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pressure subdued the hæmorrhage. The man was pretty com-fortable.Second day after the operation.-The whole of the dressings

were removed ; posteriorly the raw surface looks very healthy;perceptible reparative action has already commenced. Theorgan was enveloped in strips of zinc dressing. The patienthas slept well, and there is no constitutional disturbance.One month after the operation complete cicatrization had

taken place.The morbid mass being examined under the microscope, dis-

played the ordinary character of a warty growth—viz., en-larged papillae, and much epithelium with clear nuclei. Therewas no trace of any carcinomatous elements.

Medical Societies.MEDICAL SOCIETY OF LONDON.

SATURDAY, MAY 27, 1854.—MR. HEADLAND, PRESIDENT.

DR. HORACE GREET, of New York, was elected a corre-sponding Fellow of the Society.

BILIARY CALCULUS, PRODUCING INTENSE AND LONG-CONTINUED PAIN.

Dr. CRISP exhibited a gall-stone, with microscopic drawingsof some of the viscera of a patient whom he had seen in con-sultation with Mr. Southwood, of the Metropolitan Dispensary.The man, sixty-two years of age, and by trade a carpenter, oftemperate habits, had enjoyed a tolerable state of health untilabout sixteen or eighteen months before his death, when hewas attacked with pain in the epigastrium and region of thegall-bladder. He was confined to his bed for ten months, andwas much emaciated; the skin was yellowish, but neverjaundiced. The pain in the epigastrium was nearly constant,and at intervals very acute. He died apparently worn out bypain and exhaustion. Mr. Southwood and others had tried

various modes of treatment, but only temporary relief wasobtained, and this of short duration.

Auto_psy, ten hours after death.—Heart small and flabby.Lungs sound. Substance of the liver normal, but its peritonealcovering thickened. Kidneys small and healthy. The pancreas,which weighed 1 oz. 220 grs., wher first examined, was hardand scirrhus-like, but the day after the examination it wascomparatively lax and soft. The spleen weighed 2 oz. 380 grs. ;its capsule much thickened, apparently from old inflammation;the capsule readily peeled off, leaving a bright-red, pulpysubstance; below, the substance of the organ contained nume-rous small white spots, probably the Malpighian corpusclesdisorganized. In the right cavities of the heart was a fibrinousclot, from which a string of fibrine extended into the cavae,eighteen inches in length. The blood-corpuscles were re-markably small; not more than half their usual size. Themucous lining of the duodenum (on microscopic examination)presented a number of small black spots of pigmentary matter,like those in some reptiles and fish. In the gastro-splenicomentum was a hard, white, cylindrical tumour, two inches inlength, (probably one of the absorbent glands,) which presented,when microscopically examined, some of the characters said topertain to malignant disease. The gall-bladder was of largesize, and it contained four ounces (by measurement) of thick,yellow bile, which, on mixture with water, had a more

saponaceous appearance than usual. Close to the orifice ofthe gall-bladder was a globular tumour, which contained ablack, irregular-formed calculus, consisting of numerous rough,angular projections, and bearing a great resemblance to a

cinder. It was of light specific gravity, and measured in itslongest diameter seven lines. All the ducts (pancreatic,hepatic, cystic, and common) were pervious, but the neck ofthe gall-bladder was so twisted by the calculus as to afford apartial obstruction to the flow of bile. The branches of thepar vaga on the smaller curvature of the stomach unusuallylarge. The nerves of the hepatic plexus normal. Theabsorbent glands of the spleen were enlarged, and of a darkcolour.

Dr. Crisp said some difference of opinion might exist as tcthe cause of the intense pain in this case; but he thought,taking into account the form and situation of the gall-stone.that it was occasioned by the presence of this body, and noiby the enlarged gland. In a paper on Gall Stones which lie(Dr. Crisp) read at the Society many years since, he narratedthe case of a woman under his care, from whose gall-bladderhe removed 506 calculi; but these being of a rounded form

occasioned but slight inconvenience. In another specimen inhis museum, the calculus was one inch ten lines in length, andthree inches and a lwlf in circumference; but in this instance,also, there was but little suffering, the rough, angularcalculi being more likely to occasion severe pain and spasm,more especially when fixed at the neck of the bladder, or whenpassing the ducts.

Mr. C. CLARK related the case of a man who suffered forseven years with pain in the region of the stomach. He diedsuddenly, and after death six dozen of sloe-stones were foundaccumulated in the small curvature of the stomach. The manhad been in the habit of working on the roads, and of eatingsloes. There was considerable thickening in the neighbourhoodof the stones, but they were not enclosed by a cyst. The caseoccurred in the practice of Mr. Parsons, Becldngton, Somerset.

Dr. RoGERS and Dr. CAMPS having spoken,Dr. J. R. BENNETT read a paper on

PARACENTESIS THORACIS.

