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ossified, necrosed, and loose. Right half of cricoid consistedof necrosed bone, and was quite loose in a sloughing cavity.Externally, the advanced suppuration extended between thethyroid body and cartilage. Above this was a hollow, green-coloured space. Opening in trachea healthy. Tubes belowinflamed, and surface of a green colour, like upper part of thelarynx. Smaller tubes filled with dirty, oily, purulent mucus.Lungs inflamed in parts. Consolidated tissue here and there.One large mass, of the size of an egg, had become gangrenousand fœtid.

ST. BARTHOLOMEW’S HOSPITAL.

CHRONIC SYPHILITIC LARYNGITIS ; TRACHEOTOMY TWELVEMONTHS AGO; LOSS OF THE UVULA AND EPIGLOTTIS,APHONIA AND DYSPHAGIA; RELIEF BY TREATMENT.

(Under the care of Dr. FARRE.)A CLASS of cases of throat disease very commonly met with

in hospital practice is syphilitic ulceration of the larynx, ex-tending generally to the vocal cords, lips of the glottis, and the epiglottis itself, oftentimes destroying the cartilages, and end-ing fatally. Some of the worst cases of laryngeal disease whichhave come under our notice were syphilitic; and we have seenthe windpipe opened in apparently the most hopeless of cases,where, notwithstanding many unfavourable circumstances, arecovery has, nevertheless, ensued. We can call to mind one

very severe example of the kind in the Royal Free Hospital,with cedema of the glottis and mercurio-syphilitic gangrene ofthe mouth, in a girl under Mr. de Meric’s care. (THE LANCET,vol. i., 1859, p. 213.) The patient was absolutely dying, and,to, the astonishment of everybody, she recovered slowly afterthe trachea had been opened, thereby giving time for thedisease situated higher up to heal. A case, not less inte-

resting, appears in a former " Mirror," (ibid., vol. ii., 1856,p. 48,) of syphilitic ulceration of the larynx, producing urgentdyspnoea and threatened suffocation in a patient at the fullterm of pregnancy, in St. George’s Hospital, under Mr. Pol-lock’s care. She completely recovered after tracheotomy, andwas delivered of her child whilst wearing the tube in her neck.Some weeks later an unequivocal syphilitic eruption com-menced on the child’s body. In Dr. Farre’s patient the ulcera-tion was chronic, with destruction of a portion of the epi-glottis, which caused painful dysphagia and partial aphonia; thestructures of the throat generally were in a state of atrophy, withloss of the uvula. Most of these were the consequences of theoriginal syphilitic laryngitis, which at one time had demandedrelief by operation. The dysphagia was now a marked symp-tom, for although her appetite was good, she experienced greatdifficulty in swallowing her food, which is explained by thestate of the epiglottis, and most probably of the folds ofmucous membrane at its base. The dysphagia may be amelio-rated, but it can never be wholly removed. There was noapparent disease of the lungs beyond an attack of bronchitis,but the lining membrane of the entire air-passages would seemto have been in a state of chronic irritation, as evidenced bythe presence of the epistaxis, as well as the bronchitic affection.

For the notes of the case we are indebted to Mr. Schollick,Dr. Farre’s clinical clerk.

Eliza P-, aged forty, was admitted into Mary ward onthe 24th of Nov., 1859, under the care of Dr. Farre, forchronic syphilitic laryngitis. The patient is a very thin ema-ciated-looking woman, who states that she caught cold sixmonths ago, when she had a slight cough, with difficulty inbreathing, which has been getting gradually worse up to thepresent time. She had a similar attack twelve months ago,when tracheotomy was performed at the Metropolitan FreeHospital, with immediate relief. She was an out-patient atthis hospital ten years ago, when she had the ou,side of herthroat painted with iodine. She was subject to elongated uvulawhen a child, and has been a good deal troubled with it atdifferent times. The uvula was burnt off ten years ago withcaustic, and the epiglottis is partly destroyed. She has nowgreat difficulty in swallowing, and also of breathing, and com-plains of pain in the left side of the neck at the edge of thetrapezius muscle when she swallows. She feels well in otherrespects, were it not for the weakness caused by the state ofher throat. The skin is cool and ruoist; pulse 84, feeble; tongue

slightly furred; appetite good if she could but swallow; bowelsrelaxed. Ordered, almond mixture and syrup of poppies, thricea day, and three ounces of wine, with nourishing diet.

