The ambulances, installed on the table-land above Sebastopol, amid the roaring of the artillery, exhibit, by their regularity and excellent organization, the best specimens of those temporary establishments. Not a single case of cholera or lock-jaw has mani fested itself of late among the wounded. The internal diseases are chiefly diarrhoea, dysentery, devoid of intensity, light intermitting fevers and gastric fevers, some of which are accompanied by cerebral conges-distant, and where my assistant had pitched tion. The cold of the nights produced a few cases of bronchitis. The fleet reckons between 500 and 600 scorbutic patients, of whom the most seriously attacked have been landed. The army is completely free from that affection, and the daily distribution of fresh bread, and the very frequent distribution of fresh meat, preclude the possibility of its manifestation. The morale of the army is also a protection against it. Not withstanding the toils attending the duties in the trenches, and certain privations, the soldiers continue in high spirits. The General-in-Chief is constantly among them, seeing after their wants, and the certainty of an approaching triumph is another element of hygienic preservation."-Ibid. few shots, I did not think much of it, but paid the usual morning visits, and signed the reports. At this time, however, it was quite evident that something more than ordinary was about to occur. I took a bit of biscuit, and immediately mounted my horse, and, giving directions that the usual preparations might be made for the recep tion of the wounded, rode off to the batta lion, which was encamped about 500 yards his tent. The firing was now most severe, and the shells were bursting ahead of us in every possible direction about 250 yards in advance. I came upon some of the tents of the 2d Division, and here I first saw some wounded men of that division being carried to the rear, and could see in front of me still some Guardsmen carried on stretchers, to whom I at once advanced. We were now in the midst of the encampment, and I had directed that two of our poor wounded soldiers should be laid down under cover of one of the large hospital marquees until one of the ambulance wagons of our division, which I saw advancing, should arrive. Here, also, was Dr. Robinson, of the Fusileer Guards, attending to the more pressing wants of some men of his regiment. The ambulance wagon arrived, and we had filled ait with the wounded of the brigade. My assistant, Dr. Ricketts, was in front, intending the transport of some more wounded men to my position. The whiz of the shot and explosion of shell were at this moment incessant. While in the act of turning round to remount my horse, a shot passed through the leg of my trousers, and when in the act of remounting, a round shot came through the tent, and at the same instant my poor horse fell, having been shot through the head, his brains sprinkling my face. The latest News from the Army in the Crimea. The following extracts, from letter written by a surgeon of the Guards, dated Camp before Sebastopol, November 12, will be read with interest : super "The day before the battle [of the 5th Nov.] was a most miserable specimen of the Crimean winter-cold, damp, and rainy; a thick fog prevailing, and obstructing the view of the surrounding hills. I had, luckily, on that morning sent away to Scutari several sick men, upon whom it was evident no treatment in our situation could be of any avail. This is what we continually have an This, however, was not all. One of opportunity of doing as ships arrive, and it our poor soldiers had just shown me his is a great boon to the patient, as well as hand, which was smashed, and, having dibeing advantageous in results to the medirected him to make the best of his way to cal officer, who in these times must have great responsibility on his mind. 46 my field hospital, he was in the act of picking up his piece to do so, when, at the same time that my horse fell, I heard him cry out and saw him fall by my side, shot through 'At six o'clock, on the morning of the 5th, I was outside my tent, about to visit the sick, who at that time numbered thirty-the body. I hear, also, that several sick nine. The fog was so dense and heavy that I could scarcely discern any object fifty yards in front of me. There was some little firing of musketry towards the hill overlooking the encampment of the 2d Division, but not very rapid; and, as it is no unusual occurrence for the outposts to exchange a men were killed by the explosion of shells, while lying in the hospital tents. I now walked back to see how many wounded had arrived at the field hospital; but, as no very serious cases had yet appeared, I went across to our general's tent, who had been wounded in the arm. A servant then came, desiring that I would go to Lord Charles ance at hand; and, after superintending Fitzroy, whom I found badly wounded the transport of all my own