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" regret" than the inability of the subordi-nates" to spell even their own names. Letthe comprehensive and enlightened views ofmedical education, promulgated by SirJAMES CLARK, be adopted and acted upon,and the present corporations will die of theirown absurdity, without the possibility of

anything similar to them ’ever again arising.

ROYAL MEDICAL AND CHIRUR-GICAL SOCIETY.

Tuesday, March 14th, 1843.

EDWARD STANLEY, Esq., F.R.S., President.THERE was a very full attendance of mem-

bers this evening on the occasion of the newpresident’s taking the chair.Mr. STANLEY briefly addressed the society,

returning thanks for the honour of havingbeen elected president at a period when thesociety was in a more flourishing condition Ithan ever previously. It comprised sevenhundred fellows, its library contained six-teen thousand volumes, and its discussions i

had never been surpassed in interest. Thesuccess of the society was remarkable con-sidering that a connection with it impartedneither distinction nor reward save such asresulted from the successful cultivation ofmedical science. But these were valuableadvantages, and, in addition, the societyserved to promote kind and social feelingsamong members of the medical profession.The President alluded to the twenty-fivevolumes of the " Transactions" already pub-lished, as most valuable records, and such ofwhich any society might justly be proud.After the compliments to his predecessorsusual upon such occasions, Mr. Stanley re-sumed his seat.

Some Account of an Hysterical Affection ofthe Vocal Apparatus. By OSCAR M. P-CLAYTON, Esq.

The author prefaced the detail of his paperby drawing attention to the too frequent gene-ralisation in the treatment of hystericalaffections, which he supposed to arise chieflyfrom hysterical disease being confoundedwith diseases occurring in an hysterical dia-thesis.The cases, sixteen in number, occurred in

two groups, the first beginning in February,1841, accompanied by well-marked py-rexial symptoms, the second in October last,in which the symptoms were clearly hysteri-cal and mutative from the first. They oc-curred in a charitable institution for themaintenance of female children; those at-tacked were from eleven to fourteen years of

age.In February, 1841, seven of the children

were attacked as follows :-a short, hack-ing cough, almost constant; much pain and

distress in breathing ; no expectoration ; ;pulse quick ; hot skin ; tongue white ;bowels costive. After two or three weeks,during which time these symptoms withstoodall the remedies applied, the cough changedto sounds, varying in the different patients,in some resembling the double action of alarge saw, in another a shrill, screaming ex-piration followed a quick, catching, expi-ratory effort ; in another the sound was simi.lar to that produced by blowing into a smallmetallic tube. " In fact," says the author,"it was difficult to conceive the dissonanceand constancy of these sounds."

Besides these, one girl, aged fourteen, be-came affected with symptoms exactly resem-bling those of laryngitis, and requiring theusual means for their removal ; but after aweek or two the noise above alluded to su-pervened. In the commencement, sinapisms,blisters, expectorants, and nauseants, weretried in various forms. Sedatives alone, andthen combined with antispasmodics, werealso given without effect. When the ano-malous sounds were established, a combina-tion of hemlock, sulphate of quinine, andsulphate of zinc, was resorted to, as also fulldoses of sesquioxide of iron. These reme-dies were quite ineffectual until the childrenwere separated from each other, and then,with the exception of two, who were senthome, they all recovered; but for a long timeit was found necessary to exhibit mineraltonics to remove the very considerable debi-lity that remained.

In the second group, commencing in Oc-tober last, the double sounds, i. e., the inspi-ratory and expiratory, succeeded almost im-mediately to the hacking cough, and therewere some catarrhal symptoms. On thewhole the hysterical symptoms were wellmarked. A considerable number of childrenwere on this occasion attacked, amongstwhom were many of those who had been for-merly affected. The uproar produced bythe sounds became alarming to the neigh-bourhood. A variety of medicines, includ-ing turpentine, spiritus ammoniae succina-

tus, antispasmodics, mineral and vegetabletonics, and the regular and continued use ofthe shower-bath, availed nothing. Theauthor now determined to try the effect ofmental influence upon them, and, followingthe example of Boerhaave, he assembled thechildren, and informed them that he should,with a red-hot iron, burn the throats of allthose who were not well the following morn-ing. The next day, however, they all, withthe exception of two, ran away, and onbeing collected the day after that were allwell; while in the two that had remainedat the school the symptoms persisted. Atthe end of a week the symptoms again mani-fested themselves in all the children, andnow their throats were blistered with a spa-tula, heated in boiling water, and coveredwith a silk handkerchief. This in some cases

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succeeded. In two others, who were se-cluded from the rest, the affection graduallywore itself out; and two more were curedby being separated from their noisy compa-nions.

