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mum), and two periods of change (increasing and decreasing),and tabulated them as follows :-

v. ed Maximum.—Jan., Feb., March, April, and May, (sometimes Dec.)’" Minimum.-July, August, part of Sept.Variable Decreasing.—June, (sometimes May.)Variabl e (Increasing.—Oct., Nov., Dec., (sometimes Sept.)

He then showed the relation which these changes have to Itemperature, pressure of the atmosphere, and vapour in theair, and proved that the latter do not altogether account forthem. The relation of temperature and pressure is an inverseone, and the former is very marked in sudden accessions, andis therefore a frequent cause of variation; but a mediumdegree of temperature, as 55° to 60°, and a medium height ofthe barometer, as 29 to 30 inches, are accompanied by all thedegrees of respiratory change. He then quoted Barrall’sexperiments, showing the influence of season upon the ingestaand egesta, both of carbon and nitrogen, to prove that withincertain limits variations in the amount of carbon exhaledindicate also similar variations in the nitrogen excreted. Healso showed that as the skin had exhaled in July only sixgrains of carbonic acid per hour, in experiments upon himself,it was not important for him to refer to it. The author thenapplied this discovery to the production of disease, andshowed that the dangers of the fixed periods are from excessin both directions-i. e., excess and defect, and increase withthe duration; while those of the variable periods result fromthe want of ready adaptation of the system to the variation ofthe external influences, and particularly of temperature andfood, and are the greatest at the commencement. Hehad abstracted the deaths in each season in the five non-

epidemic years in London (1850-4) from diseases havingperiods of seasonal increase, and determined the excess ordefect in each quarter of the year from that which would haveoccurred if the deaths had been equally distributed over theyear, and showed that there was a close correspondencebetween the states of the human system at different seasonsand the type of disease then prevalent. Thus diarrhosa,cholera, plague, yellow fever, and asthenic diseases, with dis-eases of the bowels, prevail with the decreasing and loweststates of system, while diseases of the lungs and sthenicdiseases prevail with the maximum state. He also showed,further, that the advancing type of disease is that of theadvancing season, so that in epidemics of scarlatina occurringafter the minimum period the most asthenic type is observedat first, while in measles occurring with or after the maximumperiod the most inflammatory cases occur early. Scarlatinais checked by the increasing state of the system, and measlesby the decreasing. Hence, in every disease it is important tobear in mind the season of the year as indicative of the stateof the human system; and in every epidemic it is necessary toconsider the nature of the advancing season. The author hadalso investigated the viability of children born at differentseasons in reference to the period of procreation and of birth,the former illustrating the state of system in the parents, andthe latter in the child, and found that it referred only to thelatter. Of all the children who died under the age of one yearin the northern district, from Newcastle to Kendal, in 1857,and whose age in months was recorded, the largest per-centagewas born in the summer months, the period of decreasing andminimum vital action of the human system. Animals which

procreate once a year have their sexual appetites excited inthe hot season, but they bring forth their young in the coldseason. The author conclhded the paper with four deduc-tions :-1. Seasonal diseases must now be referred directly tothe state of the system, and only indirectly to meteorologicalconditions. This does not affect the fashionable search after

poisons. 2. The type of a seasonal disease varies with theadvancing season. 3. The cyclical rotation of the seasonal

changes in the system explains in great part the cessation ofseasonal diseases; for while such diseases may increase as thestate of system increases in which they arise, they must declineand cease as the state of system changes into its opposite.This was illustrated by comparing the march of a choleraepidemic from June to November with the variations thenproceeding in the system, and also the cessation of an epidemicof scarlatina and measles. 4. These cyclical changes are a partof the vis medicatrix naturae. The author having thus provedthe great importance to health of this rotation of changes,exposed the folly of endeavouring to maintain in our hospitals,public offices, and houses, an unvarying condition throughoutthe year, and stated that the contrary plan had been of in-calculable value in the treatment of phthisis. He trusted thatthese results would afford a glimpse at some of the fundamentallaws of the system.

