SURGEONS TO MILITARY PRISONS.

A CORRESPONDENT writes that he hopes, through our columns, to impress upon the notice of Mr. Cardwell an instance in which several Medical officers of the army, particularly Surgons on half-pay, anxious and fit to return to the effective list, and Assistant-Surgeons awaiting promotion, feel aggrieved and injured that the interests of one Medical officer should have for so long been an obstacle to the fulfilment of the desires of some other individual belonging to one of the above-named classes of officers. It appears that the appointment of Surgeon to the Military Prison at Dublin has been held for several years by Surgeon-Major Tufnell, who has been permitted to remain at home for almost the whole of more than twenty-seven years' full-pay service. He is now entitled to retirement with a step of honorary rank. Should he accept this, either a halfpay Surgeon would be restored to full pay, or an AssistantSurgeon would be promoted. As the establishment of Medical officers of the rank of Surgeon-Major or Surgeon is fixed, Surgeon-Major Tufnell's remaining on full pay of course prevents this. He is, we are assured, the only full-pay Army Medical officer attached to a military prison, and he would most likely continue to hold that appointment while on the retired list. Great as are his personal and Professional merits, the fact of his long home service, and the injustice to other Medical officers, as stated above, are obvious. Mr. Cardwell will probably look into the matter; otherwise some independent member of the House of Commons may, with an eye to retrenchment of the estimates for the military prisons, ask for information as to the cause of Surgeon-Major Tufnell's retention on the full-pay list.

POISONING BY COLOURED SOCKS.

Ir is understood that a committee which has been formed to investigate the ill-effects said to arise from coloured socks finds that there is more material for its labours than was at first suspected. The number of persons who have suffered from the coloured socks is very large, and their complaints of protracted pain, lameness, and utter inability to attend to business, are only equalled by their invectives against our unhappy fraternity for not having sooner detected the cause of the mischief. One gentleman, who was unable to attend to his business, and was absent from home and under Medical care for more than six months, is said to have forwarded to the committee a list of eight Physicians of eminence whom he consulted, and of whom three pronounced the cause of his illness to be "poverty of blood," three called it secondary "enthetic" disease, spite of the patient's denial that he had ever had primary disease of the kind; one called it indigestion, and one said it was a "skin affection," which last diagnosis was indisputable. We need not be too sensitive to the ridicule attaching to such diversities of judgment, but we may take the hint that new causes ought to be suspected and looked for when we meet with new and unusual symptoms. Thanks to Mr. Webber, we have a new morbific cause demonstrated, and the College of Physicians must coin a new name for the effects thereof. One most important hint we may give for the public, that, until further advised, they had better abstain from the use of all articles whatever which are dyed with the poisonous coal-tar colours. We hear not only of ladies whose skins have suffered from tinted flannel waistcoats, but seamen whose backs and arms are excoriated by wearing "singlets," i.e., tight woollen tunics similarly dyed; we hear of beautiful pink soaps which irritate the skin, of pink sweetmeats which produce aphthæ and diarrhoea in children, pink jellies which unaccountably disagree with young ladies, and even of factitious wines and cordials better suited for the eye than the stomach. There may be exaggerations, but the now well-proved fact of poisonous socks was similarly scouted as an exaggeration at first. We would say, in conclusion, that, in cases of obstinate irritation of unusual character, these dyes should be suspected and inquired

for; and, until the facts are fully investigated and settled one way or the other, nimium ne crede colori.

POOR-LAW MATTERS AT BIRMINGHAM. WE invite the attention of our readers to a memorial from the Medical Practitioners of Birmingham to the Poor-law Board, which they will find in another column. Two years ago it was the deliberate opinion of a committee of guardians that six Medical officers were inadequate to the duties which it is now proposed to intrust to five, each of whom would have the nominal care of a district containing 45,000 inhabitants. It is said that the change now deprecated has been effected with the advice and concurrence of Mr. John Clay, Professor of Midwifery at Queen's College, and a member of the Board of Guardians. There is a large Professional circle at Birmingham who would be glad to hear Mr. Clay's reasons for this peculiar line of policy, the more especially as it is said that the present Medical officers have had no opportunity of giving their opinions on the matter.

FROM ABROAD. THE PARIS MEDICAL CONSTITUTION IN DECEMBER -FRACTURE OF THE CLAVICLE EXPERIMENTS WITH VENOM OF THE VIPER.

