ART. II. Pervious Foramen Ovale, with Emphysema, at sixty-six years of age.

September 6th, 1853. Post-mortem examination of Mr. IRA BRONSON, six hours after death, æ. 66. Undertaker's measure-length six feet, breadth one and a-half feet. Body not emaciated. Skin and epithelium generally of a dark modena hue. Rigor mortis complete. Chest presenting the usual extreme rotundity of asthmatics and abnormally sonorous. Precordial dullness below usual situation, i. e. from lower edge of fourth rib downwards. Abdomen tumid but not tympanitic. Some general anasarcous effusion. The blood was fluid and flowed profusely at each stroke of the scalpel. All the cartilages were free from ossification, except the seventh of the right side. Lungs seemed held down by the walls of the thorax-pressing forward on removing the sternum. No adhesions of the pleura pulmonalis were found. Color of lungs generally livid, but exhibiting considerable carbonaceous deposit in the tissues. (His occupation was a tinsmith, and he had worked several years without a pipe to his furnace.)

The costal surface of the left lung presented several cicatrices from half an inch to one and a-half inches in diameter. The emphysema was both lobular and inter-lobular. The air vesicles both dilated, hypertrophied and broken down. Considerable serum was found in all the cavities, but was not separately measured, blood from the several veins having early flowed into the first cavity opened.

The whole amount of blood and scrum removed during the examination, was about ten quarts. The blood coagulated feebly on exposure to air. The pericardium appeared healthy, except some abnormal adhesions infero-posteriorly. It contained about 4 3 fl. of serum. The external surface of the heart appeared healthy, having about the usual amount of adipose tissue. Some fibrinous shreds existed in both ventricles, and in the right auricle. The right heart was slightly enlarged in capacity. The tricuspid valves seemed atrophied and the chorda tendiniæ attached, attenuated. Regurgitation must have been constant upon the contraction of the right ventricle. The fossa ovalis presented a deep sulcus on its right auricular surface, occupying the inner half of its elipsis; and at the bottom of this sulcus a round opening about the size of a crow-quill. The left heart was natural, except the reception of the above opening by the auricle.

Abdomen-Slight peritoneal adhesions retained the serum, effused in distinct portions. The spleen was pear-shaped, flattened, and curved laterally; its texture dark and friable; its length three inches, breadth

two and a-half inches, thickness one and a-quarter inches; the liver small, i. e., about seven inches in breadth, five and a-half in length, and three inches thick; rather hard, friable, and dark chocolate color.

Bladder con

Kidneys- No evidences of disease appeared to us. tracted and easily torn; inner surface dull white color, not appearing coated with mucous, but what we think would be called pulpy. Intestines exhibited no essentially unhealthy feature on peritoneal aspect, although an inguinal hernia existed on either side. The intestinal canal was not opened.

Previous history subsequently gathered.

Of the early life nothing is known, except that at nine years of age he suffered severe pneumonia, from which he was slow in recovering. Before adult age, hernia upon one side was produced by an apparently slight cause. At about 45 years, acquaintances observed sighing, and expressions of uneasiness in left side, and about this time he used to complain of great fatigue on ascending stairs. These symptoms may have existed long before. Flatulence was always productive of severe distress, and hence he was habitually careful in diet. Hearing became obtuse at about fifty-five years. Powerful stimulants uniformly afforded signal relief from dyspnoea and angina. Resisting with conscientious firmness an habitual use of alcoholic beverages, he sometimes spoke with apparent surprise and regret of the charming effects of good brandy. Under the care of Dr. S. S. Cutler, who had been his physician for several years, and who was present at the examination, ferri. carb. præc. had been the most reliable remedy. The general appearance of the deceased led people to suppose him much farther advanced in years. There seemed to have been premature senility, in which all but the osseous system participated. The symptoms had gradually augmented in severity for several weeks. He walked out of doors three days before death, which, as described to us, must have been by asthenia. It is a remarkable fact, that, from the first of his dyspnoea, until the last few weeks of his life, he always breathed easily in the recumbent position, and finally it was only changed as symptoms of serous effusion appeared. J. H. BEECH.

Coldwater, Sept. 16, 1853.

ART. III. To the Editor of the Peninsular Journal of Medicine.

SIR: - In looking over the medical profession at the present time, and comparing her experience and discoveries of three thousand years

and over, to say nothing of the sanction it has received from men of giant minds and profound erudition, one might well be struck with astonishment to see the little confidence that community has in her theory and practice. When we look at the practice of her disciples, conducted as it is with the most profound secrecy her theory and medieines buried beneath its compound medical language then we need not wonder that the community have so little confidence, and that we have quackery and isms of every shape and hue, from aeripathy down. to spiritpathy. This state of things will continue so long as the great mass are ignorant of the elementary principles of medicine. The question is, how to obviate the present difficulty. Let every man when called upon to prescribe for a patient, give the friends a full description of the disease, and explain the effects the medicines should produce in order to effect a cure. This course, in connection with a weekly paper, devoted to medicine and general science, well sustained and properly placed before the community, will create confidence and intelligenceand quackery and empiricism will vanish before the meridian sun of Allopathy.

