symptoms it has effected a most rapid cure. Frequently Dr. Lang has seen patients enter the hospital, who had suffered for months the most intense agonies from syphilitic rheumatism, rendering sleep almost impossible, and who by the use of this medicine, have generally been relieved in the short space of four days, and generally within a week. Another of the symptoms in which it has appeared to be particularly beneficial, is the deep ulceration of the throat which follows the submucous tubercles of this part and so frequently carries away a great part of the soft palate. The progress of these ulcers is generally stopped in the course of two weeks and they then speedily heal. Mr. Ricord usually commences with this medicine in the dose of thirty-six grains and increases it eighteen grains about every four days, provided its effects are not produced. His mode of administering it is in solution in hop tea made with an ounce of hops to the pint of boiling water, which is allowed to infuse for four hours, he then adds 36 grains of Iodide of Potassium which is taken in the course of a day. The only effect produced by the medicine besides the cure of the disease, is an increase in the appetite of the patient. In a few rare cases it will produce a little gastric irritation or a diarrhoea, and the dose should then be lessened. It is used in all the tertiary symptoms with great benefit, but in those which I have mentioned its effects are surprisingly rapid.

There are some cases of constitutional syphilitic disease, which cannot be classed either with the secondary or tertiary symptoms, but partake of the character of both: these cases are most advantageously treated, according to Mr. R., by combining the mercurial treatment with that by the Iodide of Potassium.

During the past year several new operations for the cure of de formities have been introduced amongst us.

Much attention has recently been bestowed upon this branch of Surgery, especially in Germany, where the operations referred to have originated-and so important are the results of these investigations deemed, that the relief and cure of deformities has been erected into a speciality under the name of Orthopedic Surgery.

The division of tendons, muscles, and fasciæ, is now extensively practiced, in cases where mechanical measures alone have heretofore been relied on. Many cures are reported as having been performed, in the several varieties of talipes or club foot, by division of tendons which it is thought would have resisted mechanical means, or would have been a much longer time under treatment, if trusted to these means alone. On the other hand, it has been asserted, that a properly constructed apparatus will accomplish all the ends which the division of the tendon can effect, in a period equally short, and with less injury to the limb. Without hazarding the expression of an opinion on this subject, it may safely be asserted, that much of the evidence on both sides of the question, lacks that certainty, and philosophical accuracy which should distinguish medical testimony.

Cases have been reported as cures, long before sufficient time had elapsed, for the ordinary operations of nature to effect those changes in the form and of the limb, to adapt extensive surfaces which had been distorted from birth, to such a condition, as could alone justify us to pronounce the case as cured.

Many Surgeons, charmed with the novelty and simplicity of the operation of dividing a tendon, and delighted with its immediate effects, have been led into hasty reports of success, which perhaps their more mature consideration, would scarcely justify. It is by time and more enlarged observation alone, that the value of this operation can be tested, and that its claim to be ranked amongst the improvements of Surgery can be established.

The method of operating now generally pursued was devised by Stromeyer of Hanover, and is certainly both safe and ingenious. The operation of dividing the tendo achillis, is not new, it was first performed under the direction of Thilenius, an Italian, in 1784, and was repeated by Satorius, Delpech, and Stromeyer. The latter Surgeon has, however, been chiefly instrumental in awakening general attention to it, and in extending the cure of other deformities.

Dr. Detmold, formerly of Hanover, now of New York, was amongst the first who operated in this country, and by his report of cases published in the American Journal of Medical Science, for May, 1838, the attention of American Surgeons was generally awakened to the subject. From that period, to the present time, the operation has been extensively practiced, both here and abroad, and many reports of its results have been published.

The division of muscles has been practiced in the deformities of the lower extremity, beside club-foot, as also in that distressing affection, called wry neck.

Another operation which has excited a very general interest, is that recently devised by the celebrated Berlin Professor, Dieffenbach, for the cure of Strabismus.

The account of this operation reached us about the middle of the past year, since which period it has been practiced in a great number of cases. The results are said to have been most gratifying, and the failures rare. The testimony afforded upon this subject, has also been of a doubtful character, many cases having been reported through the newspapers and other unprofessional channels, before sufficient time had elapsed, to test the actual results of the operationFrom reports which can be relied on, however, there seems to be no doubt, that some cases of strabismus have been cured, and that the operation may be ranked among the improvements of modern Surgery; while it is equally true, that its indiscriminate application to all cases, is absurd and highly detrimental to the best interests of science.

It is also to be remarked, that the short period which has elapsed since the introduction of the operation, does not enable us to judge with precision of the ultimate effects, which the division of one or

more muscles of the eye, may have upon the actions of the rest. May not the division of the internal rectus, for instance, produce a tendency to eversion of the eye ball, under the action of the opposing muscle, long after the immediate effects of the operation have passed over? It is said, that this result has occurred in some instances. How far it is to be apprehended in other cases, time alone must determine.

We shall notice one other operation of still more modern date, being the product of the present year. We allude to the operation for stammering, also devised by the Berlin Professor, Dieffenbach. This consists in an incision carried completely through the tongue, at its root. Three methods are described by the Professor. First: The transverse horizontal division of the base of the tongue. Secondly: The subcutaneous transverse division, leaving the mucous covering undivided. Thirdly: The horizontal division, with excision of a wedge shaped portion of the tongue. All of these methods were experimented upon, and the last alone considered as adequate to the end in view.

When we consider the extreme vascularity of the tongue, together with the great difficulty of arresting hemorrhage issuing from it, we need not wonder that extensive operations upon this member, have ever been regarded by Surgeons in a serious light, and justifiable only in cases where the life of the patient is in jeopardy.

