the iris, but with the curette he was fortunately enabled to lift it up, and the extraction was made without any subsequent injury to the organ. This case occurred in a gentleman who is at present a fellow of the college.

Professor Jacob next alluded to the minute foreign bodies which so frequently become fixed in the cornea, and which cause so much trouble to the practitioner in this country, where stone-cutting, quarrying, and stone-breaking is so common; and when, as elsewhere, so many working at the anvil, bench, and lathe, are liable to such accidents.

The foreign bodies in these cases (Professor Jacob observed) are either particles of the steel of the instruments used by the workmen, or portions of the stone itself, but in nine cases out of ten they are particles of the steel, and it becomes of importance to ascertain in what state the steel is at the time. As regards the difficulty of removal, a great deal depends on the size of the particle, which is sometimes wonderfully minute, so much so as to become scarcely visible after a great deal of trouble and minute examination, and occasionally only with the assistance of a lens of two and a half inch focus, after twisting and turning the eye up and down, in and out, in all directions. Yet so small a particle will be productive of the greatest mischief. In general those particles may be removed with great ease, requiring only to be touched with the point of a blunt instrument very cautiously, such as the handle of a camel-hair pencil, pared down very fine, or the convex part of his own cataract needle. If only adherent to the conjunctival layer, the particle slips off by the gentlest means, and if that does not succeed, or if the foreign body is more deeply imbedded, if it has got into the structure of the cornea, its removal is more difficult. If the foreign body has been projected with violence, and has become imbedded in the cornea itself, it must be lifted out of it. The point of the needle should be held within a very short distance of the foreign body before it touches the cornea, waiting quietly until the eye becomes steady; it should then be struck in beneath it, and the particle dug up, if not detached, by gentler means. The operator should never give up until he has fairly lifted it from its situation. Many surgeons at the other side of the water-among whom is so high an authority as Mr. Lawrence-recommend such cases to be left to nature, saying that a little spot of ulceration is formed round the foreign body which thus becomes washed away by the secretion of the tears; but this ulcer will ultimately leave behind it an opacity. As regards those cases in which small particles of steel have been projected into the cornea, and the particles so dissolved away that only a small portion of the oxide adheres to a speck of ulceration, this is to be removed with a few touches of the point of the needle, so as to prevent the occurrence of any permanent opacity. But of all circumstances connected with this subject (Professor Jacob observed) that which is of paramount importance to the practitioner refers to the condition of his patient's general health at the time of the accident. In this country these ac

cidents to the eye are in themselves generally trivial, but the worst results sometimes occur to the subjects of them from an unhealthy state of the constitution. He had known total blindness to occur in stone-breakers from this cause much oftener than would be believed. Even when the foreign body is got rid of a destructive inflammatory process is set up under these circumstances which ends in the loss of the eye. A whitish sloughy ulceration takes place in the injured part, purulent matter is deposited in the anterior chamber, and at last the sloughy ulceration extends through the cornea.

To prevent or remedy this, attention must be paid to the state of the digestive organs and health in general. A yellow coated tongue is a sure indication of that state of constitution in general, and gastric organs in particular, which leads almost with certainty to this state of things, and this must be remedied by the usual medicinal and dietetic remedies, recollecting that such cases seldom bear or require depletion.

The learned professor concluded by apologizing for the length of time that he had occupied the attention of the society. He would, he said, not have gone so much in detail upon the subject, but that there are so many practical points connected with it, not always to be found in books, and upon which he had hopes of eliciting observations from the gentlemen present, which would throw additional light on the subject.

Mr. M'Coy mentioned the case of a young female who had come under his care for a painful abscess of the lower jaw. While examining her face he observed a bright silver-like looking body adhering to the iris. Her mother stated her age to be eighteen, and that the speck alluded to had always been in the eye, at least since she was a child; on further inquiry, however, it appeared that many years ago, while playing tricks on Hallow Eve, a particle of melted lead had flown into the eye, which latter became closed for two or three days, but no further inconvenience resulted from the accident. There remained no trace of wound or injury of the cornea, nothing but the brilliant little body just described, whose measurement was about a line in one way and half a line in the other. The circumstance (Mr. McCoy observed) appeared remarkable in two points of view-first, that the substance at the moment of its penetrating the cornea must have been very hot, yet upon examination there was not the slightest trace of lymphy exudation into the corneal structure; secondly, the body having for such a length of time retained its brilliancy.

