Take, says he, any quantity of livers of cod, throw them into a very clean iron pot, and place it on a slow fire, stir them continually until they break down into a kind of pulp; water and oil will have separated. When a thermometer plunged in the pulp will have risen to 1920, the pot should be taken from the fire, its contents transferred to a canvass bag, and a vessel placed underneath. Oil and ́some water will run through. After twenty-four hours, separate the former by decantation, and filter it through paper.

This oil, thus prepared, is of a pale yellow colour; its smell is weak, and resembles that of a cod boiled for the table when in excellent condition. Its taste is bland, by no means disagreeable, and as might be expected, is totally free from rancidity. It is very liquid. Its specific gravity in my trials was 0.934, although in all the published tables of specific gravities it is stated to be 0.923. In cold weather it deposits much stearine, and this ought not to be separated.

The product of pure oil is very variable. He has obtained so much as a gallon (wine measure) from twenty-eight pounds of livers, the produce of fifty cods. Sometimes the livers will afford much less. The runnings of the first heat only should be used: a second heat will supply more oil, but it will be comparatively strong-smelling, ill-tasted, and deep-coloured. The above estimate is true only when the fish is in the best season, and fully grown. Towards the close of the season the produce will be less. The livers of some cods are flaccid and lie flat without plumpness on a plane surface. These afford a deficient quantity of oil, a brown, strong-smelling quality, and a large portion of brown water: they are totally unfit for use, and their oil is disgusting. The livers are often found diseased and dark-coloured; such afford a very bad oil, and are of course to be rejected.

On the west coast of Ireland, they consider the beginning of the year the best season, and on the east the month of November for the cod-livers. Thus, concludes Mr. Donovan, in preparing cod-oil fit for medical purposes, three chief things are to be attended to: the livers must be perfectly healthy; they must be as fresh as possible, the least putrescency being injurious; and the heat at which the extrusion of the oil is effected must not exceed 1920.

RIGIDITY OF THE LOWER JAW, cured by DIVISION OF THE ANTERIOR PORTION OF THE MASSETER MUSCLE.*

Dr. Mutter relates this case in our transatlantic contemporary. In January, 1839, he was requested to visit Harriet Wolcott, aged 16, for an affection of the mouth under which she had been labouring since her fourth year, and which followed inflammation of the cheek. Upon examination the left side of the jaw appeared much smaller than the right, and the integuments about the chin (on the same side) were much more closely connected with the bone, than is usual. The whole left half of the inferior maxillary bone, is in reality smaller than the right, and instead of presenting the natural angle at the junction of the ramus with the horizontal portion, is rounded off, so that it appears much straighter than it should be. There is no scar, nor any evidence of previous ulceration either within or without the cheek, neither does there exist any adhesion between the cheek and bone, but a strong fibrous band formed of the anterior portion of the masseter muscle was readily detected by introducing the finger between the teeth and cheek. This band is so short as effectually to prevent any thing like motion (except to a very limited extent) of the inferior maxillary bone, and the space between the upper and lower teeth is so small that an instrument

* American Journal of Medical Sciences, May 1840.

only three lines in thickness can freely be introduced between them. The patient is of course unable to chew, and has lived almost exclusively upon broths; nor can she protrude the tongue; and her teeth, in consequence of the impossibility of passing a brush between them, are in a very bad condition. Her articulation is also exceedingly defective.

Dr. Mutter thought it adviseable to divide the masseter muscle, and afterwards, by a lever, gradually force the jaws apart.

66

Having placed my patient in a good light, I passed the forefinger of my left hand along the space between the cheek and teeth until it was arrested by the band already alluded to. She was then requested to open her mouth as much as possible in order that the band might be put upon the stretch -Using my finger as a director, I next passed along it, an instrument shaped like a common gum lancet, though larger, and having but one cutting edge, until its point rested behind the band. By pressing firmly upon the handle, the blade was made to penetrate the masseter muscle about its lower third, until the point could be felt between the muscle and integument. The band was then divided by drawing the knife forwards and at the same time directing it outwards and downwards. The section was indicated by a slight snap, and the propriety of the operation at once made manifest by the improvement in the case. For example the finger could now be passed between the teeth, which before the operation was impossible.

Dr. Mutter now introduced the lever that he had prepared with a screw, and afterwards gradually separated the jaws by means of it. At the end of six weeks, when the report closes, the space between the teeth was one inch and three lines, and the patient could chew as well as ever.

CASE OF IMPERForate Vagina, and Menstruation (from the BladDER?)*

Ellen Sn, æt. 40, and married ten years, presented herself as an out-patient at St. Thomas's Hospital, under the care of Dr. Cape, on Friday, April 24, 1840. She complained of a hard and painful tumour, about the size of a melon, situated in the uterine region, which could be felt above the pubis. She had no discharge, and her general health was not impaired. On examination per vaginam being attempted, no vagina could be found. She was then requested to retire to one of the female wards, where she submitted to an ocular examination; the labia, nymphæ, clitoris, and all the external organs of generation, were quite normal, with the exception of the vagina, which was totally imperforate, not amounting even to a cul-de-sac; being perfectly flat and unyielding, with a granulated red surface. On examining per anum, the tumour could be very distinctly felt, painful on pessure, and apparently of a subcartilaginous character. She has menstruated regularly ever since she was thirteen, the period lasting four days, and of the usual quantity.

On the 15th of May, the catamenia being present, it was thought a good opportunity for ascertaining whence the discharge flowed, as, on the previous examination, the only aperture visible was the orifice of the urethra; when it was seen distinctly exuding guttatim from the meatous urinarius.

