close her lips and refrain from sucking it out of the spoon. Having done this, and then emptying the spoon by inverting it, it was followed by a much lighter spasm than when drunk from a cup. In drinking with a quill, also, her spasms were weaker. It appeared as if the wetting of the lips and the effort of sucking in the fluid favoured the production of the spasm. Ordered the blisters to be dressed with Basilicon Ointment, and prescribed submur. hydrar. grs. x. pulv. ipecac. grs. ii.

On Monday, February 11th, 8 o'clock, A. M., I visited her alone. She informed me that she had altogether during the night about one hour's unsound sleep, and more in the early part of the evening than afterwards. She was not able to drink all night, she could not swallow, and thinks her spasms, on attempting to drink, were stronger and of longer continuance. She endeavoured to get down some drink by soaking it up with toast, but she could not. During the night, two spasms came on spontaneously while lying down. She said she was very bad early this morning-she experienced feelings of intense distress, and was thrown into spasms whenever the door was opened and admitted the cold air-felt her spirits give way—and her thirst was extreme. At this time she felt the spasms working in her every four or five minutes, although they did not break out, producing great agony. She continued in this way until she made several desperate efforts to drink some warm coffee, which she succeeded in forcing into her by means of a quill to the amount of nearly half a pint. This was the largest quantity of fluid she had taken since the spasms commenced, and it had quite a tranquilising effect upon her, causing the great anxiety and distress to diminish. After this she washed her face with a camphor rag, and while doing it she was affected with spasm. Although she expressed herself much better than she had been earlier in the morning, I noticed more anxiety and wildness in her countenance than the evening before. Her pulse was not quite so full, the skin rather below the natural temperature, the tongue more thickly coated with the same kind of fur, the breathing seemed rather more difficult, and was interrupted by peculiar sobs and deep sighs. While I was there she picked up a cold handkerchief to wipe her mouth, and it brought on spasm as soon as it touched her face. She had taken two powders after we had left her last night, which produced vomiting of a yellowish, bitter and frothy fluid and some blood, but she postponed taking any more after 12 o'clock in the night in consequence of the great difficulty she experienced in swallowing them, and the sickness they produced-although she admitted that she was always relieved after vomiting. The blisters had drawn well-the cuticle being raised throughout their whole extent. I gave her another powder rubbed up in sugar, which, with the aid of coffee and the quill she succeeded in getting down, not, however, without considerable difficulty.

At 11 o'clock, A. M. visited her with my brother. Her skin was of the natural temperature and moisture, pulse fuller, tongue the same, and countenance less anxious. She had no spontaneous spasms since-they still came on, however, on every attempt to drink.-She complained that the heat of the stove sickened her, but she could not bear the doors open. On attempting to drink some coffee with a quill, she was thrown into a violent spasm, and succeeded in swallowing only a little. The powder which I had given her at my last visit caused her to throw off the same kind of fluid, and a living lumbricus. We examined the blister that had been dressed yesterday by the morphia, and the morphia appeared to be absorbed.-The fresh blistered surface on the neck was now dressed with acetate of morphia, and upon applying the cerate cold to the blister it produced a paroxysm. Her bowels not having been moved since Saturday, we prescribed in the form of pill, oleum tiglii 2 gtt. every hour until the desired effect would be produced.

At 3 o'clock, P. M. visited her in company with Dr. E. Parry. Her symp toms were about the same-pulse 88. She had taken only two doses of the oil, and without effect. Gave her another dose which she swallowed

with difficulty. Upon taking some tea after, she was thrown into severe spasms, and then said "she did not like to see drink come near her." Uniformly in taking drink she would hesitate, as before described, several times before she would place the cup to her lips, and as soon as she attempted to suck in the fluid the spasms would commence. She had got into a doze about an hour before, and was awakened by her son suddenly entering the room, which produced a violent paroxysm. Applied morphia again to a blistered surface.

At 6 o'clock, P. M. received word that she was no better, and that the medicine had not operated.

