"Some of the tubercles were very small; the largest were near the surface of the liver, and none exceeded the magnitude of the common walnut. They all had delicate cysts, and the contained matter was retained by beautiful reticulated lymph. The large kind were formed by an aggregation of the smaller: they did not project far from the surface of the liver, but had a slight central depression, without the peritoneal covering being thickened; but the blood.vessels were very numerous in those parts, and most likely would, if the man had lived much longer, have occasioned that cartilaginous opacity mentioned in some of the former cases."

These coincidences of opinions in different pathologists are highly gratifying; and the circumstance of their having occurred in Dr. Baron and Mr. Langstaff, without any mutual intimation of sentiment, adds much to the weight of each individually.

We have indulged in many of the foregoing extracts, because they will supply a deficiency in our analysis of the work of Dr. Baron; for his and Mr. Langstaff's observations of facts so nearly agree, that it is unimportant from which they are taken: but we cannot extend them much further. The following, however, we adduce, as being of great importance in a therapeutical point of view; since, with the fact that the disease when it appears in the extremities is but very rarely confined to them, it must show the impropriety of adding to the distress of the patient, in a great proportion of cases, by operations with the knife, as frequently as we have been accustomed to do.

"From what I have seen (says Mr. Langstaff) of cancer and fungus hæmatodes, I am convinced of their not being local diseases, any more than those of the scrofulous class: they must, therefore, be considered what has been termed constitutional. And, having noticed many small scrofulous tubercles in the lungs of still-born children; also pulpy tumors in the lungs of adult persons who had not been affected during their lives with the least symptom of pulmonic disorder, and who died of active disease of a different description in other viscera; I am led to suppose, that these specific and malignant diseases, such as cancer, fungus hæ matodes, and scrofula, have their origin perhaps with the formation or development of the natural parts of the fetus in utero; and that they remain, after the birth of the individual, in some instances, dormant or inactive for a series of years; and, in all, only require a peculiar morbid excitement, to occasion their increase and destructiveness."

Before we conclude, we are disposed to make a remark respecting the multitude of cases of this disease which have occurred to the observation of Mr. Langstaff, and which are so far beyond the proportion witnessed by other surgeons in extensive practice; it may probably be thus accounted for: Mr. Langstaff is surgeon to the workhouse of the ward of Cripplegate Without, which generally contains upwards cf 270 paupers, and

of the most wretched kind; "many of whom are admitted with the worst species of disease, besides having suffered, previous to their admission, all the privations which abject poverty occasions." It was there the author witnessed a great proportion of the cases here related: and this is worthy of consideration, in connexion with the facts mentioned in Dr. Baron's work, of Dr. Jenner having found that he could produce tubercles in young animals by feeding them on certain species of food, and especially by not allowing them a sufficient quantity of nutriment. Let us add to this a remark of Dr. Baron, the importance of which has now more fully struck us,-that, a peculiar want of nutrition marks the earliest stage of the apparent existence of the tuberculous diseases he has described.

All those who are but half as deeply impressed with the importance of this subject as we are, will make it an object for meditation, after having become acquainted with the facts respecting it, to which we have alluded, by the perusal of the original works.

Case of Hydrocephalus, successfully treated by the removal of the Water by Operation. By JAMES VOSE, M.D. of Liverpool.

The patient was an infant, seven weeks of age, whose head was enlarged to between two and three times its natural size. Ossification hrad made little progress since birth: shortly after which, the existence of the disease was observed. The head, when placed betwixt the eye and the light, was so transparent as to be not unaptly compared to a paper-lantern.

The operation was performed by a couching-needle, but it is neglected to be stated in what part the puncture was made. Three ounces and five drachms of limpid fluid were discharged, and the opening was closed with adhesive plaster; a roller at the same time being applied round the head. The head lost its tension and globular form, allowing the water to gravitate with the motion of the now flaccid parietes. About the same quantity of water dribbled from the orifice after the operation; and the child sunk so low as to create great alarm. It rallied, however, without the aid of medicine; and water again accumulated in a few days, so as to produce the former degree of tension. The operation was repeated in about a fortnight, with less fear and circumspection. A bistoury was used, and five ounces of fluid were evacuated. No unpleasant consequences ensued.

The head, having regained its former size in three weeks' time, was again tapped, and eight ounces of fluid abstracted, without the production of any constitutional disturbance. The head was punctured, for the last time, about nine days subsequently; and a grooved director being introduced into the orifice, twelve ounces were drawn off in a continued stream.

The head became very flaccid and shapeless, but no derangement of health followed. It was observed that, after each operation, the process of ossification went on with great rapidity.

Shortly after the last operation, a copious discharge of water from the bowels occurred; at first with the natural motions, but afterwards alone, and resembling in sensible qualities that evacuated from the head. The same sinking as followed the first puncture ensued on the second day of this discharge; and it was remarked, that a diminution of the size of the head corresponded with the quantity of fluid thus discharged. Ossification advanced rapidly; and, at the time of the report, the bones of the head were nearly as complete as is usual in a child of that age. The infant improved in health, size, and vigour : its appetite and digestion were good; and not a single convulsion had occurred since the first operation. The medical treatment was confined to a regulation of the bowels by small doses of hydrarg. cum creta.

The importance of this case will, we trust, warrant this ample detail. A want of the previous history of the disease must be regretted.

As we are about to prepare a review of the Essay of Dr. CHEYNE on Hydrocephalus, we shall defer our remarks on this case. In that, we shall give an account of another instance in which a similar operation has lately been performed with success, and show that it was advised as a common practice by Hippocrates.

