405MISS SOUIRRELL. THE SUFFOLK WONDER.-MEDICAL SOCIETIES.

with his solicitor’s clerk, and an officer of the Court, at onceproceeded to Bristol, and found Mr. BOURN on board thevessel, superintending his arrangements. He was called out

of the ship, and told he was arrested for a bill of £21 5s.,which he owed Mr. Cox. He expressed his great surprise atthis, and said that the bill of that gentleman only amountedto .62 6s. Mr. Cox thereupon made some remarks about that

being no matter, and that he could charge what he chose.The young fellow, then, having £15 in his possession, to

avoid being detained gave this sum to Mr. Cox, who agreedto receive it in full discharge of his bill and costs. Mrs.

BOURN, however, having become acquainted with all the

circumstances, brought an action for a malicious arrest.Nowthe question that the jury had to decide,was notwhether

the charge for attendance was an exorbitant one-not whethersix ounces of physic and a powder per diem formed

an unnecessary quantity of nauseous stuff for the plaintiff toswallow-not whether Mr. BouRN really suffered, as Mr.

Cox asserts, from "gonorrlroea with stricture of the urethra,"an ulcer which I believed to be syphilitic, with an eruptionon the margin of the prepuce, which was indurated and in a°° state of phimosis," with "an inflamed gland on POUPART’s"ligament on the right side"-not whether it was customaryfor medical men to foment and poultice buboes, and chargeextravagantly for so doing, as the defendant did,-but whetherthe bill had been fradulently augmented for the purpose ofenforcing the arrest, the Absconding Debtors Act onlyapplying to debts above ;E20. The Judge remarked that agross fraud had been committed.

More need not be said. The expression of the opinion ofthe learned Judge must have given great pain to Mr. Cox;he has, however, only himself to blame; for with ION wewould say,-

° Yes; ’tis the eternal law, that where guilt is,Sorrow shall answer it!"

WE feel constrained to make some apology to our readersfor again drawing their attention to the case of EuzABETH

SQUIRRELL, the heroine of Shottisham, near Ipswich, who,chameleon-like, is said to live upon air, and who is now

reported to have enjoyed her nutritious diet for rather morethan four months. Since the date of our last remarks the

enlightened inhabitants of Shottisham have been making as muchof their rara avis as possible; and it would appear hopeless to expect to convince these worthy simpletons, that instead offinding a contradiction to the laws of Nature, they have merely discovered a mare’s nest of unusual proportions.Committees and councils, convocations and consultations ofall kinds, and consisting of persons of every degree, have beenheld, with a total disregard to inconvenience and trouble

certainly worthy of a better cause; but although it has been

proved to the satisfaction of most sane intellects that the girlhas been guilty of at least one gross deception, yet themajority seem determined to remain unconvinced. So trueindeed is it that the pleasure of being cheated is as great asthe delight of cheating. What then do our readers imagineis the last explanation of this puerile absurdity? Why, just this. The girl’s total abstinence is to be accounted for on

phrenological principles-that is to say, as the bumps on herhead are large, the capacity of her stomach must be small;and as the patient camel will live for some time upon the

stock of nutritious fat in its hump, so Miss SQUIRRELL existsupon her intellect. To the miracle-seekers of Shottisham we

would only say, in the words of the clown in "Hamlet,"-" Cudgel your brains no more about it, for your dull ass willnot mend his pace with beating."

Medical Societies.

MEDICAL SOCIETY OF LONDON.

SATURDAY, OCT. 16, 1852.—DR. LANKESTER, V.P., IN THE CHAIR.(Concluded from page 386.)

Dr. RISDON BENNETT read a paper, entitled,CASES OF EMPYEMA, AND THE CHARACTER OF THE PREVALENT

PLEURO-PNEUMONIA.

