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very red portion, we sometimes see a circumscribed spot of the natural white colour. When the aorta contains very little blood, the reduess only exists in the part in contact with this fluid. The surface of the sigmoid and mitral valves sometimes exhibits this phenomenonOccasionally the whole of the arterial system. Sometimes the auricles and ventricles alone are tinged-and then it is observed that the heart is full of blood, and the arteries nearly empty. The redness is attended by no appreciable thickening of the membrane, and entirely disappears after a few hours' maceration. M. Laennec is very doubtful whether this redness ever gives rise to any general symptoms, so constant or severe as to indicate its presence. For our parts, we have no doubt on the subject. Like him we have found it in bodies dead of different affections, and without any symptom, during life, that could lead to a suspicion of its existence.

M. Laennec has seen the violet hue of the membrane in subjects dead of putrid fevers, ephysema of the lungs, and diseases of the heart. All these individuals had remained long in a moribund state, with suffocation. In all, the blood was very fluid, evidently altered, with signs of premature decomposition in the body. Accordingly, we more frequently observe this phenomenon in Summer than in Winter. Both kinds of redness-especially the violet, are accompanied by more or less softening of the heart, and an increased humidity of the arterial tunics-the consequence, most probably, of putrefaction.

Upon the whole, we may safely conclude that this tincture of the internal surface of arteries is owing either to some morbid change in the blood itself, or, at all events, to some process which takes place in articulo mortis, or post mortem. A remarkable instance lately occurred in St. George's Hospital, in the case of a man who died of phlebitis. The whole arterial system was tinged.

bones of the cranium, to the investigation of which he was led by the following case.

A female, 48 years of age, fell down stairs, and received several contusions, one of which, on the head, confined her for some days. From this time her health was bad-she had fixed pain in the head, and disordered stomach and bowels. Still she attended to her domestic concerns till within three weeks of her death, when she was seized with fever and high delirium. These subsided after venesection, and next day erysipelas appeared on the face, which, also, went off. She recruited a little, and was able to leave her bed, but complained of fixed and deep-seated pain in the right side of the head, a little above the ear, from which there was some discharge. Three days before death (one year from the date of accident) she be came comatose, with partial paralysis of the left side.

Dissection. The bones of the cranium were very soft. The inner surface of the skull-cap, when raised, exhibited a singular state of disease. The inner table seemed to be wanting through its whole extent, and there appeared the rough, irregular, and cancellated structure of the central part of the bone. Between this surface and the dura mater, there was a deposition of soft adventitious membrane of a yellowish colour, about the tenth of an inch in thickness. On raising the skull-cap, this membrane was found to adhere to the dura mater, leaving exposed the irregular cancellated structure of the bone. In other places it adhered to the bone, exposing the dura mater of its natural appearance. The greatest degree of erosion was in the parietal bones, where several portions were thin and transparent-in a few parts perforated. The external surface of the cranium was of a natural appearance. In the lower part of the right hemisphere of the brain there was an extensive abscess. On the petrous portion of the right temporal bone, the dura mater was of a dark colour, and detached from the bone, which last was sound.

There was no reason to suppose any syphilitic taint in this woman's constitution, the cranial affection must, therefore, have been the result of slow inflammatory action following the blow, and gradually destroying the bone by caries. Dr. A. has not been able to find any case on re

cord precisely similar to the foregoing. Desault mentions a case, where death followed a blow on the head. The bone appeared sound externally, but the internal table was blackened throughout the whole extent of one of the parietal bones. The dura mater adhered to the parietal bone as firmly as to the other parts of the cranium, and there was suppuration on the surface of the brain. Some other cases, analogous to this last, are collected from surgical writers by Dr. A. who considers them as examples of an uncommon modification of disease of the cranial bones, confined principally to the inner table. The more common modification, however, is that which occurs in the outer table, or which affects the whole depth of the bone, with the history of which disease some remarkable phenomena are connected. It seems to be a low inflammation, which may arise from injuries extremely slight-or without any obvious cause. Its progress is very slow, and it may terminate by exfoliation of a part of the outer table, or it may affect the whole bone, and, extending to the brain, prove fatal.

attendance at any chartered hospital— an examination."

