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the parts will have been produced as will render the limbstrong and serviceable.The examination of the part showed, that, in the present

case, the removal of the bone was the only operation likely tobe attended with benefit. The four openings were found tolead to one cavity, which was occupied by a piece of dead, re-ticulated bone. Below this, for about an inch, the bone wassolid, no trace of a cavity, or of cancellated structure existingin it. At the inferior part of this solid portion began a narrowtubular cavity, which was an inch long, and not more thanthe fifth of an inch wide. This cavitv had no connexionwith the upper and larger one, nor had it any communicationwith the surface of the bone. It contained a long fine spiculaof dead compact bone.Had the operation consisted in the mere removal of the

larger sequestrum, the only one of which the existence couldbe ascertained before the operation, there would still have re-mained this lower fragment, an almost certain source of con-tinued irritation and disease.The wound is now, six weeks after the operation, nearly

healed; there is no difference in the appearance of the twolegs, and he now begins to walk.

Medical Societies.

WESTMINSTER MEDICAL SOCIETY.

SATURDAY, MARCH 9, 1850.—PROFESSOR MURPHY, PRESIDENT.

Dr. TILT read a paperON THE CONNEXIONS OF UTERINE AND OVARIAN DISEASE.

Why should the prognosis of uterine disease be more difficultthan that of the diseases of other organs ? Why should veryslight uterine lesions be sometimes attended by intense reac-tion? Why should it happen that when patients are cured ofthese lesions they still continue to suffer as much as they didbefore ? Dr. Tilt stated that many of these cases might beexplained by the co-existence of ovarian with uterine dis-order, the first disease being masked by the symptoms of theother, or else having supervened during the course of uterinedisease. After dwelling on the anatomical unity of the gene-rative system, and also having drawn attention to the unity ofpurpose by which the different organs of that system werecharacterized, he affirmed, that as the ovaries transmit to theuterus, and receive from it, a physiological stimulus, so theycan transmit to, and receive from, the womb,a morbid stimulus;and he asks, firstly-Is inflammation transmitted from theuterus to the ovaries ? In proof of this, Dr. Tilt quoted theassertions of Madame Boivin, Drs. Bennet and Doherty, andstated that it principally occurred in cases of catarrhal in-flammation of the cervix, as it was first pointed out by Dr.Melier, of Paris. He likewise showed that this transmissionhad also often followed the injudicious application of escharo-tics to the neck of the womb, or the employment of pessariesand stem-pessaries, which he (Dr. Tilt) strongly deprecated.Secondly-Is inflammation ever transmitted from the ovariesto the womb ? Dr. Tilt, starting from the acknowledged fact,that the ovaries induce, periodically, a state of vascular tur-gescence of the walls of the uterus, then showed how thisaction is perverted in that form of dysmenorrlioea which isattended by a secretion of false membranes from the uterinesurface; and he afterwards gave cases to prove that ovarianirritation, when of long standing, brought on those turgid, vas-cular, indolent swellings, to which Professor Recamier has longsince given the name of erectile tumours;" and he alluded toan assertion lately made, by Dr. Forget, of Paris, that the neckof the womb contained erectile tissue-a fact hitherto unno-ticed. Dr. Tilt concluded by giving the following interestingcase :-A married woman, aged twenty-five, was admitted apatient at the Paddington Free Dispensary for Women andChildren. She was small in stature, of a sanguine constitu-tion, and she had been married three years, without issue.She complained of pains in the abdomen, of a slight dis-charge, and of dysmenorrhcea, with either a profuse or ascanty flow. On examination, we caused little pain by press-ing the ovarian regions. The neck of the womb was soundin every respect. Considering that the general healthof the patient was in fault, we gave opening medicine andtonics, and ordered injections with a solution of alum. Thistreatment was continued several weeks; the general healthimproved, the discharge almost disappeared, but the pains inthe ovarian regions became worse, and dysmenorrhcea in-creased. We ordered inunctions with mercurial ointment,

