratica, or Uroplania. By Salmon Augustus Arnold, M. D.

of Providence, Rhode Island ------- 41

VH. On the Respiration of Cold Air in Pulmonary Diseases. By C. Drake, M. D. of New York. Communicated in a letter to Dr. Chapman - 53

VIII. Observations tending to ascertain whether the Ancients were ac- quainted with the Disease known to us familiarly by the name of Croup.

By John Redman Coxe, M. D. Professor of Materia Medica and Pharma- cy in the University of Pennsylvania - 56

IX. Two Cases illustrative of the Pathology of the Nervous System. By William E. Horner, M. D. Adjunct Professor of Anatomy in the Univer- sity of Pennsylvania - - 87

X. Case of Organic Disease of the Brain. By John Ware, M. D. of Boston 94 XL An Account of a Case of Osteo-sarcoma of the Left Clavicle, in which

Exsection of that Bone was successfully performed. By Valentine Mott, M. D. Professor of Surgery in Rutgers College, New York - - 100

XII. Case of Compound Dislocation of the Ancle-joint, with a Dislodg- ment of the Astragalus. By S. Pomeroy White, M. D. of Hudson,

N. Y. - - ... . . - . - - 109

XIII. Case 'of Bloody Infiltrations into the Labia Pudendi. By James Guild, M. D. of Tuscaloosa, Alabama. Communicated in a letter to Dr. Dewees - 111

Xll CONTENTS.

MEDICAL EDUCATION AND INSTITUTIONS.

XIV. Sketch of the History of the Massachusetts Medical Society, with an account of their Medical Publications. By E. Hale, M. D. Member of the Society - - - - - - - - - 113

REVIEW.

XV. On the Nature and Treatment of Tetanus and Hydrophobia, with some Observations on a Natural Classification of Diseases in General. By Robert Reid, M. D. Licentiate of King and Queen's College of Physi- cians in Dublin, Member of the Royal Medical Society of Edinburgh,

&c. - * - ; ; .!;>;Vv>s:: ^-.vv^3

BIBLIOGRAPHICAL NOTICES.

1. Versuch einer Medicinisch-Chirurgischen Diagnostik, in Tabellen oder Erkenntniss und Unterscheidung der innern und aeussern Krankheiten, mittels Nebeneinanderstellung der ahnlichen Formen. Von D. Karl Gus- tav. Schmalz, Arzte und Physikus zu Kbnigsbriick. [Dresden and Leip- zig; folio, pp. 264. Fourth edition, enlarged and improved.]

An attempt at Medical and Surgical Diagnosis, in Tables; or Recog- nition and Discrimination of Internal and External Diseases, by compari- son of their resembling forms. By Charles Gustavus Schmalz, M. D. &c. 153

2. Se la Febbre Gialla sia o no un Contagio, Quistione Agitata dai Medici Europei ed Americani. Memoria del Cav. Dott. G. Palloni. Livorno, pp. 160. 8vo. 154

3. Memoire Physiologique sur le Cerveau. Par M. Magendie. Lu dans la sceance Publique de l'Academie Royale des Sciences, le 16 Juin, 1828. [Brochure, 4to. pp. 17.] 157

4. Abrege pratique des Maladies de la Peau, d'apres les Auteurs les plus estimes et surtout d'apres les Documens puises dans la Clinique de M. le Dr. Biet, Medicin de l'Hopital Saint Louis. Par MM. A. Cazenave et H. E. Schedel, Docteurs en Medicine, anciens internes de l'Hopital Saint Louis, &c. &c. Paris, 1828, pp. 527, 8vo. 162

5. Traits des Maladies des Enfans neuveaux-nes et a la Mamelle. Paris, 1828, pp. 654, 8vo. avec 10 planches coloriees, 4to. Par C. Billard 165

