far the most speedy and effectual method of cure. From the insensibility of the tumour the application of escharotics gives rise to no pain, and their destruction is speedily effected.

We have not given a proper trial to internal remedies in this disease. Dr Bateman, however, found in his first case, that, after administering the arsenical solution in small doses for a month," the tubercles were universally diminished, both in number and magnitude, most of them having gradually subsided, a few, especially on the neck, had suppurated." We have tried the arsenical solution in small doses, in Case II. it was not, however, continued so long. We also tried the Aq. Potassae, and found no appearance of improvement whatever, although both sets of remedies were continued for about a fortnight. Indeed, during their administration, the disease seemed to follow its usual course of production and of spontaneous suppuration and decay. In Case I. also, the disease followed a very similar course to what Dr Bateman has described, and has become nearly free of the affection, although no treatment whatever has been had recourse to. With regard to other remedies, we have made no trial whatever of them, and are inclined to look upon internal remedies in general as too tedious, when the local ones can be applied with so little pain to the patient, such surety to the destruction of the tumours, and in so much a shorter space of time.

Explanation of Plate.

Fig. 1. Represents the appearance of the face of case first, who communicated the disease to the breast of her mother, while the neck of the same figure shows the appearance which case second presented, having received the disease from a girl that nursed her. Both the children were females, and about the same age,-two years.

Fig. 2. Shows a patch of skin on which the disease from the shoulder of case second is represented of nearly the natural size.

Fig. 3. Represents the tumours in profile.

Fig. 4. Represents the appearance of the tumours when deprived of the skin and cellular tissue; the transparent investing membrane distinctly shows the shape of the cells shining through it.

Fig. 5. Represents a section of one of these tumours, a. the cells of which they are composed, discharging the milky fluid towards b. the canals or cavity, which conduct it to c. the orifice.

Fig. 6. Represents an enlarged external view of the base of the cells with their shape and arrangement.

Fig. 7. Represents cells under the compressor, and the milky fluid escaping.

Fig. 8. Gives a magnified representation of the cells. Upon a thin section being made, and placed under the microscope, the peculiar granules of which the milky fluid is composed, are distinctly seen occupying the cells, and increasing in size as they reach the nipple-like prominence and cavity of the tumour; a. the internal extremity of cells, and nipple-like prominence; b. the external extremity; c. the peculiar granules.

Fig. 9. Represents the peculiar globules of the milky secretion of this disease. They are observed to be of irregular shape, oblong or oval, and to contain nucleoli.

Fig. 10. Represents a medium sized granule, of which the milky fluid is composed, magnified about 500 diameters; the granule itself is about roo of an inch in diameter. a. represents the external cell; b. the vesicle or granule; and c, the granulated nucleus.

PART III.

MEDICAL INTELLIGENCE.

ANATOMY AND PHYSIOLOGY.

On the peculiar disposition of the Arteries of the Uterus. By M. BRICQUET. (Bulletin de l'Academie Royale de Medecine, 16th March 1841.)— The arteries of the uterus during pregnancy, besides their increased diameter, also acquire an increased elongation, which renders them tortuous, even whilst the uterus is still filled with the products of conception. When the uterus, however, has expelled its contents, whether at or before the full period, the arterial sinuosities, in consequence of the contraction of the walls of the uterus, increase so as to touch each other by their convex surfaces. The plane of the circles to which these belong is then parallel to that of the coats of the uterus: but, as the uterus goes on diminishing in size, the sinuosities not being able to increase any further in that direction, bulge out in another, perpendicular to the plane of the coats of the uterus. In this state, the arteries, instead of forming simple bendings or sinuosities, present the appearance of spiral or helicine vessels, which retain this form during the whole time the uterus is returning to its former contracted state. M. Bricquet found that this helicine or spiral disposition of the uterine arteries, once produced, is retained ever after, and is not lost during life He thinks this fact will prove a valuable addition to our stock of knowledge, as to the medical jurisprudence of pregnancy, as he asserts that this appearance is never produced but by pregnancy, and is never met with in the unimpregnated womb.

Case of Secretion of Air from the Human Skin. By Sir FRANCIS SMITH. (The Dublin Journal of Medical Science. January 1841.) An hypochondriac gentleman, 35 years of age, informed Sir F. Smith that he was liable to immense disengagements of gas from the stomach; that he also occasionally discharged air from the urinary bladder; and had observed an escape of air from the surface of his body when under water in the bath. Little attention was paid to the last of these statements till the 15th of May 1840, when Sir F. Smith was hastily summoned to the bath to see the phenomenon of the disengagement of air from the skin of his patient. He was found in a bath at 79°, and his chest, abdomen, shoulders, and hands were literally covered with small air bubbles. When he removed his hands from the bath, the bubbles disappeared, but when he replaced them below the water, the air bubbles were observed to make their re-appearance, at first very minute, but gradually increased in size till the palms of his hands became again coated with them. He frequently wiped away the bubbles from his hands and chest, but in every case they were soon replaced by others. The bubbles of air ran together, when pushed with the finger, like globules of mercury, without quitting the skin, or becoming loose in the water. This circumstance was observed for twenty minutes by Sir F. Smith, and towards the end of that time the margins of VOL. LVI. NO. 148.

