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mencing death of the bone beneath ; died exhausted three days after its supervention, or 17th day from commencement of dysentery ; no chest complication. Post-mortem thirty hours after death. Body pale, thin, little subcutaneous fat. Thorax—pericardium moist; heart valves normal; right side distended, with semi-fluid blood; left ventricle contracted and empty. Pleura non-adherent, moist; lungs, left, marked emphysema of edge of upper lobe in front, vesicular and interlobular—the latter preponderating. Upper lobe imperfectly crepitant, with carnified portions in centre about half an inch square; lower lobe sparingly crepitant, congested, at back part, numerous collapsed lobules. Right, upper lobe crepitant, with vesi
ccdematous; lower lobe condensed, with blood, no granulations. Bronchi generally exude a pale frothy fluid on pressure. Abdomen, stomach, tissue soft, contains a little milk and bread; not congested. Whole intestine, from stomach to within a foot of rectal end, normal, and stained throughout by bile ; about twelve inches from anus two or three ulcers, about the size of a split pea, are found, they had only destroyed the mucous membrane; for the last six inches of its course the whole rectum is covered by a deposit of lymph of honey-comb appearance, which is easily stripped off from the congested mucous membrane beneath. Liver, spleen, and kidneys, normal.
Of the fatal cases of typhoid fever, eight in number, four were examined after death :—
1. A stout female child, at. lj, was attacked by an imperfect eruption of measles, which commenced to recede quickly on the third day, attended by a typhoid form of fever and great dyspnoea; this state continued for seven days, no physical signs of chest disease having in the interval occurred, but on the evening of the seventh day a fine moist rale was heard in the lower and back part of both sides, and she died early on the eighth day of the typhoid state. Postmortem thirty-five hours after death. Body pale, not emaciated ; a good deal of subcutaneous fat. Thorax—pericardium contains about a drachm of strawcoloured serum ; heart valves normal; right side distended, with semi-fluid dark blood. Pleurfe—A few patches of lymph on diaphragmatic surface of. right pulmonary and costal surfaces of pleura?; right lung—all this lung, except a portion of about two square inches at apex, is condensed ; on section the colour of the lung is a dirty straw, with granulations: the upper lobe is not wholly in this state, there being patches of one and two square inches, with congested lung tissue between; the other lobes are uniformly granular; left, upper lobe crepitant, oedematous; lower, condensed, red, and granular on section. Bronchi, especially the smaller, exude purulent mucus on pressure. Abdomen—liver, spleen, and kidneys, congested ; otherwise normal.
2. A stout healthy female child, a;t. 2.J, was seized with an imperfect eruption of measles, and on the third day fell into a low typhoid state, attended with dyspnoea, but no physical signs of chest affection on the 7th day of the typhoid state; both cornea observed to become dim, with no previous inflammatory signs beyond slight injection of the palpebral conjunctiva ; this state was succeeded next day by ulceration between cornea and sclerotic ; ultimately both eyes sloughed, leaving a small fleshy looking mass at bottom of each orbit; died of exhaustion on tenth day of fever, or thirteenth day from appearance of eruption. Post-mortem forty-six hours after death—Body pale, emaciated; little subcutaneous fat; eyelids sunk; cornea, etc., gone. Head— membranes pale, no deposit. Brain—pale, firm ; lateral ventricles contain a little clear serum ; optic commisure, and nerves firm, but, like the brain, very anemic. Thorax—pericardium contains about half an ounce straw-coloured serum; heart valves normal; right side distended, with dark fluid blood; left auricle contains a fibrinous coagulum; ventricle contracted, empty. Pleura; moist, no adhesion; lungs, left upper lobe imperfectly crepitant, contains at
cular emphysema at apex
apex two yellowish cheesy masses, each about half an inch square, with defined borders; lower lobe condensed, with blood and carnified lobules; right, upper, and middle lobes crepitant, lower imperfectly crepitant, containing numerous crude miliary tubercles. Abdomen—liver, spleen, and kidneys normal.
