culiar lesion of mind; we see an affection of another part attended by a different class of phenomena. Here pathology, the science which phrenologists reject and despise, goes to establish the ground-work of their doctrines, that the brain consists of a congeries of parts, having each a separate and distinct function. We find, for instance, that disease of one portion of the brain affects the intellect, of another, the generative organs, of a third, the muscular system. What does this prove but that the brain is not a simple organ, but composed of a congeries of parts, each of which governs a different part of the system, or ministers to a peculiar purpose. Now what is this, but what the phrenologists themselves wish to prove?

Further, the professors of phrenology have placed all their organs on the surface of the brain, and for this they have been loudly censured. Phrenology, it is urged, knows, or professes to know, nothing about the central parts of the brain, which must be equally important with the superficial, and have confined their investigations to the surface alone. Now it is a curious fact, that the pathology, which they deny, in this instance furnishes the best reply to this objection. I mentioned at my last lecture, that if we examine the symptom of delirium, we find that it characterises the inflammation of the periphery, and is commonly wanting in that of the deep-seated portions. In other words, mental alienation is the characteristic of the disease of that portion of the brain, where the phrenologists have placed the intellectual organs. Here is a strong fact in favour of the doctrines of phrenology, derived from that science, which the mere phrenologist throws overboard and despises. Again, according to the researches of some celebrated French pathologists, there are a number of facts to shew that there is a remarkable difference between the symptoms of arachnitis of the convexity and of the base of the brain. This conclusion, which after a most careful series of investigations was adopted by them, is borne out by the results of my experience, and appears to me to be es

tablished on the basis of truth. They have discovered that arachnitis of the convexity of the brain is a disease characterised by prominent and violent symptoms, early and marked delirium, intense pain, watchfulness, and irritability. We have first delirium, pain, and sleeplessness, and then coma. But in arachnitis of the base of the brain, the symptoms are of a more latent and insidious character, there is some pain, and the coma is profound, but there is often no delirium. What an important fact for the supporters of phrenology is this, and how strikingly does it prove their absurdity in rejecting the lights derived from pathology! Here we find the remarkable fact, that inflammation of the arachnoid, investing the base of the brain to which the phrenologists attach comparatively no importance, is commonly unattended with any lesion of the intellectual powers, while the same inflammation on the convexity is almost constantly accompanied by symptoms of distinct mental alienation.

It is objected to the phrenologists, that they know little or nothing of the central parts of the brain, that though these parts may be fairly considered to be of as much importance as any others, still they do not admit them to be organs of intellect. Now, what does pathology teach on this subject? It shews that we may have most extensive local disease of the central parts of the brain, that we may have inflammation, suppuration, abscess, and apoplexy, without the slightest trace of delirium. Indeed there can be no doubt that the central portions of the brain have functions very different from those on the surface. They appear more connected with another function of animal life, muscular motion and sensation. Then let us examine the phenomena of old age. Every one is familiar with the fact, that when a man arrives at an extreme age, he gnerally experiences a marked decay of intellectual power, and falls into a state of second childhood. Does pathology throw any light upon this circumstance? It does? From a series of ingenious and accurate investigations, conducted by two conti

nental pathologists, Cauzevielh and Desmoulins, it has been found that a kind of atrophy of the brain takes place in very old persons. According to the researches of Desmoulins it appears, that in persons who have passed the age of seventy, the specific gravity of the brain becomes from a twentieth to a fifteenth less than that of the adult. It has also been proved that this atrophy of the brain is connected with old age, and not, as it might be thought, with general emaciation of the body; for in cases of chronic emaciation from disease in adults, the brain is the last part which is found to atrophy, and it has been suggested that this may explain the continuance of mental powers during the ravages of chronic disease; and also the nervous irritability of patients after acute diseases, in which emaciation has taken place.

