did-and gave him half an ounce in a small phial. From what afterwards came to his ears, however, Mr. Graham began to suspect that the poison was intended for a wrong use, and he therefore proceeded to tell Sarginson's friends and to apprise the police. Soon afterwards he was informed that Sarginson was lying poisoned at the police station. He had taken a fatal dose of the prussic acid.

HYPODERMIC INJECTION OF MORPHIA IN THE VOMITING OF PREGNANCY.-Of all means that I have tried this has proved the most successful. A grain of the acetate is dissolved in half a drachm of water, of which ten minims are injected at the epigastric region, and repeated after one, two, or three hours' interval until relief occurs. Sometimes one injection suffices, but generally two or three, or it may be even double doses (ie., grain) are required.-Dr. Baillie, Indian Medical Gazette, September 1.

"SECUNDUM ARTEM."-The old direction formerly contained in prescriptions that they should be compounded secundum artem is still sometimes necessary, notwithstanding the advanced knowledge of our times. A pharmacien having received the following formula to dispense-chlorate of potash 8 grammes, hyposulphite of soda 4, syrup 62, water 125-to expedite matters, put both the salts in the mortar and commenced a vigorous trituration. An explosion immediately took place, the pestle being propelled to a distance, and the operator getting some bad bruises. To prepare such a formula without danger, the salts should have been separately dissolved.— Union Pharmaceutique.

BUTCHER'S MEAT IN PARIS.-The consumption of this rose from 127,837,009 kilogrammes in 1867, the year of the Exhibition, to 131,438,225 kilogrammes in 1868. The retail price of beef of the first and second categories was in 1867 1 fr. 63c. and 1 fr. 40c. per kilogramme (2 lb. 3 oz.); of veal, 1 fr. 83c. and 1 fr. 57c.; and of mutton, 1 fr. 75c. and 1 fr. 47c. In 1868 the prices rose three or four centimes for each kind of meat, and those of the last month for which returns are published (Feb., 1869) exhibit a similar rise; viz., beef selling at 1 fr. 69c. and 1 fr. 44c., veal at 1 fr. 89c. and 1 fr. 62c., and mutton at 1 fr. 80c. and 1 fr. 51c.-Jour. de la Soc. de Stat., Aug.

ANOTHER year's experience confirms what we have already written on the opium question. Every year the conviction is strengthened regarding the difficulty of giving up this habit. Men of means will continue to smoke, and those without means may be occasionally driven to the expedient of attempting to throw it off, but relapses are frequent and at no distant intervals. The imperial monthly pittance of money and rice to the bannermen rescues them from absolute misery, and they at least are thus carried on from month to month. All human expedients seem vain--the grace of God alone can restrain men from following in this vice. We have made it a rule that pipes must be lodged as a guarantee of good faith. I possess a few, but the greater number who apply for relief are either so poor or so situated that they are driven to the shop and cannot boast of a pipe of their own. To possess the necessary articles, pipe, lamp, iron rod upon which the opium is prepared over the flame, small box to contain the raw material, generally with the character happiness upon it, must cost about a dollar. If deprived of their pipe, or if they find it impossible to smoke at home or at their workshop, they have recourse to the opium office. A price is charged for the medicine by some philanthropists in order that a way of escape may be made, but this and other expedients only tend in too many cases to tide them over present difficulties. During the last three years 510 opium smokers have applied for relief, but comparatively few in my opinion have been reclaimed. It is a powerful habit, a second nature, stronger and more insinuating than strong drink. I have had numerous professions of cure, but I have learned to receive such with great caution, and the more so the longer the period in which the drug has been used. To give up the fascinations and associations of the pipe, and to overcome and hold out against the agonies, pains, discomforts, even with the aid of foreign medicine, which are induced by attempts at reformation, requires great strength of will. After abstinence for months perhaps, the victims relapse into their old habits. During the last three years I have had four different applications from the same person for medicine to effect a cure. It is oftentimes very difficult to bring home the charge of opium smoking; all are more or less directly or indirectly connected with it or with other faults or sins which they dread having exposed. Informants themselves dread exposure and conviction of this or other faults, and a Chinaman's golden rule seems to be to know nothing of anything, to mind his own business and let other people's alone. The almost total want of justice in

their yamens for the control of native affairs and the amount of bribery practised and severity of the punishments inflicted have taught this people a salutary dislike of law.-The Fifth Annual Report of the Peking Hospital, by Dr. John Dudgeon.

