right lung, cavity of the ear, right lobe of her marriage, her left arm began to swell and cerebellum, right side of the neck, upper be painful, and in the first part of June last, jaw of right side, and right tonsil.

her left breast began to swell, and she soon On applying the stethescope to the region began to feel darting pains in it at intervals of of the heart, we found its action strong, and it from one to five or six days, which still conappeared to strike hard against the ribs, but tinue, and are gradually becoming more freits sound was subdued or muffled, and quent and violent. In the first part of July its action was felt and heard under the cla- last, her right ear began to swell, was very vicle of the right side, very nearly as plainly red, and soon became very painful, and the as in its own region, but could hear it very pain extended through the cavity of the ear slightly under the left clavicle, and left and into the right and middle portion of the head, right side of the back. The respiration was and in three days the swelling of the ear subnatural in every part of the chest, except in sided and left a tubercle of the size of a pea, the upper portion of the right lung, where it on the upper side of the jaw, near the ear; was very slight, and at times inaudible. but the pain in the internal ear and head has Diagnosis by stethescope: Hypertrophy of continued with intervals of ease. On the 10th the heart and tuberculated upper and front of Nov. last, this tubercle began to enlarge, portion of the right lung. and to be irritated; and the external cervicle We now inquired into the history of this and submaxillary tubercles of the same side case, which is as follows:--

The disease commenced about three years since, when she was living in Cincinnati, and soon after an attack of cholera, with the usual symptoms of chlorosis. Her catamenia commenced when she was fifteen, but appeared but twice during that year, and only two or three times a year since that time, and then only from the influence of medicine, up to the first of December, 1833, when she

was married.

began to increase in size, and to be painful, and soon after the throat, with the gum of the upper-jaw of the right side became sore and painful; and in a few days after, the right side of the neck, with the lower and upper-jaw, began to swell, and with the ear and right side of the head became very painful. Her heart began to beat very hard about the last of November, and this strong or hard beating continues. On the 26th of December she began to cough and expectorate, and this cough and expectoration continue.

fined.

The marasmus has been slow but constant, and is now much advanced, with flaccidity of the muscles.

Previous to her marriage, they had been absent eleven weeks, but appeared in a day Her stomach, from the commencement of or two after, and have re-appeared since that the disease in the uterus, has been more or time oftener than before, in a proportion of less disordered with first mild and then about two to one, but have always been very acute symptoms of dyspepsia: bowels conslight or small in quantity. About three years since, a discharge commenced from the uterus which was adhesive, and of a white or milky color, and after few months became of a yellow color, with cheesy matter or flocculi, and has continued to this time. Her feet and ankles, began to swell about six months after the discharge commenced, and about a year from that time, her legs began to swell and be painful. Her back became very weak soon after the discharge commenced, and has continued so to this time, sequently become passive, the pain produced and she has frequently more or less pain by pressure did not dart into the diseased oralong the lumbar vertebræ. About the mid-gans as before.

The disease, it will be seen by the history of this case, was traced with great accuracy to the different organs and limbs. It was then in an active state, in consequence of a cold; for when we repeated the examination, about two weeks from that time, after the cold had subsided, and the disease had con

dle of December, 1833, and two weeks after We can, therefore, not only determine the

character of the disease by these symptoms, and the tongue one-third larger than natural. which are constant in all the cases, but we The tonsils are very sensible to pressure, and

We now examined the line of glands along The disease, he informed me, commenced the neck, and under the jaws, and found in the liver about three years before, and that them very much enlarged, and told her that it was about a year since it commenced in her tonsils and palate were enlarged, and his stomach, and three weeks since it extendthat she had the dyspepsia, chronic dis-ed to his kindey, and gave ease of the liver and leucorrhoea, besides swellings of some of her limbs.

She said that was right, and that the disease commenced in the uterus five years before, and about a year after it commenced in her liver, and in a few months after that, in her stomach; and that it was now nearly three months since her ankles and legs began to swell. It is now a year since her cata- These symptoms point to the disease in menia disappeared, and they have not since every other part of the system that may be tubreturned. On examining her throat, found erculated, in the most arbitrary manner; as in the tonsils and palate very much enlarged, these cases without any regard to the classifi

cation of nosologists, or the pedantic theories of the schools.

They are the natural and scientific symptoms of the disease in its active and passive state in the organs-they are produced by natural causes, and are very plain, invariable, and easily understood.

