The writings of Dr. H. Holland, Dr. Withering, Parkinson, and Brande were referred to, for the purpose of showing that the properties of digitalis are not generally known. Mr. Turton observed that he had found digitalis useful in subduing the inflammation of ulcers depending on debility; that Dr. Younge obtained his information from Dr. Aikin, and that the botanical writings of Churchill contained a great deal of information on this subject. Mr. Thomas said that in disease of the spongy bones, digitalis was useful but only in allaying inflammatory action; and that, according to his experience, an ointment was as efficacious as a liniment made with honey. Prov. Med. Journal, June 12, 1844, p. 150.

100.-PRESTAT'S ADHESIVE PLASTER.

The following composition is said never to crack, and not to inflame the skin :-Empl. Diachyl. Gum., 400 grs., Purified Rosin, 50 grs., Tereb. Venet., 38 grs., are mixed together at a gentle heat, and then 12 grs. of Gum Mastic, and 12 grs. of Gum Ammoniac incorporated, and the mass spead on linen. In winter it is advisable to add 10 grs. more turpentine, and 12 grs. of Ol. Amygdal.

London and Ed. M. J. of M. S., Oct., 1844, p. 879.

101. THE DIFFERENT CEMENTS TO STUFF DECAYED TEETH.-By Dr. BUCHNER.

1. Ordinary Tooth Cement.-Is generally formed of a very concentrated etherial, or alcoholic solution of gum sandarac, mastic, dammar, colophony, &c., in the proportion of one-third of the solvent to two-thirds of the resins by weight. A very usual formula is: sandarac, twelve parts; mastic, six parts; amber powder, one part, to six parts of ether. This preparation is a balsam of the consistence of copaiba; it readily dries on exposure to the atmosphere, but remains for some time soft and compressible. The mass yields, with alcohol, a milk-white solution, the turbidity depending on the masticine which is precipitated.

2. Gauger's Tooth Balsam (Balsamum Odontalgicum).—Is chiefly in use in St. Petersburg. The recipe is as follows:-Dissolve 3ij of picked mastic in Ziij of absolute alcohol. Pour the solution into a bottle capable of containing two pounds, and add of dried balsam of tolu 3ix. Promote the solution by a gentle heat, and frequently shake the stoppered bottle. When the latter substance is dissolved, place the whole in a warm situation, to allow the undissolved particles to deposit. This balsam is viscid, and forms, when exposed to the air, a firm mass, which is neither acted upon by the saliva nor by other watery liquids. To prevent tooth-ache arising from exposure of the nerve, the decayed tooth should be well dried by means of cotton or blotting-paper, and a piece of cotton or wool imbued with the balsam is to be carefully inserted into the cavity.

3. Vienna Tooth Cement.-Herr V. Wirth, apothecary of Vienna, first conceived the happy idea of mixing with a viscid alcoholic solution of the resins powdered asbestos, which perfectly supplies the place of the pledget of cotton. His preparation is generally sold along with a tincture for cleansing the hollow teeth, and allaying tooth-ache. The latter tincture consists of an alcoholic solution of guaiacum and myrrh with acetic ether. Ostermaier, an apothecary at Munich, analysed this nostrum, and has perfectly succeeded in preparing it, but we are not at liberty to publish his recipe. It will, however, be a sufficient hint to the scientific man to be reminded that powdered West Indian copal gains considerably in solubility in spirit by exposure to moderately warm air, and that pure alcohol, to which a few drops of any essential oil are added, greatly augments its solubility.

4. Ostermaier's Tooth Cement.-The principle of this preparation is the formation of phosphate of lime in the cavity of the hollow tooth. For this purpose anhydrous phosphoric acid must first be formed by burning phosphorus under a large basin, fifty-eight parts of pure unslaked lime in pow.

der, are to be mixed with forty-eight parts of this flocculent anhydrous phosphoric acid, and the necessary quantity is to be pressed into the cavity of the tooth, after the tooth has been well dried; for, if the latter proceeding be not observed, the mass will become heated, and, in expanding, fall out of its place. The application should be quickly effected, for the substance becomes quite hard and useless in the course of one or two minutes. 5. Poudre Metallique.-A new metallic cement has been lately sold as an arcanum in Paris by this name. We have not ourselves seen the preparation, but hear that it is contained in fluid mercury, on removal of which the odour of ammonia is evolved, and the remaining metal forms a hard mass. We presume it to be a triple amalgam of ammonium, silver, and mercury, with an excess of the latter, and believe the ammonium to lose a portion of its hydrogen, which escapes as ammoniacal gas when the quicksilver is removed, whilst a portion of the silver, ammonium, and mercury remains a firm metal in the cavity of the tooth.

