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The abscess was opened the day after admission, when aboutan ounce of pas escaped. Tonic medicines were ordered; butthe patient became worse during the next fortnight. She losther appetite and sleep, the joint gave her excessive pain, andan abscess burst over one of the metacarpal bones. As theconstitutional irritation went on increasing, Mr. Fergusson, afew days afterwards, proposed an operation, which suggestion Imet with the patient’s ready accluiescence.

0

On February 25, 1854, the patient was removed into thetheatre, and, while she was under the influence of chloroform,Mr. Fergusson performed resection of the elbow-joint. Theusual H incision was made, and the flaps dissected back, theulnar nerve being carefully avoided. Both the extremity ofthe humerus and the opposed ends of the olecranon and radiuswere removed with the saw, a considerable amount of pusescaping during the operation.On examination of the parts removed, pulpy degeneration

was discovered, the cartilages were softened, and the ends ofthe bones much eroded but not carious. An opiate was givenat bedtime. Very little febrile excitement followed the opera-tion, and the wound went on so favourably that, on March 13,eighteen days after the resection, passive motion was daily em-ployed.The second case, also reported by Mr. Dickinson, presents

the following features:-Excision of the Elbow-y’oint.

(Performed by Mr. FERGUSSON.)Samuel H-, aged nineteen years, single, of a scrofulous

diathesis, was admitted into Albert ward, Feb. 1, 1854. The

patient has never suffered from want, is of temperate habits,and by occupation a groom. He states that two years beforeadmission his right elbow met with an injury, but apparentlyof so slight a nature as not to excite any particular notice, orserious apprehension for the future. He therefore continuedhis work, but in the space of two months the joint began toswell, and became so painful that he could not follow his voca-tion in a satisfactory manner. He had some liniment from asurgeon, but the disease went on getting worse, and he wasadmitted as an out-patient to the Hertford Infirmary, when agutta percha splint was used for five weeks, applications ofiodine being subsequently made. In spite of these measures,and the administration of cod-liver oil, no improvement tookplace.

State on admission.-The right elbow-joint is much enlarged,and there is indistinct fluctuation on the inner side of theolecranon. Flexion and extension are much impeded and causepain, the arm is bent to an obtuse angle, but pressure gives nouneasiness. On slightly flexing the limb no roughness is felt,but the muscles of the upper arm are much atrophied. Themetacarpal joint of the index finger of the same limb is affectedlike the elbow from an injury received six months before ad-mission. The patient has for some time past been subject tocough, and has not slept well for months.A week after admission Mr. Fergusson opened the joint, and

gave exit to an ounce and a half of sero-purulent matter mixedwith a cheesy, scrofulous secretion. Poultices were applied.Some constitutional disturbance followed these measures, butno improvement took place, and Mr. Fergusson resolved tohave recourse to the resection of the joint.The operation was performed on March 4, 1854, exactly as

in the preceding case, a gutta percha splint being applied, afterthe securing of the vessels, to the inner aspect of the joint, soas to keep the limb at a right angle. The synovial membranewas found in a state of pulpy degeneration, the cartilages weremuch softened, and the bones eroded, but not diseased. An

opiate was administered at bed-time, and the patient pro-gressed remarkably well. The report on March 13, nine daysafter the operation, was as follows : He suffers no pain excepton motion of the arm ; the granulations are healthy, and thepatient much improved. The splint was ordered to be re-moved, and passive motion to be employed at each time of

dressing.Disease of the Foot—Hey’s Amputation.

(Performed by Mr. FERGUSSOX.)Of the three amputations which can be performed about the

foot, viz., Hey’s, Chopart’s, and Syme’s, the first, which leavesso useful a stump, is but seldom performed in cases of chronicdisease of bone. It is probable that after injury about themetatarsal bones and toes, this operation is more frequentlyresorted to ; but it is rare to find the affection of the bones ofthe locality in question so limited that the removal of the meta-tarsus is sufficient. A case has, however, presented itself at

this hospital, and Mr. Fergusson, in accordance with the dic-tates of conservative surgery, removed no more of the footthan was necessary. The origin and progress of the osseousderangement, which led to the loss of the metatarsus and toes,are interesting and instructive ; and we beg to offer a few de-tails, obtained from the notes of Mr. Silvester, one of Mr.Fergusson’s dressers.Farmer L aged twenty-two years, and scrofulous look-

ing, was admitted March 11, 1854. He states that abouttwelve months before admission the joint of the great toe ofthe right foot, was attacked with inflammation from the pres-sure of a tight boot ; the pain became of an aching character,and the swelling presented the appearance of a bunion. Theformer became soon much worse, and was opened by a sur-geon ; but the wound so made refused to heal, and continuedto discharge unhealthy pus. After various plans had beentried the patient was induced to have the great toe amputated,and part of the metatarsal bone in connexion with it. Thiswas done at the Margate Infirmary in September 1853, by Mr.Hunter. The patient believes that the tarsal end of the meta-tarsal bone was not removed, and that its carious state pre-vented the wound from healing up, for ever since the operationthe wound made for the amputation has shown no tendency tocicatrize.

