BLACKBURN MEETING. MACCLESFIELD MEETING. At a meeting of the Medical Gentleman of Macclesfield, and the neighbourhood, held on Wednesday evening, November 20; Dr. Swanwick, President, in the Chair. Present; Dr. Brunett, Mr. Milners, Mr. Lallemand, Mr. Bland, Mr. Firth, Mr. Turner, Mr. Newbold, Mr. Mayer, Mr. Hopkins, and Mr. Cleaveland.` Resolved unaniously,-"That this meeting regards with respectful consideration the intentions of Government, in the Bill of Sir James Graham, for elevating the character of the Medical Profession; though it deems the measure seriously defective in respect to some of its provisions. "That it considers the constitution of the Council of Health and Medical Education,' incomplete and unsatisfactory; inasmuch as it contains no direct recognition of the great body of general practitioners. "That the claims of the Worshipful the Society of Apothecaries on the respectful attention of the very numerous class of Licentiates practising in this country, demand from this meeting a special notification, in any suggestions that may be offered by it to the Govern ment, for the modification of the said Bill. That the registration clauses of the Bill are likely to be virtually inoperative; because they embody no compulsory enactment, in order to a general adoption. "That the withdrawal of existing restrictions on unqualified persons, together with the omission of a summary mode of punishment in respect to unaccredited practitioners, is regarded as a capital defect in the said Bill; as it tends materially to affect the interests and respectability of the profession, and the health and well-being of the community at large. "That a petition, expressive of these opinions, be by this meeting adopted, and forwarded to the County and Borough Members, to be by them presented to the House of Commons." WARRINGTON MEETING. A meeting of the Medical Practitioners of the Town of Warrington, was held at the Dispensary, on Friday November 22nd, to take into consideration Sir James Graham's proposed bill; and after resolutions expressive of satisfaction with those provisions, which were calculated to improve the character of the profession, to raise the standard of the education of its members, to establish a central Council of Health, and the registering of all legally authorized practitioners, they regretted that the bill should allow mere pretenders to impose upon the public, and tamper with the health of the people, and expressed their opinion that a clause should be added for the purpose of effectually and speedily checking all illegal and unqualified practice. Messrs. Sharp and Robson were appointed to prepare a petition founded upon the above resolutions, which will be entrusted to the care of J. J. Blackburne, Esq., Member for the borough; and it was resolved that both he and J. Wilson Patten, Esq., Member for the county, should be respectfully solicited to support the prayer of the petition. Dr. Kendrick and Mr. Sharp were requested to confer with Mr. Blackburne and Mr. Patten on the objectionable clauses and deficiencies of Sir James Graham's bill, and a conversation ensued as to the was finally resolved that this meeting pledges itself best means of obtaining the objects sought for. It the petition, by using their personal influence with collectively and individually, to further the objects of the Members of Parliament in the neighbourhood, and through their friends who may have influence with those at a distance, The thanks of the meeting were voted to the chairman, Dr. Kendrick, who stated that he had that day commenced his 52nd year of practice in the town. BLACKBURN MEETING. At a general meeting of Medical Practitioners, held at Blackburn, on Wednesday, November 13th, John Cort, Esq., in the Chair. The following Resolutions were carried unaniMoved by George Stocks, Esq., of Blackburn, and mously seconded by Samuel Wraith, Esq., of Darwen,"That this meeting feels deeply the necessity of great the Medical Profession: and receives with lively satisand immediate, improvement in the law, as affecting faction the evidence given by Sir James Graham in his proposed Medical Bill, of his desire to promote that improvement." Moved by James Thompson, Esq., M.D., of BurnSabdon :-"That while the present meeting approves ley, and seconded by Richard Hindle, Esq., M.B., of most fully of a General Council of Health and Medical Education, as calculated to render more conof the candidates for registration, it cannot yield its sistent and dignified both the character and the title