the worms, on escaping from the bowels, become enveloped in a cyst, and that the aperture in the tube has healed before the outward abscess bursts.

9. The treatment of such cases is extremely simple: we should do very little, and not interfere with Nature in her efforts to discharge the offending matters first, and then to close up and heal the fistula which has been formed.L'Experience.

EXPULSION OF A LONG LOOP OF THE INTESTINAL CANAL BY THE RECTUM.

Three years ago, Signor Vulpes presented to the Medico-Chirurgical Academy of Naples a portion of small intestine, three feet in length, which had been passed from the rectum. The patient, a woman, who had been affected with volvulus from intus-susception, recovered perfectly-except that she was rather subject to flatulent distention of the bowels after food, and that there remained a hardness between the right hypochondriac and the epigastric regions—and she continued to enjoy very good health until last year, when she was seized with enteritis and died.

The dissection of the body was performed with much care, and the pathological specimen obtained was presented to the Academy.

The abdomen contained two pints of a sero-purulent effusion. At the distance of 27 inches from the pylorus, it was found that there was an adhesion of the two portions of intestine which had been severed or divided during the attack of volvulus. These two portions were united together by their outer or peritoneal face, and the continuity of the canal had thus been perfectly re-established. The jejunum was much expanded or dilated, and its parietes were considerably thickened and more muscular than usual, above the seat of union, so that it almost resembled a second stomach-and on slitting the gut open, it was found that, at the point of union, the diameter of the tube was very much contracted.-L'Observatore Medico di Napoli.

CASE OF REMARKABLE PULSATION IN ALL THE SUPERFICIAL VEINS OF THE ARMS AND NECK.

A man, 26 years of age, of a lymphatico-scrofulous temperament, and of a rather feeble constitution, was admitted into La Charité Hospital on the 30th of July, 1835.

In 1828 he had had a severe pleurisy of the left side; and in 1830 he had a smart attack of acute rheumatism.

For ten days preceding his admission into the hospital, he had been labouring under diarrhoea, frequent vomitings, pain in the right hypochondrium, and general feverishness. There was a very appreciable tumefaction of the left hypochondrium, attributed to an enlarged state of the spleen. The respiratory functions did not appear to be much affected. The treatment consisted in the administration of a tartarised potion, the application of leeches to the anus, and the use of bouillon coupé.

During the first fortnight of the patient's residence in the hospital, there was no amelioration of the symptoms: the action of the bowels was irregular-at one time relaxed, and at another confined-and the febrile irritation had become more and more decided. The pulsations of the heart were now very energetic and vibratory, and were accompanied with a blowing and occasionally also with a rasping sound during the first beat: blood had been thrice drawn, and at each time it was buffy. At this period it was observed that there was a distinct pulsatory movement in all the superficial veins of both upper extremities, and

in the external jugulars, more especially in that of the right side. This venous pulsation was more sensible in the dorsal veins of the hand than in those of the fore-arm; but it was strongest and most distinct in the jugular veins. Observed in relation to the arterial pulse, it was observed that this always preceded the venous one. The blood during venesection flowed out per saltum.

On the 16th of August the following was the state of the symptoms. The bowels were still more or less purged; the pulse was rapid, large, and strong; the first bruit of the heart was attended with a slight blowing sound, and a distinct purring tremor (fremissement cataire) was audible over the apex of the sternum and over the subclavian trunk; the venous pulsation was generally sensible to the finger.

The patient gradually sunk, and died two days afterwards.

Dissection.

The meninges of the brain were highly vascular, and exhibited other signs of decided sub-inflammatory action. There were very extensive adhesions, and a considerable effusion of opaque serosity, between the pleura on both sides. Both lungs were highly congested, especially in their lower thirds, and were feebly crepitant. On being divided, a quantity of sanguinolent frothy serosity flowed out, and, here and there, the pulmonary tissue exhibited some apoplectic points, when the effused blood seemed to be blended with the proper substance of the lung.

The pericardium was healthy; and the heart was of the normal size, although somewhat laxer in texture than usual. Its tricuspid valve was rather thickened at one or two points, and exhibited a fibrinous deposition; and, near the opening of the pulmonary artery, there was observed a pseudo-membranous layer of a yellowish-white colour, as if it were formed of concreted pus. The mitral valve was hard, thickened, with irregular nodulated edges; the aortic valves were singularly altered, much thickened, opaque, friable, obstruant completement la lumiere de l'aorte.

In the abdomen, a small quantity of citron-coloured serum was found; the spleen was much enlarged, weighing more than a couple of pounds, indurated in some and softened in other points, and on the whole highly congested with dark blood. The gall-bladder contained numerous dark-coloured gall-stones, and on the surface of its parietes were observed several distended varicose veins. The liver presented a great number of abscesses of various sizes and degrees of maturation. (Note.-There had never been any symptoms of jaundice during the life of the patient.)

