564 WEStMINSTER MEDICAL SOCIETY.

The above extract sufficiently proves, thatthe influence of marriage in diminishingmortality has extended to the age in whichwe live,the only diiference of result, betweenthe tables of BicHEs, and those of ODIERand

DEPARTIEUX, being in the circumstance thatthe mortality of married women, during the

period at which they commonly become

mothers; is now, comparatively, less than itwas a century ago.The facts which we have just established,

upon the authority of carefully-taken recordsin France, Switzerland, and Holland, con-firm the truth of a proposition for which,perhaps, many of our readers were not

prepared, although all will, doubtless, re- ijoice in the announcement,—that the fulfil-ment of a pleasing duty, on the part of bothsexes, is calculated to add many years to

the probable duration of human existence.

WESTMINSTER MEDICAL SOCIETY.

Saturday, Jan. 6 1838,

Dr. WILLIAMS, President.

INFLAMMATION OF THE STOMACH AND THE

THORACIC VISCERA.—REMARKABLE SOUND

IN THE HEART.

MR. THURNAM related the following case.A man,-aged 40, was admitted into theWestminster Hospital, on Thursday the 5thof January. He was a butler, and up tothe previous Tuesday had always enjoyedexcellent health. On that evening, whileeatinix his supper of cold mutton, he swal- Ilowed a very small piece of bone, aboutthree or four lines’in length, and one or twoin thickness. Shortly afterwards, he experi-enced considerable pain in the throat, whichhe referred to -his having swallowed thespicula of bone. He went to bed and sleptwell, but the following morning he foundhimself affected with a pain in the stomach ;for the relief of this be applied to a sur-geon, was bled, took an emetic, and, after-

wards, some purgative medicine. The nextday (Thursday), he was admitted into thehospital with the following symptoms :-There was pain in the epigastric region,referred chiefly to the right side, increasedupon taking a full inspiration, and on pres-sure. There was slight difficulty of breath-ing, which was attributed to the affection inthe abdomen ; the pulse was feeble, butthrilling. Leeches were applied to the epi-gastrium ; calomel and opium, in repeateddoses, administered, and saline purgativesgiven. He found much relief from theleeching, and on Friday morning felt consi.derably better; there was, however, an

anxious expression of countenance, and arestlessness of manner about him. At 10o’clock at night he endeavoured to get up-right in bed, but fell suddenly back anddied. Unfortunately, no examination withthe stethoscope had been made. On exa.mination after death, the stomach and duo-denum were found considerably inflamed,especially at the smaller curvature of theformer ; the mucous membrane of the oeso-phagus and pharynx was also ecchymosed,and there were several aphthous spots ob-servable in the former. There was someengorgement of the mucous membrane ofthe trachea and larger bronchia, and alsoof that reflected over the arytenoid car-tilages. Severe pleuro-pneumonia had ex-isted in both sides of the chest. Therewere about eight ounces of a thick yellowalbuminous fluid in the pericardium, anda copious deposition of lymph upon theheart, and also on the bag of the pericar-dium. He, Mr. Thurnam, would inquirewhether the disease in the thoracic regionhad ’preceded or followed the swallowingof the bone ; some gentlemen present at theexamination, had considered that the thora-cic disease was consequent upon the irrita-tion caused by the foreign body in the sto-mach, a conclusion which he could notcome to. It was a fact entirely new to himif such a pathological law existed; and,indeed, if it did, he doubted whether theshort space of time which had elapsed be-tween the period of the bone having beenswallowed and the death of the individual,was sufficient to allow of the production ofthe amount of disease which was present,and especially pericarditis. Was there anyrecorded- case in which an irritating sub-stance, chemical or otherwise, applied to

the stomach, had produced inflammation ofthe thoracic organs ? He also thousht thecase particularly important as exemplifyingthe great value of physical signs, and thenecessity of the employment of the stethos-cope in nearly all cases of acute disease.

Dr. JOHNSON had no doubt that if thestethoscope had been applied in this case,the disease in the thorax would have beendetected; though the treatment would nothave been affected by such discovery, that

565

which was adopted having been proper forthe case. He thought, as a pathological prin-ciple, that sixty hours were sufficient to

produce the disease which was present inthe thoracic region. He thought it impos-sible to say if it had preceded or followedthe gastritis, though he considered they weretotally independent of each other as regard-ed their primary cause. The pericarditishad produced death.

