50 PATHOLOGY. 
pretenfions to nobility, which made Buflfon ridiculous 
though born noble; nor that in love of office, which was 
the misfortune of Pliny the elder, and of which M. Cuvier 
feems to have his fhare. 
“ You are acquainted with the work which M. Geoffroy 
de Saint Hilaire publiffied laft year on philofophical ana¬ 
tomy, in which he endeavoured to bring all the types 
of organization to a primitive and unique form. M. 
Geoffroy continues to illuffrate his dil'coveries at the 
College de Pleffis before a numerous audience, and de- 
monftrates that “ infefts ire provided with a fkeleton as 
complete as that of the large quadrupeds ; that the cruf- 
tacese do not walk upon their claws, but upon their 
ribs. It is a pity that man is not a lobffer, for then, 
like ourfirft father, Adam, we might lofe our ribs with¬ 
out being aware of it, which would have diminifhed the 
rifk which M. Richerand ran in removing thole of the 
unfortunate Michelleau, in his famous operation for 
cancer. For a long time M. Richerand has publiffied 
nothing but new editions of his old works : it is matter 
of regret; for this furgeon has great talents as a writer. 
The clearnefs of his ffyle is admirable, and his works 
have been univerfally popular as elementary books. But 
M. Richerand as author, and M. Richerand as profelfor, 
are tw'o very different perfons. It appears to be matter 
of regret that M. Richerand fhould have changed his 
former chair of external pathology for that of operative 
medicine. In the latter he had to fucceed M. Dupuytren. 
Who could ftand the comparifon ? M. Dupuytren is 
perhaps the only furgeon, who with C. Bell and M. 
Delpech, has made it his ftudy to teach the art of ope¬ 
rating by fliowing the relation of different methods with 
the ftrufture of parts, and by determining the advantage 
of each proceeding according to the alterations of form 
produced on organs by difeale. “The leftures on che- 
miftry are, of all the lectures delivered at the Faculty of 
Medicine during winter, the beft attended. He who 
wiffies to know chemiftry thoroughly, muff attend M. 
Vauquelin. He who wiffies to fee chemical fails philo- 
fophically arranged and illuftrated by experiments ffiil- 
fuliy performed, muff go to the College of France, and 
to the Faculty of Sciences, to hear M. Thenard ; but he 
muff make hade, for it is as difficult to get a place to hear 
Thenard as to fee Talma. 
“A new and rival fchool has rifen by the fide of the 
Faculty of Medicine. A generous oppofition is already 
the refult, and it will probably fave the medical fchools 
of France from the deftruftion which hovers over them. 
Indeed the fchool of Val-de-Grace can only yet boaft of 
one profefi’or of celebrity ; but this teacher is endowed with 
real talent. He has all theenthufiafm of a reformer, and the 
power of communicating it when necefiary. It is in vain 
to conceal the influence which M. Brouflais already ex- 
ercifes, not only on the ftudies of the pupils, but on the' 
praftice of the phyflcians of the capital. As this influence 
is the moft important faff I have to communicate at pre- 
fent refpefting our fcience at Paris, I fiiall take an early 
opportunity of detailing to you' the doftrines of M. 
Brouflais. It would not be judging properly of his doc¬ 
trines or practice to repeat with the public, that the an¬ 
nual confumption of leeches in the civil hofpitals of Paris, 
which conllituted only an expenfe of 2000 francs, is now 
80,000. (See p. 4.6.) You will neverthelefs have heard 
that M. Brouflais is not fo much in vogue as laft year, 
when the minifter at war found it necefiary to clofe the 
doors of the hofpital to the crowd of ftudents who be- 
fleged them. As the doftrines of M. Brouflais are of a 
direft praftical application, the above-mentioned circum- 
ftance may have retarded their propagation. It does not 
much lignify. If thele doctrines are true, reflection and 
time will only ferveto eftablifn them ; if they arefalfe, it 
is perhaps better that the pupils fhould defer the exami¬ 
nation of them until they are qualified to judge and think 
for themfelves. 
