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ROYAL MEDICAL & CHIRURGICAL SOCIETY. TUESDAY, MAY 26TH, 1857.
exaggeration of sensibility. The diagnosis at the visit of M. Piorry on the 5th of February was as follows : 1st. Lesion of the left cerebral hemisphere. 2nd. After the disturbance of the faculty of forming and assembling the words, this lesion ought to occupy the anterior ROYAL MEDICAL &
Medical Societies.
irradiations of the striated bodies. 3rd. From the unparalysed condition of the extremities and the manner in which the symptoms are circumscribed, we should be inclined to affirm that the lesion is very limitedlimited to the space indicated, and that it does not include a
space larger than a nut. 4th. The absence of paralysis leads us also to believe that it is rather a cerebral softening, or "malexie," than a cerebral ’, "
cephalorrhemie." rapidity of the accident leads us to consider the malady as acute or inflammatory. 6th. Perhaps an abnormal production, as tubercle, cancer, or an hydatid cyst may constitute the lesion which occasions
haemorrhage
or
5th. The
the symptoms observed. Feb. 10th.-The patient died. On the 12th the post-mortem examination was made, and the brain examined before the students in the Amphitheatre. The oiily part of this organ which was altered was the anterior region of the left hemisphere. The posterior limit of the lesion corresponded to the distance (two centimetres) behind the fissure of Sylvius, and the disease extended anteriorly in the anterior and left portion of the left hemisphere in such a manner that the total volume of the mass affected was about three centimetres in all its diameters. The aspect of the. diseased part was of a reddish-grey, with the consistence of thick milk or pap; it did not present the slightest trace of fibres, nor of the primitive cerebral organization. It was so soft that a current of water removed it, leaving to view an unequal surface, whiter, slashed, and which, distinctly separated from the softened points, was nothing else but the cerebral substance intact limiting the softened points. A great fault was committed in neglecting to examine the arteries and veins supplying the part diseased. [This fact is not extremely rare, and M. Piorry has frequently observed cases in which he has encountered an analogous relation between the existence of a lesion of the anterior irradiations of the one or the other of the cerebral hemispheres and the presence of remarkable disorder in the function of memory and the faculty of forming words and phrases. He has seen cysts following cerebral haemorrhages occupying the anterior portion of one of the striated bodies, and which coincided with the inability to articulate or remember words. Recent " hyperémies, " occupyin gthe same site, have been equally accompanied by loss of the power of speech. We know that the relation between the seat of these lesions and the aptitude to form words and phrases, admitted by M. Bouilland, has been denied, The preceding facts goa great or at least rejected as doubtful. way towards leading us to admit its reality. It is in adopting its truth that M. Piorry has, as it vre-re, localized the seat of the disease. The kind of alteration and the extent of cavity were masked by the march of the disease and the conjunction of the symptoms. In anatomical pathology applied to morbid physiology, wemust not hastily deny a positive fact on the occasion of a negative fact, and this, above all, in the symptoms depending upon an affection of the nervous system; it is here always advisable to abstain from repudiating as doubtful authentic facts, because the lesions of the nervous system are sometimes so slight, and yet they may destroy the action of the organ, in a fashion so pronounced, that in truth one is exposed to fail to recognise such and such alteration of texture which might determine the functional troubles observed.]
exist, and
CHILD POISONING CASE
IN
LIVERPOOL.-An
adjourned
held recently before the borough coroner of Liverpool, regarding the death of a child of Mr. Sillar, of Shawstreet, under circumstances involving a charge of gross negligence, if not one of a more serious nature, against an assistant to a chemist and druggist, in introducing morphia into a prescription instead of powdered sugar, from the effects of which the child died. At the former inquest the assistant admitted that he made up the prescription in question, and the morphia must have been inserted by mistake, which was probably the
inquest
was
had been
purchasing some previously at the glass bottles had likely got misplaced. Morphia and powdered sugar were very much alike, as far as appearance went. The jury, after a lengthened inquiry, found a verdict of "Chance Medley" against the assistant, Paul Strange. The verdict does not involve any prosecution. case,
as a
party
counter, and the
two
CHIRURGICAL SOCIETY.
TUESDAY, MAY 26TH, 1857. SIR C.
LOCOCK, BART., PRESIDENT,
DR. EDWARD SMITH read
a
IN THE
CHAIR.
paper
ON THE INFLUENCE OF THE LABOUR OF THE TREADWHEEL OVER RESPIRATION AND PULSATION, AND ITS RELATION TO THE WASTE OF THE SYSTEM, AND THE DIETARY OF THE PRISONERS.
