E. H. Weber, and called 'septum' by the former author, which was shown by Steifensand, in 1835, from investigations made on fishes, reptiles, birds, mammals, and man, to consist of a peculiar involution and thickening of the tunica propria of the wall of the ampullæ. This elevation was more correctly designated crista acustica in the ampullæ and macula acustica in the sacculus by Schultze. In the majority of animals each twig of the nervus vestibuli that passes to an ampulla penetrates the furrow on its external surface, divides into two flat bundles, and mingled with ganglion-cells, runs straight through the tunica propria to the epithelium of the crista acustica. The cells at this part are two or three times the usual size, and are bounded internally by a basal seam or border. Other fibrils of the nerve run some distance up the sides of the ampulla between the membrana propria and the epithelium. The primitive nerve-fibres possess a double contour as they traverse the tunica propria, but undergo considerable diminution in diameter in the vicinity of the crista. It is not difficult to demonstrate in the ampullæ of fishes, treated with perosmic acid, as stated by Reich and Schultze, that a pale, thin fibre, constituting a direct prolongation of a primitive fibre, extends beyond the inner border of the wall of the ampulla, without communication with ganglion-cells, and then breaks up into a number of fine fibrils. The fibres certainly do not end, as Hartmann contends, in loops. The best observers-M. Schultze, E. Schultze, Odenius, Kölliker, Deiters, Hensen, Henle, and Hasseagree in stating that the pale fibres are continuations of the contoured nerves, and enter the epithelium. The nervous epithelial layer is sometimes smooth, as in man, mammals, and birds, and sometimes folded, as in many fishes. It is thickest in fishes (0·080 mm.), thinner in mammals and man, and thinnest in birds (0·016 mm.). The deepest layer of the nerve-epithelium resting on the ampullary wall is soft, loose, and nucleated. The cells are thicker near the middle, and towards the free border present a sharply defined line like the limitans externa of the retina, and beyond this is the stiff hair. In the sacculi the nervous epithelial layer is somewhat flatter than in the ampullæ. In the latter it assumes, at the parts where no nerves enter, a very flattened form; but in the sacculi it is never flatter than transitional epithelium. If the epithelial layer be broken up several cell-forms may be distinguished in it. First, and most internally, are elongated cylinders, broad at one end and bluntly conical at the other, with large nuclei, and of yellow colour in the fish and frog. These constitute supporting cells lying between the extremities of the fibre-cells. The spindle, fibre or rod-cells are much more numerous than the cylinder cells, and have been described by Schultze, Odenius, Kölliker, Henle, and Hasse, in similar terms. These cells are fusiform, with a long process running towards the centre, and a rod-shaped process running towards the periphery. They are characterised also by their pale appearance and by their blackening like, and coincidently with, the nerves on the addition of perosmic acid. Dark striæ are also seen traversing at regular distances the deeper part of the epithelial layer, and can be followed to the surface.

If the maceration in the acid be prolonged for some time, the several cells can be isolated, and now a black coloured stria may be seen in each of the fusiform fibre-cells, which Rudinger believes is enclosed within the cell. The striæ are continuous with the nervefibres, and are in connection with the nuclei of the cells, whilst at the opposite or free extremity of the several cells they seem to be continuous with the auditory hair. These appearances are especially distinct in the cyprinoid fishes, but the black stria within the cell is not visible in the cat. As soon as the delicate nerve-fibres-which it is impossible to distinguish from the axis cylinders-have entered the loose epithelial layer they form a plexus, at the anastomosing points of which, as well as elsewhere on the fibres, are minute swellings, respecting the nature of which he is doubtful, though he thinks evidence is accumulating to show they, like the similar swellings in the retina, are of a ganglionic nature; and from this plexus the fibres entering the cells are given off. In the cyprinoid fishes the auditory hairs appear to be united by a sticky substance, so as to form a mound-like elevation on the epithelial layer at the bottom of the ampullæ.

