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Objective: To compare the safety and efficacy of anti-leukotrienes and inhaled glucocorticoids as monotherapy in people with asthma. Design: Systematic review of randomised controlled trials comparing anti-leukotrienes with inhaled glucocorticoids for 28 days or more in children and adults. Main outcome measure: Rate of exacerbations that required treatment with systemic glucocorticoids. Results: 13 trials (12 in adults, one in children) met the inclusion criteria; all were in people with mild and moderate asthma. Leukotriene receptor antagonists were compared with inhaled glucocorticoids at a daily dose equivalent to 400–450 μg beclometasone dipropionate. Patients treated with leukotriene receptor antagonists were 60% more likely to suffer an exacerbation requiring systemic glucocorticoids (relative risk 1.6, 95% confidence interval 1.2 to 2.2; number needed to treat 27, 13 to 81). A 130 ml greater improvement (80 ml to 170 ml) in forced expiratory volume in one second and a 19 l/min greater increase (14 l to 24 l) in morning peak expiratory flow rate were noted in favour of inhaled glucocorticoids. Differences in favour of inhaled glucocorticoids were also observed for nocturnal awakenings, use of rescue β2 agonists, and days without symptoms. Risk of side effects was no different between groups, but leukotriene receptor antagonists were associated a 2.5-fold increase risk of withdrawals due to poor asthma control (relative risk 2.5, 1.8 to 3.5). Conclusions: Inhaled glucocorticoids doses equivalent to 400 μg/day beclometasone are more effective than leukotriene receptor antagonists in the treatment of adults with mild or moderate asthma. There is insufficient evidence to conclude on the efficacy of anti-leukotrienes in children. What is already known on this topic In 2000 a Cochrane systematic review tentatively concluded that control of asthma was better in patients treated with inhaled glucocorticoids as single agents than with anti-leukotrienes The 2002 Global Initiative for Asthma guidelines still classify the role of anti-leukotrienes as “under investigation” What this study adds Anti-leukotrienes as single agent are less effective than low doses of inhaled glucocorticoids for patients with mild and moderate persistent asthma

A medical genetics clinic is a unique and complex environment in which care requires a combination of medical knowledge, social intelligence, and emotional sensitivity. We offer a few pearls from our medical genetics clinic that we hope will help the pediatric or general dermatologist when caring for patients with known or suspected genetic disorders. This paper addresses five main topics: When is it more than just atopic dermatitis? How should the clinician approach blistering in the newborn period? What is mosaicism? When is genetic testing useful? Where can clinician, patients, and families turn for available resources?

Focal boost to dominant intraprostatic lesions (DILs) has recently been proposed for prostate radiation therapy. Accurate and fast delineation of the prostate and DILs is thus required during treatment planning. In this paper, we develop a learning-based method using positron emission tomography (PET)/computed tomography (CT) images to automatically segment the prostate and its DILs. To enable end-to-end segmentation, a deep learning-based method, called cascaded regional-Net, is utilized. The first network, referred to as dual attention network, is used to segment the prostate via extracting comprehensive features from both PET and CT images. A second network, referred to as mask scoring regional convolutional neural network (MSR-CNN), is used to segment the DILs from the PET and CT within the prostate region. Scoring strategy is used to diminish the misclassification of the DILs. For DIL segmentation, the proposed cascaded regional-Net uses two steps to remove normal tissue regions, with the first step cropping images based on prostate segmentation and the second step using MSR-CNN to further locate the DILs. The binary masks of DILs and prostates of testing patients are generated on the PET/CT images by the trained model. For evaluation, we retrospectively investigated 49 prostate cancer patients with PET/CT images acquired. The prostate and DILs of each patient were contoured by radiation oncologists and set as the ground truths and targets. We used five-fold cross-validation and a hold-out test to train and evaluate our method. The mean surface distance and DSC values were 0.666 ± 0.696 mm and 0.932 ± 0.059 for the prostate and 0.814 ± 1.002 mm and 0.801 ± 0.178 for the DILs among all 49 patients. The proposed method has shown promise for facilitating prostate and DIL delineation for DIL focal boost prostate radiation therapy.

The "View now" link directs to the finding aid only. Please email wvrhcref@westvirginia.libanswers.com or call 304-293-3536 for more information about accessing collection A&M 3054 Squire Bosworth, Physician, Papers, 1786-1964. The day book and papers of Dr. Squire Bosworth and family. Squire Bosworth was one of the earliest physicians of Randolph County, and his day book records details of his medical practice indicating common procedures and remedies as well as charges and costs during the early nineteenth century. Bosworth was also a deputy and county clerk of Randolph County, and included among the papers are court documents. Along with his son, Squire Newton Bosworth, the family acquired interests in landholding which is reflected in deeds, surveys, correspondence and tax receipts from Texas and West Virginia. Among the correspondence is an 1885 letter from William L. Wilson surveying his Congressional re-election possibilities.

In the Paper which I had last year the honour of presenting to the Royal Society, I endeavoured to point out the effects which are produced upon the organ of hearing, by a partial loss, or entire destruction, of the membrana tympani. From the facts therein detailed it appears, that an aperture in the membrana tympani does not diminish the power of the ear, and that even a complete destruction of the membrane is not followed by a total deprivation of the sense of hearing; a supposition which medical men have adopted, and common opinion has generally sanctioned.

Discoveries in the anatomy of the human body have been ever considered by this learned Society as deserving a place in the Philosophical Transactions: in the present improved state of our knowledge of this subject, a small addition to it cannot fail of being acceptable, since after the long continued labours of so many acute observers, such only can be expected, and even those are rarely to be acquired. The subject of the present Paper is a portion of a gland, which from the obscurity of its situation has hitherto escaped observation: and were it not for the change produced in it by disease, which enlarges it so much that it sometimes com­pletely shuts up the canal, by which the urine ought to pass, it would be little deserving of attention: but when this im­portant effect is considered, the part itself becomes an object of very serious interest.

The following observations are in some measure a conti­nuation of those upon the stomachs of ruminating animals contained in a former Paper. They are intended to show that the stomach of the whale forms a link in the gradation towards the stomachs of truly carnivorous animals. This subject was brought under my consideration by the following circumstances. While at Worthing, on the Sussex coast, in the month of August last, a Delphinus Delphis of Linnæus, or small bottle-nose whale of Mr. Hunter, was brought on shore by the fishermen alive. I immediately purchased it, with a view of enriching the Hunterian col­lection with the skeleton, and other parts of its structure.

Having lately fixed on the discussion of the nature of in­flammation, for the subject of an academical exercise, I found it necessary to examine attentively the mechanical principles of the circulation of the blood, and to investigate minutely and comprehensively the motion of fluids in pipes, as affected by friction, the resistance occasioned by flexure, the laws of the propagation of an impulse through the fluid contained in an elastic tube, the magnitude of a pulsation in different parts of a conical vessel, and the effect of a contraction advancing progressively through the length of a given canal. The phy­siological application of the results of these inquiries I shall have the honour of laying before the Royal Society at a future time; but I have thought it advisable to communicate, in a separate paper, such conclusions, as may be interesting to some persons, who do not concern themselves with disquisitions of a physiological nature; and I imagine it may be as agreeable to the Society that they should be submitted at pre­sent to their consideration, as that they should be withheld until the time appointed for the delivery of the Croonian Lecture. It has been observed by the late Professor Robison, that the comparison of the Chevalier Dubuat's calculations with his experiments is in all respects extremely satisfactory; that it exhibits a beautiful specimen of the means of expressing the general result of an extensive series of observations in an analytical formula, and that it does honour to the penetra­tion, skill, and address of Mr. Dubuat, and of Mr. de St. Honore', who assisted him in the construction of his expres­sions: I am by no means disposed to dissent from this enco­mium; and I agree with Professor Robison, and with all other late authors on hydraulics, in applauding the unusually accurate coincidence between these theorems and the experi­ments from which they were deduced.

