Address on Surgery was read by him. He contributed frequently to the periodicals of the day, and furnished able articles to Dr. Todd's "Cyclopaedia of Anatomy and Physiology."

Mr. Dodd was married in 1832, and has left a widow and four children to deplore his loss. In his domestic relations he possessed very strong affections. He was much beloved by all who enjoyed his friendship, and very highly esteemed by a large circle of acquaintance. He bore his illness with patience and resignation, and met his death with all the fortitude inspired by a Christian's hopes.

Mr. Dodd was many times seen by some of our leading stethoscopists, and as these gentlemen had generally expressed great doubts as to the real nature of his case, he expressed a wish that his chest might be examined, which was accordingly done by his partner, Mr. Marriott, in conjunction with his friends Dr. Engledue, of Portsea, and Dr. Salter, of Ryde. following is the result:

The

Examination forty-nine hours after death. Whole body extremely attenuated. On opening the chest, only a small part of the left lung collapsed. The lungs generally were very much charged with carbonaceous matter, and with the exception of the posterior part of the right lung, studded with tubercles. The pleura pulmonalis and pleura costalis were nearly throughout adherent, mostly by old adhesions. Under the right clavicle the adhesion was densely fibrous, and the corresponding portion of the lung contained also much fibrous deposit, in addition to the tubercles which were more numerous on this side than on the left. The tubercles under both clavicles were in the state of softening, and there were several small cavities; the largest, on the right side, was about the size of a walnut. There was much gravitation in both lungs posteriorly, but principally in the right, where the greater portion of the posterior lobe was gorged with blood and was very friable. There was, however, in this situation neither fibrous nor any other deposit, except the infiltration of blood, nor hepatization or any adventitious growth, though it was in this situation, and this only that disease had been long suspected. The heart was pale and flabby but presented no appearance of disease.

General Retrospect.

PATHOLOGICAL CHEMISTRY. COMPOSITION OF THE BLOOD IN PUERPERAL FEVER.

M. Hersent, who has taken this investigation as the subject of his inaugural thesis, terminates his researches with the following conclusions :—

1. The chief modification of the blood in severe puerperal fever consists in a great increase in the water; great diminution of the globules; and also in very -considerable decrease of albumen.

4. There are, nevertheless, some few cases in which the blood is more fluid than natural, in consequence of a loss of fibrin.

5. It is probable that the vitiation of the blood precedes the development of the disease.-Recherches sur la Composition du Sang dans les Fièvres Puerperales

1845.

COMPOSITION OF THE BLOOD IN CANCEROUS DISEASES.

Dr. Florian Heller has investigated the chemical and microscopical characters of the blood in a case of uterine cancer, and gives the following as the result of his enquiries:

1. The blood-globules are of very variable size, some being smaller, others larger than natural;. the smaller have generally a finely granulated outline, the larger are always smooth. As this condition is also observed in blood containing pus, it is not characteristic of the cancerous diathesis.

2. Cells perfectly analogous in form and size to those which are present in cancerous tumours, are also seen to exist in the blood.

3. The shining particles like fragments of gold are sometimes also met with. These particles vary much in aspect, being either yellowish or bluish, according as the field of the microscope is placed in respect to the light; they are in many cases perceptible to the naked eye, after coagulation of the blood, either in the clot itself, or floating on the surface of the serum.

4. The fibrin is constantly and absolutely augmented in all forms of cancer, whether the blood be obtained from the affected part or from the general system. 5. The albumen is either normal or below par. 6. The amount of solid matters generally is dimiu. ished. Archiv. für Physiologie und Microscopie, 1846.

PATHOLOGY.

ON THE CAUSES OF EXUDATION.

The author of an essay on this subject, Dr. Johu Hughes Bennett, observes, that the term exudation is applied not only to the act of passing out of the liquor sanguinis through the vascular walls, but also to the deposit in the tissues of the fibrinous portion of the blood. This confusion of the act and the result under the same term is, however, a failure in terminology, which is not confined to the point in question. The series of changes which precede exudation, are stated by Dr. Bennett, to be:-1. A narrowing of the capillary vessels, with consequent increased rapidity of circulation. 2. A subsequent dilatation of the same vessels, with retardation of the current. 3. Irregularity and oscillation of the current of blood. 4. The motion of the blood ceases, and the vessel appears fully distended. 5th and lastly, the liquor sanguinis, sometimes accompanied by the blood-cor. puscles, is exuded through the capillary walls, which in the latter case are ruptured.

Dr. Bennett remarks, that this view of the changes preceding exudation, is perfectly in analogy with the 2. These modifications are proportionate to the effect of stimuli on other muscles, namely, at first severity of the disease. increased contraction, and afterwards paralysis, and is

3. The proportion of fibrin is generally unaltered, therefore sufficient to account for the initiatory portion and the blood is therefore not diffluent. of the process, the contraction and dilatation of the

GENERAL RETROSPECT.

vessels, with the increased and retarded flow of the blood, but it does not account for the stoppage of the blood, nor for the exudation.

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3. The third form is that in which cancerous matter is deposited in the interior of a bone, and in its development pushes the bony tissue outwards, which yields gradually, and becomes at length so thin as to form a mere shell, within which the cancerous matter is inclosed. This is the spina ventosà of authors.

4. In this form the cancer is developed external to the bone, and beneath the periosteum. But it is readily seen that the bone is altered; in fact it gives rise to a net-work of osseous matter, mingled with spiculæ, which projects into the cancerous deposit.-Gazette des H6pitaux, Decembre, 1846.

PRACTICAL MEDICINE.

BLISTERS IN CONFLUENT SMALL-POX.

M. Piorry has for some time past derived great assistance from the use of blisters as a means of preventing the scarring of the face by the cicatrices of confluent small-pox. The pus, retained so long in contact with the tissues, and altered in character through the agency of the air which passes through the pustules by endomosis, causes extensive local destruction, and proves very injurious to the system when re absorbed. Various practitioners have proposed measures for obvi

The latter phenomena are generally attributed to obstruction, the blood-globules becoming merged together. This explanation, however, Dr. Bennett considers opposed to observation; for, 1st-the stoppage of blood does not, as is supposed, proceed from one point; and 2nd-the lymph space near the walls of the capillaries is still evident when the blood moves slowly, and only disappears at the moment it is arrested. He then examines the theory advanced by Dr. Williams and Mr. Addison, that the obstruction is due to the generation of a large number of colourless corpuscles which adhere to the sides of the vessel. He observes, that he has long doubted the truth of this assertion, and has recently performed experiments, the result of which convinces him of its fallacy. He thinks that the above named physiologists may have been deceived by the rendering distinct of the nuclei of the epidermic cells in the web of the frog's foot; which nuclei closely resemble the colourless blood-corpuscles. The explanation, the author observes, is also negatived by the recent investigations of Remak, who has noticed that the proportion of the colourless corpuscles is increasedating this inconvenience, as by cauterization of each by abstraction of blood, and that the portions first drawn in inflammation contain very few. Dr. Bennett conclades, therefore, that the cause of the obstruction is yet to be discovered, unless we are content with the bypothesis of increased attraction between the blood and the parenchyma. In the last place, Dr. Bennett criticises the opinion of Dr. Robinson, that exudation is caused by lateral pressure exercised on the walls by the vis a tergo. He denies the trustworthiness of Dr. Robinson's experiment of tying the renal vein, and asks whether the changes in the capillaries are not due to direct mechanical irritation, (drawing the kidney out of the abdomen,) with exposure to the air. Monthly Journal of Medical Science, Jauuary, 1847.

CANCER OF THE BONES.

M. Nelaton, who has contributed materially to the elucidation of this disease of the osseous system, distinguishes four forms of cancer:

pustule, (impossible in the confluent disease,) the opening them by scissors, needles, &c., &c. Experience, however, shews that over such means the blister has the advantage of-1st, opening at one time the whole of the pustules over which it is applied; 2nd, evacuating their entire contents, and preventing the consequences of the sojourn or re-sorption of pus; 3rd, counteracting the attendant erysipelas by diminishing the swelling; and, 4th, causing the scabs to fall off much sooner from the face than from other parts of the body. It has an advantage over mercurial plasters in not risking the excitement of salivation, the extent of evil which results from its use being a slight ischuria. The various plasters applied as abortives in this disease have been reproached with exerting a repellant action, and directing the morbid action upon the brain and its membranes. A blister, on the contrary, rather acts as a derivative.-Medico-Chirurgical Review, Jan., 1847, from the Gazette des Hôpitaux, No. 101.

