TO CORRESPONDENTS. NOTICE.-All communications for the Editor must be addressed, pre-paid, to his house, No. 25, LLOYD SQUARE. FIDELIS (Weymouth).-Read YEOMAN ON HEADACHES. THE DICTIONARY can be sent by post: all our publications thus transmitted are protected by envelopes. A BAKER (London).-We must see you, THE EDITOR is at home every day until One o'clock; and on the evenings A SUBSCRIBER (Praed Street, Paddington).-St. Mary's Hospital is not yet of Monday, Wednesday, and Friday, from Seven till Nine. VOLS. I. and II. of the PEOPLE'S MEDICAL JOURNAL 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. H. R. W. (Birmingham).-A fee case. JOHN WILSON (Bradford).-Your description of the state of the breast, and the past and present condition of your wife, is too indefinite. You do not mention her age, whether she is a mother as well as a wife, whether she is now, or has recently been a nurse, nor do you mention the state of her general health. MEDICUS (Preston).—All the modern standard works on Chemistry contain the symbols and "an explanation." Turner's, Thompson's, Graham's, are the best. We have now, on our table, a very useful little book, which will supply the information you seek for-called "The Alphabet of Chemistry," by Mr. Rennie. WILLIAM WARREN (Walworth Road).-If you religiously follow proper medical, dietetical, and moral instructions, your present anxiety need not be of long continuance. A POOR SERVANT GIRL (Northampton).-Take one of the following pills twice a day. Take sulphate of iron, compound aloetic pill, extract of hyosciamus, of each a scruple. Mix, and divide into twelve pills. Also, take tincture of valerian, six drachms; aromatic spirits of ammonia, two drachms; compound tincture of lavender, four drachms. Mix. Dose, a tea spoonful, in a small quantity of water, occasionally. A SUFFERER-CUTANEOUS (Clapham).-Your first letter was simply foolish; your second is both impudent and foolish; the combination is the result of ignorance. R. HERBERT.-When the residence of the invalid is within the same distance as is your's, and when the case is of a like character to your's, we never advise without the necessary advantage of a personal examination of the patient. How often are we to repeat this? ADULTERATED COFFEE.-The Lancet is doing good service by the careful analysis of coffee, and the fearless denunciation of those who deal in an impure article. We were greatly surprised to find amongst the latter the name of a pious, teetotal, "working-man's friend." "Joseph," says the honest and pious grocer of Joe Miller, "Joseph, hast thou watered the tobacco? Hast thou sanded the sugar? Hast thou mixed the chicory and the baked sawdust with the coffee?" "Yea, master, all these things have I done." "Then, Joseph, wash thy hands, and come to prayers." A GAS ENGINEER (Liverpool Road, Islington).-See answer to a POOR CLERK (Horsleydown) in last number. ROBERT JONES (Putney).-First, is possible, but not preferable. Second, by post-office orders, payable at the office in Gray's Inn Road. WILLIAM JOHNSON (Wesleyan Times Office).-Call upon the Editor. JOHN GILES.-You should have looked before you leaped. We cannot make you an exception to our general rule. THOMAS WALLACE (Tillicoultry).-We do not know the plant by the name you mention, which, in all probability, is only its local designation. W. GOODHALL (Millbank).-We are not like an Apothecary who keeps "best rhubarb" and "common rhubarb." When we do give advice, it is always, to the best of our ability, the best! Our best advice to you is, to discontinue the use of all ointments, and dirty, greasy applications; apply a cooling lotion, give the limb rest, and improve the general health. Have you a scrofulous taint? BRANDE'S ENAMEL.-We have received the following letter: "Torrington, May 8, 1851. "Sir,-About twelve months ago, I filled one of my molar teeth, which was very much decayed, with Brande's Enamel; through pressure by mastication it became concave, my gum began to swell, and lately the enamel has fallen out, and instead of the swelling going back it has become much harder and sore, so that I can scarcely bear my fingers to it; my cheek and my gum have now become contracted about half an inch up my gum, as if it was sown together, which gives me much reason to think that the hydragyrum which the enamel contained, left the tin and got into my gums. Will you have the goodness to inform me, through your valuable journal, what steps I had better take? I remain, Sir, your's most respectfully, D. T. C." We fear our correspondent will have to undergo much pain and anxiety; in all probability the bone will exfoliate. We should advise strict attention to the general health; mild but frequent purging; five drops of muriatic acid, to be taken in water twice a day; friction to the face, and eleanliness of the teeth and mouth. open for the reception of patients. AN INVALID (Bryanstone Square).