the tumour, and this occurs equally, whether the pressure be made in the upper or in the middle third of the thigh. Coincidently with the stoppage of the pulsation, the tumour is felt to become soft, and to sink down to a certain extent under the hand in the situation in which there is least resistance in the parietes. On applying the ear to the swelling (the femoral artery being free), a slight sound is heard synchronous with the arterial pulsations, but this is in no way comparable with the bruit heard in an ordinary aneurism, and is so slight as to be with difficulty distinguishable.

M. Nélaton determined upon placing a ligature upon the femoral artery, in the hope of thus arresting the progress of the tumour. The vessel was accordingly tied in the middle portion of its course, this situation being selected because it had been previously found that pressure made on this part of the artery commanded the flow of blood into the tumour as completely as when excited upon the vessel in the upper third of the thigh; and because, in case of secondary hæmorrhage, the operation of Scarpa would still remain practicable. The operation was performed on the 10th of March. The immediate result of this procedure was to cause the disappearance of all pulsation in the morbid structure, but at the end of seven days this phenomenon again made its appearance, so that the result of the operation has been unsuccessful. I may remark, in conclusion, that in the case just described are combined all the characters mentioned by authors as appertaining to this peculiar affection, with the exception of one. Lallemand, of Montpellier, describes a sensation of crackling to be perceptible to the finger when pressure is made upon the tumour. This is due to the breaking down of minute osseous septa which exist in the substance of the morbid mass. The noise produced has been compared to the "crumpling" of parchment. The above phenomenon also presented itself in a case treated by M. Roux. In the present instance, however, nothing of this nature was perceptible either to the surgeon or to the patient.

Lancet, April 12, 1845, p. 407.

M.

104.-ULCERATED PILE TREATED WITH CHROMIC ACID.-BY ALEXANDER URE, Esq.

J. L., aged 31, tailor, admitted April 27th, 1844. At the verge of anus is a dark hemorrhoidal tumour, the size of half a walnut, of which the surface is ulcerated and extremely painful. The tumour had been extruded several days, and various attempts at reduction proved of no avail. The patient seemed in a most deplorable state, haggard, and worn out by suffering, from which he could only obtain a brief respite by observing a half-bent posture. He has been subject to piles for some years. The bowels were open. I applied the chromic acid freely over the whole of the diseased surface.

The application occasioned much uneasiness for some hours. A considerable slough came away, and the excrescence shrunk to a small size, and became quite insensible. The bowels at first were torpid, and his appetite bad, but these soon yielded to epsom salts with infus. gentian, and in about a fortnight he was perfectly cured.]

Chromic acid is, as every chemist knows, a most powerful oxidizing agent, yielding half its oxygen readily to organic substances, and being reduced to sesquioxide. On this principle, I was led to employ it as an escharotic. It is exceedingly convenient for application, inasmuch as it consists of a thick crystalline pap, which, when rightly managed, does not spread beyond the prescribed limits; and so soon as its erosive operation is finished, passes into the state of inert pulverulent sesquioxide above mentioned. My colleague, Dr. Child, of Mortimer-St., requested me, on the 30th of May, 1844, to see Mrs. Wa, aged 30. For a month previously she had been suffering much from two hæmorrhoids situate upon the right side of the verge of the anus, each about the size of a kidney bean, and was anxious to obtain alleviation. Various external and internal means had been already employed, but in vain. She had been troubled with piles at different times

during the preceding eight years. Her general health is tolerably good, and the bowels usually regular. Since her last confinement, ten weeks ago, she has complained of shooting darting pain referred to the anus. It was determined to apply chromic acid, which was accordingly done. It was found necessary to repeat the application on the first of June. This caused acute burning pain both times, destruction to a considerable amount of the diseased texture, consolidation of the remainder, and permanent relief from the distressing ailment. Medical Gazette, March 21, 1845, p. 787.

105.-HÆMORRHOID NEEDLE.

[Mr. G. C. Childs, Surgeon to the City Police Force, has invented an instrument for the application of ligatures to small tumors of the vagina and rectum. Practitioners are well acquainted with the difficulty that often exists in getting the ligature to remain close around the base of the hæmorrhoidal tumours, particularly when these are not very prominent, and crowded together.]

