and discharging from every vein, which the lancet can possibly reach, parabolic jets of blood, whose streams inundate the floor. Then picture to yourself besides the phlebotomist himself, with instrument in hand, and kneeling in admiration of his work, like Pygmalion before the statue which he had made, and you will have a complete idea of the manner, in which the Salassatore announces by the aid of pictorial art the various results of his skill. I was curious to come in contact with one of these professors of Minor Surgery, and accordingly went into his shop on the pretext of asking for leeches; for the Salassatore, as is most right, deals in these adjuvants of his art. He was at the further end, gravely stretched out upon a straw couch, awaiting the entrance of a customer, with that sleepy, do-nothing calm-the 'dolce far niente' sort of air—which is so characteristic of the Neapolitans. While he was engaged in taking out the leeches from the glazed earthen vessel in which they were kept, I cast my eyes round to observe the contents of the shop. It was very poorly furnished on the whole; but there was a profusion of little cases full of bandages and compresses, that were ranged along the walls from the top to the bottom. I ventured to make an enquiry about them; he told me that each compartment represented a subscriber, who came at regular and stated times to be bled; I drew back in astonishment at the bloody statistic intelligence that was given me; and, for the first time in my life, rendered justice to the moderation of our French advocates for bleeding coup sur coup,' only in cases of sickness."

ON THE TREATMENT OF BUBOES.

As long as inflammatory symptoms are present, the usual treatment by leeches, poultices and so forth, is to be steadily pursued. When suppuration has been once established, I generally apply to the centre of the bubo a small blister, (of the size of a sixpence or shilling), the vesicated surface being afterwards kept moist with a pledget of lint dipped in a solution of Corrosive Sublimate-1 part of the salt in 32 parts of distilled water: this is kept on for two hours or so, until a superficial eschar has been formed. When this has been done, an emollient poultice is to be applied to promote the decadence of the eschar. Care should be taken that the eschar is not too deep, and that it has not destroyed the entire thickness of the dermis. The inclosed purulent matter oozes out through the pores of the latter, when the eschar falls off, and the dermoid tissue becomes agglutinated (la peau se recolle). When the bubo has opened and begins to discharge, and sloughs present themselves, I usually dress the wound with lint that has been dipped in honeyed wine; and if this plan does not answer well, I inject under the detached skin a weak solution of the Sublimate. In the event of this treatment failing, I have recourse to small blisters, which very generally have the desired effect of causing the agglutination of the sides of the wound. It is very rare that I have found it necessary to excise the loose integuments. When the edges of the abscess are effaced, and nothing but an ulcerated surface exists, the healing process will often be found to be promoted by the use of the Styrax ointment, the balsam of Arceus, the occasional application of the lunar Caustic, or of the acid nitrate of Mercury, &c. M. Regnaud speaks favourably of the Creosote ointment-which in his opinion is decidedly preferable to the powdered cantharides, as recommended by M. Ricord-in many cases.

When the bubo is in a state of chronic induration, he has used, he tells us, with most advantage, the pommade of the proto-ioduret of Mercury (3—5 parts to 30 of lard): blisters rank next in his estimation. He has occasionally employed, with good effects, the application of heated bricks, as recommended by M. Henrotay of Antwerp. The bricks, after being duly heated in a stove or

oven, are enveloped in flannel and kept on the swelling by a bandage, until they cool, when they are again heated and re-applied.-Bulletin de Therapeutique.

Remarks. The practice here recommended, by a surgeon too who must have had a very large experience from the post he has held for a length of time in the Marine Hospital at Toulon, seems to us to be very needlessly complicated. When the suppurative stage has commenced, might not the application of the caustic potass, so as to form an eschar of appropriate depth, supersede the more tedious operation of first blistering the skin and then applying a corrosive stimulant to it? Unquestionably the best method, as a general rule at least, of opening bubos is with caustic,-in preference to the use of the knife--and we are therefore glad to find that M. Regnaud is in the habit of adopting it the only objection we make to his practice is as to the mode of effecting this purpose. When the abscess is once fairly open, and its surface and edges are in an unhealthy condition, few applications are so good as the Tinct. Benzoini Comp. (Friars Balsam) applied with lint: it is an admirable detergent to foul ulcers in general. Besides its stimulating and antiseptic properties, the balsam seems to act beneficially by totally excluding the admission of the air to the sore, in consequence of the varnished coating which it forms. When the ulcer is tolerably clean, but very tardy in healing, we have seen excellent effects from covering it daily with a layer of powdered rhubarb. As a matter of course, bark and other tonics are generally required to be administered internally at the same time.—(Rev.)

ON THE TREATMENT OF SECONDARY AND TERTIARY SYPHILITIC DISEASES.

