The eyes assume a sunken appearance, and are surrounded by a dark circle; the nose becomes compressed and pointed, and seems as if it had been pinched up; the lips are shriveled and inelastic; the feet and legs are oedematous and often marbled in appearance; there is great insensiblity of the skin, as indicated by blisters causing little or no pain, and flies lighting upon the face seldom disturbing the infant whether asleep or not; the tongue is dry and coated and often covered with aphtha; deglutition is difficult and more or less painful; the fauces are dry, and the uneasiness caused by it induces iufants frequently to thrust their fingers far back into the mouth, in many instances causing vomitings or retchings; there is generally great impairment of the appetite; and the thirst is constant and most distressingly urgent.

It is now that petechiæ are frequently to be observed, as well as vibices, and sudamina on different parts of the body; these last are most commonly to be seen about the neck, upper part of the thorax and anterior upper portions of the arms. As early as 1819 the writer has been familiar with vibices and sudamina connected with this stage of cholera infantum; and, although he has regarded them as exceedingly unfavorable for recovery, from his earliest observance of them, yet, he has witnessed many recoveries after their appear

ance.

In the third stage, an unusual disposition to drowsness, or actual stupor exists, and generally attended with more or less turning, or rolling of the head on the pillow; a chewing motion of the lower jaw; or sometimes a disposition to open and close the mouth like gaping, but in rapid succession; everted eyes which are generally half open, injected, dry, or tearful, sometimes purulent, occasionally crossed, and nearly always insensible in greater or less degrees to light, or foreign bodies touching them. Convulsive or twitching motions of the muscles, and more or less rigidity of one or more of the extremities, sometimes followed by paralysis, are also attendant symptoms of this stage.

The pulse is feeble, accelerated, or slow, and greatly diminished in volume; there is sighing; often a hoarse or dry short cough; the abdomen is tumid, hot, but lss tender under pressure, and tympanitic; there is thirst, as indicated, when drinks are offered, by eagerness to imbibe them; the extremities are cool or cold, and marbled; the infant constantly tends to slide down in bed, and lies on its back; the discharges from the bowels are variously colored, black, brown, whitish as if pus was discharged, bloody, yellow, pink colored; and more or less thin and foetid, the surface of the body is cool, and dingy; an adhesive clammy moisture frequently bedews the skin; the sudamina and vibices are yet visible but much faded ; and the emaciasion and debility are extreme. Sooner or later death closes the scene, as the symptoms just enumerated indicate a tendency to a fatal issue.-Virginia Med. Journal.

was

THE "TRUE" SPINAL SYSTEM! -The Rev. Mr. Whewell somewhat censured by his own countrymen on the appearance of his celebrated "History of the Inductive Sciences," in 1837, because he was unwilling to treat of the general progress of Physiology as an inductive science. After diligently examining the bold, learned speculations of physiologists, he was unable to discover any system in which the principles and doctrines of the science were so embodied as to command any thing like general assent. The British School of Physiology boasted that it was a practical one, and that it was unincumbered with the fanciful speculations characteristic of their continental brethren. It maintained that the progress of the science in Britain had been strictly inductive, and confidently predicted that time would strengthen the doctrines it had inculcated. But, if recent reports are to be credited, we must believe, also, that the physiologists not only of Great Britain but of the Continent, have alike been guilty of hasty generalizations, and that the habit of confounding the phenomena artificially, with those normally produced, has given rise to the various hypotheses which have prevailed from the earliest period of experimental physiology down to Marshall Hall's "third great era in the history of neurology," or, to "the hand, hatchet, or cane theory" of Dr. Bennet Dowler, of New Olearns. The "True Spinal System," which Dr. Hall regarded as the reward of his years of unremitting labor, of "the sacrifice of hours which should have been devoted to repose," is now mingled with the ruins of exploded systems of former times.

Like the illustrious Harvey, Dr. Marshall Hall was a martyr to his "discovery." For many years he saw his opponents diffusing an unfavorable impression through the profession, relative to the value of his labors, and it was not until 1841, that "full reparation was attempted to be made. This, however, he asserts can never be done, for the delay itself is injustice, and, in the second place, the injury can never be completely remedied. "The stab is not the less injurious because we may afterwards endeavor to heal the wound we have inflicted." Fifteen years, therefore, is the duration the "third great era in the history of neurology." No longer shall the question be agitated, whether the glory of the discovery of the excitomotory system be due to Prochaska or to Dr. Marshall Hall. It matters little whether Sir Charles Bell or Mr. Mayo anticipated the results of their investigations now. To use the language of M. Broca, we must submit to make a tabula rasa of every thing that has been hitherto said on the physiology of the medulla spinalis. No known doctrine or system he declares can live alongside the experiments of M. Brown Sequard, experiments which were performed in the presence of MM. C. Bernard, Bouley, Broca, Giraldes, Goubaux, and Vulpian. From these experiments, it would appear, that the pos

terior chords of the spinal marrow do not transmit sensory impressions to the brain, but that it is finally effected by the gray substance of the cord, and especially its central portion.

In a communication to the editor of the Charleston Medical Journal and Review, dated Paris, Aug. 1st, 1856, and published in the September number of that Journal, Dr. Brown Sequard thus enumerates the most interesting of the facts he has discovered:

"1st. A transversal section of either the two posterior columns of the spinal chord, instead of diminishing or destroying sensibility, is followed by a notable increase of sensibility in almost all the parts of the body which are behind the section.