wounded by the through the neck; but, on my way thither, ambulance wagons, I was glad of a slight I met poor Captain Ramsden, being carried respite, after more than forty-eight hours' on a stretcher; he was evidently most anxious work. The next day I accompanied dangerously wounded, and I had both of two wounded officers to the harbour, for them taken to my tent, that I might be conveyance to Scutari, and on my return able to visit them occasionally with greater reverted to the usual routine duty, as if no facility during the day. Poor Ramsden stirring events had happened. One curious only lived for an hour; he was mortally and remarkable result of this last action wounded through the chest; but, independ-was, the very few balls I had to extract; ently of his death- wound, he had received owing to the close proximity of the combatno less than six bayonet wounds in differ- ants, they generally penetrated both sides ent parts of the body, while lying helplessly of the limb or body, which was very differwounded on the ground, and imploring the ent at Alma."-Ibid. Dec. 9, 1854. advancing enemy to leave him. Never shall I forget his countenance as he grasped Triplets-At Berja, in Spain, a primimy hand, and pointing to his wounds, told para gave birth to three infants, having me at intervals of the barbarous and cruel each distinct membranes, and placentas treatment he had received. The wounded separate. This fact may be interesting in were now fast arriving, and, having abund-regard to the theory of superfotation. ance of assistance from medical officers of other regiments, who had kindly volunteered their services, we commenced their treatment. "The wonderful patience and endurance of suffering I witnessed on this occasion were beyond anything I could have conceived possible; and surely the heartfelt thanks of the poor soldier, conscious of a benefit conferred upon him, must be a very grateful reward for the attempt to perform one's duty conscientiously. Our wounded were all transported to Balaklava, for conveyance to Scutari, as soon as possible, and when I tell you the number of wounded in this battalion alone, it will appear incredible how much could be done in so short a time. "I inclose you my return of casualties in action: Officers 11 Total all ranks 57 23 29 55 107 Cholera at Athens.-Cholera has broken out at Athens, and caused the greatest panic. A considerable part of the popula tion has fled, and the Minister of War has been obliged to place on the retired list a number of officers who, on the first appearance of the malady, quitted their posts. Medical Appointments in Paris.—M. JoBERT has been elected to the Chair of Clinical Surgery of the Faculty of Medicine of Paris, vacant by the death of M. Roux. There were nine candidates for the chair. M. CLAUDE BERNARD has been elected a member of the Academy of Sciences, in the place of the late M. Roux. M. XAVIER RICHARD, at the close of a brilliant concours, has been nominated Phy. sician of the Central Bureau of Hospitals. University of Edinburgh.-It is stated in the journals, that the number of medical students the present year, in this ancient school, is only 340. OBITUARY RECORD.-We find recorded, with deep regret, in our late journals, the 127 death of Professor EDWARD FORBES, which took place on the 18th of November, in the "You will be interested, also, to know thirty ninth year of his age. Prof. F. was that eighteen operations were performed in well known by his valuable contributions to my field-hospital, of which number one natural science, and had only recently been only was successful; but this, I deeply re-appointed to the chair of Natural History in gret to add, was upon the person of a bro. the University of Edinburgh, as the suc ther-officer. There was abundance of assist-cessor of the late Prof. Jamieson. "CLINICS. Statistical Report of the Principal Operations performed in the London Hospitals during the month of October, 1854. Lithotomy-In Case 4, of last month's report, a fair recovery has since resulted. The man has left the Hospital, but the wound is not quite healed. He is the subject of phthisis. Number of cases, 3; recovered, 3. OF WOMEN, SIXTEEN PAGES. nothing unusual occurred until the following day, when a small portion of fecal matter escaped by the wound, and made it evident that the rectum had been injured. During the three succeeding days, feces in large quantities passed by the wound; the latter however, kept throughout a healthy appearance, and the boy's health was good. The fecal discharge ceased on the fifth day, and the wound did not take more than the ordinary time in closing. The ultimate reCase 1. A boy, aged 5, in fair health,covery appeared to be complete in every under the care of Mr. Marshall, in Uni respect. The operator inclined to attribute versity College Hospital. The operation the injury of the bowel to the staff not havwas the usual one, but some little difficultying been kept hooked