Anethum fœniculum, Gentiana Chirayita, "A quantity of Cactus triangularis to be sliced, the juice drawn from it and thrown away. The remaining part should be added to the above, and both well triturated together. To be taken in quantities of * grains when required. Previous to taking this medicine, it must be dipped in salt.” Besides the efforts of the regular practitioners thus put forth in behalf of the sick, the agency of quacks and silly old women is sought, when the illness of a person is supposed to depend on mischief perpetrated by imps, wizards, hobgoblins and evil spirits. All kinds of mental alienation and disorder are laid at their door, as likewise diseases of a lingering character. The women thus called upon to exercise their craft, for the removal of these imaginary phantoms and spirits, would remind one very forcibly of the poor creatures described by writers on "Demonology,' that were burnt as witches and wizards in Scotland and England, during the reign in those countries of superstition, religious intolerance and persecution. The ceremony for dislodging these pernicious invisibles is somewhat ludicrous. A sort of shrine, with silver and marble images, leaves and flowers, is erected on a raised platform of bamboos. Before it are deposited the different offerings, in cups and on plates. An elderly female is dressed up fantastically, in tattered garments of singular shapes and colours, and decked out with wreaths of flowers and feathers. She holds in each hand a long sword; and in front of the shrine, cutting all manner of antics and capers, she dances to music. This mystical ceremony is sometimes prolonged through the period of a whole day and night, or a couple of days, by the appearance now and then of the female referred to, and of a succession of comical fellows, who dance in the same way, and kick up no uncommon kind of shindy. By looking at them, one is irresistibly led to exclaim, O what stupid infatuation! What worthless folly of concerted phrenzy and vain hope! To judge from what an observer will witness, relative to the feeling entertained by the people toward their own medical men, the conclusion is, that they do not appear to have any great confidence in their skill, or modes of practice. The Burmese are indeed very fickle in this respect. They somewhat unreasonably desire to see speedy results for good, follow the employment of medicinal means. They soon become discouraged, and quickly relinquish hope, if such do not turn up. At times as many as a dozen practitioners may be called in attendance on a case, in the *The quantity directed to be given is not legible in the original. VOL. X. course of a single day, and dismissed one after another, as soon as each one has administered his dose. If the patient die while the last physician is in the house, he gets the name of having done the business. His predicament then is anything but agreeable or pleasant. The poor fellow sneaks out, amid the noise and lamentations that are raised, as if he had by some unhappy blunder really committed a murder. The Burmese burn their dead. Young children alone are buried. Ordinary funerals are solemnly grand. In burning a priest there is great display made. In speaking of the decease of aged persons, they compare it by a figure of speech which they use, " to the dropping of ripe fruit from a tree." Here I must close the subject, not because it is exhausted, but from an apprehension of wearying my readers. Imperfect and rambling as this sketch may seem, an inquirer can gather from it some of the more prominent facts connected with the present state of Medicine in that interesting kingdom of Asia. NOTE. The translation from Burmese into English of the several passages quoted in this paper, was made by a gentleman distinguished for his acquirements and knowledge of the literature of that empire. A case of Serous Effusion in the Theca of the Medulla spinalis. By H. T. CHILD, M. D. I was requested on the morning of the 11th inst., to see R. D. S., male, aged twenty-six. I found him sitting up, and obtained the following history of his case. He had been exposed to a severe rain, two days previously; and on the afternoon of the 10th he was attacked with paralysis of the lower extremities, so suddenly that he fell over while engaged at business. When I saw him at 9 A. M., the paralysis had extended so as to partially interfere with the motions of the upper extremities; sensation appeared natural; his pulse was about 80; there was no apparent tenderness on pressure along the spine; he had passed his urine freely within an hour; his speech was somewhat affected. I directed a cathartic of extract of Colocynth combined with powdered Cantharides. At 3 P. M., my friend Dr. C. H. Bibighaus saw him with me, and we found that, soon after I left, he had lost the power of deglutition; his pulse was now SS, and rather oppressed; we directed free cupping along the spine and a blister to the nape of the neck; in the evening the pulse was 100; he had swallowed nothing, but was profusely salivated and had been all day, the cause of which we were unable to trace. I emptied the bladder by means of the catheter, and directed an enema of infusion of senna and tinct. of aloes. On the morning of the 12th, Dr. Noble saw him in company with Dr. B., and myself; his pulse was 96; he had had his bowels evacuated by the enema and had passed his urine; his mind was some what affected; sensation natural; constant restlessness and desire to be moved. We directed sixteen ounces of blood to be taken, by cups to the spine, and a repetition of the enema. At 1 o'clock, P. M., his pulse was 120; skin hot and dry. I passed a tube into his stomach, and injected a gill of milk and water; he said he felt refreshed; from this time he sank rapidly; his breathing became hurried and stertorous, and at 7 P. M., he died, about 50 hours after the first appearance of disease. A post mortem examination was made thirty-six hours after death, by Dr. Bibighaus and myself-Dr. Noble being absent from the city. We opened the spinal column in the lumbar region, and found it filled with transparent serum; the theca was somewhat softened, and there was atrophy of the medulla spinalis. We were not able to examine the condition of the brain and other viscera. On the Treatment of Young Permanent Teeth, that require Plugging. By J. F. B. FLAGG, M. D. In the course of a series of microscopic observations upon the human teeth, in which I have been engaged for more than two years past, I was early led to observe the striking difference of density in the bony portions of teeth of different ages; particularly