the face of the impostor, and shewn him A philanthrophist once said, that he

in his native hideousness.

"Vice is a monster of so frightful mien, As to be hated needs but to be seen."

In the early part of our career, it was necessary to expose the depravity of the agents, and injurious tendency of the system. These are now generally felt and acknowledged; and there are few so bold as verbally to approve, and still fewer so reckless of character as to countenance them by acknowledged contributions. So fully are we convinced of this, that we shall consider it as unnecessary to insist hereafter on the general character of the publication alluded to, and shall only crave the indulgence of our readers when any delinquency of more than usual atrocity calls for exposure and castigation.

When this Journal was first begun, the general impression seems to have been that no weekly publication could succeed against the one already established. They are "fast hastening towards dissolution, which shall not be retarded by any notice of our's," was the self-complacent language of our opponent. These hopes and fears are now at an end. The Gazette has progressively increased in circulation, and is, probably, as extensively known, and exercises as great an influence as any medical journal has ever obtained within the same period. We speak not in the language of boasting, but of truth; and though we cannot say, like a modest contemporary, that our paper is "the standard of medical science in the capi. tal of the celestial empire*," we have the satisfaction to know what is better, that there are very few medical men in this metropolis who do not read it; while it is already to be found in all the towns, and most of the villages, in the United Kingdom.

Another proof of our increasing reputation may be found in the number and value of our original contributions.

*See Lancet, May 24.

who raised a blade of grass where none grew before, was a benefactor of mankind so we request our readers to keep in mind, that he who records a single fact calculated to extend our knowledge, assist our judgment, and improve our practice, is a benefactor to his profession and to humanity. We beg to offer our grateful acknowledgments to those who have already stept forward in so good a cause, and through us have favoured their brethren with the results of their experience; and we most earnestly solicit the continuance of their co-operation and assistance.

Of the series of papers which we have published, some might well have formed the materials of a separate volume; and we would suggest to those who are disposed to send us contributions, that the insertion of papers in the Gazette on any particular subject to which they may have devoted their attention, by no means precludes the authors from afterwards publishing them in a different form. So far otherwise, that some of those essays which we have already given, are severally intended to constitute the basis of a more elaborate work. On the other hand, the authors of medical papers, by allowing us to place them in the columns of the Gazette, secure to their communications an immediate circulation much more extensive than separate volumes usually obtain, without any risk, trouble, or expense to themselves; and, should they afterwards republish them, they do so with the advantage of having made the profession previously aware that the subject of which they treat has been the object of their particular study.

The papers which we intend to lay before our readers, in the early Numbers of the present volume, are selections from Dr. Chambers's Lectures, beginning with those on Fever; Abstracts of the Lectures recently delivered at the College of Physicians, various Clinical Lectures on Surgery, and a se

ries of Essays, giving a complete view of the history and treatment of venereal complaints, and originally intended for a separate work, by a gentleman whose opportunities of investigating these diseases have been very extensive, and whose attention has long been devoted to the subject. The other departments of our Journal will be conducted without much change, although we shall modify our plan to a certain extent, according to circumstances, or in compliance with the general wishes of our readers, when these can be ascertained.

We have received many letters containing advice and suggestions with respect to the management of our paper. These all shew an interest in the Journal, and desire for its success, for which we offer our warmest thanks. Our correspondents, however, may perhaps remember a letter from Mr. Brunel, thanking the public for the interest they took in his labours and his difficulties in constructing the Thames tunnel; and especially expressing his acknowledgments to an immense number of well-wishers who recommended plans for stopping the leak. Some of these consisted in methods which were impracticable; others in such as, if practised, would have been ruinous; and others, of methods which had already been adopted, and were in operation. In fact, few of these gentlemen were acquainted with the exact nature of the difficulties to be overcome. we request our friends to believe, that if we do not adopt all the suggestions thrown out to us, it arises from no disrespect towards those who make them, but partly because we are frequently possessed of information which has not reached our correspondents, and therefore entertain opinions at variance with what is proposed, and partly because we remember to have read, in Æsop's Fables, a story of an old man and his ass-too trite to be repeated.

So

HOSPITAL REPORTS.

ST. GEORGE'S HOSPITAL.
Fatal Accident-Bleeding.

