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TO CORRESPONDENTS.

NOTICE. All communications for the Editor must be addressed, pre-paid, to his house, No. 25, LLOYD-SQUARE.

THE EDITOR is at home every day until One o'clock; and on the evenings of Monday, Wednesday, and Friday, from Seven till Nine.

GLOSSARY, OR DICTIONARY OF MEDICAL AND ANATOMICAL TERMS.-We are preparing a glossary of words that occur in medical writings, which will give an ample and correct definition of all scientific or technical words, terms, and phrases. It will be published as a supplement, and will appear with an early number.

VOLS. I. and II. are now ready, price 4s. each, bound in strong and elegant
cloth, gilt lettered.

CASES for binding Vols. I. and II. may be obtained of all news-agents,
price 1s. 3d. each, in strong and elegant cloth, gilt lettered,
BACK NUMBERS.-There should not be any difficulty in procuring back
numbers to complete volumes, or numbers containing certain articles.
They are always on sale by our publisher, and any delay that arises
must be consequent on some forgetfulness on the part of the local
bookseller or his town-agent.

THE DISEASES OF ARTISANS will be resumed in our next.

HANNAH ELLIOT.-The basis of all" washes," botunic waters," and other
nostrums for the hair, is bcrar. It frequently turns the hair red, rusty,
and rough.
TOM TIBBETTS (Alton).-If you will read the letter of VICTIMм, published
in No. 2, you will be able to judge of the honour and ability of the
rascally Jew quack into whose hands you have fallen.

D. X. Y.-Take compound decoction of aloes, four ounces; compound
iron mixture (Griffith's mixture), five ounces; tincture of ginger, two
drachms; compound tincture of cardamoms, six drachms. Mix.
Dose, two large spoonsful three times a day. Diet: animal food; few
vegetables; a pint of good beer daily. Out-of-door exercise, and
regularity in all your habits.

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THE ANTI-QUACK SOCIETY,-Secretary, Mr. Harrison, 5, New Inn, Strand. -
This society is now in operation, and we earnestly advise our subscribers
to apply for a copy of " A Few Words to News-readers," which we
believe will be forwarded by the secretary on the receipt of the post-
age-stamp which will frank it. We beg our readers to understand
that this association at present consists entirely of members uncon-
nected with medicine-noblemen, clergymen, barristers, bankers, mer-
chants, and we hope to be enabled soon to add, tradesmen, artisans,
labourers, and every moral and respectable member of the community.
SOLICITOR'S CLERK (Bristol).-See answer to THOMAS HIGGINBOTHAN
(Macclesfield) in No. 13 (page 144, Vol. I.).
ELTHIRON.-"Linctus" is the name given to soft preparations, of the con-
sistence of syrup, which are taken by being licked off a spoon. They
are ordered in coughs, sore throat, thrush, and other affections of the
tongue and mouth.

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EXPENSE.-As a votary at "the shrine of Cypris," you are referred to the answer to IXION in this number.

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GEORGE HILTON.-The "error" in question is the cause of your present misery and ill-health. If you will read any one number of our Journal, you will see why we do not give you more explicit information. SHOPMAN (Philpot Lane).-" Grocers' Itch" depends upon small animalculæ found in impure sugar, it is called the acarus sacchari, and belongs to the same genus as the acarus scabiei, or itch insect. Bakers are also liable to a somewhat similar disease; and it is known that flour frequently swarms-is, in fact," alive"-with a species of acarus. Thus, the more impure the sugar you "handle" is, the more inveterate will be your complaint.

J.

J. (Wapping Wall).-You will always be an invalid while you reside in your present neighbourhood. The Editor does not attend in Gracechurch Street now; he restricts his consultations entirely to his own house, or at the residence of invalids.

CURIOSUS.-Glycerine is a bland, syrupy liquid prepared from olive oil; it is also found in other fatty oils. It is very useful in deafness arising from thickening of the drum of the ear, and also in the deafness that frequently succeeds the eruptive, or other fevers.

GREAT SUFFERER. Read the articles on RHEUMATISM, published in No. 8, page 57, Vol. I. ELIZABETHI ANN.-Do not be alarmed: pain in the breast may arise from many causes besides the fearful one-cancer: it is sometimes merely sympathetic with some little uterine irritation, or even indigestion. We must see you.

