Robert Walker, Esq., of Carlisle, was proposed for election as a Fellow of the Society.

The Council recommended the following gentlemen for election as Honorary Fellows :

Charles Darwin, M.A., F.R.S., Joseph Dalton Hooker, M.D., D.C.L., LL.D., Thomas Henry Huxley, LL.D., Sir Charles Lyell, Bart., D.C.L., LL.D., and John Tyndall, LL.D.

They also recommended for election as Foreign Honorary Fellows :

Samuel D. Gross, M.D., Philadelphia; Professor A. Kölliker, Würzburg; Hippolyte, Baron Larrey, Paris, and Professor A. Nélaton, Paris.

The following communications were read:

I. Case of Double Axillary Aneurism successfully treated by the Ligature of both Subclavian Arteries. By E. J. FURNER, F.R.C.S., Surgeon to the Sussex County Hospital. Communicated by SIR WILLIAM FERGUSSON, Bart. (Received Dec. 23rd, 1867.)

(Abstract.)

John P, æt. 30, a labourer on the Brighton Railway, accustomed to very laborious occupation, was admitted into the Sussex County Hospital, on October 22nd, 1866, under the care of Mr. Furner, with a large aneurism of the right axillary artery. The tumour measured seven inches in length, by five inches in breadth, the clavicle being greatly pushed up by the size of the aneurism. Mr. Furner tied the subclavian artery in the third part of its course, in the usual manner, and also a large artery, the transversalis colli, which had an abnormal origin, arising direct from the subclavian artery. No unfavorable symptom occurred for the

first twelve weeks after the operation (the ligature from the transversalis colli came away on the fourteenth day, that from the subclavian on the twenty-fourth day), when suppuration of the sac took place, and upon a free incision being made through the pectoral muscle, a discharge of about eighteen ounces of most offensive matter and broken-up coagula took place. From this time the patient continued daily to improve, and he left the hospital cured on March 20th, since which time he has enjoyed good health, and has been able to resume his usual laborious occupation.

In June, 1863, Mr. Furner tied the left subclavian artery in the same patient, for an axillary aneurism. The same irregularity of distribution of the transversalis colli occurred, and was tied. The case was published in the 'Medical Times and Gazette ' of October 24th, 1863. Chloroform was not used in either case. The principal interest in this case consists in the fact that it is the only one recorded where both subclavian arteries have been tied in the same patient.

II. On an Epidemic of Typh-Fever in Trinidad. By R. H. BAKEWELL, M.D., President of the Medical Board of Trinidad, Visiting Physician to the Leper Asylum, Trinidad. Communicated by Dr. T. K. CHAMBERS, (Received Dec. 18th, 1867.)

(Abstract.)

The author stated that during the year 1867 an epidemic of fever had occurred in Port of Spain, Trinidad, which differed in many respects from any other fever which in the experience of the oldest medical practitioners had ever before visited the island, but which in all essential points was the typh fever of Europe.

Port of Spain is a badly built, ill-drained, or undrained, overcrowded town, containing upwards of 18,000, for the most part persons of the very dirtiest habits, many of them living very

poorly, and all, except the educated classes, firmly convinced that night air is deadly, and therefore closing every nook and cranny in their houses at night.

Among this population a fever appeared, which for the first few days was in almost all cases distinctly intermittent, or remittent, which then became continued, and which gradually subsided into an intermittent again. With the ordinary symptoms of fever there was in nearly every case at the commencement vomiting of bile or worms, sometimes of both. In a few cases there was also a diarrhoea of pure bile. As the fever became continued one of two sets of symptoms occurred; either there was tenderness in the right iliac fossa, gurgling, and general abdominal uneasiness, mostly with the usual pea-soup diarrhoea, or the head was attacked, and the bowels were constipated, sometimes obstinately so. In some cases the delirium and insomnia were very severe. The delirium was occasionally maniacal, and in two cases took the form of a resolute refusal of all food and medicine with clenched teeth. In the other, the so-called typhoid cases, the diarrhoea was often very severe. In nearly every case lumbrici were passed, often abundantly. No rash could be distinguished in the majority of cases on account of the colour of the patients, but in no case was a true lenticular rose-coloured spot seen. In a few cases there were the small purple spots of typhus. In one fatal case in which these were seen there were no abdominal symptoms or lesion; in the same house there were three cases of typhoid. Ulceration of Peyer's patches, &c., was found after death.

