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most prominent speakers at theseuseful institutions will be at onceentertaining and instructive. It

may not be improper to prefacethe occasional articles, which it isour intention to submit to the

public upon this subject, bv a fewremarks upon the advantageswhich result from Medical Socie-ties.-Some are composed almostentirely of the seniors of the pro-fession. In such, the conflictingopinions of the veteran practi-tioners are discussed with a calm-ness suitable to their age andstation, and the doubts and uncer-tainties of a profession, the per-plexities of which are not to becleared away by mathematical de-monstrations or closet cogitations,are submitted for considerationwith mutual advantage, and withimportant benefits to the public.Several of these Societies, how-ever, are formed principally byjunior practitioners and medicalstudents; and in these we canneither expect, nor shall we find,the philosophic calmness of age,nor the extensive practical expe-rience which years alone can be-stow.

It is also true that, in theseSocieties, occasional envy mayarise; difference of opinion maybe discussed with unnecessarywarmth : but these trifling disad-vantages are amply redeemed bymany evident benefits. Thehabit of addressing a society is

productive of a very important advantage. It imparts a facilityand promptitude of expressionwhich is most essentially neces-sary to the success of a medical

practitioner; and for want ofwhich we have not unfrequentlyseen real knowledge buried underthe appearance of total ignorance.

The public will judge of the pro-fessional acquirements of a man,of which they know little or

nothing, by his extra protessionalabilities, of which they at leastflatter themselves they know some-thing ; and there is no acquisitionmore imposing, none mure valu-able to the possessor, than that of

promptly and perspicuously stat-ing an opinion, or describing thenature of the case intrusted to hiscare, when unexpectedly calledupon. Nature may have con-

terred this power upon some intu-

itively ; by many, however, it is

acquired with difficulty. It wouldrequire but little ingenuity to di-late upon this subject. The ope-rations of The Lancet, however,must be brief. We shall firstalight upon the Westminster Me-dical Sucietv. and shall comment

upon the different speakers whoj most frequently occupy its atten-tion. As we are members of theother Metropolitan Societies, weshall pay them due attention, afterhaving devoted a few articles tothe Westminster. The order inwhich we shall notice them will be

guided entirely by our own con-venience, and is not to be con-sidered as any proof of our opinionof their respective importance.

HOSPITAL REPORTS.

GUY’S HOSPITAL.

I Nov. 19.-Charles G. the boywith a longitudinal fracture of thepatella, a short history of whosecase (,No. 3) we gave in our lastnumber, died on Tuesday morn-ing, Nov. 18.

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On Saturday, the 15th inst. theknee was considerably swollen,and appeared as if disposied to

sloogh; the adhesive plasters,which had been applied on theday of the accident, were takenoff, the sutures from the wound tothe number of fifteen were re-moved, and the part ’was enve-loped in a linseed-meal poultice ;he rested well that night, and onthe next day’ was pretty easy, withthe exception of a darting prickingpain at times in the affected knee.His bowels were during this timeregular, open once a day. Onthe Monday, Nov. 17, he felt justthe same as ori the two precedingdays. till about 5 o’clock in theevening, when symptoms of tetanus came on.

Monday, 17. Five, p. m.-Kneevery much swollen, enveloped ina linseed-meal poultice; dartingpains in the part, drawing up ofthe leg; pulse 120; jaw nearlylocked, so much so that he cannotput out his tongue ; bowels havenot been open for the day; hastaken some castor oil ; difficultyof swallowing.

In a short time after this con-vulsions of the muscles of the faceand neck came on; opium andammonia in large doses, togetherwith other remedies, were admi-nistered; turpentine was appliedto the wound, but the symptomsgrew worse, and at 5 o’clock thenext morping he expired, com-plaining almost to the last of apricking pain in the knee. Beforehis death the castor oil operated.

In the account of this ease, oneimportant -circumstance has notbeen stated, viz. that ever ’sincethe accident he was obliged tohave his water daily drawn off by

the catheter, as he could not voidit himself.

Inspectio cadaveris.The body was examined tMrty

hours after death, by Mr. Key, illthe presence of several pupils.

External appearances.-Slightextravasation under the skin indifferent parts of the body; leftknee a little larger than the other,but of a pale colour.Head-Tunics natural; brain

of the usual firmness ; very littlewater in the ventricles; extravasa.tion on the left corpus striatum;marked difference between thetwo thalami nervorum opticorum,disorganization of the left havingevidently commenced; plexuschoroides red.