M. Devergie-one of the physicians of the St. Louis Hospital, which receives a much larger number of syphilitic patients than any of the other hospitals in Paris-has, for the last eight years, met with great success, he informs us, in the treatment of the secondary and tertiary affections by adopting the following remedies. The patient is to drink every day about a quart of a sudorific ptisan, in which from five to twenty grains of the Ioduret of Potash have been dissolved, and also to take every morning, fasting, a pill composed of guiac, opium and a minute quantity of the corrosive sublimate. In the course of a week or so, a second pill is to be taken at night also. These medicines are to be persevered with for two or even three months, without intermission. A tepid bath is to be taken once a week. No wine is allowed; but milk is given freely instead. If the patient's constitution has been much damaged by irregularity or want, M. Devergie recommends the use of some ferruginous preparation, or of bark, or of both together; at the same time diminishing the dose of the sublimate, if the state of the symptoms should still require its continuance.

When, after six or seven week's use of these remedies, the local symptoms still exhibit an unhealthy character, the application of the crystallized acid nitrate of mercury-dissolved in water, to which a few drops of nitric acid have been added-will be found most convenient. The ointment of the proto-ioduret of mercury is also a valuable application, to promote the healing of certain ulcers.

APPLICATIONS OF SUBCUTANEOUS SURGERY.

The most remarkable feature of subcutaneous surgery is the speedy and genial cicatrization of divided tissues, without any accompanying inflammatory re-action, or tendency to suppuration. Another important character, that deserves to be

attentively considered, is the readiness with which many fluids, when effused into the cellular texture, are absorbed and entirely removed, if the access of the atmospheric air be prevented.

The applications of Subcutaneous Surgery may be reduced to two heads; viz: to sections, and punctures; in other words, to operations on the tissues, and to those on sacs and collections of fluid. From this two-fold view arises the consideration of the non-inflammation of the divided tissues on the one hand, and of the unalterability of effused fluids on the other. M. Guerin enumerates in the following catalogue the numerous applications that have been proposed, either by himself or others, to the various maladies and injuries of the different structures of the body.

1. The Skin. The decollement' of the skin in cases of vicious scars and adhesions.

2. Tendons.-The section of these-a, for deformities; and b, for the purpose of facilitating the reduction of old dislocations, and of recent fractures.

3. Aponeuroses.-The section of these-a, as an orthopedic means of cure; and b, as a means of relieving the tension of the tissues in various inflammatory engorgements and effusions.

4. Muscles.-The section of these-a, as an orthopaedic means; b, as a means to favour the reduction of luxations and recent fractures; c, for the purpose of facilitating the operation for strangulated hernia; d, for the radical cure of irreducible hernia; e, the section of the sphincter of the anus in cases of fissure; f, the subcutaneous cauterization of the muscles as a means of artificial con

traction.

5. Ligaments. The section of these-a, as an orthopedic means; b, as a means to facilitate the reduction of certain luxations and fractures; c, the cauterization or calefaction (?) of the ligaments, with the view of strengthening and contracting them.

6. Arteries.-a, The subcutaneous scarification or cauterisation of certain fungous tumors; b, the obliteration of arteries by section, puncture, or scarification; c, their subcutaneous ligature.

7. Veins.-a, Their subcutaneous section and scarification in the various kinds of varicose swellings; b, the ligature of the veins.

8. Lymphatic Vessels and Glands.-a, Section of the former to promote abortive treatment in buboes; b, section and scarification of the latter, affected with chronic tumefaction.

9. Nerves.-a, The section of these in cases of neuralgia; b, the scarification of their minute branches in cases of sharp pain under the skin; c, the cauterisation or calefaction of them in certain painful affections, as in arthralgia, &c. 10. Cartilages.-Subcutaneous symphyseotomy.

11. Bones.-a, The removal of small exostoses; (!) b, subcutaneous fractures to remedy certain deformities caused by irregular callus; (!) c, the extraction of sequestræ, and the resection of the sharp ends of fragments of a fractured bone, that threaten to force their way through the skin; d, scarification of the surface of a bone when tumefied and inflamed; e, cauterisation or calefaction in similar circumstances; ƒ, extirpation of osseous tumors.

Besides the above long catalogue of the applications of Subcutaneous Surgery, M. Guerin enumerates a variety of others, belonging to the second class of its applications, as the puncture and incision of incipient phlegmonous swellings; the puncture and evacuation of meliceric cysts, of chronic abscesses, of sanguineous tumors, serous deposits, of articular dropsy, &c.; the extraction of foreign bodies from the joints; the radical cure of Hydrocele and Hematocele ; the puncture of the head in chronic Hydrocephalus, and of the dorsal swelling in Spina bifida; the puncture of the thorax in Empyema, and of the pericardium in dropsy of this sac; the puncture and evacuation of tumors of the liver, ovaries, and other abdominal cysts; and lastly, "a multitude of other operations;

which cannot be performed either by section or puncture, properly speaking; but which nevertheless may be reduced, in a certain degree, to the principal condition of the method in question, and which may be benefited by its peculiar advantages. Among these applications, I may mention the Cæsarian Section." -Gazette Medicale.

Remarks.-Like all modern discoverers and inventors-if indeed he is entitled to be ranked as such-M. Guerin greatly exaggerates the value and importance of his offspring. Modesty is certainly not a character of the present age; and no set of men seem to have so little of this grace as the doctors, when they are so fortunate as to hit upon anything that is somewhat novel, or to make a new application of an old and well-known remedy. Who has not heard of chronic inflammation applied to the history of almost every disease to which the human body is subject, until nosology was deemed an empty labour, and the science of therapeutics was reduced to the application of a mere mechanical formula, which any chemist's shop-boy might understand quite as well as a Sydenham or a Cullen?

