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surgeon labours in his desire to reduce the strangulated bowelby the taxis were insisted upon, and immediate operation ad-vocated (after judicious attempts had been made to replace thebowel) in which failure was the result. The necessity for im-mediate operation was illustrated by contrasting the results ofcases in which an acutely morbid state of the intestine re-sulted in a very few hours, and on which operations had beenperformed at different periods after the development of thefirst signs of strangulation. In the application of the taxisalso, some danger results, if the patient be fully under theinfluence of chloroform, from the delicate nature of the tissuesof the sac and its anatomical relations; and it was describedhow readily the posterior wall of the sac may be torn, and theintestine pushed out of the sac and behind the peritoneum intothe iliac fossa.. The paper terminated by drawing the atten-tion of the meeting. to the following points as subjects for dis-cussion-

1. The nature of this form of hernia, its anatomical relations,varieties, mode of development, and causes.

2. Its frequency in proportion to other varieties of inguinalhernia.

3. The inutility of delay, or, it might be added, the culpa-bility of not insisting upon an operation after the judicious ap-plication of the taxis has failed.

4. The facility with which the sac yields under pressure,demanding great care in the employment of the taxis.

5. The after-treatment by opium, in comparison with othermethods.

Mr. CANTON made some observations on the necessity ofearly operations in hernia, and on the advisability of its after-treatment by opium.Mr. DE MÉRIC said that in the cases related by Mr. Birkett

the most important point was, the formation of a correct dia-gnosis, which was often difficult.Mr. BIRKETT having replied, the Society adjourned.

PATHOLOGICAL SOCIETY OF LONDON.

THE second meeting was held on Tuesday evening, Dr.WATSON in the chair.

Mr. HEXRY THOMPSON exhibited a specimen ofMYELOID TUMOUR IN THE NEIGHBOURHOOD OF THE

KNEE-JOINT,for which amputation was performed. The patient died. Thecase was mainly interesting from the fact, that the diseaseoccurred in a woman at the advanced age of sixty-eight.

Dr. SEMPLE exhibited the parts implicated in a case of

DIPHTHERIA.

The patient resided in the neighbourhood of those whose caseshe had related at the last meeting of the Society. In the i,present instance there was only a slight effusion in the larynx.The tonsils and neighbouring parts were extremely congested,and it would appear the patient had died from suffocationbefore there was time for further exudation to take place.

Dr. C. J. B. WILLIAMS had seen several cases of diphtheria,and had been much struck by their resemblance to malignantscarlet fever. He had seen one instance in which swelling ofthe parts had produced suffocation, very little effusion beingpresent. He considered the disease was essentially dependentupon some poison in the blood.*- Dr. CAMPS had been in Dorsetshire lately, and had conversedwith a practitioner there who had had thirty or forty cases ofthis disease under his care, three-fourths of which had provedfatal.

Dr. SCHULHOF related an instance in which the diseaseproved fatal in twenty-four hours.

Dr. Szsaov mentioned an instance in which the early symp-toms were very mild, but gradually became worse, and thepatient was threatened with suffocation. He performedtracheotomy on the child, who survived three days.

Mr. OBRE had performed tracheotomy in a similar case. Thepatient lived but three days; complete casts of the tracheaand bronchi having been coughed up through the wound soonafter the operation.

Dr. PEACOCK repeated his opinion, expressed at the lastmeeting, that cases of diphtheria were essentially differentfrom those of scarlet fever.

Dr. POLLOCK was of the same opinion. He had had threecases under his care, in one of which the patient had beenpreviously subject to scarlatina.

Dr. MURCHISON showed a right kidney, which had beentaken from a patient in whom there was no kidney on theopposite side. There was no capsule to the kidney, but on theopposite side, where the kidney was absent, the capsule waslarger than usual. He also showed a tumour of the medias-tinum, which pressed upon the vena cava and other largevessels in the neighbourhood.

Dr. O’CONNOR related a case, and showed the parts, in whichthere was

CANCER OF THE LIVER, PANCREAS, AND OMENTUM.The case was interesting from the circumstance that there wasa large ulceration of the stomach, the parietes of which beingadherent to the under surface of the liver, prevented theescape of the contents of the stomach into the peritoneum.

Mr. SrENCER WELLS showed two specimens of OvarianCyst, one of an enormous size, and the other in the earlieststage of its development. He also showed the parts implicatedin a case in which the arch of the aorta appeared to have ulce-rated into the left bronchus. On the parts being examined,

Dr. MURCHISON suggested that there might have beenulceration of a gland between the parts implicated.

Drs. PEACOCK and SIBSON regarded the case as one of aneu-rism of the aorta.The parts were referred to a committee of observation to

report upon.Dr. SIEVEKING mentioned an instance, lately reported in the

Charleston Journal, in which there was ulceration of the aortawithout any aneurism.

