An important peculiarity in this case was the mode in which the matter had made its way externally, namely, by perforation of the iliac fascia, and descent on the outside of the femoral vessels.

Mr. Ferrall also shewed that in this case the communication with the intestine did not, as Dr. Burne supposes, take place through the appendix vermiformis, the appendix being free from disease. The perforation had taken place from the abscess into the intestine, being the third form of the disease formerly described by Mr. Ferrall in the Edinburgh Journal. He owed the specimen to the kindness of Dr. Stokes. (Museum, St. Vincent's Hospital.)

3. Incipient Cirrhosis of the Liver, with chronic Gastritis and Congestion of the Mucous Membrane of the Intestines.-Mr. Carmichael exhibited the recent parts in this case. The viscera were those of an habitual drunkard; the liver was but slightly diminished in size; the left lobe presented a more marked type than the right, and had the mammillated appearance, which was scarcely to be detected in the right portion of the organ; the spleen was much enlarged; the mucous membrane of the stomach was thickened and of a slate colour, and that of the small intestines deeply congested; the lungs presented a great number of tubercles in different stages. (Museum, Richmond Hospital.)

This patient died with ascites, for which he had been twice tapped. Mr. Carmichael considered that in this case and others of the same description the primary lesion was inflammation of the gastric mucous membrane, and that the lungs were subsequently tuberculated.

4. Extensive Fracture of the Cranium, in Consequence of a Fall during an Epileptic Paroxysm.-Mr. Cusack exhibited a portion of the cranium of an individual, who in a paroxysm of epilepsy fell with violence on a stone floor; the skull was extremely thin; the right frontal bone was fractured and depressed, and the internal table extensively separated from the external; about two ounces of blood were effused from the middle meningeal artery, which had been torn across; the arachnoid was vascular, and some effusion existed beneath it. Subsequent to the fall the patient recovered his senses, and remained free from any attack until the next day, when the convulsion returned, and was repeated several times previous to his death. (Museum, Park-street.)

5. Formation of numerous Cysts in the Kidneys, with extensive Depositions of Phosphate of Lime. -Dr. Corrigan presented the kidneys of an individual, who had long laboured under symptoms of irritation of the bladder and urethra; he had curvature of the spine of long standing; on dissection the urethra, prostate, and bladder were found healthy; one kidney was converted into a number of large cysts, while the other presented the same disposition; but with this difference, that the loculi contained great quantities of a substance resembling putty, and composed of phosphate and carbonate of lime, with a slight trace of albumen; in the course of the disease the pa

tient laboured under hæmorrhage from the bladder. (Museum, Digges-street.)

6. Softening of the Uterus-Dr. E. Kennedy presented a specimen of this disease, taken from the body of a female, who died on the day of her admission into the Lying-in Hospital, and without having presented any remarkable symptom, excepting pain at the upper and inner part of the thigh, where a slight redness was observable. The Cæsarean section was performed, but the child was found dead, though perfectly formed. On dividing the parietes of the abdomen, the uterus appeared a deep purple or almost black colour; its texture was remarkably soft, and its mucous surface covered with grumous blood.

Dr. Kennedy said, that he considered the specimen before the Society an excellent example of ramollisement of the uterus and placenta; a disease not common in this country. He observed, that there were two forms of softening of the uterus: one superficial, and confined to the mucous membrane, the other pervading the entire texture of the organ. Under the latter circumstances, the disease assumes a virulent character, and runs its course with rapidity.

In this case there was some dilatation of the os uteri, but scarcely any labour pains. (Museum, Lying-in Hospital.)

7. Separation and Discharge of the superior Epiphysis of the Os Femoris.-Dr. Carlile exhibited the head of the femur, which had been separated from the shaft of the bone in consequence of scrofulous disease of the hip joint. The patient from whom the speciman was procured, was about twenty years of age, and of a scrofulous habit. At the age of fourteen he had suffered from acute rheumatism, which was followed by the usual symptoms of morbus coxarius. Suppuration took place in the joint, and matter escaped by several external openings. In this state he continued for four years; at the expiration of which period, the head of the os femoris presented at one of the openings, and was extracted; its removal was followed by the rapid amendment of the boy's health. (Museum, Park-street.)

