572

TUESDAY, NOVEMBER 4TJET.DR. ANDREW CLARK read, on behalf of himself and Mr.

Wm. Adams, a report upon the tumour exhibited by Mr. Price.The report confirmed the opinion previously expressed that; itwas a rare and well-marked example of colloid cancer. Thetumour was of a globular form, about three inches in diameter,lobulated, and grafted, as it were, upon the condensed mam-

mary gland tissue. The gland tissue became incorporatedwith the true substance of the tumour. The greater part ofthe cut surface of the tumour had an alveolar aspect, and thealveoli were filled with colloid matter. Other parts of thetumour had lost the alveolar aspect, and were white, opaque,and finely granular, like some kinds of encephaloid. Nodulesof this latter kind of product were found embedded in the Imidst of the colloid masses. The microscopic examination wentto show that the mass of the tumour was made up of truecolloid, which exhibited some remarkable peculiarities in thecell forms and fibrous areola. The opaque parts of the tumourresembled encephaloid cancer, and the two appeared struc-turally to blend into each other. The gland tissue was muchaltered, and contained in its vesicles and ducts numerous cellforms, similar to those constituting the opaque portions of thetumour.Mr. WM. ADAMS observed that there had been only three

specimens of colloid cancer of the breast exhibited before theSociety : the first was by the late Mr. Robinson, of Camber-well, the others by himself. In one of the cases which he

brought forward, the diseased part was removed eleven yearsago; a second time the patient was operated upon by Mr.Partridge, at King’s College Hospital; and there is now everylikelihood of the disease recurring. Still, notwithstanding itsprobable recurrence, there is no doubt that the operation pre-served the life of the woman for eleven years.The PRESIDENT asked if there was any microscopical ex-

animation of the parts referred to by Mr. Adams, and whetherthere existed any samples of encephaloid cancer. Mr. WM. ADAMS.—In the different specimens removed from (

the women referred to, there existed specimens of encephaloid and medullary cancer. The specimen removed from the same (

woman by Mr. Partridge was gelatinous. Mr. JONATHAN HUTCHINSON exhibited a specimen of

CANCER OF THE OS UTERI,removed from the same patient whose case he brought beforethe Society during the last session, and in which he performedexcision. The case did well for five months, when she againcalled on him, and said that her symptoms were the sameas those she was formerly troubled with. On examining herhe could not detect the presence of any morbid condition; buton the patient persisting in her statement, further examinationdiscovered two prominences the size of two peas. The patientwas admitted under his care into the Metropolitan Hospital,when he removed the growths with a pair of scissors. The

microscopical appearances on both occasions differed; the firstspecimen was that of medullary cancer, the second was markedby the presence of mere ciliary epithelial cells.Dr. POLLOCK showed a specimen of

DOUBLE ANEURISM OF THE AORTA,which derived some interest from the fact that the case hadbeen carefully diagnosed during life. The patient was a man,aged fifty-four, of robust build, and full, well-shaped chest.He came under Dr. Pollock’s care in February, 1856. He hadfor nine months previously suffered from a severe paroxysmalcough, with expectoration of frothy mucous matter; he hadconsiderable dyspnoea, and tightness across the chest. This

symptom was constant, and gradually increased in intensitytill his death. He complained of severe pain in the sternum,and through the chest to the right side of the spine. The phy-sical signs were deficient respiration over the whole right lung,with clear percussion note, except at the apex, and over aspace extending across the sternum opposite the third rightcostal articulation, where there existed well-marked dulness.There was slight pulsation in this spot, but no external tumour.This formed a centre of pulsation distinct from that of theheart, and which gradually decreased on approaching thatorgan. There was no murmur of any kind, either over theseat of dulness, or in any part of the chest, or above the cla-vicles. The left radial pulse was sensibly less in volume thanthe right. There was at one time considerable but varyingdysphagia. The peculiar alterations in the key of the voice sooften present in aneurism, were not heard in this case; hespoke generally in rather a hoarse tone. He removed to the