M. BESNIER, in his monthly report on prevalent diseases, presented to the Hospital Medical Society, draws attention to the extraordinary elevation of temperature observed in Paris during the whole of the month of December, especially on the 5th and 6th of that month, when the thermometer rose to 16:5' (60-15° F.) and 16.9°, an elevation never attained at this time of the year since 1815. As to the mean temperature of the month, it was 8.6° (46.10° F.), a temperature never reached since 1805, exceeding by 4° the mean temperature of the preceding month, which was only 4.9° (39.10° F.). Although it is obvious that this exceptional clemency of temperature has been favourable to persons liable to affections of the air passages, yet it constitutes only one of the clements influencing the Medical constitution of the month. In spite of it the general Hospital mortality has continued to rise from last September, when the deaths amounted to 965, increasing to 1010 in October, 1051 in November, and 1067 in December, this latter figure being higher than that attained in the month of March, which usually supplies the maximum of the year. Moreover, if this December be compared with the Decembers of 1866, 1867, and 1868, there is no indication of any benefit having accrued from this unusual high temperature. Thus, while the mortality from phthisis and pleurisy has been almost identical in the respective years, that from pneumonia, typhoid fever, and diphtheria has increased in 1868. As a general observation, it may be stated that the undoubted influence of season on the frequency of certain affections is not so unlimited as is generally believed. Certainly, if we compare August with January, the difference is great, at least as regards certain affections; but if we compare two entire seasons, that of winter and summer, each represented by six months, we are surprised at the narrow limits between which variations of different diseases are comprised. The only marked difference in favour of this December consists in the diminution in the gravity, if not in the number of cases, of bronchitis, and especially in the almost entire absence of influenza. The frequency of all other affections of the respiratory organs has been as great as usual. The deaths from pneumonia were 34.18 per cent., as compared with 32-40 per cent. for the entire year--confirming the statement made by M. Vacher, derived from private practice, that pneumonia has of late proved unusually fatal. Pneumonia, in fact, has been unusually prevalent in the Hospitals during all 1868, there having been admitted 2259 cases, with 722 deaths, as compared with 2009 cases and 651 deaths in 1866, and 1970 cases and 702 deaths in 1867. For some years past both the frequency and fatality of phthisis have been on the increase; and in 1868 there were 3028 deaths

in 5834 cases, or the high mortality of 51.93 per cent. Variola continues to prevail epidemically, and the Hospital mortality from this source in 1868 has been unusually large-viz., 224 deaths in 1771 cases, not comprising 405 individuals suffering from varioloid.

At a recent meeting of the Paris Société de Chirurgie, M. Dolbeau read a report on a paper sent in by M. Baizeau upon "The Inutility of Bandages and Apparatus in Fractures of the Clavicle," detailing a series of cases in which this accident was treated with perfect success by simple suspension in a sling. The reporter observed that the writer's views on the inutility of apparatus in these cases only express the conclusion to which the experience of the generality of Surgeons of our own times has led them. M. Chassaignac, however, protested against the accuracy of this statement, feeling certain that this abstention from treatment is not the rule of the majority of the Paris Hospital Surgeons. In his own opinion, such a rule would be attended with inconvenience and danger. He has met with pseudarthroses, irregular callus, loss of power in the limb, deformities of an unsightly character, especially in women, and the necessity of resorting to excision-a due to the abstaining from treatment of the original accident; and he regards it as something like an insult to Surgery to affirm that there are fractures of the clavicle which the Surgeon's skill cannot reduce and maintain reduced. He maintains that no such fracture can resist the reducing procedure which he has described under the name of amplexation. As to maintaining the reduction when once produced, it entirely depends upon the permanence of the extension and upon the diffusion over a large surface of the pressure exerted by the bandage. This end is attained by resorting to certain attitudes, such as the forced elevation of the point of the shoulder, combined with the application of an irremovable bandage or plaster apparatus, the pressure of which can be so conveniently extended over the whole upper limb and the lateral part of the neck. Since employing such means, M. Chassaignac has never met with a case in which union has not been accomplished in a satisfactory manner. M. Marjolin considers the opinion delivered by the author and reporter too absolute, since there are cases in which the application of some form of apparatus is indispensable in order to prevent, or, at all events, diminish, the inconveniences resulting from the accident. M. Trélat expressed a similar opinion, adding that an apparatus capable of preventing the mobility of the fragments is also necessary on account of the pain, which is often very considerable for the first few days, and which is induced by the movements and contractions of the muscles. M. Le Fort stated that he had witnessed the success of M. Chassaignac's treatment in a case declared by Malgaigne to be irreducible, in which the fracture was reduced, and kept reduced, by this apparatus. Still even this is not infallible, for there are cases which, in spite of every care that can be bestowed on them, will be followed by deformity. A simple sling will not suffice, and Mayor's sling, which is sufficient in many cases in which there is not any fear of deformity, is, in fact, a true bandage. M. Demarquay observed that there are cases in which the Surgeon must interfere and effect reduction and maintain the reduction. He referred to one treated by Mayor's sling, in which he was obliged to reduce the fracture, one of the fragments of which projected under the skin, and caused intolerable pain. After the reduction all suffering ceased. Dolbeau still maintained that, providing you can secure the immobility of the fragments by a properly applied sling, that is sufficient, as, indeed, is seen in the practice of most Hospital Surgeons. As to supposing that a fracture of the clavicle can be treated without leaving any deformity, it is an illusic but of course we must take every means, especially in the case of young women, to render the deformity as slight as possible. M. Giraldès observed that we must distinguish in these fractures whether they occur in children or adults, with or without

