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physician, (the viscera of the chest and abdomen are to b:ngured,) whilst with his pencil he perpetuates the results ohis dissections in a manner which has not been previousl;- accomplished. It is promised that each fasciculus (as thi

- does) shall contain four plates, and that each plate shall blaccompanied with two pages of letter-press. The latter consists of a commentary, or practical consideration of the relation which the dissected regions bear to surgical operationsaccidents, injuries, &c. The author is here quite as much ahome as in the more philosophic studies which we had occasion formerly to review at some length. We recommend omreaders to see the work, and judge for themselves. They mayJiave been familiar with the illustrative plates of Blandin 01Velpeau, with the special regional anatomies of Cooper, Law-rence, or Morton, with the anatomy of the arteries by Tiede-mann, R. Quain, or Dermott, these they might believe suffi-- cient for all purposes, but we doubt not that they will here.recognise much that remained to be accomplished. A man.may know well the " minute anatomy of the arteries;" he mayhave studied Swan until his vision became clouded by a ner-vous web; he may have believed himself thoroughly acquainted,with hernia by Cooper; the pharynx and fauces by Law-rence; the axilla or the neck by Morton; but he would stillbe deficient in that information which an examination of the

parts of the body, as constituting the elements of a continuous.whole, could convey; and still more deficient would his know-ledge be, if the relation of the deeper-seated parts to the sur-face had been overlooked, as has too often been the case. Mr.Maclise has been very successful in surmounting this diffi--culty. He justly remarks, that all useful anatomical know-

ledge is that which treats of the relation of parts to eachother; the deep relations are those parts which have attractedmost notice, whilst in many instance sexternal indications

might be made most useful guides to internal organs or parts.The author has therefore in his dissections preserved, and in;his figures displayed, the prominent features of the surface towhich, in his practical commentary, he directs particular at-tention. This is an important feature in the work, which, use-ful to the surgeon when surgical regions are described, cannotbe less so to the physician, when, with his ear or his hand, he.fieeks to explore the condition of the thoracic or abdominalviscera. Some very practical points, as illustrating the author’sstyle and object, might be given, but we prefer to take thework more in continuity, when some numbers of the fasci-culi have appeared. It should be stated that the number is in-tended to be eight, altogether containing thirty-two plates,and each plate two figures, about two-thirds of the size oflife. The price is so moderate, that a most extensive sale canalone remunerate the publisher; and there can be little fearof his disappointment, for the beauty and faithfulness of theexecution of the drawings, the useful, because practical infor-mation of the commentary, and the typographical excellenceof the publication as a whole, in which Mr. Churchill almost.outdoes himself, must command a place for it in the librariesof nine-tenths of the practitioners of this country.

Medical societies

MEDICAL SOCIETY OF LONDON.

MONDAY, NOVEMBER 27, 1848.—MR. HANCOCK, PRESIDENT.

TREATMENT OF CHOLERA BY CHLOROFORM.—EMETICS AND COLD

DRINKS.-IS CHOLERA LEAVING US ? 2

Dr. CL17TTERBUCK, in reference to a communication made tothe Society a few weeks since, said that the cholera hadgradually left the Peckham House Asylum, and that theyhad had no case there since the 16th. The chloroform, in allthe cases which had occurred, had sustained the characterwhich he had given it at first, and it was invariably and-uniformly successful in relieving the more painful and severesymptoms. He did not regard it as a cure for the disease, butit arrested the more imminent symptoms, and gave the pa-

tient time to rally out of the stage of danger. He still re-

garded cholera as not a specific disease, and that no specificremedies were called for.A MEMBER mentioned a case in which the inhalation of

chloroform had been used, with success, to relieve most

painful cramps in the extremities; they were unconnectedwith cholera.Mr. DENDY believed that many cases were returned and

registered as malignant cholera which were simply diarrhoea.He mentioned two cases in point.Mr. SHEARLEY made a long statement with reference to the

