Monday, February 3.

165 He had not been present at the post-mortem examination, but no communication whatever was found to exist between the tumour and the intestines, although the size of the tumour was remarkably influenced by the purging, and vomiting of many pints of a peculiar kind of fluid, said to be similar to that found in the The other ovary was healthy. tumour after death. The conversation which followed the narration of this case had tion was more frequently and carefully performed, especially in ..every doubtful case, we should hear less of its failure, or of the reference to the probability of a communication existing between the tumour and intestines. spread and virulence of secondary small-pox. Dr. A. P. STEWART made reference to a number of cases It was then announced that Mr. Pilcher would read a paper -which had occurred in his practice, all tending to prove that on cases of mechanical irritation of the nerves. vaccination was a sufficient preventive to small-pox, when it was I properly and efficiently performed. When it failed, it had not Monday, January 27, 1845. been properly applied. In confirmation of this view, he referred DR. THEOPHILUS THOMPSON, PRESIDENT. to the lately published report of the Royal Jennerian Institution. SUDDEN DEATH. His experience at the Glasgow Infirmary enabled him to confirm a strtement of Dr. Cowan, that small-pox in that city was perMr. PILCHER. related a case of sudden death occurring in a petuated chiefly by the unvaccinated Highland population. M. young lady previously in good health, except that she had sufChomel had well said, that we "could not expect more from fered for a day or two previously with some slight symptoms vaccination than from small-pox itself," for in many cases small- resembling scarlet fever, such as redness of the fauces and tongue. pox, and that of the worst kind, had attacked the same person Previous to this she had suffered from slight uneasiness of the twice or thrice, and terminated fatally. epigastrium, and cedema of the extremities. The night before she Dr. GREGORY remarked, that, even if his plan were fully died she had taken an emetic, which produced free vomiting. carried out, still nearly one half of mankind would be under the The next morning, whilst reading a letter, without any evident protection of Jenner’s discovery, for one half of the children born cause, either mental or bodily, being, in fact, better than on the in Liverpool died before puberty, and three hundred out of every previous night, she suddenly dropped dead. The only appearthousand born in London did not reach adult age. The remain- ances of importance after death was a smallness and thinness the heart, the right side being full of fluid blood, a " venous tree" ing portion only would be subjected to inoculation. on the anterior cardiac surface of the stomach, a slight congestion of the veins of the pia mater, and the presence of a corpus luteum, believed by Mr. Pilcher to be a true specimen, in one of MEDICAL SOCIETY OF LONDON. the ovaries. Monday, January 20, 1845. The cause of death was a mystery, but was possibly owing, Mr. DR. THEOPHILUS THOMPSON, PRESIDENT. Pilcher thought, to an effort, which was unsuccessful, on the part of the system to throw out congestive fever; the heart was EFFECTS OF COUNTER-IRRITATION. mainly implicated in the struggle, and death resulted. Mr. PilMr. DENDY, in reference to the discussion at the last meeting, cher, from this and other cases, considered that a true corpus remarked, that when properly and judiciously applied, blisters to luteum might exist independent of impregnation. children were by no means attended with danger. He himself, A discussion of some length followed, chiefly in reference to however, preferred the use of the acetum lyttae, which merely the appearance of corpora lutea. required to be painted on the skin with a camel’s hair brush, He was in favour of small once or twice, to produce vesication. vesications, such as the size of a shilling, being formed successively CHEMICAL SOCIETY. at intervals of twelve or twenty-four hours. The acetum Monday, Jan. 20, 1845. had the advantage of not producing strangury. MR. AIKEN IN THE CHAIR. Some remarks on the effects of blisters to children were made by several members. Applied with due caution, and allowed to A PAPER was read by R. WARRINGTON, Esq., on