The chief object of the author was to inculcate the importance*in cases of inflammatory hydro-thorax, of not hastily resortingto the operation of paracentesis. He founded his objection tothis proceeding in the early stage of the disease, both on the non-necessity of the measure, on the amenability of the disease togeneral treatment, and on the mischief which was likely toarise from puncturing the cavity of the chest. He showed thenon-necessity of the operation by the relation of cases in whichthere had been a large collection of serum in the chest, butwhich had been absorbed by general treatment and the use ofcounter-irritants, consisting either of blisters, or of the appli-cation of a very strong tincture of iodine. The medicinesadministered consisted of very small doses of blue pill, withsquill and Dover’s powders, and infusion of cascarilla, withiodide of potassium, and sweet spirits of nitre. The patientswere placed under non-stimulant but nutritious diet. He ob-jected to the use of mercury-to the production of the specificeffect of that medicine, which he regarded as injurious. Herelated a case to which he had been called in the country ofhydro-thorax in a young gentleman, in whom the symptomswere not of such an urgent character as to require operation.He recommended the employment of remedies similar to thosewhich have been mentioned, and with every prospect of theirbeing useful. Another physician was called in, however, beforea fair trial was given to the measures proposed, and paracen-tesis was Derformed. The fluid was serum; but on a secondoperation being required, about three weeks afterwards, thematter evacuated was purulent. This illustrated one of thedangers to which tapping exposed a patient suffering fromhydro-thorax. With respect to the diagnosis of the nature ofthe fluid in the chest, this could be determined without dangerby the passage of an exploratory needle. If the fluid werefound to be purulent or contained albuminous flakes, he re-commended a gradual and continued drain of the fluid ratherthan its sudden removal.A discussion of some length took place, in which several of

the fellows took part.CLOSE OF THE SESSION.

This being the last meeting of the session, the President con-gratulated the fellows present on the continued prosperity ofthe Society. The past session had been one of the most pros-perous which the Society had ever enjoyed, and the papers anddiscussions had been of unusual interest. Nearly thirty newfellows had been added to their numbers since that time lastyear, and the report of the treasurer was highly satisfactory.The Council meditated considerable changes in the rooms ofthe Society, which would afford greater comfort and con-venience to the fellows.

HARVEIAN SOCIETY.

THURSDAY, JUNE 1, 1854.—DR. HUTCHINSON POWELL, V.P.,in the Chair.

MR. TTRE made some observations on the-

TREATMENT OF STRICTURE OF THE L’RETHRA BY INTERNAL

INCISION,

and exhibited a new form of instrument, constructed for himsome time back by Pratt, of Oxford-street, v.-hich he had foundto be safe, simple, and efficient. It consisted of a straightsilver canula, about eight inches and a half long, (H,) and one-sixth of an inch in diameter, taper at the extremity for theextent of half-an-inch. In this tapering portion was a narrow

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longitudinal slit about three-fourths of an inch long throughwhich a delicate convex-shaped blade, (b,) one-twelfth of aninch broad, attached to a steel rod, (c,) could be made to

project at pleasure from the canula, by simply pressing againstthe button, (d,) and which was afterwards drawn back into its

sheath by the action of a spiral spring (e.) In the annexed

figure the blade is represented, as protruded from the extremity.The instrument differed from those in common use, in the cir-cumstance of the extremity being conical, so to speak, thusserving as a wedge, which was capable of being introduced intothe portion of the urethra, and turned in any direction thatmight be deemed expedient for the division of the stricture.He considered it well adapted for those cases in which therewas a tough membranous expansion, composed of tibro-elastictissue stretched more or less horizontally across the canal, amorbid condition which he had verified by cadaveric inspec-tion. Strictures of this description resisted all prudentattempts at dilatation beyond a very limited degree, were

uniformly aggravated by rude manipulation, but relievedpromptly, with little or no pain, and no risk of danger, by themethod in question. They were indicated by a kind of r:dgyfeel at some part of the canal on the introduction of a bougie,and by the flow of urine being impeded for about a couple ofminutes on commencing micturition. Mr. Ure adduced a casein illustration.

THE ACTION OF REMEDIES.

Some discussion arose out of two cases related by Dr. Hand-field Jones, of scrofulous disease of the mucous membrane of thebowels in children. These cases had been treated successfullyby occasional sedatives to restrain the diarrhoea, followed bycod-liver oil, and tonics consisting chiefly of the iodide of iron.

Dr. HUTCHINSON PowELL remarked, in respect to hydro-cyanic acid, that it could not, he believed, be usefully ad-ministered when the mucous membrane of the stomach wasinflamed or congested. Creasote, on the contrary, was agood medicine in such cases. In sea-sickness, in which therewas congestion of the stomach, creasote was the best remedy.

Dr. JAMES BIRD had treated cases similar to the two relatedby Dr. Jones in the same manner, with the addition of cicutato the iodide of iron. In these cases the solitary or aggregatedglands were affected, and unless means of relief were given,would go on to ulceration. With respect to cod-liver oil, itacted simply as a nutrient, and was similar in its effects to theold formula of mutton suet boiled in milk.

