these characters; if, therefore, the oval corpuscles should be regarded as sporules, they must be sporules of a peculiar kind. As it is yet questionable how the corpuscles escape from the cyst, it will be necessary to institute a further examination of this part. I have not yet succeeded in detecting an aperture. But Dr. Knox has given an engraving of one instance in which the head and neck of the cysticercus cellulose was seen to project through a natural and well-defined opening in the cyst. With what facility the oval corpuscles may be disseminated will be understood, when it is recollected how prone they are to separate from the surface of the corium.

It is an interesting question whether the spherules of the caudal vesicle may not be considered as nuclei, which advance to the neck or body of the worm, and there become invested with cells, and so formed into the complete oval corpuscles.

Although the consideration of the basis of a methodical arrangement of the entozoa forms no part of the object of the present memoir, I may express my belief that an exact knowledge of the structure and arrangement of the claws of the cystoid family is likely to lead to an accurate discrimination of many genera and species hitherto but imperfectly characterized. Rudolphi, indeed, in the formation of his orders, availed himself of the characters afforded by the tentacles of the parasites; but although the importance of these parts was thus early appreciated, it does not appear to me that they have ever yet been described with sufficient

accuracy.

It will be understood that the true body of the cysticercus is that part which, in compliance with custom, I have frequently called the neck; and that the globular portion of the hydatid is in reality the caudal or terminal vesicle."

II. CASE OF OSSEUS UNION OF A FRACTURE OF THE NECK OF THE FEMUR WITHIN THE CAPSULE. By Walter Jones, Esq.

The case was that of a man, more than 80 years of age, who slipped down about the middle of October, 1839. He had the symptoms of fracture of the neck of the femur, and a long splint, on the outside, was employed. He died about a year and a half afterwards of disease of the lungs, having been able to move about with a stick, with the limb shortened about an inch and a half, and the foot much everted.

Mr. Stanley says, in reference to the appearances found after death:"The history of the case is clearly that of fracture of the neck of the femur; the appearances of the bone show that there has been a fracture which has re-united by an osseous medium, and the direction of the frac ture is such as, in my opinion, can permit no doubt that it was confined to the portion of the neck of the bone covered by synovial membrane; consequently, that it was wholly within the capsule. The fracture extends through the basis of the head of the bone in the line of its junction with the neck. As in other cases of the same kind, great part of the neck of the bone has disappeared, and, in consequence, the head is proportionately nearer to the trochanter major and shaft of the bone; its re

union has, in fact, taken place in part to the remaining portion of the neck, and in part to the shaft. This union is certainly osseous. In addition to the first maceration of the bone with its surrounding soft parts, it was subsequently immersed for several days in a strong solution of carbonate of potash, and one half of the bone has been boiled in water for three hours without the slightest yielding perceptible in the line of the fracture.

The specimen is preserved in the Museum of St. Bartholomew's Hospital."

An interesting case.

III. OBSERVATIONS ON VACCINATION AND SMALL-POX, MORE ESPECIALLY WITH REFERENCE TO THE THEORY OF VACCINE INFLUENCE, AND THE RELATION SUBSISTING BETWEEN THE CICATRIX AND THE CHARACTER

OF THE CONSECUTIVE VARIOLA. By George Gregory, M.D.

Our able friend tells us :

The epidemic of 1838 ceased with the frosts of Christmas; and from January, 1839, to the end of September 1840, (a period of 21 months,) the metropolis was remarkably free from small-pox. The admissions into the Small-pox Hospital during the first three quarters of 1840 amounted only to 142, being at the rate of sixteen per mensem. In October 1840, a new epidemic began, and 46 patients were admitted in that month. In November the admissions were 64. In December, 75. From the 1st of January, 1841, to the present day, (Monday, January 25,) the admissions have been 93, being nearly at the rate of 4 per diem-the greatest number ever admitted in one month since the establishment of the hospital in 1746.

Among the 327 patients admitted in 1840, 11 had complaints not proving to be of a variolous nature. Of the remaining 316, 194 were wholly unprotected, of whom 87 died, or 45 out of every hundred! 120 had previously been vaccinated, of whom 8 died, being in the ratio of 7 per cent. only. Two were supposed to have previously undergone smallpox.

Of the 316 patients, 47 were under 5 years of age, of whom 28 died; 45 were between 5 and 15 years of age (inclusive,) of whom 9 died; 224 were adults, of whom 58 died. The total mortality was 95, or 30 per cent. on the gross admissions.

