RETROSPECT. RETROSPECT. TRANSMISSION OF HYDATIDS BY CONTAGION. 111 and if the process of cooking does not destroy them, we must run continual risk of contagion. With a view of ascertaining what effect digestion Some highly interesting and curious researches on would produce upon them, he instituted the following this subject have been published by Professor Klencke, experiment:-Some full-grown echinococci wère placed of Brunswick. After commenting upon the vague in the gastric juice of a dog, and in that of a man ; at the manner in which the term hydatid has been applied, end of three hours they appeared dead, their head the author proposes the following definition:-"Every being retracted, and they exhibited no signs of movevesicular production found in living organized tissues, ment. After having washed them well in warm water, which is provided with spontaneously moving organs, they were introduced into the subcutaneous cellular or which has at least the power of reproduction, apart tissue of the thigh of a kitten'; eight days afterwards from the tissue in which it is lodged by giving birth to the wound had cicatrized. He next took some individuals similar to itself." The different species are echinococci, which had been immersed în gastric juice, then characterized, the situations in which they are diluted with half the quantity of milk or water; and commonly met with, pointed out, and many other par-inoculated a young dog by an incision in the abdomen, ticulars connected with the natural history of these pro-reaching to the peritoneum, but without opening the ductions, noticed. The most important part of the memoir, however, is that occupied with an account of the experiments performed by Professor Klencke upon propagating hydatids by means of inoculation. With the object of examining the reproductive powers of the false hydatid, (Hydatis spuria,) he injected warm water containing some of these hydatids, collected from the brain of a fresh human subject, into the abdominal cavity of two puppies and two kittens. After the injection, the opening was carefully closed, the animals were restored to their parents and grew perfectly well. At the end of three months he found upon examining the abdomen, in setting out from the punctured wound, an adherence of the parietal layer of the peritoneum, with the epiploon at the seat of puncture, and upon this adhesion, as well as upon the internal surface of From an extensive series of experiments, Professor the peritoneum, in the neighbourhood of the cicatrix, Klencke deduces the following conclusions:—1st. That there existed in both the puppies, and in one of thein all hydatids we observe a cyssiparous and oviparous kittens, a very great number of false hydatids. In the other kitten, in which no adhesions had taken place, there was no trace of these productions in the neighbourhood of the cicatrix, whilst upon the peritoneal surface of the bladder, a mass of false hydatids was found projecting into the abdomen. latter, upon which he placed two of the parasites; 'the wound was accurately closed by suture, and at the end of three weeks he found a cellular and highly vascular cavity, containing a yellowish serosity, in which were two echinococci, remarkably modified in form. They were transformed into vesicles, covered upon their external surface with a number of gemmules and isolated cells, supported by pedicles. Examined under the microscope, these cells, upon being crushed, gave exit to a multitude of other small cells, similar to those found in the body of the acephalocysts, and which' represented the ovules. The hydatid's being open, exhibited upon their internal surface a still greater number of gemmules, pediculated cells, and other cells, Boating freely in the liquid. reproduction.-2nd. That there are false hydatids, which propagate by blastoderm (blastidie.)—3rd. That all hydatids are transmitted from one organism to another, and being found in our fluid aliments, and in the flesh of animals, can be transmitted by infection.→→→ 4th. That the acephalocysts are not distinct from the echinococci, but merely the ova of the latter, with or without the parent cyst.-5th. That whatever be the way by which they have entered the animal system, hydatids can be conveyed by the current of the circulation.-6th. That certain agents in the organism and medical substances have the power of destroying them.