ALUM IN PERTUSSIS.

1. In the first, nodules of cancerous matter are found in cavities in the interior of bones, which they exactly fill; the osseous tissue is in these points entirely Dr. Davies thus speaks of the employment of alum destroyed. In the vicinity of this loss of substance, the in pertussis:-After a long trial, I am disposed to bone does not appear to have undergone any alteration attach more importance to alum, as a remedy in hoopbeyond a trifling increase of vascularity. As the dis-ing cough, than to any other form of tonic or antiease progresses, the mass of cancerous matter increases spasmodic. I have often been surprised at the speed in size, and at length forms a greater or less prominence with which it arrests the severe spasmodic fits of coughon the external surface of the bone. In the longing; it seems equally applicable to all ages, and almost bones the cancerous matter frequently extends up the to all conditions of the patient. I was formerly in the medullary cavity, a fact which is to be taken into habit of taking much pains to select a certain period account in performing amputation. of the illness for its administration, and of waiting until the cough had existed at least three weeks, taking care that the bowels were open, the patient free from fever, the air-passages perfectly moist, and the disorder free from complication of any bruit. A continued observation of the remedy, however, has induced me to be less cautious, and I am disposed to think, that a very large amount of collateral annoyances will

2. In the second form, the osteo-sarcoma of authors, the tissue of the bone has undergone profound alteration; it presents a voluminous swelling, the section of which exhibitis a number of irregular cellular spaces, filled with cancerous matter, in various degrees of softening. The bony tissue between these compart ments appears to be rarified.

subside under its use. The fittest state for its admin- | extract in the form of pills, from five to ten grains, istration will be a moist condition of the air-passages, | night and morning. In general, if the pills are taken and freedom from cerebral congestion; but an opposite -condition would not preclude its use, should this state not have yielded to other remedies. It generally keeps the bowels in proper order, no aperient being required during its use. The dose for an infant is two grains three times daily; and to older children, four, five, and up to ten or twelve grains may be given, mixed with Syrupus Rhoados and water. It is seldom disliked.— Underwood's Diseases of Infants, last Edition, p. 432.

INHALATION OF ETHER.

FORENSIC MEDICINE.

CLOSURE OF THE DUCTUS ARTERIOSUS. The subjoined conclusions, by Professor Brennt, are quoted from a recent number of the Medical Gazelle :1. If the child has lived only a few seconds, the acrtal end of the duct appears contracted, and the vessel instead of being cylindrical throughout, acquires the form of a truncated cone.

2. If the child has lived for several hours, or a whole day, the duct becomes again cylindrical, although shortened and contracted in diameter. The size is about that of a goose-quill; it is therefore smaller than its root, and about as large as either of the two branches of the pulmonary artery, which have, in the meantime, become increased in size.

3. If the child has lived for several days, or a whole week, the duct contracts to a diameter of a few lines, about equal to a crow-quill; while the two branches of the pulmonary artery are equal in size to a goose's quill.

107

æther, and its being the first time it has been used in this town for any capital surgical operation, (although Mr. Tibbs, the dentist, had succeeded with it for the extraction of stumps of teeth,) I invited the following Smith, Mr. Eves, (one of the surgeons to the Hospital,) members of the profession to be present:-Dr. T. Mr. Dalton, Mr. Ocrell, Mr. Fagan, Mr. Tibbs, surgeon-dentist, Mr. Gregory, and Mr. Peart.