At 8 o'clock, P. M. called again with my brother and Mr. Landis, a student. Her pulse was 90, skin and countenance the same. The lower gums and the sides of the tongue appeared excited, resembling the mercurial blush, but it was not attended with the coppery taste nor mercurial odour. She had had several very severe spasms from cool air coming over her face, and also from her attempts to drink. She got a most violent spasm when the family were at supper, caused by the noise of pouring out the tea. This spasm raised her off her seat, and was accompanied with a peculiar spasmodic noise, great horror of countenance, and throwing the hands about. We now spread 30 grs. of submur. hydrar. on a small piece of bread, part of which she ate without difficulty, complaining of it being very dry. We offered her drink, but she did not appear to want the cup; she took the quill out of the drink and hastily drew the wetted end through her mouth, thus catching a drop. This was followed by light spasm. We then advised her to dip the bread in tea, to moisten it, but she did not seem inclined to do it. Observing her dread of the fluid, I dipped it in for her, when she ate it. She said she had dozed a little, and she thought she could doze more through the night. She had taken since the last visit two doses more of the oleum tiglii, making in all 10 gtt. without any effect. Prescribed submur. hydrar. grs. xv. pulv. ipecac. grs. 3. to be taken every three hours during the night. (To be concluded in the next number.)

BIBLIOGRAPHICAL NOTICES.

Mütter on Club Foot.1

This is not the first work of this dexterous surgeon to which we have had to direct the attention of our readers in the course of our short editorial career. Dr. Mütter has readily embraced the new method for treating club foot,-(he is wrong in making Loxarthus and Club Foot synonymous,)—and in numerous cases, detailed in the volume before us, has been entirely successful. The book is illustrated by numerous wood-cuts, exhibiting the different deviations of the feet, and various instruments for rectifying the deformities.

The following are Dr. Mütter's remarks on the operation of tenotomy or of the division of the tendons, in cases where relief cannot be obtained by an appropriate mechanical apparatus,

"The operation which I prefer is precisely that of Mr. Whipple, with

1 A Lecture on Loxarthus or Club Foot. By Thomas D. Mütter, M. D., Lecturer on Surgery, Fellow of the College of Physicians, Member of the Academy of Natural Sciences of Philadelphia, Honorary Member of the Medical Society of Philadelphia, &c. &c. 8vo, pp. 104. Philadelphia, 1839.

2 See Med. Intelligencer, vol. i. p. 418.-Ed.

the exception, that instead of dividing the tendon obliquely, I cut it directly across. The latter method I prefer, inasmuch as it is more easy of execution (although both are simple enough), and the tendon when divided, separates with an audible snap, which enables us at once to detect its complete division.

"The patient having been prepared, when this is necessary, by rest, diet, purging, &c., for the operation, it is performed as follows. If the individual be a child, he may be laid across his mother's lap; if older, he should be placed flat on his face upon a bed or table; an assistant steadies the limb, while the surgeon grasps the foot with the right or left hand, as the case may be, and forcibly extends it, so as to relax the tendon and the integuments covering it. He then passes from within outwards a narrow convexedged bistoury, about one or two inches above the os calcis, and between the integument and tendon, until its point gets beyond the outer margin of the latter the foot is then suddenly flexed, which brings the tendon against the knife, previously turned upon its edge, and with very little pressure upon the instrument the operation is completed, which is generally indicated by the snap, and by a sudden jerk. As soon as this is perceived, and not until then, the knife is withdrawn in the same way in which it had been introduced. The little wound is then closed by adhesive plaster, the stretching apparatus applied, and the subsequent treatment conducted as I have already indicated. Whenever it seems necessary to divide other tendons, the operation is to be performed upon a similar plan; make but one puncture, and divide them directly across, and then begin to extend the parts at once.

