BRITISH MEDICAL JOURNALS.

130 tion. That it has this effect is evidenced by the great diminution of pain which the patient at once experiences during micturition. But as to its niodus operandi, we have also to consider its sedative action in subduing crescent inflammation, and its probable quality in neutralizing specific virus, and arresting zymotic increase. The observance of rest and antiphlogistic regimen would, in all probability, aid the therapeutic influence of this mode of treatment; its beneficial effect is, however, developed under an ordinary mode of life, when attended with no flagrant violation of conduct. As a method of cure, it is in my opinion open to but one objection-namely, its limited adoption, owing to its applicability extending no further than the early stages of the disease, and these often exciting but little attention. Let it not, however, be disregarded on this account; for, undeniably, many cases of clap present themselves while within the power of the remedy; and for these let it be reserved and had recourse to as a means easy of application and effectual in operation; while those cases beyond its influence may, as heretofore, be set aside, to be dealt with after another more expedient mode. Failing, however, in ectrosis, the case is in a position no more unfavourable than if its cure had not been attempted; the ulterior effects and complications of the disease are likely to be, in no degree, more imminent or grave. This is borne out by asking, what are the complications to be apprehended in severe cases of gonorrhoea ?1 Phymosis and paraphymosis; excoriation of the glans, producing balanitis; inflammation of the lymphatics; abscess in the penis-rare, sometimes, however, occurring in the vicinity of the lacuna maxima; perinseal abscess, with probable retention of urine, formation of urinous abscess, or inflammation of the prostate, leading to the same results; or cystitis, orchitis, or-in protracted cases, what is of frequent occurrence-stricture. The first five of these are, comparatively speaking, of minor importance, and need not be taken into account, considering the improbability of the treatment detailed producing them ; the latter-mentioned more serious matters, so far from being excited, are certainly frustrated by nitrate of silver: they being, for the most part, true examples of extension of inflammation by continuity, the arrest of the process while localized in the extremity of the urethra, (and which is always the case so long as the remedy is applicable,) if effected, must prevent such ulterior calamities

whatever at the time to expect this as a probable occurrence, independently of the galvanism. But even admitting, for the sake of argument, that the cessation of the uterine action was not the result of the galvanic influence used, still the fact is amply sufficient to show that the galvanic current had not, at least, the power either of increasing the pains, or even of continuing and maintaining them when they offered to fail. It may be proper to add, that during the galvanic action, in none of the experiments did Dr. Barry or I find, in the intervals between the clonic uterine contractions or pains, any evidence whatever of unusual tmiic contraction of the uterus, as shown either by any degree of hardness in the general uterine tumour, or by any degree of tension in the pressure of the bag of membranes or the child’s head against the cervix uteri. " It would be hasty and logically incorrect to deduce from the preceding observations, that under no modification, and under no manner of application, does galvanism possess the power of directly exciting or increasing the contractile action of the uterus. Forms or methods of employing it may yet possibly be detected or devised, affording a different result. But I believe I am justified in inferring, from the preceding inquiry, that, as employed at the present time, and in its present mode, it is not a means which can be in any degree relied upon for the purpose in question, and is so far practically and entirely useless as a stimulant to the parturient action of the uterus."

Dr. Simpson does not wish to impugn the veracity of other writers on the subject, but believes that the increased uterine action observed by them was due to the impression produced on the patient’s mind.by the appearance of the machine about to be used, or to mere irritation of the vaginal plate when introduced. Further experience is needed before the subject can be considered settled. CONTRIBUTIONS TO PATHOLOGY AND RATIONAL MEDICINE.

