823

qu’il est extremement facile d’étabIir d

priori, si un cadavre appartient un noyé.Frequemment on voit it la Morgue des su-jets qui sont morts dans les hopitaux et quiy etaient inconnusjamaisje n’ai commis d’er-reurs a leur egard lorsqu ’ils présentaientdes signes de putrefaction. 11 en etait dememe pour les pendus rest6s accroches àun arbre dans un bois pendent trois, quatreon cinq jours, et apportés a la Morgue lorsque la putrefaction commencait a s’établir."You have had an opportunity since I

spoke of this rule as being " very liable toexception," of witnessing a striking exem-plificatión of that remark in the man whodropped down in the Strand, and was deadwhen brought to the hospital. Nothing of hishistory is ascertained, for he has not beenclaimed, and we cannot know what mayhave been the state of his health prior, tohis seizure. He was brought into the hos-pital on the 13th instant, and on the 21 st,eight clear days after death, the limbs weresreen in various parts : the shoulders, the i

neck, and the face (especially that sidewhich had been the lowest) were quitegreen, as much so as if they had been verysuccessfully injected or stained with

verdegris ; a fainter shade of the samecolour was on the lateral parts of the body,over the ribs above, and over the bones ofthe pelvis below, and appeared to be invad- Iing the anterior parietes of the abdomen,but the umbilicus and anterior surface ofthe abdomen were perfectly of the naturalcolour.We have in this case, then, a practical

illustration not in accordance with the rulethat the abdomen is the first part of thebody that becomes green when putrefactiontakes place in the air, and which does notconfirm the more general observation, inreference to the discolouration, which says," C’est par le centre de 1’abdomen qu’elledebute pour se porter a ]a poitrine au col, àlaface, aux avant bras, au-s jambes, etc."

ON

QUACKERY,AND

ON EAR MEDICINE.

By HENRY SAVAGE, Esq., M.R.C.S.L.,Lecturer on Anatomy, &c., London.

Bonis nocet ‘quiaquis pepercerit maUs.łPuBnus.

IF medical empiricism could be graspedand exhibited in all its plenitude of craftand villainy, the scales would fall from theeyes of the public, now so deluded andquack-ridden; with one voice its suppressionwould be demanded, and the monstrous Iabomination would cease to exist. Unfor- I

tunately, the subject is far too mighty to be

thus dealt with ; its ramifications are toovaried and extensive ; detection and ex-posure of one piece of empirical impostureis sure to lead to artifice still more refined;destruction of one side of the fabric is sureto be speedily counterbalanced by an in-crease in an opposite direction; vires ac-quirit eundo; in spite of the serious losseswhich it has sustained in its progressduring the last 1300 years, it has now at-tained (19th century !) in extent and in-fluence over the public, such a pitch ofpower, that it defies the unsustained attacksof a single individual.

Although quackery is diametrically op-posed to the interests of medical science,and even threatens the very livelihood ofmedical men, in general they regard thesubject with apathetic indifference. Hereand there, one more bold than the rest maybe found, at distant intervals, raising hisvoice against this pest of society, this realhydra ; he makes a vain attempt, by point-ing out the absurdity and irrationalitv ofmedical empiricism, by disclosing its evils,and by laying bare its machinery, to satisfythe popular mind that nothing in the worldcan be more hostile to their interests thanthe unrestricted practice of physic ;* but noadvantage can ever be derived from his

isolated exertions. On the other hand, thiscourse, so just, so sensible, instead of exer-cising that influence for which it was in-tended, produces too frequently the oppositeeffect ; the legitimate practitioner is accusedof selfishnees, perhaps of ignorance; and thequack, being looked upon as a persecutedvictim, is loaded with fresh proofs of thepublic infatuation. The cause of this anoma-lous working of human reason is not by anymeans easy to explain: these ignorant pre-tenders are never consulted respecting thoseemergencies to which the body is dailyliable, and many of them require on the