On the 26th of May, at about 2, P. M.
a boy was brought into the accident-
ward upon a shutter, not actually dead,
but evidently dying. We watched him
as he lay upon the bed, and he had all
the appearance of one who was dying
from some great internal hæmorrhage.
The lips were livid, the cheeks blanched,
the whole body pale and cold; the pulse
at the wrist to be felt, and that was all;
the respiration not exactly difficult,
but resembling a succession of half-
drawn sighs. On taking off his clothes,
all around observed with surprise that
the arm was tied up, as if for bleeding;
and on inquiry of the men who had
brought the poor lad to the hospital, we
ascertained the following particulars :—

He was taking care of a horse and gig in the neighbourhood of South Audley Street, when the horse ran off and knocked him down, the wheel of the gig passing over his body. At the same time it would seem that a lamp-post fell also, but whether upon the boy, was not ascertained. However, he was lifted up, and conveyed to a surgeon's, who, according to the account of the by-standers, instantly opened a vein in the arm, and, with great difficulty, contrived to abstract about six or seven ounces of blood. Whether the boy was the better for this we cannot pretend to say; but, at any rate, he was brought immediately afterwards to the hospital in the state of prostration which we have described, and in ten minutes after his arrival he expired.

Dissection.-Froth, tinged with arterial blood, was seen issuing from the nose; the surface of the body completely exsanguine. On opening the chest, the left cavity of the pleura was found to be filled with upwards of a quart of dark venous-looking blood. No fracture of the ribs-no rupture of the lungs could be discovered; but on passing the hand into the chest, the origin of the hæmorrhage was obvious enough, for the diaphragm on that side was rent across, whilst the spleen (literally torn into tatters) had been driven through this laceration of the diaphragm, and lay within the thorax. The stomach was in the abdomen, and unhurt; but

was much comminuted and projected forward; the ligaments of the right articular process had given way so as to adınit of subluxation. The membranes of the spinal marrow were not inflamed, and there was no considerable effusion of blood around them.

From the history of this case there was strong reason during life to suspect fracture of the cervical spine; and from the direction in which the force was applied, it was reasonable to suspect that the fracture extended to the body of the vertebræ. The patient appears to have suffered, in the first instance, from slight concussion of the brain, from which he had recovered when admitted; and from the amendment in the power of moving his arms, and the degree of sensibility which existed, Mr. Earle entertained hopes that he might have recovered. There can be no reasonable do but that his speedy exit was caused by the sudden and violent compression of the spinal marrow, in consequence of his efforts to move; the body of the 4th cervical vertebræ being so comminuted as to admit readily of such sudden compression.

ST. THOMAS'S HOSPITAL.

Case of Jaundice, from closure of the

Mouth of the common Duct.

WILLIAM CRUMSTON, aged 40, a mechanic, was attacked, nearly two years since, with pains in the right hypochondrium, similar to those which attend the passage of a gall-stone; and soon afterwards, his skin became yellow and his stools clay-coloured. He was admitted into a parochial infirmary, and there being then no clear evidence of the cause of the disease, nor any precise indication of cure, (for the pains had ceased, and no gall-stones had come away,) it was conjectured that the jaundice might be occasioned by an adhesion of the sides of the biliary ducts, or by some tumor pressing upon them. Mercury and iodine were given, with the object of producing absorption of such obstruction. He was at one time kept for two months under the influence of mercury, and subsequently iodine was given, to the extent of a drachm of the tincture, two or three times daily. Under this treatment, his skin occasionally recovered almost its natural colour, but the stools never assumed a healthy appearance. No gall

stones passed while he was in the infirmary. He came into this hospital six months ago. At that time he was in a state of great weakness; the skin was greenish-yellow, and the stools were clay-coloured. His appetite being very ravenous, as it had been for some time, he was allowed a larger quantity of animal food than constitutes the common house diet, and ordered to drink porter. The medical treatment was very similar to that which had previously been pursued; both mercury and iodine being given, but in smaller doses. The effect was nearly the same. The skin occasionally became almost white, but soon returned to its former colour, while the stools retained their unvarying whiteness. Two months before his death, the porter was left off, as he had a slight accession of fever. His appetite failing about the same time, he was put on house diet. A fortnight before his death, he became much worse: the skin, which had become nearly white, suddenly assumed a deep orange tint, which it retained till his death; his weakness increased, and he complained of pain affecting the whole of the abdomen, which appeared swelled. No change in the stools, until within two days of his death, when they all at once became fluid, copious, and nearly black. He had frequent evacuations of this kind until he expired.

Sectio Cadaveris.-All the viscera were found to be deeply tinged with bile.

The coats of the vessels at the base of the brain, and even the membranes of that organ, were yellow. The gall-bladder was healthy in size and appearance, and contained about twenty small angular concretions, consisting almost entirely of cholesterine. The ductus cysticus was dilated, as was also the ductus hepaticus; but the greatest enlargement was seen in the ductus communis choledochus, which was nearly an inch in its transverse diameter, while its coats were almost as thick as those of the aorta. In fact, such was its size, that it was at first supposed to be the vena portæ, till, on cutting it, the bile flowing out discovered the mistake. In this stage of the dissection, nothing had been ascertained to account for the obstruction. It was plain that it must be at the very termination of the duct, as up to that point it continued dilated. At the very point where the ductus communis coledochus began to