PERIODICAL LITERATURE.

519

find it prescribed

to the ball with pimento, and also in both drenches and powders, as the principal means of suppressing glanders and farcy. So that it was" only with Mr. Clark that Mr. Roberton’s suggestions" were productive of any good effect, and this invaluable medicine, it appears, was subsequently brought under the notice of Mr. Vines, who has not been more successful than his predecessors in giving a sure diagnostic symptom of glanders, unless it be by his favourite phrases, " an

eopcels, p.27, extent of

we

seven

grains,

"

in

a

unhealthy discharge," unhealthy appearances, &c.," and how far this is calculated to shed light on the subject we must leave

PERIODICAL LITERATURE. AMERICAN MEDICAL JOURNALS.

SEVERAL of the American Journals are before us; the dates of some of them, however, are not very recent, in consequence of a delay which occurred in their transmission across the Atlantic. Amongst them we have four Numbers of the Maryland Aledical Recorder (a publication recently started, and the existence of which will not probably be of very long duration), the North American Medical and Surgical Journal for July 1830; and the flmericaaz Journal of tlte Of Medical Sciences for August 1830. these the latter is by far the better periodical ; it is, indeed, the best of the transatlantic medical publications ; and, to make a comparison nearer home, is in most respects superior to the great majority of European works of the same description. The most remarkable of the articles in the present Number of this latter Journal are, a case of trismatic tetanus, produced by the passage of a large rough triangular piece of clay from the intestinal canal into the vagina, which was cured by tobacco injections ; a case of rupture of the uterus, successfully treated by Dr. Hendrie ; and a very clever paper on the Pathological or Abnormal State of the Circulation, by Dr. Jackson, one of the Pensylvanian professors. The second of these demands our more especial notice.

his readers to determine. It must not denied, that there is a certain morbid virulence, and a great risk of contagion, in many cases of slight discharge from the nostrils, which are almost unattended by other unhealthy indications, but how are we to distinguish between these and what Mr. Bracy Clark calls aa nasal farcy gleet," our author terms " an unhealthy nasal flux." In closing our review of this work, we must observe that the subject of glanders has lately become more interesting to the medical profession, and we may add to the public, in consequence of the well-marked cases brought forward by Dr. Elliutson of its appearance, in the human subject. A notice of these cases was given at p. 234 of the pre. sent volume, and the identity of the diseases, or rather the fact of a most horrid and fatal disorder having been in several RUPTURE OF THE UTERUS. instances propagated by contact with the The female was 33 years of age, pregnant matter of glandered animals, seems to be so with her eleventh child, and all her previous clearly established as to demand serious at- labours had been rendered difficult by a tention. small exostosis situatedon the projection of We conclude by saying, that Mr. Vines the sacrum, lessening the antero posterior shows a spirit of engrossing interest in hiss diameter of the pelvis at least one inch or subject, and exhibits evidence of persever- one inch and a half. The secale cornutum ing industry-qualities which seldom’fail to was given, as had been the practice in her effect their object ; and, on the whole, we previous labours ; vehement contractions must congratulate him on having produced ensued, and the uterus burst. In this a work which is calculated to benefit the condition she was first seen by the narprofession. The plates which accompany rator of the case. He immediately proit are executed in good style, and are well ceeded to deliver by the natural pas&agt’.s, adapted to illustrate the subject to which and this, with the assistance of the crotchet, was soon accomplished ; the operator’s hands they Iefer. during the awful extrication being, while he sought for the placenta, in contact with the naked intestines. After the operation, to

be

antiphlogistic remedies

were

assiduously

520 in four weeks she retained was able to attend to her domestic affairs ; inconvenience than a urinary complains of no particular uneasiness, except fistula, which in the course of a few months that resulting from a urinary fistula. January 20, 1830. Enjoys at present re. cured. was also

applied, and

little

more

completely markably good health ; has menstruated reo We quote, at full length, the description gularly since August. In July an apparatus of the operation and the subsequent progress was procured, for the purpose of obviating of the patient, as a curious specimen of the the inconvenience arising from the fistulous " nil desperandum " cases whichare occa- opening in.the bladder ; it has been worn till within the last few weeks, and has effected i sionally met with. I a radical cure. Having placed

