ventricular valve; and 3rdly, a deficiency at the base of the septum of the ventricles, closed by an extension of the anterior fold of the left auriculo-ventricular valve, and the subsequent expansion of this membrane into a small sac, having an aperture communicating with the cavity of the right auricle. Dr. Peacock suggested, that had this patient survived a few years longer, the sac and the opening into the auricles would doubtless have enlarged, and have assumed, both in the symptoms during life, and the appearances after death, a very close resemblance to a true aneurism of the undefended space of the base of the ventricular septum, which had opened into the right auricle.

Mr. Crisp exhibited two specimens of Diseased Heart.

The first Mr. Crisp believed to be one of "concentric hypertrophy of the left ventricle." The specimen was taken from a woman aged seventy-nine. She was only seen twice before death, and then appeared to be in great pain, but owing to mental imbecility, was unable to describe her symptoms.

Nothing remarkable was observed about the thoracic or abdominal viscera the thoracic aorta and branches being more than usually healthy. The abdominal aorta, for three inches above its bifurcation, was converted into a firm bony cylinder. The right internal iliac nearly impervious from ossific deposit; the left less ossified: the common and internal iliacs were tolerably heathy. In the lower part of the thoracic aorta was a dense fibrinous coagulum, occupying the calibre of the vessel, but not adhering to its sides. It was composed principally of fibrin, with a few blood globules.

CASE 2. The patient from whom this heart was taken first came under Mr. Crisp's care in April, 1841, when he was fifty-six years of age. His health before this period had been tolerably good, with the exception of slight attacks of difficulty of breathing. (His father died suddenly of angina pectoris, at the age of fifty-five.) At that time he suffered from great difficulty of breathing, which came on suddenly, pain and sense of oppression at the præcordia; pulse irregular; heart's sounds normal, but its impulse increased; pain in the left arm, extending to the elbow, and sometimes affecting the little and ring fingers; he had also violent pain in the epigastrium, so as to induce him to suppose that he was passing gall-stones, although none could be discovered in the evacuations. These symptoms continued for several days; he was bled from the arm, leeches and fomentations were applied to the side, and small doses of mercury given, so as slightly to affect the gums. He gradually improved in health, and was able to resume his usual avocations; he suffered, however, from frequent attacks of angina pectoris, and the pain in the left arm and fingers was at times very severe, lasting occasionally for four or five days; latterly, he had pain also in the right arm and shoulder. About eighteen months since, he suffered from acute pain in the left side, and a few days afterwards, a small calculus was voided with the urine. Of late, his health had been better than usual. Three days before his death he complained of excruciating pain in

the left arm and little finger, which was somewhat relieved by warm applications, but it soon returned. He also complained of a sense of oppression in the region of the heart-" as if (to use his own expression) the heart had been bound down." (The pain and oppression varied in severity, but continued more or less to the time of his death.) The pulse was about the same as usual, except during the acute attacks of pain, when it was quickened and less bounding. He retired to bed about half-past ten on the night previous to his death, slept for five or six hours, and in the morning expressed himself easier than he had been for two or three days. He was able to dress and shave himself, and walk down stairs; and whilst in the act of getting his breakfast, his head suddenly fell forward, and he died instantaneously.

Examination, twenty-two hours after death.-Body warm; blood fluid; face very pallid; great abundance of fat, about three inches in thickness, on the abdominal parietes.-Chest: Numerous pleuritic adhesions on the left side. Both lungs gorged with black blood, especially the left, but the blood was confined to its proper vessels. The heart was large and flabby, (weight about fourteen ounces.) Both the coronary arteries were ossified in various parts, in some places so as to form a bony cylinder; the left ventricle dilated; both auriculo-ventricular openings large; but the mitral and tricuspid valves appeared to have performed their proper functions. The aorta was of its usual calibre, but it contained numerous elevated patches of cartilaginous and atheromatous deposit, as well as three. bony plates; its colour natural. Liver large, but its structure apparently healthy. The gall-bladder filled with calculi, and its duct impervious, (as in the case which was related to this Society by Mr. Crisp a few weeks since.) Right kidney double its natural size; left, small; pelvis of both congested; the right contained a small phosphatic calculus. Brain not examined.