-The most congenial temperature for you will range from 70° to 76° Fahrenheit. A NURSE.-Try a thick gruel made with prepared groats, with the addition of a wine-glass full of old port wine. Foment the breasts with hot water, and rub them with almond oil. A STUDENT (London University).-We have many proof impressions of our illustrations; if you will send to Lloyd Square any morning before one o'clock, we shall have much pleasure in presenting you with a set. FANNY DALE (Harrow).-Read Dr. YEOMAN ON HEADACHES. AN ENTHUSIAST.-Your admirable letter is irrelevant to our Journal. Send it to the Athenæum. A WEAVER (Bethnal Green).-Take ten grains of rhubarb, and five grains of carbonate of soda, every day for a week. THOMAS HALL (Market Place, Hull).-"Mist "-"Motes in the eye,” muscœ volitantes-are, in the majority of cases, the result of a disordered state of the digestive organs. D. N. X.-The loss of the voice may be the result of inflammation of the larynx. Your history is imperfect. A LETTER CARRIER (Bayswater).-Fee "according to the circumstances of the patient." PHILIP QUARLE.-From circumstances that have come within our own observation, we should not wish to incur the responsibility of recommending you to apply to the Orthopedic Hospital. A COFFEE-HOUSE KEEPER (Seymour Street, Somers Town).-We decline defiling our Journal with the personal scandal of the quack. Such sensuality should be Coffined and buried. D. D. (A PLUMBER).-You must call upon the Editor. A WORKMAN (Highbury).-First, Yes-Second, Yes-Third, see answer to ALFRED, in No. 71. MINA MARTIN (Clerkenwell).-First, tell us the cause of the principles; we may then suggest what will "eradicate" them. JOSEPH WALKER (Berwick-on-Tweed).--As you will be in London within so short a period, we decline advising until we see you. R. NAYLAND (Bury St. Edmund's).-Read the Editor's work on Consumption, or the reprint in the first eleven numbers of the second volume of THE PEOPLE'S MEDICAL JOURNAL. FANCHETTE (Bath Street, Leamington).-Take carbonate of potash, eighteen grains; lemon juice, four drachms; distilled water, one ounce. Mix, for a draught to be taken every five or six hours. AN INVALID (Torquay).-Nevill's Arabica Food is by far the best and most economical form in which Lentils can be used, either as an article of wholesome diet, or as a healthy stimulant to the mucous membrane of the stomach and bowels. P. O. N. C. (Hitchen).—We have no faith in tar ointment. We have prescribed it in several similar cases, without one particle of benefit. JAMES (Cross Street, Hatton Garden).-We do not consider that any operation or "cutting " will be required. Call in Lloyd Square any morning before one o'clock. A M. A. H.-If you call upon the Editor, you will obtain his best consideration. GLASSBLOWER (Quay Side, Newcastle). We cannot say what will cause your cheeks to be less pendant and wrinkled; the alteration is the result of your employment. ANTHONY (Darlington).-We believe that consumption is less prevalent in the fens of Lincolnshire and Essex, than in more gravelly soils. If possible, change your residence. HEALTH OF LONDON DURING THE WEEK.-The rate of mortality that now prevails in the metropolitan population, is still higher than from the experience of late years might be expected at the beginning of May. Nevertheless the deaths have declined to 994. The unseasonable coldness of the weather has increased the number of deaths in aged persons -222 having died who were above 60 years. Hooping cough is on the decline, though it numbered last week 57. There were also 5 deaths from croup and 11 from influenza. Consumption was fatal in 145 cases, and water in the head reached the unusual number of 50 deaths. The births of 757 boys and 730 girls-in all, 1487 were registered. London: Printed by JOHN CATCHPOOL, of 35, Great Percy Street, Pentonville, at his Printing Office, Pemberton Row. Gough Square, for the proprietor, T. H. YEOMAN, Lloyd Square; and published by GEORGE VICKERS, 28 & 29, Holywell Street, in the parish of St. Clement Danes, Strand.-Saturday, May 17, 1851. THE muscular system consists of bundles of reddish soft fibres, which of all organs change their volume and form with the greatest facility, and thus produce motion, and occasion the displacement or change of position of the body, or of some of its parts. All muscles possess these characters, whatever may be their difference in form. They may, however, be divided into two principal classes, which are founded on the connexion between their activity and the actions of the intellect. These classes are the voluntary muscles, such as obey the will; and the incoluntary muscles, which do not recognize its power, but act independent of it. The muscles are composed of fasciculi or bundles of fleshy fibres, which result from an aggregration of filaments, called muscular filaments. The fibres and filaments are as long as the fasciculi, so that their length exceeds their other dimensions. The whole muscle, or its smallest