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of carbon, hydrogen, nitrogen, and oxygen, while caseine is acompound of carbon, hydrogen, nitrogen, oxygen, and sulphur.To this substance he gives the name of protein, supposing that itis the common fundamental principle of albumen, caseine, andfibrine, which it forms by uniting with certain small quantitiesof sulphur, or sulphur and phosphorus, and which latterbodies are separated by the alkali, and retained in solution.When the protein is precipitated by an acid. the precipitateobtained therefrom by Ure was not caseine, but the proteinof Millder; or we are justified in supposing this to be the casetill Ure or Dumas shall have proved by ultimate analysis that Iit is not. IThere is another test for albumen to which Ure doubtless

did, or at any rate ought to have had recourse, though hedoes not tell us so-that is, the supposed property of all albu-minous fluids to coagulate by heat; and were this charac-teristic universal, it would be a good test; but I find, thatwhen once we have dissolved albumen in caustic alkali, we areenveloped in many difficulties, from which time, perseverance,and experiment only can liberate us. I trust, ere long, to be ableto do this ; but for the present, I would only state my resultsas far as they go. I find, that when thus dissolved in certainproportions, it entirely loses the property of coagulating byheat, and that in proportions where it does not lose this pro-perty entirely, it does so to a great extent. A quantity ofalbumen is left in solution after all has been coagulated thatheat will render insoluble, and protein is precipitated from thissolution upon the addition of a slight excess of acid.

I think, therefore, that until the various properties of albu-minous fluids can be fixed by definite laws, the conflictingstatements of Liebig and Ure must fall to the ground, and wemust seek elsewhere for the grand fundamental cause of thatchange which has plunged many parts of our own, togetherwith our sister country Ireland, into a state of destitu-tion and want, than in the conversion of the albumen intocaseine.

I trust that these remarks will throw the path open forother experiments, and that others will follow it.

High-street, Colchester, March, 1846.

WESTMINSTER MEDICAL SOCIETY.

APRIL 4.—MR. HANCOCK, PRESIDENT.CASE OF INSANITY OF FIFTEEN YEARS’ STANDING, WITH EFFUSIONBENEATH THE DURA MATER, AND THE FORMATION OF NEW

MEMBRANE.

MR. FisHER related the following case :-W. P-, the son of a gentleman of fortune, at the age of

eight years, then at Winchester School, received a severe con-cussion, by the blow of a cricket bat or ball, followed by imme-diate symptoms of insanity, from which he recovered for atime, but soon after was brought to London, labouring underaberration of mind, and then came under his (Mr. Fisher’s)care for the first time. He recovered, and went into Devon-sbire with his friends, had a relapse, and was placed under ’’,private medical care for a period of eight years. He was thenbrought to town, and again became Mr. Fisher’s patient,labouring under the same malady. The history given of himduring the eight years was, that he had had occasional attacks ofinsanity, lasting two, three, four, and five months, with con-siderable lucid intervals. He was then sent a short distanceinto the country, for a period of five or six years, and forthe last two years and a half, to Messrs. Stilwell’s establish-ment, Hillingdon. It was remarked that each attack increasedin duration and violence, and there was generally a lapse ofeight or twelve months between them. He was a fine, hand-some, healthy, muscular young man ; to a common observer,merely weak in intellect, and childish in manner; loquacious,but without delusion; his appetite voracious. He was fond ofreading the lighter works of literature; played well at chess,billiards, and whist, and was capable of great bodily exertion,frequently, when in health, walking twenty miles a day. Hehad a religious turn of mind, would write sermons, and had amost retentive memory. During his insane attacks he wouldrepeat passages from Scripture for many successive hours, andquote poetry. When in health, he was amiable and kind-hearted, and very susceptible of the tender passion.The premonitory symptoms of each attack were marked by

fulness of habit, lowness of spirits, sullen, dogged manner, andloss of appetite; pugnacity, and cruelty to animals, of which,at other times, lie was fond. The last insane attack com-menced in May, 1845,and continued, with occasional intervalsof a few days’ tranquillity, until the middle of December, a

period of seven months, when he rapidly recovered, and, fromextreme prostration, he resumed his usual fulness of habit.January 3rd, 1846.-His last illness commenced with a vio-

lent pain over the forehead, accompanied by a sense ofweight, lowness and depression of spirits. He was cupped,and took calomel, with aperients.5th.-Vomiting came on, with increased pain in the head.

