WESTERN MEDICAL AND SURGICAL SOCIETY.

502 three inches long, two inches and a half and two inches deep, contained in a separate cavity partitioned from the surface externally, and from the lateral ventricle internally, by distinct walls of pulpy brain matter, communicating, however, with the latter at the extremity of its anterior horn. It had a most striking appearance. This ventricle itself contained two drachms of dark fluid blood. The organs in other parts of the body were rather more congested than natural. The heart was much hypertrophied, but no valvular irregularity existed. Both sides were completely empty. The lungs were full of frothy mucus. The bladder

coagulated blood, broad,

was

distended with

clear, limpid urine.

Athlone Barracks, Nov. 1853.

Medical Societies. SATURDAY,

MEDICAL SOCIETY OF LONDON. Nov. 19, 1853.—FORBES WINSLOW, M.D., D.C.L., President.

Dr. CRISP

lowing case

brought before

of

the notice of the

Society

the fol-

ARREST OF DEVELOPMENT IN THE FOETUS, to supposed have been produced by a mental impression upon the mother:—Mrs. A- brought her infant, aged eleven months, to the Metropolitan Dispensary on Tuesday last, Nov. 15th. On investigating the child’s symptoms, the mother stated " that the infant had only one leg ; on examination, Dr. Crisp found the right leg nearly absent, there being only about an inch below the knee-joint, and to this was attached a small, round, integumentary appendage. The mother says that her first child, now nine years of age, has a very large long head, she at the commencement of her pregnancy having been frightened by a horse. During the early months of her last pregnancy, she saw a crowd of persons in the street, and not believing herself to be in the family way, she pushed through the crowd, and was horrified at the sight of a sailor without a leg or legs. Her impression was, when she found that she was with child, that the foetus would be deformed, but she never anticipated that it would be born with one leg." Dr. Crisp remarked that he had always been a disbeliever in the effect of mental impressions of the mother upon the embryo, as no nervous communication existed between the uterus and placenta; but the instance in question somewhat startled him, and although the occurrence of the deformity might have been merely a coincidence, he thought the case was worthy of record, as it was only by the accumulation of such examples that the

could be ultimately settled. Mr. HUNT inquired the condition of the funis in this case. He recollected an instance somewhat like it which occurred in his practice some years since. In this case the arm, instead of the leg, was the seat of the arrest of development. The funis was found longer than usual, and tied in a knot round the arm at the point of malformation. The knot had interfered with the circulation, and arrested the development of the limb. There was no good proof in this cass that the mother had been affected with any peculiar impression to cause the de-

question

of the proceeding in question. In other parts of Great Britain, however, it had been adopted with great success, and especially in Jersey, by Mr. Jones, who had

respecting the merits

had six cases, five out of which were now quite well. Two of these patients were now presented. One of them, a young man of twenty, walked up the room without any artificial appliance whatever, and was able to use his limb very exten. sively, it being perfectly straight, and only half an inch shorter than its fellow, so that it is not necessary for him to wear a high-heeled boot. The knee is anchylosed, there being hardly any movement. The man is in perfect health, and stated that he had walked as far as six miles together, and is now enabled to carry on his occupation, which is that of a house-painter. The other was a boy, aged twelve, on whom the operation of excision had been performed seven months only. The limb was quite straight, as in the other, and there was perfect bony anchylosis at the knee. In this instance, however, the patella had been left so that the boy had full power of lifting the limb, inasmuch as the attachment of the great extensor tendon was left. It was noticed that this little boy walked up the room with the aid of two sticks. This was explained by the exist. ence of a circumstance which rendered the case very interesting. This was a dislocation of the hip of the opposite side, which had occurred spontaneously from disease some few weeks after the operation. Fortunately, however, the disease in the hip had become arrested, and the patient, although he ordinarily used two sticks, was enabled to walk, resting upon the arm of another person. He was daily getting strength, and doubtless in time would be able to progress with facility. If, however, amputation of the thigh had been done, and he used a wooden leg, the dislocation of the hip on the other side would have prevented progression, the superiority, therefore, of ex cision of the knee-joint was doubly shown in this example. Mr. JONES had operated in six cases; in five of these the operation was successful. The sixth would have been equally satisfactory, but the patient, a lady, died ten days after the prevalent. One of operation, of dysentery, which the patients he had operated upon could run well up a ladder, He had brought the two and another play at foot-ball. patients, just exhibited, up to London to seek the opinion of the more experienced surgeons here, with a view to determine, whether the operation were a legitimate one, or should be abandoned. (To be continued.)

was then

WESTERN MEDICAL AND SURGICAL SOCIETY.

FRIDAY, NOVEMBER 18, 1853.—DR. BARCLAY, Vice-President, in the Chair.

MR. DICKINSON communicated

a case

of

POISONING BY SULPHURIC ACID.

C-,aged fifty-two, took by mistake,.on the 20th of about an ounce of sulphuric acid, which upon inquiry was found to consist of equal parts of strong commercial oil of Mrs.