assent to the establishment of any council, which rejects from its constitution the great and respectable fees are exacted, and who are in a position to underbody of general practitioners, from whom chiefly the stand most correctly the interests both of the public and the profession." Moved by Philip Kershaw, Esq., of the Billington Asylum, and seconded by Jonathan Morley, Esq., of Blackburn :-"That this meeting wishes to record the Graham's Bill, which proposes to annul all restrictions strongest feeling of hostility to that part of Sir James hitherto placed upon unqualified practitioners, as medical practitioner legally qualified, and as tending being conceived in a spirit of glaring injustice to the directly to the serious injury of health, and the extenMoved by James Bailey, Esq., of Blackburn, and sive destruction of life, of the public generally." e most clear seconded by Richard Martland, Esq., M.D., of Blackburn :-"That this meeting entertains the and decided conviction that restrictive measures are indispensible, in justice alike to the public and to the profession; and that the only beneficial and effective means of this character, will be found in the power of summary conviction and punishment." Moved by S. E. White, Esq., of Burnley, and seconded by Thomas Dugdale, Esq., of Blackburn ;— "That this meeting wishes to express its strong conviction, that the regulations promulgated by the Apothecaries' Society, in reference to the course of study, have tended more to elevate the profession than the proceedings of any other corporate body in the kingdom." 582 r MISCELLANEOUS. Moved by J. S. Birch, Esq., of Blackburn, and by Robert Wilding, Esq., of Blackburn a petition, based upon the foregoing resolutions, be drawn up and sent for signature to each medical man in the Hundred of Blackburn-and that a copy be sent to the Representatives of the Northern Division of this County, accompanied by a request that J. Wilson Patten, Esq., will present it to the House of Commons, and that he and J. Talbot Clifton, Esq., will support its prayer." Moved by Samuel Wraith, Esq., of Darwen, and seconded by Wright, Esq., of Haslingdon :-"That a deputation, consisting of Dr. Martland, Messrs, Cort, Stocks, and Bailey, be appointed to wait upon the Members of the Borough of Blackburn and Clitheroe, to present to each a copy of the same petition, and earnestly to solicit their aid in support of its prayer." J. CORT, Chairman. The thanks of the meeting were voted to the Editors of the Times, Lancet, Medical Gazette, and Provincial Medical and Surgical Journal, for their able advocacy of the objects which the meeting had in view; and to Mr. Cort, for his able conduct in the chair. JON. MORLEY, Hon. Secretary. UNIVERSITY OF LONDON. DOCTORS OF MEDICINE, 1844. First Division: Edward Ballard, University College; Joseph Hullett Browne, Guy's Hospital; John Jones Davies, London Hospital; Thomas Inman, King's Johnson, King's College; Frederick Robert Manson, College; William Jenner, University College; George ditto; Edward Meryon, University College; William Augustus Raper, ditto; George Augustus Rees, St. Bartholomew's Hospital; John Snow, Westminster Edwin King, School of Physic in Ireland. Hospital; Stephen Henry Ward, London Hospital; Second Division: Patrick Martin, School of Physic in Ireland. BACHELORS OF MEDICINE. (Examination for Honours.) Physiology and Comparative Anatomy: R. D. Harling, (scholarship and gold medal,) University College; H. March Webb, (gold medal,) Guy's Hospital; Charles Henry Felix Routh, University College; William Thomas Edwards, ditto; Godwin William Timms, ditto; William Bird Herapath, Bristol Medical School, and London Hospital; Edwin Hearne, University College. Surgery H. March Webb, (scholarship and gold medal,) Guy's Hospital; Peter Redferne, Surgeon's ROYAL COLLEGE OF PHYSICIANS, Square, Edinburgh; William Henry Parsey, King's EDINBURGH. At the annual election meeting of the Royal College of Physicians, held on the 5th instant, the following gentlemen were elected office-bearers for the ensuing year: Dr. Wiliam Beilby, President; Dr. Robert Renton, Vice-President; Dr. T. H. Davidson and Dr. James Wood, Censors; Dr. Charles Ransford, Treasurer; Dr. David Craigie, Secretary; Dr.William Seller, Librarian; Dr. Robert Spittal, Fiscal; Dr. James Stark, Keeper of Museum; Mr. Kenneth Mackenzie, Clerk; Mr. John Small, Under Librarian; Dr. William Beilby, Dr. Robert Renton, Dr. T. H. Davidson, Dr. Robert Christison, Dr. David Craigie, Dr. Charles Ransford, and Dr. George