wadding is of an ochre or deep-reddish colour. However, when a gun has been charged immediately after having been washed, and the wadding is examined a few hours afterwards, the colour is then found to be a greenishyellow, which passes rapidly to a brown-red, when exposed to the action of the air and atmospheric moisture. If to the preceding characters we add those which are derived from the absence or presence of sulphuric acid, we may conclude to a certainty that the gun has been cleaned or not, before it has been charged. In order to render the materials which are to be submitted to the medical jurist available, certain precautions must be taken by the magistrates or police authorities into whose hands the suspected arms may, in the first instance, fall. The muzzle of the gun should be closed with a paper wadding, and then covered over with some paper, to which an official seal should be attached. The same precaution should be employed with respect to the lock of the gun, whether it be a flint or percussion one.-Arch. Gén. de Méd., Feb. 1839. Case of Tetanus, with Trismus, successfuly treated. By Dr. SPÖRER.Gustav Gustavson, æt. 24, a coachman, of robust make, was admitted into the Marine Hospital, December 11, 1831. On December 5th, when raising a heavy water-tub, he experienced a severe pain, extending from the scrobiculus cordis to the umbilicus, and the whole length of the back from the upper cervical to the lower lumbar region: this was succeeded by trismus. Having submitted to the action of the hot-air bath, which produced copious perspiration, and the application of eight cupping-glasses, to the neck and back, he was so far relieved as to be enabled on the same evening to resume his usual occupation of driving. During the night he experienced occasional and slight attacks of both trismus and tetanus; which, however, ceased after a further profuse perspiration on the following morning. During the succeeding day his avocation subjected him again to long exposure in the cold air, in consequence of which he was several times attacked by opisthotonos whilst seated on his coach-box. On December 7th the symptoms became much aggravated, and he was then (at home) bled to a pound, and twenty leeches applied to the abdomen; a warm bath and frictions to the back were also employed, and some internal remedies exhibited, with the effect of again procuring mitigation of the symptoms: but, on the morning of his admittance into the hospital (11th), all the former symptoms had recurred with increased violence, accompanied by severe spasm of the dorsal, thoracic, and abdominal muscles; his face was distorted, his teeth clenched and grinding; the head and body curved backwards, and the belly drawn inwards and as unyielding as a board; pulse 88, small, and contracted; respiration short and gasping; bowels constipated during two days. As inflammation of the theca vertebralis was presumed to be the proximate cause of this attack, the following treatment was adopted: twenty leeches were applied along the course of the vertebral column, and the patient afterwards placed in a warm soap-bath; a powder, of cal. gr. vj. cum rad. jalap. j., was administered, being passed through the intervals between the teeth; and, as no action of the bowels followed this before evening, it was repeated, and injections employed until at last two copious and fetid evacuations were procured. On the following day (December 12th), the attacks were more rare, but still severe: he was ordered to take cal. gr. j. sextis horis, and the cupping to the epigastrium and between the shoulders was repeated. On the 13th, he had passed a quieter night, and had perspired less copiously: this was, however, succeeded during the day by several sharp attacks of spasm, and the trismus continued unabated. Dry cupping-glasses were then applied along the sides of the spinal column, and to the upper part of the abdomen; frictions were again employed, and the affected parts enveloped in oiled flannels. On the two following days (14th and 15th), the symptoms became materially alleviated, and the calomel was then omitted. Between the 16th and 18th, the opisthotonos subsided: the trismus, with some spasm of the scapular muscles, continued, but in a milder form. After this report the secretions gradually resumed a healthy character, and by January 10th all muscular spasm had ceased, and he was discharged well. In comparing the earlier and later treatment, Dr. Spörer takes occasion to give it as his opinion that, in the present instance, the employment of the dry cupping-glasses, oily frictions, and frequent employment of the warm soap-bath, materially aided in procuring a successful result to the case.Zeitschrift für die gesammte Medicin. Band vi. Heft 1. And Br. and For. Med. Rev. April, 1839. Case of Fatal Inflammation of the Vermiform Process. By Dr. BIESKE. -L. H. aged twenty, tall, but of robust constitution, and previously in the enjoyment of good health, complained of being sick and uncomfortable on the evening of the 2d September. In the early part of the day he had been in excellent spirits, and had taken a hearty dinner. On the 3d he complained of want of appetite, weariness, pains in the limbs, and a slight pain in a circumscribed spot, of about three inches in diameter, in the right iliac region, which was somewhat increased by