mittent fever. He has done so to test the accuracy of a statement made by M. Piorry, that the disappearanec of the paroxysm coincides with the diminution of the volume of the spleen; that this organ sensibly diminishes in thirty or forty seconds after the administration of a full dose of quinine, in solution, and acidulated; that the diminution goes on very rapidly if the quinine be continued in a sufficiently large dose. M. Gouraud having examined into this matter, however, states that he has not found the spleen thus diminished, but that, in consequence of an accumulation of gas in the stomach, from the ingestion of the quinine, the left hypochondrium is rendered sonorous, and the dulness over the spleen becomes masked. These opposite statements M. Valleix has kept in view in making some fresh observations. He narrates a case, and its course; quite a simple case of ague, occurring in a young and robust man, who had never suffered before. It was a recent case, and there were no evidences of organic disease in any organ: the spleen had undergone very considerable enlargement, being readily perceived through the abdominal wall, and therefore its size could be estimated with the greatest precision. The sulphate of quinine, although given in a very strong dose of thirty grains, and acidulated, so as to render the salt a bisulphate, did not act as represented by M. Piorry, on the volume of the spleen, neither at the end of forty seconds, nor of twenty minutes, nor even of twenty-four hours. The medicine also had no such power when given in still greater quantity, but divided, during the day, into several doses, and continued on succeeding days. But after the application of cupping-glasses and leeches over the splenic region, the volume of the spleen, on the contrary, diminished rapidly, although the dose of quinine was abated. Lastly, notwithstanding the persistence of the splenic engorgement, the fever was cut short, and there was no trace of a recurrent paroxysm.

Another equally uncomplicated case occurred to M. Valleix, and the same method being tried, was attended by the same results. It must, however, be mentioned, that three days after the first dose of quinine, a slight diminution of the spleen was noticeable; but this little decrease, which perhaps, too, was partly owing to a bottle of eau de Vichy which the patient took, was lost sight of when compared with the rapid diminution which followed two days afterwards, when cupping-glasses were applied over the spleen, and which continued to go on. In this case, also, as in the preceding, although the enlarged spleen remained, the fever was removed.

The third case differed from the two preceding, in that it was of older date; but there was no essential difference in the effects of the treatment. The spleen remained unaffected in size during the first day, when quinine alone was given; but quickly decreased after local bleeding, although the dose of quinine was lessened. The fever was removed before the engorgement of the spleen had subsided.

Thus these observations contradict the assertions of M. Piorry, both as to the coincidence of the disappearance of the fever and the decrease

of the spleen, and as to the immediate and prolonged influence of quinine in diminishing the splenic congestion. M. Valleix also confirms the observation of M. Gouraud as to the formation of gas in the stomach upon the quinine being swallowed, augmenting the resonance over the left hypochondrium, and so hiding the dulness over the solid spleen beneath to a slight extent; not so much so, however, but that palpation and percussion will readily detect the engorged organ.— Ibid.

Suicides in France. The report of the criminal justices of France, for the year 1845, contains the following details respecting the frequency of suicide, the means employed, and the motives. Of the number of deaths of the cause of which there has been suspicion, 11,049, there have been 3084 by suicide. The number of suicides in 1845 exceeds by 111 that of 1844, and by only sixty-four that of 1843. Of the 3084 suicides, 2332 were males, 725 females. Sixteen

of the males and four of the females had not attained their sixteenth year; and among the number we find children of seven, eight, and ten years of age; 123 were between sixteen and twenty-one, 462 between twenty-one and thirty, 1201 between thirty and fifty, 945 between fifty and seventy, 203 between seventy and eighty, and forty-one above eighty. If we look to the relative number of suicides in the different months, we find 922 during the three summer months, June, July, and August; 861 during the three months of spring, March, April, and May; 756 in the three autumnal months, September, October, and November; lastly, only 545 in the three winter months, December, January, and February. The most common modes of suicide are hanging and drowning. 1110 suicides had recourse to the first of these ways, in 1845; 995 to drowning; 432 despatched themselves by firearms; whilst 213 asphyxiated themselves by the vapour of charcoal; this last named plan is most common in the Department of the Seine. The motives of suicide resemble those of other years crosses in love, jealousy, the consequence of debauchery, misery, reverses of fortune, domestic troubles, the desire to rid themselves from physical sufferings, are the most common-Ibid.