State on admission.-There is considerable swelling pect[py--ing the site of the base of the great toe, and five or six aper-tures in the same locality with the raised granulating edges,indicating the presence of diseased bone. The general healthis good, and the patient has never had either gout or syphilis.The family are not consumptive.On March 4th Mr. Fergussou examined the foot, and found

the osseous textars so diseased that he performed Hey’s ampu-tation. The progress was tolerably favourable until March 15,eleven days after the operation, when the report was as fol-lows :-The foot has been very sore all night; it is very much

swollen and inflamed, the phlogosis extending some way upthe leg. Matter appears to have formed a little above theankle. A large poultice was applied; the stump is healing,but is very painful; the patient sleeps badly, he has no appe-

tite, and feels feverish and nervous, and sweats much at night.Pulse full, soft, and frequent.The same day on which the above operation was performed,

Mr. Fergusson tied two nasvi upon young patients, and wemention the fact principally to remind our readers of thepeculiar kind of knot Mr. Fergusson is in the habit of using.A description of the same will be found in a former " Mirror,"(THE LANCET, vol. ii. 1850, p. 421.) We should not omit to statethat Mr. Fergusson explained in the theatre the mechanism ofthe knot, illustrating the description by slowly repeating themanipulations on a piece of linen. We have always thoughtthat every possible assistance should be given to the pupils inthe operating theatre, and think the short clinical remarksmade after operations at some hospitals of great value. It isto be regretted that this does not take place in all hospitals.In Germany (especially at Berlin) the professor of clinical andoperative surgery explains every step of the operation as heproceeds, the students never being in the dark as to what istaking place. This practice is no doubt advantageous to thepupils, but the safety of the patient should at the same timebe borne in mind.

Medical Societies.

ROYAL MEDICAL AND CHIRURGICAL SOCIETY.

A SPECIAL general meeting of the members of this Societywas held on Friday evening, March 24th, at their rooms inBerners-street, Dr. Copland, the president, in the chair.

’ The meeting was convened by a notice that had been ad-dressed by the Council to the whole body of the Fellows of theSociety.The PRESIDENT, in opening the proceedings, said that most

of the Fellows were aware of the circumstances out of whichthe present meeting had arisen. At the anniversary meetingof the Fellows of the Society, it was moved that a recommenda-tion should be laid before the Council, to the effect that twoperiodicals then supplied to the library should be discontinued.It was moved as an amendment to another motion, and theeffect was, as he had said, that those publications should notlie upon the table of the Society. That motion, or amendment,was brought forward unexpectedly as far as he was concerned,and without any knowledge on the part of the Council of the

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Society. He (the President) had no knowledge of it until theprevious evening, when, for the first time, he heard that hisfriend (Mr. de Morgan) intended to bring the subject beforethe meeting. On the day of the anniversary, he endeavoured,as far as his engagements would permit, to see Mr. de Morgan,in order, if possible, to dissuade him from such an undertaking.He (the President) thought that it was a matter of very littlemoment, and very much beneath the dignity of the Society, toadvert to such a subject. (Hear, lietr, and No, no.) He con-sidered that the Society had nothing to do with medicalpolitics. Its object throughout had been the advancement ofmedical knowledge, and in carrying out that object, it had.carefully abstained from all political medical agitation; andhe repeated his opinion that it was beneath the dignity of theAssociation to advert to medical politics. He was very sorrythat he was prevented from seeing Mr. de Morgan as he haddesired, to dissuade him from bringing the subject before themeeting. Gentlemen present were aware that the amendmentwhich was moved by Mr. de Morgan was carried by a largemajority, and that majority, before the Council could have anopportunity of taking the resolution into consideration, wasmet by a large requisition-a requisition, signed, in fact, by104 Fellows of the Society-impressing upon them the de-sirableness of rescinding the resolution. In this case, theCouncil found themselves placed in a dilemma, and did notelearly see how they could neglect a motion which had passedthe anniversary meeting. They thought it would be better torefer it to a special meeting, that the matter might be broughtbefore the members. A vote of the Council having thus de-termined, the present meeting had been called; and it was tobe hoped that the subject might to a certain extent be got rid ofeven now, and all discussion upon the matter avoided. (Hear,hear, and loud marks of disapproval.) Discussion, they wereaware, frequently led to dissension; and dissension very often

generated unpleasant feelings. It was their duty, as membersof that Society, to conciliate conilicting opinions, more espe-,cially when there was little cause of difference, and not topursue a course which was really beneath the dignity of theSociety. Now it was to be hoped that, although they had metto consider the question adverted to in the notice, some

