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1847.] On the Diagnosis of Adhesions in Ovarian Dropsy. 507 fluid is present; and then, again, it may be present, but so deeply placed behind the sac, that it cannot be perceived by the ear. A valuable sign of the presence of adhesions in front was communicated to Mr. Lee by Dr. Bird.

"When an ovarian sac has attained a size which is productive of great inconvenience and distress to the neighbouring organs, the parietes of the abdomen become greatly attenuated, and the space between the two recti abdominalis is much enlarged; this is well seen if the patient be told, while lying on her back, to raise herself into the sitting posture without the assistance of her arms; and if the sac within be free in its motions it will immediately be protruded through the space between the two recti muscles, and produce an oval enlargement; but supposing the cyst to be intimately adherent in front, no such bulging will take place."-P. 189.

The action of the diaphragm on the tumour will help to determine the existence of adhesions.

"Another symptom of this sort is valuable, and that is the action of the diaphragm upon the tumour. If the measurement of the abdomen be obtained after the patient has taken a deep inspiration, and again after a full expiration, you will find, when the cyst is free, that the two measurements frequently vary an inch, sometimes more; showing that the diaphragm in the inspiratory movement had driven down the unattached cyst, while it being free, the expiratory effort allowed it to repossess its original position in the abdomen."-P. 189.

Tapping the cyst is a practical means of learning the presence of adhesions.

"On the withdrawal of the fluid, the walls of the abdomen are observed to follow closely the contracting cyst, when adhesions are present, and have externally a drawn-in and puckered appearance, while the cyst does not descend into the pelvis ; whereas, when the cyst is free from adhesions, it may be found after its evacuation low in the pelvis, forming a hard tumour at the lower part of the abdomen, while the walls of the abdomen may remain free."-P. 190.

It is, however, in a careful collection of several of these signs that the complication is to be made out.

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But, although the dependence on these symptoms singly may lead us into error, the combination of many of them will generally be conclusive, supposing the patient, when rising by her own exertions, protrudes the cyst as an oval bulging tumour through the space left by the separation of the recti. That on a deep inspiration the tumour is pressed downwards more into the cavity of the abdomen, and then recedes on an expiration; that the bladder is free, and can ascend into the anterior part of the abdomen when filled with air; that all crepitation is absent, and the tumour tolerably moveable; then we may with satisfaction say that adhesions do not exist. Another additional evidence would be, if the patient had been previously tapped, and the sac had entirely disappeared after the operation."-P. 194.

Leaving the question as to whether ovariotomy is expedient or not until the conclusion of the chapter, our author describes the two different modes of operating, which are respectively called the major and minor operations. When the incision has exceeded six inches in length Mr. Lee has classed the case as belonging to the former, whilst an incision under six inches in length is ranked as a minor operation. Eighty-five cases have been operated on by the large opening, and the mortality has been one in

three. Twenty-three cases have been relieved by the minor operation, and the deaths have been one in six. It is still a disputed point which of the two is the most feasible operation. Dr. Clay, Mr. Walne, and others preferring the major, Mr. Jefferson, Dr. F. Bird, and others holding to the minor. Mr. Lee argues for the latter, and the obvious fact that the latter may, in case of need, be converted into the former is a strong general argument in its favour.

Mr. Lee has learned, by private communications from Mr. Lane, Dr. Clay and Dr. Bird, that the women on whom they operated successfully continue to enjoy good health. We conceive this to be a most important addition, and we think that these and other operators should concisely publish the after history of their cases.

Mr. Lee thinks that, in the majority of cases, " ovariotomy is most decidedly unjustifiable," and he arrives at this conclusion from the difficulty of the diagnosis in the disease, and from the frequent existence of adhesions. He thinks the increased mortality, when adhesions have been present, disqualifies such cases for this means of relief, and when the diagnosis is obscure he would of course avoid so frightful an operation. He talks in very contradictory terms of the value of the uterine sound in clearing the diagnosis in these cases, for in the text he says that "no tumour of the uterus ought to be mistaken for ovarian disease since the introduction of the uterine sound by Professor Simpson ;" and then, in a foot-note, it appears that "he and several others, men in the constant habit of using the sound, were deceived in a case of ovarian dropsy." We think he has overstrained the value which this really useful obstetric instrument affords in these cases.

Mr. Lee, however, is "decidedly of opinion that in some cases the operation is very justifiable." It is particularly so where the "cyst is single and uncomplicated with hard matter, and the powers of life active."

