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_artery and the clavicle is of some value clinically, and has nothitherto attracted much attention, at least amongst physicians.We are the more anxious, therefore, to bring it before thenotice of our readers, and shall not fail to record any well-marked instances of it similar to this case. The patient in thepresent instance has a pigeon-shaped chest, and his claviclesseem depressed.

Medical Societies.MEDICAL SOCIETY OF LONDON.

MONDAY, DEC. 19TH, 1859.

MR. HILTON, F.R.S., PRESIDENT.

DR. HYDE SALTER read a paper on

SPASMODIC ASTHMA.

The subject-matter of Dr. Salter’s paper consisted in an ana-lysis of fifty tabulated cases of spasmodic asthma, togetherwith the consideration of some interesting facts that were de-ducible from them. The circumstances in the history of asthmathat these tabulated cases recorded were-

1. Name, age, sex. 9. Premonitory symptoms.2. Appearance. 10. Whether the disease is un-3. Occupation. mixed, or complicated4. Residence, past and present. with other lung dis-5. Age at first appearance of ease.

disease. 11. Of what standing the case6. Cause. Under this head has been.

were stated, a, the original 12. Inherited or not ; familycause of the disease; b, pro- history.vocatives of the attacks. 13. Associated diseases (such,

7. Frequency of attacks. e. g., as nervous affec-8. Time of day (or night) at tion, dyspepsia).

which the attack occurs. 14. Effects of remedies.

The first six headings, the eleventh, and the fourteenth inpart, were the subjects of Dr. Salter’s comments. The firstpoint illustrated by the tables was age, and that in three as-pects : a, the actual ages of the asthmatics at the time thecases were taken ; b, the time of life of the first access of thedisease; and c, the length of time the asthma had existed.The actual ages in 48 out of the 50 cases were-Under 10 years of age 0 From 40-50 years of age 10From 10-20 " 4 7 50-60 " 5

,, 20—30 ’’ 15 ’’ 60—70 ’’ 397 20-30 " 15 " 60-70 " 3

’’ 30—40 " 9 70—80 ,, 2

From these numbers two facts were deducible: a, that veryyoung people may be asthmatic; b, that asthmatics reach agreat age, and therefore that the disease has but a slight tendencyto shorten life. These two facts, however, were respectivelymuch more strikingly illustrated by the testimony of the tableswith regard to the other two aspects of age in asthma-thetime of first access, and the standing, of the disease. Theevidence of the tables with respect to the time of life of theaccess of the disease, was as follows :-

J J

These numbers showed, first, that asthma may occur at anytime from infancy to old age. Secondly, that a large numberof asthmatics become so very early in life (19 out of 47 cases,i.e., more than two-fifths, in the first 10 years of life, and ofthese, 9 in the 1 st year). Some of these cases occurred within afew weeks of birth, and in one or two within a few days; inmany, the disease was inherited. Thirdly, that asthma is lessand less likely to appear as life advances, np to old age, whenthere is an increase. The length of time the disease had ex-isted was from a few months to 47 years; and the average in38 cases was 22 years. In 4 cases in which it had commencedin the lst year of life, it had continued 27, 35, 37, and 47 yearsrespectively. One old asthmatic of 71 had had his complaintfrom 37, and another of 7t? had had it from 33. It was of thepure nervous asthma alone, however, that this slight tendencyto shorten life could be predicated; organic asthma, symp.

tomatic of chronic bronchitis or heart disease, was much morespeedily fatal.With regard to sex, it was found that asthma occurred twice

as often in women as in men; this was to be attributed to thedifference of their circumstances, to the wear and tear andhardship of life.With respect to appearance, certain characteristics of the

asthmatic physique were remarked in almost all cases: innearly every one there was thinness; many were characterizedas small for their age, those especially in whom the disease hadcome on young; the other principal personal peculiarities re-

corded were-stooping gait, roundness of back, anxious expres-sion, a certain amount of cyanosis, watery eyes, venous tur-gidity, and a prematurely senile appearance.