In examining patients with chronic diseases, it should not be forgotten that the disease is sometimes in an active, but most commonly in a passive state. If the disease were constantly in an active state, patients would die with it in a few weeks, like those with acute diseases, instead of living as they do When the disease has commenced in one months, and sometimes years. We can alorgan or limb, it is frequently propagated ways tell, in an instant, whether it is in an from that to another organ or limb, as in the active or passive state, in the organs, by case of Mrs. J. P-cases in which it is propa-pressure in the proper places on the spine. gated from the tonsils and uvula to the lungs, If the disease is active, the pain produced by and from the stomach, to the lungs, and from the liver to the stomach, and from the uterus to the ankles, legs, and stomach, are very

common

the pressure will dart into the diseased organ with a violence proportioned to the intensity of the disease, but if it is in a passive state, pressure produces pain in the spine only

Cervical vertebræ.

Dorsal vertebræ.

Lumbar vertebræ.

Here to find them of the liver.

Here to find them of the small intestines.

Here to find them of the kidneys.

Here to find them of the uterus.

Ов соссух.

In distinguishing the disease, and in tracing it in the different organs and limbs, we commenced and pursued the examinations as detailed in the cases appended to this work as we commonly do, without any previous knowledge of them. Any person of common education and capacity may easily distinguish the disease in the same way, in any of the organs or limbs.

which does not dart into the diseased organ as in its active state, but is more or less severe in proportion to the progress of the disease.

In many cases of the disease affecting the different organs, pain more or less severe is felt along the vertebræ, when none is felt in the diseased organ. We frequently find the same phenomenon in disease of the hip

joint, where the pain is in the knee instead of cheering satisfaction, to see exhibited, to the the hip. whole medical world, so triumphant a confirmation of the truth of their theory and practice, as is obtained from the recent discoveries of several of the most distinguished physicians and anatomists of Europe. And first for the direct connection which we have claimed between the posterior spinal nerves and the organs, we extract the following notice from a late number of the London Lancet [ANATOMY OF THE GANGLIONIC NERVES.]

Patients consequently refer the disease to the place where the pain is felt, and some physcians who have no more knowledge than they, agree with them, and apply their remedies to the same place. Large blisters have been applied to the knee, and cupping, blistering, setons, issues and the moxa to the spine in such cases without mercy during many months, and an enormous amount of suffering has been frequently inflicted in this way with little or no benefit to the patient. These symptoms are magnetic, for when we press on the ganglions of spinal nerves, in the active state of the disease, and the pain produced by pressure darts into the diseased organ, a force passes into the organs, and consequently produces pain in it, and that force is magnetic.

ARTICLE III.

Recent European discoveries in Tubercular
Disease.

The researches of Volkmann and Bidder

have confirmed-what, indeed, the march of science had previously caused to be little doubted by physiologists-that the ganglionic or sympatheticis not a mere offset from the cedent system of itself. The above anatomists rebro-spinal nervous system, but an indepenhave, by the aid of the microscope, verified a great difference in the arrangement of the nervous fibrilla in the two systems. The fibrille of the sympathetic nerves are distinguished from those of the spinal cord, by being paler, thinner, and containing less granular matter. Collected in bundles they have a greyish-yellow tinge. Where they communicate with the spinal nerves, the fibrils of each system of nerves may be distinctly traced by the aid of the microscope. Those of the sympathetic system are seen not only to penetrate to the centre of the spinal nerves, but to spread themselves around the circumference of the latter, where, by a careful mea

In the preceding article, the editor has presented three cases out of many thousands that have occurred in his own practice during the last thirty years, to illustrate the symp-surement, the greater number are found to be toms of tubercular disease, upon which his peculiar mode of treatment has been founded. If those symptoms and that treatment have remained, for so long a period, comparatively unknown to, and unacknowledged by the profession in general, it is to their prejudices and their attachment to the old visionary theories and practice of the schools, that the consequences must be charged; for he has published more than fifteen thousand copies of several works which he has written upon the subject, and transmitted them far and near.

distributed. If the sympathetic nerves originated from those of the spinal cord, say Volkmann and Bidder, we ought to find fibrils belonging to them in the roots of the spinal nerves. Now, if these roots be examined, scarcely one sympathetic among fifty medulary fibrils will be found; though they ought in such a case to be met with there in greatest number. The sympathetic nerves in reality origina'e in the ganglia; but not only in the ganglia of the sympathetic cord, but those also These latter ganglia especially give origin to on the posterior branches of the spinal nerves. the sympathetic filaments destined to unite with the posterior ramifications of the spinal nerves, a fact which gives probability to the hypothesis of Weber respecting the use of the spinal ganglia.-Froriep's Notizen, xxxi., 20. It is due, however, to some of the members Now, we many years since discovered, with of the profession, to state, that their intelli- the magnetic symptoms, (by which tubercugence and candor have already, within a few lar disease is distinguished in little children, years past, cleared away much of the dense with the same certainty as in adults,) a dimass of bigotry and hostility which surround-rect connection between the posterior spinal ed them, and opened a fertile field of exten- nerves, and the ganglionic or sympathetic sive usefulness. To those enlightened and system of nerves, connected with the organs, liberal coadjutors, scarcely less than to the which connection, has been constantly denied editor himself, it must afford a high and by the advocates of the ridiculous notion of

