great reputation by removing cutaneous diseases by simply spitting upon them. Our patient subjected herself to one single operation: and the whole benefit was ascribed thereto !

Can we be surprised at any exhibition of credulity, when we know positively of the existence of such humiliating examples !

Cooper's Surgical Dictionary.-Dr. David M. Reese, Professor of the Theory and Practice of Physic in the Castleton Medical College, Vermont, is engaged in preparing for the press a new edition of Cooper's Surgical Dictionary. He proposes to add a supplementary appendix, in which he will record the improvements and operations of American surgeons since 1830-the date of the former American edition-together with a summary of all the new matter which Mr. Cooper has introduced concerning transatlantic surgery during the same period.

Pennsylvania Hospital-Dr. Pepper.-The Board of Managers of the Pennsylvania Hospital have elected Dr. Pepper to the office of Physician to this institution, in the place of Dr. B. Coates, resigned. Dr. Pepper is a zealous and practised pathologist; full of enthusiasm in the profession of his choice; who has had ample opportunities both at home and abroad for developing his natural endowments, and for becoming a well informed and able physician.

College of Pharmacy-Dr. Bridges.-The office of Professor of Chemistry having been vacated by the resignation of Dr. William Fisher, we are gratified to find, that it has been bestowed upon Dr. R. Bridges, of this city, well known as an excellent chemist.

University of Maryland-Dr. Roby.—Dr. Joseph Roby has received the appointment of Professor of Anatomy in the University of Maryland.-Boston Med. and Surg. Journal, May 11, 1842.

New York Society for the Relief of the Widows and Orphans of Medical Men. We are pleased to see a movement in this praiseworthy direction made in New York by some of the most respectable members of the profession; and although, from the programme submitted to the meeting, the contemplated relief is intended to be but small, it is the commencement of a noble scheme, and may be more fully matured hereafter. We shall look with much interest to the further developments, which, we trust, may be entirely successful.

Ileus, in consequence of Hypertrophy of the Pancreas, producing Stricture of the Duodenum. A country gentleman, of strong appearance, had felt for six or eight months, a sense of weight in the region of the stomach and navel, which prevented him moving at all after eating, as this gave rise to great uneasiness; he was in the habit of drinking great quantities of water, and experienced much relief from eructation. Four days previous to N. (narrator of the case,) seeing him, which was on the 20th July, he had indulged rather freely at an entertainment in the neighbourhood, and after having driven home somewhat late at night, he took a vomit, with effect; but instead of being relieved, he became gradually worse, and soon presented

1 Hannover. Annalen, Bd. v. 2 Heft. and Lond. and Edinb. Monthly Journal of Med. Science, April, 1842, p. 390.

all the symptoms of ileus, without any of those of inflammation. Despite of the usual remedies, he died 22d July.

Autopsy. There was no trace of inflammation, nor of effusion into abdomen. The pancreas, however, had lost its natural appearance, and exhibited a soft succulent fleshy aspect, without any scirrhous or tuberculous deposition; it was enormously hypertrophied, being almost as large as the head of a fœtus of four months old, and had so completely inclosed almost three inches of the duodenum, that this had become so narrowed as hardly to admit a goose quill. Between this stricture and the pylorus, the duodenum was expanded into a sort of second stomach, where, no doubt, the contents of the stomach remained, until so diluted as to pass the stricture; hence the patient's insatiable drinking propensity.

Case of Complete Obliteration of the Aorta. By Dr. Roemer, Professor of Anatomy at Vienna.-An officer, high in rank in the Austrian army, who had served during the war from 1770 to 1815, and had always enjoyed good health till his 45th year, went at that time to reside at Mayence. He then suffered frequently from dyspnoea and gastralgia, but did not apply for medical advice until he had had several attacks of threatened suffocation, and his stomach had refused to receive every kind of food. During a year he was treated homoeopathically, without benefit. Severe palpitations then came on, accompanied by oedema of the extremities. The continued use of bismuth and digitalis made the dyspnea and vomiting almost entirely disappear, but the pulse continued rapid, vibrating, and full. As his decease approached, he was seized with hoarseness and a small dry cough; and at last he expired suddenly in his fiftieth year, while playing at whist.

Post-mortem examination.-The contents of the cranium were healthy, with the exception of a softened and exsanguine state of the brain, and ossification of the basilar artery. Four ounces of serum were found at the base of the skull. The heart was considerably hypertrophied; the valves were healthy. The aorta, as far as the origin of the arteria innominata, was much dilated, which latter was almost twice its normal size. The subclavians and the left carotid artery did not appear unnaturally large. The coronary arteries were ossified to the extent of about three inches. From the origin of the arteria innominata, to the point where the ductus arteriosus enters, the aorta became gradually smaller, and at this latter spot the diameter did not exceed half an inch; it was there found obliterated to the same extent; its thoracic and abdominal portion was hardly as large as that of a child ten or twelve years old; the walls of these vessels were evidently thickened. The intercostal arteries, which arose below the obliteration, had nearly the diameter of a quarter of an inch, and communicated freely between the third and fourth ribs, with the mammary and thoracic arteries. It was by means of these anastomoses that the collateral circulation was established; the pulmonary arteries were greatly dilated; the left laryngeal recurrent nerve was greatly stretched, and the turn which it makes round the aorta corresponded to the obliterated point of that vessel. Biliary calculi were found in the gall-bladder. The lungs and other organs were healthy.