part of the attendant the utmost skill. Abroken bone, severe wounds of importantparts of the person, of the eye or ear, forexample, are never entrusted to a quack;acute inflammation ; fevers ; epidemics ofthe most dangerous character; fall not underthe superintendence of a quack; yet, a newinstrument, a new remedy, in short, any-thing new, or peculiar, professed by thatsapient, enlightened personage, whom thepublic positively scorn to employ for thetreatment of maladies, however serious, ifpopularly understood, is sure to meet withcredit and encouragement.But, it may be asked, is not the quack,

notwithstanding he has not traversed theslow, laborious, and expensive track of theregularly-educated practitioner, a personworthy of confidence in other respects? Andsuppose him remarkable for genius, andrespectable in his connections, such a man

* Cowan on Medical Quackery.

824

having been compelled by mere force of cir- It is suspected that the true cause lies incumstances to place implicit faith in a par- the state of extreme ignorance, which at the·ticular remedy, may, with truly philanthro- present time prevails, respecting all matterspic zeal, fairly select the most public re- of a professional nature : as observed by Drosource to advertise the world of a medica- Paris, not from a want of general informa-ment, to which he conscientiously attaches tion, but of that in which the public are

peculiar virtues. The answer is, no. He most deeply concerned, viz., their health.is a man of broken fortunes; he springs up It is a singular fact that this susceptibilityat once from a state of extreme necessity, to delusion has been manifested by personsthe consequence of thoughtless dissipation;* who on every other occasion would resentor, from a state of starvation, owing to the with indignation any attempt to talk them.imperfect exercise of a low species of handi- out of their reason, still more to persuadecraft, which he has not the ability to pur- them out of their senses.*sue,t and jumps before the world a ready- But the most ridiculous and inexplicablemade empiric. Like Pallas all armed from of incongruities, in connection with this im-the brains of Jove, so is the quack cased portantsubject, consists in the close alliance-over with native brass from top to toe, which seems to have been contracted be-armed in scale like the serpent, and,like him, tween two great rival prejudices, viz., cre-not wanting in fangs : utterly ignorant of dulity and scepticism, amongst those whothe nature of the commonest herbs-of the pin their faith on nostrums. It is difficultalphabet of medicine-without thought, to determine which of these two evils ofapprenticeship, or preparation of any kind, ignorance is most inimical to the interests ofhe marches through his short, gay, and truth and science. A medical man, of un-flourishing career, and retires from the field doubted talent, and who is respected in theloaded with gold, deriding popular cre- ordinary duties of his professional capacity,dulity. after mature philosophical reflection, intro-The reader may soon satisfy himself that duces a novelty, from the operation of which.

this sketch is far from being overdrawn; he feels justified in expecting advantageouslet him consult a few of the publications on results ; from that moment he is regarded as,the subject of this nefarious trade ; let him a visionary, one addicted to the performancecast his eye down the advertising columns of experiments, to which the public declineof any daily paper; let him recall to his to submit themselves. Disappointed, vexedmind the many instances in which death- and apprehensive of losing his hard-earnedthe close and ready attendant on all nos- reputation, in all probability he desists fromtrums-had been clearly produced by such farther trial ; declines the risk which wouldvaunted compounds as universal medicines, attend a continuance of its exhibition, withelixirs of life, pills of health, &c.; above the ulterior view of brinaing about a con-all, let him inquire into the characters of viction of its utility; and thus either aban-these self-constituted doctors, and although dons the path of improvement altogether,.volumes would hardly suffice to detail their or, for the future, introduces his noveltiesvarious iniquities, he will be convinced that on the sly. But mark ; suppose he takes.quackery is the most heartless and danger- another course,-suppose he now advertisesous piece of deception that ever could be his remedy, standing forth boldly advocat-devised. ing its universal applicability; in short, sup-When such palpable absurdities as those pose he, departing from the path of honour

above alluded to, in the shape of advertise- and respectability, becomes, in act and deed,.ments, impose not only on the fanciful and a determined quack; notwithstanding he ishippish among the weak, but also on the deservedly deserted and despised by hiswell-informed mind, it is reasonable to sup- professional brethren, he floats down thepose that the hallucination depends upon stream of public patronage, and terminatessomething beyond what is presented by the his short voyage inamuence.vulgar and often ungrammatical puffings, It has been remarked, that out of thewhich insult the understanding, in print, many ills to which the human body is hourly

