know nothing; but of the laws by which it is governed, or rather the circumstances by which it is influenced, we know enough to enable us, in some degree at least, to understand the nature and causes, and to explain the phenomena of many of its morbid affections.'

"All physiologists seem to have agreed that brute animals possess this principle to a certain degree, viz. so far as it is connected with many of the vital actions; but its powers of reason and intelligence in them have been doubted. Brutes certainly possess these powers in much lower degrees than men; but if we deny the existence of reason, although less perfect in brutes, our proofs of mankind' possessing it must be lessened. In the more perfect quadrupeds, all of us must have seen instances both of memory and judgment. Dogs, horses, and the whole of the ape tribe, possess these qualities to a considerable degree; and the elephant is said to possess them to still greater. The memory and reason of brutes as they approach the lower orders, become more and more obscure, and in the lowest order of animals we have no traces of either quality remaining, nor can much difference be perceived between some of them and vegetables. In the present inquiry I shall not enter into arguments used in proof of the materiality or immateriality of this principle, nor into the distinction which some physiologists pretend to make between the degrees of it possessed by brute animals or men; for all the knowledge which we require of it here, is the nature and extent of its connexion with the healthy and diseased actions of an animal body."

The subject of the nature of the soul, which some may suppose to have no connexion with surgery, was first introduced by Mr. Abernethy, probably, in consequence of supposing, from the sordid conduct of many of the members, that they had not given a future. state due consideration. We hope the result will be a thorough conviction of the immortality of the soul, and of future rewards and punishments, which cannot fail to have a beneficial influence their consciences.

PILES.—Mr. Blackett, an ingenious surgeon of London, has published the following case of Piles, to illustrate the good effects of a new practice, which he states he has found to succeed in several in

stances,

"G. M. aged about forty-five, a man accustomed to live free, &c. complained that he had been afflicted with piles for six or seven years; and that the first attack of them was preceded by a pain in the back and loins, head-ache, and severe griping pains in the abdomen, the bowels at the same time being obstinately costive, which has continued, more or less, ever since. Frequently, he says, there is a very great discharge of serum, and about thirteen or fourteen times since the first attack, there has been an excessive discharge of blood, which always appeared to relieve him much, but in the course of a week, the symptoms returned with increased violence. He has now the serous discharge; bowels very much confined; and rectum full of tumors, as well as five externally. I ordered him the following remedies:

Take of Sulphate of Potass, one scruple;
Precipitated Sulphur, half an ounce;
Cinnamon water, one ounce and a half.

Mix. To be taken three times a day.

Take of Powdered Nitrate of Potass, one drachm;
Pure water, eight ounces.

Mix. To be injected three times a day.

"The above injection was thrown into the rectum by maens of a uterine, or female syringe, and to be retained there as long as possible.

"The reason why I advised the female syringe was, that the fluid should be immediately applied to the diseased part, and that only, which would not be the case if the common syringe was used. My patient continued this plan for five days; when I found it necessary to omit the draughts, but to continue the injection, which I found was alone sufficient to keep the bowels perfectly relaxed; and in the course of two weeks more he was perfectly cured, and his bowels were returned regularly twice a day; since which time he has been quite free from this troublesome complaint.

66

This, in general, has been my plan for these four or five years, which I have found very successful; having, during that period, cured between thirty or forty patients; and where there was a considerable discharge of blood, I added to the injection one drachm of the tincture of galls."

PARTURITION.-SIRS, If the following extraordinary case merits a place in your journal, you will greatly oblige me by inserting it. Its fatal termination may possibly have a beneficial effect on those females whose tempers are not the most amiable or submissive when under the advice or assistance of medical gentlemen. I am, Sirs, your constant reader, CHIRURGUS.