May,

vitriol and water. She immediately felt a burning sensation at the pit of the stomach, and discovering the mistake immediately, applied for relief, having previously drunk a large quantity of cold water. Some carbonate of magnesia was immediately administered, but was at once rejected with much formity. Dr. WINSLOW referred to the effects of mental emotion in the carbonic acid. No corrosion about the mouth or fauces was production of idiots &c. in the first French revolution. What- observed, nor were any laryngeal symptoms present, and the matter vomited had not any acid re-agency. She was then ever might be the explanation, the imagination of the mother ordered to drink largely of milk, which, however, was speedily certainly did appear to influence the fcetus in utero. Dr. CHOWNE referred to a preparation in Guy’s Hospital of rejected in a coagulated state with much grumous blood, and The mother had, in the when seen at the end of two hours, she was suffering from a foetus marked very like a clown. early months of pregnancy been very much amused at the soreness at the pit of the stomach, but as no violent pain was theatre by a clown, and the marks were supposed to be the present, some castor oil was exhibited which caused the result. There was no doubt, however, that the marks were evacuation of much dark-coloured blood. Milk diet was conthe result of disease of the skin, a similar case having come tinued, and in two days, the vomiting having ceased, and blood under his own observation. being no longer passed, and the soreness of the stomach having abated, she considered herself well. Iri consequence of severe EXCISION OF THE :KNEE-JOINT. constipation and much debility, she applied for advice again Mr. SMITH introduced for the inspection of the fellows on the 4th of June, when aperients were administered with of the Society two persons on whom this operation of ex- relief. She was again seen on July 4th, when she complained cision of the knee-jointhad been successfully performed by of daily vomiting, the matter ejected exceeding the quantity Mr. Jones, of Jersey, who was present at the meeting, and of food taken; the bowels too had been confined eight days; who had been induced at his request to allow them to be brought here. All those present must be aware that much discussion had been carried on respecting this operation, and that a great deal of opposition to it had arisen in certain quarters, and unfortunately we had not yet had sufficient experience in London to lead us to form a definite conclusion

the

tongue

was

red; the pulse small ; and there

flatulency, but no pain in the stomach. followed

was

much

Calomel and colocynth,

by a senna draught, were prescribed, and the abdomen carefully examined the next day, when it was found flattened, with a slight fulness at the cardiac extremity, the stomach and intestines being free from pain on pressure. The medicine

was

503 from her, so that she should not have any idea of the nature procured, injections of warm water of the remedy. A good light and speculum are essential, and the speculum best suited is the common circular glass one, or were ordered, night and morning, and chicken-broth given in small quantities during the day, an anodyne mixture of one of glass coated with gum-elastic. Neither the two-bladed opium being also prescribed. The injections always returned metallic nor the conical glass forms are at all suited; the uncoloured, and the vomiting and other symptoms remaining former because it allows all the heat from the blades of the the same, she was seen by Mr. Lane on the 8th, who acquiesced speculum to be concentrated on those portions of the vagina. in the treatment, and ordered ten grains of compound rhubarb- which bulge between them, and the latter because it is liable pill at bed-time. On the 9th, a pint of gruel, with a glass of to be easily expelled by the vagina. A full view of the os and sherry, was injected, as she had become much weaker ; and in cervix uteri having been obtained, the os should be cleansed the evening another injection of mutton-broth was used. The with a piece of cotton or wool, and when the cautery has become same treatment, with the tincture of opium, and small quanintensely heated, it should be steadily introduced and quenched tities of beef-tea, was continued daily until the 17th, the injec- in the diseased tissue, the duration of the application and the tions being retained at each exhibition. Since the llth she depth of its introduction depending upon the effect required. had been entirely nourished by them, having only taken a little The eschars thus produced are marked with a whitish-yellow beef-tea when her lips were parched. On the 17th, some flatus border, and the cervix often visibly contracts under the applipassed, and the injection returned coJuured, and the next day cation of the cautery. The author insisted upon heating the (twenty-one days from the commencement of the constipation) porcelain to whiteness, otherwise slight haemorrhage may she had a copious yellow motion. A cup of cocoa was allowed occur, from the instrument dragging off a portion of mucous for breakfast, and the injections continued for a few days. membrane, which invariably adheres to the instrument under From this time she gradually recovered, her diet being fari- such circumstances; the surgeon should also remember that naceous, with fish occasionally, the sherry injection after a time the degree of the eschar is entirely under his control. He being the only one used. On the 30th the vomiting returned, then stated that the cases where it was applicable were those the urine became high-coloured, her countenance haggard, and of induration of the os and cervix uteri, of ulceration of the os, the bowels confined, in consequence of having partaken of some and in prolapsus uteri, and also in prolapsus of the anterior lamb, peas, and new potatoes; but these symptoms soon sub- wall of the vagina. sided under the use of aperients and simpler diet. She was not After some discussion the Society adjourned, the chairman again seen until the end of September, when she had returned announcing that on Friday, Dec. 2nd, Dr. Barnes would read Scrofulous Inflammation of the Eye." to her business apparently well, the only symptom being the a communication on occurrence of vomiting when she lay on the right side, or allowed her bowels to be confined. One remarkable thing in this case was, the absence of any corrosion of the soft parts of the mouth NORTH LONDON MEDICAL SOCIETY, -a condition alluded to by Dr. Taylor, who narrates two or three instances of the same kind. In this case the mouth was RICHARD QUAIN, F.R.S., President, in the Chair. probably shielded by the epithelium, which is always loose and abundant in the morning. It is also remarkable that salivaMR. SEDGWICK related a case of was