This investigation is a part of the series of inquiries which the author has prosecuted, and which have been presented to the Royal Society. The aim is to show how great is the wear of system caused by this mode of punishment, the inequality of the punishment, and the serious defect in the quantity of respiratory food supplied to the prisoners. The inquiries were made by the author on his own person in October, 1856, at the Coldbath-fields prison, by the courtesy of Mr. Pownall and other Middlesex magistrates. He worked the wheel during periods of a quarter of an hour each, with intervening periods of rest of a quarter of an hour, in the manner prescribed for the prisoners, and made seven series of observations. The average quantity of air breathed during the labour was 2500 cubic inches per minute, at a rate of respiration of 25 per minute, and a depth of respiration varying from 91½c. in. to 107c. in. The rate of pulsation varied from 150 to 172 per minute. During the intervals of rest he sat quietly, and after 13 minutes’ rest the rate of respiration varied from 15 to 18½ per minute, the quantity of air respired from 725 c. in. to 980 c. in., the depth from 48 c. in. to 53 c. in., and the rate of pulsation from 97 to 120 per minute. Before he entered upon the inquiry, he breathed in the standing posture about 600 c. in. per minute, at a rate of 14 per minute, and a,depth of 43 c. in., and the rate of pulsation was 75-’per nir.ude. Thus, during the exertion the quantity of air inspired was increased more than fourfold, the rate of respiration -was increased twothirds, the depth of inspiration 2 times, and the rate of pulsation 2i times. The returns during the period of rest show that the effects of the labour had not passed away in a quarter of an hour. Compared with the results in the quiet sitting posture, the author stated that the effect on the respiration was 5½ times, and on pulsation 2½ times as great; and taking together the 3 3/4hours of hard labour with a similar period of rest, he proved that the effect upon the system of the 8 hours’ labour was equal to that of 24 hours of those not condemned to hard labour; and that if the whole 24 hours’ were taken together, the effect would probably be two-thirds greater than that of occupations not laborious. He then contrasted those results with others which he had obtained for the purposes of comparison. Thus, fast walking, at upwards of four miles per hour caused a rate of respiration of 30 per minute, a depth of 80 c. in., and a total quantity per minute of 2400 c. in. The rate of pulsation was 130 per minute. Ascending steps at the rate of speed of the treadwheel-viz., 640 yards per hour, caused the rate of respiration to be 22 per minute, the depth 90 c. in., and total quantity per minute 1986 c. in., and a rate of pulsation of 114 per minute. Carrying 118 pounds at the rate of three miles per hour induced a rate of respiration of 241/3, times per minute, a depth of 90 c. in., and a total quantity of 2141 c. in. per minute, with a rate of pulsation of 189 per minute. Thus the labour of the treadwheel produces greater effect upon the respiration than any of those modes of exertion, while the effect upon pulsation was greater in the last severe labour only. The total quantity of air breathed per hour upon the tread-wheel (if the labour were continuous) would be 150,000 c. in. as opposed to 27,000 c. in. in the quiet sitting posture; and the wear of the system would, upon the known principles of science, be in a somewhat similar proportion. He then proceeded to consider the effect of this exertion upon the system, and showed that the excessive exercise of the lungs and heart must ultimately lead to phthisis,’ asthma, emphysema, congestion of various organs, and disease of the heart, and in persons with diminished vital capacity of the lungs, and weak hearts, the effect must sooner be very serious. In reference to food, he was of opinion that the reparative (nitrogenous) food, as flesh and bread, was ample, and required revision only in the better distribution of it-as, for example, the removal of 2 oz. or 3 oz. of the 6 oz. of cooked meat. allowed at the dinner four times ner week. to the break-
631
fast, which consists only of bread and cocoa. He also pointed out the importance (and especially to those who masticate imperfectly) of renderihg the meat tender, and of allowing
time between the meal and the return to the hard labour. The great and most serious defect which he pointed out was in the respiratory food, since neither fat nor sugar is allowed except in combination, as in the ox-heads, or in the briskets of bepf, and in the milk and cocoa. No sugar, lard, suet, bacon, or butter are allowed, and of course beer and alcoholic liquors are excluded; these, with starch, are almost the sole articles of respiratory food. He dwelt upon the imperative necessity for an increase of fat, both in relation to the wants of respiration, and to the due digestion of starchy food; and showed that, under the present system, much food must be wasted from non-digestion, and the system must, and often does, decrease in weight. He then explained the mode of working the ,wheel, and showed that the labour is not only in moving the ’ body as the wheel descends, but in maintaining it erect in opposition to gravity, since the centre of gravity is probably -.external to and in front of the body. He proved that it is an uneven punishment, the inequality not being that of guilt, but .of physical conformation and health; and, moreover, that the xesistance offered by the wheel is not uniform in various prisons, and has been lessened at the Cold bath- fields prison; and hence, that the lives of the prisoners are at the mercy of un’educated engineers. He showed that the old, the tall, the - feeble, those having unsouud teeth, and diseased lungs and ’heart, those not accustomed to climbing or slow walking, and - those with small bones and muscles