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so it is; and not only this, but preface and notes are filled with the most fulsome adulation of this personage; their writer evidently implying, that if we are to do honour to him who placed in our hands the means of distinguishing diseases of the chest, and left us the best description of their characters, we must surely be prepared to prostrate ourselves before the hero who tells us he can cure the most deadly of them. This is not the occasion we should choose for the exposure of the fallacy of Dr. Ramadge's views, and the curious statements they are attempted to be supported by: but we could not allow his former pupil and friend to bring his name into juxta-position with that of the great Laennec, without protesting against it, as, to say the very least, a piece of gross absurdity.

The translation (by another hand) is executed fairly enough, and several of the notes by Andral are valuable; but why the work was ever pub. lished, save for the laudation of the aforesaid Dr. Ramadge, we cannot imagine. To those who may wish to become acquainted with his views, it may prove acceptable, for they are reiterated at every opportunity, fitting or not but we believe they are too generally acknowledged as erroneous to secure many purchasers on their account.

REMARKS ON MEDICAL ORGANIZATION AND REFORM, FRENCH AND ENGLISH. By Edwin Lee. Svo, pp. 121. LONDON, 1846.

In our own struggle for medical reform, Dr. Lee believes it may be useful to exhibit the systems of Medical organization which prevail in France, Germany and Italy. These, however, are for the most part far too elaborate, methodical, and despotic, to admit of being transplanted among us. Indeed, before admiring and wishing to imitate them, we should observe how indifferently they work in their own respective countries, among persons much more accustomed to submissiveness to authority than we are; and do we not find that the profession is everywhere in a very discontented and unsatisfactory condition? That this is the case in France is notorious, and much that Mr. Lee mentions as regards that country is rather what the Congress desires, than what really exists; and in respect to essentials, we do not hesitate to affirm that, as regards the mass of medical men, their condition is much more to be deplored than in our own. We are not advocates for the transplantation of any cut-and-dried system from one country to another, in which the manners and institutions are not fitted for its reception. Each country has its peculiar abuses to remove or diminish; for, after all, the great thing we want is to be allowed unrestricted means of improving our professional position. This can only be done by improving our education, by bringing us more together, so that we may discern and support our true interests, and by preserving us and the public, from the injurious competition of uneducated and ignorant persons. The two existing medical incorporations are quite competent to these ends, but are unwilling to accomplish them. It behoves, then, the great mass of practitioners to unite boldly and firmly together. Their forbearance has hitherto been met with contumely, neglect, and opposition. They have

the power in their own hands, either of bringing their adversaries (for we regret the conduct of the corporate bodies justifies this term,) to a capitulation, or of erecting themselves into so important a rival institution as to render this a matter of no consequence. Their organization is the first essential object. That effected, they may do all they can legitimately desire; without it, they will continue to be tantalized, derided, and deceived as they have hitherto been.

Much of Mr. Lee's work is taken up with an exposition of the abuses prevailing in the Colleges of Physicians and Surgeons; but we think the profession is by this time fully aware of the nature and extent of these, as also of the impossibility of their amendment by any means short of those we have adverted to.

BEITRÄGE ZUr Ohrenheilkunde.

Von Dr. Wilhelm Kramer. Nebst

19 Statistischen Tabellen. 8vo. pp. 314. Berlin, 1845. Contributions to Aural Medicine, with 19 Statistical Tables. William Kramer.

By Dr.

THE name of Dr. Kramer is well known in this country as the author of an excellent treatise on Diseases of the Ear, published some years ago, and which was translated by Dr. Bennett. We reviewed the translation at considerable length, and reported favourably of it at the time of its publication-vide Med. Chir. Rev. for July, 1838. The present work consists chiefly of statistical tables and illustrations that serve to confirm the leading positions in his former one. The other articles are a paper on the Acoustics of the Human Ear, one on the application of Electro-Magnetism in the Treatment of Deafness, and one on Cerebral Otorrhoea. The writings of Dr. Kramer everywhere exhibit the spirit of an enlightened and judicious author, in whose statements we can place perfect reliance. Would that we could say the same of most aurists in this country! There is no branch of the healing art in which charlatanery is more rampant than in aural surgery, among those, at least, who profess to be ear-doctors. In short, they are little better than advertising quacks.

THE YOUNG STETHOSCOPIST, OR THE STUDENT'S AID TO AUSCULTATION. By Henry L. Bowditch, M.D. 8vo. pp. 276. Boston, 1846. Ticknor & Co.

