(6) Ruth Bibby. Treatment commenced February 23rd, 1904. Patch of lupus on face below left angle of mouth. Treatment twice a week up to date; too early to note any change.

Nine Cases of Epithelioma.

(1) Cornelius O'Dowd. Treatment commenced March 12th, 1903. Commenced as a rodent ulcer on right side of neck, now has the characters of an ulcerating epithelioma. Size 22in. x 12in. Treated twice a week up till May 4th, then after an interval, during which he was in the Workhouse Infirmary, twice a week from May 28th to June 15th and from June 24th to July 1st. From this date till July 16th he had applications every day. He grew worse slowly, however, in spite of treatment, and on July 17th went to Convalescent Hospital to wait there till there was a vacancy at the Christie Cancer Hospital.

(2) William Kirk. Treatment commenced April 16th, 1903. Inoperable epithelioma of floor of mouth. Glands in neck extensively implicated. Two applications given, but condition steadily got worse, and it was decided that the treatment was doing harm rather than good.

(3) Richard Hornby. Treatment commenced April 20th, 1903. Epithelioma of angle of mouth removed on February 10th, 1903, being then of 3-4 months' duration. Recurrence in glands of neck with a fistulous opening discharging pus freely. The condition appeared worse after commencement of X-ray treatment, and after two exposures it was therefore stopped.

(4) Greg Simpson. Treatment commenced June 18th, 1903. Epithelioma of floor of mouth of 3 months' duration. Excision of sub-maxillary glands on February 20th. Large masses of glands now on left side of neck discharging foul pus by several fistulous openings. He grew rapidly worse, both locally and in general condition under treatment, and ceased attending after six applications.

(5) Benjamin Mellor. Treatment commenced July 3rd, 1903. Small ulcerating epithelioma at inner angle of right eye. Free secretion of pus from it. Applications twice a week till August 15th, when he was transferred to the Christie Hospital. Not much

alteration under treatment, but patient expressed himself as feeling more comfortable.

(6) Ann Bevan. Treatment commenced August 15th, 1903. Recurrent epithelioma forming a fungating mass with considerable discharge on left side of lower jaw. Patient had five applications from August 15th to August 24th, but the condition rapidly got worse, though pain was somewhat relieved, and the treatment was discontinued on the latter date.

(7) William Wright. Treatment commenced January 18th, 1904. Epithelioma of palate. No improvement resulted from four applications, and the treatment was stopped on January 28th.

(8) George Walton. Treatment commenced October 7th, 1903. Had half of tongue removed for epithelioma about Easter, 1903, and since then secondary glands have appeared on the right side of neck. Tongue remained free from recurrence. The mass of glands was exposed to the X-rays twice a week up to November 26th, when treatment was discontinued, as the glands rapidly increased in size and became inflamed as the result of treatment.

(9) David Shorrock. Treatment commenced July 16th, 1903. Epithelioma, about the size of a florin, on right lower eyelid. He had applications twice a week, and as a result the superficial parts almost completely disintegrated into pus, though the deeper portions did not appear checked. The outer portion of the eyelid was almost eroded through. Treatment was stopped on September 21st, and on November 5th he presented himself practically completely cured. Seen again on February 25th, 1904; improvement was maintained and general health much better.

Four Cases of Carcinoma.

(1) Mary Harrington. Recurrence of carcinoma of breast in and around operation scar. Exposures twice a week from June 22nd till July 13th, 1903, and again from November 12th to November 26th, but with no benefit.

(2) Annie Dunn. Recurrent carcinoma of breast. Extensive infiltration of breast and skin overlying it. Did not appear again after the first application.

(3) Elizabeth Gatenby. Carcinoma of breast. Recurrence in axillary glands after removal of breast in August, 1902. Five applications, twice weekly produced no improvement, and she went into the Christie Hospital.

(4) Ellen Taylor. Recurrent scirrhus of breast after removal in October, 1902. Extensive infiltration of superficial tissues. Applications twice a week from November 16th, 1903, to January 18th, 1904. No effect in checking the steady spread of the disease, and patient did not attend again after the latter date.

Four Miscellaneous.

(1) Harold Sutcliffe. Redundant scar tissue resulting from incision of a boil three years ago. It forms a band on the right forearm 2in. long and in. across, with marks of five stitches, each the seat of redundant scar formation. Had applications twice weekly from June 18th to November 9th, 1903, and after that weekly to January 11th, 1904. Considerable improvement resulted, the scar tissue puckering up and becoming much less prominent.

(2) Justinia Brough. Syphilitic ulceration of nose of many months' duration. Four applications between March 5th and

March 13th, 1903. No improvement.