M.

case.

laceration of the periosteum, etc. The great difficulty is, not to reduce them, but to maintain them reduced; and to this end the irremovable bandages are the worst of all, inasmuch as the contraction of the sterno-cleido-mastoideus and the respiratory movements are constantly displacing the mould. An apparatus is required that can be supervised and modified daily during at least ten days, and the most suitable bandage cannot be stated beforehand. The Surgeon must contrive this himself at the bedside, and adapt it to the peculiarities of each M. Verneuil observed that it is true that most of the Paris Surgeons are content to treat these cases by the sling, but then it is Mayor's sling, which is a true fracture apparatus. An abstract of some of the results of experiments on the poison of the viper, performed last September by MM. Chéron and Goujon, has just been published in the Union Médicale. A rabbit was bit on the ears and neck by a ripère-aspic, common in the forest of Fontainebleau, and died in thirty hours. Twenty-four hours had passed when considerable ædema around the bitten parts was observed, and it became easy to collect sixty or seventy grammes of a reddish serosity, having a fetid odour, coloured by blood globules, and containing a few leucocytes. The serosity, heated and treated by nitric acid, did not coagulate. About two grammes of this serosity having been injected under the skin of another rabbit, in an hour and a half afterwards it became very cold and staggered in walking, and in half an hour later it died in convulsions. At the autopsy, performed immediately, a large quantity of colourless and transparent serosity was found in the abdominal cavity. Around the point where the injection had been made there was not the ecchymosis and ædema observed after the injection of the venom in the other rabbit. The muscles were very pale, and did not react under the stimulus of the induced current. All the viscera were also void of colour. The vena cava were gorged with black blood, and the arteries were completely empty. The bladder contained a large quantity of urine.

PARLIAMENTARY.-THE SICK POOR.

In the House of Commons on Wednesday, February 17,

Mr. M'Cullagh Torrens gave notice that on Wednesday, March 10, he should call the attention of the House to the present condition of the metropolis as regarded its liability to rating under the various Acts for the relief of the poor, and should ask the opinion of the House on a resolution to the following effect :-" That the proposed expenditure under the Act of 1867, entitled the Metropolis Sick Poor Act, is excessive, and that, with a view to the more effectual relief of the poor and to the ability of the ratepayers of London and its neighbourhood to bear enhanced burdens, it is desirable that no sanction to any further outlay should be given by the Poor-law Board until a full inquiry shall have been had as to the necessity for the existence of such district asylums as are proposed to be erected, and as to the ability of the ratepayers to bear such increased burdens."