of the back and upper ex’tremities, must suffer the most, and hence that the punishment falls with different degrees of severity upon different classes of tte community. He also pointed out the fact that weak hearts aaid lessened vital capacity of the lungs may exist with a fair amount of health, and hence would not be necessarily known to the prisoner, nor, indeed, to the surgeon, except on He was of opinion that it was a punisha minute examination. t. ,ment -unfit for the age, (as the discontinuance of it in many prisons also implied,) and certain, if long continued, to induce disease and a premature death; and not only rendered the prisoner a greater cost to the community whilst in prison, by reason af the increased quantity of food which the labour .demands, but subsequently from a premature old age; and .;since the labour is not employed to meet the cost of maintenance .of ’those who furnish the power, it is so much of human flesh and life wasted. In a postscript, he referred to the QO-vernment .di.etary for prisoners condemned for short periods, and showed that a system which affords only bread and water, or bread and gruel, for the whole diet, must be calculated to injure the health of the prisoners, a system far more repulsive than the private whippings which have been proposed and ,,opposed. The accompanying table exhibits the scheme of prison :diet at the date of this investigation. Dr. WEBSTER dissented from the conclusions of the author respecting the effect of the treadmill on the health of the prisoners. Persons of weak health, he said, were often benefited by the prison discipline, and the mortality in most of the London prisons was exceedingly low. The total deaths in all the London gaols during last year amounted to 81, which was a small mortality, considering there were always upwards of - 9000 inmates within these receptables, of whom a large proportion were males : while, as frequent changes of prisoners also occurred, the aggregate numbers have been much augmented. The diet, too, of the prisoners was often much better - than they were accustomed to when out of prison, with the exoeption of those who were imprisoned for seven days, and whose fare was only bread and water. Some of the injurious results attendant upon prison life were merely the moral effects of confinement ; while others wereattributable to the improper method of heating the prisons with warm air. Dr. SNOw said the author ought not to take for granted that the quantity of oxygen consumed always bore a definite proportion to the quantity inspired. Under the circumstances mentioned by Dr. Smith there would doubtless be some increased consumption ; but under other circumstances, (as after the use of narcotics,) the reverse might be the case. Nor was .it certain that an increase in the respiratory elements of food was required by the prisoners so much as an increase in that which would furnish muscular tissue, such as mutton and beef, ’especially the latter, which was consumed in large quantities more
by navigators.
Dr. MARKHAM thought it would have been better if the prac- tical results, as shown by the reports of the medical officers, had been laid before the members, rather than the theoretical conclusions of the author.
632
Mr. SPENCER WELLS referred to a statement made by Captain might reasonably have been expected to have been expelled a, his " Revelations of Prison Life," that the health month previous, when the first haemorrhage took place. of the prisoners, .when the treadmill was first brought into use STRICTURE AND ULCERATION OF THE SIGMOID FLEXURE by Mr. Cubitt, suffered from the period of labour being too OF THE COLON. protracted, but that since the period of toil had been shortened The was sent specimen by G. B. Phillips, Esq., of Hales the work proved beneficial to the system; and this was the Owen. It was removed from a lady, aged thirty-five, the those had of who of The opportunities judging. general opinion of twelve children, the youngest of whom is now seven punishment, in military prisons, of lifting shot was also found mother months old. Two days after her last confinement, she had an to benefit the men, if not carried to excess. Dr. WEBSTER said the prisoners often worked in a close attack of peritonitis, which yielded to ordinary treatment. For many years she had suffered from constipation, but no idea. atmosphere, which was, of course, prejudicial to health. Dr. STEWART said there could be no doubt that after a short of any mechanical obstruction was entertained. On the 25th Mr. Phillips was requested to see her. She had training the labour at the treadmill, like all others, would be- of March, of the abdomen and obstruction of the bowels; for great pain come less severe, so that the effects produced on the author, who was not accustomed to the exercise, could not be regarded several days she vomited large quantities of feculent matter. The treatment adopted failing to afford relief, Amussat’s (jpera,as applicable to all persons. Dr. O’CONNOR said he was informed by the governor of one tion was proposed and rejected, cancer of the colon being supof the Dublin prisons, that the work was beneficial to the posed to exist. Death took place on the 26th of April. A examination revealed a close stricture of the prisoners, their health generally improving under the exercise post-mortem when of short duration. He agreed with Dr. Webster, that sigmoid flexure of the colon; above the contracted part extenmoral causes, rather than the actual prison discipline, would sive ulceration existed. The whole of the bowels were greatly distended, and the mucous membrane highly congested. The act as promoters of disease. Dr. SMITH, in reply, referred to the reprobation of the tread- peritoneum was healthy, as also were the liver, kidneys., and mill bv Mr. Mayhew, in his " Great World of London," and other organs of the abdomen and chest. Mr. SQUIRE presented a specimen of by Mr. Reade