A NEWS AGENT (Bristol). The excellent article in the Times of the 23d A
ult. is scarcely suited to our columns. The case of Mr. Camomile is
a true one graphically related. Medical men, especially country
practitioners, are the worst paid persons in the kingdom. For £300
or £400 a year, a village doctor has to work day and night; to sup-
port an establishment equal to that of the parson and the lawyer;
educate his family, keep an assistant and two horses, and pay his
druggist's bill.

JOHN GREAVES (Sheffield).-At the present time we should not advise
you to do any thing to the eye. Probably a cataract may form here-
after, when active treatment will be required. Strange to say, at the
moment of reading your letter, a gentleman, who came from North-
ampton for the purpose of consulting the Editor, related his own case
precisely in your words-the first intimation he had of the sight being
affected was, as in your case, when out shooting; he has now a hard
cataract, which requires an operation.

J. C. (Edmonton).-It is the result of scrofula, and until the boy's general health be re-invigorated, the sore will not heal. Is the joint affected? You may bring him to us if you like, but you must distinctly understand that we do not receive gratuitous patients.

M. A. C. (A Widow).-If you read YEOMAN on COUGH, BRONCHITIS, &c., you will find several valuable hints applicable to your age and chest malady. With regard to the "fat as hard as wood," we suspect it to be a tumour, and as it is so painful, we should advise you to have a medical opinion immediately.

EMMA (Dublin). The gentleman "from Bond Street," now visiting your city, is an imposter. Run away from itinerant Jew quacks as you would run away from a mad bull.

H. J. (Cheltenham).-A well-written "Introduction to Botany" is published by Cox, St. Thomas Street, the author is Mr. Castle, the price

moderate.

R. S. T. (Walsall).-As your infirmity is neither acute nor dangerous, and as you are one of the very many who have notified their intention of personally consulting the Editor during the World's Festival, we will not advise you until that time arrives.

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N. M.-The Editor is not a physic doctor." He would rather his
patients made food their medicine than that they made medicine their
food. Moral medicine, proper diet, exercise, and cleanliness will fre-
quently do more than gallons of draughts and bushels of pills. Cer-
tainly, medicine unassisted by regimen must act injuriously.
JAMES TAYLOR (Penkhull, Stoke-upon-Trent). As you possess

"all we have published," you will find that we have given at least thirty prescriptions for "an opening pill,"-see PURGATIVES in PHARMACOLOGY, Vols. I. & IL The prescription you have sent to us, containing colocynth, scammony, and calomel, would physic a horse.

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FLAT.-You have rightly described yourself. Your letter is rig-ma-role to our dull comprehension.

WILLIAM WATSON.-If you call in Lloyd Square, we will give you a card of admission. Visitors are not admitted on Fridays and Saturdays. IXION.-Were we to lend our Journal to a detail of the infirmities of mind and body induced by vicious habits, intemperance, and "gaiety,"—as some "men of the world" designate vice, folly, and error,-we should increase our circulation several thousands per week-and lose our own character! It is our pride to know that the PEOPLE'S MEDICAL JOURNAL is emphatically a Family periodical. The father places it in the hands of his son; the mother rears and teaches her daughter by its precepts; the pastor-and we own our obligation to the elergy for their patronage-takes it as his guide to relieve the pains and ills of the body. THE DISEASES OF ERROR, which we wrote to supply the information you ask for, can be procured of the bookseller from whom you obtain the journal.

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SHOEMAKER (Walthamstow).-The symptoms you relate are too important for us to prescribe without seeing you, or at least knowing inore about the case than we now do.

CONSTANT SUBSCRIBER (Wellington). We are obliged by your expla nation. We " doubted" because we have so often expressed our dislike to correspondents employing such signatures. Suppose we received twenty letters thus signed: how can the writer of each identify EUSEBIUS (Norwich).-The Editor returns his best thanks for your very our answer with his question?

kind letter. The encouragement of men able to appreciate, and generous enough to acknowledge his labours, is his best reward. HEALTH OF LONDON.-The number of deaths registered last week amounts to 1037. Small pox was fatal in 25 cases, 5 of whom were adults. This disease is rife in the East of London, especially Mile End O Town, and in Whitechapel. Consumption was fatal in 120 cases: other chest-diseases have declined from 275 to 202. The births were in all 1599 children; namely, 815 boys, 784 girls. The mean reading of the thermometer was 45 degrees, which is 8 degrees above the average of the same week in the last ten years! When are we to have a health-giving frost?