filament, is composed of two substances, the muscular substance properly so called, and an envelope of mucous tissue. The latter, which is termed the muscular sheath, surrounds the whole muscle, and afterwards divides into large tubes, which enclose the fasciculi, and again divides anew into other smaller tubes for the fibres and filaments. A popular American writer describes the structure in the following homely and correct lan- A. Platysma myoides. guage. He says, you have probably observed that a piece of lean meat, when boiled, has a thready, fibrous appearance, but there is one thing F. The flexor carpi radialis. about muscles which does not so readily appear after boiling as it does before. A piece of meat, to be boiled, is cut off in such a manner that it G. The palmaris longus. H. The flexor carpi ulnaris. 1. The pectoralis major. K. The obliquus descendens. M. The linea alba. L. The rectus. L N. Poupart's ligament. P. The tensor vaginæ femoris. R. The internal iliac. S. The pectinalis. T. The triceps abductor femoris. V. The vastus externus. Z. The tibialis anticus. [PRICE ONE PENNY. includes several parts of several different muscles; and the whole, in this way, seem like a solid, or nearly solid, mass; whereas, with a very little care, it could be parted out, each muscle by itself, though not so easily after cooking. Such is the case with a piece of beef taken from the leg of the ox; and such would be the case with a piece of flesh taken from the human leg or arm. These separate muscles are connected to each other by means of a fine sort of membrane, called the cellular membrane. Each thread or fibre of every muscle is also connected to each other fibre which is next to it, by the same sort of cellular or filmy membrane. Thus a mass of lean flesh, similar to that which we obtain from the limbs or other parts of animals, consists of smaller bundles of flesh, connected together by the cellular membrane, but not so tightly as to hinder each bundle from moving or sliding about a little among the rest. The muscles receive numerous large blood vessels, which run through them in every direction, and cause them to assume their peculiar red colour. They are generally supplied by several arterial branches, which arise from one adjacent trunk. These vessels do not penetrate into the muscle constantly in one place, and generally they enter nearer the centre than the extremities, and on the inside rather than on the outside. The veins form two systems-the deepseated veins, which accompany the arteries; and the superficial veins, which proceed alone. The nerves of the muscles are large, and are supplied by the nerves proceeding from the cerebral system. Usually the large muscles receive several branches, while the small muscles have only one. MM. Prevost and Dumas have observed, that when a nerve enters a muscle, it appears to ramify very irregularly, unless it discovers a marked tendency to direct its branches perpendicularly to the muscular fibres, although they cut them also at right angles. As the nerve thus ramifies, it enlarges, and its secondary fibres separate, and are distributed exactly as when deprived of their proper covering, or neurilemma. It then resembles a net of fibres, from which other filaments are separated, and enters the muscle perpendicularly to its proper fibres. The forms of the muscles are very different. Usually they are solid or hollow, that is, rolled on themselves. We may therefore say, that of all the organic systems these parts differ the most from each other in size, although otherwise similar in structure. In fact, in no other do we observe a difference like that existing between the almost invisible muscles of the small bones of the ear and the large muscles of the buttocks. In regard to chemical composition, the muscles are formed principally of fibrin; but they contain also albumen, gelatin, osmazome, the phosphate of soda, of ammonia, and of lime; the carbonate of lime, and an uncombined acid, which Berzelieus called the lactic acid. The muscular instruments are active agents in producing the various movements of our body; by their means we are endued with the power of moving from place to place, and of performing every manual exercise or bodily exertion. Not only are they the prime moving powers in locomotion, but speech, singing, and the acts of chewing, swallowing, &c., are performed by muscles; indeed by means of these organs the blood is circulated, the stomach and intestines urge on their contents, and the different conduits of the glands propel their fluids. They are soft, but slightly elastic, and easily torn after death, so that they are but slightly solid; they are, however, distinguished from all other organs by the extraordinary development of their power to change their volume and form, to contract and to extend. In fact, the characteristic property of muscles is contractibility; in whatever position our limbs may repose, it must