PRECAUTIONS AGAINST INTEM PERANCE. their thirst for ardent spirit, should be immediately dismissed from office. This is the least which a so From the account of the prisons in this Commonwealth, lately published by order of the General ber and moral community ought to Court, we extract the following: Jail in Taunton-County of Bristol." It appears that Dr. L the physician of the prison, who has a salary of fifty dollars a year, is in the habit of giving certificates to prisoners to have rum, sometimes to the amount of a pint a day, if they can pay for it. There is a retail store standing on the County land, nons the putih, aad belonging to the keeper, and is rented by him to J. R―, who keeps the retail store; the rum bought by the prisoners is purchased of R." Who is the Sheriff of Bristol County ? The Doctor we know. He deserves to have his name exhibited in letters of gold, for his kindness to the poor prisoners, suffering under the severe regulations of the laws which prohibit the use of ardent spirit in prisons except in cases of sickness. The Court of Sessions must partake of the credit of the Doctor, inasmuch as they have discovered their regard to suffering humanity in selecting him for the office and appointing his salary.-Salem Gaz. This is the first time we have known the physician of a prison to issue his certificates to the prisoners to enable them to buy spirit. What need has the inmate of a jail of rum? on what principles of duty or good morals can a physician or a Court of Sessions, or any other court, permit him to have it? We rejoice to see these facts published. The subject ought to be investigated, and every officer, medical, municipal, or judicial, who is capable of aiding the intemperate in the gratification of be satisfied with. TWO ERRORS.-In the last No. of this paper, p. 90, fifth line from bottom, the word paripatetic should be peripatetic; and in p. 94, line 2, second column, enlarges should be enhances. DICTIONARY. Amaurosis, a disease of the eye, attended with a diminution or loss of sight. It is also called gutta serena. It is attended with no visible injury of the organ. Aneurism, a preternatural or morvessel going from the heart. bid dilatation of an artery, or blood which lessen heat and inflammation; Antiphlogistic remedies are those cooling remedies. Chemosis, inflammation of the conjunctive membrane of the eye, in which the white of the eye is distended with blood and raised above the margin of the transparent cornea. Coagulum, a clot of blood; coagula, plural. Collyrium, an eyewater. which distinguish one disease from Diagnosis, the signs or symptoms another. Diaphragm, the large, strong, muscular expansion, which separates the thorax or chest from the abdomen. certain portions of the intestinal canal. Duodenum and colon are names of Engorgement, from the French, congestion, an undue fulness of the vessels of a part from plethora or ob struction. Epistaxis, a bleeding from the nose. off to bind parts together like a band. Fascia, a tendinous expansion, sent Meninges, the membranes enclosing the brain. Ophthalmia, inflammation of the eye. Sclerotica, the outer coat of the eye, white, dense and tenacious. ADVERTISEMENTS. RETAIL DRUG STORE. ENRY WHITE would inform his H friends and the public, that he has now established himself as a retail druggist, at No. 188, Washington Street, opposite the Marlboro' Hotel, where Physicians and Families may depend on the most strict and personal attention to their orders. No Medicines will be put up unless of the first quality. N. B. Medicines delivered at any hour of the night. GREAT TRUSS MANUFACTORY. J. P. WHITWELL, Druggist, corner of Milk and Kilby Streets, has at his employment one of the first artists and most ingenious mechanics in the United States, for the purpose of manufacturing Trusses. At this great depository may be found every sort of Truss, manufactured either in Europe or America, made in the most elegant style, and warranted to Truss can effect. To medical men it is needless to state the important advantages which arise from having the instrument well adapted to the part to be relieved. Here the patient, if unable to suit himself with those on hand, may have one mad agreeably to the exact measurement of his body. French Elastic Catheters. Just received, from France, a few gross of the most approved Catheters, used by the first physicians and surgeons in the French metropolis; they are sold at a very low rate. Bay Rum. A few dozen bottles of this excellent embrocation in cases of hysterical and nervous affections, &c. improvements, than the heavy, cumbersome, oldfashioned ones.-This foundation of tranquillity and repose,—this illustration of neatness, taste and economy, may be seen at all hours of the day, as above. April 24. JOSEPH KIDDER, 70, Court St., FFERS for sale a full assortment of Drugs and Medicines of the best quality. Confining himself principally to the retail business, every attention will be given to meet the wishes of Physicians and others in the preparation and delivery of medicines. Prescriptions will receive constant personal attention. Rochelle and Soda Powders carefully prepared as above. Also, constantly for sale, Black Currant Wine, prepared by Mr. Fumery. ATHENEUM: OR, SPIRIT OF THE ENGLISH MAGAZINES. FOR JULY 1, 1827, UST published by John Cotton, 194 CONTENTS.