left: when it dies, a slough is thrown off, the consequence of which is a puckering of the skin; the loss of substance always leaving a very irregularshaped scar, having a tail-like extremity, a distinction by which the smallpox cicatrix is known.

In the small-pox which occurs after vaccination, it is not uncommon, about the fifth day, to find the eruption converted into small horny buttons; for the villi have not been highly inflamed. They soon recover themselves, but the cellular structure, having been amply filled with a glutinous lymph, is left in a hard and darkened state; it is tough, and remains for days without much apparent change, for the diseased action having been mild, and not attended by energetic inflammation, the absorption of these hard buttons is very slow.

In the scabbing stage of the cow-pock the regularly agglutinating process is easily observed. The cells become gradually consolidated; for the fluid thick ens, becomes hard, and at last a scab is formed, beneath which ulceration has removed a small portion of the villi of the cutis, and has left the slight mark peculiar to a mild and uninjured progress of the pock.

In the diseases of this nature, in which the constitutional irritation precedes the specific organization, there would seem to be no period at which its approach could be arrested. Considerable danger occasionally attends an attack of variolous fever, even in persons who have previously been perfectly vaccinated. I have known several cases in which death has taken place on the third day of the febrile action, the patient having been at that period covered with petechia, instead of the pimples which should have appeared.

In the inoculated cow-pock, the constitutional irritation cannot precede the specific change of structure; and in some cases it is very difficult to say when the constitutional influence has been established. Experiments have not yet decided whether the extirpation of the newly-organized structure would check the advance of the disease.

We know nothing clearly of the change of organization which takes place at various periods in the part ino culated with the hydrophobic poison. The following detail, put together from information afforded by Mr. King's journal, will shew that the investigation

of the point has not been wholly unattended to.

On the 12th March, 1807, Dr. Beddoes and Dr. Stock accompanied Mr. King to the village of Weston, near Bath, for the purpose of seeing a rabid cow, that was shut up in a barn at Farmer Wintle's. They observed the animal from an open window above its reach, and opposite to them was a strong barricade, about seven feet high, which divided that part from the rest of the barn. The space of the floor thus partitioned, in which the cow was placed, was about 20 feet by 14. She was excessively furious, and bellowed very loud; frequently attempted to leap over the bar, and several times nearly succeeded. Sometimes she ran with violence against the wall, and fell down in convulsions. A wooden block was let down from the window, at which she ran with great fury, and tossed it about. A bucket of water was similarly let down, but before it came to the ground she plunged at it and overturned it. Upon the water being splashed about, she fell into violent convulsions. Her eyes were much blood-shot.

Mr. King observed her for about two hours, and at one time she was seen attempting to eat a little hay; but it was soon vomited again, and she then voided a small quantity of black hard dung, to which she turned round, and in a short time ate it up.

The author of the article Dog, in Rees's Cyclopædia, mentions that some dogs affected with rabies will eat their own excrement, and lap their own urine. Rabid dogs are said not to evince any dread of water. It must be remarked that this cow exhibited the hydrophobic symptom; and within three or four months of the period at which she had this disease, in all that part of Gloucestershire lying northward between Bath and Bristol, the villages of Pucklechurch, Syston, &c. a very unusual number of such cases had occurred among cows, horses, and other animals.

Farmer Wintle informed Mr. King, that about two months before several rabid dogs had passed through the field in which his cow was placed, but they had not been observed to bite her. She had calved about a month before this time. It was on the 8th of March that she had been perceived to be different from her usual way. In the evening she was very unruly, and frightened the

woman who went to milk her. On the following morning she quietly submitted to be milked in the evening of that day she foamed at the mouth, ran about in a very wild manner, and rushed at people with her mouth open, as if to bite. She was then confined in the barn.

