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singularly difficult and laborious. Section after section of thespinal cord throughout its whole length, and of its complexcranial prolongation, must be carefully scrutinized, thought-fully compared, and, for the most part, minutely delineated ;and sometimes many different specimens must be prepared andexamined in order to make out a single point. In this ex-hausting work Mr. Clarke has long and meritoriously perse-vered amid the calls of an active professional life. The resultsof his labours are made known in his various papers, publishedchiefly in the " Philosophical Transactions," and in the elabo-rate delineations with which they are illustrated. And it ispleasing to know that, in all essential points, his observationshave been confirmed by the most accurate and trustworthy ofhis contemporaries.

After what has been said of the difficulties of the inquiry, itwill be readily conceived that Mr. Clarke’s investigations, suc-cessful though they have been, have left not a few intricacies ofstructure still to be unravelled ; and, in speaking of the ad-vances actually made, it will be sufficient here to indicate thechief points which have either been made known for the firsttime, or more exactly determined and placed in a clearer lightthrough Mr. Clarke’s labours.One of the principal subjects of investigation was the grey

substance which forms the interior part of the spinal cord.The figure which this part assumes in different regions of thecord has been more exactly described and delineated, and thenature and arrangement of its constituent elements more fullyexamined and more clearly exposed than heretofore. Two icolumns or tracts, composed of nerve-cells, and previously un-described,’ have been shown to exist in the grey substance

through nearly the whole length of the cord, and two others ina shorter extent. Moreover, Mr. Clarke was, as we believe,the first to point out that the central canal of the spinal cord islined with epithelium, and he certainly first explained the truenature of the tissue immediately surrounding the canal, whichhad previously been mistaken for nervous substance.The course and connexions of the fibres of the nerve-roots after

they enter the substance of the spinal cord have, as yet, beenby no means fully made out ; but Mr. Clarke’s investigationshave shed considerable light on that obscure point of anatomy,and, amongst other observations of moment, he has shown thata part of the posterior or sentient roots take, in the first in-stance, a downward direction-an unlooked-for anatomicalfact, which was afterwards strikingly shown by Brown-Sequardto be in harmony with physiological experiment.The structure of the medulla oblongata, and the relation of

its several tracts or divisions to the columns of the spinal cord,as well as the intimate nature of the grey masses which arethere superadded, and their connexion with special sets offibres and nerve-roots, are questions which have long tried theskill and patience of anatomists, and which have received freshelucidation from the keen scrutiny and sagacious interpretationof Mr. Clarke ; and in this branch of his inquiry he has arrivedat new facts, and has been able to correct serious errors whichhad been introduced on respected authority.But the researches of Mr. Clarke on the spinal cord have not

been confined to its perfected structure ; he has investigatedthe mode of its development in the fcetus ; and one of hispapers in the " Philosophical Transactions" contains a minuteaccount of the changes observable in the form and structure ofboth the white and grey substance at successive stages of deve-lopment, in man, mammalia, and birds ; also, a description ofthe intimate structure of the intervertebral ganglia, and of themode of development of the cells and fibres which enter intothe formation of these different parts.

Finally, although it must be confessed that the knowledgeacquired of the intimate structure of the nervous centres has asyet afforded but little direct insight into their functionalmechanism, it cannot be doubted that approved and trust-worthy investigations of structure tend powerfully to promotephysiological truth, by enabliug us to distinguish between trueand false anatomical data when used as a basis of physiologicalreasoning, and by sweeping away the imaginary groundworkof much vain speculation and erroneous doctrine.Mr. Clarke, I beg leave to present you with this Medal, which

has been awarded to you, on the recommendation of those inthe Council most competent to judge of the subjects on whichyou are engaged, as a well-earned reward of your perseveringlabours, which the Council is well aware have demanded fromyou the devotion of all the leisure remaining to you amidst theduties of an active professional career. I need scarcely addthat the Council hopes that this mark of approbation of servicesalready performed will also be an incitement to further laboursin the same or in kindred fields of research.

Medical Societies.PATHOLOGICAL SOCIETY OF LONDON.