- course might be adopted by means of which discussion upon itmight be prevented. He was aware that many of the Fellowsdesired discussion, but older members, who had had moreexperience of discussion and consequent dissension, deprecatedit. Many men were desirous of the excitement of a discussion,but he had no hesitation in saying that all present were sofully aware of the desirableness of encouraging kindly feelingstowards one another, that they would willingly avoid anydiscussion which was likely to produce an excitement of an un-pleasant nature. He would therefore again express a hopethat some able and much-respected Fellow of the Society-andmany such he saw before him-would get up and make amotion which would have the effect of bringing about what hehad suggested-preventing a discussion of an unpleasantnature, and preventing, in fact, the further consideration ofthe question. He was sorry to find that this matter should be

considered in such a light as it had been, generating ill feelingin a Society which ought to be an example of unity. (Cries ofVote, vote.) With these observations, and with a sinceredesire that he should consult the feelings of all present, thatthe members should stand well with one another, and thatthere should be no feelings of animosity;—and with a con-viction, moreover, that the proposed discussion was beneaththe dignity of the Society, he would conclude by trusting thatthe recommendations he had made would meet with thewarmest attention. (Hear, hear.)

Sir BENJAMIN BRODIE, Bart., said he had taken the oppor-- tunity of being present at the meeting, though at some per-sonal inconvenience, just because he thought the matter nowproposed for discussion placed the Society in a very unfortunatesituation, and because, as an old member of the Society, hewas very anxious for the honour and welfare of the institution.{Hear, hear.) He did not intend to inflict a long speech uponthe Society, but would coniine what he had to say within verynarrow limits. He proposed to end with making a motion;but before he proceeded to specify what that motion was, heshould beg leave to call attention to a few circumstances con-nected with the Society itself. It was instituted about fiftyyears ago for the advancement of medical and surgical know-ledge, and the advancement of the collateral sciences. Thesevery words, or something like them, were contained in theircharter. That was the business, these were the objects of theirSociety. He need not tell them how it had flourished-how ithad had associated with it all the most important names of the

profession in this country, as well as the names of importantpersons in other countries, who had thought it an honour to beenrolled in the list of its members. (Cheers.) He would askthose gentlemen who had been present at the discussion of theSociety whether they had ever gone away without gainingknowledge they did not possess before, or obtaining new views onsubjects with which they might have previously been acquainted.Then let them look at what the Society had done in the wayof publications. He believed its volumes amounted to thirty-six, a greater extent of publications than had been made byany other Society in the world. (Cheers.) Then let them lookat the value of those volumes. There was not one of themthat did not contain papers of much importance. As to the

multiplicity of papers, he affirmed that there was nothing tobe compared to them, with the exception, perhaps, of theFrench Academy of Surgery. The Society had attained to ahighly hononrable position. It was regarded by all medicalmen in the civilized world as an honour to belong to it. But ‘