8

Recent European Discoveries in Tubercular Disease.

sis being closed, it should be, always difficult,
and often impossible to recognize their pre-

sence.

referring tubercular disease of the organs, to spinal disease," "spinal irritation" "nervous affections of the spine," "spinal neuralgia," &c., with all their horribly torturing appliances. We also traced this connection with clairvoyants, and Volkmann and Bidder have now traced it with the microscope, and as this connection is now confirmed by foreign authority, it will be taught in our medical Our want of success in the use of the ordinary colleges, in connection with the magnetic symptoms, as soon as the conceited profes-means of diagnosticating tubercles, proves that

sors of these schools can be replaced by men
who have talents and industry to keep pace
with the improvements in our profession.
The quackery which these professors have
practised and disseminated in their lectures,
and the amount of suffering they have in-
flicted upon their patients, while they were
literally groaning under the weight of their
"SPINAL DISEASE"-"SPINAL
knowledge of
IRRITATION"-" NERVOUS AFFECTIONS OF THE

SPINE”—“ SPINAL NEURALGIA," &c., which it
is now seen were never favored with a real
existence, is absolutely appalling; yet they
have the vanity to establish rules of prac-
tice, and the barefaced effrontery to denounce
every physician who varies from them.

Tubercles may exist in parenchymatous out their existence being revealed by any external organs, may even partly annihilate them withsymptoms; or if they are discovered it is at an advanced period of their existence, when they loager of any avail. In such cases it can have so far progressed that treatment is no scarce be said that the mal dy has been recognized during life; they belong in reality to Pathological Anatomy.

those means are inadequate, that we follow an erroneous course in our investigations, and that we must resort to new modes if we wish to be successful.

but

When pulmonary tubercles are suspected, we resort to auscultation and percussion, in many cases these fail us, even when numerous tubercles are disseminated through physicians, after having greatly exaggerated the lungs, and for this reason it is that many the value of the stethoscopic signs, now declare them of little value, at least during the first stages of the disease. There is here another mode to which we may resort, induction; for instance, a patient complains for the thoracic cavity, we resort to auscultation some time of slight pain and uneasiness in and percussion, the resonance of the thorax is every where normal, pulmonary expansion guided by these data the physician declares free and easy, respiration perfectly natural, and that there are no tubercles in the lungs. But he is dece ved, the method of investigation If we consider that the patient is born of tuwhich he has followed has been inefficient. berculous parents, that he has lost brothers or from cervical tubercles, white swelling or sisters from phthisis, or that they are suffering other scrofulous affections, that his health is delicate, his growth has been deficient, in a word, if we consult with care antecedents and coincidences, we hall acquire the conviction Tubercles in particular Organs.-The con- that his lungs contain tubercles, although sideration of this part of the subject belongs auscultation is powerless to demonstrate their rather to Pathological Anatomy. The diag-presence. One of two things happens, either auscul nosis of tubercles in particular organs, is very difficult at least in the first period of their ex-tation agrees with the data furnished by inistence.

In confirmation of the views which we have so long maintained on this continent, of the general prevalence of tubercular disease in the organs and limbs, against the combined influence of the professors of our colleges, we present the following abstract of the second lecture of M. Lugol of Paris, on Scrofula.

When tubercles exist in the sub-cutaneous regions, the mere local examination of the part at once enables us to convince ourselves of their presence, although, as we have already stated, these morbid productions develope themselves gradually without pain, and without swelling of the surrounding parts, in a word without giving rise to any perceptible phenomena.

duction, then it affords a valuable concurrent testimony, or it disagrees, and then I think we should follow induction as less likely to deceive us. Especially would I rely on the evidence of hereditary taint

Tubercles in the Brain.-Out of four cases, in which tubercles were found in the brain after death, there were two in which symptheir presence, but in the other two, though toms were noted which might be referred to When, therefore, we consider, that sub-cu- the lesions were more serious, no signs retaneous tubercles only become manifest du-vealed the tuberculous disease. In one of It is remarkable ring the first stages of their existence, because these cases, the left hemisphere had nearly they are external, we can easily understand disappeared, being replaced by a cyst filled how it is, that in the mediastinum and the pa- with tuberculous matter. renchymatous organs, this source of diagno- that the brain should undergo such extensive