might say hysterical in its character, I ordered the liquor arsenicalis in the dose of three drops three times a day, and the following pills: R. Assafoetida lachrymarum, gr. xii.; Sulphatis Quinine, gr. viij. M. bene ut fiat pil. vi. duæ h. s. s., three nights before the expected attack, and to be taken for three successive nights. At the same time I forwarded to him, with the view of keeping the bowels regular, and also to restore the liver to a healthy condition, a box of pills, prepared with the compound rhubarb pill and the dandelion extract, as made according to Mr. Houlton's formula by Smith, of Brown street, Edgeware road. I am thus particular in specifying, because I know but that one place in London where good Extractum Taraxaci can be obtained.

The means prescribed were attended with success. Still, however, between this period and the latter end of November, 1831, A. B. was troubled at intervals of two months with the suffocating feeling, the retchings and vomitings; the suffocating feelings continuing sometimes day and night. He wrote to me requesting to know whether I thought fit to recommend any other means, as, in his opinion, the phenomena described originated in the removal of the fits. This idea I appreciated; and, looking, as I did, on these symptoms as indicative of the attempts of the vital powers to relieve the system from the affection of the brain, I considered it my duty to recommend the introduction of an issue, as a means by which the diseased action might be effectually removed from the brain.

On March the 23d, 1832, I received a letter from A. B., in which he stated that the insertion of the issue had been attended with the desired effect.

In the summer of 1832, A. B. went a journey, which still further promoted his cure. He is now entirely free from fits.

It will be observed that I did not order the friction on the back of the head until I had tried and used the liniment on the spine. The reason is, because I find the friction on the spine relieves cerebral congestion; and, this being removed, I then desired to apply the tonic application, the solution of the alcoholic extract of nux vomica.

Such is the case of epilepsy to which the Society has been kind enough to listen.

Before concluding, it may be proper to make one or two observations. The first is, that length of time is not to be our index as to the curability of epilepsy: this patient had been afflicted with the disease for twenty years. The second is, that marriage did not remove the epilepsy, as it often does in persons of a full habit; the seminal evacuations relieving the cerebellum. The third is, that in cases of epilepsy attended with severe dyspeptic symptoms, a cure is more likely than in those cases not so attended. The fourth is, the peculiar modification the disease assumed. The fifth is, the benefit of the issue.

HOPITAL BEAUJON.

Case of Fungus in the Bladder, reported by Dr. NICOD, Surgeon in Chief of the Hôpital Beaujon.

M. FASQUEL, Sixty-four years of age, a large and robust man, and of a sanguine temperament, who had travelled much and ridden hard on horseback, had for many years been troubled with piles. Finding himself one day more inconvenienced with the hemorrhoidal tumors than usual, he had recourse to a cold hip-bath, from which he experienced great relief: in fact, the piles disappeared; but for several years afterwards he was occasionally afflicted with slight hæmaturia. This new symptom recurred from time to time, and was aggravated whenever he travelled over paved roads or journeyed on horseback. At the beginning of the year 1826, the affection had so much increased that he could not pursue his accustomed journeys, even for a day, without losing a considerable quantity of blood, which, from its increase in quantity, became more and more alarming.

On the 19th of December, he consulted M. NICOD, and informed him that, notwithstanding every precaution in travelling over the unpaved parts of the roads, he had, on his way to him, passed about two cupfuls of blood from the bladder; that he suffered with continual pain at the glans penis; that his urine was at times clear, at others of a dark red hue, and occasionally with a mucous sediment: sometimes it passed freely, and at others with difficulty.

The bladder was examined by the catheter, which was introduced with tolerable ease, and brought away small fibrinous fragments; and, on repeating the introduction with a silver instrument, which was arrested in its progress at about two inches from the neck of the bladder, several fleshy and membranous shreds came away; and, when he passed his urine, it was at first mixed with blood, but subsequently became limpid.

On the morrow, the exploration was renewed with the same instruments, which brought away still more debris; and the patient passed a little blood during the afternoon. On the third day, he passed water more easily and frequently than heretofore, which encouraged him to persevere in the plan of treatment proposed.

Very frequently during the current week, the urethra became partially clogged up with fragments of a fungous or fleshy matter, which, according to the degree of force employed, were detached in larger or smaller shreds from the mass against which the instrument was pressed; and which, when the bladder was emptied of water, seemed to be about the size of the closed fist, and nearly to fill the whole of the vesical cavity. The softness of the tumor, which the examination rendered evident, considered along with the absence of sabulous deposits in the urine, led M. NICOD to determine this extraordinary malady was not complicated with stone. in the bladder, and that it consisted of a fungus only.