T

the upper end of the bath opposite where the shoulders had been, were coated all round for a depth of about two inches, with minute bubbles of air.

MEDICAL PATHOLOGY.

Further facts regarding the Identity of Small-Pox and Cow-Pox. By Dr BASILE THIELE of Kasan in Russia. (Bulletin de l'Academie Royale de Medecine, January 1841.)-In the spring of 1836, Dr Thiele inoculated the matter of small-pox on the udder of some cows; pustules were produced which bore all the characters of the true vaccine vesicle in those animals. The matter from these vesicles was applied by puncture to the arms of several children, and produced the true vaccine disease; only that the local symptoms were more intense, and the consecutive fever more severe. The vaccine lymph thus procured was carefully observed during seventyfive successive transmissions in the human subject, and appeared always to retain its normal character.

During the spring of 1838, M. Thiele repeated his former experiments with the same success. The cows chosen were from 4 to 6 years old, and they were inoculated with the small-pox matter on the posterior part of the udder. Whether the matter used was taken from mild or severe, from the single or the confluent form of small-pox, the vesicle produced on the udder of the cow was always of the same mild character, and the lymph obtained from it proved equally mild when applied to the human system. In general only a third of the inoculations succeeded. On the third day, slight induration of the cellular tissue at the seat of the puncture was observed. On the fifth a pustule formed; from the seventh to the ninth it had the appearance of a vaccine vesicle; from the ninth to the eleventh it began to desicate and form a crust, which fell off a few days after, leaving a deep cicatrix; from the fourth to the seventh day the circulation of the animal was slightly accelerated, and its temperature increased, but its general health appeared to remain unaltered.

Dr Thiele satisfied himself, from experiment, that the virus thus obtained from the cow ought to be allowed to remain dry on glass for five or six days before being used, and then mixed with a little fresh warm milk before being applied to the arm of the infant. The vesicles resulting from the vaccination of this lymph appeared in every respect similar to those of the ordinary vaccine vesicles. During the first transmissions through the human subject, Dr Thiele observed two separate febrile attacks; one from the third to the fourth day, and the other from the cleventh to the fourteenth day; in this respect still bearing some analogy to small-pox. He says that this double febrile accession is not got the better of till about the sixth transmission, and that it is not till then that it is safe to give up mixing the lymph with warm milk previous to vaccination. To the neglect of this precaution he attributes the occurrence of some cases of true small-pox eruption after vaccination, with this lymph during its earlier transmissions; but he immediately afterwards mentions a circumstance which appears to invalidate the statement as to its being true small-pox eruption; for he states that some of this matter, taken and mixed with milk, communicated the vaccine disease to other children, and remained as vaccine lymph in all its subsequent transmissions.

On the non-occurrence of Albuminous Urine during the Dropsy which follows Scarlatina. By DR PHILIPP of Berlin. (Casper's Wochenschrift fur die Gesammte Heilkunde. Nov. 1840.)-The results of Dr Philipp regarding the occurrence of albuminous urine during the dropsical symptoms which follow scarlatina, are at variance with what have been observed in this country. In an epidemic scarlatina which raged at Berlin, he ascertained in sixty cases that the urine was not albuminous, though the drop

sical symptoms were fully developed, and could only be traced to this complaint. The dropsical symptoms appeared at shorter or longer intervals, often four or five weeks after desquamation. The urine was tested both by means of heat and of nitric acid, but by neither of these was the slightest trace of albumen discovered. He is inclined to attribute this to the rarity of disease of the kidney at Berlin, seeing that for the last two years only two cases of Bright's disease of the kidney have been noticed. The scarlet fever, too, appears to vary somewhat in its type from that which occurs in this country, as he mentions that the deaths from this affection generally result from its complication with croup, as he calls it, or cerebral disorder. Dr Philipp mentions that the dropsical symptoms are so mild and unattended with danger, that, though they occur in most cases, he has not met with one which proved fatal.

THERAPEUTICS.

