"Our female patients require less exercise in the open air than men. We have, however, horses and carriages appropriated for their benefit. They frequently_ride, walk abroad with their nurses, and gather flowers in the garden. The matron has frequently sewing parties, which all, who are in a proper condition, attend. They consider it a great favour to attend these parties, and endeavour to conduct so as not to forfeit the privilege. Besides the animated conversation which is elicited on these occasions, some of the number frequently read some interesting book for the entertainment of the

rest.

"The religious exercises at the institution have been continued as formerly. Our new chapel affords a very commodious, neat, and convenient place for meeting on the Sabbath. Until the new building is completed, but few of the male patients will be able to attend our family worship during the week.

Much of the good effect of religious worship depends on the prudence and discretion with which it is managed. We consider the judicious employment of religious exercises an important part of our moral treatment. They serve to promote order, revive their former grateful habits and associations, and recall into exercise that self-control which tends to their recovery. That religion which breathes 'peace on earth and good will to men,' and whose cheering influences extend beyond the grave, affords solace and consolation to the insane, as well as comfort to the rational mind. No one, who has witnessed the influence of the Christian religion on the human mind, can for a moment doubt its efficacy in producing serenity under all the trials of life, and preventing that shipwreck of reason, which would otherwise inevitably have followed. I have always noticed that the humble believer in Christianity recovered more readily from insanity than one who was not. As soon as the former has a return of one ray of reason, he has something to which he clings, and which soothes and sustains him under all his troubles. From the effect of proper religious exercises upon the minds of the insane, we have no doubt but the time will soon come, when its use will be considered an important moral means in the management of every well-regulated asylum.

"From the benefits that have already attended our efforts, we feel encouraged to make further and greater exertions in behalf of this unfortunate portion of our fellow men, humbly relying on the favour of a benificent Providence to crown our exertions with success.”—p. 23.

MISCELLANEOUS NOTICES.

Remarkable State of the Blood in an Hysterical Girl.-Eliz. S., aged 18, light hair and fair complexion, and unmarried, was admitted August 14, under the care of Dr. Chowne. She had the catamenia first, when she was sixteen years of age, and has had returns during the last six months, at intervals of a fortnight, in all respects as if they had been at the usual period.

On her admission she stated, that she had been affected with pain in the forehead and the left hypochondrium for three months; the latter pain she had, however, been subject to for two years. It was stated that, during the week prior to her admission, she had been almost constantly in fits, both during the day and the night. She had a similar fit soon after her admission, the general character of which was hysterical.

She had a full habit of body; countenance pale; lips red; she complained still of severe pain in the forehead, and considerable pain and tenderness, on pressure, under the false ribs of the left side; pulse full and frequent; impulse of the heart great, the first sound loudest; tongue rather white; bowels generally costive. After she came into the hospital she had two or

three fits every day for some days; during these fits the inspirations were long and difficult, and made with a loud sobbing noise; the expirations were natural, and the action of the heart continued as usual; she closed her eyelids; appeared insensible to what was passing around; and could not be roused by speaking to her even in a loud voice. The fits came on suddenly; if she were sitting when they attacked her, she remained in the same posture, unless laid down by one of the nurses. There were no spasmodic or other movements, except the affection of respiration. The fit generally lasted about half an hour; when it was over she remembered nothing of what had passed. She had aperient medicine for a few days after her admission.

On the 20th, as there was no alteration in her health, she was cupped between the shoulders, to about ten ounces. The blood was set aside, and on the 230, three days after it was taken, presented a very peculiar appearance, which, however, it had gradually assumed. The serum was scanty and reddish, and the whole clot presented a grayish-white colour; upon examination this was found on the upper side, about a quarter of an inch thick, at the sides, and below somewhat thinner. In appearance and consistence it was very similar to congealed oil, or fat, containing a little water, and resembling the coagulated fat of gravy; it also felt greasy between the fingers. The interior of the clot was crassamentum, of the usual consistence and colour, but on being broken up particles of white matter were found in the substance of it similar to that which surrounded it.

Dr. Chowne observed, that according to an analysis of this incrustation made by Dr. John Snow, to whom he had given it for that purpose, the fatty looking substance resembled fibrin in its chemical properties. On exposure to a moderately elevated temperature it became dried to a substance resembling horn. It was not soluble in alcohol, either cold or boiling. It was completely soluble in acetic acid, but only partially so in nitric acid on hoiling. It was completely soluble in cold liquor ammoniæ, and in boiling liquor potassæ, and on the addition of an acid to these solutions, it was precipitated in the form of a soapy-looking matter. The serum of this blood, instead of being alkaline, showed an acid reaction on litmus. On being heated it formed only a very loose and curdy coagulum, and on being evaporated to dryness was found to contain eight per cent. of dry albumen and salts, which is somewhat less than the natural proportion.