her in

a

favourable

posi-

The main strength of the N. A. Med. and bladder the feet were Sit?-g.Journal lies in its analytic and criti. being previously evacuated,) readily obtained, and the body of the child cal notices, and in its judicious and exlendelivered with the utmost facility ; some sivecollection of intelligence in the several difficulty was experienced in getting the branches of medicine. The original comhead through the superior strait of the pelvis, owing to the exostosis already men- munications are few in number; we may tioned ; this was finally accomplished with remark, however, that the interest of the the aid of the crotchet ; the hand was again several articles is precisely in the inverse introduced, for the purpose of extracting the proportion to their miniature dimensions. placenta, which was found in the left side of We especially particularise Dr. Gerhard’s the abdomen. Some were

tion,

the hand

was

introduced, (the

large coagula brought away entangled with the secundines. excellent paper on In searching for the placenta, my hand was ENDERMIC MEDICATION, in contact with the naked intestines, from of which the are useful which circumstance, no doubt can remain of the rupture being complete. After ascertaining that none of the bowels protruded from the laceration, she was placed in bed in a very exhausted condition-a cordial anodyne draught was given--two hours afterwards she expressed herself as feeling

following

ex.

We wish some of the British Rochesters, who write against space, about nothing or nonsense, would condescend to take a lesson from the scientific condensation of facts contained in the paper, from which we make the annexed quotations. comfortable. quite We may premise that Dr. Gerhard’s ex18. 6 o’clock A. M.—Has rested very well since 12 o’clock. System appears to be re- periments were performed on 200 patients, acting ; pulse remains small and frequent; and embraced several classes of medicines. complains of some soreness but no pain ; yet To his theoretical points many objections the abdomen is quite tender to the touch, and is somewhat distended. Directed fo- may be started, it is true, and these have mentations to be applied to the abdomen, not escaped the acumen of several American and a cathartic mixture. 6 o’clock r. m. journalists. On his practical statements, Abdomen greatly distended, and extremely however, there can be but one opinion,painful, exquisitely so on pressure ; pulse that they are in the highest degree crefrequent and tense ; skin dry and hot, cathartic has not operated. Ordered, v. s. ditable to his general acquirements and skill. tzxviij, cathartic medicine to be repeated, and professional " its operation solicited by an occasional eneTonics.—Endermic application of cinma-fomentations continued. chona. My observations have been confined 19. Passed a very restless night, bowels to the preparations of cinchona, as affording this morning, since which the the best examples of the most concentrated freely opened pain and distension of the abdomen very and powerful tonics. The sulphate of quinia much diminished ; pulse less frequent, yet has been very frequently administered as an somewhat tense. Ordered, venesection, endermic remedy. When applied to the xij; nitro-antimon. pulv. every two hours. inflamed cutis, it powerfully stimulates the 20. Is much better-no pain, and very surface, causing pain which may continue little tenderness on pressure ; pulse soft; for a few minutes, or for a much longer skin cool; countenance lively and cheerful. period, according to the susceptibility of the 21, et seq. She is still improving, thinks individual. The pulse of the patient is herself able, if permitted, to sit up and have excited, and if examined a few hours after her bed adjusted. hest and a low diet were the application, it will be found more full enjoined, and persevered in for several days; and frequent, but rarely’rising of a febrile her convalescence was rapid and uninter- character. The permanent tonic effects do rupted ;four weeks after the accident, she not differ from those usually observed; the tracts.

