The opening between the mouth and nose is very much contracted, but not sufficiently to prevent the passage of food into the nose, which she finds rather annoying.

A semi-transparent, reddish, granular mass has been thrown out from the mucous membrane lining the remains of the cavity of the antrum beneath the orbit of the eye, which has given me some uneasiness, lest it should prove a nucleus for the regeneration of the disease. But I am in hopes, from its healthy appearance, that it is only an effort of nature to fill up the remains of the cavity, and promote, as much as possible, the convenience of the patient. The patient's articulation is improving, so that she can be more easily understood when speaking.

June 6th. I had an opportunity of examining this day the subject of the case above detailed. I find pretty much the same appearance of the parts as when last examined. The parts within the mouth are well cicatrized; the granular mass in the upper part of antrum bears very much the same appearance-it does not completely fill up the cavity. I cannot believe that it is any part of the disease for which she underwent the operation. She has contrived to obviate the inconvenience resulting from the deficiency of the roof of the mouth, by stuffing in cotton. I recommended to her a piece of sponge as a substitute. I have no doubt that the defect might be very much relieved, by an ingeniously contrived gold or silver plate. She masticates very well with the teeth which remain in the maxilla of the left side.

The tumour which was removed by this operation, is sarcomatous ; but in some respects, resembling brain, particularly since it has been immersed in spirits. When incised, the surface is smooth, and is similar to the incised surface of brain, which has been hardened in alcohol, interspersed here and there, with minute bony spicule.

The subject of the operation has returned to her former occupation (not very laborious) in the country; and from present appearances, may reasonably hope to be remunerated for her fortitude in submitting to it; and modern surgery may, without much presumption, number the case among its triumphs.

NOTE. While we sincerely hope our friend may realize his expectations regarding the non-return of the disease, the effects of which he has so skilfully extirpated in this ease, we cannot divest ourselves of the apprehension that it is malignant in its character, and may in the end destroy life. Of eleven operations on the jaws, in our practice, there has been a return in every instance where malignancy was clearly determined.-[ED.

ARTICLE XXX.

A case of Colic, relieved by Balsam Copaiva. By HENRY GAITHER, M. D., of Oxford, Georgia.

Mr. D. M., a sturdy, well-proportioned Irishman, remarkable for strength and activity, enjoyed almost uninterrupted health up to about his fiftieth year, when he began to suffer some inconvenience from frequent but slight attacks of colic, especially after any error in diet, or during moderate torpor of the bowels, for he was never troubled with such a degree of intestinal inaction as would be called constipation, neither was he subject to diarrhoea. Under this condition of the bowels, almost perfectly healthy as to action, the colic symptoms gradually increased in violence until he had to call in medical aid. The writer, who was the family physician, being sick at that time, a neighboring "Thompsonian" was sent for, whose steam soothed for a while, but whose pungent preparations of pepper and other fiery compounds aggravated the pain. Failing to get relief from these remedies, a physician was called in, under whose treatment he was relieved for a time. On all subsequent attacks I was with him, and by the use of anodynes, cathartics, sinapisms, warm bath, &c., preceded sometimes by venesection, the paroxysms passed off in the course of a few hours. Still slight and frequent twinges would generally recur before many days had elapsed, harrassing the patient and keeping him in constant dread of his frequent torture. The paroxysms which were sometimes excessively violent, came on at irregular periods of from one to three months. During the intervals various remedies were used, being such as were suggested by the conflicting pathological views of the case, to-wit, tonics, derivatives, alteratives, &c., and among the last mercury, which was given until ptyalism was induced, but without any manifest benefit. A year or so after this, when in one of his best intervals, jocund, happy and hopeful, improved in feeling and in flesh, (for his constitution was yet as elastic as a boy's) he fell into temptation, and neither conscience nor consequences restraining, he yielded, and came out worsted. A few days revealed to him the existence and nature of his new malady. He commenced the use of Bals. Copaiva with some unimportant adjuncts, and in two or three weeks was cured of both gonorrhoea and colic, or rather, permanently cured of the former and perfectly relieved of every twinge of the latter, for more than two years. But this may be viewed as a spontaneous change-the

result of natures efforts-as an instance of the post hoc and not of the propter hoc. Let the progress of the case decide the doubt. After this long exemption, the symptoms gradually returned with increasing violence, until they became as distressing as at any former time; when under my advice, he resumed the use of the Balsam, and continuing as before, a like period of immunity ensued; and he is now so fully assured of the benefits derived therefrom, that, without being urged to it by a medical attendant, he resumes the remedy on the slightest indications of his returning malady, and always with long, but varying periods of exemption, and has now remained for several years secure from violent seizures.