Reflections. A considerable number of authentic cases of venous pulsations -in some of which they were much more general and extended than in the preceding observation-are on record. This phenomenon was noticed,

1. In a young girl who died with hydrocephalic symptoms.- - (Haller's Disputationes).

2. In a case where vertigo and general pains in the limbs were the most marked symptoms. The phenomenon was observed for three days only, the patient rapidly recovering.-(Journ. der Pract. Heilk. Sept. 1815.)

3. In a man who suffered from syncope, palpitations, and dyspnoea. The dissection did not reveal any satisfactory cause of the symptom.—(Archiv. fur. Medic. Erfahrung, 1822).

4. In a soldier, who was affected with a paralysie lente on the right side, which had commenced on the 1st of December. On the 23rd of January, after a slight amendment, the pulse was full and hard, but not much quickened, the skin was hot, the face flushed, and all the superficial veins of the body and limbs were observed to pulsate—this phenomenon lasted for five days. The skin in almost every part was raised and depressed at each pulsation: even the eyes and the tongue battaient. On the 30th, there was coma; but the venous pul

sations had ceased: they re-appeared two days afterwards, and the patient died on the following day.

On dissection, "the middle semilunar valve of the left ventricle was found to be converted into an osseous concretion, so situated that it obstructed in a great measure the bore of the aorta. The lungs were much congested.”—(Journ. Complementaire, Juin 1835).

5. In a case of epidemic fever, the venous pulsation was observed for twentyfour hours.-(Dublin Hosp. Reports, Vol. 4).

6. Dr. Elliotson mentions the case of a young lady, labouring under chronic bronchitis, in whom all the veins of the hand and fore-arm were observed to pulsate synchronously. The patient recovered..

7. Dr. Ogier Ward has recorded another example of this rare phenomenon. A woman, 30 years of age, was admitted into the Wolverhampton Dispensary with symptoms of feverish malaise. The pulse was quickened, the breathing hurried and attended with cough. A week after this data, she miscarried; and, three days subsequently to this event, the dorsal veins of both hands were observed to be much distended and to pulsate very strongly. These pulsations were quite appreciable in the digital veins, in which the blood seemed to have a florid arterial hue. They extended up as far as the middle of the fore-arms, and were not stopped by pressure on the veins, unless this was made below, or distad from, the point where the experiment was made. These pulsations were isochronous with the arterial pulse, which at the time was hard, incompressible, and frequent. The phenomena lasted for three days; and the patient recovered perfectly.

A curious occurrence was observed in this case-castor-oil did not act as a purgative, but exsuded from almost every part of the body.

With regard to the rationale of venous pulsations, physiologists are uncertain whether the phenomenon is to be attributed to the action of the left or of the right ventricle of the heart-in other words, whether it is to be considered as the result of the pulsation of the arterial tubes being continued through the capillary vessels and thus reaching the blood in the veins, or whether it is caused by a retrograde pulsatory action of the right ventricle, communicated backwards from the larger to the smaller veins.-Journal Hebdomadaire.

THE SOUPE A LA MINUTE,' RECOMMENDED BY BARON PERCY.

The following letter from Dr. Valissiere of Metz appeared recently in the Lançette Française.

Having just finished reading the account, given by the Surgeon-General Baudens, of the expedition against the city of Constantine, it has occurred to me that it may prove useful to recall to the attention of the public, and more especially of military men, the receipt for preparing a 'soupe à la minute,' so much recommended by our distinguished countryman Baron Percy.

Six pounds of butter are to be put into a large saucepan; this is to be fried with a handful of onions cut small, and with the same quantity of aulx (what are these?). The mass is to be well stirred about with a spoon, and as much good flour is to be gradually added as the melted butter will absorb. To incorporate the two better together, we may add a pound or so of olive oil to the mixture. A sufficient quantity of salt and pepper is to be added, to give flavour to it, and to fit it for keeping. As the mess cools, the stirring is to be continued very steadily; and when it is quite cold and stiff, it should be preserved in pots or tin-cases.

The above quantity of materials will suffice to make 45 basins of soup. A piece of the size of an egg may be dissolved in three pints of water, and will furnish a very palatable and nourishing aliment.

Such is the substance or material recommended by Baron Percy for soldiers, who are about to start on a march, where they may find difficulty in procuring food. Each soldier may carry a supply with him sufficient to last for a week or two; and all that is necessary for the preparation of the soup is water and a fire to heat it with. The soup thus obtained is much preferable to that made with most of the dried gelatine, which is sold now-a-days, but which, according to the experiments made by MM. Donné and Gannal, is very far from being nourishing."

REMARKS ON SOME CURIOUS CASES OF SIMULATION.

Some of the French journals have lately been astonishing their readers with an account of a woman, who although fresh and healthy, had not touched food for a year and eight months, nor had any excretions during all that time, and who yet was suckling an infant six months old!' This woman was first under the care of M. Caillard, and subsequently of M. Magendie, at the Hôtel Dieu in Paris, where she still remains. We, says the reporter, have repeatedly seen her, and from the very first suspected an imposture and so it has proved. When admitted into the hospital last September, her tale was that, for the preceding year and a half, she had not tasted any food, and that she had acquired the power of living without eating. For the first few days after her admission, she certainly did not take any nourishment, leaving untouched all food, fluid as well as solid, that was left within her reach.