In respect to occupation, it was found that the upper classesfurnished a larger number of cases of asthma than the lower;thus-

This difference might, perhaps, be explained in part by thefact that all the cases in the upper classes would come under thecognizance of the physician-many of the poor would not; inpart, perhaps, from the medical and sanitary disadvantages ofthe poor, which cause a great mortality in those cases of severechest disease that often issue in asthma, which the children ofthe rich, from their more favourable circumstances, may pushthrough and survive as asthmatics. But Dr. Salter thought itpossible that the rich might be really more liable to asthmathan the poor, from a more irritable nervous organization en-gendered by the state of hyper-civilization in which we live.To organic asthma-the asthma of bronchitis and heart disease-the poor were, undoubtedly, more liable than the rich. Thefacts elicited from the column, "Residence," appeared to bethese two:-a. That asthmatics are to be found in every con-ceivable place-city and country, inland and sea coast, highand dry, low and damp situations, and in all parts of theworld-the United Kingdom, the Continent, Egypt, Syria,India, Australia, America. b. That certain localities have a

specific curative influence, city air being generally the air forasthma,-in some few cases, country air,-the cure being onlypermanent as long as the patient resides in the remedial air.The differences, in particular residences, producing the moststriking effects are so slight as to be inscrutable and to defy de-tection ; while, from the caprice of asthma, it is impossible topredict, in any given case, what kind of residence will suitthe best. The notes showed that residents in India and theCape never suffered from hay asthma.The causes of asthma, as illustrated by the tables, were next

considered. They arranged themselves under two heads-theessential cause of the asthmatic tendency, and the provocativesof the paroxysms. As the original causes of the asthmatic ten-dency, almost all the cases were to be assigned either to somebronchitic attack, or an intrinsic, sometimes congenital, ofteninherited, proclivity to the disease. Of the provocatives of theattacks, Dr. Salter read a great number, some of which werevery curious ; but he remarked they were all reducible underthree heads-1st, respired irritants ; 2ndly, alimentary irri-tants ; and 3rdly, irritants immediately affecting the nervoussystem. He concluded by describing four remarkable cases,in which the paroxysms were brought on by animal emanations ;in two (a brother and sister) from the proximity of the domesticcat; and in two (two brothers) from that of rabbits. The symp-toms were described as being very like those of hay fever, andthe asthmatic paroxysms as very violent.Some discussion took place on the value of the paper as a

statistical document. By some the cases were regarded as toosmall in number to determine any one point definitively ; butothers considered that the paucity in number was compensatedby the accuracy and completeness of the cases detailed. On all

. hands it was admitted that the production was an able and in-: teresting one.

PATHOLOGICAL SOCIETY OF LONDON.

TUESDAY, JAN. 3RD, 1860.

ANNUAL MEETING.

THE annual meeting of this Society was held at Berners-street, on Tuesday evening. There was a good attendance ofmembers. W. Fergusson, Fsq., president, occupied the chair.Balloting for the officers of the ensuing year commenced ateight o’clock, and closed at nine; the result of which was, that

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the proposed list was duly elected. It consisted of the follow-ing gentlemen :-

Presictent: Mr. W. Fergusson, F.R.S. - Vice. Presidents :Drs. T. Watson, C. J. B. Williams, G. H. Barlow; Messrs.J. M. Arnott, G. Busk, A. Shaw, J. Birkett, J. Dixon. -Treasurer: Dr. R. (Quain. - Council: Drs. S. Wilks, T. B.Peacock, A. W. Barclay, W. 0. Markham, C. Murchison,R. H. Semple, J. H. Browne, E. C. Seaton, W. D. Chowne,H. H. Salter, R. B. Todd; Messrs. T. B. Curling, J. J. Pur-nell, J. C. Langmore, T. Ballard, M. Henry, W. W. Cooper,J. Hogg, H. Lee, J. G. Forbes. -Honorary Secretaries: Dr.J. W. Ogle; Mr. H. Thompson.

