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of the Transactions; and the introduction of a new paper, con-taining additional matter written in 1846, and exceeding inlength the first paper, under pretence of " explanations of theplates; and, lastly, the modesty of Dr. Todd in referring, inthe report on Mr. Beck’s paper, to " the work of Todd andBowman," and dividing between himself and Mr. Beck theproperty of other anatomists. The mutual connexionsbetween the spinal nerves and the ganglia has been taught inthe schools for years; and the division of the credit of itbetween Mr. Beck and Dr. Todd, the latter being the

umpire, is a tolerable specimen of anatomical modesty and thepuff circumstantial. ’ Truly, the whole transaction, from thecommencement of the dissection to the publication of thepaper, is in admirable keeping !

MEDICAL SOCIETY OF LONDON.

MONDAY, OCTOBER 19TH.—MR. DENDY, PRESIDENT.

DIABETES INSIPIDUS.

THE discussion on Mr. Pilcher’s case was resumed.Mr. STEDMAN could not understand in what way the brain

could produce the disease, as supposed by Dr. Clutterbuck.He was more inclined to the opinion, that the renal vesselsmight have been congested and enlarged, and have producedthe inordinate action of the kidney.

Dr. CLUTTERBUCK considered that our observations alltended to prove that the brain was the seat of voluntary mo-tion, intellect, and sensation. Now, as he had said, therecould be no disorder of function without the organ whichmaintained that function being disordered. When he spokeof organic disorder, it did not necessarily imply change ofstructure, for there might be disordered action of an organwithout change of structure. He reprobated the unsatisfac-tory mode of treatment which had been resorted to, andconsidered that the symptoms which presented themselveswere sufficient, to warrant us in inferring that they had theirorigin in the brain, and to account for the fatal termination.The paralysis of the bladder, and the convulsions, sufficientlyindicated the brain to be affected. There were no abnormalappearances in any other organs sufficient to explain thedisease, which he believed might very well be questioned tobe diabetes. The kidney was not diseased; the intestineswere onlv " torpified;" the liver was unaffected; and thestomach did its dutv. He did not believe that the diseasecould be explained by reference to any chemical changes inthe fluids.Mr. STEDMAX could not regard the opinion expressed by

Dr. Clutterbuck to be correct. He could understand, how-ever, that irritation of the kidney, by reflex action, mightirritate the cerebellum.Mr. PILCi3Etx regarded the terms, functional and organic, as

very useful, and was willing to admit that there could be nodisorder of function without organic disorder, not necessarilya change in the substance of the organ; the fluids only mightbe affected, and no change be detectable after death. Thischild had, no doubt, died of brain disease; but this had beenthe result of previous disease in the system. The heart, too,beat violently; but this depended on the ansemiated conditionof the body,which had its origin in the urine drawing off so muchof the nitrogenized constituents of the blood. There hadbeen no symptom of brain disease, until a few hours beforedeath, and the effusion observed post mortem he believed wasthe consequence, and not the cause, of the death. The changein the kidney was the consequence of the excessive secretionof that organ, and might have originated in the nervoussystem of that gland. Taking all the circumstances into con-sideration, he thought that the apparatus of digestion andassimilation was the first affected. There had been no palsvof bladder, no convulsion, except just before death. The brainin its functions was remarkably healthy.

Dr. TnEopHiLrs THOMPSON thought that if the brain hadbeen in a normal state, it would have been materially affectedby the change in the circulating fluid. Might we not draw an,inalog.v between this case and one of hysteria, in which thereis a great secretion of urine ? He thought, with Dr. Clutter-buek, that the symptoms had been dependent on some ma-terial change in the nervous system.

Dr. GARROD said, that in hysteria and softening of the brainthe urine was increased in quantity, though it was usually

normal in quality, or of lower specific gravity than natural.In this case there was an enormous increase in the nitrogen-ized products of the urine.

Dr. CHowjfE observed that in mania, generally, it was re-markable to observe how free from disease the patient was.Brain disease was more frequently induced by disease in otherorgans than nee versa. There was always change of matterwhen there was change of function. The state of the digestivetube in this case was sufficient, in his opinion, to explain theorigin of the disease, without speculating as to a more occultcause.

Dr. G. 0. REES said, that Dr. Sutherland had lately observedthat an alkaline condition of the urine was a frequent accom-paniment of cerebral disease. He did not think, in the caseunder discussion, that disease of the brain had been the causeof the inordinate action of the kidney. He regarded the caseas one of diabetes insipidus in an advanced stage, in whichuric acid was found in the urine instead of urea, in conse-quence of the deficiency of the red particles of the blood notcontributing sufficient oxygen to form urea.Mr. HEADLAND regretted that the brain had not been

examined, though he did not expect that it would have thrownmuch light on the cause of the disease. He was inclined tolook to some defective action of the skin as thefons et origoof the disease.

A CASE FOR A "COURT MEDICAL."

To the Editor of THE LANCET.

SiB,—As you are always ready to make your valuablejournal a medium for the redress of the private grievances, aswell as of the public wrongs, of the profession, I beg toforward you the following particulars, feeling assured thatyou will act as an upright umpire between man and man, andgive such a judgment as you may form from an unprejudicedperusal of my statements.By the desire of the parents, I had engaged to operate on

the eyes of a child named B-, the subject of congenitalcataract, and only waited to name a day on which to performthe operation, when I was called on by the mother of the

. child, and, to my surprise, informed, that Mr. I- (anothermedical man, residing in this town) had visited her child, andsaid he would perform the operation.

I questioned her closely as to whether she had sent for Mr.F——, to which she answered, " she had not." I then askedher, whether she had stated to Mr. I- that I had engagedto undertake the operation, to which she replied decidedly inthe affirmative, and said, " she had called (to use her ownwords) lest I should be angry with her, as I had agreed tooperate on her child, and had always attended her before; andthat she was still anxious for me to perform the operation."I at once told her, that as Mr. I- had interfered so un-warrantably in the case, I should not have anything more todo with it. The operation was accordingly performed byMr. F——.

It may be proper to state, that the parents are paupers;that my partner, Mr. Perks, is medical officer to the districtin which they reside, and as his substitute, I had frequentlyattended the family.

These, Sir, are the facts of the case, and for their accuracyI hold myself responsible. I bring them before you and thepublic to show, that such breaches of professional etiquetteare not to be committed with impunity, as well as to give theaccused an opportunity of refuting publicly what lie has failedto disprove in his private communications with me on thesubject-viz., that he visited the patient without being sentfor, and performed the operation, knowing that I had pre-

.

vionsly engaged to operate.Should you think it necessary to publish the correspondence,

I shall have much pleasure in forwarding it.I have the honour to remain, Sir,

Your obedient servant,W. PHILSON, M.D., M.R.C.S.E.

* * * BVe do not desire to devote our pages to personal con-

troversies, and therefore decline to ask our correspondent for

any copies of the correspondence alluded to ; but we recoiii-mend him, in conjunction with Mr. F-, to submit the arbi-tration of the matter to such a professional board as he willfind described in THE LAXCET for September 12, (present vol.

p. 334.)