Dr. SMITH, in answer to a question from Dr. Webster, saidthe mortality of infant life mentioned in his paper had referencesolely to the period of the birth of the children.

OBSTETRICAL SOCIETY OF LONDON.

THURSDAY, MARCH 3RD, 1859.DR. RIGBY, PRESIDENT, IN THE CHAIR.

THE minutes of the last meeting having been read and con-firmed, the names and qualifications of fifty-nine practitionerswere read as candidates for the Fellowship. At a later periodof the evening, the ballot was taken, and these gentlemen wereafterwards declared to be unanimously elected.

A CASE OF MEMBRANOUS CROUP.BY E. U. WEST, M.D.,

’ (Of Alford, Lincolnshire.)One evening Dr. West was sent for to see a child, eight

years old, suffering from advanced croup. He ordered anantimonial emetic mixture, and a blister to the throat. The

vomiting which resulted caused the expulsion of a quantityof shreds of membrane, and a large piece which was evi-

dently a cast of the trachea. This membrane he now wishedto show to the Fellows.

ON A NEW METHOD OF EXAMINATION OF THE TUMOUR IN CASES OF SUSPECTED CYSTIC DISEASE OF THE OVARY;WITH THE DESCRIPTION OF AN INSTRUMENT FOR EFFEC’]-ING THE SAME.

BY GRAILY HEWITT, M.D.,PHYSICIAN TO THE BRITISH LYIM-Hf HOSPITAL, ETC.

The author commenced by showing the many questions whichthe physician or surgeon anxiously puts to himself when calledupon to administer relief in cases of presumed ovarian cysticdisease, and more especially the question which he has to con-sider as to the particular method of treatment to be adopted.Thus, a case of considerable enlargement of the abdomen maycome before us in which the shape of the abdomen, the natureof the visceral displacement, the general symptoms and pre-vious history of the patient, render it tolerably certain that a,

tumour connected with the ovaries is present. But it is ex-

tremely desirable that we should also be able to learn the exactnature of the ovarian tumour, and the presence or absence ofcomplications, more especially if we have to decide whether

ovariotomy or simply paracentesis and injection should be re-sorted to. Dr. Hewitt proposes, by means of an instrumentwhich he names the " ovarian sound," to probe the interior ofthe cavity in which the fluid is contained. The instrument tobe thus used consists of an ordinary canula and trocar; butthe canula is provided with an india-rubber diaphragm, havinga small perforation in its centre through which the trocarpasses. The sound is a slender rod, composed of the samemetal as the ordinary uterine sound, and, therefore, flexible,graduated in inches, and fourteen inches long. It is providedwith a smoothly-rounded extremity, and is fixed in a handle ofconvenient size. The trocar and canula having been passedthrough the abdominal wall, the trocar is withdrawn; thesound is then introduced through the canula before the con-tents of the cyst have been allowed to escape, and the operatorexamines the interior of the cavity leisurely and safely.ON TRANSFUSION OF BLOOD, ITS HISTORY AND APPLICATION

IN CASES OF SEVERE HAEMORRHAGE.

BY CHAS. WALLER, M. D.OBSTETRIC rEYSICIAN TO ST. THOMAS’S BOSPITAL.

Having given an interesting historical introduction, Dr.Waller went on to relate a case in which he seems to havesaved life by the operation of transfusion. The patient had asevere attack of flooding after labour, and when seen by theauthor was insensible, the extremities and general surface werecold, the respiration was laborious, the eyelids closed, and nopulsations could be felt in the radial or carotid arteries. Thefirst injection of two ounces of blood rendered the beat of theartery discernible; and after the introduction of an additionalsix ounces the patient rallied, and recognised her medical at-tendant. A little brandy was then given, and recovery gra-dually took place. The author concluded with a few remarkson the best mode of performing the operation.