in " It is Never too Late to Mend." The discontinuance of its use in prisons was a tacit condemnation. Dr. TRUE ANEURISM OF THE LEFT POSTERIOR CEREBRAL ARTERY. Webster had mixed up prisoners condemned and not condemned to hard labour. As the increased respiration was from natural The tumour was of considerable size, measuring four inches’ in causes, there would be a corresponding increase in the chemical circumference, and weighing half an ounce avoirdupoise; it from the vessel close to its junction with the basilar, changes. He described the "shot drill," and showed that it proceeded was less laborious than the treadwheel, although it was quite artery, and occupied the space in front of the pons Varolii and as irksome. The after effects of the -r;readwheel could seldom between the crura cerebri, pushing up the floor of the third be traced f om the short duration of the punishment ; but new ventricle, and encroaching on the left thalamus. The patient a female, over forty years of age, having children, (with inquiries in that direction are needed. The results which he was (Dr. Smith) had mentioned were subject to some deduction for whom. she was found in an incapable state;) she was under want of training, though he was strong and healthy, accus- observation only a few hours before death, from adynamic fever tomed to long walking, and experienced in the use of the spiro- or destitution; she was nat comatose; there was no paralysis of meter, and many persons would be less capable of bearing the sphincters of either of the extremities, or of the facial muscles; the senses of seeing and hearing existed, and the power of fatigue than himself. The Society then adjourned. deglutition. Mr. Squire called attention to the absence of atheromaof the coats of the arteries, to the remarkable diminution in the size of the basilar artery, and to the free anastomosis existing, both the posterior and anterior communicating PATHOLOGICAL SOCIETY OF LONDON. artery being accompanied by two and three parallel vessels, DR. WATSON, PRESIDENT, IN THE CHAIR. (shown in the preparation,) while other smaller ones were noticed in the dissection. The interior of the tumour was concentric layers of yellowish dense fibrin, the DR. OGIER WARD submitted, for the consideration of the occupied by centre being a soft dark coagulum at the base of the tumour, as to its age, Society extending three-quarters of an inch forwards from a minute AN ABORTED OVUM, cavity continuous with the vessel from which the tumour arose, of which the following is the history :-The patient ceased to menstruate February 21st, and from her symptoms believed herself to be pregnant, having had four previous pregnancies. On April 23rd, she took a very long walk, and the next day she had a very violent flooding, which continued for three or four days, during which she remarked amongst the coagula what she thought was the "after-birth." The haemorrhage The Metaphysicians: being a Memoir of Franz Carvel, Brushthen became irregular, and finally ceased about May 10th or written by Hignsey; and of Harold Fremdling, maker, 12th; and believing from her diminished size that she had written and now republished by Francis Drake, Esq.; L’’sq., aborted, she admitted her husband to her bed. On the 22nd with Discussions and Revelations relating to Speculative of May she again took a long and rapid walk up a steep hill, Philosophy, Morals, and Social Progress. pp. 416. London: which greatly fatigued her, and the next morning she passed, and Co. 1857. Longman with scarcely any pain, a substance the size of a walnut, which OF all the strange, unaccountable, weird books we ever sa,t’ was followed by occasional pains, and a flow of blood similar to down to both till the the and when read, this is decidedly the strangest, most unaccount27th, after-pains, pains discharge ceased. The substance, when examined, had an oval form, able, and most weird. Franz Carvel, the hero of the first mewith rather fimbriated ends, and, when laid open, exhibited moir, appears to have read German metaphysics, and more the structureof an ovum, all the membranes being complete, Immanuel Kant’s " Critic of Pure Reason," until particularly but without an embryo. Externally, the decidua vera, with have become addled, and he sees visions. Vision his brains its cribriform perforations distinctly visible, extended over two- I thirds of the body; beneath was the reflexa, attached to the No. 1, is England one hundred years ago; and, vision No. 2, is. vera firmly above, and extending beneath it below, to complete England one hundred years hence. Connecting these imathe figure. Under this again was the chorion, covered over its ginings, is an account of the present and Franz Carvel as upper three-fourths with a layer of villi, easily separable, and conditioned by present modes, usages, and education. The: also lined with a layer of villi exactly similar. Within the chorion again was a fourth membrane filled with an areolar’ main object of the memoir seems to be to show that we have tissue, containing a clot of blood in its meshes, but no trace of decidedly improved upon our ancestors in the science of socioan embryo. The patient believes the ovum to be not older logy, and that we are about to experience still greater imthan a week or ten days ; if so, the perfect structure of all the provements. We strongly demur, however, to the crazy scheme membranes and of the placental tufts displayed by the micro- which would convert society into a colleetion of hypertrophied scope is very striking. There is no difficulty to account for the model lodging-houses. an at such absence of the embryo early period. But if the The second memoir is supposed to be an autobiography ovum is one of two or three months, it ought to be many times its present size, and to contain an embryo. Besides that, it written by a person who has been partly the victim of errors
Chesterton, in
Reviews and Notices of Books.