(3) Louisa Horsfield. Pain in elbow and paralysis of left little and ring fingers, and loss of sensation in the area supplied by the ulnar nerve, following upon dislocation of ulnar nerve five years previously. She had applications twice a week to the elbow from October 7th to October 27, 1903. On the latter date she reported that she had had considerable pain in the elbow two nights previously, sufficient to keep her from sleeping, and that in the morning she found that power and sensation had returned to the paralysed parts. Treatment was continued till November 12th when, although there was some pain in the elbow, sensation and motion continued perfectly normal.

(4) Hannah Roebuck. Neuralgia round scar of old operation for removal of appendix (May, 1903). Four applications between January 28th and February 8th, 1904, but patient ceased attending after the latter date as the treatment was producing no improvement.

"LITERARY CAUSERIE."

By WILLIAM STIRLING, M.D., D.Sc., LL.D., Professor of Physiology and Histology in the Victoria University of Manchester; Dean of the Faculty of Medicine.

III.

Epitaph of Bartholinus on the Liver, Carmen of Turrius on the Blood-giving Liver, and the Epitaph of Benjamin Franklin written by himself.

EPITAPH OF BARTHOLINUS ON THE LIVER.

IT is recorded that the vessels we now know as lacteals were seen in animals by the physicians of Alexandria and Salerno. For all practical purposes, however, the discovery of the existence of the lacteals and lymphatic vessels dates from the first quarter of the seventeenth century.

The realistic and graphic description of the accidental discovery, on July 23rd, 1626, of the lacteals by Caspar Aselli, of Cremona, is one of the great landmarks in the history of Anatomy and Physiology. Aselli (1581-1626) was Professor in Pavia, where, in the presence of Tadinus and Septalius, he saw the "lacteal veins" "as very fine white threads with innumerable roots traversing the whole of the mesentery and the intestines." The prick of a scalpel showed that they contained a white fluid and were not nerves.

Aselli succeeded in tracing the lacteals to the group of lymphatic glands in the dog, which still bear the name "Pancreas Aselli." Aselli's work was published in 1627, i.e., one year after his death. A year later, in 1628, the lacteals were seen in the human subject by Fabrici de Peiresc (1580-1637), of Aix, one of the rich old "Seigneurs," and who though not a medical man did much to encourage medical study and research.

In 1647 Jean Pecquet (1622-1674), of Dieppe, Professor in Montpellier, discovered, also in the dog, a trunk ductus

thoracicus

common to the lacteals and lymphatics. He thought it was a vein. Aselli thought that the lacteals ultimately went to the liver. The group of lymphatic glands of the mesentery in the dog Aselli took for the pancreas and this mass still retains the name pancreas Aselli."

66

In 1652 Jan van Horne (1621–1670), Professor in Leyden, demonstrated the thoracic duct in man. Three names are associated with the discovery of the lymphatics-Jolyff (1650), an Englishman, who was a physician in Cambridge the claim is made by Wharton, not by Jolyff himself Thomas Bartholinus and Olaus Rudbeck. A careful sifting of the evidence makes it plain that Olaus Rudbeck (1630-1702) has the priority in this regard. When only twenty years of age, on January 27th, 1651, Rudbeck saw the lymphatics of the large intestine, traced them to the lymphatic glands, and observed that the so-called lacteals of the liver did not contain chyle, but a watery humor. A year later Rudbeck demonstrated the lymphatic vessels in the presence of Queen Caroline, and showed their connection with the thoracic duct, and this with the left sub-clavian vein. Bartholinus published "De lacteis thoracis in homine brutisque nuperrime observatus Hafniæ, 1652. In the following year he published "Vasa lymphatica inventis et hepatis exsequiæ." It was dedicated to the older Riolan, and in it Bartholinus claims to be the discoverer of the lymphatics. The honour belongs to the Swede of Upsala, and not to the Dane of Copenhagen. It is in the quaint chapter under the heading "Exsequiæ Hepatis" that the famous epitaph "de defuncto hepar" occurs. Formerly the liver was regarded as the great organ of coction and the source of the blood; to it was supposed to flow the chyle and the products of digestion.

As it was proved that the lacteals did not go to the liver, and as Bartholinus (1616-1680) was a supporter of Harvey's doctrine of the circulation of the blood, the liver was now no longer the source from which the blood was distributed to the body and the prime organ of digestion. Its dignity in the hierarchy of the organs was greatly lessened, and to Bartholinus it seemed that its repute was lost, and it had better be interred, and to this end he wrote the following epitaph, which several of my classical friends have translated, with what success the reader shall judge: