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MEDICAL SOCIETY OF LONDON. SATURDAY, JANUARY 20TH, 1855.
91 This disease, if detected early, may be excised with ad- case, but that they result as well from premature or climacteric vantage ; but, if more advanced, the difficulty of removing the decay, when the vitality of the ovaria is on the wane. He whole of the diseased structure may present an obstacle almost detailed four cases, in which many of the symptoms of preginsurmountable. nancy existed, and all of whom were believed pregnant : one The symptoms, in cancer of the rectum, are distressing in in the mother of eleven children; one in a lady of twenty-one, the last degree; pain and weight in the bowel, with tenesmus nine months married, who was soon after carried off by of the most horrible kind; the patient is in no way relieved phthisis; another of a lady the mother of several children; and another of a lady about forty when she married. He even by the effort at defecation, as the passage of the contents of the bowels over the ulcerated, raw surface, is only attended asked to what we were to attribute the extraordinary comby increased agony. This pain, of a hot, burning kind, even bination of symptoms which are sometimes met with, especially spreads, as we can anatomically conceive, round the loins and in those cases where an ovarian erethism may be said to exist, down the thighs, so that the patient looks forward to any and where, as in one of the cases, the health of the female meet.
the bowels with the utmost apprehension. We need scarcely remark, that the whole constitution suffers, the entire nervous system becomes disordered, and the patient is reduced to a condition of suffering utterly indescribable; even fistulous openings into the bladder or urethra may further comthis terrible state. The treatment is simply palliative: plicate the one single hope and reliance of both surgeon and opium
seems much improved, and when no absolute disease can be said to exist ? Was it simply to irritation ? He believed an impression was made on the ovaria which, unable to carry out the intentions of nature, had irregular nervous actions set up; that the subject affords a fine field for the physiologist, wrapped in mystery as it is, and that the reflex nervous actions which occur must be followed out upon that system to which Dr. Marshall Hall had at once given a simplicity and a perpatient. We place these two diseases together, as showing the neces- fection. A somewhat lengthened discussion took place, in which Mr. .sity of a careful and proper diagnosis: one, a disease quite incurable ; the other, an affection in which, by early operation, Stedman, Mr. Hird, Dr. Chowne, Mr. Charles Clark, Mr. vast good may arise: one, a disease where operation hastens Marshall, Dr. Kidd, Mr. Dendy, and the President, took part. death; the other, where our only hope rests in such inter- In the course of it, cases were related in which the presence of ference. Acting on this view of the case, Mr. Curling operated hydatids in the uterus gave rise to all the more prominent last week. The history of the case. may be given in a few symptoms of pregnancy. Cases were also referred to in which the ovum was arrested in its early stage, and yet there was a words :Mrs. -, about forty years of age, came into the London development of the deciduous membrane, and consequently Hospital with what proved epithelial disease of the anus. She most of the signs of pregnancy present. With respect to these states it came on quite unexpectedly, in the form of a " lump," signs, it was stated, that the only reliable ones were the and that she had surgical attendance out of doors. Mr. Curl- ballotment and the sounds of the fcetal heart, as evidenced auscultation; but both of these might be obscured, or ing, we believe, had a portion of the tumour examined micro- by Dr. Chowne scopically by Dr. Andrew Clark, who pronounced it epithelial rendered nugatory, by accidental circumstances. cancer. On this view of things, he deemed it advisable to mentioned a case of hydatids, occurring in an unmarried The only two evils likely to arise from the opera- woman, so like pregnancy that much difficulty was experemove it. tion, he remarked to his class at the time, were-first, the risk rienced in diagnosing the nature of the case ; and after of haemorrhage, which, in the present case, was rather severe, the expulsion of the growths, the signs and symptoms ordinary delivery were so marked, that he should hesitate requiring more than one vessel to be secured; the blood might of flow also into the intestine, so that the practitioner will require in any future cases to give a decided opinion upon the subject. great caution to prevent such an occurrence, as bleeding from Reference was made also to those cases of simulated pregthese parts, well shown in lithotomy, are very exhausting and nancy in which the uterus really contained nothing, whilst the dangerous. The second evil of the operation is, the permanent presence of an abdominal tumour, either vascular or flatulent, contraction or occlusion of the anus; this was avoided by the served to embarrass the practitioner. In these cases Dr. tumour existing chiefly at one side of the opening of the canal; Simpson and others had resorted to the use of chloroform to while the spots of disease on the opposite side, Mr. Curling determine the nature of the case. Under the influence of this rested satisfied in touching with potassa fusa. Patients agent, the muscles became relaxed, and the hand passed with this disease may live eight or ten years, according to through the abdominal walls to the spine, thereby clearly Lebert; at least, as the result of fifty cases, he says-it is not showing that pregnancy did not exist. Dr. Chowne also stated constitutional; it may return in the glands, but not in the vis- that the action of the fœtal heart might be distinguished from cera, like cancer. Such patients may die of purulent infection, other movements by the fact that anything which affected but not cancer: it has many points of analogy, but not iden- the emotional feelings of the mother failed to affect in any tity, with the latter, arising from the deposition of elementsway the fœtal circulation, whilst the slightest muscular movesingularly like those of healthy epithelium, and separated from, ment of the child immediately affected the rapidity of the action, as would be evidenced by the stethoscope. fibro-plastic degeneration by the absence of fusiform peculiar to the latter.