(1809). XLV. Observations on a late paper by Dr. Wm. Richardson, respecting the basaltic district in the north of Ireland, and on the geological facts thence deducible; in conjunction with others observable in Derbyshire and other english counties: with the application of these facts to the explanation of some of the most difficult points in the natural history of the globe. The Philosophical Magazine: Vol. 33, No. 132, pp. 257-263.

BackgroundRecent advances in mobile technologies have created new opportunities to reach broadly into populations that are vulnerable to health disparities. However, mobile health (mHealth) strategies could paradoxically increase health disparities, if low socioeconomic status individuals lack the technical or literacy skills needed to navigate mHealth programs. ObjectiveThe aim of this study was to determine whether patients from vulnerable populations could successfully navigate and complete an mHealth patient decision aid. MethodsWe analyzed usability data from a randomized controlled trial of an iPad program designed to promote colorectal cancer (CRC) screening. The trial was conducted in six primary care practices and enrolled 450 patients, aged 50-74 years, who were due for CRC screening. The iPad program included a self-survey and randomly displayed either a screening decision aid or a video about diet and exercise. We measured participant ability to complete the program without assistance and participant-rated program usability. ResultsTwo-thirds of the participants (305/450) were members of a vulnerable population (limited health literacy, annual income < US $20,000, or black race). Over 92% (417/450) of the participants rated the program highly on all three usability items (90.8% for vulnerable participants vs 96.6% for nonvulnerable participants, P=.006). Only 6.9% (31/450) of the participants needed some assistance to complete the program. In multivariable logistic regression, being a member of a vulnerable population was not associated with needing assistance. Only older age, less use of text messaging (short message service, SMS), and lack of Internet use predicted needing assistance. ConclusionsIndividuals who are vulnerable to health disparities can successfully use well-designed mHealth programs. Future research should investigate whether mHealth interventions can reduce health disparities.

In a paper which I had the honour of laying before this Society, about three years ago, and which is published in the Philosophical Transactions, some cases are related, illustrating the effects of magnesia in preventing an increased formation of uric acid, and some experiments are detailed, instituted with a view to discover its mode of action. Since that period many opportunities have occurred, both to Sir Everard Home and myself, of confirming its efficacy upon a more extended scale, and of ascertaining the efficient treatment of those cases in which magnesia is ineffectual, and in which it has even been found to aggravate the complaint.

My former account was taken from a Squalus Maximus caught at Hastings, in November, 1808, and the parts which I examined were brought to London my Mr. CLIFT, who went down, at my desire, to dissect them; but the weather being stormy and cold, the fish was brought no further than the beach, so that the examination was conducted under great disadvantages, and the parts brought away were in a mutilated state. The sketch of the fish made upon the spot by Mr. CLIFT is now found to be generally correct, except the omission of a small fin between the anus and tail, which had been buried by the weight of the fish in the sand.

In a paper formerly communicated to this Society by Sir Everard Home, and since published in the Philosophical Transactions for the year 1809, some facts were stated which render it probable that the various animal secretions are dependent on the influence of the nervous system, and this opinion seemed to derive support from some physiological experiments which were afterwards instituted by myself, and in which it was observed, that after the functions of the brain had been destroyed, although the action of the heart continued, and the circulation of the blood was maintained as under ordinary circumstances, the secreting organs invariably ceased to perform their office. It has been attempted by former physiologists to determine how far the nerves are necessary to secretion, but there are considerable obstacles in the way of this inquiry, and no observations, that have been hitherto made, appear to throw a great deal of light on the subject. The only method, which can be devised, of ascertaining by direct experiment, whether the nerves are really necessary to secretion, is that of dividing the nervous branches by which the glands are supplied. But this, with respect to the greater number of the glands, is an experiment impossible to perform; and, with respect to others, can not be executed without so much disturbance and injury to the other parts, as must render it extremely difficult to arrive at any positive results. Perhaps in future investigations, some circumstances may arise, which will enable us to determine more satisfactorily this important physiological question. In the mean time, as the labours of physiologists have hitherto contributed so little to this purpose, any facts that tend to its elucidation may deserve to be recorded, and I am therefore induced to lay before the Society the following experiments, which afford one example of a secretion being dependent on the influence of the nerves.