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London: Printed by CHARLES ADAMS, at his Printing Office, 8 St. James's Walk, Clerkerwell, for the proprietor, T. H. YEOMAN, Lloyd Square; and pub ished by Gros VICKERS, 28 and 29 Holywell Street, in the parish of St. Clement Danes, Strand

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ALL our readers are, we imagine, familiar with the form of the heart; to those who are not, the accompanying engraving will supply a correct representation.

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The heart is a hollow, muscular body, situated between the two lungs(2, fig.iii) 8 in the lower and fore part of the chest, nearly in the centre, but inclining a little to the left side. Its position is oblique; that is, its broadest part is directed upwards, backwards, and towards the right side; its apex, or point, is directed downwards, forwards, and towards the left, and is immediately opposite to the space between the cartilages of the fifth and sixth ribs. In adults of the ordinary stature, it weighs about a found. It is enclosed in a loose membranous bag, termed the PERICARDIUM (1, fig. iii), which consists of two layers. The outer one, tough and fibrous, is connected at its upper part with the heart and large 7. vessels issuing from it, and at its lower part is attached to the diaphragm, or transverse muscle separating the cavity of the chest from the belly (B, fig. viii). The inner layer is a serous membrane, that secretes or exhales a peculiar bland fluid that facilitates its every beat; and it not only

1. The Trachea, or windpipe.

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2. The right and left Bronchus; the left showing its division into smaller and smaller branches in the lung, and the ultimate termination of the branches in the air-vesicles. 3. The right Auricle of the Heart. 4. The left Auricle.

5. The right Ventricle.

6. The Aorta arising from the left ventricle, the left ventricle in this diagram is concealed by the right.

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11

15 15

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it is reflected over the surface of the heart itself, and closely invests it. It is inflammation of this membrane that constitutes the formidable disease, pericarditis (see No. 22, p.170, Vol. I.)

The heart being a hollow muscle, contains four chambers, or cavities; the two upper, at the base or flat end, are called auricles (3 and 10, fig. viii); the two lower, at the apex, bear the name of ventricles (4 and 11, fig. viii).

The right auricle (3, fig. vii; 3, fig. viii) forms the right and anterior part of the base of the heart. It, as well as the left auricle, has a loose appendage with tooth-like borders, which bear some resemblance to a dog's ear, hence the name auricle. It is a hollow muscular cavity with thin walls, separated on the left side by a thin partition from the left auricle, as shown in fig. 8. In this

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Trunk, or main branch of the pulmonary vein partition we find an oval

on its way to the left auricle of the heart.

The Pulmonary Artery arising from the right 12. The Superior Vena Cava.

ventricle, and dividing into

8. The right and

A SECTION OF THE HEART, showing its several chambers, and the great vessels in connection with them.

1. The Superior Vena Cava. 2. The Inferior Vena Cava.

3. The right Auricle.

4. The right Ventricle.

lines the whole 5. The Septum, or division, between these two

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13. The Inferior Vena Cava. 14. Air-vesicles magnified.

15. Blood-vessels distributed upon them.

FIGURE viii.

depression (centrum ovale), which before birth was open and allowed the two auricles to communicate directly with each other. There are three openings into the right auricle; two of these are the mouths of two large veins; the other is the right auri

7. The Pulmonary Artery arising from the right culo ventricular

[graphic]

ventricle, and dividing

58. Into the right and left Pulmonary Artery for

the corresponding lungs.

9. The four Pulmonary Veins bringing the blood

from the lungs into

10. The left Aurlcle.

11. The left Ventricle.

12. The Aorta arising from the left ventricle, and passing down behind the heart to distribute blood by its divisions and subdivisions, to every part of the body.

opening, or aperture by which the right auricle communicates with the right ventricle.

The left auricle (4, fig. vii; 10, fig. viii) makes up with the right auricle the remainder of the base of the heart. It has the same general appearance and structure as the right auricle, except that it lies to the back and to the left side of the heart. It has five openings into its cavity. Four of these belong to the pulmonary veins (9, fig. viii), which bring blood from the lungs. The other is the left auriculo-ventricular opening, that establishes a free communication between the left auricle and left ventricle.

