with a drop of acid, did not give any reaction with perchloride of iron. There was therefore no morphia. Another portion did not give the red coloration with concentrated nitric acid: therefore there was no brucine. Another portion, tested with nitro-sulphuric acid and bichromate of potassa and proxide of lead, produced no characteristic reaction-there was therefore no strychnine. Chloride of gold, however, was readily reduced; nitrate of silver was but slightly reduced; tincture of nut-galls, and a drop of dilute hydrochloric acid, produced a curdy precipitate; concentrated sulphuric acid produced an orange colour; and concentrated nitric acid, when allowed to remain for some time in contact in the state of vapour with the residue, produced a distinct carmine colour. These reactions indicate the presence of a trace of solanine, the alkaloid contained in poisonous susumber. The picric acid test, however, failed, so did also the test with carbonate of potassa. All residues resulting from the forementioned processes were now mixed and treated for four days with a current of sulphuretted hydrogen, being alternately exposed for a day to any sunshine that was to be obtained. The precipitate obtained was yellowish gray. It was well-washed, fused with carbonate and nitrate of soda; the fused mass decomposed with excess of sulphuric acid, and the acid solution tested by hydrosulphuric acid, and in Marsh's apparatus. Not a trace of any mineral poison could be discovered. As I am not in possession of sufficient information with regard to this case, hardly anything being known of the symptoms preceding death, it is impossible to give an opinion with confidence as to the cause of death. The stomach being completely empty, would rather discountenance the idea of the deceased having been poisoned by some powerful mineral or vegetable organic poison, which must have been administered in some vehicle. The trace of solanine would simply imply that the person had been eating of the poisonous susumber some time previous to death; and it is well known that many persons use the poisonous and non-poisonous susumber indiscriminately, although this is evidently a dangerous practice.

"J. HOFFMAN."

It is, indeed, much to be regretted that in this latter case the symptoms before death were not observed, as, in all cases of poisoning, it is only by a careful consideration of the symptoms that medical men are able to distinguish the character of the poison, and use the appropriate remedies the case requires.

As regards the botanical nature of the plant, it belongs to the Solanaceæ, natural order Luridæ. According to Lunnan, in his "Hortus Jamaicensis," the name is Solanum Bacciferum; although on this point there is some difference of opinion among botanists, as Prof. Balfour considers that they bear an analogy to the Solanum verbascifolia. It is an herbaceous plant, with a stem about five or six feet high, with tomentose prickly branches, bearing on prickly

pedicles large angular lobed soft leaves, somewhat hairy on both sides, with a prickly midrib below. The flowers appear in bunches at the side of the stalks. The flowers are monopetalous, with apices like the rest of the Solanaceæ. They have round orangecoloured berries, of the size of small cherries, five capsuled, full of an orange-coloured pulp, containing small white seeds. There are two varieties, both very common in Jamaica, one of which has a yellowish and the other a purplish stalk, though sometimes it is not easy to distinguish the two varieties. From the fact that these berries are much eaten by turkeys, they have received the name of turkey berries; they are also known under the names of soushumber, cat-nail, Port Morant tobacco, and macaw bush. With respect to the medicinal virtues of the plant, Lunnan states that their roots are "very bitter, of thin parts and excellent virtue; half-an-ounce in powder purges all humours downwards, opens obstructions of the liver and prostate, provoking urine, being used instead of the opening roots which are so much esteemed. The decoction of the roots is diuretic, and good in burning fevers; with honey in catarrh; and in strangury, with cardamoms, it expels wind. The decoction of the leaves, with sugar and limes, is good for the itch, and also for the mange in mules. The juice of the roots and leaves are said to be good for consumption; and the leaves, when boiled with a small proportion of oil-nut leaves, are recommended as a good fomentation for sores."

The Solanaceæ, as exemplified in the S. Dulcamara and the S. Nigrum, possess plants with considerable poisonous properties, due to the presence of the alkaloid solania, whose action has been principally investigated by Dr Clarus of Leipzig. According to his experiments, solania possesses some similarity to strychnia, in as far as both excite the sensibility of the skin. Like conia or nicotina, solania destroys life by producing paralysis of the muscles of respiration, as the symptoms in the case first described clearly indicate. In common with all cerebro-spinal as well as narcoticoacrid poisons, there is, in poisoning by any of the Solanaceæ, great depression and sinking of the vital powers, accompanied with cramps, together with sickness and great coldness of the surface of the body. Dr Manners' first case is, however, peculiar, as among those affected by the poison in the house of the deceased he mentions that he found the pupils dilated, a symptom characteristic of poisoning by atropine, daturine, and hyoscyamine, but not so generally present in the case of solanine.

ARTICLE III.-Fourteen Cases of Ovariotomy. By THOMAS KEITH, F.R.C.S.E.

SINCE the last series of operations for ovarian disease reported in the December number of this journal for last year, I have performed ovariotomy fourteen times. These cases are now narrated, in accordance with the practice hitherto followed, of giving to the profession an account of every operation, whether successful or not. Of these, twelve recovered and two died. In most of them the operations were severe, and in several the convalescence was tedious, giving rise to no little anxiety as to the result. In one of the fatal cases, much local difficulty from pelvic adhesion was known to exist; and the operation was commenced on the understanding that it might be completed or not according to circumstances. I have little doubt that the excessive vomiting from chloroform gave rise to accidents which were the cause, in a great measure, of the fatal result. The other unsuccessful case was one of semi-solid tumour, surrounded by viscid fluid, the product of chronic peritonitis. It was complicated with double pleuritic effusion; and nearly half-a-gallon of fluid had been removed from the left pleura a fortnight before. So much relief was thus obtained, that ovariotomy seemed warrantable; and it was hoped that by the removal of the tumour, the drain upon the system arising from the ascitic fluid would be checked. A sudden increase of the pleuritic effusion on the fifth day rapidly proved fatal. The circumstances under which this operation was performed, I need hardly say, were not favourable for success.

