3d day there appeared plainly a beginning of suppuration, and a separation of the eschars. On the 9th day there was a complete suppuration, and the rege-neration of the flesh was even so far advanced, that the singularity of it raised the curiosity of some of the first surgeons of Paris. At last, on the 15th day, the patient found himself in a more favourable state; which, according to the testimony which M. Morand, an assiduous spectator of the cure, publicly gave of it, gave hopes of a recovery in a case that had hitherto been thought desperate.' The suppuration, the separation of the eschars, and the regeneration of the flesh, being all that a surgeon can desire in a like cure, he then thought that his mission was fulfilled, and that he might return home, whither he was called by more material affairs. He had reason to repent of this journey: his patient having naturally a very voracious appetite, he had confined him to a spare diet; but he could hold out no longer; and, by the connivance of his nurse, he took various food, and that plentifully too. This conduct had soon ruined their progress. M. le Cat returned to Paris; his representations were useless: the patient had shaken off the yoke of the faculty, and of reason. Indigestions ensued one upon another. The looseness, which never left him after, totally suppressed the suppuration, and made him void the matter quite crude by stool, and at last he died. The following are the particulars of this case: From this, and some other cases, Dr. le Cat infers, that the common opinion, that it is impossible radically to cure the dry gangrene, is as false, as the ordinary method of treating it is bad. He does not establish his method as infallible; but asserts, that in 8 or 9 years practice it has not failed curing any persons who exactly followed it, and observed the regimen prescribed. Then follows M. le Cat's description of a surgical instrument of his invention; with a forceps for the extirpation of tumours too remote from the surgeon's fingers. When the fingers can lay hold of an excrescency, the surgeon need not think of making use of machines for it; he will never find any convenient enough; but all tumours that are to be extirpated are not within the reach of the fingers: there are even many of them which the fingers can reach, but where they cannot lay hold of them, nor work as the extirpation requires. Such are the excrescences situated a little deep in the anus, in the vagina, in the throat, &c. For the like extirpations M. le Cat had been obliged to invent the forceps now described. Fig. 4, pl. 11, represents the forceps shut, as they are when the instrument is closed, or when it holds a small excrescence: it is of silver, pliant as far as aa, to enable the cheeks to take the different figures which those of the tumours to be extirpated may require. The inside of these branches is lined with a slip of buffskin, or close chamoys (as at KK, fig. 5.) to prevent the tumour's slipping when once it has been laid hold of; BD is the extremity of the forceps, to be held in the hand of the operator; EF, GH, are the pieces which connect the 2 parts of the instrument, instead of the common joints or rivets of the other forceps, in a very advantageous manner. These pieces make the principal utility of this invention. Fig. 5 represents the pincers taken to pieces in 2 parts. The piece E is to go into the notch gg, so that the screw f may pass through its slit, and that the nut F, put on the screw f, is to keep the whole together but one thing which the figure cannot show, is, that this piece E is moveable in the direction lengthwise of the forceps, to answer the different openings of the cheeks; at b, fig. 4, is seen the pin on which this piece turns. The piece & also receives the screw h into its slit; and both are stopped by the nut H. But an essential remark, with regard to the piece G, is, that it must have the figure of an arch of a circle, the radius of which is the instrument itself; to the end that in the small extremity of the pincers, the ends of the cheeks may find themselves over-against each other, whatever opening may be given to the larger extremity, or to the handle GH. To explain the use of these forceps: suppose an excrescence is to be extirpated, a condyloma of 2 inches depth in the rectum. You cannot lay hold of this tumour with the fingers, nor make it come out; yet it is very troublesome to the patient, and it would be requisite to slit or lay open the anus, to make room for this extirpation. With this forceps you will avoid this cruel preparative, and will with great ease make the extirpation. First, introduce the fore-finger