CURIOUS CASE OF IRREGULAR LOCOMOTION

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owever, after that has been accomplish-ed, remain weal,:, irritable, and incapableof exertion, advantage may then be do-rived from a judicious application of sti-mulants, such as the vapour of the waterof ammonia or ether, or the applicationof blisters behind the ears, and on thenape of the neck.

OPERATION OF

SYMPHYSEOTOMY,

Performed by Professor PETRUNI, Naples’

M. VERDEROSA, twenty-four years of

age, rachitic, and of a diminutive stature, ’,wishing to marry, was conducted by herparents to M. Galbiati, in order to ascer-tain whether the size of the pelvis per-mitted her to run the chance of becoming amother without risk. She was accordinglyexamined, and the measure of a line ex-tending from the mons veneris to the su-perior spine of the sacrum gave five inchesand a quarter; the surgeon therefore ad- I,vised her not to marry, but his recom- Imendations were neglected, and the womansoon became pregnant. After a period ofnine months, she commenced, on the 31stof May, to feel the first labour pains, at sixo’clock in the evening, and at two the fol-lowing day the membranes were ruptured;the pains now relaxed a little, as is usual,and then returned, but the neck of theuterus did not dilate, and the head of thechild was stopped at the inlet of the pel-vis, which was too narrow to permit itsdescent. The midwife now called up M.Galbiati, who sent for me. ’,Our first care was to endeavour, by

every possible means, to determine theseveral diameters of the pelvis, whichwere found to be as contracted as before

marriage. It now remained to decideon our conduct. Should we wait a little

longer, although the waters had come

away for ten hours, the pains were violent,and the head was arrested at the superiororifice? But what chance was there ofthe case terminating successfully, with a

child at full term, and a sacro-pubic dia-meter of two inches and a quarter ? IHence, regarding the time which hadelapsed, and the excessive smallness ofthe pelvis, we decided upon an operation.,But as to the choice of the peculiar ope-ration which was applicable, the csesareanhad always caused the death of the motherwhen practised amongst us, whereas sym-physeotomy presented many chances ofsaving both mother and child. Besides, inthe case before us, symphyseotomy wascapable of increasing the antero-posterior

diameter by one inch and a half to twoinches and a quarter, and would thereforegive us a superior diameter of three inchesand three quarters, which is sufficient fora natural labour. I therefore performed theoperation, and in a few minutes, althoughthe symphysis was somewhat deviated;but I took fur my guide the softncss ofthe fibro-cartilagc. The completion of thesection was announced hy a loud sound,which clearly indicated the degree of dis-tention in which the inlet of the pelviswas placed. The labour was now aban-doned to the force of nature, as we hadagreed upon; the thighs were merely sup-ported, and it required a separation at thesymphysis pubis of two inches, before thehead began to descend into the superioraperture. The interval was greater to-wards the right side than to the left,whence the passage was there more free.The head acted as a wedge, dilating thepelvis, and forced on by the uterus. Aftersome pains, determined by a single doseof the secale cornutum, we perceived thehead of the child descend into the pelvis,presenting its occiput completely engagedin the interval of the symphysis. At theend of an hour, the labour terminated inthe first position, and a child was born ina state of asphyxia, from which it wassoon recovered; the child has continuedto do well; the head appeared elongated,and had therefore undergone some reduc-tion, but not more considerable than in anatural labour when it is protracted. Itscircumference was thirteen inches, its

greater diameter five, and the biparietaldiameter, measured the next day, gavethree inches and some lines. The incisionmade through the pelvis and soft partsgave disciiarge to a very small quantity ofblood ; the lochia appeared as usual, anda bandage with buckles was fixed roundthe patient’s pelvis. With common dress-

ing the wound was completely cicatrizedin thirty-five days.—Il Filaitre-Sebezio

CURIOUS CASE OF

IRREGULAR LOCOMOTION

CONSEQUENT ON

CEREBRAL INJURY.