-Woman's Love. A Fairy Tale-The Bridal of St. Omer. A TaleThe Smugglers--Kindred Hearts-The Old Warrior's Grave--May-Day-The Grumbling Traveller-London Fashions for May, 1827-Breathings of Spring-A Lion Hunt-The Borderer's Leap-Process of Burnish Gilding-Preparations for a New Voyage of Discovery-Economical mode of Cutting Cauliflowers-Alraschid -Method of Cutting Glass-Extraordinary Murder Mr. Gurney's New Steam Carriage-Waverley-Bleaching StrawDuke de la Rochefoucault-Iron Bridge at Paris-Marking Ink-Compression of Water, &c. NOTTONS & BARNARD have just Also, Whitwell's Original and Genuine C Liquid Opodeldoc. April, 1827. published, A MILITARY JOURNAL ·DURING THE AMERICAN REVOLUTIONARY WAR, from 1775 to 1783: describing interesting events and Transactions of this period; with numerous Historical Facts and Anecdotes, from the Original Manuscript. To which is added an Appendix, containing Biographical Sketches, of several General Officers. By JAMES THACHER, M. D. late Surgeon in the American Army. Second Edition, Revised and Corrected. Published weekly, by John Cotton, at 184, Washington St. corner of Franklin St., ---The price of this paper will vary with the time of payment. If paid on subscribing, or within 3 months after, the price will be 3 dollars per annum; if paid after 3 months but within the year, it will be $ 3,50; but if not paid within the year, it will be 4 dollars. No paper to be discontinued till arrearages are paid.-All communications must be addressed, postpaid, to John G. Coffm.-Advertisements, 1 dollar a square. MEDICAL INTELLIGENCER. JOHN G. COFFIN, EDITOR. THE BEST PART OF THE MEDICAL ART, IS THE ART OF AVOIDING PAIN. VOL. 5. TUESDAY, JULY 10, 1827. ON EXCISION OF PORTIONS OF THE RIBS. Observazioni Chirurgiche, &c.— Surgical Observations. By LouIS CITTADINI, Lecturer on Anatomy and Surgery at the Royal Hospital of Arezzo. On the Resection of the Ribs. Annali Universali di Medicina. Marzo, 1826. AMONG the novel and apparently formidable operations, which have lately been sanctioned by modern surgery, few have excited so much interest at the time they were proposed, and received so little attention afterwards, as that for excision of diseased portions of the ribs, believed to have been first practised by Professor Richerand of Paris, in the year 1818. The circumstances under which the operation was performed in his noted case, were such as tended to create the belief that the operation is in itself attended with very great danger,-with the most formidable, indeed, of all dangers, the death of the patient under the knife of the operator. This appears to have been the reason why his success has encouraged few to imitate his example; for we conceive that many cases must occur in which a similar method of cure would be advisable, and indeed have lately heard of a patient having died, whose life would probably have been saved by the excision of a portion of a rib. No. 8. Such being the state of matters, we think the paper of Cittadini one of great importance to the On the one hand, it profession. shows that the removal of a portion of one or more ribs, even when the pleura is at the same time wounded, is not attended with such urgent danger as a perusal of Richerand's case would lead one to imagine. And on the other, it establishes a claim on the part of the author to originality and to priority in the performance of this operation. The first of Cittadini's cases was published in 1820, in the French Journal Complémentaire, and was read before the Academia del Petrarca d'Arezzo, in January, 1813. The four other cases have been published very lately in the Milan Annals of Medicine. I. The case related in the Journal Complémentaire, is that of a woman who was affected with fistulous ulcers under the left mamma, the consequence of a neglected abscess. The sinuses had been repeatedly laid open, and treated by caustic applications without any improvement. When this patient came under the care of Cittadini, he found by probing the sinuses, that a part of the sternum and the cartilages of the sixth and seventh ribs were denuded. He therefore made an incision round the affected part, and dissected back the integu ments for the purpose of ascertaining the extent of the disease, and treating it in the first instance with the actual cautery. The sternum or breastbone proved to be carious over an extent of two fingerbreadths, and the two cartilages were swelled and perforated at various points for about three inches of their length. The actual cautery having appeared to him the most feasible plan of qure, it was applied on several places, with the view of producing exfoliation. The issue, however, was unsuccessful. The woman had an attack of inflammation of the pleura, caused by the proximity of this membrane to the seat of the cauterizations; a few fragments of bone were exfoliated afterwards; but the fistulous openings remained, and the wound did not cicatrize. In the course of six months the matter had evidently found its way into the cavity of the chest; and in consequence the patient was affected with continual pain, difficult breathing, and excessive emaciation. Cittadini then determined to attempt saving her life by removing the whole of the diseased bone and cartilages. Having removed