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first, in the air, in the form of impalpable particles; secondly,in contact with articles of food; and thirdly, and principally,in the drinking-water of infected places.

" 6. That these organisms may probably be preserved for along time in the air, with their powers unimpaired; but thatin water, which is, doubtless, the chief vehicle for their diffu-sion, they soon undergo decay, and moreover-sharing in thisthe common fate of their tribe-become the prey of beings ofa higher order.

" The conclusions, taken together, enable us to account forall the chief phenomena of the disease. They lead, besides,to practical references of the utmost importance. By actingupon this knowledge now, although we may not be able atonce to ’stay the plague,’ we may yet much abridge itssojourn among us.

" The means by which this mitigation may be accomplishedare obvious. The objects they include are these two:-

"1. To destroy, from this time forward, all the poison whichcontinues to be generated in the bodies of infected persons;and 2. To prevent, as far as possible, the poison which hasalready escaped us from taking effect."The first of these objects may be attained by the simplest

means. All that is required, in fact, is to receive henceforththe discharges from the sick into some chemical fluid knownto be fatal to beings of the fungus tribe.

" Nothing more is necessary than to choose among theseagents the cheapest and the most convenient. I content my-self merely with suggesting, that the solution of chloride ofzinc possesses strong recommendations, if it should be found,as I believe it would, effectual for the end in view.

" The second object, that of preventing the poison which hasalready been cast loose from taking effect, is more difficult toaccomplish. But for this, too, a great deal may be done.

" As water is the principal channel through which thispoison finds its way into the human body,-a fact already esta-blished by the researches of Dr. Snow, and of the discovery ofwhich he must have the whole merit,-so is the procuring purewater for drink the first and most effectual means of prevent-ing its action.From this day forward let the people of infected districts be

supplied with water from healthy quarters or from sourcesbeyond the reach of contamination; or if this be not feasible,let steps be taken to rid the water they are compelled to drinkof the deadly poison it holds. This might be done by verysimple means. It is more than probable, even, that the act ofboiling would suffice; but if boiling the water should not suc-ceed, it might be distilled rather than fail." To no part of the community is the need of an immediate

supply of pure water more urgent than to the immense float-ing population of the port of London. At present the crewsof vessels in the most tainted parts of the Thames draw upfrom it, in buckets, their daily supply of water, which theycommonly drink without any other purification than thatwhich it undergoes by a few hours’ standing.

" The importance of preventing the disease in sailors will bemore apparent when we reflect on the unquestionable fact thatships are great instruments for its diffusion.

" I am, Sir, your obedient servant," WILLIAM BUDD, M.D.Physician to the Bristol Infirmary."

Medical Societies

MEDICAL SOCIETY OF LONDON.

MONDAY, SEPTEMBER 24, 1849.—Mr. HIRD IN THE CHAIR.

THE Society held the first meeting of this, its seventy-eighthsession, this evening. In the absence of the President, Mr.Hancock, Mr. Hird presided.

LEMON-JUICE AND ACETATE OF POTASH IN RHEUMATISM.

Dr. THEOFHiHJS THOMPSON, in reference to a discussion atthe last meeting of the Society, in which it was stated thatlemon-juice and acetate of potash were identical in theirmode of action in rheumatism, related the case of a gentle-man who, whilst taking acetate of potash for effusion intothe pericardium consequent upon pericarditis, was seized witharticular rheumatism; this increased in severity so long asthe medicine was continued. The urine contained a largequantity of lithates; the heart symptoms abated. Lemon-juice was substituted for the potash, and in a few hours allthe rheumatic symptoms had disappeared, the urine havingbecome copious and clear. The case illustrated the fallacyof founding a theory on a few cases.

-

Some discussion took place, and some questions were an-swered by the narrator of the case in explanation. He shouldtrust to lemon-jnice only in such cases where the constitutionwould not bear stronger remedies.Mr. HARVEY read a paper on

RHEUMATIC DISEASE OF THE EAR.