Dr. F. H. Ramsbotham presented an Infant's heart, possessing only one Auricle and one Ventricle.

It was situated in its natural position in the chest. The auricle was separated from the ventricle by tendinous valves. There was only one artery, the aorta, arising from the ventricle, which sent off a vessel in the situation of the ductus arteriosus. This artery divided into two branches, which supplied the lungs. The vena cava and the two right pulmonary veins entered the auricle in their ordinary positions and directions, the pulmonary veins of the left side forming one common trunk before their termination in the auricle. The vena cava inferior, however, had been destroyed by opening the auricle, and the branch passing from the aorta, which divided into the pulmonary arteries, had unfortunately been cut away in removing the heart from the body.

The child was of full time, well developed, and lived ten days. The late Dr. Combe, who attended it during its short life, stated that cyanosis was perfect over the whole body, but that neither the respi

ration, temperature, nor muscular action, were materially affected. This preparation is mentioned by Dr. Farre, in his work on the "Malformations of the Human Heart ;" and a detailed description of it, accompanied by two figures, is given in the ninety-fifth volume of the Philosophical Transactions, at page 228.-London Lancet.

Erysipelas of Newborn Children By PROF. TROUSSEAU.-This is one of the most dangerous maladies which can affect the newborn child, not only in hospitals but in private practice; it is almost invariably fatal, particularly during the first month of extra-uterine life. Its danger gradually decreases as the child grows older; but still, after the fourth month, about one-half of the infants affected with it sink under its symptoms. The first appearance of this malady is treacherously insignificant: the child has merely lost a little of his good humour; his sleep is slightly diminished, and he sucks rather less than before; at the same time the skin of the pubes is the seat of a small red patch, painful to pressure; the redness gradually gains in extent on the body and limbs, and is occasionally disseminated; but when, in their turn, the foot and hand become affected, they acquire a degree of swelling and redness far greater than that assumed by the eruption in any other region. The genital organs sometimes sphacelate, in consequence of the local inflammation, and in many cases acquire an emphysematous appearance. The pubes is not the only part from which the erysipelas may take its departure: it has been observed to arise from the redness which surrounds the vaccine pustule, less frequently from any accidental laceration of the skin, or from any one of those divisious so common in the inguinal or other cutaneous folds. The general symptoms are interesting in many respects, and amongst others, because their mildness almost inevitably leads the unwary to commit errors of prognosis, which in private practice are neither forgotten nor forgiven. At first the disease appears perfectly local; it is not until several days have elapsed that general uneasiness and crossness show themselves. The colour of the skin, the expression of the countenance, often remain for some days perfectly satisfactory, when suddenly an ashy cadaverous paleness is observed, and with that degree of intensity that the child seems to be sinking under copious hemorrhage. The cry becomes incessant, jactitation continual, and loss of sleep absolute. These signs are followed by deep stupor and death; the pulse is at first frequent, and the heat of the skin ceases only during the terminal and fatal stupor. Convulsions, diarrhoea, and vomiting are very seldom met with. When the progress is such as we have described, peritonitis has occurred-a frequent disease in children, and one which has not been hitherto described. The duration of the disease varies considerably, sometimes being frightfully short, at others, on the contrary, being prolonged so far as three weeks.

On post-mortem examination the cutaneous alterations are occasionally the only changes observed; but when peritonitis (a frequent complication) has been present, the umbilical vein is often found in

flamed and filled with pus as far as the transversal furrow of the liver, and inflammatory secretions are found on the peritoneal surface of the abdominal viscera.

