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amputation was performed. No rye wasused in their diet.

Mr. SOLLY stated that a woman in St.Thomas’s Hospital, sixty years of age, hadberleg amputated for spontaneous gangrene ;sloughing of the stump followed; no ossifi.cation of the arteries or disease of the ves-sels existed.

Mr. MACILWAIN believed that sponta-neous gangrene was not always the result ofthe use of damaged rye as an article of diet;he thought the disease might be brought onby a great variety of depressing causes.

PATHOLOGICAL MEETING.

Friday, April 24, 1840.

Dr. CLENDINNING, President.I:XTEh3IVE MEDULLARY SARCOMA OF THE

OSSEOUS SYSTEM.

Mr. ARNOTT exhibited several specimensof malignant disease in various bones, ofwhich he gave the following history :-Thepatient from whom they were taken wasa man 48 years of age. He first came underMr. Arnott’s care in 1833, being at that

period in the hospital for medullary sar-coma of the left humerus, for which he un-derwent amputation of the limb at theshoulder joiut. He quickly recovered, gotstout, and appeared to he in excellent health.There was at that time not the slightestevidence of disease in any other part of thesystem: he continued weil during the years1834-35. At the latter end of 1835, Mr.Arnott lost sight of him ; but he again pre-sented himself in November, 1836, with asoft tumour over the left temporal bone,which he suspected contained matter, andrequested that it might be opened. Ileseemed in good health ; but he stated thathe had lately found his right arm weakerthan usual, and that he could not unlockhis door so readily ss be had been in thehabit of doing. On examining the tumour,which was prominent, and about seven

inches in circumference, it was found to befree from pulsation, unattended by pain,and, when pressed, gave rise to no incon-venience. Recollecting the previous historyof the case, Mr.Arnott suspected the tumourto be of the same character as that for whichhe had removed the man’s arm three years Ipreviously ; and with this impression order-ed him sarsaparilla and tonics, and requestedhim to show himself occasionally at the hospital. This he did ; and after the lapse of a short time lie complained of some swell-ing of the sternum, which, on being ex-amined, gave evidence of enlargement andthe presence ofa a tumour. In February of thefollowing year(l837) he was attacked withinfluenza, and died, as he was coming to the hospital in a cab. On examination, the im-

mediate cause of death was found to beengorgement of the lungs.The head was examined in reference to

the tumour, which, on the scalp being re-

moved, was found to be covered completelyby the pericranium, and surrounded by ahard ring of bone, the ring forming the cir.cumference of a large aperture in the cra.nium, through which the tumour projected,The tumour, iuternaUy, was covered by thedura mater, and had pressed upon the con.volutions of the cerebrum to a considerableextent. The coverings of the tumour, bothexterualiy and internally, were quite un.

affected by disease; and, on detaching them,a red, soft, semi-gelatinous mass was broughtinto view, having very much the appear.ance of red-currant jelly, but of a ratherfirmer consistence. A smaller tumour of thesame kind was formed on the opposite sideof the head, and, on peeling oft’ the entirepericranium, a vast number of minute iso.lated tumours were found in all the cranialbones. These tumours were found to havetheir origin in the diploe between the tablesof the skull, one of which, or both, becameabsorbed as the disease progressed.

’ On examining the chest both claviclescracked, although apparently healthy, Onremoving the periosteum, however, theywere found to contain tumours similar tothose in the head. The sternum was affectedin the same way, but the diseased mass washere of firmer consistence. Tumours of thesame description, in various stages of deve-lopment, were found in the different pro-cesses of the scapula, in the riglit humerus,several of the ribs, and in the thigh-bone.All the tumours originated in the cancellatedstructure of the bone, no trace of them beingvisible in those portions of the bones formedalmost entirely by the two tables. In theupper part of the right thigh, in the centreof the cancellated structure, was situated atumour about the size of a walnut-shell,having exactly the appearance of a mass ofhealthy, florid, granulations.The disease appeared, in its primary stage,

to consist of a vascular mass, red, soft, andgelatinous. In its next stage, this mass wasintersected by solid portions of a white sub-stance, which, as the disease progressed, be-came of a firmer consistence, and formed alarger portion of the growth. With the viewof ascertaining whether the channels for theveins of the cranial bones had become en-

larged, a great portion of the external tableof the slceall had been removed by a Germansurgeon, who considered the disease to havehad its origin in some affection of the ve-nous system, an opinion entertained also byseveral writers on the subject. The pointsof interest in the case related, were thefollowing. 1, Thf’. great extent to which thedisease had pervaded the osseous systern ;2, The fact of the growth having had its

origin in the lining membrane of the cancel.

