same treatment, under which the patient recovered.-Med. Times and Gaz. Aug. 20. healthy, have done so. The Medical Boards sit en permanence, and several physicians have already fallen victims to the disease. Upon a Peculiar Form of Ulceration of The King of Sweden has suspended the the Gums. By M. BAUCHET.-Persons are Swedish Consul at Lubeck for supposed seen, both in hospitals and in private prac-laxity in not announcing cases of cholera tice, who suffer for weeks, and even for that had broken out there. In spite of all months, in certain points of the gums. If quarantine precautions, this epidemic has the buccal cavity be explored, it will be re-introduced itself into Sweden, and is raging marked that at the level of the neck of one or more teeth there is a spot of ulceration which produces separation of the gum. It is a sort of diphtherite, terminating in ulceration; the ulcer heals readily under the application of astringents or mild caustics.-Ibid. from L'Union Médicale. there, though not to so fearful an extent as in Denmark. The king himself visits the cholera hospitals, and nothing is left undone to mitigate the evil. At Spendborg, on the 20th, there were 21 deaths out of 55 cases. The cholera appears to be increasing at Stockholm, as the official return on the 19th stated 21 cases and 13 deaths. The disease Cholera.—The official returns at Copen-is also prevalent at Ystad, Gothenburg, and hagen, to the 14th of August inclusive, an- Carlscrona. It is stated to have likewise nounce 6937 cases of cholera since the ap-made its appearance in Christiana. Acpearance of the epidemic, 3756 of which have been fatal. In Stockholm, the Gazette daily announces additional ports, the vessels arriving from which are to be subjected to quarantine on suspicion of cholera. The last places on the list are Danzig and all Prussian and Mecklenburg harbours, and Archangel and all Russian ports on the White Sea. Reports from St. Petersburg represent the disease raging there as presenting symptoms peculiar to cholera blend ed with those characteristic of yellow fever. In consequence of the cholera, the opening of the University in Copenhagen has been put off for a month; 600 families are living under tents and in wooden booths hastily knocked up. The troops in the camp at Powonski, near Warsaw, are much troubled with ophthalmia, and the cholera has again begun to show itself in the capital of Russian Poland. Though this has not yet been officially made known, the correctness of the information may be depended on. Med. Times and Gaz. Aug. 27, 1853. Cholera. This disease has now spread over the Baltic Provinces; cases are upon the increase at Stettin (170 had died previous to August 23), and are numerous at Dantzig, where the epidemic may become extremely dangerous, in the lower part of the town, and in the environs, in consequence of the humid atmosphere. In Den mark, the heat, which has prevailed some time, has caused great intensity to the cholera, and the alarm among the inhabitants of Copenhagen is such, that all who could leave for the provinces, which are yet counts from Copenhagen, up to the 26th inst., state that the cholera was again somewhat on the increase. The military arrangements for inspection of the troops were changed, the infantry not called out, and the cavalry only to the extent of 120 men to each squadron. The cholera was diminishing in St Petersburg, but was spreading, though in a mild form, over all the eastern provinces. Berlin.-August 30.-The cholera has appeared here in a very virulent form, though in a very few cases; since the beginning of the month up till now, 52 cases have occurred, of which 37 were fatal. Now that the epidemic is here, the deliberations as to the building a cholera hospital have been brought speedily to an end in the affirmative. Hamburg. We have received information from Hamburg, on which reli ance may be placed, that Asiatic cholera, which for several weeks has appeared there in single or isolated instances only, forming what is technically called "sporadic' cases, is now assuming an epidemic form. There appears to have been in all, from 160 to 180 cases of the disease, about two-thirds of which have been fatal, a circumstance which proves the extreme virulence of its character. The present seats of the malady are the places where the poor English sailors, to the number of about 800, lodge and spend their time on shore. They are at present wholly uncared for. During the epidemic of 1848, great numbers of lives among this class of men were lost for want of the most common precautions, and this loss of life will be repeated unless timely unpopularity and meanness,, can exercise measures are taken for their protection. only a very limited protective power. We Liverpool.