The Medical Gazette has strongly ridiculed, and, of course, censured, this new regulation. For our own parts, we do not find fault with it. If there is to be a certain degrading title kept up among physicians, namely, that of LICENTIATE, why, in the name of sense or science, make the acquisition of a diploma from a regular university, an essential item in the list of qualifications? It is quite sufficient that a man who has studied his profession for four years, should be obliged to have branded on his forehead the term licentiate, before he can practise, without being also obliged to degrade a university, as well as himself, by passing under the yoke. If the examination, in the Dublin College, be properly conducted, and the examiners take care to see that the proofs of four years' study be authentic, then we say that the said regulation must ensure properly qualified practitioners for the public-and that is the main object of all medical instituThis license does not, we suppose, confer the doctorate upon the individual, but merely gives him permission to practise. While we decidedly object to the obnoxious term of LICENTIATE, enjoyed by every pedlar who sells ribbons through the country, and every hawker who goes bawling about the streets with newspapers and penny pamphlets, we cannot see any mortal offence in the prin ciple of the regulation. It would, indeed, be a fortunate and happy circumstance, if the same regulation could be extended to medical practitioners of all kinds.

by a kind of anomaly of nutrition-or are they the product of a morbid secretion, a species of concrete pus disposed in the areolæ of parts? The author cannot tell. Another, and perhaps a more interesting question is, how are these bodies resolved? The author thinks there are three modes employed by Nature-softening, atrophy, and resorption. Messrs. Thenard and Dulong having found in tubercles the same salts, and in the same proportion, as in bones (phosphate and carbonate of lime) the author attributes the formation of these bodies to a deviation of the above salt from the bones. He strengthens this hypothesis by the fact of the greater lightness of the bones of tuberculous subjects, and the exuberant proportion of phos phate of lime in the milk of cows affected with tubercles. The commission attaches no great importance to this theory. After alluding to the fact, that these bodies are found in the foetus, he observes that hitherto they have been discovered only in the mammiferous animals and in birds. In the first class, they are seen almost exclusively in the herbivore. It is certain that tubercles have never been detected in dogs. In respect to the EFFECTS of tubercles in the organs where they exist, it appears that these effects are nearly null till the tubercles begin to soften. Then the circumjacent parts inflame, ulcerate, and form accidental tissues destined, he thinks, to isolate and envelope them. As to the primitive seat of these bodies, the author concludes that it is neither in the lymphatic system, nor in the mucous follicles, but in the cellular tissue. Tubercles in the lungs, according to the author, are the sole cause of phthisis, notwithstanding what Bayle and others have said to the contrary. The commission think this assertion is too absolute, and admit the existence of cancerous, calculous, melanic, and even osseous phthisis. The commission, also, blame the author for having attributed too much influence to pulmonic inflammation, in the production of tubercles. They think that these bodies exist before the phlegmasia-or if they become developed afterwards, it is owing to the cachectic habit of body produced by the preceding inflammation." The commission ridicule the assertion of Laennec, that tuberculous excavations have healed -or, in other words, that phthisis has been cured. Speaking of bronchial phthisis, where the softened tubercles

have discharged themselves by fistulous openings into the esophagus or bronchia, he notices the curious fact, and illustrates it by a preparation, that the perforation is always through one of the cartilaginous rings, and never through the intermediate membrane. He remarks that tubercles of the mucous membrane are very generally confined to the sub-diaphragmatic portion of the alimentary canal-and especially to the lower portion of ileum, where they lead to ulceration. In laryn. geal phthisis, he maintains that tubercles in the larynx are the primary source of the disease-an opinion which the commission contest. They believe that alceration is the primary condition.

In respect to tubercles in the brain, the author notes the intermissions of the nervous disturbances dependent on these tubercles a fact that is truly inexplicable. It certainly strengthens the doctrine, that a pure intermittent fever itself may depend on some lesion of structure, notwithstanding the periodical states of apyrexia. The author thinks that tubercles in the the bones, a disease which has excited but little attention, are the cause of many cases of white swelling, spontaneous luxations, vertebral caries. He showed a preparation exhibiting a veritable tuberculous cavern in the spinal column. The commission passed high encomium on the Essay, but did not adjudge to it the prize. They awarded its author, however, a medal, value 500 francs.

