mesenteric glands, stomach, kidneys, testes, &c. There were also tumors of scirrhoma in the liver and of cephaloma in some of the lymphatic vessels. Dr. Warren mentions that the tumors soon lost their transparency on immersion in alcohol. This is not the character of colloid cancer, and we are inclined to suspect that the disease consisted of cysts containing an albuminous fluid, which are occasionally developed in connection with carcinoma. The case however is interesting, and thanks are due to the Transatlantic Professor for the communication. XXVII. CASE OF NECROSIS OF THE LOWER JAW RECOVERED FROM WITHOUT DEFORMITY. By William Sharp, F.R.S. About two-thirds of the entire lower jaw were removed by a slight operation. The case offers, however, no features of particular interest, and is much less remarkable than a case related by Mr. Perry, in the twentyfirst volume of the Transactions, in which the whole of the inferior max. illa was taken away. XXVIII. REMARKS ON THE PATHOLOGY OF MOLLITIES OSSIUM WITH CASES. By Samuel Solly, F.R.S. The attention of the author was called to this rare disease, by two cases, in which he had the opportunity of tracing its progress during life, and examining the morbid appearances after death. After adverting to the opinion of Dr. Cummin, who, in treating of mollities ossium, calls it the rickets of adults, and to that of Mr. Curling, who, in a minute account of this disease, alluded to by Mr. Solly, has regarded it as an atrophy of bone; he describes the case of a young woman, aged 29, who having enjoyed good health in early life, began to decline at 19, after an attack of scarlet fever. She suffered pains in the back, passed urine with a whitish sediment, and her spine began to yield. She had pain in the head, became maniacal, and was admitted into St. Luke's Hospital. Whilst there she lost the power of standing, and screamed violently, as if in pain. Her head was observed to be enlarged, and her eyes to project, caused no doubt by the thickening of the walls of the orbit. She was discharged incurable, and after some time taken to Hanwell. "At the time she was received into this asylum she was much emaciated, and enfeebled, with loss of power in her lower extremities; and two or three months before her death, the bones of the extremities were observed to lose their natural direction, and become curved; subsequently, fractures took place from the slightest causes. She suffered excruciating pain during the whole time she was in the asylum, which she referred to her bones; she did not suffer from spasm of the muscles, as many of these cases do, and the urine, during the whole time she was at Hanwell, was clear and natural. Her appetite was good, and all the functions duly performed, with the exception of the catamenia. Large doses of morphia and other sedatives were administered, to procure sleep and relieve pain. Her mental aberration was extremely slight. Her sufferings were terminated by death on the 28th October, 1842." 441. * Med. Chir. Transactions, Vol. xx. On examination of the body, the author found, in addition to deformity of the spine and chest, fractures of the left humerus, both clavicles, radius, and both femurs (the left in two places.) All the bones of the extremities could be fractured with the slightest force-by merely pressing them between the finger and thumb, they gave way and cracked like a thin-shelled walnut. "A longitudinal and transverse section of the long bones showed that the osseous structure of the bone was nearly absorbed, a mere shell being left. The interior was filled with a dark grumous matter, varying in colour from that of dark blood to a reddish light liver colour. I could not detect any pus globules in it under the microscope. The bones of the vertebral column and ribs were similarly affected; cranium very much thickened, and at least half an inch in diameter, so very soft as to be easily cut with a knife, and very vascular; the two tables were confounded, and the diploë obliterated. Thin slices of the cranium, under the miscroscope, showed that a considerable alteration had taken place in its ultimate structure. The laminated structure of the outer and inner tables was extensively absorbed. The Haversian canals enormously dilated, and the osseous corpuscles diminished in quantity." 442. The second case was also that of a female, thirty-nine years of age and married. She suffered severely from the pains usually considered rheumatic; her frame became greatly distorted, much in the same way as represented in the well-known case of Madame Sapiot, many bones were fractured, and she ultimately died in St. Thomas's Hospital from asphyxia. During life, her urine was found on examination to contain a large quantity of phosphate of lime-between three and four times the quantity of healthy urine. The body was examined, and in addition to the thinning of the bones which the nature of the case would lead us to expect, the right lung was so compressed as to be almost impervious to air. The left kidney contained a large calculus, consisting solely of phosphate of lime. Sections were made of several of the diseased bones, and the alterations thus exhibited, consisted chiefly of absorption of the osseous tissue, its place being supplied with a red substance contained in cells more or less vascular. The red matter was examined under the miscroscope by Mr. Birkett and Mr. Simon of King's College. The latter gentleman states : "My examination was not at all satisfactory as to the ultimate nature of the disease. There was great excess of the natural fatty matter, and disproportion of the medullary cells to the substance of the bone; in parts there was apparently extravasation of blood, which may have arisen from violence. I was unable to discover any new cell formation, at least any mature one; cytoblasts were exceedingly plentiful, so as to suggest the probability that some such formation was in progress, but nothing further, with the exception of some two or three apparently detached young fat cells. Decidedly there was no show of growing cartilage." 