loud mucous rales. He retained the upper extremities, but there was no sensation below the shoulders. Partial sensation and motion existed also in the lower extremities, and he was able to urinate voluntarily. Bowels were distended with flatus; he was unable to conch up phlegm, and deglutition was difficult. He was a stout, full-blooded man, and was in the enjoyment of perfect health when the accident occurred. I performed venesection on the right arm at 10 A M., and abstracted about 14 oz. of blood, which soon afterwards coagulated firmly in the basin on exposure to the air The patient expressed a feeling of relief as the blood was flowing, but the improvement was only temporary, and he sank at 3 P.M., on the same day, having just previously suffered from increasing dyspnoea and asthenia of the heart.T Medical treatment consisted in giving every 2 hours stimulant mixture and brandy in order to arert the tendency to death'. Autopsy, 18 hours after death.?Body fresh; cadaveric rigidity had set in. Chest?Cellular tissue of pericardium was emphysematous; pericardium contained about 20 ozs. of sanguinolent fluid, right auricle of heart was bulged out with gas in the form of a tumour ; there was gas also in the right ventricle ; both contained some dark tarry blood in an imperfect state of coagulation and churned up with air, and the endocardium was deeply stained. Vfrlves healthy ; left ventricle contained very da>k inspissated b'ood. Altogether the heart seemed flabby and not contracted upon its contents. Lungs completely filled the cavity of the chest, and did not collapse on exposure. The superior and posterior parts of both were solidified and cederuatousi On inflating the left a distinct rent was observed at its posterior margin, close to the root There was no air in the pleural cavity, but some sanguinolent fluid. Brain was healthy. iLiver was mottled green on its convex surface, and appeared exsanguine. Kidneys, congested. The cellular tissue covering the surface of liver and spleen was inflated with small bubbles of air which could be moved by pressure along the intercellular spaces. Remarks.?The case presents several important features : 1st.? Bupture of the lung and emphysema. 1 have not come across any case on record where rupture of the lung occurred from mere force of the electric fluid, without fracture of the rit>. The occurrence may be explained on the following: hypothesis : The I.nid report of the thunder may have felled the man on the spot, and the electric fluid being discharged through his chest, whilst lying in this prostrate condition, produced such an amount of sudden compression against the unyielding surface of the ground that the lung gave way. The air, thus effused, passed through the mediastinal space into the neck and chest. It will he observed that there was partial paralysis of both, the upper and lower extremities, which was due to the exhaustion of the muscles induced by a powerful discharge of electricity. The heart also participated in the change, and the mode of death, together with the post-mortem appearance of non-contractility of the organ, confirmed the opinion we entertained during the life of the patient. The coagulability of the blood, cadaveric rigidity, and absence of any external mark of singeing, &c., are interesting facts in a medico-legal point of view. The second important appearance was the presence of air in the right side of heart. Was it due to rapid decomposition of the blood after dejith or to any immediate chemical change produced by the electric current during life ; or to the absorption by the veins of the air effused in the mediastinal space F In favour of each and all of these assumptions we can advance arguments. That rapid putrefaction results in some forms of death is a well-established fact, and 'he mottled condition of the liver. wiYh bubbles of air in its cellular tissue, may add weight in confirmation of this view. But. the body appeared quite fresh when the examination was held after death. Indeed the temperature of the heart and lungs had not quite subsided by that time, and they felt warm to the touch. If, therefore, the change was due to decomposition, it was not altogether a post-mortem one. We are then forced to the conclusion that the electric fluid so disturbs the stability of the component fluids of the body that there is a tendency to dissolution of their constituents even before life is extinct There still remains the third hypothesis to dispose of, viz., could it have been due to the absorption of air from the mediastinal space ? In an experiment in which I assisted Dr. Richardson, in London, he injected mercury into the brain of a rabbit, and scarcely two minutes had elapsed when it showed itself along

teriorly, harsh sounds with partial power of motion of

?

A CASE OF DEATH FROM LTGHTNING. Ex G. C.

Rot, M.D., F.E.C.S. {Exam.), Surgeon,

B.M.S.

A Hole, aged about 40 years, was struck by lightning on the 31st llav -vv liilsr lie was standing for shelter under si tree during n thunderstorm.' Two of his companions were killed on the spot. He remained unconscious for about an hour, and was brought to the hospital in a perfectly helpless state. I saw him on the 1st June with iJr. Swaine, when he was lying on his back and unahlp to move as if paralysed. There was a gurgling sound in his chest ; the respiration was quick and diaphragmatic, being about 60 in a minute ; pulse 150 ; temperature 10G?F. There was a good deal of emphysema on tlip neck and No over the chivic'e*, but not extending down to the chest. fracture 'of a rib was detected, and the percussion sound over Auscultation revealed, anthe chest was somewhat resonant.

20

THIS IN 131 A.N

MHaDICA.L (tAV,ISTTK.

with the current of circulation in the inferior vena cava. The needle was shown by dissection not to have ertered any vein or sinus, but was lying free in the substance of the brain, thus proving that between the intercellular spaces of our body and the radicles of the veins there is some direct channel of communication. and that under pressure a substance effused in the intercellular snaces may be made to pass direct into the general circulation. If we admit this fact the solution is an easy one? the air found in the heart, must have been taken up from that effused in the neighbourhood. Both of these explanations are plausible, and it is impossible to attach greater weight to one than to the other. The treatment requires a few words in the way of explanation. The bleedins was doubly called for. First, to avert the tendency to engorgement of the lungs ; and, second, to remove pressure from the surface of brain. Dr. Richardson found that on trying to produce artificial death by lightning.i. e., by the discharge of a powerful Leyden jar through a sheep, the brain protruded in the form of a tumour through an opening previously made in the skull. Venesection restored the organ to its natural position and brought back consciousness and life.

[January 1,

L877,