29

increased vascular action constitutes inflam-mation. In this case the submucous tissue,the seat of inflammation, becomes changedin structure,—the mucous membrane, theseat of irritation, continuing in its naturalcondition. In the same manner the cellulartissue of the liver may become inflamed andthickened, or any kind of deposition maytake place into it, the lobules at the sametime being in a state of mere irritation oractive congestion, and secreting bile naturalin quality and quantity.

RESEARCHES INTO THE DISEASESOF CHILDREN,

CONDUCTED ON THE

KNOWN PRINCIPLES OF ANATOMY ANDPATHOLOGY.

We intend to publish at intervals, in the Inumbers of the present and ensuing volumes i

of THE LANCET, a series of cases illustra-tive of the most important diseases of chil-dren, observed at the Hôspital des EnfansMalades, in Paris, the only hospital we be-lieve, in Europe, in which children of fromthree to fifteen years of age are received.Our reports of these cases will, we ex-pect, be very acceptable to British practi-tioners, to whom we present them as originalcommunications, drawn up with great care,with a view to recording facts from whichimportant practical rules in the treatmentof the diseases of children may be drawn.In mentioninsr that these cases are expressly

reported for publication in our own columns,we do so simply to prevent any erroneousimpression which may chance to be createdwith regard to the authority of reports of

foreign cases in an English journal, in con-sequence of a habit which has prevailed insome quarters, of extracting hospital casesfrom a Parisian contemporary (the Lancette Francais) without acknowledgment, -- apiracy which has excited much complaintfrom their author in the French journal.

In accordance with our arrangements wecommence the series this week by givingthe following case, to which we take the

opportunity of attaching the name of its

author, a gentleman of extensive acquire-ments and great research in medicine, andwell competent to observe and apply thefacts which anatomy and pathology canbring to bear upon the therapeutic art,

HOSPITAL OF SICK CHILDREN,PARIS.

INFLAMMATORY CROUP.—TRACHEOTOMY.—

CURE OF THE CROUPAL SYMPTOMS.—

DEATH FROM CAPILLARY BRONCHITIS ON

THE NINTH DAY AFTER THE OPERA-

TION.—AUTOPSY.

ALEXANDER GUYOX, a hoy four years of age, was received into the hospital underthe care of M. GUERSENT on the 2nd ofJune, 1835. The parents of this child areboth healthy, but he himself is in generalsubject to ill health : his chest is very nar-row, and the sternum projects slightly for-wards from lateral compression of the chest;the child however does not cough habitu-ally. For the last six or seven days thechild has been affected with the symptomsof common catarrh, to which latterly somefeverish symptoms were added. he wasseen in town, on the morning of the 2nd, bya physician, who did not say any thingabout croup, or scem to suspect the exist-ence of this disease : at five o’clock in the

evening the interne assures me that his

cough was moist, and did not at all presentthe croupy sound; the voice however was alittle harsh and hoarse. The disease de-

clared itself suddenly on the night of the2nd, and at nine o’clock on the morning of

the. 3rd, the little patient presented us withthe following symptoms : ----The face, which is habitually pale, is now

somewhat injected, for the patient has justhad a moderate access of suffocation. Theaccess was soon repeated, and lasted for afew minutes, during which the child is verymuch agitated, tosses about from side toside in the bed, and suffers evidently fromobstructed respiration. The latter, in theintervals of the fits, is laborious, abdominal,and accompanied with forced dilatation ofthe nostrils, fourty-four in the minute : asonorous rale passes in the back of the narcs.The child coughs a little, every now andthen, for a few seconds at a time, but thecough has not the crowing character re-

marked in croup ; he does not speak, wecannot therefore note the character of thevoice. The motion of the child when theaccess of suffocation comes on is very cha-racteristic : he begins to writhe about in thehed, cries, and endeavours to obtain the up-right position, but when taken up and heldat the window, the fit very soon goes off.The crachoir (tin spitting-cup) contains a

quantity of neaily clear-coloured serous

fluid, in which we observed floating a por-tion of white false membrane about threequarters of an inch long by a quarter of aninch broad. On examining the back of thefauces we find a small patch of the samepseudo-membranous concretion covering theleft amygdala. The chest sounds well uponpercussion, we think however there is somelittle matity on the right side above and