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After death the lungs were found disorganized, and there wastubercular ulceration of the ileum. Upon proceeding to removethe heart, it was found firmly adherent by the apex to thediaphragm, and by the lower part of the anterior surface tothe pericardial sac. When taken out, a hard, bony tumour,the size of a pigeon’s egg, was found attached to the apex, andin close union with the tissue of the heart itself. Upon incision,it was found to be composed of a thin but extremely hard, bonycase, and the interior was filled with fibrin of a light andtransparent appearance, except at the lower part, where it wasslightly coloured by hæmatine. Upon removing the fibrin, anoval opening, a quarter of an inch long, was seen at the bottomof the sac, and passing directly into the left ventricle. Thisopening was perfectly smooth, and covered by a dense serousmembrane, which was continuous with the endocardium on oneside, and the lining of the bony cyst on the other. This ap-peared, then, to be a case of true aneurism of the heart, in whicha perfect cure had taken place, and the patient died severalyears afterwards of another disease.

Dr. WILKS also showed a

CASE OF BONY GROWTH ON THE HEART.

This was an old specimen, belonging to Guy’s museum, whichhad been bought at the late Joshua Brooke’s collection, andwhich Dr. Wilks exhibited to the Society in order to gatherany suggestions as to what might be its probable nature. It was described in the catalogue as an osteo-chondromatous tumour of the heart, and no further particulars given. The

specimen consisted of an adult healthy heart, having upon itsanterior and right side a large tumour the size of the closedfist. This consisted of a membranous sac, having within a net-work of bony rods or spiculæ running in all directions through-out it, the latter being composed of true osseous tissue. It hadno communication with the heart or coronary vessels, and waseither the bony skeleton of a new growth, or was a congenitaltumour-that is, the remains of an included ovum attached tothe heart.

Dr. SALTER exhibitedA DISEASED HEART,

from a child, aged thirteen, who had been a patient of his inCharing-cross Hospital. During life, the amount of endo-cardial mischief was obscure on account of pericardial rub-bing ; but mitral regurgitant disease, if not double mitral, wasdiagnosed some time previous to death, and the morbid ana-tomy showed after death that the conditions for the productionof all these sounds existed. All the valves were diseased, theright as well as the left side; the valves of the pulmonaryartery the least, the mitral valve the most. This last was, bythe agglutination of the two cusps to each other, convertedinto a narrow ring, through which the extremity of the fingercould barely be passed. This must have given rise to greatobstruction; whilst the contraction of the smaller blade of thevalve, and its adhesion to the wall of the ventricle, allowedtolerably free regurgitation. But the chief interest of the caselay in its history-in the fact, that these extensive results ofinflammation were impeded by any recognisable acute attack.The child had never had rheumatic fever, or even rheumaticpains of any decided character; but, though diminutive andpallid, had always enjoyed good health. Last Christmas she

caught a cold, which left a little cough, but did not confineher to the house, or interrupt her at the dance at school asingle day. From this time she noticed palpitation, and a

slight pain in her left side. This, with a slight dry cough,gradually increased till May, when she applied for relief. Thecase terminated fatally in the last week of October, nearly sixmonths after admission; and the principal features of its coursewere extreme dyspnoea, universal dropsy, rupture of cutis inthe legs and back, and continual draining of serum, great ema-ciation, and final sinking. Dr. Salter observed, that this his-tory implied, as the essential pathology of the case, one of twoalternatives, either of which was interesting: either that theapparent cold at Christmas was really a rheumatic attack, inWhich there were no articular manifestations, but in which therheumatic inflammation fell entirely on the heart (and he be-lieved the existence of such cases was disputed); or else thepoison of catarrh is capable of producing inflammation of theheart, as well as that of rheumatism. Seeing the many pointsof analogy between catarrh and rheumatic fever (in causation,pathology, symptoms, &c.), this last supposition appeared tobr very probable. These views, if correct, would tend toexplain the so-called cases of " spontaneous" and " latent"heart disease in children, and to diminish, in respect to the

heart, what the present advances in pathology are constantlydecreasing-idiopathic inflammations.

