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which are pungent, increase the secretion (of the saliva. Whytt* observed, that the ilspirituous tincture of rosemary caused this

appearance, which also admits of explana-tion, by the connexion of the auxiliarynerves of the nose with the nerves of the

salivary glands.The action of the irritated organ of smell,

on the respiratory apparatus, is very remark-able. All pungent and volatile substances,which considerably irritate the mucous mem-brane of the nose, produce great excitementof the muscles of respiration, and, by theirconvulsive action, the act of sneezing. Inthis case, the primary irritation of the mu-cous membrane is continued by the nervesof the nose, derived from the fifth pair andspheno-palatine ganglion on all the respi-ratory nerves, viz. the portio-dura,the eighthpair, the accessory nerves of Willis, and thephrenic nerves, which are all connected withthe fifth pair, or the sympathetic nerves.Some physiologists, as Haller, Whytt,Meyer, and others, certainly consideredsneezing as an effect of an unpleasant sen-sation, produced by the irritation of the

olfactory nerves, with a retro-action of thebrain on the muscles of respiration. The icase, however, which came under G. R.Treviranus’s t notice, decidedly tells againstthis opinion. a young man, in whom thesense of smell had been wanting from hisbirth, sneezed on taking snuff. Here thesensorium, ia the absence of the sense ofsmell, could have taken no part in thesneezing. Sneezing is preceded by a pecu-liar tickling feel, which extends from thefore to the back part of the nose, and evento the prascordium and diaphragm. This isfollowed by a deep and almost convulsiveinspiration, accompanied with an inclina-tion of the head backwards, which appearsto be caused by the irritation of the acces-sory nerve of Willis ; this is succeeded by arapid and powerful expiration. The effectsof smells on the heart, are produced by theaction of the nerves of the spheno-palatineganglion on the sympathetic, and the branchof the par vagum, which supply the heart.

Very, offensive smells cause nausea, andsometimes actual vomiting, an effect whichcan be explained by the communication be-tween the eighth pair and sympathetic:.Boyle t mentions the case of a strong manwho vomited on smelling coffee. Wagner knew a person, in whom vomiting was alwaysexcited by the vapour from boiled crabs.

* Nervorum Affectiones. Vol. 1. p. 264.t Physiologische Fragmente. Th. 2. S.

210.De insigni efficaciâ effluvioram, p. 54.Hufelaud’s Journal. Vol. XXXIII. Nov.

p. 70.

( The action of smells on the genital organsis well exemphfied in mammalia ; the malesof many species are greatly excited by thescent of the female ; for the production ofthis in most animals, there are glands situ-ated at the entrance of the vagina.The organ of smell, like the other senses,

is in its turn acted on by the digestive or-gans and intestines, of which numerous in-stances might be adduced.

Sympathies of the Organ of Taste.The tongue stands in close connexion

with the salivary glands. Irritation of the

tongue by any strong substances, producesan increased secretion of saliva ; this takes

place by the irritation being continued fromthe twigs of the third branch of the fifthpair to the nerves of the salivary glands.Further, there is a striking sympathybetween the tongue, palate, and nose. Ifstrong mustard be put on the tongue or themucous membrane of the palate, a ticklingsensation is produced in the septum of thenose. This is effected by the naso-palatinenerve of Scarpa. This nerve, a branch ofthe spheno-palatine ganglion, proceeds inthe membrane covering the septum of thenose, penetrates through the anterior pala-tine foramen, or the canal behind the incisorteeth, and is distributed to the mucousmembrane of the nose. In this nerve thereis a small ganglion discovered by H. Cloquet.Lastly, the tongue stands in very close con-nesion with the stomach, by means of thecommunication between its nerves and the

eighth pair and sympathetics.The state of the organ of taste is, on the

other hand, very much affected by a dis-turbance in the functions of the stomachand intestines. In persons affected with

dyspepsia, gastritis, and bilious fevers, thetongue is foul, being covered with a whiteor yellow coat, and the taste of meat or anynutriment is hitter. During pregnancy,the tongue is also affected.

CHIRURGUS ON ANEURISM.

