University of Maryland.—We observe, by the public prints, that the long pending cause between the regents of the University and the board of trustees, to which we adverted more than once in the first volume of the "Intelligencer," has been decided in the Court of Appeals against the latter. It will be recollected that, in the year 1828, the legislature of Maryland appointed a board of trustees, by abrogating the former charter under which the regents acted. This act is now pronounced by the highest tribunal in the state to be unconstitutional, and therefore null and void.

Louisville Medical Institute.-From the catalogue recently published, we observe that there were, during the session just terminated, one hundred and twenty medical students. Of this number, fifty-four were from Kentucky, thirty-two from Tennessee, nine from Mississippi, seven from Alabama, six from Indiana, four from Illinois, two from North Carolina, two from Georgia, one from New York, one from Missouri, one from Massachusetts, and one from Louisiana.

College of Physicians and Surgeons of the Western District of the State of New York. The catalogue of this institution informs us that there were, during the last session, one hundred and twenty-four students. On the 23d of January, 1839, the regents of the University conferred the degree of doctor of medicine on thirty-three gentlemen.

BOOKS RECEIVED.

Catalogue of the officers and Students of the Medical Institute of the City of Louisville, January 1, 1839. 8vo. pp. 12. Louisville, Ky. 1839.

From Dr. Woodward.-Sixth Annual Report of the Trustees of the State Lunatic Hospital at Worcester, Dec. 1838. 8vo. pp. 88. Boston, 1839.

From the Author.-Principles of General and Comparative Physiology, intended as an introduction to the study of Human Physiology, and as a guide to the philosophical pursuit of Natural History. By William B. Carpenter, Member of the Royal College of Surgeons of London, late President of the Royal Medical and Royal Physical Societies, and Fellow of the Royal Boston Society, Edinburgh; and Lecturer on Forensic Medicine in the British Medical School. 8vo. pp. 478. London, 1839.

From George Combe, Esq.-An Enquiry into the Influence of Physical Causes upon the Moral Faculty. Delivered before a meeting of the American Philosophical Society, held at Philadelphia on the 27th of February, 1786. By Benjamin Rush, M. D. 8vo. pp. 28. Philadelphia, 1839.

[This Enquiry, from (we need scarcely say) a most distinguished source, is reprinted by Mr. Combe as "the nearest approach to Gall's discovery which has come under his notice."]

From the Author.-An Address delivered to the Students of the Louisville Medical Institute, in presence of the citizens of the place, at the commencement of the second session of the Institute, November 13, 1838. By Joshua B. Flint, M. D., Professor of Surgery. 8vo. pp. 31. Louisville, Ky. 1838.

From Professor T. R. Beck.-Circular and Catalogue of the Faculty and Students of the College of Physicians and Surgeons of the Western District of the State of New York, in Fairfield, Herkimer County, 1838-9. 8vo. pp. 16. Albany, 1839.

THE

AMERICAN MEDICAL INTELLIGENCER.

Vol. II.

March 15, 1839.

No. 24.

ART. I-VACCINATION AND RE-VACCINATION.

In a letter (dated Bristol, Jan. 26, 1839,) received by the Great Western from William B. Carpenter, Esq., the able author of the "Principles of General and Comparative Physiology," referred to more than once in the pages of this miscellany, he thus expresses himself on the subject of the new vaccine virus.

"I shall hope to hear from you continued good accounts of the success of our new vaccine lymph. It has certainly quite fulfilled the expectations which were at first excited, regarding its general characters and its increased effect on the constitution; but the actual value of its protective power still remains to be tested. Mr. Estlin has employed it with complete success for the removal of a nævus, over which the vesicles spread in a very remarkable manner."

The following letter from a respectable physician in this state affords additional testimony in favour of the new lymph :

Robley Dunglison, M. D.

Canonsburg, Feb. 18th, 1839.

Dear Sir, I duly received the portion of vaccine crust, the product of the recent English virus noticed in your journal, which you so promptly and so kindly sent to me by mail. In order to extend your benefit as widely as possible, I divided the vaccine crust between myself and two of my professional neighbours. With the small portion which I reserved to myself, I succeeded in producing two beautiful, well-defined cow pocks on the arms of two healthy infants, æt. 5 months, and from these I obtained a supply of matter which has, in a number of cases, infallibly produced its own likeness to my entire satisfaction. A detail of the first two cases would be found to bear a close resemblance to the cases described by Dr. Bridges in your "Library and Intelligencer" for Jan. 1st. In all my limited experience in vaccination for fifteen years, I have never seen the specific local appearances as well as the constitutional symptoms of cow pock more distinctly marked than in the cases which I have vaccinated with this matter. To satisfy myself, I have, also, in a few of these cases, applied Bryce's test of the constitutional effect of vaccina. In short, from the published experience of others, as well as from my own observation, I feel confident in pronouncing the cases which I have vaccinated with this English matter, to be true Jennerian cow pocks.

