He might here observe, that it is well known the soup obtained by such poor creatures as the above from the soup shops is entirely insufficient for the support of life without some addition of solid material, and this is more particularly true in reference to Paul's parish, where this man and woman lived, the soup there, from the poverty of the parish, being little more than meal and water, which, in the entire absence of solid food in the stomach, passes through the intes tinal tract as it is taken in, or gives rise to diarrhoea. The facts of these cases led him to suggest that a certain quantity of solid food might be allowed once or twice a week to the suffering poor in addition to the distribution of soup, and to hope that some notice of the subject might be taken by the public prints.

After finishing the post-mortem examination of the above cases, they proceeded to an adjoining apartment, the area of which was certainly not more than six feet square, and here lay (if he might use the expression) a mere living skeleton, stretched on a portion of straw, the eyes sunken, and their whites suffused, cheeks hollow, nose pinched-in fact, absolutely famishing, unable to move, and just able to call in a voice that reminded him of the voice in cholera for a little water, stating that her mouth was like the burning fire, and it was perfectly parched. The emaciation was so great that her arms were no thicker than candles, and the legs were swollen. She was unable to say when she had tasted food.

In reply to a question, Dr. Leeson stated that no urine was contained in the bladder in either case. Delerium, he believed, too, is only observed in cases of absolute starvation, not in those of gradual starvation, as here.-Dub. Med. Press.

On the Treatment of certain Surgical Affections by Elevation of the Diseased Parts.-M. Gerdy has for some time been in the habit of treating certain inflammatory affections by placing the limb, or part, in such a position as to favour the return of blood to the heart. This plan has this advantage, that it does not exclude the application of the usual means of treatment; but, as is shown by M. Dupuy, it is in many cases in itself sufficient to effect a cure.

The question meets us in limine. What are the phenomena which are induced by elevating a part of the body? If the hand, for instance, be allowed to hang down, we observe that it becomes engorged with blood. Place it in the contrary position, and the livid colour disappears, and the vessels empty themselves. It is evident from this experiment that in the first instance the blood accumulates in the most depending part; in the other the reverse occurs, the blood readily finding its way toward the centre of the circulation. What is thus seen to occur in a healthy condition of parts, also happens under certain modifications in disease. M. Dupuy gives the following account of the practical application of the above principles :

If the thumb or hand be inflamed, the patient is made to lie in such a position that the elbow is maintained in a position higher than the

shoulder. The fore-arm is placed perpendicular, supported by cushions, care being specially taken that the circulation is not impeded by bandages; the hand is then enveloped in bandages, to which tapes are fixed, and attached to the top of the bed. These means, with some simple modifications, are likewise made use of in inflammation of the lower extremities. M. Gerda raises the end of the bed by placing a chair under it, thus raising the foot upon the summit of an inclined plane. Once so placed, and care being taken that no injurious pressure is exerted, the patient must not move from the position even to satisfy natural wants; for he may destroy in a few minutes all the benefits which have been obtained by whole days of repose. Although elevation cannot be so efficaciously applied to the head and trunk as to the extremities, it yet may be employed to a certain extent. Supposing the eye to be inflamed,-the patient will lie with his head high, and on the opposite side to the one affected. Why are inflammatory affections and discharges from the womb so tedious in recovery, but for the stagnation of the blood in the organ? Let a woman, who has been accustomed to keep herself in the vertical posture, go to bed, and raise her hips by means of pillows, and she will soon find her case amended. The same principles apply to inflammatory affections of the face, breast, &c.

The advantage of this plan of treatment is not, however, confined to inflammation, but it is equally serviceable in ulcers, uterine hæmorrhages, and varicose veins. In many instances of the latter disease, in M. Gerdy's wards, elevation alone of the limb has been completely successful. The utility of the plan is also incontestable in varicocele. The communication of M. Dupuy terminates with these conclusions:

1st. That elevation of the diseased part is able, without the intervention of other therapeutical measures, to cut short certain inflammations, if it be employed sufficiently early.

2nd. That in phlegmon it relieves pain by diminishing the quantity of blood in the part.