After detailing several cases of empyema opening by thebronchi, two of which did well, he remarked that the terminationof these cases by the discharge of the purulent accumulationthrough the bronchi, he thought to be one of the least frequent ;and consequently the cases selected offered additional points ofinterest, besides being illustrations of the general character of theinflammatory disease which has prevailed to a considerable extentwithin the last eighteen months or more. The gradual change inthe treatment of pneumonia, and the increasing want of faith inbleeding, antimony, and mercury, were next alluded to, and theremark made, that in illustration of the non-accordance of theexperience of Louis with that of British practitioners, it is wellknown, that apart from differences in what is called the epidemicconstitution, there are important differences in the same disease,dependent perhaps on climate, national constitution, habits, modesof life, &c., as well as differences dependent on varieties of indi-vidual constitution, and that this, although known, is not alwaysremembered in practice. This difference was shown by the treat-ment of erysipelas, of which Dr. Bennett saw some cases lastsummer at the Hotel Diea; and on inquiring into the treatment,was told that rest, and some simple dietetic rules, were all thatwere required, it being a very slight disease, and never fatal,unless associated with some visceral disease or cachectic habit,the reverse being the case in the London hospitals, and even inprivate practice in these kingdoms. Dr. Bennett, however, didnot consider it right to discard altogether the results of formerexperience, because bleeding and antimony, &c., are not nowfound so serviceable in the treatment of pneumonia as we wereled to believe, or as they formerly were. They are not to berejected altogether as fallacious; for they will warrant our con-fidence, if judiciously employed, in the treatment of the sametype of disease as that for which they were recommended. Theauthor then went on to assert, that true sthenic pueumonia of thecroupous variety, that is, inflammation attacking the air-cells,characterized by the effusion of plastic matter by which they areobliterated, leading to solidification of the lung, has become acomparatively rare disease of late. The ordinary descriptions ofthis disease are true to nature, and the attendant pleuritis, itself asubsidiary or secondary disease, merely induces an effusion ofplastic lymph upon the serous membrane, unaccompanied bymuch liquid; but the inflammatory disease which has prevailedlatterly differs from it in its pathology and treatment. Neither isit exactly the typhoid pneumonia, and certainly not associatedwith typhus or typhoid fever. The pleuritis has frequently pre-ceded the pneumonia, and has often been the more severe andprominent complaint. The disease has occasionally commencedwith catarrh, passing subsequently into the pleuro-pneumonia.The pain is usually very severe, and effusion takes place withgreat rapidity and to a considerable extent, soon becoming puru-lent ; cough not troublesome ; the sputa copious, and more or lesstenacious and glairy ; sometimes streaked with blood, at othersresembling prune juice, or of a dirty green-yellow colour. It doesnot always present the same characters in the same cases, butmay vary daily; dyspncea not urgent generally, nor the respira-tions much increased in frequency. The skin and tongue usuallymoist; the former clammy, and the latter covered with a dirty,creamy fur. Pulse rapid but soft, and often feeble; urine some-times high-coloured and scanty, at others copious and of a palestraw colour. The physical signs indicate the rapid spread ofinflammation over a great extent of surface, usually confined toone side. The subsequent solidification of lung is not very great,

406

however, nor very complete, being checked by the pleuriticeffusion, which compresses the organs, and prevents its solidi-fication. When the effusion has not been great, instead of exten-sive solidification there is usually suppurative infiltration of thelung, showing a tendency to gangrenous destruction, the chiefpoints of interest in the autopsies being the small amount ofsolidification, notwithstanding the extent of lung involved, itbeing greatest in the immediate vicinity of the gangrenouscavities. The tendency to suppuration was more marked in thepleural cavity. In one case detailed, Dr. Bennett thought theprincipal accumulation of pus was interlobular, and that, as theacute stage passed away, the effusion into the cavity of the pleurawas absorbed, while a considerable quantity remained betweenthe lobules of the lung and its base, so that when it had its exit,the outlet was very direct, opening immediately, or nearly so,into the larger bronchial trunks, thus effecting the more speedyand complete evacuation of the cavity, and its consequent oblitera-tion. These signs and symptoms the author thought sufficientto show that this form of inflammation differs materially fromthe ordinary pleuro-pneumonia. This difference, he said, wasnot owing to mere peculiarities of individu.il constitution, for hehas met with it in persons of various constitutions, and movingin different social spheres. Neither has it any necessary con-nexion with continued fever; but he is inclined to refer it to aform of erysipelas, although it is not generally associated with itsexternal manifestations. The pneumonia of fever, erysipelas,and cachexia is usually asthenic ; but this variety Dr. Bennettregards as itself a form of erysipelatous inflammation, chieflybecause in its pathological features it closely resembles that form ’’