Shaftesbury, Dec. 1, 1820. Sarah Cousens, a person whose occupation in life placed in her way some difficulties during pregnancy, being accustomed to ride a donkey from place to place, and having, in the later months of gestation, been thrown off the back of this animal, she occasionally felt sensations as if the child had been displaced from its natural position; this was her own description: these symptoms did not hinder her in her usual employment. On Tuesday morning, the 3d of October, 1820, she called on us for assistance, having felt slight griping. uterine pains during the preceding night; upon examination we found the os uteri was not yet dilated, the progress of the first stage was slow; we returned home, waiting a regular and more efficient course of pains to establish the completion of the first stage of labour; in the evening we found the first stage completed, and the liquor amnii was now collected in considerable quantity; and, as we had been informed that she had been delivered of five still-born children, and in each case, as she termed it, bred the dropsy with them, at this time we discovered the like occurrence had taken place; the membranes were now ruptured, and, in all probability,

would have succeeded in saving the life of the child, had not the fol-
lowing unpleasant circumstances occurred to prevent it: the pre-
sentation was ascertained immediately to be that of the left shoulder;
the female attendants in the room were made acquainted with the
position of the child, which, in the language amongst midwives, is
called "lying across;" the patient's strength was good, she took a
little tea occasionally, but ate nothing during this day. It was
deemed proper to attempt the delivery by the usual means of turning
the child; the attempt was made, and to our great astonishment, the
patient at this time began to be passionate, she suspected matters
went not with her as all could wish; she was made acquainted with
the situation of the labour, and of the necessity of such assistance
being given to her, to which she eagerly replied, in a strain of
marked irritability of temper and contempt, "that she would not be
interrupted, that nature should effect the expulsion by the regularity
of her process of delivery, and that she would not submit to any
assistance of art to relieve her at that time." At this moment
(Tuesday night), every persuasive means, every inducement the
mind could offer to her to submit, availed nothing; her obstinacy.
became more and more determined, her passion and irritability in-
creased to excessive anger, and all her fury was bent against her
attendants; she wished now to pass the remainder of the night in
rest. Other attempts were again made to persuade her to com-
pliance, assuring her the pain would be but little in comparison to
the usual labour-pains; she would not yield either to tender solicita-
tions or remonstrances of any kind; in fact, the determined resolution
of her mind was constantly expressed in these words: "I would
rather die than suffer the delivery by art." In this perilous condition
no alternative presented itself but death, or a speedy delivery by.
coercion; she was left to sleep, for several hours, which was re-
freshing; the pains remitted during the whole of the next day
(Wednesday), and the following night, till next day (Thursday);
about eight o'clock in the morning we were again using the most
affecting means to subdue the spirit of resistance which predominated-
so powerfully in her mind against the usual and only means whereby
she could be saved from evident destruction; all exertions were
equally ineffectual as before; others of her friends came in to im-
plore her to allow the accoucheur to proceed in his means of de-
livery; temptations of every kind were held out to her, and repeated-
assurances, that if she yielded not, death must soon put a close to her
existence; the pains were now quite strong, and regular at intervals
of two or three minutes. At twelve o'clock she appeared to con-
sent to the aid of her medical attendants; another trial was now
made to deliver her; every thing seemed to proceed with correctness
and regularity for the space of ten minutes. At length, her passions
were again roused to resist; she became infuriated against all around
her; the tremendous condition she was now in induced every person
about her to request her submission to the means but a few minutes
longer when all would be well. At this instant,

"That Passion, whose tempestuous sway
Tears up each virtue planted in the heart,
And shakes to ruin proud Philosophy;

For, pale and trembling, Anger rushes in

With falt'ring speech, and eyes that wildly stare,
Fierce as the Tiger, madder than the Seas,

Desp'rate, and arm'd with more than human strength."

The whole of this night (Thursday) was spent in agonies of pain, and the same disposition of mind. Her only excuse now was, that she waited the return of her husband, who had been gone a journey, and whose return was uncertain. She remained in this awful state during the whole of the day (Friday), until 6 at night. Her pulse. continued good up to this time, and her strength supported by. taking light nourishment. Her countenance and speech remained

unaltered.