Good advice cannot be too often repeated, nor in too many forms. We have read with pleasure, therefore, the views of Dr. HUGHES BENNETT, as expressed in the first of a series of articles under the above title in the Edinburgh Monthly as perinseal abscess, prostatis, or cystitis. Again, stricture, J aurnal. He sums up the arguments which he advocates as when it supervenes, does so only in protracted cases of clap, a series of suggestions for the advancement of our science, and where such a grade of the inflammatory process is main tained as favours plastic exudation and organization. Pre- and we extract them nearly in the author’s words:— vention of the continuance of the gonorrhoea must therefore "1. To encourage the idea among the profession which conobviously tend to diminish the probability of the stricture’s siders him to be the truly practical man who exercises a supervention. sound reason and judgment in the practice of medicine and Ectrosis being available only prior to the suppurative crisis, surgery, based rather upon a knowledge of anatomy and phya gonorrhoea which has advanced thus far must be regarded siology-morbid anatomy and pathology-than upon mere as beyond its influence ; and should the disease persist and experience. progress after one, or at most two injections, any further per"2. To encourage the habitual use of specula, stethoscopes, sistence in the use of the remedy must be deemed unadvisable, sounds, microscopes, and every instrument capapleximeters, and the case consigned to the ordinary tedious treatment. ble of bringing the products of disease under the immediate Gorleston, Suffolk, June, 1846. cognizance of the senses, and thus rendering diagnosis exact. "3. To encourage the study of pathological anatomy on rational grounds-that is, by examining all the organs in BRITISH MEDICAL JOURNALS. every case-investigating into the minute structure of every morbid product - and by obtaining a chemical analysis of THE INFLUENCE OF GALVANISM ON UTERINE ACTION. these, and of the blood, whenever this is practicable. in all hospitals connected with medical schools " 4. To GALVANISM has been by many practitioners supposed to ’, an officer place well acquainted with morbid anatomy, and the exercise a powerful influence over uterine action, and several modern means of cultivating it, whose duty it shall be to conduct the post-mortem examinations, keep a minute record of cases of this apparent power have been recorded in this and other journals. Dr. J. Y. SIMPSON, believing in this influence, each, teach morbid anatomy to the students, and publish a report. desired to measure its exact amount, and, strange to say, has yearly " 5. That in our public institutions the history of disease arrived at a conclusion opposed to his previous belief and should not be recorded by young men inexperienced in obto general experience. It is unnecessary to go into the servation, but should in all cases be dictated by the physician details of the experiments which he performed, but the and surgeon. " 6. To extend and give greater importance to clinical ingeneral results obtained in eight cases are thus detailed struction by introducing the system of bed-side tuition, so "In one instance, the pains were more frequent in their re- advantageously practised in continental universities, and by currence, but shorter in their duration, during the application taking care that those who teach are enabled to communicate of the galvanism. In five other cases, the employment of the to their pupils the manual dexterity and knowledge in the galvanism neither increased the average frequency of the use of all those instruments essential to an exact diagnosis. pains, nor their average duration. In one, the pains ceased " 7, and lastly. To impress upon the legislature the necessity whilst the galvanism was applied, and returned upon its re- of introducing some system which will ensure the appointmoval. In the instance which I have last detailed, the ment to our public hospitals of well-educated physicians and uterine action ceased while the galvanism was applied, and surgeons, intimately acquainted with pathology and the prindid not return upon the withdrawal of the galvanic action, ciples of rational medicine. Otherwise, it cannot be reanor for twenty-four hours subsequently. There was no reason sonably anticipated that the extensive opportunities for &mid ot;

,

131 observation which these institutions afford will ever be made available in advancing the healing art, for the good of the

community at large." To these useful aphorisms wemay append the

AMMONIA AS A VESICANT.

The stronger solution of ammonia has been much employed on the particularly in France, for some years back, as a speedy blistering agent, but has been very little used hitherto in this country. Various directions are given as to the mode in which it ought to be employed, but Dr. Gondret’s ointment is the preparation in most general use, and is that one most highly spoken of. As prepared according to the formula originally published by him, it has been found in many instances not to act satisfactorily. The inventor of it, in consequence, recently made public the following formula for its preparation:—Take of axunge, one ounce; oil of sweet almonds, half an ounce; melt together with a gentle heat; into a wide-mouthed glass pour the mixture, while still vessel; then add, solution of caustic ammonia, five ounces, and mix with constant agitation till cold. Particular care must be taken that the axunge be merely melted; if it be too fluid, or too warm, some of the ammonia will be vaporized, and the resulting ointment too weak. The ammoniacal ointment, thus prepared, retains its properties for many months if kept in stoppered glass bottles in a cool place. Gondret’s blistering ointment produces vesication in about ten minutes; it is applied, by spreading it on the skin, and covering the part with a compress. The French use it most frequently for blistering the temples in diseases of the eyes. The rapidity and certaint,y of its action, however, renders this vesicant of great value in many diseases.—.DtfMt’M Journal.