During the above period, several other bones became similarly diseased, and a large sequestrum was discharged from the humerus. The affected lower extremity was six inches shorter than the opposite limb.

Dr. Carlile exhibited a second specimen of separation of the epiphysis. This specimen was from the museum of the Richmond School of Medicine; and had been sent to Mr. Adams by Mr. Shaw, of the Clonmel Dispensary. The patient was a child, and recovery followed the separation of the bone.

8. Extensive Tubercular Excavation of the right Lung, communicating with the Cavity of the Pleura.-Dr. William Beatty exhibited the recent parts in this case. The cavity in the lung was perfectly free from fluid. In this case the pulmonary disease followed upon gastric derangement; and the patient, though presenting the usual signs of pneumo-thorax, with fistula, yet made no complaint with reference to thoracic disease. He sank from diarrhoea.

Ninth Meeting, February 2.

DR. HARRISON in the Chair.

1. Cerebriform Depositions in the Spleen and Lymphatic Glands of the Pelvis and Abdomen.-Dr. Hutton exhibited the recent parts in this case. The spleen was more than four times its natural size, and very firm. It contained a number of large cerebriform tumours, of a circular form, soft, elastic, and of a pearly whiteness. The intervening structure of the spleen was of a deep red colour, and intensely vascular. A large cerebriform tumour occupied the iliac region of the right side, and dipped downwards into the pelvis, so as to displace the bladder and rectum. The glands along the course of the iliac vessels and ureter had undergone a similar degeneration. In the left axilla, the lymphatics were also engaged, and a large portion of the osseous structure of the sixth rib was converted into the cerebriform matter. There was no disease of the lung or liver.

The right femoral vein was plugged with coagula, but the corresponding artery was pervious. The right kidney was paler than natural, and presented a large serous cyst.

These parts were taken from the body of a man, aged 56, of a cachectic appearance. He was admitted into the Richmond Hospital with œdema of the right lower extremity; the appearance of which resembled, in some respects, that of a limb affected with phlegmasia dolens. The femoral vein was felt as a hard cord, and obviously was obstructed by coagula. This swelling had existed for about four months, having been preceded by the iliac tumour, but it almost completely subsided before death. (Museum, Richmond Hospital.)

2. Caries of the Temporal Bone, with Destruction of the Mastoid Cells, and Perforation of the Cranium; Sloughing of the Cerebellum.-Dr. Greene presented the temporal bone in this case, shewing extensive caries, with destruction of the mastoid cells, and perforation of the petrous portion; corresponding to the internal perforation, the dura and pia mater were in a state of slough, and that portion of the cerebellum which rests on the petrous bone was in a state of complete sphacelus, which penetrated about three lines in depth. A quantity of purulent matter was diffused among the muscles of the neck, and along the course of the great vessels and nerves. Some lymph existed upon the pericardium. (Museum, Richmond Hospital.)

The patient had been treated for fever in the Hardwicke Hospital, during the course of which he complained of pain in the right ear; after leaving the hospital he was exposed to cold, and was again seized with severe pain in the ear, accompanied by nausea and delirium, and subsequently purulent discharge from the ear; a swelling appeared below the parotid and extended downwards, and shortly afterwards he was suddenly seized with intense dyspnoea, and died as if from asphyxia.

VOL. XV. NO. 44.

2 Q

3. Edema of the Glottis, following an Attempt at Suicide, in which the Larynx was divided. Tracheotomy subsequently performed.-Mr. Adams laid before the Society the larynx of an individual, who attempted to destroy himself by cutting his throat. Thirteen days after the infliction of the injury, which was of the lower part of the larynx, he was attacked with oedema of the glottis, and his symptoms became so urgent that Mr. O'Reilly, in consultation with Mr. Adams, determined upon opening the trachea; the operation was difficult, from the natural shortness of the neck and its turgescence from dyspnoea; the perforation of the trachea was performed by Mr. O'Reilly with the chain trocar, an instrument to the value of which Mr. Adams would bear the fullest testimony; the canula was allowed to remain in the trachea, and the patient survived the operation thirteen days, when death took place, partly from exhaustion, and partly from inflammation of the bronchial mucous membrane. Mr. Adams . exhibited the preparation with drawings of the recent appearances; the lining membrane of the larynx and trachea presented an intensely vascular sppearance, and the rima was still greatly narrowed by the sub-mucous infiltration.