Paterson, Examiners of Foreign Graduates. Edinburgh, December 5th, 1844. ROYAL COLLEGE OF SURGEONS OF The first examination for the Fellowship under the new Charter of this College, commenced on Tuesday last. Twenty-five candidates presented themselves. The result of the examination has not yet reached us, but among the gentlemen who passed on this occasion, were Mr. H. W. Rumsey, of Gloucester, Mr. John Soden, of Bath, and Mr. J. H. Walsh, of Worcester. In reply to the question which has been put to us respecting the supposed omission of Mr. Crosse, of Norwich, senior surgeon to the Norfolk and Norwich Hospital, from the Fellowship of the College, we may state that there is no foundation whatever for the statements of a contemporary on this point. Mr. Crosse was included in the first appointment of Fellows, and stands number 114 on the list.-See Provincial Medical Journal, volume 7, page 260. Gentlemen admitted Members on Friday, December 6, 1844-G. F. D. Evans; E. Hutchinson; J. A. Walmsley; T. H. Watt; W. H. Meadows; R. Thornton; H. Douglas. College; Edwin Hearne, University College; William Bird Herapath, Bristol Medical School, and London Hospital. medal,) University College; Peter Redfern, (gold Medicine: R. D. Harling, (scholarship and gold Evans, University College; William Henry Parsey, medal,) Surgeon's Square, Edinburgh ; John versity College; William Bird Herapath, Bristol King's College; Frederick William Marshall, UniMedical School, and London Hospital; Henry March Webb, Guy's Hospital; Godwin William Timms, University College; Edwin Hearne, ditto. University College; William Bird Herapath, Bristol Midwifery: William Thomas Edwards, (gold medal,) Medical School, and London Hospital; William Henry Parsey, King's College; Henry March Webb, Guy's Hospital. Vegetable Physiology and Structural Botany : Henry March Webb, Guy's Hospital; William Bird Herapatlı, Bristol Medical School, and London Hospital. THE LATE DR. DALTON. has left the sum of £2000 to found a Professorship This celebrated and deeply lamented philosopher of Chemistry at Oxford. TO CORRESPONDENTS. Communications have been received from Dr. C. R. Hall; H.; M.R.C.S.; Mr. G. King; Dr. Borton: Sir John Fife; and Mr. Carter. The Critical Analysis of the Principal Facts of Disease, will be continued in our next, as well as Mr. Carter's letter, the second part of which is in type. It is requested that all letters and communications be sent to Dr. Streeten, Foregate Street, Worcester. Parcels, and books for review, may be addressed to the Editor of the Provincial Medical and Surgical Journal, care of Mr. Churchill, Princes Street, Soho. PROVINCIAL MEDICAL & SURGICAL JOURNAL. REPORT OF CASES OCCURRING IN HOSPITAL AND PRIVATE PRACTICE. By FRANCIS ELKINGTON, Esq., Surgeon to the Lying-in Hospital, Birmingham. The frequent occurrence of cases similar to the following, and the very able papers which have lately been written on the subject, leave little room for comment; but I have thought, as faithful reports, they might offer some features of interest. If the Editor of the Provincial Medical and Surgical Journal should think them worth recording, be will be kind enough to publish them in that journal. FRANCIS ELKINGTON. PHLEBITIS FOLLOWED BY ABSCESS. Jan. 11, 1844. I was requested by my brother to visit Mrs. Whittington, aged 36, mother of five children, pregnant, and considers herself to be seven or eight months advanced, expecting to be confined about the end of February. She has been troubled with varicose veins of the legs and thighs nearly ever since she has been pregnant. About four or five weeks ago the veins began to inflame, first of the right leg, and then of the thigh, accompanied by fever and great constitutional disturbance; the leg and thigh were repeatedly leeched, and the case, in other respects, treated in the most active antiphlogistic manner; the left labium suppurated and ulcerated in two places. About three weeks since the right hip began to swell; to-day there is a large swelling over the right hip, extending to the right labium in front, to the anus posteriorly, and nearly as high, externally, as the crista ilii. On examining per vaginam, there was found considerable fulness of the right side; pushing the side of the vagina inwards, with two fingers of the right band placed against the vaginal swelling, and the left hand on the external swelling, and applying pressure alternately with each hand, a fluctuation was produced. The swelling has increased rapidly the last two days; externally it feels boggy; the integuments are red, and in the centre of the swelling they are of a very deep red, almost purple; pulse 120; tongue reddish; has had very little sleep. It was proposed to open the abscess, but we were obliged to defer it till the next day. No. 38, December 18, 1844. 