and Cooper, at Glasgow Infirmaries, have severally amputated the arm by the circular incision, the results of which are now subjoined: Of xxx amputations, 1 had Un. by Suppurat.; 2, second Hem.; 3, Phlebit.; 1, Erysipelas; 6, Gang.; 1, Abscess; 4, Spasm; 3, Conical Stumps; and 5, Necrosis; 4, Resected Circular Stumps. Generally, 4 ligatures were applied. Time of cure, 14 to 60 days. Majority, chronic cases. Average age, 20. Deaths, 9. 3 from immediate amputation, 2 of which were succeeded by phlebitis in debilitated cases, æt. 11 and 18; 1 phlebitis and another erysipelas, succeeding amputation for gangrene, æt. 18 and 72; 1 scrofulous disease, æt. 11; 1, gangrene, æt. 58; 1, diseased lungs; and 1 from the effects of the operation, æt. 63. 2. Flap Operation.-Syme and Lizars conceive, that if this method is applicable anywhere on the body, it is between the elbow and shoulder joint, and within these limits has the former and Dr. Busche found it successful, in cases of emaciated individuals, where there was flaccidity of muscular fibre. Key, Morgan, and Bransby Cooper, at Guy's; Liston, and Mr. Cooper, at the North London; Wardrop, at the Hospital of Surgery, Panton Square; Ballingall, and Syme, at Edinburgh: and Messrs. Weir, and Perry, at Glasgow Infirmaries, have amputated by the double flap, as well as Klein, Gräefe, and Langenbeck, who, by such a system, have made admirable stumps, with results as follows: Of xxiv amputations, 1 Un. by Suppurat.; 2, Sec. Hem.; 1 Phlebit. ; 2, Erysipelas; and 4 Gangrene. Generally, 4 ligatures were applied. Deaths 5. 2 from secondary amputation, the one being followed by phlebitis the other gangrene, æt. 55: 1 from the effects of gangrene causing amputation, æt. 20; and two from gangrene attacking the stump. Klein, Liston and Cooper, have advocated antero-posterior flaps, which, though of general application, still possess the disadvantage of favouring a protrusion of bone, when formed at the insertion of the deltoid muscle; but by their adopting the lateral flaps, as employed by Garengeot, and Mr. Morgan at Guy's, this occurrence will be entirely prevented. Hey deemed the flap unnecessary in the arm, and many operators are of opinion that a sufficient stump can be effected by the circle; but even here there are living monuments of its deficiency, such as have never yet been recorded of the flap. AMPUTATION OF THE FORE-ARM. At Guy's, Key, and Bransby Cooper; St. Bartholomew's, Lawrence, and Sir Anthony Carlisle; and at the Edinburgh Infirmary, Latta, have amputated the fore-arm by the circular operation, the result of whose experience with that of others is now detailed: Of xxvi amputations, 2 had Un. by Suppurat.; 1, Sec Hem.; 1, Phlebit.; 2, Spasms; and 1, Conical Stump. Generally, 3 to 5 ligatures were applied, Deaths, 2. 1 from Phlebit. following amputation for gangrene, æt. 21.; the other from hæmorrhagic disease, æt. 39. By Key, and Bransby Cooper, at Guy's: Lawrence, St. Bartholomew's: Wardrop, Hospital of Surgery, Panton Square; Latta, Ballingall, and Syme. Edinburgh; and Messrs. Cooper and Perry, at Glasgow Infirmaries, has the flap been employed with the following results: Of xxvii amputations, 2 had Un. by Sup,; 1 Sec. Hem.; 2, Gang.; and 1 Cystitis. Time of cure, 7 to 25 days. Majority, chronic cases. AMPUTATION OF THE THIGH 1. Circular Amputation.-At La Charité, Kuhk; Guy's, Sir Astley Cooper, Key, Keate, and Morgan; St. Bartholomew's, Lawrence, Vincent, Lloyd, Stanley, Earle and Keate; Middlesex, Bell and Mayo; Westminster, Guthrie and White; St. George's, Brodie, Keate, Jeffreys and Hawkins; St. Thomas's, Sir C. Blike and Green: and, at the London Hospital, Sir William Blizard and Mr. Andrews, have employed the circular incision on the thigh; with what success the following statistics exhibit : Of c amputations, 20 had Un. by Sup.; 9, Sec. Hem.; 3, Phlebit.; 2, Erysip.; 7, Gang.; 4, Cystitis; 7, Spasms; 5, Con. Stump; and 10 Necrosis. 6 Resections of circular stumps. Generally, 2, 5, 6, 8, 9, 12, and 16 ligatures were applied. Deaths, 28. 6 from secondary amput., I followed by gang., respective æts. 2, 26, 44, 45, 57, and 64; 1, immed. amp. drayman, æt. 42; 1, effects of operation. for gang. æt. 52; 1 gang. lax fibre, æt. 52; 2, suppuration, 1 in arteries, the other in stump, æts. 4 and 12; 1, sec. hem.; 6, irritable stump, inducing secondary disease, æts. 20, and upwards; 3, phlebit. æts. 30, upwards; 2, hectic fever; 1, gout; 1, general injury previous to operation; 2, scrofulous diathesis; and I from the effects of resection. 2. Flap Amputation.