6. Traite General d'Anatomie Compared par J. F. Meckel, traduit de PAl- lemand et augmente de notes. Par MM. Riester et Alph. Sanson, Doc- teurs en Chirurgie, de la Faculte" de Paris. Precede d'une lettre de l'auteur. Vols. I. and II. 8vo. Paris, 1828 ih,

7. Medico-Chimrgical Transactions, published by the Medical and Chi- rurgical Society of London, Vol. XIV. London, 1828, pp. 463, with five plates 166

8. The Morbid Anatomy of the Bowels, Liver, and Stomach, illustrated by a series of Plates from drawings after Nature, with explanatory letter- press, and a summary of the Symptoms of the Acute and Chronic Affec- tions of the above-named Organs. By John Armstrong, M. D. Lecturer on the Principles and Practice of Physic, and Consulting Physician to

CONTENTS.

xiii

the London Fever Hospital. Fasciculi, 1 and 2. lithographic plates. London, 4to. 1828 177

9. Elements of Physics, or Natural Philosophy, General and Medical, ex- plained independently of Technical Mathematics, and containing new disquisitions and practical suggestions. By Neil Arnott, M. D. of the Royal College of Physicians. Third edition. London, 1828, pp. 647, 8vo. 181

10. A short Treatise on the different methods of investigating the Diseases of the Chest, particularly by Percussion, and the Use of the Stethoscope. Translated from the French of M. Collin, by W. N. By land, M. D. Third edition; with additional Notes and Instructions, a plate of the Viscera of the Thorax, &c. London, 1828, pp. 86, 18mo.

A rational exposition of the Physical signs of the Diseases of the Lungs and Pleura, illustrating their Pathology, and facilitating their Diagnosis. By Charles J. B. Williams, M. D. London, 1828, pp. 193, 8vo. With 2 plates - - - - - 182

11. A Manual of Modern Surgery, founded upon the Principles and Prac- tice lately taught by Sir Astley Cooper, Bart. F. R. S. &c. &c. and Jo- seph Henry Green, Esq. F. R. S. &c. &c. Edited by Thomas Castle, Esq. F. L. S. Member of the Royal College of Surgeons, &c. London, 1828, pp. 337, 18mo. 183

QUARTERLY PERISCOPE, FOREIGN INTELLIGENCE.

ANATOMY,

Page.

1. On Different Kinds of Malfor- mation of the Heart. By Dr. Gendrin - - - - 184

2. Case of Imperforate Vagina. By

M. Hervey de Chegoin - 185

3. Apparent Hermaphrodism. By

M. Hervey de Chegoin - ib.

4. Remarks on the Stomach of

Page

Man. By Dr. S. Th. de Soem- mering -

5. On Valves in the Pulmonary Veins. By Professor Mayer

6. Microscopic Researches upon the intimate structure of Ani- mal Tissues. By M. Raspail

186

ib,

Physiology.

7. Case of Disease of the Brain, illustrating the Functions of the Fifth Pair of Nerves. By E. Stanley, Esq. - - - 187

8. Case in which there was a di- minution of Sensibility on one side, without loss of the power of Motion; and a loss of Muscular Power on the other side, with- out any diminution of Sensibili- ty. By H. Ley, M. D. - 188

9. On the Effects of the Division or Organic Lesion of the Fifth Pair

of Nerves 189

10. Vision after Destruction of the Optic Nerves. By M. Ma- g'endie -

11. Five Children at a Birth. By Dr. Gaievsky -

12. Case of Superfoetation, the Uterus being naturally formed.

By Dr. Farhenrost - - ib,

190

ib.

XIV

CONTENTS.

Page.

13. Case of Superfcetation. By M. Castes ... 191

14. On the Connexion between Respiration and Circulation. By Dr. Defermon - - . - ib.

15. On the Effects of Galvanism

on the Nerves. By Weinhold ib.