of inflammation, because it has prevailed contemporaneouslywith external erysipelas, and because an erysipelatous form ofcynanche has been very common, and in many cases has been anattendant on the thoracic inflammation, sore-throat having beenfrequently complained of in the beginning, and, as this has sub-sided, bronchial symptoms have occurred, to which the pleuro-pneumonia has succeeded. With respect to treatment, generalbleeding is inadmissible; the local loss of blood in the beginningis useful, if to a limited extent. Counter- irritation may be em-ployed safely, more early than in the sthenic form of inflamma-tion ; blisters have yielded markedly beneficial results. Calomeland antimony, if given at all, must be used most sparingly, andwith the utmost caution. Five grains of Dover’s powder, withone grain of calomel, three or four times a day, have appeared tobe very useful, the calomel not being given so as to affect themouth. Ammonia is the best expectorant, and is given by Dr.Bennett, combined with its acetate, and camphor mixture, orsometimes with serpentaria or senega. Beef-tea always, andwine frequently, are generally necessary. Under any form oftreatment, the affection is attended with great danger, and, in itsworst forms, is very fatal. In some cases, so rapid is the prostra-tion, that Dr. Bennett has thought stimulants necessary from thefirst. An ample and efficient blister, with wine, beef-tea, andammonia, are, he believes, the remedies on which most relianceshould be placed in the most aggravated and most characteristicexamples of the disease.

Dr. OGIER WARD having made some inquiries as to themeaning of some expressions in the paper, and remarked that hehad found empyema usually affecting the left side,

Dr. MURPHY made some remarks on inflammation, or ratherpseudo-inflammation, occurring in other parts than the lungs, inconnexion with a peculiar state of constitution, such as thatwhich appeared to prevail in Dr. Bennett’s cases. In these cases,blood-letting, if at all resorted to, must be employed with theutmost caution. Now, why was this caution more necessary inLondon than in Ireland? What was the influence of change ofdiet? He was inclined to believe with Dr. Bennett, that in thepseudo-inflammation under review, stimulants and nutritious diet,rather thau what were called antiphlogistic remedies, were indi-cated.

Dr. HARE believed it was generally known as a fact, thatempyema was more frequent on the left than the right side : thiswas more especially the case, however, with children. In sixcases occurring in children between one and a half and nineyears, the empyema was on the left side. Dr. Hare then relatedthe following case, which presents some points of difference fromthose related by Dr. Bennett. In this instance the diseaseaffected the upper part of the lung, and while all his occurredon the left side, this one was on the right. Dr. Hare first sawthe patient on August 5, 1851. She was twenty years of age, ofslight conformation, fair complexion, and light hair. For a

fortnight past she had been very ill, and confined to bed, underthe care of Mr. Browne, in consultation with whom she was seenby Dr. Hare, who found her with hot skin, very rapid pulse, much dyspnoea, and frequent cough; there was considerabledulness and intensely bronchial respiration a little below the

right clavicle; at each base posteriorly, but especially the right,there was also some dulness, with crepitant and sub-crepitantrhonchi. but no sign of fluid effusion. Dr. Hare, being out oftown, did not see her again for more than a fortnight. He thenfound, in place of the bronchial respiration, loud, large, gurglingrhonchus from the upper edge of the right third rib, nearly tothe apex of the lung, with well-marked bruit de pot fe’16 onpercussion over the same region, and considerable dulnessaround ; still some sub-crepitant rhonchi at right base, but in theleft one they had much diminished; the dyspncea was very great;she had much difficulty in getting up some puriform aud veryfoetid expectoration. In a few days more the dyspnoea was stillmore urgent, and the cough incessant ; suffocation appearedimminent; the expectoration was exceedingly foetid; the patient’sstrength was very much reduced, and the case had put on theworst appearances ; there was still loud gurgling below theclavicle, and now the second intercostal space, near the sternum,appeared thinner than before. At this point, Dr. Hare suggestedthat an incision should be made, and one three-fourths of an inchlong was accordingly made, and large quantities of pus and debrisescaped, mixed with air, each time the patient coughed; altogether,twelve ounces came away at the time ; it was offensive, like thatexpectorated. The relief to the dyspnœa, was almost immediate,and from that time the case improved. The patient is now alive,has regained flesh and strength, and can walk a considerabledistance ; but there is still occasionally a little discharge from asmall fistulous opening where the incision was made; there ismuch flattening under the clavicle, and some procidentia of theshoulder.

