ulceration, which gradually oozing its lymph into the right cavity of the chest, occasioned a gradual compression of the lungs; which, in the course of the progress of the disease, must have been compressed into a very contracted space. It would appear too, as if the lungs themselves were free from ulceration, as he had but little cough, and but very little expectoration, which was perfectly mucous, and not approaching to the nature of the fluid drawn off.' Effusion into the chest arising from erosion of a lymphatic vessel! That the lungs were themselves free from ulceration, we have no doubt: but what, then, becomes of the previous supposition of the author, that the small masses discharged through the canula in the operation were decayed portions of the bronchia? We beg to ask in what way the vacuity left in the chest by drawing off the fluid was filled up? Is it possible that the compressed lung could have expanded sufficiently for this purpose? Two Cases of Fatal Constipation of the Bowels. By Dr. W. Stoker. The disease arose from a schirro-contracted rectum. Case of ruptured Uterus. By Dr. C. Frizel. In his introductory remarks, Dr. F. states the proportion of cases of rupture of the uterus, during parturition, as about 1 in 940. The present case is then perspicuously detailed, and it impresses us with a very favorable opinion of the author's professional abilities. He found great difficulty in preventing the escape of the intestines through the wound, but at length succeeded by causing the edge of it to overlap the other. The woman happily recovered, has since had another child, and was in good health when the paper was drawn up. Case of unusual Termination of Psoas Abscess. By Dr. S. Wilmot. The subject of this report was affected with a tumour at the upper part of the left thigh, which both Dr. Wilmot and Dr. Stoker considered as psoas abscess; and which seems, indeed, to have possessed sufficiently the characters of that disease. After the interval of nearly a year, the tumour was found to be much increased in size, measuring nearly 14 inches in circumference at the base, and seven inches from the base to the apex. No sense of fluctuation was now perceptible, but it was elastic, and felt as if filled with air. By pressure, the swelling was made to recede into the abdomen and when such pressure was no longer applied, it became again distended to its usual size, although the patient was laid in a horizontal position. The tumour was completely removed in seven weeks by means of pressure, strong astringent lotions, and the application of a truss. Dr. W. supposes : that that the purulent effusion had in this case been absorbed, and that the vessels which formerly secreted that fluid had afterward acquired the property of secreting air. The paper is accompanied by a drawing of the tumour. On Apoplexia Cephalica. By Dr. W. Stoker. Dr. S. proposes to divide Apoplexia Hydrocephalica of Cullen into two species, Apoplexia Cephalitica, and Apoplexia Hydrocephalica, designating by the former the early stage of what is usually termed acute hydrocephalus; and he proceeds to detail two cases, in which this disease existed. One of these proved fatal, but no effusion or disorganization of the parts within the skull could be detected: the other was successfully treated, and the patient recovered. In this latter instance, benefit seems to have been derived from the use of a strong infusion of green tea; and a case of typhus is afterward shortly noticed, in which marked relief in a comatose state and vomiting was obtained from the same beverage: - yet green tea is itself emetic. The treatment of the favorable case of acute hydrocephalus evinces promptitude and ability. An Essay on Dreaming, including Conjectures on the proximate Cause of Sleep. By A. Carmichael, M. R. I. A. &c. The writer commences this paper by considering in succession the different theories of dreaming which have been advanced by modern metaphysicians; and he declares himself dissatisfied with all of them. That they are liable to objections and difficulties we readily admit, but we fear that the theory of Mr. C., however ingenious, is not free from similar imperfections. Sleep has by many writers been considered merely as a state of repose, produced by exhaustion: but he goes farther, and supposes that it is occasioned by the assimilating process. The new particles have never been exercised in any mode of thinking. They can differ but little on their first arrival, from so many foreign bodies of equal dimensions; and is it surprising, that the oppression occasioned by their deposition should be felt throughout the delicate volume of the brain, until they are perfectly assimilated with the other particles, and fitted like them for mental operations? a result which may, perhaps, in some measure, be effected by the very sleep which they induce.' Thus, if we may be permitted to borrow the phraseology of the material psychologist, as soon as any attempt is made to repair and rebuild the intimate structure of the brain, it ceases to secrete thoughts. Nothing can be more true than that long and intense exercise of the mind impedes nutrition, and produces emaciation and debility of the bodily frame : but we cannot admit that the converse of the proposition is correct, correct, and that the processes set up to rebuild the dilapidations of the cerebral structure arrest the flow of thought, and induce a state of sleep. We have no evidence, as the author himself admits, that assimilation is not constantly going on in all parts of the frame. The tide of blood is incessantly coursing through every portion of the body, and the absorbent vessels are as unceasingly pouring into that tide their supplies of fresh nutriment and decayed particles: therefore, we would ask, why is the deposition of new matter to be delayed during our waking hours, and vacuities filled up only while we are wrapt in sleep? The apparatus of life, the heart, and other organs, are, as Mr. C. acknowleges, in uninterrupted activity during existence, yet the waste of their structure is as regularly and constantly supplied as the waste of any other part of the frame. To explain this fact, as he has done, by asserting that their nutrition takes place during the minute intervals of their action, is to furnish materials for the overthrow of his theory; for in like manner might the brain be repaired, during the brief intervals that occur in the progress of thought. If the repairing of the waste of the brain throws us into a state of sleep, how is it that we awake? Does a glare of light flashing on the face, or a loud sound striking the membrane of the tympanum, put an instant stop to the process of assimilation? or do these circumstances only prove sufficient to rouse the senses, which would