ample of both. Under the influence of certain passions, that organ becomes hypertrophied; and again, when the valves, seated at the outlet of any of its great cavities, become impaired in their structure, the parietes, from the increased labor they are called upon to perform, acquire abnormal dimensions. We lately saw a heart in the possession of Dr. Enders, in which this was beautifully illustrated by the valvular vegetations, which obstructed the passage of the blood through the organ. Atrophy, the opposite of hypertrophy, often coexists with it in the same compound organ. Thus while one tissue is reduced below its proper size, another may be increased beyond-and vice-versa. More commonly, however, all the tissues of an organ are equally reduced. Atrophy implies deficient nutrition, or excessive absorption. Pressure external or internal frequently leads to it, and is said, in the common parlance of the profession, to do so by promoting absorption. In these cases, however, the supply of blood is limited by the compression of the nutrient arteries. In this manner portions of the lung and liver are occasionally greatly reduced in size-contracting coagulable lymph having been effused about and within them. The causes of atrophy are, however, extremely various. Thus the disuse or rather nonuse of an organ or a limb rapidly reduces its size; and a lesion of its innervation, impairing its function of nutrition, may have the same effect. In old age nearly all the parts of the body pass into a state of atrophy; on the other hand, the whole never rise into hypertrophy. The great bulk which some aged persons exhibit, arises from hypertrophy of the adipose tissue alone. Our author next arrives at transformations-the conversion of one texture into another. He regards the whole as "effected under the influence of inflammatory irritation." To this sweeping generalization we are not quite prepared to give our assent. Nevertheless, many transformations take place almost under our eyes, and can be seen to depend on inflammatory action. Thus when the skin is transformed into mucous membranes, it is under circumstances of irritation, and with the appearance of inflammation; when a deep seated abscess does not fill up with granulation and a fistula remains, this artificial efferent duct comes to be lined with a mucous membrane, analagous to that of the excretory vessels of certain glands,—which may be regarded as the transformation of cellular into mucous membrane. A few months since we saw an extensive adipous transformation of the gastrocnemii and other muscles of the leg, in connexion with chronic inflammation and articular ulceration of the ankle, rendering amputation necessary. The skin of the same limb was changed into a tissue nearly resembling cartilage. Many transformations, however, are not preceded by symptoms of inflammation. Such are ossifications of the cartilages of the ribs, the valves of the heart, and the parietes of the vessels-on the other hand, bones occasionally pass into the state of cartilage, without the signs of inflammation being present. Transformation is, in fact, a lesion of nutrition and may take place with or without inflammation. The following are the analagous transformations admitted by our author: 1. the cellular-2. the mucous-3. the cutaneous-4. the fibrous-5. the cartilaginous-6. the osseous7. the adipous. These cannot be formed in or out of any other tissue of the body, indiscriminately. The law which governs their production, is nearly the same that presides over the softening of the tissues. The cellular may pass into the mucous, and this into the dermoid-or into the fibrous which may then become fibro-cartilaginous, cartilaginous and osseous. Under no other aspect does the science of general anatomy appear more attractive and useful, than when administering to the study of these transformations; the contemplation of which fills the mind with cheering anticipations of the future condition of pathological science. D. ART. III.-Guy's Hospital Reports. No. viii, April, 1839. A. &c., and James P. London, 1839. THE present number of this most excellent and highly practical work contains the following articles : On the Disorders of the Brain, connected with diseased Kidneys. By Thomas Addison, M. D.-On Perforations of the Stomach, from Poisoning and Disease. By Alfred T. Taylor. On the Diurnal Variations of the Pulse. By William Augustus Guy, M. B., &c.-Observations on Poisoning by the Vapours of Burning Charcoal and Coals. By Golding Bird, M. D., &c.-Two cases of Poisoning by the Inhalation of Carburetted Hydrogen. By Thomas Pridgin Teale, F. L. S.-Case of Imperforate Uterus, with Remarks. By Alexander Tweedie.-On Incision in Cases of Occlusion and Rigidity of the Uterus. By Samuel Ashwell, M. D.