PATHOLOGICAL SOCIETY OF LONDON. TUESDAY, DEC. 5TH, 1865.

39 virus. This is an important fact, with which I have been ex- proper time arrived he wished himself to preserve a strict tremely struck, and which showed me that I had before me a neutrality in the matter. Mr. de Méric had been disappointed thing which ought to be studied. At the same time, when we that the officers of the Lock Hospital had not brought forward have obtained this immunity, we have also a healthy indi- something more tangible; but would he not have had much vidual before us. This fact cannot be denied; we see it every more occasion to find fault with them if they had, with the day, and it must strike every scientific physicianan the highest imperfect data they at present possessed, come down with degree. But this immunity does not exist, says Mr. de Meric. hastily-formed conclusions, which must have been practically This objection has been made before. Thirteen years’ expe- valueless on one side or the other ? It had been urged, among rience, however, has shown me that I in every case attain this other objections to inoculation, that we do not know how it immunity. Another question is, how long will this immunity acts, or what remotely injurious influences may arise from it. last ? It is true that after a shorter or a longer time we obtain The objection might be urged with equal force against almost This pustule, however, is ordinarily small, and the every remedy in common use. Do we know how quinine acts ? a pustule. And if, again, we inoculate from this pustule, then And might we not equally refrain from experimenting with sore also. I every new remedy, for fear it might have some remote and we shall have only a very short series of inoculations. will explain, however, in another manner the state which mysterious influence on the system ? Mr. de Meric had comis obtained by continued inoculations. The organism, with miserated the patients subjected to syphilization. He (Mr. regard to the syphilitic virus, never comes back to the same Lane) could only say that none of them had been so treated state in which it was before syphilization. I presume it is without their own deliberate consent after the matter had a well-known fact that it is not seldom the case that, a week been fully explained to them. None of them had wished to after the first vaccination, by the second vaccination we obtain have the treatment discontinued. In several it had been unanother little pustule, and that most of the individuals, after dertaken by their own express wish. The treatment, in fact, a number of years, are no more insusceptible. Therefore I was not nearly so severe as might be supposed. They had as to vaccination, also ask the question, where is the also been told that syphilization was immoral. It would have can, immunity ? With regard to children born by syphilized been more to the point if they had been told how, or why, or women, the same result takes place as after the mercurial wherefore it was immoral; for without further enlightenment, treatment-that is, when the woman has been syphilitic, the he, for one, was altogether unable to conceive how morality first child, according to the rule, is syphilitic; when the could have anything to do with it one way or the other. It man has been syphilitic, as a rule, the children are healthy. was an ad captanduna argument which, he thought, would Mr. de Meric gives statistics for the different methods of treat- hardly have been employed if more weighty ones could have ment from my published works. We have more recent data been found. The question which these experiments had been from Dr. Bidenkap’s memoirs. But I take the numbers as undertaken to decide was, whether syphilization could do what they are given by Mr. de Méric. In my opinion it matters it professed. If it could, he believed it would confer a great little whether the treatment requires some days more or less; benefit upon the community. It might be that it would not it also matters little whether a new rash appears. It is of entirely prevent relapses-that they would still occur in a more consequence when the relapse is connected with loss of certain proportion of cases; but the quality as well as the the nose, as we have seen in the patient this evening presented quantity of the relapses must be taken into consideration. After before the Society. The principal thing to ascertain, however, syphilization the relapses, it was said, are so trifling in degree is that the interior organs are not affected-the nervous svs- as to be of no importance, while they must all know from sad tem, the liver, the kidneys. The study of these internal experience what they sometimes come to after the ordinary syphilitic diseases is yet in its infancy; but in several hospitals methods of treatment.