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lated structure, and not in the dura mater ;3, The circumstance of the patient remainingfree from disease for two years and a haltafter the amputation of a limb affected withmedullary sarcoma, showing that an opera-tion for the removal of malignant diseasesmight be, and was, in this instance, at least,attended with great benefit; 4, The fact ofthe disease affecting the greater number ofthe bones of the body, showing that theobservation, that when you have disease inone bone it is rarely found in another, hadan exception in the present case; 5, Theabsence of all pain from the disease, exceptin the humerus, which was removed by am-putation ; 6, The absence of the disease inevery other than the osseous structure ; 7,The absence of all symptoms of compression,except the slight weakness of the right arm.

With regard to writers on the diseaseunrler consideration, Cruveilhier had relatedthree cases of a siniil-ii, kind, and had re-marked that it generally occurred in coiiuec-tion with disease in other structures. ManyGerman authors had written on the subject.Dr. CLENDINNING had never seen a case of

r.:edullary sarcoma confined to the osseoustissues alone.

Mr. BAINBRIDGE, in reference to the caseof tumour in the brain, related by himself atthe last meeting of the Society, and reportedin last week’s LANCET, said, that he wasinclined to agree vtith Mr. Laagst’dF, thatthis tumour was congenital, which he

thought wuuld perhaps account for the pecu-liarities observed in the case, and for theoccurrence of the paralysis on the same sideas that upon which the pressure existed.

DISEASED LIVER.

Mr. MACILWAIN showed a small portionof a liver, which he considered to have be-come diseased in consequence of the patientfrom whom it was taken having been fre-quently and violently salivated for supposedsyphilis. The portion of liver was exhibitedin a small bottle, and appeared to he of theconsistence of leather. !

Dr. HENRY LEE recollected that M. Gal-lois used to relate two cases in his lecturesin which the liver had become of the con-sistence of leather in two men, who, duringthe first revolution in France, had taken soactive a part in the stormy proceedings ofthat period, as to allow themselves scarcelyany time for eating, drinking, or sleeping.Both died suddenly. In addition to theaffection of the liver, the speen was alsovery much much enlarged in both instances.

PLACENTAR PRESENTATION.

Mr. BAINBRIDGE exhibited the uterus of awoman who had died at the ninth month ofpregnancy, in consequence of the attachmentof the placenta to the os uleri. The casewas briefly this. Three weeks before death,while lifting a bucket of water, she was

seized with haemorrhage, which continuedup to her death. As she considered that theflooding was not dangerous, and wouldcease without the assistance of art, she didnot send for a medical man until the night ofher death. She was then seen by the assist-ant of a practitioner in the neighbourhood,who, finding the os uteri scarcely at alldilated, thought plugging would be srafli-cient. He resorted to this proceeding, andleft her, but she died in the course of thenight, flooding, to a great extent, havingcome on. The placenta, on examination,was found to be completely adherent, exceptwhere it lay over the mouth of the uterus,which was very rigid. This case showedthe importance of early interference in pla-centar presentations, and illustrated the

danger of plugging. A case of a similarkind was recorded in THE LANCET of theprevious week.

IIYDATID3 OF THE LUNG.

Mr. BAINBRIDGE also showed the lungs ofa patient who ha.d died with the symptomsof peripneumonia; after death, the rightlung was fouud to contain large cysts, filledwith about two quarts of serum. Several

small hydatids were visible in various partsof the lung.The patient, a male, had suffered from

symptoms of thoracic disease many monthsbefore death ; but at one time got apparentlymuch better,after venesection and salivation.He had a fresh attack shortly before death,which treatment did not relieve, and he diedsuddenly.

Dr. KINGSTON’ related the following case,in which one of the aortic valves had be-come adherent to the aorta, and one of thecoronary arteries was obliterated :-

ADHESIONS OF ONE OF THE AORTIC VALVES TO

THE SURFACE 0F THE AORTA, AND OBLITE-

RATION OF ONE OF THE CORONARY ARTE-

RIES.

Dr. KINGSTON showed a preparation exhi-biting two lesions, no cases of either ofwhich have yet been recorded ; one of thesewas a perfectly close adhesion of one of theaortic valves through its whole extent to thesurface of the aorta. In addition to tough,thready membrane, connecting the surface ofthe valve to the artery, there was a thin,firm, reddish membrane passing from theaorta straight over the free edge of the

valve, a minute portion only of which it leftuncovered. This membrane extended forabout an inch upon the surface of the ven-tricle, its extremity being in sonce placesloose and shreddy ; the adherent valve, aswell as the other two, had a little cartilagi-nous thickening at its edges ; the portion of

the aorta to which it adhered was athero-

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matous, and greatly thickened, and the restof the upper part of the aorta was irregu-larly thickened with patches of atheroma,under the inner membrane, alternatingwith cartilaginous degeneration of the innermembrane itself; the orince and channel ofthe aorta were of moderate calibre.