The blood was richer than natural in colouring matter and fibrine, but as it had been exposed during a few days to the evaporating of a part of its water, the exact proportion could not be stated.

23. The fits not so frequent, but the patient still complains of pain in the head and left side. To be cupped behind the neck to four ounces. The serum of this blood presented a milky appearance; it was alkaline, and in other respects appeared natural, and on being kept a few days underwent only the usual changes.

26. Remains much in the same state; pulse full, 90. arm to four ounces.

Was bled from the

31. The blood taken on the 26th, and to-day, perfectly natural. This appeared to be one of those examples, said Dr. Chowne, in which temporary peculiarities were found in the qualities of the cultivating fluid, not attributable to any particular cause that admitted of being recognised or associated with any particular set of appearances. There were abundant instances of the ordinary products of disease being found in the blood, under such circumstances as to leave no doubt of their having been formed there during its circulation; sometimes, instead of blood, a curdy friable matter, of a dirty gray colour, more or less firm, and resembling the semi-concrete pus of certain chronic abscesses. There was an extraordinary degree of apparent capriciousness about the existence of such unusual conditions of the blood. It was not always general, and there was great want of unformity in the quality of the blood in different parts; similar peculiarities

had been found in some vessels, while they had not existed in others. In the present case there appeared to be a disposition in the blood of the second bleeding to undergo the same change, but in that of the third and fourth all tendency to it appeared to have been lost.'

On the Cephalic Ganglion, commonly called the Pituitary Gland, and on its connections with the Nervous System of Organic Life. Py M. BAZIN. -After an historical account of the researches relating to the connections of the pituitary gland with the filaments of the sympathetic, the author passes to the facts which he has observed.

"The filaments by which the cephalic ganglion or pituitary gland is connected with the organic nervous system arise from the anterior and posterior aspects of the ganglion, from which they pass laterally to proceed immediately to the internal carotid artery, around which they wind, giving filaments to the carotid plexus. Several filaments thus anastomose with the net formed by the cavernous plexus.

"The filaments arising from the anterior aspects of the cephalic ganglion, are the largest: they form a fasciculus two millimetres wide, which is produced by the union of the two principal trunks. Arrived at the internal carotid, in the level of the concavity of the curve which it makes to go to the brain, they form a small gangliform plexus. A filament given off by the anterior trunk turns round the anterior and external aspect of the internal carotid, and divides into two filaments, each of which passes to one of the opposite extremities of the carotidian or cavernous ganglion. This ganglion furnishes several filaments, which pass to the third pair, and go to the ophthalmic ganglion. Behind, the cavernous ganglion sends several filaments to another ganglion situated between the external surface of the carotid and the first branch of the trifacial. The last ganglion gives several filaments to the outer surface of the carotid; others go to unite with a plexus situated between the third pair and the ophthalmic branch of the fifth; and this plexus gives two filaments to the sixth pair. The others go backwards, to what appears to us to be a true ganglion, situated in the internal surface of this first branch of the trifacial. The ganglionic plexus resulting from the union of the nerves coming off anteriorly from the cephalic ganglion, sends two moderate-sized filaments over the concavity of the last curve of the internal carotid, which are connected on the one hand with the nervi molles of the cavernous plexus, and on the other with the large filament which the superior cervical ganglion sends under the lower and outer surface of the internal carotid. Other filaments proceeding from the anterior surface of the cephalic ganglion, and others still which arise on its posterior aspect, embrace, and twine round the carotid, and are also continued to the filament we have just pointed out.

"I have discovered the same relations, only less complicated, between the cephalic ganglion (pituitary gland) and the superior cervical ganglion, in the eagle and the ostrich."-Comptes-Rendus, Oct. 21, 1839.2

A Peerage refused by a Physician.-At the late creation of peers in France, the name of M. Double was decided on as that of one fit to be raised to the dignity in question. The offer was then made to him, on condition that he should renounce the exercise of his profession! To this proposal M. Double refused to consent, not choosing to purchase the honour at so dear a price; and we cannot but remark, that the spirit evinced by the French government on this occasion is very different from that which actuated Napoleon, when he constituted Cabanis, Berthollet, and Fourcroy, peers of the empire.3

3

3 Ibid. p. 333.

Medical Convention for Revising the Pharmacopaia.-This convention assembled at Washington on the first Wednesday of January. Owing to a mistake made in convening it on the first Wednesday, instead of the first Monday, of January, the delegates from the University of Maryland and New Hampshire did not reach Washington until after the convention had adjourned.