521 of the patient admissible in nearly every case of disease in fine, the where a long continuance of their use is dryred tongue rarely follows intermittents, requisite, and frequently in acute affections ; if treated by quinia externally administered. in this manner exhibiting its powers, after In the alms-house, it has for a long time all the ordinary forms of exhibition have been the established practice, to dress the been exhausted, and permitting an irritated blisters of patients exhausted from severe stomach to regain its susceptibility to remedisease with the sulphate of quinia, and the dial impressions. Narcotics, when applied permanence of the practice sufficiently at- externallv, produce their specific action The quantity with much greater promptitude than most tests its apparent efficiency. in which it should be applied as a mere other medicines, a few minutes being genestimulant is large ; from four to twelve rally sufficient to exhibit a marked effect; grains. Upwards of twenty cases of inter- this may arise from their action being in mittent fever were treated by the sulphate ’, part directed to the nerves of the surface of quinia applied externally, and with the ’, with which they are in contact ; for very most perfect success, except in three or little local pain is suffered, except in the four cases, where, from accidental causes, ’, cases where a large dose has been improits use was discontinued before the period perly applied to a blistered surface highly of the paroxysm. Of this number nine were inflamed from some accidental cause. The tertian, the remainder quotidian, including phenomena which result do not differ from all the cases of which a connected history those usually observed when the same remecould be obtained. In twelve instances, there dies are given internally, excepting that the was no return of the chiil after the first drowsiness which follows the slight local applications; the others were rarely attend- sensation is less suddenly excited, but of ed by more than one paroxysm, and never much more permanent duration. Narcotics by a third, excepting in a single instance, have been applied to all parts of the body, where severe attacks supervened before the and in all the cases in which I have witentire removal of the disease. In every nessed their use, they acted with the greatcase, however, each succeeding paroxysm est energy when placed nearest to the cenwas marked by a great diminution of its tral organs; but in painful local diseases a intensity and duration. The average quan- directly sedative action seemed to be extity of quinia applied before the cliills were erted upon the nerves of the part; hence, if arrested, was about twenty grains; although the paiu arise from an organ easy of access, it varied in the different patients from eight it is always better to apply the remedy in Some absorp- its immediate vicinity. The average dose, to one hundred and twelve. tion appeared certainly to have taken place, if the remedy be placed immediately in confor only a small residue of the quinia re- tact with the cutis, is about double or treble mained at the subsequent dressings, and the ordinary quantity; but if it be incorposometimes no trace of it could be perceived. rated with cerate, or mingled with a poulThe quinia was generallv used in powder, tice, we cannot be sure that the absorption either alone or diluted with some mild sub- will be as perfect as in the former instance. stance, and sprinkled upon the surface ; Allowance is then of course to be made by sometimes it was incorporated with cerate, adding a larger quantity." " OPIUM.—The acetumopii)0r black drop, by which less pain was produced. It was remarked by most of the gentlemen who is added to many liniments, as the most adopted this practice, that the quinia cured powerful liquid preparation of opium, and, more speedily in this form than when given with the exception of the salts of morphia, internally, and that the permanence of the it is, when pure, the best form for adminiscure was at least as great. tering this narcotic as an endermic remedy : The author illustrates and supports these it may be spread upon the surface without which is preferable, diassertions by the detail of five satisfactory any admixture, or, luted with thif k mucilage. From the cases The important class of narcotic re- which fell under cases. my notice, I should think medies most engages his attention. that the endermic dose of black drop is from " NARCOTICS.—The application of these fifteen to twenty minims upon the epigasto painful ulcers, as well as other diseased trium, but half a drachm if applied to the parts covered by the cuticle, has long extremities. " been familiarly known in medical practice ; SULPHATE AND ACETATE OF MORPHIA. solutions of opium are also sometimes em- - These salts may be taken as the type of ployed to relieve excessive pain or inflam- all the other combinations of morphia ; the mation of blistered surfaces ; but although sulphate especially, from its greater solubino one could be ignorant that a narcotic to any other of its lity, is far effect was sometimes produced, the local class. The morphia may be formed into a disease was the only object of treatment. cerate, or, what is generally to be preferred, The endermic administration of narcotics is the powder may be directly applied: the

appetite increases, the health

becomes

more

vigorous; and,

preferable

522 Dr. - Gerhard necessary quantity varies from half a grain to three or four grains, and its operation is speaks of the local endermic application of generally perceptible a few minutes after its croton oil to the extent of ten minims at a exhibition. Other narcotics were used with since we had occasion to time. Not frequent advantage upon blistered surfaces, notice Dr. long Short’s proposal and manner of as the extracts of belladonna, cicuta, stramonium, &c., a smaller quantity sufficing its application, as a powerful external irri. for the relief of any pain than if the epider- tant, capable of inducing a pustular erup’ mis had not been detached." tion. Either one or other of these gentleTwo cases are also detailed in which digi- men must be wrong, not to speak more talis was used in this manner with excellent harshly, and our own knowledge of the exeffect. Though we have not space to in- ternal action of croton oil induces us to besert these, we subjoin the remarks which lieve that Dr. Short is perfectly correct in Dr. Gerhard advances on the subject. his several assertions. " The result of these cases is very gra-

strange andunaccountable.