The object of this paper is to show that the nerves which accompany the arteries regulate their actions, and occasion different proportions of blood to be supplied to different parts of the body. The facts which first led the author to entertain this opinion, were the accidental consequence of an extremely painful application of pure kali to a wound, which occasioned a general pulsation of the limb to which it was applied, although the pulsations of distant arteries were at the same time undisturbed. In order to he quite certain that this consequence was really dependent on the irritation of nerves, the author made two experiments on rabbits in the neighbourhood of the carotid artery. Having laid hare the par vagum and intercostal nerves, a probe was passed under the former so as to separate it, so that the irritation might be first given to this nerve alone; but no sensible effect was thus produced upon the artery. But when the same application of pure kali was made to the adjacent intercostal nerve, by which the artery is supplied, the dilatations and contractions of the artery were considerably increased, and the violence of the pulsations continued about three minutes before they began to subside. The same experiment being repeated on a second rabbit, was attended with the same result; and it was afterwards repeated on a dog without any perceptible difference.

The following experiments were begun with a view to as­ certain the manner in which certain poisons act in destroying life. I soon found that, in order to make any considerable progress in such an inquiry, it is necessary to ascertain how far the powers of the nervous and sanguiferous systems di­rectly depend on each other. There seems never to have been any difference of opinion respecting the direct depend­ence of the nervous on the sanguiferous system. When the powers of circulation are increased or diminished, the nervous system always suffers a corresponding change, nor can the latter, under any circumstances, continue to perform its functions after the former are destroyed. I speak of the warm blooded animals. In cold blooded animals the process of dying is so slow, that the functions of the nervous system abate very gradually, after the circulation has wholly ceased. The converse of the above proposition is by no means so generally admitted. It is evident that certain changes of the nervous, produce corresponding changes in the sanguiferous, system ; yet, while some assert, that the action of the heart depends as immediately on the brain, as that of the latter does on the heart, others maintain, that the nervous power may be wholly destroyed without impairing the vigour of this organ. This point it is necessary to determine, before we can trace with precision the modus operandi of poisons. The following inquiry therefore may be divided into two parts. In the first, I shall endeavour to ascertain how far the power of the heart is influenced by the state of the nervous system; in the other, by what steps certain poisons destroy the powers of both. This I shall reserve for another paper, and here confine my­self to the first part of the subject. Till the time of Haller, it seems to have been the general opinion, that the muscles derive their power from the nervous system. He taught, that the power of the muscles depends on their mechanism, that the nervous influence is merely a stimulus which calls it into action, and consequently that those muscles, the heart for example, which act only by the appli­cation of one peculiar stimulus, unconnected with the nervous system, are wholly independent of it. This opinion seemed confirmed by its being generally admitted, that the action of the heart continues after it is removed from the body, and that it cannot be influenced by stimulating the brain, or spinal marrow, or the nerves which terminate in it. Haller and his followers maintain, that there are two distinct vital powers, one of the nervous and another of the sanguiferous system.

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A knowledge of the readiness with which liquids pass from the stomach into the circulation, carrying along with them the impregnation of different medicines; and the readiness with which such medicines are carried off from the circulating blood, by the action of the kidneys, led Mr. Brande and myself to an enquiry respecting the prevention of gravel and gout, upon which subject he has laid two separate papers before the Society. In these communications, the action of different substances on the contents of the stomach has been considered, and those substances most efficient in depriving them of the principal ingredient met with in stone and gout, are pointed out.