Your correspondence with those parts of England where the cow pock is endemic, and your receipts of virus from the fountain-head, will doubtless greatly serve the cause of humanity, by preserving this great prophylactic in all its vigour and purity.

With feelings of gratitude and great regard, I remain, yours truly,
D. S. STEVENSON.

We may remark, that Dr. Bridges will now be able to supply the lymph to country practitioners on the ordinary terms.

In the last number of the British and Foreign Medical Review (for Jan. 1839, p. 186,) is contained an account of the results of vaccination and re-vaccination, during a period of five years, in the kingdom of Wirtemberg. The despotic governments of the continent have, in cases like this, a great advantage over free countries; as they have merely to issue decrees to have them obeyed, whether they relate to matters of public or domestic nature. For this reason, England, although the birth-place of vaccination, has always been behind many of the continental nations in deriving full benefit from this great discovery; and, consequently, we must now look abroad for data whereon to found trust-worthy conclusions respecting many doubtful points in its history. Although in Wirtemberg the despotic authority of the government has not been carried to its full extent in respect to the enforcement of vaccination, still this has reached a degree of universality which it is not likely to attain in England for many years to come; as it is well known that John Bull would rather die by his own free will, and in his own way, than be saved by authority from plague or pestilence. It is, perhaps, well for medical science that countries may be found where such an experiment as is now making in Wirtemberg, on the protective powers of cowpox, can still be made on the grand scale. The time that has elapsed since the experiment was begun, is yet too brief to furnish certain results as to the absolute power of vaccination to protect from smallpox, or as to the degree of permanency or duration of this protective power; but the results arrived at, as detailed in the article before us, are very important, and such as have not been heretofore obtained. Our limits will not permit us to enter, at any length, on the subject; but we must lay before our readers a few of the more prominent details.

The population of Wirtemberg is. 363,293; and it appears that during the period of five years 208,322 children were vaccinated, leaving only the insignificant number of 271, above three years of age, yet unvaccinated. The total number of cases of smallpox that occurred during the same period was 1677, of which 354 were cases of genuine smallpox, and 1043 modified (in other words, rendered milder) by previous vaccination; being about one case of failure in every 217 individuals. The total number of persons re-vaccinated (i. e. vaccinated a second time after the lapse of a certain number of years) was 44,009; of this number upwards of 20,000 took the disease perfectly; 9,006 imperfectly, and 15,000 not at all. It might be inferred from this that little more than one third of those vaccinated in infancy could be regarded as protected from smallpox ; but althongh probable, it is by no means yet proved, that a susceptibility for the vaccine is tantamount to a susceptibility for small-pox. If this were admitted, we must admit, also, that the proportion of persons liable to a second attack of smallpox is much greater than is commonly believed. Thus it apears that of 297 persons who had previously had smallpox, and were marked by the disease, 95 received the cow-pox in a perfect form, and 76 in a modified form, while only 126 resisted it altogether. Are we justified in inferring from this, that no less than 58 per cent. of those who have had smallpox, are still liable to an attack of this loathsome malady?

It resulted from the Wirtemberg trials that the proportion of persons that took the cow-pox well, on the second vaccination, progressively increased with the age of the subjects,—that is, with the distance of time from the first vaccination. Thus, in some of the departments of the kingdom where the re-vaccinated were chiefly children, the proportion of cases in which the operation succeeded was comparatively small; among the military (14,334 in number), where the subjects were nearly all about the age of twenty-one, a much greater number received the disease; while in one whole department (the Jakstkreis), in which the persons re-vaccinated were thirty years old or upwards, a still larger proportion was affected. All these results bear strongly on the expediency of a second vaccination; and, accordingly, Dr. Heim urges this as absolutely necessary for the protection of the public. The author of the article in the Review, however, is of opinion that we have not, as yet, sufficient experience positively to decide the point; but it must be admitted, that such experience as we yet have, tends decidedly to countenance the advantage of second vaccinations; and a potent argument in their favour, in the present stage of the enquiry, is, that they may do good and cannot possibly do harm. One very important point seems fully established in this article, viz.--that the existence of a cicatrix or mark of the primary vaccination in the arm, is no test whatever of the security of the individual from smallpox; it having been found, in Wirtemberg, that those with and those without the mark were equally susceptible of cow-pox on the second trial. Thus, out of the 14,334 re-vaccinations among the military, 8,845, or more than half, showed what has usually been considered as good marks of previous vaccination; and of this number the success of the re-vaccination was complete in 31 per cent., modified in 29 per cent., and it failed altogether in 40 per cent.: while of those with imperfect marks, the re-vaccination was complete in 28 per cent., modified in 26 per cent., and totally failed in 46 per cent.

