774

bring on the effect of the first. There isone more observation relating to the water.Mr. Leeson has forgotten to mention the ex-periments in which the temperature of se-veral glasses of water was equalised bywarm water being added, some beingmesmerised, others not. But he perhapsthought this " too glaringly absurd to wasteany time about."We now go to the metals, and here again

Mr. Leeson admits that all succeeded, butstill sticks to one and the same explanationthat he applied to the water, viz., the in-crease of temperature. And again Mr. Lee-son forgets to mention that the temperatureof the unmesmerised sovereigns was madethe same as the mesmerised by means of ahot iron placed on them. Now, really, onewould have supposed that in this long rig-marole of three columns, Mr. Leeson wouldhave brought forward some glaring in-stances of total failure in the experiments;but no, he admits that they succeeded, andendeavours to explain them away by startinga futile objection, and altogether omitting anynotice of several important particulars, be-cause he " considered them too glaringly ab-surd to waste any more time about." Now, ifMr. Leeson thought proper to state the par-ticulars of a part of what he saw, why not, ifor the sake of impartiality, state the whole,and thus give persons an opportunity of

forming rheir own conclusions. But I thinkthis is enough to show that implicit reli-ance should not be placed on Mr. Leeson’sversion of these experiments. I look uponthe explanation here offered by Mr. Leesonas 44 grossly absurd" as he considers theexperiments to be. " So far, then, can"Mr. Leeson " be seen in his true light," andbe must be considered more the victim of

prejudice than Dr. Elliotson of imposition.I feel convinced that your impartiality onthis subject will induce you to insert this atyour earliest convenience. I am, Sir, yourobedient servant,

WM. WOOD, M.R.C.S.Aug. 21st, 1838.

UNIVERSITY COLLEGE HOSPITAL

INSIDIOUS ORGANIC DISEASE.

L. N. was admitted, May 19, under the.care of Dr. A. T. THOMSON. He is 41 yearsof age, and has been a waiter at an inn.,Has enjoyed pretty good health in general,with the exception of occasional slightcough. Seven months since he was seized,suddenly with extreme weakness, pain in thelimbs and loins, general feverishness, and.loss of appetite. He was also taken with a.shivering fit, which came on regularly every,day at two o’clock. The shivering was not,followed by any increased heat or perspira-,tiou. He continued with these symptoms

for five months, without any medical as-sistanee. Six weeks since the symptomsbecame aggravated, by his catching cold;his breathing, also, became oppressed, andhe was affected with great hoarseness. Hasoccasionally expectorated small quantitiesof blood.

Present Symptoms.—Great debility, withloss of appetite ; sleeplessness; pain be.tween the shoulders ; slight cough, with lit.tle expectoration ; considerable hoarseness;respiration sonorous in the upper part ofthe right lung ; pulse small, 104 ; bowelsrather confined.From the presence of the shivering and its

periodicity, together with the ahsence of allsymptoms of specific disease, Dr. Thomsontreated the case as an intermittent, and ad.ministered an emetic, followed by quinineand infusion of bark.

23. No shivering since last report;countenance pale, and of a yellow tinge.

25. No shivering ; weakness still in.creasing.

28. Is better in every respect but withregard to the hoarseness. A solution ofnitrate of silver was applied to the epiglot.tis, from the suspicion that the glottis wasdiseased.June 16. Has been much the same since

the last report ; debility increasing. Today and yesterday has expectorated largequantities of frothy and tenacious sputa;tinged with blood ; harassing cough. Omit! medicine, and give dilute sulphuric acid,with gallic acid.

28. Better ; cough less ; no blood withthe matter expectorated. He seemed today in every respect better ; imperfectpectoriloquy under the right clavicle ; per.cussion dull.

30. Died this morning, having graduallysunk without any remarkable symptom.

AUTOPSY.—Head.—The duramatersome,what congested ; some serum effused be-tween this membrane and the arachnoid;the right hemisphere smaller than the left.There was a small tumour in the posteriorcornua of both lateral ventricles. A smallhard carcinomatous tumour at the base ofthe brain. Chest.-Adhesion of the lungsalmost in their entire extent ; in the upperlobe of the right lung was a ragged ex.

cavation, and the rest of the lobe was ren.dered hard by the great quantity of graysemi-transparent substance, intermixed hereand there with small portions of the yellowopaque matter ; the other lobes containedseveral masses of the gray matter, with hereand there the carcinomatous depositions;the larynx, trachea, and epiglottis werehealthy. Abdomen.—Liver was studded invarious parts with schirrhomatous tumoursof a character detailed in the following re,marks ; the apex of the pancreas containeda carcinomatous deposit;