.

tifying, and affords great reason to believe that the proper method of administering digitalis in the diseases of the heart, is by Edinburgh Medical and Surgical Journal. applying it to an external surface. In ft. No. CVI. very large majority of patients the stomach will be found so much excited that the direct WE have examined the present number just gastritis, which the internal use of a power- of the " Blue Journal," and we feel pleaful irritant produces, will counterbalance sure in stating that it is replete with valuany ultimate effects that may be desired. No one now controverts the declaration of able matter. We subjoin an ample and very Broussais, Andral, and all other practi- interesting extract from a paper by Dr. tioners, that " la digitale ne ralentit Ie pouls Bryce, on 11 the state of medicine in Conqu’autant qu’elle n’irrite pas 1’estomac ;" stantinople," in which city the author reo and in a large number of diseases of the heart and other affections which have fallen sides. In our next we shall advert to an under my: observation within the last two article by Dr. Christison on the mutual acyears at the Philadelphia Almshouse, this tion of blood and air, which, as is the case statement was amply verified. The enderall Dr. Christison’s writings, evinces mie dose of digitalis should, I think, be great ingenuity, and is aptly calculated to about two grains, repeated three times a the author’s eminent reputation. increase in the and of

with

day

commencement,

gradually increased;

care,

course

however,

must

be taken to avoid great irritation of the blistered surface, which might in some cases counteract

our

object."

.

Sketch of the State and Pratice of /?clicirze at Constantinople. By C. Bnycfi, M D. " The influence which Islamism exercises over the minds of its proselytes, explains the reason why medicine should have retrograded, or at least had its progress arrested, in Turkey, and why its native medical science is only the remains of former times, disfigured and disguised uader a thousand forms. - - - ,,,The chief source of medical practice amongst Turkish practitioners, springs from that spirit of charity which so largely pervades Islamism, and of which the foundation of hospitals and the establishment of schools forms a prominent feature. Of the former there are several at Constantinople, either endowed by revenues from Mosques, or directly supported by government, of which the medical attendants are Turks, under the appointment and control of the Hakim Bashi, or first physician to the sultan. Their internal economy and medical management are, it is true, alike defective, if judged by the double object we propose in "

’

Dr. Gerhard has also used squill in powder as an endermic medicine, and its action Of the minewas completely established. ral emetics, the irritating nature of some entirely interferes with their use. Of the. vegetable class, emetine and the oil of tobacco have been successfully used. The author does not seem to have had any experience of the agency of mercury in this way; he however informs us of a case treated by another practitioner in which the local use of red precipitate induced salivation ; and we nnd, in Dr. Mackintosh’s Practice of Physic the extraordinary statement, that the application of the black wash almost invariably induces the constitutional symptoms, at least so far as tenderness of the gums.’ Before we conclude we have a remark to offer on one point, which appears to us such *

