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Medical Societies.MEDICAL SOCIETY OF LONDON.

SATURDAY, NOVEMBER 24TH, 1855.DR. SNOW, PRESIDENT.

DR. GIBB related the following case ofSUPPURATIVE PHLEBITIS

in an infant -,t few days old, with post-mortem softening of thestomach. This day ( Nov. 24th) he made a post-mortem in-spection of a female child, nine days old, forty-four hours afterdeath, and who died on the 22nd, after three rapidly-succeedingconvulsions. The child was of the usual size, but the bodywas freely covered with roundish, crimson spots, varying insize from a pea to a shilling. Both hands were of a blue,colour; the right contained a fluctuating swelling over theback of the wrist, which consisted of pus; and over the left.elbow, which was irregularly ecchymosed, a swelling was alsofound, the size of a pigeon’s egg, which likewise contained pus.Both of these abscesses were seated over joints, and communi-cated with them. These swellings commenced at birth, andgradually increased in size, and appeared to give the childgreat pain; it took the breast notwithstanding. An internal

inspection did not exhibit anything very remarkable, with theexception of the liver, which occupied nearly the whole ab-dominal cavity; but in structure and general appearance itseemed natural; there were a few light-coloured, circularpatches on its surface, the largest the size of a sixpence. Thestomach was in a totally disorganized condition from softening,and was apparently dissolved in many parts by the post-mortemaction of its own fluids; it contained clear white curds of milk,’some of which escaped into the peritoneum during the examina-tion. The bowels presented a shrivelled-up and contractedappearance. The rest of the viscera were normal. The brainwas not examined, and no appearance of external congestionwas manifest about the head. Had time been permitted for acareful dissection, he had no doubt inflammation of the veinswould have been discovered, which has here been followed bypurulent deposits in the joints. This condition is one so rarem infants, or even in children, that it is not even mentionedin works devoted to diseases of children, at any rate, by anyEnglish author.

Dr. WILLSHIRE remarked that many writers described casesof suppuration in the joints and cavities of new-born children.He inquired the condition of the umbilical cord in Dr. Gibb’scase, and whether it exhibited any signs of phlebitis ? Hadthe parents of the child suffered from syphilis ?

Dr. Gzss replied that, with the exception of thickening,there was nothing remarkable in the condition of the umbilicalcord. The eruption on the skin consisted of little congestivepatches on the upper parts of the body. The mother had notsuffered from puerperal fever, but the father was in the laststage of consumption.

Dr. WILLSHIRE remarked that new-born children occasionallyexhibited purulent deposits in various parts of the body; themother in these cases suffered afterwards from puerperal fever.The diseases in both cases had probably a common origin.Mr. HENRY SMITH related the following case, occurring in

the practice of Mr. Fereday, of Dudley.SUCCESSFUL CASES OF LITHOTOMY IN TWIN CHILDREN.

A few weeks ago a woman brought a male infant to the Dudley Dispensary, labouring under symptoms of stone in the bladder,which subsequent sounding proved to be correct. She statedthat it was a twin, and that the fellow suffered in every re-spect the same as the one she had brought with her. TheyWere two years and a half old, healthy, stout-looking children.The mother’s account was, that they got on remarkably welltill teething commenced, at the age of twelve months, whenthe bowels became irritable, and severe diarrhosa. set in. Asshe did not take them to a medical man, she was recommended

by her neighbours to administer some port-wine, which she didin considerable quantities to both equally for the space of threemonths and upwards. At the end of this time she did notnotice any amendment of the diarrhoea,, but she perceived thatthe urine of each had become high-coloured, and depositedcopiously a yellowish sediment. She, however, persevered forsome time longer with the port-wine. About twelve and eightmonths ago the symptoms of calculus became evident. The

ordinary operation of lithotomy was performed on the first case

on the 14th of last July, and on the second on the 20th oAugust. No untoward symptoms occurred either during theoperation or afterwards, and the wounds were well in aboutten days. The stones were about the siz-i of an almond, onlya little more rounded; they consisted of almost pure lithicacid, and were much roughened on the surface.Mr. SMITH inquired whether the port-ivine had had any in-

fluence in the formation of the calculi?Dr. CRISP considered the cases interesting from the long

time which the children had taken the port-wine. In Norfolkand Suffolk the great prevalence of stone cases was attributedto Norfolk dumplings, but there was no proof of the correct-ness of this opinion.