775

In lecturing on the above case, Dr. Thom- nomatous matter is deposited from the blood,son said, the disease, as far as it can be either in the manner of a secretion or a nu-named by the appearances displayed in the tritive deposit. As the former, it appearsvarious affected organs, is that species of on the surface of serous membranes ; as thecarcinoma which my learned friend and latter, in the structural tissue of the organscolleague, Dr. Carswell, has classed under where it is found, as for example, in its ear-the term " Scirrhoma." The organ which liest stage, in the acini of the liver, as point-it has chiefly affected in this case, is the ed out by Dr. Carswell, and in this case itliver. It is only necessary to look on both is accompanied with cellulo-fibrous tissue,surfaces of that organ to recognise, at once, which is supposed to be produced by thethe disease. On the convex surface, it ap- uniform distribution and molecular deposi-pears as hard tumours, some of them nearly tion of the carcinomatous matter. In scir.an inch in diameter, elevated above the rhoma, no blood-vessels peculiar to the dis-surface of the organ, with rounded, smooth, ease seem to exist; a feature which, inde-transversely striated edges, and depressed pendent of the hardness of the tumour, dis-in the centre, so as to represent a cuplike tinguishes scirrhoma from cephaloma.appearance, of an ivory, or pale-yellow co- Of the real causes of carcinoma we know

lour, and, in consistence, as hard as the nothing ; but from the probable existence ofmost compact cartilage. Its elevation de- the virus in the blood it is probable that itspends on the less resistance to its growth diathesis is somewhat similar to that whichin its outward direction than that opposed causes tubercular deposits.to it by the substance of the liver. The The difficulty of ascertaining the exist-tumours, on the convex surface of the organ, ence of the disease in this case arose fromare less developed from the pressure of the the absence of tumours, of any considerablediaphragm and the abdominal parietes. The size, occupying the convex surface of thedepression in the centre is supposed to de- liver, and the bulk of the organ not beingpend upon the periphery of the tumour materially augmented. Neither was therebeing softer than its nucleus, consequently any pain in the hepatic region, which wouldmore capable of dilatation. The internal have especially directed our attention totumour is large ; for in general the disposi- the liver as the seat of disease. Indeed thetion of the carcinomatous matter is not so absence of pain is singular, as it is in scir-considerable as on the surface of the organ, rhoma that the sensibility is most acute.The consistence of these tumours is not to The suspension of the biliary secretion sel-be regarded as unusual, for scirrhoma is in- dom occurs when the liver is the seat ofvariably more consistent in the liver than the disease ; when it does occur, however,in the lungs or the mesentery. it most commonly arises from tumours in theNotwithstanding the firm consistence of duodenum pressing upon and obstructing

these tumours, softening sometimes takes the common duct. In our patient the gall-place, originating in the vascular system of bladder was full of apparently healthy bile.the tissues within the tumours ; but this is Dr. Carswell says he has never seen both

more, in comparison with its occurrence in kidneys affected, to which he attributes thecephaloma. little change both in the quantity and theThis case is an admirable illustration of quality of the urine. The prognosis in these

the number of organs which may become cases is always unfavourable. Instances,affected with carcinoma at the same time. indeed, have occurred in which the mam-It is a curious fact, which occasionally oc- ma has been removed, and the patient hascurs, although not always, as this body de- lived for many years without any trace ofmonstrates, that the carcinomatous deposits the disease, and died eventually of somedo not take place in double organs, such as other complaint.the mammae, testes, and kidneys, which, didit invariably occur, might be regarded as Dr. Thomson then went into a history ofan instance of benevolent design. The the treatment of the disease by the prepara-stomach, in this case, is free from disease, tions of iron, and referred, in speaking of thealthough it is by no means uncommon to use of conium in this affection, to an inte-find the disease extending from the liver to resting case in which it was employed, andthat organ. which is recorded in the 2nd vol. of THEThe age of our poor patient is that at LANCET, 1836-37, page 606.

which carcinoma appears most frequently in males; and the organs in which the diseasemost commonly appears in men are the liver COMPOUND DISLOCATION OF THE ANKLE.

and the stomach : the latter, in our patient, July 30. On carefully examining E. J.,is free, notwithstanding the extension of the whose case is reported at page 526 of thedisease to so many other organs. The lym- present volume, we have difficulty in de-phatic temperament is that in which carci- tecting any shortening of the limb whichnoma most frequently appears : in the case was injured. This is remarkable, taken inbefore us it is in the bilious. connection with the fact, that nearly an- There can be little doubt that the carci- inch and a half of the tibia was removed.

