1846 The Lancet  
686 the properties of those proximate constituents which are common to the animal solids and fluids. The protein and gelatinous compounds, the fatty and extractive matters, and the i inorganic constituents, are considered with regard as well to their microscopic as their chemical characteristics; and in these, as in other narrations, Dr. Griffith shows himself to be aware of the importance of combining the use of the microscope with the employment of chemical analysis. Successive sections are
more » ... voted to the blood and other human secretions and excretions. Their physical characters, obvious and microscopic, and, more particularly, their chemical qualities, are detailed; the adventitious ingredients which intrude into their composition are treated as their comparative consequence demands; and directions, as ample as the most searching practitioner can require, are adduced for conducting the qualitative analyses of healthy and diseased fluids. The whole is clearly and tritely written, and the two Parts are provided with four plates, presenting trustworthy delineations of the microscopic appearances described in the text. In short, the Manual is an useful addition to our stock of elementary treatises on chemical physiology and pathology, and will prove of service to those whose professional engagements do not allow them time for perusing the more comprehensive works of Simon and his coadjutors in this department of science. BRITISH MEDICAL JOURNALS. CASES OF POPLITEAL ANEURISM CURED BY COMPRESSION ON THE CARDIAC SIDE OF THE TUMOUR. DR. PORTER records, in the Dublin Journal, two of these cases, and adds to their details some interesting observations. The first case presented nothing unusual; the second occurred in the person of a medical gentleman, and is rendered remarkable by the cure of the disease, occurring after pressure had been removed; the result being attributed to the effects of its previous application. Dr. Porter enters at some length on the advantages of this method of treating aneurism. He shows that much ignorance prevails on the subject, having evidence to show, that by some, compression of the tumour itself has been strangely enough confounded with that applied on the trunk of the artery; by others it has been tried in cases to which it was inapplicable, and in which it could not possibly succeed; and by others it has been improperly and wrongfully employed altogether: errors which our readers are not likely to commit, as the method has been several times described in the pages of THE LANCET. The tedious character of the progress of the treatment he contrasts with that by ligature, and shows, that if the latter has, in this respect, a superiority, the former is infinitely more safe in practice. The inconvenience which is sometimes complained of may be diminished by a diminution of the amount of pressure, and by an alteration in its seat. In indicating the difficulties of the application of a ligature, he directs attention to a point which, though previously noticed, has not been sufficiently dwelt upon. He says,-' " " There is a remarkable condition of an artery which I do not recollect to have seen described, although it must be familiarly known, and doubtless has often been a source of perplexity to every operating surgeon : it is where it forms an abnormal but close adhesion to its adjacent structures, and particularly to its accompanying vein. Every surgeon, in operating, must have observed that it was more difficult to detach from its connexions and to denude an artery in some patients than in others; and the dissection of dead subjects will exhibit the same phenomenon, if carefully sought for. I am wholly uninformed as to its exciting cause, its progress, I and its course; and it would only be a conjecture to attribute it to some species of chronic inflammation rendering the cellular coat of the artery thicker and shorter, and disposing it to contract close adhesions to every surrounding structure. However explained, the result is but too evident in many cases where arteries and veins lie in close juxtaposition, and become so mutually adherent as not to permit of separation even by the knife; or, as I have heard it forcibly expressed by a distinguished anatomist, 11 two possess but one and the same wall." This condition I was formerly in the habit of regarding as existing only between the popliteal artery and vein, where I had heard it spoken of, and seen it demonstrated by anatomists as the natural and ordinary state of the parts ; but some years since I was led to modify that opinion by observing, in the dissection of a case of axillary aneurism, this very adhesion established between the subclavian artery and vein at the only point where the vessels came in contact, and where it must have proved a source of insurmountable embarrassment had an operation been attempted." The author then mentions having observed similar appearances in other cases, and suggests how far this very " state of chronic inflammation" may be a predisposing cause of aneurism, and thus be present in those cases in which it would prove most embarrassing. The most practical point in the communication of Dr. Porter is, that a great amount of pressure is not required; that which he employed was barely capable of communicating an impulse from the artery to the instrument; and this may be gradually increased if found to be necessary. ANALYSIS OF THE LIQUID OF SPINA BIFIDA. Dr. PERCY gives, in the Medical Gazette, the results of his analyses of two specimens of this fluid. "1. Odour precisely similar to that of fresh brain; specific gravity, 1010°; temperature, 590 Fahr.: restored slowly, yet completely, the colour of reddened litmus paper. Russian metropolis, appear to be conducted on the most humane and scientific principles. From the ample tables, it appears that here, as elsewhere, the bachelor is more liable to insanity than the married man; while, at the same time, the proportion of the insane is much greater in the higher and in the educated classes of society, than among shopkeepers and the artizaus and labourers of a still lower grade. More than one half of the cases proved incurable. Of those who recovered, the great majority belonged to the lower classes; and complete returns to health were especially frequent among those individuals who, at an early period of their disorder, had disturbed the public peace, and had been in consequence transferred to the asylum. The richer classes, of course, refrain as long as possible from placing their friends and relatives in such institutions, and continue to hope for a cure under imperfect treatment at home, till recovery becomes almost impossible. A full and lengthy account is given of the entire management of the institution : -' The female lunatics are chiefly busied in the household duties ; while the males, during the summer months, are busily occupied with the hay harvest, and in winter,'when the severity of the season confines them to the house, they manufacture thousands of pill-boxes, and articles in pasteboard, for the supply of the shops of the apothecaries. The more educated are occasionally employed in illuminating manuscripts, and some write to the dictation of others.' "—j5rM& and Foreign Review.
doi:10.1016/s0140-6736(02)70607-7 fatcat:htqng4jd4rcmnejcypkz3i2vou