THERE were two deaths from gangrene, the result of frostbite. The winters are severe, the thermometer for several nights standing a little below zero. The beggars, who are numerous and ill-provided for, too often sleep in doorways and on the public street, and not a few of them have had frostbite. In the case of one of the men who died, all attempts to stop the spread of the disease failed. Before his death he requested to be dressed for burial, a custom common among the Chinese. His brother who was in attendance secured him suitable clothes, in which he might with propriety appear in the next world. His face was covered with a sheet of white paper. In this way they are often starved to death. The brother remonstrated when congee, or water, or wine was administered, as simply retarding his death, and giving himself and me trouble. He frequently called upon him to be quick in dying; we were all waiting, he said, and the cart at the door hired in the belief of a speedy dissolution. This practice is revolting to our more humane feelings. The Chinese are to a large extent dead to mere feelings of humanity-they are utilitarians par excellence.-The Sixth Annual Report of the Peking Hospital, by Dr. Dudgeon.

REVIEWS..

Stone in the Bladder: with special Reference to its Prevention, Early Symptoms, and Treatment by Lithotrity. By WALTER J. COULSON, F.R.C.S., Surgeon to St. Peter's Hospital for Stone and other Diseases of the Genito-Urinary Organs, and to the Lock Hospital. London: John Churchill and Sons. 1868.

Ix this work Mr. Coulson republishes in a somewhat extended form the substance of three lectures delivered by him at the special Hospital to which he is attached. The objections urged by the Profession against the establishment of this institution have never led to any personal ill-will against the gentlemen connected with it, and we may therefore calmly examine this work upon its own merits without expressing an opinion upon the vexed subject of specialism. The object of the volume is, as stated in the preface, "to draw particular attention to the early symptoms of stone in the bladder," with a view to its early recognition, prevention, and treatment. But although throughout the volume the author exhibits a manifest desire to attain this desirable end, we cannot discover that any new facts have been brought to light, or any new aids in diagnosis or treatment have been discovered; at the same time we freely admit that Mr. Coulson has succeeded in placing before his readers a carefully arranged summary of the knowledge at present possessed by the Profession upon this subject. The first lecture is devoted to the consideration of the early symptoms of stone, and the author draws special attention to the influence of exercise and rest in developing and masking such symptoms-a point to which Surgeons formerly paid much attention, as the habits of life and modes of travelling on horseback or by coach rendered these facts especially patent to every observer.

In making a preliminary examination Mr. Coulson advocates the use of the lithotrite in preference to the sound - a plan which we think but few Surgeons would wish to adopt, and which would not prove very acceptable to the patient. We cannot agree that this instrument causes less discomfort in its passage through the urethra than that produced by a moderate-sized sound, whilst its more formidable appearance might well create much uneasiness in the mind of the patient at his first interview with the Surgeon. The argument that "it enables you to deal with the enemy at once is of but little value, as it can rarely happen that a Surgeon would venture to crush a stone the moment he has detected its presence without any preparation on the part of the patient.

The second lecture will probably prove the most useful to those for whom the work is specially designed. It contains some excellent advice upon the preparatory treatment of the patient and upon the method of conducting the operation of lithotrity, every step of which procedure is carefully described in a clear and practical manner. Mr. Coulson urges the importance of students making themselves familiar with the use of the lithotrite by frequent practice upon the dead subject, and he draws attention to the fact that in no London school are proper facilities afforded for this kind of study. We believe that this is in the main truc, but at some schools at least the operation is taught as a part of the regular course of operative surgery, and we hope that this may soon be rendered compulsory by the examining boards.

Here

The third portion of the volume is devoted to the chemical and physical characters of the various calculi, to the conditions under which they may be produced, and to the preventive and solvent treatment which may be adopted in such cases. the author acknowledges that he is chiefly indebted to Drs. Broadbent and Roberts for the facts and opinions stated in the text, and he advances nothing but what has already become part of the common stock of Professional knowledge upon this subject. The work will probably prove useful to those who have not time to study any of the larger and more elaborate works which have preceded it.

GENERAL CORRESPONDENCE.

HOSPITAL ADMINISTRATION. LETTER FROM DR. FLEETWOOD BUCKLE.

To the Editor of the Medical Times and Gazette.] SIR, As the author of the paper on the above subject, read before the Social Science Association, commented on in your impression of January 30, and transcribed into the provincial papers, I trust you will allow me a small space to reply to these criticisms.