-Observations on Fibrinous Concretions in the Heart. By Dr. Hughes, M. D., &c.-Analysis of Bones affected with Mollities Ossium. By G. O. Rees, M. D., &c.-Case of Division of the Tibia, for the Cure of Deformity occasioned by a Gun-shot Wound. By Charles Aston Key. Case of Spermatocele, or Varico cele, treated Excision of a portion of the Scrotum. By Bransby B. Cooper, F. R. S.-Observations on Abdominal Tumours and Intumescence: illustrated by Cases of Renal Disease. By R. Bright, M. D. F. R. S. Our object is merely to present in a brief abstract the most interesting matter contained in the above enumerated articles. 1.-On the Disorders of the Brain, connected with Diseased Kidneys. By Thomas Addison, M. D. In the first paragraph of his article, the author states the object of his communication to be: "First, To point out the general character and individual forms of cerebral disorder connected with interrupted function of the kidneys, from whatever cause such interrupted function may arise. Secondly, To shew, that, in recent as well as chronic disease of the kidney, the cerebral disorder is not unfrequently the most prominent, and occasionally the only obvious symptom present. And, Thirdly, To establish a means of diagnosis, in such obscure or in unsuspected cases, upon the peculiar character of the cerebral affection." After stating the general character of cerebral disorder connected with disease of the kidneys, to be "marked by a pale face, a quiet pulse, a contracted or undilated and obedient pupil, and the absence of paralysis"-he enumerates the five following, as the individual forms: "1. A more or less sudden attack of quiet stupor; which may be temporary and repeated; or permanent, ending in death. "2. A sudden attack of a peculiar modification of coma and stertor; which may be temporary, or end in death. "3. A sudden attack of convulsions; which may be temporary, or terminate in death. "4. A combination of the two latter; consisting of a sudden attack of coma and stertor, accompanied by constant or intermitting convulsions. "5. A state of dullness of intellect, sluggishness of manner, and drowsiness, often preceded by giddiness, dimness of sight, and pain in the head; proceeding either to coma alone, or to coma accompanied by convulsions; the coma presenting the peculiar character already alluded to. "With respect to the first mentioned form of cerebral disorder connected with renal disease, that of quiet stupor, it is, in its most exquisite form, probably the least frequently met with; the face is pale, the pulse quiet, the pupil natural, or at least obedient to light; and although the patient may lie almost completely motionless, there is no paralysis; for, on attentively watching him for some time, he will be observed slightly to move all the extremities. By agitating him, and speaking loudly, he may sometimes be partially roused for a moment, but quickly relapses into stupor, as before; or it may not be possible to rouse him at all. There is little or no labour of respiration, no stertor, and no convulsions. Slight degrees of it, occasionally precede and pass into the next or second form. "This second form of cerebral affection is that of a sudden attack of coma with stertor, or, in other words, apoplexy: it is, nevertheless, different from ordinary apoplexy: it is the serous apoplexy of authors, and presents the usual general characters of cerebral affection depending upon renal disease; for the face, instead of being flushed, is, in almost every instance, remarkably pale; the pulse, though sometimes small, and more rarely full, is remarkably quiet, or almost natural; the pupil, also, although occasionally dilated or contracted, is often remarkably natural in size, and obedient to light; and there is no paralysis. When the labour of respiration is very great, the general character is apt to be modified by an accelerated pulse, and occasionally by a slight flush of the countenance. The coma is for the most part complete, so that the patient cannot be roused to intelligence for a single moment. The stertor is very peculiar, and in a great measure characteristic of this form of cerebral affection connected with renal disease; it has not, by any means, in general, the deep, rough, guttural, or nasal sound of ordinary apoplexy: it is sometimes slightly of this kind; but much more commonly the stertor presents more of a hissing character, as if produced by the the air, both in inspiration and in expiration, striking against the hard palate or even against the lips of the patient, rather than against the velum and throat, as in ordinary apoplectic stertor: the act of respiration, too, is usually, from the first, much more hurried than is observed in the coma of ordinary |