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limits. Remarking on the benignity of the form of scar-latina now prevalent in Paris, M. Besnier states that, not-withstanding the more severe character which scarlet fevergenerally assumes in children, not one fatal case of themalady has been observed out of sixteen in the children’swards of Ste. Eugenie Hopital; whilst there was a complete- absence of the disease in M. Roger’s wards in the Hopitaldes Enfants.

CASE OF URTICARIA COMPLICATING SMALL-POX.

The case (which occurred at the Hopital Beaujon, underthe care of M. Gubler) was that of a non-vaccinated femalepatient, who, on the third day of a variolous eruption of asevere character, became covered with urticaria, attendedby intense pruritus. This lasted three days, during whichthe variolous eruption remained stationary. Variola thenresumed its course, and the patient eventually rallied,notwithstanding such bad symptoms as epistaxis, intenserachialgia, vesical paralysis, and a vinous hue of the pus-tules.

TYPHOID FEVER.

During the month of October a severe epidemic of typhoidfever prevailed in Paris, and sent numerous sufferers to thehospitals. Out of 169 cases registered in the hospitals, thereoccurred 55 deaths. The adynamic form prevailed. Childrenwere quite liable to the disease, and women in the puerperalcondition were especially affected. Sudden death was ob-served in a larger number of cases than usual. The appli-cation of cold to the skin produced very favourable resultsin the ataxic form of the disease, and where the temperaturewas high. Other interesting details, contributed, in con-nexion with this subject, by the various hospital physicians,may be summed up under the following headings :-

Hôpital Beaujon. (Under the care of Dr. Gubler.)-Eightcases ; 1 death; 2 cures ; 5 under treatment. Age of thepatients : 7 from eighteen to twenty-nine years ; 1 of fiveyears. In 6 cases the lenticular eruption was extremelyabundant; in 1 the disease followed a very slow course, andon the fiftieth day there appeared haemorrhagic purpura,exclusively confined to the lower limbs. In the one fatalcase, of a severe ataxo-adynamic character, there was in-tense delirium; and yet, on examining the encephalon afterdeath, nothing was discovered but a moderate congestionof the meninges.

Hûtel DMM. (Under the care of Dr. Tardieu.) - Sixteencases-8 female patients, 8 male; 3 deaths; 8 cur es ; the

remaining cases still under treatment. Prevailing trade orprofession: servants. Three of the female patients hadbeen recently confined, and were then nursing. In twocases the disease manifested itself on a sudden, withoutbeing ushered in by any prodromic symptoms. Two deathsoccurred through syncope, and one through insufficiency ofthe heart’s action, showing the frequency and importanceof cardiac symptoms in this epidemic. In one case therewas a complete absence of the ordinary symptoms of thedisease ; and as the patient was in a condition of violent

delirium, with dilated pupils, restlessness, &c., the diagnosiswas delirium tremens. On performing the autopsy, how-ever, several enormous Peyer’s patches were discovered,some of which showed a central eschar on the point of beingdetached.

Hôpital Ste. Etig6nie, or Children’s Hospital. (Under thecare of Drs. Barthez and Bergeron.)-Twenty-three cases;three deaths through intestinal perforation.

Hôpital des Enfants. (Under the care of Dr. Roger.)-Three cases of a mild character.Hpitl Militaire du Val de Grâce. (Under the care of

Dr. Coindet.)-Nineteen cases ; two deaths. In one instancedeath occurred suddenly on the thirty-first day of the dis-ease, which had shown a cerebro-pulmonary form. Dr.Coindet observes that the greater number of the patients,who were generally soldiers, had just returned from an ex-cursion at the Camp de St. Maur.

Hópital St. Antoine.-Several cases were observed, but thenumber is not stated. In two instances, multiplied ab-scesses supervened in the course of convalescence. Incisionof the tumours and washing out with alcoholic or iodine ’isolutions speedily brought on a cure.