His attention was first directed to the subject by observingthe effect of rheumatic inflammation on the tissue of the eye,and from noticing, in many cases of ear disease that cameunder his care, the presence of articular rheumatism, whichinfluenced, either directly or indirectly, the ear disease, therelief of one, for instance, being followed immediately byaggravation of the other, &c. Believing, from observatior,that many such cases were made worse, and even irremediable,by mistaking the cause of the disease, and by the applicationof stimulating remedies, he determined on investigating thesubject. The result has been, that in a great number of caseslie has been able to trace the connexion of the ear affectionwith rheumatism of the system generally. In the eye, thesecondary attack has been usually found to come on after thesystem has been well saturated by the poison of the disease;but the ear may become affected early, the parts first impli-cated, as in the eye, being the fibrous tissues, and subse-quently, the nervous expansions. The disease exhibited itselfunder two forms-the acute or destructive, and the chronic orinsidious; both, when neglected, tended to impair the sense ofhearing; and the former, to the entire destruction of the organ.The acute form generally attacked males, and was connectedwith articular rheumatism; the chronic was more frequent infemales, and was associated with rheumatism of the muscularsystem. The symptoms of the acute form of the disease, towhich the paper was restricted, are, that the attacks areparoxysmal, usually following a seizure of articular rheumatism,tinnitus aurium, resembling the pumping of a steam-engine orforge-bellows,and generally abenumbed sensation over the tem-poral and mastoid regions. This was the part chiefly implicatedin the disease, which, if not speedily relieved, ended in the ex-foliation of the bone. Some cases were detailed by Mr. Harvey;in one, the patient was a strong, robust man, in whom the attacksupervened on a severe rheumatic affection of the joint, which.had been treated’ actively. On the entire subsidence of thejoint-affection, the left ear became the subject of severe pain;there was a benumbed sensation over the temporal and mas-toid processes, accompanied with a heavy, deep tinnitus.There was considerable tenderness over that portion of head.The meatus was much swollen, in consequence of the applica-tion of hot and stimulating remedies. He had difficulty inswallowing; the left tonsil was much enlarged. He wascupped and leeched over the mastoid process, and placedunder the influence of mercury with colchicum. This waspursued for ten days; the tympanum could now be seen; itwas of a brownish-red colour, and had lost its transparency.The pain had diminished in intensity, but the tinnitus con-tinued ; he had occasional flying pains about the joints. Painand tenderness continued over the mastoid process, andthough no fluctuation could be detected, an incision wasmade over the part down to the bone. Relief followed -he slept better. Colchicum, with quinine, was given, andthe patient recovered, though for twelve months his hearingwas somewhat affected. The second case was of a similarcharacter, but owing to the obstinacy of the patient, a female,who refused to allow of any incision being made over themastoid process, the structure of the ear was destroyed, andthe bone exfoliated, notwithstanding active and judiciousmeans were used to prevent it. The third case was one as-sociated with cardiac inflammation, which ended fatally; theear disease, under the treatment pursued in the first case,was but little benefited. In concluding his paper, the authorlays great stress on the necessity of the incision over the seatof pain, and considers, that in the second case, that proceeding,if adopted, would have been as beneficial as in the first. Insome remarks on colchicum he says-" It appears to me thatcolchicum may act chemically by producing some change inthe urinary and alvine secretions, both of which it tends to in-crease in quantity and alter in quality; and secondly, it actsparticularly upon the nervous system. If given in large doses,it should be carefully watched as to its effects. It should notbe given in a weakened constitution without either a tonic oran opiate, and it is better to have the bowels freely acted uponat first. I have found it extremely beneficial to continue itsuse internally for a lengthened period, in small and repeateddoses, in chronic affections of the ear presumed to have arisenfrom rheumatism. I have found it by no means beneficialwhen it produces nausea, vomiting, or purging, and more par-