treatment of cholera, in 1832, by nitrous acid. This remedyhad been employed with much success, by Dr. Hope, amongthe convicts at Woolwich.Mr. PjLciiER said that however successful the inhalation of

chloroform had been in the asylum at Peckham, it hadsignally failed at Edinburgh.Mr. HEADLAND could not admit that cholera was really

leaving us. Its disappearance from Peckham House did nowarrant us in believing that the disease was retreating. Thehistory of the plague and of other great epidemics showecthat many cases occurred before the great outbreak came onand he believed that in this instance the cholera had hardlyas yet, reached us. He agreed with Mr. Dendy respecting theerroneous returns which were occasionally made as to thedisease, and mentioned an instance in which a case of tape’worm was registered as cholera. With respect to chloroform,it was extraordinary that a remedy so generally known had notarrested, to some extent at least, the disease in Berlin and Viennain which cities the mortality from the disease was very great.We yet know scarcely anything of the nature of cholera.What was it ? It was an error to suppose that it was a dis-ease merely consisting of vomiting and purging, which were,in reality, the mere symptoms of a diseased condition of thesystem. The following might be regarded as the summary ofour knowledge regarding treatment:-1. By stimulants, iin-satisfactory ; 2. Calomel, unsatisfactory; 3. Emefics alone thebest treatment, less satisfactory when combined with calomel.The more simple the treatment the better. What was theexperience of members respecting warm applications to thesurface, particularly warm baths ? Mr. PILCHER said in Berlin the cold douche was applied

with the view of bringing on re-action. It had been ascer-tained by the Germans, that the mucous membranes through-out the body in cholera were all similarly affected, all ofthem being attacked, and the epithelial cells removed.Mr. STEDMAN had seen much of the cholera in 1832-the

nitrous acid was a scarcely more successful application thanany other. It formed with water a grateful drink.Mr. HIRD spoke of the necessity of arresting the profuse

diarrhoea in cholera, and eulogized the treatment by acetateof lead, and minute doses of opium, as prescribed by Dr.Graves, of Dublin. He agreed with Mr. Headland as to thevalue of emetics in producing re-action. He knew nothingof the warm bath in this disease, but had found benefit fromfrictions with mustard.Mr. DENDY said it might be and was necessary to arrest the

profuse diaphoresis of the intestines" in cholera, but stillthat was not curing the disease, the cause lay deeper. Hemade some remarks on the value of giving cold drinks inlarge quantities, to supply the fluid parts of the blood carriedoff’by the intestines. The warm bath was injurious.Mr. STEDMAN considered the free use of cold drinks bene-

ficial. Hot baths were injurious.Mr. HEADLAND said that the diarrhoea would go on as long

as the cause of cholera continued in the system. He believedacetate of lead of little or no use, and contended that, inrecommending this medicine in cholera, Dr. Graves had con-tradicted himself, for he had said acetate of lead was of nouse in diarrhosa, except when it was accompanied by tympa-nitis. Now in cholera there was no tympanitis. It wasremarkable that when vomiting was most persistent, in thosecases the diarrhoea, was less.

WESTMINSTER MEDICAL SOCIETY.NOVEMBER 18, 1848.—J. WEBSTER, M.D., F.R.S., PRESIDENT.

MORBID APPEARANCES FROM SUFFOCATION.