* Le Flevre, a German, failing in his * Boyle,whose whole life was devoted to’business as a wine-merchant, set up as a philosophy, was pre-eminently credulous

gout doctor, and was much patronised by with respect to specifics : he seriously re-the nobility. After having made his for- commended the thigh-bone of an executedtune in England, he retired to his own criminal against dysentery. He died at the

country, and drunk daily, as his first toast, age of sixty-four.., To the credulous and stupid Nobility, Lord Bacon, the father of inductive philo-Gentry, ard opulent Merchants, of Great sophy, believed in the existence of a pana-Britain." cea that would prolong life beyond its na-

t The most successful, of late years, in taral term. This great man took three grainthe pill trade is a man who, a short time of nitre, his favourite salt, for the last thirtyago, was a barber, and shaved for a penny. years of his life, but died, nevertheless, at- Cou:an, Op. Cit" p. 22 notes. the age of sixty-six.

825

exposed, but few fall under the notice of i

the empiric ; now, the truth is, that were he ,called upon to risk his reputation in the treat-ment of emergencies, for which the attentionof the regular practitioner is demanded, !,there would soon be an end of him; it wouldnot, therefore, suit his purpose to undertake ithe management of cases on which the pub-lic are tolerably well informed, because his Iignorance would not then escape detection -,and here we have the true reason why dis-eases not well understood even by medical Imen themselves are selected by the quack Ifor his coup d’essai. He glories in maladiesthe very names of which excite horror anddread; such, for example, as cancer,* pul-monary consumption and diseases of thehip-joint; or he cunningly fixes upon someorgan of the body, intricate in structure, andmost indispensably necessary to the comfortof existence, as the eyet or the ear.§ Booksin all shapes and sizes, from the royal quartoto the shilling gilt-edged pamphlet, profess-ing to explain, in a manner suited to everycomprehension, the nature of the disease andrationale of its treatment, are most exten-sively circulated or advertised ; but, needwe say that the eager purchaser, anxious tocatch at anything promising relief, meetswith nothing but disappointment ; he findsthem, in reality, a larger species of adver-tisement, directing him to apply to the quackin person.

If ignorance respecting those subjectswhich are made the very turning points ofthe whole quack machinery, be the greatcause of empiricism,-and the writer sin-cerely believes that it is,-that deficiencyought to be supplied by the requisite infor-mation. The diffusion of knowledge onmany points, with particular reference to thedanger of many drugs ; to the absurdity ofusing them at random, by drawing themfrom the fortune-wheel of a patent medicineshop ; to the conformation and uses of suchorgans as the eye and ear, with the princi-ples which should regulate their treatmentwhen in a diseased condition; would dimi-nish the number of those who now fall intothe hands of the charlatan from ignorance.The duty of thus guarding the public

against quackery, is incumbent on every in-dividual member of the medical profession,but, more particularly does it devolve uponthose who have obtained more than ordinarypopular confidence. Whilst they continue tolook down with indifference on the scene

* Cured without the knife.-(Dailypapers.)

t Cured by rubbing, inhalation, &c.-(Daily papers.)

t Cataract cured by an easy, familiar, andsimple operation.-(Daily papers.)

