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cataract never existed, and soon after, as if to spite him, one ofhis colleagues extracted one. Several cases had been recorded,all presenting similar appearances. He might refer to thosefound by Stallwerg, and taken from the dead subject, in whichmultitudes of black granules were found interspersed betweenthe fibres of the lens and in the substance of the fibres.Another, as examined and exhibited before the Society Biologiê,in Paris, by Blot, had the same characters as those beforereferred to. The case of his colleague was diagnosed as hardcataract, with white striae in the circumference. The patientdid well, and the sight is good.Mr. POLLOCK mentioned a case confirmatory of what had

been already said. It was in an old general officer, and hadbeen seen by him and by the late Mr. Dalrymple; but theophthalmoscope was not then known, nor the use of a stronglight, but all the symptoms of cataract were present. Thepatient could see better in the dark than in a bright light.The case was one that did not admit of operation by extrac-tion, attacks of chorea being frequent, but depression was per-formed, and he got good vision. Mr. Dalrymple said it wasthe only case of black cataract he had ever seen.The PRESIDENT called Mr. Walton’s attention to the micro-

scopical appearances mentioned by Mr. Dixon.

MEDICAL SOCIETY OF LONDON.

SATURDAY, DECEMBER 8TH, 1855.DR. SNOW, PRESIDENT.

PROLAPSUS OF THE WOMB.

Mr. BAKER BROWN related the case of a young woman, agedtwenty-seven, who had suffered from the worst form of thisdistressing affection for three years and a half, which hadcome under his care in St. Mary’s Hospital. It appeared fromher history, that the perinæum had been ruptured six yearspreviously, up to, but not through, the sphincter; and thatalthough she had worn every kind of pessary and bandage, theprolapsus had increased, until the womb and bladder and entirevagina completely extruded. He (Mr. Brown) performed hisplastic operation on this patient with most signal success; hemerely mentioned this case that he might lay claim to havinghimself originated this operation, and he hoped shortly toplace before the profession very many cases of a similar kind.

Dr. GIBB attributed the success of Mr. Brown’s operation tothe formation of the bridge or cushion at the outlet, bywhich the perinæum was strengthened. He had seen the ope-ation performed in France, where it was not always successful.The great point of success in Mr. Brown’s cases was the depthto which he placed his quill suture; in unsuccessful cases, thesuture had been more superficial.

Mr. DENDY considered the success of these operations inMr. Brown’s hands depended on his strict attention to theminutiae of the operation, and to his careful after-treatment.

Dr. MACKENZIE read a paper on

FUNCTIONAL DERANGEMENT OF THE LIVER AS A CAUSE OFUTERINE DISEASE.

The author began by drawing attention to the importance ofstudying the constitutional origin of uterine diseases, believingthem to be far more frequently dependent upon constitutionalthan local causes. In a series of papers published by him in1852, he had dwelt upon the origin of uterine disease from dis-turbed states of the nervous system, when the exciting causemakes its impression upon the nervous centres, such as settled grief or anxiety, and impoverished or unhealthy states of theblood. He now proposed to resume the subject by consideringanother mode in which the nervous system might be unfavour-ably impressed, and uterine disease equally result-viz., fromsevere or persistent disease or derangement of any of the moreimportant organs of the body; and as none illustrated theprinciple more fully than the liver, both from its extensivesympathies ana great liability to disorder, he had selected itas the subject of the evening’s paper. Having indicated thegeneral influence exercised by the liver upon all the processesof health and disease, he referred to its special influence uponthe uterus, founded upon the intimate sympathy subsistingbetween these organs, &c., and showed, from statistical data,how frequently derangements of these organs co-exist. Con-

trary, however, to prevailing opinions, the facts he had collectedclearly proved that the hepatic disease generally preceded, andprobably occasioned, the uterine, when both co-existed. Hebelieved that it might do so in the three following wavs : first.