Sanitary Measures in Egypt.-The Egyptian government, to give the fullest effect to quarantine regulations, has ordered the number of European and Arab physicians to be doubled throughout the country. Until the present time, there was one Arab and one European physician to fifty villages. Now there are to be four for the same locality, and this number may be increased when they are procurable. At the school of medicine at Cairo, the number of pupils has been doubled, as also the class of inferior medical officers. Such a demand for medical men in Egypt surely offers an opportunity to some of our over-numerous body to exercise the healing art in that country, and in a more profitable manner than they can hope to do at home, under the tender mercies of Boards of Health and Guardians, who

consider five shillings per diem ample pay for any amount of toil, and any risk of life.-Ibid.

Election by Concours.-It is stated, that the three Faculties of Medicine, of Paris, Montpellier, and Strasbourg, have given their voices, in answer to the request of their opinion, made by the Minister of Public Instruction, in favour of the maintenance of the election to vacant professorships by concours. The French Reform Bill just passed the Chamber of Peers, annulled the mode of election by concours for professorships, which had existed for some years, and it is on this ground that most of the opposition to the Bill is raised by the French profession.-Ibid.

On the Internal use of the Nitrate of Silver. By MR. RICHARD SOUTHEE, Cambridge. The nitrate of silver being much more frequently prescribed than heretofore, it may not be uninteresting to some of your numerous readers to learn that the discolorization of the skin is not of that frequent occurrence generally supposed; in fact, large and repeated doses may be given without producing such effect. In the year 1831, when the cholera raged to a frightful extent at the port of St. Petersburg, I ordered it in grain doses in every case of collapse, and frequently repeated the same quantity every quarter of an hour, without in one instance discolouring the skin. This remedy was mentioned as being very successful, in the report of the Government Commissioners, Drs. Russell and Barry, at the time; and I know of no medicine capable of producing reaction with so much certainty, though this sometimes was sudden and violent, requiring the immediate use of the lancet; and in several cases the inordinate excitement was difficult to suppress, but no discolorization followed. -London Medical Times.

Congenital Imperforation of the Urethra the whole depth of the Glands. By E. WHITEHEAD, Surgeon, Dakinfield.-Mrs. B. gave birth to a male child on Christmas eve, 1846. I called the following day, but no remark was made. Being a distance of a mile and a half, I omitted visiting on the second day, but intended doing so on the third. However, early on the morning of my intended call I was hastily summoned. On my arrival, I found the infant screaming vehemently, and apparently in great pain. Upon inquiry, I was informed its bowels had been moved repeatedly; but the nurse could not say it had ever passed any urine. Upon examination this was verified, the glans penis being imperforate; bladder considerably distended. Not having my pocket-case with me, I ordered the little sufferer to be brought to my house, where, assisted by my friend Mr. Hunt, surgeon, of Ashton-under-Line, an opening was made with a lancet in the place where the orifice of the urethra is usually situated, and an attempt made to pass a probe; the lancet and probe were again used, but without success.

The incision was then carried through the inferior length of the glans, upon which urine escaped freely. Not the slightest vestige of

an opening could be found in the glans other than the one made by the operation, which was allowed to heal. The artificial outlet now supplies the place of the natural one.—Ibid.

Case of Strangulated Inguinal Hernia, reduced on the New Method recommended by Dr. Andrew Buchann, Professor of Institutes of Medicine in the University of Glasgow. By ARCHIBALD WALLIS MACKIE, Cupar, Fife.-G. M., aged seventeen years, railway labourer, of a stout habit of body, and enjoying previous good health, whilst employed lifting some heavy railway sleepers on Friday last, felt something to give way at the lower part of his abdomen. The patient was unable to walk, and was carried to a neighbouring house, where he remained till next day, when he was conveyed to his father's residence, a distance of eleven miles. I was called to visit him on Sunday morning, and on examination found a tumour the size of a hen's egg, situated in the right iliac region, the general characters of which led me to conclude that it was a case of strangulated oblique inguinal hernia. The patient had not had his bowels opened since the morning of the accident. I ordered him an enema, and, after waiting till it was expelled, I applied the taxis, but unsuccessfully; I then had recourse to the usual remedies adopted in such cases, but without any effect. I bethought me of the plan recommended by the talented Professor of Physiology in the Glasgow University, and I was glad to see my efforts crowned with success. The mode is very simple. I placed my patient on his back, flexing the thighs on the pelvis, and putting the muscles of the abdomen in as relaxed a condition as possible. I then desired the patient to empty his lungs of as much air as possible, and having an assistant at hand, who immediately held his nose and mouth to prevent inspiration, I applied gentle pressure over the tumour in the proper direction, and had the satisfaction to feel it give way, and, as it were, draw up into its natural cavity.