All Hospital reformers must anticipate interested opposition, but I certainly did not expect the insignificant and obviously vexatious quibble, raised by Messrs. Hawkins and Wilkinson, as to the relative cost of in- and out-patients, and per bed (the latter depending on the sum spent on the in-patients): they saddle the indoor sick with nearly the whole of the expenditure. I maintain the out-patients should bear their fair share of the cost of management, salaries and wages, printing and advertising, and drugs. It is obvious to any one acquainted with the vast crowds who daily assemble in the London outpatient rooms, that large sums must be expended under these headings for them. Now of the £216,000 disbursed by the twenty-two metropolitan general Hospitals, Messrs. Hawkins and Wilkinson would apportion £213,000 to the in-, and less than £3000 to the out-patients (who are ten times as numerous) -a sum utterly inadequate for the purpose. My figures would show £146,000 and £70,000 respectively--a much more accurate estimate. However, it matters little to the public which way the division is made: in either, the averages show marvellous and totally unexplained differences in the cost of administration in the various institutions.

My book on Hospital statistics has done such good service in forcing prominently before the public the unsatisfactory nature of the reports issued by Hospitals, and has so long been accepted as an authority, that whether individuals are able to prove their theories by it or not is of little moment. Mr. Hawkins must surely have been angry when he insisted that draft reports were usually issued; the public do not see them. I would remind this gentleman that the statistics he would not accept were supplied to me by the secretaries to the various Hospitals-St. Mary's amongst the number-who at least could not be suspected of giving unfavourable figures.

Notwithstanding the opposition, the points I have so long been working for, and sparing neither time nor money to carry, have at last been adopted, and we may now hope soon to see proper and uniform reports issued, drawn up in so clear a manner that the public can check the expenditure of their money; the accounts carefully supervised by a Government official, public auditor, a committee, or some central directing body; the working Medical officers remunerated; some check put to indiscriminate Medical almsgiving; the income of the general Practitioner more rarely trenched upon by persons who, though able to pay for treatment, are tempted to seek assistance from some puffing special charity; the pauperisation of the working classes lessened by making them feel the necessity of self-reliance; a mutual relation existing between Hospitals supported by voluntary contributions and those under the control of the Poor-law Board; and the poor-rates consequently decreased. I am, &c.

FLEETWOOD BUCKLE, M.D. 7, Alleroft-road, Haverstock-hill, N. W., February 15.

RESULT OF AN OPERATION FOR MALIGNANT GROWTH IN THE EYEBALL SIX YEARS AGO. LETTER FROM MR. ROBERT BRUDENELL CARTER.

[To the Editor of the Medical Times and Gazette.] Sm, In the Medical Times and Gazette for December 5, 1863, you did me the favour to publish an account of a case in which, on the 10th of the preceding January, I had removed from a child an eye containing a malignant growth. Six years have now elapsed since the operation, and I have just received a letter from the patient's father. He informs me that the child has had uninterrupted health, that there has been no return of the disease in the orbit, and no reason to suspect it elsewhere. I shall be much obliged if you will give publicity to this, the sequel of the history, which certainly supports the views of those who advocate early operations in such cases. ROBERT BRUDENELL CARTER, 8, Princes-street, Hanover-square, W., February 16.

I am, &c.

MR. HAYNES WALTON brought forward a double case of Conical Cornea on which he had performed four operations.

Mr. DE MERIC then read a paper entitled "How Syphilis begins and ends." The author, in stating the results of his whole experience of cases of syphilis, discussed its possible initial symptoms under the following heads:-1. Gonorrhoea. He had not met with a single patient who suffered syphilitic symptoms after a simple gonorrhoea. The difficulty of diagnosis, however, in females rendered it impossible to state that the law was infallible, though it appeared to be so. 2. Balanitis. This he had never known to be an initial symptom of syphilis. 3. Bubo. This could, the author considered, result from local irritation of the lymphatics propagated to the lymphatic glands, and, when thus directly produced, was not an initial symptom of syphilis. 4. Simple Abrasion. At first it was probably impossible to diagnose between simple abrasion and commencing chancre; time, however, soon solved the difficulty. Chancre. The author believed this could initiate syphilitic symptoms. 6. Hard Chancre or Hard Erosion. The author entered at length into the subject of this affection as the initial symptom of syphilis. 7. General Symptoms. The author considered that secondary symptoms may be communicated without any obvious primaries. The question of the endings of the disease was then considered. The disease may prove fatal, usually from phagedæna or necrosis, or it may pass away entirely from the system, and the patient completely recover. In twenty years' experience, the author had only met with twenty deaths.

