WESTMINSTER MEDICAL SOCIETY, Saturday, February 4, 1837.

756 He had been careful of checking the cough euce. He would not dens that it might with, opiates, as he considered it rather have originated from such cause, but it Ms useful than otherwise. The pains it) the not lept up, by )t. It did not occur in dif. Read, which were chiefly confined to the ferent places at the same time, but had a sinuses, he had found give way progressive character; for instance, it ap. before the simple fomentations of warm peared and was very prevalent in the Bo. water. Iii some cases, of course, inflamma- rough of Southwark, some days before it supervene on some of these had reached Kennington, and when most tion might and require depletion; he had prevalent in the latter place, had entirelv pot,however, in any case he had treated, ceased in the former. It spread from piac’e to place, ajtd, like other epidemics, he confoundsuch to be the fact. Mr. BRYANT had examined only five fatal sidered that when once established, it was In all, the minute divisions of the spread universally by contagion. The dis. cases. bronchial tubes were full of a viscid secre- ease was essentially of an inflammatory chation. In cutting intothe tubes, the mucous racter. ; It. was a fever accompanied with membrane was found thicker and higher inflammation, generally in the mucous tis. coloured than usual. There was emphysema sues ; but he had occasionally seen it affect of the lungs, and in one or two cases solidi- the serous tissues. The inflammation, liiiv. fication. He could well suppose that cases ever, was not of the common character, but one depletion might be sui generis, and requiring, a particular kind mightoccur in which necessary, but he had not seen such. He of treatment. It wasa disease which would had seen in many cases, where the lungs run its course, and could only be palliated, were over laboured, the administration ofnot cured, by art. He should say, speal. calomel with ipecacuanha very beneficial, ing generally, and from his own experience, regulating their continuance by cautiously that it was a mild disease. The mortality

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which had taken place, appeared to be do. watching their effects. Mr. MOORE had adopted the plan of treat- pendent upon two causes, First, a congested ment recommended by Sydenham, and pur- state of the membranes of the bronchial sued in the epidemic which prevailed in histubes, or air cells, obstructing the circula. time. He, (Mr. M.), had treated it as a re-tion. The second consisted in the obstrucmittent fever with catarrh. In simple cases,, tion to respiration produced by the exces.

the use of sudorifics and tonics he had foundsive secretion of mucus. He had not seen other causes ;_and in no successful; but where the lungs in aged death result from " persons had been previously affected, orinstance from simple debility." In some were clogged with mucus, calomel com- cases he had found bloodletting absolutely bined with elaterium he had found of greatnecessary and successful in the congestive service. The most violent case he had seenstate, it was, therefore, when cautiously em. was that of a lady 65 years of age ; in thatployed, in some cases of great benefit. He case her physician had given her five grainshad bled in six cases and none had died. of calomel, with half a grain of elaterium; Auscultation was valuable as a means of she was in a dreadful state, her lips weree forming a prognosis in the affection, he had blue, her countenance injected and suffused,, found, when one lung was affected, the pa. and her piilse intermitting, as though she wastient likely to recover, but when both were dying. Next day she evacuated about halff involved he generally perished. a gallon of watery faeces, and soon recovered. Mr. CLIFTON could not agree that the He, (Mr. M.), considered that the affection’ disease was contagious; he had seen whole might generally be treated as remittent fever;; families simultaneously affected, if any the tonic plan might be resorted to early.member escaped at first,he generally escaped He had found quinine the best tonic. Healtogether. Mr. Clifton stated another rea. had seen no fatal cases except those which! son against its being contagious,, but we were complicated with diseased heart. could not hear it from the noise caused by the Mr. HEADLAND had blamed large doses off members adjourning. calomel and antimony. He did not say thatt medical aid was of no good, but that, in very numerous instances, persons had recovered without any assistance from medicine. He was glad to find that the general WESTMINSTER MEDICAL SOCIETY, opinion of the Society was in favour of the Saturday, February 4, 1837. affection not being of an ordinary inflamMr. COSTELLO in the Chair. matory kind, and that bleeding in general was neither safe nor called for. He did not conceive the mortality had been so great as MEDICO-LEGAL QUESTIOVS.—INJCRIES OF THE HEAD FROM FALLS.—SPIRIT IV THE STOdid Dr. Bureaud, considering the immense MACH. population of London. Dr. WHITING, in the first place, referred Mr. VERRALL inquired the opinion of the to the prevailing opinion, that the epidemic Society as to the extent to which injury oi depended altogether on atmospheric influ- the skull might be inflieted by a fall donn ,