-A death from Asiatic cholera do not require an extension of the present has occurred in Liverpool. The deceased worthless system, but the maintenance of a was a German emigrant, and had imported supply of good lymph, and the careful and the disease from Hamburg, and the death repeated examination, by skilful, conscienoccurred in a crowded lodging-house in one tious, and remunerated medical officers, of of the inferior parts of the town. The at- each case operated upon. Let public vaccitention of the health committee has been nation, under these conditions, be offered to drawn to the case, and also to the dangerous the public; and when vaccination under overcrowding of these emigrants' lodging-these conditions has been rejected, it will houses, which are numerous in Liverpool. be time enough to discuss the necessity of a Several cases of sickness among the ships compulsory bill. in the harbours of Stockton and Hartlepool have been reported as English cholera. Some of them have been accompanied with aggravated appearances, and the faculty are divided in opinion as to the nature of the disease. Whatever be the disorder, several seamen on board different ships, have died after a few hours' illness, and have been hastened to their graves. —Lond. Med. Times and Gaz. Sept. 10, 1853. 66 "The bill is unworkable in its machinery, because it attempts tyrannically to impose onerous gratuitous services upon the medical profession. The poverty of some and the thoughtlessness of others make many of our body accept poor-law appointments at nonremunerative rates; and the mad scramble of an overstocked profession tempts too many of our young physicians and surgeons to go cap in hand to hospital governors, beseeching to be nominated to perform an amount of gratuitous duty which, if not fabulously described in the printed reports of our hospitals, is so vast as to require for its even tolerable performance almost superhuman physical powers, as well as the entire surrender of every other professional occupation. It is not remarkable that Lord Lyt. tleton, cognizant of these facts as the chairman of a rural board of poor-law guardians, and as a peer of Parliament, should think it kind to impose any amount of unpaid work upon medical officers and practitioners,' and believe that he is giving them that which they most ardently desire, because it is that which they are always most clamorously seeking to obtain. We must, however, for the sake of truth, declare that medical gratuitous services, like all other gratuitous services, are of comparatively small value. Parliament may, in the magnitude of its power and wisdom, decree that 'medical officers and practitioners' are to perform certain work without fee or reward;' they cannot, however, secure the efficient per Compulsory Vaccination.-A bill has been introduced into Parliament by Lord Lyttleton, to render vaccination compulsory, and which is so unjust to the profession in requiring from them services for which no adequate remuneration is offered, that we hardly think it possible that it can become a law. The bill is justly denounced in the Association Medical Journal, April 15, 1853, as unsound in principle; because it seeks to enforce, by legal compulsion, that which it ought to offer as a boon-that, too, which, if kindly tendered, and accompanied with a truthful warrant of efficiency, would, we are inclined to think, be generally received as a great blessing. Should excep-formance of that work, unless it be adetional cases, in which ignorance resists the boon, still be found, it may then be right to think of a compulsory enactment; but till an efficient system of voluntary vaccination be attractively placed within the reach of all, it would be monstrous to inflict upon the community compulsory submission to poorlaw vaccination, a system which, from its quately paid for. Lord Lyttleton must be profoundly ignorant of human nature, and of the practical working of the present system of poor-law vaccination, if he fancy that such a clause as the following can sup ply any part of a machinery calculated to diminish the spread of smallpox. The following is an extract from the bill : That, in the event of a child becoming 100,000 living, there are 4046 deaths annusick or indisposed in consequence of having ally. It is in England that, contrary to all been vaccinated as aforesaid, then, and in expectation, the mortality is less than in such case, it shall be the duty of the medical all civilized states; and this, notwithstandofficer or practitioner who vaccinated the ing the high rate of mortality in her great said child, to attend upon and prescribe for manufacturing towns. It is the agricultural the said child during such sickness or indis-districts that produce for England this faposition, and to furnish it with such medi-vourable result, as compared with other cines as may be necessary for its recovery, countries.-L' Union Médicale. without fee or reward other than is provided for by the above-mentioned act.'"' Chloride of Barium for the Preservation "The 'fee or reward' here referred to is of Animal Substances.-M. BLAUDET rethe EIGHTEEN PENCE which at present the commends the chloride of barium for injectguardians of the poor' are legally obliged ing dead bodies, when it is desirable to to give to their vaccinators for each success-retain their living appearance, because it ful case-the paltry amount of which sum, hinders the putrefaction of the blood. as any man of reflection must perceive, is in itself an explanation of much of the worthlessness of the existing system. Pruritus of the Genitals.