12th. Passed a restless night; pulse 120; dysuria; the swelling much increased; skin much discoloured. An opening was made, and a quart of dark coloured and very offensive pus discharged in a strong stream; the colour of the discharge improved, getting more healthy-looking as it flowed, particularly towards the last. The veins of the thigh continue cord-like, and as hard as sticks. She says that when she has pressed on the right buttock, she has felt a sensation as though there was labium. The discharge from the left labium ceased some communication with the abscess in the left after the external abscess was opened. The bladder was emptied with the catheter; she was ordered to take a mixture with decoction of cinchona and nitric acid, an opiate at night, port wine negus, &c. She said that she had not felt the child for two or three days, and thought it was dead; on applying the stethoscope to the abdomen, the placental souffle was heard distinctly, the foetal heart acting very feebly. 13th. Better; slept all night; countenance much improved; pulse 100 and fuller; swelling much less; a copious sanguineous purulent discharge; integuments still discoloured, and there is some hardness; vaginal swelling less; there is still some fluctuation internally. 15th. Better in all respects, swelling much less. 20th. Improving. 30th. Well. Feb. 12th. Down stairs, and attending to her domestic affairs; the femoral veins are less. This case is interesting, as it shows the amount or great extent of mischief which can sometimes be borne. My Feb. 21st. After a short labour she was delivered of a live female child, about seven a.m. brother was called to her about six o'clock; when he arrived he found the os uteri fully dilated, and the head beginning to press on the perineum, but the os externum not well dilated; she has always had quick labours; the membranes ruptured just before my brother got there, after which there was a slight remission of pain; she had one strong pain at last, and felt as if something had given way; she felt a smarting. On making an examination immediately after delivery, nothing wrong was dis covered. About four hours after delivery, in trying QQ 584 CASES IN PRIVATE AND HOSPITAL PRACTICE. to make water, she perceived a swelling in the right labium, which has rapidly increased. At three o'clock p.m., the swelling had increased to nearly the size of the head of a new-born child; the integuments were much discoloured, and on the inner surface of the labium, where it terminates in the vagina, were lacerated, the laceration being nearly two inches long, and extending upwards very nearly to the urethra or meatus; there was considerable bleeding from the wound; pulse 100; no appearance of exhaustion; uterus well contracted; intestines much distended with flatus; on pressing on the outer side of the labium, so as to evert its inner surface, a very large coagulum was turned out. A piece of soft sponge was then placed in the wound, a soft pad applied over the external surface of the labium, and that confined by means of a bandage. A catheter was introduced, and a pint of urine drawn off. 22nd. Comfortable; no return of swelling. 23rd. Sponge removed; no return of hæmorhage; better in herself. From this date she continued toimprove, and was down stairs March 14th, and convalescent. V ABSCESS IN THE PELVIS, &c. Mrs., soon after marriage, and for some time before, occasionally complained of pain in the right iliac fossa; she became pregnant and aborted between the second and third month; during the time she was pregnant the pain was more frequent, but there was no hardness nor swelling perceptible. She says she miscarried four times before she went her full time, and twice since. She became pregnant again, and went her full period. Her labour was lingering and severe; she was delivered with the forceps of a still-born male child. She did very well till about the seventh or eighth day; the pulse then became quick; she had rigors, followed by a smart attack of fever, pain in the right side, opposite the anterior superior spine of the ilium, extending some way both above and below, increased by pressure, and accompanied by fulness or swelling, constipation, dysuria, restlessness, and great constitutional