16. Case illustrative of the Effects

18. Complete Retention of Faeces,

for Six Months. By Dr. Thune 195

19. Hydatids in the Female Breast resembling a Scirrhus Tumour 196

20. Remarkable Predisposition to Haemorrhage. By Dr. Schreyer ib.

21. Spasmodic Stricture of the Urethra from Mental Excite- ment. By Dr. Reimoneng - ib.

22. Habitual Haemorrhage from the Mammae. By Dr. Jacobson 197

23. Action of the Uterus from Sympathy. By Dr. Pichon - 198

24. Extraordinary Instance of Sup- pression and Retention of Urine.

By Dr. Racum - - - ib.

25. Inflammation of the Placenta.

By M. Brachet 199

26. On Morbid Softening of the Uterus. By S. G. Luroth, M. D. ib.

33. On Pyroligneous Acid. By

M. Schultz 206

34. On the Use in Fevers of the Sulphate of Quinine and of the Quinquina. By M. Vulpes - ib.

35. On a new Preparation of Bal-

38. Dysentery cured by Nitrate

of Soda. By M. Mayer - 207

39. Treatment of Croup. By M. Jadelot .... ib.

40. Case of Gout. By M. Mesti- vier ^ - 208

41. Case of Obstinate Hiccough, cured by the Actual Cautery.

By M. Dupuytren - - 209

42. On the Use of Mercury in Ve- nereal Complaints. By S. D. Broughton, Esq. - - ib.

43. Treatment of Syphilis with- out Mercury. By M. Fricke 212

Page.

of a Division of the Spinal Mar- row, between the third and fourth Dorsal Vertebrae, in the Human Subject. By William Wallace, Esq. - - - 192 17. New Researches on the Im- mediate Agent of Vital Move-

ments. By M. H. Dutrochet 194

27. Gangrene of the Lung termi- nating favourably. By M. Lau- rent 201

28. Instance of Obliteration of the

Aorta opposite the Fourth Dor- sal Vertebrae. By Professor Meckel - - - - ib..

29. Case of Mollescence of the Coats of the Stomach. By M. Chomel 202

30. Case of Tumour of the Cere- bellum. By Joseph Houlton, Esq. 203

31. On Diseases of the Heart caus- ed by Onanism. By Dr. Kri- mer 204

32. Case of Rupture of the Sto- mach, produced by Vomiting.

By J. N. WTeekes, Esq. - 205

sam of Copaiba. By M. Dublanc, Jr. 206

36. On Oleum Ricini. By M. Lan- gier 207

37. On Phosphorus as a Caustic.

By Dr. Paillard - - - ib.

44. On the Injurious Effects of Sulphuric Acid during Suck- ling. By Mr. Thomas Bevan 212

45. Case of Anasarca, successful- ly Treated. By Dr. Juger - ib,

46. On Ptyalism. By Dr. Elliot- son 213

47. Case of Purpura Hemorrha- gica treated by Venesection.

By Dr. Latham - - - ib,

48. Chronic Ulcerations \)f the Tongue and Pharynx, cured by Todine. By M. Magendie - ib

Pathology.

Materia Medica.

Practice op Medicine.

CONTENTS.

XV

49. Treatment of Spots on the Cor- nea. By M. Dupuytren - 214

50. On Foreign Bodies in the Puncta Lachrymalia. By M. Demours - - - ib.

51. Case of Affection of the Eye produced by Lightning1. By Mr. Mayo 215

52. On the Cauterization of the

Cornea for Idiopathic Paralysis of the Iris. By M. Serres - 215

53. Case of Cataract with Amau- rosis, Successfully Treated. By

M. Demours - - - 216

54. Case of Fistula Lachrymalis cured by the Extraction of a Stony Concretion. By Dr. Kri- mer - - - - ib.

Subgeby.

