No. 463.

LONDON, SATURDAY, JULY 14. [1831-32.

LECTURES

ON

VETERINARY MEDICINE,DELIVERED IN THE

UNIVERSITY OF LONDON,BY

MR. YOUATT.

LECTURE XXXVI.

THE BRAINS OF DOMESTICATED ANIMALS.

(Continued.) ,

IN the following rapid description of the Bform and convolutions and structure, bothexternal and internal, of the brain, I shallprincipally confine myself to that of thehorse, merely glancing at the pints of dif-ference as we pass along. It will, however,be, I fear, a most unsatisfactory detail, aBMrtifying proof of human ignorance. Tovery few of the internal irregularities andrecesses and tubercles of this organ, shall II be able to assign any dafinite functicnand with regard to the great majority ofthem, I shall be compelled to confess utterignorance. The common sensorium. the veryseat of intelligence, is enveloped in dark-ness and mystery, through which humanken has 110t yet been enabled to penetrate.

The Structure of ’the Brain.—I am firststruck with the manifest difference betweenthe substance of the brain, and that of anyother part of the frame. I can find little orno cellular texture within the brain. Al-

though, after long maceration, and by thepower of the lens, I can resolve the wholeinto a collection of fibres, the tissue whichconnects these fibres together still escapesmv observation. There is no relative mo-tion,—no relative change of place betweenthe parts,-no elasticity required, and theinterposition of any considerable quantityof cellular substance would not only beuseles:, but an evil. There is no interpo-siticn of adipose matter in the brain ;-thatwould necessarily be connected with theexistence of considerable cellular texture,

! and would either imply, or cause, a certain

degree of motion between the parts of thebrain ; and, more than this; the adipose sub-stance is most of all under the power of theabsorbent vessels, and rapidly increased ordiminished, according to the healthy or dis-eased state of the frame. The accumulationor absorption of the adeps is a matter oflittle consequence elsewhere ; but in sick-ness and in health the bulk of the brainmust remain unchanged ; there must be noincrease of substance to press upon the

origins of the nerves,-there must be noloss of substance to create a vacuum, or to

produce eng-orgement, or perhaps a ruptureof the vessels.

The Chemical Composition of the Brain.-I find an apparently pulpy mass which haslittle interposed cellular or adipose matter.When I triturate this pulpy matter, I canform a perfect emulsion, that will passthrough the finest sieve. I congulate it byheat or by acids, and I find that the coagu-lum is different from that which can be pro-duced from any other similar substance ; itconsists of mingled albumen and oil, andwith none of that which we almost regardas the priuciple of animal matter,-nitro-gen. In place of this, I discover somethingwhich no other part of the frame will yield-uncombined phosphorus ; and this albumenand oil, with one-twentieth part of the va-rious salts of potassa, sodium, lime, andmagnesia, and one-sixtieth part of osma-zome, make up the solid part of the brain.The cerebral mass is composed of one part ofall these solids combined, and four paits ofwater. While,. therefore, I trace to thebrain a peculiar function, I find a peculiarcompo3ition. There seems to be little orno difference in the chemical compos tionof the cortical and the medullary parts. I! have ventured to assign to them a differencein function. This theory, however plausibleLand interesting it may appear at present,and firmly as 1 may now be disposed to be-lieve in it, may hereafter be discovered tobe as untenable as that which assumed thatthe cortical portion consisted of a congeriest of blood-vessels for the production and nou- rishment of the medullary part, whereas, the latter had almost attained its full deve-

450

lopment, before a trace of the former couldbe discovered. The microscope has also

ascertained, that instead of the larger arte-rial branches being found in the cineritious,and their minute ramifications dipping intothe medullary, the vessels of the medullaryportion are considarably larger than thoseof the cortical. But I must proceed to theenumeration (it will be little more) of thetubercles and cavities and irregularities ofthe brain.

