ARMY MEDICAL. LIBRARY WASHINGTON Founded 1836 Section._ Number -^.°b_Qo_%0 Fobm 113c, W. D.. S. G. O. bpo 3—10543 (Revised June 13, 1936) DUE IW9 WMKO FilUUVI LAST DATE ,95- UUN t i »6*. APR 8 m JM,5.S GPO 881473 SURGICAL MEMOIRS OF RUSSIA, GERMANY, AND FRANCE, BARON D. J. LARREY, SUBGEON-IN-CHIEF OF THE HOSPITAL OF THE HOYAL GUABD, EX-INSFECTOB GENEBAX OF THE MIUTABY MEDICAl STAFF, EX-PBIME BURGEON OF THE GBAND ABMY IN BUSSIA, SAXONY, ETC. n i-t • /*.'■' (^TRANSLATED FROM THE FRENCH, ^MJ /■* 4 t-s. '<, BY JOHN C. MERCER OF VIRGINIA, STUDENT OF MEDICINE. " In spite, therefore, of the obloquy with which principles have been treated, let us resolve to cultivate them as long as we live. This is my determination, while I am able to totter to this chair; and if a tombstone be afforded after my death, to rescue my humble name for a few years from oblivion, I ask no further addition to it, than thaC ' I was an advocate for principles in medicine^ "—RUSH. Pfjilatrrlpfjta: CAREY & LEA, CHESNUT STREET. 1832. L,T'J> • VJI, loo L3335m 1831. 25ttUt0tf according to Act of Congress, December 24th, 1831, by Carey & Lea, in the Clerk's Office of the District Court of the Eastern District of Pennsylvania. Y THOMAS HARRIS, M. D. SURGEON OF THE U. S. NAVY, &c. &c. THE PATRON OF SCIENCE AND VIRTUE--THE VALUED FRIEND AND PRECEPTOR OF THE TRANSLATOR. TABLE OF THE CONTENTS. CAMPAIGN IN RUSSIA. Page Departure for the grand army, ... - 2 Passage across the Niemen, ----- 6 Entrance into Wilna, ...--- 6 Entrance into Witepsk, .... - 14 Extirpation of the thigh performed with success, - - 16 Assault and capture of Smolensk, - - - - 18 Extirpation of the shoulder, - - - - - 19 Amputation of the arm at the shoulder-joint, . - 20 Commencement of every species of privation at Dorogobouj e, - 23 Establishment of the ambulance of retreat at Kolloskoi, - 26 Battle of Mosaisk, ...... 26 Important operations during and after this battle, - - 28, 29 Extirpation of the thigh executed with complete success, - 30 Comminuted fractures of the femur, - - - - 31 Entrance into Moscow, ------ 37 Hospitals of this capital, ----- 39 Burning of Moscow, ----- 43,44 Departure from Moscow, .... 47 Battle of Malajaroslaw, - - - Arrival at Smolensk, .... - 55 Commencement of disasters in the retreat, - - 55 Arrival at Bornsow, - Passage across the Berezina, . - - - Arrival at Osmiana, thermometer at 27°, - 64 Arrival at Miedneski, thermometer at 28°, - - - 65 Effects of the excessive cold, - 65 Arrival at Wilna, ... - - - 66 Arrival at Kowno, .... Arrival at Konigsberg, - - - - - 70 Circular on the treatment of ulcers arising from congelation, CONTENTS. Page 76 85 91 93 Description of the influence of the cold, Epidemic supervening in consequence of the almost sudden pass- ing from a state of complete privation, to an abundance and abuse of hygeinic articles, Arrival at Leipsic, - Arrival at Magdeburg, CAMPAIGN IN SAXONT. Opening of the campaign in Saxony, .... 95 Battle of Lutzen, ----- 95 Disadvantage of sutures in amputation, - - - 98 Entrance into Dresden, - - 99 Battle of Bautzen and Wurchen, .... 100 Armistice, ..----- 10j Removal of the wounded in wheel-barrows, - - - 103 Remarkable case of legal military surgery, - - 105 Report on the results of surgery in the campaigns of Russia and Saxony, . - - . - - - 108 Reflections on wounds of the head, with fracture of the bones of the cranium, and the presence of foreign bodies; and on the cause of abscesses in the liver, following these wounds, - 111 Very remarkable wound of the head, - - - 127 Singular wound of the face, .... - 129 Abscesses of the liver, their causes, - - - - 131 Superficial wounds of the head, .... 146 of the ears, .... 146 ________________ of the mouth, . „ . . 147 Wounds of the throat, - - - - - 150 . of the neck, ...... 152 i of the thorax, ..... 153 ------ of the abdomen, ..... 164 ______ of the abdomen with protrusion of the omentum, - 167 Memoir on wounds of the bladder, .... 175 Reflections on wounds of the arteries, and some aneurisms, - 193 Reflections on the compression of the femoral artery, with the view of causing its obliteration, - - - 203 Of varicose aneurism, ...... 208 Aneurism of the brachial artery, .... 220 Memoir on the beneficial action of the actual cautery, and especi- ally on that of the moxa, in the treatment of racbialgia, femo- ro-coxalgia, &c. ...... 223 Of the amputation of the arm at the shoulder-joint, - 261 CONTENTS, vii RETBEAT FBOM THE CAMPAIGN IN SAXONY. Page Renewal of hostilities, ..... 267 Battle of Dresden, - - ... - - 268 Departure from Dresden, ..... 269 Battle of Leipsic, ------- 270 Retreat from Leipsic, ------ 273 Fight at Hanau, .---.-- 275 Remarks on the dressing of the wounded in this combat, - 276 Transportation of the wounded to Franckfort, and stay of the army in this city, ------- 277 Arrival of the army at Mentz on the days of the 1st and 2nd of Nov. 277 CAMPAIGN IN FBANCE. Departure from Mentz to Metz, ... - 279 Report to the minister to war on the inspection of the hospitals along the line of evacuation, established between these two cities, etc. ....... 279 Epidemic in the army, ..... 281 Second inspection of the hospitals in the cities in the vicinity of Metz,.......- 282 Return to this city, ------ 283 Return to Paris, ------- 283 Arrival at Chalons-sur-Marne, .... 283 Fight at Brienne, ------- 283 Retreat of the army from Brienne to Troyes, - ■. - 284 Combat at Montereau, ------ 285 Fight at Mery, ... - 286 Battle'of Craonne, ...... 286 Wounds of several officers of distinction, ... 287 March of the army to Laon; fight before this city, and return to Soissons, ....... 290 Combat at Rheims, ------ 290 March upon Arcis-sur-Aube, ----- 291 Fight before this city, - - - - - 291 March upon Saint Dizier, - - - - - - 292 Combat of Saint Dizier, ----- 292 March upon Troyes, ..-.-- 292 March upon Paris; arrival of the advanced guard and head-quar- ters of the army at Fontainbleau, - Return of the author to Paris; conclusion, - 293 TRANSLATOR'S PREFACE. A few remarks, tending to point out the various public stations which our distinguished author has occupied in the capacity of surgeon may, perhaps, be the most appro- priate introduction to the following pages. His experience, thus made known, cannot fail to strike every one as hav- ing been most remarkably extensive. Rare are the exam- ples of medical writers, either of this or any preceding epoch, who can justly assert higher claims to celebrity than Baron Larrey. Bold, enlightened, and abounding in expedients as a surgeon, devoted and energetic as an offi- cer, he enjoyed a pre-eminent reputation in the eyes of Napoleon. Genius is quick in detecting genius, and does' not give credit for intellect, where intellect does not exist. Such undoubtedly was the fact in the present instance. In the mind of Larrey, Buonaparte discovered an energy, which he thought proper to reward by making him sur- geon-in-chief of his armies. Happy for his country was this elevation; for while the Emperor executed plans de- structive of life, our author exerted his abilities in lessen- ing the misfortunes thus created. Here then, at one pe- riod, was talent counteracting talent. But what a con- trast has been since, and is still presented in the fate of these two illustrious personage's! The genius of the one has withered on St. Helena; that of the other still flour- ishes, to render stronger his country's pretensions, as the B x PREFACE. nursery of medical philosophers. ' The one now exhibits, on a spot in the ocean, in man's last tenement on earth, merely the mouldering remains of an exile, while the other lives in the enjoyment of happy reflections on a life spent in mitigating the ills brought on his country by war's fell influence. May he long survive : and should France, amid the present turmoils in Europe, be again doomed to act a part in the bloody scenes of strife, may he, by his counsel in surgery, subtract from the sufferings of his countrymen. But more especially is it my object in these lines to con- duce to the benefit of the reader, and with this view 1 will now proceed to present the following epitome. Baron Larrey entered the French navy, as an assistant- surgeon, in the year 1787, and was soon after promoted to the station of a full surgeon. In 1792, he received the commission of a surgeon-major in the army of the Rhine, and two years afterwards was appointed surgeon-in-chief. This office, with the additional one of inspector-general, he enjoyed until the restoration of the Bourbons. During this period, he was present in almost every great battle, and, in general, performed all the most difficult ope- rations himself. These exceeded fifty or sixty in a day, and on one occasion, if not on more, amounted to two hundred. His Chirurgical and Military Memoirs consti- tute a history of his life. In them are minutely and in- structively described, the countries and cities through which he passed, the people with whom he associated, the wounds he witnessed, and operations he performed, the battles in which he was engaged, and sufferings he experienced, and, in fine, various other things of interest. These Memoirs, as the author himself states, are modelled after those of Ambrose Pare. The medical reader is, perhaps, well acquainted with Dr. Hall's translation of the first three volumes of this PREFACE. XI work. Subsequently to the publication of this translation, Baron Larrey's fourth volume appeared in Paris, and the following pages exhibit its English version. These memoirs are thus completed in our own tongue. May I be permitted to ask a lenient critique for my first literary effort 1 Its chief merit consists in a faithful adhe- rence to the meaning and style of the author, and 1 am not unconscious of the benefit that would have attended my labours, had I acted comformably to the " decks cas-. tigata^ &,c. precept of Horace. But the execution of this object would have involved the consumption of more time than 1 could devote to such an occupation. Philadelphia, 1832. OAISIPAIIfBHB &MS ISSSfi©B_m CAMPAIGN IN RUSSIA. PART THE FIRST. Promising myself the repose, which very active duties in a war of twenty years duration should have secured for me, I formed the design of collecting the notes con- tained in the journal of my campaigns, with the view of submitting them for publication, and thus rendering my labours profitable to younger military surgeons. This difficult task, which I imposed upon myself, had scarcely been accomplished at the expiration of the year 1811, by the publication of three volumes of my Memoirs, when we were apprized of the great preparations of the government for the purposes of war, and of the measures in progress, indicative of a distant expedition. My fears on this point were by no means tardily con- firmed by the reception of an unexpected order of depar- ture, accompanied by the decree (of February 12th, 1812) appointing me surgeon-in-chief of the grand army. I could no longer entertain my doubts respecting the opening of a new campaign. Mentz was fixed upon as the place of rendezvous for the head-quarters of the army. Previously, however, to repairing thither, I was engaged, so far as it was my duty to act, with the organization of the medical staff of the hospital for the guard, and the necessary appointments to its ambulances, the special management of which was 1 2 CAMPAIGN confided, agreeably to a proposition on my part, to M. Paulet, adjunct surgeon-in-chief. I left Paris on the 24th of the same month, and reached Mentz on the first of March. This day was spent in visit- ing the military authorities. On the succeeding one, I received instructions necessary for the organization of my staff, from M. Joinville, the director and comptroller gene- ral pro temp. The greater portion of the troops, consti- tuting the army, had already crossed the Rhine, and were marching with hasty steps towards Prussia. The object of the expedition was not known; but it was generally supposed, that an embarkation would be effected on the Baltic, for the purpose of passing over to England, or to other countries more remotely situated. The head-quar- ters of the army bringing up the rear of the troops, de- parted from Mentz, on the eighth of March, and arrived at Fulde on the twelfth. After remaining here some time, they moved on to Erfurt, which place we reached on the eighteenth. An order, commanding our presence at Magdeburg, was soon received. The bad state of the weather, together with the ruinous condition of the roads, caused by the artillery, rendered this march, though short, extremely laborious. During our stay at Magdeburg, M. Baron Desgenettes, physician-in-chief of the army, and myself, took steps for the improvement of the hospitals. This city, one of the most commercial in Germany, had become, under the French government, an almost impreg- nable fortress. It formed a considerable depot for arms, and an immense magazine for the armies of the confedera- tion of the Rhine, and in the lapse of time would have been rendered one of the principal citadels of the Elbe, and one of the strongest keys to Saxony. The fortifications and preparations for a siege were conducted with much activity. The cathedral and arsenal should not be unno- ticed. This city gave birth to the celebrated Otho Guer- ricke, the inventor of the pneumatic apparatus. From Magdeburg the head-quarters of the army were ordered to proceed to Berlin, taking Brandenburg in their route. On our arrival in the former city, (April the second,) I col- IN RUSSIA. 3 lected together all the surgeons of the army, with the view of rendering myself acquainted with their merits, and as- signing distinct situations, to be occupied by each one indi- vidually, in our ambulances. I instructed them in mili- tary surgery, and obliged them to perform operations in my presence. The junior surgeons in the academy of Berlin contended with ours in point of zeal and emulation. They attended my lectures with regularity, and partici- pated in the labours of the amphitheatre. M. Chevalier Goercke, surgeon-general of the Prussian armies, excited them to these exertions. This celebrated practitioner en- tertains a permanent solicitude for the welfare of his pupils; he is prodigal of his attention towards them, and affords them all the assistance which one could expect from a parent. We were very kindly treated by this respectable professional brother, and it will always be a source of plea- sure to recall those evidences of interest manifested towards us by MM. Hufeland; Grseffe, professor of surgery; Wibel, physician-in-chief of the armies, and Rudolphi, professor of anatomy and director of the anatomical museum. I was much gratified on paying a second visit to this rich museum, and observed in it some specimens of dis- sected vessels, which prove that the anatomists of Berlin have carried the art of injections to the degree of perfec- tion presented by those of Prochaska and Soemmering. The preparations of injected synovial membranes, liga- ments, and articulating extremities of the bones, possess much beauty. Embryos of extreme curiosity, because of their organic derangements, are likewise contained in this valuable collection. I remarked, as being a matter of sin- gularity, in the prepared stomach of a horse, the chrysalis of the horse-fly. As soon as this nympha approximates the period of its metamorphosis, it is detached from the stomach, ascends to the oesophagus, should it be near the latter, or else reaches the intestinal canal, and is exhibit- ed externally under the form of a perfect insect. It fre- quently happens, that this change is effected in the mouth of the animal or in the rectum. This fact has induced some naturalists to believe that this fly passes through the whole intestinal apparatus, without difficulty, and in dif- ferent directions. The insect, soon after being extricated from the prima viae of the animal, attaches itself to a favour- 4 CAMPAIGN able point on the surface of his body, and there deposits its eggs. The horse removes with his tongue, and swallows the latter, and the heat of the animal causes them to be speedily hatched in his stomach. The larvae secreting themselves between the folds of this organ, are there nou- rished, and grow with rapidity. They are soon converted into nymphae, or chrysalides, and are subsequently changed into flies as we have already remarked. Another object possessed of no less curiosity, though by no means unknown, is the male and female pipa, which we saw in this museum. The cabinet of the king at Paris also contains these pipas. The female presents on its back a kind of honey-comb, or rather a series of round per- forations, very contiguous to each other, and under differ- ent degrees of dilatation or contraction. During the period at which they lay their eggs, these openings are dilated, and, as this process is effected, the male pipa seizes the eggs with its anterior claw, and deposits them in the foramina, which are successively filled. The hatching takes place in them, and the young are there nourished until their metamorphosis; they are then finally discharged from this situation. These foramina are constantly filled with a mucilaginous substance, which undoubtedly serves for the nourishment of these curious animals. I will give, in another place, an account of some surgical diseases, observed by us in the hospitals of Berlin. Previously to my departure from this capital, I organized six divisions of flying ambulances, each one consisting of eight surgeons. The surgeons-major exercised their divi- sions daily, according to my instructions, in the perform- ance of operations, and in the application of bandages. The greatest degree of emulation, and the strictest discipline, were prevalent among all the surgeons. We left Berlin on the thirtieth of April, and reached Franckfort on the Oder, May the second. During our stay here, I employed myself in perfecting our ambulances, and causing improvements to be effected in the hospitals, which we found in a very bad state. Two remarkable monuments justly merit the admiration with which strangers behold them. One is the tomb of General Kleist; the other, situated on the right bank of the river, at a very short distance from the bridge, is a mauso- IN RUSSIA. 5 leum, erected in honour of Prince Leopold, of Brunswick, governor of the city, in order to perpetuate the commemo- ration of the heroic act of devotion, of which he was the victim, in April, 1795. Emblematic statues, of exquisite workmanship, describe the virtues of the prince, and the lamentations of the inhabitants. On the tenth of May, we arrived at Posen. The object of the campaign was still unknown to us; the corps of the army were in the mean time increasing, and formidable troops of artillery, and numerous equipages were advancing from all quarters. An opportunity being afforded me by several days of rest in this city, I availed myself of it in order to organize the flying ambulances^ and cause my assistants to exercise themselves in the performance of ope- rations. We instituted new researches into the nature and causes of plica polonica. They confirmed me in the opi- nion I adopted respecting it, during the first campaign in Poland, viz. that this affection is nothing more than a fac- titious disease. The grand army soon arrived on the left bank of the Vistula. The enumeration which was made at the time of its passage, gave us about four hundred thousand men, there being equally as many infantry as cavalry troops. These soldiers consisted of French, Spaniards, Neapoli- tans, Italians, Austrians, Prussians, Bavarians, Wirtem- bergers, Westphalians, and Saxons, forming ten corps, comprising the guard and their cavalry. Skilful generals, subject to the orders of Napoleon, commanded these troops. The head-quarters of the army, marching in the rear, proceeded to Thorn, which place we reached on the morn- ing of the second of June. On the following day, the differ- ent authorities assembled, for the purpose of holding secret councils. I was a member of the grand council presiding over the hospitals. Having collected the opinions and ob- servations of each of these bodies, respecting the depart- ments of business delegated to it, the commander-in-chief of the army issued an order of the day, in which were laid down the march of the troops, and the precautions to be adopted in order to pass with all possible celerity those desert countries, which lay in our way to Russia. After a general review, we continued on our march, and arrived at Hielsburg June the tenth, the anniversary of 6 CAMPAIGN the battle fought by the French before this city, in 1807, during the first campaign in Poland. There was no delay in this place, and the head-quarters of the army received orders to pursue the road to Tilsitt. But this route was soon abandoned, and that to Kowno resumed, where we arrived on the twenty-fourth of June. Some troops of the Russian advanced guard, then in this city, had scarcely time to destroy the bridge, and betake themselves to flight. Our advanced troops, however, passing the Niemen in boats, attacked a part of the rear-guard, and some engage- ments ensued, in which an hundred of our men were wounded. I caused them to be located in the hospitals of Kowno. This city is advantageously situated on the right bank of the Niemen, at the extremity of a hill, extending in a winding manner, as far as the environs of Wilna. The road runs at the base of this eminence, and borders on a very deep stream, which, following the course of the mountain, isolates the path, and renders it impossible to return, after having once entered upon this route. We had a laborious march from Kowno to Wilna, in consequence of the bad state of the roads, the constant rains, and the want of shelter. These unfavourable cir- cumstances, in conjunction with the immoderate use of chenaps, (the brandy of the country,) proved fatal to a large number of the conscripts of the junior guard. This iiquor, particularly when drunk in too large quantities, un- doubtedly has an injurious effect on persons not habituated to its employment. It is obtained from corn, and is made by adding to the fermented liquor of this grain, exciting plants of the narcotic class. The latter impart to it a stu- pefying power, which was fully exemplified in the young soldiers. Those who died from the effects of the abuse of this drink, presented the following phenomena, viz.: loss of muscular movements, vertigo, and drowsiness; the eyes half-closed, dull, weeping, and the conjunctiva appearing as though injected. They, in fine, sat down in the ditches, even in the roads, and there frequently perished. Many presented gangrenous spots on their feet and legs. Our advanced guard entered Wilna without encounter- ing much resistance. On the day preceding their arrival, the Emperor Alexander was still remaining in this town, and had not the most distant idea that the French were IN RUSSIA. / approaching with so much rapidity. In the pelty fights that ensued at the gates, or in the environs of the city, we had one hundred and fifty of our men wounded, who were conveyed, by my direction, to the two hospitals of Saint Jacques and La Charite. It were impossible to bestow a sufficiency of eulogy on the gray sisters of these establish- ments for the assiduous attention with which they so pro- digally administered to our sick. Among the wounded whom I operated upon, and caused to be dressed in my presence, there were some that pre- sented singular phenomena. The first was a Polish officer, who was wounded twenty-four hours previous. His body was inflated to an extreme degree, by a general emphysema, and the skin so distended as to render the limbs stiff and inflexible; the folds surrounding the joints were also effaced, and the eyes entirely closed by the turgescency of their lids. The lips acquired a prodigious thickness, and impeded the passage of liquids into the mouth; the pulse and respira- tion had nearly ceased, anxiety was extreme, and the voice feeble and interrupted; in short, it may be said that this officer was in imminent danger. The spear of a Cossack had penetrated obliquely under the inferior angle of the left scapula into the thorax, effect- ing at the same time a lesion of the lung. Although the wound in the integuments was not on a line with the divi- sion of the intercostal muscles, its lips were united with exactness, by means of adhesive plaster. The patient was then placed in a cart, and conveyed to Wilna, which place he reached during the night. The air, continually issuing from the lung, escaped through the aperture in the thorax, and spread itself into the cellular tissue, whence it ex- panded through the body, giving rise to this enormous emphysema. In the treatment of this case, I, in the first instance, re- moved the adhesive straps, laid open the wound, and brought it on a line with the perforation in the thorax. Dry cups were immediately applied to the wound, and were speedily filled with gas and blood. I then brought together its lips, and kept them in their relative situation by means of linen dipped in warm camphorated wine. Cups with scarifications were applied over the whole 8 CAMPAIGN surface of the body, but chiefly to the thorax and extre- mities. By my direction embrocations with camphorated and ammoniated wine were employed frequently during the day. The scarifications were repeated as often as neces- sary. Those parts to which cups could not be applied were simply pricked. I prescribed, as a drink, the infu- sion of arnica montana, in conjunction with rich broth and good wine. The patient was much relieved after his wound was dressed; his danger disappeared, and he improved from day to day. At the period of our departure, two-thirds of the body were freed from their inflation, and every thing indicated a speedy recovery. On our return from Moscow I had an opportunity of seeing this officer. So great an improvement had taken place in his condition, that I should not have recognized him, had he not made himself known to me. I was in no slight degree astonished at this cure. A countryman of one of the neighbouring farms, danger- ously wounded by a ball in the left shoulder, when very contiguous to the wounding instrument, was conveyed to the same hospital a short time after the Polish officer. The superior sister of this institution entreated me to visit him, and afford him the benefit of my services. I recognized, at first sight, the injury sustained by the wounded part; but previously to making any examination, I requested the attendance of M. Professor Becu, surgeon-major of the hospital. The ball had traversed the arm, from before backwards, very near the shoulder. The muscles, brachial nerves, and axillary artery, had been ruptured or lacerated, the hume- rus shattered below the head, and throughout a great portion of the body of the bone. The limb was cold, insensible, deprived of all motion, and menaced with complete spha- celus. The shoulder and corresponding part of the thorax were labouring under a very extensive ecchymosis. The wounds caused by the entrance and exit of the ball, being small, and not pointing out evidently the disorder which I presumed to exist, the members of the consultation, in the first instance, supposed my proposition to remove the limb, not justified by the necessities of the case, and that IN RUSSIA. 9 the subject of the wound would be enabled to preserve his arm. They, however, yielded to my views, and advised the immediate performance of the operation. Notwith- standing the disorder of the parts, I was capable of pursu- ing my method. The operation was tedious and difficult, in consequence of a part of the head of the humerus, which was fractured, being driven through the meshes of the bra- chial plexus, under the sub-scapular muscle; the artery also being ruptured high up, I was obliged to search for it under the pectoral muscle, for the purpose of throwing the ligature around it. This patient had completely recovered, when, through the influence of causes unknown to me, he was attacked, several months subsequently, by an internal malady, which eventuated in his death. Several other interesting cases of wounds were treated under my supervision in this hospital. My observations on the nature of these injuries, and their treatment, will be reported in other articles. During the few days we continued at Wilna, I observed and watched the progress of plica polonica. The professors politely exhibited to us some cases of this affection, in the persons of a few females, who had been, for a long period, languishing inmates of the hospital of Saint Jacques. They were said to be affected with general trichoma and plica of a more or less hideous aspect, which had been brought on with the view of establishing a crisis in their preponderant malady. In fact, in almost all of these females, ulcers or cicatrices of a bad appearance were observed on different portions of the body. In both cases, the man of experience could detect traces of an inveterate scrofulous or venereal taint. MM. Castel, Ribes, and several other French phy- sicians, entertained the same opinion with myself. These views were not adopted by the professors, who supposed that this condition of things was caused by the existence of a true trichoma, accompanied by plica, which was cha- racterized, in some of these females, by a state of the hair resembling twisted wicks matted into a thick cap: in others, by masses resembling felt, abounding in filth and vermin. In all, however, the roots and extremities of the hair labour- ing under plica, were constantly free from disease, and in a natural state. On this point we grounded our arguments, and the professors were incapable of solving this problem. 2 10 CAMPAIGN We unavailingly requested them to remove the whole of the hair affected with plica, and to subject all these women to a methodical treatment, based on the mercurial prepara- tions. This advice was rejected, and each party adhered to their respective opinion, thus exemplifying the very great difficulty with which prejudice is eradicated. Ga- dowski, a young Polish physician, more candid and pre- cise in his observations, disclosed these errors in his inau- gural dissertation on plica. Doctor Gasc, a French practi- tioner, has just written a work especially on this pretended malady; and has left no desideratum on this point. The anatomical museum, commenced but a very short time previous, was exhibited to us by one of the professors. We observed in it, however, some singular preparations, particularly a collection of the heads of numerous male- factors. These offenders were executed by a species of guillotine, which had been used throughout Lithuania, for a very great number of years. One of these crania was that of a man renowned for his crimes and courage. After having frequently escaped from prison, and fallen again into the hands of justice, he was about suffering capi- tal punishment, to which he had been doomed, when, for the purpose of escaping this kind of death, he attempted his destruction by removing the principal part of his geni- tal organs. He endeavoured to effect his object by means of a small dull knife, which he had cunningly concealed. Notwithstanding several efforts, it was with difficulty that he opened the scrotum, and laid bare one of the testicles. Urged on doubtless by the occasion, and by his impatience, he seized it with his fingers, and suddenly tore it from its connexions. The spermatic cord was ruptured high up in the abdomen. The most acute pain was immediately suc- ceeded by syncope and other alarming symptoms, which caused a suspension of this criminal's execution. He was conveyed to the hospital, whence he escaped a short time after, to resume his practices as a poacher. The testicle which was removed, was found in his possession. It was put into spirits of wine, in which it was preserved. About three inches of the cord were attached to it. After having been again guilty of many murders, this wretch was retaken, condemned anew, and immediately beheaded. IN RUSSIA. 11 There was also contained in this cabinet, the skeleton of a dwarf, of whose birth nothing was known. He was fre- quently seen in the forests of Lithuania, clad in the unpre- pared skins of animals. His body was covered with hair. He rarely approached any habitation, and fed on the flesh of animals and wild fruits, of which he doubtless made provision in the proper season. These are the only de- tails we could collect respecting the life of this man, whose cranium appeared to me to resemble strongly the head of the savage of Aveyron, which I saw in the possession of Doctor Itard, on my return from Egypt. The skeleton of the savage of Lithuania is very analo- gous to that of the orang-outang. The cranium is very small, when compared with that of persons even of this sta- ture and age. There is scarcely any forehead; the occiput is well developed, and projects very much at the occipital protuberance. The maxillae are very salient at the dental arches. The incisor and canine teeth, of a shining white, are nearly conical, sharp, and longer than in the ordinary state. The superior extremities possess a greater degree of length than those of a well-formed man; the inferior are proportionally very short, and the bones of the heel extend very far backwards. I will make no reflection on the character and habits of this individual. Necessary measures were adopted by us for the succes- sive reception and careful treatment of six thousand patients in Wilna. An order of the day, issued on the ninth of July, regulated the march of the grand army and that of the head-quarters. The minor head-quarters of the army received orders to hold themselves in readiness for a departure after the re- view, which should take place on the tenth. Being offi- cially invited to the levee of the commander-in-chief of the army, I there received a direct order to repair to the review with our flying ambulances. The hour of four o'clock was appointed, but it did not take place until six o'clock. The weather was warm and calm, but the thick clouds that obscured the horizon, menaced us with a storm, which broke forth some moments subsequently. When the trum- pet announced the arrival of the emperor, claps of thun- der were heard in uninterrupted succession, and a dreadful 12 CAMPAIGN tempest ensued. The heavens were darkened to such a degree, that persons could not be recognized at a very short distance, but by the flashes of lightning. Large pieces of hail, driven with violence by the impetuous winds, caused the lines to be broken, and forced the horsemen to alight, in order to avoid being thrown. The terrified horses betook themselves to flight, and rushed with violence against each other. We were in an instant inundated with vast bodies of hail and rain. The review, in short, was interrupted, and Napoleon, accompanied by his chief offi- cers, forced to return to the city. I have never witnessed so horrific, so frightful a storm. Was it the sinister fore- boding of the misfortunes which awaited us? We did not delay our march, however, to Mentianoni and Benchenkowiski. Here our advanced troops attacked those of the Russian rear-guard. A battle ensued, which was rendered more obstinate, in consequence of the ex- tremely advantageous position of the enemy. Our troops, notwithstanding, advanced boldly against their lines, broke their ranks, and forced them to retreat with precipitation. This fight put into our hands about six hundred French and five hundred Russian wounded, who were not removed from the field of battle. These patients, who were conveyed by my direction to the Jewish temples in this last named city, received the assistance from us, to which they were entitled. I will mention some upon whom I operated. A Russian colonel, who was among the first taken to the hospital, had received from one of our horsemen, a stroke with a sabre, which cut off his nose at its base throughout its whole length. The instrument, being directed obliquely, had effected a division of the two canine regions, and two lateral parts of the upper lip, extending into the substance of the two maxillary bones on a level with the nasal fossae. This division was bounded by the palatine arch, which formed a part of the flap, turned over upon the chin, and remaining adherent to the living parts of the face, merely by two small shreds of the upper lip, forming the commis- sures of the mouth. The entire extent of the nasal fossae and the cavity of the mouth, without the alveolar arch, were seen on one side, and on the other, the flap formed by the whole of the nose, the upper lip, and the palatine IN RUSSIA. 13 vault, hanging over the chin. One of my pupils, finding this flap cold, and attached to the other portions of the face only at the two points, of which we have spoken, was pro- ceeding to detach it entirely and dress the wound, accord- ing to the indications it presented, when I arrived at the bedside of the patient. I laid aside the scissors of the surgeon, and after examining the wound, arranged every thing, for the purpose of employing the suture. I had some difficulty in removing the clots of blood, which filled the nasal fossae, and had been made hard by dust. I then detached the portion of the palatine vault, which adhered to the flap. It consisted of the anterior half of the superior alveolar arch. It had been separated from the remainder of the maxilla, on one side, between the canine and first molar, and on the other between the first two molar teeth. I also detached from the flap, several pieces of the proper bones of the nose, and ascending processes of the maxillary bones. The nose and lip were placed in their relative position, and I proceeded to reunite them with the sur- rounding parts, by the interrupted suture, commencing at the root of the nose, and descending successively on its sides, the edges of which were approximated by ten parallel points of the suture. A piece of fine linen dipped in salt water, was applied over the whole extent of the triangle, which was formed by the wound. I introduced into the nostrils two portions of large gum elastic sounds, for the purpose of preserving their form and diameter. They were commanded on the exterior by means of a thread, which I inserted into their anterior extremities. Graduated compresses were placed on the side of the nose, and a retentive bandage terminated the dressings. I had the satisfaction to learn, on my return from Moscow, that this superior officer had perfectly reco- vered without any deformity. The cure of this case is remarkable, on account of the seriousness of the wound, and the few vessels which kept up a communication be- tween the flap, and the integuments of the face. Vitality was restored to the nose, and its reunion with the edges of the wound was exact and perfect. Several partial amputations of the foot, of the leg, through the substance of its condyles, with removal of the fibula and of the arm at its articulation with the scapula, were 14 CAMPAIGN performed in the same day, and in general proved com- pletely successful. Those possessing the greatest interest will be reported in my account of these operations. From Benchenkowiski we marched to Witepsk. We arrived in the vicinity of this city on the evening of July the twenty-sixth, and on the following day came up with the enemy, who had stationed themselves before it. An attack was almost immediately commenced on our part. A battle ensued, and victory decided for neither party, in consequence of the very advantageous position of the Rus- sians on the border of a semi-circular hill, defended by a river which had been deprived of its bridges by the enemy. The city is situated on an elevated plain, which is at the termination of this eminence. Measures were adopted by us in the night for the pur- pose of turning this position, and establishing bridges, at those points of the river where it was most practicable. At break of day it was perceived that the Russians had effected their retreat. Our army marched hastily into Witepsk with the view of pursuing them, but in conse- quence of no knowledge being had of the direction of their retreat, the commander-in-chief of the army issued an order for a retrograde movement. He returned to the city with his chief officers and guard, as much for the purpose of obtaining information respecting the manoeuvres of the Russian army, as to recruit his troops, which until that period had been constantly making forced marches. The want of sustenance was already experienced, and the sol- diers had not received their regular distributions for many days. During our first passage towards Witepsk, we observed many appropriate situations for the establishment of hos- pitals, which were highly necessary. They were imme- diately fitted up for the reception of the wounded in the battles of the twenty-seventh, twenty-eighth, and twenty- ninth of July. There were about seven hundred and fifty on the side of the French, and nearly as many on the side of the Russians. I had much difficulty in procuring the primary dressings of the wounded on the field of battle. It became necessary to make use of the linen of the soldiers, and even our own shirts, for effecting this object. Three hundred and fifty IN RUSSIA. 15 of the most helpless Russians had been forgotten or aban- doned in different houses, from which the inhabitants had fled. Notwithstanding the examinations which I caused to be instituted, I did not discover them until the fourth day. It would be difficult to describe the lamentable spectacle presented by these unfortunate individuals, who, with few exceptions, had been mutilated by the fire of artillery. They had been incapable of leaving their place of retreat with the view of demanding relief. We found them lying on dirty straw, heaped one upon the other, and living, as it were, in an atmosphere of infection itself. Mortification or hospital gangrene had destroyed the limbs of the major- ity who had been lacerated by the gunshot injuries, and all were dying of hunger. Food was in the first place speedily supplied to these unfortunate individuals. I then caused their wounds to be dressed, and performed on many those operations that were the most difficult. They were finally conveyed with our wounded to the hospitals, pre- pared for this object, in which they received the same as- sistance and attention as the French. Forty-five amputations of the arm, fore-arm, thigh, and leg, were performed in my presence by the surgeons-major of our light ambulances. Those operations, that were executed in the first twenty-four hours, generally proved successful; those, on the contrary, which were delayed until the third, fourth, or fifth days, were not attended with such fortunate issues. This difference has been perceived and observed by all army surgeons, and there can remain no doubt, as to the necessity of an immediate amputation, when it is indicated. Among the serious wounds, there were some of a very remarkable character. The first occurred in an officer of the ninety-second regi- ment, who received a ball into his bladder. It was ex- tracted by the operation of lithotomy, and the patient re- covered before the thirtieth day. This operation forms the subject of a memoir, which will be placed at the con- clusion of the campaign. The second wound was observed in a Russian soldier, whose left thigh was disorganized by a cannon-ball. The femur was shattered as high as the trochanter, and the soft parts destroyed throughout two-thirds of the member. It 16 CAMPAIGN was decided in a consultation, consisting of several skilful surgeons, among whom was M. Ribes, that removal of the thigh was the only means of saving the life of the patient. It was immediately performed in the presence of the members of the consultation. I pursued my method, and the operation was terminated in less than four minutes. The flaps were approximated and maintained in their rela- tive situations by several adhesive straps, care being taken, however, not to effect too exact an union. This Russian, who bore the amputation with great fortitude, laboured under no unfavourable symptoms, until the twenty-fifth day. Suppuration was established without difficulty; the ligatures were detached from the seventh to the eleventh day; cicatrization was far advanced, and union had taken place in every part, but the commissures of the flaps, where the ligatures were situated. Means of subsistence failing suddenly in this hospital, in consequence of causes of which I am not aware, our wounded, particularly those who were incapable of leaving the place of their confine- ment, were subjected to the effects of famine. Their cravings were appeased by eating potatoes, badly cooked, and bulbous plants, or inferior fruits. Their drink con- sisted only of water, or very indifferent beer, though, pre- viously to my departure, I procured about two hundred bottles of wine, to be administered in a medicinal point of view to those of the wounded, who were in the most dan- gerous state. My unfortunate and interesting Russian patient became debilitated, and febrile action, accompa- nied with dysentery, manifested itself. This affection was aggravated, and, progressing with rapidity, caused his strength to be exhausted. He died with many other wounded about the twenty-ninth or thirtieth day after the operation, which would have been completely success- ful, had not these fatal complications ensued. This report was made to me at Moscow by M. Bachelet, surgeon-ma- jor of Witepsk. This health officer received, some time subsequently, in his hospital, one of our dragoons, upon whose left thigh I had performed the same operation. The wound had com- pletely cicatrized, with the exception of a very small por- tion, at the time of his entering this city, and the patient also enjoyed good health. He was conveyed farther into IN RUSSIA. 17 the interior of Poland, and recovered perfectly. I will resume the subject of this amputation at another time. It is evident, however, that it succeeded in two individuals; the first, after being nearly cured, was exposed to famine, became melancholy and miserable, and of necessity perished. I still entertain hopes of discovering the second, whose case may be cited as one of complete recovery after this operation. A wound, possessed of no less interest, was observed in the person of a Russian soldier, whose forehead was pierced in its centre by a ball, weighing four ounces. This case will be related in the memoir on injuries of the head. Several partial amputations of the foot were likewise per- formed; others through the substance of the condyles of the tibia, and at the superior fourth of the thigh, were also exe- cuted. The fractures of the inferior extremities, and am- putations of the thigh in general,^were attended with un- favourable results, in consequence of the patients being unable, by their own efforts, to procure for themselves good food and invigorating drinks among the inhabitants. They sank under the effects of abstinence, and their grievous wounds. Having established, so far as I was concerned, the duties of the four hospitals, which we had organized in Witepsk, I made my arrangements to depart with the light ambu- lances. The enemy was pursued to Smolensk, a strong city, and advantageously situated on a very elevated promontory, defended by the Dnieper on the side of Russia, and bounded towards our army by lakes and marshes. It was the key to ancient Poland, and could be defended with facility, especially against those who might attack it from the Russian side. About thirty thousand Russians were entrenched in this fortress, and on the neighbouring heights. In our way to Krasnoe, our advanced guard attacked the rear troops of the enemy. They could not sustain the shock caused by the vigorous assault of our men. Fourteen pieces of cannon, and several banners fell into our posses- sion. We also took many prisoners, among whom were a large number of wounded. I located them together in the synagogue, and immediately dressed their wounds. We had five hundred wounded on our side, nearly all of whom laboured under injuries inflicted by polished weapons. I 3 18 CAMPAIGN left several surgeons in this city, in order to arrange the duties of the hospital, which was there established. The army soon reached the heights of Smolensk. It was necessary to assault and carry them in succession by the bayonet. The execution of this object, though effected with very great difficulty, in consequence of the position and the tortuous defiles through which it was requisite to pass, was completed in twenty-four hours. 1 arrived in seasonable time with our ambulances for dressing the wounded. The town was attacked and taken by storm on the succeeding day, the eighteenth of August. The enemy made a most vigorous resistance in all quarters; but what could they accomplish, when opposed to the so frequently tested valour and intrepidity of the French ? The capture of Smolensk will be regarded, as one of the most glorious exploits of the whole campaign. Several parts of the city and suburbs being fired during the attack, there ensued a conflagration, which was rendered more horrific, in con- sequence of the greater portion of the houses being built of wood. This accident was favourable to the retreat of the Russians, and the entrance of the French into the town. The storming of Smolensk was one of the most bloody fights I have ever witnessed. The passages through the gates, breaches, and principal streets were filled with the dead and the dying, nearly all of whom were Russians. The loss of the latter was so immense, that it would have been difficult to compute the large number of killed, who were found successively in the ditches of the city, the ra- vines of the hills, as well as on the banks of the river and on the bridges. About six thousand of our men were wounded, and twelve hundred killed. The majority receiv- ed preliminary aid on the field of battle, as soon as they were wounded. I performed numerous operations in the ambulances of the advanced guard, whence we removed the wounded with all possible celerity, in order to locate them together in fifteen large buildings, which were con- verted into hospitals. Several were in the vicinity of the principal points of the field of battle, others in the suburbs, and the largest number in the city. Our situation here was similar to that at Witepsk, in re- lation to the deficiency of all kinds of materials for dress- ing the wounded. It became necessary for me in this, as IN RUSSIA. 19 ' in many other instances, to discover substitutes for such means as were wanting. Thus, in lieu of linen, which we had exhausted during the preceding days, I employed the paper found in the building which we converted into an hos- pital, and which contained the archives of the city. Parch- ment served the purpose of splints and splint cloths, tow and the down of the birch tree (betula alba) were used in the stead of charpee and paper for covering the patients. But, what difficulties was it not necessary to surmount? what toils did we not endure at this conjuncture? Nearly all the inha- bitants of the city had abandoned their houses, and the'ma- jority of those, which offered any resources, had been a prey to flames and pillage. I was actively aided in all these la- bours by the surgeons of the ambulances attached to head- quarters, and by those of the guard. We were occupied, both during the night and day, in dressing those wounds, that were caused by the sword and fire, and notwithstand- ing the scarcity of means in our possession, every necessary operation was performed in twenty-four hours. The capture of Smolensk gave rise to numerous cases of wounds, of the most serious and varied nature. One of the most remarkable of these injuries, was that sustained by a corporal of the thirteenth regiment of the line. A bullet, of large size, shattered the head of the left humerus, the clavicle, and the whole of the scapula. The bony fragments were thrown posteriorly upon the back, and the soft parts abraded and lacerated. The wound pre- sented a very unfavourable aspect. This soldier, in a state of insupportable agony, loudly demanded the removal of the remaining portion of his arm, and the numerous osseous splinters, driven into its muscular parts. Notwithstanding the slight hopes inspired by the situation of this unfortu- nate individual, 1 attempted the following operation. After having removed the arm, which was attached to the body merely by some shreds of flesh, and tied the axillary artery, I extracted all the osseous fragments, detached from the muscles and periosteum. The principal disorganized soft parts were then excised, and the lacerated and unequal edges of this extensive wound approximated, and maintain- ed in this state of contiguity by means of adhesive straps and a large piece of linen, dipped in a solution of gum ara- bic, rendered stimulating by the chloride of sodium. The 20 CAMPAIGN dressings were terminated by the application of fine tow, and the scapular bandage. This patient, after experiencing evident relief, was confided to the care of M. Sponville, one of the surgeons-major of the light ambulances. I was subsequently informed, that he was removed on the thir- ty-fifth day from Smolensk to Poland in a state progress- ing to a cure. I have since had no tidings respecting him; but there is no doubt of this soldier's recovery, provided he escaped other maladies. I performed, in the first twenty-four hours, eleven am- putations of the arm at its articulation with the scapula. Nine of the subjects of these operations completely reco- vered, previously to our return from Moscow, and two died of dysentery. This extraordinary success justifies the fa- vourable opinion entertained respecting this operation. I also'executed several amputations of the thigh, in its superior fourth, with the formation of two flaps. I shall have an opportunity of speaking of this operation, at the conclusion of the campaign. It was extremely difficult to provide the hospitals with necessaries for the great number of wounded French and Russian patients. The latter were treated indiscriminately with our sick, and received from us the same attention and aid. Brandy, wine, and a large number of highly neces- sary medicines, were saved from the pillage and conflagra- tion. Persons were despatched into the neighbouring country for cattle and food. Charpee and linen, for dress- ing wounds, were received from the ambulances of re- serve. These different resources, and the indefatigable zeal of our surgeons, speedily restored to health the indivi- duals, who were but slightly wounded. Those injuries that partook of a serious nature, were generally in a good state, when, a month subsequent, all means of subsistence sud- denly failed, with the exception of flour, which had been received by convoys from the interior. The soldiers, who were not wounded in the inferior extremities, were capable of avoiding the effects of these deprivations; others, how- ever, suffered much in consequence of them. The urgent necessity of securing the benefits of succour to about ten thousand Russian and French wounded, located in the hospitals of Smolensk, and my persuasion, that the army, after such signal success, and on account of the ap- IN RUSSIA. 