distinguished teacher had disavowed for him the authorship of the ridiculous paragraph, which went the rounds of the newspapers, about a year since, describing, in exaggerated terms, the injuries resulting from the employment of calomel. As the allusion is retained in the paper now published, this statement seems to be due to all the parties concerned. Y.]

ART. III.—A Case of Renal Calculi, with Abscess and Destruction of the right Kidney. Reported by R. MARTIN, M.D., of Nashville, to the Medical Society of Tennessee. May, 1843.

On the 30th of January, 1841, I visited a negro man, the property of W. S. Y., Esq., who, in the latter part of the preceding month, had complained of violent pain in the abdomen, extending along the spermatic cord of the right side. When I saw him he had severe pain between the umbilicus and spine of the ilium, with a prominence of, perhaps, six inches in its several superficial diameters, pretty well defined, and acutely sensible to the touch. Along with an anxious and depressed countenance, a hot, dry skin, small, frequent and slightly tense pulse, his urine was scanty, his tongue nearly natural.

During the month of February his sufferings were materially mitigated by medical treatment, his appetite improved, and he slept pretty well at night; the sensibility of the prominent section of the abdomen abated, and about the first of March the prominence suddenly decreased in size, and was followed, as the patient reported, by the discharge at one time of at least a pint of pus through the urethra, and by smaller quantities at irregular intervals for some days. From that time his apparent improvement was more steady and ob

vious.

About the first of April, he thought himself able to go out to work, and did plough a part of a day, contrary to my advice, and without his master's permission.

From that time he again declined, the local fulness of the abdomen reappearing, and on the 22d of April, its character

Anderson's

about the ace, the s

Pece, and e

istic local prominence was merged in a less marked, though general increased volume of the abdomen. I did not see him and was until the 25th; at which time he had distressing and incessant hiccough, shrunken and anxious countenance, feeble, very frequent, thready pulse, violent pain and excessive tenderness over the entire abdomen-position, as when first seen, on the back, with the thighs flexed on the pelvis; skin cool and moist; extremities cold.

acterist

Every P

bstance.

the rect smilar s

stence.

The n

The

May 20th.-Patient died. This morning, corpse greatly emaciated, presenting an unusual dimension, forward and laterally in the upper third of the abdomen, and lower section of the chest-the whole anterior extent of this prominent section sounded dull on percussion. When the sternum was raised a healthy liver was found lying directly under the low-ly er third of that bone, adhering by a very delicate texture of t lymph to the anterior concavity of the diaphragm and parietes of the abdomen to its margin. Lower down in the abdomen, the omentum adhered to the walls of the cavity before, and to the intestines behind, and they to each other wherever there i was contact. Five pints of consistent inodorous pus were taken from the abdomen, occupying every accessible portion of its cavity, though much the largest collection was found in the posterior part of the right lumbar, extending through the hypochondriac region, encroaching on the chest, by forcing the diaphragm upward, and the liver upward, forward and to the left, until it was brought into the position already described, and also displacing the heart, to some extent. In a word, every thing moveable was carried more or less upward, and to the left.

The peritoneum was here much thickened, and so it was in several other situations. In the chest were some adhesions.

No vestige of the right kidney, in its peculiar renal structure, was detected, but, occupying the right half front of the upper part of the first and second lumbar vertebræ, were found three calculi, enclosed in an enlarged sacculated ureter, the coats of which were very thick.

The bladder contained six or eight ounces of a more fluid

pus, and was healthy with two exceptions, a slight thickening about the orifice of the diseased ureter, and a loss of substance, the superficial extent of which was equal to a shilling piece, and extending nearly through the bladder, while the characteristic features of ordinary ulceration were absent.

Every portion of the large intestines was occupied by a substance, in color an invisible green-wanting the odor of fæces in consistence ranging from that of cheese to cream. In the rectum it was most firm; the small intestines contained a similar substance in smaller quantity, and of more fluid consistence.

The muscular coat of the intestines pretty generally, but especially of the large ones, was almost black, without any other apparent alteration in their physical structure. The same alteration of color was also observed in the portion of the ureters enclosing the calculi.

The length of time that elapsed from the escape of pus from its original situation, to the death of the patient, is a circumstance worthy of remark.

May, 1843.

ART. IV.-A Case of protracted and difficult Labour, followed by Sloughing of the Vagina, and Recto-Vaginal Septum. By Dr. JOHN P. ANDERSON, of Sparta, Alabama.

The case about to be described cannot be regarded as unimportant, in a practical point of view. It admonishes, in a manner the most impressive, of the danger of suffering the head of the fœtus to remain long impacted in the pelvis, pressing with such force against the soft parts as to arrest the circulation in them, and finally destroy their vitality. The unhappy subject of the following case has consulted an eminent surgeon, in the hope that the injury might be repaired by an operation. She has not received much encouragement, and meantime the particulars of the case are laid before the

profession. Should an operation be determined on, the result of it shall be communicated.

Mrs. B., æt. 24 years, was taken in labour in November, 1841; a physician was called in, who, on examination, ascertained that the waters had been discharged. On inquiry he was told that this had occurred some hours previously; otherwise all things promised well. Six hours passed without much increase of pain, but about the seventh hour it came on with such force that it was thought the child must be soon expelled, as the head had already descended far into the pelvis. In this situation things continued for thirty-eight hours, every effort at effecting delivery by natural means being made by the physician in vain. The powers of her system began now to give way, and as the medical attendant was reluctant to resort to embryotomy, although the child had been dead for some hours, the patient requested that I should be sent for, at a distance of forty-five miles. Many hours necessarily elapsed before I could reach her bed-side, and when I did so, I had the satisfaction to learn that her delivery had been accomplished two hours before. The head, of monstrous size, had been perforated, and removed, piece-meal, by her physician. Her life was thus preserved, but the most serious consequences resulted. The inflammation which followed, terminated in sloughing. A communication between the vagina and rectum was established, by the destruction of a large portion of the recto-vaginal septum, through which the fæces when fluid now find their way into the vagina, and are discharged involuntarily. She has perfect control over the urinary discharge, although the urethra was involved to the extent of five-eights of an inch in the sloughing. She menstruates regularly, and her general health is good. She is ready to submit to any surgical operation which affords any prospect of relief, preferring death to her present situation.

January, 1844.

REVIEWS.

ART. V.-A Treatise on Food and Diet: with observations on the Dietetical Regimen, suited for Disordered States of the Digestive Organs; and an Account of the Dietaries of some of the principal Metropolitan and other Establishments for Paupers, Lunatics, Criminals, Children, the Sick, &c. By JONATHAN PEREIRA, M.D., F.R.S., &. L.S., Licentiate of the Royal College of Physicians in London, &c. &c. Edited by CHARLES A. LEE, M.D. New York: J. & H. G. Langley. 1vol. 8vo. pp. 325. 1843.

In our last number we noticed, at considerable length, the Elements of Materia Medica, by Pereira-an encyclopedia of knowledge in that department of medical science-by the common consent of the profession, the most elaborate and scientific treatise on Materia Medica in our language. We have now to call the attention of our readers to a work by the same author on a cognate branch of science-the Materia Alimentaria-to a treatise on Food and Diet. They will agree with us, we suppose, that what one eats is a matter not less worthy of grave consideration, than what he takes from his apothecary. The study of the composition of aliments, and their adaptation to the various conditions of the sick, is one in which physicians must feel the liveliest interest. They know that their best directed remedial efforts are often rendered abortive, by the indulgence of their patients in unsuitable articles of diet. Daily it is their experience how difficult it is to impress upon nurses, and the friends of sick people, the importance of seconding their medicines by proper

ww