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water at 68°F.; and one part of uric acidwith salt remains in 7199 parts of water at61° F.These results tend to establish Dr. Prout’s

opinion, showing how urate of ammonia ismodified in form and in solubility.The experiments may give a further in-

sight into the various causes of the fre-

quent deposit of urate of ammonia whichoccurs in healthy urine.

Salt may increase or diminish the solubi-lity of urate of ammonia, as it is in moderatequantity or great excess. The sulphate,acetate, and muriate of ammonia lessen thedissolving power of water. Each salt thatoccurs in the urine has most probably someeffect on the solubility of the urate of ammo-nia, and it may be by a very extended in-quiry into the relative reactions of the dif-ferent salts, that we may arrive at an accu-rate knowledge of the occasional deposits in

’ healthy urine.

Cysticercus Cellulosae of the Brain. ByDREWRY OTTLEY, Esq. Communicated byJOHN FORBES, M.D., F.R.S.

The author remarks that the presence of

cysticerci in the brain is sufficiently rare towarrant, he thinks, the communication of asingle case, which, moreover, possesses aninterest, as being the only one, as far as hecan discover, in which an opportunity wasafforded of watching the progress of the dis.ease from an early period, and also fromthere being no complication likely to disturbthe cerebral functions, so that the symptomsobserved were clearly due to the parasiticanimals.The patient was a woman setat. 40, for

many years suffering from emphysema of thelungs and bronchitis. In the early part of1838 she began to complain of frequent gid-diness and a dull, stupefying pain in thehead. In July of that year she sufferedfrom temporary numbness and loss of powerin the right hand and arm, with some con.fusion of intellect and difficulty of articula-tion. Cupping relieved her, but the symp-toms returned, and after a time the giddinessbecame more constant, and the loss of me-mory and confusion of intellect more con-siderable. In 1839 she became subject tofits, during which there was entire loss ofconsciousness and convulsions ; they differedfrom epileptic fits in being less sudden, bothin their invasion and their termination ; therecovery from them was, also, slower for

she would often remain for two or threedays in a stupefied state. During the lasttwelve months of her life the pain in the headwas constant, though never extremely acute ;her sight became dim, and the convulsionsoccurred more frequently. At the end of Oc-tober, 1840, after frightful convulsions for

twenty-four hours, she expired. The stateof the brain after death is thus described :-The vessels on the surface of the brain weresomewhat congested, and the sub-arachnoidcellular tissue infiltrated with serum ; nume.rous small fibrous cysts were found in the

pia mater, covering the surface of the hemispheres, and dipping between the convolutionsof the brain. The cysts were present onboth sides, but were most numerous on thesurface of the left hemisphere ; they variedin size from that of a pea to less than apepper-corn ; they were seated in the piamater, but had become partially imbeddedin the grey matter of the convolutions.None existed in the white matter, in thecentral ganglion, or in the choroid plexus;a few were found at the under surface of thecerebral convolutions, but none either in thecerebellum or medulla oblongata. Thecerebral tissue around these cysts appearednatural as to colour and consistence, and thebrain generally, except for the presence ofthe animals, would have been termedhealthy. There was rather more fluid thannatural in the ventricles and at the base ofthe brain. Several of the cysts were after-wards examined, and each was found tocontain a vesicular worm, consisting of aposterior transparent vesicle, in which theanterior cylindrical portion or body, fur-

nished at its extremity with four suckers anda double circlet of hooks, lay retracted likethe finger of a glove turned in, and could beexpelled by gentle pressure on the contain-ing vesicle ; in short, answering exactly tothe description given of the cysticercus cellu-losse of Rudolphi.

MEDICAL SOCIETY OF LONDON.

Monday, December 4, 1843.

Mr. PILCHER, President.ERYSIPELAS.

DR. CLUTTERBUCK, in allusion to the dis-cussion at the last meeting, ex plained thathe confined his remarks to the more ordinaryform of erysipelas, affecting the head and

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face. He proceeded to remark that he con-sidered the term erysipelas should be con-fined to cases in which the skin only wasaffected, and considered the definition ofCullen respecting the disease to be the mostcorrect," an inflammation of the skin tendingto spread around."We regret that we have not space to give

in full the observations made by Dr. Clut-terbuck, and that we must content ourselveswith a summary of the copious report sent tous. The chief points insisted on were thefacts that erysipelas was of the nature of allother inflammations, but modified by thestructure affected-that the skin being anorgan of sense influenced more or less thebrain, and particularly so when the erysi-pelas affected the head and face. This inju-rious influence might amount to mere irrita-

tion, or extend to inflammation, but, gene-rally speaking, it did not require very activetreatment either by blood-letting or stimu-lants. He was still of opinion that the

passive or palliative treatment, such as hehad advocated at the last meeting, was themost likely to be generally successful.

