I was induced to undertake an operation for extirpating this tumour, chiefly because no symptoms of cerebral affection could be discovered other than those which a moderate determination of blood to the head might produce. Two long incisions were first made at right angles near the centre of the swelling, and afterwards the scalp was dissected up from the whole surface, and to some extent, around the sound bones. With a long narrow saw, held in a tangent to that portion of the circumference of the cranium, I then cut off the entire tumour, apparently at its base. The saw moved with difficulty while it was passing through the external table, but with great ease when it was acting upon the interior of the mass. This first led to the suspicion that the disease was not an exostosis; and when the prominence had been removed, it was made evident that a far worse state of things had to be encountered. The exposed surface presented perpendicular cells, or cavities, like those of a honeycomb, which were filled with a bloody, or pulpy and sanious matter. The case was at once decided to be a spina ventosa of the skull, and it was therefore deemed necessary to extract the whole mass from the surface of the dura-mater beneath. A long and tedious extension of the operation was then undertaken. The whole mass of the tumour was circumscribed by the circular edge of a small Hays's saw, and the mass was pried out in successive fragments by an elevator, occasionally aided by the bone nippers and forceps. This part of the operation proved exceedingly difficult, for the tumour extended inwards much deeper below the internal table, than its outer surface had risen above the external table of the skull. Finally, however, a removal of the whole morbid structure was effected, and the dura-mater was exposed, thin and livid in appearance, at the bottom of a deep cavity which the bystanders estimated to be capable of holding four and one-half ounces of water. There were no pulsations visible, although the circulation was strong and full. Some small spicule of bone adhered to the dura-mater, which were extracted by the aid of forceps. In extracting the last of these, which appeared to penetrate the dura-mater, a prodigious gush of venous blood issued, after which the patient fell into a convulsive syncope. The hemorrhage was supposed to proceed from the longitudinal sinus, and was therefore arrested by graduated compresses and a bandage. The angles of the wound were brought as near together as possible over the compresses, for the purpose of affording support to them while they were confined by the bandages. Very little irritation resulted from this operation.

In nine days, the compresses were loosened by suppuration, and on removing them, the whole of the exposed surface was found to

be granulating, and the orifice in the great sinus was closed. But the brain had not risen up to occupy the exposed cavity; and it was found impossible to place the flaps of the scalp in contact with the dura-mater in the usual way, so as to close the wound. Mild dressings of patent lint were applied over the surface, and confined with moderate pressure by means of a double-headed roller. On the twelfth day after the operation, the cavity below the bone was evidently diminished, and every day thereafter it continued to decrease, until, in the fourth week, the surface of the brain covered by the granulating dura-mater had risen up to the level of the inner table. The natural pulsatory motions did not appear, however, until the cavity was nearly filled; and, in the mean time, forcible pressure could be made on the surface of the brain without exciting any degree of stupor or inconvenience on the part of the patient. But as soon as the pulsations began to appear, every kind of pressure proved irritating to the brain. At the same time, a remarkable change took place in the character and bearing of the patient. He then became exceedingly timid and irresolute. It would render him pale and almost pulseless to approach him with a pair of scissors for the purpose of trimming away his hair from the margins of the wound; and the sight of a piece of lunar caustic, or a pair of forceps, in the surgeon's hands, would throw him into great trepidation. This state of his mental faculties continued for a long period after his complete recovery from the wound. He could not even go down into a cellar containing some plaster busts, without a sense of faintness and sinking; and the operation of taking a cast of his head in plaster, nearly prostrated all the functions of his mind and body. His carriage also became remarkably affected. Instead of maintaining his natural erect posture and bearing, he sunk his head and shoulders into an awkward stoop, and looked timidly and anxiously forward, as if he was afraid of blundering against a door-post.

At the time of the operation, and until the pulsations of the exposed portion of his brain returned, he was remarkable for his firmness of mind and resolution. No patient ever bore a severe and protracted operation with more intrepidity. He sat upright in a chair, without any confinement, until the blood-vessel gave way at the close of the operation; and during its performance, he repeatedly inquired of the bystanders if it was the brain which was coming out under the efforts of the surgeon. It has been, moreover, stated by those who have known him well for years, that previous to this injury he had always been distinguished for his firmness, courage, and inde. pendence.

He is now (two years after the operation) living in perfect health

at the Exchange Hotel, Pittsburg. He is engaged in active business, and is entirely exempt from any symptom of a return of the disease. His former firmness and intrepidity of mind have been gradually returning for a year past, and at present no departure from a healthy condition of mind or body can be discovered. A thickening or induration of the flaps of the scalp, which resulted from their long exposure and separation from the subjacent dura-mater, and which at one period gave origin to a report that the disease had reappeared, has become entirely softened down, and attenuated by the natural process of absorption.

As this case occurred during the period of Mr. Combe's first course of lectures in Philadelphia, it excited great attention among all phrenologists. One of the gentlemen who attended the operation, addressed a letter to Mr. Combe, stating that both organs of Firmness were lost or destroyed; and asked for an explanation of the apparent contradiction in the conduct of the patient to the principles of phrenology. Mr. Combe read this letter publicly to his class, and endeavoured to explain away the difficulty, by locating the position of the tumour posteriorly to the organs of Firmness. On a further, and subsequent examination of the wound, however, he decided that a great portion of the skull, over the region of Firmness, had been removed, together with that of several of the neighbouring organs, as I have enumerated them.

