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ROYAL MEDICAL & CHIRURGICAL SOCIETY. TUESDAY, JUNE 25TH, 1861.
11 23rd.-Wound cicatrizing; finger nearly of normal size. 30th.-The part nearly healed. Patient discharged. After the operation on the 25th April, Mr. Curling remarked that he had no doubt this was a case of degenerated nasvua, the mass consisting of fibrous tissue and enlarged veins, but by no He had excised means largely supplied with arterial vessels. several similar growths without risk of bleeding, and had found the wound heal slowly afterwards, owing to the low vitality of the parts. The tumour interfered with the use of the finger, had become painful, and was excised at the girl’s
month, improved
request.
ROYAL MEDICAL &
___
____
as regards the local inflammation, but of still lame and unable to bear much weight on the limb, or to run, or even to walk quickly, without the support of a slightly-curved splint in the ham and a bandage.
course
Medical Societies. CHIRURGICAL SOCIETY. TUESDAY, 25TH, 1861. JUNE
UNIVERSITY COLLEGE HOSPITAL.
DR.
RUDIMENTARY FINGERS, WITH BULBOUS TERMINATIONS; ABNORMAL
(Under the
care
TOES.
of Mr. HENRY THOMPSON.)
RUDIMENTARY as well as supernumerary fingers are not by any means rare, in persons otherwise well formed. But occasionally there are peculiarities associated with either the arrest or excess of development which invest a case with interest. Thus on the 19th of June a little girl was brought into the operating theatre of this hospital with absence of one of the phalangeal bones of two of the fingers of her right hand, which gave them a short and stunted appearance. The nails were normal, but at the extreme end of these fingers, beyond the nail, was a soft bulbous enlargement of the size of a marble, which caused much inconvenience to the patient. These were removed by Mr. Thompson without any difficulty. Two or three of the of this hand, as well as one on the left, had circular circumferential depressions as if a string had been tied around them, there being an absence of some of the subcutaneous structures. The forefinger of the left hand was quite rudimentary and useless, projecting somewhat from the base of the middle finger; it was therefore removed. On examining this girl’s feet, it was noticed that the three middle toes of the left foot were more or less united at their origin, and the same circumstance was observed in two of the toes of the right foot. These deformities were not hereditary in this patient, so far as could be ascertained.
BABINGTON, PRESIDENT,
IN THE
CHAIR.
ON A CASE IN WHICH THE CORPUS CALLOSUM AND FORNIX WERE IMPERFECTLY FORMED, AND THE SEPTUM LUCIDUM AND COMMISSURA MOLLIS WERE ABSENT. BY DR. J. LANGDON H. DOWN.
THE patient, a boy aged nine years, was an inmate of the Asylum for Idiots, Earlswood, and had been under the daily
observation of the author for two years and a half. He waS the firstborn of three children, of whom the second (a boy) is also idiotic; the third and youngest (a girl) healthy and intelligent. No consanguinity existed between the parents. Prior to the birth of this child, and also to marriage, the mother had suffered intense pain in the side, caused, according to the opinion of Sir Benjamin Brodie, by renal oxalate of lime calculus. During pregnancy opiates had been largely resorted to; the parturition was normal. At nine years old, the time of his death, his mental capacity was very limited; he could only fingers say two words, and had scarcely learned anything. A post. mortem examination was made thirty-three hours after death. The encephalon weighed 2lbs. 8 oz. avoirdupois. The anteroposterior diameter of the cerebrum was 6½ in.; the width 5½ in. The antero-posterior diameter of each half of the cerebellum The size, form, arrangewas 2½in.; its entire width 3’ in. ment, and colour of the convolutions of the cerebrum were normal. On removing the encephalon from the cranium, the hemispheres separated to an unusual extent, without bringing into view the great commissure of the brain. On separating the the interiors of the lateral ventricles were exposed, and covering the floor of the interval the velum interpositum appeared, anterior to which and on the same plane WESTMINSTER HOSPITAL. The velum interwas a narrow band of medullary structure. DISLOCATION OF THE PATELLA UPWARDS. positum being removed, neither fornix nor septum lucidum could be discovered, nor was there any trace of the commissura (Under the care of Mr. HOLTHOUSE.) mollis. The medullary band, the only representative of a E. C-, aged twelve, a stout but unhealthy-looking boy, corpus callosum, had anteriorly and posteriorly crescentic thinned margins, and measured at its narrowest part, which was admitted on the 4th of April, 1861, for lameness and weakwas slightly to the left of the mesial line, one-third of an inch. ness of the right leg, the knee-joint of which was swollen, and At a further stage of the dissection the lateral representatives the skin over it of an unhealthy dusky-red colour. On exami- only of the fornix were discovered. The rudiment of corpus nation of the joint, obscure fluctuation was felt; but the swel- callosum was situated opposite the widest portion of the ling