When I laid before the Society my Paper upon this subject, I was anxious to establish what appeared to me to be two important facts; one, that the infusion of the colchicum can be received into the circulation without producing any permanent mischief; the other, that it is through the medium of the circulation, its beneficial effects upon gout are produced and, therefore, the sudden relief which is experienced can be readily explained. Having attended to the effects of the eau medicinale, and of this medicine for several years in cases of gout, both in my own case, and in those of my friends, I found, invariably, that they diminished the frequency of the pulse, 10 or 20 beats in a minute, and this effect generally took place about twelve hours after the medicine was exhibited: I therefore considered this to be the criterion of the constitution being under the influence of the medicine; and when I found that the pulse was affected in the same way by the medicine received into the circulation, and in a much shorter time, I became satisfied that in both cases this arose from an effect upon the circulation, and not upon the stomach, and therefore did not farther prosecute the enquiry; since exhibiting larger doses could only confirm what is already known, namely, that the medicine is capable, when injudiciously used, of producing very violent effects. It has been suggested to me since the Paper was read, that the only mode of proving that the medicine acts through the medium of the circulation, is to show that when a sufficient quantity is received into the blood, all the violent effects are produced, that result from a large dose taken by the mouth; and as I had no object but the pursuit of truth, I lost no time in complying with this suggestion, and introduced into the circulation of a dog 160 drops of the same infusion before employed.

In the prosecution of an inquiry in which I have been en­gaged for several years, some of the results of which were published in the Philosophical Transactions of last year, I have had occasion to make many experiments with galvanism, which seem to me to point out with more precision than has yet been done, what we are to expect from it in the cure of disease; and I think it will appear from what I am about to say, that to the want of discrimination in its employment we must ascribe the little advantage which medicine has hitherto derived from the discovery of this influence. It seems to be an inference both from my own experiments and observations and those of others, which I had the honour to lay before the Society in my first paper, that what is called the nervous system, comprehends two distinct systems, the sensorial, and the nervous system properly so called. Now it does not appear that galvanism can perform any of the functions of the sensorial system, yet, in the greater number of instances in which it has been used in medicine, it has been expected to restore the sensorial power. It has been expected to restore hearing, and sight, and voluntary power. It may now and then happen in favorable cases, from the connection which subsists between the sensorial and nervous systems, that by rousing the energy of the latter, we may excite the former. It would be easy to show, that we have little reason to expect that this will often happen. It also appears from the experiments to which I allude, that galvanism has no other power over the muscular system, than that of a stimu­lus; we are, therefore, to expect little more advantage from it in diseases depending on faults of the sanguiferous system, than from other stimuli. Hence its failure in tumors, &c. But I cannot help regarding it as almost ascertained, that in those diseases in which the derangement is in the nervous power alone, where the sensorial functions are entire, and the vessels healthy, and merely the power of secretion, which seems immediately to depend on the nervous system, is in fault, galvanism will often prove a valuable means of relief.

I laid before the Society, some experiments and observa­tions in favour of this medicine acting upon the gout through the medium of the circulation, and not by its effects directly upon the stomach and intestinal canal. The object of the present Paper is to show that the infu­sion throws down a deposit, the separation of which does not appear to diminish the specific effects upon the gout, and renders those upon the stomach and intestines milder than when the deposit is taken along with the infusion.

Several of my friends, much more deeply versed in mathematics than myself, who were present at the reading of the Croonian Lecture, remarked that no spherical bodies could be accurately measured by the common micrometer, and therefore no correct idea of the diameter of a globule of the blood could be obtained by that means. They were also led to doubt the appearance represented in the coagulum, being real, since air, in all ordinary circumstances, when let loose, forms itself into globules, not moving in straight or curved lines. These objections, coming from philosophers for whose opinions on such subjects I have the highest respect, induced me to request permission of the President to withdraw the Lecture, that I might correct any errors I had fallen into before the Paper came before the Committee. I found also upon reflection, that I had left the investigation more imperfect than I was aware of, since it is of very little consequence whether, in the act of drying, coagulated blood puts on this particular appearance or not, if I cannot at the same time adduce proofs of the same changes taking place in coagula while they are still moist, and also in the blood when it is extravasated, and coagulates in the interior parts of living animals.

Mr dear Sir, Having met with a well defined case of a fœtus in the human ovarium, which illustrates in a very satisfactory manner the explanation contained in your paper on the corpora lutea , respecting the mode in which the ovum is sometimes retained, and the embryo formed, within the cavity of the corpus luteum , I beg leave, through you, to communicate it to the Royal Society, that it may have a place amongst your observations on that subject. To render it still more deserving of that honor, Mr. Bauer, to whom you and the public are so much indebted, has made drawings of the parts in a manner which, I may say, no one but himself could have executed.

