to be so much greater, in proportion to the amount of chemical change which has taken place, as to confirm the belief that the nervous force has a character altogether peculiar to itself, its mechanical operations being executed solely through living muscular tissue, but being exerted through this instrument far more powerfully than those of any other force developed by an equal amount of chemical change.

The remaining five lectures are occupied with the phenomena of muscular contraction and with the mechanism of its application in the animal body; the circulation of the blood; the action of the vocal apparatus; and the physical phenomena of hearing and sight. All these subjects are discussed, with more or less fulness, in our ordinary physiological works; and as Professor Matteucci has evidently derived the greater part of his information from these sources, especially from the laborious and detailed investigations of Müller, it is unnecessary for us to follow him through his exposition of these topics; more especially as our analysis has already reached its due limits. We shall only say that, although these lectures contain no novelty, they embrace a very clear and complete account of the several subjects embraced in them.

On the whole, then, we commend this little work to the careful study of our younger readers, with the conviction that they cannot fail to profit by it in more ways than one. It will give them a well-digested summary of the greater number of the physical actions going on in the living body; and if this summary is less complete on some points than could be desired, it is peculiarly full upon others; and whilst the former topics are for the most part of a kind on which ample information may be obtained elsewhere, the latter are such as will be almost entirely new to them, and are not readily accessible in any other form. But a still greater advantage will be derived from its perusal, if it be studied as an example of the proper method of scientific investigation, and if the success which has been attained by its philosophic author become an inducement to others to follow in the same path of inquiry with a sagacity and perseverance at all approaching his. Nor should such an example be lost upon any who are desirous of elevating the character of physiological and medical science, and whose inclinations and opportunities lead them rather to the investigation of the purely vital phenomena of living beings, than to those of a mixed or of a purely physical character. It is only by keeping constantly in view, as we have frequently urged, the general principles of scientific investigation, and by exercising yet greater caution in the analysis and comparison of results than is elsewhere necessary, in accordance with the greater complexity of the conditions under which vital phenomena occur, and the numerous sources of fallacy to which our inferences are liable, that such researches can acquire any real value; and it is consequently the more desirable that a thorough acquaintance should be first gained with works like the one now before us, which gives as good a practical lesson as could be desired on the art of observing, experimenting on, and generalizing from, the phenomena presented by living animals.

XLVI.-XXIII.

.7

ART. V.

Medico-Chirurgical Transactions. Vol. XXVIII.-London, 1845. 8vo, pp. 623. Six plates.

We have written so many prefaces to the notices of the preceding volumes of this work, that we can find nothing new to say on the general subject. We shall, therefore, proceed at once to review the contents of the present volume, giving the titles of all the papers, and commenting on such as most call for or best admit of commentary. And it must not be supposed that the papers not commented on do not contain matter of value or importance. All deserve perusal, and several not commented on by us will be found highly interesting.

I. Case in which the vena cava inferior was obstructed from the commencement of the common iliac veins, and its cavity entirely obliterated between the entrance of the emulgent and hepatic veins; by T. B. Peacock, M.D. Physician to the Royal General Dispensary, Aldersgate Street.

II. On the classification, structure, and development of the echinococcus hominis, showing reasons for regarding it as a species of cysticercus; by Erasmus Wilson, F.R.S., Consulting Surgeon to the St. Pancras Infirmary; Lecturer on Anatomy and Physiology in the Middlesex Hospital.

III. A case of aneurism of the popliteal artery, cured by compression of the femoral artery; by E. Greatrex, Esq. Surgeon, and W. T. C. Robinson. Esq. Assist. Surgeon of the Coldstream Guards.

IV. On extravasations of blood into the cavity of the arachnoid, and on the formation of the false membrane, which sometimes envelopes these extravasations; by Prescott Hewett, Esq. Curator of St. George's Pathological Museum.