appeared to be caused more by a thickened condition of corpora striata, and did not exceed one-sixteenth of an inch at the synovial membrane and skin than by the fluid within the any part of it; its fibres spread out anteriorly and posteriorly on the hemispheres. This was the only case out of joint, the quantity of which was evidently small. The most fiftyreaching brains of idiots examined by the author in which the remarkable feature of the case, however, was the displacement Dr. corpus callosum and fornix were imperfectly formed. of the patella, which, instead of occupying its normal position Down referred to similar fases recorded Messrs. Solly, by in front of the joint, was drawn up above it, its lower margin Paget, and Reil, in which the patients were but little below being fairly above the articular surface of the condyles of the the average standard of intelligence; and called special notice femur; and lower than this no tractive force could bring it. to the fact that in those cases the commissura mollis was preNo rudiment of the ligamentum patellae could be discovered, sent and extra large, while in the present instance it was either in connexion with this bone or with the tibia. He suggested that further inquiry would absent. entirely The history of the case was the following :-A year and a lead to assigning a higher importance to the commispossibly half ago the boy was playing at leap-frog, when he fell on his sura mollis than had hitherto been attached to it. right knee (the rupture of the ligamentum patellse probably taking place at that moment), and hurt himself so much that CASES ILLUSTRATING THE CAUSED AND EFFECTS OF OBSTRUCTIONS IN THE ARTERIES, BOTH OF THE BRAIN AND he was unable to rise, and was carried to bed. The following OF OTHER ORGANS. morning he got up with difficulty, and went down stairs, supBY SEPTIMUS W. SIBLEY, ESQ., F.R.C.S.,, porting himself by the banisters, but was unable to go about, LECTURER ON PATHOLOGICAL ANATOMY AT THE MIDDLESEX HOSPITAL and sat all day with the le-- up on another chair. The knee MEDICAL COLLEGE. at this time was much inflamed and very painful, and leeches and fomentations were prescribed with benefit. In about a THE object of this communication was to review a series of week he was able to go about a little, walking, however, very cases which had occurred in the Middlesex Hospital, with the lame, and having " a lump above the knee," which, he says, view more especially of testing the theory which ascribes these has never gone down. No means have been used for restoring obstructions to the washing away of vegetations, &c., from the this lump, which is the dislocated patella, to its normal position. valves of the heart. The cases were divided into four groups. The treatment of the case while in the Westminster Hospital In the first group (eleven cases) were placed those instances in was limited to subduing the inflammation of the knee-joint. A softening of the brain was found associated with a plug splint was applied at the back of the leg, and linseed-meal in one of the cerebral arteries. In the second group were poultices to the joint in front. He was discharged in about a placed three cases in which there was softening of the brain
hemispheres
which
12 associated with vegetations on the valves of the heart; but in of breathing for eighteen months. He died in a sudden attack these instances the state of the cerebral arteries was not ascer- of asphyxia. At the necropsy the two sides of the trachea tained. The third group was formed by two instances of cica- were found laterally compressed, so much so that their naturally trix of the brain, which the author believed to havebeen pro- concave surfaces had become convex, and an interval of only duced by the plugging of a cerebral vessel. In the fourth one-eighth of an inch existed between them. Dr. BRISTOWE related a similar case, the preparation of which group were placed ten instances in which there were fibrinous deposits in the internal organs, but in which the brain was not is now in the museum of St. Thomas’s Hospital; and Mr. HEATH affected with softening. The cases were then analyzed. It and Dr. R. BENNETT referred to others. was found that in twelve out of the fourteen examples of softARTERIES OBSTRUCTED BY F1BRINOUS COAGULA. ening of the brain there were fibrinous deposits in the internal Dr. cases were not DICKINSON showed specimens of clots from the aorta two It the also remaining organs; complete. appeared that, in twelve out of the fourteen cases of softening and branches, from a patient at St. George’s Hospital, who of the brain, there were warty growths on the valves of the had symptoms of peritonitis, and took mercury for some weeks, heart. In one of the remaining cases there was extensive under which they subsided, and he got almost well. Subseatheromatous and calcareous disease of the aorta; in the other, quently he had obstinate diarrhcea and vomiting, and was the heart and vessels were healthy, but there was hepatization much reduced. Soon afterwards he had severe pain in the of the lung. Other points relating to the fibrinous deposits in foot, which subsequently extended up the leg, leaving the leg the organs were also