633
Medical Societies.
irradiations of the striated bodies. 3rd. From the unparalysed condition of the extremities and the manner in which the symptoms are circumscribed, we should be inclined to affirm that the lesion is very limitedlimited to the space indicated, and that it does not include a
space larger than a nut. 4th. The absence of paralysis leads us also to believe that it is rather a cerebral softening, or "malexie," than a cerebral ’, "
cephalorrhemie." rapidity of the accident leads us to consider the malady as acute or inflammatory. 6th. Perhaps an abnormal production, as tubercle, cancer, or an hydatid cyst may constitute the lesion which occasions
haemorrhage
or
5th. The
the symptoms observed. Feb. 10th.-The patient died. On the 12th the post-mortem examination was made, and the brain examined before the students in the Amphitheatre. The oiily part of this organ which was altered was the anterior region of the left hemisphere. The posterior limit of the lesion corresponded to the distance (two centimetres) behind the fissure of Sylvius, and the disease extended anteriorly in the anterior and left portion of the left hemisphere in such a manner that the total volume of the mass affected was about three centimetres in all its diameters. The aspect of the. diseased part was of a reddish-grey, with the consistence of thick milk or pap; it did not present the slightest trace of fibres, nor of the primitive cerebral organization. It was so soft that a current of water removed it, leaving to view an unequal surface, whiter, slashed, and which, distinctly separated from the softened points, was nothing else but the cerebral substance intact limiting the softened points. A great fault was committed in neglecting to examine the arteries and veins supplying the part diseased. [This fact is not extremely rare, and M. Piorry has frequently observed cases in which he has encountered an analogous relation between the existence of a lesion of the anterior irradiations of the one or the other of the cerebral hemispheres and the presence of remarkable disorder in the function of memory and the faculty of forming words and phrases. He has seen cysts following cerebral haemorrhages occupying the anterior portion of one of the striated bodies, and which coincided with the inability to articulate or remember words. Recent " hyperémies, " occupyin gthe same site, have been equally accompanied by loss of the power of speech. We know that the relation between the seat of these lesions and the aptitude to form words and phrases, admitted by M. Bouilland, has been denied, The preceding facts goa great or at least rejected as doubtful. way towards leading us to admit its reality. It is in adopting its truth that M. Piorry has, as it vre-re, localized the seat of the disease. The kind of alteration and the extent of cavity were masked by the march of the disease and the conjunction of the symptoms. In anatomical pathology applied to morbid physiology, wemust not hastily deny a positive fact on the occasion of a negative fact, and this, above all, in the symptoms depending upon an affection of the nervous system; it is here always advisable to abstain from repudiating as doubtful authentic facts, because the lesions of the nervous system are sometimes so slight, and yet they may destroy the action of the organ, in a fashion so pronounced, that in truth one is exposed to fail to recognise such and such alteration of texture which might determine the functional troubles observed.]
exist, and
CHILD POISONING CASE
IN
LIVERPOOL.-An
adjourned
held recently before the borough coroner of Liverpool, regarding the death of a child of Mr. Sillar, of Shawstreet, under circumstances involving a charge of gross negligence, if not one of a more serious nature, against an assistant to a chemist and druggist, in introducing morphia into a prescription instead of powdered sugar, from the effects of which the child died. At the former inquest the assistant admitted that he made up the prescription in question, and the morphia must have been inserted by mistake, which was probably the
inquest
was
had been
purchasing some previously at the glass bottles had likely got misplaced. Morphia and powdered sugar were very much alike, as far as appearance went. The jury, after a lengthened inquiry, found a verdict of "Chance Medley" against the assistant, Paul Strange. The verdict does not involve any prosecution. case,
as a
party
counter, and the
two
CHIRURGICAL SOCIETY.
TUESDAY, MAY 26TH, 1857. SIR C.
LOCOCK, BART., PRESIDENT,
DR. EDWARD SMITH read
a
IN THE
CHAIR.
paper
ON THE INFLUENCE OF THE LABOUR OF THE TREADWHEEL OVER RESPIRATION AND PULSATION, AND ITS RELATION TO THE WASTE OF THE SYSTEM, AND THE DIETARY OF THE PRISONERS.