The Corpus Callosum.—Having stripped I r

off the dura mater, and holding the hemi-spheres a little apart, I observe a whiteconvex body occupying the bottom of thesulcus. It has the appearance of the crown fof a compressed arch, and so it is : it is the (central portion of the roof of two cavities, ]

which 1 shall have presently to describe-the lateral ventricles. This is the corpuscallosum, or hard medullary body ; it is offirmer consistence than the medullary por-tion of the brain generally. I can plainlysee the direction of the sides or supports ofthis arch, and by a little dissection I can

clearly trace them. The anterior supportor pillar I can follow down to between thecorpora striata ; and the posterior ones are

continuous with the fornix and the cornua ammonis. When I examine it more closely,I perceive that it is not only the roof of theventricles, but a bond of union, or a con-necting medium between the medullarymatter of the superior part of the brain oneach side. I make a transvere incision

horizontally across it, and continued overthe ventricle on each side, and I can seethe fibres or bands of medullary matter,running from one hemisphere to the other.Therefore it is that human anatomists callit the great commíssure. Running along thecentre of this body is a little depression orchannel. It is occupied by one of the cere-bul arteries, and is worthy of notice, asbeing the central line of the brain,-thatthrough which it might be divided longitu-dinally into two equul parts.

Is of different Size in different Animals.—This corpus callosum, or great commissure,is, as you will perceive, very different insize in our different patients. It is, as wehave seen, a body or band of very consider-able bulk in the horse. In the ox it is con-

siderably smaller, smaller even in propor-tion to the size of the two brains. In the

dog it is larger than in the sheep ; it seemsto bear a relative proportion to the deve-lopment of the cerebral hemispheres. Itincreases in size in proportion to the rotun-dity of the brain and the intelligence of theanimal, and is largest of all in man. It is

developed in a direct ratio with the cere-bellum in every animal, and also the tuberanuulare and optic thalami, but it is in in-

verse proportion to the corpora quadrige-mina, and the spinal chord.

Not found in some Animals.—The corpuscallosum is said to be wanting in the hare,the rabbit, the rodentia generally, and inbirds. There are no lateral ventricles inthese animals of wir.ch it can become theroof, yet it exists in smaller size, as thecommissure or bond of union between themedullary matter in the superior portion ofeach hemisphere. The fibres or bands run-

ning from one hemisphere to the other, aremore. remarkable than where the corpusseems to have a double duty to perform.

The Septum Lucidum.—Either droppingfrom the under side of the corpus callosumor rising from the fornix, are two medullary

laminae partly united together by their in-

terior surfaces, and called from their semi-transparency the septum lucidum. It is a

medullary curtain let down between thelateral ventricles, and dividing them fromeach other, a commumcation between them

being left only under the arch o’ the fornix.An incision being made along the centraisulcus, these laminae are easily separatedfrom each other ; and between them is founda little fissure or cavity, called by some thefifth cavity, and by others the fossa syl-rii.It usually contains a moisture or dew withinit; but I have never seen the abundantserous fluid of which some have spoken.

The Fornix.—The fornix is now broughtinto sight, the French call it the medullaryor cerebral triangle ; there is an indistinct

. resemblance to a triangle, with one of theangles presenting anteriorly, and the othertwo posteriorly; its lower surface is toward

the third ventricle, and is spread over theoptic thalami,-a beautiful vascular mem., brane is interposed between them,-and the

impression of the vessels of this membraneseem to be formed upon it ;-this is the

spsalterium or harp, and on its upper surfacet rests the septum lucidum. Of its four ir-

regular extremities or crura, the anterioror inferior ones may be traced from thecorpus albicans—winding round the tha’amibending upwards behind, and becomingconnected with the anterior commissure ;then approximating towards each other, and,erroneously supposed to unite, forming thearch or body of the fornix within the ven-tricles ;—the posterior or superior crura areprolonged into the hippocampi, and runningalong the crura of the hippocampi form thecorpora fimbriata, by their thin fringedfloatmg edges.

The Lateral Ventricles.—They are first

brought into view when BB e are dividingthe septum lucidum to demonstrate thefifth ventricle, and on reflecting back the roof we have their irregular shape andstrangely-irregular floor fully exposed. Thefloor consists mainly of two couvex, pyri-

451

form substances, and a central channel. IThat which appears outwardly and an-teriorly is the corpus striatum. It may besaid indeed to occupy almost the whole ofthe outer portion of the floor, being narrowposteriorly, and assuming a broad pear-like form anteriorly. It is covered by alamina of medullary matter, so thin thatthe colour of the cortical substance be-neath is seen through it. If this corticalsubstance is cut into, it presents an appear-ance more or less striated, differing in dif-ferent species of animals, and often varyingin animals of the same species; more evi-dent usually in the herbivorous than thecarnivorous animals, with the exception ofthose that hunt by scent. The strite take adirection from above downwards, and fromwithout inwards ; and the broad extremitiesof the corpus striatum in each ventricle

lying in approximation with each other,the striæ from each seem to unite under theanterior commissure. I have never seenthe changing direction of the striae whichis spoken ofin the human being. The cor-

pus striatum is visible again at the base ofthe brain, where it evidentlv becomes oneof the origins of the olfactory nerve as wellas the commencement of the mamillary pro-cess. In the rodentia and edentata the

corpora striata are much larger than they arein the carnivora, the ruminantia, or the

solipeda. In the bird they are larger still,and the olfactory nerve plainly ar;ses fromtheir anterior extremity. The corpus stria-turn varies in form in the different speciesof birds, but in almost all of them it consti-tutes nearly the whole of the hemisphere.