21 proach of the autumnal rains, would make but little pro- gress towards the north, induced me to leave in this city, besides all the surgeons of the reserve, five divisions of our light ambulances. I departed with the sixth division, and my two private pupils, in order to repair to Volontina, which is from five to six leagues distant from Smolensk, on the road to Moscow. Our advanced guard, commanded by General Gudin, had in this place engaged in a combat, which was rendered more obstinate by the fact of the rear- guard of the enemy having taken a position on a chain of small mountains, bordering on the right bank of the Dnieper, and extending, contrary to its course, parallel to the city of Smolensk and the adjacent hills. I caused the wounded of this battle to be dressed. General Gudin was among this number; but I arrived at too late a period for the performance of the operation, necessitated by his wounds. One of his legs had been carried away by a cannon-ball, and the calf of the other totally removed. Symptoms of very violent inflammation, were promptly developed in the two limbs. Irritation and gangrene were speedily mani- fested in the seat of injury, and death terminated, on the third day, the sufferings of this worthy and valiant general, who had carried, at the point of the bayonet, the almost impregnable position, on the mountain of Volontina, though it was defended by the grenadiers of the imperial Russian guard. The defile of this mountain was found crowded with the dead of this troop of elite. Our killed were in the proportion of one to four of the enemy. Doubtless this novel success, or the hope of fighting speedily a dernierand decisive battle, led Napoleon to pursue the enemy in their retreat towards Moscow. With the view of enabling my- self to rejoin him, I hastily dressed the wounded in the last battle, amounting to from six to seven hundred men, with whom it became necessary for me to leave my sixth divi- sion of light ambulance ; the latter returned with them to Smolensk. There remained with me but two assistants, and it was impossible for us to overtake the head-quarters of the army, until they arrived at Dorogobouje, the first station. After having passed this city, and the chain of mountains before it, the Dnieper was re-crossed for the last time, and the immense plains, which comprise the greater part of Russia proper, were discovered. At the entrance 22 CAMPAIGN into these plains, and on the bank of the river, there were remarked several small mounds of earth, pyramidal in form, which the inhabitants of a neighbouring village in- formed us, were the tombs of those who were killed in a bloody battle, fought in former times between the Russians and Poles. M. Baron Percy has described, in a very learn- ed memoir read before the Institute, similar monuments, which he observed in different countries of Germany. The sight of these tombs made a sad impression on my feelings. Indeed, was it not calculated to awaken sombre thoughts in the minds of men, so remote from their country, at a pe- riod, when the rainy season was about to commence, (the first indication of winter in this climate,) and when it was to be apprehended, that the bad condition of the roads would expose the army to many dangers, as we had already experienced at Pultousk? (See the Jirst campaign in Po- land.) The roads in Russia, which are of immense breadth, are neither paved, nor kept in repair. These plains, which extend beyond Moscow, are covered with abundant crops in summer, and with snow, of greater or less depth, in winter. We had scarcely crossed the last branch of the Dnieper at Dorogobouje, when I suddenly experienced all the symp- toms of sea-sickness, such as frequent nausea, yawning, a sensation of being stunned, or vertigo, and vomiting. It appeared to me, that I saw, at the immeasurable limits of the horizon a scintillation or trembling of the earth, which had an effect on my senses, similar to that caused by the tossing of a vessel at sea. This illusion or these sensations were increased, when I walked,—diminished, when I was mounted on my horse, and almosttotally disappeared, when I lay in a horizontal posture. The latter was the most favour- able position I could adopt. I laboured under this indispo- sition, until my return to Smolensk. From what could it have originated? Was it an optical illusion, or an excess of sensibility in my organs which received a deranged im- pression from the constant motion of the large bodies of individuals and objects, by which I was continually sur- rounded, on these immense plains? In our passage through Dorogobouje, we found those houses, that could have offered us resources, to be in flames. The rapid progress of the conflagration obliged us to bi- IN RUSSIA. 23 vouac. The Russian soldiers had set fire to the city, which was deserted by all of its inhabitants. Here commenced every species of privation. Thislament- able prelude should have warned us of the calamities, we were destined to endure on the remainder of our route to Mos- cow. Led on by irresistible inducements, and flattered with the vain hopes of peace, we continued our march. We shortly after attacked Viasma, a considerable city, which served as a depot for the commerce of the two Rus- sias. It contained immense store-houses of oil, brandy, soap, sugar, coffee and furs. We found it almost entirely consumed. It was with great difficulty, that the army tra- versed it, and in consequence of the violence of the winds it was impossible to arrest the progress of the flames. The inhabitants had also abandoned the city, and our suffer- ings in the midst of this desolation may be conceived. The soldiers however collected from some houses, that had es- caped the flames, and even in the cellars of those that had been burnt, a quantity of flour, oil, brandy, sugar and coffee. From Viasma, we moved on hastily to Giad, a city of less importance, and built almost entirely of wood. It con- tained but one street, of very great length. We passed through it, as through the two preceding cities, in the midst of flames. Abundant showers of rain, which super- vened on our arrival in this place, arrested the conflagra- tion, and permitted the general officers and guard to take up their quarters in those houses, that had been preserved. The fields in the vicinity of this city abounded in large- headed cabbages, which, together with the bacon and bis- cuit found in a store-house, proved highly serviceable. Our soldiers enjoyed a momentary satiety on this food. The rains, by their long duration, had rendered the roads impassable by the artillery. The army was neces- sitated to arrest their march about Giad, with the view of awaiting fair weather, which no one expected with any cer- tainty. We were, however, greatly and agreeably sur- prised by the sudden change of the winds to the north north-east, anddry weather ensued. Duringthisintervalin- formation was received, that the Russian army had finally ta- ken a position on the heights of Mosaisk and in the neigh- bourhood of the Moscowa, and were strongly entrenched 24 CAMPAIGN in this situation. Preparations for a grand battle were or- dered to be made, and notice was given me by the com- mander-in-chief to make my arrangements accordingly. I was much affected by this intelligence, in consequence of my surgeons having remained at Smolensk, and the am- bulance waggons being still in the rear. For the pur- pose of supplying my deficiency in this respect, I solicited an order of the day, which placed at my disposal all the surgeons of the regiments, the surgeon-major, an assistant and sub-assistant being excepted, for the corps of infantry, and a surgeon-major and sub-assistant for the cavalry. This proceeding procured me forty-five surgeons, assistants or sub-assistants, whom I attached to head-quarters. A prolongation of our sojourn at Giad for twenty-four hours, gave opportunity to several of our ambulance wag- gons to rejoin us; and I was fortunate, notwithstanding the remoteness of the reserve, in being capable of furnishing the requisite succour in the battle which was about to take place. IN RUSSIA. 25 PART THE SECOND. After a march of thirty-six hours, we found ourselves in the presence of the Russian army. It was stationed and entrenched on the top of a circular hill, extending from Calouga and the grand road to Moscow on our left, to the distant forests on our right. At the base of the hill, there ran a deep stream, difficult to be forded, and giving this position immunity from an attack. The want of sustenance and forage, particularly of oats, had nearly reduced both soldiers and horses to a state of exhaustion. Arriving on the field of battle, the army was destitute of every species of food. There was even a great scarcity of water, which it was necessary to obtain from the above mentioned stream in the very face of the enemy. Giad and the abbey of Kolloskoi, in the vicinity of the field of battle, were almost totally devoid of any resources. On our departure, the flames broke out anew in Giad, which was deserted by all of its inhabitants without exception. The conflagration, supported by the violence of the winds, reduced the city to ashes in a few hours. The churches and three or four brick houses were all that remained undestroyed. They were used by us as hospitals, in which I was necessitated to leave some of my surgeons. The troops of our advanced guard in the mean time dis- . played their ranks and attacked, September the fifth, at two o'clock, P. M. the first line of the enemy, which fell back on the second. Some redoubts were carried by our cannon. The enemy's forces were giving way in all quarters and every thing indicated a glorious issue for our arms, when the combatants were suddenly surrounded by the shadows of night, and both parties forced to interrupt the fight and resume their respective positions. I caused our wounded to be dressed during the night, 4 26 CAMPAIGN and removed immediately to the abbey of Kolloskoi, where the general ambulance of retreat had been established. The day of the sixth was spent in recruiting the troops, and in a strict reconnoitring of the enemy's lines. I availed myself of this opportunity to have dressings prepared, and placed on duty thirty-six surgeons, who were under my immediate control. All the materials of the ambulances were likewise arranged by my direction. The positions to be occupied by the ambulance of head-quarters and the guard were designated by Napoleon himself. Previously to repairing to this bivouac, I passed through the whole line, for the purpose of giving my instructions to the of- ficers, who presided over the ambulances of the corps and divisions. A proclamation was issued during the night intervening the sixth and seventh of September. (See the bulletin of the army.) Accompanied by the ambulances, I proceeded, before the dawn of day, to the appointed place. It was a square space of about three thousand feet in circumference, situa- ted in the centre of the line and in the vicinity of the tents of head-quarters. The battle commenced by a general at- tack at the rising of the sun. Prince Eugene commanded the left wing, Prince Poniatowski the right, and Prince Murat the centre, in which situation were stationed the corps of the guard and the Emperor. Upwards of two thousand pieces of artillery, appertain- ing to the two armies, were simultaneously discharged. Our battalions advanced boldly across the enemy's fire, in order to seize upon the first redoubts and break through their lines. The left wing routed a column, which defended one of the strongest positions on the road to Moscow, and advanced hastily on Mosaisk. The centre, under the im- mediate command of Marshal Ney, after standing a very brisk fire from the numerous batteries and redoubts, which defended the most important part of the enemy's line, carried these fortifications, and made itself master of this formidable and almost inaccessible position. General Caulaincourt,commander of the assaulting column, was killed on the first redoubt. The Generals Morand and Lausnaberg, who succeeded him in command, were wounded on the same spot. The latter died a few days IN RUSSIA. 27 after the reception of his wound, which was caused by the passage of a ball through his abdomen, and involved the intestines. The loss of these officers retarded the pro- gress of this column, and it was with some difficulty that these troops retained possession of the redoubts and posi- tion. Prince Poniatowski marched with an equal degree of boldness on the ranks of the enemy, to which he was opposed, and attacked them with similar success. Their whole line tottered, and their first position was carried. They would doubtless have been totally destroyed, had the reserve been capable of aiding the central column, or the space occupied by the infantry and cavalry, already very much fatigued, been less extensive; and in short had not the day been so far spent. It was for some moments doubtful, which party would prove victorious. Our bat- talions however closed up, and, animated by a new impulse, moved on with rapidity, and possessed themselves of the whole field of battle, vigorously driving the Russian army before them. The bold resistance made by the latter proved fatal to many, and the remainder of the troops pre- cipitately retreated to Moscow. They made no halt in this place, but continued their march hence to Calouga. This bloody battle continued from six o'clock, A. M. to nine o'clock, P. M. We had forty generals killed and wounded, and from about twelve to thirteen thousand men, both officers and soldiers, placed hors de combat. The number of wounded amounted to nine thousand five hun- dred. The loss of the enemy was estimated at upwards of twenty thousand. It would be difficult to describe the scenes of horror presented during this dreadful fight, in which more than from five to six hundred thousand com- batants were engaged in a space of about a league square. Two-thirds of the above mentioned wounded were loca- ted in our general ambulance, the whole army being made aware of its position by the order of the day, and its vici- nity to the tents of head-quarters. I had scarcely made the necessary preparations, when the wounded arrived in a crowd, and much confusion would have ensued, had I not pursued the order of dressing and arrangement, observed by me in all battles, and detailed under its principal heads in my first campaigns. I owe much praise and many thanks to my estimable assistants, 28 CAMPAIGN to M. Laubert, chief pharmaceutist of the army, and to several of his juniors, for the zeal with which they aided me in this memorable battle. The limited number of my assistants, high in rank, forced me to perform personally all the difficult operations. It was also necessary, that I should exercise an active su- pervision over this ambulance, and all those of the line. Two or three hours had elapsed since the commence- ment of the battle, when I was called to the assistance of General Montbrun, commander of one of the cavalry corps, who was mortally wounded. It was requisite that his wound should be dressed on the spot where it was received. The loins were traversed, from side to side, by the projec- tile. Little could be done, death was certain, and not far distant. I applied dressings, and caused this general to be conveyed to a small village in the vicinity, where he died a few hours subsequently. During the dressing of this wound, my situation was one of very great peril, some horses, which were behind us, being killed by a ball. # I.re- turned to my ambulance, to which I was recalled for the purpose of bestowing my services on the Generals Nan- souty, Lausnaberg, and Romeuf. The first had the inter- nal side of the right knee traversed by a ball, which for- tunately had not injured the articulation. I laid open the wounds, applied a suitable dressing, and placed the patient under the charge of chief-surgeon Bancel, who attended him, until he was perfectly cured. I have already made known the wound of the second. It presented no other indication than that of a simple dressing and subsequent care, which was prodigally bestowed upon him with the greatest zeal, but unhappily proved unavailing. Being > unable to fall in with the latter of these generals, I did not see him until the succeeding day. He had been dressed on the field of battle, and conveyed to the same village to which General Montbrun had been carried. The very great injury, caused by a spent ball, in the right hip and lumbar region of the same side without any exterior mark, was not recognized. A long incision, made immediately in the skin of this region, which was disorganized and dis- tended by a large quantity of extravasated blood, revealed to me the whole extent of the interior disorder. The mus- cles were lacerated and reduced to the consistence of jelly, IN RUSSIA. 29 and the os innominatum and corresponding lumbar vertebrae fractured. The commotion, which the abdominal viscera must have experienced, may be imagined. General Ro- meuf died on the same night. It were impossible to ex- hibit more valour and courage, than was displayed by these noble sufferers, whose names deserve to be recorded in the annals of history. 1 speedily returned to the general ambulance, where I continued, without intermission, the performance of diffi- cult operations, until late in the night of the following day. Our duties were rendered proportionally more laborious by the very cold and frequently cloudy weather. The north, north-east, or north-west, winds, which prevailed constantly during the whole month, were very violent, in consequence of the approach of the equinox. It was with great difficulty, that a wax taper was kept burning before me during the night. I had no absolute need of it, but for the application of ligatures to arteries. The surgeons, without exception, gave the most signal proofs of courage and devotion in this battle. The ambu- lances of the corps, and those of the regiments were at their posts, and perfectly fulfilled their duties. Two only of the individuals, upon whom I performed the operation of amputation at the shoulder joint during the first day, died during theremovals, as I was subsequently in- formed. The others arrived cured in Prussia and Germa- ny, previously to our return to those countries. The most remarkable of those wounded individuals was a chief of battalion, attached to one of the regiments of infantry of the line. Immediately after the operation had been perform- ed, he commenced his journey, mounted on his horse, which he speedily lost. This circumstance did not impede his progress; hepursuedhis way, uninterruptedly to France, where he arrived cured three months and a half ai'.er he re- ceived the wound.* I was much occupied with the execution of another de- * This officer daily sponged his dressings, which were not renewed un- til his arrival at Paris. This shoulder was afterwards covered with a sheep-skin. 30 CAMPAIGN licate operation. My allusion has reference to amputation of the thigh with a flap. This member was found disorganized in the persons of many soldiers of all classes, sufficiently high up to prevent the performance of the circular amputation, and yet not disorganized to such a degree as to render necessary the extirpation of the limb. I was obliged, in every case, to amputate on a level with the great trochanter, and at a very short distance from this apophysis. I have elsewhere pointed out the manner of performing this operation. There was, however, among the wounded a sub-officer of dragoons, whose injury necessitated a removal of the thigh. A bullet had traversed this member from the ex- ternal side of the fold of the groin to the great trochanter. The muscles along the whole tract of the projectile were destroyed, and the bone shattered as high up as the hip joint. The crural artery, however, though very contiguous to the wound, was not injured. The patient lost little blood, and no serious symptom as respects the internal or- gans, presented itself. His condition, in short, was highly favourable (the local disorder being excepted) to the opera- tion, which I undertook, though on the field of battle, with a greater degree of boldness, inasmuch as the patient re- quested its immediate performance. The internal flaps had already been formed by the course of the wound; it was merely smaller than it would have been, had it been made of uninjured parts. The pectineus muscle being separated from it,T left it in its situation, and, without removing his portion of the soft parts, cut under this muscle the inter-ar- ticular ligajnent, which retained a part of the head of the bone in its cavity. The operation was terminated in the ordinary manner. Having applied the ligatures, I approx- imated the two flaps, and maintained them in their relative position hy adhesive straps and suitable dressings. This patient was then conveyed to the abbey of Kolloskoi, whence he wag successively removed to Witepsk and Or- cha. The surgson-major, who received him in the latter city, informed me by letter, that this sub-officer had re- covered perfectly from the operation. I know not what has since become of him. If gunshot wounds of the thigh, accompanied with frac- ture of the os femoris, in general render necessary the am- IN RUSSIA. 31 putation of the limb, there is an injury of this character, which strongly demands this operation, or else the patient is doomed to perish, after having endured excruciating tor- ture. Little is known about it, and indeed it is one of those wounds, which appear the most favourable to the preservation of the limb, since it does not indicate, by any exterior mark, the danger which accompanies it. A ball, with all the violence of its impulse, pierces the thigh, in an antero-posterior direction, immediately above the patella. This projectile traverses the limb throughout, or is arrested in the popliteal fossa, according to the resist- ance it experiences from the bone. In both cases, the fe- mur is broken transversely above the condyles, and the two apophyses are separated from each other by a vertical fracture, which extends into the joint. The patient loses his equilibrium, and falling immediately aggravates the in- ternal injury. The series of unfavourable symptoms, which are developed, and the necessary termination of such a wound, may be easily imagined. It is, moreover, quite dif- ficult to recognize the seriousness of this lesion. Should the ball have terminated its course without effecting a rup- ture of the popliteal artery, the two wounds, at first sight, present nothing serious in their nature. There is scarcely any or no displacement of the bony fragments, and the pa- tient suffers little during the first hours succeeding the ac- cident. But tumefaction soon supervenes, and renders farther ex- amination impracticable. Thus, on one hand, a surgeon is led to believe, that the wound is not of so serious a charac- ter, as to require amputation of the limb; and, on the other, the nature of the cause, which produces these consecutive symptoms, is not known. This circumstance may doubt- less have frequently led practitioners into error, and I have been myself deceived, in cases of individuals labouring under this kind of wound, whom I hoped to be capable of curing without an operation. Experience has taught me to decide, in a precise manner, upon those cases of gun- shot wounds of the thigh, accompanied by fracture or a shattered condition of the femur, in which amputation is indispensable, and those in which an attempt may be made to preserve the limb by the ordinary means. In order that we may be able to treat fully this question, we will give an 32 CAMPAIGN account of our observations on this point in the battle of the Moskowa. The first wound of this character, which presented itself in this battle, the seriousness of which I was so fortunate as to discover, was observed in the person of Count Sacko- veninsk, colonel of the regiment of cuirassiers, belonging to the Russian imperial guard, an officer of very fine ap- pearance, . strong constitution, and considerable embon- point. This soldier, of superior rank, was brought to the general ambulance. He had been wounded by a ball above the left knee. This projectile, after having fractured the femur above the condyles, was arrested under the skin of the ham, from which it was extracted by our chief-surgeon, M. Bancel, who was making arrangements for the appli- cation of a fracture apparatus to the injured thigh. I was called, in the mean time, for the purpose of examining *he wound, which, at first sight, did not appear to be of an un- favourable nature. A very careful examination revealed to me, besides the complete fracture of the inferior extre- mity of the bone, the separation of the two condyles by a vertical division, which appeared to communicate with the articulation. I did not hesitate to propose the amputation of the limb. The surgeons present did not approve of it, and the patient was not decided on this point. But after some moments of reflection he consented, and requested me to operate on him immediately. I performed the cir- cular amputation above the seat of injury. My method was conformable to the rules pointed out in several articles of my Campaigns. The patient was removed from our am- bulance, and conveyed with other prisoners to a neigh- bouring village. The objections which were raised against the operation, led me to have the detached limb immedi- ately dissected. The bone was divided, at its union with the condyles, by a transverse fracture, and the two apo- physes separated in a vertical direction. The articulation was filled with black albuminous blood, the popliteal artery lacerated, and the muscles of the leg in a state of engorge- ment. It is indeed difficult to meet with a case, which demands more imperiously the operation of amputation. We will again speak of this patient on our return from Moscow. Three cases nearly similar presented them- selves in this battle. The same phenomena were observed IN RUSSIA. 33 in the examination of the amputated limbs, which was con- ducted by one of my pupils. I have preserved the knee in many instances of wounds, in which the leg has been carried away, or disorganized by a bullet at a point so contiguous to this articulation, as to have induced me to perform amputation of the thigh, had not experience demonstrated to me the success of the operation executed through the substance of the head of the tibia. The advantages of this latter amputation have never been more appreciated by patients than in these adverse situa- tions. Many indeed among them, who were capable of manufacturing for themselves wooden legs, were so fortunate, though they were very awkwardly made, as to avoid the painful vicissitudes, which were experienced until our return from Moscow by those whose thighs had been am- putated in the ambulances. The}' were also enabled to guard themselves against the severe cold, which destroyed the majority of the wounded, who were incapable of walk- ing, and especially those, who were transported in the rear of the army. I will briefly relate the case of amputation near the knee, which I consider as most worthy of re- mark. A young Russian officer, belonging to the regiment of the colonel above mentioned, was wounded in the calf of the right leg by a small mortar. One of the projectiles, contained in the latter, escaping from it at the time of its passage through the substance of the limb, was driven into the hollow of the ham, ascended the thigh, following the course of the popliteal vessels, and issued externally at the middle and internal part of the limb. The calf of the leg was totally removed, and the two bones shattered very high up and near the knee. Although the joint was not injured, none of the surgeons present supposed it possible to preserve the knee. One of them indeed was making arrangements for amputating the thigh, when the Russian colonel, who spoke the French language, directed that I should be sent for. After having made a strict examination of the wound throughout, 1 proceeded to amputate the leg through the head of the tibia, above the level of the tuberosity for the insertion of the patella. Previously to sawing through the tibia, I dislocated the fibula. The head of the bone 5 34 CAMPAIGN was sound. I was capable of preserving merely a small part of the integuments, for the purpose of affording a co- vering to the anterior half of these divided eminences. The integuments of the ham had been removed, as high up as the thigh. A ligature was placed around the popliteal artery at the point of its bifurcation. I laid open the wound of the thigh, and established a communication be- tween it and that of the stump, by means of a strip of linen, recommending the extraction of the latter, when suppuration was established. The application of a piece of fine linen, and the ordinary apparatus, terminated the dressing of the wound. This patient was conveyed with the colonel, Prince Gallizin, who was slightly wounded, and other Russian officers, to a neighbouring village, in which they remained until their recovery. The wounds, received in this battle, were generally of a serious nature, in consequence of nearly all of them being caused by artillery, and by musketry, inflicted at the very extremity of the guns, or at least very nearly so. The balls of the Russians, moreover, as we have frequently re- marked, are larger than those used by our soldiers. A large number of wounds, caused by artillery, required amputation of one or two limbs. I performed, in the first twenty-four hours, about two hundred operations of this character. The most favourable results would have suc- ceeded, had not our wounded been destitute of an asylum, of straw for their beds, bed-clothes, and sustenance. But such was our unfortunate situation, and we were, moreover, very remote from those places which could have furnished us these succours. The absence of means, necessary for transportation, ren- dered it necessary, that we should dispose of our sick in all the neighbouring villages, comprising the abbey of Kollos- koi, in which the majority were located. The stay of the cavalry in the limited range of places occupied by our wounded, had occasioned the consumption of all kinds of forage, and it was with difficulty that we were enabled to obtain a sufficient quantity of straw to make beds for them during the first days. The small quantity of bread and flour in our possession was soon consumed. Our wounded were reduced to the necessity of eating the flesh of the horse, potatoes, and the stocks of cabbage. The latter, together with the flesh of IN RUSSIA. 35 this animal, were used for some time for the purpose of making soup. This aliment was soon exhausted, and the march of our convoys was rendered more difficult, in con- sequence of the roads being infested with Cossacks. Charpee and linen for dressings were wanting equally in almost every situation. Many articles of primary neces- sity, such as bread, flour, beer, medicines, and linen, might however have been obtained from several places, in which we found succours. Agreeably to my request, orders were given, by the superior officers of the army, to take advan- tage of this opportunity. But the execution of such mea- sures ordinarily depends on too many individuals, and, as a consequence, must meet with great difficulties. The op- portunity was suffered to pass by, and the wounded did not receive the succour, to which they were entitled. The surgeons, the only consolers of these unfortunate men, were forced to wash personally, or cause to be washed in their presence, the linen, which had already served as dressings, in order that they might be daily renewed. It is to the indefatigable zeal and industry of my assistants, that the majority of the wounded are indebted for their preservation. The army marched, on the day after the battle, in pur- suit of the Russians, who did not deem it proper to halt at Mosaisk, where, however, they had an advantageous posi- tion. I delayed my departure three days, with the view of having the dressing of our wounded completed, and also of attending to the Russians, who were successively removed from the field of battle, and conveyed to our ambulances. On entering Mosaisk, we found several quarters of the city on fire. All the inhabitants had abandoned it, and the principal houses were filled with the wounded Russians, who were incapable of following the army, and were left without any kind of succour. Nearly all of these unfortu- nate individuals had their limbs mutilated, and were con- sequently unable to procure sustenance by their own ex- ertions. If their wounds be excepted, they suffered most acutely from burning thirst. This affection appears to me to have contributed a great deal to the death of a large number of these ill-fated soldiers, whose bodies were permitted to lie for a time in the midst of the living. Ten 36 CAMPAIGN of these patients had each lost a limb by amputation, per- formed by the Russian surgeons. The first two had had their arms extirpated at the shoulder joint. Two large flaps had been formed, a superior or scapular, and an inferior or axillary. Several ligatures passed through the sub- stance of the latter, for the purpose of embracing the axillary artery, and the two flaps were maintained in their relative situation by several points of suture. In the case of one of these two wounded individuals, the stump became very much tumefied; irritation and gangrene were deve- loped on the same day, and the patient died on the follow- ing, notwithstanding the precaution, adopted by me, to cut the ligatures. We found the second patient expiring in consequence of the haemorrhage, which supervened a very short time after the extirpation of the limb. He had been operated upon according to the same method, and it ap- peared that oil the arteries had not been tied. As in the former case, however, the union of the flaps was exact, and the points of suture even more multiplied. I have not learned any thing, as to the fate of the remainder of these patients, upon whom amputation had been per- formed. Assisted by some soldiers of the guard, whose humanity I frequently put to the test, I provided, in the first place, for the most urgent necessities of these unfortunate per- sons. Water and biscuit, which I discovered in a store- house, were distributed to them by my direction. I then caused the dead to be removed. All the wounded, who had not been dressed, had this attention immediately paid to them. The churches and public house were placed in a proper condition for the reception of the wounded French. The Russians were located in the houses of merchants, and I left with them the few surgeons that remained with me, under the supervision of a chief-surgeon, preferring to await the successive arrival of those who were in the rear. Having remained two days at Mosaisk, head-quarters moved on to Moscow. We were scarcely distant some miles from Mosaisk, when we were much astonished at finding ourselves, notwithstanding our vicinity to one of the largest capitals in the world, in a sandy, arid, and com- pletely desert plain. The sad aspect of this solitude, which discouraged our soldiers, appeared to presage the entire de- IN RUSSIA. 37 sertion of Moscow and the misfortunes that awaited us in this city, the splendour of which should have promised ua another fate. The army traversed this plain with difficulty. The horses were fatigued and exhausted by famine and thirst, for there was as great a scarcity of water, as forage. The soldiers endued many hardships, and were overcome with fatigue, and deprived of sustenance. A long time had elaps- ed, since a distribution was made to the troops, and the few resources found in Mosaisk merely served for the ju- nior and elder guard. A large number of conscripts of the former corps became victims to the abuse of chenaps, (the brandy of the country.) They were observed to re- move themselves some steps from their companions, to stagger, turn round, and then to fall upon their knees, or sit down involuntarily. They remained motionless in this position, and soon expired, without giving utterance to a single groan. These young soldiers were predisposed to the pernicious effects of this drink, by ennui, privations, and excessive fatigue. We reached, on the evening of the fourteenth of Sep- tember, the suburbs of Moscow, and there learned, that the Russian army, in its passage through that city, had taken along with it all the citizens and public functionaries. There merely remained in the city, some of the inferior order of the people, and those who acted in the capacity of servants; so that, in passing through the principal streets of this grand city, which we entered on the morning of the following day, we scarcely met any one. All the houses were totally abandoned, but we were very much surprised at seeing several remote quarters of the city on fire, whither our soldiers had not yet repaired, and especi- ally the bazar of the Kremlin,* a very extensive build- ing, ornamented with porticoes, which bear some resem- blance to those of the Palais Royal in Paris. When comparing the city of Moscow with what we had witnessed in our march through Russia minor, we were much astonished at its grandeur, its numerous churches and palaces, the splendid architecture of its edifices, the commo- * Palace of the Czars. 38 CAMPAIGN dious arrangement of its principal houses, the richness of their furniture, and the objects of luxury, observed in the greater part of it. The streets generally were spacious, regular, and well paved. There appeared nothing in this city which was discordant with its general character. Every thing indicated its opu- lence, and very extensive trade in the products of the four quarters of the globe. The varied construction of the palaces, houses, and churches, added infinitely to the beauty of the city. There were portions of it, which, by the kind of architecture of the different houses, signified by what nations they were generally inhabited. Thus, the quarter occupied by the Franks, was easily distinguished, and that of the Chinese or Indians, and Germans, known without difficulty. The Kremlin may be considered as the citadel of Moscow. It is situated in the centrCof the city on an elevated piece of ground, surrounded by a wall with battlements, and defend- ed, at intervals, by towers armed with cannon. The bazar, to which we have aliuded, ordinarily filled with the mer- chandise of India and precious furs, had become a prey to the flames. No relief could be obtained, but from those ar- ticles, which were stored away in the cellars. Into these vaults our soldiers penetrated after the conflagration, which consumed nearly the whole exterior of this splendid edifice. The palace of the emperors, that of the senate, the archives, arsenal, and two very ancient temples, occu- pied the remaining part of the Kremlin. These different structures of rich architecture, presented a majestic appear- ance around the arsenal. An individual would imagine himself transported to the public square of ancient Athens, admiring in the one, the Areopagus and temple of Miner- va, in the other, the academy and arsenal. Between the two temples there arose a cylindrical tower, in the form of a column, and designated by the name of the tower of Yvan. It was, properly speaking, an Egyptian minaret, in the in- terior of which were suspended several bells of varied grandeur. At the base of this tower, one was observed of immense size, to which allusion is made by all historians. The whole city, and its environs, were seen from this ele- vation; its delineations resembled a star with four bifur- cated branches. The variety of colour in the roofs of the IN RUSSIA. 39 houses, the gold and silver, which covered the domes and chapiters of the numerous steeples, gave to this city the most picturesque appearance. Nothing could equal in splendour one of the temples or churches of the Krem- lin. It was the tomb of the emperors. Its walls were overlaid with plates of gold or silver, gilt from five to six lines in thickness, on which were represented in re- lief the history of the Old and New Testament. The can- dlesticks and chandeliers of massive silver were particular- ly remarkable for their extraordinary size. The hospitals, which attracted my especial attention, were not unworthy of the most civilized nation of the world. I divide them into military hospitals and civil monkish institutions. The great military hospital con- sisted of three parts, forming together a parallelogram. The principal portion of it was built on the edge of a large road, in front of immense barracks, which may be compared to the royal military school at Paris.. Two lateral buildings, constituting right angles with the former, completed the enclosure of the court, which communicated with a beautiful and large garden, the latter serving as a promenade for the sick. A portico, with columns, formed the front of this building, the height of which was two stories. The entrance led first into a spacious vestibule; into this opened the doors, conducting to the apartments of the basement story. A large and magnificent stair- case, leading to the upper stories, was also here situated. The halls occupied the whole length of the building, and were provided with windows, on each side, extending almost from the floor to the ceiling, and consisting of double sashes, as is the case throughout Russia. They were perfectly closed during the winter. Stoves, with impressions upon them, were placed in the interior of these apartments, at suitable distances. There were four rows of similar beds, at such distances from each other, as was requisite for the preservation of health. Each row consisted of fifty beds, the total number of which may have amount- ed to more than three thousand, the three buildings form- ing the hospital containing fourteen principal halls, of nearly the same extent. The manufactory, medicine, and cooking apartments, and the accessories of this hospital, occupied very distinct and convenient situations, a short 40 CAMPAIGN distance from the halls. This building was one of the best constructed, largest, and most beautiful I have ever seen. We found in it but a very small number of patients, who were removed to the second hospital, which was less ex- tensive, and situated in the vicinity of an establishment, called Institutes, devoted to the education of the male and female children of those who had been killed in battle. The civil monkish institutions, which it was my duty to visit, for the purpose of locating our wounded in them, are equally worthy of attention. The four principal were the hospital of Cheremetow, that of Gallizin, the hospital of Alexander, and that of the Foundlings. The first, remarkable on account of its shape, its con- struction and internal arrangements, was pitched upon for the reception of the wounded and sick of the guard. This hospital, consisting of three stories, was built in the form of a crescent. Its accessories were situated in the rear of this edifice. A beautiful portico, just in the centre of this half moon, formed the entrance into a chapel, which occupied the middle of the building. This chapel, sur- mounted by a dome, and surrounded by the principal halls, designed for the sick, contained the mausoleum of the prince who founded this hospital. It was ornamented with stuccoed columns, statues, and beautiful pictures. The apartment, in which the medicines were deposited, was one of the handsomest and most splendid with which I am acquainted. The rooms, to which access was gained by means of galleries, differed as respects size. The beds and other movables, were kept in very neat order. We found here twenty old men belonging to the household of the prince, whom we placed by themselves in one of the best quarters of the hospital, in order that they might not be situated in the midst of our sick. The same succour was administered to them and to our soldiers. The Hospital of Gallizin, situated at the "opposite extre- mity of the city, was the most beautiful in Moscow. In it were located the wounded French officers. Our attention was bestowed in an equal degree on thirty Russian officers, who were labouring under serious wounds, and were placed in this hospital by their companions on their departure from Moscow. Three of them had undergone amputation; IN RUSSIA. 41 two, that of the leg, and the other, that of the thigh. The latter died, during our stay here, of fever arising from the irritation of a conical stump. The wounds of the two amputated legs had been seized with hospital gangrene, when I first saw them. One of the patients succumbed to this affection; but a favourable change took place in the other individual, and he recovered. The gangrene which we were fortunately enabled to arrest in proper time, de- stroyed the flap, formed of the calf of the leg by the Rus- sian surgeon in the operation. From this period the wounds became regular, and cicatrization was effected, though indeed slowly. Several other Russian officers la- boured under very extensive comminuted fractures, accom- panied with disorganization of the soft parts. I had much difficulty in persuading them of the necessity of amputa- tion. Two of them, however, decided upon its perform- ance. It was the cause of their preservation, and they were cured in a very short space of time. Two French officers, attached to the Polish corps com- manded by Prince Poniatowski, were brought from the advanced guard to this hospital. Both of them had received, in one of the battles in which these troops were engaged, wounds of so serious a nature as to necessitate amputation of the limb. It was performed, in one case, upon the thigh, and in the other, on the leg. The chief Polish surgeon, M. La Fontaine, author of a work on Plica, executed these two operations. He attempted the union of the two woundsby the first intention, and maintained their edges together by means of several points of the interrupted suture. One of these officers laboured under considerable haemorrhage on entering the hospital, and the stump was already seized with gangrene. I immediately divided the sutures, and found the stump filled with coagulated blood. There was no ligature what- ever; but haemorrhagy did not again supervene, and the patient experienced some relief. Gangrene, however, was not less tardy in its progress, and at the expiration of a few hours the patient was no longer in existence. The other was in a state of violent irritation, which I was incapable of allaying by any known means. The suture had likewise been employed in this instance. The latter was divided, and emollients applied.to the whole of the affected member. We entertained hopes of his reco- 6 42 CAMPAIGN very for a short period; but gangrene developed itself, and progressed with alarming rapidity. It soon extended to the thigh, which it speedily seized upon, and the patient died in twenty-four hours. This is the second opportunity I have had of witnessing this mode of amputating. I shall have occasion to speak of it again. The Hospital of Foundlings, situated on the edge of the Moscowa, and protected by the cannon of the Kremlin, was undoubtedly the most extensive and most beautiful establishment of this kind in Europe. It consisted of two buildings; the first, in which was the door of entrance, was designed for the residence of the governor, chosen from among the old army generals, and for that of the govern- ment officers, the surgeons, and all the individuals connect- ed with the duties of the hospital, as well as for the location of the offices of the institution. The second building was a perfect square. In the middle of the court, which was very large, there were a fountain and reservoir distri- buting the water of the river throughout the hospital. It consisted on all sides of four lofty stories, around which ran a regular corridor, of little width, but sufficiently spa- cious for the free circulation of air, and passage of per- sons through it. The rooms occupied the remaining breadth and entire length of the wings of the building. In each apartment, there were two rows of beds, provided with curtains, their size being proportional to that of the chil- dren. The quarter of the building in which the boys re- sided, was separated from that occupied by the females. The greatest degree of neatness and order reigned through- out this establishment. It should be remarked, that the former building and the greater part of the rooms in the second, were arched, and con- structed in such a manner, as to be proof against the flames. The manufactories, and all the accessories of this institu- tion generally, were in the highest state of improvement. The Russians, in their retreat from this city, took with them all the children of both sexes, who were beyond the age of seven years, and there merely remained a small num- ber of the younger class. These were located together in a distinct portion of the hospital, and the remainder of the building was arranged for the reception of the French pa- tients whom it was not possible to transport. This asylum IN RUSSIA. 43 was selected under the intimate persuasion that it would command greater respect from the Cossacks, in the event of a precipitate retreat of our army. We had scarcely possessed ourselves of the city, and ex- tinguished by our exertions the flames lighted up in its most beautiful quarters, when, in consequence of two more powerful causes, the conflagration was renewed in a more violent manner, was propagated with rapidity from one section of the city to another, and totally destroyed it. The first of these causes was justly attributed to the evident voluntary acts of a certain class of Russians, who were said to have been confined in the prisons, the doors of which were opened on the departure of the Russian army. These wretch- ed individuals, excited to the deed either by orders from a superior source, or influenced by their own desires, and having in view doubtless the pillage of the city, went from palace to palace, in the eyes of every body, and from house to house, for the purpose of setting fire to them. The French patrols, though numerous and frequent, could not prevent the execution of their purposes. I saw several of these persons taken in the act of perpetrating their schemes; they held in their hands lighted matches and combustible materials. Death, which was inflicted on those who were caught in this flagrant offence, had no effect on the rest, and the conflagration raged incessantly* for three days and three nights. It was without avail, that our soldiers pulled down houses with the view of arresting it. The flames soon spread beyond these intervals, and, in a moment, the buildings thus isolated were wrapped in this destructive element. The second cause of the renewal of this conflagration may be found in the impetuosity of the equinoctial winds, which are con- stantly very violent in these countries. By their influ- ence the fire increased, and spread with extraordinary ra- pidity. * One of these incendiaries entered the palace occupied by General Grouchy, and, with a lighted torch in his hand, was proceeding to set fire to the house, by applying the flame to the curtains of his bed, when the son of this general, (who related to me the occurrence,) leaped sud- denly on the miscreant, and, assisted by his servants, succeeded in con- veying him to the door, where he was arrested by a French patrol, and conducted to the tribunal, instituted against these incendiaries. 44 CAMPAIGN It were difficult, under any circumstances whatever, to present to the eye a more horrific spectacle than that, which it was so melancholy to behold. It was particularly during the night between the eighteenth and nineteenth of September, a period at which the flames were at their height, that it exhibited an astonishing appearance. The weather was fine and dry, and the winds blew without intermission, from the east towards the north, and from the north towards the east. Duringthisnight, the dreadful image of which will remain indelibly impressed upon my memory, the whole city was involved in the conflagration. Vast bodies of fire, of various colours, arose from all quarters to the clouds, and obscuring totally the horizon, sent forth to a distance a resplendentlight and burning heat. The flames, driven in all directions, and propelled by the violence of the winds, were accompanied, in their ascent and rapid progress, by an awful hissing sound and dreadful detonations, resulting from the combustion of powder, salt-petre, oil, rosin, and brandy, with which the great part of the houses and shops were filled. The plates of varnished iron, covering the houses, were speedily detached from them by the heat, and pro- jected to a great distance. Very large pieces of joists or burning beams of fir, thrown afar off, caused the fire to be propagated to those buildings, which were the least ex- posed, in consequence of their remote situation. Every body was seized with fright and terror. The guard, head- quarters, and commander-in-chief of the army, left the Kremlin and the city, and established a camp at Petroski, the castle of Peter the Great, on the road to St. Peters- burgh. I remained, with a very small number of my com- rades, in a house built of stone, and situated in an isolated spot on the summit of the quarter of the city occupied by the Franks, and in the vicinity of the Kremlin. I could observe without difficulty from this location, all the phe- nomena presented by this dreadful conflagration. We had sent our baggage to the camp, and were constantly on the alert for our preservation, preparing for events or prevent- ing their occurrence. Those of the lower classes of people, that remained in Moscow, driven from house to house by the flames, gave utterance to mournful lamentations. Being very desirous IN RUSSIA. 45 of saving from the general ruin, the most valuable of their possessions, they burthened themselves with large pack- ages, which they carried with difficulty, and were frequent- ly obliged to abandon, in order to remove themselves from the flames. The females, influenced by their natural af- fection, took one or two of their children on their shoul- ders, and dragged the others by the hand. In order to es- cape the death, which menaced them on all sides, they hastened, with their garments tucked up, to take refuge in the squares and corners of the streets. But the rapid progress of the flames soon forced them to abandon this asylum, and fly with precipitation from all quarters. It sometimes happened, that they were incapable of extricat- ing themselves from this species.of labyrinth, in which several of them met with an unhappy fate. I saw old men, whose long beards were burned by the flames, drawn in small carts by their own children, who were making great exertions to snatch them from this true resemblance of Tartarus. As respects our soldiers, who suffered much in conse- quence of hunger and thirst, they exposed themselves to every danger, in order to gain possession of the articles of food, wine, liquors, and other things of greater or less utility, contained in the burnt cellars and shops. They ran through the streets promiscuously with the desperate inhabitants, carrying with them all that they were capable of snatching from the ravages of this awful fire. In short, in eight or ten hours, %this extensive and splendid city was reduced to ashes, with the exception of the palaces of the Kremlin, some large houses, and all the churches, which were built of stone. This calamity gave rise to great consternation in the army, and foreboded greater misfortunes. It was univer- sally supposed that it was no longer possible to obtain either sustenance, or cloth, or other articles necessary for clothing the troops, and of which there was the most urgent need. What idea of more ominous import could have presented itself to our imagination? Head-quarters, subsequently to the fire, were established anew in the Kremlin, and the guard located itself in some houses, situated in the quarter of the Franks, which had 46 CAMPAIGN not been destroyed by the flames. Every body resumed the exercise of his duties.* Examinations being instituted, magazines of flour, meat, salted fish, oil, brandy, wine, and liquors were discovered. The soldiers received distributions of a portion of these articles; but there prevailed too great a desire to preserve or store them away, and this excess of foresight, which is sometimes nothing more than a pretext, led to the subse- quent destruction by fire or desertion of these various stores in the magazines. They would have proved most beneficial, and would have sufficed for the necessities of the army, during a period of more than six months, had it continued to remain in Moscow. More especial attention should have been paid tp the acquisition of cloths and furs, so as to furnish our troops with garments capable of de- fending them as much as possible against the rigour of the cold, which was to be expected. In relation to themselves, however, the soldiers, who entertained no thought con- cerning the future, instead of supplying this deficiency of precaution for their own benefit, were occupied solely in collecting wine, liquors, gold and silver, and disregarded every thing else. This unexpected abundance, for which the soldiers were indebted to their indefatigable labours, affected the disci- pline of the army, and proved injurious to the health of those who were intemperate in their habits. This cause alone should have accelerated our departure to Poland. Moscow became a new Capua for our troops. The supe- rior commanders attached to the army of the enemy, in- dulged our chiefs with the hopes of peace, and the signa- ture of the preliminaries was postponed from day to day. In the mean time, large bodies of Cossacks hovered around our encampments, and daily cut off many of our foragers. * The rooks (corvus-comix) which inhabited the steeples of the churches, being driven also by the fire from their accustomed abodes, returned to the possession of their asylum. In point of numbers, these birds might be compared to the pigeons, seen by us in Egypt. Indeed, when these crows issued from their houses in the evening and morning, the horizon was obscured by them. They fed on grain and insects, and were never discovered on the carcasses of horses, lying in great numbers around the city, as was falsely reported. IN RUSSIA. 