I might bring forward many other facts to shew that phrenology is indebted to pathology for some of the strongest arguments in its favour, and I think that those phrenologists who neglect its study, or deny its applicability, are doing a serious injury to the doctrines they seek to establish. The misfortune is that very few medical men have turned their attention to the subject, and that with few exceptions, its supporters and teachers have been persons possessing scarcely any physiological, and no pathological knowledge. Phrenology will never be established as a science until it gets into the hands of scientific medical men, who, to a profound knowledge of physiology, have added all the light derived from pathological research. To give you an instance of the mode of reasoning of the non-medical phrenologists. In their drawing-room exhibitions, they appeal with triumph to the different forms of

taught, may answer well for the class of dilletantis and blue stockings, or for the purposes of humbug and flattery, but its parent was anatomy, its nurse physiology, and its perfection must be sought for in medicine. The mass of inconsequential reasoning, of special pleading, and of false facts, with which its professors had encumbered it, must be swept away, and we shall then, I have no doubt, recognise it as the greatest discovery in the science of the moral and physical nature of man that has ever been made. I feel happy, however, in thinking that of late the science has been taken up on its true grounds in Paris, London, and Dublin. Vimont's splendid work on Comparative Phrenology will form an era in the science. In London, Dr. Elliston has directed the energies of his powerful mind to the subject, and in Dublin we have a Phrenological Society, of which Dr. Marsh is the president, and my colleague, Dr. Evanson, the secretary, and under such auspices much is to be expected."

We cannot follow Dr. Stokes through his extensive lectures on the subject of encephalitis; and we have introduced these extracts and observations, chiefly on account of their bearing on phrenology. Dr S.'s lectures are calculated to repress the prurient imaginings of the phrenologists, and to lessen the inordinate scepticism of the opposers of the new science. We think, indeed, that Dr. Stokes has taken the view of phrenology which every observant physician, and acurate pathologist will come to at last.

MIDDLESEX HOSPITAL.

THE MINERAL ACIDS.*

of prey.

Our active contemporary, the Medical Gazette, has published three cases, related by Dr. Wilson at the last Conversazione for the present season, held The at the College of Physicians.

* Medical Gazette, July 5th, 1834.

cases in question are instances of poisoning by carbonate of barytes-by nitric, and by sulphuric acid. The first and the last were not fatal, but the second unfortunately was so.

1. A Case of Poisoning by Carbonate of Barytes.

A young woman who had fasted for twenty-four hours previously, and who seems to have laboured under some weighty moral depression, half filled a tea-cup with carbonate of barytes, and then filled up the cup with water. She swallowed the whole, in which she discovered no particular taste. Soon afterwards, medicine which occasioned vomiting was given to her.

"On her way to the Middlesex Hospital in the evening, two hours after the event, she found, for the first time, dimness of vision, succeeded by double vision, ringing in the ears, pain in the head, and throbbing in the temples, a sensation of distention, and weight at the epigastrium; she said she felt as if blown up with wind, and complained of palpitations.

When in bed, she first complained of pain in the legs and knees, and cramps in the calves. She vomited twice a fluid like chalk and water, which formed a deposit. Her skin was hot and dry; her face flushed; pulse 80, full and hard. Repeated doses of sulphate of magnesia were given to her. During the night she had fifteen evacuations; had no sleep, from pain in the head and epigastrium, and ringing in the ears.

The next day she had a hot skin, with profuse perspiration, and slight pain about the pharynx. Her tongue was covered with a white fur, and moist.

A day or two after, the cramps became more severe in all the extremities with a sense of weight, and soreness when touched.

These symptoms, slightly modified, lasted a long time: those which persisted the longest, and which still exist, are severe pains in the head, pain in the left side and epigastrium, great and long-continued palpitations. There

has been much difficulty in persuading her to take any sustenance."

She recovered slowly, and left the hospital in the latter end of June.

