PATHOLOGICAL SOCIETY OF LONDON. TUESDAY, APRIL 2ND, 1867.

567

Medical Societies. PATHOLOGICAL SOCIETY OF LONDON. TUESDAY, APRIL 2ND, 1867. MR. JOHN SIMON, F.R.S., PRESIDENT. MR. H. ARNOTT exhibited a specimen of Cystic Enchondroma of the Thyroid Gland, situated behind the common carotid

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artery. Dr. BAGSHAWE brought forward a patient, a middle-aged had suffered from severe pain in each arm, and ’, in whom about nine small tumours were found in each forearm, ’, one of which was removed, and discovered to consist for the most part of fat. There was also a similar tumour in the axilla. They had been noticed for about eighteen years. Dr. MURCHISON referred to similar cases, occurring in two sisters and their father. The PRESIDENT also cited cases in his own experience, and dwelt upon the interesting fact of the occurrence of these innocent multiple tumours in contrast to the single occurrence of cancer as a primary disease. Mr. BRYANT also referred to a case of multiple fibro-plastic tumour which he was about to exhibit to the Society: one in the leg, a second in the parotid, and a third in the abdominal region; the first of which was removed by operation. Mr. MOORE mentioned cases in which a primary tumour seemed to have been innocent, while that which recurred woman, who

afterwards was distinctly malignant. Dr. MURCHISON showed a Hydatid Tumour of the Liver, followed by suppuration of the cyst and secondary gangrenous abscesses in the liver. In this case, though there was no gangrene of the lung, a very foul odour was exhaled from the

patient’s body. Mr. H. SMITH brought forward the parts removed from a child, aged three, after median lithotomy. The child was very fat, and the operation was extremely difficult, so much so that at first it

was feared that the bladder would not be reached. The child died of shock about twenty-four hours afterwards. Mr. BRUCE displayed a portion of the lung in which a piece of broken rib was embedded. The accident which had occasioned this had occurred three years before death. The man had died of heart disease, with bronchitis and emphysema. The embedded bone was more than an inch in length, enclosed in a cavity with smooth walls in the lung, and covered with thickened pleura. The ribs were also exhibited, showing the traces of the old injury. Dr. A. CLARK brought forward a case of Fatal Hæmaternesis, caused by calcification and thrombosis of the portal vein. The patient was an officer, fifty-three years of age. Dr. A. CLARK also showed some specimens from rabbits’ lungs, in which disease had been artificially produced by inoculation. The specimens revealed the results of inoculating grey tubercle into a wound behind the ear. After this operation grey granulations were found in the lung and greyish tubercles in other parts of the body. In all these cases (thirtytwo in number) several points of difference were observed from the grey granulations of man. The structure was cellular, not corpuscular. If the rabbits were left to live for some months, the grey granulations were not found. None of the secondary changes which invariably follow in man were here observed. For these reasons Dr. Clark thought the identity of these bodies with the grey granulations in man was unproved. Besides, the inoculation of other matters (in one case cancerous) gave the same result. He also pointed out that in the President’s cases no abscess formed after the experiment, which was always the case after his experiments. He likewise remarked that by using °°yellow tubercle,"so called, the operator was not sure what he was using, as so many different substances were described by that name. The introduction of a large mass of matter into a deep wound was quite another affair from inoculation. Dr. A. CLARK likewise showed a form of disease artificially produced in rabbits by privation of air and food, consisting of a deposit of masses resembling yellow tubercle, but really a form of scrofulous pneumonia. A report was then read by Dr. Bristowe, Dr. Dickinson, and Mr. Sibley on the specimens brought forward by the President at the last meeting. The reporters described the ap-

pearances to the naked eye and microscope minutely. They dwelt on the numerous resemblances of these formations to crude tubercle; and they also dwelt on the differences which existed between the specimens and either pysæmic deposits, pneumonic abscess, or other diseased products. And they thought the tuberculous nature of the specimens was beyond reasonable doubt. Dr. WILSON Fox demurred to Dr. A. Clark’s description of the tubercular product as corpuscular and not cellular. He (Dr. Fox) believed the reverse ; but thought that in tubercle the walls break down very early, especially when the process of degeneration goes on rapidly. Dr. A. CLARK remarked on the specimens brought forward by the President, dwelling on the uncertain nature of the definition of yellow tubercle with which the inoculations were performed, and which was produced by the inoculation. The same formations can be produced by inoculation of other matters, or even by keeping animals in certain insalubrious conditions. Dr. GREENHOW observed that this did not apply to the deposits in the spleen or mesenteric glands. Dr. WILLIAMS observed that it seemed to him that these minute distinctions were unnecessary and inaccurate, and that what he taught long ago was being proved true-namely, that tubercle is only a degeneration of the plastic material of the body. This tendency to degeneration was also shown by the description of the changes in the deposits in the specimens to which the report referred. Mr. BARWELL related a case in which he produced some deposits in the lungs of rabbits, resembling tubercles, by passing a thread through some of the bones. The PRESIDENT replied by stating that he had inoculated these rabbits with very small quantities of animal matter (called tubercle), and they died after some months with symptoms, and with extensive deposits in the lungs and elsewhere, not, as far as is known, producible by any irritant which could be introduced. This could hardly be regarded as otherwise than specific. His experiments differed from the others in being really inoculations-minute punctures into which a very small quantity of the matter was inserted, notmuch more than is used in vaccination. In Lebert’s and in the others, as in Dr. A. Clark’s, the operation was quite different-a large mass of matter being introduced into a considerable wound, which was followed by an abscess. Whether called tubercle or otherwise, the action in his (the President’s) cases must be allowed to be specific ; and M. Villemin’s conclusion, he thought, must be accepted-that tubercle, in the ordinary sense, is inoculable. Dr. PYE SMITH showed a specimen of Retro-peritoneal Hernia, from a subject in the dissecting room-an old woman.

