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"this subject, we have met with but few parallel cases. Dupuytren, in his Clinique Chirurgicale, has devoted a special article to wounds of the heart, in which he remarks " that penetrating wounds of the ventricles or auricles, provided they be narrow (étroites) are not necessarily and instantaneously mortal, but may even be healed; this is more especially tque of punctured wounds. For example in the chase, animals are often killed in the substance of whose hearts balls and well-marked cicatrices are met with, the results of former injuries. Cases in which all the rational symptoms of wounds of the heart were manifest have, nevertheless, recovered,--that one so especially remarkable, of a soldier, who died six years after recovering from a wound of the heart, and in whom a bullet was found imbedded in the substance of the right ventricle, near its apex, covered in part by the pericardium ; all these prove the correctness of this opinion.” As regard the time during which life may be
prolonged after the wound, he adds, “ A number of instances might be cited in which, after wounds of the entire thickness of the wall of the right ventri. cle, patients have survived through three, four, five, six, eight, and fourteen days; and of the left ventricles, five hours; other eases, in which both ventricles were wounded, have survived from five to twenty days.” In relation to their diagnosis, he adds, “ It is difficult to establish, because the symptoms are rarely combined (réunis); and it is this uncertainty which causes us to mistake the cure of a considerable number of penetrating wounds of this organ. It is not the less certain, however, that their cure is possible.” Senac, Morgagni, and others, have expressed the same opinion. We have been surprised to find so few cases recorded in the books; and we have derived but little information from surgeons of large experience. Dr. Vandervoort has kindly furnished us with two cases of gun-shot wounds, from the Edinburgh Journal, in one of which the ventricle was perforated and the ball found in the pericardium; patient survived fourteen days, without any marked symptoms of disturbance about the breast; in the other case, a wound of the auricle by a pistol ball, patient survived forty-four hours. A very interesting case of lacerated wound of the heart, furnished us by Dr. J. D. B. Stillman, was intended for publication in the present No., but has been crowded out. We hope that these remarks upon a subject of great interest, may be the means of exciting to farther investigation into the history of all cases hitherto recorded.
J. G. A. Constriction of the Jaw. We have lately received a letter from Dr. W. E. Johnston, President of the
American Medical Society in Paris, on the subject of a Thesis recently presented for the degree of Doctor of Medicine, by Mr. Sarazin, Chirurgien, Aide-Major at the Military Hospital at Val de Grace, Paris; a copy of said Thesis having been forwarded, by the same opportunity, to Prof. Mott. Dr. Johnston remarks, “ The facts as regards the Amer. ican operations were principally furnished by myself; and I am happy to add, that, for once, justice is done by a Frenchman to American originality in surgery.” The Thesis is before us, occupying forty-six pages quarto, being a
complete treatise on the “constriction des machoires,” its causes and treatment. M. Sarazin awards to Prof. Mott the honor of having performed the first successful operation on record; this was published in the American Journal of Medical Sciences, for November, 1829; he also alludes to fifteen other cases, operated on by the same surgeon with success. Velpeau, in the first edition of his Médicine Operatoire, published in 1832, makes no allusion to this operation ; but in his second edition, published in 1839 he does ample justice to Prof. Mott. Malgaigne, however, in his Médicine Operatoire, published in 1834, alludes to this method as completely successful. M. Velpeau has fallen into a strange error in describing the instrument invented by Prof. Mott to overcome the rigidity of the muscles and ligaments. He says, “ M. Mott has devised an instrument which acts at once in the manner of a wedge, lever, and saw.” M. Sarazin cannot conceive how the instrument alluded to can act by sawing, and inquires if there had not been some other modification adapted by Prof. M. We have received a letter from Dr. M. on this subject, an extract from which we have his permission to publish.