A case of Poisoning with Laudanum. By Casper Morris, M. D., of Philadelphia.—Mrs. A. intending to administer a dose of oil to her infant, four months old, to prevent griping, attempted to add to it two drops of laudanum. It escaped more rapidly than she wished from the vial, but supposing from the appearance, there might be about three drops, she gave it

Arch. Gén. de Médecine, Dec. 1841, and Lond. and Edinb. Monthly Journal of Med. Science, April, 1842, p. 391.

2 Quarterly Summary of the Transactions of the College of Physicians of Philadelphia. February, March and April, 1842.

at a venture. The child soon fell asleep, and though it appeared nervous and twitched frequently, she felt no uneasiness till it was seized with convulsions, about three hours after the dose had been taken. I was then sent for, and found it with general convulsions, stertorous breathing, hot skin, pupils contracted to mere points-the stupor was so deep that it could not be aroused by any efforts I could make. I at once administered a dose of sulphate of zinc, which I had carried with me, and enema of strong salt and water hourly, a part of which was retained without exciting the least sensation. On examining the laudanum bottle, I found there were about twenty drops remaining at the bottom of an ounce vial, the sides of which were coated with a deposit of opium; the little fluid at the bottom being very turbed, and containing many fragments of opium of considerable size. I at once come to the conclusion that we had no means of estimating the amount of opium taken. In the first place, the uncertainty as to the number of drops, was very great; any one who has dropped laudanum into castor oil, may have observed how very deceptive is the appearance it presents. In addition to this cause of uncertainty, the turbed fluid was of much greater strength than the clear filtered tincture; but above all, the probability that a portion of solid opium had escaped with the fluid was so great as to amount almost to certainty. Under these circumstances, the stomach being little likely to respond to the impression of remedies, I introduced a large catheter into it, and injected a quantity of warm water. This was promptly returned through the tube, (and I may remark in passing, that I have before witnessed the same result,) so freely and promptly, that there was no occasion for any effort to draw it off by the syringe. The water was returned perfectly pure; there was, however, no mitigation of the symptoms. In the meanwhile mustard cataplasms had been applied to the extremities, and iced water repeatedly dashed upon the head, but neither was sufficient to arouse the child. On the contrary, the respiration became more slow-the skin cold, and the consciousness diminished. I had the child placed in a warm mustard bath, which excited one cry, the first and only token of sensation manifested for many hours. Dr. Hodge, who had been summoned to my aid, arrived at this juncture. The coldness of the surface and tokens of prostration becoming urgent, we agreed to administer brandy and water. In the effort to swallow the first tea-spoonful, convulsions set in, whether caused or not by some drops insinuating themselves into the larynx, it would be difficult to say.-Convulsion after convulsion ensued, destroying the power of deglutition entirely. Fearing, lest in the passage of the tube into the stomach for the purpose of stimulating the child by a continued use of the brandy, the spasm might be aggravated, we threw a table-spoonful of brandy mixed with a cupful of warm water into the rectum. The surface still continued cold; there was not even heat of the head; the breathing was much interrupted-the face livid. A warm mustard bath was again resorted to, but without any effect; the child was indeed taken from it, as we thought, moribund. The spasm increasing in violence, the action of the heart alone indicated the retention of life. While Dr. Hodge was employing friction to the body, I thrust my finger into the mouth, and found the jaw rigid and the tongue thrust forcibly backward and upward against the palate. It occurred to me at the moment that even if an effort at respiration should be made, all access of air to the lungs was effectually prevented by this condition of the mouth; placing, therefore, two fingers upon the tongue and the thumb between the jaws, I held it forciby open, at the same time requesting Dr. Hodge to compress forcibly the chest and belly so as to empty the lungs: this was repeated frequently, the elasticity of the cartilages, and the descent of the diaphragm causing air to be drawn into the lungs. This was repeated for at least three minutes, action of the heart only giving indication of the presence of vital power. At length a long sigh was drawn and natural respiration re-established. Still the surface remained cold, and there was no manifestation of a diminution of the influence of the opium, although between six and seven hours had elapsed

