attention of M. Belleti was directed to a foreign body which had made its appearance at the orifice of the ear; this was of a pearl white colour, smooth, convex and adherent to the neighbouring parts. As it was found impossible to extract this body, an incision was made into it with the effect of giving exit to a large number of worms, of a yellow colour, and three lines in length. During the following three days injections were made into the auditory canal, and a few worms continued to be discharged. A probe was then passed into the meatus and impinged upon a hard elastic body. By using the probe as a lever, a worm was extracted six times the size of the others, but in other respects closely resembling them. These worms were characterised by M. Caleaca, Professor of Natural History at the university of Palermo, as being the larvæ of a coleoptrous insect, of a yellow colour, with symmetrical feet, and which, had they remained in the auditory canal, would have become perfect coleopters, of the tribe claricornes, and probably of the genus Nicrophorus dermestes, which generally inhabit the skin of carcases in a state of putrid fermentation. The patient recovered entirely from the disease of the ear, but some months afterwards she died of apoplexy; and, on examination of the head, the sinuses of the dura mater, and the meningeal and cerebral vessels were found gorged with blood, and the cerebral substance softened, on the left side the membrana tympani no longer existed, and the malleolus had also disappeared. M. Beletti accounts for the development of worms in this situation by the supposition that his patient had introduced into her ear a piece of putrid auimal matter, in which one of these insects had deposited its ova.-Giornale psichiatrico de Pisani, and L'Union Médicale. Part Fourth. MEDICAL NEWS. MEDICO-CHIRURGICAL SOCIETY OF EDINBURGH. November 16, 1853.-Professor SIMPSON, President, in the Chair. 1. PEDUNCULATED EXOSTOSIS OF THE LONG BONES. This paper is inserted in the present Number. BY PROFESSOR SYME. Mr Lister read an account of the structure and examination of one of these exostoses, which is also inserted in the present Number. Professor Miller said, that he could not concur in the sweeping condemnation of Sir Astley Cooper. The author of the paper had certainly included a great deal too many things in the term Exostosis. He did not think that Sir Astley had called the ordinary exostosis, tipped with its transitional cartilage, a "Cartilaginous Exostosis," although, under that term, he had improperly included the osteosarcoma and enchondroma of modern pathologists,-the one essentially, the other occasionally and partially, consisting of cartilaginous structure. Neither could Professor Miller agree to Mr Syme's proposed classification of tumours of bone,-solid, hollow, or spicular: it was both theoretically and practically erroneous. Solid, for example, would include osseous, osteosarcomatous and osteocephalomatous, formations,-all differing widely, pathologically, as well as in regard to treatment; the first simple, and often requiring no treatment at all; the second simple, at least in the first instance, requiring and admitting of removal by operation; the third malignant, and seldom, comparatively, admitting of operative interference. The hollow tumours, again, would include the expansion of bone under chronic abscess, as well as its hollow growth in osteocystoma (the Spina Ventosa of old authors),-conditions also differing essentially, in both natureand treatment. Mr Liston had certainly, at one time, amputated much too freely for simple exostosis of the distal phalanx of the great toe; and to this the University Museum was indebted for a very beautiful series of specimens of that affection. Latterly, he had taken to excision of the exostosis alone; except in those cases in which the growth threatened to be obstinately reproduced, and in which removal of the phalanx may still be expedient. Professor Miller, as a teacher of surgery, and as author of a "Students' Book," had been always ready to acknowledge Mr Syme's understood claim to priority in this country, as to successful excision of the upper jaw. But at the same time he, with equal readiness, acknowledged Mr Lizars' merit, as having first proposed the operation; a merit not slight-much in the same way as Sir R. Murchison may be supposed to have some merit in having, from purely scientific knowledge, pointed out where Australian gold was to be found; even in comparison with the man who dug up the first nugget. Professor Miller also objected to Mr Syme's general statement, that solid cartilaginous tumours of bone always required removal of the entire bone, or part of the bone, from which they sprung. Of Enchondroma, there were two recognised varieties: And one of these the least common certainly-being external to the bone, admitted of