The truly valuable discovery of Laennec has suffered much more at the hands of its friends than of its enemies; and its extravagant laudation some years ago is beginning to give way to its undeserved disparagement in the present day.

Of later years, the doctrines of the reflex function and of the excito-motory actions, as they have been called, has been pushed by its propounder to a most wearisome length, until the profession has become sick of the endless iteration of the same thing in different guises. There is far too frequent a repetition of 'I' and 'my' in all his writings on the subject. M. Guerin is guilty of the same bad taste as our more talented countryman. He writes not as the expositor of truth or the interpreter of nature, but rather as an interested advocate in support of a cause which he has undertaken to uphold.-Rev.

USE OF COLOMBA-ROOT AGAINST VOMITING.

This well-known and long-established drug is an admirable remedy in many cases of ataxic and nervous Vomiting. A writer, in a recent number of the Annali Universali, mentions the case of a soldier, who was suddenly seized, after a fright, with violent pain in the abdomen, accompanied with vomiting and diarrhoea. The other symptoms gradually ceased; but the vomiting (which was evidently of a nervous character) still continued. The patient had a yellow cachectic look, a furred white tongue, and loss of appetite; slight epigastric pain usually preceded the coming on of the fits of vomiting. They generally returned six or seven times every day. Every thing tried failed in checking this obstinate irritability of the stomach, until-seven months after the commencement of the disease-Dr. Manfredonia suggested the use of Colomba: it was given in the form of powder, and in the dose of eight grains four times in the 24 hours, in a small cupful of goats' milk. A very sensible amendment in the state of the patient speedily took place, but the vomiting did not entirely cease for some time. The Colomba was subsequently given in the form of the decoction; and under its use the health was gradually, but completely, restored.

(Colomba is an excellent remedy in a great many cases of gastric ailment: a favourite formula of ours is-Infusi Colomba 3vj., Liq. Potassæ 3iss., Tinct. Humuli 3iij., Aquæ Pimenta 3iss. M. It is often very useful in phthisical patients.-Rev.)

TOBACCO-SMOKE APPLIED TO GOUTY LIMBS.

In M. Reveillé-Parise's work on Gout and Rheumatism, we read that "the fumigations of Tobacco-recently proposed by the Abbé Girod, canon of Nozeroy, and which consist in exposing the pained part to the smoke of the dried leaves, thrown upon heated coals, for about a quarter of an hour at a time-have been often found to afford great relief: they may be repeated three or four times in the course of the day. To guard against the return of the malady, the Abbé advises the occasional use of a foot-bath made by boiling tobacco-leaves in water."

The remedy is cheap, and may certainly be sometimes useful. Dr. Hinard reports very favourably of its soothing effects upon himself.

(Have any of our French brethren ever tried the homely remedy of cabbage. leaves-previously softened by steeping them in hot water, and then slightly dried-as an application to gouty and rheumatic joints? Often have we occasion to witness its good effects. Another very convenient and useful application is a wash composed of water, vinegar, and any spirit-from gin to eau de Cologne: it should always be used lukewarm, and the part should be covered with oilskin.-Rev.)

FALLACY OF THE NUMERICAL METHOD IN MEDICINE.

The following very sensible remarks, in reprobation of the mistaken importance attached by Louis, Forget, Bouillaud, and such writers, to one of their favourite doctrines, are from the pages of the Revue Medicale—the organ of the Hippocratic School in France.

"The principles of the Healing Art should be based on the discrimination of diseases, and not on their confusion. Now it is this very nosological error that the numerical system has given rise to; and with it at first the confusion, and subsequently the negation, of all genuine therapeutic medicine. Look where we are, now-a-days, with respect to Typhoid Fever-a term of such elastic pliancy as to admit any thing we choose; it is a sort of medical goddam, (Query, Is this a skit at English manners?); almost the sum-total of medical language of the present age. We are indeed quite well aware that the numerical system is not alone chargeable with all this confusion; Chemistry and Pathological Anatomy must come in for their share of the blame. If we would avoid the errors of our predecessors, we must be careful not to base the principles of the Healing Art on either of these sciences any more than on the Numerical System, that has been so much vaunted of late years. They, and indeed almost every branch and department of science, may render important services to practical medicine; but to seek to make any one its only basis, is assuredly a great folly it is to make a principal of a mere accessory.'

LONG TUBULAR MEMBRANE EXPELLED IN A CASE OF CROUP.

In a recent number of the Brussels Journal de Medicine is narrated a case of Croup, in a child three years and a half old, where a membranous tube nearly five inches in length was expelled during the act of vomiting: on the surface of the tube were several reddish lines which looked like minute venous ramifications. The symptoms-which up to the time of the expulsion had been very alarming— immediately subsided, and the young patient afterwards rapidly recovered.

There was every reason to believe that the tubular membrane was the result of