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became blanched, restless, cold, and clammy, and died in about Itwelve hours, with symptoms of internal haemorrhage. On

opening the body, the liver was found to be enlarged, weighing If,ninety-one ounces. There was a distinct feeling of fluctuationin the right lobe, from which a quantity of dark-red fluidescaped on being cut into. In the cavity was found a largelayer of decolorized fibrine, which, on being detached, wasfound to be stained with bile, and it was rough and irregularlylaminated. From the cavity there was a large opening into abiliary duct, accompanied by many smaller openings into otherducts. The hepatic duct was much dilated in circumferencenear its junction with the cystic duct. The weight of the liverafter emptying the large cyst, was fifty-four ounces; its con-tents weighed thirty-seven ounces. There were two other andsmaller cysts, containing thick ochre-coloured matter, of a

creamy consistence, and with a cartilaginiform wall. The

cheesy matter in one of the cysts was, on examination underthe microscope, found to be partly granular, and to containmany plates of cholesterine. Ecchinococci, or at any rate theteeth, or characteristic hooks of them, could be found in abun-dance. The upper portion of the large intestine was filled withfluid blood, and the lower two-thirds of the ileum was empty.The liver was, no doubt, the seat of three hydatid cysts; thelarger of these communicated freely with the biliary duct;haemorrhage had occurred into the cyst, probably from a branchof the hepatic artery; this blood had in part passed into theintestines, along the hepatic, or common bile ducts, so as tocause haematemesis and melasna, and fill half the small intes-tines.

Mr. PARTRIDGE exhibited a specimen ofFRACTURED SPINE,

removed from a boy, thirteen years of age, who had fallen froma scaffolding at Somerset House, and was admitted into King’sCollege Hospital. On his arrival there he was sensible, pulseslow, and he was inclined to be drowsy. On examination atthe upper part of the spine at the dorsal portion a fracture wasdiscovered. Crepitus was distinct, and he complained of painin the part; the only other injury was a graze on the chin andthe lower part of the back. He complained of sickness that Ievening; there was general paralysis; there was no loss of sen-sation, but he could grasp less firmly with the left hand; there wasno reflex action of the lower extremities; there was no actionof the intercostal muscles; the breathing was purely with thediaphragm. After three or four days there was a little reflexaction by tickling the lower extremities; subsequently the legswere flexed on the thighs. After rallying from the shock, thebreathing was easier and the pulse regular. His ordinarymode of lying in bed was with his hands grasped over his head;the breathing was easier when lying down, and more difficultwhen in the erect posture. The abdomen was tympanitic, andthere was no power over the sphincters; he passed dark fasces.The bladder was emptied three or four times a day, and some-times washed out ; the urine was sometimes ammoniacal.There were bed-sores, for which he was put on a water bed.The bladder was contracted, and contained only four or fiveounces of urine. There was priapism. This state continuedwithout variation until three weeks before his death, when lowfever came on, and he sank. Though the fracture was in thesixth dorsal vertebra, the symptoms were those of injury aboutthe phrenic nerve. On a post-mortem examination some ofthe spinous processes were found fractured; the spinal mar-row was disintegrated, and in a fluid condition. Probablysome of the symptoms were caused by the effusion of fluidblood into the spinal canal. The lungs and liver were healthy.There was slight ulceration in some portions of the intestines.The kidneys were healthy. A small calculus was found in oneof the ureters, and a small calculus was also found in thebladder. The mucous coat of the bladder was healthy. Thecalculus was not examined as to its composition.