7. On the 6th September, 1869, M. Papillon subjected a young pigeon to the following regimen:-Distilled water, containing hydrochlorate, sulphate and nitrate of potash and soda, with grain ground down to a paste with strontia. It remained in perfect health till the 1st April, 1870, when it was killed. Its bones were calcined, and an analysis of the ashes gave the following per-centage results:

In another experiment, commenced on the 16th September, 1869, a young white rat, ten days old, was subjected to a similar regimen, except that phosphate of alumina was substituted for the strontia given to the pigeon, in proportion of about 15 grain per diem. The animal apparently remained in good health, but on the 29th November, 1869, it died suddenly in convulsions. Examination of the body showed the presence of intense enteritis. The analysis of the bones gave the following results:-In 100 parts there were of

A sister of the foregoing rat was supplied with phosphate of magnesia instead of phosphate of alumina, and was killed on the 25th November. Analysis showed the presence of magnesia in the following proportions in 100 parts:

Magnesia
Lime

In all the animals the bones presented their normal appearance, and appeared to possess their natural physiological peculiarities.

REPORT ON SURGERY.

SELECTION OF CASES FROM THE FOREIGN JOURNALS.

BY ALFRED POLAND, F.R.C.S.

On the Influence of the Weather over the Results of Surgical Operation.-Dr. A. Hewson enters into this subject very fully, and discusses the value of the barometer as a guide in the choice of the time for the prognosis in such operations, as shown by the results of "immediate amputations" during a period of thirty years in the Pennsylvania Hospital. He thus sums up his conclusions: "I shall, to avoid the error which would otherwise arise from novel differences in the barometric indications, compare those of the same hour of each day; and to secure further accuracy I shall, in all instances, state the results from observations extending from the day previous to the operation to that of the fourth day after it.

In this way it would appear that on the occasions of the 259 operations the barometer was ascending in 102, descending in 123, and stationary in 34.

Fifty-four of the whole number were fatal. Eleven of them were operated on when the barometer was ascending, 35 when it was descending, and 8 when it was stationary.

Of the successful cases 91 were operated on with an ascending barometer, 88 with it descending, and 26 with it stationary.

From which it would seem that we get a mortality where operations were performed with the barometer ascending, of not quite 11 (107) per cent.; of over 20 (206) per cent. with it stationary; and over 28 (284) per cent. with it descending.

Of the fatal cases the average length of time which the patient survived the operation was only 7 days when the barometer was ascending, and 13 when it was descending; and of the cases which died within three days over 7.5 per cent. were when the barometer was ascending.

Surely these figures need no commentary as to how well they sustain the idea that the results of the operations are materially influenced by the weather, and that the risks from shock and fever are increased by opposite conditions.

The practical deductions to be drawn from them are quite evident. One can certainly rely on the barometer to guide him in the choice of occasions for doing operations where he had the power to choose, or in the prognosis of the results in cases where he is deprived of such option.-Pennsylvania Hospital Reports, vol. ii, p. 17, 1870.

Hypodermic Injection of Ergotine in a Case of Aneurism of the Innominata.-M. Albanese (Gazetta Clinica di Palermo,' No. 1, 1870) relates the following case:

A female, æt. 38, was admitted into the hospital on April 27th with an aneurismal tumour of the brachio-cephalic trunk of six months' duration. It was of the size of a mandarine orange, situated

in the supra-sternal fossa, and reached four centimetres above the clavicle, pulsatile and synchronous with the right radial pulse. The circulation in the arm was impeded; there was oedema, and the hand and fingers bluish. The patient could not lay down, and complained of pain in the shoulder, and had had frequent syncopes, often attended with danger of death. The movements of the arm were very impeded. Air entered with difficulty into the apex of the right lung; there was obscurity in the sounds of the heart. The temperature in the right axilla was 37-6° centigrade, and pulsation of right radial 72; temperature of left axilla 37°, and pulsation of radial 70. On the 1st of May a solution of ergotine was injected between the subcutaneous cellular tissue and the sac; and on the following day a second injection. Immediately there followed severe dyspnoea, cyanosis of the face, and coldness of the extremities; the pulsations of the radials became imperceptible, and these alarming phenomena yielded to warm fomentations to the hand, dry-cupping over cardiac region, and two small venesections.