Orfila has concluded that pure ba rytes, or the carbonate, produces death by acting on the nervous system, and that it corrodes the parts it is brought in contact with. Mr. Brodie believes, from experiments with the hydrochlorate of barytes, that death is occasioned by its action on the brain and on the heart. In the case related by Dr. Wilson, the nervous and the circulating systems were disturbed; but the fortunate issue prevented the discovery of the actual lesions, if such there were, which the poison occasioned in the stomach.

The appropriate antidote, or rather the most useful remedy, in poisoning by barytes, is thought to be the sulphate of magnesia. This is founded on the fact, that sulphate of barytes is readily formed, and constitutes an insoluble and inactive compound.

2. Case of Poisoning by Nitric Acid.

This case, we perceive, is one which has been previously reported by Mr. Arnott, and was noticed in the 38th Number of this Journal. Perhaps it may be thought that the surgeon and physician have looked upon the fact through different glasses-that the medical features have arrested the attention and engaged the affections of the one, whilst the surgical beauties have subdued the imagination of the other. Yet we see so small an amount of variation in the respective descriptions of the surgeon and physician, that we willingly refer to the narration of the former.

3. Case of Poisoning by Sulphuric Acid.

A young woman swallowed some oil of vitriol, and immediately afterwards was constrained to take magnesia. She was then taken to the Middlesex Hospital. She laboured under a constant desire to vomit, and what she threw up was of a dark brown colour. Abbreviation of the following circumstances would be useless.

"Two hours after, her lips began to swell; the pain in the throat and stomach increased, with a violent burning sensation. She had a restless night, with frequent vomiting, and a sensation as if she were going to be choaked. Her tongue was covered with a white dense fur, with traces of dark veins, like those of the leaf of a tree; but in vomiting, something like skin was said to have been brought up; since which the tongue has been red. There were scabs forming about the lips, hands, and arms, where the acid had touched them.

During the first four days she was bled to upwards of thirty ounces, and had about 100 leeches applied to the throat; and she took magnesia and linseed-tea, &c.; after which, the abdominal pains became much less, the vomiting less frequent, and she could swallow with less difficulty. Her voice was pretty distinct, with a soft and regular pulse, and a moist and cool skin; but she had two or three shivering-fits, followed by what she called a cold pain felt about the navel.

Two days after, the cough became more troublesome, with constant irritation in the throat, which continued for some time; when, during a violent fit of vomiting and coughing, she brought up a large piece of sloughy membrane, which was found to consist of the inner coats of the œsophagus, much thickened, and very firm in texture; its length was eight or nine inches, and its width that of the oesophagus, being pervious throughout its whole extent. The inside was quite smooth, the exterior ragged; so that the entire mucous membrane, with perhaps some of the circular fibres of the muscular coat, may both be found in the ejected tube which has been preserved, and is now placed upon the table. She experienced great pain in the night after."

The patient had not quitted the hospital in the early part of July, the date of the report.

She had been within the walls for six months, and was better during the two last than she had been in the first four. Yet she was rarely able to swallow any thing but fluids, and on the days when she suf

fered most, she vomited a pint or two of mucous liquid. She had wasted greatly, but her spirits were good.

It would be interesting to be informed of the termination of this case, which appears to have been treated with judgment and decision. The quantity of mucous membrane destroyed in the oesophagus, and, perhaps, some disorganized in the stomach, must render ultimate and perfect recovery difficult, tedious, and uncertain. Should such a recovery take place, it would be curious to observe how the stomach and œsophagus performed their functions, and to ascertain if extensive cicatrization of the latter occasioned any sensible and permanent contraction. Should the patient die, the public would be benefited by a knowledge of the facts disclosed by her dissection.

CITY OF LIMERICK INFIRMARY.

We have received from Mr. Kane, one of the surgeons of the City of Limerick Infirmary, a report of some cases that have occurred under his care in that institution. In an accompanying note, that gentleman alludes to the anxiety we have always shewn for the publication of hospital reports. We are, indeed, most desirous that clinical facts should be closely observed and extensively diffused, and we shall always continue to promote the healthy taste which their study generates. Without further preface, we shall introduce the cases transmitted to us; and we take this opportunity of stating, that we shall feel great pleasure in publishing reports from provincial institutions. All that we require is accuracy in the execution, and brevity in the details.

