Botany, Medical Jurisprudence, and Natural History; 4th. Obstetrics; and 5th. Chemistry and Materia Medica.

At the commencement of the year 1839, the organisation and discipline of the University were remodelled, and some changes were made in the Medical School. The medical students receive constant instruction in the hospitals.

These particulars are extracted from a paper by Pliny Earle, M.D. in the American Journal of the Medical Sciences, for February, 1840.

SECTION OF THE HAMSTRING TENDONS, FOR CONTRACTED KNEE-JOINT.
By DR. BURLEIGH SMART.*

CASE. A scrofulous boy nine years old. The knee of the left leg began to enlarge, on each side of the ligament of the patella, six years ago, accompanied with a slight lameness in walking,-no pain, tenderness or redness. At this time there was a perceptible tightness of the tendons in the ham, and a disposition to flexion of the limb when in a recumbent posture. This thickening of the integuments of the joint, was followed by an apparent enlargement of the articular extremities of the bones of this joint. The enlargement, however, never became very great, sufficiently so, to render it distinctly perceptible at sight About two years since, the boy was found to be affected with an angular anterior curvature of the spinal column, at the junction of the lumbar, with the sacral vertebra; and the knee-joint more flexed, other appearances of the joint remaining the same. At this time the general health, always good before, appeared to be affected-some loss of flesh and strength, and restless nights. By the use of moxa and caustic issues, each side of the angular projection, kept open for about eight months, and the internal use of sarsaparilla, soda, and the hydriodate of potassa, the disease of the spine was apparently cured. But now there was a considerable degree of stoop, or inclination forward, given to that portion of the trunk above the pelvis. In this state Dr. Brown, Boston, being consulted, advised the application of a mechanical apparatus, to be constantly worn, together with the use of an inclined plane; which seemed to afford important aid in rectifying the forward inclination of the trunk. But as the straightening of the spinal column progressed, an increase of the flexion of the knee was observable.

For the period of about five years, this lad, in walking, has been able to bring only the toes and ball of the foot to the ground; the heel not coming to the ground, in the ordinary step, by the distance of between two or three inches, the latter part of that period of time. The leg has been a little smaller than the other, below the knee, ever since the commencement of the distortion.

On the 15th of November, the tendons of the biceps flexor cruris on the one side of the popliteal depression, and of the semi-tendinosus and semi-membranosus on the other, were divided, about two inches above their insertion. The operation was performed with a slightly curved and sharp-pointed bistoury, which was introduced with the flat surface parallel and close to the inner side of the tendons, with the point upwards, and penetrating sufficiently deep to hook the point of the instrument under the tendon, by gently depressing the handle and turning the blade of the bistoury on its own axis, until it revolved a quarter of a circle, and the edge was presented transversely to the tendon. Then, by a gently sawing motion, depressing the handle, and at the same time elevating the point of the instrument, the parts were divided with but very trifling pain. The punctures were accurately closed by court and adhesive plaster, and a

* American Journal of Medical Sciences, Feb. 1840.

www

compress and bandage were applied, with a crooked splint outside the bandage; the limb having been extended about two inches, measured at the heel, before the dressings were applied. The flexion of the leg previous to the operation was about 40 degrees.

The 8th day subsequent to the operation, no pain or troublesome inflammation having supervened, a carved wooden splint, with its cavity padded. and having a hinge joint at the knee, by which the two parts were connected, was applied and confined with broad padded straps passing from one side of the splints to the other, fastening with buckles above and below the knee. On the posterior surface of the splints was fixed a screw, connecting the two splints; by the daily turns of which, the limb was gradually extended until it became very nearly straight, which was effected in a fortnight after the extending apparatus was applied, and three weeks after the operation.

This patient commenced walking as soon as the extending apparatus was applied. He is now able to walk with or without it, bearing his weight on the entire length of the foot; he can place the heel on the ground at every step, which he had not been able to do for about five years.

OBSERVATIONS ON THE EMPLOYMENT OF CIMICIFUGA IN THE TREATMENT

OF CHOREA.*

The cimicifuga, known in America under the common name of black snake root, has been recommended by Dr. Young of Pennsylvania, as a remedy for chorea. Dr. Kirkbride has just published seven cases in which he tried it. He concludes them by observing:

"We feel satisfied of the value of the cimicifuga, in the treatment of chorea, and disposed to attribute to it powers in some other affections in which we have not yet had an opportunity of giving it a satisfactory trial. After the details we have given, it is hardly necessary to say, that we do not look upon it as a specific in chorea. We have scarce ever met with a case where the primary treatment was not plainly indicated by the disordered digestion, the loaded bowels, the pain or heat of the head, and the languid circulation of the skin. But it is also right to state, that where these symptoms have been properly treated, the involuntary muscular movements, have often continued unchanged, until after the employment of the black snake root. Purging we have always used before the cimicifuga, and general frictions with salt or the flesh-brush, and pustulation with croton oil over the spine, we have believed to be of much value in the chronic cases. Of the two preparations we have employed, we are disposed to give the powdered root the preference, and now regret that we did not administer large doses in that form in our fifth case, where the decoction certainly had no effect."

