dullary spaces, which are reddish when blood-vessels are present, and yellowish or brownish-yellow when these are absent. A whitish-yellow line lies internally next the bone which corresponds to the layer of young bone; and between this and the bluish layer intervenes a red irregular margin, broad in some places, narrow in others, consisting of red points clustered together, which are recently formed, and vascular medullary spaces. Various scattered ossific points found here, especially in the intercellular portions of the matrix are finely striated, are composed of delicate fibrillae, and terminate in a thicker, stronger, shining layer, which forms the enveloping capsule of the neighbouring cell-groups. Homogeneous calcification occurs in this marginal layer, and the intercellular spaces become infiltrated with a finely granular yellow mass. But osseous deposition does not occur in this marginal layer alone, for it goes on also, in many places, within the cell groups-principally at the points of junction between their individual cells. A thin stripe of calcareous matter often intervenes between two cells, while these are still bounded on both sides by an unossified layer. At other times ossification commences in the internal capsules, (leaving the dividing bridges within quite unaffected), and calcareous rings are formed which give the whole structure a uniform reticulated aspect.

(To be Continued.)

ON THE INOCULABILITY OF SECONDARY SYPHILIS.

The Imperial Academy of Medicine in Paris having decided against the truth of the doctrine of syphilisation, after the discussions of which an abstract is given in the February number, proceeded at subsequent meetings to consider whether or not secondary syphilis is inoculable.

M. Velpeau said, that the transmissibility of secondary syphilis was not a new question. Hunter had first directed special attention to the subject, and had decided in the negative; but his opinion met with little favour at the time, although of late years it has found a good many partizans in France. M. Velpeau's own opinion was, that not only those who have had chancres or a virulent gonorrhoea, or who are descended from syphilitic parents, are liable to the constitutional affection, but that all or almost all the manifestations of secondary syphilis, are contagious. His opinions were founded on several grounds :—1st. Universal belief. It was scarcely possible that what had been believed for centuries could be absolutely false. No doubt numerous fabulous modes of contagion had been described, as, for instance, by the breath or saliva, but still he believed the general belief to be founded on truth. 2d. The experience of medical men in different countries. Although it be conceded that in many of their observations there is a certain amount of error, still there must be some truth in such a mass of facts coming from such various sources. 3d. M. Velpeau would appeal to his own observations. He had begun by trying to inoculate animals with syphilis, and in this he had constantly failed; and he might observe that, in spite of what had been said to the contrary, he did not consider it proved that this inoculation was possible. But he had observed secondary symptoms inoculate themselves. Thus, a young man who had had chancres on the penis six months before, was affected with a small vegetation on the glans. M. Velpeau kept the prepuce in close apposition to this for some days, and a similar vegetation made its appearance in the latter situation. He had since made the same observation frequently, and had observed that condylomata (plaques muqueuses) were often propagated in the same way. These considerations had first established in the mind of M. Velpeau the possibility of the transmission of secondary syphilis. Other facts, to which he should immediately allude, had confirmed him in this opinion. Those who maintained the opposite opinion, were inconsistent with their own doctrines. They admitted hereditary transmission, but not the direct transmissibility of secondary symptoms. But what is hereditary transmission but the transmission of a constitutional affection? Another important proof of the truth of his opinion, was drawn NEW SERIES.-NO. LII. APRIL 1854.

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from what is seen in the case of nurses or infants affected with secondary syphilis. In many instances it had been observed that the unhealthy nurse could affect the healthy infant, and vice versa. Among other cases, M. Velpeau mentioned the following: A family consisted of a husband, wife, and four children, all healthy. The woman took to nurse an infant covered with an eruption, and suffering from sore throat. The family being poor, the same drinking cup was used by all. Soon afterwards, one of the daughters became affected with symptoms similar to those of the infant, and died; the nursling died; the mother and two other daughters were attacked with sore throat, and were cured by mercury. On the other hand, many cases might be quoted where a nurse affected with constitutional syphilis has transmitted it to her nursling. As to inoculation, M. Velpeau, without approving of it, would not absolutely reject it, though he considered it a mistake to suppose that it could furnish much reliable information. If it it succeed, it only proves what hardly requires proof; if it fail, it does not prove that the affection was not syphilitic. Supposing that primary affections are always and easily inoculable, it does not follow that secondary affections should be inoculable with equal facility. But it had been shown in a number of cases that secondary affections could be inoculated. He would only refer to the observations of Wallace in England and Waller in Germany. For these reasons he believed that secondary syphilis was contagious.