Mr. CANTON gave a detailed account of certain morbid ap-pearances which he had met with in the examination of the! bodies of three children, two of which had been " overlain,"and the third intentionally suff’ocated. Each case had beenthe object of judicial inquiry. The subjects were only a few

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months old. E-clerio2- of the body: Features placid; lips con-gested ; eyes not unduly prominent; conjunctives rather extravascular; hands clenched; no blotches of ecchymosis to beanywhere detected.—fec; Patches of effused blood, here andthere, beneath the pericranium ; cranial bone en withblood. In two cases, great congestion of the pia mater, ac-companied by numberless subjacent sanguineous extravasa-tions, varying in size from a pin’s point to a silver penny inall its superficial extent: no such cifusion within the brain orits contained membranes; a little clear flt:ic1 in the ventricles.In the third case the intra-cranial appearances were natural,whilst those of the skull bones and pericranium were thesame as described. A little clear frothy mucus in the tracheaand bronchi, with redness of their lining membrane.—y/MM’CKC;No fluid within, or adhesions across, the pleural cavities.Lungs much congested and crepitant, whilst beneath thevisceral and reflected pleurae, blood had been everywhereeffused, presenting numerous small bright red patches, andfine points; all the blood of the substance of the lungs waswithin its vessels. The pericardium contained some serum,and was spotted in its whole extent after the manner de-scribed ; the vasa vasorum of the heart’s great vessels andthoracic aorta were minutely injected. In one case therewas a large quantity of blood extravasated posteriorly, andespecially on the left side, in the groove between the auriclesand ventricles, as though the coronary vein had been rup-tured ; this latter point, however, was not ascertained. Inthis instance, too, the substance of the heart, particularly itsleft ventricle, was so soft as to become readily pulpy on slightpressure between the finger and thumb. The right cavitiesin all the cases were replete with dark, liquid blood; the leftones nearly empty; the tissue of the organ free from extrava-sation. The surface only of the thymus gland was mottled likethe heart. No unnatural appearance within the abdomen.Mr. Canton inquired if any member of the Society had metwith similar appearances in these cases, as those relating tothe ecchymosis were not, he believed, mentioned by medico-legal authorities.

Dr. MtmpiiY suggested that the appearances might havebeen the result of enlargement of the thymus gland.Mr. CANTON said in only one case was this gland enlarged,

and no symptom of such state existed during life.

HERNIA OF THE HEART.

Mr. HIRD exhibited a specimen of a portion of pericardium,on the right side of which was a pendent cyst, communicatingwith the cavity of that membrane by a slit-like opening. Thepreparation was obtained from a dissecting-room subject,aged sixty-five years, and no history was attached. Sixounces and a half of fluid were contained in the pericardiumand cyst together. The walls of the latter were composed ofpleura externally, and serous pericardium within. The sur-face of the heart was rough from an old effusion of lymph, andthe mitral valves presented vegetations.

ON GOUT AND PHTHISIS.

Dr. GARROD read a paper on the simultaneous progress ofcases of gout and phthisis. He was induced to bring thissubject before the notice of the Society, as in a paper onphthisis, communicated during the last session, it was assertedthat a gouty condition of the system or blood was inimical tothe development of tubercular disease, and it was suggestedthat, for the purpose of preventing or curing the latter affec-tion, an attempt should be made to produce a gouty diathesis;and even the internal administration of urate of soda washinted at. Dr. Garrod first spoke of some recent researcheshe had made on the subject of gout, which will appear in thevolume of the Transactions of the Royal Medico-ChirurgicalSociety now in the course of publication, and described whathe considered to constitute a gouty condition of blood,alluding to the presence of an excess of uric acid, before andduring the paroxysm, in acute gout, and as an almost constantaccompaniment in those forms of the disease where tophaceousor chalk-like deposits take place in different parts of the body.Dr. Garrod then stated, that if the gouty and tubercular- diathesis were antagonistic, plithisis would never becomedeveloped in the inveterate forms of gout above alluded to.To prove, however, the fallacy of the idea, the following casewas related:-A young man, aged twenty-eight, a native ofLondon, whcse father and grandmother had suffered fromgout, applied for relief at University College Hospital, andwas admitted, under the care of Dr. Williams. He was a

painter by trade, and for some years he had been of veryintemperate habits, but until the last few, had had plenty of