The ordinary mode of procceeding in such cases is to pass the ligature around the tumour, with the right and left index fingers, either aided by a tenaculum or not, as the operator may deem expedient: with the utmost precaution it sometimes occurs that our endeavours to complete the operation may prove unsuccessful, from the ligature embracing a portion only of the hæmorrhoid. Such accidents are less likely to occur when the hæmorrhoid needle is resorted to, for it enables the operator with great facility to keep the silk in close contact with the base of the tumour, and when two or three are close together, and are situated high up the rectum, the ligature is readily passed between them. Mr. Childs' instrument is of a very simple construction, and in shape is somewhat similar to a button-hook; on its under surface is a groove for the reception of the silk, which latter must be well waxed before it is used; at each extremity is a slit or notch for the purpose of nipping the silk and retaining it in its proper situation. The operator carries the needle, previously threaded, behind the tumour, and with the handle slightly raised, in order that the groove may be brought to bear upon its base, he gives it to an assistant to hold, directing him to keep a steady and firm pressure downwards and outwards; the operation is then completed in the ordinary way; the ligature as it is tied releasing itself from the groove of the needle. A modification of the same instrument might be advantageously resorted to for the removal of polypi and other tumors of the uterus. Med. Gaz., April 18, 1845, p. 925.

106. ON THE DETECTION OF NEEDLES, &c., IMBEDDED IN THE BODY. By ALFRED SMEE, F.R.S., &c.

[Portions of iron or steel are extremely liable to be introduced into the body, frequently proving very injurious. There are means, however, by which their presence may be readily determined. Mr. Smee, after some remarks on a case which came under his care, where a needle was introduced into one of the joints of the finger, and caused suppuration and subsequent anchylosis, which might have been prevented could it have been shown that the needle was actually present, and its exact spot demonstrated, says :-]

You are all acquainted with the curious condition which steel assumes under certain circumstances, whereby it evinces properties which are called magnetic; you know, moreover, that inagnetic poles repel, and opposite attract, each other. You have, therefore, but to render a piece of enclosed steel a magnet, and you will be able not only to ascertain its presence, but to determine by its polarity its general direction; and by the amount of magnetism it evinces, you may even infer its probable bulk. When you suspect the presence of a piece of needle, or other steel instrument, you must subject the suspected part to a treatment calculated to render the needle magnetic; and there are two principal methods by which this object may

be effected. The first, by transmitting a galvanic current, at right angles, to the suspected part; the second, by placing a large magnet near the part affected, so that the object may be magnetized by induction. You may accomplish the first end, by taking a copper wire, covered with cotton, or still better with silk (in fact you may employ the covered wire as generally used for the formation of electro-magnets), and wind it round the parts suspected to contain steel, several times, so that the same current may act at right anglés, many times, upon the piece of steel; you may then take a galvanic battery (one of my little tumbler batteries will amply suffice), and connect one end of the wire to the zinc, the other to the platinized silver. The current might be continued for half an hour, or more, when the steel would become magnetized, and, thereby, give strong indications of its presence.

For my own part, I should use the second plan, or the plan of magnetizing by induction, to render the needle magnetic. For this purpose, I have employed a temporary electro-magnet, which I magnetized by the voltaic battery, and you will find, that by keeping the part affected as close as possible to the instrument, for about half an hour, you will sufficiently obtain the desired object. To test the existence of a magnet within the body, we may take a magnetized sewing needle, and suspend it by a piece of silkworm's silk, when it will exhibit certain phenomena upon the approach of the suspected part, provided it contain a piece of magnetized steel. Although this simple contrivance will amply suffice, I, myself, possess a needle, which was made for me by Messrs. Willtats, of Cheapside, and which is well adapted for the purpose. It consists of a delicate needle, about six inches long, centred upon a small agate cup, resting upon a steel point, so that the smallest possible amount of resistance is offered to its free play. When a part, containing magnetic steel, is brought near the needle, it may be attracted, or repelled, it may move upwards or downwards, or it may exhibit disquietude according to the position in which the new magnet is held. We may detect the position of the foreign body, when it is of any size, by ascertaining where its north and south poles lie, and these are determined by their repelling and attracting the opposite poles of the magnetic needle. The disquietude or motion upwards and downwards, merely indicates magnetism, but not the direction of the magnet.