analyzed; and this was followed by a white; two days afterwards the other leg and one arm showed comparison of the symptoms in the cases of softening of the the same change, and pulsation was lost in all. A specimen brain. The author proceeded to describe the phenomena which from the left leg, which was first affected, was exhibited; the followed the sudden obstruction of an artery. The complete vessel was tightly plugged with coagulum, which was black, arrest of circulation, the attempt at its restoration, and the loose, and detached, being adherent only at one point above. In the other popliteal and both brachials the same condition reason why in the cases of the brain, spleen, and kidney this attempt is not successful. The partially restored circulation is was found. In reply to a question from Mr. CALLENDER, the author characterized by a zone of enlarged vessels around, and by a low form of inflammation in, the part affected. In conse- stated that the arterial coats and the veins were found healthy. quence of this the nutrition of the part is damaged, and fatty MALFORMATION OF THE DUODENUM. granules accumulp-te among the cell structures, thus causing the Dr. BucIIANAN showed this specimen, from a patient of bright yellow colour which is seen in the so-called fibrinous deposits. As the circulation becomes more complete, the more Dr. West at the Children’s Hospital. The child was well until plastic products of inflammation are formed, the yellow colour three weeks before death, and the cause of death was obscure, fades, the bright zone of enlarged vessels slowly disappears, until, at the post-mortem examination, a septum was found in and at length a cicatrix is formed. The paper concluded with a the duodenum with so small an opening in it, that it was diffireview of the arguments for and against the theory which sup- cult to imagine that anything but mere fluid could have passed poses these fibrinous obstructions to have been washed away through it. from the cavities of the left side of the heart. The author beENLARGED SPLEEN AND LYMPHATIC GLANDS. lieves that obstructions may be formed in the arteries, or that Mr. HUTCHINSON exhibited these, as an illustration of cointhey may be washed away from the heart; and after describing cidence of disease of the lymphatic system and enlargement of the mode in which obstructions formed in these two modes are the in a girl aged seven years. The glands in the neck spleen to be distinguished from each other, he proceeded to give the were the largest he had ever seen there. The spleen was of reasons for affirming that in all the cases mentioned in this size. Throughout the period of affection she had, very large the had come from the from or the arteries, heart, plugs paper in spite of all treatment, been gradually getting worse, and from an inflamed lung. The chief arguments made use of for sank from extreme debility. In the organ named the disease arriving at this conclusion were: the peculiar appearance and was limited. Notubercle or softened deposit was found in the structure of the plugs; their analogous structure to warty cell growth and fibroid deposit. The blood did only glands ; growths on the valves of the heart; the situation at which not exhibit increase of the white corpuscles, after careful exaplugs are usually met with; the condition of the artery at the mination. obstructed part; the occurrence of several plugs in neighbourHYDATIDS IN THE LIVER, WITH ENDOCARDITIS, ETC. ing or distant vessels; the very frequent, or indeed almost I fibrinous association with in the Dr. BUCHANAN showed these specimens of endocarditis, toconstant, deposits spleen and with deposits in the spleen, supposed to have resulted kidney; and, lastly, the arguments which are derived from a consideration of the symptoms of this form of brain disease. from detached fibrin from the valves of the heart. There was also a collection of hydatids in the liver. The PRESIDENT congratulated the Society on the precision and acumen which had characterized the communications that PATHOLOGICAL SOCIETY OF LONDON. had been made at the meetings over which he had presided. TUESDAY, MAY 21ST, 1861. From the time of the Sepulchretum to the present day, the great characteristic was improved precision in observation, DR. COPLAND, PRESIDENT. which marked the rate of progress. Continuing to improve in this particular, the proceedings of the Pathological Society would furnish some of the most valuable records in the profesBRANCHED COAGULA OF THE HEART. sion. He urged on the members to send in the reports of their MR. H. LEE showed drawings of the right side and of left side of the heart, with coagula from the aorta and from the cases to the Society as soon as possible, for publication in the pulmonary arteries. The parts shown came from a patient forthcoming volume of Transactions." who died with sloughing bubo in the Lock Hospital. It was remarkable that there was none of that difficulty of breathing generally met with in such cases. Two other preparations were shown to illustrate the same disease, originating in different causes. Dr. BRISTOWE stated that such coagula, and of very firm con- On Food and its Digestion ; being an Introduction to Dietetics.
