them, the liver displayed inflammation or its evident ef fects. The substance of the organ, in two of them, was found utterly destroyed. Four of them were complicated with inflammation, adhesion, induration or abscess of the lungs, and thoracic or pericardial effusion: two, with inflammation or gangrene of the diaphragm: four, with the existence of gall stones: three, with enlargement or gangrene of the spleen; in one instance, this viscus adhered to the enlarged liver: two, with lividity and gangrene of the stomach from previous inflammation: four, with inflammation and gangrene of the intestines, or peritoneal effusion: one, with destruction of the omentum: one, with contraction of the aorta in its thoracic and abdominal portions. This last we are inclined to consider an adventitious circumstance, wholly unconnected with the morbid state of the liver. Three of these cases we shall concisely exhibit. They posses considerable interest; and the works, in which they are originally recorded, cannot be accessible to the generality of our readers. 1. Morbid appearances: The substance of the liver ut terly destroyed, its membrane only remaining sac-like; the parietes thickened, and containing a quantity of fluid like the washings of flesh. Symptoms: Hepatitis, followed by the fluxus hepaticus of six months duration; extreme marasmus; discharge per anum of fluid resembling that discovered, after death, in the hepatic cyst. Subject, an adult male. Bontius, Lieutaud, 787. 2. Morbid appearances: Liver enlarged; externally, of a red-brown color, internally, quite filled with fetid pus, so as to resemble, on the evacuation of this fluid, an hollow sac; the gall-bladder so enormously elongated as almost to touch the crest of the os ilium, and filled with a blackish fluid; the intestinal canal distended with air; the colon much dilated at its extremities, but greatly_contracted in the vicinity of the spleen. Symptoms: Hepatic inflammation, apparently cured; in the progress of convalescence, shiverings, recurring every evening, and succeeded by increased heat; the surface of the body assuming universally a deep red color; the urine also becoming red; progressive emaciation; shiverings more frequent; fatal syncope. Subject, a man of 48 years. Hasenorhl, Histor. morb. Epist. 3. Morbid appearances: Body emaciated; omentum destroyed; liver inflamed on its concave surface, and verging towards gangrene; the internal membrane of the sto mach affected with putrefaction; the lungs dry and universally adherent to the costal pleura; the pericardium dry, and the heart flabby and emaciated. Symptoms: Hydrophobia, with utter incapability of swallowing a drop of liquid; accession of fury on the third day, with inundation of the salivary secretion, and constant spitting at the attendants. Convulsions and sudden death, as by suffocation, on the fourth day. Subject, a stout man, of middle-age. Brecktfeld, Lieutaud, 599. We are not informed whether this last deplorable malady was consequent on the bite of a rabid animal. Immediately afterwards, M. Portal observes: "I have seen, with M. Salmade, real hydrophobia supervene in hepatic inflammation. It was successfully treated by venæsection, soothing and cooling remedies; and subsequently, anodynes and opiates." Ten other histories are here also presented from our author's observation, and five borrowed from the works of Lieutaud and Bertrandi. They are intended principally to illustrate the connexion and co-existence of hepatic and pulmonary inflammation. Sometimes the liver and lungs are simultaneously attacked; sometimes the phenomena of hepatitis are consequent on those of pneumonia; but more frequently, according to the experience of M. Portal, the liver is primarily, and the thoracic organs secondarily, affected by the inflammation. The results of two of our.author's most instructive cases we shall concisely exhibit. 1. Morbid appearances: Liver greatly enlarged and indurated, adherent to the diaphragm, stomach, colon, and universally to the peritoneum, by false ligaments; presenting internally several abscesses: the gall-bladder containing black bile and many gall-stones; much fetid water in the peritoneal sac; right lung unusually red, compact, and adherent to the costal pleura; the heart and cerebral vessels turgid with blood. Symptoms: Pain in the inferior part of the thorax and epigastric region, extending afterwards to the right hypochondrium and summit of the right shoulder; nausea; slight cough and bloody expectoration; palpitations and tremor of the heart; abdomen tense; urine very red, but copious; enormous evacuation of yellow serum, tinged with blood, by the rectum; death on the ninth day of the disease. Subject: A man of thirty years, thin, and naturally of a sallow complexion. 2. Morbid appearances: Liver of a prodigious size, and soaked, throughout a greater part of its extent, in bloody serum, but indurated in its anterior border; that portion of the diaphragm, to which it adhered, greatly inflamed; its superior (diaphragmic) surface covered by a layer of false membrane: the spleen enlarged and gorged with black blood: much blood in the vessels of the lungs the heart much dilated and full of blood, particularly the right (pulmonary) auricle and ventricle: the uterus large and filled with blood. Symptoms: Indigestion; frequent pains of the head, and nasal hæmorrhage; repeated hæmoptysis: afterwards, difficult respiration, aggravated on the approach of the menstrual flux, commonly very abundant; this discharge suddenly suppressed by mental commotion; immediate accession of violent vomiting, with severe pain in the epigastric region, subsequently extending to the whole right hypochondrium; jaundice; incapability of lying on the left side; abdomen becoming tumified and hard; urine very black; hiccough with extreme dyspnœa supervening; pulse very hard and frequent; internal sensation of great heat, the surface of the body and extremities retaining their ordinary temperature: the progress of the disease to its fatal termination rapid. Subject: A lady, aged twenty-eight years. It seems to be the opinion of M. Portal, that in these cases, as