Abstract
Although the present volume of the French Academy Memoirs is inferior in interest to some of its predecessors, and contrasts disadvantageous!}' in practical value with our Medico-Chirurgical Transactions, yet it contains much well worthy of the attention of our readers. There is the same fault in it that characterises almost every work issuing from the French Medical press?inordinate diffusencss. Paper and print had indeed need he cheaper on the Continent than with us, but, unless a book is to be considered valuable in proportion to the number of words it contains, it is an unfortunate circumstance for the reader that they are so. Casting aside the 216 Medico-ciiirukgical Review.
Abstract
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Medico-ciiirukgical Review.

[July 1 endless repetitions, the circumlocutory verbosity, and the irrevalent observations, which disfigure them, there can be no doubt that both author and reader would gain vastly by the compression of any of these works into one-third of their compass. Certainly the present volume would gain by the process.

Passing over the eulogia upon the deceased members of the Academy, and a comparative view of the recent progress of Medicine and Surgery in France, we come to the consideration of the various Cases and Memoirs.

A Memoir on Uretro-Plastie. By M. Segalas.

M. Segalas, in a letter addressed to M. Dieffenbach in 1840, stated his opinion, that the attempts at reparation of a breach of substance of the urethra had hitherto failed in consequence of the contact of the urine with the parts concerned not having been prevented ; and, at the same time, detailed the particulars of a case in which, this latter object being attained by making a preliminary incision in the perineum, and introducing a catheter through it into the bladder, a complete cure resulted. A second case was similarly treated by M. Ricord, and a third forms the subject of the present communication.

This patient, aged 30, exhibited a large loss of the spongy portion of the urethra, the consequence of gangrene supervening upon a ligature he had attached to the penis when a child. The urine and seminal fluid passed entirely by this aperture, which was an inch in length, and occupied the entire thickness of the urethra, a deep transverse cicatrix being observed also to surround the corpus cavernosum. The portion of the urethra anterior to the loss of substance was much narrowed, but easily admitted a probe, and when the patient approached the two orifices of the defective portion he could force urine through it. The operation was divided into three stages ; in the first, the prepuce, which was phymotic, was divided, in order to relax the parts afterwards to be operated upon. Six days after, a free opening was made into the membranous portion of the urethra, and a gum-elastic catheter introduced. The urine thus being prevented coming in contact with the canal, and the parts being in a tranquil state, the operation was completed, three weeks after the first incision of the prepuce, by dividing the edges of the defective portions of urethra and bringing them into contact over a bougie by means of the twisted suture.

The wound healed kindly, except at one minute point, which remained fistulous for a very long period, notwithstanding the application of various cauteries, &c. It however eventually completely healed, though not until its orifice had been incised. The operation was performed the 18th August, and the catheter removed from the perineum the 26th November. Dieffenbach had objected to this operation, that the wound made in the perineum might itself remain fistulous. Such has not been the case in the other cases reported, and in the present one, it closed in a few days after the removal of the instrument. Although perfectly able to evacuate the bladder by the urethra, the patient was recommended to do so for a considerable time by means of a catheter. Throughout the treatment of the case, neither fever or irritation manifested itself. details the particulars of 16 cases, all but one being corroborated by careful post-mortem inspection. In six of these the haemorrhage was seated between the arachnoid and pia mater. In nine others blood was found, either in a fluid or coagulated state, in the cavity of the arachnoid itself.

In the sub-arachnoid variety the blood is found, either fluid or coagulated, on any part of the surface of the brain or spinal marrow, being separated from the nervous substance by the pia mater only, which is even sometimes penetrated. When the effusion is very considerable it is found at the base, and is generally due to The acuteness of the affection, the symptoms, and the general physiognomy, are so many replies in the negative; but if, on the other hand, we study the etiology, the terminations, and some of the symptoms, we shall be obliged to acknowledge that acute delirium approaches some of the acute forms of insanity. If The patient's general condition was satisfactory, and no sign of internal haemorrhage existed. A few attempts at reduction were made but not persevered in, owing to the tenderness and strangulated state of the omentum. It was covered with oiled lint and a poultice; the most absolute repose was insisted upon, a bleeding practised, and complete abstinence enjoined.

In the first day or two the omentum became much inflamed and engorged, but this state was much relieved by applying leeches in its vicinity and the Use of baths. On the 4th day a healthy suppurating surface became established, and some time after the danger of further strangulation was lessened by the formation of a small ulceration at the internal angle of the wound. Towards the tenth day the omentum, which had continued firm and tender, and was freely suppurating, began to diminish in size and to slightly retract, and from this time the gradual lessening and disappearance of the swelling went on, these being aided after a-while by the application of nitrate of silver to the irritable surface, and the compression of a bandage. By the thirty-sixth day the tumour was reduced to the level of the skin, and in ten days more cicatrization nearly completed, the wound having contracted to a small aperture, which continued to the last very sensitive to the touch. The position of the patient should be flexed and easy, and if peritonitis, colic, &c. supervene, the appropriate treatment must be employed. The local inflammatory symptoms at first augment, and the omentum becomes more tumefied : but, after a while, suppuration, which prepares the parts for their future reduction, occurs. When this diminishes, the exposed part lessens in size, tenderness, and redness, and is gradually retracted towards the cavity of the abdomen. This latter stage is expedited by the application of caustics and the use of a bandage. A firm cicatrix opposes the production of any consecutive hernia in this site.

The desire to present our readers with a full view of this volume in one article, has deprived us of the space we might otherwise have employed in remarking upon its various contents.

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