During the general advancement of science which has lately taken place in this country, observations have been gradually accumulating in the schools of the metropolis, which prove that the department of Anatomy has not been stationary. The nervous system, hitherto the most unsatisfactory part of a physiologist's studies, has assumed a new character. The intricacies of that system have been unravelled, and the peculiar structure and functions of the individual nerves ascertained; so that the absolute confusion in which this department was involved has disappeared, and the natural and simple order has been discovered. In proceeding to give some account of these new observations, the Author of this paper had conceived, that it would be more suitable to the scientific body he had to address, to lay the subject before them in the precise manner in which it first presented itself to his enquiries, and to detail his observations and experiments in the succession in which they were made; but he has been persuaded by some of the Members of this Society to change that form, and to present the subject in the manner to which he has been accustomed, in teaching these doctrines; and they were pleased to say, that in this way, a new subject would be more readily comprehended.

In a former paper an examination was made of the nerves of the face; that part of the system was taken, as proving in a manner the least liable to exception, that two sets of nerves, hitherto undistinguished, possessed distinct powers; and that very different effects were produced when the muscles and integuments were deprived of the controuling influence of the one or of the other of these nerves. In that paper it was shown, that parts remote in situation, were yet united by the closest sympathy with the lungs. That by a division of one nerve, these organs could be severed from the other parts of the apparatus of respiration; and though rendered dead to the influence of the heart and lungs, were yet possessed of their other properties, such as sensibility and voluntary motion. In the present paper it is proposed to prosecute this sub­ject, by tracing the nerves which influence the motions of the trunk of the body in respiration, and to subject them to a similar enquiry.

In a paper on the temperature and saltness of various seas, which the Royal Society did me the honour to publish in their Transactions for the year 1819, I threw out a conjecture, that the sea might contain minute quantities of every substance in nature, which is soluble in water. For the ocean having communication with every part of the earth through the rivers, all of which ultimately pour their waters into it; and soluble substances, even such as are theoretically incom­patible with each other, being almost in every instance capable of co-existing in solution, provided the quantities be very minute, I could see no reason why the ocean should not be a general receptacle of all bodies which can be held in solution. And although it will appear from the following account, that I have been unsuccessful in some of my attempts to prove the truth of this conjecture, it may fairly be ascribed either to a want of sufficient accuracy in our present methods of chemical analysis, or of the requisite degree of skill in the operator. Some time after the communication to which I have just referred, an extraordinary statement was pointed out to me, upon the authority of Rouelle, a French chemist of the last century, from which it appeared that mercury was contained in sea salt: and I saw soon after in the ‘ Annales du Musée ,' Vol. VII. a paper by the celebrated chemist Proust, who, in a great measure, confirmed that statement, by announcing that he had found traces of mercury in all the specimens of marine acid which he had examined.

That a free, or at least an unsaturated acid usually exists in the stomachs of animals, and is in some manner connected with the important process of digestion, seems to have been the general opinion of physiologists till the time of Spallanzani. This illustrious philosopher concluded, from his nume­rous experiments, that the gastric fluids, when in a perfectly natural state, are neither acid nor alkaline. Even Spallanzani, however, admitted that the contents of the stomach are very generally acid ; and this accords not only with my own observation, but with that, I believe, of almost every indivi­dual who has made any experiments on the subject. With respect to the nature of this acid, very various opinions have been entertained. Some of the older chemists seem to have considered it as an acid, sui generis ; by others it was supposed to be the phosphoric, the acetic, the lactic acid, &c. No less various have been the opinions respecting After I had discovered the principal fact related in this paper, I was surprized to find how nearly Scopoli had come to the same conclusion. He did not indeed come to the conclusion, as far as I can ascertain, that free muriatic acid exists in the stomach, but he advanced the opinion, that the muriatic acid, in union with ammonia, found in such abundance in the stomach of ruminating animals, is secreted by that organ itself. The only account of Scopoli’s experiments I have seen is in Johnson’s Animal Chemistry, i. 183. its origin and use ; some supposing that it is derived from the stomach itself, and is essential to the digestive process; others, that it is derived from the food, or is a result of fementation, &c. ; in short, there seems to be no physiological subject so imperfectly understood, or concerning which there has been such a variety of opinions.