It is, therefore, truly surprising, that an operation so formidable as that under consideration, should be attempted for the relief of a defect, extremely inconvenient and distressing, it is true, but not injurious to the health of the individual. A defect too, which in a large proportion of cases, is dependent upon habit, or upon peculiar states of mind, and is to be remedied by a protracted system of mental and moral discipline, with appropriate vocal exercises, rather than by a resort to so dangerous an expedient.

The inventor's own estimate of the dangers of the operation are thus stated: "It can never be performed, says he, by any one who has not the temperament of an operator; the hemorrhage must hold all others at a respectable distance. The extent and importance of the operation, the possible danger to life, or loss of the tongue, through a want of skill in the assistants, who may tear it, when so nearly separated, or from mortification or ulceration of its connecting isthmus-these are contingencies rationally to be feared, and which must be carefully weighed beforehand.”

And yet with these "rational fears" before him, the Professor hesitates not to recommend the operation, and Surgeons of eminence, in France and England, are rash enough to act upon the suggestion, even at the risk of human life. And this too, when the results of the operation are doubtful, and before sufficient time has elapsed to pronounce with certainty upon them. No account of the operation of Dieffenhach having been performed in this country, has

reached us, and we hope, for the honor of American Surgery, that no respectable operator, will attempt it.

In hinting thus briefly at the several new operations introduced for the cure of deformities, we cannot withold the expression of sincere regret, that this department of surgery, which however useful in its place, is still subordinate to the higher aims of the science, which consists in the cure of those various surgical diseases, involving the life or limbs, without a resort to the knife, should be magnified into undue importance, and seized upon by the unprincipled and ambitious, as a means of exciting popular attention towards themselves.

Within the past few years, the records of Surgery have been defaced by the most extravagant accounts of the success of tendon cutting, and other operations to cure deformities. Take the following heading as an example: "Subcutaneous section of forty-two muscles, tendons or ligaments, practiced the same day, on the same person, to cure a general articular deformity, by M. Jules Guerin," of Paris.

Cases have been reported as cures, long before sufficient time had elapsed, to pronounce them as such, according to the fixed cases of nature, and the legitimate deductions of reason. Thus it is, that the confidence of the profession on medical testimony is weakened, and the permanent progress of the science is impeded.

We cannot close this subject, without a brief allusion to several novel operations, which have originated in our own city, although they do not belong to the particular period under review.

We shall first designate the operation of Dr. Rhea Barton, for the cure of a most distressing deformity of the lower extremity, from inflammation of the knee joint, resulting in anchylosis. This operation has excited the admiration of Surgeons both here and abroad. and may well be ranked among the recent brilliant triumphs of Surgical skill-it consisted, as is generally known, in excising an angular portion of the osofemris, a few inches above the knee-joint, the apex of the triangle, being on the lower surface of the bone, and the continuity of its shaft being preserved, by a thin ledge of bone, which was left untouched.

The loss of this triangular piece, presented of course two cut surface of bone, and a considerable vacuity, increasing in width from the apex to the base of the triangle; these two surfaces, were now gradually approximated, and as they approached each other, the leg, which was bent at right angles with the thigh, was extended, union between the bony surfaces took place, and as it progressed, the limb was placed in a position occasioning the least deformity and inconvenience to the patient, and enabling him to use it with facility, for all the purposes of locomotion.

We do not attempt here an accurate description of the operation, but must refer the Fellows to the American Journal of Medical Science, in which a full report of the case will be found.

A most ingenious operation for the cure of recto-vaginal fistula has also been devised by the same Surgeon, within a short period, for an account of which we must also refer to the same Journal.

Dr. B. H. Coates read a communication, on the moral grounds for the condemnation of Quackery, &c.

Dr. B. H. Coates also communicated, verbally, a case of Typhoid Fever, with ulceration and discharge of fecal matter from the umbilicus, without hernia, in which, however, no autopsical examina tion was permitted.

Stated Meeting of the College, December 7, 1841, Dr. Fox in the chair.

Dr. Parrish read the following "observations on a change of voice following extirpation of the tonsils."

About four years since, I assisted my late lamented father in ope rating upon a young girl, in her 13th year, who had been for several years sorely afflicted with enlarged tonsils. The glands were readily and successfully excised by the circular knife, ring and spear, known as Dr. Fahnestock's instrument. That is, the face of the tumours was removed, leaving a broad raw surface, which granulated and cicatrized, contracting the glands to at least their usual size. The result, as far as the inconvenience and danger arising from the tumours were concerned, was perfectly satisfactory, and the patient has since enjoyed an immunity from suffering from this source. It was not long, however, after the operation, when she was observed to have a peculiar shrill, nasal twapg in pronouncing certain words, which so modified her voice, as to be exceedingly unpleasant to herself and friends.

As the patient was just approaching the age of puberty, it was hoped, that some change might occur, in the voice, at this period. This hope however was not realized, and the same shrill, whistling sound is still observable in a voice naturally soft and well toned. The young lady is now in her 17th year, possessed of considerable personal attraction, and is well educated. Such a defect is of course, a source of mortification, as well as of considerable inconvenience. The cause of this defect of speech appears obvious, by an examination of the posterior part of the mouth.

It will be remembered, that the anterior and posterior half arches are separated from each other by the space which is appropriated to the tonsil glands, and that this space widens as the soft palate approaches its points of insertion upon the sides of the throat. Any increase or diminution in the normal size of the gland which occupies the space between the arches must, of course, widen or contract it. In cases where the glands are much enlarged, the relative po