Dr. SIBSON wished to know if the movements of the sterno-cleido and the scalenic muscles were noticed in the case re-lated by Mr. Partridge. Dr. Hodgkin had shown him a caseof a young man who fell down some area steps in which therewas fracture of the cervical vertebra, and the sterno-cleido andscalenic muscles acted strongly. The respiration was abnormal.In another patient, a woman, under his own care in St. 1’Iary’sHospital, there was intercostal respiration where fracture ofthe last dorsal and first cervical vertebra existed; there wasno action of the abdominal muscles, and pus was found en-circling the spine at the place corresponding to the fractures.Mr. PARTRIDGE said that he had frequently examined the

patient, and did not notice the action of the muscles referredto. The hands appeared to be kept in the position over the

head before noticed to aid the action of the great pectorals,for when they were removed the patient put them back again.

Mr. BRODH1JRST exhibited casts of

CONTRACTIONS OF THE SECOND TOE OF BOTH FEET.

The patient, aged twenty-five, had suffered for seven yearsfrom this distortion, which was first induced by wearing tightFrench boots; both feet were nearly equally affected and pain.ful. Walking was most painful, and could only be attemptedwith the aid of sticks. The third phalanx was doubled flatunder the toe, and the dorsum rested on the ground; the nailwas destroyed, and the skin over the articulation ulcerated;there was slight motion in the joint. After dividing thetendon, complete extension was gradually effected, and in twomonths the patient was able to walk with ease.

Mr. BRODHURST, in answer to a question by Mr. Partridge,said that the tendon on the plantar surface of the foot, theextensor tendon of the toe, was divided, and of course thesheath cut through.

Mr. ASHTON said he had a similar case under his care whichhe cured by mechanical extension, by means of a piece of corkplaced under the toe at its whole length.The PRESIDENT reminded Mr. Partridge that cases of that

description are common withth ose who wear small-pointed boots.Mr. HUTCHINSON exhibited a specimen ofINVAGINATION OF THE CAECUM AND ASCENDING COLON,

which existed three months, and was removed from a man whocame under his care three weeks before his death for supposedphthisis. There was great loss of flesh; no disease in the chest;the tongue was red; the pulse was quick; and he had frequentsickness after meals. He complained of uneasiness in his rightside, which he relieved by suspending himself from a ladder.During the last fortnight of his illness he complained of severepain in his right side; and the night before his death, whilstat ten, he was seized with severe pain, which caused him to rollon the ground in great agony.

Dr. CRISP wished to know why Mr. Hutchinson supposedthat invagination had existed three months. He doubted itsexistence for so long a period.Mr. HuTCHiNSON.—All the symptoms being more or less in

existence for that time, and there was great sickness.Dr. HARE agreed with Dr. Crisp, and doubted the existence

of invagination for so long a time. If it were so, there musthave been great pain, and the invagination must be discoveredby ordinary examination. In such cases as that now beforethe Society it was almost impossible to afford relief by opera-tion, the adhesion of the invaginated portions was so firm.

Mr. HUTCHINSON. - There was no examination of theabdomen, for there was no symptom to arrest attention duringlife. He believed that an operation might have been beneficial,for the intestine could be easily divided at the post-mortem,but it was now hardened by the alum, in which it was kept.

Mr. EpiCHSEN.—Dr. Hare stated correctly that, looking atthe intestine from above, an operation could be of no avail in.this case. He saw a case, with Dr. Watson and Dr. West, inwhich there was decided evidence of invagination in a child,and where an operation was not admissible, but relief wasafforded by inflating the intestine from below.

Dr. PEACOCK could not agree with Dr. Hare, that great painalways existed in these cases. In a case of obstruction in thelower bowel, which he saw with Mr. Shilletoe, it had existedfor seven years.

Dr. BARCLAY wished to know the state of the evacuations.If invagination existed so long, it was impossible to have anyevacuations. There must have been complete constipation.Mr. HuTCHINSON did not examine the faeces; they were

always passed in the closet.Dr. HARE, in reply to Dr. Peacock, said that his observa-

tions did not apply to obstructions, but to invagination of theintestines.

Dr. CRISP said the plan had recourse to by Mr. Erichsen wasnot at all new.

WESTERN MEDICAL AND SURGICAL SOCIETYOF LONDON.