being dissected away, leaving the bone entire. As to Mr Syme's alleged discovery of an investing cyst to the common "pedunculated exostosis" of long bones, that part of their pathology was well known already. He (Prof. M.) had described it in his "Book for Students"-his Principles of Surgery; and had taught in his class these practical circumstances in connection with it:-1. That it obviously facilitated removal of the growth at its neck; 2. That, after removal by operation, this adventitious serous cyst was apt to inflame untowardly; 3. That, in consequence of a blow or other injury, an inflammatory process was apt to be kindled in the parts, whereby serous accumulation might take place within the cyst, imparting to the tumour a simulation of the rapid growth, pain, and elastic feel of malignant formations; and that so, serious error of diagnosis might accrue. At the same time, he must protest against this membrane being called synovial, The cartilaginous investment of the growing exostosis (for it is found only in those in process of growth) is not articular cartilage, lined by a synovial membrane, but transitional cartilage, invested by something periosteal, and condensation of surrounding areolar tissue into an adventitious cyst, of serous character. Dr Bennett remarked that the distinction sought to be established by Mr Syme did not appear to be so much founded on the structure of the tumours as on their situation. The structure of the external exostosis, according to Mr Liston, was at first cartilaginous, and the cartilage was afterwards transformed into bone. There was every reason to believe that the tumours originating in the interior of the bone were formed in the same manner. Hence the situation of these tumours was of more importance practically, than pathologically. He could not agree with Mr Miller's views as to the malignant diseases of bone, believing that the distinctions he had sought to establish, as guides to surgical interference, were not founded upon a just appreciation of the nature of these growths. Dr Dunsmure exhibited a calculus he had removed by lithotomy from a man, the nucleus of which was composed of a piece of woollen cloth. The case was as follows: II. CASE OF LITHOTOMY. NUCLEUS OF THE STONE A PIECE OF THE PATIENT'S William Howell, æt. 53, a bookbinder, admitted into the Royal Infirmary 18th October 1853, states that he enjoyed good health till the commencement of his present illness in 1842. Having slipped his foot while stepping from the Bass Rock into a fishing boat, he fell backwards on the " thowe pin," which entered the perinæum at the posterior margin of the right side of the anus. Although much hurt, he was able to raise himself, and take his seat in the boat, without acquainting his companions of the accident. Very little hemorrhage occurred, 1854.] THE MINERAL WATERS OF HOMBURG. and when the boat landed, he walked home, a distance of a quarter of a mile, without assistance. He was confined to bed for three weeks with severe inflammatory symptoms. A large abscess formed in the perinæum, which burst externally, and in three days after this he observed his urine to flow through the opening. He gradually regained his strength, and in about five months from the date of the accident the perineal wound closed. Shortly afterwards he first observed the stream of urine to be suddenly interrupted, as if by some foreign body. Upon examination of the bladder at this time by a sound, no stone could be detected. About two and a half years ago he was again sounded, when a calculus was discovered. He refused, however, to submit to an operation; and it was only on his sufferings becoming greatly aggravated, that he again applied for relief. The operation of lithotomy was performed on the 4th of November 1853 by Dr Dunsmure, and a stone extracted about two inches long, one and a half broad, and three-fourths of an inch thick. Upon making a section of the calculus, it was found that it consisted of phosphates, was very brittle, and contained in its centre an oval cavity, about an inch long and a half of an inch broad, within which was a portion of woollen cloth of the size of a small filbert nut. The cavity was considerably larger than the cloth, which had apparently shrunk, after the phosphates had been deposited upon it, by the urine passing off through the walls by exosmosis. The patient made an excellent recovery, no bad symptom having occurred after the operation. December 7th, 1853.-PROFESSOR SIMPSON, President, in the Chair. 