TUESDAY, DEC. 6TH, 1864.MR. PRESCOTT HEWETT, PRESIDENT.

Dr. HARLEY read a report upon a specimen of Diseased Liverexhibited by Dr. F. Robinson at the previous meeting. Theconclusion at which they arrived was that the case was one ofacute atrophy, on account of the small weight of the liver, theabsence of liver-cells on microscopical examination, the presenceof tyrosine in the kidneys, and the history of the case.

Dr. HERMANN WEBER exhibited a specimen ofKIDNEYS WITH SO-CALLED FIBRINOUS DEPOSITS, FROM EMBOLISM

OF THE RENAL ARTERIES.

The patient, a woman aged twenty-six, had been admitted intothe German Hospital on the 3rd of October with old mitral dis-ease and pulmonary apoplexy. On Oct. 5th she was suddenlyseized with violent pain in the right side, just below the twelfthrib, coupled with great collapse, vomiting, and diarrhoea, thepain being increased by pressure. These symptoms abated afterabout two days. On Oct. 12th a similar but still more violentattack occurred, the pain being this time in the left side, last-ing almost a week with varying intensity, and being only re-lieved bv frequent subcutaneous injections of morphia. Theurine, which had exhibited only a very small quantity of albu-men before these attacks, became highly albuminous during,and for about a fortnight after, this occurrence, containing manytube-casts of various kinds, but principally of the transparentones. From the end of October, however, until the time ofdeath, the urine was free from albumen and casts. Traces ofblood only had existed during a few days at the time of theattacks. Anasarca of the lower extremities, which had beenmoderate before the attacks, had much increased immediatelyafter them, but diminished again with the disappearance of thealbumen from the urine. There was intense icterus during thelast fortnight. Death occurred from pulmonary apoplexy andpleuritic effusion on Nov. 11th.The post mortem examination manifested mitral stenosis,

with roughness of the edges of the very narrow, oval-shaped.opening, and great dilatation of the left auricle; and alsomoderate contraction of the tricuspid orifice (from adhesionbetween two of the folds, and slight thickening of all three),and corresponding dilatation of the right auricle. The rightlung exhibited the products of pulmonary apoplexy in variousstages of progress, and the right pleural cavity was filled withsero-purulent fluid. The mucous membrane of the small in-testines was swollen, closing the opening of the gall-duct. Theliver was of a nutmeg appearance, with commencing atrophy,and the tissue very tense; spleen likewise hard and tense, asalso were the supra-renal capsules. The right kidney containedin the centre a pale-yellowish deposit, shrunk and depressedbelow the surface of the surrounding tissue; the left kidneycontained several larger deposits, likewise of a pale-yellowcolour, but slightly raised above the level of the surroundingnormal tissue : the deposits occupied the greater part of theupper portion of the kidney. The corresponding artery wasobliterated by an old fibrinous plug; while the artery supply-ing the normal portion was free. The plug in the obstructedbranch of the artery was slightly adherent to the walls, whichcould, however, be separated without injuring them; it didnot obstruct the whole length of the branch, but terminated attwo ramifications rather abruptly, leaving the remainder free.

Dr. Weber remarked, that amongst the many points of in-terest, the case showed, with regard to the so-called fibrinousdeposits of the kidney, their embolic nature by the presenceand the characters of the plug in the upper branch of the leftrenal artery; that it further elucidated the symptoms of em-bolism of the kidneys, which affection, in this instance, hadbeen diagnosed by Dr. Baumler, the resident physician at thehospital, at the time of the occurrence ; and that it manifestedalso the changes taking place in these " deposits," that in theright kidney, having occurred thirty-eight days before death,

being already shrunk below the level of the surrounding tissue,: while the "deposits" in the left kidney, having occurred be-tween a week and a fortnight later, were still slightly promi-nent above the level of the surrounding tissue, but without theIelevated red margin seen in still more recent cases. The time of the Society being much occupied, Dr. Weber did not enter

into the description of the microscopic appearance of the de-posits.