the distilled .remain only a short period, they might be and were serviceable in waters of the Pharmacopoeia, and on the practice of preparing submany cases. Their abuse, however, was calculated to do much stitutes for such waters, by triturating the essential oils with magevil, and never more so than when applied by ignorant persons, nesia. Mr.Warrington has made many experiments on the distilled who allowed them to remain on for a long period. waters of the Pharmacopoeia, which prove that the. use of spirits In order to shew that blisters, or any other kind of counter- of wine, added to preserve these waters, has a contrary effect; irritation, might occasionally be of serious consequence to the pa- that after a time it is converted into acetic acid, and that in no it was PILCHER six observed by Mr. that he recollected tient, respect is it desirable. He traced the origin of the practice to cases of inflammation of the chest succeeding to measles, in which !, of 1690, and pointed out the evil resulting the blisters had been applied, and they were all fatal. He men- fromPharmacopoeia it in cases where these waters are prescribed as solvents instance of a fifteen or of tioned also the sixteen years youth age, for many chemical articles. The substitution of waters prepared in whom the irritation produced by a compound frankincense by triturating essential oils with magnesia or chalk, he conceives plaster applied to the chest, was so great that the parts sloughed, to be equally, if not more objectionable, as these substances are and the patient sunk. In these cases, doubtless, the constitu- taken up by water in such quantities as to render the waters tional powers of the patients were very low. unfit for the preparation of prescriptions. The magnesia or Mr. STEDMAN had found the acetic acid as efficacious as the chalk does not act by forming a soluble compound with the acetum lyttæ, and considered the efficiency of the latter preparation essential but simply by mechanically dividing the oil, and oil, to be dependent on the vinegar. thus exposing a very large surface to the solvent action of the Mr. DENDY recollected Sir A. Cooper mentioning a case in water. Hence Mr. Warrington proposes to substitute perfectly which a young lady, recently arrived from Jamaica, fell a victim insoluble such as fine porcelain clay, powdered materials, to the application of common blister to her knees. She sank in or calcined flints, for the magnesia or pumice-stone, glass, three days, from sloughing of the parts. In respect to the effects chalk; and he finds, by experiment, that these substances effect of the various paper preparations of lyttæ, he had found them so the purpose perfectly, charging the water with the essential uncertain that he never employed them. and not themselves dissolving in it. Prepared in this way, oil, Mr. BisHop remarked that when a large surface was exposed, the waters are quite equal to those distilled, and keep extremely either as the result of a blister or a burn, nervous irritation of well. such a character might be produced as to terminate fatally, A long. conversation ensued, from which nothing could be and this even when the sore itself might have a healthy aspect. deduced the great deficiency of pharmaceutists in The nervous irritation killed Miss Clara Webster. In cases in chemical except knowledge. ____ which this irritation was set up, opium often exerted a most benign influence. He related cases in which the application of a Monday, February 3. mustard poultice for several hours to the throat was succeeded by R. PORRETT, ESQ. IN THE CHAIR. destruction of the thyroid gland, and such a state of constituAn elaborate and highly scientific paper " On the Metamortional irritation as to place the life of the patient, a gentleman, in danger. Buboes occasionally sloughed after the application phoses of Indigo, and the production of- Organic Bases containof blisters to them. ing Chlorine and Bromine," was presented by Dr. AUGUSTUS W. Mr. PILCHER detailed some particulars of a case of an old HOFMANN, assistant in the Giessen’laboratory, and read. It was the history of a research undertaken to decide the correctness of woman who had suffered for some time with ovarian tumour. The particulars of the case, Mr. Pilcher remarked, were imperfect. Laurent’s views respecting the theory of substitutions. That

