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and the action was that of a powerful narcotic. The young man stated that he felt all the symptoms of intoxication.

Dr. Ure had been recommended the use of the extract of hemp by his son; but although he tried it for some time, he never experienced the slightest effect from it. The extract was the same as the above, having been obtained from Mr. Squire.

The Chairman thought that the present state of medical knowledge, in reference to the action of Indian hemp, was very unsatisfactory and imperfect.-Dublin Med. Press.

Dilatation of the Heart consequent upon Teetotalism. By RICHARD CHAMBERS, M. D., Physician to the Essex and Colchester Hospital.Case I. A gentleman, aged fifty of good constitution, and accustomed to live freely, became a convert to teetotalism. For a period of six months subsequently, there was no perceptible alteration in his state of health; but about this time he became subject to attacks of nervousness and paroxysms resembling angina, which gradually increased in frequency and intensity up to the time that I visited him. I saw him on August 16th, in consultation with his ordinary attendant. In addition to the above particulars I ascertained, that repeatedly in the course of the night and day, he was subject to attacks of breathlessness, that compelled him to rush to an open window to relieve the sense of impending suffocation. In the intervals he was quite cheerful. He complained of pain in the back of the head; pulse 84; bowels regular; urine copious. On examination of the thorax, (which was extremely well formed,) I found the lungs perfectly sound; the action of the heart was regular, and its sounds unusually clear, but there was scarcely any impulse. He had been bled the day before, principally at his own request,) but with no relief.

As he had latterly been using a restricted diet, I placed him upon meat daily, with four glasses of good old port, and prescribed five grains of the carbonate of ammonia every four hours, and three grains of the sulphate of quinine thrice a day.

Under this line of treatment he began gradually to amend. At a subsequent period the sulphate of zinc was prescribed for him, and with the alternate use of zinc and quinine, and an increased allowance of wine, his health has been sufficiently restored to enable him to participate in the manly and trying game of cricket.

Case II. Henry Taylor, aged 30, a working gardener, applied at the Essex and Colchester Hospital, June 4th, 1846, complaining of headache and general weakness. He was of middle stature, and of a full habit, presenting a slightly bloated appearance. His appetite was good; pulse 78; bowels regular. On stethoscopic examination, the lungs were found to be perfecty healthly; the heart's action was regular, the sounds clear and healthy, but there was only a very slight impulse. He slept indifferently. For the last six months has been a teetotaller, but denies that he was a drunkard previously.

R Pil. saponis; rhei; utrq., gr. iiss. M. Fiat pilula omni nocte sumenda.

R Ammon. carb., gr. v. ; tinct. camph. comp. dr. ss.; Aquæ, oz. j. M. Sumat ter indies.

15th. His wife applied for medicine for him to-day, and I found that my suspicions as to his intemperate habits were correct.

R Pil. saponis, gr. v.; omni nocte. Rept. haust. To have a little gin-and-water after dinner.

This treatment was continued up to the last fortnight, and being free from complaint he discontinued his attendance.

I bring these cases before the association as examples of dilatation of the heart, consequent upon the adoption of teetotalism. The modus operandi appears to me to be the yielding of the muscular structure of the heart, in consequence of the less stimulating character of the blood; but, in addition to this, it must not be overlooked, that another element may also be in operation,-I mean an actual increase in the quantity of blood to be circulated, as I have invariably found that a great increase of appetite accompanies teetotalism; not a healthy appetite, but a morbid craving for food, and to oppose which opium is frequently resorted to.

These cases present the principles of the treatment to be adopted, and there is but one caution necessary, and that is, to draw a careful distinction between actual determination of blood to, and merely congestion of blood in, the brain. In the cases just related the headache was referred to the back of the head, and appears to have arisen from venous congestion, but on the stethoscopic induction I wish to place the chief reliance.-Ibid.

Insanity in Eygpt.-The following extract from a clever work just published, conveys a wretched picture of the condition of the insane in Egypt. It is to be hoped that Ibrahim Pacha was not allowed to leave this country without witnessing the treatment pursued at Hanwell and others of our best conducted asylums.