-Though Dupuytren declared, that the flap operation in the trunk of a member had for long been banished from modern surgery, yet its revival in the thigh seems well established by Roux at La Charité; Key, Morgan, and Bransby Cooper, Guy's; Vincent, St. Bartholomew's; Mayo, Middlesex; Sir Anthony Carlisle, Westminster; Brodie, St. George's; Walker and Green, St. Thomas's; Luke, London; Liston, North London; Ballingall, Syme, and Lizars, Edinburgh; Drs. Buchanan, and Macfarlane, Messrs. Davidson, and Perry, Glasgow Infirmaries, with the subscribed results: Of cii amputations, 13 Un. by Sup. ; 9, Sec. Hem.; 8, Phlebit.; 1, Ery.; 9, Gang.; 4, Cyst.; 3, Partial Con. Stumps, oc. by disad. in cure; and 2 Nec.; 4, Flap Resections of Circular Stumps; and of 1 Flap Stump, occasioned by phagedenic ulceration. Deaths, 28. 5 from second. amput., gang. supervening on 2, and phlebit. on one, æts, 50, 56, 58; 1, immed. amput. and general bruises; 3, loss of blood depending on operation, one in which no arteries were tied, æts. 10, 20; 8, phlebit. æts. 11 to 32; 2, gang. appearing previous to the operation in one, and subsequent in the other, æts. 18 and 40; 1, effects of necrosis previous to amputat., æt. 10; 1, excessive suppurat.; 1, erysip.; 2, operation for compound fracture, æts. 40 and 58; 1, abscess; 1, exhaustion, æt. 31; and 2 from fever, æts. 34 and 36. AMPUTATION OF THE LEG. 1. Circular Amputation.-By M. Cloquet, at Hôpital de l'Eisle; Morgan, Key, and Bransby Cooper, Guy's; Sir Charles Blike, Lawrence, and Earle, St. Bartholomew's; Guthrie, Westminster; Travers and Hawkins, St. George's; and Messrs. Macfarlane and Weir, Glasgow Infirmaries, the circular division of the leg has been performed; and although Bromfield, Syme, and Mr. Langstaff have instanced weful results from this operation, yet Latta and Sir Astley Cooper have found it very successful. However, the following numerical results may aid the illustration : Of xliii Amputations, 9 had Un. by Sup. ; 3, Sec. Hem; 2, Phlebit.; 2, Erysip.; 7, Irrit. or Spasms; 6, Con. Stump; 6, Gang. ; and 1, Necrosis. 3, C. Rections. Generally, 3 to 6 ligatures were applied. Time of cure, 21 to 50 days. Majority, chronic cases. Deaths, 7. 2 from Amput. for Comp. fract. tending to Gang. æts. 60 and 21; 1, Amput. for Gang. æt. 52; 1, immed. Amput. Gang. supervening, æt. 17;. 2, Amput. for dislocations, Gang. attacking the stumps, æts. 60 and 53; 1, excessive Suppurat.; and 1, Second. Amputat.* 2. Flap Amputation of the Leg.--The lateral double-flap operation, as practised by Key at Guy's; White, Westminster; Travers and Green, St. Thomas's; Wardrop, Hospital of Surgery, Panton Square; Syme, at Edinburgh; and Macfarlane, at the Glasgow Infirmaries, has now almost been laid aside even by Roux, who revived it, and has given place to the antero-posterior flaps, or, more These results, meagre as they may be, confirm the views in favour of primary amputation, so ably and justly advocated by Thomson (Obs. on Hosp. in Belg. 1816,) Cooper, Lawrence, Guthrie, Buchanan, Depuytren, Boucher (Mém. de l'Acad. de chir. t. 2, 1753, p. 461,) and Larrey (Mem. de chir. milit. t. 1 et 3, p. 349.) By primary amputation, Percy, at the head of the military surgery in France, lost 6 out of 92, or about 1 in 15, Lucus, 5 out of 75, or 1 in 15; and, on the last days of July, all were cured, generally in the space of 25 days. Of secondary, 7 died out of 11 at Glasgow Infirmary (Glas. Med. Jour. v. 3 and 4, pp. 113, 220) Pelletan, at the head of the Civil Hospitals in Paris, lost 5 out of 6, or 1 in every 1 and one-fifth; and similar results have been observed by C. T. Kuhk at Hôpital La Charité; and at Meath Hospital, Dublin, as is learned from its quarterly reports. strictly, the single flap of Depuytren or Liston, to the former of which, however, viz. the lateral amputation, the following results apply: Of xii Amputations, 1 had Un. by Sup. ; 1, Sec. Hem.; 3, Phlebitis; and 2 Sinus.; 1 Resect. of Cir. Stump. Generally, 1 to 3 ligatures were applied. Deaths, 4. 3 from Phlebit; and 1 from Gang. æts. 35, 47. GENERAL COMPARISON OF THE TWO OPERATIONS. Out of 199 cases by the Out of 165 cases by the 42 or 1 in every 4.73- had Un. by Suppurat, 21 or 1 in every 7.85 113.26- Sec. Hem.. . This then, says our author, is experience, without which, as Lock and Bacon have declared, no science can be complete; and if these facts are as true as they have been impartially collected, they evidently show the double superiority of the flap over the circular incision. These are the statistical data collected for us. They reflect, if accurate, which we presume they are, very great credit on the industry of their compiler. But we do think him rather hard on the "Circulists" and Circular Amputation. He badgers them unmercifully. In fact they can't survive it, and we soon shall hear of circular amputations as obsolete samples of the wisdom of our ancestors. "Just as if better stumps could be formed by the circular