5. Soft

Mr. Dunn, Mr. Hunt, Mr. Adams, Dr. Semple, Mr. Wolff, Dr. Colomiati Meredyth, Dr. Camps, Mr. Weeden Cooke, and Dr. Gibbon took part in the debate. The author replied, and the meeting adjourned.

HARVEIAN SOCIETY OF LONDON. THURSDAY, JANUARY 21.

E. HEADLAM GREENHOW, M.D., President, in the Chair.

THE PRESIDENT, on taking the chair, delivered a brief address, in which he referred to the important work which the Society had done scientifically as well as socially. Many years since he had induced the Society to move the Government to make the first Medical officer to the Privy Council a permanent one. This had been done with how much advantage to science and humanity all knew. The results which the Society had achieved in dealing with questions such as those of Prevention of Infanticide and the Repression of Venereal Contagion, were matters of national importance. Important scientific papers were promised, and constant contributions of clinical matter in the way of short cases might be expected, as had been customary.

Mr. J. ZACHARIAH LAURENCE showed a patient in whom there was a very high degree of Hypermetropia, and suggested that, in order to meet the convergent obliquity of the eyes which occurred in associated vision, it was useful to give to the spectacles a correspondingly oblique plane. With this view he had the frames bent so as to give a suitable degree of inclination to the glasses.

Mr. ERNEST HART read a portion of a detailed paper on the Ophthalmoscopic Signs of Constitutional Disease. The nervous and vascular tissues of the eye, as observed by the ophthalmoscope, gave characteristic indications, according to the author, not only of a number of cerebral and spinal diseases, but of many cardiac, visceral, and vascular diseases. The part of the paper read (the whole being too long for the purpose) gave a minute description of the changes of the optic nerve and retina in spinal and cerebral affections. The general views were in most respects opposed to those of Bouchut, whose conclusions were not accepted: those of Galezowski being stated to be more accurate. Mr. Hart said that he had been called upon, from time to time, to give an ophthalmoscopic diagnosis to physicians of St. Mary's Hospital, not only with a view to the elucidation of the degree of organic change accompanying any particular series of brain symptoms, but in order to help to distinguish between simulated or hysterical and real disease. In private life the ophthalmoscope had decided the diagnosis when the question lay between typhoid and meningitis, and had indicated more than once impending cerebral or other organic disease where only failure of sight was complained of. In a recent case he had prevented an insurance company from advancing a heavy sum on the life of a gentleman already insured, but in whom there had been ground for ophthalmescopic observation, owing to an anomaly of sight. The examnation led to the conclusion that the arteries of the brain were atheromatous, which subsequent events have confirmed.

Mr. J. Z. LAURENCE said the subject was one which only ophthalmic Surgeons in connexion with general hospitals had much opportunity of following out, and constituted in itself quite a speciality in ophthalmic research. The paper was so full of valuable data that he hoped it would soon be printed for reference and discussion.

Mr. BOWATER VERNON showed a beautiful specimen of Tubercles in the Choroid, from a patient who had died in King's College Hospital. The tubercle had been seen during life by Mr. Soelberg Wells with the ophthalmoscope.

The PRESIDENT referred to remarkable cases of loss of vision during and after pregnancy. The author replied.

MIDLAND MEDICAL SOCIETY.

WEDNESDAY, FEBRUARY 3.

THOMAS SWAIN, Esq., in the Chair.

MR. W. S. MANN was appointed one of the Honorary Secretaries, and a number of new Fellows and members were elected.

Mr. WILLIAM THOMAS exhibited a patient, aged 14, with numerous Exostoses on the Long Bones. Nearly all the long bones are thus affected, the largest tumours being on the lower end of each femur, upper end of each tibia, and head of each humerus. The structure of two of them which had been removed was found to be light and cancellated, like the heads of the long bones. The principal fact of interest about these tumours is that each corresponds with the situation of the epiphysal cartilage. This is most marked in the enlargements found on the phalanges and metacarpal bones. If the tumours thus correspond with the epiphysal cartilage, as they appear to do, and spring from them, it will be interesting to ascertain whether or not they cease to enlarge when the bones become fully developed.