AMENDMENT OF THE MEDICAL ACTS.

TO THE EDITOR OF THE MEDICAL TIMES AND GAZETTE.

SIR,-I enclose a copy of a letter which I addressed to her Majesty's Secretary of State for the Home Department, and his reply.

My object in asking for an interview at my date was to enable me to communicate with a number of those who signed the memorial, and by whom I hope to be accompanied when I present it. I now beg that any one desirous of forming part of the deputation will be good enough to communicate with me. On receipt of the Secretary's appointment, I shall forward invitations for a meeting of the Medical Club an hour before the time which may be fixed for attendance at the Home Office.

Bearing, as the memorial does, the signatures of 9471 members of the Medical Profession from all parts of the United Kingdom, it is a document without parallel in our Professional history, and one which cannot fail to have great weight in promoting the desired amendment of the Medical Acts. Personally, I attach the utmost importance to the following clauses of the memorial:

"The undersigned are of opinion that the system of Medical education should be revised, so as to insure the possession of a thoroughly scientific and practical acquaintance with Medicine and Surgery on the part of persons applying for the legal qualification.

"To this end it is held to be necessary to substitute for the present system of examination, and for the many forms of licence to practise now granted, one high and uniform standard of examination, and one legal qualification."

The one-faculty system granted, all other desirable reforms must follow. The reconstitution of the Medical Council is essential; but I trust there will be no split on the method of representation of the Profession, by the direct or the indirect plan, as the rival schemes have been respectively designated. It is pretty evident that the Government intend introducing a Bill to amend the Medical Acts next session; and now that so large a majority are agreed on the general principles of the desired reform, I think the safest course is to wait the appearance of the Government measure and dispassionately consider its provisions.

The task of eliciting the opinion of the whole Profession has entailed an outlay in printing and postage of about £400; towards this sum we have received £161 0s. 7d., from 1782 contributors. I beg that further donations by cheque, post-office order, or stamps, be forwarded to the Treasurer, Mr. Arthur Oates, 9, Old-square, Birmingham.

I shall, in any case, deem it a very honourable duty to appear at the Home Office with a deputation to present the memorial intrusted to me; but I confess I should feel stronger in the responsible position if I had better evidence than I now possess on which to assure the Secretary of State that the majority of the Profession are prepared to do something more than merely sign a memorial for the amendment of the Medical Acts. Confident that those who have co-operated with me in this matter will not be allowed to be pecuniary losers by their labours in the general interest, I am, &c. BELL FLETCHER, Chairman, Senior Physician to the General Hospital. 7, Waterloo-street, Birmingham, October 25.

7, Waterloo-street, Birmingham, October 14, 1869. To the Right Honourable H. A. Bruce, her Majesty's Secretary of State for the Home Department.

Sir, I have the honour to inform you that I have been intrusted with a petition for presentation to you, signed by nine thousand four hundred and seventy-one (9471) registered Medical Practitioners, throughout the United Kingdom, praying that her Majesty's Government may introduce a Bill into Parliament for the amendment of the Medical Acts.

I shall feel greatly obliged by your naming a day in the ensuing month of November when I may have the honour of waiting upon you with a deputation to present the memorial.

I am, Sir, your most obedient servant,

BELL FLETCHER, Chairman,
Senior Physician to the Birmingham General Hospital.

Whitehall, October 19, 1869. Sir, I am directed by Mr. Secretary Bruce to acknowledge the receipt of your letter of the 14th inst. requesting an interview for a deputation to present a memorial from certain registered Medical Practitioners, praying for the introduction into Parliament of a Bill to amend the Medical Acts; and I am to inform you that Mr. Bruce is unable, at present, to fix a day to receive he deputation, but will do so in November, when due notice will be given to you. I am, Sir, your obedient servant, KNATCHBULL HUGESSEN. Bell Fletcher, Esq., M.D., 7, Waterloo-street, Birmingham.

NOTES, QUERIES, AND REPLIES.

He that questioneth much shall learn much.—Bacon.

T. F. C. should apply to the secretary of the association. Dr. Palfrey is not pleased that we did not insert in full his answer to the charge made against him of violation of Medical etiquette. But we did not insert the accusation in full, but only the points thereof to which, in our opinion, Dr. Palfrey gave no satisfactory answer. B.A., Manchester.-You will find the information in our advertising columns. The next arts examination at the College of Surgeons will take place on Wednesday, Thursday, and Friday, December 15, 16, and 17. You must send in your name on or before the 24th proximo.

A Victim (Leeds) should avoid advertisers and consult some respectable Surgeon in his own town. Cases of the kind are by no means uncommon, and are amenable to treatment.

Lector. The barber-surgeons practise their calling under ordinances confirmed by the Mayor and Aldermen of the City of London. In one of the ordinances their privileges are made secure. Thus they were to practise "without the scrutiny of any persons or person of any other craft or trade, under any name whatsoever, other than the craft of the said barbers, either as to shaving, making incisions, blood-letting, or any other matters pertaining to the art of barbery or of Surgery in the craft of the said barbers, now practised or to be practised hereafter."

A CASE OF INTUSSUSCEPTION OF THE CECUM (CONGENITAL?) WITHIN THE COLON.

By HENRY HORSLEY.

L. L., a fine healthy infant, aged four months, was brought to me one evening in a state of collapse. The child had the appearance of having suffered from severe diarrhoea, which, I was informed, was not the case, but the following history was given to me. The baby, usually a very contented child, whilst being undressed, suddenly commenced crying, and evidenced great pain in its abdomen by drawing its legs up. Very soon after this, blood, pure and bright, commenced to come away from the rectum, not mixed with faeal matter, nor having any of those appearances so common in children suffering from dysenteric diarrhoea. I may here mention that there never had been any disorder of the bowels; on the contrary, the child had regular and normal evacuations daily. From the appearance of the little patient I did not think that it would survive the night. I was wrong, for it lived for two and a half days. I visited the child on the next day, and found it still looking very ill. Vomiting had now set in; it could not retain any of the breast milk. A little blood still oozed from the bowels. There appeared to be no abdominal tenderness, nor were the bowels distended. The symptoms continued much the same until it died.

A post-mortem examination was readily allowed, as the mother thought that the child must have met with some injury. The inspection revealed the following extraordinary abnormalities:-Half the transverse colon with the descending portion, as also the rectum, looked as if filled with hard fæcal matter, and, when handled, felt like it also. At the transverse colon there was an intussusception. The portions of bowel were carefully cut out of the body and examined, when it was found that what appeared to be hardened fæces was really the caecum inverted and very much compressed, the ileo-colic valve end, with the appendix vermiformis, reaching actually to within an inch of the anus. The cæcum was opened, and a piece of ileum found running down its whole length, so that, if the bowel had been cut through at the sigmoid flexure of the colon, three different portions of intestine would have been divided. The rectum, colon, and ileum were healthy, but not so the cæcum, that being intensely congested and becoming gangrenous. I may mention that all other parts of the bowels were healthy, and not at all distended as if there had been any previous obstruction. The cæcum was wanting in its proper site.

I believe that this was not a case of ordinary intussusception coming on suddenly, but that the child was born with its crecum contained in the colon and rectum, for the latter was so much larger than usual, and the former (the cacum) had such an extraordinary compressed appearance, that it could not have possibly been put on in a day or two. I do not pretend to explain the reason why the symptoms came on so suddenly, unless they were due to some strangulation of the gut at that part where I first noticed the intussusception-namely, at the arch of the colon. On the other hand, the case might possibly have been one of acute crecitis, but that the attack of inflammation was greatly influenced by the abnormal situation of the cecum.

Croydon, Surrey.

Inquirer is not quite correct. Dr. Lettsom was the second President of the
Medical Society of London. The first holder of the office was Dr. John
Millar, who occupied the chair from 1773 to 1775.
M.D.-The late Professor Forbes published an excellent account of the
Acalephæ or sea-nettles. The function is possessed probably by only a
few species. The Cyanea capillata, which is a terror to bathers, possesses
it in a remarkable degree. You will no doubt find specimens in the
College Museum recently mounted by Mr. W. S. Kent.

A Country Surgeon.-The subscription to the Poor-law Medical Officers' Association is seven shillings and sixpence yearly. This includes payment for the bi-monthly journal of the Association. Without the journal the yearly subscription is five shillings.

Candidate. The following is the regulation referring to the subject:"The fee for the degree of Master in Surgery shall be five pounds. No candidate shall be admitted to the examination unless he shall previously have paid this fee to the Registrar. If a candidate withdraw or fail to pass the examination, the fee shall not be returned to him, but he shall be admissible to any one subsequent M.S. examination without the payment of any additional fee, provided that he gives notice to the Registrar at least fourteen days before the commencement of the examination." A Metropolitan Teacher.-The returns of the number of dissecting pupils was published in the Medical Times and Gazette last week, and is quite correct, notwithstanding the statement to the contrary published in the Standard.

R. P.-It is published annually. Spero must pass the preliminary. Vaccination in the Ipswich District.-Dr. Elliston's appointment as public vaccinator for the Ipswich district dates from June 24, 1868. From that date to the corresponding day in the present year, he vaccinated, in his public capacity, 1534 persons. In the four preceding years the yearly average was 750 only. It was feared on the introduction of the new regulations that the abolition of the old practice of domiciliary vaccination, and the reduction of the number of public vaccinators from six to one, would have a prejudicial effect. The great improvements, however, in the machinery for enforcing vaccination, and the active steps which have been taken in this union to make such machinery effective, have tended very largely to the promotion of vaccination both public and private.-Suffolk Chronicle.

THE PRESENT EPIDEMIC OF SCARLATINA.

TO THE EDITOR OF THE MEDICAL TIMES AND GAZETTE.

SIR,-It appears to me that a peculiar feature in the present epidemic of scarlet fever is the great susceptibility of adults to its influence, a prior attack in chilhood not giving the usual immunity. I should be glad to know if this has been noticed generally, or if it be but a coincidence in my practice. ROBERT DEBENHAM.

Stepney, October 26.

I am, &c.

We believe our correspondent's experience agrees with that of other Medical Practitioners. We have five children in one house, all of whom have had scarlet fever before.

L.S.A.-There will be a midwifery examination in December. The licence is registerable.

Pharmaceutist.-It is said that Parr's life pills were made and introduced to the public by the late Mr. Ingram, and the profits were so large that he was soon enabled thereby to start the Illustrated London News. Poets' Corner.-The letter of Mr. Trimmer, the Secretary to the College, was sent to the dean or secretary of all the Medical schools so long ago as December 20, 1867, and we believe that for some time past the schedules have been signed by only one recognised person.

CORRIGENDUM.

TO THE EDITOR OF THE MEDICAL TIMES AND GAZETTE.

SIR, The Medical Times and Gazette of October 2 records the death, at Will you allow me Ilfracombe, of Mr. Barber, from taking prussic acid.

to correct this error? He died from the effects of a mixture of chloroforma and laudanum. I send the evidence at the inquest, and also the verdict, for your perusal. It was well known to his friends that he always carried with him a mixture of chloroform and laudanum for some pains in the stomach to which he was subject. He stated what he had taken before be became insensible, and it is a source of great regret to his relatives that, though he lived for more than two hours, no emetic was administered, the stomach-pump used. The fear of choking him was assigned as a reason. With a supply of chloroform and laudanum in his stomach, little benent could result from the artificial respiration which was resorted to. A friend ship of twenty-five years with the deceased, interrupted occasionally through foreign service, must be my apology for troubling you with this I am, &c. THOMAS GREENISH. communication. [The verdict was as follows:-"That the deceased had died through taking a mixture of chloroform and laudanum, but whether by accident or design there was no evidence to prove."-ED. M. T. and G.]

Dr. McM.-The preliminary examination in arts, etc., will take place at the College in December, and, it is stated, will be the last at that institution.

P. Malthus, M.D.-In Lenham Church, north of the chancel, on the tomb of Robert Thomson, Esq., it is stated that he was grandchild to Mary Honeywood, of Charing, who had at her decease 367 children lawfully descended from her-viz., 16 of her own body, 114 grandchildren, 225 in the third generation, and 9 in the fourth.