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In reply to the remark of a gentleman that he did not believethat pieces of tibrin sufficiently 1,tI’ge to obstruct a. principalbranch of the renal artery could be propelled by the heart andcarried by the blood to some distance, Dr. Weber mentionedthat Virchow had clearly proved by experiment that muchlarger pieces of fibrin than that forming the plug in the casebefore the Society could be propelled by the heart and carriedby the blood to distant organs, until they were arrested by thediminished size of the artery, or by a bifurcation, leading thusto plugging of some irterial branch or branches.

Dr. DICKINSON exhibited the

SUPRA RENAL CAPSULES FROM A CASE OF ADDISON’S DISEASE.

The case has been already published in THE LANCET by Dr.Sturges. There were all the symptoms described by Dr. Addi-son, and no disease in any part of the body except in the cap-sules. These were to’ally disorganized, much enlarged, andunder the microscope showed somewhat like the structure of afibro-plastic tumour. Very small spots, like mustard-seeds,were found under the peritoneum, resenxuline in microscopicstructure that of the supra-renal capsutes. Oa examinationunder the microscope, the deposit in the skin was found onlyin the rete mucosum, exactly like a specimen figured by Mr.Hutchinson in a previous volume of the Transactions. Theskin of a Hindoo was examined soon afterwards, and here thepigmentary deposit was found diffused through all the layersof epithelium.Mr. FERGUSSON showed a specimen of

EXCISION OF THE SHOULDER-JOINT PERFORMED METY

YEARS AGO,forwarded by Mr. Harkly, of West Haddon. The operationwas performed in 1814, by Dr. Locock, at the NorthamptonHospital. The head of the humerus, which was carious, wasremoved, with an inch of the shaft and the gleaoid cavity.The patient recovered useful motion, and used the arm inhewing timber, though he could not raise the arm.Mr. FEEGUSSON also showed some Milky Fluid removed from

a case supposed to be one of common hydrocele, the symptomsbeing merely those of that affection. After the first tappingthe fluid re-collected, and was of the same character. It wasanalysed by Dr. Thudichum, who found the milky character ofthe fluid to be due to fat.A similar case is recorded by Vidal de Cassis, who proposed

the name of " galactocele."The fluid was referred to Dr. Harley and Mr. Mason.

ODONTOLOGICAL SOCIETY OF GREATBRITAIN.

MR. E. SAUNDERS, PRESIDENT.

SPECIMENS of diseased and abnormally formed Teeth wereexhibited by Mr. ENGLISH, of Birmingham. Also an apparatusshowing various methods of Regulating Teeth, by M. PRETERRE,of Paris.The PRESIDENT related a case of Spasmodic Closure of the

Jaws, attended with severe neuralgic pain, caused by a cariouslower second molar tooth, combined with an irregularly placedwisdom tooth, and cured by removal of the former.Dr. NORMAN W. KINGSLEY, D.D.S., of New York, read a

paper upon Treatment of Congenital Cleft Palate and ArtificialVelum, which appeared in extenso in THE LANCFT of last week.Mr. SERCOMBE said that the paper just read divided itself

into three heads : first, practical ; secondly, ethical; and,thirdly, physiological. He should only allude in his remarksto the first head. Still he must say a word or two upon thephysiological. He differed from Dr. Kingsley in his opinionhat the deformity was not usually a transmitted one. In all

his (Mr. Sercombe’s) cases-and he saw about twelve a year-he could trace a congenital influence. He differed also fromthe view that deglutition was a natural and speech an acquiredhabit. He alluded to infants who had cleft palate being starvedfrom not being able to suck at the breast. He agreed withDr. Kingsley that speech and voice were very different, andrelated a case of a professional singer who had a cleft palate,and could hardly be understood when he spoke, though hissinging might almost be called perfect. He (Mr. Sercombe)did not consider that the uvula had any influence upon speech ;it seemed a useless appendage. The more simple the apparatusemployed for restoring speech was the better ; he first con-structed complicated ones, but now as simple as possible. Heregretted he had not been able to get some of ’his patients toattend, to illustrate the success of his practice. He read ex-

