be expected in it? Besides, the sympathetic nerve is also destined for the production of motion; the pulsation of the heart, and the peristaltic motion of the intestines last longer than all the other motions of the body. I am of opinion, that for the performance of its functions of this nature, the connexion with the anterior roots of the spinal system of nerves is very essential, for Scarpa's opinion, that the muscular fibrils of the heart, and of the intestines, receive the stimulus to their action not from the nerves, but from contact with the blood, and from the ingesta, seems to me entirely inadmissible. Does not also the important function of secretion which the vegetative nerve presides over, maintain uninterruptedly a peculiar species of motion in all the secretory

organs.

The circumstance that the sympathetic nerve is not obedient to our will, would likewise be, in my opinion, not better explained, if this communicated only with the posterior root of the spinal system of nerves. If it be one of the functions of the ganglia, that in them the further passage (leitung) of the will's influence should be interrupted, (as I am firmly convinced it is;) for this, the spinal ganglion is not necessary, indeed, to the sympathetic nerve, as this, in itself, possesses for this end ganglia enough, which are disposed in such a series upon its principal chord, (the so called stem,) that the connecting arches coming from the spinal nerves, must pass over immediately into those terminal ganglia. The presence of these latter appears to me, accordingly, to be perfectly sufficient, to explain the degree of independence which exists between the sympathetic nerve and the sensorium commune.

A phenomenon much more difficult of explanation is presented in the fact, that the motor and sensitive nerves having arisen separately from the spinal marrow, soon after their origin are placed in immediate apposition, and by a continued decussation of their finest fibrils enter into most intimate connexion; yet, notwithstanding this, by cutting across the posterior or the anterior roots of the spinal nerves, sensation or motion can be abolished at will. The correctness of this fact has been decidedly ascertained; the experiments which Professor Mueller had the goodness to repeat in my presence, upon frogs, leave no doubt upon my mind with regard to it. Also, since I can, by my own experiments, confirm the observations of Fontana, Prevost, Dumas, Ehrenberg, and J. Mueller, that no where a perfect anastomosis of the substance of the nervous fibrils can be ascertained, but only its immediate apposition can be demonstrated: the question still remains, how, whilst the most intimate contact of the parts of both systems of nerves is preserved, can the separate operation of each be explained? The pleasing comparison of nervous agency with the operations of electricity, which as long as each separate cord of the spinal system of nerves might be reckoned as simultaneously the conductor of sensation and motion, had much in its favor, from this receives a severe blow; for what physician (natural philosopher, physiker,) would have it in his power to explain the separate agency of two conductors which stand in the most intimate connexion with one another by means of conducting wires? I am of opinion, that the cellular tissue which lies between the separate cords effects this remarkable isolation of agencies, in somewhat of the same manner, as by means of cellular substance, the separate layers of the intestinal parietes are so separated from one another, that they mutually do not disturb

one another in their functions, but that even pathological processes påss with difficulty from one to another. At all events a wide field remains for further investigation with respect to this subject.-Dublin Journal, Jan. 1835.

2. Observations on the Existence of a proper Fibrous Tunic of the Lung, communicated by Dr. Stokes.-It has been long taught, that while the pericardium could be demonstrated to be a fibro-serous membrane, at least in that portion not reflected over the heart, the pleura was a serous membrane, between which and the pulmonary tissue nothing intervened, except the sub-serous cellular tissue.

I

That this opinion is grounded on an imperfect examination of the parts, have for several years satisfied myself; and I have repeatedly demonstrated the existence of a strong capsule between the serous membrane and the lung, and which completely envelopes this latter organ. In the healthy state, this capsule, though possessing great strength, is transparent, a circumstance in which it differs from the fibrous capsule of the pericardium, and which has probably led to the fact of its being heretofore overlooked.

The first instance in which I discovered this membrane, was in dissecting the lung of a patient who had died of a chronic pneumonia. On dividing the organ with a sharp knife, through the pleura, I observed three distinct layers. One the pleura; another apparently the sub-serous cellular tissue, much thickened and hardened; and a third of great density, and nearly opaque. This was the tunic in question. Since then I have several times observed it in the diseased, and also have succeeded in demonstrating it in the healthy lung. But it is always more perceptible in the case of disease, when the tissues are more or less hypertrophied and rendered opaque.