The right ventricle (5, fig. vii; 4, fig. viii) forms the right half of the lower portion of the heart: it is a triangular cavity with muscular walls, thicker than those of the auricles, and extends from the right auricle to nearly the apex, or point of the heart. The inner surface presents a great number of muscular bands, commonly designated by the name of carnea columnæ, or fleshy pillars, some of which are furnished with delicate tendons or sinews, which are attached to a valve, the nature of which we shall presently describe. There are two openings into the right ventricle; one of these is the auriculo-ventricular opening, formerly noticed, by which it communicates with the right auricle. This remarkable opening, if viewed from the ventricle, is seen to be furnished with a valve, which is a structure of great importance. This is called the tricuspid valve, from its having three points, formed of three triangular folds of the membrane which lines the cavities of the heart, and are attached by their bases to the edge of the auriculo-ventricular orifice, whilst their points hang loose into the cavity of the ventricle. They can fold back freely into this space, and therefore allow the blood to pass readily from the auricle into the ventricle; but they are prevented from folding back into the auricle by the tendons of the carneæ columnæ; and therefore, when any blood attempts to rush from the ventricle to the auricle, they arrest its progress, by stretching across the auriculo-ventricular opening and closing it up. The other opening into the right ventricle is a large blood-vessel going to the lungs, called the pulmonary artery (7, fig. vii; 7, fig. viii), the entrance to which is protected by a set of valves called, from their half-moon shape, the semilunar valves, which act by allowing the blood to pass freely from the ventricle into the artery, but prevent it from regurgitating in the opposite direction.

The left ventricle (11, fig. viii, and in fig. vii it is concealed by the right ventricle, 5) forms the remainder of the heart. Its walls are thicker than those of any other portion of the heart, and extend from the lower part of the left auricle to the apex. Its internal appearance is very similar to that of the right ventricle, being marked by the fleshy columns, and having likewise two openings into the cavity. One of these openings is the left auriculo-ventricular orifice, which, like that of the right, is furnished with a valve, which, from its having only two points, and from a fancied resemblance to a mitre, is called the mitral valve. The other opening is the orifice of the great artery, the aorta (6, fig. vii; 12, fig. viii), by which blood is sent to all parts of the body. This is likewise furnished with three semilunar valves, similar to those which guard the mouth of the pulmonary artery. We have now described, as briefly as may be consistent with intelligibility, the structure of the heart; and we now proceed to detail the manner in which the blood is sucked up by it and pumped out, so as to maintain life in the animal machine.

THE CIRCULATION OF THE BLOOD proceeds in the following manner :-The veins from all parts of the body unite to form the two vena cavæ; the superior (12, fig. vii; 1, fig. viii), the inferior (13,fig.vii; 12, fig.viii), which entering into the right auricle of the heart (3, fig. viii), discharge their contents-the venous blood-contaminated by its traversing through the body, into

that receptacle. By a muscular contraction of the right auricle the blood is pushed into the right ventricle (4, fig. viii), or second chamber, and is prevented from returning partly by the tricuspid valves, and partly by the pressure of blood from behind. The right ventricle being filled, contracts with great force, and discharges its contents into the pulmonary artery (7, fig. vii; 7, fig. viii), and here the blood is again prevented from going back by the semilunar valves. By means of the pulmonary artery, which divides into right and left bronchus (8 and 9, fig. vii), the blood is dispersed throughout the lungs. Here it meets the atmospheric air, and imbibing a portion of the oxygen, or vital principle of the air, which is contained within the lungs, the blood becomes altered in colour and quality; it loses its dark, venous hue, which it had acquired while in circulation; it parts with its carbon, as we described in the last number, and assumes a scarlet tinge, thus becoming true arterial blood, fit for the purposes of nutrition and secretion. From the very minute branches of the pulmonary artery in the Rete Mirabile (or wonderful network) arises another set of vessels, termed the pulmonary veins (10, fig. vii), which receive the blood from the venous vessels spread out on the air-vesicles of the lungs; for the pulmonary artery is functionally a vein, since it contains venous blood, though it is nominally an artery, because it carries blood from the heart; and in like manner the pulmonary veins are functionally arteries, since they contain arterial blood, though they are nominally veins, because they carry blood to the heart. In the Rete Mirabile the junction of the air-vessel with the blood-vessel is accomplished, and the manner in which the two fluids-air and blood-are brought together is well shown in the magnified drawing (14 and 15, fig. viii). The combination of these two sets of vessels-the minute branches of the bronchial tubes and the minute branches of the blood-vessels, in fact, constitute the lungs.