be muscular contraction that produces their action. Muscular contractibility also is displayed in the amputation of a limb; for immediately the muscles are divided, the two ends contract in opposite directions, having between them a space proportionate to their retraction. This contractibility of muscles constitutes muscular action, and consists in drawing the more moveable towards the most fixed point to which it is connected. Every moveable point in the animal frame is constantly situated between two muscular powers opposed to each other; thus, to employ the familiar and clear explanation of PALEY, every muscle is provided with an adversary. They are like two sawyers in a pit, by an opposite pull; the nature of the muscular fibre being what it is, the purposes of the animal could be answered by no other. And not only the capacity for motion, but the aspect and symmetry of the body, is preserved by the muscles being thus marshalled according to this order; thus the mouth is held in the middle of the face, and its angles kept in a state of exact correspondency, by several muscles drawing against and balancing each other. In hemiplegia (paralysis of one side of the Body), when the muscles on one side of the face are weakened, the muscles on the other side draw the mouth awry. The tendons are a part of the muscle; they are a kind of fibrous cord, conducting the motions of the muscle to the bone, particularly where there is not room for the insertion of the muscular fibres which are necessary for the motion of the joints; they frequently concentrate the whole power of a very large muscle on a small bony surface; indeed, without such a medium of attachment, the articulations would be encumbered in their actions. They are composed of small white fibres, closely united to each other, having a beautiful shining, silvery appearance; they possess very little elasticity or sensibility; they havefew bloodvessels; in fact, none are observed in their ordinary state, nor have nerves or lymphatics been traced into them. The study and the perfect knowledge of the muscular system is essential to the physician and to the surgeon; and we are happy to know that our artists also consider myology a part of their education. Hitherto great and useless difficulties have presented themselves to the student in medicine, and the painter and sculptor, by the very ridiculous names given to the muscles of the human body. Many years ago, the great Abernethy, whose memory will ever be venerated as a benefactor to his race, said, with greater emphasis than elegance, "Now I remember, when I was young, people used to say, O, it's not necessary to study anatomy, taking into consideration all these small muscles; d-'em, they would puzzle anybody.' They used to call them the little muscles with the long names. Now I was pleased to hear that, for it always gave me an opportunity of saying, it would be a great desideratum to have all the muscles named the same, in one way. What's the use of calling a muscle oblique or straight? Does that tell you where it is, or what it does, or anything about it? There are many muscles named after mathematical figures, to which they bear no similitude whatever; but I defy anybody to hear the name of sterno-cleido-mastoideus pronounced, without imagining the muscle; it recognizes the attachment of the muscle, and if you know the attachment, you know the use; and the use is, to bring that which is most moveable to that which is most fixed. What is the use, for instance, of calling one of these muscles digastricus? Really the whole nomenclature of muscles is quite ridiculous. But you must know the muscles if you would be anatomists, and you must be anatomists if you would be surgeons." (To be continued.) THE TREATMENT OF WOUNDS. (Continued from page 155.) POISONED WOUNDS. JOHN HUNTER has defined a poison as a "matter which produces a peculiar mode of irritation, and vital principle in a peculiar manner, even when given in the smallest possible quantity, and this without relation to any known chemical or mechanical powers." From the sting of a nettle to the direful effects arising from the bite of a rabid animal, such distinct phenomena result, that medical aid is necessarily required for their relief. Lice, bugs, and fleas-which, besides their ordinary smart, in some irritable persons, occasionally produce a swelling which, if the bite be on the eyelid, especially of children, will now and then close the eye-are not poisonous; but merely produce inconvenience by the introduction of their sucking organs. Gnat bites occasion a most grievous smarting, and although they are “sucking" insects, yet, according to entomologists, they instil into the wound made with their mouth a poison, the principal use of which is to render the blood more fluid and fit for suction. The mosquito is a bloodthirsty rascal of the same class, but more ferocious, and the wound is still more irritating. Smearing the