In the Papers which I have had the honour of addressing to the Society on the arrangement of the nerves of the human body, I have proceeded upon a comparison of the nerves of the spinal marrow with the nerves of the encephalon. It was shown that the former were compounded of filaments possessing different powers, and that each nerve, having several properties or endowments collected within itself, proceeded to its destination without intricacy.

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While Mr. Bauer was engaged in making the microsco­pical observations contained in a former paper on the struc­ture of the human lungs, he compared the appearances with those in the lungs of other animals, and found in the quadru­ped the principal difference to be, the more minute branches of the bronchiæ have imperfect cartilaginous rings to a greater extent towards the air cells than in the human lungs. In cold blooded animals, as the turtle, the bronchiæ do not in their ramifications diminish as in the quadruped, but remain of a considerable size, and the lateral branches degenerate into a trellis work, which is only bounded by the circum­ference of the organ.

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The experiments relating to the function of digestion detailed or referred to in a paper which I lately had the honour to present to the Society, appear to throw light on the function of the ganglionic nerves, which hold a higher place in the animal economy than those either of sensation merely or voluntary power, being as essentially a vital organ as the heart or lungs, as will more fully appear, I think, from the review of facts which I now beg leave to submit to the Society. For the last fifteen years I have been engaged in an experimental inquiry relating to the laws of the vital functions; and have from time to time laid the results before the Royal Society in six papers, which the Society has done me the honour to publish. All the experiments on which the statements are founded, having been made in the presence of competent witnesses, the rule from which I never deviated, has been to repeat each experiment till no doubt respecting the result remained in the mind of any one present; and it is satis­factory to me to be enabled to state, that, although many of these experiments have been repeated by the physiologists both of this country and the continent, they have in no instance been found inaccurate. I have always abstained from troubling the Society till I had some new facts to state, which appeared to me to deserve its attention; and I have confined myself to the simple statement of the facts and the means by which they were ascertained.

I Have to beg the indulgence of the Society to some minute details of anatomy, for the sake of those deductions which can be attained by no other means: and that a zeal for its cultivation may be preserved among us. There is an obvious practical benefit derived from anatomy, but the public do not comprehend its importance as a science. It is to the Royal Society that those who prosecute this science must look for countenance in their slow and painful investigations. Nine years ago, at the request of our late President, I submitted to the Society a paper on the Nervous System; in which I arranged the nerves strictly according to the anatomy, and illustrated the principles of the arrangement, by exhibiting the different functions of the Nerves of the Face. On presenting a second paper on the same part of the nervous system after so considerable a lapse of time, there will be some novelty both in the facts and in the illustrations; yet I have more gratification in showing that after the most minute inquiries in different countries, my positions drawn from the anatomy have been admitted, and my reasoning on the experiments, with one exception, found to be correct. Confident in the accuracy of my deductions from the anatomy of the fifth nerve, I had attributed to one of its branches a function which belongs to another branch of the same nerve. The subject will form a part of the present paper.

In a former paper which the Royal Society has done me the honour to place among its Transactions*, a method of producing intense light is described, the object of which is to render visible distant stations in geodetical operations. At the conclusion of that paper I ventured to suggest that this method might be found useful for other purposes besides that for which it had been contrived; and more especially for the illumination of light-houses. Soon after its publication, I received, through my friend Colonel Colby, a communication from the Trinity House, under whose jurisdiction and manage­ment the greater number of light-houses on the coast of England and Wales are placed, intimating the intention of that Corporation to give the method pro­posed a fair trial, whenever the apparatus should be brought to such a state of perfection as would ensure the steady continuance of the light, while at the same time it admitted of being entrusted with safety to the hands of the ordi­nary attendants. A good deal remained to be accomplished before this degree of simplicity could be considered as attained: nevertheless, the offer of the Cor­poration was prompt and liberal; and, with the assurance that the time and labour devoted to this object would not be vainly and unprofitably expended, I was anxious to undertake the necessary experiments without delay.