of the chest, and the fore-arm. In adults I have seen a number of cases where it attacked the hand and fingers. Never have I observed it in the inferior extremities; but that it sometimes occurs here, the writings of pathologists abundantly testify. Encephaloïd has likewise been noticed in the veins, especially in those of the liver, of the kidney, and the uterus."

We have seen this malady attack the knee, the upper and inner part of the thigh, the soft parts about the ischium, the super-costal cellular substance between the axilla and the spine of the ilium, but above all the scapulary region which has seemed to us to be its favorite seat. But why this region should be more obnoxious than other cellular parts, we cannot tell. Since beginning this article, we have been consulted by a man whose case may be thus stated. He is thirty-one years of age, and by trade a cabinet-maker. About four years ago he discovered a small tumour in the right side, over the eleventh and twelfth ribs, which grew slowly for three years. Under exercise he felt some pain from the beginning, and tenderness on pressure. For the last year, he thinks it has rather decreased in size; but this is probably the result of the absorption of the healthy tissues in and around it. At this time it has an oval base, is but little elevated, feels knotted and corded within, and has formed attachments for the skin above, which is somewhat livid and marbled in its appearance, and exhibits many small varicose veins. From this tumour up to the shoulder there is a degree of fulness, which is quite perceptible to the eye when the patient is seen from behind. Indeed the scapula seems thrown outwards, and the sterno-spinal circuit of that side is an inch longer than the other. All round the margin of the scapula the parts are tender to the touch, and between that bone and the spine the pain has been such as to cause him to

apply an adhesive plaster. This pain is increased by the motion of the arm. The axillary ganglia are unaffected. We take this to be an incipient fungus hæmatodes.

We have met with but one case of this disease affecting the mamma, and then it had extended to that organ from the axilla and shoulder. We have twice been tempted to extirpate the eyeball disorganized by this malady. In the first instance, that of a child, it was associated with such a degree of ossification as rather to interfere with the progress of the knife. A fungus shot up rapidly from the socket, and the disease went to a fatal termination. In the other case, that of a woman near fifty years old, there were strong symptoms of reproduction, when she passed from under our care to a distant state, whence we have not heard the final issue. When lately at Zanesville, we were shewn by our friend, Dr. Rhodes, a testicle affected with this malady which he had extracted and the patient afterwards remained exempt.

The following is our author's account of the progress of this malady:

Encephaloïd disease, after having attained a certain development, may remain stationary for years, unaccompanied by the slightest uneasiness, until the part receive some injury, when it often grows with frightful rapidity. When seated in the subcutaneous cellular tissue, the tumour that is thus formed is at first quite movable, smooth on the surface, and devoid of sensation; but gradually, as the enlargement progresses, it becomes stationary, irregularly lobulated, elastic to the touch, and more or less painful. If allowed to proceed, the diseased mass has a tendency to open and protrude, generally by ulceration, sometimes by sloughing, and occasionally by the bursting of an abcess situated in its interior. In either case, the exposed surface presents a dark reddish fungous appearance, is highly sensitive, extremely vascular, very prone to hemorrhage, and constantly bathed with a thin, fetid, irritating, sanious fluid, the quantity of which is sometimes quite profuse. In many instances, pure blood is effused, caused by a rupture

of some of the vessels of the morbid growth; and this may be so obstinate and copious as gradually to destroy the patient. Occasionally there is a discharge of thin, glairy fluid, resembling the white of an egg. Such sores, besides being always highly disagreeable, never heal, from the inability of the parts to form healthy granulations. Sometimes the ulcerated mass sloughs as completely away as if it were dissected out; but these cases are uncommon, and are soon followed by a reproduction of the heterologous substance.

