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combined external and internal manipulation the breech wasbrought down, and the fundus pushed up. Delivery was theneffected ; the child was dead. The mother did well. Theauthor remarked on the facts—1st, that the full time had beenreached; 2ndly, that the symptoms were not such as to exciteattention previously; and 3rdly, the possibility of replacernentat this late period.

In answer to a question put by Dr. G raily Hewitt, the authorstated that the patient, when formerly under his care and

single, had, he believed, been the subject of retroflexion.ON SLOUGHING OF THE FŒTAL SCALP AS A RESULT OF TEDIOUS

LABOUR.

BY W. 0. PRIESTLY, M.D., M E.C.P., ETC.

The author related a case, under the care of a midwife, inwhich the head had been impacted for about forty-eight hoursin the pelvis, in a first labour. Eight days after delivery thechild died. On the third day, the back of the head was muchinflamed; later, the scalp assumed a darker colour, and thechild gradually sank. A slough, of the size of a shilling, hadseparated, leaving a wound, which extended nearly to the bone,over the occipital protuberance; and there was extensive ecchy-mosis around almost to the ear on each side; and the peri-cranium was in part separated from the bones. The sloughingin question resulted, in the anthor’s belief, from the long im-paction of the head in the pelvis.CASE OF FIBROUS TUMOUR OF THE UTERUS, ILLUSTRATING A

SURGICAL OPERATION FOR ITS CURE.

BY 1. BAKER BROWN, F. E. C. S. E.

In a woman aged forty-nine, ill for six years, there wasfound an abdominal tumour, extending half-way to the

umbilicus, composed of the uterus, enlarged by the presence ofa fibrous tumour. The os uteri was incised, and the tumourbrought into sight. The author then proceeded to operateupon it by piercing it in the centre, cutting out a portion,much in the manner of coring an apple. Through the cavitythus formed as much as possible of the surrounding tissue wasbroken down. A copious discharge occurred for the next fewdays; and at the end of four months a slightly enlarged uteruswas all that could be detected. The principle on which theoperation in question (which, the author observed, had beenperformed by Atlee and Recamier) was adopted, was the know-ledge of the faact, thit when polypi are ligatured the whole ofthe growth perishes—not only that on the distal side, but alsothat on the other side of the ligature. By removing a portionof the fibrous tumour, the same effect-the destruction of thewhole—was in this case obtained.

Dr. BARNES believed Atlee’s operations had been attendedwith great mortality. He would suggest that Dr. Simpson,just elected an honorary fellow, should furnish the Societywith the results of his enucleation practice.

Dr. PRIESTLY believed that Dr. Simpson had abandoned in-terfering with large fibroid tumours of the uterus by operativemeasures.

The PRESIDENT remarked on the varying degrees of themenorrhagia attending cases of fibroid tumour.

CASE OF EXTREME EMACIATION, THE RESULT OF OBSTINATEVOMITING IN PREGNANCY.

BY W. TYLER SMITH, M.D., F.R.C.P., ETC.A girl, aged nineteen, unmarried, was admitted into St.

Mary’s Hospital in July last. Obstinate vomiting, at first

supposed to depend on cerebral disorder, continued from thetime of her admission. She became so extremely reduced inflesh, that at the end of six weeks her weight was only forty-seven pounds and a half. At this time she was unable to movein bed; delirium was frequent, bed-sores appeared over thesacrum and nates, and she appeared to be dying. Pregnancywas now suspected. The catamenia were found to be absent ;the breasts were full, notwithstanding the emaciation of therest of the body; and the uterus had increased in size. Re-medies had been of no avail. She was too weak to permit ofartificial abortion. A nurse was put by her bedside to give hera single teaspoonful of nourishment every half hour. The bodywas rubbed with oil, and beef-tea injections were administereddaily. Under this plan the sickness ceased ; the quantity ofnourishment was slowly increased, and she improved in

strength, and became comparatively stout. Pregnancy went onto December 3rd, when she miscarried at the fifth month, andis now recovering.In answer to a question by Mr. Cleveland, Dr. Tyler Smith

stated that the enemata given were retained.