In reply to some questions by Dr. Tanner, the author statedthat he had resorted to transfusion altogether in five cases,and that four had recovered. He also explained that though

careful not to allow anv air to Dass into the vein- vet he did

266

not think this occurrence would be always attended with those formidable results usually predicted.

Dr. BARNES observed that every one who had seen a womanperish from flooding must have been haunted by the regret thathe had not been prepared with the means of transfusing. Itwas much to be desired that this operation should be broughtto a state of practical perfection. There were yet, however,several points which required investigation. He was glad tolearn from a letter from M. Brown-Sequard, that that distin-guished physiologist contemplated delivering in London a seriesof lectures on the means of preventing death from asphyxia, inthe course of which he (Dr. Barnes) trusted that the wholequestion of transfusion would receive a thorough elucidation.The experiments related in his Journal de Physiologie wererenlete with interest. The leading facts established were, thatall the contractile and nervous tissues may recover their func-tions under the influence of blood charged with oxygen, andthat the success of transfusion depended upon supplying blood-globules, charged with oxygen, as the essential condition. It

appeared that venous blood, bearing an excess of carbonic acidand less oxygen, was not so useful. The fibrin was of no use;and in order to obviate the risk of coagulation, it was better toremove it by whipping it out. By this process the red-globuleswould also become charged with oxygen, and fitted for trans-fusion. Thus the objection to using venous blood, which wasmuch more convenient to obtain, was removed. Amongstmany deeply-interesting experiments, M. Brown-Sequard hadshown, that by transfusing blood, the function of irritability inthe muscles of an amputated arm might be restored many hoursafter separation from the body. In illustration of these views,Dr. Barnes cited seven cases of transfusion, related by Mr.Higginson, of Liverpool, in 1&57. Two of these cases wereperfectly successful, and it could not be said that the othersdied from the operation. In one, however, the operation wasimpeded by coagulation of the blood, and in two others it wasstated that the blood was dark and sluggish. It was highlyprobable, then, that the mode adopted by Dr. Waller, of in-jecting venous blood direct was not the best, and he lookedforward with extreme interest for the further researches of M.Brown-Séquard.

Dr. DRUITT drew the attention of the Fellows to the in-genious apparatus for transfusion, invented by Mr. Whitehouse,and which has been made by Weiss. Mr. Whitehouse hasalso recommended that the blood should be defibrinated, bybeing beaten up with a fork before it is injected, so as to avoidembarrassment with clots.

OX A CASE OF EMOTIONAL MONOMANIA RECURRING DURINGSUCCESSIVE PREGNANCIES.

BY ROBERT DUNN, F.R.C.S.

After making some general observations on the effect ofbodily states upon mental manifestations, Mr. Dunn proceededin the detail of a striking instance of the dominant power ofemotional apprehension-the sheer dread of bodily pain-inupsetting the balance of the mind, in the case of an intelligentbut highly impulsive and excitable lady, during the parturientstate in several successive pregnancies. The patient was underMr. Dunn’s observation from 1848 until 1854, when she leftLondon. She died eighteen months afterwards, and unfortu-nately no post-mortem examination was made. In her firstlabour she underwent severe bodily pain and suffering; andthe great fear of pain in prospect embittered the period of ges-tation in her four subsequent pregnancies, the dominant anddepressing feeling of her mind constituting a kind of mono-mania. After the birth of her last child, favourably accom-plished while under the influence of chloroform, the fear ofdeath took possession of her, and she tortured herself withthinking of the pain and agony of the act of dying. It was invain to attempt to reason with her; she became violent andexcited at times, and it was necessary to have a female atten-dant from an asylum to take care of her. For the rest of herlife she remained an invalid ; her fears continued undiminished;and she became exhausted and attenuated to the last degree,until at length she sank, her perceptions remaining acute untilthe last hour of her existence.