operation of
,
bodis heart’s
SOCIETY. MONDAY, JANUARY 8TH, 1855.
PHYSIOLOGICAL
Medical Societies. MEDICAL SOCIETY OF LONDON. SATURDAY, JANUARY 20TH, 1855. MR. HEADLAND, PRESIDENT. DR. O’CONNOR exhibited a preparation of quina with codliver oil, in the proportion of two grains of the former to one ounce of the latter. It had been prepared by Mr. Bastick, and found by Dr. O’Connor to be a most valuable medicine in all cases in which cod-liver oil was desirable. It enabled the patient to continue the medicine longer than under other circumstances, and added greatly to its efficacy. Dr. BURKE RYAN read a paper on SPLPIOITS PREGNANCY.
After dwelling on the anxious nature of such cases, he referred to a discussion on the subject which took place at Edinburgh last year, and having mentioned the names of those who have taken most interest in the subject, such as Drs. Montgomery, Simpson, Gooch, &c., he said that though such cases usually occur about the turn of life, yet that such is not always the
MR.
HEADLAND, PRESIDENT,
IN THE
CHAIR
ŒSOPHAGUS OF THE CROCODILE.
.
DR. CRISP exhibited the cesophagua of a large crocodile, (C. acutus,)which, when moderately distended with air, measured fourteen inches in circumference, and which, when recently taken from the body, was so elastic as to admit of
great
extension in
a
lateral direction.
ARREST OF DEVELOPMENT OF THE TADPOLE OF THE FROG.
Dr. CRISP likewise showed a living tadpole of the frog, which he took, with many others, on the first of last September. The hind legs were developed, but the fore extremities were not perceptible. These tadpoles, and some of the water-newt, (Triton cristatus,) had been kept in glass vessels, exposed to the light, in a room without a fire, but no progress had been made in their development; they had breathed by branchie up to the present time. The interesting questions, Dr. Crisp thought, were these: Was cold the cause of the arrest of development ? What became of these tadpoles, millions of which were produced in autumn ? and did the frog deposit its eggs more than once in the year? None of these physiological subjects had been mentioned in Mr. Bell’s work on the British
Reptiles.
the bowels with the utmost apprehension. We need scarcely remark, that the whole constitution suffers, the entire nervous system becomes disordered, and the patient is reduced to a condition of suffering utterly indescribable; even fistulous openings into the bladder or urethra may further comthis terrible state. The treatment is simply palliative: plicate the one single hope and reliance of both surgeon and opium
seems much improved, and when no absolute disease can be said to exist ? Was it simply to irritation ? He believed an impression was made on the ovaria which, unable to carry out the intentions of nature, had irregular nervous actions set up; that the subject affords a fine field for the physiologist, wrapped in mystery as it is, and that the reflex nervous actions which occur must be followed out upon that system to which Dr. Marshall Hall had at once given a simplicity and a perpatient. We place these two diseases together, as showing the neces- fection. A somewhat lengthened discussion took place, in which Mr. .sity of a careful and proper diagnosis: one, a disease quite incurable ; the other, an affection in which, by early operation, Stedman, Mr. Hird, Dr. Chowne, Mr. Charles Clark, Mr. vast good may arise: one, a disease where operation hastens Marshall, Dr. Kidd, Mr. Dendy, and the President, took part. death; the other, where our only hope rests in such inter- In the course of it, cases were related in which the presence of ference. Acting on this view of the case, Mr. Curling operated hydatids in the uterus gave rise to all the more prominent last week. The history of the case. may be given in a few symptoms of pregnancy. Cases were also referred to in which the ovum was arrested in its early stage, and yet there was a words :Mrs. -, about forty years of age, came into the London development of the deciduous membrane, and consequently Hospital with what proved epithelial disease of the anus. She most of the signs of pregnancy present. With respect to these states it came on quite unexpectedly, in the form of a " lump," signs, it was stated, that the only reliable ones were the and that she had surgical attendance out of doors. Mr. Curl- ballotment and the sounds of the fcetal heart, as evidenced auscultation; but both of these might be obscured, or ing, we believe, had a portion of the tumour examined micro- by Dr. Chowne scopically by Dr. Andrew Clark, who pronounced it epithelial rendered nugatory, by accidental circumstances. cancer. On this view of things, he