Mr. BRYANT showed

A PART OF THE INTERNAL JUGULAR VEIN, WHICH HAD BEENWOUNDED BY A FALL UPON BROKEN CHINA,

from a little girl, aged nine years, who was admitted into Guy’sHospital on Nov. lst, under Mr. Birkett. About one hourprevious to admission she was running down-stairs with a.

chamber utensil in her hands, when she stumbled and fell overthe broken china. A scalp wound over the right front was theresult, and a wound on the right side of the neck. From thissevere bleeding followed. No other means than the applicationof a piece of plaister were employed, and the child was broughtto Guy’s. When admitted, the child was pulseless, and in adying condition. A wound over the right front existed, anda peculiar induration of the bone, evidently produced by a.sharp edge, but no fracture. The wound in the neck was upon.the right side, about one inch in length, and about one inch tothe outer side of the thyroid cartilage; the edges were cleanlycut, no bleeding occurred, and in less than five minutes thechild ceased to breathe. On making a post-mortem examina-tion, the source of the haemorrhage was detected: the sharpedge of the broken china had perforated the skin and deepfascia, dividing some few fibres of the sterno-cleido mastoidmuscle, and entered the internal jugular vein, producing a cleanoblique incision in its outer wall, about a quarter of an inchlong, giving an observer the impression that the wound hadbeen produced by a stab from a sharp instrument. The modeof production of such an injury as the above forms the principalpoint of interest in this case.

WESTERN MEDICAL AND SURGICAL SOCIETY.

FRIDAY, OCT. 17TH, 1856.MR. S. A. LANE, PRESIDENT, IN THE CHAIR.

THE first ordinary meeting was held this evening. After a.short opening address from the PRESIDENT, and the nominationof new members,

Dr. SEATON read a paperON THE PROTECTING AND MODIFYING POWERS OF

VACCINATION.

He commenced by correcting erroneous notions which some-entertained as to the views held by Dr. Jenner on the protect-ing power of vaccination, and showed that when he spoke ofthis as an absolute and perfect protection, he meant that itprotected to the same extent and in the same manner thatsmall-pox itself did. He regretted that the rules and cautions-laid down by Jenner for the performance of vaccination shouldso often be departed from, and that the operation, from itssimplicity, should not always have received, either from medicalmen or from parents, the attention due to it. Hence it wasnecessary, in every case of small-pox in which previous vac-cination was alleged, to ascertain accurately whether theperson had really gone through the vaccine disease or not. Indetermining the relative protection against small-pox affordedby a previous attack of the disease casually or by inoculationon the one hand, and by vaccination on the other, there wasalso the necessity, in the former case, of determining whether-the primary disease had really been small-pox, or whether theinoculation had been successful, and there was the necessity,in both cases, of being assured with regard to the presentattack that it was a genuine one, and not one of the manydiseases which had at different times been mistakeri for small-pox. Again, the comparison must be made in classes of indi-viduals similarly circumstanced as to age, condition of life,liability to exposure, &c. &c. These conditions were all ful-filled in the Royal Military Asylum, in which it had beenshown, by Dr. Balfour, that out of every 1000 boys admittedprotected by previous small-pox, 6.15, and out of every 1000protected by vaccination, 7 ’06, were attacked subsequently bysmall-pox. This result might be looked upon as conclusive asregards children under puberty, and shows that as regardsthem Dr. Jenner’s opinion of the equal protecting value ofsmall-pox and of vaccination was borne out. Dr. Seaton saidthese statistics were further of great value in showing thatsmall-pox after small-pox was by no means the rare occurrenceit was sometimes represented to be, a point which must alwaysbe borne well in mind in any attempt to estimate the value ofvaccination. There were no statistics by which the relative