Professor Jacob.-What Mr. M'Coy has just stated, one would at first sight say was a very improbable occurrence-namely, the projection of a particle of lead into the eye without producing great destruction. Again, the great improbability of a particle of such a body as lead being projected with such a degree of violence as to penetrate the cornea, and be deposited in the anterior chamber. Yet he was inclined entirely to agree with Mr. M'Coy as to the facts of the case. Particles of melted lead thrown upon water are sometimes cast up with great force, and he had known instances in which children have

had particles of melted lead thrown into the eye and retained beneath the lid, while persons were unaware of their presence there. In one such case, were a good deal of distress and mischief had been produced, he had removed after some weeks a portion of lead which had evidently found its way under the lid in a melted condition.

Dr. Hargrave wished, while engaged on this subject, to ask Professor Jacob what means he was in the habit of using for examining the fold of conjunctiva lying between the globe of the eye and upper lid. He recollected the case of a young man in respectable life who had been treated very actively for acute inflammation of the eye, and who maintained himself that a particle of the bearded portion of barley had got into his eye, but on the most careful examination nothing of the kind could be detected. On seeing him some time after, there was still a good deal of distress, accompanied by symptoms resembling chronic inflammation, and the patient still insisted on the presence of the foreign body. Dr. Hargrave could scarcely oredit this statement, knowing how accurately he had searched for it before, yet upon again examining closely, a bit of the bearded barley, half an inch in length, was found completely impacted in the fold of conjunctiva just alluded to. The great difficulty of examination in these cases arises from the spasmodic action of the orbicularis muscle, which was found to be equally uncontrollable either in the very young, the middle aged, or the old. He would beg to express his admiration of the truly practical and valuable remarks of Professor Jacob on the subject under discussion.

Professor Jacob said the suggestion made by Dr. Hargrave respecting the impaction of foreign bodies and the difficulty of their removal from the situation indicated, was a very important one. Examples of the kind are recorded by Scarpa, Monteith, &c., and a case is mentioned by Mackenzie in which a portion of straw had become impacted in the sulcus alluded to. By the same author the case of a child is mentioned in whose eye a common fly had got entangled, followed by a great deal of mischief. He would say that the most feasible way to remove such would be to carry the curette slowly round between the eyeball and orbit. In such a case he thought it would be better not to evert the lid. By a little nice and dexterous management on the part of the surgeon, he was of opinion that even the smallest specks could be detected and removed.

Dr. Bigger suggested a mode of removing foreign bodies (not impacted) in this situation. The method is one proposed by an authority who has written on this subject, and by whom it had been successfully applied on many occasions. It is simply this: on raising the upper lid which conceals the foreign body, the struggles of the patient cause the lashes of the lower lid to approximate the globe, and the foreign body falling down becomes entangled in them, and thus carried out of the eye. Dr. Bigger had frequently tried this method with success in children, but of course if the body be impacted, additional means of extraction will be found necessary.

Professor Apjohn observed in reference to one particular point alluded to in the discussion of this very practical subject-viz., the preservation of their natural brilliancy by the little metallic bodies projected into the eye in those cases, that the explanation appeared to him to be as follows. The liquid in which the foreign body is immersed is totally devoid of free oxygen-it is, in fact, alkaline. Thus the body lying in a fluid which, unlike common water, contains neither air nor oxygen in a gaseous condition, maintains its characteristic lustre. If a piece of metal were placed in a vessel hermetically sealed, so as entirely to expel the air, its brilliancy might be preserved for any length of time, and the bit of metal in the cases alluded to might be looked on as placed very much in that predicament.