,

establishments, a charitable institutioa

523 the treatment of these is, as it should be, usefulness is not less con- entrusted to churchmen, who make, as in spicuous, and their existence affords the other more enlightened countries, a lucraready means at any future period of extend- tive business, by offering prayers and eming their advantages. The mad-houses, al-ptoying exorcism for the deliverance of those though disgustingly kept, and offering the affected. "In prescribing, vegetable preparations most deplorable objects to the curiosity the stranger, show how wisely the Prophet are usually preferred, which, as indeed made his scheme of legislative religion sub- every quality of drug, is administered in the servient to the calls of humanity. Of the simplest form. It must, however, be said, schools at Constantinople, one is particu- that if their drugs are subjected to few altelarly dedicated to medical science, or, more rations in the laboratory, yet in the physicorrectly, was,-for, if actually not altoge- cian’s hands they are compounded in the ther abandoned, its object is entirely super- most ignorant manner, medicines of very seded by the new school lately opened, of opposite virtues being combined in a prewhich I shall afterwards speak. The only scription of fifteen or twenty different drugs ; previous preparations for this study required and the more lengthy the writing, the more of the students, who on an average amounted complex the remedies, the more highly are to thirty, was a competent knowledge of the the skill and learning of the prescriber estiArabic, in which language, under the direc- mated. Solid purgatives of the strongest tion of Turkish teachers, they read, and kind are freely administered, the more so learnt to explain the ancient Egyptian and as Moslemin have a great repugnance to a!few European authors. In this course of enemata. Syphilis has been long successinstruction, which occupied two hours daily, fully treated by purgatives and sudorifies, little if any reference was made to anatomy joined to the use of the vapour-bath, contior chemistry; and even attendance at hospi- nued during twenty or thirty days, or until tals was not comprised. Six or seven years the patient be much exhausted ; and this as indicating a were thus employed, when, without any condition is considered form of examination, and by a simple license speedy cure. Emetics are little used, from or permission from the Hakim Bashi, the a great aversion to vomiting. An opinion doctoral bonnet might be assumed, and the of a vitiated state, or false course of the person was held qualified for the first pro- blood, enters largely into their explanation fessional employments of the state. The of the cause of diseases ; and bleeding, present Hakim Bashi and his brother, phy- either general or local, fortunately is abun" sician in chief of the army, are from this dantly pursued ; though much of the efficacy of the former is deemed to depend on the school, " From my observations and inquiries nicety with which the physician distinwhat vein should be opened. amongst this class of practitioners, the study guishes " But it is not to the application of rules, of medicine is reduced to the knowledge of a few doctrines; and the practice thence or the exhibition of drugs alone, that the promulgated accords with this simplicity. Ottomans confide in their treatment of maThe leading principles are to recognise only ladies. Ignorance makes them reverence a three classes of diseases; depraved humours, variety of superstitious remedies ; and Turks sudden cold, and great heat ; and accord- holding the highest posts of learning and ingly, to admit three forms of cure ; purga- rank are not ashamed to employ openly tives, heating medicines, and refrigerants. these productions of fanaticism and charlaOther Turkish nosologists adopt a different tanism. Of this credulity religion is the system, in which all diseases are distin- common basis ; and it is matter of daily guished into three orders,-namely, neva- occurrence to find the Iman supplant the xil, mayazil, and yel. To the first, which physician, or at least his mediations sought answers to the genus catarrhus of the an- to aid the virtue of the prescription. The cients, belongs almost every disease which practice is varied according to the caste of has its seat in the head, throat, and thorax. the Dervisch, and qualified with pomp and Diseases of the abdomen and affections of ceremony corresponding to the quality of the skin are ranked in the second order, the invalid or price paid. To some the which may be translated hemorrhoidal. The practitioner prescribes a course of several neuroses, whether or not accompanied by days’ reading from the Koran, with certain forms of breathing on the patient by one or pyrexia, affections of tendinous parts, &c., are placed in the third class.. Yel signifies more of the initiated ; while others are or-wind ; and to its presence and inordinate dered to combine the swallowing of bits of localities are ascribed the most severe and almonds, or of pork, eating off particular the most opposite complaints. Other in- plates, having words written on them, and congruous ailments, not assorting easily in fevers to tie knotted threads on the wrists with these genera, are implicitly believed and ancles. to be the effect of Satanic influence ; and « These simple plans of empiricism, or of

and s school for instruction ;but their

mediate

general

im-

of

524 gross superstition, are frequently abandoned’. variety, however, of this class of drugs and by the people, especially in lower com- compositions is that used with the intention plaints, for a treatment that so closely re- of affording enjoyments, whether real or

