PRESERVATION OF SUBJECTS FOR DISSECTION.

319 a little external to it; the -inferior degree, in the other vertebrae of the neck. This tubercle is placed thyroid, crossing behind the carotid arin front of the transverse process, and is tery to gain the thyroid body, is also very the more prominent as the individual is close to it; the tubercle will, therefore, advanced in age ; it varies considerably, serve as a useful point de depart for the both in size and form, in some subjects exploration of the surgeon when about to being nothing but a simple osseous slip; apply one or more ligatures. Should any in others forming a perfect hook, with the difficulty be experienced in seeking this concavity turned forward. This process tubercle through the integument, it is corresponds with the primary carotid arte- immediately obviated by a division of the and superficial layer of tissue. r.y, which is placed in front, and a little to the inner side of it, and furnishes so certain a guide to the vessel, that by placing a finger on the eminence, we may plunge PRESERVATION OF SUBJECTS FOR a scalpel into the artery with the eyes DISSECTION. shut, without any previous incision. In consequence of this connexion, M. Chas- TREATMENT OF DISSECTION WOUNDS. saignac has given it the name of carotid tubercule. The process can be easily felt To the Editor of THE LANCES. through the integuments, at least in the dead body, being only covered by the SiR,ńIn your last number, you menskin, subcutaneous muscle, cervical fascia, tioned the strong antiseptic qualities of and exterior edge of the sterno-cleido- charcoal and its consequent powder, mastoid muscle. To find it, we have power in reproving the stench connected extend the neck and to merely slightly, with dissection. As the warm weather press the finger on the inner edge of the has now commenced, and the scalpel will, above-mentioned muscle, two inches above I hope, be liberally used in the dissectingthe clavicle; at the same time we should rooms this summer, it may be of utility to be careful that the neck is perfectly state that I find nothing so effectual in prestraight, for the least rotation is enough venting putrescencyas injecting the veins* to alter the relations between the artery solution of nitre and common with a and tubercle. In the living body the pro- salt. If strong used warm, before arteries are injectcess is not so easily discovered, in conseed with the wax and tallow, it preparatorily quence of the greater resistance given by increases the temperature of the body. the subcutaneous and sterno-mastoid mus- This is much better than scattering salt cles. other antiseptic over the dissection, any or In an anatomical point of view, the tu- which must obscure, if not bercle, of which we speak, serves to dis- derange, the necessarily The plan I have parts. tinguish the sixth cervical vertebra from mentioned preserves the pearly whiteness all the others, and to determine in a posiof the tendons, and often improves the tive manner the situation of different or- colour of muscles. I have seen the latter, gans in the cervical region. As applied been in the dissecting-room having to surgery, a knowledge of this process ’ three or four weeks, when cut into, as red, may serve to direct us with the greatestas christmas beef in the shambles. Ancertainty to the primitive carotid, and inother recommendation is, that should the this respect is analogous to the osseous3dissector cut his the stimulus of tubercle on the first rib, close to the edgethe salt seems to finger, counteract the effects of It of the subclavian artery. also presentsthe impregnating matter. Out of the nua surface well fitted as a point d’appui to merons instances of my pupils who have compress the vessel in cases of sudden1 I cut themselves, I have not known a. hemorrhage. In the case of a penetrating troublesome case, save one, where there wound, with hemorrhage, inflicted in the palpable neglect. My invariable adneighbourhood of this process, the blood vice to the student who cuts himself is, may come either from the primary caro-to wash the part for ten minutes with tid, from the inferior thyroid, from the ; soap and warm water, then to suck the vertebral artery, or from the posterior orcut well for the same length of time, and, ascending cervical branches. The rela-lastly, defend it completely by surroundtions of these different arteries with the it with several turns of straps of process in question may serve to deter- adhesive plaster, so as to perfectly intermine the precise source of the hemorthe wounded finger from all advencept rhage, a question otherwise extremelytitious matter, when the student may imdifficult to resolve. It is immediately below this process that the vertebral artery * Mr. Brookes used to a solution of nitre penetrates into the canal of the cervicalalone into the arteries. Thisinject i- nut su well, because the cervical is wax. below. it obstructed the progress of the vertebrae; posterior