The author stated that, having for several years adopted Dr. King Chambers' plan of treatment for fever in England, he determined to adopt it in the West Indies, and give it a fair trial. Out of 103 cases, of which a table was given by Dr. Bakewell, 90 were treated by Dr. Chambers' plan, modified slightly to meet the exigencies of the climate. Of these 90 only 3 died, and one of the three was under treatment only two days, having been under the care of another practitioner. The remaining 13 were for various reasons fully given in the paper, not treated by Dr. Chambers' plan. Several of them were in extremis when first seen; one refused all medicine; two were attended before the disease was accurately diagnosed.

The slight modifications of Dr. Chambers' treatment were that in every case of insomnia opiates were freely given. No patient, if it could be prevented, was allowed to pass two consecutive sleepless nights. Astringents were given when the diarrhoea was very severe, but not otherwise. Small doses of tincture of aconite were given to children, combined with the acid, the author having by eight or nine years' experience satisfied himself that aconite possesses a peculiar power of allaying febrile excitement in children.

The treatment was pursued under every disadvantage. Probably in not six of the cases was the beef-tea given regularly. Wine was only given, as a rule, after the fever had begun to intermit for the second time; no form of alcoholic stimulant was given at the commencement of the fever.

The paper was accompanied by a table of 103 cases with remarks, and some of the important cases were given at more length in the paper itself.

April 28th, 1868.

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

Present-28 Fellows and 6 visitors.

Books were presented from Dr. Edward Ballard, Dr. Lockhart Robertson, Mr. Hinton, and Mr. J. G. Forbes, and from the Linnean and Obstetrical Societies.

The following gentlemen were admitted Fellows of the Society:

Thomas Crawford, M.D.

T. Henry Green, M.D.

Julius Lawrence Levy, Esq.

The following communications were read :

I. On Tubercular Pneumothorax. By R. DOUGLAS POWELL, M.D., M.R.C.P. (Received Feb. 7th, 1868.)

(Abstract.)

1. There is a constant tendency in phthisis to the occurrence of pneumothorax, though this tendency is commonly counteracted by the adhesions which take place between the pleuræ.

2. The softening down of tubercular masses and the ulceration round them are the commonly recognised causes of the production of pneumothorax; but this phenomenon is sometimes produced by a different morbid process, which results in the formation of a sinus analogous to those leading from diseased bone or old abscesses in limbs.

3. The character of the dyspnoea in pneumothorax resembles more that of cardiac than pulmonary disease.

4. The most important physical signs are hyper-resonance, with suppressed or very feeble respiration on the affected side, and displacement of heart to the opposite side.

5. The intensity of the symptoms in pneumothorax, and likewise the prognosis, are dependent on-1st. Condition of lung at time of rupture. 2nd. Nature of the opening. 3rd. State of the other lung. 4th. Previous condition of the patient.

6. Though in all' ordinary degrees of lung collapse the pulmonary circulation is not appreciably affected, yet, in the complete collapse of the lung in pneumothorax, the circulation through it is greatly impeded.

7. The air-pressure within the pleural cavity in cases of pneu mothorax has not hitherto been ascertained. In five experiments made post-mortem by the author, it varied from two inches to six inches of water.

8. The result of the impediment to the circulation through the affected lung is a disturbance of the relation normally existing between the pulmonary and systemic circulations. This disturb ance is in a measure compensated for by the capacity of the venous, and more particularly of the portal, system, admitting of consi derable accumulation of blood, and consequent retardation of its return to the right auricle.

The indications for treatment are dependent upon the different