In the conversation which followed, the

subject of the contagious nature of erysipelaswas discussed. No facts, however, on eitherside of the question were advanced, but thepresident was of opinion, from his own ex-perience, that the disease never was conta-

gious, although it might certainly becomeepidemic in hospitals, from persons breathingconstantly the impure atmosphere surround-ing those persons affected with the disease.He mentioned, also, in regard to the treat-ment of the affection, that a physician ofmuch practice in London was so confidentof the value of the nitrate of silver in thisaffection that he went so far as to assert thatwhen a strong solution of this chemical wasapplied sufficiently early over the inSamedsurface it invariably succeeded in effectinga cure.

LUPUS.

A case was afterwards read (from the penof Mr. Stedman) of lupus exedens. The

patient was a strong and previously healthyyoung lady, of dark complexion, and twenty-five years of age, when the disease firstaffected her. The detail of this truly dis-

tressing case would offer no valuable hintsto the practitioner, as it seemed to set all re-medies at defiance, and progressed more orless rapidly during a period of about twelve Iyears until it destroyed the unhappy pa-’tient. At intervals she was free from pain,but at other times the agony was so excru-

ciating that it was most painful to witnessher sufferings. She had the advantage ofthe attendance of the most experienced me-dical practitioners, among whom was SirA. Cooper ; a variety of local applicationswere made to the affected parts, amongwhich were nitric acid, iodide of mercury,

and oxide of arsenic. The first seemed theonly application which exerted- any benefi-cial influence over the ulceration, but thiswas only temporary, and the use of the thirdwas attended with such extreme pain thatit was not thought advisable to repeat it.The narrator of the case concluded with thefollowing remarks z" The only applicationwhich afforded relief to the pain was a mix-ture of mucilage, lime-water, and laudanum.I have no doubt it will be said that this wasan aggravated form of lupus, but have wenot many specimens in our museum showingan equal extent of disease? I have hadsome opportunities of seeing lupus in differ-ent forms, and I can speak with confidenceof three varieties. The one related in thispaper is the lupus exedens of authors, it is

deep-seated, attacking the skin, cellularmembrane, and tissues beneath of every tex-ture, even the bones. The treatment in thisform is most disheartening ; in short, I ’be-lieve that there is no cure. By the applica-tion of powerful caustics the progress of thedisease may be kept in check, even for years,but I have never seen a case perfectly re-stored. The second form is the lupus non-exedens, one of a milder and less virulent

type than the former, but still one that ad-mits of no cure, although it does not go onto the destruction of life. The disease isconfined to the skin and cellular tissues, itextends over a large surface. Tubercularindurations spring up about the face andneck, or tip of the nose, which, in process oftime, desquamate, not with the sanious dis-

charge of the former kind, but with a ten-dency to thicken, the skin assuming hyper-trophy. On desquamation the tuberclesbecome livid, a puckering of the skin takesplace, with deep and linear indentations,new tubercles arise around the former, andnew indentations go on ; so that in course oftime the affected part has a map-like appear-ance, somewhat like, though closer than, theinterstitial sulci of the convolutions of thepia mater and arachnoid membrane on thesurface of the brain. I know several per-sons suffering from this form of lupus, havingbeen twenty years so afflicted. Not unfre-quently these two forms, which may, anddo exist separately, combine, and we haveexamples of both in the same patient. Thethird form is of a more superficial character,it is only skin-deep,-it attacks the carti-lage and ala- of the nose, or the cheeks.Applications of nitric acid, iodide of mer-cury, chloride of zinc, arsenious acid, andmany other remedies, will arrest its pro-gress and effect a cure. I have seen a large,denuded surface submit to treatment, moreparticularly when combined with those me-dicines administered internally as usuallygiven in scorbutic or scrofulous constitutions.Females are most frequently the subject oflupus. They are often attacked at an earlyage ; those are most prone to the disease in

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whom there is a deficiency of the menstrualdischarges, or in whom the menstrual periodhas begun late in life."