We shall publish the account of the proceedings of the body, of which we formed a part, as soon as we receive it from the secretaries. Nothing could have passed off more harmoniously and satisfactorily in all respects.

The Maryland Medical and Surgical Journal.—We have received the first number of this new periodical, of neat appearance, and well "got up" in all respects. It is intended to appear quarterly, at the rate of $2.50 in advance, or at one dollar per number. The editorial committee are Drs. G. C. M. Roberts, Nathaniel Potter, James H. Miller, Robert A. Durkee, John R. W. Dunbar, and Samuel G. Baker.

We wish it every success.

NECROLOGY.

[We regret to observe in one of the latest foreign journals,' the death of an old and venerated preceptor.-Ed.]

Dr. Hamilton.-Dr. Hamilton, whose illness we announced last week, died on the 14th instant, at his house in St. Andrew's Square, Edinburgh. He had been for a great number of years Professor of Midwifery, and was the last of a generation now completely gone by. He was a very animated lecturer, and we believe, an energetic practitioner, retaining to the last the utmost vivacity in the maintenance of his opinions, as some papers published only last year, in the pages of this journal, [Lond. Med. Gazette,] will sufficiently demonstrate.

We have already heard of various candidates, both in Edinburgh and London, who are anxious to succeed him.

BOOKS RECEIVED.

Remarks on some of the Medicinal Springs of Virginia. By George Hayward, M. D. (Read before the Boston Society for Medical Improvement Sept. 23, 1839.)

From the Author.-Introductory Lecture before the Surgical Class of the College of Physicians and Surgeons, Fairfield, N. Y. Delivered Dec. 3, 1839. By Frank H. Hamilton, M. D., Professor of Surgery. (Published at the request of the Class.) 8vo, pp. 22. Albany, 1839.

From the Author.-A Defence of the Cosmogony of Moses, being, 1st, A Vindication from the attacks of Geologists; 2d, An Examination of that portion of Dr. Buckland's Geology, (one of the Bridgewater Treatises,) entitled Consistency of Geological Discoveries with Sacred History; 3d, A Review of an Essay on "Geology and Revelation" by J. G. Morris-an article in the American Museum for Nov. 1838. By J. Horwitz, M. D. 8vo, pp. 31. Baltimore, 1839.

Lond. Med. Gaz. Nov. 22, 1839, p. 336.

THE

AMERICAN MEDICAL INTELLIGENCER.

Vol. III.

February 1, 1840.

No. 21.

ART. I.-ON THE SOUNDS OF RESPIRATION AND OF THE

VOICE.'

BY PEYTON BLAKISTON, M. D.,

Physician to the Magdalen Asylum, and the General Dispensary, Birmingham.

Respiration.-On applying the ear to the neck and chest of a person in health, certain sounds are heard during respiration, which vary with the region in which they are listened to.

In the trachea, a coarse hollow sound is heard during inspiration and expiration, (tracheal respiration.)

At the upper part of the inter-scapular region, the sound during expiration is less intense than that during inspiration, and both are softer and weaker than in the trachea, (bronchial respiration.)

At the remaining parts of the chest, the sound during expiration is scarcely perceptible, being in most cases reduced to a short puff; while the sound of inspiration is much softer and weaker than at the inter-scapular region (vesicular respiration.)

This description of vesicular respiration differs from that of Laennec, who remarks, en entend pendant l'inspiration et l'expiration un murmure très legère, mais extrêmement distinct, qui indique la pénétration de l'air dans le tissu pulmonaire, et son expulsion," thus failing to observe the disproportion between the duration of the sounds of inspiration and expiration. Those persons who are in the daily habit of practising auscultation of the chest, will, however, I think, confirm the accuracy of the description here given.

I shall now endeavour to ascertain the manner in which these sounds are produced, and the causes of the variations in quality, intensity, and comparative duration; observed at different parts of the apparatus in which they are engendered.

This apparatus consists of a tube commencing at the mouth, divided and subdivided until it terminates in the air cells. During inspiration air is passed into it by the weight of the atmosphere, and is expelled during expiration by muscular reaction, and the resilience of the air cells and of the cartilages of the ribs. In thus passing and repassing through these tubes, the air meets with obstacles at every point where their direction is changed. Now when a current of air meets with opposing obstacles, as the wind blowing upon trees, or into a tube inclined at an angle to its direction, it is thrown into sonorous vibration, and therefore noise must be produced in the trachea and its division during respiration. This sound is not sufficiently intense to be heard until the listener places his ear in contact with the

'Read before the British Association for the Advancement of Science, Aug. 27, 1839. Lond. Med. Gaz. Oct. 12, 1839, p. 78.