Dr. ROUTH did not think the port-wine would tend to theproduction of the calculi; but that the bitartrate of potashit contained would have a contrary effect.

Dr. GIBB mentioned some cases in which he had administeredport ’wine for some time to children suffering from depressingdiseases. In these cases he had observed a deposit of lithicacid in the urine. He thought that the wine might have hadgreat influence in the formation of the calculi.

Dr. EDWARD SMITH remarked that port-wine was so adul-terated that it was almost impossible to say what the childrendid take.A case was read from Dr. HERBERT BARKER, of Bedford, of

POISONING BY OXALIC ACID.

The patient was a lad, sixteen years of age, who took, accord-ing to his own account afterwards, a drachm of the acid be-tween seven and eight in the evening. In about an hourafterwards he was found lying in a lane, moaning, and withsome coloured fluid (as if from vomiting) close by him. Hewas seen by a surgeon who was passing; he was insensible,pulseless, and his lower jaw was spasmodically closed. Coldwater dashed on his face restored sensibility, and relaxed hisjaw. The boy said he had eaten the acid without dissolvingit in anything. He was removed home in a cart some dis-tance, and Mr. F. Clarke, of Luton, saw him between ten andeleven. He found him but partially sensible, very drowsy,and in a state of collapse; he had vomited bloody matter, aswell as some whitish fluid, which did not contain any crystals;his tongue and lips were unusually pal but there was no ex-coriation; he died about half-past three the next morning.After death the tongue was found dotted over with whitespecks; the œsophagus was not inflamed; the stomach wasextensively disorganized, and had the appearance of gangrenein some parts. Portions of the mucous membrane were de-tached, exposing the muscular coat. The points of interest inthe case were, the youthfulness of the victim, the taking thepoison in the solid state, and the small quantity of it whichproved fatal. The severe lesion of the stomach was probablyowing to the solid and concentrated condition in which thepoison was introduced into it.

Dr. SNOW related a case of poisoning by oxalic acid in ayoung woman, aged seventeen. The poison was partly undis-solved, and she died rapidly. After death the mouth and lipswere found very white, the stomach was black and congested.

Dr. RICHARDSON believed that the smallest dose of oxalicacid ever known to produce death, previous to this case, wasfour drachms. He related a case in which six drachms weretaken by a young woman; spontaneous vomiting occurred, andshe recovered, but suffered afterwards from salivation, and aspongy state of the gums. In another case in which an ouncewas taken, insensibility and coldness followed; but the patientrecovered under treatment. There was little difference ineffect, in regard to quantity, between oxalic and citric acid,the former of which might be prescribed, he thought, in largerdoses than was usually done.

Dr. ROUTii and Dr. ROGERS observed that the post-mortemappearances observed in Dr. Barker’s case were such as com-monly presented themselves in cases of poisoning by oxalicacid.

Dr. Cpisr remarked that the case was defective, in theabsence of any statement as to whether any antidotes were

applied. If such were given, the poisoning by so small a dosewas the more remarkable.

Mr. EDENBOROUGH observed that there was no evidence,except that of the boy himself, as to the quantity of the poisontaken. What became of the three drachms over the dose ?

Dr. E. SMITH related a case, probably of Strangulation of theSmall Intestine, which will be found at page 519.A long discussion followed the narration of this case, in

which Drs. Crisp, WEBSTER, RouTH, SNOW, and ROGERS tookpart. It was generally considered that the case was one rather

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of impaction than strangulation. Cases were related in whichingested articles of various kinds, such as a piece of eel,walnuts, spinach, and other substances, had been retained

for days, weeks, and even months, in the stomach or intestines,giving rise to all or many of the symptoms of strangulation.These cases were treated successfully by opium and enemata.The system of giving strong purgatives in these cases was con-demned, as was also the hasty resort to exploration, to determinewhether stricture or hernia existed.

