47 
PATHOLOGY. 
confequence of inflammation of a more or lefs chro¬ 
nic kind. He relates fome cafes which feem to Ihow 
that it has, at lead fometimes, fuch an origin. He ad¬ 
vances a carious propofition refpe£ling delirium, that has 
much apparent probability. He fays, delirium is never 
obferved in cafes of inflammation of the brain alone; 
this fymptom appertains efpecially to inflammation of 
the arachnoid membrane. It is not becaufe the arach¬ 
noid is the feat of the immediate caufes of delirium ; but 
becaufe this membrane, when inflamed, irritates the fur- 
face of the brain which is in contact with it; and, as 
the tifl'ue of this organ is then not altered, its functions 
are merely “exalted thefe functions, on the contrary, 
ceafe (to an extent correfponding with the extent of the 
inflammation,) when inflammation has its feat in the 
proper fubftance of the brain. 
A work of very conflderable value on inflammation of 
the arachnoid membrane of the brain and fpinal marrow, 
has been publilhed by two young phylicians of Paris, 
Drs. Martinet and Parent-Duchatelet,which is the refult of 
feveral years’ obfervation at the Hotel-Dieu and the Hof- 
pice des Enfans Malades, under the direction, and indeed 
afliflance, of Drs. Recamier and Jadelot, phyficians, ref- 
pe< 5 tively, to thofe inftitutions. This work prefents' 
fuch a number of cafes (not feledled, and therefore the 
more valuable, as prefenting a view of what is of ordi¬ 
nary occurrence,) as will admit of general inferences, of 
more or lefs validity, refpedling every point of moll inte- 
rdl in the hiltory of the difeafe. 
The charafters of arachnitis appear to vary as the dif- 
eafe occurs in parts of the membrane correfponding to 
different parts of the brain. Thus, the fymptoms of 
arachnitis at the bale of the brain, prefent, in general, 
charadlers by which the difeafe may be recognized, and 
diftinguiflied from arachnitis in the convexities. There 
are, however, fome varieties in thofe fymptoms, con- 
nedled with dfverfities in the age of the patient., In 
children, for example, who are difpofed to be afFedled 
with this form of the difeafe-almolt exclufively, the ex- 
cefflve irritability of their nervous fyllem occanons fpafms 
in different parts, which give a particular character to 
the malady. Thefe affections fometimes appear in a fud- 
den manner, without any previous indications; at other 
times, the progrefs to them is more gradual; the Hate 
of the intellectual faculties prefents lefs varieties than 
that of other organs. The degree of energy which the 
brain pofleffes in adults, and even in adolefcents, ena¬ 
bles patients of this clafs to refill much longer the difpo- 
fition to llupor; fo that this fymptom is much lefs early 
andcompletely manifelled in them than in children. In 
both, thelefion of the intellectual faculties refults effen- 
tially from the want of aCtion of the brain, from the in¬ 
ertia of this organ, and not from the derangement of its 
functions, or delirium, which is the predominating cha- 
radteriilic of arachnitis of the convexities. When in¬ 
flammation is feated in the portion of the arachnoid 
which lines the ventricles, the fymptoms are the fame 
as thofe which refult from it at the bafe of the brain ; and 
in the greater number of cafes it is prefent alfo in the 
latter region. Thirteen cafes of inflammation of the 
arachnoid membrane of the fpinal marrow are related, 
from which it appears, that the chief charadteriftic fymp¬ 
toms of this affedlion, areltiffnefs of the neck and trunk, 
pain along the vertebral column, in addition to the com¬ 
mon fymptoms of irritation of the nervous fyllem, with 
the abfenceof fignsof cerebral diforder when the inflam¬ 
mation is confined to the arachnoid of the fpine, and 
their coincidence when the ferous membrane of the 
brain partakes of the inflammation. 