Account of a Case of defective Power to distinguish Colours. By WHITLOCK NICHOLL, M.D. F.L.s. of Ludlow. Read May 26, 1818.

This case is similar to one before related by Dr. Nicholl, and published in the seventh volume of these Transactions. On the Use of the Actual Cautery as a Remedy for the Cure of Diseases. By J. P. MAUNOIR, Professor of Surgery in the University of Geneva.

Further Account of the result of an Operation for forming an artificial Pupil. Extracted from Letters addressed to Professor Scarpa. By the same.

This will not admit of an abstract.

Cases shewing the Coincidence of Worms in the Intestines with Hæ. moptysis, and Remarks on the Probability of the two Affections having a Connexion with each other. By NATHANIEL KÚMSEY, Esq. Surgeon, Beaconsfield, Bucks. Communicated by Dr. BATEMAN. Read June 24, 1818.

The connexion of hæmoptysis with a disordered state of the intestinal canal, has been frequently observed; and those physicians who have most attended to verminous affections, have

been led to believe that their presence in the bowels is more fréquently a consequence than a cause of a disordered state of those viscera. This indication is almost solely followed by the Italians in their treatment of those maladies; and every person who has witnessed their practice, is forcibly struck with their extraordinary success. We must however remark, respecting this paper, that Mr. Rumsey's observations have led him to think that intestinal worms derive their origin from some morbid secretion into that canal, not from ova. In this opinion he will find himself very powerfully supported by RUDOLPHI, whose accurate researches on this subject have determined the question, in the judgment of the greater number of pathologists on the continent.*

Two Cases of Aneurism, in which the Temporary Ligature was em ployed. By B. TRAVERS, Esq. F.R.S. Vice-President of the Society. Read May 26, 1818.

The ligature was employed, in the first, for aneurism of the radial artery below the elbow, by a loop-knot, and was removed fifty hours afterwards. Obliteration of the artery above the situation of the ligature was effected. But, from the circumstances which occurred in the second case, Mr. Travers expresses his determination to relinquish the use of the temporary ligature; and, he adds, he should regret to hear of the repetition of the experiment. The grounds of his expectation, and the motives which led him to the practice, will be seen in his papers in the fourth and sixth volumes of the Society's Transactions. He candidly acknowledges that he had formed too favourable an opinion of it; but that it is to him "a source of high satisfaction, that the decision of the question, which I deemed of importance, has been obtained without loss of life or limb.”

The use of a cylinder of waxed linen, to be placed between the artery and the ligature, which Mr. Travers speaks of in this paper, though not in a favourable manner, as à means not so likely to be followed by secondary hæmorrhage as the simple ligature, has been noticed in the 245th volume of this Journal. The most important objection is, we think, the extensive separation of the artery from the surrounding parts which it requires; a thing itself likely to be followed by ulceration of the artery, and consequent haemorrhage. Yet SCARPA still favours this practice. The question respecting its utility cannot be considered finally determined.

Mr. Travers says, he has long been in the occasional practice of applying the noose-ligature to the arteries of stumps, and

*See Entzoorum Vermium Intestinalium Historia Naturalis. Auctore C. A. RUDOLPHI Amstelodamiæ, 1808, 1810, and 1819.

removing them at the first dressing; and that he has not known a single instance of secondary hemorrhage, after the use of that measure.

Observations on some Points relating to the Physiology and Pathology of the Ear. By JOSEPH SWAN, Esq. Surgeon of Lincoln Hospital. Read May 12, 1818.

We have transcribed this little memoir into our Collectanea. As it is only an exposition of observations, it does not admit of any other critical comments than such as designate the interesting nature of the facts detailed.

Account of a Case in which some singular Preternatural Appearances were observed in the Ovarium and Female Bladder. By EDWARD PHILLIPS, M.D. of Andover. Read June 24, 1818.

The interest of this case consists in the singular appearances witnessed after death: of these we shall transcribe the history. The symptoms during life, were only those of irritation of the bladder two years previously to the fatal termination of the malady; and, soon afterwards, all those which generally accompany the more active forms of disease of the ovaries. Yet it is singular, that, when the signs of the disease of the ovary became more forcibly characterized, all the symptoms of irritation of the bladder were suspended, and continued so, Dr. Phillips remarks, until the patient was released from her sufferings. The patient was about thirty years of age; but the author has omitted to mention whether or not she was married.

"Dissection. The body was opened fourteen hours after death, by Mr. Pitinan, jun. a young surgeon of great promise; and the following particulars were the result of the examination:

"On opening the cavity of the abdomen, there escaped about two gallons of water mixed with blood. On the left side of the umbilical region there was an ovarial tumor, rather larger than a human heart, the contents of which were a semi-fluid substance, a good deal resembling in appearance clouted cream. In the middle of this cream-like substance was found a tuft of hair, about the size of a hen's egg. The surface of the tumor was nearly covered by clusters of hydatids, beau. tifully transparent, and connected like a bunch of grapes. On the broad ligament of the left side of the uterus there arose a number of small white tumors, of the size of common peas. The uterus itself was not diseased. The bladder was very much distended, or rather plugged-up, with a substance similar to that which was contained in the ovarial tumor; and here also was discovered another large tuft of hair. The coats of the bladder were very much indurated, and particularly the inner coat. The urethra appeared to have no direct communication with the bladder, at the under and posterior part of which there was attached a small cyst, having the same cream-like substance before described, and also a quantity of hair; and, what is deserving of par.