3rd. That it advances the cure of engorgements and chronic profluvia of the uterus.

4th. That certain hæmorrhages may be suspended by it.

5th. That it is able to cure certain ulcers of the lower extremities. 6th. That varices and hæmorrhoids are advantageously modified by elevation.

7th. That where it is not sufficient in itself to effect a cure, it is always a potent auxiliary.-Provincial Med. and Surg. Journ., from Archives Générales.

Method for preventing the projection of the Bones in Fracture of the Leg.-The leg is to be placed in the bent position on the outside, with a common side splint placed above and below, slightly hollowed out to fit the leg. In addition to these, two straight splints are used, padded on one side,-one of sufficient length to extend from the patella to the upper part of the lower third of the leg, the other long

enough to reach from the hollow of the knee to beyond the heel. If the straps be now passed round the leg, including the shorter of the two straight splints on the front, and the longer splint on the back of the leg, along with the two bottom splints on the upper and under side, the tibia and fibula above the fracture will be pushed backwards, whilst the foot with the part below the fracture is pressed forwards. In this manner the tendency of the tibia to pass forwards, after simple dislocation or fracture near the ankle, is effectually presented.-Ibid, from Ormerod's Clinical Observations.

On Etherization.-In our historical notices of the effects resulting from the use of ether, we have endeavored merely to record the facts as they arise. It would seem, however, that the article in our last number has led to some misapprehension. In alluding to the alleged fatal effects of this substance, we thought we had been sufficiently cautious. It was asked," is this result, the effect of ether? an answer in the affirmative cannot be decidedly given, but all such cases require to be put on record." We continue to be of the same opinion, and shall put on record all the fatal cases that occur after the employment of ether, being satisfied that it is of the utmost consequence to ascertain whether it be innocuous or occasionally dangerous, and in the latter case, what are the contraindications to its employment. A correct judgment can only be formed by further experience and multiplied observations. We deprecate alike the excessive enthusiasm which insists that under no possible circumstances, ether can be, or ever has been prejudicial, and the unreasonable timidity which prevents the employment of a useful agent, because, in a few cases, injurious effects have been apparently occasioned by it.

During the past month Etherization has been extensively practised, but few novelties have been published with respect to it. Its advantages and applications are still debated at the meetings of the Academy of Natural Sciences and the Academy of Medicine in Paris. We observe, however, that the cases noticed in our last number have produced an effect on the warmest advocates of inhalation. Even MM. Velpeau and Roux, though still maintaining its great advantages, now speak of the necessity of caution in its use. This is as it should be.

The third case to which we alluded, as likely to be fatal after the use of ether, in the Royal Infirmary has since expired. It was a case of tibio-tarsal amputation, under the care of Mr. Syme. A girl, aged 14, of good general health, was affected with caries of the tarsal bones, and fistulous openings leading from them. The amputation was performed in the usual manner on the 24th of February, without the slightest pain, the ether having produced its full effect. She died April 5. On dissection the blood was found unusually fluid, and secondary purulent deposits existed in the lungs, left kidney, right knee, and left hip joint. Such are the facts. As to whether death in this, or the other two Infirmary cases, resulted from the etheriza

tion, that is a matter of opinion. Some say no, others say yes. It is the first fatal case of tarsal amputation which has occurred in Mr. Syme's practice, and it is only right to state that in his opinion it is attributable to the ether. The observation of other cases will sooner or later decide the point.

Applications. In the case of a young man, aged 23 years, subject for some years to epileptic attacks, which returned every 15 days, M. de Rabodanges caused ether to be inhaled, the evening before the day on which the attack was expected, with the result of preventing it. (L'Union Medicale, No. 42.) M. Marc Dupuy has injected large doses of ether into the rectum of two dogs, and found that in this way it will cause perfect loss of sensation. Slight inflammation of the mucous membrane was produced in one case. (Ibid, No. 24.) M. Stolz, of Strasburgh, has published a case of turning, in which he met with considerable resistance, in endeavoring to pass his hand into the uterus, notwithstanding the complete insensibility of the patient, by means of ether. He concludes from it that ether in no way facilitates the turning or extraction of the fœtus.-Monthly Jour. of Med. Sci., from Gaz. Med. de Stras.