M. Lagneau considered it undoubted that secondary symptoms were contagious; but, from the very fact of their being consecutive, their contagious power was not so strong nor so easily proved as in the case of the primary. In fact, in general, secondary symptoms could not be inoculated; sometimes, however, they might, though they were propagated readily by sexual intercourse. M. Lagneau referred to the case before the Academy, in which the individual had inoculated himself with pus from a secondary ulcer on the tonsil; the inoculation was fol[owed by the characteristic pustule. The fact of the inoculability of secondary syphilis takes away from inoculation all its importance as a diagnostic agent.

M. Ricord regarded this question as most important, both with reference to pure science, to public and private hygiene, and to legal medicine. He had begun the study of syphilis without any preconceived views; much had indeed been already done by Hunter, but his doctrines had been established on his own experience. From clinical observations and experiments, he (M. Ricord) had proved, 1st. That it is only pus from a chancre, taken at a particular period, which is inoculable and capable of reproducing chancre. 2d. That a bubo, the result of absorption, following a non-indurated chancre, furnished like the chancre itself inoculable pus. 3d. That a bubo, considered veneral, may not furnish inoculable pus; because, the pus surrounding the affected gland may have been employed, not the purulent matter of the gland itself; because, the bubo may have been merely sympathetic; or, because the bubo may have been idiopathic, and have been mistaken for a direct manifestation of syphilis (Bubon d'emblée). 4th. Constitutional symptoms, whether secondary or tertiary, have not been found capable of inoculation. 5th. Syphilitic affections which are not inoculable are not contagious. 6th. Simple gonorrhoea, not symptomatic of urethral chancre, is not inoculable. Since he had established these doctrines, they had been confirmed by numerous other observers. Those who maintained the inoculability of secondary syphilis appealed to clinical observation and experiment. It was singular, however, that they had so few proofs to refer to; their cases were evidently exceptional; whereas if their opinion were correct the number should be immense, so many individuals being affected with secondary syphilis who take no precautions against infecting others. Many of the observations brought forward on the other side, left much to be desired. It was often very difficult to determine whence the first symptoms had been derived; and even supposing that patients have no desire to deceive, how can they always describe with accuracy the condition of the other party? In most cases it is no doubt easy to distinguish between primary and secondary affections, but sometimes it is exceedingly difficult. What is called condyloma, and which is considered as invariably a secondary affection, is sometimes the

remains of a chancre which has altered its form, but which is still a primary affection and is still inoculable. Here, then, is a source of error in diagnosis. Before saying that secondary affections are inoculable, it must be shown that the diagnosis was precise and free from all possible sources of error. This M. Ricord did not consider to be the case with regard to the observations which had been brought forward. He himself had attempted very frequently to inoculate secondary symptoms, but had invariably failed. With regard to the proof derived from the alleged transmission between nurses and infants, the facts stated were quite at variance with his own experience; and M. Ricord referred to others who had enjoyed the best means of observation, and who were on this point completely of his own opinion. M. Velpeau had told them of the contagiousness of vegetations, but in M. Ricord's opinion vegetations were not syphilitic at all, and it was anything but proved that they were contagious. The same cause which produced them at one point might have given rise to them at others. As to considering the possibility of the hereditary transmission of secondary syphilis as a proof of its contagious nature, he was surprised to hear M. Velpeau make such a statement. On this principle it might be maintained that phthisis, cancer, gout, or insanity, are contagious. M. Ricord said he did not wish to systematise and maintain that secondary symptoms were absolutely neither contagious nor inoculable, but in order to make him change his opinion, much stronger proofs than had been hitherto brought forward would be required.

