revolutionary in its effects. He found one of Brown's prescriptions was to the following effect, and they would recognise in it something not unlike what they had seen in their own time:-"For breakfast, toast and rich soup made on a slow fire; a walk before breakfast, and a good deal after it. A glass of wine in the forenoon from time to time. Good broth or soup to dinner, with meat of any kind he likes, but always the most nourishing. Several glasses of port or punch to be taken after dinner, till some enlivening effect is produced from them, and a dram (of whisky?) after everything heavy. One hour and a half after dinner, another walk. Between tea-time and supper a game with cheerful company at cards or any other play, never too prolonged; a little light reading; jocose, humorous company, avoiding that of popular Presbyterian ministers and their admirers, and all hypocrites and thieves of every description; lastly, the company of amiable, handsome, and delightful young women, and an enlivening glass." He thought in that prescription they could see what was the nature of the famous Brownonian system, and the end and issue of Brown's lectures upon direct and indirect debility and excitability. It was a very curious proof of how things went to sleep and were revived again in medicine, that they should have seen a revival of this in their own day. People had come repeatedly to himself who had been advised to take four or five glasses of port wine after dinner, and after that as much toddy as their heads could carry, as a regular part of a prescription going on for weeks together. But the advancement which had taken place in the sciences, the fact that the clinical study of medicine had been far more carefully systematised, and the introduction of those practical methods of teaching to which Sir Robert Christison had referred, had made it impossible for any man coming forward with a new theory to make such a revolution as was the case in Brown's time, and as had been the case in the history of medicine almost from the days of Hippocrates. In regard to medical teaching, he sympathised very much with Sir Robert Christison's remarks. The true ideal was to have the practical and the systematic methods in one hand; and that, he believed, would do all that could be done to secure medical doctrines against such revolutions as he had referred to. Regarding the medical art as a tree, he remarked that unless its roots were well fixed into the realms of fact, it would be overturned, and unless its leaves were freely opened to the current of opinion, it would be choked out.

In the chair of the Psychological Section, Dr. Lowe, who was president, made the following remarks:-In opening the proceedings he took occasion to refer to the ebb and flow which, he said, no one would deny to be continually taking place in medical opinion. For example, it was not long since antimonial wine was almost universally prescribed; but now, how little was it employed! He would not say that the trade of the leech was gone, but certainly leeches were at present scarcely sold; while a more recent instance of the caprice to which he alluded was to be found in the fact that podophyllin was introduced within the easy recollection of them all by a practitioner of high and well-deserved repute, and yet he was told by druggists that it was now rarely made up. Nor would anyone, he thought, deny that this fashion, this ebb and flow of opinion and practice, had obtained in that particular branch of medicine which they called the psychological school. A few years ago they heard a great deal of the pack-sheet and Turkish baths, which, with many other things, had, as they all knew, been from time to time extolled; and then, from no other reason, so far as he could see, except than that of want of novelty, these had fallen into disuse; and who dared say that chloral and bromide of potassium-their sheet-anchors at present-would not in turn give place to other remedies? This ebb and flow could not be taken as always indicative of progress; yet this was all they had apparently arrived at until a few years ago, when something more than a temporary fashion in psychological medicine was seen to dawn on the horizon. It was in this country, from the slight but brilliant scintillations which emanated from their venerable friend, Dr. W. A. F. Browne, Dumfries, that a truer and more lasting course of study was inaugurated. Psychology was now only in its infancy: happily the infant was a vigorous one. Then, again, if to Dr. Browne belonged the honour of the first steps in psychological instruction, could they forget the more recent and more systematic teaching of their late friend Dr. Skae? A very few years ago the now well-recognised disease of general paralysis was scarcely known; now, alas! how little was treatment available except