"Obstinate hemorrhage is most apt to occur in such tumours as are of the class to which Mr. Key applied the term fungus hæmatodes. In the eye, for example, much more frequently than elsewhere, the morbid growth, if it be permitted to go on unrestrained, is extremely prone to bleed. The reason of this is obvious. The diseased mass is almost always composed, in part, of a vascular, erectile tissue, interspersed with encephaloïd matter, and, as soon as ulceration sets in, hemorrhage, occasionally to an alarming and even fatal extent, is the consequence. The eroded surface, in these cases, is pale, livid, or mahogany color, and studded with large fungous excrescences, so grouped together as to resemble a cauliflower.

"In this advanced state of the disease, there is a rapid failure of the strength, the flesh wastes, the appetite declines, the patient is harassed with hectic fever, and the countenance assumes a peculiar yellowish, cadaverous hue. The lymphatic ganglions in the neighborhood meanwhile become enlarged, and converted into a substance resembling that of the original tumour. Two modes of explanation may be offered to account for this phenomenon. The one supposes that these bodies are effected merely sympathetically, in consequence of which their vessels pour out encephaloïd matter; the other, that this substance is carried to them by absorbing vessels coming from the affected part. Although this enlargement of the lymphatic ganglions seldom occurs before ulceration sets in, yet, in a few instances, I have known it to exist at an early period after the development of the heteroclite mass, a good while before the skin covering it manifested a disposition to give way."

We here close our analysis of the first part of Prof. Gross's Elements-that which treats of General Pathological Anatomy. The analysis of the second part will be commenced with our third volume. In thus continuing it through many successive numbers, our object is not so much to make known

the merits of this very excellent treatise, as to make it the occasion of a series of papers, designed to promote the study of pathology and pathological anatomy, in a region of country where these branches, particularly the latter, have not hitherto received the attention they deserve. For this purpose it seems to us peculiarly proper to employ as our text, a work written among those for whom we purvey, especially when we are compelled to regard it as superior to any other within their reach.

If we are not greatly misinformed the alumni of our Western Schools, and justice requires us to add of our Eastern likewise, have been seldom examined on morbid structure. A knowledge of healthy anatomy and of symptomatology has been demanded, but who can attempt to justify the omission of pathological anatomy? We trust that the day is not distant when the onus of our examinations will rest on that branch; and that a diploma will not be granted to one who is not as well acquainted with the morbid as the healthy structure of the body.

D.

ART. VII.-Transactions of the Medical Society of the State of New York.-Parts II and III, Vol. IV.

The Medical Society of the State of New York is a legal organization of the medical profession, designed to protect the community against the impositions of unqualified practitioners, and to provide for the suitable education of those who aspire to the honorable but responsible office of healing the maladies of their fellow-citizens. And surely no object can be presented to the mind of an enlightened and patriotic

legislator, which should more powerfully enchain his attention, or more vigorously call forth all his energies for its attainment. Such an one must feel, after midnight vigils spent in devising remedies for the over-reaching of the avaricious and crafty, where dollars and cents alone are involved, that his solicitude would have been more worthily bestowed in guarding against the wiles of quackery, which filches not only the purse, but the health and lives of its dupes.

The State Medical Society of New York, which owes its existence to wise and provident legislation, is composed of delegates from county medical associations, that have each a corporate capacity, and are empowered by law to grant licenses to practice to such as have complied with specified conditions, and are found qualified after an examination by a board of censors. The County and State Societies hold regular meetings for the mutual improvement of their members, and to contribute their quota to the advancement of science. The State Society convenes annually at the capitol, in the month of February, and publishes, in the shape of Transactions, the avails of the systematic and stimulated labors of all within the limits of its jurisdiction.

Parts No. II and III of vol. IV, which are now before us, contain Addresses delivered on different occasions, and Essays on various subjects, together with abstracts of the Proceedings of the Society at its annual sessions in 1839, 1840. The following enumeration will convey an idea of their genral character:-1. Annual Address on Quackery, delivered before the Medical Society of the State of New York, February 6th, 1839, by LAURENS HULL, M. D., President of the Society. 2. Address on Spinal Disease, delivered before the Tompkins County Medical Society in 1833, by Dr. A. CHURCH, President of the Society. 3. Address on Quackery, delivered