in all where the liver and heart are suffering from co-existent enlargement, the first of these organs is primarily affected, the latter in a symptomatic and consecutive manner. On this subject we do not entirely accord with the French pathologist. In the former of the preceding cases, we believe the liver to have been the original seat of morbid action; in the latter, the heart; and we imagine that any one, who contemplates with an unprejudiced eye the train of external phenomena which they respectively exhibit, will adopt the same conclusion. That a compli cation of diseased heart and liver exists much more frequently than is in general suspected, we have long been aware. It is a point of inquiry which has occupied recently much of our attention. The light we have already drawn from it, although at present feeble and imperfect, has served to explain to us some very mysterious features in the progress, some vexatious occurrences in the treatment or termination, of hepatic maladies: and we feel ourselves justified in stating an opinion, that, where certain forms of liver disease and organic lesion of the heart are complicated, it will very often, though not invariably, be discovered, upon the minute and comprehensive examination of an intelligent patient as to the origin of his com plaints, that the symptoms of cardiac derangement were first, those of the hepatic affection subsequently, manifested. On these interesting considerations we shall not now pause. We are shortly to discuss them in a direct and extended manner. Ere quitting this department of our author's work, we shall transcribe from one of his notes some observations on pulmonary and hepatic abscess, which we deem alike novel to many of our readers, and deserving to be remembered and reflected upon by all. The perusal of them will sufficiently apologize for their introduction : "In a body brought in for the purpose of my anatomical demonstrations, I discovered an enormous abscess of the liver; which, after having contracted adhesions to the peritoneum, opened posteriorly between the lumbar and abdominal muscles: the contained pus had found its way along the ribs to the axilla. In my work on pulmonary phthisis, I have recorded the history of an abscess, which had formed between the pleura and the ribs. It was believed, at first, to be empyema; but this was not the case. I have also discovered, upon dissecting a body, a large abscess of the right lung; which, a strong adhesion having been established between the costal and pulmonary pleura, had found a passage between the intercostal muscles and serratus major anticus. Thus abscesses of the liver and pulmonary organs may resemble, and be confounded with, each other in the passage of their contents from the abdomen and from the thorax." (To be concluded in our next. ) SELECTIONS. The French Dictionary of Medical Sciences. IN our Journal for July last, we announced the publication of this great work, and stated, at some length, the grounds upon which, at least in respect to plan, we con sider it decidedly superior to our two latest and most com. prehensive British Dictionaries of Medicine. Of its execution and relative merits, as confronted with these productions, we promised to present some detailed specimens. This promise we have not forgotten; and we shall now proceed to its execution. Upon the expedience of admitting the necessary extracts from the French dictionary into the critical department of our Journal, we have long hesitated. We have at last decided, that they should occupy that portion of it devoted to " Selections." When the mag nitude of the French work is considered, and the great length to which our extracts will probably be extended; when it is understood, that we propose generally to exhibit the translations from that work, and the most striking passages from correspondent articles of the London and Edinburgh Dictionaries, unincumbered by diffuse criticism, and unmixed with opinions of our own, as to their com parative merits; when we add, that the first of these productions contains many valuable articles to which there is no parallel in the two latter, the propriety of our decision will, it is presumed, be evident. In forbearing to decide upon the relative claims of the three works, and leaving the reader to form opinions for himself on the subject, we anticipate also his approbation. Such are the little vanities, affections, and prejudices inherent in the human heart; so powerful and unvarying, however imperceptible is their influence, that few men are capable of reflecting with coolness, and determining with strict impartiality upon questions in which these passions are warmly interested. And if, on the one hand, we were sufficiently free from the common and natural predilection for the productions of our own country to deliver an unbiassed opinion, the pride of superior elevation of sentiment, and the ostentation of being exempt from vulgar prejudices, might betray us, on the other, into extremes not less faulty and pernicious. Besides, in quoting from a book which, on the score of its costliness as of its language, is by no means generally accessible, we shall obviously do right to select the best-written, and most instructive articles, to mingle utility with amusement; so that a clear and tolerably comprehensive view of the present state of medical science in France may be exposed to the British reader. Hence any but a general comparison of these extracts with corresponding subjects of discussion in the British dictionaries, would be manifestly unfair. Our Selections will commonly, though not invariably, follow the alphabetic order. The article Abdomen will constitute the first. After noticing the derivation from the term of the Latin verb, abdere, M. Renauldin, the writer of the article, proceeds thus: "The Abdomen is that part of the trunk situate below the thorax and above the inferior extremities. It is in figure oblong; convex anteriorly, especially at the inferior part; posteriorly and laterally concave; but this form varies somewhat with the position of the body. The size of the abdomen is also subject to considerable changes. It |