Epidemic of Scurvy in Edinburgh.-A very singular epidemic of scurvy has broken out among the railway labourers in the neighborhood of Edinburgh. On the day we write this, no less than 92 cases of the disease, in all its different stages, may be seen in the Royal Infirmary, special wards having been opened for their reception. In the autumn of last year a similar epidemic occurred among the prisoners of the General Penitentiary at Perth. Both these epidemics have fortunately found an able historian in Professor Christison, who, at the last meeting of the Medico-Chirurgical Society, read an elaborate memoir, abounding in novel views of the etiology and mode of treatment of the disease. We shall have the pleasure of presenting our readers with this valuable contribution to medical science in our next number.--Ibid.

Observations on the condition of Asphyxia, or Insensibilty, induced by the inhalation of ether; and of the indications to be fulfilled in the Treatment of the Effects of its Maladministration. By CHARLES SEARLE, M. D., M. R. C. S. E., of Bath.-In the Medical Times of the 19th ult. is a report, made to the Académie de Médecine à Paris, by M. Amussat, of his experiments on animals under the influence of the vapour of ether, in which he said :-" that, during the condition of insensibility induced by the ethereal inhalation, the blood in the arteries was found to be of the venous character, and resumed its florid appearance when the state of unconsciousness had ceased. And that, in animals which had died during the inhalation, the blood was found of the same venous colour in the heart, veins, and arteries." If such are the results of M. Amussat's experiments, they establish,

beyond doubt, the correctness of my views on the subject, published in the Medical Times, under date of Jan. 5, to the effect that the condition of the patient under the influence of the ethereal vapour is that of asphyxia; and that the sedative or narcotic effects of ether as ordinarily administered is of the same character. Its stimulant operation when so administered, that is, by the stomach, I must, however, first explain, or the views I entertain of its inhalation will not be rightly apprehended. To make this understood, it is necessary for me first to observe that life, the attributes of which are heat and motion, is the result of the chemical action developed in the animal system by the agency of the oxygen of the air inspired in its combination with the hydro-carbonaceous constituents of the food existing in the blood--caloric and electricity, the actuating stimuli of all vital phenomena, being evolved in the process. And as this process of chemical combination and electrical evolution, we may justly infer, takes place more particularly in the capillary or hair-like vessels, wherein the particles of the blood are brought into the closest approximation, and in which the final changes in its composition in relation, at least, to the conversion of arterial into venous blood takes place, hence the excitement of these vessels and motion of the blood in the capillary vessels, or organic life of animals; capillary action being the first visible motion to be discerned in the egg in the process of incubation, and the last to be discovered in animals when death takes place. These views I submitted to the profession as long back as 1830, when I had the honour of reading to the Westminster Medical Society a paper on the subject, and have since enlarged upon in a work recently published, entitled "The Philosophy of Life, Health, and Disease."

Now, the transitory stimulating effects of ether, when received into the blood from the stomach, is in virtue of its composition, it being a compound of carbon and hydrogen; its absolute composition is carbon, hydrogen, and oxygen; but the latter, it is presumed, exists in combination with its equivalent of hydrogen in the character of water -that it virtually is, as I say, a hydro-carbon. This, then, we may fairly presume, from its highly inflammable nature, must exist in a looser state of combination, or a condition of greater affinity for oxygen, than that of the fatty or other hydro-carbonaceous constituents of the blood, and would, therefore, when received into the general eirculation from the stomach by predilection of affinity, enter immediately into combination with the oxygen of the blood, and a more active combustion, and, by consequence, excitement of the capillaries of the general system, would ensue; and thus the stimulating qualities of ether, in common with other hydro-carbonaceous alcoholic fluids which operate in like manner. And hence Mr. Spalding, the celebrated submarine operator, found that, when he drank alcoholic beverage, he required a greater amount of air being supplied to him during his operations. But the stimulating qualities of ether are of a very transitory nature, these effects being soon followed by its opposite condition of narcotism; but before I proceed with these, its