THE subject of aneurism is so truly im-portant, that contributions having for theirobject practical improvements in that dis-ease, must obtain ready admission into the.pages of your widely circulated and usefulpublication. No. 12 of the new series ofthe London Medical and Surgical Journalcontains a letter from Mr. Dickenson ofMacclesfield, detailing a case of diffusedaneurism in the leg. The treatment whichI formerly advised for adoption in popliteal

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aneurism, was resorted to, and the life ofthe little patient preserved. My reasonsfor preferring amputation, were publishedin the Ninth Number of the Fifth Volume ofTHE LANCET ; but I am not prepared to gothe length of recommending loss of limb,where the aneurismal affection is situated ineither of the branches of the popliteal ar-tery, because the fears I entertain of morti-fication in such cases, unconnected withother diseased structure, are so few, that Iwould generally hazard the method of Hunteras a preliminary step. 1 am here supposedto admit the probability of true aneurismoccurring in the principal arteries of the Ileg, a circumstance I have never ,met with,and which, in young subjects, I am much idisposed to doubt, although I am aware Ithat Sir A stley Cooper, in his lectures, ialludes to the rare case of a boy of eleven Iyears of age who was affected with the dis-ease, but whether true or false aneurism is inot stated. Many influential circumstances Imust be taken into account, previous to theformation of a decision, as to the best modeof treatment in those affections. The course Iadopted in Mr. Dickinson’s case was, Ithink, perfectly judicious ; but, notwith- Istanding the presence of extravasated blood,I venture to differ from him in the belief, ’’,that the case was originally one of an aneu-rismal nature. Mr. Dickinson will, I trust,pardon me for offering a few comments onhis recorded statements, because they may ihave a tendency to alter the opinion enter-tained by him. My reasons for thinkingthat he has too hastily assumed the affectionto be aneurismal, are founded upon the fol-lowing facts : the age of the patient, thepeculiar character of the swelling, uncon-nected with pulsation in its early stage ;the coagula mingled with brainy matter ;no regular tissue of a sac ; the surface ofthe muscles assuming the character of ulceror abscess four inches of the fibula de-stroyed ; the posterior tibial mtery ex-hibiting insufficient signs of dilatation, &c.From such a state of things, I am disposedto view the case as one of a purely scrofu-lous character. Internal ulceration had beengoing on for some time, until the bone be-came carious, and the artery eroded, followedby extensive extrav asation of blood. Themethod of cure was clearly indicated, andno attempt to save the limb could have suc-ceeded. Much as I am disposed to advo-cate an occasional practical deviation inpopliteal aneurism, yet the importance ofpreserving a limb is so great, that I wouldwell review all the attendant circumstancesof such cases ; call to my recollection thesuccessful, as well as ullsuccessful effortswhich had been made in their treatment,and finally submit to a conclusion, whichthe weight of Qvidence alone could establish

as rational. The first case which inducedme to send a communication to THE LANCET,was that which was unsuccessfully treatedby Mr. Key in the Borough Hospital. Asimilar occurrence presented itself some-time after in the practice of Sir AstleyCooper, who also adopted the method byligature, and failed. Two such results weresufficient to excite the attention of practicalmen in the profession. I feel indebted toMr. Dickinson for the notice he has takenof my communication, because it inducesme once more to promulgate my viewsupon so interesting a question, which, Itrust, may lead to useful results. In the

metropolitan and county hospitals of thiskingdom, favourable opportunities are con.stantly presenting themselves for obsena.tion. I would, therefore, beg to call theattention of surgeons, and more especiallythe surgeons of public institutions, to theconsideration of a practice I am disposed toadvocate, which frequently may be themeans of saving life. No one feels a higherrespect for the memory of John Hunterthan myself, but had he lived to witness re-sults produced by the indiscriminate appli-cation of the ligature, he would have beenbrought to modify his practice according tocircumstances, and by so doing have render.ed a more essential service to suffering hu-manity. The preservation of human life, itmust be admitted, is the primary object ofthe surgeon ; and when it can be clearlydemonstrated that death has frequentlyfollowed the liunteriali method, our in.

quiries should be directed to the causes offailure. Continental surgeons have beenaccused of slowness in adopting the Englishpractice, arising probably from their occa-sional want of success. Equally unsuccess-ful have their attempts been to save thelimbs and the lives of their patients, by thedirect popliteal operation. A laudable anx.

iety to save a limb ought, at all times, to beencouraged; but we should be careful notto expose the life of an individual to almostcertain destruction, by an injudicious andill-timed attempt. A knowledge that a few ’cases of diffused aneurism, under favourablecircumstances, have been successfully treatedwith ligature, is not enough to establish onegeneral and undeviating line of proceeding;and it would be well if some practical rulecould be laid down for our guidance. If itcan be done, an improvement commensurateto the importance of the subject will be ob.tained; and, if due attention be paid todiagnosis, we shall not so often hear oflimbs mortifying after operations, anddeath following as a consequence.

