of the practice of medicine. True, the diagnosis is sometimes difficult, but is not this often the case in adults? In the very young patient we are deprived of the subjective signs, but we have a better opportunity of analyzing the objective, than we have in the adult. Another fact is that the objective signs in the child are more reliable than the objective signs in the adult. What physician has not been often misled when he placed too much confidence in the subjective signs? We have the expressions and color of the countenance and skin, gestures, peculiarities of sleep, respiration, breath, cry, tongue, evacuation, etc., etc. The observing physician can soon learn to form from these a correct diagnosis. The child's physician needs a large amount of patience and quick perception. In examining the child we are not compelled to violate any rules of seeming modesty, but can examine thoroughly from head to foot. The child is not a malingerer, or, in plainer terms, never lets on to be any sicker than it really is-it is just as sick as it appears, and no more nor less. How different often with the adult.

Every physician knows the intimate relation existing between the mind and body. Now, in the child we are rid of all those mental emotions which often aggravate disease in the adultanxiety, cares of life, fear of death, etc., are all unknown to the infant, and their depressing effects are not felt.

The sexual system being undeveloped, what a train of diseases we can exclude when forming a diagnosis. Hysteria, with its protean forms never shows itself in the cradle. Uterine diseases are strangers, as are those imaginary aches and pains, the narration of which so often annoy the physician.

They are more easily influenced by most medicines, and it remedies are rightly applied, we may hope to see changes made for the better, sooner than in the adult.

My design in writing this article is to awaken in the minds of young physicians a love for this branch of our science, and not allow it to become the opprobrium of young physicians. It is a subject worthy of our attention and deep study, and the deeper we dive into it the casier it becomes, and the less gigantic its form assumes.

ART. V.-Ligature of the Femoral Artery. Ex B. F. DUVALL, M. D., Forks of Elkhorn, Franklin County, Kentucky.

I desire to report the following case of successful ligation of the right femoral artery, just under Poupart's ligament, so as to place it among the statistics of the ligature of this artery.

H. Smith, private Co. F, 21st Va. regiment rebel infantry, received, in the battle of the 19th of October, 1864, near Middleton, Va., a wound through the upper third of both thighs, and root of scrotum, wounding the epididymis of both testicles.

He came under my care October 21st, two days after being wounded, and was suffering comparatively but little pain from his injuries. The scrotum was much ecchymosed and swollen. The wounds in the thighs were but slightly inflamed, and there was but little tumefaction of the limbs. On the third day from the date of the injury, the wounds commenced suppurating healthily, with no indications of hemorrhage. The wound in the. scrotum did not suppurate at all, healing by the first intention; the swelling and ecchymosis disappeared in ten days. Up to November 12th he continued to improve, the wound in the left thigh having almost entirely healed, as did the one in the right, excepting the point of exit on the internal side. In attempting to move him upon a litter for the purpose of transferring him to another hospital, profuse hemorrhage took place from the internal wound of the right thigh. On being called to the patient, I caused the artery to be compressed against the pubic bone by the thumb of an intelligent nurse, which controlled the hemorrhage perfectly. A longitudinal incision was made down to the bleeding vessel, following the track of the wound as a guide, which proved to be a a double femoral, the bifurcation taking place just under Poupart's ligament, the divisions running parallel for three or four inches before uniting. The arteria profunda was given off from the internal bifurcating branch, which was cut just above the profunda, so close to its margin as to preclude the idea of ligating the wounded branch. When the compression was removed, the blood flowed freely from both the distal and the cardiac ends of the wounded vessel. We then secured the main artery by ligature close under Poupart's ligament. The wound was closed in the usual way, and a fold of linen wet with cold water applied

to it. He was then removed to the hospital, where he was comfortably put to bed.

My apprehensions for the success of this case were great; I knew that the main supply of blood to the limb was cut off, and the latter would have to depend upon the ischiatic artery for its support, which, in his prostrated condition from the loss of blood, would not, I feared, be adequate to perform this duty.

This operation took place sixteen days after the injury, and for several days thereafter there was some tumefaction of the parts, running in the direction of the absorbents and blood vessels; but this soon began to subside, and in twelve days the ligature came away, the wound was suppurating healthily, and in ten days more the limb was almost of normal size.

I watched this case closely, and discovered but little diminution of temperature, not enough at least to require the addition of artificial heat. He continued to improve for six weeks, when he was sent North to prison, cured.

The treatment consisted of the simplest dressings. The constitution bore up well under the loss of blood, assisted by nutritious diet and stimulants.

ART. VI.-Two cases of Cutaneous Discoloration caused by Oxide of Silver. By D. H. MCDONALD, M. D., Quincy, Ind.