In no respect, however, does this case militate against the principles of phrenology. The organs, instead of being destroyed, were merely displaced or depressed by the growth of the tumour, in the same way that deformities are produced in some of the savage tribes by gradual pressure of the skull. Perhaps a better analogy may be drawn between the state of these organs and the parts of the brain pressed upon by internal effusions of blood, and depressed fractures, which do not produce the symptoms of compression. A compensation is then made for the space occupied by the effused blood or depressed bone, by a corresponding amount excluded from the cavity of the vessels, and retained in the general circulation.

A careful examination of this case will, I think, elicit observations in support of phrenology. The tone and excitement of the depressed region of the brain must probably have been increased by the inva. sion of the tumour, on the same principle that the muscles of labouring men are sometimes supported by leathern straps and bandages. On the other hand, the extirpation of the tumour must have had the same effect in removing the tension and mechanical support of the organs, as tapping for abdominal dropsy exerts upon the viscera of that great cavity. As soon as the depressed convolutions began to

be unfolded or distended by the pulsation of the blood-vessels, they experienced a want of that pressure which had before stimulated them into an increase of activity. Their tone then became enfeebled, and continued so until the scalp had contracted adhesions to the outer surface of the dura-mater, and the cicatrix became consolidated, so as to afford a firm and counteracting support to the pressure of the circulation below.

While Mr. Richardson was recovering from the operation, he was visited by several phrenologists, for the purpose of establishing the precise location of the wound. Although they differed in their opinions in regard to the degree in which the organ of Firmness was involved, they all agreed that Self-esteem was affected, and some thought the injury extended also to the organ of Concentrativeness. Inquiries were therefore directed by them to the manifestations of these faculties; and the patient did suggest some points of character in relation to which he conceived he had undergone an alteration. He asserted that he had for a long time previous to the operation lost his self-respect in the presence of company, and his power of confining his mind to any particular train of thought. But these peculiarities were not obvious to me, or to any of his familiar friends; and I have not thought it right to put them down in my estimate of his condition, as affected by the operation. Such affections may have been the result of that confusion in the mind which generally accompanies excessive determination of blood to the head. It has been suggested that they were produced by a paralysis of those organs which were most severely depressed by the deepest portion of the tumour; while, at the same time, the convolutions which lay under the edges of the tumour, and were only slightly pressed upon by it, were stimulated into increased activity of their functions. I will leave the decision of this point, however, to more experienced phrenologists, trusting that the facts which I have here given, will be judged of according to their merits.

ARTICLE VI.

STATISTICS OF PHRENOLOGY IN THE UNITED STATES.

An article with this title has just appeared in the "American Medical Almanac for 1841." This work is published annually in Boston, and is compiled by Dr. J. V. C. Smith, editor of the Boston

Medical and Surgical Journal. It is designed, as its name imports, more especially for members of the medical profession, and contains a great variety and amount of matter on subjects connected with this profession. It is particularly valuable, as a work of reference, for its numerous statistics of medical institutions and societies, as well as for its various notices and essays on medicine. Among other matters, there is an interesting article on the Statistics of Insanity and Institutions for the Insane in the United States, by Dr. S. B. Woodward, superintendent of the Massachusetts State Lunatic Hospital.

We are glad to find the subject of phrenology introduced into the Medical Almanac. If the principles of this science are designed, by their numerous and important applications, to interest and benefit any class of persons, it is certainly physicians. And as this annual circulates extensively among the members of this profession, the article on the Statistics of Phrenology is well calculated to give them some idea of the present state of the science in this country. Though many of the facts here stated may not be altogether new to our readers, yet we are induced to present the following extracts, under their several heads, as they appear in the Medical Almanac :

History of the Science.-The two principal agencies by means of which phrenology was introduced into the United States were, first, the circulation of foreign periodicals and works; and, secondly, the reports and labours of some of our own countrymen who had made tours in Europe. It is probable, however, that even the influence of these means raised up more enemies than friends to the science. The number of intelligent believers and advocates of it, prior to 1830, was quite small, and those were mostly confined to members of the medical profession. Between the years of 1820 and '26, phrenological societies were formed in New York, Philadelphia, Baltimore, and Washington; this was effected chiefly through the instrumentality of Dr. Charles Caldwell.

The two other most important agencies in advancing phrenology, have been the writings, lectures, and personal influence of Dr. Spurzheim and George Combe, Esq. Dr. Spurzheim landed at New York in August, 1832, and died at Boston in November, three months after his arrival. And though he had scarcely entered upon his labours, yet he lived long enough amongst us to give a strong impulse to the science. While here, he made arrangements for publishing several of his works on phrenology, and delivered two courses of lectures; one in Boston, and the other at Harvard University, Cambridge. His early and unexpected death was greatly lamented. His remains now lie deposited in Mount Auburn Ceme