3. A stout female child, set. 2, had been labouring under well marked pertussis for several weeks, with well-formed hoop and accompanying bronchitis; the paroxysms were becoming less frequent and severe, when it was seized with measles, which came out imperfectly, receding suddenly in twenty-four hours, again appearing imperfectly three days after, and permanently disappearing in twenty-four hours. She fell into a low typhoid state, with slight dyspnoea, and died exhausted on nineteenth day of typhoid state, the chest signs being, during that period, slight inspiratory roughness, with no marked rale. Post-mortem forty-eight hours after death—Body pale, emaciated ; little subcutaneous fat. Thorax—pericardium moist; heart valves normal, right side filled with semi-decolorised clots; left contracted, empty; pleura?, no adhesions, moist; lungs, left upper lobe crepitant; lower lobe condensed, tougb, carnified ; right, upper lobe, superior half, crepitant, inferior half, non-crepitant, externally presenting a nodulated appearance, exactly similar to that observed in cirrhosis of the liver in an advanced stage; the middle lobe is atrophied, and seems made up of these nodules, which, on being cut into, are firm, fibrouslooking, and with no apparent cavities; they are about the size of a small marble, and have an imperfectly crepitant tissue between; lower lobe noncrepitant, carnified ; smaller bronchi exude a tenacious yellow fluid. Abdomen —liver, and spleen, normal; kidneys congested, lobulatcd.
4. A stout healthy female child, a;t. 2, was seized with an imperfect eruption of measles, which receded quickly on the third day, followed by a typhoid state, accompanied with dyspnoea, slight croupal symptoms, and no chest signs beyond inspiratory roughness, and for a few days before death dorsal impairment of percussion, with resistance. Died exhausted, on nineteenth day, of fever, a small abscess of cornea commencing. Post-mortem forty-eight hours after death—Body pale, emaciated, little subcutaneous fat. Thorax—pericardium moist ; heart, valves normal; right side gorged with semi-decolorised clots; left, contracted, empty. Pleune—recent adhesions of pleura? in front of left lung, soft, white, and easily detached from opposed surfaces; lungs, left upper lobe crepitant, normal; lower, condensed, carnified; right, upper lobe, crepitant; middle, condensed, carnified; lower lobe, imperfectly crepitant, containing some lobules of fawn-colour and granular, with healthy crepitant tissue between ; larynx and trachea, pale, no exudation. Abdomen—liver pale, spleen and kidneys normal.
To recapitulate the results of these post-mortem examinations, we find,—1st. That in the case of toxxmia, from sudden recession of the rash, the only changes observed were extreme congestion of the viscera, and a fluid state of the blood.
2d. That in the cases of respiratory sequelae examined, the evidences of marked collapse were present in all, and coexistent with a state favourable for its development; but that emphysema was generally absent, contrary to what is found in the adult, and probably so in consequence of the conditions necessary for its production, being absent owing to the enfeebled state the patients were in, and the yielding state of the parieties of the chest.
Zd. That in the fatal case of digestive sequelae—a case of dysentery—we have the unusual circumstance of the formation of a false membrane upon the interior of the intestine, and also evidence of the occurrence of marked collapse of the lung in a child who never lia.d bronchial disease, but who had been lying in a semi-lifeless state for several days, thus proving the accuracy of the opinion of Dr "West, that collapse may occur in such circumstances without bronchitis.
4th. That in the four cases fatal from typhoid fever which were examined, the parenchyma of the lungs was primarily affected in two; and in two secondarily, in the one case labouring under pertussis, the lesions found seemed more the result of it than of measles.
A.KTICLE V.—Postscript to a Paper in the January Number of this Journal, confirming the discovery by Keber of a Remarkable Body Penetrating into the Ovum of the Fresh Water Mussel. By MarTin Barrt, M.D., F.R.S.
Had this discovery by Keber extended no further than that of the penetration into the interior of the ovum of a body having always the same appearance, form, and size, and this by a funnel-shaped canal evidently provided for the purpose,—had Keber's discovery gone no further than even this, there would have been sufficient in it to induce the thought with every one deserving to be called an embryologist, "What else can this be than a spermatozoon?" But when to that discovery he has it in his power to add, This body which I saw, not only at the very mouth of the micropyle, but in countless instances at all degrees of penetration through that canal, and in the yelk itself,—this body which has always the same general appearance, colour, form, and size,—and after getting into the ovum divides into many parts,—this body I know to be a spermatozoon, for I have traced the spermatozoon of the same animal from its earliest origin through all stfiges of development, and become perfectly familiar with its appearance, colour, form, and size: I say, when a man has it in his power, as Keber has, to add all this, he speaks with authority which no man has a right to question, until he shows that Keber misinterpreted what he saw; for at mere denials a man sure of his facts can afford to laugh and "bide the time," as some of us have done before him.