Mr. CHRISTOPHER HEATH showed two specimens, one of

epithelial cancer of the œsophagus, which opened into thetrachea, and another in which he had been obliged to removea large portion of the sac in a case of umbilical hernia. Thepatient recovered.

Dr. WILKS exhibited specimens ofNEUROMA.

They came- from a subject which was used for anato nicalpurposes by Mr. Poland, when the tumours of tte nerveswere accidentally discovered. They were not very large, thelargest, on the sciatic, being the size of a pigeon’s eg;; butnearly all the nerves of the body were affected in a slight de-gree. The composition of the tumours was a simple fibroustissue, occupying the spaces amongst the fibrillæ; and if theterm " inflammation " can be used, as it often is, to express afibrous exudation and induration of a part, it might be saidthat the whole of the nerves had been the subject of chronicinflammation, whereby a lymph, afterwards becoming fibrous,had been effused amongst the nerve-fibres, connecting theseclosely together in some parts and forming tumours in others.Nothing could be said of the pathology, though syphilis mightbe suggested, as it is believed by some to be one cause ofneuroma.

Dr. HARLEY inquired if any sugar had been found in theurine in this case, and stated that sugar was often secreted bythe kidneys when the action of the phrenic nerve had beeninterfered with.

Dr. WILKS had not examined the urine.Mr. PRICE exhibited a Leg which he had amputated twenty-

seven months after he had performed the operation of resectionof the knee-joint. He had not examined the structure of thejoint, but would do so, and report at the next meeting.

Mr. BALLARD showed a case of Encephaloid Cancer of theKidney, in which the patient had died from hmmatiiria. Thecase was very obscure, and many eminent practitioners whohad seen it differed widely in opinion as to its nature.

Mr. BRYANT showed a case of Scrofulous Disease of the Tes-ticle, and also one of Necrosis of the Maxilla.Mr. OBRE exhibited an Ulcerated Bladder, in which there

was also a large tumour situated over the right kidney.

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

and ALFRED POLAND. Third Series. Vol. IV. pp. 371.London : Churchill.

THE present issue of these practical and valuable records is.

marked by accounts of two important surgical operations, con-coming one of which there was no British experience to guidethe operator, and relative to the other, but very little. The

478

former operation is that of gastrotomy, performed by Mr.Cooper Forster upon a patient of Dr. Habershon, suffering fromepithelial cancer of the oesophagus. It was undertaken with aview of affording the sufferer " some relief to the fearful stateof starvation to which he had been reduced in consequence of

inability to take nourishment by the natural channel." The

patient died rather more than forty-four hours after the opera-tion.

" It was submitted to the patient that such an operationmight be quickly fatal, or prolong his life for a few weeks.Even with such a slight hope he most readily assented, so ter-rible was the sense of starvation and of thirst. These symp-toms were relieved, and the horrors of such a death partiallymitigated.......The consideration of the complete particulars ofthe case lead to the conviction, that if the operation had beenperformed earlier, more permanent benefit might have accrued."- (p. 11.)

S8ùillot, of Strasburgh, has twice opened the stomach. Theother operation is that of " pharyngotomy" for the extractionof a foreign body, by Mr. Cock. The patient had swallowedduring sleep a false central incisor tooth, fixed in a gold plateextending some distance on either side of the tooth. " Theoue extremity of the plate terminated in a slender clasp, withtwo points as sharp as needles, which encircled the bicuspidtooth, while the other extremity formed a single sharp point."

" In three weeks after the operation, the use of the feedingtube was abandoned, and he was enabled to swallow with dailyincreasing facility. In about another week the external woundhad closed, and the recovery might be said to be complete."—(p. 226.)Nearly three years have now passed since the pharynx was

opened; the patient has since married, " is well and hearty, hasacquired stoutness, and, as he affirms, stature.......His voicehas regained a strong manly tone, but has undergone a decidedtransformation. In his earlier days he somewhat prided him-self as the possessor of a fine tenor voice, he now owns a veryrespectable bass. How much of this change is owing to naturaltransition, and how much to the division of the recurrentlaryngeal filaments may be a matter of speculation." -(p. 227.)