let them consider how the Society had attained this prominence.It was because they had stuck to its original objects-thatnothing had been discussed there except what related to thepractice of medicine and surgery. He believed there had notbeen an instance of any other kind of discussion in the Societyprevious to this. (Hear, hear.) The members had always met onfriendly and amicable terms, and amongst themselves it had thisexcellent effect, that it brought together people who would nototherwise meet, and got rid of unfriendly feelings which notunfrequently existed amongst persons who seldom had anopportunity of meeting. (Hear, hear.) Now, he did not meanto give an opinion at all upon the amendment which he under-stood was made in the report at the anniversary meeting.He did not wish to give an opinion one way or another, or tosay whether the amendment was right or wrong; but this hewould say, that it was better that such a subject as that theyhad been called together to consider should not be broughtbefore the Society at large; and he implored the Society itself,for the sake of its members individually, and especially for thesake of the younger members of the Society who had lives beforethem, and to whom it was of the utmost importance that theprofession should be honoured and respected by the public,-for the sake of the younger members, to whom this was ofmore importance than to himself, the President, or the oldermembers,-for the sake of all, he implored that the Societyshould not be mixed up with disagreeable disputes or dissen-sions. (Hear, hear.) As he had before remarked, he did notwish to offer any opinion whether the amendment which hadbeen proposed at the anniversary was right or wrong. Hebelieved that whoever made that motion made it with rightintentions, and he (Sir B. Brodie) threw no blame upon him oranyone else. But it was a matter for the Council, a questionpertaining to the library of the institution. If they interferedwith the Council in one thing they might interfere in othertransactions, and thus involve the Council and themselves inendless perplexities and difficulties. The members appointedthe Council once a year to do all this business for them, andthe Council ought to be permitted to do it in its own way.He thought it would be very well for the Council to take intoconsideration what was the feeling of the Society generally;but he deprecated the threatened discussion on the question atissue, and he implored the Society, and the younger men espe-cially, for their own sakes, not to set an example by intro-ducing this subject, which ought to be avoided-an examplewhich would have the effect of producing painful and jealousfeelings where there ought to be nothing but harmony and unionof sentiment. (Hear, hear.) Perhaps he might be told thatthe Council felt the responsibility too great to decide thematter, but he thought the Council would not say so them-selves. In undertaking that or any other office they must un-dertake responsibilities. Life was made up of responsibilities.Medical men took upon themselves greater responsibilitiesevery day of their lives, and no one was fit for the medical pro-fession who was afraid of encountering such responsibilities,and it might be difficulties. He felt sure the Council wouldhave no hesitation in taking upon themselves the responsibilityin this matter, and that they would do what they thoughtright ander the peculiar circumstances of the case. Underthese circumstances, and hoping there would-be no discussionwhich would lead to dissension, he should beg to move-" Thatthe question mentioned in the notice sent to the members besent back to the Council to act upon it as they may think right."When Sir B. Brodie resumed his seat, Dr. Webster and Mr.

de Morgan rose to address the meeting, the calls, however, forDr. Webster were so loud and general, that Mr. de Morgansat down.

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Dr. WEBSTER entirely agreed in the remark that the questionproposed to be discussed should never have been brought beforethe Society, (hear,hear, ) and with a view of preventing a dis-cussion he rose to second the motion. One of the reasons he hadfor signing the requisition was to show the Council that therewas a difference of opinion amongst the members on the pointraised, and that some amongst them thought that the Councilshould deal with the question. The gentlemen he had actedwith did not originate this movement, and their only objectwas to prevent any further unpleasantness. He believed thatif the matter were left entirely in the hands of the Council,they would deal with it in a manner which would conferbenefit upon the Society. (Hear, hear.)

Mr. DE MORGAN said he had risen to second the motion ofSir Benjamin Brodie, having taken a part in bringing theamendment before the anniversary meeting, and he now verysincerely supported the proposition, for he thought that thequestion which had been submitted to the Council should notbe referred back to that meeting to be discussed. In doing so,however, he must make one or two observations, because hethought some degree of censure had been implied, if not ex-pressed, with regard to his bringing forward the amendmentproposed at the Society on the occasion of its anniversarymeeting. The chairman had stated that he was anxious thatsuch a proposition should not have been made. He (Mr. deMorgan) knew that such was the case, and also that it was not

in accordance with the feelings of several other gentlemenwhom he respected as his seniors in the profession. He bowedwith some degree of submission to those gentlemen, but anobservation which fell from the chairman made him feel thathe was acting rightly and for the honour and dignity of theprofession. The Society was created merely for the advancementof medical science, and he brought his amendment forward tomeet matters which were not in his estimation likely to pro-mote such advancement of medical science. Sir BenjaminBrodie had very properly mentioned the condition in whichthe Society had so long existed, and in which he hoped itwould long continue to exist. But sometimes, from mattersnot being taken up as they ought to be, a crisis arrived whenthose who respected each other were compelled to dissent. Inall Societies, at one period or another, such must be the case.It was unfortunate that there should be differences of opinion,but he did not believe that any differences which might springup on the question under consideration would tend to weakenthat feeling of professional honour and credit which ought toactuate every man in the Society and the profession. He

thought this matter ought not to have been referred back to ageneral meeting of the members. The chairman had statedthat the fellows had no notice of the amendment which he hadmoved at the anniversary. He could not give any notice ofthe amendment; it would have been irregular; but he men-tioned it to many of the members, to the two secretaries, toboth the librarians, and to several of the Council, and it was astrange thing that amongst those who differed so much uponthe point, it should not have been talked of by the Fellows.He mentioned it three weeks or a month before the time cameon, and he could not see that there was any better reason forsupposing that there was less knowledge on that subject thanon most things that were brought before the Society. Hebelieved that what he did was done in a perfectly fair and openmanner. (Ironical laughter.) Gentlemen laughed at this state-ment, but it was true. (Derisive laughter.) Since that amend-ment was carried the Council had received a requisition from cer-tain members of the Society, and had now referred the questionback to that special general meeting. He thought it was a pitythat the Council did not determine it upon the vote of theanniversary meeting, taking into consideration any accidentalcircumstance, for instance, the requisition which had beenpresented. If the decision of the Council were to rest uponrequisitions, he thought it would have been easy to get onequite as large as that which had been presented, and thenthere would have been two to direct the judgment of theCouncil. But he could not help directing attention to thewords of the requisition; they were something to this effect :-"’ That some members of the Council had recommended a