Hûpital Lar2boasie-re. (Under the care of Dr. :Millard.)-Thirteen cases ; 3 deaths ; 1 occurring suddenly, withoutany lesion to explain the event on the post-mortem exami-nation.

J

Medical Societies.MEDICAL SOCIETY OF LONDON.

MR. PETER MARSHALL, PRESIDENT.

THIS Society is so prolific in meetings, that we find itimpossible to publish its weekly proceedings as we wish.,and we are obliged to limit our report to a short note of twoor three of its meetings.On November 1st, Mr. JABEZ HoGG brought forward a

case in which he had performed a modification of Dieffen-bach’s operation for Ectropion. Dr. SEMPLE read a paper onHeart Disease, in which he questioned the propriety of

informing the patient of the nature of his ailment, in allcases where a bruit is found, on the ground in part that heartdiseases are less fatal than is generally supposed. Dr.

Semple took some credit for helping on this view.On November 8th, the paper of the evening was read

by Mr. W. ADAMS; it has appeared in our columns in ezteaaso.On the 15th uit., Mr. TEEVAN exhibited a calculus, weigh-

ing two and a half ounces, composed of lithic acid and thephosphates, removed from a patient who had walked fromBirkenhead, 208 miles, in twelve consecutive days-the lastday thirty-three miles in the greatest agony. Dr. DicKshowed a knife suitable for all operations, where two knivesare required, the cutting blade being covered at will by asliding sheath, secured by a spring in the handle.

Dr. HAWKSLEY, read a paper on °° The Stetho-Spbygmo-graph

" as an aid to the physiological and pathological in-

vestigation of the functions of respiration and circulation.He exhibited the practical application of the instrument ona case of phthisis pulmonalis, and one of well-marked mitralregurgitation. In every case three simultaneous and

synchronous tracings of moving organs are taken-as, forexample, the two lungs and the radial pulse; or the heart,the radial pulse, the carotid or the femoral. It was shownthat the tracings would show any disparity in the action ofthe two lungs, also the relation of inspiration to expira-tion ; and, associated with the pulse tracing, it afforded theopportunity of observing, not only the peculiarities or modi-fications of the circulation, as in the case of Marey’ssphygmograph, but, in addition, their relation to the respi-ratory process. By aid of this instrument, any question asto relative time in the transmission of the blood-wavethrough the arteries may be solved; as, for example, thetime occupied in transmission to the radial, the carotid, orthe femoral artery. This may be found to have importantconnexion with the diagnosis of aneurisms and tumours,as well as with diseased states of the arteries with chronicdisease of organs.On November 22nd, Mr. DE MÉRIC exhibited a prepa,ra-

tion and a series of drawings illustrating two cases of Ele-phantiasis ; one of the clitoris, and the other of the wholeright lower limb. In both, the patients had sufferedfrom syphili s, and llr. de W14ric conceived that, although thelatter affection was perhaps not the sole cause of the hyper-trophy, it had, nevertheless, had a share in its production.The author reminded his hearers that deposits and infiltra-tions were extremely common in syphilis, but that the simpleincrease n bulk without change of texture (true hyper-trophy) was rare in lues venerea. Mr. de Méric then alludedto the distinction to be made between hypertrophy andinfiltration, and showed a series of drawings offering goodexamples of enormous clusters of mucous tubercles occupyingthe vulva, infiltration of the lahia majora, and several in-stances of hard, voluminous prepuce, resembling elephanti-asis, the result, not of inflammation and lymphatic obstruc-tion, but of actual specific infiltration. These, in general, hefound very difficult to control, either by the use of iodide ofpotassium or mercurial frictions.

Dr. TILBURY Fox objected to the term elephantiasis asapplied to the hypertrophous conditions, which were bettercalled spargosis.Mr. HENRY LEE showed a case of resection of the hip-

joint, in which complete recovery with shortening of thelimb had taken place, and all the motions of the joint pre-served. Also the portions of bone removed in a case ofexcision of the knee-joint. The patient was thirty-fouryears of age, and made an excellent recovery. Mr. Henry L( ethen read an abstract of some " Unusual Surgical Cases."