FRIDAY, OCTOBER 19TH, 1855.DR. JAMES ARTHUR WILSON, PRESIDENT, IN THE CHAIR.

AFTER the transaction of the usual business, the Presidenttook the opportunity of addressing a few remarks to themembers present. He observed that it was the duty of indi-

416

vidual members to endeavour to sustain the practical utilityof the Society in all ways that lay in their power, butespecially in bringing before the meetings records of cases ofinterest, and short, suggestive papers on particular matters,especially those connected with present epidemics, and thespecial characteristics of disease in the great western districtunder thoir charge. Still he objected to the notion of suchcommunications being, in the popular sense, merely practical,to the exclusion of scientific analogies and deductions, all ofwhich, in a proper measure, belonged legitimately to the term" practical "-a term which unfortunately had been muchabused, and appropriated by those whose views of professionalduty were deficient or contracted. He then passed on to the stateof the public health at the present time, observing that, accord-ing to the published records, the bills of mortality continuedlow, and that the season had been remarkably free from theusual autumnal diarrhcoa-a fact of much importance when weremember how cholera and diarrhoea, had ravaged the countrylast year, and how severe the former has been in Italy, Spain,and in many of the German towns, during the present season.This naturally led him to remark upon the attention which theprofession was now giving to prophylaxis-a subject of con-siderable importance; indeed, all the modern improvements insewerage and buildings were prophylactic, and perhaps tothem were owed much of the present immunity of the metro-polis from any unusual epidemic. The same attention to pro-phylaxis had been extended to tropical countries and the coastof Africa, and our navy was now reaping the advantages of thisapplication of science. He urged upon all to extend its advan-tages, and not to rest until the pest sources of the metropolis(with special regard to the Ranelagh sewer) were closed. The

subject of the advance of chemistry was a matter of congratula-tion, and the production of aluminium (a specimen of which,owing to the kindness of Mr. Morson, jun., was exhibited) inmarketable quantities anticipated; its medical application wasnot yet known. He also remarked upon the attention thatwas being given to the local extinction of pain by ether andcold, the former being applied through the medium of albumen,with which it forms a compound, and which readily permitsits application to any part.Much interesting conversation then followed on the invitation

of the President, during which Dr. Aldis and Dr. Simpsonremarked upon the imperfect sewerage of Brighton, Hastings,and Samlgate, and the fact that in these, and many otherwatering-places, the sea was polluted with the sewage of thetown at the very spots which were frequented by the bathers,whereby, at low water, the atmosphere was loaded witheffluvia.

Reviews and Notices of Books.Guy’s Hospital Reports. Edited by SAMUEL WILKS, M.D.

Lond., Demonstrator of Morbid Anatomy at Guy’s Hos-pital, &c. &c.; and ALFRED POLAND, Assistant-Surgeonand Teacher of Anatomy at Guy’s Hospital, &c. &c. ThirdSeries. Vol. 1. London, 1855. pp. 387. With numerousIllustrations.

The Dnblin Hospital Gazette; cc JO?11’nal for the Cultivat’ionand Improvement of Pl’actical Medicine and Surgery, ,fof’1854. Vol. I. Dublin, 1855.

IF there are two serials of repute for which we have moreliking than for any others, they are the Gzcy’s Hospital Reportsand the Dublin Hospital Gazette. Our leaning towards themis fostered by their essentially practical character. Being theorgans of hospital observation, these periodicals were bound tobe records of useful information in the form of carefully ob-served facts and consequent legitimate inductions. We arefree to say they have always fulfilled their duty, and must re-main, and will we hope continue to be, some of the most valu-able modern archives of practical medicine. It is clear, how-ever, that the profession has not always supported these twoserials in a very satisfactory manner, and they had eachdropped for a time beneath the flood of that transcendental andphysiologico-pathologic diet with which it has been of late thefashion to feed the hungry in the schools of " young medicine."The permanent withdrawal for want of support of two suchjournals from our professional literature, would, in our opinion,