"I might next say something about the dangers of this operation, but, gentlemen, so far as I have been able to learn, there are no dangers. The opponents of the division of tendons to overcome deformities of different kinds, daily preach to us of tetanus, of sloughings, of erysipelas, and even of death, but their fears are idle. There is no case upon record, in which, when the operation has been properly performed, and no other cause operating to produce dangerous symptoms, serious consequences have resulted. In the case of the person operated on by Delpech, who was several months in recovering, it is evident that all the distressing symptoms to which he was subjected originated in the manner in which the operation was performed. Inflammation may supervene, it is true, even when the operation has been properly performed, but in no case have I heard of its resistance for any time, to the action of proper remedies. Tetanus has never, in any case reported, been present as a direct consequence of the operation. 1 have understood from a friend who performed the operation in one instance, that slight tetanic symptoms supervened; but in this case the boy was exposed to both cold and wet, and the probability is, that the tetanic affection was the result of the last mentioned causes, rather than of the operation. The idea that this operation would be likely to bring on tetanus, has its origin in the well known fact, that punctures or lacerations of tendons often occasion this disease, but the nature of the wound is here altogether different. Others have feared a division of the posterior tibial artery, but as I have already explained to you, there is no danger of this, provided the operation be properly performed. I think, gentlemen, that I have a right to make these statements, inasmuch as I have divided for different affections, between fifty and sixty tendons, and have never, as yet, met with the slightest bad symptom of any kind. I would, however, advise you in giving your prognosis in such cases, to leave some way of escape for yourselves in the event of disagreeable symptoms supervening. An individual may die, you know, from a prick of his finger, or from wounds equally trifling; you should, therefore, let such a possibility be borne in mind when your opinion is asked relative to the dangers of the operation in question. "I have already told you that this operation is a very simple one; but you will occasionally be not a little annoyed after its performance, at finding

the heel (when the tendo Achillis has been divided) still forcibly resisting our efforts for its depression. This arises from the thickness of the sheath of the tendon, and before we can accomplish our object this must be divided, especially if the patient is somewhat advanced in life. I have been obliged to perform the operation in three or four cases: the last one was that of a child of Mr. Creass, to whom I was called by Dr. Ruan, one of our most eminent practitioners, You can generally detect the existence of this condition of the sheath, by passing your finger along the back of the tendon until you reach the point of its division, at which, instead of meeting with a considerable depression, as is usually the case, you will find a firm and resisting substance; not, of course, as firm as the tendon, but sufficiently so to be readily detected. This may be divided by passing the knife generally employed for the section of the tendon, through the wound made in the integuments for this purpose. I always examine the foot on the morning after the operation, when, if the sheath seems to offer much resistance, I immediately divide it. I make this statement, with a full knowledge of the importance set upon preserving the integrity of this sheath, by Mr. Bouvier, who contends that it is chiefly concerned in the reproduction and proper modeling of the new tendon."-p. 74.

Prof. Baxley's Introductory Lecture.1

We know not what effect the late decision of the Court of Appeals of Maryland will have on the incumbents of the chairs in the university. The author of the lecture before us and his colleagues belong to the dispossessed, unless some arrangement is made by which they can continue as teachers. Of the talents of more than one of them, and of their productions, during their brief career, we have had occasion to speak more than once. Professor Baxley's qualifications for his chair we deposed unhesitatingly at the time of his appointment, and all that we have since heard has confirmed us in the opinions we then expressed.

To

The publication of the lecture was solicited by Dr. Baxley's colleagues on account of its containing a passing eulogy on the character of Dr. John D. Godman," a tribute to one whose memory is cherished by all who admire genius and love virtue;" and one whose example we ourselves have, on various occasions, held up for imitation to the young aspirant.2

"And who," says Professor Baxley, "is not familiar with the fate of Godman? I would we had earned, and were worthy the high privilege of calling him our own Godman! But that deprivation is alike our fault, and our misfortune-those who should have cherished him cast him off to seek honours and distinction among strangers-let his undying fame, while it perpetuates their reproach, stand upon the enduring foundation of his own merit.