At the meeting of November 17th,Dr. WINN related the particulars of a

REMARKABLE CONVULSIVE DISEASE,occurring in a boy, nine years of age. The patient was a fresh-coloured, but fragile and delicate child, who had been affiictedsince infancy with continued attacks of an uncontrollablerotatory movement of the body from left to right. Each

paroxysm lasted about ten minutes, and recurred incessantlythroughout the day. Occasionally, when the attention wasstrongly excited, the movements might be arrested, but onlyfor a few moments. If forcibly kept in the sitting postureduring an attack, a waving motion of the body from left toright was substituted for the ordinary gyrations. When firstseen, the child was suffering from headache, catarrh, andgastric disturbance. Blisters behind the ears, and an aperient,were ordered. Dr. Winn saw the child a second time, whenno improvement had taken place. Since then he had lost sightof the case. He was inclined to suppose that the affection wasowing to chronic irritation of the cerebellum, or one of the cruracerebelli. Lesions of the crura cerebelli were on record, whichappeared to establish a connexion between rotatory movementsof the body and the cerebellum. Dr. Winn was desirous of

ascertaining whether any of the members had met with asimilar case, or could throw light upon the nature of the casehe had related. Dr. Winn said that he made a very carefulexamination of the patient, but could detect no signs of chronicspasms of any of the muscles of the body. Had such been thecase, he should have suspected softening of the brain.Mr. DE MERIC exhibited a preparation showing a

COMPLETE ABSORPTION OF THE HEAD AND NECK OF THE FEMUR,AND FRACTURE IN THE SHAFT FROM SLIGHT EFFORT.

The patient was a woman, fifty years of age, who had beenbedridden and paraplegic for the last twelve months. On the1st of November, 1855, Dr. Lichtenberg, the Resident MedicalOfficer of the German Hospital, Dalston, being in the house ofthe patient, was apprised that the latter had, on raising herself ’,in bed, heard a crack towards the upper third of the femur, andthat fracture was suspected. On examination, an obliquefracture was easily detected, and the woman was taken into thehospital. The legs were found much atrophied, powerless, andtwisted inwards; considerable reaction had taken place at theseat of the fracture, where much swelling was observed, thoughhandling of the part gave the patient no pain whatever. Thelimb was put into a starched apparatus, the manipulationsbeing rendered somewhat difficult by continual convulsivemovements. Severe diarrhœa soon supervened, the apparatuswas removed, and the poor woman sank very rapidly. On a

post-mortem examination, the head and neck of the rightfemur (the former seeming to move freely in the cotyloidcavity) were found almost completely absorbed; the cavitywas deprived of most of its cartilage, and in it were foundfrom five to six pieces of cartilaginous substance, tipped on oneside with phosphate of lime, varying from the size of a bean tothat of a grape-seed. The fracture was very regularly oblique,the bone stripped of its periosteum, and seemingly necrosed.Mr. de Méric remarked that joints long condemned to inactiongenerally became anchylosed, and that fracture from slight effortin paralysis mostly occurred in consequence of the widening ofthe cells and thinning of the walls of the shaft. But in thisinstance the pathological changes had been of a different kind;absorption of the head and neck had taken place, and the wallsof the shaft were necrosed and not thinned.

PATHOLOGICAL SOCIETY OF LONDON.

TUESDAY, NOVEMBER 6TH, 1855.—MR. ARNOTE IN THE CHAIR.