disturbance; lochia copious; plenty of milk. The pains and pyrexia continued in spite of all our efforts to remove it by leeches, &c., She had retention of urine; rigors every day or two; about the sixth day from the commencement of the attack there was a copious discharge of pus, apparently from the bladder. On introducing the catheter, after the urine had passed, a quantity of thick white pus followed through the instrument to the extent of six or eight ounces. This continued to nearly the same amount each time the catheter was passed, which was three times a day for nearly a fortnight. The discharge continued more or less for some weeks, gradually getting less, and nearly always following the urine, or mixed with it. After the discharge commenced, the febrile symptoms gradually subsided, and she slowly re covered. She was unable, on first getting up, to move, or bear any weight on, her right thigh. The lameness continued for nearly two months; she was unable to bend forwards. After she had recovered, she had, nearly every month, pains about the right side and aching in the back, accompanied by feverish symptoms. This was always followed by some purulent discharge. The discharge generally passed from the meatus, but it sometimes appeared to come from a small opening by the side of the urethra, although an ordinary sized probe could not be passed into it. She became pregnant a third time; during the early part of it she was much troubled with constipation and frequent returns of the discharge of pus. After quickening she was not much troubled. After a lingering labour she was again delivered of a dead child, apparently from dropsy of the amnion and disease of the placenta. After this delivery she had a return of her former sufferings, but in a much less degree. She had the discharge, periodically as before, but sometimes there would be an interval of two or three months. In the fourth pregnancy she was less troubled; still before quickening she had two or three slight attacks, followed by discharge. She got through this pregnancy better than the two former ones. She was delivered at the full period. The child presented with the breech, and there was considerable delay between the birth of the breech and the head, consequently the child was not alive. She recovered without any bad symptom. She had after each confinement a very copious flow of milk, continuing for three or four months. She became pregnant the fifth time, went ber full period, and had a living child in October, 1842. She got through her confinement without having any untoward symptom, and has been remarkably well ever since. At the commencement of her last pregnancy, she said she had a slight discharge two or three times, but unaccompanied by constitutional disturbance. This most likely was a case of abscess in the cellular tissue of the pelvis, making its exit through the bladder. It is probable that the inflammation commenced in the right ovary, and extended to the cellular tissue, or it might have been encysted abscess of the ovary. Early in January, 1844, she again became pregnant. I saw her May 14th. She thought she was then gone about half her time. She menstruated December 15th. About three weeks ago, in April, she fell down, and broke one of the ribs on the right side, since then she has had frequent pain on the right side, all over it, and extending to the thigh, the pains frequently shooting. She says that one half of the body feels differently to the other, taking it from the middle of the spine to the sternum, &c. She has frequent shooting pain from the sacrum to the pubis. On Saturday night, May 18th, she felt a great fulness in the right side, before she went to bed; in the night she was awoke by a CASES IN PRIVATE AND HOSPITAL PRACTICE. sudden discharge of a purulent character, and without pain. She thought it was a discharge of liquor amnii, and that she was going to miscarry. May 20th. Before and when she makes water there is a similar discharge. The urine is covered by a thick greasy looking pellicle, also the bottom of the vessel, and there is a deposit of separate patches of blood and pus. She continued about the same for three or four days, and then aborted. She remained out of health, and troubled with a purulent discharge, for some weeks. She then went to the sea, where she got quite well. September 22nd. She is now looking better, and is in better health than she has been for some years. ABSCESS IN THE PELVIS. Mrs. N., pregnant the third time, about four months gone; has had two children