It is to be borne in mind, that the medicine in question is a stimulant; and that, when marks of irritation in the primæ viæ exist, care should be taken to clear the bowels, and remove, if possible, the causes of irritation, before exhibiting the remedy. The following form, we perceive, is that which our author generally employs :

B. Ferri iodureti, gr. ij. ad gr. iv.
Aquæ distillat. 3xj.

Tinct. aurantii, 3j.

Ft. haustus ter die sumendus. Cases are adduced by our author, and by respectable correspondents, where the remedy was found useful in chlorosis, in carcinomatous diseases, in syphilitic cachexia, &c. for which we must refer to the pamphlet itself. As each of the ingredients, singly, is of known efficacy in many diseases, we consider it very probable that the combination will be found a valuable formula.

A DICTIONARY OF TERMS EMPLOYED BY THE FRENCH IN ANATOMY, PHYSIOLOGY, &c. &c. By SHIRLEY PALMER, M.D. Part I. July, 1834.

This is an extraordinary work, and, if completed, will be a very valuable one. We learn from the advertisement, that

"The present work has been undertaken with a view of facilitating the perusal of French and German literature to the Medical Student or Practitioner who appreciates, as they deserve, the literary productions continually emanating from the press, in France and Germany; and who feels honourably solicitous to appropriate to himself, from their original source, the valuable facts, and the novel and often important views and opinions with which these productions teem. It may also serve to refresh his recollection, ever fleeting and evanescent without practice, of the elements of the Greek and Latin languages.

"How far the work, now offered, is calculated to achieve such objects, experience can alone determine. It was

not undertaken in a rash and unreflecting spirit: it has not been, thus far, executed without great labour and research. Had a longer period for its completion been allowed him, or had the Author been able, during such period, to concentrate his attention more exclusively upon the performance, the numerous errors and deficiencies, which the enlightened and experienced eye will readily detect, would not have been suffered to escape correction.

The Second Part will appear about December next,-the Third and last, with Title-page Preface, and an Index of the German terms, in the Spring of next year."

It is, as we said, an extraordinary work, full of erudition and pregnant with research. We cannot, of course, give an analysis of a dictionary; but, by exhibiting one or two specimens, the reader will be enabled to judge of the work.

"ANE VRYSME, ANEURYSME, S. m. —ανεύρυσμα (ανευρύνω, I dilate)-aneurisma, aneurysma, n. L.-aneurisma, anevrysma, n., pulsadergeschwullst, f., die erweiterung einer arterie, G.-aneurism, swelling, dilatation of an artery. Aneurism may be defined, a tumor, formed by arterial blood from dilatation, rupture, or division, of the coats of an artery. The term has been also applied, by some writers, to dilatation of the cavities of the heart, and even to enlargement of the organ from thickening of its parieties.

Aneurism shews itself under three different forms: 1. that of true aneurism-vrai, F.-aneurysma verum, L.

das wahre anevrysma, G.-formed by dilatation, circumscribed or diffused, without breach, of all the coats of an artery. In the former case, it constitutes the variety called circumscribed― circonscrit-circumscriptum,umschreibene;-in the latter, the diffused-diffus-diffusum-ausgebreitete-of true aneurism: 2. false or spurious-fauxspurium - das falsche anevrysma formed by a breach of two or all of the arterial tunics, and presenting two varieties;-the circumscribed, in which the blood, escaping through a rupture of the internal and middle coats, con

verts the external coat of the vessel into an aneurismal sac;-and the diffused -where the external coat, also, has subsequently given way, and the blood been poured out into the surrounding

cellular structure: 3. mixed aneurismmixte―mistum―—das gemischte-which likewise comprehends two varieties; one, the internal, consisting of an hernia-like protrusion of the internal, through a wound or rupture of the middle and external coats of an artery; -and the other, external, produced by rupture of the dilated coats of true aneurism, and consequent diffusion of its contents through the circumjacent membrane.

Besides these principal forms, there is Aneurism by Anastomosis-anévrysme par anastomose, F.-das anastomotische anevrysma, G.-apparently caused by aneurismal dilatation of the extreme vessels of a part, and extravasation of blood into the distended cells of the cellular structure.