have been a great slur upon us, and it gives us high satisfactionin reminding the reader that the first volume of a new issue ofthe Guy’s Hospital Reports has just been published, as also avolume of the fresh series of the Dublin Hospital Gazette. Theformer, edited by Dr. Wilks and Mr. Poland, is a goodlyvolume of nearly four hundred pages, few of which do not con-tain sound practical matter. Drs. Gull, Pavy, Lever, Haber-shon, Oldham, Hughes, Rees, Wilks, and Odling, and Messrs.France, Birkett, Cock, Callaway, Salter, each contribute a valu-able paper. Of course, all may not be most attracted by the samereports; the physician will not dwell so long on Mr. France’sobservations " On Sub-conjunctival Dislocation of the Crystal-line Lens" as he will on Dr. Hughes’ "Digest of Two Hun-dred and Nine Additional Cases of Chorea"; nor will the sur-geon feel so much at home with Dr. Wilks’

" Report on Fever"as with Mr. Birkett’s memoir on " Adenocele." Nevertheless,physician, surgeon, and obstetric practitioner will be willingto admit that this first volume of the new series is a most satis-

factory pledge of what may be expected in the future. We

heartily wish both the London and the Dublin Hospital Reportsa wide-spread influence amongst the practitioners of medicine.

(7HM!6, lYecet7ae·, and Disease; being a Sketch of the Opinionsof the most Celebmted Ancient and ..LVfodern Writers withregard to the Influence ofClímate and Weat7aer·izz ProducingDisease. By ALFRED HAviLAND, Member of the RoyalCollege of Surgeons of England, Surgeon to the CanniugtonDispensary, &c. London, 1855. pp. 144. With fourcoloured copper-plate engraved diagrams.THE classical physician may here renew very agreeably,

through Mr. Haviland’s assistance, his previous acquaintance-ship with the " epidemics," " the aphorisms," and "the airs,waters, and places" of Hippocrates, and refresh his memorywith some of the more important observations of Galen,Areteus, Aristotle, and Celsus relative to iatro-meteorology.Further than this the reader will find much matter of moremodern origin relative to hygienic influences, usefully inter-woven with the general text, and may safely trust himself inthe hands of the author, who is both a scholar and observantpractitioner, if desirous of gaining a general idea as to thestate of our knowledge upon the climatorial epidemic andendemic relations of many important diseases. With that

portion of the book treating of the "Pestilential Constitution"we have been more particularly interested.

T7te J1fedical Student a St1ldcI1t in Science. The IntroductoryLecture delivered at King’s College, London, October lst,1855. By LIONEL SMITH BEALE, M.B., Professor of Phy-siology in King’s College. London: J. Churchill.

HAVING already spoken very favourably of Dr. Beale’s Intro-ductory Address, it only remains for us to recommend it to theperusal of those who had not the good fortune to hear it. It is

eloquently written, and is especially deserving of attentionfrom its high moral tone, no less than from its inculcating thegreat value of practical studies. Remembering how often wehave given the same advice, it is gratifying to find so true aconfirmation of our teaching as the following paragraph testifies.Speaking in praise of the plan adopted at King’s College Hos-pital, of appointing young men who have just completed theirstudies to the various resident medical offices, Dr. Beale says:-"Now, I shall be able to show you, in a very simple manner,

how important these offices are to the school, and, at the sametime, the Committee will feel satisfied that their confidencewas not misplaced in the men who have been selected to fillthem. Upon looking through the names of the thirty menwho have filled these offices since the hospital was first esta-blished, I find that nearly one-half now hold important ap-pointments as teachers in our own or in other medical schools.The names of these gentlemen are well known to most of you.They are as follows: Lee, Frere, G. Johnson, Brinton, Tanner,S. J. Salter, Griffith, Jordan, Wood, Hyde Salter, AlexanderEdwards, and Hulke. Of those who do not hold teaching ap-