and poultices to the inguinal regions, and the pain abated;but a fortnight afterwards leucorrhoea reappeared, with painin the back, and on a second examination we found an ulcera-tion of the inner surface of the cervix, which was outwardlyred and swollen. We therefore admitted having taken awrong view of the case: it was an ordinary case of ulcerationof the neck, so we cauterized it with nitrate of silver, thenwith the acid nitrate of mercury, and lastly with potassa fusa.Such was the treatment employed during the space of eightmonths, the patient being sometimes better, at others worse,and sometimes remaining without treatment for the space ofthree weeks. The ovarian pains likewise varied; but threemonths ago, finding that they were very intense, being aug-mented by walking or pressure, and tired by the pertinacityof the case, we made an exploration per anum, and found theovaries swollen, and very painful when touched. We imme-diately changed our plan of treatment, and ordered ten leechesto each inguinal region, and the regular rotation of blistersand ointment, besides cold enemata twice a day. The painssubsided, the leucorrhoea stopped, and a few weeks afterwardsthe neck of the womb was merely congested, but offered noulceration. After the following menstrual period we ordereda repetition of leeches, blisters, and ointment, and now thecervix is sound, the ovaries painless, and the patient well. Inthis case we think that ovaritis produced the inflammation ofthe neck of the womb, and kept it up until the primary diseasewas discovered and energetically treated. Now it seems tous, that if our explanation holds good, it will throw light onsome of the anomalies of uterine pathology. Dr. Tilt, in con-clusion, observed, that in Dr. Murphy’s cases, as in his own,we could not cure the disease of the womb, because beyondthe womb, preceding the womb in the development of theorgans of reproduction, and governing them through life, are theovaries, which often participate in and cause that uterine in-flammation which we alone attack; and thus, while we curethe small visible lesion, a hidden one remains, to bring on re-lapses, and to perpetuate the patient’s sufferings. In thetreatment of those painful states of the neck of the bladder,so often caused by diseases of the kidneys, we depend muchless on direct applications to the neck of the bladder than wedo on those means by which we can attack the kidney, thediseased organ. Should not we be governed by the same logicin treating diseases of the organs of reproduction ?In the discussion which ensued several fellows of the

Society took part.

PATHOLOGICAL SOCIETY OF LONDON.

MONDAY, MARCH 4, 1850. — DR. LATHAM, PRESIDENT.(Communicated by Mr. POLLOCK.)

MR. WARD exhibited a specimen ofRUPTURE OF THE ILEUM.

A man, aged thirty-two, was admitted into the London Hos-pital, under Mr. Adams, in the evening of the 2nd March.A loaded omnibus had passed over his abdomen and chesthalf an hour previously. He was collapsed; extremities cold;pulse extremely feeble; complained of great pain, and a senseof fulness about the stomach. No marks of contusion wereobserved on the abdomen, but in the right lumbar regionthere was an effusion of blood the size of a hen’s egg. Re-action came on in about two hours, accompanied with intenseabdominal pain: the slightest pressure could not be tolerated.A large dose of opium was administered. Three hours subse-quently the countenance became pinched and anxious; pulserapid and fluttering; violent flying pains over the body; greatdifficulty of breathing, and occasional vomiting of dark coffee-ground-looking fluid. These symptoms continued about twohours, when he passed about a quart of dark-coloured urine,but no blood. On the following morning he vomited a pint ofstercoraceous matter ; the vomiting gradually increased infrequency, the abdomen becoming more tense and tender, andhe died twenty-four hours after the accident.

Post-azzortena EXaJr"ination.-:Marks of contusion over theabdomen and back well observed ; about eight ounces ofbloody fluid was found in the left pleural cavity, and there wasa comminuted fracture of the eleventh rib. A quantity offlatus escaped on opening the abdomen, and in the cavity ofthe peritonaeum were three pints of dark fluid blood, betweenthe folds of the intestines, mixed up with a few flakes oflymph. A longitudinal rent was found in the ileum about aninch and a half long, and occupying its long axis, and fromthis rent the large quantity of blood had escaped. The con-tents of the intestine had not passed into the abdominal cavity.