AN INSTALMENT OF RELIEF FOR THE TROOPS IN INDIA.- Recent intelligence from India informs us that "Leatherstocks are abolished: Her Majesty’s forces in India are to dis-continue their wear." Is it possible that it is not until now thatthis necessary measure has been adopted ? We hope, however,it is a beginning for further improvements in the equipmentsof the soldier.

Reviews and Notices of Books.A Treatise on Diseases of the Air-Passages, comprising an In.A quiry into the History, Pathology, Causes, and Treatment otquiry into the History, Pathology, Causes, and Treatment of

those Affections of the Throat called Bronchitis, ChronicLaryngitis, Clergyman’s Sore-throat, &c. &c. By HORACE

’

GREEN, M.D., LL.D., President and Emeritus Professor ofthe Theory and Practice of Medicine in the New YorkMedical College, &c. Fourth Edition, revised and enlarged,

, with an Appendix. pp. 348. New York: Wiley andHallsted. 1858.

’, THE author, being in this country in 1835, had a conversa-tion with the late Dr. James Johnson, (the well-known physi-cian, and editor of the "Medico-Chirurgical Review,") on

the subject of the treatment of chronic laryngeal disease. The

latter alluded to the frequent occurrence of the affection amongstmembers of Parliament, the clergy, and other public speakers,and also to the difficulty of treating it successfully after theordinary methods. This want of success was said to be due tothe fact of the disease having extended into the laryngealcavity, where it was, of course, beyond the reach of garglesand other topical remedies, as ordinarily applied. The sugges-tion, however, was hazarded that, if proper applications couldbe applied below the glottis, no difficulty would occur in

successfully treating the malady. Upon Dr. Green returning toAmerica, he acted upon this suggestion. He made the attemptto enter the larynx, did enter it, he affirmed, and thus succeededin curing a well-marked and severe case of laryngeal disease.A short time after this, MM. Trousseau and Belloc published atreatise on this method, which was being slowly introducedinto America by Dr. Horace Green. This gentleman, how-ever; pursued his way, collected cases and gained experience,and published an account of the latter in 1846. The work was

widely read, the new curative procedure investigated, andmuch dispute arose about the whole affair. One party, bothhere and in America, maintained that Dr. Green had intro-duced and widely practised a very valuable addition to ourtherapeutic measures, and that by his plan, of sponging theupper air-passages with caustic solutions, could certain hithertoobstinate diseases alone be satisfactorily treated. Another

party stoutly maintained that the " new method" was a mistakealtogether; that Dr. Green had made a great error in supposingthat he could pass a sponge probang into the box of the wind-pipe, and that such an operation was impossible, indeed, uponthe living subject. After a short time a third party arose, whotried to mediate between the other two. This party awardedDr. Green much credit for more satisfactorily explaining thepathologic nature of certain throat affections, attended withhoarseness of voice, &c., and for his exposition generally ofwhat he termed " follicular disease of the throat and air-pas-sages." They asserted that its proper treatment was to require,inter alia, the use of the sponge and caustic solution, and theyadmitted that it was occasionally possible to penetrate the box ofthe larynx, and to sponge it, with much benefit to the patient.They confessed their suspicion, however, that in the majority ofinstances where the probang was thought to have enteredbelow the chink of the glottis, it had done no such thing. Theybelieved it to be a difficult thing to effect, and when accom-plished, more the result of chance than of anything more defi.nite. In the course of time, however, sponging the throat withsolutions of the nitrate of silver, and trying to mop the glottiswith the same, became regular methods of treatment, and fewwho had much to do with " follicular disease of the throat and

air-passages," could avoid admitting that Dr. Green’s recom-mendations were often remarkably useful in practice. Gradually,too, it has come to be more generally admitted that the larynxcan be more easily entered than was at first supposed, al-

though we think there still prevails the idea in this countrythat neither Dr. Green, nor other practitioners, succeed so oftenas they fully believe they do. Two names of high authority