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urticaria, zoster. Anaesthesia also receives considerable attention.

The leading pathological views of the author are thus succinctly presented in his Introduction:

"Neuroses of the skin are, generally speaking, of two of the sensitive or of the vaso-motor nerves. kinds. These are caused by peculiar conditions either Cutaneous neuralgia is productive of zoster on the peripheral branches of the nerves affected. This is the reason why this eruption always has its origin and termination at the median line of the anterior and posterior portions of the body. Prurigo is consequent upon an intense pruritus, and also upon the mechanical irritation produced by scratching. Temporary spasm of the blood-vessels of the cutis, from exces-ive irritation of the vaso-motor nerves, causes the wheals in urticaria to become bloodless; while paralysis of these nerves produces the opposite effect."

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THE fact of any work reaching a seventh edition renders all review unnecessary. It is only sufficient to say that the present treatise is equal in completeness to any that have preceded it, and gives ample evidence of being fully up to the present time. The views of the author have been very essentially modified in many points, in accordance with the progressive state of his specialty, which gives evidence of a laudable intention on his part of making each successive edition better than dominant and sinful fashion of our time, and ignored We rejoice that Dr. Damon has not followed the the preceding. The plates, which by the way are only the therapeutics of disease. The best methods of treatfair representations of what may be done in that line, ment are given in elaborate detail; and the author has are increased in number by the publisher, who has judiciously added those prepared by the author to illus-diagnosis, and then allowing his patients to suffer and contented himself with making a evidently not trate his work on Constitutional Syphilis and Syphilitic Eruptions. We regret, however, that the treatment for these distressing neuroses of the skin is not more satisfactory. The large variety of prescriptions recommended shows that our most advanced dermatologists are still feeling in the dark.

THE NEUROSES OF THE SKIN, THEIR PATHOLOGY AND TREATMENT. By HOWARD F. DAMON, A.M., M.D., Fellow of the Massachusetts Medical Society, &c. 8vo., pp. 111. Philadelphia: J. B. Lippincott & Co. 1868.

ANY one who rightly interprets the signs of the times, must see that the study of nervous diseases is rapidly assuming an interest, a dignity, and an importance second to no other department of medical science. Monographs on the various phases of nervous affections are continually appearing, both in this country and in Europe, and if the coming ten years shall witness as great progress in their pathology, diagnosis, and treatment, as has been observed during the last ten years, humanity will be a great gainer. It is not too much to say that in the future, and that not far distant, neurology is, in a certain sense, to assume the commanding position now held by gynecology. The causes that will lead to this revolution in medical thought and fashion, are twofold:

First, nervous diseases are increasing in frequency and in severity, and multiplying their phases with the rapid advance of civilization.

Secondly, our method of diagnosis, and the accumulated experience of scientific observers, are demonstrating more and more that a very large class of diseases that have hitherto been ignored as obscure, are to be classed among the neuroses.

This graceful monograph of Dr. Damon is designed to call our attention to the fact that many of the ordinary affections of the skin are in their character essentially nervous, and should be treated accordingly. The leading ideas advanced are accredited to the influence of the labors and teachings of Prof. Brown-Séquard, to whom the author very appropriately dedicates the volume.

The author proposes the following classification of skin diseases:

I. Neuroses of the skin.

II. Functional diseases of the cutaneous glands. III. Inflammations of the skin.

IV. Structural lesions of the skin.

"This monograph is intended to supply all that is now positively known of the first of these classes of cutaneous affections."

to die.

Speaking of the treatment of anesthesia, the author strongly recommends electricity, believing that it "is destined to become a powerful remedial agent in the restoration of sensibility." He should have added that the results of the treatment of anesthesia by electricity depend very materially on the manner in which it is employed. Constitutional diseases demand constitutional treatment, and in those cases of anesthesia that depend on or are associated with any vice or feebleness of the general system, electricity, if used at all, should be applied all over the person of the patient, from the head to the feet. Electricity thus used, in the form of general electrization, will oftentimes produce more rapid and permanent results in anaesthesia than any other system of treatment. On the other hand, localized electrization, with the wire brush that is sometimes recommended and employed in such cases, is at best a very painful process, and usually achieves but partial and unsatisfactory results.