Dr. Gregory relates a case, and proceeds:—

"One hundred and twenty cases, I have said, of variola succeeding vaccination occurred at the hospital during the past year. My attention had long been directed to ascertain whether any, and what, relation subsisted between the number and character of the vaccine cicatrices, and the intensity of the consecutive variola; and I took this opportunity of investigating the subject. I found, by careful inspection of the arms of those who attended for vaccination, and for revaccination, that much caution was requisite in forming any conclusion regarding the original vaccination, by the appearance of the arms in after life. It must always be borne in mind, that the full measure of vaccine influence is received by each individual on the eighth day from insertion. If the disease be subsequently rendered mild, either by art or peculiarity of habit, the cicatrix will be small and fugitive. Even should the vesicle be then destroyed by caustic, or the

part cut out, and allowed to heal as a common sore, and no specific scar remain, still the individual would remain vaccinated. On the other hand, should the disease be aggravated by neglect or bad management, or a foul or inflammatory state of the child's blood, high secondary inflammation would be set up, and a large, wafery, or otherwise irregular cicatrix would form, which is permanent in after life. The amount of vaccine protection remains however in both instances the same, and the probable character of the consecutive variola receives no elucidation from inspection of the arm. The character of the cicatrix, then, depends more on the accidental or secondary, than it does on the primary or specific inflammation, and hence arises the small reliance which can be placed on it as a measure of vaccine protection.

Undoubtedly in the majority of cases wherein the cicatrixes are numerous, normal, and well defined, the consecutive variola is mild and varicelloid; again, where the consecutive disease proves severe, there the cicatrixes will be imperfectly seen, or altogether wanting. But instances of the converse of these propositions are so numerous as scarcely to be called exceptions to a rule. As the profession are probably not so familiar with these latter cases, I have ventured to submit two opposing series to the notice of the Society. The first shows that small-pox after vaccination often proves severe where the cicatrices are normal. The second points out that the lightest and most truly varicelloid eruptions coexist with small and very imperfect cicatrices." 19.

The two cases which follow bear out the assertion, and show that the cicatrix cannot be relied on as affording any certain test of the degree to which the constitution has imbibed an anti-variolous influence. Peculiarity of habit, similar to that which rendered certain persons patient of the variolous poison before the discovery of vaccination, and which now makes some patient under the venereal or mercurial poisons, and others irritable under the most minute quantities of those poisons, must probably be looked to as the best means of explaining the diversities in the aspect of consecutive variola. This is Dr. Gregory's opinion, and it seems very likely to be true.

Dr. G. next touches on the question, if the variolous and vaccine poisons are the same. After alluding to the affirmative conviction of Jenner, and the able experiments of Ceely, he sums up the evidence thus —

The morbid secretions from the cow, which possess the singular properties of transplantation to the human frame, of exciting there a like disease, and subsequently of protecting the human body, to a certain extent, from the assaults of small-pox, may be produced in that animal in four modes.

1. They are generated, spontaneously in the cow, under certain circumstances of soil, season, and locality. Such diseased secretions are often met with in cows soon after parturition, in the spring season, and when feeding upon young grass. But they arise also spontaneously from other and less known causes, and the disorder spreads like other epizootic maladies. It was this form of vaccine disease which Jenner chiefly studied.

2. The very same malady, developing the very same morbid secretion, is often observed to spread by contagion:-that is, by the application of the diseased secretion, thus generated, to the teats of healthy cows, differently circumstanced, by the hands of the milker.

3. The same morbid secretion, possessed of the same qualities, may be and frequently has been generated in the teats of the cow by the application to them of the matter formed by the heel of the horse, when affected with the disorder called by farriers The Grease. This greasy matter may

also be transplanted to man directly, without the intervention of the cow, proving that the anti-variolous property does not depend on any peculiar change which the virus undergoes while passing through that animal.

4. The same morbid secretion may be excited artificially in the cow by applying to the teats, or the mucous surfaces of the vagina, vaccine lymph from the arms of a child, even though 20 years had elapsed since that lymph had been humanized or assimilated to the human constitution.

5. To these four modes of exciting that kind of morbid secretion in the cow, which we call Vaccinia, (one constitutional and three artificial,) the labours of Mr. Ceely have now added a fifth. He has shown that the very same object may be obtained by applying to the mucous surfaces of the cow the matter of human small-pox. The vessels of the part are thereby excited to the production of a fluid or humour, identical in all its properties with that which arises from a constitutional and febrile disturbance in the cow's system, from contagion, from the matter of Grease, or the longhumanized vaccine virus.