F through the medium of the direct sympathy subsisting betweenthe uterus and the liver; secondly, through the derangement! of the assimilative processes, which invariably results from. chronic hepatic disturbance : and, thirdly, through the debility

of the nervous system, which sooner or later inevitably followsupon long-continued derangement of any important organ ofthe body. From the first of this series of causes could be de-duced many uterine affections of a variable and casual cha-racter, such as hysteralgia, leucorrhœa, and menstrual irre-gularity ; from the second, many functional and structurallesions of the uterus of a more fixed and persistent character,such as congestion and inflammatory conditions, indurations,hypertrophies, fibrous growths, certain forms of leucorrhoea, andrheumatic hysteralgia; from the third, a predisposition to uterinedisease generally, the precise character and nature of which wouldvary with the nature of the exciting and other occasional causes.In connexion with this part of the subject, attention wasdirected to the generally depressed state of the nervous systemwhich accompanies the majority of uterine affections, and this,from various facts referred to by the author, was regarded byhim as being rather due to the coincident hepatic than uterinecomplaint. The latter had, however, received greater atten-tion, because, whilst the liver was an organ of dull sensibility,the uterus, on the other hand, had extensive sympathies withthe sensorial parts of the nervous system, and its functionaland structural conditions admitted of the closest scrutiny. Theauthor then proceeded to show how the pathological history ofthe more common uterine affections supported the views hehad submitted to the Society, and concluded by adverting tothe practical conclusions to be drawn from them. The treat-ment of these cases should, in his opinion, be conducted withreference to three principal indications-first, to restore thetone and functional activity of the liver by the perseveringemployment of small, undebilitating doses of mercury, keepingstrictly within the tonic and stimulating range of the remedy;secondly, to improve the assimilative functions generally, bycareful attention to dietetic and hygienic measures, togetherwith various therapeutical means, which were cursorily alludedto; thirdly, to restore the tone and vigour of the nervoussystem, which had been impaired by the long continuance ofhepatic derangement. The general means adapted to this pur-pose were treated of, and the author took occasion to lay beforethe Society some observations upon the remedial powers ofamorphous phosphorus in certain affections of the uterineorgans, attended with weakness and irritability of the nervoussystem. He had given it a large and extensive trial in thesecases, and in some had found it remarkably beneficial. Itcould be given in doses averaging from ten to thirty grains,and, although insoluble, it readily diffused itself in water orany aqueous vehicle, and could be conveniently given in thatway. It appeared to act as a direct tonic or stimulant uponthe uterine system, and when properly prepared could be givenwithout any risk or danger. He had given it with much suc-cess in certain cases of amenorrhoea, hysteria, and passivemenorrhagia. He had known pregnancy to supervene upon itsemployment after a lengthened period of sterility subsequentlyto marriage, and had found it useful in correcting the ten-dency to miscarriage when dependent upon morbid weaknessor irritability of the uterine organs. Under these circum-stances, he thought it worthy of a more extended trial, andrecommended it confidently to the notice of the members ofthe Society.

Dr. RouTH concurred in the general views enunciated in thepaper. He had very frequently remarked the co-existence ofhepatic with uterine disease, and he had found that so long asmeasures were exclusively directed to the uterus little or nobenefit resulted ; whereas, by treating the derangement of theliver, the greatest relief was obtained. He referred to someforms of menorrhagia in which mercurials were of great service,and reminded the Society of the great success which Sir AstleyCooper had obtained in the treatment of uterine disease by thealmost empirical use of small doses of the bichloride of mercurywith tincture of bark. He had found mercurials very usefulalso in the treatment of ulcerative affections of the cervix. Hehad given ordinary phosphorus in small doses with great advan-tage in certain morbid states of the sexual system, and wouldbe glad to know the advantages of the allotropic form. Itseemed to him that the large doses that could be given of thelatter was rather a disadvantage than otherwise.