It is thus made apparent, that a more cor.rect criterion is required for our practicalguidance. I will endeavour to supply thedesideratum so much wanted, and shall be

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glad -to find that the subject is taken upwith spirit by the more enlightened mem- Ibers of the profession. In cases of purepopliteal aneurism with decided pulsation,and where the sac is entire, I would resortto ligature ; but in those cases where theaneurismal tumour has burst internally, andthe femOIal engorgement is extensive, Iwould invariably have recourse to the opera-tion of amputation. Notwithstanding therule I am endeavouring to establish, it maystill be a question worthy of consideration,whether an effort may not occasionally bemade to save a limb in a healthy subject,when the aneurism is known to have re-

cently burst, still pulsates, and is mode-

rately difased. My present prejudices,however, lead me to prefer a contrary prac-tice ; but experience alone can determinethe propriety of the suggestion. In allcases, no time should be lost in coming to adecision, for when the aneurism has givenway, the rapid progress of disease may becalculated upon, and every practical sur-geon is well aware of the superior advan-tages which result from operations per-formed previous to the occurrence of cozz-stitutional irritation. It may be well to add,that there is a judgment in some men supe-rior to all rule, which will lead them to

adopt one or other of the methods advisedwith a fair chance of ultimate success ; butit is equallv certain, that there are otherless qualified individuals in the profession,who, from timidity and other causes, requirethe guidance of their more favoured bre-thren. In a former part of this paper, Ihave adverted to the possibility of trueaneurism occurring in one of the arteries ofthe leg, and, supposing it to become dif-fused, a question arises, What ought to bedone ? Before I give my opinion upon thesubject, I shall take the liberty of premis-ing a few anatomical remarks essentiallynecessary to be well understood. The pop-liteal artery is a continuation of the femo-ral, and divides into two branches the pos-terior tibial and femoral ; the former, in itsstraight course, may be said to give off theanterior tibial, which passes through a holeinto the inter-osseous ligament near thehead of the fibula. I will now suppose thatthe aneurism is seated in any part of theanterior tibial artery, and that it has dif-fused itself by bursting into the muscularand cellular tissue. It is unnecessary tosay much to the senior members of the pro- I,fession on the value of the circulation by ,,anastomosis ; but to the junior aspirants toprofessional knowledge, it may not be amissto state, that the articular arteries of theknee are five in number, encircling it inall directions, communicating freely witheach other, and the branches of the pro-fundu femoris, as well as with those below

the knee, which spring from the anterior

tibial and others. The peroneal and poste-rior tibial arteries pass down the back ofthe leg, the latter forming the plantar arch,freely communicating with the anteriortibial branches which are led to it, passingnear the root of the great toe into the soleof the foot. We are now prepared to uii-derstand how little probability there is of a

limb mortifying under favourable circum-stances, when the collaterals of the thighare in a healthy condition. My practice inthe case above alluded to, would be to tiethe femoral artery at the point where it iscrossed by the sartorius muscles, and I’ should look forward with confidence to a, favourable result. I will now suppose thateither artery of the’leg has been woundednear its origin by a sharp-pointed instru-1 ment, constituting a case of false aneurism,and that a tumour has formed in conse-

i quence of the injury, what is now to be; done ? If ligatures cannot, without consi-- derable difficulty, be applied above and be-low the orifice, I would resort to Hunter’s- method, trusting to the power of anastamos-- ing branches, and a languid circulation in

, the injured vessel, together with moderate- pressure, for my hope of ultimate success.

I beg to add the narrative of a case whichoccurred to me about seventeen years since,in which the femoral artery was tied tocheck hæmorrhage proceeding from thesurface of an amputated stump. It suf-

ficiently points out the value of resorting tothe operation of Hunter, when one of theprincipal arteries of the leg has beenwounded, or is in a state of disorganisa-tion. The limb was amputated for a scrofu-lous affection of the ancle joint—the pa-tient’s age 25. The usual number of ar-teries were secured, and nothing uncommonoccurred to interrupt the successful progressof the case for the space of eight days. Atthe expiration of that time, the centre of thealmost united integuments exhibited a dis-position to open, as indicated by the pre-sence of a small protruding fungoid-likemass. Arterial oozing shortly showed it-self, which obliged me to separate the partsand search for the bleeding orifice. Havingdiscovered it to be the posterior tibial ar-tery, it was secured by ligature, and theparts replaced in contact as before. At the

expiration of twenty-four hours the hsemor- ·

rhage recurred, and a similar inquiry wasmade. ; but the diihculty of finding the ori-fice was increased, which induced me tohave recourse to the use of a crooked nee-die and ligature, after which the bleedingceased. On the following day, however, myhopes were again frustrated by a copiousand continued arterial flow. The frequentuse of the tourniquet had, by this time,produced considerable tumefaction, so that

