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System of Parochial Medical Relief," asagreed to by the Council;"* that the Com.missioners had given the most serious atten-tion to the representations made to them byThe Depntation, and that while they fearedthat, for the most part, grievances were nowiartmediable, they had expressed their ear-neat desire to adopt, for the future, aach a ,

system as should secure the profession fromjust causes of complaint, and provide thebeat medical attendance for the poor. Tothis Report was appended a letter, whichbad been received by the President, and ofwhich the following ia a copy. viz.:—

" Sir,—The Poor-Law Commissioners begleave to acknowledge the receipt of the Report nnd Plans for an Amended Systemttf Medical Relief to the Poor,’ which havebeen transmitted to them by you, on behalfof the British Medical Association.

" As the Commissioners intend to reportshortlr, to the Set retary of State for theHome Department, their opinions on the sub-ject of medical relief, they do not think it

necessary to say more at present tbxn thatthey will give to the suggestions of the Bri-tish Medical Association their most attentiveconsuipration.

" The Commissioners, however, take thisopportunity of expressing their sense of thecandid and satisfactory manner in which the’fiews of the British Medical Associationwith reapect to medical relief, have beenbrought under their notice by the Deputa-tions of that body which they have latelyhad the honour of receiv ing.

" Signed by order of the Board," H. W. PARKER, Auist, Sec.

" George Webster, Esq., M.D., Presidentof the British Medical Association."

Two letters were considered which hadbeen received from the President of theStroud Branch of the Association, on thesubject of the Yoor-Law ; and requestingthe opinion of the Cuuncil on the case of an illegal practitioner in that district, Hhichhad been aubtnitted to him. The necessaryMtfurmanon was directed to be communi-cattd by the President.

Letters from llr. Fowke, on the illegalpractice of medicine, and from Mr. Atten-burrow, of Nottingham; from Mr. Edmonds,of Kinton ; from Hr. Taylor, of Kingston ;from Mr. Ralph, of Saling ; and from Mr. M Leod, of Okehampton, on the subject of thePoor-Law, %%ere then read end considered.

It was moved bv Dr.GRANVILLE, secondedby Dr. HULL, and resolved unaoimouslr,—" That a letler be addressed to Mr. Wakley,M.P., with a request that he will take anearly opportunity of asking Lord John itus-sell, in Parliamea’, whether it be the inten-tioo of Government to publish, in the courseof the present session, the concluding part of

* To be published in Tu LANCRT of next week.

the evidence taken before the Medical Com-mittee of 1834, which was long sioce orderedby the Honse of Commons to be printed, andwhich his Lordship had led a Depatatioa ofthe British Medical Association, who hadthe honour of waiting npon him in 1838, toexpect would be forthcoming without unne.cessary delay : it being essentially necessaryto the full and effective consideration of thepresent state of the medical profession inthe United Kingdom, and to the reform ofthe manifest abuses existing therein, that theevidence in question, obtained at so muchexpense and trouble by the Legislatureshould no loner be withheld from thepublic."A report having been received from the

Finance Committee appointed to conduct theexpenditure in the lection of Mr. Wakleyas Coroner for Middlesex, aud it havingappeared therefrom that the expenses in-curred had, in consequence of the vexa-

tious opposition of the non-medical can-

didate. greatly eveei-dpd the amount hithor-

to subscribed, the Council strongly recom-mended to the consideration of their medi-cal brethren, both in the metropolis andthe country, the propriety of incTeasing thefund commenced by the Council for the pur-pose of security the election of a MedicalCoroner, free from expense to him ; and inorder to promote this desirable object Messrs.Davidson and Farr were appointed as a De.putation to confer and arrange with theFinance Committee on the subject, with aview to collecting suflicient funds to preventthe expense falling to so large an amount onMr. Wakley.The heada of a Parliamentary Bill, which

had been drawn up on the report of the Sub.committee appointed to consider the ques.tion of a Tripartite Natiunal Faclilty ofMedicine, were presented, but the considera.tion thereof was referred for the present to

’

thl’ Sub-committee.The meeting was then adjourned.

MEDICAL SOCIETY OF LONDON.

Monday, April 1st, 1839.DR. L. STEWART, President.

CURE OF CONGENITAL CLUB-FOOT.

