Chapter 18

Our readers will observe a great similarity, in this, to the arrangement of the lobules of the kidneys.--_Ibid._

4. _Trachea perforating the Aorta._--This odd distribution of parts, was observed by M. ZAGORSKY, at St. Petersburg, in 1802. The aorta divided itself, at its arch, into two branches, which received the trachea between them, and again united, exactly fitting the organ they received. They were found to have compressed the trachea, and probably produced difficulty of breathing.

In another case, in 1808, the right subclavian artery, instead of its usual origin, arose from the left extremity of the arch of the aorta, and crossed behind the trachea, thus including the latter between it and the aorta.

Why do we call the common trunk of the right subclavian and carotid, the arteria innominata? Is coining words so difficult a task, that we cannot find a proper and expressive name for it? The French call it _brachio-cephalic_, and this expresses its office and distribution.--_Ibid._

5. _Monsters._--These productions, hitherto considered as mere objects of wonder, from the study of which no useful inference could be drawn, have recently attracted a good deal of attention in Paris. There seem to be some close affinities discoverable in many of them, not only with the natural and complete forms of animals of various tribes, but even with the actual condition of their own species, while in the foetal state.

The views of M. GEOFFROY ST. HILAIRE seem to us rather mystical and vague. Those of BRESCHET, and the other practical anatomists, we can understand much better.

6. _Malformation of the Heart._--Drs. BAILLIE,[29] LANGSTAFF,[30] and FARRE[31] have each published cases; and M. TIEDEMANN, in his journal of Physiology, now adds a fourth, in which the aorta and pulmonary artery were found to have changed places. In professor TIEDEMANN'S case, the two circulations were entirely distinct; the systemic blood passing from venæ cavæ to right auricle, from right auricle to right ventricle, and from this, through the aorta, to the body at large; while the pulmonary blood ran through an equally simple circle, by the route of pulmonary veins, left auricle, left ventricle, and pulmonary artery. The only communications between the two circulations, were the foramen ovale, the ductus arteriosus, and, in the opinion of M. TIEDEMANN, the inosculations between the branches of the _pulmonary_ and _bronchial_ arteries.

The infant is recorded to have presented _no peculiar appearances_ till the ninth day; when attacks of suffocation came on, attended with the blackish blue colour, and followed by death, at the end of twelve days. Similar histories are said to be given of the cases mentioned above, and the references to which we have copied. We have not the time to consult them.--_Ibid._

7. _Acephalous Mummy._--M. GEOFFROY ST. HILAIRE has read a memoir of some length to the Academy of Sciences, on an acephalous mummy. It was found in a catacomb, destined, with this exception, exclusively to animals. It had an amulet suspended round its neck, being an earthen figure of a cynocephalus, for which it was very probably mistaken by the Egyptians. The collector, M. PASSALACQUA, who obtained it, showed it to M. G. ST. H. as a monkey, of which he wished to know the species. Yet the latter observes that these amulets were only put on human mummies.

M. G. concludes that the monkeys, elephants, &c. said by Livy, Valerius Maximus, Pliny, and others, to have been born of women in their times, and considered as omens of public calamity, were acephala.

8. _New Anatomical Plates._--Messrs. E. W. TYSON and GEORGE SIMPSON are publishing anatomical plates, in London. They are spoken of with approbation. The labours of the latter are designed for the use of painters.

9. _A Manual of Osteology_ has been undertaken by Dr. WEBER, of Bonn, and one volume published.

10. _Soemmering's fine work on the anatomy of the ear_, has been translated into French, and his splendid folio plates copied in lithography.

