934 TsEW BRODIE JOB.-CLINICAL REPORT.

been found against both parties on thecharge of forcibly performing a " surgical"operation ; but that " reverend " personhaving appeared and pleaded, traversedhis trial to the next assizes. After a pa-tient investigation of the evidence, thewhole trial occupying six hours, a verdictof " guilty " was returned against the de-fendant MONCKTON.

We have the means before us of furnish-

ing a full and complete account of thetrial ; but cannot prepare it for publicationin time for the issue of the present numberof THE LANCET. We, therefore, contentourselves this week with saying, in addi-

tion, that Mr. Justice GASELEE deferred

passing the sentence of the Court,-not in

consequence of the existence of any doubt

in his mind as to the law of the case, the

jury having decided on the facts,-but be-cause he regarded the circumstances as

too important for pronouncing judgmentuntil he had conferred with his brother

judges on the case, as he believed that

it was the first of the kind which had

been tried in a British Court of law. He

therefore held Mr. MONCKTON under re-

cognizances to appear and receive judg-ment, when the court above should cite

him for that purpose.The hardihood with which Dr. JOHN

BRANSTON WILMOT and some others em-

ployed the words " untruths," " wilful

misrepresentations," " false and unjustinsinuations," " gross exaggerations," and" pure inventions," with reference to the

first public notice of this outrage, is of

a piece with nineteen-twentieths of the" flat contradictions " which are given tothe statements of the independent portionof the medical press,-but for whose ex

posure, some weeks since, of the leadingfacts of the case, it is most probable thatnot one word relating to it would ever have ebeen heard in a court of justice.

THE ROYAL MEDICAL AND CHIRURGICALSOCIETY.

i BEFORE inserting the communication

which we have received from " F.R.M.C.N., L.," relative to the election of the

distinguished president of the above So-Icietv, our correspondent must favour uswith answers to the following questions :-! 1st. Was not Mr. EARLE the senior ofSir BENJAMIN BRODIE on the list ofmembers of the Society ?

2nd. Did not some member propose

that the eminent Sir BENJAMIN BRODIEshould be chosen president at the lastelection of officers, the celebrated Mr.

EARLE being passed over in the choice?3rd. Did not Mr. EARLE, on learning

that this proposition had been made, in-dignantly send in his resignation ?

4th. Did not Sir B. BRODIE, on beinginformed of Mr. EARLE’s resignation,withdraw ?

5th. Did not Mr. EARLE, on being in-formed of Sir BENJAMIN’S withdrawal,willingly accept office ?

6th. Who communicated with Sir B.BRODIE on this matter?

7th. Who communicated on the subjectwith Mr. EARLE ? ?On some of these points our corre-

spondent must be aware that he has care-fully avoided entering in his defence ofthe reputation of the now Royal Medicaland Chirurgical Society. Distinct answers

must, therefore, be given to the above

queries, before the Editor can allow.F.H.M.C".’S’..L. to call in question eitherthe accuracy or the veracity of hissources of information on this occasion.

ST. GEORGE’S HOSPITAL.

ERYSIPELAS, WITH DIFFUSE CELLULAR

INFLAMMATION.

i A CASE of erysipelas, with diffuse cellu-lar inflammation of the arm, reported ina late No., and which has since terminatedfatally, obtained the following clinical no-tice from the surgeon a few days after theman’s death :-

I commence my remarks upon thiscase, by observing that there are certainperiods, both of life and time, in which

certain diseases appear to be more com-

935

mon than others to the system, and this with it, and was of a green and yellowcase peculiarly illustrates that fact. When tinge, to Dr. PROUT, who told me that heI was a pupil-nay, when I was assistant- found it was impregnated with prussiansurgeon of this hospital, it was very rare blue, which is, I believe, a ferroginate ofto meet with cellular inflammation like the peroxyde of iron. I mention to youthis occurring after any accident, how- this circumstance, because it proves a

ever unfavourable it might be. In con- fact that may be followed up with greatvcrsing, however, with Mr. KEATE upon advantage ; for if it be proved that thisthis subject, I find that such cases as serum which is effused under the cellularthese first became common when the texture, be the poisonous agent which de-government took off the duty from gin stroys the vitality of the part, we shalland other spirits, and it is very true that have gained a great step towards com-those persons in whom this severe cellular bating the disease. The idea of a localinflammation -is most common, are gene- morbific virus, is also supported by therally addicted to dram-drinking-a fact following case :-A man was bitten by awhich if you fail to discover during life, rattlesnake, and nearly expired from theand it is sometimes difficult, you can effects. Syncope followed the accident,generally obtain from the honest testi- diffuse inflammation of the cellular tissuemonyof a post-mortem. After some ex- around the bite supervenecl, and there

perience in such cases, we were ena- was the same constitutional disturbancebled to establish what were the peculiar as occurs in cases which are more idio-instances in which we might expect this pathic. If the report of this case be cor-peculiar morbid affection to occur, and rect, it follows that your treatment of suchsince no after-treatment proves of service, a case ought to consist in giving free exitit became a matter of importance to ascer- to the poisonous secretion, either by punc-tain what prophylactic means would check turing, or by making free incisions in theits supervention. The first idea that struck part with a lancet through the skin co-me on this point, was the propriety of al- vering it. This latter method you willlowing the same quantity of stimuli to find to be the best, where oedema, em-patients as they had previously used to physema, or suppuration, is present. Yourindulge in. They could not bear absti- only chance of preserving the vitality ofnence from it, and it is wonderful how the cellular membrane beneath the skin,few of the patients who have been thus is to give free exit to the poisoning fluidtreated have had attacks of cellular in- which it secretes, for it is a law of theflammation. A gentleman placed himself animal economy, that when any partunder my care some years ago to have his situated beneath another is destroyed, thetesticle removed. Up to the period of my structure superimposed also suffers. In-

