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tions. Her ingesta were of such a character that the fattymatter could not be a modification of them. Alkalies, withopium, afforded her the most relief. He had lately lostsight of the patient. There was occasionally fulness andenlargement of the intestinal canal, but this originated fromthe collection of matter consequent upon the morbid con.dition of the tube.Mr. HEADLAND made some remarks on the diffibulty of

diagnosis in cases of abdominal tumours, and inquired ifDr. Willsbire had decided that the swelling, in his case,was situated in the intestines? In cases like Dr. Will-shire’s, generally, he looked upon the adipocere as a mere ex-crementitious matter, in fact, the relics of digestion, in con-stitutions which were deficient in the assimilative power asfar as regarded fatty substances. Castor oil, when found inthe evacuations, was still castor oil, and unchanged in itscondition, and never produced a concrete substance likethat observed in the present instance. The termination ofDr. Willshire’s case proved that there was no serious dis-ease. He (Mr. Headland) had seen adipocere in the evacua-tions of children and persons of all ages.Dr. CLUTTERBUCK considered the case before the society

an obscure one ; he was inclined, however, under all thecircumstances, to consider that it was originally one of in-:flammation, either primary or secondary, and that the tume-faction was the result of a collection in the intestinal tube,produced by the paralysing influence of the inflammation onthe passage.Dr. THOMPSON related a case of a boy in whom there was

found two transverse arches of the colon, the supplementaryone being attached by a mesentery to the spine, which con-tained lacteals, &c. No fatty matter was found in thefaeces. He was the subject of diarrhoea, and died of pul-monary disease.

INJURIOUS EFFECTS OF ENEMATA.

Dr. WILLSHIRE detailed the case of a young woman whohad injured the lower bowels by the injection of largequantities of water into them, with the view of exciting themto action. She had originally injected only half a pint, butfinding in a short time that this did not succeed in procuringa motion, gradually increased the quantity to three pints,and on one occasion introduced as much as two quarts.Such was the paralysed condition of the muscular coat ofthe intestines that she never had a motion unless a largequantity of fluid was injected. With the view of removingthis condition, the quantity of water was very much dimi-nished, and purgatives of various kinds administered, withno good result. Under these circumstances, and consideringthat the paralysis might be removed by strychnine, thismedicine, in doses of a twelfth of a grain, with two grainsof blue pill, and two of colocynth, was administered, withthe effect of affording almost instant relief. The pills werecontinued for three nights successively, and then an intervalof two or three days was allowed. The intestines had re-

gained their tone, and she had used no injections for five orsix years.Some conversation followed on the advisability of inter-

fering with large collections of fascal matter, when they hadexisted for a long time in the floating intestines of aged per-sons. In some cases it was deemed advisable not to inter-fere at all, and cases were related in which purgation hadended fatally. In other cases, where the patient had suffi-cient strength, the cautious use of stimulating purgativesand tonics might be successfully resorted to.

ROYAL MEDICAL & CHIRURGICAL SOCIETY.

Tuesday, April 9, 1844.EDWARD STANLEY, F.R.S., President.

On the Oxalic Acid Diathesis. By BENCE JONES, M.D.THE author commences his paper with a quotation fromM. Vigla, who, in 1838, says, ’- Nous avions frequementobservé dans les sediments de I’urine de semblables cristaux(octoedriques) que leur forme aurait pu faire supposer etreforms de chlorure de sodium, si la solubilité de ce sel et la

petite quantité qui s’en trouve dans l’urine avaient permisde s’arreter a cette idée."

Dr. Golding Bird, in 1842, stated that these octahedralcrystals were oxalate of lime ; no chemical proof having,

as far as the author knows, been given, he was led to ana-lyse the sediment. On examining urine for this purpose, thevery frequent occurrence of these crystals in rheumatism wasobserved. In one case, in which the rheumatism was slight,the influence of diet and exercise on the mixed deposit, urateof ammonia and oxalate of lime, was made the subject ofexperiment.