least, a very strong proof of the author’s own faith in the efficacy of cow-pox; for why was it employed in this case? unless to protect the individual still more against a disease which she had previously received by inoculation. He (Dr. W.) thought that sufficient care was not always taken in respect of the purity and condition of the vaccine lymph, and he felt convinced, ifre-vaccina-

lyttæ

,

166 chemist had advanced the opinion that chlorine, bromine, &c., may be made to replace hydrogen in a compound, without changing the properties of that compound. Some examples are already known to chemists-as, for instance, chloracetic acid, discovered by Dumas,-but to complete the theory it was necessary to decide whether the substitution could take place in basic bodies. Dr. Hofmann completely succeeded in this object, and produced a series of substances bearing the closest analogy to organic bases, in which part of the hydrogen was replaced by an equivalent amount of chlorine or bromine. , To this paper the following note was appended :" I have had the pleasure of witnessing the care and accuracy with which the author of this paper has proceeded, in making his and in establishing his facts. observations, " It appears to me, that he has produced a definite and irre- ’, fragable proof, that the chemical character of a compound does not depend, as the electro-chemical theory supposes, upon the nature of the elements it contains, but solely on the manner of I " their grouping. JUSTUS LIEBIG." z

,

I

*** We shall have occasion to bring some of the details interesting paper before our readers at a future time.

of

this

turned ; but there has always remained a small indurated swell-

ing, which about eighteen months ago gradually enlarged, and became more painful, until at length he was totally unable to expose the glans. He went into St. Martin’s Workhouse, and was placed under the care of Mr. Bainbridge, the surgeon of that institution, to whose kindness I am indebted for the case. This gentleman slit up the prepuce, which relieved the pain considerably: there was at this time no ulceration, but as an ulcer appeared in a few weeks, he was salivated, but without any benefit. Upon admission into the hospital he did not complain of much pain: his general health was tolerably good. There was an ulcer on the prepuce, and one corresponding on the glans penis, extending over the corona glandis. The surface of the ulcer was uneven, and of a sloughing brownish colour, whilst the edges were elevated, irregular, hard, and whitish. The prepuce, glans penis, and corona glandis, were very hard, like cartilage, and the glans penis was inclined over to the left, the sore being on the opposite side. The pulvis opii was ordered to the wound, and the patient directed to take bark and to be placed on meat diet. Under this treatment his general health improved, but as on the 20th of June the disease appeared to be spreading, and there several fresh indurated swellings about the prepuce, he was advised to submit to an operation. I accordingly amputated his penis on the 24th of June, at about an inch behind the corona glandis, his health then being good. were

HOSPITAL REPORTS. CHARING-CROSS HOSPITAL. CASES OF CANCER OF THE PENIS.

(With Clinical Remarks by

Hancock.) GEORGE C-,aged sixty-five, residing at Colnbrook, was admitted an in-patient on the 30th of January, 1844. At this time the penis was excessively swollen; the skin thickened, and of a livid colour; the prepuce hard, swollen, could not be drawn back to expose the glans penis. At the base of the prepuce, corresponding to the corona glandis, was a cancerous ulcerated opening, discharging freely; also one at the root of the penis, on its right side, close to the scrotum, the whole substance of the penis being implicated in the mischief, which extended to the pubis. He stated that he never had phymosis, but that about a year ago he observed some warts on the under surface of the penis, at the corona glandis, but he destroyed them by applying powdered alum; a hardness remained, which gave him no inconvenience until nine months ago, when, in turning a piece of three-inch plank, he struck the sharp corner against the penis, causing the most excruciating pain for a quarter of an hour, after which it subsided, and he thought nothing more of it until three months since, when he was seized with shivering, succeeded by heat. The left leg became inflamed and swollen, and subsequently the penis. He applied poultices, and placed the penis in hot water from time to time, and took large quantities of aperient Mr.

medicine. ’

Upon examination, I felt fluctuation, and therefore made a free opening on either side of the penis, at the same time freeing the phymosis. Considerable discharge followed these incisions, and upon exposing the glans some warty excrescences were observed. The discharge presented different appearances, being at parts like chalk-and-water discharge of cancer, in others like pus; it

confined in a sac, but flowed from innumerable points, apparently from the cells of the corpora cavernosa. The orifice of the urethra was larger than natural, the lips thickened and everted, exposing the ulcerated internal surface of that canal, from which an opening extended to the right side of the corona glandis. The glands in the groin were hard, and considerably enlarged, especially those on the right side. was not