at the full period. Was taken September, 1843, with flooding, after some exertion. The flooding continued more or less for three or four weeks. She was then taken in labour. The pains were of the most violent, expulsive, and at times, spasmodic character I ever witnessed; they were frightful; I fully expected some laceration would be caused; there was some delay in the expulsion of the placenta, and considerable flooding. The placenta was expelled in about two hours after the fœtus. She remained very faint and exhausted for several hours, but gradually recovered. A few days after she had rigors, followed by pyrexia, pain in the right side, and right iliac fossa. She was very much relieved by the repeated application of leeches, followed by a blister, aperients, diaphoretics, calomel and opium, &c. 585 was followed by sloughing of the parts covering the rami of the pubes, more particularly on the left side, retention of urine, fever, &c. At one time the finger could be passed through an opening formed by the slough,down to the bone. With great care and attention, regularly drawing off the urine and syringing out the vagina, she so far recovered as to be able to get down stairs at the end of the third week. Her general health was much improved; she could pass her urine without the use of the cathether, and the ulceration over the ramus of the pubis was nearly healed. After being down stairs for two or three days, she had rigors followed by fever, pain in the pelvis, left groin, and in the left iliac fossa. This was followed by swelling in the left iliac fossa, and then in the groin. The swelling increased, and in a short time fluctuation was felt. I opened the abscess in the groin, and I should think nearly a quart of fetid pus was discharged in a full stream. She was much relieved, but she became hectic, and died about ten weeks after her confinement. The discharge continued more or less from the groin up to the time of her death. The ulceration in the vagina had healed, and there was no contraction of the vagina in consequence. No post-mortem was allowed. INFLAMMATION OF THE UTERUS, ENDING IN Mrs., a patient of the Lying-in Hospital, after a rigor occurring immediately after the cessation of the catamenia, became feverish, with aching pain in the back, shooting pains about the lower part of the belly, accompanied by a sensation of heat internally, a weight, and bearing down when The pain returned two or three times, accom- standing, and pain on evacuating the bladder and panied by swelling, frequent rigors, &c. After rectum. The pulse was quickened, and the tongue two or three weeks suffering, a considerable dis-furred. On examination per vaginam, the anterior charge of pus took place with the urine, and continued more or less for nearly a month, and then ceased. Before the discharge commenced there had been dysuria and retention of urine, for which it was necessary to pass the catheter. On examination per vaginam, previous to the discharge, there was detected heat, dryness, and tenderness of the vagina, also a fulness on the right side of the pelvis, and indistinct fluctuation. She menstruated for the first time since she aborted, December 9th; and December 18th, she was quite well. ABSCESS IN THE PELVIS. Mrs. Hands, aged 30, was delivered of her first child, March 26, 1842. She had a severe lingering labour, and was delivered with the forceps. After the forceps were applied, it required more force to deliver, than I thought justifiable, but Dr. Ingleby, who was present, advised me to deliver, if possible, without taking off the forceps, and rather than have recourse to craniotomy. The child was born alive, and continued to live, so far we were justified in persisting to deliver with the forceps. Delivery part of the uterus, near the cervix, was found to be INFLAMMATION OF THE UTERUS AND ABSCESS. Feb. 26, 1844. Mrs. Perry, aged 24, has had two has been children, the youngest is five months old; married nine years; twelve months ago she had a bad miscarriage; since then she has never felt so well; has menstruated regularly, and lost a good deal; a fortnight since she had a purulent discharge for a week; she then menstruated, and has continued to do so very freely up to the present time, with the exception of a few hours, when it ceased. She has had pain in her back and bowels the last fortnight, which gets worse; she is very sick, but does not vomit; has bearing down, and difficulty in making water; feels a weight in the uterine region; tongue slightly furred and reddish; |