tracts from letters to the same effect. He thought Dr. Kings-ley’s apparatus much resembled Mr. Stearn’s in its construc-tion, but was more simple, and differed in its material ; stillhe considered the former too complic3/ed, and doubted if thematerial would be found to last many years.A gentleman alluded to a case which Mr. Sercombe had

treated, where marked improvement had at once followed, asalso general improvement in health.Mr. J. B. BELL stated that he had always found immediate

benefit to result, from mechanical appliances where the fissurehad resulted from ulceration, but in congenital cases it wasvery different.Mr. COLEMAN asked Dr. Kingsley if he had ever found

patients were troubled with retching or vomiting upon the firstintroduction of his apparatus, and stated that in his treatmentof these cases he had met with one where the patient wasseized with excessive vomiting when the apparatus (a simpleform like that employed by Mr. Sercombe) was put into hismouth. He had to remove the artificial velum from the appa-ratus, and instruct the patient how to attach it by instalments.Mr. POLLOCK paid a high tribute to the ingenious antn prac-

tical instrument Dr. Kingsley had introduced, and said hecould endorse most of the observations made by that gentle-man. He stated that very discouraging results generally at-tended the surgical operation for congenital cleft palate as

regarded the improvesnent of speech ; usually there continueda very unpleasant cavernous sound. But still there were somecases very favourable for operation. He considered that con-genital cases should be attended to early in life, and not neg-lected until the period for operation arrived. His experienceentirely coincided with that of Dr. Kingsley, that ths defor-mity was not transmitted, though it was often seen in morethan one member of the same family. He did not considerthat children died from not being able to suck, but rather frombeing deprived of their mother’s milk. He differed from whathad been sid respecting the uvula; he had seen cases with im-paired speech from simple cleft or loss of uvula alone. For con-genital cases where mechanical treatment was advisable heconsidered Dr. Kingsley’s apparatus eminently adapted ; butfor fissure resulting from ulceration he thought the simpleapparatus described by Mr. Sercombe better adapted; andMr. Pollock raised the questions how far Dr. Kingaley’s couldon the ground of expense be supplied to hospital patients, andwhether it was also durable? He alluded to a case of staphy-loraphy performed some years ago by Mr. Avery, where arti-culation was so improved that it was difficult to detect thatthe patient had ever hsd the deformity. He related a casewhere a patient, after operation, made very poor progress inspeaking his own language (English), but learned to speakGerman very distinctly.Mr. MASON alluded to Mr. Fergusson’s practice, of which he

had witnessed much; some of his cases had not been very satis-factory, but others had been quite so. He thought, if anyimprovement could be effected by operation, it was better itshould be performed than that the patient should always beencumbered with a troublesome apparatus. He asked Dr.Kingsley what proportion of cases he had seen in Americawhich had not been successful in the results. He also askedwhat prevented the apparatus from falling down the throat.

Dr. Ki,-zGsLEY said he could not say what proportion of un-successful cases he had seen in America; but his experiencehad proved to him that successes recorded of operations inAmerican prints were exaggerated, and he adduced the namesof a large number of eminent American surgeons who had toldhim that they had abandoned the operation on the ground ofits not ultimately succeeding in restoring a good articulation.The apparatus was attached by a gold wire to a tooth or teeth.He was sorry the discussion should have turned upon thecomparative merits of his and other instruments, but he feltsure his would be found to possess certain advantages overthose hitherto described. He alluded to Mr. Stearn’s appa-ratus, and spoke of it in high terms, but said it was, as theinventor had told him, very complicated and liable to get outof order, which his was not. His he could stamp upon orcrush in his hand [doing so). and it returned to its originalshape unimpaired. He (Dr. Kingsley) said he had never ex-perienced any (jifficulty from patients retching or vomiting whenit was introduced ; if there was any it went off directly.The PRESIDENT alluded to the inconvenience he had found

patients experience from retching in his practice. He exhibitedsome very ingenious appliances for fissured palate. He hadused iadia rubber for-the velum, but now generally employed thingold plate, adjusted to follow the movements of the velum withdelicate springs, as this was more durable than the former.