55. Case of Extirpation of a Can- cerous Excrescence from the Margin of the Anus, By Pro- fessor Lallemand - . 216

56. Case of Dislocation of the Me- tatarsus. By Mr. Sandwith ib.

57. Treatment of Phagedenic and Corroding Herpes. By M. Du- puytren .... 217

58. Case of Ligature on the Com- mon Carotid Arteries. By Pro- fessor Langenbeck - - ib.

59. On the Application of Plates of Lead to Wounds. By M. Re- veilee-Parise - - - 218

60. Case of Fracture into the Knee- joint, Successfully Treated ib.

61. On Amputation of the Neck of the Uterus - - - ib.

62. Case of Amputation of half the Lower Jaw for Sarcoma, suc- cessfully performed. By M. Lis- franc 219

63. Case of Gun-shot Wound of the Forehead, in which the Ball remained for along period in the Skull. By Baron Larrey 220

64. On Strangulated Hernia - ib.

65. On Lithotrity. By Dr. Civiale 221

66. On Lithotrity - ib.

67. Case of Cancer of the Uterus Cured by Injections with Hy- drocyanic Acid. By Dr. Bruni ib.

68. Case of Abscess in the Cavity of the Meninges, cured by the Application of the Trephine.

By M. Roux - - - 222

69. Case of Extirpation of a Can- cerous Tumour from the Axilla.

By Professor Lallemand - ib.

70. On Amputation of the Thigh at the Hip-Joint. By M. Del- pech 223

71. On Staphyloraphy. By M. Roux .... ib.

Mid wifebt.

72. Case of Rupture of the Uterus, and of the Safe Delivery of the Woman by the Caesarian Sec- tion. By Dr. Ludwig Frank 223

73. Case of Expulsion of the Pla- centa, Four Months after Delive-

iy - "m .., - - - 224

74. On Pregnancy, with Cancer of the Cervix Uteri. By Dr. Lau- breis 224

75. Detachment of the Placenta

by Injection of the Funis - ib.

Medical Jtjbispbudesce,

76. Case of Sulphuric Acid detect- ed in the Foetus of a Woman who poisoned herself with Sulphuric Acid 225

77. Case of Poisoning by Sulphu- ric Acid. By Dr. Lebidois ib.

78. Experiments serving to deter-

mine the Question, whether, in cases of Poisoning, it is possible to discover the nature of thePoi sonous Substance, even a long time after death. By MM. Or- fila and Leseur - - - 226

CONTENTS.

Chemistry.

79. Analysis of the White species of Ipecacuanha. ByM. Vauque- lin 229

). Analysis of a specimen of Cu- taneous Perspiration. ByJ.Bos- tock, M. D. ... 229

Miscellaneous.

81. Seven Epileptic patients de- stroyed by excessive doses of the Hydrocyanic or Prussic Acid, prescribed by the physician of one of the principal hospitals in Paris. By Dr. A. N. Gendrin 230

82. Encyclopedial Dictionary of the Medical Sciences - 231

83. Institute for the Blind at Co- penhagen .... ib.

84. Yellow Fever. By Dr. Cher- vin 232

85. Vaccination in France - ib.

86. Secondary Symptoms of Sy- philis after various modes of treatment - ib.

87. Anatomical Collection at Bres- lau 233

88. Prize of Experimental Physi- ology .... ib,

AMERICAN INTELLIGENCE.

On Dengue. By Isaac Hays, M. D. &c. - - - - 233

Description of an Instrument for Separating the Sternum. By W. E. Horner, M. D. - 242

On the discharge of various mat- ters from the Trachea. By J. R. Coxe, M. D. - - - 243

On Prussiate of Iron in Intermittent Fevers. By William M. Fahnes- tock 244

A Case of Tetanus, accompanied and followed by a severe Affec- tion of the Muscles of the Right Arm and Shoulder, successfully

treated. By George W. Sted- man, M. D. of St. Croix - 244

On the Use of the warm Sand-bath in Tetanus. By George W. Stedman, M. D. of St. Croix 247

A Case of Swelling of the Ancle- joint cured by Acupuncturation. By Dr. John Davis, of Jackson, Tennessee - ib.

Jackson's American Practice of Medicine .... 248

Hatin's Compendium of Operative Midwifery - ib.

