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cated, by making an alteration in supposed ; that they can often be the drains." It is, we believe, truly proved to have been the acthe decided opinion of the more tual causes of fever when this scientific portion of the medical has been attributed to fallacious profession, that the anomalous fe- or imaginary ones ; and that this ver which prevailed to such an poison is probably always the reat alarming extent, about two years cause of the disorders under resince, in the Penitentiary at Mil- view." bank, had its origin in the malaria of the swamps which surround

Mr. Fessenden, the 'able and ingethat edifice : the strongest proof nious Editor of the N. England Farof which was the fact, that the mer, bas invented and obtained a prisoners, on being removed to patent for an apparatus for beating the more salubrious district of the water, cooking, and other economiRegent's Park, speedily became

cal convalescent. Dr. Macculloch

purposes, which is very conve. notices with regret the error

nient and highly useful. We intend committed by professional men in next week to insert his advertisment, mista sing remittent fever for ty- with numerous recommendations. phus. “An error so universal, that we trace it through almost Those persons who have recently every medical work; and so com- subscribed for this paper, can obtain mon, even to this hour, as to be the back numbers, so as to begin coin nitted every day by ninetenths of practitioners, or more,

with the 5th, or present volume, if is one which, while it confuses

desired. the whole history of endemic, as well as of epidemic fevers, has

The tongue is that part of the hualso produced a train of incalcula- man frame by which Physicians know ble evils in the cure ; with even

the diseases of the body, and Philofar deeper and wider evils in the sophers those of the soul.

of husbands is that of business of prevention." As our limits will not, howe- er is abused it degenerates into ty

protection and love ; when this powver, permit us to go more at

ranny. length into the different circum

The prodigal robs his heirs, the stances and localities which Dr. miser himself. Macculloch demonstrates as hav A bad husband is sometimes a ing a very perceptible influence good father, but a bad wife can neon the aggregate amount of hu- ver be a good mother. man disease, we must recommend Vice stings us even in our pleathe work to our readers as well sures, but Virtue consoles us ever worthy their serious attention, in our misfortunes. and conclude with the author's

If universal charity prevailed, this own words :-" To complete this earth would be a heaven, and the discussion, however, as to pur

internal regions a fable. poses of utility, I must repeat different games. One person seems

It happens in conversation as in briefly, what I hope I have pre- to excel, till another does better, and viously proved,—that the sources we then think no more of the first. of malaria are far more widely Many women are the sport of cadiffused than has generally been price, ihe slaves of fashion.

The power


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national, at least one hundred of the most THE MEDICAL RECORDER. respectable medical gentlemen in the

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From these circumstances, it is not deemthe quantity of matter now on hand, be- ed necessary to call in a reinforcement of sides Reviews, Analysis of late foreign names. The Medical Recorder will conpublications, the time of receiving essays tinue to be devoted to the interests of sciis extended till the 10th day of October

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Candidates for the prize essay on the arand calculated to promote the science of ticles of the " Indigenous Materia Medica medicine by their publication, are entitled of the United States, embracing their practo fifty dollars, to be paid in books. tical application,” &c. will please to re

The above being a standing rule, the collect that their dissertations must be de. attention of the profession is particularly livered on or before the first day of Januacalled to it, as being, perhaps, one of the ry, 1828. The premium Hospital Reports best modes of “enlisting the medical ge- will be received at any time most suitable nius and learning of our country,” and of to the authors.--For more particulars conmaking the journal truly National. A cerning the prize essays, see Recorder, number of papers have been published number 39, page 197. under this arrangement, by gentlemen of

The Medical Recorder contains upthe first literary talent in our country; wards of 250 pages, each number. many are also now engaged in writing ex

Terms, Fire Dollars per annum, pressly for this department of the journal. ADDITIONAL ARRANGEMENT. By this, it will be perceived, that premi N. B. Should any Medical or Suryal ums are not only offered for essays on par- information, either in this or any other ticular subjects, but that all contributions country, be promulgated between the reof merit have been, and will continue to gular times of publication of the numbers be liberally paid for.