455. Mr. Solly, after alluding to some of the opinions as to the nature of this disease entertained by writers, remarks," after a careful consideration of all the facts, but especially by comparing the appearances after death, with the symptoms during life of this awful disease, I am led to believe that it is of an inflammatory character; that it commences with a morbid action of the blood-vessels, which gives rise to that severe pain in the limbs, invariably attendant on this disease, but more especially in its comNo. 100. 29 mencement, and exhibits itself after death by an arterial redness of the part. The absorbent vessels are at the same time unnaturally excited, and the earthy matter of the bone is absorbed and thrown out by the kidneys in the urine, which excretion is sometimes so abundant, as we have seen in the last case, that it clogs up the calices and pelvis of the kidney, and forms there a solid calculus." The cases related by Mr. Solly are interesting and well deserving of record, but it will be perceived that he has not succeeded in throwing much light on the nature of mollities ossium. We believe him to be quite wrong in describing it as of an inflammatory character. The altered state of the osseous tissue is essentially different from that which commonly occurs in bone, as the consequence of inflammation. The appearances of extravasation of blood and of injected vessels, most probably arose from the disturbed state of the bones-the fractures and distortions; and the excessive deposition of fatty matter would necessarily be accompanied with increased redness of the part. The whitish sediment generally remarked in the urine of persons affected with this disease, has long been suspected to consist of the phosphate of lime; and the fact is established by the chemical examination of the urine in the second case in this paper. Mr. Solly states "the miscroscopic examination of this matter, showing cell development in its various stages, confirms my impression that it is an adventitious morbid product, and not simply the fatty matter of the bone altered by the effusion of blood into it." It is clear from the account given by Mr. Simon, above quoted, that the evidence of cell development did not appear so satisfactory to him as it did to Mr. Solly and Mr. Birkett, and we have not so firm a faith in the revelations of the miscroscope, to induce us to dissent from what has always appeared to us the most satisfactory account yet given of the character of this curious and rare disease, viz., that published by Mr. Curling, who describes it as an extreme atrophy of the bones, analogous to that occurring in a less degree in old age, the place of the osseous tissue being supplied by an excess of the natural fatty matter. XXIX. CASE OF FISTULOUS COMMUNICATION BETWEEN The patient was an old woman, aged 65, who, after an obscure abdo. minal affection, was seized with a disturbance of the urinary organs, attended with intense suffering. The leading symptoms were frequent and painful micturition, and bloody, ropy, and highly offensive urine, which was observed occasionally to deposit fragments of extraneous matter. On examination after death, the bladder was found to contain fæculent matter and portions of undigested food, such as currants, seeds, and other vegetable matter, which had escaped through an ulcerated opening in the fundus of the bladder communicating with the ileum. The author concludes by referring to a similar case observed by Camper. A TREATISE ON POISONS. By Robert Christison, M.D., F.R.S.E. Part III. TOXICOLOGY. 8vo, pp. 170. Tenth It says much for the progress and stability of Toxicological Science, that while the fourth editions of the two first-named celebrated works contain a large addition of new facts, and many improvements upon former modes of investigation, their authors find it necessary to abandon no important principles heretofore laid down. Readers will here find a record of every, even the most recent, improvement, whether as regards the detection of the poison or the administration of its antidote. But, although the attentive perusal and frequent consultation of M. Orfila's Treatise, rich as it is in its original observations, ingenious processes, and collection of innumerable experiments, is essential to all engaged in the study of this branch of medical science, yet for the practical man we consider Dr. Christison's book a very superior guide, by reason of its greater per spicuity, the more complete view of the entire subject which it embraces, and the constant references to useful cases, sources of farther information, and important trials with which it teems. In the present article we intend to notice the subject of General Poisoning at some length, availing ourselves especially of Dr. Christison's observations, which are far more complete upon this subject than those of Orfila; and afterwards to allude to some of the more important particular poisons. PHYSIOLOGICAL ACTION OF POISONS. 