In the healthy lung, however, it is not difficult to exhibit it. The mode which I adopt is the following. A portion of the lung being made to a certain degree tense, by grasping the subjacent parts, so as to inflate the more superficial layer of cells, I make with a sharp scalpel the lightest possible scarification of the figure of an U. This divides the serous membrane, but leaves the fibrous untouched. The lower edge of the serous membrane is then to be seized with a delicate forceps, and by gentle traction, and an occasional division of the sub-serous cellular tissue, a flap of the pleura can be turned up, leaving the air cells still protected by the strong though transparent fibrous coat. The surface of this latter investment, even after the removal of the serous membrane, is still smooth and shining. The knife is now to be carried through the fibrous coat, and it is to be turned back in the same mode. Its great strength is at once apparent, on its being grasped with the forceps, or raised upon the point of the knife, and the surface of the lung then displayed is irregular and fleshy.

This tunic invests the whole of both lungs, covers a portion of the great vessels, and the pericardium seems to be but its continuation, endowed in that particular situation with a still greater degree of strength, for purposes sufficiently obvious. It covers the diaphragm, where it is more opaque, and in connection with the pleura lines the ribs, and turning, forms the mediastina, which thus are shown to consist of four layers, two serous and two fibrous.

This description of the investments of the lung is interesting in a physiological and pathological, as well as an anatomical point of view. It establishes

an additional analogy between the lung and the parenchymatous and the glandular organs of the abdomen, which have their fibrous capsules, and illustrates the general law, of the constant association of serous and fibrous membrane, as we see to occur with respect to the arachnoid, pericardium, peritoneum, tunica vaginalis testis, and the synovial capsules. Considered pathologically, it may explain the pain of pleurodynia and pleuritis, and the rarity of perforations of the pleura, so remarkable when considered in connection with the frequency of ulcerations of the lung, which constantly approach so close to the surface as to be bounded by the fibro-serous membrane alone. In pleuritis with effusion, its existence may assist in explaining the binding down of the lung and its corrugated appearance after the removal of the effusion, and as has been suggested to me, it may be the seat of ossifications of the pleura.

Since the above was written, I have been informed that Dr. Hart has demonstrated this tunic, in his anatomical lectures in the Park-street School, and in conversation with that gentleman, I have found that he has held the same opinions as those expressed above, for some years; and it is interesting, that he was first led to the observations of the existence of this tunic, by circumstances similar to those which I have described, namely, the dissection of the lung, which had been affected by chronic pneumonia. He describes it as most strong beneath the costal pleura. It is highly gratifying to me to find that my opinions are corroborated by those of this eminent and philosophical anatomist.-ib.

3. Case of Rupture of the Tendon of the Biceps Flexor Cubiti. By SIR GEORGE BALLING ALL.-Mr. D. a healthy active man, about 50 years of age, well known to many members of this society as an eminent chemist and druggist, while raising a heavy weight, with the tips of the fingers of his right hand, suddenly felt a snap, accompanied with a numb pain, in the lower part of the arm, a little above the elbow. The weight instantly dropped from his hand, and he was conscious of an inability to use his arm as formerly. On endeavoring to take off his coat, within a few seconds after the accident, he had great difficulty in doing so, owing to the swelling which had already taken place in the arm. On examination, there was observed a large tumour about the middle of the arm, occupying the seat of the belly of the biceps muscle. This being considered by Mr. D. as arising from effusion, he had a pretty tight bandage applied. He now felt scarcely any pain, and comparatively little inconvenience in the use of his arm,

Next morning, on removing the bandage and examining the arm carefully, Mr. D's son, a medical man, was of opinion, that the tumour, which had now increased much, arose entirely from the retraction and swelling of the biceps itself. In this opinion he was confirmed by finding, that, in the hollow which existed below the tumour, there could be detected a body, apparently the tendon of the biceps, which was loose at one extremity, and could be moved from one side to the other with great facility. Bandages were now applied, consisting of two pieces of leather accurately and tightly laced, one on the arm and the other on the fore-arm, with a strap passing from the lower to the upper piece of leather, for the purpose of keeping the arm in the bent position. Owing to the patient using his arm much, the bandages were not kept accurately applied, and after ten or fourteen days they were thrown aside.

The tendon has gradually contracted adhesions to the neighbouring parts; and although there is still considerable swelling of the muscle, and some difference between the form of the two arms, yet the patient can use the arm tolerably well. It is not by any means so strong as formerly, and he cannot make any great exertion with it. He experiences difficulty, and some degree of pain or cramp in attempting to raise a weight with the points of his fingers, and finds the power of pronation considerably impaired in the affected arm.-Edinburgh Medical and Surgical Journal, January, 1835.