Mustard poultices and blisters were applied to the stomach;and calomel was frequently given, with relief to the sickness.Cold lotions were applied to the head. During this periodthe mind was perfectly clear.9th.-He became so drowsy that it was almost impossible

to rouse him, and when this was effected, he relapsed im-mediately into a comatose state. When conscious, he com-plained of great pain in the head. All his symptoms indi-cated great congestion of the brain, for which active treatmentwas resorted to.13th.-The patient was, in every respect, worse. The right

eye turned outwards, and the eyelid dropped down, the willhaving little power over it; the pupil more dilated than theleft, but no paralysis of the muscles of the face.17th.-The symptoms had all been alleviated by cupping,

leeching, and calomel, and he appeared to be doing well.20th.-The right eye had recovered from its paralytic state,

and the pain in the head was much relieved, but coma con-tinued, and he was with difficulty roused to take food andmedicine.23rd.-The mercury appeared to be affecting his gums; the

symptoms slightly improved. He could get out of bed with..out assistance, and knew the persons about him.

26th.-He changed for the worse, became feebler, and sleptconstantly. He cohtinued slowly to sink, and died on the 30th,at the age of twenty-three, not having been sensible for thelast thirty-six hours. - !

Post-mortem examination, twenty-four hours after death, by3fes.gr8. Stilzvell and PisheT.- Upon sawiug through thecranium, the instrument perforated the dura mater, and twoounces of blood escaped, which were caught in a glass;upon the removal of the calvarium, the dura mater, the piamater, and arachnoid, were found highly injected. Thewhole right hemisphere of the brain had the appearance of abladder of fluid lying under the dura mater, and from it tenmeasured ounces of grumous blood, containing a clot and somered blood, escaped. The whole of the brain was then re-moved, and brought to town with the calvarium, and examined,without minute dissection, by Dr. Marshall Hall, Dr. Sayer,.and himself, (Mr. Fisher.) The right hemisphere of thebrain was rather less than the left, and its surface was of adeeper colour than usual. The arachnoid could, be distinctlytraced, from convolution to convolution, over the- wholesurface of the cerebrum. No effusion had taken place ineither of the ventricles. The left corpus striatum, and theleft thalamus, were larger than the corresponding parts onthe right side. The medullary and cortical substances ofcerebrum and cerebellum were well defined and perfectlyhealthy. It was suggested that the dura mater should beminutely examined by Mr. Lane and Dr. Sayer, and it wastaken away by the latter gentleman, Mr. Lane being out oftown. It was, without any dissection, examined by Dr. Sayer;and the impression on his mind was, that the longitudinalsinus was in an abnormal condition; that a gradual separationof the laniinso of the dura mater had taken place, to the-extent of several inches on the right side of the falx, by whicha large pouch had been formed, capable of containing manyounces of venous blood." The membrane was returned the,same evening, Feb. 1st; and on the 22nd of March it wasvery minutely examined, and carefully dissected, by Mr. Han-.cock, in the presence of Mr. Hird, Dr. Sayer, and Mr. Fisher.The true nature of this membranous pouch then becameapparent, and Mr. Hancock gives the following description ofthe appearances observed:-" The preparation shows a largecyst, formed evidently of adventitious membrane, situatedbetween the layers of arachnoid, and extending the wholelength of the right hemisphere of the brain, which has beenremoved, together with the arachnoid and pia mater. Thiscyst also extends from the falx major laterally to the portionof the dura mater covering the outer border of the cerebrum.It does not communicate either with the superior or inferiorlongitudinal sinuses, the former of which has been laid opento prove this fact ; neither does it communicate with the

lateral sinuses, but appears to be the result of abnormal, action. The bones of the cranium are much thinner

than natural, at no part being more than a quarter ofan inch thick, but in places consisting of merely the two, tables: there is an evident bulging of the right parietal,