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I despaired of finding the vessel again. Itoccurred to me that the simplest and easiestmode would be that of tying the femoral ar-tery in the middle of the thigh, a thoughtwhich was immediately executed. The re-sult was favourable ; the stump bled nomore, the tumefaction quickly subsided,and the recovery of the patient was rapid.Here the direct impetus of the circulationwas removed, and a new course given to it,which enabled the orifice to close, aided bythe inflammatory action excited in the pre-vious attempts to restrain the arterial dis-charge. A circumstance occurred in thiscase analagous to that which happened inMr. Hunter’s. About the tenth day I madean effort to withdraw the ligature ; no un-usual strain was put upon it, but a very co-pious and alarming flow of blood followed.The artery was compressed at the groinwith the thumb for a few seconds ; thebleeding ceased, and the future progress ofthe case was not interrupted by any occur-ronnn of an untoward nafnrn

It is Worthy of remark, that Mr. Hunter’sfirst case, which is related by Sir EverardHome in the first volume of the Transactionsof a Society for the improvement of MedicalKnowledge, was not diffused aneurism whichaccounts, I think, for the success attend-ant upon his brilliant operation. The partswere removed after death, and a very cor-rect engraving of the circumscribed sac maybe seen in the third part of the Philosophi-cal Transactions for 1826. The professionis indebted to Sir Everard Home for it, whosuggests a mode of coagulating the fluidblood of an aneurismal tumour by the intro-duction of a hot needle. This experiment,as far as it went, was conclusive, but theadvantages likely to result from his inge.nious suggestion are problematical.Plymouth, Aug. 18th, 1827.

REMARKS ON THE USE OF THE SECALE

CORNUTUM.

By JAMES PROWSE, Esq., Surgeon, Bristol.

I HAVE used the ergot of rye, which I regardas a specific in a great many cases, and withthe most decided success, whenever it wasretained in the stomach. With the inten-tion of adding my testimony in favour ofthis medicine, I will relate the principalfacts of three interesting cases, which hap-pened ia my own practice. The first casewas that of Mrs. -, who had been pre-viously attended by two practitioners. Thepoor woman had been in labour a great manyhours, and the flooding was profuse, so that

excessive debility and syncope were bothpresent. On my arrival at the bed-side ofthe patient, I found that the flooding hadsomewhat abated, but it did not cease. Theos uteri was much dilated, the head of thefœtus had not advanced beyond the brim ofthe pelvis, and the uterus itself seemed alto-gether incapable of making any effort to-

ward expelling the child, for there had beenno pains for a very considerable time. Twohalf drachm, doses of the ergot were ad.

ministered, and the child being a very smallone was suddenly expelled, almost withoutany conscious effort on the part of themother, in about an hour afterwards, the

flooding having ceased before. A consider-able portion of the placenta was firmly at-tached to the fundus uteri, upon which therewas a central or hour-glass contraction ofthe uterus itself. This difficulty I over-

came by manual operation, and the patientrecovered. The second case was that ofMrs. Wh , who had been flooding veryprofusely at intervals for the space of sixweeks before my seeing her, which was onthe second of June last. Considering therewas no chance of preventing abortion, Idetermined to have recourse to the ergot ofrye, in order that the foetus might be ex-pelled, and the patient restored to health.Four doses of the medicine were adminis-tered at short intervals, not one of which,however, being retained, and the floodingsoon after ceasing, no further efforts at ex-pulsion were made at this time. The pa-tient went on tolerably well until the 16th,when. I was called in again. The excessive

discharge of blood had produced fainting, andthe os uteri was small and tense, and partlyfilled with coagulum, and the fœtus couldnot be felt by an ordinary examination.These circumstances, together with thenow settled state of the stomach, inducedme once more to try the ergot ; accsrdingly,two half drachm doses were given, and, inthirty minutes after the first dose, the painswhich had altogether ceased returned andbecame continual, and a still-born foetus ofabout five months was expelled, within anhour and a half from the time of visiting thepatient.The third case is here introduced forthe purpose of showing the effects of the

remedy on the tense bitt not iriflamed os uteri.I was induced to do this, on account of theremarks of your excellent correspondentDr. Rudge, which are, I think, a little toocautious on this part of the subject, and cal-culated not only to deter the timid prac-titioner from using the remedy in thosecases which will detain him, and thus en-croach upon his valuable time ; but what isof much more importance, unnecessarily toprolong the anxiety and suffering’! of the

patient, by preventing the use of the medi-