Of the probable cause of the malady we may say this much, that we observe it principally when an ill wind of puerperal fever blows over the lying-in hospitals of Paris. The children seem to have in. herited from their mother a purulent diathesis, and they appear still to be within certain limits subject to the same ailments as the mother, whose constitution has so lately been theirs. The peritonitis of the children may be, therefore, as aptly termed puerperal as that of the mother, because its general cause is to be sought for in the circumstances which have accompanied the last stage of child-bearing and parturition. It is natural that the skin should be the seat of disease, because that surface has been so lately called to perform functions as new as they are important; in such children the unbilical cicatrix does not form readily, and is sometimes the occasional, the local, cause of the cutaneous disturbance. With regard to the treatment, we have tried almost every local application imaginable, and without success; ointments, lotions, blisters-even the actual cautery-without suspending the progress of the disease. Three cases only have we seen recover during the first month under the use of the ethereal solution of camphor, and of baths containing corrosive sublimate; but in how many have we not since tried the same methods without the slighest benefit! -London Medical Times.

Lectures on Distortion of the Spine not connected with Caries, delivered in the Theatre of St. George's Hospital. By Sir B. C. BRODIE, Bart. F. R. S.-In a person of what is called a good figure, when the feet rest on the ground with the heels in contact, the lower limbs being straight, and the upper limbs occupying the same position on the sides, the spine rises perpendicularly in the same line with the os sacrum, and making on each side the same angle with the pelvis; the centre of gravity being somewhere in the middle line of the body. Whatever causes the centre of cavity to shift its place so as to be on one side of the central line, will necessarily cause some alteration in the position of the spine. A heavy weight in one pocket, or held in one hand, where there is none in the other; the greater height of the heel of one shoe, or an unequal leaning on the two lower limbs even such trivial matters as these will occasion more or less of lateral deviation of the spine. If from any cause whatever, the centre of gravity be moved far away from the spine, the individual would necessarily fall to the ground if he were not to make an effort to prevent it. The result of that effort is, that, while the cause first in operation, whatever that may be, produces a bending to one side in one part of the spine, by the action of the muscles another part of the spine is bent in the opposite direction: and thus, in all cases in which a lateral curvature exists, the curvature is double, the whole spine assuming a form which is usually, and not very inaptly, com

pared to that of the italic S. The degree of such curvature of course varies in different cases. In many persons it is so trifling as to be scarcely perceptible, in others it is so considerable as to become a great and obvious deformity.

From whatever cause the spine becomes affected with a lateral curvature, it cannot but happen that the effects of it should extend to other parts of the trunk. The ribs corresponding to the convex side of the curvature are at their anterior extremities separated from each other by a wider interval than is natural, while on the opposite side they are, as it were, squeezed together, and compressed into a smaller compass. The os ilium of one side appear to be more prominent than that of the other; and there is a corresponding change in the appearance of the scapula, and clavicles, and even of the sternum. I notice these changes only briefly at present; I shall explain them more particularly hereafter.

No part of the body can be permanently displaced without undergoing an alteration in its figure. In a case of unreduced dislocation of the humerus, the old glenoid cavity is absorbed, and a new articulating surface is generated on the lower margin of the scapula, while the head of the humerus becomes reduced in size, and otherwise altered so as to correspond to the parts with which it is now in apposition. In like manner, in an established case of lateral curvature of the spine, the bodies of the vertebræ are found reduced in thickness on one side, increased in thickness on the other; the ribs bulge unnaturally in one place, and are unnaturally depressed in another: and corresponding changes takes place in the clavicles and sternum, and even in the scapula. These changes are produced the more readily, because when lateral curvature exists it almost invariably begins to show itself in early life, while the process of growth is going on. These facts should be borne in mind, with a reference to practice. As deviations from the natural figure occur with more facility during the period of growth, so is the restoration of the natural figure more easily obtained during the same period also. The treatment of the disease cannot be begun too soon after the first signs of spinal curvature are perceptible, and little or no benefit can arise from the continuance of the treatment after the period of growth is completed.

Having made these preliminary observations, I am better enabled to explain to you the various circumstances in which lateral curvature of the spine may have its origin.

If one lower limb be shorter than the other, the ilium on that side (both feet being planted equally on the ground) must necessarily be depressed, and a double curvature of the spine is the consequence, produced in the manner which I have already mentioned; that is, one by the altered position of the pelvis, the other by the muscular effort which the patient makes to keep the centre of gravity in its proper place.

A difference in the length of the two limbs is in some instances the result of original formation. I have had young persons brought to me because one shoulder was observed to be higher than the other,