Now, what is the nature of this case? what is the disease? where its seat? and what its pathology? It would consume too much time and space, tire my unaccustomed hand, and be unacceptable to the reader, to show or attempt to prove that it is not neuralgic, nor from biliary calculi, &c., &c. But is it bilious colic? I think not. It is true the patient had a liver, as all of our patients have, and it is a fine thing, a matter to be rejoiced over, that if we get a patient we know he has a liver. This hydrargyric target, scape-goat of the viscera, great hiding place of all manner of ills and errors,-yes, this grand, magnificent organ being where it is, and doing what it does, has relieved many an Esculapian from a world of embarrassment, and it does it so easily, so rationally, and so invisibly, that there is neither doubt of the truth, nor appeal from the decision. The thing is done on this wise: if after due searchings and explorations we fail to find the disease elsewhere, we know, as a matter of course, it must be in the liver. And I believe it is an admitted fact among the fraternity, that it is always right to find a disease before we cure it, on the same high and philosophic ground, that it is right to catch a hare before we cook him.

But dropping bagatelle, I proceed to the investigation. The liver has been accused of a great many sins that it never committed; but, like other organs, it may sometimes be at fault-it may be disorder. ed in structure or function, and when so, its secretion may be redundant, deficient or vitiated. Evidence of these or other morbid conditions should appear, before we locate disease there. It is not enough that the patient is sick, and we know not what else ails him, to justify us in pronouncing it "liver disease," any more than it is, to pronounce every fever congestive that terminates fatally. It is not enough that we can puke or purge out bile, for it is no more

evidence of diseased liver, that bile flows copiously under certain excitants in the stomach or bowels, whether food or physic, than that the salivary glands are diseased because they secrete copiously when excited. I have admitted that the liver may be at fault. Well, suppose it is diseased and pours out an acrid secretion, the intestines, though in a healthy condition, are fretted by it, and resent the morbid influx, by taking on a dysenteric, diarrhoeal or colical action, this sometimes occurs; but, by the way, these effects are not sufficient evidence that the primary disease is seated in the liver. But on the contrary, suppose the intestines are out of order, (say the mucous membrane,) and the liver pours into them its accustomed healthy secretion, is it any more strange that they should resent it, by showing colic or something else, than that healthy tears should smart an inflamed eye, or healthy urine an inflamed urethra? Before proceeding further, however, that I may not be misunderstood, I would say, whatever organ may be primarily affected, in any case, the contiguous ones, or those more intimately associated in office or sympathy, and even the system at large, may become more or less involved in the progress of the disease. But in the case before us there were no symptoms indicating extensive diseased action, and I believe the primary, the chief, and perhaps the only disease, was a morbid irritability of the mucous membrane of the intestinal canal, confined probably to the colon, evidently there was no liver disease, or it came without a single one of its numerous retinue; there was no bilious tint of skin or eyes, no enlargement, hardness, or tenderness of the epigastric or hypochondriac regions, no pain in the shoulder or other remote part; he could lie on either side or back with equal comfort; no cough, no melancholy, and indeed, not to dwell longer on the symptoms, there was no evidence at all of hepatic derangement, and although his digestion continued good, he had to be careful as to his diet, more in reference to the effects on the colon produced by the residuum of digestion, than from the impres sion made during that process on the stomach and small intestines. That the stomach, liver and the other associate organs, more immediately concerned in digestion, were in a healthy state, is further rendered probable by his resiliency from the debility induced by severe attacks, and his keeping in a healthy fulness of habit, under the almost constant harrassings of disease. And again, these views, as to the seat and nature of the disease, are further corroborated by the effects of remedies, particularly those like the Balsam, which have

long had an established reputation in affections of the mucous mem branes.

I claim to have made no discovery in this case; but was led, as before stated, to the use of an old remedy, in a disease which had not before been treated by it, so far as I know; although administered frequently (if my pathology is correct,) in diseases of a kindred nature. I do not pretend to say, for I do not believe it is adapted to any large proportion of colic cases, but there are doubtless those occasionally occurring in every one's practice, in which bals. copaiva and similar remedies would be found useful.

I am aware that I have not positively established the truth of my views or the correctness of my position, but if the one is correct and the other untenable, I nevertheless flatter myself, that the facts will interest the medical public.

ARTICLE XXXI.

Febris Typhoides, as at present prevailing in the Alms House and Prison Hospitals of New-York. By CHAS. T. QUINTARD, M. D., of Athens, Clarke county, Ga., late Assistant Physician to the Alms House and Prison Hospitals of the City and County of N. York.

The New-York Journals have of late been filled with accounts of the rapid spread of the Ship and Typhoid Fever, in those parts of the city where poverty, vice, and filth encourage the development of disease. The hospitals are crowded at the Quarantine there are more cases than have ever before been known; at the New-York hospital it is the same; while at the Bellevue Institution there are so many cases that temporary buildings have been erected for the accommodation of the convalescing patients. The number of patients treated in Bellevue, from January, 1846 to January, 1847, was 4132; the deaths, 521 or 123 per cent.