The other remarkable lesion exhibited bythis preparation was a total obliteration ofthe orifice of the left coronary artery, andthence of its channel, for the distance of aninch; this part of the channel was flattened,with firm adhesion of its opposite surfaces ;the right coronary was of rather small cali-bre, and healthy texture.With respect to the heart, the ti-ictispid

orifice was dilated to a circumference of fiveinches, while its valve was somewhat short-ened ; the cavities were all greatly dilated,but those of the left side much the most so ;the left ventricle was attenuated nearly inproportion to its dilatation ; the right ven-tricle was somewhat hypertrophous.

There was extensive bronchitis, pulmo-nary apoplexy, rather recent adhesion ofthe left lung to the pericardium, granularliver, the mucous membrane of the stomachdeeply reddened, and softened over its wholeextent.

The subject of these lesions had been a married woman, aged 53 ; she had, in thelast stage of her illness, been a patient ofDr. Kingston and Mr. Walsh; in youth, butnot of late years, she had been subject toarticular rheumatism; her fatal complaintshad come on four or five years ago at thedecline of the catamenia ; she used to be

seized, while walking, with urgent dysp-noea, pain extending from the heart to theleft scapula, and such extreme faintness asto be in danger of falling; she used fre-

quently to wake in the night with similarsensations, obliging her to start up in bed,and continue erect fo.- a considerable time;there was great weight at the stomach afterfood, frequently combined with crampishpain and vomiting. Is both kinds of parox-ysm she derived relief from hot stimulating drinks.

Six months before death her complaintswere much aggravated by affliction at thedeath of her husband, during the last nightof whose life she was ia a sta’e of alarmingsyncope for some hours. Cough supervened,with great excitability, depression of spirits,and debility; the pulse used to be about ahundred while in bed, but was much acce-lerated, and sometimes unequal after theexertion of walking; it was not decidedlydeficient in firmness and fulness ; there wasnone of that visible pulsation of the arterieswhich has been supposed pathognomonic ofaortic regurgitation ; there was a rough,sawing murmur ill the region of the ventri-cles, owing to the regurgitation at the tri-

cuspid orifice ; and there was a strongblowing murmur at the region of the semi.lunar valves, owing to the regurgitationthrough the aortic orifice, one-third of whichwas permanently patent. To this extraor-dinary degree of regurgitation may likewisebe referred a peculiar vibratory pulsation,which alternated with the heart’s impulse,just to the left of the sternum, between thethird and fourth cartilage.On admission to the dispensary, fourteen

weeks before death, she obtained great relieffor six weeks from tonics, antispasmodics,and carminatives ; hut she relapsed, and hy-dropericardium and anasarca supervened; she was confined to bed a month, and sunkslowly.

In connection with this case Dr. Kingstonmentioned another he had met with, in whichthe orifice of one of the coronary arteries,though not quite obliterated, was reducedto the breadth of a small pin ; it was sur.rounded by a yellow rim ; the channel be.yond was much contracted, and drawn upinto longitudinal folds for the distance ofthree quarters of an inch ; the other coronaryartery was much narrowed in various partsof its course by atheromatous and osseousthickening ; there was a little cartilaginousthickening of the aortic valves, an atrophicperforation of the mitral valve, great thick.ening, partly cartilaginous and atheroma.tous, of the aorta, great hypertrophy of theleft ventricle, combined with great dilata.tion of all these orifices and cavities.

The subject had been a sweep, aged 48;had occasionally had rheumatism of no greatseverity ; had for ten years been subject tovertigo, dyspnoea on exertion,and wheezing;and for five or six years to cardiac palpita-tion. About four months before death the

dyspnoea greatly increased, and was con-joined with a severe epigastric pain, ’as ifhe were drawn up in knots," on walkingfast or laying down, and often with a sensa-tion as of something rising to the larynx,and producing sense of suffocation, whichoften waked him in the night, and obligedhim to start up and walk about; the pulseranged from 104 to 124, and was harsh,hard, firm, moderately full; the heart’s im-pulse was very strong, and extended over

and to the left of the cardiac region ; neverany oederna ; what most relieved him was asmall bleeding, and an antimonial salinemixture.

The day before death he was easier, andmore cheerful thau previously. At night,after being in bed some hours, he got out,saying, "I am very ill !" After,walkingabout the room for a minute he returned tobed. Five minutes afterwards he jumpedup, exclaimed," I am dying !"and, after oneor two gurglings in the throat, fell downdead.