of London I have seen such diseases, which havebeen shown to me as of syphilitic origin. This evening the different kinds of chancre have been spoken of. My experiments in the treatPATHOLOGICAL SOCIETY OF LONDON. ment by syphilization havemade me a unicist. It would be TUESDAY, DEC. 5TH, 1865. out of place to discuss this point now. I shall only make one I is Dr. DR. observation, which, think, convincing. My colleague, PEACOCK, PRESIDENT. Bidenkap, has every day during a fortnight inoculated from an indurated chancre the man himself on both his sides, but DR. RAMSKILL showed without effect. Subsequently he irritated the chancre with A HEART WITH RUPTURE OF THE LEFT VENTRICLE, savin powder, and then, when the matter had become purulent, he had a positive result by the inoculation, papules having from a lady of mature years, occurring soon after taking food, been developed at the sites of the former inoculations. These the heart being in a state of fatty degeneration. The coronary papules were covered with crusts, and were of the same appear- arteries were not diseased, nor were the valves. The rupture ance as those which occur on healthy persons after inoculation of the heart was preceded by pain, referred to the epigastrium, from secondary symptoms. (These inoculations, as you know, in the morning of the day on which she died. After the access have principally been made in Germany; I have never prac- of this pain she had dressed herself and taken food. Her tised them.) As to the question, how does syphilization act ? death took place in the evening.. I answer I do not know; but if you will have my theory, I will Mr. CALLENDER exhibited the parts removed at an give it. The syphilitic disease tends to go through a certain EXCISION OF THE ENEE, and does so often when we let it without course ; alone, very any medicine. But often Nature cannot help herself in these in a child seven years of age. There had been partial dislocachronic diseases, as we have many relapses. Mercury will arrest tion of the knee. The femur was so soft that it was broken in a short time the development of the disease on the skin and at the operation by the assistant in flexing the knee. This on the mucous membranes. But is this desirable ? I believe caused more shortening after recovery than would otherwise not. When the disease cannot go through its own natural havetaken place. Mr. CALLENDER also showeda specimen of recent Fracture course, the interior organs are very easily affected. By syphilization I help Nature. Now, we come to another point-the of the Carpal End of the Radius, with Fracture of the Styloid immorality of the treatment. Here I stop ; I have no answer, Process of the Ulna and Fracture of the Scaphoid Bone. because I cannot understand the meaning of it. I cannot conThe PRESIDENTintroduced a specimen of ceive how it can be immoral to apply on the skin a matter DISSECTING ANEURISM OF THE AORTA. which already flows in every drop of blood. Mr. de Meric has The first symptoms occurred a week before death. There was shown that I have changed my opinion with regard to the of blood in the posterior mediastinum, connature of the radesyge. This is true. I hope Mr. de Meric great ecchymosis the lung, but not bursting into the will follow my example, and when he is convinced that syphi- siderably compressing The coats of the carotid artery were separated from pleura. lization is not immoral he will avow it frankly. and there was another opening near the root of Mr. J. LANE, in reply, said he thought the discussion which each other, case on record had taken place could not fail to be satisfactory to Prof. Boeck. the left subclavian artery. This was the only instead of the the where extended into mediastinum, rupture The opponents of the practice of syphilization had been reprethe into or pericardium as usual. pleura sented by Mr. de Méric, who was as able as anyone in that The PRESIDENT also showed, in conjunction with Dr. HICKS, room to do justice to any case which he took up. The result a specimen of must be considered favourable to syphilization, if no more ULCER OF THE ŒSOPHAGUS arguments could be brought against it than those they had heard from Mr. de Meric. Its true value, however from a person of intemperate habits, who had long complained could only be settled by time and by experience; and till the ) of difficulty of swallowing, referred to the lower part of the