Mr. PRESCOTT HEWITT exhibited a specimen of COMPOUND FRACTURE OF THE THIGH, WITH LACERATION OF

THE VESSELS, PRODUCED BY THE RAMROD OF A CANNON,removed from a man, aged thirty-five, admitted into St.George’s Hospital on the 5th of November. He was loading a

cannon, twenty inches long, with a bore of three-quarters ofan inch, for the amusement of his children, and as he wasramming down two ounces of powder, a boy with a lightedsquib ran by, who set fire to the priming; but before the mancould get out of the way, the cannon went off, driving theramrod through his thigh. He was knocked over, and in ashort time lost a large quantity of blood. On examination, itwas found that the ramrod had passed right through the thigh,entering the front at the lower third of the bone, and made itsway out at the back higher up, so that it had an oblique direc-tion upwards and backwards. The wound in front was largeenough to admit two fingers; the bone was completelyshattered, several pieces being found amongst the muscularfibres. The soft parts about were extremely infiltrated withblood, some of which was still oozing out of the wound, andthere was some effusion in the knee. It was impossible toascertain the exact state of the vessels. The parts below theinjury were not cold, but, from the large quantity of bloodwhich had been lost, and the proximity of the main vessels to thebone, at the seat of injury, it appeared probable they had beenimplicated. Amputation was performed by Mr. Prescott Hewitt,who had recourse to the circular operation. So completelywas the bone shattered and splintered, that the saw was notnecessary for the removal of the limb, which was removed atits upper third. The jagged extremity of the bone wassmoothed by sawing off a small piece of bone. A dissection of £the amputated limb showed the thigh-bone, at its middle third,completely split into fragments, the largest of which wasnot more than two inches in length. The muscles around wereextensively lacerated, and infiltrated with blood. This infiltra-tion was traced under the vasti muscles down to the synovialcul-de-sac, but no blood was found in the knee-joint itself, thecavity of which had a healthy appearance. Lodged in theback part of the thigh was the screw end of the ramrod, abouttwo inches long, which had been snapped off by coming incontact with the bone; this screw was filled in its whole lengthwith powdered bone. On passing the probe down the femoralvein, a rent of half an inch in length was found in that part ofthe vessel corresponding to the canal of the adductor magnus;and a careful examination of the artery showed, also, in thecorresponding part of this vessel, a small hole, just largeenough to admit the blunt extremity of a small probe; theseopenings were blocked up with coagulated blood. Thelacerations were evidently produced by the splinters of bone.Mr. Prescott Hewitt brought forward this specimen to showthe great difference in the appearance of the parts, andespecially the extensive slitting and splintering of the bone,which occurred in gunshot wounds - appearances differingwidely from those usually presented in civil hospitals, in casesof compound fracture of the thigh.The PRESIDENT remarked that high operations in the Crimea

have been very unsuccessful.

Dr. BRINTON exhibited a specimen ofULCER OF THE STOMACH,

removed from an unmarried woman, aged forty-eight years, ofcachectic and emaciated appearance, admitted a patient of theRoyal Free Hospital on the 6th of July last. Two years beforeshe had suffered from frequent nausea and retching, withoutcomplete vomiting. One year before her menses had suddenlyceased, and soon after a discharge of dark-coloured blood tookplace per anum. Six months before she suffered from severepain and tenderness in the epigastrium, coming on shortly aftereating, and accompanied with voiding of coffee-coloured fluid.The tenderness was suffused over the epigastrium, but mostsevere near its middle. The liver could be distinctly heard bycareful percussion, and below the situation of its left lobe partof the epigastric region exhibited dulness on percussion andhardness to the feel; the dulness shifted from day to day,being sometimes on the right of the mesian line, sometimes onit, sometimes it was absent. From these symptoms, Dr. Brintonhad diagnosed an ulceration of the stomach, but found it im-possible to decide whether it was the result of a simple ulcer orof malignant disease. The duration of the malady, on onehand, and the discharge of blood one year before, rather favouredthe supposition of simple ulcer; but, on the other hand, thebeginning of the malady at the close of the menstrual period,the general appearance of the patient, as well as suspicioussigns in the situation of the pylorus, rather favoured the ideaof its being of malignant character. The treatment was directedto support the failing strength, and allay the vomiting, whichwas for a time successful, but the patient died about threemonths after admission. The post-mortem examination showeda simple ulcer, of about two inches in diameter, at the upper