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effects, as ordinarily administered, I must explain that of the insensibility induced by its inhalation.

The offices of respiration, are, the exhalation of carbonic acid gas, and the reception into the blood of its equivalent of oxygen. Now, in the ethereal inhalation, as the air of the lungs presented to the blood for absorption is not only diluted with this vapour, but in admixture also with this hydro-carbonaceous compound, the latter, when imbibed from the air-cells in admixture with the air, from its greater affinity for oxygen than the constituents of the blood, immediately seizes upon the oxygen, and, combining therewith, thus de-oxidates the blood in the lungs, whereby the blood, thence returned to the heart for general circulation, is deprived of its vitalizing qualifications; and hence defective capillary excitement of the heart and brain, and of all the functions, and thus the condition of insensibility and asphyxia induced limited, of course, by the extent and period of the inhalation; but involving, necessarily, caution that it is not carried to too great an extent, considering that it virtually consists in a species of burking.

We may now comprehend the narcotic and sedative influence of ether which so soon succeeds to its use when received into the blood from the stomach. It having, as I have already explained, by its union with the oxygen of the blood in the general circulation, produced a certain amount of excitement, other portions of the ether existing in the blood, in their circulation through the lungs, enter into combination with the oxygen of the air imbibed, and here de-oxidating the blood at the expense of the general system, produce effects, though less in degree, yet analogous in kind, to its inhalation-narcotism; and thus its sedative influence and reducing power. And thus are all the operations of ether, I am of opinion, very satisfactorily accounted for, and established as such, I think I may venture to say, by the expreriments adduced of M. Amussat.

Reverting to a former observation, I may be permitted to add, that precisely in character with the operation of ether, in producing both excitement and asphyxia, are the effects of alcohol, though modified in description by the difference that exists between them: alcohol being soluble in water, and mixable with the blood; and ether not so, but much more volatile and combustible. Alcohol is accordingly much more permanently stimulant in its effects, and only asphyxiating when received into the system in a concentrated form, or where the quantity in a more diluted state has been so considerable that the blood in its passage through the lungs has become incapacitated for transmitting oxygen for the purposes of the general system; that is to say, the amount of alcohol present in the vital stream de-oxidates the blood in the lungs before it is returned to the heart for general circulation; and hence the more enduring condition of insensibility which succeeds intoxication, the whole vital stream abounding with its polluting influence.

If the explanation afforded be considered the true one, the circumstances prohibiting it use are obviously those of feeble power, as well

as apoplectic predisposition, as the effect of all narcotics and reducing agents on the system is to produce venous congestion; and, from reasons afforded in my work "On the Philosophy of Life," but too lengthy in description to be here adduced, and more especially manifested in the liver and brain; hence there was found, on examination, in the case of death recorded from ethereal inhalation, congestive fulness of the blood-vessels of the brain; and, moreover, that bleeding was found useful in the recovery of dogs which had been rendered apparently dead by its use, as so stated in France. But the most obvious and direct indication to be fulfilled, in the case of its maladministration, is the re-excitement of capillary action by the inhalation of oxygen gas; subsidiary to this, or when this is not immediately available, judicious blood-letting is the next object, followed by the excitement of the skin, and respiratory function of the lungs, by the sudden splash of cold water, followed by galvanism and artificial respiration in extreme cases. And, as an internal stimulant, ammonia, alcoholic fluids, or agents of the like character, being interdicted, nitric acid might prove more useful in these cases than ammonia. In India I once drank an entire drachm in a tumbler of water, and with, I thought soon after, decided exhilarating effects. In addition to these means, warm salt-water clysters are clearly indicated; and, although the last to be noticed, I am not sure that it is the least in importance, an emetic may prove a useful ancillary.-London. Med. Times.