of the left hand into the rectum over the tumour to be extirpated, to make sure of the situation: with the right hand take the part of the forceps CD, and thrust it into the rectum, under the finger which is already there, and make it slide along the right side of the tumour, which to you is the left side. With the fingers of the left hand support this instrument in its situation, while with the right hand you introduce the other part of the forceps AB, and let it slide along the left side of the tumour, which is over-against your right hand. Without taking the fore-finger of your left hand out of the rectum, put together the parts of the instrument; press between its cheeks the tumour by its root; after which draw the fore-finger out of the rectum; take with the left hand the handle of the forceps BD, fig. 4; thrust along the right side of their cheeks underneath the knife, fig. 6, the button a being turned against the cheeks, and the back CD towards the inside of the rectum, Push this instrument as far as beyond the tumour under the extremity of the cheeks of the forceps, of which you may make yourself sure with the fore-finger of the left hand. Then raise towards the upper part the cheeks of the forceps, to prolong as much as possible the root of the excrescence; and in this condition pull towards yourself with the right hand, the knife, which does not fail cutting the tumour. There are cases, in which the instrument fig. 7, will be of more convenient use. This cuts only by its crescent ab, pushed forward, and moved alternately from one side to the other, to assist its cutting. There are circumstances in which the knife fig. 8, may be preferable. Forceps for extracting stones, and other foreign bodies, lodged in the partswhere the common forceps are of no use, are shown in fig. 9. The same me-chanism just now described in the foregoing forceps, may be applied with advan-tage to the forceps with which the stone is pulled out, and to other instruments designed for extracting bullets, splinters of granadoes, pieces of iron, and other foreign bodies. There are several cases in the cutting for the stone, in which no use can be made of the common forceps: the most frequent is this; when a stone, laid hold of by the ordinary forceps, escapes from the instrument half-way, and so remains engaged in the incision. The expedient commonly taken, is to push the stone back into the bladder, in order to have again the necessary room for managing the forceps; but besides the cruel pain in thus pushing back the stone into the bladder, this foreign body may enter into the cellular texture which surrounds the bladder, and lodge itself there, and then the forceps not having any longer that play which was endeavoured to procure to them, the stone will remain in that fatal lodgment, without possibility of pulling it out, and the patient will die. The stone having stopped in the passage of the incision, you slide along the body of it one of the cheeks of the forceps, A or c, well oiled, which will be done without much trouble; the other cheek afterwards will pass on the other. side; after which you join them, as shown above, taking care to press close the extremity AC on the stone, and to leave the largest opening on the side of the handle BD, as in fig. 10, both to hinder the stone from escaping, and to widen its passage; then, having well secured the screw G, you leave the screw F almost at liberty. You grasp the instrument with both hands, as near the stone as you can, and you draw the body out, managing it as is usual with the common forceps. A second case of cutting for the stone, where these new forceps will be of great use, is this; when the stone is exactly embraced by the internal coat of the bladder; whether it completely fills this whole organ, or that it fills part of it, which may have closed itself on the stone; or that the stone has made itself a lodgment or bed in the inside coat of the bladder, prolonging itself towards the cellular texture, which surrounds a small part of those inside coats. In short, every foreign body lodged in the substance of any part of the human body, be it of what nature it will, becomes the object of our instrument; and the extracting. of it will become much more easy by the means of these forceps, than by the bullet-drawers, and most of the other instruments invented for that purpose.. On the Parabolic Paths of Comets. By Nicholas Struyck of Amsterdam, F. R.S. From the Latin. N° 492, p. 89. That tracing the courses of comets belongs to the principal parts of the sublimer astronomy, has been established since Newton, 63 years ago, published a problem on finding