sembles magnetism, that, were it not for its ideal. The common sort is that formed distant origin, it might be pronounced from opium, hellebore, and strong aromatics. a variety of that process. The operator con- The more rare and expensive is the philosulted listens to the case with the utmost nium, consisting of fine opium with atiiber. seriousness, refers to his Koran, and having gris, musk, essential oils, and saffron, and theriaic. - - - chosen and written an appropriate passage, " The second class of foreign practitionfolds it in a mysterious manner, and prescribes this to be worn in contact with the ers at Constantinople, consists of Greeks part affected ; after which, the fingers smear- who have passed a year or two at the ed in saliva are stroked over the supposed university of Padua or Pisa. This cirseat of disorder, and prayers are recited at cumstance, which give a more formal autho. three intervals. As Dervisches and Imans rity to their pretensions, is further used are the privileged in this function, it is not to force their practice by a display of techto be wondered at if it exercise some in- nical terms and uncomprehended doctrines. iluence over Osmanlies ; but Christians and But as their residence abroad is too limited Jews likewise have recourse to these mag- to ensure those acquirements in medicine zietizers, who change nothing of their spiri- which depend more on study and experi. tual remedies in regard to Greek, Arme- ence than endowments of genius, it is natu. nian, or Jew. It is singular enough that ral to suppose that these students must, for the saliva and breathing are used in imi- the most part, enter on practice with little tation of Christ resuscitating the dead child, less acquired knowledge, and infinitely more and restoring hearing to the deaf man by dangerous hardihood, than the less favoured anointing with spittle. Patients are often tribe of Dragomans and druggists; yet it directed to swaltow, several times a day, seldom happens that these, by perseverance slips of paper on which the name Allah or and the use of certain arts of chicanery, Alabomet has been written by some vene. elsewhere reprobated, but which here pass rated priest or hadgi. Much faith is also current without opprobrium, fail to gain inplaced by Mussulmans in the efficacy of dependence and even reputation.* Itwould water sanctified by holding in solution pas- be not less invidious than unprofitable to sages of the Koran, which an Iman has disclose the minute details of the practice traced with ink on the inside of the cup ; pursued by the one and the other branch of and, incredible and absurd as it may seem, ’i these men. Suffice it to say, that in acute it has happened to several European prac- cases the system of Broussais, as prescrib. titioners in Turkey to find, on their second ing bloodletting, diet, and simple remedies, visit, that the true believer has deemed has been happily pretty generally adopted, swallowing the prescription left him more to the exclusion of drugs, the efficacy of advisable than sending it to the apothecary. which, under the most prudent administraIn further illustration of this spirit of fana- tion, is doubtful, and which in this climate, ticism, I may add that I saw in Egypt, and in the hands of ignorant adventurers, would the caste may be traced throughout Turkey, be useless ; and that in chronic cases pa. Arabian conjurors, whose name corresponds tient and doctor are alike satisfied to alleto Messiah, from whom they pretend to de- viate urgent symptoms, and trust to cirrivetheir science as chief of the sect. Their cumstances to decide the result. A novel peculiar province is to neutralise by charms and most despicable feature of this routine the venom of serpents and scorpions, and should not, however, be unnoticed, namely, render innoxious the bite even of the Abu- the avowed alliances, offensive and defenshahat. sive, established betwixt bands of these in° Besides the drugs prescribed to alle- dividuals whose twofold object is to support viate sickness, many more are used in each other’s merits and doctrines at their health, from the influence of climate or edu- chosen apothecary, and to approve and ratify cation, rendering people unsatiable of vo.. each other’s practice in the presence of the luptuousness. Some are used to acquire patient at consultation ; and, secondly, to plumpness and beauty of the skin, as muci-, oppose all collision of science with quacklages, feculent fruits, and seeds; others, as ery, by attacking, with the vilest subtercosmetics, composed of fine oils, the fat of fuges, the character and skill of the regular animals, odorous resins, alkaline and me- practitioner. - - - tallic soaps, prepared with great care and by difficult processes. But the virtue of these * Tt would be insulting the good sense of many remedies, and the chief cause of their being Greeks of Constantinople, who by a regular course study, and by their talents and character, have sought after with such avidity, proceed of obtained a well-merited distinction, to from their being always mixed with various deservedly offer assurance that this criticism cannot remore

the

I I

-

excitants and stimulants.

The most valued

any

flect

on

them.