1. REMARKS ON THE MINERAL WATERS OF HOMBURG. EDINBURGH. BY W. SCOTT, M.D., Dr Scott was induced to bring this subject before the Society, on account of the slight acquaintance possessed by practitioners generally with the virtues of the Homburg springs, and from the circumstance that a recent residence of some months there had enabled him personally to investigate and observe their effects in certain diseases. Dr Scott then gave an account of the village of Homburg, and of the principal springs which existed there, such as the Elizabethen, the Kaiser, the Stahl, The waters contained variable proportions the Sauer, and the Bad Brunnen. of the muriate of soda, muriate of lime, and carbonate of iron. The Kaiserbrunnen was considered the strongest saline, from its possessing much more of muriate of soda in its composition. The Stahl-brunnen, on the other hand, was the strongest chalybeate. The season extended from the middle of May to September; and during this period, from the sheltered situation, the temperature was remarkably regular. The time for taking the waters was from 6 to 9 A.M., when the grounds presented a scene of great gaiety, from the numerous promenaders, who walked about to the enlivening strain of an excellent band. The baths were generally taken three hours after breakfast. In the dietary, which Dr Scott gave at length, he recommended the avoidance of vegetables, as potatoes and fruits, while animal food should be as digestible as possible, consisting of plain roast and boiled meat. Occasionally disastrous effects were found to follow the use of the waters. He referred at length to the case of the late member for Peterborough, whose death This gentleman had long been suffering from a dishad occurred in July last. turbed state of the bowels, and a variety of treatment was had recourse to in vain. He tried the waters; but they produced a spasmodic affection of the bowels, which led to a fatal issue. The case too of the late Duke of Nassau might also be mentioned, where death suddenly took place after using the bath. As to the so-called Bad-krisis, with its disagreeable train of symptoms, he thought it might be entirely obviated by giving some mild alterative, or suspending for a time the use of the waters. NEW SERIES.-NO. XLIX. JANUARY 1854. In his own experience, he had found the waters of Homburg especially useful in all forms of biliary derangement, and particularly in the dyspepsia resulting from too close attention to business; although, no doubt, a good deal of the benefit obtained was due to the change of scene and mode of living, etc. Also in rheumatism and gout; in hepatic diseases, although perhaps here Homburg was surpassed by some of the thermal springs of Bohemia; in female complaints, in which, next to dyspepsia, the most benefit was obtained; and finally, in chronic catarrhal diseases, and in glandular and hæmorrhoidal affections. As to the affections of the skin, the various forms of herpes and impetigo were found especially tractable. Generally speaking, the waters were contra-indicated in all acute and febrile diseases, in organic diseases of the heart and lungs, and in cases with tendency to congestion of the head. The waters should not be used in cases of irritability of the stomach, where it depended on disease of the kidney. In conclusion, Dr Scott mentioned that Artesian wells were being bored, which would add greatly to the present supply; and recommended to the notice of the Society the late work of Frederic Müller on the waters of Homburg. The waters of Homburg contained no bromine, and thus differed from those of Kreuznach. Professor Syme had found that the use of mineral waters generally aggravated hæmorrhoidal affections. As to the case of sudden death mentioned by Dr Scott, he attached little importance to its having occurred after taking the bath; as patients at these mineral springs were so continually going in and out of the baths, it was no wonder that death should overtake them in one or other of these processes, just as it did other people in their beds. He also considered Dr Scott to labour under a popular error, in supposing meat to be most digestible when roasted and boiled. Stewed meats and French cookery generally, he believed to be preferable. Professor Simpson, after inquiring of Dr Scott as to the differences subsisting between our own Scotch mineral waters and those of Homburg, stated that in this country the chief ingredient was muriate of lime. He had latterly seen good reason to adopt Sir Robert Carswell's views with regard to fibrous tumours of the uterus, viz., that they were merely a nodose collection of the ordinary tissue of the uterus, and liable to go backwards, or undergo a species of involution, just as took place in the normal uterus after delivery. If this were the case, the beneficial effects of the waters of Kreuznach were easily explained. Cases, however, he had seen, which had returned to this country without the slightest benefit; and in such the sustained use of bromide of potassium was followed by marked diminution in the size of the tumours; in one case, fully one half. This salt is more potent than the iodide of potassium, and seems to be useful as a tonic as well as a