There is a wide and, as yet, untrodden field for investigation in the treatment of the neuroses of the skin by electrization, and we earnestly urge upon Dr. Damon to devote his practical attention to this suggestive and interesting study, in the full confidence that with his scientific enthusiasm, his large and various experience, and his abundant clinical material, his experiments might ultimately be crowned with a success that would be at once pleasing to himself and useful to science.

In conclusion, we unqualifiedly commend this monograph, not only to dermatologists, but to neurologists, to all general practitioners who seek to do their whole duty towards those patients who are afflicted with these distressing neuroses of the skin. We venture, however, to express the hope, that in the rapid advance of science, this treatise will shortly be superseded by others, in which the therapeutics will be more logical, more established, and more satisfactory.

BREVET LT.-COL. B. A. CLEMENTS, Surgeon, U. S. A., in addition to his other duties, has been appointed InUnder hyperæsthesia are included dermalgia, prurigo, | spector of Quarantine in the Department of Louisiana.

Reports of Societies.

NEW YORK PATHOLOGICAL SOCIETY.
STATED MEETING, APRIL 8, 1868.

DR. W. B. BIBBINS, PRESIDENT, in the Chair.

AORTIC AND CORONARY ANEURISM.-CARDIAC HYPERTRO-
PHY.-FREE CYSTS IN THE BRAIN.

of coagulum were removed from the cavity of the tumor. Under its pressure nearly one-half the sternum and a part of two ribs had disappeared.

DR. LOOMIS had seen but one case of aortic aneurism bursting externally. That was for two years under the observation of Dr. Camman, who had fitted a sheet of lead as a shield to the tumor. The aneurism pointed about the junction of the second rib with the sternum, a little to the right side. Death was sudden. DR. ROGERS presented, for a candidate, a specimen with written history.

PYÆMIA.

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DR. JANEWAY presented the heart, the abdominal viscera, the radial artery and its venæ comites, of a boy dead of pyæmia. The patient, a newsboy sixteen years old, was admitted to Bellevue Hospital, on the morning of April 4th, giving an imperfect history, to the effect that, three days before, he had, on waking in the morning, observed an "injury to his right forearm, near the wrist; and had that day seen a physician, who applied splints. Upon admission to hospital these were removed, and evaporating lotions applied. that time the patient manifested no cerebral symptoms; but in the evening he was slightly delirious, though he still walked about the ward. The next morning he was in much the same condition; towards night he became comatose, and so remained until his death, at 10 P. M., April 6th. While in this state the pulse was from 120 to 130 per minute, the respiration about 40.

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DR. FINNELL presented four specimens, with brief histories. The first was the heart of a man about forty years of age, found dead in the street. The aorta showed an aneurismal dilatation the size of a small orange, commencing immediately above the semi-lunar valves, and extending upwards and backwards. Both here and in the undilated portion the artery was atheromatous, and at one point there was calcareous deposit. The coronary arteries were much dilated, either of them readily admitting the index finger. The Jungs and the kidneys were healthy. As the aneurism had not ruptured, it was supposed to have caused death by some interference with the heart's action. Next was shown an hypertrophied heart, from a man aged about forty-five, dead of apoplexy. It weighed eighteen ounces; the walls of the left ventricle were one inch thick, those of the right from two to three lines. No valvular lesion was discoverable; and, in the absence of other cause, Dr. Finnell was inclined to attribute the hypertrophy to the deficient length of the musculus papillaris, or its chorda tendineæ, conExamination sixteen hours post-mortem showed the nected with one curtain of the mitral valve, preventing forearm and hand oedematous. A fluctuating swelling its complete closure. Jones and Sieveking had menat the wrist gave vent, on opening, to a quantity of tioned that this condition often accompanies hypertro-sanious pus. This had burrowed among the tendons phy. The apoplectic extravasation was extensive into the middle and the posterior lobe of the left hemisphere, and into the fourth ventricle.