The treatment which Dr. F. Bird adopts after extirpation consists principally in being able pretty quickly so to raise the temperature of the room as to cause profuse sweating, for which purpose also he gives the patient plentifully of ice. Should febrile symptoms arise, he brings on the free action of the skin, and watches his patient unremittingly for some days.

We have thus brought before our readers the principal results which flow from Mr. Lee's compilation on this interesting subject, and with it our observations on his Dissertation. We congratulate him on the honourable prize which he has won, and we cordially wish him success in the department of medicine which he appears to have chosen. But we seriously advise him, while he yet has time, to cultivate a knowledge of general literature, not only for the alluring purposes of disciplining, storing and enlarging the mind, but for the lower and indispensable object of writing correctly.

1847.]

Matteucci's Lectures and Researches.

509

I. LECONS SUR LES PHENOMENES PHYSIQUES DES CORPS VIVANTS.
By Signor Carlo Matteucci, Professor in the University of Pisa,
&c. Paris, 1847. 12mo. pp. 406, 18 woodcuts.
Lectures on the Physical Phenomena of Human Beings.

II. ELECTRO-PHYSIOLOGICAL RESEARCHES.
MUSCULAR CURRENT. By the same.

First Memoir. THE

III. ELECTRO-PHYSIOLOGICAL RESEARCHES.

Second Memoir. ON

THE PROPER CURRENT OF THE FROG. By the same.

Third Memoir. ON

IV. ELECTRO-PHYSIOLOGICAL RESEARCHES.
INDUCED CONTRACTIONS. By the same.

[From the PHILOSOPHICAL TRANSACTIONS for 1845. Part II. Communicated by Michael Faraday, Esq. F.R.S.]

In the Medico-Chirurgical Review for April 1845, we published a somewhat lengthened article on the interesting and important investigations of Professor Matteucci, contained in his Traité des Phénomenes Electro-physiologiques des Animaux, as well as in the Rapport entre le Sens du Courant Electrique et les Contractions Musculaires dues a se Courant, published jointly by MM. Longet and Matteucci, and noticed in the Comptes Rendus for September, 1844.

In that article we announced that the Council of the Royal Society had, on the recommendation of its Committee of Physics, adjudged to Professor Matteucci the Copley Medal, on account of the novelty and importance of his researches. To show his gratitude to the Society for the distinction thus accorded to him, Matteucci communicated, in the three Memoirs whose titles stand at the head of this article, some fresh researches on electro-physiological phenomena.

In 1844, the Government of Tuscany appointed Matteucci to deliver, in the University of Pisa, a course of lectures on the physical phenomena of living beings; an interesting subject, for the elucidation of which Matteucci's studies and investigations peculiarly fitted him. These lectures were published in Italy, and have passed through two editions; but they have only recently become known to the English public by the French edition published in the present year, under the direction of the author, who has in it made considerable additions to the matter contained in the second Italian edition.

In these Leçons, Matteucci discusses the subjects of the three Memoirs published in the Transactions of the Royal Society, and in the edition now before us he has introduced a notice of all his most recent investigations on Electro-physiology. This of course renders the French edition greatly superior to the editions previously published in Italy.

Professor Matteucci's course consists of twenty lectures, and embraces the following subjects:

Molecular Attraction; Capillarity; Imbibition; Endosmose; Absorption No. 108

33

in animals and vegetables; Digestion; Respiration; Gaseous Endosmose; Hæmatosis or sanguification; Nutrition; Animal Heat; Phosphorescence of organized beings; Muscular Electrical current; Electric Fish; Proper currents of the frog; Physiological action of Gravity, Light, Heat, and the Electrical current; Nervous force; Muscular contraction; Animal Mechanics; Circulation of the blood; Vocal apparatus; Voice; Hearing; Vision.

In the first lecture the Professor shows that living beings possess the general properties of all the bodies of nature; that the physical forces act on these as well as on other natural bodies; but that organized beings present phenomena termed vital, which, in the present state of our knowledge, cannot be referred to mere physical agencies. During life there is, between the physical and vital forces, a constant struggle, which terminates in the triumph of the former, that is, in death.

Although the study of the influences of physical agents on living beings is a subject of paramount importance in physiology; and although it can be demonstrated that light, heat, and electricity exercise, in the interior of living beings, the same kinds of physico-chemical actions which they do in inorganic bodies, yet it must be confessed that, at present, it is quite impossible to explain vital phenomena by reference to physical agency only. No one is more impressed with the truth of this fact than Matteucci.

"With the aid of all this knowledge and of these analogies, dare we hope," says Matteucci, "to obtain a complete explication of all the phenomena of living beings? Alas! such hope for the present would be vain.