-Gazette Medicale: Annals of Natural History. PECULIAR FORM OF PARALYSIS. Some very small hydatic cellules were taken from the plexus choroides of a man, and with them the orbit of a hen was inoculated. The inflammation which supervened subsided by the eigthth day. At the end of thirteen weeks the whole external wall of the orbit was tumified, and the eye pushed inwards. Upon examination after death, the orbit was found filled with a cellular mass containing a very great number of false hydatids. The whole brood of these The form of paralysis here alluded to is known by hydatids was injected into the femoral vein of a kitten. the name of "drop-hand," and has been described by At the end of three weeks the animal became sullen Dr. William P. Buel, in the New York Journal of and habitually sleepy. Upon examination there was Medicine. It affects the nerves and muscles of the found in the heart, and especially in the right auriculo- fore-arm, the hand, the thumb, and the fingers; proventricular orifice, a fibrinous and gelatinous precipi-ducing loss of sensation, partial or complete, from the tate, containining an innumerable quantity of false bydatids. bend of the elbow to the tips of the fingers. The motions of the fore-arm upon the arm, depending The false hydatids are more rare in the lower animals entirely upon muscles seated above the elbow, are not than in man, and their transmission is more easily impaired. The muscles which move the hand, the effected when the species of animal inoculated is not fingers, and the thumb, and which perform the various far removed from that which furnished the parasite. motions of flexion and extension, pronation and In regard to the acephalocysts and echinococci, the supination, abduction and adduction, are paralysed. author says that he has found the former in the milk The hand drops helplessly when the fore-arm is of the cow, and floating along with them, in the serum extended, and turned in the direction of pronation. of that fluid, the small ovules that are met with in The power of grasping between the thumb and fingers the bodies of these animals. Both forms of hydatidis, in many cases, entirely lost; as also that of closing are met with daily in the flesh and blood of animals, the fingers upon the pain. As in other cases of para lysis, the flexors predominate over the antagonist muscles of extension, and the fingers are in a state of semi-flexion. The loss of sensation, somewhat enfeebled at the upper part of the fore-arm, is increasingly so as we pass downwards, until we reach the fingers, where it is often complete. The ulnar nerve, from its being exposed at the point where it passes round the condyle of the humerus, being more subject to the cause of the affection than the radial, those parts of the fore-arm and hand receiving their nervous supply from it, are generally most affected, sometimes exclusively so. One branch of the ulnar nerve, is distributed over the back of the hand, to its ulnar edge, and to the little and ring fingers, and the loss of sensation in these parts is complete, they being numb and powerless, while the middle and fore-fingers and the thumb retain the power of motion and sensation. The cause of the affection appeared to Dr. Buel, in all the cases met with by him, to be the long continued pressure of the weight of the body upon the nerves of the fore-arm in sleep. The subjects of these affections tell you they went to bed at night as well as usual; and when they awoke in the morning they found the fore-arm and hand numb and powerless in the manner above described. | shape or form. 2ndly. Because the affection was unaccompanied by constipation of the bowels. 3rdly. Because the attack was sudden, and not gradual, as we should expect from the gradual introduction of lead into the system. 4thly. Because in all the instances, the affection was removed by the application of a remedy purely local; a result certainly not to be expected, supposing it to have been produced by a cause operating on the whole system, as the poison of lead.-New York Journal of Medicine. PALPITATION OF THE HEART. In a clinical lecture upon disease of the heart, delivered by Dr. O. B. Bellingham, at St. Vincent's Hospital, the following summary of the diagnostic signs of palpitation, the result of organic and inorganic causes, is given :— Cardiac Disease.-1. Palpitation constant, though more marked at one period than at another: sometimes occurring in paroxysms of extreme severity. 2. Impulse usually stronger than natural, sometimes remarkably increased, (in a few cases diminished,) occasionally heaving and prolonged, or abrupt and jogging, or double. 3. Percussion elicits a dull sound over an increased extent of surface in the præcordial region, and the degree of dulness is greater than natural. 4. Palpitation often accompanied by auscultatory signs of diseased valves. 5. Action of the heart, regular, irregular, or intermittent, seldom much quicker than natural. They had no doubt gone to sleep with the fore-arm under the body, and remaining in that condition for several hours, paralysis, the usual consequence of continued pressure upon nerves, is the result. These cases occurred in hard-working people, whose slumbers after the labours of the day are deep and heavy. In several instances, it was suspected that some extra 6. Palpitation often less distressing to the patient, narcotism had been produced by libations of beer and and less complained of than that which accompanies spirits. The treatment which Dr. Buel found success-inorganic affections; but occasionally attended by ful in these cases was the application of moxas along severe pain, extending to the left shoulder and arm, the palmar surface of the fore-arm, and this, after constituting what is termed angina pectoris. stimulating frictions along the track of the nerves and blisters, had proved unavailing. From two to three moxas, successively applied, were found