DR. LOOMIS thought this condition should be regarded as a consequence of the hypertrophy, not as its cause. As the third specimen Dr. Finnell exhibited two cysts from the brain of a man subject to epilepsy and found dead after a fit of intemperance. The larger of the cysts resembled in form and size a Malaga grape. Both were found floating, unattached, in the fluid of the right or left lateral ventricle; and near the larger were two little masses looking like organized fibrine. In the choroid plexus cysts were not uncommon, but the Doctor had seen none of this size. He presented these for microscopic examination, thinking they might be due to cysticercus.

AORTIC ANEURISM BURSTING EXTERNALLY.

DR. FINNELL'S last specimen consisted of a part of the thoracic viscera and the interior thoracic wall, from the body of a man about forty-five years of age. The history of the case was imperfect. About four years ago had first been noticed a pulsating tumor in the sternal region, which had then been diagnosed as aneurism of the aortic arch. It had continued to enlarge until the patient's death, though prevented by the pectoralis major from projecting far forwards. The day before his death, the patient had gone down town to his business; the next morning he arose as usual, but failed to appear at breakfast, and was found sitting up in bed, holding a wash-basin, into which blood was slowly flowing from a point of ulceration in the tumor. He gradually sank and died from loss of blood. At the autopsy the true aneurismal dilatation was seen to begin just above the aortic valves, gradually enlarging higher up until it attained a diameter of about four inches; then it suddenly enlarged, the pleura forming a part of the false aneurismal sac. At least two pounds

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to the bone, of which the periosteum was thickened
and vascular, but had no pus beneath it. The outer one
of the radial venæ comites contained, in the middle of
its course, a firm clot about two inches in length; the
inner one, a whitish clot of soft consistency from com-
mencing disorganization. The basilic and axillary
veins, with the brachial venæ comites, were distended,
throughout their course, by soft clots, buff-colored in
parts, moist, and apparently of post mortem formation.
Upon the brain, chiefly upon its convexity, were seen
numerous little opacities in the arachnoid and the pia
mater, due to thickening, each surrounded by a red
border, due sometimes to congestion, sometimes to ex-
travasation. The substance of the brain showed several
small points of extravasation. Three of its large: veins
contained detached fibrinous clots, evidently formed
some time before death. Upon the pleura at the base
of the left lung was a small amount of lymph.
lung itself exhibited several points of pulmonary
apoplexy, the largest the size of a hazel-nut. In both
lungs were several points of commencing catarrhal
pneumonia. The heart showed, all over its surface,
beneath the pericardium, numerous little white points,
more or less softened, similar to those found on the
arachnoid. At its apex were two small cavities filled
with broken-down, puriform matter. Within, scattered
over the muscular structure of both ventricles, were
white points similar to those on the outside, and, like
them, surrounded in most cases by a red areola. None
were to be found in the auricles. In the left ventricle,
upon each papillary muscle was an ulcerated excava-
tion, perhaps one-eighth of an inch in diameter, and as
deep, apparently the result of a puriform collection
which had been discharged into the ventricular cavity.
Entwined among the tendinous chords, and attached
to the free border of the anterior curtain of the mitral
valve, was a soft, thin lamina of fibrine, about an inch
and a half long by an inch broad, attached by one of its

edges, the other floating more or less free. Upon this lamina were seated numerous little bead-like vegetations; and there were similar vegetations upon either papillary muscle. The liver presented upon its convex surface many of the white points noticed elsewhere, semi-softened, few of them larger than a pin's head, and very few surrounded by a red areola. Both kidneys were studded with them, all having the red border. Those in the medullary portion had a longitudinal arrangement; those in the cortical portion were much softened, as was especially noticeable beneath the capsule; upon peeling this off, some of them were ruptured. In the small intestine were to be seen numerous elevated points, from the size of a pin's head to that of half a split pea, surrounded by the red areola; some of them strung along like rows of beads, others evidently due to enlargement of the solitary glands. Some of the larger ones were denuded of epithelium, and showed commencing ulceration. The stomach presented one of these points; throughout the large intestine was to be found but one, which was in the cæcum. The prostate, bladder, etc., showed nothing abnormal.

AORTIC ANEURISM. RUPTURE INTO ESOPHAGUS.