Works Preparing for Publication ib.

PageJ.

Plate.!. Vol.3.

THE

AMERICAN JOURNAL

OF THE

MEDICAL SCIENCES.

Art. I. On an Operation for the Cure of Natural Fissure of the Soft Palate. By John C. Warren, M. D. Professor of Anatomy and Surgery in the Medical Institution of Harvard University, Boston.

Some years ago I had occasion to perform an operation for reme- dying the natural fissure in the soft palate. At that time I understood the operation had been once done in Poland or Germany, and once by Professor Roux$ but I sought in vain for details which might as- sist me in its performance. However, I executed it satisfactorily then, and have since repeated it; and therefore believed that an account of the manner in which it was effected might be useful, although I sup- pose it very possible that Professor Roux and others may have de- vised more ingenious methods.

As the operation in the first case succeeded, and was imitated in the others, I shall describe it in connexion with that case. The pa- tient was a healthy young woman of sixteen. She was induced to apply for an operation, in consequence of the impracticability of dis- tinctly articulating her words, so that her speech was offensive from its guttural tones, and not intelligible to those unaccustomed to it. The fissure began at the edge of the os palati, where the fleshy mem- brane was so thin as to be transparent. Its width was about three= quarters of an inch.

The patient being well supported and secured, a piece of wood an inch wide, a little curved at the end, with a handle to be held by an assistant, was placed between the molar teeth on one side, to keep the mouth open. A sharp-pointed curved bistoury was thrust through the top of the palate, above the angle of the fissure, and carried down on one edge of the fissure to its extremity. The same was done on the opposite side, thus cutting out a piece in the form of the letter

No. V.— Nov, 1828. [1]

2 Warren's Operation for Natural Fissure of Soft Palate.

V, including about a line from each edge. Next a hook with an eye in its extremity, of the form represented, in PI. I. armed with a triple thread of strong silk, was passed doubled into the mouth, through the fissure and behind the palate. The palate was pierced by it, at one-third of the length of the fissure from the upper angle of the wound, so as to include about three lines of the edge of the soft pa- late. The eye with the ligature being seen, the latter was seized by a common hook and drawn out. The eyed hook was then drawn back, turned behind the palate, and the other edge transfixed in a similar manner. A second and a third stitch were passed in the same man- ner, the third being as near as possible to the lower end of the fis- sure. Then seizing the upper ligature, I found no difficulty in tying it with my fingers, without the aid of a serve-noeud. The others were tied in the same manner, and the knots placed on one side of the wound, in order to prevent their pressing into the fissure. On drawing the third ligature I had the satisfaction to see the whole fis- sure closed.

The patient was exhausted by the operation, but soon revived. She passed twenty-four hours without speaking, or taking a drop of liquid in her mouth. For two days more she took only a little water. On the fourth day I ascertained that the edges of the wound had per- fectly united, except at the lower extremity, where a slight separa- tion took place, which afterwards united by means of an additional stitch. At the end of seven days I cut out the stitches, which were already loose. This patient left the hospital a day or two after. About two years subsequent to the operation I saw her, and found she swallowed perfectly, spoke very well, and was daily improving.

During the prevalence of the influenza of 1826, I operated with some reluctance on a lad of eleven years old, who had been brought a great distance for the purpose. A perfect union was effected: but at the end of three days he was seized with the influenza, and not understanding how to manage his cough, he tore open the adhesions, and I at once removed the stitches. This occurrence has led me to advise against the operation in children. The boy spoken of will un- dergo it a second time in the course of the next year.

The principal difficulty I met with in this operation, was in disen- gaging the ligature from the hook, after it had perforated the palate. In order to obviate this, I had hooks of various forms made after- wards by Weiss, of London; but none of them answered the purpose so well as the one here represented. I have thought that one with a moveable point, made to slip from a socket in the hook, so that the point and the ligature might be drawn out together, would lessen

Dickson's Account of the Dengue.