I

I

solid

which

40 the calibre of the oeso- suffocated him. Mr. Hawker, the house-physician, however, found much narrowed by the cicatrization of a removed the canula, and extracted a complete fibrinous cast of small ulcer, which was nearly healed. There was no enlarge- the trachea and larger bronchial tubes. The child at once ment of the glands in the neighbourhood. The origin of the rallied, but unfortunately died from pneumonia on the ninth disease was connected with a violent fit of coughing, in which day after the operation. he was said to have brought up some blood. Dr. GIBB also showed a Mr. CANTON showed a specimen in which there was a TAPEWORM EXPELLED WITH ITS HEAD, Clubbed state of the Fingers of the Right Hand only, with from with the oil of malefern. fern. The patienttreatedwith an hospital patient disease (subclavian aneurism) aneurism) of the side;; the arteries on the right side in of the habit with sucpractice Dr. Gibb is pursuing general side the other being healthy. The artery in this case was tied on the distal side ; but the disease progressed, and the patient died in a fortnight of pleuro-pneumonia. The clubbed fingers dose of castor oil three or four hours afterwards, the patient no appeared thickened, but with no adventitious deposit, of the head of the worm is, of been to be the the as has enlargement phalanges, thought treatment, case. Another view of the pathology of this disease refers it to obstruction in the capillary circulation, and consequent enMr. CURLING exhibited a specimen of largement of the veins. This was not verified in this case, in COLLOID CANCER OF THE LOWER PART OF THE COLON, consequence of the part not having been injected. in which colotomy had been performed for the relief of sympDr. DICKINSON showed three cases of toms of obstruction of the intestine, with temporary success. DISEASED CORONARY ARTERIES, The was a lady of advanced age, who had suffered in which the patients had died of angina pectoris. One patient frompatient a tumour in the pelvis unconnected with the uterus. All the She was a middle-aged man, a patient of Dr. Dudfield. had great pain in the part, followed by total obstrucother organs were natural. The aortic valves were very slightly tion.had The patient survived the operation for eleven days. diseased. The heart was enlarged. The root of the aorta was There had been The gut was no bloody or mucous discharge. atheromatous, and the atheroma had encroached on the origins diseased for about three inches, and there was colloid cancer of the coronary arteries, so that one was quite impervious ; of one but not pressing on the gut. Mr. Curling dwelt otherwise the coronary arteries were tolerably healthy. The on the ovary, relief of pain which followed the operation, and the other cases were extremely similar to the above. In one of the slight prolongation of life which followed it. latter, the patient was out walking at the time of death. In Mr. SOLLY thought that there was too great fear of opening all these cases, one of the coronary arteries was obliterated at the colon in such cases as this-an operation which he believed its origin, the other nearly impervious. In all of them also, to be called for. urgently the muscular substance was hypertrophied, but with very Mr. also showeda drawing from a child one slight fatty degeneration. Dr. Dickinson called attention to relation of the close arteries with the the nervous coronary tissues of the heart, and to the occurrence in all these cases of at the time of birth; the scrotum being developed, but empty. cardiac neuralgic symptoms, while the nutrition of the heart Hence he inferred that the muscular tissue was unimpaired. must be nourished from some other source. had performed an operation for the replacement of the testicle Mr. ERNEST HART exhibited a specimen of in its proper place. He succeeded in removing it from the CANCER SPRINGING FROM THE DURA MATER AND perineum, but could only succeed in transferring it to the PROJECTING INTO THE ORBIT. neighbourhood of the ring. He referred the difficulty in this The patient was a child. The eyeball was protruding, but the case to the action of the cremaster not being balanced by the sight was perfect. There was a smaller projection on the gubernaculum, as is usually the case. Mr. GASCOYEN showed a Fatty Tumour of large size, weightemple. After death, extensive disease and thickening of the dura mater were found, with spots of cancer strewn about on ing 51bs. 6 oz., removed by Mr. Lane from the scrotum of a the membrane, and thickening of the periosteum of the bones patient fifty-two years of age. The tumour seemed to be conof the orbit. A point of interest in this case, which he saw in nected with the cord, which itself was healthy. (This tumour consultation with Mr. J. B. Walker, of Bayswater, was the per- was referred to Dr. Hicks and Mr. Barwell for a report.) fect vision coincident with great lengthening of the optic nerve. Dr. OGLE showed a Tumour of a Cancerous Nature from the Mr. Hart mentioned another case in which the eyeball was Mesenteric Gland in an adult. There had been no vomiting or affected with cancer, and where the power of sight was imme- other symptom. Many cysts had been found in the tumour. diatelv lost. In this case, which he saw in consultation with Dr. OGLE also showeda False Membrane lining the ArachMr. of Brompton, the cancer had originated in the noid in a patient suffering from and several optic nerve, and there was a great predominance of large gan- massesCavity of calcareous matter found in the brain, and apparently glionic cells. In the case where sight was long preserved, the the result of the degeneration of tubercle. cancer had originated in a fibrous membrane ; the dura mater a specimen of Fibro-eystic Tumour of Dr. FAGGE and much fibrous tissue were found in it, with small nuclei, the Uterus, which had existed for at least twenty years before Dr. CAYLEY showed a specimen of Arrested Development the death of the patient. There had been no uterine sympin the Upper Extremity. toms known. The patient had had one miscarriage, but no a case of Abscess of the Dr. CAYLEY also brought children. There suspicion of extra-uterine pregCerebellum, with Caries of the Temporal Bone. The tumour was negatived. The but the idea of died at the age of forty, having had disease of the bones of the uterus was dilated, and contained a small polycavity the ear from the age of five years. pus. The right ovary was not found. The tumour Mr. T. SMITH showed a Foot in which four Cuneiform Bones rounded on all sides by the fibres of the uterus, and a good were found, the internal cuneiform bone being divided into deal of calcareous matter was present in the tissue of the two ; the scaphoid having four articular surfaces, and the great tumour. toe two. Mr. Smith had found several feet in which the sepaMr. LEGGATT showeda case of Dissecting Aneurism of the cuneiform bone was not complete, but Aorta with rupture into the pericardium, situated about half an inch There was some loss of power, p but Mr. SMITH also showed a large CongenitalFatty Fatty Tumour, no complete paralysis. removed from a young female child, situated in the buttock, showed a specimen of Aneurism of the and lapping round the femur, presenting on both sides of the Middle Cerebral which had burst into the brain. Artery It was adductor magnus. firmly connected to the pelvis. Mr. GAY introduced to the Society a living specimen of The tumour was successfully removed. Glandular Disease, forming a large collar round the neck and Dr. GIBB exhibited a a large mass in the axilla on both sides. The disease had FIBRINOUS CAST OF THE TRACHEA AND BRONCHI begun about a year ago with enlargement, followed by inof a child five years old, admitted into Westminster Hospital, flammation and subsequent ulceration of the affected gland. who had had croup for three days previous, and upon whom The disease spreads rather externally than internally, like elements of tracheotomy was performed the night of admission. The child cancer; but it does not possess the microscopic went on well up to the third day, when the tube of the canula cancer or of tubercle. The general health is good and the became blocked up by portions of loose fibrin, which nearly secretions are healthy.

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cess isto administera doseof castoroil at ,night, followed by the fern oil at seveno’clock thenext morning, and another meanwhile fasting. Thepassage whenthe desirecl in the

ofcurecourse, treatment, the greatcomplete. thing is considered complete.

month CURLING old, in whom the testiclewas foundin the perineum Hean likewiseproduced, byway of contrast, a photograph from the testicle was in adult patient, in whom the perineum, anhadadultscrotumonon thatsidewas empty.Mr. of theCurling Curling performed operation for was quite replacemerit

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above the valves.

Dr. BROADBENT

was sur-