Mr. I. B. BROWN fully admitted the dependence of manyuterine affections upon derangement of the liver, or rather, hewould say, upon derangement of the chylopoietic system gene-rally, for he believed the liver was not exclusively at fault.He had given the bichloride of mercury, as recommended by

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Sir A. Cooper, very extensively, and he believed it to be the -’best preparation that could be given in these cases. He hadoften seen hypertrophy and induration of the cervix disappearunder its use, and it had exercised a beneficial influence uponcervical ulceration. He regretted that the author had notgiven some cases in illustration of his views, and pointed outthe particular class of uterine diseases which were traceable tohepatic disease.

Dr. GREENHALGH fully supported the opinions of the author;he believed, however, that there was a general derangement ofthe chylopoietic organs in the cases referred to rather than anyisolated affection of the liver. He had tried local treatmentvery extensively in uterine diseases, and had found it to bealtogether useless, and therefore he very seldom resorted to itnow. He entertained extreme views with regard to the specu-lum, which he believed had tended very seriously to damagefemale morality, and considered it ought never to be employedexcept to save life. Since he had almost entirely discarded it,his treatment of uterine complaints had been much more satis- Ifactory. ,

Dr. RoGERS concurred in the general views of the author, andstrongly deprecated the abuse which had lately been made ofthe speculum in the treatment of uterine diseases.Mr. CLARKE thought favourably of the paper, but was op-

posed to extreme views in the treatment of uterine affections.He believed that local and constitutional treatment should becombined, and deprecated the manner in which the speculumhad been decried, feeling sure that, if properly employed, itwas capable of materially assisting us, in many instances, in thetreatment of uterine disease.Mr. HIRD was disposed to approve generally of the views

expressed in the paper, but he would wish to know what par-ticular class of uterine affections were curable by correctinghepatic derangement. He was of opinion that some were notto be cured by constitutional treatment, as, for instance, dis-ease of the cervix. He objected to the doctrine that thebichloride of mercury cured certain uterine affections solelythrough its influence upon the liver, as he had found it usefulin some in which no hepatic derangement existed.Mr. HUNT fully supported the doctrine of the constitutional

origin of uterine diseases, and went so far as to assert that allchronic uterine disease would ultimately yield to constitutionaltreatment perseveringly and judiciously employed. He hadoften remarked how intestinal accumulation simulated or pro-duced some of the worst symptoms of uterine disease, and hadfound them to disappear entirely by the use of purgatives.

Dr. SAM. GRIFFITH agreed in some respects with the opinionsexpressed in the paper; but did not accept all the views of theauthor, because no line had been drawn between the cases tobe treated by constitutional and local treatment. He citedseveral in which the nature of the uterine disease could onlyhave been determined by physical examination, and thereforedeprecated the objections which had been raised to this kindof investigation.Mr. C. CLARK wished to observe that certain cases could

only be clearly made out by the use of the speculum. He had ’,attended one with the author of the paper, in which thegreatest assistance was derived from it.

Dr. MACKENZIE, in reply, would only address himself to onepoint which had been mooted in the discussion-viz., Whatare the specific diseases of the uterus which arise from hepaticderangement ? Now, he never meant to assert that any specificdisease could be so produced, but rather that the liver mightbe the starting-point of many of the more common forms ofuterine disease. It must be obvious that an organ might bederanged through direct sympathy with some other in an ab-normal condition, through a general derangement of the assi-milative functions, and through an impaired state of thenervous system. Now, in each of these ways it would befound that uterine derangement might follow upon hepatic;for no organ sympathized so intimately with the uterus as theliver, none exercised a more important influence upon theassimilative functions, and none had more extensive sympathieswith the vital parts of the nervous system. Hence, throughdirect sympathy, assimilative disorder, and nervous debilitv,the liver might prove the primary cause of many uterineaffections, the precise nature and character of which wouldvary with the nature of various predisposing and occasionalcauses which might otherwise come into play. With re-

gard to the employment of ordinary phosphorus, he (Dr.Mackenzie) had made many trials of it, and it was only whenhe had found it to be a very hazardous and dangerous Iremedy that he had been led to make trial of the amorphous iphosphorus. ,

PATHOLOGICAL SOCIETY OF LONDON.