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The saddest sight I have seen in Cairo is the Mooristan or madhouse-misery mitigated by nothing but its own oblivious antidoteRazing the written troubles of the brain.'

"A horrid court-yard, surrounded by tiers of iron cages, where men are cooped, and sometimes chained, with less of space, air, light, and cleanliness, than are allowed to a wild beast in one of our travelling menageries. Poor helpless wretches!-the moping idiot, the gay madman, the furious maniac,-sullen and weeping, laughing and singing, grinning, howling, and tearing behind the bars;-of all the fearful ills that flesh is heir to,' this overthrow of reason is surely the most painful to look upon.


'Membrorum damno major Dementia.'

I saw one poor patient brought out of his den and set at liberty; he lay for a few minutes upon a filthy mat on the stone pavement, his features drawn, lived, and stiff-a shudder passed through his wasted frame, and he was dead!

"After several visits, I have established an acquaintance with two or three, and make them presents of bread and tobacco, for which they are very eager. One captive, quiet, self-collected, and hand some featured, tells a long well-sustained story of female jealousy and a family conspiracy to obtain his property and confine him for life he stoutly maintains that he is as much in his senses as any man in Muzr—a strong reason for doubting the tale, which if true, would have driven a philosopher crazy. My new servant, Black Omar, who stands interpreter, believes every word, and thinks it no uncommon case; he tells me that snake broth is the sovereignis't thing on earth' for these mental maladies, and that no other medicine is used in the Mooristan, save the iron-chained collar and the bastinado,"-Nozrani in Egypt and Syria.


Retroversion of Uterus-Retention of Urine for fifteen days-Fatal Inflammation of the Bladder.-Mr. DUMVILLE presented the genitourinary organs of a woman, aged 22, who died in the fourth month of pregnancy from acute inflammation of the bladder consequent on retroversion of the uterus. The body was examined twenty-four hours after death. The bladder contained some urine; its peritoneal covering was thickened and opaque, and had contracted adhesions with the surrounding intestines. There was also some muscular hypertrophy. The whole inner surface was thickly coated with false membrane, which hung in shreds, and was mixed with earthy matters. The uterus was firmly impacted in the pelvic cavity; it contained a four months' foetus, and the right ovary had within it the corresponding corpus luteum.

The woman had borne two children, and in the latter months of the second pregnancy suffered from prolapsus of the Uterus, which disappeared after delivery. She became a third time pregnant, and during the entire four months preceding death she had suffered from pain in the pubic region, and had also the sensations of prolapse, without, however, any well-ascertained descent of the parts. Twenty-two days previous to death, whilst occupied with manual labour, she experienced a sudden and violent pain in the hypogastrium, with great desire, but inability, to void urine. A surgeon drew off three pints of water, but neglected to repeat the operation for sixteen days. During this interval the bladder was never properly evacuated, the urine mostly escaping guttatim, and with extreme suffering. She was then first visited by Mr. Dumville, who, on examination, discovered a retroversion of the uterus, with the os resting on the symphisis pubis. Marked symptoms of acute inflammation of the bladder presented themselves, which he treated in the usual manner. On introducing the catheter, he withdrew a large quantity of urine, which was strongly ammoniacal, and yielded albumen plentifully. It was of a blood-red colour, and 1012 specific gravity. Microscopically examined, it was found to contain blood-discs, pus globules and crystals of neutral triple phosphate of ammonia and magnesia.

The inflammation of the bladder in this case was, in a certain sense, attributable to the retroversion of the uterus, but still more clearly to the neglect of periodically withdrawing the urine by catheter; for the distension caused by the retained urine, and its irritating properties, determined the fatal issue; so much the more to be regretted, seeing the rules for the management of similar cases have been so distinctly defined that no apology remains for the omission of putting them into practice.-Dub. Med. Press.

Cancer of Pylorus-Obscurity of Symptoms-Suppuration of Gallbladder.-Dr. FRANCIS sent for exhibition a fine specimen of cancerous ulcer which involved the whole of the pylorus. Its surface was ragged and burrowing, the margins raised and everted; in length it measured four inches, in breadth two. The stomach was pale, and unusually small; the duodenum was of a deep slate colour.