Besides these, there is given a case in which, after emptying the cyst, there was found to exist such an intimate connexion of its posterior surface with the small intestine, mesentery, aorta, and common iliac vessels, that I made no attempt to do more. The wound was closed, a free opening being left in the cyst communicating with the cavity of the peritoneum. No bad consequences followed; and when this patient was seen a few days ago, she was going about in excellent health, and as yet there was no appearance of the cyst refilling.

CASE XLVII.-Multilocular Ovarian Tumour, upwards of forty pounds. Once tapped. Ovariotomy. Recovery.

A widow lady from Southport, sixty-five years of age, extremely fat, with a feeble heart, but of a tolerably healthy aspect, consulted me in July 1866 as to the propriety, at her time of life, of having a large ovarian tumour removed. Its nature had been recognised about a year before by Dr Millington of Wolverhampton, and of late its increase had been decided. Fluctuation was uniform over the

abdomen, which measured forty-seven inches at the umbilicus. The uterus was central, low down, and movable. The impression left by a single examination was, that the tumour was composed of nearly a single cyst, and that, notwithstanding her age, and the extreme thickness of the abdominal wall, the case was one in which ovariotomy might be performed without more than the ordinary risk. She went home to advise with her family, and returned in September. Meanwhile a correspondence had taken place with Dr Millington. He informed me that many of the patient's bloodrelations suffered from feeble fatty hearts, and that some years ago, when reduced by long confinement, in consequence of an injury, this lady had shown symptoms of becoming similarly affected. He had not seen her since he detected the tumour; but he then thought that the base of it was solid.

On her return, her general condition was not so good as before. She was pale, the pulse generally about ninety, and somewhat feeble. The girth had increased to fifty inches and a half; and as the wall below the umbilicus was oedematous, it appeared more prudent to have a preliminary tapping. After eighteen pounds of thick bloody fluid had flowed, the canula became choked with pieces of fibrine. She was somewhat relieved by this, though her size was not much reduced. The semi-solid that remained was large, and in the left iliac region the tumour felt as hard as a fibroid. Much to my surprise, the slightest movement of this solid portion was communicated at once to the uterus, which, previous to the tapping, was quite movable, though now it seemed that the connexion between the uterus and tumour was close. uterus lay low and far back in the pelvis; and taking into account the unusual thickness of the abdominal wall-afterwards found to exceed three inches-there did not appear much hope that it would be possible to secure the pedicle externally. It seemed to me that the case was one in which success after operation would very much depend upon whether this would be possible or not, for the general condition of the patient was not good; and the impression left upon me was, that should it be necessary to return the pedicle with the ligatures, the chances would be that red serum would be thrown out in place of healthy lymph, and that she would probably die of low abdominal inflammation.

The

Under these circumstances, and considering the amount of semisolid, such a favourable prognosis could not now be given as formerly. The chances of success and failure seemed about equal, while at sixty-five the gain was not great. The proper course was to leave the decision to the patient and her family. The result was, that ovariotomy was agreed on, and performed on the 4th of October. The incision extended from the umbilicus downwards, being made larger than usual, on account of the thickness of the parietes. The peritoneum was so firmly adherent to the cyst that a careful dissection was for some time necessary. The tumour was freely cut

into, and a great quantity of fibrinous matter removed. The semisolid portion was then broken up, and the cavity carefully sponged before separating the adhesions, which were extremely firm, and extended over nearly the whole anterior surface of the cyst. The base was adenoid, and a very short pedicle was transfixed and tied about an inch from what felt to be the uterus, for from the size of the semi-solid portion it was impossible to see the exact state of the parts. On cutting away the tumour, what appeared at first to be the uterus was found to be a thin, tense, round cyst in the broad ligament, the size of the fist. It arose close to the uterus; and on emptying it of its clear watery contents, a very fair pedicle was obtained, which was secured by a clamp. The position of this cyst explained most satisfactorily the apparent close connexion which seemed to exist after the tapping between the uterus and tumour. The broken down cysts and fibrinous contents weighed twenty-four pounds, and eighteen pounds of fluid had been removed by tapping ten days before.

The chloroform vomiting was severe, and continued till next morning. There were, however, no unfavourable symptoms. The stitches were removed on the fifth day, when the wound was quite united. The clamp was removed on the eighth day. After this she had for some days a troublesome cough with some expectoration. In consequence of this, irritation was set up in the wound, and there followed suppuration in the sheath of the rectus muscle. Towards the end of the second week there was troublesome irritation of the bladder, which was relieved after free discharge from the side of the pedicle. This most probably came from suppuration of the cyst in the broad ligament. Though her convalescence was slow, she was able to leave her lodgings six weeks after operation, to pay a visit to some friends previous to her return to Southport in the end of November.

CASE XLVIII.-Semi-solid Ovarian Tumour. Ovariotomy.

Recovery.

In September 1866, I saw, with Dr Buchanan of Dumbarton, a a married lady, forty-two years of age, with a large semi-solid tumour. The abdomen was very hard, and there was a good deal of general tenderness. The circumference at the umbilicus was forty-one and a half inches. To the left side there was, at one spot, obscure fluctuation and coarse crepitus over a small extent. The uterus was central, far back, and, though movable, felt as if closely connected with the tumour. She remained in town for some days, and, after several examinations, the diagnosis given was semi-solid ovarian tumour of left side-no evidence of adhesion-pedicle probably short." The prognosis given was favourable. It was evident that nothing was to be gained by tapping, and Dr Buchanan and I, therefore, felt justified in

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