The following communication in a recent medical periodical,' by William B. Hutchinson, exhibits the results of re-vaccination at the Foundling Hospital, London:

"I have recently submitted 216 children at the Foundling Hospital to the test of re-vaccination, and as this subject is just now creating so much interest among the members of the profession, it may be useful to lay before your readers the result of my observations upon these cases.

"Of these two hundred and sixteen re-vaccinated, eleven went through the different stages of regular cow-pox, as if they had never had the disease; proving that in these the primary vaccine had lost its prophylactic power.

"In one hundred and twenty-two a spurious form of cow-pox was developed, producing in some considerable local inflammation and constitutional disturbance. The irregular nature and progress of the spurious affection in all these cases, proved that the constitution was still under the protective influence of the first vaccination.

"In eighty-three no effect (more than slight irritation from the puncture) was produced, though many of them were re-vaccinated twice, thus affording negative evidence of the undiminished preservative powers of the priinary vaccine.

"I was led in the first instance to recommend a general re-vaccination of the children, from observing that the arms of many of those recently arrived

I London Medical Gazette, Jan, 26, 1839, p. 638.

from the country (of the age of five) presented very imperfect cicatrices: but I think the following short observations will go far to prove that the condition of the cicatrix does not furnish any criterion whereby to estimate the success or efficacy of the early vaccination, and I feel justified in concluding that the intensity of the local inflammation produced by the vaccine virus, bears no relation to its subsequent protective virtues.

"Of the eleven cases re-vaccinated in which all the stages of natural cow-pox were regularly developed, eight presented perfectly formed cicatrices, (some having four, none less than two); two presented no trace of a cicatrix; and had an imperfect scar. The youngest of the eleven was æt. 5, the oldest æt. 13.

"I selected three arms, in neither of which could any trace of a cicatrix be discovered (though the children were all carefully vaccinated when infants), and I re-vaccinated them TWICE with the greatest care from a fine arm without any result, more than a slight degree of inflammation in one out of the three cases.

"Being desirous to employ only recent lymph from the infant's arm (for the greater security of the children re-vaccinated), I had no extensive opportunity of testing the lymph of those cases of successful re-vaccination, and the few experiments which I did make were inconclusive.

"I will conclude this brief notice by earnestly calling the attention of the profession to the necessity of enforcing the practice of periodical re-vaccination. The period of time during which the vaccine may be said to preserve its prophylactic power does not seem to be agreed upon; and, in the absence of any positive rules for our guidance, it is surely better that we should be on the safe side, and as we do see cases where we must believe that the regular cow-pox has been produced twice within the period of five years, we should consider this the maximum term of years over which the protective power of vaccine may be said to extend, and re-vaccinate accordingly every fifth year."

ART. II.-ON DEFORMITY OF THE CHEST IN YOUNG CHILDREN, FROM DISEASE OF THE LUNGS.

BY G. A. REES, ESQ.

There is a deformity of the chest met with in infants and young children, occurring in connection with disease of the lungs, which, though not of very rare occurrence, I do not recollect to have seen described. The deformity consists in a depression existing at the line of union between the ribs and their cartilages, in consequence of which the arched form of the front of the thorax is lost, and a channeled appearance external to the sternum on each side produced.

Accompanying such deformity, there is an altered movement of the ribs in breathing, and there are well-marked symptoms of lesions of the organs of respiration; the infant suffers habitually from shortness of breath and a short dry cough, when attacked with any bronchial affection not in itself of a dangerous character-bronchial irritation, for example, to which they are subject and the breathing becomes hurried, the pulse much accelerated, the countenance assumes a livid hue, and the appearance of the child indicates a severe form of the pulmonary disease.

The following is a very slight sketch of a case of this kind, which, though imperfect, will, I think, best illustrate the description, and serve as an introduction to the remaining remarks.

James Goullee, aged eleven months, was brought to me in the month of April, labouring apparently under severe inflammation of the lungs; there