47 General Kutusoff drew together the remnant of his army, and strengthened it with recruits from all quarters. His advanced guard, gradually, and under the guise of peaceful motives, approached our troops in the van. The period fixed upon for' the expiration of the negotiation had at length arrived, and at the time when the French ambassa- dor expected a final decision, the corps, commanded by Prince Joachim, was surrounded. Our ambassador found much difficulty in overcoming the obstacles which opposed his return to Moscow. Some of our troops, and several pieces of cannon had already been captured. The different corps of the van guard, however, being in the first instance put to flight, rallied, and broke through the Russian column which surrounded it. They took possession of a favourable position, and rushed in their turn on the numerous cavalry of the enemy, which they repelled with violence, seizing on the cannon and soldiers that were taken during the first at- tack. The arrival of General Lauriston and the wounded rendered us certain at head-quarters, as to the renewal of hostilities. Orders were immediately issued for the speedy departure of the army, the general beating of drums was heard, and all the troops prepared for the execution of this precipitate movement. They hastily provided themselves with sustenance, and commenced their march on the nine- teenth of October. Previously to our departure, we removed to Mosaisk, under the escort of a strong division of infantry com- manded by General Claparede, all the transportable wounded and sick. Those, whom it was not possible to carry along with the army, we located together in the Foundling Hospital, in which I left three divisions of sur- geons, in order to secure medical attendance to the patients within it. I placed the wounded Russians under the care of several French surgeons, who had resided a long time in the city, and requested this employment of me, with the view of rendering themselves serviceable to these indivi- duals, and meriting the favour of the Russian government. The majority of the French established in Moscow fol- lowed the convoy of the sick, under the special protection of the commander of the division, to whose charge Napo- leon had committed them. ■'"V i x ij-jt ,\ %:r*/ ' * ' ■"".'' %i\ i *"' & ■' ' *' ''"'V •*■* i 48 CAMPAIGN It was doubtless the intention of our commander-in-chief to attack the army of the enemy, to move on to Kalouga, and effect a retreat into Poland through Ukraine. The apprehensions entertained of, the failure of provi- sions, and the recollection of the privations which had already been experienced, induced all of our companions to provide themselves with necessaries. Some loaded waggons, others, their horses, and the soldiers their sacks, with articles of this character. The army was never so much encumbered with baggage, as on its departure from Moscow. The troops of Darius, at the period of their leaving Babylon, doubtless did not present such splendour, nor did they possess so large a quantity of baggage. A humid mist, which appeared on the following day, rendered the progress of these equipages extremely difficult, and dis- order for the first time ensued, in consequence of each one being desirous of saving his provisions. We rejoined the advanced guard, on the evening of the twenty-third. At this moment the enemy abandoned their position, and marched towards Kalouga. Prince Eugene, who commanded the troops of the van, received orders to repair, by a cross road, to Malajaros- law, a small city situated in a defile among the moun- tains, through which the army of Kutusoff would pass. The treachery of the guides and the bad state of the roads, retarded their march, and the enemy arrived at the defile two hours previous to the corps of the Prince. Our general, however, crossed the rivers, ascended the mountain, boldly attacked the troops of his adversary, and, after a bloody fight, possessed himself of the defile; but it was too late, the greatest part of the Russian troops having already passed through it. This combat reflected the greatest honour on this warrior. The Russians lost upwards of six thousand men. A large number of prisoners, with many pieces of cannon and artillery waggons, were likewise captured by us in this battle. Several of our distinguished soldiers, among whom was General Delzon of the advanced guard, one of my companions in Egypt, and an officer of great merit and rare intrepidity, were killed in this fight. We had also nearly two thousand wounded, who were dressed on the field of battle, and transported in the rear of the army in IN RUSSIA. ' 49 private carriages, brought from Moscow. I owe especial praise to MM. Assalini, first surgeon to the Prince, Pingon, chief-surgeon of the corps, and to all the sur- geons of these troops and the ambulances of the guard, for the active and vigilant care, bestowed by them upon our wounded. Head-quarters and the guard reached Malajaroslaw at the termination of the combat, in time to be witnesses of the victory o£ Prince Eugene. The cannon and waggons, that had been captured, were respectively spiked and burnt, and after a reconnoitring of the troops of the enemy, they were pursued beyond the defile, some leagues on the road to Kalouga. The wounded Russians were conveyed by my direction to Malajaroslaw. It was not possible for me to remain, in order to see the requisite attention paid to them; but I departed with the hope that they would receive assistance from their countrymen. The etat-mqjor and the guard, returned on the same evening to the position occupied by them on the preceding day, in a large village, two leagues from the field of battle. I followed this movement, and, on my arrival, arranged an ambulance for the reception of the wounded. On the morning of the succeeding day, which was the twenty-fifth, at dawn, Napoleon, returning from Mala- jaroslaw, where he had spent the night, was suddenly surrounded, together with his guard, by several thousand Cossacks, whom it was at first impossible to distinguish, in consequence of a thick fog. They took some pieces of cannon, and wounded many of our light horse. Napoleon himself was exposed to great danger. The troopers of the guard, however, having recognized the enemy, performed prodigies of valour, and, dispersing them, notwithstanding very great difficulties, regained possession of the pieces of artillery. The only resource for the opposite party was a prompt retreat, which they commenced on the following day. The course we should pursue was not yet known to us. We moved on to Borosck, or the city of filberts, so surnamed, in consequence of the great quantity of this fruit found by us in the houses in our first passage through it. After passing this place, we traversed a portion of coun- try, which was agreeable, rich, and very thickly inhabited. 7 50 CAMPAIGN It was desirable, that we should be enabled to continue our route in this direction, and enter Ukraine, in order to effect our retreat through this province. But Napoleon wishing, doubtless, to save the great number of our wound- ed and sick, in the ambulances at Mosaisk, Kolloskoi, Giad, Wiasma, etc. and being aware of the arrival of Tor- masow, who had intercepted the communications with Bor- risow, concluded upon resuming the road pursued by us on entering the country. We reached it in a rery few days. This was a subject of much melancholy throughout the army, which had glimpses of the misery we were doomed to endure, in passing through an immense tract of country, already become desert and waste, in consequence of the de- struction of its villages and cities, and the constant passing and repassing of our troops and the Cossacks. We entered Mosaisk, in which there were many sick, both Russian and French. Those who were capable of marching, or of being transported, were removed. The rest were located in an hospital, and I left them and the wounded Russians also, under the charge of surgeons, having procured for them all other possible succour. A large portion of the equipage of the army had already disappeared, and there had been but a partial distribution of the biscuit and flour, which were found in the storehouses. We continued our march, however, and arrived at Kol- loskoi. The weather was remarkably fine from the period at which the battle of the twenty-fourth was fought, until our arrival at Mosaisk. But on our departure from this city, the north-east winds commenced blowing, the cold progressively increased, and became very severe, so that in our passage across the field, the scene of the battle of the Moskowa, we found the bodies of those who had been kill- ed in this combat in a state of congelation. In the villages contiguous to the road, and at the abbey of Kolloskoi, we met with the ambulances which had been there established. In one of those were the Russian offi- cers, of whom I have already spoken. They were cured of their wounds, and some of them came to express their gratitude. They requested permission to remain in their native country, which I obtained for them without diffi- culty. Money was also given them by me, for the purpose IN RUSSIA. 51 of procuring from the travelling Jews articles of primary necessity, until the arrival of their countrymen. I recom- mended, at the same time, our patients to their care, and have grounds for believing, that these officers protected them, and were not forgetful of the services they had re- ceived from us. I adopted the same measures respecting the wounded at Kolloskoi, that had been pursued at Mosaisk. A part of the night was spent in performing operations on certain of these patients, who were exposed to death from com- minuted fractures and extensive ulcerations of the extre- mities. Placed in the carriages of the army, they fol- lowed the baggage of head-quarters. The surgeons of our ambulances, who accompanied them, performed the duty of daily dressing their wounds. The scarcity of means had already become great. The snow fell in large quantities, and the cold was constantly augmenting in intensity. Here commenced the disorganization of the army, which rallied but imperfectly at Wiasma. The^oad had already become difficult of being passed in consequence of the snow, with which the ground was covered, and the soldiers en- dured much suffering in the bivouacs. At Wiasma, the army received some distributions of flour, and a very small quantity of bread. Head-quarters and the guard remained in this place twenty-four hours, for the purpose of recruiting the troops, and dividing among them the few provisions that remain- ed in the storehouses of this town. Having dressed the wounded, both Russians and French, in the hospitals, we removed towards France those of our men in a condition to proceed on the journey, and located together those patients that could not be transported. We placed these in a building both strong and affording protec- tion against the flames, which were constantly renewed in the wooden houses, either through the imprudence of our soldiers, or in consequence of the contiguity of the bivouac fires to these buildings. This is one of the calamities attendant on war, and of very common occurrence, par- ticularly in winter campaigns. Means of transportation being wanting, the emperor Na- poleon placed at our disposal his covered waggons and car- 52 CAMPAIGN riages for the benefit of the wounded. His household sur- geons and physicians, were charged with the duty of fol- lowing and attending to them. I should commend the zeal and devotion, exhibited on this occasion, by MM. Ribes, Jouan, Lherminier, and Mestavier. M. Rouyeres, the phar- maceutist, was no less serviceable to our sick. IN RUSSIA. 53 PART THE THIRD. The rear-guard, commanded at that time by Prince Eu- gene, immediately followed us in our passage out of Wias- ma, a city almost totally reduced to ashes, and filled with the ruins of burnt houses. This rendered the march very difficult, particularly for the equipage and artillery. Se- veral divisions of the Russian army arriving in consequence of it near this city, previously to the departure of our rear- guard, took advantage of this circumstance to attack these troops. The assault was attended by results, which were rendered more fatal, by the thick and hazy mist, through which it was made. Such was the obscurity, in which every thing was involved, that the troops of the fourth corps were soon confounded with those of the Russians, and it proved to be a very unfortunate catastrophe. This event was one of the primary causes, which gave rise to the loss of our wounded, (at least of those attached to the fourth corps,) and a part of the French families that had been established at Moscow, and by which these sol- diers were accompanied. The corps of Marshal Ney was substituted for that of Prince Eugene, whose troops sustained considerable loss in this unfortunate affair. The army, however, moved on in sufficiently good or- der, but the effects of privation and cold were felt more and more sensibly. Already had the wounded, and the most debilitated individuals, succumbed to these cruel vi- cissitudes. The horses, particularly, deprived of forage, and constantly on the bivouac, perished in great numbers. It frequently happened, that the soldiers killed them pre- viously to their falling down. The flesh of these animals, which was roasted at the first fire of the night watch, allay- ed the hunger with which our men were tortured. 54 CAMPAIGN We passed the Dnieper, a short distance from Dorogo- bouje. As three-fourths of this city had been destroyed by fire, it offered very few resources. We found in this place many wounded, for whom it was difficult to obtain flour, and even a small quantity of bread. Those that were able to proceed on the journey followed the army, and the non-transportable patients were located together in the strongest and best of the hospitals. Some of the latter, alas! perished in the flames, which broke out, during the night, in a house contiguous to the ambulance. The fire, progressing with very great rapidity, destroyed, in a few moments, all the buildings in the same quarter. I escaped from this hospital through the midst of the flames, and not until I had had recourse to all the means which I, in con- junction with my assistants, could suggest for the preserva- tion of the wounded, and which the rapid propagation of the fire suffered us to employ. After a very laborious march of several days, through a country uninhabited and covered with snow, we arrived at Smolensk, November the twelfth. During this interval, our soldiers continued to feed on the flesh of the dead horses, which were found in great numbers on the road. We all entertained hopes, that our sufferings would terminate on reaching the confines of ancient Poland. There were grounds for believing that large storehouses had been established at Smolensk, and that we should be en- abled to repose here for some days. But our expectations were not realized. There was scarcely any sustenance, in this place, for the wounded and sick, who crowded the hospitals. The army received very limited distributions, and was necessitated to continue its march in this state of deprivation. Here, indeed, commenced the horrible sufferings, to which we were doomed to be subject during this fatal retreat. The soldiers, enduring much misery from hunger and the want of all the necessaries of life, after having broken through the gates of the city, and penetrated into the magazines, from which they took the small quantity of inferior buscuit remaining in them, were destined to un- dergo the most grievous privations. The situation of the surgeons was particularly lamentable. Being obliged to IN RUSSIA. 55 spend the whole of their time in dressing the many wounded, situated in the hospitals, they were incapable of making exertions for the purpose of procuring sustenance for themselves. No resources whatever could be found by them in these establishments, since the patients were in need of such things. I was, however, so fortunate as to purchase, for a large sum, two bags of flour, which I distributed among those of my comrades, whose necessities were most urgent. 1 visited all the hospitals of this city, and after having bestowed upon them my services, and caused those opera- tions, which were more immediately necessary, to be per- formed on the great number of wounded there located, left them under the care of fifty surgeons, who requested to remain. Arrangements for resuming our march had scarcely been made, when our rear-guard was attacked by the Russian advanced troops, by which it was pursued until its entrance into Smolensk on the thirteenth of November. A vigorous resistance, however, was made by our troops, and the army had time to evacuate the city and betake itself to the moun- tains in its vicinity. This new occurrence, by hastening the progress of apart of the equipages and treasures, which pursued a cross road, produced such confusion that they soon became a prey to the Cossacks. The cold had become very intense. Already had the thermometer of Reaumur fallen to 19° below zero, and the north-east winds were blowing with violence. This severe cold, supervening so suddenly, proved destructive to many of our younger soldiers, and particularly to animals, which were frequently found, on the edges of the road, lying dead upon the snow. Those of our companions that were accustomed to marching, and had preserved some coffee and sugar, were less exposed to the dangers of their situation. Habitual exercise prevented numbness of the limbs, and supported the calorification and play of the organs, whereas the cold, seizing on the indi- viduals carried on horses or in carriages, soon threw them into a state of torpor and paralytic stiffness. They were thus induced to approach the fires of the bivouacs more nearly, in consequence of their not being sensible of the heat in the frozen parts. Gangrene was brought on; and I had the good fortune to preserve myself from this 56 CAMPAIGN affection, by walking constantly, and totally depriving my- self of the enjoyment of fire. No habitation was found between Smolensk and Kras- noe, distant from each other about twenty-four leagues. Every thing had been burned, the ground was covered with snow, and the cold had increased two degrees in in- tensity. The army took some hours of repose during the night in the forests through which it was passing. But the troops generally endured many hardships, arising from hunger, and the great reduction of temperature. In this short march much search was made for the bodies of horses. The horse that had gone astray was immediately knocked down and devoured, when scarcely dead. Unfortunate was the fate of that animal, which departed a few steps from his master! The division of this booty sometimes became a subject of dispute between individuals of all ranks. Even the females surmounted all obstacles, in order to obtain their portion of the spoil. The army, which was disunited in its passage out of Smolensk, again lost many men between this city and Krasnoe. Cold and hunger were the chief causes of their death. The equipages and parks of artillery were cut off and dispersed by the Cossacks, with a greater degree of facility, in consequence of the roads being covered with ice, by which the march was rendered extremely difficult. We had entertained hopes of finding provisions in Kras- noe, and of remaining there at least twenty-four hours. But we were again doomed to disappointment. At the dawn of the following day, the seventeenth of November, we dis- covered ourselves to be almost surrounded by a very numer- ous Russian army. It was necessary to engage in battle, as much for the purpose of rendering ourselves capable of continuing our retreat, as to prove to the enemy, that we were not so destitute of means of defence, as they supposed. The rear and elder guards were alone in a condition to sus- tain the shock. The troops of this latter corps, particular- ly, fought with extreme valour. Nearly two hundred of our men were wounded, whom I caused to be conveyed to the hospital in Krasnoe. I repaired thither, with the view of operating on those who were most seriously wounded, and dressing the remainder of them. Although a pretty large number of inhabitants continued in this city, the IN RUSSIA. 57 majority of them were Jews. We were in want of nearly all the necessary means for dressing the wounds of these interesting sufferers, and I experienced the greatest diffi- culty in securing to them the requisite assistance. They were thus destined to endure much misery, subsequently to our departure. In consequence of our destitution of modes for transporting the sick, we were able to take with us, but a very small number of these patients. Those, who were incapable of following the army, were placed together in the hospital of the city, in which I left surgeons, for the purpose of pursuing their treatment.* It was a matter of urgent necessity that the army should resume its march after the battle, in order to avoid a new attack, and reach, as speedily as possible, those parts that were inhabited and provided with store-houses. All the troops, with some exceptions, were without arms, and in complete disorder. The guard, though reduced to less than half of its original number, was the only corps that had preserved their arms and good discipline. It was this body that protected the march of the isolated troops, and kept in awe those of the enemy, which incessantly pursued and harassed us. On our departure from Krasnoe, the temperature rose from ten to twelve degrees, and our sufferings from the cold were much diminished. But we were greatly fatigued by the snow, which fell in great quantities for several days, and were much tortured with hunger, as hunting for pro- visions had become more difficult, on account of the many partisan attacks on the flank of our army. No halt was made at all, except for some hours during the night, in those places where resources could be found, or in the forests, with the view of kindling the fires of the bi- vouacs. * In this painful and extremely perilous situation, every body in the army exhibited an imperturbable sangfroid. The French females even, who were capable of following the army, partaking of our privations and dangers, carried their courage to such a pitch, as to aid us in dress- ing the wounded under the cannon of the enemy. Madame Aurore Bur- say, directrix of the theatres at Moscow, and moreover celebrated for her dramatic talents, particularly distinguished herself for her humanity, and a degree of firmness little known in her sex. 8 58 CAMPAIGN We moved on hastily to Dumbrona, a small city inha- bited by Jews, in which, however, we were enabled to purchase a small quantity of indifferent brandy and bread. Our sick in the ambulance established in this place were numerous. Several surgeons were left here also, in order to secure medical aid to the wounded, incapable of follow- ing the army. A violent conflagration developed itself, at the moment of our departure, in one of the quarters of this city; but I have since been informed, that the flames were not propagated to the hospital. On arriving at Orcha, we passed the Dnieper for the last time. The bridge very fortunately had not been cut down, and the river was not entirely frozen. The whole army under the constant protection of the guard, crossed it without difficulty. The rear-guard, commanded by Mar- shal Ney, it is true, kept back the Russian troops, which pursued us. At the period, when he hoped to effect a junction with us, the marshal was surrounded, and summon- ed to surrender. Our communications with this corps were intercepted, and we spent twenty-four hours at Orcha with- out receiving any tidings respecting them; our uneasiness on their behalf was at its height. In this place we found some resources, which served particularly for our sick. Nearly all of those patients who followed the army, were lo- cated in the hospitals of this town. I spent the whole night, of our arrival and the following day, in having the wounded dressed, and in seeing the necessary attention paid to them. I also left with them the requisite number of surgeons. The troops continued their march towards Tolecsehyn ; but a guard was placed at the bridge, as we did not de- spair of the arrival of the rear-guard. Indeed, an officer, despatched by Marshal Ney, brought us the information, that his intrepid soldiers, entertaining no thought of sur- rendering, notwithstanding the numerous troops of the enemy, by whom they were surrounded, had broken through the Russian columns, opened a passage for them- selves, and arrived on the banks of the Dnieper. It was with extreme pleasure, that we again saw them in our presence. These troops having crossed the bridge, it was broken down and burnt in the face of the enemy. Their IN RUSSIA. 59 march was thus arrested for some days, in consequence of the river being not yet completely frozen. Notwithstand- ing this advantage, our retreat became progressively more difficult. The horses, attached to the artillery, were in bad order, the roads almost impassable, and the snow had not ceased to fall, since our departure from Krasnoe. We then reached Tolecsehyn, a city distinguished for the bloody battle fought under its walls between Charles XII. and the Russians. A considerable storehouse for flour, together with a pretty large quantity of brandy, was found in this place. Our stay here of twenty-four hours was of the greatest benefit both to the troops and horses. We left few patients in this town. On departing from Tolecsehyn information was brought to us, that the second corps, commanded by Marshal Vic- tor, had effected a junction with our advanced guard; but we were at the same time apprized of the arrival of Torma- soff's army at Borrisow. Marshal Victor suspended his march, and suffered us to move on, for the purpose of form- ing the rear-guard, his troops superseding those of Marshal Ney, which had endured many hardships. The winds, having continued to blow a pretty long time from the north-west, passed gradually around to the north- east. The temperature suddenly became still lower and the cold intense, being proportionally aggravated by the violence of the winds. We then arrived before Bor- risow, the bridge at which place had been destroyed by Tormasoff, who occupied the city and its environs on the right bank of the Berezina, a position both impregnable and out of the reach of our cannon. Our path of retreat being cut off and being inaccessible, it was resolved to cross the river some leagues higher up, while preparations for an attack should be apparently made opposite the enemy. The point, at which the passage was to be effected, was before a very large village, where nearly all the materials, necessary for the construction of the bridges, could be obtained. It appears, that Charles XII. crossed the Berezina at the same spot before the battle of Tolecsehyn, when he went in pursuit of the Russians, and avoided entering Borrisow, defended doubt- less by numerous troops. While the bridges were being constructed, head-quarters 60 CAMPAIGN and the guard established themselves, on the night between the twenty-fourth and twenty-fifth of November, in the castle of a prince of Radziwil, distant about a league from the place which was pitched upon for passing the river. This castle, with its dependancies, occupied the eastern side of a hill, which was situated on the right bank of the river. The farms belonging to it abounded in forage and cattle, which proved very serviceable to the cavalry, that remained with us, and to the whole guard. Flour and a large quantity of dried pulse were also found on them. In consequence of my entertaining fears of being burned in the barns, I remained in the bivouac among the grena- diers. The sky was serene and the cold intense. Being obliged to pass through the camp, during the night, for the purpose of visiting the wounded that followed the army, I could observe, without difficulty, all that sur- rounded us. I was quickly struck by the appearance of a comet, which was nearly parallel with the horizon, and could be seen by the army, situated directly in the north. This luminous body appeared to descend towards the north pole, and, becoming elongated in a perpendicular direction, terminated in a point, from which was sent forth a small beam, rising in a vertical line to a very great distance. It disappeared on the same night, and did not again present itself. This singular phenomenon was ob- served in several parts of Europe, and particularly at Leipsic. The two bridges, the construction of which had been undertaken, were, in the mean time, completed without the knowledge of the enemy. The guard succeeded the first and fourth corps in their passage across them, and reached the opposite bank, without opposition and without accident. But as the cannons of large calibre were passing to the opposite side of the river, one of these bridges was broken down. The progress of the remainder of the ar- tillery, of all the equipage, and ambulances, was thus ar- rested. This occurrence gave rise to great alarm among those that remained on the left bank. At this moment of suspended operations, the troops of Wittgenstein, which followed us closely, attacked our rear guard. All possible resistance was made by the latter. Being forced from its IN RUSSIA. 61 position, this body endeavoured to effect their retreat, and facilitated by this movement the approach of the enemy, whose bullets and other projectiles fell among the im- mense crowd already collected at the head of the bridges. The latter had doubtless been repaired, but had become impassable from the impediments and disorder, of which they were the scene. Fear pervaded the minds of all. The multitude crowded, dashed on all sides, and rushed one against the other. The strong overpowered the weak, and the latter were trodden under the feet of the crowd. The carriages, artillery and baggage waggons were overturned and broken to pieces, and the horses and drivers crushed under the wreck. In short, nothing was heard on all sides, but lamentable shrieks. To complete this tragic affair, the badly secured bridges were again broken. From this moment, all hope of safety was appa- rently destroyed. The majority of the multitude were influenced only by despair. They rushed on a body of ice, supposing it possible to cross the river in this way, as the stream appeared to be congealed. But their pro- gress was arrested, near the opposite bank, at a point, where the body of ice was interrupted by the force of the current. Some swam across this space: others had the mis- fortune to be drowned, or to become entangled amidst the sheets of the frozen element. They perished in this situa- tion the more speedily in consequence of their being already benumbed by the cold, and attenuated by priva- tions. Those possessed of more courage and prudence returned, in order to throw themselves into the power of the Russians, and withdraw from the horrid spectacle they were witnessing. Many individuals, of all classes, lost their lives in cross- ing the Berezina. Mothers were seen voluntarily follow- ing the fate of their children, who had fallen into the river, or drowning themselves with their offspring, holding them tightly in their arms. Many other acts, of a character equally touching, were observed during this calamitous state of things. Notwithstanding the difficulties, which were almost in- surmountable, I had repassed one of the bridges some hours previously to its rupture, for the purpose of having 62 CAMPAIGN some cases of surgical instruments, which were much need- ed by the wounded, conveyed to the right bank of the river. This short journey was near costing me my life. I had like to have perished in the crowd in my turn, when fortunately I was recognized. Every one immediately made exertions to aid my efforts, and carried from sol- dier to soldier, I found myself, to my great surprise, in a few moments on the bridge. This evidence of their at- tachment to me soon obliterated from my memory both the dangers, to which I had been exposed, and the loss of my baggage. The corps, that passed the river in the first instance, surprised the enemy behind the city of Borrisow. The troops of the latter defended the passage with obstinacy, and appeared inclined to abandon the city, in order that they might retain possession of the road. Our position was thus rendered very difficult, on account of the losses we had sustained. In the first battle, however, which oc- curred, three thousand Russians were made prisoners and many of them killed. About six hundred of our men were wounded, whom I located in a neighbouring village, where I caused them to be dressed. A retrograde movement, made by Tormasoff, as much for the purpose of facilitating his retreat as for arresting our march, gave rise to a second combat, in which was chiefly engaged the corps of Prince Poniatowski. Among the soldiers who were seriously wounded in this battle, I received, in the ambulance on. the field of battle, General Zayonzeck, one of the oldest Polish generals in the service of France. He had made the campaign in Italy, Egypt, and all the northern countries of Europe. This brave general laboured under a comminuted fracture of the right knee, caused by a ball, which inflicted the injury almost immediately after being discharged from the gun contain- ing the projectile. He received the wound at the head of his division. Amputation of the thigh was imperiously demanded, and 1 performed it immediately under the can- non of the enemy, on the snow, and during the most se- vere cold. This operation, remarkable for the singular phenomena which presented themselves, was followed by unexampled success, and Poland boasted of still possessing IN RUSSIA. 63 one of her most illustrious warriors, aged upwards of eighty years. With the exception of some individuals, mortally wounded, whom I left with succour in the village of which I have just spoken, all those who had been wound- ed in these two combats, were immediately removed to Wilna on sleds, obtained from the inhabitants of the country. A transverse road was discovered, by pursuing which we would be enabled to reach this city before Tormasoff, and without being disturbed by his troops. This route was first entered upon by the wounded, and, as respects the equipage, it was entirely out of the question, in conse- quence of its still remaining at the point where the Bere- zina was crossed. Having vanquished and repelled the army of the Russian general, who thought to allure us on the road he was pursuing, we promptly commenced our march through the defile, which had been discovered to us. It passed through immense forests and marshy places, interrupted frequently by streams or rivers, the bridges across which were in a very bad condition. A company of Cossacks, provided with but one piece of artillery, could have arrested our progress on this route with facility. We fortunately marched through it without any remark- able obstacle or accident, and reached the grand road to Smorgonia,* two days in advance of Tormasoff. From this city. Napoleon departed in order to return to France, hav- ing intrusted the command of the army to Prince Joachim Murat. Though the cold had been constantly augmenting, since our passage across the Berezina, the mercury had not yet fallen below from ten to twelve degrees. On the day of our arrival at Smorgonia, snow fell crystallized in the form of stars. This phenomenon was the precursor of excessive cold, which appeared immediately afterwards. During the night, which we spent in bivouacing, the mer- cury descended to eighteen degrees. It then passed • Smorgonia is distinguished by a kind of academy, for the exercise of young bears. 64 CAMPAIGN quickly to the nineteenth, twentieth and twenty-first of Reaumur. On the following day, December the sixth we commenced our march at a very early hour, for the purpose of arriving very speedily at Osmiana, another pretty large city, in which we found some Jews. Indifferent brandy and bread were purchased of the latter. The cold progressively in- creased. The rivers were entirely frozen, before we reached Smorgonia. On entering Osmiana, my thermom- eter indicated twenty-five degrees it fell during the night to twenty-six degrees of Reaumur, and the bivouac was one of much suffering. I was so fortunate, as to pass this fatal night in a warm chamber on a little straw, after hav- ing taken some aliment, which was kindly presented to me by M. Pla, one of my old companions in Egypt. We pursued our march before dawn on the following morning, the mercury standing at twenty-seven degrees. It was with difficulty, that any one could then keep himself erect and execute simple movements. He who lost his equilibrium and fell to the ground, was immediately seized with a mortal stupor and icy coldness. We found on the road a great number of dead, of the twelfth division, which we met at Osmiana.* I left in this city, together with some surgeons, all the wounded, who were desirous of remaining. It was a matter of great pain to me to see them perish on the road, without being capable of afford- ing them any assistance. With the exception of some choice troops of the guard, which had preserved their cloaks or over coats, their shoes and stockings and gloves, the whole army was in a state of sad deprivation, unpro- vided with arms, and any mark capable of distinguish- ing the corps. Marching in complete confusion, they resembled large masses of men moving on in one body. The cold, and their debilitated condition, led each one to support himself on the other, and stand in close contact. But nothing was more odd and more lament- able at the time, than the manner in which they were * This division, commanded by General Loison, consisted of twelve thousand men on leaving Wilna, but three hundred and sixty of whom returned to France, according to the report of several officers. IN RUSSIA. 65 clad. Their garments consisted of portions of furred robes, cloaks, or cloths of various colours. The fire of the bivouacs had gradually, and in a great measure, consumed these articles of dress, and the soldiers possessed no means for mending them. Indeed, they thought not on this score, and little opportunity was afforded them to do so, as no halt was made at any place. All these circumstances ex- plain the state of destitution to which this grand army was reduced, before its arrival in ancient Prussia. Our journey to Miedneski, a place remarkable for a cas- tle (Rownopoli,) blackened and dilapidated by age, was distinguished for the extreme intensity of the cold. The majority of the houses in the village, situated at the foot of this castle, having been burnt or demolished, the whole army was necessitated to bivouac. Woe to the man, who suffered himself to be overtaken by sleep! A few minutes sufficed for his entire congelation, and he perished on the spot where he slept. My thermometer, suspended some moments during the night to my buttonhole, indicated twenty-eight degrees. The temperature of the day differed in a very slight de- gree from that of the night; the rays of the sun being una- ble to penetrate the air, which was much condensed. We were surrounded by a mist, very much rarefied, and form- ing crystals, both on the hairs of the body, and villous parts of our clothing. Those which were suspended from the eye-lashes, in the form of stalactites, intercepted the light, in a more or less complete manner. This circumstance greatly impeded the march, which was attended with ex- treme difficulty, to Wilna, Kowno, and to a greater dis- tance, in consequence of the cold continuing nearly at the same degree of intensity. The edges of the road were strewed with soldiers, who had perished in their march, during the night between the eighth and ninth of December. They had chiefly belonged to the twelfth division, which consisted almost totally of young men. We were, in short, in such a state of faint- ness and torpor, that we were scarcely able to«- recognize each other. Our march was conducted in sullen silence. The organ of vision and muscular power were respectively so much debilitated and reduced, that it was difficult for an 9 66 CAMPAIGN individual to pursue his way, and preserve his equilibrium. The soldier, that was overpowered, fell at the feet ot his companions, who did not turn aside to behold him. 1 hough one of the stoutest individuals of the army, it was scarcely possible for me to reach Wilna. On my arrival in this city, my strength and courage were exhausted. I was near falling, doubtless to rise no more, as was the case with other unfortunate persons, who died before my eyes. The very tender reception I received from the grey sis- ters of La Charite, on entering their hospital the evening of the ninth, and the vigilant attentions, prodigally tender- ed me by them, restored me to life. This circumstance will continue for ever engraven on my memory. The eagerness with which every one endeavoured to enter Wilna, the arrival at which had been anticipated with so much pleasure, but in which, we met only with suffer- ings, and misery, produced in a few moments a dreadful confusion at the gates. The soldiers knocked down and tore each other awaj^, in order to gain entrance into the city. Although the convents had been assigned, and arranged for each body of troops, all the corps disseminated themselves through the city, and immediately filled the coffee-houses, inns, and grocers' shops. They drank and eat with such avidity, that in a short time all the liquids and eatables were consumed. Notwithstanding the extreme disorder, prevalent in all quarters, the night passed off without accident. Those that were not able to obtain lodgings in the convents or houses, bivouaced in the squares and streets of the town, and found this more pleasant than their preceding bivouacs. The Cossacks, in the mean time, menaced the suburbs of Wilna. Their approach caused the rear of the column to retreat precipitately, on the morning of the tenth, with- in the boundaries of the city, and the disturbance and con- fusion were thus augmented. The sentinels, guarding the magazines, were driven from their posts, the doors forced, and the articles of food and clothing pillaged by our troops and the Jews. The disorder was carried to an extreme, and the voice of authority totally disregarded. Through the midst of the tumult, Prince Murat, who had command of the army, issued hastily from his palace, IN RUSSIA. 67 passed through the crowd without his guard, and proceed- ed to establish himself in the suburb on the road to Kow- no, where the etat major and guard rejoined him a few moments subsequently. The pillage of the magazines had placed a large quantity of rum and brandy at the discretion of the soldiers, the majority of whom made an immoderate use of these articles. The number of sick was thus multi- plied ; gangrene was developed in the extremities, and caused the death of many of them. In relation to myself, after having taken some hours of repose, I quickly visited the hospitals, in order to ren- der secure the duties to be performed in them, so far as they had reference to my province. I located in the hos- pital of La Charite the sick surgeons and principal wound- ed officers, whom I confided to the particular care of the good sisters. Independently of the invalid surgeons, a sufficient number of these health officers, of all ranks, was left in each hospital, for the treatment of the wounded re- maining in this city. I gave them letters of recommenda- tion to the chief physicians of the Russian army, and made my arrangements to effect a junction with the guard and head-quarters. I commenced my journey during the night, between the tenth and eleventh, and, instead of stopping in the suburb, in which they were situated, proceeded on my route towards Kowno. On the morning of the following day, the eleventh, the Cossacks entered Wilna, and threw terror into the ranks of all the French, who remained there in considerable numbers. The Jews treated them unkindly, and epidemic maladies successively attacked a great part of those who had escaped the foregoing catastrophe, and the destructive effects of cold and hunger. I shall have occasion to speak of these affections in particular memoirs.* On our departure from Wilna, the temperature rose some degrees. There fell, in this short time, a very large quantity of snow, which rendered almost impassable the passage across the mountain, lying in our route, some * We subsequently learned, that the arrival of the Emperor Alexan- der re-established order in this city, and that our prisoners derived much benefit from his munificence and humanity. 68 CAMPAIGN leagues from the city. The few equipages and waggons laden with treasures, which had been preserved from the preceding dangers, were abandoned or burnt on this fatal mountain*; it may thus be said, that Wilna was the scene of almost as much misfortune to us, as the Berezina. During the night between the twelfth and thirteenth, the temperature was again reduced, and the cold resumed its former intensity. It continued at the same degree, un- til we had proceeded beyond Kowno. Our entrance into, and passage through, this city, were attended with as much difficulty and labour as at Wilna. Many of our junior sol- diers perished in this place, in consequence of intoxication, brought on by alcoholic liquors. I had the good fortune to find, in this city, my friend Doctor Ribes, whom I had not seen since our departure from Wilna. He was in the lowest stage of exhaustion, caused by fatigue and the effects of the rigorous cold, which overcame the most robust constitutions. I have remarked, cseteris paribus, that those temperaments, entitled warm and sanguine, resist much better the action of this sedative agent, than those designated by the generic term of lym- phatic. Thus, the ravages of death were more rarely dis- played among those individuals, who were from the south- ern countries of Europe, than among the inhabitants of the northern and moist locations, such as the Hollanders, Hanoverians, Prussians, and some of the people of Ger- many. The Russians even, agreeably to the report made to me by several surgeons who remained at Wilna, lost, from this sole cause, more men, in proportion, than the French. I employed all the means, which friendship de- manded of me, for restoring to M. Ribes the strength of which he had been deprived, and for aiding him to reach the frontiers of ancient Prussia, a country which we but lately considered as a second home. On the day succeeding our arrival at Kowno, I was busily occupied in visiting the hospitals, which were filled with sick. Those, that were able to accompany us in our march, were removed to Prussia. Provision was made for the subsistence of the rest, and the requisite number of surgeons was left with them to render secure their medical treatment. Here, as at Wilna, the magazines were pil- IN RUSSIA. 69 laged, a circumstance that prolonged the disorder and excesses of our army. Our partizan enemies, moreover, did not delay their attacks upon us. The greater part of our troops resumed their march on the morning of the thirteenth of December. I did not take my departure from this place until the fourteenth, at break of day, ac- companied by my friend, and some soldiers of the guard We had much difficulty in passing the bridge, which was in a state of great confusion, and also reached with much labour the summit of the mountain, situated before Kow- no. Nearly all the pieces of artillery removed from the city, were abandoned on this path, which was both steep and covered with ice. This route proved fatal to many of our soldiers, who were debilitated by fatigue, cold, and famine. They could not escape the pursuit of the Cos- sacks, who had passed the Niemen with dry feet. This river was frozen several feet in depth, and this circum- stance proved as advantageous to them, as it was unlucky for us, in consequence of our being almost totally desti- tute of a rear-guard to protect the march of our isolated soldiers. Some of the guard, who were still in possession of their arms, finding themselves exposed to the charge of these Cossacks, made vain efforts to rally in order to repel them. The cold steel of their weapons paralyzed their fingers, and their guns fell from their hands, they being incapable of loading and using them. These soldiers were forced to rejoin us precipitately. The enemy finally arrested their march, and ceased harassing us, either because they preferred capturing the remainder of our equipages and pieces of artillery, which they found accumulated in the road, or on the back of the mountain, or because they were fearful of removing them- selves too speedily from their frontiers. We marched for some days peaceably and in safety. The soldiers of differ- ent nations, profiting by this period of repose, dispersed and repaired by diverse routes to their points of destina- tion. The French alone pursued the road to Gumbinen. Three thousand men, consisting of the best soldiers of the guard, as well infantry as cavalry, nearly all of whom were from the southern parts of France, were those only, who had truly resisted the cruel reverses of the retreat. 70 CAMPAIGN They still preserved their arms, their horses, and their warlike appearance. The marshals, dukes of Dantzick and Istria were at their head. Princes Joachimrand Eugene marched in the centre of this corps, which may be consi- dered as the remnant of an army, composed of more than four hundred thousand men, whom the inhabitants of the country saw, six months previous, marching in all .their strength and glory. The honour and renown of the French armies were, in a measure, concentrated in this small chosen body. The first two days after our departure from Kowno were spent in much suffering. We constantly endured many hardships through hunger and the severe cold. But having reached Gumbinen, and subsequently to our arrival in this place, we found lodging-places, and a sufficiency of sustenance for the nourishment of the troops. Never did I spend a night more agreeably, than that passed by me in this city. This was the first occasion, since I had left Moscow, on which I enjoyed a complete repast, and lay in a warm chamber and good bed. This also was the first opportunity, which we had of continuing in the midst of these advantages. The interval permitted the isolated troops to continue their way to Konigsberg, and ena- bled many soldiers, who had been separated from the guard, to rally under its colours. Some detachments of Neapolitan guards were likewise received, with several pieces of cannon, and some cavalry. These different rein- forcements so augmented our corps d'elite as, to render it capable of facing the enemy, and even forming our rear- guard. From this period, we continued our march with order and better discipline. Quarters and regular distribu- tions were procured in those places where storehouses were established. New garments, furnished by the French magazines in the first cities of ancient Prussia, were given to the soldiers, and they entered Konigsberg from the twenty-fifth to the twenty-sixth of December, in good or- der and pretty good plight. In the hospitals, lying on our route, I merely left, with the necessary number of surgeons, those patients that were incapable of accompanying our troops. At Insterburg I was detached from head-quarters, and the guard, in or- IN RUSSIA. 71 der that I might arrive speedily at Konigsberg, where my presence was urgently demanded for the organization of the hospitals. I reached this place, attenuated by fatigue and overcome by the intense cold, which still* prevailed, during the night between the twenty-first and twenty-second of December, leading by the bridle the only horse which remained in my possession. His preservation I owed merely to the useful precaution I had adopted, of having him shod appropriately in consequence of the ice, previously to my departure from Insterburg. * On our entrance into Konigsberg, the thermometer of Reaumur stood at twenty degrees. On the following day it stood at eighteen de- grees, and had not risen above fifteen degrees on our departure from this city, the second of January. 72 CAMPAIGN PART THE FOURTH. On the day following my arrival at Konigsberg, Decem- ber the twenty-second, notwithstanding my debilitated con- dition, I visited all the hospitals of the place, accompanied by M. Gilbert, physician-in-chief. I gave instructions, here- after laid down to the surgeons, for the dressing of gangre- nous affections, resulting from congelation, and distributed among the hospitals all the health-officers, whom I had brought from the army. I finally gave an account to the inspector-general of the result of our examination, demand- ing of him the execution of measures for the improvement of these establishments. The number of sick and wounded, already collected in this city, which became the general rendezvous for the grand army, amounted nearly to ten thousand. The hospi- tals were greatly crowded with them, and some even were located in the houses of the town. Each corps, however, having received a particular destination on the borders of the Vistula, repaired successively to their 'respective situa- tions. By means of sleds and over the frozen Frisch- Haff, all the sick, that were capable of supporting the journey, were removed towards Elbing and Dantzick. The imperial guard alone, with the etat-major, remained at Konigsberg. Having organized my staff, I gave M. Bancel, chief-sur- geon, instructions to exercise a supervision over all of its departments, and to treat the surgical diseases with all pos- sible care. I subjoin the extract of my letter to this sur- geon: " I beg you, Sir, to transmit to the surgeons on duty the following observations, which you will subject to the modi- IN RUSSIA. 73 fications, that may be suggested by your experience, and by attending circumstances. " Ulcers resulting from congelation generally present the same phenomena as burns. Indeed, parts disorganized by caustics, or by cold, form a gangrenous eschar of greater or less thickness, the removal of which it is necessary to promote by topical applications, supporting the action of parts that remain sound, and at the same time softening the parts labouring under gangrene. " The most simple and appropriate means for fulfilling this double indication is the unguent of storax, spread upon linen, or pledgets of charpee, according to the extent of the sloughs. This aromatic and balsamic substance keeps up the action of the subjacent vessels, and mollifies the eschar. Alcoholic liquors and the decoction of bark, which are com- monly used in hospitals, have the disadvantage of causing a contraction of the healthy vessels, impeding the purulent secretion necessary to the detachment of the slough, and tanning or rendering it hard, thus preventing its removal and retarding the work of nature. Should the decoctions contain a superabundance of water, they are again liable to give rise to oedema and promote the progress of gangrene. These liquids, moreover, always prove injurious in conse- quence of their temperature. They are rarely employed at a proper degree of heat, which is speedily lost or in- creased, through the influence of the atmosphere in the halls, these being of various temperatures. In both cases, disadvantages may result from them. The decoctions then should not be used, except as lotions at the period of dressing the ulcer, should they be indicated. For the pre- servation of cleanliness, warm water, with soap, or rendered stimulating by vinegar, is preferable.. " The sloughs having been detached, the sores should be considered simple, and treated as such. The most mild and ordinary means will consequently be the most beneficial. Saffron cerate, spread on fine linen, suffices for the prompt cicatrization of the ulcer. Should the loss of substance be considerable, the pieces of linen may be split and covered with pledgets of fine charpee. The rest of the dressings should be employed in a dry state, and fine charpee be applied to the sore, when the sensibility of the parts is 10 74 CAMPAIGN much diminished. It is necessary to be careful in main- taining the greatest degree of cleanliness in the surrounding parts, and to perform the dressings with mildness and promptitude. This should be done, in order to prevent the ulcer from being seized with hospital gangrene, to which the diseased parts are very much disposed, how little soever the rooms may be impregnated with the putrid mi- asm. On this account it is useful to cause guitonniennes • fumigations to be made during the time of dressingthe sores. " When one or more fingers of an extremity are sphace- lated, or when the limb throughout is in this condition, and when the limits of the mortification are not in relation with the articulations, it is requisite to remove the mem- ber at a preferable point between the joints, above the seat of disease. Nature alone cannot separate parts, labouring under necrosis, in the body of the bone. A very speedy union of the wounds, resulting from these amputations, ought not to be attempted, in consequence of the impover- ished state of the parts; they should be permitted to in- flame and suppurate. The surgeon should content himself with their approximation, by means of a piece of linen, containing a slight layer of the unguent of storax. If the limits of the mortification be at the joints of these appen- dages, or some part of the member favourable to this ob- ject, the operations of nature should be aided by cutting the articular ligaments, for the purpose of extirpating the necrosed bone. The articulation is again closed up, and a cure may take place. In all cases, the progress of these affections should be,attentively watched, and in their treat- ment, those rules adopled which have been pointed out in the Memoirs on Gangrene, inserted in my Cam- paigns." I informed the prince, commander-in-chief of the army, and Count Daru, inspector-general, of all our operations during the retreat from Moscow, until our arrival at Ko- nigsberg. On the day following the succeeding one, I had scarcely concluded my arrangements, when I was suddenly seized with symptoms of the catarrhal fever attendant on con- gelation, a species of typhus having the greatest analogy to hospital fevers. I will, hereafter, describe its principal IN RUSSIA. 