§ Deafness cured by a new instrument,which clears out the tympanum.-(Dailyvapers.)

around them, permitting, under their verynoses, the open violation of their rights ; andwhilst the people fail to obtain from themthe information which every soi-disant doctorseems most disinterestedly desirous to afford;.so long will they transfer their confidence in,respect to diseases, of which they knownothing, to quacks, whom, in their simpli-city, they believe to understand them so-well. Contemptuous indifference will notdo now, when empiricism has nearly becomethe National Faculty of Medicine, anel the-well educated physician the interloper; be-sides, it is a lamentable fact, that severalpersons holding medical or surgical diplo-mas, have seceded from their profession andenlisted under the banner of quackery ; andis it surprising that they should abandontheir sect, if it will not protect them fromevery species of innovation.There is no department of medicine, which

will serve better to illustrate the truth ofthe foregoing remarks, than ear medicine, asit is practised at the present momant.An instrument, called an air-press, has

been lately introduced into this countrybeing intended by its ingenious inventor, forthe treatment of those diseases of the earwhich are confined to the tympanum, and tawhich alone it can be of any service what-ever. Kramer, a German physician of con-siderable eminence, in a work on Otic Dis-eases, which, unlike any of its predecessors,..national or foreign, bears, on every page, the-stamp of truth, amongst other valuable mat-ter, has given ample direction for the use ofthis instrument. He points out, and distin-guishes, with the utmost precision, thosecases for the treatment of which it is pecu-liarly adapted; in fact, he has quite revolu-tionised ear medicine, before practised so.

empirically, by applying curative measuresdirectly to the tympanum and Eustachiantube, in those complaints which hithertohave been exclusively submitted to externaltreatment. -

It is a well known fact, which is under-stood on the slightest anatomical examina-tion of the ear, that the channel through.which sonorous impressions are conveyed tothe brain consists of three distinct portions,which have no opening of communicationwith each other. The external portion, call-ed also exte1"nal ear, consists of a cartilagi-nous expansion, and a canal, partly osseous.and partly cartilaginous. The latter, frombeing incurvated, and consequently not

easily seen throughout the whole of its.inner surface, has given rise to the popularerror of its forming an unobstructed chan-nel into the head; but cautious and well di-rected examination shows that it is perfectlyclosed at its further end by a membrane,which effectually cuts off every communica-tion with the portions beyond. This is themembrane of the t3 mpanum, or drum ; inappearance it resembles a circular piece of

826

thin parchment, and like its patronym seemsstretched across a second portion of the organor tympanum itself; it is strengthened onits inner side by the lining of the last-namedcavity, and on its outer by that of the canal.The tympanum (middle ear) is an irregularly-shaped cavity, situated intermediately be-tween the outer ear, above described, andthe inner ear. The outer side of the latterthus becomes the inner side of the former,and forms a partition between the two. Inthis partition are two apertures (fenestrœ) ;each, however, is perfectly closed by a spe-cial membrane, in reality a tympanic mem-brane ; but there it takes the name of theopening it serves to close, and is calledfenestral. The tympanum contains a chainof little bones (tympanic ossicula), which areextended from within, outwards, across its

cavity, one end being attached to the tym-panic membrane, the other to one of thefenestral membranes. The Eustachian tube,so called after its supposed discoverer,EUSTACHIUS, is a canal by which the ca-

vity of the tympanum communicates withthe external air; and it opens opposite tothe corresponding nostril at the upper andback part of the throat. The inner portion(inner ear) called, also? on account of itscomplex conformation, labyrinth, containsthe auditory nerve, and is the most impor-tant part of the organ, inasmuch as it isthere only that the sonorous percussions areperceived by the sensorium. It is difficultto convey briefly to those not accustomed toanatomical pursuits, an adequate idea of thesingular beauty of this portion of the acous-tic apparatus as it exists in man, withoutreferring to the more simple forms, underwhich it is found in animals of a lower gradein the animal scale.The condition here alluded to, is shortly