Dr. THEOPHILUS THOMPSON expressed his admiration ofthe graphic manner in which the cases had been related, butregretted that Dr. Bennett should have adopted the term

"muco-crepitant" rhonchus, which Dr. Thompson consideredambiguous and objec.ionable. Indeed, he was not sure that heunderstood what was intended by the term, although a know-ledge of the rhonchus really present was essential to a decidedopinion regarding the appropriate treatment. The use of suchdesignations unnecessarily increased the difficulty of beginnersin auscultation ; and it was much to be desired that a well con-sidered nomenclature for stethoscopic signs could be introduced.He agreed with Dr. Bennett in the great prevalence of a tendencyto asthenic inflammation of the chest, and believed that in the

country, as well as in London, simple acute pneumonia had, oflate years, become much less frequent. In most forms ofpulmonary inflammation, Dr. Thompson objected to the use ofopium, which, even in the form of Dover’s powder, he believedcalculated, whilst any crepitant rhonchus remained, to render

respiration more difficult and the expectoration less free. Inconditions such as those described by Dr. Bennett, he believedantimony alone to be of doubtful efficacy, and mercury given soas to affect the mouth, unsafe ; but blue pill, in doses of about agrain, combined with hyoseyamus, and sometimes minute dosesof antimony given cautiously and perseveringly, he believed tobe one of the best measures that could be used. He as ofopinion that certain forms of pleuro-pneumonia, and perhaps ofbronchitis, might depend on the introduction of a poison similarto that of fever or erysipelas, the organ on which the injuriousinfluence was to be exerted remaining for some time uncertain ;and mentioned the case of a lady, who, after residing for a fort-night in a badly drained district, where fever was prevailing,became attacked with incomplete febrile symptoms, which, in aweek, merged in pneumo-bronchitis, in which antimony proveduseless, but the mild mercurial plan rapidly cured. In conclu-sion, Dr. Thompson related a case of empyema terminatingfavourably, in which openings formed both into the bronchialtubes and externally ; the patient’s strength being supportedby tonics while the external opening formed. He was of

opinion that unless the dyspnoea and other symptoms, in such acase, required immediate interference, if a natural process ofrelief was in progress, it was undesirable to have recourse tosurgical operation.

Dr. BENNETT, in reply, after some observations on the termswhich lie had employed, remarked that the left side was that

generally affected in these cases. He had, however, seen thedisease on both sides of the chest, and in the majority of fatalcases both sides were affected. The disease was not confined toLondon, nor to any particular class, and was not more frequentin the lower than in the higher. The only point in which hediffered from Dr. Thompson was in respect to the administrationof opium. Upon this point he spoke decidedly, and in favour ofthat remedy, but more particularly of small doses of Dover’spowder, such as four or five grains, three or four times a dayHe had found these most beneficial. Perhaps Dr. Thompson’objection to it might be met by the fact that he (Dr. Bennett)gave with it one grain of calomel or grey powder, not for the

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purpose of mercurialization, but with the view of preventing anyill effects from the opium. The etiology of the disease was mostinteresting. He was inclined to think that it was associated insome way with malaria, as was erysipelas, &c. He said he

thought paracentesis was generally too long delayed, and thatthere were other circumstances more important than dyspnoea indetermining its necessity. -

SATURDAY, OCT. 23, 1852.—MR. CANTON, V.P., IN THE CHAIR.LACERATION OF THE UMBILICAL CORD.

