ROYAL MEDICAL & CHIRURGICAL SOCIETY. TUESDAY, JUNE 27, 1854.

9 was admitted June 1st, 1854, under the care of Mr. Erichsen. The patient states that she has had hernia for two years, the bowel usually going up of itself, but coming down again when & CHIRURGICAL SOCIETY. she walked. She never wore a truss, and was in the habit of ROYAL MEDICAL on her loads head. Four before admission, heavy days carrying TUESDAY, JUNE 27, 1854. the hernia protruded when the patient returned from market, JAMES COPLAND, M.D., F.R.S., PRESIDENT. but the swelling was quite soft, and the bowels had been open in the morning. The next day the woman suddenly felt great pain at the umbilicus, was seized with retching, and during CASE OF DISTORTION OF THE SPINE, WITH OBSERVATIONS; the effoits the hernial tumour increased in size. The pain ROTATION OF THE VERTEBRE AS A COMPLICATION OF went on the whole day, nothing being, however, thrown off LATERAL CURVATURE. the stomach, though the retching was very violent. For the two following days the symptoms remained unabated, and BY DR. HODGKIN AND MR. W. ADAMS. the patient threw up everything she took; she, in fact, was THE early history of this patient, the well-known Gideon in such distress, that the surgeon who was consulted sent her Mantell, and the symptoms of the disease from which he here. State on admission.—Pulse weak, 96, regular, and soft; suffered so long, were given by the first author. It appears that doubts existed in the minds of Dr. Mantell’s protongue slightly furred ; over the right, saphenous opening there considerable is an oval, elastic, tense swelling, the skin covering it having a fessional friends as to the exact nature of the affection, but by brown tint; the tumour is very tender on pressure, and no many it was supposed to be a lumbar abscess, connected in all with caries of some of the vertebrae; others, feeling impulse is conveyed by coughing. No crepitation nor gurgling probability a prominent swelling, partly hard and partly fluctuating, in are heard on handling it; pressure on the abdomen gives pain, but the neighbourhood of the swelling is not more sensitive the lumbar region, concluded that there was a tumour of doubtthan the rest of the surface. The knees are not drawn up; ful character. The patient used to suffer most excruciating there is no hiccough; the breathing is regular; and the patient agony. After death it was ascertained by 2vlr. Adams that there was no disease either of the bones or the intervertebral complains of a dragging pain at the umbilicus. The woman was placed in a warm bath, and the taxis tried substances; that there was no trace of any abscess, all the for about half a minute; but it was not found advisable to surrounding tissues being quite healthy; but the vertebræ were continue the efforts at reduction, and Mr. Erichsen determined twisted in such a way that, with considerable lateral curvature, there existed a backward projection of the lumbar transverse to operate at once. When the patient had been rendered insensible with chloro- processes, to an extent sufficient to form a prominence. The form, a crucial incision was made through the skin and cellular spinous processes were in their proper relations to one another. tissue over the neck of the tumour. The textures were found A very accurate description of the dissection was followed by hard and thickened, and the sac was exposed after the usual general remarks upon this form of disease. dissection; on opening it, some foetid pus gushed out, and a knuckle of green and gangrenous intestine, here and there adON THE PATHOLOGICAL CHANGES OCCURRING IN CERTAIN herent to the sides of the sac by effused lymph, came into view. DEVITALIZED TISSUES. The coats had, however, not burst. The stricture at GimBY GEORGE ROBINSON, M.D., ETC., bernat’s ligament was divided as usual, but the bowel, for Newcastle-on-Tyne. obvious reasons, was not retured into the abdomen, the wound was left open, and a warm poultice applied over it. Mr. IN this communication the author offered some observations Erichsen ordered half a drachm of Battley’s sedative, and one on the general character of those pathological changes denominated softening, contraction or diminished bulk, induration, grain of opium to be taken every fourth hour. The draught was taken at two in the afternoon, and the fatty degeneration, and calcareous degeneration. The suborgrain of opium about one hour afterwards. The patient was dination of ordinary chemical laws to the superior controlling very restless for a time, and took wine and beef-tea during the powers of life was one of the most interesting and important day. principles of physiology; and modern pathology had now On the next morning she was found to have slept at night, established the converse of this proposition, by demonstrating and had taken the opium and wine regularly. She had been that the partial or complete destruction of their inherent vital slightly sick, and the wound was very offensive, the bowel powers again subjected to the general laws of matter the strucbreaking down and coming away. Hot fomentations were tures thus morbidly affected. Having detailed the ordinary applied to the abdomen, as the patient complained of pain in features of the pathological changes above enumerated, the that cavity. author referred to some of his researches, published in the When Mr. Erichsen saw the patient, he ordered the opium "Transactions" for 1843, having for their object an investigato be taken only every sixth hour, as the narcotic effects had tion into the immediate effects of obstructed circulation in the been produced; some sphacelated shreds of intestines were kidney. He then proceeded to describe the effects produced torn and cut away with forceps and scissors. Peritonitis now by ligature of the renal vein or artery. The kidney became occurred, and sickness supervened. enveloped in a cyst, formed by the surrounding cellular tissue, On the fourth day fæcal matter escaped through the wound, infiltrated with blood and lymph. In the interior of this cyst, with a gurgling sound during an examination. Brandy and the kidney, deprived of vitality, underwent a process of beef-tea were ordered. liquefying or softening. He found that under certain circumOn the fifth day the inguinal anus was fully established, stances this protecting cyst was not formed; whilst in some when a small quantity of solid meat was allowed. instances the kidney which had undergone congestion, and unOn the sixth day the brandy was given in water and in a less surrounded by a cyst, exhibited merely atrophy, or contraction quantity; the wound was rather tender on pressure, and to and induration. In some experiments, where the kidney had prevent burrowing downwards, a pad was put on, and kept thus become atrophied, fat-globules were detected, exhibiting tight with a roller. The patient was very drowsy, and the the character of fatty degeneration. Calcareous degeneration pupils contracted; pulse 90, weak; peritonitic tenderness very had also been noticed as the effect of ligature of the renal slight. artery. Some experiments made on rabbits, by tying the On the seventh day the woman had two evacuations per renal vein and artery, were then detailed, and the results anum in the night, and one by the day, the matters discharged ’, illustrated by some models. The effects produced by these were referred by the author to an impaired vitality, being quite healthy; no sickness. ligatures On the ninth day, wine, which had always been rejected and he thought them strictly analogous to those pathological before, was well borne, and two evacuations per anum took conditions aboveenumerated, which were characteristic of a devitalization of the tissues. place. A large portion of slough came away from the groin. On the sixteenth day it was found that no more faecal matter passed through the wound, and the latter was in a very CASE OF DEFORMITY IN AN INFANT. favourable condition, as its marains had been kept free from BY C. J. B. ALDIS, M.D., ETC. irritation by means of collodion. The evacuations per rectum had been regular all the while, and the nourishment had prinTHIS was a, case of a double hare-lip, complicated with cleft cipally consisted of brandy and beef-tea. The wound healed palate. The infant only survived eleven hours, and died convery satisfactorily, and on the 26th of June, twenty-five days vulsed. The dissection was made by -Alr. Cooper, student of after the operation, cicatrization was complete, and the woman anatomy at the College of Surgeons, and was very carefully left the hospital in excellent condition. and minutely detailed. The case was illustrated by a drawing.