776CALCULUS IN THE BLADDER.—OPERATION.G. P., a groom, twenty years of age, was

admitted on the 25th of July, under the careof Mr. Liston. Nine years ago he firstfound considerable difliculty in makingwater, and passed some blood with it.Shortly afterwards he voided a large quan-tity of gravel with his urine. With theexception of the passage of the blood, hehas suffered from the above symptoms to

the present time. In addition to these, hehad also pain in the perineum, the urine

stops suddenly, and he had pain in thebladder on using any exertion by which thebody was shaken. General health alwaysgood. Complains now of pain across thelower region of the abdomen, and in thelumbar region ; no pain at the end of thepenis ; urine stops suddenly during mictu-rition. There is a thick sediment, but it isnot ropy, in the urine after standing a shorttime. Great pain in the perineum. Twoor three days after his admission, Mr. Lis-ton performed the bilateral operation, whichwas done in the usual manner, and a mid-dling sized, very rough, mulberry calculuswas extracted ; the patient went on wellaud is now about to leave the hospital.

TUMOUR OF THE HAND—continued from p. 491.July 20. J. B.’s hand is now completely

healed. He has already experienced thevalue of the treatment employed, as he isnow able to apply the limb to various uses.

BRIDGEWATER INFIRMARY.

RESUSCITATION OF STILL-BORNCHILDREN.

By JONATHAN TOOGOOD Esq., Surgeon to theBridgewater Infirmary.

CASES of apparently still-born infants arevery common. The attempts to restore lifeare frequently ill-directed, and not calcu-lated to promote the object. It will befound that a very large proportion of chil.dren, apparently dead born, may be resusci-tated, if proper means be resorted to andpersevered in for a sufficient length of time ;but the modes generally employed to restorelife, such as immersing the infant in warmwater, friction, and pouring stimulants down the throat, are not at all calculatedto produce the effect intended, and if thesemeans do not succeed after a short trial, allfurther attempts are generally abandoned.The plan I always adopt, which has neverfailed where the child was living duringbirth, is very simple, and only requires per-severance. The following cases, under cir-cumstances by no means favourable, whichhave been selected from a great many more,will prove the success of the practice re-commended.

Grace White, a very weakly woman, faradvanced in consumption, was seized, in themorning, with uterine haemorrhage, whichcontinued slightly till the evening, when Isaw her, and, whilst standing by her bed,side, the flooding increased with such vio,leiice, that I thought it best to deliver her

i instantly ; the child was still-born. Assoon as I had removed it from the mother,and seen her safe from any immediate dan.ger, I placed a napkin over the child’s mouth,and inflated its lungs from my mouth,pressing out the air from the chest after.wards, and thus imitating natural respira.I tion. After having continued this processfor thirty-five minutes, the child made avery slight attempt to breathe, and the facebecame slightly suffused ; by perseveringten minutes longer, the free action of thelungs was established, and the child criedlustilv.The next case was that of a poor woman,

named Sarah Holmes, of the parish ofSpaxton, who had been in labour a longtime, with a presentation of the arm, and,as it was her first confinement, it became

very dilricult to turn the child, particulailyas she was advanced in age, and the partswere very rigid. The child was still-born;but, by pursuing the same plan actively forthree-quarters of an hoxr, animation was per.fectly restored.The next was a case of presentation of

the funis, and as the labour was slow, thechild was still-born, but recovered by thesame means in half an hour.The last case with which I shall trouble

you, was such as to encourage the attemptat resuscitation under any circumstances ;it was a case of twins, and the second childpresented with the head, before which aconsiderable portion of the funis haddescended. The delivery was extremelyslow, from the general weakness of thewoman, who had been for a long time in abad state of health, and the child was born,apparently, quite dead. As the mother’ssituation was extremely critical, more thanhalf an hour had elapsed before I could at-tend to the child, and, on inquiring, I foundit had been wrapped in a cloth and placedon a chair in another room. I immediatelymade the attempt to restore it, and, by per-severing steadily for twenty-five minutes, Ihad the satisfaction to see symptoms of reoturning life ; and, in about fifteen minutesmore, the child breathed freely.

Everything in this last case was unfavour-able to the restoration of the child ; themother’s long-continued disease ; the cir-cumstance of her having’ two children, andmore particularly the delay which tookplace before any attempt was made, duringwhich time the child was exposed in a

room without fire, in the winter, with apartial and very slight covering. I am war-

ranted, by my own experience, in recom.