Dr. BuRKE RYAN exhibited the ends of an umbilical cordwhich had become lacerated during sudden delivery in the erectposture, On the morning of the 12th of October, his patient,who had an occasional twinge of pain during the night, got upat eight o’clock, dressed, and sat on a chair at the window, whereshe had a smart labour pain, after which she walked across theroom, and with another sharp pain, the child, with the liquoramnii, was forcibly expelled, falling on the floor. Thecord was lacerated within two inches of the abdomen, the umbilical vein being retracted, but the arteries elongated, a condition most likely to prevent haemorrhage. The patientdid not expect deliverv for hours. Dr. Ryan alluded to thecase of Ann Pendry, who, in 1845, was suddenly delivered ina water-closet, and against whom a verdict of " wilful murder"was returned by the coroner’s jury. At the time, Dr. Ryan tookoccasion to show the unsoundness of the verdict, and instanced acase in his own practice, referred to by Dr. Taylor in his Juris-prudence, where a primipara was suddenly delivered in the erectposition as he entered the room. Dr. Ryan considered the recordof such cases of great importance, as, in connexion with otherproofs, enabling the medical jurist to save an innocent life. It isthe duty of a medical jurist to hold the balance equally, to weighinnocence and guilt according to their kind; and while usingevery effort to save the innocent, it is equally his bounden dutyto worm out and detect the criminal, the more especiallyat a time when infanticide is so rife as to procure for this countrya very unenviable notoriety. Clergymen should well impressupon their flocks the fact, which those flocks seem carelessabout, that murder in the womb, or shortly after birth, is no lessmurder than in the full age; and that though the murderer mayescape the temporal, he cannot escape the eternal consequencesof the crime.

INTERNAL STRANGULATION.

Mr. RICHARDSON exhibited a morbid specimen taken from apig which had died after six hours illness, having been pre-viously in good health. There was an opening in the mesentery,probably congenital, through which a loop of intestine hadslipped, become strangulated, and proved fatal.Some few remarks were made by Mr. CANTON, Mr. DENDY,

and Dr. 0. WARD, on the little resistance which the loweranimals made to congenital or other diseases.Mr. HUNT read a paper

ON THE CONSTITUTIONAL TREATMENT OF SCALD HEAD AND

RINGWORM.

The object of this paper was to show the uncertainty and generalinefficiency of local treatment, and the grounds on which con-stitutional treatment might be considered as rational and hopeful.The disease, in all its forms, is believed by the author to be com-municable by one and the same contagion, and to be either theconsequence or the cause of a vegetable parasite, which, takingroot in the hair bulbs, became a sourse of disease; and the objectof the treatment was to destroy the parasite. Considering im-paired health as one of the conditions favourable to the develop-ment of this disease, the first object of the treatment is to rectify,if possible, any deviation from health, or any deficiency of sthenicvigour, which might complicate the local disease; and if thiscould not be done, the author believed that the complaint mightthen, and then only, prove incurable. He related cases whichhad occurred in the Dispensary for Diseases of the Skin in illus-tration of this difficulty; and others, in which the disease hadrecovered under constitutional treatment, directed only to theimpaired condition of the general health of the patient, totallyirrespective of the disease in the scalp. In these cases it wasconsidered that the improved condition of the blood, and conse-quently of the nidus, rendered it unfit for the nourishment of theparasite, which consequently died, and the disease spontaneouslyceased to exist. The remaining difficulty was how to dispose ofthe disease in healthy subjects. In this case Mr. Hunt proposedto poison the parasite through the medium of the blood, just aswe poison the acarus scabiei through the medium of the skin.For this purpose he believed that many poisons, carefully admini-stered in medicinal doses, might avail. He particularly mentioned