3

this difficulty, and have had one constructed by Rose & Sellers, of which a drawing accompanies this paper. This has the same form as that I first used, but that the point is removeable.

If a needle without the moveable point is used, care must be taken in drawing out the ligature to draw on each side from the concavity of the hook. If attention is not paid to this, it may happen, that in drawing out the ligature on the first side, you entirely disengage it from the hook, which must then be armed anew. And again, when you draw out the ligature on the second side, the hook may be re- tained by the ligature, which cannot then be withdrawn, unless the stitch is drawn from the wound. This last would be a worse mistake than the other. Both of these accidents are avoided if the point be move- able. In this case the point and ligature are withdrawn together, by passing a common hook through the eye of the point. The point is to be armed anew with the opposite end of the ligature, and then pass- ed on the second side of the fissure as on the first. There can be no danger of the point falling down the patient's throat, since it is se- cured by the ligature.

I have been very desirous to try this operation on the case of natu- ral fissure of both soft and hard palate, such as often accompanies the hare-lip. In such a case it might be justifiable to- try the opera- tion on an infant; for if a union of the soft palate could be procured at an early period of life, it is quite probable that a disposition would be produced to fill up the bony fissure.

Whether in an adult any benefit could be derived from such an operation is doubtful. I shall embrace the first opportunity of making the trial.

Art. II. Account of the Dengue, as it appeared in Charleston, S. C, during the Summer of 1828. By S. Henry Dickson, M. D. Pro- fessor of the Institutes and Practice of Medicine in the Medical College of South Carolina.

About the end of June, 1828, a singular disease made its ap- pearance in our city, through which it spread with unexampled ra- pidity, soon bringing under its influence the greater part of our po- pulation. The name by which I have designated it is a Spanish term, and was first affixed to it, as far as I can learn, in the island of Cuba. Its application is arbitrary; the various explanations offered respect- ing it being far-fetched and unsatisfactory. Our spring and summer

4

Dickson's Account of the Dengue.

had been dry, pleasant, and temperate, and with the exception of whooping-cough, which prevailed through April and May, uncom- monly healthy. Few attacks of ordinary endemic fever were met with, and these few were particularly manageable.

In the numerous cases of Dengue a very great variety of symptoms were presented, numerous modifications being occasioned by age, constitution, and other circumstances of the sufferers. The attack was rarely preceded by a formed chill. In general the earliest indication of seizure consisted in a painful affection of some part of the body, some limb, joint, or muscle. The wrist, the ancle, the back, the knee, nay even the extremities of the toes and fingers were thus selected. In one case a single finger became stiff and swollen some time before any other symptoms were felt. I saw a child eat a hearty breakfast, after complaining of pain in his foot his hand became stiff next, then his knees; the disease developing itself thus gradually during a space of at least five hours before there was any regular febrile exacerba- tion as denoted by change in the pulse, breathing, heat of the sur- face, &c. In a very old woman all the fingers were at once attacked they were bent and could not be straightened and the intensity of pain was such as to occasion tears with loud sobs and screams. In a stout young man this pain in the very ends of the fingers was such that he cried bitterly. After these local pains had endured for a greater or less period, fever came on with its usual concomitants, headache, red eyes, full, abrupt, frequent pulse, hot, pungent, dry skin, pain in the back, restlessness. The fever did not remit, but was usually of short continuance; from eighteen to forty-eight hours, the average perhaps being about thirty-six. There was some- times nausea and vomiting, though in a very large majority of cases in the early stage of the disease, the stomach was quiet and the tongue clean. It was more usual to find excessive determination to the head. I met with several instances in which delirium was among the first symptoms, coming on with the commencement, and going away at the subsidence of the febrile exacerbation. The skin I have said was hot and dry at first; it soon however became relaxed, and an abundant perspiration was thrown out, attended occasionally by a sort of rash or miliary eruption. This eruption appearing in the first stage of Dengue, was very various and by no means regular or charac- teristic. Children were often thus affected by it, and in several adults a thick crop of pimples was the first token of disorder. These usually disappeared in a day or two. On the subsidence of the febrile excite- ment, the extreme suffering from the local affections above enumerat- ed was somewhat diminished for the most part, but they did not by