At a previous meeting a report was read on Mr. Curling’s specimen of Recurrent Fatty Tumour of the Rectum by Mr. De Morgan and Mr. Hulke, describing the minute structure of this rare form of growth. A report was also read by Mr. Moore and Mr. J. Wood on a case of Villous Tumour of the Bladder, previously exhibited by Mr. J. Forster, in which the naked-eye and microscopical characters of the growth were minutely described, and references were made to similar cases in the Society’s Transactions. There was no proof of malignancy in this disease. Dr. H. GREENHOW exhibited a specimen of Cancer of the Supra-renal Capsule from a girl aged twelve, who was admitted in a dying condition into the Children’s Hospital at Birmingham, under the care of Dr. B. Foster. The microscopic chaThe racters of the disease were described by Dr. Cayley. tumour formed by the diseased capsule was about twice the size of the kidney, and loosely adherent to it. There was no

cancer in any other organ, in which respect Dr. Greenhow believed the case to be unique. In all other cases on record, there was either cancer of the liver or of some other organ. There were no symptoms in this instance. The specimen was referred to Dr. Dickinson and Mr. Hulke. Mr. BRYAXT brought forwarda specimen of Naso-pharyngeal Polypus removed from a boy aged fourteen, who had suffered from attacks of epistaxis and difficulty of breathing and swallowing for about two years. An ecraseur was applied through the nostril and gradually tightened. It came away in about days ; but the tumour did not come away, though it withered up, and the soft palate came back to its normal position, and breathing became free through both nostrils. The was sent back into the country, but in about nine a

five patient

568 months he was readmitted in a similar condition as at first. The tumour was now found attached to the base of the skull and pharynx. The same treatment was resorted to, and the chain of the ecraseur (which was formed of whipcord) was brought through in five days again, but this time the tumour came away-about twice the size of a chesnut. Mr. HULKE thought it probable that on the previous occasion the wire chain cut through the base too quickly, which reunited; and the tumour, which had withered at first, afterwards reunited. Dr. MURCHISON exhibited a portion of a Liver in which some fibroid nodules were formed independent of syphilis. The outer aspect of the viscus exactly resembled those of the cases of tertiary syphilis, but the history clearly showed that there had been no venereal disease. The symptoms dated from an accidental iniurv. in an elderlv man. who at first Dresented

the symptom of peritonitis, referred to probable malignant disease. On post-mortem examination, the appearances of chronic peritonitis were plain enough; the pyloric orifice of the stomach was much pressed upon, and the mucous membrane somewhat eroded. There were thirty or forty nodules in the

some slight violence. The duration of the disis about ten years. The groovewhich separates the toe occurs through the proximal phalanx, not at the joint. The distal phalanx sometimes appears to be atrophied, and all the tissues seem to be the subjects of fatty degeneration. After accidental or surgical removal the wound heals well. The disease generally occurs in adults. The negroes say that the affection is common in Africa. Several members of the Society joined in the discussion of this curious specimen, which was referred to Mr. De Morgan and Mr. Wood for report. Dr. DICKINSON showed some Artificial Amyloid Matter produced by artificially depriving fibrin of its alkali, and showing the characteristic reaction. Dr. CAYLEY showed a case of Embolism of the Pulmonary

the

toe, from

ease

Artery.