to prolong a wretched existence; but who could say to what results the pathological observations of that disease-first made, he believed, at the Royal Edinburgh Asylum by Dr. Howden-might presently lead? At all events, let them contrast the value of such researches with the speculations and practices of a former generation, when they floated on the opinions of the day guided by little else but phenomena, of the cause of which they were entirely ignorant. It was even in his day, and in the remembrance of many present, that their asylums were many of them dens, or at best only receptacles for lunatics. They were now throughout the country a credit to humanity and civilisation, and, instead of being dens or mere homes for the insane, each might now be regarded as a school of psychology, instead of psychology being tacked to the end of the course of medicine. Public lectures and clinical teaching were provided for any who might desire to cultivate this most important branch of study. If such was the progress made within the last few years, was it too much to predict that ere long they should see not only extramural teaching, but in the Edinburgh University a chair of psychological medicine? The subject would never be justly estimated or fitly taught till this important step was gained. The present Professor of Medicine, Dr. Laycock, whose efforts had ever been directed in forwarding the science of psychology, would not, he was sure, be the one to retard its progress. Were every commissioner in lunacy and every physician of an asylum compelled to produce his diploma in psychological medicine, while the class was at the same time open to the general student, who could doubt but that this great measure would be valued, and more, would be self-supporting? He believed he was neither too sanguine nor too enthusiastic in believing that, in much shorter time than it had taken to accomplish the present hopeful state of things, the imaginary chair he had sketched would be attained.

One very important and useful function the Association has lately assumed is the assistance given by them pecuniarily to investigators of physiological phenomena. On the present occasion, Dr. Falconer submitted the report of the Committee on Grants for the carrying on of scientific investigations. The Committee stated that they had thought it desirable to adopt for the present year the "conditions" for grants which were in use by the British Association for the Advancement of Science. The following were the grants recommended by the Committee at their meeting in January, 1875, and approved by the Committee of Council:-Mr. Hicks-Researches on Alcohol, £50; Mr. P. M. Braidwood and Mr. Francis Vacher, Birkenhead-The Life History of Contagion, £15; Dr. R. Caton, Liverpool Royal Infirmary-The Electric Currents of the Brain, £20; Dr. J. M. Fothergill, London-The Effect of certain Agents upon the Circulation, £10; Dr. M'Kendrick and Mr. James Dewar, Edinburgh-Physiological Action of Chinodine and Pyridine Compounds, £25; Dr. Mahomed, London-The Pathology of Albuminuria, £20; Dr. Munro, Cupar-An Antidote for Chloroform, £5; Dr. W. H. Spencer, Clifton, Bristol-The Action of Uranium Salts in Diabetes, £20;-in all, £165. Of these grants the following amounts have been expended:-Mr. P. M. Braidwood, £12 12s. 4d.; Dr. R. Caton, Liverpool, £8 16s. 9d.; Dr. Fothergill, London, £3 18s. 10d.; Dr. M'Kendrick, £5; Dr. Mahomed, £5 12s. 8d.; Dr. Munro, £2 15s. 11d.; and Mr. W. H. Spencer, £13 15s. 11d. The Committee also recommended a grant of £30 in aid of researches carried out during the past year on the Biliary Secretion by Professor Rutherford, University of Edinburgh, and M. Vignal. The results of this investigation would be laid before the Association at the present meeting by Professor Rutherford in his Address on Physiology. The balance in hand would then be £101 6s. 5d., which would be returned to the treasurer. Committee recommended that a further grant of a total sum not exceeding £300 be made for the purposes of scientific work during the year ending July 30, 1876.

The

Dr. J. D. HEATON, Leeds, moved that the report be adopted, and a grant of £300 made for the year 1876, in accordance with its recommendation.

Dr. MORTON, Glasgow, seconded the motion, remarking that the only thing he regretted was that the sum at the command of the Association for such purposes was not much greater.

Mr. HUSBAND, York, said he believed the Association was quite disposed to make as large grants for the promotion of medical investigation as Dr. Morton could desire; but they had ascertained, after careful inquiry in committee, what the requirements would be for next year. If they found a dispo

ON THE LINGAM (OR PHALLIC?) AND SERPENT WORSHIP: GREAT PREVALENCE OF LINGAM WORSHIP; EMBLEMS FOUND WHEREVER SIVA IS ADORED; PURE LINGAYETS; NATURE OF RITES; SIGNIFICANCE OF THE WORSHIP; NOT INDECENT, LIKE THE PHALLUS; PROBABLE ORIGIN; SERPENT WORSHIP AND ITS SIGNIFICANCE.

ONE of the matters that is regarded with some curiosity by strangers here is the worship of the Lingam; and as this is a custom followed by millions of the human race, and is a part of the natural history of the human mind, it deserves the notice of the physician and the philosopher.

To show how prevalent it is, let me recapitulate that in the Presidency of Fort St. George, or Madras, there were, as Dr. Cornish tells us, at the Census of 1871, thirty-one millions and a half of people. Of these, the Hindus numbered more than twenty-nine millions (29,160,807), the Mohammedans nearly two millions (1,866,363), the Christians more than half a million (545,120), of whom 501,627 are native Christians. Out of the twenty-nine millions of Hindus, there are eleven and a half millions of worshippers of Vishnu, nearly a million of "other" and miscellaneous, and between sixteen and seventeen millions of worshippers of Siva; and the Sivaites take and worship the Lingam, or organs of generation, as the visible emblem of God. (a)

in the

Sometimes, I am told, the Lingam is worshipped in the form of any conical or cylindrical stone, and for this purpose oval pebbles from the bed of a sacred river are much esteemed. Dr. Furnell describes "the famous Lingam stone Temple of Bisheswar at Benares, as a "plain black stone, shaped very much like the large conical shot of modern artillery, placed on the floor, and standing about eighteen inches or two feet high." (b)

FIG. 1.

FIG. 1.-This represents the upper part of an upright tombstone in one of the Hindu cemeteries at Madras. The sacred bull, the vahan or appropriate vehicle of Siva, is seen guarding the sacred emblem. The Lingam, guarded by a five-headed cobra, which is erect over it, stands up from the middle of the Argha. The Yoni, on the side next the bull, ends in a spout, to allow the water poured on the Lingam by worshippers to run off.

But far most frequently the Lingam, which represents the masculine power, is seen in conjunction with the Argha or boat-shaped cavity, whose rim is called the Yoni, which

(a) Lingam" is a Sanskrit word meaning a mark, sign, token, emblem; anything that distinguishes or defines; mark of sex or gender. (b)"From Madras to Delhi and Back," p. 60.

typify the female elements. The conventional form is seen in Fig. 1. There is sometimes said to be some attempt at representing anatomical details, but they are hardly, if at all, recognisable in general. As things are, the outline of the Lingam and Yoni resembles that of a flat candlestick, or of a steamer with a funnel, or a sauceboat, and no one would detect the resemblance that is intended unless he knew it beforehand. In conjunction with the Argha and Yoni, Lingams are made of all sizes out of stone and other materials-some of large size, and stationary, in temples; some very minute and portable, for houses, or to be worn in little caskets by the devotees. The Lingam is generally guarded by Nandi, the sacred bull of Siva, an effigy of which accompanies it on the walls and pinnacles of temples, and in religious books. But the places where these emblems are seen most constantly are the Hindu cemeteries. At the Sivaite end of the cemetery may be seen substantial brick and stucco tombs aud monuments (Fig. 1), each with its Lingam. As I have said before, many of the Sivaites bury their dead, although the caste people, or upper classes amongst them, burn, as the Vishnuvites do. In one cemetery I lately walked through, at Mylapore, the Sivaites occupied one end of the cemetery with substantial tombs and graves on which shrubs were planted. The Vishnuvites had a few tombs only, amongst the burning-places at the other end. (Let me say, by way of parenthesis, that I was horrified at seeing a Pariah woman grubbing with her hands amongst the heap of cinders and clinkers where a body had been lately burned, to find out any portions of unburned fuel, which she put into a basket and carried home to cook her dinner; and I am told that many people will steal fuel from a funeral pyre whilst the body is burning, unless strictly watched.)

The Lingam, as an emblem of God, occupies the chief place in all temples dedicated to Siva under any one of his thousand names, or to his wife, or to his sons, or sons' wives, or servants; for in the complicated mythology of the Hindus every god has a large family, and it is supposed that the sons or other inferior deities are the channels by which petitions on important matters reach the Supreme himself. Their images are innumerable.

But there is a sect numbering 155,658 persons in the Madras Presidency, who are known as Jangams, Vira Saivas, or Lingayets, who are followers of Basava, a prophet of the twelfth century, who "determined to get rid of all Brahmanical priestcraft, and refused to worship any deity but Siva, whose image, the Lingam, is the most ancient idol known to the Hindus." (c) These Lingayets wear a silver casket containing a Lingam, suspended from the neck by a string, or tied to their left arm, or concealed in their hair. These people, when duly initiated, have the privilege of making for their daily devotions a temporary Lingam of earth or clay (Parthiva Linga), which they put upright in their left hand. This is next "consecrated or made a symbol of the divine presence by the utterance of muntrums or sacred formula, of which, I am told, the words "I put in life" are the chief. Having made and consecrated his idol, the devotee proceeds to offer to it Puja, or worship. First he offers to it water for ablution, or water mingled with honey, sugar, and milk. He adorns it with a garland of flowers, and utters muntrums, especially repeating 108 of the 1000 names of Siva. Then he burns camphor and benzoin, on a silver dish if a rich man, on a leaf if poor; then offers to it fruits, rice, and other eatables, which are afterwards consumed by the worshipper or given to the poor; and then disconsecrates the idol, uttering the words "I send it back to its own place," and throws it into water. I have seen mud or clay Lingams on newly made graves.