B
gethe’r
the
"
of Books. Reviews and Notices
in the dead-house, in the absence of other blood contamination. He believed that they occurred in persons dying slowly. These coagula were nonadherent, as Mr. Lee allowed, and he could not admit the evidence of death by pyaamia. Mr. LEE replied that these clots were remarkably firm and tenacious, and so differed from the ordinary post-mortem clots.
sistence,
pyaemia
were common
or
ENLARGEMENT OF THE THYROID GLAND.
DR. DICKINSON exhibited a case of enlarged thyroid, occasioning fatal obstruction of the air-passages, which he believed to be rare. It occurred in a lad aged eighteen, who was an inmate of St. George’s Hospital, and who had some difficulty
M.D.,
WILLIAM BRINTON, F.R.C.P., Physician and Lecturer on Physiology in St. Thomas’s Hospital. pp. 485. London: Longmans.
By
ALL works on physiology include, among other subjects, that of food and nutrition. But the matter is of such obvious importance in connexion with our daily life and the laws of health, that it is worthy of separate treatment. The works of Pereira and Moleschott, estimable as they are each in its own way, do not either of them fill up the gap in this department of science quite in the mode that we should wish to see it occupied. The former only of food, and even in that respect is somewhat in the
treats
month, improved
request.
ROYAL MEDICAL &
___
____
as regards the local inflammation, but of still lame and unable to bear much weight on the limb, or to run, or even to walk quickly, without the support of a slightly-curved splint in the ham and a bandage.
course
Medical Societies. CHIRURGICAL SOCIETY. TUESDAY, 25TH, 1861. JUNE
UNIVERSITY COLLEGE HOSPITAL.
DR.
RUDIMENTARY FINGERS, WITH BULBOUS TERMINATIONS; ABNORMAL
(Under the
care
TOES.
of Mr. HENRY THOMPSON.)
RUDIMENTARY as well as supernumerary fingers are not by any means rare, in persons otherwise well formed. But occasionally there are peculiarities associated with either the arrest or excess of development which invest a case with interest. Thus on the 19th of June a little girl was brought into the operating theatre of this hospital with absence of one of the phalangeal bones of two of the fingers of her right hand, which gave them a short and stunted appearance. The nails were normal, but at the extreme end of these fingers, beyond the nail, was a soft bulbous enlargement of the size of a marble, which caused much inconvenience to the patient. These were removed by Mr. Thompson without any difficulty. Two or three of the of this hand, as well as one on the left, had circular circumferential depressions as if a string had been tied around them, there being an absence of some of the subcutaneous structures. The forefinger of the left hand was quite rudimentary and useless, projecting somewhat from the base of the middle finger; it was therefore removed. On examining this girl’s feet, it was noticed that the three middle toes of the left foot were more or less united at their origin, and the same circumstance was observed in two of the toes of the right foot. These deformities were not hereditary in this patient, so far as could be ascertained.
BABINGTON, PRESIDENT,
IN THE
CHAIR.