-Dr. MAYER considers this one of the commonest affections to which women are subject. He considers that it may arise from self-abuse, from herpetic eruptions, from syphilis, from incipient scirrhus of the uterus, or from disease of the kidneys. In the last case, nitre, magnesia, soda, or lime-water, seem of use. Should metritis with profuse blennorrhoea be combined with the pruritus, leeches and aperient medicines are advisable. Very frequently, however, cases occur where no material affection is to be discovered; then borax, preparations of lead, mercury, or nitrate of silver, are employed in succession. In many instances, injections and lotions of creosote water removed the symptoms. More recently, Mayer has employed with success an ointment composed of chloroform, one part; fat, twenty parts.-Ver 'Since the above was in type we have learned that this bill has become a law. The Lancet of Sept. 10, states: The Vaccination Extension Bill has become the law of the land. In spite of the earnest remonstrances of Mr. Brady, the only mem. { ber of either House of Parliament who was known to have any practical knowledge of the subject-in spite of the expostulations of the Vaccination Committee, from whom the House of Commons had received all the important suggestions which had enabled them to amend the Bill in any degree-in spite of the assurances of Lord Lyttleton, that every attention should be paid to these suggestions, and of Lord Palmerston, that he would use his best in fluence in getting the measure postponed for another season-in spite of the repre-handl. d. Ges. f. Geburtsh. VI. 1852. From sentatives of the National Vaccine Board- Med. Times & Gaz. May 21, 1853. of the universal medical press, which may be taken to be the voice of the professiona Bill has been passed, as if in mockery and contempt of all professional science, of which the best thing that can be said is that it will probably be inefficient; we wish we could add, harmless and free from mischief."" The Contagious Influence of Croup.-The son of a highly esteemed practitioner of Paris, M. Blache, has just met with an untimely death by closely watching a child suffering from croup, who was under his father's care. The little patient, aged nine years, had had very severe symptoms of suffocation, and M Blache had performed Comparative Mortality in France, Eng-tracheotomy; the son, himself a very proland, and Prussia.—In France, the annual mising house-surgeon to a Paris Hospital, mortality is 1 in 42; in England, 1 in 45;} was entrusted with the watching of the in Prussia, 1 in 38; in Austria, 1 in 33; in Russia, 1 in 28. In the latter country, the mortality to 100.000 living is 3590 annually; while that of 100,000 living in England is 2207. In most of the towns of Italy, the mortality is 3 or 4 per 100; at Naples, to child at this critical period. The poor young man took the disease, and died in three days, the patient succumbing soon afterwards. The profession in Paris have expressed unfeigned sympathy for the be reaved father. CLINICS. Statistical Report of the Principal Operations Performed in the London Hospitals during August, 1853.-The subjoined report comprises, it is believed, all the more important operations performed, during the month of August, at the following hospitals: University College, King's College, St. George's, St. Bartholomew's, Guy's, St. Thomas's, the Middlesex, the London, the Westminster, Charing-cross, St. Mary's, and the Metropolitan Free. Lithotomy. 186 187 187 187 190 191 5 192 192 . 192 192 EIGHT PAGES. Herniotomy.-Number of cases, 11; recovered, 5; under treatment, 1; died, 7. In but one of these was the sac not opened. The patient was under the care of Mr. Cutler, in St. George's Hospital, and recovered well. In another, under the care of Mr. Paget, in St. Bartholomew's Hospital, the sac ruptured spontaneously just as the bowel was passing up; the patient is doing well. Of the unusual number of fatal cases, the majority are susceptible of easy explanation. One was an operation performed in extremis, on a man who had refused to submit to it Number of cases, 5; of when first proposed, and in whom there which 4 have recovered, and 1 is progress-was, in fact, some doubt as to the existence ing favourably under treatment. Lithotrity.