DR. KRAUSS was induced to send a paperto the Society on club-foot, in consequenceof some ohsenations made to the memberson the subject by Dr. Little, in which hementioned a case of congemtal varus, thecure of which he considered doubtful. Dr.Krauss is of opinion that the anatomy of thisdeformity is intimately connected with itacure, and beiieves, in opposition to Scarptand Dr. Little, that the di3placf’meut of theastragalus is one of the principal and mostcbaracttristic symptoms of varus. Theascertainment of lhia displacement, whether

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it be of a primary or a secondary origin, washighly important, as on it were founded thetwo principal conditions of the mechanicalinstrument employed in its cure. With alldeference to the merits of Dr. Stromeyer, he(Dr. Krauss) did not consider the methodsand principles of that physician’s practiceto be so perfect as not to admit of improve-ment. Regarding the Stromeyerian methodof dividicg tendons with two punctures ofthe skin, and with a concave or convex

fistula knife, Dr. Krauss observed, that theconvex knife could be used with advantage,only when the tendon to be divided was pro-minent, the skin covering it not too thin andtight, and the part to which the tendon wasattached of small volume. If the tendonwas not prominent, and more of a flat thanof a rounded shape, it was difficult toencircle the tendon at once by a concaveknife, and thus it was often preferable touse a short convex knife, with a straightback, if it was possible and required to

press down the skin on one side of the ten-don, in order to introduce the knife deepenough to pass through the whole of itsbody. Although it was of no particularconsequence to make two punctures of theskin, yet, as the operation could be moreeasily performed by making one puncture,the former method need not be adopted.Dr. Little sometimes used a convex, some-times a concave knife, for the purpose ofdividing the tendo Achillis. Dr. Kraussconsidered that a concave knife was notconvenient for that purpose, because thefront surface of the tendon was flat, and itsposterior surface convex ; and, again, in di-viding the tendon, even with a convex knife,the part of the tendon corresponding withits greatest convexity becomes divided thelast. Dr. Krauss also objects to the modeof introducing the knife flatways, and thenturning its cutting edge towards the tendon,for he says that by this proceeding the partsare apt to be injured by the turning of theblade of the iustrument. It was inconve-nient to place the patient in a chair whenthe tendo Achillis was to be divided, inas-much as the back surface of the leg was notbrought towards the face of the operator,and it was, therefore, impossible to make anaccurate examination either during or afterthe operation. In proof of the justice ofthese remarks, Dr. Krauss referred to thefourth and fifth cases of Dr. Little, recordedin THE LANCET, in which it was necessaryfor the operations to be repeated;’ in conse-quence of some fibrous strings remainingundivided by the first operation.The mechanical part of the treatment of

cluh-foot was by far the most important anddifficult. He (Dr. K.) considered that the

. footboard of Stromeyer was deficient, as it

possessed no proper means of fastening thefoot, or of straightening the curve which

fixed pressure, and did not admit either ofthe patient’s walking or standing.

Dr. Krauss insisted upon the necessity of _distinguishing accurately between congesi.tal and non-congenital varus. In the latter,as the displacement and change of shape ofthe tarsal bones did not arrive at such ahigh degree; as the ligaments were looser,and as the deformity was almost maintainedthrough the contraction of certain muscles,it followed that the cure was, in general,possible, up to the age which permitted thedivision of tendons; while, on the contrary,the cure of congenital varus depended notonly upon the age and constitution of thepatient, but also upon the degree of dis-placement and change of shape of the tarsalbones, and the degree of the rigidity of theligaments.Dr. Krauss considered that bony vegeta-

tions did not often prevent the cure ofvarus; the articulating surfaces, it was

true, had partly lost their polish, and wererough, but the efforts of nature powerfullyassisted in polishing them again after thestraightening of the foot had been effected.Indeed, he believed that there were fewcases of congenital varus previous to theage of thirty which did not admit of cure.The cases of congenital varus cured byStromeyer, and related in his recent publica-tion, referred to children of one, two, andfive years of age, only one as late as theninth vear being recorded. and in this the

deformity existed only in a slight degree.In the case of congenital varus, presentedby Dr. Little to the Society, at the firstmeeting of the session, as the most difficulthe had cured, the foot assumed its naturalshape in eight or nine weeks after the divi-sion of the tendo Achillis, and was, there-fore, evidently a case of a slight kind. Themeans of curing aggravated cases of conge-nital varus consisted in a proper mechanicaltreatment, for which purpose the instru-ments of Stromeyer were insufficient.

Monday, April 8th, 1839.DIVISION OF TENDONS.-CASES OF SUDDEV

DEATH.

Mr. BRYANT inquired whether Dr. Krausshad had the opportunity of examining anytendons after division in the human subject;and if so, what was the nature of the inter-mediate substance!

Dr. KRAUSS had never had such opportu-nity. He had, however, made a variety ofexperiments on rabbitslaud other animals, andhe had found that the uniting substance wasof a fibrous texture, the fibres running ratherin a transverse than a longitudinal direction,and forming a structure quite as strong asthe tendon itself. He had often found thatthe intermediate substance was of muchlarger volume than the tendon. In one case,in the human subject, in which he had di.