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ticularly beneficial when the skin secretes freely: the prepara-tions I place most reliance upon are the wine of the seedsinternally, and the acetous extract, combined with spermaceti,as an external application." He usually administered thecolchicnm wine in small doses, such as five or six di’ops, at:first, in chronic cases, continuing the remedy for a long period.He conjoined it with a bitter infusion. In acute cases he

gave half a grain of the acetous extract, with two grains ofcalomel, three times a day, till ptyalism was produced,

Dr. CRisp suggested that incisions similar to those employedby Mr. Harvey in the cases detailed might be attended withbenefit in cases of ear disease supervening on scarlet fever, inwhich the symptoms resembled those described in the paper.Dr. COPLAND said Mr. Harvey had fully proved his case. He

(Dr. Copland) had seen cases in which the ear had sufferedfrom acute rheumatism, so that the patient could not rest uponhis pillow: this attack had supervened on rheumatism of theface and head. The patient was treated by alkalies, sarsapa-rilla, and iodide of potassium, and did well; no deafness re-mained. He knew the case of a lady who had been the sub.ject of a more chronic form of the disease, and in whom theear attacks alternated with the joint-affection. She was nowdeaf. The cases were not uncommon. He made some re-marks on the mode of administering colchicum employed byMr. Harvey, which he considered judicious. Some couldscarcely bear any dose of colchicum, and it was better to beginwith a small dose, combined with an alkali or a bitter, quinineor camphor. The bowels should be first purged.In reply, Mr. HARVEY said that he believed, with Dr. Crisp,

that incision in otitis, primary or secondary, would be bene-ficial, and in many cases save exfoliation of the bone.

INFLUENCE OF COLCHIOUM ON LONGEVITY.

Some remarks were made on this subject by several speakers,Dr. CRISP, Mr. HuNT, Mr. ROBARTS, and Dr. COPLAND. It wasadmitted on all hands, that whilst colchicum, in proper doses,when administered with care, and under the watchful eye of amedical man, was a valuable remedy, and not only relieveddisease, but in reality prolonged life; that its injudicious employment, its too long continuance and frequent use, its em-ployment in constitutions unsuited to it, and particularly as itwas recommended in some of the quack nostrums, was notonly injurious, but destructive of life.

Reviews.

Researches on the Development, Structure, and Diseases of theTeeth. By ALEXANDER NASMYTH, F.L.S., F.G.S., andM.R.C.S. London: Churchill. 8vo, pp. 230.

THIS is an admirable work, and worthy of our warmest re-commendation. Totally different in its character from thosepuny compilations which are put together for the mere pur-pose of an advertising medium, we find here the results of alaborious philosophic and practical inquiry, by which theboundaries of knowledge are extended, by which human suf-fering may be relieved, and by which the character of theprofession to which the lamented author belonged will be Ielevated. It is greatly to be deplored that he did not live toenjoy the fruits of his zealous, and, it is to be feared, tooearnest labours, though the fatal illness to which he fell avictim did not arrest his labours until he had completed themanuscript of this work. We find that it contains eleven

.chapters. The first is devoted to the general physiology ofthe dental system; the second gives an admirable descriptionof the anatomy of the mouth and jaws; the third and fourthchapters include the descriptive, general, and minute anatomyof the teeth; the fifth comprises the development of the for-mative organs of the teeth; the sixth contains the minuteanatomy of the dental capsule and pulp; in the seventh

chapter, the development of the permanent teeth is described;in the eighth chapter the teeth are considered as a test ofage; and, in the ninth, as an indication of the progressive im-provement of the human race. The much debated questionof the mode of development of the ivory is discussed in theninth chapter; whilst in the tenth and last chapter, the che-mical composition of the teeth is given. Illustrations onwood and stone, admirably executed, greatly enhance the

value of the text. The following extract will convey someidea of the variety of topics which are here treated, and ofthe mode in which they are discussed."On the structzcre and de2elopnzent of that portion of the epi-