Nov. 25th.-Slept a little last night. Does not generallysleep well from pains in the head. To have half a drachm of £syrup of iodide of iron, and two grains of iodide of potassiumin infusion of quassia, thrice a day. She states that her hus-band had a " bad disorder " some time ago, and she has had asore herself. The catamenia have appeared only three timessince the operation on her windpipe.26th.-Her throat feels sorer than it did, but the difficulty

in breaking is not increased; the pain in the left side of theneck relieved by a mustard plaster; skin cool and moist; pulse96, feeble; tongue clean; appetite good; bowels relieved twiceby some castor oil. She did not sleep last night. Sibilantrales under the right clavicle; expectoration scanty, thick, andviscid.28th.-She feels worse; the cough was very troublesome

last night; skin cool and moist; pulse 90, feeble; tongue clean;appetite pretty good; bowels confined. To take confection ofsenna,ev,ery alternate night.29th.-Cough still troublesome, but she can swallow her

medicine much better; skin cool and moist; pulse 86, veryfeeble; tongue clean; appetite good; bowels not sufficientlyrelaxed yet; slept better last night; complains of pain in theleft lower axillary region when she coughs.

Dec. 2nd.-Voice improved; she can talk and swallow muchbetter; neck feels stiff; cough not so troublesome and expecto-ration less; pulse 74; cheeks and lips less livid than when shecame in; appetite good. To have a chop.5th.-Cough rather worse, and she feels a little tightness

about the chest; complains of pain and tenderness about thenose and head. Skin cool and moist; pulse 92; bowels freelyopen.9th.-Much better to-day. Yesterday she had pain all over

her, but it is now confined to the right side of the head. Pulse104. Wine increased.12th.-Pain in the head not so bad, but there is no further

improvement in swallowing. Pulse 100, feeble. Has not sleptwell for the last three nights, from pain in her nose; the coughis not so troublesome, but expectoration is difficult. To havedecoction of bark, dilute nitric acid, and syrup of poppies, threetimes a day.13th.-Nose still painful, and bled very much last night;

clots of blood sometimes come up when she coughs.15th.-Seems a little better to-day; the nose did not bleed

so much last night as it did the night before. Has been takingthree grains of acetate of lead every six hours since yesterday.

19th.-Epistaxis has ceased, but the difficulty in swallowingstill continues. Pulse 86, feeble; appetite good; sleeps betterat night. Ordered three grains of iodide of potassium threetimes a day in infusion of gentian.On the 21st some hyoscyamus was added to her mixture,

and she improved in every way, and was discharged on the23rd, but was requested to attend the hospital as an out-patient.

ST. GEORGE’S HOSPITAL.

IMPACTION OF A FLINT STONE INTO THE LARYNX OF A

CHILD ; SUCCESSFUL REMOVAL AFTER TRACHEOTOMY;DEATH ON THE SECOND DAY.

(Under the care of Mr. TATUM.)

THE present is another example of impaction of a foreignbody in the windpipe of a child, in whom the operation oftracheotomy proved unsuccessful, notwithstanding that thestone was effectually got rid of. Although our "Mirror" hasafforded many illustrations similar to the present, this is thefirst time we have had to record the presence of a stone made

up of silicious materials. Amongst the last cases which we re-ported were, a tamarind stone removed successfully from thelarynx of a child, by Mr. Skey, at St. Bartholomew’s Hospital,(THE LANCE r, vol. ii., 1859, p. 160;) and a crumb of bread inthe larynx of another at the Middlesex Hospital, in whomtracheotomy, performed by Mr. Mitchell Henry, proved un-successful, (ibid, vol. ii., 1858, p. 374.)The notes of the following case were furnished by Mr. G. F.