417

bone, towards its anterior and inferior angle, and here thediploe has been entirely absorbed by the continued pressureOf the cyst within. The right half of the frontal, and the occi-pital and squamous portion of the temporal bones of the sameside, have been subject to a similar action. It appears thatthe whole brain must have been pushed over to the left side,and that considerable pressure has been exerted on the left

parietal bone, which, towards its anterior and inferior angle,is in places almost deprived of its diploe, although not to the’extent of the opposite side; neither does it bulge, as in thatsituation. The left half of the frontal and occipital bonesappears to have escaped this pressure. When the calvariumis measured internally, there is an addition of half an inch infavour of the right side. The left portion of the lesser wingof Ingrassias, and the corresponding anterior clinoid process,are reduced to the thickness of a sheet of writing paper, almostto a cutting edge."Mr. FisHER remarked, that cases of the formation of these

cysts, or adventitious membranes, under the dura mater, werenot uncommon. MM. Andral and Foville had noticed them,the latter in the llth vol. of the " Dictionnaire de Medecineet de Chirurgie," under the head "Meningite," and otherFrench pathologists, as one of the forms of "apoplexie desmeninges." Mr. Prescott Hewett, the curator of St. George’sHospital Museum, had brought this subject before the Medico-Chirurgical Society, and had published cases in the Transac-tions. He had shown to him, Mr. Fisher, four specimens, putup by himself and Sir B. Brodie, in the St. George’s Museum.It had been demonstrated that these membranes were suppliedwith secretory and absorbent vessels, which facts accountedfor the occasional attacks of insanity in this patient. It was

always remarked, that when he became plethoric, the attack. came on, and upon his losing flesh and becoming very thin,

his reason returned. The cause during life was consideredhereditary, his father having been insane from an injury ofthe brain, resulting from a fall from his horse, two yearsbefore the birth of this son. The result of this investigationcould not be otherwise than satisfactory to the family of the-patient ; it tended to do away with any impression withregard to hereditary predisposition to insanity, as it took usback to the accident when at school, as the exciting cause.Mr. STILWELL, under whose care the patient had been,

said that he had had only one maniacal attack during his stayat the asylum at Hillingdon. This attack lasted seven

months, and came on at the expiration of two or three yearsfrom his admission. The attack was of the usual kind, andwas treated by quiet, occasional doses of calomel, and mild’aperients, with large doses of henbane..

Mr. HEWETT had seen many such cysts as that before the,Society. They were by no means -commonly associated withinsanity, nor were. there, indeed, any symptoms during lifewhich were certainly indicative of’their presence. In some-they were accompanied by symptoms of apoplexy; in others,f softening of the brain; in others, again, of large and extensiveeirusions of blood into the structure of the brain. Two yearssince, a man was admitted with fever into St. George’s Hos-- pital; the fever soon became typhoid, and the patient paralyzed.Under the use of calomel, and cupping,. he .partially recovered,but relapsed in a month, and died. Over each hemisphere of thebrain was a cyst as large as the one before the Society.Several cases,similar to Mr. Fisher’s were in the museum at tSt. Bartholomew’s. With respect to the situation of thesecysts, all writers previous to 1834 had described them as situ-ated between the dura mater and parietal arachnoid, but since.that period, it had been demonstrated that they were situatedbetween the two folds of arachnoid-the parietal and thevisceral.

, Dr. SAYER read a case from Andral to show that that greatauthority had considered these cysts to be situated betweenthe dura mater and arachnoid.

After some observations from other speakers, having-relationto the difficulty of explaining -the mode of formation of thesecysts, and of their exact situation, the Society adjourned.

MEDICAL SOCIETY OF LONDON.

MARCH 30TH, 1846.—MR. DENDY, PRESIDENT.NATURE AND TREATMENT OF PURPURA.