It was taken from the body of a man, æt. 60, who, within the last eighteen months, had suffered much from privation and severe domestic troubles. He was under the daily and close observation of Dr. Francis for the last six months of his life, during which time he gradually emaciated. There was never any vomiting or complaint of pain, or other symptom indicative of local disease, but he was throughout the subject of a settled gloom, under the influence of which he seemed to be slowly sinking. A few weeks before death he contracted diarrhea, which was then epidemic.

Dr. Francis considers that a very interesting and instructive feature in this case was the absence of local manifestations of disease, notwithstanding the existence of so formidable a lesion in a part of the stomach so almost uniformly attended with vomiting or pain. It added another to many instances he had had the opportunity of observing at the workhouse, of the fact, that where strong grief had taken possession of the mind it sometimes happened that sensibility seemed to have become so impaired that the symptoms ordinarily resulting from local irritation had not been developed. In several inspections of persons who had died whilst labouring under the melancholic form of insanity, or under that particular state of mind which, in popular language, is described as "a broken heart," he had never failed to find organic disease of some part or other, however obscure its existence might have been during life.

Along with the cancer of the stomach, the gall-bladder was found to be distended with a puriform fluid untinged with bile, which, under the microscope, was seen to contain pus, mucus, and inflammation globules, and behaved as pus on the addition of liq. potassæ. Several superficial granulating ulcers were observed upon the inner surface of the viscus, and, a short distance within its duct, was firmly impacted a round calculus, nearly a third of an inch in diameter, and composed chiefly of cholesterine. The liver did not seem to be unhealthy, and there was no cancer elsewhere than in the stomach.


Two cases of Spina Bifida-one of them Cured.-Mr. DUMVILLE exhibited a preparation of spina bifida taken from a child aged five months. The arrest of developement happened in the spinous processes of the third, fourth, and fifth lumbar, and first and second sacral vertebræ, which gaped widely apart. The sac in which the cauda equina partly expanded was large enough to contain an ounce of fluid. The tumour was punctured at the urgent instance of the friends, but at a period when the failing powers of life offered scarcely a hope of recovery. The child died with the usual symptoms.

Mr. Dumville related the particulars of another case, in which the congenital deficiency was situate in the same locality. He evacuated the sac by puncture, and the recovery was complete. The child, which was nine months old at the time of the operation, has now attained eighteen months; and its health is unexceptionable. The operation was quickly followed, in this instance, by a profuse perspiration; the face immediately became deeply congested; and there was much derangement of the stomach, attended with vomiting. The child was very fretful, had excessive twitchings, but no distinct convulsion. When the sac was quite empty all the symptoms were aggravated; but on becoming again distended with secretion, which occasionally took place in consequence of mechanical obstruction of the aperture, the symptoms underwent amelioration. The discharge. of fluid, with more or less of the symptoms described, having lasted fourteen days, the orifice then healed over, and no further secretion of serum following, the child convalesced without any relapse. This case he adduced rather as an exception to, than as an example of a general rule.

Judging from the aggravation of the symptoms whenever any excess of the fluid happened to drain off, it would appear that too much precaution cannot be taken in order to secure the evacuation of the sac as gradually and in as constant a manner as possible, in these cases, and that the plan of operation most suitable for the attainment of this desirable end should be adopted, and, above all, timely put in practice.-Ibid.

Treatment of Bursal Disease of the Knee-joint. By JOHN RICHARD, Esq., of Leamington.-The plan of passing a bit of sewing-silk through the centre of the tumour I have practised for the last fifteen years. It has never failed in my hands, and I do not think that I have ever allowed the silk to remain longer than through the third day. When the inflammation has been very considerable, I have always enjoined rest, and applied a few leeches, followed up by a liq. plumbi lotion, previous to introducing the silk.--Ibid.

History of a case of remarkable coloured Secretion from the Skin. By C. D. PURDON, M. D., Belfast.-Barbara Murphy, æt. 40, an inmate of the Infirmary attached to the Belfast Charitable Society, the mother of two children: catamenia regular up to the last six months; attributes the first commencement of her state to a fever with which she was

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