Excision of a Fatty Tumour without Pain. By Dr. JOHNSTONE, of Madras. Our knowledge of Dr. Johnstone, as well as the inherent correctness of the report, induces us to publish the following case: Mrs., European, of a well regulated mind, a well formed figure, and a system remarkably free from any kind of nervousness. Has been six years and a half in India. General health good. Before leaving England, she observed a tumour about the size of a field bean over the posterior aspect of the right shoulder. It continued to enlarge gradually but slowly, and at the end of five years had attained the size of a small egg. For the last two years it has increased much more rapidly, and now constitutes a tumour of an adipose nature, lobulated, mobile and kidney-shaped. It measures about six inches in length, four inches in breadth, and two and a half inches in thickness at its thickest part, and stretches from the spinous process of the seventh cervical vertebra, downwards and outwards towards the acromion and outer third of the spine of the scapula, along the upper border of the trapezius muscle. A sensation of weight and slight numbness of the right arm are the chief inconveniences complained of.

Various kinds of treatment having been useless, the patient determined on having it removed. Dr. Johnstone having carefully examined into the evidence brought forward by Dr. Esdaile of Calcutta, in support of the fact of his having performed upwards of one hundred painful surgical operations within the last two years upon natives, under the influence of alleged mesmeric agency; having also read

the favourable report of the committee appointed by the honourable the deputy governor of Bengal, to observe and report upon such operations, he advised his patient to try the effect of mesmerism previous to the operation. She consented, and he succeeded on seven following days in putting her into a cataleptic sleep, in which she latterly was unconscious of pinching, pricking with a pin or lancet, and of the manipulation of the tumour. On the eighth occasion, January 9th, 1847, the tumour was removed in the usual way, by means of two elliptical incisions, each seven inches and three lines long, and subsequent dissection of the morbid growth. Three arteries required ligature. The edges of the wound were brought together by four stitches, supported by straps of adhesive plaster. Dr. Smith, Mr. S. S. Young, surgeon, and patient's husband, an apothecary, and a nurse were present. Professor Key had promised to attend, but was unavoidably detained in his class room.

The time of the operation, from the commencement of the first incision to the application of the last roll of bandage, amounted to eighteen minutes, during all of which time, not the slightest trace of suffering or sensibility on the part of the patient could be detected. The pulse continued unchanged at eighty, as S. S. Young satisfied himself, and the respiration perfectly tranquil; no moan or sigh escaped her lips-no alteration in the impression of her features was observed-no instinctive motion or wincing detected; once only she moved her head instinctively to free her mouth and nostrils from a little pool of blood which had collected about them, and was interfering with her breathing. She was easily demesmerized, before which care was taken to conceal as much as possible all traces of the operation. When she awoke the following dialogue ensued. Well, have you been asleep to-day ?" Yes, I think I have." "Do you think you slept more soundly to-day than yesterday?" "I cannot say." "Did you feel me turn you or do any thing to you to-day?" "No, but I feel something smarting, and my face and my eyes feel stiff." She now put her left hand up to her shoulders as she had often done before, and perceived that the tumour had been removed, of which she confessed perfect unconsciousness. The stiffness of the eyelids and face was caused by dried blood. Pulse eighty-respiration natural.

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The tumour weighed 3 lbs. 1 dr. two hours after removal. wound was dressed with cold dressings, and almost entirely healed up by the first intention. She suffered no pain in the wound, continued perfectly free from fever, and was confined to her room only one day. The pulse continued at eighty for two or three days after the operation, when it rose to ninety, apparently its natural standard. She speedily recovered, and now feels better than she did previous to the commencement of the mesmeric sittings.--Monthly Journ. of Med. Science.

On a source of fallacy in testing the Urine for Sugar. By G. OWEN REES, M.D., F R. S., Assistant Physician to Guy's Hospital, and Principal Medical Officer to the Pentonville Prison.--The many

sources of fallacy connected with the examination of the urine are not, perhaps, so fully recognized by the profession as they ought to be. These fallacies, inasmuch as they interfere with a due appreciation of symptoms, tend seriously to affect the correctness of diagnosis in urinary affections; and I therefore think it well to publish from time to time such facts as may come under my notice in relation to the subject.

A short time ago I received a specimen of urine said to contain both albumen and sugar in considerable quantity. The presence of sugar had been determined to the entire satisfaction of the medical attendant, who had demonstrated it to some friends, who had become equally well satisfied on the point. On examination, however, though I found albumen in abundance, I could not detect the slightest indication of sugar, notwithstanding that I used the same specimen of urine from which others had obtained satisfactory evidence.

