however, any just estimate could be made of the value of analogy in cholera, it was necessary that preconceived opinions in favour of a lung theory of the disease should be given up, so as to allow the attention for a time to be transferred from the outworks to the centre of organic life; otherwise it would be physiologically impossible to explain why, for example, lactation should usually continue, and the urine be suppressed, whilst the condition of the brain itself was undisturbed; and, although analogy could only be referred to for the purpose of supplying indirect evidence, yet, on the present occasion, that evidence was so strongly in favour of cholera being primarily due to an affection of the sympathetic nervous system, developed through the medium of the digestive canal, as scarcely to need any further support. But before concluding it would perhaps be useful to state that such experimental evidence as the subject admitted, strengthened the argument from analogy; and that, among such corroborative evidence, it might be advantageous to note the following observation, published some years ago by Dr. Davey, that "the fatal depressions in cholera, consisting in the complete annihilation of the action of all the vital organs, may be at any time simulated by pressing the solar ganglion on the fore part of the bodies of the vertebræ, over which it lies. At the conclusion of the meeting Dr. Brunetti exhibited some anatomical specimens of the heart, lungs, liver, &c., prepared by his peculiar process, which consists in injecting the organ with water, so as to get rid of the blood, then extracting the fat with ether, and lastly, injecting with solutions of tannin, by which the structures are preserved, and having been inflated while moist, they maintain their shape when dried, and are at the same time both light and incorruptible. The specimens exhibited showed the arrangement of the valves of the heart both in the adult and in the fœtus, the structure of healthy and diseased lungs, a section of the liver, &c. Mr. A. Bruce exhibited some further improvements in his new form of "blowpipe gas cautery." November 26, 1867. SAMUEL SOLLY, F.R.S., President, in the chair. Present-60 Fellows and 6 visitors. Books were presented from Dr. Sieveking, Dr. Reginald Southey, Dr. E. J. Waring, and Mr. T. B. Curling; Dr. J. B. Russell, Dr. Sandahl, Dr. Tröltsch, and Mr. Danby Fry; from the Linnean Society, and the Surgeon-General of the United States Army. Samuel Edwin Solly, Esq., was proposed for election as a Fellow of the Society. The following communication was read: On Excess of Urea in the Urine as a guide to the diagnosis and treatment of certain forms of Dyspepsia and Nervousness. By HENRY WILLIAM FULLER, M.D. Cantab., F.R.C.P., Physician to St. George's Hospital. (Received October 3, 1867.) (Abstract.) Dr. Fuller began by stating that, in the year 1864, his attention was arrested by the existence of a great excess of urea in the urine of a patient whom he was treating for dyspepsia, accompanied by strongly-marked nervous or hypochondriacal symptoms. The amount of urea in a given bulk of the urine was so great that, on the addition of nitric acid, crystals of nitrate of urea began to form in about twenty minutes, and ultimately filled the interior of the test-tube. This condition of the urine has never been described as a feature either of dyspepsia or of nervousness; and as, from its persistency in the case under observation, Dr. Fuller was inclined to regard it as an essential feature of the malady, he resolved in future to search for urea in the urine of every patient who presented a similar train of symptoms. The result has been that he has discovered an excess of urea in twenty-seven patients; twenty-six of whom were males, varying in age from twenty-three to fifty-four. After describing the general symptoms by which this condition of the urine was accompanied, Dr. Fuller gave the details of two well-marked cases; and stated that since his attention had been directed to the subject he has seldom been disappointed in his expectation of finding an excess of urea when the symptoms have led him to suspect its existence. Without exception the patients have been tolerably healthy in appearance, and often somewhat florid, though in some instances they have lost flesh slightly— indeed, their aspect has been so little indicative of disease, and their complaint of suffering has been so constant and so urgent, that any practitioner who did not examine the urine for urea could scarcely fail to regard them as simply hypochondriacal. Their complaint has been of flatulence and acidity, extreme languor, restlessness at night, and distressing nervousness. Even a moderate amount of exertion has induced fatigue, so that they have abstained almost wholly from exercise. This last Dr. Fuller regarded as an important feature of the complaint, inasmuch as it bears upon the point which was next discussed— namely, the source of the excess of urea. He maintained, by reference to the history of the cases and to the marked indisposition to and incapacity for exertion, whether mental or bodily, manifested by sufferers from this complaint, that the urea is not formed, solely at least, during the destructive process of assimilation as a consequence of the wear and tear of the tissues-the source whence urea is commonly supposed to be derived,—but is due to the production of urea from the elements of the food during the primary process of assimilation, probably as a consequence of perverted nervous action. In conclusion, Dr. Fuller mentioned several circumstances which induced him to believe that this affection is nearly allied to .gout. December 10, 1867. SAMUEL SOLLY, F.R.S., President, in the chair. Present-61 Fellows and 21 visitors. Books were presented from Dr. Graily Hewitt, Dr. Burdon Sanderson, Dr. James Morris, Sir William Fergusson, Bart., Mr. James Glaisher, and Dr. Dereins; the Royal Society, the Zoological Society, and the Royal Institution. A bronze medal of the celebrated Joannes Baptista Morgagni, by T. Mercandetti, was presented by Mr. H. W. Kiallmark. The following gentlemen were elected Fellows of the Society: William MacCormac, M.D. Richard Douglas Powell, M.D. Thomas Bridgwater, Esq., M.B. The following gentlemen were proposed for election as Fellows of the Society: John Cavafy, M.B. William Robert Cornish, Esq. Walter Butler Cheadle, M.D. George Eastes, Esq. John Cockle, M.D. John D. Hill, Esq. Arthur Leared, M.D. The following communication was read: 1st. On certain points in the Anatomy and Pathology of Bright's Disease of the Kidney; and 2ndly. On the Influence of the minute Blood-vessels upon the Circulation. By GEORGE JOHNSON, M.D., Physician to King's College Hospital. (Received November 11, 1867.) (Abstract.) It is now generally admitted that cases of chronic Bright's disease may be arranged in two distinct classes:-1. Cases in which the kidney is large, pale, and smooth on the surface. 2. Cases in which the kidney is small, red, and granular. In the forty-second volume of the 'Medico-Chirurgical Transactions' the author pointed out the chief features by which the two classes of cases might be distinguished. There is some difference of opinion with regard to the anatomy and pathology of the various forms of Bright's disease. Some pathologists maintain that the small granular kidney is the result of an intertubular deposit. The author maintains that there is no proof of such deposit; while the red colour and the vascularity of these kidneys even in an advanced stage afford proof that no such deposit exists. All the essential changes in this disease are intratubular. In the thirty-third volume of the Transactions' the author first noted the fact, that in all the forms of chronic Bright's disease the muscular walls of the minute renal arteries are hypertrophied. He then supposed that this was the result of an effort to propel the blood onwards. It is now generally admitted that the minute arteries act as stop-cocks; that they regulate the blood supply, but they have no propelling power. The explanation of the hypertrophy of the small renal arteries which is most in accordance with the facts is that, in proportion to the destruction of the renal gland cells, there is less demand for blood to be acted upon by the gland; the renal arteries consequently contract upon their contents so as to maintain the balance between the blood supply and the diminished secretory |