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pint of fluid, like pure blood with a vermilion froth on the top,in the porringers at the bedside, mixed with a certain amountof saliva. On examining his mouth, it was found to be filledwith clotted blood, which adhered to the gums. On removingthese clots, some half-dozen black vesicles were seen on thetongue, of the size and shape of split-peas, from which bloodwas seen to ooze. Over the whole of his body were numerouspurpuric spots. His urine contained blood and albumen ; butno blood was discovered to have passed from the bowels. Hedid not complain of pain, nor indeed was he so exhausted asone might have supposed after the severe haemorrhage that hadoccurred. His appetite was good, and his bowels were opennaturally. He was ordered ice; sulphuric acid and turpentinedraughts ; with a mouth-wash of logwood, catechu, and sul-phuric acid. His diet consisted of beef-tea and milk alter-nately every two hours.On February 3rd there was very little improvement, but his

colour and pulse did not fail. He was ordered to keep in hismouth occasionally a lump of ice coated with powdered tannin.

Feb. 4th.-Much about the same, but somewhat weaker.Haemorrhage from mouth still continued, though the blood wasdiscoloured by the tannin. Pulse 108, quicker and weaker,also uneven. Ordered an ounce and a half of infusion of digi-talis every three hours. Sulphuric-acid and turpentine draughtsemitted.5th.-Evidently much weaker. The haemorrhage had not

diminished. Pulse in the morning 120; in the afternoon 110,regular and even, but narrower. He also complained of sorethroat, nausea, and faintness. Digitalis draughts were orderedevery four hours, instead of every three hours. In the courseof the evening his breathing became short and difficult, and hesank early on the morning of Feb. 6th.

Autopsy, two days after death.-The body was that of awell-formed man, and not emaciated. The skin was remark-ably pallid. The whole front of the body was covered withpurpuric spots, those on the chest having pale-yellow centres.There were but few spots on the back. The pericardium, smallintestines, bladder, bronchi, trachea, and larynx were studdedwith numerous purpuric spots. On the upper part of the larynx they were very numerous, and on the fauces and back of the I

tongue formed a continuous discoloration. On the tongue they Iwere black and swollen, and blood oozed from them on itsbeing handled. The heart was hard and firmly contracted ; onits external surface were numerous purpuric spots. The lefrauricle contained firm but non-adherent clots of fibrin. Theventricles were not opened, because it was determined to pre-serve the heart as a pathological specimen. All the other organswere normal in appearance.

WEST LONDON HOSPITAL.CASES OF GASTRALGIA AND IRRITABLE STOMACH ; USE OF

THE PURIFIED OXIDE OF MANGANESE.

(Under the care of Dr. GODDARD ROGERS.)FROM the perusal of Dr. Leared’s observations on manganese

as a remedy in disease of the stomach, Dr. Rogers was led tomake a trial of this drug in cases of obstinate dyspepsia. Twoof the patients in the following cases suffered from gastralgia ;one from uterine derangement and sympathetic irritation of thestomach ; and in the fourth, the discomfort after meals wasprobably caused by exalted sensibility of the mucous membranein the manner described by Dr. Leared.M. S-, aged twenty nine, a florid-looking married woman,

had been under treatment for severe pain at the scrobiculuscordis, with occasional vomiting, since the latter part ofNovember, 1863. Various remedies had been tried, none ofthem affording more than temporary relief. Dr. Rogers pre-scribed for the patient oxide of manganese in doses of ten grainsthree times a day.

Jan. 12th.-Tht’re was some difficulty in persuading her topersevere with the medicine, as she complained of its extreme" grittiness."15th.-Has had no vomiting ; less pain. To leave off eating

supper, but before bed-time to take a dose of the mixture.19th.-No pain after meals yesterday; bowels costive. To

take a senna draught immediately.29tb.-Has not felt so " light and cheerful" for months, and

is full of profuse expressions of gratitude. No nausea aftertaking the medicine.