572

conntry for some weeks, and got worse ; and, on his return,was again seen by Dr. Pollock in consultation with Mr. EvanJones, of Southwark-bridge-road. The dyspncea, and othersymptoms had increased to a painful extent, and his sufferingsat the last were extreme. His last few days were passed in a,chair, and he was constantly fanned. He was aware thatsome uuusual cause existed for his sufferings, and requestedthat his body should be examined after death. The postmortem, made twenty hours afterwards, revealed a large sac-culated aneurism arising from the front of the aorta, near itsorigin, and occupying the space exactly indicated by the dul-ness on percussion during life. A second sac opened from theback part of the arch; and it was this posterior sac whichpressed on the right bronchial tube, the trachea, the right pul-monary artery, and on the cesophagus. The right lung wasmuch atrophied; the upper lobe condensed, and exhibiting the

usual appearances of capillary bronchitis.

HARVEIAN SOCIETY.

THURSDAY, NOVEMBER 6TH, 1856.

THE President, Dr. RAMSBOTHAM, opened the session with! AN INTRODUCTORY ADDRESS.

After acknowledging the embarrassment he had met with inchoosing a fitting subject, in consequence of the intelligence ofhis audience, he proceeded to say that he was desirous of lead-ing them to ponder on some of the causes that had impededthe advance of medical knowledge. He considered this toarise chiefly from the uncertain nature of the profession,-theever-varying phenomena that are presented to the view of thephysician, - the amazing difference that age, sex, climate,race, constitution, and diathesis occasion in the various indi-viduals, the victims of the same disease. He contended thatthe inductive philosophy was not applicable to medicine, whichcannot therefore be received into the list of the exact sciences.Still it was correctly a science, and not an art. The neglectof the study of anatomy, until comparatively recent times,had added greatly to the retardation of medicine. He showedthat for nearly 1700 years, from the time of Herophilus, thefounder of the medical school at Alexandria, and the first dis-sector of the human body, until 1315, when Moudini, pro-fessor at Bologna, ventured to re-establish practical anatomy,the science had absolutely made no progress, the climate of theeastern world being exceedingly unfavourable to the pursuit ofsuch a study, and the habits and tastes of the people being asmuch averse to it then as in our own day. He consideredthe Jewish and Mahomedan tenents, respecting the unclean-ness of those who had handled a corpse, tended in the samedirection; and he proved that the prejudices of the Roman-catholic church had a similar effect, by the fact that, in themiddle of the sixteenth century, the Emperor Charles V. orderedconsultation of divines to assemble at Salamanca, in order todetermine whether, in point of conscience, it was lawful todissect a dead body. Although after Moudini some advancewas made, it was not till the crowning discovery of Harveythat any anatomical description of the body approaching toaccuracy could be given, or any correct noticns of physiologyformed. This new doctrine was promulgated before the Col-lege of Physicians, in 1616, and published in 1628. To Harveywe are certainly indebted for the first correct notion of theblood’s circulation. But he was far from being the first personwho had seen the valves that led him to reason so justly on thesubject; for Galen mentions those of the heart; and Fabricius," ab aquapendente," published an account of those in the

veins, in the beginning of the seventeenth century, shortlybefore his death. He had been in the habit of demonstratingthem, indeed, in his lectures some years before, at the timewhen Harvey was his pupil. After contrasting the state ofEngland and Italy now with what it was 260 years ago, whenHarvey was comrelled to resort to that part of the continent forphilosophical and medical knowledge, the speaker proceededto bring before the attention of the Society the wonderful pro-gress that science in general has made during the last halfcentury; instancing the travelling by steam on sea and land,the wonders of the electric telegraph, photography, the Menaibridge, and the development of the mineral wealth of England.He had no doubt that the globe would soon be encircled by theelectric wire, " when a man may generate a spark in Londonwhich, with one fiery leap, will return back under his handand disappear-that spark being a human thought." " Thusit seems probable that the boast of Puck - " I’ll put a

