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of the parts be unsuccessful, or should the diseased condition have been previously neglected until no longer amenable to medical treatment, then we may seek a cure by surgical means. The measure I propose resembles in principle the one I have adopted in prolapse of the anterior and posterior walls-viz: in mechanically curing the displacement by contracting the relaxed, loose mucous canal. With this object I suggest the removal of a portion of mucous membrane anteriorly, posteriorly, and laterally, and the introduction of sutures after the same plan as in the other operations. A similar course of proceeding appears called for in those very rare instancer of prolapse of the entire vaginal canal without procidentia uteri. Such a condition is spoken of as a distinct one by Dr. Churchill, who quotes a case recorded by Noel, where the prolapse reached the knees. But a relaxation of the vaginal walls seems almost necessarily to entail a more or less complete subsidence of the uterus, when, according to the accepted nomenclature, we should rather refer to the condition as one of prolapsed uterus than of prolapsed vagina. However this may be, the general treatment would be the same.

II. Prolapsus Uteri.-Resembles procidentia in all points but in the extent of displacement, which does not proceed beyond the canal of the vagina. It is of more common occurrence than procidentia. The symptoms attending the two conditions are alike, except that in procidentia they may present greater severity. Moreover, the causes and general treatment are similar, and need here no detail. It seems almost unnecessary to add that, as in the last accident, I object to pessaries. Unless the perineum be much dilated, and have lost its usual tonicity, I should confine myself to the use of the perineal bandage to support it, and to obviate the pressure of the uterus upon it; but if much dilated, I should attempt to restore its natural supporting power by contracting it and the dilated vagina, by removing a piece from the centre of the perineum, dissecting back the mucous membrane over the recto-vaginal septum, and bringing the edges together by sutures.

III. Relaxation of the Uterus.-This is the least degree of displacement of the viscus. It implies merely a subsidence of the womb from debility of its structures-its attachments or, so-called, ligaments, and of the vagina. It is very open to general medical treatment, associated with attention to the recumbent posture, avoidance of fatigue, straining, &c., and proper hygienic conditions. In this slight form surgical measures are not called for.”

ON THE TREATMENT AND PREVENTION OF CONSUMPTION, AND INCIDENTALLY OF SCROFULA. With a Demonstration of the cause of the Disease. By HENRY MCCORMAC, M. D. London. Published by Langman, Brown, Green, and Langman. pp. 111.

Starting with the assertion that "Consumption and Scrofula in all essentials are one," the author takes the common-sense view that they depend upon constitutional depravity. He believes that Tubercle "is a foreign body, a body that has no business to be present, obtruding itself instead of, in and upon, the natural fluids and tissues, but when present more especially in the lungs, constituting phthisis, or in other words, consumption of the lungs.”.

This is an excellent little book, and we hope it may be reprinted in this country.

DR. H. D. BULKLEY, formerly editor of the N. Y. Medical Times, has become associated with Drs. Purple and Smith, of the N. Y. Journal of Medicine, which is one of our best medical periodicals. By this union both journals become consolidated.

THE COLLEGES.-Dr. L. M. Lawson, who recently resigned his professorship in the Kentucky School of Medicine, has been elected to the Chair of Theory and Practice of Medicine in the Medical College of Ohio. In the same school Mr. E. S. Wayne, an experienced analytical and practical chemist and pharmaceutist, has been appointed Lecturer on Practical and Experimental Chemistry. This is a capital idea, and the appointment, we should judge, a worthy one. We wish other colleges would follow the good example set by the Medical College of Ohio.

Dr. Middleton Goldsmith, for many years Professor of Surgery in the Castleton Medical College, Vt., has been appointed to the Chair of Surgery in the Kentucky School of Medicine.

Dr. E. Andrews has resigned his position as Lecturer on Comparative Anatomy and Demonstrator in Rush Medical College, Chicago, Ill. Med. Reporter.

ORIGINAL AND SELECTED.

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DARTMOUTH MEDICAL SCHOOL!
WINTER COURSE.

0

A course of Practical Anatomy will commence at the dissecting rooms
of the College, on Thursday, December 4th, 1856, and continue during
the Winter months.

There will be daily recitations and demonstrations, illustrated by the
preparations of the College; the minute structure of the tissues being
demonstrated with the Microscope,

Fee for the course inclusive,.....

..$15,00.

DARTMOUTH MEDICAL COLLEGE, ALPH. B. CROSBY, M. D.,
Hanover, N. H., Nov. 1856.

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Demonstrator.

PUBLIC

LIBRARY

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The existence of foreign bodies in the knee-joint is comparatively a rare occurrence. Most surgeons meet with this affection however, although those of the most extensive experience rank it as a rare affection. The subject acquires a good deal of interest, because the inconvenience which it occasions the patient is very serious. Besides, the well known irritability of the knee-joint leads the careful surgeon to view with anxiety anything which may either impede its motion, or serve as a source of irritation. The treatment of this affection is not without interest, inasmuch as the most serious consequences frequently result from it. I propose to treat of cartilaginoid, and osseous bodies.

Foreign bodies of the knee-joint are usually found within the capsule, and are either loose, or attached by a pedicle which is longer or shorter according to the age of the affection, and the amount of motion to which the joint has been subjected. The number of these bodies is usually small. The majority of cases would probably give

evidence of only one.

at the same time, and

Several such bodies have however been found successfully removed. I shall confine myself to the knee-joint, although there is not wanting proof that other joints are subject to the same affection.

We have reports of the ankle, elbow, jaw, shoulder and wrist joints affected in this way, and foreign bodies have been removed from all of them with success. Cartilaginoid bodies are usually oblong, flattened, and present a shiny appearance. Some of these are round, others flat, and still others irregular in shape. The texture of these bodies varies considerably. They are soft, or cartilaginous with a bony nucleus. Osseous bodies occur in the knee-joint, as the result of ossification of floating cartilages, and sometimes, very rarely, as fragments fractured from the extremities of the bones forming the joint. I am enabled to present an interesting case of this last variety, which, so far as I know, is unique. Loose cartilaginoid bodies may be perfectly smooth, but usually they present an unorganized appearance, with a roughened and even granular surface. The symptoms of this affection vary with the size, form, position, and the fact of their being attached or loose. If the substance is attached, and so far removed from the articulation that it cannot slip between the ends of the bones, the patient will experience no inconvenience from it. If however the pedicle is sufficiently long, or the body loose, it may readily slip between the ends of the bones, and sudden loss of motion, accompanied with intense pain, is the result. As soon as the body escapes again, the motion of the joint is restored. and the pain relieved. Under the above condition of things, the slightest motion of the joint causes the most excruciating pain, almost always accompanied by faintness. The position of the body is more frequently to the one or the other side of the patella. If it is loose, however, it may vary its position indefinitely, and the patient can voluntarily change its position.

Sometimes the symptoms come on gradually. More frequently external violence is the cause. Inflammation supervenes, or pain is the first thing noticed; and the other symptoms follow. Frequently pain is a constant symptom, and inflammation may evince itself with profuse secretion of synovia. If the foreign body cannot be distinguished externally, these pains may be confounded with rheumatism. The pathology of these bodies has received considerable attention

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