This investigation is a part of the series of inquiries which the author has prosecuted, and which have been presented to the Royal Society. The aim is to show how great is the wear of system caused by this mode of punishment, the inequality of the punishment, and the serious defect in the quantity of respiratory food supplied to the prisoners. The inquiries were made by the author on his own person in October, 1856, at the Coldbath-fields prison, by the courtesy of Mr. Pownall and other Middlesex magistrates. He worked the wheel during periods of a quarter of an hour each, with intervening periods of rest of a quarter of an hour, in the manner prescribed for the prisoners, and made seven series of observations. The average quantity of air breathed during the labour was 2500 cubic inches per minute, at a rate of respiration of 25 per minute, and a depth of respiration varying from 91½c. in. to 107c. in. The rate of pulsation varied from 150 to 172 per minute. During the intervals of rest he sat quietly, and after 13 minutes’ rest the rate of respiration varied from 15 to 18½ per minute, the quantity of air respired from 725 c. in. to 980 c. in., the depth from 48 c. in. to 53 c. in., and the rate of pulsation from 97 to 120 per minute. Before he entered upon the inquiry, he breathed in the standing posture about 600 c. in. per minute, at a rate of 14 per minute, and a,depth of 43 c. in., and the rate of pulsation was 75-’per nir.ude. Thus, during the exertion the quantity of air inspired was increased more than fourfold, the rate of respiration -was increased twothirds, the depth of inspiration 2 times, and the rate of pulsation 2i times. The returns during the period of rest show that the effects of the labour had not passed away in a quarter of an hour. Compared with the results in the quiet sitting posture, the author stated that the effect on the respiration was 5½ times, and on pulsation 2½ times as great; and taking together the 3 3/4hours of hard labour with a similar period of rest, he proved that the effect upon the system of the 8 hours’ labour was equal to that of 24 hours of those not condemned to hard labour; and that if the whole 24 hours’ were taken together, the effect would probably be two-thirds greater than that of occupations not laborious. He then contrasted those results with others which he had obtained for the purposes of comparison. Thus, fast walking, at upwards of four miles per hour caused a rate of respiration of 30 per minute, a depth of 80 c. in., and a total quantity per minute of 2400 c. in. The rate of pulsation was 130 per minute. Ascending steps at the rate of speed of the treadwheel-viz., 640 yards per hour, caused the rate of respiration to be 22 per minute, the depth 90 c. in., and total quantity per minute 1986 c. in., and a rate of pulsation of 114 per minute. Carrying 118 pounds at the rate of three miles per hour induced a rate of respiration of 241/3, times per minute, a depth of 90 c. in., and a total quantity of 2141 c. in. per minute, with a rate of pulsation of 189 per minute. Thus the labour of the treadwheel produces greater effect upon the respiration than any of those modes of exertion, while the effect upon pulsation was greater in the last severe labour only. The total quantity of air breathed per hour upon the tread-wheel (if the labour were continuous) would be 150,000 c. in. as opposed to 27,000 c. in. in the quiet sitting posture; and the wear of the system would, upon the known principles of science, be in a somewhat similar proportion. He then proceeded to consider the effect of this exertion upon the system, and showed that the excessive exercise of the lungs and heart must ultimately lead to phthisis,’ asthma, emphysema, congestion of various organs, and disease of the heart, and in persons with diminished vital capacity of the lungs, and weak hearts, the effect must sooner be very serious. In reference to food, he was of opinion that the reparative (nitrogenous) food, as flesh and bread, was ample, and required revision only in the better distribution of it-as, for example, the removal of 2 oz. or 3 oz. of the 6 oz. of cooked meat. allowed at the dinner four times ner week. to the break-
631
fast, which consists only of bread and cocoa. He also pointed out the importance (and especially to those who masticate imperfectly) of renderihg the meat tender, and of allowing
time between the meal and the return to the hard labour. The great and most serious defect which he pointed out was in the respiratory food, since neither fat nor sugar is allowed except in combination, as in the ox-heads, or in the briskets of bepf, and in the milk and cocoa. No sugar, lard, suet, bacon, or butter are allowed, and of course beer and alcoholic liquors are excluded; these, with starch, are almost the sole articles of respiratory food. He dwelt upon the imperative necessity for an increase of fat, both in relation to the wants of respiration, and to the due digestion of starchy food; and showed that, under the present system, much food must be wasted from non-digestion, and the system must, and often does, decrease in weight. He then explained the mode of working the ,wheel, and showed that the labour is not only in moving the ’ body as the wheel descends, but in maintaining it erect in opposition to gravity, since the centre of gravity is probably -.external to and in front of the body. He proved that it is an uneven punishment, the inequality not being that of guilt, but .of physical conformation and health; and, moreover, that the xesistance offered by the wheel is not uniform in various prisons, and has been lessened at the Cold bath- fields prison; and hence, that the lives of the prisoners are at the mercy of un’educated engineers. He showed that the old, the tall, the - feeble, those having unsouud teeth, and diseased lungs and ’heart, those not accustomed to climbing or slow walking, and - those with small bones and muscles of the back and upper