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body, the result of a fall down a flight of stairs, of which hedied on the evening of the 2nd of March. At the autopsy,

I

thirty-nine hours after death, the body was observed to be ingood condition. The sternal end of the left clavicle was veryprominent. On examination, the joint was found to presentthe appearance of chronic arthritis, the head of the bone, aswell as the cavity on the sternum, being much enlarged, theinterarticular cartilage partly absorbed, and the osseous struc-ture exposed and polished. The opposite joint presented thesame appearances, but was not in so advanced a condition. Asmall portion of new bone was found near this joint on the(ossified) cartilage of the first rib. The sixth, seventh, eighth,ninth, and tenth ribs, on the right side, were fractured neartheir angles, and the posterior fragment of the seventh hadperforated the pleura, which contained some bloody fiuid anda good deal of air. The latter, however, must have been aproduct of decomposition, since the lung was uninjured. Thebronchial tubes throughout both lungs were reddened and fullof purulent fluid, and the lungs emphysematous at their edges.The heart was very large, weighing more than twenty-fourounces. This was due to enormous hypertrophy of the leftventricle. The valves were healthy. The kidneys wereatrophied, their cortical structure very thin, their surfacerough, cicatrized, and highly granular.

HOSPITAL FOR CONSUMPTION AND DISEASESOF THE CHEST, BROMPTON.

PHTHISIS, ASSOCIATED WITH CEREBRAL SYMPTOMS; FATALRESULT. AUTOPSY: TUBERCLE IN THE CEREBELLUM.

(Under the care of Dr. COTTON.)THE notes of the following very interesting case were taken

by Dr. Footman, resident clinical assistant:-J. M-, aged twenty-eight, gentleman’s servant, admitted

on the 29th of November, 1860. He had been sufferingunder ordinary chronic phthisis for seven months. At the

time of admission there was much cough, with purulentsputa occasionally tinged with blood, together with night-sweats and emaciation. Pulse about 90; tongue furred. The

physical signs were indicative of a considerable cavity andmuch tubercular deposit in the right lung. At the apex there

were cavernous breathing and rhonchus, and abundant sub-crepitant rales throughout the rest of the lung. No improve-ment seemed to follow any kind of treatment ; the cough be-came worse, the strength less, and the emaciation more evident.On the 23rd of March, 1861, the patient complained of head-

ache, unattended with gastric disturbance, uninfluenced bychange of posture, and of wearying and continuous character.The tongue was moist; the pulse bO, and full, and there wereno symptoms of pyrexia. Until the end of the fourth day fromthe outset of headache, he suffered continuously, and had littleor no sleep, but he was quite sensible.On the fifth day (March 29th), vomiting took place, the

headache increased, the patient became alternately restless andlethargic, and complained of cramps in the lower extremities.Both legs were numb; there was deafness of the left ear ; thepupils were large, sluggish, but equal; the pulse was 80, softand regular. These symptoms gradually increased until April2nd, when the pulse was only 64, and irregular; the pupilsrather contracted; the skin hot and dry; and slight deliriumpresented itself.The following day the patient became unconscious, the re-

spiration stertorous, and the case terminated. A few hoursbefore death the mouth was drawn to the right side, and theleft eyelid was raised with more difficulty than the right.The autopsy, which took place thirty-six hours after death,

revealed a large vomica at the summit of, and a considerableamount of tubercle in, the right lung. The membranes of thebrain were somewhat opaque and highly congested ; and uponthe pia mater at the base of the organ were a few minute and Iscattered tubercular granules. The cerebral substance itself was Isoft, and presented on section numerous red points; and a con-siderable quantity of clear serum escaped from each ventricle.In the right lobe of the cerebellum, at the junction of the whitewith the grey matter, was a tubercular mass, about the size ofa small hazel-nut, of the consistence of firm cheese, and of ayellowish-green colour; the surrounding substance of the cere.bellum seeming to be unaffected.

This case, it will be observed, presented chiefly the symp-toms of cerebritis-a termination of consumption of unfrequentoccurrence, but when it happens it is generally if not invari-ably fatal, and associated with tubercular deposit either uponor within the brain. Although Carswell, Cruveilhier, Louis,and others have described tubercle as occurring in the cere-bellum, it is, we believe, singularly rare. Dr. Cotton informsus that the present case is the only instance in which it hasfallen under his observation; and that, altogether, only threeother cases of tuberculosis of the brain or membranes have oc-curred amongst his own in-patients at the hospital, in two ofwhich the deposit was found within the brain itself, and in thethird upon the pia mater.

Medical Societies.ROYAL MEDICAL & CHIRURGICAL SOCIETY.

TUESDAY, APRIL 23RD, 1861.DR. BABINGTON, PRESIDENT, IN THE CHAIR.

ON THE TRUE NATURE AND ABSOLUTE PREVENTABILITY OFTUBERCULAR CONSUMPTION.

BY HENRY M’CORMAC, M.D.,CONSULTING PHYSICIAN TO THE BELFAST HOSPITAL.

THIS paper, which was of considerable length, set forth theforegoing thesis, and wound up with some comments on theravages of consumption and scrofula, which, the author as-serted, follow entirely from the respiration of a befouled andimpure atmosphere; for this, he said, was the causa sine quanon, without which consumption or scrofula there could notbe. An imperfect hasmatosis, deficient aeration of the blood,insufficient oxidation of the tissue-waste, were the conditionsshort of which tubercle was simply impossible. Consumptionand scrofula were as purely artificial and as entirely avoidableas poisoning by arsenic or corrosive sublimate. There neednot be either of them if men will. The air by day, if possible,and assuredly by night, should be as pure as that which tra-verses the hill-top or is washed by the sea-wave. He wouldas soon send an infant to sleep in a cellar as in an airlessnursery, and he considered that there could be no immunityfrom the twofold scourge of phthisis and scrofula until medicalpractice and popular conviction concur alike as to the indis-pensableness of fresh, untainted air.

Dr. CHAMBERS characterized the reading of the paper as a-waste of time. It simply stated that close rooms, foul air, andother injurious influences, favoured the production of’consump-tion. All knew this bhfore, and it was waste of time to en-large upon a truism.

Dr. O’CONNOR inquired whether the paper had been referredto a committee previous to its being read to the Society.

Dr. TANNER said that it would be desirable that the fellowsshould be made acquainted with the papers to be read on cer-ta.in evenings. He had expected that a paper would havebeen read from the pen of Mr. Birkett, or he certainly shouldnot have attended. Dr. M’Cormae’s views on the subject ofphthisis were well known, and were more than five hundredyears old. He had advanced no facts in support of his theory,and he (Dr. Tanner) contended that the Society had wasted itstime in listening to the statements which had been made. Itwas not to be wondered at that the Society’s meeting-roomwas empty, if such papers were submitted to the considerationof the fellows.

Dr. LITTLE said he must press the question as to whetherthe paper had been referred to a committee. The Societyought to be protected against the reading of such productions.The PRESIDENT said it was not the custom of the Society to

refer papers previous to their being read. It was not compe-tent to the members to discuss any question which did notrelate to the paper before them.

Mr. ASHTON concluded that the Society refused to pass avote of thanks to Dr. M’Cormac. (Hear.)

ON A PREVIOUSLY UNOBSERVED PREVENTABLE CAUSE OF

IDIOCY, IMBECILITY, AND THE ALLIED AFFECTIONS.BY THOMAS BALLARD, M.R.C.S. ENG., L.S.A.

The deplorable condition, idiocy, is neither limited to localitynor to any rank of society. The two most recent writers onthe subject, Dr. Howe, of Massachusetts, and Dr. Morel, of