up sufficiently close was encountered in entering the bladder. under the arch of the pubes. A second By a second incision, however, it was satis point of interest was the difficulty which factorily accomplished, and a moderately-had been experienced before the operation sized stone removed. The patient recovered in detecting the stone. Several had been without a bad symptom. Case 2. A boy, inclined to suspect that there was only a aged 3, in good health. The usual lateral thickened condition of the vesical mucous operation was performed, Blizard's knife membrane, with adherent sand. The small being used for the incision of the prostate.size and very light specific gravity of the A small, very light stone was removed, and calculus fully accounted for this obscurity. 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. VOL. XIII.-2 Case 3. A boy, aged 6, in good health, lasted subsequently for eight days; after under the care of Mr. Cock, in Guy's Hos- which it ceased for a day or two. During a pital. The usual operation was performed, slight attack of erysipelas, however, the and recovery without a bad symptom en-artificial anus reopened, and has since consued. tinued to discharge. The patient is doing fairly. Case 6. A man, aged 55, under the care of Mr. Johnson, in St. George's Hospital; hernia inguinal, strangulated seven hours; sac opened.. Death from peritonitis followed on the third day. Case 7. A man, of middle age, under the care of Mr. Luke, in the London Hospital; hernia femoral; sac not opened. Recovered. Case 8. A man, aged 55, under the care of Mr. Ward, Lithotrity. The case under the care of Mr. Adams in the London Hospital, and mentioned last month as recovered, has again come under treatment. A week or two after his discharge, the man voided a fragment the size of a hazel-nut; and Mr. Adams has since detected the presence of other portions. It is intended to repeat the operation. Herniotomy.-Number of cases, 16; re-in the London Hospital; hernia femoral, covered, 8; under treatment, 1; died, 7. strangulated twenty-eight hours; sac not opened. The patient in this case was the subject of advanced phthisis, and the protrusion had been caused by severe cough. Case 1. A woman, aged 34, under the care of Mr. Coote, in St. Bartholomew's Hospital; hernia femoral, strangulated thirty-six hours; sac opened. Some sup-ing. In the operation a very small incision puration in and about the sac followed, but the patient made a good recovery. Case 2. A man, aged 70, under the care of Mr. Stanley, in St. Bartholomew's Hospital; hernia femoral, strangulation twelve hours; sac not opened. Death followed on the eighth day. At the autopsy, there were found evidences of peritonitis; suppuration both in and around the sac had occurred, and the pus extended between the abdominal muscles as high as the umbilicus. Case 3. A woman, aged 76, under the care of Mr. Paget, in St. Bartholomew's Hospital; hernia femoral, as large as a small apple, strangulated sixteen hours; sac not opened. Recovery without a bad symptom ensued Case 4. A man, aged 45, under the care of Mr. Tatum, in St. George's Hospital; hernia scrotal, strangulated twelve hours; sac opened. Death from peritonitis on the fourth day. At the autopsy, besides the evidences of peritonitis, there were found an abscess in the structure of the cord and diffuse inflammation of the cellular tissue of the scrotum. Case 5. A man, aged 45,man, aged 27, under the care of Mr. Tatum, under the care of Mr. Prescott Hewett, in St. George's Hospital; hernia scrotal, period of strangulation not known exactly, but of several days; sac opened. The strangulation was found to have been caused by recent bands of adhesion in the of the integument was made on the inner side of the sac, and the stricture divided with a bistouri caché. Afterwards, erysipelas spread from the wound over the whole side of the trunk, and an attack of bronchopneumonia occurred. From the combined effect of these maladies the patient sank on the fifth day. At the post-mortem, besides the tuberculous mischief, evidences of recent inflammation were found; the portion of bowel which had been strangulated was still deeply congested, but there were no traces of peritonitis. Case 9. A woman, aged 39, under the care of Mr. Cock; hernia femoral; strangulated nine hours; sac opened. Recovered. Mr. Cock's rule is to avoid opening the sac where prac ticable; in the present instance he deviated from it, because there was reason to expect very close adhesions of the sac to the surrounding tissues. The patient had been operated on two years previously on the same side, and she had for many years worn a truss over the part. Case 10. A in St. George's Hospital; hernia scrotal; strangulated eight hours; sac opened. The hernia was of a large size, and fifteen inches of gut were exposed in the operation. Recovered well. Case 11. A man, aged 39, under the care of Mr. Le Gros Clarke, in St. Thomas's