minds of a delusion which, if encouraged, will undoubtedly lead to disastrous consequences. I should hold myself guilty, if I did not admonish the student that the attendance on lectures is but a very small part of the labour he will be called upon to perform, whilst preparing himself for the arduous. and responsible duties of a medical practitioner. In the lecture room, he will be instructed only in the general principles of his science; he will have arrayed before him the opinions of the luminaties in the profession; and he i will receive from the lips of the professor comments, which may or may not be based on true philosophy. It then remains to subject these princi ples and comments to the rigid test of experience; from generalisation we proceed to abstract investigation; and all theories in medicine, which will not accord with facts derived from bed-side observation, must be considered so many sophisms calculated only to lumber and retard our knowledge. "In times of old when the Aurora of our art, was far below the horizonwhen chance seemed to be the only regulator of men's views, it was custo mary to pay a holy respect to the opinions of individuals; these opinions were regarded as oracles, to depart from which was deemed the highest offence. According to the early traditions, the first collection of medical precepts was derived from Thouth, reputed to have possessed extraordinary talents and unequaled skill. These precepts were collected into a volume, which constituted the text-book of the priests, who were the only physicians in those early days. As part of their religion, the priests were required to regard, and in fact follow in their practice the precepts as sacred and unerring guides. It mattered not what consequences ensued, they were always certain of impunity so long as they adhered scrupulously to the prescriptions of Thouth; whilst, on the other hand, the slightest attempt at deviation, however favourable the issue, was menaced with forfeiture of life. In those times of darkness and superstition it was considered far better that ninety and nine should fall victims, than that the validity of the precepts of the mighty oracle should be called in question, or one heretical patient presume to recover in contradiction to them. Would that these prejudices, originating among a people who knew not the blessings of Christianity, were confined to the period of ignorance and folly. Their existence has been felt, and their influence acknowledged, even beneath the light of revelation, pervading the most sacred depositories of literature, and contaminating the wisdom of sages. Medical science has felt deeply the pernicious effects of idolatry paid to the dicta of men; she has suffered for years from the perversion of truth; and her votaries now feel that facts must be substituted for hypothesis, and patient investigation take the place of wild and unsupported conjecture. Medicine is a science of facts, and all that is excellent in her domain reposes on fixed and immutable data. Nature, in her varied phases, is the sage mistress from whom we derive the fundamental principles of our art. In health, she discloses to us the beautiful harmony of her system; whilst in disease, she points us to the effects of morbid action, and admonishes us of the means by which it is to be arrested. This knowledge, so essential to the successful discharge of professional duty, cannot be attained but by daily communion with the sick and the dead. In watching over the former, we are enabled to discover the value of written testimony; in con templating the latter, we become familiarised with the devastating effects of disease." p. 21. Restoration of a Large Portion of the Face.'-The following case presents an example of one of the most fortunate attempts which, perhaps, has ever been made to restore, by surgical operation, a large portion of the human figure: A Belgian soldier received. in 1831, a gun-shot wound, which shattered the lower jaw, cut through the tongue, and carried away the upper lip, with the cheek and superior maxilla. The mouth and nasal fosse were thus converted into one cavity; behind the velum pendulum and palatine bones were untouched, but the mouth communicated on either side with the zygomatie fossa. On the right side the floor of the orbit was driven in, and the eyeball forced out of its cavity. This enormous wound did not bleed, and the man was carried off the field three hours after its receipt. A long time elapsed before any regular surgical aid could be afforded, when the face presented the most deplorable appearance. The portion of the nose which remained had become adherent to the roof of the palate; the fragments of the lip and right cheek were rolled up and useless; the perpendicular diameter of the face was much reduced by the loss of the upper jaw-bone, while the lower maxilla was carried upwards and touched the dorsum of the nose. The tongue was adherent to the roof of the mouth, and the patient could only express himself by indistinct guttural sounds. On the 18th of March, 1839, M. Burgraeve endeavoured to correct these deformities by the following operation: The lower lip was separated on either side by two cuts with the scissars; two other incisions were then made (the convexity being downwards) from the opening of the nasal fossa to the anterior edges of the maxillary bones, while two incisions descended: at right angles to the last, along the masseter muscles to the angles of the lower jaw. Two flaps were thus formed, and separated from the subjacent parts, being adherent to the skin of the neck by two pedicles of an inch in breadth. The nose