She was then put into a small room by herself and various articles of diet,all of which had been previously weighed and measured-were left at her disposal. It seems that she had resisted all the cravings of appetite for eight days; but on the ninth day she began to eat, and has continued to do so ever since. On examining the mattrass, numerous pieces of dry feculent matter were found concealed in the wool. Here then was an end of this extraordinary tale, which some of the journalists were making such a fuss about.

If we now ask ourselves, what possibly could have been the motive of this woman's conduct, and what interest was to be served by this most strange imposture?-perhaps the only answer we can make is, that it was the love of notoriety, of being spoken about, and, in short, of being the subject of curiosity to others. This in truth is a very strong feeling in many minds, and will often impel the vain and foolish to extraordinary acts of self-punishment.

Perhaps it is this motive, more than any other, which has caused so many young females to be misled by the practices of the animal magnetiser, and to simulate so many fantastic feelings and sufferings. But to drop any further allusion to these, it may be amusing to mention briefly another case, similar in many respects to the one, we have already recorded, of the woman in the Hôtel Dieu.

About fifteen years ago, there was a woman in the wards of La Charité, who it was said, had not voided by the natural passages 'le moindre atome' of fæcal matter or of urine, for the space of two years. The former, it was alleged, was evacuated by vomiting, and the urine partly in this way, and partly by oozing from the umbilicus. The truth of all this was very generally believed, at the time, in the hospital, both by the pupils and by Professor Leroux. It was even published by M. Nysten, in one of the journals, as an extrordinary case of aberration of the normal functions! It was indeed quite true that the patient was seen to vomit every day, a portion of fæcal matter; and she kept a piece of sponge to wipe away the urinous moisture from the umbilicus. No person suspected a trick, until old Boyer, observing that the vomited faces were of a rounded form and consistent, remarked that they must have come from the large, and not the small intestines. This sagacious remark excited the curiosity of the

attendants, and precautions were accordingly taken to guard against further imposition, if this had really been hitherto practised. The woman was made to wear a pair of drawers, which were secured round the body and ancles, so that it could not be undone, without being discovered; and the hands also were covered with gloves, which were then stitched to the sleeves of a waistcoat. An attendant remained in the apartment all night.

She repeatedly indicated great uneasiness, complained of pain, and kept her hands applied to the stomach; still she asserted most positively that she had no desire to pass either urine or stool; but that she felt the severe pain which always preceded the oozing of the urine from the umbilicus.

In the morning her distress was extreme, and the abdomen was found to be exceedingly distended. In the course of the day, elle n'y put plus tenir;' for she urined so abundantly that the mattrass of the bed was wetted through and through. It was now discovered that she had concealed under the bolster a quantity of dried feculent matter; portions of which she had no doubt been in the habit of swallowing, for the purpose of afterwards vomiting it up again, in order to keep up the strange imposture, which she had most unaccountably thought of practising.—Bulletin General de Therapeutique.

ON THE PRESENCE OF UREA IN THE BLOOD.

It has long been a problem of much interest, and of no easy solution, in physiology to determine whether the secretions of the body are eliminated and prepared by the secretory organs themselves, or whether they already exist, formed in a more or less perfect degree of composition, in the blood itself, and are merely separated, and, as it were, drawn off from it at the different emunctories. Most of the chemical physiologists have been inclined to adopt the latter of these two opinions, and it has been supposed that considerable probability has been added to it by the experiments of MM. Prevost and Dumas, wherein they discovered the presence of urea in the circulating blood of animals, from which the kidneys had been extirpated.

It would seem, however, from the recent very careful researches of MM, Mitscherlich, Gmelin, and Tiedemann, that they could not discover the smallest traces of urea in the blood of a healthy animal; although by previous experiments they had assured themselves that they were able, by chemical analysis, to discover so minute a quantity as a 250th part (of a grain?) of this animal product in blood, (on pouvait retrouver encore 1,250 d'urée dans le sang.)

M. Marchand states that he has repeated their experiments with the most minute accuracy, and has obtained the same results.

Deeming it, however, not improbable that a minute quantity of any substance like urea might be so entangled and, as it were, involved in some of the constituents of the blood, that its presence might be more or less completely disguised from the researches of the analyst, M. Marchand has performed numerous experiments to determine the question.

For example, he took 200 parts of the serum of blood, and mixed one part of urea with it; the fluid was then heated in a sand-bath, until the albumen freely coagulated, and when it cooled, the urea was sought for by the most delicate tests. But not more than one-fifth of it could be detected: how the rest of it was withdrawn or disguised, M. Marchand was not able to satisfy himself.

He also found that the fibrine and the colouring matter of the clot had a similar effect, as the albumen of the serum, in this respect: the entire quantity of the urea, which had been blended with them, could never be recovered.

M. M. invites the attention of animal chemists to this fact, as the knowledge of it cannot fail to affect very materially the results of many of their analyses. No. LIX. R