have remained uninfluenced by smaller stimuli? Dreaming, according to Mr. Carmichael, is produced merely by the activity of those parts of the brain which are not at the moment subjected to the process of assimilation; and in this manner he is led to the adoption of the theory of Gall, which he has amusingly illustrated in the ensuing fanciful passage: The mechanic's imagination may rove among machinery, the mathematician may solve a problem, the orator pour forth unstudied eloquence, the poet unpremeditated verse, the wit delectable jests, the musician unprecedented harmony; yet this does not always occur, but occasionally. If the peculiar organ happens to be asleep, there is no music, no wit, no poetry, no oratory, no mathematics, no mechanics a different faculty may be active, and these individuals may wander through inextricable difficulties, or fly before wild beasts, or combat with enraged assailants, or dissolve in a cold sweat at the frightful visit of some spectre from the grave. It is not because the organ may have been frequently or recently exercised, that it is employed in a dream; it is simply because it has escaped from the trammels of sleep which still envelope the remainder of the brain, or at least the senses, which open a communication with the external world, and supply the only means by which we are informed whether similar objects of thought are realities or illusions.' REV. AUG. 1822. E e We We beg to ask, how has any one of these supposed organs thus happily escaped the trammels of sleep? Doubtless, some slight accident has prevented the usual repairs from being continued in that part of the building. Dreaming appears to us to possess many features which strongly ally it to some states of insanity. In both, the ideas succeed each other in the same strange and incongruous manner, and the mind adopts conclusions which in its waking hours would appear the most ridiculous and absurd. In our dreams, we often dispute the possibility of that which has occurred to our fancies, and which is in fact wholly impos-sible: then, perhaps, we suddenly fall into some train of thought entirely foreign to that which has preceded; or we cease to dream, and sink into a state of profound sleep. We suspect that, in dreaming, none of the faculties are exempted from a state of activity, although imagination is that of all others which is most powerfully at work. We often remember past events in our dreams, reason on the most proper conduct to be pursued, and combine our ideas in the strangest and most grotesque groupes. Nay, we are not altogether without the perception of external objects; for it is certain that external impressions powerfully influence our dreams. A sound that is not sufficient to awaken us will often divert our thoughts into some new and extraordinary channel; and sensations of bodily pain seldom fail to affect in a remarkable manner the character of our dreams. The greater variety and distinctness of the pictures, which exhibit themselves to us in our morning-dreams, are no doubt to be ascribed to the refreshed state of the frame, and the approaching cessation of sleep: but they are also due in some measure to the numerous sounds which then begin to assail our ears, although they have not become so powerful as to break our slumbers. The doctrine of Gall on the organs of the brain is too unphilosophical to demand from us any attempt at a formal refutation; and such a system never could have been invented by any man having a distinct conception of the powers of the human mind, or acquainted with the analysis of those desires, passions, and mental peculiarities, to each of which the founder of this system has dedicated a particular organ in the brain. It was not without surprise, therefore, that we read the extravagant praises of this doctrine in which Mr. C. has indulged. Gall and Spurzheim are compared by him to Davy and Herschell: the two latter of whom are distinguished by the brilliancy and stability of their discoveries; and the former for having ascertained the probable existence in the brain of upwards of thirty material organs of the mind, each of which is endowed with its own desire, memory, and imagination.!! (P. 93.) The author pleads guilty to the charge of materialism, in one sense of that word, but endeavors to shelter himself behind the revealed doctrine of the resurrection of the body. It An Account of the Extirpation of a Tumour of the Neck engaging the Parotid Gland. By Richard Carmichael, M.R.I.A., &c. This very formidable tumour had pushed up the external ear from its situation, and measured five inches in breadth and the same in length. It had existed for fourteen years, had been once removed, but had grown again, and had since been partially subjected to the escharotic action of the arseniate of potass. There seemed every reason to believe that it was not of a malignant nature, malignant nature,-During the operation, a great deal of blood was lost, owing to the inefficacy of the pressure applied to the carotid artery. was originally the intention of Mr. C. to pass a ligature under the main trunk of the vessel, before he proceeded to the operation: this wise precaution, however, had not been adopted, and the patient was in consequence very nearly lost: but the wounded vessel was fortunately discovered and tied. In detaching by the fingers, for the operator did not now venture to use the knife, that portion of the root of the tumour which grew from between the mastoid and the styloid processes, the portio dura of the seventh pair of nerves was forcibly torn away, in consequence of which a paralysis of that side of the face was induced. Another portion of its root was separated in like manner from the transverse process of the atlas; and a third was found so deeply inserted into the basis of the skull, that it was deemed advisable to pass a ligature around it, and suffer it to drop off.-A great deal of pain and constitutional disturbance followed this operation, and on the fifth day the patient was found muttering and delirious: but Mr. C. very wisely judged that this state arose only from the exhaustion by pain, from sleeplessness, and loss of blood, and accordingly endeavored to relieve it by wine and nourishment. He succeeded; and he remarks that an opposite treatment, by depletion, would in all probability have destroyed his patient. The wound was completely healed in 36 days from the operation: six months afterward, no hardness, or any appearance as if the disease were about to return, could be perceived; and the paralytic affection of the face was considerably lessened. A Case on the Use of Turpentine. By Dr. Whitlock Nicholl. A diseased state of the bowels, and various febrile symptoms, were removed by the exhibition of oil of turpen tine. Ee 2 Case |