arsenic, as possessing a specific action on the hair bulbs, as wellas constituting a very manageable medicine, and a medicine which,as a remedy in scald head and ringworm in healthy subjects, hadnever disappointed him. He related several cases in which thedisease had more or less readily yielded to a course of arsenic,no external application having been used, except tepid water forthe sake of cleanliness. Some of these consisted only of baldness,which the author believed to be caused by the parasitic fungus.Beautiful wax models of the disease in its various forms andstages, executed by Mr. Tuson, the artist, were exhibited by theauthor, in preference to attempting (what he conceived to be avery fallacious undertaking) a definition of the eruption. Mr.Hunt concluded by observing, that if, as he had reason to believe,the same principles of treatment should prove to be applicableto these contagious forms of scalp-disease which he had found sopractically useful in other chronic cutaneous affections, the diffi-culties of diagnosis would be reduced to a very simple and easyproblem, so far as practice is concerned. For, whatever be thecharacter of the disease, provided it be neither syphilis nor scabies,all that is necessary is to rectifv the general health, or if that fails,to restore the skin, and to administer some powerful alterativetonic in proper doses for a proper time. For this purpose, theauthor preferred arsenic as more manageable, mere certain, andmore permanent in its effects than any other remedy; and hehad the satisfaction of knowing that this is the experience of everypractitioner largely engaged in the treatment of diseases of theskin.

Dr. SEMPLE said that there was a want of philosophy in Mr.Hunt’s paper. He granted that there might be found unnecessarysubdivisions of these diseases, but Mr. Hunt had evidently con-founded together three diseases totally dissimilar-viz. favus,impetigo, and baldness. Favus was of parasitic origin; impetigoa pustular eruption arising from inflammation; baldness was

owing to neither, but was the result of weakness. And a verydifferent treatment was applicable to each. Impetigo was im-proved by a proper diet, ring-worm required local treatment, andbaldness stimulating applications. He thought Mr. Hunt’s viewswere behind the science of the day.

Mr. DENDY thought that different treatment was necessary indifferent cases; what would be good in one was bad in another;though he admitted that in consequence of the porrigo lupinosabeing common in France, and very rare in this country, someauthors had made a complete jumble of the subject. He hadhimself been sadly and wofully misunderstood. He regrettedthat Mr. Hunt had not favoured the fellows with nicer definitions,without which no clear views could be entertained. He (Mr.Dendy) had found arsenic a total failure in some cases. Headmired Mr. Hunt’s tact, and the paper was nicely written, buthe could not say he was at all enlightened by it.

Dr. LANKESTER felt, with Dr. Semple, that Mr. Hunt hadrather confounded together different diseases; but he would n6)ton that account object to Mr. Hunt’s views. These diseases sooften ran one into another, that all attemps at diagnosis and de-finitions will fail. Then the same disease, however distinct andwell marked, will vary under epidemic and other influences.Small-pox is not always contagious-a solitary case may occur inan un-vaccinated district; so of measles and scarlatina. He wasnot convinced that the parasitic fungus which was found in ring-worm was the cause of that disease. Fungi often exist as theresults of disease, and he regarded them generally, as well as allparasites, rather as indications of previously existing disease.Nor must we infer that because a disease is contagious, the vegeta-tion can be transferred from one person to another. And our aimshould be, in the treatment, to withdraw the existing disease, andthen you deprive the vegetable of life. It is the same with theanimal parasites which infest vegetables. If the vegetable is

healthy they are not found. The aphis, which feeds on beans,will multiply in wet, moist weather, when the plant is drooping,but a few fine sunny days will invigorate the plant, and the aphisdisappears, to re-appear in the coming damp. He believed Mr.Hunt was most correct in urging the vast importance andnecessity of constitutional treatment in diseases of the skin, forthe same disease will occur in different conditions of the body,and the only rational mode of procedure was to treat the con-ditions. He thought Mr. Hunt had done great service in point-ing out how much cutaneous affections depended upon the generalhealth, and how important it is to treat them accordingly.

Dr. WILLSHIRE complained of a want of definitions, but stillhe understood what Mr. Hurt meant. He approved of constitu-

tional treatment, but thought it necessary that it should becombined with local. He as not accustomed to regard disease

: as a mere accident or deviation ; and he referred to papers hehad published on the subject, tending to show that disease wasan entity, that it depended upon the decomposition of the organic

. cellules which formed a part of another animal, and the disease