You will doubtless be surprised when I tell you, that, in this manner, I have detected a piece of needle impacted in the finger of a young woman, although it weighed but the seventh of a grain. This gave such marked indications, that I found out tolerably well the position of its north and south poles, though I could not ascertain the presence of a foreign body in any other way. I tried experiments on smaller pieces, at short distances, such as half an inch to an inch, and I found that a piece of needle, weighing 1-60th of a grain, gave decided indications after having been magnetised, and, perhaps, even a still smaller amount of steel might in some cases be detected. Medical Times, Dec. 14, 1844, p. 224.

107.-ON THE PROPER MODE OF APPLYING THE TOURNIQUET.-By ROBERT LISTON, Esq., F.R.S.

When you first put on the tourniquet, no pressure must be made on the vessels; the surgeon must be ready to make his incision before it is screwed up; for if you allow it to remain on a minute or two, the whole limb is gorged with blood. If you are desirous that the patient should not lose blood, it is of the utmost moment to attend to this point. Put on the tourniquet; you may even allow the surgeon to transfix the limb with his knife; the instant the principal vessel is about to be divided, screw it up quickly, and again, as soon as the larger arteries are secured, take it off. If you go on screwing it up, look at the end of the vessels, then unscrew it; if you see something bleeding, try to catch the vessels, and then screw again; there is an immense quantity of blood lost, the veins pour it out as fast as the arteries, you do not know what you are tying, and you are almost certain to tie a great many vessels unnecessarily. Lancet, Jan. 4th, 1845, p. 5.

108. PERIOSTEAL THICKENING CURED BY IODIDE OF POTASSIUM. [Mr. Alexander Ure relates a case of periosteal inflammation of left ulna. about its middle third, of two months standing, which, after blisters, leeching, &c., had been tried, was cured by taking two grains of iodide potass. twice daily, in infus. gent. co., and a grain of opium at bedtime, for a fortnight; bran poultices applied to the arm.]

Medical Gazette, March 21st, 1845, p. 785.

109.-CREOSOTE IN NÆVUS MATERNUS.

Dr. Thornton informs us that of all the applications he has tried against nævus, the most effectual is creosote. He had treated three cases in the course of the year successfully with this substance. It is applied two or three times daily, more or less diluted. Excoriation, ulceration, and gradual disappearance of the nævus ensues; the cicatrix had always been smooth and sound. Northern Journal of Medicine, Dec., 1844, p. 119. 110.-SUFFOCATION FROM A BODY LODGED IN THE LARYNX.-By CHARLES JAMES CAMPBELL, Esq., Interne of the Sainte-Perine Hospital, Paris. [This case of suffocation is chiefly remarkable from the fact, that the epiglottis was evidently unable to fulfil its office perfectly, on account of retraction of the glosso-epiglotic median ligament." The woman was threatened with suffocation twice before the third time a piece of boiled beef was drawn into the larynx and destroyed her. Mr. Campbell describes the post-mortem examination as follows:-] I then proceeded, with the greatest care, by a lateral dissection of the neck, to uncover the larynx, after disarticulation of the inferior jaw bone, thus leaving the tongue in its natural position and connexions. The epiglottis is closely applied to the root of the tongue, and behind the epiglottis the superior orifice of the larynx is discovered to be entirely filled up with a piece of boiled beef, the end of the morsel not being at all prominent above the edges of the superior opening of the larynx, in such a manner that at first sight it was impossible to ascertain the whole volume of the foreign body. This evidently was the cause of death. I then extracted the boiled beef-it formed a sort of cork of compact meat, partially chewed, was about an inch long, and weighed a little more than a quarter of an ounce (eight grammes, eight decigrammes). It must have reached, in situ, the cricoid cartilage. The epiglottis was then carefully examined, and found to be rather less in its dimensions than usual. It not only left the posterior angle of the superior opening of the larynx uncovered in a comparatively too large extent, but we felt an unnatural resistance when we attempted to bring down this cartilage over the aperture. We remarked, that in so doing the median glosso-epiglottic ligament was so extended as to pull back and elongate those fibres of the root of the tongue to which it is adherent, and when let go, the epiglottis resumed its first position with more than its ordinary elasticity. Having removed the larynx and tongue, I kept them in water slightly alcoholized, for forty-eight hours; the epiglottis still retained that stiffness and insufficiency in its play, the tongue being placed in its natural relative position. The anatomists and medical observers who have seen the parts agree with me in the opinion that this organic lesion, which consists either in atrophy or retraction of the median glosso-epiglottic ligament, has been the first cause of suffocation in this case, by giving a freer access to foreign bodies into the air-tube. Lancet, Dec. 21st, 1844, p. 371.