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protection afforded by vaccination and by small-pox could beestimated with the same precision for the adult. The statisticsof the army and navy were not available for this purpose,though they afforded most conclusive proof of the general valueof vaccination, these forces being at times much exposed, andfour-fifths of them owing their protection to vaccination.Dr. Seaton then entered into the question of the protectionafforded by vaccination under circumstances of long-con-tinued exposure during epidemic influence. Having men-tioned some striking facts on this subject, he gave theresults of an inquiry instituted some few years ago by theEpidemiological Society as to the extent to which medicalmen, whose profession exposed them of course, in a peculiardegree, to small-pox, were liable to take on the disease. Itappeared from the returns, that of 347 medical men protectedby vaccination, 44, or 12’6 per cent., had had variola; and of82 who had been inoculated in infancy, 3, or 3’6 per cent.,had variola subsequently. Dr. Seaton cautioned the Societyagainst accepting these statements as representing correctlythe ratio in which medical men, in the ordinary practice oftheir profession, were liable to variola. In the first place, theinquiries had been addressed to a great many more who hadnot replied. Now, as variola after inoculation, or after vacci-nation, was undoubtedly the exceptionable case, the proba-bility is, that in every case in which it occurred it was re-ported, and that those who did not reply had not suffered.This would materially lessen the per centage. Again, the in-quiries were addressed to selected persons : the selection being,in many instances, made because of the known extent to whichthey were in the habit of meeting with small-pox. And, fur-ther, a great many of the cases of small-pox thus reportedwere cases of variolous inoculation in the dissecting-room.Making allowance for these points, the returns would, at firstsight, show that under circumstances of considerable exposure,the protecting power of vaccinia was inferior to that of variola.But an analysis of the returns, with the view of determiningthe character of the vaccination relied on, gave some interestingresults. Of 18 who stated that there was no cicatrix visible,3 had had small-pox, or 16’6 per cent.; and of 32 who made.no, mention about the cicatrix, 6 had had small-pox, beingabout the same proportion. Of 235, with one or two cicatrices,33 had had small-pox, or 14 per cent.; but of 62 with three,four, or more cicatrices, 2 only had had small-pox, or 3’2 percent. Taking these facts in connexion with the immense valueof the cicatrices as an index of the efficiency of vaccination,as shown by the researches of Mr. Marson, the results are

sufficiently remarkable. It does not appear that the liabilityto take small-pox is any greater in those having more than twocicatrices of vaccination than in those who have had previoussmall-pox, so far as these observations go. Granting at oncethat the number of observations is far too limited to allow usto draw with confidence any positive conclusion, they certainlyjustify a negative one, and call upon us to pause before weadmit that duly and efficiently performed vaccination will notprotect the system, even under circumstances of severe expo-sure, to the same extent that inoculation itself would havedone, as stated by Jenner. It was clear, at all events, thatthere was no truth in those statements, which treat of small-pox, after inoculation, as a bare possibility scarcely to be takeninto account; and of small-pox, after vaccination, as a thingalmost to be expected, especially after a lapse of pears. Inreference to the doctrine involved in this latter phrase-viz.,that the protecting influence of vaccination is liable to wearout, Dr. Seaton cited various facts to show that it ought not tobe accepted. The author then proceeded to consider the modi-fying power of vaccination; and exhibited in a table theresults of various returns to the Epidemiological Society ofthe observations made in various epidemics, and of the re-

cords kept by Mr. Marson, at the Small-pox Hospital. Heshowed that the mortality from small-pox, in persons re-

puted to be vaccinated, was not more than 3 or 4 per cent., ’,under favourable circumstances, nor more than 7 underthe more unfavourable, while the mortality of the naturalsmall-pox varied from 20 to 35 per cent. He gave an accountof the analysis of the cases of post-vaccine small-pox in theSmall-pox Hospital, made by Mr. Marson, and published inhis paper in the Medico-Chirurgical Transactions," which Dr.Seaton characterized as the most important contribution evermade to our knowledge on this branch of the subject. Bythese it appeared that in persons well vaccinated, and havingmore than two cicatrices, the mortality was less than 1 percent. It was only, the author observed, by taking in connexionthe protecting and modifying powers of vaccination that we ecould arrive at any just estimate of the real value of the dis-