The majority of the worshippers of Siva do not wear the Lingam about them, saying that they prefer to have God in their heart, and do not think it needful to hang him to a string round their neck.

Pouring water on the Lingam is one of the chief acts of worship, and all the little temples and shrines have a spout outside to let it run away.

So far we have dealt with matter of fact-with what people say and do. Now for theory. And first of all let me say what the Lingam is not. Especially there is nothing about this highly conventionalised emblem to suggest indecency or licentiousness. Here let me quote from Mr. Fergusson:"Nothing is more common than to connect the worship of the Lingam with the impurities with which the Hindu (c) C. P. Brown, "On the Creed, etc., of the Jangams," Madras Journal of Literature and Science, vol. xi., p. 143.

religion is only too justly reproached. This, however, is a mistake. The worship of Siva is too severe, too stern for the softer emotions of love, and all his temples are quite free from any allusion to it. The contrary is the case with the Vaishnavas, who abhor the Lingam. Love pervades all their myths, and their temples are full of sexual feelings, generally expressed in the grossest forms. The existence of any such representation in a temple at once fixes it as originally dedicated to the worship of Vishnu or some of his Avatars."(Fergusson, "Tree and Serpent Worship," p. 71.)

"This symbol," says Mr. Brown (op. cit.), "is as separate from indecency in the Hindu mind as circumcision is in the Mohammedan mind."

The Hindu speaks of the Lingam as innocently of any prurient meaning as possible. I am not learned enough to say whether the origins of the Hindu Lingam, of the Egyptian Thau or symbol of life, and of the Greek and Roman "phallus" and "priapus" were identical. But anyone who has ever seen a "phallus," or any of the priapic images preserved in a museum of Italian antiquities, will see that they are distinctly sexual and prurient in form and intent, whilst the Lingam is not. Let me quote, in support of this, from that charming account of an Italian tour in Matthews's "Diary of an Invalid." He is describing the objects in what used to be called Museo Borbonico at Naples, but since the fall of the Bourbons it is known as Museo Nazionale.

"The Phallic ornament worn round the necks of the ladies as a charm against sterility appears in every variety of material-gold, silver, coral; and invention seems to have been racked to represent it under every variety of shape. Sometimes it is a snail peeping out of its shell; sometimes a Cupid astride is crowning it with a chaplet; and sometimes it terminates in some frightful reptile, that turns round with an expression of rage. What can demonstrate more clearly the coarseness and corruption of ancient taste, unless it be the monstrous conjunctions, consecrated by their abominable superstition, which are still more shocking evidences of the depravity of their imaginations ?"-(Matthews's "Diary of an Invalid," p. 191; Lond., 1820.)

The worship of the Lingam, decently or indecently, was early very widely spread, and its origin seems to point to a time when men were less artificial than at present, and when they spoke and thought with freedom of those most miraculous forces of generation by which the human race is increased and preserved from extinction. Amongst ourselves, people are becoming so nice and superfine that they object to the plain speaking of the Office for Holy Matrimony, and really blush to be told that the end of marriage is the procreation of children. At one time, when men were simpler, the renewal of all created beings by generation and birth must have appealed to their minds with all the force of wonder and mystery which really belong to it. To them it was creation made visible; and it is not to be wondered at that they took the instruments of the process to be symbols of the power that lay beneath; for, observe, in the first place, these symbols are not worshipped otherwise than as symbols. It is not the genitals, or their function, which are the object of idolatry; there is nothing prurient or impure about them or their worship; it is not sex which is worshipped, but the god whose power is manifested in the operations of sex. In the second place, in worshipping Siva, they intend to worship the supreme and only god, although, most likely, they only look upon him as co-existent with, and pervading and animating all matter, living and dead, and not such a personal God as we contemplate, who is over all, separate from all, and the pre-existent Creator of all. The Phallus of the Greeks and Romans had degenerated, before the time when Roman literature flourished, into the emblem of Lust; it was essentially impure, and suggestive of licentious thoughts, and intended to be so.