11. _Does the conjunctiva run over the cornea?_ Messrs. LECOQ, LEBLANC, and ARTUS, state that they have each seen a case in which regular _skin_ and _hair_ were seen, forming a small patch on the cornea of the eye of a quadruped. This is considered as a proof of the existence there of a membrane naturally analogous to the skin; which must, of course, be the conjunctiva. An officer saw another case, in which a hair was seen in the middle of the eye of a horse.--_Bulletin._

II. PHYSIOLOGY.

12. _Electro-Galvanic phenomena of Acupuncturation._--M. POUILLET, after making a complete circuit, through a needle introduced in acupuncture, through wires, and through the patient's mouth, found, by means of a multiplier of SCHWEIGHER with a magnetic needle, that the electro-magnetic rotation could be readily produced; at least so far as to effect small vibrations backwards and forwards. On repeating it with two needles, one of them run into an artery and another into a vein, or one into the medulla spinalis, at the neck, and another into an extremity, in a rabbit, no effect whatever took place.--_Magendie's Journ. de Physiologie._

13. _Variations in Milk._--Milk, says M. VALLOT, in his memoir read to the Academy of Dijon, may be _red_. The cause of this is unknown, though it has given rise to superstitious fears. Some have observed that the cow's teats are then tender. Whether this be cause or effect has not been ascertained.

_Yellow milk_ is said to have been produced by the cow's eating the caltha palustris, (marygold.) _Blue milk_, from a cause still unknown, in the departments of Seine-inférieure and Calvados. Some have ascribed it to the hyacinthus comosus; others to butomus umbellatus.

The _green milk_ of some writers is supposed to be only blue. _Milk not coagulable_ is produced by feeding on husks of green peas, and on mint. _Bitter milk_, from wormwood, sonchus alpinus, and the leaves of the artichoke; and in goats, from eating freely of elder, (sambucus nigra,) and potato-tops; _a disagreeable taste_, from turnips, in Upper Canada. _Garlicky milk_, from causes well known. _Insipid milk_, and _lead-coloured butter_, from equisetum fluviatile. _Milk unnaturally sweet and luscious_, (sucré,) from alpine clover, (trifolium alpinum;) and _red butter_, from the ripe berries of asparagus.--_Bulletin._

14. _Hyoscyamus dilates the pupils of the eyes_, the same manner as stramonium, several Eastern species of datura, and belladonna, which the Europeans use. The strongest species was datura fastuosa.--_Oriental Magazine, apud Du Fermon._

15. _Worms in the Eye._--Several cases of worms in the eye are mentioned in the Bulletin des Sciences Medicales, for Feb. 1826. DEGUILLEME saw several in the eye of a cow; and the case was published by GORIER, a veterinary teacher, in his memoirs. In the report of the proceedings of the veterinary school at Lyons, in 1822-3, there is the case of a mule, in which a knot of worms (crinons) was seen in one eye. _Two_ were extracted; (why no more is not said;) and another subsequently. No inflammation was produced; but a violent nervous agitation of the head, and a turning of it to the left side took place. Next follows an account of a memoir read before the Medical Society of Calcutta, but of which the name of the author is not given. He is represented as stating, that the strongylus armatus minor of RUDOLPHI, and the _filiaris_ (filaria) papillosa, are frequently found in the eyes of the horses in India, but much more so in the cellular membrane, particularly about the loins. He believes that they make their way into the blood-vessels, and, through them, into the eye. Their most ordinary seat is the cellular membrane of the loins; where they exist for years, producing emaciation, and, at length, paralysis of the hind legs. This last the Calcutta author is represented as ascribing to the penetration of the spinal marrow; but he does not appear to have verified it by dissection. TREUTTLER says, he has seen the strongylus armatus in _aneurisms_ of the mesenteric artery of the horse; but the writer in the Bulletin doubts whether any have ever been found in sound arteries.

Dr. KENNEDY, in the Edinburgh Philosophical Transactions, describes a worm, which he calls _ascaris pellucidus_, (pellucida,) as being common in the eyes of horses in India. A review of BREMSER'S work on worms is expected in our next, and inferences will then be drawn from these singular facts.

16. _Digestion._--MM. LEURET and LASSAIGNE, in their very interesting and valuable experimental essay on this subject, have met with many curious results.

They found no remarkable difference in the saliva of carnivorous and herbivorous animals. The purest saliva was obtained for their experiments directly from the parotid duct, in man, the horse, and dog. The composition was as follows:

Water, 99 parts; mucus, traces; albumen, soda, chloride of sodium, chloride of potassium, carbonate of lime, and phosphate of lime, 1 part. Total, 100.

Their experiments on the bile confirmed the results of THENARD and CREVREUIL.