occupation of a basket-woman,

Medical Societies.

The central pendant lobe was found to consist of two separate of bone, connected in the centre, and each contained well-formed incisor teeth. These teeth had particularly wellmarked the three small " cusps" which usually distinguish the incisor teeth in the infant; a small second tooth on the left side of the central lobe had them also. The two lateral incisors had not a perfect alveolus in the superior maxillary bone, but their existence at all in connexion with that bone was highly singular, and unless considered altogether as an exceptionable case, the fact would seem to throw some doubt on the assumed separation in man of an inter-maxillary bone corresponding to that found in the mammalia generally.

crude tubercles. On examining the positive proof was obtained that a cancerous tumour was increasing in the breast simultaneously with the increase of tubercular disease of the lungs, and that for a, period of at least six weeks. The author thought that a single instance of the concurrent existence of these diseases was sufficient to destroy the doctrine of the absolute incompatibility

ON THE DEVELOPMENT AND SIGNIFICATION OF VIBRIO UREOLA, BODO URINARIS, AND ON CERTAIN FUNGOID AND OTHER ORGANIC PRODUCTS GENERATED IN ALKALINE AND ALBUMINOUS URINE.

Contemporary Medical Literature.

portions

BY ARTHUR H.

HASSALL, M.D.,

ETC.

THE author having first given a description of the vibriones of the urine, enumerated the causes and conditions under which they were developed. The following were the conclusions arrived at :1. That vibriones are not developed in strongly acid urines so long as these retain their decided acidity. 2. That so soon as such urines have lost a considerable part of their acidity, and have become but feebly acid, vibriones begin then to appear. It is thus that the occurrence of both torulse and vibriones in the same urine is explained. While the urine is strongly acid the torulæ are formed, but as soon as the acidity becomes greatly reduced, the vibrones make their appearance. 3. That vibriones are invariably developed in different proportions in all those urines which areeither feebly acid, neutral, or more particularly alkaline. 4. That the greatest development of vibriones takes place in all those urines which contain most animal matter, as mucus, epithelium, and albumen, and which, at the same time, are decidedly alkaline. Hence, although not an exact test of the degree of alkalinity of any one sample of urine, or of the amount of animal matter (especially albumen) present, yet by their early appearance, and by the quantity developed, to a certain extent vibriones may be regarded as affording valuable information on both these heads. 5. That vibriones are most freely developed when the urine is exposed to the air. But vibriones are not the only kind of animalculæ found in urine. A second species not unfrequently occurs in great abundance, entirely different in size, form, and structure ; this is the bodo urinarius. The author gave a minute description of this animalcule, showing that they multiplied by fissiparous reproduction. Some carefully executed drawings illustrated the characters of this animalcule. The author’s investigations had led him to the discovery of a third kind of fungus developed in alkaline urine, entirely different from the two which had been described in a former communication. Like them, this recently discovered fungus presented three distinct stages of growthsporules, thallus, and aerial or perfect fructification. These were severally described. The author abstained from giving this fungus a distinctive name, wishing, before doing so, to ascertain whether it had heretofore been described by any other

observer.