Pharm. Trans., July 1, 1844, p. 589.

102.-TREATMENT OF SOME OBSTINATE SKIN DISEASES.-By G. M. DANGERFIELD, M.D., Newport.

[In the South of France, some of the most obstinate cutaneous affections are treated by what is called the "Traitement Arabique." This, however, is chiefly used when the more ordinary methods of treatment have failed. In cases of maculæ syphiliticæ, syphilitical psoriasis, idiopathic chronic eczema and psoriasis, Dr. Dangerfield has seen the treatment singularly successful. The "Traitement Arabique" consists of "pills, an electuary, a decoction, and a particular diet.]

The pills are the following;-Quicksilver, bichloride of mercury, of each half a drachm; senna, pellatory of Spain, agaric, of each one drachm. The bichloride and quicksilver are first rubbed together, the vegetable substances are then reduced to a very fine powder, and all mixed with the mercury, until the globules have disappeared; then made into a mass with honey, and divided into four or six grain pills. The electuary consists ofSarsaparilla root, six ounces: China root, three ounces; dried nut-shells, one ounce; cloves, two drachms. Reduce all to a fine powder, and make an electuary with honey. The decoction :-Sarsaparilla root, two ounces; water, three pints. Boil to a quart, and strain.

The diet, which particularly appears to influence the treatment, consists in the patient confining himself for twenty-five, thirty, or forty days (seldom more) rigorously to the following regimen; avoiding all other substances, he shall eat only cakes, biscuits, and dried fruits, such as nuts, walnuts, figs, almonds, &c. To drink no fluid of any description, except decoction of sarsaparilla.

This severe regimen, however, cannot always be enforced in very debilitated subjects; hence in these extreme cases, a broiled mutton-chop may be allowed once a day, but experience has shown that this has been rarely necessary. The medicines are administered in the following manner :

A pill is given every night and morning, followed by a wine-glassful of the decoction; an hour after the pill a drachm of the electuary, gradually increased to six drachms, is to be taken, the decoction being drank at intervals during the day.

The mode of treatment must vary, of course, according to the age and temperament of the patient, and the intensity and duration of the disease. The practitioner must exercise his own judgment as to augmenting or diminishing the dose of the pills, when to suspend or recommence them; in a word, it is for him to modify but not to diverge more than possible from the rules laid down until the disease is removed.

There is one remark I would make relative to the pills, as the cause of their requiring the constant attention of the practitioner depends upon their producing frequently, sooner or later, salivation. It has been remarked that

this effect commonly depends upon their being recently prepared, and that when they have been made two or three months, such accident rarely takes place. This depends, doubtless, upon the constant contact of the bichloride with the quicksilver and other ingredients; it becomes modified in its chemical condition, and loses more or less its corrosive qualities, and hence is more adapted for its present application.

My sole object in bringing this treatment before the profession is a desire to hear of its merits being put to the test of experience. In the few cases in which I have seen it employed (cases of maculæ syphiliticæ psoriasis, idiopathic chronic eczema psoriasis) it was singularly successful, after the ordinary remedies had failed, and I may remark that it has now stood the test of a considerable number of cases of the most obstinate and inveterate character in the hospitals of Montpelier and Marseilles. The most singular part of it is, that in some cases of syphilitic psoriasis, where mercury pushed to salivation, decoction of the woods, mercurial baths, nitric acid lotions, &c., had been administered without permanent benefit, the employment of the "Traitement Arabique" was successful, and that in the short space of four or five weeks. These are points for reflection, and it will be for experience to determine how far the withdrawal of all fluids from the diet, with the exception of decoction of sarsaparilla, can influence the action of the preparations of mercury, for these cases had a syphilitic origin, and mercury had been given previously a fair trial.