525

practice of surgery is considered the honour of their profession, and recover conpeople a department of science very a portion of that distinction and credit distinct from, and inconsistent with, the ferred on it in Europe. Without fear of being dignity of the physician ; and although able accused of national prejudices, it may be surgeons have, by their skill and respecta- said that Englishmen have always enjoyed bility, distinguished themselves, and been a flattering station amongst the most disbonoured by the Turks as general practition- tinguished practitioners of the place ; and, ers, yet, until the present day, the prejudice at the present day, the humanity and skill against the custom is such, that few Euro- of my friends, Dr. M’Guffog and Dr. peans profess to be Gerats, although, with M’Carthy, are rewarded by the confidence two or three exceptions, all would operate. of the higher ranks of the empire, and a Surgery has, therefore, from this imaginary reputation amongst every denomination of opprobrium, been abandoned to certain ad- people, perhaps never surpassed at Conventurers, and has fallen into disrepute. stantinople. The probable cause of this disparagement From these disagreeable details, sketchmay be ascribed to the ignorance of anatomy ed with as much leniency as fidelity permits, among native practitioners, and their conse- we turn with gratification to the improved quent necessity to appear superior to an art, prospects of medical instruction offered by the dexterity and success of which may be the institution lately established at Conappreciated by the commonest capacity. stantinople. We have seen the inefficiency of the Capital operations are unknown at Constantinople, partly from this cause, and partly former means of attaining this object, and from the few accidents occurring in civil its consequent evils; and we are therefore life; and it is a notorious fact, that in the disposed to receive with satisfaction, and last war there were not five surgeons capa- judge favourably of the endeavour, with all ble of performing the most common opera- its defects, to bestow on this department a tions on the field of battle attached to the portion of those ameliorations developed in Ottoman army. Particular branches of the the scheme of military organization and art, as bone-setting, hernia, and eye opera- general instruction planned and prosecuted tions, are exercised by Persians and Mo- by the Sultan. The groans and murmurs of reats, with a success and celebrity similar the wounded of the last war have touched to the like people with us. Midwifery is the sensibility of the divan, and shown the almost exclusively practised by Jewish and Moslem legislators the great necessity of Turkish women ; and it is worthy of re- yielding to the calls of humanity, and, by mark, that the obstetric art forms a very this establishment, of remedying the terribly small portion of their adroitness or employ. augmented destruction of their troops from ment. A ll pretend to possess, and some absence of surgeons. This medical school, have become famous and wealthy by their at the expense of government, was opened pretensions to certain means, not only to ob. three years ago. It is under the direct viate sterility, but also to produce abortion control of the Hakim Bashi, whose talents by administration of drugs,-a practice and liberality fully qualify him for this avowedly tolerated and frequently resorted important charge, and by whom teachers It is to by Turkish females, both from their dis- are appointed and students selected. like to frequent pregnancy, and from com- at present composed of four professors, two mand of their lords, when their harem for the Arabic and French languages, and « The

by

the

"

"

threatens to become too numerous. " These facts, without further comment, exemplify the degradation of medicine at Constantinople ; and the character might, with equal justice, be extended to the em-

pire are,

at large. Our regret and indignation however, somewhat assuaged in refer-

ring t61 the conduct and character of several European and Greek medical men here. With equal truth and pleasure we bear testimony to the integrity of those whose prin-

ciples

and talents redeem in

some measure

for medicine and surgery, and 140 scholars from fourteen to thirty years of age, divided into these several classes. By an ill-advised economy, the salary of the first is too small to encourage any competition of respectable talents for the appointment ; and, where the honour and influence thereto attached is questionable, this circumstance must affect the interests and utility of the seminary. But, on the other hand, the pay, rations, and prospects held out to the students, have excited a great eagerness on the part of the better classes of the people to ensure their children these

two

+ The abandonment of surgery in the capital be better illustrated than by the fact, that a advantages. of the nose from the " successful caseofoftheformation The first of this course of educaforehead has acquired to the integuments a competent knowwriter more fame and applause than the tying the tion is spent in would have done. The Sultan himselfledge of the Arabic and French languages, subclavian and his mmisters sent to express their interest in the object and of which are alike the case, aud had the man subsequently exhibited cannot

period obtaining utility

in full divas.

conspicuous.