The pancreatic juice is of the specific gravity 1.0026; at 15° of the thermometer: (centigrade, we presume.) Its composition is:

Water, 99.1 parts; animal matter soluble in alcohol, animal matter soluble in water, traces of albumen, mucus, soda, chloride of sodium, chloride of potassium, and phosphate of lime, 0.9 parts. Total, 100. This greatly confirms the analogy long observed between the pancreatic liquor and the saliva.

In the _gastric liquor_, there are:

Water, 98 parts; _lactic acid_, muriate of ammonia, chloride of sodium, animal matter soluble in water, mucus, and phosphate of lime, 2 parts. Total, 100.

Dr. PROUT and Mr. CHILDREN have announced the gastric acid, of which so much has been said, to be the muriatic, while M. CHEVREUIL had stated it to be the lactic. MM. LEURET and LASSAIGNE confirm the results of CHEVREUIL, and that with great confidence in their own accuracy. They found the contents of all the four stomachs of ruminating animals acid. MM. PREVOST and LEROYER had stated those of the three first to be alkaline. The observations of LEURET and LASSAIGNE agree with those of MONTEGRE, (vide Dict. des Sci. Med.) who believes digestion to produce acidity as a result of the regular process.

The _fæces_ become alkaline.

_Substances which contain no azote, from whatever class they are obtained, cannot serve for nutrition._ We cannot understand this, especially when compared with what follows. "If, on the contrary, they are soluble, one part is absorbed and another is expelled, either by urine or by the anus; such are sugar, gum, &c." This seems to us like a contradiction.

It is impossible, in the present state of science, to determine the chemical change which aliments undergo in the digestive organs; both on account of their mixture and the insufficiency of our means of analysis.

"The absorption of chyle takes place by the villi." "These communicate directly with the lacteals and the vena portæ."

"The transference of the chyle takes place by the lacteals; nevertheless, if they are obliterated, _this may be done through the vena portæ_."

_The section of the pneumo-gastric nerves does not stop the dilution of aliments in the stomach, or chylification._

The juices secreted by the liver and pancreas, are poured into the intestines in greater quantity during digestion than at any other period; in consequence of the contact of the acid chyme with the biliary and pancreatic orifices.

The pancreatic juice is analogous to the saliva.

The spleen is an appendage to the liver; it swells during the absorption of liquids by the vena portæ.

Liquid aliments are digested, just as much as solid; but they do not require so great a quantity of gastric and intestinal juices.

Watery drinks are absorbed in the stomach and intestines, by the radicles of the vena portæ. Spirituous drinks occasion an afflux of the gastric juices, become acid, and are absorbed.

Excrements owe their colour and odour to the bile, and their consistence to the absorption of a portion of the water they contain. They carry off a large amount of the nutriment.

Great obscurity still remains as to the cause of hunger.

Thirst is thought to be produced by the drying which the pharynx undergoes, from the passage through it of the air used in respiration, and at a time when the supply of mucous fluid is scanty.

Our readers will have perceived, long ere this, that here are several propositions at war, not only with our received opinions, but with the experimental researches of some others among the modern physiologists. We do not know what Dr. WILSON PHILIP would say to his observations being so cavalierly dismissed: they seem scarcely to condescend to mention his name in France. Not having the original, we could do no better than translate, almost literally, the conclusions of these experimenters, as stated in the Bulletin; and the result of this is what we have just given our readers. From the words "the absorption of chyle," to the end, is nearly verbatim the language of the review.

III. PATHOLOGY.

17. _Dothinenteria. Pustules of the small Intestines._--From [Greek: dothinê], a pustule, and [Greek: enteron], an intestine. This name is given to a disease which has been described by M. BRETONNEAU, of Tours, and, after him, by SERRES, BROUSSAIS, ANDRAL, and several others, and consists in pustules, generally situated at the lower end of the ileum.

We are constantly lamenting to ourselves the contracted bounds allotted to our Quarterly Summary. Indeed, were it not for other objects, it might occupy, with advantage, half of the number, and most of the time employed in the preparation of the work. Every thing must be curtailed, though cut off at the most interesting and valuable point; and the painful exertion of the attention, necessary to condense information for our readers' use, of the amount of which they cannot possibly be aware, can only be equalled by the constant feeling of disappointment at rejecting so much important matter.