"Open an animal, examine the kidneys and liver, and then ask yourselves by what physical force you can explain how the blood, which is carried to an organ, forms bile and urine? Can you, by having recourse to chemical affinities, modified as much as you please, and aided by the peculiar structure of organs and even by the actions of contact,-can you, I will not say comprehend, but even obtain a glimpse of, the means by which the various organs affect the separation and transformation of the constituent parts of the blood, in which all the organic elements are mixed, partly suspended, partly dissolved, and of which they have need to repair their continual losses? What can we say of the functions of the nerves or of generation ?"

Endosmose.-Passing over molecular attraction, capillarity, and imbibition, we come to that fertile principle endosmose, which forms the subject of Matteucci's third lecture, and to which no less than forty-one pages of the Leçons are devoted.

We much wish that our space permitted us to transfer the whole of this interesting lecture to our pages, for it abounds in important matter. It is not a mere resumé of what is known on the subject, but contains many novel and ingenious views of paramount interest to the physiologist and practical physician.

In the early part of the third lecture Matteucci falls into an error which is very common with continental, and even with some British, writers; that of ascribing to Dutrochet* the discovery of endosmose.

* Science has to deplore the recent loss of this eminent philosopher, who died on the 4th February of the present year, in the 70th year of his age.

1847.]

Porrett's Discovery of Endosmose.

*

511

The credit of this is, however, really due to our distinguished countryman, Mr. Porrett, the present Treasurer of the Chemical Society of London; who, in a letter (dated June 6th, 1816) to Dr. Thomson, the editor of the Annals of Philosophy, describes two "curious galvanic experiments," one of which involves the discovery of endosmose. Mr. Porrett is not only the discoverer of the fact just referred to, but he also had the sagacity to suggest its application to the explanation of physiological phenomena. That portion of his paper which relates to the phenomena of endosmose being very short, we feel it our duty, as an act of justice to Mr. Porrett, to reprint it entire, for the benefit of those of our readers, who may not have the time and convenience to refer to the volume which contains it.

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Exper. 2.-I took an ounce medicine phial, and with a red-hot rod of iron cut it in a horizontal direction, so as to form the lower part into a small jar. I threw away the upper part and divided the small jar into two equal parts in the direction of its length, so as to make a vertical section of it. The two halves of the jar were then pressed together in their original position, having first interposed a piece of moistened bladder. All the parts of the bladder which protruded beyond the outside of the jar were then cut away; and when this was completed, melted sealing-wax was run down the outer edge of the bladder, and thus the two halves of the glass vessel were firmly united. By this means the inside of the glass jar was divided into two cells, by the bladder interposed between them.

"One of these cells having been filled with water, and left for several hours, was found to have retained the water. The bladder, therefore, was not sufficiently porous to allow the water to filtrate through it. The cell filled with water was now positively electrified, with a battery of 80 pairs of 14 inch double plates, and a few drops of water were put into the empty cell, so as to cover the bottom of it. This small quantity of water was then negatively electrified. The phenomena which ensued were exceedingly curious and instructive. Independent of the decomposition of a small part of the water, which of course took place in the usual manner, the principal part of it obeyed the impulse of the voltaic current from the positive to the negative wire, first overcoming the resistance occasioned by the compact texture of the bladder, so as in about half an hour to have brought the water in both cells to the same level, and afterwards overcoming the additional resistance occasioned by the gravitation of the water, by continuing to convey that fluid in to the negative cell, until its surface in that cell was upwards of of an inch higher than in the positive cell. A much greater difference of level might doubtless be obtained by operating with a larger apparatus, and for a longer time; but the results are perfectly conclusive when the experiment is performed on the small scale in which I tried it.

"I have repeated the above experiment several times, and invariably found the liquid, whatever it was, descend on the side positively electrified, and ascend on that negatively electrified, chemical changes at the same time going on, as in the celebrated transfer experiments of Sir H. Davy; but those experiments could not show the mechanical action of the voltaic current, consequently only the chemical action was observed in them. To render the mechanical action evident, it is an indispensable condition that there should be interposed between the positively and negatively electrified liquids a body which, although porous, is yet sufficiently compact to prevent filtration taking place in common circumstances. Bladder answers this condition. I do not think, however, that it does so as well as filtering-paper that has been prepared in the following manner, suggested to me by my very ingenious friend Mr. Wilson, of Guy's Hospital:-Spread the white of an egg thinly upon filtering-paper; then immerse the paper into boiling

* See the Annals of Philosophy for July, 1816, Vol. 8, p. 74.

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