Dr. MAYO referred to that class of reme-dies in this disease which acted through theinfluence of the imagination, exciting fearand apprehension in the patient, and re-marked that these remedies were only bene-ficial by imparting power to the patient to dothose things which he could not otherwisehave effected. Such were cold affusion, andsimilar means of treatment. He suggestedthat the word " imitation" should be super-seded by " sympathy," which more properlyexplained the similar affection of some per-sons who saw others labouring under theeffects of hysteria. He had never seen suchmarked cases of hysterical affection of thevocal apparatus as those detailed by theauthor; but he recollected a case of " malehysteria," if such a term were admissible,which in some respects was similar to

Mr. Clayton’s cases, and which occurred inthe Marylebone Infirmary. The man was ad-mitted there for what appeared to be pulmo-nary disease. He was subject to paroxysms iof severe cough, alternating with sickness.it was remarkable that when the pulmonarysymptoms were most severe, and the coughand pain worst, auscultation over any partof the thorax failed to detect any respiratorysound ; at all other times the breathing wasquite free. Percussion of the chest eliciteda clear sound. This patient was cured bytonics and antispasmodics. Was this pecu-liarity in the breathing noticed in Mr. Clay-ton’s cases?

-

’

Mr. CLAYTON replied, that during the pa-roxysms it was probable that the noise of thecoughing might have interfered with the at-tempts to listen to the sounds of the chest,but during the paroxysms the respiratorymurmur was deficient. Percussion was

clear.

Case of Erectile Tumour in the PoplitealSpace, and its Removal. By ROBERT LIS.TON, Esq., F.R.S.

The patient was a stout, healthy-looking lad,ten years of age. He had a tumour in the

right ham, of an oval shape, about three anda half inches in its long diameter, unat-tached to the skin and unattended withpain. It bad a doughy, elastic feel, givinga sensation, when the limb was extended,almost exactly resembling fluctuation pro-duced by deeply-seated matter. When thelimb was flexed this sensation was less per-ceptible, and it had more the feel of an elas-tic solid tumour, which was moveable, andcould be distinctly raised from the bone.The tumour first attracted attention whenthe patient was about two years of age. Inthe course of a year it had increased in size,

so as to be nearly as large as a turkey’s egg.Being punctured at this time with a groovedneedle no fluid escaped. It slowly increased,without occasioning pain or inconvenience,and three years ago a surgeon passeda seton through it. This was withdrawn ina few days, when a discharge had been esta-blished. No benefit was gained by this pro-ceeding, or by other means adopted to reduceits size. The operation for its removal wasperformed January 6th. An exploratorypuncture with a bistoury was first made intothe centre of the tumour. This was followedby a profuse discharge of blood, and theswelling somewhat diminished in size. Itssurface was next exposed, by dividing theskin and fascia; and it was now observedthat it had the aspect of a fatty tumour, andwas evidently much less in its dimensionsthan before the operation. As the operationwas proceeded with the tumour continuedto decrease in size. It was found that thesubstance of which it was composed wascovered by the fibres of the semi-membrano-sus muscle, and to extirpate it it was neces-sary to cut into that muscle. In the courseof the operation the tumour had to be fol.lowed deeply into the popliteal space, and agood deal of blood was lost. Only onevessel required ligature. The wound healedfavourably, and the boy was able to walkabout the ward on the sixteenth day from theoperation. On making a section of the tu-mour it was found to consist of a mass,about the size of a hen’s egg, of most perfecterectile tissue. On microscopic examinationan appearance was visible like that of themusculi pectinati of the heart ; the columnsof the reticulated structure being coveredwith a smooth membrane, resembling thatlining the inner surface of the veins. Theauthor adds some observations on the cir-cumstances which were peculiar in the case,directing attention especially to the difficul-ties occasioned in the operation, by the tu-mour being covered on all sides by muscularfibres, and by the diminution which occurredin its size as he proceeded. He closes hisremarks by offering his opinion, that thetumour was developed in the substance ofthe muscles with which it was connected.