Dickson's Account of the Dengue,

5

any means absolutely disappear, swelling, stiffness, and tenderness of the diseased parts remaining for many days. This state of things con- stituted a sort of deceptive interval between the first and second stages of this strange disease. In the mean while many patients believed themselves well, and resumed their ordinary occupations, but their sufferings were by no means ended. On the third or fourth day, there being no fever present, or a very obscure degree of it, the tongue would begin to be coated with a yellowish fur, and the sto- mach would exhibit much uneasiness and distress. The patient was low-spirited, impatient, fretful, and at night exceedingly restless. Many, and myself among them, regarded this as the most oppressive and insufferable stage of the attack. There was now not uncommon- ly nausea and vomiting, with great languor, lassitude, and debility. About the sixth day these symptoms were more or less relieved by the coming out of an abundant eruption, which I am disposed to re- gard as an essential or characteristic part of the disorder. It con- sisted in irregularly-shaped patches, red and elevated; the feet and hands swelling with a sense of thickening and numbness. There was much itching and burning of the skin, and at this time a second fe- brile paroxysm often came on, and the pains of the joints were in many aggravated to their former severity. I saw several cases in which the first stage of the disease, including both local pains and general fever, had passed over with very little notice or complaint, in which this second stage was very violent. Many became sensible on the third or fourth day of an inflammation and enlargement of the lymphatic glands, in the groin, axilla, on the neck, &c. and these continued swollen and painful for a length of time after convalescence was fairly established.

Very young children were liable to the disease, even from a few days after birth; some were supposed indeed to be born with it. The circumstances which induced the belief of their being thus affected were as follows— the skin was of a scarlet red, the tongue and lips smooth and fiery, the child could not bear to be disturbed, screaming violently if lifted from its place or if any of its limbs were moved. Below five years of age convulsions very commonly attended the in- vasion, and sometimes continued with great frequency throughout the whole of the attack.

Pregnant women were very liable to abortion, and a very remark- able number of instances of such miscarriage occurred among them. They were usually seized at the very commencement with violent pains in the back and loins, extending downwards into the thighs, ul- timately occasioning the expulsion of the foetus.

6

Dickson's Account of the Dengue.

In very old persons, the disease at once occasioned great debility and excessive prostration. In one who had previously suffered much from rheumatism, there was a sort of paralytic affection of the limbs, which could merely be moved, but not to such an extent as to be used in any degree. In several elderly persons there was left behind an erysipelatous inflammation of one or both legs. In many, regular rheumatic inflammations of some joint or joints supervened during convalescence. In two young individuals, however, who had been martyrs to rheumatism, there was evident relief from the chronic stiff- ness and immobility of limbs and muscles, under which they had long laboured. In one the relief was absolute and entire, in the other partial and imperfect, yet notable in degree.

A sore mouth was among the symptoms of Dengue. It usually ap- peared before or about the time of the eruption. This was often at- tended with a free flow of the saliva, and a looseness, iividness, and sponginess of the gums, bearing a close resemblance to the cir- cumstances of ptyalism. Ulcers formed in the mouth, which were very painful and irritable, and healed very slowly. In two patients there was haemorrhage from the gums and fauces. The most ordinary consequences of Dengue were in the first instance the production of a permanent and remarkable degree of languor and feebleness, and beyond this, and somewhat less universally, a liability to very acute pain in some joint or muscle, attended perhaps by swelling and ten- derness; this was variable, and shifted singularly from point to point; in the knees to-da}', in the ancles to-morrow, and the wrists the next day. In the greater number those joints or parts which had been at- tacked in the first stage of the disease were specially thus tortured, but the pains