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covery; and he showed from the preceding facts, that of a cer-tain number of children vaccinated in infancy, the proportionwho would at any period of life take fatal small-pox was in-finitely smaller than the number who, out of a given numberof children inoculated, would die from the immediate effects ofthe operation itself. Hence the practice of vaccination was in-finitely preferable to inoculation as regarded the individual.The great objection, however, to inoculation was, that it keptalive and propagated the disease. This was the case in thepresent day in India, in Ireland, and other places, where it wasstill practised, and it had been the case in England. Henceduring last century, while inoculation was in vogue, the mor.tality from small-pox underwent no diminution; while sincethe introduction of vaccination it had steadily and progressivelydeclined. For the ten years ending 1800, the average annualmortality from small-pox within the Bills of Mortality was1780 in a population ascertained in 1801 to be 261,233; whilethe four years ending 1841, it was only 1659 in a populationascertained in 1841 to be nearly 2,000,000. Then came theAct establishing parochial vaccination, and for the fourteenyears ending 1855 the average annual mortality from small-poxwas but 821 in a population considerably above 2,250,000. Theauthor then showed that by far the greater part of this mor·

tality was unnecessary and preventible; and comparing andcontrasting the mortality from small-pox in this country withthat existing in other countries, and glancing at the state of

I Scotland, Ireland, and our colonies in this respect, he pro-nounced our present condition to be most discreditable to us asa nation, and especially as the nation in which the discovery ofvaccination took place, and expressed his hope that when theattention of the Legislature was turned, as it would be imme.diately, to the subject, the medical profession would make itsvoice heard in proclaiming the value of the practice, and thefutility of the objections that had been raised, and in pointingout and supporting the establishment of a better system forsecuring its benefits to the entire population.The Society then adjourned.

EPIDEMIOLOGICAL SOCIETY.

MONDAY, NOVEMBER 3RD, 1856.

THE seventh session of this Society was inaugurated thisevening by Dr. BABINGTON, who, in a brief address, reviewedthe main operations of the Society during the past year, andexpressed a confident hope, now peace is restored to Europe,that the medical officers of the various branches of the publicservice would carefully collect the results of their experiencein the extensive field of observation afforded by the Crimeancampaign, both as regarded the course of epidemic diseases,and the casualties incident to active warlike operations.

Dr. MILROY read a paper, entitled

REMARKS ON THE STUDY OF SOME EPIDEMIC DISEASES.

Like many other phenomena in nature, the origin and develop-ment of pestilences are involved in obscurity. We are ignorantof their immediate and efficient cause,-the mate1’ies morbi,—and of the circumstances which lead to their occasional andtemporary outbreaks. They come and go, but the why andthe where we can neither predict or explain. If we had accu-rate tables of the geography and chronology of epidemics overa multitude of years, and in different countries and continents,light might possibly be thrown on several problems in theirhistory. Mr. Wilde, of Dublin, has recently set an excellentexample in this direction, in Part V. of the Census Report ofIreland. Again, by carefully comparing the features of diffe-rent pestilences together, our knowledge might be much ad-vanced. One of the chief objects of the present paper was toapply this principle of examination to plague, yellow fever, andcholera. The admirable works published during the last tenyears on each of these diseases enable us to do this with muchgreater exactitude than previous:y-viz., the Report of theFrench Academy on Plague and Quarantine ; the Reports onthe Cholera Epidemic of 1849 by the General Board of Health,the Registrar-General, and the London College of Physicians;and the Report of the Sanitary Commission of New Orleans onthe Yellow Fever of 1853. The monographs of Dr. Burrell onthe Malta Plague of 1813, of the Government Commissionon the Bermuda Fever of 1853, and of Dr. M’William on thatof Boa Vista, are highly valuable; and the Report on theCholera in Jamaica contains much reliable information. Thefacts related in these works prove that outbreaks of these three