of some excitement, but which soon disappeared. On the 21st, three weeks after the accident, she so far recovered as to be allowed to go down stairs, and walk in the garden towards the cool of the day. The ptosis of the right eyelid had then disappeared, and the countenance had resumed its natural expression. The power over the right arm, although still imperfect, was gradually improving, and the only thing noticeable was that she carried her head in a stiff and formal manner, with a drooping forwards, a condition which continued more or less until the beginning of October, when it gradually passed off, and she recovered by slow degrees control over the motions of the head. The morbid sensibility of the surface of the head and neck, with pricking of the skin, and occasional pain under the jaw, continued more or less for a fortnight, and there was likewise up to that period a sense of falling backwards, if unsupported, or any attempt made to raise the head.

The treatment consisted in keeping the patient perfectly quiet in the upright position, with the head well supported by pillows, low diet, an evaporating lotion to the head, and fomentation to the neck by means of the spongio-piline.

The author concluded the history of the case by some remarks as to its precise nature, accounting for the skull not having been fractured by the blow causing the accident on the supposition that the head must rather have been violently pushed aside than directly struck; and he alluded especially to the interesting physiological phenomena announcing temporary pressure or injury of the spinal marrow-namely, the difficulty of breathing, the exalted sensitiveness of the scalp and integuments of the neck, the general numbness, incomplete palsy of the right arm, and ptosis of the right eyelid, all of which symptoms gradually disappeared, leaving the patient free from any trace of injury, eleven weeks after the accident.

February 11, 1868.

SAMUEL SOLLY, F.R.S., President, in the chair.

Present-55 Fellows and 6 visitors.

Books were presented from Dr. W. T. Gairdner, Dr. Murchison, Dr. Philipson; Mr. Alex. Bruce, Mr. Carr Jackson, Mr. John Marshall, Messrs. Longman; the Quekett Microscopical Club, the officers of Guy's Hospital, and the "Société de Chirurgie" of Paris.

The following gentlemen were elected Fellows of the Society:

Henry Charles Bastian, M.D.
William Henry Broadbent,

M.D.

Thomas Buzzard, M.D.
John Cavafy, M.B.

Walter Butler Cheadle, M.D.
John Cockle, M.D.

William Ainslie Hollis, M.B.
William Johnston, M.D.

Arthur Leared, M.D.

William Robert Cornish, Esq.
John Croft, Esq.

George Eastes, Esq.

William Henry Freeman, Esq.
William Chapman Grigg, Esq.
John D. Hill, Esq.
James Hinton, Esq.

William Daniel Michell, Esq.
John Foster Reeve, Esq.
Samuel Edwin Solly, Esq.

T. Henry Green, M.D., and John William Hubbard, Esq., were proposed for election as Fellows of the Society.

The following communications were read:

I. Infantile Remittent Fever, erroneously called Typhoid. By J. BRENDON CURGENVEN, M.R.C.S. (Received November 5, 1867.)

(Abstract.)

The author observed that the points of analogy between typhoid and infantile remittent were not so well marked as between typhoid and typhus, or scarlet fever and measles. The error of confounding the two diseases had arisen from the continued character of the fever in severe cases, the duration of the fever, the diarrhoea that exists in most cases, and the eruption that appears on a few.

Several English physicians had been misled by the writings of M. Rilliet, M. Barthez, and other French authors. "To M. Rilliet," says Dr. West, we are indebted for a most elaborate inquiry into this subject, which shows so close a resemblance to subsist between the two diseases as must, I think, remove all doubt with reference to their identity. Medicine," he says, "has not been able to cut short the course even of their mildest forms......And it will tend," continues Dr. West, "greatly to the avoidance of errors......if, for the future, we altogether discard the term infantile remittent fever from our scientific nomenclature, and speak, as many French writers do, only of typhoid fever in children.”

The symptoms of typhoid fever in children, as given by Dr. West and Dr. Tanner, were related, and shown to correspond entirely with the symptoms of infantile remittent fever. They were-loss of appetite, listlessness, drowsiness, an exacerbation of fever at night with delirium, exacerbation also at 11 a.m. and 3 p.m., the remission being accompanied by a subsidence of most of the symptoms. In severe cases the remissions became less marked, and might be altogether overlooked, the fever then appearing continuous. There is mostly constipation at first, which is succeeded by diarrhoea, the stools being dark and offensive. There is pain and often tenderness in the abdomen; this is at the epigastrium, and not in the right iliac region. There is

short hacking cough, with sibilus and rhonchus in the lungs. The rose spots are stated to appear in the second week; but, as Dr. West remarks, "they are often very few in number, and not infrequently are altogether absent." "The fever," he says, "cannot be considered as passed before the thirtieth day. The convalesence is slow, and it is often prolonged for months." The right course to follow in the treatment, we are told, "is to carry the patient through an affection which we cannot cut short, with as small an amount of suffering and danger as possible." Diluents, laxatives, alteratives, leeches to the abdomen and the head when the symptoms so indicate; tartar emetic and opium; blisters to the occiput. In convalescence it is said that "tonics either do no good, or are actually injurious by rekindling the fever."

One of the most important features of the disease is the temperature of the body, which falls quite, or nearly, to that of health between the exacerbations; and, when such is the case, the disease is not, nor can it be, associated with continued fever or typhoid, in which the temperature is above that of health, and continues so with but slight variation through the whole course of the disease.

The characteristic symptom of the disease is the remission of the febrile symptoms. This may occur once, sometimes twice, and even three times, in the twenty-four hours. The period of remission varies in its duration and in its period of accession. The remission may last for six or twelve hours, or its period may be so short as to escape notice; and the fever presents then the appearance of continued fever or typhoid. The disease in severe cases passes to this state at once, and is thus easily mistaken for typhoid or typhus, as the abdominal or cerebral symptoms most predominate. In mild cases the nightly fever is unaccompanied by delirium, and may escape notice altogether, the gastric symptoms or the cough alone attracting attention, the ailment being then regarded as arising from gastric derangement or bronchial congestion, as one or other of these symptoms predominates.

While the symptoms point to malaria as the cause of infantile remittent, the result of the treatment of the disease by quinine

fully confirmed the views of the author. He related eleven cases of variable severity, in which large doses of quinine at once arrested the symptoms, and the children within a few days became convalescent. All these cases occurred in a new, welldrained district, in the month of March, 1867, with the exception of the eleventh, which occurred in October. The district is remarkably free from typhoid fever, the author having had but one case there during eleven years, and that was in a young lady who was brought home from Worthing ill with the disease. He believes typhoid to be more rare in children than is commonly supposed, that disease occurring more frequently between the ages of fifteen and thirty. He does not deny that typhoid occurs in them; but the typhoid poison more frequently produces in children a fatal diarrhoea.

Infantile remittent is caused by a malaria in the spring and autumn months, the same malaria that, in adults, gives rise to various masked forms of malarial disease, such as paroxysmal cough, remittent sickness, diarrhoea, neuralgia, &c. The adult may, in fact, have one or more of the symptoms of the disease, but in them the cerebral symptoms and the fever are much less marked than in children.

II. Case of Double Hernia in a single Sac. By HENRY LEE, F.R.C.S., Surgeon to St. George's Hospital. (Received November 11, 1867.)

(Abstract.)

In this paper the particulars of a case were related in which, during the operation for hernia, two openings were discovered between the sac and the peritoneal cavity. These openings both existed in the neck of the sac at the internal ring. It was supposed that the testis, which had not descended on the side of the hernia, had lodged at the internal ring, and that, by its pressure on the one hand, and the pressure of a truss on the other, adhesions had been established between the two layers of the