An Old Practitioner.-We believe that the Royal College of Physicians has still the power, in virtue of the charter, to pay periodical visits to chemists' shops for the purpose of ascertaining the quality of their drugs; it is, however, confined to the City, and not the metropolis generally. The College was formerly in Warwick-lane, Newgate-street. Associate King's College.-You will find the subject mentioned in Dr. Budd's lectures on "Organic Diseases and Functional Disorders of the Stomach" published in the Medical Times and Gazette, vol. xxvii. p. 363, et seq.

PENSIONS FOR POOR-LAW MEDICAL OFFICERS.

TO THE EDITOR OF THE MEDICAL TIMES AND GAZETTE. SIR,-As you have always supported the Poor-law Medical Officers, par haps you will rouse them up to look after their own interests, as they have hitherto been so supine. I know what it is, from formerly having bee Poor-law Medical Officer myself, to have to put up with many things that are very unpleasant to our feelings as gentlemen, and to be stigmatistas the "parish Doctor"-a sort of inferior Professional person-when I had received an education to fit me for consulting practice in London, bad I been inclined to settle there. I would therefore recommend every young man to think twice before he accepts a Poor-law Medical appointme under the present régime. I think, if an alteration takes place, that then it should be offered to the very best men, as our London Hospital appoint ments are, and then I think it would be appreciated.

One thing is especially necessary, which is, that gentlemen holding Post law appointments should be entitled to a pension after twenty years' service, quite irrespective of age, to be increased every three, four, or five years, till they had completed the period of thirty years' service. This sum should be paid out of the Consolidated Fund. It would amount to very

little, and I am quite sure that no Englishman would begrudge it. The Irish Bill is a perfect failure, for it fixes sixty years as the time to be entitled to a pension, which is much too old, and the raoney is to be paid out of the parish rates, so that it would be always, thrown up in the face of the parish Doctor that he was receiving a pension from the poor ratepayers. It behoves every Poor-law Medical Officer to bestir himself, and to write individually a letter to the Poor-law Board, complaining of the wrongs to his class, and the Poor-law Medical Reform Association should at once send a deputation to the President of the Poor-law Board, asking him to bring in a Bill early next session to provide this pension for a most deserving class of men; and they must be determined that the next session shall not pass over without the Bill becoming law. They might form one themselves, with a graduated scale of pension, according to the number of years each Medical officer has served. I am quite sure that you have the interest of the Profession at heart, and will assist them. London, October 27. I am, &c.

COMMUNICATIONS have been received from—

MEDICUS.

Mr. T. BRYANT: Dr. LEWINS; Mr. H. K. HITCHCOCK; Mr. F. HENSMAN; Mr. G. B. PARTRIDGE, of Calcutta; Mr. J. F. COLLINGWOOD; Dr. GERVIS; Mr. T. WOOLLCOMBE; Mr. H. K. COTTEN; Dr. FAIRBANK; Mr. H. M. SIMMONDS; Mr. T. STOKES; Dr. QUINLAN: Mr. SAMPSON GAMGEE; MEDICUS; Mr. R. DEBENHAM; Dr. FOTHERBY; Dr. J. A. Ross; Dr. DAY; Dr. J. P. ALDRIDGE; Assistant-Surgeon N. ALCOCK; Dr. D. H. STIRLING; Mr. J. CHATTO; Dr. B. W. RICHARDSON; Dr. FELCE; Mr. MAUNDER; Mr. LOWNDES; Dr. ELLISTON; Dr. PALFREY; Mr. POOLE; Mr. J. B. CURGENVEN.

At the Royal Observatory, Greenwich, the mean height of the barometer in the week was 29'846 in. The barometrical reading increased from 29-15 in. at the beginning of the week to 30'33 in. on Friday, Oct. 22. The general direction of the wind was N.N.W. and W.S.W.

Note. The population of Cities and Boroughs in 1869 is estimated on the assumption that the increase since 1861 has been at the same annual rate as between the censuses 1851 and 1861; at this distant period, however, since the last census it is probable that the estimate may in some instances be erroneous.

The deaths in Manchester and Bristol include those of paupers belonging to these cities who died in Workhouses situated outside the municipal boundaries.

+ Inclusive of some suburbs.

West
463388
North. 618210
Central 378058
East
South.

571158 1

773175 1

Total

127

METEOROLOGY.