deemed it advisable to mentioned a case of hydatids, occurring in an unmarried The only two evils likely to arise from the opera- woman, so like pregnancy that much difficulty was experemove it. tion, he remarked to his class at the time, were-first, the risk rienced in diagnosing the nature of the case ; and after of haemorrhage, which, in the present case, was rather severe, the expulsion of the growths, the signs and symptoms ordinary delivery were so marked, that he should hesitate requiring more than one vessel to be secured; the blood might of flow also into the intestine, so that the practitioner will require in any future cases to give a decided opinion upon the subject. great caution to prevent such an occurrence, as bleeding from Reference was made also to those cases of simulated pregthese parts, well shown in lithotomy, are very exhausting and nancy in which the uterus really contained nothing, whilst the dangerous. The second evil of the operation is, the permanent presence of an abdominal tumour, either vascular or flatulent, contraction or occlusion of the anus; this was avoided by the served to embarrass the practitioner. In these cases Dr. tumour existing chiefly at one side of the opening of the canal; Simpson and others had resorted to the use of chloroform to while the spots of disease on the opposite side, Mr. Curling determine the nature of the case. Under the influence of this rested satisfied in touching with potassa fusa. Patients agent, the muscles became relaxed, and the hand passed with this disease may live eight or ten years, according to through the abdominal walls to the spine, thereby clearly Lebert; at least, as the result of fifty cases, he says-it is not showing that pregnancy did not exist. Dr. Chowne also stated constitutional; it may return in the glands, but not in the vis- that the action of the fœtal heart might be distinguished from cera, like cancer. Such patients may die of purulent infection, other movements by the fact that anything which affected but not cancer: it has many points of analogy, but not iden- the emotional feelings of the mother failed to affect in any tity, with the latter, arising from the deposition of elementsway the fœtal circulation, whilst the slightest muscular movesingularly like those of healthy epithelium, and separated from, ment of the child immediately affected the rapidity of the action, as would be evidenced by the stethoscope. fibro-plastic degeneration by the absence of fusiform peculiar to the latter.
operation of
,
bodis heart’s
SOCIETY. MONDAY, JANUARY 8TH, 1855.
PHYSIOLOGICAL
Medical Societies. MEDICAL SOCIETY OF LONDON. SATURDAY, JANUARY 20TH, 1855. MR. HEADLAND, PRESIDENT. DR. O’CONNOR exhibited a preparation of quina with codliver oil, in the proportion of two grains of the former to one ounce of the latter. It had been prepared by Mr. Bastick, and found by Dr. O’Connor to be a most valuable medicine in all cases in which cod-liver oil was desirable. It enabled the patient to continue the medicine longer than under other circumstances, and added greatly to its efficacy. Dr. BURKE RYAN read a paper on SPLPIOITS PREGNANCY.
After dwelling on the anxious nature of such cases, he referred to a discussion on the subject which took place at Edinburgh last year, and having mentioned the names of those who have taken most interest in the subject, such as Drs. Montgomery, Simpson, Gooch, &c., he said that though such cases usually occur about the turn of life, yet that such is not always the
MR.
HEADLAND, PRESIDENT,
IN THE
CHAIR
ŒSOPHAGUS OF THE CROCODILE.
.
DR. CRISP exhibited the cesophagua of a large crocodile, (C. acutus,)which, when moderately distended with air, measured fourteen inches in circumference, and which, when recently taken from the body, was so elastic as to admit of
great
extension in
a
lateral direction.
ARREST OF DEVELOPMENT OF THE TADPOLE OF THE FROG.
Dr. CRISP likewise showed a living tadpole of the frog, which he took, with many others, on the first of last September. The hind legs were developed, but the fore extremities were not perceptible. These tadpoles, and some of the water-newt, (Triton cristatus,) had been kept in glass vessels, exposed to the light, in a room without a fire, but no progress had been made in their development; they had breathed by branchie up to the present time. The interesting questions, Dr. Crisp thought, were these: Was cold the cause of the arrest of development ? What became of these tadpoles, millions of which were produced in autumn ? and did the frog deposit its eggs more than once in the year? None of these physiological subjects had been mentioned in Mr. Bell’s work on the British
Reptiles.