Another case is appended, in which the authorremoved a tumour of a different structurefrom the side of the neck, and where he wasof opinion that the morbid substance origi-nated in the interior of the sterno-cleido-mas-toid muscle. In this case there was greathasmorrhage.Mr. LAwRENCE remarked that the first

case mentioned by Mr. Liston, of erectiletissue occurring in the substance of a muscle,was a form of disease very rarely met with.He had seen one instance, however, of asimilar kind, in the operation forthe removalof which he had been assisted by the Presi-dent. The patient was a child about threeyears old, the daughter of a physician, and

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was affected with a tumour apparently over tended up the thigh and down the leg. Thethe centre of the deltoid muscle. Various constitutional symptoms, loss of rest, &c.,applications had been tried for the purpose of again made head, and the patient was

getting rid of it, but without any good anxious that something further should beresult. When the patient was brought attempted to relieve him. Mr. L. advisedunder his notice he found the tumour of an that no operation should be performed, theindolent character, not well defined, and result of the first having been so discouraging,apparently quite loose under the integu- nor had he any other remedy to propose.ments. As it was increasing somewhat in The patient, however, urgently requestedsize, he resolved to extirpate it by the knife. that the operation might be performed, andOn dividing the integuments, he expected it was accordingly. An incision was madeto find a loose tumour, but his surprise was extending from the middle of the thigh togreat to observe that the swelling appeared the middle of the calf of the leg. Portionsto be part of the deltoid muscle, and had no of the biceps were taken away with diffi.defined boundaries. He was at a loss in culty, during the operation, together withwhat manner to proceed, and obtained the portions of medullary-looking, yet not soft,co-operation of Mr. Stanley. On proceed- deposit, and which contained muscular

ing with the operation it was found that the fibres, as if the matter had been adherent totumour, which consisted of a congeries of muscle, and large vessels ramified all aroundvascular ramifications, could not be entirely the tumour. The patient recovered, andtaken out without removing a portion of the lived three years after the operation, but mmuscle with it. This was accomplished bad health, and died at the expiration of thatwith the loss of a considerable quantity of time of disease of one of the internal organs.blood, and when removed, the distinct firm The first of these tumours was formed ofswelling was reduced to a very small bulk, erectile tissue, the second was not so.and only the enlarged vessels were visible. Mr. LISTON could enumerate various casesThe edges of the incision united, the cica- of tumours in the popliteal space, similar totrix remained sound, and the child, at a that detailed by Mr. Lawrence, but theseperiod of several years since the operation, bore no similarity to the one he had broughtnow remained quite well. He had, also, before the society. In one instance thesome time since, met with a somewhat simi- tumour involved the posterior tibial nerve,lar tumour in the ham in a gentleman forty three inches of which were removed withoutor fifty years of age. About eight months producing paralysis either of sensation orbefore applying to him he had tlavelled a motion! The wound healed, but the diseaselong distance outside of a stage coach, in returned at the expiration of six months inthe front of which he sat. The iron edge of the form of a tumour in the thigh, and alsothe seat pressed on the ham, causing pain of the crural nerve. He did not interfere onat the time, and both pain and- swelling this occasion. The patient afterwards diedafterwards. Leeches, cold lotions, and of malignant disease.other applications, were used, but the swel- Mr. CHARLES HAWKINS said he would

ling continued to increase, and remained take the liberty of relating a case to thevery painful. The tumour when he (Mr. L.) society very similar to the second describedfirst saw it, was as large as the fist, seemed in the paper just read. The acquaintanceto be deeply seated, and was tolerably move- with such another, Mr. Liston said he wasable. The general health of the patient far from courting; he could quite under-was deteriorated by the suffering which he stand what was meant by that observation,had undergone; and on hearing the history from what he had witnessed in the followingof the case, and the means which had been case. In the commencement of the presentineffectually used for the removal of the winter he had had the opportunity of seeingtumour, he (Mr. L.) suggested that it should Sir Benjamin Brodie remove a tumour frombe cut out. The operation could be performed the neck of a lady, towards the same situa-with perfect safety. On dissecting down to tion with that described by Mr. Liston. Itthe tumour he could not clearly detect its was of a considerable size, and had beenboundaries ; it appeared to consist of a con- latterly increasing. In the commencement

geries of large veins, and it became neces- of the operation the external jugular wassary, in order entirely to remove the tumour, tied and divided. It was then intended to

to take away portions of the muscles with it. cut across the sterno-cleido-mastoideus, andThis was done, and the hæmorrhage was turn aside the two portions, but that musclevery great. The sides of the wound were was found to be so intimately connectedbrought together, covered with plaster, and with the tumour that it could not be detachedcompressed by a bandage. The patient went from it. After some dissection the tumour ,:on favourably, got relief and sleep from the was found to occupy a much larger space

‘

removal of the tumour, and the wound than was at first imagined : it extended from

healed, with the exception of a small open- under the angle of the lower jaw to theing, from which there was a considerable clavicle, and from the thyroid cartilagedischarge. The tumour again formed, but backwards towards the spine. When it hadwas not now confined to the ham; it ex- been in a great part removed from the sur-