In other cases in which these crystals occurred the symp-toms were altogether different, irritation of the urinaryorgans being the most prominent. The concretion of thecrystals into oxalate of lime (gravel) seemed, in one case atleast, to be the cause of this diversity of symptoms.The author observes that these crystals do not often occur

in sufficient quantity to admit of analysis ; but in October,t843, he examined the urine of a patient of Mr. Cutler’s,and at the same time three small renal calculi, which hadbeen passed in July, August, and September. The urineunder the microscope contained multitudes of octahedra,mixed with some crystals of uric acid ; all the calculi con-sisted of oxalate of lime mixed with the uric acid. Theauthor has also examined cases of acute rheumatism,and always found the presence of these octahedral crystalsin the urine of patients labouring under this disease.This deposit is also not unusually found mixed with urateof ammonia in chronic rheumatism. In one case he wasenabled to make some experiments on the effects of dietand exercise on the deposit of urate of ammonia, and in ithe first observed that the octahedral crystals varied in quan-tity at different hours of the day.The daily results of this experiment are given very

minutely during the four weeks it lasted. ,

The author states it would be easy to multiply examplesof the connection between octahedral crystals and rheuma-tism ; but as it indicates no variation in the treatment of thedisease, the fact seems only interesting as showing the closeconnection between the red deposit and octahedral crystals,and thus giving additional support to the theory of ProfessorLiebig regarding the origin of oxalate of lime.The presence of octahedral crystals in the urine is fre-

quently accompanied with symptoms of a totally differentkind. The patient complains of pain in the loins, frequentdesire to pass urine, which is sometimes small in quantity,at other times so much as to simulate diabetes. There aresudden calls to empty the bladder, and if they are delayedconsiderable pain is produced. The urine, when examined,contains only a slight cloud, which does not disappear onthe application of heat. When examined with the micro-

scope this cloud is seen to consist sometimes entirely ofoctahedral crystals, more frequently of those crystals mixedwith globules of mucus, and sometimes there are large andsmall scales of epithelium. The symptoms closely resemblethose produced by a small calculus in the kidney, and in onecase they suddenly ceased after sharp pain in the course ofthe right ureter, and slight retraction of the testicle.The author concludes by observing that the treatment

which has proved most beneficial has been that which im-proved the general health. In two of Mr. Cutler’s casesthe symptoms appeared to follow mental anxiety ; medicinehad little effect, but as the cause for anxiety disappearethe symptoms ceased.

Case of Aneurism of the External Iliac in which a Ligaturewas applied to the Common Iliac Artery. By RICHARDHEY, Esq., F.R.C.S., Surgeon to the York County Hos-pital.

The patient, a gentleman, aged forty, perceived, on the lOthof November, a small hard tumour in his left groin, abovethe centre of Poupart’s ligament. Three days afterwardshe had severe pain in the part, and on the following daythe swelling increased in size, accompanied with pulsation.The tumour gradually enlarged, assumed at one part aconical shape, and the skin was tense and red. By mode-rate continued pressure the swelling could be reduced insize, but it resumed its former magnitude when the pres-sure was taken off. It was resolved, in consultation, toapply a ligature to the common iliac artery, which opera-tion was performed by the author on December the 3rd.At this time the tumour measured six inches across, in atransverse direction, and projected three inches from the

plane of the abdomen. At one point it was about an inch

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and a half from the navel. The incision was begun two’inches and three-quarters above the navel, and three inchesfrom the median line, and was carried six inches down-wards, in a semicircular direction, with a prolongation of’an inch and a half, in a straight line, outwardly. The

layers of muscles and fascia transversalis having beendivided to the whole extent of the incision, the peritoneumwas gently separated from the parts beneath, and the com-mon iliac artery was easily reached. A little time wasoccupied in scratching through the sheath with the point ofthe aneurism-needle, after which it was passed under theartery, from within outwards, armed with a double ligatureof staymaker’s silk, and the operation completed. The ’,pulsation in the tumour ceased immediately after the artery ’,was tied. The patient proceeded, on the whole, favour-ably after the operation, except that he was in great dangerat one time from an accumulation of hardened faeces in therectum. The tumour gradually subsided in size, and bothlegs were nearly of the same temperature, the affected limb’being kept suriounded with flannel. A week after theoperation pulsation was felt in the anterior tibial artery.On the twenty-eighth day the ligature was found loose inthe wound and removed. About the twentieth of Januarythe patient was free from complaint, and was able to walkabout.Mr. HANCOCK inquired if the operator had employed any

means to keep up the temperature of the limb after the per-formance of the operation. In the case which had beenoperated upon by Mr. Guthrie, some years since, for atumour of the hip, the temperature of the limb fell to suchan extent that it was deemed advisable to keep up constantfriction of its surface night and day until the pulsation inthe anterior tibial artery was restored. The ligature cameaway at the end of twenty-five days.The PRESIDENT referred to the paper in order to answer

