CASE OF DEATH BY POISONING WITH THE LEAVES OF ACONITE OR MONKSHOOD, PASSED OFF In Jest for PARSLEY. BY AL. RAMSAY, Surgeon. (Northern Journal of Medicine, June 1844.)

At about 11 a.m. a boy named Hanton, aged 14, on passing a garden in the parish of Murroes, looked over the wall, and asked a young man in the garden, "if he would give him some parsley"; to which it was answered, that he would get some new parsley, as being much better than the old kind. The young man accordingly gave Hanton a handful of green leaves, of which he ate some. In about two hours after he complained of a burning sensation in the mouth, throat, and stomach, and was very sick. For this his mother made him take a glass of whiskey. Some time after this he took a fit and fell on the ground-at 6 o'clock p.m. on his mother returning from her work, she found him lying across the bed, with his hands in his pockets, dead and stiffening. At the post-mortem the blood-vessels within the head were found enormously distended with darkcoloured fluid blood; upwards of a pound of which escaped from the skull and spinal canal. The stomach was empty, with a deep inflammatory blush over its whole internal surface and here and there patches of a darker colour-further dissection was not allowed.

Death appears in this case to have been caused by the apoplectic state of the brain, probably ending in asphyxia.

TINCTURE OF IODINE.

In the Montreal Medical Gazette, (April 1, 1844) Dr. Crawford draws the attention of the profession to the beneficial influence of Tincture of Iodine (Magendie's form), applied to variola, erysipelas, acute rheumatism, and neuralgia. During the last four years, erysipelas has been very prevalent in Montreal, and Dr. C. has applied the iodine with great apparent advantage. He does not exclude the use of constitutional remedies; but he has seen the most decided advantages result from the local application, where no internal means were employed. In variola he tried the comparative merits of the iodine and the nitrate of silver, but gives the preference to the former. This application is very manageable and very bearable.

ON THE MORAL TREATMENT OF INSANITY IN BETHLEM HOSPITAL. By R. WILLIS, M.D. (From the Medical Gazette, May 3.)

From the Report* we learn that, in the course of the year 1843, 284 patients109 males, 175 females-were admitted into the Royal Hospital of Bethlem, and that the relative number of cures, progressively on the increase, has been greater in this than in any preceding year; being as high as 56 per cent. upon the admissions. The advantages of providing employment for the patients have been ascertained; and to this circumstance doubtless much of the success of the remedial measures must be ascribed. Besides the ordinary and incidental occupations, as gardening, cleansing the wards, &c. a range of workshops has been added. Experience has fully proved that no risk whatever is incurred in allowing the patients the use of the ordinary implements necessary in their respective

* The General Report of the Royal Hospitals of Bridewell and Bethlem, and of the House of Occupations, for the year ending 31st December.

trades. On the female side, the matron has added to the old list of occupations straw-plaiting, bonnet-making, shirt-making, lace-making, and fancy-work, with the best effect. Considerable additions have been made to the amusements of the patients on both sides of the Hospital. On the male side a library is in course of formation, and contains a selection of useful and entertaining works, which have been under the charge of a patient as librarian. Chess, draughts, cards, and backgammon, have long been allowed with very beneficial effects. On the female side, a piano-forte has been purchased, which is a sonrce of great gratification both to those who can play, and to the other patients also. It was in Bethlem that the example was set in this country of liberating lunatics from personal restraint-in 1840 the weekly average number of patients under restraint was 13; in 1841 it was 9; and in 1842 and 1843, about 3. The attendants are aroused to increased vigilance by the necessity of closer attention; and living with and among the patients, gradually acquire their confidence, and become the directors of their occupations, and the companions of their amusements. By the new regulations every patient has a tepid bath once a week, unless forbidden by the physician, and each patient has also two changes of body linen in the course of the week, instead of one as formerly. Considerable improvements have been made in the bedding, horse-hair and wool mattrasses having been substituted for the old straw sack. Tea and coffee with sugar, now form part of the ordinary dietary of the hospital. This change has of itself entailed an additional expense of £400. per annum.

The necessity of seeking early advice in cases of insanity is well known to the profession, and its advantages are illustrated in the Report in the best of all ways, an appeal to the success of the remedial treatment at different periods of the disease. The chance of recovery is in exact proportion to the shortness of time during which the disease has existed; the probability of effecting a cure of the patient who is received within one month is generally just double that of restoring one who is received within two months from the commencement of the attack. From the table No. 8, we see that of the entire number of 284 patients, 106 were received within one month; but between one and three months the number is still greater, viz. 108. The great relative disproportion of cures effected in males and females, is somewhat startling. Whilst 103 of the 175 female patients are discharged cured within the year; of the 109 male patients no more than 56 are so discharged. The cause of this immense disproportion is well worthy of consideration. The total proportion of cures, and the general sanatory state of the hospital, it is most gratifying to observe have gone on steadily improving. In the middle of the last century the cures amounted to only 33.20 per cent. annually, and the ratio of deaths was as high as 25.43. Last year (1843) the ratio of recoveries reached 56 per cent. and the deaths were only about 6 per

cent.