Spinal Marrow-Centre of thecord more soft than natural; no.thing else remarkable was ob-served.

After we quitted the room, thechest and abdomen were examin.ed. With very great difficulty wehave collecte’d the following par-ticulars :

’

Chest-Lungs of a livid appear.ance externally, internally of a

bright red colour, and when cut

into, blood oozed out from the sur-face, -of’the divided parts. Pleurae,’very vascular ; no adhesion of thelungs to the pleura costalis; heart,redder than natural ; aorta, and’pulmonary arteries full of unco-

agulated blood ; bronchise filledwith a frothy mucus, of a red

,

tinge; -

Abdomen-Liver healthy, noin-:nammatory appearence in any-oftheviscera, excepting the bladder,the mucous membrane of whichwas highly inflamed.

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The anterior surface of the spinewas examined. but -nothing re-

markable observed.The sciatic nerve was traced

from the upper part of the thighdown to its division ; the lower

part was very red ; suppurationof the wound had taken place.The anterior part of’ the knee

joint was dissected. Very consi-derable extravasation of dark co-loured blood; patella fracturedlongitudinally.The following accidents are the

only ones of consequence that have.been admitterl this week : -

Nov. 21. J. S., aged 9 years,was admitted into the AccidentWard, on Saturday,Nov.14, una- erthe care of Mr. Lucas, with simplefracture of the right os femoris.The thigh is placed on a pillow inan elevated position, with the legsemiflexed, and is constantly keptwet with spirit wash ; no splintshave as yet been applied ; theboy is free from pain ; sleeps well ; tongue clean ; bowels regutar; ap- i

petite good ; he is allowed fulldiet ; pulse natural.The thigh is fractured about the

middle ; there is not much swell-

ing.2. Mary H. aged 25 years was

admitted into Chappel Ward,Wednesday morning, Nov. 18, witha fracture ot the -inner condyle ofthe thigh bone. The limb is placedin an extended position, and or-dered to be kept wet with the spiritwash ; she also received an injuryin the neighbourhood of the rightelbow joint, to which 12 leecheshave been applied; it is muchswollen ; slight constitutional dis-turbance.

3. J. W., aged 12, was admitted

into this Hospital, to-day, Nov. 21,with a severe injury of the left kneejoint. Says that he was holdingthe candle to a farrier this morn-ing who was shoeing a horse, whenthe animal kicked at him andstruck him in the knee. On ex-amination, it is found that there isan oblique fracture of the condyleof the left os femoris ; the part isswollen and tense ; there is a verygreat projection on the outer andlower part of the thigh, and a de-pression in the same place on theinner side. The obliquity of thefracture is very considerable, andthe bones are very much displac-ed ; reduction has been attempted,but in vain ; and Sir A. Cooperhas recommended extension to

be kept up by means of Boyer’ssplints, or the one mentioned in hiswork, and which he advises to beused in such cases. The limb isnot painful except when moved;it is placed in an extended post-tion ; he has taken a grain ofopium, together with some anti-mony, which it is expected willtend to relax the muscles; skin is

very hot ; he is thirsty, and hispulse is 123.

Nov. - 17. OPERATIONS. Therewas an amputation of the thighto-day, performed by Sir AstleyCooper. Two cases of hydrocelewere also operated on.

Friday, Nov. 21. At half pai.tone o’clock the operating theatrewas crowded to excess, in conee-

quence of its having been statedon the preceding Tuesday thatsome experiments were to be triedon a dog this day, for the purpose ofascertaining whether liquids couldbe put into the stomach, and re-raoved from it by meaDS ef an iR-strument, which bad been lately

276

invented by Mr. Reed, of Hos- ’into the stomach, the mouth of dwmonden Lane, Kent. syringe is put into the vessel con.

Prior, however, to the making taining it, and a long tube, com.of the experiment, a middle-sized posed of elastic gum or leather,steatomatou,s tumour was removed with a joint in the middle, pre-from a female, just below the viously put into the stomach, isinferior angle of the left scapula. attached to the lateral opening;

At two o’clock precisely, a dog and, when the piston is raised, thewas placed on the table. Its legs fluid is received into the cylinderand body being secured by two from the vessel, which is pre-or three of the pupils, an iron vented passing back by means ofpestle was put into its mouth, to a spherical valve in the mouth;keep the jaws separated ; and when the piston is pressed downthen a drachm of opium, dissolved the fluid passes, by means of thein four ounces of water, was pour- ,tube attached to the lateral open.ed into the stomach. After this, ing, into the stomach, and thusthe pestle was removed, and the any quantity of fluid may be in.dog left free on the table. jected into it. On the contrary,