Dr. SiBSOX remarked that the treatment of disease consistedless in the minute classification of it, than a strict attention tothe state of the constitution. With respect to cod-liver oil, ifthis offended the stomach, the milk and suet might be sub-stituted.

Dr. H. POWELL drew the attention of the Society to thecocoa-nut’oil, which had been found a good substitute for cod-liver oil by Dr. Theophilus Thompson.

Dr. H. JoxES, in reference to frictions by oil to affordnutrition to the body, mentioned a case in which the pro-ceeding had appeared serviceable to a patient in St. Mary’s-Hospital.

Dr. SIBSON remarked that the Inspectors of Factories hadobserved that children employed in the wool mills did notsuffer from scrofula.Mr. J. F. CLARKE directed the attention of. the Society to

Mr. Taylor’s work on the Application of Oil or Greasy Mattersto the Surface in Cases of Fever.

Dr. H. GREEXHOW had seen frictions of oil applied to thesurface of the body twice a day, attended with excellent effectsin debilitating diseases.

Dr. JAMES BIRD referred to the use of oil to the skin in theEast. Those who used it in Egypt were said to be exemptfrom the plague.

Dr. SIEVEKING had seen large pieces of fat applied over thechest in cases of phthisis. With reference to the hydrocyanicacid, he regarded it as one of our best and safest sedatives, andfar preferable in the cases of children to opiates, which wereattended with danger. He had given it extensively in irritativestates of the system with much henelit, and without any illeffects resulting in a single instance. He mentioned a case inwhich the administration of a single minim of the tincture ofbelladonna to P. child was followed hy symptoms of poisoning.

Dr. RIDGE observed that when several remedies were ad-

ministered in any case, it was difficult to determine to whichagent the beneficial effects were to be attributed. He hadfound the oil of bergamot disguise the offensive smell of thecod-liver oil, when used as an external application.Mr. W. J. ANDERSON read a paper on

CONTINUED FEVER IN CHILDREN,

and alluded, in the first instance, to the contagious nature ofthe complaint and the necessity of an early diagnosis, not onlyfor the sake of the patient, but for the safety of others, inorder that they may avoid contagion as much as possible. Theauthor divided his subject into three heads: first, simple, un-complicated continued fever; secondly, continued fever aggra-vated with complications; thirdly, continued fever commencingin the first instance with remittent symptoms. The first of.these divisions was described as differing in no material pointfrom the same affection in the adult, with the exception of its.occurring in a child of tender age, and it therefore required nominute description. The second class was of a more severenature, and rendered more dangerous by the complicationsattending it; the necessity, too, of bearing in mind the lownature of the complaint was strongly urged, in order to showthat no unnecessary amount of depletion should be used in thetreatment of the complication. The third form of fever wasthen entered into somewhat more fully. It was said to com-mence with languor and a feeling of illness, existing for some

little time; irregular febrile symptoms then appeared in slightperiodical exacerbations, with intervening remissions; theexacerbations became more severe, and the remissions shorter,until they ceased altogether, and the fever assumed the con-

tinued form. This second period having been passed over, astate very similar to hectic fever remained, accompanied bynocturnal exacerbations and debilitating sweats, the emaciationbeing extreme. In addition to this, there was a peculiar in-

difference about the patients with regard to the result,.whichwas particularly noticed as a prognostic sign, for wheneverthis symptom began to pass off, the strongest hopes of recovery.might be entertained. This form of fever was then dividedinto three stages: first, the remittent stage; secondly, the-continued stage ; and thirdly, the hectic stage. All cases of.this nature were stated to be of a severe kind, lasting for aconsiderable time, convalescence being always protracted.Various illustrative cases--were brought forward in the course.of the paper, under the different subdivisions to which they

belonged; and some passing remarks were made, more parti-cularly with regard to the treatment of complications arisingin the course of the complaint. The necessity of support inthe last stage of the third division was strongly urged, inas-much as the patients, under such circumstances, had alreadybeen greatly enervated, and, in addition to this, had a longperiod of debilitating illness to bear up against. The authorthen made some remarks upon the term "continued." This,he said, had been-frequently objected to, but he preferred.retaining it until some better name could be adopted, andquoted Drs. Watson and Cullen in support of his opinion; thelatter more especially to show that various forms of fever mayrun insensibly one into another, and that the true types of.disease are the exceptions, and the anomalous cases the generalrules in practice. Lastly, remittent fever in children wasalluded to. This was considered as a symptom, and not adisease; it arose from gastro-enteritic irritation, and the re-moval of this cause was the sole treatment that could in anycase be relied on. This symptom differed in no respect, as asymptom, from the typhoid fever in diffuse cellular inflamma-tion, or the hectic fever in phthisis pulmonalis; and it wouldbe as rational to treat the typhoid symptoms alone, regardlessof the local cause, or the hectic symptoms in the other case,forgetting the pulmonary affection, as to treat the remittentsymptoms in the so-called remittent fevers, without regardingthe fact that the gastro-enteritic irritation still remains as acause.