734

flect on the great number of circumstanceswhich may modify the concentration ofmilk ; it is, on the contrary, interesting tohave found in two different cows the samesalts in perfectly similar relative quantities.One hundred parts of cow’s milk were

found to contain-Butter ........................ 3.0Sugar of milk and soluble salts ... 4.6Casein and insoluble salts ....... 5.1

12.7

Human milk, which Haidlen examinedwith relation to its proportion of butter,sugar of milk, and casein, had a very stronglyalkaline reaction, and it was coagulated withdifficulty by sulphate of lime. ,’No. I., of very good appearance, gave in

100 parts 10.8 of residue, which was formedof-

Butter .................... 3.4

Sugar of milk .............. 4.3Casein .................... 3.1

10.8

No. II. at once announced, by its aqueousappearance, its poverty in fixed principles.100 parts gave 7.2 of residue, which con-tained-

Butter .................... 1.3

Sugar of milk .............. 3.2Casein .................... 2.7

7.2 .

Annalen des Chem. and Pharm., quotedin The Chemist,

ANTAGONISM OF GOITRE AND TUBERCLE.

ACCORDING to Escherich, a Bavarian phy-sician, goitre is incompatible with tubercu-lar phthisis ; and he regards as a wickedattempt (sic) the endeavour to remove goitrein subjects who otherwise would be (?) con-stitutioually predisposed to consumption.For four years he has had under his care a

woman, with a cavern in the upper lobe ofthe right lung, and pectoriloquy with habi-tual cough and expectoration ; yet this pa-tient has remained in a stationary conditionduring the period stated, which the doctorconsiders to be due to the conjoint presenceof a large goitre, adding that he had neverknown a patient affected with the latter dis-ease to die of phthisis. Other physicians inthe mountainous regions of Styria and theTyrol have made similar state ments.-Med.Corresp. Blatt. bayerische, &c.

WE see clearly that glanders is essentiallya disease of the respiratory organs, thoughother parts may become implicated duringits progress. We see, also, that Jm’cy is anaffection of the glands and absorbents.-Veterinarian.

REMARKABLE CASE OF

PUS-CONCRETIONS,WITH AN EXPLANATION OF THEIR

MODE OF FORMATION.

By ERASMUS WILSON, Esq., Surgeon,London.

My attention was lately attracted by theperusal, in the last number of the " Veteri-nary Transactions," of a case which had oc.curred in the practice of Mr. Daws, of 255,Oxford-street, and Rathbone-place, and waslaid before the Veterinary Association byMr. Hunt. The pathological phenomenaattending this case are peculiar; and no

parallel case, as far as I am aware, has yetoccurred in the human subject or the horse,although there can be no reason why suchshould not be. In anticipation of an eventof this kind, I will briefly detail the historyof the patient and the observations which Ihave since made through the kindness ofMr. Daws, on the products of the disease.It may be further necessary to remark, on theauthority of Mr. Daws, that the case is

unique in the horse.In January, 1842, a gentleman purchased

a horse, which was shortly afterwards at-tacked with strangles, and placed under thecare of Mr. Daws. A slight enlargementwas apparent near the angle of thelowerjaw,which disappeared under stimulating treat-ment. The horse continued at work for sixmonths, when a soft fluctuating tumour wasperceived between the angle of the jaw andthe larynx on the left side, and when thetumour was pressed some healthy pusescaped through the left nostril. It wasnow evident that there was a large abscessin the situation referred to, and that as fre-quently as it become distended, relief wasobtained by the spontaneous escape of partof its contents through the nose. A blisterwas applied four or five times over the

tumour, but with no result, and Mr. Dawscame to the resolution of opening the abscessin a depending situation, an operation thatwas performed in February last by Mr.Hunt.When the abscess was cut into, about three

pints of pus escaped, and with it betweenthree and four hundred irregularly shaped,flattened bodies, of a yellowish colour andvarious size. In general aspect these bodiesbore a close resemblance to broad beans, andmany were equal in diameter to a broad beanof the largest size, none being smaller than acommon horse-bean. They were behevedto be masses of concreted pus ; the bordersand angles were rounded and polished, aswere any prominences on their surface,whilst their flat sides presented a very slightconcavity, which was roughened by a whitishdeposit of granular albumen. Their weightwas twenty ounces.