Mr. HENRY THOMPSON, the surgical secretary, read the an-nual report and balance sheet of the accounts, which displayeda most prosperous condition of the Society. The receipts haveamounted during the past year to £375 5s. 8d. and the ex-penditure, including the cost of the annual volume of " Trans-actions," to X299 10s. 6d. ; leaving a balance on this year’saccount, in the treasurer’s hands, of £75 15s. 2d. The Societynumbers more members, and possesses greater resources, thanat any previous period of its history; the existing membersamount to 364, of whom 37 have joined during the precedingsession. The volumes of "Transactions" which have beenissued, and the demand for them amongst non-subscribers, wereheld to be substantial evidence of the value of the Society’slabours, and of the estimation in which it is held by the pro-fession.

It was moved by Mr. CURLING, seconded by Dr. HARLEY,and carried unanimously,-,’ That the report now read be re-ceived and adopted."

It was moved by Dr. ARazrTAGE, seconded by Mr. HLLKE,and carried unanimously,-" That the thanks of this meetingbe given to the retiring officers of the Council for their servicesto the Society."The exhibition of specimens then took place as usual.

Dr. OGLE exhibited a specimen ofENLARGEMENT OF THE LYMPHATIC GLANDS THROUGHOUT THE

BODY; PECULIAR DEPOSITS IN THE LIVER AND SPLEEN; ANDCONDITION OF THE BLOOD.

The case was that of a housemaid, M. B-, aged thirty-nine,who until about two months previous to her death had beenhealthy. At that time she had an attack of fever, and whenrecovering found that an enlargement in the left hypochondriumhad come on. This was followed by œdema of the legs, andconsiderable dullness on percussion was found over the lefthypochondrium, which was very painful. The pulse becamevery frequent, the tongue red, and the general health muchdisordered, the face having a very cachectic appearance. Fluidwas also detected in the peritoneal cavity, and the glands inthe neck and groin became enlarged. Dyspnoea and acute painin the back came on, and finally delirium, which precededdeath.On post-mortem examination, the left pleural cavity was

found to contain a very large amount of turbid fluid, and thebase of the right lung was rather consolidated, otherwise thethoracic visceræ were natural. The lymphatic glands aboutthe root of the aorta were enlarged ; not so, however, themediastinal or bronchial glands. The cervical, femoral, in-guinal, pelvic, lumbar, and mesenteric glands, &c., were enlarged,and some of them were dark and soft; the others being of ayellowish-red colour. The thyroid gland also was enlarged.But the chief gland enlarged was the spleen, which weighedas much as four pounds, was of a dark bluish-brown colour,and was very greatly elongated. On section, the spleen wasfound to contain several, chiefly wedge-shaped masses, mostlyof a yellowish-white colour ; and the liver, which was verylarge also, contained a great number of small masses of thesame kind of material, none exceeding in size, however, that ofa pea. The kidneys were granular, and highly diseased.

Microscopical examination showed that the main elements ofall the enlarged glands were alike in character, and consistedof delicate bodies, of a rounded form, and of a size perhapsrather larger than that of the white corpuscles of the blood.Here and there, however, large-sized cells or vesicles, contain-ing large nuclei, some having three or four nuclei, were seen.Moreover, the light-coloured masses met with in the spleenand liver presented exactly the same elements as those abovedescribed as existing in the enlarged lymphatic glands. Theblood was found to contain, in addition to the ordinary micro-scopical elements, cell formations of a peculiar kind. Thus, inthe splenic vein, numbers of round and oval large cells, ofvarious dimensions, existed ; some containing, in addition to adelicate, half-transparent material, nuclei, varying in number

from one to six or seven, and in some cases, besides thesenuclear bodies, most of which possessed a nucleolus, a numberof small, round, refracting bodies existed. Occasionally moreor less spindle-shaped fibres, containing these nuclei, existed.At times, parts of the circumference of the walls of the largenucleus-holding bodies were very much thickened. Again, inthe blood of the superior vena cava, numbers of very large,transparent cell bodies were seen, in which existed round, non-nucleolated nuclei, and also numbers of nucleolated free nu-cleus-like bodies, as well round as oval.