We are told that the earliest idols were stones or logs; and that " some shapeless log, or a black stone or the red-stained trunk of a tree, is still the object of adoration amongst the masses in India" (Hunter's "Orissa," vol. i., p. 95). What we know as modern Hindu religion, in which Siva or Vishnu is recognised as the representative of God, is Aryan and Brahmanical. The question then comes, Did the Brahmans accept the ancient prehistoric fetish, and give it a sexual meaning, or were the ancient stocks and stones sexual emblems from the first?

Anyhow, the Lingam is now environed with subtle theories by the priests, and with grotesque legends amongst the vulgar. The prevalent sect of philosophers say that when the supreme

being (such a being as the German Universum) became conscious of his own existence, he felt desire to be; and so the world came into being, which next divided itself into male and female, or siva and sacti, out of which all things were generated; the Lingam is therefore an emblem of God in creation. [N.B.-God and matter are inseparable.] Of the popular legends, I need not quote samples; they are grotesque and silly rather than indecent.

The sum is, that the Lingam is the emblem of God, and worshipped as such, and, when consecrated, is believed to be Swami or God. No doubt women pray to it for children; but so they do to every other conceivable god and goddess.

Amongst antique objects of reverence are trees and snakes -not to mention the sun, and other objects of nature. Trees and snakes are worshipped still in Madras; and here and there by the roadside may be seen two trees-the peepul and margosa,-and under them three carved stones: one representing two snakes in conjunction, another Krishna strangling a snake, and the third probably a Lingam guarded by a seven-headed cobra. Ages of Brahmanism, says Talboys Wheeler, have failed to stamp out the old primitive worship of the serpent, as not only the deity of the regions below, but as the guardian of the household. There is said to be a sacred serpent in a garden near the Lying-in Hospital in Madras, to which the patients address their prayers. That the serpent-worship was once widespread is evident from the serpents represented as twining round the rod of Esculapius, which are the same as those sculptured by the Hindus of old. These figures abound in the ruins of Pompeii. Mighty nations-as the Scythians of old-took the serpent for their emblem (Fig. 2); there were naga, or serpent dynasties; and FIG. 2.

FIG. 2.-This represents an upright stone, with two serpents sculptured in relief, and the Lingam between them.

of such nations, one tribe at least-the Nagas of Assam-have made themselves known to the British public of late. There is a monument in Madras Cathedral to Mr. Mack, a young surgeon of great promise, and this represents Hygeia holding the funeral urn with one hand, and giving drink to a serpent out of a patera with the other. All these familiar emblems deal with the serpent as a good guardian and tutelary genius; but it has the greatest repute as a bestower of offspring, and hence these serpent-shrines are much frequented by childless mothers. For my own part, I suspect a phallic significance in the serpent as an emblem. This opinion is fully worked out by the Rev. Dr. Donaldson in his well-known "Book of Jasher."

I must not conclude without expressing my thanks to various Hindu friends who have supplied me with informa

tion on their religion, worship, morals, and customs. On all matters connected with Vishnu, I have to repeat my acknowledgments to T. Ramachendra Row, Esq., J.P. I must thank Mr. C. Sabapathy Iyah, barrister-at-law, for procuring me some most interesting conferences with the learned Sivaite pundit, Tambrapurney Subramany Dikshitur, Shastru, and for acting as interpreter.

REVIEWS.

A Treatise on Food and Dietetics, Physiologically and Therapeutically Considered. By F. W. PAVY, M.D., F.R.S., F.R.C.S., Physician to, and Lecturer on Physiology at, Guy's Hospital. Second edition. Pp. 613. London: J. and A. Churchill.