food and clothing. From the age of seventeen, he hadsuffered from what lie termed rheumatism," (gout ?) buthad had an affection of the heart with it. Formerly, hewas of full habit, but about three years since, began tolose both flesh and colour, although he did not feel parti-cularly ill, and had no cough at the time. . IIe was soonafter seized with an attack of gout, both in his feet and hands,tophaceous deposits formed, and he was confined to his bedfor twenty-eight weeks. About two months after his reco-very, he was again attacked, and then had a severe cough,with expectoration of a greenish hue. The pectoral symptomscontinued for about four months, the gouty two months longer.From this date until his admission into the hospital he wasconstantly suffering from chest affection and gout; haemoptysishad occurred once, and deposits of urate of soda frequentlycame away from his joints. When admitted into the hospital,he was pallid and emaciated; complained of pain in variousjoints arising from gouty inflammation; also of pain in hisside, cough, and expectoration of a muco-purulent character.On physical examination, clear evidence was found of the exist-ence of tubercular deposition in both lungs, especially the left,at the apex of which, a distinct cavity was indicated by theproduction of pectoriloquy and cavernous respiration; duringthe remaining month of his life, the gouty affection continuedto progress, now appearing in one part, now in another, andoccasionally with the discharge of urate of soda from some ofthe joints. The thoracic affection also continued to advance,accompanied with hectic symptoms, increase of cough, andsharp pain in different parts of the chest, until he fell into astate of stupor, and so continued for a day or so, when deathtook place. The post-mortem appearances fully proved theaccuracy of the diagnosis. At the apex of the right lung acavity was found, large enough to contain a walnut, the restof the lung being studded with scattered tubercles in differentstages of development. The apex of the left lung was ex-cavated to the depth of four or five inches, and the remainingportion was sprinkled throughout with grey tubercles. Theheart was healthy; the liver had patches of soft tuberculousdeposit on its surface ; the kidneys were small, and many ofthe tubuli filled with a white matter, consisting of crystallizedurate of soda and uric acid; spleen enlarged. Mucous mem-brane of the colon ulcerated in patches. An examination ofthe blood was also made, and it was found to contain a verylarge amount of uric acid, larger than Dr. Garrod had everbefore obtained. Some remarks were then made on othercases, in which gout and phthisis existed together ; therarity of the combination being easily accounted for by thefact, that gout in general does not appear till after the age offorty, whereas tubercular disease is much more frequent be-fore that period. It also appeared very doubtful to the -

author whether, granting the correctness of hypothesis ad-vanced in the paper alluded to, a gouty condition of bloodcould be induced by the internal administration of urate ofsoda.A discussion of some length ensued, which we cannot find

space for. ___

SATURDAY, NOVEMBER 25, 1848.—MR. HIRD, PRESIDENT.

DR. WEBSTER made some

, REMARKS ON THE STATISTICS, PATHOLOGY, AND TREATMENTOF PUERPERAL INSANITY,

and entered into several elaborate yet interesting statementsrespecting the frequency of puerperal insanity compared withother varieties of mental disease. To illustrate this point, hestated, that in 1091 curable female patients recently attackedby insanity, and admitted into Bethlem Hospital, during thelast six years, 131, or one eighth of the whole, were puerperalcases; thus showing the malady is not so unfrequent as manymay perhaps believe. Again, as to the curability of this formof mania, more recoveries were reported than in the othervarieties of lunacy; 81 puerperal patients having been cured,or at the rate of 61.83 per cent.; whereas the average reco-veries during the last twenty years, in all cases of insanefemales treated at this institution, was 53.67 per hundred.Hence, three in every five cases of puerperal insanity may beconfidently expected to get well within a year. In regard tohereditary tendency to mental disease, 51 of the 131 patientswere so predisposed, or 39 per cent.; whilst 41 were suicidal,being at the rate of 31 in every 100. l3oth these peculiaritiesare of much importance in this malady, and materially influ-ence the disease, its progress, and result. The total deaths inthe 131 puerperal patients amounted to six, or four and a half