DR. LOOMIS presented a specimen of aortic aneurism from a case in which death had occurred from its rupture into the oesophagus. The patient, an Irishman, forty years old, had been admitted to Bellevue Hospital, on the 20th of Dec. last, for facial erysipelas of a severe type, from which he recovered in about three weeks. He was a man of temperate habits; had no hereditary predisposition to phthisis; had seven years before contracted syphilis, which had been treated with mercury to ptyali-m, but from which he had never fully recovered, the manifestations of the disease frequently recurring. During his convalescence from the erysipelas the patient first noticed and called attention to a swelling of the abdomen, found, on examination, to be due to ascites. The liver was very small and nodulated on its under surface. The spleen was enlarged, with tenderness on pressure over it. Examination of the chest discovered a loud, rough, systolic murmur heard all over its anterior portion, the point of maximum intensity being at the junction of the third rib with the sternum, on the right side. There was no impulse at this point, no swelling, no unnatural area of dulness, no pain, no tenderness on pressure, no difficulty of deglutition. The only rational symptom referable to the chest was a cough, coming on in paroxysms which were very frequent during the early part of the patient's stay in hospital, but later became less so. During this time he had repeated attacks of epistaxis, some of them so severe as to demand the plugging of the nares. About four weeks before his death, there was physical evidence of fluid in both pleural cavities, attended with more or less dyspnoea, but not aggravated. A week or two later he became deeply jaundiced, and after this he would at times pass into a state of coma, in which he would remain for an hour or two and then come out bright again. He was generally aroused by a paroxysm of coughing. On the 12th of March, during one of these spells of coughing, he was seized with profuse hemorrhage from the mouth and nose, of which he died in a few minutes.

On opening the thorax, both pleural cavities were found half-full of serum. The heart was pale and flabby, but of natural size. The aorta, from its origin to its passage through the diaphragm, was converted into a number of aneurismal pouches. One of these had ruptured into the oesophagus, about two inches above its passage through the diaphragm, making an opening

about three-fourths of an inch in diameter. This opening had apparently been caused by the gradual thinning of the walls under pressure; there was no evidence of ulceration. Along the course of the aorta were several of these pouches, with very thin walls, all of small size, varying from half an inch to an inch in diameter. One, upon the descending portion of the arch, had by pressure upon the lung caused inflammation sufficient to produce close adhesions between the lung and the walls of the sac. It was so thin that it must very soon have burst. One of them pressed upon the recurrent laryngeal nerve; and this was probably the cause of the paroxysmal cough. The abdominal cavity was found half-full of serum. The liver was a typical specimen of cirrhosis. The spleen was enlarged, weighing thirtytwo ounces, and abnormally firm. The kidneys were apparently healthy.

DR. LOOMIS remarked that the point of maximum intensity of the murmur in this case was worthy of notice; as this was the third specimen he had presented to the Society of aneurismal tumor given off at the origin of the aorta, into which the maximum intensity of murmur had been upon the right side. The seat of rupture was also interesting; he had seen no other case of rupture into the oesophagus. Another noticeable point was that there should have been no difficulty of deglutition.

DR. FINNELL said that Dr. Beach had presented a specimen of aortic aneurism ruptured into the œsophagus.

DR. BEACH said he had seen two cases of the kind. DR. SANDS had seen, some years ago, a case in which the aneurism had burst simultaneously into the oesophagus and the trachea. Forty-four ounces of blood were found in the stomach.

DR. ROGERS thought that if the cough, in the case presented, had been caused by pressure upon the recurrent laryngeal, the voice should have been deranged.

DR. LOOMIS replied that the pressure evidently was not constant, or the cough would have been constant; and that during the paroxysms of coughing the voice became very husky, though there was not complete aphonia.

DR. SANDS presented, in the name of the Pathological Society of Albany, a collection of excellent stereoscopic photographs of pathological specimens, taken under its superintendence. He stated that the Commissioners of Public Charities and Correction, of this city, had provided for the use of the hospitals the means of taking a similar record of interesting specimens and cases; and that physicians were at liberty to avail themselves of its advantages in their private practice, at a very cheap rate.