ON A CASE IN WHICH THE CORPUS CALLOSUM AND FORNIX WERE IMPERFECTLY FORMED, AND THE SEPTUM LUCIDUM AND COMMISSURA MOLLIS WERE ABSENT. BY DR. J. LANGDON H. DOWN.
THE patient, a boy aged nine years, was an inmate of the Asylum for Idiots, Earlswood, and had been under the daily
observation of the author for two years and a half. He waS the firstborn of three children, of whom the second (a boy) is also idiotic; the third and youngest (a girl) healthy and intelligent. No consanguinity existed between the parents. Prior to the birth of this child, and also to marriage, the mother had suffered intense pain in the side, caused, according to the opinion of Sir Benjamin Brodie, by renal oxalate of lime calculus. During pregnancy opiates had been largely resorted to; the parturition was normal. At nine years old, the time of his death, his mental capacity was very limited; he could only fingers say two words, and had scarcely learned anything. A post. mortem examination was made thirty-three hours after death. The encephalon weighed 2lbs. 8 oz. avoirdupois. The anteroposterior diameter of the cerebrum was 6½ in.; the width 5½ in. The antero-posterior diameter of each half of the cerebellum The size, form, arrangewas 2½in.; its entire width 3’ in. ment, and colour of the convolutions of the cerebrum were normal. On removing the encephalon from the cranium, the hemispheres separated to an unusual extent, without bringing into view the great commissure of the brain. On separating the the interiors of the lateral ventricles were exposed, and covering the floor of the interval the velum interpositum appeared, anterior to which and on the same plane WESTMINSTER HOSPITAL. The velum interwas a narrow band of medullary structure. DISLOCATION OF THE PATELLA UPWARDS. positum being removed, neither fornix nor septum lucidum could be discovered, nor was there any trace of the commissura (Under the care of Mr. HOLTHOUSE.) mollis. The medullary band, the only representative of a E. C-, aged twelve, a stout but unhealthy-looking boy, corpus callosum, had anteriorly and posteriorly crescentic thinned margins, and measured at its narrowest part, which was admitted on the 4th of April, 1861, for lameness and weakwas slightly to the left of the mesial line, one-third of an inch. ness of the right leg, the knee-joint of which was swollen, and At a further stage of the dissection the lateral representatives the skin over it of an unhealthy dusky-red colour. On exami- only of the fornix were discovered. The rudiment of corpus nation of the joint, obscure fluctuation was felt; but the swel- callosum was situated opposite the widest portion of the ling appeared to be caused more by a thickened condition of corpora striata, and did not exceed one-sixteenth of an inch at the synovial membrane and skin than by the fluid within the any part of it; its fibres spread out anteriorly and posteriorly on the hemispheres. This was the only case out of joint, the quantity of which was evidently small. The most fiftyreaching brains of idiots examined by the author in which the remarkable feature of the case, however, was the displacement Dr. corpus callosum and fornix were imperfectly formed. of the patella, which, instead of occupying its normal position Down referred to similar fases recorded Messrs. Solly, by in front of the joint, was drawn up above it, its lower margin Paget, and Reil, in which the patients were but little below being fairly above the articular surface of the condyles of the the average standard of intelligence; and called special notice femur; and lower than this no tractive force could bring it. to the fact that in those cases the commissura mollis was preNo rudiment of the ligamentum patellae could be discovered, sent and extra large, while in the present instance it was either in connexion with this bone or with the tibia. He suggested that further inquiry would absent. entirely The history of the case was the following :-A year and a lead to assigning a higher importance to the commispossibly half ago the boy was playing at leap-frog, when he fell on his sura mollis than had hitherto been attached to it. right knee (the rupture of the ligamentum patellse probably taking place at that moment), and hurt himself so much that CASES ILLUSTRATING THE CAUSED AND EFFECTS OF OBSTRUCTIONS IN THE ARTERIES, BOTH OF THE BRAIN AND he was unable to rise, and was carried to bed. The following OF OTHER ORGANS. morning he got up with difficulty, and went down stairs, supBY SEPTIMUS W. SIBLEY, ESQ., F.R.C.S.,, porting himself by the banisters, but was unable to go about, LECTURER ON PATHOLOGICAL ANATOMY AT THE MIDDLESEX HOSPITAL and sat all day with the le-- up on another chair. The knee MEDICAL COLLEGE. at this time was much inflamed and very painful, and leeches and fomentations