4. Tracheotomy.-The following very extraordinary case, was reported at a recent meeting of the Acadamie Royale de Medecine. A young woman, aged 22, who had been cured of extensive syphilitic ulcers of the throat by the ordinary means, experienced a total loss of voice, and so much difficulty of breathing, that the operation of laryngotomy was resorted to as the only means of affording relief. The division of the crico-thyroid ligament, however, did not give passage to the air, this portion of the larynx being doubtless obliterated by adhesions and false membranes, and it was found necessary to extend the incision downwards, so as to divide several of the cartilaginous rings of the trachea. As soon as this was accomplished, the air passed freely, and respiration was established through the opening. A canula was introduced with the intention of leaving it in the aperture; but as its frequent closure by mucus gave rise to repeated attacks of suffocation, M. Regnoli resolved to excise several rings of the trachea, in order to establish an aperture of sufficient extent, to allow of the uninterrupted passage of the air, and the free exit of the mucous and purulent secretions. Several fruitless attempts were made to re-establish the natural opening of the larynx, by means of probes passed from the artificial opening upwards. The individual had, nevertheless, survived four years at the period of this report, breathing freely through the artificial passage, which she kept open herself by means of a canula. When she closed the tube, she could make herself understood, a small portion of air finding its way into the mouth, through the larynx, which was probably not completely obliterated.-Revue Medicale, Oct. 1834.

5. Purulent Matter found in the centre of a Fibrinous Concretion.—M. Bricheteau presented a heart affected with aneurism, in the right auricle of which there was a fibrinous tumour as large as an ordinary nut, containing in its centre, consistent purulent matter. The fibrine was disposed in concentric laminæ, similar to the arrangement that is observed in aneurisms of long standing.-Ib.

6. Singular cure of an Anasarca!!!-The patient was attacked with anasarca and dropsy after typhus fever. His body was completely infiltrated, and he was reduced to a perfect state of inaction. He had tried in vain various remedies, when some one advised him to apply to the abdomen a certain number of the domestic toads, and to second their action with frequent friction.

During three days the patient had recourse to this disgusting application. Thirty-six toads were put on, and renewed every now and then, and the extremities were submitted to powerful friction. On the second day abundant

stools were the result of this new remedy. There was alternation, with a copious discharge of urine. The toads were continued with a similar effect, and in a few days the man was cured of both affections.-Lancet, Dec. 1834.

7. Pulsations in the Abdomen. By DR. STOKES.—As a sign of diseased action, throbbing of the abdominal aorta has been long recognized. But its nature in all cases does not seem to have been discovered. It has been described as a nervous phenomenon; as the result of the pressure of tumours on the vessel, and as a symptom of aortitis. It may also be seen in cases of great retraction of the abdomen. But there is a pulsation of the adominal aorta or its immediate vessels, which is symptomatic of inflammatory disease in the digestive system, and which a long experience enables me to say may be considered an important assistance in diagnosis. A throbbing generally commensurate with the disease; removed by treatment calculated to relieve enteric inflammation, and aggravated by every thing which will increase this affection. In other words, we may have from enteritis or peritonitis a throbbing of the abdominal aorta or its vessels, perfectly analogous to the morbid action of the radial artery in whitlow, or of the carotids or temporal arteries in cerebritis.

The cases in which I have most frequently observed this symptom, are those of the gastro-enteric fever of this country; and when we reflect on the latency of the follicular ulcerations of the intestine, and the great number of times that this lesion is overlooked, and exasperated by improper treatment, we must see of what importance the knowledge of any prominent symptom must be. I do not say that it occurs in all cases, such is far from the fact; but I know that it occurs in many, and may be made a great assistance in diagnosis.

I have also found it in cases of fever after corrosive poisoning, where the pulse was almost absent at the wrist; and in peritonitis, where no pulse could be felt.

In these cases we have frequently the following group of circumstances: fever, prostration, thirst, tenderness of the epigastrium or the ileo-cœcal region. The pulse at the wrist is often small and feeble, while the abdominal pulsations are comparatively violent. In most cases the other symptoms of gastro intestinal disease are sufficiently plain. But in several instances this want of proportion between the action of the radial, and abdominal arteries, combined with fever, has been the principal indication of enteric disease.

As might be expected, the increased action may extend to the femoral arteries. This fact enabled me on one occasion to arrive at an accurate diagnosis. A patient who had been subject to chronic disease of the stomach, was brought into hospital in a dying state. Something, he said, suddenly gave way within him a short time before his admission. His countenance was collapsed; the hands blue, and no pulse could be felt at the wrist. The belly was swelled, but not very tender.

It was suggested that the case might be a rupture of an abdominal aneurism; others supported the opinion that it was an example of peritonitis by perforation: and that the latter diagnosis was the right one, I concluded from the fact, that while no pulse could be felt at the wrist, the femoral arteries at the groin were pulsating strongly. Recollecting also that the patient had