in’ -a less marked

and

skin

after

was e ,ing

320 if he chooses, his dis- mother of a child infected with the small. section, again, with impunity. In every pox, and the wife of a journeyman coachcase where the above plan has been maker named Vantandillo, then residing

mediately renew,

adopted, no sensible degree of local inflam- in a court near Long-Acre, for exposing mation has succeeded, and no bad effects and taking the child in a diseased state of whatever have been produced. small-pox through the public streets to In some neglected cases a great deal of the house of the surgeon who inoculated it, pain is often produced by a collection of a by which the contagion infected most of very small quantity of matter under the the children in the court where she reaponeurosis of the finger, which, if not let sided. The second case emerged from the fore. out, will be probably succeeded by enlarged axillary glands and more extensive symp- going (if my recollection is correct). toms of irritation. I know the presence Burnett, a surgeon-apothecary, was of matter has been denied by many, but tried and found guilty in the King’s my experience has proved that as soon as Bench, for unlawfully advising and an exit was made for it, the intolerable allowing a child to be brought through pain has at once ceased. This was re- the public streets in a state of disease markablv so in the troublesome case al- to his residence. So it appears to be ready alluded to. This pupil I took to a I an indictable offence in an apothecary, consulting surgeon of high repute, and after having inoculated children, unlawproposed to him that an opening should fully and injuriously to cause them to be be made, with which he did not coincide, exposed in the public streets to the danger alleging that no matter was present. In of public health. The learned judge the night, however, the pain became so (Le Blanc), in passing sentence on the de. intolerable that I was induced to do it; a fendant in this case, observed that the insmall quantity of matter escaped, and the troduction of vaccination did not render patient was instantaneously and perma- the practice of inoculating for the smallnently relieved from pain. pox unlawful, but that at all times it was Yours very obediently, unlawful and an indictable otfence to exG. D. DERMOTT. pose persons infected with contagious disorders liable to be communicated to the 35, Dean-street, Soho. public, and injurious to the public health. The defendant was sentenced to six -

PUBLIC EXPOSURE

OF

CHILDREN

WITH

THE SMALL-POX.

To the Editor

of THE LANCET.

months imprisonment. A case under similar circumstances was tried some terms subsequent to the above trials. Mr. Ridout, of Paternoster-row, was, in this instance, found guilty, but was not called up for judgment, on a promise to

observe in the last number

SIR,-I of your Journal, a letter from a correspondent signed Jf. M. on inocalation,

wherein he confesses himself to be not well acquainted with the subject of medical jurisprudence, yet justly complains of a parish surgeon introducing the smallpox in the neighbourhood near where he resides. If you think that the information I here forward can serve his case, may I ask the favour of its insertion in vour next number? From the relation of the following cases, which are to be found in Maule and Selwyn’s Reports, it is evident that inoculation under the circumstances he relates in his letter is unlawful. It is in. their book said to be unlawful and injurious to carry a child infected with small-pox along a public highway in which persons are passing, and ner to the habitations of the King’s subjects, and it is an indictable offence, as the following cases evince. Some years ago two trials took place in the Court of King’s Bench ; one, of the

discontinue the practice. 1

remain, Sir, Yours, &c., 1:,y. W. WALFORD. WALFORD.

Church

Row, Limehouse, May 11, 1834.

To the Editor of THE LANCET.

SIR,-The surgeon referred to by M. M. punishable by indictment, not for inoculating children with small-pox, but for ordering them to be brought for inspection. The decision of Mr. Justice Bailey, the Royal ’Jennerian Socicty and London Vaccine Institution publish every year in

is

-

their

yearly report ; I beg to inclose it. Believe me yours, &c., JOHN EPPS, Epps, M.D.,

Director of the Royal Jennerian Directcr Jenneriun and anJ London Vaccine Institution.

89, Great Russell Street May 13,1834.