Cooper, the late surgical registrar to the hospital :-H. S-, aged six years, admitted May 2nd, 1859. Shortly

before admission the child swallowed a stone. On being

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brought to the hospital he was in a partially asphyxiated state ;but quite suddenly his face became black, and he was almostsuffocated. As Mr. Hooper (assistant-obstetrician to the hos-pital) was the only medical officer present, he took up a knifewhich was on the table, and opened the trachea directly,which immediately relieved the child. The wound was keptopen with a pair of forceps till a canula could be got, whichwas then introduced, and the patient breathed quietly.May 3rd.-Ten A.M.: Dozed a little in the night; pulse 180,

strong; breathes easily.-One P.M.: Considerable dyspnoea hascome on rather suddenly. Mr. Tatum was sent for, and hedirectly took the canula from the trachea, when the child hadsome convulsive coughing, bringing up a few flakes of lymph.The canula was again put into its place, as the patient was ina threatening state of suffocation, and it again brought up(through the canula) something more, which was supposed tobe lymph and mucus. This much relieved the child. Mr.Tatum then with his finger examined the fauces, &c., trying tofeel the stone, but was unsuccessful. The whole of the partswere much thickened by inflammation. During this exami-nation, which was repeated two or three times, the child be-came much convulsed. Mr. Tatum then called for a consulta-tion, to ascertain the propriety of dividing the thyroid cartilage,in order to remove the stone ; but in a few minutes, whilstwaiting for the surgeons, the nurse found the stone (it beingabout the size of two peas joined together, and almost round) onthe bed. It was supposed that when the canula was removed,during a convulsive inspiration, the stone must have beenbrought down into the trachea, and that upon the renewed in-sertion of the canula it was by a convulsive cough ejected.On examining the throat when tracheotomy was performed,the stone could be felt, and seemed to be impacted betweenthe cordæ vocales. Ordered two ounces of wine and two grainsof calomel every four hours.-Nine P.M.: Pulse weak, 170; re-spiration quick and laboured; face pale; sensible. In thenight, dyspnœa became more severe. Mustard poultices wereapplied, and the canula removed several times to displace anylymph that could be seen ; but early next morning the childdied from suffocation. No autopsy was allowed.

Medical Societies.MEDICAL SOCIETY OF LONDON.

ANNIVERSARY MEETING, THURSDAY, MARCH 8TH, 1860.

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

THE eighty-seventh anniversary meeting of this Society washeld at the Albion Tavern, Aldersgate-street.

THE ANNUAL ORATION.

Mr. GAY commenced by speaking of the flourishing con-dition of the Society, and of the important influence which thescience and practice of medicine exerted over both the externaland internal circumstances of man. He then entered into anelaborate statement of the connexion of medicine with the col-lateral sciences, of which he adduced various instances in proof.He next went into an inquiry as to the effects of modern dis-coveries on medicine. The proceedings of the Society, duringthe past session, were then reviewed, and an allusion made tothe valuable work of Dr. Waters, of Liverpool, " On theHuman Lung," for which that gentleman justly obtained theFothergillian medal. A well-deserved compliment was thenpaid to the President, Mr. Hilton. In conclusion, the speakerdrew the attention of the Fellows of the Society, as well as ofthe members of the profession generally, to the fact that, not-withstanding all the advance that medical science had made,there were discoveries, just in advance of its present attain-ments, for which the world were in eager expectancy. In theHouse of Commons, Sir Cornewall Lewis had recently alluded,in strong terms, to the uncertain state of the medical professionwith regard to poisons, adding, that the same imperfection anduncertainty are necessarily communicated to those legal ques-tions with which they are connected. Should there have beenan occasion for this rebuke? The question is not asked dis-paragingly in reference to the labours of those who are engagedin toxicological inquiries, but to show the just expectancy ofsociety when it seeks enlightenment on subjects within theprovince of medical art, but as yet not so understood as tomake them practically available. Sanitary science also, whilst

