valerianate of ammonia in neuralgia

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and loose fragments of bone, which will become disintegratedwill be sure to pass. This,plan of treatment has really provd ,most effectual of late, numerous records of cases appearing inour "Mirror" from several of the hospitals. Blisters andcounter-irritation may do very well for a little time, but even-tually something more important is recluirccl. Trephining thebone and removal of the disease by suppuration affords ameans of permanent cure. _

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DEGENERATED AXILLARY GLANDULAR TUMOUR.

Two years ago one of the right axillary glands began to en-large in a boy, now fourteen years old, in University CollegeHospital, and gradually increased till it attained the size of asmall flattened orange. There was no sign of degeneration,nor of malignancy; it was movable, lobulated, and from thesomewhat strumous appearance of the lad, Mr. Erichsen be-lieved it to be glandular. It was removed by him on the 24thof June, and found to consist of one large, and some smallerglands; the larger, on section, was composed of gland tissue,with tuberculous matter infiltrated throughout, undergoing theprocess of degeneration, and possessing a yellowish-chcesy ap-pearance. This would have gone on to suppuration, and mighthave caused much trouble if allowed to remain. It thereforebecomes necessary, for many reasons besides the one mentioned,to remove these tumours, and this seems to be the adopted rule.Last year Mr. Erichsen removed a tumour very similar to thisone from the axilla of a girl, and our records afford abundantevidence of the extirpation of glandular enlargements.

VALERIANATE OF AMMONIA IN NEURALGIA.

Fop some time back. Dr. O’Connor has been prescribing,with success, the valerianate of ammonia in cases of neuralgiaunder his care at the Royal Free Hospital. It has alsobeen given in a few cases of epileptoid disease. In one caseof paralysis of the facial nerve which did well, there was con-siderable pain along its course, sometimes of a very excruciating character. The valerianate of ammonia, was administered withbenefit, and in a very short time the patient got well. Thisremedy has been freely used in the Parisian hospitals, butespecially at the Salpêtrière and the Bicetre; and Dr. Tnffliell,Professor of Military Surgery in Dublin, has also tried it, and

found it eminently successful.

Medical Societies.PATHOLOGICAL SOCIETY OF LONDON.

DR. WATSON, PRESIDENT, IN THE CHAIR.

MR. JABEZ HOGG read a report of a case ofCYSTIC DISEASE OF THE LIVER.

F. S. A-, aged forty-five, of fair complexion, nervoustemperament, and health not very robust, while in the country,on September 12th, 1846, caught a cold, which was ushered inwith violent pain across the epigastric region. A medicalpractitioner being called in, he prescribed, but at the sametime advised him to return home, as from the symptoms heconsidered the patient was suffering from an attack of icterus-hepaticus. On his arrival, I found him suffering much painwithout vomiting; but a slight yellow tinge being perceptibleover the skin, 1 concluded that gall-stones were obstructingthe duct. The next day the skin cleelened in colour, thefseces were colourless, and the urine was of a very deep saffronhue. All these symptoms gradually yielded to the remediesemployed; and in about four weeks he was sufficiently well togo to the country again. On the 9th of February, 1857, theformer symptoms presented themselves, but not with equalseverity, and more readily yielding to the remedies admini-stered, he was enabled in about a fortnight to resume his ordi-nary occupation. A good deal of debility, and a loss of appe- Itite, followed this attack. I, therefore, recommended country Iair once more; but the weather proving unfavourable, he could Inot be prevailed on to remain away more than eight days, andjourneying home caught cold. I was summoned to attend himon the 25th of March, and found him labouring under sickness,accompanied with considerable pain, which I apprehended wasthe precursor of another attack of the former disease. On thesecond day, the skin was of a deep yellow coloar, the urine