TUESDAY, NOVEMBER 20TH, 1855.MR. ARNOTT IN THE CHAIR.

DR. SEMPLE presented a specimen ofDISEASED MITRAL AND AORTIC VALVES,

from a young woman, aged twenty-one, admitted under his careat the Northern Dispensary. Ten years ago she had scarlet-fever,and six years after an attack of acute rheumatism. She appliedto the dispensary for amenorrhoea. On examination of thechest, a systolic murmur was perceptible with the first soundof the heart. She frequently suffered from faintings. Dropsysupervened. Only partial relief was afforded. Death soontook place. At the post-mortem examination, the heart wasnot increased in size; the aortic orifice did not close completely.The chief disease existed at the mitral orifice, which was sur-rounded by a ring of ossific deposit.

Dr. BARKER exhibited

A PERICARDIUM WHICH CONTAINED PUS,taken from a man admitted into St. Thomas’s Hospital. Hisbreathing was rapid, from 45 to 50 in a minute; there was ex-tensive dulness on percussion over the cardiac region; at thesame time the sounds of the heart could scarcely be heard; thedulness increased from the left to right of the sternum. Atthe upper part of the chest, for a few inches below the clavicle,there was great resonance, giving an idea of air in the lungs orthe cavity of the pleura. Both sounds of the heart becamegradually deeper over the whole of the left side, and the mandied a week after his admission, and three weeks after thecommencement of the attack. On a post-mortem examinationby Dr. Bristowe, the pericardium was found enormously dis-tended with purulent fluid, amounting to nearly three quarts.There were large adhesions of lymph at the posterior part ofthe pericardium. The lungs exhibited signs of lobular inflam-mation. The cause of death, no doubt, was the great effusioninto the pericardium.

Dr. BARKER also exhibited

HYDATID CYSTS FROM THE LIVER,taken from a married woman, thirty-four years of age, admittedinto St. Thomas’s Hospital. She looked prematurely old. Onexamination, she complained of great pain in the mammas;and she had ceased to menstruate five months before. Shesoon perceived her abdomen to swell, and fancied she waspregnant. She had been tapped one or two weeks before inanother hospital, when two pails of fluid were drawn off. Ova-rian dropsy was supposed to exist. She was again tappedwith great relief, but she became restless, and died five daysafter. At a post-mortem examination by Dr. Bristowe, aquantity of straw-coloured fluid was found in the abdomen;the small intestines afforded evidence of recent inflammation.There was a tumour behind the greater hepatic omentum, anda hydatid cyst, the size of a cocoa-nut, in the lobulus Spigelii.The liver adhered to the surrounding parts and to the posteriorpart of the stomach. The vena porta was flattened andcompressed.Mr. GRAY presented a specimen of

PROSTATIC GLANDULAR TUMOUR,removed from a man, sixty-five years of age, admitted into St.George’s Hospital, in January last, under one of the physicians,for pain in the abdomen, and he complained of difficulty inpassing urine. On introducing the catheter, prostatic diseasewas discovered. Low febrile disease came on while undertreatment for diseased prostate, and he died in eleven days.On examination, a round tumour, the size of a large walnut,was found near the mouth of the bladder. When examined,it was found to consist of fibrous capsule, inclosing a mass thesize of a hazel-nut, with all the characters of the prostategland. The bladder was congested, and its surface coveredwith blood. The ureters, calices, and infundibuli, with bothkidneys, enlarged, and filled with small abscesses. The tumourwas interesting, as bearing some resemblance to some tumoursin the mammary gland. When first examined, it appearedlike hypertrophy of the gland. and protrusion into the bladder.He had examined some cases, and found a distinct tumour pro.jecting into the bladder. There were cases of a similar naturebefore the Society on previous occasions: one by Mr. Shaw, in1848; and Mr. Fergusson relates two cases, in which he ope-rated for lithotomy.