this : a membranous sac containing fluidserves as a surface for the expansion of theauditory nerve into sentient points of extrememinuteness. This inner sac, thus preparedfor the reception of auditory impressions, isenclosed within a second or outer sac ; butthe latter also contains fluid, by which it isprevented from coming into actual contactwith any part of the delicate nervous surfaceof the former.Now, we are taught, by a well-known

hydrostatic law, that this fluid, which sepa-rates the two sacs, by reason of the propertywhich it possesses in common with all fluids,transfers instantaneously to every point ofthe inner sac, in all its intensity, an impulsereceived on any point of the outer one. Itis not necessary, therefore, that the entiresurface of the outer sac should be exposedto sonorous impulses ; a limited circumscrib.ed spot is quite sufficient for the purpose;hence it isusual to find the outer sac osseous,with the exception of a small aperture orfenestra, which is closed by a fenestral mem-brane. This arrangement is repeated pre-

cisely in the formation of the human laby-rinth ; the difference consisting only in theconfiguration into which the two sacs aredrawn out and extended; but these respec-tive relations, as they exist in the less com-plicated conditions, remain unaltered.The functions of the various parts above

described, are shortly these. The outer earcollects sonorous impulses and conveysthem along its canal to strike on the tym-panic membrane. The chain of ossicula con-ducts them across the tympanum to thefenestral membrane, or circumscribed unos-sified point of the outer labyrinthic sac.

Lastly, by means of the fluid between thetwo sacs, the impressions are multiplied, andso are received on every sentient point of thenervous inner sac quite as well as if thewhole surface were exposed to them withoutintermediation. The only difference betweenthe nervous sentient surface in the ear, andthat in the eye, which forms the retina, isthis : the former is expanded on the outeror convex side of a sac of fluid, and thelatter, on the inner and concavity of a similarstructure.As one essential condition for perfect

hearing, the tympanic membrane must befree to vibrate; sound results not from oneimpulse long continued, but from many, fol-lowing each other in quick succession. Thelimits between whicti regularly recurringimpulses are perceptible, as sounds havebeen generally stated at 30 in a second, forthe lowest ; and 12,000 for the most acute ;or, in other words, during that almost inap-preciable space of time between two ticksof an ordinary watch, the membranes of thetympanum, and of course the ossicula, mustbe in alternate conditions of action and in-action 30 times ; that is to say, in order tohear through the channel afforded by theseparts, they having been put into actionby one impulse, must return to their for-mer quiescent condition before they cantransmit a second impulse, and this processmust he repeated for the whole 30 times. Inorder to accomplish this inconceivably rapidalternation of activity and repose, the bonesare articulated in angular directions, pre-senting a series of levers in connection witheach other, and furnished with muscles orelastic ligaments, which readily restore themto their inactive state. This arrangementforcibly reminds us of that in a pianoforte,between the finger key and the hammer whichstrikes the wire, whereby the impulse of thefinger on the former is propagated with acertain mechanical advantage to the latter,and the whole returns to its original condi-tion immediately after the note has beenstruck.

If the tympanum were a closed cavity thetympanic membrane and ossicula could notthus vibrate, and one of the most importantpurposes of the Eustachian tube is to providefor the necessary external communication.

827

- Deductions of the utmost practical import-ance may be drawn from the above imperfectsketch of the anatomical and physiologicalpeculiarities of the organ.

1. Disease may be exclusively confined toone of the three compartments of the ear; theother two remaining unaffected.

2. Curative measures may be directedimmediately to the outer ear; and also tothe tympanum, through the Eustachian tube,but none can ever reach the labyrinth.