He experienced great relief from the incisions, but as the dishad extended too far for any operation to be attended with benefit, I endeavoured to improve his health generally, and by the occasional application of leeches and anodyne fomentations, to arrest the progress of the disease as much as possible, but without much success. He left the hospital on the 17th of June. At this time the skin of the scrotum was implicated, being thickened, hard, of a purple colour, and nodulated; the ulcers on the penis were considerably enlarged, and had extended deeply into the substance of the corpora cavernosa, so that a probe introduced on one side passed freely out through the opposite side of the penis. ease

The other

case

is that of Francis Charles

Faged fifty-

the 30th of May, that he has always had congenital phymosis; that thirty years ago he had syphilis, since which time the part has not been sound. At first he observed some warty excrescences on the prepuce, which were excised, and have not re-

five, admitted from St. Martin’s Workhouse, 1844.

He

states

on

important points. In the one, had phymosis; in the other, that inconvenience all his lifetime. In C--’scase the disease spread with great rapidity, in the course of nine months involving the whole of the corpora cavernosa, corpus spongiosum, and skin, as far as the pubis, as well as the glands in the groin: there was a copious discharge at parts, of pus, at others, of the chalk-ard-water fluid, whilst the ulcers presented all the appearances of those observed in cancer of the breasts, being also of great extent, and penetrating in all directions through the organ. On the other band, in the case of F--, the hardness, which he attributes to syphilis, remained in a quiescent state for nine and twenty years; it then for eighteen months increased gradually, the glans penis becoming involved in the mischief. The ulceration of the prepuce and glans only commenced about three weeks before his admission; it was comparatively superficial, the edges white, indurated, and considerably elevated above the surrounding parts; and the thin sanious discharge very offensive. The swelling of the prepuce had so pushed back the glans penis, on the one hand, and elongated the prepuce on the other, as to give the extremity of the penis the appearance of a parrot’s beak, but the rest of the skin was natural. This disease rarely falls under the observation of the surgeon until it has progressed to some extent; this is owing partly to the insidious nature of the complaint, and the absence of pain, but more frequently to the pre-existence of phymosis; it may commence either in the prepuce, in the glans penis, or in the corona ’, glandis, but it quickly involves the whole three, in whichever I situation it begins. Individuals most subject to cancer of the penis are those who have congenital phymosis or elongated foreskins, although this is by no means an invariable rule; as Hey, in his paper on this subject, relates the history of three cases in which there was no phymosis ; and in the case of C-- you have another instance, and there are several others recorded. The disease also occurs mostly in individuals of an advanced. age, very rarely before the middle period of life. Commonly the patient’s attention is first arrested by a hardness, but as this i& unaccompanied by pain, he thinks but little of it until he observes a discharge which stains his linen, and he then consults his surgeon. This discharge has frequently been mistaken for gonorrhcea, and in some instances is somewhat similar to it, but it is more commonly thinner and more offensive, being very copious, sanious, and foetid: when you handle the part you will at once ascertain that the complaint is not gonorrhoea, but one of a more serious character ; you will then find that the hardness is not the common induration of inflammation, but more of the stony hardness of cancer. You direct the patient to withdraw the prepuce, and he will tell you that he cannot, and most probably that he never has been able to do so. Under these circumstances you at once introduce a director, and slit the prepuce up, and you will then find fungous growths, situated either on the under surface of the glans, or completely covering the glans, whilst in some cases they grow from the prepuce, pushing the glans backwards. Where the disease is more advanced, ulceration ensues. This ulceration is not the same in all cases. I have before pointed out to you that in the case of C-- the ulceration was deep, unThese

cases

differ in several

C--, the patient had never Fńń,he had been subject to