The effusions, which are the subject of this last paper, are found in four different states. In the first and simplest, the blood recently extravasated, is found either liquid, or coagulated in the form of clots or of a thin membranous layer, covering a greater or less extent of the surface of the brain. If life be prolonged for any time, this membranous layer becomes partially, or almost altogether deprived of colouring matter, and presents the appearance of a false membrane, which may be found loose in the arachnoid cavity, or, which is by far the most common, be pretty firmly connected with the parietal arachnoid. This is the second state. When thick the membrane is often divisible into distinct layers. Clots of blood, and cysts containing serum and blood, or serum alone, are occasionally met with in the substance of the adventitious tissue. An effusion of this kind has been frequently mistaken for the result of inflammatory action. In the third state, the extravasated blood is fixed to the free surface of the parietal arachnoid by a fine, delicate, transparent membrane, apparently possessing all the characters of the serous membrane itself, of which it at first sight appears to be a part. The blood in these cases, may either be collected in one cavity, or disseminated in patches over the surface of the serous membrane, the intervening parts of which present a natural aspect. In the fourth division, the blood is contained in a completely closed bag, which

may be detached from the parietal arachnoid, and with its contents removed unbroken. In the great majority of cases, such encysted collections correspond to the upper surface of the cerebral hemispheres. If the disease be of some standing, the cavity of the cyst may be perfectly smooth and polished, or it may be intersected with fibro-cellular bands, running in various directions; sometimes fibrinous clots are found adhering to this internal surface. After a certain period, the walls of the cyst become fully supplied with blood-vessels, and the cyst itself possesses all the physiological characters of an original serous membrane.

How are these cysts and attaching membranes formed? It is commonly believed that the irritation of the effused blood gives rise to an exudation of lymph; but this explanation, according to Mr. Hewett, is altogether unsatisfactory as regards the majority of cases, seeing that any evidence of inflammation, beyond their presence, is altogether wanting. He believes they are formed by the blood itself; and in support of this view brings forward several examples in which similar effusions, in various localities, have become thus surrounded without the supervention of any inflammatory process.

V. On the colostrum of the cow; by John Davy, M.D. F.R.S., Inspector General of Army Hospitals, F.R.S.

VI. Case of obstruction of the large intestine, in which the ascending colon was opened with success, the patient dying three months afterwards of another disease; by Samuel Evans, Esq. of Derby.

This is a very interesting case. The advanced stage of the disease and the general condition of the patient rendered success most doubtful; yet the patient recovered perfectly from the effects of the operation, and had regained a good measure of health and strength, when imprudence in diet and exercise brought on an attack of peritonitis, with diabetic urine, which proved fatal. The operation performed was Callisen's modified by Amussat.

VII. On the mortality in prisons, and the diseases most frequently fatal to prisoners; by W. Baly, M.D., Physician to the Millbank Prison, and Lecturer on Forensic Medicine at St. Bartholomew's Hospital.

We beg to direct the special attention of our readers to this very valuable communication. In it the author has most conclusively shown, from extensive statistical researches, that the state of imprisonment induces a rate of mortality much higher than that which prevails among the same class of persons unconfined; that this mortality, in some few instances, is the result of certain endemic influences, but that the development of tubercular disease, under various forms, is by far the most efficient operative

cause.

VIII. Observations on cleft palate, and on staphyloraphy; by W. Fergusson, Esq. Professor of Surgery in King's College, London.

After a few observations on the various forms of cleft palate, and a rapid sketch of the different operations which have been performed for its cure, the author describes the mode of proceeding which he has been led to adopt from a consideration of the anatomy and physiology of the parts. He believes that the chief mechanical obstacles to the junction of the margin in the mesial line, are the levator palati and palato-pharyngeus muscles, and he consequently advises the division of these, by which means

all motory power in the soft palate is, for the time being, destroyed. The following is a short account of his operation:

"With a knife whose blade is somewhat like the point of a lancet, the cutting edge being about a quarter of an inch in extent, and the flat surface being bent semicircularly, I make an incision about half an inch long, on each side of the posterior nares, a little above and parallel with the palatine flaps, and across a line straight downwards from the lower opening of the Eustachian tube, by which I divide the levator-palati muscle on both sides, just above its attachment to the palate. Next I pare the edges of the fissure with a straight blunt-pointed bistoury, removing little more than the mucous membrane; then, with a pair of long blunt-pointed scissors, I divide the posterior pillar of the fauces, immediately behind the tonsil, and, if it seems necessary, cut across the anterior pillar too; the wound in each part being about a quarter of an inch in extent. Lastly, the stitches are introduced by means of a curved needle, set in a handle; and, the threads being tied so as to keep the cut edges of the fissure accurately in contact, the operation is completed. These different incisions may be made in the order here detailed, or possibly it may be found most convenient to divide the palato-pharyngeus first, next the levator palati, and then to pare the edges when the mus cular action has been taken off."

Two cases are narrated in which the operation was practised with success. The plan seems worthy of full trial, being founded on correct scientific principles.