were prescribed with benefit. In about a THE object of this communication was to review a series of week he was able to go about a little, walking, however, very cases which had occurred in the Middlesex Hospital, with the lame, and having " a lump above the knee," which, he says, view more especially of testing the theory which ascribes these has never gone down. No means have been used for restoring obstructions to the washing away of vegetations, &c., from the this lump, which is the dislocated patella, to its normal position. valves of the heart. The cases were divided into four groups. The treatment of the case while in the Westminster Hospital In the first group (eleven cases) were placed those instances in was limited to subduing the inflammation of the knee-joint. A softening of the brain was found associated with a plug splint was applied at the back of the leg, and linseed-meal in one of the cerebral arteries. In the second group were poultices to the joint in front. He was discharged in about a placed three cases in which there was softening of the brain
hemispheres
which
12 associated with vegetations on the valves of the heart; but in of breathing for eighteen months. He died in a sudden attack these instances the state of the cerebral arteries was not ascer- of asphyxia. At the necropsy the two sides of the trachea tained. The third group was formed by two instances of cica- were found laterally compressed, so much so that their naturally trix of the brain, which the author believed to havebeen pro- concave surfaces had become convex, and an interval of only duced by the plugging of a cerebral vessel. In the fourth one-eighth of an inch existed between them. Dr. BRISTOWE related a similar case, the preparation of which group were placed ten instances in which there were fibrinous deposits in the internal organs, but in which the brain was not is now in the museum of St. Thomas’s Hospital; and Mr. HEATH affected with softening. The cases were then analyzed. It and Dr. R. BENNETT referred to others. was found that in twelve out of the fourteen examples of softARTERIES OBSTRUCTED BY F1BRINOUS COAGULA. ening of the brain there were fibrinous deposits in the internal Dr. cases were not DICKINSON showed specimens of clots from the aorta two It the also remaining organs; complete. appeared that, in twelve out of the fourteen cases of softening and branches, from a patient at St. George’s Hospital, who of the brain, there were warty growths on the valves of the had symptoms of peritonitis, and took mercury for some weeks, heart. In one of the remaining cases there was extensive under which they subsided, and he got almost well. Subseatheromatous and calcareous disease of the aorta; in the other, quently he had obstinate diarrhcea and vomiting, and was the heart and vessels were healthy, but there was hepatization much reduced. Soon afterwards he had severe pain in the of the lung. Other points relating to the fibrinous deposits in foot, which subsequently extended up the leg, leaving the leg the organs were also analyzed; and this was followed by a white; two days afterwards the other leg and one arm showed comparison of the symptoms in the cases of softening of the the same change, and pulsation was lost in all. A specimen brain. The author proceeded to describe the phenomena which from the left leg, which was first affected, was exhibited; the followed the sudden obstruction of an artery. The complete vessel was tightly plugged with coagulum, which was black, arrest of circulation, the attempt at its restoration, and the loose, and detached, being adherent only at one point above. In the other popliteal and both brachials the same condition reason why in the cases of the brain, spleen, and kidney this attempt is not successful. The partially restored circulation is was found. In reply to a question from Mr. CALLENDER, the author characterized by a zone of enlarged vessels around, and by a low form of inflammation in, the part affected. In conse- stated that the arterial coats and the veins were found healthy. quence of this the nutrition of the part is damaged, and fatty MALFORMATION OF THE DUODENUM. granules accumulp-te among the cell structures, thus causing the Dr. BucIIANAN showed this specimen, from a patient of bright yellow colour which is seen in the so-called fibrinous deposits. As the circulation becomes more complete, the more Dr. West at the Children’s Hospital. The child was well until plastic products of inflammation are formed, the yellow colour three weeks before death, and the cause of death was obscure, fades, the bright zone of enlarged vessels slowly disappears, until, at the post-mortem examination, a septum was found in and at length a cicatrix is formed. The paper concluded with a the duodenum with so small an