The blood having thus received its vivifying principle from the atmosphere, it is conveyed by innumerable channels-the pulmonary veins, which unite and form one common trunk (11, fig. vii)—into the left auricle (10, fig. viii), by the sudden contraction of which it is propelled into the left ventricle (11, fig. viii), and is here prevented returning by the mitral valve, aided by the continual pressure from behind. From the ventricle it rushes through the great arch of the aorta (6, fig. vii), from whence, by. means of the arteries, it is distributed to every part of the body in a pure state; when, after performing all the duties demanded of it, in the various secretory processes to which it is subjected, it is returned by the veins in a contaminated condition, again to undergo the same passage through the heart, and to receive a similar revivification in the lungs.

It is important to bear in mind that both the sides of the heart fill at the same instant, the two auricles contracting at the same moment, and the two ventricles obeying the same law: thus, at the identical time that the right ventricle is pushing its blood into the pulmonary artery, the left ventricle is propelling its contents into the aorta, by which it will be seen that the auricles and ventricles contract and dilate alternately; the auricles and the arteries acting together, and the same with the ventricles and the veins. It is the contraction of the ventricles that causes the beat of the heart, and which is felt so plainly on the outside of our bodies. It takes place in a male adult, in good health, about once in a second; in females it is rather more frequent. It is greatest, both in males and females, at birth, and diminishes in frequency until we arrive at middle age.

The force with which the ventricles press the blood to push it out of the heart has been variously estimated, but it is quite

impossible to arrive at any correct information; perhaps it may average, in an adult, a force equal to twenty or thirty pounds, or to a force apparently equal, if not superior, to that of the gripe of a very strong man with his fist.

Each ventricle is calculated to contain at least one ounce of blood. The heart contracts four thousand times in one hour, from which it follows that there pass through the heart every hour four thousand ounces, or three hundred and fifty pounds of blood. The whole mass of blood circulating in the system is said to be about twenty-five pounds, so that a quantity equal to this passes through the heart fourteen times in one hour, which is about once in every four minutes.

"Consider," says Paley, "what an affair this is, when we come to very large animals. The aorta of a whale is larger in the bore than the main pipe of some water-works; and the water roaring in its passage through a pipe of that description is inferior, in impetus and velocity, to the blood gushing from a whale's heart."

We have already minutely described the blood; the structure of the arteries and the veins; and the pulse, in Nos. 15, 16, 17, and 18, to which we beg to refer our readers, as a proper appendix to this article.

In our next we shall describe and illustrate the stomach (two engravings), the organs of digestion, and the physiology of diges

tion.

DROPSY.

WHEN the body is is in a state of natural health, the functions of nutrition, secretion, and excretion are performed in a regular and proper manner; but in the performance of these all-important functions various vital organs are employed, and these organs are often liable to undergo changes which not only derange the function over which they preside, but the whole system suffers secondarily.

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The

The following cases illustrate this subject :CASE 1. J S-k.-Dropsy of the lower extremities, of six weeks' duration. The pulse is full and sharp; there is a foul tongue; he has had a cough with expectoration two months, but can draw a deep breath without pain; the urine is scanty and high-coloured, but not coagulable by the ordinary tests; and, lastly, a loud valvular murmur can be distinctly heard. There then is, as far as we can judge, a pure case of disease of the heart; we have no reason to suppose that any other organ is affected. The urine is not coagulable, and its specific gravity is not lowered. There is no ascites, (dropsy of the abdomen,) and the sound of the heart itself marks the disease. cavity of the heart is enlarged, while the orifice through which the blood has to pass retains its natural size, and, consequently, the rushing sound which we hear is produced. We have the same sound produced by another cause, but then the anasarca, and the other symptoms attendant upon it, are not present. The heart may be of its natural size, but the force of the circulation through it may be augmented: here, then, the force of the current is too great for the size of the orifice through which it has to pass, and we have the same blowing sound. We often meet with this in hysterical girls, in whom there is no disease of the heart. In such a case as S-k's, of course, the exciting cause of the disease cannot be removed, but much may be done to alleviate the symptoms; in fact, the anasarca in this case was, for the time being, entirely got rid of by the remedies employed. In the first instance he took a combination of digitalis, squills, and blue pill, which acted very efficaciously as a diuretic; his mouth became sore, and he then left off the pill, and took the bitartrate of potash, and was completely relieved, as far as the anasarca was concerned.