Dear Doctor.--I have carefully read Dr. Johnston's letter to me from Paris, received a few days since. He is desirous of knowing from me, whether the instrument alluded to in the Thesis of M. Sarazin, combines the saw with the screw and lever principle. I cannot imagine how this could have been asserted. I am certain that I have never so described it, and it can never be required in these operations. Hundreds who have seen me use it at the Clin. iques, can testify that no saw was ever connected with it, or required to be used. At the time I had the instrument constructed, I certainly supposed that it was a new invention, and continued of that opinion for several years. At the suggestion of some one, I was induced to look into Scultetus Armamentarium Chirurgicum, where I found an admirable delineation of it; since which period, I have uniformly mentioned to my classes, all the facts in relation to it. I did, therefore, claim the instrument, and still claim the operation as my own. I certainly never heard nor read of any thing of the kind, up the time of my first operation. * * * * I think now that there will be novelty and interest in my chapter on this subject, from the great number of cases upon which I have operated. But of this, hereafter, DR. ADAMS.
Yours, truly, V, MOTT. We are happy of the opportunity of having this matter cleared up by the letter of our distinguished fellow-citizen, who is admitted by all authorities to have done more for operative surgery than any other living member of the profession, in this or other countries. The mistake, probably, originated from the term saw having been mistaken for screw.
J. G. A. Academy of Medicine. — The March meeting was well attended, and rendered interesting by the reading of memoirs of Dr. J. A. Swett by Dr. McCready, and of Dr. McNevin by Dr. W. W. Jones. Those Fellows deserve the thanks of the Academy for having discharged the duties assigned them so promptly and so well. We trust that their good example may stimulate those long since appointed to a similar service, to discharge this religious duty at the earliest possible period. At the April meeting, papers will be read, by Dr. Buck, “On the treatment of badly united fractures of the thigh; and by Dr. J. W. Green, “On the effect of curare poison, as illustrated by experiments on ani. mals." We learn that the committee “on the employment of injections of nitrate of silver into the bronchial and tubercular cavities," will be soon prepared to report.
Personal. -Our remarks in the March No., upon the censors appointed by the State Medical Society, to attend examination of candidates, having been misconstrued, it is proper to state that they were intended to be applied to the manner in which they (the censors) were appointed (by open nomination during the hurry and confusion attendant upon the last moments of the meeting); and not to the individuals so appointed, many of whom, as is well known, are among our personal friends. The regularly elected censors of the Southern District were, of course, not intended. We are in favor of rigid examinations, and consider that the possession of a good moral character should, especially, be insisted on; which is known not to be the case under the present system. A board of censors, duly elected by the Academy of Medicine and the County Medical Society, would, with the State censors, in our judgment “ fulfill all the indications."
J. G. A. Erratum.-In Dr. Fisher's communication, p. 215, twenty-fourth line, for “ the cases bear no resemblance,” read “the cases bear a resemblance.”
Report of the Sanitary Commission of New Orleans, on the Epidemic
Yellow Fever of 1853 ; published by authority of the City Council of New Orleans. N. Orleans : 1854. pp. 542.
The duty of investigating the different subjects referred to this Commission was discharged by Drs. Anson and McNeill, Dr. Riddell, Dr. Simonds, and Dr. Barton; and the result is a volume unsurpassed in extent and variety of information respecting yellow fever, which reflects great credit both on the city which originated it and the physicians who have executed it. By far the most extended and elaborate of the separate Reports is that by Dr. Edward H. Barton, to whom was assigned the arduous duty of making " a thorough examination into the Sanitary Condition of New Orleans, and of all agents and causes influencing it during the present and previous years, and to suggest whatever in the evidence of the Commissioners would tend to improve and preserve the health of this Metropolis." This report, which occupies about two hundred and fifty pages, is illustrated by charts and tables, drawn up with great care, and embodies an amount of information which will be sought for in vain elsewhere. The range of his labors extends through all the realms of the yellow-fever zone, in both South and North Americas, and the West Indies. The conclusion to which Dr. B. arrives as to the cause of yellow fever is, that "the emanations arising from the upturning and exposure of the original soil in the summer season, together with filth, under certain determinate conditions, has been the main, if not the special cause, of every EPIDEMIC yellow fever that has ravaged not only this city (New Orleans) but the Southwestern part of the United States, for more than half a century." The causes of ENDEMIC yellow fever he considers to be the same, differing only in degree-varying only in extent of prevalence, and sometimes in malignancy; while a lesser cause of the same materials produces bilious and periodic fevers so that the difference between bilious and yellow fevers exists in degree only. Two principles are thought to have been settled by the Commission : that yellow fever is, and always has been, a preventable disease ; and that the presence of two general hygeinic conditions are absolutely indispensable to the origination and transmission of the disease—one of these atmospheric, the other terrene—both of which must meet in combination to produce the resnlt. According to the report of Dr. Barton, the total number of cases of yellow fever in New Orleans during 1853 was 29,020, of which number 8,100 died, being 27.91 per cent., or 1 in 3.58, a mortality less in proportion to the number of cases than has ever occurred in a great and malignant epidemic yellow fever. Fourteen physicians and more than thirty apothecaries fell victims to the disease, in the discharge of their respective duties. The subjects assigned to the associates of Dr. Barton were an inquiry into the origin and mode of transmission or propagation of the disease, the subject of sewerage and common drains, &c., and the subject of quarantine ; on each of which reports were made, which afford matter of interest, but of which our limits will allow of no further notice at present. What to Observe at the Bed-side and after Death in Medical Cases."