opening in it, that it was diffireview of the arguments for and against the theory which sup- cult to imagine that anything but mere fluid could have passed poses these fibrinous obstructions to have been washed away through it. from the cavities of the left side of the heart. The author beENLARGED SPLEEN AND LYMPHATIC GLANDS. lieves that obstructions may be formed in the arteries, or that Mr. HUTCHINSON exhibited these, as an illustration of cointhey may be washed away from the heart; and after describing cidence of disease of the lymphatic system and enlargement of the mode in which obstructions formed in these two modes are the in a girl aged seven years. The glands in the neck spleen to be distinguished from each other, he proceeded to give the were the largest he had ever seen there. The spleen was of reasons for affirming that in all the cases mentioned in this size. Throughout the period of affection she had, very large the had come from the from or the arteries, heart, plugs paper in spite of all treatment, been gradually getting worse, and from an inflamed lung. The chief arguments made use of for sank from extreme debility. In the organ named the disease arriving at this conclusion were: the peculiar appearance and was limited. Notubercle or softened deposit was found in the structure of the plugs; their analogous structure to warty cell growth and fibroid deposit. The blood did only glands ; growths on the valves of the heart; the situation at which not exhibit increase of the white corpuscles, after careful exaplugs are usually met with; the condition of the artery at the mination. obstructed part; the occurrence of several plugs in neighbourHYDATIDS IN THE LIVER, WITH ENDOCARDITIS, ETC. ing or distant vessels; the very frequent, or indeed almost I fibrinous association with in the Dr. BUCHANAN showed these specimens of endocarditis, toconstant, deposits spleen and with deposits in the spleen, supposed to have resulted kidney; and, lastly, the arguments which are derived from a consideration of the symptoms of this form of brain disease. from detached fibrin from the valves of the heart. There was also a collection of hydatids in the liver. The PRESIDENT congratulated the Society on the precision and acumen which had characterized the communications that PATHOLOGICAL SOCIETY OF LONDON. had been made at the meetings over which he had presided. TUESDAY, MAY 21ST, 1861. From the time of the Sepulchretum to the present day, the great characteristic was improved precision in observation, DR. COPLAND, PRESIDENT. which marked the rate of progress. Continuing to improve in this particular, the proceedings of the Pathological Society would furnish some of the most valuable records in the profesBRANCHED COAGULA OF THE HEART. sion. He urged on the members to send in the reports of their MR. H. LEE showed drawings of the right side and of left side of the heart, with coagula from the aorta and from the cases to the Society as soon as possible, for publication in the pulmonary arteries. The parts shown came from a patient forthcoming volume of Transactions." who died with sloughing bubo in the Lock Hospital. It was remarkable that there was none of that difficulty of breathing generally met with in such cases. Two other preparations were shown to illustrate the same disease, originating in different causes. Dr. BRISTOWE stated that such coagula, and of very firm con- On Food and its Digestion ; being an Introduction to Dietetics.
B
gethe’r
the
"
of Books. Reviews and Notices
in the dead-house, in the absence of other blood contamination. He believed that they occurred in persons dying slowly. These coagula were nonadherent, as Mr. Lee allowed, and he could not admit the evidence of death by pyaamia. Mr. LEE replied that these clots were remarkably firm and tenacious, and so differed from the ordinary post-mortem clots.
sistence,
pyaemia
were common
or
ENLARGEMENT OF THE THYROID GLAND.
DR. DICKINSON exhibited a case of enlarged thyroid, occasioning fatal obstruction of the air-passages, which he believed to be rare. It occurred in a lad aged eighteen, who was an inmate of St. George’s Hospital, and who had some difficulty
M.D.,
WILLIAM BRINTON, F.R.C.P., Physician and Lecturer on Physiology in St. Thomas’s Hospital. pp. 485. London: Longmans.
By
ALL works on physiology include, among other subjects, that of food and nutrition. But the matter is of such obvious importance in connexion with our daily life and the laws of health, that it is worthy of separate treatment. The works of Pereira and Moleschott, estimable as they are each in its own way, do not either of them fill up the gap in this department of science quite in the mode that we should wish to see it occupied. The former only of food, and even in that respect is somewhat in the
treats