We have been much pleased on the whole with this manual, and can truly recommend it to the student of Auscultation as an excellent guide. We had hoped to have found space to have noticed its contents more at length; but the extension of some of the articles in the present number has put this out of our power. The very copious index adds very much to the value of the work It would be well that authors in general would pay as much attention to this important point as Dr. Bowditch.

ON THE USE OF TURPENTINE AS A COLLYRIUM IN VARIOUS DISEASES OF THE EYE. By Dr. LAUGIER, Surgeon of Hôpital Beaujon.

M. SERRES D'ALAIS having mentioned to Dr. Laugier the success he had met with in the application of the Essence of Juniper to the eye in chronic keratitis, with an anormal development of the corneal and conjunctival vessels, it occurred to him that Venice Turpentine might have a like good effect in similar cases, and he therefore gave it a trial upon several cases of acute and chronic conjunctivitis, keratitis, &c., he had under his care. All these patients were already using the nitrate of silver lotion, and the substitution of the turpentine was attended with marked benefit. Other cases have also been treated, and justify the author in declaring the utility and harmlessness of this remedy. He has also found it of service in opacities of the cornea. M. L. allows that his experiments with this lotion have not yet been frequent enough: but they have been sufficiently so to justify his publication of their results. After various trials he has found the following formula that best adapted for use, although some patients can bear the pure essence without any admixture.

Venice Turpentine, 20 parts,

Essence of Turpentine, 10 parts,

Place the turpentine in a marble mortar and gently heat it; and when it has become fluid, add the essence gradually. Drop three or four drops into the eye night and morning.-Archives Générales.

FRACTURE OF THE LOWER EXTREMITY OF THE Radius.

M. Blandin, in a clinical lecture upon this accident, observed that authors erroneously represent pronation to be impossible, while in fact it can be effected, but induces great pain. Another gratuitous assertion is, that the interosseous space is destroyed, when indeed it can scarcely be said to exist at all at the lower part of the fore-arm. This it is important to bear in mind, in order to avoid the injurious, or at least useless, practice of applying graduated compresses for the purpose of maintaining the space between the two bones.

The history and appearance of the case usually suffice for the diagnosis, a fall on the wrist, or rather on the palm, being the most common cause of the accident. It is, however, not unfrequently confounded with sprain, in which deformity of the joint from effusion also takes place. There is, however, much less mobility of the part than in fracture, and the characteristic depression of the edge of the limb (le coup de hache) is absent. The mere absence of crepitation does not indicate anything, as it is not often perceived in this fracture. The No. 105.

17

confounding this accident with luxation of the wrist has, in a great degree, arisen from the minute description given by surgical writers of this last, as if it were of common occurrence, whereas it is very rarely met with, and indeed never, except as the result of great external violence, when it is also accompanied by more or less injury of the soft parts or fracture of bones. At all events it is never produced by a simple fall on the palm of the hand.

We have placed the limb upon its ulnar side. Some surgeons only continue the splints to the lower end of the fore-arm, but if we wish to act upon both fragments we must support the hand also in the apparatus. When there is anteroposterior displacement, the mere cubital splint will not suffice, and we have seen Dupuytren much surprised at its ill-success. Compression is required at the anterior and posterior faces of the fore-arm. To supply this, we employ broad, but not graduated, con.presses, merely doubling them where most pressure is requir ed. Thus, e. g., if they are so folded as to present but one thickness opposite the lower fragment, and four or five thicknesses opposite the upper one in front, the disposition may be reversed behind, so as to give us a double purchase upon the broken ends of the bone. When inflammation and swelling have subsided, these may be covered with the starch bandage.

M. Robert, lecturing upon the same accident, observes that, like in fractures of the other pyramidal bones, the upper fragment is frequently impacted in the lower one, more or less completely. At the palmar face of the limb, near the carpus, the anterior edge of the upper fragment forms a projecting crest beneath the skin, while posteriorly there is a corresponding depression: on this account, and because of the obliquity of the fracture, the lower part of the limb much resembles the letter Z in form-furnishing a very characteristic mark of the accident. M. Velpeau represents it as a constant one: but it may be absent, until produced by the following manœuvre. Embrace the upper fragment with one hand and the lower one with the other, and exercise a certain degree of pressure at the posterior part of the arm where the fracture is supposed to be situated. This projects the fragments forwards upon the palmar surface, and exhibits the characteristic plainly. The displacement from within outwards, noticed by Dupuytren, is proved by the experience of subsequent surgeons to be a far less frequent sign than he supposed it to be.