diminution in the number of periodicals." That seemed anevasive manner of putting the subject. The requisitiondid not put before the Council the exact state of tiiings,and he did not believe that the gentlemen who signed therequisition knew what they signed. (Oh, oh ! and loud

laughter.) There was another subject he must mention, andit was with great pain he did so, because he did not like falsethings to go about. The name of a member standing high inthe profession had been made U2e of to get signatures to the

requisition. It had been stated that the name of his formerpreceptor and friend, Mr. Arnott, would be attached to therequisition. (No, no.) That had been stated to himself andto others. He could only say that using the name of anygentleman in that manner who had not given any authority,and who, moreover, did not coincide in the terms of the reso-lution, was not a proper way of getting signatures. He hadmentioned these matters because he thought the Council shouldbe aware of all that had taken place, and he hoped therewould be no further discussion upon the subject. (Laughter,and hear, hear.)The PRESIDENT.—The resolution has been moved and

seconded, and Mr. de Morgan has explained; and I think itwill be to the advantage of the Society if we proceed to takea vote upon the motion; and I therefore request that thosegentlemen who are in favour of the motion proposed by SirBenjamin Brodie, will hold up their hands.

This request appeared to startle the meeting, and at leasta dozen gentlemen rose to speak. Amidst the Babel of tongueswhich ensued,

Dr. TYLER SMITH was understood by the reporter to say thathe wished to have the memorial read.The PRESIDENT.—I consider you are now too late in offering

any opinion.Dr. TYLER SMITH advanced to the table in order to speak to

the President, and was conversing with him as well as the cir-cumstances would allow, when his explanation was cut shortby Sir Benjamin Brodie, who pulled him back by the tails ofhis coat.

Dr. O’CONNOR.—I submit with all deference-The PRESIDENT, (interrupting him. )-The question is that

the matter shall be referred back to the Council.During the interruption which ensued, a show of hands was

taken, and while several gentlemen were protesting, and de’claring that " the contrary" should be put-The PRESIDENT said,-I am happy to say that the pacific

motion proposed by Sir Benjamin Brodie has been carriedunanimously, (some cries of No, No, and much confusion,) andthat our functions are now concluded. Of the remaining portionof the President’s address, " amicable" and " happy" were theonly words the reporter could catch.The proceedings were then abruptly brought to a close,

many of the gentlemen protesting in very loud and angry tonesagainst the arbitrary dictum of the President in not allowingthose Fellows to speak who desired to answer Mr. de Morgan.

TUESDAY, MAKCH 28, 1854.—JAMES COPLAND, M.D., F.R.S.,PRESIDENT.

IMMEDIATELY after the usual proceedings of the ordinarymeeting had terminated,

Dr. CoPLAND rose and said,-The Council have decided thatit is inexpedient to make any alteration in the list of journalstaken ill by the Society.A suppressed cheer followed this announcement.

To the Editor of THE LANCET.

SIR,—As my object In attempting to address the meeting atthe Medico-Chirurgical Society, on Friday evening last, when1 was stopped upon a point of form by the president, may bemisunderstood, I beg to trouble you with a few observations.

As Mr. de Morgan was allowed to speak upon other mattersbesides those immediately connected with the motion of SirBenjamin Brodie, it appeared to me only fair that the pointshe advanced, which threw imputations on the ‘ memorial"opposed to his own " amendment" of the lst of March, andupon those who signed it, should at once have been replied to.This was my sole object in rising. After the observations of Sir

Benjamin Brodie and Dr. Webster I had no wish to enter uponthe general discussion.Mr. de Morgan described the memorial incorrectly; stated

his impression that many of those who signed it did not knowwhat they were about ; and declared that Mr. Arnott’sname was used improperly, to induce others to attach their

signatures.I desired, as the wording of the memorial was called inquestion, that it might have been read to the meeting. Itwould then have been evident that no such words as those

quoted by Mr. de Morgan were contained in the memorial itself.With reference to the remark that some of those who signed

it did not know what they were about, I would observe thatMr. de Morgan, in his own defence, wished the meeting to