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the catheter, and this took place ing it up like the mouth of a a considerable time after the oc- purse, and giving it a very uncurrence. . I now speak of ulcer- sightly appearance ; I say it ation, which may be the result of puckers it up, this happens in weakness or undue action. Mr. circular sores. Prosecutions have Hunter fixed his mind a good deal been instituted against surgeons, on an anecdote which a man, not for supposed malpractice; a child,
medical man, reported. I for instance, has become burnt in mean the chaplain of Lord Anson's the neck and face, and the chin voyage. In passing the southern and collar bone come in contact. parts of America, they were The surgeon takes his fee, makes short of provisions, and sickness his bow, and if he did not apprise and scurvy attacked most of the the parties of what would probacrew. The narrative says, that bly happen, he deseryes, I say, in those who had broken bones, to be prosecuted ; another surthe bones became disunited, by geon is called in, and he says, the absorption of callus, and sores o O! I'll soon set this to rights," which had healed, to all appear- so he cuts it, and lets it loose, ance soundly, broke out again : but in a short time the same conwhich shows that newformed parts traction happens again. are not endowed with so much Mr. Earle in several cases cut life as the original compages of away the cicatrix and made an the body. The story, by many elliptical ulcer, and there was no common readers, was looked on contraction. Mr. James, of Exto partake rather of the marvel- eter, followed up this practice, lous; but it is perfectly consist- and put a collar on. I was at ent with the phenomena observed Exeter this last autumn, and saw in disease, and there is no reason a patient at the county hospital to suppose this man reported any- with one of these collars on. thing but what was true ; he was Children, as you know, are not a medical man, and had no sometimes born webfooted, and new or favorite theory to support. also webfingered—and great cauUlcers heal by granulation, and tion is requisite to prevent this the process of granulation is tar- puckering, when operations are dy, as newly formed parts have performed in such cases. less energy of life. In the pro It seems to me, that the tongue cess of skinning, the vessels shoot joins in this manner-a person horizontally. Mr. Hunter called may have a fit of epilepsy, and it skinning; some call it cicatriz- may bite his tongue two thirds ation-now this is not a good term, through. Now, what would you for the word cicatrix means a scar. do? Would you sew it up? No, Does the rete mucosum become certainly not, it would be absurd. reproduced ? Some think not, Monsieur Louis made a little bag for in the ulcers of Africans, the for the tongue-he had a horror new formed skin covering sores of sutures the patient should be is white ; no part of the body is enjoined to keep quiet, and if his
completely reproduced. tongue is not an unruly one, this Say that there was a circular ul- will be attended to. I have told cer, three inches in diameter ; you of the filling up of an ulcer, the skin puckers in healing, draw- which is a very compound dis
ease :--when the granulations are the irritability, and if you ask me carried on healthily, they are what is the best application, I small and of a conical shape, and should say a watery solution of red. I remember when I was opium, and apply it warm ; for young, the patients were always irritable parts do not bear cold kept in a horizontal position-if applications. An irritable tooth, you let the limb hang down the for instance, tortures one most granulations become purple, they horribly, if cold water be applied, have neither the healthy color, but not so with warm water. nor the life of the other granula- This is the way irritable sores tions, differently treated. Now ought to be treated ; by soothing, the deviations in ulcers from a endeavoring to produce tone and healthy state are various, some- tranquillity, as I am accustomed times they discharge merely sa- to express it. I now lay down a nies, often ichor, and not unfre. principle which I would have you quently an acrid ichor oozes from regulate your conduct by in treatthe sore.
You are often obliged ing these sores; I may instance to use an ointment to defend the what happens in irritable ophthalirritable and tender skin from the mia, you first sooth the eye with action of the ichor; you generally tepid water, and then you use a judge of the morbid state of the weak solution of sulphate of zinculcer by the discharge.