incision, which, though evidently entitled to the appellation of 'plump,' still, generally bear no small rememblance to a ship amputation, where the Captain operated as another read; so by the alternate use of theory and practice, the limb was dismembered in the course of a day, leaving for years, in every sense, rotundity of parts, but an almost denuded bone." "Analogous to those cases of extensive burns on the neck, where the cure was deemed complete, yet the chin left bridled to the breast, are the instances of circular amputations of the thigh, condemned to the Cripplegate Workhouse, for twenty years under the superintendence of Mr. Langstaff, in whose museum relics yet remain, emblems of unphilosophic surgery-of unphilosophic men!" Our author winds up : "Just as three memorable eras have arisen in surgery-the invention of the ligature by Ambrose Paré-the tourniquet by Louis Petit-and the flap by Loudham and Yonge-so have torsion and styptics made attempts to subvert the first, manual compression the second, and an incorrigible ancestral adherence to the circular incision the last. Yet each have been fraught with blessings to mankind—each has revived the Syracusan ejaculation-Eignna! Eignna!” Spirit of the Foreign Periodicals, &c. REMARKS UPON FRENCH PHYSIC AND PHYSICIANS BY A GERMAN. We all know the importance of hearing the opinions of enlightened strangers on our habits, manners, and institutions; self-love and egotism are too strong among nations, as well as among individuals, to allow the parties themselves to form an impartial judgment. Dr. Wunderlich, of Stuttgard, recently visited Paris, and carefully examined the numerous hospitals of that attractive capital. Being well acquainted with French literature, and having had an opportunity of coming into contact with many of its most distinguished ornaments of the present day, he has thrown his observations together in a small volume, entitled "Vienna and Paris," from which we shall make a few extracts. "At Paris," says he, 66 a young physician is obliged to do a something, and that as early as possible, to bring himself into notice; if he does not every now and then busy himself to strike out a novel idea or discovery, on some subject or another, he will inevitably lapse into the most profound obscurity. It is of very little consequence whether the propounded discovery be soon found to be unimportant, or even utterly worthless; the momentary effect has been produced; the author is spoken of, and his fortune is made. A German, on the contrary, is amassing materials during the whole of his life; he goes on, heaping facts upon facts, and waits many a long year before publishing anything he then may acquire the reputation of being a profound solid man, although he has never brought anything before the public." "When a Frenchman meets with what seems to him a new idea in his path, he at once makes it known in every possible way; it is propounded and illustrated in lectures, extended in memoirs, condensed in reclamations, and finally brought again and again forward in a variety of articles by pupils, who fatigue every one that approaches them with their favourite theme. If the discovery turns out to be a fallacy, it is, as a matter of course, forgotten, and the author sets about finding out another. If, however, it is at all admitted, he at once derives honour and profit; but he does not allow himself to sleep upon it; for the public is forgetful, and he must soon seize some other plan of re-awakening its attention. In Germany a savant broods over an idea until it has become old, or until a more active neighbour carries it off from him. In this manner nothing, generally, is published at a mere hazard, and often nothing at all is published by the discoverer himself; hence, in spite of the immense development of German literature, works which contain new ideas are exceedingly rare. In France, the spirit of emulation (concurrence) gives birth to numerous abortive productions: but, at the same time, it has the effect of quickening the mental faculties, keeps them in constant play, and thus often ends in producing good results. In Germany, men of merit fall back upon themselves, repose in the conviction that they know more than other people, and are silent. There is amongst us (Germans) more than one physician whose equal for knowledge and experience could not be found in France; but unfortunately science is nothing the better for this; for the light is hid under a bushel, and the treasures are buried in the grave. How many able men shun publicity and keep all their ideas to themselves, for fear of being attacked by bold and ignorant critics!" Effects of Centralization. "In France every thing is at Paris and for Paris. Whoever has pretensions to |