The Hippocampi—The convex body whichoccupies the inner and posterior portion ofthe floor is the hippocampus—narrower andmore prominent than the corpus striatum,and consising of cortical or striated matter,covered by a thicker lamina of medullarysubstance. As this body proceeds superiorly,outward.’y, and presently downwards, andnarrows as it goes, it assumes the name ofthecrus hippocampi, and it descends into ablind pouch or hollow,-the superior cornu,- where it ends in a distinct bulb, the peshippocampi. In none of our domesticatedanimals have I observed the ventricle in thepes hippocampi which exists in the humanbeing. The medullary covering is derivedfrom the corpus callosum, the striated por-tion is obtained from the very centre ojtit- hemispheres.

The Corpus Fimbriatum.—Along the sideof the hippocampus, of considerable widthanteriorly, and narrowing as we trace it

posteriorly, is the corpus fimbriatum, of’71,lCh I have already spoken, skirted bythe p’.exus choroides, and partly covering it1m the margin of the fornix prolonged. Ite-nters with the hippocampus into the pos-

terior cornu, and terminates acutely nearthe pes hippocampi.

The Plexus Choroides.—Occupying thechannel between the hippocampus and thecorpus striatum, we find the plexus choroides,a considerable collection of minute blood-vessels, both arterial and venous, enve.

loped in folds of the pia mater. It enters,or the arteries of which it is composed,enter, the ventricle under the arch of thefornix, then taking a direction anteriorly, itspeedily terminates in a kindofbulb; but, be-ing reflected backwards, a portion skirts thewhole edge of the corpus fimbriatum, anddips deeply into the superior cornu, whereit also terminates, but rather acutely. Afterit has discharged some important officewithin the ventricle, the veins escape bythe same opening, and those from theopposite ventricles uniting form the venaGaleni. There can be little doubt, I ap-prehend, with regard to the function of thechoroides. It secretes the fluid containedin the ventricles. It is occasionally subjectto disease; a small enlargement is observed,and a gritty matter is not unfrequently de-tected in it, and sometimes the vessels ap-pear to be agglutinated together, and anovoid tumour appears considerably largerthan an almond. Here are two extraordi-

nary specimens ; of the history of one I amignorant-in the other specimen each plexus,when first taken from the brain, weighednearly ten drachms ; the ventricles were dis.tended with serum, and the disease walmarked by the principal symptoms of staggers.

-. - -- - - -- - .. -

Use of the Ventricles.—Much dispute hasarisen with regard to the use of the ven-tricles. Even in the healthy living animalthey contain some portion of fluid. If thehorse is destroyed and the cranium openedas speedily as possible, serum is found inthe lateral ventricles. Some physiologistshave contented themselves with observingthat the ventricles are merely cavities leftin certain parts of the brain where irregularsurfaces are opposed to each other ; othersas plausibly have imagined that they areformed by the foldings of the convolutionsof the brain-while some have supposedthat they were intended to preserve thatfull and perfect occupation of the cranialcavity which seems to be necessary to thesafety of the brain in the natural motions ofthe animal. If a portion should be diseasedand absorbed, the plexus choroides or themembrane of the ventricles may secrete aproportionate quantity of nuid : to whichwe may add these spaces left in the centreof the brain or filled only with fluid, are

adapted to neutralise any concussion towhich the brain may be exposed.