sufficient, and the cure was generally complete in from three to four weeks. The form of moxa made use of was that of "small bits of gum camphor." Electropuncture is said to be employed in the New York Hospital in this affection with equal success. From the striking analogy of Dr. Buel's cases, with certain symptoms resulting from exposure, to some of the preparations of lead, the Editor of the New York Journal, Dr. Samuel Forry, was induced to solicit further information. Dr. Buel, in reply, states that in the apparently similar cases arising from lead, constipation of the bowels is the marked and prominent symptom, to which the attention of the practitioner would primarily be directed, while the cases which he describes were unattended by constipation, or indeed any other disturbance in the general functions of the system; the patient declaring themselves to be in their usual health, with the exception of the paralysis of the hand and fore-arm. In the cases to which he alludes also, the attack was sudden, the patients in every instance having retired to rest in their usual health, and waking with the fore-arm and hand paralysed. He thinks, then, it is fairly to be inferred that these cases were not the effect of lead. 1st. Because on diligent inquiry, he could not ascertain that there had been any exposure to lead in any 7. More common in the male than in the female, and in the adult than about puberty. 8. Lips and cheeks often livid; countenance bloated; anasarca of lower extremities common. 9. Palpitation increased by exercise, by stimulants, and tonics, &c. ; relieved by rest, and frequently also by local or general bleeding, the antiphlogistic regimen, &c. Inorganic Affections.-1. Palpitation not constant, having perfect intermissions. 2. Impulse not increased, neither heaving nor prolonged; often abrupt, knocking, and circumscribed, and accompanied by a fluttering sensation in the epigastrium or præcordial region. which yields naturally a dull sound on percussion, not increased. 3. The extent of surface in the region of the heart, 4. Auscultatory signs of diseased valves absent; sounds of heart, particularly the first sound, shorter and louder than natural. Bruit de soufflet often present in the large arteries, and continuous murmur in the jugular veins. 5. Rythm of heart usually regular; its action generally more rapid than natural. 6. Palpitation more readily induced by mental or moral causes, and usually more distressing to the patient than when depending upon cardiac disease; POOR-LAW VACCINATION ACT. 113 often accompanied by pain in the left side, but never abnormally developed. The contractions of the heart by symptoms of angina pectoris. at birth were twenty-seven in a minute, so long as the 7. More common in the female than in the male, cord was attached; immediately after its separation and about puberty than at any other period. 8. Lips and cheeks never livid; countenance usually pale, often chlorotic; venous congestion and anasarca absent; the latter, in a slight degree, sometimes observed in extreme cases. 9. Palpitation increased by sedentary occupations, by local or general bleeding, &c.; relieved by moderate exercise, and by stimulants or tonics, particularly the preparations of iron.-Dublin Medical Press. INVERSION OF THE UTERUS. The following conclusions are deduced by Mr. T. H. Barker, of Bedford, from a case of this affection which he has published in the Medical Gazette:-1. That inversion of the uterus may occur spontaneously, and without that degree of force which has been too generally regarded as almost the only cause.-2. That certain circumstances, capable of producing relaxation or irregular contraction of the uterus, are therefore, in every case, to be guarded against.-3. That inversion of the uterus may be accompanied with profuse hæmorrhage.-4. That in all cases of hæmorrhage following the expulsion of the placenta, it should be the first duty of the practitioner to ascertain if it proceed from displacement of the uterus.-5. That reinversion of the uterus should be attempted as speedily as possible after the discovery of the accident; but that the practitioner should not be deterred from the attempt even after a considerable period bas elapsed. 6. That in cases were the placenta is still adherent, that body should be first removed.-7. That the mode of reduction likely to be most efficient, is by grasping the tumor in the hand, and exerting some degree of pressure upon it, after the manner of reducing a strangulated hernia.