1861 The Lancet  
500 lined with sheet lead. These animals were invariably seized after a time (about ten days or a fortnight) with the epileptic form of poisoning by lead, and finally died from the poison, although the quantity of lead absorbed, as determined by chemical analysis, was but very small. On placing a layer of straw over the leaden floor of the kennel, the animals remained in perfect health. Again, it is well known that horses are much less liable to be affected by many poisonous substances than
more » ... although horses are so delicate that Pi-ofessor Bernard has never been able to establish a pancreatic fistula in these animals without the operation proving rapidly fatal. Dr. HARLEY said, that in undertaking the experiments related in the paper, his object was not to prove nor to disprove any particular views, but to gain information on the subject of slow poisoning. The chief point to which he would advert was, that we could not hope to gain information on the subject of slow poisoning by investigating cases of acute poisoning. In reference to experiments on animals, the author said that he did not pretend that poison could produce exactly the same effect as in man. There was, however, probably greater similarity than was generally supposed. He thought that, as a rule, the mineral poisons acted on animals in the same way as on man. MEDICAL SOCIETY OF LONDON. MONDAY, NOV. 11TH, 1861. MR. COULSON, PRESIDENT. MR. 1. B. BROWN related the history of a female patient, aged -thirty-three, a widow, the mother of three children, on whom he had operated for a fibrous tumour in the walls of the uterus on the left side, by puncturing the capsule of the tumour, and leaving it partly to become disintegrated, and partly absorbed. In this case the operation was followed by the most urgent symp-toms—severe pain, peritonitis, and the formation of a uterine hæmatocele. After the lapse of some time, fluctuation was detected on the right side of the abdomen, and he punctured the abdominal parietes through the linea semilnnaris, and drew off a pint or more of very fetid blood-like fluid mixed with some pus. A similar discharge took place through the rectum by ulceration. The opening in the abdominal walls became fistulous, and a sanguineous and purulent discharge continued to pour from this aperture and from the rectum for about three months. The patient ultimately recovered, and is now quite well, and free of the tibrous tumour. Mr. Brown remarked that this was one of the rare instances of uterine hæmatocele which had terminated successfully. The PRESIDENT inquired of Mr. Brown what were the anatomical boundaries of the blood in uterine hsematocele ? Mr. BROWN said that some uterine vessel having been wounded, the blood hltd escaped into the peritoneal cavity, and had become extravasated, and occupied a space in the abdomen extending from the fundus of the uterus to the broad ligaments and ovaries. Dr. GREENHALGE remarked that during an experience of twenty years he had observed several fibroid conditions of the uterus, and that a large number of such cases got well spontaneously. There is, however, a form of the disease where the tumour increases to a very considerable size, but he had never heard of one terminating fatally. He thought that in such cases it was a question whether an operation which was so fraught with danger to life was justifiable. Mr. BROWN said he was sorry to hear Dr. Greenhalgh object to surgical treatment under the T)lea that sometimes these tumours got well when left alone. He (Mr. Brown) had hoped to see Dr. Greenhalgh take his position amongst those who advocated progressive medicine and surgery. Mr. HAYNES WALTON then related a case of CANCER OF THE MAMMA, WITH AN ULCERATED WOUND Or THE SKIN, in. a woman sixty-one years of age. There was no constitutional affection, and the neighbouring glands were not involved. He extirpated the breast, and the patient made a good recovery, and continued well for four years, when some of the glands became affected, and these, at her request, he also removed. He had quoted this case. as it was one of a class which a. large number of surgeons would have refused t to meddle with, on account of the strong prejudice which existed against surgical interference with malignant disc' se of the breast in which the skin was also ulcerated. The good results which followed proved the propriety of the operation in this patient. Mr. BRYANT, after making some remarks advocating the performance of an operation in cases of scirrhus of the mamma, even when the skin was ulcerated, stated that the latest statistics went to show that operations for the removal of the disease tended to lengthen life, rather than, as it was said by an eminent authority some few years since, to shorten it. Mr. HENRY LEE thought there were two conditions under which the skin became ulcerated in these malignant affections. In the first, the skin was infiltrated with cancerous matter, and so became a part of the disease; while in the second, the skin simply ulcerated from the pressure of the tumour beneath. He considered that if the patient suffered much inconvenience and pain from a malignant tumour of the breast, even though the skin was ulcerated, an operation was undoubtedly justifiable. A further discussion on this subject ensued, in which Mr. Hird and Mr. Adams took part. Dr. EDMUNDS exhibited a specimen of ANEURISM OF THE ARCH OF THE AORTA, taken from the body of a young man, aged thirty-five, who had died suddenly in the streets.. Mr. ADAMS drew the attention of the Society to some cases of CHRONIC RHEUMATIC ARTHRITIS OCCURRING IN OLD PEOPLE, which had lately come under his notice. The joint involved was generally the hip. He recognised two distinct forms of this affection. In the first, there was an excess of bony matter, the cartilage disappeared, and there was a distinct porcellaneous deposit. In the second, there was wasting and softening of the head and neck of the femur, accompanied with lameness and shortening of the limb, sometimes to the extent of two inches. It was this class to which he now specially referred. He quoted two cases which well illustrated this peculiar affection, and pointed out the difficulty of diagnosis. He advocated, in the treatment of such cases, moderate use of the limb, a liberal diet, with the phosphate of lime, and cod-liver oil. Mr. CANTON agreed with all Mr. Adams had stated of this malady, and recognised the two classes which Mr. Adams had mentioned. In the second class of cases he had observed that' there had usually been some injury, as a blow. In such instances there is a history of chronic rheumatic disease, and the injury acts as the exciting agent, determining the disease to that particular joint. In the form of the disease where there is an excess of bony deposit, several of the joints are generally involved: whereas in the other, where there is softening and wasting of the bone, no other articulation is affected. The PRESIDENT remarked, that in such cases he had never found medicine afford much relief to the patient. Dr. EDWARD SMITH quoted some interesting statistics of the TEMPERATURE, PREDOMINANT WINDS, AND AMOUNT OF MOISTURE IN THE ATMOSPHERE AT SCARBOROUGH, and advocated its great suitability as a place of residence for phthisical patients. He showed that the range of temperature was more equable, and the warm winds more predominant, there than in any other part of England. Dr. ALTHAUS then related a case of HYPER ÆSTHESIA, ANAESTHESIA, LOSS OF MUSCULAR POWER AND SENSE OF TOUCH, occurring in a patient aged thirty years, caused by prolonged immersion in the sea after shipwreck. Although all these symptoms were very severe, a complete cure was brought about in a week's time by Faradization. Tms paper was intended as an abstract of the history of puerperal fever as it occurred at the General Lyin in Hospital from 1833 to 1838, both inclusive. It appeared from statistical evidence that ISO deaths occurred out of 5833 labours, giving the very high death-rate of 3.085 per cent. The author then proceeded to show that from the want of a clear understanding of the nature of puerperal fever, much had been mixed up
doi:10.1016/s0140-6736(02)20961-7 fatcat:g3qnnswcofef3k5mezxwmyvazy