On the best mode of employing Electricity or Galvanism in the Cure of Neuralgia. By M. C. JAMES. (Gazette Medicale de Paris, 24th October 1840.)-M. James states that the following mode of applying galvanism or electricity to nerves suffering from neuralgic affections, rarely fails in effecting a cure. He is inclined to attribute the numerous failures which other practitioners have met with in the use of this remedy, to the circumstance, that the electric fluid was never made to pass through the nerve at all, but alongst the skin merely,-rarely, if ever, being made to penetrate to the affected nerve. A fine needle, of about two inches and a halť loug, made of some metal which is not easily oxidized, platina or gold being the best, and finely polished, is introduced into the seat of the affected nerve. The needle is recommended to be pushed straight down at once to the affected nerve, and not to be turned round, as is often done in introducing needles into rheumatic parts. All needles composed of metals which are oxidizable are condemned as hurtful, both because they give pain from their loss of polish, and from their causing an indelible stain in the spot where they are introduced,—a circumstance which is especially to be avoided when operating on the face or other exposed parts of the body. The neighbourhood of important blood-vessels, is, if possible, to be avoided; at least, they should not be transfixed. It is not, however, indispensable to pierce the nerve; it is stated that it is sufficient if the needle be in contact with it. Two needles are generally requisite,-one at the origin of the affected nerve, the other towards its affected terminating branch. The introduction of the needle rarely gives pain.

The needles being fixed, a current of electric fluid is made to pass along the nerve, the positive pole being put in communication with the needle fixed in the origin of the nerve, and the negative pole with the needle inserted at the extremity of the branch. The voltaic pile of five or six plates usually furnishes a sufficiently powerful current for the first sitting. The electro-magnetic apparatus of Mr Clark of London is recommended as being that which is both most convenient, and whose intensity can be increased most easily at will. The wires of the electric apparatus are only kept in contact with the needles for a few seconds; in some cases, however, a continued current of the electric fluid is made to pass along the nerve. A kind of pricking pain is experienced under the influence of the electricity, most acute at the negative pole.

Several sittings are required before the neuralgic pain leaves the nerve; after it does leave it, however, the application must not be immediately discontinued, as sometimes it returns. It is, therefore, recommended, before withdrawing the needles, to wait for a few minutes, and direct the person to make the motion which usually brought on the pain; if it returns one or two additional shocks, passed along the nerve, will make it

completely disappear. No after treatment is necessary; and when properly performed, the punctures give no uneasiness, and require no treatment. M. James relates a number of instructive cases of neuralgic affections of the nerves, which occurred chiefly in the practice of M. Magendie, who is the great advocate for this mode of treating neuralgia, which were relieved by the use of electricity.

On the prevention of Pitting in Small-pox by means of Sulphur Ointment. By Dr V. MIDAVEINE. (Annales de la Societé de Medecine de Gand, December 1840.)-The danger of applying mercurial perparations to the whole surface of the body induced Dr Midaveine to seek some other means which would be more generally applicable, and yet possess an equally modifying power over the variolous pustule. From the success he obtained in sixteen cases of small-p -pox, he thinks he has found in sulphur ointment a remedy equally efficacious in preventing the maturation of the pustule and the subsequent pitting, as the mercurial preparations, whilst its application is not attended with the same danger to the patient. He employed it of the strength of one and a-half to two drachms of flowers of sulphur to each ounce of lard, the smaller proportion being used for the varioloid affection, the larger for the confluent small-pox. The whole body is rubbed with this three times daily; and the sooner the application is made after the appearance of the eruption, the greater is the chance of its speedily arresting its developement. The pustules shrivel and dry up under this treatment, the appetite speedily returns, and convalescence is soon established.

On the utility of Oxalic Acid in Inflammations of the Mucous Membranes. By M. NARDO. (Repertorio delle Scienze Fisico-Mediche del Piemonte. January 1841.)-At the scientific meeting at Turin in September last, M. Nardo made known the results of his experiments on the therapeutic effects of oxalic acid; to which subject he had been devoting his attention for the last twelve years. From his experiments he concluded that this acid possesses antiphlogistic properties superior to that of any other vegetable acid, as the malic, the citric, the acetic, or the tartaric, and that, in addition, it possesses the precious property of calming the violent pain which attends inflammation of the mucous membranes. He especially recommends its employment in all diseases where this membrane is implicated, as in angina, gastritis, gastro-enteritis, stomatitis, and aphtha. He says that the use of oxalic acid renders the loss of blood much less necessary. The dose he employed was one and a-half grain in about eight ounces of fluid. It is not mentioned how often it ought to be repeated. He regards it as a contra-stimulant.

SURGERY.

Two cases of Goitre cured by Ligature. By M. J. BACH of Strasbourg. (Gazette Medicale de Paris, 2d January 1841.)-Henri Klein, aged 30, first perceived an enlargement in the front of the neck, about ten years ago, which gradually but slowly enlarged, until it attained such dimensions as to become very troublesome, from its pressure on the larynx and trachea. The tumour was moveable, though adherent by a pretty broad base. It felt at certain points hard, almost cartilaginous or osseous, whilst in others it was soft and presented fluctuation. It extended upwards to within two finger-breadths of the ramus of the lower jaw, and downwards to about the same distance from the clavicle, displacing outwards the sterno-mastoid muscle and carotid artery on the right, and pushing the larynx inwards and towards the left.

M. Bach having resolved to free him of this tumour by operation on the 25th of July, made a crucial incision over the centre of the tumour, and, after dissecting back the flaps of skin thus formed with his fingers, broke