CASE OF HYSTERIA SIMULATING IN THE MOST PERFECTDEGREE NATURAL LABOUR.

BY RICHARD HODGES, M.D. (ROCHFORD).The author was engaged to attend a woman said to be in

the fifth month of pregnancy. Four months afterwards he wassent for, the patient being stated to be in labour. The painswere found to be severe, and like those of the last stageof parturition. On examination, however, a tumour was foundto present, which turned out to be the bladder, distended andprolapsed. There was no pregnancy.The PRESIDENT then announced that the first session of the

Society, which had been a most successful one, was now broughtto ê1 close. The first meeting of the next session would be held,

on Wednesday, January 4th, 1860.

Reviews and Notices of Books.The Mineral Springs of Vichy: a Sketch of titei2- Clierraicul and

Physical Characters, and of their Efficacy in the Treatmentof various Diseases. By The Author of the " Spas of Ger-many," &c. pp. 243. London: Charchill.

UPON the banks of the Allier, at an hour’s distance from oneof the lesser stations on the Orleans and Lyons Railroad, liesthe once remote village of T’i;;us Calidas of Theodosius the

Emperor, and now the fashionable and highly-reputable spaof Vichy. " Vicus Calidas" being transformed into " VillageChaud," the nomenclators, who clip names by halves, takingvi from village, and cha (which they pronounce chi) from cha?td,constructed the far-famed name of Vichy, at present a most im-portant place in the estimation of hydrologists. In very ancienttimes—perhaps during the lirst and second centuries—the" Aquæ Calidæ" of Vichy were in great request; even the great

Cæsar, our author imagines, may have tasted of them on hisreturn from the siege of Gergovià. But a cloud settled uponVichy, and for a time it was lost to fame, when Lonis XI. raisedit again into importance. With variable fortune and renown, itstruggled on pretty well against the rivalries of hostile spasuntil 1853, when it appeared amongst the latter as determinedto earn for itself a positiun of high standing.

" Since the year 1853, when a decree of the French Govern-ment placed the neglected mineral establishment of Vichy inthe hands of a highly respectable and responsible society ofshareholders, that spa has been rahicli y emerging from com-parative obseirity into the noon-day of popularity. Its name,but littlc, if at all, known in England until within the lastthree or four years, is now in the mouths of many hundredvisitors, who have returned from Vichy more or less benefitedby its waters, to which they had recourse on the recommenda-tion of French physicians, or their works. English nractitioners,especially such as are consulted by chronic invalids, eager toseek health abroad from mineral waters, or the mere influenceof foreign travels, have adopted the views and panegyrics oftheir Continental brethren, and the names of Vichy, VichyWctters, Vichy baths, and Vichy pastilles, are accordingly to beheard every day in the drawing-rooms as well as the sick roomsof the rich of the metropolis. "—p. ii.

Vichy affords mineral waters of one kind only-viz., thealkaline class, but which differ at the various springs in theirdegrees of temperature. In certain minor points there are someother differences, no doubt, at the various springs, but the grandchemical feature of all the founts is their great richness in thepossession of the bicarboaute of soda. Every pint of the water,speaking generally, holds in solution from thirty-five to fortygrains of this alkaline salt, besides other ingredients. In their

alkalinity the waters of Vichy are inferior only to three or fourother known springs in Europe. But it is not alone for this

quality that they are famous : the waters of Vichy are warmwaters, and some are of a high degree of temperature. Thewaters of the " Cetestin" have a temperature of 61° Falir.;. thoseof "L’Hôpital," one of 878; and those of the " Piuts Carre,"one of 113° Fahr. In two sources of power and virtue thesesprings of Vichv are thus very rich. They are highly alkaline’