CASE 2. E- C- -n, is also a well-marked case of dropsy from disease of the heart. There was palpitation of the heart, dyspnoea (difficulty in breathing,) rendering it impossible for her to lie down in bed; there is quickness of breathing and pain across the lower part of the chest, especially in the left side. There is some anasarca of the lower extremities, but this is described as having been much greater; and there has been some swelling of the abdomen. Here we have disease of the heart occurring in an elderly female, and, from the pain expressed during life, we might easily imagine that there was disease of the aorta as well; the pain in such cases being often very acute, and not met with in simple enlargement of the heart, that there was disease of the heart was made manifest by the anasarca, which never happens in cases where the aorta alone is diseased, the heart being unaffected. There is another thing worthy of remark in this case, and that is, the history which the patient gave of the subsiding of the swellings; the unhappy patient looking upon the dropsy as the sole disease, and looking upon its disappearance as a most fortunate circumstance, but in truth it is only the precursor of death, which in many cases occurs suddenly, either from effusion into the chest or pericardium.

There are certain causes which produce dropsy without any organic change of parts: for instance, we meet with cases of anasarca (general dropsy) after sudden exposure to cold, and it is not an uncommon thing to see it after scarlet fever; these cases yield readily to treatment; there is no organic change, and, consequently, when a cure is effected it is permanent. These cases depend upon a disordered state of the capillaries supplying the skin; and the immediate cause of the dropsy is the same as it is in the other cases, with the exception of the absence of any organic change of structure. The circulation in the capillaries supplying the skin is for the time impeded, and the loaded circulation is relieved by the effusion of serum. Unfortunately, in most cases, there is some organic change of structure in a vital organ, and, consequently, our treatment can only alleviate the symptoms; we may sometimes remove them for the time, but we cannot cure them, the primary cause remaining, and the disease is therefore always liable to return. Perhaps one of the most common causes of this disease is an affection of the main organ of circulation itself, the heart becomes enlarged; it has not sufficient power to contract upon the fluid contained within its cavities, and conse-nately for these two patients, the disease of the kidneys was comquently becomes an obstacle to the circulation; the return of blood to the right side of the heart is impeded, and the blood is thrown back upon the venous system. It is necessary that something should relieve this, or life could not exist; and to effect this the capillaries throw out fluid to relieve the loaded circulation. Here we see that the dropsy is merely a symptom of a much more formidable disease.

In other two cases, D- D-, and C- B―, we have the same disease. The kidneys in both were large and congested, which is always the case in an early stage of the disease, though afterwards they become atrophied. Unfortu

bined with disease existing in other viscera, rendering the treatment more complicated, and the alleviation of their symptoms more difficult to be achieved. In the treatment of these cases what remedies are we to employ? If we use diuretics we do but add fuel to the flame; we must, therefore, trust principally to purgatives. If the action of the skin can be augmented, and perspiration can be produced to any amount, it is often of great

service; but there is generally much difficulty in producing this effect. The remedies which seem to be most generally used, and often with marked benefit, are the neutral salts, with vegetable acid bases; as the tartrate of potash, or the acetate of potash, in large doses; for instance four drachms of the bitartrate of potash every morning; which in some instances will destroy the coagulable quality of the urine, where the disease has not proceeded to too great an extent.

We have heard from good authority the following account given of the modus operandi of these neutral salts, when they destroy the coagulable quality of the urine;-" An alkaline property of the blood is necessary to hold the particles of albumen in solution; if this be lost, the albumen is drawn off by the kidneys. A neutral salt with a vegetable acid base supplies a larger quantity of alkaline matter to the blood, and prevents the albumen being drawn off by the kidneys, causing it to be held in solution by the blood."

The species of dropsy concerning which we have been hitherto speaking consists in an effusion of serum into the cellular tissue in various parts of the body, called anasarca; but there yet remains another kind, in which the fluid is poured out into various cavities, constituting hydrothorax, (water on the chest see No. 46, page 154, Vol. II,) hydrocephalus, (water on the brain) and ascites, (dropsy of the abdomen,) it is concerning this last form that we wish to make a few remarks. There are two states of the liver which may produce ascites; they differ in this all-important fact materially, that the one will yield to treatment, whereas the other is incurable. We meet with one occurring after an attack of ague; the spleen and liver become affected, and occasionally ascites follows; but this will yield under much the same plan of treatment that is employed during the continuance of the intermittent fever. Bark administered in large doses will remove the affection of the liver and spleen, and having removed the exciting cause the dropsy will disappear, and will not return. Not so where there is an organic change of structure in the liver; there, as in all cases where an organic change has taken place, it is beyond our power to effect a cure; we cannot renovate or restore to their pristine state organs which have already undergone this change; and, therefore, all we can hope for is to alleviate the symptoms and ward off the impending fate as long as possible.