It is important to remember that fractures of the radius consolidate very rapidly, i. e., in from 20 to 25 days. At this period the apparatus should be removed and the joint exercised; for, if this be too long neglected, adhesions of some of the numerous tendons and ligaments of the part may ensue, producing a degree of stiffness or semi-anchylosis of the joint-a matter of especial consequence to a working man.-Gazette des Hôpitaux, Nos. 10 et 26.

FRACTURE OF THE LOWER END OF THE FIBULA.

M. Robert recommends the following means of distinguishing this accident from a sprain of the ankle-joint, after waiting two or three days for the swelling to subside, if necessary. Apply one thumb upon the external malleolus, and the other over the supposed fracture, and transform the fibula into a lever, having its fulcrum at the inferior perineo-tibial articulation. A certain degree of pressure is to be exerted by the thumb on the malleolus externus. If the fibula is uninjured, its entire length is felt to slightly and uniformly bend under the pressure; but if there be a fracture, the lower fragment moves more or less, and projects under the finger, so that even its form may be distinguished. The fracture in these cases is almost always oblique from above downwards and from behind forwards, occurring at only a short distance from the ankle-joint.

M. R. observes that the fracture may thus always easily be detected, and is

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surprised the mode has not occurred to others. Dupuytren was not aware of it, but used to seize the leg with one hand and the foot with the other, which means will however only suffice to detect a fracture when situated at a considerable distance from the malleolus.-Gazette des Hôpitaux, No. 35.

STRABISMUS CURED BY AN ACCIDENTAL DISPLACEMENT OF THE PUPIL. ANESTHESIA OF THE IRIS AND MYOPIA OBSERVED IN THE SAME PATIENT. By Dr. TAVIGNOT.

The patient, a young girl, aged 17, and of weak constitution, was attacked by measles in 1842. From this period, the eyes, which had heretofore been healthy, became affected with strumous ophthalmia. The left one was much the worst of the two, and after 18 months of unavailing treatment, Dr. T. was consulted respecting it. He found perforation had taken place at the upper and inner part of the cornea, the iris having protruded through the corneal aperture and contracted adhesions to it. Diligent treatment by small but frequent local bleedings, purgatives, and emmenagogues, and by a great variety of local applications, eventually triumphed over the obstinacy of the disease, and restored to the patient sufficient vision for the ordinary occupations of her sex.

From her infancy she had been the subject of a double convergent strabismus, that on the right side being much the most considerable. Had her eyes not become inflamed, she would have been operated upon to relieve this. Upon examining them, however, more than fifteen months after the cure of the ophthalmia, not the slightest trace of the strabismus could be discovered. The cornea of the left eye was quite transparent, except at the point where it was perforated, where there was a semi-transparent leucoma, behind which the dark, adherent iris could be seen. The pupil was elliptical and directed from above below, and from within outwards. It acted in a normal manner, except that under a very strong light it became altogether closed. She could read small print with this eye at more than eighteen inches distant, as well as when brought nearer to her. Somewhat distant objects were, however, only confusedly seen.

The appearance of the right eye was natural, and the action of the pupil normal, when the two eyes were examined simultaneously. If the left eye were closed, we observed the right pupil, after oscillating for some time, gradually enlarge and then remain motionless in a considerable, but not cxcessive, state of dilatation. This state continued, however bright the light, provided the left eye was kept closed, and the cornea not irritated by frictions: but energetic contraction took place the instant that light was again admitted to the left eye. When both eyes were open, it was scarcely possible to decide what part either took in the exercise of vision, for then she was enabled to read fluently, and was neither myopic nor presbyopic: but when she endeavoured to read with the left eye closed, she was obliged to bring the book close to her face, and even then could not see distinctly. Believing the myopia to depend upon the dilated state of the pupil, M. T. desired her to read through a small aperture made in a card. Vision was more clear and distinct, and the myopia less distinct; but still there was a difficulty which did not exist on the opposite side.

"In this case the displacement of the pupil, upwards and inwards, has changed the relations which heretofore existed between the axes of the two eyes. The left eye, in order to direct the new pupil towards objects, is carried a little outwardly, and that the more so as being the best eye, the patient employs it the more willingly. This external deviation has produced a kind of divergent strabismus, balancing the convergent strabismus of the right eye, and in this way re-establishing the parallelism of the two ocular axes. We do not believe the myopia depends upon any particular condition of the humours of the eye or