62389

From Observations at the Greenwich Observatory.

Mean height of barometer

Mean temperature

Highest point of thermometer

Lowest point of thermometer

Mean dew-point temperature

General direction of wind.

Whole amount of rain in the week

8428

Operations at the Metropolitan Free Hospital, 2 p.m.; St. Mark's Hospital for Diseases of the Rectum, 1 p.m.; St. Peter's Hospital for Stone, 2) p.m.

MEDICAL SOCIETY OF LONDON, 8 p.m. Mr. Jabez Hogg, "On a Case of Ectropium following a severe Burn." Mr. Henry Lee, "On severe and long-continued Pain relieved by the Removal of the whole of the Humerus."

ODONTOLOGICAL SOCIETY, 8 p.m. Mr. Mummery, "On the Evidences of Dental Caries among Ancient Races of Mankind and existing Savage Tribes."

Operations at University College Hospital, 2 p.m.; St. Mary's, 1 p.m.;
Middlesex, 1 p.m.; London, 2 p.m.; St. Bartholomew's, 13 p.m.; Great
Northern, 2 p.m.; St. Thomas's 14 p.m.; Ophthalmic Hospital, South-
wark, 2 p.m.; Samaritan Hospital, 2.30 p.m.
OBSTETRICAL SOCIETY, 8 p.m. Dr. Barnes, "On Hemorrhage after
Labour." Dr. Hall Davis, "On Puerperal Convulsions." Dr. J. H.
Aveling, "A new Principle of Treatment in Prolapsus and Procidentia
Uteri." And other Papers by Dr. Madge and Dr. Mendenhall.

ON HYDRATE OF CHLORAL. (a) (Concluded from page 511.)

PHYSIOLOGICAL ACTION.

Effects on Animal Temperature.

I OBSERVED in my experiments in August last, and reported the observation at the Exeter meeting of the British Association for the Advancement of Science, that the administration of the hydrate of chloral reduces the animal temperature. The fact is true, and has been corroborated by every experiment since performed, in all by fifty carefully conducted experiments. In this line of research I have not rested content with taking the temperature at long intervals or occasionally, but have had the thermometer in action during the whole period of narcotism; and, summing up the facts to this moment, I find that in birds and rabbits the temperature may fall five, six, and even seven degrees Fahrenheit, and yet the animal may recover.

We have an extreme case of this kind before us now in the rabbit which is so profoundly narcotised; the temperature of that animal declined at one time full seven degrees. This, however, I would repeat, is an extreme case, the dose of the hydrate having been carried to the verge of danger; but so soon as the thermometer commences to rise the danger is over. In ordinary narcotism from the hydrate the decline of temperature, at the minimum, is three or from that to four degrees. There would, in fact, be no difficulty in learning precisely the exact dose of hydrate required to bring down the animal temperature to a given degree, the temperature of the air and of the animal, together with the weight of the animal, being first ascertained; for the phenomena of the narcotism are just as steady and reliable as are other chemical phenomena when one understands them by taking the mere trouble to read and learn them off.

Side by side with decrease of temperature is decrease of respiration. I am unable to determine whether the fall of temperature is sequential to the reduction of the muscular respiratory power, or whether it be the cause of reduced respiratory power.

Administration by Inhalation.

The hydrate of chloral, as we have seen in an early experiment, volatilises when subjected to heat, but it is not sufficiently volatile to be administered directly by the process of inhalation. I find, nevertheless, that a little may be introduced by means of the lung in a very simple manner. We have seen that the substance is very soluble in ethylic ether. I make, then, a solution by dissolving as much as I can of it, or nearly so, in absolute ether, and with this compound I narcotise. The effects produced by ether alone are very transient, but when the hydrate is combined the sleep is prolonged half an hour in birds, and in other animals a much longer time. Here is a mouse which, after this mode of narcotism, has been asleep nearly two hours. In a globe of one hundred cubic inch capacity here before us I have diffused the ethereal solution of hydrate of chloral. I introduce into the globe another mouse. Within the minute the animal is narcotised. We must not remove it at once, or it will very quickly recover, but if we let it remain a little time it will take up sufficient hydrate to get a sleep that shall last for two or three hours.

Action on Blood.