"When we consider," adds Dr. Gregory, "that five modes of producing this morbid secretion in the cow are now known to exist, it is not unreasonable to suppose that others may hereafter be discovered. In this state of our knowledge, then, surely we cannot be justified in assuming the fifth and the last discovered of the whole, as the most important, and as affording the true clue to the mystery of vaccine protection. We should reflect that Mr. Ceely's experiments have entirely set aside Dr. Jenner's notion that vaccinia was the original or primitive poison, which time and fortuitous circumstances had aggravated into the malignant or secondary form, which we call small-pox. They have proved (if indeed they have any bearing on the intimate nature of these poisons) that small-pox is the primary, and cow-pox the secondary form. But when we further reflect on the absence of a contagious principle in Vaccinia, and the remarkable fact that febrile disturbance is not essential to its perfect development, we shall probably be nearer the truth in saying that the vaccine is a poison sui generis; that its relation to variola is still hypothetical; that the real and intimate nature of the protection which it affords is still unknown to us; and that a thorough acquaintance with its anti-variolous powers must be derived, not from analogy, but from an extended and careful observation of facts, continued through a long series of years.

It is worthy of record, that among the 120 cases of variola occurring at the hospital in 1840, subsequent to vaccination, eleven only were under 16 years of age. The youngest person admitted under such circumstances was of the age of 7. The first occasion on which I have ever known a child under 5 years admitted with small-pox after vaccination, occurred last week." 28.

Dr. Gregory adds the case. This, like all Dr. Gregory's communications on the subject, is extremely valuable.

IV.-ON GOUTY CONCRETIONS, WITH A NEW METHOD OF TREATMENT. By Alexander Ure, Esq. M. D.

Mr. Ure observes that it is well known that persons afflicted with gout are liable to the effusion of a white liquid into many of the internal cavities of the body. This liquid consists of serum and urate of soda, with sometimes a little urate of lime. In the course of time, the serous particles become absorbed, leaving a kind of soft clayey residuum, which afterwards

becomes hard and friable; thus forming the so-called tophaceous concretions or chalk-stones.

Gout may be regarded as a specific inflammation which seems to affect the serous and fibrous structures. Accordingly, we find that the above depositions most generally take place in the cavities of joints, in the bursæ muscosæ, in the ligaments, neighbouring aponeuroses and cellular membrane, and in the periosteum. They have even sometimes been met with between the cutis and cuticle.

The effusion from which these concretions are derived, occurs not only during fits of gout, but likewise in the intervals; and as the extremities of the body, particularly the hands and feet, are the principal seat of the disease, it is there that the greatest accumulations take place. They occasionally, however, make their appearance about the articulations of the jaw and spine.

Although this process is usually preceded and accompanied by inflammation, yet there is no extravasation of coagulable lymph, no new covering or cyst surrounding the concrete matter,-like pus in an abscess. A circumstance which distinctly proves that the inflammation is not of a phlegmonous character, and that the non-absorption of the deposit is to be ascribed to physical causes.

Gouty tophus is not confined to man; it occurs also, though more rarely, in animals, when placed in a similar condition, that is, when fed for a length of time upon a highly azotised diet. Aldrovandi has detailed its effects in birds of prey, more especially in hawks. Gout-stones sometimes attain a very great size. Now, says Mr. Ure,

"Since one part of urate of soda requires about 4000 parts of water to dissolve it, it may be reasonably assumed that the refractory nature of the above deposits is due to their very sparing solubility in the fluids with which they come in contact. It therefore occurred to me as a consequence deduced from some researches into the composition of the renal secretion in certain of the lower animals, that some means might be devised to enable us through the medium of the circulation so to modify that secretion in man as to supersede, for a time, the urates altogether.

The graminivorous animals, as the horse and cow, secrete from the kidneys a peculiar acid (the hippuric.) It is present in their urine combined with soda. Now, the hippurate of soda, which may be considered the analogue of the basis of gout-stones, is an exceedingly soluble salt, (requiring only two parts of water, at 60° F., to dissolve one,) as are likewise the hippurates of potash, of ammonia, and of lime. Hence it appeared probable that were we to adopt such therapeutic measures as would determine the human kidney to secrete this acid instead of the uric, we should thereby, in all likelihood, control and prevent the deposition in question.

I ascertained in the course of last summer, by repeated experiments, made first of all upon myself, and afterwards upon individuals labouring under gout, that the above substitution could be perfectly accomplished without the slightest risk of affecting the general health, or of irritating the urinary organs. The substance employed for this purpose was the benzoic acid. If an hour after a meal, a scruple of this acid be taken into the stomach, in the course of a couple of hours subsequently the urine voided, amounting to five or six ounces, will be found, on adding a small quantity of muriatic acid, to yield a copious precipitate of beautiful rose-pink acicular crystals, which weigh, after being allowed to settle for a day, about fifteen grains. This quantity is by atomic computation equiva