On the 4th of May another injection was practised. Since this the pulsations in the tumour were manifestly more feeble, and on the 5th of May she could move freely the head and arm, and the respiration was easy. From the 6th to the 8th of May four injections were performed night and morning. The local amelioration was very marked, the tumour diminished in size; there was a slight induration at the seat of punctures. Another injection was made on the 9th, and there was a fresh threatening of syncope, which yielded to stimulants. From the 10th to the 30th of May seven more injections were made. The state of the patient improved daily; she could get up, speak freely; the swelling of the arm disappeared. On the night of the 31st of May there was a fresh syncope, which subsided under ordinary means. On the 1st of June all local measures were given up, and the patient, finding herself better, left the hospital.-Gazette Hebdom. de Méd. et de Chir., May 13th,

1870.

STATISTICS OF TUMOURS.

Billroth (Chirurg. Erfahr. Zurich,' 1860-1867; ' Archiv. f. Klin. Chir.,' Bd. x) gives a tabular survey of 558 cases of tumours observed by him in Zurich, and with regard to the frequency of the different kinds and their relations to the sex.

As to frequency they are grouped in the following order :-Carcinoma 212, lymphoma 82, fibroma and myo-fibroma 67, cysts 57, adenoma 46, sarcoma 42, lipoma 22, angioma 22, chondroma 5,

osteoma 3.

As regards the sex, fibroma, fibro-myoma, and carcinoma were more frequent in males (uterine myoma and uterine carcinoma were seldom treated in the surgical wards); whilst lipoma, sarcoma, adenoma, and cysts were more common in females.

With respect to the seat of the tumours the most frequent situation was the scalp and face, skin of the gluteal region, and the extremities. The influence of the atmosphere on the face as a cause of its frequency

is not established. The disposition to formation of tumours in different periods of life showed that the tumour diathesis in the first decennium is exceedingly small, from the second decennium it increases rapidly up to the fourth, remaining then of equal height, and afterwards it proceeds slowly, largely increasing in the sixth, seventh, and eighth decennium. The average duration of life in cancer was two and a half years; the ordinary course of a sarcoma was from one year and three and a half months to thirty-nine years.

Meckel's Ganglion and the Propriety of its Removal for the Relief of Neuralgia of the Second Branch of the Fifth Pair of Nerves.Dr. Conner, Professor of Surgical Anatomy in the Medical College of Ohio, commences his observations with an extract from Dr. Carnochan's well-known report of the cure of three cases of neuralgia of the second branch of the fifth pair by exsection of the superior maxillary trunk:

"I believe that in such aggravated cases of neuralgia the key of the operation is the removal of the ganglion of Meckel, or its insulation from the encephalon. Where even a large portion of the trunk of the second branch of the fifth has been simply excited from the infra-orbital canal, the ganglion of Meckel continues to provide to a great extent the nervous ramifications which will still maintain and keep up the diversified neuralgic pains. Besides the ganglion of Meckel, being composed of grey matter, must play an important part as a generator of nervous power, of which, like a galvanic battery, it affords a continual supply; while the branches of the ganglion, under the influence of the diseased trunk, serve as conductors of the accumulated morbid nervous sensibility."

Dr. Conner enters into a very elaborate detail of the anatomy and physiology of the ganglion and its branches, and after adverting to the pathology thereof in reference to neuralgia, he refers to the practical bearing of operative interference. He says:

"But whether the disease, for the cure of which the operation is performed, is of central or peripheral origin, is a question of little importance, if it can be shown that permanent relief may be expected from exsection of the superior maxillary trunk back to the foramen rotundum. But if it is a fact that the relief afforded by it is only temporary, in a considerable proportion of cases of not longer duration than the intermissions secured by other and less formidable operations, or by medication, then it becomes a serious question if the "Carnochan operation" is not an "act of desperation " to which recourse should be had hardly sooner than to the division of the sympathetic in the neck, that Charles Bell wished could be performed with safety, believing it would relieve the neuralgia under consideration.

Dr. Conner gives the record of thirteen cases of exsection of the superior maxillary nerve with the following results, seven in which pain is known to have recurred, and six in which return of pain has not been reported. The return of the pain in the seven cases was,within one month one case, within two months one case, in three

93-XLVII.

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