ex’tremities, must suffer the most, and hence that the punishment falls with different degrees of severity upon different classes of tte community. He also pointed out the fact that weak hearts aaid lessened vital capacity of the lungs may exist with a fair amount of health, and hence would not be necessarily known to the prisoner, nor, indeed, to the surgeon, except on He was of opinion that it was a punisha minute examination. t. ,ment -unfit for the age, (as the discontinuance of it in many prisons also implied,) and certain, if long continued, to induce disease and a premature death; and not only rendered the prisoner a greater cost to the community whilst in prison, by reason af the increased quantity of food which the labour .demands, but subsequently from a premature old age; and .;since the labour is not employed to meet the cost of maintenance .of ’those who furnish the power, it is so much of human flesh and life wasted. In a postscript, he referred to the QO-vernment .di.etary for prisoners condemned for short periods, and showed that a system which affords only bread and water, or bread and gruel, for the whole diet, must be calculated to injure the health of the prisoners, a system far more repulsive than the private whippings which have been proposed and ,,opposed. The accompanying table exhibits the scheme of prison :diet at the date of this investigation. Dr. WEBSTER dissented from the conclusions of the author respecting the effect of the treadmill on the health of the prisoners. Persons of weak health, he said, were often benefited by the prison discipline, and the mortality in most of the London prisons was exceedingly low. The total deaths in all the London gaols during last year amounted to 81, which was a small mortality, considering there were always upwards of - 9000 inmates within these receptables, of whom a large proportion were males : while, as frequent changes of prisoners also occurred, the aggregate numbers have been much augmented. The diet, too, of the prisoners was often much better - than they were accustomed to when out of prison, with the exoeption of those who were imprisoned for seven days, and whose fare was only bread and water. Some of the injurious results attendant upon prison life were merely the moral effects of confinement ; while others wereattributable to the improper method of heating the prisons with warm air. Dr. SNOw said the author ought not to take for granted that the quantity of oxygen consumed always bore a definite proportion to the quantity inspired. Under the circumstances mentioned by Dr. Smith there would doubtless be some increased consumption ; but under other circumstances, (as after the use of narcotics,) the reverse might be the case. Nor was .it certain that an increase in the respiratory elements of food was required by the prisoners so much as an increase in that which would furnish muscular tissue, such as mutton and beef, ’especially the latter, which was consumed in large quantities more
by navigators.
Dr. MARKHAM thought it would have been better if the prac- tical results, as shown by the reports of the medical officers, had been laid before the members, rather than the theoretical conclusions of the author.
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Mr. SPENCER WELLS referred to a statement made by Captain might reasonably have been expected to have been expelled a, his " Revelations of Prison Life," that the health month previous, when the first haemorrhage took place. of the prisoners, .when the treadmill was first brought into use STRICTURE AND ULCERATION OF THE SIGMOID FLEXURE by Mr. Cubitt, suffered from the period of labour being too OF THE COLON. protracted, but that since the period of toil had been shortened The was sent specimen by G. B. Phillips, Esq., of Hales the work proved beneficial to the system; and this was the Owen. It was removed from a lady, aged thirty-five, the those had of who of The opportunities judging. general opinion of twelve children, the youngest of whom is now seven punishment, in military prisons, of lifting shot was also found mother months old. Two days after her last confinement, she had an to benefit the men, if not carried to excess. Dr. WEBSTER said the prisoners often worked in a close attack of peritonitis, which yielded to ordinary treatment. For many years she had suffered from constipation, but no idea. atmosphere, which was, of course, prejudicial to health. Dr. STEWART said there could be no doubt that after a short of any mechanical obstruction was entertained. On the 25th Mr. Phillips was requested to see her. She had training the labour at the treadmill, like all others, would be- of March, of the abdomen and obstruction of the bowels; for great pain come less severe, so that the effects produced on the author, who was not accustomed to the exercise, could not be regarded several days she vomited large quantities of feculent matter. The treatment adopted failing to afford relief, Amussat’s (jpera,as applicable to all persons. Dr. O’CONNOR said he was informed by the governor of one tion was proposed and rejected, cancer of the colon being supof the Dublin prisons, that the work was beneficial to the posed to exist. Death took place on the 26th of April. A examination revealed a close stricture of the prisoners, their health generally improving under the exercise post-mortem when of short duration. He agreed with Dr. Webster, that sigmoid flexure of the colon; above the contracted part extenmoral causes, rather than the actual prison discipline, would sive ulceration existed. The whole of the bowels were greatly distended, and the mucous membrane highly congested. The act as promoters of disease. Dr. SMITH, in reply, referred to the reprobation of the tread- peritoneum was healthy, as also were the liver, kidneys., and mill bv Mr. Mayhew, in his " Great World of London," and other organs of the abdomen and chest. Mr. SQUIRE presented a specimen of by Mr. Reade