In addition to ascites or an effusion of fluid into the cavity of the peritoneum, we meet with another form of dropsy very much resembling it, as far as outward symptoms are concerned, and this is ovarian dropsy (dropsy of the ovaries-important appendages of the uterus). The fluid here is not effused into the cavity of the peritoneum, but is encysted, being contained within the ovary. This form of dropsy, however, often proceeds to an enormous extent, and in such cases how are we to distinguish it from ascites? In ascites, where the intestines are free, they invariably rise to the surface of the fluid, in whatever position the patient may be placed, and they there give out a resonant sound on percussion. This is not the case in ovarian dropsy, the enlarged ovary rises in front of the intestines, which, from being tied down by the mesentery, are pressed back by the tumour, and, if any resonant sound be given on percussion, it is in the flanks, and there alone, whatever be the position of the patient. The same remark holds good with regard to the nmbilical region, for, how ever much the position be varied, we always meet with a dull sound in that situation. These remarks, of course, only refer to the advanced stage of ovarian dropsy, for, in a more early stage, the situation of the tumour, and the fact that the fluid is not equally diffused throughout the whole abdominal cavity, and but circumscribed in extent, will at once mark the nature of the dis

ease.

Now, with regard to the treatment. The fluid, when it

increases to a great extent (which it generally does,) should be evacuated, and this should be repeated as often as necessary; the intervals between the tappings become shorter, and generally after some length of time the patient dies, completely worn out by the disease. Of late years the operation of removing the diseased ovary has been resorted to, sometimes with success, but often with a fatal result; certainly it is a grave operation, and it behoves the physician to pause and think before recommending it, and the surgeon also previous to performing it.

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HOMEOPATHIC ABSURDITIES.

ARSENIC, which, by its extreme power to change the state of the human system, may become as dangerous in the hands of an ignorant person as it is beneficial in the hands of an educated one, would not have produced such striking cures of cancerous ulcerations about the face, if this metallic oxide did not possess the power of exciting in healthy persons very painful and incurable ulcers, which, according to some, may be malignant and corroding, and according to others may put on a cancerous action."—(Organon). Arsenic, then, according to Hahnemann, produces in a healthy man corroding and malignant ulcerations? Nothing can be more incorrect or more absurd than such a statement. If the author of it had ever studied the effects of arsenic on animals, or its action when administered medicinally to man, he would not have stated fallacies for facts. If arsenic is useful in cases of cancer, it does not cure the disease, and it is not the only remedy which possesses the power it is said to hold. This power cannot arise from a supposed property, inherent in arsenic, of producing malignant and corroding ulcers, because it does not possess such a property. Homoeopathists will say undoubtedly that we do not understand their founder's meaning. Very likely not; still the fact is a simple one; it must be either true or false. What constitutes a malignant and corroding ulcer? Is it possible, from the vague assertions of obscure authors, to draw such formal inductions as the above? Homœopathists, however, do not look so closely into matters. In Hahnemann we find numberless theories founded on facts of just as little value. Thus he tells us that arsenic produces in a healthy man buboes and dyspnoea, and that on this account it cures pestilential buboes and quinsies. We deny these assertions entirely, as being op posed to the true facts. We can easily conceive, however, that. on account of the ignorance which prevails in medical matters, men may be found who really believe such a system.

DR. MASON GOOD mentions the case of a clergyman who became raving mad in consequence of genital irritation. He recovered in six months, and soon after, finding the same symptoms returning which had ushered in the previous attack, and this clergyman, himself, having spontaneously referred his irritation to the right cause, married his servant, and was for upwards of twenty years most happily united. In a confidential statement to the doctor. soon after his marriage, he gave as his reasons for this apparen indiscretion, the necessity of marriage, and the impossibility of being admitted into any respectable family when having jus emerged from a madhouse. His friends, however, thought this marriage only a greater proof of his madness. Now, suppose him to have had a title, or a large fortune, these friends might have goaded him into madness, by a commission, by confinement, and by restraint; but he providentially escaped this, and lived in unusual happiness with his wife and children for upwards of twenty years.

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