* Med. Gazette, June 26, 1840.

MALFORMATION OF THE ESOPHAGUS.*

This case is communicated to our contemporary by Mr. Mellor, of Charltonupon-Medlock, near Manchester.

"In the month of August 1839, Mrs. P., the mother of four healthy children, was delivered of her fifth, a fine, well-formed infant, after a perfectly natural labour of a few hours duration. When in due time the infant was put to the breast, it was observed that the nipple was scarcely retained in the mouth beyond a minute, when the little creature became apparently convulsive, and almost instantly rejected the nutriment which it had taken. On my subsequent visit I was made acquainted with the above particulars, when I felt disposed to assent to the opinion expressed by the mother, that flatulency might be the cause of the symptoms, and accordingly prescribed a simple carminative. This was almost immediately rejected, as the milk had been, the infant notwithstanding manifesting the greatest eagerness to supply its instinctive wants. Inferring the existence of some obstruction in, or malformation of the oesophagus, I attempted to pass a common bougie, which however proceded only for a very short distance, and then became curved upon itself, apparently not having arrived further than the commencement of the oesophagus. Matters went on in this way for six days, no other evacuation having taken place from the bowels than the meconium, and the infant continuing to apply its mouth to the breast with no other result than that of a slight convulsive paroxysm so soon as the pharynx became filled, and the immediate repulsion of its contents. Early on the morning of the seventh day it died, when a post-mortem examination disclosed the existence of little more than the membranous pouch of the pharynx, which terminated in a cul-de-sac a little below the cricoid cartilage, no trace of the œsophagus being visible beyond this part. The stomach presented no deviation from its ordinary form and dimensions, with the exception of its cardiac orifice, where there existed a slight bulging at the part corresponding with the termination of the gullet, and which was firmly united to the diaphragm. Further, a probe, introduced at this aperture, could not be made to pass into the stomach. Between this point and the sternum not the slightest trace of œsophagus, or any bond of connexions whatever with the pharyngeal portion existed. The stomach contained nothing but air and a little mucus; the other viscera appeared perfectly normal.

In juxtaposition with the foregoing case of defective conformation, I may mention an instance lately communicated to me by Mr. Heath, a highly respectable practitioner of this town. In this, the infant, which was of ordinary size, presented symptoms very analogous to those above described, and survived until the eighth day. On inspection after death, the duodenum was found obliterated to the extent of an inch or more, no further malformation having been observed."

ANALYSES OF THE MINERAL WATERS AT Brighton.

We extract the following Table from a pamphlet recently published by Mr. Pickford, on the Artificial Mineral Waters prepared at Brighton. So many invalids are sent to that watering place, that it may be useful to many of our readers to see, at a glance, the composition of the waters prepared there.

* Med. Gazette, June 26, 1840.

INFLUENCE OF THE LEFT BRONCHUS IN CLOSING THE DUCTUS ARTERIOSUS.* Mr. T. W. King, Curator of the Museum of Guy's Hospital, advances the following hypothesis to account for the rapid closure of the ductus arteriosus after birth.

"In foetal life the air-tubes contain only a little fluid; they are probably but partially expanded, while the circulation is nearly single and equable, the auricles pretty equally full at all times, and the ventricles equally powerful. The chest continues of limited capacity; the diaphragm high, and the lungs confined about the heart. We may now reflect upon the principal effects of the first inspiration: a general expansion is made, which is never again to have its commensurate collapse; and, although that fulness of the lungs (as to air) which may be regarded as necessary and permanent, be not obtained till later, it seems pretty evident that the first inspirations must have a far larger share than any others in effecting this condition. Now the trunk becomes straighter: the neck is no longer bent forwards on the breast, and the trachea is elongated; the diaphragm, and with it the heart, is considerably drawn down, while the lungs are generally expanded, but most particularly outwards: and one particular result of all these changes, I imagine to be, that the left bronchus is rendered more full and tense, and also raised at the same time that the ductus arteriosus is drawn down with some force, and perhaps with some disposition to elongation. In fine, it is to the sudden and intimate cross contact of these two tubes that I would mainly attribute the closing of the blood-vessel, which is in a manner bent over the bronchus, and has also a more oblique direction given to its communication with the aorta."

We confess that we are inclined to attach more importance to the indraught of blood into the lungs, which inspiration must occasion, than to the mere stretching of the bronchus. Our readers, however, will judge for themselves. Mr. King's view is certainly ingenious.

RUPTURE OF THE HEART INTO THE PERICARDIAL SAC.

HOURS.

LIFE FOR TEN

Dr. Stroud relates the following case. Case.--Frederick P., aged 29, after anxiety and vexation endured for a considerable time, and after having been liable to profuse bleeding of the nose, during the spring season, for many years, was, on the non-occurrence of this bleeding, subject for six weeks to a sense of fulness in the head, with lassitude and somnolency. On the morning of April 27, 1839, after having returned from Covent Garden Market, he was seized with faintness, giddiness and vomiting, and insensibility. The pulse became imperceptible, and he was apparently in a dying state. He was promptly bled by Mr. Symes, to three pints, recovered a little, continued complaining of great tightness of the chest, and weight at the heart, but died the same evening.

The pericardium contained a quart of blood which had escaped through an opening in the right auricle just below the insertion of the vena cava superior, the edges of which were not attenuated or apparently ulcerated. The author accordingly suggests the prudence of relieving plethoric oppression, even where signs of structural disease in the sanguiferous system are not evident. In this patient the heart was large, and loaded with fat.-Med, Gaz. June 19, 1840.

* Med. Gaz. July 10, 1840.