IX. On the pulsating tumours of bone, with the account of a case in which a ligature was placed around the common iliac artery; by Edward Stanley, F.R.S., Surgeon to St. Bartholomew's Hospital.

There are three different sources of pulsation in these tumours. Most commonly the proximity of a large arterial trunk is the cause. Of this condition Mr. Stanley mentions several instances. In more rare cases the pulsation is dependent upon the development of blood-vessels and bloodcells, constituting a sort of erectile tissue within the tumour. The case in which the common iliac was recently tied, at St. Bartholomew's, was of this nature. It originated in the ilium, and was supposed to be an aneurism. The man died from peritonitis on the third day. Still more rarely the pulsation is caused by enlargement of the arteries of the osseous tissue.

The most interesting point in respect of these tumours is the extreme difficulty of diagnosis. They simulate aneurisms so closely that it is sometimes altogether impossible accurately to determine which disease the surgeon has to treat.

X. Description of a malformation of the duodenum, with notices of analogous cases; by Robert Boyd, M.D., Resident physician, St. Marylebone Infirmary.

The malformation was discovered in the body of a still-born male infant. The organ was somewhat of an oval shape, six inches long, and two inches in diameter at the lowest and widest part, at the termination of which the canal was completely closed by a transverse membrane. Two inches and a quarter above this a valve extended across, nearly half closing the gut; it proceeded from the concave side, the central attachment of the septum being opposite the mesentery. The stomach was natural. The remainder of the small intestines were very small, and the large intestines were not fully developed. The contents of the cranium were natural.

XI. Case of remarkable hypertrophy in the fingers in a girl, with a notice of some similar cases; by T. B. Curling, Lecturer on Surgery, and Assistant Surgeon at the London Hospital, &c.

XII. On the ophthalmia of puerperal women; by Robert Lee, M.D. F.R.S., Fellow of the Royal College of Physicians, London; Physician to the British Lying-in Hospital; and Lecturer on Midwifery at St. George's Hospital.

In this paper Dr. Lee brings forward several cases in proof of his opinion that this formidable and rapidly destructive affection of the eyes, is connected with, and consequent upon, uterine phlebitis. His views appear to us important, and consonant with truth.

XIII. Additional observations on obstructions of the pulmonary arteries; by James Paget, F.R.C.S., Lecturer on Physiology, and Warden of the College at St. Bartholomew's Hospital.

This is an appendix to a paper in the last vol. of the Transactions. It contains the account of an extremely interesting case, of a man under treatment for stricture of the urethra, who presented no symptoms of pulmonary obstruction, had been only heard to cough once very slightly, and casually mentioned that at times his breath was momentarily rather short. He died suddenly, while in the apparent enjoyment of perfect general health; the fatal event seemingly having been induced by the exertion of defæcation. No disease of any moment was found either in the heart or lungs, but nearly all the branches beyond the primary divisions of the pulmonary artery contained clots of blood, which Mr. Paget conceived to be from three to ten days old. Some very interesting questions are suggested to the mind by such cases as these. How can life be prolonged with so much comfort, while the circulation through such an important organ is so greatly obstructed? Mr. Paget believes this is effected by the proportionally diminished rapidity of the systemic circulation, which follows upon the decreased quantity of blood conveyed to the left ventricle from the lungs. But as the original causes continue in operation, the blood ceases, or nearly ceases, to flow in the systemic vessels; the brain and heart become deprived of their natural stimulus, and sudden or gradual death is the result. But how is the coagulation effected when there is no external cause of obstruction? Mr. Paget is of opinion that it depends upon an altered condition of the blood itself, by which its adhesive properties are augmented, and he points attention to the remarkable fact, that in many of the cases on record, (in the present among others,) the kidneys have been found more or less affected with Bright's disease.

XIV. Two cases of anesthesia and loss of motory function of the fifth nerve; by James Dixon, Esq., Assistant Surgeon to the Royal London Ophthalmic Hospital.

These cases are carefully observed and well narrated, and illustrate some interesting points in physiology.

XV. Account of a case of external and internal cephalhæmatoma, complicated with fracture of the right parietal bone in a new-born infant; by Charles West, M.D., Lecturer on Midwifery at the Middlesex Hospital, Physician to the Royal Infirmary for Children, and Physician Accoucheur to the Finsbury Dispensary.

The subject of this case, a female infant, lived for twenty-five days, and