Reviews

and

Notices of Books.

liver, exactly resembling syphilitic nodules both in external and microscopic characters. The negative evidence as to the Inorganic Chemistry. By the late GEORGE Wmsos, M.D., F.R.S.E., Professor of Technology in the University of absence of syphilis was strong. The man had been married Edinburgh. Revised and Enlarged by STEVENSON MACand had seven children. living healthy twenty-three years, ADAM, Ph. D., F. R. S. E. ; with new Notation added. London The wife was free from all evidence of syphilis, and there was .9.ncl Edinburgh W a.nrl R. f!ha.mharc no mark of syphilitic lesion on any part of the body. THE late Professor George Wilson, in addition to his chemical Air. TROTTER brought forward some small Fibrous Tumours removed from over the trochanter major. These tumours are attainments, had a singular gift for popular exposition, and often found in soldiers, and are referred to lying on the was the most appropriate expositor to whom the Messrs. "guard-bed," or boards on which the soldiers rest during their Chambers could have entrusted the compilation of a treatise period of guard. on chemistry for their educational course. The success of his Dr. DucKWORTH exhibited a portion of the Aorta showing a little volume more than justified their choice of its compiler; stain which was thought to be due to taking nitrate of silver, and it has now taken rank as the most

perhaps intelligible, in a patient whose face was stained by that medicine. The muscles and most of the viscera were so stained. attractive, and satisfactory manual by which the pupil can Mr. THOMPSON exhibited for Mr. Jordan, of Birmingham, a prepare himself for a further prosecution of the science. It Calculus from the Bladder; and another for Mr. Cadge, of has kept pace, by many opportune revisions, with the aclNorwich. The former was very large, the latter only small. vancing perfection of chemical knowledge ; and when, by the Neither of the patients had been the subject of treatment. lamented decease of its gifted author, an editor had to be The large one had quite filled the bladder, and showed on its chosen for it, the publishers again made a happy selection surface the marks of the trigone and ureters. It presented a in Macadam. Of all the recent advances in Dr. Stevenson circular mark on the posterior part, corresponding to the recto-vesical pouch. The patient died a short time before the chemistry, the most important is that of the new system of time appointed to see him. In the other case, the stone-a notation, originally suggested by Gerhardt, and now almost small one-was discharged through an abscess in perineo. universally approved and accepted. This system Dr. MacMr. BRUCE brought forward a series of Enlarged Thymus adam has introduced into the present edition, retaining, howGlands from adults : the first aged twelve, the second aged ever, in brackets, the older and more familiar notation. In fourteen, both males, who died through accident; the third, other departments the manual has also been squared with the a female aged sixteen, who died of cholera ; the fourth, a male state of the science, and may be regarded as on the aged twenty-one, a criminal lunatic, in whom no supra-renal improved best introductory volume on chemistry to which the the whole could be the a female found ; fifth, capsules aged twenty-nine, in whom, however, the gland had commenced to degenerate ; novice can have recourse. The only point in which revision is and the sixth, a woman aged forty, the gland in this case still required, is that of etymology. Never satisfactory in weighing only forty grains. In a seventh case, a woman aged this respect, the volume has deteriorated in the hands ot Dr. fifty-seven, the body was entirely fibrous, but the position and Macadam. He derives phosphorus from " two Greek wordsshape were still those of the thymus. The PRESIDENTremarked that in all those instances in which &phgr;&ohgr;s, light, and 95opv3, beaming" ! (sic). We used to trace the the thymus was very large the patient had not attained the word to &phgr;&ohgr;s, light, and &phgr;∈&ohgr;&rgr;, to bring, and to make it synoage of puberty. The case in which the supra-renal capsules nymous with its Latin form of Lici-fer. No classical scholar were said to be absent deserved careful sifting. would intrude on the domain of chemistry without the requiDr. BASTIAN remarked that in this case one supra-renal cap- site preparation. Why should not Dr. Macadam observethe sule at least was found, and probably the other might have converse duty ? been present, but could not be discovered. Dr. WEBER showed specimens of Ancylostomum Duodenale from a case at Bahia, in which " tropical anæmia" had been The Tropical -Resident at Home. Letters addressed to Europeans returning from India and the Colonies on Subjects diagnosed. Dr. Griesinger had suggested the presence of this connected with their Health and General Welfare. By EDW. worm as a cause of this affection, but it had been much J.WARING, M.D. &c. London: Churchill and Sons. doubted. Dr. Wucherer, at Bahia, had discovered theparasite in five cases of this form of anaemia, where no other cause DR. WARING, in a clear and attractive style, supplements the was found. As a suggestion had been m^:le that the parasite ordinary sanitary rules, which all Europeans must observe, by might be common in other cases, Dr. Wacherer had made additional prescriptions according to which the tropical resimany examinations, but never found it, except in cases of dent must regulate his health on his return to the anemia, of this special kind-never in anæmia, from fevers &c. He traverses a section of the medical field which has The fatality resulting from the presence of these worms might be explained from their firm attachment to the mucous memoften been cultivated, and his work will be found useful brane, and from their sucking up the blood itself for their alike to the well-educated Anglo-Indian and to the genenourishment. who may be called upon to treat case in Dr. WEBER also exhibited a Little Toe from a negro at ral practitioner, which a constitution formed in European latitudes has been Bahia affected the disease called "Ainhum"—a

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the

parent

country.

not

furrow

by

peculiar

impaired by long-continued residence in tropical affectedWe would recommend Letter IX., Tropical Indis-

the little toe in negroes, and (though very seldom in their children) which sometimes causes the loss of ones. seen on

or

on