UNUNITED FRACTURE: FAILURE OF BRAINARD'S OPERATION: FIRM UNION, BUT WITH PARTIAL PARALYSIS, AFTER RESECTION AND WIRE LIGATURE.

DR. SANDS presented a beautiful preparation of united fracture of the humerus, the dissection of which, showing the musculo-spiral nerve, had been made for him by Dr. Curtis. The history of the case was, in brief, that the patient, a chief engineer in the navy, thirtythree years old, large, robust, quite fat, and quite intemperate, had broken his left arm, about the junction of its middle with its lower third, April 18, 1866. He had entered the New York Hospital, where Dr. Sands had accidentally seen him, and noticed that the splints were applied to the arm alone, leaving the forearm free. In the latter part of June he applied to Dr. S. to be treated for non-union of the fracture. This was complete, there having been no attempt at repair. On the 22nd of July, Brainard's operation was performed

the bone being perforated in three or four places, through a single cutaneous opening; and the limb was put up in a starch apparatus. No benefit resulted, and the operation was repeated August 16, and again September 22. On the 11th of October a note was made that there was some firmness at the seat of fracture. On the 20th of that month Brainard's operation was tried for the fourth time. On each occasion the drilling had seemed to be very thoroughly done; though owing to the thickness of the muscular and adipose tissues, it was impossible to tell the exact position of the fragments, or just how the drill was penetrating them. It was now proposed to cut off the ends of the fragments and wire them together. To this the man did not immediately accede. He travelled, and consulted various practitioners, regular and irregular, finally returning for the operation, which was performed February 9, 1867. Cutting down upon the bone, the fracture was found to be oblique, the acute ends of the fragments overriding each other in such a way as to present the least possible surface for repair. It was probably to this peculiar position, that the failure of the previous operations was attributable. The ends were sawn off, and the fragments tied together by a single stout silver wire (No. 27). This was effected with no little difficulty, from the thickness of the soft parts and their infiltration. Great care was taken to avoid injury to the musculo-spiral nerve, which should run just at the point of fracture. A note was made that it was looked for, but not found and not injured. On the 27th of April the limb was finally removed from splints, firm union found, and the wire withdrawn. It was observed that the patient had lost power over the extensors; and the doctor gave an unfavorable prognosis, fearing that the nerve just referred to had become included in the cicatrix.

After this date the Doctor did not see the patient; but the man had lately fallen dead in the street, and he had obtained the specimen. This showed the fracture oblique; the position of the resected ends almost perfect; no trace of the wire ligature. The musculo-spiral nerve ran directly over the seat of fracture, and was either partially or wholly divided; it was difficult to say which, though traction upon one part would move the other. As to the way in which this injury occurred, Dr. Sands was inclined to think that, in spite of the precautions taken, it had been done with the knife; it might have been due to pressure of the nerve between the bones; or the nerve might have been included in the cicatrix; it could not have been included in the wire ligature, for that was passed upon the opposite side. This accident was not a rare one, as several cases of it were already on record. The Doctor did not see how it could always be avoided where the patient was fat and muscular, for it is necessary to resect the ends of the bone without removal of the soft parts to any great extent.

This specimen was preserved in gasoline, which has been proposed as a cheap substitute for alcohol. Some discussion ensued concerning the merits of this fluid, the general opinion being that its antiseptic properties were insufficient for the preservation of fresh specimens, though such as had been already hardened by alcohol might be safely kept in it.

OVARIOTOMY-INTERESTING DIAGNOSIS.

DR. PEASLEE presented an ovarian tumor, together with the other ovary, the uterus showing the ligatures as applied to both pedicles, and a portion of the abdominal wall showing union of the incision, from a patient upon whom he had performed double ovariotomy. He