Dr. JOLLY showed a Malignant Tumour of the Tibia, removed by amputation from a girl aged 18 years, of twelve months' duration. The tumour was globular, hard, and inelastic, involving the middle and upper third of the right tibia. The surface was somewhat irregular, and the integument covering it presented a glistening appearance, but was not discoloured. The tumour was the seat of intense pain, worse at night. There was no affection of the neighbouring glands. The muscles attached to the affected portion of bone were found on dissection to be extensively infiltrated with cancer cells. The disease presented a good example of osteo-cephaloma, originating in the medullary membrane and periosteum covering the bone.

Dr. JOLLY also exhibited a Cancroid Ulcer of the Heel, removed by amputation of the leg from a man aged 40. The disease originated two years previously in a slight abrasion caused by a tight boot. The growth continued to increase slowly for several months, and caused the man little inconvenience. It then became painful, and began to grow with more rapidity. When the patient first came under observation the sore had all the characteristics of a chronic ulcer in connexion with

disease of the bone, except at its lower and outer part, where the granulations were elevated into tuberous, hard, warty projections. All means having failed to heal the sore, and the man's general health becoming unsatisfactory, the leg was removed at the middle third by Teale's method. The stump healed rapidly, and the patient's health is now excellent. A microscopic examination of the warty growths showed them to contain nucleated cells in all stages of development, with molecules, granules, and naked nuclei.

Mr. J. F. WEST brought under the notice of the Society a case of large Femoral Aneurism in a man aged 38, healthy and apparently free from atheromatous disease in other parts, which had come on spontaneously and without any history of strain or other injury. The aneurism in three weeks had attained the size of a child's head. The tumour was on the point of bursting when Mr. West ligatured the external iliac artery. The ligature separated on the seventeenth day, and the patient was able to leave his bed at the end of a month, the aneurism having became quite solid and greatly reduced in bulk. Mr. West made a few observations on the treatment of femoral and inguinal aneurisms, giving a brief abstract of Dr. Norris's and M. Broca's papers on this subject. In Mr. West's opinion, the Hunterian method of applying the ligature to the external or common iliac arteries in these cases is, as a rule, preferable to the old method which has recently been recommended and used by Mr. Syme, as also to that of compression as practised in Dublin. Mr. West advocated a further trial of the method employed by Drs. O'Ferrall and Mapother, of Dublin, of entirely arresting the flow of blood through the aneurismal sac, in preference to that of moderating the current by partial and intermittent pressure.

ARMY MEDICO-CHIRURGICAL SOCIETY
OF PORTSMOUTH.
WEDNESDAY, FEBRUARY 3.

Deputy-Inspector General Dr. GORDON, C.B., in the Chair.

ASSISTANT-SURGEON POWER, of the 2nd Battalion 13th Light Infantry, read a paper on the Topography of the Mauritius in relation to the Epidemic of Malarial Fever of 1867. Having given an outline of the natural features and geological formation of the island, more particularly with reference to the districts where the fever prevailed and those which entirely escaped, he entered into particulars regarding the meteorology of the island and the peculiarities which characterised the hot season 1866-67-viz., an absence of rain in the proper rainy season, greater and more continued heat than usual, the al sence of the usual electrical phenomena, as thunder and lightning, and the absence of cyclones. There was thus a comparative stagnation of the atmosphere, the breezes which did prevail being purely local in their nature. He observed that high temperature and an absence of rain, acting upon soil saturated with organic matter, were the exciting causes of the fever, many parts left dry having heretofore been always covered with water, and the temperature being further raised by the circumstance of the sun's rays being absorbed and retained by the thinly covered basaltic rocks. He believed that this view was confirmed by the fact that those parts where the greatest rainfall occurred and where the soil was moist were almost entirely free from fever.