Is a remarkably short time Dr. Pavy's book has passed into a second edition,-a due appreciation on the part of the public of its merits. It is in many respects by far the best work we have seen on food physiologically considered. In especial we can commend the earlier chapters as giving in a concise and accurate manner the modern ideas of food and its destination, of the relationship of nitrogenous, fatty, and starchy food to work and other developments of force. In this part, food is spoken of merely as seen in chemically pure substances; but later it is discussed as to its origin in the shape of flesh from various animals, the products of various vegetable substances, and of the simpler vegetables themselves. This is perhaps, in some respects, the most unsatisfactory part of the book. As regards our ordinary articles of diet, knowledge as to the digestible nature of substances is so uncertain that a proper standard is hardly possible-not even, we fear, if renewed experiments similar to those on Alexis St. Martin were undertaken. The conditions of life, too, are so various, are so different, that it is not easy to obtain comparative results. These, however, are absolutely necessary, and very much might be done in this way by making extended researches on a group of convicts. Theirs is the only class subject to perfect and absolute control; they are generally healthy, and are seldom troubled with the activity of brain which is apt to disturb calculations founded on more highly intellectual beings than most of the class. This was the day-dream of an old friend who had long studied convicts, but who is now no more. We have never heard of a better mode of investigation. Dietaries for convicts are now in existence, but they are hardly so perfect as might be. To return to Dr. Pavy, we find that in this second edition his chapter on wines is decidedly improved, and is now very fair indeed; and when we come to the foods of various nations we are still more pleased with the book. The whole reads much like a noveli.e., a novel of the older sort, not such as we get nowadays. In this chapter is collected a vast deal of information as to the food of various nations, and the way in which they mix it. Turning to the subject of cooking, we find the various processes enumerated, but little said about it as seen in actual practice. Among the multitude of cookery-books-and they are many and various-there are few hints given as to cookery for invalids. The subject is not a great one in one sense, but very great in another; for the messes palmed off on poor patients as very nice are often detestable. It perhaps hardly falls into the compass of a book like this, yet the want is none the less real. True, the few hints here given are good as far as they go; but we could desire to see them in a separate form go a good deal further. We have but given a faint sketch of the book itself, but we should exceedingly desire to see it in the hands of the profession and the public; it cannot fail to do much good. In the new edition the price has been reduced, though several pages have been added-an exceedingly sensible step on the part of the publishers.

A Manual of Family Medicine in India. By W. J. MOORE, L.R.C.P.E., M.R.C.S.E., etc., Surgeon to the Rajpootana Political Agency, &c. Pp. 518. London: J. and A. Churchill. We do not know that we can do more for this worthy little volume than tell its history. Some years ago the Government of India instituted a competition. The reward was a large one, and many came forward. There had a great want been felt by European sojourners in India. Far from any reliable medical help, they wanted some reliable book on elementary medicine, especially one which would enable them to utilise the resources of the country. The competition was

declared; Dr. Moore came out victorious, and we have now before us the mature outcome of his labours. It seems to us entirely suitable to its purpose.

Affections of the Throat and Larynx: their Classification, Pathology, Diagnosis, and Treatment. By ARTHUR TREHERN NORTON, F.R.C.S., Assistant-Surgeon at St. Mary's Hospital, etc. Second edition. London: Baillière, Tindall, and Cox. 1875.

THIS little work gives a succinct yet adequate account of the principal diseased conditions of the pharynx and larynx from a clinical point of view. Mr. Norton has not followed the hackneyed descriptions of the text-books, but has evidently studied each disease carefully from nature. His remarks on treatment are practical and, we think, judicious. We would venture to suggest that the hints on the use of the laryngoscope, which are almost too brief to be useful to an inexperienced person, should either be omitted entirely or else expanded in another edition, and that some account of the instruments used in laryngeal operations might be inserted with advantage. In all other respects the book is excellent, and we can recommend it to our readers as the most complete treatise on diseases of the throat, of moderate compass, as yet published in England. The plates are well executed, and the general appearance of the book reflects great credit on the publishers.

GENERAL CORRESPONDENCE.

A CORRECTION.

LETTER FROM MR. R. BRUDENELL CARTER.

[To the Editor of the Medical Times and Gazette.] SIR,-In the last number of your journal you have described me as "late" Surgeon to the Royal South London Ophthalmic Hospital. Will you permit me to say that I still hold the officeindicated, and that I have no intention of relinquishing it. August 9. I am, &c., R. BRUDENELL CARTER.

REPORTS OF SOCIETIES.

THE PATHOLOGICAL SOCIETY.
TUESDAY, MAY 18.

GEORGE POLLOCK, F.R.C.S., President, in the Chair.

REPORTS OF THE COMMITTEE ON MORBID GROWTHS. THE report of the Morbid Growths Committee on Mr. Bryant's case of Cancerous Stricture of the Rectum (vide Medical Times and Gazette, January 16, p. 75), was read. The characters of the growth were those of true cancer; the disease was probably not primary in the rectum, but had extended thence from the

ovary.