O! the patient winces, and dashes The most scientific work on down the cup, and swears he will ulcers I know is that of Sir Eve- not touch it any more-he washes rard Home. I refer you to his it again, and it smarts it is true, book on the subject, for really I but not so much, and he bears it have no adequate powers of de- tolerably on the third application. scription ; if one were to describe You diminish morbid sensibility an ulcer that seems simply weak, the same way as you do natural one would say that it had a pallid sensibility. This is the proper aspect; that the process of gra- surgery of susceptible and morbid nulation went on slowly, and that surfaces in general. Now this the granulations should be flat, requires a reference to principle and not pointed. There seems
There seems to do it properly ; and when a much less vigor in ulcers the fur- surgeon has once got an ulcer to ther they are removed from the bear stimulants, I may say he has source of life, I mean the heart-- got the whip hand of that sore. if, for instance, a man had two Sir Everard Home next describes ulcers, one above the knee, and an indolent sore ; he, in short, deone above the ankle, that above scribes the common ulcerated leg the knee would get well first. admitted into our hospitals. In Sir Everard Home speaks of ir- fact, weakness is the characterritable ulcers; that in this kind istic of an ulcer from the beginthere is surrounding inflammation, ning to the end. The irritable that there is great sensitivity of ulcers are to be soothed, the inthe surface; it is ulceration going dolent are to be stimulated; an on which produces this surround- irritable ulcer will become indoing inflammation ; and it is of un- lent, and an indolent one irritable. equal depths. What is to be I recollect the time when plaster done in this ulcer? O! to sooth of Paris was applied to sores, and
it is astonishing how well it suc- there is in charcoal to correct ceeded with indolent ulcers ; but putrefaction. I once saw the sometimes it was applied to an wonderful effects of charcoal in irritable one, and then the pain this way. Some leeches had died was excessive. After all, no- in a bottle of water, and the wathing can inform a surgeon how he ter stunk most horribly; some is to treat these sores but expe- powdered charcoal was put in the rience—it is tact ; he has been so bottle, and allowed to subside to long accustomed to them, that he the bottom, and the water besays at first sight, I know what came perfectly sweet. will do for this or that description mention also fresh vegetable of sore.
I perceive this, that juices ; these seem to operate on the morbid peculiarities are but the discharges of sores. Carrots the offspring of general indisposi- and turnips are of this quality. I tion from irritability in the system have an aversion to scraping carat large. The most effectual rots and applying them to sores. way of relieving the morbid state I would express their juice and of the ulcer is by tranquilizing mix it with crumbs of bread. the general health; they are more Balsams are applied with good likely to get well by medical effect to some sores.—These baltreatment. I
there is some sams seem to act on sores like thing empirical in the manage- cordials to the stomach. Balment of ulcers ; the applications guire, who wrote on amputations, are so various to sores. I have ordered balsams. The balsam of often said give me the “ Materia Peru is used, but this balsam acts Medica,” and you can scarcely in certain cases as a stimulant. show me a substance which has This is a branch of surgery I not some time or other been ap- would have you by no means to plied to sores. The discharges slight ; but study to the utmost of from sores are also a good indica- your ability, and if you can get a tion of the state of health. The dressing that suits the taste of a bad quality of these discharges sore, O, use it ! But there is may be corrected by the differ- something empirical in this pracent acids in water ; Nitric Acid, tice, and all surgeons know this. Muriatic Acid, Verjuice and wa- A round of applications has been ter, &c. O! there can be no doubt tried, and the last pitched on, that many sores have this tenden- has, perhaps, agreed with it.-cy corrected by acids. Acids Tar is a good application. I reshould be used very weak, in a member once the case of a sore high state of dilution. If you which nothing would cure, and sublime cinnabar, what do you the tar ointment agreed, and convert it into ? Volatile sul- seemed to act like magic. Some phuric acid gas, and an oxyd of years ago there was a medical quicksilver. Sores have been man in this town, who gained fumigated with the carbonic acid great reputation by recommendgas. The fermenting poultice ing and using a flannel roller. with yeast is of this description; Thanks are due to Mr. Baynton, and charcoal fresh powdered has of Bristol, who improved on this been sprinkled over sores. It is practice, and ordered a manyastonishing what great power tailed bandage of sticking plaster. .