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Sept 1

Published weekly, by John Cotton, at 184, Washington St. comer of Franklin St.






VOL. 5.

NO, 18.

Observations on the Surgical Pa- physician and the surgeon, strictly

thology of the Larnynx and Tra- so called, more completely lost sight chea, chiefly with a vier to il- of ; and in none is it of so much molustrate the affections of these ment for the physician to derive organs which may require the beneficial guidance from surgery, operation of Bronchotomy; in- or for the measures of the surgeon cluding remarks on Croup, Cy- to be regulated by sound medical nanche Laryngea, Foreign bodies knowledge. in the Windpipe, Wounds, &c.

In the present work, it is the By William HENRY PORTER, principal object of Mr. Porter to A. M. Member of the Royal investigate the pathology of the College of Surgeons in Ireland, larynx and trachea, as their morbid &c. &c. London and Edinburgh, states become the object of surgical 1826.

treatment. In this point of view it The liability of the air passages to possesses great merit, and is entidisease, to injury, or to accident, tled to very considerable commenthe extreme urgency of the symp-dation. The author has evidently toms with which their diseases and studied the pathological changes ininjuries are attended, their rapid cident to the windpipe and its appenprogress and frequent fatility, are dages with great assiduity and micircumstances which invest them nute attention; and though his rewith the highest importance, and searches and observations have been irresistibly demand the attention of more especially directed to the dethe practitioner of the healing art. termination of the circumstances The study of these affections, though demanding surgical management, equally incumbent on the physician he has, nevertheless, added considand on the surgeon, is rendered erably to the mass of useful medimore indispensable to the latter, in cal knowledge, and has procuced a consequence of the frequency with work which cannot fail to be equalwhich his interposition becomes ly useful to the medical practitionnecessary, as a means of saving the er and the surgical operator. life of the patient. It would be Mr. Porter begins with some juidle in the extreme to attempt to dicious observations on the pathaestimate the comparative import- logical changes incident to the laance of physic and surgery in de- ryngeal, tracheal, and bronchial tecting and treating these com- mucous membrane, in the course of plaints. It may be justly remark- which he adverts to the influence of ed, that in no class of diseases is the submucous tissue in causing the distinction between the pure disease, and considers the circum


stances under which the exudation tion of an albuminous membrane of lymph, of blood, of morbid mu- within the larynx or trachea. The cus, or of puriform fluid ulceration, second stage he distinguishes by the and the formation of sloughs, may secretion of lymph ; and the object respectively take place. He then then is to procure for the air an proceeds to the more immediate artificial passage, which may at discussion of his subject, under the once preserve the lungs from contwo general heads of idiopathic af- gestion, and allow repose to the fections of the larynx and trachea, larynx, while the adventitious memand affections of these canals origi- brane is detached and expelled. nating from mechanical injury, or The third stage he considers to be the operation of chemical agents. that in which, from impeded respiUnder the former head he enters ration, the brain becomes loaded minutely into the pathology of croup with unrespired blood, and its funcin all its forms and varieties ; of in- tions are impaired and gradually flammation of the larynx, acute and extinguished. chronic ; of laryngeal consumption ; In applying these distinctions to of sloughing or death of the laryn- the admissibility of the operation geal cartilages ; and the effects of of bronchotomy as a means of savabscesses and tumor compressing ing life, Mr. Porter takes the same the canal and impeding the transit view which Dr. Cheyne does. of the air. Under the head of ac- Though the effusion of lymph, he cidental injuries, he examines the justly remarks, is generally confined effects resulting from swallowing to the larynx, in a number of cases, boiling water, or any of the concen- nevertheless, inflammation trated acids ; those occasioned by "mences in the bronchial cells and the presence of foreign bodies with- proceeds upwards. As there is no in the windpipe ; and the effect of mode therefore of distinguishing acwounds inflicted by accident, or in- curately the original seat of the tention, chiefly in attempts to com- disease, and as an opening made in mit suicide. It would be super- the larynx or trachea cannot facilifluous to follow the steps of Mr. tate the admission of air to the Porter in his attentive discussion of lungs, in cases in which the broneach of these subjects ; for his ob- chial cells are loaded with viscid servations, though judicious, and exuded matter, the operation unentitled to the serious attention of der such circumstances is entirely the pathological reader, cannot be out of the question. In the case of reasonably expected to be always spasmodic croup, the occurrences