The report of the Morbid Growths Committee on Mr. Wood's two specimens exhibited on March 16 (vide Medical Times and Gazette, p. 379), was read. The tumour of the scapula was found to be a spindle-celled sarcoma with certain peculiarities. The tumour from the zygomatic fossa was found to be a myxoma with a certain amount of adipose tissue.

BLOOD CYST FORMED IN A SARCOMA.

Mr. GODLEE exhibited a specimen of the above. The specimen handed round was a sample of the contents of what is known as a "blood cyst," which had been growing for a year in the outer part of the leg of a man forty-seven years old. A seton had been passed through it once, and free incisions made in it on two other occasions, without effecting a cure. It formed a tumour, three inches in diameter, projecting above the surface, distinctly fluctuating, and having on its surface two or three purple patches which exuded a dark red fluid. The tumour was removed by Mr. Erichsen; it contained a little fluid blood, a considerable amount of what had the naked-eye characters of blood-clot, and some rather firmer material in the walls. It was superficial to the deep fascia. The supposed blood-clot, however, proved to be the tumour itself when examined microscopically; it was a sarcoma with round and spindle cells, the individual fasciculi of which were separated by hæmorrhages which had taken place into the interior.

Two similar cases reported by Mr. Holmes and Mr. Lawson were referred to, which differed from the present one in an important particular: that, whereas in them the new growth existed only in a thin layer in the cyst wall, and had thus been expanded into a cavity by the hæmorrhage, in this case the microscopical elements were throughout the whole mass separated by the bleeding which had occurred at an indefinite number of points.

NAILS IN THE CROP OF A DUCK.

Mr. ARNOTT showed a specimen of this nature for Mr. Curran, of India. Seventeen nails were found in the crop.

TUBERCLE IN PHEASANTS.

Dr. EDWARDS CRISP exhibited recent specimens of tubercle in a pheasant. He had examined thirty birds within the last few weeks; the liver was affected in all, the intestines in many, the lungs in one only. The tubercle differed essentially, Dr. Crisp held, from that found after inoculation. Cocks were rarely affected; and the affected hens had had, as a rule, two broods within the year.

The PRESIDENT inquired of Dr. Crisp whether he had ever seen a disease resembling scarlatina in fowls. He had been informed of a fatal disease among fowls, resembling scarlatina. Dr. CRISP replied in the negative.

HÆMORRHAGE INTO THE CORD OF A FOWL.

Dr. CRISP also showed this specimen, which was taken from the body of the fowl shown by him at a former meeting. The animal did not improve, and was killed. A few small coagula were found in the cervical portion of the cord.

CANCER IN THE FOWL.

Dr. CRISP showed a third specimen-a malignant tumour from the breast of a fowl; also a cystic tumour from the 'orbit.

DRY GANGRENE OF THE LOWER EXTREMITIES.

Dr. DUKA exhibited a specimen of dry gangrene of both the lower extremities from a young Hindu married woman, aged fifteen years and a half. She was first seen in the eighth month of her first pregnancy, early in March, 1868, at Simla, in the Himalayan Sanitarium of the Punjaub, when Dr. Duka was in medical charge of it. Mortification appears to have commenced spontaneously in the feet, and ascended symmetrically to within two to three inches of the knee-joint. The line of demarcation being well defined, and the general strength of the patient fair, amputation was at once performed. The parts were in the same mummified condition as they were exhibited. There was hardly any bleeding; the conical stumps soon healed, and the patient gave birth to a fully developed child in the following April, about five weeks after the operation. The infant survived nearly three months, and the mother was still alive and in good health in August last, more than six years after the loss of her limbs. Dr. Fayrer, who saw the patient some months later, mentions, in his work on "Clinical Surgery of India," cases of gangrene caused by malarious poisoning. In Dr. Duka's case plugging of the artery seems to have been the pathological condition, as no pulsation could be discovered below the popliteal space.

The PRESIDENT asked whether the patient had been exposed to cold.

Dr. DUKA said that she had not.

PROLAPSUS Linguæ.