Let observers mark well what Keber says of the size of the ova in which they should find a funnel-shaped micropyle, and the entering or entered spermatozoon, namely, ova of to g^"'. And let them notice his experience of the season of the year—September—in which ova of this size are most frequent. By attending to these two things they will not have to look long before seeing a confirmation in several parts of the field of view; for when once seen, the objects in question are so easily recognized that the observer wonders how it was that they were not seen sooner. If they neglect attention to the size of ova, they may perhaps see a globule or albumen, and think that Keber
NEW SERIES.—NO. IV. APRIL 1855. 2 R
took this for a spermatozoon; instead of which he pointed out particularly, in his first work,1 the nature of the same. All that Keber asks for is, that observers should rigorously test his observations. I never read an account of a discovery in which such testing was shown to be more anxiously desired. Only let me warn observers not to publish denials until they are quite sure that they have been looking at the thing which Keber pointed out; otherwise they will make themselves ridiculous by " a beating of the air," and wish that what they wrote could be expunged. I have seen smaller ova of the animal in question in which, as Keber says, no micropyle existed. Again, I have seen larger ova in which no remains of the micropyle could be discerned, while in ova of the size above mentioned, I think I never failed to find it when the ovum lay in a manner which made the seeing of it possible. And rarely has it happened that in ova of about the said size, I did not find the remarkable body in question either entering or already entered. He who has not seen all this, and traced the spermatozoon from its earliest origin through all stages of its development to a body not distinguishable from that which penetrates into the interior of the ovum, if he respects his own reputation, let him pause before denying the discovery of Keber.
Keber terms the spermatozoa cells. I have been in the habit of terming their large extremity a nucleus. No doubt, however, if it be a nucleus it is vesicular, as other nuclei become. And really it is no easy matter to point out where the nucleus ends, and where the cell begins; that is to say, it would not be easy to point out this in a manner that would be satisfactory to every eye. There is a fact, however, noticed by myself, of which I omitted to make mention, and which it may be worth while to make known here, as a fact which is in perfect keeping with what I saw to follow the penetration of the spermatozoon into the ovum of the rabbit. My feet is this: that the many parts into which Keber saw the said large extremity to divide, are nuclei themselves.
Second Postscript, confirming Keber's view that the Penetrating Body is a Spermatozoon.
I have lately (in March 1855) resumed my examinations of unio, directing my attention chiefly to the testis. It is now in my power to state, with Dr Keber, that / am quite incapable of seeing any difference either in size, oblong form, or behaviour towards light, between the body or anterior end of the mature spermatozoon of unio, and the body which he has figured entering its ovum.
1 De Spermatozoorum Introitu in Ovula. Kdnigsberg, 1853.
IJHuile de Foie de Morue EnvisagSe sous tous les Rapports Comme moyen thirapeutique. Par L. J. De Jongh, Docteur de medecin k la Have.
Cod Liver Oil regarded in all its relations as a therapeutic agent. By L. J. de Jongh, Doctor of Medicine at the Hague. Paris, 1853. 8vo, pp. 262.
De V Huile de Foie de Morue et de son Usage en MMecine. Par M. Ed. Taufflieb, Docteur en Medicine, a Barr (Bas-Rhin).
On Cod Liver Oil and its Use in Medicine. By M. Ed. TaufFlieb, Doctor of Medicine at Barr. Paris, 1853. 8vo, pp. 95.
The Pathology of the Broncho-Pulmonary Mucous Membrane. By C. Black, M.D., etc. Edinburgh, 1855. Part U.
Since the year 1841, when Professor Bennett first introduced codliver oil into the medical practice of this country as a valuable means of removing scrofulous and tubercular diseases, its therapeutical and commercial importance has gradually increased to an extent seldom witnessed in tne history of the materia medica. Previous to the publication of his monograph, indeed, it had been employed here and there, and especially by Kay and the elder Bardsley of Manchester, as a remedy in rheumatism. But even for that disease it had been allowed to fall into unmerited neglect, so that when Dr Bennett, after watching its good effects in some German hospitals, first wrote, almost the entire profession were unacquainted with its value, while druggists were in a complete state of ignorance as to its properties, and knew not even where to obtain it. The amount retailed by one of the first druggists of Edinburgh in 1841, was one gallon, and that altogether to tanners and shoemakers, for the purpose of softening leather, whilst during the last year the same druggist has disposed of no less than 600 gallons I So little disposed were medical practitioners in general to employ this substance, that it was with the greatest difficulty the proposer could induce even his
deserve honourable mention, viz., Dr Andrew Wood and the late Dr Robert Spittal, the first of whom tried it largely in several public institutions for children, and at once observed its good effects; while the latter was the first hospital physician who administered it, and satisfied himself of its value in the phthisical cases of the Royal Infirmary. At this period cod-liver oil was the subject of
Two exceptions to this, indeed,