On relating the result of my examination to my friend, from whose patient the urine had been obtained, I received an exact account of the manner in which sugar had been sought for, and was shewn the effect produced in the specimen by boiling with a solution of caustic potash-the excellent test proposed by Mr. Moore. I now perceived the whole contents of the tube to be of a deep brown colour, and should have been somewhat shaken in the fidelity of my own observation, had I not on a previous occasion applied this same test to the specimen, with a negative result.

I now observed that the liquor potassa which had given the reaction had been kept in a white glass bottle, and immediately suspected that it might consequently contain lead; and that the dark colour produced, generally known as indicating the presence of sugar, might in this case be owing to the formation of sulphuret of lead; for lead dissolved in the liquor potassæ would unite to the sulphur of the albumen during the boiling, and I had satisfactorily ascertained the presence of albumen in this urine.

The liquor potassæ with which I had obtained a negative result was free from lead. On testing that of my friend, however, with hydrosulphuret of ammonia, the black sulphuret of lead was thrown down in considerable quantity, shewing the correctness of the foregoing explanation.

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It is very important that this source of fallacy should be borne in mind, as Mr. Moore's test is very much used for ascertaining the existence of diabetes mellitus and liquor potassæ is unfortunately too often kept in white glass bottles, instead of in those of green glass, which contain no lead in their composition on which the alkali can exercise a solvent action. The hydro-sulphuret of ammonia, applied as above described, will at once shew the practitioner whether or not his liquor potassæ be free from lead, in which case it produces no change of colour on being boiled with urine, even when albumen is present in large proportions.-Lon. Med. Gaz.

Medical Problems.

By WILLIAM GRIFFIN, M. D., Physician to the County of Limerick Infirmary.

When miscarriage or premature labour takes place at fixed periods, from the influence of acquired habit, may not the periodical movements be prevented by such remedies as prevent the recurrence of an epileptic fit or a paroxysm of ague?

I was called on some years since to attend Mrs. C., a lady who was ill with the usual symptoms of miscarriage at the third month. She informed me, that she had had a miscarriage at the end of the third month of her first pregnancy. She reached nearly to her full time on the second occasion, fell into puerperal convulsions in her labour, and was delivered of a dead child. In her next pregnancy she had a miscarriage at three months; in her fourth at three months; and now in her fifth she was again threatened exactly at the same period. She informed me that everything had been done to prevent it. She had been bled repeatedly, kept for weeks upon low diet, and was confined during the time entirely to the horizontal position. She lived, in fact, between the bed and the sofa. In this new attack some friends recommended her to send for me, with the hope of having some plan of treatment devised by which she might be enabled to go on to her full time. The amount of the hæmorrhage was, however, so considerable, and the uterine pains so general and regular, I told her it was impossible to prevent the miscarriage, but if I was informed of her condition on any future occasion, when six weeks or two months should elapse, I might, perhaps, succeed. Miscarriage, I believe, took place on that night or on the next morning.

In three or four months afterwards I received an intimation from this lady that she was two months pregnant. On considering the probable causes of the previous miscarriages, I could not detect any very obvious one. Her health was excellent, her habits regular, her diet moderate. The extreme regularity with which the miscarriage always occurred at the end of the twelfth week rather confirmed the only conjecture I could form, that it depended wholly on the influence of an acquired habit; and the question necessarily arose, how was this acquired habit to be interrupted or controlled? All the ordinary measures had already been adopted, and the poor lady had been subjected for weeks to the most irksome and tantalizing restrictions, without the slightest advantage. In this difficulty it occurred to me, that as periodical attacks of epilepsy may often be prevented by a long course of any of the metallic tonics, the periodical movements connected with the action of the uterus might be also under their control. I therefore directed my patient to take two and a half grains of oxide of zinc, with two grains of extract of hops, three times a day, and after each pill, two table-spoonsful of a mixture of valerian, aromatic spirits of ammonia, and infusion of snake root. She was also ordered a box of pills, containing a grain of opium in each, one of which she was to take when pain came on, and to repeat the dose every hour until relief was obtained. As she was of a nervous

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