Mr. King was desirous of trying an experiment with the saliva of this cow, and, accordingly, in one of the attempts she made to leap over the barricade, her head projecting over it, he succeeded in obtaining on his hands an immense volume of foam which was discharged from her mouth *. He had made two incisions under the wings of a common barn-door hen, quite through the integument, the lancet scratching the muscular part. The foam immediately taken from the cow's mouth was inserted, by rubbing, into these cuts. The fowl was confined in a basket, her head projecting through an aperture; she was secured in such a manner as to prevent her from pecking at the ineisions; and thus the bird was sent to Dowry Square, in Dr. Beddoes' carriage. The next day this fowl was let loose, among others, in a poultry-yard at Mr. King's residence. On examining it from time to time, the incisions were found to be soon healed, and their place could with difficulty be discovered. The habits of this fowl appeared to be exactly like those of the rest. On the 25th May, however, she was observed to run at the other fowls, and she refused her food. She had a wild, strange expression, and her eyes were bloodshot. Early in the following day, her legs became contracted, so that she very soon lost the power of standing upright. She remained sitting, with the legs rigid, a long time, refusing food and water, and appearing very irri

• This cow died on the night of the 12th March.

and on the 14th was brought to Mr. King's house, in Dowry Square, where he dissected it on the 15th. The brain and spinal marrow were very soft they were not at all inflamed: the tongue, as far as the root, was natural. The whole sur face of the fauces, pharynx, larynx, and mucous membrane of the trachea, was of a dark colour, and in appearance resembled brownish crimson velvet. The pleura costalis, to within two ribs of the diaphragm, was of the same tint: in parts it was putrid. The pericardium was full of a darkcoloured fluid. The cavities of the heart were distended with dark grumous blood. The diaphragm and stomach were healthy. The liver was small, pale, and shrivelled. No bile was perceivable in the small intestines. The spleen was very dark, flabby, and full of grumous blood. The kidneys were in a putrid state. The rest of the abdominal viscera appeared healthy.

VOL. II.-NO. 27.

table when touched. She died in the evening, immediately after readily drinking a large quantity of water, which had been offered to her.

Early on the morning of the 27th of May, this fowl was examined by Dr. Macartney. The inoculated parts appeared recently inflamed. There was great vascularity about the cicatrices, which exhibited three small tumors, each about the size and shape of a compressed pea, the vessels of which were turgid with blood. At the time of the inoculation, Mr. King observed no injected appearance about the parts, nor was such apparent when the bird had been examined at any subsequent period. The trachia and oesophagus were considerably inflamed, and the vessels of the brain were distended with blood.

A question which naturally occurs, upon the consideration of these tumors, is, can there be a specific character in the change of organization which appears at the cicatrix of inoculation with rabid poison?

In the year 1822, the sister of one of my servants having been attacked with hydrophobia, was sent by me to the Middlesex Hospital. She had been bitten by a little dog in the hand, about six weeks previously. After exhibiting the usual train of distressing symptoms, unrelieved by the exhibition of very large doses of opium, she died. I could not conveniently attend the examination of the body, but I requested my late friend, Mr. Shaw, to pay particular attention to the state of the cicatrix in the hand; and his observation to me afterwards was, that there appeared to be much vascularity about the spot: not having, however, turned his attention to the post mortem state of scars left by lacerated wounds, he was unable to say whether the degree of vascularity was unusual, or whether there was present in the part a structure which could be called specific. Additional and more minute observations are, therefore, wanting, to establish whether hydrophobia be or be not accompanied by a specific organization of the inoculated part.

London, May 1828.

C

18

ANATOMICAL PREPARATIONS.

On the use of Oxalic Acid in aqueous solution as a preservative for Anatomical Preparations.

To the Editor of the London Medical Gazette.

SIR, HAVING repeatedly employed the various means hitherto recommended for the preservation of anatomical preparations in the humid way, and been frequently disappointed by perceiving the different colours of the several parts, so beautiful and distinct in the recent state, quickly fade into an almost uniform paleness, I have been induced to institute experiments on many other substances allowed to possess antiseptic properties, with a view to obviate the above imperfection.

It is unnecessary to enumerate the failures I might instance; I shall be more than recompensed for my trouble, should my endeavours prove satisfactory upon further experience; and with this intention, I beg to recommend a solu. tion of the oxalic acid in pure water, (in the proportion of one scruple of the former to an ounce of the latter) as far superior to any other menstruum with which I am at present acquainted. The muscular parts are as distinctly marked

be prevented, as they, especially iron, become rapidly oxidized by the acid, whole; for which reason all dissections and would, consequently, discolour the are recommended to precede the use of the acid.

;

The portions employed in cleaning, &c. may be set by for future occasions. but the cheapness of the material can hardly be supposed to render this degree of economy necessary.

The peculiar property which sugar possesses, of preserving both animal and vegetable substances without materially impairing their colours, induced me to try this acid. Some experiments on its applicability to the preservation of articles of food, are in progress. I apprehend but little danger from the small quantity of the acid which may be inseparable on washing, any more than from nitre when similarly employed, if the sour taste can be got rid of or covered. J. M'DONNELL, M.D.