In the discussion which followed this casethe chief question mooted was the connec-tion of the cases of lupus with scrofula.Was there such a connection ?-Mr. Pilcherhad found that in cases of the more formid-able character the patients were usuallybrunettes, while those in whom the diseaseyielded to remedies quickly possessed lighthair, fair complexions, and other charac-teristics of scrofula. He had found in mildcases the repeated application of leeches tothe affected parts most beneficial. Was theliquor hydriodatis arsenici et hydrargyri ofservice in these cases ?-Dr. Bennett hadfound it of no service whatever in cases ofchronic eczema and psoriasis; but, on thecontrary, it had produced great irritation ofthe mucous membrane of the intestinal

canal; but in ordinary cases of lepra andpsoriasis he had found it of service.-Dr.Willis had used this preparation in variousskin diseases with a good result.

December 11, 1843.REMOVAL OF A LARGE OVARIAN TUMOUR.

Dr. FREDERIC BIRD this evening intro-

duced, for the inspection of the society, alarge ovarian tumour, which he had recentlyremoved with success from a young lady,aged 21. The tumour was of an ovoid

shape, somewhat irregular at its inferiorportion, covered by numerous minute arterialramifications having their origin in two

large trunks. The total weight of the tu-mour was twenty-seven pounds. The dis-ease had existed for about two years, but its

development had been so gradual, and theconsequent abdominal enlargement so slow,that the patient was for a time unconsciousof the presence of disease. During the firsttwelve or fifteen months few local symptomsoccurred to mark the progress of her malady,and the general health was not materiallyinterfered with. Menorrhagia, however,had frequently occurred. Several physiciansof deserved eminence saw the patient, andremedies of every kind were judiciously andperseveringly employed, but without avail ;the abdomen continued to enlarge, increasingmore rapidly in the last six months, duringwhich period her general health became im-paired. About a month ago Dr. FredericBird was consulted, at which time the ab-domen was found to measure nearly fortyinches in circumference, and about fifteenfrom pubis to ensiform cartilage ; fluctua-tion was distinct; no signs of peritoneal ad-hesions existed, and the powers of the pa-tient, although depressed by mental suffer-ing and the continuance of her disease, wereyet sufficiently good to enable her to bearthe operation for extirpation. The operationwas performed as in the case in which he

had previously operated ; an exploratory in-cision of an inch and a half in length wasfirst made a little below the umbilicus, andhaving ascertained, by the effect of respira-tion upon the position of the tumour, and bymanual examination, that no peritoneal ad-hesions existed, the excision was enlargedto about five inches towards the pubis ; thetumour was next grasped and opened, andwithout any forcible traction, rose from theabdominal cavity, and, by the continuedflow of fluid, served to completely close upthe wound and prevent the admission of air.The lower part of the tumour was then

grasped, but the peduncle attaching it to theuterus was so ill-defined and so very shortthat the attachment was nearly sessile. Aligature was first made to encircle theprincipal artery, situated in that partof the attachment nearest to the fundusof the uterus ; two other ligatures were thenintroduced, and the cyst was removed. Somecare was required in effecting this object, asso little room existed for the passage of theknife between the ligatured portions and thesac; the external membrane of the latterwas cut through, but the cavity of the cyst wasnot opened. The tumour being thus removed,the lips of the incision were brought togetherby several sutures, the ligatures fixed at itslower edge, and cold-water dressing applied.Reaction of a high character came on inabout six hours, and was met by appropri-ate remedies ; from that time not an unto-ward symptom occurred to retard the rapidconvalescence of the patient; the ligatureshave all come away, the wound has healed,and recovery is complete. Dr. Bird re-

marked that the return to health in the pre-sent case had been even more rapid than inthat in which he had previously operated,and if it were carefully considered it wouldbe found to furnish much additional evi-dence in favour of the method of operatinghe had advocated. He believed that a verylarge incision, admitting of the removal ofthe tumour in its entire state, was unneces-sary in the great majority of cases. It wastrue that by such procedure the operationwas more easily performed, but the completerecovery of the patient was less probable.He alluded especially to the condition inwhich patients are subsequently left inwhom large abdominal incisions have beenmade; reunion of the parietes does not takeplace in a perfect manner, and the liabilityto hernial protrusion is very great. Hewished, however, not to be understood asadvocating the employment of a very smallincision ; but that an opening sufficientlylarge to admit the hand, and thus permit ofthe removal of adhesions, and the applica-tion of the necessary ligatures, was all thatcould be required, and for this purpose anincision of five inches would suffice, andwould secure to the patient every probabilityof success without incurring a liability to