____

pleura

were

numerous

dates of this case,

of tubercle and cancer with each other. The paper concluded with some appropriate remarks on the constitutional diathesis tending to the concurrent development of these two diseases.

(To

be

concluded.)

THE VENOM OF SERPENTS.

DR. J. GILMAN arrives at the following conclusions :-1. That the venom of all serpents acts as a poison in a similar manner. 2. That the venom of some varieties is far more active than that of others. 3. That a variety of the colitber, known as the " cotton-mouth," is the most venomous serpent in Arkansas. 4. That the venom of serpents destroys all forms of organized life, vegetable as well as animal. 5. That alcohol, if brought into contact with the venom, is, to a certain extent, an antidote. 6. That serpents do possess the power of fascinating small animals. 7. That the blood of small animals destroyed by the venom of serpents, bears a close resemblance to that of animals destroyed by lightning or hydrocyanic acid; it loses its power of coagulation, and cannot be kept long from putrefaction.-St. Louis Medical and Surgical Journal.

WEIGHT OF THE BRAIN.

The brain of the late Senator Atherton, of 2vew Hampshire, weighed fifty-six ounces and a half, avoirdupois, which is seven ounces and a quarter less than the weight of Mr. Webster’s, or little more than that of Spurzheim, and seven ounces more than that of Dupuytren. Cuvier’s brain weighed sixty-four ounces and a quarter, and Abercrombie’s sixty-three.—Philadelpia -4ledical and Surgical Journal.

ERYSIPELAS.

Erysipelas has usually been described as an unhealthy inflammation of the skin alone, or of the skin and sub-cutaneous areolar or cellular tissue; but this is too limited a description of the disease, for erysipelas is not invariably confined to the surface of the body, but may spread from the face to the throat, and to the larynx and bronchial tubes; it may migrate from the fauces to the pharynx and lining membrane of the gastrointestinal canal, or it may, on the other hand, suddenly leave the surface of the body and attack the brain or its membranes, leading thereby to special, and not infrequently fatal, forms of internal innammation...... The danger in erysipelas is not to be reckoned so much by the extent of the local inflan-itna ion as by the amount and type of its accompanying fever.-Dr. HUGHES in Dublin Hospital Gazette. -

AN EXAMPLE OF THE CONCURRENT DEVELOPMENT OF CANCER AND TUBERCLE.

PERICARDITIS.

The invasion of this disease when ptyalism is established, proves how groundless is the opinion of Niemann and others, that the mercurial treatment of rheumatism carried to such an extent has any power in preventing those formidable complications, which so often are the starting points of structural change in the heart, rendering it one of the most dangerous diseases, at least in its remote and probable termination.-Dr. BANKS, Op. cit.

BY SEPTIMUS WM. SIBLEY, Registrar to the Middlesex Hospital. (Communicated by Mr. ARNOTT.) THIS was the case of a woman, aged forty-eight, admitted into the Middlesex Hospital, with a sloughing cancerous sore in the left breast; there was a hard tumour on the inner side of the size of an orange, and several small nodules of cancer at its edges. In the course of five days after her admission nearly the ivhole remaining portion of the tumour sloughed away, ALBUMINURIA. a clean-looking surface, which immediately began to leaving is a curious fact that It cicatrize. Subsequently, pulmonary symptoms became depatients affected with this disease veloped, profuse expectoration followed, and she sank and died are very liable to secondary hsemorrhage after operations or three months after her admission. On making a section of the any injury. This is probably due to the peculiar morbid state structure of the left breast, it was seen to be an extremely dense of the blood inseparable from this condition of the system, as form of infiltrating scirrhus, traces of breast tissue, such as it is highly azotised by the urea circulating in it, and the ducts, being very apparent. In the thorax, large masses of divided vessels do not appear to close by the usual process of tuberculous lung tissue was observed. Tubercular cavities coagulation and adhesion, probably owing to the deficiency of existed in the apices of both lungs; a part of the lower lobe of albumen. It has also been observed that women who are the the right lung was in a state of grey hepatization, and the subjects of this disease are very liable to severe haemorrhages In the left after delivery.-Dr. LEES, ut s2cpru. bronchial tubes were thickened and dilated.