Mr. Hancock’s question. He read some extracts, whichare, however, embodied in the abstract of the paper, andare more fully elucidated in the practical remarks of Mr.Hey. The President further remarked, that in the casebefore the society the artery had been reached with unusualfacility, the operator having met with none of the usualembarrassments of this proceeding.Mr. HEY said, that in order to make the case as concise

as possible, he had refrained from entering into two or threepoints, which, however, he might now take the opportunityof dwelling upon for a moment. First, with reference tothe means employed to keep tip the temperature of the limbof the affected side. To effect this purpose no artificialmeans were employed except the application of fine flannelround the member, the quantity of the flannel being so regu-lated that the temperature of the limb was never allowed torise or fall, to any extent, below or above that which ob-tained in the opposite leg. To carry this into execution, ofcourse considerable attention was required. He thoughtone point of great interest in the history of the case was theremarkable rapHity with which the tumour progressed insize after its first detection. Scarcely three weeks hadelapsed, from its first appearance of the size of the hazel-nut, before it had increased to such an extent, that it wassix inches and a half long, six inches broad, and three inchesprojecting from the plane of the belly; this projection, ofcourse, being measured from the external part of the abdomen;had this measurement been takea interna’ly, it would, pro-bably, have been five inches instead of three. So rapid wasthe increase of the tumour for a few days preceding theoperation, that much apprehension was entertained that thatproceeding would be too long delayed to be of service. Theirresolution of the patient being overcome, the operation wasresor,ed to as quickly as possible. He had dwelt particu-larly on the exact position of the incision in this case, as apoint of much importance in the operation, for he recollectedthat, in a case recorded by Dr. Pease, in which the incisionwas made much lower down, that the ureter and spermaticcord were embarrassing to the operator. By cutting higherup, as he (1-’lr. Hey) had done, the epigastric artery, thecord, and the ureter were quite out of the way, and formedno kind of obstacle to the operator. Indeed, he had expe-rienced no difliculty whatever in getting down to the tumourand passing a ligature round the vessel. In reflecting onthis case afterwards, he had no doubt that he could have as

readily passed a ligature round the aorta itself, so easily wasthe last step of the operation effected. The exact spot atwhich the ligature was passed round the vessel was art 4point opposite to the lower edge of the last lumbar vertebrabut one, and the upper edge of the last. The tumour de-creased rapidly in size after the operation, and, at the end ofthree weeks, was not larger than half a Seville orange ; butthere was a sinus connected with this which had not healed.One day, Mr. Nelson, the house-surgeon, observed morethan usual discharge of blood and pus from the canal, and itsoon became evident that the tumour had ulcerated into thesinus, and was discharging its contents through the opening.This was proved by the fact that whenever the patient wasin a position to favour this discharge, it increased in quan-tity, as it did also when pressure was applied over thetumour. When in other positions, and without pressure, thedischarge was lessened. The case had progressed most fa.vourably of late, and last Sunday, when he saw the patient,he was in good health, and there was no remains of eithertumour or sinus. He might mention, that in consequence ofsome tendency to protrusion of the bowels, an abdominalbandage had been applied, and, over the more prominentpart, a truss, with a four-inch pad, had been placed. Theonly other inconvenience of which the patient complainedwas a weakness in the limb of the affected side, near to theankle-joint. The patient was a thin, scrofulous-lookingsubject. The spareness of his form had been consideredfavourable to the operation, there being, consequently, littleperitoneum, and this being easily retained in position by theassistants.

Sir G. LEFEVRE inquired into the statistics of the opera-tion in question, and referred to one which had been per-formed successfully by Dr. Salaman, a Russian surgeon,and which he, the speaker, had some years since trans-mitted to the society. It had afterwards been published inthe “ Medical Gazette." In this case; the most troublesomesymptom after the operation was the occurrence of sphacelusof the integuments of the knee and ankle on the affectedside.

The PRESIDENT referred to the case of Mr. Guthrie, inwhich the common iliac was tied, for a tumour which wassupposed to be aneurismal, but was found afterwards to befungoid. Sir Philip Crampton had performed the opera-tion ; the case terminated fatally by the occurrence ofsecondary hæmorrhage. Dr. Mott’s case was successful.

Mr. HEY referred to an article in the first volume of the" Medical Gazette" for 1842-43, in which all the operations,whether successful or otherwise, were mentioned. Amongthem was the case of Dr. Salaman. Sir Philip Cramptonhad attributed the failure of his operation to his havingemployed a cat-gut ligature, which he supposed had becomeabsorbed, and had given rise to fatal haemorrhage. Mr.Liston had tied the common iliac for secondary haemorrhage,but without success. Of the cases mentioned in the articlereferred to, only three or four were successful.