1. The Mode of Action.-The belief that poisons produce their effects. through the medium of the nervous system, i. e., by sympathy, was at one time generally entertained. The discoveries of Magendie upon venous absorption, and the experiments of later enquirers, have demonstrated that, in the great majority of instances, absorption becomes the active agent in influencing the remote organs. Indeed Mr. Blake endeavours, in his papers in recent volumes of the Edinburgh Journal, to prove this to be their exclusive mode of action, even in cases in which death seems to occur almost instantaneously. Dr. Christison, while admitting that the explanation of the modus operandi of certain of the poisons upon the principle of sympathy is somewhat shaken, is unable, in the present state of the inquiry to concur with Mr. Blake in his opinion that it is never admissible. "Mr. Blake, who is altogether opposed to the occurrence of nervous trans mission in the instance of any poison, has found that ammonia, injected into the jugular vein of a dog, was indicated in its breath in four seconds; and that chloride of barium or nitrate of baryta, introduced into the same vessel, could be detected in the blood of the carotid artery in about sixteen seconds in the horse, in less than seven seconds in the dog, in six seconds in the fowl, and in four seconds in the rabbit. These interesting discoveries will not however absolutely destroy the conclusiveness of all the facts quoted above in support of the existence of a sympathetic action. For example, they do not shake the validity of those observations, in which it appeared that an interval inappreciable, or barely appreciable, elapsed between the application and action of hydrocyanic acid and of conia. Mr. Blake indeed denies the accuracy of these observations, insisting that, in those he made himself with the most potent poisons, he never failed to witness, before the poison began to act, an interval considerably longer than what had been observed by others, and longer also than what he had found sufficient for the blood to complete the round of the circulation; that, for example, the wourali poison, injected into the femoral or jugular vein, did not begin to act for twenty seconds, conia and tobacco for fifteen seconds, extract of nux vomica for 12 seconds; and that hydrocyanic acid dropped on the tongue did not act for eleven seconds if the animal was allowed to inhale its vapour, and not for sixteen seconds if direct access to the lungs was prevented by making the animal breathe through a tube in the windpipe. But Mr. Blake cannot thus summarily rid himself of the positive facts which stand in his way. Duly weighed, the balance of testimony is in favour of those whose accuracy he impugns. For, in the first place, they had not, like him, a theory to build up with their results, but were observing, most of them at least, the simple fact of the celerity of action. Then, their result is an affirmation or positive statement, and his merely a negative one. They may perfectly well have observed what he was not so fortunate as to witness. And lastly, it is not unreasonable to claim for Sir B. Brodie, Dr. Freer, Mr. Macaulay, and Mr. Taylor, all of them practitioners of experience, the faculty of noting time as accurately as Mr. B. himself. As for my own observations, I feel confident they could not have been made more carefully, and that I had at the moment no preconceived views which the results upheld, but, if any thing, rather the reverse. It is impossible therefore to concede, that Mr. Blake's inquiries, merely because they are at variance with prior results, apparently not less precise and exact than his own, put an end to the argument which has been drawn, in favour of the existence of a sympathetic action, from the extreme swiftness of the operation of some poisons. At the same time, on a dispassionate view of the whole investigation, it must be granted to be doubtful, whether this argument can be now appealed to in its present shape with the confidence which is desirable. And on the whole, the velocity of the circulation on the one hand, and the celerity of the action of certain poisons on the other, are both of them so very great, and the comparative observation of the time occupied by the two phenomena respectively becomes in consequence so difficult and precarious, that it seems unsafe to found upon such an inquiry a confident deduction on either side of so important a physiological question as the existence or non-existence of an action of poisons by sympathy." 2. The Action of Poisons through Absorption.--However the action of a few poisons through the medium of the nervous system may be disputed, there can be no doubt the majority act by being absorbed into the blood. Various familiarly-known experiments amply prove this. Addison and Morgan have endeavoured to show that the poisons so admitted into the blood do not act by being transmitted with that fluid to the organs affected by them, but by the influence they exert upon the nerves of the blood |