We are told that this pustular disease is as common and as destructive as the _small pox_, (indeed!) the measles or the scarlatina; that few persons spend the whole of their lives without having, at some period, suffered by it; that it never affects individuals but once; and that it is suspected of being contagious.

M. BRETONNEAU has prepared a set of specimens, taken from the bodies of those who have died in various stages of this complaint. He traces the malady day by day, with a precision which we will not copy here. The seat of this affection is the glands of PEYER and BRUNNER. The former are found in groups, throughout the lower half of the jejunum and the whole of the ileum, gradually increasing in the size and number of their clusters, till they reach the valve of the colon, where they cease. They have been mistaken by some dissectors of the modern school for the effects of inflammation. They are found in honey-combed patches; which are agglomerations of mucous glands. The glands of BRUNNER are thinly dispersed mucous follicles which are scattered singly throughout the whole length of the small intestines, with nearly equal frequency. These organs are well described by HALLER in the great Physiology. They are not seen well, unless in a young subject, and by cutting into the intestine very close to the mesentery.

When inflamed, they swell and thicken, and, after some days, the membrane around them assumes a reddish tint. The mesenteric glands are enlarged. M. BRETONNEAU has seen one as large as a hen's egg: they generally equal in size that of a pigeon. The disease spreads and affects an additional number of glands. It reaches its acme generally on the 9th day; after which sometimes all, and always a part of the affected glands return to their natural condition, by resolution of the inflammation. Those which are to run the full course of the disease continue to augment in size and projection into the intestine. On the 13th and 14th days they are discovered tinged with bile, which penetrates their substance, and thus proves the occurrence of disorganization. On the 15th and 16th, the sloughs separate, and leave from one to six ulcers. These penetrate the gland, and with it the mucous membrane, of which it forms a part, and next, the cellular tissue of the intestine. In numerous instances they perforate the muscular coat, leaving nothing but peritoneum at the bottom; and frequently, passing this, they induce inflammation of the cavity of the belly, and death.

The cases of simple resolution terminate in three weeks: those in which sloughs are formed, in from 30 to 40 days, if not fatal. If death be from peritonitis, it is of course soon after the 15th and 16th days; if from exhaustion, at periods varying according to the strength of the sufferer. Dothinenteria occurs in many of the cases commonly called typhus fever, gastro enteritis, &c. It is proper to remark that both the author and the journal are in opposition to Dr. BROUSSAIS.--_Archives._

18. _Dr. Broussais._--While the opinions of this celebrated reformer have been gradually becoming more extensively known among our countrymen, the war has prevailed with increased heat in his native land. The most vehement attacks are made, from various quarters, upon his system of _medicine physiologique_. No one appears to deny that he has clearly proved the existence of mucous gastritis and enteritis in many or most fevers, or the propriety of directing a part of the remedies to them. Criticisms and invectives are freely emitted: but they are only levelled against the too extensive application of this doctrine, and the inconsistencies, unquestionably often real, of the system of which he has made it the foundation. Indeed, if the quotations given are correct, we think no one who has not assumed a party, can refrain from concurring in their condemnation.

"Those who understand our doctrine never attack it; they speak of it only to express their admiration: above all, they never think of wishing to modify it, because they know that its fundamental dogmas are unshakeable." "Surtout ils ne s'avisent jamais de vouloir la modifier," &c. A man who assumes such ground as this, had need be very careful in assuming his positions, indeed; and should particularly avoid any thing like self-contradiction.

The _Lettres a un medecin de province_, in a style of lively criticism, labour to show a great variety of inconsistencies in this immoveable doctrine. The review of this publication in the Revue Medicale, including copious extracts, coincides with, and evidently wishes to aid, the author's satire. In the same journal are a series of criticisms on some of the elementary propositions of Dr. BROUSSAIS, published in a late edition of his Examen; (nearly the same which were published here, some time since, in the American Medical Recorder, having been translated by Dr. ATKINS.) In these critiques, great severity is shown, in dealing with the new dogmas, and the doctrine is treated as one of dangerous tendency; while, at the same time, high praise is awarded to their author, for his discoveries in the diseases of the alimentary mucous membranes.