757 stairs. He askedtllis question from having been present in the Old Bailey Court on the previous day, when’a medical man gave the followingopinion:—A womafi,of about forty-five years of age, was found in a dying state at the bottom of six or seven ’stairs, the occiput resting on the ’flag-stones, and her feet lying up the stairs. There was found, after death, a fracture of the occipital and the petrous portions of the temporal bones; the lambdoidal suture was burst open, to the extent of a quarter of all met; and a large quantity of blood was efiused at the base of the brain. Could such extensive injuries result from the Mm-

Mr. STREETER had known two instances fractures of the petrous portion of one or both temporal bones, one of which was attended with bleeding from the ear aud a wound of one of the sinuses, yet the man walked into the hospital, and was capable of giving monosyllabic answers. A person would fall down stairs with greater violence than would be -experienced by any other kind of fall. A much greater ’number of fatal cases occurred from injuries of the back of the head than of the front. A MEMBER mentioned some experiments detailed by Dr. Andrew Coombe, in which it was proved that ardent spirit never re= mained in the stomach for more than half an

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fall down the stairs, an opinion whict . the surgeon gave on the ti ial ; or was it hour. not probable that the deceased had been Dr. BROWN stated that a solution of struck on the head with some heavy instru- opium could not be detected in the stomach ment? Some suspicions circumstances were after a period of six hours, and he should consider that the presence of spirit would connected with the case, which, as they not materially affect the question as to the continue about as long. extent of injury producible by the fall, Mr. THURNAM thought that a fall backchief point), we need not detail. wards down stairs might be quite sufficient Mr. CHANCE saw the body at the time of to produce the injuries in question, having the inquest, and examined the external f seen cases in point. wound, as also the stairs, &c., and he wasIls Dr. BUREAUD Rion’REY alluded to some decidedly of opinion that the cause of experiments made by Magendie with ether, woman’s death was the fall, and not a sup- and also with spirit, upon a guinea-pig, in nrsed blow from a shoemaker’s hammer. which it was found that those substances, Indeed, he was disposed to’ question the when introduced into the stomach, through power of a man to produce such extensivei a tube, the oesophagus being afterwards injury as was reputed to have been produce tied, escaped in the course of half an hour ed by a single blow, (and had more by the lungs. one been given the marks would have been I ,

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unless the instrument was much hea. NEW INSTRUMENT FOR DISEASED PROSTAI’I’ vier and longer than the one in question. Mr. COSTELLO alluded to an operation Such a blow, however, he considered might which lie had been in the habit of performbe received by a fall directly backwards ing as a substitute for leeches. In perdown a flight of stairs, the back and upper forming lit1lOtrity some time since lie accipart of the head being the first point to dentally wounded the lining membrane of receive the shock, the whole weight of the the prostatic portion of the urethra with the body telling upon it. Such a blow, more- safety-button of the lithotrite. Haemorrhage over, would explain the injuries, as the occurred to the extent of a few ounces, the coutnecoup to it would be the injured parts, blood coming away like the bodies of whereas, if caused by a blow given with leeches, and an affection of the prostafe the hand, that blow must have been given under which the patient laboured was bya person from above the- deceased, di- greatly relieved. Seeing the benefit thus rectly downwards, for any other direction conferred, he (Mr. C.) considered that an wontd not explain them. On one medico- instrument might be invented which would legal point connected with the case, he have the eft’ect of scarifying a portion ofthe should like the opinion of the Society, viz., urethra with safety, in diseased prostate. the greatest length of time during which He had invented such an instrument, and spirit or beer would leave traces of their employed it with remarkable benefit in one presence in the stomach, suflicient to enable case. The operation was not, in the least, the surgeon to testify to the sober or oppo- painful. site state of all individual examined postDr. WILLIAMS inquired whether it would In the case in it was not be necessary to employ the catheter for lilferred that the woman was sober, from the ’! a short time after the operation, to prevent htomnch being found empty and contracted, ’,the urine from irritating the scarified parts ? dt an examination performed thirty or more ’, In enlarged and inflamed tonsils the appliours after death, all inference which he plication of leeches, which were easily ensidered could nut be justly drawn. The by passing a needleful of silk wqnan lived several hours after the alleged through their bodies, he had found of benefit. itittxicittioti. He would also inquire the Mr. COSTELLO thought that his instrument freqency or rarity of fractures of the pe- held out hopes of relief iii some of the forms

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