Mr. FAIRLIE CLARKE related the further history of the case of prolapsus linguæ which he had exhibited three years ago. The child had been seen occasionally since the operation; he had grown an active, intelligent boy. The tongue was still thick, but could be kept in the mouth, although the stump habitually presented behind the teeth. Speech was thick and indistinct to all but his friends. The teeth were regular, and approached mutually to within a quarter of an inch. The case was unique in this country of the operation at such an early age. Mr. WAGSTAFFE inquired into the nature of the portion removed by operation, and respecting the intelligence of the child. He had seen a case where the tongue was very large, and there certainly was defect of intellect.

Mr. CLARKE replied that one inch and a quarter of the tongue had been removed by the écraseur. The microscopical characters had been described in the Transactions. There was no intellectual defect.

TUMOURS IN THE SACRAL REGION.

Mr. FRANCIS MASON showed such a specimen, which proved to be a lymphadenoma. It occurred in a child of sixteen

months-first as a protrusion from the anus; a large tumour was then felt behind the rectum. Concomitant acute renal catarrh precluded operation. Post-mortem a lymphadenomatous tumour was found lying between the rectum and sacrum. A sister of this child had spina bifida (and was brought forward by Mr. Mason), and the mother had an angular curvature of the lower part of the spine.

SOFTENING OF THE CEREBELLUM.

Dr. EDWARDS CRISP exhibited such a specimen, taken from the body of a woman of twenty, who was found dead in bed. She had complained of severe headache for two years, chiefly over the left ear. The serious nature of her disease would appear not to have been suspected. Post-mortem the left lobe of the cerebellum was reduced to a pulp, and the lateral ventricles were distended. This was the fourth case observed by Dr. Crisp without impairment of motion.

Dr. HARE inquired whether the bone was diseased.

Dr. CRISP replied in the negative. There was no affection of vision.

Dr. COUPLAND inquired as to otorrhoea.

Dr. CRISP said there had been none. Neither was there any suspicion of syphilis.

PURULENT PERICARDITIS.

Dr. CRISP also exhibited a specimen illustrating this condition, from a young man.

COMPLICATED DISLOCATION OF THE ASTRAGALUS. Mr. MAC CORMAC showed a specimen, cast, and drawings illustrative of this injury. A bricklayer fell from a scaffold, and is supposed to have been treated for fracture at the ankle; he was cured, and returned to work. Two years later his thigh was amputated by Mr. Mac Cormac for disease of the knee, and in dissection of the limb the seat of the previous injury was examined. The ankle was quite anchylosed, the head of the astragalus was still in contact with the scaphoid, but the rest of it was displaced backwards; the tendo Achillis adhered to its external articulating surface; the internal malleolus had been fractured; the other tendons were much displaced. A case had occurred to Mr. Le Gros Clark in 1863, and the description given of it might apply to this. Mr. Mac Cormac had just found this patient; he now walked about perfectly well; the bone still lay as it did at first. It was a remarkable fact that little harm seemed to come of displaced astragalus-nearly all cases had been successfully treated.

The PRESIDENT asked how much movement there was, in the second case, at the ankle. From considerable experience he concluded that dislocation of the astragalus was rare without fracture-rarer than in Sir Astley Cooper's practice.

Mr. MAC CORMAC stated that there was considerable movement in the second case, with rough crepitation in the anklejoint.

Mr. DE MORGAN, speaking from memory, described two cases where the astragalus had to be removed by operation; both recovered. He had seen another case a few months ago of dislocation backwards-of the astragalus only; there was probably no fracture of any bone above or below: the displacement was readily reduced.

The PRESIDENT related his experience of several cases.

COLLOID CANCER OF THE RECTUM.

Mr. ARNOTT showed the parts from a case of colloid cancer of the rectum two years after colotomy. A girl of twentyseven was first seen suffering from hæmorrhage from the anus two years after this symptom, as well as pain and obstruction, had begun. A hard substance was readily felt surrounding the rectum one inch from the anus. Colotomy was at once performed on February 24, 1872; recovery was fairly satisfactory. In the following November, menstruation returned, and the girl returned to her employment. Next summer the cancer appeared externally, and obstruction was complete. Fifteen months after the operation the disease invaded the vulva, and probably had travelled up the bowel as well. patient lived for two years after being relieved by colotomy. The prevertebral glands became invaded at last, and a striking appearance was produced by the consequent oedema, which invaded the lower part of the body and the legs, but left the rest free. Post-mortem the whole of the rectum, perineum, part of the vulva, and to within one inch and a half of the

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