Published under the authority of the London Medical Society of Observation. Second American, from the second and enlarged London edition. Philadelphia: Blanchard & Lea, 1855. pp. 228.
The favorable opinion entertained of this work in our notice of the first edition of it, two years ago, is fully sustained by the fact that another edition has been so soon called for. The whole of the work has been carefully revised, and a section on Treatment introduced. The members of the committee who drew up the former edition were—Drs
. Walshe, Jenner, Snow, Beck, Hare, and Ballard. They have been assisted in preparing the present one by Drs. Reynolds and Lionel Beale, and Mr. Morris-a list of names which is a guarantee of care and accuracy in its preparation. We recommend it to those not familiar with it, as a work calculated to afford much aid in the observation and registering of cases, and well worthy of a place on the table, where it can always be at hand for daily use.
Ertracts from Journals.
Change of Life in Woman.- Abuse of the Speculum.-Injury to the
morale of the Sex. Dr. Joseph Parrish, late of Burlington, N. J., now of Philadelphia, has recently published in the “ New Jersey Medical Reporter," of which he was formerly one of the Editors, a series of Essays on “The Change of Life in Woman.” His remarks on this topic are characterized by such sterling and practical good sense, that we could wish to see them laid before the whole profession, not only in this but other countries. We are sorry to present them in a mutilated form, owing to our usual want of space; but we ask for them the special attention of our readers. - [Eds.]
It is a curious fact, that in cases where the menses are arrested by disease, the moral and mental phenomena are not perverted, as they are when a natural cause interrupts their regular appearance.
It is true the brain may be oppressed and the countenance dejected; and there may be pain, or a sense of weight and fullness in the head, perhaps. And while all these symptoms indicate a near sympathetic relation between the brain and the uterus, they present a modification which strikingly indicates the line between organic disease or disturbance, and the nervous or, as we have already called it, the telegraphic power, which maintains a relation or intercourse between the two.
In amenorrhea, for example, depending upon an atonic state of the system, or perhaps the result of cold or other accident, we see neither the morbid taste, which is exhibited in pregnancy, for strange and disgusting food, or none of the exquisite apprehensions which are constantly agitating the mind of the matron, as she approaches the last " critical period,” peculiar to her sex. It will not be denied we think, by any one of experience who has closely observed the psychical expressions of the female under the various manifestations of uterine disturbance, whether natural or morbid, that the brain maintains a nearer sympathetic relation with the generative system than any other organ of the body, with, perhaps, the exception of the stomach, which also participates largely in the disturbances induced through the nervous system. If it were not so, we might reasonably expect to find engorgement of the liver as well as of the brain, in the event of a suppression of the catamenia. We should expect our patients to refer to the hypochondriac region as often as to the cerebral, as the seat of uneasiness. And we see no reason why the con. tiguity of the bladder, the kidneys, or the bowels, might not render them as liable to take on sympathetic action, if it was not that the brain was ordained the guardian of that particular system of organs which refers to the production of intelligent beings. We must be careful not to lose sight, at this juncture, of the fact that since the womb has been an ac