it is busily engaged in combating fever and pestilence, is it notoverlooking the serious fact that thousands of children are con-stantly dying of starvation in this land of unparalleled luxuryand abundance ? With regard to the great and fundamentaldoctrines of medical science, is there not room for inquiry ?Have the profession an accurate idea of the nature of disease?And is it not too much regarded as a hap-hazard innovation,rather than that of a readjustment of the morphological andconstituent elements of the organism, in conformity with a ne2atype, necessitated by a deviation, more or less wide, from itsoriginal and healthy condition ? If it were possible to substi-tute a healthy for a morbidly-changed heart, or a slow for arapid beat, should we, leaving its associated disorders uncor-rected in all probability, mend the condition and improve thegeneral powers of the system ? Is no light thrown upon thisquestion by the recurrence of cancer, or of bone disease, againand again after their removal by a surgical operation ? Inalluding to the Medical Society of London, the speaker saidthat societies have ever been established to effect more thanindividual enterprise, or even the dissociated efforts of its

members, could accomplish; and if the seventeenth centurystood in need of such as the " Royal" and analogous societiesto dispel the gloom with which superstition and ignorance hadinvested it, surely the nineteenth needs such helps too. If SirJohn Floyer sent the infant lexicographer to be " touched forthe evil" a century and a half ago, the present day witnessesthe sadder spectacle of men tramed in the highest seats oflearning, and devoted to the service of religion, inculcating abelief in demoniacal agencies, in " spirit rapping and tableturning," in "coming tribulation," and in the vulgar conceitsof the disciples of Mesmer and Hahnemann. And as the greatmen of the profession are removed, is the system of medicaleducation by which their places are to be filled such as canbest promote that end ? Is it not the case that the circle fromwhich the future Coopers and Brodies are to spring has beengradually lessening, so that now it might be said to be repre-sented by a small division in the schedule of the Income-taxassessor ? Is it not the reverse of that which furnished LordCampbell with glowing materials for the " Lives of the Chan-cellors," and the Bench and the Bar with such men as a Ten-terden and a St. Leonards? Should not the profession, its postsand emoluments, be open to all, without, comparatively, any" prohibitory dues" but those of intelligence, learning, and in-tegrity ? The speaker concluded by a reference to the reinter-ment of the remains of John Hunter.

Election of Officers and Council. -The following gentlemenwere declared to b elected the officers and Council for theensuing year:-President: A. B. Garrod, M.D., F.R.S. Vice-Presidents: G. O. Rees, M.D., F.R.S.; F. Sibson, M.D., F.R.S..;C. H. Rogers - Harrison, Esq.; R. Wade, Esq. Treasurer:James Bird, M.D. Libt-a2,iait: John Cockle, M.D. Secretariesiiz Ordinary: T. Bryant, Esq.; Hyde Salter, M.D., F.R.S.Secretary for Foreign Cornspondence: T. Davidson, M.D.Councillors: W. Adams, Esq.; J. Birkett, Esq.; J. F. Clarke,Esq.; R. Druitt, M.R.C.P.; W. T. Dyer, M.D.; J. Erichsen,Esq.; A. Fisher, Esq.; H. W. Fnller, M.D.; C. J. Hare, M. D.;W. Harvey, Esq.; T. Hawkesley, M.D.; J. Hilton. Esq., F. R. S.;T. Hunt, Esq.; E. Lankester, M. D., F.R.S.; J. Love, Esq.;P. Marshall, Esq.; J. F. Marson, Esq.; S. W. J. Merriman,M.D.; F. W. Pavy, M. D.; W. R. Rogers, M.D. Orator for1861: A. Clark, M.D.The silver medal for services to the Society was granted to

the President, Mr. Hilton.The Fellows of the Society afterwards dined together.

OBSTETRICAL SOCIETY OF LONDON.WEDNESDAY, MARCH 7TH, 1860.

DR. RIGBY, PRESIDENT, IN THE CHAIR.

LETTERS were read from Professor Scanzoni and Dr. Meigs,acknowledging the gratification which they felt at being electedhonorary fellows.

A CASE OF FALLOPIAX PREGNANCY.

BY HENRY GRACE, ESQ., M. R. C. S. E. , ETC.

(Communicated by DR. GRAILY HEWITT.)The patient was six or seven weeks advanced in pregnancy,

and died from rupture of the tube. At the post-mortem ex-aminatiou, about three pints of blood, partly coagulated, werefound within the peritoneal sac. The source of thia was a rnp-found within the peritoneal sac. The source of this was a rup-ture of the left Fallopian tube, which was enlarged about its