CURE OF SQUINTING BY DIVISION OF THE RECTUS INTERNUS MUSCLE. This operation is beginning to attract attention, indeed it may be looked on as already an established one. Proposed, and first, we believe, executed by Dieffenbach, it has been taken up by Dr. Franz, and by several surgeons in town, and the cases in which it has been resorted to are respectable in appearance and number. As Dr. Franz's cases have had the priority of publication, we think it only fair to notice them. We shall select the first case.

* American Journal Medical Sciences, Feb. 1839.

CASE-Louisa M'Cleish, aged 18, affected with squinting since the age of two years. "On examination, I found the left eye slightly inverted, but the right eye so much turned inwards, that one third of the cornea was hidden by the inner canthus. She stated that the right eye was larger than the left, having been frequently told so by others; but this I found to be an error, probably arising from the circumstance that so little of the cornea was visible, whilst a large portion of the sclerotica presented itself. With considerable exertion of will she was scarcely able to direct the right eye so as to look straight before her, and could not in the slightest degree move the globe towards the exterior angle. When not under the influence of the will this eye instantly returned to its usual position inwards. On closing the left eye she could only distinguish large objects, and was not able to read even the largest print.

Having provided myself with three assistants, the patient, whose left eye was closed by a bandage, was seated facing the light with her head inclined backwards, in which position it was retained by an assistant, who at the same time fixed the upper eyelid with a retractor. A second assistant kneeling before the patient, fixed the lower lid by means of a retractor, held in his right hand; the eyelids being by these means well secured and drawn asunder, I perforated the conjunctiva at the inner corner of the eye close to the eye-ball, with a small and very sharp hook, and gave it to the second assistant to hold with his left hand, with which he was, by means of this hook, to draw the globe outwards. I next made a semicircular incision with a scalpel through the conjunctiva, about six lines in length; then dissecting through the subjacent cellular tissue, exposed the internal rectus muscle, and terminated the operation by dividing it close to the sclerotica with a very small pair of curved scissors, the one blade of which was passed beneath the muscle. The duty of my third assistant was to hold the patient's hands, reach me the instruments, and attend to the bleeding, which in this case was very inconsiderable. On the removal of the hook from the conjunctiva, the eye-ball was no longer inverted, but stood in the proper position, the pupil occupying the centre of the eye. The edges of the wound in the conjunctiva were brought together by the motions of the eye itself, which were perfectly free in all directions, except inwards. Cold water dressings were ordered, and a common draught. The patient then walked home.”*

Mr. Mayo, Mr. Liston, and others, have performed this operation. It is probable that the simple, division of a single muscle will be found inefficient in some, if not in many, cases, and no doubt experience will suggest modifications in the method.

STUDENTSHIPS IN ANATOMY.-COLLEGE OF SURGEONS.

It is with great gratification that we publish the following: The President and Council have great pleasure in announcing to their members, that three Studentships in Human and Comparative Anatomy have been instituted by the College, to be held respectively for the term of three years, with the annual stipend of one hundred pounds attached to each studentship; and that, at the instance of the Director-General of the Medical Department of the Army, the Physician-General of the Royal Navy, and of the Chairman of the Honourable East India Company, the General Commanding the Army in Chief, the Lords Commissioners of the Admiralty, and the Court of Directors, have, with the view of promoting the objects of the College, been pleased to place at the disposal of the President and Council an Assistant-Surgeoncy, in each service, once in three years, for such of the said Students as may be considered worthy of these honourable distinctions.

The President and Council have also the pleasure to announce, that, with the view of

*Med. Gaz. April 17, 1840.

rendering the prizes granted by the College more worthy of competition amongst their younger members, they have augmented the collegial (Triennial) Anatomical Prize from thirty to fifty guineas; and have added ten guineas to the like sum, allotted by its founder, to the Jacksonian (Annual) Surgical Prize.

(By Order)

May 18, 1840.

EDMUND BELFOUR,
Secretary.

RETURN OF CASES OF HYDROCELE TREATED AT THE NATIVE HOSPITAL, CALCUTTA, AFTER THE PLAN OF J. R. MARTIN, Esq. BY A RETAINED INJECTION OF SOLUTION OF TINCTURE OF IODINE, from the 9th March 1832, to 31st December, 1839.