bitten-part with olive-oil is the best application, Wounds from the sting of the hornet and wasp are sometimes very troublesome, and not altogether unattended with danger in persons of an irritable temperament, and require soothing remedies to prevent the constitutional effects otherwise likely to occur. The agonizing pain which follows the sting of a wasp or bee, is probably, for the time, as great as any to which we are liable. The throbbing is intense, and if the skin be thin, and loosely connected with the parts beneath, a swelling quickly rises; the skin becomes tight, shiny, and almost transparent, as if air or water had been forced beneath it. This swelling comes on very rapidly and spreads very quickly, so that if the eyelid be stung, the eye is quickly closed; or if the lip, it becomes twice its usual size. Several cases are on record in which death has followed the attack of a hive of bees, in which the assault had been made on the chest or throat. The first thing to be done after the infliction of the injury is, to look carefully if any part of the sting has been left in the wound, and if so it should be carefully pulled out with a pair of tweezers. If, however, a portion of the sting has been broken off and left in, and, as too frequently happens, the part has been roughly rubbed, the mischief is increased; all rubbing adds to the pain; the sides of the wound should be gently squeezed, so as, if possible, to push the sting out. The best application to mitigate the effects is composed of one drachm of opium rubbed down in an ounce of sweet oil; with this a piece of lint should be soaked, and applied over the wound, changing it occasionally. If it assumes a very red and angry appearance, and is tender, a cold bread and water poultice will afford relief. Many remedies have been vaunted for their efficacy, and we recently saw a notice that, in some parts of France, rubbing the part with garlic is a common and successful practice; indigo has also been employed. In the absence of other remedies, common sweet oil, which can always be readily obtained, should be tried. If the constitution becomes irritable and inflammatory, a brisk purge should be ordered, and the usual means to reduce fever adopted. turally look for the best authorities upon the treatment of those FRACTURE OF THE STERNUM, OR BREAST BONE. W. M., a middle-aged man, of spare habit, was brought to Guy's Hospital in the afternoon of the 24th of June, and placed in the accident ward. He had received severe injury to the chest, in consequence of falling from a ladder at the same time that he had a sack of flour on his back. The ladder also gave way, and he fell forward, his chest forcibly striking against the ladder. He did not cough up, or vomit any blood, but bled from the nose. Bleeding from the arm was had recourse to, and he was then brought to the Hospital. At the time of admission, there was great swelling and ecchymosis about the sternum, but it was distinctly ascertained that a fracture of the breast bone had taken place, at about the middle of its second portion, the upper part remaining considerably elevated. The patient's respiration was difficult; he was placed in bed, leeches applied to the part, and some aperient medicine The sting of the viper of this country rarely proves fatal to adults, but there are many cases on record of children having fallen victims to the effects of their poisonous bite. The bite, however, is invariably followed in very short time by very severe symptoms, some of which are local, and others general. At the instant of the bite, the bitten part is seized with an acute pain, which rapidly shoots over the whole limb: soon afterwards the wounded part swells and reddens, and very frequently the swell-exhibited. ing is not confined to the circumference of the injury, but spreads extensively, and quickly affects every part of the limb, and even the trunk itself. There is an immediate effect produced on the whole frame; the pulse sinks; the surface of the body is cold and clammy; the countenance is pale and anxious; and the patient is overcome with fear and apprehension, The local inflammation should be soothed by tepid bathing and poultices, and the part anointed with sweet oil; and with respect to the general treatment, it is necessary to rouse the patient by stimulants, as brandy and ammonia, and afterwards to combat the symptoms as they arise by the remedies appropriate for each. The excision of the part has been recommended by many surgeons, who have afterwards applied caustic to the new wound. It is a popular error to suppose that the viper carries with it an antidote for its poisonous bite in the fat contained within its belly. It is commonly considered that the toad is capable of inflicting a poisonous bite-this is incorrect; when, however, they are roughly handled, a peculiar secretion is squirted from the surface, which, according to Dr. Davy, produces sometimes a smarting sensation. 