Mr. Adams next exhibited a series of drawings illustrative of oedema of the glottis in the following cases:

1. From the effects of scalding water.

2. From exposure to cold air.

3. Consequent upon the diffuse inflammation.
4. Consequent on wounds of the larynx.

(Museum, Richmond Hospital.) 4. Fungous Disease of the Antrum.-Mr. Ferrall exhibited a recent specimen of fungous disease of the antrum, which had destroyed the walls of that cavity; the displacement and disorganization of the bones and soft parts in the vicinity of the tumour were considerable; the septum of the nose and the superior maxillary and palate bones were in a great measure destroyed; the eye was displaced upwards and outwards in the direction of the corresponding temple, but vision continued unimpaired to the last; a lymphatic gland under the jaw in the digestive space was found in a state of carcinomatous degeneration; a few tubercles in a hardened state and surrounded by puckered cicatrices existed in the upper portion of left lung. (Museum, St. Vincent's Hospital.)

There was no other visceral disease. The patient died in St. Vincent's Hospital; she suffered very little, except from the constant stillicidium of foetid pus from the nostril; she appeared to sink gradually from the disturbance of the digestive functions occasioned by this foetid discharge passing into the stomach. With respect to the operation Mr. Ferrall remarked, that this, as well as other cases, had convinced him, that there was not a strong disposition to visceral contamination in this disease; but the patients seldom apply for relief before the neighbouring lymphatics are engaged.

5. True Aneurism of the first Portion of the Aorta; sudden Death without Rupture of the Sac.-Dr. Russell exhibited a specimen of aneurism by dilatation of the above mentioned portion of the aorta; the sac contained laminated coagula, and was constituted of all the coats of the aorta; the sac compressed the right bronchial tube. The aortic valves were free from disease. (Museum, Richmond Hospital.)

In this case the patient died suddenly, without rupture of the sac; the symptoms were stridulous breathing, dysphagia, diminished respiration in the right lung, and stridulous cough; there was no bruit. de soufflet, no alteration of voice, nor any perceptible impulse.

6. Fibrous Tumours and Polypi of the Uterus.-Dr. Montgomery presented the uterus of a woman of advanced life shewing a soft polypus attached to the upper part of the organ, and a fibrous tumour close to the cervix; the cavity of the uterus was enlarged; attached to the termination of each fallopian tube there was a cyst containing fluid.

Dr. Montgomery next exhibited the uterus of an aged female, which contained two polypi in its cavity, and a small fibrous tumour in the substance of the organ. For the opportunity of exhibiting these recent specimens, illustrative of the combination of different forms of disease in the same uterus, to which Dr. Montgomery had before drawn the attention of the Society, he was indebted to Mr. Smith. (Museum, Richmond Hospital.)

7. Peculiar Alteration of the Liver, in a Case of poisoning by Sulphuric Acid and Alcohol.-Dr. Gabriel Stokes exhibited the liver in this case; it presented the same appearance that it does when boiled; it was of a light brown colour and singularly hard; this condition was most remarkable in the upper portion of the left lobe; the change extended about an inch in depth into the substance of the organ; the stomach was greatly disorganized, and exhaled a strong smell of sulphuric ether.

The patient having determined to destroy himself swallowed a quantity of ardent spirits, and soon after some concentrated sulphuric acid; he died in great torture: that this peculiar change of the liver had taken place during life, Dr. G. Stokes considered to be established by the fact, that the blood arterial, as well as venous, was found coagulated in the vessels of the organ; he believed that the appearances observed were the result of the action of heat on the hepatic structure evolved by the combination of the sulphuric acid and alcohol. In illustration of this opinion he exhibited a portion of the liver which he had boiled, and which presented appearances perfectly similar to those in the specimen. (Museum, Park-street.)

Tenth Meeting, February 9.

MR. ADAMS in the Chair.

1. Tumour compressing the Cerebellum.-Mr. Hamilton presented to the meeting a specimen of a tumour, which lay upon the inferior