In the space of twenty minutes when it is wanted to empty thethe dog manifested a disposition to stomach of any liquid, all that it is

- vomit, which was immediately necessary to do is to change thechecked by pressing the finger position of the month of the sy-against the oesophagus. The opi- ringe : the tube in the stomach is’um; however, had no very sensible very long, and, as stated above,effect on the dog till .the expira- has a joint in the middle; the

tion of thirty minutes, when the tube must be disjointed, and thatdog was unable to stand upright. part of the tube in the stomach is

. When the opium was adminis- to be attached to the extreme mouthtered, the dog’s pulse was 120. and the other part to the lateralIn seven minutes after it became mouth ; thus when the piston is110, and gradually sunk to 90, raised, the fluid is taken from thewhich was the lowest point. stomach into the cylinder in the

At-the expiration of thirty-three same manner as it was beforeminutes from the time the opiuni taken from the basin ; and whenwas given, the stomach was eva- the piston is forced down, the valvecuated of its contents, and washed in the mouth prevents the Mout by means of -the instrument, from again entering the stomach,a description of which we shall and it escapes by the lateral tube;now give. in this tube there is also a valve,The instrument consists of a but its action is different to the one

- brass syringe, capable of- holding im the mouth; this. valve cloaesthree ounces, with a tube.pro- when the piston is raised, and

ceeding from an inch above the opens when the piston is forced-

mouth, at nearly right angles to down; the other, on the contrary,it ; by this contrivance the syringe opens when the piston is raisedhas two distinct outlets for -the and closes when it is forced down.’attachment of two tubes. The Near the top of the cylinder is amanner of - using it is as follows : small tube for the admission of air,

--when, any -liquid is to be thrown which enables it to be worked

27 7

more easily. The instrument I,succeeded very well in the dog,which appeared to be littleworse for the experiment. Mr.Reed was in the theatre duringthe whole of the time, and super-intended the use of the instru-ment ; on quitting he received theunanimous applause of thosepresent.

Sir Astley Cooper, just afterthe experiment had been tried,looking at what had been removedfrom the stomach, smiled, and saidthat the instrument would do wellfor an alderman after a city least.—(A laugh.)

ST. THOMAS’S HOSPITAL.

. (Nose Case continued.)

Saturday, Nov. 15. Not so well;slept badly; appetite bad ; pulse78, hard; took some castor oil;has had two stools; nose very flat,and the line of separation betweenthe lower two thirds of the noseand the upper part very distinct;upper lip and the head very sore;face gets very warm towards

night.16th. Sleep disturbed ; spi-

rits low ; pulse G6, small ; bad ’’,taste in his mouth ; tongue white ;the lower two thirds of the nose

completely separated from the

upper part ; head sore.

17th. Slept soundly ; pain inthe head ; pulse 72, bard , bowelsnot open since Saturday; dis-

charge from the forehead andnose; lower part of the nose com-plptely separated ; upper lip sore.

18th. Rest disturbed in the

night; pulse 72; spirits low; ap-petite good ; bowels not open :

Mr. Travers removed the de-tached piece of the nose by cut-ting the suture:Wednesday, 19. Slept better;

spirits good ; has taken some cas-tor oil ; bowels open twice ; pulse72.

Granulations of the foreheadexceedingly healthy ; edges of theremaining part of the nose not in; accurate opposition ; pain in head! gone.! 20. llis sleep is not sound;pulse 90, small; nose and fore-head just the same.

21. Symptoms as yesterday;has kept his bed ever since theoperation; continues taking wineand bark; and castor oil occa-

sionally, to regulate his bowels.No. operations have been per-

tormed here this week. Very fewaccidents of importance have.beenadmitted, excepting that of a childwho was seriously scalded.

MIDDLESEX HOSPITAL.

The case of lacerated Perineum.Nov. 18. We stated in oap last

Number, that no material benefithad been derived from the oper-ation in this case, which on afurther examination we are anxi-ous to correct. The pessary wasthis day removed and the partsexamined ; and although the sur-iaces of the wound anteriorly didnot unite, yet the angle formed bythe rupture of the rectum has filledup ; the vagina at the lower partis likewise consolidated, partly byadhesion and partly by granula-tions; the anus has likewise par-