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rounding parts, it was found to lay for aboutthree inches on the internal jugular vein andcarotid artery, and to be in such close con-nection with the vein as to render it neces-

sary to tie that vessel, both above and belowthe tumour, and to divide it, leaving the in-termediate portion of vein on the tumour.After much careful and tedious dissection itwas removed from its relation with theartery; but before it was quite severed fromail the surrounding parts, a most profusevenous heamorrhage took place, upon whichalarming syncope occurred, the surface of thebody becoming cold, and the respiration andcirculation scarcely perceptible. From thisstate, in about half an hour, the patient re-covered sufficiently to allow of a ligaturebeing applied to the bleeding vessels, whichuntil then had been secured by the hand.The wound was dressed and the patient putto bed. Except a difficulty of swallowingfor some time afterwards, and some irrita-bility of the pulse consequent on the loss ofblood, Mr. H. believed the patient recoveredwithout any bad symptoms. The tumourremoved is in St. George’s Hospital museum.Mr. H. thought the case worth relating tothe society in connection with Mr. Liston’ssecond case, as an example of what severeoperations and great loss of blood may berecovered from : in this case the tying bothjugular veins, and the unavoidable inter-ference with the carotid artery, added to anoperation which necessarily occupied a greatlength of time. He was not satisfied thatthe tumour was of a malignant kind ; atleast, he had seen Sir Benjamin Brodie re-move such another from very nearly the samesituation in a lady’s neck, and very analogousto it in structure, fIve years ago, and in thatcase there had been as yet no symptom of areturn of the disease.

Mr. STANLEY recollected the first case

mentioned by Mr. Lawrence. The tumour,when removed, was quite flaccid, and, in

fact, nearly collapsed altogether. Whencut into it very much resembled a piece ofspleen from which the blood had beensqueezed out. The presence of nævus inmuscular structure was a very rare patho-logical change. A surgeon might veryreasonably expect in these cases to find, oncutting down to the tumour, a fatty or cellu-lar growth, and not be prepared for the re-markable condition of parts which were pre-sented to him.Mr. BRAN&BY COOPER, on one occasion,

had seen Mr. Green cut down upon a

tumour in the thigh about as large as apullet’s egg. It was deeply seated, and in-fluenced by the motion of the muscle; buton making an incision through the skin andfascia, hardly any tumour was discoverable.It became a question in this case whether itwould be better to allow the tumour to re-main or to remove a large portion of therectus with it. The former plan was judged

to be the better. The edges of the woundwere brought together; the patient did well ;and the tumour, during the next six or sevenyears, did not increase in size. He (Mr. B.Cooper) suggested that a like proceedingmight be resorted to in similar cases inwhich the removal of similar tumours wouldrequire the extirpation of important parts.Mr. MACILWAIN called attention to some

other cases of erectile tumour, treated byseton, which he had published in theSociety’s 11 Transactions."

MEDICO-BOTANICAL SOCIETY.

THE INDIAN HEMP.

MARCH 22ND.-A communication fromMr. Ley was read this evening (Mr. H.GIBBS in the chair) detailing the results ofhis experience with the cannabis Indica, orIndian hemp, in the treatment of certain con-vulsive and inflammatory diseases. One ofthe most important and interesting of thecases detailed by him was that of a ladywho had been confined to the hydrostaticbed for five years from disease of the spineand hip, and in whom, whenever she wasremoved from the bed for the renewal of theIndia-rubber sheet covering it, there was

produced a disturbance, little felt at thetime, but inducing at night a succession ofviolent spasms of the muscles of the spine,drawing the body back into the form of anarch, and as suddenly relaxing. Thesespasms would follow each other rapidlythrough the night, producing faintness,sickness, and insensibility, all through thenext day. This alternate state of nocturnaltetanus and daily fainting continued, gene-rally, after each moving, for a fortnight orthree weeks, obstinately resisting every me-dicine that could be applied for its relief.When Mr. Ley obtained possession of someof the resinous extract of hemp, he had pillsof one grain weight made, of which he gavehis patient six, directing her to take one on

the occurrence of the first symptom of thespasm, and to repeat the dose every half-hour until the spasm was relieved, or someother reason offered for their discontinuance.Five pills were taken, when she felt over-

powered, the muscles relaxed, and she fellinto a profoundly tranquil sleep, likened byher afterwards to a trance, because she wasfor a long time after she had apparentlyfallen asleep conscious of passing events,but unable to make known her perceptions.The spasmodic attacks returned for severalsuccessive nights, but were not so violent norof such duration as previously. The opi-nion of this lady, who, from long illness, isfamiliarised with medicines, is, that the ex-tract of hemp affects the muscles principally,relieves ordinary pains less surely thanopium, disturbs the stomach little, if at all,but produces an unpleasant sensation in thehead, not excitement, but objects appear