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remarked as follows: The patient was a lady twentyfour years old, married two years. Shortly after mar riage she first noticed a tumor in or near the right iliac fossa. About last August she observed fluid in the abdominal cavity. In October she was visited by a physician, and the case was pronounced one of ovarian tumor complicated with ascites. On the 1st of February she was tapped, and about fifty pounds of fluid were drawn off. About four weeks later I saw her. largest circumference of the abdomen was then 42 inches; before the tapping it had measured 48. No definite information could be gained as to the nature of the fluid removed; and the diagnosis of the case offered some points of interest, to which I would call the attention of the Society. With the patient on her back I found fluctuation, and dulness on percussion, over every part of the abdominal walls. Turning her to either side, there was dulness everywhere except low down over the region of the colon. No fluctuation was communicated, from the mass of liquid in the abdomen, to the finger passed per vaginam or per rectum. patient standing, a tumor, apparently globular and solid, could be felt just above the ramus of the pubes on the right side; and this could be raised easily, as if floating in fluid; and upon removing the pressure, it would fall back again, as does the head of the fœtus in the process of ballottement. The umbilicus was somewhat prominent, showing that some fluid, at least, had accumulated in the peritoneal cavity. I concluded that the diagnosis lay between that of an ovarian tumor complicated with ascites, and that of a very large ovarian sac, with a smaller one floating in a smaller quantity of ascitic fluid. I decided in favor of the former supposition, though some of the facts just mentioned militated against it. The patient was immensely anasarcous all over the lower half of the body; but there was no pitting on pressure upon the upper limbs or the face.

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Proceeding to the operation, I made an incision three inches long, midway between the umbilicus and the symphysis pubis, through the skin and down to the abdominal aponeurosis; and through this a very nute incision, to ascertain the nature of the fluid in the abdomen. It was evidently ascitic. A steel bougie was passed around the tumor, and its pedicle easily made out as very long. The peritoneal fluid was then evacuated; and before enlarging the incision-not to be again deceived as in another case presented to the Society, where the tumor turned out to be an outgrowth from the uterus-I passed a sound into the uterus, and then found I could completely grasp this organ through the now flaccid abdominal walls, and distinctly feel the pedicle passing off to the right side. The tumor, on being brought into view, was found to be polycystic, but the sacs were all so very small that it could not be diminished by tapping. The incision was accordingly prolonged to an inch and a half above the umbilicus, and the tumor drawn out and removed. Its pedicle was the longest I have ever seen, measuring 34 inches; and in ligation more than half of it was removed as undesirable. The other ovary was sought, and found to have commencing disease of the same kind, so I took that out also. Both pedicles were ligated with the double silk ligature, cut off short and returned into the cavity, as I have always done. Not a drop of blood had escaped into the abdominal cavity. closing up the incision, passing my hand down towards the Douglas cul-de-sac, I found that I could not reach it, but met there a globular mass, about three inches in diameter, resembling calves' foot jelly inclosed within a very thin membrane; and another smaller one, about the size of a hen's egg. I took them out and laid them on

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a plate for examination; but for this I had no opportunity; for in about twenty minutes, during which I was attending to the patient, the contents had dissolved away the investing membrane, leaving a semi-fluid mass out of which I could make nothing. I have no doubt that they had originally belonged to the ovarian tumor, and, becoming separated, had fallen down into the Douglas cul-de-sac, completely filling it. The fact that the cul-de-sac was filled in this way explains the non-transmission of the fluctuation from the abdominal cavity to the finger in the vagina or the rectum. The dulness on percussion over the abdominal walls, the patient lying supine, was no doubt due to the fact that the fluid rose higher than the length of the mesentery would allow the intestines to rise, so that there was a layer of fluid still above them. Before the operation the fluid had for some time been accumulating at the rate of a pound and a half a day. In view of this, and of the fact that the peritoneum was found more highly congested than I had ever before seen, I expected that the effusion of ascitic fluid would still continue for a time after the operation. I therefore introduced a tent at the lower end of the incision, intending after four or five days to pass a silver catheter to ascertain the amount and character of the fluid in the abdominal cavity.

servedly attracting much attention at present in the profession, and as the reason of its non-transmissibility has never to my knowledge been explained, I submit these few lines, that you may-if you deem it propergive publicity to them, not that I claim infallibility in my explanation, but as everything that awakens discus ion elucidates truth, I may hope that by this view becoming the bone of contention, the absolute truth may be revealed. That the non-transmissibility of syphilis is founded upon sound doctrine, is, I think, clearly demonstrated by Beale's germinal-mat er theory. He inculcates that germinal matter, from whatever tissue taken, and placed in the substance of another, will always produce that from which it was obtained, and not that in which it is placed, e.g., Periosteum will never produce anything but bone, no matter where it is placed. This holds good in pathological processes; transplant syphilitic virus to a healthy soil, and it will form a chancre; inoculate a person with vaccine lymph and vaccine will be produced. Again, germinal matter possesses the inherent property of CONVERTING the nutritive material derived from the blood into matter like itself.