75 phenomena. This malady made rapid progress, and ren- dered, in a very few days, my situation extremely danger- ous. I am indebted for my preservation to the efficacious attention, which was prodigally bestowed on me by my host and respectable friend, M. Jacobi, who, moreover, was not a physician. This intelligent old man knew, from ex- perience, the remedies that were appropriate to this affec- tion, and was acquainted with the proper mode of adminis- tering them to me. I rapidly became convalescent, and was capable of leaving my bed, for the first time, on the day preceding the first of the year, 1813. The precipitate retreat of the Duke of Tarentum was announced on the same day. This marshal marched, in the first instance, on Riga, in concert with Yorck, the Prussian commander-in-chief. But the separation of these two corps induced Marshal Macdonald, to retreat to Konigsberg. This intelligence, reaching the latter city, the hospitals, ar- senals, and magazines were quickly evacuated, and ar- rangements made for the departure of head-quarters. On the ensuing day, January the first, our soldiers entered upon their march from this place. The rear-guard, under the conduct of the Duke of Tarentum, entered Konigsberg on the evening of the second, and the enemy appeared there during that night. I summoned all my strength, in or- der to commence my journey, and remove myself from this city. M. Doctor Bourgeois, one of my most estimable as- sistants, from whom I received much attention, accompa- nied me. I rejoined head-quarters at Elbing. On our passage from Framberg, I was desirous of ascending the observatory of the immortal Copernicus. Extreme debility did not permit me to satisfy my curiosity. The cold, moreover, was still very intense, and the thermometer stood at fourteen or fifteen degrees. On our arrival at Elb- ing, the cold increased, for two or three days, about two degrees. From the tenth to the eleventh of January, the temperature was somewhat elevated, and the augmentation gradually continued, until our arrival at Franckfort, on the Oder, the tenth of February. The thermometer, however, still indicated in this city ten and eleven degrees below zero. The old men of Russia and Poland declared to us, that they had never witnessed so long and so severe a winter. 76 CAMPAIGN Here, properly speaking, terminated the retreat from Moscow. Joachim suddenly left Posen for Italy, and was succeeded in the command of the army by Prince Eugene, who possessed the confidence and friendship of the troops. My journey from Konigsberg to Posen and Franckfort was attended with nothing of a particular character. I was engaged, in these places, in the improvement of the medical staff of the hospitals, and took advantage of our more than ordinary length of stay at Franckfort, to arrange the notes of my journal, respecting the action of cold. I continued my researches into the direct causes of the ma- lignant fever from cold, the phenomena which characterize it, its results and treatment. As may be seen in my hasty exposition of our expedi- tion from Moscow, the most cruel sufferings we experi- enced in our retreat were undoubtedly cold and hunger. The former of these began to assume its intensity on our passage from that part of the Borysthenes in the vicinity of Dorogobouje. It progressively increased, almost without interruption, until we crossed the Niemen, and continued nearly at the same degree, until our arrival at Konigsberg and even Posen. At those periods when the temperature rose some degrees, the snow fell in large quantities, often crystallized in the form of stars with six radii, of different sizes. The same crystalline arrangement and symmetry were observed alike in the small and large stars. From the time of our departure from Smolensk, where the mercury had already fallen, in the thermometer of Reaumur, to nineteen and twenty degrees, the cold conti- nued between nineteen and twenty-eight degrees, until we reached Kowno. On our arrival at Osmiana, the mercurial column had descended to twenty-two degrees, and during the night fell to twenty-three. On the following day it stood at twenty-four and twenty-five degrees,and during the bivouac at Miedneski, where we passed the night between the eighth and ninth of December, at twenty-six, twenty- seven, and twenty-eight degrees. The cold afterwards varied from twenty-four to eighteen degrees. The whole army being constantly on bivouac was in- capable of avoiding, except with great difficulty, the effects of this sedative and mortiferous agent, which first seized IN RUSSIA. 77 upon those animals that were destitute of protection. Dead horses were found at every step, and the places at which 'the troops encamped abounded in them. It was principal- ly during- the night that they perished. The soldiers, nearly all of whom were deprived of furs, overcoats or cloaks, were seized with numbness, immediately on their taking the least repose. The younger men, more inclined to sleep, died in greater numbers. I have remarked, that individuals of a dark complexion, and of a bilio-sanguine temperament, almost all from the southern countries of Europe, resisted the severe cold bet- ter than those of a fair complexion and lymphatic tempera- ment, who, with few exceptions, were inhabitants of northern situations. This is contrary to the generally re- ceived opinion. The circulation in the former is doubtless more active, and the vital forces possessed of more energy. It is also probable, that their blood preserves much better, even under the influence of the most intense cold, the prin- ciples of animal heat, which is identified with its colouring portion. From the same cause, their moral powers are sustained to a greater degree, courage does not abandon them, and by a careful preservation of themselves, they can shun dangers better than the inhabitants (who are in general phlegmatic) of cold and humid climates. Thus we saw the Hollanders of the third regiment of grenadiers, belonging to the guard, consisting of one thousand seven hundred and eighty-seven men, both officers and soldiers, almost totally perish, for there returned to France two years subsequent, but forty-one of the number, comprising the Colonel, General Tindal,who was wounded.* The other two regiments of grenadiers, however, consisting of men who were, with few exceptions, from the southern pro- vinces of France, preserved a pretty large part of their soldiers. It is moreover true, that in proportion to their numbers, the Germans lost more soldiers than the French. Several of our physicians that remained at Wilna, have * This information was communicated to me by M. Coucourt, a Hollander, marechal de camp, who belonged to this corps, and whose leg I amputated in the battle of Lutzen. 78 CAMPAIGN assured me, that the cold destroyed more individuals of the coalition, proportionally speaking, than of the French, (as I have already remarked;) though the former had access to a greater variety of means of guarding themselves against the effects of this deadly agent, than our unfortu- nate countrymen. The latter, deprived of their garments by the Cossacks, and driven from place to place in a state of more or less complete nakedness, did not resist in a less degree the greater part of the injurious effects, resulting from the cold air, and, by dint of courage and industry, obtained for themselves an immunity from total congelation. On the sixth, seventh, eighth, ninth and tenth of Decem- ber, there was no bivouac in which several men were not left in a totally frozen state. Some perished even during the march. The periods that proved most fatal were, the days and nights of the eighth, ninth, thirteenth, fourteenth and fifteenth of December. It would be difficult to com- pute the exact number of dead bodies we observed between Miedneski and Wilna. The death of these unfortunate victims was preceded by paleness of the countenance, by a kind of delirium, dif- ficulty of speech, weakness of sight, and even entire loss of this sense. In this state some walked to a greater or less distance, supported by their comrades or their friends. Muscular power was sensibly diminished, and these per- sons staggered, like men under the influence of intoxicat- ing liquors. Their debility progressively augmented until they fell prostrate, which was a certain evidence of the total extinction of life. The uninterrupted and rapid march of the soldiers in a body obliged those that were incapable of keeping up with the progress of the troops, to quit the centre of the column, in order to resort to the edges of the road, and proceed along its sides. Separated from this compact body, and abandoned to themselves, they soon lost their equilibrium, and fell in the ditches, filled with snow, from which they arose with difficulty. A painful numbness soon seized upon them, and lethargic drowsiness supervening, their sad existence was soon terminated. There frequently occurred, previously to death, an involuntary discharge of urine. In some instances, haemorrhage took place from the nose, IN RUSSIA. 79 a circumstance that was particularly remarked by us on the heights of Miedneski, which appeared to me to be one of the most elevated points of Russia. I have grounds for be- lieving, that the barometer would have fallen considerably in this high situation. The exterior atmosphere having become rarefied, and the elevation of this region offering no resistance to the action of the fluids, the movements of which are supported by the internal vital powers and the expansion of animal heat, they escape at those points where they meet with the least resistance. It is commonly from the mucous surfaces, and particularly that of the nasal membrane, in which the capillaries are very abundant and susceptible of prompt dilatation, that these discharges take place.* This death did not appear to me to be attended with much suffering. The vital powers were gradually extin- guished, and together with them the general sensibility was removed, and the perceptions of the sensitive faculties lost. It is probable, that the heart was at last paralyzed, and all the vital organs arrested at the same time in the perfor- mance of thqir functions. The fluids, already reduced in quantity by privations, and the absence of caloric, speedily coagulated. We found nearly all of those, who perished under the continued influence of cold, lying on the abdomen. Their bodies were stiff, their limbs inflexi- ble, the skin discoloured, and without any appearance of a gangrenous spot. (I have made known, in a Memoir on Mortification arising from Congelation, the immediate cause of this gangrenous affection. Tome III. Campagnes d'Espagne.) Death generally supervened, more or less promptly, according as the individual had been subjected to abstinence for a longer or shorter period. Not far from the situation in which we endured so ma- • Madame Blanchard having ascended in her balloon to the height of eighteen thousand feet, became excessively cold, (her thermometer indicated 25 degrees,) and would have perished in consequence of it, had she not, at the same instant, opened the valve of the reservoir containing the hydrogen gas, and had there not occurred a nasal haemorrhage, which speedily took place. Seethe supplement to the Institutions Phy- siques of Professor Sages, page 224. 80 CAMPAIGN ny hardships, in the immense forests of Lithuania, Charles XII. lost also an entire division of his army, in consequence of these two united causes, hunger and cold, A fact of this kind is contained in Vol. V. of the Prix de PJlcademie royale de Chirurgie. In 1732, some Dutch travellers, traversing during the winter a part of the Island, were suddenly attacked by such intense cold^that they could not resist it, notwithstanding the precautions they adopted to make themselves warm. Their limbs became stiff, and they experienced acute pains in them. Having lost the power of motion, they remained benumbed, and perished in succession. The last of them thus con- cludes his journal: " All of my companions have become victims to a miserable death; and I, who am scarcely able to write these words, border on the confines of my exist- ence." This journal was found, the ensuing spring, by travel- lers, with the emaciated bodies of these unfortunate indi- viduals. Instead of recognizing in these phenomena the tonic pow- ers of cold, which many authors attribute to it, particularly the illustrious writer to whom we are indebted for the Esprit des Lois,* are we not constrained to believe in its sedative and stupefying influence? Previously to at- tempting to demonstrate the existence of the latter, let us again report some facts, which will perhaps furnish better proof of such powers. Alexander the Great, bathing in the river Cydnus dur- ing the heat of a summer's day, and in a burning climate, was so much affected by the icy coldness of its waters, that his whole body became stiff and inflexible. The skin was of a livid paleness, and lost its natural heat. He was removed from the river destitute of strength, without the use of his senses, and in a word apparently lifeless. (See Quintus Curcius, lib. 3. cap. 5.) The celebrated professor Bernouilly, from Petersburgh, laving in the Neva, during the intense heat of summer, * See his System on the Influence of Climates. IN RUSSIA. 81 was seized with convulsions and drowned, although he could swim. Prince Poniatowski, one of the most eminent captains in Poland, perished in this manner in the river Heister, on departing from Leipsic. It may be supposed, that, though he was wounded, this general would have reached the opposite shore, had not the water been so intensely cold. Many of our countrymen, who were ignorant of the art of swimming, would probably also have been capable of saving themselves in the passage across the Berezina, if this river had not been on the point of being entirely congealed. (It was frozen on the same night.) The un- fortunate individuals had scarcely entered the water, whe^n their members became stiff, and they died in consequence, before being drowned; for some were seen, who had per- ished in the midst of the flakes of ice, between which they were in some manner suspended. It is evident, that cold exercises principally its sedative effects on the brain and nervous system. This is strongly proved by the fact, that, on our return from Moscow, those who were destitute of furred caps or had little hair on their heads, were more obnoxious to the cold, the head being more easily deprived of its natural heat. The serous fluids, effused from the internal surface of the membranes of the brain, doubtless coagulated more speedily. Those even, which are contained in the vessels of these mem- branes and the brain, were rendered liable to lose their fluid character by the diminution of caloric, whence re- sulted engorgement and compression of the encephalon. The frigorific* effluvia in the atmosphere and the emana- * Gaertner has pointed out the radiation of cold from ice, extending to ten and twenty steps, when a piece of it was placed in the focus of his concave mirror. This emission of cold rays is also manifested by the beautiful experi- ment of Leslie in the vacuum caused by an air pump, when the ther- mometer falls some degrees. Cold is disengaged in part from ice in the lowest degree of reduced temperature, since, in the space of twenty- four hours, it loses an hundredth part of its weight, as has been observed by Musembroeck. (Remarks extracted from the Supplement to the Institutions de Physique of Professor Sages, edition of 1812, page 23 et seq.) 11 82 CAMPAIGN tions that arose from the ice and deep snow, with which the plains of Russia were covered, impeded to a certain ex- tent calorification in the capillaries of the skin and pulmo- nary organs. The snow and cold water, which the sol- diers swallowed for the purpose of allaying their hunger or satisfying their thirst, caused by the irritation of the mu- cous membrane of the stomach, contributed greatly to the destruction of these individuals, by absorbing the small por- tion of heat remaining in the viscera. These agents pro- duced the death of those particularly who had become ema- ciated in consequence of abstinence, and had been deprived of nutriment. In the latter, it was preceded by pains, accompanied with a sense of constriction in the epigastric region, immediate fainting, painful contraction of the glottis, and well marked anxiety, which were symptoms of hunger. I have remarked, from experience, that a small quantity of good wine, or coffee, removed the hunger, and caused a cessation of its painful effects. I recollect to have spent three entire days without eating or taking any thing, were I to except two or three cups of pure coffee, without sugar, when a friend gave me a glass of Bourdeaux wine, which I drank with indescribable pleasure. From this moment disappeared all the symptoms of hunger, to which I had been exposed for many hours. Famen vini potio solvit. (Hipp. Jiph. section II. aph. 21. edit, by Demercy.) The horses, particularly, having eaten snow, speedily perished. In order to preserve them, the snow, or ice, was melted at the fires of the bivouacs, where they had vessels proper for this purpose, and a small quantity of this water was given them. Since our return to France, we have seen many persons, who were in the expedition from Moscow, labouring under hemiplegia, depending, evidently, on a kind of incomplete and partial disorganization of the brain. We would report the cases of a majority of these patients, were we not fearful of being prolix. Unfortunate was the fate of him, who, with his animal functions nearly annihilated, and his external sensibility almost destroyed by the cold, should suddenly enter too warm a room, or approach too nearly a large bivouac fire. The projecting parts of the body, grown insensible, or be- ing frozen, and remote from the centre of circulation, were IN RUSSIA. 83 attacked with gangrene, which manifested itself at the same moment, and was developed with such rapidity, that its progress was perceptible by the eye, or else the individual was suddenly suffocated by a sort of turgescence, apparent- ly invading the pulmonary and cerebral systems. He per- ished, as if in a state of asphyxia. In this manner died M. Sureau, chief-apothecary to the guard. He reached Kowno without accident, being merely debilitated by the cold and abstinence. A retreat was offered him in a very warm medicine apartment of the hospital. He had scarcely spent some hours in this atmo- sphere, to which he was a stranger, when his limbs, no longer possessed of any sensibility, became tumefied and swollen, and he soon expired in the arms of his son, and one of his assistants, without being capable of uttering a word. Persons were seen to fall dead at the fires of the bi- vouacs. Those, who approached them sufficiently near to warm their frozen feet and hands, were attacked by gan- grene, in all points where the vital powers had been reduced. These fatal occurrences, mutilating the majority of our soldiers, threw them into the power of the enemy. Imagine, if it be possible, the sufferings and miseries which must have been experienced by these unfortunate prison- ers, dragged or transported, with little care, from Poland or the frontiers of ancient Prussia, to the most distant parts of Russia! The French, Portuguese, Spaniards, and Italians, were again those, from whose ranks was derived the smallest number of victims to these cruel reverses. This is a new argument against the assertion of the author of the Esprit de Lois, a new proof, that the inhabitants of these southern countries have more energy and power to resist the action of cold, than those of northern locations. Agreeably to the report of several physicians and surgeons, who parti- cipated in the fate of our soldiers, and were conveyed with them to Siberia, nearly all the individuals belonging to our allies from Germany, Hanover, and Holland, perished at an early hour. Some Russian troops and Poles, how- ever, resisted these calamities much better. But, as I have remarked in my campaigns when speaking of it, this 84 CAMPAIGN latter nation originated in Asia Minor,* and, according to this report, must have great similitude of physical constitu- tion and character to the inhabitants of the southern countries of Europe, such as the French. Thus, whatever may be the governments and laws, under which the inhabitants of southern countries live, they will always be superior in ac- tivity, moral energy, and physical constitution, to those, whom cold and permanent humidity must, by restraining their energies, keep in a constant state of apathy, indolence, and a kind of timidity. Spain furnished us a signal proof of this truth. The conduct pursued by it demonstrates, in an undeniable manner, the error of Montesquieu, which has already been rendered notable by the bishop of Fer- nambouc, member of the Academy of Sciences, of Lisbon. (See the Decade Philosophique, No. 22, Year Eleventh.) Doctor Mestivier, who lived several years at Moscow, assured us, that the French alone could walk,with impunity, in the streets of that city, during the most intense cold of winter, with a simple great coat over their other garments, whereas the inhabitants could scarcely withstand the severe weather, although they were covered with furred cloaks. It will easily be conceived, after what I have just said, why, in mortification of some external part of the body, caused by cold, instead of submitting it to heat, which pro- vokes gangrene, it is necessary to rub the affected part with substances containing very little caloric, but which may absorb a good deal at the moment of their melting, and transmit it to the frozen part by rubbing. For it is well known, that the effect of caloric on an organized part, which is almost deprived of life, is marked by an acceleration of fermentation and putrefaction. Before pointing out the means to be employed, let us succinctly describe the symp- toms which characterize congelation. The part labouring Under this affection is whiter than other parts of the surface of the body; all its sensibility is extinct, and the individual has no longer any sensation in it. Snow and ice are the substances, to which recourse * The same observations are applicable to those dwelling in the pro yinces bordering on Turkey and Asia, as the majority of the Cossacks IN RUSSIA. 85 should be had, for the first application. Dry frictions also, are very serviceable, and should always be made with substances which possess but little heat. I employed no other means for defending myself from gangrenous affec- tions, which would at least have taken place in my toes and fingers, for they were frequently deprived of all sensibility. In this state, I took care to rub the affected parts with snow, and continued, as much as possible, the use of these or dry frictions. Should these remedies fail, the part ought to be plung- ed in cold water, in which it should be bathed, until bub- bles of air are seen to disengage themselves from the con- gealed part. This is the process, adopted by the Russians, for thawing a fish. If they soak it in warm water, they know, from experience, that it will become putrid in a few mi- nutes; whereas, after immersion in cold water,fit is as fresh as if it had just been caught. It is still necessary to sustain, as far as practicable, the powers of the stomach and lungs. No internal maladies had as yet developed themselvesin the army, notwithstanding the fatigue, privations of every kind, and excessive cold, to which it was subjected. The soldiers were not necessitated to stop on our route, except in consequence of partial congelations of the feet and hands. Patients, labouring under affections of this character, were those only, whom we found among the wounded in the hospitals, on the line of evacuation, between Moscow and Konigsberg. But having reached ancient Prussia, where the army enjoyed some days of repose, had access to ali- ment, placed at their discretion, and were provided with warm rooms, the majority of the soldiers, who had fortu- nately withstood the fatal effects of cold and hunger, were almost suddenly attacked with a disease, which we will de- signate by the term of meningeal fever, catarrhal in its nature, arising from congelation. This affection assum- ed, in a few days,.an epidemic character, and having reach- ed its third stage, became contagious, particularly when complicated with a gangrenous state of the extremities. We will attempt an explanation of the causes of this sud- den change in the health of the troops. During the whole period of our subjection to the influ- 86 CAMPAIGN ences of cold from eighteen to twenty-eight degrees, in a rarefied atmosphere, and to an almost continual abstinence from nourishing aliment and potable drinks, possessing greater or less tonic powers, we all experienced, in different decrees a state of sedation on the exterior, and a gradual diminution in the diameter of the intestinal tube. This con- dition was attended with general emaciation, and a tendency, in consequence of the want of equilibrium, to expansion of the capillary vessels of the internal membranes, in which la- tent heat and life appeared to he concentrated. A stay, pro- longed for a greater or less length of time, in apartments warmed by stoves, augmented sensibly this vascular expan- sion, giving rise to engorgement of the membranes, particu- larly of the meninges and mucous membrane of the air-pas- sages. These two principal effects were announced by com- pressive painsin the head, accompanied with heaviness, injury of the mental faculties, and alteration in those of the sensual organs. The patient was seized with general debility, and extremely painful anxiety. Cough manifested itself, and rapidly augmented. It was more or less violent, and at- tended with a mucous, and occasionally a bloody expectora- tion. There frequently supervened, at the same time, diar- rhoea, with an inclination to vomit, and colicky pains. The pulse was febrile, the skin dry, and the patient experienced a painful numbness in the limbs, cramps, convulsions, and a stinging pain in the soles of the feet. The patient slept with difficulty, and was subject to sinister dreams. The vessels of the conjunctiva were injected. Paroxysms of fever were manifested during the evening. The pulsations of the carotid, and temporal arteries, became sensible to the eye, and delirium, or lethargic drowsiness was established, and the danger of the sufferer became imminent. Such are the principal symptoms, that accompanied this affection, which may be called catarrhal ataxia arising from congelation. Its progress varied in rapidity, ac- cording to the constitution, age, and emaciation of the patient. Many circumstances influenced the intensity of these phenomena. When the affection would eventuate favourably, the inflammatory stage was of short duration, and ordinarily IN RUSSIA. 87 terminated by nasal haemorrhages, or by a momentary dys- entery, which supervened from the fifth to the ninth day. This formed a crisis to the disease, and saved the life of the patient. Instead of a discharge of blood from the mucous membranes, there sometimes occurred profuse sweats of a brownish hue, staining the linen of the individual. These phenomena bear much analogy to those, that are observed in scorbutus acutus. Should the issue, on the contrary, manifest its fatality, the symptoms indicative of apoplexy were developed and progressed with rapidity. The body, particularly the lower extremities, was covered with erysipelatous spots, which soon assumed a gangrenous character. The urine, of a dark colour, became scanty; the alvine evacuations foetid and black. All the functions were successively anni- hilated, and the patient died before the fifteenth day, or even at an earlier period, did he discover his danger, and had the disease been preceded by much anxiety previously to his becoming delirious. General Lariboissiere furnished a sad example to this effect. After having borne, quite successfully, the hard- ships of the campaign of 1812, he very speedily became a victim to this affection, after reaching Konigsberg. This brave general had witnessed the death of his son in the battle of Mosaisk, and to this cause of personal grief were added the sincere regrets, in which he had participated in common with all men of sensibility, for the loss of the army. General Eble, so celebrated for his warlike talents and virtues, succeeded him in the command of the artillery; but being attacked by the same disease, he soon after expe- rienced a similar fate. How many others of our noble com- panions followed the destiny of these victims, at the mo- ment of their reaching their native soil! In the inspections of the dead bodies, which I frequently had an opportunity of making, a white layer of albuminous substance, unconnected with any suppurating point, was found on the surface of the brain. The sinuses of the dura mater were filled with black coagulated blood. The ence- phalon was compressed, its tissue more dense than in ordi- nary cases, and its vessels injected with dark coloured blood. The mucous membrane of the larynx and bronchia 88 CAMPAIGN was of a blackish brown tint in some parts of its surface, the intestines considerably shrunk, and the omenta scarcely observable; the latter was the result of abstinence. Gan- grenous eschars were perceived in almost every instance, in the inferior extremities and abdomen. This typhous fever, with which I was attacked, as I have remarked, a few days subsequent to my arrival at Konigsberg, and succeeding my long and tedious visit to the numerous hospitals of this place, came on with symptoms, at first slight, but afterwards becoming so deve- loped as to augment progressively in intensity until the seventh day. The fever was then at its height, the pains in my head extreme, and delirium began to supervene. Having unavailingly entreated that I should be bled from the jugular vein, a pretty copious haemorrhage took place from the nose, by which these symptoms were dissipated, and the danger of my situation removed. A mild emetic, afterwards administered to me, and embrocations with cam- phorated vinegar, which I caused to be frequently made over the whole surface of the body, together with an infu- sion of bark, taken in the morning, and the use of good wine, coffee, and broths, gradually liberated me from this malady. I was fortunately capable of following the move- ments of the army, on its departure from Konigsberg, Janu- ary 2nd, 1813. My convalescence was long and tedious. Agreeably to the expose of these phenomena and my own experience, the following remedies are, I think, to be generally preferred in the treatment of this disease. 1st, In the stage of cerebral and mucous congestion, it is neces- sary to apply cups with scarifications to the temples, head, and back of the neck. It is always beneficial to shave the head of the patient for the purpose of making these appli- cations, and those which may succeed them. If the symptoms of congestion continue after the em- ployment of the cups, leeches should be applied to the scarifications, or else one of the jugular veins or temporal arteries should be opened. The application of the skin of of an animal flayed alive, or of a pigeon emboweled, while living, may be here advantageously applied to the head. The efficacy of these topical remedies in violent contusions have been pointed out in my campaigns of Newfoundland IN RUSSIA. 89 and Spain. Good effects may also result from the employ- ment of ice in small pieces on the head after the local bleed- ings; but circumspection is necessary in the use which is made of it. Pediluvia, sinapisms to the feet, and embro- cations with camphorated vinegar over the whole surface of the body, at such a temperature as is indicated by the state of the skin, should be resorted to in conjunction with all these means. 2nd, When the inflammatory symptoms are dissipated and marks of a gastric saburral affection are developed, a favourable moment should be selected for the administra- tion of an emetic, composed of a strong filtered infusion of ipecacuanha (made cold) and a small portion of tartar eme- tic. It is an excellent remedy, when suitably given. 3rd, Subsequently to cleansing the primae viae, the patient should be placed on the use of mild tonics and nutritive substances imparting strength, such as bark infused in wine, or a mild decoction of serpentaria or chamomile, vinous, theriacal and ethereal potions. Broths, rendered aromatic by the addition of cinnamon, together with wine and some cups of coffee, should be administered in the evening. The individuals, who laboured under this disease, were for a long time in a state of convalescence, in consequence of the prolonged abstinence, to which they had been sub- jected. The intestinal canal, as we have observed, had con- tracted considerably, and only returned to its primitive state in a slow and gradual manner. Nutrition and the re- storation of strength were tardily effected, as the slightest deviation in diet speedily gave rise to relapses, and the least excesses in eating caused colics and painful twitchings throughout the abdomen. The patient was necessitated to eat often, and take little at a time. A girdle was also drawn tightly around the abdomen. This convalescence was suc- ceeded, in many cases, by the loss of the hair from the head, and from all other parts of the body. But a singular phe- nomenon was presented in the person of surgeon-major Adorne, one of my assistants, whom I saw at Konigsberg during the prevalence of his malady, and whom we found in France on our return. I refer to the falling off of the nails on the hands and feet, which are subsequently rege- nerated, as is the case with all the pilous parts of the body. 12 90 CAMPAIGN This disease made great ravages in the first cities of Poland and ancient Prussia, where many of our compa nions were obliged to stop on account of fatigue and con- gelation of the feet.* During our stay at Posen, Prince Eugene, commander- in-chief of the army, was presented by me with an account of every thing that had occurred, having reference to my staff, between Konigsberg and that city. On reaching Franck- fort, I commenced a circumstantial report to the minister at war, relative to the surgical department, during the re- treat from Moscow. This report described succinctly all we have said concerning the ambulances. The Russians having crossed the Oder on the ice, and * On our return to France we saw a pretty large number of soldiers, especially those of the junior guard, who had made the campaign, af- fected with concretions, forming flattened tumours of greater or less ex- tent, in the cellular tissue, and skin of different parts of the body, par- ticularly the face, neck, and shoulders. The limbs and rest of the sur- face of the body, in a few of these soldiers, had become hard, so as to resemble very much the firm consistence of newly born children. One of the individuals labouring under this affection was conveyed to the rooms appropriated to the wounded; he was aged twenty-seven years. His body was very much inflated, and no impression could be made on it by the finger. This tumefaction was more evident in the face, shoul- ders, and arms, than in other situations. The surface of the skin was rough and dry. The patient was oppressed, his pulse scarcely to be felt, and the pulsations of the heart were with difficulty perceived, even when the ear was placed to the chest. It was without avail that we employed, in opposition to this malady, dry cups and cups with scarifications on the thorax and sides of the ver- tebral column, in conjunction with moxa to the same parts, mucilagin- ous and diaphoretic drinks, vapour baths, etc. After a continuance of this treatment from five to six weeks, this young soldier died, having previously lost, for some hours, all the phenomena of the circulation of the blood. On examining the body, we found the skin considerably thickened, and containing in its substance parts resembling lard. The cellular tis- sue had also become more dense, and was filled with yellowish albumi- nous concretions. The lungs were destitute of crepitation, and reduced to a very small size. The heart was in a state of atrophy, and devoid of blood. An albuminous concretion only, of a yellow colour, was found in the right ventricle; it extended towards the orifice of the pulmonary artery. The liver was very voluminous, and suppurating tubercles were disseminated through its substance. The other viscera presented no marks of a pathological condition. IN RUSSIA. 91 interrupted our communications with Berlin, we were ne- cessitated to continue our retreat to the Elbe. On this account we left Franckfort the twenty-second of February, directing our march to this capital, after having surmount- ed the obstacles with which we met. From Berlin we moved on to Wittemberg, and afterwards to Leipsic. On reaching the former of these cities, I visited the temple, which contained the tombs of Luther and Melanc- thon. The full-length portraits of these two theologians presented a striking contrast. That of Luther indicates an orator, animated by an ardent imagination, and excited by a noble enthusiasm for the doctrines which he success- fully preached. He was observed to have been of the or- dinary stature, to have possessed embonpoint, an highly coloured face, a sharp and sparkling eye, black beard, and a high and open forehead. The physiognomy of Me- lancthon bore a strong resemblance to that of my cele- brated master Sabatier, and it is a very singular circum- stance, that there should be a perfect resemblance between the hand-writing of these two illustrious men. Melanc- thon, like Sabatier, was small in stature, thin and withered. His appearance was that of a man, who has spent his whole life in study and meditation. His large protube- rant forehead and very broad head indicated exalted intel- lectual powers. He possessed the eye of a man of genius. Labour and application seem to have marked out the wrin- kles, which were observed on his face. An individual on viewing these portraits would be inclined to believe, that the artist had executed a perfect resemblance, and could judge without difficulty, that one of these celebrated per- sonages composed sermons, and that the other delivered them. But all the honour of these productions is concen- tered in the person of Luther, as being him whose image has made a deeper impression on the minds of the auditors. We proceeded from Wittemberg, where we crossed the Elbe, to Leipsic, and entered it on the ninth of March. This was the first place, at which we supposed the campaign to be concluded; a repose of some months duration, was in- deed announced. We were well received here, and treated with perfect politeness. The inhabitants were mild, affa- ble, and generous, the city in itself very agreeable, and its 92 CAMPAIGN environs delightful, particularly in fine seasons. These ad- vantages were of infinite value to me, but I did not prize less the important means of instruction, offered by this city. Among others, were the anatomical cabinet, possessed by the university, and the observatory, which contained some excellent telescopes. The specimens in the former were few in number; but there were some well made, and ex- tremely delicate preparations of the nerves of the face and head, than which nothing could be more exact and elabo- rate. The most minute nervous filaments with the small- est anastomoses were preserved and evidently demonstrated. To these dissections of the nerves might be compared some beautiful preparations of the lymphatic vessels. The por- trait of Plathner was observed in this cabinet; his coun- tenance bore the mark of the genius and profound wis- dom, which rendered him distinguished among the men of his age. We were entertained in the observatory with the pas- sage of a comet, which presented itself at the end of Octo- ber, 1812, by the astronomer who exhibited to us, through the telescope, the most visible stars, and particularly the surface of the moon. I saw the same comet, when crossing the Berezina, November twenty-fourth, of the same year. Agreeably to the journals, it appeared in France from the twenty-first of September, until the ensuing October. It exhibited itself under the form of a cloudy spot, without tail or beams. From the observatory of Leipsic, a vertical beam was apparently attached to this phenomenon, during the latter part of October, contiguous to the Great-Serpent, and extending to the north-east. In consequence of some urgent repairs, to be made in the observatory, its course could be no farther followed, nor could it be longer observ- ed. These particulars were given to me by M. Speisner, observing astronomer of Leipsic. During our stay in this city, I addressed to the minister at war an appendix to the report I had already made to him, for the purpose of acquainting him with all that had occurred in my staff between Franckfort and this place. I continued my researches into, and observations on, the reigning malady, the catarrhal malignant fever of con- gelation ; its contagious or pernicious effects had spread IN RUSSIA. 93 among the inhabitants. The mortality was consider- able, and many individuals perished, also in the cities of Prussia, where the army in its passage left a large number of sick. I received, at Leipsic, a letter in reference to this disease, the progress of which was attended with great alarm, from the head of the etat major, written in the name of the commander-in-chief. My report, while removing the disquietude of the prince, pointed out the hygienic measures to be adopted for impeding the developement of this fever, for arresting its progress, and preventing its con- tagious influence. We had scarcely spent fifteen days in this place, when we were menaced on all sides by the enemy, who had already seized upon Upper Saxony. This circumstance ren- dered our position insecure, and it became expedient also to prevent the blockade of Magdeburg, the provisioning and fortifications of which for a seige were not completed. On this account, the Prince was induced to leave Leipsic for the purpose of repairing to Magdeburg, where we arrived in a few days. At Halle, in which place I stopped twenty- four hours, in order to cause our patients in the hospital of this city to be removed, I had the pleasing gratification of becoming acquainted with the son of the celebrated Mec- kel, whom I had not seen since my arrival in that place during the first campaign in Prussia. This young and learned professor exhibited to us a very beautiful and splendid set of anatomical preparations, made for the most part by his father. Nearly all of the specimens were dry. They consisted of injected capillary vessels of the osseous system and serous and mucous membranes of such a degree of perfection, as has been reached by very few anatomists. Some beautiful mercurial injections of the lymphatic ves- sels, and other particular specimens, moreover, attracted my special attention. We entered Magdeburg during the latter part of March, being threatened towards Prussia by numerous troops, which approached the advanced posts of our fortifications. Prince Eugene crossed the river, April the second, with his army, composed of from twelve to fifteen thousand men,and moved on some leagues in advance. A corps of Prussians of about thirty thousand men presented themselves, but retreated 94 CAMPAIGN immediately on seeing our troops, with the view of effect- ing their passage across the river at a more remote point. The movements of this corps were observed for some days, and arrangements were made for a return to Magde- burg, where our advanced guards were secretly attacked, during the night between the sixth and seventh, by supe- rior forces. A battle ensued, which placed about two hun- dred wounded in our hands; they were conveyed to the hospital of the city, which was a very short distance off. It was, moreover, impossible to dress their wounds on the field of battle. In connexion with these injuries, some in- teresting facts presented themselves, of which I shall have occasion to speak in other articles. Prince Eugene, being well convinced that the Prussians had passed the river, and effected their junction with the Russians in the vicinity of Leipsic, departed from Mag- deburg in order to establish his line of operations on the Saale, after having adopted all the necessary measures for the defence of this place. By virtue of his orders, I took such steps as were in my power with the view of rendering secure the duties of the hospitals, and was momentarily de- tached from head-quarters for the purpose of visiting the ambulances and hospitals in the neighbouring situations. Among these was Halberstat, where I spent several days; I rejoined head-quarters at Mersburg. On reaching this latter city, April the thirtieth, the advanced posts of our army engaged in battle, and we had from five hundred to six hundred wounded, whom I caused to be dressed and operated on in the hospital which we had established in this city. IN SAXONY. 95 PART THE FIFTH. Movements were made by the allies for some days, with the view of cutting off our small army, and moving on in front to the frontiers of France. But their march was arrested by the arrival of Napoleon, who at the head of fresh troops effected a junction, on the first of May, with those commanded by Prince Eugene in advance of Mers- burg. From this period the two etats-majors were reunited, and I received an order to rejoin the grand head-quarters at Lutzen. Leaving Mersburg with the light ambulances during the night between the first and second of May, we arrived at Lutzen on the morning of the second at eleven o'clock. A violent cannonade was already heard to the right of our army, and very active measures were in pre- paration with both parties for a grand battle. It com- menced indeed a few moments subsequently with great violence along the whole line. The commander-in-chief observing me while passing through the troops, came up and personally addressed his orders to me : " You have ar- rived at a very proper time, said he; go into the city and select the necessary places for the reception of the wounded in the combat at hand, and adopt measures for affording them all the requisite succour." Having determined upon the situations of the ambu- lances, and arranged every thing for dressing the wound- ed, I returned to the field of battle for the purpose of ob- serving the first effects of the fight, and placing the ambu- lances of the first line, which I took for the most part from those of the guard. The attack on both sides was very spirited, and, for whom victory would decide, was a matter of doubt for some moments. Our young soldiers, however, excited by 96 FIRST CAMPAIGN the examples of valour before their eyes, and by the pre- sence of the emperor, rushed impetuously against the co- lumns of the enemy, which they broke through and dis- persed. Victory rendered us masters of the field of bat- tle, and placed at our disposal a large number of prisoners, pieces of artillery, and a great part of the baggage of the enemy. The remainder of the allied army retreated pre- cipitately to Dresden, in which place it made no halt. These troops contented themselves with cutting down the bridge across the Elbe, in order to give themselves an op- portunity to rally and to take a stand on the heights of Bautzen. The field of battle at Lutzen was covered with the dead and the dying, of whom the majority had belonged to the Prussian ranks. We caused all the wounded, as well of the French as the allied army, to be collected together, and located them in the small city of Lutzen, which was almost totally filled with ambulances. We were occupied during the first two days and nights in dressing their wounds; near- ly all the difficult operations were performed by myself. Among the amputations of the leg executed immediately below the knee, I will cite that of Brigadier General Che- mineau, as the most remarkable of the kind. The leg had been disorganized by a bullet of large size, as high as its superior part. Being intimately persuaded, that the artic- ulation was not injured, I entertained a hope of preserving this part by amputating through the head of the tibia, though the injury extended to a point very contiguous to it. I marked out the course of the amputation with my eye by a line extending from the summit of the insertion of the ligament of the patella to the head of the fibula. Having cut the soft parts on a level with this circular line, I dis- located the head of this bone and sawed through the tibia even with this articulation. But how great was my sur- prise and that of my assistants, when we observed a frac- ture separating longitudinally the head and extending to the knee joint! We were inclined to amputate the thigh, when, after having reflected on the internal state of this articulation, in which there was no evidence of effusion, we concluded that the fracture did not penetrate into it, and that the operation would be followed by success. I IN SAXONY. 97 therefore approximated the fractured parts, and maintained them in their relative apposition by means of a bandage of moderate tightness. The patient experienced some con- stitutional disturbances, which were successively dissipated, and his recovery was perfect. This conclusively decides the question of the advantages of this operation when com- pared with that performed on the thigh, even when the injury is contiguous to the knee, and in the event of the head of the tibia being fractured, provided the soft parts are uninjured. I should prefer executing the operation in the keee-joint to ascending the thigh for this purpose. The same treatment would not be pursued, should the condyles of the femur be fractured; amputation of the thigh in this case is indispensable. Eighteen amputations of the arm at the shoulder, pre- senting many varieties, were performed. In all the wound- ed, the injury of the arm extended as high as the shoulder, at which the operation took place. My method was employed in every instance with the greatest advantages. The reports, which I received subsequently from the sur- geons of the hospitals in Leipsic, and other cities in the line of evacuation, informed me that all the wound- ed, with the exception of three, were restored to perfect health. Having caused all the French and foreign patients to re- ceive the primary attentions, I secured to them the benefits of medical aid by placing them under the care of the requi- site number of surgeons, to whom I gave the necessary in- structions for their removal and consecutive treatment. Preparations were hastily made by me to rejoin head-quar- ters, which I could not overtake but at Colditz, where the army had halted. Here the enemy might have waited for us in security; for this small town commands a defile between pretty high mountains, through which it is very difficult to pass. An ambulance was established at the general hospital, as being very spacious and well built. All the individuals of the province, labouring under chro- nic diseases or incurable infirmities, were received into it. Among the latter, we observed some Cretins, particularly females, who bore a strong resemblance to those I saw in the Maurienne valley in Savoy. 13 98 FIRST CAMPAIGN The regulations of this establishment were remarkable for certain usages. The livery of the infirmary servants was peculiar and singular. Their clothing comprising stockings, consisted of two colours, one half being yellow and the other dark violet. We reached, in a few hours after leaving Colditz, the hills bordering on the left bank of the Elbe, from the tops of which were seen the capital of Saxony, and the moun- tains of Bohemia. The prospect was magnificent, and ex- tremely variegated. The advanced soldiers of the van- guard soon apprized us, that the troops of the enemy had not halted in the city, and that after evacuating it, they had destroyed the bridge. On receiving this intelligence, the head-quarters and the guard entered the place, and the different corps encamped in its environs. I visited imme- diately all the hospitals and establishments, which were filled with wounded, as well Russians as Prussians. The former had been dressed, and all the operations required by their wounds performed. But the subjects of these operations appeared to experience intolerable pains. I requested the Saxon surgeons, under whose charge they were, to exhibit to me some of the stumps resulting from amputation. I had previously imagined, that sutures had been employed according to the method generally adopted in Saxony, and some parts of Prussia and Poland. And in- deed, in the stump of each of these unfortunate and mutilat- ed individuals, we found two, three, and four points of su- ture, protected by adhesive plasters, tightly applied. Irri- tation and inflammation had already been developed in every case, with different degrees of intensity. I advised the Saxon surgeons to cut the sutures, remove the ad- hesive straps, and apply emollients to the stumps. They did not, at first, accede to my proposition, observing, that this disturbance was transient, and that these symptoms would not impede the recovery of the patients. It was my duty to respect their opinions; notwithstanding,-however, I took it upon myself to remove a dressing of this character, from one of our officers of artillery, who had been convey- ed from the field of battle at Lutzen, with the view of being carried to Dresden, and had undergone the amputation of his thigh. This patient experienced very great relief IN SAXONY. 99 subsequently to the removal of the dressings ; but irritation was very far advanced, and it was impossible to prevent gangrene, which, having already manifested itself in the in- terior of the wound, made rapid progress, and caused the death of this officer on the third or fourth day. All the others, upon whom amputation had been performed, died, without exception, in the same manner, some at an earlier, others at a more remote period. As there were still many wounded French, who required amputation, I caused them to be operated upon by the surgeons-major of our ambu- lances. Those of the most difficult character were per- formed by myself, in the presence of the Saxon physicians and surgeons, who were soon capable of distinguishing our method of amputating from that employed by themselves, and did not hesitate, as to the adoption of this plan, evi- dently so advantageous. The Saxons divided the skin and muscles by means of a curved knife at one stroke, and the bone nearly on a level with the section of the soft parts. The tourniquet exercising a strong compression on the arteries, the wound was sewed up without the appli- cation of ligatures to the vessels. The exact and close union of the edges of the wound generally prevented haemorrhage. Notwithstanding the simplicity and reasonableness of the French method, nothing less than experience and the suc- cess obtained, could convince the physicians of the country of its utility, who, in other respects, were very estimable for their social qualities, and distinguished merit. The progress of the army was arrested for some days on the left bank of the Elbe, in awaiting the construction of two bridges of boats, and the reparation of the stone bridge, the principal arch of which had been destroyed. I took advantage of this delay to organize the divisions of our light ambulances, and to have manufactured some surgical instruments, which were wanted. Lessons in clinical surgery were also given by me over those of the wounded, who were in a condition to endure an operation of greater or less importance. The bridges being completed, the troops effected their passage in succession. Head-quarters and the guard, whose movements I constantly followed, departed from Dresden on the nineteenth of May, and we reached the heights of 100 FIRST CAMPAIGN Bautzen on the twenty-first. Information had already been communicated to us, that the enemy had entrenched themselves to the east and south-east of this city on a ran«re of circular hills, which were lost insensibly in the chafn of mountains, bordering on the frontiers of Bohemia. The heads of the columns, in reconnoitering the enemy's lines, engaged in battle; but the combatants were separated by the bad weather and the approach of night. We se- cured surgical assistance to the wounded in this fight, and continued our preparations for the battle of the following day, which to us appeared inevitable. Passing through Bautzen on the evening of the twenty-first, I caused differ- ent places to be arranged for our ambulances, and con- fided the general direction of these establishments to M. Fabre, adjunct-surgeon-in-chief. At the dawn of the fol- lowing day, I proceeded with the light ambulances to the field of battle. The attack had been commenced simulta- neously by both armies, and had been conducted by each in a very spirited manner. Several of our battalions had already tottered under the impetus of the allies, who would probably have obtained some successes, but for the skilful and rapid movements of our generals. Under their direc- tion our troops soon cut off the progress of the enemy's wings, broke through the centre, and carried the principal redoubts, which were scaled by our young soldiers, with unparalleled intrepidity. The French soldiers had not ex- hibited such ardour, since the campaigns of 1792,1793 and 1794. They surmounted all obstacles and gained a signal victory, which resulted in the capture of a line of redoubts, established on the heights of Wurchen, forty pieces of cannon, waggons, baggage, and a pretty large number of men. We had about six thousand five hundred wounded in this combat, both of the line and guard. Having ad- ministered the primary succour on the field of battle to those whose necessities were most urgent, I proceeded to the city in company with the majority of my assistants, for the purpose of continuing our services to those there located. I spent the first three days in having their wounds dressed, in conjunction with my estimable colleague, M. Fabre. My care was bestowed especially on Generals Laurance, Laboissiere, and a large number of officers and IN SAXONY. 