25. The man's breathing is now easy; he states that he found much relief from the lecches. The pulse is 96, and moderate; he has been bled from the arm this morning to the amount of twelve ounces; his bowels are freely open. He is placed on his back with pillows underneath, so that his shoulders are thrown backwards, and the sternum advanced. But the irregularity of the bone still remains; the elevation of the upper, or, we may say, rather the depression of the lower portion, being perceptible to the sight, now that the swelling of the soft parts has subsided. 27. Complains of cough-in other respects, doing well. The same position is maintained; but it is worthy of remark, that he lies with his knees drawn up, in which position he says that he feels most easy. From this time nothing material occurred. On the 2nd of August, he was walking in the Hospital square; he said he felt quite well, his breathing was not at all interrupted. We found, on examining the sternum, that the projection of bone was still distinct. No bandage had been applied. This case is interesting, as an example of fracture of the sternum, unattended by any signs of internal mischief, a circumstance of rare occurrence, considering the violence necessary to the production of a fracture of the bone. The treatment employed, also, is worthy of remark: it is generally directed to pass a roller round the chest, which was not adopted in the present case; indeed, we can scarcely suppose any good likely to have resulted from its use, but can easily conceive it might have In this country there are but few reptiles the bite of which produce fatal effects; but in warmer climates there are many, the poisonous virus of which proves rapidly destructive. The cobra de capella and the rattlesnake are the most fatal of the kind, and in the East Indies many persons annually fall victims to their deadly venom. It is to India, therefore, that we na-been productive of much mischief. POISONING BY NITRIC ACID. BY DR. F. A. B. PUCHELT, PROFESSOR IN THE UNIVERSITY OF HEIDELBERG. Caspar R, a locksmith, aged 52, having long led a life of intemperance and extreme wretchedness, determined on committing suicide, and for this purpose procured two ounces of diluted nitric acid (Scheidewasser), which he swallowed in the afternoon of the 19th of May, 1845, having just previously eaten a portion of cheese. Immediately afterwards he was seized with severe burning pain in the mouth, gullet, and back part of the throat. Vomiting also shortly supervened, and the greater part of the nitric acid swallowed was probably thereby removed from the stomach. After remaining several hours alone, the man came and informed the police of what he had done; whereupon he was at once taken to the hospital and seen by an assistant, who was unable to detect any symptoms showing the recent administration of poison, or any which required immediate attendance. He was, therefore, not admitted, but was removed to prison, where an oily emulsion was administered to him, and where he passed a sleepless night, bitterly repenting his rash act, and tormented by the fear of death. On the afternoon of the following day, the burning pains in his mouth being worse, he was admitted into the hospital, and it was not until the 21st, thirtysix hours after swallowing the poison, that Dr. Puchelt saw him, and that an accurate note of his condition was taken. The mucous lining of the mouth and throat was covered with a white shreddy membrane, which could be readily peeled off; parts were already abraded. A similar appearance was presented by the tongue. The soft palate, and the tonsils, were swollen, painful, and vascular. Externally there were several yellow stains of the cuticle about the mouth, especially upon the upper lip. There was considerable difficulty in swallowing, and fluids only could be taken. Respiration was laborious. There was some tenderness on pressure over the upper part of the belly, though less than might have been expected: the abdomen was rather hard and retracted. The pulse was small and not accelerated; the intellect clear; the bowels acting properly; the urine quite natural; and his general condition was so little deranged that, although there was unequivocal evidence of poisoning by nitric acid, yet there was reason to hope that but little real injury had been inflicted on the stomach. Thirty-six hours having elapsed since the poison was taken, it could not be expected that the ordinary antidotes for nitric acid would be of much service: a few leeches were therefore applied over the abdomen, an oily emulsion administered, and directions given that he should drink plenty of cold water, and rinse out his mouth and gargle his throat with luke-warm water. During the following few days the symptoms varied; occasionally he suffered rather severe pains in the region of the stomach, but these were relieved by the repeated applications of leeches and warm