From these data it seems plausible to infer that vaccine lymph possesses the same property as other germinal matter of REPRODUCING ITSELF, and TRANSFORMING the fluids (syphilitic ?) which it receives from the blood INTO ITSELF, and therefore it is that when taken in a perfect state, it can never transmit any disease except its own. Yours truly,

28 West 15th Street, N. Y.

ALEX. W. STEIN.

LOOSE CARTILAGES IN THE KNEE-JOINT. (INFORMATION DESIRED IN Regard to unpublished cases.)

TO THE EDITOR OF THE MEDICAL RECORD.

After the operation the patient appeared to be doing well, and presenting no unusual symptom except that she passed, almost constantly, an immense amount of urine, which seemed to be so irritant that she could not hold it. The anasarca disappeared completely, so that in forty-eight hours she was reduced to a mere skeleton. This gave me anxiety, as it showed much greater emaciation than I had supposed. Still the case went on favorably, with the single exception of irritation of the bladder. There was nothing to denote peritonitis, the pulse rarely rising above 100, though once to 112. On the morning of the third day, the patient, who had passed a good night, was spitting up a little mucus, to which she attached no importance, as she had often SIR-In February, 1861, Doctor T. H. Squire, of this done it before. Two hours later, at 11 A.M., I was in- city, and myself were obliged to defend a suit for alformed that she had vomited a little bile. Soon after leged malpractice, growing out of an operation per12 o'clock, the vomited matter much resembled the formed by us for the removal of a loose cartilage from black vomit of yellow fever; and at 1 o'clock she was the knee-joint-the result of the operation being anchydead. Death was so sudden that there was hardly time to losis-the result of the suit being in our favor. În send down stairs to tell her husband that it was im- preparing ourselves for defence, assisted by physicians minent. This was about 72 hours after the operation. at home and abroad, we collected information in regard You will see by the specimen that there is no evidence to 206 operations for this troublesome difficulty, while of any loss of vitality in the pedicles beyond the liga-information, in tabular form, was published by Baron tures. A very slight degree of peritoneal inflammation Larrey in the Gazette des Hopitaux for June 8, 1861. was found. About two quarts of fluid were contained in the peritoneal cavity, all, or nearly all, ascitic, with less than a drachm of fibrinous material floating in it.

The Society then went into Executive Session.

Correspondence.

TRANSMISSIBILITY OF SYPHILIS BY
VACCINE VIRUS.

TO THE EDITOR OF THE MEDICAL RECORD.

MY DEAR SIR-At a meeting of the Journal Association, held June 5, a discussion arose relative to the transmissibility of syphilis by vaccine matter, in respect to which a diversity of opinion was elicited. I believe experience more and more establishes the fact, that syphilis is not transmitted by vaccine lymph, except it be mixed with blood, or the secretion from a specific sore, or when taken at the pustular stage. As this is a subject of vital interest, and one which is de

After an interval of seven years, a letter has been received by Dr. Squire from Alfred Poland, Surgeon to Guy's Hospital, London, in which he states that he is about to publish a small work upon loose cartilages in the knee-joint. He has tabulated all published cases, up to the present date. He is now pushing his investigations still further, and desires of his medical brethren information in regard to cases that have never been published.

Any reader of the MEDICAL RECORD who may possess such information, will confer a favor upon Mr. Poland, and render a service to the cause of science, by communicating the same to me as soon as possible.

The chief items of information are the name, residence, age, and occupation of the patient; the part articular knee affected; the size, mobility, supposed cause, and symptoms of the foreign body; the duration of the difficulty; the treatment, whether by operation or otherwise; and if operated upon, by what method, and finally, the result of the case, together with any reflections or remarks that may be added.

Proper acknowledgment of thanks, and due credit,

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