In the other journals, there is a division; some favouring the new opinions, while others oppose them with more or less of vehemence.

That the doctrine of gastritis has made a great impression at Paris, that almost every one believes in it, to a greater or less extent, appears undeniable; but there, as well as here, most of the more rational, and moderate minded men are evidently of the only school a physician ought to belong to, the _eclectic_. Borrowing largely from BROUSSAIS, and having had their minds powerfully stimulated by the succession of striking and novel ideas which he has introduced, they think it unmanly to "bind themselves to his chariot-wheel," but form conclusions for themselves from every resource within their power. If the great French reformer really wishes to establish as absolute a power over the minds of his followers, as MAHOMET or PYTHAGORAS did, and as the above-quoted extract seems pretty fairly to indicate, he must certainly undergo many mortifications. Notwithstanding the "inebranlable" nature of his dogmas, M. MIQUEL has furnished us with several variations from them, in the writings of Messrs. BOISSEAU, ROCHE, SANSON, REMUSAT, RICHOND, and BEGIN; and the last-named individual has had a public dispute with his preceptor.

M. BEGIN has produced his promised work on surgery, according to the principles of the new school. We have not seen the volume, but have read a review of it in the Revue Medicale, by M. BELLANGER. The latter describes it as a cursory work, having for its object the adaptation of surgery to a set of general principles, rather than a detailed system of instructions how to proceed in each individual case. It contains only what is easy to be remembered, and omits those matters for which it is usual to refer to books. Thus two pages only are appropriated to fractures of the body and neck of the femur! and twenty-six for the whole subject of fractures, wounds, and six or eight of the most important diseases, of bones! Yet all this criticism is not without a compliment, well-merited at least by the former productions of the same author, to his talents and ingenuity.

19. _Whooping-cough._--"There is no disease of children, in which the resources of medicine are more manifestly serviceable than in an obstinate whooping-cough." Such, in amount, was the opinion of Dr. UNDERWOOD, and Dr. WATT uses language almost equally strong. Certainly, we are not at all times equally successful or equally sanguine in America.

Dr. A. CAVENNE considers whooping-cough a true bronchitis, a pulmonary catarrh; accompanied with greatly heightened nervous symptoms, owing to the irritable period of life at which it occurs, and particularly to its frequent existence in nervous constitutions. Professor TOURTELLE calls it a pneumo-gastric, pituitous catarrh; and certainly, the pupils of a modern school will find no difficulty in recognizing symptoms of gastritis in its severer forms. The further inferences drawn by Dr. CAVENNE, are as follows:

1. That the whooping-cough, in an individual of a sanguine temperament, requires, in general, the use of bleeding, and a debilitating regimen.

2. That bleeding and a debilitating treatment are equally necessary, whatever be the temperament, in whooping-cough of the chronic form.

3. The antispasmodics are necessary in nervous constitutions.

4. That blood-letting and the debilitating treatment should be rejected, when the subject is endowed with a lymphatic temperament. This observation, says our author, is equally applicable to early infancy, in which lymph predominates over the red blood, and the fluids are more diluted.

Finally, if the disease be obstinate and there be disturbance in several functions, there is certainly reason to believe that a lung, a viscus of the abdomen, or the brain, is in an unfavourable condition; (the author means of the inflammatory kind;) and this is ground for the moderate abstraction of blood.--_Journ. Univ. Feb._

20. _Antiperistaltic globus. Globus hystericus._--Dr. TROLLIET, of Lyons, observes that hysteria cannot, with propriety, be said to exist in the male sex; that it arises, as its name imports, from derangement of the uterus, and that CULLEN and SYDENHAM have done wrong, and stand alone, in teaching the contrary. When there exists a real hysteria, the contractions are not confined to the intestinal regions, but invade the neighbouring parts; (quere, which of them contract?) they are always accompanied, when existing in a high degree, with convulsions and loss of the mental powers. In the intervals, the patients affected can satisfy their appetite.