Asst-Surgeon, 55th Regt.

PARISIAN NEWS.

Choice of an Hospital Surgeon-Amputation at the Hip-Joint-DelpechLarrey-Magendie-Seven persons poisoned with Prussic Acid at the Bicètre.

SIR,

Gazette.

Paris, May 20.

The subject to be preserved should be carefully cleared in the first instance of all its superfluous parts, and all necessary dissections should be performed; the free blood, and all impurities carefully removed; in doing which, all washing, with plain water, and more especially spirits, must be avoided if possible, as they tend to render the muscular parts pale. If washing is necessary, a little of the solution may be used: it should be then immersed for about two hours in some of the solution, whence it is to be transferred to the glass or stone-ware jar, in which it is intended to remain until finally put up. All contact with metallic matters must

IF our medical examinations in England be too superficial, I really do not think that any one can bring a similar charge against our Gallic neighbours. The concours publique, for the election of an hospital surgeon, which I described in my last letter, has had several meetings, and the candidates continue at each heat to struggle most keenly for the mastery. Two of them, as I mentioned before, broke down, and the number being thus reduced to nine, they were formed in one set instead of two, as formerly. They have been subjected to a second and third oral examination. Examination, perhaps, is not a correct expression, as they are not questioned; but a subject is given them, on which they deliver a kind of extemporaneous lecture -twenty minutes being allowed for reflection, and a like period for speaking. On the present occasion the question

was, "The high operation for the stone, and lithotritic-to describe the advantages and disadvantages of each." The candidates were then called in separately, and spoke in succession; a few well, others indifferently, and some badly enough.

The next part of the ceremony consisted in drawing by lot subjects for a thesis. About a week is allowed to compose this, and they are then called upon to defend their opinions in public. The subjects drawn by the nine candidates were-dislocation in general, and that of the hip in particular-partial amputation of the foot-fractures of the scull-fistula lachrymalis-amputation, the cases in which it ought to be performed, and those in which it ought to be avoided the Cæsarean section and division of the symphisis pubis-strictures of the urethra-gun-shot wounds -and, lastly, diseases and injuries of the spinal column. Excellent matter, you will allow, for dissertations; but I presume the judges must have made up their minds beforehand about the merits of the candidates, as, the subject of each thesis being different, renders it impossible to institute any accurate comparison; I shall return to this subject when the business has been completed.

DELPECH, the celebrated surgeon of Montpellier, has been here lately, and I was very much gratified at witnessing a discussion at the Academie Royale de Médecine, in which he took part. Delpech communicated to the Society the following interesting facts :

M.

In June 1823, a young man came to the hospital of Montpellier, with numerous fistulous openings in the thigh, some of them leading down to the bone, of which the probe detected several loose portions, and some fragments had been evacuated with the discharge. It was manifestly a case of necrosis of the femur. The repeated attacks of inflammation in different parts of the limb had given to it a degree of lardaceous density (densité lardacée were M. Delpech's words). It was impossible to amputate in the course of the thigh, from the necrosis having extended so high up; but the hip joint remaining sound, it was resolved to remove the limb by its disarticulation, notwithstanding the great enlargement of the surrounding soft parts, as the narrator had found, by experience, that such tumefactions speedily

disappear when their exciting cause has been removed.

The crural artery was tied in the first place by means of a thread passed through the groove of a catheter, the point of which had been insinuated between the artery and vein. Instead, however, of making two flaps, as has been usual (one external and the other internal), M. Delpech resolved to make only one large flap, and that on the inside: this flap he proposed bringing from within outwards, so as to make it cover the articular cavity with a thick cushion of muscle.