3. Diseases of the labyrinth are necessa-rily attended with absolute loss of hearing.The various affections of the outer ear andtympanum may render hearing exceedinglyimperfect, but complete deafness requires amorbid alteration of the labyrinth.* *The new system of ear medicine mainly

consists in the circulation of fluids throughthe tympanum, by the way of the Eusta-chian tube, with the view of clearing it ofmucous obstructions, or of inducing ahealthy state of its membrane. By thismode its followers profess to cure the majo-rity of deaf cases, and it remains to showhow far their pretensions are to be reliedon. Good or bad, they have not escaped thelot common to all novelties, when firstushered forth into the world ; and, as mighthave beeu expected, the greatest oppositionthey met with sprung from the professors of the old school. !A recent medico-legal investigation into

the cause by which sudden death had occur-red during the use of this most important ofmodern acoustic instruments; the air-press,-afforded these ancient aurists a rareop-portunity, which did not escape their jealous watchfulness, of raising a clamour againstthe new system, and bringing its advocatesinto disrepute. The latter had fairly ex-posed themselves to the rebuke of settingup this instrument, by way of clap-trap, tocatch unwary patients, who, having beenattracted solely by the encomiums lavishedupon it, would not be contented unless itwas tested upon themselves ; at least, thisis the most charitable excuse that can beoffered in exculpation of that great want ofdiscrimination which attended its employ-ment. The rival aurists now amused thepublic, and disgusted the profession, by va-rious explanatory counter-statements ; bothparties joined in reprobating the mode ofpractice of their poor confrére in distress,

* It is worthy of remark, that there is a wide difference between a mere perceptionof sonorous impulses, and the capability of I

discriminating sounds, as is indispensablefor vocal communication. The assertionthat loss of the tympanic membrane andossicula is not attended by impairment ofthe sense, is a grave error,—natura nihilagit frustra. What, then, can be the nse ofa complicated apparatus of bones and naem-branes ?

whilst each endeavoured to show how muchtheir individual plans differed from thatwhich led to the lamentable occurrence inquestion. Clap-trap cannot be considereda term too harsh in the designation of anymeans introduced to the world as an univer-sal agent, when it is not eligible in morethan one case out-of ten of those very dis-eases which it is stated to cure in all formsand conditions. The reader will find thisassertion confirmed if he choose to consultthe works of the great fathers of modern earmedicine,- Kramer, Itard, and Deleau,under whose sacred names the catheter iscrammed down the Eustachian gullet of thecapricious and credulous, day after day.Kramer, who deserves implicit credence,

gives us the following statistical statement,which is drawn up with the greatest care.Out of 300 cases, taken as they occurred,104 were uncured, 96 cured, 92 relieved,and 8 incurable. Of this 300-55 were casesof disease of the tympanum, 85 of the exter-nal ear, 152 of the internal ear, and the re-maining 8, which are reckoned as incurable,were cases of deaf-and-dumb deafness. The55 cases of tympanic disease may be clas-sified as follows :-

Thus, out of 300 cases, the instrument iseligible only in 55, and of this little propor-tion, only 28 were cured by it.From this admirable table we may get at

the true value of the air-press. Its applica-bility, as a curative agent, is limited to lessthan 1 in 10 of those cases which presentthemselves in the ordinary routine. Itsrange of utility, as a diagnostic agent, takesa wider sweep, but in this capacity it willinclude but 300 - 85, or 215 cases; and, asnot more than 28 are curable by it, the ratiobecomes something above 1 in 8 out of thosecases in which its most strenuous advocatescan reasonably expect relief. If insufflationwas perfectly harmless, its trial in every

case would not be so much objected to; butit is a dangerous remedy, requiring greatdiscrimination when administered by means