since its administration. A large sinapism was applied to the anterior part of the body, which speedily induced redness, but without exciting the sensibility of the patient. It was then removed to the back without any more favourable result. Cold air was blown upon the face repeatedly with equal want of success. The mustard failing to excite permanent warmth, at the suggestion of Dr. Hodge, linen cloths were heated at the fire and applied so hot, that it was with difficulty they could be retained in the hands; by this means an artificial heat was communicated to the skin and the congestion of the great vessels relieved, the body soon becoming red as though covered with a vivid eruption. Before this was finally effected, convulsions again occurred, producing the same suspension of the respiration, and coldness and lividity of the surface, and this time there was no perceptible action of the heart. We all thought the child dead. The same process was again resorted to for the purpose of inflating the lungs, with the addition of blowing into the throat whilst held open. So satisfied was I that the case was past recovery that I should have abandoned it as hopeless, but the active and untiring zeal of Dr. Hodge was not so easily subdued, and we persevered again, and were both astonished and delighted to witness the re-establishment of natural respiration. For several hours we persevered in the application of the hot linen cloths-certainly the most effectual way of imparting heat to the body—and at ten o'clock at night, just eleven hours after the dose had been given, we left the child crying heartily for drink, and by the next morning it had entirely recovered from all the consequences of the dose.

Dr. Condie suggested whether the case related by Dr. Morris, was not one in which the establishment of artificial respiration, as practised by Mr. Charles S. Smith, in an instance recorded in the twentieth volume of the London Medico-Chirurgical Transactions, would have contributed to a more prompt restoration of the vital functions, or at least have been an additional means of securing the final recovery of the patient. Dr. C. believed that in very many cases of poisoning by opium and other narcotics, the employment of artificial respiration would most effectually contribute to the success of the other means resorted to, if not in itself sufficient to prevent a fatal result. He should not, himself, hesitate, where the artificial inflation of the lungs could not otherwise be effected, to make an opening into the trachea for the introduction of a tube.

Dr. Parrish remarked that the present case was a peculiarly interesting one, in consequence of the complete restoration of the powers of life, after the entire cessation of the action of the heart and lungs. The length of time during which the vital functions may be suspended, with the possibility of their subsequent restoration, has been the subject of considerable discussion. In the case just related, the cessation of the entire functions of respiration and circulation continued, as it appears, but for a few minutes, and Dr. P. believed, that there was no well authenticated instance of resuscitation in cases of asphyxia from submersion, where the suspension of respiration has continued longer than three or four minutes.-Instances have been related, it is true, in which resuscitation is said to have taken place after a body has been fifteen to twenty minutes under water, but it is evident, that, in these instances, there is a positive mis-statement as to the time the body has remained in the water. It may be very confidently asserted, that after the lungs have ceased acting for five minutes, every effort to again rouse them into action will be in vain. This is the opinion of Dr. Edwards, whose recent experiments and observations constitute the highest authority on this subject.

Dr. Pepper observed that a careless observer might too readily be lead into error, as to the period during which the lungs and heart have ceased to act, in cases of poisoning with opium, in consequence of the extreme slowness and feebleness with which their functions are often performed for some time before they cease entirely.

ART. I.-NEW MODE OF TREATING HYDROCELE.

BY J. PANCOAST, Prof. of Anatomy, Jefferson Medical College, Philada. My dear Doctor,-I send, at your request, the following notice of a new mode for the cure of hydrocele in children:—

Hydrocele in children, even where the opening has been closed, that led from the tunica vaginalis to the cavity of the abdomen, is a disease of frequent Occurrence. In early infancy strong discutient lotions will usually suffice for its cure. But after the second year, some more efficient means are required to produce this result. Mere evacuation of the serum with a common lancet or trochar, or a number of punctures made into the sac with a large needle, so that the fluid may escape into the cellular tissue of the scrotum, and be subsequently removed by the absorbents, are the modes of cure commonly relied on. But I have found them so uncertain in their result, success in many cases being attained only by a repetition of the process, that I have latterly adopted the following plan of treatment, which in three cases that I have tried it in has proved perfectly successful.

I puncture the swelling, in front and below its middle, with a common thumb lancet. When the serum is discharged a little pressure causes the serous or vaginal tunic to protrude in the form of a small cyst. This I lay hold of with a pair of forceps, and draw it out, as far as it will admit. I then divide the lower half of the cyst next the skin with a pair of scissors, and traction again being made upon the pedicle, still more of the tunic may be drawn out from the upper portion of the scrotum, which is nipped partly off and treated in like manner as before. I repeat this process, while any portion of the vaginal tunic can be made to readily protrude at the opening, so as to be laid hold of with the forceps. I then surround the side of the scrotum and the testicle involved with strips of adhesive plaster, after the manner of Fricke of Hamburg for the cure of hernia humoralis. By this means, the cellular tissue of the scrotum (the tunica vaginalis reflexa having been removed, to a considerable extent, with the forceps and scissors) is brought directly into contact with, and ultimately becomes adherent to that portion of the vaginal tunic which is closely attached to the fibrous coat of the testicle.

The child is allowed to run about as usual, and in a few days is perfectly well. Excepting as regards the puncture of the skin, the operation is entirely devoid of pain.

This plan of cure will, I think, be generally found applicable in children. It is certainly more speedy and certain in its results than any measure short of injection of the sac, which is not usually practised in children.

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