854

it may be controlled. The work or the habits that involvEit can be relinquished.The chapter on treatment is one which may be read by

practitioners with advantage. The value of medicines is wellstated, including the right use of digitalis in heart disease,which is a new lesson to be learned in therapeutics. Dr.

Fothergill’s remarks on rest, on proper blood nutrition inheart disease, on the treatment of the sequelse of it, and onthe actions of special medicines, all indicate that, in study-ing the pathology of heart disease, he has earnestly kept inview the best means of mitigating suffering and inconve-nience, and of prolonging life.

SURGICAL INSTRUMENTS AT THE COLLEGEOF SURGEONS.

No. III.

THE old operation of trepanning, and the more moder;one of trephining, are sufficiently illustrated. A set o

"ancient trephining instruments," presented by Sir WLawrence, shows the ordinary form in use during the lascentury, and contains solid trephines, the pin of whiclcould be removed with the key fitted for the purposethe old-fashioned raspatory and lenticular, and the tripocelevator. Several examples of the old trepanning drill.

stocks, both straight and conical, are to be seen, and it Ì1curious that the Americans should have quite recentlyreturned to the conical, in preference to the straight-edged,instrument, for their operations. A trephine with side.levers to press in portions of the ring so as to seize andbring away the piece of bone cut out, is an example of mis-placed ingenuity; and we are not aware that the trephineswith movable guards, to obviate danger to the dura mater,have ever been much employed. One great improvementin modern trephines is the making of openings to relievethe teeth of the dust, and this is shown and claimed forWeiss. Several elevators, lentioulars, and Hey’s saws areshown, besides those in the cases.

It would be curious to learn how many surgeons or in-strument-makers know what "Hoffman’s forceps" are.

Eight pairs of them are here shown, and they appear tohave been designed for the purpose of "nibbling off smallportions of bone of various shapes. Each instrument isdifferent in form, and the whole series resemble more closelyinstruments for embossing leather than surgical appliances.A circular saw, six inches in diameter, and worked by acoiled spring, is fortunately not frequently required insurgery, but there are no fewer than three specimens ofthe kind, each more complicated than its predecessor.Heverman’s bleeding-fleam, with a spring to make theblade protrude, is also happily a thing of the past, and maybe contrasted with a more ancient bleeding instrument usedby the Maltese and shaped like a cross-bow.Various instruments with a rack movement, for tightening

the ligature on a nsevus, are preserved, as are also severalvariously-shaped aneurism-needles. Cupping-glasses, withan exhausting syringe attached, are also shown, and anapparatus for the transfusion of blood. Some ancient andmodern bullet-extractors complete the collection of instru-ments proper.In a separate case is a very meagre collection of splints,

both iron and wooden, of no special interest; and here alsois a model of Mr. Luke’s fracture-bed, in which the frameon which the patient lies is raised by levers, much after themanner of Hooper’s bed, but applied at the head instead ofthe sides. Outside the room, in the passage, is an oldchair intended for the reduction of dislocation, and re-sembling the "Ambi" of Hippocrates, contrived by Dr.Robertson, of Kelso. This was presented by Sir WilliamFergusson, who has also given a series of illustrations ofthe methods of reducing dislocations, which adorn the wallsof the museum.From the list we have given it will be sufficiently evident

that the collection of instruments is far from complete, andthat there is plenty of room for additions. It does not

follow that the Council or the Museum Committee is boundto accept every old or new instrument which may be offeredthem, but with a little care in selection, and with the co-operation of their numerous fellows and members, they canhave no difficulty in bringing together a collection whichwill be worthy of the building in which it is placed.

Foreign Cleanings ..L

_ PHYSIOLOGICAL RESEARCHES ON A NEW POISON : PAHONIM.

AT one of the recent meetings of the Societe de Biologie,MM. Carville and Polaillon made known the results ofvarious researches which they had been carrying on withthe seed of the poison of pahonim, from Gabon. The chiefconclusions arrived at are the following :-The pahonimpoison is extremely violent; one-tenth of a grain of thealcoholic extract is enough to kill a large dog; it producesdeath by stopping the heart’s action ; it first abolishes thecontractility of the muscular fibres of the heart, then thatof other muscles; when put in the pericardium, it arrests theheart more rapidly than when injected in equal quantities;it does not abolish excitability of nerves; it brings on deathwithout seeming to act on the great sympathetic, the en-cephalon, the spinal cord, or the pneumogastric; there isno antagonism between this poison and woorari; it actsless rapidly through gastric absorption than through cuta-neous absorption; it acts more rapidly than digitaline andantiarine, but the final effects are slower in supervening;it stops the heart of the snail, and kills it, which digitalinedoes not; it produces vomiting in the higher animals.ARSENICAL INTOXICATION THROUGH EXTERNAL ABSORPTION.

This case has been under treatment in Dr. Isambert’swards at St. Antoine, and is recorded by him in the ParisL’Union jMecKcce. The patient had been handling cakes ofSchweinfurt’s green, and reducing them to powder. Fourdays after, an eruption broke out on the face and scrotum;in this latter situation the eruption was followed by aneschar. Two months later, intense pain (nocturnal espe-cially) supervened along the limbs and in the joints. Atthe same time disorders of motility and sensibility ap-peared in the limbs, particularly the lower ones, which nowpresent veritable paralysis. Dr. Isambert states that thesesymptoms are due to the local penetrating action ofarsenic, symptoms due to its exit or elimination being espe-cia]]y marked on the mucous membrane. In these cases of

poisoning through external absorption, symptoms of in-ternal poisoning are exceedingly rare.

RADICAL CURE OF FISTULA ANI WITHOUT THE USE OF

THE ENIFB. e .

This proceeding, advocated by Dr. Hute, of America, con-sists in the use of an injection of a solution of iodine inether. The ethereal tincture is more exciting than thealcoholic tincture, and the ether, evaporating rapidly,leaves the walls of the fistula in contact with the pureiodine. There is scarcely any reaction, and the patientneed not stay in bed.

I PURULENT OPHTHALMIA TREATED BY ALCOHOL.

M. Lannelongue, of the Hôpitalla Charite, advocates theuse of alcohol (one-third of alcohol to two-thirds of water)for the treatment of purulent ophthalmia. The injectionsact both by their direct effect and as a wash, and havebeen highly successful in his hands. The proportion ofalcohol may be increased or diminished, according to cases.-France JJIédicale, Dec. 7th, 1872.

NEW MODE OF DILATING THE URETHRA IN CASES OF

STRICTURE.

M. Coze, in the Gazette Hebdomadaire, No. 32, 1872, re-commends a mode of treatment for strictures that mightin some cases possibly be adopted with advantage. It con-sists in the application of hydraulic pressure by means ofa funnel raised to some distance from the floor, and con-nected with the urethra by means of an india-rubber tube.No pain is given, it can be maintained for a considerableperiod, can be stopped in a moment, and, according toM. Coze, a sound can be passed immediately after withgreat ease.