The Cornua of the Ventricles.—The clian-nel running along the floor of the ventricle

452

terminates posteriorly in a blind pouchleading downwards towards the centre of i

the brain, and in which are found the peshippocampi, and ,he acute termination ofthe plexus choroides-this is the superiorcornu the inf’erior cornu is more compli-cattd ; it takes a direction also towards thebase of the brain, and is continued eveninto the 2ethmoidal ventricle, which I shallhave presently to describe. From the

winding course of both these canals, thename of cornua has bt’en given to them.The Thalami Nervorum Opticorum.—Having

turned back the posterior angle of the for-nix, and lifted the interposed membrane orveil which is stretched beneath it, we re-cognise two white prominent bodies ; theyare broad and somewhat divergent fromeach other posteriorly, but they approxi-mate as they proceed forwards, and gra-dually contract into two medullary bands,which wind round the crura cerebri, or ac-cumulated mass of medullary matter below,and are the origins of the optic nerves--they will be more particularly degcribedhereafter, and they are now particularlypointed out to you as illustrations of theorigins of the sensitive nerves deep in thecentre of the brain. We observe considerabledifference in the development of these tu-bercles : in proportion as the lobes of thecerebellum are enlarged, so are the opticthalami—in proportion as other tubercleswhich I shall have presently to describe,are enlarged, the optic tubercles are di-minished. When we cut into the thalamiwe find a considerable quantity of cineri-tious matter, as in all the other irregularprominences at the base of the brain.

The Commissura Mollis.—These thalamiare united together by a medullary mass sosoft and pulpy as to assume the name of thesoft commissure. It yields to the slightestattempt to separate the thalami ; in fact itis a continuation of the cineritious matterunder the medullary covering, and of whichthe thalami are composed. i

The Tœnia Semicircularis.—Between the Ithalami and the corpora s,triata, and partlyconcealed by the plexus choroides, we ob-serve a singular tract of medullary matterrunning from the hippocampi down to theanterior commissure, and connecting to-

gether the posterior and anterior parts ofthe brain as the anterior commissure fromone corpus striatum to the other, and theposterior commissure above the commis-sure mollis connect together the sides ofthe brain. The use of all these links will beascertained by some future physiologist.

The Foramen Commune Inferius.-Thereis a curious connexion between the cavitiesas well as the substance of the brain, ofwhich we have here an evident proof. Ob-serve this triangular.formed hole below the

soft commissure, and between it and thei inferior one; it conducts to a sulcusbe-

tween the thalami, formed by their diverg- ence. We call it a ventricle, but it is no-thing more than a little gutter, having the! thalami, the fornix, and the velum, as its

roof, and the crura cerebri as its floor. Itis continued backward under the posteriorcommissure to a wider canal, the fourth ven-tricle, lying under the cerebellum, and hav-ing it as its roof, and the medulla oblongataas its floor.

The Infundibulum.—At the bottom of theanterior part of the third ventricle, and underthe foramen commune inferius, is anotherfunnel-shaped opening. It is compara.tively large in the ventricle, but rapidlynarrows, and conducts towards the pituitarygland, seated immediately beneath. Of itsoffice, or rather that of the pituitary gland,I shall immediately spealc.

The Pineal Gland.—Between the com-missuræ mollis and superior, is anotherforamen, which leads down to the thirdvenricle, and would likewise form a com-munication between the lateral and thirdand fourth, if it were not closed by thevelum interpositum. Placed over thisforamen, and between the thalami and be.hind the quadrigemina, is the pineal gland.It is a small pear-shappd reddish-grey body,enve oped in folds ot the pia mater, and, notonly bv means of the pia mater, but dis-tinct pedunculi proeeefting from itself, con-nected not only with almost every neigh-bouring part but some distant tracts of thebruin. It!-) little peduncles are tra ed with-out much diinculty ; they look like nervesproceeding from it. Observe them runningover the thalami, and penetrating even tothe crura of the fornix, and then considerwith how many and how important parts ofthe brain these are connected. We term ita gland, for it is surrounded by a plexus ofvessels, with which it is intimately asso-ciated, and which may be traced into andfrom it. Galen thought that it was the

very seat of the soul; others have assignedan iiifei-ior office to it, namely, that of amanufactory or reservoir of serous fluid

separated trom the blood. I must honestlyconfess that I know nothing about it: butwhen I see it so connected, so curiouslv

organised, and so securely defended, I ampersuaded that it does discharge some im-portant function, which a more fortunateinquirer may probably be hereafter enabled

r to develop. In the hare and rabbit it sternsto be more decidedly vascular than in anyother domesticated animal, and although I

’ have not been able to find in the horse the

gritty, sandy matter of which human physi-f ologists speak, this is abundant enough insome of the ruminantia, and particularly of} the deer kind.

