needle into its head, but the instrument has always slipped off when he made the attempt. Whenever he was hungry, the serpent always became importunate. On all other subjects this patient was quite rational; and as he urgently requested that this serpent should be extracted, because he was assured that he should be quite well then, M. Manry performed the operation, as in the preceding case; and from that hour all his sufferings vanished. One day indeed he began to be alarmed at some uneasy feelings in the stomach, which he thought might arise from some ova of the serpent having been left behind; but his fears on this score were at once quieted, when he was told that the serpent was a male. The cure in this case was permanent.

Illusions depending upon a Disturbance of the Sensibility of the Generative Organs.

A woman, well advanced in years, was haunted with the idea that the devil had crept into her womb, and that nothing could dislodge him from his dark abode. This woman died, and it was found on dissection that there were several hydatids on the external surface of the uterus.

In another case, in which the patient believed that some venomous animal had entered her womb, and was accordingly in the habit of pushing pieces of meat up her vagina to entice it downa similar disease was found affecting the uterus.

Such are a few examples illustrative of delusions which appear to take their origin from corporeal impressions, acting upon a disturbed mind. We mean not to enter into any investigation of this most abstruse subject; our only motive has been to afford some authentic data to the enquirer.-Journ. Hebd.

properties of this recently-discovered substance, which from all accounts seems to be a potent, and consequently, under a judicious use, a useful remedy. A drop put upon the tongue causes very severe pain, and blisters the part; even the epidermis is usually detached from a portion of the skin, moistened with the pure creosote.

The solution of it in water is the preparation which Reichenbach has chiefly employed;-its strength may be made to vary according to the strength of the irritation required; but in most cases a solution of one part of the creosote in fifty of warm water will be found most convenient. He has used it successfully in scalds and in burns, whether the epidermis has been detached or not; in numerous cases of chronic herpes and impetigo, in itch, &c. When these cutaneous diseases are very obstinate and resist the effects of the creosote solution, he is in the habit of applying the substance either directly and in its pure state, or mixed with lard, so as to form an ointment;-under the use of this ointment, the pustules or vesicles very quickly dry and fall off. The period usually required for the cure varies from one to three weeks; and as a matter of course, this must depend on the duration of the disease, and on the constitution of the patient. Several cases of troublesome, and sometimes apparently malignant ulceration are reported as having been cured by the creosote. Scrofulous ulcers are benefited by it in an especial degree; and when there are any sinuses or fistulæ, no injection will be found so useful as water impregnated with the creosote. If the ulcers should be obstinate, it may be well to touch the edges of them occasionally with the pure creosote; but in most cases the application of pledgets of linen wet with the solution will be found sufficient. Tooth-ache may be often cured instantaneously by introducing a drop of it into the cavity of the decayed tooth. Even the mere gargling with the solution in water, will not unfrequently relieve the pain. The efficacy of the use of the creosote internally we should deem much more problematical, and especially in such a

disease as hæmoptysis, for which it has been recommended; the dose given was four drops rubbed up with lump sugar, (it is not stated whether the four drops are to be given in one or in divided doses,) and this was repeated for six or seven days.-Bulletin Therapeut.

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HYPERTROPHY OF THE MAMMÆ.

Galen is the earliest author who has noticed this malady, and most of the comprehensive records of disease published since his time present some cases of it. Boulli mentions the case of a woman whom he saw at Koenisberg, and in whom the mammæ had become so prodigiously enlarged that she was obliged to support them with bandages, passed round her body and across her shoulders; each of them must have weighed 30 pounds at least. This poor woman had been advised to have the mammæ extirpated, and this murderous operation would have been performed, had Boulli not happened to visit her; he at once discovered that the hypertrophy of the gland was connected, or at least associated, with amenorrhoea, and ordered emmenagogue medicines, derivatives, leeches to the ancles, cupping-glasses to the hips, &c. The result was quite satisfactory; the menstrual flux was restored, and the volume of the mammæ speedily decreased.