The rationale seems to me to be, when the lungs are emptied of air, the diaphragm is, as it were, sucked up to fill the diminished thoracic cavity; it (diaphragm) exerts a tractile power over the floating viscera of the abdomen, and draws the protruded intestine upwardsnaturally assisting, if not altogether accomplishing the reduction of

the hernia.

Such is the mode, I conceive, in which the reduction is accomplished; and I have no doubt that, in addition to the mechanical influence, the temporary suspension of the breathing must have a powerful sedative effect, and consequently a relaxing influence, on any part morbidly constricted. Before operating I would always give this plan a fair and impartial trial, and I am confident, if practitioners would adopt this method, they would have the satisfaction of relieving their patients, and thus averting the dangers of a painful and often fatal operation.—Ibid.

Typhoid Fever and Smallpox. By M. SERRES.-On a former oc. casion we mentioned the treatment which M. Serres considers most

efficient in typhoid fever, viz., the black sulphuret of mercury; and, also, how the profession was led to adopt this method, from the good effects of mercurial preparations on the eruption of smallpox. another communication to the Academy of Sciences the learned professor continues the same subject.

In

The intercurrent affections, says M. Serres, two diseases progressing at the same time in the same individual, each preserves its physiognomy, its special characters, although the intimate nature of both may have undergone a considerable modification. The most severe of the two almost invariably communicates its gravity to the other, and diminishes if it does not destroy the chances of recovery. In the treatment, therefore, of intervening disorders, the most dangerous must exclusively occupy the attention of the therapeutist; in order to judge a curative method, it should be put to the test of these intercurrent affections, and to this test I have submitted the method I propose for the cure of typhoid fever; and have chosen the most severe complication-variola. The dangers of confluent smallpox are known to all; vaccination has considerably diminished them, but within certain limits. Thus, at the Hospital of La Pitié, during the epidemic of 1825, out of 162 vaccinated subjects attacked by the epidemic, twenty-five died. From the statistics published by Dr. Bousquet, it appears that in the thirty epidemics of smallpox observed in France between the years 1816 and 1841, 5963 vaccinated persons were attacked, and sixty-two died. Analogous results have been noticed in England, Germany, Italy, and Sweden. This revival of smallpox was attributed to the inefficiency of vaccination-a conclusion which we consider erroneous: "It is," continues M. Serres, "to the influence of intercurrent disorders that this impotency of vaccination to prevent variola should be attributed, and chiefly to typhoid fever. During the epidemic of 1825 we were struck principally by two facts: the first was the progress of the pustular eruption, which was the same in the vaccinated subjects as in those who had not been vaccinated; and the second was the presence in the intestines of the facial characters of typhoid fever. The epidemic, in one word, was double; it was at the same time variolic and typhoid. The mortal influence of typhoid fever in cases of smallpox has appeared to us still more evident in cases of non-vaccinated patients. We may ask ourselves if, before the discovery of vaccine, the interference of typhoid fever was not one of the great elements of the danger of variola ; and we will find in the symptomatic history of ancient epidemics abundant proofs that such was the fact. Typhoid fever is not, therefore, a new disease, but smallpox and typhoid fever were, perhaps, coeval: the cutaneous eruption of the former struck more forcibly the observer, and concealed the complication. It would seem that, after Jenner's discovery, variola was in a great measure arrested, and typhoid fever, being unmasked, was at last recognised." After having established that in most cases the complication of typhoid fever was the principal source of danger in cases of smallpox, the learned professor proceeded to say that he had watched attentively the effects of the black sulphuret of mercury in such cases, and that, in proportion