453

The Corpora Quadrigemina.-Behind thepineal gland, the fornix, and the corpuscallosum, are four t-min,2nces, the corporaquadrigemina. We know not their func-

tion, but it must be an important one, for theyare the fimt portions of the medullary matterthat appear. They are eariest seen in theform of two little tubercle-, (listiiiet frorneach other; by degrees a well-defined thun-nel aplmais between t’ em, and, at a stillmore advanced period of utero-gestation,a transverse line is di covered dividi geach of thl’m into two, ar d compleing thecorpora quadrigemina. They are important,h weve), in comparative aniitomy, as unerr-ingly pointing out the clas t. which theanimal belongs.

The Nates and Testes, considered uith re- Bferellce to Comparative Anatomy.—The tu-bercles are divided into the ales and testes,

Bof which you may perhaps form some idea Bfrom a reference to the following singularfancy of anatomists. They supposed thisportion of the human brain to bear someresemblance to the posteriors of an herma-phrodite,-the vulva is the foramen com-mune anterius, the anus is the foramenbetween the soft and the superior commis-sures, and then the division of the tubercleswill answer to the relative situation of thenates and testes ; the uppermost are thenates, the lower ones the testes. Thetransverse line is differently placed in dif-ferent animals. In herbivorous animals itis placed lower, so that the nates are mostdeveloped; in carnivorous animals, it isfound higher, so that the testes prepon-derate, and in omnivorous animals, as inthe human being, the transverse line isnearly in the centre, and there is little dif-ference in the size of the tubercles. Theobservation of these brains of the sheep, thedog, and the swine, will impress this onyour minds. You need only to see thetubercula quadrigemina in order to decideon the character of the animal as designatedby his food.

Proportion to other parts of the Brain.-These tubercles present us with anotherlesson of comparative anatomy. Observehow much larger they are, compared withthe bulk of the brain, in the ox than in thehorse, and particularly how much more sothan in the dog. Their development is in

proportion to that of the optic nerve andthe spinal chord, and in all inverse propor- ition to that of the tuber annulare. Con-nected with this, it is evident that in pro-portion to the bulk of these tubercles, thatof the cerebral hemispheres is diminished,or the animal principle preponderates overthe intellectual. We have already seen,that the optic thalami bear also an inverseproportion to the tubercles. On thesepoints of coincidence and of difference, we

shall probably be hereafter enabled to founda rational theory of the functions of thevarious parts of the brain. In the hare andrabbit, and the rodrntin generally, these tu-bercles have an extraordinary development.In these animals .here are no lateral veiitri-cle, and the quadrigemina are hollowed cutto form leaser ventricles, that probably an-swer the purpose of the lateral ones in

I others. An incision mto these tubercles

will brain, to view numerous faint striæ of

; cineritious and mpdutlary matter. At thebase of the testet is a medullary hand ortritct, which rem hes as far as the optic- thalami, and conuects t ese prominences; together; and 31,0 a modullat-y curtain or

screen, somewhat resembling the septumlucidum, rises up, connecting itself withthe cru a cerebelli, and form ng a kind of roof, , for the anterior part of the fourth ventricle.

The Crura Cerebri.-I now turn to thebase of the brain, and there I observe inevery domesticated quadruped the greatpreponderance of medullary matter. I can

distinctly trace three lobes on each side ;on the two anterior or inferior ones, I recog-nise the mamillary processes resting uponthe sethmoid bone, and abutting upon thecribriform plate of the same bone, and alsothe distinct and largely-developed bulk ofthe olfactory nerves. In the middle lobes,resting upon the same bone, I observe theovoid projection of the corpora striata, andthe origins of the olfactory nerves from

them ; and my attention is more particularlydirected to the crura cerebri, or condensa-tion of the medullary matter of the base ofthe brain. They are large white chords orpillars, beginning to appear opposite to theanterior portion of the corpora striata, andpursuing on each side a direction inwardlyand posteriorly towards each other. Theycontain some grey and dark.,brown-colouredcineritious substance, in flakes and in masses,but no longer in strise. The crura, restingupon the wings of the sphenoid bone, gra-dually approximate, and a little before theirpoint of union there is interposed betweenthem a small round medullary body.

The Corpus Albicans.-When I say asmall round medullary body, I am describ-ing the corpus albicans, as it exists in thehorse and in all ruminants and herbivorousanimals. In the omnivora and carnivora it is

. divided into two. This is another lessonof comparative anatomy. The corpus albi-cans is placed immediately posterior to thelower opening of the infundibulum. It

t would seem half to surround it, as if by its, elevated edge to turn away, and direct tor the anterior portion of the base of the brain,, any fluid that might descend the infundi-bulum. But of this we know nothing.