thelium which li7ies the cavity of the mouth. In the foetal subject,previous to the extrusion of the teeth, it forms on the alveolararch a dense projecting layer, distinguishable from the sur-rounding membrane by its whiteness, and by. the existenceon its surface of ridges and sulci, having a waving course anda variable direction. The alveolar epithelium is thicker inproportion to the youth of the subject examined. It is mostprominent where it corresponds with the molar teeth; its in-ternal surface is concave, receiving the projecting mucousmembrane. This disposition presents various objects for in-vestigation. Firstly, as regards its composition: it is made upof a mass of scales, lying one on the surface of the other. Thisdisposition shows that the terms dental cartilage,’ or the‘ cartilage of the gum,’ which have hitherto been applied tothe structure, give an erroneous idea of its true nature, forcartilage always presents the corpuscles discovered and de-scribed by Purkinje. As in other portions of the epithelium,the external scales here are the larger, and this holds goodgenerally, until we come to the surface of the vascular mucousmembrane, which presents simple cells with their corpuscles.In the interior of this alveolar epithelium, where it corre-sponds to the molar teeth, small vesicles may be frequentlyobserved, varying in size from one-fourth to one-eighth of aline in diameter. They appear to the naked eye to be trans-parent ; under the microscope their parietes are found to con-sist of attenuated scales, and their cavity to contain a fluidabounding in minute granules and cells.* The internal sur-face of the epithelium, covering the alveolar arch, frequentlypresents concavities or indentations, which are from a lineand a half to three or four lines in circumference; they corre-spond to projections from the mucous membrane, formed by alarger species of vesicle. The latter is deeply implanted inthe vascular mucous membrane. The parietes of the vesiclesare composed of a very delicate membrane; they contain atransparent fluid, which coagulates on the application of heat,or acid, or on immersion in spirit; and in this fluid float nume-rous globules and scales, similar to those of the epitheliumgenerally. The internal surface of the alveolar epitheliumalso presents numerous fringed processes, measuring from oneline to one line and a half in length, and half a line in breadth,which sink into the substance of the subjacent mucous mem-brane ......... Although it contains no bloodvessels, theepithelium receives its nutrition from the blood circulating inthe capillary vessels of the mucous membrane, and it followsfrom this circumstance, that if from any cause the blood shouldbecome morbidly altered in its qualities, the epithelium winsuffer accordingly. Many of the appearances which the sur-face of the tongue presents under the influence of disease, andwhich offer to the medical practitioner so valuable a guide to

diagnosis, are in reality nothing more than alterations in theepithelium, resulting from vascular changes in the papillse ofthat organ. In like manner the dental practitioner becomesfamiliar with morbid states of the epithelium of the mucousmembrane of the alveolar arches and gums."Valuable practical suggestions like that comprised in the

concluding paragraph abound throughout the work, andrender it not only interesting from its general character, butpositively and practically instructive to all engaged in thehealing art; whilst to those who practise that branch towhich the author belonged, we consider the work to be asessential as it must be a valuable acquisition. Mrs. Nasmythmerits the highest praise for the very judicious manner inwhich she has performed the melancholy duty of placing thework before the profession.* The vesicles here alluded to are most probably those which Serres de-

scribes as glands for the secretion of tartar : they are very numerous, evenafter the extrusion of the incisor teeth of the calf, and are seen with greatfacility internally.

QUEEN’S COLLEGE, BIRMINGHAM.—In a late report of theCouncil of this College it was stated, that within the periodcomprised between the 1st of October, 1848, and the presentdate, eighty students have been registered, of whom the follow-ing presented themselves at the matriculation examination inJuly last, at the University of London, and passed : In thefirst class : Cantrell, Franks, Mitchell, Coleman, Lambert,Smith.-In the second class: Chatwin, Earle, Vincent, Wil-liams, Cockerill, Fox, Waller, Day, Turner, White.