Aneurismal Varix-Varice anevrysmale, F.-das anevrysmatische Venengeschwulst, G.-is said to exist, when, from the transfixion of a vein, and penetration of the subjacent artery, by a lancet, or other sharp instrument, and consequent adhesion of the two vessels, a direct communication has been established between them; and the blood, flowing from the artery into the vein, dilates the coats of the latter into a sac. If, however, from the obliquity of the wound or other circumstance, such communication be not direct, but take place through the medium of an aneurismal sac formed by dilatation of the wounded artery, and interposed between the vessels, the disease is termed Varicose Aneurism-variqueux, F.aneurysma varicosum, L.-das varikose anevrysma, G.

Aneurisms, from their situation, are, lastly, distinguished into internal and external. To the former, belong aneurisms of the cerebral, and especially of the basilar, arteries-probably a frequent source of fatal apoplexy-and of the thoracic and abdominal aorta: to the latter, aneurisms of the temporal and carotid arteries, and of the larger arterial trunks of the extremities. For

a minute description of the varieties, formation, and distinguishing characters, of the disease, consult Hodgson's Treatise; and Art. Aneurism, in Cooper's Surgical Dictionary.”

"CLIMACTE'RIQUE, adj. — climactericus (xλμantǹg, every seventh year of human life,)L.-klimacterisch, G. The ancients believed that human diseases were developed with greater frequency and fatality in certain years than others: and,hence,everyseventh year was called by them, the climacteric year-année climactérique, F.-κλιμακτηρικὸς ἐνιαυτὸς -annus climactericus, L.-stufenjahr, n. G; while the sixty-third, as a multiple of 7 by 9, and therefore peculiarly pregnant with mortal ailments, was distinguished by the title of the grand Climacteric. Some physicians have also termed climacteric―époques climactériques, F.-certain periods of life, as characterized by revolutions in the human economy not dependent on the numerical progression of years. Such are the period of puberty in both sexes; and that of the cessation of the menstrual flux in the female."

We sincerely hope Dr. Palmer will complete the work, which will form a monument to his industry-an extremely useful Dictionary for all who consult the works of our Continental writers.

MR. GUTHRIE'S OPERATION OF TYING

THE COMMON ILIAC ARTERY.

In the 39th number of this Journal, we mentioned that Mr. Guthrie had tied the right common iliac artery for what appeared and was deemed an aneurysm. The operation was thought to be successful, but the patient has since died. and the truth of the Hippocratic axiom

observatio difficilis, experientia fallax-has been illustrated by the event.

The Medical Gazette contains a long and an interesting lecture delivered by Mr. Guthrie on the subject. Much is needlessly apologetic, for Mr. Guthrie can afford to be mistaken. When we subject the lecture to a gentle pressure, its solid residuum is this.

The patient, a lady, was not young, yet amidst the abundance of statements and of information, we find no mention of her age. She had laboured for some time under pain in the hip, when she accidentally struck it. Soon after this a tumor appeared, and when it had attained the size of her fist, it began to beat "like her heart." It continued to increase, and after the lapse of a year she came to town. At this time, the tumor was as large as an adult head, situated on the right buttock, and so inconvenient as to prevent her from lying on that side, or even on her back. Separate examinations were made by Mr. Guthrie, Sir A. Cooper, Mr. Thomas, and Mr. Keate. On the whole, they concluded that the tumor was aneurism, and the common iliac was tied by Mr. Guthrie.

We believe we must be indulged with Mr. Guthrie's own account of the operation.

"I began the operation by placing her on a table, as much on her back as the tumour would allow, and by making an incision upon the fore part of the belly extending, beginning below the inside of the interior spine of the ilium, about an inch, carrying it upwards and diagonally inwards towards the edge of the rectus muscle above the umbilicus, so that the incision was between six and seven inches long. I may state, that if the incision is made in the side, from the ribs to the ilium, in a straight line, the greatest possible difficulty is experienced in turning over the peritoneum so as to place your finger upon the last vertebra; but if a diagonal inclination be given towards the rectus muscle, not opening its sheath so as to expose it, but carrying the incision fully up to that part, then there is room to turn over the peritoneum with its contents, so as to get at the artery.