was now dissected away from its adherences to the palate, and two side-flaps brought together, the nose being placed on their juncture at the middle line of the new lip. The upper and internal angle of the right flap was fixed by two points of suture under the angle of the right orbit, and the other portions of the edges were also united by points of the interrupted suture. This tedious and terrible dissection lasted an hour and a quarter. No dressings, save lint and water, were applied; the patient took an opiate draught. The cold lotions were continued. On the third day it was found necessary to remove a silver plate which had been placed under the flap to represent the maxillary bone and dorsum of the nose. As the mouth was too narrow to permit its extraction, M. Burgraeve divided the sutures along the median line of the wound, and extracted the metal plate without difficulty. On the healing of the different parts of the wound it was found that the lower jaw still ascended above the upper lip, and rendered the ingestion of food difficult. To remedy this defect the surgeon elevated the commissures of the mouth on either side by removing elliptical portions of the skin, in the direction of the naso-labial lines, and this had the desired effect; he also cut away the indurated cellular tissue of the cheek, which had been occasioned by the dissection of the flaps.- French Medical Gazette, Sept. 31, 1939. Population of France. The total number of births in Paris during the year 137, was 29,192; or, 14,651 boys and 14,541 girls. Of the number born, no less than 9,578, or nearly one third, were born out of wedlock. The number of deaths amounted to 28,134. There died-at home, 17,127 persons; in hospital, 10,604; in prison, 99; while 304 bodies were deposited at the Morgue. London Lancet, Oct. 12, 1839, p. 102. ↑ Ibid. Oct. 5, 1839, p. 71. Hence of every five persons who die in Paris only three have the satisfaction of dying in bed. The number of deaths from small-pox, out of a population of 774,338, amounted to 458; in the year 1836, it was only 227. The proportion of males to females born is as 17 to 16; but of children born out of wedlock, the proportion is as 24 to 23. As there is one birth for every 32.7 inhabitants, if we suppose the population to remain nearly stationary, the mean duration of life is expressed by 32.7 years. Before the revolution, it was only 28.75.-French Lancet, Sept. 10, 1839. Prison Mortality in France.'-From 1815 to 1818, the general mortality of the prisons in Paris was one death for every 12.01 prisoners; from 1819 to 1825, the mortality was reduced to 1 in 15.30. In the other prisons of the kingdom the general mortality was 1 in 20.9. In the places where galley slaves are confined, the mortality from 1816 to 1827 was as follows: Rochefort, 1 in 11.51 1 in 20.25 1 in 27.06 French Med. Gazette, Sept. 21, 1839. BOOKS RECEIVED. From the Publisher.-Plates of the Arteries, with references; for the use of Medical Students. By Paul B. Goddard, M. D., Demonstrator of Anatomy in the University of Pennsylvania, &c. &c. 4to, pp. 49. 12 lithographic plates. Philad. 1839. From Dr. John H. Dix.-The Boston Medical Journal for Sept. 25, 1839; containing his communication on Deafness relieved by Injections of water through the Eustachian Tubes. From the American Editor and Publishers.-The London Dissector, or Guide to Anatomy, for the Use of Students; comprising a description of the muscles, vessels, nerves, lymphatics, and viscera of the human body, as they appear on dissection; with directions for their demonstration. From the first American edition. Revised and corrected by Edward J. Chaisty, M. D., Demonstrator of Anatomy in the University of Maryland. 12mo, pp. 273. Baltimore, 1839. From Messrs. Lea & Blanchard, the Publishers.-New Remedies: the Method of Preparing and Administering them; their Effects on the Healthy and Diseased Economy, &c. &c. (Prodesse quam conspici.) By Robley Dunglison, M. D., M. A. P. S., Professor of the Institutes of Medicine and Materia Medica in Jefferson Medical College of Philadelphia, Attending Physician to the Philadelphia Hospital, &c. &c. 8vo, pp. 503. Philadelphia, 1839. From the Translator-Anatomical, Pathological and Therapeutic Researches on the Yellow Fever of Gibraltar, of 1828. By P. Ch. A. Louis, Physician to the Hotel-Dieu, President for life of the Society for Medical Observation of Paris, Member of the Royal Academy of Medicine of Paris, Honorary Member of the Massachusetts Medical Society, &c. &c. From Observations taken by himself and M. Trousseau, as Members of the French Commission at Gibraltar, Translated from the manuscript by G. Shattuck, Jr., M. D., Member of the Society for Medical Observation at Paris, Fellow of the Massachusetts Medical Society. 8vo, pp. 374. Boston, 1839. From the Author.-A Table of Chemical Equivalents, arranged for chemists and pharmaceutists. By James Hamilton, M. D. Baltimore. (One large sheet.) 1 London Lancet, Oct. 5, 1839, p. 71. ART. I.