Reviews and Notices of Books

1854 The Lancet  
103 the subcutaneous cellular tissue.-Cranium: The dura mater 'was more adherent to the bones than is natural; in other respects the membranes and substance of the brain were healthy.—Neck: On the right side of the neck, just below the body of the jaw, was a small aperture leading into a large sloughing cavity, full of offensive, purulent fluid, and implicating the margin of the parotid gland. On cutting into the latter, a small mass of encephaloid deposit was seen infiltrated into its tissue.
more » ... d into its tissue. The whole chain of the cervical glands on the right side of the neck was distended with a similar deposit, some of them being solid, whilst others were softened and broken down in their interior. Three cysts were also found on this side of the neck, one to the right of the thyroid gland, and two others above it, filled with a glairy, tenacious fluid. The glands on the left side were healthy. No malignant deposit -was found, either in the chest or abdomen, the viscera being quite sound, excepting a certain amount of congestion. ENCEPHALOID TUMOUR DEVELOPED OVER AND IN THE PAROTID GLAND; DEATH; AUTOPSY. (Under the care of Mr. TATUM.) W. C-, aged forty years, was admitted May 31st, 1854, on account of a swelling on the right side of the neck, which had been growing, according to his account, for about four months. It was difficult to make out the exact limits of the tumour, which seemed to extend from about the base of the jaw nearly to the root of the neck; the deeper parts of the tumour appeared to be solid and rather resisting; but superficial to this was a large quantity of fluid, which presented very distinct fluctuation a little above the thyroid cartilage on the right side. The man's appearance was cachectic, but not remarkably so; he complained of weakness, and said that he had been falling away both in flesh and strength since the development of the .disease, but had no other distinct ailment. He was ordered good diet, bark, and iodide of potassium, and, as the disease was suspected to be malignant, it was thought better not to interfere too much with it. A few days after admission, the skin at the most prominent fluctuating point gave way; on this opening being a little enlarged, a considerable quantity of bloody serum escaped, and continued to run through the wound during the remainder of %he patient's life. Ee was observed to get weaker for the next fortnight, and some wine was therefore allowed, although no distinct ailment -could be made out. In a few days this weakness had so far increased, that the man took to his bed. On the twenty-fifth day, symptoms came on which were conjectured to arise from poisoned blood circulating through the brain-viz., frequent twitchings of the muscles of both lower and upper extremities, 'a semi-comatose condition, from which he could be roused only occasionally to answer questions, and low delirium. The pulse was very weak and frequent, and the bowels acted unconsciously. Diffusible stimulants and tonics were ordered, and he could swallow what was presented to him, but his condition never improved. The twitehings became more frequent and violent, amounting at length almost to convulsions. The man became listless and insensible, and, after lingering for three days, died exhausted, on the twenty-ninth day after admission. Post-mMte1n examination, pnf01'med, eighteen hours after death, by Mr. &RA!*.—Body well formed and very muscular. There was a small sloughy opening about the centre of the neck, of irregular form, leading into a large sloughy cavity, full of dark-coloured putrid pus, and extending beneath .the centre of the sterno-mastoid muscle as high as the central portion of the parotid gland. The lower part of the gland was lying in the cavity, and was infiltrated with a plastic deposit, part probably of the tumour previously occupying this locality. At the back part of the sloughy recess were found lying the large cervical vessels, the common carotid and its bifurcation, and the external carotid, both covered with portions of the sloughing mass, but pervious throughout. Not so the internal jugular vein, for this vessel, for about two inches of its central part, had entirely =sloughed away; the two ends of the vessel being blocked up by masses of lymph, as far as its junction with the subclavian vein. Some of the cervical glands on both sides of the neck contained masses of calcareous matter; on the right side others were filled with a soft pulpy substance of new formation, apparently a fibrinoid deposit, not malignant. No encephaloid growth was found in any of the splanchnic cavities, the viscera of which were in a tolerably healthy condition. Reviews and Notices of Books. Recherches Cliniques sur les Eazuc Bonnes. Par EDOUARD CAZENAVE, Docteur en Medecine de la Faculté de Paris, &c. 8vo. pp. 105. THAT there is "nothing like leather" holds good with relation to authors as well as defenders of besieged towns. Whether the object of the writer be to recommend a particular kind of medicine, or a particular locality for the cure of disease, he fails not to give it his unqualified praise. Making allowance for much exaggeration, there is still a good deal of valuable matter in Dr. Cazenave's ba-ochure, which conta,ins an account of the physiological action of the Bonnes waters on the healthy, and of their therapeutical application to the diseased. Under the former head we are informed of a peculiar and specific power these waters are said to possess, in causing, after a few days' use, a state of active congestion of the cerian mucous membrane and fauces, with a sense of heat and constriction in the same parts. The circulation is quickened, and the digestive functions are performed with increased activity; the urinary and other secretions become more abundant, while at the same time the nervous system is much excited, with a degree of restlessness and sleeplessness, and the intellectual faculties become more active and exalted in their energies. These effects are very transient, and they leave the patient commonly in very improved health, particularly if there have been any chronic disorder of the air passages, such as aphonia, chronic bronchitis, asthma, incipient phthisis, &c. The climate of the Eaux Bonnes must be very favourable to many of these pulmonary diseases, protected as this locality is from high winds by the elevated ridges of the Pyrenees; situated 790 metres above the level of the sea, it possesses a calm, soft atmosphere, with a remarkably steady temperature. The waters belong to the class of thermal hydrosulphureted alkaline. We subjoin the analysis of M. Ossian -Henry :-There is also sulphuret of sodium, and iodine and bromine have also been discovered. Female PhysioLoryy; a Treatise of the Diseases of Women, their
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