Encouraged by the visible improvement of the patient's health,

and the readiness with which the hemorrhage disappeared, after having passed the catheter four or five times, the operation was repeated twice a day, or more, according to circumstances.

Frequently portions of transparent membrane came away, having a resemblance to fragments of nasal polypi; one of which, when floated in water, was something of the shape of the blossom of a convolvulus, and at least two inches across.

Every day the facility of introducing and moving the instrument in the bladder increased, so that subsequent catheterism proved that no stone existed in the viscus, but that the diagnosis had been correct; the tumor consisting of a fungus only, which was attached on the right side of the bas fond of the bladder. The more the fungus was destroyed, the more solid did the remaining part become; and, the more the eyes of the instrument were pressed against it, the more pure blood was voided. The bladder, however, had lost much of the morbid sensibility it exhibited during the early stages of the treatment: this led to the frictions on the tumor being increased, and which terminated by the entire destruction even of the pedicle, which was about eighteen lines in diameter from before backwards. The diseased spot gradually shrunk, and at last ceased to yield any more blood to reiterated frictions by the catheter.

The patient's appetite improved, and week after week his strength increased, and, at the end of about six weeks, he was enabled to ride round Boulogne wood, in a carriage, without passing a drop of blood; and, some days after, he went to Versailles and back, only stopping there an hour, without suffering any hemorrhage. In seven weeks he was entirely cured, and remained well until the year 1831, when he died, at the age of sixty-nine, of apoplexy, attended with a chronic disease of the liver.

This case has proved, as it were, almost by chance, the practicability of what BICHAT thought scarcely possible, viz. the cure of fungus in the bladder; because, as he says, it is so difficult to arrive at any certain diagnosis of these lamentable diseases; and, consequently, to institute any efficacious means of cure; but this case shows that both are possible, because both were done.—Gazette Medicale.

HOPITAL DE SAINT LOUIS.

Injury of the First Pair of Nerves, followed by Loss of Smell. AMONG several cases of gunshot wounds admitted into the Hôpital de Saint-Louis, reports of which have been made by M. VOISIN (interne de l'hôpital,) the following is physiologically interesting:

In this case, the ball had passed through both orbits in the plane of the root of the nose, destroying the two eyeballs and the olfactory nerves. The sense of smell is entirely lost. Vinegar, strong ammonia, and so forth, have been employed without any effect to

produce their ordinary results. This case is reported for the benefit of those modern physiologists who would dispossess the olfactory nerves (the first pair) of their ancient privileges, for the special aggrandisement of the Trigemini.-Ibid.

COLLECTANEA.

Floriferis ut apes in saltibus omnia libant,
Omnia nos, itidem, depascimur aurea dicta.

PATHOLOGY.

Curious Account of Phthisis caused by Mental Depression. AMONG the occasional causes of phthisis, I know of none of more assured operation than the depressing passions, particularly if strong and of long continuance; and it is worthy of remark, that it is the same cause which seems to contribute most to the development of cancers, and all the other accidental productions which are not analogous to any of the natural tissues. This is, perhaps, the only cause of the greater frequency of consumption in large cities. In these, the single circumstance of the inhabitants having more numerous relations with one another, is in itself a cause of more frequent and deeper vexation; while the greater prevalence of immorality of every kind is a constant source of disappointment and misery, which no kind of consolation, and not even time itself, can effectually remove. I had under my own eyes, during a period of ten years, a striking example of the effect of the depressing passions in prodncing phthisis; in the case of a religious association of women of recent foundation, and which never received from the ecclesiastical authorities any other than a provisional toleration, on account of the extreme severity of its rules. The diet of these persons was certainly very austere, yet it was by no means beyond what nature could bear. But the ascetic spirit which regulated their minds was such as to give rise to consequences no less serious than surprising: not only was the attention of these women habitually fixed on the most terrible truths of religion, but it was the constant practice to try them by every kind of contrariety and opposition, in order to bring them as soon as possible to an entire renouncement of their own proper will. The consequences of this discipline were the same in all after being one or two months in the establishment, the catamenia became suppressed, and in the course of one or two months thereafter phthisis declared itself! As no vow was taken in this society, I endeavoured to prevail upon the patients to leave the house as soon as the consumptive symptoms began to appear, and almost all those who followed my advice were cured, although some of them exhibited well-marked indications of the disease. During the ten years that I was physician of this association, I witnessed its entire renovation two or three different times, owing to the entire loss of all its members, with the exception of a small number, consisting chiefly of the superior, the gatekeeper, and the sisters who had the charge of the garden, kitchen, and infirmary. It will be observed that these individuals were those who had the most constant distractions from their religious tasks, and that they also went out pretty often into the city, on business connected with the establishment. In like manner, in other situations it has appeared to me that almost all those who became phthisical, without being constitutionally predisposed to the disease, might attribute the origin of their complaint to grief, either very deep or of long continuance. -FORBES' Translation of LAENNEC on Diseases of the Chest.