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vided the tendo Achillis, inflammation of of the pulmonary artery was larger than Ga-the intermediate substance, of an acnte cha- tnrat, and would admit three Ingen. Theraeter, set in three or four weeks after the ventricle, also, was a little dilated, Theoperation. The new structure was, by this lining membrane of the aorta was of a darkmeans very much thickened; the thickness brick-dust colour, and had the appearancetns eventually considerably, though never of having been dyed. The intestines wereentirely, reduced. In another instance he darker than usual, apparently from the fluidhad felt the new tendon to be very hard to state of the blood. The viscera were allthe touch, as though there was a deposit of healthy, with the exception of the cardiaccartilage in it; and, in another case in which extremity of the stomach, which had a lividitnammation and suppuration followed the aspect. This viscus, although much dis-division of the tendon, unioneventually took tended with flatus, was found empty on anplace, but it was three months before the incision being made into it. The mucouslimb could be exercised. membrane appeared rather softened.

Mr. BRYANT said that the experiments Mr. Crisp said that the only morbidjust alluded to differed in their results from changes detected in this case being a verythose of Sir A. Cooper, who had found that unusually fluid state of the blood, a flabbydivided tendons invariably united by bone. condition of the heart, and the dilatation of

Dr. KRAUSS replied, that as far as he the pulmonary artery, he was at a loss to

knew, in the experiments on the division of know the cause of death. He had little

tendons, made by various continental opera- doubt, however, that it resulted from a

tors, bony union did not follow. change produced in the blood, but uponwhat that change depended he was at a loss

SUDDEN DEATH. to imagine. He had never before seen so

Mr. CRIsp related a case which hnd occur- peculiar a state of the integuments, which,red in the practice of a surgeon in the Ro- on being cut into poured out blood as is therough, who, on being called to a patient in case during life.the neighbourhood, found him dead. The Dr. JOHNSON thought the case related waspatient in question, 43 years of age, had one of ’ petechia hemorrhagica," and thatbeen a strong, healthy, temperate man. He the patient was suffocated by the engorge-had a day or two before his death complained ment of the lungs. He had seen a case of

of being a little feverish, and of a slight this disease in a young healthy man, who,soreness of the throat. He was better, how- forty-eight hours before death, had not aever, on the day in the night of which be symptom of disease. He ate a hearty sup-died, went about his usual employment as per at night; the following morning he wasan ostler, played with his children in the covered with spots and stripes of a dark

evening, and went to bed apparently well. colour over the entire surface, and blood

After he had been in bed a few minutes his flowed from the outlets, from the chest,wife perceived he breathed very laboriously, stomach, intestines, and bladder. In this

and in the space of a few minutes he died. case the lungs were gorged with dark fluidExternally the body was plump and muscu- blood, and every membrane of the body waslar, being beautifully developed ; the face, spotted with black patches. head, and shoatdert were of a livid hue, Dr. BENNETT was inclined to attribute the

some parts presenting a mottled appearance. sudden fatality in Mr. Crii;p’s case to

Small patches, of a purptish colour, were functional disease of the heart. He had

visible on various parts of the skin ; these related a case early in the session in whichwere, however, much less distinct than they a man who had been the subject of anginahad been when the body was warm; they pectoris died suddenly ; and in this instancewere then red. A quantity of bloody mucus the only appearances observed were, an un-flowed from the mouth. usually flabby state of the heart, a fluid con-

Exaesination internally, thirty-sir hours after dition of the blood, and the same stain ofExamination internally, thirty-six hours after integuments as was observed in Mr.

Death. Crisp’s case.The brain and its membranes were heal- Mr. BRYANT thought that the sudden

thy, the vessels not being so turgid as in death depended upon the flabby state of theother parts of the body. The lining mem- heart; that organ, from some unknownbrane of the trachea was very red and co- cause, having been suddenly incapaC"1tatedvered with bloody macus. On dividing the from performing its office. He recollectedinteguments of the thorax, blood flowed the case of a medical man who died veryfrom the surface, the lungs were gorged with suddenly, while in apparently excellentfluid blood, of a colour not so dark as usual; health ; in this instance the only morbidthe pericardium presented a healthy appear. appearance was an unusually flabby state

ance ; there were about two drachms of fluid of the heart, with a fluid state of the blood., initseavity. The heart was of natural size, Mr. PILCHER thought that in Mr. Crisp’s

but very flabby ; a small quantity of dark case death might have aritea from the effu-

. Suid blood was (ouad in both auricles; all sion of bloody the bronchial tubes producingthe valves were perfectly healthy. The root suffocation. It might, however, have de-

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pended upon a flabby condition of the heart.This organ, when softened and flabby, as inthe eases related, might go on performing itsfunctions tolerably for a long period ; but onthe occurrence of some cause calling on itto do more than usual, death might ensue.It was exceedingly necessary in cases ofsudden death to examine all parts carefully.He had lately inspected a body, in which amedical man, under a coroner’s order, hadonly been able to find some mucus in thebronchi to account for the sudden death.He, Mr. P., had found that suffocation hadbeen produced by enlargement of the tonsils.