M. Gibert did not lay much stress on experiments as proving the inoculability either of primary or secondary syphilis; he would only trust to clinical observation. Drawing his knowledge from this source, he felt justified in making the following assertions:-1st. The primitive symptoms of syphilis are multiple; 2d. The regular progress of deve opment of secondary symptoms, which some have endeavoured to establish, is far from being constant. 3d. Secondary symptoms may exceptionally show themselves contagious, under particular circumstances of intimate cohabitation. 4th. Inoculation should not be employed for any purpose, even as a diagnostic agent, seeing that its results are not to be depended on.

M. Roux acknowledged the services which had been rendered by M. Ricord, and stated that he agreed with him on many points, but still as to the contagiousness of secondary symptoms he sided with the others.

On the conclusion of this discussion, which occupied the greater part of six meetings of the Academy, a vote was not taken on the subject; but it was decided that at some future period a committee should be appointed to inquire into, and if possible resolve, the question of the transmissibility of secondary syphilis. As yet, however, no steps have been taken in the matter,

DR LONDRES ON INSECT-LARVÆ UNDER THE HUMAN SKIN.

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According to this author, there are often found in Surinam, below the skin, both of Europeans and negroes, the larvæ of an insect called there the " quito-worm," which resembles closely the Oestrus Bovis. These occasion furunculoid circumscribed tumours, the size of a nutmeg, which discharge a bloody serum through a small opening at the surface. These tumours are very painful, and, if not subjected to treatment, they form open ulcers. The treatment adopted is blowing tobacco smoke into the tumour through the aperture, and thereafter squeezing it, which causes the larva to crawl out of its centre. Dr L. found them rapidly cured by free incisions. He cannot yet determine whether these larvæ belong to the Oestrus Bovis species, or whether they are different, the Oestrus Hominis. Howship mentioned to the Medical Chirurgical Society of London, the case of a soldier from Surinam, who had the Oestrus Hominis in his shoulder, and of a youth in Santa Anna, in South America, in whose scrotum they were discovered. Baron von Humboldt also saw Indians in South America, whose abdomens were covered with small tumours, which he conceived to be due to the subcutaneous presence of the larvæ of the Oestrus.-Nederland Weekbl. July 1852.

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BLUMHARDT ON THE USE OF COLLODION IN BURNS.

This fluid, when applied to burns, promotes healing and prevents suppuration. Blumhardt has tried it, with great success, in three cases, one of them caused by explosion of gunpowder, and two by the ignition of spirits of wine, where the breast, neck, face, and hands were all severely scorched. was applied to the skin an hour and a half after the accident, by a hair-pencil; Collodion the redness, pain, and swelling, were thereby diminished, and the patients soon experienced no inconvenience save the tension occasioned by the firmly adherent pellicle. The inflammation completely subsided, and the recovery was rapid. He considers the collodion to act beneficially in two ways; first, by affording a safe protective covering to the sensitive cutis, and second, by giving a uniform support to the part, and relieving the capillaries from all undue distension.-Würtemburg Corresp. Bl. No. 56.

Part Fourth.

MEDICAL NEWS.

EDINBURGH OBSTETRICAL SOCIETY.

SESSION XII.

INDIAN MIDWIFERY-NOTES ON, BY DR WISE, H.E.I.C.S.

Dr Simpson read the following communication from Dr Wise, author of the learned "Commentary on the Hindoo System of Medicine.”

Remarks on the Treatment of Women during Pregnancy and Labour by

the Asiatics.

The vast countries which the Mahommedans conquered extended from Spain to China, embracing a portion of Europe and a large part of Africa and Asia; in all of which countries they have left traces of their manners and customs. Even among the Hindoos, so prejudiced in favour of their own habits, considerable changes have taken place, from the mingling of these two great races. In both, the treatment of females during parturition resembles so much each other, that the following remarks may be applied to either; although some differences in unimportant local customs may be found in parts of these extensive countries.