in " It is Never too Late to Mend." The discontinuance of its use in prisons was a tacit condemnation. Dr. TRUE ANEURISM OF THE LEFT POSTERIOR CEREBRAL ARTERY. Webster had mixed up prisoners condemned and not condemned to hard labour. As the increased respiration was from natural The tumour was of considerable size, measuring four inches’ in causes, there would be a corresponding increase in the chemical circumference, and weighing half an ounce avoirdupoise; it from the vessel close to its junction with the basilar, changes. He described the "shot drill," and showed that it proceeded was less laborious than the treadwheel, although it was quite artery, and occupied the space in front of the pons Varolii and as irksome. The after effects of the -r;readwheel could seldom between the crura cerebri, pushing up the floor of the third be traced f om the short duration of the punishment ; but new ventricle, and encroaching on the left thalamus. The patient a female, over forty years of age, having children, (with inquiries in that direction are needed. The results which he was (Dr. Smith) had mentioned were subject to some deduction for whom. she was found in an incapable state;) she was under want of training, though he was strong and healthy, accus- observation only a few hours before death, from adynamic fever tomed to long walking, and experienced in the use of the spiro- or destitution; she was nat comatose; there was no paralysis of meter, and many persons would be less capable of bearing the sphincters of either of the extremities, or of the facial muscles; the senses of seeing and hearing existed, and the power of fatigue than himself. The Society then adjourned. deglutition. Mr. Squire called attention to the absence of atheromaof the coats of the arteries, to the remarkable diminution in the size of the basilar artery, and to the free anastomosis existing, both the posterior and anterior communicating PATHOLOGICAL SOCIETY OF LONDON. artery being accompanied by two and three parallel vessels, DR. WATSON, PRESIDENT, IN THE CHAIR. (shown in the preparation,) while other smaller ones were noticed in the dissection. The interior of the tumour was concentric layers of yellowish dense fibrin, the DR. OGIER WARD submitted, for the consideration of the occupied by centre being a soft dark coagulum at the base of the tumour, as to its age, Society extending three-quarters of an inch forwards from a minute AN ABORTED OVUM, cavity continuous with the vessel from which the tumour arose, of which the following is the history :-The patient ceased to menstruate February 21st, and from her symptoms believed herself to be pregnant, having had four previous pregnancies. On April 23rd, she took a very long walk, and the next day she had a very violent flooding, which continued for three or four days, during which she remarked amongst the coagula what she thought was the "after-birth." The haemorrhage The Metaphysicians: being a Memoir of Franz Carvel, Brushthen became irregular, and finally ceased about May 10th or written by Hignsey; and of Harold Fremdling, maker, 12th; and believing from her diminished size that she had written and now republished by Francis Drake, Esq.; L’’sq., aborted, she admitted her husband to her bed. On the 22nd with Discussions and Revelations relating to Speculative of May she again took a long and rapid walk up a steep hill, Philosophy, Morals, and Social Progress. pp. 416. London: which greatly fatigued her, and the next morning she passed, and Co. 1857. Longman with scarcely any pain, a substance the size of a walnut, which OF all the strange, unaccountable, weird books we ever sa,t’ was followed by occasional pains, and a flow of blood similar to down to both till the the and when read, this is decidedly the strangest, most unaccount27th, after-pains, pains discharge ceased. The substance, when examined, had an oval form, able, and most weird. Franz Carvel, the hero of the first mewith rather fimbriated ends, and, when laid open, exhibited moir, appears to have read German metaphysics, and more the structureof an ovum, all the membranes being complete, Immanuel Kant’s " Critic of Pure Reason," until particularly but without an embryo. Externally, the decidua vera, with have become addled, and he sees visions. Vision his brains its cribriform perforations distinctly visible, extended over two- I thirds of the body; beneath was the reflexa, attached to the No. 1, is England one hundred years ago; and, vision No. 2, is. vera firmly above, and extending beneath it below, to complete England one hundred years hence. Connecting these imathe figure. Under this again was the chorion, covered over its ginings, is an account of the present and Franz Carvel as upper three-fourths with a layer of villi, easily separable, and conditioned by present modes, usages, and education. The: also lined with a layer of villi exactly similar. Within the chorion again was a fourth membrane filled with an areolar’ main object of the memoir seems to be to show that we have tissue, containing a clot of blood in its meshes, but no trace of decidedly improved upon our ancestors in the science of socioan embryo. The patient believes the ovum to be not older logy, and that we are about to experience still greater imthan a week or ten days ; if so, the perfect structure of all the provements. We strongly demur, however, to the crazy scheme membranes and of the placental tufts displayed by the micro- which would convert society into a colleetion of hypertrophied scope is very striking. There is no difficulty to account for the model lodging-houses. an at such absence of the embryo early period. But if the The second memoir is supposed to be an autobiography ovum is one of two or three months, it ought to be many times its present size, and to contain an embryo. Besides that, it written by a person who has been partly the victim of errors
Chesterton, in
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