The failures from first to last would appear to be about one per cent., or rather under it. There were, of reported failures, six cases, up to 1837, of which three were out of twelve cases treated experimentally by undiluted port wine instead of the iodine solution. Nine cases were treated at once successfully, up to 1837, by the iodine solution, in which the solution of port wine and sulphate of zinc had failed. Of late years it would appear that a large proportion of those treated are natives of Orissa, where hydrocele would seem to be endemic. No ordinary complication has interfered with the operation, and it has now superseded all others in India.

N. B.-The details of treatment will be found at pages 204 and 411 of the 7th volume of the Medical Transactions of Calcutta, and at page 12 of the Quarterly Journal of the Medical and Physical Society of this City.

(A true copy)

P. O'BRIEN, 1st. Assist. Native Hospital.
J. R. MARTICE.

Native Hospital Calcutta, 1st. January 1840.

UNFERMENTED BREAD.

The profession is aware that Dr. Whiting, a few years ago, took out a patent for bread prepared without yeast, by combining muriatic acid and carbonate of soda, so as to produce common salt in the dough. From some cause or other, Dr. Whiting's bread did not take with the public, though it certainly was a wholesome composition for weak stomachs. Mr. Dodson, of Blackman street, Southwark, has much improved upon Dr. Whiting's formula. We have been using his bread, prepared in the same manner as Dr. W's., but with larger proportions of the muriatic acid and soda, for some months, as have several of our ends and patients. We can speak to its wholesome qualities, and to the ease

with which it is digested, without turning acid on the stomach. We recommend our dyspeptic friends to try it-especially the brown bread, of which all our patients highly approve. Mr. D. has extended the same process to several species of pastry, and, we think, with much success.

TESTIMONIAL TO SIR B. C. BRODIE, BART.

All who are anxious to see professional honour and talent appreciated, will be glad to find that a subscription has been set on foot, for the purpose of presenting a Testimonial to Sir Benjamin Brodie, on his retirement from the office of Surgeon to St. George's Hospital. The motives which led to that step were so conscientious, and the step itself so unusual a sacrifice of emolument and influence to a fine sense of propriety, that it would be a wrong to Sir Benjamin Brodie individually, and a more serious wrong to the best interests of the profession, were it allowed to pass unsignalized by some exhibition of public feeling. Sir Benjamin Brodie's retirement from the hospital is, unfortunately, the termination of the more active and onerous part of his career, and in receiving a testimonial on such an occasion, he may be said to obtain during his life-time something like posthumous fame. And who can merit that more than Sir Benjamin Brodie has done? With a zeal that never flagged, and industry that would not submit to the restrictions demanded by a constitution far from robust—with a singleness of purpose, we may add, of heart, which those who know him best, are the foremost to acknowledge-with a quickness of observation, precision of ideas, and correctness of conclusion that are admirably qualified for scientific investigations. Sir Benjamin Brodie commenced and carried on, with a success that needs no chronicle, those pathological researches which have been the foundation of his fame and fortune. A Testimonial to the man, is affixing the seal of public approbation on the qualities that made him what he is, qualities that, so esteemed, will become the heritage of younger minds. And what can be more agreeable than rewarding past and fostering future merit in the same breath? On the students, young and old, of St. George's Hospital, Sir Benjamin Brodie has a peculiar claim. Who does not know the urbanity of his demeanour, the punctuality of his attendance, the spirit of observation that he promoted, the studies that he encouraged, the example that he set! No man was, in every sense, more thoroughly the student's friend than Sir Benjamin Brodie has been. On the look out for merit, he always encouraged, always fostered, and not seldom fed it. Nor was his the cheap encouragement of words only, the open purse has often seconded the earnest exhortation; and the aid which he has given to the professional struggle of the young man, has been exceeded only by the munificence which relieved the distresses of the old.

To those who know Sir Benjamin Brodie, this picture will not seem overcharged. If any think it so, it is because a modesty, which in such cases amounts to a fault, and an aversion to publicity which is unjust to its possessor, have but too effectually concealed from common observation the most liberal feelings and most generous acts.

We trust that the subscription list will evince the respect that the profession entertains for one who still adorns it. May this Testimonial, the crowning honour of one scene of usefulness be the introduction to another. May the ease and dignity of a private practice, which, however great, is still inferior to his merits, enable its possessor to accumulate his experience, arrange its treasures, and leave to us as a legacy some, at least, of the knowledge he has hived, as well as the honourable name of which his professional and lineal descendants may be proud.