results are but moderately satisfactory Other cases have been recorded in the journals, and in time a sufficient number of experiences on the matter will be brought together (perhaps in a future pamphlet by Mr. Broadbent) to enable the profession to form a judgment of this method. While we refrain from expressing any sanguine hope as to the value of this particular treatment, we hail all such suggestions as steps towards the ultimate discovery of a method, or methods, to check the growth of this most fearful disease; especially where, as in the present instance, they are free from all suspicion of the "charlatanism, quackery, and imposture" which Mr. Broadbent deprecates in his quotation from Lavater. Mr. Broadbent has given a stimulus to other observers, and we are aware of various fresh efforts which are being made to solve the important problem of the curability of cancer. Of the results of these investigations it will be our duty to keep our readers duly informed from time to time.

A Treatise on the Practice of Medicine. By GEO. B. WOOD, M.D., LL.D., &c. 6th Ed. 2 Vols. Philadelphia: Lippincott & Co. 1866.

WHEN a book has reached the sixth edition what more need be said about it. We have examined this one carefully, and find it brought fully up to the level of the day, and in every respect fitted to maintain the high position already attained by this favourite class book.

PART III.

MEDICAL MISCELLANY.

Reports, Retrospects, and Scientific Intelligence.

PROCEEDINGS OF THE PATHOLOGICAL SOCIETY
OF DUBLIN.a

DR. R. W. SMITH, President.

Popliteal Aneurism.-DR. FLEMING said that the case which he begged to lay before the society was one of popliteal aneurism, in which the treatment by compression was apparently advancing satisfactorily, although slowly, when, suddenly, the aneurism became diffused, and it was decided to tie the femoral artery. Suppuration of the sac subsequently supervened, and violent hemorrhage having taken place into it, amputation of the thigh was performed.

The subject of the case was a man aged between thirty and thirty-five years. He had been a guard on one of the Irish railways, and about twelve months back, whilst engaged at his usual duty, forcibly pushed his right foot against the door of a third class carriage in order to shut it, when he felt a most painful sensation in the ham and on the outside of the corresponding thigh and leg, extending to the foot,

Although suffering much pain he continued for two or three days at his employment, when, at the end of that time, he perceived a small tumour in the popliteal space about the size of a bean. This tumour gradually increased, yet he continued at his work for the succeeding six months, at the end of which period he was obliged to apply for relief, and was admitted into the Richmond Hospital in the last week of June. All the essential features of aneurism of the popliteal artery were present. The tumour was about the size of a large orange, and occupied the inferior angle of the popliteal space. It was uniformly smooth on its surface, had a strong expansive pulsation, and a distinct systolic bruit. These signs were completely controlled by pressure on the femoral artery at the pubis; and the sac of the aneurism, moreover, was completely emptied.

• These reports are furnished by the Secretary to the Society.

rapidly refilling on the removal of the pressure. The man was tall in stature, had an anemic look, and from his history was decidedly of a rheumatic habit. During his stay in hospital he had repeated attacks indicative of this diathesis at irregular intervals, which necessarily interfered with the treatment of the aneurism. The sounds of the heart were natural; its action, however, was feeble and unsteady, and he had precordial uneasiness, with occasional faintness, almost amounting to syncope. Shortly after his admission into hospital he suffered considerable abdominal uneasiness, often specially referred to the left lumbar region, and accompanied by symptoms strongly simulating the passage of a renal calculus, and materially influencing the condition of the urine from the large amount of lithates present. These symptoms yielded to ordinary remedies; and on their subsidence the treatment of the aneurism by compression was carried out in the most extended application of that term. Throughout it there was not the slightest indication of œdema of the limb, and the pulsation of the tibial artery was perfectly ascertainable. There were occasional interruptions to the compression from local annoyances unnecessary to particularize; when, in the beginning of September, a most obvious change had taken place in the aneurism. It was diminished in size; it was solid in consistence, and its pulsation was extremely feeble; in fact, there was every reason to anticipate its ultimate cure; and my colleague Professor Smith, entertained the opinion that a cure would be effected in the same manner as in a case lately under his care, where the remnant of the aneurismal sac permitted of the passage of the blood through it, a small pulsating tumour being persistent.

About this time it became quite evident that the aneurism had given way, not alone from the sensation of the patient, but also from the altered condition of the popliteal region. Pulsation was distinctly traceable in it, but there was a tense swelling, which not alone occupied the ham, but also extended along the inner and lower fourth of the thigh and the upper part of the calf of the leg. Deligation of the femoral artery was decided upon; and it may be here remarked that the several stages of the operation were materially complicated by the local effects of the compression, which, influenced not alone the depth of the artery from the surface but also the condition of the sheath, the areolar tissue between the artery and the vein being deeply ecchymosed. Two arteries were tied, the first in the line of the femoral, with its anatomical relations, obvious to all present, only producing a temporary suspension of the pulsation in the aneurism, when a second was discovered, external to, and on a place posterior to it, around which a ligature was passed, completely and permanently obliterating the pulsation in the aneurism.