and

repeated as it had failed to act, and the vomiting continued, as no

motions

were

"

tion-a common symptom-was absent in this case. That the stomach had sustained injury was certain, and as the vomiting generally occurred some hours after the food had been taken, the lesion was probably seated at the pyloric extremity. The long continuance of the constipation and the sudden recovery of the patient on its removal were worthy of notice. Dr. BARCLAY then related two cases of poisoning, one by caustic potash, and the other probably by caustic ammonia, in both of which ulceration resulted. Cicatrization, however, occurred, and caused such constriction as to prevent the passage of food, in the one case at the cardiac, and in the other at the pyloric orifice, as was proved after death. Mr. ELLIS then read a paper

OSTEOID

CANCER ; a the case short review of the history and with opening pathology of this rare form of cancer, which he stated had apparently escaped the notice of pathologists, until Muller, in the year 1843, published a memoir on the subject, accompanied with descriptions of several cases of the disease. In commenting on the reasons for considering the disease cancer, Mr. Sedgwick was of opinion that they were fully confirmed by the case which he had recently had the opportunity of observing; and he took occasion to draw attention to the opposite view entertained on this point by Lebert, who had included " osteoids" in the list of benign tumours. After ON THE GALVANIC CAUTERY IN THE TREATMENT OF UTERINE alluding to the observations on the disease contained in Mr. Stanley’s work on the Bones, and in Mr. Paget’s DISEASE. He commenced by stating, that while the older surgeons had recently published " Lectures of Surgical Pathology," Mr. considered the actual cautery as a highly valuable remedy in Sedgwick entered intoa very full description of the case, many cases of long-standing disease, the moderns had relin- which was illustrated with preparations of all the parts affected by the disease. The subject of the case was a young quished it for the more painful and less manageable potential woman aged nineteen, formerly a patient in University College cautery. He remarked that the actual cautery had seldom been applied to the uterus in situ, until M. Jobert had recom- Hospital, under Mr, Quain, who had amputated the left thigh mended it in chronic disease of that organ. He also alluded to for an osteoid tumour affecting the lower end of the femur. the researches of Mr. Marshall, who, in his investigations on After remaining free from disease for nearly three years, his "Electric Heat in Surgery," appears to have been the first who chest became affected in consequence of " taking cold;" he eorroborated the views of the ancients respecting the remedial spat up a little blood during the first twoor three days, and agency of the actual cautery. This gentleman used only a had a troublesome cough. It was not till some weeks after heated wire, which necessarily acted upon a small surface, and the appearance of disease in the chest that he came under the The experiments of the author notice of Mr. Sedgwick, who diagnosed cancer affecting nearly was consequently inefficient. soon led him to adopt a better method, by which he was the whole of the left lung, a small portion only towards the enabled to concentrate the heat evolved over a considerable apex being free. A tumour was at the same time noticed in surface,-an important element in cauterization by electric the right clavicle, considered to be cancer. Mr. Sedgwick heat. The instrument he employed was a good-sized silver gave an abstract from his notes of the case, extending over a catheter, straightened out, with the end cut off, which formed period of nearly five months. A few weeks before death, the body of the instrument. It was then slit open at the symptoms of the head being affected showed themselves, upper end and broached, so as to form a socket for the porcelain ending in convulsive attacks of the right side of the body, cauterizer, and also to allow the internal wires to pass out. which continued to appear at intervals up to the time of death. Within the catheter are placed the two conducting wires, On post-mortem examination, an osteoid tumour, about the insulated, they being at one end connected with the wires of size of a fist, was found in the posterior mediastinum, and a the battery, and at the other with a piece of platinum wire, similar tumour of larger size in the right side of the chest. which is coiled around the porcelain cauterizer. The battery Three or four small tumours, some of them unossified, were employed is Groves’, of four or five cells, and of these two are found near the base of the right lung. The tissue of the right required to heat the porcelain to whiteness, which degree of lung was healthy. The left lung was riddled with cavities, heat is essential. From this simple contrivance the instrument containing purulent matter. The thoracic aorta, for more than derives its principal value, the heat being thus both intense three inches, was surrounded by a firm cancerous mass, which and permanent. When ready for use it is entirely under the on section presented centres of ossification. A portion of a control of the surgeon, a matter of vast importance in its similar mass was found in the vena azygos, and the left application. The patient to be operated upon should be in the bronchus was completely blocked up with a partly calcareous usual obstetric position, and the batteries and wires concealed mass. A medullary tumour was found in the left hemisphere