the paths of comets by 3 observations, on the hypothesis that they describe a parabolic orbit about the sun. By this method, Dr. Halley determined, by calculation, the paths of 24 comets, in a table in the Philos. Trans. N° 297. There are indeed 21 different comets. In like manner Mr. S. has noted 18 other comets, not found in that table, in hopes that the periodic times may at length be found. Of these, the path of the comets of 1723 and 1737 was determined by Dr. Bradley; that of 1744, by Mr. Betts; of 1699, 1702, 1739, by La Caille; the 2d comet of 1743, by Mr. Klinkenberg; the 2d of 1746 by M. des Chezeaux; of the 1st of 1748 by Maraldi. Mr. Struyck gave the observations of the comets seen in 1533, 1678, 1718, 1729, to Mr. C. Downes to calculate; but the comets of 1706, 1707, 1742, the first of 1743, and the 2d of 1748, Mr. S. has calculated himself. He also thinks that in May 1748, both at Amsterdam and other parts of Europe, on the very same night, 3 comets were visible; of which there is no other certain instance in history. He has also added the comet seen at the end of 1680, and beginning of 1681, because in the last edition of Newton there are emendations, by which is determined the ellipse it described about the sun. He further remarks, that of the 31 observations he had of the comet seen in 1742, there are 22 whose longitudes hardly differ 1', and 23 whose latitudes differ not so much as l′. The following table shows the paths of the 19 comets above mentioned. 1737 Jan. 1739 June 1742 Jan. 35 19 8 20 6 9 59 28 4 20 Dec. 30 21 15 ww 41 10 35 1 0 | ୪ 15 45 15 77 om 16 22 0 18 20 25 55 0 22282 Dir. 49 27 25 14 55 42 12 38 40 67358 50 5 35 45 67 4 11 m 7 33 44 76555 16 II 8 10 48 2 15 50 2 58 4 83811 18 Υ 5 16 25 45 48 21 6 33 52 52157 20 47 88 36 ww 08 12 15 20 96942 Retro. 58 22 16 53 406980 Dir. 45 44 Retro. Retro. Dir. Retro. 1747 Feb. 17 11 44 19 25 27 77 56 6 A Letter from John Jas. Huber, M.D., concerning a Dead Body, in which the Gall-bladder was wanting, and concerning a Gibbosity of the Sternum. An Abstract from the Latin. N° 492, p. 92. 1. In the dead body of a woman, about 60 years of age, Dr. H. found the liver to be destitute of a gall-bladder; but its place was supplied by a preternatural enlargement of the hepatic duct, which was wide enough to admit the little finger. The coat of this duct (the hepatic duct) was nearly as thick as the coats of the arteries, not white, but yellowish, villous within, and dotted with a number of small spots, which Dr. H. supposes to have been so many simple folliculi. From the liver to the duodenum this duct was of the before-mentioned diameter, so that it might easily have been taken for the vena portarum: but it opened into the duodenum by an orifice of the usual form and dimension. In like manner the pori biliarii were enlarged to the size of arteries; they were all of a yellow colour externally, and were turgid with bile. 2. Not in a single subject, but in the bodies of many children, Dr. H. had observed a deformity of the chest, which he imputes to an improper mode of handling and nursing. This deformity was particularly striking in the case of an infant 8 weeks old, in whom the sternum was so exceedingly prominent, and the cartilages of the ribs (at their junction with the sternum) were so much pressed inwards (more so on the left than on the right side), as to give to the thorax the resemblance of a saddle. On opening the thorax, several of the depressed ribs were found to be gibbous on the surface next the lungs, thus contributing not a little to the straitening of the cavity of the chest. The lungs were found obstructed, and adhering in many places to the pleura. Hence (remarks Dr. H.) it is easy to comprehend how children thus deformed die consumptive. Dr. H. suspects that this deformity is occasioned by a very common but very improper mode of nursing, which consists in grasping the child's buttocks, and letting its body, inclined forwards, rest on the right hand applied, with expanded fingers, to the chest, and in this posture repeatedly tossing the child up and down. During this exertion, the whole weight of the child's body falls on the nurse's right hand, whence the pressure is often so great, as to cause the cartilages of the ribs (at that early period of growth) to give way, leaving pits or depressions in the places where resistance was opposed by the nurse's fingers. This was particularly conspicuous in the infant above mentioned. Those therefore who have the care of children should be cautioned against handling them in this manner. Dr. H. adds that the deformity above described must not be confounded with rickets. |