The progress of the case for the succeeding fortnight was most

satisfactory; and at the time of the separation of the respective ligatures— one on the 14th, the other on the 18th day—every hope was entertained that the absorption of the contents of the diffused aneurism was being effected, when the ordinary signs of suppuration of the sac manifested themselves. An opening was made into it, and a quantity of dark grumous fluid, mixed with a few flakes of coagulated blood, escaped; and again, from day to day, sanguine hopes were being entertained of a favourable result, when, suddenly, it was accidentally perceived by the man that some fluid was passing along the limb, and on examination all about was found saturated with bright arterial blood. The hemorrhage was temporarily controlled; but quickly recurred, and escaped by large masses of semi-coagulated blood. There was now no alternative, amputation of the thigh alone affording any prospect of saving life.

Dr. Fleming now directed attention to the prominent pathological features disclosed by the dissection of the amputated limb. The amount of oedema was trifling. In the calf of the leg betwen the gastrocnemius and soleus muscles an enormous sac, filled with dark coagulated blood, was visible. It extended throughout the popliteal space, and along the inner hamstring muscles, completely obscuring the artery and vein, and the aneurismal tumour, now reduced to the size of a walnut. There was a rent at its inferior portion, and a total deficiency of arterial structure for at least an inch and a-half between it and the posterior tibial artery. The popliteal, about two inches above the sac, presented two small aneurismal dilatations. The remainder of the sac contained laminated coagula.-November 24, 1866.

Gangrene of the Lung.-DR. LEET exhibited a recent specimen of gangrenous abscess of the lung taken from the body of Corporal King, 9th Lancers, who was admitted into the General Military Hospital, Dublin, November 10, 1866, from his Regimental Hospital, Arbourhill, with the statement that he was a well conducted soldier, of temperate habits, and had been in hospital six days with influenza; but severe rigors having set in on the 8th instant, he was sent up to the garrison fever wards.

On admission he appeared like a man in delirium tremens; face flushed; eyes congested; tongue coated with moist white fur, and trembling when protruded; skin hot and sweating; pulse 110, soft and easily compressible; bowels confined; manner excited; constantly asserting that he sees faces looking at him through the windows. Careful examination of the chest fails to detect anything abnormal in the physical signs, beyond a few sonorous râles in both bases posteriorly. He has had no sleep for two nights.

November 11.-Tongue and skin same as yesterday; had one thin

motion; heart's impulse feeble; pulse 112, irregular; bronchial râles increasing, but no dulness on percussion; urine scanty, deep red colour, no deposit; prostration considerable.

November 14.-Several large maculæ, fading under pressure, are observed coming out to-day on the trunk; all the symptoms of well marked typhus fever are now present; urine daily measured and examined, contains excess of urea.

November 17.-During these three days the fever has been increasing in severity; prostration greater; has constant muttering delirium; tongue coated with brown fur; unable to sit up from feeling of syncope; secondary pulmonary congestion not increased; chest has been examined every day.

November 19.-Marked improvement in the general strength, and the eruption is not so livid, though it is now permanent under pressure, and a few petechia have appeared on the chest posteriorly. He complains of severe catching pain, during inspiration, below the right nipple. There is no dulness on percussion, but a loud coarse friction sound at that point, and posteriorly over lower half of right lung; well marked comparative dulness; bronchial respiration and bronchophony; the sonorous râles, so distinct yesterday morning, have disappeared; respiration audible throughout left lung, accompanied with muco-crepitating râles; respiration 36; pulse 112, feeble as usual; has occasional distressing paroxysms of coughing; expectoration very scanty; frothy mucus.

November 21.-Was seized with severe rigors, followed by sweating; at 11 a.m., he says the chest pain is now slight, but he has difficulty of breathing. A physical examination of the chest, gave the following:Right side-posteriorly, slight comparative dulness; the bronchial respiration and bronchophony have given place to coarse vesicular breathing and intense moist râles anteriorly; at seat of pain all friction sounds gone; respiration almost inaudible from clavicle to mamma, and percussion note remarkably clear; left lung congested as usual; sputa scanty, purulent, not fetid; extensive suppuration in the cellular tissue around the left parotid gland; the abcess was now lanced, and discharged healthy pus.

November 25.-During the last four days the poison has been getting the mastery, and nature giving ground, ague-like paroxysms are continuing; prostration is very great. It is to be regretted no examination could be made posteriorly, as no doubt the physical signs would then clear up the diagnosis, but he implored not to be moved on to either side, the coughing would become so distressing and the chest pain so intense. The front of the chest has been daily examined, the percussion note, from clavicle to nipple, has been increasing in clearness, and is now decidedly tympanitic; respiration is quite inaudible, and no amphoric phenomena present; delirium, brown tongue, dusky face, livid eruption, and dark