101 soldiers, whose wounds required operations of greater or less difficulty and importance. The first was labouring under a fracture of the condyles of the left femur immedi- ately above the knee, without any solution of continuity whatever in the soft parts. It was caused by the shock of a spent cannon-ball. There also existed a simple gunshot wound in the right thigh, though the bullet was buried in the flesh. Having dressed this latter wound, I prepared, with the assistance of M. Fabre, for paying the requisite attention to the fracture of the left thigh. An eighteen tailed bandage, made and applied with care, preserved the straightness and proper conformation of the general's limb. This case, extremely serious in its character, was one of those, in which it is very difficult for the surgeon to decide; the patient however recovered. The second individual had received in his left leg a fragment of a bomb from an howitzer, which had removed a part of the tibia a short distance from the maleolus. I postponed the amputation of the limb, which appeared indispensable. This general was so fortunate as to preserve the member ; but it remained somewhat deformed, and shortened about the breadth of two fingers. I removed the arm at the shoulder in the persons of the following soldiers: Louis Jerome Brigot, soldier of the eighty-eighth; Leonide Staure, sol- dier of the hundred and fifty-first; Dominique Lem, ser- geant of the thirty-second ; Jean Brigod, of the seventy- fifth; Delauzanne, soldier of the hundredth and thirty- sixth ; Fourchartre and Gilbert, cannoneers of the second of artillery ; Raymond, fusileer of the hundredth and se- cond; Antoine Turios, of the third light troop. All of these individuals, without exception, were cured. Several partial amputations of the foot were also performed, and resulted in as fortunate a manner. The army contending constantly with the enemy, whom it pursued with the utmost vigour, I received an order from the Emperor Napoleon to rejoin the troops in all possible haste. The adjunct surgeon-in-chief remained in Dresden, having under his charge these wounded patients, whom he attended until their removal. On my arrival at head-quarters, a short distance from Hai- naut, I learned the sad intelligence of the death of Generals 102 FIRST CAMPAIGN KirchenerandBruyeres,and of the mortal wound of Marshal Duroc, Duke of Frioul. This general frequently demanded my presence, and was looking for my arrival with extreme impatience. He had been conveyed to the house of an in- habitant of the village where he was wounded. On en- tering this cottage, in which I found the marshal lying on a pile of straw, and still clad in his uniform dress, I was seized with terror at seeing him labouring under a mortal injury. My sinister presentiments were too soon realized. He could scarcely articulate a few words. The conse- quences of his wound were perceptible through the dress- ings which covered it, and the pallor of death was stamped upon his countenance. The parietes of the abdomen had been removed by a ball of large size, the intestines lacerat- ed in several parts, and protruded from the abdominal ca- vity. I saw, with the most acute grief, that all the succour of our art could not rescue him from the speedy and inevi- table death, which was approaching. Indeed, in a few hours subsequent, this general officer, one of my honoura- ble companions in Egypt, terminated his brilliant career. His name, and those of Generals Desaix and Lannes, are deeply impressed on my heart, in gratitude for the friend- ship constantly manifested for me by these illustrious and exalted warriors. On reaching Hainaut, we found three hundred and sixty persons, who had been wounded in an unfortunate combat on the heights of this city, involving one of our divisions, which was surprised by a numerous body of the enemy's troops. Among them were three female sutlers, and two children. In the case of one of the former, a sabre, after removing a portion of the left parietal bone, had cut the dura mater, and the cortical substance of the brain. I bestowed my services upon her, as upon all of the patients, and recommended her, with her companions, to the care of the surgeon-major of the hospital. Information of her recovery has since been communicated to me. Three amputations of the arm at the shoulder, and some other important operations which I performed, likewise even- tuated in the most successful manner. The majority of these patients were removed to Dresden, and those that wrere incapable of being transported, were located toge- IN SAXONY. 103 ther in an hospital established by us at Hainaut. These accidents did not arrest the march of our army, and the enemy was pursued with much spirit by our troops. They could have been repulsed beyond the Oder, where we could have repossessed ourselves of the garrisons, which had been left in this situation. These consisted of excellent troops, and were capable of compensating for greater losses than we had sustained in the battles of Lutzen, Baut- zen, and Wurchen. But having arrived at Neumarck, ten leagues from Breslau, the French accepted of an armistice, and the preliminaries of peace that were proposed to them. Each army then took stated positions, and we returned to Dresden. During our short stay at Neumarck, a small city inhabited by Jews, we suffered from the want of good food, the inferior quality of the water, and the inclemency of the season, which was rainy. These circumstances oc- casioned an obstinate diarrhoea and hepatic affections in a large number of our soldiers. Many of our horses were destroyed by a singular affection, le vertigo, which these animals contracted doubtless, under the influence of this hu- mid and very unhealthy climate, and in consequence of their drinking the waters of marshes, which were both muddy, and filled with insects or animalculae. I accelerated my progress in order that I might have an opportunity of revisiting the wounded in Bautzen. Two-thirds of them had been conveyed to Dresden by the inhabitants, who, highly zealous and humane, and in con- formity with my advice, had employed for their removal a kind of wheel-barrow, very commodious and much in use in the country for the transportation of wares and mer- chandise. Each private man had several of them. The road from Bautzen to Dresden being throughout a descent, the progress of these means of conveyance was not at all impeded. We saw as many as a hundred and a hundred and fifty moving in succession. No method of transporta- tion could have been more convenient or expeditious. This circumstance proves how important it is for a surgeon- in-chief to study the countries through which armies pass, in order that he may be capable of converting to the ad- vantage of the wounded the resources presented in dif- ferent localities. 104 FIRST CAMPAIGN Tetanus supervened during the first stages of these wounds, and attacked more especially those individuals whose injuries were connected with fractures of the joints and limbs, and loss of substance, together with a large number of those whose thighs had been amputated. All that were subjected to this cruel malady, with the excep- tion of one, succumbed to its destructive influence. This patient, who was wounded in the foot, was indebted for his preservation to amputation of the leg, performed at the period of the invasion of the first tetanic symptoms. The extirpations of the arm and amputations of the leg in general eventuated fortunately. I had an opportunity of observing some wounds of the head, which manifested singular phe- nomena. Mention will be made of them in a particular memoir. On my return to Dresden, where head-quarters had been established, I was at first engaged with the organization of my staff and the location of the wounded. I commenced a course of practical and clinical surgery, to which the French and Saxon surgeons paid assiduous attention, and pursued the careful treatment of our sick. The commander- in-chief of the army being satisfied with the staff of our light ambulances, though in a very incomplete stale, and being desirous of giving honourable stations to the military surgeons, ordered that a council, composed of the inspector- general, director, and surgeon-in-chief of the army, should examine, under the auspices of the minister, Count Daru, a project for a law relating to the organization of a corps of military surgeons. During the armistice, the King of Saxony returned to his capital. He received on this occasion, from his subjects, the most touching testimonials of respect and attachment. The French joined their acclamations to those of the in- habitants of Dresden, and from that period did not cease admiring the generous conduct of this virtuous Prince, whose solicitude for our wounded and sick was tender and constant, and by whose direction all the succour they re- quired was prodigally bestowed on them by the civil offi- cers of the hospitals. While exercising an active supervi- sion in the hospitals, and continuing my lectures in clinical medicine, I endeavoured to organize anew our ambulances, IN SAXONY. 105 and classify the surgeons of the regiments. An account of the resultof my operations during this astonishing campaign, was given to the two ministers in the army and at Paris, with whom it was my duty to correspond. Fine weather having become established, and the tempe- rature during the night being nearly the same as that pre- valent in the day, the tetanic symptoms disappeared, and the gangrenous affections rapidly subsided. From this moment every wound progressed to a cure without any sensible obstacle. Some individuals, accustomed to conceal the truth, with the view of diminishing in the eyes of Napoleon the con- siderable number of those who were wounded in the battles of Lutzen, Bautzen, and Wurchen, told him, that many of these individuals had been voluntarily mutilated, in order to incapacitate themselves for duty. In this class were in- cluded, all those whose fingers were mangled, and whose hands were traversed by balls. An order, based on these assertions, was given to collect all the wounded of this char- acter, and confine them in the entrenched camp, a quarter of a league from the city, on the grand road to Bautzen. They amounted to nearly three thousand. Being interrogated by the commander-in-chief of the army personally, as to the difference presented between wounds, resulting from a cause put in operation by the individual himself, and those, which are the effect of a foreign power, I gave it as my opinion, that, no surgeon, caeteris paribus, could establish any dissimilarity whatever in reference to these two kinds of wounds. My ideas did not accord with those entertained by some of my colleagues. These notions did not, prevail, and an order to form a sur- gical jury, over which I should preside, was immediately intimated to me. This court was charged with the duty of designating those whom it should find guilty of these offences, in order that they might be placed at the disposal of the general, grand-provost of the army. I will not transcribe here what was written me on this subject by this general officer; his letter contained the detail of the measures to be adopted for the government of the camp during our proceedings. Persuaded of the importance of the decision which I was called upon to make, in this 14 106 FIRST CAMPAIGN remarkable case of legal surgery, I persisted in the main- tenance of my primitive opinion. The remaining mem- bers of the court participated in my notions, and, after having carefully examined all the wounded, we made the following report: "In accordance with the order of the commander-in- chief of the army, and in virtue of the instructions of M. Count Daru, minister director of the army, expressed in his letter of June 13th, 1813. " The surgical jury, composed of MM. Baron Larrey, inspector-general and surgeon-in-chief of the army and guard; " Eve, principal-surgeon and knight of several orders; " Charmes, surgeon-major and Knight of the Legion of Honour; "Thebaut, surgeon-major of the hospitals; and, "Becoeur, surgeon-major of the ambulances, met on the sixteenth of the same month at five o'clock, A. M. at the appointed place, for the purpose of visiting two thousand three hundred and fifty soldiers, and two hundred and eighty-two brought from the ambulances of retreat, the to- tal amount being two thousand six hundred and thirty-two soldiers of the whole army, who were wounded in the hands and fingers. " This examination, uninterruptedly continued from the period of its commencement until the present time, the nineteenth of June, twelve o'clock, has been witnessed by a superior officer of the etat-major and an officer of the king's horse, sent by the grand-provost of the army. " The inspection, made with the most scrupulous atten- tion, had reference, first, to the character of the wounds, and the mutilations resulting from them; " Second, To the causes producing these wounds, and the modus agendi of these causes; " Third, To the circumstances which accompanied or preceded these solutions of continuity. " And there result from this inquiry the following re- marks: " First, That nearly all the wounds were inflicted by contusing bodies, propelled by fire-arms, and that a few of them were caused by polished weapons, exerted against those who laboured under these injuries. IN SAXONY. 107 "Second, That the majority of the wounded presented at the same time other wounds in different parts of the surface of the body, or rents in their garments, more or less multiplied in number, made by the passage of balls. "Third, That the small part of the wounded, in whom the foregoing circumstances did not obtain in so evident a manner, consists of veteran soldiers, whose fidelity it could scarcely be permitted to question.* " The court in short declare, that there are no certain marks indicative of the difference, which may exist be- tween two wounds from fire-arms, received at a very short distance from the instrument inflicting the injury, either voluntarily or involuntarily produced. "The jury, in recapitulating, assert, that it is physically impossible to establish the least proof of any of the soldiers, visited by them, having voluntarily mutilated themselves. They are, moreover, of opinion, that the attentive examina- tion of the circumstantial accounts,t which have been drawn up in writing, in reference to all the wounded subjected to this inspection, by explaining the causes of apparently so large.a number of mutilations, will contribute to the dissi- pation of the unfavourable report propagated in relation to those who suffered these injuries." I presented this report to the emperor, and declared to • Our examinations led us to believe, that the want of skill in the management of arms was the principal cause of these mutilations among the conscripts; that when they fired in three ranks, those in the second and third involuntarily rested the barrels of their guns on the hands of those in the first rank; that in managing their fire-arms, they were frequently wounded, as we have observed; and, in a word, the charges being made by the infantry in the battles of Bautzen and Wurchen on the back of the hills, and the soldiers having their hands constantly rais- ed to their guns, that when they leveled them at the enemy, who occu- pied the summit of these hills, the balls of their adversaries would gene- rally impinge on their hands, as the most projecting parts. A similar reason caused a large number of fusileers of the guard, who uselessly attacked the enemy on the heights of Heilsberg, during the first campaign in Poland, to be wounded in the hands. These brave young soldiers were also accused of being voluntarily mutilated, through the assertion of physicians possessed of little knowledge. These cir- cumstances occurred also frequently in Spain in mountain warfare. f These details of the wounded were deposited with the minister, Count Daru. 108 FIRST CAMPAIGN him, that the charge preferred against these two thousand six hundred and thirty-two soldiers was entirely false, and that it appeared to me a matter of justice to restore all these individuals to their respective corps, in which they received a farther destination, according to the information we gave respecting their invalid condition. The report was favourably received and my propositions adopted. A new order of the day was therefore establish- ed, by which the proceedings of the court were extended to all the wounded of the army, for the purpose of de- ciding upon their state of health. I was charged with the duty of giving the necessary in- structions to the principal surgeons of the different corps and surgeons-major of the hospitals, desiring them to make known to me, with as little delay as possible, the result of their operations. On this result, which I received at the end of July, was based my report to the commander-in- chief of the army, of the fourth of August of the same year, 1813. It has appeared to me of sufficient importance to be em- braced in my narration. "In giving an account of the result of the campaign, which has just been concluded, so far as I am concerned, I have observed, that of the number of wounded, amounting to about twenty-two thousand, in the battles and engagements of the different corps of the grand army, comprising the guard, from the first of May, 1813, until the ensuing June, exclusive of the wounded belonging to the armies of the enemy, who were conveyed to our ambulances, fourteen thousand and eighty-four remaining in the hospitals situ- ated between the Oder and the Rhine, have been examin- ed by the courts of health, established in virtue of the order of the day for June 30th, 1813. Of these, six thousand seven hundred and three officers or cured soldiers have been restored to their respective corps, in order to resume their active duties; four thousand and twenty-seven in a state of relative sickness have been or will be employed in the train of artillery, equipages, or battalions of the ambu- lances; and in fine, three thousand three hundred and fifty- four, decided upon as being incapable of performing any IN SAXONY. 109 military duty, and in a state of absolute sickness, have been sent to France, with the exception of a small number, whose wounds had not sufficiently progressed towards a cure. Seven hundred and thirty-one of these three thou- sand three hundred and fifty-four have undergone amputa- tion of one or two limbs; I performed amputation of the arm at the shoulder in twenty-two of these soldiers. " I think, that of the seven thousand nine hundred and sixteen, who remained, and whose wounds had come to a termination before the general visit, decreed by the order of the day for the thirtieth of June, upwards of three thou- sand had already returned cured to their regiments, and about two thousand five hundred, who, I presume, were in a state of relative or absolute sickness, had arrived at this period in the cities of the Rhine, or passed into France, according to the report made to me by the surgeons-major of the hospitals. " Two thousand four hundred and sixteen constitutes the total number of those who succumbed to their serious wounds. Of the dead, I compute the tenth part to have consisted of such individuals as had been subjected to am- putation, and these being added to the seven hundred and thirty-one above mentioned, twenty of whom were depriv- ed of two limbs, the total number of amputated amounts to nine hundred and seventy-two. " This success, if the scarcity of resources, and the fre- quent variations of the atmosphere, which provoked teta- nus, be considered, is essentially owing to the prompt and methodical succour received by the wounded on the field of battle, and to the vigilant and assiduous attention constantly bestowed on them by our surgeons in the hos- pitals." I had still the duty to perform, of proposing surgeons for the regiments, and classifying those who had been sent to the army by the prefects of the departments. This task was laborious and difficult. It would certainly have been more beneficiarto form one, or several schools, nurseries as it were, of military surgery, in which the requisite number of young surgeons could have been educated. In their in- formation, zeal, and energy, greater confidence could have been placed,and the inhabitants of the country still have kept 110 FIRST CAMPAIGN their own surgeons. We were also engaged in improving, provisionally, the active ambulances in the event of a new war. During the whole of this period, I continued my les- sons in practical and clinical surgery, and pursued uninter- ruptedly the treatment of all the sick under my charge, visiting personally one of the principal departments of the wounded. I had an opportunity, in these daily visits, of making important observations on some surgical diseases, of which we are about to speak. Some reflections on wounds of the head, will form the commencement of this dissertation, and the lesions of the organs contained in the other cavities, etc. will afterwards be successively considered. The summary of our observa- tions on some organic diseases of the extremities, and the results of our methods of operating having reference to them, will also be reported. IN SAXONY. HI Reflections on Wounds of the Head, accompanied with fracture or shattering of the Bones of the Cranium, on Injuries of the same Part, complicated by the presence of foreign Bodies, and on the causes of Ab- scesses in the Liver, following some of these Lesions. To avoid repeating what authors have written on wounds of the head, we will confine ourselves to pointing out : First, Those cases in which trephining is indispensable, and the period at which this operation should be per- formed ; Secondly, Those instances in which the trephine, though as strongly recommended by authors, is useless, even in- jurious, and the means that may be adopted, under some circumstances, as substitutes for this operation ; Third, What is expedient in hernia of the brain ; Fourth, and finally, the causes of abscesses in the liver, succeeding wounds of the head. Proposition the First. To point out the cases in which trephining is indis- pensable, and the time proper for the performance of this operation. In a wound of the head, accompanied by a fracture of the cranium, should the fragments of bone be displaced and driven internally, so as to injure the brain and dura mater, the trephine is indispensable. When the foreign body, which has caused the wound, is enclosed between the pieces of bone, or has penetrated in- to the interior of the cranium, without being removed from the vault of this cavity, the case is again one which de- mands the application of the trephine. Finally, when the surgeon is assured of the existence of . effused fluid under the cranium, this instrument is also indicated. But previously to performing this operation, it is impor- tant to know, whether or not the symptoms, characteristic 112 FIRST CAMPAIGN of lesion or compression of the internal parts, actually ex- ist. One of the principal symptoms of compression is pa- ralysis, of greater or less extent, seated in parts on the side opposite to that on which the wound is situated. I have remarked, indeed, that when the parts of the brain or medul- lary productions directly emanating from it, as the processes of the medulla oblongata, or those of this part that are con- nected with its pyramidal eminences, are labouring under the lesion, paralysis is constantly developed on the side op- posite the seat of injury. This circumstance explains, per- haps, why the tongue in hemiplegia is paralysed in that part of it, situated on the side of the body, other than the one which is the seat of the hemiplegia. For the ninth pair of nerves arise from the roots of the olivary bodies of the medulla oblongata, and these eminences are connected with the cerebellum, in which there is no crossing of fibres, so that paralysis takes place on the side of the lesion. These symptoms are recognized with so much the greater facili- ty, as they are manifested immediately after the accident, and are developed in a gradual and progressive manner, unless the fracture be bounded at the anterior part by the frontal sinuses, and unless the foreign body be stopped in these cavities. In the latter case, which is distinguished without difficulty, these symptoms will be looked for in vain. Thus, for example, should a ball of a small size, or a small piece of a ball, be arrested in these cavities, after hav- ing penetrated into them, the surgeon should not hesitate to lay open the whole extent of the fracture by suitable incisions,* and to apply a trephine of a diameter propor- tioned to the extent of the parietesof the sinus, so as not to exceed its limits. The foreign body, when laid bare, is easily extracted. * Lesion of the branches of the frontal nerve should be avoided as much as possible in making the incisions, or if this be not possible, care should be taken to divide them completely. Even a slight injury of these nerves ordinarily gives rise to loss of sight in the eye of the same side, and sometimes causes tetanus. An example of this is found in our Cam- paigns; whereas the complete division of these nervous branches does not disturb the functions of those which contribute to vision. IN SAXONY. 113 The same indication is presented, when the foreign bodies are enclosed in one of the fossae of the superior jaw, as the orbitary, nasal, zygomatic and maxillary sinuses. In this case, however, long and harsh examinations would be dangerous to the patient, since they would give rise to symptoms more serious than those which would result from the presence of a foreign body in one of these cavities. This rule is developed in the note, which accompanies se- veral curious cases relative to this subject, in the third volume of my Campaigns. Previously to demonstrating the uselessness and danger of the application of the trephine in wounds of the head, when this operation shall be indicated, we will report some facts having reference to our former assertion, viz. to the imperious necessity of extracting foreign bodies by some means, and giving issue to the fluids effused into the inte- rior of the cranium. After the battle of Witepsk, in 1812, 1 was called by one of our surgeons-major to examine two singular wounds, which occurred in the persons of two young Russian sol- diers. The first had received in the frontal region, somewhat above the right eye-brow, a ball, which having penetrated and fractured the os frontis between the superciliary arch and frontal boss of the right side, had passed into the inte- rior of the cranium. This projectile was situated on the top of the anterior and right lobe of the brain, and the mammillary or orbitar boss and internal crista of the fron- tal bone. Notwithstanding the large size of this ball, it appeared on the exterior to be very small, and the aperture, through which it was seen, was not more than from three to four lines in diameter. The trials and efforts made for its ex- traction had on this account been fruitless. The patient experienced a sensation of weight and ex- tremely painful dulness in the head, and fell into a state of syncope, when he assumed an inclination backwards. He kept himself constantly in a sitting posture, resting his head on his knees. All the symptoms of compression of the brain were, moreover, manifested. The jar communi- cated to a probe by the visible portion of the foreign body, 114 FIRST CAMPAIGN apprized us that it was an iron ball, the size of which must greatly exceed the diameter of the opening made by it in its passage. We also perceived that it was necessary, even urgent, to apply the trephine.* The wound in the integuments being enlarged by two longitudinal incisions, the whole circumference of the aper- ture in the frontal bone was laid bare, particularly at its superior part, where we applied three small crowns of a trephine communicating with each other and with the per- foration made by the ball. The osseous angles that were * The difficulty of extracting the ball is generally presented in all cases, where a projectile has traversed the substance of bones, and par- ticularly those of the cranium. (It is supposed to be arrested, as in this case, at the edge of the perforation it has made in its passage; for should the foreign body be buried in the interior of parts, particularly in the brain, no examination would be made.) This obstacle depends on the contraction of the aperture through which the foreign body has been transmitted. The osseous fibres, previously to being ruptured, yield and become curved under the weight and pressure of the instrument which produces the wound. But when the resistance is overcome, these fibres return to a straight line, and tend to approximate by converging towards each other, so that the foramen which results from the fracture and loss of substance in the osseous fibres, grows smaller in proportion to the elasticity and power of the tissues. This is what is observed in young individuals, as was seen in the case of the Russian, of whom mention has just been made. The bones, on the contrary, of old men are shattered, instead of bending or yielding, as in the former persons, to the force of the projectile, which does not overcome the resistance but by rupturing a portion of the bone equal, at most, to the half of its diameter. The small or large size of the osseous fragment will be in proportion to the spongy or compact state of the bone. The perforation of the latter, in the former condition, is effected without fracture. In all cases, if the ex- traction of the foreign body be desired, either when it is situated in the substance of the bone, or has passed through it, the surgeon is necessita- ted to empfoy the trephine, which, however, it is not requisite to apply but when it is evident that the presence of the foreign body menaces the life of the patient. Yet a favourable period should be selected for the performance of this operation. In the contrary case, where the foreign body does not and cannot in- jure any organ of more or less importance to the life of the individual, it should be left to nature. She at length operates by necrosis, followed by exfoliation, or by the decomposition of a superficial bony circle, which retains and covers the foreign body. The latter, being gradually liberated and expelled from its situation by a subjacent vascular deve- lopement, may be extracted by the least aid of art, and without any dif- ficulty. IN SAXONY. 115 left being divided, the extraction of the iron ball, which weighed seven ounces, was easily effected by means of a strong pair of forceps and an elevator. (It has been depo- sited in the cabinet of the school of medicine at Paris.) A large quantity of coagulated blood, which had accumulated in this part of the cranium, was entirely removed by a wooden scoop. The pia mater, covering the correspond- ing lobe of the brain, was in a state of ecchymosis, and the encephalon itself presented a depression from about three to four lines in depth. Having extracted several small fragments of bone, which resulted from the fracture of the upper wall of the frontal sinus, we placed on the wound a piece of fine linen dipped in warm sweet wine. The open space caused by the loss of substance, being filled with soft charpee, was covered with several compresses, and the whole of the dressings were kept in their situation by the bandage of Galen. From this period the patient was relieved, and enjoyed a tranquil sleep of nearly two hours duration. Towards the evening, however, he became hot and febrile, and ex- perienced acute pains in the head. He was bled copiously from the saphena vein, and the first dressing having been removed, a large emollient cataplasm was applied to the whole circumference of the wound. The patient was then placed on the use of diluent mucilaginous drinks, and anodyne and antispasmodic medicines. On visiting him the following day, I found his condition to be highly satisfactory, and unattended by any disturbance whatever in the sensitive functions. He, together with all the wounded in the same room, was put underthe special charge of M. Rousselle,* a well instructed and zealous surgeon- major, who informed me some time subsequently, and dur- ing our stay at Moscow, that this patient, having entirely recovered, was removed with other prisoners to Poland. This cure is remarkable in many respects. The second wounded Russian had been injured five days * This estimable surgeon is numbered among those whom we la- ment. 116 FIRST CAMPAIGN previously in the left temple by a leaden bullet. One half of this projectile had penetrated into the cranium, becoming flattened by passing through a narrow fissure, which was caused by its impulse. The remaining half had inserted it- self under the temporal muscle, as far as its posterior at- tachment, towards the base of the mastoid apophysis, at which point it had been arrested. The patient was labouring under hemiplegia of the right side; he had lost the use of his senses, and was in a con- stant state of perturbation. The wound in the temple be- ing laid open, and the point of fracture made bare, I dis- covered the course of the piece of lead, which had pene- trated under the muscle, and extracted it through a coun- ter-opening, made at the point where this foreign body projected. A trephine was applied to the lower part of the wound, and very contiguously to the part, where the other piece of lead had buried itself. I displaced it without difficulty, and extracted this foreign body, together with several splinters of bone, which were near it. Effused blood, to which I gave issue, was also contained between the crani- um and dura mater. The patient was at first relieved; but some days subse- quent he fell into a state of asthenia, to which he succumb- ed. It is evident that this operation, (trephining,) if per- formed at an earlier period, would have saved his life. A third individual, of the ex-guard, wounded in the battle of the Moskowa, entered the hospital of Chereme- tow at Moscow. The injury, under which he was labour- ing, presented nearly the same symptoms as occurred in the case of the last mentioned patient. It was caused by a ball, which, after having fractured the middle and posterior part of the right parietal bone, had become enclosed be- tween several bony fragments. These latter, propelled for- wards by the projectile, had been forced by it under the cranium. The ball, which was supposed entire, came out through the same aperture. It was thought sufficient, simply to lay open the wound and apply ordinary dressings. Symptoms of compression of the brain progressed slow- ly, and it was supposed that the patient would recover without an operation. But these symptoms became se- IN SAXONY. 117 vere, and placed his life in danger. The surgeon-ma- jor, M. Pierron, at this period directed that I should be sent for. Relying constantly on the resources of nature, they re- jected the operation of trephining, which we advised; the symptoms increased, and the individual died on the twen- ty-first day after the reception of the wound. The examination of the cranium revealed the fourth part of a ball and a splinter driven into the dura mater, the part of the brain, at which they were observed, having ulcerated quite extensively. It is probable, that if these foreign bodies had been extracted at an early hour, the pa- tient would have been saved. We have seen analogous cases, in which the trephine was indicated. This operation, however, was not performed for fear of departing from the principles of the celebrated Desault. who considered it as fatal. Indeed, we repeat it, should the foreign bodies be situated at a distance from the internal face of the cranium, so as to penetrate into the brain, it is better to abandon the patient to temporizing measures than to make examinations in the interior of this organ, as we have seen done by some practitioners. Proposition the Second. To point out those cases in which trephining, though generally recommended by authors, is unavailing, indeed injurious, and the means to be adopted, under some cir- cumstances, as substitutes for this operation. The trephine should not be applied in wounds of the head, accompanied by fracture of the bones of the cranium, whatsoever may be the extent of this fracture and the number of its radii, if the fragments of bone be not driven inwards, no foreign bodies present, or symptoms of com- pression not very evident. The brain suffers less from concussion in those instances of extensive wounds, with loss of substance in the soft parts, and fracture of the bones of the cranium, since the effects of the shock, caused by the wounding instrument, are expended on the external injured parts, particularly 118 FIRST CAMPAIGN when it acts in the diagonal direction of the vault of the cranium. In consequence of the internal parts in this case escaping lesion, the absorption of effused fluids is effected more speedily; the fragments of bone gradually approxi- mate, and the disease may be cured by the efforts of nature alone The trephine in such cases, without being at all beneficial, cannot but retard the cure of the patient. Were we desirous of entering into the details of the dis- advantages connected with the operation of trephining, as it is ordinarily performed, we would speak of the scraping of the bones as one of the most serious. This act, in- deed, lacerates the membranes much beyond the spot where the trephine is to be applied. It provokes or aug- ments the irritation of the neighbouring tissues, destroy- ing the osseous fibres. Necrosis is thus brought on in all the denuded portion of bone, and sympathetic symptoms, more or less alarming according to circumstances, as for instance, abscesses of the liver, (these latter will form the subject of another article,) are produced. But we should here confine ourselves to repeating, that it is not necessary to apply the trephine, but when the necessity for it is well perceived; and this necessity is established only when fluids are effused into the interior of the cranium, and frag ments of bone, or some other foreign bodies are injuring the brain or its membranes. The expose of the following facts will, moreover, determine, better than the most en- lightened theory, those cases in which the trephine is use- less, and even injurious. Case the first. On our way to Berlin, in May, 1812, M. ■------, having under his charge the clothing of the army, was thrown down by a carriage which was passing very near him. His head struck first against the sharp edge of a large stone ; the skin of the forehead, and all that covering the cranium, as far as the occipital protu- berance, was detached, so that this very large flap hung over the neck and ears. The head was totally denuded, and in several parts was deprived of its periosteum. A fracture, in the form of a star, was presented on the left frontal boss, and one of its radii extended to the parietal bone of the same side. There was neither depression nor displacement of the bony fragments. IN SAXONY. 119 This patient had not lost his reason since the period of his fall, though he bled pretty profusely from the nose and ears; primary dressings were afterwards applied to the wound. On the following day, this individual being very sick, was conveyed to the hospital of the officers at Charlotten- burg, where we saw him for the first time on the same day. The pains being acute and constant, were accompa- nied by delirium, mental aberration, and nervous move- ments. The pulse was contracted, and the face inflamed. Preparations had been made for the application of the trephine, which seemed to be indicated by the fracture to which we have alluded. This operation was suspended and we were engaged in dressing the wound. It became, in the first place, necessary to detach the flap, which had been applied to the cranium with too little care. Large masses of hair and charpee had been interposed between it and the head. Having shaved all the exterior surface, and remov- ed all the foreign bodies, we made several incisions in the contused and inflamed parts of the pericranium, and through the flap, one of these being situated at its base, for the pur- pose of facilitating the escape of the fluids. One incision corresponded to the fracture. The wound was washed with warm sweet wine, and the soft parts re-applied and maintained in their natural relations with the contiguous parts, by means of adhesive straps and a piece of fine linen dipped in the same liquid. The dressing of the wound was terminated by the application of charpee, compresses, and the bandage of Galen. The patient was bled from the foot, and cooling drinks, glisters, and pediluvia pre- scribed. The evacuation caused by the incisions in the flap and neighbouring injured parts, in conjunction with the means of which we have just spoken, removed the pains and deli- rium. ,The patient became tranquil, and continued in this state until night. But then, symptoms of inflammation were again developed and progressively augmented. Bleed- ing from the jugular vein, and mucilaginous, sedative, and antispasmodic drinks allayed them, and the patient was re- lieved. The remaining part of the night was calmly spent; but the two following days were again attended with dis- 120 FIRST CAMPAIGN turbance The intensity of these symptoms, however, di- minished, and a sero-purulent secretion was manifested on the third day ; the first dressings were removed on the fourth day. The flap had become adherent in many noints and suppuration began to be established in its whole circumference. A piece of linen was applied again, having on it the unguent of storax, with the view of facilitating the detachment of the sloughs, which were observed on the edges of the flap. The same treatment was continued. Pus was secreted in large quantities, the strength of the patient was diminished, and he was attacked by a febrile asthenic affection, which began with rigours, colicky pains, nausea, and extreme anxiety. A burning fever succeeded the cold stage, and was accompanied by thirst and pain in the head. We were called during this paroxysm, and pre- scribed mucilaginous drinks, acidulated and containing ice. The whole surface of the body was bathed with cold cam- phorated vinegar, and the camphorated unguent of storax was continued in the dressings of the wound. These alarming symptoms were gradually allayed, and the intermission was announced by perfect tranquillity, and a general cessation of these phenomena. Spontaneous vo- miting of bile and an involuntary evacuation occurred. This favourable moment was seized upon for the adminis- tration of an emetic, consisting of a scruple and a half of a strong and cold infusion of ipecacuanha and a grain of tar- tar emetic. This medicine was followed, without exertion, by copious emesis, and abundant and very foetid alvine eva- cuations. On the following night, a very violent paroxysm with delirium, and a pain fixed in the occiput towards the base of the flap, ensued. This pain was seated in that part of the head which had suffered most from laceration. The application of two cups, with scarifications, to the part, re- moved it, as if by a charm. The scarifications £yad the whole of the occipital region were covered with a double compress, dipped in camphorated wine containing ice. On visiting the patient the following day, all the symptoms of pyrexia had entirely disappeared. But his vital powers were very much debilitated, and every thing induced me to fear the approach of a pernicious fever. As there still IN SAXONY. 121 existed tension in the back of the neck and pain on moving the head, we caused a large blister to be applied to the part, and prescribed bark in substance in an infusion of arnica and Virginia serpentaria, with the addition of sul- phuric ether. The bark was given in drachm doses, re- peated every hour, and some small glasses of Hungarian wine were administered during the interval. The parox- ysm in the night was slight, and on the succeeding day, which was the nineteenth of his fall, the patient, who until then had continued in a state of stupor, resumed power over his senses. With the exception of some parts of the frontal bone, which appeared to be necrosed, the remainder of the wound, which was red and covered with large granu- lations, was disposed to cicatrize. Being obliged to follow the movements of head-quarters, which took up their march on the twenty-first of May, we put this patient, already liberated from danger, under the charge of M. Billequin, one of our surgeons of the first class, who had under his direction the hospitals established in Berlin. This surgeon-major subsequently informed us, that after our departure the patient continued to improve; that several small fragments of bone were exfoliated, and that the removal of one of these, comprising the two tables of the bone, left a part of the dura mater exposed. The wound gradually cicatrized, and M.-------left the hos- pital perfectly cured, the ninetieth day after entering it. We have seen this officer since our return from Russia; he was enjoying perfect health. A cicatrix of half a fin- ger's breadth extended in a circular direction from the frontal bosses to the temples, terminating on each side about an inch from the occipital protuberance, at the point where the flap terminated. He continued bald, and had almost totally lost the recollection of proper names. All the other mental faculties were sound, and appeared to be correctly exercised. This singular fact and cure are worthy of remark. Should the trephine have been applied in conformity with the opinion of authors and many surgeons who saw the patient, there is every reason to believe that he would not have survived the operation. Indeed, had the dura mater, which was doubtless inflamed by the third-day after the acci- 16 122 FIRST CAMPAIGN dent, been laid bare, and irritated by the trephine, it is probable that a gangrenous affection would have supervened. In cases of such a nature, this is the principal cause that counterindicates the operation. In those instances which demand its performance, and which we have pointed out, it should at least be deferred, should symptoms of inflam- mation exist in the cerebral membranes. Case 2nd. M. Giraud, chief of battalion of the ex-guard, directing the works in the explosion of a mine, was struck on the head by a large piece of rock as it was descending. One of its sharp angles divided the integuments of the superior and posterior part of the cranium, and caused a fracture, with several radii, at the posterior angle of the left parietal, and the superior of the occipital bones. The middle fragments were denuded of their periosteum, and the wound in the integuments was about two inches and a half in extent. The patient did not fall on receiving the blow, and was not deprived of his reason. Local pains only were expe- rienced by him. His mental faculties were not affected, and no symptom of compression of the brain was manifest- ed, nor was there paralysis of the opposite limbs. A slight traumatic fever supervened the third day after the accident. The attending surgeon in the mean time had resolved upon the application of the trephine, as the only means from which any advantage could be expected. Dr. Ribes and myself were consulted. Besides the symptoms of which we have spoken, the wound was found to occupy the whole posterior part of the head, with four irregular flaps, which had just been formed. A large part of the cranium had been laid bare, and a portion of it scraped. As no serious symptoms presented themselves, we judged it necessary to defer the operation, and proposed even to approximate the four flaps; and having washed and cleansed the wound, to cover it with fine linen, dipped in warm wine. The dressing was completed by the application of charpee, compresses, and the bandage of Galien. The patient was placed on the use ef sweetened lemonade and antispasmodic potions. The pains subsided, the irritation was gradually allayed, and the condition of the patient so much improved, that IN SAXONY. 123 the operation of trephining was abandoned. The dressings of the wound were renewed at suitable periods, and the same regimen continued. A few days subsequently, the army commenced its retreat to France. I lost all knowledge of this superior officer, and supposed him to be dead ; but, in the vicinity of Kowno, I found him during the night, lying in the house of an inhabitant of a village near this city, where I found shelter. His wound was progressing rapidly towards ci- catrization, and several small pieces of the bones of the cranium had been already exfoliated. This brave officer, who had the boldness to follow on foot the laborious marches of the army, had almost completely recovered on reaching ancient Prussia; here we again had an opportunity of seeing him, and dressing his wound. The cicatrix was large, ad- herent in nearly the whole of its extent, and presented in its centre a pretty considerable loss of substance. The sensitive and mental functions had experienced no alteration, and this commander enjoyed perfect health. A third case of this kind will be reported in the article on abscesses of the liver, following wounds of the head. These facts prove, that the operation of trephining is rarely indicated, and that it should not be performed but with the utmost circumspection in reference to the stage of the wound which requires it. We have pointed out those cases, in which we recom- mend this operation; it now remains for us to determine, at what stage of the wound it may prove salutary, and at what period dangerous. If a surgeon be called to a wounded individual during the first hours after the accident, he should take advantage of this moment to perform the operation, and thus extract the foreign bodies which are effecting a lesion of the dura mater or brain. Inflammation is generally established in the meninges after the first twenty-four hours succeeding the occurrence of the injury. Should it already be deve- loped, the trephine could not be applied without causing new irritation, which would be augmented in proportion to the extensive removal of the pericranium, and the increased number of perforations of the instrument. Finally, the 124 FIRST CAMPAIGN moisture, or unhealthy' state of the atmosphere, may also aggravate the effects of inflammation. The portions of the membranes that are laid bare, being inflamed, are quickly altered, and it rarely happens that they do not soon become gangrenous. We have seen several cases to this effect, and such is doubtless the cause which led Desault to the abandonment of this operation. In the latter case, the tre- phine should not be applied, until the inflammatory symp- toms are dissipated. The presence of the foreign body, whence result the effects of compression of the brain, is less dangerous than the attempts made during the existence of inflammation to displace or extract it. The death of the patient will ensue even more speedily than if he were abandoned to the resources of nature alone; for his dissolu- tion is inevitable, when inflammation and suppuration are deeply established in the membranes of the brain and its proper substance. We will repeat then, that it is necessary to apply the trephine, when it is strongly indicated, previously to the developement of inflammatory symptoms, which are mani- fested more or less speedily, according to the idiosyncrasy and age of the patient, and the nature of the cause produc- ing the wound ; and that when these symptoms appear, the operation should be delayed until their subsidence. Should this second stage not present itself, it is preferable to abandon the individual to his certain doom, than to at- tempt the execution of a remedial plan which is unavail- ing, and cannot but hasten his latter moments. The operation having been performed, a piece of fine linen, dipped in wine containing honey or sugar, together with soft charpee and a simple retentive bandage, should be placed in the perforation formed by the trephine, and over the whole wound. The balsam of Fioraventi and other re-percussive irritating fluids should be rejected from surgical practice. The dressings, consisting of simple means, should be applied tightly, and with the necessary precautions, so as to defend the wound from the external cold and humid atmosphere. The mucous and cutaneous secretions should be promot- ed, in order to divert the irritation and congestion from IN SAXONY. 125 the injury, or organs susceptible of sympathetic derange- ment. Cups with scarifications and diluent acidulated drinks perfectly fulfil this indication. Proposition the Third. To point out what is expedient to be done in hernia of the brain. Before entering upon this proposition, an important question, and one difficult of solution, naturally presents it- self; viz. to determine what causes hernia of the brain, through an aperture made in the cranium, either by some wounding instrument, or by the trephine. Without pre- tending to solve perfectly this problem, I will attempt an answer, which may lead to the truth. We have been enabled to observe in many individuals, that the irritation which is concentrated in the part of the brain corresponding to the opening in the cranium, may depend as well on the contact of the external air, as on the presence of foreign bodies. The encephalon, traversed in all directions by innumera- ble arterial branches, must undergo a spontaneous expan- sion, the effects of which become so much the more sensi- ble, as the walls of the cranium do not offer an equal re- sistance at all parts of its cavity. Thus, when a portion of these osseous parietes is suddenly removed, the corres- ponding part of the brain becomes exuberant, and a me- chanical irritation exercised from the exterior towards the interior, this expansion is increased, and hernia immedi- ately produced. The displacement of this exuberance gra- dually augments, and a tumour of greater or less size is formed on the exterior, exhibiting vital phenomena that are not observed in the healthy state. Pressure, exerted on these cerebral productions, gives rise to a feeling of pain in the whole circumference of the wound, and if it be con- tinued, the patient experiences nausea, and is subjected to pandiculations; the sensitive functions are disturbed, and syncope supervenes. Should this tumour be cut off, the same part immediate- ly furnishes a new exuberance, which, if removed, has another formed in its stead. These excisions, moreover, 126 FIRST CAMPAIGN cannot be made, without bringing on very serious symp- toms followed by death. . We saw one example of this in the armv in Saxony, during the year 1813. InTur visit to the hospital of the arsenal at Dresden, we saw one of our wounded, who had just been dressed, Te in horrible convulsions of a few minutes duration. We were informed that the surgeon, conformably to the advice Tf authors, had thought it necessary to cut off a pretty \Le part of the brain, which protruded through an open- L of about half an inch in diameter, resulting from the extraction of a splinter of bone. During the operation there had occurred only a slight syncope, preceded by a desire to vomit and to yawn. The> removal of the dress- ings indeed disclosed to us the excision of the part of the brain, external to the above mentioned aperture. Authors have recommended the exercise of pressure on these tumours, and some have proposed for this purpose nlates of lead. This method may cause the deve opement of serious symptoms, similar to the effects produced by the use of alcoholic and astringent liquids, since they all aggravate the irritation, and disturb the vital powers of that portion of the brain with which they are in contact What then ought the surgeon to do in a case of encepna- locele, formed through an accidental deficiency tn the bones of the cranium? . - , , . • It should be observed, that a large hernia of the brain is one of the most grievous accidents which accompany wounds of the head, and that individuals, labouring under it, rarely recover. The developement of these hernias pre- supposes an extreme exaltation of the irritability of the pia mater and cerebral vessels, and an extensive alteraUon Fn the encephalon itself. It is difficult, if not impossible, to remedy it, and the means recommended for repressing these growths, instead of being favourable to their return nto the cavity of the cranium, only develope the cause of hese exuberances. All the wounded, in whose case these remedies were employed, have been observed by us to perish; but one (the hernia however was not large) es caped the symptoms we have described! • The simole means alone, of which we are going to speak, were empWedlZ tumour gradually subsided, and the patient recovered. IN SAXONY. 