loaded with bile, and stools nearly white. upon making anexamination over the seat of the pain, 1 found on percussionconsiderable dulness below the false ribs; some convexity, anda hardened condition of the liver, great prostration of strength,without any abatement of the symptoms, induced me at theend of a week to recommend a second opinion on his case.There was from time to time considerable variation in thecompleteness of the biliary obstruction; for although the urinewas always full of bile, and the stain of the skin deep, therewas often some bile in the motions, especially after a purgative.We inferred, therefore, that the source of biliary obstruction,though persistent, was not complete. He complained for afew days of pain, or, rather, a sense of uneasiness over theliver, which was increased by pressure; but this subsided,whilst the extent of the dulness increased. At this time aslight undue visibleness of the superficial veins of the epigastricregion was first noticed, which showed that the source of thejaundice was exercising pressure on the inferior cava. Therisht hypochondriac and the epigastric regions were now com-plete, the dulness extending from the level of the nipple andlower part of the sternum to near the umbilicus, and a parallelline extending to the right.The course of the symptoms from this period was as follows :

Increasing conspicuousness of the superficial veins; oedema be-ginning at the feet, and extending up the thighs, scrotum,loins, and ahdominal parietes, so intense at last as to renderthe patient quite helpless, constituting the principal source ofsuffering, and which with occasional rigors greatly exhaustedhim. Just towards the last, the hardness of the dull regionbelow the margin of the right false ribs was exchanged for asense of fluid, there being a circumscribed fluctuation, and thefinger, when pushed forcibly, meeting at first with a fluctuousand soft yielding, and then striking something hard, giving theidea of’ a harder tumour below, covered with a stratum of fluid,and this the post-mortem showed to be the fact. Two daysbefore death fluid was detected in the peritoneal cavity, butonly in very small quantity. It was somewhat remarkablethat there should have been throughout the case, at least withthe exception of the first two or three days, an absence of pair,tenderness, and vomiting, or any derangement of digestior,and until the last of ascites. The condition that all the signspointed to was enormous enlargement of liver, biliary obstruc-tion, and pressure on the inferior cava, but no pressure on theportal vein or alimentary canal. He was taking a full amountof nourishment up to the time of his death, which was precededby a severe and very distressing attack of dyspnoea on the 30thof Aprii. This lasted up to within an hour of his death, whenhe became perfectly calm, dying soon after twelve the samenight, retaining to the last full possession of his faculties.

I’o.st-naortem Exanzinat-ion.-On opening the body fourteen hours after death, about a gallon of deeply-coloured yellowfluid escaped ; the liver was then seen to occupy the wholeepigastric and right hypochondriac region. The transversecolon lying across the umbilical enormously distended explain-ing the resonant prominence in that situation during life. Theheart and lungs were completely pushed up out of place, andlooked very small, the pericardium being deeply stained withbile. The convex surface of the liver was very mottled andirregular, and was firmly adherent to the diaphragm, whichoffered some impediment to its removal. When placed in thescales, it weighed eight pounds and a half. The right lobewas occupied by a largely-distended hydatid cyst, from whichflowed, on cutting into it, a quantity of a peculiarly gelatinousmaterial of a, pale-amber colour, the consistence of thick gruel,and having a very offensive odour. This was followed by a moreopaque and fluid matter, which looked like, and proved to be,pus. This discharge left a large cavity, of which the small amountof liver structure that remained formed the shell. The matterthus liberated, when examined under the microscope, gave anabundance of hydatid walls of all sizes, from the one-tenth tothe one-hundredth of an inch, with here and there echinococciand their hooklets, some needle-shaped crystals, fatty mattersand cholestrine, with epithelium scales. The cyst had com-pletely obliterated the gall-duct, and in the gall-bladderfour g,tll-stones were found, with some colourless fluid madeup of cylindrical epithelium, most of which was enclosed instructureless spherical globules. The left lobe of the liver wasmuch changed in its character, being a softened mass filled upwith inspissated bile. The heart was small, readily breakingdown under the fingers, and was in a state of fatty degenera-tion. The kidneys were, as might have been anticipated, muchcongested, and the whole of the viscera and tissues more orless stained with biliary colouring matter. (The specimen was

exhibited.