Dr. Ogle drew the attention of the Society to some observa-tions by Dr. Friedreich, of Würzburg, on cases somewhatsimilar, in which he had found the blood in various parts ofthe body to possess an acid reaction.

Dr. OGLE also exhibited a second case of

ENLARGEMENT OF THE VARIOUS LYMPHATIC GLANDS

THROUGHOUT THE BODY.

The case was that of a middle-aged man, who had enjoyedgood health until nearly two years before death, when he firstperceived a swelling, not much larger than a pea, near theangle of the lower jaw on the right side; and, a few weekslater, a similar swelling at the corresponding part of the oppo-site side. Both swellings increased rapidly, but were not theseats of any pain. About one year previous to death, a glandin the right axilla became enlarged, and two months later theopposite axilla became affected. Six months after, the glandsin the groin became enlarged, and about this time pain in theumbilical region was complained of, and the abdomen wasgenerally enlarged, the superficial veins being very visible; nodistinct tumour, however, was found. Two months beforedeath, the patient was in a state of great debility and depres-sion, and the pulse was quick and frequent. The cervicalglands were all of them greatly enlarged, but none were adhe-rent to the skin. In the axillae, the enlarged glands formed soft,elastic masses, but the inguinal ones were harder. The numberof inspirations was more than usually frequent, but no sign ofparticular thoracic disease was obtained by auscultation. Slightbronchitic rales were, however, heard. Distension of the ab-domen came on, and the bronchitic symptoms increased, thesputa becoming bloody. Orthopncea, irregularity of the heart’saction, and semi-stupor preceded death. On post-mortemexamination, the lymphatic glands in almost every part of thebody were found enormously enlarged, and in the neck, chest,and abdomen, very closely invested, the large and deep vesselsand nerves being moulded on them, and not apparently inter-fering much with them. At one part, the pneumogastricnerve was found passing through a canal of some length, formedby enlarged mediastinal glands; and at one part in the abdo-men, below a united mass of enlarged lumbar and mesentericglands, the inferior vena cava was seen greatly dilated. Allthe enlarged glands presented the same general characters.Their consistence was considerable; some of them were evenindurated. Their outer surface was of a lightish-yellow colour,but sectional surfaces presented generally a bright red colour,and they were easily broken down into a pulpy state. In no

case had softening or suppuration taken place. The variousviscera were found greatly congested, but nothing more. Bothpleural cavities contained large quantities of a milky-lookingfluid, and on the left side a slight amount of fibrinous exudationexisted.

Microscopical examination showed that the enlargement ofthe various glands was due to the presence of material consistingalmost entirely of corpuscles, somewhat larger than pus-globules,with very delicate parietes, and almost transparent contents, sothat they were very often with difficulty recognised. Occasion-ally, instead of being round, these corpuscles were elongated atone side. Nothing like a nucleus was visible within them whenrecent; but after immersion for some time in spirit, their con-tents became more opaque, and more or less granular, withhere and there something like a nucleus. Occasionally, largebodies were seen, formed apparently of aggregations of theabove corpuscles.

WESTERN MEDICAL AND SURGICAL SOCIETY.

A. B. BARNES, ESQ., PRESIDENT, IN THE CHAIR.

’ MR. F. WEBB PETTIGREW read a paper on

CHLOROFORM AXD INSTRUMENTAL LABOUR,in which he advocated the use of this anæsthetic in all instru-mental labours, turning, and most lingering parturitions. Asa general rule, he deprecated its use in ordinary or naturallabour for the following reasons:-