-Medical Gazette. MONSTROSITY. A fœtus born at the eighth month of pregnancy, which showed some very extraordinary specimens of malformation, was exhibited by Dr. Mitchell at a recent meeting of the Surgical Society of Ireland. From arrest of development, almost the whole of the abdominal viscera, including the testes, were lying on the anterior wall of the abdomen, and the defined line of the integuments could be seen at the point of protrusion, the serous covering of the viscera appearing to be continuous with the surrounding skin; the heart was lying outside the cavity of the thorax, and its pulsations could be seen and felt distinctly while the child lived, which it continued to do for an hour and fifty minutes after birth. The action of the heart being visible, was, he (Dr. M.) thought, a matter of considerable physiological interest, as it would appear satisfactorily to disprove the old opinion of the heart's impulse being caused by the tilting forward of its apex, and to confirm strongly the view which he believed was put forward by Dr. Corrigan-namely, that the impulse was caused by the shortening of the muscular fibres of the heart and consequent increase of its transverse diameter. The left arm and hand were considerably deformed, and, from presenting during labour, caused a good deal of difficulty in the diagnosis. The left lung was atrophied, and respira→ tion carried on entirely by the right lung, which was they fell to twenty, and just before death, came down to seventeen. The respirations were all through only three in a minute, and not performed as if by the usual effort, but by convulsive jerks. The viscera were in general perfect, but the colon, from its commencement to the sigmoid flexure, presented none of its natural appearances, not being thicker than a crow quill, and cerebrum and cerebellum were perfectly developed, without any appearance of transverse bands. The completely filling the cranial cavity, and no fluid being present; the corpora striata and optic thalami of both sides were perfectly normal. The pelvic viscera were in their natural position, with the bladder of enormous size and much distended, occupying the entire cavity of the pelvis. There was but one umbilical artery and vein, the former of large size and running obliquely from left to right to enter the cord.—Dublin Medical Press. FEEDING SYPHON. Mr. Rotch, at a meeting of the Society of Arts, held on the 6th of March, exhibited and explained a glass feeding syphon for sick rooms, by means of which the patient may be fed whilst lying in any position. The upper limb of the syphon is placed in a tumbler or other vessel, from which the liquid food is to be drawn by the patient who has the lower end in his mouth; the upper limb is extended above the bend of the syphon, and is open at top; so that the attendant can, by placing his finger close to the aperture, either allow the supply to be continued or cut off, at pleasure, without hastily removing the syphon from the mouth of the sick person.-Literary Gazette. VACCINATION UNDER THE POOR-LAW ACT. TO THE EDITOR OF THE PROVINCIAL MEDICAL AND SURGICAL JOURNAL. SIR, For the information of those gentlemen whose names are affixed to a letter, which appeared in last week's journal, on the subject of "contracts for vaccination under the Poor-Law Act," I beg to state that I held an appointment to an extensive and populous district of the Poole Union, during the year 1840, when a separate contract for vaccination was proposed by the Commissioners; I accepted it at the rate fixed on by the Guardians, which was 1s. 6d. per head, being distinctly informed at the time that that was the maximum sum that would be given. As vaccination had been very much out of fashion in the district, partly from antipathy to it, and partly from neglect, I ascertained there were a great number on whom it had never been performed; I, therefore, thought that, although the sum was small for each individual case, the number would in some measure compensate me for the trouble. I vaccinated upwards of 500. The other gentleman, who attended the In-district of the Union, also vaccinated on the same terms, and it is the sum which has been invariably given to all the medical men who have subsequently attended the Union. I am, Sir, yours obediently, ROYAL COLLEGE OF SURGEONS. ADMISSION TO THE FELLOWSHIP, It is said to be the purpose of the Council of the Royal College of Surgeons to give the most liberal interpretation to their lately received new charter; to raise to the rank of the Fellowship all the members of a certain standing, who do not practice at once as surgeons, and trade as chemists and druggists; and to confer the same honour upon younger members, either on the recommendation of three of the present 300 select Fellows, or on their giving proof of their worthiness by undergoing the prescribed examination. -Medical Gazette. STATEMENT. OF THE SOCIETY OF APOTHECARIES. TO THE EDITOR OF THE PROVINCIAL MEDICAL AND 2.2. SURGICAL JOURNAL. SIR,. I have read with attention the statement of the Society of Apothecaries on the subject of their administration of the Act of 1815, and have learned with much surprise and concern, that Government has not communicated with that Society on the projected measure of Medical Reform. Most of your readers are aware that the Home Secretary has declined repeated overtures for an interview on the part of different bodies of the medical profession. Under these circumstances, therefore, I cannot but think there is ground to apprehend that the Bill will operate unfavourably to the welfare of the general practitioner; and this apprehension is strengthened by reports in circulation as to the features of the measure. I am, therefore, desirous to express, through the medium of your journal, my obligations to the