Continent,

SUGGESTION OF A PLAN FOR THE PROMOTION OF MEDICAL KNOWLEDGE.

The following idea, suggested by Mr. HUNT, at a meeting of the Ashford Branch Provincial Association, is not a bad one. On many occasions useful knowledge has thus been gleaned; and a well-arranged system for bringing forth the experience of the provincial practitioners would open a mine rich indeed in facts, and every fact worth loads of opinions :" It has occurred to me, that our [a ?] weekly periodical might be made the medium of certain definite inquiries, addressed to all our members on any given question, and the statistical results of their replies might be published in our annual volume of Transactions, and there collated and compared with whatever practical information on the same subject might be gleaned from the periodicals during the last year or seven years; and thus wemight settle some disputed point, or discover some new principle. This would be a beginning, and by degrees, the system might be extended over the whole profession, through some respected medium."Provincial Journal. FUNGOID DISEASE OF THE KIDNEY IN A CHILD.

Dr. FLETCHER presented, at a recent meeting of the Birmingbam Pathological Society, the right kidney taken from an infant aged fifteen months. It weighed two pounds and a quarter, and the following history was given with the case :" A few days before his death, he was seen as a patient at the General Dispensary, and a large tumour was found situated in the right side of the abdomen, extending downwards from the right hypochondrium, very much in the situation of the spleen, an enlargement of which it was thought most probable, but that it had not that abrupt termination internally by which enlargements of that organ are usually characterized. The child was very much emaciated, and evidently could not live many days. It died, and a post-mortem examination of the body was made. The capacity of the chest was very much diminished by the pressure of the enlarged contents of the abdomen upwards against the diaphragm ; the contents healthy. Abdomen : A tumour was found, consisting of the right kidney, in a fungoid state of disease, which pressed upwards the liver, stomach, and spleen, and pushed forwards the pancreas and colon, the descending portion of which passed down in front of it : it filled up all the right side of the abdomen from the right hypochondrium down to the pelvis, below the pancreas and arch of the colon; within the descending colon the small intestines lay upon it, and posteriorly it passed as far as the spine. The other kidney, and all other organs of abdomen and pelvis, healthy."—.Mem.

PECTORAL ABSCESS FOLLOWING RHEUMATISM

liquid,

I

LARGE PECTORAL ABSCESS FOLLOWING THE REDUCTION OF A DISLOCATION.

This is a rare form of complication in such an injury; and the case which illustrates it is from the practice of Mr. GREENHow. The dislocation being unreduced for a week, and the man continuing his work, the lacerated parts were deprived of that rest which was necessary for their healthy union. The principal facts are the following :" A stout, healthy-looking man, aged twenty-six, admitted, with a very extensive diffused abscess in the left pectoral region; the whole of that part greatly swollen, red, hot, and exceedingly painful on the slightest pressure; distinct fluctuation throughout, particularly at the lower part of the origin of the great pectoral muscle, and the axillary space felt like a bladder tensely filled with fluid, the movement of the arm giving great pain; had intolerable thirst, and high febrile commotion. The history was, that he travelled with a menagerie, and three weeks before, whilst lifting a heavy weight, lost his grasp, and felt something in his left shoulder give way; after this, he had all the symptoms of dislocation into the axilla, but owing to the nature of his employment, he was unable to get it reduced until a week had elapsed, when, continuing his work, (which he had never intermitted,) a violent throbbing pain set in, and was soon followed by the other symptoms of an abscess." He was treated in the usual way, and, after much suffering, recovered,. the shoulder-joint being still stiff.

TRICKS IN THE BOOK TRADE. To the Editor of THE LANCET.

A seaman, twenty-five an equally rare complication. Princes-street, 28th July, 1846. years of age, was admitted, with a large abscess occupying further illustration of the " deception" exposed by SiR,ŇA the right pectoral and axillary regions. He suffered from Dr. Bostock, both in THE LANCET and Gazette of July 18th, is made apparent in the following note, addressed to illr. Henry symptoms of inflammatory fever, and gave the following cold ten days ago, whilst at sea, and G. Bohn, and to which that gentleman has not thought proper ".SM<
is

progress.