the whole irregular cicatrix and laid bare the bone, he found a free opening into the chest between the sixth and seventh ribs. He then divided the intercostal muscles, secured both intercostal arteries by means of a curved bluntpointed needle, armed with ligatures, and cut the two diseased ribs on the sternal side of the ligatures. He next applied the crown of a large trephine to the diseased part of the sternum, and finally detached the whole from the pleura by means of a spatula. The subjacent pleu ra, though unhealthy, was allowed to remain, as he considered it unsafe to attempt its removal on account of the proximity of the internal mammary artery. The operation was tedious, and the introduction of air into the cavity of the chest threatened immediate suffocation. The wound was therefore hastily covered up with pledgets of cerate, and secured with an elastic bandage; and stimulants, friction and artificial respiration, were successfully resorted to for rousing the expiring energies of nature. During two months, and till the cicatrization was completed, she continued to suffer from difficult breathing; but after this she recovered rapidly, and she was in the end restored to perfect health. II. A farm servant had been for some time affected with a fungoid tumor, situated over the cartilages of the sixth, seventh, and eighth ribs, and about an inch distant from the ensiform cartilage. It had been repeatedly extirpated by caustics and with the knife, but constantly returned. As it appeared evident to our author, that the ordinary methods of treatment would be fruitless, and as the morbid growth was distinctly incorporated with the cartilages, he proposed the excision of the whole portions of the ribs from which it sprung. An incision being accordingly made round the tumor, a portion of the integuments was removed of the diameter of three inches, some fibres of the rectus and great oblique muscles were next separated, and the whole cartilaginous part of the three above mentioned ribs laid bare. The area of the disease was then found not to exceed two inches. An incision was now made with a strong bluntppointed knife round the base of the tumor, and the knife was turned round and round till the cartilages were divided. The diseased portion was then raised by a strong spatula, and was found to separate from a fungoid mass below, the laceration of which gave rise to great hemorrhage. This was checked by the actual cautery; the cicatrization, though slow, was completed in four months, no unpleasant symptom appeared during this period, and the fungus did not return during the remainder of the patient's life. III. A young man of lively imagination, sanguine temperament, and strong constitution, was taken ill with ataxic fever, and in the height of delirium got possession of a stilette, and tried to stab himself to the heart with it. instrument struck the lower edge The of the left nipple, traversed the left rectus muscle, and grazing the upper edge of the cartilage of the sixth rib, fixed itself finally in the bony substance of this rib. A great deal of blood was lost in consequence. Though the fever was speedily removed, the wound suppurated: and two months afterwards it healed, with a fistulous opening, which led to the injured rib. Incisions and cauterizations were then tried, but without effect. Eleven months after the wound was received, the patient came under the charge of Cittadini, who found the whole cartilage and part of the bone of the sixth rib denuded and rough. He therefore resolved on removing the diseased portion of the rib. On dissecting back the integuments, be found this portion was an inch and a half long. vided the cartilaginous part with He di 123 a bluntpointed knife, and the bony part with a pair of oblique cutting pincers; next tied the chief bleeding arteries, and compressed the smaller branches; and then separated the diseased parts of the rib in the usual manner. The pleura having been perforated in various places during the operation, the breathing became for the moment short and laborious. In a few hours, however, it became easy again; the wound healed in two months; and the man enjoyed ever afterwards the most perfect health, and never had any unpleasant feeling in the region of the wound. IV. A robust athletic man, 50 years of age, was attacked with pleurisy of the right side, which, though it commenced with violence, was speedily checked by progress of convalescence, he felt the proper remedies. During the under the right nipple a firm tumor, painful on pressure, and situated over the cartilage of the sixt rib, near its union with the sternum. slowly to suppuration, and in two This tumor advanced months opened externally, forming a small fistulous sinus, which remained stationary for a year and a half, in spite of frequent attempts to heal it by incisions. Its termination was evidently in a carious portion of the cartilage above mentioned. soon as he determined the nature Cittadini, so of the case, proceeded to remove the disease by excision of the cartilage. The integuments having been removed in the usual way, he found he could not divide the cartilages conveniently with the ordinary knife, as they were unusually deepseated, and sunk as the muscular tissue of the greater it were in adipose substance and |