735

When divided with a knife, the pus-con-cretions were found to possess the density ofmoderately tough cheese. The centre of thesection was cream-coloured, homogeneous,tough, and somewhat loose in texture, butthe exterior was yellow, dense, firm, semi-transparent, and even horny; indeed, therewas a distinct, semi-transparent, horny pelli-cle surrounding each concretion.Upon examination with the microscope I

find the central part of these concretions tobe composed of pus-corpuscles, very closelyaggregated. From having been kept in

spIrit of turpentine and compressed the cor-puscles are irregular in their outline, andmeasure somewhat less than the ordinarydiameter of the pus-corpuscle, viz., 1-3300thof an inch, while the measurement of the

corpuscle of fresh pus, according to my ob-

servations, varies from 1-3000th to 1-2500thof an inch.

A. Section of one of the larger concre-tions drawn to the natural size. The granu-lar deposit of albumen is seen at a, a, a, andthe laminated texture of the pellicle of theconcretion is also best seen in this situation,b, b, b. The borders and projecting emi-nences of the concretion rounded and polished.

B. A group of pus-corpuscles as they ap-peared with the microscope.The cortical part of the concretions is too

closely condensed to give any satisfactoryresults when examined with the microscope.But the white albuminous deposit on thesurface is distinctly granular.We have next to inquire, How these con-

cretions have been formed? The explana-tion which I should give, in answer to thisquestion, is as follows :-The case was ori-ginally one of ordinary abscess, which dis-appeared under treatment. Now, this I

regard as the period whe,l the pus, from

himng been fluid, became inspissated andlaminated by the absorption of its fluid por-tion, the liquor puris.Subsequently, a purulent secretion is

reproduced, the new secretion containing anexcess of albumen dissolved in its liquorpuris, The effect of the new secretion I

imagine to have been the breaking up of theinspissated and laminated pus and its im-pregnation with albumen.In a third period, the broken fragments

floating in the purulent fluid and constantlyrubbing against each other, obtained therounded form which their angles presented,and the general smooth polish of their exte*rior. The latter effect must have been a

consequence of the cohesion of the purulentmatter produced by the albumen with whichit was saturated, otherwise we cannot sup-pose the purulent concretions to have ob-tained the solidity which they really pos-sess.

The granular albumen deposited on theprotected surfaces of the concretions is a

subsequent formation.I need scarcely refer to the physical agen-

cies that must have assisted in the above

processes,-for example, the use of counter-irritants, the disturbance of the contents ofthe sac caused by currying the animal andhandling the tumour, the pressure of the

harness, and the active exertions made bythe creature during the six months workthat intervened between the disappearanceof the first tumour and the opening of thesecond.

PHLEGMASIA DOLENS, ORBUCNEMIA.

I To the Editoi- of THE LANCET.

SIR,-I have read with pleasure your ex-tract from the Paris journals upon the abovevery interesting malady; and, perhaps, youwill allow me a corner in your widely-circu-lated hebdomadal publication to observe thatI agree with the French, and may add, also,with some American and British practitioners,in opinion that it is not confined to parturientfemales alone, having myself seen two un-questionable cases in the male subject, eachof which was successfully treated by calomelpurges, saline antimonial mixtures, leechesto the groin, and evaporating lotions, carefullyand repeatedly applied, through the mediumof an interrupted bandage to the entire sur-face of the greatly enlarged limb. When Ibegan practice in 1816, I regarded andtreated phlegmasia dolens as an inflammatorydisease, and considered it one always affect-ing the local lymphatics, but subsequentexperience and careful observation have con-vinced me that the more modern pathologyof Drs. Davis, Lee, and others, as to itsseat, is generally correct, and that inflamma-tion of the pelvic or femoral veins is mostfrequently the cause of the complaint; as,however, I have not been unfortunate

enough to see a case terminate fatally, it hasnot been in my power to confirm this view ofits cause by post-mortem investigation. I

am, Sir, your obedient servant,G. YEATES HUNTER, Surgeon.

Margate, August 12,1843.

SuGAx is certainly formed in the stomachin diabetes.ŇDr. Percy.

G. YEATES HUNTER, Surgeon.