Mr. PAGET said that the person operated on by Dr. Salamanhad died about twelve months since, and an account of hisdissection had been published.Mr. HANCOCK remarked that Mr. Hey had, in his obser-

vations, referred to the difficulty which had been experiencedby some operators in avoiding the cord and the internal

epigastric artery. In the operation performed by Mr.Guthrie, and at which he (Mr. Hancock) had assisted, nosuch difficulty was encountered. That gentlemen com-menced his incision opposite to the umbilicus, or rathermidway between the umbilicus and the anterior superiorspinous process of the ilium, and continued it downwardsin a semi-lunar direction to the outer side of the internalabdominal ring, thus avoiding the cord and artery entirely.The value of this proceeding was shown in the operationfor Mr. Guthrie had commenced with the intention ofplacing the ligature on the internal iliac artery, but a largetumour was found in the pelvis, interfering so much with thenatural position of the contained viscera, and so completelyconcealing the internal artery, that it was deemed advisableto tie the common iliac at once. This was done without the

slightest difficulty, or any necessity for enlarging the wound;indeed, it would have been quite as easy to have applied theligature to the lower end of the aorta itself.

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CM Obstructions of the Pulmonary Arte: y. By JAMES PAGET.The obstructions treated of are those produced by clots

of blood formed during life. They occur in nearly all casesin which the capillary circulation through a part of a lungis prevented for a considerable time before death ; and thisin consequence of the arrangement of the pulmonary arterieswhich do not anastomose, except at their smallest branchesand in the capillary system ; so that, whenever any part ofthat system is obstructed there must be a stagnation of theblood in all the branches of the arteries leading to that part.The branches of the pulmonary arteries are usually foundfilled by old coagula, in cases—first, of compact pulmonaryapoplexy; second, of extreme oedema of the lungs, espe-cially in that form which is attended by peculiar rottennessof their texture, and which is apt to supervene in old per-sons with disease of the heart or emphysema. after repeatedattacks of bronchitis; third, ofpneumoma, with solid de-posit ; fourth, of cancer of the lung, when cancb/ous matterhas been conveyed by the circulation into the branches of thepulmonary artery. Cases of the occurrence of such coagulain these several diseases are related.But besides those cases in which the formation of the

coagula is in a greater or less degree the consequence of ob-struction of the capillaries of the lung, there are others inwhich it appears as the chief and primary disease. Threesuch cases are detailed. In all of them numerous branchesof the pulmonary arteries of the second, third, and moredistant orders were completely blocked up by coagula, whichhad evidently been formed long before death, and besideswhich no sufficient cause of death could be found. In oneof the cases some of the coagula became organised andformed pale firm bands and loops attached to the-walls ofthe artery. In two of these cases there was no indicationwhatever of inflammation of the pulmonary artery or itsbranches having existed : they were in all respects healthyexcept in having spots of yellow deposit in their coats,a change which the author states to be very common

in the secondary and smaller branches of the pulmonaryartery. In the last case related there were abundantfibrinous deposits in the pulmonary valves, with wart-likegrowths and ulceration of the adjacent part of the artery.There were only two valves in this pulmonary artery, andthe author takes this occasion to mention the fact that, inthe majority of cases in which only two valves have beenfound in the pulmonary artery or aorta those valves have beendiseased. He points it out as an example of a congenitaldefect in the shape of a part being accumpanied by a moreimportant congenital imperfection of its tissue, and alludesto the necessity of considering the latter imperfections aspredisposing causes of disease in the imperfect part.

Mr. HEWETT had seen three cases in which there wereonly two valves to the aorta; in one case the valves werehealthy, in the others diseased. ,

HOUSE OF COMMONS, APRIL 16TH, 1844.

OPERATION OF THE ANATOMY ACT.

MR. COPELAND moved an « Address to her Majesty,praying that she will lay before this house a copy of allcommissions, and names of commissioners, appointed to

inquire into the working of the Anatomy Act, and also intothe official conduct of any inspector of schools of anatomyfor England, Scotland, and Wales, and reports (if any) ofthe evidence taken by the commissioners."