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1. A case of ossific union of the femur, at the age ofninety-eight. This case he considered conclusive as to the

question which had lately been under consideration-viz.,whether old age in itself was a reason for the non-union offractures.

2. A case of the loss of nearly the entire tongue fromsyphilitic ulceration. The ulceration in this case was

speedily stopped by the administration of the calomel vapour-baths.

3. A case in which one testis suddenly disappeared, tothe dismay of the patient. It had escaped into the inguinalcanal of the same side.

4. A case of most severe and long-continued pain in thearm, accompanied by abscess in the joint and deposit ofnew bone, in an hysterical subject. Several operationswere performed: the joint was excised, the arm ampu-tated ; but the pain did not cease until the whole of thebone was removed at the shoulder-joint. The point of thecase to which Mr. Lee directed particular attentionwas that it illustrated the fact that hysterical symp-toms might co-exist with real disease ; but these would actand re-act upon each other, and that the former could notbe cured until the latter was removed. In this case, the

pain appeared to be in the nerves of the bone itself, as nopermanent benefit was derived from dividing the nerveswhich supplied the soft parts.

5. A case of embolism simulating syphilis. A gentlemanwas suddenly prostrated on his return from India. He hada tubercular eruption, and long-continued excessive painin the bones. One leg became much swollen and verypainful, then the other ; one e eye became affected; verylarge thick patches appeared under the conjunctiva.These Mr. Lee regarded as characteristic of the nature ofthe disease. The cornea sloughed.

6. A case of double vision with a single eye. In a trialfor compensation after a railway injury, Mr. Lee observed,the question had come before the court whether any injuryor disease of the brain could produce double vision with asingle eye. Mr. Lee had now a case under his care in whichthis actually was the case. Under certain states of physicalderangement this patient sees distinctly double when oneeye is closed, and if he keeps both eyes open, and mechani-cally displaces the axis of one by pressing his finger againstthe globe, then he would see four objects, or double withboth eyes. There had been no injury in this case.On Nov. 29th Mr. SPENCER WATSON read notes of a case of

Traumatic Cataract, remarkable for the presence ofsymptoms similar to those met with in idiopathic glaucoma,all which symptoms subsided after the removal of thecataract by the linear incision. Mr. E. CALTHROP exhibitedan umbilical belt made of black india-rubber. Instead ofthe central pad, two wedges of wood, encircled by anelastic cord, are made to act laterally, and close the um-bilical opening. Dr. SEMPLE exhibited two specimens ofheart disease. The first was large, fat, soft, and flabby;cavities larger than usual; pulmonary and tricuspid valveshealthy, but the tricuspid orifice very large; the mitralorifice was large enough to admit four fingers ; there werefour aortic valves. The points of interest in this case werethat the patient complained of dyspeptic symptoms; thedilated condition of the cavities, great patency of theventricular orifices, and the four aortic valves. Theother specimen was a contrast to the first. There wasextensive disease of the aortic valves, almost bony, themitral orifice very small, and the valves hard and rigid. Inthis patient a presystolic and systolic murmur at the apexwas heard at the angle of the scapula, and a systolic anddiastolic murmur at the base.

Dr. COCKLE read a paper entitled 11 Further Notes on

Pulsating Tumour of the Neck," which will appear inextenso in a future number of THE LANCET.

PATHOLOGICAL SOCIETY OF LONDON.

TUESDAY, DEC. 7TH, 1869.DR. QUAIN, PRESIDENT, IN THE CHAIR.

A REPORT, by Drs. Murchison and Bristowe, was readupon Dr. Moxon’s case of Thrombosis of the PulmonaryArtery. The reporters did not endorse Dr. Moxon’s state-ment that the clot migrated from the femoral vein.