Hospital; hernia scrotal, and of large size; strangulated fourteen hours; sac opened. The seat of stricture was the neck of the sac itself. The case was complicated by hydrocele of the same side. The man recovered without bad symptoms. Calo was passed freely into the abdomen, and a portion of the colon drawn into sight; but no stricture could be discovered. Death took place on Oct. 15, eight days from the first protrusion, seven after the reduction by taxis, and six after the exploratory opera. tion. The treatment subsequent to the Case 12. A man, aged 24, under the care 10 P. M., when the symptoms of strangulaof Mr. Le Gros Clarke, in St. Thomas'stion were present, but not in a degree such Hospital, hernia scrotal; strangulated ten as deemed to warrant an operation. hours; sac opened. As in the preceding mel and opium (gr. ss, and gr. j) were case, the seat of stricture was the neck of ordered every hour. At 1 P. M. on the the sac itself. The after-treatment was following day, his condition was worse; complicated by great flatulent distension of face anxious; pulse small and rapid; the the bowels, which persisted in spite of treat- vomiting had ceased, but there was more ment for several days. Recovered. Case of tympanitis. The left inguinal canal 13. A woman, aged 70, under the care of being decidedly fuller than the right, Mr. Mr. Quain, in University College Hospital; Birkett decided to perform an exploratory hernia femoral; strangulated twenty hours; operation. The sac having been opened, sac not opened; recovered. Case 14. Ait was found very greatly thickened, but woman, aged 40; hernia femoral; strangu. containing only a little serum. The finger lated fifty hours; sac opened. The intestine being gangrenous in spots, was only partially returned. On the next day it was slit up, and a tube introduced to evacuate the feces. No action of the bowels occurred per anum. Death took place on the fourth day. At the post mortem much blood was found in the abdominal cavity, and on disoperation had consisted in the application of section it was discovered that the obturator blisters to the abdomen, and the exhibition artery, given off from the epigastric, had of opium and stimulants. The prostration crossed the neck of the sac, and had been had continued extreme, and there had been divided in the operation. No external bleed- troublesome diarrhoea. Autopsy. - Very ing had at first occurred. Case 15. A man, slight evidence of peritonitis. Jejunum and aged 48, the subject of old-standing inguinal ileum intensely congested and distended bernia, was an inmate of the Westminster with thick port-wine-coloured fluid, the inHospital, under the care of Mr. Holt, on actensity of colour increasing as the cæcum count of a fracture of the skull. He had was approached. There was great diffibeen about a week under treatment, and culty in determining the portion of bowel was doing well, when suddenly his hernia which had been strangulated. No obstruccame down, and got so tightly strangulated tion existed in any part. that reduction by taxis could not be effected. Ten hours after the strangulation the operation was performed; the sac was opened; death from peritonitis ensued on the fourth day. Case 16. In this case the operation amounted only to an exploration, as no bowel was found in the sac. A man, aged 40, the subject of congenital hernia on the right side, was admitted at 4 P. M., on Oc-for six months, and had increased rapidly tober 8, into Guy's Hospital, under the care until it nearly filled the abdomen. Paraof Mr. Birkett. His rupture was down, and centesis had been attempted, but failed, a surgeon had in vain tried to reduce it, even from the fluid being too thick and glairy to after practising venesection. On admission, escape by the canula. The woman's conhe was at once placed in a warm bath, and {dition was such, that it was evident a fatal the bowel was then without difficulty re-result would ensue before long, if nothing turned. An hour afterwards the bowels could be done to relieve her; and, she being acted spontaneously, a fluid, very offensive very anxious to have an operation performed, evacuation being passed, very soon after Dr. West thought it warrantable to attempt which he began to complain of severe pain ovariotomy. An incision about two inches in the abdomen, the belly became tym-long was made in the median line, midway panitic, and great prostration came on. between the pubes and umbilicus, and the Stimulants and opium were given, and he cyst exposed. Very intimate adhesions somewhat rallied. Mr. Birkett saw him at were found between the cyst and abdominal Ovariotomy (exploration).—An exploration, with the intention of removing an ovarian cyst, had it been found practicable, was performed in September, by Mr. Paget. The patient was a woman, aged 43, in a very reduced state of health, under the care of Dr. West, in St. Bartholomew's Hospital. The tumour had only been known to exist |