The reading of this report led to an animated discussion. M. ANDRAL freely censured the doubts cast by the commission on possibility of cicatrization in tuberculous excavations-and consequently the sanability of phthisis. Both these are proved, he observed, by symptoms, by pathological anatomy, and by analogy. Thus, a person will present all the symptoms of phthisis, with unequivocal pectoriloquism under one of the clavicles. The patient recovers, and dies of some other disease; and in the place where the pectoriloquism was heard, will be found a cavity lined, or filled, or filling up with various kinds of tissue, proving the restorative process that had been going on or completed. Analogy shows us that the excavations of diseased lymphatic glands will fill up in various ways. M. CHOMEL also criticised the commission

The right thigh had lately become the seat of a disagreeable sensation of formication. The urine was passed very frequently, and in small quantities at a time, during the preceding four months. The bowels were constipated-the disease had been left to itself. On examination, there was perceived a swelling in the hypogastrium, rising a couple of inches above the pubes, and accompanied by the most acute sensibility on pressure. There was some inconsiderable discharge from the vagina. No fever; but the vital powers were evidently sinking. She lingered out till the 28th of April, when she died. Latterly she had been affected with diarrhœa.

Dissection. Omitting the notice of some unimportant lesions in the stomach and bowels, we come to the urinary organs. The kidneys were pale, and not more than half their natural size, and yet their pelves and infundibula were very much enlarged. The lining membrane of these last parts, as well as that of the ureters, was thrice its natural thickness. The bladder was very small. The internal surface presented a strange medley of morbid productions, which it would be very difficult to describe. There were three layers, as it were, of diseased growths-one appeared to consist of pyriform vesicles, demi-transparent, containing a clear, but yellowish fluid. These were mixed with, or joined to, another set of bodies, bearing more the character of tubercular bodies. mucous membrane, and the submucous tissue, was in a state of great disease. The uterus presented several scirrhous masses growing about its cervix and body. -REPERTOIRE.

The

The above are curious specimens of morbid anatomy.

We have said that rupture of the left auricle of the heart, within the pericardium, is a rare accident. We lately saw, in the possession of Dr. Somerville, jun. a fine specimen of aneurismal pouch, of aortic origin, but within the pericardium -that is, behind the semilunar valves. It had attained the size of a large goose-egg -and, ultimately, burst into the cavity of the pericardium, causing immediate death, of course.

2. HOPITAL DES ENFANS MALADES.

PERIPNEUMONY OF CHILDren.

In the HÔPITAL DES ENFANS MALADES, M. Guersent, has lately been induced to try the efficacy of tartarized antimony, in the pulmonic inflammations of children, in the above institution, and has published in the September Number of the ARCHIVES GENERALES, a few cases illustrative of this plan of treatment. M. Guersent, does not like Laennec, and some of the Italian Physicians, trust, almost exclu sively, to antimony. He bleeds vigorously at first-but finding that this measure is insufficient, he employs the above remedy in large doses. Thus, in the first case, a boy of 12 years of age-the inflammation occupied almost the whole of the left lung, and the second stage, or hepatization, had taken place. The patient had been repeatedly bled and leeched, but still the cough, the dyspnoea, the fever, the viscid and scanty expectoration, threatened the boy's life. In this state, M. Guersent ordered six grains of tartar emetic to be dissolved in twelve ounces of orange-flower water, and this portion to be taken in divided doses, every two or three hours, in the course of one day and night. The first dose vomited the child once, and produced three or four alvine evacuations. The three next doses occasioned neither sickness nor purging. The little patient had some sleep, and next morning the symptoms were mitigated. During the succeeding two days, the same medicine was administered, without any inconvenience, though the daily quantum was augmented to eight grains. The disease was very quickly subdued. Some of the other cases were more formidable, and the same treatment was adopted with success.-ARCHIVES.

3. MEATH HOSPITAL, DUBLIN.

HEPATIC DISEASE. Drs. GRAVES and STOKES.

In the following case, related by Drs. Graves and Stokes, from the Meath Hospital, some observations will be found, corroborating certain opinions which we gave in our review of Dr. Bright's work,