EPIDEMIOLOGICAL SOCIETY. MONDAY DECEMBER 3Rd, 1855.

abounding in irregularities and cells of all kinds, as well as prefer to call a puerperal plague. The name puerperal feve rather extensive canals running throughout the bone. In is the most commonly used, and therefore the best understood proceeding to speak of the causes of dental caries, Mr. White He denied that it was puerperal peritonitis, because it did no considered, with the best authors, that the structural defects agree with that inflammation, either in the mode of the attack just alluded to strongly predisposed to caries; although he in the symptoms, in its morbid appearances, or in the influenci of remedial agents. He pointed out the sudden manner of th( was unable to point out the precise mode in which these states conduced to it, saving that such defects were found to exist attack without any obvious cause, the cases where the symptoms of puerperal peritonitis were absent, and yet the patient diec more frequently amongst those of scrofulous habits than of other of this disease, and presented all the usual morbid appearance: constitutions. Such defectively formed teeth then, in which the lime appears in the peritoneum. He compared the morbid changes observeo to have been irregularly deposited, leaves its substance more in peritonitis from ruptured uterus with those described ir pervious to the fluids of the mouth. Besides which the lime puerperal fever, and pointed out the difference ; and, lastly, might be deficient in quantity, and more susceptible of change directed attention to the great difference in the effect of the from the action of the saliva, which, under some circumstances, treatment most commonly pursued for peritonitis, stating that acts as a solvent. Remembering also, that the saliva will depletion has been used successfully in cases of puerperal feveI sometimes show the presence of both an acid and an alkali in to such an extent as fifty ounces of blood, in cases the parallel of which in peritonitis will not bear bleeding at all. Mercury a state of imperfect neutralisation ; that the quantity contained in a tooth is very small, and the length of time over has failed utterly in arresting this disease, and opium ia which the destructive action spreads; and that the defects and equally useless, unless in combination with the most powerful cavities referred to, form so many recesses into which this acid stimulants. He therefore thought it quite incorrect to call may penetrate and remain, it was safe to conclude that de- puerperal fever "puerperal peritonitis." It seemed to him fective formation was one cause of caries. Passing on, the equally an error to name the disease "acute uterine phlebitis," author discussed, in succession, the various states of"ill admitting the greater difficulty of distinguishing each because health" observed in patients suffering with dental caries-in- both were blood diseases. He thought true uterine phlebitis digestion ; sympathetic ailments, as neuralgia and others; and a rare disease; that the most eminent pathologists have agreed fortified his opinion, that the teeth were greatly under con- that the lining membrane of the veins is scarcely susceptible seitutional influence, by reference to experiments and physio- of inflammation; that the uterine veins consist only of a lining logical observation. The author also expressed his belief in membrane, and do not inflame; if they did so easily, uterine the hereditary influence, and cited some curious instances. would be the result of every severe labour, especially Certain trades again tend to produce caries, of which grocers with putrid children. He quoted some cases of true uterine and lucifer-match makers were examples. Certain localities, phlebitis and puerperal fever with the veins chiefly engaged, especially damp ones, and those where imperfect drainage in order to point out the difference. He considered the depoexisted, appear to be amongst the causes; and, also, mechanical sitions of pus so frequently found as the evidence of depraved violence. Of the teeth most likely to be affected the first molars or poisoned blood, and quoted a case of Mr. M’Whinnie’s, from appeared to occupy the highest place, and those of the upper the " Transactions" of the Royal Medical and Chirurgical Sojaw usually were the first to decay. The " wisdom teeth" were ciety, as an illustration of his argument. Assuming puerperal often evolved in an unsound state. The popular idea of the fever to be the result of a poison, he stated that we did not as yet contagion of caries was met by asserting, that the apparently know what that poison was, but the nearest approach we could successive decay of adjoining teeth was due to the pressure of the make to it was its