Œsophagotomy has been already performed by Goursauld,Beguin, Roland, and Arnott. Mr. Cock holds the opinion, thatit is preferable to incise the neck upon the left side unless undersome very particular contra-indicating circumstances.Another paper worthy of attention is that by Dr. Pavy,

"On the Alleged Sugar-forming Function of the Liver." Ten

years ago it was announced that this organ possessed a sugar-forming function, and the statement was supported with appa-rently such conclusive evidence, that it was soon received asan established physiological fact. Dr. Pavy had often per-formed-he tells us-the original experiments, and with thesame result as Bernard. But it seems there has been "a a grandmistake," for having alluded to an experiment upon a dog, Dr.Pavy now writes-

’’ The error under which physiologists had been recentlylabouring was now seen with full force and exposed to demon-stration. What has been regarded as the result of a functionaloperation of life, would seem to be nothing more than a post-mortem chemical transformation taking place so instantly afterlife is destroyed as to have hitherto led us into a misconceptionupon the subject. "-(p. 299.)A misconception indeed!

" And isn’t this a dainty dish to set before the king!"To find sugar upon examining a liver after death is no proof

that such was present during life, and all the evidence uponwhich the glucogenic theory was founded rested upon ordinarypost-mortem investigations! Well done modern physiology !

The British and Foreign Medico-Chirurgical Iaezriew, or Quar-terly Journal of Practical Medicine and Surgery. No.XLIV. October, 1858. London: Churchill.

THIS number of the leading " Quarterly" of our professionalliterature contains some interesting and important articles.

Even when we may differ from the views expressed in them,we are willing to admit the ability with which they are sup-ported. The first article is " On Dipsomania," and mainlydiscusses the question, "not whether the inveterate drunkardshould be subject to restraint at all, but whether he should besubjected to that restraint as an insane person, and, therefore,in a lunatic asylum. " The writer refuses to acknowledge thedrinker as ipse facto insane, and, therefore, as a fit inmate forthe ordinary asylum. He admits that the community has aright to escape the "nuisance and indecency" of the drunkard’sconduct, and advises the formation of asylum- or " cure-vil-lages" for the detention and residence of dipsomaniacs. Gross,Peaslee, and Valentin’s works form the basis of a review ofPathological Anatomy, following which is one upon Obstetrics,canvassing the merits of Drs. Cazeaux, Miller, and Waller.The fourth article is entitled, " Materialism and Spiritualism,"and is written by one evidently equal to, and enjoying, the taskhe has set himself to accomplish. This is to show Dr. BUchnerand the disciples of his school of materialism, that there is validknowledge beyond that which is reducible to the sense-percep-tions of external phenomena. The general character of thisreview is somewhat different to that of most articles in medical

journals. It adds a freshness and relief, from its literary andphilosophical tone, to the purely-professional essays, and which,we think, will be found agreeable in its variety. Messrs.Bucknill and Tuke " On Insanity," are next brought beforeus; after which appears a review of Dr. Hughes Bennett’svaluable " Clinical Lectures on the Principles and Practice ofMedicine." Armstrong " On Naval Hygiene," is noticed atsome length; and then follows a discussion upon the truthcontained in the doctrine of " General Homologies" as ad-vanced by Richard Owen. The writer’s opinion upon this mattermay be gleaned from the following extract :-"When, years ago, we attended a course of Professor

Owen’s lectures On Comparative Osteology,’ beginningthongh we did in the attitude of discipleship, our scepticismgrew as we listened, and reached its climax when we came tothe skull; the reduction of which, to the vertebrate structure,reminded us very much of the interpretation of prophecy.The recent delivery, at the Royal Society, of the CroonianLecture, in which Professor Huxley, confirming the statementsof several German anatomists, has shown that the facts ofembryology do not countenance Professor Owen’s views re-specting the formation of the cranium, has induced us to recon-sider the vertebral theory as a whole......Not only, then, do wefind that the hypothesis of an ’ ideal typical vertebra’ is irre-concilable with the facts; but we see that the facts are inter-pretable without gratuitous assumptions. "-pp. 413, 416.The opinions expressed in the review entitled " The First

Decennium of the Pathological Society of London," are incomplete accordance with our own. The Society ought to feelgreatly indebted to the writer for his analyses of the eightvolumes of its published reports. Articles upon" Military Sur-gery" and " Wasting Palsy" conclude the review department.

The Indian A nnals of Medical Science. A Half-yearly Journalof Practical .3fedici?ze and Surgery. No. X., July, 1858.Calcutta: Lepage and Co.WE are glad to find our Asiatic contemporary so well able

to sustain himself amidst the belligerent turmoil which is

disturbiug the East. The present number contains twelve

original communications, a paper upon " Jail Statistics," andthe " Minute by the Most Noble the Governor-General of Indiaon the Indian Medical Service."

A List, with Descriptions and Illustrations, of whatever relatesto Aquaria. By W. ALFORD LLOYD. 19,20, & 20A, Port-land-road, Regent’s Park.THIS is a very useful little work, by a person acquainted

practically with all the details of aquaria and their inhabitants.It may be consulted with advantage by all persons interestedin these elegant additions to the drawing-room.