deobstruent. In two cases in his practice it produced salivation. Dr Locock had stated to him that several of his cases had been much improved by the Kreuznach waters. But in a case which had occurred lately in Dr Simpson's practice, no good had followed the use of the waters, though the medical attendant at the place thought otherwise. II. CONTAGIOUS NATURE OF CHOLERA. BY DR TRAILL, OF ARBROATH. This paper presented a well drawn-up history of all the cases of cholera which had occurred in Arbroath during the recent visitation of the epidemic. The cases in all amounted to twenty-six, of which fifteen died, eight recovered, and three were still under treatment. Of the twenty-six, four cases were ascertained to have been imported; in thirteen, communication with infected individuals could be traced; but in nine no communication with infected persons could be determined. In five of the cases, cholera was only fully developed after removal to the House of Refuge; but all the cases were affected with diarrhoea. Of the nurses, one died; and all suffered from diarrhoea. Five of the patients were of dissipated habits; two remarkably so: the remainder consisted of children and of persons reputed sober. In the town itself there is a general want of good dwelling-places for the labouring classes. The water, which is obtained from 1854.] NON-CONTAGIOUS NATURE OF CHOLERA. wells, is abundant, and the soil rests on dry gravel. The sanitary condition of Of the twenty-seven, all but one escaped, and that was an infant; whereas Professor Simpson called on Dr Tait of Dunse to favour the Society with an account of the recent epidemic in that town. Dr Tait stated, that of the ten cases which had occurred he had only seen eight. Between the first and second cases no communication could be traced, but the houses were contiguous. The drainage was bad. Case No. 3 lived about 100 yards from No. 2; he was a railway-guard, and had communication with Newcastle in the discharge of his duties; he suffered from diarrhoea for a day or so, and was drunk the day previous to his seizure. No. 4 was the wife of No. 3. Nos. and 6, the Knoxes, father and daughter, lived in the middle floor of the same house as Nos. 3 and 4, who were waited on by the daughter, and had some clothes washed by her. One old woman who resided on the same floor with Nos. 5 and 6 had no communication with persons labouring under cholera, and escaped: He was the sexton, and had, the same is true of three people who occupied the ground floor. No. 7 lived several hundred yards away from the last cases. on several occasions, assisted the nurse in waiting on those affected. No. 8 was the late Dr Drysdale, who attended all the cases; but on the day of his seizure was more than usually exposed, as for three hours he had to officiate as nurse, and from the extreme jactitation of the patients, was brought into closer contact with them. No. 9 was a woman who came to attend upon the Knoxes, and was No. 10 was the wife of No. 7; she assisted occasionally in Case No 1 was of a delicate frame of drunken habits. nursing; she died of the consecutive fever. of body; while case No. 2 was of intemperate habits. The drainage in the neighbourhood of both their houses was very imperfect. Such facts no doubt gave a strong predisposition. He had remarked the immense number of midges which loaded the atmosphere during the prevalence of the epidemic. In Dunse, the average duration of the disease was from twenty-four to twenty-eight hours. The whole duration of the epidemic was seventeen days, and the number of cases of diarrhoea was twenty. Dr Lowe had also observed an unusual number of midges which seemed to be of different kinds in different epidemics. Shortly after the commencement of the epidemic in 1848, he had observed that the ordinary midges were replaced by Aphides. Dr W. T. Gairdner said that in the last epidemic, he obtained reports from practitioners in various parts of the country; and that he had at one time been engaged in making a summary of these reports. In the course of his study of these reports, he was at first inclined to the opinion that cholera was not contagious; but before he came to the last of them, he was convinced that cholera, although not so communicable as typhus, was still strongly contagious, and that the contagion followed the track of typhus, and could often be traced to the same houses and in the same order; and that sometimes these visitations were not in the worstdrained or most unhealthy parts of the town, just as was also observed in the case of typhus. The second fact to be noted was, that in a large number of cases, the disease could be ascertained to spread after importation, not before it; sometimes a series of cases could be traced to occur, evidently owing to importation, although the importation itself could not be satisfactorily made out. For |