easy; sleeps pretty well; bowels moved once or twice daily; is frightfully emaciated.

January 22d.-For the last two days he has been quite easy, but died at twelve o'clock to-day. About twenty hours before death he had inward spasms, with difficult breathing, and seemed to suffer very much.

Autopsy twenty-four hours after death. Body excessively emaciated; the external tumor in the iliac region was found to extend from a little above the anterior superior spinous process of the ilium to the pubes, and toward the middle of the abdomen about four inches across.

In dissecting up this tumor it was found to be resting upon the external oblique muscle, and adherent only by connective tissue to that structure. On making a section of this growth an appearance similar to that of soft marrow was presented, with here and there patches of a pinkish hue. Under the microscope this structure was found to consist of fat, with other cells, characteristic of myeloid tumor, (as described by Paget.) Some of these cells were shown, by means of acetic acid, to contain a nucleus, nearly filling the cell, and with one or more nucleoli.

Ex

The internal tumor, which had been recognized through the integuments, was found occupying a part of the umbilical and right hypochondriac regions. It was attached along its lower margin to the transverse colon, above and posteriorly to the duodenum; the latter was found very much thickened. This tumor also involved the head of the pancreas, and was adherent to the omentum and surrounding structures. amined by the microscope it presented the same appearance as abovementioned. The right lobe of the liver was found enlarged, very much congested, and infiltrated with bile. The gall-bladder was distended to two or three times its natural size, and filled with bile; its duct being large enough to admit the index finger with ease. This distension was

probably caused by the pressure of the pancreatic tumor.

Firmly attached to the lobus Spigelii was found a third tumor, about two inches in diameter, and of a much darker color than either of the others, but microscopically the same.

The consistence of the pancreas was denser than normal. Upon opening the stomach an ulcer, which had perforated all of its coats, was found upon its posterior wall, a little below the lesser curvature, and nearly midway between the cardiac and pyloric orifice. An enlarged gland upon the outer surface of the stomach, and near the ulcer, acting as a valve, probably prevented any escape of fluids into the cavity of the abdomen; the patient never having shown any symptoms of peritonitis, and no evidence of the same was discovered upon dissection.

The kidneys and spleen were very much congested, but presented no other abnormal appearance. The knee was not examined, but, from the symptoms of the patient, it may fairly be inferred that the same disease existed in the inner condyle. Heart and lungs healthy. Brain not examined.

Dr. Darrach spoke of the views of Paget and Lebert, who compared myeloid tumors in their structure to the marrow of bone. Paget refers to a tendency shown by them to occupy the same seat as epulis. Dr.

Darrach thought that in this case the tumors had formed previous to last June, and caused the jaundice by pressure. The disintegration of the liver-cells may perhaps have had something to do with the death.

Dr. Gross spoke of the equivocal position of myeloid tumors in nosology, and expressed a belief that they would be ultimately placed among encephaloid growths. The ulcer in the stomach, he thought, partook of the same character as the mass in the pancreas.

specimen be referred for examination to a committee.

He moved that the

DOUBLE PREGNANCY ONE TUBAL, THE OTHER UTERINE. - Dr. Packard presented a specimen of tubal pregnancy, sent to Dr. Hodge in 1849, by Dr. Craghead, of Danville, Virginia.

The woman was a negress, aged thirty-five. She had had symptoms of an ovarian tumor; these suddenly became aggravated by the occurrence of collapse, and she aborted, discharging a well-formed fœtus of somewhat over three months. Two days afterwards she died.*

At the post-mortem examination, "the whole abdominal cavity was found filled, anteriorly, with coagulated blood, and posteriorly with serum, which had proceeded from the rupture of some of the vessels of the left Fallopian tube, now greatly enlarged, and converted into a membranous sac, containing a foetus of the same size as the one delivered per vias

naturales."

INTRACAPSULAR FRACTURE OF THE NECK OF THE FEMUR: FRACTURE OF THE TROCHANTER MINOR.-Dr. Lenox Hodge exhibited an intracapsular fracture of the femur.

H. F., aged seventy years, having fallen while going down the stairs of the Merchants' Hotel, fractured the neck of his femur, and was admitted into the Pennsylvania Hospital, on the 11th of December, 1858. He lived for five weeks and three days, and died from the effects of a diarrhoea, on the 18th of January, 1859.

An autopsy showed the fracture of the neck of the femur to be within the capsule, except for a short distance at one point. The trochanter minor also had been fractured at its base. This last had united, and was surrounded with callus, though not perfectly consolidated; in the other case there had been no attempt at union. The specimen thus exhibits at once the difference in the action of nature when the fracture is intracapsular and when it is not.

INGUINAL HERNIA: DEATH FROM PERITONITIS.-Dr. James Hutchinson, in presenting the specimens, said: James Mackay, aged twentyseven years, had been the subject of a reducible hernia in his left groin for a number of years. About the close of November, while engaged in lifting heavy barrels, it became strangulated, and after suffering for twenty-four hours he applied to a surgeon, who placed him under the influence of chloroform, and succeeded in reducing it by taxis.

Ever since the man has suffered from severe pains in his abdomen, ac

*Case reported in Am. Journal for 1850.

companied with vomiting and constipation. He entered the hospital six weeks after.