W. M. H.

SELECTIONS.

From the Boston Medical and Surgical Journal.

Aphonia of Twenty Months' Standing, relieved by Iodine Inhalation. By EDWARD B. STEVENS, M.D., Lebanon, O.

In a communication to the American Medical Association, in its volume of Transactions for 1850, Prof. Pancoast has given the record of two cases of loss of voice - the one of six, the other of seven months' standing- both cured by inhalation of a dilut. chlorine vapor.

In connection with these cases, Dr. Pancoast remarks: "The form of aphonia here alluded to, is that which practitioners must have met with, following an ordinary cold, without leaving any perceptible organic lesion in the pulmonary apparatus. The voice is reduced to a faint, hoarse whisper, distinguishable only at the distance of a few feet, and at continued attempt to talk, though it gives no pain, becomes quickly attended with a feeling of fatigue, as though there was some obstruction to the passage of air through the larynx. In breathing merely, there is little or no difficulty, in these cases, as the individuals are capable of undergoing considerable exertion without any unusual signs of fatigue. The difficulty has appeared to me to be in the paralyzed condition of the muscles of the larynx, whose business it is to dilate the rima glottidis, during the act of articulation."

The conclusion of Dr. Pancoast is, that such agent as will excite a healthy and proper degree of stimulation in the affected structure ought rationally to restore the power of articulation. He consequently used the dilut. chlorine vapor, with entire success in the two cases referred to at the same time suggesting that iodine, or other similar agents, would doubtless produce a similar effect.

The following case of this kind lately occurred in my practice, chiefly remarkable from the long duration of absence of voice, being twenty months, in other respects similar to those related by Dr. Pancoast. April 6, 1853. Miss applied for medical advice and treatment, in a case of loss of voice, of twenty months' standing, supervening upon a slight attack of influenza. Has been subject to brief attacks of hoarseness, lasting for a few days at a time, for several years. General health delicate. Since the present attack, has been subject to a great variety of treatment, including the application of nit. silv. in strong solution, within the larynx, by means of the sponge probang. Nothing, however, produced any effect upon the voice. I find, upon careful examination, no especial evidence of disease in the fauces; there

is an entire inability to produce sound of any description with the proper vocal organs; all attempts at speaking are made with the lipswhispering. But not being able to divest myself of the idea that a follicular inflammation of the throat and bronchial tubes was the cause of the mischief in some way, I commenced the treatment by directing the inhalation of nit. silv. prepared with the lycopodium, as an impalpable powder, and inhaled by means of the apparatus introduced by Dr. Ira Warren. This treatment was faithfully persevered in for one month, with no better results than the previously-tried remedies.

May 7.- Acting upon the idea suggested by Prof. Pancoast, of paralysis of the muscles of the larynx, I now determined to try the iodine vapor. I accordingly selected an apparatus, consisting of a metalic vase or urn, with a close-fitting cover, flexible tube, and mouth-piece attached, (used some years since for breathing medicated vapors in the treatment of consumption.) I directed my patient, after filling the vessel half full of hot water, to drop in twenty drops tinct. iodine, and inhale the vapor produced by the heated water. Inhalation to be repeated once to thrice daily, according to the irritation or effects, otherwise produced. The first inhalation produced great nausea for a short time, and copious bloody expectoration, but accompanied by an almost immediate, though partial, restoration of voice. The dose of iodine was directed to be reduced to fifteen drops; and thereafter no unpleasant effects were produced. The voice continued to improve steadily under this treatment, until, at the end of a week, it had acquired the natural fullness and distinctness of tone.

June 15. More than a month has elapsed since the restoration of voice; it continues distinct and natural. Western Lancet.

From the New York Journal of Medicine.

Remarks on Milk-sickness and Trembles. By I. N. CONVERSE, M. D. (Submitted to the Faculty of Starling Medical College, Columbus, Ohio, as an Inaugural Thesis for the Degree of M. D.)

THIS disease may truly be called one of a malignant character. It prevails in many places in the western part of the United States, and generally during the summer and autumnal months, commencing about the first of July, and terminating as soon as vegetation is destroyed by frost. It commences earlier, and is more general and more malignant, in dry, hot seasons than in others.

The cause of milk-sickness, in its primitive form, is not easily settled, In fact, it is as yet almost entirely unknown. In the horse or cow, may be found a perfect sample in the earliest form of its development. In other animals and man is another form (secondary) of the same disease, which seldom varies from the first, but is produced from the milk or flesh of animals, and has never been known to change or lose its character, though transmitted through other animals; its first development is, however, confined to the lower animals that feed npon vege