One or two topics, there- of which Mr. Porter sees reason to fore, only shall be selected as the admit, (p. 29,) he thinks it ofers subject of remark.

means of resuscitation ; but the Croup.-Acute croup is regard- suddenness with which infants in ed by Mr. Porter as an inflamma- some instances recover, and with tory disease occurring in a particu- which they may be cut off, makes lar structure, and tending, by three it appear doubtful to him how far stages, to a given termination. In surgical interference may be serthe commencement the disease con- viceable. In short, Mr. Porter is sists in incipient intiammation ; and averse to the operation in children, the intention is to subdue morbid and thinks that in cases where action, and to prevent the forma- death seems to take place from


sudden interruption of respiration, Porter, after pointing out the urgent the safest plan is to attempt to in- necessity of the prompt and enerflate the lungs by impelling air, by getic employment of the antiphlomeans of an elastic gum tube, gistic regimen, recommends the through the nostril into the wind- early adoption of the operation, pipe.

wherever the inefficacy of the usual Laryngitis oedematosa.By this remedies and the suddenness of the term Mr. Porter understands that fits of difficult breathing indicate, variety of laryngeal inflammation in that the impediment depends on obwhich the mucous membrane of struction of the airpassages. He the larynx, more especially of the insists, however, on its early perrima glottidis, assumes a swelled, formance, which alone, he contends, glistening, but paleblue appear- can render success probable. If it ance, in consequence of infiltration be delayed till the difficult respiraof the submucous celular tissue. tion by operating on the bronchial The name is not very judicious, as cells and the pulmonary circulation it may lead to the notion that the induces the congestion of asphyxia, reflection thus designated is peculiar and consequent extinction of the and different from all others inci- functions of the brain by the applident to the larynx. In general it cation of unrespired blood, though may be viewed as merely one of the operation may not render the the effects of inflammation of the patient's condition worse, yet its larynx ; and the perfection in which failure under such circumstances it appears, will depend first on the brings discredit on surgery. proximity of the morbid action to Chronic laryngitis. Under this the rima glottidis, and secondly on name Mr. Porter includes “ all the stage which the inflammation those affections of the larynx which bas attained. If indeed Mr. Por- materially impede respiration, but ter's account be intelligible, he ap- which commence so insidiously, and plys the term of laryngitis oedema- proceed so slowly, as often to protosa to ordinary laryngeal inflam- duce incurable disease before the mation, of which however, it is patient's attention is awakened to merely one of the morbid appear- the danger of his condition. This

is perhaps rather vague and defiIt is chiefly in this disease, and in cient in precision ; but, in the subthe case of the effect now mention- sequent observations, the views ed as resulting from it, that the given become somewhat more deoperation of bronchotomy becomes finite. So far as the morbid changes at once a remedial and a necessary are concerned, Mr. Porter gives expedient. Mr. Lawrence may be his reader to understand, that the regarded as the first surgeon who mucous membrane may be thickeninvestigated the circumstances in- ed to such an extent as never to redicating this operation ; and the cover its healthy structure ; that excellent essay of this author in the it may be ulcerated ; that the carSixth Volume of the London Medi- tilages may be degenerated, that is coChirurgical Transactions, may to say, partially conveyed into bony still be referred to as containing the or earthy matter, and undergoing most accurate and useful informa- exfoliation ; or that they may untion on the circumstances which dergo the process of inflammation render bronchotomy necessary. Mr. terminating in mortification. Again,


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