Feb. 9th.-I discbarged cured, but recommended to continuethe mixture once a day for another week.

J. C-, aged thirty-four, employed in the main-drainage’works. Had symptoms very similar to the above, for which,he had been treated early last autumn at the hospital, but soondiscontinued his attendance. He came again on Jan. 19th,anc6attributed all his " queer pain" to the beer he drank, but couldnot make up his mind to forego his favourite luxury. Th&

manganese was given in doses of ten and fif een grains threetimes a day, the diet not being altered in the least. On the9th of February he was discharged well, having taken altogethersixty-two doses of the manganese.H. D-, aged twenty, a young woman of nervous tempera-

ment. Suffers from leucorrhoea, and a few months since wasin the hospital under the care of Mr. Bird, who removed &

vascular excrescence from the urethra. In addition to leucor-rbcea, she complains of hypogastric pains, disrelish for food,and considerable thirst. There is constant pain at the epi-gastrium, and occasionally rejection of the food immediatelyaftt-r it is swallowed. Dr. Rogers contemplated giving theoxide of silver, but the manganese has already done so much torelieve the gastric irritability that it is hoped a persistence inits use will effect a cure.The fourth case is that of A. G-, aged twenty four, a

laundress, who had constant heartburn and great discomfortafter every meal, most likely attrioutable, as before stated, tounduly exalted sensibility of the mucous lining of the stomach,arising either from an irritable condition of the nervous fila-ments, or from excessive secretion of gastric juice, accompaniedby increased vascularity. This patient was also troubled withshifting rheumatic pains. The uterine functions were regular;the bowels rather costive; tongue dirty. Bismuth gave no reohef, and the mineral acids and bitter tonics were tried, butwith no good effect. At times she was compelled to leave offwork for a week together. Hydrocyanic acid and soda palliatedthe symptoms, but she was soon as bad as ever. On the 15thof January she commenced taking the oxide of manganese inten-grain doses three times a day, and steadily continued it upto the 9th of February, when she stated that she was free fromall uneasiness, and was about to take a new situation.These four cases, which are not picked ones, but such as

come before the hospital physician every time he attends in the-out-patient rooms, are intended further to illustrate the effectsof a valuable agent which Dr. Leared has already so success.fully employed in the treatment of certain forms of dyspepsia.Its comparative cheapness is, as Dr. Leared says, a great reocommendation for hospital practice. Independently of this,however, there is a strong probability that Dr. Leared is cor-rect in affirming its superiority to bismuth in many cases ofgastralgia.At the West London Hospital the purified oxide of man.

ganese is procured as originally recommended from Messrs.Garden and Robbins, of Oxford street. It has not yet been?exhibited in the form of powder, but as a draught; the com.pound tragacanth powder being used to suspend the manganese.It may be as well to mention that Dr. Neligan has recom-mended the sulphate of manganese in dyspeptic affections andbilious disorders, not with a view of sheathing the mucous sur.face denuded of its epithelium, which is Dr. Leared’s aim, but.of promoting increased biliary secretion.

Medical Societies.ROYAL MEDICAL & CHIRURGICAL SOCIETY.

TUESDAY, FEB. 23RD, 1864.MR. PARTRIDGE, PRESIDENT.

As soon as the Honorary Secretary had read the minutes ofthe preceding meeting of the Society,

JM r. HuLKE rose and said that he wished to enter his protestagainst a proceeding which had taken place at the last meeting.His paper had then been read out of the order which had been-announced in the journals and elsewhere, and without anynotification of the intention to do so having been made to him.He had no personal feeling in the matter, but as a principle itwas bad to read a paper in the absence of the author when itrcould be avoided. Had he been informed that his paper-wouldbe read, he might have illustrated it by diagrams ; and he-thought some law should be in force on the point, and that itwas the duty of the secretary to acquaint authors when theirpapers would be read.