573

girdle round the earth in twenty minutes"-fantastical andaudacious as it must have seemed when it was written,will soon be immeasurably distanced and outdone. Norhas medicine been behindhand in this glorious race. Whatdo we not owe to the stethoscope and the speculum? Theformer has added a new sense to our perceptions; while thelatter, in conscientious and judicious hands, is a most valuableaddition to our means of diagnosis. He felt compelled, how-ever, to declare his conviction, with regret, that in some in-stances the speculum had been shamefully abused, and had ledto quackery in its most humiliating form. What an improve-ment has taken place in pathological anatomy and pathologicalchemistry! what an advantage we possess over our predeces-sors in the concentrated and elegant form in which we canexhibit many of our most active drugs ! But to nothing doesmodern medicine owe such deep obligations as to the microscope,which has so greatly enlarged our knowledge of physiology ;has made us so intimately acquainted with the growth of theyoung ovum, as well as development in general; has discovereddiseases hitherto unknown to exist; has disclosed the truenature of some before mistaken, and has confirmed the diagnosisof others previously doubtful; has taught us to distinguish be-tween malignant and harmless growths, and to determine withprecision the condition of some internal organs by the excre-tions. He believed that the microscope would be as useful tomedicine as the telescope had been to astronomy. The way inwhich medicine and its professors have been regarded andtreated by the public is another cause that has impeded itsprogress. After passing some just and severe censures on thegovernment of England for their habitual carelessness in allmatters connected with the profession in a legislative point ofview, for their permitting the sale of quack medicines, for theirstudied neglect of the profession in excluding them from allplaces of trust and emolument, he stated that he thought wehad a remedy in our own hands, if we would but use it. If wecould only persuade some of the leading men of the profession Ito offer themselves for the honour of the representation, he was Isure great efforts would be made by the body at large to securetheir return; when we should not be so totally unrepresentedas at present, and medical questions would not be so indecentlyslurred over and shelved as they are now. It was gratifying,however, to think that the members of the medical professionindividually were regarded with much consideration by thecommunity; and that this has been the case from the remotestperiods of history, ample proofs will be found in Homer, aswell as in the lives of Hippocrates and other physicians ofancient fame. We have certainly had to bear up against thebanter of some wits, with the sarcastic raillery of others, andthe misrepresentation of many, either from ignorance or malice.Cervantes, Moliere, Le Sage, Dean Swift, D’Alembert, Addi-son, and a host of minor fry, have levelled their shafts at ourprofession; perhaps excusably at the time they each of themwrote, when there was so much pretension and so little know-ledge. But it was not to be expected that a member of theEnglish legislature would at this time of day, in his place inParliament, stand up to vilify the professors of medicine, bysaying" that if the doctors had had their way we should neverhave had chloroform, nor any of the valuable discoveries thatin modern times have been introduced with such advantage tothe interests of humanity." Yet these were the words of Mr.Drummond, member for West Surrey, on April 2nd of thisvery year. Nor should we have expected that the leadingjournal of Europe would have declared that "the president ofthe College of Physicians is so nearly on a level with themeanest herbalist," &c. &c., which, however, will be found inThe Times’ leader of April 3rd, in the comments it makes onthe debate of the evening before. When such sentiments fallfrom the leaders of public opinion, we cannot wonder at theilliberal views entertained by a large portion of the people.He would tell Mr. Drummond that the public owed the Sani-tary Bill to the doctors; that they worked heart and soul forthe accomplishment of this great end, and at the same timeknew well they were cutting their own throats. He consideredthat no more disinterested and self-sacrificing move was evermade by a large body of men. The desire of many persons tointerfere in the treatment of their own cases, and thus to clogthe usefulness of their physician, has both tended to prevent theadvance of medicine and to further the spread of quackery, whichof itself militates against the progress of the legitimate science.As far as homoeopathy is concerned, much as we must despiseit as arrogating to itself the distinctions of a science we arenevertheless under no small obligations to it for teaching ushow many serious disorders will gradually subside if Nature isonly allowed to have her own way unshackled. Although we