pressure. The tongue was coated, and the pulse rather frequent. The disease was considered as a slight febrile attack, eight leeches were applied to the painful part, and a dose of acetate of potash given internally. In the evening the pain was removed, and the patient appeared to be doing well. An emulsion of castor oil with laurel water was given to open the bowels. The condition of the patient remained much the same during the 4th; on the 5th he was more restless, and complained of a return of the pain in the side, which was again removed by the application of leeches. In the evening there were still no unfavourable symptoms, but on the morning of the 6th matters had assumed a different aspect; the pulse could scarcely be counted, was small, hard, and wiry, the abdomen tense and tympanitic, but not painful; the face collapsed, and the extremities cold. The patient was immediately bled, but his weakness prevented more than two cups of blood being taken. In spite of a variety of remedies, his state went on from bad to worse, and he expired at 1 o'clock on the morning of the 7th. On dissection, the processus vermiformis was found in a state of mortification, and a concretion, about the size of a large coffee berry, the probable cause of the disease, was found impacted in it. A section of the concretion showed its nucleus to be formed by the stone of a grape.-Rust's Magazin für die gesammte Heilkunde. Vol. lii. Part 2. And Br. and For. Med. Rev. April, 1839. Fricke and Oppenheim's Journal. The last number of this valuable periodical, which we have received,' contains abstracts of cases, &c. by Dr. Posey, Dr. E. A. Anderson, Dr. Vedder, and Drs. Purdie and Annan, published at different times in the "Intelligencer." BOOKS RECEIVED. From the Author.-On Scarlatina, in a letter addressed to his son. By William Ingalls, M. D., MM. S. Soc. &c. Second edition, with an appendix. 8vo. pp. 40. Boston, 1839. From the Author.-Address of Dr. T. J. White, before the St. Louis Total Abstinence Society. (In the St. Louis Commercial Bulletin, May 15, 1839.) 1 Zeitschrift für die gessammte Medicin u. s. w. May, 1839. The disease of Bright-Morbus Brightii, or Maladie de Bright, as it is termed, on the continent of Europe-has attracted much attention of late; and some of the best monographs on the subject have been reprinted in the pages of the "Library" department. By many it is supposed that the presence of albumen in the urine is a certain indication of that disease, which consists—as is now well known-in a granular degeneration of the cortical or secretory portion of the kidney. By others, however, albumen has been met with in the urine, where there was no reason whatever to believe in the existence of renal mischief. In Dr. Christison's excellent work "On Granular Degeneration of the Kidneys"-reprinted in this year of the Library-the author refers to the views of various writers-Messrs. Osborne, Rayer, Solon, and Forget-on this subject, and expresses his own opinion, that "although coagulability may be observed without granular disorganisation of the kidneys, the occurrence is very rare." To arrive at still more satisfactory information on this head, we instituted experiments on the urine of different patients in the wards of the Blockley Hospital, and intend to pursue the investigations hereafter. The following note by Dr. McKee-one of the senior resident physicians-exhibits the results of one series of experiments. Philadelphia Hospital, June 6th, 1839. Dr. Dunglison requested that the urine of the patients might be preserved on the morning of his next visit. Accordingly eleven cases were selected: out of that number there were of Each individual's urine was tested separately, and but two found to produce a coagulum by heat, and an albuminous precipitate with nitric acid. These two were dysentery. MCKEE, M. D. The only two cases, it will be observed, in which the urine was albuminous, were dysentery, and in both the quantity of albumen was considerable. In neither case was there the slightest reason to suspect renal disease. Since these examinations were made, we have received the Gazette Médicale de Paris for February, 1839, in which we find some remarks by M. Toulmouche, of Rennes, "On the Uncertainty of the Diagnostic Signs of Albuminuria." He details two cases of albuminous urine. In both, the urinary membrane of the bowels was affected; in the one there was "chronic enteritis with ulceration ;" in the other "ulcerations and tubercles in the jejunum and ileum, with larger ulcerations in the cæcum and colon." In the latter patient, however, there was the first stage of the morbus Brightii. So far, then, as these few cases go, they would seem to favour the idea, that albuminuria may be connected with other morbid conditions than granulation of the kidneys, and especially, perhaps, with eso-enteritis or inflammation of the lining membrane of the bowels. The results, thus far obtained, will at least encourage investigation in this direction. M. Toulmouche affirms, that he has often met with albumen in the urine of patients labouring under dropsy, without the kidneys being affected. "The product of their secretion," he observes, "had alone been modified, without any change in their size, consistence, or colour." Perhaps," he adds, "this might have supervened, if—as Valentin thinks-the alteration of the urinary secretion ultimately induces the morbid condition, discovered by the English physician." In a case which recently fell under our care, and in which enlargement of the liver had given rise to ascites, and general loss of balance between the exhalants and absorbents; the urine was distinctly and largely albuminous; the degeneration of the kidney was, however, but in its incipient stage,' and death occurred from the lesions of other organs. ART. II.