Society of Apothecaries for their statement, and my earnest hope that the profession will co-operate with them, for the purpose of counteracting any part of the Bill which may tend to act injuriously on the interests of general practitioners, of which I believe the Society to have been faithful guardians, so far as their power has extended. I am also anxious to bespeak the immediate atten. tion of my medical brethren to the Bill, whenever it may appear, in order that they may be prepared to unite with the Society of Apothecaries, in resisting the introduction of any clauses which may be obnoxious to the great body of medical practitioners; and particularly in keeping the education and examination of general practitioners under the control of their own grade. May 18, 1844. I remain, Sir, A PROVINCIAL. In the report of the Sheffield Medical Society, in the last number, p. 90, lines 24 and 25 of the second column, instead of “dilute sulphuric acid," read, a decoction of malt. SYDENHAM SOCIETY. At the anniversary meeting of this Society, held on the 1st instant, Sir James Clarke, Bart., in the chair, Dr. Paris was elected President in the room of the late Sir Henry Halford; Dr. Babington and Dr. Risdon Bennett were respectively re-elected Treasurer and Secretary. In addition to the work of Hecker, on the Epidemics of the Middle Ages, already issued, the members will receive Louis on Phthisis, and a new edition of the works of Sydenham, by Dr. Greenhill, ration for the current year, are Schwann on the of Oxford. The works announced as being in prepa Microscopic Identity of the Structure of Plants and Animals; Hasse's Morbid Anatomy of the Thoracic Viscera; the works of Hewson, and the works of Paulus Ægineta. The number of members now amounts to upwards of 1700. PROVINCIAL MEDICAL & SURGICAL JOURNAL. REPORT OF SURGICAL CASES OCCURRING IN THE CHELTENHAM HOSPITAL, FROM 1830 to 1840. By CLEMENT JAMES HAWKINS, Esq., Surgeon to the Dispensary Department of the Hospital. The Institution in which the following cases occurred, consisted of a Dispensary to which a Casualty Hospital was attached, for the reception of accidents and cases for surgical operation, and occasionally urgent cases, both Medical and Surgi. cal, were admitted, the nature of which prevented their being properly treated at their own houses. In the year 1839 the establishment was converted into a General Hospital and Dispensary. The Medical Staff at present consists of two physicians and two surgeons for the Hospital, and three surgeons and three physicians for the Dispensary, and a house surgeon and apothecary. The cases were, for the most part, witnessed by myself during the time I was a pupil, and since I have settled in the town, many were treated by myself, under the direction of the surgeons of the establishment, to whom I gladly avail myself of an opportunity of publicly acknowledging many personal acts of kindness, both in professional and private life. cated with a wound of the knee joint, and with laceration of the popliteal artery. The man was found lying in the road immersed in snow, and was admitted in an almost dying state; reaction ensued in a few hours, and the hæmorrhage returned; the thigh was amputated, and very little bleeding took place during the operation, but the patient died soon after he was removed from the table, from the combined effects of loss of blood and shock to the nervous system. In the second instance, the limb was crushed by a heavy load of earth falling on it; the patient, a labourer on the Gloucester and Birmingham railroad, was admitted in a very exhausted state; amputation of the thigh was performed, but he died fourteen hours after the operation. In one of the successful cases the operation was done under very unfavourable circumstances; the nature of the injury was very severe, viz., compound fracture of the thigh, with laceration of the knee joint, and popliteal artery. The limb was very high up; secondary hæmorrhage followed, but the man eventually did well. (See case.) removed The operation at the shoulder joint was performed for a very severe compound fracture of the whole limb, occasioned by a heavy load of stone falling on it. (See case.) With regard to the secondary amputations, the parts removed are mentioned in the accompanying table. The limb in the first case was removed near the shoulder joint, for fungus hæmatodes. The subject was a lad, aged 18; the operation was successful; but he eventually died of pectoral disease, the exact nature of which was not ascertained. The case in which the arm was removed at the shoulder joint was one of a very formidable character. The unfortunate patient was admitted from the railroad works, having sustained some very severe injuries; among which was a very bad compound fracture of the humerus, which, at first, promised to prove directly fatal. Contrary to all expectation he rallied, and in consultation it was determined to give him the chance of the operation; this was done three days after his admission; it terminated unsuccessfully twenty hours afterwards. Dissection discovered extensive internal injury. The operations above the knee were performed K |