828

of the air-press. The air loses its latentheat in proportion to the degree of its con-densation, and as it has to regain it when itresumes its former volume, the stream of airwhich issues from the reservoir acquires agreat refrigerating power. " Now, the ap-plication of cold in any form acts injuri-ously on the ear, not only on the auditorynerve, but even on the membranous coats ofthe organ, where the vital heat and smallsupply of blood is quite unequal to resistthe power of cold."-(Kramer.) I myselfhave witnessed several cases of dangerouslyprotracted syncope, from merely syringingthe ears with cold water; and the late in-stance of sudden death, alluded to in theformer part of this paper, was undoubtedlyproduced by the long-continued circulationof a stream of air, which had become highlyrefrigerating, in escaping from the air-press.The explanation is furnished by the relativeanatomy of the region : the carotid canal isseparated from the tympanum by a septumof bone, which is not thick enough to pro-tect the vessel within it from the constrin-gent effects of cold ; the brain may in thisway be suddenly deprived of its accustom-ed supply of arterial blood ; the equilibriumbetween the cerebral substance and thefluids circulating within the skull is dis-turbed ; and syncope, dangerous in propor-tion to the suddenness of the alteration, isthe consequence. Hence the sickness,faintness, and other unpleasant symptom?which attend the operation, especially onsusceptible invalids. Any one may provein his own person that these observationsare not chimerical, by a simple experiment ;let him syringe his ears with cold water,and, however sceptical before, he will atonce join with me in the hope, that anothersacrifice of human life will not be requiredto teach a proper distrust of universal re-medies.One would almost conclude, from the

many precautions interspersed in Kramer’swork, that he must have met with untowardcases of this description. Thus, he enjoinsthat the whole force of the stream shouldnot be turned on at once, but gradually, theoperator attentively listening at the ear ofthe patient to ascertain when it reaches thetympanum. In some aggravated cases theair will not be found to enter that cavity fora considerable time; when it does, if thedulness of hearing depends on mucous ob-struction, remarkable improvement is expe-rienced immediately ; if the case be not oneamongst the few which can be thus bene-fited, the operator improves his diagnosisby noticing the particular anormal soundmade by the circulating air. In either casethe instrument should be laid aside, as itcan be of no further use on that occasion ;on the contrary, it may do harm by " excit-ing the ear."Mucous engorgement is the only ailment

remediable by the air-press ; the relief de-pends on the re-establishment of the vibra-tile power of the tympanic membranes. Dis-tention of the tympanum is relieved by apartial discharge of the fluid ; if the latterbe thin, no material deafness is experienced,because it will find a ready outlet throughthe Eustachian tube. In all cases, whetherrecent or ancient, the douche should be usedoccasionally only, and general treatment re-sorted to. Under these circumstances is it

exceeding the bounds of justice to includeall those who profess to cure deafness byexclusive measures, air-press or no air-press,under the opprobrious epithet of quacks,especially as the principles of rational treat-ment are few, plaiu, and simple, and are-

easily deducible from a limited anatomicalexamination of the organ. Moreover, whensuch persons assert, in the face of the wholeworld, through the medium of pamphlet,book, or any other species of advertisement,that they can cure all complaints of thisdescription, ought not such communicationsto be regarded as forming a part of thatgreat system of imposture by which thepublic are every day misled, and preventedfrom seeking relief at the hands of thosewho really merit their confidence ?

7, Lower Southampton-street,Fitzroy-square, August 21st, 1839.

EFFICACY OF THE

IODIDE OF ARSENIC

IN THE

CURE OF CANCER.

To the Editor of THE LANCET.Sitt:-The following recital of a perfect

cure of a cancerous disease of the breast,and the efficacy of the iodide of arsenic,may prove worthy of your valuable columnsand acceptable to the profession : -M. H., mtat. 29, in the early part of No-

vember, 1838, presented herself to me withdisease of the right breast ; by her own ae-count she had received a blow upon it fromthe clenched hand of a person in play, abouteight or nine years ago, since which timeshe had occasionally experienced lancinat-ing pains in it. Had been married nine years,but borne no children.In the last two years the breast had in-

creased much in size, and become very sensi-tive to the touch,and pressure of clothes. Shefelt several distinct swellings in the breast,accompanied by severe shooting pains, ex-tending to the arm-pit, and down the corre-sponding arm, affecting her constitutionally,making her weak, and extremely uneasy inher mind. Had shown the breast to severalmedical gentlemen; who told her it was can-