The great importance of this invention as regards should make known all the cases that come under their operative surgery, renders it necessary that surgeons observation, and on that account I have given the full

notes of this one.

managed for me by Dr. T. Smith, (one of the physicians The inhalation of the sulphuric æther was kindly it with a simple gum elastic tube, with an ivory-mouth to the Hospital and Dispensary here,) who administered pipe attached to a damp bladder, placing in it about water. The æther used was Howard's sulphuric, which two ounces of æther, and putting the bladder in warm had been washed and re-distilled by Mr. Smith, chemist, 4. The duct is met with perfectly closed and quite of this town. At first we had some trouble to persuade impervious, at a much later period-i.e., after the lapse the patient to inhale properly, but after a short time, of a very uncertain number of weeks, or even months. and becoming herself anxious to have the operation Among the exceptional conditions, Brennt remarks performed, she did so vigorously, and the ethereal that the contraction may be first observed at the cardiac effect was prcduced in about four minutes from that instead of the aortal end. In one instance of a still-time. She fell back in bed, the arms dropped to her born child which was resuscitated, and breathed freely for a short time, and in which the thymus gland was absent, the duct was found of the size of a crow-quill, as in children which have lived for several days. He also states, on the authority of Joseph Schallgruhu, that the duct is sometimes entirely absent.

NEW METHOD OF DISTINGUISHING ARSENICAL
STAINS FROM THOSE OF ANTIMONY.

M. Cottereau proposes a new proceeding for the above purpose, which consists in submitting the stain to the action of the vapour of phosphorus. The phosphorus is divided into small fragments, and placed on a plate, upon which the porcelain containing the stain is reversed. The experiment is conducted at the ordinary temperature. Spots produced by the arsenic disappear after a few hours, while those of antimony remain from twelve to fourteen days. These also disappear at length, but re-appear as the red sulphuret of antimony, by the exposure to vapour from a solution of hydro-sulphuric acid. Arsenical spots thus treated re-appear with the characteristic yellow of the sulphuret of arsenic.-Gazette Médicale, No. 37, 1846.

OPERATION FOR SCIRRHUS OF THE LEFT

side, the pupils dilated, eyes turned up to the orbit, and sensibility apparently gone.

I commenced my operation, which was performed by two elliptical incisions of about four inches in length, extending fully round the nipple to the border of the axilla, dissecting out the disease; one small artery had to be tied. The operation occupied about two minutes.

After the lapse of six minutes the patient recovered her consciousness, and when asked if she had felt any pain, said, "None whatever, you have not done the operation, you are only deceiving me," and we had some difficulty to persuade her to the contrary; in fact, she would not credit it until I gave her the breast to look at. Since the operation she has been questioned by several parties how she felt, and her answer is, "It was a pleasant sensation, no pain of any kind, and she could not now even believe it possible the disease was cut out with a knife.”

The

The patient had not any bad symptoms from the wether either during its inhalation or afterwards. pulse rose from 80 to 125; she complained shortly after of a little pain in the region of the heart, but this left her in a short time; one wine glass-full of brandy and water was given her after the effect of the æther had

BREAST PERFORMED DURING THE IN. left, and at night the pulse was soft, 100; patient very

HALATION OF SULPHURIC ETHER.

By W. PHILPOT BROOKES, M.D., M.R.C.S., Surgeon to the General Hospital and Dispensary, Cheltenham. Having occasion to perform the operation of extirpation of the left breast for a scirrhous tumour, but in which the glands of the axilla had not become diseased, I gladly availed myself of this the first opportunity I have had of trying the effect of the inhalation of

tranquil; skin moist; complains of some difficulty in voiding the urine. A sedative draught was given her. All the gentlemen present, whose names I have deemed it advisable to give, felt perfectly satisfied that the operation was performed without the slightest sensation of pain or uneasiness, and expressed themselves highly gratified with the result.

On reviewing the cases of operations already performed under the influence of æther, we cannot regard

the invention in any other light than as one of the and above all, not to hurry the operation by the introgreatest boons ever offered to operative surgery, induction of the vapour too rapidly; for, with regard alleviating the greatest distress of mind and body to the success of it, quite as much depends upon the which patients always suffer when they are told they manner of inhaling, as it does upon the operator who must undergo a surgical operation, and it must now administers it. become the duty of every surgeon to watch well I remain, Sir, the progress of this remedy, and judge for himself whether or not it is not capable of being brought into very general use. I am only sorry the talented inventor should have clogged it with a patent, which I trust will never be allowed to stand; he deserves a far higher reward than that of turning it to a mere mercantile production.