BLEGBOROUGH’S FACTS, &C. ON THE AIR-PUMP VAPOUR BATH, &C¢. 
779 
symptoms which arise sufficiently explain the . hand, the bougie passes without any diffi- 
nature of the disease. 
«* Strictures appear to be a disease belong- 
ing to the earlier periods of life, while the 
other two are more commonly met with at 
an advanced age. 
*¢ Passing a bougie in cases of stricture in 
the zsophagus requires considerable dexterity 
as well as in those of the urethra, and I have 
found that it is more easily done while the 
tongue is brought forwards out of the mouth, 
than in any other-state of the parts.” 
% * * * 
*¢ When a bougie is passed with a view to 
determine the nature of the complaint, and 
it passes down to the distance of eight inches, 
measuring from the cutting edge of the front 
teeth in the upper jaw, the surgeon may be 
satisfied that it is beyond the usual seat of 
the stricture ; and if it is brought back with- 
out any resistance, he may conclude, that 
the aperture of the esophagus considerably 
exceeds the size of the bougie which had 
been used. But if the bougie stops at the 
distance of six and a-half inches, or even 
lower, he is to retain it there with an uni- 
form steady pressure for half a minute, so as 
to receive on its point an impression of the 
surface to which it was opposed. If the end 
of the bougie retains its natural form, or 
nearly so, and there is an indentation like 
the mark of a cord on its side, whether all 
round, or only partially, he may decide that 
the disease is a stricture; but if, on the other . 
culty to the distance of seven and a half 
inches, and when brought back the point has 
an irregular jagged surface, it is equally clear 
that the disease is an ulcer on the posterior 
surface of the esophagus.” 
A successful case of strictured rectum, 
cured by caustic, concludes the work. 
Such are the general contents of this 
volume. The whole subject is highly 
important to surgeons, as embracing a 
very interesting part of surgical prac- 
tice; one which is much controverted, 
and which is of too serious a nature to 
be taken up or rejected lightly. Mr. 
Home is fully aware that he is wielding 
a most active and hazardous weapon, and 
*a statement like the present was demand- 
ed of one who stood a conspicuous advo- 
cate for its use. Wedo not think hehas 
altogether made out so satisfactorily, 
(and perhaps the thing is in its nature 
impossible) the extent of injury which 
the caustic is capable of committing, as 
the denefit which may attend its use, but 
we are convinced, that no one can peruse 
the volume before us without participat- 
ing in some of the advantages which the 
author himself has acquired by very suc- 
cessful and very extensive practice. 
Aan XLVII. Facts and Observations respecting the Air-Pump Vapour-Bath in Gout, 
Rheumatism, Palsy, and other Diseases. 
By Ratew Brecsoroven, M.D. Member 
' of the Royal College of Surgeons, London. S8vo. 
IT‘is necessary to inform our readers 
what this air-pump vapour-bath is. It 
is, as its name imports, an air-pump; 
what answers to the receiver is an oblong 
truncated wooden box, made very strong 
and tight, somewhat in the form of a 
fracture-box for the leg, but perfectly 
close, excepting an opening at one end, 
_ just wide enough to admit the limb, and 
with a broad border of oil-silk, which, 
when the limb is in the box, draws round 
_ it, and the opening where it entered, so 
as to exclude the external air. At the 
other end of the box, is a common piston 
for exhausting the air, and also a tube 
_ through which steam may be thrown 
into the box, and foment the part within 
it. 
It was invented, we are told, by a Mr. 
Smith of Brighton, who took it from the 
old idea of sucking out poison from’ 
wounds, and supposed that gout, rheuma- 
tism, and other morbid causes might, in 
like manner, be sucked out from a limb. 
It is, in fact, a machine for dry-cupping, 
united to one for fomenting, and both 
the idea and the execution deserve some 
attention, as we are convinced there are 
many cases in which such a powerful 
derivative topical application mightprove 
of material service. 
The author gives some cases of its uti- 
lity, and many speculations as to the ex- 
tent to which the practice might be car- 
ried, The practitioner will readily con- 
ceive the cases where it might be advise- 
able, rheumatic indolent tumours, para- 
lysis, perhaps gout, &c. &c. Dr. Bleg- 
borough also proposes it for ulcers,— 
Here, however, much discrimination is 
required, for such a powerful topic is 
equally capable of doing great mischief. 
His proposal for using it to chilblains is 
promising. The machine is the pro- 
perty of a patentee, who disposes of the 
privilege of using it both personally and 
professionally. 
The machine is illustrated by a very 
neat plate. 