The Vice President expressed his admiration of the very valuable communication made by Professor Jacob; the observations which fell from that gentleman were, he said, ten times the more valuable because they were of such a nature as cannot be conveyed in books. He (Mr. Cusack) felt desirous to know Professor Jacob's opinion upon the difference in the state of oxydation of these metallic particles as seated in the interior of the eye or only under the conjunctiva; for it appeared to him that in the latter case the thinness of the mucous membrane rendered it perhaps not altogether impermeable to atmospheric air. For instance, many years ago it had happened to him in the case of a person admitted to the hospital for chronic inflammation of the eye, when turning up the lid for the purpose of examination, to observe something black in the corner of the eye. Examination with a probe proved it to be a metallic substance, and it appeared to Mr. Cusack, when pressed on, to be lodged in the substance of the eye itself. The history was as follows:-The man had some time before had, in a scuffle, a fork thrown at him, which consisted of but one prong. This it appears having passed through the eye, was broken off, leaving the small portion, which was now visible, projecting at the inner canthus and edge of the upper lid. It was difficult (Mr. Cusack remarked) to conceive how the fork should have taken such a direction, unless we suppose the person hit to have been placed in a position above that of the aggressor, and it is with this supposition only that we can account for the orbital plate of the frontal bone having escaped penetration under the circumstances. Another circumstance in Professor Jacob's remarks must (Mr. Cusack observed) have struck the students amongst the audience as a very peculiar feature in connection with this subject-namely, the intense sensibility of the conjunctival membrane and the acute attacks of inflammation it undergoes from comparatively trivial causes, while the eye itself can be subjected to so much violence. As an example of this intense degree of sensibility on the part of the conjunctiva, Mr. Cusack mentioned the case of a gentleman of rank into whose eye a fly had passed, and got impacted under the conjunctiva; this was a source of suffering for a length of time until discovered by a practitioner of acute observation.-Dublin Medical Press.

PATHOLOGICAL SOCIETY OF LONDON.

Mr. Ebenezer Smith exhibited a fetal heart, presenting Premature Occlusion of the Foramen Ovale; diseased Mitral Valve; contracted left Heart; large Pulmonary Artery and Duct.

The preparation was accompanied with diagrams. The following is the history connected with the case:

A small infant, the seventh of healthy children by the same parents, was born on Oct. 20th, 1846. His mother had noticed unnatural quietude during the last three months of gestation. Its birth was natural, the head, body, and limbs, well developed, and of the usual colour, till, in about five minutes after it first breathed, its face became dark blue, and the respiration difficult. The ligature on the umbilical cord was untied, but no blood flowed; the skin soon became similarly blue; and the respiration very difficult and irregular; the heart beat about 130 in a minute, clearly and strongly ; the temperature appeared natural. In eight or ten hours apoplexy came on, the cyanosis being universal, the right arm paralyzed, and the left convulsively contracted. In sixteen hours the child was perfectly comatose, and it died twenty-one hours after birth.

Inspection, twenty-four hours after death.-The body full grown, well proportioned; skin marbled with large dark and white patches; pericardium contained two or three drachms of serum; the lungs about the usual size, full of dark blood, slightly emphysematous anteriorly; the liver apparently healthy; umbilical vein pervious and empty; venæ cavæ capacious; heart rather more vertical than natural, smaller and narrower in consequence of flatness of the left ventricle; both vena cava, the right heart, and coronary veins, engorged. On the opening of the right auricle, which was distended, and of the usual form, the fossa ovali was seen in its natural position, but closed by a strong reticulated membrane firmly attached to its distinct annulus, impervious and pouched. A probe could be passed down to the left three lines into a considerable impervious inter-auricular fossa. Below the fossa ovalis, a mere vestige of the Eustachian valve; valves of the coronary vein distinct; the right auriculo-ventricular opening large, patent, and furnished with a very good valve, differing in form from the usual shape of the tricuspid, but with distinct, fixed and distended columns and curtains, and moderator bands, as demonstrated by Mr. Wilkinson King; walls of the right ventricle rather hypertrophied, the cavity being large, and not only descending to the apex, but curving round the left ventricle, so as alone to form the apex of the heart: no inter-ventricular communication whatever. The pulmonary artery very large, and three and a half lines wide at its origin; a little above its origin, more than four lines; its valves being perfect; it gave off, in the usual situation, branches to the right and left lung, and was then continued perpendicularly upwards, in a scarcely diminished trunk, the ductus arteriosus to the under surface of the aortic arch, nearly opposite the left subclavian, so that the blood from it would flow, not only into the descending aorta, but upwards, and somewhat contrary to its previous direction,