Mr. Baynton did not seem to un- sore like arsenic ; but it must be derstand his own practice in its used cautiously. I once dressed full extent. He supposed the an irritable sore with Belladonna, ulcer got well by approximating and next day my patient told me its edges, similar to what is adopt- how tranquil the sore had been, ed in simple wounds. It acts by and I was going to dress it again ; compressing gently the sore, and but he said, “ yesterday a curious keeping down the afflux of fluids thing happened, about an hour afto it when the skin is tender. ter you dressed it, I was blind for The plaster often irritates it, and a time;" so I thought it best not then it will be requisite to use to apply that again. I mention some fine linen over the sore. It this, that you may be cautious in is morbid peculiarities which the selection of what you apply keep up the actions of these irri- to sores. table
A poor wretch When varicose veins are in the showed me a leg with two or neighborhood of ulcers, I should three sinuous, bad, foul sores. prefer a bandage or laced stockHe thought the bone was diseas- ing to dividing them. I think it a ed; but I found, on examination, bad practice so to divide them. that the bone was not diseased. Mr. Brodie used to divide the Sometime after, an abscess form- branches of these veins, but the ed in the tibia. The sores were practice is now pretty well exin the course of the fibula. The ploded; in fact, it has had its day, abscess broke and reduced him; and may hereafter be revived he being much reduced before. again. I take it, there is no very They were unhealthy abscesses, efficient good to be done by this degenerating into sinuses. I wish- practice generally. ed to get him out of the bad air of Now, sores are divided, in surLondon. I resolved to put on gical books, into sloughing sores, Baynton's bandage, and a calico sinuous sores, bleeding sores, &c. roller over it, directing him to Mr. Hunter was led to adopt a wet it with tepid water. I call- practice, in sores attended with ed on him the next day, and he hemorrhage, which seemed to the said his leg had given him no pain profession an absurdity. He apfrom the time I had dressed it till plied stimulants, and the practice six o'clock in the morning. I dis- was very proper; for a stimulant covered the cause. Matter had will prevent hemorrhage, where collected in one of the sinuses. I hemorrhage, is occasioned by laxcut a little hole opposite and let ity of vessels. There is a parout the matter. I sent him out tial sloughing occurs in some of town, and in a fortnight he re- sores, called hospital gangrene ; turned, and was serving in his own but this is a sore I shall have ocshop. Sores are the most active- casion to speak of hereafter. ly absorbing surfaces we know, The breaking out of hospital ganand you should be careful how grene is of rare occurrence. you dress them, that the dressing contains nothing which, if imbibed, NEW METHOD OF PERCUSSION OF will prove injurious. There is no application which so complete Mr. Piorry read a memoir to ly revolutionizes the actions of a the Academy, on this new me
THE FRENCH SCHOOLS.
thod. It consists in striking on a this public suspension of their lasmall circular plate, one line in bors, the noble portico of this fair thickness, made of the pine used temple of Hygeia is disfigured by musical instrument makers, with crucifixes, wax candles, and supported by a bent handle. painted images, and such disBy this means, a stronger sound graceful trumpery. is obtained, the differences of The medical students of Paris which may be perceived even have long been distinguished as a through the clothes. We may body for their liberal opinions in also strike harder, and with a politics and religion ; they form a more sonorous substance than the little republic in the very heart fingers, &c.-Arch. Gen.
of the capital, which has long been looked on with the greatest maa
levolence by Erassinous and his The Influence of the Jesuits on colleagues. Supposing that their Medical Education.
opinions derived strength from The influence of “ The Con- their frequent opportunities of asgregation” on the political institu- sembling together, and from their tions of France has been long since communications with the students discovered and perseveringly pro- of the Ecole de Droit, a proposia tested against by the liberal press tion was introduced into the of that country, unfortunately, Chambre des Deputés, during the hitherto with little effect ; but it past year, for the establishment must not be supposed that the ef- of a certain number of secondary forts of the Jesuits have been schools in the Provinces, for the confined to the cabinet and the purpose not only of preventing the church, or that they prop up ab- great annual accumulation of stusolute monarchy and ecclesiasti- dents in Paris, but that by being cal infallibility from mere love of scattered over the country they gain. It is done rather from an might be brought more within the inherent love of power, a propen- observance and dominion of the sity which has distinguished their priests. How the priests influoperations in all ages. They are ence, the local authorities from perfectly aware that, in order to the highest to the lowest, has retain the influence they now been very ably exposed in the hold, the education of the rising Constitutionnel, and other daily generation must be brought with journals, but which it would be in their grasp, and of no branch too great a digression to recapituof instruction are they more jeal- late here. This scheme was renous than of medicine. Within dered abortive by some of the the last two years more especial- Deputies reminding the Minister ly, great efforts have been made for Education, that the Museums to bring the medical students of at the Jardin des Plantes, and the Paris under something like spirit- Libraries of the Metropolis, colual subordination : the Ecole de lected at an immense expense, Medecine is closed, on an average, would exist to no purpose if the two days in the week, on account youths destined to practise mediof its being the fete of this or that cine were educated in the counSaint; and lest the impious stu- try ; that such students must be dents should forget the cause of kept in a state of comparative ig.