The Pituitary Gland. - Placed imme-

diately under the lower opening of the

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infundibulum, and separated from it by alamina of dura mater, is the pituitary gland.This is a dark-reddish body of a compressedcircular form, occupying the sella turcica ofthe sethmoid bone. It is flat inferiorly, andconvex towards the brain, and has everyappearance of a glandular structure. The

profusion of arterial vessels around itis almost incredible, and veins havebeen clearly traced from it into the ca-

vernous sinuses on each side. Being placedimmediately under the infundibulum, weare naturally induced to trace some con-nexion between it and the infundibulum,and likewise the other sinuses with whichthe infundibulum communicates ; but therehas been no anatomical proof of this : ithas never been shown that the lamina of thedura mater is actually pierced, nor has anychannel been pointed out through whichthe moisture so derived might be conveyedaway. The pituitary gland has rarelyseemed to be affected by any disease in theventricles, or accumulation of fluid there.Here, again, we must confess our utter ig-norance. There is no difference in theconstruction of the pituitary gland in dif-ferent animals, except that it seems to beproportionally larger in them than in thehuman being, and large in proportion to thequantity of medullary matter ; while these

specimens will show you that it varies mate-rially in bulk in animals of the same species.

Immediately anteriorly to the pituitarygland, the tractus optici cross the crura

cerebri, and creep into sight from under thecorpora striata, in order to form the opticnerves, with which indeed they are con.tinuous.

Posteriorly to the pituitary gland, thecrura cerebri are found in perfect approxima-tion, and so they proceed to the tuber an-nulare, giving out in their way the thirdpair of nerves. At the tuber they are joinedby two large medullary chords from thelateral lobes of the cerebellum ; but the na-ture of the union which there takes placecannot be understood until we have in-quired into the structure and function ofthe cerebellum.

USE OF POTASSIUM AS A CAUSTIC.-Potassium burns on coming into contactwith water. To apply it as a caustic, a cardis perforated by a hole of the size of theulcer, which it is wished to produce ; thecard is moistened, and adapted to the placeto be cauterized. A small bit of potassiumis to be then placed in the perforation, andsome drops of water let fall on the metal.The combustion is performed with the ra-pidity of lightning, and the pain lasts onlyduring the oxydation of the potassium.When completed, the burned place is to bedressed with lint and simple cerate.

CASE OF

MALIGNANT CHOLERA,TREATED AT FIRST ON DR. STEVENS’ PLAN,

W. J. LITTLE,

Temporary Improvement following Saline In-jections, and, subsequently, Spirituous Iu-

jection.-Excitement.-Death.

To the Editor of THE LANCET.

SIR,—Having observed in one of yourcontemporaries a query, whether the in-

jection of spirits and water into the veinshad been tried in the epidemic cholera, Iam induced to forward to you for publica-tion, the particulars of a case in which thatplan was resorted to by Mr. Bennett andmyself, after a return of collapse, pievicnstyrelieved by saline injection. The result

’ was unsuccessful, though not unfavourableto further trial, since the same effect was

. produced as that described to have taken- place when the experiment was performedon healthy animals, namely " sudden pro-- duction of the same state of excitement’ which is observed to come on slowly, when* taken into the stomach."* I am, Sir,

Your humble servant,

15, Billiter-street, July 3, 1832.

) CASE.

Athalf-past 11 a.m., June 22, 1832, visit-ed, for the first time, Mrs. Bowles, xtat. 35,complaining of uneasiness at the epigas-trium, thirst, and sickness. She statedthat she had had diarrhoea upwards of a week;but it was not until half past three that

morning that she was seized with faintness,cramps, and vomiting ; the latter of whichcontinued, the diarrhoea also has been con.

; siderable, and there was then a slight dis-. charge. The mind appeared clear ; thetrunk was warm, but the extremities were. cold, of a dusky hue, although not muchf shrunken. The tongue and breath belowthe natural temperature. Mr. Luff informedme, that the pulse had been imperceptible

- nearly two hours, and that she had beent

1 Although irrelevant to the present subject, it isnot qnite unworthy of remark, that the increase ofthe number of cholera cases in London about thethird week in June was coincident with a similar* increase in Paris (as will be seen by the subjoined1 table), and with the irruption of the dis,ase in

Brussels and other towns of Belgium.Official Sanitary Bulletin. Deaths from Cholera

in Paris.June U’...... 8June .....21

e 13 ......14’

14 ...... 1716 .....21

June 17 ...... 2.is ...... 10519 ...... 4220 ...... 3821 ,.... 38

W.J.L.