This plan was but incompletely executed: the inner flap was formed of the proposed length and thickness, by turning the knife at an early stage of the operation from within backwards, so as to take in the most fleshy part of the thigh. The limb was placed in a state of artificial abduction, and the capsular ligament was pierced, and then divided on the head of the bone through the half of its circumference. There was rather brisk hæmorrhage at this time, which, however, was suppressed by tying one artery. The thigh being now turned inwards, in place of cutting in a curved line nearly parallel to the upper or iliac edge of the buttock, the muscles of which would thus have been divided about their middle, and the formation of an external flap avoided, the knife was directed obliquely downwards, by which a small external flap also was made. The capsule was then divided through the rest of its circumference on the head of the bone, and the limb completely removed. Two more ligatures were necessary. The only thing remaining to be done was to promote the immediate union of the two flaps, as the patient could not probably have borne the suppuration of such an immense extent of surface. The extreme density of the inner flap rendered it very difficult to make it fold outwards, to effect which required both perseverance and some degree of force. Numerous points of interrupted suture, including the skin only, brought the edges exactly together; but the surgeon had the mortification to perceive that the line of junction crossed the external edge of the acetabulum, where the covering over the joint was not sufficiently thick, Compresses and bandages were applied, so as to keep the flap in its proper position. Next day the dressings required to be changed, in consequence of the

abundance of serous discharge, by which, however, the swelling of the parts was diminished, and union by the first intention took place, except at the spot over the edge of the articular cavity above mentioned. Here a sero-sanguinolent discharge came on, followed by suppuration of a healthy character, which gradually diminished, and at the end of thirty days the cure was complete. At present this patient, whom M. Delpech exhibited to the meeting, appears to enjoy perfect health, and even walks tolerably, by means of a wooden leg.

The second operation was performed in 1824, and precisely on the plan abovementioned, no difficulty having been experienced in forming the flap in the manner intended. The patient had suffered from an old ununited fracture at the upper part of the femur. Unfortunately he would not submit to the operation till his life had become endangered by abdominal inflammation. The operation perfectly succeeded; the adaptation of the flap to the other parts was complete, and the wound healed perfectly in 20 days, without any suppuration. The patient died eight months after, and the dissection of the stump shewed the articular cavity filled with the soft parts constituting the inner surface of the flap; cellular membrane, of considerable density, formed the medium of union between the joint and the parts covering it.

After giving these details, M. Delpech went on to explain the motives by which he had been guided. Premising the ligature of the artery he thought necessary, on account of the little dependence that can be placed in compression, for arresting the hæmorrhage;-the suture he used, because he has not found it hurtful-provided the skin only be included. But what he chiefly dwelt upon, was the advantage of not making an external flap; because the tendons which are then involved unite less readily with the parts to which they are applied, and are much more disposed to suppurate than the muscular fibres. He regards it as of great moment to cover the cavity of the joint well with a thick envelope of soft parts. This precaution, indeed, he regards as mainly contributing to prevent suppuration.

Whether this method may possess all the advantages attributed to it by M. Delpech, I am unable to say; but the impression he produced upon the mem

bers of the Academy was obviously of the most favourable nature. Indeed it is difficult to imagine any one more calculated to carry his hearers along with him, owing to the clearness of his ideas, the elegance of his diction, and the gracefulness of his manner. He spoke for nearly an hour, without a single repetition or the slightest hesitation; and when, in the course of the discussion, he was called upon to reply, it became apparent that his eloquence was not the result of study, as his extemporaneous speeches were in no respect inferior to his opening address. He is by far the best speaker I have heard here-nay, the only medical man I have met with who has any pretensions to eloquence; for the French, although abundantly ready in conversation, are generally incapable of any thing like a sustained harangue.

LARREY, who, by the by, is remarkably like the portraits of Oliver Cromwell, claimed for himself the priority in this method of operating, which, he said, he had described in his Memoirs nearly as M. Delpech had just done: the preliminary tying of the artery, the attempt at union by the first intention, the suture, and the internal flap-all these he had recommended, but he also made an external flap. Now the peculiarity of M. Delpech's method, be it good or bad, consists in making but one flap, and therefore M. Le Baron's but is rather an im

portant one. He invited M. Delpech to visit a man at the Hôtel des Invalids, who had been operated upon after his method at Waterloo. He alluded, 1 presume, to the French soldier on whom Mr. Guthrie performed this operation with success, and whom I saw soon after the operation, with a very good stump-if it can be properly so called where no stump is left. Larrey grows old, and is rather vain, though certainly a very zealous man in his profession. I remember him at Brussels, after the battle of Waterloo, where he was taken prisoner. He was walking through one of the many hospitals at that time filled with soldiers, when he observed an hospitalassistant dressing a wound not precisely in a manner he approved of. "Tell him," said he to some one present, "tell him that Baron Larrey is looking at him!!"-"Tell Baron Larrey, he may be -," was the ungracious reply of the young gentleman, whom