Indeed it is a very common occurrence, that when the catamenia have been suddenly checked, the mammæ became swollen and painful. Dorsten relates the case of a young lady, in whom an extraordinary enlargement of the mammæ took place in the course of one night; it was very evidently connected with the retention of the milk, the lady being a nurse at the time; the left breast measured 37 inches round its base, and 18 inches from the base to the nipple-the right one 31 inches round, and 17 in height. Dorsten employed emollient fomentations and revulsive remedies; but, unfortunately, his patient was so feeble, that she could not continue the course prescribed. The catamenia were suppressed for six

months, all the means which had been used to restore them having proved quite ineffectual. The lady died; and when the breasts were weighed after death, the left one was found to weigh 64 pounds. No decided structural change could be detected in the gland, except the mere hypertrophy of the cellular tissue which enters into its composition.

Hey, in his practical observations on Surgery, alludes to several such cases, in all of which the enlargement of the mamma was associated with amenorrhoa: one of these is so remarkable that it deserves notice. A young girl, æt. 13, on the first occurrence of the menstrual flow, had imprudently put on a damp chemise, with the hope of stopping it the discharge was thus suddenly arrested, and could not be recalled: themammæ forthwith began to swell, and gradually attained such a size, that she could not keep herself erect, but was) obliged to bend her head and body to diminish the extreme tension, and to draw her limbs up to her stomach, fore the purpose of supporting the huge pendulous glands. The left mamma, being the most cumbersome, was extirpated-it weighed 15 pounds. The girl was cured, but ever afterwards had a slight curvature forwards of the spi nal column.

The hypertrophy of the mamma sometimes takes place during pregnancy, and disappears with the cessa-a tion of the milk fever after delivery. When the nipples are too small, so that the child cannot easily take hold: of them, the tendency to the engorge! ment of the glands is necessarily greate er. Professor Cerutti alludes to the case of one of his patients, who was in this condition. The left mamma attained the dimensions of 38 inches in circumference, and 15 in height.

This woman was safely delivered, and when the milk fever set in, the breasts did not seem to become any longer; as it subsided, they very rapidly decreased in volume, and in the course of a month or so, they measured round their bases only 18 inches.— Meckel's Archives fur die Physiologie.

1. CLINICAL REMARKS ON UNUNITED FRACTURES. By Mr. BRODIE.*

A case of ununited fracture which had been received into the hospital, gave rise to some clinical remarks, by Mr. Brodie, on the methods which have been adopted for the cure of this unpleasant accident.

Mr. Brodie considered, in succession, the employment of the seton-of pressure-the removal of the fractured extremities of the bone-irritation of those extremities, and the subsequent retention of lint between them. We may mention, before we proceed to particulars, that when a fracture is not repaired by bony union, it either unites by the intervention of a ligamentous substance, or a false joint is formed between the ends of the broken bone. When the latter is the case, those ends are covered with a ligamentous structure, and surrounded by a capsular ligament lined with a synovial membrane. In the case which formed the peg upon which the clinical lecture was hung, the former condition obtained.

In alluding to the employment of the seton, Mr. Brodie observed that Dr. Physic tried it in three cases, in two of which it was attended with success. Experience would appear to shew, that it rarely succeeds in the lower extremity.

Amongst the cases in which Dr. Physic adopted it, I have been informed that there was not one case of ununited fracture of the lower extremity in which it did not fail: indeed, I am not aware that there is a single case on record in which it has succeeded in the lower limb, excepting one which was under my care. The patient was a boy, in this hospital with an ununited fracture of the thigh. A seton was in

* Med. Gaz. July 26th, 1834. VOL XXI. No. 42.

troduced between the broken ends of the bone, and he recovered."

Mr. Brodie alludes, in a favourable manner, to the mode of pressure employed by Mr. Amesbury. Mr. Brodie has known it prove successful-indeed, it answered in a case of Mr. Brodie's which occurred in the hospital last Au

tumn.