performing the operation, he had (as I cisions with the scalpel will evacuate theafterwards learned) led a very irregular sloughs beneath, granulations will springlife, drunk much wine, and was taking up from.the bottom, the parts will heal,brandy in drams all day long. He died and the patient soon get well. There isfrom diffusive cellular inflammation of one very singular fact noticed in this dis-the scrotum. A person scratched his arm, ease--I mean the peculiar disposition toand another individual met with a slight metastasis which it shows. It would seem,accident of a similar nature. Both these indeed, that this erratic transference ofpersons being of bad unhealthy constitu- the disease from one part of the body totions, they died of this cellular inflamma- another, constitutes a leading symptomtion. These cases will be sufficient to of the affection. You know that all me-prove to you how very disproportionate tastases of disease occur through the in-the first set of symptoms are to the tervention of continuous tissue between

secondary symptoms. A man was ad- the parts. The metastasis in this man’smitted into this hospital with a compound case only occurred twenty-four days afterfracture of the right leg. The surface of his admission. MORGAGNI has publishedhis body was as yellow as if the skin had some cases of injury of the head, whichbeen injected with bile. The leg took on terminated fatallv from the formation ofthis cellular inflammation, and I punc- abscesses in the lungs. DESAULT, also,tured it with a lancet, and sent some of has narrated some cases of abscess of thethe fluid that exuded to Dr. PROUT, who liver succeeding to injury of the head,examined, but could make nothing of it. and I have had the opportunity of seeingHe analyzed it for bile, but could find many cases where matter had formed be-none, and having exhausted the stock he tween the cranium and the dura mater,had received from me, he could make no where, eventually, inflammation of somefurther experiments on it. The punctures part of the cellular structure of the bodycontinuing to discharge, I sent him some has taken place, and, on examination afterof the patient’s linen, which was saturated death, I have frequently found traces of

936

purulent deposition in the lungs. Somesurgeons believe that the absorbent ves-sels possess the power of taking up thisfluid, and depositing it in another part ofthe body by means of the capillaries of thepart; but this theory is false, as, in somecases, the inflammation in the part origi-nally affected does not proceed to suppu-ration. A more correct solution of what-ever is problematic in such instances ap-pears to be this,-that a certain febrilestate of the system is set up in some partof the body, determining this peculiarspecies of inflammation to this part. Or,in common fevers, we have somethingvery analogous to this, causing a deter-mination of blood in greater or less quan-tity to any of the internal organs, such asthe brain, the lungs, or the liver, occa-sionally terminating in abscesses whichhave sometimes been termed " critical."This diffuse inflammation of the cellulartexture comes on in so insidious a manneras to cause at first but little apprehensionas to the result. The pulse becomes quickand small; the countenance is pale, lan-guid, and sallow, and, after a certain time,exhibits great anxiety; but the patientmakes no great complaint, nor, appa-rently, is there much the matter withhim. Inflammation of the part first be- ’’igins, and then there are oedema, and, afterwards, suppuration and sloughing.Although the precise characters of thisinflammation are at first somewhat am-biguous and indistinct, you may, if youpay attention, most clearly distinguish itfrom erysipelas. The colour of the skinis, in this case, of a more dingy hue, andit has not the characteristic marginal rimwhich more especially marks the boundaryof erysipelatous inflammation. The pa-tient loses strength every day, the tonguebecomes dry, red, and encrusted; thereare aphthous ulcerations about the mouthand fauces, and he soon sinks and dies.As this disease is highly indicative of alow state of the system, it would be per-fectly absurd to have recourse to any

antiphlogistic measures for its relief. Ifyou bleed and purge your patient, youdeprive him of much of that strength andstamina which are essential to recovery;on the contrary, your plan of treatmentshould be such as to support his strength.Give him bark, wine, ammonia, and rawbrandy, if he seems to require it. Do not

merely make simple punctures, but boldand free incisions into the parts. Whenthis affection of the cellular membrane is

set up in deep-seated parts, the patientnever recovers. At least (said Sir BEN-JAMIN BRODIE, in conclusion) I havenever heard of a case of recovery.

CORRESPONDENTS.

Mr. Beaumont of 31, Penton-street, Pen-tonville, has been strongly recommendedto us by a competeiit jucige who is per-sonally acquainted with his abilities as ateacher of foreign languages.

Observer is informed that the anthenti-cation of his letter hs.s been received, butin consequence of some inquiries whichare in progress for our satisfaction as tothe exact character of the transaction, hisstatements must remain unnoticed thisweek.

W. The operator in that case was

Mr. Rose of St. Geoir-ge’s Hospital, now deceased.The operation was performed in the year 1826or 27.

X. Yes; but it is very uncertain atwhat time the change will be etlected.Can A Subscriber resupply us with the

statement respecting the alleged " chicanery ?"The circumstances hdve escaped our mentory.

Corrected reports of their several ora-tions at the late grand veterinary dinner not hav-ing yet been returned to us by the speakers, v ecannot this week give insertion to the account ofthat interesting and important festival.

ERRATUM.ERRATUM.—The name of Mr. Barnett at page896 of our last No., should have been printedJOHN HALES BARNETT.