Assist.-Surg. ALCOCK, 35th Regt., read a paper on the Influence of Nervous Power in controlling the Temperature of the body. Starting with the generally received theory that "the blood itself is the seat of those chemical changes that develope force in the body," he alluded to the mechanical part played in the development of heat by the dilatations or contractions of the capillaries coincident with paralysis or irritation of the sympathetic nerves, as proved by the experiments of Bernard and Brown-Séquard. Accepting destructive metamorphosis as the only source of the production of heat, he suggested that, as the process of formative nutrition could only be carried on in the presence of a certain temperature, it was allowable to infer that some heat may be abstracted and rendered latent by this act, so that, on the diminution of nutrition by disease, another cause arises why its outward manifestations should be greater. To exemplify the direct influence of the nervous centres over the metamorphosis of tissue, he instanced the sixfold increase of urea in the urine of the rutting ram as proved by Professor Haughton. He thus reasoned that preternatural heat was the result of three conditions-suspension or exhaustion of the functions of the sympathetic, diminished nutrition,

and increased metamorphosis-but believed the second and third to be consequences of the first, and brought forward heat apoplexy as a disease in every way typical of an exhausted sympathetic, in support of which he showed that, in two out of eleven cases of this affection which occurred in the 35th Regiment in Mooltan, there was a distinct history of previous nervous exhaustion from fatigue, intemperance, or disease. In conclusion he laid before the meeting the thermometric record of a case in his own practice in India, in which uterine hæmorrhage caused temporary paralysis of the right half of the body, with lowering of the temperature of that side. Fever supervened, and then the temperature on the paralysed side rose considerably above even the fever heat shown on the sound side, thus proving the elevation of temperature on invasion of disease to be in direct proportion to the previous nervous depression.

A case of Calculus in the Bladder, reported by Surgeon Porter, 97th Regt., was then read. The patient was a native of India, aged 22 years. The calculus was readily detected. There existed a fistulous opening in the right lumbar region through which passed urine, pus, and “ gravel." The lateral operation was performed, and the calculus extracted with difficulty. It consisted of the triple phosphates, and weighed three ounces and four drachms. The fistula in the lumbar region closed, and in six weeks after the operation the man returned to his home.

OBITUARY.

JOSEPH HODGSON, ESQ., F.R.S.

AT the ripe age of 81 Mr. Hodgson died on Sunday, the 7th inst., having survived his wife about twenty-four hours. He had been long in failing health, and had not practised his Profession for several years. Mr. Hodgson's father was a Birmingham merchant, and articled his son to Mr. George Freer, a leading Medical Practitioner in that town. Owing to reverses in business, the elder Mr. Hodgson was unable to defray the expenses of his son's education in London, but funds were supplied to the extent of £100 by an uncle, and with this young Hodgson repaired to the metropolis and entered as a student at St. Bartholomew's Hospital. Having obtained the diploma of the College of Surgeons, he commenced practice in King-street, Cheapside, but did not remain there long. During this period, he eked out his scanty income by taking pupils and writing articles for the London Medical Review. He subsequently became editor of this periodical, but its circulation gradually declined, and it ultimately collapsed. On leaving King-street, he obtained, through the interest of Mr. Travers, a Medical appointment at the York Military Hospital, Westminster, where he remained for some time in comparatively comfortable pecuniary circumstances. On removing to Birmingham he was elected Surgeon to the General Dispensary, and in 1821 became Surgeon to the General Hospital. This office he filled for nearly thirty years, obtaining a large and lucrative practice, and a reputation which was equal to that of any Surgeon of the day. During a large portion of the time he resided in Birmingham political and Professional feeling ran very high, and probably many of the hot and bitter quarrels in which he was engaged were inevitable. However, this may be, they had no effect upon his reputation or success, and he maintained to the last his position as the leading Surgeon of the midland counties. On his retirement from the Birmingham Hospital in 1848, the Governors subscribed for a portrait of him by Mr. Partridge, which was placed in the committee-room. During his practice in the town he was mainly instrumental in founding the Eye Infirmary, which was opened in 1824, Mr. Hodgson being the only Surgeon attached to it; his first colleague was Mr. Middlemore the present Consulting Surgeon to the institution. Mr. Hodgson, before leaving Birmingham, was solicited to become one of the Surgeons to the Middlesex Hospital, and he was subsequently invited by the Council of King's College to accept the post of Professor of Surgery to that institution-a post which had become vacant in 1840 by the resignation of Mr. Arnott. Both these invitations he declined. When he settled in the metropolis in 1849, honours were almost heaped upon him. Thus, in that year, he was elected a member of the Council of the College of Surgeons; subsequently he became an Examiner in Surgery at the University of London, and resigned this appointment in 1856 to become one of the Examiners of the Royal College of Surgeons. He was President of the College in 1864. He