The Koran has always been considered by the Mahommedans as the standard to regulate their religious, civil, and scientific pursuits. One of its peculiarities is its robbing the female of her rights, and placing her in a degraded position in society, and from their ignorance, the minds of their offspring remain uncultivated, and are filled with prejudice and superstition. This want of confidence in females induces the Mahommedans to employ ignorant and prejudiced menials during the period of parturition, by which both the mother and offspring suffer. So frequently are their lives sacrificed, and so convinced are they of the superior method of proceeding of European practitioners, that they often require their assistance in the hour of difficulty and danger. On this account I had frequent opportunities of witnessing their method of treatment, and the tenets which they inculcated both among the Mahommedans and Hindoos, of which the following are a few particulars :From the time that the female becomes pregnant, various religious ceremonies and superstitious observances are used to promote the welfare of the fœtus, and to prevent the influence of the evil eye. This is so much dreaded, that during pregnancy, the woman is rarely allowed to go abroad. At the same time, her peace of mind, happiness and comfort must be promoted, and gentle exercise enjoined with attention to diet, which is varied with the period of utero-gestation. On the fourth month curdled milk should be

administered; on the fifth milk, on the sixth ghee (clarified butter), on the seventh ghee and milk, so as to promote the formation and development of the foetus; while on the eighth month, to ensure an easy delivery, enemas with milk, oil, and ghee are administered, and the body is smeared with oil. This is followed by other arrangements for the delivery, which will be afterwards described.

During the period of utero-gestation, the female is to avoid anger, fear and grief, venery, fatigue, and watching, raising heavy weights, coughing, and violent exercise. Before the fourth month, bleeding, cupping, and purgation, and emetic medicines, are only to be used in cases in which it is absolutely necessary, when bleeding in small quantity, and laxatives may be employed. In all such cases external applications should be preferred. For a like reason, indigestible food, strong and pungent liqours, and disagreeable smells are to be avoided. Precepts which prove that considerable care had been taken by Asiatics in observing, and discrimination in inculcating the line of conduct, which ought to be pursued in such cases.

For lessening the distressing symptoms which so often accompany pregnancy, they recommend-for nausea, gentle exercise, keeping in the mouth mint leaves, and the seeds of the pomegranate. For an unnatural craving, gentle aperients, with mild acids, such as a syrup made of unripe grapes. A want of appetite is treated by poultices over the pit of the stomach; and heartburn by sipping warm water, with gentle exercise, carminatives, with a diminution of food. Hemorrhage during pregnancy is treated by certain astringent leaves which are bruised, mixed with vinegar, and applied externally over the abdomen.

Before considering the means employed by the higher classes of natives in India, I shall add a few remarks on labour as it occurs among the rude tribes of Hindostan. The females of such races are accustomed to so much exercise and labour, that they are generally of a healthy habit of body, possess fine figures, live on simple food, and nature is allowed to follow her own course during parturition, which is more rapid, and attended with less suffering and danger than among more civilised nations.

This is promoted by the relaxed habit of body of Asiatic females, the early age at which they marry, their temperate habits, and healthy systems, which render childbirth peculiarly quick and safe. The poorer classes often merely go aside when labour commences, a few pains complete it, and the only assistance which they require is a piece of a broken pot to divide the umbilical cord after it had been tied. The secondines being removed, the infant is wrapped in a piece of rag, the mother cleans the mud floor of the hut, walks down to the neighbouring stream, and after she has washed and bathed, returns to her domestic occupation as if nothing particular had occurred.

I knew an instance of a slave girl being delivered without awaking a female sleeping with her. At Agra, a class of women are in the habit of walking several miles to graze their cattle, and when thus at a distance they are sometimes delivered in this easy manner. They wrap their offspring in a piece of cloth, bathe, and return in the evening several miles on foot, driving their cattle before them. Next day they continue their usual occupation. They suffer much in after years from such premature exertion; as also from their early marriages, as they often become mothers before they reach their twelfth year. It is, however, to be recollected that in Asia, especially in a hot and moist country like Bengal, the female arrives at puberty between eight and nine years, and the male at fifteen or sixteen, which is three or four years earlier than in Europe. Among such a primitive race deformities will sometimes occur, and unfavourable presentations will retard delivery, and render it dangerous; but such events are much more rare than among refined, and, consequently, more civilized nations. When native practitioners are consulted on these occasions, they chiefly rely on prayers (montres), and charms; such as expanding dried and shrivelled-up sea-weed, by putting it in water, or pul.ing up certain plants by the roots, which operation is famed to assist delivery.