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future disease. Dr. Bird said that he hadbeen induced to bring the case before thenotice of the society from the conviction thatevery addition to the practical acquaintancewith the operation was of importance ; hehad pleasure in relating the case, and instating its very successful issue, but had itbeen otherwise he would still have given itan equal degree of publicity. It was fromfaithful statistical records alone that therelative value of the treatment of ovariandisease by operation could be determined.Some successful cases had been urged intogreat publicity, but there had been alsocases in which death had been the result ofthe operation, and of them, beyond mere

rumour, the profession knew nothing. Hetrusted that they would yet be made public,and that medical practitioners might thus beenabled to speak with greater accuracy than iat present of the probabilities of success orfailure. Dr. F. Bird, in reply to questionson the subject, said that the diagnosis ofovarian from other abdominal tumours wasstill enshrouded in much difficulty, and caseshad occurred in which operations had beencontemplated, and even begun, when the sup-posed ovarian tumour was found to be en-largement of some other organ. He wasnot disposed to attach much importance tothe previous history as regards the part ofthe abdomen in which the tumour was first

observed ; in the greater number of cases hehad seen it had generally been described ashaving commenced in the middle of the hy-pogastric region, whilst in others attentionhad not been drawn to the disease until ithad obtained considerable size. The stateof the menstrual function was of greatervalue, the occurrence of menorrhagia beinga most frequent sign. Vaginal examinationswere very important aids, although in thecase he had related circumstances existedrendering it desirable that such mode ofinquiry should not be had recourse to, andhe had therefore not employed it. Percus-sion of the abdomen he regarded as a veryvaluable assistance in forming a diagnosis ;firstly, in reference to the uniform dull soundelicited from every part of the abdomen

occupied by the tumour ; and, secondly, tothe detection of fluctuation, which, in thosecases, having the ovarian tumour entirelyformed of a single collection of fluid, wouldbe found to exist in an equal degree in everypart; whilst, if any solid growth were alsopresent, the indistinctness, absence, or differ-ent character of the fluctuation, would serveto declare its presence and locality. But inall doubtful cases he would have recourseto a means which he had formerly sug-gested, namely, that of introducing a smallti-ocar at one or more points, and examiningthe character of the fluid ; or the whole ofthe secretion might be removed, and theabdominal walls rendered flaccid, and readilyadmitting of a most accurate manipulation,

thus to allow of the detection of any othercoexistent disease. Such a proceedingwould not militate against the success of asubsequent operation for extirpating the dis-eased organ.

Dr. CLUTTERBUCK and other members eulo-gised what they regarded as the candidand lucid manner in which Dr. Bird haddetailed the particulars of his case and thedanger of the operation.

In the discussion which ensued, the chiefpoints dwelt upon were the difficulties of

diagnosis in cases of abdominal tumours, andthe relative advantages of the large and ofthe moderate sections in removing diseasedovaria. Cases were related to show thatovarian tumours might be mistaken for otherabdominal swellings, and vice rersd. It was

generally considered that the large sectionwas the easiest for the surgeon, but not thesafest for the patient. It was still an opera-tion attended with such danger that it couldhardly be called an established one. Anearnest wish was expressed by the presidentand others that all cases, whether successfulor otherwise, should be published, for it wasonly by such a honest and candid proceed-ing that the real value of the operation couldbe determined.

WESTMINSTER MEDICAL SOCIETY.

Saturday December, 2, 1843.

Mr. FISHER, President.AFTER the admission and proposal of new

members, ,

The PRESIDENT stated that within the lastyear or two he had used the chlorate of potashin five. grain doses every second hour, in casesof sore throat connected with scarlet fever,wine and stimulants being used at the sametime. He had found the remedv in ques-tion of very great benefit when the throatwas in a sloughy condition.Mr. CHANCE introduced a cast of a case

of congenital hernia of both side3. The

peculiarity of the case consisted in the herniabeing confined to the groin, and in the fact ofthe testicles not having descended ; thebowel could be returned, but even then thetesticle could not be detected either in thegroin or in the scrotum. Mr. Chance in-quired if any members had seen cases of

congenital hernia confined to the groin, asPott had remarked that he had seldom, ifever, seen such a case.

Mr. HANCOCK did not think Mr. Chance’scase was by any means a rare one, and look-ingly attentively at the cast he should decidethat the bowel was not confined to the

groin, but had commenced its descent intothe scrotum.

,

Mr. HALE THOMSON had seen many casesof congenital hernia in which the bowel wasconfined to the groin, but he did not recol-lect any such in which the testicle had not