When hydrate of chloral is added to freshly drawn blood, it acts like other readily soluble salines, preventing the process of coagulation. I place before you a specimen of blood thus held fluid and retained in the fluid state since the meeting of the British Association at Exeter in August last. The blood has undergone a little decomposition, proving that the hydrate is not a persistent antiseptic. From the first this blood was quite fluid and thin, but the corpuscles were not immediately destroyed; they were reduced in size and rendered crenate at the edge, but they did not undergo solution until decomposition commenced.

(a) Delivered on Tuesday, October 5.

VOL. II. 1869. No. 1010.

If an excess of hydrate of chloral be added to freshly drawn blood, there is complete and sudden decomposition; the fluid becomes pasty, and of iron colour, but remains soluble in water; the corpuscles are entirely destroyed. The effects are, I had almost said, identical with those which follow upon the addition of formic acid to blood. These observations have reference to blood which has been drawn; on living blood circulating in the animal system the changes named are never presented after the administration of a dose of the hydrate which is insufficient to kill outright; but when the dose is so large as to prove quickly fatal an approach to some of these changes is distinguishable-that is to say, the blood remains fluid, and the corpuscles are shrunken and crenate.

One other observation is of moment. When the hydrate of chloral is first added to blood, the odour of chloroform from the blood is distinctly perceptible, and I have, in fact, been able, by mixing free quantities of blood and hydrate, to drive over and condense a few minims of chloroform from the vapour of such blood. It is clear, therefore, that blood possesses the property of decomposing the hydrate of chloral. I think, too, it is clear that the decomposition is effected by the alkali of the blood.

Theory of Action.

I am inclined on the whole to accept the theory of Liebreich as the most reasonable explanation of the action of hydrate of chloral, and as most in accordance with all the facts at present before us. The odour of chloroform in the breath of the sleeping animals, the fact that chloroform is eliminated when the hydrate is added to blood, together with the decomposition which ensues in blood when treated with a large quantity of the hydrate (a decomposition analogous to that which follows upon the addition of a formate or of formic acid), all tend to show that blood within and without the body liberates chloroform. To these evidences in favour of the theory of Liebreich we may add analogy of symptom between the action of the hydrate and of chloroform subcutaneously injected; for, on introducing chloroform subcutaneously in birds, I have been able to produce the same kind of narcotism as we have seen to-day-narcotism preceded by no excitement, and succeeded by prolonged sleep, with the extreme muscular prostration, cataleptic in character, which follows on the administration of the hydrate itself.

On the whole, then, I am bound at this moment, I repeat, to accept the theory of Liebreich as reasonable, but I hold myself at the same time open to correction after further research. APPEARANCES AFTER DEATH FROM THE HYDRATE OF CHLORAL,

AND ON CAUSE OF DEATH.

When hydrate of chloral is administered in sufficient dose to destroy life, the sinuses of the brain are found, after the death, distended with dark fluid blood; the membranes are injected, but the brain itself is free of congestion and is of natural colour. The same observation extends to the spinal cord. The muscles are dark in colour and filled with fluid blood, which flows freely from them when they are incised. The heart contains blood on both sides, and the distinctive characters of the venous and arterial bloods are preserved in respect to colour. The lungs are of pale white and contain blood, but are free from congestion. The changes in the blood itself have already been glanced at. The other organs of the body are left natural except the stomach, the inner surface of which is sometimes found, in rabbits, more vascular than is natural.

As to the cause of death I am at one with Liebreich in attributing it ultimately to paralysis of the heart. The heart seems to me to be the last organ which suffers, and the long duration of life which is seen in the presence of apparent death during the stage of extreme muscular prostration is due, I doubt not, to a continued although imperceptible action of

the heart.

SUMMARY.

The effects of hydrate of chloral may be summed up as follows:

(a) Deep and prolonged narcotism can be safely produced by the hydrate of chloral.

(b) During a portion of the period of narcotism there may be complete anesthesia with absence of reflex actions, and a condition in which every kind of operation fails to call forth consciousness.

(c) During the narcotism there are intervals of apparent exalted sensibility.

(d) In the transition from drowsiness to stupor there is no stage of muscular excitement, but in birds there is vomiting, as is common in the same animal in the second stage of narcotism under chloroform.