“ There are fome people in the world, doubtlefs, who 
with to eftabliffi the amount of a falary upon any other 
confideration than the fervice rendered for it; but we 
mult look to a madhoufe only to fee the falary increafein 
direct proportion to the diminution of attendance. In the 
hofpital of lunatics at Charenton, the following regula¬ 
tion appears: “The phyfician fhall refide in the efta- 
bliffiment; he fhall receive a falary of 4000 francs, and 
pay five vifits a w'eek ; if he does not refide, he is to re¬ 
ceive 6000 francs, and pay only three vifits.” Talking 
of the Charenton, I rnuft give you an account of a new 
method of improving the falsifies of phyflcians in hofpi¬ 
tals where the patients pay for their board. This plan 
conflfts in affigning to the former a certain fhare, fay two- 
twelfths, of the favings which are made on the fum the 
patient pays, rendering it of courl’e the intereft of the 
phyflcians to make this faving as confiderable as pofiible. 
The firfary of the phyfician, therefore, it is evident, can 
only be limited by the bad intentions of a director too 
much attached to the welfare of the patients. This may 
be eafily obviated. By the affiftance of calumny, the di¬ 
rector is got rid of; and, to prevent all future difputes, 
the direction of the hofpital is made the marriage-portion 
of the phyfician’s daughter. I need not tell you that the 
Lunatic Afylum of Charenton is out of the adminiftrative 
control of the hofpitals of Paris. 
“When a man profefles zeal for his profeffion and love 
for humanity, his ardour in difeharging his duties is 
above all remuneration. At the Hotel Dieu, M. 
Dupuytren receives a very moderate falary, which is 
neither direftly nor inverfely proportioned to the number 
of his vifits, and which does not prevent his going winter 
and fuminer to the hofpital from half-paft five in the morn¬ 
ing to ten, and again returning in the afternoon to fee 
the patients who have been recently operated upon. 
Here, aIfo, M. Dupuytren, before performing an ope¬ 
ration, eftablifhes, in prefence of a numerous audience, 
the caufes which indicate it; he difeufles the methods of 
operating employed by furgeons, and deferibes the one at 
length which he is about to employ. 
At the Charite, MM. Boyer and Roux alternately 
take charge of the clinical department. M. Boyer ex¬ 
amines the houfe-pupils on the patients entrufted to their 
care. The profefl’or difeufles the moft important cafes, 
and difplays all that profound knowledge and practical abi¬ 
lity which have long ranked him amongft our firft furgeons. 
At the Hofpice de la Faculte, there are only forty beds, 
and the patients are feleCted with great care. M. Dubois 
can therefore devote to each patient a fufficient time to 
eftabliffi the diagnofis, and anfwer the queftions which 
each pupil has a right to addrefs to him. In the theatre, 
the profefl’or enters on the cafes which have been ope¬ 
rated on, or thofe which are about to take place. The 
operation is then performed, after which M. Dubois fees 
the out-patients. Here he applies public inftruftion to 
private praftice, and prefents us in part with the advan¬ 
tages of thofe private eftablifhments which in Germany 
are called clinica ambulatoria. M. Dubois is really inde¬ 
fatigable ; to the experience of age he joins the ardour of 
youth. Charged with the inftruftion of female midwives 
at the Hofpice de la Maternite, he has juft commenced a 
public courfe of leftures on midwifery for medical ftu¬ 
dents. Thefe leftures will be quite an epoch, and un¬ 
fortunately they will be the laft which M. Dubois will 
give on a lubjeft which requires more to be reduced than 
extended. Who will be better able than this learned fur¬ 
geon to reduce to their proper value the pretenfions of 
thofe furgeons, who haVe only become great accoucheurs 
becaufe they were not fit for any thing elfe ? 
“M. Roux has repeated wfith fuccefs the beautiful 
operation of the future of the velum palati, which he was 
the firft to praftife, upon an American, who had hqd a 
congenital divifion of this mufculo-membraneous part. 
Some months ago, at the Royal Academy of Sciences, 
the fubjeft of this operation, whofe voice before was 
hardly perceptible, read his own cafe very diftinftly.” 
The 