Two interelting cafes of inflammation, and confequent 
dilorganization, of the fpinal marrow itfelf, have been 
lately publilhed by Dr. Pinel the younger, which were 
characterized by continual convulfive motions of the 
whole of the trunk of the body, followed by an almoll 
complete annihilation of the fundlions of the nerves of 
voluntary motion, and accompanied by a febrile Hate of 
the fyllem, having a paroxyfmof exacerbation every eve¬ 
ning. 
The furgery of France, as far as operations are con¬ 
cerned, lcarcely appears on an equal footing with the 
furgery of this country; and, if we were difpofed to cri- 
ticife our Gallic neighbours, we might further remark, 
that a great want of attention and refpedt is manifelled 
by them for the labours of others. Thus Brouffais, juft 
mentioned above, has been lately labouring to Ihow that 
we know next to nothing; and very unfairly fupports 
his affertions by quoting the pradlice or the reveries of 
fome of the obfcurell contributors to our periodical pub- L 
lications. And Boyer, a charndter of great repute in 
France, and author of one of their flandard furgical 
works, has the blindnefs to rejedl Mr. Hunter’s excellent 
mode of operating for popliteal aneurifm, and even de¬ 
nies his claim to the difcovery of it. By the way, we 
mayjuft extradl from a cafe lately publilhed by DeRoux, 
an account of the method in which the operation for 
aneurifm is performed in France : “ I performed the ope¬ 
ration,” he fays, “ in the place where it is now pradtifed 
in England. The artery was completely infulated from 
all adjacent parts, even from the crural vein, for the 
fpace of an inch. I placed four ligatures at about two 
lines diltant from each other. Thus there were two li¬ 
gatures to intercept the blood, the firfl and lall being 
only left as ligatures d'uttente. I then followed the re¬ 
commendation of Scarpa, in applying upon the artery a 
fmall cylindrical body, an inch long and two lines in 
diameter, upon which I put a piece of linen, which had 
been dipped in melted plalter; on this I tied the two 
middle ligatures. I took care not to let the wound 
unite, and kept the lips feparated by foft lint.” An 
Englifii furgeon will have little difficulty in feeing the 
fcriking contrail exhibited between this operation and the 
manner it is performed in the hofpitals of London. Let 
us not however confound all in thiscenfure: there are 
many who duly appreciate our toils and our merits; and 
there are many who deferve from us the fame regard. 
We might mention fcores of names in proof of this ; 
but Larrey, Richerand, and Dupuytren, are fufficiently 
known to our medical readers. 
In parturition, we have two curious recent cafes to re¬ 
cord.—-A male child was born in May lall, at the Hofpi- 
tal of la Maternite, at Paris, with the whole furface of 
the body deeply wrinkled, like that of a very old man. 
Its hands and feet are double the ordinary length, and 
are equally wrinkled. It has llrong grey hair, and a 
beard of the fame colour. In every other refpeCt it en¬ 
joys perfect health, and is nurfed in the hofpital.—The 
following is not lefs interelling ; though we have already 
remarked, (fee the article Parturition, in the prece¬ 
ding volume,) that the French are in general more fuc- 
cefsful in thefe defperate cafes than ourfelves. At a 
meeting of the Royal Academy of Medicine at Paris, 
on the 7th of July lall, (1821.) M. Beclard, one of the 
moll dillinguilhed furgeons of that capital, reported that 
he had, the day before, performed the casfarian operation, 
by an incifion made in the direction of the linea alba ; 
and that both mother and child were doing well. The 
report continues favourable down to the 10th, on which 
day the account was tranfmitted. 
The French pay more attention to pharmacy than per¬ 
haps any other nation, and confequently their attain¬ 
ments in that branch of the healing art are very great. 
Simplicity has affumed the place of that multiplicity of 
formulae which had overrun all the old pharmacopoeias; 
and the analyfis of vegetables w-hich at prefent engages 
fo much the attention of the French chemilts, promifes 
to afford very important information in regard to the 
modus operandi of medicinal fubllances; a fubjeCt of 
which very little is at prefent known. 
Thefe remarks have occurred to us in perufing the lall 
Paris Pharmacopoeia, or Codex, publilhed in 1818, in a 
1 handfome 