-Number of cases, 1. The patient remains under care, and is suffering from cystitis. The case reported last month as under the care of Mr. Avery, in Charing-cross Hospital, has since been discharged, and there is reason to believe that no part of the calculus now remains in the bladder. of a stricture, as the protruded portion had been reduced several times. A second was an instance of umbilical hernia in the male. In a third, although at the operation the stricture had seemed freely divided, and the bowel was easily returned, yet at the autopsy it was discovered that strangulation had been still kept up by a band of mem. brane within the abdomen. Death occurred Published monthly by BLANCHARD & LEA, Philadelphia, for One Dollar a year; also, furnished GRATUITOUSLY to all subscribers of the "American Journal of the Medical Sciences," who remit the Annual Subscription, Five Dollars, in advance, in which case both periodicals are sent by mail free of postage to the subscriber. In no case will this work be sent unless the money is paid in advance. three days after the operation, and the symp- fracture of the skull and depression of the toms of strangulation, which had previous-bone. The dura mater was not injured. ly existed for thirty-six hours, persisted The man recovered his consciousness soon through that time. In a fourth, strangula. after the operation, and has since proceeded tion had existed six days before the opera without a single bad symptom. He may tion. In a fifth, the hernia was very large, now be considered quite out of danger. and had been strangulated several days Ligature of Arteries, etc.-On a patient before the patient's admission. The post-in King's College Hospital, who had remortem showed the intestines matted to gether with lymph, and gangrenons in several circumscribed patches. The two cases which we reported last week as remaining under treatment have since been discharged. ceived a stab in the forearm, probably wounding the ulnar and interosseous arteries, Mr. Partridge performed ligature of the brachial, on account of very profuse bleeding. The operation succeeded in every I respect, and the patient recovered without any drawback. In St. Bartholomew's Hospital, Mr. Lloyd was obliged to perform ligature of the femoral artery for popliteal aneurism, in a case in which compression had been perseveringly tried, with, at first, much hope of success. Since the ligature, the man has done well. He is still in the hospital. The case of Mr. Le Gros Clarke's, with a similar history, which remained under treatment at the time of our last month's report, has since been discharged well. During the last month, there have been in Ovariotomy. This operation has been performed once in the Metropolitan Free Hospital, by Mr. G. Borlase Childs. The major incision was adopted, and a large multilocular and thick-walled cyst removed. It required to be separated from the great omentum, to which it had contracted adhesions, and a vessel in the latter which bled had to be ligatured. After the opera tion, the patient, a middle-aged woman, lived nine days, during which she suffered much from diarrhoea and sickness, and took very little food. The wound, with the ex-St. George's Hospital one, and in Guy's ception of a small portion, had united by first intention. At the post-mortem, peritonitis was found only around the track of the ligatures; death appeared to have resulted from exhaustion. A case operated on at this hospital, a few months ago, by Mr. Childs (the lesser incision), recovered satisfactorily, and is now quite well. Hospital two, cases of popliteal aneurism undergoing treatment by compression. The case in St. George's is under the care of Mr. Hewitt. The pulsations in the tumour have become much more feeble than they were at first, and the size of the whole is diminishing; pressure is still kept up, and with every prospect of a pleasing result. Both the Guy's cases are under the care of Mr. Hilton; one of them has left the hos Trephining the Skull.-Number of ope rations, 3; 2 of which were for compound fracture with depression, and 1 for abscesspital, the aneurism having become quite between the dura mater and skull. The solid, and much contracted; the other repatient, in the latter case, had been ad mains under treatment. mitted on account of a scalp wound (bone Amputations.-Number of cases, 15; reexposed), which subsequently took on pha-covered, 1; under treatment, 13; died, 1. gedænic action. Symptoms of compression The case which has terminated fatally was ensued, and the trephine was accordingly an amputation in the upper third of the leg, resorted to. Death occurred two days after on account of disease of the tarsal bones the operation, and five weeks after the ori- and ankle-joint. The patient was an old ginal accident. In one of the cases of and irritable man, whose arteries were compound fracture with depression, the much diseased. Some difficulty was ensymptoms of compression did not show countered in endeavouring to arrest the themselves till the second day, when the bleeding immediately after the operation, operation was at once performed. Death which was only accomplished by the assisttook place two days later. In the third ance of an unusually large number of ligathe operation was performed by Mr.tures. Death took place on the sixth day, Poland on one of the sufferers from the late in consequence of secondary hemorrhage. accident at the Sydenham Crystal Palace, who was admitted into Guy's Hospital in a state of insensibility, and with compound case, The case which has recovered is one of amputation of the forearm for diseased carpus, performed by Mr. Pollock, in Saint |