-LECTURE ON THE VENEREAL DISEASE. BY F. C. SKEY, F. R. S. &c.2 There is a long history appended to the venereal disease, into which, however, I shall not enter unnecessarily. The general belief prevails, that the venereal disease was unknown in Europe before the close of the fifteenth century. In the year 1494, it is reported by the Spanish historians of that date to have been introduced into the peninsula from St. Domingo, and other islands of the West Indies, by the Spanish sailors who attended Christopher Columbus and his brother Bartholomew, in their several expeditions of discovery; that it was communicated to the French troops at Naples by the Spaniards, and was by them conveyed to France, and named the "morbus Gallicus," previous to which it was well known in Spain under the name of "las bubas" (whence possibly our name bubo). The glory attendant on 1 See Christison, Op. citat. Lect. 1. London Med. Gazette, May 11, 1839, p. 229. the successful issue of the French expedition, for a time reconciled the people to the opprobrious name of their new acquisition, though they ere long became captious and sensitive to the indignity; they named it, and not unreasonably, "le mal de Naples." As it extended through the various countries of Europe and Western Asia, it took invariably the name of the country through which it travelled. The English called it the French disease, as did the Germans; the Poles knew it under the designation of the disease of the Germans; the Russians, the disease of the Poles; the Persians and Turks, as the disease of the Franks. "At length," says Astruc, "the French physicians became ashamed of the infamy which was grown so common, and thought themselves engaged to throw off the scandal which had been unjustly thrown on their country, and by common consent it was named the venereal disease." The venereal disease, naturally acquired, may exhibit itself in three distinct primary forms :- 1st. As a discharge of purulent matter from the urethra. 2d. As an ulcer. And 3d. As an induration of the subcutaneous or submuco-cutaneous cellular membrane, succeeded by ulceration. Of these, the two former are of most frequent occurrence. Besides these, the genital organs are the seat of sundry varieties of disease strongly resembling the venereal, from which it is often most difficult to distinguish them. Before I proceed to the immediate subject of the disease itself, I wish to introduce some points of interest for your attentive consideration. It is a common opinion that the form of the affection developed by sexual intercourse, corresponds with that of the party by, or from whom, it has been produced; and also, that this disease is the product of a specific poison. There is, as it appears to me, abundant evidence to the contrary; to prove which, I need not, for my own satisfaction, travel out of the record of my own recollection. One of the most credible authors on this subject, an army surgeon, states, "I have been present at the public examination of 200 women of the town, and most frequented by soldiers, and not one case of disease was found; nevertheless, the hospitals continued to have the usual number of venereal cases. Subsequently 100 were examined, and only two were diseased; and the author most justly remarks, “It is impossible that these two women could have infected the whole garrison"— an opinion that I presume will admit of no altercation. Now, either the disease in these women existed beyond the surface exposed-a supposition at variance with every day's experience-or the above facts are false; or the diseases under which these men were labouring, were spontaneous, or at least self-generated; and if self-generated, I do not see why I am compelled to place an unqualified faith in the history given by Astruc and others, of the introduction of the venereal disease in the fifteenth century, because if these maladies be susceptible of an origin independent of specific contagion, it is clear that they may have been similarly produced at any period in history. The term self-generated (I will not say spontaneous, for that is still more objectionable) expresses something short of the idea I wish to convey. I mean that, in a certain condition of constitution, the elements of a poison lie dormant, which may be developed by the action of a simple irritant, and that that irritant may exist in the form of any apparently simple, but unhealthy exciting cause in the female, such as leucorrhoea, menstrual fluid, or indeed any impure secretion of a puriform character; and may also be developed by mechanical irritation. I do not say that the venereal disease is invariably propagated by these means, because there is plenty of experience to the contrary; but looking, first, to the frequency of disease, whether ulcerative or catarrhal, obtained by intercourse with women, without ground for suspicion of disease; se |