After dividing, then, the skin and the common integuments, the three muscles were of course also divided in layers; the division of the latter, the transversalis, was attended with very considerable difficulty, inasmuch as there was little fascia transversalis, and the peritoneum was remarkably thinas thin as the common white silver pa

per, or nearly so, that is used for ordinary purposes. On attempting to reach the under part, on the inside of the ilium, so as to push the peritoneum over, I found this could not be done; that the tumour had extended inwards; and some bleeding took place from the large veins which surrounded it, giving rise to the caution not to proceed farther in that direction. At this moment, in spite of the greatest possible care that could be taken by Mr. Keate, who protected the peritoneum, a little nick took place in it, and the small intestine made its appearance below. I then tried to gain a greater extent of room upwards; but where the tendon of the transversalis passes directly across to form the sheath from the lower ribs, the peritoneum is usually so exceedingly thin, and so closely attached to it, that it can scarcely be separated but with the greatest difficulty. I knew this from an operation of a similar kind which I performed at the Westminster Hospital the year before, and in spite of all the precaution that I could then take, the peritoneum was on that occasion injured. I was so well aware of the great probability of its being wounded at this part, that I took double precaution; but in spite of all the care that could be taken, this part of the peritoneum was opened, and the right lobe of the liver made its appearance through it. The opening on the fore part of the belly was not large enough to admit the two hands, and there were two openings in the peritoneum, one above, and the other below, each of them much disposed to increase in size by the moving of the patient; and the operation did not seem to be the most agreeable one that could be performed. The peritoneum, however, being separated a litfrom the posterior wall of the abdomen from the outside, four fingers of one hand could now be introduced under it, and turned a little over towards the opposite side.

There is a point here of great importance to recollect, and it is, that the peritoneum must be raised over without the hand being pushed back towards the posterior wall of the abdomen but as little as can be avoided; for there is

some fat usually at that part, if there be any to be found in the body, and behind which you are very apt to get in performing the operation, instead of going in the front; and if you do, it leads to the under edge of the psoas muscle instead of the upper, and renders the operation much more difficult.

The peritoneum being now separated from behind and carefully turned over, I found I could only get one hand, or a little more, underneath in search of the artery, and that no more room could be obtained by increasing the incision upon the fore part of the belly. Under these circumstances it became obvious that, to seek in the dark, without being able to have the advantage of sight, for the internal iliac artery, which can hardly be found at any rate but with difficulty, was not likely to be attended with success, and I therefore determined upon placing the ligature on the common trunk of the artery. In order to effect this, I separated the peritoneum, passed my finger across the psoas muscle until it rested upon the fifth lumbar vertebra; and I now thought, of course, that I must feel the common iliac artery; it was not, however, to be felt. I passed my finger up as high as the fourth lumbar vertebra, trusting that I should feel the end of the aorta; but even that could not be felt, from a circumstance that I was satisfied had occurred in the previous operation, which is not known in surgery, but which I will now state: it is, that the common iliac artery rises with the peritoneum, which I believe the vein does not. My finger then, resting upon the spine, was beneath the vessel I was searching for. Mr. Keate endeavored, to raise the peritoneum, to give me an opportunity, if possible, of seeing the vessel; but that was quite out of the question; the incision, however long, was not sufficient to allow this to be done. However, on raising the peritoneum a little, he felt the pulsation of the external iliac artery; and I now then, passing my finger upwards, found the common iliac adhering to the peritoneum. I separated it carefully with the point of the fore-finger of the right hand, with the finger and thumb of the

left-for no more room could be given I passed the aneurismal needle, and placed a common thread ligature (now on the table) round the artery, which was done without seeing it. In an operation like this, you must have your eyes at the extremities of the fingers, and your head in your hand. I could bring the artery a little forward, by means of the aneurismal needle which was underneath it; and in this manner it was brought into view. It appeared to be perfectly clear; and I calculated, from feeling the division of the aorta above, that the artery was tied exactly in the middle."

We need not pursue closely the subsequent details. On the following day the patient required bleeding, and was bled. The temperature of the limb was preserved by constant frictions, with the application of hot bottles to the feet. The operation was performed on the 24th of August, and on the 19th of September, the ligature came away. The tumour rapidly diminished in size, and, in a month, it lessened by onehalf. In the course of two months the wound had healed, with the trifling exception of one small point. In December or January the patient went to Scotland. The tumor again augmented in size, and on the 30th of April the patient died, exhausted by disease.

Perhaps it is not necessary to state more than that the tumor was not an

aneurism, but a malignant growth, of the nature of medullary sarcoma. The common iliac had been tied about its middle, where its cavity was found, on dissection, to be obliterated. It was pervious above and below, to an eighth of an inch from the actual site of the ligature. No coagulum had consequently formed between the latter and the nearest branch arising from the ves

*De Graefe, who saw the patient, recommended the application of cold water to the limb, to maintain vital heat! How strange that the ablest foreigner has always an absurdity to set off against his merits. His organ of common sense is seldom free from a flaw.