111.-USE OF CHLORIDE OF LIME IN DISEASES ATTENDED WITH CONTAGIOUS DISCHARGE.-By DR. RADCLYFFE HALL.

Gonorrhoea. In the first stage, before the discharge has become completely puriform, or the scalding great, a single injection of about two fluid drachms of the strong solution will always put a stop to the disease, either in a first or subsequent clap. In the second stage, when there is a consid

erable discharge of pus, and more pain, several injections are required. In gleet, provided the discharge be not kept up by some structural change in the urethra, the strong injection is likewise useful, but not to so striking an extent. The effects of injecting the strong solution are, sharp pain, and often erection for the moment, slight puffiness and eversion of the orifice of the urethra, and tenderness on pressure, and a feeling of unusual firmness for two or three inches down the corpus spongiosum, where these did not already exist. In a short time the pain subsides, and in a quarter or half an hour a serous discharge issues from the mouth of the urethra.

Purulent Ophthalmia Dr. Hall has treated with like success. He thus uses the solution :-The eyelids are slowly and gently separated until the cornea can be seen, when that is manageable, and all secretion is wiped away with a fine soft sponge. A large bushy camel-hair pencil, charged with the strong solution, is then insinuated beneath the upper eyelid and swept round the front of the eye; the pencil is again charged with the solution and applied to the everted lower lid. Unless plenty of fluid be thus applied, the application will be equally painful but less effectual. There is considerable pain, of a smarting, burning character, for half an hour or longer, and the already swollen eyelids become more tumid and prominent. This tumefaction is oedematous in character, the skin losing in some measure its peculiar redness, and becoming more transparent. In a few hours a serous discharge oozes out from between the eyelids, and the swelling partially subsides. This is followed by secretions of matter, but after two or three applications of the chloride, in perceptibly diminished quantity, the discharge gradually loses its characteristic yellow colour, and is seen in flakes on opening the eyelids. After three or more applications, the eyelids no longer swell as they did after the first, and the pain is much less. The eyes are kept clean with warm water, matter never being suffered to collect beneath the upper lid; a little spermaceti ointment is smeared on the edges of the eyelids, and the strong solution is applied once in every twenty-four hours, until the secretion ceases to be in the least degreee puriform. No other treatment whatever is necessary. Lancet, Jan. 11th, 1845, p. 37.

112.-ON OBSTRUCTION OF THE VENA CAVA.-BY THOMAS BEVILL PEACOCK, Esq., M.D.

This was a case of complete obstruction of the inferior cava, from the uterine and common iliac veins to the entrance of those from the liver. The obstruction in the former vessels, and the inferior portion of the cava, was the result of the adherent masses of pale lymph, while above, the vessel was converted into a ligamentous cord. The right kidney was in an advanced stage of granular degeneration, the left completely atrophied; the liver was also of small size. The author considered the disease of the vein to have been wholly unconnected with the death of the patient, and ascribed the general dropsy under which she laboured during the last period of her life, to the condition of the kidney and liver. The circulation had been maintained by means of the branches of the vena azygos. The author was of opinion that the adhesions of the uterus to the adjacent organs, and the appearances of the veins, as exhibited in the preparations shown to the Society, were conclusive of the dependence of the obstruction in the vein on inflammation of the vascular tunics.

[Dr. Budd remarked that sufficient attention had not been paid to the influence of adhesive phlebitis in producing atrophy of the glandular organs,]

He had seen instances in which both the liver and kidney had become atrophied to a great extent, from the presence of adhesive phlebitis in the portal and renal veins. He had seen the liver so atrophied as to be indented with deep fissures, and on examination it was found that the branches of the portal veins supplying the atrophied parts were completely obliterated, as the results of phlebitis. He had seen the same effects in the kidneys from a like cause.