After a few words from Messrs. Linacre,Procter, and Kingdon, the Society ad-journed.

WESTMINSTER MEDICAL SOCIETY.

Saturday, April 6th, 1839.

THE Society was occupied this evening by the relation of some cases in which mes-meric 11 manipulations" had been performedon several " young ladies." The relationof the absurdities connected with this hum-bug kept the members in a roar of laughter,and altogether the atfair was " as good as aplay."

This evening (Saturday) will be holden aspecial general meeting to consider mattersof great importance to the welfare of theSociety.

SUFFOLK LENT A S S I Z E S.

Tuesday, April 2nd, 1839.

ACTION AGAINST A CIJRATE FOR DESTROYING

THE LEG OF A CHILD BY AN ATTEMPT TO TREAT

IT MEDICALLY. ,

THE following case is reported in theBury Poat of April 3rd. Sir JOHY VAUGHAN

presided in Court :-GLADWELL r. STEGGALL.

This was an action brought for the impro-per medical treatment of the plaintiff, who,being an infant, sued through Mr. White,surgeon.Mrs. Gladwell, of RattIesden, stated that

the plaintiff, her daughter, was aged nearly10 years; the defendant is a surgeon and

clergyman ; he keeps a little shop; he attend-ed the family of witness previous to thisoccurrence, and witness had paid him forattendance ; he attended females in theirconfinements, drew teeth, &c. -On Friday,the 23d of March, 1838, her daughter com-plained of pain in her leg and knee, and wit-ness called in the defendant. Witness neverheard her complain of any accident; de-fendant pat her foot on his knee and exa-mined her; he asked for some vinegar, bot

witness had none ; he then called for somecold water, and he afterwards had about 4yards of calico; he then asked for a bookcover, and an old cover of a Biblf was cut inhalves ; he put one on each side of the ankle ;before he put it on he wetted the leg withcold water and also the cover. He theu boundit up and told witness to send down for somelotion to bathe it with. He said it was afracture, and that the ankle-bone " stoppedout," and went in again, and dislocatedthree little bones on the top of the foot. Wit-ness received the lotion and kept the placemoist, according to defendant’s direction;the leg that night appeared inflamed, andthere was more pain. When witness put onthe wash, steam appeared to come from theleg, and the child appeared as if her senseswent away, and she said she felt worse.The lotion was applied many times duringthe night. Both witness and her husbandsat up all night and applied the wash; itdried up very fast. The defendant came onSaturday, undid the binding, and desiredwitness to get some new calico, as the oldwas not strong enough. With the new calicohe bound up the foot, keeping the cover on.The child told him her leg was very full ofpain, and seemed getting worse. He stayedabout half an hour. On Sunday witnessloosened the bandage down part of the leg,which appeared to give very little relief;her senses were almost gone. On the Sun.day the leg was much swelled ; defendantundid it, and applied the wash, and did itup as before, and expressed his surprise atseeing it in that state. He did not then saywhat was the matter. ’The child once calledout" Oh!" and Mr. Steggall said that heshould call out, for it was such a fracturethat the child must know how she did. Shereplied that it was only a pain in the knee.On Monday defendant undid the bandage,and there was a large blister on the insideankle, and three blisters on the top of thefoot. The book-cover laid over the largeblister ; he took a lancet out and pricked it;some matter followed ; about a teaspoonfulcame out. The leg was very much swelled.He ordered the ankle to be fomented, and apoultice to be applied were the blister was.Witness afterwards had some powders andmedicine from the defendant. Poulticeswere applied about three times a day ; theleg got worse and worse, and the bone keptparting away, quite visible, decayed ; thedischarge was as much as a teacupful at a

time when-she dressed the leg, and the childgot weaker and weaker. On the MondayMr. Cottingham called with the defendant,and saw the leg, and witness was directed touse a poultice of bread and turnip, and togive wine, with a powder. Witness beardthem say it was a serious case. To the 18thof April, the child grew worse, and she ap-peared as if she could not live. On that day

her husband sent for Mr. White, of Gedding,