Lancet, July 13, 1844, p. 495.

103.-TREATMENT OF FRACTURES OF THE CLAVICLE-By A. L. Cox, M. D., New-York.

The difficulty of obtaining a perfect control of this fracture, by the different bandages now in use, is very generally admitted by practical surgeons. This, however, is no less certain, than that the great principles on which such control is attempted, are well ascertained and universally admitted. The action of the sternomastoid and great pectoral muscles, holds the sternal fragment in its proper position, while the scapular portion falls with the weight of the arm or by the action of the muscles, and is then drawn inwardly, so that the inner portion overrides the outer, and the position of the shoulder is altered from its natural state, to one more inward, downward, and forward.

The indications of treatment are, therefore, obviously to extend, elevate, and hold back the shoulder. For this purpose surgeons formerly resorted to a figure-of-eight bandage, applied over the back between the shouldersa plan of treatment liable to the objection that it does not meet all the proper indications of the case, and does not insure a perfect restoration of the functions and configuration of the fractured shoulder.

Dessault's bandages have also been generally used, and are designed with reference to the great and acknowledged principles of the case; but it is very generally admitted that these bandages are not as successfully used as is desirable, and many surgeons have consequently returned to the old figure-of-eight bandage in preference to them. Even our schools, if I am correctly informed, teach their abandonment; a fact to be regretted, as they certainly have several decided advantages over the more simple means now generally superseding them.

Of these, the first is the advantage of a direct and perfect extension of the fractured bone, effected by the cushion in the axilla, and the transverse turns of the roller over the arm of the fractured side, round the body, and under the armpit of the sound side. This important point of proper extension is well attained and kept by this part of Dessault's management.

The great defect, which, as far as I have been able to learn, is pretty generally admitted against the bandages in question, exists in the last bandage, the object of which is to retain the fractured shoulder in a sufficiently elevated posture.

Dessault's direction for its application is, to commence with a roller nine yards long, at the axilla of the sound side, to bring it in front of the chest over the shoulder of the fractured side, down behind the arm to the elbow, then to bring it in front of the chest to the point of beginning, then over the back from the axilla to the fractured shoulder, crossing it to the front of the arm, under the elbow, and so obliquely over the back again to the axilla of the sound side, and in this way till the roller is applied.

That this plan should fail in keeping the fractured shoulder and arm in a proper elevation, is, I think, obvious a priori, and unfortunately it is found to be so in practice.

The axilla is below the shoulder of the opposite side, and the bandage, therefore, exerts a direct influence to depress it just in proportion to the strictness of its application. If, indeed, the turns which are made under the elbow of the affected side could be brought over the shoulder of the sound side, thus making the sound shoulder a point d'appui from which to suspend the elbow and arm of the fractured side, there would be some influence exerted towards the end in view. But when we reflect that this turn would support the elbow only by an oblique application, and that the bandage, from its yielding to the weight of the arm, could afford little or no support, thus applied, it needs but a moment's reflection to perceive that the end which the surgeon has in view is completely lost by passing the turns of the roller under the axilla of the unaffected side.

What has been said will, I trust, serve to prepare the reader for the sug gestion which it is the object of this paper to make in the modification of Dessault's bandage.

Instead of making the axilla of the sound side the point of support of the shoulder of the fractured side, I propose that this point of support be sought close to the neck, on the side of the fracture. The roller may start from the sound axilla, pass over the other shoulder down behind the arm and under the elbow, then upward over the fracture, obliquely across the back, and under the axilla of the sound side; thus making a figure-of-eight, by which the elbow will be drawn directly upward, and the point at which the bandage crosses on the shoulder being properly secured by pins, will be retained permanently close to the neck by means of the turns which pass under the sound axilla. This arrangement seems to possess all the properties at which the last bandage of Dessault is aimed, and of which it undoubtedly fails.