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and very warm. In half an hour after drinking the water, theurine, it is said, seldom fails to show its alkalinity; it becomes

clear, limpid, and free from uric acid sediments. In quantitythere is often a loss of two pints of it, (considering the amountof mineral water drunk,) arising from the augmented cutaneoustranspiration whilst drinking the water. On the other hand,to quote Dr. Granville,-

" The presence of any degree of heat in a mineral water,above the ordinary temperature of the surrounding atmosphere,imparts to that water a virtue which its mere mineral compo-nents could not produce; and that, in fact, where, of twomineral waters of similar or identical composition, the onebrings along with it to the surface a temperature any numberof degrees higher than the average summer temperature of thesurrounding atmosphere, while the other presents and retainspermanently a temperature lower than, or equal only to, theheat of the surrounding air, results will be obtained from theapplication of the former to the human body, which it wouldbe in vain to expect from the latter. Nor would the latterproduce the same results were it raised to an equal degree oftemperature by artificial calefaction.......I have long been con-vinced that volcanic or central heat, besides being an agentacting per se on the human frame, is capable of modifying theaction of the soluble substances with which it is associated in amineral water. "-p. 122.The prophylactic and curative virtues of these famous mineral

springs are most prominently seen in connexion with disordersof the assimilative functions and chylopoietic viscera. Such ofthese diseases, too, as are more immediately followed by ex-cessive uric acid formation and gout are believed to be mostpowerfully influenced. In the opinion of some it has been con-sidered that diabetes, in its earlier stages, is greatly under thebeneficial action of these warm alkaline waters. Others hold thesame high opinion of them in the various disturbances to whichthe sexual system of females is liable. The waters of Vichyare largely employed as baths and douches, as well as for drink-ing and using in the form of lozenges, &c. Upon these andkindred topics, the reader will find full, practical, and en-tertaining information in Dr. Granville’s very opportunetreatise. Barring certain minor objections as to style andmatter, we can recommend its perusal, as the work of one,perhaps, better acquainted than any other English physicianwith the particulars relating to mineral waters.

Remarks on the Treatment of Consumption; with Notices ofSuccessful and Unsuccessful Cases. By CHARLES THOMASONTHOMPSON, M.D., M.R.C.P. pp. 25. London.

Phthisis Pulnzonalis, and Tubercular Phthisis. By CHARLESJoNES HUMPHREYS, Surgeon, &c. pp. 32. London.

Two pamphlets of which the less said the better.

Foreign Department.A REVOLUTION IN ANÆSTHETICS.

THE Paris medical papers are full of the new method of pro-ducing anaesthesia, introduced by M. Azam, of Bordeaux.

It would appear that, about eighteen months ago, M. Azamhad under his care an hysterical young lady, who was subjectto cataleptic attacks. Upon this patient very extraordinaryphenomena were noticed, which, coming to the ears of M.Bazin, professor at the Faculty of Sciences of Bordeaux, thisgentleman advised M. Azam to consult a work published inEngland in 1842 by Mr. Braid, in which the means of pro-ducing catalepsy and artificial anxsthesia were detailed. M.Azam procured this book, of which Dr Carpenter has writtenan analysis in Dr. Todd’s Cyclopaedia, under the head of" Sleep," and began a series of experiments on his youngpatient and about thirty other persons. He found that mostof Mr. Braid’s statements were correct, and that catalepsy andansesthesia could actually be obtained in the following man-ner :-

