and friends, I need make no apology for having introduced myself in connexion with this subject. I am persuaded they will hail with cordial approbation the establishment of an institution, and the introduction of a new department of surgical practice, hitherto a desideratum, and unexplored but most important region in the geography of Surgical Anatomy, and which is destined to supply such pressing wants and to fulfil such high purposes; in short, to redress the evils of feeble nature and to repair the injuries of misguided art.

Well knowing, from a long career of experience in my own country, the parental anxiety which naturally attaches to all kinds of deformities, I am satisfied that, in appealing more directly to fathers and to mothers, they will welcome any efforts which have for their object the relief or removal of the most unpleasant class of affections that can afflict their offspring.

In founding an orthopaedic establishment in this country, it has not been my design to serve myself only, but a higher and nobler feeling, I trust, has actuated me in this step, which I cannot doubt will be properly estimated by all who know me. I design it as a national establishment; and, should my life not be spared, trust to be enabled to make such arrangements that others may be benefited by it.

H

BELGIU M.

FROM Paris, accompanied by my young friends Dr. Schmidt and Dr. King, of New-York, we proceeded to Belgium, Holland, and Germany, and in our route stopped a short time at the capital of Belgium. We find, indeed, the beautiful city of Brussels abounding in charities of all descriptions and hospitals of great extent.

Here we notice a union of English with French practice; this mixed tone originating from so many of both these nations having selected this place for their residence. The English usages, however, and the English practice of medicine and surgery rather predominate. Netherlands has produced men of great merit in our profession; among whom I must be permitted to name Mr. Seutin, the author of the new system of healing fractures, now much adopted in that country and in France, denominated "La Bandage Immobile," or

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L'Appareil Amidonnée," so called from the starch or dextrine with which the bandages are saturated, forming, when they and the successive layers of pasteboard are dry, an immovable encasement to the limb, as much so as if it were enclosed in a dried paste envelope of plaster of Paris. An admirable contribution to practical surgery under many circumstances.

We had the happiness of knowing the author, and of being shown by him every step of the process, and of hearing his proofs and arguments in favour of it. As is natural to an inventor, he is perhaps more enthusiastic in its favour than many who listen to and witness his illustrations. Many surgeons, with great justice, will object to the immediate application of this apparatus at

the moment of the fracture, and of this number we profess ourselves to be, from a fear of the perfectly inelastic character of the appareil, and the natural tendency we all know there is to vesications and excoriations when a recent fracture is too tightly bandaged, and the heat thereby is made to accumulate.

From instances which I have known of severe inflammation caused by this practice, extending frightfully through the limb, and from suppurations permanently impairing the functions of motion, I would advise great circumspection in the use of it immediately after an accident.

This was strikingly illustrated in the case of one of my surgical friends, Dr. Doubovitsky, professor of surgery in the Imperial Academy of St. Petersburgh. He had this appareil applied to a simple fracture of the left arm, involving the elbow joint, immediately after the accident. And so intense was the inflammation, which extended to the ends of the fingers, that contractions of the muscles and tendons, and such deformities of the forearm, wrist, and hand were the consequence, that I am confident he never will have the perfect use of the limb, notwithstanding all the aid that orthopaedic surgery, directed by so great a master as Guerin himself, whom he came to Paris to consult, could offer to him. An inconceivable misfortune to a young and distinguished surgeon as he is.

But unquestionably, after the inflammatory symptoms have subsided, this process adds vastly to the comfort of the patient, and abridges greatly the irksomeness of confinement.

Seutin, however, stoutly maintains that an important part of the efficacy of his method consists in its immediate application after an injury. He cited to me ex

amples of attempts made to depreciate his practice, in which the application was delayed for a number of days instead of being used instantly, as he insists it should have been.

In army practice, where soldiers are to be transported, and in civil life also, under such circumstances, Seutin's method will be in every point of view justified.

As for ourselves, we admire the simplicity, the everything surgical, in the admirable dressings of the modern father of military surgery, Baron Larrey.

His flat and cylindrical cushions of rolled-up straw sewed in common linen cloth, composed thus of materials accessible on all occasions, and which are placed longitudinally next to the limb and beneath the splints, forming with the latter an open framework around it, have an advantage over all other dressings, by their elasticity, coolness, and cleanliness, and at the same time giving an opportunity for the limb to be daily examined.

This simple and cheap apparatus is, in fact, an imitation of Nature herself in the adjustment of the action of the long muscles, by which their antagonist powers, in an unfractured healthy limb, exert, like so many levers, a proper equipoise of extension and flexion in preserving the bones in a correct position upon their hinges or joints.*

It is due to my friend Dr. P. S. Townsend, of this city, to say, that this apparatus of Baron Larrey was first introduced into this country at the hospital of the Seamen's Retreat on Staten Island, in the vicinity of this city, about the year 1831–2. This charity was founded chiefly through the instrumentality of Dr. Townsend.

HOLLAN D.

JOURNEYING on through many cities of less importance in Belgium and in Holland, we alighted at ancient Leyden. At the name of Leyden, every historic association dear to our profession is summoned before us. It was here, in this great school of learning, that lived the immortal Boerhaave, and a galaxy of so many great names in every department of science; giving a metropolitan renown to this otherwise inconsiderable though beautiful city.

We visited the lecture-rooms, the hospitals, the museums, which were once walked and occupied by Boerhaave. His humble dwelling, a rural villa, is yet to be seen in the environs of the town. In the Botanic Garden, attached to the now very small School of Medicine, they take great pride in showing a tree which was planted and nursed by the great champion of the Humoral Pathology. From this tree we took and preserved a leaf with great care, as a souvenir of the spot hallowed by the footsteps and consecrated by the fame of that master-mind in medicine, whose name is not more illustrious by his profound learning and extensive reputation as a professor and a physician, than it is by his exemplary virtues as a man and a Christian.

But Leyden was-and is no more. Its spirit departed with him who gave it life. It now stands like a city of the dead, deserted, alone, scarce a voice heard within its walls the rank grass growing in its streets-the scum of the green conferva gathering on the surface of its stagnant canals, whose waters are never ruffled or