close resemblance to the poison of putrid teeth against each other, caused by the upward and forward animal matter. In illustration he mentioned the effect of the growth of them. For if such teeth were examined at an early effluvia, from Mont Fanen on the Maternite at Paris. He period, long before caries had manifested itself, a round chalky referred to a case of severe labour, in which, having to remove spot might be noticed, caused by the crumbling of the enamel a putrid placenta, his arm afterwards exhibited a malignant fibres beneath the firm, but steady, pressure exerted upon pustule, which was very like the pustules sometimes found them: this opens the dentine to attacks of acid, and other amongst the meat-slaughterers in the south of France from irritants, and sphacelus is the result. Having thus discussed putrid meat. He mentioned a case of putrid uterus, which many and various causes of dental caries, and contrasted the produced all the symptoms of so-called puerperal peritonitis, frequency of the disease in civilized society with the immunity although in the Dublin Lying-in Hospital, where the patient enjoyed by man in his savage state, as well as that of the lower was, there had not been a single case of this fever for a year animals, the author was impelled to the conclusion, that"it before or for a year and a-half afterwards. He referred to Mr. may in great measure be attributed to the artificial mode of Henry Lee’s researches, and to Weal, in support of his opinion, living in a civilized state, which brings on a morbid condition that the uterine veins do not easily inflame, and concluded by of the fluids, resulting in impaired nutrition. The treatment making a marked distinction between pus and putrid matter. must, of course, vary with the states and circumstances of the He denied that healthy pus was a poison; its properties were disease. In an incipient state, from pressure, the removal of to preserve the circulation from contamination; decomposed the affected enamel, and polishing the surface was recom- animal matter had the contrary effect, because it destroyed mended. Where, on the contrary, the disease has proceeded those healthy properties of the blood; it had less power of so far as to excavate the substance, the sooner it is cleaned out coagulation, was easily dissolved into pus, and in such cases and stopped with gold, or amalgam, the better. When the pus, or what is called pus, is found everywhere, infiltrating the caries has progressed to such an extent that the dentine is soft uterus, in the liver, spleen, lungs, and even the heart, and all and yielding, the slightest pressure causing intense pain, this without inflammation. He therefore objected to the term stopping is inapplicable, and recourse must be had to escha- "uterine phlebitis,"as used to express that form of puerperal rotics. Of these, perhaps, the most efficient was a combination fever, but did not wish to be understood to assert that a specific of oxide of arsenic with acetate of morphia, mixed into a inflammation could not form a part of this epidemic, but it paste, with creosote. This gives slight pain for about two appeared to him that we might as well adopt Broussais’ doctrine, hours, after which it ceases, and the tooth can then be stopped and call typhus fever "gastro-enteritis," as name puerperal and made serviceable for some time. The practice of indis- fever by these local inflammations. On a future occasion he would conclude this subject. criminate extraction was declared to be unwarrantable.

phlebitis

EDINBURGH UNIVERSITY.-The various classes have settled down to the customary routine of the winter

now

EPIDEMIOLOGICAL

SOCIETY.

session. Professor Goodsir has offered several prizes for comby the students of his Anatomy Class, and Dr. Gregory petition 3Rd, has announced the same intention with regard to his. These DR. BABINGTON, PRESIDENT. prizes, it must be remembered, are at the private expense of each professor; for, with the exception of a few bursaries and scholarships to the students in the Faculty of Arts, there are DR. MURPHY read the following paper, on scarcely any of consideration at this University. The Hope PUERPERAL FEVER, Prize, instituted by the late Dr. Hope for the chemical in which he dwelt at some length on the importance of defining students, although a large one, has had no candidates more accurately the true character of this disease. He objected for it during the last few years; however, it is to be hoped, to the terms "puerperal peritonitis," "uterine phlebitis," with the additional incentives given to students this session, correct expressions of what he would that so valuable a prize will not be wanting in competitors. "arthritis," &c.,as 610 MONDAY

DECEMBER

1855.