Another point alluded to in the Report is the admission of pupils to the wards of Bethlem Hospital, as a school where they may acquire a competent knowledge of insanity.

ON THE USE OF OLEUM TIGLII, EXTERNALLY APPLIED, IN CASES OF DYSPHONIA, CYNANCHE TRACHEALIS, &c. By S. CORP Ellis, M.D. (From the New York Journal of Medicine, May, 1844.)

In the case of a lady who for several weeks had been unable to speak, except in a faint whisper, Dr. Ellis directed her to rub three drops of croton oil along the trachea; a few hours after doing so, she had a sense of constriction about the upper part of the thorax, followed by "two" expectorations of sanguineous mucus. Shortly after, her voice became quite natural.

In a case of cynanche trachealis, in a child three years old, wherein the little patient lay in a comatose state, with his neck stretched back to its utmost extent, countenance livid, respiration nearly annihilated, Dr. Ellis ordered the following ointment: scil. twelve drops of croton oil with two drachms of lard. A portion, the size of a large pea, was directed to be gently rubbed along the course of the trachea every fifteen or twenty minutes-in about 15 minutes after the first application of the ointment there was a visible improvement; the breathing became easier, and the countenance assumed a more natural appearance, coma began to disappear, and a quantity of tenacious mucus was forcibly ejected. The use of the ointment was continued at much longer intervals; the next day the membrane disappeared entirely, and the child got well. The same treatment was adopted in other cases with similar success.

ON THE USE OF MUSTARD IN THE CONVULSIONS OF CHILDREN. BY CHAS. S. TRIPLER, M.D.

Dr. Tripler treated a case of convulsions from teething with mustard, which he employed for its emetic effects-he had previously employed antimony, sulphate of zinc, sulphate of copper and the usual emetics, but without being able to make any impression on the stomach. In a few minutes after its employment it arrested a fearful attack of convulsions, which had lasted five hours, and that without vomiting the patient for some time afterward-he afterwards used it in several other cases and with equal success. Its efficacy seemed to have no relation to its emetic properties.

(The Doctor should have stated the dose, mode of administration, &c.)—Rev.

MIDWIFERY.

A LIVING CHILD, 39 DAYS ATTER QUICKENING-147 DAYS AFTER CONCEPTION.

This curious case happened in the practice of Mr. C. Smythe, of Castle Douglas. A female, in her second pregnancy, and in the 147th day of utero-gestation, had a severe flooding, with rupture of the membranes. Labour did not take place till the next night, when a very small but well-formed fœtus was expelled, giving no other indication of life than a very feeble action of the heart, and a strong pulsation in the cord. By proper means, however, it was resuscitated, and cried as strongly as a child born at the full period of pregnancy. It weighed less than two pounds, and measured exactly twelve inches. It swallowed some nourishment, but died at twelve hours and-a-half after birth. The Membrana Pupillaris was entire-the testicles had not descended-the head well covered with hair. Some ecchymosis appeared on the back and on the hands before death. From peculiar circumstances, it was evident that the mother of the infant was perfectly correct in respect to dates.

There was clearly nothing in the organisation of this child to prevent its growing to the age of maturity. We believe there is a case recorded in the Edinburgh Medical and Surgical Journal, where a premature fœtus of eighteen weeks was preserved by great care. In the present case the period of uterogestation extended to 21 weeks.-Ed.

INVERSIO ET EXTIRPATIO UTERI. (Prov. Med. Journ.)

This case occurred in the practice of Dr. J. G. Crosse, the talented surgeon of Norwich. A female had a bad delivery, of her first child, at the age of 29 years. Two years afterwards, January 14, 1843, she fell in labour with profuse hæmorrhage. The child was safely born, but she continued very weak, and almost pulseless for many hours. The Placenta was delivered piecemeal. On using the catheter, 36 hours post partum, Dr. Crosse found the uterus inverted in the vagina, and used every effort, (in conjunction with the surgeon who had delivered her,) to replace the organ, but in vain. The tumor was firm and contracted. At the expiration of four days, the patient, by straining, forced the uterus through the labia into open day. The fundus had a ragged sloughy appearance. She continued in an alarming state, with the pulse at 120 or more. By various manipulations the tumor was supported, and the patient rendered more comfortable: but still the profuse mucous discharge was undermining the constitution, and, at the end of a month, Dr. C. determined to apply a ligature, for removal of the organ. On the 12th of February, therefore, the ligature (silk) was applied, and tightened two or three times a day. On the second day, the tumor was dark as a mulberry. Every day the ligature was tightened. On the sixth day, the sphacelated mass was removed by the knife below the ligature, which was, itself, removed on the eighth day. The health improved-the urine flowed spontaneously. By the 20th March, she had recovered, and was able to attend to her domestic occupations. It is now sixteen months since the operation, and no catamenia have, of course, appeared. She enjoys good health.

DR. RAMSBOTHAM'S REPORT ON THE ROYAL MATERNITY CHARITY. (From the Medical Gazette.)