A DISCUSSION took place on the nature and treatment ofpurpura haemorrhagica, arising out of the narrative of a case ofthis disease by Mr. STEDMAN, in which the patient, a boy ofabout ten years of age, had all the hsemorrhage arrested onhis mouth becoming slightly affected by the action of mer-cury.

The questions discussed were-What is the essential natureof purpura ? What is the best treatment ?-which elicited thefollowing opinions:-

1st. That purpura in general resembles scurvy, and consistsessentially of a depraved state of the circulating fluid, in whichthere is a deficiency of fibrine. Taking this view of the sub-ject to ’be correct, after attention to the state of the primsevise, citric and other vegetable acids were considered asmost likely to be productive of benefit.

2nd. That the blood was not in itself diseased, but was suffi-ciently decarbonized, and the disease, treated with reference tothese points, was simple and easily cured.To these views of the pathology and treatment of the disease,

excptions were taken by some speakers. In the hands of one,purpura had invariably yielded to the employment of purgativesfollowed by chalybeates, particularly the acetate of iron.Cases were also related in which purpura was, attended by aplethoric or congestive condition of the vessels, and yielded tothe influence of small bloodlettings, when all other modes oftreatment had been ineffective.The PRESIDENT regarded the discussion as exhibiting the

fact of the presence of two distinct and different conditions ofthe system in cases of purpura. The essential character ofthe disease consisted in an increased or a diminished action ofthe capillaries. The tonic plan of treatment was usually re-quired ; but the remedies must depend on the condition of thepatient.

BRITISH MEDICAL ASSOCIATION. EXETER HALL, APRIL 7, 1846.

A MEETING of the Council was held this evening, when thefollowing resolution was carried unanimouslyResolved," That in consequence of the extraordinary at-

tendance of the’Council this evening, and -the importance ofthe propositions discussed, it is the opinion of this meetingthat the Council should be adjourned to TUESDAY, the 14thinstant, at half-past seven o’clock precisely, when the presenceof every member of the Council is specially invited :’ _

The members did not separate until a late hour.

UNUSUAL MARK (NÆVUS?) ON THE NECK.MR. GEORGE HARVEY, Surgeon, of Castle Hedingham, ha,!3

forwarded to us the following statement for publication :—" On Friday, Feb. 6th, 1846, between seven and eight P.M., Iwas summoned in haste, to attend M. E--, in labour with hersecond child. This event had not been expected to take placebefore the beginning of March. On arrival, I found the meut-branes had just ruptured ; the os uteri was fully dilated, andthe breech pressing on the perineum. Two moderate painsexpelled the child, which never breathed, but merely ga.vetwo or three convulsive gasps, and died. Whilst endeavor-ing to restore animation, I observed a bright-red mark, ex-tending completely across -the upper and fore part of the neck,from Qne angle of the lower jaw to the other, exactly. asthough produced by strangulation with a cord, except thatthe mark was not continued round to -the back part of theneck. This mark was not like a bruise or ecchymosis, b4was of the vivid red colour of arterial blood; it was not raisedabove the surface, but had very much the appearance of arecent excoriation, so much so, that on first touching it, I ex-pected to find my finger stained with blood, but the epidermiswas in no part broken or abraded. This mark was most clearlydefined in front, where it was about a quarter of an inch imbreadth; at the sides it was more diffused, particularly on theleft, extending down towards the clavicles. The face was notswollen, neither were the veins full, as though -an obstructionexisted to the return of blood to the heart, but the externaljugulars, below the mark, were both filled with dark blood.Had this mark been caused by strangulation, the jugular, be-low the stricture, would probably have been found empty, andthe face turgid. The funis was of the usual length, and notcoiled, either around the neck or any other part, but perfectly,free. I have, hundreds of times, seen the funis coiled roundthe neck of the child, but have never once known it to producethe slightest bruise or mark of any kind. On examiningthe part on the following morning, with a powerful lens, Icould discover no bloodvessels ramifying, either over the sur-face-or around the edges, as commonly seen in a true naevusmaternus. The placenta was thrown off spontaneously imme.-diately- after the -birth of the child." -

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