Sir J. GRAHAM said, that he was in the house when theAnatomy Act was introduced, and lie extended to that Acthis cordial support, under the belief that it would be pro-ductive of great benefit. All his subsequent experienceestablished that the measure was well advised. It haddone much good, and that good might be tested by the quietoperation of the measure. What was the case before theAct was introduced ? There was hardly a churchyard inthe metropolis which was not violated. Such a price wasgiven for subjects that life was rendered quite insecure.All these evils had disappeared, and the schools were plen-tifully supplied. In his office an accurate record was keptof the disposal of all the bodies given for dissection. Cer-tain irregularities had been pointed out, but these had beenrectified. Let honourable members examine for them-

selves. He deprecated all noxious agitation on the subject.The evils which that Act of Parliament was intended toremove had disappeared. The greatest inconveniencewould arise from the production of the papers moved for,and he hoped that the house would oppose the motion.

Mr. F. FRENCH thought that the right hou. baronet had?not fairly met the motion. The first report of the commis.sioners li,id not been made. When he brought forward thequestion some years back the right hon. baronet eulogisedvery highly Dr. Somerville, the inspector of anatomy.Since the right hon. baronet had been in office he had dis.missed Dr. Somerville, in consequence of his havingfavoured some particular schools in the distribution of sub.jects. The right hon. baronet was in the habit of usingextraordinary phraseology ; on a former occasion he hadused the term Jack Cade legislation, and now he had ap-plied the term “ noxious agitation" to a motion broughtforward by one of his own supporters.

Sir J. GRAHAM said he did not refer the term to themotion of Mr. Copeland, but to ’he petition presented sometime ago by a DIr. Roberts.Mr. FRENCH believed there was not a more illused man

than Mr. Roberts, whose discoveries had been of essentialservice to anatomy. The letters set foi-th in his petition,from Sir G. Sinclair, from Mr. M’Murdo, of St. Thomas’sHospital, even from Dr. Somerville, and at one time fromMr. Warbutton, fully admitted the value of Mr. Roberts’sdiscovery. He, therefore, must protest against the term" noxious agitation" beiug applied to anything Mr. Robertshad done. He had only brought forward the shamefulabuse of the Act of Parliament. The public did not thinkit noxious agitation. Mr. Roberts would persevere until the

grievances he had exposed were remedied.Mr. WARBURTON entirely agreed that nothing could be

more noxious than agitation upon this subject. As oneof the first commissioners appointed to investigate Dr.Somerville’s conduct, he (Mr. W.) stated, upon his

honour, that in his opinion, and that of the com-

missioners, Dr. Somerville had conducted himself in amanner highly conducive to the interests of science. Dr.Somerville had not been permitted to retire with a paymentof 1001., but had been dismissed receiving a sum of 100l.He (Mr. W.) could not know what was the report of thesecond commission ; but, if he was not very much mis-

taken, it was a complete and honourable acquittal of Dr.Somerville from all the charges which had been broughtagainst him.

Sir J.GRAHAM said, that the conduct of Dr. Somervillehad been submitted to a second commission, and that its

report was a complete acquittal of Dr. S.Mr. P. BORTHWICK said, that it did not necessarily follow

that all agitation on a noxious subject should be noxiousagitation. He admitted that this was not a fit subject forpopular discussion, but he had not laid Mr. Roberts’s peti-tion on the table until he had carefully perused every state-ment it contained. If Mr. Roberts had engaged innoxious agitation, that agitation had been shared by Sir A.Cooper, Sir B. Brodie, Mr M’Murdo, lJr. Grainger, Mr.B. Cooper, Mr. Stanley, Mr. Partridge, and Mr. Todd.Unless the evils of which the petition complained wereremedied, it would be his (Mr. B.’s) duty on a future dayto c.tll the attention of the house to those complaints.Mr. WARBURTON begged to ask whether or not he really

intended to bring on a discussion of that petition? He

(Mr. W.) had attended on days in which the notice of thehon. member had stood on the paper, and the hon. membermust know that to place a notice on the books, and after-wards put it off, was not personally convenient to members.Mr. P. BORTHWICK said his motion had only once been

postponed, and it now stood for the 25th instant; but, asthat would be a drawing-room day, it was not likely itcould then be brought ou. He trusted that the govern-ment would adopt such measures as would make the motionunnecessary. If not, he would fix a day for it.Mr. M’KiNON trusted that, after the statement of Sir J.

Graham, Mr. Copelund would not press his motion.Mr. COPELAND thought the statement satisfactory, and’

therefore would withdraw his motion.—Motion, by leave;,withdrawn,—Times.