But one case has occurred to me whereby I could test the soundness of my reasoning by an appeal to practical results. This happened in an elderly woman, who fell from a chair in attempting to wind the kitchen clock. Dessault's plan failed, after careful and patient repetition; so also did the old figure-of-eight bandage, and several other modifications of them which successively suggested themselves to my mind in the management of her case. I made the application, which I have attempted to describe above, with the best results. It retains the shoulder in its proper position, and the bones in perfect coaptation, and is at the same time comfortable to the patient. It is well to commence by preparing the arm of the affected side with a roller, carefully and accurately applied. This precaution has the double advantage of guarding the arm from the pressure of the turns of the first roller, and also of furnishing the means of fastening the last application to the elbow by means of pins.

If it shall be thought worthy of trial by the profession generally, I believe it will be found to be an improvement; and I therefore feel it to be a duty to make the suggestion, and submit it to the judgment of my medical brethren. No one can be more aware than myself of the very simple nature of the alteration in Dessault's bandage, that I have ventured to propose; but if it should be found on trial to be better adapted to attain the very ends, and to apply the very principles of practice, which Dessault taught, it will doubtless be justly appreciated by the profession.

New-York J. of M. and S. May, 1844, p. 321.

104.-SPINA-BIFIDA.-BY PRESCOTT HEWITT, Esq. Curator of St. George's Patholog. ical Museum

Spina-bifida may, it is well known, be found in any part, either at the anterior or posterior surface, of the vertebro-sacral column; but its common situation is at the posterior part of the lumbo-sacral region.

The existence of this disease is generally explained by an arrest in the developement of the osseous tissue, which, M. Cruveilhier thinks, is, in some cases, the consequence of adhesions having taken place between the integuments and the coverings of the spinal chord, before the cartilaginous tissue of the lamina was formed; by these adhesions the chord is kept out of the canal, and consequently prevents the formation of the laminæ in the corresponding region.

The connexion which generally exists between the chord, or the nerves, and the walls of the sac, is a point of the utmost importance.

Some cases are related, by various authors, in which neither the chord nor the nerves had any connexion with the sac; these parts followed their usual course down the spinal canal; but in by far the greater number of cases that have been placed upon record, the nerves presented some kind of connexion with the sac. Of twenty preparations of spina-bifida, occupying the lumbo-sacral region, which I have examined in various collections, I have found but one in which the nerves were not connected with the sac.

With regard to this connexion of the nerves with the sac, it appears that the two following general rules may be laid down. 1st, if the tumour corresponds to the two or three upper lumbar vertebræ only, the chord itself very rarely deviates from its course, and the posterior spinal nerves are generally the only branches which have any connexion with the sac. 2d, if the tumour occupies partly the lumbar, and partly the sacral region, then, generally, the chord itself, and its nerves, will be found intimately connected with the sac. M. Cruveilhier believes, from his dissections, that this connexion is constant.

Various reasons have been assigned for this connexion of the chord with a tumour lying over the sacrum, and Morgagni enters into a long discussion about this point; but, for his suggestions, I must refer to his work, “De sed. et caus. Morb., Ép. xii." The true explanation is that, in these cases, the disease takes place during the first month of fœtal life, when the chord is situated in the sacral canal.

For a detailed account of the various ways in which both the chord and the nerves have been found connected with the sac, I must refer to Mr. Stafford's Treatise on the Spine.

In by far the greater number of cases the fluid is found in the subarachnoid cellular tissue, the visceral arachnoid being more or less extensively stripped off from the chord and its nerves; in a few cases only the fluid is effused into the cavity of the arachnoid. This difference in the situation of the fluid will, I think, serve to explain some of the varieties which have been observed as the connexions of the chord, or nerves with the sac.

1. If the fluid is effused into the cavity of the arachnoid previous to the formation of any adhesion between the two layers of that membrane, no nerves will, I think, be connected with the sac; for the fluid, thus effused, accumulating at that point where it meets with the least resistance, will project at the back part of the spine, which is deficient, and pushing against the bodies of the vertebræ, the chord, and its nerves, it will serve to keep them in their proper situation.

2. In those cases where the chord and its nerves have been found passing through the cavity of the tumour, the fluid has, I think, been effused into the sub-arachnoid cellular tissue after partial adhesions had formed between the chord, with its nerves, and the two layers of the arachnoid at the posterior part; the membranes having been subsequently made, by the accumulation of the fluid, to project where the least resistance was offered, have