1,N a late number of the Filaitre-Sebeziowe find the following curious case ofirregu-lar locomotion resulting from an injury tothe brain. Our readers cannot have forgot-ten the experiments of Magendie and Ro-lando, from which it would seem to followthat there exist four different impulsions

99

in different points of the brain, viz., in thecerebellum, the corpora striata, and on

either side in the two crura cerehri. Thus

when the upper part of the medulla oblon-

gata, or back of the cerebellum, was wound-ed in birds, they exhibited the curious phe-nomenon of endeavouring to fly backwards;if the corpora striata were removed or

injured, forward motion in a direct linewas the consequence. It will be curiousto see how far these experiments, madeupon animals, are confirmed by the au-topsy of the case which we proceed todescribe.

Case.-C. Viola, 26 years of age, of a sanguineous and very excitable tempera-ment, had given himself up from a veryearly period to the pleasures of the table,and to wine in particular. At the age of 11years he was attacked by convulsions,which came on suddenly, either duringsleep or while he was awake, and wereannounced by violent cries and the sus-

pension of the senses. During the fit, thepatient commenced to run forwards withrapidity, neither turning to the right or tothe left, without falling, or being arrestedby any obstacle that was not very difficultto be surmounted. It frequently hap-pened that he was seized with the fit whilegoing up-stairs, when he commenced tomount with rapidity, but always in a rightline. When arrested by no impediment,he continued this pace for a few seconds,and finished after having gone twenty orthirty paces. He now stopped and re-covered his senses ; his face appearedmore animated than usual, and his eyessparkled, but the intellect remained

stupified and confused ; there was no

memory of what had taken place; he

merely remembered to have felt, beforethe attack of convulsion, an aura, a sen-sation of vapour mounting from the feetto the head along the vertebral column,and terminating in the annihilation ofconsciousness. These fits continued, withirregular intervals, during seven years,returning once or twice a-day : after that

period they assumed somewhat of anotherform. Instead of the forward course thepatient threw himself on the ground, andcommenced to roll himself in one directionfor ten or twelve paces length, duringwhich sensation was suspended. The con-stant and regular propensity to roll in onegiven direction, ceased with the access

and the recovery of the intellect. Whenthus attacked he did not cry out as before,but expressed himself in a prolonged kindof howl. Finally, two years ago, the con-vulsions became more prolonged and fre-

’ quent.and again changed their form. The. rotatory movement ceased, and gave placeto the most bizarre distortions ; at presentit is rare that a day passes without a fit,and he has often as many as three or four.It is important to remark, that even

during the intervals of the fit, the patient’sphysical and moral condition is muchaltered, and he is a prey to many nervousaccidents. During sleep he is tormentedby frequent subsultus tcndinum ; he alsofeels a pricking in the spine, accompaniedwith a kind of shriek. IIe is taciturn;‘sombre, and irascible, and his mind is con-! fused by fantastic ideas. The affection has

been rebellious to every kind of treatment,and the physician now contents himselfwith being a simple spectator of thedisease.

THE LANCET.

London, Saturday, Oct. 11, 1834.

" GRINDERS" IN THE DUBLIN COLLEGE.

THE luxury of a new abuse we latelythought to be an impossible indulgenceon the part of the Irish College of Sur-

geons, thoughtlessly imagining that if theschool of that institution even wished it,the example of the voluptuary who offereda reward for some novelty in the exhaust.ed field of physical pleasure must be imi-tated. But the corporation have beaten the

voluptuary, have drained to the lees the cupof official delinquency, and in the " lowest

deep a lower deep" yet found. A vergedoes not limit them. When at the end,they can still go a step farther. The Col-

lege school proves to be a notable excep’ 4tion to those general laws which, in ex-plaining the physiology of similar bodies.,enable us to predict the limits of their

criminality from previous observation oftheir capabilities in crime. In this school,satiety plainly provokes esuriency, and

enjoyment merely excites ingenuity to

produce other means of degrading fruition.Its criminal career incessantly developsnew opportunities of guilty revelry, whichare seized with the utmost indifference to

results, and the most perfect contempt forH 2