127 The applications to the protruding portion of the brain should be confined to a piece of fine linen, dipped in the oil of chamomile, containing a small quantity of camphor. The causes of the interior excitement and external me- chanical irritation should be considered, and this increased action reduced by cooling drinks. All foreign bodies, giving rise to it, should be removed with the requisite precautions, and to as great a degree as possible. The injured parts should be defended from the external air, and, finally, the dressing executed with great mildness. No pressure ought to be exercised by the dressings on the sensible parts. When the encephalocele is capable of being reduced, na- ture, thus aided, gradually carries on her work, and the en- tire protruding portion of the brain returns into the inte- rior of the cranium, like the omentum which has escaped through a wound in the abdomen.* While speaking of serious wounds of the brain, we will report, in this place, the summary of two cases of injuries of the head accompanied with lesion of this organ. Al- though they have no reference to that on which we have just been discoursing, they have appeared to us of too in- teresting a character to be excluded from this chapter. During the campaign of Moscow, Barbin, foot-grena- dier of the ex-guard, was wounded by the lance of a Cos- sack in the posterior part of the head, near the point cor- responding to the union of the posterior and superior an- gle of the left parietal to the occipital bone. The iron point of the lance was so well tempered, that it penetrated through the bone without causing it to be shattered, pass- ed into the cranium, injured the posterior and left lobe of the brain, and buried itself deeply in its substance. The subject of this wound was left on the field of battle, supposed to be dead. He was, however, removed some hours subsequently, and conveyed to the neighbouring city; his sensitive faculties were for a long time suspended. * Though there is not a perfect resemblance between these two af- fections, we will endeavour to explain, by analogy, the mechanism of the reduction of the omentum, in the article on this subject. C 128 FIRST CAMPAIGN The wound was dressed, and passed through its stages, until cured, without any remarkable occurrence. The cicatrix continued sunken, and there existed at the corres- ponding point of the bone a loss of substance an inch and a half, or about this, in length, and half an inch in depth. The individual does not at present experience any pain in this part, and his intellectual faculties do not appear to be deranged. But it is evident, that this wound has affect- ed the functions of the nerves of the medulla oblongata or vertebralis, as .the glosso-pharyngeal, par vagum, hypo- glossal, spinal, and sub-occipital. In the first place, the voice, after having been hoarse and low, has gradually disappeared, so that Barbin has fallen into a state of complete asphonia. Deglutition is per- formed with difficulty; taste and smell are diminished ; the extrinsic and intrinsic muscles of the larynx are partly pa- ralysed, so that this organ is removed about half an inch from its natural position. The edges of the glottis are drawn together by this unnatural falling of the part, and the epiglottis is bent over this aperture, by the dragging force exercised on the aryteno-epiglottideal muscles. Thus, to respire, the patient standing up, is obliged to close his jaws tightly at every instant, for the purpose of raising the larynx by a simultaneous contraction of its elevator mus- cles, and those of the pharynx and maxillae, as is the case with frogs, in order to inhale the air necessary to their res- piration. The diaphragm of Barbin, participating in the paralysis, cannot act on the lungs. Frogs that are destitute of this muscular partition, supply its absence, as Heroldt* has ob- served, by closing their jaws, and it is probable, according to the experiments made before the Philomathic Society on this individual, that had his jaws continued separated for some seconds longer, he would have been suffocated, as are these animals, when they are subjected to the same expe- riment for some moments. The pharynx, oesophagus, and stomach, participate also in the paralysis, for deglutition is performed with difficulty, * Nouveau Diet. d'Hist. Nat. torn. X. art. Grenouille. IN SAXONY. 129 and tartar emetic, administered in large or small doses, has no effect on the stomach. Since the occurrence of the accident, no emetic operation whatever has been produced on this grenadier. The abdomen scarcely moves alternately and isochron- ously with the respiratory motions, as is observed in all persons. When the patient is subjected to the slight- est experiments which we perform on him, his face be- comes discoloured, his body covered with sweat, the cold habitually experienced by him in his extremities augments, the action of the heart is very tardy, and scarcely sensible, and the pulse almost absent. Barbin breathes better, and is more comfortable, in a horizontal position. His diges- tion is slow and painful, and he is obliged to eat often, and a little at a time, having recourse only to the lightest ali- ment. He is very much emaciated, and threatened with marasmus. Such, in general, are the phenomena which arose from this remarkable wound. Case 2nd. M. Derampan (Edward) an ex-officer of cavalry, about twenty-six years of age, having made the campaign in Russia, and received during it several slight wounds, was struck while fencing by a foil, (the point of which was broken against his plastron) March second, 1817, in the middle part of the left canine region, near the ala of the nose, in an oblique direction from below up- wards, and somewhat from the exterior to the interior. The instrument penetrated to the depth of three inches and a half through the left nasal fossa, and doubtless passed through the cribriform plate of the ethmoid bone, near the insertion of the falx major of the dura mater. It seemed to have been thrust in a vertical and somewhat oblique di- rection, from before backwards, to the extent of eight or nine lines, into the internal posterior part of the left an- terior lobe of the brain, so as to approach the front part of the corpus callosum. Very violent haemorrhage occurred on the infliction of the wound, and a considerable sanguineous effusion into the interior of the cranium probably took place. A short time afterwards, the subject of the injury fell into a state of syncope, and from that moment totally lost the use 17 130 FIRST CAMPAIGN his senses ; the activity of which has been restored, how- ever in a manner gradual, imperfect, and attended with re- markable peculiarities. Vision returned in a few days in the ri°-ht eye, whereas the left one was totally deprived of itfor°more than a month. By degrees, however, it has been entirely restored to both, but the patient even now sees objects double. The sense of smell having been there totally extinct, now exists on the right side, and the indi- vidual readily distinguishes, by this portion of the organ, the odour of alcoholic liquors from inodorous liquids. This sense, however, is still less active than on the left side. The patient also lost his taste, but in such a manner that the right half of the tongue possesses this power in a very considerable degree, while its left side is destitute of it. The whole of this organ is drawn to the right in opposition to the hemiplegia which exists on this side, and the com- missure of the lips is carried to the left part of the body. Hearing, which was at first destroyed in the ear of the side where the wound existed, was subsequently restored to it. The voice, which was also lost, has gradually returned, and there merely remains a slight degree of stammering. The organs of generation have undergone no change. The whole of the right side became completely paralys- ed. At present sensibility exists; motion, however, is still restrained, but improvement is plainly evidenced. The recollection of substantive nouns, which bore much analogy to proper names, was totally destroyed, and is not at present regained but with very great difficulty; whereas the memory of images, and every thing susceptible of de- scription, is in a state of perfect integrity. Thus, for in- stance, the patient recalled very readily the person and fea- tures of M. Larrey, whose services he had frequently re- ceived in different diseases and wounds. He knew him very well, and saw him constantly before his eyes, (ex- pressions used by the patient,) but he could never recollect his name, so that he designated him by that of M. Chose. He also forgot the names of his relations and friends,* and * The same fact was observed in the case of M. de Brbusonnet, pro- fessor at Montpelier, some time before his death, as well as in the per- sons of several other individuals. (See the eulogy of Cuvier.) IN SAXONY. 131 was entirely incapable of remembering those of the various pieces which enter into the composition of a gun-carriage, although he could very well describe them. The mental aberration to which this officer was subject, in the first instance, has ceased ; but every thing relating to his self-love, military successes, he. still causes an alie- nation of mind, (this may be called So^avia,) and gives rise to profound melancholy; while in conversations that refer to his family connexions and friends, he is perfect master of his intellectual powers. Proposition the Fourth. To inquire into the causes of abscesses of the liver, fol- lowing wounds of the head. Many hypotheses have been successively formed for the explanation of the causes of abscesses in the liver, conse- quent on injuries of the head and the sympathetic relations, which have been supposed to exist between the brain and hepatic viscus. These have been more or less accredited, according to the celebrity of their authors, or the period at which they lived. I shall not attempt to combat those which have already been discussed by the academy of sur- gery and by authors. I shall only make some reflections on the new doctrine, which appears to be most generally adopted at the present day. The celebrated author with whom it originated, refers the causes of abscesses in this organ to the direct or indi- rect blow, received by the liver, at the time that the wounds of the head are produced by the wounding instrument. To support this assertion, the author says, " that those injuries arising from the immediate blow on the head, in which the concussion is confined to the brain, and does not extend to the other viscera, are not complicated with abscess of the liver, an evident proof that the connexion existing between those affections must be attributed to the shock communi- cated simultaneously to the liver and brain." (Nosographie Chirurgicale, 4th edition, 1815.) This explanation is accompanied with several cases, and experiments made on forty dead bodies. 132 FIRST CAMPAIGN We shall confine ourselves to the following remarks: 1st All the cases do not appear to have an exact relation with the lesions of the head, at least, in the true sense of the question. Indeed, the subjects of the first two which the author reports, died during the twelve hours immedi- ately succeeding the accident. In their severe fall from a very elevated situation, the impetus of their bodies being directed against the right hypochondrium, the hepatic vis- cus, a dense and friable organ, was subjected to such vio- lence, that it must necessarily have been ruptured and la- cerated to a greater or less extent, while the integuments of the thorax and abdomen remained uninjured. This state of things resembles that produced by a spent ball in the soft and rounded parts, with which it comes in contact. The wheel of a carriage, passing over the same portion of the body, would produce a similar effect. But these disor- ders of the liver may occur in case of an individual's fall- ing without there being the least alteration in the cranium or brain. We have frequently observed this fact, and the lesion, either of the hepatic organ or encephalon, though arising from analogous causes, may exist very well in a separate state. Here we have an example to this effect. On the thirteenth of February, 1817, a domestic was con- veyed to the military hospital of Gros-Caillou, in conse- quence of a severe fall from his horse, in the trenches of the Champ-de-Mars. The weight of the body was exerted principally against the right hypochondrium, and the indi- vidual died a few hours after his entrance into the hospital. On examining the body the following day, we found the integuments of its whole surface uninjured, the abdomen swollen, the right hypochondrium much more elevated than the left, and an effusion of about two pounds of dark bilious blood in the abdominal cavity. All the viscera in the latter were inflamed, and two fissures were observed in the concave face of the liver, the whole body of which was reduced in size. The tissue of the corresponding ribs was softened, and was destroyed by the least effort. The intercostal muscles and right side of the diaphragm were in a state of ecchymosis. It is evident, that the almost sudden death which took place, should be attributed to laceration IN SAXONY. 133 of the liver; this almost always proving fatal, if it commu- nicates with the abdominal cavity. 2nd. The experiments made on dead bodies do not ap- pear to throw greater light on this question, which we will attempt to solve at another time. Can the causes of the phenomena, observed in bodies destitute of vital action, be applied to those in the living state? What must be thought of the concurrence of the circumstances, which affect a change, simultaneously, in the liver and brain, when, in cases of severe falls, followed more or less speedily by the death of the individuals, we have frequently found, on in- specting their bodies, the cranium and limbs fractured, and the liver still in a sound condition? Let us, for a moment, interrupt the succession of objec- tions suggested to us by the above mentioned hypothesis, and report succinctly three cases, which will prove, (contra- ry to the opinion entertained by the advocates of the me- chanical causes of abscesses in the liver,) the extreme diffi- culty with which this organ is disorganized by falls or blows, particularly when the weight of the body does not act directly and violently on this viscus. This circumstance, again, is very uncommon, for I have met with it only on one occasion. A young horseman of the ex-guard, in a paroxysm of delirium, threw himself from the window, in the second story of one of the halls for fever patients, in the hospital of Gros-Caillou, and fell on the pavement of the court. He expired some hours after being conveyed to the rooms appropriated to the wounded. The extreme debility, occasioned by the haemorrhage from his nose and ears, and the concussion of the brain, did not permit the per- formance of any operation. We saw the patient pre- viously to his death, which was preceded by convulsive movements. His body was carefully examined, with the view of dis- covering the disorder, which we supposed to be seated in the liver. There were observed ; first, a well marked se- paration between the parietal bones respectively, and be- tween these and the frontal bone; and, second, in the occi- pital, which had undergone no displacement, a splintered fracture, the radii of which extended in a diverging man- 134 FIRST CAMPAIGN ner towards the base of the cranium, and as far as the occi- pital foramen. The dura mater was detached in several points from the vault of the cranium, the brain sunken and congested with blood. The ventricles contained a large quantity of this fluid. Third, the right arm was luxated, and the elbow of the same side fractured. The left thigh, and sixth and seventh vertebra? were broken. On opening the abdomen, we were astonished at finding the liver and other viscera in a sound condition; the intes- tines were merely distended by gas. Blood in a small quantity was extravasated into the right cavity of the thorax, arising from the rupture of the vena azygos. The lungs and heart presented nothing remarka- ble. Case 2nd. Pierre Gerard, master-cook in the hospital of Gros-Caillou, returned home intoxicated during the night between the fourth and fifth of September, 1815. Being very warm, he seated himself on the edge of the window, in his chamber in the second story, with his back turned towards the court. He fell asleep in this position, involun- tarily inclined backwards, turned over, and was precipitated to the ground. On hearing the noise occasioned by his fall, they ran, and found him lying perfectly motionless and almost destitute of life. The two inferior limbs were shattered, and the right one, particularly, entirely disorganized. A superficial contused wound was also observed on the right temple, unattended with fracture of the cranium, and several violent contu- sions were seen on different parts of the body. We learn- ed, on visiting him the following day, that he had expe- rienced symptoms of concussion, and that there had been considerable haemorrhage from the anterior tibial artery, which, as was the case with the soft parts of the right leg, was lacerated by the separation and disorder of the bony fragments. Notwithstanding the extreme debility of the patient, we thought that the first indications could and should be fulfilled. Of these, the most urgent was the am- putation of the disorganized leg. This operation was per- formed at a point very contiguous to the knee, through the head of the tibia. The condition of the other limb, though the fracture was comminuted, being such as to inspire IN SAXONY. 135 us with hopes of saving it, we placed it in an apparatus appropriate to this injury. Embrocations with warm camphorated brandy were made over the whole surface of the body, and a proper regimen prescribed. The first three or four days were attended with' much disturbance; but the seventh day having elapsed, a calm succeeded the alarming symptoms, which, resisting until that period the remedies we employed, had deprived us of all hope of saving the patient's life. Suppuration was es- tablished in the stump, and became abundant, and in a few days the wound assumed a healthy condition. A traumatic fever, which might be looked upon as favourable, was developed, the individual continued to improve, and ap- peared with the most favourable symptoms, when he unex- pectedly died during the night of the seventeenth of Sep- tember, after having conversed a long time with the keep- er of the hall. This individual incessantly experienced pains in the epigastrium, accompanied with oppression and debility. Blisters and cups with scarfications were applied to this part. In the examination of the body the succeeding day, we found the abdomen tense and flatulent: the stomach and intestines were discoloured and distended with gas, and the mucous coat of the former presented, in some parts of its surface, marks of phlogosis. The liver and other vis- cera of the abdomen were in their natural state, and no- thing of a particular character was observed in the lungs. The ventricles of the heart contained yellow albuminous concretions, and were devoid of blood. The arteries were filled with gas, and the very small quantity of blood in the veins was black and coagulated. The vessels of the brain were slightly congested, and, at a point corresponding to the contusion on the temple, an ecchymosis of moderate degree, occupying a large part of the middle lobe of the right hemisphere, was perceived on this organ. The causes of death in this case may be re- ferred essentially to the concussion of the brain, the almost sudden atony of the intestines, the sinking of the nervous system, and the hemorrhage which occurred immediately after the fall of the patient. Case 3rd. This case, I think, will confirm the principles 136 FIRST CAMPAIGN which we have laid down, that hepatic abscesses, the sub- ject of our present remarks, do not result from mechanical causes. Frederic Habrer, baggage-soldier of the fourth regiment of cuirassiers belonging to the royal guard, aged thirty-four years, of a strong constitution, standing on a cart loaded with hay, for the purpose of tightening the rope employed for pressing down and confining the latter, was thrown upwards by the sudden slipping of the cord, which was un- hooked from the capstan, the transverse piece of the latter having escaped from the hands of his assistant. Being thrown some feet above the hay, he was dashed against the pavement of the street, where he continued for some mo- ments without evincing any symptoms whatever of life. He lay on his right side amidst the blood, urine, and faecal matter, arising respectively from the hemorrhage from his nose and ears, and the sudden and involuntary discharge of the urine and alvine contents. He was, however, taken up, and conveyed to the hospital of Gros-Caillou at seven o'clock in the morning, the hour of my visit ; it was the fifth of October, 1816. He was pale and discoloured, and was labouring under stupor, depression, and general paralysis. The whole of the right side of the face was ecchymosed, and the cheek very much tumefied. The nose was crushed, and a trans- verse wound was observed above the right eye-brow, accompanied with a radiated fracture of the frontal bone, very great swelling of the eye-lids, and total closure of the eye. The shoulder, arm, elbow, back, and particularly the buttock of the same side, were covered with ecchymoses and excoriations. There existed, for a short time, mental aberration and tremor in all the limbs. The patient had scarcely any pulse, and could not answer the questions that were pro- posed to him; in short, I saw his condition to be one of the greatest peril. In the first instance, heat was applied, and the whole of his head shaved and covered with compresses dipped in ver}r warm camphorated vinegar. I prescribed a mustard plaster to the feet, and an antispasmodic potion at night. These symptoms of concussion were soon suc- ceeded by those of inflammation in the injured parts and IN SAXONY. 137 the membranes of the brain, (the second day after the acci- dent.) I made deep incisions into the wound and laid bare the point of fracture. The external wall of the frontal sinus was divided into fragments resembling stars, and one of the radii extended some lines above this part. The branches of the frontal nerve, lacerated by the wounding instrument, were comprised in my incisions, and no unfa- vourable symptom occurred in consequence of it. But I guarded against scraping the bone for the purpose of re- moving the pericranium, (as authors advise,) seeing previ- ously that the trephine would not be necessary, since there were no depressed fragments of bone. It was requi- site to apply a ligature to the frontal artery. A piece of fine linen was placed over the wound, with the pre- caution to approximate its angles. Soft charpee, com- presses, and the bandage of Galien, terminated the dress- ings. The patient was placed on the use of cold diluent drinks, accompanied with the administration of purgative glysters and embrocations, with camphorated brandy on the parts labouring under ecchymosis. These primary means allayed the inflammatory symptoms, and the nervous spasm in which the patient was found. In consequence, however, of the acute pains experienced in his head, he was bled pretty largely from the jugular vein, and his legs placed in a warm mustard bath. Several cups with scari- fications were applied to the neck and epigastrium, and leeches to the right cheek, which was still very much tu- mefied. The inflammatory symptoms having, in the first instance, been dissipated, returned towards the fifth day with renewed intensity, and particularly those seated in the head. Cups, with scarifications, were again employed around the neck, and the saphena vein opened. We conti- nued the same drinks with ice, and had recourse to cold emollient cataplasms to the head. The antispasmodic po- tion was still taken by the patient at night. A state of calm finally supervened, and the individual, who, until that period, (the eighth day,) had remained in a stupor, and had been deprived of his sensitive func- tions, became repossessed of his senses, and asked for every thing he required. Chamomile tea was substituted for the diluent drinks, and I prescribed a theriacal vinous 18 138 FIRST CAMPAIGN potion at night, and broth, with a small quantity of wine. Suppuration was established in the wound, and pus was co- piously secreted. Several small abscesses, which formed successively in the lids of the right eye, and at the root of the nose, were opened. On the thirteenth day, the patient beino- in the most promising condition, symptoms of asthe- nia, attended by stupor and well marked gastric disorder, were suddenly developed. The secretion of pus was not diminished, but the colour of the matter was greyish, and the wound presented a bad aspect. An emetic, composed of 25 grs. of ipecacuanha, and 1 gr. of tartar emetic, was administered to the patient without delay. This medicine produced copious evacuations, both upwards and down- wards, which were followed by abundant perspiration and a perfect calm. The patient was still habitually somnolent, and constantly complained of pains in his head. As no symptom of paralysis in the limbs nor effusion under the cranium existed, I refused applying the trephine, though several physicians, who saw the individual, thought it to be indicated. The part of the head corresponding to the wound, by my direction, was covered with a large blister; and I prescribed for the following day, (the sixteenth after the accident,) the calisaya bark in decoction. The broths, strong wine, and aromatic embrocations were continued. All the alarming symptoms were speedily dissipated, the pa- tient progressively improved, and his sensitive and organic functions were gradually re-established. Several small frag- ments of the proper bones of the nose, and external wall of the frontal sinus were exfoliated; the wounds cicatrized pretty promptly, the vision of the right eye was not chang- ed, and this soldier was found in such a condition, as to be able to leave the hospital the first of December of the same year. This fact also proves, that the trephine is only ne- cessary in those cases we have indicated. Should the liver, as has been asserted, in consequence of a fall of moderate violence, be susceptible of laceration or alteration, so as to produce inflammation or large abscesses in its parenchyma, the subjects of the foregoing cases must have presented these changes in their greatest degree. But we frequently met with them, following slight wounds of the head without fracture, the individuals having had no IN SAXONY. 139 fall, nor been subjected to a concussion of sufficient vio- lence to impart a shock to the hepatic viscus. The weight, organization of this gland, and the situation it occupies in the abdomen, have been artfully cited to sup- port the hypothesis of the changes, which have been so gratuitously supposed to take place in it. Nature, in this respect, has been accused of negligence. But in relation to this organ, as to all of the living system, she has, on the contrary, regulated so well her designs, and taken so many precautions, that, except by a direct and truly destructive action upon it, the liver is not more liable than any other organ to be detached, ruptured, or altered in consequence of a fall, or any other indirect mode of exerting force upon it. Whatever, moreover, may be the state of the stomach, the individual will never lose his equilibrium, and this as- sertion could be proved without difficulty, did not daily ex- perience exempt us from such an undertaking. 1 have made some similar remarks on the subject of spontaneous rupture of the arteries, to which it has been pretended to refer the essential cause af aneurisms, even of those that are internal. But it is time we should enter upon the question, of which we are going to attempt a solution, viz. to determine the causes of the formation of abscesses in the liver, follow- ing wounds of the head. Some modern authors, and particularly Desault, have had a, presentiment of these causes, without having deve- loped them. We have, for a long period, had occasion to observe, that the functions of the pulmonary and bilious organs, especi- ally the latter, are disturbed, and signally influenced by the phlegmasia^ of the fibrous membranes of the head or limbs, chiefly of those parts which have the most direct correspondence with these viscera. It appears, that irrita- tion, established in one portion of these membranes, is ra- pidly propagated by sympathy towards the centre of the organs supplied with the nerves of internal life. The li- ver, as being the most complex viscus, and that in which the capillary circulation is least active, and the filaments of the intercostal nerve most numerous, seems to be more lia- ble to the effects of this sympathetic irritation. Its vital 140 FIRST CAMPAIGN properties are soon impaired, inflammation is established with more or less promptness and intensity, and abscesses are in consequence, readily formed. The purulent col- lections, when they once occur, contribute doubtless to the death of the patient. They will be capable of destroying him at a later period, should he resist the primary or trau- matic inflammation. We have seen many individuals, la- bouring under wounds in the gynglimoid articulations of the superior or inferior extremities, die in consequence of abscess in the liver, formed, probably, after the superven- tion of inflammation in the wounded parts.* Previously to entering into farther details on the causes of the formation of abscesses in the liver, we will report some cases, which will doubtless suffice to fix the opinion of practitioners. Case 1st. One of the Prussian soldiers, treated under our immediate observation in the royal hospital of Gros-Cail- lou, in the course of June, 1814, had laboured, since the battle of Paris, under two fistulous wounds in the middle of the right arm, accompanied with loss of substance in the humerus and a false articulation. The two fragments appeared to be rounded on their surfaces, so as to be capable of gliding one upon the other. Both the limb and the patient were in a pretty healthy condition. With the view of causing the union of the bony fragments, a seton was employed in the treatment of this false point, consti- tuting a remedy that originated with the English,! and has been extolled by some French writers. (See the learned Dissertation of Doctor Laroche.) By means therefore of a seton needle, a small piece of tape was passed through between the two portions of bone. Inflammation supervened before the fifth day, and pro- * It is also possible that fluids more or less heterogeneous in their char- acter, furnished by the wound, may be conveyed to the liver by the cel- lular tissue, and to these traumatic causes are added the sudden suppres- sion of perspiration, that of the more or less abundant alvine discharges and the disposition to disease in the hepatic organ. -j- Baron Larrey is in error on this point. Surgery is indebted for this valuable invention to the genius of the celebrated Physick, who had re- course to it first in 1802. See Dorsey's Elements of Surgery. Tb. IN SAXONY. 141 gressed with rapidity. The two osseous fragments, and surrounding soft parts, were so much tumefied, that the engorgement extended as high as the shoulder, and as far as the fingers. Very acute pains in the right hypochon- drium, accompanied with difficulty of breathing, oppression, and a very violent traumatic fever, were soon added to these local symptoms. On seeing the patient in this con- dition, our first object was to extract the seton, to apply emollients to the affected member, and cups with scarifica- tions to the hypochondrium, with the employment, finally, of cooling and antispasmodic articles. These means proved unavailing, the symptoms increased in violence, and gan- grene was established in the two wounds of the arm, the size of which was much augmented; the individual expe- rienced at the same time lancinating pains in the region of the liver. We perceived, a few days subsequently, on the edge of the false ribs, a projecting fluctuating tu- mour, presenting, moreover, all the symptoms of abscess in the liver. The extreme debility and decline of the patient did not warrant a recourse to the means indicated for the affection of the arm and liver. He died twenty-four hours after the invasion of the symptoms. The dissection of the arm, on the following day, revealed a profound and extensive in- flammation in the membranes of the bony fragments, in which it had evidently commenced. Purulent collections extended along the arm as high as the axilla, and under the pectoral muscles. The examination of the abdomen disclosed to us a very large abscess in the substance and centre of the large lobe of the liver, on the eve of opening into this cavity. It is very certain, that these abscesses arose from the irritation and inflammation of the arm, since, until that pe- riod, the patient had laboured under no disease which could cause any suspicion of the least hepatic alteration. The three following cases are those of three soldiers of the ex-guard, who, in 1811, were successively conveyed to the hospital of Gros-Caillou, in order to undergo treatment for sabre wounds received in duels. Case 2nd. A young horseman was brought to the hos- pital, labouring under a wound inflicted by a sabre, which 142 FIRST CAMPAIGN had removed, together with the integuments, an oval piece, about an inch and a half in length, of the external table and diploe, from the middle part of the right parietal bone ; the internal table was uninjured. This wound was treated as a simple one. It was covered with a pledget of linen dipped in warm sweet wine, and confined by compresses and a suitable bandage. The patient was subjected to a cooling regimen. The first ten days were spent without any occurrence of note; but on the eleventh, the suppura- tive process ceased, the edges of the wound became red and swollen, and fever supervened, accompanied by head- ache, tinnitus aurium, delirium, burning thirst, deep pain and oppression in the right hypochondrium. We caused leeches to be applied around the wound, and cups with scarifications to the temple and right hypochon- drium ; the head was covered with an emollient cataplasm. Pediluvia, enemata, and sweet diluent drinks were em- ployed; but, notwithstanding the use of these means, in- flammation continued to progress with rapidity. The pains in the side were lancinating and constant. The patient soon experienced rigors and cold sweats, preced- ed by paroxysms of fever of a pernicious tendency. He finally died during the night between the thirtieth and thirty-first day after his wound. The body was examined on the following day. We found the pericranium so much inflamed, that one would have supposed the vessels injected with a fine fluid. The part of the dura mater, corresponding to the internal wound, was red and tumefied. The brain exhibited no marks of disease, and its ventricles contained little serosity. We pursued our inspection in the thorax and abdomen. In the latter cavity a pretty large quantity of purulent matter was effused, which issued from a very large abscess in the convex part of the liver. The seat of suppuration extended into the proper substance of this viscus. The cause of the death of this patient may be referred to this double affection, and particularly to that of the liver. Case 3d. A few days subsequent to the dissolution of the subject of the preceding remarks, a dragoon of the guard was conveyed to the hospital of Gros-Caillou, la- IN SAXONY. 143 bouring under a wound of the head inflicted by the cut- ting edge of a sabre. A portion of the integuments, and a pretty thick lamina of the lateral part of the right occipi- tal bone, had been removed by the instrument. The in- ternal table was not injured. This dragoon did not fall on receiving the blow. His wound having appeared slight, he had been located in the hall of the convalescents, and put under the charge of the surgeon of this room. Simple dressings were applied, and nothing of a particular character occurred during the first fifteen days. The wound was in a very good state, and commenced cicatriz- ing at its edges, when symptoms of inflammation were suddenly developed, and the right hypochondrium became painful. At first, no attention was paid to these phenom- ena, and they thus progressed with so much rapidity, that the fever was violent, and the inflammation in the edges of the wound assumed the utmost intensity. The pains in the side were also rendered more severe and pulsating. No disturbance in the functions of the brain and no symptoms of effusion were manifested. Such was the condition of the patient, when we were called to him. Local bleedings, cooling laxatives, pedilu- via, and antispasmodics merely produced momentary and slight relief, and he died on the thirty-seventh day after his entrance into the hospital. The body being examined twenty-four hours after death, we observed that there had existed, 1st, a very violent inflammation in the pericranium, the bone that had been cut, and the corresponding part of the dura mater, which participated in this affection; 2nd, A pretty large abscess in the concave'face of the liver. A portion of the purulent matter had already been effused into the cavity of the abdomen. Case 4th. A foot grenadier entered the hospital a short time after the above mentioned soldiers. He had received a longitudinal wound in the right lateral part of the forehead, caused by a sabre, which had divided the external table of the os frontis as far as the diploe. There were in the first instance some symptoms of con- cussion; but the subject of the injury did not fall under the stroke, and was not deprived of his reason, until some 144 FIRST CAMPAIGN moments subsequently, while in a tavern near the place of combat; he had repaired thither for the purpose of be- ing dressed. The first ten days elapsed without the occur- rence of more symptoms; at this period, however, the pa- tient complained of an acute and constant pain in the bot- tom of the wound, in which suppuration had been sud- denly arrested. Somnolency, interrupted by convulsive movements, and slight attacks of delirium prevailed, and he experienced, at the same time, oppression and a dull incessant pain in the right hypochondrium. Local deple- tion, and the use of diluents, mucilaginous and emollient substances applied exteriorly, moderated the inflammation. But independently of the symptoms pointed out, those of compression were developed, the patient had already lost the use of his left arm, and the leg of the same side was almost constantly in motion. Although he suffered very acute pains in his wound, he had a continual inclination to lie on the same side. The unnatural projection of the hypochondrium, the pul- sating pains, irregular rigors, and frequent desire to vomit, characterized sufficiently well the aggravated disease of the liver. In order to fulfil the indication presented by the com- pression of the brain, we applied a trephine to the lower part of the seat of fracture. The perforation having been effected, there issued through it a common spoonful of pu- rulent matter, mixed with small clots of blood. This fluid was situated between the cranium and dura mater, which latter was depressed from about five to six lines. A blister, composed of cantharides and camphor, was applied to the region of the liver, and the proper regimen continued. The patient experienced a momentary relief; but this apparent calm was of short duration, for it was soon super- seded by symptoms of well marked asthenia; such as pros- tration of strength, cold sweats, small pulse, colliquative diarrhoea, tumefaction of the abdomen, difficulty of breath- ing, and gangrene of the liver. Death soon succeeded this sinister group, and it was a source of much regret to me, that I thus had an opportunity of confirming my opinion as to the causes of hepatic abscesses supervening on wounds of the head; for the subjects of the latter had been sub- IN SAXONY. 145 jected to no fall or violent concussion. And, on examining the abdomen of this patient, we found a collection of puru- lent matter situated above the transverse mesocolon; it was furnished by a very large abscess in the greater lobe of the liver, very near the suspensory ligament. The inspection of the cranium disclosed, besides the sup- purating point of the dura mater, inflammation of this mem- brane and the pericranium, together with suppuration of the part of the brain corresponding to it. It should be observed, that none of these wounded indi- viduals fell, even under the strokes they received. The last three, moreover, according to their own account, en- joyed excellent health, previously to the accidents which occurred to them. Doctor Aumont, one of the superior assistants in the hos- pital, examined the bodies of two subjects of the latter cases. To recapitulate what we have said respecting the causes of hepatic abscesses following wounds of the head, we are of opinion : 1st. That these abscesses are but very rarely essentially owing to a blow, or direct pressure exercised on the liver, by the fall of.the person injured, or by any contusing body, which may have acted violently on the right hypochon- drium;* 2nd. That the origin of these abscesses should be referred to the sympathetic irritation, experienced by the viscus in which they are seated, in consequence of the inflamma- tion established in the fibrous membranes of the cranium, or bones of the superior or inferior extremities, particularly those of the same side, and the determination towards this viscus of the ichorous miasm, or a fluid more or less acrid and subtile. 3d. It appears, finally, that the communication of the morbific principles of the injured parts with the liver is * Should the weight of the individual's body happen to be exerted in his fall against the right hypochondrium, the liver may undergo some change, and perhaps be lacerated. But this change would then be to- tally independent of wounds of the head, as we have shown. 19 146 FIRST CAMPAIGN more easily effected, when they are not forced to traverse the median line of the body. These causes and facts, which we have reported, appear to solve the important question, considered in the preced- ing remarks. We may, at least, suppose ourselves to have marked out the track to be pursued by those practitioners, who shall wish to verify the principles which we have advocated. To conclude my reflections on wounds of the head, I will make a few observations on the manner of treating those caused by fire-arms and polished weapons, which in- jure only the membranous envelopes of the cranium, with- out producing a fracture in this latter part.' All wounds of the head by polished weapons should, in general, be reunited, but in such manner as not to exert too great a degree of traction on their edges. A piece of fine linen, dipped in warm wine containing sugar or honey, is the best retentive application for ordinary cuts. Should the wound, however, be very extensive, or be complicated with flaps, adhesive plaster ought previously to be employ- ed, and in some of these cases sutures are indicated; such, for example, are wounds with large flaps thrown back- wards, formed of the posterior parts of the head. The su- tures, in these instances, should be preceded by the forma- tion of a counter opening in the base of the flap, for the purpose of facilitating the escape of fluids, and should be aided by the bandages indicated. Nearly the same treatment must be pursued in con- tused wounds of the same parts, viz. after having shaved the head and removed the foreign bodies, if any be present, they should be covered with linen dipped in a tonic liquid, such as wine, vinegar and water, or salt and water. It is not necessary to lay them open, unless there be culs-de-sac in some parts of the wound, or lacerations or severe contu- sions of the periosteum; simple dressings are preferable. Muscular power is almost totally lost, and the integuments of the head are slightly irritable; the laying open of the wounds is then of slight utility; they are, however, more speedily cured by it. Wounds of the ears also demand particular attention, Should the external part of this organ be divided in its IN SAXONY. 147 thickness, it matters not in what direction, the edges of the wound should be speedily approximated by means of the interrupted suture, made with needles of my model, and of relative size. This suture should be protected by an ap- paratus or bandage, which would fill up the inequalities of the ear, and maintain it in a proper position. Whatsoever may be the extent of the division, provided the cut portion adheres to the remaining part of the ear by the smallest at- tachment whatever, re-union is accomplished in a perfect manner. The same rules are applicable to wounds of the eye-lids, nose, and other parts of the face. The manner of treating these latter wounds has been already pointed out in dif- ferent articles of my Campaigns. Of the wounds of the-face, caused either by cutting or contusing instruments, some are of a very remarkable cha- racter. I have already spoken of those, in which nearly the whole of the nose was cut off, in such a manner as to remain attached to the remainder of it merely by an ex- tremely minute pedicle, and still re-union took place. When the parietes of the mouth are divided by any in- strument, whether cutting or contusing, after having ren- dered the wound a simple one, it is necessary to approxi- mate its edges by a suture, which should be assisted by bandages. Several cases of the successful performance of this operation, even in gunshot wounds, have been report- ed in my Memoirs. I will, however, subjoin that of one of the body-guard, treated in the military hospital of Gros- Caillou. M. de R------, one of the king's body guard, labour- ing under a severe gunshot wound of the face, was con- veyed to the hospital of Gros-Caillou, during the winter of 1815. This individual appeared to be dying when I paid him my first visit, twelve hours after the accident. A pis- tol*barrel loaded with two balls, applied to the palatine arch, and embraced within its circumference by the lips and jaw, was turned slightly forwards at the moment of the discharge, from which resulted a very violent explosion in the cavity of the mouth, and the escape of two balls ex- ternally through the arch of the palate and the nose. The anterior half of the former was destroyed, and the bony 148 FIRST CAMPAIGN septa of the nasal fossae, together with the part separating these from the cavity of the cranium, were broken into pieces. The exterior surface of the nose was divided into three flaps, a middle one formed of its extremity, and the septum beneath, and the remaining two by the alae of this eminence, and the corresponding portion of the lip. The middle of the latter was totally wanting, and a void space of about two inches in circumference existed; its edges were ragged and turned over. The velum palati and base of the tongue were cleft in a parallel direction from before backwards ; and the left wall of the mouth presented an opening filled with coagulated blood. Every part of the face and neck was tumefied, and contained spots of ecchy- mosis, and vision was obstructed in both eyes, in conse- quence of the swollen condition of their lids. The re- maining sensitive functions were also suspended. The pulse, almost entirely absent, was nervous, and the patient in a permanent state of convulsion and anxiety ; in short, every thing induced us to fear a speedy dissolution. It was, however, a matter of urgency to examine all parts of the wound, for the purpose of extracting foreign bodies, and simplifying it, as much as possible, with the view of causing the more or less exact reunion of its edges. Having prepared suitable dressings, I proceeded, in the first place, to the removal of'several bony fragments from the palate and nasal fossae. Some portions of the edges of the wound were laid open, and those parts removed which were irregular, or had suffered from attrition. I afterwards inserted eleven points of the interrupted su- ture, in order to reunite with accuracy the three flaps of the nose and the uneven and very widely separated ed°-es of the upper lip, taking care to include in the middle part the under septum of the nose. Several intervening su- tures were employed, in order that the most exact relation might exist in every portion of the wound. With «he view of promoting the approximation of the two maxillary bones, I fastened a platina wire around the two canine teeth, where the loss of substance ceased. Two pieces of large gum elastic catheters were introduced into the nose, to the extremities of which I attached thread for the pur- pose of maintaining them in this position. These canulae, IN SAXONY. 149 while aiding in the transmission of air for the purposes of respiration, contributed greatly to the preservation of the form of this organ. Small graduated compresses, placed on its sides and in the canine fossa?, and bound.down and sustained by a retentive uniting bandage, completed this difficult and tedious operation. Scarcely was it terminated when the patient experienced relief, and the nervous symptoms, indicative of tetanus, were immediately allayed. I took advantage of this mo- ment of calm to place him in a warm semi-bath, and ad- ministered, by means of a sucking-bottle, cooling anti- spasmodic drinks containing ice. Deglutition was per- formed with extreme difficulty; but by dint of care and patience, it was gradually restored. The night was pass- ed in a pretty tranquil manner; on the following day, however, febrile action, which may be called traumatic, was developed, together with symptoms of head-ache and approaching suffocation. The application of a dozen leeches around the neck, and cups with scarifications to the back of the same part and to the thorax was with eagerness put in practice; the patient was also bled from the foot, and the same drinks and purgative enemata con- tinued. All the symptoms were speedily dissipated, and the in- dividual recovered the power of his senses, with the ex- ception of that of smell, of which he is destitute. The dressings were not removed until the eighth day; the wounds had united very uniformly and almost entirely. Some adhesive straps sufficed for perfecting their cicatriza- tion; but an abundant secretion of pus, followed by the exfoliation or removal of several splinters of the proper bones of the nose, the ossa turbinata and a part of the maxillary bone, hollowed out by the balls, took place from the interior of the nasal fossae and the arch of the palate. The destruction of the osseous vault of the nose produced an increased flow of tears in both eyes, with fistula lachry- malis, caused by the displacement or momentary obstruc- tion of the nasal canal. The use of the catheters, of which we have spoken, the daily replacement of the bony frag- ments near the root of the nose by means of a sound, and injections into the puncta lachrymalia with Anel's syringe, 150 FIRST CAMPAIGN re-established the course of the tears, and the fistulae disap- peared. The two maxillary bones also gradually approxi- mated each other so as to obliterate the communication between the mouth and nasal fossae, and to render the pos- session of an obturateur by the patient unnecessary. In fine, after an attention of two months and a half contin- uance, M. de R-------was restored to his family, in very good health, and without any sensible deformity. Wounds of the Throat. Two individuals received gun-shot wounds in the throat, in the battle of Dresden, in whom some singular phenomena were presented. The first was an officer of light infantry. The wound occupied the left side of the larynx. It extended obliquely downwards and inwards, in the first place, under the thy- roid cartilage, which appeared to me to be slightly scoop- ed out. Its course seemed to be continued, then, under the trachea towards the thorax, where the projectile was lodged. This patient suffered from a constant compres- sive pain, accompanied with difficult respiration ; his face was always red, and all parts of his neck in a state of en- gorgement; it was impossible for him to accomplish the deglutition of solid aliment, while liquors were swallowed with difficulty. We were incapable of discovering the true seat of the ball, either by the sound, or any other method. The pa- tient continually pointed to the cricoid cartilage, as the point at which it was situated, and believed he felt it on assuming certain attitudes ; my examinations of this part were unavailing. In order, however, to explore every portion of the larynx corresponding to the wound, I adopt- ed the plan of laying it open, both upwards and down- wards, notwithstanding the contiguity, of the branches of the thyroid artery. No advantage was derived from this method; the foreign body could not be discovered. I could not suppose it to be contained in the proper cavity of the larynx ; for, if such were the case, the patient would have laboured under more serious symptoms, which would IN SAXONY. 151 have proved fatal. He did not lose the power of speech, and experienced no mark of suffocation. I was induced, by every circumstance, to believe that the ball had been ar- rested behind the trachea, at the posterior part of its bifur- cation. Indeed, a few days subsequent, this body pre- sented itself at the bottom of the wound, where we were so fortunate as to seize it with forceps, and extract it. From this period the patient continued to improve, and quickly left the hospital, perfectly cured. Jacques Brisnot, the second individual, was a junior sharp-shooter of the guard. He was wounded the day be- fore the battle of the twenty-seventh of August, and was one of a small number of patients of this character, under the charge of M. Emangard, one of our surgeons-major. The danger of his situation was indicated by the very great embarrassment with which he breathed; his speech was nearly extinct, and he suffered the agonies of death. Res- piration was scarcely carried on, and some bubbles of air, with a large quantity of frothy blood, escaped with diffi- culty, through a gunshot wound in the left side of the la- rynx, between the thyroid cartilage and os hyoides, which latter was fractured. The ball traversed the throat, and made its exit behind the angle of the jaw. The patient lost much blood, and was nearly suffocated, in consequence of that contained in the cavity of the larynx; the epiglottis cartilage had been removed, and the thyroid cut. The at- tending surgeon-major hesitated as to the manner in which he should proceed to promote a restoration of the functions of respiration, and to cause the blood effused into the la- rynx, to issue from it. The very happy idea, however, of cutting the thyroid cartilage, occurred to him. At that moment, the air rushed with violence from the bronchia, and pushed before it the clots of blood, which filled this canal, and were about to cause the suffocation of the patient. The surrounding parts were relieved from their congested state, respiration re-established, and the life of the patient no longer in danger. The wound gradually assumed a healthy condition, the functions were successively per- formed with more regularity, the edges of the wound ap- proximated, the cicatrix pretty speedily completed, and 152 FIRST CAMPAIGN the patient cured in a very short time; merely a slight degree of aphonia remained. This case proves the necessity of giving free vent to matters retained in the cavity of the larynx. In order to fulfil well the indication presented in contused wounds of this organ, with penetration of it, and extravasation of fluids, or the presence of foreign bodies, it is better to en- large the wound on the side of this cavity towards the tra- chea, like the celebrated Spanish surgeon Virgilii, so far as the principal surrounding vessels or nerves permit, than to make an opening at one of the points selected for the performance of laryngotomy and bronchotomy. There would, in such a case, be two apertures in the larynx in- stead of one, and the functions of respiration be thus in- jured. The passage of balls into the muscular and lateral parts of the neck, howsoever superficial may be the track form- ed by them, has almost invariably given rise to paralysis of the arm, of the same side. Experience has taught me, that the laying open of the wound, executed with care, immedi- ately after the accident, prevents this paralytic affection, doubtless because the nervous branches, lacerated or ruptur- ed by the projectile, do not, as in the contrary case, con- tract too close adhesions at the depressed portion of the cicatrix, whence results an alteration in the vital proper- ties of the injured nerves, and those with which they are connected. In consequence, also, of the binding force and compression exercised upon them, their sensibility is de- stroyed, and paralysis is developed and propagated to all the parts to which the affected nerves are distributed. Moxae, however, applied to the cicatrices, and along the course of the primitive branches of these nerves, restore their functions, and dissipate the paralysis. The employ- ment of this remedy, in the treatment of this disease, has proved successful in many instances. The mode of using it is pointed out in another article of my Campaigns, and in the Dictionnaire des SciencesMedicales under the head of Moxa. IN SAXONY. 