-CASE OF EXTREME SENSIBILITY OF THE RETINA. Professor Dunglison. BY JAMES W. SALTER, M. D. Richmond, Ia., Nov. 16th, 1839. Dear sir, I herein take the liberty of sending you a report of a case of extreme morbid sensibility of the retina, possessing, I think, some interest. If you should deem it worthy of a place in the "Medical Intelligencer," please give it an insertion. As the case proved a "stumbling-block" to some who had been long in practice, perhaps its publicity may be of use to others. Very respectfully, your obed't. servant, JAMES W. SALTER, M. D. The subject of the following case was a daughter of Mr. M. K., residing in this vicinity, æt. 3. She was attacked about eight months ago with violent inflammation of both of the eyes, which was partially subdued by an antiphlogistic course of treatment. Several states of relapse and partial alleviation occurred during the first three or four months. The eyes then became permanently so irritable as not to admit a particle of light, which state continued until the case was dispaired of, and finally given up by a respectable practitioner as incurable. On the 1st of October, and about six months after the first attack, I was requested to see her. I found the little patient lying upon her face, which position she obstinately maintained both day and night, with the eyelids much swollen and some abrasions about the nose and forehead, produced by the constant pressure and friction; pulse quicker and more frequent than natural; tongue slightly coated; bowels regular; appetite tolerable; and the mind excessively irascible, not bearing the least attention. All my attempts to examine the state and appearance of the balls of the eyes were rendered perfectly fruitless, partly by the swollen state of the lids and partly by the excessive suffusion of tears whenever the attempt was made. My pathological deductions were, that this was no longer an inflammatory disease, but purely a morbid sensibility of the retina superinduced by the previous inflammatory action, and kept up by the entire exclusion of light. I prescribed sulph. quinæ, elix. vit. and tr. opii comp. in combination as freely as the stomach would bear, and ordered a more generous and nutritive diet. In less than three weeks' time I had the satisfaction of seeing the use of my little patient's eyes entirely restored-the only vestige of disease being a small opaque spot upon the cornea of the left eye, which is gradually being absorbed. JAMES W. SAlter. ART. II.-CASES OF THORACIC DISEASE. Dr. Dunglison. Por the American Medical Intelligencer. Dear sir,-I send you abstracts of my notes of two interesting cases of thoracic disease, which you are at liberty to publish-all, or as much as you may think proper. Yours respectfully, JAMES M. GREEN. Case of T. L. S., in his fortieth year. A man of sanguine temperament and active habits, formerly of athletic frame, has been much exposed in various climates for twenty years. Has suffered from bronchial affections coughs, colds, difficulty of breathing, &c., for sixteen years, increasing in violence and frequency, and lately accompanied by disordered action of the heart. Present state, Nov. 5, 1838.-Great fatigue and violent palpitation on ascending a flight of steps; distressing cough, and plentiful muco-purulent expectoration every morning on awakening; stomach disordered in its fuctions; anorexia; bad digestion, &c. Liver and spleen both enlarged and sore to the touch. Heart apparently dilated, and laborious in its action, impulse feeble, but distinct in both hypochondria and in the epigastrium. Sound on percussion on left side very clear from spine behind to sternum in front. On the right side in front relatively flat above and more so about the mammary region; same characters in lateral regions, but not so distinct; flatter on the right side behind than on the left. Stethoscopic examination :-sound of the heart, loud all over the lower and front part of thorax, in the right and left hypochondria and epigastrium. No respiratory sound on the right side, with the exception of an obscure vesicular respiratory murmur below the clavicle, and at the internal edge of the right scapula. Left side, in front or in the lateral regions the respiration somewhat puerile, with an occasional sonorous rattle; posteriorly there is a loud tracheal blowing sound, about as wide as two fingers, and extending from the middle of the scapula in a straight line to eighth rib, where it disappears; it is attended with loud resonance of the voice, and is distinctly defined at its margins. For several months he made a persevering use of various means of counter-irritation, including a seton on the upper part of the sternum, together with a long-continued purging with aloes, myrrh, and sulph. ferr. pills, and other modes of local and general treatment. Under the use of these remedies, and a more prudent indulgence and exposure, his face assumed its natural hue-the liver and spleen their natural size and functions, and his abdomen, from being full and prominent became flat and even depressed; appetite and digestion quite healthy. The stethoscopic changes, noticed during many successive observations, were a gradual increase in the roughness and puerility of the respiration, until it became intensely puerile; this change seemed to take place behind, and advanced to the front of the chest, until it included the whole of the left lung; and there seemed to be a marked diminution in the apparent volume of the heart-it seemed to contract itself behind the sternum. Aug. 16, 1839. Present state.-Abdomen flat; liver, spleen and stomach natural. A slight sound of inspiration and expiration under the right clavicle, and a blowing sound at the lower angle of right scapula; not the slightest indication of the entrance of air into any other part of right lung. The heart has changed its location entirely; it is now, as indicated by the dulness on percussion, the impulse to the hand, and the sounds to the ear, in the right inferior thoracic region. The line of pulsation and sound is considerably to the right of the zyphoid cartilage; pulsation is no longer evident in the epigastrium: with respect to size and sound the heart seems natural. Left side: the respiration is loud, rough, and puerile, except in |