During the year 1832, there were delivered in the eastern district of the Royal Maternity Charity, under the superintendence of Dr. Ramsbotham

2,344 women-of which cases,

33 were twins-one in about every 71 cases: of these in 18 cases both heads presented; in 10 the presentations were head and breech, or inferior extremities --in 11 of those cases the children were both boys; in 11 both girls; and in 11 one girl and one boy. 1,197 were males-1,180 females-2,320 were presentations of some part of the head; of which 8 were face presentations—one in about every 297 births-51 were breech presentations, or of some part of the lower extremities-about one in every 464 births-of these 16 were twins-six were transverse presentations-about one in every 396 children. In two the placenta was entirely, and in one partially, implanted over the os uteri-one in every 7814 cases-11 were complicated with dangerous hæmorrhage before delivery, not the result of placental presentations-about one in every 213 cases. In 25 cases the placenta was retained within the uterus either by atony, irregular contraction, or morbid adhesion-two women were delivered by craniotomy-one in every 1,172 cases, in both the pelvis was narrowed very much. In four cases premature labour was induced-one in every 586 cases-in three by the use of ergot-in each the pelvis was contracted. The time chosen was between the 7th and 8th month of pregnancy-13 women died within the puerperal month, or from puerperal causes-one in every 180 cases-2,287 children born living-89 still-born, about one in every 25 births.

Still-born Children.-28 were premature-13 were putrid, at or near the full time-six breech presentations.

During the year 1833 there were delivered 2,619 women-of these cases

22 were twins-one in every 119 cases-1,372 males-1,269 females-2,437 head presentations-64 breech, or lower extremities-about one in every 414 births of these 17 were twins. In 18 cases there was retention of the placenta -one in every 145 cases-nine complicated with alarming hæmorrhage after expulsion of placenta, onei n every 291 cases-three were delivered by craniotomy, one in every 873 cases. In three premature labour was induced-five were complicated with puerperal convulsions, about one in every 524 cases-16 women died either from puerperal causes, or within the puerperal month-one in about every 166 cases-2,556 children were born living-85 still-born.

Deaths.-Four from hæmorrhages one from puerperal convulsions-two from fever-one from diffused pelvic inflammation nine days after delivery by craniotomy-two from pneumonia-five from phthisis.

During the year 1834, there were delivered 2,447 women-of which cases 26 were twins, about one in every 94 cases-1,285 were males-1,188 females2,408 were head-presentations-57 were breech or lower extremities-about one in every 43 births-eight were transverse-one in every 309 births-five had alarming accidental hæmorrhage, not the consequence of placental presentation— in 10 there was retention of placenta-6 had alarming hæmorrhage after placental expulsion-about one in 412 cases. Four were delivered by forceps one in every 618 cases. Two had puerperal convulsions-in two premature labour was induced from contracted pelvis-one in every 1,236 cases-10 women died within the puerperal month, about one in 245. 2,408 children were born living -79 still-born, about one in every 314 births.

Deaths.-Three from hæmorrhage-one from convulsions-one from rupture of uterus--one from hysteritis-two from cholera-one from universal dropsy. During the year 1835, 2,311 women were delivered in the Eastern District of the Royal Maternity Charity of these cases 16 were twins-in 8 cases of these both hands presented; in 4 the presentation was head and breech or inferior extremities, and in one case the breech and shoulder presented. In 3 of those cases both children were males; in 6 both were females; and in 7 they were of different sexes-1,229 children were males--1,098 females-2,437 were head presentations-57 were breech or some part of the lower extremities-7 were transverse presentations-all of some part of the upper extremities. In 3 the placenta was implanted over the os uteri, that is, about 1 in every 776 cases.

Seven were complicated with alarming accidental hæmorrhage before delivery, not the result of placental presentation, that is, about 1 in every 330 cases. In 8 the placenta was retained within the uterus, either by irregular contraction or atony of the uterine fibres, or by morbid adhesion to the uterus-all required the introduction of the hand-5 were complicated with alarming hæmorrhage after the natural expulsion of the placenta-1 in every 462 cases. One (a primary labour) was delivered by craniotomy. Three were delivered by the forceps-about 1 in 776 cases. Four were complicated with puerperal convulsions-about 1 in every 578 cases. In all these cases the attack occurred during labour. All were benefited by bleeding and purging-they all recovered.

In one case premature labour was induced from the woman's possessing a small pelvis. Seven women died either from puerperal causes, or within the puerperal month, about 1 in every 330 cases. 2,241 children were born living -86 born dead-being about 1 in every 27 births.

Of the Deaths.-1 from the effects of hæmorrhage eleven days after labourthere had been a draining of blood for some weeks previously-2 after delivery under shoulder presentation, both on the third day-one after version, and one from hysteritis after decapitation. One on the eighth day after labour from apoplexy originating in violent mental agitation six days after labour. Two from malignant puerperal fever prevalent at the time-1 from peritonitis 31 days after delivery.

Of Still-born Children.-26 were premature-6 were putrid, at or nearly at