Having now been unsuccessful in our endeavours to deliver her from the above circumstances, we were induced to recommend the calling in another surgeon-accoucheur. This was agreed to, in order to see if a fresh face could surmount the obstacles we laboured under, and prevail upon her to concede to the only method for saving her own life. The child was now dead, and the presentation down upon the os externum. A third practitioner was now arrived, to witness the most extraordinarily obstinate woman that ever breathed, under a case similar in its uterine state. She had said, that when the other accoucheur came, she would then submit to all the means; but upon his arrival, he received the same violent responses, from her positively asserting, that she would not suffer any one to touch her; and it was not without considerable difficulty and perseverance that the united efforts of all produced any desirable effects upon her mind, by representing urgently to her the dreadful situation she stood in. She now yielded, and became as good a patient as most, but not until she began to feel herself sinking very rapidly. The pulse grew more frequent, but less powerful, and much debilitated. Exhaustion was become her companion until death, the approach of which was certain. As no injury could be done to the child (being dead), the crotchet was used, and the delivery effected with this instrument alone, but with more difficulty than was expected,' no doubt, increased by the want of contraction of the uterus. At 10 o'clock on Saturday morning she expired.

We have not heard of, or seen, a case upon record, in substance similar to the one above stated. The remarkable influence of the passions on this patient must be truly astonishing to all your readers, and, I believe, admits of no parallel. She was strongly led to believe, in her own mind, that Nature wonld effect the delivery in due time; and it was this circumstance, coupled with the wish to see her husband, that restrained her from submitting to the usual means adopted in all cases of this kind. Many cases of this particular presentation have occurred in our practice, but in no one instance were we ever led to imagine the life of the mother could possibly be in danger from this circumstance alone. The child will, in the best regulated practice, be often born dead, but by no means is it a necessary consequence that fatal results, as to the mother, should take place.

CONCUSSION OF THE BRAIN.-For the following interesting case of concussion of the brain, and valuable practical remarks, we are indebted to the observant and scientific Surgeon Wansbrough, of Fulham :

William Parish, aged eight years, fell from a tree, at a height of twenty feet, upon the turf of Parson's Green, at eight o'clock, A. M. July I. The direction of his body in the fall was oblique; he struck his head on the occiput, and glided forcibly on the spine: he was taken up totally insensible. I saw him half an hour after the accident, lying stretched on his back, breathing deeply but regularly. The pupils were alternately contracted and dilated, but strongly susceptible to light, contracting immediately upon the window curtain being withdrawn. He had thrown up a quantity of foam, mixed with blood, and was vomiting the same matter when I saw him. The effort seemed to distress him exceedingly. Susceptibility of local stimuli was here conspicuously present; for upon being pinched, he hallowed loudly, but did not utter a word; upon being roused, he cried out lustily, and turned himself away from his disturber, then sunk into his former lethargy. He swallowed with little difficulty. From the symptoms, I could not doubt that the case was one of concussion. The pulse strong and full, yet soft, at 75-6, breathing regularly, &c. I directed him to be kept quiet, and all light excluded. In the course of the day I saw him four times. Twenty grains of jalap powder, and six grains of calomel, were given to him in gruel, with great difficulty. On the following day (second), he continued nearly in the same state. The powder had been repeated three times without any effect; an attempt to administer a lavement was rendered unavailing by the resistance he offered. In this state things were until six o'clock, when he became restless; the pulse rose in number to 100, and assumed the inflammatory character; his head incessantly moved on the pillow, and the least admission of light was sensibly felt by the iris and retina. Here then was reaction: inflammation of the brain was approaching with hasty strides. I immediately opened a vein in the arm, and took away twenty-four ounces of blood the pulse sunk to 70, but fainting did not supervene. The vomiting, which had ceased six hours after the accident, now returned, but very little froth was ejected. The head was shaved, and a cold lotion kept constantly applied. Nine o'clock, pulse 96. 1 opened the temporal artery, whence I obtained about six ounces of blood. He became tranquil, and the pulse again sunk to 80. The irritability of the stomach rendered the attempt to administer any medicine useless, as he threw out his gruel, which till this period he had readily swallowed without difficulty. Half-past eleven P. M. I was sent for, as his parents thought him dying; he certainly appeared to justify their fears, for he tossed about the bed in restless agony, and was in high delirium. Twelve leeches were immediately applied to the temples, and a large blister ordered between the shoulders high up. I left him at twelve o'clock, with a quick small pulse, and in a state threatening a fatal termination ere my morning visit. I was agreeably surprised, however, to find him alive and better; the medicine had operated most copiously. The leeches