CASE 1.-Severe Injury of the Ankle Joint. Charles Haurahan, 27 years of age, a pilot, was admitted 19th March, 1834. About four hours previously, while steering a vessel past another, near one of the city quays, his right foot got entangled in a coil of rope, and was caught between the ships. On examination of the limb, the foot was

found to be twisted inwards, at a right angle with the leg; the inferior extremity of the fibula nearly protruded through the skin, and, were the man held erect, it would be found to be the part nearest to the ground-the skin in front of the joint was slightly contused. By flexing the limb, and making extension and counter-extension, reduction was effected with some difficulty. During the reduction, crepitation was very evident. The limb was placed in the usual position in the splints, with bandages, &c.-cold lotions ordered.

On the following day, not feeling much pain in the limb, and anxious to return home, this patient got out of bed, and attempted to walk about the ward; when obliged by the nurse to return to bed, he continued to toss the limb about on this and the following day, which brought on inflammation so violent, as to resist all attempts to subdue it, and which terminated in ulceration and sloughing of the integuments at either side, with profuse purulent discharge from the joint. Hectic symptoms soon set in-the pulse became frequent and small-he had diarrhoea and night-sweats-became much emaciated-appetite impaired, although quinine and other tonics were given. At length it was agreed, in consultation, that amputation afforded the man the only chance of saving his life; he, however, did not consent until the 8th of April, when, assisted by Surgeons Thwaites and Franklin, I removed the limb, at the usual distance from the knee-very little blood was lost; four arteries were tied. The stump was dressed on the 5th day, when it looked healthy, and apparently united, except where the ligature came out.

April 17th. The condition of the patient is much improved since the amputation-the hectic symptoms have disappeared-the centre of the wound, however, this day, shews some tendency to slough; it was accordingly dressed with powdered bark and lint. None of the ligatures have as yet come away.

April 20th. At 11 o'clock, p.m. hæmorrhage suddenly took place from the stump; and, before the tourniquet was

secured, about a pint of blood was lost, which weakened and agitated the patient very much. On my arrival, I removed the dressings and slackened the tourniquet, when a smart jet of blood came, apparently, from the anterior tibial artery. I made three or four attempts to secure the bleeding_artery with the tenaculum, but the soft parts giving way, I could not succeed; however, on again slackening the tourniquet, the blood nearly ceased flowing. I then placed a dossil of lint on the bleeding orifice, and filled up the wound with dry lint, and applied compresses and bandages over all.

There was no return of the hæmorrhage the wound gradually filled up, and was cicatrized by the latter end of May.

On examining the amputated leg, it appeared that the fibula was unbroken -the external lateral ligaments of the ankle-joint were torn from the fibulathe malleolar process of the tibia was broken-and the internal part of the articulating surface of the astragulus was broken off, and lay loose in the joint-the synovial membrane was thickened and pulpy, and the joint was bathed in pus.

CASE 2.-Lithotomy.

John Minahan, aged 12 years, of a pale and sickly appearance, and with a tumid abdomen, was admitted to hospital 22d April, 1834. Has had symptoms of stone in the bladder for upwards of six years, from which he suffered extremely. He was sounded on presenting himself at the hospital, and the presence of the stone ascertained.

He was ordered to be kept quiet in bed-to get half an ounce of castor oil, and flax-seed tea for drink.

April 26th. The existence of the calculus was confirmed by the sound; the boy has been kept on low diet, and repeatedly purged. In consultation, the operation of lithotomy was determined on, and the consent of the boy's parents obtained.

April 28th. A purgative having been administered at 6 o'clock this morning, and the escape of urine prevented by a ligature on the penis, the operation was