fomentations, and by the internal employment of emulsions and other such remedies. Indeed, after the eighth day, when his mouth and throat had become better, a little appetite returned, and a portion of light food was taken and tolerated. Nevertheless, the patient's strength gradually diminished, his aspect became more unfavourable, his body emaciated, and on the 3rd of June his stomach rejected the food which had been taken: on the 4th a little blood was found mixed with his stools. On the night of the 5th (seventeen days after swallowing the poison), the pains in the stomach became more severe, and were accompanied by great uneasiness and frequent nausea, which shortly terminated in violent vomiting. The vomited matter diffused a highly gangrenous odour, and consisted in part of black fluid blood, and in part of a broad foul-smelling membrane, which when spread out was about a foot in breadth. This membrane was marked with black spots as though burnt, and was perforated with numerous small and large apertures. On closer examination, blood-vessels and their ramifications were distinctly recognized in it: its general structure was fibrous; very little mucous membrane was found on it. Shortly after the vomiting, an evacuation through the bowels took place; a large quantity of black, putrid, and foul-smelling blood was contained in the stools. After this the patient became greatly distressed and exhausted, and talked frequently of his death. His pulse was small and frequent; the pain in the epigastrium more severe, though not much aggravated on pressure. The pain was relieved somewhat by oily emulsions and opium; and the patient was then able to take a little animal broth and milk. The night of the 7th was a sleepless one, and on the 8th the vomiting returned, a quantity of black putrid blood being thrown up: a discharge of the same kind of foul-smelling blood took place also from the bowels. The patient himself emitted such a putrid odour, that no one could remain near him The extremities were cold; the pulse for any length of time. very frequent, small, and feeble; and the eyes dull and lustreless. From time to time the patient became delirious, and talked of his approaching death. The vomiting of bloody matter fre quently recurred. Nevertheless the man continued to live on until the morning of the 10th, when he died about 6 A. M.; having lived, therefore, 23 days after taking the poison, and 76 hours after the discharge of the membrane from the stomach. The body was examined about twenty-four hours after death. When the abdominal cavity was opened, the intestines were seen first, being pushed forwards by the left lobe of the liver, which extended considerably over to the left side. The peritoneum was healthy; no foreign matfer found in its cavity. At the first glance nothing could be seen of the stomach; but upon lifting up the left lobe of the liver, and separating it from the transverse colon to which it was adherent, an open cavity was observed, which occupied the situation of the stomach, and extended from the oesophagus to the duodenum; a finger could be quite readily passed from this cavity into the orifice of the duodenum. The walls of this cavity were formed, in front, by the posterior surface of the liver and transverse colon; below, by the remains of the coats of the stomach; behind, by gangrenous, half-dissolved, and putrid portions of the same coats; on the left, by the spleen and The whole of that another portion of the coats of the stomach. portion of the stomach, therefore, which forms the anterior wall, the lesser curve and the upper part of the posterior wall of the organ, was completely absent. Yet, although a considerable portion of the coats of the stomach was wanting, none of it had passed into the peritoneal cavity, for the free margin of the liver was adherent to the transverse colon; the posterior wall and larger curvature still remained, and the other undestroyed portions of the coats were adherent to the spleen and diaphragm; so that in this way, through the medium of the neighbouring organs, the continuity of the stomach was still preserved. The liver and the transverse arch of the colon were held together by tough, probably old, adhesions, and this union was continued from where the liver formed the anterior wall of the stomach, to the pylorus. The concave surface of the left lobe of the liver, where in contact with the remains of the stomachal cavity, was covered with a dirty, pulpy, blackish-green mass, of a highly foetid odour; its surface was rendered uneven by it. A similar kind of matter was contained in the cavity of the stomach. The peritoneum covering the liver was uninjured; of that of the stomach no traces were found. The liver itself, as well as the gall-bladder, was quite healthy. The portions of stomach near * By reference to the engravings of the abdominal viscera, in Nos. 55 and 59, the reader will be able to follow the author's description. |