153 Wounds of the Thorax. Numerous penetrating wounds of the chest have given me an opportunity of verifying the advantages of the precepts, laid down by me, for the treatment of these injuries. (See Tome III. of my Campaigns.) Those, that were accom- panied with emphysema, exhibited some singular pheno- mena, which were particularly observed in the case we met with at Wilna, on our passage into Russia. I will re- port in this place two very remarkable cases of two sol- diers, from each of whose chests we extracted a ball, and will make some reflections on the effects of the pre- sence of this projectile in this cavity. These reflections will follow the memoir relating to the operation for empye- ma, contained in Tome III. of my Campaigns, page 442. I believe I am the first who has made known, through the above mentioned memoir, the mechanism by which nature, aided by art, cures an individual who has been operated upon for empyema in consequence of the exist- ence of a fluid in one of the thoracic cavities. In this paper, the circumstances are described, under which the patient offers the resources necessary for attaining the desired end, and the prognosis thus possesses a degree of accuracy not found among authors. I have here, also, pointed out the changes experienced by the viscera and parietes of the thorax during the accumulation of the fluid, and those which attend and follow its removal, until a perfect cure is accomplished. The cases I am here going to report, while justifying the principles established in my memoir, appear to me to be proper guides for young practitioners, in the new track they will have to pursue, for the extrac- tion of foreign bodies from the thorax, where it would have appeared impossible to effect this object. Should some of the large number of soldiers, labouring under gunshot wounds penetrating into the thorax, and accompanied by lesion of its organs and loss of the projec- tile in one of its cavities, escape the generally fatal accidents attendant on these injuries, they are greatly troubled by the presence of these foreign bodies, which keep up in the 20 154 FIRST CAMPAIGN part they occupy an inexhaustible supply of purulent mat- ter with empyema, or a collection of this fluid. If the wound, made by the ball in its passage, remain open and fistulous, the pus flows through it with greater or less difficulty, according to its situation. The prognosis is thus rendered more or less alarming. In all cases, from the first periods, nature labours for the expulsion of the foreign body, or endeavours to prevent its impeding the functions of the parts with which it is in contact. Under the former supposition, this body is de- tached by the suppuration occurring in the point where it was at first arrested, and is carried by its weight to the most inferior situation; the suppurative process is carried on along its whole course, and its progress is continued, until it meets with resistance, and finds a point of support, the sensibility of which is not susceptible of exaltation. A new seat of purulent secretion is, however, established, and keeps up fistulae, or constitutes empyema of proportional extent. This operation cannot take place, and the patient expe- rience no pain and febrile affection, caused by the absorp- tion of a morbific principle; hence emaciation, marasmus, and death. When, on the contrary, the ball cannot fall into the pro- per cavity of the thorax, it becomes fixed in the substance of its parietes, sometimes insinuating itself between the muscles, gets into the intercostal space, is stationary in this position, and may there remain for a pretty long period, without giving rise to any remarkable symptoms (I have seen several such examples); it rarely makes its way externally. Suppuration once occurring, the foreign substance, which causes it, continues moving about in the cavity of the tho- rax, and the patient will perish, if relief be not promptly afforded. Previously, however, to putting any measures in execution, the presence and respective position of the projectile should be well ascertained. In the first stages of the disease, the ball may pass through the inferior inter- costal spaces; but when the parietes of the thorax are contracted, the ribs are so nearly approximated, that these IN SAXONY. 155 intervals can no longer give passage to it, particularly if it be of a large size. The surgeon is then obliged to enlarge the intercostal interval, selected as the most favourable for the introduc- tion of the proper instruments for seizing the foreign body and extracting it without much exertion. To accomplish this object, a part of one of the ribs should be removed; but must the saw, trephine, or some other means be em- ployed for this purpose? The saw, howsoever modified, and the trephine, whatever may be its size, are equally in- applicable, in consequence of the round form of the rib, and its very great contiguity to the one in its immediate vicinity. It merely remains then to divide the rib, and this is done with more facility than would be supposed, particularly if the patient be not too far advanced in years, by employing a lenticular knife, which is one of the instru- ments used in trephining. The two cases 1 shall report will justify these rules, and make known the progress of the symptoms produced by the presence of foreign bodies in the thorax, and the pheno- mena observed after their removal. The latter are similar to those which I have described in my memoir on the ef- fects of the operation for empyema; viz. the cause of the suppuration no longer existing, the parietes of the seat of the pus assume a healthy condition, and are approximated by the contractility, elasticity, and power of the tissues. These tissues are developed in all directions, and the sur- rounding parts, more or less remotely situated, co-operate in this work. The cavity is gradually obliterated by the enlargement of the capillary vessels of the pleurae, medias- tinum, diaphragm, and perhaps also a part of the lung. The intercostal muscles, the action of which becomes of no consequence, lose their contractile power, the ribs approach each other, the cartilages are deprived of their curvature, and depressed towards the thoracic cavity; the nutritive pro- cess in the sternum and ribs undergoes such a change, that these bony arches, having lost their curvature, augment in thickness and assume a cylindrical form, thus contributing to the reduction of the vacancy. In fine, all the organizing forces concur, by this work of convergence, to obliterate gradually the considerable void left by the blood, pus, or ._ FIRST CAMPAIGN loo serum effused into the cavity <***£»% ™" ^S S stv el The ball, which had passed from above down- wards removed, as though it was effected by nippers, the roerior half of the body of the fourth rib, about an inch and a half from its sternal cartilage. This projectile pene- Jraled into the thorax, traversed a portion of the lung, and vvas doubtless, driven against the dorsal column, towards ^ eighth or ninth vertebra of this region, where its pro- ^ress Reared to have been arrested. This woundwas ac- companied with haemorrhage, extravasation of blood,, ire- quTnPt disposition to.faint, oppression, anxiety, and spitting 2f blood; in short, I was told that the danger of the patient ^HeTas'conTeyed, in the first instance, to the abattoirs of Paris, where he remained until August, 1814 at which period he was transferred to Gros-Caillou. This indivi- dual laboured, at that time, under a fistulous wound in the superior and right part of the chest, the purulent matter emaining in the corresponding cavity He was exhausted by this abundant suppuration and the fever of absorption. At each dressing there issued from the wound one or se- veral cups of pus, which the patient V™?1*/*1^ £ J king on his right side, and inclining his body and head. His condition was that of extreme emaciation, and he sul- fered from a slow paroxysmal fever. That I might be ap- prized of the direction and extent of this wound, 1 intro- duced a flexible sound, slightly curved, into the thorax. It nassed without exertion to the lowest part, and traversed a larse portion of this cavity, at the bottom of which I felt a hard metallic body; this I supposed to be the ball. It vvas situated nearly at the point selected for the operation lor empyema, which was ascertained by measuring on the ex- terior with the same sound. In accordance with these in- dications, I thought it indispensable to make a counter- opening in the chest, at a point having the strictest rela- IN SAXONY. 157 tion with the seat of disease, where the foreign body was situated. The very wide interval between the eighth and ninth ribs appeared to me the most favourable* for this purpose, because the patient referred the presence of the ball to this part. The operation for empyema being resolved on, in a consultation of surgeons assembled with this view, I per- formed it agreeably to the rules laid down in my Memoir. Through this opening there issued about three porringers of pus; the ball also was discovered, and removed without difficulty, by means of polypous forceps, the intercostal space being very large and the projectile flattened. The operation was followed by symptoms of disturb- ance, which subsided before the third day. Pus was con- stantly secreted in abundance, but no longer passed through the upper wound, which speedily cicatrized. In order to aid nature in her work of obstruction, I caused different preparations of bark to be administered to the patient. The discharge of purulent matter diminished daily, the re-establishment of the general functions was perceptible, and the individual recovered his appetite and ability to sleep. The diseased side of the thorax, which pro- jected more than the opposite one before the operation, subsided sensibly from day to day, and the ribs were brought to such a degree of approximation, that the inter- costal interval, through which I performed the operation, was totally obliterated previously to the termination of the third month, and the right nipple had descended two fin- gers' breadth below the level of that on the left part of the chest. At this period a stilet could scarcely be passed into the wound, from which pus of a good quality and small in quantity was secreted. In short, every thing indicated a complete and very speedy cure, when this young soldier, having drunk brandy in excess, contracted an acute enteritis, accompanied with paroxysms of fever. He died in the course of December, six months after the accident, and about an hundred days subsequent to the operation. On examining the body, we found the superior wound cicatrized on the exterior, and filled up between the ribs by a dense cellular tissue, which was, however, destroyed with 158 FIRST CAMPAIGN facility by the handle of a scalpel. There no longer ex- isted any communication with the seat of the disease, ex- tending to a very short distance from the inferior opening. The latter had contracted considerably, and the two cor- responding ribs were very contiguous to each other. The pleura costalis was very much thickened, and the medias- tinum depressed on the diseased side. A fungous mass, furnished doubtless by the cellular tissue of the obliterated lung, occupied the superior part of the thoracic cavity. The preparation, which I presented to the society of the medical faculty, and is deposited in their anatomical cabi- net, proves the majority of the facts above laid down;* Case 2nd. Louis Claye, aged twenty-six years, a na- tive of Mouchy, in the department of Oise, and corporal in the former sixty-first of the line, received a gunshot wound in the battle of Moillow, in Russia, July the twenty- second, 1812. The ball entered the thorax through the space between the eighth and ninth ribs of the right side, and was arrested in its course in the corresponding cavity. This soldier, deprived of his reason, fell on this portion of his body, and remained two days on the field of battle, threat- ened every moment with suffocation. He was, however, removed on the second day, and conveyed to one of the hospitals of Moillow. Three days subsequent, he was near perishing, in con- sequence of a very great effusion into the thorax. Assist- ance was fortunately afforded him by one of our surgeons- major, who skilfully introduced a probe-pointed bistoury into the wound, and enlarged it in a direction parallel to the superior edge of the inferior rib. This operation, which may be called that selected for the performance of the operation of empyema, in relation to the situation in which it is ordinarily executed, was a source of much re- lief to the patient. He was liberated from his impending danger, and having spent the rest of the season at Moillow, was removed to the hospitals of Kowno, Konigsberg, and Thorn. * In Tome III. of my Campaigns there is a case, very analogous, at least as to the result, to that of this horseman. IN SAXONY. 159 After a stay of some weeks in the hospitals of the latter city, his wound being momentarily closed, symptoms of oppression and restraint were again experienced in the tho- rax. They, however, subsided on the bursting of an ab- scess, which formed suddenly under the edge of the false ribs. The aperture, having given passage to several pieces of clothing and a large quantity of purulent matter, was gradually closed. But the wound in the intercostal space became again patulous, and there issued from it a new col- lection of puriform, bloody matter; care was taken to keep up a permanent discharge of the latter, by means of a bunch of thread. Fruitless attempts had been made for the discovery of the ball, which, by the patient's account, had penetrated into the chest. Notwithstanding the symp- toms, which complicated this serious injury, he was ena- bled to proceed from hospital to hospital, for four years, until his arrival at Paris. From the period of his entrance into France till the year 1814, this soldier, being dismissed as incurable by the de- cision of a counsel of health, was restored to his parish. But the constant suffering he endured, and his desire to have the ball extracted, its weight alone proving a source of much inconvenience, induced him to repair to Paris. His efforts to gain admission into a military hospital, were at first unavailing, and I obtained, with difficulty, the favour of treating him in a private chamber of that of Gros-Caillou; he was finally admitted, June the fifteenth, 1816. In my first visit, I felt the ball by means of a probe, in the bot- tom of the right cavity of the thorax. The fistulous wound occupied precisely the point selected for the performance of the operation for empyema. Its aperture was very small, the secretion of pus abundant, and the patient labour- ed under the primary symptoms of hectic fever. After having laid open, and enlarged the wound in the direction of the ribs, I made vain attempts to extract the foreign body. The intercostal space was by far too nar- row, and the two ribs did not admit of the least separation. I seized upon the ball in a point of its surface, displaced, and brought it near the opening; but it immediately escaped from my grasp, and fell again to the bottom of the thoracic cavity. It was a matter of increased pain to me, to aban- 160 FIRST CAMPAIGN don the patient in this condition, inasmuch as nature had no power to expel the foreign substance from the thorax, in which it kept up a purulent empyema, and as I saw he would undoubtedly become a victim to this affection. But how was this body to be extracted? I could solve this question with difficulty. The plan, however, of saw- ing through the lower rib, and thus enlarging the space at the seat of the wound, in order to give passage to the ball and forceps, with which it should be seized, had already enter- ed my mind. But the difficulty or impossibility of exe- cuting the operation opposed this idea; for, in consequence of the proximity of the two ribs, anchylosed doubtless with the corresponding dorsal vertebras, since they yielded in no degree whatever to the greater or less separating force of the forceps, and other instruments which I employed, a was (made even expressly for the purpose) could not act on the convex surface of one of the ribs without cutting the other. How then would it be possible to effect a total division of it, and not lacerate the internal soft parts? The application of the trephine was attended with the same ob- stacles, as I was convinced "by a subsequent trial. I therefore endeavoured to discover a method of operat- ing, which might be advantageously substituted for these two modes. Reason was not wanting for entertaining the belief, that the tissue of the ribs in individuals not advanced in years, particularly in a diseased condition, could be acted on a by cutting instrument. The lenticular knife, used in removing the projecting angles which result from the ap- plication of several crowns of a trephine to the head, appeared to me perfectly appropriate for the accomplish- ment of my object, and on this instrument was based the plan of operating in this case. The patient being resolved, and every preparation made, I undertook this unique ope- ration (I am not aware at least of its having yet been per- formed) on the twenty-second of July. The patient and assistants were placed in favourable positions, the former on the edge of his bed. In the first place, I again enlarged the wound in the in- tercostal interval, and afterwards made a perpendicular incision in the parts covering the inferior rib. Its two angles were then separated, and the convex surface of this IN SAXONY. 161 rib laid bare to the extent of an inch and a half. Two ar- terial branches, from which haemorrhage took place, were first tied, and the lenticular knife (its lenticular portion having been removed) introduced between the two ribs. I then cut, layer by layer, the superior edge of the lower rib, and formed in the substance of this bone a semilunar hollow from five to six lines in depth. Being desirous of avoiding a lesion of the intercostal artery, which runs along the internal side of the inferior costal edge, I arrested this part of the operation nearly in the middle of the rib, and made new efforts to extract the ball. But in consequence of its large size* I was inca- pable of drawing it through the aperture ; it escaped from the strongest forceps, or the latter yielded to its resistance. In fine, I perceived the necessity of cutting out an exten- sive portion of the rib, even to three-fourths of its sub- stance. Being apprehensive of injuring the intercostal artery, I stopped ultimately, two lines from the inferior border of the rib, and providing myself with new polypous forceps, seized upon the projectile, and finally succeeded in extracting it, but not without difficulty. The obstacles, which it was necessary to surmount, might have been judged of by the abrasions observed on the ball. After its removal, I injected into the cavity of the thorax the contents of two or three syringes, consist- ing of tepid water, which contained the althea officinalis. A piece of fine linen, dipped in the same liquid, was then placed over the wound, and the dressing terminated by the application of an ordinary bandage. I prescribed for the patient, who had borne the operation with the greatest fortitude, an antispasmodic potion, mucilaginous cooling drinks, emollient enemata, anodynes, and embrocations on the abdomen with the camphorated oil of chamomile, and diet. A calm prevailed during the period immediately suc- ceeding the operation ; but a state of disturbance supervened in the night. On visiting him the morning of the follow- * The balls used by the Russians weigh an ounce and a quarter; ours only six drachms, 21 162 FIRST CAMPAIGN ing day, I found the pulse febrile, with thirst and general heat; he experienced acute pulsating pains in the region of the liver, and the whole circumference of the wound. Having removed the first portions of the dressings, I ap- plied several cups with scarifications to the painful parts, and continued the use of antispasmodics and acidulated drinks containing ice. The inflammatory symptoms were allayed, and the patient relieved. During the night of the twenty-second, a ligature around one of the muscular arteries being de- tached, haemorrhage supervened, yielding however to slight compression. The symptoms of inflammation appeared to be entirely dissipated; but the patient was sad and uneasy, and his pulse, though weak, continued febrile. 1 substi- tuted mild tonics for the cooling drinks, and added the ex- tract of opium to the antispasmodic potions. The two following days were passed in tranquillity; suppuration was established, and every thing indicated a favourable progress, when, at 2 o'clock, P.M. on the 25th, going alone to the privy, he suddenly and violently bent his body to the side of the wound, and fractured the small and fragile portion of the rib, which I had hollowed out. This accident was immediately followed by the rupture of the intercostal artery, which gave rise to a hemorrhage that nearly proved fatal to the patient. Being called imme- diately, I was so fortunate as to suppress the bleeding, and to prevent its return, by means of the compressive and very ingenious pouch of Desault. The pulse could scarcely be felt, the limbs were cold, and every circumstance induced me to fear a speedy death. Having terminated the dressing, I prescribed for him ethereal frictions, rich wine, cordials, and absolute rest. The day was spent without accident. Heat and the vi- tal forces were gradually re-established; towards the even- ing, however, febrile action, accompanied with an inexpres- sible uneasiness and acute pains in the wound and surround- ing parts, was developed. Apprehending a renewal of the hsemorrhage, I did not disturb the dressings. A strong antispasmodic opiate potion and mucilaginous drink, acidu- lated with nitric alcohol, were prescribed. On the 26th, symptoms of asthenia manifested them- IN SAXONY. 163 selves; the pains in the wound, and particularly those in the hepatic region, became more intense. I still suffered the dressings to remain, but caused very large blisters to be applied to this latter region, and to the whole circum- ferepce of the wound. The medicines ordered on the pre- ceding day were continued. A paroxysm of fever, of a pretty violent character, took place during the night be- tween the 26th and 27th. On the following day, the pros- tration was evident; the tongue was covered with a sabur- ral coat, and the patient threatened with new danger. I removed the dressings with the necessary precautions. A large quantity of purulent matter issued through the wound, the appearance and extreme sensibility of which foreboded the invasion of hospital gangrene. Entertaining no fears of the effect of the agitation caused by an emetic, which I thought it urgent to administer, I prescribed for the succeeding day, twenty-five grains of ipecacuanha, with one grain of tart, emetic. This combination, producing copious evacuation both upwards and downwards, sudden- ly changed the dangerous condition of the patient. From this moment he improved, and we were enabled to admin- ister to him bark, and other tonic substances, without diffi- culty. The wound was dressed with the unguent of storax, sprinkled with camphor. During the first three or four days the disease appeared stationary; but then strength gradually.returned. I entertained new hopes from this period; indeed, the wound assumed a healthy state, the se- cretion of pus became abundant, and the matter of a better quality, and all the nervous and inflammatory symptoms were entirely dissipated. After the thirtieth day of the operation, the patient found himself progressing towards a cure; and on the 22d August, was presented to the Society of Medicine. (See the Bulletin of this academy, No. 8, year 1816.) The vacuum, which resulted in the commencement from the evacuation of the fluids effused into the thoracic cavity, with the exception of the suppurating track extending from the ball to the fistulous wound, had become gradually filled up by the work of concentration, to which all the soft and hard parts of the parietes of this cavity had been subjected, during the four years that had elapsed since the 164 FIRST CAMPAIGN accident. The ribs, in fact, have lost their curvature, like the subject of the first case, and indeed, become cylindrical; the sternum is more depressed on this than on the left side; the mediastinum is inclined very much to the right, and the pulsation of the heart is no longer observed in the usual place, viz. on the left side. The diaphragm and liver have risen considerably into the cavity of the thorax, and their elevation, as well as the approximation of other parts, has rapidly increased since the operation, there being no longer any obstacle to this process. These phenomena are characterized by the total subsidence of the corresponding part of the chest, the relative situation of the right nipple, and the void observed under the edge of the false ribs of the same side; at the latter point, a projection, formed by the liver, was observed previously to the operation. This soldier returned home, October the first, 1816; he had completely recovered. Several months subsequently he came to Paris, in the enjoyment of good health. Wounds of the Abdomen. Wounds of the hypochondria, accompanied at once with lesion of the thoracic and abdominal viscera, have particu- larly engaged my attention. Those of the right hypochon- drium are more or less dangerous, according to the degree of their penetration. The liver, which occupies this entire region, is generally injured to different depths, and the nature of the lesion should not be disregarded. Should the projectile, suppos- ing the wound to be caused by a gunshot, penetrate ob- liquely from above downwards, and from before back- wards, or the contrary, into the side of the thorax, it passes at first into the cavity of the chest, and may injure the vessels of its parietes, break the ribs, or wound the lung; it goes hence into the proper substance of the liver, effecting a lesion in it, of greater or less depth. In this case, there may be extravasation of sanguineous fluids in both cavi- ties, or in only one of them. These effusions are charac- terized by their appropriate marks, but in every instance, howsoever superficial may be the injury of the liver, such IN SAXONY. 165 disturbance immediately supervenes in the functions of or- ganic life, that in a very few moments the patient appears to be in the most imminent danger. The escape of bilious matter into the abdominal cavity proves fatal. The skin on the surface of the body becomes, in the first instance, of a yellowish tint; the eye is sunken, sad, and filled with-tears; the extremities become cold; nausea, hic- cup, and anxiety are developed; the urine is bloody and scanty; the alvine excretions are destitute of their bilious hue; the pulse is small and febrile; the voice extinct; res- piration short, and more or less laboured, and anxiety ex- treme. These symptoms are speedily aggravated, and the patient dies, if nature be not aided by art. The first indication presented, is to lay open the wound deeply, to extract the foreign bodies with the requisite precaution, should there be any, to apply one or two dry cups afterwards over the wound, even if there be extrava- sated blood in the cut cellular tissue, to employ them over scarified portions of the surrounding parts, and to repeat this operation, when the local pains shall become somewhat intense. Having reduced the wound by all these means to as simple a state as possible, its edges should be approximated, and kept in their relative positions by adhe- sive strips, a piece of linen dipped in sweet wine, and a ban- dage simply retentive. Cups, particularly, have the power to remove the blood effused into the sinuses of the wound, to relieve the ves- sels, weakened by the shock imparted to them by the pro- jectile, of their engorgement, to promote the absorption of the extravasated fluids, and to prevent inflammation, or at least to diminish its effects, by the revulsion or irritation which they produce on the exterior. General blood-let- ting has none of these advantages, and is attended with many ill consequences. It gives rise, especially, to gene- ral debility, and disposes to asthenia. The interior of the wound should be preserved from the contact of the air, the patient put on a rigid diet, and cooling, mucilaginous, and laxative drinks, according to circumstances; in fine, the skilful administration of antispasmodic anodynes should not be neglected. A young officer of the light infantry, wounded by a ball 166 FIRST CAMPAIGN in the right hypochondrium, the ninth rib being fractured, and the liver injured, during the battle of Dresden, has been cured. I was in the hospital of the officers, when he was brought thither, a few moments after the accident. The ball, traversing the hypochondrium in an artero-poste- rior direction, broke the most projecting part of the above mentioned rib, and left a flap in the integuments,- about two inches and a half in extent. A pretty large quantity of blood was extravasated, one of the intercostal arteries hav- ing been lacerated. In the first place, I incised the flap in the integuments occupying the interval of the two wounds. Several splin- ters of the fractured rib were then detached and removed. With a pair of nippers, I cut off a projecting point of a fragment of this bone, which would have pricked the parts, and impeded the dressing of the wound. I ex- tended the inferior incision over the part from which the ball issued, in a posterior direction, in order to facilitate the escape of fluids. The edges of the wound were then brought together, an opening, however, being left in its lower part, and maintained in their relative positions, by means of a piece of linen, dipped in warm wine contain- ing a large quantity of honey. The liver was superficially cut, as we have said, on its convex surface, immediately under the attachments of the diaphragm. Diluent, laxative, and ethereal drinks were prescribed, with rest and diet. The local pain, anguish, and anxiety were allayed. In general, the patient experienced relief, and spent the first three days without any occurrence of note. But symp- toms of inflammation manifesting themselves at this period, cups with scarifications were again employed, by my direc- tion, around the wound, and the laxative diluents con- tinued. The injured parts were dressed rarely, and with the precautions indicated. This treatment was pursued a pretty long time, and with complete success, for the sub- ject of it recovered before the seventieth day. IN SAXONY. 167 Wounds of the Abdomen, accompanied with Protrusion of the Omentum. In a case of a penetrating wound of the abdomen, with the escape of the omentum, contained in my Campaigns, I have already pointed out the advantage of suffering this adi- pose membrane to remain exterior to this cavity, provided it cannot be reduced at that moment, and before swelling has supervened in the protruding part, and leaving it to the resources of nature alone. It should not be neglected, how- ever, to envelope the whole of the epiploon, that has issued from the wound, or been displaced, in fine linen spread with saffron cerate, for the purpose of preventing its adhesion to the integuments around the wound, and guarding it from the air, and violence of external bodies. If this portion of omentum be strangulated, in conse- quence of the contracted state of the wound which gave passage to it, it is necessary to lay it open to an extent suf- ficient for the liberation of this membrane from all re- straint, and rendering it capable of returning into its cavity, when nature shall recall it to its ordinary situation. These primary indications having been fulfilled, the patient should be placed in a favourable position, to be preserved by him during the rest of the treatment. The first phenomena that are observed in an hernia of the omentum without a sac, are thickening, and an almost sudden tumefaction and puffing up of every part of the membrane. In a few days it appears dense, red, wrinkled, and quickly becomes highly sensible. These symptoms progressively augment, in a gradual manner, until the third day, the tumour then remaining stationary until the fifteenth. At this period it begins to subside; the sensibility and red- ness disappear by degrees, and it is observed to be speedily reduced from the circumference to the centre. The angles of the wound, in the first place, are drawn apart, and the cicatrization of its edges is continued without the interven- tion of any foreign body. The reduction, moreover, is accomplished with greater or less rapidity, according to 168 FIRST CAMPAIGN the situation of the wound, and the age and constitution of the patient. When the wound, through which the omentum protrudes, is below the umbilical line, it returns into the abdo- men with a degree of facility increased by the distance from its attachments; nature promotes its restoration, and exerts traction in proportion to its remoteness. I have attempted an explanation of this phenomenon sub- sequently to the above mentioned case.* This reduction of the omentum has been observed by me to take place more promptly and with greater facility in young indivi- duals. Before pointing out a second case, as remarkable as that which I have just cited, I will indicate what should be done, when the protruding portion of the epiploon be- comes gangrenous. Authors recommend its excision, after having placed a ligature around its pedicle, or tying its arteries separately, if they bleed after the removal of the part. Their ob- ject in the performance of this operation is, by extirpat- ing the entire gangrenous portion, to impede the progress of mortification towards the abdomen, and prevent the effusion of blood into this cavity. Is the gangrene confined to the protruding omentum, or does it extend to the viscera contained in the abdominal cavity ? In the former case the gangrenous portion of the epiploon on the exterior may be removed by curved scissors, without touching the living parts, so as to avoid dividing the arterial branches, in which the blood still circulates. The temporary adhesive inflammation, which is established between the omentum and edges of the wound, arrests the gangrene; the slough which remains successively comes away; the pedicle, continuing sound, is quickly and spontaneously returned, and the patient is saved. In those cases, in which gangrene has already invaded the viscera contained in the abdominal cavity, (and the marks of it are not equivocal,) nothing can be * See Tome III. of my Campaigns. IN SAXONY. 169 done. The patient must be abandoned to the resources of nature, those means, however, being continued, which may promote her beneficial objects. In no case then, except in that which we have just sup- posed, should the protruding portion of the omentum be cut off or tied. For, notwithstanding the precaution that may be taken to throw a ligature around the vessels sepa- rately, after having removed the tumour, consecutive haemorrhages may supervene and jeopard the life of the patient. If one entire ligature be placed around the sound part of the epiploon, profound and violent irritation, ac- companied by inflammation, abscesses, and frequently by gangrene and death, supervenes. I have seen many ex- amples to this effect. These ill consequences are deve- loped with much care in the Memoirs of the Royal Acad- emy of Surgery, Tome III. p. 394, quarto edition. To recapitulate, then, the treatment of this species of wounds, the surgeon having fulfilled the indications ex- plained above, and supposing the omentum to be healthy, should restore it to as great an extent as possible, but in a mild and gradual manner. He should envelope the part without in fine linen spread with cerate and soaked in warm wine, and wait until nature employs her resources for effecting the reduction of this membrane. He should aid her work by methodical pressure exerted on the tumour, and, if this process be too tardy, should excite it power- fully by the actual cautery applied several times, provided it be necessary. This measure is painful, and thus proves that sensibility is developed in these adipose membranes, particularly when they are exposed to the external air. We have frequently had occasion to make this remark. The following case will confirm what we have said on the spontaneous reduction of the omentum. M. de L------, a young officer, was brought to the hospital of Gros-Caillou in August, 1815, nearly in a dying condition, labouring under a penetrating wound of the ab- domen inflicted by a polished weapon, and attended with haemorrhage, protrusion of the omentum, and lesion of the stomach. The surgeon of the guard applied a primary apparatus, and made fruitless efforts to remove the lipothy- 22 170 FIRST CAMPAIGN mia, to which this individual had been subjected ever since "very short period after the accident. His imminent dan- bb/>bl> Its superior arut inferior pardons bai*in/f preserve* t their oau/frr. c r A'etr internal braneb . ,/,/ Do. aalm^ ,/<>■ ee xftw anastomosis been vol the wUernal braneh and posbriortHud ariery. f A vessel oftvnwutnientitm between the tderior bmtuli itnd' anterwr tibial artery. t Miplitea/ artery in a healthy sta/r relative!;/ to (be hux-Joint SjPoptitea/ aia^nt in a. healtiu/ stair isolated anel with its bmneltcs. ■i s -s : - i ^ ~s § % ^ y ^%. \ ■ X THE PEOPLES LIBRARY. " The editors and publishers should receive the thanks of the present generation, and the gratitude of posterity, for being the first to prepare in this language what deserves to be entitled not the ENCYCLO- PAEDIA AMERICANA, but the people's library."—A7: Y. Courier and Enquirer. Jvst Published, by Carey tan. " It is but justice to Mr. Grattan to say that he has executed his laborious task with much industry and pro- portionate effect. Undisfigured by pompous nothingness, and without any of the affectation of philosophical pro- fundity, his style is simple, light, and fresh—perspicuous, smooth, and harmonious."—La Belle Assemblee. "Never did work appear at a more fortunate period. The volume before us is a compressed but clear and im- partial narrative."—Lit. Gaz. " A lone residence in the country, and a ready access to libraries and archives, have furnished Mr. Grattan with materials which he has arranged with skill, and out of which he has produced a most interesting volume."— Gent. Mag. LARDNER'S CABINET CYCLOPAEDIA. 1 IT IS NOT EASY TO DEVISE A CURE FOR SUCH A STATE Or THINGS (THE DECLINING TASTE FOR SCIENCE;) BUT THE MOST OBVIOUS REMEDV IS TO PROVIDE THE EDU- CATED CLASSES WITH A SERIES OF WORKS ON POPULAR AND PRACTICAL SCIENCE, FREED FROM MATHEMATICAL SYMBOLS AND TECHNICAL TERMS, WRITTEN IN SIMPLE AND PERSPICUOUS LANGUAGE, AND ILLUSTRATED BY FACTS AND EXPERIMENTS, WHlCn ARE LEVEL TO THE CAPACITY OF ordinary minds."—Quarterly Review. CABINET OF AMERICAN HISTORY PHILOSOPHY. By J. T. W. Herschel, A. M. late Fellow of St. John's College, Cambridge. " Without disparaging any other of the many interest- ing and instructive volumes issued in the form of cabinet and family libraries, it is, perhaps, not too much to place at the head of the list, for extent and variety of condensed information, Mr. Herchel's discourse of Natural Philoso- phy in Dr. Lardner's Cyclopaedia."— Christian Observer. " The finest work of philosophical genius which this age has seen."—Mackintosh's England. "By far the most delightful book to which the existing competition between literary rivals of great talent and enterprise has given rise."—Monthly Review. " Mr. Herschel's delightful volume. * * * We find scattered through the work instances of vivid and happy illustration, where the fancy is usefully called into action, so as sometimes to remind us of the splendid pictures which crowd upon us in the style of Bacon."—Quarterly Review. " It is the most exciting volume of the kind we ever met with."—Monthly Magazine. " One of the most instructive and delightful books we have ever perused."—C. S. Journal. Volumes published. I. II. HISTORY of the SPANISH DISCOVERIES prior to the year 1520. To be succeeded by III. IV. V. HISTORY of ANAHUAC, or MEXICO, from its discovery to the present time. In 3 vols. VI. VII. HISTORY of PERU. In 2 vols. PRELIMINARY DISCOURSE ON THE OB- ttic™pv ™ rr a 7tt t„ o „„i= s „ i JECTS, ADVANTAGES, AND PLEAS- IVIIL IX' HISTORY of BRAZIL. In 2 vols. &C.&C. URES OF THE STUDY OF NATURAL IGODUV. TS™- -T. T". -%1iT. II„..^I,»1 Under this comprehensive title, it is proposed to publish a General History of America, divided into parts making together a continuous whole; yet each, having an integral form, adapted for separate publica- tion. Each portion will be brought down to the period at which it shall be written, and will contain a popular description of the geology, climate and pro- ductions, and the civil history of the country to which it relates. No work of this general nature has been published in the English language. The work of Dr. Robertson is rather a philosophical essay on American history, than an historical narrative ; and though originally designed to embrace the whole of the American continent, it remains unfinished. It is written also, with a bias unfavorable to America and its produc- tions, is incorrect in many important particulars, and is too much abstracted for popular use. This void in literature might have been properly filled by the writers of Spain, Portugal, France, or England, but has been supplied for Europe, in a measure, by an Italian, the Cavalier Campagnoni, of whose meritorious labor much use will be made in ihe proposed enterprise. The volumes herewith presented, may be deemed introductory to the whole work, since they narrate the history of the discovery, of the three great portions of America. In the prosecution of the subject, the existing political divisions will be pursued and con- nected with former ones, by proper explanations; and where due regard for unity does not forbid, the chronological order will be preserved. Thus, the next succeeding part of the work, now advanced in preparation, will contain ihe history of Anahuac, or Mexico: including its ancient annals, an account of its subjugation, and the policy of its conquerors, of its late revolutions, and of its present constituent states. In the same manner will be treated Central America, Peru, Chili, Bolivia, the United Provinces of La Plata, A TREATISE ON MECHANICS. By Capt. Kater, and the Rev. Dionysius Lardner. With numerous engravings. "A work which contains an uncommon amount of useful information, exhibited in a plain and very intelli- gible form."—Olmsted's Nat. Philosophy. "This volume has been lately published in England, as a part of Dr. Lardner's Cabinet Cyclopaedia, and has re- ceived the unsolicited approbation of the most eminent men of science, and the most discriminating journals and reviews, in the British metropolis.—It is written in a popular and intelligible style, entirely free from mathe- matical symbols, and disencumbered as far as possible of technical phrases."—Boston Traveller. " Admirable in development and clear in principles, and „ especially felicitous in illustration from familiar sub-1 Brazil and Cdomoia. Due attention v. nl also be given jects."—Monthly Mag. to the independent Indian nations of South America. "Though replete with philosophical information of the The history of the remainder of the country will highest order in mechanics, adapted to ordinary capaci- ,be embraced by the following divisions:—1. Russian; ties in a way to render it at once intelligible and popu- 2. British; 3. Spanish; 4. French; 5. Danish; 6. Dutch lar."— Lit. Gazette. ! America; and 7, the United States and their depend- " A work of great merit, full of valuable information, j eneies. In treating the last division, a separate vol- not only to the practical mechanic, but to the man of sci ence."—N. Y. Courier and Enquirer. A TREATISE ON HYDROSTATICS AND PNEUMATICS. By the Rev. D. Lardner. With numerous engravings. " It fully sustains the favorable opinion we have already expressed as to this valuable compendium of modern sci- ence."—Lit. Gazette. " Dr. Lardner has made a good use of his acquaintance with the familiar facts which illustrate the principles of science."—Monthly Magazine. " It is written with a full knowledge of the subject, and in a popular style, abounding in practical illustra- tions of the abstruse operations of these imporant sci- ences."— U. S. Journal. ume will lie appropriated to each State and Territory, the history of \\ hich may require it, and " The History of the United Slates" will be confined to the events of the Revolution and the operations of the general gov- ernment. A survey having been thus made of the whole Western Hemisphere, the concluding volume will contain the history of the Indian races, particularly those of the northern part of the continent, with a critical examination of the theories relating to the original peopling of America. The general title of the work is sufficiently com- prehensive to include a biography of distinguished Americans, and others connected with American history; and should the public support warrant it, "An American Biography" may also be published under it, in a cheap and popular form. CABINET LIBRARY. No. 1.—NARRATIVE OF THE LATE WAR IN GERMANY AND FRANCE. By the Marquess of Londonderry. With a Map. No. 2.—JOURNAL of a NATURALIST, with plates. No. 3.—AUTOBIOGRAPHY of SIR WAL- TER SCOTT. With a portrait. No. 4.—MEMOIRS of SIR WALTER RA- LEGH. By Mrs. A. T. Thomson. With a portrait. No. 5.—LIFE of BELISARIUS. By Lord Mahon. No. 6.—MILITARY MEMOIRS of the DUKE of WELLINGTON. By Capt. Movle Sherer. With a portrait. No. 7.—LETTERS to a YOUNG NATU- RALIST on the STUDY of NATURE and NATURAL THEOLOGY. By J. L. Drummond, M. D. With numerous en- gravings. IN PREPARATION. LIFE of PETRARCH. By Thomas Moore. GLEANINGS in NATURAL HISTORY, being a Companion to the Journal of a Nat- uralist. "The Cabinet Library bids fair to be a series of great value, and is recommended to public and private libraries, to professional men, and miscellaneous readers generally. It is beautifully printed, and furnished at a price which will place it within the reach of all classes of society."— American Traveller. "The series of instructive, and. in their original form, expensive works, which these enterprising publishers are now issuing under the title of the " Cabinet Library," i« a fountain of useful, and almost universal knowledge; the advantages of which, in forming the opinions, tastes and manners of that portion of society, to which this varied information is yet new, cannot be too highly estimated."—National Journal. " Messrs Carev and Lea have commenced a series of publications'under the above title, which are to appear monthlv, and which seem likely, from the specimen before us, to acquire a high degree of popularity, and to afford a mass of various information and rich entertainment, at once eminently useful and strongly attractive^ The mechanical execution is fine, the paper and typography excellent."—Nashaille Banner. MEMOIRS OF THE LIFE OP SIR WAL- TER RAL.EGH, with, some Account of the Period in which he lived. By MRS. A. T. THOMSON. With a Portrait. "Such is the outline of a life, which in Mrs. Thorn- son's hands, is a mine of interest; from the first page to the last the attention is roused and sustained and white we approve the manner, we still more applaud the spirit in which it is executed."-Z,«t£rar!/ Gazette. JOURNAJL OF A NATURALIST. With Plates. ______Plants trees, and stones we note; Birds, insects, beasts, and rural things. » We a^ain most strongly recommend this little unpre tenting *o?uSie to the attention of every lover of nature and more particularly of our country readers. It will induce them, we are sure, to examine more closely than they have been accustomed to do, into the objects of ani- mated nature, and such examination will prove one of the most innocent, and the most satisfactory sources of gratification and amusement. It is a book that ought to find its way into every rural drawing-room in the kingdom, and one that may safely be placed in every lady's boudoir, be her rank and station in life what they may."'—Quarterly Review, No. LXXVIII. "We think that there are few readers who will not be delighted (we are certain all will be instructed) by the Journal of a Naturalist.' "—Monthly Review. " This is a most delightful book on the most delightful of all studies. We are acquainted with no previous work which bears any resemblance to this, except ' White's History of Selborne,' the most fascinating piece of rural writing and sound English philosophy that ever ssuod from the press."—Atkcnaum. "The author of the volume now before us, has pro-1 duced one of the most charming volumes we remember to have seen for a long time."—New Monthly Magazine, June, 1829. " A delightful volume—perhaps the most so—nor less instructive and amusing—given to Natural History since White's Sel borne."—Blackwood's Magazine. " The Journal of a Naturalist, being the second num- ber of Carey and Lea's beautiful edition of the Cabinet Library, is the best treatise on subjects connected with this train of thought, that we have for a long time pe- rused, and we are not at all surprised that it should have received so high and flattering encomiums from the Eng- lish press generally."—Boston Traveller. "Furnishing an interesting and familiar account of the various objects of animated nature, but calculated to afford both instruction and entertainment."—Nash- ville Banner. " One of the most agreeable works of its kind in the language."—Courier de la Louisiane. " It abounds with numerous and curious facts, pleas- ing illustrations of the secret operations and economy of nature, and satisfactory displays of the power, wisdom and goodness, of the great Creator."—Philad. Album. THE MARQUESS OF LONDONDERRY'S NARRATIVE OF THE LATE WAR IN GERMANY AND FRANCE. With a Map. " No history of the events to which it relates can be correct without reference to its statements."—Literary Gazette. " The events detailed in this volume cannot fail to excite an intense interest."—Dublin Literary Gazette. "The only connected and well authenticated account we have of the spirit-stirring scenes which preceded the fall of Napoleon. It introduces us into the cabinets and presence of the allied monarchs. We observe the secret policy of each individual.- we see the course pursued by the wily Bernadotte, the temporizing Mettemich, and the ambitious Alexander. The work deserves a place in every historical library."—Globe. "We hail with pleasure the appearance of the first volume of the Cabinet Library." " The author had sin- gular facilities for obtaining the materials of his work, and he has introduced us to the movements and measures of cabinets which have hitherto been hidden from the world."—American Traveller. "It maybe regarded as the most authentic of all the publications which profess to detail the events of the important campaigns, terminating with that which se- cured the capture of the French metropolis."—Nat. Jour- nal. " It is in fact the only authentic account of the memo- rable events to which it refers."—Nashville Banner. " The work deserves a place in every library."—Phila- delphia Album. MISCELLANEOUS. A MEMOIR OF SEBASTIAN CABOT, with a Review of the History of Maritime Dis- covery. Illustrated by Documents from the Rolls, now first published. " Put forth in the most unpretending manner, and without a name, this work is of paramount importance to the subjects of which it treats."—Literary Gazette. " The author has corrected many grave errors, and in general given us a clearer insight into transactions of considerable national interest."—lb. " Will it not," says the author, with just astonishment, " be deemed almost incredible, that the very instrument in the.Records of England, which recites the Great Discovery, and plainly contemplates a scheme of Colonization, should, up to this moment, have been treated by her own writers as that which first gave permission to go forth and explore ?" —lb. " We must return to investigate several collateral matters which we think deserving of more space than we can this week bestow. Meanwhile we recommend the work as one of great value and interest."—lb. " The general reader, as well as the navigator and the curious, will derive pleasure and information from this well-written production."—Courier. "A specimen of honest inquiry. It is quite frightful to think of the number of the inaccuracies it exposes : we shall cease to have confidence in books." " The investi- gation of truth is not the fashion of these times. But every sincere inquirer after historical accuracy ought to purchase the book as a curiosity: more false assertions and inaccurate statements were never exposed in the same compass. It has given us a lesson we shall never forget, and hope to profit by."—Spectator. HISTORY OF THE NORTHMEN, OR NOR- I'AMS AND DANES ; from the earliest times to the Conquest of England by William of Normandy. By Henry Whea- toii) Member of the Scandinavian and Icelandic Iiiterary Societies of Copenha- gen. This work embraces the great leading features of Scan- dinavian history, commencing with the heroic age, and advancing from the earliest dawn of civilization to the introduction of Christianity into the North—its long and bloody strife with Paganism—the discovery and coloniza- tion of Iceland, Greenland, and North America, by the Norwegian navigators, before the time of Columbus—the military and maritime expeditions of the Northmen— their early intercourse of commerce and war with Con- stantinople and the Eastern empire—the establishment of a Norman state in France, under Rollo. and the sub- jugation of England, first by the Danes, under Canute the Great, and subsequently by the Normans, under Duke William, the founder of the English monarchy. It also contains an account of the mythology and litera- ture of the ancient North—the Icelandic language pre- vailing all over the Scandinavian countries until the formation of the present living tongues of Sweden and Denmark—an analysis of the Eddas, Sagas, and various chronicles and songs relating to the Northern deities and heroes, constituting the original materials from which the work has been principally composed. It is intended to illustrate the history of France and England during the middle ages, and at. the same time to serve as an introduction to the modern history of Denmark, Norway, and Sweden. LETTERS TO A YOUNG NATURALIST, on the Study of Nature, and Natural The- ology. By JAMES L. DRUMMOND, M. D. &c. With numerous engravings. " We know of no work, compressed within the same limits, which seems so happily calculated to generate in a young mind, and to renovate in the old, an ardent love of nature in all her forms."—Monthly Review. "We cannot but eulogize, in the warmest manner, the endeavor, and we must say the successful endeavor, of a man of science, like Dr. Drummond, to bring down so exalted a pursuit to the level of youthful faculties, and to cultivate a taste at once so useful, virtuous, and refined." —New Monthly Mag. PRIVATE MEMOIRS of NAPOLEON BO- NAPARTE, from the French of M. Fauvk- let de Bourrienne, Private Secretary to the Emperor. In 2 vols, 8vo. The peculiar advantages of position in regard to his present subject, solely enjoyed by M. de Uourri- enne, his literary accomplishments and moral quali- fications, have already obtained for these memoirs the first rank in contemporary and authentic history. In France, where they had been for years expected with anxiety, and where, since the revolution, no work connected with that period or its consequent events has created so great a sensation, the volumes of Bour- rienne have, from the first, been accepted as the only trustworthy exhibition of the private life and political principles of Napoleon. !' We know from the best political authority now liv- ing in England, that the writer's accounts are perfectly corroborated by facts."—Lit. Gaz. ANNALS of the PENINSULAR CAM- PAIGNS. By the Author of Cyril Thorn- ton. In 3 vols. 12mo. with plates. The HISTORY OF LOUISIANA, particu- larly of the Cession of that Colony to the United States of North America; with an Introductory Essay on the Constitution and Government of the United States, by M. de Marbois, Peer of France, translated from the French by an American Citizen. In 1 vol. 8vo. The PERSIAN ADVENTURER. By the Author of the Kuzzilbash. In 2 vols. 12mo. 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CONSIDERATIONS ON THE CURREN- CY AND BANKING SYSTEM OF THE UNITED STATES. By Albert Galla- SONGS of the AFFECTIONS. By Felicia Hemans. Royal 18mo. JCOTT, COOPER, AJWD WASHZNOTOXT mVJ38&. BY SIR WALTER SCOTT. COUNT ROBERT OF PARIS, a Tale of the Lower Empire. By the Author of Wa- verley. In 2 vols. Nearly ready. "The reader will at once perceive that the subject, the characters and the scenes of action, could not have been betttr selected for the display of the various and un- equalled powers of the author. All that is glorious in arts and splendid in arms—the glitter of armor, the pomp of war, an 1 the splendor of chivalry—the gorgeous scenery nf the liosphonis—the ruins of Byzantium—the magnifi- cence of the Grecian capital, and the richness and volup- tuousness of the imperial court, will rise before the reader in a successiun of beautiful and dazzling images."