in their more external parts, as the bone approaches either toward the enamel or cortex. In two preparations, consisting of transverse sections at the neck, one, an adult tooth, the other of the age of eight years, I have observed this peculiar development most decidedly illustrated. A section of the older tooth being prepared sufficiently to allow the light to pass between its pores, when subjected to a powerful lens, presented a uniformly fibrous, or striated appearance, from the edge bordering upon the chamber of the nervous pulp, quite to its outer surface, with the slight exception of the cortex at this part of the tooth; that being beautifully defined by its clustering stars. A similar section of the young permanent molar, although it appeared equally opaque as the other at its inner portion, yet it gradually became less so, for about two-thirds of the way towards its outer circumference, when all its fibrous appearance was lost, and the external third became perfectly translucent. Much difficulty has been experienced in the practice even of our best operators in regard to saving these early permanent teeth. It is not unfrequently necessary to fill the same cavity twice or three times, at periods varying from one to three years, before we can confidently pronounce it to be an operation lasting and permanently useful. The probable reason for this is the change which is constantly progressing within the tooth, necessary to its growth and full development; the capillary tubes, in the immediate vicinity of the cavity so filled, evidently acting to its detriment. I think it reasonable to suppose that this condition may be superinduced by vital action being in contact with a foreign substance. Be this as it may, having pursued the following practice with uniform success, I recommend it to others desirous of benefiting the condition of young sufferers in this respect. After removing every particle of decay, I devote as much time to burnishing the bony surface as is necessary to close the mouths of the tubuli opening into the cavity. This should be done with a smooth instrument, capable of reaching every portion of exposed bone, and with sufficient strength to cause the bone to present under the instrument somewhat the feeling of enamel; then wipe dry, and fill full, solid, and finish. On the radical cure of Varices, deduced from the proximate cause. Explained and demonstrated in Two Memoirs, by Dr. TOMMASO RIMA; Ordinary Member of the Athenæum, Senior Surgeon to the Civil Provincial Hospital of Venice, formerly Chief Surgeon of the Navy, Clinical Professor, and Surgeon in Chief to the Military Hospital, of the late Kingdom of Italy. Rewarded with the Golden Medal of S. M. I. R., Ferdinand First, from the Royal Institute, for the invention of permanent and moveable swimming baths, &c., &c., &c. Second Edition, with an appendix by the Author. Translated from the Italian, by JAMES BRYAN, M. D., Lecturer on Surgery, &c., &c. On Varicocele. In the classification of the innumerable disorders to which the human organism is subject, some are alterations of tissue, which sooner or later according to the importance of the part attacked, tend to the destruction of life; others are so circumscribed in their effects, that they occasion only a slight alteration in the function of the organ or viscera where they are seated. Thus they sometimes disappear spontaneously, instead of increasing with advancing years. But some of these occasionally remain within certain limits, and produce an amount of suffering disproportioned to the actual extent of the organic lesion. Of this number is Varicocele. This consists, as is well known, in a morbid enlargement of the veins which con vey the blood from the testicle to the general circulation, coursing, enclosed and covered by the scrotum, along the spermatic cord, commonly in an irregular serpentine matter. It will not be in place here to speak of the essential character of this disease, of the degree of alteration which the membranous tissues of the spermatic veins undergo, of the mode of distinguishing it from hernia of the omentum, or of other diseases with which it may be confounded. We will merely state, to fix it in its place, not to verify the disease, as all writers have asserted, one characteristic sign of Varicocele, which will distinguish it from omental hernia: it is, that the former developes itself from the testicle towards the abdominal ring, while the latter, or epiplocele, descends from the inguinal canal to the scrotum. A theory which is well proved by physiological and pathological laws, is not always established by a clinic, at the bedside of the patient. There is no doubt but that an epiplocele must descend from above, and pass the inguinal canal into the scrotum. But we cannot so certainly say that a varicocele must pass from below upwards, from the testicle to the ring. If we admit (for the moment) a new supposition, that the blood in varicocele may descend from the vena cava and renal veins, and oppose that which naturally ascends from the testicle to the spermatic veins. This symptom would cease to be pathognomic, and the obscure would become diagnostic. We will return to the argument when it becomes necessary to prove that such a supposition may be demonstrated by facts. In the majority of cases, varicocele remains latent and innocuous. It is, for the most part, by mere accident that the most careful discover it under the fingers. It generally appears as a group of worms, covered by the integuments of the scrotum, merely inducing a sense of weight in the testicle, a dull sense of stretching in the region of the kidney, and this not constantly. The patient, half mechanically, supports his scrotum for relief. With this precaution he walks, rides, dances and undergoes any other gymnastic exercise without pain. Our predecessors limited their prescriptions to a suspensory bandage, local astringents, bathing and cold water. The cure was merely palliative. We do not speak of certain empirical ministers of Hygeia, who applied various pharmaceutical preparations, whether sanctioned by experience and reason, or not, to all diseases. All surgeons, who are not entirely unknown, will occasionally have patients present themselves to be relieved of varicocele. Some apply to us to relieve them of a varicocele, which is neither voluminous, nor incompatible with the uses of life. Here, it will not be difficult to convince the patient, that greater harm will result from the operation, than the benefit which can be hoped for. Though it is true that this is the ordinary course of the disease, yet |