An interesting Report on Mr. Hill’s case of Diaphrag-matic Hernia, was likewise received from Mr. Callender.

Dr. MURCHISON exhibited a specimen of Impacted Gall-stones. The symptoms present were repeated attacks ofhepatic colic; later on there was daily occurrence of painand sickness, without jaundice ; but finally jaundice didoccur. Rupture of the duct afterwards took place, anddeath occurred. The stone was very large.

Dr. DAVEY exhibited a Ruptured Spleen, taken from awoman who was run over.

Dr. Cpisr showed a specimen of Calculus taken from thebladder of a certain Japanese dog, and imperfect ova re-moved from improperly fed hens; also the ovaries of fowlsin a state of inflammation.

Dr. LEARED showed the Cancerous Lung of a patient ad-mitted into the Great Northern Hospital with symptoms ofapparent phthisis, but with tumour pushing up the clavicleon one side. The upper two-thirds of the right lung were’invaded by cancer of the encephaloid kind. Cancer cellswere found in the sputa during life.

Dr. FAGGE brought to the Society a living specimen ofScleriasis or Seleroderma. The patient was a woman sixty-five years of age, who had been ill for about a year. Theinduration commenced in the neck, and now affected thecheek, arms, back, chest, and breasts, extending to the-umbilical region, and in a similar manner to that describedby Thirial. The woman is of an older age than in other de-scribed cases. The sensation seemed not to be impaired. Infront of each elbow-joint is a band of dense tissue, reachingup and down some distance, and becoming tense and sear-like when the arm is extended, and was such as describedby Addison under the term morphaea. Dr. Fagge did notthink the disease had aught to do with leprosy, as imagined,and he thought it also different from the condition describedby Rasmussen under the term scleroderma, and whichwas inflammatory.

I

Dr. CRISP asked what relation existed between the diseasenow referred to, and the hard condition of the skin foundsometimes in infants.

Mr. WEEDEN CooEE here showed the case of a, youngwoman, the skin of whose thigh hung in loose and hyper-trophied folds from its upper part to below its middle. He-applied the term elephantiasis to it. The integuments wereof very lax feel, and very elastic and dark coloured. The-disease seemed to consist of an overgrowth of the fibro-cellular tissues.

Dr. TILBURY Fox agreed with Dr. Fagge in believingthat scleroderma had nothing to do with leprosy. It wasunfortunate that the term morphœa was not limited to theanaesthetic white patches of true elephantiasis, for it was-the application of that term to the white indurated spotsthat occur in connexion with scleroderma that had led toconfusion, and the classing together of different things. Hethought that the cases described by Rasmussen were of thesame nature as that exhibited by Dr. Fagge. The minute

changes, as given by Förster, Rasmussen, and others,seemed to show that the pathological changes in the twosets of cases consisted in an hypertrophous growth of thefibro-cellular tissue ; and the connexion between this andchanges in the lymphatic system seemed to be indicatedspecially by the researches of Rasmussen. The changemight be local and limited, as in the so-called niorphoaa,occurring in connexion with scleroderma, in which largertracts, in bands or wide areas, might be af’ected. Thedifferences in regard to aspect were probably dependentupon the varying contractility of the new-formed tissue..It was a question whether all the cases referred to by thosewho had spoken might not be placed in one group, includingeven such cases as Mr. Weeden Cooke’s, which was remark-able for the laxity or non-contractility of the hypertrophied.fibrous tissue.

Dr. PYE SMITH exhibited a specimen of a Heart in whichsuppurationthe result of syphilis, probably-had takenplace. It was taken from a dissecting-room subject.The same gentleman also showed the Spleen of a chlorotic

patient, in whom the whole viscera were blanched. Theimmediate cause of death was diphtheritic inflammation ofthe fauces and colon. A marked rise in temperature was,observed some time before death. Dr. Smith directed spe-cial attention, however, to the condition of the spleen. Theorgan weighed twelve ounces, and its external surface wascovered by small nodules ; on section, these same formations