—Com- mercial Advertiser. AUTOBIOGRAPHY OF SIR WALTER SCOTT. With a Portrait. ' This is a delightful volume, which cannot fail to sat- isfy every reader, and of which the contents ought to be known to all those who would be deemed conversant with the literature of our era."—National Gazette. HISTORY OF SCOTLAND. In 2 vols. " The History of Scotland, by Sir Walter Scott, we do not hesitate to declare, will be, if possible, more exten- sively read, than the most popular work of fiction, by the same prolific author, and for this obvious reason : it com- bines much of the brilliant coloring of the Ivanhoe pic- tures of by-gone manners, and all the graceful facility of style and picturesqueness of description of his other charming romances, with a minute fidelity to the facts of history, a:id a searching scrutiny into their authenti city and relative value, which might put to the blush Mr. UurriH and other professed historians. Such is the magic charm of Sir Walter Scott's pen, it has only to touch the simplest incident of every-day life, and it starts up invested with all the interest of a scene of romance ; ami vet such is his fidelity to the text of nature, that the knights, and serfs, and collared fools with whom his in- ventive genius has peopled so many volumes, are regarded by us as not mere creations of fancy, but as real flesh and blood existences, with all the virtues, feelings and errors of common-place humanity."—Lit. Gazette. TALES of a GRANDFATHER, being a series from French History. By the Author of Waverley. LIONEL LINCOLN, or the LEAGUER of BOSTON, 2 vols. The LAST of the MOHICANS, 2 vols. 12mo. The PRAIRLE, 2 vols. 12mo. BY WASHINGTON IRVING. BY MR. COOPER. THE BRAVO. By the Author of the Spy, Pilot, &c. In 2 vols. In the Press. The WATER-WITCH, or the SKIMMER of the SEAS. In 2 vols. "We have no hesitation in classing this among the most powerful of the romances of our countryman. — U. States Gazette. "We could ont break from the volumes, and may pre- dict that they will excite the same interest in the minds nf almost every reader. The concluding chapters produce intense emotion."—National Gazette. New Editions of the following Works by the same Author. NOTIONS OF THE AMERICANS, by a Travellino- Bachelor, 2 vols. 12mo. The WEPT OF WISH-TON-WISH, 2 vols. 12mo. The RED ROVER, 2 vols. 12mo. The SPY, 2 vols. 12mo. The PIONEERS, 2 vols. 12mo. The PILOT, a Tale of the Sea, 2 vols. 12mo VOYAGES and ADVENTURES of the COMPANIONS of COLUMBUS. By Washington Irving, Author of the Life of Columbus, &c. 1 vol. 8vo. "Of the main work we may repeat that it possesses the value of important history and the magnetism of ro- mantic adventure. It sustains in every respect the repu- tation of Irving." " We may hope that the gifted author will treat in like manner the enterprises and exploits of Pizarro and Cortes; and thus complete a series of elegant recitals, which will contribute to the especial gratifica- tion of Americans, and form an imperishable fund of delightful instruction for all ages and countries."—JVo£. Gazette. " As he leads us from one savage tribe to another, as he paints successive scenes of heroism, perseverance and self-denial, as he wanders among the magnificent scenes of nature, as he relates with scrupulous fidelity the errors, and the crimes, even of those whose lives are for the most part marked with traits to command admira- tion, and prhaps esteem—everywhere we find him the same unde»iating, but beautiful moralist, gathering from every incident some lesson to present in striking lan- guage to the reason and the heart."—Am. Quarterly Re- view. This is a delightful volume; for the preface truly says that the expeditions narrated and springing out of the voyages of Columbus may be compared with attempts of adventurous knights-errant to achieve the enterprise left unfinished by some illustrious predecessors. Washington living's name is a pledge how well their stories will be told: and we only regret that we must of necessity defer our extracts for a week."—London Lit. Gazette. A CHRONICLE of the CONQUEST of GRENADA. By Washington Irving, Esq. In 2 vols. " On the whole, this work will sustain the high fame of Washington Irving. It fills a blank in the historical library which ought not to have remained so long a blank. The language throughout is at once chaste and animated ; and the narrative may be said, like Spenser's Fairy Ciueen, to present one long gallery of splendid pic- tures."—Lend. Lit. Gazette. "Collecting his materials from various historians, and adopting in some degree the tone and manner of a monk- ish chronicler, he has embodied them in a narrative which in manner reminds us of the rich and storied pages of Froissart. He dwells on the feats of chivalry performed by the Christian Knights, with all the ardor which might be expected from a priest, who mixed, according to the usage of the times, not only in the palaces of courtly nobles, and their gay festivals, as an honored and wel- come guest, but who was their companion in the camp, and their spiritual and indeed bodily comforter and as- sistant in the field of battle— Am. Quarterly Review. New Editions of the following Works by the same Author. The SKETCH BOOK, 2 vols. 12mo. KNICKERBOCKER'S HISTORY of NEW YORK, revised and corrected. 2 vola BRACEBRILXiE HALL, or the HUMOR- ISTS, 2 vols. 12mo. TALES of a TRAVELLER, 2 vols. 12mo. TRAVELS, ANNUALS, &c. NOTES on ITALY during the years 1829-30. By Rembrandt Peale. In 1 vol. 8vo. "This artist will gratify all reasonable expectation; he is neither ostentatious, nor dogmatical, nor too mi- nute; he is not a partisan nor a carper; he admires with- out servility, he criticises without malevolence; his frankness and good humor give an agreeable color and efl'ect to all his decisions, and the object of them; his book leaves a useful general idea of the names, works, and de- serts, of the great masters; it is an instructive and enter- taining index."—Nat. Gaz. " We have made a copious extract in preceding columns from this interesting work of our countryman, Rembrandt Peale, recently published. It has received high commen- dation from respectable sources, which is justified by the portions we have seen extracted."—Commercial Advertiser. " Mr. Peale must be allowed the credit of candor and entire freedom from affectation in the judgments he has passed. At the same time, we should not omit to notice the variety, extent, and minuteness of his examinations. No church, gallery, or collection, was passed by, and most of the individual pictures are separately and carefully noticed."—1m. Quarterly Review. FRAGMENTS of VOYAGES and TRAV- ELS, including ANECDOTES of NAVAL LIFE; intended chiefly for the Use of Young Persons. By Basil Hall, Capt. R. N. In 2 vols, royal 18mo. " His volumes consist of a melange of autobiography, naval anecdotes, and sketches of a somewhat discursive nature, which we have felt much pleasure in perusing." "The title page to these volumes indicates their being chiefly intended for young persons, but we are much mis- taken if the race of gray-beards will be among the least numerous of the readers of ' midshipmen's pranks and the humors of the green room.'"—Lit. Gazette. A TOUR in AMERICA. By Basil Hall, Capt. R. N. In 2 vols. 12mo. SKETCHES OF CHINA, with Illustrations from Original Drawings. By W. W. Wood. In 1 vol. 12mo. " The residence of the author in China, during the years 1826-7-8 and 9, has enabled him to collect much very eurious information relative to this singular people, which he has embodied in his work; and will serve to gratify the curiosity of many whose time or dispositions do not allow them to seek, in the*voluminous writings of the Jesuits and early travellers, the information contained in the present work. The recent discussion relative to !the renewal of the East India Company's Charter, has oxcited much interest; and among ourselves, the desire to be further acquainted with the subjects of 'the Celes- tial Empire,' lias been considerably augmented." EXPEDITION to the SOURCES of the MISSISSIPPI, Executed by order of the Government of the United States. By Ma- jor S. H. Long. In 2 vols. 8vo. With Plates. HISTORICAL, CHRONOLOGICAL, GEO- GRAPHICAL, and STATISTICAL AT- LAS of NORTH and SOUTH AMERI- CA, and the WEST INDIES, with all their Divisions into States, Kingdoms, &c. on the Plan of Le Sage, and intended as a companion to Lavoisne's Atlas. In 1 vol. folio, containing 54 Maps. Third Edition, improved and enlarged. ATLANTIC SOUVENIR, FOR 1832. This volume is superbly bound in embossed leather, and ornamented with numerous plates, executed in the best style, by the first artists. No expense has been spared in the endeavor to render it worthy of the purpose for which it is intended. Embellishments.—1. The Hungarian Prin- cess, engraved by lllman and Pillbrow, from a picture by Holmes.—2. The Bower of Paphos, engraved by Ellis, from a picture by Martin.— 3. The Duchess and Sancho, engraved by Du- rand, from a picture by Leslie.—4. Richard and Saladin, engraved by Ellis, from a picture by Cooper.—5. The Rocky Mountains, engraved by Hatch and Smilie, from a picture by Doughty.—6. Lord Byron in Early Youth, engraved by Ellis, from a picture by Saunders. —7. Tiger Island, engraved by Neagle, from a picture by Stanfield.—8. The Blacksmith, engraved by Kelly, from a picture by Neagle. —9. The Tight Shoe, engraved by Kelly, from a picture by Richter.—10. Isadore, engraved by lllman and Pillbrow, from a picture by Jackson.—11. The Dutch Maiden, engraved by Neagle, from a picture by Newton.—12 The Mother's Grave, engraved by Neagle, from a picture by Schaffer. ATLANTIC SOUVENIR FOR 1831. Embellishments.—1. Frontispiece. The Shipwrecked Family, engraved by Ellis, from a picture by Burnet.—2. Shipwreck off Fort Rouge, Calais, engraved by Ellis, from a pic- ture by Stanfield.—3. Infancy, engraved by Kelly, from a picture by Sir Thomas Law- rence.—4. Lady Jane Grey, engraved by Kelly, from a picture by Leslie.—5. Three Score and Ten, engraved by Kearny, from a picture by Burnet.—6. The Hour of Rest, engraved by Kelly, from a picture by Burnet.—7. The Min- strel, engraved by Ellis, from a picture by Les- lie.—8. Arcadia, engraved by Kearny, from a picture by Cockerell.—9. The Fisherman's Return, engraved by Neagle, from a picture by Collins.—10. The Marchioness of Carmar- then, granddaughter of Charles Carroll of Car- rollton, engraved by lllman and Pillbrow, from a picture by Mrs. Mee.—11. Morning among the Hills, engraved by Hatch, from a picture by Doughty.—12. Los Musicos, engraved by Ellis, from a picture by Watteau. A few copies of the ATLANTIC SOUVE- NIR, for 1830, are still for sale. THE BOOK of the SEASONS. By William Howitt. "Since the publication of the Journal of a Naturalist, no work at once so interesting and instructive as the Book of the Seasons has been submitted to the public. Whether in reference to the utility of its design, or the grace and beauty of its execution, it will amply merit the popularity it is certain to obtain. It is, indeed, cheering and refreshing to meet with such a delightful volume, so full of nature and truth—in which reflection and experi- ence derive aid from imagination—in which we are taught much; but in such a manner as to make it doubt- ful whether we have not been amusing ourselves all the time we have been reading."—New Monthly Magazine. "The Book of the Seasons is a delightful book, and recommended to all lovers of nature."—Blackwood's Mag- azine. EDUCATION, LESSONS on THINGS, intended to improve Children in the Practice of Observation, Re- flection and Description, on the System of Pestalozzi, edited by John Frost, A. M. The publishers request the attention of teachers, school committees, and all who are desirous of improving the methods of instruc- tion, to this work, which is on a plan hitherto unattempted by any school-book in this coun- try, and which has been attended with extra- ordinary success in England. The following remarks on the work are ex- tracted from the " Quarterly Journal of Edu- cation." " This little volume is a 'corrected and re-corrected' edi- tion of lessons actually given to childrea, and, therefore, possesses a value to which no book made in the closet can lay claim, being the result of actual experiment. The work consists of a number of lessons, divided into five series; beginning with subjects the most easy and elementary, it gradually increases in difficulty, each suc- cessive step being adapted to the mind of the child as it acquires fresh stores of knowledge. " Every part of these lessons is interesting to the child, both on account of the active operation into which his own mind is necessarily called by the manner in which the lessons are given; and also by the attractive nature of many of the materials which form the subject of the lessons. In the first and most elementary series, the pupil is simply taught to make a right use of his organs of sense, and to exercise his judgment so far only as relates to the objects about him; and accordingly the matter brought before him at this stage, is such that its obvious properties can be discovered and described by a child who bas acquired a tolerable knowledge of his mother tongue." OUTLINES of HISTORY from the Earliest Records to the Present Time. Prepared for the Use of Schools, with Questions, by John Frost, A. M. " The main object of the work is, by giving a selection of interesting and striking facts from more elaborate his- tories, properly and carefully arranged, with chronological tables, to render the study of general history less dry and repulsive than it has been heretofore. This, we think is fully accomplished. Very great care appears to have been bestowed on the selections, and in arranging the chrono- logical tables, as well as in the classification of the his- torical matter into parts and chapters. The work will sufficiently recommend itself to all who examine it."— Sat. Evening Post. "To concentrate in one comparatively small volume, a complete epitome of the entire history of the world, an- cient and modern, so treated as to present a correct image of it, would seem to be an object to be wished for, rather than expected; the 'Outlines of History,' however, realize this object."— Asiatic Journal. "We consider that Mr. F has done a service to schools, by the time and labor which he has bestowed upon this work; the marginal dates will be found of great service, but the chapters of questions upon the text, and upon the maps, to illustrate the geography of the history, will es- pecially recommend the work to the attention of teach- ers."—U. S. Gazette. Philadelphia, July Wth, 1831. "The 'Outlines of History,' I consider an excellent class-book of general history for the use of schools. The questions added by Mr. Frist, are a most valuable auxili- ary for the teacher as'well as the pupil. I shall use the 'Outlines' in my school, and cordially recommend it to parents and teachers. S. C. WALKER." Philadelphia, April 20th, 1831. "De^r Sir —I have just received a copy of your edition of the ' Outlines of History.' From a cursory perusal, I am disposed to give it a high rank as a school-book. So well satisfied am I with the arrangement and execution of the work, that I intend to put it immediately into the hands of a class in mv own school. " Very respectfully, your obedient servant, " MR. John Frost." " LEVI FLETCHER. FRENCH AND SPANISH. BY A. BOLMAR. PHPaS?^10"^ COLLOQUIAL riiKAbLfc on every Topic necessary to main- tain Conversation, arranged under aifferent heads, with numerous remarks on the peculiar pronunciation and use of various words—the whole so disposed as considerably to facilitate the acquisition of a correct pronunciation of the French. By A. Bolmar. One vol. 18mo. A SELECTION of ONE HUNDRED PERRIN'S FABLES, accompanied by a Key, containing the text, a literal and free trans- lation, arranged in such a manner as to point out the difference between the French and the English idiom, also a figured pronunciation of the French, according to the best French works extant on the subject; the whole preceded by a short treatise on the sounds of the French language, compared with those of the English. Les AVENTURES de TELEMAQUE par FENELON, accompanied by a Key to the first eight books; containing like the Fa- bles—the Text—a Literal—and Free Trans- lation ; intended as a Sequel to the Fables. The expression 'figured pronunciation,' is above em- ployed to express that the words in the Key to the French Fables are spelt and divided as they are pronounced. It is what Walker has done in his Critical Pronouncing Dic- tionary ; for instance, he indicates the pronunciation of the word enough, by dividing and spelling it thus, e-nuf. In the same manner I indicate the pronunciation of the word coinptaient thus, kon-le. As the understanding of the figured pronunciation of Walker requires the student to be acquainted with the primitive sounds of the English vow- els, he must likewise, before he can understand the figured pronunciation of the French, make himself acquainted with the 20 primitive sounds of the French vowels. This any intelligent person can get from a native, or from anybody who reads French well, in a few hours. A COMPLETE TREATISE on the GEN- DERS of FRENCH NOUNS; in a small pamphlet of fourteen pages. This little work, which is the most complete of the kind, is the fruit of great labor, and will prove of immense service'to every learner. ALL THE FRENCH VERBS, both REG- ULAR and IRREGULAR, in a small volume. The verbs lire to be, avoir to have, parler to speak, finir to finish, recevoir to receive, vendre to sell, se lever to rise, se bien porter to be well, s'en alter to go away, are here all conjugated through—affirmatively —negatively—interrogatively—and negatively and in- terrogatively—an arrangement which will greatly fa- cilitate the scholar in his learning the French verbs, and which will save the master the trouble of explain- ing over and over again what may be much more easily learned from books, thus leaving him more time to give his pupil, during the lesson, that instruction which cannot be found in books, but which must be learned from a master. NEUMAN'S SPANISH and ENGLISH DICTIONARY. New Edition, in one vol. 16mo. CLASSICAL LITERATURE. INTRODUCTION to the STUDY of the GREEK CLASSIC POETS, for the use of Young Persons at School or College. Contents.—General Introduction; Ho- meric Questions; Life of Homer; Iliad; Odyssey; Margites; Batrachomyomachia; Hymns; Hesiod. By Henry Nelson Cole- ridge. " We have been highly pleased with this little volume. This work supplies a want which we have often painfully felt, and affords a manual which we should gladly see placed in the bands of every embryo undergraduate. We look forward to the next portion of this work with very eager and impatient expectation."—British Critic. " Mr. Coleridge's work not only deserves the praise of clear, eloquent and scholar-like exposition of the prelimi- nary matter, which is necessary in order to understand and enter into the character of the great Poet of anti- quity; but it has likewise the more rare merit of being admirably adapted for its acknowledged purpose. It is written in thai fresh and ardent spirit, which to the con- genial mind of youth, will convey instruction in the most effective manner, by awakening the desire of it; and by enlisting the lively and buoyant feelings in the cause of useful and improving study; while, by its preg- nant brevity, it is more likely to stimulate than to super- sede more profound and extensive research. If then, as it is avowedly intended for the use of the younger readers of Homer, and, as it is impossible not to discover, with a more particular view to the great school to which the au- thor owes his education, we shall be much mistaken if it does not become as popular as it will be useful in that celebrated establishment.1'—Quarterly Review. " We sincerely hope that Mr. Coleridge will favor us with a continuation of his work, which he promises."— Gent. Mag. " The author of this elegant volume has collected a vast mass of valuable information. To the higher classes of the public schools, and young men of universities, this volume will be especially valuable; as it will afford an agreeable relief of light reading to more grave studies, at once instructive and entertaining."—Wesleyan Methodist Magazine. ATLAS OF ANCIENT GEOGRAPHY, con- sisting of 21 Colored Maps, with a complete Accentuated Index. By Samuel Butler, D. D., F. R. S. &c. Archdeacon of Derby. By the same Author. GEOGRAPHIA CLASSICA: a Sketch of Ancient Geography, for the Use of Schools. In 8vo. Extract of a Letter from Professor Stuart of Andover. " I have used Butler's Atlas Classic.! for ]-2 or 14 years and prefer it on the score of convenience and correctness to any atlas within the compass of my knowledire. It is evidently a work of much care and taste, and most happily adapted to classical readers and indeed all others, who consult the history of past ages. I have long cherish- ed a strong desire to see the work brought forward in this country, and I am exceedingly gratified that you have carried through this undertaking. The beautiful manner in which the specimen is executed that you have sent me does great credit to engravers and publishers. It cannot be that our schools and colleges will fail to adopt this work, and bring it into very general circulation. I know of none which in all respects would supply its place." "The abridged but classical and excellent work of But- ler, on Ancient Geography, which you are printing as an accompaniment to the maps, I consider one of th- most attractive works of the kind, especially for young p-Tsons studying the classics, that has come under my notice. I wish you the most ample success in these highly useful publications." MECHANICS, MANUFACTURES, &c. A PRACTICAL TREATISE on RAIL- ROADS, and INTERIOR COMMUNI- CATION in GENERAL—containing an account of the performances of the different Locomotive Engines at, and subsequent to, the Liverpool Contest; upwards of two hundred and sixty Experiments with Tables of the comparative value of Canals and Rail- roads, and the power of the present Locomo- tive Engines. By Nicholas Wood, Colliery Viewer, Member of the Institution of Civil Engineers, &c. 8vo. with plates. Nearly Ready. " In this, the able author has brought up his treatise to the date of the latest improvements in this nationally important plan. We consider the volume to be one of great general interest."—Lit. Gaz. " We must, in justice, refer the reader to the work itself, strongly assuring him that, whether he be a man of science, or one totally unacquainted with its technical difficulties, he will here receive instruction and pleasure, in a degree which we have seldom seen united before."— Monthly Rev. REPORTS on LOCOMOTIVE and FIXED ENGINES. By J. Stephenson and J. Walker, Civil Engineers. Witli an Ac- count of the Liverpool and Manchester Rail- road, by H. Booth. In 8vo. with plates. MILLWRIGHT and MILLER'S GUIDE. By Oliver Evans. New Edition, with ad- ditions and corrections, by the Professor of Mechanics in the Franklin Institute of Pennsylvania, and a description of an im- proved Merchant Flour-Mill, with engrav- ings, by C. & O. Evans, Engineers. THE NATURE and PROPERTIES of the SUGAR CANE, with Practical Directions for its Culture, and the Manufacture of its various Products; detailing the improved Methods of Extracting, Boiling, Refining, and Distilling; also Descriptions of the Best Machinery, and useful Directions for the general Management of Estates. By George Richardson Porter. "This volume contains a valuable mass of scientific and practical information, and is, indeed, a compendium of everything interesting relative to colonial agriculture and manufacture."—Intelligencer. "We can altogether recommend this volume as a most valuable addition to the library of the home West India merchant, as well as that of the resident planter."—Lit. Gazette. " This work may be considered one of the most valua- ble books that has yet issued from the press connected with colonial interests; indeed, we know of no greater service we could render West India proprietors, than in recommending the study of Mr. Porter's volume."—Spec- tator. " The work before us contains such valuable, scientific and practical information, that we have no doubt it will find a place in the library of every planter and peison connected with our sugar colonies."—Monthly Magazine. A TREATISE on MECHANICS. By James Renwick, Esq. Professor of Natural and Experimental Philosophy, Columbia Colleg-e, N. Y. In bvo. with numerous engravings. In the Press. ©hemtstrs, Natural f^istors, wto ^lulosophg. TI1E CHEMISTRY OP THE ARTS, on the basis of Gray's Operative Chemist, being an Exhibition of the Arts and Manufac- tures dependent on Chemical Principles, with numerous Engravings, by ARTHUR L. PORTER, M. D. late Professor of Chemistry, &c. in the University of Ver- mont. In 8vo. 'With numerous Plates. The popular and valuable English work of Mr. Gray, which forms the groundwork of the present volume, was published in London in 1829, and de- signed to exhibit a systematic and practical view of the J numerous Arts and Manufactures which involve the application of Chemical Science. The author himself, a skilful, manufacturing, as well as an able, scientific chemist, enjoying the multiplied advantages afforded by the metropolis of the greatest manufacturing nation on earth, was eminently qualified for so arduous an undertaking, and the popularity of the work in Eng- land, as well as its intrinsic merits, attest the fidelity and success with which it has been executed. In the work now offered to the American public, the practical character of the Operative Chemist has been preserved, and much extended by the addition of a great variety of original matter, by numerous correc- tions of the original text, and the adaptation of the whole to the state and wants of the Arts and Manu- factures of the United States. Among the most con- siderable additions will be found full and extended treatises on the Bleaching of Cotton and Linen, on the various branches of Calico Printing, on the Manufac- ture of the Chloride of Lime, or Bleaching Powder, and numerous Staple Articles used in the Arts of Dying, Calico Printing, and various other processes ofManufacture, such as the Salts of Tin, Lead, Man- ganese, and Antimony; the most recent Improve- ments on the Manufacture of the Muriatic, Nitric, and Sulphuric Acids, the Chromates of Potash, the latest information on the comparative Value of Dif- ferent Varieties of Fuel, on the Construction of Stoves, Fire-Places, and Stoving Rooms, on the Ven- tilation of Apartments, &c. &c. The leading object has been to improve and extend the practical charac ter of the Operative Chemist, and to supply, as the publishers flatter themselves, a deficiency which is felt by every artist and manufacturer, whose processes involve the principles of chemical science, the want of a Systematic Work which should embody the most recent improvements in the chemical arts and manu- factures, whether derived from the researches of sci- entific men, or the experiments and observations of the operative manufacturer and artisans themselves. CHEMICAL MANIPULATION. Instruction to Students on the Methods of perform' ing Experiments of Demonstration or Research, with accuracy and success. By MICHAEL FARADAY, F. R. S. Firs \merican, from the second London edi' tion, with Additions by J. K. MITCHELL, M.D. " After a very careful perusal of this work, we strenu- ously recommend it, as containing the most complete and excellent instructions for conducting chemical experi- ments There are few persons, however great their ex perience who may not gain information in many impor- £n particulars; and for ourselves, we beg most unequ.v- ocallv to acknowledge that we have acquired many new a?dimportant hints^on subjects of even everyday occur- rence."—Philosophical Mag. •• A work hitherto exceedingly wanted in the labora- torv eqnBllv useful to the proficient and to the rtudenl. and eminently creditable to the industry and skill of the author, and to the school whence it emanates.'Wour. nal of Science and Arts.________________ GEOLOGICAL MANUAL, by H. T. De la Beche, F. R. S., P. G. S., Mem. Geol. Soc. of France. In 8vo. With 104 Wood Cuts. In the Press. ELEMENTS of PHYSICS, or NATURAL PHILOSOPHY, GENERAL and MEDI- CAL, explained independently of TECH- NICAL MATHEMATICS, and containing New Disquisitions and Practical Sugges- tions. By Neili, Arnott, M. D. Second I American from the fourth London edition, | with Additions by Isaac Hays, M. D. ' Dr. Arnott's work has done for Physics as much as Locke's Essay did for the science of mind."—London Uni- versity Magazine. " We may venture to predict that it will not be surpass- ed."— Times. Dr. A. has not done less for Physics than Blackstone did for the Law."—Morning Herald. Dr. A. has made Natural Philosophy as attractive as Buffon made Natural History."—French Critic. " A work of the highest class among the productions of mind."—Courier. " We regard the style and manner as quite admirable." —Morning Chronicle. " As interesting as novel-reading."—Athenaeum. " Never did philosophic hand wield a pen more calcu- lated to win men to be wise and good."—Edinburgh Ob- server. " Of this valuable, or we might say, invaluable work, a second edition has been speedily demanded by the pub- lic voice."—Lit. Gaz. A FLORA of NORTH AMERICA, with 108 colored Plates. By W. P. C. Barton, M. D. In 3 vols. 4to. ARNOTT'S ELEMENTS of PHYSICS. Vol. II. Part I. Containing Light and Heat. " Dr. Arnott's previous volume has been so well receiv- ed that it has almost banished all the flimsy productions called popular, which falsely pretend to strip science of its mysterious and repulsive aspect, and to exhibit a holy- day apparel. The success of such a work shows most clearly that it is plain, but sound knowledge which the public want."—Monthly Review. AMERICAN ORNITHOLOGY, or NATU- RAL HISTORY of BIRDS, inhabiting the UNITED STATES, by Charles Lu- cien Bonaparte; designed as a continua- tion of Wilson's Ornithology, Vols. I. II. and III. %* Gentlemen who possess Wilson, and are de- sirous of rendering the work complete, are informed that the edition of this work is very small, and that but a very limited number of copies remain unsold. Vol. IV. in the Press. A DISCOURSE on the REVOLUTIONS of the SURFACE of the GLOBE and the Changes thereby produced in the ANI- MAL KINGDOM. By Baron G. Cuvier. Translated from the French, with Illustra- tions and a Glossary. In 12mo. "With Plates. ' One of the most scientific and important, yet plain and lucid works, which adorn the age-----Here is vast aid to the reader interested in the study of nature, and the lights which reason and investigation have thrown upon the formation of the universe."—Neic Monthly Mag- azine. PHYSIOLOGICAL MEDICINE AND ANATOMY. HISTORY OF CHRONIC PHLEGMASIA, OR INFLAMMATIONS, founded on Clin- ical Experience and Pathological Anatomy, exhibiting a View of the different Varieties and Complications of these Diseases, with their various Methods of Treatment. By F. J. V. Broussais, M. D. Translated from the French of the fourth edition, by Isaac Hays, M. D. and R. Eglesfeld Griffith, M. D. Members of the American Philosoph- ical Society, of the Academy of Natural Science, Honorary Members of the Phila- delphia Medical Society, &c. &c. In 2 vols. 8vo. EXAMINATION OF MEDICAL DOC- TRINES AND SYSTEMS OF NOSOL- OGY, preceded by Propositions containing the Substance of Physiological Medicine, by F. J. V. Broussais, Officer of the Royal Order of the Legion of Honor; Chief Phy- sician and First Professor in the Military Hospital for Instruction at Paris, &c. Third edition. Translated from the French, by Isaac Hays, M. D. and R. E. Griffith, M. D. In 2 vols. 8vo. In the press. A TREATISE ON PHYSIOLOGY, Applied to Pathology. By F. J. V. Broussais, M. D. Translated from the French, by Drs. Bell and La Roche. 8vo. Third American edi- tion, with additions. " We cannot too strongly recommend the present work I to the attention of our readers, and indeed of all those who wish to study physiology as it ought to be studied, in its application to the science of disease." " We may safely say that he has accomplished his task in a most masterly manner, and thus established his reputation as a most "excellent physiologist and profound pathologist." —North American Med. and Surg. Journ. Jan. 1827. THE PRINCIPLES AND PRACTICE OF MEDICINE. By Samuel Jackson, M. D. Adjunct Professor of the Institutes and Prac- tice of Mecicine in the University of Penn- sylvania. 8vo. THE PRACTICE OF MEDICINE, upon the Principles of the Physiological Doctrine. By J. G. Coster, M. D. Translated from the French. An EPITOME of the PHYSIOLOGY, GENERAL ANATOMY, and PATHOL- OGY of BICHAT. By Thomas Hender- son, M. D. Professor of the Theory and Practice of Medicme in Columbia College, Washington City. 8vo. " The Epitome of Dr. Henderson ought and must find a place in the library of every physician desirous of useful knowledge for himself, or of being instrumental in im- parting it to others, whose studies he is expected to super- intend."—JV. A. Med. and Surg. Journ. No. 15. A TREATISE on FEVER, considered in the spirit of the new medical Doctrine. By J. B. Boisseau. Translated from the French. In the Press. DIRECTIONS for MAKING ANATOM- ICAL PREPARATIONS, formed on the basis of Pole, Marjolin and Breschet, and including the new method of Mr. Swan, by Usher Parsons, M. D. Professor of Anatomy and Surgery. In 1 VoL 8vo. with plates. A TREATISE on PATHOLOGICAL ANATOMY. By William E. Horner, M. D. Adj. Prof, of Anatomy in the Univer- sity of Pennsylvania. "We can conscientiously commend it to the members of the profession, as a satisfactory, interesting, and instruc- tive view of the subjects discussed, and as well adapted to aid them in forming a correct appreciation of the dis- eased conditions they are called on to relieve."—American Journal of the Medical Sciences, No. 9. By the same Author. A TREATISE on SPECIAL and GENERAL ANATOMY. Second edition, revised and corrected, in 2 Vols. 8vo. LESSONS in PRACTICAL ANATOMY, for the use of Dissectors. 2d edition, in 1 Vol. 8vo. SYSTEM of ANATOMY, for the use of Stu- dents of Medicine. By Caspar Wistar. Fifth edition, revised and corrected, by W. E. Horner, Adjunct Professor of Anatomy in the University of Pennsylvania. In 2 Vols. 8vo. ELEMENTS of GENERAL ANATOMY, or a description of the Organs comprising the Human Body. By P. A. Beclard, Pro- fessor of Anatomy to the Faculty of Medi- cine at Paris. Translated by J. Togno. TREATISE on SURGICAL ANATOMY. By Abraham Colles, Professor of Anatomy and Surgery, in the Royal College of Sur- geons in Ireland, &c. Second American edition, with notes by J. P. Hopkinson, De- monstrator of Anatomy in the University of Pennsylvania, &c. &c. A TREATISE on PATHOLOGICAL ANATOMY. By E. Geddings, M. D. Pro- fessor of Anatomy in the Medical College of South Carolina. In 2 vols. 8vo. (In the press.) ELEMENTS OF MYOLOGY. By E. Ged- dings, M. D. illustrated by a series of beau- tiful Engravings of the Muscles of the Hu- man Body, on a plan heretofore unknown in this country. In the press. This work, in addition to an ample and accurate description of the general and special anatomy of the muscular system, will comprise illustrations of the subject from comparative anatomy and physiology, with an account of Ihe irregularities, variations and anomalies, observed by the various ancient and mod- ern anatomists, down to the present time. MEDICINE AND SURGERY. A TREATISE on FEVER, By Southwood Smith, M. D., Physician to the London Fever Hospital. "No work has been more lauded by the Reviews than the Treatise on Fevers, by Southwood Smith. Dr. John- son, the editor of the Medico-Chirurgical Review, says, 'It is the best we have ever perused on the subject of fever, and in our conscience, we believe it the best that ever flowed from the pen of physician in any age or in any country.' "—Am. Med. Journ. An ESSAY on REMITTENT and INTER- MITTENT DISEASES, including generic- ally Marsh Fever and Neuralgia—compris- ing under the former, various Anomalies, Obscurities, and Consequences, and under a new systematic View of the latter, treating of Tic Douloureux, Sciatica, Headache, Ophthalmia, Toothache, Palsy, and many other Modes and Consequences of this gene- ric Disease; by John Macculloch, M. D., F. R. S. &c. &c. " In rendering Dr. Macculloch's work more accessible to the profession, we are conscious that we are doing the state some service."—Med. Chir. Review. " We most strongly recommend Dr. Macculloch's trea- tise to the attention of our medical brethren, as present- ing a most valuable mass of information, on a most im- portant subject."—JV. A. Med. and Surg. Journal. A PRACTICAL SYNOPSIS OF CUTANE- OUS DISEASES, from the most celebrated Authors, and particularly from Documents afforded by the Clinical Lectures of Dr. Biett, Physician to the Hospital of St. Louis, Paris. By A. Cazenave, M. D. and H. E. SCHEDEL, M. D. " We can safely recommend this work to the attention of practitioners as containing much practical informa- tion, not only on the treatment, but also on the causes uf cutaneous affections, as being in fact the best treatise on diseases of the skin that has ever appeared."—Ameri- can Journal of the Medical Sciences, No. 5. SURGICAL MEMOIRS OF THE RUSSIAN CAMPAIGN. Translated from the French of Baron Larrey. Nearly ready. LECTURES ON INFLAMMATION, exhib- iting a view of the General Doctrines, Pa- thological and Practical, of Medical Sur- gery .° By John Thompson, M. D., F. R. S. E. Second American edition. THE INSTITUTES AND PRACTICE OF SURGERY; being the Outlines of a Course of Lectures. By W. Gibson, M. D. Profes- sor of Surgery in the University of Pennsyl- vania. 3d edition, revised, corrected, and enlarged. In 2 vols. 8vo. PRINCIPLES OF MILITARY SURGERY, comprising Observations on the Arrange- ments, Police, and Practice of Hospitals, and on the History, Treatment, and Anoma- lies of Variola and Syphilis; illustrated with cases and dissections. By John Hennen, M D F R. S. E. Inspector of Military Hospitals-first American from the third London edition, with the Life of the Author, by his son, Dr. John Hennen. »ThP value of Dr. Hennen's work is too well appreci- the volume ««J*!„fJ^* withbut it."^*M«ea/ Gaz AMERICAN JOI/RNAI. OP THE MEDICAL SCIENCES. Published Quarterly. And supported by the most distinguished Physicians in the United States, among which are Professors Bigelow, Channing, Chapman, Coxe, De Butts, De- wees, Dickson, Dudley, Francis, Gibson, Hare, Henderson, Horner, Hosack, Jackson, Macneven, Mott, Mussey, Physick, Potter, Sewall, Warren, and Worthington; Drs. Daniell, Drake, Emerson, Fearn, Geddings, Griffith, Hale, Hays, Hayward, Ives, Jackson, Moultrie, Ware, and Wright- It is published punctually on the first of November, February, May, and August. Each No. contains about 280 large 8vo. pages, and one or more plates —being a greater amount of matter than is fur- nished by any other Medical Journal in the United States. Price $5 per annum. The following Extracts show the estimation in which this Journal is held in Europe:— " Several of the American Journals are before us. * * * Of these the American Journal of the Medical Sciences is by far the better periodical; it is, indeed, the best of the trans-atlantic medical publications; and, to make a com- parison nearer home, is in most respects superior to the great majority of European works of the same descrip tion."—The Lancet, Jan. 1831. " We need scarcely refer our esteemed and highly emi- nent cotemporary, \The American Journal of the Medical Sciences,'] from whom we quote, to our critical remarks on the opinions of our own countrymen, or to the princi ple3 which influence us in the discharge of our editorial duties." " Our copious extracts from his unequalled pub lication, unnoticing multitudes of others which come be- fore us, are the best proof of the esteem which we enter- tain for his talents and abilities."—London Medical and Surgical Journal, March, 1830. "The American Journal of the Medical Sciences is one of the most complete and best edited of the numerous periodica^ publications of the United States."—Bulletin des Sciences Medicates, Tom. XIV. PATHOLOGICAL and PRACTICAL RE- SEARCHES on DISEASES of the BRAIN and SPINAL CORD. By John Abercrom- bie, M. D. " We ha%re here a work of authority, and one which does credit to the author and his country."— North Amer Med. and Surg. Journal. By the same Author. PATHOLOGICAL and PRACTICAL RE- SEARCHES on DISEASES of the STO- MACH, the INTESTINAL CANAL, the LIVER, and other VISCERA of the ABDOMEN. "We have now closed a very long review of a very valuable work, and although we have endeavored to con- dense into our pages a great mass of important matter, we feel that our author has not yet received justice."— Medico- Chirurgical Review. A RATIONAL EXPOSITION of the PHYSICAL SIGNS of DISEASES of the LUNGS and PLEURA; Illustrating their Pathology and facilitating their Diag- nosis. By Charles J. Williams, M. D. In 8vo. with plates. " If we are not greatly mistaken, it will lead to a better understanding, and a more correct estimate of the value of auscultation, than any thing that has yet appeared." —Am. Med. Journal. MANUAL of the PHYSIOLOGY of MAN; or a concise Description of the Phenomena of his Organization. By P. Hutin. Trans- lated from the French, with Notes, by J. Togno. In 12mo. MEDICINE. The PRACTICE of PHYSIC. By W. P. Dewees, M. D. Adjunct Professor of Mid- wifery, in the University of Pennsylvania, 2 Vols. 8vo. " We have no hesitation in recommending it as deci- dedly one of the best systems of medicine extant. The tenor of the work in general reflects the highest honor on Dr. Dewees's talents, industry, and capacity for the exe- cution of the arduous task which he had undertaken. It is one of the most able and satisfactory works which mod- ern times have produced, and will be a standard authori- ty."—London Med. and Surg. Journal, Aug. 1830. 9EWEES on the DISEASES of CHIL- DREN. 3d ed. In 8vo. The objects of this work are, 1st, to teach those who t.ay the charge of children, either as parent or guar- dir the most approved methods of securing and im- proving their physical powers. This is attempted by pointing out the duties which the parent or the guar- dian owes for this purpose, to this interesting, but helpless class of beings, and the manner by which their duties shall be fulfilled. And 2d, to render available a long experience to these objects of our affection when they become diseased. In attempting this, the author has avoided as much as possible, " technicality;" and has given, if he does not flatter himself too much, to each disease of which he treats, its appropriate and designating characters, with a fidelity that will prevent any two being confounded together, with the best mode of treating them, that either his own experience or that of others has sug- DEWEES on the DISEASES of FEMALES. 3d edition, with Additions. In 8vo. A COMPENDIOUS SYSTEM OF MID- WIFERY ; chiefly designed to facilitate the Inquiries of those who may be pursuing this Branch of Study. In 8vo. with 13 Plates. 5th edition, corrected and enlarged. By W. P. Dewees, M. D. The ELEMENTS OF THERAPEUTICS and MATERIA MEDICA. By N. Chap- man, M. D. 2 vols. 8vo. 5th edition, cor- rected and revised. MANUAL of PATHOLOGY: containing the Symptoms, Diagnosis, and Morbid Char- acter of Diseases, &c. By L. Martinet. Translated, with Notes and Additions, by Jones Quain. Second American Edition, 12mo. " We strongly recommend M. Martinet's Manual to the profession, and especially to students; if the latter wish to study diseases to advantage, they should always have it at hand, both when at the bedside of the patient, and when making post mortem examinations."—American Journal of the Medical Sciences, No. I. CLINICAL ILLUSTRATIONS of FEVER, comprising a Report of the Cases treated at the London Fever Hospital in 1828-29, by Alexander Tweedie, M. D., Member of the Royal College of Physicians of London, &c. 1 vol. 8vo. "In short, the present work, concise, unostentatious as it is, would have led us to think that Dr. Tweedie was a man of clear judgment, unfettered by attachment to any fashionable hypothesis, that he was an energetic but judicious practitioner, and that, if he did not dazzle his readers with the brilliancy of theoretical speculations, he would command their assent to the solidity of his didac- tic precepts."—Med. Chir. Journal. The ANATOMY, PHYSIOLOGY, and DIS- EASES of the TEETH. By Thomas Bell, F.R.S., F.L.S. &c. In 1 vol. «vo. With Plates. " Mr. Bell has evidently endeavored to construct a work of reference for the practitioner, and a text-book for the student, containing a 'plain and practical digest of the information at present possessed on the subject, and results of the author's own investigations and expe- rience.' " * * * " We must now take leave of Mr. Bell, whose work we have no doubt will become a class-book on the important subject of dental surgery."—Medko-Chi- rurgical Review. "We have no hesitation in pronouncing it to be the best treatise in the English language."—North American Medical and Surgical Journal, No. 19. AMERICAN DISPENSATORY. Eighth Edition, improved and greatly enlarged." By John Redman Coxe, M. D. Professor of Ma- teria Medica and Pharmacy in the Univer- sity of Pennsylvania. In 1 vol. 8vo. V This new edition has been arranged with spe- cial reference to the recent Pharmacopoeias, published in Philadelphia and New-York. ELLIS' MEDICAL FORMULARY. The Medical Formulary, being a collection of prescriptions derived from the writings and practice of many of the most eminent Phy- sicians in America and Europe. By Benjamin Ellis, M. D. 3d. edition. With Additions. " We would especially recommend it to our brethren in distant parts of the country, whose insulated situations may prevent them from having access to the many autho- rities which have been consulted in arranging the mate rials for this work."—Phil. Med. and Phys. Journal. PREPARING FOR PUBLICATION, CYCLOPiEDIA OF PRACTICAL MEDICINE; COMPRISING TREATISES ON THE NATURE AND TREATMENT OF DISEASES, MATERIA MEDICA AND THERAPEUTICS, MEDICAL JURISPRUDENCE, &c. JOHN FORBES, M.D. F.R.S. Physician to the Chichester Infirmary, &c. edited by ALEXANDER TWEEDIE, M.D. Physician to the London Fever Hospital, &c. JOHN CONOLLY,M. .. Professor of Medicine -in the London University ,&c. WITH THE ASSISTANCE OF THE FOLLOWING PHYSICIANS: JAMES APJOHN, M.D. M.R.I. A. Professor of Chemistry to the Royal College of Surgeons in Ire- land. JAMES L. BARDSLEY, M.D. Physician to the Manchester Royal Infirmary, Dispensary, &c. EDWARD BARLOW, M. D. Physician to the Bath United Hospital and Infirmary. R. H. BRABANT, M. D. Devizes. JOSEPH BROWN, M. D. Physician to the Sunder- land and Bishopwearmouth Infirmary. THOMAS H. BURDER, M. D. Member of the Royal College of Physicians, London. JOHN BURNE, M. D. Physician to the Carey-street Dispensary. H.W.CARTER, M.D. F.R.S.E. Fellow of the Royal College of Physicians, London, Physician to the Kent and Canterbury Hospital. JOHN CHEYNE, M. D. F. R. S. E. M. R. I. A. Physician-General to the Forces in Ireland, &c. &c. JAMES CLARK, M. D. Physician to St. George's Infirmary, &c. &c. JOHN CLENDINNING, M. D. Fellow of the Royal College of Physicians, London. JOHN CRAMPTON, M. D. M.R. I. A. King's Pro- fessor of Materia Medica, Physician to Stevens's Hospital, &c. &c. Dublin. ANDREW CRAWFORD, M. D. Physician to the Hampshire County Hospital, Winchester. WILLIAM CUMIN, M. D. Glasgow. JAMES CUSACK,M.B. Steevens' Hospital,Dublin. JOHN DARWALL, M. D. Physician to the General Dispensary, Birmingham. D. D. DAVIS, M. D. M. R. S. L. Professor of Mid- wifery in the London University. JOHN ELLIOTSON, M. D. F. R. S. Physician to St. Thomas's Hospital. R. J. GRAVES, M.D. M.R. I. A King's Professor of the Institutes of Medicine, Honorary Fellow of the King's and Queen's College of Physic.™.Phy- sician to the Meath Hospital and County of Dublin Infirmary. .ton GEORGE GREGORY, M. D. Physician to the Small- Pox Hospital. „„„„„. r MARSHALL HALL, M.D. F.R.S.E. Member of the Royal College of Physicians, London, &c. &c- THOMAS HANCOCK, M.D Liverpool, Member] of the Royal College of Physicians, London. CHARLES HASTINGS, M. D. Physician to the Worcester General Infirmary. BISSET HAWKINS, M. D. Fellow of the Royal College of Physicians, Professor of Materia Medica and Therapeutics in King's College, Dublin. J. HOPE, M. D. Member of the Royal College of Physicians, London. ARTHUR JACOB, M.D. M.R.I.A. Professor of Anatomy to the Royal College of Surgeons in Ireland. ROBERT LEE, M. D. F. R. S. Physician to the British Lying-in Hospital. CHARLES LOCOCK, M. D. Physician to the West- minster General Lying-in Hospital, &c. &c. H. MARSH, M. D. M.R. I. A. Professor of the Prin- ciples and Practice of Medicine to the Royal College of Surgeons in Ireland, &c. Dublin. JONES QUAIN, M. B. Lecturer on Anatomy and Physiology in the Medical School, Aldersgate-Street. J. C. PRICHARD, M. D. F. R. S. Physician to the Infirmary and to St. Peter's Hospital, Bristol. ARCHIBALD ROBERTSON, M. D. Physician to the Northampton General Infirmary. P. M. ROGET, M. D. Sec. R. S. Consulting Physi- cian to the Queen Charlotte's Lying-in Hospital and to the Northern Dispensary, &c. &c. JOHN SCOTT, M. D. Edinburgh. WILLIAM STOKES, M. D. Physician to the Meath Hospital. WILLIAM STROUD, M. D. Physician to the North- ern Dispensary. A. T. THOMSON, M. D. F. L. S. Professor of Ma- teria Medica in the London University. THOMAS THOMSON, M.D. F.R.S. L. & E. Re- gius Professor of Chemistry in the University of Glas- gow, &c. &c. T. J. TODD, M. D. Physician to the Dispensary, Brighton. RICHARD TOWNSEND, A. B. M. D. M. R. I. A. Fellow of King and Queen's College of Physicians, Dublin. CHARLES J. B. WILLIAMS, M.D. Londoa. &c. &c. &c. To be completed in five volumes 8vo. of about 600 pages each.—The first vol- lime will be published early in 1832. CYCLOPAEDIA OF PRACTICAL MEDICINE. The want of a comprehensive work on subjects connected with Practical Medicine including Pathology and Pathological Anat- omy, is one which has long existed in this country. The Medical Dictionaries heretofore published, and the Systems of Medicine in the hands of the student, may be said, without invidiousness, to fall very far short of presenting the English reader with such a compendious survey of the actual state of British and Foreign Medicine as is absolutely required by him. Some of them are too limited and too superficial in their character; others are too volu- minous, too intricate in their arrangement, and too indiscriminate in their contents; and all are open to the serious objection of fail- ing to represent the improvements and discoveries by which the scientific labors of the members of the medical profession, in vari- ous parts of the world, have been rewarded since the commence- ment of the present century. It is the object of the Cyclopaedia of Practical Medicine to supply these deficiencies, and to meet the acknowledged wants of the medical reader. Such ample arrangements have been made for effecting these important objects, as enable the Editors to lay before the public the nature and plan of a publication in which they have endeavored, by dividing the labor of a work including subjects of great diversity, and all of practical importance; by combining the valuable exertions of several contributors already known to the medical public; by excluding mere technical and verbal explanations, and all superfluous matter; and by avoiding multiplied and injudicious divisions; to furnish a book which will be comprehensive without diffuseness, and contain an account of whatever appertains to practical medicine, unembarrassed by dis- quisitions and subjects extraneous to it. In pursuance of this design, every thing connected with what is commonly called the Practice of Physic will be fully and clearly explained. The subject of Pathology will occupy particular at- tention, and ample information will be given with relation to Pa- thological Anatomy. Although the excellent works already published on the subjects of Materia Medica and Medical Jurisprudence can be so readily and advantageously consulted, as to make the details of those branches of science uncalled for in the Cyclopaedia, it belongs to the proposed plan to comprise such general notices of the applica- tion and use of medicinal substances as may be conveyed in a CYCLOPAEDIA OF PRACTICAL MEDICINE. general account of each class into which they have been divided, as of Tonics, Narcotics, &c; and to impart, under a few heads, as Toxicology, Suspended Animation, &c. such information con- nected with Medical Jurisprudence as is more strictly practical in its character. It is almost unnecessary to say that a work of this description will form a Library of Practical Medicine, and constitute a most desirable book of reference for the general practitioner, whose numerous avocations, and whose want of access to books, afford him little time and opportunity for the perusal of many original works, and who is often unable to obtain the precise information which he requires at the exact time when he is in greatest need of it. The Student of Medicine, who is attending lectures, will, also, by means of this work, be enabled, whatever order the lecturer may follow, to refer, without difficulty, to each subject treated of in the lectures of his teacher; and it is presumed that Lecturers on Medicine will see the advantage of recommending to their pupils a work of highly respectable character, the composition of original writers, and which, it is hoped, will neither disappoint the advanced student by its brevity and incompleteness, nor perplex those commencing their studies by an artificial arrangement. But, whilst the Editors have felt it to be their duty to prepare a safe and useful book of reference and text-book, it would be doing injustice to those by whose co-operation they have been honored, not to avow that they have also been ambitious to render the work acceptable and interesting to readers who have leisure and inclination to study what may be termed the Philosophy of Medi- cine : whatever is truly philosophical in medicine being also useful, although the application of the science to the art requires much re- flection and sound judgment.—For the assistanceof those who desire to pursue a regular course of medical reading, ample directions will be given when the work is completed; and for those who may be anxious to prosecute any particular subject to a greater extent than the limits of the Cyclopaedia permit, a list will be given, in an Appendix, of the best works relating to each. The means of accomplishing an undertaking of the importance j of which the Editors are fully sensible, will, doubtless, be appre-| ciated after an inspection of the list of contributors who have \ already promised their co-operation. It is, of course, desirable j il at a work of this kind should be characterized by unity of de- j CYCLOPAEDIA OF PRACTICAL MEDICINE. sign, but, at the same time, as each author will, generally speak- ing, contribute his knowledge and his opinions on the subjects which have occupied his chief attention, the superiority of the whole performance to any thing which the mere labor of compila- tion could accomplish will be unquestionable. To each important article the name of the author will be appended. The acknowledged want of such a publication, already alluded to, and the extensive encouragement which Dictionaries of a much greater extent have met with in France and Germany, although some of them are very unequal as regards the value of different parts, and encumbered with much that is absolutely useless, afford sufficient reason to hope for the success of a work in which what is valuable will, as much as possible, be separated from what is merely calculated to distract the attention, and to frustrate the inquiry, of those who study the science of medicine with a view of regulating and improving its practice. In order to insure this success, it is the desire, and will be the endeavor, of the Editors to make the Cyclopaedia of Practical Medicine not only obviously useful to those for whom it is more immediately intended, but so creditable to British Medical Science as to deserve and to obtain the patronage of all classes of the Medical Profession. In the American edition, all interesting details on the subjects of Materia Medica and Medical Jurisprudence, omitted in the original, will be supplied.—Much new matter in relation to Ameri- can Surgery and Medical Practice will be introduced; and for this ample materials have been promised.—Full explanations will be given of all medical terms, especially those which modern dis- coveries have introduced into the nomenclature of the science, and without a knowledge of which, many of the works of the present day are almost unintelligible.—At the termination of each article ! the most copious references will be given to the best writers on the subject, so as to enable the student who desires it, to pursue j his investigations with the least trouble and the greatest advan-1 tage.—Finally, the whole work will be carefully revised, and such { additions made as may tend to increase its value, and to render it, j what it is desired it should be—A complete Library of the Medical . Sciences.