"In former times, it was a common practice to cut down upon the bones engaged in an ununited fracture, and to remove their extremities with a saw: in other words, to make a severe compound fracture. This practice has been, I believe, occasionally successful; but the instances of its success have been very few, compared with those of its failure. I remember conversing with an old surgeon of eminence, who had had frequent opportunities of seeing this practice resorted to, and he told me that he had not himself known a single case in which it had been attended with advantage. But, at any rate, there would be a decided objection to it in this case; for if I were to remove much of the tibia with the saw, the severed ends would not come in contact again, unless I were to perform the same operation on the fibula; and this would be altogether a frightful operation, attended with considerable danger to the patient. What, then, can be done? Sir E. Home was accustomed to mention, in his lectures, delivered in this hospital, a remarkable case which was under the care of Mr. Hunter. A patient had an ununited fracture of the humerus, in which a false joint had formed. Mr. Hunter cut down upon the part, and having introduced a spatula, scraped the fractured ends of the bone; inflammation followed; lymph was effused, and became organized. Bone was deposited in its centre; and in a short time bony anchylosis took place."

We may now glance briefly at the case which gave rise to the preceding observations. It was that of a little

Now, what I believe to have happened during this time, was the formation and bursting of an abscess into one kidney, and that probably the right, from an affection of respiration, with pain on that side, which he laboured under for a few days. The discharge of pus from the kidney occurs in three different states-first a quantity is secreted from the tubular structure of the kidney, and from the infundibula and pelvis, without any cavity like that of an abscess, and while the cortical substance is only inflamed. I have seen this discharge take place suddenly, and to the amount of many ounces daily; so that it seemed almost impossible that it could have happened from the secretion from a mucous surface only; and yet dissection has shewn that it did so. Secondly, you find small quantities of pus partially confined in cysts, consisting of the infundibula and tubes, enlarged and dilated; these cysts communicating with the excretory tubes. Thirdly, you find circumscribed abscesses in the kidney, not communicating with the excretory tubes; even these, however, you can often trace to the commencement of the tubes, where a drop or two of pus, confined by adhesive inflammation, become the origin of larger collections of matter.

I judge that Weighell had a circumscribed abscess, from the rigors, and so on, preceding the purulent discharge, and because there was also a large quantity of blood before the pus, as if the wall of an abscess had been ruptured to give exit to its contents. If I am right on this point, the abscess has since probably filled up."

The treatment employed during this condition of stupor were stimulants, of course-a blister to the right side and a blister, also, to the nape of the neck.

The sequel of the case may be briefly stated. The patient became gradually reduced in strength-emaciation made progress-about the 20th of June he was attacked with diarrhoea, attended with much general pain in the abdomen-and he died on the 6th of July, having suffered for a day or two from pain in the head, unaccompanied, how

ever, with actual stupor. During the period that elapsed between the comatose attack and his death, the urethral symptoms continued nearly stationary. The suppuration from the abscess that was thought to exist in the prostate was diminished, and the cartilaginous tumor in the perinæum had increased. A catheter was occasionally passed.

Dissection. The cartilaginous tumor in the perinæum was placed anterior to the stricture, and contained a small abscess, communicating with the urethra. The stricture was itself broad and firm, white in appearance, and situated rather on the left side of the urethra. A catheter of tolerable size could be passed through it. The prostate gland contained an abscess, capable of holding a table-spoonful of pus. At the side of the verumontanum was an opening into the abscess, in which the extremity of the catheter had frequently been involved. The bladder was thickened to the extent of more than half an inchits muscular fibres were prominent and enlarged, and its mucous membrane was dark-coloured, vascular, and folded into numerous little pouches. The ureters, the pelves of the kidneys, especially the left, and the infundibula, were in some degree enlarged, and their mucous membrane was inflamed. The secreting structure of both kidneys was condensed, and of a yellow colour; the left, which was nearly of its natural size, was more vascular and brittle than the right, which was diminished to half its natural bulk.

The chain of consequences resulting from the stricture of the urethra, and the lodgement of urine in the bladder, in the ureters, and in the pelves of the kidneys, are obvious even to the inexperienced pathologist. Perhaps it may be briefly, though not quite correctly, summed in the expression, that chronic inflammation was induced in all the portions of the urinary apparatus affected by the urinary accumulation. The case is interesting, because it informs us what we may expect, and what we should avoid. Mr. Hawkins judiciously dwells upon the circumstance, that pus may be secreted from the mucous membrane of the kidney, in a man