"2d. All the parts of the encephalon which are situated in the posterior or superior side of this nervous centre resemble the posterior columns of the spinal marrow in this respect-that a state of hyperæsthesia always follows a transverse section upon any of them.

"3d. After a complete transversal section of the whole spinal chord, except the posterior columns, the transmission of sensitive impressions, from almost all the parts behind the section, does not take place,

5th. A longitudinal section on the lumbar enlargement of the spinal cord, sepa rating it in two lateral halves, although it does not inujure the posterior columns, destroys sensibility in the two posterior limbs.

"5th. The gray matter of the spinal chord seems to be deprived of sensibility, although it is a conductor of sensitive impressions. "6th. If the whole spinal cord is left undivided, while the central gray matter, and a good part of the posterior cornua are divided transversely, sensibility is lost almost entirely behind the section."

66

Now, as to my conclusions, here are some of them. You will see how widely they differ from Dr. Dowler's conclusions:

"1st. There are two kinds of sensitive fibres in the posterior columns (these columns are the only sensitive parts of the cord), some going up towards the encephalon (centripetal or ascending fibres), some going in the opposite direction (centrifugal or descending fibres).

"2d. There are also ascending and descending fibres in the pos terior gray cornua, and the lateral columns; but these fibres, although able to transmit sensitive impressions, are deprived of sensibility.

"3d. The ascending and descending fibres of the posterior col umns, and also of the gray cornua, and very likely those of the posterior parts of the lateral columns, come mostly from the posterior roots of the spinal nerves.

"4th. The ascending and descending fibres which have passed from the posterior roots into the posterior columns, the gray cornua,

and very likely also in the lateral columns, soon leave these parts to go into the central gray matter.

"5th. The ascending and descending fibres coming from the posterior roots, decussate in the spinal cord, and they make their decussation, in a great measure, very near their place of entrance into this organ. This conclusion is proved, not only by experiments, but by many pathological cases observed in man.

"6th. The transmission of sensitive impressions through the spinal cord towards the encephalon, takes place in some definite directions, and not, as many German physiologists have thought, in almost every direction.

"7th. There are some transversal fibres in the spinal cord, coming from the posterior roots, which do not seem to transmit sensitive impressions.

"8th. The part through which sensitive impressions are in the last place transmitted to the sensorium (in the encephalon), is the gray matter, and particularly that of the centre of the cord." Western Lancet.

B.

IPECACUANHA IN DYSENTERY.

It is well known that Ipecacuanha was first brought into use as a remedy by the remarkable success which attended its administration in dysentery; and that, for a long while afterwards, its principal use was confined to this disease, and it was considered by many to be by far the most valuable remedy known. By degrees, however, as other and important remedies were introduced, this gradually fell into comparative disuse, and now it is not uncommon to read, in our works on practice and in our medical journals, long lists of remedies for dysentery, without even any mention of this once celebrated article. Our convictions, founded on experience, not unfrequently leads us to the employment of old remedies in preference to new, and thus we have been able, in several instances, to cure this formidable disease by a substitution of the ipecac treatment for other means. under the use of which life had well nigh been despaired of. Many years ago a young man came under our care, after a long and ineffectual course of treatment for dysentery, when nearly all hope of recovery had fled; and nearly every other remedy having been used, under the direction of able physicians, scarcely any resource remained but an experiment with this ancient remedy, which was made, the ipecac being given in very large quantities for several successive days, exclusive of all other medicine, when the disease subsided, and the patient was cured. We have used it frequently

since, with excellent effect, both in substance and decoction; but very recently a patient has recovered under this treatment, whose case is worthy of notice, as showing what large quantities of powdered ipecac the stomach will bear in a confirmed and obstinate case of this disease.

This was a case of several days' continuance, resisting the remedial power of various appliances in common use in this disease. The continuance of the same plan of treatment, or any part of it, seemed to promise little benefit after the experiments already made, and we, therefore determined to make a fair trial of the ipecac. We began by administering one dram of powdered ipecac, which producing no nausea, or other perceptible effect, was followed by another dram in half an hour. Two other one-dram doses were given at intervals of one hour, before vomiting was produced, and then only to a slight extent. Soon afterwards a feculent stool gave the patient temporary relief from the painful tenesmus with which he was suffering. The ipecac was continued in doses of one dram each, prolonging the intervals as the nausea and vomiting indicated, until one ounce had been given. Afterwards, as the stomach had become more and more impressionable, the doses were reduced to half a dram each, with occasional prolongation of the intervals, until a full half-ounce more was given. Then, on account of the greater susceptibility of the stomach to its influence, the doses were further reduced to fifteen grains, which now caused greater nausea than one dram in the beginning. The dysenteric symptoms gradually subsided under this treatment, and the patient recovered. No other medicine was used until after the dysenteric symptoms were relieved.-Memphis Med. Recorder.

NEW-HAMPSHIRE JOURNAL OF MEDICINE.

MANCHESTER, NOVEMBER, 1856.

"LIBERAL SENTIMENTS."-What is meant by "liberal sentiments" in medicine?

This question suggests itself to our mind upon noticing in our exchanges that DR. J. V. C. SMITH, for so many years editor of the Boston Medical and Surgical Journal, has established a new periodical, which he calls the "Medical World," and which is to advocate more liberal sentiments, or as he has it, " a wider range and more liberal sentiments in regard to the various sentiments now prevailing on the subject of medical science."