The patient, either sitting up or lying down, is put in aconvenient position. The operator then, standing either be-fore or behind him, places before his eyes, at the distance of a

few inches, but generally nearer than the point which allowsof distinct vision, some bright object, upon which the patientshould steadily and continuously fix hia eyes. The bright ob-ject should be so placed that the eyes, in looking at it, mustbe forcibly directed upwards, the contraction of the superiorrecti being carried to its maximum degree. In this position, thelevatores palpebrarum and recti are strongly contracted, and con-vergent strabismus takes place. After this attitude, which iscertainly fatiguing, has been kept up for two or three minutes,the pupils are noticed to contract, and soon afterwards to

dilate; the eyelids quiver rapidly, then fall, and the patient isasleep. Two symptoms, almost always present, are then ob-served ; they are, however, in different cases, more or lessmarked and lasting: 1, catalepsy, exactly as described inbooks; 2, anaesthesia,, which lasts from three to fifteen minutes,either complete or incomplete, but which allows of pinching,pricking, and tickling, without any feeling being aroused inthe patient, and without any change in the cataleptic statebeing produced. This anaesthetic state is generally followedby a very opposite condition-namely, very remarkable hyper-sesthesia, in which the senses, the feeling of heat, and muscularactivity reach an unusual degree of excitability. At any mo-ment of the experiment the symptoms may suddenly bestopped, by rubbing the eyelids, and directing upon them astream of cold air. Vr hen the patients recover their senses,they remember nothing of what has taken place.

Several experiments have been instituted in Paris by Messrs.Follin, Broca, and others ; and M. Velpeau seems so convinced,that he has presented a short paper on the subject, by M.Broca, to the Academy of Sciences at the meeting of the 5thinst.The Gazette Hebdomadaire of the 9th of December mentions

the following case :-A woman, aged twenty-four, rather ner-vous and timid, had, in consequence of a burn, a large abscessby the verge of the anus, and was told that she would be nar-cotized before it was opened. A bright brass tube (a telescopemade by Bruecke) was placed five inches in front of the nose.The patient was obliged to squint considerably in order to looksteadily at the object, the pupils contracting very strongly.The pulse, which before the experiment was quick, becamenow quicker, but immediately afterwards weaker and slower.After a couple of minutes the pupils began to dilate, and theleft arm being artificially lifted up vertically above the head,remained motionless in that attitude. Towards the fourthminute the answers became slower and almost painful, but per.fectly sensible, and the respiration slightly irregular. At theend of five minutes, M. Follin pricked the skin of the leftarm, which was still held up at a right angle with the trunk,but the patient did not move. Soon afterwards a puncture wasmade, which drew a little blood, but no feeling was evinced.The right arm was now placed in the same attitude as the left,and the region where the abscess was situated brought intoview. The patient yielded willingly, saying, very quietly, thatshe was doubtless going to be hurt.

Finally, about seven minutes after the beginning of the ex.periment, M. Follin laid the abscess largely open, and freed agreat quantity of fcetid pus. A faint cry, which lasted lessthan a second, was the only sign of reaction which thepatient gave. No movement of the muscles of the face orthe limbs was observed; and the arms remained in the samecataleptic state which they had previously assumed. Two

minutes later, the attitude was still the same: the eyes wideopen and a little vascular; the face motionless; the pulse as itwas before the experiment began; the breathing quite free;and the patient insensible. The left heel was now raised, andit remained unsupported in the air, whilst the cataleptic stateof the arms persisted. M. Broca at this period removed thebright object which had hitherto been constantly kept beforethe patient’s eyes, gently rubbed her eyelids, and directedupon them a current of cold air. She now made a few move-ments, and was asked if she had felt anything; upon whichshe answered that she did not know. Both arms and the legremained, however, in the artificial position in which they hadbeen put. At this stage the left arm was again pricked, andno sensation thereby excited.

Eighteen minutes after the beginning of the experiment,and twelve after the operation, another friction on the eyelidsand another current of cold air were used; whereupon thepatient awoke almost suddenly, the cataleptic limbs all fallingtogether. The patient then rubbed her eyes, came to hersenses, remembered nothing that had passed, and was surprisedthat the operation was over. Her state was somewhat analo-gous to that of patients who wake from anaesthesia induced byordinary means; though the waking was certainly more sud-