A parallel instance of phthisis being caused, or its latent causes being aroused, by violent depressing passions, will be in the recollection of all as occurring in the case of the late lamented Mr. Rose, surgeon to St. George's hospital.-ED.

PRACTICAL MEDICINE.

Ptyalism cured by Opium; by Dr. J. GRAVES. A middle-aged woman, of delicate appearance, applied to me for advice on the 26th of December last. She had laboured under a profuse and long-continued leucorrhoea, which ceased rather suddenly in the beginning of September, and was followed by a slight degree of anasarca. This disappeared under a course of diuretic and purgative medicines, but she remained in a debilitated state, and experienced much distress from irritability of stomach, and finally from obstinate retching. In October this symptom also suddenly subsided, and was succeeded by a remarkable and profuse salivation, which continued unabated, notwithstanding the use of various purgatives and astringent medicines, gargles, &c.

In twenty-four hours she spits more than a pint and a half of fluid, consisting of a whitish, viscid mucus, secreted by the mucous membrane of the fauces and back of the pharynx, from whence it is thrown into the mouth by a hawking, renewed every two or three minutes, with scarcely any interruption either during the night or day, and rendering the patient truly miserable from want of sleep. The throat and fauces are pale, and their soft parts extremely flabby and relaxed, although there is constant irritation in the throat, in consequence of the presence of an unnatural quantity of mucus; yet no soreness is felt, neither do the parts appear inflamed. The salivary glands are not concerned in the disease, and do not secrete more than the usual quantity of fluid. Her appetite is very bad, her skin dry, and she has a haggard, emaciated countenance.

The well-known good effects of opium in several diseases of increased secretion, diabetes, diarrhoea, and certain forms of dropsy, suggested to me the trial of this medicine in the apparently almost hopeless case I have related, and I accordingly ordered the patient one grain of opium every fourth hour. On the following day, she returned to inform me that she had slept during the whole night, and on awaking had no return of the spitting. Her joy was great, and she and her friends considered the effect of the pills, in thus suddenly stopping the spitting, as most extraordinary; and I must confess that my surprise was almost equal to theirs. She then told me that several medical students, who lived in her house, and who had witnessed the previous violence and obstinacy of her complaint, had been so much struck by its sudden cessation under the influence of the pills, that she was commissioned by them to inquire what I ordered. I mention this circumstance, to shew how very remarkable was the benefit she received from the opium. The pills were continued for some days, when the quantity of opium was augmented on account of some recurrence of the spitting: unfortunately they induced constipation of bowels, and, consequently, she has been frequently obliged to leave them off; but she is, on the whole, much improved in health, and although she is still subject to the disease, its severity is comparatively trifling, and it uniformly disappears almost entirely when she recurs to the use of opium. She visited me this day, the 18th of March. In connexion with this subject I may observe, that a lady, a patient of mine, who took a large quantity of mercury many years ago, has been ever since subject to occasional returns of salivation, in every respect resembling that produced by mercury. During these fits, which are always brought on by exposure to cold, the mouth is sore; the gums red and swollen; the salivation copious, and the breath is strongly impregnated with the mercurial fetor. Several such cases have been recorded by others, and are extremely instructive, proving that the deleterious effects of mercury on the system may lie long dormant, and be afterwards suddenly called into action by various causes. In this way we may explain the attacks of periostitis, to which persons who have been mercurialized are often liable for years, upon exposure to cold. Formerly such attacks were indiscriminately attributed to a remnant of the syphilitic taint, but I have witnessed the same occurrence in persons who had no syphilitic disease, and who had taken mercury for other complaints. One of the most