"To what were his hardships and his early fate to be attributed ?-Let his brief history answer. 'Left motherless,' as he himself says, 'at the early age of two years, and fatherless and friendless before he was fivecast among strangers-deprived of his property by fraud, and compelled to eat the bread of misery, and drink of the cup of sorrow, he passed the flower of his days in a state little better than that of slavery, and arrived at manhood through poverty and desolation.' And yet by incessant toil. and unbending energy of mind, he acquired the treasures of classical learning, and

1 Introductory Lecture delivered by H. Willis Baxley, M. D., Professor of Anatomy and Physiology in the University of Maryland, Nov. 2, 1837. 8vo, pp. 29. Baltimore, 1839.

2 Medical Student, p. 36. Philadelphia, 1837.

the honours of a profession at an early age. In this school he first sought the streams of science-here his genius first expanded its wing, and gave token of the loftiness of its future flight-here were made by the observant and the generous, the predictions of that eminence which he subsequently reached and these halls first echoed that eloquence, which, in after years, distinguished him as a teacher of anatomy above all his cotemporaries.

"Solicited, at the moment of his stepping upon the threshold of his profession, and without particular preparation, to discharge for a time the unrequited duties of a professorship, the able incumbent of which had met with a severe casualty, the manner in which he fulfilled the task commanded for him the admiration and friendship of all, except those who should have been the first to acknowledge, and the readiest to reward, his merit. And why was it that the preceptors of his youth did not become the patrons of his genius? Why, when want kept him hovering about the scene of his early struggles, was not patriotism prompt to secure the glory of his future renown? Why was a son of Maryland forced to quit her soil, sad of heart and disappointed in hope, to seek among strangers that pittance and encouragement which was denied him by those who should regret their own heartless injustice? Did prejudice close the avenue to fame against merit? Or contracted envy dread the competition of superior talent?-Or, were the portals of the Temple shut against him because inheritance had not bestowed the magic word, nor fortune given to him the golden key, that commanded the entrance? Whatever may have been the cause of Godman's loss to the institution, of which he would have been its highest boast and proudest ornament, his star had risen not to set obscurely, and the bright rays which it has cast over the world of science have lighted thousands to the pure sources of instruction from which he drank so deeply. He had cast the pebble into the deep waters of knowledge, and no jealous hush could again still their disturbed bosom, but as the wavelets spread, and their circles widened, the joyous shores received their hallowed kiss, and echoed in gladness the tribute of Nature's young apostle.

"Conscious of the force of his powers, and though sorrowful, not dismayed by early adversity, he fixed his eye upon the most elevated and honoured station known to the profession in this country, and resolved to render, sooner or later, complete justice to those who had failed to cherish his talents and to respond to his righteous aspirations; and how nearly he achieved the great purpose of his ambition is matter of history. Like his great exemplar, Bichat, he was the builder of his own fame. Like him, overcoming all obstacles, he accomplished more than any other of his countrymen in the same brief period. And like him he left us in the dawn of his glory-as 'the light cloud fading away into heaven with the morning breath, rather than travail through the weary day, to gather perhaps in darkness and end in storm.'

"In his private life, as in his professional, Dr. Godman was an example of excellence. The child of impulse in his early years, and indulging Occasionally in a petulance that was not native to him, but which sprang from that sense of dependence so apt to make one of just pride appear unamiable, he soon, by the force of his vigorous sense, overcame that tendency, and by an honourable life, sedulously devoted to the cultivation of a strong understanding, and the improvement of a generous, kind, and feeling heart, he was enabled to direct judiciously the taste of others, as well as those confided to his instruction; while he looked on his equals without jealousy, and his seniors with deferential respect.

"And here I might apply to him the beautiful description of a favourite writer, who little knew, when giving expression to the images of his chaste fancy, that his ideal sketch would have a living representative; and that he but delineated the character and the feelings of one who was to adorn a far distant land-one, young in years, old in knowledge, and wise in all that reconciles us to present ills, and best fits us for the enjoyments of the