Dr. WILLIAMS had seen two or three casesof a similar kind of universal inflammation,in which the lungs, pleurae, and pericar-dium were involved ; the symptoms werethose rather of general depression than of

violence; and the affection was treated underthe name of influenza. One of these casesoccurred in a boy three years of age, anotherin a woman between fifty and sixty. Thedisease went on several days, and was con-sidered severe influenza. It was only twoor three days before death that the extentof the disease was detected by careful exa-mination.Dr. J. JOHNSON said, that, though we

might often be deceived from the want of pro-minent symptoms in diseases, yet prominentsymptoms might, occasionally, give greatalarm, though they were not dangerous. Hehad lately been consulted by a gentlemanwho had just arrived from a foreign climate;he being annoyed by a remarkable symptom,which was a source of great anxiety, andprevented him from sleeping. This symp-tom was a whistling sound heard in theheart; it was distinctly audible at the dis-tance of several feet, and resembled thequick, sharp whistle which persons are inthe habit of employing as a call for dogs.This sound was always present. His generalhealth was unaffected, and he suffered noother inconvenience than that arising fromthe anxiety of constantly hearing the sound,and a great degree of restlessness. Thissound had come on gradually. He believedit accompanied the first sound of the heart,and was heard loudest where the apex ofthe organ strikes against the ribs, and didnot seem to be conveyed along the arteries.There was no other abnormal sound in theheart, but a rather greater degree of impulsethan natural existed in it. The pulse wassynchronous with the heart, and normal.He (Dr. J.) considered the symptoms toarise from some peculiarity in the semilunarvalves of the aorta, but what that peculi-arity consisted in he could not offer anopinion. The treatment he had recom-

mended was chiefly of a moral kind, and hehad advised the patient to totally disregardthe sound, considering it, as he did, of littleimportance.

Dr. WILLIAMS had seen eight or ten casesin which a whistling sound was present inthe heart. Generally speaking, this symp-tom arose from disease in the aortic valves,by which regurgitation was allowed, and,

according to his experience, accompaniedthe second sound of the heart. He hadheard this sound, however, in cases wherethe mitral valve was affected and the aorticvalves were healthy. This sound might goon for years without alfecting the generalhealth of the patient, though, in a case ofthe kind, one of the patients died of fever,slighter than that which probably wouldhave taken off a person not so affected.

BRITISH MEDICAL ASSOCIATION,Exeter Hall, January 9, 1838.

Dr. WEBSTER in the chair.

A MEETING of Council was held thisevening,-

Dr. WEBSTER in the chair.The minutes of the last meeting having

been read and confirmed, the following gen.tlemen were admitted members of the Asso.ciation :-Mr. Henry Holt, Grosvenor-terrace, Horae.

ferry-road.Mr. Charles Packer, No. 27, Pitfield-street,Hoxton.

Mr. Skegg, St. Martin’s-place, St. Martin’s-lane.The PRESIDENT informed the meeting,

with great regret, of the death of one of theirCouncil, Mr. Whitmore, and notified thatthe election of another Councillor wouldtake place at their next meeting.Mr. Lavies, of King-street, Westminster,

was then unanimously elected one of theCouncil, to fill a previous vacancy.A letter was then read by the President

from Dr. Wilmot, of Stroud, announcingthe formation of a Branch Association, andits wish to co-operate with the parentAssociation in London, as also an accountof a meeting held at Stroud on the 3rd ofJanuary.

The PRESIDENT read a communicationfrom a Committee of Medical Practitionersof Plymouth, asking some questions rela-tive to the objects of the contemplatedNational Faculty of Medicine.A communication was also received from

Mr. Rumsey, of Chesham, on the subject ofthe Poor-Law question.The Honorary Solicitor (Mr. D. DAVIES)

read the report which had been drawn upby the Committee chosen to take into con-sideration the mode of addressing the Com-mittee of the House of Lords relative tothe Imprisonment for Debt Bill, and somemethod of securing payment to medicalmen.

The SECRETARY also read the report of thePoor-Law Committee relative to the betterremuneration of parochial medical officers,and the mode of their appointment, whichwas received and ordered to be taken intoconsideration on Tuesday next.