From the statement made in the U. S. Dispensatory I was led some years ago to prescribe oxide of silver, and was so unfortunate as to discolor two of my patients with it. In reading the last edition I find that doubts are still entertained of its power to produce discoloration. For this reason I lay before the readers of your Journal the two following cases:

CASE 1. A. Johnson, æt 26, farmer, has been subject to epilepsy for several years. I prescribed the oxide of silver in one grain pills, to be taken one before each meal. He continued the use of the remedy until he had taken fifty grains, when, to my surprise, I discovered a notable discoloration of the surface. The drug was immediately abandoned. It had no appreciable effect as a curative agent.

CASE 2. N. J. Woldridge, æt 21, farmer's wife. Found her laboring under pyrosis, uterine leucorrhoea, and epilepsy. OrVOL. II.-No. 1.-2.

dered the same prescription as in case first. The pyrosis was promptly relieved, the leucorrhoeal discharge rapidly disappeared, but the epileptic symptoms remained unchanged, recurring every second or third day. She had taken thirty grains of the oxide, when, to my intense mortification, cutaneous discoloration was manifest.

The discoloration grew deeper, day by day, until within a fortnight it was as intense as I ever witnessed.

Some three or four months after, the lady died of pernicious fever. Case 1, is yet a living witness of the power of the oxide to discolor the human cuticle. The discoloration in this case is not so deep, by probably a half, as is usually seen from the nitrate. I prescribed the oxide in a case ef epilepsy prior to these, in which the patient took two grain pills thrice a day, until sixty grains were taken; and more recently, in a fourth case, until one hundred and twenty grains were taken,without any effect whatever.

ART. VII.-Bronchocele Successfully Treated with Strychnia. Br CHARLES MANN, M. D., Nicholasville, Ky.

Mrs. Mc. presented herself for treatment on the 24th of April, 1866. Says She is troubled with great difficulty in breathing while asleep, caused by a swelling of the neck. Frequently in the night, jumps up in bed, feeling as if she would "suffocate." She is about thirty years old; mother of six children; nursing a babe six months old. Says this swelling began four years ago, but never troubled her much until within the last year. Both lobes of the thyroid gland are enlarged; the right is the larger. It is about the size of a turkey's egg. She has slight palpitation; a dry, husky cough; frequent pains in the chest, with soreness of the muscles on side of neck; sometimes buzzing in the ears; occasionally slightly hysterical. She has a pallid, anxious countenance, with considerable proptosis of both eyes. Menstruates regularly, although she is nursing. Bowels habitually constipated. Has been treated for one year by different physicians, but receives no benefit, and is now worse than ever before.

R. Syr. iodid iron thrice daily, with ext. belladonna and iodine ointment applied freely to tumors.

May 1st.-No better; continue treatment.

May 13th. But little change since last visit.

May 28th. No better. R. Strychnia, gr. j; hydrochloric acid, gi; water 3 vij. M. S., 10 drops thrice daily; gradually increase to 30.

June 16.-Much improved. Tumor decreasing; sleeps better; menstruation ceased; bowels move once a day; stools healthy; eyes not so prominent; complexion better. Continue treatment.

June 29th. Still improving. Very slight enlargement remaining. July 29th.-Feels as well as ever she did. Has gained flesh. Gland natural in appearance. Discontinue treatment. She has remained in good health, and no return of goitre up to this date.

Dr. Murney has published in the Dublin Hospital Gazette, for 1860 (which is republished in the 42d number of Braithwaite), three cases of bronchocele, successfully treated by strychnia, which treatment he considers unique. So, if Dr. M. will read the medical journals of America, he may find another similar case to add to his list. I think Dr. M. takes a very rational view of this disease, when he says: "Hence I deduce that the most of our cases of bronchocele are the result of impaired innervation or a perverted action of the nervous functions," etc.

SELECTIONS.

We republish, from the London Lancet, December 8th, the charge of the Lord Chief Justice, in the celebrated libel trial of Hunter v. Sharpe.

The Lord Chief Justice then addressed the jury upon the case as follows: Gentlemen, this is an important case, no doubt. It is important to the plaintiff; for on your verdict must mainly depend his professional position, and, what is more, his personal character as a member of society. For if a man is an imposter and a scoundrel his personal as well as his professional character must be irretrievably ruined. It is also of great importance to the defendant that if he has done what he might honestly do, and no more, the character of the plaintiff should not be rehabilitated at his expense. The case, again, is more or less important with reference to the system of advertisement pursued by the plaintiff, and the conduct of a public writer and his responsibility in writing upon public matters. And it is important, likewise, incidentally in this view, that you may have to consider how far the character of an honorable profession may be damaged by recourse to such a system of advertising as you may perhaps see reason to consider improper and unprofessional. There can be no doubt that the article -unless it can be justified or excused-is libelous. But it is in the pleas put upon the record we find the true nature of the contest between