had seen such results in the eye, and other parts that comeunder the sight, we were scarcely prepared for the spontaneousfavourable termination of so many and such various morbidaffections; and we should do well to keep this constantly be-fore our minds. The present taste for specialities has also hadan injurious effect. Although in large communities it is bothfor the good of the public and the advantage of the professorthat particular departments should be undertaken by particularindividuals, still the parcelling out the profession into littlebundles-into petty pennyworths, as it were-has a tendencyboth to direct the attention of the practitioner too much to theinfluence that his own pet organ exercises over the system atlarge, and also to degrade the profession in the eyes of thepublic; they catch the infection, and are constantly talkingabout a lung doctor, a stomach doctor, an eye doctor, an eardoctor, and they seem to think that a man may have witenough to grapple with one disease, but that two are beyondhis powers, and that in the treatment indeed of any excepthis own particular favourite he is little better than a dolt." It has always been my strong desire," said Dr. P) amsbotham," that the public mind should be disabused in this particular;that they should know that medicine is studied as a whole, andpractised as a whole; and that, although some amongst usmay pay more attention to the derangements of one particularorgan than to those of others, still that such selection does notincapacitate any man of ordinary intelligence from treatingscientifically and with judgment whatever diseases come beforehim." The President tinished a most learned and philosophicaladdress, and one that had an eminently practical and desirabletendency in various directions, by a just tribute to the steadyand marked progress of the Society, and to the value of itscontributions and discussions, which had been second to none,and a zealous appeal to the associates to promote further,through reports to their friends of the advantages they hadthemselves derived from its meetings, the accession of visitorsand new members.

Dr. Ramsbotham received the hearty applause and thanksof a large audience, and an unanimous request that he wouldpublish his very important and eloquent discourse.

Reviews and Notices of Books.A Treatise on T7terapeutics and Pharmacology, 01’ JJIate1’ia

3f,-,dica. By GEORGE B. WOOD, i42.D., President of theCollege of Physicians of Philadelphia, Professor of Medicinein the University of Pennsylvania, &c. In two volumes.Philadelphia : J. P. Lippincott & Co. London: Trubner &Co. 1856.

I THE author of these volumes is already favourably known tothe profession in this country by his works on the Practice ofPhysic, and the Dispensatory of the United States-the last inconjunction with Dr. Franklin Bache, and a book which is aa monument of perseverance, labour, originality, and very greatresearch, and one which will stand as long as medicine remainsa science. Anything, therefore, emanating from such a sourcedemands some attention, and, as we expected, we find thatthis last production of the author’s pen is by no means inferiorto its predecessors. The work is divided into two parts,the first embracing General Therapeutics and Pharmacology,and the second, Special Therapeutics and Pharmacology. The

first part consists of four chapters, with their subdivisions intosections, in which the operation, effects, application, and classi-fication of medicines are considered. This part forms but asmall portion of the work, and does not exceed ninety pages;enough, however, is given to render these important subjectsclear and intelligible, without being tedious. The second partforms the bulk of the two volumes, and leaves very little indeedto be desired. It is divided into systemic and non-systemicremedie3. Under the head of systemic, the author gives (usinga sub-division into chapters, sections, and classes) PermanentStimulants as Astringents and Tonics; Diffusible Stimulants,divisible into Arterial, Nervous, Cerebral, and Spinal Stimu-lants. General Sedatives-Arterial Sedatives and Refrigerants,Nervous and Cerebral Sedativ Alteratives. Local Reme-dies affecting the Functions, comprising ten classes; Local

0

573