At the time of his admission into the hospital a small firm tumor occupied the inguinal canal, and some fulness was observable in the course of the cord below. His pulse was seventy-two, and even during the paroxysms of pain it never at any time exceeded ninety. The features wore a pinched expression. He vomited incessantly. His bowels were readily acted upon by enemata, which invariably afforded relief, and which brought away large quantities of fæcal matter, which was on one or two occasions ribbon-shaped.

During the past week his symptoms had decidedly improved. The vomiting had entirely ceased, and the pain was present only at rare intervals. Suddenly, on Sunday evening, he was seized with the signs of peritonitis, and death took place in a few hours.

An autopsy was made eight hours after death. The abdomen was somewhat distended with gas which had escaped into the cavity of the peritoneum. Upon cutting down upon the course of the cord, a small piece of omentum was found in the inguinal canal; it was, however, not at all strangulated. The abdomen, when opened, was found filled with fæcal matter, which had escaped from the jejunum. The omentum was united to the abdominal parietes, just outside of the internal ring, and bound down with it a portion of the small intestines, so diminishing its calibre that a large-size urethral bougie could hardly be passed through it. Just above the constricted portion was a small ulcer, by means of which the perforation had taken place.

Dr. Gross gave a further history of the case. He had succeeded in reducing the hernial tumor, although it had been strangulated for several days, by placing the patient under one grain of morphine and employing chloroform. The man was in good health for three weeks afterwards, when he commenced to complain of some abdominal tenderness, for which he was sent to the hospital. Dr. Gross further stated that since the introduction of anaesthetics he seldom used the knife, even when strangulation had existed for thirty hours

Selected Papers.

THE ILL-USED HOMOEOPATHISTS.

THOUGH not strictly a medical journal, we shall make no apology for quoting from Mr. Punch. Being a sworn enemy to humbug in every form, that redoubtable hero has dealt some strokes of his baton upon that of homœopathy. Some of the adherents of that sect had, it appears, made a remonstrance, and the following is the sort of comfort they get. Upon the whole, Punch is the best person to deal with all such trifling.

Mr. Punch is accustomed to receive letters and treatises, imploring him not to call homoeopathy fudge, and some of them attempting to assign reasons why he should not. In all these communications, the medical opponents of homoeopathy are called "allopathists." "Allopathist," as contradistinguished from "homoeopathist," of course means a person who treats diseases with other medicines than those which produce similar diseases, that is, who endeavors to cure unlike with unlike, instead of endeavoring to cure like with like. Who are the allopathists? Mr. Punch has an extensive medical acquaintance, but he does not know any. No intelligent medical practitioner attempts to cure diseases in general with specific medicines of any kind. There are very few such medicines known to the medical profession. The principle on which diseases, for the most part, are treated by rational and scientific physicians and surgeons is that of removing impediments to the natural process of recovery, or that of assisting the curative efforts of nature, not necessarily, and not always, by causing people to swallow drugs. When drugs are given by such practitioners, they are generally given with a view to their indirect influence on disorders. For instance, the combination popularly known as the "black and blue reviver," which directly affects internal parts of the trunk, may be "exhibited" for the relief of a headache, or for the removal of an inflammation of the great toe.

Professor Holloway is perhaps an allopathist; however, he does not tell us on what principle his pills and ointment cure all diseases. The various doctors who advertise their patent medicines in the quacks' corners of

newspapers of the baser sort, may be allopathists also; and likewise the medical profession possibly contains a few fools or impostors who are so describable. But the few specifics used in the ordinary practice of physic may absolutely even act on the homoeopathic principle, that "like cures like;" thus differing from homoeopathic doses only in not being infinitesimal, and, Mr. Punch supposes, in being efficacious.

In none of the communications about homoeopathy received by Mr. Punch is there any thing like scientific proof that infinitesimal globules produce any other than infinitesimal effects. Cases of alleged cures, subsequent to the swallowing of those globules, prove nothing, until they amount to enormous numbers. Professor Holloway, and Messrs. Du Barry and Co., adduce plenty of such proofs; perhaps not fictitious. Mere swallowing and cure can be connected as cause and effect only by immense clouds of cases in which the cure is almost the invariable sequence of the swallowing. It does not signify whether the thing swallowed is a great bolus or a pill of the size of a pin's head, containing an invisible dose.

Quinine is acknowledged, on the strength of a vast accumulation of evidence, as a remedy for ague. It cures ague in one grain, two grain, three grain doses. Will quinine, or any thing else, in infinitesimal doses, cure ague as obviously in an equal number out of a vast multitude of cases? Will an infinitesimal quantity of sulphur exert any curative influence on that cutaneous affection which delicacy expresses by the euphemism of the Caledonian Violin?

Mr. Punch's homoeopathic friends seem to forget that statements of facts which are contradictory to common sense and received science, require rigid proof. None of them propose any method by which the active properties of an infinitesimal globule can be demonstrated. Neither homoeopathists, nor mesmerists, nor spiritualists, either offer or accept the test of any experimentum crucis; and when Mr. Punch asks for it, they answer by abuse, and the comparison of themselves to Galileo, and those who laugh at them to the Inquisition.

A NEW PARTURIENT.

THE following from our friend and late colleague, Professor Merrill, of Memphis, arrived too late to appear in its proper place. We hope to hear at greater length from him.

If you think the enclosed memorandum any account, you can make a note of it. You know a single experiment of the kind is often unreliable; but the effect in this case appeared to be very decided, and exactly such as the old witch of a woman predicted while preparing the remedy.