The second is devoted

to

526

medicine ;but unfortanately the means of there exists no law of the prophet, nor deci. imparting or acquiring this knowledge are sion of his commentators, against anatomical so imperfect, that it is quite impossible for demonstration, and, therefore, that a decree teachers, however talented or zealous, not to from the Mufti, or order from the Hakim compromise themselves, or for pupils, what- Bashi, would be sufficient to authorise their It is already fully sanctioned ever their capabilities and application, not performance. to be disappointed by the event. From the by the precedent of the school of medicine limited time of study, the non-appointment near Cairo. My friend Dr. Clot, who has of additional lectures has not yet been so done himself distinguished honour by that severely felt as the want of those means of establishment, had influence to obtain from practical instruction which are indispensable the Pasha an unqualified order to employ to the acquisition of useful medical know- the dead of the military hospital for this ledge, namely, anatomical demonstrations, object. No moment can be more propitious chemical experiments, and hospital attend- than the present for establishing the custom,

The latter defect was most manifest when the marvellous changes affecting the first visit to the institution, on wit- manners and opinions of the people, and acts nessing the eagerness of the young men to of the government, hinder too severe examiimpress a favourable opinion of their appli- nation of particular measures and prepare cation, and the interest and pride with which men’s minds for every innovation. It is, they listened to inquiries and remarks on moreover, believed that the spirit of the showing their manuals of anatomy, physio- Turkish religion, which is stript of much of logy, and materia medica, a new prepara. its former fanaticism and intoleranee, would tion of the blood-vessels of the head, some be easily reconciled to the matter, and plates, and a skeleton, as if these, their would overcome any scruples which the Derlibrary and museum, evinced and ensured visch or Iman might oppose to this concestheir acquirements, and unfolded the mys- sion." ance. on my

teries of medical science. 11 The lecture attended fully exemplified this. The person was surrounded by students in an oriental posture, with a French CONVULSIONS. epitome of anatomy in their hands, from CASES OF THE " PECULIAR SPECIES OF CONwhich he was labouring to explain, by VULSION" DESCRIBED BY THE LATE DR. translation and reference to a skeleton, one JOHN CLARKE, OCCURRING SIMULTANEof the most intricate points of surgical OUSLY IN TWINS, WITH REMARKS. anatomy, that of the shoulder-joint. The result of his utmost exertions was to store By MARSHALL HALL, M.D., F.R.S.E., &c. the learner’s memory with technical words, [Lond. Med. and Phys. Journal.] of the import of which they cuuld form no ‘ THESE cases of the " peculiar species of precise or useful application. ‘ This pitiable abuse of time, industry, convulsion " described by the late Dr. John and genius, on the part of teacher and Clarke, are quoted and sketched, rather than scholar, must be speedily redressed in the described, in this paper, chiefly for the sal-e system of education, or experience will of the opportunity thus afforded me of pre. effectually support the malevolent ridicule of , senting a few cursory remarks on this inte. those opponents, whose selfish motives de- resting morbid affection of infants. The two sire its failure ; for, besides the positive little patients were twin brothers, aged harm done by teaching nothing, its continu- nearly nine months. They became affected, ance on the same plan must destroy all ’, nearly simultaneously, by restlessness during habit of reflection or reasoning, and implant the night, and with a hooping or crowing false comprehensions of the extent and im- noise in the breathing, three weeks before portance of the study. any symptom occurred which gave alarm. " These faults, into the origin of which it On the 27th of February, 1824, Master is useless to inquire, but which are in part F. L. G. was observed to be indisposed, it inseparable from a system of instruction so was supposed, from cold. The medical little understood and appreciated in Turkey, friend of the family was sent for in the evenmeantime, however, the infant had may be alleviated, if not entirely removed, the simple authority of the head of the fallen asleep, and seemed composed. On by institution, without encroaching on the pre- the next day, at eleven A.M., the little pa. judices of the people, or doctrines of the tient was again visited : it was perfectly Kotan. The only point which has entered lively. All on a sudden it gave a slight into discussion is that of dissections. My hoop. The gums were promptly lanced; attention has been directed to this question three grains of the hydrargyri submurias by inquiries amongst native practitioners, were prescribed to be administered imme. people of the church, and others capable of diately, and to be repeated in four hours.

ing :

knowing; and their uniform ariswei is, that

!

In the

evening it was found that the bowels